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Nicolle R, Bachet JB, Harlé A, Iovanna J, Hammel P, Rebours V, Turpin A, Ben Abdelghani M, Wei A, Mitry E, Lopez A, Biagi J, François E, Artru P, Lambert A, Renouf DJ, Monard L, Mauduit M, Dusetti N, Conroy T, Cros J. Prediction of Adjuvant Gemcitabine Sensitivity in Resectable Pancreatic Adenocarcinoma Using the GemPred RNA Signature: An Ancillary Study of the PRODIGE-24/CCTG PA6 Clinical Trial. J Clin Oncol 2024; 42:1067-1076. [PMID: 37963313 PMCID: PMC10950182 DOI: 10.1200/jco.22.02668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 06/02/2023] [Accepted: 09/07/2023] [Indexed: 11/16/2023] Open
Abstract
PURPOSE GemPred, a transcriptomic signature predictive of the efficacy of adjuvant gemcitabine (GEM), was developed from cell lines and organoids and validated retrospectively. The phase III PRODIGE-24/CCTG PA6 trial has demonstrated the superiority of modified folinic acid, fluorouracil, irinotecan, and oxaliplatin (mFOLFIRINOX) over GEM as adjuvant therapy in patients with resected pancreatic ductal adenocarcinoma at the expense of higher toxicity. We evaluated the potential predictive value of GemPred in this population. PATIENTS AND METHODS Routine formalin-fixed paraffin-embedded surgical specimens of 350 patients were retrieved for RNA sequencing and GemPred prediction (167 in the GEM arm and 183 in the mFOLFIRINOX [mFFX] arm). Survival analyses were stratified by resection margins, lymph node status, and cancer antigen 19-9 level. RESULTS Eighty-nine patients' tumors (25.5%) were GemPred+ and were thus predicted to be gemcitabine-sensitive. In the GEM arm, GemPred+ patients (n = 50, 30%) had a significantly longer disease-free survival (DFS) than GemPred- patients (n = 117, 70%; median 27.3 v 10.2 months, hazard ratio [HR], 0.43 [95% CI, 0.29 to 0.65]; P < .001) and cancer-specific survival (CSS; median 68.4 v 28.6 months, HR, 0.42 [95% CI, 0.27 to 0.66]; P < .001). GemPred had no prognostic value in the mFFX arm. DFS and CSS were similar in GemPred+ patients who received adjuvant GEM and mFFX (median 27.3 v 24.0 months, and 68.4 v 51.4 months, respectively). The statistical interaction between GEM and GemPred+ status was significant for DFS (P = .008) and CSS (P = .004). GemPred+ patients had significantly more adverse events of grade ≥3 in the mFFX arm (76%) compared with those in the GEM arm (40%; P = .001). CONCLUSION This ancillary study of a phase III randomized trial demonstrates that among the quarter of patients with a GemPred-positive transcriptomic signature, survival was comparable with that of mFOLFIRINOX, whereas those receiving adjuvant gemcitabine had fewer adverse events.
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Affiliation(s)
- Rémy Nicolle
- Université Paris Cité, Centre de Recherche sur l'Inflammation (CRI), INSERM, U1149, CNRS, ERL 8252, F-75018, Paris, France
| | - Jean-Baptiste Bachet
- Service d'Hépato—Gastro—Entérologie, Hôpital Pitié Salpêtrière, Assistance Publique—Hôpitaux de Paris (APHP), Sorbonne Université, Paris, France
| | - Alexandre Harlé
- Service de Biopathologie, Institut de Cancérologie de Lorraine, Université de Lorraine, CNRS UMR 7039 CRAN, Vandœuvre-lès-Nancy CEDEX, France
| | - Juan Iovanna
- Centre de Recherche en Cancérologie de Marseille (CRCM), INSERM U1068, CNRS UMR 7258, Aix-Marseille Université and Institut Paoli-Calmettes; Parc Scientifique et Technologique de Luminy, Marseille, France
| | - Pascal Hammel
- Digestive and Medical Oncology, Paul Brousse Hospital, Assistance Publique—Hôpitaux de Paris (AP-HP), Université of Paris Saclay, Villejuif, France
| | - Vinciane Rebours
- Université Paris Cité, Centre de Recherche sur l'Inflammation (CRI), INSERM, U1149, CNRS, ERL 8252, F-75018, Paris, France
- Pancreatology and Digestive Oncology Department, Beaujon Hospital, APHP, Clichy and Centre de Référence des Maladies Rares du Pancréas—PAncreaticRaresDISeases (PaRaDis), Paris, France
| | - Anthony Turpin
- Department of Oncology, Lille University Hospital; CNRS UMR9020, INSERM UMR1277, University of Lille, Institut Pasteur, Lille, France
| | | | - Alice Wei
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - Emmanuel Mitry
- Department of Medical Oncology, Paoli-Calmettes Institute, Marseille, France
| | - Anthony Lopez
- Hepatogastroenterology Department, University Hospital, Nancy, France
| | - James Biagi
- Department of Oncology, Queen's University, Kingston, Canada
| | - Eric François
- Hepatogastroenterology department, Hôpital Jean-Mermoz, Lyon, France
| | - Pascal Artru
- Medical Oncology department, Institut de cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France
- Université de Lorraine, APEMAC, équipe MICS, Nancy, France
| | - Aurélien Lambert
- Medical Oncology department, Institut de cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France
- Université de Lorraine, APEMAC, équipe MICS, Nancy, France
| | - Daniel J. Renouf
- Division of Medical Oncology, BC Cancer, Vancouver, British Columbia, Canada
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | - Nelson Dusetti
- Centre de Recherche en Cancérologie de Marseille (CRCM), INSERM U1068, CNRS UMR 7258, Aix-Marseille Université and Institut Paoli-Calmettes; Parc Scientifique et Technologique de Luminy, Marseille, France
| | - Thierry Conroy
- Medical Oncology department, Institut de cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France
- Université de Lorraine, APEMAC, équipe MICS, Nancy, France
| | - Jérome Cros
- Université Paris Cité, Centre de Recherche sur l'Inflammation (CRI), INSERM, U1149, CNRS, ERL 8252, F-75018, Paris, France
- Université Paris Cité, Department of Pathology, Beaujon/Bichat University Hospital (APHP), Clichy/Paris, France
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Weng G, Tao J, Liu Y, Qiu J, Su D, Wang R, Luo W, Zhang T. Organoid: Bridging the gap between basic research and clinical practice. Cancer Lett 2023; 572:216353. [PMID: 37599000 DOI: 10.1016/j.canlet.2023.216353] [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: 06/23/2023] [Revised: 08/11/2023] [Accepted: 08/17/2023] [Indexed: 08/22/2023]
Abstract
Nowadays, the diagnosis and treatment system of malignant tumors has increasingly tended to be more precise and personalized while the existing tumor models are still unable to fully meet the needs of clinical practice. Notably, the emerging organoid platform has been proven to have huge potential in the field of basic-translational medicine, which is expected to promote a paradigm shift in personalized medicine. Here, given the unique advantages of organoid platform, we mainly explore the prominent role of organoid models in basic research and clinical practice from perspectives of tumor biology, tumorigenic microbes-host interaction, clinical decision-making, and regenerative strategy. In addition, we also put forward some practical suggestions on how to construct a new generation of organoid platform, which is destined to vigorously promote the reform of basic-translational medicine.
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Affiliation(s)
- Guihu Weng
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuaifuyuan, Wangfujing Street, Beijing, 100730, China
| | - Jinxin Tao
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuaifuyuan, Wangfujing Street, Beijing, 100730, China
| | - Yueze Liu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuaifuyuan, Wangfujing Street, Beijing, 100730, China
| | - Jiangdong Qiu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuaifuyuan, Wangfujing Street, Beijing, 100730, China
| | - Dan Su
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuaifuyuan, Wangfujing Street, Beijing, 100730, China
| | - Ruobing Wang
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuaifuyuan, Wangfujing Street, Beijing, 100730, China
| | - Wenhao Luo
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuaifuyuan, Wangfujing Street, Beijing, 100730, China
| | - Taiping Zhang
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuaifuyuan, Wangfujing Street, Beijing, 100730, China.
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3
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Grützmeier SE, Kovacevic B, Vilmann P, Rift CV, Melchior LC, Holmström MO, Brink L, Hassan H, Karstensen JG, Grossjohann H, Chiranth D, Toxværd A, Hansen CP, Høgdall E, Hasselby JP, Klausen P. Validation of a Novel EUS-FNB-Derived Organoid Co-Culture System for Drug Screening in Patients with Pancreatic Cancer. Cancers (Basel) 2023; 15:3677. [PMID: 37509338 PMCID: PMC10377599 DOI: 10.3390/cancers15143677] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 06/26/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
Cancer-associated fibroblasts (CAFs) have been shown to impact the chemosensitivity of patient-derived tumor organoids (PDTOs). However, the published literature comparing PDTO response to clinical outcome does not include CAFs in the models. Here, a co-culture model was created using PDTOs and CAFs derived from endoscopic ultrasound-guided fine-needle biopsies (EUS-FNBs) for potential use in drug screening applications. Co-cultures were established, and growth was compared to monocultures using image metrics and a commercially available assay. We were able to establish and expand validated malignant PDTOs from 19.2% of adenocarcinomas from EUS-FNBs. CAFs could be established from 25% of the samples. The viability of PDTOs in the mixed cell co-culture could be isolated using image metrics. The addition of CAFs promoted PDTO growth in half of the established co-cultures. These results show that co-cultures can be established from tiny amounts of tissue provided by EUS-FNB. An increased growth of PDTOs was shown in co-cultures, suggesting that the present setup successfully models CAF-PDTO interaction. Furthermore, we demonstrated that standard validation techniques may be insufficient to detect contamination with normal cells in PDTO cultures established from primary tumor core biopsies.
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Affiliation(s)
- Simon Ezban Grützmeier
- Gastro Unit, Endoscopic Division, Copenhagen University Hospital Herlev and Gentofte, 2730 Herlev, Denmark
| | - Bojan Kovacevic
- Gastro Unit, Endoscopic Division, Copenhagen University Hospital Herlev and Gentofte, 2730 Herlev, Denmark
- Department of Surgery and Transplantation, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen, Denmark
| | - Peter Vilmann
- Gastro Unit, Endoscopic Division, Copenhagen University Hospital Herlev and Gentofte, 2730 Herlev, Denmark
- Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Charlotte Vestrup Rift
- Department of Pathology, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen, Denmark
| | - Linea Cecilie Melchior
- Department of Pathology, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen, Denmark
| | - Morten Orebo Holmström
- National Center for Cancer Immune Therapy, Department of Oncology, Copenhagen University Hospital Herlev and Gentofte, 2730 Herlev, Denmark
- Department of Immunology and Microbiology, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Lene Brink
- Gastro Unit, Endoscopic Division, Copenhagen University Hospital Herlev and Gentofte, 2730 Herlev, Denmark
| | - Hazem Hassan
- Gastro Unit, Endoscopic Division, Copenhagen University Hospital Herlev and Gentofte, 2730 Herlev, Denmark
| | - John Gásdal Karstensen
- Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark
- Pancreatitis Centre East, Gastroenterology Unit, Copenhagen University Hospital-Amager and Hvidovre, 2650 Hvidovre, Denmark
| | - Hanne Grossjohann
- Department of Surgery and Transplantation, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen, Denmark
| | - Deepthi Chiranth
- Department of Pathology, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen, Denmark
| | - Anders Toxværd
- Department of Pathology, Copenhagen University Hospital Herlev and Gentofte, 2730 Herlev, Denmark
| | - Carsten Palnæs Hansen
- Department of Surgery and Transplantation, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen, Denmark
| | - Estrid Høgdall
- Department of Pathology, Copenhagen University Hospital Herlev and Gentofte, 2730 Herlev, Denmark
| | - Jane Preuss Hasselby
- Department of Pathology, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen, Denmark
- Department of Immunology and Microbiology, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Pia Klausen
- Gastro Unit, Endoscopic Division, Copenhagen University Hospital Herlev and Gentofte, 2730 Herlev, Denmark
- Department of Pathology, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen, Denmark
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Piquemal D, Bruno R, Bournet B, Ghiringhelli F, Noguier F, Canivet C, Bertaut A, Pierrat F, Evesque L, Gamez A, Cros J, Rederstorff E, Petit E, Adnet J, Saint A, Drouillard A, Kempf E, Soularue E, Vincent J, Baumgaertner I, Hennequin A, Tournigand C, Lopez Trabada Ataz D, Bengrine L, Lepage C, Manfredi S, Afchain P, Trouilloud I, Gagnaire A, LoConte NK, Bachet JB. Performance of a blood-based RNA signature for gemcitabine-based treatment in metastatic pancreatic adenocarcinoma. J Gastrointest Oncol 2023; 14:997-1007. [PMID: 37201091 PMCID: PMC10186541 DOI: 10.21037/jgo-22-946] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 03/21/2023] [Indexed: 05/20/2023] Open
Abstract
Background Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal cancer, and chemotherapy is a key treatment for advanced PDAC. Gemcitabine chemotherapy is still an important component of treatment; however, there is no routine biomarker to predict its efficacy. Predictive tests may help clinicians to decide on the best first-line chemotherapy. Methods This study is a confirmatory study of a blood-based RNA signature, called the GemciTest. This test measures the expression levels of nine genes using real-time polymerase chain reaction (PCR) processes. Clinical validation was carried out, through a discovery and a validation phases, on 336 patients (mean 68.7 years; range, 37-88 years) for whom blood was collected from two prospective cohorts and two tumor biobanks. These cohorts included previously untreated advanced PDAC patients who received either a gemcitabine- or fluoropyrimidine-based regimen. Results Gemcitabine-based treated patients with a positive GemciTest (22.9%) had a significantly longer progression-free survival (PFS) {5.3 vs. 2.8 months; hazard ratio (HR) =0.53 [95% confidence interval (CI): 0.31-0.92]; P=0.023} and overall survival (OS) [10.4 vs. 4.8 months; HR =0.49 (95% CI: 0.29-0.85); P=0.0091]. On the contrary, fluoropyrimidine-based treated patients showed no significant difference in PFS and OS using this blood signature. Conclusions The GemciTest demonstrated that a blood-based RNA signature has the potential to aid in personalized therapy for PDAC, leading to better survival rates for patients receiving a gemcitabine-based first-line treatment.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Erwan Petit
- Centre Georges François Leclerc, Dijon, France
| | - Johan Adnet
- Centre Georges François Leclerc, Dijon, France
| | | | | | | | | | | | | | | | | | | | | | - Come Lepage
- CHU Dijon Bourgogne - Hospital François Mitterrand, Dijon, France
| | - Sylvain Manfredi
- CHU Dijon Bourgogne - Hospital François Mitterrand, Dijon, France
| | | | | | - Alice Gagnaire
- CHU Dijon Bourgogne - Hospital François Mitterrand, Dijon, France
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5
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Fraunhoffer N, Chanez B, Teyssedou C, Iovanna JL, Mitry E, Dusetti NJ. A Transcriptomic-Based Tool to Predict Gemcitabine Sensitivity in Advanced Pancreatic Adenocarcinoma. Gastroenterology 2023; 164:476-480.e4. [PMID: 36496056 DOI: 10.1053/j.gastro.2022.11.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/22/2022] [Accepted: 11/30/2022] [Indexed: 01/04/2023]
Affiliation(s)
- Nicolas Fraunhoffer
- Cancer Research Center of Marseille (CRCM), INSERM, CNRS, Institut Paoli-Calmettes, Aix-Marseille University, Marseille, France
| | - Brice Chanez
- Cancer Research Center of Marseille (CRCM), INSERM, CNRS, Institut Paoli-Calmettes, Aix-Marseille University, Marseille, France; Medical Oncology Department, Institut Paoli-Calmettes, Marseille, France
| | - Carlos Teyssedou
- Cancer Research Center of Marseille (CRCM), INSERM, CNRS, Institut Paoli-Calmettes, Aix-Marseille University, Marseille, France; Endocrine and Visceral Surgery Department, University Hospital Angers, Angers, France; Haut Anjou Hospital Center, Château-Gontier, France
| | | | - Juan L Iovanna
- Cancer Research Center of Marseille (CRCM), INSERM, CNRS, Institut Paoli-Calmettes, Aix-Marseille University, Marseille, France; Medical Oncology Department, Institut Paoli-Calmettes, Marseille, France.
| | - Emmanuel Mitry
- Cancer Research Center of Marseille (CRCM), INSERM, CNRS, Institut Paoli-Calmettes, Aix-Marseille University, Marseille, France; Medical Oncology Department, Institut Paoli-Calmettes, Marseille, France
| | - Nelson J Dusetti
- Cancer Research Center of Marseille (CRCM), INSERM, CNRS, Institut Paoli-Calmettes, Aix-Marseille University, Marseille, France.
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6
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Hogenson TL, Xie H, Phillips WJ, Toruner MD, Li JJ, Horn IP, Kennedy DJ, Almada LL, Marks DL, Carr RM, Toruner M, Sigafoos AN, Koenig-Kappes AN, Olson RL, Tolosa EJ, Zhang C, Li H, Doles JD, Bleeker J, Barrett MT, Boyum JH, Kipp BR, Mahipal A, Hubbard JM, Scheffler Hanson TJ, Petersen GM, Dasari S, Oberg AL, Truty MJ, Graham RP, Levy MJ, Zhu M, Billadeau DD, Adjei AA, Dusetti N, Iovanna JL, Bekaii-Saab TS, Ma WW, Fernandez-Zapico ME. Culture media composition influences patient-derived organoid ability to predict therapeutic responses in gastrointestinal cancers. JCI Insight 2022; 7:e158060. [PMID: 36256477 PMCID: PMC9746806 DOI: 10.1172/jci.insight.158060] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 10/12/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUNDA patient-derived organoid (PDO) platform may serve as a promising tool for translational cancer research. In this study, we evaluated PDO's ability to predict clinical response to gastrointestinal (GI) cancers.METHODSWe generated PDOs from primary and metastatic lesions of patients with GI cancers, including pancreatic ductal adenocarcinoma, colorectal adenocarcinoma, and cholangiocarcinoma. We compared PDO response with the observed clinical response for donor patients to the same treatments.RESULTSWe report an approximately 80% concordance rate between PDO and donor tumor response. Importantly, we found a profound influence of culture media on PDO phenotype, where we showed a significant difference in response to standard-of-care chemotherapies, distinct morphologies, and transcriptomes between media within the same PDO cultures.CONCLUSIONWhile we demonstrate a high concordance rate between donor tumor and PDO, these studies also showed the important role of culture media when using PDOs to inform treatment selection and predict response across a spectrum of GI cancers.TRIAL REGISTRATIONNot applicable.FUNDINGThe Joan F. & Richard A. Abdoo Family Fund in Colorectal Cancer Research, GI Cancer program of the Mayo Clinic Cancer Center, Mayo Clinic SPORE in Pancreatic Cancer, Center of Individualized Medicine (Mayo Clinic), Department of Laboratory Medicine and Pathology (Mayo Clinic), Incyte Pharmaceuticals and Mayo Clinic Hepatobiliary SPORE, University of Minnesota-Mayo Clinic Partnership, and the Early Therapeutic program (Department of Oncology, Mayo Clinic).
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Affiliation(s)
- Tara L. Hogenson
- Schulze Center for Novel Therapeutics, Division of Oncology Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Hao Xie
- Department of Gastrointestinal Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
- Division of Medical Oncology, Department of Oncology
| | - William J. Phillips
- Schulze Center for Novel Therapeutics, Division of Oncology Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Merih D. Toruner
- Schulze Center for Novel Therapeutics, Division of Oncology Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Jenny J. Li
- Division of Medical Oncology, Department of Oncology
| | - Isaac P. Horn
- Schulze Center for Novel Therapeutics, Division of Oncology Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Devin J. Kennedy
- Schulze Center for Novel Therapeutics, Division of Oncology Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Luciana L. Almada
- Schulze Center for Novel Therapeutics, Division of Oncology Research, Mayo Clinic, Rochester, Minnesota, USA
| | - David L. Marks
- Schulze Center for Novel Therapeutics, Division of Oncology Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Ryan M. Carr
- Schulze Center for Novel Therapeutics, Division of Oncology Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Murat Toruner
- Schulze Center for Novel Therapeutics, Division of Oncology Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Ashley N. Sigafoos
- Schulze Center for Novel Therapeutics, Division of Oncology Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Amanda N. Koenig-Kappes
- Schulze Center for Novel Therapeutics, Division of Oncology Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Rachel L.O. Olson
- Schulze Center for Novel Therapeutics, Division of Oncology Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Ezequiel J. Tolosa
- Schulze Center for Novel Therapeutics, Division of Oncology Research, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Hu Li
- Department of Pharmacology, and
| | - Jason D. Doles
- Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, Minnesota, USA
| | - Jonathan Bleeker
- Sanford Research, Oncology, Sanford Health, Sioux Falls, South Dakota, USA
| | | | | | | | - Amit Mahipal
- Division of Medical Oncology, Department of Oncology
| | | | | | | | - Surendra Dasari
- Division of Computational Biology, Department of Quantitative Health Sciences, and
| | - Ann L. Oberg
- Division of Computational Biology, Department of Quantitative Health Sciences, and
| | - Mark J. Truty
- Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Rondell P. Graham
- Division of Anatomic Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Michael J. Levy
- Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Mojun Zhu
- Division of Medical Oncology, Department of Oncology
| | - Daniel D. Billadeau
- Schulze Center for Novel Therapeutics, Division of Oncology Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Alex A. Adjei
- Division of Medical Oncology, Department of Oncology
| | - Nelson Dusetti
- Cancer Research Center of Marseille (CRCM), INSERM U1068, CNRS UMR 7258, Aix-Marseille Université and Institut Paoli-Calmettes, Parc Scientifique et Technologique de Luminy, Marseille, France
| | - Juan L. Iovanna
- Cancer Research Center of Marseille (CRCM), INSERM U1068, CNRS UMR 7258, Aix-Marseille Université and Institut Paoli-Calmettes, Parc Scientifique et Technologique de Luminy, Marseille, France
| | | | - Wen Wee Ma
- Division of Medical Oncology, Department of Oncology
| | - Martin E. Fernandez-Zapico
- Schulze Center for Novel Therapeutics, Division of Oncology Research, Mayo Clinic, Rochester, Minnesota, USA
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7
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Turpin A, Neuzillet C, Colle E, Dusetti N, Nicolle R, Cros J, de Mestier L, Bachet JB, Hammel P. Therapeutic advances in metastatic pancreatic cancer: a focus on targeted therapies. Ther Adv Med Oncol 2022; 14:17588359221118019. [PMID: 36090800 PMCID: PMC9459481 DOI: 10.1177/17588359221118019] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 07/18/2022] [Indexed: 12/12/2022] Open
Abstract
Mortality from pancreatic ductal adenocarcinoma (PDAC) is increasing worldwide and effective new treatments are urgently needed. The current treatment of metastatic PDAC in fit patients is based on two chemotherapy combinations (FOLFIRINOX and gemcitabine plus nab-paclitaxel) which were validated more than 8 years ago. Although almost all treatments targeting specific molecular alterations have failed so far when administered to unselected patients, encouraging results were observed in the small subpopulations of patients with germline BRCA 1/2 mutations, and somatic gene fusions (neurotrophic tyrosine receptor kinase, Neuregulin 1, which are enriched in KRAS wild-type PDAC), KRAS G12C mutations, or microsatellite instability. While targeted tumor metabolism therapies and immunotherapy have been disappointing, they are still under investigation in combination with other drugs. Optimizing pharmacokinetics and adapting available chemotherapies based on molecular signatures are other promising avenues of research. This review evaluates the current expectations and limits of available treatments and analyses the existing trials. A permanent search for actionable vulnerabilities in PDAC tumor cells and microenvironments will probably result in a more personalized therapeutic approach, keeping in mind that supportive care must also play a major role if real clinical efficacy is to be achieved in these patients.
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Affiliation(s)
- Anthony Turpin
- Department of Medical Oncology, CNRS UMR9020,
Inserm UMR-S 1277-Canther-Cancer Heterogeneity, Plasticity and Resistance to
Therapies, University Lille, CHU Lille, Lille, France
| | - Cindy Neuzillet
- Department of Medical Oncology, Curie
Institute, Versailles Saint-Quentin University, Paris-Saclay University,
Saint-Cloud, France
| | - Elise Colle
- Department of Digestive and Medical Oncology,
Hospital Paul Brousse (AP-HP), Villejuif, University of Paris Saclay,
France
| | - Nelson Dusetti
- Cancer Research Center of Marseille, CRCM,
Inserm, CNRS, Paoli-Calmettes Institut, Aix-Marseille University, Marseille,
France
| | - Rémy Nicolle
- Centre de Recherche sur l’Inflammation, INSERM,
U1149, CNRS, ERL 8252, Université de Paris Cité, Paris, France
| | - Jérôme Cros
- Department of Pathology, University of Paris
Cité, Hospital Beaujon (AP-HP), Clichy, France
| | - Louis de Mestier
- Department of Gastroenterology and
Pancreatology, University of Paris Cité, Hospital Beaujon (AP-HP), Clichy,
France
| | - Jean-Baptiste Bachet
- Department of Gastroenterology and Digestive
Oncology, Pitié-Salpêtrière Hospital, Sorbonne University, UPMC University,
Paris, France
| | - Pascal Hammel
- Department of Digestive and Medical Oncology,
Hôpital Paul Brousse (AP-HP), 12 Avenue Paul Vaillant-Couturier, Villejuif
94800, University of Paris Saclay, France
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8
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Peschke K, Jakubowsky H, Schäfer A, Maurer C, Lange S, Orben F, Bernad R, Harder FN, Eiber M, Öllinger R, Steiger K, Schlitter M, Weichert W, Mayr U, Phillip V, Schlag C, Schmid RM, Braren RF, Kong B, Demir IE, Friess H, Rad R, Saur D, Schneider G, Reichert M. Identification of treatment-induced vulnerabilities in pancreatic cancer patients using functional model systems. EMBO Mol Med 2022; 14:e14876. [PMID: 35119792 PMCID: PMC8988213 DOI: 10.15252/emmm.202114876] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 01/12/2022] [Accepted: 01/13/2022] [Indexed: 02/06/2023] Open
Abstract
Despite the advance and success of precision oncology in gastrointestinal cancers, the frequency of molecular-informed therapy decisions in pancreatic ductal adenocarcinoma (PDAC) is currently neglectable. We present a longitudinal precision oncology platform based on functional model systems, including patient-derived organoids, to identify chemotherapy-induced vulnerabilities. We demonstrate that treatment-induced tumor cell plasticity in vivo distinctly changes responsiveness to targeted therapies, without the presence of a selectable genetic marker, indicating that tumor cell plasticity can be functionalized. By adding a mechanistic layer to precision oncology, adaptive processes of tumors under therapy can be exploited, particularly in highly plastic tumors, such as pancreatic cancer.
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Affiliation(s)
- Katja Peschke
- Medical Clinic and Polyclinic IIKlinikum rechts der IsarTechnical University of MunichMünchenGermany
| | - Hannah Jakubowsky
- Institute for Translational Cancer Research and Experimental Cancer TherapyTechnical University of MunichMunichGermany
| | - Arlett Schäfer
- Medical Clinic and Polyclinic IIKlinikum rechts der IsarTechnical University of MunichMünchenGermany
| | - Carlo Maurer
- Medical Clinic and Polyclinic IIKlinikum rechts der IsarTechnical University of MunichMünchenGermany
| | - Sebastian Lange
- Medical Clinic and Polyclinic IIKlinikum rechts der IsarTechnical University of MunichMünchenGermany
- Institute of Molecular Oncology and Functional GenomicsTUM School of MedicineTechnical University of MunichMunichGermany
| | - Felix Orben
- Medical Clinic and Polyclinic IIKlinikum rechts der IsarTechnical University of MunichMünchenGermany
| | - Raquel Bernad
- Medical Clinic and Polyclinic IIKlinikum rechts der IsarTechnical University of MunichMünchenGermany
- Institute for Translational Cancer Research and Experimental Cancer TherapyTechnical University of MunichMunichGermany
| | - Felix N Harder
- Institute of Diagnostic and Interventional RadiologyTechnical University of MunichMunichGermany
| | - Matthias Eiber
- Department of Nuclear MedicineKlinikum Rechts der IsarTechnical University of MunichMunichGermany
| | - Rupert Öllinger
- Institute of Molecular Oncology and Functional GenomicsTUM School of MedicineTechnical University of MunichMunichGermany
| | - Katja Steiger
- Institute of PathologyTechnical University of MunichMünchenGermany
| | | | - Wilko Weichert
- Institute of PathologyTechnical University of MunichMünchenGermany
- German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK)HeidelbergGermany
| | - Ulrich Mayr
- Medical Clinic and Polyclinic IIKlinikum rechts der IsarTechnical University of MunichMünchenGermany
| | - Veit Phillip
- Medical Clinic and Polyclinic IIKlinikum rechts der IsarTechnical University of MunichMünchenGermany
| | - Christoph Schlag
- Medical Clinic and Polyclinic IIKlinikum rechts der IsarTechnical University of MunichMünchenGermany
| | - Roland M Schmid
- Medical Clinic and Polyclinic IIKlinikum rechts der IsarTechnical University of MunichMünchenGermany
| | - Rickmer F Braren
- Institute of Diagnostic and Interventional RadiologyTechnical University of MunichMunichGermany
- German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK)HeidelbergGermany
| | - Bo Kong
- Department of SurgeryKlinikum rechts der IsarTechnical University of MunichMunichGermany
- Department of General SurgeryUniversity of UlmUlmGermany
| | - Ihsan Ekin Demir
- Department of SurgeryKlinikum rechts der IsarTechnical University of MunichMunichGermany
| | - Helmut Friess
- Department of SurgeryKlinikum rechts der IsarTechnical University of MunichMunichGermany
| | - Roland Rad
- Institute of Molecular Oncology and Functional GenomicsTUM School of MedicineTechnical University of MunichMunichGermany
- German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK)HeidelbergGermany
| | - Dieter Saur
- Institute for Translational Cancer Research and Experimental Cancer TherapyTechnical University of MunichMunichGermany
- German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK)HeidelbergGermany
| | - Günter Schneider
- Medical Clinic and Polyclinic IIKlinikum rechts der IsarTechnical University of MunichMünchenGermany
- Department of General, Visceral and Pediatric SurgeryUniversity Medical Center GöttingenGöttingenGermany
| | - Maximilian Reichert
- Medical Clinic and Polyclinic IIKlinikum rechts der IsarTechnical University of MunichMünchenGermany
- German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK)HeidelbergGermany
- Center for Protein Assemblies (CPA)Technical University of MunichGarchingGermany
- Translational Pancreatic Cancer Research CenterMedical Clinic and Polyclinic IIKlinikum rechts der IsarTechnical University of MunichMünchenGermany
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