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Pohl L, Friedhoff J, Jurcic C, Teroerde M, Schindler I, Strepi K, Schneider F, Kaczorowski A, Hohenfellner M, Duensing A, Duensing S. Kidney Cancer Models for Pre-Clinical Drug Discovery: Challenges and Opportunities. Front Oncol 2022; 12:889686. [PMID: 35619925 PMCID: PMC9128013 DOI: 10.3389/fonc.2022.889686] [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: 03/04/2022] [Accepted: 04/13/2022] [Indexed: 11/25/2022] Open
Abstract
Renal cell carcinoma (RCC) is among the most lethal urological malignancies once metastatic. The introduction of immune checkpoint inhibitors has revolutionized the therapeutic landscape of metastatic RCC, nevertheless, a significant proportion of patients will experience disease progression. Novel treatment options are therefore still needed and in vitro and in vivo model systems are crucial to ultimately improve disease control. At the same time, RCC is characterized by a number of molecular and functional peculiarities that have the potential to limit the utility of pre-clinical model systems. This includes not only the well-known genomic intratumoral heterogeneity (ITH) of RCC but also a remarkable functional ITH that can be shaped by influences of the tumor microenvironment. Importantly, RCC is among the tumor entities, in which a high number of intratumoral cytotoxic T cells is associated with a poor prognosis. In fact, many of these T cells are exhausted, which represents a major challenge for modeling tumor-immune cell interactions. Lastly, pre-clinical drug development commonly relies on using phenotypic screening of 2D or 3D RCC cell culture models, however, the problem of “reverse engineering” can prevent the identification of the precise mode of action of drug candidates thus impeding their translation to the clinic. In conclusion, a holistic approach to model the complex “ecosystem RCC” will likely require not only a combination of model systems but also an integration of concepts and methods using artificial intelligence to further improve pre-clinical drug discovery.
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Affiliation(s)
- Laura Pohl
- Molecular Urooncology, Department of Urology, University Hospital Heidelberg, Heidelberg, Germany
| | - Jana Friedhoff
- Molecular Urooncology, Department of Urology, University Hospital Heidelberg, Heidelberg, Germany
| | - Christina Jurcic
- Molecular Urooncology, Department of Urology, University Hospital Heidelberg, Heidelberg, Germany
| | - Miriam Teroerde
- Molecular Urooncology, Department of Urology, University Hospital Heidelberg, Heidelberg, Germany
| | - Isabella Schindler
- Molecular Urooncology, Department of Urology, University Hospital Heidelberg, Heidelberg, Germany
| | - Konstantina Strepi
- Molecular Urooncology, Department of Urology, University Hospital Heidelberg, Heidelberg, Germany
| | - Felix Schneider
- Molecular Urooncology, Department of Urology, University Hospital Heidelberg, Heidelberg, Germany
| | - Adam Kaczorowski
- Molecular Urooncology, Department of Urology, University Hospital Heidelberg, Heidelberg, Germany
| | - Markus Hohenfellner
- Department of Urology, University Hospital Heidelberg and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | - Anette Duensing
- Department of Urology, University Hospital Heidelberg and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany.,Precision Oncology of Urological Malignancies, Department of Urology University Hospital Heidelberg, Heidelberg, Germany.,Cancer Therapeutics Program, UPMC Hillman Cancer Center, Pittsburgh, PA, United States.,Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Stefan Duensing
- Molecular Urooncology, Department of Urology, University Hospital Heidelberg, Heidelberg, Germany.,Department of Urology, University Hospital Heidelberg and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
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2
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Whole-Exome Sequencing Identifies the VHL Mutation (c.262T > C, p.Try88Arg) in Non-Obstructive Azoospermia-Associated Cystic Renal Cell Carcinoma. Curr Oncol 2022; 29:2376-2384. [PMID: 35448166 PMCID: PMC9030033 DOI: 10.3390/curroncol29040192] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/14/2022] [Accepted: 03/10/2022] [Indexed: 11/17/2022] Open
Abstract
Von Hippel-Lindau (VHL) genes are intimately involved in renal cell carcinoma (RCC), including clear cell RCC (ccRCC) pathogenesis. However, the contribution of pathogenic VHL mutations to ccRCC remains poorly understood. We report a xanthoderm with non-obstructive azoospermia (NOA)-associated cystic ccRCC, and the missense VHL mutation (c.262T > C, p.Try88Arg). In a 34-year-old patient, a urologic physical examination identified hard epididymis, and imaging tests revealed deferens-associated NOA, as well as multi-organ hydatid cysts, including bilateral epididymal cysts, bilateral testicular cysts, bilateral renal cysts, and pancreatic cysts. Five years later, ccRCC was developed based on clinical and radiologic evidence. Two different prediction models of protein structure and multiple sequence alignment across species were applied to assess the pathological effects of the VHL mutation. The reliability of the assessment in silico was determined by both the cellular location and protein levels of the mutant products, using IF and Western blot, respectively. Our study shows that the missense VHL mutation (c.262T > C, p.Try88Arg) plays a deleterious role in pVHL functions, as predicted by multiple sequence alignment across species. While a structural analysis identified no significant structural alterations in pVHL, the detrimental effects of this mutation were determined by exogenous expression, evidenced by a markedly different spatial distribution and reduced expression of mutant pVHL. This is the first report of the VHL gene mutation (c.475T > C, p.Try88Arg) in a xanthoderm.
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Ayotte Y, Bernet E, Bilodeau F, Cimino M, Gagnon D, Lebughe M, Mistretta M, Ogadinma P, Ouali SL, Sow AA, Chatel-Chaix L, Descoteaux A, Manina G, Richard D, Veyrier F, LaPlante SR. Fragment-Based Phenotypic Lead Discovery To Identify New Drug Seeds That Target Infectious Diseases. ACS Chem Biol 2021; 16:2158-2163. [PMID: 34699722 DOI: 10.1021/acschembio.1c00657] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Fragment-based lead discovery has emerged over the last decades as one of the most powerful techniques for identifying starting chemical matter to target specific proteins or nucleic acids in vitro. However, the use of such low-molecular-weight fragment molecules in cell-based phenotypic assays has been historically avoided because of concerns that bioassays would be insufficiently sensitive to detect the limited potency expected for such small molecules and that the high concentrations required would likely implicate undesirable artifacts. Herein, we applied phenotype cell-based screens using a curated fragment library to identify inhibitors against a range of pathogens including Leishmania, Plasmodium falciparum, Neisseria, Mycobacterium, and flaviviruses. This proof-of-concept shows that fragment-based phenotypic lead discovery (FPLD) can serve as a promising complementary approach for tackling infectious diseases and other drug-discovery programs.
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Affiliation(s)
- Yann Ayotte
- Institut national de la recherche scientifique - Armand-Frappier Santé Biotechnologie Research Centre, 531 Boulevard des Prairies, Laval, Quebec H7V 1B7, Canada
| | - Eve Bernet
- Bacterial Symbionts Evolution, Institut national de la recherche scientifique, Armand-Frappier Santé Biotechnologie Research Centre, 531 Boulevard des Prairies, Laval, Quebec H7V 1B7, Canada
| | - François Bilodeau
- NMX Research and Solutions, Inc., 500 Boulevard Cartier Ouest, Laval, Quebec H7V 5B7, Canada
| | - Mena Cimino
- Microbial Individuality and Infection Group, Cell Biology and Infection Department, Institut Pasteur, 25-28 Rue du Docteur Roux 75015, Paris, France
| | - Dominic Gagnon
- Centre de recherche du CHU de Québec-Université Laval, Département de Microbiologie-Infectiologie et d’Immunologie, Université Laval, Quebec, Quebec G1V 0A6, Canada
| | - Marthe Lebughe
- Bacterial Symbionts Evolution, Institut national de la recherche scientifique, Armand-Frappier Santé Biotechnologie Research Centre, 531 Boulevard des Prairies, Laval, Quebec H7V 1B7, Canada
| | - Maxime Mistretta
- Microbial Individuality and Infection Group, Cell Biology and Infection Department, Institut Pasteur, 25-28 Rue du Docteur Roux 75015, Paris, France
| | - Paul Ogadinma
- NMX Research and Solutions, Inc., 500 Boulevard Cartier Ouest, Laval, Quebec H7V 5B7, Canada
| | - Sarah-Lisa Ouali
- Institut national de la recherche scientifique - Armand-Frappier Santé Biotechnologie Research Centre, 531 Boulevard des Prairies, Laval, Quebec H7V 1B7, Canada
| | - Aïssatou Aïcha Sow
- Institut national de la recherche scientifique - Armand-Frappier Santé Biotechnologie Research Centre, 531 Boulevard des Prairies, Laval, Quebec H7V 1B7, Canada
| | - Laurent Chatel-Chaix
- Institut national de la recherche scientifique - Armand-Frappier Santé Biotechnologie Research Centre, 531 Boulevard des Prairies, Laval, Quebec H7V 1B7, Canada
| | - Albert Descoteaux
- Institut national de la recherche scientifique - Armand-Frappier Santé Biotechnologie Research Centre, 531 Boulevard des Prairies, Laval, Quebec H7V 1B7, Canada
| | - Giulia Manina
- Microbial Individuality and Infection Group, Cell Biology and Infection Department, Institut Pasteur, 25-28 Rue du Docteur Roux 75015, Paris, France
| | - Dave Richard
- Centre de recherche du CHU de Québec-Université Laval, Département de Microbiologie-Infectiologie et d’Immunologie, Université Laval, Quebec, Quebec G1V 0A6, Canada
| | - Frédéric Veyrier
- Bacterial Symbionts Evolution, Institut national de la recherche scientifique, Armand-Frappier Santé Biotechnologie Research Centre, 531 Boulevard des Prairies, Laval, Quebec H7V 1B7, Canada
| | - Steven R. LaPlante
- Institut national de la recherche scientifique - Armand-Frappier Santé Biotechnologie Research Centre, 531 Boulevard des Prairies, Laval, Quebec H7V 1B7, Canada
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4
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Li J, Pohl L, Schüler J, Korzeniewski N, Reimold P, Kaczorowski A, Hou W, Zschäbitz S, Nientiedt C, Jäger D, Hohenfellner M, Duensing A, Duensing S. Targeting the Proteasome in Advanced Renal Cell Carcinoma: Complexity and Limitations of Patient-Individualized Preclinical Drug Discovery. Biomedicines 2021; 9:biomedicines9060627. [PMID: 34072926 PMCID: PMC8227814 DOI: 10.3390/biomedicines9060627] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 01/26/2023] Open
Abstract
Background: Systemic treatment options for metastatic renal cell carcinoma (RCC) have significantly expanded in recent years. However, patients refractory to tyrosine kinase and immune checkpoint inhibitors still have limited treatment options and patient-individualized approaches are largely missing. Patients and Methods: In vitro drug screening of tumor-derived short-term cultures obtained from seven patients with clear cell RCC was performed. For one patient, a patient-derived xenograft (PDX) mouse model was established for in vivo validation experiments. Drug effects were further investigated in established RCC cell lines. Results: The proteasome inhibitor carfilzomib was among the top hits identified in three of four patients in which an in vitro drug screening could be performed successfully. Carfilzomib also showed significant acute and long-term cytotoxicity in established RCC cell lines. The in vivo antitumoral activity of carfilzomib was confirmed in a same-patient PDX model. The cytotoxicity of carfilzomib was found to correlate with the level of accumulation of ubiquitinated proteins. Conclusions: In this proof-of-concept study, we show that patient-individualized in vitro drug screening and preclinical validation is feasible. However, the fact that carfilzomib failed to deliver a clinical benefit in RCC patients in a recent phase II trial unrelated to the present study underscores the complexities and limitations of this strategy.
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Affiliation(s)
- Jielin Li
- Molecular Urooncology, Department of Urology, University Hospital Heidelberg, Im Neuenheimer Feld 517, D-69120 Heidelberg, Germany; (J.L.); (L.P.); (N.K.); (A.K.); (W.H.)
| | - Laura Pohl
- Molecular Urooncology, Department of Urology, University Hospital Heidelberg, Im Neuenheimer Feld 517, D-69120 Heidelberg, Germany; (J.L.); (L.P.); (N.K.); (A.K.); (W.H.)
| | - Julia Schüler
- Charles River Laboratories, Am Flughafen 12, D-79108 Freiburg, Germany;
| | - Nina Korzeniewski
- Molecular Urooncology, Department of Urology, University Hospital Heidelberg, Im Neuenheimer Feld 517, D-69120 Heidelberg, Germany; (J.L.); (L.P.); (N.K.); (A.K.); (W.H.)
| | - Philipp Reimold
- Department of Urology, National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Im Neuenheimer Feld 420, D-69120 Heidelberg, Germany; (P.R.); (M.H.)
| | - Adam Kaczorowski
- Molecular Urooncology, Department of Urology, University Hospital Heidelberg, Im Neuenheimer Feld 517, D-69120 Heidelberg, Germany; (J.L.); (L.P.); (N.K.); (A.K.); (W.H.)
| | - Weibin Hou
- Molecular Urooncology, Department of Urology, University Hospital Heidelberg, Im Neuenheimer Feld 517, D-69120 Heidelberg, Germany; (J.L.); (L.P.); (N.K.); (A.K.); (W.H.)
| | - Stefanie Zschäbitz
- Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Im Neuenheimer Feld 460, D-69120 Heidelberg, Germany; (S.Z.); (C.N.); (D.J.)
| | - Cathleen Nientiedt
- Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Im Neuenheimer Feld 460, D-69120 Heidelberg, Germany; (S.Z.); (C.N.); (D.J.)
| | - Dirk Jäger
- Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Im Neuenheimer Feld 460, D-69120 Heidelberg, Germany; (S.Z.); (C.N.); (D.J.)
| | - Markus Hohenfellner
- Department of Urology, National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Im Neuenheimer Feld 420, D-69120 Heidelberg, Germany; (P.R.); (M.H.)
| | - Anette Duensing
- Precision Oncology of Urological Malignancies, Department of Urology, University Hospital Heidelberg, Im Neuenheimer Feld 517, D-69120 Heidelberg, Germany;
- Cancer Therapeutics Program, UPMC Hillman Cancer Center, 5117 Centre Avenue, Pittsburgh, PA 15213, USA
- Department of Pathology, University of Pittsburgh School of Medicine, 200 Lothrop Street, Pittsburgh, PA 15213, USA
| | - Stefan Duensing
- Molecular Urooncology, Department of Urology, University Hospital Heidelberg, Im Neuenheimer Feld 517, D-69120 Heidelberg, Germany; (J.L.); (L.P.); (N.K.); (A.K.); (W.H.)
- Department of Urology, National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Im Neuenheimer Feld 420, D-69120 Heidelberg, Germany; (P.R.); (M.H.)
- Correspondence: ; Tel.: +49-6621-566255; Fax: +49-6221-567659
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Abildgaard C, Rizza S, Christiansen H, Schmidt S, Dahl C, Abdul-Al A, Christensen A, Filomeni G, Guldberg P. Screening of metabolic modulators identifies new strategies to target metabolic reprogramming in melanoma. Sci Rep 2021; 11:4390. [PMID: 33623106 PMCID: PMC7902673 DOI: 10.1038/s41598-021-83796-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 01/22/2021] [Indexed: 12/13/2022] Open
Abstract
The prognosis of metastatic melanoma remains poor due to de novo or acquired resistance to immune and targeted therapies. Previous studies have shown that melanoma cells have perturbed metabolism and that cellular metabolic pathways represent potential therapeutic targets. To support the discovery of new drug candidates for melanoma, we examined 180 metabolic modulators, including phytochemicals and anti-diabetic compounds, for their growth-inhibitory activities against melanoma cells, alone and in combination with the BRAF inhibitor vemurafenib. Two positive hits from this screen, 4-methylumbelliferone (4-MU) and ursolic acid (UA), were subjected to validation and further characterization. Metabolic analysis showed that 4-MU affected cellular metabolism through inhibition of glycolysis and enhanced the effect of vemurafenib to reduce the growth of melanoma cells. In contrast, UA reduced mitochondrial respiration, accompanied by an increase in the glycolytic rate. This metabolic switch potentiated the growth-inhibitory effect of the pyruvate dehydrogenase kinase inhibitor dichloroacetate. Both drug combinations led to increased production of reactive oxygen species, suggesting the involvement of oxidative stress in the cellular response. These results support the potential use of metabolic modulators for combination therapies in cancer and may encourage preclinical validation and clinical testing of such treatment strategies in patients with metastatic melanoma.
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Affiliation(s)
- Cecilie Abildgaard
- Molecular Diagnostics Group, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark
- Department of Clinical Genetics, Lillebaelt Hospital - University Hospital of Southern Denmark, Vejle, Denmark
| | - Salvatore Rizza
- Redox Biology Group, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Helle Christiansen
- Lundbeckfonden Center of Excellence NanoCAN, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
- Molecular Oncology, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
- Roche Innovation Center Copenhagen, Hørsholm, Denmark
| | - Steffen Schmidt
- Lundbeckfonden Center of Excellence NanoCAN, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
- Molecular Oncology, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
- Roche Innovation Center Copenhagen, Hørsholm, Denmark
| | - Christina Dahl
- Molecular Diagnostics Group, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark
| | - Ahmad Abdul-Al
- Molecular Diagnostics Group, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark
| | - Annette Christensen
- Molecular Diagnostics Group, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark
| | - Giuseppe Filomeni
- Redox Biology Group, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Biology, Tor Vergata University of Rome, Rome, Italy
- Center for Healthy Aging, Copenhagen University, Copenhagen, Denmark
| | - Per Guldberg
- Molecular Diagnostics Group, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark.
- Department of Cancer and Inflammation Research, Institute for Molecular Medicine, University of Southern Denmark, Odense, Denmark.
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6
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Zhang Z, Chen YC, Urs S, Chen L, Simeone DM, Yoon E. Scalable Multiplexed Drug-Combination Screening Platforms Using 3D Microtumor Model for Precision Medicine. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2018; 14:e1703617. [PMID: 30239130 DOI: 10.1002/smll.201703617] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 04/12/2018] [Indexed: 05/15/2023]
Abstract
Cancer heterogeneity is a notorious hallmark of this disease, and it is desirable to tailor effective treatments for each individual patient. Drug combinations have been widely accepted in cancer treatment for better therapeutic efficacy as compared to a single compound. However, experimental complexity and cost grow exponentially with more target compounds under investigation. The primary challenge remains to efficiently perform a large-scale drug combination screening using a small number of patient primary samples for testing. Here, a scalable, easy-to-use, high-throughput drug combination screening scheme is reported, which has the potential of screening all possible pairwise drug combinations for arbitrary number of drugs with multiple logarithmic mixing ratios. A "Christmas tree mixer" structure is introduced to generate a logarithmic concentration mixing ratio between drug pairs, providing a large drug concentration range for screening. A three-layer structure design and special inlets arrangement facilitate simple drug loading process. As a proof of concept, an 8-drug combination chip is implemented, which is capable of screening 172 different treatment conditions over 1032 3D cancer spheroids on a single chip. Using both cancer cell lines and patient-derived cancer cells, effective drug combination screening is demonstrated for precision medicine.
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Affiliation(s)
- Zhixiong Zhang
- Department of Electrical Engineering and Computer Science, University of Michigan, 1301 Beal Avenue, Ann Arbor, MI, 48109-2122, USA
| | - Yu-Chih Chen
- Department of Electrical Engineering and Computer Science, University of Michigan, 1301 Beal Avenue, Ann Arbor, MI, 48109-2122, USA
- University of Michigan Comprehensive Cancer Center, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA
| | - Sumithra Urs
- University of Michigan Health System, Ann Arbor, MI, 48109, USA
| | - Lili Chen
- Department of Electrical Engineering and Computer Science, University of Michigan, 1301 Beal Avenue, Ann Arbor, MI, 48109-2122, USA
| | - Diane M Simeone
- University of Michigan Health System, Ann Arbor, MI, 48109, USA
| | - Euisik Yoon
- Department of Electrical Engineering and Computer Science, University of Michigan, 1301 Beal Avenue, Ann Arbor, MI, 48109-2122, USA
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
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7
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Hatiboglu G, Hohenfellner M, Arslan A, Hadaschik B, Teber D, Radtke JP, Hallscheidt P, Tolstov Y, Roth W, Grüllich C, Huesing J, Duensing S, Pahernik S. Effective downsizing but enhanced intratumoral heterogeneity following neoadjuvant sorafenib in patients with non-metastatic renal cell carcinoma. Langenbecks Arch Surg 2016; 402:637-644. [PMID: 28012035 DOI: 10.1007/s00423-016-1543-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 12/15/2016] [Indexed: 01/20/2023]
Abstract
OBJECTIVES To evaluate the safety and feasibility of sorafenib prior to surgery for downsizing tumors in patients with non-metastatic cT1-3 renal tumors together with a characterization of functional intratumoral heterogeneity (ITH). MATERIALS AND METHODS The effects of 4-week sorafenib prior to curative surgery were assessed in a prospective, single-center, randomized, placebo-controlled, double-blinded, pilot trial in patients with T1-3N0M0 renal cell carcinoma (RCC). Patients received sorafenib or placebo for 28 days prior to surgery. MRI was performed at baseline and prior to surgery to calculate tumor volume. The clinical responses were further characterized on the molecular level by immunohistochemical stainings for Ki-67, cleaved caspase-3, and CD31. RESULTS After enrolling 20 patients into the study, 14 patients were randomized, of which 12 patients were available for analysis. While no significant change in tumor volume was seen for placebo (range = -24.2-0.2%) a reduction of 29.0% (range = -4.9-61.1%) was detected for sorafenib (p < 0.05). Primary renal tumor diameter changed from 10.6 cm (range = 6.5-10.8) to 10.7 cm (range = 6.7-11.1) in the placebo group, and from 5.4 cm (range = 4.3-7.3) to 4.4 cm (range = 3.5-6.8) for the sorafenib group, at baseline vs. 28 days of treatment. Correlative assessment of proliferation, apoptosis, and microvessel density revealed an enhanced degree of functional ITH in treated patients suggesting adaptive and/or regenerative processes with potential relevance for the development of drug resistance. CONCLUSIONS Sorafenib in standard dosage, given preoperatively for 28 days, was clinically active in downsizing tumors in patients with locally confined, non-metastatic RCC together but led to an enhanced functional ITH in the residual tumor tissue.
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Affiliation(s)
- Gencay Hatiboglu
- Department of Urology, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
| | - Markus Hohenfellner
- Department of Urology, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Aysenur Arslan
- Molecular Urooncology, Department of Urology, University of Heidelberg, Heidelberg, Germany
| | - Boris Hadaschik
- Department of Urology, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Dogu Teber
- Department of Urology, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Jan Philipp Radtke
- Department of Urology, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Peter Hallscheidt
- Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany
| | - Yanis Tolstov
- Molecular Urooncology, Department of Urology, University of Heidelberg, Heidelberg, Germany
| | - Wilfried Roth
- Institute for Pathology, University of Heidelberg, Heidelberg, Germany
| | - Carsten Grüllich
- Medical Oncology, National Center for Tumor Diseases, University of Heidelberg, Heidelberg, Germany
| | - Johannes Huesing
- Coordination Centre for Clinical Trials, University of Heidelberg, Heidelberg, Germany
| | - Stefan Duensing
- Molecular Urooncology, Department of Urology, University of Heidelberg, Heidelberg, Germany
| | - Sascha Pahernik
- Department of Urology, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
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8
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Hoefflin R, Lahrmann B, Warsow G, Hübschmann D, Spath C, Walter B, Chen X, Hofer L, Macher-Goeppinger S, Tolstov Y, Korzeniewski N, Duensing A, Grüllich C, Jäger D, Perner S, Schönberg G, Nyarangi-Dix J, Isaac S, Hatiboglu G, Teber D, Hadaschik B, Pahernik S, Roth W, Eils R, Schlesner M, Sültmann H, Hohenfellner M, Grabe N, Duensing S. Spatial niche formation but not malignant progression is a driving force for intratumoural heterogeneity. Nat Commun 2016; 7:ncomms11845. [PMID: 27291893 PMCID: PMC4910022 DOI: 10.1038/ncomms11845] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 05/04/2016] [Indexed: 01/19/2023] Open
Abstract
Intratumoural heterogeneity (ITH) is a major cause of cancer-associated lethality. Extensive genomic ITH has previously been reported in clear cell renal cell carcinoma (ccRCC). Here we address the question whether ITH increases with malignant progression and can hence be exploited as a prognostic marker. Unexpectedly, precision quantitative image analysis reveals that the degree of functional ITH is virtually identical between primary ccRCCs of the lowest stage and advanced, metastatic tumours. Functional ITH was found to show a stage-independent topological pattern with peak proliferative and signalling activities almost exclusively in the tumour periphery. Exome sequencing of matching peripheral and central primary tumour specimens reveals various region-specific mutations. However, these mutations cannot directly explain the zonal pattern suggesting a role of microenvironmental factors in shaping functional ITH. In conclusion, our results indicate that ITH is an early and general characteristic of malignant growth rather than a consequence of malignant progression. It has been increasingly recognised that tumours are not made up of a homogeneous population of cells. Here, the authors show heterogeneous expression of five protein markers in renal cell cancer and demonstrate that the progression of the tumour does not influence the degree of heterogeneity in the tumour.
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Affiliation(s)
- Rouven Hoefflin
- Section of Molecular Urooncology, Department of Urology, University of Heidelberg School of Medicine, Medical Faculty Heidelberg, Im Neuenheimer Feld 517, D-69120 Heidelberg, Germany
| | - Bernd Lahrmann
- Hamamatsu Tissue Imaging and Analysis (TIGA) Center, BioQuant, University of Heidelberg, Im Neuenheimer Feld 267, D-60120 Heidelberg, Germany
| | - Gregor Warsow
- Division of Theoretical Bioinformatics (B080), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, D-69120 Heidelberg, Germany
| | - Daniel Hübschmann
- Division of Theoretical Bioinformatics (B080), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, D-69120 Heidelberg, Germany.,Department for Bioinformatics and Functional Genomics, Institute for Pharmacy and Molecular Biotechnology (IPMB) and BioQuant, University of Heidelberg, Im Neuenheimer Feld 267, D-69120 Heidelberg, Germany.,Department of Pediatric Immunology, Hematology and Oncology, University Hospital Heidelberg, Im Neuenheimer Feld 430, D-69120 Heidelberg, Germany
| | - Cathleen Spath
- National Center for Tumor Diseases, Department of Medical Oncology, Im Neuenheimer Feld 460, D-69120 Heidelberg, Germany
| | - Britta Walter
- Department of Pathology, University of Heidelberg School of Medicine, Im Neuenheimer Feld 224, D-69120 Heidelberg, Germany
| | - Xin Chen
- Section of Molecular Urooncology, Department of Urology, University of Heidelberg School of Medicine, Medical Faculty Heidelberg, Im Neuenheimer Feld 517, D-69120 Heidelberg, Germany
| | - Luisa Hofer
- Department of Urology, University of Heidelberg School of Medicine, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany.,Center for Kidney Tumors, National Center for Tumor Diseases and University of Heidelberg School of Medicine, Im Neuenheimer Feld 460, D-69120 Heidelberg, Germany
| | - Stephan Macher-Goeppinger
- Department of Pathology, University of Heidelberg School of Medicine, Im Neuenheimer Feld 224, D-69120 Heidelberg, Germany
| | - Yanis Tolstov
- Section of Molecular Urooncology, Department of Urology, University of Heidelberg School of Medicine, Medical Faculty Heidelberg, Im Neuenheimer Feld 517, D-69120 Heidelberg, Germany
| | - Nina Korzeniewski
- Section of Molecular Urooncology, Department of Urology, University of Heidelberg School of Medicine, Medical Faculty Heidelberg, Im Neuenheimer Feld 517, D-69120 Heidelberg, Germany
| | - Anette Duensing
- University of Pittsburgh Cancer Institute, Cancer Therapeutics Program, 5117 Centre Avenue, Pittsburgh, Pennsylvania 15232, USA
| | - Carsten Grüllich
- National Center for Tumor Diseases, Department of Medical Oncology, Im Neuenheimer Feld 460, D-69120 Heidelberg, Germany.,Center for Kidney Tumors, National Center for Tumor Diseases and University of Heidelberg School of Medicine, Im Neuenheimer Feld 460, D-69120 Heidelberg, Germany
| | - Dirk Jäger
- National Center for Tumor Diseases, Department of Medical Oncology, Im Neuenheimer Feld 460, D-69120 Heidelberg, Germany.,Center for Kidney Tumors, National Center for Tumor Diseases and University of Heidelberg School of Medicine, Im Neuenheimer Feld 460, D-69120 Heidelberg, Germany
| | - Sven Perner
- Institute of Pathology, University Hospital Lübeck and Leibniz Research Center Borstel, Ratzeburger Allee 160, D-23538 Lübeck, Germany
| | - Gita Schönberg
- Department of Urology, University of Heidelberg School of Medicine, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany.,Center for Kidney Tumors, National Center for Tumor Diseases and University of Heidelberg School of Medicine, Im Neuenheimer Feld 460, D-69120 Heidelberg, Germany
| | - Joanne Nyarangi-Dix
- Department of Urology, University of Heidelberg School of Medicine, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany.,Center for Kidney Tumors, National Center for Tumor Diseases and University of Heidelberg School of Medicine, Im Neuenheimer Feld 460, D-69120 Heidelberg, Germany
| | - Sanjay Isaac
- National Center for Tumor Diseases, Department of Medical Oncology, Im Neuenheimer Feld 460, D-69120 Heidelberg, Germany.,Center for Kidney Tumors, National Center for Tumor Diseases and University of Heidelberg School of Medicine, Im Neuenheimer Feld 460, D-69120 Heidelberg, Germany
| | - Gencay Hatiboglu
- Department of Urology, University of Heidelberg School of Medicine, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany.,Center for Kidney Tumors, National Center for Tumor Diseases and University of Heidelberg School of Medicine, Im Neuenheimer Feld 460, D-69120 Heidelberg, Germany
| | - Dogu Teber
- Department of Urology, University of Heidelberg School of Medicine, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany.,Center for Kidney Tumors, National Center for Tumor Diseases and University of Heidelberg School of Medicine, Im Neuenheimer Feld 460, D-69120 Heidelberg, Germany
| | - Boris Hadaschik
- Department of Urology, University of Heidelberg School of Medicine, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany.,Center for Kidney Tumors, National Center for Tumor Diseases and University of Heidelberg School of Medicine, Im Neuenheimer Feld 460, D-69120 Heidelberg, Germany
| | - Sascha Pahernik
- Department of Urology, University of Heidelberg School of Medicine, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany.,Center for Kidney Tumors, National Center for Tumor Diseases and University of Heidelberg School of Medicine, Im Neuenheimer Feld 460, D-69120 Heidelberg, Germany
| | - Wilfried Roth
- Department of Pathology, University of Heidelberg School of Medicine, Im Neuenheimer Feld 224, D-69120 Heidelberg, Germany
| | - Roland Eils
- Division of Theoretical Bioinformatics (B080), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, D-69120 Heidelberg, Germany.,Department for Bioinformatics and Functional Genomics, Institute for Pharmacy and Molecular Biotechnology (IPMB) and BioQuant, University of Heidelberg, Im Neuenheimer Feld 267, D-69120 Heidelberg, Germany
| | - Matthias Schlesner
- Division of Theoretical Bioinformatics (B080), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, D-69120 Heidelberg, Germany
| | - Holger Sültmann
- National Center for Tumor Diseases, German Cancer Research Center, Division of Cancer Genome Research, German Cancer Consortium (DKTK), Im Neuenheimer Feld 460, D-69120 Heidelberg, Germany
| | - Markus Hohenfellner
- Department of Urology, University of Heidelberg School of Medicine, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany.,Center for Kidney Tumors, National Center for Tumor Diseases and University of Heidelberg School of Medicine, Im Neuenheimer Feld 460, D-69120 Heidelberg, Germany
| | - Niels Grabe
- Hamamatsu Tissue Imaging and Analysis (TIGA) Center, BioQuant, University of Heidelberg, Im Neuenheimer Feld 267, D-60120 Heidelberg, Germany
| | - Stefan Duensing
- Section of Molecular Urooncology, Department of Urology, University of Heidelberg School of Medicine, Medical Faculty Heidelberg, Im Neuenheimer Feld 517, D-69120 Heidelberg, Germany.,Department of Urology, University of Heidelberg School of Medicine, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany.,Center for Kidney Tumors, National Center for Tumor Diseases and University of Heidelberg School of Medicine, Im Neuenheimer Feld 460, D-69120 Heidelberg, Germany
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9
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Grüllich C, Vallet S, Hecht C, Duensing S, Hadaschik B, Jäger D, Hohenfellner M, Pahernik S. Local salvage therapy for late (≥2 years) metastatic and local relapse of renal cell cancer is a potentially curative treatment irrespective of the site of recurrence. Urol Oncol 2016; 34:238.e9-17. [DOI: 10.1016/j.urolonc.2015.11.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2015] [Revised: 11/23/2015] [Accepted: 11/24/2015] [Indexed: 10/22/2022]
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10
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Ritterson Lew C, Guin S, Theodorescu D. Targeting glycogen metabolism in bladder cancer. Nat Rev Urol 2015; 12:383-91. [PMID: 26032551 DOI: 10.1038/nrurol.2015.111] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Metabolism has been a heavily investigated topic in cancer research for the past decade. Although the role of aerobic glycolysis (the Warburg effect) in cancer has been extensively studied, abnormalities in other metabolic pathways are only just being understood in cancer. One such pathway is glycogen metabolism; its involvement in cancer development, particularly in urothelial malignancies, and possible ways of exploiting aberrations in this process for treatment are currently being studied. New research shows that the glycogen debranching enzyme amylo-α-1,6-glucosidase, 4-α-glucanotransferase (AGL) is a novel tumour suppressor in bladder cancer. Loss of AGL leads to rapid proliferation of bladder cancer cells. Another enzyme involved in glycogen debranching, glycogen phosphorylase, has been shown to be a tumour promoter in cancer, including in prostate cancer. Studies demonstrate that bladder cancer cells in which AGL expression is lost are more metabolically active than cells with intact AGL expression, and these cells are more sensitive to inhibition of both glycolysis and glycine synthesis--two targetable pathways. As a tumour promoter and enzyme, glycogen phosphorylase can be directly targeted, and preclinical inhibitor studies are promising. However, few of these glycogen phosphorylase inhibitors have been tested for cancer treatment in the clinical setting. Several possible limitations to the targeting of AGL and glycogen phosphorylase might also exist.
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Affiliation(s)
- Carolyn Ritterson Lew
- Department of Surgery (Urology), University of Colorado, 12700 East 19th Avenue, RC2/P15-6430D/MS-8609, Aurora, CO 80045, USA
| | - Sunny Guin
- Department of Surgery (Urology), University of Colorado, 12700 East 19th Avenue, RC2/P15-6430D/MS-8609, Aurora, CO 80045, USA
| | - Dan Theodorescu
- University of Colorado Comprehensive Cancer Center, MS F-434, 13001 East 17th Place, Aurora, CO 80045, USA
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