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Le Gall J, Dehainault C, Boutte M, Petitalot A, Caputo SM, Courtois L, Vacher S, Bieche I, Radvanyi F, Pacquement H, Doz F, Lumbroso-Le Rouic L, Gauthier Villars M, Stoppa-Lyonnet D, Lallemand F, Houdayer C, Golmard L. Germline HPF1 retrogene insertion in RB1 gene involved in cancer predisposition. J Med Genet 2023; 61:78-83. [PMID: 37541786 DOI: 10.1136/jmg-2022-109105] [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: 12/09/2022] [Accepted: 07/23/2023] [Indexed: 08/06/2023]
Abstract
About half of the human genome is composed of repeated sequences derived from mobile elements, mainly retrotransposons, generally without pathogenic effect. Familial forms of retinoblastoma are caused by germline pathogenic variants in RB1 gene. Here, we describe a family with retinoblastoma affecting a father and his son. No pathogenic variant was identified after DNA analysis of RB1 gene coding sequence and exon-intron junctions. However, RB1 mRNA analysis showed a chimeric transcript with insertion of 114 nucleotides from HPF1 gene inside RB1 gene. This chimeric transcript led to an insertion of 38 amino acids in functional domain of retinoblastoma protein. Subsequent DNA analysis in RB1 intron 17 revealed the presence of a full-length HPF1 retrogene insertion in opposite orientation. Functional assay shows that this insertion has a deleterious impact on retinoblastoma protein function. This is the first report of a full-length retrogene insertion involved in human Mendelian disease leading to a chimeric transcript and a non-functional chimeric protein. Some retrogene insertions may be missed by standard diagnostic genetic testing, so contribution of retrogene insertions to human disease may be underestimated. The increasing use of whole genome sequencing in diagnostic settings will help to get a more comprehensive view of retrogenes.
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Affiliation(s)
- Jessica Le Gall
- Department of Genetics, Institut Curie, Paris, France
- Department of Genetics, PSL University, Paris, France
| | - Catherine Dehainault
- Department of Genetics, Institut Curie, Paris, France
- Department of Genetics, PSL University, Paris, France
| | - Matteo Boutte
- Department of Genetics, Institut Curie, Paris, France
- Department of Genetics, PSL University, Paris, France
| | - Ambre Petitalot
- Department of Genetics, Institut Curie, Paris, France
- Department of Genetics, PSL University, Paris, France
| | - Sandrine M Caputo
- Department of Genetics, Institut Curie, Paris, France
- Department of Genetics, PSL University, Paris, France
| | - Laura Courtois
- Department of Genetics, Institut Curie, Paris, France
- Department of Genetics, PSL University, Paris, France
| | - Sophie Vacher
- Department of Genetics, Institut Curie, Paris, France
- Department of Genetics, PSL University, Paris, France
| | - Ivan Bieche
- Department of Genetics, Institut Curie, Paris, France
- Université de Paris, Paris, France
| | - François Radvanyi
- Department of Genetics, PSL University, Paris, France
- Molecular Oncology Team, UMR144, Paris, France
| | - Hélène Pacquement
- Department of Genetics, PSL University, Paris, France
- Oncology Center SIREDO, Institut Curie, Paris, France
| | - François Doz
- Molecular Oncology Team, UMR144, Paris, France
- Oncology Center SIREDO, Institut Curie, Paris, France
| | - Livia Lumbroso-Le Rouic
- Department of Genetics, PSL University, Paris, France
- Department of Ophthalmology, Institut Curie, Paris, France
| | - Marion Gauthier Villars
- Department of Genetics, Institut Curie, Paris, France
- Department of Genetics, PSL University, Paris, France
| | - Dominique Stoppa-Lyonnet
- Department of Genetics, Institut Curie, Paris, France
- Department of Genetics, PSL University, Paris, France
| | - François Lallemand
- Department of Genetics, Institut Curie, Paris, France
- Department of Genetics, PSL University, Paris, France
| | - Claude Houdayer
- Department of Genetics, University Hospital Centre Rouen, Rouen, France
| | - Lisa Golmard
- Department of Genetics, Institut Curie, Paris, France
- Department of Genetics, PSL University, Paris, France
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2
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Abramson DH. Ten things you learned in your residency about retinoblastoma that have changed the 2023 Victor T. Curtin Lecture. Ophthalmic Genet 2023; 44:321-326. [PMID: 36995014 PMCID: PMC10688026 DOI: 10.1080/13816810.2023.2189948] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 02/18/2023] [Accepted: 03/04/2023] [Indexed: 03/31/2023]
Abstract
Retinoblatoma is now the pediatric cancer with the highest cure rate. More than any other ocular malignancy the approach to this cancer has changed dramatically in the past 10 years. Most of the things taught to the majority of all Ophthalmology residents is out of date. Because few Ophthalmologists deal with retinoblastoma they are not aware of these seismic changes so this summary of my Curtin lectures outlines some of the major changes all Ophthalmologists should be familiar with.
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Affiliation(s)
- David H Abramson
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Ophthalmology, Weill/Cornell Medical School, New York, New York, USA
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3
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Dall GV, Hamilton A, Ratnayake G, Scott C, Barker H. Interrogating the Genomic Landscape of Uterine Leiomyosarcoma: A Potential for Patient Benefit. Cancers (Basel) 2022; 14:cancers14061561. [PMID: 35326717 PMCID: PMC8946513 DOI: 10.3390/cancers14061561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/10/2022] [Accepted: 03/16/2022] [Indexed: 11/16/2022] Open
Abstract
Uterine leiomyosarcoma (uLMS) is a rare and aggressive gynaecological malignancy. Surgical removal and chemotherapy are commonly used to treat uLMS, but recurrence rates are high. Over the last few decades, clarification of the genomic landscape of uLMS has revealed a number of recurring mutations, including TP53, RB1, ATRX, PTEN, and MED12. Such genomic aberrations are difficult to target therapeutically or are actively targeted in other malignancies, and their potential as targets for the treatment of uLMS remains largely unexplored. Recent identification of deficiencies in homologous recombination in a minority of these tumours, however, has provided a rationale for investigation of PARP inhibitors in this sub-set. Here, we review these mutations and the evidence for therapeutic avenues that may be applied in uLMS. We also provide a comprehensive background on diagnosis and current therapeutic strategies as well as reviewing preclinical models of uLMS, which may be employed not only in testing emerging therapies but also in understanding this challenging and deadly disease.
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Affiliation(s)
- Genevieve V. Dall
- Walter and Eliza Hall, Institute of Medical Research, Parkville, VIC 3052, Australia; (C.S.); (H.B.)
- Department of Medical Biology, University of Melbourne, Parkville, VIC 3010, Australia;
- Correspondence:
| | - Anne Hamilton
- Department of Medical Biology, University of Melbourne, Parkville, VIC 3010, Australia;
- Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia
- Royal Women’s Hospital, Parkville, VIC 3052, Australia;
| | | | - Clare Scott
- Walter and Eliza Hall, Institute of Medical Research, Parkville, VIC 3052, Australia; (C.S.); (H.B.)
- Department of Medical Biology, University of Melbourne, Parkville, VIC 3010, Australia;
- Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia
- Royal Women’s Hospital, Parkville, VIC 3052, Australia;
| | - Holly Barker
- Walter and Eliza Hall, Institute of Medical Research, Parkville, VIC 3052, Australia; (C.S.); (H.B.)
- Department of Medical Biology, University of Melbourne, Parkville, VIC 3010, Australia;
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Abstract
ABSTRACT Morcellation is a surgical technique used to reduce the size of the uterus or myomas by creating smaller pieces to allow the tissue to be removed through small incisions or with laparoscopic instruments. Open (uncontained) morcellation of the uterus and myomas has been scrutinized because of the possible spread of an unsuspected leiomyosarcoma while using a power morcellator during a hysterectomy or myomectomy for presumed symptomatic uterine leiomyomas. Before considering morcellation of the uterus, a woman should be evaluated to determine if she is at increased risk of malignancy of the uterine corpus. Morcellation of a malignancy is contraindicated and women should be evaluated preoperatively to identify malignancy. However, leiomyosarcoma cannot be reliably diagnosed preoperatively; thus, there is a risk that a woman with a presumed leiomyoma may have a malignancy that may be spread through morcellation, leading to a potentially worsened prognosis. Although an abdominal hysterectomy or myomectomy may reduce the chance of spreading cancer cells in women with undiagnosed leiomyosarcoma, it is associated with increased morbidity when compared with minimally invasive approaches. The obstetrician-gynecologist and patient should engage in shared decision making, including informed consent, explaining the risks and benefits of each approach to surgery for presumed leiomyomas, the risks and benefits of morcellation, and alternatives to morcellation.
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van Hoefen Wijsard M, Schonfeld SJ, van Leeuwen FE, Moll AC, Fabius AW, Abramson DH, Seddon JM, Francis JH, Tucker MA, Kleinerman RA, Morton LM. Benign Tumors in Long-Term Survivors of Retinoblastoma. Cancers (Basel) 2021; 13:cancers13081773. [PMID: 33917779 PMCID: PMC8068196 DOI: 10.3390/cancers13081773] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/31/2021] [Accepted: 04/02/2021] [Indexed: 12/15/2022] Open
Abstract
Simple Summary It is well-established that hereditary retinoblastoma survivors have a substantially increased risk of developing subsequent malignant neoplasms (SMNs). Although clinicians have long suspected that this population is also at increased risk for developing benign neoplasms, the evidence is unclear. Benign tumors can substantially impact health status and quality of life, while raising questions for clinicians, when faced with a mass in a retinoblastoma survivor. By 60 years following retinoblastoma diagnosis, 17.6% of hereditary survivors had developed a benign tumor, with lipomas and leiomyomas being the most frequently diagnosed types. Additionally, we report both an increased risk of benign tumors after SMNs and a reciprocal increased risk of SMNs after benign tumors among hereditary retinoblastoma survivors. If confirmed, the large magnitude of the absolute risks and the association between benign tumors and SMNs in this population may have implications for long-term surveillance. Abstract Hereditary retinoblastoma survivors have substantially increased risk of subsequent malignant neoplasms (SMNs). The risk of benign neoplasms, a substantial cause of morbidity, is unclear. We calculated the cumulative incidence of developing benign tumors at 60 years following retinoblastoma diagnosis among 1128 hereditary (i.e., bilateral retinoblastoma or unilateral with family history, mutation testing was not available) and 924 nonhereditary retinoblastoma survivors diagnosed during 1914–2006 at two US medical centers with follow-up through 2016. Using Cox proportional hazards regression, we compared benign tumor risk by hereditary status and evaluated the association between benign tumors and SMNs. There were 100 benign tumors among 73 hereditary survivors (cumulative incidence = 17.6%; 95% confidence interval [CI] = 12.9–22.8%) and 22 benign tumors among 16 nonhereditary survivors (cumulative incidence = 3.9%; 95%CI = 2.2–6.4%), corresponding to 4.9-fold (95%CI = 2.8–8.4) increased risk for hereditary survivors. The cumulative incidence after hereditary retinoblastoma was highest for lipoma among males (14.0%; 95%CI = 7.7–22.1%) and leiomyoma among females (8.9%; 95%CI = 5.2–13.8%). Among hereditary survivors, having a prior SMN was associated with 3.5-fold (95%CI = 2.0–6.1) increased risk of developing a benign tumor; the reciprocal risk for developing an SMN after a benign tumor was 1.8 (95%CI = 1.1–2.9). These large-scale, long-term data demonstrate an increased risk for benign tumors after hereditary versus nonhereditary retinoblastoma. If confirmed, the association between benign tumors and SMNs among hereditary patients may have implications for long-term surveillance.
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Affiliation(s)
- Milo van Hoefen Wijsard
- Department of Ophthalmology, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, 1081 HV Amsterdam, The Netherlands; (M.v.H.W.); (A.C.M.); (A.W.F.)
| | - Sara J. Schonfeld
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA; (S.J.S.); (M.A.T.); (R.A.K.)
| | - Flora E. van Leeuwen
- Department of Epidemiology, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands;
| | - Annette C. Moll
- Department of Ophthalmology, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, 1081 HV Amsterdam, The Netherlands; (M.v.H.W.); (A.C.M.); (A.W.F.)
| | - Armida W. Fabius
- Department of Ophthalmology, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, 1081 HV Amsterdam, The Netherlands; (M.v.H.W.); (A.C.M.); (A.W.F.)
| | - David H. Abramson
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (D.H.A.); (J.H.F.)
| | - Johanna M. Seddon
- Department of Ophthalmology and Visual Sciences, University of Massachusetts Medical School, Worcester, MA 01605, USA;
| | - Jasmine H. Francis
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (D.H.A.); (J.H.F.)
| | - Margaret A. Tucker
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA; (S.J.S.); (M.A.T.); (R.A.K.)
| | - Ruth A. Kleinerman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA; (S.J.S.); (M.A.T.); (R.A.K.)
| | - Lindsay M. Morton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA; (S.J.S.); (M.A.T.); (R.A.K.)
- Correspondence: ; Tel.: +1-240-276-7377
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6
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Schaefer IM, Lundberg MZ, Demicco EG, Przybyl J, Matusiak M, Chibon F, Ingram DR, Hornick JL, Wang WL, Bauer S, Baker LH, Lazar AJ, van de Rijn M, Mariño-Enríquez A, Fletcher JA. Relationships between highly recurrent tumor suppressor alterations in 489 leiomyosarcomas. Cancer 2021; 127:2666-2673. [PMID: 33788262 DOI: 10.1002/cncr.33542] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 10/02/2020] [Accepted: 10/09/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Leiomyosarcoma (LMS) is the most common soft tissue and uterine sarcoma, but no standard therapy is available for recurrent or metastatic LMS. TP53, p16/RB1, and PI3K/mTOR pathway dysregulations are recurrent events, and some LMS express estrogen receptor (ER) and/or progesterone receptor (PR). To characterize relationships between these pathway perturbations, the authors evaluated protein expression in soft tissue and uterine nonprimary leiomyosarcoma (np-LMS), including local recurrences and distant metastases. METHODS TP53, RB1, p16, and PTEN expression aberrations were determined by immunohistochemistry (IHC) in tissue microarrays (TMAs) from 227 np-LMS and a comparison group of 262 primary leiomyosarcomas (p-LMS). Thirty-five of the np-LMS had a matched p-LMS specimen in the TMAs. Correlative studies included differentiation scoring, ER and PR IHC, and CDKN2A/p16 fluorescence in situ hybridization. RESULTS Dysregulation of TP53, p16/RB1, and PTEN was demonstrated in 90%, 95%, and 41% of np-LMS, respectively. PTEN inactivation was more common in soft tissue np-LMS than uterine np-LMS (55% vs 31%; P = .0005). Moderate-strong ER expression was more common in uterine np-LMS than soft tissue np-LMS (50% vs 7%; P < .0001). Co-inactivation of TP53 and RB1 was found in 81% of np-LMS and was common in both soft tissue and uterine np-LMS (90% and 74%, respectively). RB1, p16, and PTEN aberrations were nearly always conserved in p-LMS and np-LMS from the same patients. CONCLUSIONS These studies show that nearly all np-LMS have TP53 and/or RB1 aberrations. Therefore, therapies targeting cell cycle and DNA damage checkpoint vulnerabilities should be prioritized for evaluations in LMS.
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Affiliation(s)
- Inga-Marie Schaefer
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Meijun Z Lundberg
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Elizabeth G Demicco
- Department of Pathology and Laboratory Medicine, Sinai Health System, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Joanna Przybyl
- Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Magdalena Matusiak
- Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Frédéric Chibon
- The Institut national de la santé et de la recherche médicale (INSERM) U1037, Cancer Research Center of Toulouse, Department of Pathology, Claudius Régaud Institute, IUCT-Oncopole, Toulouse, France
| | - Davis R Ingram
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jason L Hornick
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Wei-Lien Wang
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sebastian Bauer
- Department of Medical Oncology, Sarcoma Center, West German Cancer Center, University Duisburg-Essen Medical School, Essen, Germany.,Partner Site Essen and German Cancer Consortium, Heidelberg, Germany
| | - Laurence H Baker
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Alexander J Lazar
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Matt van de Rijn
- Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Adrian Mariño-Enríquez
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jonathan A Fletcher
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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7
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Long-term risk of subsequent cancer incidence among hereditary and nonhereditary retinoblastoma survivors. Br J Cancer 2021; 124:1312-1319. [PMID: 33473166 PMCID: PMC8007574 DOI: 10.1038/s41416-020-01248-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 12/14/2020] [Accepted: 12/17/2020] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Increased sarcoma and melanoma risks after hereditary retinoblastoma are well established, whereas less is known about epithelial subsequent malignant neoplasms (SMNs) and risks for multiple (≥2) SMNs. METHODS Leveraging long-term follow-up and detailed histologic information, we quantified incident SMN risk among 1128 hereditary and 924 nonhereditary retinoblastoma survivors (diagnosed 1914-2006; follow-up through 2016). Standardised incidence ratios (SIRs) compared cancer risk after retinoblastoma relative to the general population. We estimated cumulative incidence accounting for competing risk of death. RESULTS Hereditary survivors had statistically significantly increased SMN risk (N = 239; SIR = 11.9; 95% confidence interval [CI] 10.4-13.5), with SIRs >80-fold for sarcomas, nasal cavity tumours and pineoblastoma. Significantly increased risks were also observed for melanoma and central nervous system, oral cavity and breast SMNs (SIRs = 3.1-17), but not the uterus, kidney, lung, bladder, pancreas or other types. Cumulative incidence 50 years following hereditary retinoblastoma was 33.1% (95% CI 29.0-37.2) for a first SMN and 6.0% (95% CI 3.8-8.2) for a second SMN. SMN risk was not increased after nonhereditary retinoblastoma (N = 25; SIR = 0.8; 95% CI 0.5-1.2). CONCLUSION Beyond the established sarcoma and melanoma risks after hereditary retinoblastoma, we demonstrate increased risk for a more limited number of epithelial malignancies than previously suggested. Cumulative incidence estimates emphasise long-term SMN burden after hereditary retinoblastoma.
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8
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Tonorezos ES, Friedman DN, Barnea D, Bosscha MI, Chantada G, Dommering CJ, de Graaf P, Dunkel IJ, Fabius AWM, Francis JH, Greer MLC, Kleinerman RA, Kors WA, Laughlin S, Moll AC, Morton LM, Temming P, Tucker MA, van Leeuwen FE, Walsh MF, Oeffinger KC, Abramson DH. Recommendations for Long-Term Follow-up of Adults with Heritable Retinoblastoma. Ophthalmology 2020; 127:1549-1557. [PMID: 32422154 PMCID: PMC7606265 DOI: 10.1016/j.ophtha.2020.05.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 05/05/2020] [Accepted: 05/08/2020] [Indexed: 12/17/2022] Open
Abstract
PURPOSE To generate recommendations for long-term follow-up of adult survivors of heritable retinoblastoma. DESIGN We convened a meeting of providers from retinoblastoma centers around the world to review the state of the science and to evaluate the published evidence. PARTICIPANTS Retinoblastoma is a rare childhood cancer of the retina. Approximately 40% of retinoblastoma cases are heritable, resulting from a germline mutation in RB1. Dramatic improvements in treatment and supportive care have resulted in a growing adult survivor population. However, survivors of heritable retinoblastoma have a significantly increased risk of subsequent malignant neoplasms, particularly bone and soft tissue sarcomas, uterine leiomyosarcoma, melanomas, and radiotherapy-related central nervous system tumors, which are associated with excess morbidity and mortality. Despite these risks, no surveillance recommendations for this population currently are in place, and surveillance practices vary widely by center. METHODS Following the Institute of Medicine procedure for clinical practice guideline development, a PubMed, EMBASE, and Web of Science search was performed, resulting in 139 articles; after abstract and full-text review, 37 articles underwent detailed data abstraction to quantify risk and evidence regarding surveillance, if available. During an in-person meeting, evidence was presented and discussed, resulting in consensus recommendations. MAIN OUTCOME MEASURES Diagnosis and mortality from subsequent neoplasm. RESULTS Although evidence for risk of subsequent neoplasm, especially sarcoma and melanoma, was significant, evidence supporting routine testing of asymptomatic survivors was not identified. Skin examination for melanoma and prompt evaluation of signs and symptoms of head and neck disease were determined to be prudent. CONCLUSIONS This review of the literature confirmed some of the common second cancers in retinoblastoma survivors but found little evidence for a benefit from currently available surveillance for these malignancies. Future research should incorporate international partners, patients, and family members.
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Affiliation(s)
- Emily S Tonorezos
- Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medical College, New York, New York.
| | | | - Dana Barnea
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | | | | | | | - Pim de Graaf
- Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Ira J Dunkel
- Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medical College, New York, New York
| | - Armida W M Fabius
- Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | | | | | - Ruth A Kleinerman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Wijnanda A Kors
- Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Suzanne Laughlin
- Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Annette C Moll
- Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Lindsay M Morton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | | | - Margaret A Tucker
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | | | | | | | - David H Abramson
- Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medical College, New York, New York
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9
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Kleinerman RA, Tucker MA, Sigel BS, Abramson DH, Seddon JM, Morton LM. Patterns of Cause-Specific Mortality Among 2053 Survivors of Retinoblastoma, 1914-2016. J Natl Cancer Inst 2020; 111:961-969. [PMID: 30698734 DOI: 10.1093/jnci/djy227] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 10/22/2018] [Accepted: 12/05/2018] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Previous studies of hereditary retinoblastoma survivors have reported elevated mortality, particularly for sarcomas, compared with the general population. However, cause-specific mortality patterns for long-term hereditary and nonhereditary retinoblastoma survivors are poorly understood. METHODS Among 2053 retinoblastoma patients diagnosed during 1914-2006 at two major US treatment centers and followed to 2016, we estimated cumulative mortality, standardized mortality ratios (SMRs), and absolute excess risks (AERs) compared with the US general population. RESULTS Most deaths occurred in 1129 hereditary retinoblastoma patients (n = 518 deaths, cumulative mortality 70 years after retinoblastoma = 75.8%, 95% CI = 69.0% to 82.6%; SMR = 8.5, 95% CI = 7.7 to 9.2). Of these, 267 were due to subsequent cancers (SMR = 27.4, 95% CI = 24.2 to 30.9; AER = 72.3 deaths/10 000 person-years), for which SMRs were highest 15-29 years after diagnosis (n = 69, SMR = 89.9, 95% CI = 70.0 to 113.8) but remained statistically significantly elevated at 60 and more years (n = 14, SMR = 6.7, 95% CI = 3.6 to 11.2), whereas AERs increased with time (AER<15years = 38.0; AER60+years = 327.5). Increased risk of death due to cancers of pancreas, large intestines, and kidney were noted for the first time. Overall risk of subsequent cancers was greater for those treated with radiotherapy and chemotherapy compared to radiotherapy alone, although patterns varied by organ site. For 924 patients with nonhereditary retinoblastoma, we noted a modestly increased risk of death for subsequent cancers (n = 27, SMR = 1.8, 95% CI = 1.2 to 2.6) possibly due to treatment or misclassification of hereditary status. Risks of noncancer causes of death were not elevated for hereditary or nonhereditary patients. CONCLUSION Hereditary retinoblastoma survivors died mainly from an excess risk of subsequent cancers up to six decades later, highlighting the need to develop long-term clinical management guidelines for hereditary retinoblastoma survivors treated in the past.
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10
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Atzori L, Pilloni L, Zanniello R, Ferreli C, Rongioletti F. Clear-cell variant of superficial cutaneous leiomyosarcoma associated with RB1 mutation: Clinical, dermoscopic, and histopathological characteristics. J Cutan Pathol 2020; 47:571-575. [PMID: 31999365 DOI: 10.1111/cup.13655] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 01/17/2020] [Accepted: 01/24/2020] [Indexed: 12/16/2022]
Abstract
Leiomyosarcoma is a relatively rare soft tissue tumor whose clear-cell variant has only been reported in leiomyosarcomas of the uterus. We report here for the first time a primary cutaneous clear-cell leiomyosarcoma in the trunk skin of a 49-year-old man, characterized by a very indolent clinical and dermoscopic presentation, mimicking a dermatofibroma. Genetic analysis of the otherwise healthy patient revealed a germline mutation in the retinoblastoma 1 gene (RB1); the same mutation was found in his son, who had previously developed retinoblastoma. Moreover, the mother of the patient had died of uterine leiomyosarcoma with clear-cell changes. Mutations in the RB1 gene occur commonly in human neoplasms. In this patient, we were able to link his clear-cell variant of cutaneous leiomyosarcoma with the loss of retinoblastoma protein expression, as revealed by immunohistochemical staining analysis.
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Affiliation(s)
- Laura Atzori
- Dermatology Clinic, Department Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Luca Pilloni
- Pathology Unit, Department Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Ramona Zanniello
- Dermatology Clinic, Department Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Caterina Ferreli
- Dermatology Clinic, Department Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Franco Rongioletti
- Dermatology Clinic, Department Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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Eag1 Gene and Protein Expression in Human Retinoblastoma Tumors and its Regulation by pRb in HeLa Cells. Genes (Basel) 2020; 11:genes11020119. [PMID: 31973216 PMCID: PMC7074590 DOI: 10.3390/genes11020119] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 01/12/2020] [Accepted: 01/18/2020] [Indexed: 11/17/2022] Open
Abstract
Retinoblastoma is the most common pediatric intraocular malignant tumor. Unfortunately, low cure rates and low life expectancy are observed in low-income countries. Thus, alternative therapies are needed for patients who do not respond to current treatments or those with advanced cases of the disease. Ether à-go-go-1 (Eag1) is a voltage-gated potassium channel involved in cancer. Eag1 expression is upregulated by the human papilloma virus (HPV) oncogene E7, suggesting that retinoblastoma protein (pRb) may regulate Eag1. Astemizole is an antihistamine that is suggested to be repurposed for cancer treatment; it targets proteins implicated in cancer, including histamine receptors, ATP binding cassette transporters, and Eag channels. Here, we investigated Eag1 regulation using pRb and Eag1 expression in human retinoblastoma. The effect of astemizole on the cell proliferation of primary human retinoblastoma cultures was also studied. HeLa cervical cancer cells (HPV-positive and expressing Eag1) were transfected with RB1. Eag1 mRNA expression was studied using qPCR, and protein expression was assessed using western blotting and immunochemistry. Cell proliferation was evaluated with an MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay. RB1 transfection down-regulated Eag1 mRNA and protein expression. The human retinoblastoma samples displayed heterogeneous Eag1 mRNA and protein expression. Astemizole decreased cell proliferation in primary retinoblastoma cultures. Our results suggest that Eag1 mRNA and protein expression was regulated by pRb in vitro, and that human retinoblastoma tissues had heterogeneous Eag1 mRNA and protein expression. Furthermore, our results propose that the multitarget drug astemizole may have clinical relevance in patients with retinoblastoma, for instance, in those who do not respond to current treatments.
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Kleinerman RA, Schonfeld SJ, Sigel BS, Wong-Siegel JR, Gilbert ES, Abramson DH, Seddon JM, Tucker MA, Morton LM. Bone and Soft-Tissue Sarcoma Risk in Long-Term Survivors of Hereditary Retinoblastoma Treated With Radiation. J Clin Oncol 2019; 37:3436-3445. [PMID: 31622129 PMCID: PMC7001778 DOI: 10.1200/jco.19.01096] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2019] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Survivors of hereditary retinoblastoma have excellent survival but substantially increased risks of subsequent bone and soft-tissue sarcomas, particularly after radiotherapy. Comprehensive investigation of sarcoma risk patterns would inform clinical surveillance for survivors. PATIENTS AND METHODS In a cohort of 952 irradiated survivors of hereditary retinoblastoma who were originally diagnosed during 1914 to 2006, we quantified sarcoma risk with standardized incidence ratios (SIRs) and cumulative incidence analyses. We conducted analyses separately for bone and soft-tissue sarcomas occurring in the head and neck (in/near the radiotherapy field) versus body and extremities (out of field). RESULTS Of 105 bone and 124 soft-tissue sarcomas, more than one half occurred in the head and neck (bone, 53.3%; soft tissue, 51.6%), one quarter in the body and extremities (bone, 29.5%; soft tissue, 25.0%), and approximately one fifth in unknown/unspecified locations (bone, 17.1%; soft tissue, 23.4%). We noted substantially higher risks compared with the general population for head and neck versus body and extremity tumors for both bone (SIR, 2,213; 95% CI, 1,671 to 2,873 v SIR, 169; 95% CI, 115 to 239) and soft-tissue sarcomas (SIR, 542; 95% CI, 418 to 692 v SIR, 45.7; 95% CI, 31.1 to 64.9). Head and neck bone and soft-tissue sarcomas were diagnosed beginning in early childhood and continued well into adulthood, reaching a 60-year cumulative incidence of 6.8% (95% CI, 5.0% to 8.7%) and 9.3% (95% CI, 7.0% to 11.7%), respectively. In contrast, body and extremity bone sarcoma incidence flattened after adolescence (3.5%; 95% CI, 2.3% to 4.8%), whereas body and extremity soft-tissue sarcoma incidence was rare until age 30, when incidence rose steeply (60-year cumulative incidence, 6.6%; 95% CI, 4.1% to 9.2%), particularly for females (9.4%; 95% CI, 5.1% to 13.8%). CONCLUSION Strikingly elevated bone and soft-tissue sarcoma risks differ by age, location, and sex, highlighting important contributions of both radiotherapy and genetic susceptibility. These data provide guidance for the development of a risk-based screening protocol that focuses on the highest sarcoma risks by age, location, and sex.
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13
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Leinwand GZ, Greenberg JW, Sholl AB, Krane LS. Synchronous Urothelial Bladder and Renal Malignancies. Case Report and Review of Urologic Cancers in Patients With Familial Rb Mutations. Urology 2019; 131:89-92. [DOI: 10.1016/j.urology.2019.05.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 05/21/2019] [Accepted: 05/22/2019] [Indexed: 10/26/2022]
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15
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Analysis of the CDK4/6 Cell Cycle Pathway in Leiomyosarcomas as a Potential Target for Inhibition by Palbociclib. Sarcoma 2019; 2019:3914232. [PMID: 30804704 PMCID: PMC6360577 DOI: 10.1155/2019/3914232] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 11/12/2018] [Accepted: 11/26/2018] [Indexed: 12/16/2022] Open
Abstract
Leiomyosarcoma (LMS) is characterized by high genomic complexity, and to date, no specific targeted therapy is available. In a genome-wide approach, we profiled genomic aberrations in a small cohort of eight primary tumours, two relapses, and eight metastases across nine different patients. We identified CDK4 amplification as a recurrent alteration in 5 out of 18 samples (27.8%). It has been previously shown that the LMS cell line SK-LMS-1 has a defect in the p16 pathway and that this cell line can be inhibited by the CDK4 and CDK6 inhibitor palbociclib. For SK-LMS-1 we confirm and for SK-UT-1 we show that both LMS cell lines express CDK4 and that, in addition, strong CDK6 expression is seen in SK-LMS-1, whereas Rb was expressed in SK-LMS-1 but not in SK-UT-1. We confirm that inhibition of SK-LMS-1 with palbociclib led to a strong decrease in protein levels of Phospho-Rb (Ser780), a decreased cell proliferation, and G0/G1-phase arrest with decreased S/G2 fractions. SK-UT-1 did not respond to palbociclib inhibition. To compare these in vitro findings with patient tissue samples, a p16, CDK4, CDK6, and p-Rb immunohistochemical staining assay of a large LMS cohort (n=99 patients with 159 samples) was performed assigning a potential responder phenotype to each patient, which we identified in 29 out of 99 (29.3%) patients. Taken together, these data show that CDK4/6 inhibitors may offer a new option for targeted therapy in a subset of LMS patients.
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Chen I, Firth B, Hopkins L, Bougie O, Xie RH, Singh S. Clinical Characteristics Differentiating Uterine Sarcoma and Fibroids. JSLS 2018; 22:JSLS.2017.00066. [PMID: 29398899 PMCID: PMC5779798 DOI: 10.4293/jsls.2017.00066] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background and Objectives: Uterine fibroids are a common indication for laparoscopy. Unsuspected sarcoma can pose a serious risk if morcellation is used in the procedure. We sought to determine the clinical factors associated with uterine sarcoma compared with uterine fibroids. Methods: We conducted a case–control study of 66 women who had hysterectomy for uterine sarcoma from April 1, 2007, to March 31, 2014. Sixty-six patients who had hysterectomy for fibroids were randomly selected as controls. Results: Women with sarcoma vs women with fibroids, tended to be older (mean ± SD 62.1 ± 10.1 vs 46.5 ± 6.6; P < .0001), were more likely to be postmenopausal (81.8% vs 9.2%; P < .0001), and were more likely to have a history of another nonuterine malignancy (16.7% vs 4.6%; P = .02). Women with sarcoma were more likely to have masses that were subserosal (69.4% vs 34.8%; P < .0001), rather than intramural (11.1% vs 37.0%; P = .01), and to have a solitary rather than multiple uterine mass (56.3% vs 18.5%; P < .0001). They were also more likely to have a history of documented rapid growth (16.7% vs 4.6%; P = .02). Conclusion: Despite limitations in sample size related to infrequency of uterine sarcoma, our results suggest some preoperative clinical differences between women who have uterine sarcoma vs uterine fibroids. Further studies on such features may assist us in identifying patients who are at higher risk of having a uterine sarcoma among women with a uterine mass contemplating surgery.
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Affiliation(s)
- Innie Chen
- Department of Obstetrics and Gynaecology, University of Ottawa and the Ottawa Hospital Research Institute
| | - Bianca Firth
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Laura Hopkins
- Department of Obstetrics and Gynaecology, University of Ottawa and the Ottawa Hospital Research Institute
| | - Olga Bougie
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Ri-Hua Xie
- Department of Obstetrics and Gynaecology, University of Ottawa and the Ottawa Hospital Research Institute
| | - Sukhbir Singh
- Department of Obstetrics and Gynaecology, University of Ottawa and the Ottawa Hospital Research Institute
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17
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Abstract
With the increased use of modern next generation sequencing technologies in routine molecular pathology practice, the proportion of cancer cases with a definite or probable hereditary background seems to be steadily increasing. Currently, it is assumed that ≥10% of all malignancies develop in the setting of germline predisposition. Diagnosis and recognition of cancer predisposition syndromes relies not rarely on distinctive histopathological features that proved to be highly valuable and reproducible in uncovering those diseases that would otherwise have gone undetected by clinicians as being hereditary in nature. This is especially true in case of new mutations without suspicious family history. Example of such entities are fumarate hydratase-deficient renal cell carcinoma (RCC), succinate dehydrogenase-deficient RCC, hereditary gastrointestinal stromal tumor syndromes and many other diseases. It is remarkable that many of these inherited cancer syndromes do present as unifocal disease with highly variable age of onset so that many of them are misinterpreted as sporadic on clinical grounds. Availability of specialized cancer screening programs and disease-specific follow-up schemes for several hereditary cancer syndromes encourages the recognition of such disorders, so that "at risk patients" can be enrolled in such programs for early detection and timely intervention/ treatment of these malignancies which are in the majority of cases aggressive. In several conditions, as in familial adenomatous polyposis coli (FAP), well established prophylactic surgical interventions may be adopted to prevent the disease manifestations, highlighting the importance of the timely recognition of these potentially life-limiting neoplasms. In this review, the clinicopathological, demographic and histological features that are considered highly suggestive of a hereditary basis of "a neoplasm under consideration" are highlighted and discussed briefly. The details of some of these entities are in addition dealt with in reviews devoted to them in this special issue.
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Affiliation(s)
- Abbas Agaimy
- Institute of Pathology, Friedrich-Alexander-University Erlangen-Nürnberg, University Hospital, Erlangen, Germany.
| | - Arndt Hartmann
- Institute of Pathology, Friedrich-Alexander-University Erlangen-Nürnberg, University Hospital, Erlangen, Germany
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18
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Lee PJ, Yoo NS, Hagemann IS, Pfeifer JD, Cottrell CE, Abel HJ, Duncavage EJ. Spectrum of mutations in leiomyosarcomas identified by clinical targeted next-generation sequencing. Exp Mol Pathol 2017; 102:156-161. [DOI: 10.1016/j.yexmp.2017.01.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 01/12/2017] [Indexed: 10/20/2022]
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Rommel B, Holzmann C, Bullerdiek J. Malignant mesenchymal tumors of the uterus - time to advocate a genetic classification. Expert Rev Anticancer Ther 2016; 16:1155-1166. [PMID: 27602604 DOI: 10.1080/14737140.2016.1233817] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Sarcomas are rare uterine tumors with leiomyosarcomas and endometrial stromal sarcomas constituting the predominant entities often making their first appearance in young and middle-aged women. By histology combined with immunostaining alone some of these tumors can offer diagnostic challenges e.g. for the differential diagnosis between leiomyosarcomas and smooth muscle tumors of uncertain malignant potential (STUMP). Areas covered: Recent advances in the genetic classification and subclassification, respectively, have shown that genetic markers can offer a valuable adjunct to conventional diagnostic tools. Herein, we will review these recent data from the literature also referring to genetic alterations found in STUMP, endometrial stromal nodules, and leiomyomas including their variants. Expert commentary: For the future, we consider genetic classification as a necessary step in the clinical management of these tumors which will help not only to improve the diagnosis but also the therapy of these malignancies often associated with a worse prognosis.
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Affiliation(s)
- Birgit Rommel
- a Center for Human Genetics , University of Bremen , Bremen , Germany
| | - Carsten Holzmann
- b Institute of Medical Genetics , University Rostock Medical Center , Rostock , Germany
| | - Jörn Bullerdiek
- b Institute of Medical Genetics , University Rostock Medical Center , Rostock , Germany
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Hayashi T, Horiuchi A, Sano K, Kanai Y, Yaegashi N, Aburatani H, Konishi I. Biological characterization of soft tissue sarcomas. ANNALS OF TRANSLATIONAL MEDICINE 2016; 3:368. [PMID: 26807423 DOI: 10.3978/j.issn.2305-5839.2015.12.33] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Soft tissue sarcomas are neoplastic malignancies that typically arise in tissues of mesenchymal origin. The identification of novel molecular mechanisms leading to mesenchymal transformation and the establishment of new therapies and diagnostic biomarker has been hampered by several critical factors. First, malignant soft tissue sarcomas are rarely observed in the clinic with fewer than 15,000 newly cases diagnosed each year in the United States. Another complicating factor is that soft tissue sarcomas are extremely heterogeneous as they arise in a multitude of tissues from many different cell lineages. The scarcity of clinical materials coupled with its inherent heterogeneity creates a challenging experimental environment for clinicians and scientists. Faced with these challenges, there has been extremely limited advancement in clinical treatment options available to patients as compared to other malignant tumours. In order to glean insight into the pathobiology of soft tissue sarcomas, scientists are now using mouse models whose genomes have been specifically tailored to carry gene deletions, gene amplifications, and somatic mutations commonly observed in human soft tissue sarcomas. The use of these model organisms has been successful in increasing our knowledge and understanding of how alterations in relevant oncogenic and/or tumour suppressive signal cascades, i.e., interferon-γ (IFN-γ), tumour protein 53 (TP53) and/or retinoblastoma (RB) pathway directly impact sarcomagenesis. It is the goal of many in the physiological community that the use of several mouse models will serve as powerful in vivo tools for further understanding of sarcomagenesis and potentially identify new diagnostic biomarker and therapeutic strategies against human soft tissue sarcomas.
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Affiliation(s)
- Takuma Hayashi
- 1 Department of Immunology and Infectious Disease, Shinshu University School of Medicine, Nagano, Japan ; 2 Promoting Business using Advanced Technology, Japan Science and Technology Agency (JST), Tokyo, Japan ; 3 Sigma-Aldrich Collaboration Laboratory, Rehovot 76100, Israel ; 4 Horiuchi Ladies Clinic, Nagano, Japan ; 5 Department of Laboratory Medicine, Shinshu University Hospital, Nagano, Japan ; 6 Department of Pathology, Keio University Graduate School of Medicine, Tokyo, Japan ; 7 The International Human Epigenome Consortium (IHEC) and CREST, Japan Science and Technology Agency (JST), Saitama, Japan ; 8 Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Miyagi, Japan ; 9 The Cancer System Laboratory, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan ; 10 Department of Obstetrics and Gynecology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akiko Horiuchi
- 1 Department of Immunology and Infectious Disease, Shinshu University School of Medicine, Nagano, Japan ; 2 Promoting Business using Advanced Technology, Japan Science and Technology Agency (JST), Tokyo, Japan ; 3 Sigma-Aldrich Collaboration Laboratory, Rehovot 76100, Israel ; 4 Horiuchi Ladies Clinic, Nagano, Japan ; 5 Department of Laboratory Medicine, Shinshu University Hospital, Nagano, Japan ; 6 Department of Pathology, Keio University Graduate School of Medicine, Tokyo, Japan ; 7 The International Human Epigenome Consortium (IHEC) and CREST, Japan Science and Technology Agency (JST), Saitama, Japan ; 8 Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Miyagi, Japan ; 9 The Cancer System Laboratory, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan ; 10 Department of Obstetrics and Gynecology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kenji Sano
- 1 Department of Immunology and Infectious Disease, Shinshu University School of Medicine, Nagano, Japan ; 2 Promoting Business using Advanced Technology, Japan Science and Technology Agency (JST), Tokyo, Japan ; 3 Sigma-Aldrich Collaboration Laboratory, Rehovot 76100, Israel ; 4 Horiuchi Ladies Clinic, Nagano, Japan ; 5 Department of Laboratory Medicine, Shinshu University Hospital, Nagano, Japan ; 6 Department of Pathology, Keio University Graduate School of Medicine, Tokyo, Japan ; 7 The International Human Epigenome Consortium (IHEC) and CREST, Japan Science and Technology Agency (JST), Saitama, Japan ; 8 Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Miyagi, Japan ; 9 The Cancer System Laboratory, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan ; 10 Department of Obstetrics and Gynecology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yae Kanai
- 1 Department of Immunology and Infectious Disease, Shinshu University School of Medicine, Nagano, Japan ; 2 Promoting Business using Advanced Technology, Japan Science and Technology Agency (JST), Tokyo, Japan ; 3 Sigma-Aldrich Collaboration Laboratory, Rehovot 76100, Israel ; 4 Horiuchi Ladies Clinic, Nagano, Japan ; 5 Department of Laboratory Medicine, Shinshu University Hospital, Nagano, Japan ; 6 Department of Pathology, Keio University Graduate School of Medicine, Tokyo, Japan ; 7 The International Human Epigenome Consortium (IHEC) and CREST, Japan Science and Technology Agency (JST), Saitama, Japan ; 8 Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Miyagi, Japan ; 9 The Cancer System Laboratory, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan ; 10 Department of Obstetrics and Gynecology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Nobuo Yaegashi
- 1 Department of Immunology and Infectious Disease, Shinshu University School of Medicine, Nagano, Japan ; 2 Promoting Business using Advanced Technology, Japan Science and Technology Agency (JST), Tokyo, Japan ; 3 Sigma-Aldrich Collaboration Laboratory, Rehovot 76100, Israel ; 4 Horiuchi Ladies Clinic, Nagano, Japan ; 5 Department of Laboratory Medicine, Shinshu University Hospital, Nagano, Japan ; 6 Department of Pathology, Keio University Graduate School of Medicine, Tokyo, Japan ; 7 The International Human Epigenome Consortium (IHEC) and CREST, Japan Science and Technology Agency (JST), Saitama, Japan ; 8 Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Miyagi, Japan ; 9 The Cancer System Laboratory, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan ; 10 Department of Obstetrics and Gynecology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiroyuki Aburatani
- 1 Department of Immunology and Infectious Disease, Shinshu University School of Medicine, Nagano, Japan ; 2 Promoting Business using Advanced Technology, Japan Science and Technology Agency (JST), Tokyo, Japan ; 3 Sigma-Aldrich Collaboration Laboratory, Rehovot 76100, Israel ; 4 Horiuchi Ladies Clinic, Nagano, Japan ; 5 Department of Laboratory Medicine, Shinshu University Hospital, Nagano, Japan ; 6 Department of Pathology, Keio University Graduate School of Medicine, Tokyo, Japan ; 7 The International Human Epigenome Consortium (IHEC) and CREST, Japan Science and Technology Agency (JST), Saitama, Japan ; 8 Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Miyagi, Japan ; 9 The Cancer System Laboratory, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan ; 10 Department of Obstetrics and Gynecology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ikuo Konishi
- 1 Department of Immunology and Infectious Disease, Shinshu University School of Medicine, Nagano, Japan ; 2 Promoting Business using Advanced Technology, Japan Science and Technology Agency (JST), Tokyo, Japan ; 3 Sigma-Aldrich Collaboration Laboratory, Rehovot 76100, Israel ; 4 Horiuchi Ladies Clinic, Nagano, Japan ; 5 Department of Laboratory Medicine, Shinshu University Hospital, Nagano, Japan ; 6 Department of Pathology, Keio University Graduate School of Medicine, Tokyo, Japan ; 7 The International Human Epigenome Consortium (IHEC) and CREST, Japan Science and Technology Agency (JST), Saitama, Japan ; 8 Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Miyagi, Japan ; 9 The Cancer System Laboratory, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan ; 10 Department of Obstetrics and Gynecology, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Friedman DN, Chou JF, Oeffinger KC, Kleinerman RA, Ford JS, Sklar CA, Li Y, McCabe MS, Robison LL, Marr BP, Abramson DH, Dunkel IJ. Chronic medical conditions in adult survivors of retinoblastoma: Results of the Retinoblastoma Survivor Study. Cancer 2016; 122:773-81. [PMID: 26755259 DOI: 10.1002/cncr.29704] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 05/21/2015] [Accepted: 06/01/2015] [Indexed: 11/06/2022]
Abstract
BACKGROUND Limited data are available regarding long-term morbidity in adult survivors of retinoblastoma (Rb). METHODS The Retinoblastoma Survivor Study is a retrospective cohort of adult survivors of Rb diagnosed between 1932 and 1994. Participants completed a comprehensive questionnaire adapted from the Childhood Cancer Survivor Study surveys. Chronic conditions were classified using the National Cancer Institute's Common Terminology Criteria for Adverse Events (version 4.03). Multivariate Poisson regression was used to compare survivors of Rb with 2377 non-Rb controls, consisting of the Childhood Cancer Survivor Study sibling cohort and survivors with bilateral versus unilateral disease. RESULTS Survivors of Rb (53.6% with bilateral disease) and non-Rb controls had a mean age of 43.3 years (standard deviation, 11 years) and 37.6 years (SD, 8.6 years), respectively, at the time of study enrollment. At a median follow-up of 42 years (range, 15-75 years), 86.6% of survivors of Rb had at least 1 condition and 71.1% had a severe/life-threatening (grade 3-4) condition. The adjusted relative risk (RR) of a chronic condition in survivors compared with non-Rb controls was 1.4 (95% confidence interval [95% CI], 1.3-1.4; P<.01); for a grade 3 to 4 condition, the RR was 7.6 (95% CI, 6.4-8.9; P<.01). Survivors were at an excess risk regardless of laterality. After stratifying by laterality and excluding ocular conditions and second malignant neoplasms (SMNs), only those with bilateral disease were found to be at an increased risk of any nonocular, non-SMN condition (RR, 1.2; 95% CI, 1.1-1.2) and for grade 3 to 4 nonocular, non-SMN conditions (RR, 1.7; 95% CI, 1.2-2.5). CONCLUSIONS Survivors of Rb have an increased risk of chronic conditions compared with non-Rb controls. After excluding ocular conditions and SMNs, this excess risk was found to persist only for those with bilateral disease. Cancer 2016;122:773-781. © 2016 American Cancer Society.
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Affiliation(s)
| | - Joanne F Chou
- Department of Epidemiology-Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kevin C Oeffinger
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Ruth A Kleinerman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Rockville, Maryland
| | - Jennifer S Ford
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Charles A Sklar
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Yuelin Li
- Department of Epidemiology-Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Mary S McCabe
- Clinical Director, Survivorship Center, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Leslie L Robison
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Brian P Marr
- Ophthalmic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - David H Abramson
- Ophthalmic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ira J Dunkel
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York
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Potential Therapeutic Targets in Uterine Sarcomas. Sarcoma 2015; 2015:243298. [PMID: 26576131 PMCID: PMC4632006 DOI: 10.1155/2015/243298] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 09/30/2015] [Indexed: 12/30/2022] Open
Abstract
Uterine sarcomas are rare tumors accounting for 3,4% of all uterine cancers. Even after radical hysterectomy, most patients relapse or present with distant metastases. The very limited clinical benefit of adjuvant cytotoxic treatments is reflected by high mortality rates, emphasizing the need for new treatment strategies. This review summarizes rising potential targets in four distinct subtypes of uterine sarcomas: leiomyosarcoma, low-grade and high-grade endometrial stromal sarcoma, and undifferentiated uterine sarcoma. Based on clinical reports, promising approaches for uterine leiomyosarcoma patients include inhibition of VEGF and mTOR signaling, preferably in combination with other targeted or cytotoxic compounds. Currently, the only targeted therapy approved in leiomyosarcoma patients is pazopanib, a multitargeted inhibitor blocking VEGFR, PDGFR, FGFR, and c-KIT. Additionally, preclinical evidence suggests effect of the inhibition of histone deacetylases, tyrosine kinase receptors, and the mitotic checkpoint protein aurora kinase A. In low-grade endometrial stromal sarcomas, antihormonal therapies including aromatase inhibitors and progestins have proven activity. Other potential targets are PDGFR, VEGFR, and histone deacetylases. In high-grade ESS that carry the YWHAE/FAM22A/B fusion gene, the generated 14-3-3 oncoprotein is a putative target, next to c-KIT and the Wnt pathway. The observation of heterogeneity within uterine sarcoma subtypes warrants a personalized treatment approach.
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Ford JS, Chou JF, Sklar CA, Oeffinger KC, Novetsky Friedman D, McCabe M, Robison LL, Kleinerman RA, Li Y, Marr BP, Abramson DH, Dunkel IJ. Psychosocial Outcomes in Adult Survivors of Retinoblastoma. J Clin Oncol 2015; 33:3608-14. [PMID: 26417002 DOI: 10.1200/jco.2014.60.5733] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Survival rates for individuals diagnosed with retinoblastoma (RB) exceed 95% in the United States; however, little is known about the long-term psychosocial outcomes of these survivors. PATIENTS AND METHODS Adult RB survivors, diagnosed from 1932 to 1994 and treated in New York, completed a comprehensive questionnaire adapted from the Childhood Cancer Survivor Study (CCSS), by mail or telephone. Psychosocial outcomes included psychological distress, anxiety, depression, somatization, fear of cancer recurrence, satisfaction with facial appearance, post-traumatic growth, and post-traumatic stress symptoms; noncancer CCSS siblings served as a comparison group. RESULTS A total of 470 RB survivors (53.6% with bilateral RB; 52.1% female) and 2,820 CCSS siblings were 43.3 (standard deviation [SD], 11) years and 33.2 (SD, 8.4) years old at the time of study, respectively. After adjusting for sociodemographic factors, RB survivors did not have significantly higher rates of depression, somatization, distress, or anxiety compared with CCSS siblings. Although RB survivors were more likely to report post-traumatic stress symptoms of avoidance and/or hyperarousal (both P < .01), only five (1.1%) of 470 met criteria for post-traumatic stress disorder. Among survivors, having a chronic medical condition did not increase the likelihood of psychological problems. Bilateral RB survivors were more likely than unilateral RB survivors to experience fears of cancer recurrence (P < .01) and worry about their children being diagnosed with RB (P < .01). However, bilateral RB survivors were no more likely to report depression, anxiety, or somatic complaints than unilateral survivors. CONCLUSION Most RB survivors do not have poorer psychosocial functioning compared with a noncancer sample. In addition, bilateral and unilateral RB survivors seem similar with respect to their psychological symptoms.
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Affiliation(s)
- Jennifer S Ford
- Jennifer S. Ford, Joanne F. Chou, Charles A. Sklar, Kevin C. Oeffinger, Danielle Novetsky Friedman, Mary McCabe, Yuelin Li, Brian P. Marr, David H. Abramson, and Ira J. Dunkel, Memorial Sloan Kettering Cancer Center; Jennifer S. Ford, Charles A. Sklar, David H. Abramson, and Ira J. Dunkel, Weill-Cornell Medical College, New York, NY; Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; and Ruth A. Kleinerman, National Cancer Institute, Bethesda, MD.
| | - Joanne F Chou
- Jennifer S. Ford, Joanne F. Chou, Charles A. Sklar, Kevin C. Oeffinger, Danielle Novetsky Friedman, Mary McCabe, Yuelin Li, Brian P. Marr, David H. Abramson, and Ira J. Dunkel, Memorial Sloan Kettering Cancer Center; Jennifer S. Ford, Charles A. Sklar, David H. Abramson, and Ira J. Dunkel, Weill-Cornell Medical College, New York, NY; Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; and Ruth A. Kleinerman, National Cancer Institute, Bethesda, MD
| | - Charles A Sklar
- Jennifer S. Ford, Joanne F. Chou, Charles A. Sklar, Kevin C. Oeffinger, Danielle Novetsky Friedman, Mary McCabe, Yuelin Li, Brian P. Marr, David H. Abramson, and Ira J. Dunkel, Memorial Sloan Kettering Cancer Center; Jennifer S. Ford, Charles A. Sklar, David H. Abramson, and Ira J. Dunkel, Weill-Cornell Medical College, New York, NY; Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; and Ruth A. Kleinerman, National Cancer Institute, Bethesda, MD
| | - Kevin C Oeffinger
- Jennifer S. Ford, Joanne F. Chou, Charles A. Sklar, Kevin C. Oeffinger, Danielle Novetsky Friedman, Mary McCabe, Yuelin Li, Brian P. Marr, David H. Abramson, and Ira J. Dunkel, Memorial Sloan Kettering Cancer Center; Jennifer S. Ford, Charles A. Sklar, David H. Abramson, and Ira J. Dunkel, Weill-Cornell Medical College, New York, NY; Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; and Ruth A. Kleinerman, National Cancer Institute, Bethesda, MD
| | - Danielle Novetsky Friedman
- Jennifer S. Ford, Joanne F. Chou, Charles A. Sklar, Kevin C. Oeffinger, Danielle Novetsky Friedman, Mary McCabe, Yuelin Li, Brian P. Marr, David H. Abramson, and Ira J. Dunkel, Memorial Sloan Kettering Cancer Center; Jennifer S. Ford, Charles A. Sklar, David H. Abramson, and Ira J. Dunkel, Weill-Cornell Medical College, New York, NY; Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; and Ruth A. Kleinerman, National Cancer Institute, Bethesda, MD
| | - Mary McCabe
- Jennifer S. Ford, Joanne F. Chou, Charles A. Sklar, Kevin C. Oeffinger, Danielle Novetsky Friedman, Mary McCabe, Yuelin Li, Brian P. Marr, David H. Abramson, and Ira J. Dunkel, Memorial Sloan Kettering Cancer Center; Jennifer S. Ford, Charles A. Sklar, David H. Abramson, and Ira J. Dunkel, Weill-Cornell Medical College, New York, NY; Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; and Ruth A. Kleinerman, National Cancer Institute, Bethesda, MD
| | - Leslie L Robison
- Jennifer S. Ford, Joanne F. Chou, Charles A. Sklar, Kevin C. Oeffinger, Danielle Novetsky Friedman, Mary McCabe, Yuelin Li, Brian P. Marr, David H. Abramson, and Ira J. Dunkel, Memorial Sloan Kettering Cancer Center; Jennifer S. Ford, Charles A. Sklar, David H. Abramson, and Ira J. Dunkel, Weill-Cornell Medical College, New York, NY; Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; and Ruth A. Kleinerman, National Cancer Institute, Bethesda, MD
| | - Ruth A Kleinerman
- Jennifer S. Ford, Joanne F. Chou, Charles A. Sklar, Kevin C. Oeffinger, Danielle Novetsky Friedman, Mary McCabe, Yuelin Li, Brian P. Marr, David H. Abramson, and Ira J. Dunkel, Memorial Sloan Kettering Cancer Center; Jennifer S. Ford, Charles A. Sklar, David H. Abramson, and Ira J. Dunkel, Weill-Cornell Medical College, New York, NY; Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; and Ruth A. Kleinerman, National Cancer Institute, Bethesda, MD
| | - Yuelin Li
- Jennifer S. Ford, Joanne F. Chou, Charles A. Sklar, Kevin C. Oeffinger, Danielle Novetsky Friedman, Mary McCabe, Yuelin Li, Brian P. Marr, David H. Abramson, and Ira J. Dunkel, Memorial Sloan Kettering Cancer Center; Jennifer S. Ford, Charles A. Sklar, David H. Abramson, and Ira J. Dunkel, Weill-Cornell Medical College, New York, NY; Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; and Ruth A. Kleinerman, National Cancer Institute, Bethesda, MD
| | - Brian P Marr
- Jennifer S. Ford, Joanne F. Chou, Charles A. Sklar, Kevin C. Oeffinger, Danielle Novetsky Friedman, Mary McCabe, Yuelin Li, Brian P. Marr, David H. Abramson, and Ira J. Dunkel, Memorial Sloan Kettering Cancer Center; Jennifer S. Ford, Charles A. Sklar, David H. Abramson, and Ira J. Dunkel, Weill-Cornell Medical College, New York, NY; Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; and Ruth A. Kleinerman, National Cancer Institute, Bethesda, MD
| | - David H Abramson
- Jennifer S. Ford, Joanne F. Chou, Charles A. Sklar, Kevin C. Oeffinger, Danielle Novetsky Friedman, Mary McCabe, Yuelin Li, Brian P. Marr, David H. Abramson, and Ira J. Dunkel, Memorial Sloan Kettering Cancer Center; Jennifer S. Ford, Charles A. Sklar, David H. Abramson, and Ira J. Dunkel, Weill-Cornell Medical College, New York, NY; Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; and Ruth A. Kleinerman, National Cancer Institute, Bethesda, MD
| | - Ira J Dunkel
- Jennifer S. Ford, Joanne F. Chou, Charles A. Sklar, Kevin C. Oeffinger, Danielle Novetsky Friedman, Mary McCabe, Yuelin Li, Brian P. Marr, David H. Abramson, and Ira J. Dunkel, Memorial Sloan Kettering Cancer Center; Jennifer S. Ford, Charles A. Sklar, David H. Abramson, and Ira J. Dunkel, Weill-Cornell Medical College, New York, NY; Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; and Ruth A. Kleinerman, National Cancer Institute, Bethesda, MD
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Barriers prevent patient access to personalized therapies identified by molecular tumor profiling of gynecologic malignancies. J Pers Med 2015; 5:165-73. [PMID: 26011384 PMCID: PMC4493494 DOI: 10.3390/jpm5020165] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2015] [Accepted: 05/14/2015] [Indexed: 12/27/2022] Open
Abstract
Objective. This study was designed to evaluate the ability of commercial molecular tumor profiling to discover actionable mutations and to identify barriers that might prevent patient access to personalized therapies. Methods. We conducted an IRB-approved retrospective review of 26 patients with gynecologic malignancies who underwent commercial tumor profiling at our institution during the first 18 months of test availability. Tumor profiles reported targeted therapies and clinical trials matched to patient-specific mutations. Data analysis consisted of descriptive statistics. Results. Most patients who underwent tumor profiling had serous epithelial ovarian, primary peritoneal, or fallopian tube carcinoma (46%). Patients underwent profiling after undergoing a median of two systemic therapies (range 0 to 13). A median of one targeted therapy was suggested per patient profile. Tumor profiling identified no clinically actionable mutations for seven patients (27%). Six patients sought insurance approval for a targeted therapy and two were declined (33%). One patient (4%) received a targeted therapy and this was discontinued due to tumor progression. Conclusions. There are formidable barriers to targeted therapy for patients with gynecologic malignancies. These barriers include a dearth of FDA-approved targeted agents for gynecologic malignancies, lack of third party insurance coverage and limited geographic availability of clinical trials.
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Chen I, Hopkins L, Firth B, Boucher J, Singh SS. Incidence of Tissue Morcellation During Surgery for Uterine Sarcoma at a Canadian Academic Centre. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2015; 37:421-425. [DOI: 10.1016/s1701-2163(15)30256-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Francis JH, Abramson DH. Update on Ophthalmic Oncology 2013: Retinoblastoma and Uveal Melanoma. Asia Pac J Ophthalmol (Phila) 2014; 3:241-56. [PMID: 26107765 DOI: 10.1097/apo.0000000000000079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
PURPOSE The aim of this study was to discuss the clinical and translational content of the literature as well as advancement in our knowledge pertaining to retinoblastoma and uveal melanoma that were published from January to December 2013. DESIGN This study is a literature review. METHODS The search terms retinoblastoma and uveal melanoma were used in a MEDLINE literature search. Abstracts were studied, and the most relevant articles were selected for inclusion and further in-depth review. RESULTS In retinoblastoma, fewer eyes are lost because of the expanded use of ophthalmic artery chemosurgery and intravitreal melphalan, and the past year marks a deepening in our understanding of these modalities. Knowledge on the genetic underpinnings of uveal melanoma has broadened to include genes associated with a favorable prognosis. This is accompanied by promising results in the treatment of metastatic uveal melanoma. CONCLUSIONS This past year, there were important advancements in our knowledge of retinoblastoma and uveal melanoma.
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Affiliation(s)
- Jasmine H Francis
- From the Ophthalmic Oncology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
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MacCarthy A, Bayne AM, Brownbill PA, Bunch KJ, Diggens NL, Draper GJ, Hawkins MM, Jenkinson HC, Kingston JE, Stiller CA, Vincent TJ, Murphy MFG. Second and subsequent tumours among 1927 retinoblastoma patients diagnosed in Britain 1951-2004. Br J Cancer 2013; 108:2455-63. [PMID: 23674091 PMCID: PMC3694232 DOI: 10.1038/bjc.2013.228] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background: Retinoblastoma is an eye tumour of childhood that occurs in heritable and non-heritable forms. In the heritable form, there is a predisposition to the development of non-ocular subsequent primary tumours (SPTs). Methods: This study included 1927 retinoblastoma patients diagnosed in Britain from 1951 to 2004. Ascertainment was through the (UK) National Registry of Childhood Tumours; cases were followed-up for the occurrence of SPTs. Standardised incidence ratios (SIRs) were calculated. Results: We identified 169 SPTs in 152 patients. The SIR analysis included 145 SPTs with cancer registrations from the years 1971 to 2009. These tumours occurred in 132 patients: 112 of the 781 heritable and 20 of the 1075 (presumed) non-heritable cases under surveillance at the start of this period developed at least one registered SPT. The SIRs for all tumours combined were 13.7 (95% confidence interval 11.3–16.5) in heritable cases and 1.5 (0.9–2.3) in non-heritable cases. The main types of SPT in the heritable cases were leiomyosarcoma, (31 cases; SIR 1018.7 (692.2–1446.0)), osteosarcoma (26 cases; SIR 444.6 (290.4–651.4)), and skin melanoma (12 cases; SIR 18.6 (9.6–32.4)). Conclusion: The risk of SPTs in heritable retinoblastoma is extremely high. This has important implications for the clinical follow-up and counselling of survivors and their families.
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Affiliation(s)
- A MacCarthy
- Childhood Cancer Research Group, New Richards Building, University of Oxford, Old Road Campus, Headington, Oxford OX3 7LG, UK.
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Abstract
This review article discusses hereditary cancer predisposition syndromes with uterine manifestations. Lynch syndrome accounts for 2% to 3% of endometrial cancers. The identification of endometrial cancer patients at risk for Lynch syndrome is discussed, as are the characteristics of Lynch syndrome-associated endometrial cancer and the screening and prevention options for women at risk for Lynch syndrome-associated endometrial cancer. Endometrial cancer associated with PTEN hamartoma tumor syndrome (also known as Cowden syndrome) is also discussed. HLRCC (hereditary leiomyomatosis and renal cell carcinoma), which has an associated high risk of symptomatic uterine leiomyomas, is reviewed.
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Affiliation(s)
- Molly S Daniels
- Clinical Cancer Genetics Program, Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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Kleinerman RA, Schonfeld SJ, Tucker MA. Sarcomas in hereditary retinoblastoma. Clin Sarcoma Res 2012; 2:15. [PMID: 23036192 PMCID: PMC3499233 DOI: 10.1186/2045-3329-2-15] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2011] [Accepted: 01/23/2012] [Indexed: 12/21/2022] Open
Abstract
Children diagnosed with the hereditary form of retinoblastoma (Rb), a rare eye cancer caused by a germline mutation in the RB1 tumor suppressor gene, have excellent survival, but face an increased risk of bone and soft tissue sarcomas. This predisposition to sarcomas has been attributed to genetic susceptibility due to inactivation of the RB1 gene as well as past radiotherapy for Rb. The majority of bone and soft tissue sarcomas among hereditary Rb survivors occur in the head, within the radiation field, but they also occur outside the radiation field. Sarcomas account for almost half of the second primary cancers in hereditary Rb survivors, but they are very rare following non-hereditary Rb. Sarcomas among hereditary Rb survivors arise at ages similar to the pattern of occurrence in the general population. There has been a trend over the past two decades to replace radiotherapy with chemotherapy and other focal therapies (laser or cryosurgery), and most recently, chemosurgery in order to reduce the incidence of sarcomas and other second cancers in Rb survivors. Given the excellent survival of most Rb patients treated in the past, it is important for survivors, their families and health care providers to be aware of the heightened risk for sarcomas in hereditary patients.
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Affiliation(s)
- Ruth A Kleinerman
- Epidemiology and Biostatistics Program Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 6120 Executive Boulevard, Rockville, MD 20852, USA.
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Saboo SS, Ramaiya N, Jacene H, Rainville I, Diller L, Hornick JL, George S. Synchronous small bowel and atypical primary leiomyosarcoma of inferior vena cava in a patient with RB1 mutation. ACTA ACUST UNITED AC 2012; 39:33-9. [DOI: 10.1007/s00261-012-9904-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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