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Cavalluzzi MM, Viale M, Rotondo NP, Ferraro V, Lentini G. Drug Repositioning for Ovarian Cancer Treatment: An Update. Anticancer Agents Med Chem 2024; 24:637-647. [PMID: 38367265 DOI: 10.2174/0118715206282904240122063914] [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: 10/14/2023] [Revised: 12/28/2023] [Accepted: 01/06/2024] [Indexed: 02/19/2024]
Abstract
Ovarian cancer (OC) is one of the most prevalent malignancies in female reproductive organs, and its 5-year survival is below 45%. Despite the advances in surgical and chemotherapeutic options, OC treatment is still a challenge, and new anticancer agents are urgently needed. Drug repositioning has gained significant attention in drug discovery, representing a smart way to identify new clinical applications for drugs whose human safety and pharmacokinetics have already been established, with great time and cost savings in pharmaceutical development endeavors. This review offers an update on the most promising drugs repurposable for OC treatment and/or prevention.
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Affiliation(s)
| | - Maurizio Viale
- U.O.C. Bioterapie, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Valeria Ferraro
- Department of Pharmacy - Drug Sciences, University of Bari Aldo Moro, Bari, Italy
| | - Giovanni Lentini
- Department of Pharmacy - Drug Sciences, University of Bari Aldo Moro, Bari, Italy
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2
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Ebetino FH, Sun S, Cherian P, Roshandel S, Neighbors JD, Hu E, Dunford JE, Sedghizadeh PP, McKenna CE, Srinivasan V, Boeckman RK, Russell RGG. Bisphosphonates: The role of chemistry in understanding their biological actions and structure-activity relationships, and new directions for their therapeutic use. Bone 2022; 156:116289. [PMID: 34896359 PMCID: PMC11023620 DOI: 10.1016/j.bone.2021.116289] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/16/2021] [Accepted: 12/03/2021] [Indexed: 12/13/2022]
Abstract
The bisphosphonates ((HO)2P(O)CR1R2P(O)(OH)2, BPs) were first shown to inhibit bone resorption in the 1960s, but it was not until 30 years later that a detailed molecular understanding of the relationship between their varied chemical structures and biological activity was elucidated. In the 1990s and 2000s, several potent bisphosphonates containing nitrogen in their R2 side chains (N-BPs) were approved for clinical use including alendronate, risedronate, ibandronate, and zoledronate. These are now mostly generic drugs and remain the leading therapies for several major bone-related diseases, including osteoporosis and skeletal-related events associated with bone metastases. The early development of chemistry in this area was largely empirical and only a few common structural features related to strong binding to calcium phosphate were clear. Attempts to further develop structure-activity relationships to explain more dramatic pharmacological differences in vivo at first appeared inconclusive, and evidence for mechanisms underlying cellular effects on osteoclasts and macrophages only emerged after many years of research. The breakthrough came when the intracellular actions on the osteoclast were first shown for the simpler bisphosphonates, via the in vivo formation of P-C-P derivatives of ATP. The synthesis and biological evaluation of a large number of nitrogen-containing bisphosphonates in the 1980s and 1990s led to the key discovery that the antiresorptive effects of these more complex analogs on osteoclasts result mostly from their potency as inhibitors of the enzyme farnesyl diphosphate synthase (FDPS/FPPS). This key branch-point enzyme in the mevalonate pathway of cholesterol biosynthesis is important for the generation of isoprenoid lipids that are utilized for the post-translational modification of small GTP-binding proteins essential for osteoclast function. Since then, it has become even more clear that the overall pharmacological effects of individual bisphosphonates on bone depend upon two key properties: the affinity for bone mineral and inhibitory effects on biochemical targets within bone cells, in particular FDPS. Detailed enzyme-ligand crystal structure analysis began in the early 2000s and advances in our understanding of the structure-activity relationships, based on interactions with this target within the mevalonate pathway and related enzymes in osteoclasts and other cells have continued to be the focus of research efforts to this day. In addition, while many members of the bisphosphonate drug class share common properties, now it is more clear that chemical modifications to create variations in these properties may allow customization of BPs for different uses. Thus, as the appreciation for new potential opportunities with this drug class grows, new chemistry to allow ready access to an ever-widening variety of bisphosphonates continues to be developed. Potential new uses of the calcium phosphate binding mechanism of bisphosphonates for the targeting of other drugs to the skeleton, and effects discovered on other cellular targets, even at non-skeletal sites, continue to intrigue scientists in this research field.
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Affiliation(s)
- Frank H Ebetino
- BioVinc LLC, 2265 E. Foothill Blvd, Pasadena, CA 91107, USA; Department of Chemistry, University of Rochester, Rochester, NY 14617, USA; Department of Oncology & Metabolism, University of Sheffield, Sheffield, UK.
| | - Shuting Sun
- BioVinc LLC, 2265 E. Foothill Blvd, Pasadena, CA 91107, USA.
| | - Philip Cherian
- BioVinc LLC, 2265 E. Foothill Blvd, Pasadena, CA 91107, USA
| | | | | | - Eric Hu
- BioVinc LLC, 2265 E. Foothill Blvd, Pasadena, CA 91107, USA
| | - James E Dunford
- Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, The Oxford University Institute of Musculoskeletal Sciences, The Botnar Research Centre, Nuffield Orthopaedic Centre, Headington, Oxford OX3 7LD, UK
| | - Parish P Sedghizadeh
- Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA
| | - Charles E McKenna
- Department of Chemistry, University of Southern California, Los Angeles, CA 90089, USA
| | - Venkat Srinivasan
- Department of Chemistry, University of Rochester, Rochester, NY 14617, USA
| | - Robert K Boeckman
- Department of Chemistry, University of Rochester, Rochester, NY 14617, USA
| | - R Graham G Russell
- Department of Oncology & Metabolism, University of Sheffield, Sheffield, UK; Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, The Oxford University Institute of Musculoskeletal Sciences, The Botnar Research Centre, Nuffield Orthopaedic Centre, Headington, Oxford OX3 7LD, UK; Mellanby Centre for Musculoskeletal Research, University of Sheffield, Sheffield, UK
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Abstract
Although endometrial cancer management remains challenging, a deeper understanding of the genetic diversity as well as the drivers of the various pathogenic states of this disease has led to development of divergent management approaches in an effort to improve therapeutic precision in this complex malignancy. This comprehensive review provides an update on the epidemiology, pathophysiology, diagnosis and molecular classification, recent advancements in disease management, as well as important patient quality-of-life considerations and emerging developments in the rapidly evolving therapeutic landscape of endometrial cancers.
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Shaik MS, Nadiveedhi MR, Gundluru M, Katike U, Obulam VSR, Cirandur SR. Efficient catalyst free green synthesis and in vitro antimicrobial, antioxidant and molecular docking studies of α-substituted aromatic/heteroaromatic aminomethylene bisphosphonates. SYNTHETIC COMMUN 2020. [DOI: 10.1080/00397911.2020.1853778] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
| | | | - Mohan Gundluru
- Department of Chemistry, Sri Venkateswara University, Tirupati, A.P, India
- DST–PURSE Centre, Sri Venkateswara University, Tirupati, A.P, India
| | - Umamahesh Katike
- Department of Biochemistry, Sri Venkateswara University, Tirupati, A.P, India
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Li YY, Gao LJ, Zhang YX, Liu SJ, Cheng S, Liu YP, Jia CX. Bisphosphonates and risk of cancers: a systematic review and meta-analysis. Br J Cancer 2020; 123:1570-1581. [PMID: 32901134 PMCID: PMC7652831 DOI: 10.1038/s41416-020-01043-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 07/28/2020] [Accepted: 08/14/2020] [Indexed: 01/02/2023] Open
Abstract
Background It is unclear whether bisphosphonates are associated with risk of cancers. Therefore, this meta-analysis aimed to evaluate the effect of bisphosphonates on overall cancers. Methods A search in Pubmed, Embase, Cochrane Library and Web of Science databases was conducted, from the inception date of each resource to September 26, 2019. The summarised effect estimates with 95% CIs were calculated using a random-effect model. Heterogeneity and publication bias were explored. Results Thirty-four articles were included in this study (4,508,261 participants; 403,196 cases). The results revealed that bisphosphonates significantly decreased the risk of colorectal cancer (RR = 0.89, 95% CI: 0.81–0.98), breast cancer (RR = 0.87, 95% CI: 0.82–0.93) and endometrial cancer (RR = 0.75, 95% CI: 0.61–0.94), but no significant association was observed in all-cause cancer. Furthermore, nitrogen-containing bisphosphonates only had protective effects both on breast cancer (RR = 0.94, 95% CI: 0.90–0.99) and endometrial cancer (RR = 0.70, 95% CI: 0.54–0.92). Non-nitrogen-containing bisphosphonates tended to increase the risk of liver cancer (RR = 2.14, 95% CI: 1.23–3.72) and pancreas cancer (RR = 1.75, 95% CI: 1.32–2.33). Conclusion Bisphosphonates are significantly associated with risk reduction of colorectal, breast and endometrial cancer, especially nitrogen-containing bisphosphonates. It should be noted that non-nitrogen-containing bisphosphonates might increase the risk of liver and pancreas cancer. Large prospective cohort studies are needed to find the causal association between bisphosphonates and risk of cancers.
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Affiliation(s)
- Yuan-Yuan Li
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Li-Jie Gao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yu-Xue Zhang
- Department of Preventive Medicine, Public Health School, Harbin Medical University, Harbin, China
| | - Shu-Juan Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Shuo Cheng
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yu-Peng Liu
- Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China.
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.
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Nunes M, Henriques Abreu M, Bartosch C, Ricardo S. Recycling the Purpose of Old Drugs to Treat Ovarian Cancer. Int J Mol Sci 2020; 21:ijms21207768. [PMID: 33092251 PMCID: PMC7656306 DOI: 10.3390/ijms21207768] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/13/2020] [Accepted: 10/17/2020] [Indexed: 02/07/2023] Open
Abstract
The main challenge in ovarian cancer treatment is the management of recurrences. Facing this scenario, therapy selection is based on multiple factors to define the best treatment sequence. Target therapies, such as bevacizumab and polymerase (PARP) inhibitors, improved patient survival. However, despite their achievements, ovarian cancer survival remains poor; these therapeutic options are highly costly and can be associated with potential side effects. Recently, it has been shown that the combination of repurposed, conventional, chemotherapeutic drugs could be an alternative, presenting good patient outcomes with few side effects and low costs for healthcare institutions. The main aim of this review is to strengthen the importance of repurposed drugs as therapeutic alternatives, and to propose an in vitro model to assess the therapeutic value. Herein, we compiled the current knowledge on the most promising non-oncological drugs for ovarian cancer treatment, focusing on statins, metformin, bisphosphonates, ivermectin, itraconazole, and ritonavir. We discuss the primary drug use, anticancer mechanisms, and applicability in ovarian cancer. Finally, we propose the use of these therapies to perform drug efficacy tests in ovarian cancer ex vivo cultures. This personalized testing approach could be crucial to validate the existing evidences supporting the use of repurposed drugs for ovarian cancer treatment.
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Affiliation(s)
- Mariana Nunes
- Differentiation and Cancer Group, Institute for Research and Innovation in Health (i3S) of the University of Porto/Institute of Molecular Pathology and Immunology of the University of Porto (Ipatimup), 4200-135 Porto, Portugal;
- Porto Comprehensive Cancer Center (PCCC), 4200-162 Porto, Portugal; (M.H.A.); (C.B.)
| | - Miguel Henriques Abreu
- Porto Comprehensive Cancer Center (PCCC), 4200-162 Porto, Portugal; (M.H.A.); (C.B.)
- Department of Medical Oncology, Portuguese Oncology Institute of Porto (IPOP), 4200-162 Porto, Portugal
| | - Carla Bartosch
- Porto Comprehensive Cancer Center (PCCC), 4200-162 Porto, Portugal; (M.H.A.); (C.B.)
- Department of Pathology, Portuguese Oncology Institute of Porto (IPOP), 4200-162 Porto, Portugal
- Cancer Biology & Epigenetics Group, Research Center—Portuguese Oncology Institute of Porto (CI-IPOP), 4200-162 Porto, Portugal
| | - Sara Ricardo
- Differentiation and Cancer Group, Institute for Research and Innovation in Health (i3S) of the University of Porto/Institute of Molecular Pathology and Immunology of the University of Porto (Ipatimup), 4200-135 Porto, Portugal;
- Porto Comprehensive Cancer Center (PCCC), 4200-162 Porto, Portugal; (M.H.A.); (C.B.)
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Department of Sciences, University Institute of Health Sciences (IUCS), CESPU, CRL, 4585-116 Gandra, Portugal
- Correspondence: ; Tel.: +351-225-570-700
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Göbel A, Zinna VM, Dell'Endice S, Jaschke N, Kuhlmann JD, Wimberger P, Rachner TD. Anti-tumor effects of mevalonate pathway inhibition in ovarian cancer. BMC Cancer 2020; 20:703. [PMID: 32727400 PMCID: PMC7388525 DOI: 10.1186/s12885-020-07164-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 07/10/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Ovarian cancer remains the most fatal gynecological malignancy. Current therapeutic options are limited due to late diagnosis in the majority of the cases, metastatic spread to the peritoneal cavity and the onset of chemo-resistance. Thus, novel therapeutic approaches are required. Statins and amino-bisphosphonates are inhibitors of the mevalonate pathway, which is a fundamental pathway of cellular metabolism, essential for cholesterol production and posttranslational protein farnesylation and geranylgeranylation. While this pathway has emerged as a promising treatment target in several human malignancies, its potential as a therapeutic approach in ovarian cancer is still not fully understood. METHODS Human ovarian cancer cell lines (IGROV-1, A2780, A2780cis) were treated with increasing concentrations (0.5-100 μM) of statins (simvastatin, atorvastatin, rosuvastatin) and zoledronic acid. Effects on cell vitality and apoptosis were assessed using Cell Titer Blue®, Caspase 3/7 Glo®, clonogenic assays as well as cleaved poly (ADP-ribose) polymerase (cPARP) detection. The inhibition of the mevalonate pathway was confirmed using Western Blot of unprenylated Ras and Rap1a proteins. Quantitative real-time PCR and ELISA were used to analyze modulations on several key regulators of ovarian cancer tumorigenesis. RESULTS The treatment of IGROV-1 and A2780 cells with statins and zoledronic acid reduced vitality (by up to 80%; p < 0.001) and induced apoptosis by up to 8-folds (p < 0.001) in a dose-dependent fashion. Rescue experiments using farnesyl pyrophosphate or geranylgeranyl pyrophosphate evidenced that blocked geranylgeranylation is the major underlying mechanism of the pro-apoptotic effects. Gene expression of the tumor-promoting cytokines and mediators, such as transforming growth factor (TGF)-β1, vascular endothelial growth factor (VEGF), interleukin (IL)-8, and IL-6 were significantly suppressed by statins and zoledronic acid by up to 90% (p < 0.001). For all readouts, simvastatin was most potent of all agents used. Cisplatin-resistant A2780cis cells showed a relative resistance to statins and zoledronic acid. However, similar to the effects in A2780 cells, simvastatin and zoledronic acid significantly induced caspase 3/7 activation (6-folds; p < 0.001). CONCLUSION Our in vitro findings point to promising anti-tumor effects of statins and zoledronic acid in ovarian cancer and warrant additional validation in preclinical and clinical settings.
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Affiliation(s)
- Andy Göbel
- Division of Endocrinology, Diabetes, and Bone Diseases, Department of Medicine III, Technische Universität, Fetscherstraße 74, 01307, Dresden, Germany.
- German Cancer Consortium (DKTK), Partner Site Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Valentina M Zinna
- Institute for Research in Biomedicine (IRB Barcelona), Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Stefania Dell'Endice
- Division of Endocrinology, Diabetes, and Bone Diseases, Department of Medicine III, Technische Universität, Fetscherstraße 74, 01307, Dresden, Germany
| | - Nikolai Jaschke
- Division of Endocrinology, Diabetes, and Bone Diseases, Department of Medicine III, Technische Universität, Fetscherstraße 74, 01307, Dresden, Germany
- Center for Healthy Aging, Technische Universität Dresden, Dresden, Germany
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology and Metabolism, Medical University of Innsbruck, Innsbruck, Austria
| | - Jan Dominik Kuhlmann
- German Cancer Consortium (DKTK), Partner Site Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Gynecology and Obstetrics, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- National Center for Tumor Diseases (NCT), Dresden, Germany: German Cancer Research Center (DKFZ), Heidelberg, Germany; Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Helmholtz-Zentrum Dresden - Rossendorf (HZDR), Dresden, Germany
| | - Pauline Wimberger
- German Cancer Consortium (DKTK), Partner Site Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Gynecology and Obstetrics, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- National Center for Tumor Diseases (NCT), Dresden, Germany: German Cancer Research Center (DKFZ), Heidelberg, Germany; Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Helmholtz-Zentrum Dresden - Rossendorf (HZDR), Dresden, Germany
| | - Tilman D Rachner
- Division of Endocrinology, Diabetes, and Bone Diseases, Department of Medicine III, Technische Universität, Fetscherstraße 74, 01307, Dresden, Germany
- German Cancer Consortium (DKTK), Partner Site Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Center for Healthy Aging, Technische Universität Dresden, Dresden, Germany
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8
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Tao MH, Chen S, Freudenheim JL, Cauley JA, Johnson KC, Mai X, Sarto GE, Wakelee H, Boffetta P, Wactawski-Wende J. Oral bisphosphonate use and lung cancer incidence among postmenopausal women. Ann Oncol 2019; 29:1476-1485. [PMID: 29617712 PMCID: PMC6005043 DOI: 10.1093/annonc/mdy097] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background Bisphosphonates are common medications for the treatment of osteoporosis in older populations. Several studies, including the Women’s Health Initiative (WHI), have found inverse associations of bisphosphonate use with risk of breast and endometrial cancer, but little is known about its association with other common malignancies. The objective of this study was to evaluate the association of bisphosphonate use on the incidence of lung cancer in the WHI. Patients and methods The association between oral bisphosphonate use and lung cancer risk was examined in 151 432 postmenopausal women enrolled into the WHI in 1993–1998. At baseline and during follow-up, participants completed an inventory of regularly used medications including bisphosphonates. Results After a mean follow-up of 13.3 years, 2511 women were diagnosed with incident lung cancer. There was no evidence of a difference in lung cancer incidence between oral bisphosphonate users and never users (adjusted hazard ratio = 0.91; 95% confidence intervals, 0.80–1.04; P = 0.16). However, an inverse association was observed among those who were never smokers (hazard ratio = 0.57, 95% confidence interval, 0.39–0.84; P < 0.01). Conclusion In this large prospective cohort of postmenopausal women, oral bisphosphonate use was associated with significantly lower lung cancer risk among never smokers, suggesting bisphosphonates may have a protective effect against lung cancer. Additional studies are needed to confirm our findings.
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Affiliation(s)
- M H Tao
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, USA.
| | - S Chen
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, USA
| | - J L Freudenheim
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, USA
| | - J A Cauley
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, USA
| | - K C Johnson
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, USA
| | - X Mai
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, USA
| | - G E Sarto
- Department of Obstetrics and Gynecology, University of Wisconsin, Madison, USA
| | - H Wakelee
- Division of Oncology, Department of Medicine, Stanford University and Stanford Cancer Institute, Stanford, USA
| | - P Boffetta
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, USA
| | - J Wactawski-Wende
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, USA
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Wakinoue S, Chano T, Amano T, Isono T, Kimura F, Kushima R, Murakami T. ADP-ribosylation factor-like 4C predicts worse prognosis in endometriosis-associated ovarian cancers. Cancer Biomark 2019; 24:223-229. [PMID: 30594917 DOI: 10.3233/cbm-181836] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Endometrioid ovarian carcinoma and clear cell ovarian carcinoma are both classified as endometriosis-associated ovarian cancer (EAOC). Despite the high rates of recurrence and mortality of EAOC, no prognostic biomarkers have been determined. ADP-ribosylation factor-like protein 4C (ARL4C) has been reported to be involved in various tumor progression processes, but its clinical significance for predicting prognosis in EAOC cases has never been studied. OBJECTIVE The present study aimed to determine the clinical significance of ARL4C expression in EAOC prognosis. METHODS ARL4C expression was semi-quantitatively evaluated via immunohistochemistry in 61 EAOC patients, and the correlations between ARL4C expression and clinicopathological data and survival were statistically analyzed. RESULTS Thirty-six (59%) cases had high levels of ARL4C, which was related to worse 5-year overall survival (OS) (log-rank test, p= 0.036). In multivariate Cox proportional hazard model, high ARL4C expression was a significantly independent predictive factor for worse 5-year OS (hazard ratio = 12.048, p= 0.0201) and 5-year PFS (hazard ratio = 8.130, p= 0.0036). CONCLUSIONS ARL4C is a biomarker for worse prognosis and a novel therapeutic target in EAOC.
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Affiliation(s)
- Shiro Wakinoue
- Department of Obstetrics and Gynecology, Shiga University of Medical Science, Shiga 520 2192, Japan
| | - Tokuhiro Chano
- Department of Clinical Laboratory Medicine, Shiga University of Medical Science, Shiga 520 2192, Japan
| | - Tsukuru Amano
- Department of Obstetrics and Gynecology, Shiga University of Medical Science, Shiga 520 2192, Japan
| | - Takahiro Isono
- Central Research Laboratory, Shiga University of Medical Science, Shiga 520 2192, Japan
| | - Fuminori Kimura
- Department of Obstetrics and Gynecology, Shiga University of Medical Science, Shiga 520 2192, Japan
| | - Ryoji Kushima
- Department of Clinical Laboratory Medicine, Shiga University of Medical Science, Shiga 520 2192, Japan
| | - Takashi Murakami
- Department of Obstetrics and Gynecology, Shiga University of Medical Science, Shiga 520 2192, Japan
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10
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Wang Y, Ren F, Song Z, Chen P, Liu S, Ouyang L. Statin use and the risk of ovarian and endometrial cancers: a meta-analysis. BMC Cancer 2019; 19:730. [PMID: 31340777 PMCID: PMC6657066 DOI: 10.1186/s12885-019-5954-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 07/18/2019] [Indexed: 02/07/2023] Open
Abstract
Background The relationship between statin use and the risk of ovarian or endometrial cancer remains controversial. Here, we investigated the relationship between statin use and the risk of ovarian and endometrial cancers. Methods We conducted a meta-analysis using articles retrieved from the PubMed, Embase, and Web of Science databases. All original comparative studies published in English that were related to statin use and the risk of ovarian or endometrial cancer were included. Results This meta-analysis included 19 studies enrolling 1,999,362 female subjects and 19,849 cancer cases (7,948 ovarian cancer cases and 11,901 endometrial cancer cases). The overall analysis indicated that statin use did not significantly reduce the risk of ovarian cancer [relative risk (RR) = 0.88, 95% confidence interval (CI) 0.76–1.03, p = 0.12] or the risk of endometrial cancer (RR = 0.88, 95% CI 0.78–1.00, p = 0.05.) Subgroup analyses based on study type, percentage of cancer cases, study location, and quality of studies also supported our conclusions. No association was found between long-term statin use (> 5 years) and the risk of ovarian cancer (RR = 0.73, 95% CI 0.51–1.04, p = 0.08) or endometrial cancer (RR = 0.79, 95% CI 0.58–1.08, p = 0.14). Conclusions Statin use did not lower the risk of ovarian cancer or endometrial cancer. The long-term use of statins (> 5 years) was not associated with a reduction in the risk of ovarian or endometrial cancer. Electronic supplementary material The online version of this article (10.1186/s12885-019-5954-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yizi Wang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Fang Ren
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Zixuan Song
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Peng Chen
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Shuang Liu
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Ling Ouyang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China.
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11
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Oral bisphosphonate use and the risk of female breast, ovarian, and cervical cancer: a nationwide population-based cohort study. Arch Osteoporos 2019; 14:41. [PMID: 30888545 DOI: 10.1007/s11657-019-0588-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 03/04/2019] [Indexed: 02/03/2023]
Abstract
UNLABELLED Bisphosphonate use was not associated with the risk of female breast, ovarian, or cervical cancer. The results according to bisphosphonate type or concurrent drug uses were not associated with the cancer risk. The protective effect of bisphosphonate use on female breast cancer was significant in the low comorbidity group. PURPOSE Despite the antitumor mechanisms, the effect of bisphosphonates on the risk of cancer is still unclear. We investigated the association between oral bisphosphonate use and the development of female breast, ovarian, and cervical cancer. METHODS We accomplished a population-based cohort study using the National Health Insurance Services (NHIS) database. A total of 204,525 participants were included in a cohort, and we identified the incident cases of each cancer from 2007 to 2013. We assessed cumulative bisphosphonate exposure from 2003 to 2006 using the defined daily dose (DDD) system. Hazard ratios (HRs) and their 95% confidence intervals (CIs) were presented to assess the association between bisphosphonate use and cancer incidence using multivariate Cox proportional hazard regression models. Subgroup analyses were performed to assess cancer development according to risk factors and concurrent drug use. RESULTS There was a total of 1547, 266, and 370 incident cases of female breast, cervical, and ovarian cancer, respectively, during the study period of 1,367,294 person-years. Bisphosphonate exposure was not significantly associated with risk of female breast (adjusted HR (aHR), 0.78; 95% CI, 0.60-1.02), ovarian (aHR, 1.30; 95% CI, 0.82-2.07), nor cervical cancer (aHR, 0.70; 95% CI, 0.44-1.12). Further subgroup analyses also revealed no statistically significant effects of bisphosphonate use with various risk factors and concurrent drug use. CONCLUSIONS Our study showed no significant associations between bisphosphonate exposure and female breast, cervical, and ovarian cancer. In the future, large prospective studies or a meta-analysis would be needed to verify the associations.
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Wen DT, Xu Z, Xuan ML, Liang GR, Zheng WL, Liang XF, Xiao J, Wang XY. Prognostic Effect of Bisphosphonate Exposure for Patients With Diagnosed Solid Cancer: A Systematic Review With Meta-Analysis of Observational Studies. Front Oncol 2018; 8:495. [PMID: 30420942 PMCID: PMC6215818 DOI: 10.3389/fonc.2018.00495] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 10/11/2018] [Indexed: 01/04/2023] Open
Abstract
Background: Bisphosphonates are widely prescribed for the prevention and treatment of osteoporosis. Recent epidemiological studies indicate that people with bisphosphonate use may have lower cancer risk and have improved survival. The aim of this study is to determine the association between bisphosphonate use and survival outcomes in solid cancer patients using systematic review and meta-analysis. Methods: A systematic literature search was performed using the PubMed, Embase, and Cochrane databases. Original articles published until April, 2018 were selected. The survival outcome measures assessed included overall survival (OS), cancer-specific survival (CSS) and recurrence-free survival (RFS). Pooled hazard ratio (HR) and their 95% confidence interval (95% CI) were derived using a random-effects model. Results: Out of 9,742 retrieved citations, six cohort studies and two nested case-control studies satisfying the inclusion criteria were included for analyses. Bisphosphonate use was significantly associated with improved OS (HR 0.84, 95% CI 0.76–0.93), CSS (HR 0.73, 95% CI 0.58–0.90) and RFS (HR 0.72, 95% CI 0.53–0.96). The results of subgroup analyses stratified by major study characteristics were generally consistent with the main findings. For individual cancer type, we found that bisphosphonate use was significantly associated with longer OS for patients with gastroesophageal cancer (HR 0.62, 95% CI 0.40–0.98), as well as longer CSS for patients with breast cancer (HR 0.73, 95% CI 0.55–0.95). Conclusions: Current evidence indicates that bisphosphonate use is significantly associated with improved survival for patients with solid cancer. However, the prognostic effects in specific solid tumors remains to be confirmed by further large prospective cohort studies.
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Affiliation(s)
- Dan-Ting Wen
- Department of Gynecology, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.,Postdoctoral Research Station, Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Gynecology, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Zheng Xu
- General Office of Multiple Functional Chinese Medications, Bao'an TCM Hospital Group, Shenzhen, China
| | - Mei-Ling Xuan
- Department of Gynecology, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Guo-Rong Liang
- Department of Gynecology, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Wei-Ling Zheng
- Department of Gynecology, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xue-Fang Liang
- Department of Gynecology, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Jing Xiao
- Department of Gynecology, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Xiao-Yun Wang
- Department of Gynecology, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
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Akinwunmi B, Vitonis AF, Titus L, Terry KL, Cramer DW. Statin therapy and association with ovarian cancer risk in the New England Case Control (NEC) study. Int J Cancer 2018; 144:991-1000. [PMID: 30006925 DOI: 10.1002/ijc.31758] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 06/25/2018] [Accepted: 07/04/2018] [Indexed: 12/17/2022]
Abstract
Statins are widely used to lower blood cholesterol and reduce risk for cardiovascular diseases, but attention has recently focused on a role in cancer prevention or therapy. Here we present data from a large case-control study addressing whether statin use can lower the risk for epithelial ovarian cancer (EOC). Between 1992 and 2008, data including medications used for at least 6 months were collected from 2,040 cases with EOC and 2,100 frequency-matched controls without the disease who participated in the New England Case Control study. We used unconditional logistic regression controlling for matching factors and potential confounders to examine the association between statin use and the risk for EOC. Overall, women who used statins had 32% lower risk of ovarian cancer compared to non-users (Odds ratio (OR) 0.68, 95% Confidence Interval (CI): 0.54-0.85), adjusting for the matching factors and other covariates. The reduced risk was most apparent in women taking a lipophilic statin who began use after age 49, and who had used them 2-4.9 years. Statin use was associated with lower risks for both serous and non-serous histologic subtypes with the strongest effect seen for mucinous and mixed epithelial subtypes. The association became apparent about a decade after the introduction of statins and did not appear to be confounded by indications for use of statins or medications used concomitantly. In this case-control study, statins were found to lower the risk for both serous and non-serous EOC and especially mucinous EOC.
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Affiliation(s)
- Babatunde Akinwunmi
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Boston, MA.,Department of Global Education, Harvard Medical School, Boston, MA
| | - Allison F Vitonis
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Boston, MA
| | - Linda Titus
- Departments of Epidemiology and Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH
| | - Kathryn L Terry
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Boston, MA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, MA
| | - Daniel W Cramer
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Boston, MA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, MA
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14
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Zhang XS, Zhang YM, Li B, Fan B, Zhao Y, Yang SJ. Risk reduction of endometrial and ovarian cancer after bisphosphonates use: A meta-analysis. Gynecol Oncol 2018; 150:509-514. [PMID: 29960711 DOI: 10.1016/j.ygyno.2018.06.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 06/06/2018] [Accepted: 06/07/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Recent epidemiological studies have investigated the associations between the use of bisphosphonates and the development of endometrial cancer and ovarian cancer; these studies have shown controversial results. Hence, this meta-analysis was conducted to evaluate the changes in the risks of developing endometrial and ovarian cancers after using bisphosphonates based on current evidence. METHODS A comprehensive search was performed in the MEDLINE, EMBASE, and Web of Science databases through January 2017. The summary relative risk (RR) estimates for the effects of the use of bisphosphonates on the risks of developing endometrial and ovarian cancers were calculated using a random-effects model. RESULTS Seven studies were included with a total of 6471 endometrial cancer cases (7 studies with 213,920 participants) and 6783 ovarian cancer cases (4 studies with 105,507 participants). This meta-analysis suggested that any use of bisphosphonates was associated with a significant 27% reduction in the risk of endometrial cancer (RR = 0.73, 95% CI: 0.58-0.93, P = 0.012), but the reduction in the risk of ovarian cancer (RR = 0.81, 95% CI: 0.58-1.14, P = 0.227) was not significant. The protective effects of the use of bisphosphonates against endometrial cancer are mainly found in postmenopausal women (RR = 0.53, 95% CI: 0.34-0.93, P = 0.012) or in those who have taken bisphosphonates for longer than 1 year (RR = 0.57, 95% CI: 0.35-0.93, P = 0.024). CONCLUSION This meta-analysis suggests that the use of bisphosphonates is associated with a reduction in the risk of endometrial cancer but not ovarian cancer.
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Affiliation(s)
- Xiao-San Zhang
- Department of Internal Medicine, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan 450008, China
| | - Yi-Ming Zhang
- Department of Internal Medicine, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan 450008, China
| | - Bin Li
- Department of Internal Medicine, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan 450008, China
| | - Bo Fan
- Department of Internal Medicine, Luoshan County Traditional Chinese Medicine Hospital, Luoshan County, Xinyang, Henan 464200, China
| | - Yan Zhao
- Department of Internal Medicine, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan 450008, China
| | - Shu-Jun Yang
- Department of Internal Medicine, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan 450008, China.
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15
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Li X, Zhou J. Impact of postdiagnostic statin use on ovarian cancer mortality: A systematic review and meta-analysis of observational studies. Br J Clin Pharmacol 2018; 84:1109-1120. [PMID: 29453799 DOI: 10.1111/bcp.13559] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 02/06/2018] [Accepted: 02/07/2018] [Indexed: 12/15/2022] Open
Abstract
AIMS To comprehensively evaluate the association between postdiagnostic statin use and mortality of ovarian cancer (OC) patients. METHODS Using a comprehensive strategy, multiple databases (Medline, Embase and Web of Science) were systematically searched to identify observational studies that examined the correlation between statin use and OC mortality up to 31 December 2017. The studies were independently reviewed and selected based on predetermined selection criteria. Data were extracted independently and in duplicate. The risk of bias was evaluated with the Newcastle-Ottawa scale. Hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality were summarized with a profile likelihood random effects model. RESULTS Of 269 studies, eight cohort studies of 19 904 OC patients met the inclusion criteria. Postdiagnostic statin use was inversely associated with all-cause mortality/overall survival (summarized HR = 0.74; 95%CI = 0.63-0.87; I2 = 55%; n = 7) and cancer-specific mortality (summarized HR = 0.87; 95%CI = 0.80-0.95; I2 = 0%; n = 3) of OC patients. These findings were consistent by subgroup analyses stratified by study and patient characteristics as well as adjustments made for potential confounders. A meta-regression analysis found no effect of modification by these variables. Of note, similar significant inverse effects were also observed when increasing the intensity (highest vs. lowest) of postdiagnostic statin use (summarized HR = 0.84; 95%CI = 0.74-0.96; I2 = 0%; n = 3). CONCLUSION Postdiagnostic statin use can improve the survival of patients with OC. Further prospective cohort and randomized controlled trials are warranted to confirm the therapeutic role of statin use on the outcome of OC.
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Affiliation(s)
- Xia Li
- Department of Gynecology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jing Zhou
- Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, China
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Abdullah MI, Abed MN, Richardson A. Inhibition of the mevalonate pathway augments the activity of pitavastatin against ovarian cancer cells. Sci Rep 2017; 7:8090. [PMID: 28808351 PMCID: PMC5556066 DOI: 10.1038/s41598-017-08649-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 07/11/2017] [Indexed: 11/29/2022] Open
Abstract
Only 40% of patients with advanced ovarian cancer survive more than 5 years. We have previously shown that pitavastatin induces regression of ovarian cancer xenografts in mice. To evaluate whether the response of ovarian cancer cells to pitavastatin is potentiated by farnesyl diphosphate synthase inhibitors or geranylgeraniol transferase I inhibitors, we evaluated combinations of pitavastatin with zoledronic acid, risedronate and GGTI-2133 in a panel of ovarian cancer cells. Pitavastatin (IC50 = 0.6–14 μM), zoledronic acid (IC50 = 21–57 μM), risedronate (IC50 > 100 μM) or GGTI-2133 (IC50 > 25 μM) inhibited the growth of ovarian cancer cell cultures. Combinations of pitavastatin with zoledronic acid displayed additive or synergistic effects in cell growth assays in 10 of 11 cell lines evaluated as well as in trypan blue exclusion, cellular ATP or caspase 3/7, 8 and 9 assays. Pitavastatin reduced levels of GGT-IIβ and the membrane localization of several small GTPases and this was potentiated by zoledronic acid. siRNA to GGT-Iβ and GGT-IIβ used in combination, but not when used individually, significantly increased the sensitivity of cells to pitavastatin. These data suggest that zoledronic acid, a drug already in clinical use, may be usefully combined with pitavastatin in the treatment of ovarian cancer.
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Affiliation(s)
- Marwan Ibrahim Abdullah
- Institute for Science and Technology in Medicine, Guy Hilton Research Centre, Keele University, Thornborrow Drive, Stoke-on-Trent, UK
| | - Mohammed Najim Abed
- Institute for Science and Technology in Medicine, Guy Hilton Research Centre, Keele University, Thornborrow Drive, Stoke-on-Trent, UK
| | - Alan Richardson
- Institute for Science and Technology in Medicine, Guy Hilton Research Centre, Keele University, Thornborrow Drive, Stoke-on-Trent, UK. .,School of Pharmacy, Keele University, Keele, United Kingdom.
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Ou YJ, Chiu HF, Wong YH, Yang YH. Bisphosphonate use and the risk of endometrial cancer: a meta-analysis of observational studies. Pharmacoepidemiol Drug Saf 2016; 25:1107-1115. [DOI: 10.1002/pds.4075] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 07/05/2016] [Accepted: 07/08/2016] [Indexed: 12/27/2022]
Affiliation(s)
- Ying-Ju Ou
- School of Pharmacy, College of Pharmacy; Kaohsiung Medical University; Kaohsiung Taiwan
- Department of Pharmacy; Kaohsiung Medical University Hospital; Kaohsiung Taiwan
| | - Hui-Fen Chiu
- Graduate Institute of Medicine; College of Medicine, Kaohsiung Medical University; Kaohsiung Taiwan
- Department of Pharmacology; College of Medicine, Kaohsiung Medical University; Kaohsiung Taiwan
| | - Yun-Hong Wong
- Graduate Institute of Medicine; College of Medicine, Kaohsiung Medical University; Kaohsiung Taiwan
| | - Yi-Hsin Yang
- School of Pharmacy, College of Pharmacy; Kaohsiung Medical University; Kaohsiung Taiwan
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Abstract
Background:
Bisphosphonates are drugs commonly used for the medication and prevention of diseases caused by decreased mineral density. Despite such important medicinal use, they display a variety of physiologic activities, which make them promising anti-cancer, anti-protozoal, antibacterial and antiviral agents.
Objective:
To review physiological activity of bisphosphonates with special emphasis on their ongoing and potential applications in medicine and agriculture.
Method:
Critical review of recent literature data.
Results:
Comprehensive review of activities revealed by bisphosphonates.
Conclusion:
although bisphosphonates are mostly recognized by their profound effects on bone physiology their medicinal potential has not been fully evaluated yet. Literature data considering enzyme inhibition suggest possibilities of far more wide application of these compounds. These applications are, however, limited by their low bioavailability and therefore intensive search for new chemical entities overcoming this shortage are carried out.
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19
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Tomao F, Colombo N, Panici B. Is Endometrial Cancer Risk Reduced by Oral Bisphosphonate Use? J Clin Oncol 2015; 33:3670. [PMID: 26282662 DOI: 10.1200/jco.2015.62.0930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Affiliation(s)
- Federica Tomao
- European Institute of Oncology, Milan; and University of Rome Sapienza, Rome, Italy
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20
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Ruckhäberle E. Orale Bisphosphonate senken möglicherweise die Inzidenz von postmenopausalen Korpuskarzinomen. Strahlenther Onkol 2015. [DOI: 10.1007/s00066-015-0871-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Newcomb PA, Passarelli MN, Phipps AI, Anderson GL, Wactawski-Wende J, Ho GYF, O'Sullivan MJ, Chlebowski RT. Oral bisphosphonate use and risk of postmenopausal endometrial cancer. J Clin Oncol 2015; 33:1186-90. [PMID: 25713431 DOI: 10.1200/jco.2014.58.6842] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
PURPOSE Bisphosphonates are common medications used for the treatment of osteoporosis and are also used to reduce metastases to bone in patients with cancer. Several studies, including the Women's Health Initiative (WHI), have found that use of bisphosphonates is associated with reduced risk of developing breast cancer, but less is known about associations with other common malignancies. This study was aimed at examining the effects of bisphosphonates on the risk of endometrial cancer. METHODS We evaluated the relationship between use of oral bisphosphonates and endometrial cancer risk in a cohort of 89,918 postmenopausal women participating in the WHI. A detailed health interview was conducted at baseline, and bisphosphonate use was ascertained from an inventory of regularly used medications at baseline and over follow-up. All women had an intact uterus at the time of study entry. RESULTS During a median follow-up of 12.5 years, 1,123 women were diagnosed with incident invasive endometrial cancer. Ever use of bisphosphonates was associated with reduced endometrial cancer risk (adjusted hazard ratio, 0.80; 95% CI, 0.64 to 1.00; P = .05), with no interactions observed with age, body mass index, or indication for use. CONCLUSION In this large prospective cohort of postmenopausal women, bisphosphonate use was associated with a statistically significant reduction in endometrial cancer risk.
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Affiliation(s)
- Polly A Newcomb
- Polly A. Newcomb, Michael N. Passarelli, Amanda I. Phipps, and Garnet L. Anderson, Fred Hutchinson Cancer Research Center; Polly A. Newcomb, Michael N. Passarelli, Amanda I. Phipps, and Garnet L. Anderson, School of Public Health, University of Washington, Seattle, WA; Jean Wactawski-Wende, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo; Gloria Y.F. Ho, Albert Einstein College of Medicine, Bronx, NY; Mary Jo O'Sullivan, University of Miami, Miami, FL; and Rowan T. Chlebowski, Los Angeles Biomedical Research Institute at Harbor-University of California Los Angeles Medical Center, Torrance, CA.
| | - Michael N Passarelli
- Polly A. Newcomb, Michael N. Passarelli, Amanda I. Phipps, and Garnet L. Anderson, Fred Hutchinson Cancer Research Center; Polly A. Newcomb, Michael N. Passarelli, Amanda I. Phipps, and Garnet L. Anderson, School of Public Health, University of Washington, Seattle, WA; Jean Wactawski-Wende, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo; Gloria Y.F. Ho, Albert Einstein College of Medicine, Bronx, NY; Mary Jo O'Sullivan, University of Miami, Miami, FL; and Rowan T. Chlebowski, Los Angeles Biomedical Research Institute at Harbor-University of California Los Angeles Medical Center, Torrance, CA
| | - Amanda I Phipps
- Polly A. Newcomb, Michael N. Passarelli, Amanda I. Phipps, and Garnet L. Anderson, Fred Hutchinson Cancer Research Center; Polly A. Newcomb, Michael N. Passarelli, Amanda I. Phipps, and Garnet L. Anderson, School of Public Health, University of Washington, Seattle, WA; Jean Wactawski-Wende, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo; Gloria Y.F. Ho, Albert Einstein College of Medicine, Bronx, NY; Mary Jo O'Sullivan, University of Miami, Miami, FL; and Rowan T. Chlebowski, Los Angeles Biomedical Research Institute at Harbor-University of California Los Angeles Medical Center, Torrance, CA
| | - Garnet L Anderson
- Polly A. Newcomb, Michael N. Passarelli, Amanda I. Phipps, and Garnet L. Anderson, Fred Hutchinson Cancer Research Center; Polly A. Newcomb, Michael N. Passarelli, Amanda I. Phipps, and Garnet L. Anderson, School of Public Health, University of Washington, Seattle, WA; Jean Wactawski-Wende, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo; Gloria Y.F. Ho, Albert Einstein College of Medicine, Bronx, NY; Mary Jo O'Sullivan, University of Miami, Miami, FL; and Rowan T. Chlebowski, Los Angeles Biomedical Research Institute at Harbor-University of California Los Angeles Medical Center, Torrance, CA
| | - Jean Wactawski-Wende
- Polly A. Newcomb, Michael N. Passarelli, Amanda I. Phipps, and Garnet L. Anderson, Fred Hutchinson Cancer Research Center; Polly A. Newcomb, Michael N. Passarelli, Amanda I. Phipps, and Garnet L. Anderson, School of Public Health, University of Washington, Seattle, WA; Jean Wactawski-Wende, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo; Gloria Y.F. Ho, Albert Einstein College of Medicine, Bronx, NY; Mary Jo O'Sullivan, University of Miami, Miami, FL; and Rowan T. Chlebowski, Los Angeles Biomedical Research Institute at Harbor-University of California Los Angeles Medical Center, Torrance, CA
| | - Gloria Y F Ho
- Polly A. Newcomb, Michael N. Passarelli, Amanda I. Phipps, and Garnet L. Anderson, Fred Hutchinson Cancer Research Center; Polly A. Newcomb, Michael N. Passarelli, Amanda I. Phipps, and Garnet L. Anderson, School of Public Health, University of Washington, Seattle, WA; Jean Wactawski-Wende, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo; Gloria Y.F. Ho, Albert Einstein College of Medicine, Bronx, NY; Mary Jo O'Sullivan, University of Miami, Miami, FL; and Rowan T. Chlebowski, Los Angeles Biomedical Research Institute at Harbor-University of California Los Angeles Medical Center, Torrance, CA
| | - Mary Jo O'Sullivan
- Polly A. Newcomb, Michael N. Passarelli, Amanda I. Phipps, and Garnet L. Anderson, Fred Hutchinson Cancer Research Center; Polly A. Newcomb, Michael N. Passarelli, Amanda I. Phipps, and Garnet L. Anderson, School of Public Health, University of Washington, Seattle, WA; Jean Wactawski-Wende, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo; Gloria Y.F. Ho, Albert Einstein College of Medicine, Bronx, NY; Mary Jo O'Sullivan, University of Miami, Miami, FL; and Rowan T. Chlebowski, Los Angeles Biomedical Research Institute at Harbor-University of California Los Angeles Medical Center, Torrance, CA
| | - Rowan T Chlebowski
- Polly A. Newcomb, Michael N. Passarelli, Amanda I. Phipps, and Garnet L. Anderson, Fred Hutchinson Cancer Research Center; Polly A. Newcomb, Michael N. Passarelli, Amanda I. Phipps, and Garnet L. Anderson, School of Public Health, University of Washington, Seattle, WA; Jean Wactawski-Wende, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo; Gloria Y.F. Ho, Albert Einstein College of Medicine, Bronx, NY; Mary Jo O'Sullivan, University of Miami, Miami, FL; and Rowan T. Chlebowski, Los Angeles Biomedical Research Institute at Harbor-University of California Los Angeles Medical Center, Torrance, CA
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