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Wang C, Nagayach A, Patel H, Dao L, Zhu H, Wasylishen AR, Fan Y, Kendler A, Guo Z. Utilizing human cerebral organoids to model breast cancer brain metastasis in culture. Breast Cancer Res 2024; 26:108. [PMID: 38951862 PMCID: PMC11218086 DOI: 10.1186/s13058-024-01865-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 06/25/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND Metastasis, the spread, and growth of malignant cells at secondary sites within a patient's body, accounts for over 90% of cancer-related mortality. Breast cancer is the most common tumor type diagnosed and the leading cause of cancer lethality in women in the United States. It is estimated that 10-16% breast cancer patients will have brain metastasis. Current therapies to treat patients with breast cancer brain metastasis (BCBM) remain palliative. This is largely due to our limited understanding of the fundamental molecular and cellular mechanisms through which BCBM progresses, which represents a critical barrier for the development of efficient therapies for affected breast cancer patients. METHODS Previous research in BCBM relied on co-culture assays of tumor cells with rodent neural cells or rodent brain slice ex vivo. Given the need to overcome the obstacle for human-relevant host to study cell-cell communication in BCBM, we generated human embryonic stem cell-derived cerebral organoids to co-culture with human breast cancer cell lines. We used MDA-MB-231 and its brain metastatic derivate MDA-MB-231 Br-EGFP, other cell lines of MCF-7, HCC-1806, and SUM159PT. We leveraged this novel 3D co-culture platform to investigate the crosstalk of human breast cancer cells with neural cells in cerebral organoid. RESULTS We found that MDA-MB-231 and SUM159PT breast cancer cells formed tumor colonies in human cerebral organoids. Moreover, MDA-MB-231 Br-EGFP cells showed increased capacity to invade and expand in human cerebral organoids. CONCLUSIONS Our co-culture model has demonstrated a remarkable capacity to discern the brain metastatic ability of human breast cancer cells in cerebral organoids. The generation of BCBM-like structures in organoid will facilitate the study of human tumor microenvironment in culture.
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Affiliation(s)
- Chenran Wang
- Department of Cancer Biology, University of Cincinnati College of Medicine, Cincinnati, OH, 45267, USA.
| | - Aarti Nagayach
- Department of Cancer Biology, University of Cincinnati College of Medicine, Cincinnati, OH, 45267, USA
| | - Harsh Patel
- Department of Cancer Biology, University of Cincinnati College of Medicine, Cincinnati, OH, 45267, USA
| | - Lan Dao
- Division of Developmental Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 45229, USA
| | - Hui Zhu
- Division of Developmental Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 45229, USA
| | - Amanda R Wasylishen
- Department of Cancer Biology, University of Cincinnati College of Medicine, Cincinnati, OH, 45267, USA
| | - Yanbo Fan
- Department of Cancer Biology, University of Cincinnati College of Medicine, Cincinnati, OH, 45267, USA
| | - Ady Kendler
- Department of Pathology and Laboratory Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, 45267, USA
| | - Ziyuan Guo
- Division of Developmental Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 45229, USA.
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Levy BB, Biasio MJD, Toledo NA, Das S, Bartling M, Aldahari F, de Almeida JR, Weinreb I, Chan Y. Sinonasal Malignancy Following Cranial Irradiation: A Scoping Review and Case Report of Sinonasal Teratocarcinosarcoma. J Neurol Surg Rep 2024; 85:e101-e111. [PMID: 38974921 PMCID: PMC11226344 DOI: 10.1055/s-0044-1788310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 06/17/2024] [Indexed: 07/09/2024] Open
Abstract
Background Radiation therapy is a mainstay of treatment for brain tumors, but delayed complications include secondary malignancy which may occur months to years after treatment completion. Methods We reviewed the medical records of a 41-year-old female treated with 60 Gy of radiation for a recurrent astrocytoma, who 6 years later developed a locally advanced sinonasal teratocarcinosarcoma. We searched MEDLINE, Embase, and Web of Science to conduct a scoping review of biopsy-proven sinonasal malignancy in patients who previously received cranial irradiation for a brain tumor. Results To our knowledge, this is the first report of a patient to present with a sinonasal teratocarcinosarcoma after receiving irradiation for a brain tumor. Our scoping review of 1,907 studies produced 14 similar cases of secondary sinonasal malignancy. Median age of primary cancer diagnosis was 39.5 years old (standard deviation [SD]: 21.9), and median radiation dose was 54 Gy (SD: 20.3). Median latency time between the primary cancer and secondary sinonasal cancer was 9.5 years (SD: 5.8). Olfactory neuroblastoma was the most common sinonasal cancer ( n = 4). Fifty percent of patients died from their sinonasal cancer within 1.5 years. Conclusion Patients who receive radiation exposure to the sinonasal region for treatment of a primary brain tumor, including low doses or scatter radiation, may be at risk of a secondary sinonasal malignancy later in life. Physicians who monitor at-risk patients must be vigilant of symptoms which may suggest sinonasal malignancy, and surveillance should include radiographic review with careful monitoring for a secondary malignancy throughout the entire irradiated field.
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Affiliation(s)
- Ben B. Levy
- Department of Otolaryngology–Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | | | - Nilo Alvarez Toledo
- Division of Neurosurgery, Department of Surgery, St. Michael's Hospital, Unity Health, Toronto, Ontario, Canada
| | - Sunit Das
- Division of Neurosurgery, Department of Surgery, St. Michael's Hospital, Unity Health, Toronto, Ontario, Canada
| | - Mandolin Bartling
- Department of Otolaryngology–Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Fahad Aldahari
- Department of Otolaryngology–Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - John R. de Almeida
- Department of Otolaryngology–Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
- Department of Otolaryngology–Head and Neck Surgery, University Health Network, Toronto, Ontario, Canada
| | - Ilan Weinreb
- Department of Pathology, University Health Network, Toronto, Ontario, Canada
- Department of Pathobiology and Laboratory Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Yvonne Chan
- Department of Otolaryngology–Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
- Department of Otolaryngology–Head and Neck Surgery, St. Michael's Hospital, Unity Health, Toronto, Ontario, Canada
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Xu K, Sun G, Wang Y, Luo H, Wang Y, Liu M, Liu H, Lu X, Qin X. Mitigating radiation-induced brain injury via NLRP3/NLRC4/Caspase-1 pyroptosis pathway: Efficacy of memantine and hydrogen-rich water. Biomed Pharmacother 2024; 177:116978. [PMID: 38906028 DOI: 10.1016/j.biopha.2024.116978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 06/02/2024] [Accepted: 06/15/2024] [Indexed: 06/23/2024] Open
Abstract
Radiation-induced brain injury (RIBI) is a significant challenge in radiotherapy for head and neck tumors, impacting patients' quality of life. In exploring potential treatments, this study focuses on memantine hydrochloride and hydrogen-rich water, hypothesized to mitigate RIBI through inhibiting the NLRP3/NLRC4/Caspase-1 pathway. In a controlled study involving 40 Sprague-Dawley rats, divided into five groups including a control and various treatment groups, we assessed the effects of these treatments on RIBI. Post-irradiation, all irradiated groups displayed symptoms like weight loss and salivation, with notable variations among different treatment approaches. Particularly, hydrogen-rich water showed a promising reduction in these symptoms. Histopathological analysis indicated substantial hippocampal damage in the radiation-only group, while the groups receiving memantine and/or hydrogen-rich water exhibited significant mitigation of such damage. Molecular studies, revealed a decrease in oxidative stress markers and an attenuated inflammatory response in the treatment groups. Immunohistochemistry further confirmed these molecular changes, suggesting the effectiveness of these agents. Echoing recent scientific inquiries into the protective roles of specific compounds against radiation-induced damages, our study adds to the growing body of evidence on the potential of memantine and hydrogen-rich water as novel therapeutic strategies for RIBI.
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Affiliation(s)
- Kai Xu
- Shanxi Provincial Key Laboratory of Drug Toxicology and Radiation Damage Drugs, Department of Radiology and Environmental Medicine, Co-innovation Center for Radiation Medicine, China Institute for Radiation Protection, Taiyuan 030006, China
| | - Ge Sun
- Shanxi Provincial Key Laboratory of Drug Toxicology and Radiation Damage Drugs, Department of Radiology and Environmental Medicine, Co-innovation Center for Radiation Medicine, China Institute for Radiation Protection, Taiyuan 030006, China
| | - Yuhao Wang
- Shanxi Provincial Key Laboratory of Drug Toxicology and Radiation Damage Drugs, Department of Radiology and Environmental Medicine, Co-innovation Center for Radiation Medicine, China Institute for Radiation Protection, Taiyuan 030006, China
| | - Hao Luo
- State Key Laboratory of Medicinal Chemical Biology, College of Pharmacy, Nankai University, Tianjin 300353, China
| | - Yong Wang
- Fenyang Hospital, Shanxi Province, Shanxi Medical University, Fenyang, Shanxi 032200, China
| | - Mengya Liu
- Shanxi Provincial Key Laboratory of Drug Toxicology and Radiation Damage Drugs, Department of Radiology and Environmental Medicine, Co-innovation Center for Radiation Medicine, China Institute for Radiation Protection, Taiyuan 030006, China
| | - Huan Liu
- Shanxi Provincial Key Laboratory of Drug Toxicology and Radiation Damage Drugs, Department of Radiology and Environmental Medicine, Co-innovation Center for Radiation Medicine, China Institute for Radiation Protection, Taiyuan 030006, China
| | - Xiaoyu Lu
- School of Public Health, Shanxi Medical University, Taiyuan 030001, China
| | - Xiujun Qin
- Shanxi Provincial Key Laboratory of Drug Toxicology and Radiation Damage Drugs, Department of Radiology and Environmental Medicine, Co-innovation Center for Radiation Medicine, China Institute for Radiation Protection, Taiyuan 030006, China.
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Dong Z, Xue K, Verma A, Shi J, Wei Z, Xia X, Wang K, Zhang X. Photothermal therapy: a novel potential treatment for prostate cancer. Biomater Sci 2024; 12:2480-2503. [PMID: 38592730 DOI: 10.1039/d4bm00057a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
Prostate cancer (PCa) is a leading cause of cancer-related death in men, and most PCa patients treated with androgen deprivation therapy will progress to metastatic castration-resistant prostate cancer (mCRPC) due to the lack of efficient treatment. Recently, lots of research indicated that photothermal therapy (PTT) was a promising alternative that provided an accurate and efficient prostate cancer therapy. A photothermic agent (PTA) is a basic component of PPT and is divided into organic and inorganic PTAs. Besides, the combination of PTT and other therapies, such as photodynamic therapy (PDT), immunotherapy (IT), chemotherapy (CT), etc., provides an more efficient strategy for PCa therapy. Here, we introduce basic information about PTT and summarize the PTT treatment strategies for prostate cancer. Based on recent works, we think the combination of PPT and other therapies provides a novel possibility for PCa, especially CRPC clinical treatment.
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Affiliation(s)
- Zirui Dong
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
| | - Kaming Xue
- Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Anushikha Verma
- Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Jian Shi
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
| | - Zhihao Wei
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
| | - Xiaotian Xia
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jiefang Ave, Wuhan 430022, Hubei, China.
| | - Keshan Wang
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
| | - Xiaoping Zhang
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
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Ma J, Cao H, Hou D, Wang W, Liu T. Investigation of high-dose radiotherapy's effect on brain structure aggravated cognitive impairment and deteriorated patient psychological status in brain tumor treatment. Sci Rep 2024; 14:10149. [PMID: 38698048 PMCID: PMC11066031 DOI: 10.1038/s41598-024-59694-0] [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: 10/09/2023] [Accepted: 04/15/2024] [Indexed: 05/05/2024] Open
Abstract
This study aims to investigate the potential impact of high-dose radiotherapy (RT) on brain structure, cognitive impairment, and the psychological status of patients undergoing brain tumor treatment. We recruited and grouped 144 RT-treated patients with brain tumors into the Low dose group (N = 72) and the High dose group (N = 72) according to the RT dose applied. Patient data were collected by using the HADS and QLQ-BN20 system for subsequent analysis and comparison. Our analysis showed no significant correlation between the RT doses and the clinicopathological characteristics. We found that a high dose of RT could aggravate cognitive impairment and deteriorate patient role functioning, indicated by a higher MMSE and worsened role functioning in the High dose group. However, the depression status, social functioning, and global health status were comparable between the High dose group and the Low dose group at Month 0 and Month 1, while being worsened in the High dose group at Month 3, indicating the potential long-term deterioration of depression status in brain tumor patients induced by high-dose RT. By comparing patient data at Month 0, Month 1, Month 3, Month 6, and Month 9 after RT, we found that during RT treatment, RT at a high dose could aggravate cognitive impairment in the short term and lead to worsened patient role functioning, and even deteriorate the overall psychological health status of patients in the long term.
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Affiliation(s)
- Jianpeng Ma
- Department of Magnetic Resonance Imaging, Dingbian County People's Hospital, Dingbian, Yulin, 718600, Shaanxi, China
| | - Hetao Cao
- Department of Medical Imaging, Affiliated Hospital of Nantong University, No.20 Xisi Road, Chongchuan District, Nantong, 226001, Jiangsu, China
| | - Dongmei Hou
- Department of Medical Imaging, Affiliated Hospital of Nantong University, No.20 Xisi Road, Chongchuan District, Nantong, 226001, Jiangsu, China
| | - Weiqi Wang
- School of Pharmacy, Nantong University, Nantong, 226019, Jiangsu, China
| | - Tingting Liu
- Department of Medical Imaging, Affiliated Hospital of Nantong University, No.20 Xisi Road, Chongchuan District, Nantong, 226001, Jiangsu, China.
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Hahnemann L, Krämer A, Fink C, Jungk C, Thomas M, Christopoulos P, Lischalk J, Meis J, Hörner-Rieber J, Eichkorn T, Deng M, Lang K, Paul A, Meixner E, Weykamp F, Debus J, König L. Fractionated stereotactic radiotherapy of intracranial postoperative cavities after resection of brain metastases - Clinical outcome and prognostic factors. Clin Transl Radiat Oncol 2024; 46:100782. [PMID: 38694237 PMCID: PMC11061678 DOI: 10.1016/j.ctro.2024.100782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 04/17/2024] [Accepted: 04/20/2024] [Indexed: 05/04/2024] Open
Abstract
Background and Purpose After surgical resection of brain metastases (BM), radiotherapy (RT) is indicated. Postoperative stereotactic radiosurgery (SRS) reduces the risk of local progression and neurocognitive decline compared to whole brain radiotherapy (WBRT). Aside from the optimal dose and fractionation, little is known about the combination of systemic therapy and postoperative fractionated stereotactic radiotherapy (fSRT), especially regarding tumour control and toxicity. Methods In this study, 105 patients receiving postoperative fSRT with 35 Gy in 7 fractions performed with Cyberknife were retrospectively reviewed. Overall survival (OS), local control (LC) and total intracranial brain control (TIBC) were analysed via Kaplan-Meier method. Cox proportional hazards models were used to identify prognostic factors. Results Median follow-up was 20.8 months. One-year TIBC was 61.6% and one-year LC was 98.6%. Median OS was 28.7 (95%-CI: 16.9-40.5) months. In total, local progression (median time not reached) occurred in 2.0% and in 20.4% radiation-induced contrast enhancements (RICE) of the cavity (after median of 14.3 months) were diagnosed. Absence of extracranial metastases was identified as an independent prognostic factor for superior OS (p = <0.001) in multivariate analyses, while a higher Karnofsky performance score (KPS) was predictive for longer OS in univariate analysis (p = 0.041). Leptomeningeal disease (LMD) developed in 13% of patients. Conclusion FSRT after surgical resection of BM is an effective and safe treatment approach with excellent local control and acceptable toxicity. Further prospective randomized trials are needed to establish standardized therapeutic guidelines.
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Affiliation(s)
- L. Hahnemann
- Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - A. Krämer
- Department of Radiation Oncology, University Hospital of Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - C. Fink
- Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
- National Center for Radiation Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - C. Jungk
- Department of Neurosurgery, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - M. Thomas
- Department of Thoracic Oncology, Thoraxklinik and National Center for Tumor Diseases at Heidelberg University Hospital, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Germany
| | - P. Christopoulos
- Department of Thoracic Oncology, Thoraxklinik and National Center for Tumor Diseases at Heidelberg University Hospital, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Germany
| | - J.W. Lischalk
- Department of Radiation Oncology, Perlmutter Cancer Center at New York University Langone Health at Long Island, New York, NY, USA
| | - J. Meis
- Institute of Medical Biometry, University of Heidelberg, Im Neuenheimer Feld 130, 69120 Heidelberg, Germany
| | - J. Hörner-Rieber
- Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
- National Center for Radiation Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - T. Eichkorn
- Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
- National Center for Radiation Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - M. Deng
- Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
- National Center for Radiation Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - K. Lang
- Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
- National Center for Radiation Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - A. Paul
- Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
- National Center for Radiation Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - E. Meixner
- Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
- National Center for Radiation Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - F. Weykamp
- Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
- National Center for Radiation Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - J. Debus
- Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
- National Center for Radiation Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
- Heavy Ion Therapy Center (HIT), Heidelberg University Hospital, Im Neuenheimer Feld 450, 69120 Heidelberg, Germany
- Clinical Cooperation Unit Radiation Oncology (E050), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - L. König
- Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
- National Center for Radiation Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
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Routman DM, Jusue-Torres I, Brown PD, Trifiletti DM, Vora SA, Brown DA, Parney IF, Burns TC, Yan E. Pre-operative vs. post-operative stereotactic radiosurgery for operative metastatic brain tumors: study protocol for a phase III clinical trial. BMC Cancer 2024; 24:332. [PMID: 38475765 PMCID: PMC10929171 DOI: 10.1186/s12885-024-12060-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 02/26/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Almost one third of cancer patients in the United States will develop brain metastases on an annual basis. Surgical resection is indicated in the setting of brain metastases for reasons, such as maximizing local control in select patients, decompression of mass effect, and/or tissue diagnosis. The current standard of care following resection of a brain metastasis has shifted from whole brain radiation therapy to post-operative stereotactic radiosurgery (SRS). However, there is a significant rate of local recurrence within one year of postoperative SRS. Emerging retrospective and prospective data suggest pre-operative SRS is a safe and potentially effective treatment paradigm for surgical brain metastases. This trial intends to determine, for patients with an indication for resection of a brain metastasis, whether there is an increase in the time to a composite endpoint of adverse outcomes; including the first occurrence of either: local recurrence, leptomeningeal disease, or symptomatic radiation brain necrosis - in patients who receive pre-operative SRS as compared to patients who receive post-operative SRS. METHODS This randomized phase III clinical trial compares pre-operative with post-operative SRS for brain metastases. A dynamic random allocation procedure will allocate an equal number of patients to each arm: pre-operative SRS followed by surgery or surgery followed by post-operative SRS. EXPECTED OUTCOMES If pre-operative SRS improves outcomes relative to post-operative SRS, this will establish pre-operative SRS as superior. If post-operative SRS proves superior to pre-operative SRS, it will remain a standard of care and halt the increasing utilization of pre-operative SRS. If there is no difference in pre- versus post-operative SRS, then pre-operative SRS may still be preferred, given patient convenience and the potential for a condensed timeline. DISCUSSION Emerging retrospective and prospective data have demonstrated some benefits of pre-op SRS vs. post-op SRS. This study will show whether there is an increase in the time to the composite endpoint. Additionally, the study will compare overall survival; patient-reported outcomes; morbidity; completion of planned therapies; time to systemic therapy; time to regional progression; time to CNS progression; time to subsequent treatment; rate of radiation necrosis; rate of local recurrence; and rate of leptomeningeal disease. TRIAL REGISTRATION NUMBER NCT03750227 (Registration date: 21/11/2018).
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Affiliation(s)
- David M Routman
- Department of Radiation Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | | | - Paul D Brown
- Department of Radiation Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | | | - Sujay A Vora
- Department of Radiation Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
- Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ, USA
| | - Desmond A Brown
- Neurosurgical Oncology Unit, National Institute of Health, Bethesda, MN, USA
| | - Ian F Parney
- Department of Neurological Surgery, Mayo Clinic, Rochester, MN, USA
| | - Terry C Burns
- Department of Neurological Surgery, Mayo Clinic, Rochester, MN, USA
| | - Elizabeth Yan
- Department of Radiation Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
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Marino N, Bedeschi M, Vaccari ME, Cambiaghi M, Tesei A. Glitches in the brain: the dangerous relationship between radiotherapy and brain fog. Front Cell Neurosci 2024; 18:1328361. [PMID: 38515789 PMCID: PMC10956129 DOI: 10.3389/fncel.2024.1328361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 02/22/2024] [Indexed: 03/23/2024] Open
Abstract
Up to approximately 70% of cancer survivors report persistent deficits in memory, attention, speed of information processing, multi-tasking, and mental health functioning, a series of symptoms known as "brain fog." The severity and duration of such effects can vary depending on age, cancer type, and treatment regimens. In particular, every year, hundreds of thousands of patients worldwide undergo radiotherapy (RT) for primary brain tumors and brain metastases originating from extracranial tumors. Besides its potential benefits in the control of tumor progression, recent studies indicate that RT reprograms the brain tumor microenvironment inducing increased activation of microglia and astrocytes and a consequent general condition of neuroinflammation that in case it becomes chronic could lead to a cognitive decline. Furthermore, radiation can induce endothelium reticulum (ER) stress directly or indirectly by generating reactive oxygen species (ROS) activating compensatory survival signaling pathways in the RT-surviving fraction of healthy neuronal and glial cells. In particular, the anomalous accumulation of misfolding proteins in neuronal cells exposed to radiation as a consequence of excessive activation of unfolded protein response (UPR) could pave the way to neurodegenerative disorders. Moreover, exposure of cells to ionizing radiation was also shown to affect the normal proteasome activity, slowing the degradation rate of misfolded proteins, and further exacerbating ER-stress conditions. This compromises several neuronal functions, with neuronal accumulation of ubiquitinated proteins with a consequent switch from proteasome to immunoproteasome that increases neuroinflammation, a crucial risk factor for neurodegeneration. The etiology of brain fog remains elusive and can arise not only during treatment but can also persist for an extended period after the end of RT. In this review, we will focus on the molecular pathways triggered by radiation therapy affecting cognitive functions and potentially at the origin of so-called "brain fog" symptomatology, with the aim to define novel therapeutic strategies to preserve healthy brain tissue from cognitive decline.
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Affiliation(s)
- Noemi Marino
- Bioscience Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Martina Bedeschi
- Bioscience Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Melania Elettra Vaccari
- Bioscience Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Marco Cambiaghi
- Bioscience Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Anna Tesei
- Bioscience Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
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Samanci Y, Ali Tepebasili M, Deniz Ardor G, Haluk Duzkalir A, Orbay Askeroglu M, Peker S. Efficacy of hypofractionated Gamma Knife radiosurgery in treating surgical beds of metastatic brain tumors. J Clin Neurosci 2024; 121:105-113. [PMID: 38387112 DOI: 10.1016/j.jocn.2024.02.020] [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: 01/11/2024] [Revised: 02/01/2024] [Accepted: 02/17/2024] [Indexed: 02/24/2024]
Abstract
OBJECTIVE Surgery alone for metastatic brain tumors (METs) often results in local recurrence due to microscopic residual tumor tissue. While stereotactic radiosurgery (SRS) is commonly used post-surgery, hypofractionation may be required for large surgical beds. This study evaluated the efficacy and safety of hypofractionated Gamma Knife radiosurgery (hf-GKRS) for the first time as a post-operative adjuvant therapy. METHODS This retrospective study involved 24 patients (28 surgical beds) who underwent hf-GKRS within four weeks after surgery. The study primarily focused on local control (LC) rate and analyzed distant intracranial failure (DICF), intracranial progression-free survival (PFS), leptomeningeal disease (LMD), overall survival (OS), and radiation necrosis (RN). RESULTS During a median follow-up of 9 months, LC was achieved in 89.3 % of surgical beds. LC estimates at 6, 12, and 24 months were 96.4 %, 82.7 %, and 82.7 %, respectively. DICF was observed in 45.8 % of patients, and LMD was identified in two patients (8.3 %). At the end of the follow-up, 58.3 % of patients were alive, and the median OS was 20 months. RN occurred in only one surgical bed (3.6 %). No grade 5 toxicity was observed. The univariate analysis identified a longer interval to GKRS (HR 11.842, p = 0.042) and a larger treatment volume (HR 1.103, p = 0.037) as significant factors for local failure. CONCLUSIONS hf-GKRS shows potential as an effective and safe adjuvant treatment for surgical beds. It offers an alternative to SRS, SRT, or WBRT, particularly for larger volumes or tumors near critical structures. Further research is needed to confirm these results and optimize treatment approaches.
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Affiliation(s)
- Yavuz Samanci
- Koc University School of Medicine, Department of Neurosurgery, Istanbul, Turkey
| | | | - Gokce Deniz Ardor
- Koc University Hospital, Department of Neurosurgery, Gamma Knife Center, Istanbul, Turkey
| | - Ali Haluk Duzkalir
- Koc University Hospital, Department of Neurosurgery, Gamma Knife Center, Istanbul, Turkey
| | - M Orbay Askeroglu
- Koc University Hospital, Department of Neurosurgery, Gamma Knife Center, Istanbul, Turkey
| | - Selcuk Peker
- Koc University School of Medicine, Department of Neurosurgery, Istanbul, Turkey.
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10
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Ghadirian S, Tabibzadeh A, Rezvani H, Jafarzadeh M. Investigation of Fibroblast Growth Factor Peptide Antagonist on Mouse Model Breast Tumor through ERK/MAPK and PI3K/AKT Signaling Pathways. Asian Pac J Cancer Prev 2024; 25:473-483. [PMID: 38415533 PMCID: PMC11077103 DOI: 10.31557/apjcp.2024.25.2.473] [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: 07/29/2023] [Accepted: 02/11/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND In the majority of cancers, metastasis of tumor cells is the main cause of treatment failure. This study intended to investigate the effectiveness of basic fibroblast growth factor (bFGF) peptide designed to inhibit tumor growth in 4T1 metastatic breast cancer through the PI3K/AKT and ERK/MAPK signal transduction pathways. METHODS The tumor was induced through 4T1 tumor graft in BALB/c mice. The designed peptide was injected intraperitoneal at three selected doses after two weeks for 14 days. The PBS and doxorubicin were used as the negative and positive control groups, respectively. Tumor size was measured and after the treatment period, the mice underwent a surgery and tumors were used for the western blot examinations. RESULTS the peptide injection was effective in reducing or inhibiting tumor growth in mice model and in vitro. The western blot analysis results showed that the p-AKT and p-ERK levels in peptide treated tumors were reduced (p<0.05). CONCLUSION The peptide injection was effective in mice model. Findings showed that in the two signal transduction pathways, the p-AKT and p-ERK levels were significantly different from the negative control group.
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Affiliation(s)
- Shahrzad Ghadirian
- Department of Biochemistry and Biophysics, Faculty of Advanced Science and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
| | - Alireza Tabibzadeh
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Hamid Rezvani
- Department of Oncology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mehrzad Jafarzadeh
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Science, Tehran, Iran.
- Department of Medical Laboratory Sciences, Faculty of Allied Medical Sciences, Tehran, Iran.
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11
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Dharnipragada R, Dusenbery K, Ferreira C, Sharma M, Chen CC. Preoperative Versus Postoperative Radiosurgery of Brain Metastases: A Meta-Analysis. World Neurosurg 2024; 182:35-41. [PMID: 37918565 DOI: 10.1016/j.wneu.2023.10.131] [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: 10/08/2023] [Accepted: 10/26/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE While postoperative resection cavity radiosurgery (post-SRS) is an accepted treatment paradigm for brain metastasis (BM) patients who undergo surgical resection, there is emerging interest in preoperative radiosurgery (pre-SRS) followed by surgical resection as an alternative treatment paradigm. Here, we performed a meta-analysis of the available literature on this matter. METHODS Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a search of all studies evaluating pre-SRS and post-SRS was completed. Local recurrence (LR), overall survival (OS), radiation necrosis (RN), and leptomeningeal disease (LMD) were evaluated from the available data. Moderator analysis and pooled effect sizes were performed using a proportional meta-analysis with R using the metafor package. Statistics are presented as mean [95% confidence interval]. RESULTS We identified 6 pre-SRS and 33 post-SRS studies with comparable tumor volume (4.5-17.6 cm3). There were significant differences in the pooled estimates of LR and LMD, favoring pre-SRS over post-SRS. Pooled aggregate for LR was 11.0% [4.9-13.7] and 17.5% [15.1-19.9] for pre- and post-SRS studies (P = 0.014). Similarly, pooled estimates of LMD favored pre-SRS, 4.4% [2.6-6.2], relative to post-SRS, 12.3% [8.9-15.7] (P = 0.019). In contrast, no significant differences were found in terms of RN and OS. Pooled estimates for RN were 6.4% [3.1-9.6] and 8.9% [6.3-11.6] for pre- and post-SRS studies (P = 0.393), respectively. Pooled estimates for OS were 60.2% [55.8-64.6] and 60.5% [56.9-64.0] for pre- and post-SRS studies (P = 0.974). CONCLUSIONS This meta-analysis supports further exploration of pre-SRS as a strategy for the treatment of BM.
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Affiliation(s)
- Rajiv Dharnipragada
- University of Minnesota Medical School, University of Minnesota Twin-Cities, Minneapolis, Minnesota, USA.
| | - Kathryn Dusenbery
- Department of Radiation Oncology, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Clara Ferreira
- Department of Radiation Oncology, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Mayur Sharma
- Department of Neurosurgery, University of Minnesota Twin-Cities, Minneapolis, Minnesota, USA
| | - Clark C Chen
- Department of Neurosurgery, University of Minnesota Twin-Cities, Minneapolis, Minnesota, USA
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Lee H, Kang H, Moon C, Youn B. PAK3 downregulation induces cognitive impairment following cranial irradiation. eLife 2023; 12:RP89221. [PMID: 38131292 PMCID: PMC10746143 DOI: 10.7554/elife.89221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
Cranial irradiation is used for prophylactic brain radiotherapy as well as the treatment of primary brain tumors. Despite its high efficiency, it often induces unexpected side effects, including cognitive dysfunction. Herein, we observed that mice exposed to cranial irradiation exhibited cognitive dysfunction, including altered spontaneous behavior, decreased spatial memory, and reduced novel object recognition. Analysis of the actin cytoskeleton revealed that ionizing radiation (IR) disrupted the filamentous/globular actin (F/G-actin) ratio and downregulated the actin turnover signaling pathway p21-activated kinase 3 (PAK3)-LIM kinase 1 (LIMK1)-cofilin. Furthermore, we found that IR could upregulate microRNA-206-3 p (miR-206-3 p) targeting PAK3. As the inhibition of miR-206-3 p through antagonist (antagomiR), IR-induced disruption of PAK3 signaling is restored. In addition, intranasal administration of antagomiR-206-3 p recovered IR-induced cognitive impairment in mice. Our results suggest that cranial irradiation-induced cognitive impairment could be ameliorated by regulating PAK3 through antagomiR-206-3 p, thereby affording a promising strategy for protecting cognitive function during cranial irradiation, and promoting quality of life in patients with radiation therapy.
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Affiliation(s)
- Haksoo Lee
- Department of Integrated Biological Science, Pusan National UniversityBusanRepublic of Korea
| | - Hyunkoo Kang
- Department of Integrated Biological Science, Pusan National UniversityBusanRepublic of Korea
| | - Changjong Moon
- Department of Veterinary Anatomy and Animal Behavior, College of Veterinary Medicine and BK21 FOUR Program, Chonnam National UniversityGwangjuRepublic of Korea
| | - BuHyun Youn
- Department of Integrated Biological Science, Pusan National UniversityBusanRepublic of Korea
- Department of Biological Sciences, Pusan National UniversityBusanRepublic of Korea
- Nuclear Science Research Institute, Pusan National UniversityBusanRepublic of Korea
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13
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Li W, Liang M, Qi J, Ding D. Semiconducting Polymers for Cancer Immunotherapy. Macromol Rapid Commun 2023; 44:e2300496. [PMID: 37712920 DOI: 10.1002/marc.202300496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 09/09/2023] [Indexed: 09/16/2023]
Abstract
As a monumental breakthrough in cancer treatment, immunotherapy has attracted tremendous attention in recent years. However, one challenge faced by immunotherapy is the low response rate and the immune-related adverse events (irAEs). Therefore, it is important to explore new therapeutic strategies and platforms for boosting therapeutic benefits and decreasing the side effects of immunotherapy. In recent years, semiconducting polymer (SP), a category of organic materials with π-conjugated aromatic backbone, has been attracting considerable attention because of their outstanding characteristics such as excellent photophysical features, good biosafety, adjustable chemical flexibility, easy fabrication, and high stability. With these distinct advantages, SP is extensively explored for bioimaging and photo- or ultrasound-activated tumor therapy. Here, the recent advancements in SP-based nanomedicines are summarized for enhanced tumor immunotherapy. According to the photophysical properties of SPs, the cancer immunotherapies enabled by SPs with the photothermal, photodynamic, or sonodynamic functions are highlighted in detail, with a particular focus on the construction of combination immunotherapy and activatable nanoplatforms to maximize the benefits of cancer immunotherapy. Herein, new guidance and comprehensive insights are provided for the design of SPs with desired photophysical properties to realize maximized effectiveness of required biomedical applications.
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Affiliation(s)
- Wen Li
- Tianjin Key Laboratory of Biomedical Materials and Key Laboratory of Biomaterials and Nanotechnology for Cancer Immunotherapy, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, 300192, China
| | - Mengyun Liang
- State Key Laboratory of Medicinal Chemical Biology, Key Laboratory of Bioactive Materials, Ministry of Education, and College of Life Sciences, Nankai University, Tianjin, 300071, China
| | - Ji Qi
- State Key Laboratory of Medicinal Chemical Biology, Key Laboratory of Bioactive Materials, Ministry of Education, and College of Life Sciences, Nankai University, Tianjin, 300071, China
- School of Materials Science and Engineering & Smart Sensing Interdisciplinary Science Center, Nankai University, Tianjin, 300350, China
| | - Dan Ding
- State Key Laboratory of Medicinal Chemical Biology, Key Laboratory of Bioactive Materials, Ministry of Education, and College of Life Sciences, Nankai University, Tianjin, 300071, China
- School of Materials Science and Engineering & Smart Sensing Interdisciplinary Science Center, Nankai University, Tianjin, 300350, China
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Zdravkovski P, Ilievski B, Rendevski V, Chaparoski A, Filipce V, Zupanoski A, Gavrilovska AD, Shuntov B, Stolevski V, Stojkovski I, Lazareska M, Rendevska AM, Petrushevska G. Unveiling The Neuropathology Tumour Landscape: 10-Year Statistical Analysis With Global Comparison - Single Centre Experience. Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2023; 44:17-26. [PMID: 38109442 DOI: 10.2478/prilozi-2023-0043] [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] [Indexed: 12/20/2023]
Abstract
Introduction: Central nervous system (CNS) tumours represent a significant public health issue worldwide, and their incidence and distribution vary across different populations. Although studies on CNS tumours have been conducted in various countries, there is a lack of information regarding their patterns in Macedonia. Therefore, this study is aimed at investigating the distribution, histopathological types and subtypes and demographic features of CNS tumours in our country. Materials and Methods: A cross sectional study was conducted using the electronic database of the Institute of Pathology - Medical Faculty, University "Ss. Cyril and Methodius" in Skopje which contains data from 3286 received and analysed surgical specimens, mainly from the University Clinic of Neurosurgery in Skopje, and a smaller number of surgical specimens from the University Surgical Centre "St. Naum Ohridski" in Skopje between 2012 and 2022. The collected and analysed data includes patient age, sex and histopathological types and subtypes of the tumours. Results: The majority of CNS tumours were diagnosed in adults aged between 50-70, with a male to female ratio of 1.5:1. The most common location of the tumours was the cerebrum, followed by the pituitary gland and cerebellum. The most frequent histological groups were gliomas, with glioblastoma as the most common diagnosis, followed by meningiomas. Conclusion: Following a detailed and thorough review of the CNS tumours in our study, we can conclude that the R. of Macedonia follows global statistics and trends regarding brain tumours.
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Affiliation(s)
- Panche Zdravkovski
- 1Institute of Pathology, Medical Faculty, University "Ss. Cyril and Methodius'' in Skopje, RN Macedonia
| | - Boro Ilievski
- 1Institute of Pathology, Medical Faculty, University "Ss. Cyril and Methodius'' in Skopje, RN Macedonia
| | - Vladimir Rendevski
- 2University Clinic for Neurosurgery, Medical Faculty, University "Ss. Cyril and Methodius'' in Skopje, RN Macedonia
| | - Aleksandar Chaparoski
- 2University Clinic for Neurosurgery, Medical Faculty, University "Ss. Cyril and Methodius'' in Skopje, RN Macedonia
| | - Venko Filipce
- 2University Clinic for Neurosurgery, Medical Faculty, University "Ss. Cyril and Methodius'' in Skopje, RN Macedonia
| | - Aleksandar Zupanoski
- 2University Clinic for Neurosurgery, Medical Faculty, University "Ss. Cyril and Methodius'' in Skopje, RN Macedonia
| | | | - Blagoj Shuntov
- 2University Clinic for Neurosurgery, Medical Faculty, University "Ss. Cyril and Methodius'' in Skopje, RN Macedonia
| | - Vlado Stolevski
- 5University Clinic for Surgical diseases "St. Naum Ohridski'', Medical Faculty, University "Ss. Cyril and Methodius'' in Skopje, RN Macedonia
| | - Igor Stojkovski
- 3University Clinic for Radiotherapy and Oncology, Medical Faculty, University "Ss. Cyril and Methodius'' in Skopje, RN Macedonia
| | - Menka Lazareska
- 4University Clinic for Radiology, Medical Faculty, University "Ss. Cyril and Methodius'' in Skopje, RN Macedonia
| | - Ana Mihajlovska Rendevska
- 4University Clinic for Radiology, Medical Faculty, University "Ss. Cyril and Methodius'' in Skopje, RN Macedonia
| | - Gordana Petrushevska
- 1Institute of Pathology, Medical Faculty, University "Ss. Cyril and Methodius'' in Skopje, RN Macedonia
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Tew BY, Kalfa AJ, Yang Z, Hurth KM, Simon T, Abnoosian E, Durant ST, Hamerlik P, Salhia B. ATM-Inhibitor AZD1390 Is a Radiosensitizer for Breast Cancer CNS Metastasis. Clin Cancer Res 2023; 29:4492-4503. [PMID: 37585496 PMCID: PMC10618650 DOI: 10.1158/1078-0432.ccr-23-0290] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 06/07/2023] [Accepted: 08/14/2023] [Indexed: 08/18/2023]
Abstract
PURPOSE Limited effective treatments are currently available for central nervous system (CNS) metastasis (CM). This is largely driven by the inability of current therapeutics to penetrate the blood brain barrier (BBB) and the lack of preclinical models for testing new therapies. Here we study the efficacy of AZD1390, a BBB penetrating ataxia-telangiectasia mutated inhibitor, as a radiosensitizer for breast cancer CM treatment. EXPERIMENTAL DESIGN Three patient-derived xenograft (PDX) tumors including 2 HER2+ and 1 triple-negative breast cancer harboring DNA damage response (DDR) gene mutations, were implanted subcutaneously in the flank of mice to assess tumor growth inhibition by AZD1390 combined with radiation. Animal survival was further assessed by implanting the best responding PDX model orthotopically in the brain. RESULTS Pretreatment with AZD1390 followed by radiation therapy inhibited growth of PDX tumors implanted in the flank, and improved survival in orthotopic models with average survival of 222 days compared with 123 days in controls. Administration of AZD1390 posttreatment for 21 days had no further benefits. While the combination therapy resulted in sustained tumor inhibition, sporadic regrowth was observed in some mice 50 to 100 days posttreatment in all models. Gene expression comparing these tumors with complete responders demonstrated changes in upregulation of oncogenic proteins, which are potential drivers of tumor growth after treatment. CONCLUSIONS Our results demonstrate that AZD1390 effectively sensitizes breast cancer CM to radiation therapy in DDR mutant tumors. This study demonstrates the potential of using AZD1390 as a novel therapeutic agent for patients with breast cancer CM.
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Affiliation(s)
- Ben Yi Tew
- Department of Translational Genomics, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Alex J. Kalfa
- Department of Translational Genomics, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Zeyi Yang
- Department of Translational Genomics, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Kyle M. Hurth
- Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Thomas Simon
- Department of Translational Genomics, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Eric Abnoosian
- Department of Translational Genomics, Keck School of Medicine, University of Southern California, Los Angeles, California
| | | | - Petra Hamerlik
- Early Oncology R&D, AstraZeneca, Cambridge, United Kingdom
| | - Bodour Salhia
- Department of Translational Genomics, Keck School of Medicine, University of Southern California, Los Angeles, California
- Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California
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16
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Tao B, Du R, Zhang X, Jia B, Gao Y, Zhao Y, Liu Y. Engineering CAR-NK cell derived exosome disguised nano-bombs for enhanced HER2 positive breast cancer brain metastasis therapy. J Control Release 2023; 363:692-706. [PMID: 37813124 DOI: 10.1016/j.jconrel.2023.10.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 09/18/2023] [Accepted: 10/04/2023] [Indexed: 10/11/2023]
Abstract
HER2-positive breast cancer brain metastasis (HER2+ BCBM) is a refractory malignancy with a high recurrence rate and poor prognosis. The efficacies of conventional treatments, including radiation and the FDA-approved drug trastuzumab, are compromised due to their significant obstacles, such as limited penetration through the blood-brain barrier (BBB), off-target effects on HER2+ tumor cells, and systemic adverse reactions, ultimately resulting in suboptimal therapeutic outcomes. In order to address these challenges, a novel biomimetic nanoplatform was created, which consisted of a combination of chimeric antigen receptor-natural killer (CAR-NK) cell-derived exosomes (ExoCAR), and a nanobomb (referred to as Micelle). This nanoplatform, known as ExoCAR/T7@Micelle, was designed to enhance the effectiveness of antitumor treatment by disrupting ferroptosis defense mechanisms. Due to the transferrin receptor binding peptide (T7) modification and CAR expression on the exosome surface, the nanoplatform successfully traversed the blood-brain barrier and selectively targeted HER2+ breast cancer cells. Moreover, integration of the reactive oxygen species (ROS) -amplified and photodynamic therapy (PDT)-based nanobomb facilitated the spatiotemporal release of the cargos at specific sites. Upon systemic administration of ExoCAR/T7@Micelle, mice with orthotopic HER2+ BCBM demonstrated a robust antitumor response in vivo, leading to a significant extension in survival time. Furthermore, histological analyses and blood index studies revealed no discernible side effects. Collectively, this study is the first to indicate the possibility of HER2+ BCBM therapy with a CAR-NK cell-derived biomimetic drug delivery system.
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Affiliation(s)
- Bolong Tao
- State Key Laboratory of Cancer Biology, Biotechnology Center, School of Pharmacy, Air Force Medical University, Xi'an 710032, China
| | - Ruoxin Du
- State Key Laboratory of Cancer Biology, Biotechnology Center, School of Pharmacy, Air Force Medical University, Xi'an 710032, China
| | - Xiangmei Zhang
- Hebei Provincial Key Laboratory of Tumor Microenvironment and Drug Resistance, Hebei Medical University, Shijiazhuang City 050017, China.
| | - Bo Jia
- State Key Laboratory of Cancer Biology, Biotechnology Center, School of Pharmacy, Air Force Medical University, Xi'an 710032, China
| | - Yuan Gao
- State Key Laboratory of Cancer Biology, Biotechnology Center, School of Pharmacy, Air Force Medical University, Xi'an 710032, China.
| | - Yipu Zhao
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong, SAR 999077, China; Advanced Biomedical Instrumentation Centre Limited, Hong Kong, SAR 999077, China.
| | - Yunjiang Liu
- Hebei Provincial Key Laboratory of Tumor Microenvironment and Drug Resistance, Hebei Medical University, Shijiazhuang City 050017, China; Department of Breast Center, Fourth Hospital of Hebei Medical University, Shijiazhuang City 050011, China.
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17
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Koyuncuer A. Role of intraoperative touch imprint cytology and immunohistochemistry in the diagnosis of metastatic malignancies in the central nervous system: Cyto-histomorphological findings and differential diagnosis. Diagn Cytopathol 2023; 51:612-628. [PMID: 37435815 DOI: 10.1002/dc.25192] [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: 05/31/2023] [Revised: 06/24/2023] [Accepted: 06/26/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND Brain metastases (BMs) are intracranial neoplasms that are more common in adults than primary brain tumors, causing significant mortality and morbidity in cancer patients. This study aimed to evaluate the definitive histopathological diagnosis using touch imprint cytology and the importance and use of immunohistochemistry in the diagnosis of primary origin. METHOD Cytological, paraffin section, and immunohistochemical study slides of all metastatic brain tumors consecutively consulted at the pathology department between 2018 and 2023 were evaluated. The sensitivity, specificity, and accuracy of patients' diagnostic results who underwent imprint cytology were compared based on the final diagnosis histopathological report. RESULTS A total of 45 patients with and without intraoperative consultation were included in the study. The definitive histopathologic diagnosis and the diagnostic accuracy rate of imprint cytology for distinguishing glial and metastatic tumors on paraffin sections was 100%. Immunohistochemistry was performed in all patients (except one patient; immediate exitus) and histological classification of the primary tumor was performed by analysis of clinical findings and biomarkers. The primary origins of metastatic tumors were often lung and breast, with adenocarcinoma subtype histomorphology, cerebral hemispheres, and discrete foci of metastasis. CONCLUSION TPs is a simple and rapid technique that supports diagnosis in intraoperative neuropathology and is a very cost-effective procedure. The pathologist's experience is the key factor in the diagnosis and reduces the need for a frozen section. In our series, the final histopathologic correlation of imprint cytology in the diagnosis of primary and metastatic tumors is 100%.
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Affiliation(s)
- Ali Koyuncuer
- Department of Pathology, Umraniye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
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Qu J, Zhang W, Shu X, Wang Y, Wang L, Xu M, Yao L, Hu N, Tang B, Zhang L, Lui S. Construction and evaluation of a gated high-resolution neural network for automatic brain metastasis detection and segmentation. Eur Radiol 2023; 33:6648-6658. [PMID: 37186214 DOI: 10.1007/s00330-023-09648-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/23/2023] [Accepted: 02/08/2023] [Indexed: 05/17/2023]
Abstract
OBJECTIVES To construct and evaluate a gated high-resolution convolutional neural network for detecting and segmenting brain metastasis (BM). METHODS This retrospective study included craniocerebral MRI scans of 1392 patients with 14,542 BMs and 200 patients with no BM between January 2012 and April 2022. A primary dataset including 1000 cases with 11,686 BMs was employed to construct the model, while an independent dataset including 100 cases with 1069 BMs from other hospitals was used to examine the generalizability. The potential of the model for clinical use was also evaluated by comparing its performance in BM detection and segmentation to that of radiologists, and comparing radiologists' lesion detecting performances with and without model assistance. RESULTS Our model yielded a recall of 0.88, a dice similarity coefficient (DSC) of 0.90, a positive predictive value (PPV) of 0.93 and a false positives per patient (FP) of 1.01 in the test set, and a recall of 0.85, a DSC of 0.89, a PPV of 0.93, and a FP of 1.07 in dataset from other hospitals. With the model's assistance, the BM detection rates of 4 radiologists improved significantly, ranging from 5.2 to 15.1% (all p < 0.001), and also for detecting small BMs with diameter ≤ 5 mm (ranging from 7.2 to 27.0%, all p < 0.001). CONCLUSIONS The proposed model enables accurate BM detection and segmentation with higher sensitivity and less time consumption, showing the potential to augment radiologists' performance in detecting BM. CLINICAL RELEVANCE STATEMENT This study offers a promising computer-aided tool to assist the brain metastasis detection and segmentation in routine clinical practice for cancer patients. KEY POINTS • The GHR-CNN could accurately detect and segment BM on contrast-enhanced 3D-T1W images. • The GHR-CNN improved the BM detection rate of radiologists, including the detection of small lesions. • The GHR-CNN enabled automated segmentation of BM in a very short time.
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Affiliation(s)
- Jiao Qu
- Department of Radiology, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, China
| | - Wenjing Zhang
- Department of Radiology, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, China
| | - Xin Shu
- Machine Intelligence Laboratory, College of Computer Science, Sichuan University, Chengdu, China
| | - Ying Wang
- Department of Radiology, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, China
- Department of Nuclear Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Lituan Wang
- Machine Intelligence Laboratory, College of Computer Science, Sichuan University, Chengdu, China
| | - Mengyuan Xu
- Department of Radiology, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, China
| | - Li Yao
- Department of Radiology, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, China
| | - Na Hu
- Department of Radiology, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, China
| | - Biqiu Tang
- Department of Radiology, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, China
| | - Lei Zhang
- Machine Intelligence Laboratory, College of Computer Science, Sichuan University, Chengdu, China
| | - Su Lui
- Department of Radiology, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, China.
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Man C, Lau V, Su S, Zhao Y, Xiao L, Ding Y, Leung GK, Leong AT, Wu EX. Deep learning enabled fast 3D brain MRI at 0.055 tesla. SCIENCE ADVANCES 2023; 9:eadi9327. [PMID: 37738341 PMCID: PMC10516503 DOI: 10.1126/sciadv.adi9327] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/21/2023] [Indexed: 09/24/2023]
Abstract
In recent years, there has been an intensive development of portable ultralow-field magnetic resonance imaging (MRI) for low-cost, shielding-free, and point-of-care applications. However, its quality is poor and scan time is long. We propose a fast acquisition and deep learning reconstruction framework to accelerate brain MRI at 0.055 tesla. The acquisition consists of a single average three-dimensional (3D) encoding with 2D partial Fourier sampling, reducing the scan time of T1- and T2-weighted imaging protocols to 2.5 and 3.2 minutes, respectively. The 3D deep learning leverages the homogeneous brain anatomy available in high-field human brain data to enhance image quality, reduce artifacts and noise, and improve spatial resolution to synthetic 1.5-mm isotropic resolution. Our method successfully overcomes low-signal barrier, reconstructing fine anatomical structures that are reproducible within subjects and consistent across two protocols. It enables fast and quality whole-brain MRI at 0.055 tesla, with potential for widespread biomedical applications.
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Affiliation(s)
- Christopher Man
- Laboratory of Biomedical Imaging and Signal Processing, The University of Hong Kong, Hong Kong SAR, People’s Republic of China
- Department of Electrical and Electronic Engineering, The University of Hong Kong, Hong Kong SAR, People’s Republic of China
| | - Vick Lau
- Laboratory of Biomedical Imaging and Signal Processing, The University of Hong Kong, Hong Kong SAR, People’s Republic of China
- Department of Electrical and Electronic Engineering, The University of Hong Kong, Hong Kong SAR, People’s Republic of China
| | - Shi Su
- Laboratory of Biomedical Imaging and Signal Processing, The University of Hong Kong, Hong Kong SAR, People’s Republic of China
- Department of Electrical and Electronic Engineering, The University of Hong Kong, Hong Kong SAR, People’s Republic of China
| | - Yujiao Zhao
- Laboratory of Biomedical Imaging and Signal Processing, The University of Hong Kong, Hong Kong SAR, People’s Republic of China
- Department of Electrical and Electronic Engineering, The University of Hong Kong, Hong Kong SAR, People’s Republic of China
| | - Linfang Xiao
- Laboratory of Biomedical Imaging and Signal Processing, The University of Hong Kong, Hong Kong SAR, People’s Republic of China
- Department of Electrical and Electronic Engineering, The University of Hong Kong, Hong Kong SAR, People’s Republic of China
| | - Ye Ding
- Laboratory of Biomedical Imaging and Signal Processing, The University of Hong Kong, Hong Kong SAR, People’s Republic of China
- Department of Electrical and Electronic Engineering, The University of Hong Kong, Hong Kong SAR, People’s Republic of China
| | - Gilberto K. K. Leung
- Department of Surgery, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People’s Republic of China
| | - Alex T. L. Leong
- Laboratory of Biomedical Imaging and Signal Processing, The University of Hong Kong, Hong Kong SAR, People’s Republic of China
- Department of Electrical and Electronic Engineering, The University of Hong Kong, Hong Kong SAR, People’s Republic of China
| | - Ed X. Wu
- Laboratory of Biomedical Imaging and Signal Processing, The University of Hong Kong, Hong Kong SAR, People’s Republic of China
- Department of Electrical and Electronic Engineering, The University of Hong Kong, Hong Kong SAR, People’s Republic of China
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20
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Chen M, Guo Y, Wang P, Chen Q, Bai L, Wang S, Su Y, Wang L, Gong G. An Effective Approach to Improve the Automatic Segmentation and Classification Accuracy of Brain Metastasis by Combining Multi-phase Delay Enhanced MR Images. J Digit Imaging 2023; 36:1782-1793. [PMID: 37259008 PMCID: PMC10406988 DOI: 10.1007/s10278-023-00856-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 05/16/2023] [Accepted: 05/18/2023] [Indexed: 06/02/2023] Open
Abstract
The objective of this study is to analyse the diffusion rule of the contrast media in multi-phase delayed enhanced magnetic resonance (MR) T1 images using radiomics and to construct an automatic classification and segmentation model of brain metastases (BM) based on support vector machine (SVM) and Dpn-UNet. A total of 189 BM patients with 1047 metastases were enrolled. Contrast-enhanced MR images were obtained at 1, 3, 5, 10, 18, and 20 min following contrast medium injection. The tumour target volume was delineated, and the radiomics features were extracted and analysed. BM segmentation and classification models in the MR images with different enhancement phases were constructed using Dpn-UNet and SVM, and differences in the BM segmentation and classification models with different enhancement times were compared. (1) The signal intensity for BM decreased with time delay and peaked at 3 min. (2) Among the 144 optimal radiomics features, 22 showed strong correlation with time (highest R-value = 0.82), while 41 showed strong correlation with volume (highest R-value = 0.99). (3) The average dice similarity coefficients of both the training and test sets were the highest at 10 min for the automatic segmentation of BM, reaching 0.92 and 0.82, respectively. (4) The areas under the curve (AUCs) for the classification of BM pathology type applying single-phase MRI was the highest at 10 min, reaching 0.674. The AUC for the classification of BM by applying the six-phase image combination was the highest, reaching 0.9596, and improved by 42.3% compared with that by applying single-phase images at 10 min. The dynamic changes of contrast media diffusion in BM can be reflected by multi-phase delayed enhancement based on radiomics, which can more objectively reflect the pathological types and significantly improve the accuracy of BM segmentation and classification.
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Affiliation(s)
- Mingming Chen
- Department of Radiation Physics, Shandong First Medical University Affiliated Cancer Hospital, Shandong Cancer Hospital and Institute (Shandong Cancer Hospital), Jinan, 250117, China
- College of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250117, China
| | - Yujie Guo
- Department of Radiation Physics, Shandong First Medical University Affiliated Cancer Hospital, Shandong Cancer Hospital and Institute (Shandong Cancer Hospital), Jinan, 250117, China
| | - Pengcheng Wang
- College of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250117, China
| | - Qi Chen
- MedMind Technology Co., Ltd, 100084, Beijing, China
| | - Lu Bai
- MedMind Technology Co., Ltd, 100084, Beijing, China
| | - Shaobin Wang
- MedMind Technology Co., Ltd, 100084, Beijing, China
| | - Ya Su
- Department of Radiation Physics, Shandong First Medical University Affiliated Cancer Hospital, Shandong Cancer Hospital and Institute (Shandong Cancer Hospital), Jinan, 250117, China
| | - Lizhen Wang
- Department of Radiation Physics, Shandong First Medical University Affiliated Cancer Hospital, Shandong Cancer Hospital and Institute (Shandong Cancer Hospital), Jinan, 250117, China
| | - Guanzhong Gong
- Department of Radiation Physics, Shandong First Medical University Affiliated Cancer Hospital, Shandong Cancer Hospital and Institute (Shandong Cancer Hospital), Jinan, 250117, China.
- Department of Engineering Physics, Tsing Hua University, Beijing, 100084, China.
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21
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Khan IM, Khan SU, Sala HSS, Khan MU, Ud Din MA, Khan S, Hassan SSU, Khan NM, Liu Y. TME-targeted approaches of brain metastases and its clinical therapeutic evidence. Front Immunol 2023; 14:1131874. [PMID: 37228619 PMCID: PMC10204080 DOI: 10.3389/fimmu.2023.1131874] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 04/17/2023] [Indexed: 05/27/2023] Open
Abstract
The tumor microenvironment (TME), which includes both cellular and non-cellular elements, is now recognized as one of the major regulators of the development of primary tumors, the metastasis of which occurs to specific organs, and the response to therapy. Development of immunotherapy and targeted therapies have increased knowledge of cancer-related inflammation Since the blood-brain barrier (BBB) and blood-cerebrospinal fluid barrier (BCB) limit immune cells from entering from the periphery, it has long been considered an immunological refuge. Thus, tumor cells that make their way "to the brain were believed to be protected from the body's normal mechanisms of monitoring and eliminating them. In this process, the microenvironment and tumor cells at different stages interact and depend on each other to form the basis of the evolution of tumor brain metastases. This paper focuses on the pathogenesis, microenvironmental changes, and new treatment methods of different types of brain metastases. Through the systematic review and summary from macro to micro, the occurrence and development rules and key driving factors of the disease are revealed, and the clinical precision medicine of brain metastases is comprehensively promoted. Recent research has shed light on the potential of TME-targeted and potential treatments for treating Brain metastases, and we'll use that knowledge to discuss the advantages and disadvantages of these approaches.
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Affiliation(s)
- Ibrar Muhammad Khan
- Anhui Province Key Laboratory of Embryo Development and Reproduction Regulation, Anhui Province Key Laboratory of Environmental Hormone and Reproduction, School of Biological and Food Engineering, Fuyang Normal University, Fuyang, China
| | - Safir Ullah Khan
- Hefei National Laboratory for Physical Sciences at the Microscale, School of Life Sciences, University of Science and Technology of China, Hefei, China
| | - Hari Siva Sai Sala
- Anhui Province Key Laboratory of Embryo Development and Reproduction Regulation, Anhui Province Key Laboratory of Environmental Hormone and Reproduction, School of Biological and Food Engineering, Fuyang Normal University, Fuyang, China
| | - Munir Ullah Khan
- MOE Key Laboratory of Macromolecular Synthesis and Functionalization, International Research Center for X Polymers, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou, China
| | | | - Samiullah Khan
- Institute of Entomology, Guizhou University, Scientific Observing and Experimental Station of Crop Pests, Guiyang, Ministry of Agricultural and Affairs, Guiyang, China
| | - Syed Shams ul Hassan
- Department of Natural Product Chemistry, School of Pharmacy, Shanghai Jiao Tong University, Shanghai, China
| | - Nazir Muhammad Khan
- Department of Zoology, University of Science and Technology, Bannu, Pakistan
| | - Yong Liu
- Anhui Province Key Laboratory of Embryo Development and Reproduction Regulation, Anhui Province Key Laboratory of Environmental Hormone and Reproduction, School of Biological and Food Engineering, Fuyang Normal University, Fuyang, China
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22
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Wang L, Han H, Feng Y, Ma J, Han Z, Li R, Zhu W, Li S, Tian J, Zhang L. Capilliposide B inhibits the migration of prostate cancer by inducing autophagy through the ROS/AMPK/mTOR pathway. Phytother Res 2023. [PMID: 36867511 DOI: 10.1002/ptr.7785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
Capilliposide B (CPS-B), a novel oleanane triterpenoid saponin derived from Lysimachia capillipes Hemsl, is a potent anticancer agent. However, its anticancer mechanism remains elusive. In the present study, we demonstrated the potent anti-tumor activity and molecular mechanism of CPS-B both in vitro and in vivo. Proteomic analysis using isobaric tags for relative and absolute quantitation techniques suggested that CPS-B modulated autophagy in prostate cancer (PC). Moreover, Western blotting showed that both autophagy and epithelial-mesenchymal transition occurred place after CPS-B treatment in vivo, which was also proven in PC-3 cancer cells. We deduced that CPS-B inhibited migration by inducing autophagy. We examined the accumulation of reactive oxygen species (ROS) in cells, and in downstream pathways, LKB1 and AMPK were activated while mTOR was inhibited. Transwell experiment results showed that CPS-B inhibited the metastasis of PC-3 cells and that this effect was significantly attenuated after pretreatment with chloroquine, indicating that CPS-B inhibited metastasis via autophagy induction. Altogether, these data suggest that CPS-B is a potential therapeutic agent for cancer treatment that acts by inhibiting migration through the ROS/AMPK/mTOR signaling pathway.
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Affiliation(s)
- Luping Wang
- College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, People's Republic of China.,Institute of Basic Medicine and Cancer, Chinese Academy of Sciences, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
| | - Haote Han
- College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, People's Republic of China
| | - Yue Feng
- Institute of Basic Medicine and Cancer, Chinese Academy of Sciences, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
| | - Jiahui Ma
- Marine Science College, Zhejiang Ocean University, Zhoushan, Zhejiang, People's Republic of China
| | - Zhuo Han
- Institute of Basic Medicine and Cancer, Chinese Academy of Sciences, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
| | - Ruyi Li
- College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, People's Republic of China
| | - Wei Zhu
- Institute of Basic Medicine and Cancer, Chinese Academy of Sciences, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
| | - Shouxin Li
- Institute of Basic Medicine and Cancer, Chinese Academy of Sciences, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
| | - Jingkui Tian
- Institute of Basic Medicine and Cancer, Chinese Academy of Sciences, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
| | - Lin Zhang
- College of Life Sciences and Medicine, Zhejiang Sci-Tech University, Hangzhou, People's Republic of China
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23
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Ma K, Zhao D, Li X, Duan H, Yan C, Wang S, Zeng L, Xu K, Lai Y, Chen B, Mu N, Yang C, Quan Y, Li Z, Wang X, Feng H, Li F. Case report: Multiple brain metastases of atrial myxoma: Clinical experience and literature review. Front Neurol 2023; 13:1046441. [PMID: 36845225 PMCID: PMC9944787 DOI: 10.3389/fneur.2022.1046441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 12/22/2022] [Indexed: 02/11/2023] Open
Abstract
Myxoma is the most common type of benign cardiac tumor in adults, and it has a strong tendency to embolize or metastasize to distant organs. Patients with multiple brain metastases have rarely been seen in clinics; hence, standard treatment protocols for multimyxoma metastasis in the brain have not been established. We present the case of a 47-year-old female who had convulsions in the right hand and repeated seizures. Computed tomography revealed multiple tumor sites in her brain. Craniotomy was conducted to remove the tumor sites. However, recurrent brain tumors and unexpected cerebral infarctions occurred frequently shortly after the treatment because the cardiac myxoma had not been treated due to the patient's personal concerns. The myxoma was resected by gamma knife radiosurgery, and temozolomide was given prior to cardiac surgery. There has been no evidence of tumor recurrence from the 2 years following the surgery until the present. This case highlights the importance of prioritizing cardiac lesions over cerebral lesions; if a cerebral metastasis has been found, it is likely that the cardiac myxoma is already unstable, with high rates of spread and metastasis. Therefore, it is unwise to treat metastasis sites before the cardiac myxoma. Additionally, the case suggests that gamma knife radiosurgery combined with temozolomide is effective as treatment for multiple myxoma metastasis in the brain. Compared with conventional cerebral surgery, gamma knife radiosurgery is safer, causes less bleeding, and requires a shorter time for recovery.
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Affiliation(s)
- Kang Ma
- Department of Neurosurgery and Key Laboratory of Neurotrauma, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Dawei Zhao
- Department of Neurosurgery, Chongqing Sanbo Changan Hospital, Chongqing, China
| | - Xuegang Li
- Department of Neurosurgery and Key Laboratory of Neurotrauma, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Haijun Duan
- Department of Neurosurgery and Key Laboratory of Neurotrauma, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Chaojun Yan
- Department of Cardiosurgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Shi Wang
- Department of Neurosurgery and Key Laboratory of Neurotrauma, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Lan Zeng
- Department of Neurology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Kai Xu
- Department of Neurosurgery and Key Laboratory of Neurotrauma, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Ying Lai
- Department of Neurosurgery and Key Laboratory of Neurotrauma, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Beike Chen
- Department of Neurosurgery and Key Laboratory of Neurotrauma, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Ning Mu
- Department of Neurosurgery and Key Laboratory of Neurotrauma, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Chuanyan Yang
- Department of Neurosurgery and Key Laboratory of Neurotrauma, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Yulian Quan
- Department of Neurosurgery and Key Laboratory of Neurotrauma, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Zhengyang Li
- Department of Neurosurgery and Key Laboratory of Neurotrauma, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Xiaoming Wang
- Department of Neurology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Hua Feng
- Department of Neurosurgery and Key Laboratory of Neurotrauma, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Fei Li
- Department of Neurosurgery and Key Laboratory of Neurotrauma, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China,*Correspondence: Fei Li ✉
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24
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Scorsetti M, Navarria P, Cozzi L, Clerici E, Bellu L, Franceschini D, Marzo AM, Franzese C, Torri V, Reggiori G, Lobefalo F, Raspagliesi L, Attuati L, Pessina F, Franzini A, Picozzi P, Tomatis S. Radiosurgery of limited brain metastases from primary solid tumor: results of the randomized phase III trial (NCT02355613) comparing treatments executed with a specialized or a C-arm linac-based platform. Radiat Oncol 2023; 18:28. [PMID: 36750848 PMCID: PMC9906937 DOI: 10.1186/s13014-023-02216-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/30/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Comparative prospective data regarding different radiosurgery (SRS) modalities for treating brain metastases (BMs) from solid tumors are not available. To investigate with a single institute phase III randomized trial whether SRS executed with linac (Arm-B) is superior to a dedicated multi-source gamma-ray stereotactic platform (Arm-A). METHODS Adults patients with 1-4 BMs from solid tumors up to 30 mm in maximum diameter were randomly assigned to arms A and B. The primary endpoint was cumulative incidence of symptomatic (grade 2-3) radionecrosis (CIRN). Secondary endpoints were local progression cumulative incidence (CILP), distant brain failure, disease-free survival (DFS), and overall survival (OS). RESULTS A total of 251 patients were randomly assigned to Arm-A (121) or Arm-B (130). The 1-year RN cumulative incidence was 6.7% in whole cohort, 3.8% (95% CI 1.9-7.4%) in Arm-B, and 9.3% (95% CI 6.2-13.8%) in the Arm-A (p = 0.43). CIRN was influenced by target volume irradiated only for the Arm-A (p << 0.001; HR 1.36 [95% CI 1.25-1.48]). Symptomatic RN occurred in 56 cases at a median time of 10.3 months (range 1.15-54.8 months), 27 in the Arm-B at a median time of 15.9 months (range 4.9-54.8 months), and 29 in the Arm-A at a median time of 6.9 months (1.2-32.3 months), without statistically significant differences between the two arms. No statistically significant differences were recorded between the two arms in CILP, BDF, DFS or OS. The mean beam-on time to deliver SRS was 49.0 ± 36.2 min in Arm-A, and 3.1 ± 1.6 min in Arm-B. CONCLUSIONS Given the technical differences between the treatment platforms investigated in this single-institution study, linac-based SRS (Arm-B) did not lead to significantly lower grade 2-3 RN rates versus the multi-source gamma-ray system (Arm-A) in a population of patients with limited brain metastases of small volume. No significant difference in local control was observed between both arms. For Arm-B, the treatment delivery time was significantly lower than for Arm-A. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT02355613.
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Affiliation(s)
- Marta Scorsetti
- grid.417728.f0000 0004 1756 8807Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan Italy ,grid.452490.eDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan Italy
| | - Pierina Navarria
- Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy.
| | - Luca Cozzi
- grid.417728.f0000 0004 1756 8807Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan Italy ,grid.452490.eDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan Italy
| | - Elena Clerici
- grid.417728.f0000 0004 1756 8807Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan Italy
| | - Luisa Bellu
- grid.417728.f0000 0004 1756 8807Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan Italy
| | - Davide Franceschini
- grid.417728.f0000 0004 1756 8807Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan Italy
| | - Antonio Marco Marzo
- grid.417728.f0000 0004 1756 8807Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan Italy
| | - Ciro Franzese
- grid.417728.f0000 0004 1756 8807Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan Italy ,grid.452490.eDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan Italy
| | - Valter Torri
- grid.4527.40000000106678902Oncology Department, IRCCS Istituto Mario Negri, Milan, Italy
| | - Giacomo Reggiori
- grid.417728.f0000 0004 1756 8807Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan Italy
| | - Francesca Lobefalo
- grid.417728.f0000 0004 1756 8807Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan Italy
| | - Luca Raspagliesi
- grid.417728.f0000 0004 1756 8807Neurosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, Milan Italy
| | - Luca Attuati
- grid.417728.f0000 0004 1756 8807Neurosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, Milan Italy
| | - Federico Pessina
- grid.417728.f0000 0004 1756 8807Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan Italy ,grid.452490.eDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan Italy
| | - Andrea Franzini
- grid.417728.f0000 0004 1756 8807Neurosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, Milan Italy
| | - Piero Picozzi
- grid.417728.f0000 0004 1756 8807Neurosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, Milan Italy
| | - Stefano Tomatis
- grid.417728.f0000 0004 1756 8807Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan Italy
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25
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Sen D, Sarkar S, Mukhopadhyay P. Prime Editing: An Emerging Tool in Cancer Treatment. Mol Biotechnol 2023; 65:509-520. [PMID: 36251123 PMCID: PMC9574179 DOI: 10.1007/s12033-022-00580-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/26/2022] [Indexed: 11/30/2022]
Abstract
Prime Editing is a CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats) based genome editing technique having promising potential in terms of reducing off target activity. It introduces fragments of DNA sequences into the target site using a guide RNA (gRNA) molecule, composed of both the sequence that is to be inserted into the target site along with an inactive Cas9 nickase and a reverse transcriptase. Prime Editing can cause insertions, deletions, and various point mutations for reverting the phenetic characteristics of a disease specially tested in human adult stem cells and cancer cell lines. The main aim of our review is to explore how Prime Editing and its various forms are being utilized as an emerging tool to cure deleterious diseases like cancer, also as a delivery strategy of the tool into cells. There are almost five generations of Prime Editors (PE) with increasing levels of efficiency from one level to another that have huge clinical potential in correcting mutations; however, the necessity for a pegRNA design is extremely significant. But besides having such advantages, the limitations of this technology particularly include generation of double nicks while optimizing the efficiency of PE3. So, it is important to consider all such consequences and customize PE as per requirements.
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Affiliation(s)
- Debmitra Sen
- Department of Microbiology, Barrackpore Rastraguru Surendranath College, Kolkata, West Bengal 700120 India ,Department of Microbiology, University of Kalyani, Nadia, 741235 India
| | - Sutripta Sarkar
- Department of Food and Nutrition, Barrackpore Rastraguru Surendranath College, Kolkata, West Bengal 700120 India
| | - Poulami Mukhopadhyay
- Department of Microbiology, Barrackpore Rastraguru Surendranath College, Kolkata, West Bengal, 700120, India.
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26
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Rossi S, Marinello A, Pagliaro A, Franceschini D, Navarria P, Finocchiaro G, Toschi L, Scorsetti M, Santoro A. Current treatment approaches for brain metastases in ALK/ ROS1/ NTRK-positive non-small-cell lung cancer. Expert Rev Anticancer Ther 2023; 23:29-41. [PMID: 36548111 DOI: 10.1080/14737140.2023.2162044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Oncogene-addicted non-small cell lung cancer (NSCLC) patients present a high incidence of CNS metastases either at diagnosis or during the course of the disease. In this case, patients present with worse prognosis and are often excluded from clinical trials unless brain metastases are pre-treated or clinically stable. AREAS COVERED As a result of the discovery of several oncogenic drivers in ALK/ROS1/NTRK-positive NSCLC, targeted agents have been tested in several trials. We evaluate and compare the intracranial efficacy of available targeted agents in ALK/ROS1/NTRK-positive NSCLC based on subgroup analysis from pivotal trials. EXPERT OPINION Last-generation ALK inhibitors have shown slightly superior intracranial activity but pivotal trials do not consider the same endpoints for intracranial efficacy, therefore data are not comparable. Local treatments for BM including surgical resection, stereotactic radiosurgery (SRS) and WBRT, should be integrated with systemic therapies basing on specific criteria like presence of oligoprogression or symptomatic progression.
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Affiliation(s)
- Sabrina Rossi
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Arianna Marinello
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Arianna Pagliaro
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Davide Franceschini
- Department of Radiotherapy and Radiosurgery, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Pierina Navarria
- Department of Radiotherapy and Radiosurgery, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Giovanna Finocchiaro
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Luca Toschi
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Marta Scorsetti
- Department of Biomedical Sciences, Humanitas University, Milan, Italy.,Department of Radiotherapy and Radiosurgery, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Armando Santoro
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Italy
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Cicin I, Martin C, Haddad CK, Kim SW, Smolin A, Abdillah A, Yang X. ALK TKI therapy in patients with ALK-positive non-small cell lung cancer and brain metastases: A review of the literature and local experiences. Crit Rev Oncol Hematol 2022; 180:103847. [DOI: 10.1016/j.critrevonc.2022.103847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 08/01/2022] [Accepted: 10/12/2022] [Indexed: 11/12/2022] Open
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Thommen R, Kazim SF, Rumalla K, Kassicieh AJ, Kalakoti P, Schmidt MH, McKee RG, Hall DE, Miskimins RJ, Bowers CA. Preoperative frailty measured by risk analysis index predicts complications and poor discharge outcomes after Brain Tumor Resection in a large multi-center analysis. J Neurooncol 2022; 160:285-297. [PMID: 36316568 DOI: 10.1007/s11060-022-04135-z] [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: 08/23/2022] [Accepted: 09/14/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE To evaluate the independent effect of frailty, as measured by the Risk Analysis Index-Administrative (RAI-A) for postoperative complications and discharge outcomes following brain tumor resection (BTR) in a large multi-center analysis. METHODS Patients undergoing BTR were queried from the National Surgical Quality Improvement Program (NSIQP) for the years 2015 to 2019. Multivariable logistic regression was performed to evaluate the independent associations between frailty tools (age, 5-factor modified frailty score [mFI-5], and RAI-A) on postoperative complications and discharge outcomes. RESULTS We identified 30,951 patients who underwent craniotomy for BTR; the median age of our study sample was 59 (IQR 47-68) years old and 47.8% of patients were male. Overall, increasing RAI-A score, in an overall stepwise fashion, was associated with increasing risk of adverse outcomes including in-hospital mortality, non-routine discharge, major complications, Clavien-Dindo Grade IV complication, and extended length of stay. Multivariable regression analysis (adjusting for age, sex, BMI, non-elective surgery status, race, and ethnicity) demonstrated that RAI-A was an independent predictor for worse BTR outcomes. The RAI-A tiers 41-45 (1.2% cohort) and > 45 (0.3% cohort) were ~ 4 (Odds Ratio [OR]: 4.3, 95% CI: 2.1-8.9) and ~ 9 (OR: 9.5, 95% CI: 3.9-22.9) times more likely to have in-hospital mortality compared to RAI-A 0-20 (34% cohort). CONCLUSIONS AND RELEVANCE Increasing preoperative frailty as measured by the RAI-A score is independently associated with increased risk of complications and adverse discharge outcomes after BTR. The RAI-A may help providers present better preoperative risk assessment for patients and families weighing the risks and benefits of potential BTR.
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Affiliation(s)
- Rachel Thommen
- School of Medicine, New York Medical College, Valhalla, NY 10595, USA
- Bowers Neurosurgical Frailty and Outcomes Data Science Lab, Albuquerque, NM 87131, USA
| | - Syed Faraz Kazim
- Bowers Neurosurgical Frailty and Outcomes Data Science Lab, Albuquerque, NM 87131, USA
- Department of Neurosurgery, University of New Mexico, Albuquerque, NM 87131, USA
| | - Kavelin Rumalla
- Bowers Neurosurgical Frailty and Outcomes Data Science Lab, Albuquerque, NM 87131, USA
- Department of Neurosurgery, University of New Mexico, Albuquerque, NM 87131, USA
| | - Alexander J Kassicieh
- Bowers Neurosurgical Frailty and Outcomes Data Science Lab, Albuquerque, NM 87131, USA
- Department of Neurosurgery, University of New Mexico, Albuquerque, NM 87131, USA
| | - Piyush Kalakoti
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Meic H Schmidt
- Bowers Neurosurgical Frailty and Outcomes Data Science Lab, Albuquerque, NM 87131, USA
- Department of Neurosurgery, University of New Mexico, Albuquerque, NM 87131, USA
| | - Rohini G McKee
- Department of Surgery, University of New Mexico Hospital (UNMH), Albuquerque, NM 87131, USA
| | - Daniel E Hall
- Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Wolff Center at UPMC, Pittsburgh, PA, USA
- Center for Health Equity Research and Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA
- Geriatric Research Education and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Richard J Miskimins
- Department of Surgery, University of New Mexico Hospital (UNMH), Albuquerque, NM 87131, USA
| | - Christian A Bowers
- Bowers Neurosurgical Frailty and Outcomes Data Science Lab, Albuquerque, NM 87131, USA.
- Department of Neurosurgery, University of New Mexico, Albuquerque, NM 87131, USA.
- Department of Neurosurgery MSC10 5615, University of New Mexico, Albuquerque, NM 81731, USA.
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29
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Devan SP, Jiang X, Luo G, Xie J, Quirk JD, Engelbach JA, Harmsen H, McKinley ET, Cui J, Zu Z, Attia A, Garbow JR, Gore JC, McKnight CD, Kirschner AN, Xu J. Selective Cell Size MRI Differentiates Brain Tumors from Radiation Necrosis. Cancer Res 2022; 82:3603-3613. [PMID: 35877201 PMCID: PMC9532360 DOI: 10.1158/0008-5472.can-21-2929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 02/05/2022] [Accepted: 07/21/2022] [Indexed: 11/16/2022]
Abstract
Brain metastasis is a common characteristic of late-stage lung cancers. High doses of targeted radiotherapy can control tumor growth in the brain but can also result in radiotherapy-induced necrosis. Current methods are limited for distinguishing whether new parenchymal lesions following radiotherapy are recurrent tumors or radiotherapy-induced necrosis, but the clinical management of these two classes of lesions differs significantly. Here, we developed, validated, and evaluated a new MRI technique termed selective size imaging using filters via diffusion times (SSIFT) to differentiate brain tumors from radiotherapy necrosis in the brain. This approach generates a signal filter that leverages diffusion time dependence to establish a cell size-weighted map. Computer simulations in silico, cultured cancer cells in vitro, and animals with brain tumors in vivo were used to comprehensively validate the specificity of SSIFT for detecting typical large cancer cells and the ability to differentiate brain tumors from radiotherapy necrosis. SSIFT was also implemented in patients with metastatic brain cancer and radiotherapy necrosis. SSIFT showed high correlation with mean cell sizes in the relevant range of less than 20 μm. The specificity of SSIFT for brain tumors and reduced contrast in other brain etiologies allowed SSIFT to differentiate brain tumors from peritumoral edema and radiotherapy necrosis. In conclusion, this new, cell size-based MRI method provides a unique contrast to differentiate brain tumors from other pathologies in the brain. SIGNIFICANCE This work introduces and provides preclinical validation of a new diffusion MRI method that exploits intrinsic differences in cell sizes to distinguish brain tumors and radiotherapy necrosis.
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Affiliation(s)
- Sean P Devan
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Chemical and Physical Biology Program, Vanderbilt University, Nashville, TN, 37232, USA
| | - Xiaoyu Jiang
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Guozhen Luo
- Department of Radiation Oncology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Jingping Xie
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - James D Quirk
- Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO 63110, USA
| | - John A Engelbach
- Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO 63110, USA
| | - Hannah Harmsen
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Eliot T McKinley
- Department of Cell and Developmental Biology, Vanderbilt University, Nashville, TN, 37232, USA
| | - Jing Cui
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Zhongliang Zu
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Albert Attia
- Department of Radiation Oncology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Joel R Garbow
- Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO 63110, USA
- Alvin J Siteman Cancer Center, Washington University, St. Louis, MO, 63110, USA
| | - John C. Gore
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232, USA
- Department of Physics and Astronomy, Vanderbilt University, Nashville, TN 37232, USA
| | - Colin D McKnight
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Austin N Kirschner
- Department of Radiation Oncology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Junzhong Xu
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232, USA
- Department of Physics and Astronomy, Vanderbilt University, Nashville, TN 37232, USA
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30
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Wu MY, Zou WJ, Yu P, Yang Y, Li SJ, Liu Q, Xie J, Chen SQ, Lin WJ, Tang Y. Cranial irradiation impairs intrinsic excitability and synaptic plasticity of hippocampal CA1 pyramidal neurons with implications for cognitive function. Neural Regen Res 2022; 17:2253-2259. [PMID: 35259846 PMCID: PMC9083168 DOI: 10.4103/1673-5374.336875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Radiation therapy is a standard treatment for head and neck tumors. However, patients often exhibit cognitive impairments following radiation therapy. Previous studies have revealed that hippocampal dysfunction, specifically abnormal hippocampal neurogenesis or neuroinflammation, plays a key role in radiation-induced cognitive impairment. However, the long-term effects of radiation with respect to the electrophysiological adaptation of hippocampal neurons remain poorly characterized. We found that mice exhibited cognitive impairment 3 months after undergoing 10 minutes of cranial irradiation at a dose rate of 3 Gy/min. Furthermore, we observed a remarkable reduction in spike firing and excitatory synaptic input, as well as greatly enhanced inhibitory inputs, in hippocampal CA1 pyramidal neurons. Corresponding to the electrophysiological adaptation, we found reduced expression of synaptic plasticity marker VGLUT1 and increased expression of VGAT. Furthermore, in irradiated mice, long-term potentiation in the hippocampus was weakened and GluR1 expression was inhibited. These findings suggest that radiation can impair intrinsic excitability and synaptic plasticity in hippocampal CA1 pyramidal neurons.
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Affiliation(s)
- Min-Yi Wu
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Wen-Jun Zou
- State Key Laboratory of Organ Failure Research, Key Laboratory of Mental Health of the Ministry of Education, Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Key Laboratory of Psychiatric Disorders of Guangdong Province, Collaborative Innovation Center for Brain Science, Department of Neurobiology, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Pei Yu
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Yuhua Yang
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Shao-Jian Li
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Qiang Liu
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Jiatian Xie
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Si-Qi Chen
- Department of Anesthesiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Wei-Jye Lin
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine; Medical Research Center, Sun Yat-sen Memorial Hospital; Guangdong Province Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Yamei Tang
- Department of Neurology, Sun Yat-sen Memorial Hospital; Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-sen Memorial Hospital; Guangdong Province Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong Province, China
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Xu M, Song K, Zhou Z, Yu Z, Lv Y, Xu H. Survival and prognostic factors in patients undergoing the resection of solitary brain metastasis from non-small cell lung cancer: a retrospective cohort study. J Thorac Dis 2022; 14:4113-4124. [PMID: 36389303 PMCID: PMC9641336 DOI: 10.21037/jtd-22-1279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 10/12/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Neurosurgery is the standard of care for resectable solitary brain metastasis (BM) from non-small cell lung cancer (NSCLC), but still with a poor outcome. Postoperative whole-brain radiotherapy (WBRT) was reported to reduce local recurrence, whether it could prolong survival was uncertain. In this study, we attempted to evaluate WBRT and other prognostic for overall survival (OS) in these patients. METHODS In this retrospective study, NSCLC patients with a solitary BM and controlled primary tumor who underwent neurosurgical resection were selected from the medical records database between January 2014 and December 2018. Clinical data, disease control/progression results and survival outcomes were obtained from the medical records, regular outpatient follow-up and telephone interviews. Univariable and multivariable Cox analyses of potential prognostic factors including patients' characteristics, BM features, tissue-based parameters and postoperative treatments were conducted. OS was illustrated using Kaplan-Meier curves, and group differences were assessed using the log-rank test. The subgroup analysis compared each variable between the WBRT group and the untreated control by the hazard ratio and its 95% confidence interval (CI). RESULTS A total of 94 patients were included, with a median OS of 812 days. Univariable analysis showed that postoperative WBRT and targeted therapy were associated with OS. Multivariable analysis demonstrated that postoperative WBRT [P<0.001, hazard ratio (HR) 0.357], chemotherapy (P=0.008, HR 0.512), targeted therapy (P<0.001, HR 0.265), and smaller tumor size (P=0.018, HR 0.553) were independent prognostic factors for prolonged OS. However, tissue-based parameters (Ki67 tumor cell proliferation index, epidermal growth factor receptor, and checkpoint levels) were identified as statistically insignificant factors. In the subgroup analysis, the beneficial effect of WBRT was only observed in patients that did not receive systematic treatments. CONCLUSIONS Postoperative WBRT and systematic treatments after solitary BM resection improve the prognosis of NSCLC patients with a controlled primary tumor. Postoperative WBRT could be considered, especially for those who not receive systematic chemotherapy or targeted therapy treatments, as they might be more likely to benefit from it.
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Affiliation(s)
- Ming Xu
- Department of Anesthesiology and Perioperative Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Kun Song
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China;,National Center for Neurological Disorders, Shanghai, China;,Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, China;,Neurosurgical Institute of Fudan University, Shanghai, China;,Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
| | - Zhirui Zhou
- Radiation Oncology Center, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Ziye Yu
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China;,National Center for Neurological Disorders, Shanghai, China;,Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, China;,Neurosurgical Institute of Fudan University, Shanghai, China;,Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
| | - Yizheng Lv
- Department of Anesthesiology and Perioperative Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Hongzhi Xu
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China;,National Center for Neurological Disorders, Shanghai, China;,Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, China;,Neurosurgical Institute of Fudan University, Shanghai, China;,Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
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32
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Zhu L, Yang F, Wang G, Li Q. CXC Motif Chemokine Receptor Type 4 Disrupts Blood-Brain Barrier and Promotes Brain Metastasis Through Activation of the PI3K/AKT Pathway in Lung Cancer. World Neurosurg 2022; 166:e369-e381. [PMID: 35817351 DOI: 10.1016/j.wneu.2022.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 07/02/2022] [Accepted: 07/04/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND CXC motif chemokine receptor type 4 (CXCR4) is an indispensable factor in the process of lung cancer brain metastasis (LCBM). The PI3K/AKT signal pathway is crucial in affecting cell invasion and metastasis and serves as a pivotal regulator in LCBM. However, the relationship between CXCR4 and the PI3K/AKT signal pathway is unclear. This study aimed to explore the underlying mechanisms of CXCR4 and PI3K/AKT in LCBM. METHODS Two lung cancer cells (A549 and H1299) and cells transfected with short hairpin RNA (shRNA)-CXCR4 were cocultured with normal human astrocyte cells and human brain endothelial (hCMEC/D3) cells to establish a blood-brain barrier model in vitro. The proliferation, migration, and invasion tight junction proteins (claudin-5, occludin, and ZO-1) were examined. Finally, results were verified in a nude mice model. RESULTS The abilities of cell proliferation, migration, and invasion were significantly reduced in A549 and H1299 cells transfected with shRNA-CXCR4 compared with the negative control group. The proteins phosphorylated PI3K and phosphorylated AKT were downregulated in lung cancer cells transfected with shRNA-CXCR4. The proteins claudin-5, occludin, and ZO-1 were upregulated in the A549 and H1299 cells transfected with shRNA-CXCR4. In vivo experiment results confirmed that the knockdown of CXCR4 played a protective role in the process of LCBM. CONCLUSIONS Our findings revealed that CXCR4 promotes LCBM by regulating the PI3K/Akt signal pathway. We also demonstrated that inhibiting CXCR4 could lead to prevention of LCBM. This study provides further rationale for clinical therapy that targets CXCR4/PI3K/AKT.
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Affiliation(s)
- Lei Zhu
- Department of Neurosurgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China; Department of Thoracic Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China; Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Fugui Yang
- Department of Thoracic Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Guangxue Wang
- Research Center for Translational Medicine, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Qinchuan Li
- Department of Thoracic Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China.
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33
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Zhang Z, Jiang J, He Y, Cai J, Xie J, Wu M, Xing M, Zhang Z, Chang H, Yu P, Chen S, Yang Y, Shi Z, Liu Q, Sun H, He B, Zeng J, Huang J, Chen J, Li H, Li Y, Lin WJ, Tang Y. Pregabalin mitigates microglial activation and neuronal injury by inhibiting HMGB1 signaling pathway in radiation-induced brain injury. J Neuroinflammation 2022; 19:231. [PMID: 36131309 PMCID: PMC9490947 DOI: 10.1186/s12974-022-02596-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 09/07/2022] [Indexed: 12/04/2022] Open
Abstract
Background Radiation-induced brain injury (RIBI) is the most serious complication of radiotherapy in patients with head and neck tumors, which seriously affects the quality of life. Currently, there is no effective treatment for patients with RIBI, and identifying new treatment that targets the pathological mechanisms of RIBI is urgently needed. Methods Immunofluorescence staining, western blotting, quantitative real-time polymerase chain reaction (Q-PCR), co-culture of primary neurons and microglia, terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) assay, enzyme-linked immunosorbent assay (ELISA), and CRISPR–Cas9-mediated gene editing techniques were employed to investigate the protective effects and underlying mechanisms of pregabalin that ameliorate microglial activation and neuronal injury in the RIBI mouse model. Results Our findings showed that pregabalin effectively repressed microglial activation, thereby reducing neuronal damage in the RIBI mouse model. Pregabalin mitigated inflammatory responses by directly inhibiting cytoplasmic translocation of high-mobility group box 1 (HMGB1), a pivotal protein released by irradiated neurons which induced subsequent activation of microglia and inflammatory cytokine expression. Knocking out neuronal HMGB1 or microglial TLR2/TLR4/RAGE by CRISPR/Cas9 technique significantly inhibited radiation-induced NF-κB activation and pro-inflammatory transition of microglia. Conclusions Our findings indicate the protective mechanism of pregabalin in mitigating microglial activation and neuronal injury in RIBI. It also provides a therapeutic strategy by targeting HMGB1-TLR2/TLR4/RAGE signaling pathway in the microglia for the treatment of RIBI. Supplementary Information The online version contains supplementary material available at 10.1186/s12974-022-02596-7.
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Affiliation(s)
- Zhan Zhang
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China.,Brain Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Jingru Jiang
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China.,Brain Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Yong He
- Radiotherapeutic Department, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jinhua Cai
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China.,Brain Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Jiatian Xie
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Minyi Wu
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Mengdan Xing
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Zhenzhen Zhang
- Key Laboratory of Brain, Cognition and Education Science, Ministry of Education, Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou, 510631, China
| | - Haocai Chang
- MOE Key Laboratory of Laser Life Science & Institute of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou, 510631, China
| | - Pei Yu
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Siqi Chen
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Yuhua Yang
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Zhongshan Shi
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Qiang Liu
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Haohui Sun
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Baixuan He
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Junbo Zeng
- Brain Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Jialin Huang
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Jiongxue Chen
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Honghong Li
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Yi Li
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China. .,Brain Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China.
| | - Wei-Jye Lin
- Brain Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China. .,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China. .,Guangdong Province Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China.
| | - Yamei Tang
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China. .,Brain Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China. .,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China. .,Guangdong Province Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China.
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34
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Oishi T, Ito M, Koizumi S, Horikawa M, Yamamoto T, Yamagishi S, Yamasaki T, Sameshima T, Suzuki T, Sugimura H, Namba H, Kurozumi K. Efficacy of HSV-TK/GCV system suicide gene therapy using SHED expressing modified HSV-TK against lung cancer brain metastases. Mol Ther Methods Clin Dev 2022; 26:253-265. [PMID: 35892087 PMCID: PMC9307584 DOI: 10.1016/j.omtm.2022.07.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 07/03/2022] [Indexed: 11/29/2022]
Abstract
Lung cancer is one of the most common cancers, and the number of patients with intracranial metastases is increasing. Previously, we developed an enzyme prodrug suicide gene therapy based on the herpes simplex virus thymidine kinase (HSV-TK)/ganciclovir (GCV) system using various mesenchymal stem cells to induce apoptosis in malignant gliomas through bystander killing effects. Here, we describe stem cells from human exfoliated deciduous teeth (SHED) as gene vehicles of the TK/GCV system against a brain metastasis model of non-small cell lung cancer (NSCLC). We introduced the A168H mutant TK (TKA168H) into SHED to establish the therapeutic cells because of the latent toxicity of wild type. SHED expressing TKA168H (SHED-TK) exhibited chemotaxis to the conditioned medium of NSCLC and migrated toward implanted NSCLC in vivo. SHED-TK demonstrated a strong bystander effect in vitro and in vivo and completely eradicated H1299 NSCLC in the brain. SHED-TK cells implanted intratumorally followed by GCV administration significantly suppressed the growth of H1299 and improved survival time. These results indicate that the TKA168H variant is suitable for establishing therapeutic cells and that intratumoral injection of SHED-TK followed by GCV administration may be a useful strategy for therapeutic approaches.
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Affiliation(s)
- Tomoya Oishi
- Department of Neurosurgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Masahiko Ito
- Department of Virology and Parasitology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Shinichiro Koizumi
- Department of Neurosurgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Makoto Horikawa
- Department of Neurosurgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Taisuke Yamamoto
- Department of Neurosurgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Satoru Yamagishi
- Department of Organ and Tissue Anatomy, Hamamatsu University School of Medicine, Hamamatsu, Japan.,Preeminent Medical Photonics Education and Research Center, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Tomohiro Yamasaki
- Department of Neurosurgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Tetsuro Sameshima
- Department of Neurosurgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Tetsuro Suzuki
- Department of Virology and Parasitology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Haruhiko Sugimura
- Department of Tumor Pathology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hiroki Namba
- Department of Neurosurgery, Enshu Hospital, Hamamatsu, Japan
| | - Kazuhiko Kurozumi
- Department of Neurosurgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
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Li G, Wu S, Zhao H, Guan W, Zhou Y, Shi B. Non-invasive prognostic biomarker of lung cancer patients with brain metastases: Recurrence quantification analysis of heart rate variability. Front Physiol 2022; 13:987835. [PMID: 36148296 PMCID: PMC9486009 DOI: 10.3389/fphys.2022.987835] [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: 07/06/2022] [Accepted: 08/15/2022] [Indexed: 11/28/2022] Open
Abstract
Background: It has previously been shown that the time-domain characteristic of heart rate variability (HRV) is an independent prognostic factor for lung cancer patients with brain metastasis (LCBM). However, it is unclear whether the nonlinear dynamic features contained in HRV are associated with prognosis in patients with LCBM. Recurrence quantification analysis (RQA) is a common nonlinear method used to characterize the complexity of heartbeat interval time series. This study was aimed to explore the association between HRV RQA parameters and prognosis in LCBM patients. Methods: Fifty-six LCBM patients from the Department of Radiation Oncology, the First Affiliated Hospital of Bengbu Medical College, were enrolled in this study. Five-minute ECG data were collected by a mini-ECG recorder before the first brain radiotherapy, and then heartbeat interval time series were extracted for RQA. The main parameters included the mean diagonal line length (Lmean), maximal diagonal line length (Lmax), percent of recurrence (REC), determinism (DET) and Shannon entropy (ShanEn). Patients were followed up (the average follow-up time was 19.2 months, a total of 37 patients died), and the relationships between the RQA parameters and survival of LCBM patients were evaluated by survival analysis. Results: The univariate analysis showed that an Lmax of >376 beats portended worse survival in LCBM patients. Multivariate Cox regression analysis revealed that the Lmax was still an independent prognostic factor for patients with LCBM after adjusting for confounders such as the Karnofsky performance status (KPS) (HR = 0.318, 95% CI: 0.151–0.669, p = 0.003). Conclusion: Reduced heartbeat complexity indicates a shorter survival time in patients with LCBM. As a non-invasive biomarker, RQA has the potential for application in evaluating the prognosis of LCBM patients.
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Affiliation(s)
- Guangqiao Li
- School of Medical Imaging, Bengbu Medical College, Bengbu, China
- Anhui Key Laboratory of Computational Medicine and Intelligent Health, Bengbu Medical College, Bengbu, China
| | - Shuang Wu
- Department of Radiation Oncology, First Affiliated Hospital, Bengbu Medical College, Bengbu, China
| | - Huan Zhao
- School of Medical Imaging, Bengbu Medical College, Bengbu, China
- Anhui Key Laboratory of Computational Medicine and Intelligent Health, Bengbu Medical College, Bengbu, China
| | - Weizheng Guan
- School of Medical Imaging, Bengbu Medical College, Bengbu, China
- Anhui Key Laboratory of Computational Medicine and Intelligent Health, Bengbu Medical College, Bengbu, China
| | - Yufu Zhou
- Department of Radiation Oncology, First Affiliated Hospital, Bengbu Medical College, Bengbu, China
| | - Bo Shi
- School of Medical Imaging, Bengbu Medical College, Bengbu, China
- Anhui Key Laboratory of Computational Medicine and Intelligent Health, Bengbu Medical College, Bengbu, China
- *Correspondence: Bo Shi,
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Neoadjuvant Stereotactic Radiotherapy for Brain Metastases: Systematic Review and Meta-Analysis of the Literature and Ongoing Clinical Trials. Cancers (Basel) 2022; 14:cancers14174328. [PMID: 36077863 PMCID: PMC9455064 DOI: 10.3390/cancers14174328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/01/2022] [Accepted: 09/02/2022] [Indexed: 11/17/2022] Open
Abstract
Simple Summary The available treatment strategies for patients with brain metastases remain suboptimal, with current research focused on identifying therapies intended to improve patient outcomes while reducing the risk of treatment-related complications. Several studies have investigated the role of pre-operative neoadjuvant stereotactic radiotherapy, and have proposed it as a valid alternative to post-operative adjuvant stereotactic radiotherapy. The aim of our systematic review was to comprehensively analyze the current literature and ongoing clinical trials evaluating neoadjuvant stereotactic radiotherapy in patients with brain metastases, describing treatment protocols and related outcomes. Early evidence suggests that neoadjuvant stereotactic radiotherapy may offer rates of local control and overall survival comparable to those obtained with adjuvant postoperative SRS, but comparative studies are currently lacking. In addition, neoadjuvant stereotactic radiotherapy shows low rates of post-treatment radiation necrosis and leptomeningeal metastases. Ongoing clinical trials aim to evaluate long-term outcomes in large patient cohorts, with some focused on comparing neoadjuvant stereotactic radiotherapy to adjuvant stereotactic radiosurgery. Abstract Background: Brain metastases (BMs) carry a high morbidity and mortality burden. Neoadjuvant stereotactic radiotherapy (NaSRT) has shown promising results. We systematically reviewed the literature on NaSRT for BMs. Methods: PubMed, EMBASE, Scopus, Web-of-Science, Cochrane, and ClinicalTrial.gov were searched following the PRISMA guidelines to include studies and ongoing trials reporting NaSRT for BMs. Indications, protocols, and outcomes were analyzed using indirect random-effect meta-analyses. Results: We included 7 studies comprising 460 patients with 483 BMs, and 13 ongoing trials. Most BMs originated from non-small lung cell carcinoma (41.4%), breast cancer (18.7%) and melanoma (43.6%). Most patients had single-BM (69.8%) located supratentorial (77.8%). Patients were eligible if they had histologically-proven primary tumors and ≤4 synchronous BMs candidate for non-urgent surgery and radiation. Patients with primary tumors clinically responsive to radiotherapy, prior brain radiation, and leptomeningeal metastases were deemed non-eligible. Median planning target volume was 9.9 cm3 (range, 2.9–57.1), and NaSRT was delivered in 1-fraction (90.9%), 5-fraction (4.8%), or 3-fraction (4.3%), with a median biological effective dose of 39.6 Gy10 (range, 35.7–60). Most patients received piecemeal (76.3%) and gross-total (94%) resection after a median of 1-day (range, 1–10) post-NaSRT. Median follow-up was 19.2-months (range, 1–41.3). Actuarial post-treatment rates were 4% (95%CI: 2–6%) for symptomatic radiation necrosis, 15% (95%CI: 12–18%) and 47% (95%CI: 42–52%) for local and distant recurrences, 6% (95%CI: 3–8%) for leptomeningeal metastases, 81% (95%CI: 75–87%) and 59% (95%CI: 54–63%) for 1-year local tumor control and overall survival. Conclusion: NaSRT is effective and safe for BMs. Ongoing trials will provide high-level evidence on long-term post-treatment outcomes, further compared to adjuvant stereotactic radiotherapy.
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Liu K, Jiang L, Shi Y, Liu B, He Y, Shen Q, Jiang X, Nie Z, Pu J, Yang C, Chen Y. Hypoxia-induced GLT8D1 promotes glioma stem cell maintenance by inhibiting CD133 degradation through N-linked glycosylation. Cell Death Differ 2022; 29:1834-1849. [PMID: 35301431 PMCID: PMC9433395 DOI: 10.1038/s41418-022-00969-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 02/27/2022] [Accepted: 02/28/2022] [Indexed: 11/08/2022] Open
Abstract
Gliomas are the most aggressive primary brain tumors. However, no significant improvement in survival has been achieved with the addition of temozolomide (TMZ) or radiation as initial therapy, although many clinical efforts have been carried out to target various signaling pathways or putative driver mutations. Here, we report that glycosyltransferase 8 domain containing 1 (GLT8D1), induced by HIF-1α under a hypoxic niche, significantly correlates with a higher grade of glioma, and a worse clinical outcome. Depletion of GLT8D1 inhibits self-renewal of glioma stem cell (GSC) in vitro and represses tumor growth in glioma mouse models. GLT8D1 knockdown promotes cell cycle arrest at G2/M phase and cellular apoptosis with or without TMZ treatment. We reveal that GLT8D1 impedes CD133 degradation through the endosomal-lysosomal pathway by N-linked glycosylation and protein-protein interaction. Directly blocking the GLT8D1/CD133 complex formation by CD133N1~108 (referred to as FECD133), or inhibiting GLT8D1 expression by lercanidipine, suppresses Wnt/β-catenin signaling dependent tumorigenesis both in vitro and in patient-derived xenografts mouse model. Collectively, these findings offer mechanistic insights into how hypoxia promotes GLT8D1/CD133/Wnt/β-catenin signaling during glioma progression, and identify GLT8D1 as a potential therapeutic target in the future.
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Affiliation(s)
- Kun Liu
- Key Laboratory of Animal Models and Human Disease Mechanisms of Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Kunming, Yunnan, 650223, China
- Kunming College of Life Science, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Liping Jiang
- Key Laboratory of Animal Models and Human Disease Mechanisms of Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Kunming, Yunnan, 650223, China
| | - Yulin Shi
- Key Laboratory of Animal Models and Human Disease Mechanisms of Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Kunming, Yunnan, 650223, China
- Kunming College of Life Science, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Baiyang Liu
- Key Laboratory of Animal Models and Human Disease Mechanisms of Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Kunming, Yunnan, 650223, China
- Kunming College of Life Science, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Yaomei He
- Key Laboratory of Animal Models and Human Disease Mechanisms of Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Kunming, Yunnan, 650223, China
- Kunming College of Life Science, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Qiushuo Shen
- Key Laboratory of Animal Models and Human Disease Mechanisms of Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Kunming, Yunnan, 650223, China
| | - Xiulin Jiang
- Key Laboratory of Animal Models and Human Disease Mechanisms of Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Kunming, Yunnan, 650223, China
- Kunming College of Life Science, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Zhi Nie
- Key Laboratory of Animal Models and Human Disease Mechanisms of Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Kunming, Yunnan, 650223, China
- Kunming College of Life Science, University of Chinese Academy of Sciences, Beijing, 100049, China
- Kunming Medical University, Kunming, 650500, China
| | - Jun Pu
- Kunming Medical University, Kunming, 650500, China
| | - Cuiping Yang
- Key Laboratory of Animal Models and Human Disease Mechanisms of Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Kunming, Yunnan, 650223, China
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200030, China
| | - Yongbin Chen
- Key Laboratory of Animal Models and Human Disease Mechanisms of Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Kunming, Yunnan, 650223, China.
- Center for Excellence in Animal Evolution and Genetics, Chinese Academy of Sciences, Kunming, Yunnan, 650223, China.
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Liu X, Xiao Y, Xiong X, Qi X. MUC21 controls melanoma progression via regulating SLITRK5 and hedgehog signaling pathway. Cell Biol Int 2022; 46:1458-1467. [PMID: 35579188 DOI: 10.1002/cbin.11817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 03/30/2022] [Accepted: 04/23/2022] [Indexed: 11/08/2022]
Abstract
Mucins are heavily glycosylated proteins secreted by various cell types, to protect the epithelial surface of the gastrointestinal tract from damage. Currently, increasing studies provided evidence to suggest that mucins play an essential role in regulating tumor progression. However, the role of mucins and the underpinning mechanism of how mucins drive melanoma progression remains elusive. In this study, we first demonstrated that mucin 21 (MUC21) expression was significantly upregulated in metastatic melanoma tissues, and a higher MUC21 expression resulted in poor overall survival in melanoma patients by The Cancer Genome Atlas database analysis. In vitro, MUC21 overexpression markedly promoted proliferative properties and aggressive behavior of melanoma cell A375 and A875, as assessed by Cell Counting Kit-8 and transwell assay. In mechanism, we proved that MUC21 suppressed expression of SLITRK5, an integral membrane protein, leading to activation of prosurvival hedgehog pathway and sustained melanoma development. More importantly, we found that combination of hedgehog pathway inhibitor cyclopamine and chemotherapy revealed an improved anticancer effect in MUC21 overexpression xenograft model. Altogether, our study described a novel role of MUC21 in regulating tumor progression, which offers a promising target for melanoma diagnosis and therapy.
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Affiliation(s)
- Xueping Liu
- Department of Dermatology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Yajun Xiao
- Department of Geriatrics, The Third Hospital of Mianyang, Mianyang, Sichuan, China
| | - Xia Xiong
- Department of Dermatology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Xiaoyi Qi
- Department of Dermatology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
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Liu HJ, Wang M, Shi S, Hu X, Xu P. A Therapeutic Sheep in Metastatic Wolf's Clothing: Trojan Horse Approach for Cancer Brain Metastases Treatment. NANO-MICRO LETTERS 2022; 14:114. [PMID: 35482117 PMCID: PMC9050993 DOI: 10.1007/s40820-022-00861-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 04/06/2022] [Indexed: 05/13/2023]
Abstract
Early-stage brain metastasis of breast cancer (BMBC), due to the existence of an intact blood-brain barrier (BBB), is one of the deadliest neurologic complications. To improve the efficacy of chemotherapy for BMBC, a Trojan horse strategy-based nanocarrier has been developed by integrating the cell membrane of a brain-homing cancer cell and a polymeric drug depot. With the camouflage of a MDA-MB-231/Br cell membrane, doxorubicin-loaded poly (D, L-lactic-co-glycolic acid) nanoparticle (DOX-PLGA@CM) shows enhanced cellular uptake and boosted killing potency for MDA-MB-231/Br cells. Furthermore, DOX-PLGA@CM is equipped with naturally selected molecules for BBB penetration, as evidenced by its boosted capacity in entering the brain of both healthy and early-stage BMBC mouse models. Consequently, DOX-PLGA@CM effectively reaches the metastatic tumor lesions in the brain, slows down cancer progression, reduces tumor burden, and extends the survival time for the BMBC animal. Furthermore, the simplicity and easy scale-up of the design opens a new window for the treatment of BMBC and other brain metastatic cancers.
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Affiliation(s)
- Hai-Jun Liu
- Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, SC, 29208, USA
| | - Mingming Wang
- Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, SC, 29208, USA
| | - Shanshan Shi
- Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, SC, 29208, USA
| | - Xiangxiang Hu
- Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, SC, 29208, USA
| | - Peisheng Xu
- Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, SC, 29208, USA.
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Bjørnhart B, Hansen KH, Asmussen JT, Jørgensen TL, Herrstedt J, Schytte T. Effect and Tolerability of Immunotherapy in Patients with NSCLC with or without Brain Metastasis. Cancers (Basel) 2022; 14:cancers14071682. [PMID: 35406453 PMCID: PMC8997168 DOI: 10.3390/cancers14071682] [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: 03/09/2022] [Revised: 03/23/2022] [Accepted: 03/24/2022] [Indexed: 02/04/2023] Open
Abstract
Sparse data exist on immune checkpoint inhibition (ICI) in NSCLC patients with brain metastasis (BM), especially for those with no local therapy (LT) (whole brain radiation therapy (WBRT), stereotactic RT (SRT) or neurosurgery) preceding ICI. Our aims were to investigate the prevalence of BM, rate of intracranial response (ICR), and survival and quality of life (QoL) in real-life patients with advanced NSCLC undergoing palliative ICI. This was a prospective non-randomized study (NCT03870464) with magnetic resonance imaging of the brain (MR-C) performed at baseline resulting in a clinical decision to administer LT or not. ICR evaluation (MR-C) at week 8–9 (mRECIST criteria) for group A (LT) and group B (untreated) was assessed. Change in QoL was assessed using EQ-5D-5L. Of 159 included patients, 45 (28%) had baseline BM. Median follow-up was 23.2 months (IQR 16.4–30.2). Of patients in group A (21) and B (16), 16/37 (43%) had symptomatic BM. ICR was 8/21, 38% (complete or partial response) for group A versus 8/16, 50% for group B. No statistical difference in median overall survival of patients with BM (group A: 12.3 (5.2-NR), group B: 20.5 months (4.9-NR)) and without (22.4 months (95% 16.2–26.3)) was obtained. Baseline QoL was comparable regardless of BM, but an improved QoL (at week 9) was found in those without BM. Patients with NSCLC and BM receiving ICI had long-term survival comparable to those without BM.
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Affiliation(s)
- Birgitte Bjørnhart
- The Department of Oncology, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense, Denmark; (K.H.H.); (T.S.)
- Department of Clinical Research, University of Southern Denmark, J.B. Winsløvs Vej 19,3, 5000 Odense, Denmark
- OPEN, Odense Patient Data Explorative Network, Odense University Hospital, J.B. Winsløws Vej 9a, 5000 Odense, Denmark
- The Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Sdr. Boulevard 29, 5000 Odense, Denmark; (T.L.J.); (J.H.)
- Correspondence:
| | - Karin Holmskov Hansen
- The Department of Oncology, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense, Denmark; (K.H.H.); (T.S.)
- OPEN, Odense Patient Data Explorative Network, Odense University Hospital, J.B. Winsløws Vej 9a, 5000 Odense, Denmark
| | - Jon Thor Asmussen
- The Department of Radiology, Odense University Hospital, J.B. Winsløwsvej 4, 5000 Odense, Denmark;
| | - Trine Lembrecht Jørgensen
- The Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Sdr. Boulevard 29, 5000 Odense, Denmark; (T.L.J.); (J.H.)
| | - Jørn Herrstedt
- The Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Sdr. Boulevard 29, 5000 Odense, Denmark; (T.L.J.); (J.H.)
- The Department of Clinical Oncology and Palliative Care, Zealand University Hospital Roskilde, Sygehusvej 10, 4000 Roskilde, Denmark
| | - Tine Schytte
- The Department of Oncology, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense, Denmark; (K.H.H.); (T.S.)
- Department of Clinical Research, University of Southern Denmark, J.B. Winsløvs Vej 19,3, 5000 Odense, Denmark
- The Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Sdr. Boulevard 29, 5000 Odense, Denmark; (T.L.J.); (J.H.)
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Choi S, Lee J, Lee K, Yoon SM, Yoon M. Porphyrin-decorated ZnO nanowires as nanoscopic injectors for phototheragnosis of cancer cells. NEW J CHEM 2022. [DOI: 10.1039/d2nj02084j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Newly synthesized protoporphyrin-decorated ZnO-nanowires exhibited optical waveguided and photodynamic properties to be useful nanoscopic injectors for photo-theragnosis of cancer cells.
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Affiliation(s)
- Sunyoung Choi
- Molecular/Nano Photochemistry and Photonics Lab, Department of Chemistry, Chungnam National University, Daejeon, 34134, Republic of Korea
| | - Jooran Lee
- Molecular/Nano Photochemistry and Photonics Lab, Department of Chemistry, Chungnam National University, Daejeon, 34134, Republic of Korea
- TheraNovis Inc. 32 Seongnae-ro 6-gil, Gangdong-gu, Seoul, Republic of Korea
| | - Kangmin Lee
- Department of Chemistry, Wonkwang University, 460 Iksandae-ro, Iksan, Jeonbuk, Republic of Korea
- Wonkwang Materials Institute of Science and Technology, 460 Iksandae-ro, Iksan, Jeonbuk, Republic of Korea
| | - Seok Min Yoon
- Department of Chemistry, Wonkwang University, 460 Iksandae-ro, Iksan, Jeonbuk, Republic of Korea
- Wonkwang Materials Institute of Science and Technology, 460 Iksandae-ro, Iksan, Jeonbuk, Republic of Korea
| | - Minjoong Yoon
- Molecular/Nano Photochemistry and Photonics Lab, Department of Chemistry, Chungnam National University, Daejeon, 34134, Republic of Korea
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Kumala Wardani B, Yueniwati Y, Naba A. The Application of Image Segmentation to Determine the Ratio of Peritumoral Edema Area to Tumor Area on Primary Malignant Brain Tumor and Metastases through Conventional Magnetic Resonance Imaging. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.7777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Primary malignant brain tumor and metastases on the brain have a similar pattern in conventional Magnetic Resonance Imaging (MRI), even though both require entirely different treatment and management. The pathophysiological difference of peritumoral edema can help to distinguish the case of primary malignant brain tumor and brain metastases.
AIM: This study aimed to analyze the ratio of the area of peritumoral edema to the tumor using Otsu’s method of image segmentation technique with a user-friendly Graphical User Interface (GUI).
METODS: Data was prepared by obtaining the examination results of Anatomical Pathology and MRI imaging. The area of peritumoral edema was identified from MRI image segmentation with T2/FLAIR sequence. While the area of tumor was identified using MRI image segmentation with T1 sequence.
RESULTS: The Mann-Whitney test was employed to analyze the ratio of the area of peritumoral edema to tumor on both groups. Data testing produced a significance level of 0.013 (p < 0.05) with a median value (Nmax-Nmin) of 1.14 (3.31-0.08) for the primary malignant brain tumor group and a median value (Nmax-Nmin) of 1.17 (10.30-0.90) for the brain metastases group.
CONCLUSIONS: There was a significant difference in the ratio of the area of peritumoral edema to the area of tumor from both groups, in which brain metastases have a greater value than the primary malignant brain tumor.
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Zhu X, Li L, Tang J, Yang C, Yu H, Liu K, Zheng Z, Gu X, Yu Q, Xu FJ, Gan Z. Cascade-responsive nano-assembly for efficient photothermal-chemo synergistic inhibition of tumor metastasis by targeting cancer stem cells. Biomaterials 2021; 280:121305. [PMID: 34890970 DOI: 10.1016/j.biomaterials.2021.121305] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 11/28/2021] [Accepted: 11/30/2021] [Indexed: 12/12/2022]
Abstract
Metastasis has been widely recognized as the most lethal threats for cancer patients. Due to their special genetic and environmental context, cancer stem cells (CSCs) which are resistant to most cytotoxic drugs and radiation, are considered as the dominant culprit for metastasis. Thus, the efficient targeting and thorough elimination of CSCs are significantly urgent for the enhancement of therapeutic efficacy. Herein, we developed a facile and smart photothermal-chemo therapeutic nano-assembly system, of which the surface was modified by a sheddable PEG shell and acid-activatable pro-penetration peptide, to surmount the physiological barriers in targeting CSCs. A highly-efficient diradical-featured croconium-based photothermal agent and a natural cytotoxic heat shock protein (HSP) inhibitor were co-loaded in redox-sensitive chitosan matrices to realize the synergistic photothermal-chemo therapy. Within solid tumors, the PEG shell that prevents the nano-assembly from mononuclear phagocytic clearance could rapidly leave to expose the positively charged chitosan, and the detached iRGD could further actuate the tumor penetration of chitosan nanoparticles, and allow the CSCs targeting by selective recognition of CD44 protein. Owing to the HSP inhibition and chemo-sensitization, both the CSCs and non-CSCs could be thoroughly eliminated by the designed nano-assembly, largely inhibiting the tumor growth and metastasis. This work provides a potential strategy for CSCs-targeting drug delivery to solve the CSCs-related metastasis.
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Affiliation(s)
- Xianqi Zhu
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering, State Key Laboratory of Organic-Inorganic Composite Materials, Beijing Laboratory of Biomedical Materials, College of Life Science and Technology, College of Materials Science and Engineering, State Key Laboratory of Chemical Resource Engineering, Beijing University of Chemical Technology, Beijing, 100029, China
| | - Lin Li
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering, State Key Laboratory of Organic-Inorganic Composite Materials, Beijing Laboratory of Biomedical Materials, College of Life Science and Technology, College of Materials Science and Engineering, State Key Laboratory of Chemical Resource Engineering, Beijing University of Chemical Technology, Beijing, 100029, China
| | - Jin Tang
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering, State Key Laboratory of Organic-Inorganic Composite Materials, Beijing Laboratory of Biomedical Materials, College of Life Science and Technology, College of Materials Science and Engineering, State Key Laboratory of Chemical Resource Engineering, Beijing University of Chemical Technology, Beijing, 100029, China
| | - Chunyu Yang
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering, State Key Laboratory of Organic-Inorganic Composite Materials, Beijing Laboratory of Biomedical Materials, College of Life Science and Technology, College of Materials Science and Engineering, State Key Laboratory of Chemical Resource Engineering, Beijing University of Chemical Technology, Beijing, 100029, China
| | - Hao Yu
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering, State Key Laboratory of Organic-Inorganic Composite Materials, Beijing Laboratory of Biomedical Materials, College of Life Science and Technology, College of Materials Science and Engineering, State Key Laboratory of Chemical Resource Engineering, Beijing University of Chemical Technology, Beijing, 100029, China
| | - Kunpeng Liu
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering, State Key Laboratory of Organic-Inorganic Composite Materials, Beijing Laboratory of Biomedical Materials, College of Life Science and Technology, College of Materials Science and Engineering, State Key Laboratory of Chemical Resource Engineering, Beijing University of Chemical Technology, Beijing, 100029, China
| | - Ziyan Zheng
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering, State Key Laboratory of Organic-Inorganic Composite Materials, Beijing Laboratory of Biomedical Materials, College of Life Science and Technology, College of Materials Science and Engineering, State Key Laboratory of Chemical Resource Engineering, Beijing University of Chemical Technology, Beijing, 100029, China
| | - Xinggui Gu
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering, State Key Laboratory of Organic-Inorganic Composite Materials, Beijing Laboratory of Biomedical Materials, College of Life Science and Technology, College of Materials Science and Engineering, State Key Laboratory of Chemical Resource Engineering, Beijing University of Chemical Technology, Beijing, 100029, China.
| | - Qingsong Yu
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering, State Key Laboratory of Organic-Inorganic Composite Materials, Beijing Laboratory of Biomedical Materials, College of Life Science and Technology, College of Materials Science and Engineering, State Key Laboratory of Chemical Resource Engineering, Beijing University of Chemical Technology, Beijing, 100029, China.
| | - Fu-Jian Xu
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering, State Key Laboratory of Organic-Inorganic Composite Materials, Beijing Laboratory of Biomedical Materials, College of Life Science and Technology, College of Materials Science and Engineering, State Key Laboratory of Chemical Resource Engineering, Beijing University of Chemical Technology, Beijing, 100029, China
| | - Zhihua Gan
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering, State Key Laboratory of Organic-Inorganic Composite Materials, Beijing Laboratory of Biomedical Materials, College of Life Science and Technology, College of Materials Science and Engineering, State Key Laboratory of Chemical Resource Engineering, Beijing University of Chemical Technology, Beijing, 100029, China
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Emamekhoo H, Olsen MR, Carthon BC, Drakaki A, Percent IJ, Molina AM, Cho DC, Bendell JC, Gordan LN, Rezazadeh Kalebasty A, George DJ, Hutson TE, Arrowsmith ER, Zhang J, Zoco J, Johansen JL, Leung DK, Tykodi SS. Safety and efficacy of nivolumab plus ipilimumab in patients with advanced renal cell carcinoma with brain metastases: CheckMate 920. Cancer 2021; 128:966-974. [PMID: 34784056 PMCID: PMC9298991 DOI: 10.1002/cncr.34016] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/27/2021] [Accepted: 09/28/2021] [Indexed: 12/11/2022]
Abstract
Background Nivolumab plus ipilimumab (NIVO + IPI) has demonstrated long‐term efficacy and safety in patients with previously untreated, advanced renal cell carcinoma (aRCC). Although most phase 3 clinical trials exclude patients with brain metastases, the ongoing, multicohort phase 3b/4 CheckMate 920 trial (ClincalTrials.gov identifier NCT02982954) evaluated the safety and efficacy of NIVO + IPI in a cohort that included patients with aRCC and brain metastases, as reported here. Methods Patients with previously untreated aRCC and asymptomatic brain metastases received NIVO 3 mg/kg plus IPI 1 mg/kg every 3 weeks × 4 followed by NIVO 480 mg every 4 weeks. The primary end point was the incidence of grade ≥3 immune‐mediated adverse events (imAEs) within 100 days of the last dose of study drug. Key secondary end points were progression‐free survival and the objective response rate according to Response Evaluation Criteria in Solid Tumors, version 1.1 (both determined by the investigator). Exploratory end points included overall survival, among others. Results After a minimum follow‐up of 24.5 months (N = 28), no grade 5 imAEs occurred. The most common grade 3 and 4 imAEs were diarrhea/colitis (n = 2; 7%) and hypophysitis, rash, hepatitis, and diabetes mellitus (n = 1 each; 4%). The objective response rate was 32% (95% CI, 14.9%‐53.5%) with a median duration of response of 24.0 months; 4 of 8 responders remained without reported progression. Seven patients (25%) had intracranial progression. The median progression‐free survival was 9.0 months (95% CI, 2.9‐12.0 months), and the median overall survival was not reached (95% CI, 14.1 months to not estimable). Conclusions In patients who had previously untreated aRCC and brain metastases—a population with a high unmet medical need that often is underrepresented in clinical trials—the approved regimen of NIVO + IPI followed by NIVO showed encouraging antitumor activity and no new safety signals. CheckMate 920 is the first prospective, multicohort study of nivolumab plus ipilimumab as first‐line therapy for advanced renal cell carcinoma in patients who have a poor prognosis and a high unmet medical need. In cohort 3 (advanced renal cell carcinoma and brain metastases), nivolumab plus ipilimumab has a safety profile consistent with previous reports of this dosing regimen with encouraging antitumor activity.
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Affiliation(s)
- Hamid Emamekhoo
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Mark R Olsen
- Oklahoma Cancer Specialists and Research Institute, Tulsa, Oklahoma
| | - Bradley C Carthon
- Department of Hematology and Medical Oncology, Emory University Hospital Midtown, Atlanta, Georgia
| | - Alexandra Drakaki
- Division of Hematology/Oncology, Institute of Urologic Oncology, UCLA Health, Los Angeles, California
| | | | | | - Daniel C Cho
- Perlmutter Cancer Center at New York University Langone Medical Center, New York, New York
| | - Johanna C Bendell
- Sarah Cannon Research Institute/Tennessee Oncology, Nashville, Tennessee
| | - Lucio N Gordan
- Florida Cancer Specialists North/Sarah Cannon Research Institute, Gainesville, Florida
| | | | | | | | | | | | | | | | | | - Scott S Tykodi
- University of Washington and Fred Hutchinson Cancer Research Center, Seattle, Washington
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45
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Tesolin D, Vergidis D, Ramchandar K. Craniospinal irradiation in the treatment of chemotherapy refractory leptomeningeal metastasis from breast cancer: A case report. Cancer Rep (Hoboken) 2021; 5:e1556. [PMID: 34761557 PMCID: PMC9327655 DOI: 10.1002/cnr2.1556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/11/2021] [Accepted: 09/01/2021] [Indexed: 12/28/2022] Open
Abstract
Background Leptomeningeal carcinomatosis is a relatively uncommon complication of solid tumors that is associated with significant morbidity and mortality. Prognosis is typically weeks to months and the neurologic complications of this disease can significantly affect quality of life. The role of craniospinal irradiation is unclear as evidence exploring this treatment option is limited. Despite lack of evidence, its use has decreased due to its associated acute toxicities and newer intrathecal alternatives. Case Here we report the case of a 50‐year‐old patient who received craniospinal irradiation for chemotherapy‐refractory leptomeningeal disease, with survival well beyond the median and good quality of life for the majority of that time. Conclusion This patient's remarkable survival and performance after treatment suggests that craniospinal irradiation could be considered more frequently in the treatment of leptomeningeal metastases. To our knowledge, this is the first case with significant survival following craniospinal irradiation for chemotherapy refractory disease presented. Further study on the use of craniospinal irradiation to treat leptomeningeal metastasis is recommended.
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Affiliation(s)
- Daniel Tesolin
- Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada
| | - Dimitrios Vergidis
- Providence Health Hematology/Oncology, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Kevin Ramchandar
- Regional Cancer Care Northwest, Thunder Bay Regional Health Sciences Centre, Thunder Bay, Ontario, Canada
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46
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Identification of potential genes related to breast cancer brain metastasis in breast cancer patients. Biosci Rep 2021; 41:229807. [PMID: 34541602 PMCID: PMC8521534 DOI: 10.1042/bsr20211615] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/26/2021] [Accepted: 09/08/2021] [Indexed: 01/04/2023] Open
Abstract
Brain metastases (BMs) usually develop in breast cancer (BC) patients. Thus, the molecular mechanisms of breast cancer brain metastasis (BCBM) are of great importance in designing therapeutic strategies to treat or prevent BCBM. The present study attempted to identify novel diagnostic and prognostic biomarkers of BCBM. Two datasets (GSE125989 and GSE100534) were obtained from the Gene Expression Omnibus (GEO) database to find differentially expressed genes (DEGs) in cases of BC with and without brain metastasis (BM). A total of 146 overlapping DEGs, including 103 up-regulated and 43 down-regulated genes, were identified. Functional enrichment analysis showed that these DEGs were mainly enriched for functions including extracellular matrix (ECM) organization and collagen catabolic fibril organization. Using protein-protein interaction (PPI) and principal component analysis (PCA) analysis, we identified ten key genes, including LAMA4, COL1A1, COL5A2, COL3A1, COL4A1, COL5A1, COL5A3, COL6A3, COL6A2, and COL6A1. Additionally, COL5A1, COL4A1, COL1A1, COL6A1, COL6A2, and COL6A3 were significantly associated with the overall survival of BC patients. Furthermore, COL6A3, COL5A1, and COL4A1 were potentially correlated with BCBM in human epidermal growth factor 2 (HER2) expression. Additionally, the miR-29 family might participate in the process of metastasis by modulating the cancer microenvironment. Based on datasets in the GEO database, several DEGs have been identified as playing potentially important roles in BCBM in BC patients.
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47
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Klemm F, Möckl A, Salamero-Boix A, Alekseeva T, Schäffer A, Schulz M, Niesel K, Maas RR, Groth M, Elie BT, Bowman RL, Hegi ME, Daniel RT, Zeiner PS, Zinke J, Harter PN, Plate KH, Joyce JA, Sevenich L. Compensatory CSF2-driven macrophage activation promotes adaptive resistance to CSF1R inhibition in breast-to-brain metastasis. NATURE CANCER 2021; 2:1086-1101. [PMID: 35121879 DOI: 10.1038/s43018-021-00254-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 08/09/2021] [Indexed: 02/08/2023]
Abstract
Tumor microenvironment-targeted therapies are emerging as promising treatment options for different cancer types. Tumor-associated macrophages and microglia (TAMs) represent an abundant nonmalignant cell type in brain metastases and have been proposed to modulate metastatic colonization and outgrowth. Here we demonstrate that targeting TAMs at distinct stages of the metastatic cascade using an inhibitor of colony-stimulating factor 1 receptor (CSF1R), BLZ945, in murine breast-to-brain metastasis models leads to antitumor responses in prevention and intervention preclinical trials. However, in established brain metastases, compensatory CSF2Rb-STAT5-mediated pro-inflammatory TAM activation blunted the ultimate efficacy of CSF1R inhibition by inducing neuroinflammation gene signatures in association with wound repair responses that fostered tumor recurrence. Consequently, blockade of CSF1R combined with inhibition of STAT5 signaling via AC4-130 led to sustained tumor control, a normalization of microglial activation states and amelioration of neuronal damage.
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Affiliation(s)
- Florian Klemm
- Department of Oncology, University of Lausanne, Lausanne, Switzerland
- Ludwig Institute for Cancer Research, Lausanne, Switzerland
| | - Aylin Möckl
- Georg-Speyer-Haus, Institute for Tumor Biology and Experimental Therapy, Frankfurt am Main, Germany
| | - Anna Salamero-Boix
- Georg-Speyer-Haus, Institute for Tumor Biology and Experimental Therapy, Frankfurt am Main, Germany
- Biological Sciences, Faculty 15, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Tijna Alekseeva
- Georg-Speyer-Haus, Institute for Tumor Biology and Experimental Therapy, Frankfurt am Main, Germany
| | - Alexander Schäffer
- Georg-Speyer-Haus, Institute for Tumor Biology and Experimental Therapy, Frankfurt am Main, Germany
| | - Michael Schulz
- Georg-Speyer-Haus, Institute for Tumor Biology and Experimental Therapy, Frankfurt am Main, Germany
- Biological Sciences, Faculty 15, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Katja Niesel
- Georg-Speyer-Haus, Institute for Tumor Biology and Experimental Therapy, Frankfurt am Main, Germany
| | - Roeltje R Maas
- Department of Oncology, University of Lausanne, Lausanne, Switzerland
- Ludwig Institute for Cancer Research, Lausanne, Switzerland
- Neuroscience Research Center, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
- Department of Neurosurgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Marie Groth
- Cancer Biology and Genetics Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Benelita T Elie
- Cancer Biology and Genetics Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Robert L Bowman
- Cancer Biology and Genetics Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Monika E Hegi
- Neuroscience Research Center, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
- Department of Neurosurgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Roy T Daniel
- Department of Neurosurgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Pia S Zeiner
- Institute of Neurology (Edinger Institute), Goethe University Hospital Frankfurt, Frankfurt am Main, Germany
- Dr. Senckenberg Institute of Neurooncology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Jenny Zinke
- Institute of Neurology (Edinger Institute), Goethe University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Patrick N Harter
- Institute of Neurology (Edinger Institute), Goethe University Hospital Frankfurt, Frankfurt am Main, Germany
- German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt am Main, Germany
- Frankfurt Cancer Institute (FCI), Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Karl H Plate
- Institute of Neurology (Edinger Institute), Goethe University Hospital Frankfurt, Frankfurt am Main, Germany
- German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt am Main, Germany
- Frankfurt Cancer Institute (FCI), Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Johanna A Joyce
- Department of Oncology, University of Lausanne, Lausanne, Switzerland.
- Ludwig Institute for Cancer Research, Lausanne, Switzerland.
| | - Lisa Sevenich
- Georg-Speyer-Haus, Institute for Tumor Biology and Experimental Therapy, Frankfurt am Main, Germany.
- German Cancer Research Center (DKFZ), Heidelberg, Germany.
- German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt am Main, Germany.
- Frankfurt Cancer Institute (FCI), Goethe University Frankfurt, Frankfurt am Main, Germany.
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Lee SY, Lomax N, Berkmann S, Vollmer K, Riesterer O, Bodis S, Rogers S. Successful salvage of recurrent leptomeningeal disease in large cell neuroendocrine lung cancer with stereotactic radiotherapy. Strahlenther Onkol 2021; 197:1143-1147. [PMID: 34459938 DOI: 10.1007/s00066-021-01814-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/01/2021] [Indexed: 11/28/2022]
Abstract
A 70-year old male with stage I large cell neuroendocrine carcinoma (LCNEC) of the lung underwent resection of a metachronous 5 cm brain metastasis and received postoperative hypofractionated stereotactic radiotherapy (hfSRT). Five sequential nodular leptomeningeal metastases up to 5.3 cm in diameter were diagnosed on MRI within 10 months and were treated with SRT. Currently the patient has no evidence of intracranial disease 24 months after last irradiation without chemotherapy or whole brain radiotherapy. This is the first report of sustained complete remission of multiple large leptomeningeal metastases achieved with hfSRT, highlighting this brain-sparing approach in selected patients with LCNEC lung cancer.
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Affiliation(s)
- Seok-Yun Lee
- Radio-Onkologie-Zentrum KSA-KSB, Kantonsspital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland.
| | - Nicoletta Lomax
- Radio-Onkologie-Zentrum KSA-KSB, Kantonsspital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland
| | - Sven Berkmann
- Klinik für Neurochirurgie, Kantonsspital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland
| | - Kathrin Vollmer
- Klinik für Onkologie, Kantonsspital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland
| | - Oliver Riesterer
- Radio-Onkologie-Zentrum KSA-KSB, Kantonsspital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland
| | - Stephan Bodis
- Radio-Onkologie-Zentrum KSA-KSB, Kantonsspital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland
| | - Susanne Rogers
- Radio-Onkologie-Zentrum KSA-KSB, Kantonsspital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland
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Raghavapudi H, Singroul P, Kohila V. Brain Tumor Causes, Symptoms, Diagnosis and Radiotherapy Treatment. Curr Med Imaging 2021; 17:931-942. [PMID: 33573575 DOI: 10.2174/1573405617666210126160206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 12/15/2020] [Accepted: 12/17/2020] [Indexed: 11/22/2022]
Abstract
The strategy used for the treatment of given brain cancer is critical in determining the post effects and survival. An oncological diagnosis of tumor evaluates a range of parameters such as shape, size, volume, location and neurological complexity that define the symptomatic severity. The evaluation determines a suitable treatment approach chosen from a range of options such as surgery, chemotherapy, hormone therapy, radiation therapy and other targeted therapies. Often, a combination of such therapies is applied to achieve superior results. Radiotherapy serves as a better treatment strategy because of a higher survival rate. It offers the flexibility of synergy with other treatment strategies and fewer side effects on organs at risk. This review presents a radiobiological perspective in the treatment of brain tumor. The cause, symptoms, diagnosis, treatment, post-treatment effects and the framework involved in its elimination are summarized.
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Affiliation(s)
- Haarika Raghavapudi
- Department of Biotechnology, National Institute of Technology Warangal, Warangal -506004, Telangana, India
| | - Pankaj Singroul
- Department of Biotechnology, National Institute of Technology Warangal, Warangal -506004, Telangana, India
| | - V Kohila
- Department of Biotechnology, National Institute of Technology Warangal, Warangal -506004, Telangana, India
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50
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Xu YB, Zhang Y, Song Z, Wang W, Shao L. Treatment and Prognosis of Solid and Cystic Brain Metastases in Patients with Non-Small-Cell Lung Cancer. Cancer Manag Res 2021; 13:6309-6317. [PMID: 34408492 PMCID: PMC8364339 DOI: 10.2147/cmar.s314060] [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: 04/02/2021] [Accepted: 07/13/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Brain metastasis (BM) is an important factor shortening the lives of patients with lung cancer. Patients with cystic BM have seldom been reported. Here, we compared the efficacy and prognosis of different therapeutic schedules for solid BM and cystic BM in patients with non-small cell lung cancer (NSCLC). METHODS A retrospective study was conducted of 355 patients with pathologically confirmed stage IV NSCLC, all of whom had BM. We analyzed the clinical characteristics of these patients and the efficacy of targeted drugs and chemotherapy regimens. RESULTS A total of 255 patients with solid BM (cohort 1) and 33 patients with cystic BM (cohort 2) had evaluable efficacy. We evaluated these 33 patients in cohort 2. The median progression-free survival (PFS) and overall survival (OS) were 8.4 months and 23.0 months, respectively. A significant difference was observed between targeted regimens and chemotherapy treatment in terms of the PFS (12.6 months vs 6.3 months, P = 0.001) and OS (47.9 months vs 17.0 months, P = 0.007). Multivariate analyses showed that treatment regimen (chemotherapy) was a poor prognostic factor for PFS (P < 0.05). Cystic BM may be more likely to occur in patients with NSCLC with genetic mutations. A difference in prognosis was observed between patients who underwent targeted treatment and chemotherapy. A significant difference in intracranial PFS was observed between cohorts (cohort 1 vs cohort 2: 15.4 months vs 9.9 months, P = 0.015), and this advantage was clear in patients who did not receive targeted therapies (11.7 months vs 6.5 months, P = 0.003). However, the OS in patients with targeted therapies in cohort 2 was significantly longer than that in cohort 1 (23.4 months vs 47.9 months, P = 0.013). CONCLUSION Patients with NSCLC, particularly those who develop cystic BM, should be genetically tested as much as possible to find out more suitable drug therapies.
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Affiliation(s)
- Yi-Bing Xu
- Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, 310022, People’s Republic of China
- Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, 310022, People’s Republic of China
| | - Yiping Zhang
- Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, 310022, People’s Republic of China
- Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, 310022, People’s Republic of China
| | - Zhengbo Song
- Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, 310022, People’s Republic of China
- Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, 310022, People’s Republic of China
| | - Wenxian Wang
- Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, 310022, People’s Republic of China
- Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, 310022, People’s Republic of China
| | - Lan Shao
- Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, 310022, People’s Republic of China
- Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, 310022, People’s Republic of China
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