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Niezni D, Taub-Tabib H, Harris Y, Sason H, Amrusi Y, Meron-Azagury D, Avrashami M, Launer-Wachs S, Borchardt J, Kusold M, Tiktinsky A, Hope T, Goldberg Y, Shamay Y. Extending the boundaries of cancer therapeutic complexity with literature text mining. Artif Intell Med 2023; 145:102681. [PMID: 37925210 DOI: 10.1016/j.artmed.2023.102681] [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: 02/22/2023] [Revised: 08/30/2023] [Accepted: 10/03/2023] [Indexed: 11/06/2023]
Abstract
Drug combination therapy is a main pillar of cancer therapy. As the number of possible drug candidates for combinations grows, the development of optimal high complexity combination therapies (involving 4 or more drugs per treatment) such as RCHOP-I and FOLFIRINOX becomes increasingly challenging due to combinatorial explosion. In this paper, we propose a text mining (TM) based tool and workflow for rapid generation of high complexity combination treatments (HCCT) in order to extend the boundaries of complexity in cancer treatments. Our primary objectives were: (1) Characterize the existing limitations in combination therapy; (2) Develop and introduce the Plan Builder (PB) to utilize existing literature for drug combination effectively; (3) Evaluate PB's potential in accelerating the development of HCCT plans. Our results demonstrate that researchers and experts using PB are able to create HCCT plans at much greater speed and quality compared to conventional methods. By releasing PB, we hope to enable more researchers to engage with HCCT planning and demonstrate its clinical efficacy.
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Affiliation(s)
- Danna Niezni
- Faculty of Biomedical Engineering, Technion - Israel Institute of Technology, Haifa, Israel
| | | | - Yuval Harris
- Faculty of Biomedical Engineering, Technion - Israel Institute of Technology, Haifa, Israel
| | - Hagit Sason
- Faculty of Biomedical Engineering, Technion - Israel Institute of Technology, Haifa, Israel
| | - Yakir Amrusi
- Faculty of Biomedical Engineering, Technion - Israel Institute of Technology, Haifa, Israel
| | - Dana Meron-Azagury
- Faculty of Biomedical Engineering, Technion - Israel Institute of Technology, Haifa, Israel
| | - Maytal Avrashami
- Faculty of Biomedical Engineering, Technion - Israel Institute of Technology, Haifa, Israel
| | - Shaked Launer-Wachs
- Faculty of Biomedical Engineering, Technion - Israel Institute of Technology, Haifa, Israel
| | | | - M Kusold
- Allen Institute for AI, Seattle, USA
| | | | - Tom Hope
- Allen Institute for AI, Tel Aviv, Israel; The Hebrew University, Jerusalem, Israel
| | - Yoav Goldberg
- Allen Institute for AI, Tel Aviv, Israel; Bar-Ilan University, Ramat-Gan, Israel
| | - Yosi Shamay
- Faculty of Biomedical Engineering, Technion - Israel Institute of Technology, Haifa, Israel.
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Valderrama BP, González-del-Alba A, Morales-Barrera R, Peláez Fernández I, Vázquez S, Caballero Díaz C, Domènech M, Fernández Calvo O, Gómez de Liaño Lista A, Arranz Arija JÁ. SEOM-SOGUG clinical guideline for localized muscle invasive and advanced bladder cancer (2021). Clin Transl Oncol 2022; 24:613-624. [PMID: 35347572 PMCID: PMC8986688 DOI: 10.1007/s12094-022-02815-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2022] [Indexed: 11/05/2022]
Abstract
Most muscle-invasive bladder cancer (BC) are urothelial carcinomas (UC) of transitional origin, although histological variants of UC have been recognized. Smoking is the most important risk factor in developed countries, and the basis for prevention. UC harbors high number of genomic aberrations that make possible targeted therapies. Based on molecular features, a consensus classification identified six different MIBC subtypes. Hematuria and irritative bladder symptoms, CT scan, cystoscopy and transurethral resection are the basis for diagnosis. Radical cystectomy with pelvic lymphadenectomy is the standard approach for muscle-invasive BC, although bladder preservation is an option for selected patients who wish to avoid or cannot tolerate surgery. Perioperative cisplatin-based neoadjuvant chemotherapy is recommended for cT2-4aN0M0 tumors, or as adjuvant in patients with pT3/4 and or pN + after radical cystectomy. Follow-up is particularly important after the availability of new salvage therapies. It should be individualized and adapted to the risk of recurrence. Cisplatin-gemcitabine is considered the standard first line for metastatic tumors. Carboplatin should replace cisplatin in cisplatin-ineligible patients. According to the EMA label, pembrolizumab or atezolizumab could be an option in cisplatin-ineligible patients with high PD-L1 expression. For patients whose disease respond or did not progress after first-line platinum chemotherapy, maintenance with avelumab prolongs survival with respect to the best supportive care. Pembrolizumab also increases survival versus vinflunine or taxanes in patients with progression after chemotherapy who have not received avelumab, as well as enfortumab vedotin in those progressing to first-line chemotherapy followed by an antiPDL1/PD1. Erdafitinib may be considered in this setting in patients with FGFR alterations. An early onset of supportive and palliative care is always strongly recommended.
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Affiliation(s)
- Begoña P. Valderrama
- Medical Oncology Department, Hospital Universitario Virgen del Rocío, Av. Manuel Siurot, s/n, 41013 Sevilla, Spain
| | | | - Rafael Morales-Barrera
- Medical Oncology Department, Vall d’Hebron Institute of Oncology, Vall d’Hebron University Hospital, Barcelona, Spain
| | | | - Sergio Vázquez
- Medical Oncology Department, Hospital Universitario Lucus Augusti, Lugo, Spain
| | - Cristina Caballero Díaz
- Medical Oncology Department, Hospital General Universitario de Valencia, CIBERONC (Centro de Investigación Biomédica de Red en Cáncer), Valencia, Spain
| | - Montserrat Domènech
- Medical Oncology Department, Medical Oncology Service, Hospital Fundació Althaia, Manresa, Spain
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Ravikumar R, Ross A, Khan MS, Khan G, Desai S. Metastatic Adenocarcinoma of the Bladder Presenting as Malignant Pleural Effusion: A Rare Presentation of Bladder Adenocarcinoma. Cureus 2021; 13:e15152. [PMID: 34178487 PMCID: PMC8216572 DOI: 10.7759/cureus.15152] [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] [Indexed: 01/19/2023] Open
Abstract
Bladder cancers rarely are non-urothelial in origin. We present here, possibly the youngest case of a 35-year-old White female presenting with shortness of breath. She was found to have a malignant pleural effusion with unknown primary, eventually confirmed with genetic testing as metastatic adenocarcinoma of the urinary bladder with brain and lung metastasis. She was scheduled for palliative chemotherapy, however, passed away before it could be started. We highlight this rare case because of its unique presentation. Owing to similarity in receptors between adenocarcinoma and enteric cancer, similar chemotherapy regimens may be used for both. Unfortunately, treatment of metastatic disease remains highly controversial and needs to be studied further if there is an actual survival benefit to this or not.
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Affiliation(s)
| | - Astrid Ross
- Internal Medicine, Mercy Health, Toledo, USA
| | | | - Ghazal Khan
- Internal Medicine, University of Missouri, Kansas City, USA
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4
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Fan FS, Yang CF. Advanced primary nonurachal adenocarcinoma of urinary bladder responding to modified FOLFOX6 and capecitabine: a case report. Oxf Med Case Reports 2018; 2018:omy050. [PMID: 30151217 PMCID: PMC6101595 DOI: 10.1093/omcr/omy050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 05/26/2018] [Indexed: 11/12/2022] Open
Abstract
Careful morphology and immunohistochemistry study can make an accurate differential diagnosis of primary adenocarcinoma of urinary bladder from metastatic lesions involving bladder, especially cancer arising in colon, but there is yet no consensus regarding the standard chemotherapy for advanced adenocarcinoma of urinary bladder among medical oncologists. Sustained response to modified FOLFOX6 (fluorouracil, oxaliplatin plus leucovorin) regimen and oral capecitabine for multiple metastases in a patient with primary nonurachal adenocarcinoma of urinary bladder is presented here as a strong support that the frontline chemotherapy for this infrequent malignant disease is just like what could be chosen for colorectal cancer.
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Affiliation(s)
- Frank S Fan
- Section of Haematology and Oncology, Department of Medicine, Ministry of Health and Welfare Changhua Hospital, Chang-Hua County, Taiwan, ROC
- Correspondence address. 80, Sec. 2, Chung-Jeng Rd, Pu-Shin Township, Department of Administration, Ministry of Health and Welfare Changhua Hospital, Chang-Hua County, Taiwan, ROC. Tel: 886-4-829-8686x8802; Fax: 886-4-829-9962; E-mail:
| | - Chung-Fan Yang
- Department of Pathology, Ministry of Health and Welfare Changhua Hospital, Chang-Hua County, Taiwan, ROC
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5
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Roy S, Pradhan D, Ernst WL, Mercurio S, Najjar Y, Parikh R, Parwani AV, Pai RK, Dhir R, Nikiforova MN. Next-generation sequencing-based molecular characterization of primary urinary bladder adenocarcinoma. Mod Pathol 2017; 30:1133-1143. [PMID: 28548125 DOI: 10.1038/modpathol.2017.33] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Revised: 03/13/2017] [Accepted: 03/13/2017] [Indexed: 12/24/2022]
Abstract
Primary bladder adenocarcinoma is a rare and aggressive tumor with poor clinical outcomes and no standard of care therapy. Molecular biology of this tumor is unknown due to the lack of comprehensive molecular profiling studies. The study aimed to identify genomic alterations of clinical and therapeutic significance using next-generation sequencing and compare genomic profile of primary bladder adenocarcinoma with that of high-grade urothelial carcinoma and colorectal adenocarcinoma. A cohort of 15 well-characterized primary bladder adenocarcinoma was subjected to targeted next-generation sequencing for the identification of mutations and copy-number changes in 51 cancer-related genes. Genomic profiles of 25 HGUCs and 25 colorectal adenocarcinomas using next-generation sequencing of 50 genes were compared with primary bladder adenocarcinoma. Genomic profiles were visualized using JavaScript library D3.js. A striking finding was the distinct lack of genomic alterations across the 51 genes assessed in mucinous subtype of primary bladder adenocarcinoma. Eleven of 15 primary bladder adenocarcinoma harbored at least one genomic alteration in TP53, KRAS, PIK3CA, CTNNB1, APC, TERT, FBXW7, IDH2 and RB1, many of which are novel findings and of potential therapeutic significance. CTNNB1 and APC mutations were restricted to enteric subtype only. While genomic alterations of primary bladder adenocarcinoma showed substantial overlap with colorectal adenocarcinoma, FGFR3 and HRAS mutations and APC, CTNNB1 and IDH2 alterations were mutually exclusive between primary bladder adenocarcinoma and high-grade urothelial carcinoma. These alterations affecting the MAP kinase, PI3K/Akt, Wnt, IDH (metabolic) and Tp53/Rb1 signaling pathways may provide the opportunity for defining targeted therapeutic approaches.
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Affiliation(s)
- Somak Roy
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Dinesh Pradhan
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Wayne L Ernst
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Stephanie Mercurio
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Yana Najjar
- Department of Medical Oncology and Hematology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Rahul Parikh
- Department of Medical Oncology and Hematology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Anil V Parwani
- Department of Pathology, Ohio State University, Columbus, OH, USA
| | - Reetesh K Pai
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Rajiv Dhir
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Marina N Nikiforova
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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Primary Mucinous Adenocarcinoma of the Urinary Bladder with Signet-Ring Cells: Description of an Uncommon Case and Critical Points in Its Management. Case Rep Urol 2016; 2016:6080859. [PMID: 28078160 PMCID: PMC5203876 DOI: 10.1155/2016/6080859] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 11/08/2016] [Accepted: 11/15/2016] [Indexed: 11/20/2022] Open
Abstract
We present an uncommon case of mucinous adenocarcinoma of the bladder (MAB) with signet-ring cells extensively infiltrating prostate gland and pelvic/retroperitoneal lymph node stations and not responsive to usual systemic chemotherapy regimens. This case highlights the important features of MAB including the pattern of tumor spread, the tendency for initial misdiagnosis, and the importance of immunohistochemical study in order to define its primary origin from the bladder and choose the most appropriate treatment since the beginning.
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7
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Pugashetti N, Yap SA, Lara PN, Gandour-Edwards R, Dall'Era MA. Metastatic signet-ring cell carcinoma of the urinary bladder: A novel management approach to a rare tumour. Can Urol Assoc J 2015; 9:E204-7. [PMID: 26085880 DOI: 10.5489/cuaj.2447] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Primary signet-ring cell carcinoma (SRCC) of the urinary bladder, a variant of adenocarcinoma, is exceedingly rare and as a result no gold standard exists for its management. We report a case of primary SRCC of the bladder with recurrent metastases; we utilized an innovative diagnostic approach and the patient exhibited a treatment response to palliative FOLFOX-6 chemotherapy.
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Affiliation(s)
- Neil Pugashetti
- Department of Urology, University of California, Davis, Sacramento, CA
| | - Stanley A Yap
- Department of Urology, University of California, Davis, Sacramento, CA
| | - Primo N Lara
- Division of Hematology and Oncology, Department of Internal Medicine, University of California, Davis, Sacramento, CA
| | | | - Marc A Dall'Era
- Department of Urology, University of California, Davis, Sacramento, CA
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Tatli A, Uysal M, Goksu S, Gunduz S, Arslan D, Ozdogan M. Complete Response of Primary Bladder Adenocarcinoma with the FOLFOX4 Regimen. Urol Int 2013; 94:363-5. [DOI: 10.1159/000354332] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Accepted: 07/11/2013] [Indexed: 11/19/2022]
Abstract
Introduction: Primary adenocarcinoma of the bladder is a very rare disease that is difficult to treat. In this paper, we report the second case in the literature with primary mucinous adenocarcinoma of the bladder which showed complete response to FOLFOX4 (fluorouracil, leucovorin, oxaliplatin) chemotherapy regimen. Case Report: A 41-year-old man was admitted to our hospital with a diagnosis of primary adenocarcinoma of the bladder. Due to the similarity in histology with colon carcinoma, a FOLFOX4 regimen was started. Complete response was achieved at the end of this treatment. Today the patient is free of local or systemic disease. Conclusion: FOLFOX4 regimen may be a treatment option for primary adenocarcinoma of the bladder.
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Tatli AM, Uysal M, Goksu SS, Arslan D, Gunduz S, Ozdogan M, Coskun HS, Bozcuk H, Savas B. Primary mucinous adenocarcinoma of the bladder: complete response with FOLFOX-4 regimen. Med Oncol 2011; 29:1935-7. [DOI: 10.1007/s12032-011-0090-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2011] [Accepted: 10/10/2011] [Indexed: 10/15/2022]
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