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Adames A, O'Brien DR, Kelly AR, Saltz LB, Garcia-Aguilar J, Zinovoy M, Williams V, Wu A, Reyngold M, Hajj C, Crane C, Cercek A, Smith JJ, Markova A, Cuaron J, McCann P, Romesser PB. Penile-scrotal erythrodysesthesia among rectal cancer patients receiving fluoropyrimidine-based chemoradiation: a case report series. Int J Colorectal Dis 2024; 39:75. [PMID: 38780794 PMCID: PMC11116207 DOI: 10.1007/s00384-024-04647-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/08/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Palmar-plantar erythrodysesthesia (PPE) is a slowly developing cutaneous reaction commonly experienced by patients treated with fluoropyrimidines. While erythrodysesthesia normally presents in a palmar-plantar distribution, it can also present with genital involvement, but this presentation is likely underreported and incorrectly attributed to an acute reaction from radiation therapy. This article aims to define erythrodysesthesia of the penis and scrotum as a rare but significant side effect of capecitabine. CASE PRESENTATION We identified five cases of moderate to severe penis and scrotal erythrodysesthesia over a 2-year period at a large tertiary cancer center, representing an estimated incidence of 3.6% among male patients with rectal cancer who were treated with fluoropyrimidine-based chemoradiation within our institution. CONCLUSIONS Improved understanding of erythrodysesthesia involving the penis and scrotum can facilitate early identification and treatment of symptoms, and possibly prevent the discontinuation or delay of cancer treatment in patients treated with capecitabine and similar drugs. These clinical advances would improve and prolong patient quality of life during cancer treatment and prevent complications that result in hospitalization.
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Affiliation(s)
- Angela Adames
- Department of Nursing, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Diana Roth O'Brien
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Alison R Kelly
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Leonard B Saltz
- Department of Medicine, Gastrointestinal Cancer Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Julio Garcia-Aguilar
- Department of Surgery, Colorectal Cancer Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Melissa Zinovoy
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Vonetta Williams
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Abraham Wu
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Marsha Reyngold
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Carla Hajj
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Christopher Crane
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Andrea Cercek
- Department of Medicine, Gastrointestinal Cancer Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - J Joshua Smith
- Department of Surgery, Colorectal Cancer Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Alina Markova
- Department of Medicine, Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - John Cuaron
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Patrick McCann
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Paul B Romesser
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Department of Medicine, Early Drug Development, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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2
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Chai J, Zhu J, Tian Y, Yang K, Luan J, Wang Y. Carbon monoxide therapy: a promising strategy for cancer. J Mater Chem B 2023; 11:1849-1865. [PMID: 36786000 DOI: 10.1039/d2tb02599j] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Cancer is one of the acute life-threatening diseases endangering the whole of humanity. The treatment modalities for cancer are various. However, in most cases, a single treatment choice provides multiple side effects, poor targeting, and ineffective treatment. In recent years, the physiological regulatory function of carbon monoxide (CO) in the cancer process has been reported gradually, and CO-related nano-drugs have been explored. It shows better application prospects in cancer treatment and provides new ideas for treatment. The present review introduces the pathophysiological role of CO. The recent advances in cancer therapy, such as CO-mediated gas therapy, combined application of CO chemotherapy, photodynamic therapy (PDT), photothermal therapy (PTT), and immunotherapy, are described. Current challenges and future developments in CO-based treatment are also discussed. This review provides comprehensive information on recent advances in CO therapy and also some valuable guidance for promoting the progress of gas therapy nanomedicine.
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Affiliation(s)
- Jingjing Chai
- Department of Pharmacy, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital of Wannan Medical College, Wuhu, China.
| | - Junfei Zhu
- China-Japan Friendship Hospital, No. 2 Sakura East Street, Chaoyang District, Beijing, China
| | - Yu Tian
- Department of Pharmacy, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital of Wannan Medical College, Wuhu, China.
| | - Kui Yang
- Department of Pharmacy, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital of Wannan Medical College, Wuhu, China.
| | - Jiajie Luan
- Department of Pharmacy, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital of Wannan Medical College, Wuhu, China.
| | - Yan Wang
- Department of Pharmacy, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital of Wannan Medical College, Wuhu, China.
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3
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Nguyen CV, Zheng L, Zhou XA, Ernst MK, Kye Y, Choi JN, Lu KQ. High-Dose Vitamin D for the Management of Toxic Erythema of Chemotherapy in Hospitalized Patients. JAMA Dermatol 2023; 159:219-222. [PMID: 36542397 PMCID: PMC9856756 DOI: 10.1001/jamadermatol.2022.5397] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 10/14/2022] [Indexed: 12/24/2022]
Abstract
This case series describes the outcome of high-dose vitamin D treatment in 6 inpatients with acute skin injury.
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Affiliation(s)
- Cuong V. Nguyen
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - Lida Zheng
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - Xiaolong A. Zhou
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - Madison K. Ernst
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
- University of Minnesota Medical School, Minneapolis
| | - Yae Kye
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
- Paul L Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso
| | - Jennifer N. Choi
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - Kurt Q. Lu
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
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4
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Seervai RNH, Cho WC, Chu EY, Marques-Piubelli ML, Ledesma DA, Richards K, Heberton MM, Nelson KC, Nagarajan P, Torres-Cabala CA, Prieto VG, Curry JL. Diverse landscape of dermatologic toxicities from small-molecule inhibitor cancer therapy. J Cutan Pathol 2021; 49:61-81. [PMID: 34622477 DOI: 10.1111/cup.14145] [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: 07/16/2021] [Revised: 08/29/2021] [Accepted: 10/02/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Advances in molecular biology and genetics have contributed to breakthrough treatments directed at specific pathways associated with the development of cancer. Small-molecule inhibitors (Nibs) aimed at a variety of cellular pathways have been efficacious; however, they are associated with significant dermatologic toxicities. METHODS We conducted a comprehensive review of dermatologic toxicities associated with Nibs categorized into the following five groups: (a) mitogen-activated protein kinase; (b) growth factor/multi-tyrosine kinase; (c) cell division/DNA repair; (d) signaling associated with myeloproliferative neoplasms; and (e) other signaling pathways. Prospective phase I, II, or III clinical trials, retrospective literature reviews, systematic reviews/meta-analyses, and case reviews/reports were included for analysis. RESULTS Dermatologic toxicities reviewed were associated with every class of Nibs and ranged from mild to severe or life-threatening adverse skin reactions. Inflammatory reactions manifesting as maculopapular, papulopustular/acneiform, and eczematous lesions were frequent types of dermatologic toxicities seen with Nibs. Squamous cell carcinoma with keratoacanthoma-like features was associated with a subset of Nibs. Substantial overlap in dermatologic toxicities was found between Nibs. CONCLUSIONS Dermatologic toxicities from Nibs are diverse and may overlap between classes of Nibs. Recognition of the various types of toxicities from Nibs is critical for patient care in the era of "oncodermatology/dermatopathology."
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Affiliation(s)
- Riyad N H Seervai
- Medical Scientist Training Program, Baylor College of Medicine, Houston, Texas, USA.,Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, Texas, USA.,Department of Dermatology, Baylor College of Medicine, Houston, Texas, USA
| | - Woo Cheal Cho
- Department of Pathology, Section of Dermatopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Emily Y Chu
- Department of Dermatology, The University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mario L Marques-Piubelli
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Debora A Ledesma
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kristen Richards
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Meghan M Heberton
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kelly C Nelson
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Priyadharsini Nagarajan
- Department of Pathology, Section of Dermatopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Carlos A Torres-Cabala
- Department of Pathology, Section of Dermatopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.,Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Victor G Prieto
- Department of Pathology, Section of Dermatopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.,Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jonathan L Curry
- Department of Pathology, Section of Dermatopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.,Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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5
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Deutsch A, Leboeuf NR, Lacouture ME, McLellan BN. Dermatologic Adverse Events of Systemic Anticancer Therapies: Cytotoxic Chemotherapy, Targeted Therapy, and Immunotherapy. Am Soc Clin Oncol Educ Book 2021; 40:485-500. [PMID: 32421446 DOI: 10.1200/edbk_289911] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Over the past 2 decades, rapid advancement in systemic anticancer therapeutics has led to astounding improvement in survival rates of patients with cancer. However, this celebrated progress has brought with it an evolving spectrum of drug toxicities that limit their prodigious capabilities. Cutaneous adverse events are of the most frequent of these toxicities, with substantial impact on quality of life and commonly resulting in dose reduction or change in therapy. Thus, familiarity with the array of dermatologic manifestations caused by these drugs is prudent for patient treatment. As such, the advent of dedicated oncodermatologists, and their introduction into multidisciplinary cancer care, has been crucial in optimizing treatment through therapeutic achievement and overall well-being. This review will address the epidemiology, clinical presentations, and management strategies of the major dermatologic adverse events of systemic anticancer agents, including cytotoxic chemotherapy, targeted therapy, and immunotherapy.
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Affiliation(s)
- Alana Deutsch
- Division of Dermatology, Department of Internal Medicine, Albert Einstein College of Medicine, Bronx, NY
| | - Nicole R Leboeuf
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.,Department of Cutaneous Oncology, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Mario E Lacouture
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Beth N McLellan
- Division of Dermatology, Department of Internal Medicine, Albert Einstein College of Medicine, Bronx, NY
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6
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Kafatos G, Dube S, Burdon P, Demonty G, Flinois A, Leclerc M, Lowe K, Feudjo-Tepie M, Segaert S. Management of EGFR Inhibitor-induced Skin Toxicity and Factors Impacting Patients' Adherence to Skin Toxicity Treatment: Health Care Provider and Patient Surveys in European Oncology Centers. Clin Colorectal Cancer 2020; 19:100-108.e9. [PMID: 32113902 DOI: 10.1016/j.clcc.2020.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 01/06/2020] [Indexed: 02/07/2023]
Abstract
INTRODUCTION This study aimed to provide a description of existing measures for the prevention and management of epidermal growth factor receptor inhibitor monoclonal antibody-induced skin toxicities and factors impacting patients' adherence to those measures in France, Germany, and Spain. MATERIALS AND METHODS The study consisted of 2 separate surveys. Health care professionals (HCPs; oncologists and nurses) in France, Germany, and Spain were interviewed, and patients with metastatic colorectal cancer and head-and-neck cancer in France and Germany self-completed questionnaires. The study was conducted between February and July 2018. RESULTS A total of 53 oncologists, 44 nurses, and 143 patients participated in the study. HCPs stated that skin toxicities moderately (52%) or severely (28%) impacted patient care. Ninety percent of HCPs reported routine provision of prophylactic measures. The great majority of patients self-reported adherence with the prophylactic (80% to 88% depending on the type of measures) and reactive (93% to drug prescription) skin toxicity recommendations. HCPs estimated patient adherence to be 45% for full adherence and 40% for partial adherence. Most HCPs reported a positive or very positive impact of preventive measures and recommendations on skin toxicity incidence and severity, patients' quality of life, and various aspects of quality of anti-cancer treatment. CONCLUSIONS Skin toxicities are an important adversity negatively impacting on patient care. However, despite the positive perception of the effectiveness of skin toxicity prophylaxis, almost one-third of oncology centers did not provide formal guidelines, and 10% of HCPs did not provide routine prophylactic measures. Patient adherence appears to be high for epidermal growth factor receptor inhibitor monoclonal antibody-induced skin toxicity prevention measures.
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Affiliation(s)
- George Kafatos
- Center for Observational Research, Amgen Ltd, Uxbridge, United Kingdom.
| | - Sabada Dube
- Center for Observational Research, Amgen Ltd, Uxbridge, United Kingdom
| | - Peter Burdon
- EU Medical Affairs, Amgen (Europe) GmbH, Rotkreuz, Switzerland
| | | | | | | | - Kimberly Lowe
- Center for Observational Research, Amgen Inc, Thousand Oaks, CA
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Cabanillas ME, Ryder M, Jimenez C. Targeted Therapy for Advanced Thyroid Cancer: Kinase Inhibitors and Beyond. Endocr Rev 2019; 40:1573-1604. [PMID: 31322645 PMCID: PMC7341904 DOI: 10.1210/er.2019-00007] [Citation(s) in RCA: 180] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 07/11/2019] [Indexed: 02/07/2023]
Abstract
The treatment of advanced thyroid cancer has undergone rapid evolution in the last decade, with multiple kinase inhibitor drug approvals for each subtype of thyroid cancer and a number of other commercially available drugs that have been studied for this indication. Although most of the US Food and Drug Administration (FDA)-approved drugs are antiangiogenic multikinase inhibitors-vandetanib, cabozantinib, sorafenib, lenvatinib-there are two FDA indications that are mutation specific-dabrafenib/trametinib for BRAF-mutated anaplastic thyroid cancer and larotrectinib for NTRK-fusion thyroid cancer. Furthermore, other mutation-specific drugs, immunotherapies, and novel strategies for advanced thyroid cancer are under investigation. Understanding the molecular basis of thyroid cancer, the drugs of interest for treatment of advanced thyroid cancer, and how these drugs can be administered safely and in the appropriate clinical scenario are the topics of this review.
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Affiliation(s)
- Maria E Cabanillas
- Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Mabel Ryder
- Department of Endocrinology and Medical Oncology, Mayo Clinic, Rochester, Minnesota
| | - Camilo Jimenez
- Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, Texas
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8
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Kaul S, Kaffenberger BH, Choi JN, Kwatra SG. Cutaneous Adverse Reactions of Anticancer Agents. Dermatol Clin 2019; 37:555-568. [DOI: 10.1016/j.det.2019.05.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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9
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Pignata I, Vicenzi G, Ravetto Enri L, Baratta F, Quaglino P, Comandone A, Ala A, Icardi M, Spadi R, Brusa P. The importance of a multidisciplinary care: community pharmacies as a hub to support oncologic patients with cutaneous reactions due to treatments. Ital J Dermatol Venerol 2019; 156:79-80. [PMID: 31525843 DOI: 10.23736/s2784-8671.19.06418-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Irene Pignata
- Department of Drug Science and Technology, University of Turin, Turin, Italy -
| | - Gaia Vicenzi
- Psychologist Psychotherapist Cognitive and Behavioral, Pavia, Italy
| | | | - Francesca Baratta
- Department of Drug Science and Technology, University of Turin, Turin, Italy
| | - Pietro Quaglino
- Department of Medical Sciences, Dermatologic Clinic, University of Turin, Turin, Italy
| | | | - Ada Ala
- Unit of Breast Surgery, Department of General and Specialistic Surgery, Città della Salute e della Scienza, Turin, Italy
| | - Massimiliano Icardi
- Second Medical Oncology Division, Città della Salute e della Scienza, Turin, Italy
| | - Rosella Spadi
- Department of Oncology, Medical Oncology Uno, Città della Salute e della Scienza, Turin, Italy
| | - Paola Brusa
- Department of Drug Science and Technology, University of Turin, Turin, Italy
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10
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PI3K inhibitors protect against glucocorticoid-induced skin atrophy. EBioMedicine 2019; 41:526-537. [PMID: 30737086 PMCID: PMC6441871 DOI: 10.1016/j.ebiom.2019.01.055] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 01/16/2019] [Accepted: 01/17/2019] [Indexed: 12/20/2022] Open
Abstract
Background Skin atrophy is a major adverse effect of topical glucocorticoids. We recently reported that REDD1 (regulated in development and DNA damage 1) and FKBP51 (FK506 binding protein 5), negative regulators of mTOR/Akt signaling, are induced by glucocorticoids in mouse and human skin and are central drivers of steroid skin atrophy. Thus, we hypothesized that REDD1/FKBP51 inhibitors could protect skin against catabolic effects of glucocorticoids. Methods Using drug repurposing approach, we screened LINCS library (http://lincsproject.org/LINCS/) to identify repressors of REDD1/FKBP51 expression. Candidate compounds were tested for their ability to inhibit glucocorticoid-induced REDD1/FKBP51 expression in human primary/immortalized keratinocytes and in mouse skin. Reporter gene expression, microarray, and chromatin immunoprecipitation were employed to evaluate effect of these inhibitors on the glucocorticoid receptor (GR) signaling. Findings Bioinformatics analysis unexpectedly identified phosphoinositide-3-kinase (PI3K)/mTOR/Akt inhibitors as a pharmacological class of REDD1/FKBP51 repressors. Selected PI3K/mTOR/Akt inhibitors-Wortmannin (WM), LY294002, AZD8055, and two others indeed blocked REDD1/FKBP51expression in human keratinocytes. PI3K/mTOR/Akt inhibitors also modified global effect of glucocorticoids on trascriptome, shifting it towards therapeutically important transrepression; negatively impacted GR phosphorylation; nuclear translocation; and GR loading on REDD1/FKBP51 gene promoters. Further, topical application of LY294002 together with glucocorticoid fluocinolone acetonide (FA) protected mice against FA-induced proliferative block and skin atrophy but did not alter the anti-inflammatory activity of FA in ear edema test. Interpretation Our results built a strong foundation for development of safer GR-targeted therapies for inflammatory skin diseases using combination of glucocorticoids with PI3K/mTOR/Akt inhibitors. Fund Work is supported by NIH grants R01GM112945, R01AI125366, and HESI-THRIVE foundation.
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11
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Jubierre L, Jiménez C, Rovira E, Soriano A, Sábado C, Gros L, Llort A, Hladun R, Roma J, Toledo JSD, Gallego S, Segura MF. Targeting of epigenetic regulators in neuroblastoma. Exp Mol Med 2018; 50:1-12. [PMID: 29700278 PMCID: PMC5938021 DOI: 10.1038/s12276-018-0077-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 01/13/2018] [Accepted: 01/31/2018] [Indexed: 12/20/2022] Open
Abstract
Approximately 15,000 new cases of pediatric cancer are diagnosed yearly in Europe, with 8–10% corresponding to neuroblastoma, a rare disease with an incidence of 8–9 cases per million children <15 years of age. Although the survival rate for low-risk and intermediate-risk patients is excellent, half of children with high-risk, refractory, or relapsed tumors will be cured, and two-thirds of the other half will suffer major side effects and life-long disabilities. Epigenetic therapies aimed at reversing the oncogenic alterations in chromatin structure and function are an emerging alternative against aggressive tumors that are or will become resistant to conventional treatments. This approach proposes targeting epigenetic regulators, which are proteins that are involved in the creation, detection, and interpretation of epigenetic signals, such as methylation or histone post-translational modifications. In this review, we focused on the most promising epigenetic regulators for targeting and current drugs that have already reached clinical trials. Treatments that target chromatin, the combination of DNA and proteins, are emerging as alternative ways to treat aggressive neuroblastomas, cancers of neural tissue. Altering the structure and function of chromatin is a form of “epigenetic therapy”, treatment that affects inheritable molecular signals controlling the activity of genes, rather than targeting the genes directly. Researchers in Spain led by Miguel Segura at the Vall d’Hebron Research Institute in Barcelona review progress in developing epigenetic therapies for neuroblastomas. A growing body of fundamental research and evidence from clinical trials suggest this approach could open promising new avenues to treating aggressive and drug-resistant cancers. The authors recommend an increased effort to identify and explore the activities of small molecules that could form the basis of effective epigenetic therapies for various cancers.
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Affiliation(s)
- Luz Jubierre
- Group of Translational Research in Child and Adolescent Cancer, Vall d'Hebron Research Institute, Passeig Vall d'Hebron 119, 08035, Barcelona, Spain
| | - Carlos Jiménez
- Group of Translational Research in Child and Adolescent Cancer, Vall d'Hebron Research Institute, Passeig Vall d'Hebron 119, 08035, Barcelona, Spain
| | - Eric Rovira
- Group of Translational Research in Child and Adolescent Cancer, Vall d'Hebron Research Institute, Passeig Vall d'Hebron 119, 08035, Barcelona, Spain
| | - Aroa Soriano
- Group of Translational Research in Child and Adolescent Cancer, Vall d'Hebron Research Institute, Passeig Vall d'Hebron 119, 08035, Barcelona, Spain
| | - Constantino Sábado
- Vall d'Hebron Hospital, Passeig Vall d'Hebron 119, 08035, Barcelona, Spain
| | - Luis Gros
- Vall d'Hebron Hospital, Passeig Vall d'Hebron 119, 08035, Barcelona, Spain
| | - Anna Llort
- Vall d'Hebron Hospital, Passeig Vall d'Hebron 119, 08035, Barcelona, Spain
| | - Raquel Hladun
- Group of Translational Research in Child and Adolescent Cancer, Vall d'Hebron Research Institute, Passeig Vall d'Hebron 119, 08035, Barcelona, Spain.,Vall d'Hebron Hospital, Passeig Vall d'Hebron 119, 08035, Barcelona, Spain
| | - Josep Roma
- Group of Translational Research in Child and Adolescent Cancer, Vall d'Hebron Research Institute, Passeig Vall d'Hebron 119, 08035, Barcelona, Spain
| | - Josep Sánchez de Toledo
- Group of Translational Research in Child and Adolescent Cancer, Vall d'Hebron Research Institute, Passeig Vall d'Hebron 119, 08035, Barcelona, Spain.,Vall d'Hebron Hospital, Passeig Vall d'Hebron 119, 08035, Barcelona, Spain
| | - Soledad Gallego
- Group of Translational Research in Child and Adolescent Cancer, Vall d'Hebron Research Institute, Passeig Vall d'Hebron 119, 08035, Barcelona, Spain.,Vall d'Hebron Hospital, Passeig Vall d'Hebron 119, 08035, Barcelona, Spain
| | - Miguel F Segura
- Group of Translational Research in Child and Adolescent Cancer, Vall d'Hebron Research Institute, Passeig Vall d'Hebron 119, 08035, Barcelona, Spain.
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12
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Abstract
BACKGROUND Congenital infantile fibrosarcoma (CIF) is rare and represents less than 1% of all childhood cancers. It is a tumor that originates in the connective fibrous tissue found at the ends of long bones and then spreads to other surrounding soft tissues. These lesions are typically large, grow rapidly, and can often be mistaken for teratomas. Diagnosis is confirmed by pathology, where cellular proliferation of fibroblasts occurs. Imaging is an important part of the diagnosis, which includes the use of magnetic resonance imaging and/or computed tomography scan. Although surgical resection is the primary treatment, chemotherapeutic agents may be used as adjuvant therapy. PURPOSE To describe modalities for accurate diagnosis and treatment of CIF. METHODS/SEARCH STRATEGY PubMed was searched using terms "congenital infantile fibrosarcoma" and "infantile fibrosarcoma." Eleven relevant, English language articles were identified and utilized in the preparation of this case presentation. FINDINGS/RESULTS Complications addressed in this case presentation are prenatal diagnostic challenges, pharmacologic interventions in the setting of prematurity, immunosuppression, and acute liver and renal failure. Pharmacologic treatments will include chemotherapy agents, antimicrobial agents, as well as granulocyte colony-stimulating factor for immunosuppression. Nursing challenges included positioning and integumentary disturbances. IMPLICATIONS FOR PRACTICE Utilization of diagnostic imaging and pathology to accurately identify and diagnose CIF is essential. IMPLICATIONS FOR RESEARCH Safety and efficacy of chemotherapeutic agents in premature infants with CIF need to be established.
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13
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Li AW, Yin ES, Stahl M, Kim TK, Panse G, Zeidan AM, Leventhal JS. The skin as a window to the blood: Cutaneous manifestations of myeloid malignancies. Blood Rev 2017; 31:370-388. [DOI: 10.1016/j.blre.2017.07.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 05/26/2017] [Accepted: 07/11/2017] [Indexed: 12/18/2022]
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14
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Cinausero M, Aprile G, Ermacora P, Basile D, Vitale MG, Fanotto V, Parisi G, Calvetti L, Sonis ST. New Frontiers in the Pathobiology and Treatment of Cancer Regimen-Related Mucosal Injury. Front Pharmacol 2017. [PMID: 28642709 PMCID: PMC5462992 DOI: 10.3389/fphar.2017.00354] [Citation(s) in RCA: 133] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Mucositis is a common complication of chemotherapy, radiotherapy and targeted agents. It often affects compliance to anticancer therapies as it frequently causes schedule delays, interruptions or discontinuations of treatment. Moreover, the economic impact related to the management of mucositis is topical and several estimations of additional hospital costs due to this clinical condition have been recently reported. The ability to determine risk factors for mucositis, to early detect its onset, to assess correctly the degree of this toxicity and to plan its multidisciplinary management are all key elements to guarantee the quality of life of patients and to avoid useless dose reduction or interruption of treatment. The pathogenesis of mucositis is multifactorial and it is classily subdivided into oral and gastrointestinal mucositis according to its anatomic presentation. Treatment and patients’ related factors might help in predicting the frequency and the potential degree of symptoms onset. Here we discuss about clinical presentation and pathogenesis of mucositis in relation to different kinds of treatments. Moreover, we focus on therapeutic and prevention strategies, describing past and present management according to international guidelines and the most promising new data about agents potentially able to further improve the treatment of mucositis in the next future.
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Affiliation(s)
- Marika Cinausero
- Department of Oncology, University and General HospitalUdine, Italy
| | - Giuseppe Aprile
- Department of Oncology, University and General HospitalUdine, Italy.,Department of Oncology, San Bortolo General HospitalVicenza, Italy
| | - Paola Ermacora
- Department of Oncology, University and General HospitalUdine, Italy
| | - Debora Basile
- Department of Oncology, University and General HospitalUdine, Italy
| | - Maria G Vitale
- Department of Oncology, University and General HospitalUdine, Italy
| | | | - Giuseppe Parisi
- Department of Oncology, University and General HospitalUdine, Italy
| | - Lorenzo Calvetti
- Department of Oncology, San Bortolo General HospitalVicenza, Italy
| | - Stephen T Sonis
- Divisions of Oral Medicine, Brigham and Women's Hospital, BostonMA, United States.,Dana-Farber Cancer InstituteBoston, MA, United States.,Biomodels LLC, WatertownMA, United States
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15
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Piotrowska-Kempisty H, Klupczyńska A, Trzybulska D, Kulcenty K, Sulej-Suchomska AM, Kucińska M, Mikstacka R, Wierzchowski M, Murias M, Baer-Dubowska W, Kokot Z, Jodynis-Liebert J. Role of CYP1A1 in the biological activity of methylated resveratrol analogue, 3,4,5,4′-tetramethoxystilbene (DMU-212) in ovarian cancer A-2780 and non-cancerous HOSE cells. Toxicol Lett 2017; 267:59-66. [DOI: 10.1016/j.toxlet.2016.12.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 12/02/2016] [Accepted: 12/29/2016] [Indexed: 12/18/2022]
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16
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McGirt LY. Varied skin manifestations of malignancy: critical clues in diagnosis and treatment. Semin Oncol 2016; 43:327. [PMID: 27178682 PMCID: PMC10129874 DOI: 10.1053/j.seminoncol.2016.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Laura Y McGirt
- Director of Dermatologic Oncology, Levine Cancer Institute, Charlotte, NC.
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