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Choderlos de Laclos X, Risbourg S, Brennan B, Bertucci F, Gaspar N, Gelderblom H, Hawkins DS, Janeway K, Juergens H, Kasper B, Krailo MD, Cécile Le Deley M, Marec-Bérard P, McCabe MG, Metzler M, Ranft A, Strauss S, Tabone MD, Windsor R, Dirksen U, Gandemer V. Impact of age on safety of Busulfan-Melphalan followed by autologous hematopoietic stem-cell transplantation versus standard chemotherapy in the patients of the EURO-E.W.I.N.G. 99 and Ewing 2008 clinical trials. Eur J Cancer 2024; 208:114229. [PMID: 39032218 DOI: 10.1016/j.ejca.2024.114229] [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: 06/18/2024] [Revised: 07/10/2024] [Accepted: 07/12/2024] [Indexed: 07/23/2024]
Abstract
INTRODUCTION Ewing sarcoma (ES), is a rare cancer affecting children, adolescents and adults. After VIDE (vincristine-ifosfamide-doxorobucin-etoposide) induction chemotherapy, Busulfan-Melphalan (BuMel) high-dose chemotherapy followed by autologous hematopoietic stem cells transplantation improved outcomes in unfavourable localized ES, but with more toxicities than conventional chemotherapy (VAI: Vincristine-dactinomycin-Ifosfamide). We evaluated whether the risk of acute toxicity associated with BuMel compared to VAI varied according to age in patients recruited in the R2Loc and R2Pulm randomised trials of the Euro-E.W.I.N.G.99 and Ewing-2008 trials. METHODS We included patients with a localized high-risk disease, or pulmonary or pleural metastasis. We analysed the risk of severe toxicity according to randomised treatment group (VAI versus BuMel) and age group (<12 years, 12-17 years, 18-24 years, ≥25 years). We evaluated the heterogeneity of treatment effects by age group using interaction terms in logistic multivariable models. RESULTS The analysis included 243 patients treated with VAI and 205 with BuMel. Overall, BuMel was associated with a higher risk of severe acute toxicity than VAI particularly haematological, gastrointestinal, liver, sinusoidal occlusive syndrome, and infections. Severe haematological toxicity and lower general condition were significantly more frequent in younger patients, whatever treatment. We did not observe any significant heterogeneity in terms of the excess risk of severe toxicities associated with BuMel compared to VAI according to age group. CONCLUSION The excess of acute toxicity associated with BuMel compared to VAI does not vary significantly with age, suggesting the feasibility of BuMel across all age groups.
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Affiliation(s)
| | - Séverine Risbourg
- Methodology and Biostatistics Unit, Oscar Lambret Centre, 3 Rue Frédéric Combemale, Lille, France.
| | - Bernadette Brennan
- Department of paediatric oncology, Royal Manchester Children's Hospital, Manchester, UK.
| | - François Bertucci
- Department of Medical Oncology, Paoli-Calmettes Institute, Aix-Marseille Université, 232 Boulevard de Sainte-Marguerite, Marseille, France.
| | - Nathalie Gaspar
- Department of Oncology for Child and adolescent, Gustave Roussy, 114 rue Edouard Vaillant, Villejuif, France.
| | - Hans Gelderblom
- Department of Medical Oncology, Leiden University Medical Center, The Netherlands.
| | - Douglas S Hawkins
- Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA, USA.
| | - Katherine Janeway
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, USA.
| | - Heribert Juergens
- Department of Pediatric Hematology and Oncology, University Children's Hospital Muenster, Germany, West German Cancer Centre (WTZ) Network, Muenster, Germany.
| | - Bernd Kasper
- University of Heidelberg, Mannheim University Medical Center, Mannheim Cancer Center (MCC), Sarcoma Unit, Mannheim, Germany.
| | - Mark D Krailo
- University of Southern California, Los Angeles, CA, USA.
| | - Marie Cécile Le Deley
- Methodology and Biostatistics Unit, Oscar Lambret Centre, 3 Rue Frédéric Combemale, Lille, France.
| | - Perrine Marec-Bérard
- Department of Pediatric Oncology, Institut d'Hématologie et d'Oncologie Pédiatrique, 28 Prom. Léa et Napoléon Bullukian, Lyon, France.
| | - Martin G McCabe
- Division of Cancer Sciences, University of Manchester & The Christie NHS Foundation Trust, Manchester, UK.
| | - Markus Metzler
- Department of Pediatrics, University Hospital Erlangen, and NCT WERA, Erlangen, Germany.
| | - Andreas Ranft
- Pediatrics III, University Hospital Essen, Essen, Germany, West German Cancer Centre (WTZ), German Consortium for Translational Cancer Research (DKTK), and National Center for Tumordiseases site Essen, Essen, Germany.
| | - Sandra Strauss
- London Sarcoma Service, UCL Hospitals NHS Foundation Trust, London, UK.
| | - Marie-Dominique Tabone
- Pediatric Hematology and Oncology Department, Armand Trousseau Hospital, AP-HP, Sorbonne University, 26 avenue du Docteur Arnold-Netter, Paris, France.
| | - Rachael Windsor
- London Sarcoma Service, UCL Hospitals NHS Foundation Trust, London, UK.
| | - Uta Dirksen
- Pediatrics III, University Hospital Essen, Essen, Germany, West German Cancer Centre (WTZ), German Consortium for Translational Cancer Research (DKTK), and National Center for Tumordiseases site Essen, Essen, Germany.
| | - Virginie Gandemer
- Department of Pediatric Onco-hematology, University Hospital, 16 Bd de Bulgarie, Rennes, France.
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Schulpen M, Haveman LM, van der Heijden L, Kaal SEJ, Bramer JAM, Fajardo RD, de Haan JJ, Hiemcke-Jiwa LS, Ter Horst SAJ, Jutte PC, Schreuder HWB, Tromp JM, van der Graaf WTA, van de Sande MAJ, Gelderblom H, Merks JHM, Karim-Kos HE. The survival disparity between children and adolescents and young adults (AYAs) with Ewing sarcoma in the Netherlands did not change since the 1990s despite improved survival: A population-based study. Eur J Cancer 2024; 208:114209. [PMID: 39018631 DOI: 10.1016/j.ejca.2024.114209] [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: 05/03/2024] [Revised: 06/28/2024] [Accepted: 07/03/2024] [Indexed: 07/19/2024]
Abstract
BACKGROUND Adolescents and young adults (AYAs) with Ewing sarcoma have a worse prognosis than children. Population-based survival evaluations stratifying findings by important clinical factors are, however, limited. This Dutch population study comprehensively compared survival of children and AYAs with Ewing sarcoma over three decades considering diagnostic period, tissue of origin, tumor site, and disease stage. METHODS Data on all children (0-17 years, N = 463) and AYAs (18-39 years, N = 379) diagnosed with Ewing sarcoma in the Netherlands between 1990-2018 were collected from the Netherlands Cancer Registry with follow-up until February 2023. Five-year relative survival was calculated using the cohort method. Multivariable analyses were conducted through Poisson regression. RESULTS Children with Ewing sarcoma had a significantly higher 5-year relative survival than AYAs (65 % vs. 44 %). An increasing trend in survival was noted reaching 70 % in children and 53 % in AYAs in 2010-2018. Results were similar for Ewing bone sarcoma and extraosseous Ewing sarcoma. AYAs had a poorer prognosis than children for most tumor sites and regardless of disease stage. Survival probabilities were 60 % vs. 78 % for localized disease and 20 % vs. 33 % for metastatic disease. Multivariable-regression analysis, adjusted for follow-up time, diagnostic period, sex, disease stage, and tumor site, confirmed increased excess mortality among AYAs compared with children (excess HR: 1.7, 95 % CI: 1.3-2.1). CONCLUSIONS Despite survival improvements since the 1990s, AYAs with Ewing sarcoma in the Netherlands continue to fare considerably worse than children. This survival disparity was present irrespective of tissue of origin, tumor site, and disease stage.
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Affiliation(s)
- Maya Schulpen
- Princess Máxima Center for pediatric oncology, Utrecht, the Netherlands
| | - Lianne M Haveman
- Princess Máxima Center for pediatric oncology, Utrecht, the Netherlands
| | | | - Suzanne E J Kaal
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jos A M Bramer
- Princess Máxima Center for pediatric oncology, Utrecht, the Netherlands; Department of Orthopedic Surgery and Sports Medicine, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Raquel Dávila Fajardo
- Princess Máxima Center for pediatric oncology, Utrecht, the Netherlands; Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Jacco J de Haan
- Department of Medical Oncology, University Medical Center Groningen, Groningen, the Netherlands
| | - Laura S Hiemcke-Jiwa
- Princess Máxima Center for pediatric oncology, Utrecht, the Netherlands; Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Simone A J Ter Horst
- Princess Máxima Center for pediatric oncology, Utrecht, the Netherlands; Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Paul C Jutte
- Department of Orthopedics, University Medical Center Groningen, Groningen, the Netherlands
| | - Hendrik W B Schreuder
- Princess Máxima Center for pediatric oncology, Utrecht, the Netherlands; Department of Orthopedics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jacqueline M Tromp
- Department of Medical Oncology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Winette T A van der Graaf
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Michiel A J van de Sande
- Princess Máxima Center for pediatric oncology, Utrecht, the Netherlands; Department of Orthopedics, Leiden University Medical Center, Leiden, the Netherlands
| | - Hans Gelderblom
- Department of Medical Oncology, Leiden University Medical Center, Leiden, the Netherlands
| | - Johannes H M Merks
- Princess Máxima Center for pediatric oncology, Utrecht, the Netherlands; Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Henrike E Karim-Kos
- Princess Máxima Center for pediatric oncology, Utrecht, the Netherlands; Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, the Netherlands.
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Luo T, Jiang M, Cheng Z, Lin Y, Chen Y, Zhang Z, Zhou J, Zhou W, Yu XF, Li S, Geng S, Yang H. Biodegradable FePS 3 nanoplatform for efficient treatment of osteosarcoma by combination of gene and NIR-II photothermal therapy. J Nanobiotechnology 2023; 21:224. [PMID: 37443019 DOI: 10.1186/s12951-023-01961-9] [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: 02/23/2023] [Accepted: 06/17/2023] [Indexed: 07/15/2023] Open
Abstract
As a common tumor with high incidence, osteosarcoma possesses extremely poor prognosis and high mortality. Improving the survival of osteosarcoma patients is still a great challenge due to the precipice of advancement in treatment. In this study, a combination strategy of gene therapy and photothermal therapy (PTT) is developed for efficient treatment of osteosarcoma. Two-dimensional (2D) FePS3 nanosheets are synthesized and functionalized by poly-L-lysine-PEG-folic acid (PPF) to fabricate a multifunctional nanoplatform (FePS@PPF) for further loading microRNAs inhibitor, miR-19a inhibitor (anti-miR-19a). The photothermal conversion efficiency of FePS@PPF is up to 47.1% under irradiation by 1064 nm laser. In vitro study shows that anti-miR-19a can be efficiently internalized into osteosarcoma cells through the protection and delivery of FePS@PPF nanaocarrier, which induces up-regulation of PTEN protein and down-regulation p-AKT protein. After intravenous injection, the FePS@PPF nanoplatform specifically accumulates to tumor site of osteosarcoma-bearing mice. The in vitro and in vivo investigations reveal that the combined PTT-gene therapy displays most significant tumor ablation compared with monotherapy. More importantly, the good biodegradability promotes FePS@PPF to be cleared from body avoiding potential toxicity of long-term retention. Our work not only develops a combined strategy of NIR-II PTT and gene therapy mediated by anti-miR-19a/FePS@PPF but also provides insights into the design and applications of other nanotherapeutic platforms.
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Affiliation(s)
- Tingting Luo
- Guangdong Provincial High-level Clinical Key Specialty, Guangdong Province Engineering Research Center of Oral Disease Diagnosis and Treatment, The Institute of Stomatology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, Guangdong, China
| | - Mingyang Jiang
- Materials and Interfaces Center, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Ziqiang Cheng
- Department of Applied Physics, School of Science, East China Jiaotong University, Nanchang, 330013, China
| | - Yuntao Lin
- Guangdong Provincial High-level Clinical Key Specialty, Guangdong Province Engineering Research Center of Oral Disease Diagnosis and Treatment, The Institute of Stomatology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, Guangdong, China
| | - Yuling Chen
- Guangdong Provincial High-level Clinical Key Specialty, Guangdong Province Engineering Research Center of Oral Disease Diagnosis and Treatment, The Institute of Stomatology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, Guangdong, China
| | - Zhenyu Zhang
- Materials and Interfaces Center, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Jian Zhou
- Guangdong Provincial High-level Clinical Key Specialty, Guangdong Province Engineering Research Center of Oral Disease Diagnosis and Treatment, The Institute of Stomatology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, Guangdong, China
| | - Wenhua Zhou
- Materials and Interfaces Center, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Xue-Feng Yu
- Materials and Interfaces Center, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Shuchun Li
- Guangdong Provincial High-level Clinical Key Specialty, Guangdong Province Engineering Research Center of Oral Disease Diagnosis and Treatment, The Institute of Stomatology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, Guangdong, China.
| | - Shengyong Geng
- Materials and Interfaces Center, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China.
| | - Hongyu Yang
- Guangdong Provincial High-level Clinical Key Specialty, Guangdong Province Engineering Research Center of Oral Disease Diagnosis and Treatment, The Institute of Stomatology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, Guangdong, China.
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Establishment, Maintenance, and Performance of the Cooperative Osteosarcoma Study Group (COSS). Cancers (Basel) 2023; 15:cancers15051520. [PMID: 36900310 PMCID: PMC10000534 DOI: 10.3390/cancers15051520] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/22/2023] [Accepted: 02/26/2023] [Indexed: 03/06/2023] Open
Abstract
INTRODUCTION Osteosarcoma treatment has benefitted greatly from collaborative research. This paper describes the history and accomplishments of the Cooperative Osteosarcoma Study Group (COSS), mainly dedicated to clinical questions, as well as remaining challenges. MATERIALS AND METHODS Narrative review of over four decades of uninterrupted collaboration within the multi-national German-Austrian-Swiss COSS group. RESULTS Since its very first prospective osteosarcoma trial starting in 1977, COSS has continuously been able to provide high-level evidence on various tumor- and treatment-related questions. This includes both the cohort of patients enrolled into prospective trials as well as those patients excluded from them for various reasons, followed in a prospective registry. Well over one hundred disease-related publications attest to the group's impact on the field. Despite these accomplishments, challenging problems remain. DISCUSSION Collaborative research within a multi-national study group resulted in better definitions of important aspects of the most common bone tumor, osteosarcoma, and its treatments. Important challenges continue to persist.
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Wang H, Xu S, Fan D, Geng X, Zhi G, Wu D, Shen H, Yang F, Zhou X, Wang X. Multifunctional microcapsules: A theranostic agent for US/MR/PAT multi-modality imaging and synergistic chemo-photothermal osteosarcoma therapy. Bioact Mater 2022; 7:453-465. [PMID: 34466745 PMCID: PMC8379422 DOI: 10.1016/j.bioactmat.2021.05.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/14/2021] [Accepted: 05/05/2021] [Indexed: 12/18/2022] Open
Abstract
Development of versatile theranostic agents that simultaneously integrate therapeutic and diagnostic features remains a clinical urgent. Herein, we aimed to prepare uniform PEGylated (lactic-co-glycolic acid) (PLGA) microcapsules (PB@(Fe3O4@PEG-PLGA) MCs) with superparamagnetic Fe3O4 nanoparticles embedded in the shell and Prussian blue (PB) NPs inbuilt in the cavity via a premix membrane emulsification (PME) method. On account of the eligible geometry and multiple load capacity, these MCs could be used as efficient multi-modality contrast agents to simultaneously enhance the contrasts of US, MR and PAT imaging. In-built PB NPs furnished the MCs with excellent photothermal conversion property and embedded Fe3O4 NPs endowed the magnetic location for fabrication of targeted drug delivery system. Notably, after further in-situ encapsulation of antitumor drug of DOX, (PB+DOX)@(Fe3O4@PEG-PLGA) MCs possessed more unique advantages on achieving near infrared (NIR)-responsive drug delivery and magnetic-guided chemo-photothermal synergistic osteosarcoma therapy. In vitro and in vivo studies revealed these biocompatible (PB+DOX)@(Fe3O4@PEG-PLGA) MCs could effectively target to the tumor tissue with superior therapeutic effect against the invasion of osteosarcoma and alleviation of osteolytic lesions, which will be developed as a smart platform integrating multi-modality imaging capabilities and synergistic effect with high therapy efficacy.
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Affiliation(s)
- Hufei Wang
- Beijing National Laboratory for Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences, Beijing, 100190, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Sijia Xu
- Beijing National Laboratory for Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences, Beijing, 100190, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Daoyang Fan
- Department of Orthopaedic, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Xiaowen Geng
- Department of Cardiology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Guang Zhi
- Department of Cardiology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Decheng Wu
- Beijing National Laboratory for Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences, Beijing, 100190, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Hong Shen
- Beijing National Laboratory for Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences, Beijing, 100190, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Fei Yang
- Beijing National Laboratory for Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences, Beijing, 100190, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Xiao Zhou
- Department of Cardiology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Xing Wang
- Beijing National Laboratory for Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences, Beijing, 100190, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
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Geng B, Yang X, Li P, Shi W, Pan D, Shen L. W-Doped TiO 2 Nanorods for Multimode Tumor Eradication in Osteosarcoma Models under Single Ultrasound Irradiation. ACS APPLIED MATERIALS & INTERFACES 2021; 13:45325-45334. [PMID: 34533945 DOI: 10.1021/acsami.1c14701] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Sonosensitizers play crucial roles in the controlled production of reactive oxygen species (ROS) under ultrasound (US) irradiation with high tissue-penetration depth for noninvasive solid tumor therapy. It is desirable to fabricate structurally simple yet multifunctional sonosensitizers from ultrafine nanoparticles for ROS-based multimode therapy to overcome monomode limitations such as low ROS production yields and endogenous reductive glutathione (GSH) to ROS-based treatment resistance. We report the facile high-temperature solution synthesis of ultrafine W-doped TiO2 (W-TiO2) nanorods for exploration of their sonodynamic, chemodynamic, and GSH-depleting activities in sonodynamic-chemodynamic combination tumor therapy. We found that W5+ and W6+ ions doped in W-TiO2 nanorods play multiple roles in enhancing their ROS production. First, W doping narrows the band gap from 3.2 to 2.3 eV and introduces oxygen and Ti vacancies for enhancing their sonodynamic performance. Second, W5+ doping endows W-TiO2 nanorods with Fenton-like reaction activity to produce •OH from endogenous H2O2 in the tumor. Third, W6+ ions reduce endogenous GSH to glutathione disulfide (GSSG) and, in turn, form W5+ ions that further enhance their chemodynamic activity, which greatly modifies thae oxidation-reduction tumor microenvironment in the tumor. In vivo experiments display the excellent ability of W-TiO2 nanorods for enhanced tumor eradication in human osteosarcoma models under single US irradiation. Importantly, the ultrafine nanorod morphology facilitates rapid excretion from the body, displaying no significant systemic toxicity. Our work suggests that multivalent metal doping in ultrafine nanomaterials is an effective and simple strategy for the introduction of new functions for ROS-based multimode therapy.
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Affiliation(s)
- Bijiang Geng
- School of Environmental and Chemical Engineering, Shanghai University, Shanghai 200444, China
| | - Xue Yang
- School of Environmental and Chemical Engineering, Shanghai University, Shanghai 200444, China
| | - Ping Li
- School of Life Sciences, Shanghai University, Shanghai 200444, China
| | - Wenyan Shi
- School of Environmental and Chemical Engineering, Shanghai University, Shanghai 200444, China
| | - Dengyu Pan
- School of Environmental and Chemical Engineering, Shanghai University, Shanghai 200444, China
| | - Longxiang Shen
- Department of Orthopedic Surgery, Shanghai Jiao Tong University affiliated Sixth People's Hospital, Shanghai 200233, China
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Qu L, Zhang W, Li J, Liu P. The miR-146b-5p promotes Ewing's sarcoma cells progression via suppressing the expression of BTG2. Sci Prog 2021; 104:368504211002043. [PMID: 33844600 PMCID: PMC10454925 DOI: 10.1177/00368504211002043] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Ewing sarcoma (ES) is a malignant tumor that occurs mostly in children. However, the underlying mechanisms of ES are still unknown. Analyzing the results of two previous miRNA array reports, we found that miR-146b-5p might be an onco-miRNA in ES progression. To test this hypothesis, we detected the expression levels of miR-146b-5p by real-time PCR and observed the effects of miR-146b-5p on the progression of ES cells by CCK8 and transwell assays. Bioinformatics and luciferase assays were used to identify the target genes of miR-146b-5p. It showed that the expression levels of miR-146b-5p were upregulated in ES cell lines compared with human mesenchymal stem cells (MSCs). Up- or downregulation of miR-146b-5p in ES cell lines could effectively promote or block the proliferation, migration, and invasion of ES cells, respectively. Furthermore, we demonstrated that BTG2 was one of the target genes and mediated the effects of miR-146b-5p in ES cells. Interestingly, we also found that miR-146b-5p was partly involved in the anticancer effects of pemetrexed in ES cells. Our study revealed that miR-146b-5p affected the progression of ES by suppressing BTG2, which might shed light on anticancer drug development and ES treatment in the future.
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Affiliation(s)
- Lizhen Qu
- Department of Orthopedics Trauma, Zaozhuang Municipal Hospital, Zaozhuang, Shandong, P.R. China
| | - Wu Zhang
- Department of Orthopedics, Zaozhuang Hospital of ZaoZhuang Mining Group, ZaoZhuang, Shandong, P.R. China
| | - Jiajiang Li
- Department of Orthopedics, Zaozhuang Hospital of ZaoZhuang Mining Group, ZaoZhuang, Shandong, P.R. China
| | - Peng Liu
- Department of Orthopedics Trauma, Zaozhuang Municipal Hospital, Zaozhuang, Shandong, P.R. China
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Al-Hashimi MM, Warttan HA. Modelling count data with an excess of zero values applied to childhood bone tumour incidence in Iraq. GEOSPATIAL HEALTH 2021; 16. [PMID: 33733648 DOI: 10.4081/gh.2021.873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 10/18/2020] [Indexed: 06/12/2023]
Abstract
Bone tumours are rarely found in children and adolescents (0- 19 years old), but there are reports from some provinces in Iraq indicating possible increases in the incidence of childhood bone cancer. Since counts are very low and often zero, or near zero, we fitted zero-inflated Poisson, zero-inflated negative binomial, Poisson hurdle, and negative binomial hurdle regression models to investigate these changes. We used data covering the 2000-2015 period taking age, gender and province into account with the aim of identifying potential health disparities. The results indicate that the zero-inflated Poisson is the most appropriate approach. We also found that, the incidence rate ratio of bone tumours for age groups of 5-9, 10-14 and 15-19 years were 134%, 490% and 723% higher, respectively, compared to the 0-4 year olds. The incidence rate was higher by 49% higher in males compared to females. Compared to 2000-2004, the rate was higher during 2005-2009 and 2010-2015 by 23% and 50%, respectively. In addition, the provinces Al-Muthana and Al-Diwaniyah in the South were found to have a higher incidence rate than other provinces. Join point analysis showed that the age-adjusted incidence rate had a significant, increasing trend, with an average percentage change of 3.1% during 2000-2015. The study suggests that further research into childhood tumours, bone tumours in particular, is needed. Reference to the effect of environmental factors in this group of medical disorders would be of special interest.
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Affiliation(s)
| | - Hasmek Antranik Warttan
- Department of Business Management Techniques, Administrative Technical College, Northern Technical University, Mosul.
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Felix A, Berlanga P, Toulmonde M, Landman‐Parker J, Dumont S, Vassal G, Le Deley M, Gaspar N. Systematic review of phase-I/II trials enrolling refractory and recurrent Ewing sarcoma: Actual knowledge and future directions to optimize the research. Cancer Med 2021; 10:1589-1604. [PMID: 33452711 PMCID: PMC7940237 DOI: 10.1002/cam4.3712] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Optimal Phase-II design to evaluate new therapies in refractory/relapsed Ewing sarcomas (ES) remains imperfectly defined. OBJECTIVES Recurrent/refractory ES phase-I/II trials analysis to improve trials design. METHODS Comprehensive review of therapeutic trials registered on five databases (who.int/trialsearch, clinicaltrials.gov, clinicaltrialsregister.eu, e-cancer.fr, and umin.ac.jp) and/or published in PubMed/ASCO/ESMO websites, between 2005 and 2018, using the criterion: (Ewing sarcoma OR bone sarcoma OR sarcoma) AND (Phase-I or Phase-II). RESULTS The 146 trials identified (77 phase-I/II, 67 phase-II, and 2 phase-II/III) tested targeted (34%), chemo- (23%), immune therapies (19%), or combined therapies (24%). Twenty-three trials were ES specific and 48 had a specific ES stratum. Usually multicentric (88%), few trials were international (30%). Inclusion criteria cover the recurrent ES age range for only 12% of trials and allowed only accrual of measurable diseases (RECIST criteria). Single-arm design was the most frequent (88%) testing mainly single drugs (61%), only 5% were randomized. Primary efficacy outcome was response rate (RR=CR+PR; Complete+Partial response) (n = 116/146; 79%), rarely progression-free or overall survival (16% PFS and 3% OS). H0 and H1 hypotheses were variable (3%-25% and 20%-50%, respectively). The 62 published trials enrolled 827 ES patients. RR was poor (10%; 15 CR=1.7%, 68 PR=8.3%). Stable disease was the best response for 186 patients (25%). Median PFS/OS was of 1.9 (range 1.3-14.7) and 7.6 months (5-30), respectively. Eleven (18%) published trials were considered positive, with median RR/PFS/OS of 15% (7%-30%), 4.5 (1.3-10), and 16.6 months (6.9-30), respectively. CONCLUSION This review supports the need to develop the international randomized phase-II trials across all age ranges with PFS as primary endpoint.
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Affiliation(s)
- Arthur Felix
- Department of Oncology for Child and AdolescentGustave Roussy Cancer CampusVillejuif cedexFrance
| | - Pablo Berlanga
- Department of Oncology for Child and AdolescentGustave Roussy Cancer CampusVillejuif cedexFrance
| | - Maud Toulmonde
- Medical Oncology DepartmentInstitut BergoniéBordeauxFrance
| | | | - Sarah Dumont
- Department of Medical OncologyGustave Roussy Cancer CampusVillejuifFrance
| | - Gilles Vassal
- Department of Oncology for Child and AdolescentGustave Roussy Cancer CampusVillejuif cedexFrance
| | - Marie‐Cécile Le Deley
- Direction de la Recherche Clinique et de l'InnovationCentre Oscar LambretLilleFrance
| | - Nathalie Gaspar
- Department of Oncology for Child and AdolescentGustave Roussy Cancer CampusVillejuif cedexFrance
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10
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Li Y, Qu J, Zhang P, Zhang Z. Reduction-responsive sulfur dioxide polymer prodrug nanoparticles loaded with irinotecan for combination osteosarcoma therapy. NANOTECHNOLOGY 2020; 31:455101. [PMID: 32688350 DOI: 10.1088/1361-6528/aba783] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Combination therapy can boost the therapeutic effectiveness of monotherapies by achieving synergy between therapeutic agents. Herein, a reduction-responsive sulfur dioxide (SO2) polymer prodrug was synthesized as a nanocarrier to load irinotecan (IRN) to be used in combination osteosarcoma therapy. The SO2 prodrug (denoted as mPEG-PLG (DNs)) was synthesized by coupling a small-molecule SO2 donor, N-(3-azidopropyl)-2,4-dinitrobenzenesulfonamide (AP-DNs), to the side chains of methoxy poly (ethylene glycol)-block-poly (γ-propargyl-L-glutamate) block copolymer. The mPEG-PLG (DNs) had the ability to self-assemble into micelles while simultaneously encapsulating IRN in aqueous media. The formed micelles led to enhanced SO2 and IRN release in reductive conditions. Using nile red as a model drug, the loaded micelles were efficiently internalized by cancer cells, demonstrated by confocal laser scanning microscopy and flow cytometry. The release of SO2 within nanoparticles (NPs) in tumor cells led to enhanced intracellular reactive oxygen species amounts together with induced oxidative destruction to cancer cells. Furthermore, the IRN-loaded SO2 polymer prodrug NPs mediated synergistic therapeutic effects against osteosarcoma cells, leading to improved biodistribution and enhanced tumor growth inhibition over control groups in a murine osteosarcoma model. Taken together, this work highlights the potential of SO2 polymer prodrugs as reduction-responsive nanocarriers to load chemotherapeutics for effective combination osteosarcoma therapy.
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Affiliation(s)
- Yongshuang Li
- Department of General Surgery, the Fourth Affiliated Hospital of China Medical University, 4 Chongshandong Road, Shenyang 110032, People's Republic of China
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11
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Reed DR, Naghavi A, Binitie O. Sarcoma as a Model for Adolescent and Young Adult Care. J Oncol Pract 2020; 15:239-247. [PMID: 31075215 DOI: 10.1200/jop.18.00684] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Sarcomas occur across all ages and are relatively abundant in the adolescent and young adult populations compared with older adults. Because of an overall rarity combined with a broad diversity of diagnoses, expertise is often concentrated in comprehensive cancer centers. The sarcoma model of care is an excellent model for overall adolescent and young adult care. We summarize some of the natural advantages of the field for developing adolescent and young adult programs, review management and referral touchpoints, and summarize recent biologic and clinical trial insights that have affected sarcoma management recently.
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Affiliation(s)
- Damon R Reed
- 1 H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Arash Naghavi
- 1 H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Odion Binitie
- 1 H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
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12
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Raze T, Lacour B, Cowppli-Bony A, Delafosse P, Velten M, Trétarre B, Defossez G, Hammas K, Woronoff AS, Ganry O, Plouvier S, Coureau G, Guizard AV, Bara S, Monnereau A, Daubisse-Marliac L, Troussard X, D'Almeida T, Baldi I, Bouvier V, Boissel N, Clavel J, Desandes E. Cancer Among Adolescents and Young Adults Between 2000 and 2016 in France: Incidence and Improved Survival. J Adolesc Young Adult Oncol 2020; 10:29-45. [PMID: 32412825 DOI: 10.1089/jayao.2020.0017] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Purpose: This study was undertaken to determine cancer survival and describe the spectrum of cancers diagnosed among French adolescent and young adult (AYA) population. Methods: All cases of cancer diagnosed in 15-24 years, recorded by all French population-based registries (18% of the French population), over the 2000-2016 period, were included. Age-standardized incidence rates, conventional annual percentage change (cAPC) of incidence over time, and 5-year overall survival (5yOS) were calculated. Results: We analyzed 2734 cancer diagnoses in adolescents and 4199 in young adults. Overall incidence rates were 231.9/106 in 15-19 year olds and 354.0/106 in 20-24 year olds. The most frequently diagnosed cancers in male AYA were malignant gonadal germ-cell tumors (GCT), Hodgkin lymphoma (HL), and malignant melanoma and were HL, thyroid carcinoma, and malignant melanoma in females. Cancer incidence was stable over time with a cAPC of 0.8% (p = 0.72). For all cancers combined, 5yOS was 86.6% (95% CI: 85.8-87.4), >85% for HL, non-Hodgkin lymphomas (NHL), GCT, thyroid carcinomas, and malignant melanomas, and around 60% and lower for osteosarcomas, Ewing tumors, hepatic carcinomas, and rhabdomyosarcomas. The 5yOS has significantly improved from 2000-2007 to 2008-2015 for all cancers pooled, with a substantial gain of 4% for 15-19 year olds and 3% for 20-24 year olds. Conclusion: Notwithstanding the encouraging results for some cancers, and overall, persistent poorer survivals in AYA were shown compared to children for acute lymphoblastic leukemia, osteosarcoma, Ewing tumor, rhabdomyosarcoma, and malignant hepatic tumors. These disparities require further investigation to identify and address the causes of these inferior outcomes.
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Affiliation(s)
- Thomas Raze
- Registre National des Cancers de l'Enfant, Registre National des Tumeurs Solides de l'Enfant, CHRU Nancy, Vandœuvre-lès-Nancy, France
| | - Brigitte Lacour
- Registre National des Cancers de l'Enfant, Registre National des Tumeurs Solides de l'Enfant, CHRU Nancy, Vandœuvre-lès-Nancy, France.,Centre de Recherche en Epidémiologie et en Statistique Sorbonne-Paris Cité (CRESS), UMR 1153, INSERM, Université Paris-Descartes, Paris, France
| | - Anne Cowppli-Bony
- Registre des Tumeurs de Loire-Atlantique et Vendée, CHU de Nantes, SIRIC-ILIAD, Nantes, France
| | | | - Michel Velten
- Registre des Cancers du Bas-Rhin, Laboratoire d'épidémiologie et de Santé Publique, Inserm UMR-S1113/Centre Paul Strauss, Service de Santé Publique, Université de Strasbourg, Strasbourg, France
| | | | - Gautier Defossez
- Registre des Cancers de Poitou-Charentes, CHU Poitiers, Poitiers, France
| | - Karima Hammas
- Registre des Cancers du Haut-Rhin, ARER68, Groupe Hospitalier de la Région de Mulhouse et Sud-Alsace (GHRMSA), Mulhouse, France
| | | | - Olivier Ganry
- Registre Général du Cancer de la Somme, CHU Amiens, Amiens, France
| | - Sandrine Plouvier
- Registre Général des Cancers de Lille et de sa Région, GCS-C2RC, Lille, France
| | - Gaelle Coureau
- Epicene, Centre Inserm U1219/CHU de Bordeaux, Service d'information Médicale, Université Bordeaux, Bordeaux, France
| | | | - Simona Bara
- Registre des Cancers de la Manche, Cherbourg-Octeville, France
| | - Alain Monnereau
- Institut Bergonié, Registre des Hémopathies Malignes de la Gironde/Université de Bordeaux, Inserm U1219, équipe EPICENE, ISPED, Bordeaux, France
| | - Laetitia Daubisse-Marliac
- Institut Claudius Regaud, IUCT-O, Registre des Cancers du Tarn, CHU Toulouse/UMR 1027 Université de Toulouse, UPS, Inserm, Toulouse, France
| | - Xavier Troussard
- Registre des Hémopathies Malignes de Basse Normandie, Caen, France
| | - Tania D'Almeida
- Registre Général des Cancers en Région Limousin, CHU de Limoges, Limoges, France
| | - Isabelle Baldi
- Equipe EPICENE, INSERM U1219, Université de Bordeaux/Service Santé Travail Environnement, CHU Bordeaux, Bordeaux, France
| | | | - Nicolas Boissel
- Unité d'Hématologie Adolescents et Jeunes Adultes, Hôpital Saint-Louis, Assistance Publique des Hôpitaux de Paris/EA-3518, Institut de Recherche Saint-Louis, Université de Paris, Paris, France
| | - Jacqueline Clavel
- Centre de Recherche en Epidémiologie et en Statistique Sorbonne-Paris Cité (CRESS), UMR 1153, INSERM, Université Paris-Descartes, Paris, France.,Registre National des Hémopathies Malignes de l'Enfant, Villejuif, France
| | - Emmanuel Desandes
- Registre National des Cancers de l'Enfant, Registre National des Tumeurs Solides de l'Enfant, CHRU Nancy, Vandœuvre-lès-Nancy, France.,Centre de Recherche en Epidémiologie et en Statistique Sorbonne-Paris Cité (CRESS), UMR 1153, INSERM, Université Paris-Descartes, Paris, France
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13
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Survival after cancer in children, adolescents and young adults in the Nordic countries from 1980 to 2013. Br J Cancer 2019; 121:1079-1084. [PMID: 31719686 PMCID: PMC6964683 DOI: 10.1038/s41416-019-0632-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 10/21/2019] [Accepted: 10/23/2019] [Indexed: 01/10/2023] Open
Abstract
Background The present study aimed to assess whether the widespread concern of inferior cancer survival in adolescents and young adults (AYAs) compared with children and adults holds true in a Nordic setting with important differences in healthcare organisation compared with the United States (e.g. free access to healthcare) and the United Kingdom (e.g. young teenagers are treated in paediatric departments). Methods Five-year relative survival was calculated for 17 diagnostic groups in patients diagnosed in 2000–2013 in three diagnostic age categories: children (0–14 years), AYAs (15–24 years) and adults (25–34 years). Results For 13 out of 17 diagnostic groups examined, there was no difference in survival between AYAs and neighbouring age categories. For acute lymphoblastic leukaemias, astrocytomas, rhabdomyosarcomas and non-rhabdomyosarcoma soft tissue sarcomas we found survival in children to be superior to that in AYAs. For these four diagnostic groups, the rate of survival improvement over three calendar periods (1980–1989, 1990–1999 and 2000–2013) was not particularly low in AYAs compared with neighbouring age categories. Conclusions The present study suggests that in an affluent setting with free access to healthcare, meaningful differences in survival between AYA patients and either childhood or adult patients are a phenomenon of the past for most AYA cancer diagnostic groups.
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Marec-Berard P, Laurence V, Occean BV, Ray-Coquard I, Linassier C, Corradini N, Collard O, Chaigneau L, Cupissol D, Kerbrat P, Saada-Bouzid E, Delcambre C, Gouin F, Guillemet C, Jimenez M, Lervat C, Gaspar N, Le Deley MC, Brugieres L, Piperno-Neumann S. Methotrexate-Etoposide-Ifosfamide Compared with Doxorubicin-Cisplatin-Ifosfamide Chemotherapy in Osteosarcoma Treatment, Patients Aged 18-25 Years. J Adolesc Young Adult Oncol 2019; 9:172-182. [PMID: 31702419 DOI: 10.1089/jayao.2019.0085] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Purpose: The French standard chemotherapy for osteosarcoma combines high-dose methotrexate (HDM) and etoposide-ifosfamide (EI) in children and adolescents, and API-AI (doxorubicin-cisplatin-ifosfamide) in adults. We herein present the results of M-EI and API-AI in 18- to 25-year-old patients. Methods: Patients, 18-25 years old, received either M-EI or API-AI regimens. M-EI comprised seven M and two EI doses preoperatively then M-EI in standard-risk patients (good histological response without metastasis) and five M-AP (methotrexate-doxorubicin-cisplatin) in high-risk patients (poor histological response, metastasis, and/or unresectable primary), postoperatively. API-AI comprised three API and two AI doses preoperatively, then two AI and two PI in standard-risk patients and five EI in high-risk patients, postoperatively. Results: We analyzed 95 patients 18-25 years of age: 55 received M-EI and 40 API-AI. The groups had similar baseline characteristics. Eighty-nine patients (94%) had surgery. Twenty-nine of 55 M-EI patients (60%) and 16/40 API-AI patients (41%) had good histological responses to preoperative chemotherapy. At 5 years, event-free survival was 50% (95% confidence interval [CI]: 39-60) and overall survival was 65% (95% CI: 54-74). Acute toxicity was similar, without treatment-related deaths. Conclusions: Survival outcomes with M-EI and API-AI were not significantly different. Tolerance was acceptable with both regimens. HDM is thus feasible for young adults. However, our study limitations preclude any definitive conclusions.
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Affiliation(s)
- Perrine Marec-Berard
- Unité de Traitement de la Douleur de l'Enfant, Centre Léon Bérard, Institut d'Hématologie et d'Oncologie Pédiatrie, Lyon, France
| | | | - Bob-Valéry Occean
- Biostatistics and Epidemiology Unit, Institut Gustave Roussy, Villejuif, France
| | | | - Claude Linassier
- Department of Cancer Medicine, Centre Hospitalo-Universitaire, Tours, France
| | - Nadège Corradini
- Department of Pediatric and Adolescent Hematology-Oncology, Hôpital Mère-Enfant, Nantes, France
| | - Olivier Collard
- Department of Medical Oncology, Institut de Cancérologie de la Loire, Lucien Neuwirth, St Priest en Jarez, France
| | - Loïc Chaigneau
- Department of Medical Oncology, CHRU Jean Minjoz, Besançon, France
| | - Didier Cupissol
- Department of Medical Oncology, Centre Val d'Aurelle, Montpellier, France
| | - Pierre Kerbrat
- Department of Medical Oncology, Centre Eugène-Marquis, Rennes, France
| | - Esma Saada-Bouzid
- Medical Oncology Department, Centre Antoine Lacassagne, Nice, France
| | | | - François Gouin
- CHU Nantes Hôtel-Dieu/Laboratoire UMR1238 Phyos, Faculté de Médecine de Nantes, Nantes, France
| | - Cécile Guillemet
- Medical Oncology Department, Centre Henri Becquerel, Rouen, France
| | | | - Cyril Lervat
- Pediatric Oncology Unit-Adolescents and Young Adults, Centre Oscar Lambret, Lille, France
| | - Nathalie Gaspar
- Department of Pediatric Oncology, Institut Gustave Roussy, Villejuif, France
| | | | - Laurence Brugieres
- Department of Pediatric Oncology, Institut Gustave Roussy, Villejuif, France
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16
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Gordon LM, Johnson RH, Au MA, Langer SL, Albritton KH. Primary Care Physicians' Decision Making Regarding Initial Oncology Referral for Adolescents and Young Adults With Cancer. J Adolesc Health 2018; 62:176-183. [PMID: 29248393 DOI: 10.1016/j.jadohealth.2017.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 09/05/2017] [Accepted: 09/05/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE The objectives of this study were to determine whether pediatricians are more likely than other primary care physicians (PCPs) to refer newly diagnosed adolescent and young adult patients with cancer to pediatric oncological specialists, and to assess the physician and patient characteristics that affect patterns of referral. METHODS A cross-sectional vignette survey was mailed to PCPs to examine hypothetical referral decisions as a function of physician characteristics and patient characteristics, including diagnosis, age, gender, race/ethnicity, family support, transportation, insurance, and patient preference for site of care. Pediatrician PCPs and nonpediatrician PCPs (family medicine, internal medicine, and emergency medicine physicians) practicing in North Carolina and in Washington State participated in the study. RESULTS A total of 406 surveys were completed (35.8% response rate). Sixty percent of pediatric PCPs referred their hypothetical patients with cancer to pediatric specialists (PSs), compared with only 37% of nonpediatric PCPs. Patient age also influenced referral patterns; 89% of 13-year-olds, 74% of 16-year-olds, 25% of 19-year-olds, and only 9% of 22-year-old patients were referred to a PS. Multivariate logistic regression demonstrated that diagnosis and physician practice setting also were associated with referral patterns. CONCLUSIONS Both patient age and PCP specialty were significant predictors of referral patterns in hypothetical vignettes of newly diagnosed adolescent and young adult patients with cancer. Pediatricians were more likely than nonpediatrician PCPs to refer patients to a PS. Referrals to PSs decreased dramatically between ages 16 and 19. Because the site of oncological care can impact outcomes, these data have the potential to inform awareness and education initiatives directed at PCPs.
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Affiliation(s)
- Lynne M Gordon
- Department of Public Health, University of Washington, Seattle, Washington
| | - Rebecca H Johnson
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington
| | - Margaret A Au
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii
| | - Shelby L Langer
- School of Social Work, University of Washington, Seattle, Washington
| | - Karen H Albritton
- Departments of Medical and Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
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Pini SA, Gibson F, Fern LA, Morgan SJ, Phillips RS, Stark DP. Multi-Professional Perspectives on Adolescent and Young Adult Oncology Across Europe: An e-Delphi Survey. J Adolesc Young Adult Oncol 2017; 6:178-185. [PMID: 28080182 DOI: 10.1089/jayao.2016.0051] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The aims of this article are to describe the ongoing development of adolescent and young adult (AYA) cancer services within the European Union (EU), and to develop consensus on key areas within the field. This survey used an e-Delphi design. An initial survey was distributed via email to professionals working in Europe. A snowball sampling technique was used to promote distribution. Consensus was sought over three rounds from October 2012 to April 2015. Consensus was defined as >80% agreement ("agree" or "strongly agree"). Sixty professionals participated in round 1, 106 in round 2, and 61 in round 3. Twenty-six countries were represented across all rounds. Consensus was achieved for: the need for national policy guidance, the importance of patient choice, the validity of the International Charter of Rights for Young People, and some aspects of multi-disciplinary working. There was 75% agreement on a single definition of the patient age range within AYA cancer care. European professionals with expertise in AYA cancer care reached consensus on key elements of care for this group. The optimal AYA age range remained an elusive topic on which to agree. The broad engagement and interest in AYA cancer across the EU through the European Network for Cancer in Children and Adolescents (ENCCA) network was also demonstrated.
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Affiliation(s)
| | - Faith Gibson
- 2 Great Ormond Street Hospital for Children, NHS Foundation Trust and University of Surrey , London, United Kingdom
| | - Lorna A Fern
- 3 University College London Hospitals NHS Foundation Trust , London, United Kingdom
| | | | | | - Dan P Stark
- 1 St. James's Hospital , Leeds, United Kingdom
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18
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Corradini N, Dagorne L, Retailleau M, Rédini F, Sudour-Bonnange H, Gofti-Laroche L, Le Rhun A, Gaspar N. [Which approach of therapeutic education (TE) for adolescents and young adults with cancer? Experience from the TE working group of "Go-AJA"]. Bull Cancer 2016; 103:966-978. [PMID: 27863724 DOI: 10.1016/j.bulcan.2016.10.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 10/03/2016] [Accepted: 10/06/2016] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Therapeutic education (TE) is a practice developed over 40 years at an international level to give people with chronic illness the skills necessary to help them better manage their disease. The lengthening survival time of cancer patients as well as changes in the patient-caregiver relationship have contributed to the development of TE in oncologic diseases. Every year in France, about 1900 adolescents and young adults (15-25 years old) are diagnosed with cancer which is the second leading cause of death in this age group. The observed survival rates for these patients are lower when compared with children's. Some of the hypotheses put forward to explain this difference include a lack of constancy in care and a non-following treatment, as failure to adhere to therapies is common in this age group. "Go-AJA", an interdisciplinary national organization established in 2012, aims to improve the quality of care and treatment results for AYA living with cancer. Therapeutic education for AYA in oncology is an active working group of "Go-AJA" and intends to draw recommendations and to improve adapted communication on different education topics. Elaboration and preparation of TE programs by skilled multidisciplinary teams engaged in interactive educational actions is the first and most crucial step. MATERIALS AND METHODS The TE "Go-AJA" working group has federated pediatric and adult oncologists, nurses, psychologists, TE professionals, and resource patients, thanks to the commitment of professionals from the 8 national teams supported by the National Cancer Institute. Physical meetings and conference calls were organized from 2012 to 2015 to construct TE tools and programs for AYA with cancer. RESULTS A competence referential was built and adapted to AYA population with cancer, after focused groups organized in 2 main oncology centers with on-therapy sarcoma patients and members of the multidisciplinary TE working group. Tools were validated and adapted to adolescents or young adults with cancer, to help in the 4 stages of TE: the "educational diagnosis" allowing the caregiver to better understand the patient in his life journey with the disease; the "therapeutic alliance" allowing to agree with the patient on his/her priorities; the "implementation" which is an action step: information, awareness, learning and psychosocial support. The final step called "assessment" allows the caregiver to take stock on the changes and difficulties with the patient. TE for AYA with cancer included individual and/or group sessions to improve self-care skills: knowledge about the disease (group sessions "what is cancer?" with use of microscopes to visualize sarcoma cells, and guided tours in a tumor research laboratory), and details about the treatment and its consequences (workshops about "management of febrile neutropenia"). Moreover, TE aimed to enrich the field of coping skills, in particular to improve the coordination and experience of cares between the different complex and varied network of care (group and/or individual sessions focused on physical rehabilitation, and adapted school/professional orientation). CONCLUSION Regardless of the care system, care workers dedicated to AYA with cancer should use TE-specific actions to reinforce treatment participation and therapeutic relationships. This active multidisciplinary TE working group dedicated to AYA with cancer elaborated TE programs by skilled multidisciplinary teams engaged in interactive educational actions. After this work of a national TE organization, more studies using methodological tools are still required to evaluate the impact of such implemented programs on the treatment results and the quality of life.
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Affiliation(s)
- Nadège Corradini
- Institut d'hémato-oncologie pédiatrique, centre Léon-Bérard, dispositif AJA en cancérologie, 28, prom. Léa-et-Napoléon-Bullukian, 69008 Lyon, France.
| | - Loïc Dagorne
- Cancer campus Gustave-Roussy, département de cancérologie de l'enfant et l'adolescent, équipe transversale SPIAJA, 114, rue Edouard-Vaillant, 94800 Villejuif, France
| | - Marielle Retailleau
- CHU de Nantes, hôpital mère-enfant, département d'oncologie pédiatrique, quai Moncousu, 44093 Nantes cedex 1, France
| | - Françoise Rédini
- Faculté de médecine, Inserm UMR957, « laboratoire de PHysiopathologie de la résorption osseuse et thérapie des tumeurs osseuses primitives », 1, rue Gaston Veil, 44035 Nantes cedex 1, France
| | - Hélène Sudour-Bonnange
- Centre Oscar-Lambret, unité d'oncologie pédiatrique, équip'AJA, 3, rue Frédéric-Combemale, 59000 Lille, France
| | - Leila Gofti-Laroche
- CHU Grenoble Alpes, hôpital couple enfant, équipe AJA Arc Alpin, avenue Maquis-du-Grésivaudan, 38700 La Tronche, France
| | - Anne Le Rhun
- CHU, hôpital Saint-Jacques, département de santé publique, unité d'éducation thérapeutique, bâtiment Louis-Philippe, 85, rue Saint-Jacques, 44093 Nantes cedex 1, France
| | - Nathalie Gaspar
- Cancer campus Gustave-Roussy, département de cancérologie de l'enfant et l'adolescent, équipe transversale SPIAJA, 114, rue Edouard-Vaillant, 94800 Villejuif, France
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Marec-Bérard P, Boissel N. [Teenagers and young adults facing cancer: Specific issues]. Bull Cancer 2016; 103:955-956. [PMID: 27817862 DOI: 10.1016/j.bulcan.2016.09.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 09/30/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Perrine Marec-Bérard
- Groupe d'oncohématologie adolescents et jeunes adultes, 75010 Paris, France; Centre de lutte contre le cancer Léon-Bérard, 69008 Lyon, France.
| | - Nicolas Boissel
- Groupe d'oncohématologie adolescents et jeunes adultes, 75010 Paris, France; AP-HP, université Paris 7, hôpital Saint-Louis, EA-3518, 75010 Paris, France
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Trama A, Botta L, Foschi R, Ferrari A, Stiller C, Desandes E, Maule MM, Merletti F, Gatta G. Survival of European adolescents and young adults diagnosed with cancer in 2000-07: population-based data from EUROCARE-5. Lancet Oncol 2016; 17:896-906. [PMID: 27237614 DOI: 10.1016/s1470-2045(16)00162-5] [Citation(s) in RCA: 181] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 03/03/2016] [Accepted: 03/03/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Data from EUROCARE have consistently shown lower survival for adolescents and young adults (AYAs; aged 15-24 years) than for children (0-14 years) for most cancers that affect both groups, and modest survival improvements up to 2000-02. AYAs have longer survival than that of adults for most cancers. We used the latest definition of AYAs (aged 15-39 years) and provided estimates of 5-year relative survival for European AYAs with cancer diagnosed in 2000-07, compared with children and adults (40-69 years) with cancer, and assessed survival improvements over time. METHODS We analysed data from population-based cancer registries of 27 European countries participating in EUROCARE-5. We used the so-called complete method to estimate 5-year, population-weighted relative survival for 19 cancers affecting AYAs and children, and for 27 cancers affecting AYAs and adults. We assessed relative-survival differences between children versus AYAs, and between AYAs versus adults, using the Z test. We used the period approach to estimate 5-year relative survival over time for children and AYAs, and used a generalised linear model to model survival time trends (1999-2007) and to assess the significance of changes over time. FINDINGS We analysed 56 505 cancer diagnoses in children, 312 483 in AYAs, and 3 567 383 in adults. For all cancers combined, survival improved over time for AYAs (from 79% [95% CI 78·1-80·5] in 1999-2002 to 82% [81·1-83·3] in 2005-07; p<0·0001) and children (from 76% [74·7-77·1] to 79% [77·2-79·4]; p<0·0001). Survival improved significantly in children and AYAs for acute lymphoid leukaemia (p<0·0001) and non-Hodgkin lymphoma (p<0·0001 in AYAs and p=0·023 in children). Survival improved significantly in AYAs only for CNS tumours (p=0·0046), astrocytomas (p=0·040), and malignant melanomas (p<0·0001). Survival remained significantly worse in AYAs than in children for eight important cancers: acute lymphoid leukaemias, acute myeloid leukaemias, Hodgkin's lymphomas, non-Hodgkin lymphomas, astrocytomas, Ewing's sarcomas, and rhabdomyosarcomas (p<0·0001 in all cases), and osteosarcomas (p=0·011). INTERPRETATION Notwithstanding the encouraging results for some cancers, and overall, we showed poorer survival in AYAs than in children for the eight important cancers. Recent European initiatives to improve outcomes in AYAs might reduce the survival gap between children and AYAs, but this reduction can only be verified by future population-based studies. FUNDING Italian Ministry of Health, European Commission.
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Affiliation(s)
- Annalisa Trama
- Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
| | - Laura Botta
- Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Roberto Foschi
- Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Andrea Ferrari
- Paediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Charles Stiller
- Childhood Cancer Research Group, University of Oxford, Oxford, UK
| | - Emmanuel Desandes
- CHU Nancy, Registre National des Tumeurs Solides de l'Enfant, Vandoeuvre-lès-Nancy, France; Université Paris-Sorbonne, CRESS équipe 7, INSERM UMRS-1153, Paris, France
| | - Milena Maria Maule
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Torino, Italy
| | - Franco Merletti
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Torino, Italy
| | - Gemma Gatta
- Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
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Évolution de la prise en charge des sarcomes de l’enfant et de l’adolescent. ONCOLOGIE 2016. [DOI: 10.1007/s10269-016-2610-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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22
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Stark D, Bielack S, Brugieres L, Dirksen U, Duarte X, Dunn S, Erdelyi D, Grew T, Hjorth L, Jazbec J, Kabickova E, Konsoulova A, Kowalczyk J, Lassaletta A, Laurence V, Lewis I, Monrabal A, Morgan S, Mountzios G, Olsen P, Renard M, Saeter G, van der Graaf W, Ferrari A. Teenagers and young adults with cancer in Europe: from national programmes to a European integrated coordinated project. Eur J Cancer Care (Engl) 2015; 25:419-27. [DOI: 10.1111/ecc.12365] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2015] [Indexed: 01/28/2023]
Affiliation(s)
- D. Stark
- Leeds Institute of Cancer and Pathology; Leeds Institute of Oncology and St James's University Hospital; University of Leeds; Leeds UK
| | - S. Bielack
- Klinikum Stuttgart; Center for Pediatric and Adolescent Medicine; Pediatrics 5 (Oncology, Hematology, Immunology); Olgahospital; Stuttgart Germany
| | - L. Brugieres
- Department of Children and Adolescents Oncology; Institut Gustave Roussy; Villejuif France
| | - U. Dirksen
- University Hospital Muenster; Department of Pediatric Hematology and Oncology; Westfalian Wilhelms University; Muenster Germany
- Hospital Infantil Universitario Niño Jesús; Madrid Spain
| | - X. Duarte
- Instituto Português de Oncologia de Lisboa; Lisbon Portugal
| | - S. Dunn
- Teenage Cancer Trust; London UK
| | | | - T. Grew
- Oxford University Clinical Academic Graduate School; Oxford UK
| | - L. Hjorth
- Department of Pediatrics; Skåne University Hospital; Clinical Sciences Lund University; Lund Sweden
| | - J. Jazbec
- Division of Pediatrics; Unit of Hematooncology; University Medical Centre Ljubljana; Ljubljana Slovenia
| | | | | | - J.R. Kowalczyk
- Children's University Hospital; Skubiszewski Medical University of Lublin; Lublin Poland
| | - A. Lassaletta
- Hospital Infantil Universitario Niño Jesús; Madrid Spain
| | - V. Laurence
- Department of Medical and Pediatric Oncology; Institut Curie; Paris France
| | - I. Lewis
- Alder Hey Children's NHS Foundation Trust; Liverpool
| | - A. Monrabal
- Spanish Association of Adolescents and Young Adult with Cancer; London
| | - S. Morgan
- Teenage Cancer Trust Unit; St James's University Hospital; Leeds UK
| | - G. Mountzios
- University of Athens School of Medicine; Athens Greece
| | - P.R. Olsen
- Department of Oncology; Aarhus University Hospital; Aarhus C Denmark
| | - M. Renard
- Department of Pediatric Hemato-Oncology; University Hospitals Leuven; Leuven Belgium
| | - G. Saeter
- Institute for Cancer Research; Oslo University Hospital; Oslo Norway
| | - W.T. van der Graaf
- Department of Medical Oncology; Radboud University Medical Centre; Nijmegen the Netherlands
| | - A. Ferrari
- Pediatric Oncology Unit; Fondazione IRCCS Istituto Nazionale Tumori; Milan Italy
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23
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Abstract
Adolescent and young adult (AYA) patients with cancer are a unique category of patients who, depending on age at time of diagnosis, might receive treatment from oncologists specializing either in the treatment of children or adults. In the USA, AYA oncology generally encompasses patients 15-39 years of age. AYA patients with cancer typically present with diseases that span the spectrum from 'paediatric' cancers (such as acute lymphoblastic leukaemia [ALL] and brain tumours) to 'adult' tumours (such as breast cancer and melanoma), as well as cancers that are largely unique to their age group (such as testicular cancer and bone tumours). Research indicates that outcomes of AYA patients with cancer are influenced not only by the treatment provided, but also by factors related to 'host' biology. In addition to the potential biological and cancer-specific differences between AYAs and other patients with cancer, AYA patients also often have disparate access to clinical trials and suffer from a lack of age-appropriate psychosocial support services and health services, which might influence survival as well as overall quality of life. In this Review, these issues are discussed, with a focus on two types of AYA cancer--ALL and melanoma--highlighting findings arising from the use of emerging technologies, such as whole-genome sequencing.
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