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Desai R, Pelargos PE, Dunn IF. Chordoma: Genetics and Contemporary Management. Int J Mol Sci 2024; 25:5877. [PMID: 38892063 PMCID: PMC11172617 DOI: 10.3390/ijms25115877] [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: 04/22/2024] [Revised: 05/20/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
Chordomas, arising from notochord remnants, are rare neoplasms with aggressive growth patterns despite their histologically low-grade nature. This review explores their embryological origins, molecular markers like brachyury, and genetic alterations driving pathogenesis. Diagnosis relies on advanced imaging and biopsy confirmation due to overlapping features with chondrosarcoma. The WHO classification distinguishes conventional, dedifferentiated, and poorly differentiated chordomas, each with distinct prognostic implications. Recent genomic analyses uncovered recurrent mutations in PI3K signaling pathways and chromatin remodeling genes, informing prognostic models. Surgery remains the cornerstone of treatment, though adjuvant radiation complements surgical resection. Although chordomas are generally considered refractory to medical therapy, emerging targeted molecular strategies show potential promise in ongoing trials. This review aims to provide a concise yet comprehensive overview of chordomas, guiding clinicians in diagnosis, treatment, and prognostication for improved patient outcomes.
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Affiliation(s)
| | | | - Ian F. Dunn
- Department of Neurological Surgery, University of Oklahoma, Oklahoma City, OK 73104, USA; (R.D.); (P.E.P.)
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2
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Uzunparmak B, Haymaker C, Raso G, Masciari S, Wang L, Lin H, Gorur A, Kirby B, Cimo AM, Kennon A, Ding Q, Urschel G, Yuan Y, Feng G, Rizvi Y, Hussain A, Zhu C, Kim P, Abbadessa G, Subbiah V, Yap TA, Rodon J, Piha-Paul SA, Meric-Bernstam F, Dumbrava EE. HER2-low expression in patients with advanced or metastatic solid tumors. Ann Oncol 2023; 34:1035-1046. [PMID: 37619847 DOI: 10.1016/j.annonc.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 08/02/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Human epidermal growth factor receptor 2 (HER2)-low is a newly defined category with HER2 1+ or 2+ expression by immunohistochemistry (IHC) and lack of HER2 gene amplification measured by in situ hybridization (ISH). Much remains unknown about the HER2-low status across tumor types and changes in HER2 status between primary and metastatic samples. PATIENTS AND METHODS HER2 expression by IHC was evaluated in 4701 patients with solid tumors. We have evaluated the HER2 expression by IHC and amplification by ISH in paired breast and gastric/gastroesophageal (GEJ) primary and metastatic samples. HER2 expression was correlated with ERBB2 genomic alterations evaluated by next-generation sequencing (NGS) in non-breast, non-gastric/GEJ samples. RESULTS HER2 expression (HER2 IHC 1-3+) was found in half (49.8%) of the cancers, with HER2-low (1 or 2+) found in many tumor types: 47.1% in breast, 34.6% in gastric/GEJ, 50.0% in salivary gland, 46.9% in lung, 46.5% in endometrial, 46% in urothelial, and 45.5% of gallbladder cancers. The concordance evaluation of HER2 expression between primary and metastatic breast cancer samples showed that HER2 3+ remained unchanged in 87.1% with a strong agreement between primary and metastatic samples, with a weighted kappa (Κ) of 0.85 (95% confidence interval 0.79-0.91). ERBB2 alterations were identified in 117 (7.5%) patients with non-breast, non-gastric/GEJ solid tumors who had NGS testing. Of 1436 patients without ERBB2 alterations, 512 (35.7%) showed any level HER2 expression by IHC. CONCLUSION Our results show that HER2-low expression is frequently found across tumor types. These findings suggest that many patients with HER2-low solid tumors might benefit from HER2-targeted therapies.
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Affiliation(s)
- B Uzunparmak
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - C Haymaker
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - G Raso
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - S Masciari
- Department of Sanofi, The University of Texas MD Anderson Cancer Center, Cambridge, USA
| | - L Wang
- Department of Sanofi, The University of Texas MD Anderson Cancer Center, Cambridge, USA
| | - H Lin
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - A Gorur
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - B Kirby
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - A-M Cimo
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - A Kennon
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Q Ding
- Department of Anatomical Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - G Urschel
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Y Yuan
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - G Feng
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Y Rizvi
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - A Hussain
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - C Zhu
- Department of Sanofi, The University of Texas MD Anderson Cancer Center, Cambridge, USA
| | - P Kim
- Department of Sanofi, The University of Texas MD Anderson Cancer Center, Cambridge, USA
| | - G Abbadessa
- Department of Sanofi, The University of Texas MD Anderson Cancer Center, Cambridge, USA
| | - V Subbiah
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - T A Yap
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, USA; Department of The Institute for Applied Cancer Science, The University of Texas MD Anderson Cancer Center, Houston, USA; Department of Khalifa Institute for Personalized Cancer Therapy, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - J Rodon
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, USA; Department of Khalifa Institute for Personalized Cancer Therapy, The University of Texas MD Anderson Cancer Center, Houston, USA; Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - S A Piha-Paul
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - F Meric-Bernstam
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, USA; Department of Khalifa Institute for Personalized Cancer Therapy, The University of Texas MD Anderson Cancer Center, Houston, USA; Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - E E Dumbrava
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, USA.
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Passeri T, Champagne PO, Giammattei L, Abbritti R, Cartailler J, Calugaru V, Feuvret L, Guichard JP, Polivka M, Adle-Biassette H, Mammar H, Bresson D, Herman P, Mandonnet E, George B, Froelich S. Management strategies in clival and craniovertebral junction chordomas: a 29-year experience. J Neurosurg 2023; 138:1640-1652. [PMID: 36272118 DOI: 10.3171/2022.8.jns221621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 08/30/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Chordomas represent one of the most challenging subsets of skull base and craniovertebral junction (CVJ) tumors to treat. Despite extensive resection followed by proton-beam radiation therapy, the recurrence rate remains high, highlighting the importance of developing efficient treatment strategies. In this study, the authors present their experience in treating clival and CVJ chordomas over a 29-year period. METHODS The authors conducted a retrospective study of clival and CVJ chordomas that were surgically treated at their institution from 1991 to 2020. This study focuses on three aspects of the management of these tumors: the factors influencing the extent of resection (EOR), the predictors of survival, and the outcomes of the endoscopic endonasal approaches (EEAs) compared with open approaches (OAs). RESULTS A total of 265 surgical procedures were performed in 210 patients, including 123 OAs (46.4%) and 142 EEAs (53.6%). Tumors that had an intradural extension (p = 0.03), brainstem contact (p = 0.005), cavernous sinus extension (p = 0.004), major artery encasement (p = 0.01), petrous apex extension (p = 0.003), or high volume (p = 0.0003) were significantly associated with a lower EOR. The 5-year progression-free survival (PFS) and overall survival (OS) rates were 52.1% and 75.1%, respectively. Gross-total resection and Ki-67 labeling index < 6% were considered to be independent prognostic factors of longer PFS (p = 0.0005 and p = 0.003, respectively) and OS (p = 0.02 and p = 0.03, respectively). Postoperative radiation therapy correlated independently with a longer PFS (p = 0.006). Previous surgical treatment was associated with a lower EOR (p = 0.01) and a higher rate of CSF leakage after EEAs (p = 0.02) but did not have significantly lower PFS and OS compared with primary surgery. Previously radiation therapy correlated with a worse outcome, with lower PFS and OS (p = 0.001 and p = 0.007, respectively). EEAs were more frequently used in patients with upper and middle clival tumors (p = 0.002 and p < 0.0001, respectively), had a better rate of EOR (p = 0.003), and had a lower risk of de novo neurological deficit (p < 0.0001) compared with OAs. The overall rate of postoperative CSF leakage after EEAs was 14.8%. CONCLUSIONS This large study showed that gross-total resection should be attempted in a multidisciplinary skull base center before providing radiation therapy. EEAs should be considered as the gold-standard approach for upper/middle clival lesions based on the satisfactory surgical outcome, but OAs remain important tools for large complex chordomas.
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Affiliation(s)
| | | | | | | | | | - Valentin Calugaru
- 3Department of Radiation Oncology, Institut Curie-Proton Beam Therapy Center, Orsay; and
| | - Loïc Feuvret
- 3Department of Radiation Oncology, Institut Curie-Proton Beam Therapy Center, Orsay; and
- 4Department of Radiation Oncology, La Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, France
| | | | | | | | - Hamid Mammar
- 3Department of Radiation Oncology, Institut Curie-Proton Beam Therapy Center, Orsay; and
| | | | - Philippe Herman
- 7Otorhinolaryngology, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris
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Esposito V, Benigno D, Bello I, Panza E, Bucci M, Virgilio A, Galeone A. Structural and Biological Features of G-Quadruplex Aptamers as Promising Inhibitors of the STAT3 Signaling Pathway. Int J Mol Sci 2023; 24:ijms24119524. [PMID: 37298475 DOI: 10.3390/ijms24119524] [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: 05/10/2023] [Revised: 05/25/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023] Open
Abstract
In this paper, we investigate the structural and biological features of G-quadruplex (G4) aptamers as promising antiproliferative compounds affecting the STAT3 signalling pathway. Targeting the STAT3 protein through high-affinity ligands to reduce its levels or activity in cancer has noteworthy therapeutic potential. T40214 (STAT) [(G3C)4] is a G4 aptamer that can influence STAT3 biological outcomes in an efficient manner in several cancer cells. To explore the effects of an extra cytidine in second position and/or of single site-specific replacements of loop residues in generating aptamers that can affect the STAT3 biochemical pathway, a series of STAT and STATB [GCG2(CG3)3C] analogues containing a thymidine residue instead of cytidines was prepared. NMR, CD, UV, and PAGE data suggested that all derivatives adopt dimeric G4 structures like that of unmodified T40214 endowed with higher thermal stability, keeping the resistance in biological environments substantially unchanged, as shown by the nuclease stability assay. The antiproliferative activity of these ODNs was tested on both human prostate (DU145) and breast (MDA-MB-231) cancer cells. All derivatives showed similar antiproliferative activities on both cell lines, revealing a marked inhibition of proliferation, particularly at 72 h at 30 µM. Transcriptomic analysis aimed to evaluate STAT's and STATB's influence on the expression of many genes in MDA-MB-231 cells, suggested their potential involvement in STAT3 pathway modulation, and thus their interference in different biological processes. These data provide new tools to affect an interesting biochemical pathway and to develop novel anticancer and anti-inflammatory drugs.
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Affiliation(s)
- Veronica Esposito
- Department of Pharmacy, University of Naples Federico II, Via D. Montesano 49, I-80131 Naples, Italy
| | - Daniela Benigno
- Department of Pharmacy, University of Naples Federico II, Via D. Montesano 49, I-80131 Naples, Italy
| | - Ivana Bello
- Department of Pharmacy, University of Naples Federico II, Via D. Montesano 49, I-80131 Naples, Italy
| | - Elisabetta Panza
- Department of Pharmacy, University of Naples Federico II, Via D. Montesano 49, I-80131 Naples, Italy
| | - Mariarosaria Bucci
- Department of Pharmacy, University of Naples Federico II, Via D. Montesano 49, I-80131 Naples, Italy
| | - Antonella Virgilio
- Department of Pharmacy, University of Naples Federico II, Via D. Montesano 49, I-80131 Naples, Italy
| | - Aldo Galeone
- Department of Pharmacy, University of Naples Federico II, Via D. Montesano 49, I-80131 Naples, Italy
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Vuong HG, Le MK, Nguyen TPX, Eschbacher K. De novo Versus Secondary Dedifferentiated Chordomas: A Population-Based Analysis and Integrated Individual Participant Data Meta-Analysis. World Neurosurg 2023; 173:208-217.e7. [PMID: 36804481 DOI: 10.1016/j.wneu.2023.02.062] [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: 12/10/2022] [Revised: 02/10/2023] [Accepted: 02/11/2023] [Indexed: 02/18/2023]
Abstract
OBJECTIVE There is a lack of data about the clinicopathological and molecular characteristics of de novo versus secondary dedifferentiated chordoma (DC). This integrated study aimed to investigate the similarities and differences in clinicopathological manifestations, prognoses, and molecular profiles of these 2 subtypes. METHODS We accessed the Surveillance, Epidemiology, and End Results (SEER) Program for DC cases from 1975 to 2020. Three electronic databases were also searched for additional DCs. Individual patient data of DC patients from SEER and published literature were combined in integrated analyses. RESULTS After excluding duplicated patients, we identified 14 and 116 DC patients from SEER and published literature, respectively. There were 74 de novo, 39 secondary, and 18 cases with unknown origin. Our results showed that de novo and secondary DCs were not statistically different in terms of age, gender, primary location, tumor size, distant metastasis at diagnosis, extent of resection, and chemotherapy receipt. There was limited available molecular data for de novo and secondary DCs, though examples TP53 mutations were found in both. In addition, the rates of tumor relapse, metastasis during follow-up, and patient mortality were also comparable between the 2 groups. In the multivariate Cox regression model, we demonstrated that gross total removal and radiotherapy use were associated with prolonged survival of DCs. CONCLUSIONS De novo and secondary DCs were statistically comparable in terms of patient demographics, clinical manifestations, and prognoses. Gross total excision and radiotherapy were optimal treatments associated with better outcomes of DC patients.
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Affiliation(s)
- Huy Gia Vuong
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
| | - Minh-Khang Le
- Department of Pathology, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Truong P X Nguyen
- Department of Pathology, Chulalongkorn University, Bangkok, Thailand
| | - Kathryn Eschbacher
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
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Salle H, Durand S, Durand K, Bourthoumieu S, Lemnos L, Robert S, Pollet J, Passeri T, Khalil W, Froelich S, Adle-Biassette H, Labrousse F. Comparative analysis of histopathological parameters, genome-wide copy number alterations, and variants in genes involved in cell cycle regulation in chordomas of the skull base and sacrum. J Neuropathol Exp Neurol 2023; 82:312-323. [PMID: 36779322 DOI: 10.1093/jnen/nlad008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
Chordomas are rare tumors of the axial skeleton that are refractory to conventional therapy. Few studies have compared the morphological and molecular characteristics of chordomas according to the skull base and sacral locations. Histopathological data and changes revealed by array comparative genomic hybridization (CGH) and next-generation sequencing (NGS) of cell cycle regulation genes were analyzed for 28 skull base (SBCs) and 15 sacral (SC) chordomas. All cases were conventional chordomas. SBCs were significantly more frequent in patients aged <40 years and SCs predominated in patients aged >60 years. Mitotic indices ≥2 mitoses/10 high-power fields were correlated with high degrees of nuclear atypia and Ki67 labeling indices ≥6%. We identified 321 genomic positions, and copy number variation losses were more frequent than gain. Moreover, we report a panel of 85 genetic variants of cell cycle genes and the presence of molecular clusters for chordoma as well in CGH as in NGS. These new data strengthen the view that the chordoma should not be considered as a single molecular entity.
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Affiliation(s)
- Henri Salle
- Department of Neurosurgery, CHU Limoges, Limoges, France
- Inserm, CAPTuR (Contrôle de l'Activation Cellulaire, Progression Tumorale et Résistance; Thérapeutique), Faculty of Medicine, Limoges University, Limoges, France
| | - Stéphanie Durand
- Inserm, CAPTuR, GEIST Institute, University of Limoges, Limoges, France
| | - Karine Durand
- Inserm, CAPTuR (Contrôle de l'Activation Cellulaire, Progression Tumorale et Résistance; Thérapeutique), Faculty of Medicine, Limoges University, Limoges, France
| | | | - Leslie Lemnos
- Department of Neurosurgery, CHU Limoges, Limoges, France
| | - Sandrine Robert
- Inserm, CAPTuR (Contrôle de l'Activation Cellulaire, Progression Tumorale et Résistance; Thérapeutique), Faculty of Medicine, Limoges University, Limoges, France
| | - Justine Pollet
- Plateforme Technique BISCEm US 42 INSERM/UMS 2015 CNRS, Limoges, France
| | - Thibault Passeri
- Department of Neurosurgery, Lariboisière Hospital, University of Paris Diderot, Paris, France
| | - Wassim Khalil
- Department of Neurosurgery, CHU Limoges, Limoges, France
| | - Sébastien Froelich
- Department of Neurosurgery, Lariboisière Hospital, University of Paris Diderot, Paris, France
| | - Homa Adle-Biassette
- AP-HP, Hôpital Lariboisière, Service Anatomie Pathologique and Université de Paris, NeuroDiderot, Inserm, Paris, France
| | - François Labrousse
- Inserm, CAPTuR (Contrôle de l'Activation Cellulaire, Progression Tumorale et Résistance; Thérapeutique), Faculty of Medicine, Limoges University, Limoges, France
- Department of Pathology, Limoges University Hospital, Limoges, France
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7
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Advances in the development of chordoma models for drug discovery and precision medicine. Biochim Biophys Acta Rev Cancer 2022; 1877:188812. [DOI: 10.1016/j.bbcan.2022.188812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/31/2022] [Accepted: 09/28/2022] [Indexed: 12/24/2022]
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Rubino F, Alvarez-Breckenridge C, Akdemir K, Conley AP, Bishop AJ, Wang WL, Lazar AJ, Rhines LD, DeMonte F, Raza SM. Prognostic molecular biomarkers in chordomas: A systematic review and identification of clinically usable biomarker panels. Front Oncol 2022; 12:997506. [PMID: 36248987 PMCID: PMC9557284 DOI: 10.3389/fonc.2022.997506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 09/12/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction and objectiveDespite the improvements in management and treatment of chordomas over time, the risk of disease recurrence remains high. Consequently, there is a push to develop effective systemic therapeutics for newly diagnosed and recurrent disease. In order to tailor treatment for individual chordoma patients and develop effective surveillance strategies, suitable clinical biomarkers need to be identified. The objective of this study was to systematically review all prognostic biomarkers for chordomas reported to date in order to classify them according to localization, study design and statistical analysis.MethodsUsing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically reviewed published studies reporting biomarkers that correlated with clinical outcomes. We included time-to-event studies that evaluated biomarkers in skull base or spine chordomas. To be included in our review, the study must have analyzed the outcomes with univariate and/or multivariate methods (log-rank test or a Cox-regression model).ResultsWe included 68 studies, of which only 5 were prospective studies. Overall, 103 biomarkers were analyzed in 3183 patients. According to FDA classification, 85 were molecular biomarkers (82.5%) mainly located in nucleus and cytoplasm (48% and 27%, respectively). Thirty-four studies analyzed biomarkers with Cox-regression model. Within these studies, 32 biomarkers (31%) and 22 biomarkers (21%) were independent prognostic factors for PFS and OS, respectively.ConclusionOur analysis identified a list of 13 biomarkers correlating with tumor control rates and survival. The future point will be gathering all these results to guide the clinical validation for a chordoma biomarker panel. Our identified biomarkers have strengths and weaknesses according to FDA’s guidelines, some are affordable, have a low-invasive collection method and can be easily measured in any health care setting (RDW and D-dimer), but others molecular biomarkers need specialized assay techniques (microRNAs, PD-1 pathway markers, CDKs and somatic chromosome deletions were more chordoma-specific). A focused list of biomarkers that correlate with local recurrence, metastatic spread and survival might be a cornerstone to determine the need of adjuvant therapies.
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Affiliation(s)
- Franco Rubino
- Department of Neurosurgery, Division of surgery, The University of Texas MD Anderson Cancer Center, University of Texas, Houston, TX, United States
| | - Christopher Alvarez-Breckenridge
- Department of Neurosurgery, Division of surgery, The University of Texas MD Anderson Cancer Center, University of Texas, Houston, TX, United States
| | - Kadir Akdemir
- Department of Neurosurgery, Division of surgery, The University of Texas MD Anderson Cancer Center, University of Texas, Houston, TX, United States
| | - Anthony P. Conley
- Department of Sarcoma Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, University of Texas, Houston, TX, United States
| | - Andrew J. Bishop
- Department of Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, University of Texas, Houston, TX, United States
| | - Wei-Lien Wang
- Department of Pathology, Division of Pathology-Lab Medicine Division, The University of Texas MD Anderson Cancer Center, University of Texas, Houston, TX, United States
| | - Alexander J. Lazar
- Department of Pathology, Division of Pathology-Lab Medicine Division, The University of Texas MD Anderson Cancer Center, University of Texas, Houston, TX, United States
| | - Laurence D. Rhines
- Department of Neurosurgery, Division of surgery, The University of Texas MD Anderson Cancer Center, University of Texas, Houston, TX, United States
| | - Franco DeMonte
- Department of Neurosurgery, Division of surgery, The University of Texas MD Anderson Cancer Center, University of Texas, Houston, TX, United States
| | - Shaan M. Raza
- Department of Neurosurgery, Division of surgery, The University of Texas MD Anderson Cancer Center, University of Texas, Houston, TX, United States
- *Correspondence: Shaan M. Raza,
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9
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Anoshkin K, Zosen D, Karandasheva K, Untesco M, Volodin I, Alekseeva E, Parfenenkova A, Snegova E, Kim A, Dorofeeva M, Kutsev S, Strelnikov V. Pediatric chordoma associated with tuberous sclerosis complex: A rare case report with a thorough analysis of potential therapeutic molecular targets. Heliyon 2022; 8:e10291. [PMID: 36051260 PMCID: PMC9424951 DOI: 10.1016/j.heliyon.2022.e10291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/27/2022] [Accepted: 08/11/2022] [Indexed: 11/25/2022] Open
Abstract
Chordoma associated with tuberous sclerosis complex (TSC) is an extremely rare tumor that was described only in 13 cases since 1975. Сhordoma itself is a malignant slow-growing bone tumor thought to arise from vestigial or ectopic notochordal tissue. Chordoma associated with TSC differs from chordoma in the general pediatric population in the median age, where the diagnosis of TSC-associated chordoma is 6.2 months, whereas for chordoma in the general pediatric population it is set to 12 years. The majority of TSC-associated chordomas are localized in skull-based and sacrum regions, and rare in the spine. Chordomas are genetically heterogeneous tumors characterized by chromosomal instability (CIN), and alterations involving PI3K-AKT signaling pathway genes and chromatin remodeling genes. Here we present the 14th case of chordoma associated with TSC in a 1-year-old pediatric patient. Alongside biallelic inactivation of the TSC1 gene, molecular genetic analysis revealed CIN and involvement of epigenetic regulation genes. In addition, we found the engagement of CBX7 and apolipoprotein B editing complex (APOBEC3) genes that were not yet seen in chordomas before. Amplification of CBX7 may epigenetically silence the CDKN2A gene, whereas amplification of APOBEC3 genes can explain the frequent occurrence of CIN in chordomas. We also found that KRAS gene is located in the region with gain status, which may suggest the ineffectiveness of potential EGFR monotherapy. Thus, molecular genetic analysis carried out in this study broadens the horizons of possible approaches for targeted therapies with potential applications for personalized medicine.
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Affiliation(s)
- Kirill Anoshkin
- Research Centre for Medical Genetics, Moskvorechye Str. 1, 115522 Moscow, Russia
| | - Denis Zosen
- Faculty of Mathematics and Natural Sciences, University of Oslo, PO Box 1068, Blindern, 0316 Oslo, Norway
| | | | - Maxim Untesco
- UNIM LLC, Podsosensky Lane 23, 105062 Moscow, Russia.,Pathology Department, Telemark HF Hospital, Ulefossveien 55, PO Box 2900 Kjørbekk, 3710 Skien, Norway
| | - Ilya Volodin
- Research Centre for Medical Genetics, Moskvorechye Str. 1, 115522 Moscow, Russia
| | - Ekaterina Alekseeva
- Research Centre for Medical Genetics, Moskvorechye Str. 1, 115522 Moscow, Russia.,I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Str. 8-2, 119991 Moscow, Russia
| | - Anna Parfenenkova
- Saint Petersburg State University, University emb. 7-9, 199034 Saint Petersburg, Russia
| | - Eugenia Snegova
- Saint Petersburg State Budget Healthcare Facility "Advisory and Diagnostic Center for Children", Oleko Dundicha Str. 36/2, 192289 Saint Petersburg, Russia
| | - Aleksandr Kim
- Almazov National Medical Research Centre, Akkuratova Str. 2, 197341 Saint Petersburg, Russia
| | - Marina Dorofeeva
- Veltischev Research and Clinical Institute for Pediatrics of the Pirogov Russian National Research Medical University, Taldomskaya Str. 2, 125412 Moscow, Russia
| | - Sergei Kutsev
- Research Centre for Medical Genetics, Moskvorechye Str. 1, 115522 Moscow, Russia
| | - Vladimir Strelnikov
- Research Centre for Medical Genetics, Moskvorechye Str. 1, 115522 Moscow, Russia
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Extent of Resection Research in Skull Base Neurosurgery: Previous Studies and Future Directions. World Neurosurg 2022; 161:396-404. [PMID: 35505559 DOI: 10.1016/j.wneu.2021.10.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/27/2021] [Accepted: 10/28/2021] [Indexed: 10/18/2022]
Abstract
Surgery is the first-line therapy for most benign and malignant skull base tumors. Extent of resection (EOR) is a metric commonly used for preoperative surgical planning and to predict risk of postoperative tumor recurrence. Therefore, understanding the evidence on EOR in skull base neurosurgery is essential to providing optimal care for each patient. Several studies from the skull base neurosurgery literature have presented investigations of various topics related to EOR, including 1) preoperative EOR scoring systems, 2) intraoperative EOR scoring systems, 3) EOR and tumor recurrence, and 4) EOR and functional outcomes. We propose that future investigations should focus on the following elements to improve EOR research in skull base neurosurgery: 1) multi-institutional collaboratives with treatment propensity matching; 2) expert consensus and mixed-methods study design; and 3) predictive analytics/machine learning. We believe that these methods offer several advantages that have been described in the literature and that they address limitations of previous studies. The aim of this review was to inform future study design and improve the overall quality of subsequent investigations on EOR in skull base neurosurgery.
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11
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Passeri T, Dahmani A, Masliah-Planchon J, Naguez A, Michou M, El Botty R, Vacher S, Bouarich R, Nicolas A, Polivka M, Franck C, Schnitzler A, Némati F, Roman-Roman S, Bourdeaut F, Adle-Biassette H, Mammar H, Froelich S, Bièche I, Decaudin D. Dramatic In Vivo Efficacy of the EZH2-Inhibitor Tazemetostat in PBRM1-Mutated Human Chordoma Xenograft. Cancers (Basel) 2022; 14:cancers14061486. [PMID: 35326637 PMCID: PMC8946089 DOI: 10.3390/cancers14061486] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 03/08/2022] [Accepted: 03/10/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary Chordomas are rare bone tumors characterized by a high recurrence rate. Presently, no medical treatment is available for advanced diseases due to the lack of molecular data and preclinical models. The current study showed the establishment and characterization of the largest panel chordoma xenografts, allowing pharmacological studies. In one PBRM1-mutated model, we demonstrated a strong therapeutic efficacy of the EZH2-inhibitor tazemetostat, encouraging further research on EZH2-inhibitors in chordomas. Abstract Chordomas are rare neoplasms characterized by a high recurrence rate and a poor long-term prognosis. Considering their chemo-/radio-resistance, alternative treatment strategies are strongly required, but their development is limited by the paucity of relevant preclinical models. Mutations affecting genes of the SWI/SNF complexes are frequently found in chordomas, suggesting a potential therapeutic effect of epigenetic regulators in this pathology. Twelve PDX models were established and characterized on histological and biomolecular features. Patients whose tumors were able to grow into mice had a statistically significant lower progression-free survival than those whose tumors did not grow after in vivo transplantation (p = 0.007). All PDXs maintained the same histopathological features as patients’ tumors. Homozygous deletions of CDKN2A/2B (58.3%) and PBRM1 (25%) variants were the most common genomic alterations found. In the tazemetostat treated PDX model harboring a PBRM1 variant, an overall survival of 100% was observed. Our panel of chordoma PDXs represents a useful preclinical tool for both pharmacologic and biological assessments. The first demonstration of a high antitumor activity of tazemetostat in a PDX model harboring a PBRM1 variant supports further evaluation for EZH2-inhibitors in this subgroup of chordomas.
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Affiliation(s)
- Thibault Passeri
- Laboratory of Preclinical Investigation, Translational Research Department, Institut Curie, University of Paris Saclay, 75005 Paris, France; (T.P.); (A.D.); (A.N.); (M.M.); (R.E.B.); (F.N.)
- Department of Genetics, Institut Curie, University of Paris Saclay, 75005 Paris, France; (J.M.-P.); (S.V.); (C.F.); (A.S.); (I.B.)
- Department of Neurosurgery, Lariboisière Hospital, Assistance Publique des Hôpitaux de Paris, University of Paris, 75010 Paris, France;
| | - Ahmed Dahmani
- Laboratory of Preclinical Investigation, Translational Research Department, Institut Curie, University of Paris Saclay, 75005 Paris, France; (T.P.); (A.D.); (A.N.); (M.M.); (R.E.B.); (F.N.)
| | - Julien Masliah-Planchon
- Department of Genetics, Institut Curie, University of Paris Saclay, 75005 Paris, France; (J.M.-P.); (S.V.); (C.F.); (A.S.); (I.B.)
| | - Adnan Naguez
- Laboratory of Preclinical Investigation, Translational Research Department, Institut Curie, University of Paris Saclay, 75005 Paris, France; (T.P.); (A.D.); (A.N.); (M.M.); (R.E.B.); (F.N.)
| | - Marine Michou
- Laboratory of Preclinical Investigation, Translational Research Department, Institut Curie, University of Paris Saclay, 75005 Paris, France; (T.P.); (A.D.); (A.N.); (M.M.); (R.E.B.); (F.N.)
| | - Rania El Botty
- Laboratory of Preclinical Investigation, Translational Research Department, Institut Curie, University of Paris Saclay, 75005 Paris, France; (T.P.); (A.D.); (A.N.); (M.M.); (R.E.B.); (F.N.)
| | - Sophie Vacher
- Department of Genetics, Institut Curie, University of Paris Saclay, 75005 Paris, France; (J.M.-P.); (S.V.); (C.F.); (A.S.); (I.B.)
| | - Rachida Bouarich
- Integrated Cancer Research Site, Institut Curie, 75005 Paris, France; (R.B.); (F.B.)
| | - André Nicolas
- Department of Tumor Biology, Institut Curie, 75005 Paris, France;
| | - Marc Polivka
- Department of Pathology, Lariboisière Hospital, Assistance Publique des Hôpitaux de Paris, University of Paris, UMR 1141 Inserm, 75010 Paris, France; (M.P.); (H.A.-B.)
| | - Coralie Franck
- Department of Genetics, Institut Curie, University of Paris Saclay, 75005 Paris, France; (J.M.-P.); (S.V.); (C.F.); (A.S.); (I.B.)
| | - Anne Schnitzler
- Department of Genetics, Institut Curie, University of Paris Saclay, 75005 Paris, France; (J.M.-P.); (S.V.); (C.F.); (A.S.); (I.B.)
| | - Fariba Némati
- Laboratory of Preclinical Investigation, Translational Research Department, Institut Curie, University of Paris Saclay, 75005 Paris, France; (T.P.); (A.D.); (A.N.); (M.M.); (R.E.B.); (F.N.)
| | - Sergio Roman-Roman
- Department of Translational Research, Institut Curie, University of Paris Saclay, 75005 Paris, France;
| | - Franck Bourdeaut
- Integrated Cancer Research Site, Institut Curie, 75005 Paris, France; (R.B.); (F.B.)
| | - Homa Adle-Biassette
- Department of Pathology, Lariboisière Hospital, Assistance Publique des Hôpitaux de Paris, University of Paris, UMR 1141 Inserm, 75010 Paris, France; (M.P.); (H.A.-B.)
| | - Hamid Mammar
- Proton Therapy Center, Institut Curie, 91400 Orsay, France;
| | - Sébastien Froelich
- Department of Neurosurgery, Lariboisière Hospital, Assistance Publique des Hôpitaux de Paris, University of Paris, 75010 Paris, France;
| | - Ivan Bièche
- Department of Genetics, Institut Curie, University of Paris Saclay, 75005 Paris, France; (J.M.-P.); (S.V.); (C.F.); (A.S.); (I.B.)
| | - Didier Decaudin
- Laboratory of Preclinical Investigation, Translational Research Department, Institut Curie, University of Paris Saclay, 75005 Paris, France; (T.P.); (A.D.); (A.N.); (M.M.); (R.E.B.); (F.N.)
- Department of Medical Oncology, Institut Curie, 75005 Paris, France
- Correspondence: ; Tel.: +33-1-56-24-62-40
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Heft Neal ME, Michmerhuizen NL, Kovatch KJ, Owen JHJ, Zhai J, Jiang H, McKean EL, Prince ME, Brenner JC. Advancement of PI3 Kinase Inhibitor Combination Therapies for PI3K-Aberrant Chordoma. J Neurol Surg B Skull Base 2022; 83:87-98. [PMID: 35155075 PMCID: PMC8824629 DOI: 10.1055/s-0040-1716694] [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: 05/05/2020] [Accepted: 07/19/2020] [Indexed: 10/23/2022] Open
Abstract
Objectives Targeted inhibitors of the PI3 kinase (PI3K) pathway have shown promising but incomplete antitumor activity in preclinical chordoma models. The aim of this study is to advance methodology for a high-throughput drug screen using chordoma models to identify new combination therapies for chordoma. Study Design Present work is an in vitro study. Setting The study conducted at an academic research laboratory. Materials and Methods An in vitro study on automated high-throughput screening of chordoma cells was performed using a library of 1,406 drugs as both mono- and combination therapies with PI3K inhibitors. Combination indices were determined for dual therapies and synergistic outliers were identified as potential therapeutic agents. T (brachyury) siRNA knockdown in combination with PI3K pathway inhibition was also assessed. Results Fifty-nine combination therapies were identified as having potential therapeutic efficacy. Effective combinations included PI3K inhibitors with GSK1838705A (ALK/IGF-1R inhibitor), LY2874455 (VEGFR/FGFR inhibitor), El1 (selective Ezh2 inhibitor), and (-)-p-bromotetramisole oxalate (alkaline phosphatase inhibitor). The top ranking targets identified included ALK, PDGFR, VEGFR, aurora kinase, and BCL-2. T (brachyury) inhibition produced significant reduction in cell viability and growth; however PI3K inhibition in combination with T (brachyury) knockdown did not result in further reduction in growth and viability in vitro. Conclusion High throughput with in vitro combination screening is feasible with chordoma cells and allows for rapid identification of synergistic dual-therapies. Potential combination therapies and targetable pathways were identified. T (brachyury) knockdown produced significant reduction in cell viability, but did not show additional benefit with PI3K pathway inhibition in this model. Further in vitro and in vivo validation of these therapeutic combinations is warranted.
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Affiliation(s)
- Molly E. Heft Neal
- Department of Otolaryngology—Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, United States
| | - Nicole L. Michmerhuizen
- Department of Otolaryngology—Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, United States
- Department of Pharmacology, University of Michigan Medical School, Ann Arbor, Michigan, United States
| | - Kevin J. Kovatch
- Department of Otolaryngology—Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, United States
| | - John Henry J. Owen
- Department of Otolaryngology—Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, United States
| | - Jingyi Zhai
- Department of Biostatistics, School of Public Heath, University of Michigan, Ann Arbor, Michigan, United States
| | - Hui Jiang
- Department of Biostatistics, School of Public Heath, University of Michigan, Ann Arbor, Michigan, United States
- Rogel Cancer Center, University of Michigan Medical School, Ann Arbor, Michigan, United States
| | - Erin L. McKean
- Department of Otolaryngology—Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, United States
| | - Mark E.P. Prince
- Department of Otolaryngology—Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, United States
| | - J. Chad Brenner
- Department of Otolaryngology—Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, United States
- Department of Pharmacology, University of Michigan Medical School, Ann Arbor, Michigan, United States
- Rogel Cancer Center, University of Michigan Medical School, Ann Arbor, Michigan, United States
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Yuan W, Wei F, Ouyang H, Ren X, Hang J, Mo X, Liu Z. CMTM3 suppresses chordoma progress through EGFR/STAT3 regulated EMT and TP53 signaling pathway. Cancer Cell Int 2021; 21:510. [PMID: 34560882 PMCID: PMC8461898 DOI: 10.1186/s12935-021-02159-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 08/18/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Chordomas are rare, slow-growing and locally aggressive bone sarcomas. At present, chordomas are difficult to manage due to their high recurrence rate, metastasis tendency and poor prognosis. The underlying mechanisms of chordoma tumorigenesis and progression urgently need to be explored to find the effective therapeutic targets. Our previous data demonstrates that EGFR plays important roles in chordoma development and CKLF-like MARVEL transmembrane domain containing (CMTM)3 suppresses gastric cancer metastasis by inhibiting the EGFR/STAT3/EMT signaling pathway. However, the roles and mechanism of CMTM3 in chordomas remain unknown. METHODS Primary chordoma tissues and the paired adjacent non-tumor tissues were collected to examine the expression of CMTM3 by western blot. The expression of CMTM3 in chordoma cell lines was tested by Real-time PCR and western blot. CCK-8 and colony forming unit assay were performed to delineate the roles of CMTM3 in cell proliferation. Wound healing and Transwell assays were performed to assess cell migration and invasion abilities. A xenograft model in NSG mice was used to elucidate the function of CMTM3 in vivo. Signaling pathways were analyzed by western blot and IHC. RNA-seq was performed to further explore the mechanism regulated by CMTM3 in chordoma cells. RESULTS CMTM3 expression was downregulated in chordoma tissues compared with paired normal tissues. CMTM3 suppressed proliferation, migration and invasion of chordoma cells in vitro and inhibited tumor growth in vivo. CMTM3 accelerated EGFR degradation, suppressed EGFR/STAT3/EMT signaling pathway, upregulated TP53 expression and enriched the TP53 signaling pathway in chordoma cells. CONCLUSIONS CMTM3 inhibited tumorigenesis and development of chordomas through activating the TP53 signaling pathway and suppressing the EGFR/STAT3 signaling pathway, which suppressed EMT progression. CMTM3 might be a potential therapeutic target for chordomas.
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Affiliation(s)
- Wanqiong Yuan
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.,Beijing Key Laboratory of Spinal Disease, Beijing, China.,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China
| | - Feng Wei
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.,Beijing Key Laboratory of Spinal Disease, Beijing, China.,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China
| | - Hanqiang Ouyang
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.,Beijing Key Laboratory of Spinal Disease, Beijing, China.,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China
| | - Xiaoqing Ren
- Department of Pharmacy, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, China
| | - Jing Hang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Beijing, China. .,Peking University Third Hospital, Key Laboratory of Assisted Reproduction, Ministry of Education, 49 North Garden Road, Haidian District, Beijing, 100191, China. .,Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproduction, Beijing, China.
| | - Xiaoning Mo
- Department of Immunology, Key Laboratory of Medical Immunology, Ministry of Health, School of Basic Medical Sciences, Peking University Center for Human Disease Genomics, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing, 100191, China.
| | - Zhongjun Liu
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China. .,Beijing Key Laboratory of Spinal Disease, Beijing, China. .,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China.
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14
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Shen Y, Li M, Xiong Y, Gui S, Bai J, Zhang Y, Li C. Proteomics Analysis Identified ASNS as a Novel Biomarker for Predicting Recurrence of Skull Base Chordoma. Front Oncol 2021; 11:698497. [PMID: 34540668 PMCID: PMC8440958 DOI: 10.3389/fonc.2021.698497] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/17/2021] [Indexed: 01/29/2023] Open
Abstract
Background The prognostic factors of skull base chordoma associated with outcomes of patients after surgery remain inadequately identified. This study was designed to identify a novel prognostic factor for patients with skull base chordoma. Method Using a proteomic technique, the tumor biomarkers that were upregulated in the rapid-recurrence group of chordoma were screened and then narrowed down by bioinformatic analysis. Finally one potential biomarker was chosen for validation by immunohistochemistry using tissue microarray (TMA). A total of 187 patients included in TMA were randomly divided into two cohorts, the training cohort included 93 patients and the validation cohort included 94 patients. Kaplan-Meier survival analysis was used to assess the patients’ survival. Univariable and multivariable Cox regression analysis were used to identify prognostic factors predicting recurrence-free survival (RFS). CCK-8 assay, clonal formation assay and transwell assay were used to test the effect of asparagine synthetase (ASNS) on the proliferation, migration and invasion in chordoma cell lines. Results Among 146 upregulated proteins, ASNS was chosen as a potential prognostic biomarker after bioinformatics analysis. The H-scores of ASNS ranged from 106.27 to 239.58 in TMA. High expression of ASNS was correlated with shorter RFS in both the training cohort (p = 0.0093) and validation cohort (p < 0.001). Knockdown of ASNS by small interfering RNA (siRNA) inhibited the growth, colony formation, migration and invasion of chordoma cells in vitro. Conclusion This study indicates that high expression of ASNS is correlated with poor prognosis of patients with skull base chordoma. ASNS may be a useful prognostic factor for patients with skull base chordoma.
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Affiliation(s)
- Yutao Shen
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Mingxuan Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Yujia Xiong
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Songbai Gui
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jiwei Bai
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yazhuo Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.,Center of Brain Tumor, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Chuzhong Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
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15
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Liu FS, Zheng BW, Zhang TL, Li J, Lv GH, Yan YG, Huang W, Zou MX. Clinicopathological and Prognostic Characteristics in Dedifferentiated/Poorly Differentiated Chordomas: A Pooled Analysis of Individual Patient Data From 58 Studies and Comparison With Conventional Chordomas. Front Oncol 2021; 11:686565. [PMID: 34490087 PMCID: PMC8418060 DOI: 10.3389/fonc.2021.686565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 07/27/2021] [Indexed: 12/17/2022] Open
Abstract
Background Currently, the clinicopathological and prognostic characteristics of dedifferentiated chordoma (DC) and poorly differentiated chordoma (PDC) remain poorly understood. In this study, we sought to characterize clinicopathological parameters in a large PDC/DC cohort and determine their correlations with progression-free survival (PFS) and overall survival (OS) of patients. We also attempted to compare clinical features between PDC/DC and conventional chordoma (CC). Methods Literature searches (from inception to June 01, 2020) using Medline, Embase, Google Scholar and Wanfang databases were conducted to identify eligible studies according to predefined criteria. The local database at our center was also retrospectively reviewed to include CC patients for comparative analysis. Results Fifty-eight studies from the literature and 90 CC patients from our local institute were identified; in total, 54 PDC patients and 96 DC patients were analyzed. Overall, PDC or DC had distinct characteristics from CC, while PDC and DC shared similar clinical features. Adjuvant radiotherapy and chemotherapy were associated with both PFS and OS in PDC patients in the univariate and/or multivariate analyses. In the DC cohort, tumor resection type, adjuvant chemotherapy and tumor dedifferentiation components significantly affected PFS, whereas none of them were predictive of outcome in the multivariate analysis. By analyzing OS, we found that surgery, resection type and the time to dedifferentiation predicted the survival of DC patients; however, only surgery remained significant after adjusting for other covariables. Conclusions These data may offer useful information to better understand the clinical characteristics of PDC/DC and may be helpful in improving the outcome prediction of patients.
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Affiliation(s)
- Fu-Sheng Liu
- Health Management Center, The First Affiliated Hospital, University of South China, Hengyang, China.,Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Bo-Wen Zheng
- Health Management Center, The First Affiliated Hospital, University of South China, Hengyang, China.,Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Tao-Lan Zhang
- Department of Radiation Oncology, Indiana University School of Medicine, IU Simon Comprehensive Cancer Center, Indianapolis, IN, United States
| | - Jing Li
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Guo-Hua Lv
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yi-Guo Yan
- Department of Spine Surgery, The First Affiliated Hospital, University of South China, Hengyang, China
| | - Wei Huang
- Health Management Center, The First Affiliated Hospital, University of South China, Hengyang, China
| | - Ming-Xiang Zou
- Department of Spine Surgery, The First Affiliated Hospital, University of South China, Hengyang, China
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16
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Abstract
CONTEXT.— Chordomas are uncommon malignant neoplasms with notochordal differentiation encountered by neuropathologists, bone/soft tissue pathologists, and general surgical pathologists. These lesions most commonly arise in the axial skeleton. Optimal therapy typically involves complete surgical resection, which is often technically difficult owing to the anatomic location, leading to a high rate of recurrence. Lesions have been generally resistant to radiation and chemotherapy; however, experimental studies involving targeted therapy and immunotherapy are currently underway. OBJECTIVE.— To summarize the clinical and pathologic findings of the various types of chordoma (conventional chordoma, dedifferentiated chordoma, and poorly differentiated chordoma), the differential diagnosis, and recent advances in molecular pathogenesis and therapeutic modalities that are reliant on accurate diagnosis. DATA SOURCES.— Literature review based on PubMed searches containing the term "chordoma" that address novel targeted and immunomodulatory therapeutic modalities; ongoing clinical trials involved in treating chordoma with novel therapeutic modalities identified through the Chordoma Foundation and ClinicalTrials.gov; and the authors' practice experience combined with various authoritative texts concerning the subject. CONCLUSIONS.— Chordoma is a clinically and histologically unique malignant neoplasm, and numerous diagnostic considerations must be excluded to establish the correct diagnosis. Treatment options have largely been centered on surgical excision with marginal results; however, novel therapeutic options including targeted therapy and immunotherapy are promising means to improve prognosis.
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Affiliation(s)
- Veronica Ulici
- From the Department of Pathology and Laboratory Medicine, Rhode Island Hospital, The Warren Alpert School of Medicine, Brown University, Providence, Rhode Island
| | - Jesse Hart
- From the Department of Pathology and Laboratory Medicine, Rhode Island Hospital, The Warren Alpert School of Medicine, Brown University, Providence, Rhode Island
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17
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Zhao T, Siu IM, Williamson T, Zhang H, Ji C, Burger PC, Connis N, Ruzevick J, Xia M, Cottone L, Flanagan AM, Hann CL, Gallia GL. AZD8055 enhances in vivo efficacy of afatinib in chordomas. J Pathol 2021; 255:72-83. [PMID: 34124783 DOI: 10.1002/path.5739] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 05/17/2021] [Accepted: 06/09/2021] [Indexed: 01/02/2023]
Abstract
Chordomas are primary bone tumors that arise in the cranial base, mobile spine, and sacrococcygeal region, affecting patients of all ages. Currently, there are no approved agents for chordoma patients. Here, we evaluated the anti-tumor efficacy of small molecule inhibitors that target oncogenic pathways in chordoma, as single agents and in combination, to identify novel therapeutic approaches with the greatest translational potential. A panel of small molecule compounds was screened in vivo against patient-derived xenograft (PDX) models of chordoma, and potentially synergistic combinations were further evaluated using chordoma cell lines and xenograft models. Among the tested agents, inhibitors of EGFR (BIBX 1382, erlotinib, and afatinib), c-MET (crizotinib), and mTOR (AZD8055) significantly inhibited tumor growth in vivo but did not induce tumor regression. Co-inhibition of EGFR and c-MET using erlotinib and crizotinib synergistically reduced cell viability in chordoma cell lines but did not result in enhanced in vivo activity. Co-inhibition of EGFR and mTOR pathways using afatinib and AZD8055 synergistically reduced cell viability in chordoma cell lines. Importantly, this dual inhibition completely suppressed tumor growth in vivo, showing improved tumor control. Together, these data demonstrate that individual inhibitors of EGFR, c-MET, and mTOR pathways suppress chordoma growth both in vitro and in vivo. mTOR inhibition increased the efficacy of EGFR inhibition on chordoma growth in several preclinical models. The insights gained from our study potentially provide a novel combination therapeutic strategy for patients with chordoma. © 2021 The Authors. The Journal of Pathology published by John Wiley & Sons, Ltd. on behalf of The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Tianna Zhao
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - I-Mei Siu
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Tara Williamson
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Haoyu Zhang
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Chenchen Ji
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Peter C Burger
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nick Connis
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jacob Ruzevick
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Menghang Xia
- National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD, USA
| | - Lucia Cottone
- Department of Pathology, UCL Cancer Institute, University College London, London, UK
| | - Adrienne M Flanagan
- Department of Pathology, UCL Cancer Institute, University College London, London, UK.,Histopathology Department, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Christine L Hann
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Gary L Gallia
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Otolaryngology/Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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18
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Cavallo LM, Mazzatenta D, d'Avella E, Catapano D, Fontanella MM, Locatelli D, Luglietto D, Milani D, Solari D, Vindigni M, Zenga F, Zona G, Cappabianca P. The management of clival chordomas: an Italian multicentric study. J Neurosurg 2021; 135:93-102. [PMID: 32886913 DOI: 10.3171/2020.5.jns20925] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 05/20/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE In the last 2 decades, the endoscopic endonasal approach in the treatment of clival chordomas has evolved to be a viable strategy to achieve maximal safe resection of this tumor. Here, the authors present a multicentric national study, intending to analyze the evolution of this approach over a 20-year time frame and its contribution in the treatment of clival chordomas. METHODS Clival chordoma cases surgically treated between 1999 and 2018 at 10 Italian neurosurgical departments were included in this retrospective study. Clinical, radiological, and surgical findings, adjuvant therapy, and outcomes were evaluated and compared according to classification in the treatment eras from 1999 to 2008 and from 2009 to 2018. RESULTS One hundred eighty-two surgical procedures were reviewed, with an increase in case load since 2009. The endoscopic endonasal transclival approach (EETA) was performed in 151 of 182 cases (83.0%) and other approaches were performed in 31 cases (17%). There was an increment in the use of EETA, neuronavigation, and Doppler ultrasound after 2008. The overall postoperative complication rate was 14.3% (26 of 182 cases) consisting of 9 CSF leaks (4.9%), 7 intracranial hemorrhages (3.8%), 5 cases of meningitis (2.7%), and 5 cerebral ischemic injuries (2.7%). Gross-total resection (GTR) was achieved in 93 of 182 cases (51.1%). Extent of resection (EOR) improved in the second era of the study. Signs and/or symptoms at presentation worsened in 27 cases (14.8%), and the Katz Index worsened in 10 cases (5.5%). Previous treatment, dural involvement, EETA, and intraoperative Doppler ultrasound correlated with GTR. Patients received adjuvant proton beam radiation in 115 of 182 cases (63.2%), which was administered more in the latter era. Five-year progression-free survival (PFS) and overall survival (OS) were 62.3% and 73.5%, respectively. GTR, EETA, proton beam therapy, and the chondroid subtype correlated with a better survival rate. The mean follow-up was 62 months. CONCLUSIONS Through multicentric data collection, this study encompasses the largest series in the literature of clival chordomas surgically treated through an EETA. An increase in the use of this approach was found among Italian neurosurgical departments together with an improved extent of resection over time. The satisfactory rate of GTR was marked by low surgical morbidity and the preservation of patient quality of life. Surgical outcome was reinforced, in terms of PFS and OS, by the use of proton beam therapy, which was increasingly performed along the period of study.
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Affiliation(s)
- Luigi Maria Cavallo
- 1Department of Neurosciences and Reproductive and Odontostomatological Sciences, Division of Neurosurgery, University of Napoli "Federico II", Naples
| | - Diego Mazzatenta
- 2Department of Biomedical and Neuromotor Sciences, University of Bologna, IRCCS Institute of Neurological Sciences of Bologna, "Bellaria" Hospital, Bologna
| | - Elena d'Avella
- 1Department of Neurosciences and Reproductive and Odontostomatological Sciences, Division of Neurosurgery, University of Napoli "Federico II", Naples
| | - Domenico Catapano
- 3Division of Neurosurgery, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo
| | | | - Davide Locatelli
- 5Division of Neurosurgery, Università degli Studi dell'Insubria, Ospedale di Circolo e Fondazione Macchi, Varese
| | | | - Davide Milani
- 7Division of Neurosurgery, Humanitas Research Hospital, Rozzano
| | - Domenico Solari
- 1Department of Neurosciences and Reproductive and Odontostomatological Sciences, Division of Neurosurgery, University of Napoli "Federico II", Naples
| | - Marco Vindigni
- 8Neurosurgery Unit, Department of Neurosciences, Santa Maria della Misericordia University Hospital, Udine
| | - Francesco Zenga
- 9Department of Neuroscience, "Rita Levi Montalcini", Neurosurgery Unit, University of Turin; and
| | - Gianluigi Zona
- 10Neurosurgery and Neurotraumatology, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Paolo Cappabianca
- 1Department of Neurosciences and Reproductive and Odontostomatological Sciences, Division of Neurosurgery, University of Napoli "Federico II", Naples
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Sbardella E, Puliani G, Feola T, Pofi R, Pirchio R, Sesti F, Verdecchia F, Gianfrilli D, Moffat D, Isidori AM, Grossman AB. A clinical approach to parasellar lesions in the transition age. J Neuroendocrinol 2021; 33:e12995. [PMID: 34138496 DOI: 10.1111/jne.12995] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/23/2021] [Accepted: 05/11/2021] [Indexed: 12/16/2022]
Abstract
Many reviews have summarised the pathology and management of the parasellar region in adult patients, although an analysis of these aspects in the transition years, from puberty onset to the age of peak bone mass, has been lacking. A comprehensive search of English-language original articles, published from 2000 to 2020, was conducted in the MEDLINE database (December 2019 to March 2020). We selected all studies regarding epidemiology, diagnosis and management of the following parasellar lesions: germinoma, craniopharyngioma, Langerhans cell histiocytosis, optic glioma, hypothalamic hamartoma, tuber cinereum hamartoma, cranial chordoma, Rathke cleft cyst, hypophysitis and hypothalamitis during the transition age from childhood to adulthood. In the present review, we provide an overview of the principal parasellar lesions occurring in the transition age. Symptoms are usually a result of the mass effect of the lesions on nearby structures, as well as anterior pituitary deficits. Diabetes insipidus occurs frequently in these patients. In this age group, pubertal developmental disorders may be more evident compared to other stages of life. Parasellar lesions in the transition age mostly include neoplastic lesions such as germinomas, hamartomas, optic gliomas, craniopharyngiomas Langerhans cell histiocytosis and chordomas, and rarely inflammatory lesions (hypophysitis, hypothalamitis). There are limited data on the management of parasellar lesions in the transition age. Endocrine evaluation is crucial for identifying conditions that require hormonal treatment so that they can be treated early to improve the quality of life of the individual patient in this complex age range. The clinical approach to parasellar lesions involves a multidisciplinary effort.
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Affiliation(s)
- Emilia Sbardella
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Giulia Puliani
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
- Oncological Endocrinology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Tiziana Feola
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
- Neuroendocrinology, Neuromed Institute, IRCCS, Pozzilli, Italy
| | - Riccardo Pofi
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Rosa Pirchio
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy
| | - Franz Sesti
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Federica Verdecchia
- Dipartimento Pediatrico Universitario Ospedaliero, Bambino Gesù Children Hospital, Rome, Italy
| | - Daniele Gianfrilli
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Daniel Moffat
- Department of Neurosurgery, Barts and the London NHS Trust, London, UK
| | - Andrea M Isidori
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Ashley B Grossman
- Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, University of Oxford, Oxford, UK
- Centre for Endocrinology, Barts and the London School of Medicine, London, UK
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20
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Passeri T, di Russo P, Champagne PO, Bernat AL, Cartailler J, Guichard JP, Mammar H, Giammattei L, Adle-Biassette H, George B, Mandonnet E, Froelich S. Tumor Growth Rate as a New Predictor of Progression-Free Survival After Chordoma Surgery. Neurosurgery 2021; 89:291-299. [PMID: 33989415 DOI: 10.1093/neuros/nyab164] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 03/14/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Currently, different postoperative predictors of chordoma recurrence have been identified. Tumor growth rate (TGR) is an image-based calculation that provides quantitative information of tumor's volume changing over time and has been shown to predict progression-free survival (PFS) in other tumor types. OBJECTIVE To explore the usefulness of TGR as a new preoperative radiological marker for chordoma recurrence. METHODS A retrospective single-institution study was carried out including patients reflecting these criteria: confirmed diagnosis of chordoma on pathological analysis, no history of previous radiation, and at least 2 preoperative thin-slice magnetic resonance images available to measure TGR. TGR was calculated for all patients, showing the percentage change in tumor size over 1 mo. RESULTS A total of 32 patients were retained for analysis. Patients with a TGR ≥ 10.12%/m had a statistically significantly lower mean PFS (P < .0001). TGR ≥ 10.12%/m (odds ratio = 26, P = .001) was observed more frequently in recurrent chordoma. In a subgroup analysis, we found that the association of Ki-67 labeling index ≥ 6% and TGR ≥ 10.12%/m was correlated with recurrence (P = .0008). CONCLUSION TGR may be considered as a preoperative radiological indicator of tumor proliferation and seems to preoperatively identify more aggressive tumors with a higher tendency to recur. Our findings suggest that the therapeutic strategy and clinical-radiological follow-up of patients with chordoma can be adapted also according to this new parameter.
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Affiliation(s)
- Thibault Passeri
- Department of Neurosurgery, Lariboisière Hospital, Assistance Publique - Hôpitaux de Paris, University of Paris, Paris, France
| | - Paolo di Russo
- Department of Neurosurgery, Lariboisière Hospital, Assistance Publique - Hôpitaux de Paris, University of Paris, Paris, France
| | - Pierre-Olivier Champagne
- Department of Neurosurgery, Lariboisière Hospital, Assistance Publique - Hôpitaux de Paris, University of Paris, Paris, France
| | - Anne-Laure Bernat
- Department of Neurosurgery, Lariboisière Hospital, Assistance Publique - Hôpitaux de Paris, University of Paris, Paris, France
| | - Jérome Cartailler
- Department of Anesthesiology, Lariboisière Hospital, Assistance Publique - Hôpitaux de Paris, University of Paris, Paris, France
| | - Jean Pierre Guichard
- Department of Neuroradiology, Lariboisière Hospital, Assistance Publique - Hôpitaux de Paris, University of Paris, Paris, France
| | - Hamid Mammar
- Protontherapy Center, Institut Curie, Orsay, France
| | - Lorenzo Giammattei
- Department of Neurosurgery, Lariboisière Hospital, Assistance Publique - Hôpitaux de Paris, University of Paris, Paris, France
| | - Homa Adle-Biassette
- Department of Anatomo-pathology, Lariboisière Hospital, Assistance Publique - Hôpitaux de Paris, University of Paris, Paris, France
| | - Bernard George
- Department of Neurosurgery, Lariboisière Hospital, Assistance Publique - Hôpitaux de Paris, University of Paris, Paris, France
| | - Emmanuel Mandonnet
- Department of Neurosurgery, Lariboisière Hospital, Assistance Publique - Hôpitaux de Paris, University of Paris, Paris, France
| | - Sébastien Froelich
- Department of Neurosurgery, Lariboisière Hospital, Assistance Publique - Hôpitaux de Paris, University of Paris, Paris, France
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Brčić I, Rosenberg AE. Pathology of pleomorphic/undifferentiated and dedifferentiated bone neoplasms. Semin Diagn Pathol 2021; 38:163-169. [PMID: 34049746 DOI: 10.1053/j.semdp.2021.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 04/01/2021] [Accepted: 04/09/2021] [Indexed: 11/11/2022]
Abstract
Primary malignant bone tumors are uncommon and their accurate classification requires careful correlation of clinical, radiological, and pathologic findings. It is a heterogeneous group of tumors with a wide spectrum of morphology and their biological potential can be of low- or high-grade, depending on their risk for developing metastases. Over the past several decades, the classification of bone sarcomas has remained largely constant. However, some of the tumors have been reclassified and several new entities have emerged. In this review, we will focus on pleomorphic fibrosarcoma/UPS and dedifferentiated bone tumors, discuss their key diagnostic features, differential diagnosis, and their relation to prognosis.
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Affiliation(s)
- Iva Brčić
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Andrew E Rosenberg
- Department of Pathology and Laboratory Medicine, Division of Bone and Soft tissue, University of Miami, Sylvester Comprehensive Cancer Center, and Jackson Memorial Hospitals, Miami, FL, USA.
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22
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Akinduro OO, Suarez-Meade P, Garcia D, Brown DA, Sarabia-Estrada R, Attia S, Gokaslan ZL, Quiñones-Hinojosa A. Targeted Therapy for Chordoma: Key Molecular Signaling Pathways and the Role of Multimodal Therapy. Target Oncol 2021; 16:325-337. [PMID: 33893940 DOI: 10.1007/s11523-021-00814-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Chordoma is a rare but devastating tumor that arises in the cranial skull base or spine. There are currently no US Food and Drug Administration-approved targeted therapies for chordoma, and little understanding of whether using more than one therapy has benefit over monotherapy. OBJECTIVE The objective of this study was to systematically review the current status of clinical trials completed for patients with chordoma to determine if multimodal therapy offers a benefit in progression-free survival over monomodal therapy. METHODS We performed a systematic review of the literature according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to review the available clinical trials of targeted therapy for chordoma. We compiled the clinical data to determine if there is a benefit of multimodal therapy over monotherapy. RESULTS Our search resulted in 11 clinical trials including 270 patients with advanced chordoma who were treated with targeted therapies. The most commonly employed targeted therapies acted within the following pathways: platelet-derived growth factor receptor (187 patients), vascular endothelial growth factor (66 patients), and mammalian target of rapamycin (43 patients). Reported progression-free survival for included studies ranged from 2.5 to 58 months, with the longest progression-free survival in a trial that included a platelet-derived growth factor receptor inhibitor, nilotinib, and concurrent radiotherapy (58.2 months). There was a higher range of progression-free survival for trials treating patients with multimodal therapy (10.2-14 months vs 2.5-9.2 months, except for a monotherapy trial published in 2020 with a progression-free survival of 18 months), and those published in 2018 or later (14-58.2 months vs 2.5-10.2 months). Only 23% of patients with chordoma in published clinical trials have been treated with multimodal therapy. CONCLUSIONS Progression-free survival may be enhanced by the use of targeted therapy with concurrent radiotherapy, use of multimodal therapy, and use of newer targeted therapy. Future clinical trials should consider use of concurrent radiotherapy and multimodal therapy for patients with advanced chordoma.
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Affiliation(s)
- Oluwaseun O Akinduro
- Brain Tumor Stem Cell Laboratory, Department of Neurologic Surgery, Mayo Clinic, 4500 San Pablo Rd. S, Jacksonville, FL, 32224, USA
| | - Paola Suarez-Meade
- Brain Tumor Stem Cell Laboratory, Department of Neurologic Surgery, Mayo Clinic, 4500 San Pablo Rd. S, Jacksonville, FL, 32224, USA
| | - Diogo Garcia
- Brain Tumor Stem Cell Laboratory, Department of Neurologic Surgery, Mayo Clinic, 4500 San Pablo Rd. S, Jacksonville, FL, 32224, USA
| | | | - Rachel Sarabia-Estrada
- Brain Tumor Stem Cell Laboratory, Department of Neurologic Surgery, Mayo Clinic, 4500 San Pablo Rd. S, Jacksonville, FL, 32224, USA
| | - Steven Attia
- Department of Hematology and Oncology, Mayo Clinic, Jacksonville, FL, USA
| | - Ziya L Gokaslan
- Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Alfredo Quiñones-Hinojosa
- Brain Tumor Stem Cell Laboratory, Department of Neurologic Surgery, Mayo Clinic, 4500 San Pablo Rd. S, Jacksonville, FL, 32224, USA.
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23
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Pennington Z, Ehresman J, McCarthy EF, Ahmed AK, Pittman PD, Lubelski D, Goodwin CR, Sciubba DM. Chordoma of the sacrum and mobile spine: a narrative review. Spine J 2021; 21:500-517. [PMID: 33589095 DOI: 10.1016/j.spinee.2020.10.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 09/11/2020] [Accepted: 10/07/2020] [Indexed: 02/03/2023]
Abstract
Chordoma is a notochord-derived primary tumor of the skull base and vertebral column known to affect 0.08 to 0.5 per 100,000 persons worldwide. Patients commonly present with mechanical, midline pain with or without radicular features secondary to nerve root compression. Management of these lesions has classically revolved around oncologic resection, defined by en bloc resection of the lesion with negative margins as this was found to significantly improve both local control and overall survival. With advancement in radiation modalities, namely the increased availability of focused photon therapy and proton beam radiation, high-dose (>50 Gy) neoadjuvant or adjuvant radiotherapy is also becoming a standard of care. At present chemotherapy does not appear to have a role, but ongoing investigations into the ontogeny and molecular pathophysiology of chordoma promise to identify therapeutic targets that may further alter this paradigm. In this narrative review we describe the epidemiology, histopathology, diagnosis, and treatment of chordoma.
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Affiliation(s)
- Zach Pennington
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe St., Meyer 5-185A, Baltimore, MD 21287, USA
| | - Jeff Ehresman
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe St., Meyer 5-185A, Baltimore, MD 21287, USA
| | - Edward F McCarthy
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - A Karim Ahmed
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe St., Meyer 5-185A, Baltimore, MD 21287, USA
| | - Patricia D Pittman
- Department of Neuropathology, Duke University School of Medicine, Durham, NC 27710, USA
| | - Daniel Lubelski
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe St., Meyer 5-185A, Baltimore, MD 21287, USA
| | - C Rory Goodwin
- Department of Neurosurgery, Duke University School of Medicine, Durham, NC 27710, USA
| | - Daniel M Sciubba
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe St., Meyer 5-185A, Baltimore, MD 21287, USA.
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24
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Dedifferentiated Chordoma: Clinicopathologic and Molecular Characteristics With Integrative Analysis. Am J Surg Pathol 2020; 44:1213-1223. [PMID: 32427623 DOI: 10.1097/pas.0000000000001501] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Dedifferentiated chordoma is a rare chordoma subtype characterized by a high-grade sarcoma juxtaposed to conventional chordoma. We identified a series of dedifferentiated chordomas, reviewed clinicopathologic features, performed next-generation sequencing in select cases, and analyzed all related English-language publications. Our series included 7 men and 3 women (age 15 to 80 y [median: 54 y]; <1% of >1000 chordomas surveyed). The tumor (2.8 to 24.5 cm [median: 5.8 cm] in size) presented de novo or as recurrence (including postradiotherapy) in sacrum (n=5), skull base (n=2), lumbar spine (n=1), thoracic/mediastinum (n=1), and lung (n=1; as metastasis). Histologically, the dedifferentiated component (3% to 95% [median: 60%]) was pleomorphic-to-fibrosarcomatous, juxtaposed to conventional (n=8) or chondroid (n=2) component. By immunohistochemistry, the conventional/chondroid component consistently expressed cytokeratin and brachyury, whereas the dedifferentiated component showed loss of both. We identified a sacral conventional chordoma with INI1 loss, with one of the lung metastases showing biphasic histology with loss of cytokeratin and brachyury in the dedifferentiated component. Sequencing identified tumor suppressor mutations in 4 tumors, including TP53 mutations in the dedifferentiated component in 3 tumors. Of 7 patients with follow-up, 6 developed metastases; 4 died at 15 to 99 months (median: 24 mo) after dedifferentiated chordoma diagnosis. Collectively, of 87 dedifferentiated chordoma patients described in 1913-2020 (including 10 herein), the median overall survival was 20 months. In summary, dedifferentiated chordoma involves diverse sites and presents de novo, postradiotherapy, or as recurrence/metastasis months-to-years after initial diagnosis. The dedifferentiated component shows loss of brachyury and cytokeratin staining and harbors recurrent TP53 mutations, implicating tumor suppressor dysregulation in chordoma dedifferentiation.
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25
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Anderson E, Havener TM, Zorn KM, Foil DH, Lane TR, Capuzzi SJ, Morris D, Hickey AJ, Drewry DH, Ekins S. Synergistic drug combinations and machine learning for drug repurposing in chordoma. Sci Rep 2020; 10:12982. [PMID: 32737414 PMCID: PMC7395084 DOI: 10.1038/s41598-020-70026-w] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 07/20/2020] [Indexed: 12/18/2022] Open
Abstract
Chordoma is a devastating rare cancer that affects one in a million people. With a mean-survival of just 6 years and no approved medicines, the primary treatments are surgery and radiation. In order to speed new medicines to chordoma patients, a drug repurposing strategy represents an attractive approach. Drugs that have already advanced through human clinical safety trials have the potential to be approved more quickly than de novo discovered medicines on new targets. We have taken two strategies to enable this: (1) generated and validated machine learning models of chordoma inhibition and screened compounds of interest in vitro. (2) Tested combinations of approved kinase inhibitors already being individually evaluated for chordoma. Several published studies of compounds screened against chordoma cell lines were used to generate Bayesian Machine learning models which were then used to score compounds selected from the NIH NCATS industry-provided assets. Out of these compounds, the mTOR inhibitor AZD2014, was the most potent against chordoma cell lines (IC50 0.35 µM U-CH1 and 0.61 µM U-CH2). Several studies have shown the importance of the mTOR signaling pathway in chordoma and suggest it as a promising avenue for targeted therapy. Additionally, two currently FDA approved drugs, afatinib and palbociclib (EGFR and CDK4/6 inhibitors, respectively) demonstrated synergy in vitro (CI50 = 0.43) while AZD2014 and afatanib also showed synergy (CI50 = 0.41) against a chordoma cell in vitro. These findings may be of interest clinically, and this in vitro- and in silico approach could also be applied to other rare cancers.
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Affiliation(s)
- Edward Anderson
- UNC Catalyst for Rare Diseases, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Tammy M Havener
- UNC Catalyst for Rare Diseases, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kimberley M Zorn
- Collaborations Pharmaceuticals, Inc., 840 Main Campus Drive, Lab 3510, Raleigh, NC, USA
| | - Daniel H Foil
- Collaborations Pharmaceuticals, Inc., 840 Main Campus Drive, Lab 3510, Raleigh, NC, USA
| | - Thomas R Lane
- Collaborations Pharmaceuticals, Inc., 840 Main Campus Drive, Lab 3510, Raleigh, NC, USA
| | - Stephen J Capuzzi
- UNC Catalyst for Rare Diseases, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Dave Morris
- UNC Catalyst for Rare Diseases, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Anthony J Hickey
- UNC Catalyst for Rare Diseases, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- RTI International, Research Triangle Park, NC, USA
| | - David H Drewry
- Structural Genomics Consortium, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Sean Ekins
- UNC Catalyst for Rare Diseases, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Collaborations Pharmaceuticals, Inc., 840 Main Campus Drive, Lab 3510, Raleigh, NC, USA.
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Salle H, Pocard M, Lehmann-Che J, Bourthoumieu S, Labrousse F, Pimpie C, Lemnos L, Guichard JP, Froelich S, Adle-Biassette H. Development of a Novel Orthotopic Primary Human Chordoma Xenograft Model: A Relevant Support for Future Research on Chordoma. J Neuropathol Exp Neurol 2020; 79:314-324. [PMID: 31841164 DOI: 10.1093/jnen/nlz121] [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: 07/30/2019] [Revised: 09/18/2019] [Accepted: 11/08/2019] [Indexed: 01/04/2023] Open
Abstract
Chordomas are slow-growing rare malignant neoplasms. The aim of this study was to establish a primary model of chordoma in the lumbosacral orthotopic area, to compare the growth rate to the subcutaneous site, and to show that this new graft site optimizes tumor growth and bony invasion. Eleven chordoma samples were transplanted subcutaneously in the flank and/or in contact with the lumbosacral region and grown into nude mice. Engraftment rate was significantly more successful in the lumbosacral environment compared with the flank at P0. Two xenografts from 2 patients showed bone invasion. One tumor was maintained through multiple rounds of serial transplantation, creating a model for study. Histological and immunostaining analysis confirmed that tumor grafts recapitulated the primary tumor from which they were derived, consisting of a myxoid chordoma expressing brachyury, cytokeratin AE1, EMA, and VEGF. Clear destruction of the bone by the tumor cells could be demonstrated. Molecular studies revealed PIK3CA and PTEN mutations involved in PI3K signaling pathway and most of the frequently reported chromosomal alterations. We present a novel orthotopic primary xenograft model of chordoma implanted for the first time in the lumbosacral area showing bone invasion, PIK3CA, and PTEN mutations that will facilitate preclinical studies.
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Affiliation(s)
- Henri Salle
- From the Université Paris-Diderot, Unité INSERM U965-Paris 7, Paris, France.,Service Neurochirurgie, Hôpital Lariboisière - AP-HP, Paris, France.,Hôpital Dupuytren, CHU Limoges, Université de Limoges, Limoges, France.,Hôpital Dupuytren, CHU Limoges, Service Neurochirurgie, Limoges, France
| | - Marc Pocard
- From the Université Paris-Diderot, Unité INSERM U965-Paris 7, Paris, France.,Service Neurochirurgie, Hôpital Lariboisière - AP-HP, Paris, France
| | - Jacqueline Lehmann-Che
- Université de Paris, HIPI INSERM U976, Paris, France.,Molecular Oncology Unit, AP-HP, Hôpital Saint Louis, Paris, France
| | - Sylvie Bourthoumieu
- Université de Limoges, EA6309 Maintenance myélinique et neuropathie périphérique, Limoges, France
| | | | - Cynthia Pimpie
- From the Université Paris-Diderot, Unité INSERM U965-Paris 7, Paris, France
| | - Leslie Lemnos
- Hôpital Dupuytren, CHU Limoges, Service Neurochirurgie, Limoges, France
| | | | - Sebastien Froelich
- From the Université Paris-Diderot, Unité INSERM U965-Paris 7, Paris, France
| | - Homa Adle-Biassette
- Service d'Anatomie et de Cytologie Pathologiques, Hôpital Lariboisère - AP-HP, Paris, France.,Plateforme de Bio-Pathologie et de Technologies Innovantes en Santé, Centre de Ressources Biologiques BB-0033-00064, Hôpital Lariboisière-APHP, Paris, France.,Université Paris, NeuroDiderot, Inserm, Paris, France
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27
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Chordomas: A review with emphasis on their pathophysiology, pathology, molecular biology, and genetics. Pathol Res Pract 2020; 216:153089. [PMID: 32825957 DOI: 10.1016/j.prp.2020.153089] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 06/24/2020] [Accepted: 06/26/2020] [Indexed: 12/21/2022]
Abstract
Chordomas are uncommon, bone, axial, or (rarely) extra-axial tumors that are malignant and frequently recur but less commonly metastasize. They usually affect adults, with a very small proportion being pediatric tumors. For children, such tumors present a different biology, since they are more common as scull rather than sacral tumors, with aggressive histological features, including a loss of SMARCB1/INI1 and a dismal prognosis. Histologically, chordomas, believed to derive from notochordal tissue, characteristically show physaliphorous cells in a myxoid or chondroid matrix. Dedifferentiated and poorly differentiated forms can be observed. Moreover, a grading scale for chordomas has been proposed. Cytokeratin, EMA, S100, and brachyury are expressed by most chordomas. These are chemo-resistant tumors, for which surgical resection and/or radiotherapy are the treatments of choice. In this review, the histological, immunohistochemical, molecular, and clinical data of chordomas are discussed.
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Bai J, Shi J, Zhang S, Zhang C, Zhai Y, Wang S, Li M, Li C, Zhao P, Geng S, Gui S, Jing L, Zhang Y. MRI Signal Intensity and Electron Ultrastructure Classification Predict the Long-Term Outcome of Skull Base Chordomas. AJNR Am J Neuroradiol 2020; 41:852-858. [PMID: 32381547 DOI: 10.3174/ajnr.a6557] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 03/08/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND PURPOSE MR imaging is a useful and widely used evaluation for chordomas. Prior studies have classified chordomas into cell-dense type and matrix-rich type according to the ultrastructural features. However, the relationship between the MR imaging signal intensity and ultrastructural classification is unknown. We hypothesized that MR imaging signal intensity may predict both tumor ultrastructural classification and prognosis. MATERIALS AND METHODS Seventy-nine patients with skull base chordomas who underwent 95 operations were included in this retrospective single-center series. Preoperative tumor-to-pons MR imaging signal intensity ratios were calculated and designated as ratio on T1 FLAIR sequence (RT1), ratio on T2 sequence (RT2), and ratio on enhanced T1 FLAIR sequence (REN), respectively. We assessed the relationships among signal intensity ratios, ultrastructural classification, and survival. RESULTS Compared with the matrix-rich type group, the cell-dense type chordomas showed lower RT2 (cell-dense type: 1.90 ± 0.38; matrix-rich type: 2.61 ± 0.60 P < .001). The model of predicting cell-dense type based on RT2 had an area under the curve of 0.83 (95% CI, 0.75-0.92). In patients without radiation therapy, both progression-free survival (P = .003) and overall survival (P = .002) were longer in the matrix-rich type group than in the cell-dense type group. REN was a risk factor for progression-free survival (hazard ratio = 10.24; 95% CI, 1.73-60.79); RT2 was a protective factor for overall survival (hazard ratio = 0.33; 95% CI, 0.12-0.87); and REN was a risk factor for overall survival (hazard ratio = 4.76; 95% CI, 1.51-15.01). CONCLUSIONS The difference in MR imaging signal intensity in chordomas can be explained by electron microscopic features. Both signal intensity ratios and electron microscopic features may be prognostic factors.
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Affiliation(s)
- J Bai
- From the Department of Neurosurgery (J.B., P.Z., S. Geng, S. Gui, Y. Zhang), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Beijing Neurosurgical Institute (J.B., S.Z., C.Z., Y. Zhai, S.W., M.L., C.L., Y. Zhang), Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases (J.B., P.Z., S. Geng, S. Gui, Y. Zhang), Beijing, China
| | - J Shi
- Department of Neurosurgery (J.S.), Tsinghua University Yuquan Hospital, Beijing, China
| | - S Zhang
- Beijing Neurosurgical Institute (J.B., S.Z., C.Z., Y. Zhai, S.W., M.L., C.L., Y. Zhang), Capital Medical University, Beijing, China
- Department of Neurosurgery (S.Z.), Anshan Central Hospital, Anshan, China
| | - C Zhang
- Beijing Neurosurgical Institute (J.B., S.Z., C.Z., Y. Zhai, S.W., M.L., C.L., Y. Zhang), Capital Medical University, Beijing, China
| | - Y Zhai
- Beijing Neurosurgical Institute (J.B., S.Z., C.Z., Y. Zhai, S.W., M.L., C.L., Y. Zhang), Capital Medical University, Beijing, China
- Department of Neurosurgery (Y. Zhai), First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - S Wang
- Beijing Neurosurgical Institute (J.B., S.Z., C.Z., Y. Zhai, S.W., M.L., C.L., Y. Zhang), Capital Medical University, Beijing, China
| | - M Li
- Beijing Neurosurgical Institute (J.B., S.Z., C.Z., Y. Zhai, S.W., M.L., C.L., Y. Zhang), Capital Medical University, Beijing, China
| | - C Li
- Beijing Neurosurgical Institute (J.B., S.Z., C.Z., Y. Zhai, S.W., M.L., C.L., Y. Zhang), Capital Medical University, Beijing, China
| | - P Zhao
- From the Department of Neurosurgery (J.B., P.Z., S. Geng, S. Gui, Y. Zhang), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases (J.B., P.Z., S. Geng, S. Gui, Y. Zhang), Beijing, China
| | - S Geng
- From the Department of Neurosurgery (J.B., P.Z., S. Geng, S. Gui, Y. Zhang), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases (J.B., P.Z., S. Geng, S. Gui, Y. Zhang), Beijing, China
| | - S Gui
- From the Department of Neurosurgery (J.B., P.Z., S. Geng, S. Gui, Y. Zhang), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases (J.B., P.Z., S. Geng, S. Gui, Y. Zhang), Beijing, China
| | - L Jing
- Department of Health Statistics (L.J.), Shanxi Medical University, Taiyuan, China
| | - Y Zhang
- From the Department of Neurosurgery (J.B., P.Z., S. Geng, S. Gui, Y. Zhang), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Beijing Neurosurgical Institute (J.B., S.Z., C.Z., Y. Zhai, S.W., M.L., C.L., Y. Zhang), Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases (J.B., P.Z., S. Geng, S. Gui, Y. Zhang), Beijing, China
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Fingolimod inhibits proliferation and epithelial-mesenchymal transition in sacral chordoma by inactivating IL-6/STAT3 signalling. Biosci Rep 2020; 40:222049. [PMID: 32027356 PMCID: PMC7029154 DOI: 10.1042/bsr20200221] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 02/05/2020] [Accepted: 02/05/2020] [Indexed: 12/18/2022] Open
Abstract
Purpose: To explore the sensitivity of the immunosuppressive agent fingolimod (FTY720) in chordoma and determine whether it can serve as an appropriate alternate treatment for unresectable tumours in patients after incomplete surgery. Methods: Cell viability assays, colony formation assays and EdU assays were performed to evaluate the sensitivity of chordoma cell lines to FTY720. Transwell invasion assays, wound healing assays, flow cytometry, cell cycle analysis, immunofluorescence analysis, Western blotting analysis and enzyme-linked immunosorbent assays (ELISAs) were performed to evaluate cell invasion, epithelial–mesenchymal transition (EMT) and activation of related pathways after treatment with FTY720. The effect of FTY720 was also evaluated in vivo in a xenograft model. Results: We found that FTY720 inhibited the proliferation, invasion and metastasis of sacral chordoma cells (P < 0.01). FTY720 also inhibited the proliferation of tumour cells in a xenograft model using sacral chordoma cell lines (P < 0.01). The mechanism was related to the EMT and apoptosis of chordoma cells and inactivation of IL-6/STAT3 signalling in vitro and in vivo. Conclusions: Our findings indicate that FTY720 may be an effective therapeutic agent against chordoma. These findings suggest that FTY720 is a novel agent that can treat locally advanced and metastatic chordoma.
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Michmerhuizen NL, Owen JH, Heft Neal ME, Mann JE, Leonard E, Wang J, Zhai J, Jiang H, McHugh JB, Brenner JC, Prince MEP. Rationale for the advancement of PI3K pathway inhibitors for personalized chordoma therapy. J Neurooncol 2020; 147:25-35. [PMID: 32067197 DOI: 10.1007/s11060-020-03418-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 01/30/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE Chordomas are rare and serious tumors with few effective treatments outside of aggressive surgery and radiation. Targeted therapies may present a more effective option for a subset of patients with lesions possessing certain genetic biomarkers. METHODS A small molecule inhibitor library was tested in patient-derived UM-Chor1 cells to identify targeted therapies with potential efficacy. Targeted exome sequencing of UM-Chor1 and UM-Chor2 cells was performed to investigate genetic aberrations in relevant pathways. Chordoma cell lines were treated with inhibitors of the phosphotidylinositol 3-kinase (PI3K), epidermal growth factor receptor (EGFR), and cyclin dependent kinase (CDK) pathways, and responses were determined using resazurin cell viability assays, Annexin V apoptosis assays, and western blotting. Pan-PI3K inhibitor BKM120 was also tested in five chordoma xenograft models. RESULTS Unbiased small molecule profiling nominated PI3K-AKT-mTOR pathway inhibitors as a promising therapy in chordoma, and genetic analyses of UM-Chor1 and UM-Chor2 cell lines revealed aberrations in PTEN, EGFR, and CDKN2A. Treatment of UM-Chor1 and UM-Chor2 with targeted PI3K, EGFR, and CDK inhibitors inhibited growth and proliferation and induced apoptosis more robustly than imatinib, a currently used chordoma therapy. Furthermore, BKM120 significantly inhibited tumor growth in a subset of the xenograft models tested. CONCLUSION Targeted therapies, especially those inhibiting PI3K, display promising effects in multiple chordoma cell line and xenograft models. Nevertheless, the limited effects of PI3K, EGFR, and CDK targeting agents in other models reveal the presence of resistance mechanisms, which motivates future research to both identify biomarkers of response and develop combination therapies.
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Affiliation(s)
- N L Michmerhuizen
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan Medical School, 1150 E. Medical Center Dr., 9301B MSRB3, Ann Arbor, MI, 48109-0602, USA
- Department of Pharmacology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - J H Owen
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan Medical School, 1150 E. Medical Center Dr., 9301B MSRB3, Ann Arbor, MI, 48109-0602, USA
| | - M E Heft Neal
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan Medical School, 1150 E. Medical Center Dr., 9301B MSRB3, Ann Arbor, MI, 48109-0602, USA
| | - J E Mann
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan Medical School, 1150 E. Medical Center Dr., 9301B MSRB3, Ann Arbor, MI, 48109-0602, USA
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - E Leonard
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan Medical School, 1150 E. Medical Center Dr., 9301B MSRB3, Ann Arbor, MI, 48109-0602, USA
| | - J Wang
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan Medical School, 1150 E. Medical Center Dr., 9301B MSRB3, Ann Arbor, MI, 48109-0602, USA
- Department of Pharmacology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - J Zhai
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - H Jiang
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Rogel Cancer Center, University of Michigan Medical School, Ann Arbor, MI, USA
| | - J B McHugh
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
- Rogel Cancer Center, University of Michigan Medical School, Ann Arbor, MI, USA
| | - J C Brenner
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan Medical School, 1150 E. Medical Center Dr., 9301B MSRB3, Ann Arbor, MI, 48109-0602, USA.
- Department of Pharmacology, University of Michigan Medical School, Ann Arbor, MI, USA.
- Rogel Cancer Center, University of Michigan Medical School, Ann Arbor, MI, USA.
| | - M E P Prince
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan Medical School, 1150 E. Medical Center Dr., 9301B MSRB3, Ann Arbor, MI, 48109-0602, USA
- Rogel Cancer Center, University of Michigan Medical School, Ann Arbor, MI, USA
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Ozair MZ, Shah PP, Mathios D, Lim M, Moss NS. New Prospects for Molecular Targets for Chordomas. Neurosurg Clin N Am 2020; 31:289-300. [PMID: 32147018 DOI: 10.1016/j.nec.2019.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Chordomas are malignant, highly recurrent tumors of the midline skeleton that arise from the remnants of the notochord. The development of systemic therapy is critically important to ultimately managing this tumor. Several ongoing trials are attempting to use molecular targeted therapies for mutated pathways in recurrent and advanced chordomas and have shown promise. In addition, immunotherapies, including brachyury-directed vaccination and checkpoint inhibition, have also been attempted with encouraging results. This article discusses the major pathways that have been implicated in the pathogenesis of chordoma with an emphasis on molecular vulnerabilities that future therapies are attempting to exploit.
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Affiliation(s)
- Mohammad Zeeshan Ozair
- Laboratory of Stem Cell Biology and Molecular Embryology, The Rockefeller University, 1230 York Avenue, New York, NY 10065, USA
| | - Pavan Pinkesh Shah
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 733 North Broadway, Baltimore, MD 21287, USA
| | - Dimitrios Mathios
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 733 North Broadway, Baltimore, MD 21287, USA
| | - Michael Lim
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 733 North Broadway, Baltimore, MD 21287, USA
| | - Nelson S Moss
- Department of Neurosurgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
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D'Agati G, Cabello EM, Frontzek K, Rushing EJ, Klemm R, Robinson MD, White RM, Mosimann C, Burger A. Active receptor tyrosine kinases, but not Brachyury, are sufficient to trigger chordoma in zebrafish. Dis Model Mech 2019; 12:dmm.039545. [PMID: 31221659 PMCID: PMC6679381 DOI: 10.1242/dmm.039545] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 06/13/2019] [Indexed: 01/09/2023] Open
Abstract
The aberrant activation of developmental processes triggers diverse cancer types. Chordoma is a rare, aggressive tumor arising from transformed notochord remnants. Several potentially oncogenic factors have been found to be deregulated in chordoma, yet causation remains uncertain. In particular, sustained expression of TBXT – encoding the notochord regulator protein brachyury – is hypothesized as a key driver of chordoma, yet experimental evidence is absent. Here, we employ a zebrafish chordoma model to identify the notochord-transforming potential of implicated genes in vivo. We find that Brachyury, including a form with augmented transcriptional activity, is insufficient to initiate notochord hyperplasia. In contrast, the chordoma-implicated receptor tyrosine kinases (RTKs) EGFR and Kdr/VEGFR2 are sufficient to transform notochord cells. Aberrant activation of RTK/Ras signaling attenuates processes required for notochord differentiation, including the unfolded protein response and endoplasmic reticulum stress pathways. Our results provide the first in vivo evidence against a tumor-initiating potential of Brachyury in the notochord, and imply activated RTK signaling as a possible initiating event in chordoma. Furthermore, our work points at modulating endoplasmic reticulum and protein stress pathways as possible therapeutic avenues against chordoma. Summary: An injection-based chordoma model in zebrafish shows that the hypothesized chordoma oncogene brachyury is insufficient, whereas EGFR and VEGFR2 are sufficient, to trigger notochord hyperplasia in our model.
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Affiliation(s)
- Gianluca D'Agati
- Institute of Molecular Life Sciences, University of Zürich, 8057 Zürich, Switzerland
| | - Elena María Cabello
- Institute of Molecular Life Sciences, University of Zürich, 8057 Zürich, Switzerland
| | - Karl Frontzek
- Institute of Neuropathology, University Hospital Zürich, 8091 Zürich, Switzerland
| | - Elisabeth J Rushing
- Institute of Neuropathology, University Hospital Zürich, 8091 Zürich, Switzerland
| | - Robin Klemm
- Institute of Molecular Life Sciences, University of Zürich, 8057 Zürich, Switzerland
| | - Mark D Robinson
- Institute of Molecular Life Sciences, University of Zürich, 8057 Zürich, Switzerland.,SIB Swiss Institute of Bioinformatics, University of Zürich, 8057 Zürich, Switzerland
| | - Richard M White
- Cancer Biology & Genetics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.,Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Christian Mosimann
- Institute of Molecular Life Sciences, University of Zürich, 8057 Zürich, Switzerland
| | - Alexa Burger
- Institute of Molecular Life Sciences, University of Zürich, 8057 Zürich, Switzerland
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Morimoto Y, Tamura R, Ohara K, Kosugi K, Oishi Y, Kuranari Y, Yoshida K, Toda M. Prognostic significance of VEGF receptors expression on the tumor cells in skull base chordoma. J Neurooncol 2019; 144:65-77. [PMID: 31240525 DOI: 10.1007/s11060-019-03221-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 06/16/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Chordoma is a rare refractory neoplasm that arises from the embryological remnants of the notochord, which is incurable using any multimodality therapy. Vascular endothelial growth factor (VEGF) is a potent activator of angiogenesis that is strongly associated with the tumor-immune microenvironment. These factors have not been elucidated for chordomas. METHODS To evaluate the characteristics of vascular and tumor cells in chordoma, we first analyzed the expression of VEGF receptor (VEGFR) 1, VEGFR2, CD34, and Brachyury in a cell line and 54 tumor tissues. Patients with primary skull base chordomas were divided into the following two groups as per the tumor growth rate: patients with slow progression (SP: < 3 mm/year) and those with rapid progression (RP: ≥ 3 mm/year). Thus, the expressions of VEGF-A, VEGFR 1, and VEGFR2 on tumor cells; tumor infiltrative immune cells, including regulatory T cells (Tregs) and tumor-associated macrophages (TAMs); and immune-checkpoint molecules (PD-1/PD-L1) were analyzed with the clinical courses, especially in a comparison between the two groups. RESULTS In chordomas, both VEGFR1 and VEGFR2 were strongly expressed not only on vascular endothelial cells, but also on tumor cells. The recurrent cases showed significantly higher VEGFR1 expressions on tumor cells than the primary cases. The expression of VEGF-A was significantly higher in RP than that in SP group. The numbers of CD163+ TAMs and Foxp3+ Tregs were higher in RP than that in SP group. CONCLUSIONS Expression of VEGFR1 and VEGFR2 on tumor cells and immunosuppressive tumor-microenvironment were related to tumor growth in patients with chordomas.
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Affiliation(s)
- Yukina Morimoto
- Department of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Ryota Tamura
- Department of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kentaro Ohara
- Department of Pathology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kenzo Kosugi
- Department of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yumiko Oishi
- Department of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yuki Kuranari
- Department of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kazunari Yoshida
- Department of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Masahiro Toda
- Department of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
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The Importance of the Hedgehog Signaling Pathway in Tumorigenesis of Spinal and Cranial Chordoma. J Clin Med 2019; 8:jcm8020248. [PMID: 30769952 PMCID: PMC6406847 DOI: 10.3390/jcm8020248] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 02/06/2019] [Accepted: 02/12/2019] [Indexed: 12/20/2022] Open
Abstract
Chordomas is rare malignant bone tumors thought to arise from remnants of embryonic notochord along the spine, frequently at the skull base and sacrum. Although chordoma is slow growing tumors, while are extremely recurrent, and aggressive, as well as the rate of prognosis remains poorly. Radical surgery and high-dose radiation are the most used treatments. Currently, there is no effective chemotherapeutic standard for chordomas. The Hedgehog (HH) pathway adjusts various processes included in expansion and differentiation of tissues and organs throughout the fetus’s life, furthermore cell growth and differentiation in the adult organism, of the cell in an adult organism, in which acute anesthesia is involved in multiple cancers. To study the role of signaling the hedgehog in the base of the skull and sacrum chordomas, the expression of SHH and GLI-1 levels were detected immuno histochemically, Additionally, PTCH-1 and GLI-1 expressions were distinguished by in- Situ- hybridization. Based on the findings presented herein, it is likely that the HH signal cascade was revealed even in cranial, where consecoently spinal chordoma and their recurrences play an important role. Our staining exhibited a canonical, ligand- dependent and autocrine Hedgehog signaling in skull base and sacrum chordomas including relapse. Due to the high levels of SHH and GLI-1 expression in all investigated chordoma samples, the study suggests a possible autocrine ligand-dependent activation of the canonical HH signaling cascade. A paracrine or non-canonical pathway cannot be excluded. Our results suggest that Hedgehog-inhibitors, like SHH-, GLI- and SMO- inhibitors, might serve as a potential and effective target for the treatment of chordomas.
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Sautier L, Guillier D, Coste M, Servely JL, Pignon C, Laloy E, Donnelly TM. Coccygeal chordoma in a degu: case report and review of the literature. J Vet Diagn Invest 2018; 31:142-145. [PMID: 30541399 DOI: 10.1177/1040638718814584] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
An 8-y-old, intact female degu ( Octodon degus) was presented with a slow-growing mass on the tail tip. The mass was completely removed by partial caudectomy. Histologically, the last coccygeal vertebra was replaced by a lobulated neoplasm composed of large clear polygonal cells embedded in a myxoid alcian blue-positive matrix with highly vacuolated cytoplasm (physaliferous cells) and intracytoplasmic periodic acid-Schiff-positive granules. The neoplasm exhibited the morphologic features of a "classic" chordoma of humans, which is 1 of 3 distinct chordoma subtypes. Immunohistochemistry revealed dual expression of cytokeratin AE1/AE3 and vimentin, consistent with a diagnosis of chordoma. Chordomas are uncommon slow-growing neoplasms in humans and animals, arising from notochordal remnants. Depending on their subtype and location, they can have a high local recurrence rate and metastatic risk. Chordoma should be included in the differential diagnosis of a soft tissue mass on the tail of a degu, similar to the clinical situation in ferrets.
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Affiliation(s)
- Lucile Sautier
- Laboratoire d'anatomo-cytopathologie, Biopôle Alfort (Laloy, Sautier, Servely), Ecole Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France.,Unité Nouveaux Animaux de Compagnie (Donnelly, Guillier, Pignon), Ecole Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France.,Laboratoire Cerba Vet, Wissous, France (Coste).,INRA, Département de Recherche PHASE, Nouzilly, France (Servely)
| | - David Guillier
- Laboratoire d'anatomo-cytopathologie, Biopôle Alfort (Laloy, Sautier, Servely), Ecole Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France.,Unité Nouveaux Animaux de Compagnie (Donnelly, Guillier, Pignon), Ecole Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France.,Laboratoire Cerba Vet, Wissous, France (Coste).,INRA, Département de Recherche PHASE, Nouzilly, France (Servely)
| | - Margaux Coste
- Laboratoire d'anatomo-cytopathologie, Biopôle Alfort (Laloy, Sautier, Servely), Ecole Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France.,Unité Nouveaux Animaux de Compagnie (Donnelly, Guillier, Pignon), Ecole Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France.,Laboratoire Cerba Vet, Wissous, France (Coste).,INRA, Département de Recherche PHASE, Nouzilly, France (Servely)
| | - Jean-Luc Servely
- Laboratoire d'anatomo-cytopathologie, Biopôle Alfort (Laloy, Sautier, Servely), Ecole Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France.,Unité Nouveaux Animaux de Compagnie (Donnelly, Guillier, Pignon), Ecole Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France.,Laboratoire Cerba Vet, Wissous, France (Coste).,INRA, Département de Recherche PHASE, Nouzilly, France (Servely)
| | - Charly Pignon
- Laboratoire d'anatomo-cytopathologie, Biopôle Alfort (Laloy, Sautier, Servely), Ecole Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France.,Unité Nouveaux Animaux de Compagnie (Donnelly, Guillier, Pignon), Ecole Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France.,Laboratoire Cerba Vet, Wissous, France (Coste).,INRA, Département de Recherche PHASE, Nouzilly, France (Servely)
| | - Eve Laloy
- Laboratoire d'anatomo-cytopathologie, Biopôle Alfort (Laloy, Sautier, Servely), Ecole Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France.,Unité Nouveaux Animaux de Compagnie (Donnelly, Guillier, Pignon), Ecole Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France.,Laboratoire Cerba Vet, Wissous, France (Coste).,INRA, Département de Recherche PHASE, Nouzilly, France (Servely)
| | - Thomas M Donnelly
- Laboratoire d'anatomo-cytopathologie, Biopôle Alfort (Laloy, Sautier, Servely), Ecole Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France.,Unité Nouveaux Animaux de Compagnie (Donnelly, Guillier, Pignon), Ecole Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France.,Laboratoire Cerba Vet, Wissous, France (Coste).,INRA, Département de Recherche PHASE, Nouzilly, France (Servely)
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Rekhi B, Karmarkar S. Clinicocytopathological spectrum, including uncommon forms, of nine cases of chordomas with immunohistochemical results, including brachyury immunostaining: A single institutional experience. Cytopathology 2018; 30:229-235. [PMID: 30218622 DOI: 10.1111/cyt.12631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 08/30/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To present clinical and cytopathological features of nine cases of chordomas, diagnosed over 9 years and confirmed by brachyury (T) immunostaining. METHODS Conventional cytological smears, stained with Papanicolaou and May-Grünwald Giemsa, along with corresponding histopathological (n = 8) and immunostained sections (n = 8) were reviewed. Immunohistochemical staining was performed on tissue sections by polymer detection technique. RESULTS Nine tumours occurred in seven males and two females, with age ranging from 36 to 72 years (average = 58.7), in the sacrum (seven) and spine (two). On fine needle aspiration cytology, five cases were either diagnosed with or diagnosed with a suggestion of a chordoma, while three cases were diagnosed with chordoma as a differential diagnosis. On review, smears were moderately cellular, comprising myxoid stroma (9/9), epithelioid cells (9/9), physaliphorous cells (8/9), including binucleation (7/9), prominent nucleolisation (2/9), pleomorphic cells (2/9) and intranuclear inclusions (3/9). Immunohistochemically, tumour cells expressed cytokeratin (4/4), pan cytokeratin (4/4), epithelial membrane antigen (8/8), S100 protein (6/8) and brachyury (8/8). Five patients underwent surgical excision, including two who underwent adjuvant radiotherapy (RT) and four patients who underwent RT. During follow-up (n = 8), a single patient developed recurrence and another presented with metastatic lesions. Finally, five patients were alive with disease (7-53 months); a single patient was free of disease (4 months), and two patients died of disease; the latter cases displayed pleomorphic cells and intranuclear inclusions. CONCLUSIONS Chordomas can be primarily diagnosed by fine needle aspiration cytology in a typical clinicoradiological setting with a combination of key cytomorphological features. Pleomorphic cells and intranuclear inclusions are associated with a relatively aggressive subtype. An exact diagnosis has treatment implications and requires confirmation by brachyury immunostaining.
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Affiliation(s)
- Bharat Rekhi
- Department of Surgical Pathology, Tata Memorial Hospital, Mumbai, India
| | - Srushti Karmarkar
- Department of Surgical Pathology, Tata Memorial Hospital, Mumbai, India
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Tian K, Wang L, Wang K, Ma J, Li D, Yang Y, Jia G, Wu Z, Zhang L, Zhang J. Analysis of variants at LGALS3 single nucleotide polymorphism loci in skull base chordoma. Oncol Lett 2018; 16:1312-1320. [PMID: 30061951 DOI: 10.3892/ol.2018.8780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 04/09/2018] [Indexed: 11/06/2022] Open
Abstract
Although LGALS3 has been widely studied, the genotypes of the LGALS3 single nucleotide polymorphism (SNP) loci in skull base chordoma (SBC) have been not well defined. The aim of the current study was to analyze two LGALS3 SNP genotypes in patients with SBC. A total of 48 patients with SBC who underwent surgical treatment in Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University (Beijing, China) and 66 healthy participants were included in the present study. A total of two SNPs (LGALS3+191 C>A and LGALS3 +292 A>C) were selected for sequencing analysis of amplified target fragments from DNA that was extracted from blood samples. The clinical features of the patients were recorded, follow-up was conducted and statistical analysis was performed with SPSS 20.0. There were no differences in age and sex between the patients and control group. In addition, there were no significant differences in the distribution of genotypes (P=0.662) and allelic frequencies (P=0.638) at LGALS3+191 C>A between the two groups. However, significant difference was observed in the allelic distributions at LGALS3 +292 A>C between them (P=0.016), and allele A was associated with the occurrence of SBC. The distribution of the genotypes at LGALS3 +292 A>C was not significantly different in the additive model (CC vs. AC vs. AA, P=0.083) but was significantly different in the dominant model (CC+AC vs. AA, P=0.043). In the Kaplan-Meier analysis, there were no significant differences in the overall survival and progression analysis between different genotypes at LGALS3 +191 C>A (P=0.168 and P=0.120) in patients with SBC. There was no significant difference in overall survival was observed between the genotypes at +292 A>C (P=0.595). However, the progression-free survival (PFS) time of the CC+AC genotype group was longer compared with the AA genotype group (P<0.001). In the univariate and multivariate analysis of tumor progression, PFS was shorter in the AA genotype group compared with the CC+AC genotype group (P<0.001). The allele A and AA genotype at LGALS3 +292 A>C were observed to be associated with a higher risk of SBC, and the AA genotype at +292 A>C was associated with a shorter PFS time.
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Affiliation(s)
- Kaibing Tian
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, P.R. China.,Center of Brain Tumor, China National Clinical Research Center for Neurological Diseases, Beijing 100050, P.R. China.,Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing 100050, P.R. China.,Beijing Key Laboratory of Brain Tumor, Beijing 100050, P.R. China
| | - Liang Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, P.R. China.,Center of Brain Tumor, China National Clinical Research Center for Neurological Diseases, Beijing 100050, P.R. China.,Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing 100050, P.R. China.,Beijing Key Laboratory of Brain Tumor, Beijing 100050, P.R. China
| | - Ke Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, P.R. China.,Center of Brain Tumor, China National Clinical Research Center for Neurological Diseases, Beijing 100050, P.R. China.,Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing 100050, P.R. China.,Beijing Key Laboratory of Brain Tumor, Beijing 100050, P.R. China
| | - Junpeng Ma
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, P.R. China.,Center of Brain Tumor, China National Clinical Research Center for Neurological Diseases, Beijing 100050, P.R. China.,Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing 100050, P.R. China.,Beijing Key Laboratory of Brain Tumor, Beijing 100050, P.R. China
| | - Da Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, P.R. China.,Center of Brain Tumor, China National Clinical Research Center for Neurological Diseases, Beijing 100050, P.R. China.,Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing 100050, P.R. China.,Beijing Key Laboratory of Brain Tumor, Beijing 100050, P.R. China
| | - Yang Yang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, P.R. China.,Center of Brain Tumor, China National Clinical Research Center for Neurological Diseases, Beijing 100050, P.R. China.,Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing 100050, P.R. China.,Beijing Key Laboratory of Brain Tumor, Beijing 100050, P.R. China
| | - Guijun Jia
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, P.R. China.,Center of Brain Tumor, China National Clinical Research Center for Neurological Diseases, Beijing 100050, P.R. China.,Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing 100050, P.R. China.,Beijing Key Laboratory of Brain Tumor, Beijing 100050, P.R. China
| | - Zhen Wu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, P.R. China.,Center of Brain Tumor, China National Clinical Research Center for Neurological Diseases, Beijing 100050, P.R. China.,Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing 100050, P.R. China.,Beijing Key Laboratory of Brain Tumor, Beijing 100050, P.R. China
| | - Liwei Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, P.R. China.,Center of Brain Tumor, China National Clinical Research Center for Neurological Diseases, Beijing 100050, P.R. China.,Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing 100050, P.R. China.,Beijing Key Laboratory of Brain Tumor, Beijing 100050, P.R. China
| | - Junting Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, P.R. China.,Center of Brain Tumor, China National Clinical Research Center for Neurological Diseases, Beijing 100050, P.R. China.,Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing 100050, P.R. China.,Beijing Key Laboratory of Brain Tumor, Beijing 100050, P.R. China
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Tumor Reduction with Pazopanib in a Patient with Recurrent Lumbar Chordoma. Case Rep Oncol Med 2018; 2018:4290131. [PMID: 29850323 PMCID: PMC5914121 DOI: 10.1155/2018/4290131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 02/20/2018] [Accepted: 03/13/2018] [Indexed: 12/30/2022] Open
Abstract
Introduction Chordomas are rare malignancies of bone origin that occur in the axial skeleton, typically the skull base and lumbar/sacral regions. Although often classified as low-grade neoplasms, its locally infiltrative behavior may result in significant morbidity and mortality. Optimal surgical resection may be curative, but up to 50% of the cases relapse within 5 years, and currently there are no systemic treatments approved in this setting. A large proportion of these tumors express stem-cell factor receptor (c-KIT) and platelet-derived growth factor receptors (PDGFRs), providing a rationale for the use of tyrosine-kinase inhibitors (TKIs). Case report A 27-year-old male presented with recurrent chordoma of the lumbar spine 4 years after initial diagnosis. Salvage therapies in the interval included repeat resections and radiation therapy. He ultimately developed multifocal recurrence not amenable to complete excision or reirradiation. A comprehensive genomic profiling assay was performed and revealed nondrugable alterations. Decision was made to proceed with systemic treatment with pazopanib 800 mg/day, resulting in tumor reduction (-23.1% reduction in size) and prolonged disease control. Conclusion For this patient with a multiple recurrent chordoma and limited treatment options, pazopanib resulted in sustained clinical benefit following initial tumor reduction.
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Abstract
Purpose of Review Chordoma are rare tumours of the axial skeleton which occur most often at the base of the skull and in the sacrum. Although chordoma are generally slow-growing lesions, the recurrence rate is high and the location makes it often difficult to treat. Both computed tomography (CT) and magnetic resonance imaging (MRI) are crucial in the initial diagnosis, treatment planning and post-treatment follow-up. Recent Findings Basic MRI and CT characteristics of chordoma were described in the late 1980s and early 1990s. Since then, imaging techniques have evolved with increased resolution and new molecular imaging tools are rapidly evolving. New imaging tools have been developed not only to study anatomy, but also physiologic changes and characterization of tissue and assessment of tumour biology. Recent studies show the uptake of multiple PET tracers in chordoma, which may become an important aspect in the diagnosis, follow-up and personalized therapy. Summary This review gives an overview of skull base chordoma histopathology, classic imaging characteristics, radiomics and state-of-the-art imaging techniques that are now emerging in diagnosis, treatment planning and disease monitoring of skull base chordoma.
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Sanusi O, Arnaout O, Rahme RJ, Horbinski C, Chandler JP. Surgical Resection and Adjuvant Radiation Therapy in the Treatment of Skull Base Chordomas. World Neurosurg 2018; 115:e13-e21. [PMID: 29545225 DOI: 10.1016/j.wneu.2018.02.127] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 02/20/2018] [Accepted: 02/22/2018] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Chordomas are rare tumors of notochordal origin that are known to be locally aggressive and are often treated with surgical resection followed by adjuvant radiation therapy (RT). The accepted standard of treatment for chordomas of the mobile spine, which includes en-bloc resection with wide margins, cannot be easily applied to the chordomas of the skull base because of their proximity to critical neurovascular structures. We describe our experience with the role of surgery and adjuvant RT in the treatment of chordomas over 16 years. METHODS We performed a retrospective chart review on patients with diagnoses of clival chordoma between the years 2000 and 2015 at Northwestern Memorial Hospital. We reviewed presenting symptoms, tumor location and size, extent of resection, complications, recurrence, adjuvant treatment, and follow-up duration. RESULTS A total of 20 patients underwent 32 surgeries. Of the 20 initial surgeries, 80% underwent gross total resection, and 20% had subtotal resection. The mean follow-up time was 60.75 months. Mean tumor volume was 23.07 cm3. Most common presenting signs and symptoms were headaches (70%), cranial nerve palsies (45%), and diplopia (55%). Diplopia was defined as complaints of double vision without any objective evidence of a cranial nerve palsy. Median time to progression was 57 months, and median overall survival was 136 months. Initial tumor volume and the need for a second dose of RT either as sole or as adjuvant treatment of a recurrence had a statistically significant effect on progression-free survival (P = 0.009, 0.009). None of the factors studied had a statistically significant effect on overall survival. CONCLUSIONS The treatment of chordomas remain challenging and requires multimodal treatment strategies spanning different specialties. Initial tumor size and need for second dose of RT for recurrence appear to play a significant role in progression-free survival. Adjuvant RT after gross total resection may play a role in improved progression-free and overall survival in patients with clival chordomas.
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Affiliation(s)
- Olabisi Sanusi
- Department of Neurological Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Omar Arnaout
- Brigham and Women's, Harvard School of Medicine, Boston, Massachusetts, USA
| | - Rudy J Rahme
- Department of Neurological Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Craig Horbinski
- Department of Neurological Surgery and Pathology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | - James P Chandler
- Department of Neurological Surgery and Otolaryngology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.
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Du P, Xu B, Zhang D, Shao Y, Zheng X, Li X, Xiong Y, Wu C, Jiang J. Hierarchical investigating the predictive value of p53, COX2, EGFR, nm23 in the post-operative patients with colorectal carcinoma. Oncotarget 2018; 8:954-966. [PMID: 27888614 PMCID: PMC5352209 DOI: 10.18632/oncotarget.13512] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 11/07/2016] [Indexed: 12/11/2022] Open
Abstract
The aim of this study was to evaluate the correlations between p53, COX2, EGFR, nm23 expression and the progression free survival (PFS) of post-operative patients with colorectal carcinoma. Immunohistochemistry was used to detect the expression of p53, COX2, EGFR and nm23 in 459 specimens from colorectal carcinoma patients. Kaplan-Meier estimates, Cox proportional hazard regression analyses and hierarchical analyses were performed on the collected data. Kaplan-Meier estimates analysis suggested that EGFR expression was as a negative predictor, the median PFS of patients with EGFR high expression was 21.73 months, and the median PFS of patients with low EGFR expression was 57.83 months (χ2=20.880, P<0.001); nm23 expression was positive predictive factor for the prognosis of patients with colorectal carcinoma, the median PFS of patients with high nm23 expression was 37.77 months, and the median PFS was 21.47 months in the patients with low nm23 expression (χ2=7.364, P=0.007). Cox regression analysis revealed that comparing with the patients with low expression of EGFR, the patients with high EGFR expression were at higher risk of tumor progression (HR=1.667, P=0.004); Comparing with the patients with high nm23 expression, the patients with nm23 low expression had a higher risk of tumor progression (HR=0.412, P<0.001); and the risk of tumor progression was higher in the patients with high EGFR expression and low nm23 expression (HR=0.245, P<0.001). Hierarchical analysis showed that EGFR expression mainly correlates with the PFS of TNM stage I-II colorectal cancer patients, the median PFS was 33.53 months in the TNM stage I-II colorectal cancer patients with high EGFR expression patients; The median PFS of the TNM stage I-II colorectal cancer patients with low EGFR expression was 70.43 months (χ2=9.530, P=0.002); The median PFS was 19.2 months in the TNM stage III-IV colorectal cancer patients with high expression EGFR, the PFS of the TNM stage III-IV colorectal cancer patients with low EGFR expression was 37.87 months (χ2=7.97, P=0.005). nm23 expression mainly correlates with the PFS of TNM stage III-IV colorecatal cancer patients. The median PFS was 47.27 months in TNM stage I-II colorectal cancer patients with nm23 high expression, the median PFS was 48.85 months in TNM stage I-II colorectal cancer patients with low nm23 expression (χ2=0.101, P=0.750); The median PFS was 28.8 months in TNM stage III-IV colorectal cancer patients with nm23 high expression, the median PFS was 14.7 months in TNM stage III-IV colorectal cancer patients with low nm23 expression (χ2=13.213, P<0.001). EGFR is mainly a predictive factor for the prognosis of post-operative patients with TNM stage I-II colorectal cancer, and nm23 is important for predicting the prognosis of patients with stage III-IV, and EGFR and nm23 could be as predictor of combination.
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Affiliation(s)
- Peng Du
- Department of Tumor Biological Treatment, The Third Affiliated Hospital, Soochow University, Changzhou 213003, Jiangsu, China.,Jiangsu Engineering Research Center for Tumor Immunotherapy, Changzhou 213003, Jiangsu, China.,The Second People's Hospital of Gansu Province, Lanzhou 730000, Gansu, China.,Institute of Cell Therapy, Soochow University, Changzhou, 213003, Jiangsu, China
| | - Bin Xu
- Department of Tumor Biological Treatment, The Third Affiliated Hospital, Soochow University, Changzhou 213003, Jiangsu, China.,Jiangsu Engineering Research Center for Tumor Immunotherapy, Changzhou 213003, Jiangsu, China.,Institute of Cell Therapy, Soochow University, Changzhou, 213003, Jiangsu, China
| | - Dachuan Zhang
- Department of Tumor Biological Treatment, The Third Affiliated Hospital, Soochow University, Changzhou 213003, Jiangsu, China.,Jiangsu Engineering Research Center for Tumor Immunotherapy, Changzhou 213003, Jiangsu, China
| | - Yingjie Shao
- Department of Tumor Biological Treatment, The Third Affiliated Hospital, Soochow University, Changzhou 213003, Jiangsu, China.,Jiangsu Engineering Research Center for Tumor Immunotherapy, Changzhou 213003, Jiangsu, China.,Department of Radiation Oncology, The Third Affiliated Hospital of Soochow University, Changzhou 213003, Jiangsu, China
| | - Xiao Zheng
- Department of Tumor Biological Treatment, The Third Affiliated Hospital, Soochow University, Changzhou 213003, Jiangsu, China.,Jiangsu Engineering Research Center for Tumor Immunotherapy, Changzhou 213003, Jiangsu, China.,Institute of Cell Therapy, Soochow University, Changzhou, 213003, Jiangsu, China
| | - Xiaodong Li
- Department of Tumor Biological Treatment, The Third Affiliated Hospital, Soochow University, Changzhou 213003, Jiangsu, China.,Department of Oncology, The Third Affiliated Hospital, Soochow University, Changzhou 213003, Jiangsu, China.,Jiangsu Engineering Research Center for Tumor Immunotherapy, Changzhou 213003, Jiangsu, China
| | - Yuqi Xiong
- Department of Tumor Biological Treatment, The Third Affiliated Hospital, Soochow University, Changzhou 213003, Jiangsu, China.,Jiangsu Engineering Research Center for Tumor Immunotherapy, Changzhou 213003, Jiangsu, China.,Institute of Cell Therapy, Soochow University, Changzhou, 213003, Jiangsu, China
| | - Changping Wu
- Department of Tumor Biological Treatment, The Third Affiliated Hospital, Soochow University, Changzhou 213003, Jiangsu, China.,Department of Oncology, The Third Affiliated Hospital, Soochow University, Changzhou 213003, Jiangsu, China.,Jiangsu Engineering Research Center for Tumor Immunotherapy, Changzhou 213003, Jiangsu, China
| | - Jingting Jiang
- Department of Tumor Biological Treatment, The Third Affiliated Hospital, Soochow University, Changzhou 213003, Jiangsu, China.,Jiangsu Engineering Research Center for Tumor Immunotherapy, Changzhou 213003, Jiangsu, China.,Institute of Cell Therapy, Soochow University, Changzhou, 213003, Jiangsu, China
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Immunophenotypic features of dedifferentiated skull base chordoma: An insight into the intratumoural heterogeneity. Contemp Oncol (Pozn) 2018; 21:267-273. [PMID: 29416431 PMCID: PMC5798418 DOI: 10.5114/wo.2017.72385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Accepted: 08/26/2017] [Indexed: 01/05/2023] Open
Abstract
Chordomas are rare and low-grade malignant solid tumours, despite their histologically benign appearance, that arise in the bone from embryonic notochordal vestiges of the axial skeleton, a mesoderm-derived structure that is involved in the process of neurulation and embryonic development. Chordomas occurring in the skull base tend to arise in the basiocciput along the clivus. Three major morphological variants have been described (classical, chondroid, and atypical/dedifferentiated). The pathogenesis and molecular mechanisms involved in chordoma development remain uncertain. From a pathological standpoint, the microenvironment of a chordoma is heterogeneous, showing a dual epithelial-mesenchymal differentiation. These tumours are characterised by slow modality of biologic growth, local recurrence, low incidence of metastasis rates, and cancer stem cell (CSC) phenotype. The main molecular findings are connected with brachyury immunoexpression and activation of the downstream Akt and mTOR signalling pathways. The differentiation between typical and atypical chordomas is relevant because the tumoural microenvironment and prognosis are partially different. This review provides an insight into the recent and relevant concepts and histochemical markers expressed in chordomas, with special emphasis on dedifferentiated chordomas and their prognostic implications.
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Beccaria K, Tauziède-Espariat A, Monnien F, Adle-Biassette H, Masliah-Planchon J, Pierron G, Maillot L, Polivka M, Laquerrière A, Bouillot-Eimer S, Gimbert E, Gauchotte G, Coffinet L, Sevestre H, Alapetite C, Bolle S, Thompson D, Bouazza S, George B, Zérah M, Sainte-Rose C, Puget S, Varlet P. Pediatric Chordomas: Results of a Multicentric Study of 40 Children and Proposal for a Histopathological Prognostic Grading System and New Therapeutic Strategies. J Neuropathol Exp Neurol 2018; 77:207-215. [DOI: 10.1093/jnen/nlx118] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Kévin Beccaria
- Department of Pediatric Neurosurgery, Necker Hospital, APHP, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | | | - Franck Monnien
- Department of Pathology, Jean Minjoz Hospital, Besançon, France
| | | | | | - Gaëlle Pierron
- Department of Oncogenetics, Curie Institute, Paris, France
| | | | - Marc Polivka
- Department of Pathology, Lariboisière Hospital, APHP, Paris, France
| | | | | | - Edouard Gimbert
- Department of Pediatric Neurosurgery, Pellegrin Hospital, Bordeaux, France
| | | | - Laurent Coffinet
- Department of Pediatric Otorhinolaryngology, Nancy Hospital, Nancy, France
| | - Henri Sevestre
- Department of Pathology, Amiens Hospital, Amiens, France
| | - Claire Alapetite
- Department of Radiation Oncology & Proton Centre, Institut Curie, Paris and Orsay, France
| | - Stéphanie Bolle
- Department of Radiotherapy, Gustave Roussy Institute, Villejuif, France
| | - Dominic Thompson
- Department of Pediatric Neurosurgery, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | | | - Bernard George
- Department of Neurosurgery, Lariboisière Hospital, APHP, Paris, France
| | - Michel Zérah
- Department of Pediatric Neurosurgery, Necker Hospital, APHP, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Christian Sainte-Rose
- Department of Pediatric Neurosurgery, Necker Hospital, APHP, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Stéphanie Puget
- Department of Pediatric Neurosurgery, Necker Hospital, APHP, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Department of Radiotherapy, Gustave Roussy Institute, Villejuif, France
| | - Pascale Varlet
- Department of Neuropathology, Sainte-Anne Hospital, Paris, France
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Vilela MD, Pedrosa HA, Dias Filho MA. A Hemorrhagic Clival Chordoma with a Long Progression-Free Survival. World Neurosurg 2017; 105:1042.e1-1042.e4. [DOI: 10.1016/j.wneu.2017.06.169] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 06/24/2017] [Accepted: 06/28/2017] [Indexed: 12/17/2022]
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Yamaguchi T, Imada H, Iida S, Szuhai K. Notochordal Tumors: An Update on Molecular Pathology with Therapeutic Implications. Surg Pathol Clin 2017; 10:637-656. [PMID: 28797506 DOI: 10.1016/j.path.2017.04.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Recent molecular investigations of chordoma show common expression of various receptor tyrosine kinases and activation of downstream signaling pathways contributing to tumor growth and progression. The transcription factor brachyury (also known as T) is important in notochord differentiation, and germline duplication of the gene is often found in familial chordomas. Nuclear expression of brachyury is consistent in chordoma and in benign notochordal cell tumor. Based on the molecular evidence, targeting of several kinds of molecular agents has been attempted for the treatment of uncontrolled chordomas and achieved partial response or stable condition in many cases.
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Affiliation(s)
- Takehiko Yamaguchi
- Department of Pathology, Koshigaya Hospital, Dokkyo Medical University, 2-1-50 Minami-Koshigaya, Koshigaya, Saitama 343-8555, Japan.
| | - Hiroki Imada
- Department of Pathology, Koshigaya Hospital, Dokkyo Medical University, 2-1-50 Minami-Koshigaya, Koshigaya, Saitama 343-8555, Japan
| | - Shun Iida
- Department of Pathology, Koshigaya Hospital, Dokkyo Medical University, 2-1-50 Minami-Koshigaya, Koshigaya, Saitama 343-8555, Japan
| | - Karoly Szuhai
- Department of Molecular Cell Biology, Leiden University Medical Center, PO Box: 9600, Post Zone: R-01-P, Leiden 2300 RC, The Netherlands
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Jäger D, Barth TFE, Brüderlein S, Scheuerle A, Rinner B, von Witzleben A, Lechel A, Meyer P, Mayer-Steinacker R, Baer AV, Schultheiss M, Wirtz CR, Möller P, Mellert K. HOXA7, HOXA9, and HOXA10 are differentially expressed in clival and sacral chordomas. Sci Rep 2017; 7:2032. [PMID: 28515451 PMCID: PMC5435709 DOI: 10.1038/s41598-017-02174-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 04/10/2017] [Indexed: 12/20/2022] Open
Abstract
Chordomas are rare tumours of the bone arising along the spine from clivus to sacrum. We compared three chordoma cell lines of the clivus region including the newly established clivus chordoma cell line, U-CH14, with nine chordoma cell lines originating from sacral primaries by morphology, on genomic and expression levels and with patient samples from our chordoma tissue bank. Clinically, chordomas of the clivus were generally smaller in size at presentation and patients with sacral chordomas had more metastases and more often recurrent disease. All chordoma cell lines had a typical physaliphorous morphology and expressed brachyury, S100-protein and cytokeratin. By expression analyses we detected differentially expressed genes in the clivus derived cell lines as compared to the sacral cell lines. Among these were HOXA7, HOXA9, and HOXA10 known to be important for the development of the anterior-posterior body axis. These results were confirmed by qPCR. Immunohistologically, clivus chordomas had no or very low levels of HOXA10 protein while sacral chordomas showed a strong nuclear positivity in all samples analysed. This differential expression of HOX genes in chordomas of the clivus and sacrum suggests an oncofetal mechanism in gene regulation linked to the anatomic site.
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Affiliation(s)
- Daniela Jäger
- Institute of Pathology, University of Ulm, Ulm, Germany
| | | | | | | | - Beate Rinner
- Division of Biomedical Research, Medical University of Graz, Graz, Austria
| | | | - André Lechel
- Department of Internal Medicine I, University of Ulm, Ulm, Germany
| | - Patrick Meyer
- Department of Dermatology, University of Ulm, Ulm, Germany
| | | | | | | | | | - Peter Möller
- Institute of Pathology, University of Ulm, Ulm, Germany.
| | - Kevin Mellert
- Institute of Pathology, University of Ulm, Ulm, Germany
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In Reply to “Ki-67 Index as a Prognostic Marker in Chordomas: A Systematic Review of the Literature”. World Neurosurg 2017; 101:785. [DOI: 10.1016/j.wneu.2017.02.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 02/08/2017] [Indexed: 11/21/2022]
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Wang XB, Lv GH, Li J, Zou MX. Ki-67 Index as a Prognostic Marker in Chordomas: A Systematic Review of the Literature. World Neurosurg 2017; 101:782-784. [DOI: 10.1016/j.wneu.2017.01.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 01/07/2017] [Indexed: 11/16/2022]
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Owen JH, Komarck CM, Wang AC, Abuzeid WM, Keep RF, McKean EL, Sullivan S, Fan X, Prince MEP. UM-Chor1: establishment and characterization of the first validated clival chordoma cell line. J Neurosurg 2017; 128:701-709. [PMID: 28430034 DOI: 10.3171/2016.10.jns16877] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVE Chordomas are rare malignant tumors thought to arise from remnants of the notochord. They can be located anywhere along the axial skeleton but are most commonly found in the clival and sacrococcygeal regions, where the notochord regresses during fetal development. Chordomas are resistant to many current therapies, leaving surgery as the primary method of treatment. Cancer cell lines have been useful for developing new cancer treatments in a laboratory setting that can then be transferred to the clinic, but there are only 4 validated chordoma cell lines available. The objective of this work was to establish chordoma cell lines from surgical tissue in order to expand the library of lines available for laboratory research. METHODS Chordoma tissue from the clivus was processed and sorted by flow cytometry to obtain an isolated population of chordoma cells. These cells were grown in culture and expanded until enough doublings to consider the line established. Identification of a chordoma cell line was made with known markers for chordoma, and the line was observed for ALDH (aldehyde dehydrogenase) subpopulations and tested in serum-free growth conditions as well as in vivo. RESULTS A fifth chordoma cell line, UM-Chor1, was successfully established. This is the first chordoma cell line originating from the clivus. Validation was confirmed by phenotype and positivity for the chordoma markers CD24 and brachyury. The authors also attempted to identify an ALDHhigh cell population in UM-Chor1, UCH1, and UCH2 but did not detect a distinct population. UM-Chor1 cells were able to form spheroids in serum-free culture, were successfully transduced with luciferase, and could be injected parasacrally and grown in NOD/SCID mice. CONCLUSIONS The availability of this novel clival chordoma cell line for in vitro and in vivo research provides an opportunity for developments in treatment against the disease.
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Affiliation(s)
| | | | | | | | | | | | | | - Xing Fan
- 2Neurosurgery, and.,3Cell and Developmental Biology, University of Michigan, Ann Arbor, Michigan
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Genetic aberrations and molecular biology of skull base chordoma and chondrosarcoma. Brain Tumor Pathol 2017; 34:78-90. [PMID: 28432450 DOI: 10.1007/s10014-017-0283-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 03/27/2017] [Indexed: 12/20/2022]
Abstract
Chordomas and chondrosarcomas are two major malignant bone neoplasms located at the skull base. These tumors are rarely metastatic, but can be locally invasive and resistant to conventional chemotherapies and radiotherapies. Accordingly, therapeutic approaches for the treatment of these tumors can be difficult. Additionally, their location at the skull base makes them problematic. Although accurate diagnosis of these tumors is important because of their distinct prognoses, distinguishing between these tumor types is difficult due to overlapping radiological and histopathological findings. However, recent accumulation of molecular and genetic studies, including extracranial location analysis, has provided us clues for accurate diagnosis. In this report, we review the genetic aberrations and molecular biology of these two tumor types. Among the abundant genetic features of these tumors, brachyury immunohistochemistry and direct sequencing of IDH1/2 are simple and useful techniques that can be used to distinguish between these tumors. Although it is still unclear why these tumors, which have such distinct genetic backgrounds, show similar histopathological findings, comparison of their genetic backgrounds could provide essential information.
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