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Wang T, Zhang M, Gong X, Chen W, Peng Y, Liao C, Xu H, Li Q, Shen G, Ren H, Zhu Y, Zhang B, Mao J, Wei L, Chen Y, Yang X. Inhibition of Nogo-B reduces the progression of pancreatic cancer by regulation NF-κB/GLUT1 and SREBP1 pathways. iScience 2024; 27:109741. [PMID: 38706871 PMCID: PMC11068639 DOI: 10.1016/j.isci.2024.109741] [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: 10/10/2023] [Revised: 01/22/2024] [Accepted: 04/10/2024] [Indexed: 05/07/2024] Open
Abstract
Pancreatic cancer (PC) is a lethal disease and associated with metabolism dysregulation. Nogo-B is related to multiple metabolic related diseases and types of cancers. However, the role of Nogo-B in PC remains unknown. In vitro, we showed that cell viability and migration was largely reduced in Nogo-B knockout or knockdown cells, while enhanced by Nogo-B overexpression. Consistently, orthotopic tumor and metastasis was reduced in global Nogo knockout mice. Furthermore, we indicated that glucose enhanced cell proliferation was associated to the elevation expression of Nogo-B and nuclear factor κB (NF-κB). While, NF-κB, glucose transporter type 1 (GLUT1) and sterol regulatory element-binding protein 1 (SREBP1) expression was reduced in Nogo-B deficiency cells. In addition, we showed that GLUT1 and SREBP1 was downstream target of NF-κB. Therefore, we demonstrated that Nogo deficiency inhibited PC progression is regulated by the NF-κB/GLUT1 and SREBP1 pathways, and suggested that Nogo-B may be a target for PC therapy.
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Affiliation(s)
- Tianxiang Wang
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, Anhui Provincial International Science and Technology Cooperation Base for Major Metabolic Diseases and Nutritional Interventions, College of Food and Biological Engineering, Hefei University of Technology, Hefei 230000, China
| | - Min Zhang
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, Anhui Provincial International Science and Technology Cooperation Base for Major Metabolic Diseases and Nutritional Interventions, College of Food and Biological Engineering, Hefei University of Technology, Hefei 230000, China
| | - Xinyu Gong
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, Anhui Provincial International Science and Technology Cooperation Base for Major Metabolic Diseases and Nutritional Interventions, College of Food and Biological Engineering, Hefei University of Technology, Hefei 230000, China
| | - Wanjing Chen
- Department of General Surgery, The Second Affiliated Hospital, Anhui Medical University, Hefei 230000, China
| | - Ying Peng
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, Anhui Provincial International Science and Technology Cooperation Base for Major Metabolic Diseases and Nutritional Interventions, College of Food and Biological Engineering, Hefei University of Technology, Hefei 230000, China
| | - Chenzhong Liao
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, Anhui Provincial International Science and Technology Cooperation Base for Major Metabolic Diseases and Nutritional Interventions, College of Food and Biological Engineering, Hefei University of Technology, Hefei 230000, China
| | - Hongmei Xu
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, Anhui Provincial International Science and Technology Cooperation Base for Major Metabolic Diseases and Nutritional Interventions, College of Food and Biological Engineering, Hefei University of Technology, Hefei 230000, China
| | - Qingshan Li
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, Anhui Provincial International Science and Technology Cooperation Base for Major Metabolic Diseases and Nutritional Interventions, College of Food and Biological Engineering, Hefei University of Technology, Hefei 230000, China
| | - Guodong Shen
- Department of Geriatrics, The First Affiliated Hospital of University of Science and Technology of China, Gerontology Institute of Anhui Province, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230000, China
| | - Huirong Ren
- Department of Geriatrics, The First Affiliated Hospital of University of Science and Technology of China, Gerontology Institute of Anhui Province, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230000, China
| | - Yaxin Zhu
- Institute for International Health Professions Education and Research, China Medical University, Shenyang 110000, China
| | - Baotong Zhang
- Department of Human Cell Biology and Genetics, School of Medicine, Southern University of Science and Technology, Shenzhen 518000, China
| | - Jiali Mao
- Department of Anesthesiology, The First Affiliated Hospital of University of Science and Technology of China, Hefei 230000, China
| | - Lingling Wei
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, Anhui Provincial International Science and Technology Cooperation Base for Major Metabolic Diseases and Nutritional Interventions, College of Food and Biological Engineering, Hefei University of Technology, Hefei 230000, China
| | - Yuanli Chen
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, Anhui Provincial International Science and Technology Cooperation Base for Major Metabolic Diseases and Nutritional Interventions, College of Food and Biological Engineering, Hefei University of Technology, Hefei 230000, China
| | - Xiaoxiao Yang
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, Anhui Provincial International Science and Technology Cooperation Base for Major Metabolic Diseases and Nutritional Interventions, College of Food and Biological Engineering, Hefei University of Technology, Hefei 230000, China
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2
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Zhang J, Wang Y, Wang L, You L, Zhang T. Pancreatic ductal adenocarcinoma chemoresistance: From metabolism reprogramming to novel treatment. Chin Med J (Engl) 2024; 137:408-420. [PMID: 37545027 PMCID: PMC10876258 DOI: 10.1097/cm9.0000000000002758] [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: 03/28/2023] [Indexed: 08/08/2023] Open
Abstract
ABSTRACT As pancreatic cancer (PC) is highly malignant, its patients tend to develop metastasis at an early stage and show a poor response to conventional chemotherapies. First-line chemotherapies for PC, according to current guidelines, include fluoropyrimidine- and gemcitabine-based regimens. Accumulating research on drug resistance has shown that biochemical metabolic aberrations in PC, especially those involving glycolysis and glutamine metabolism, are highly associated with chemoresistance. Additionally, lipid metabolism is a major factor in chemoresistance. However, emerging compounds that target these key metabolic pathways have the potential to overcome chemoresistance. This review summarizes how PC develops chemoresistance through aberrations in biochemical metabolism and discusses novel critical targets and pathways within cancer metabolism for new drug research.
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Affiliation(s)
- Jingcheng Zhang
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
- Peking Union Medical College, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Yutong Wang
- Peking Union Medical College, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Lejunzi Wang
- Department of Anaesthesia, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Lei You
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Taiping Zhang
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
- Clinical Immunology Centre, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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3
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Çaparlar MA, Durhan A, Süleymanov M, Binarbaşı C, Koşmaz K. Prognostic Effect of Preoperative Inflammatory Markers on Morbidity and Overall Survival in Pancreatic Adenocarsinoma. Niger J Clin Pract 2023; 26:1902-1909. [PMID: 38158359 DOI: 10.4103/njcp.njcp_426_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 08/14/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND/AIM His study aimed to evaluate the availability of common diagnostic tests and biochemical markers in predicting poor prognosis in patients with pancreatic adenocarcinoma (PAC). The primary outcome measure was to identify predictive prognostic factors. The secondary outcome measure was to compare predictive measures in patients who survived or did not survive in the follow-up period. MATERIALS AND METHODS Medical data of 51 patients were obtained who underwent resection surgery for PAC between January 2016 and May 2022. There were two groups according to the mortality in the follow-up period group general mortality positive (GMP; n = 29) and group general mortality negative (GMN; n = 22). Stage IIb was the most common stage in subgroups. RESULTS Preoperative diagnostic tests revealed that aspartate aminotransferase (AST) level, De Ritis ratio (DRR), carcinoembryonic antigen (CEA), cancer antigen 19-9 (CA 19-9), immature granulocyte (IG) count, and IG ratio (IG%) are higher, and hemoglobin (Hgb) levels are lower in the GMP group (P < 0.05). In univariate analysis, seven variables, including AST ≥20.5 (P = 0.001), DRR ≥1.05 (P ≤ 0.001), CEA ≥3.32 (P = 0.02), IG count ≥0.06 (P < 0.01), Hgb ≤11.75 (P = 0.01), poor differentiation (P < 0.001) and existence of life-threatening complication (P < 0.01) were identified. In multivariate analysis, only DRR (≥1.05;100% specificity and 72% sensitivity) and poor differentiation (P = 0.019) were found to be independent prognostic factors for overall survival. The median overall survival of patients with the DRR ≥1.05 and poor tumor differentiation was lower, and the mortality rate was higher than the patients with DRR and without poor tumor differentiation (10.65 ± 3.11 months vs. 61.86 ± 5.36 months and 100% vs. 26.7%, P < 0.001). CONCLUSION Pretreatment high DRR, high IG counts and IG%, and poor differentiation of the tumor might be used as independent predictors of poor prognosis and mortality in patients with PAC.
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Affiliation(s)
- M A Çaparlar
- Department of General Surgery, Ankara Education and Research Hospital, Ankara, Turkey
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4
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Zhang B, Sun J, Guan H, Guo H, Huang B, Chen X, Chen F, Yuan Q. Integrated single-cell and bulk RNA sequencing revealed the molecular characteristics and prognostic roles of neutrophils in pancreatic cancer. Aging (Albany NY) 2023; 15:9718-9742. [PMID: 37728418 PMCID: PMC10564426 DOI: 10.18632/aging.205044] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 08/21/2023] [Indexed: 09/21/2023]
Abstract
Pancreatic cancer, one of the most prevalent tumors of the digestive system, has a dismal prognosis. Cancer of the pancreas is distinguished by an inflammatory tumor microenvironment rich in fibroblasts and different immune cells. Neutrophils are important immune cells that infiltrate the microenvironment of pancreatic cancer tumors. The purpose of this work was to examine the complex mechanism by which neutrophils influence the carcinogenesis and development of pancreatic cancer and to construct a survival prediction model based on neutrophil marker genes. We incorporated the GSE111672 dataset, comprising RNA expression data from 27,000 cells obtained from 3 patients with PC, and conducted single-cell data analysis. Thorough investigation of pancreatic cancer single-cell RNA sequencing data found 350 neutrophil marker genes. Using The Cancer Genome Atlas (TCGA), GSE28735, GSE62452, GSE57495, and GSE85916 datasets to gather pancreatic cancer tissue transcriptome data, and consistent clustering was used to identify two categories for analyzing the influence of neutrophils on pancreatic cancer. Using the Random Forest algorithm and Cox regression analysis, a survival prediction model for pancreatic cancer was developed, the model showed independent performance for survival prognosis, clinic pathological features, immune infiltration, and drug sensitivity. Multivariate Cox analysis findings revealed that the risk scores derived from predictive models is independent prognostic markers for pancreatic patients. In conclusion, based on neutrophil marker genes, this research created a molecular typing and prognostic grading system for pancreatic cancer, this system was very accurate in predicting the prognosis, tumor immune microenvironment status, and pharmacological treatment responsiveness of pancreatic cancer patients.
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Affiliation(s)
- Biao Zhang
- Department of General Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Jiaao Sun
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Hewen Guan
- Department of Dermatology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Hui Guo
- Department of General Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Bingqian Huang
- Laboratory of Integrative Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
- Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, Liaoning, China
| | - Xu Chen
- Department of General Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Feng Chen
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Qihang Yuan
- Department of General Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
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5
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Basoglu T, Babacan NA, Ozturk FE, Arikan R, Demircan NC, Telli TA, Ercelep O, Dane F, Yumuk PF. Prognostic value of Gustave Roussy immune score in operable pancreatic adenocarcinoma. Indian J Cancer 2023; 60:179-184. [PMID: 36861712 DOI: 10.4103/ijc.ijc_1049_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Background The Gustave Roussy immune score (GRIm score) is a laboratory index developed to predict survival in nonsmall cell lung cancer patients undergoing immunotherapy and has shown that the pretreatment value is an independent prognostic factor for survival. In this study, we aimed to determine prognostic significance of GRIm score for pancreatic adenocarcinoma that have not been determined in the literature for pancreatic cancer before. The reason for choosing this scoring is to show that the immune scoring system works as a prognostic marker in pancreatic cancer known as immune-desert tumor via immune properties of microenvironment. Methods Medical records of patients with histologically confirmed pancreatic ductal adenocarcinoma, who were treated and followed up between December 2007 and July 2019 at our clinic, were reviewed retrospectively. GRIm scores of each patient were calculated at the time of diagnosis. Survival analysis were performed according to risk groups. Results A total of 138 patients were included in the study. While 111 (80.4%) patients were in the low-risk group; 27 (19.6%) were in high-risk group according to GRIm score. Median OS was 36.9 months (95% Confidence interval (CI): 25.42-48.56) in lower GRIm scores, and it was 11.1 months (95% CI: 6.83-15.44) in higher GRIm scores (P = 0.002). One-two-three-year OS rates were 85% versus 47%, 64% versus 39%, 53% versus 27% for low versus high GRIm scores, respectively. The multivariate analysis revealed that high GRIm score was an independent poor prognostic factor. Conclusion GRIm can be used as a noninvasive, easily applicable, practical prognostic factor in pancreatic cancer patients.
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Affiliation(s)
- Tugba Basoglu
- Department of Medical Oncology, Marmara University School of Medicine, Turkey
| | | | - Fatih E Ozturk
- Internal Medicine, Marmara University School of Medicine, Marmara University, Turkey
| | - Rukiye Arikan
- Department of Medical Oncology, Marmara University School of Medicine, Turkey
| | - Nazim C Demircan
- Department of Medical Oncology, Marmara University School of Medicine, Turkey
| | - Tugba Akin Telli
- Department of Medical Oncology, Marmara University School of Medicine, Turkey
| | - Ozlem Ercelep
- Department of Medical Oncology, Marmara University School of Medicine, Turkey
| | - Faysal Dane
- Department of Medical Oncology, Marmara University School of Medicine, Turkey
| | - Perran F Yumuk
- Department of Medical Oncology, Marmara University School of Medicine, Turkey
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6
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Zhao Z, Bian J, Zhang J, Zhang T, Lu X. Hyperprogressive disease in patients suffering from solid malignancies treated by immune checkpoint inhibitors: A systematic review and meta-analysis. Front Oncol 2022; 12:843707. [PMID: 35992878 PMCID: PMC9381837 DOI: 10.3389/fonc.2022.843707] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 06/06/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Hyperprogressive disease (HPD) is a paradoxically rapid disease progression during or shortly after antitumor treatment, especially immune checkpoint inhibitors (ICIs). Various diagnosis criteria of HPD cause heterogeneous incidence rates in different clinical research, and there is no consensus on potential risk factors associated with HPD occurrence. Hence, we aimed to summarize incidence of HPD in ICI treatment for solid tumors. Clinicopathological factors associated with HPD are also analyzed. Methods Clinical studies about HPD during/after ICI treatment of solid malignancies are included. Pubmed, Embase, and Cochrane library were searched for eligible studies published before October 7. The Newcastle–Ottawa scale was used to assess the quality of the included studies. Random effect and fixed effect models were, respectively, used for pooling incidence of HPD and analysis of risk factors for HPD. Heterogeneity, subgroup analysis, and publication bias were also analyzed. All meta-analysis was performed via R software (y -40v4.0.2). Results Forty-one studies with 6009 patients were included. The pooled incidence of HPD was 13.2% (95% CI, 11.2%–15.4%). Head and neck cancer (HNC) had the highest incidence of HPD (18.06%), and melanoma had the lowest (9.9%). Tumor types (P = .0248) and gender ratio (P = .0116) are sources of heterogeneity of pooled incidence of HPD. For five clinicopathological factors associated with HPD, only programmed cell death protein 1 ligand 1 (PD-L1) positivity was a preventive factor (odds ratio = 0.61, P <.05). High lactate dehydrogenase (LDH) level (OR = 1.51, P = .01), metastatic sites >2 (OR = 2.38, P <.0001), Eastern Cooperative Oncology Group Performance Score ≥2 (OR = 1.47, P = .02), and liver metastasis (OR = 3.06, P <.0001) indicate higher risk of HPD. Conclusions The pooled incidence of HPD was less than 15%, and HNC had the highest incidence of HPD. LDH and PD-L1 are remarkable biomarkers for prediction of HPD in future medical practice.
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Affiliation(s)
| | | | | | | | - Xin Lu
- *Correspondence: Xin Lu, ;
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7
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Gebauer L, Moltz JH, Mühlberg A, Holch JW, Huber T, Enke J, Jäger N, Haas M, Kruger S, Boeck S, Sühling M, Katzmann A, Hahn H, Kunz WG, Heinemann V, Nörenberg D, Maurus S. Quantitative Imaging Biomarkers of the Whole Liver Tumor Burden Improve Survival Prediction in Metastatic Pancreatic Cancer. Cancers (Basel) 2021; 13:cancers13225732. [PMID: 34830885 PMCID: PMC8616514 DOI: 10.3390/cancers13225732] [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: 10/03/2021] [Revised: 11/12/2021] [Accepted: 11/13/2021] [Indexed: 12/15/2022] Open
Abstract
Simple Summary Finding prognostic biomarkers and associated models with high accuracy in patients with pancreatic cancer remains a challenge. The aim of this study was to analyze whether the combination of quantitative imaging biomarkers based on geometric and radiomics analysis of whole liver tumor burden and established clinical parameters improves the prediction of survival in patients with metastatic pancreatic cancer. In this retrospective study a total of 75 patients with pancreatic cancer and liver metastases were analyzed. Segmentations of whole liver tumor burden from baseline contrast-enhanced CT images were used to derive different quantitative imaging biomarkers. For comparison, we chose two clinical prognostic models from the literature. We found that a combined clinical and imaging-based model has a significantly higher predictive performance to discriminate survival than the underlying clinical models alone (p < 0.003). Abstract Finding prognostic biomarkers with high accuracy in patients with pancreatic cancer (PC) remains a challenging problem. To improve the prediction of survival and to investigate the relevance of quantitative imaging biomarkers (QIB) we combined QIB with established clinical parameters. In this retrospective study a total of 75 patients with metastatic PC and liver metastases were analyzed. Segmentations of whole liver tumor burden (WLTB) from baseline contrast-enhanced CT images were used to derive QIBs. The benefits of QIBs in multivariable Cox models were analyzed in comparison with two clinical prognostic models from the literature. To discriminate survival, the two clinical models had concordance indices of 0.61 and 0.62 in a statistical setting. Combined clinical and imaging-based models achieved concordance indices of 0.74 and 0.70 with WLTB volume, tumor burden score (TBS), and bilobar disease being the three WLTB parameters that were kept by backward elimination. These combined clinical and imaging-based models have significantly higher predictive performance in discriminating survival than the underlying clinical models alone (p < 0.003). Radiomics and geometric WLTB analysis of patients with metastatic PC with liver metastases enhances the modeling of survival compared with models based on clinical parameters alone.
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Affiliation(s)
- Leonie Gebauer
- Department of Medicine III, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (J.W.H.); (M.H.); (S.K.); (S.B.); (V.H.)
- Correspondence:
| | - Jan H. Moltz
- Fraunhofer Institute for Digital Medicine MEVIS, Max-von-Laue-Str. 2, 28359 Bremen, Germany; (J.H.M.); (H.H.)
| | - Alexander Mühlberg
- CT R&D Image Analytics, Siemens Healthineers, Siemensstr. 1, 91301 Forchheim, Germany; (A.M.); (M.S.); (A.K.)
| | - Julian W. Holch
- Department of Medicine III, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (J.W.H.); (M.H.); (S.K.); (S.B.); (V.H.)
| | - Thomas Huber
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (T.H.); (J.E.); (N.J.); (W.G.K.); (D.N.); (S.M.)
- Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Johanna Enke
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (T.H.); (J.E.); (N.J.); (W.G.K.); (D.N.); (S.M.)
| | - Nils Jäger
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (T.H.); (J.E.); (N.J.); (W.G.K.); (D.N.); (S.M.)
| | - Michael Haas
- Department of Medicine III, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (J.W.H.); (M.H.); (S.K.); (S.B.); (V.H.)
| | - Stephan Kruger
- Department of Medicine III, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (J.W.H.); (M.H.); (S.K.); (S.B.); (V.H.)
| | - Stefan Boeck
- Department of Medicine III, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (J.W.H.); (M.H.); (S.K.); (S.B.); (V.H.)
| | - Michael Sühling
- CT R&D Image Analytics, Siemens Healthineers, Siemensstr. 1, 91301 Forchheim, Germany; (A.M.); (M.S.); (A.K.)
| | - Alexander Katzmann
- CT R&D Image Analytics, Siemens Healthineers, Siemensstr. 1, 91301 Forchheim, Germany; (A.M.); (M.S.); (A.K.)
| | - Horst Hahn
- Fraunhofer Institute for Digital Medicine MEVIS, Max-von-Laue-Str. 2, 28359 Bremen, Germany; (J.H.M.); (H.H.)
| | - Wolfgang G. Kunz
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (T.H.); (J.E.); (N.J.); (W.G.K.); (D.N.); (S.M.)
| | - Volker Heinemann
- Department of Medicine III, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (J.W.H.); (M.H.); (S.K.); (S.B.); (V.H.)
| | - Dominik Nörenberg
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (T.H.); (J.E.); (N.J.); (W.G.K.); (D.N.); (S.M.)
- Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Stefan Maurus
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (T.H.); (J.E.); (N.J.); (W.G.K.); (D.N.); (S.M.)
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Ma Y, Shi L, Lu P, Yao S, Xu H, Hu J, Liang X, Liang X, Wei S. Creation of a Novel Nomogram Based on the Direct Bilirubin-To-Indirect Bilirubin Ratio and Lactate Dehydrogenase Levels in Resectable Colorectal Cancer. Front Mol Biosci 2021; 8:751506. [PMID: 34746234 PMCID: PMC8564357 DOI: 10.3389/fmolb.2021.751506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 10/04/2021] [Indexed: 01/03/2023] Open
Abstract
Background: Recently, many studies have suggested that bilirubin is associated with the prognosis of colorectal cancer (CRC). Conversely, there is substantial evidence that lactate dehydrogenase (LDH) levels are associated with the prognosis of cancer. Therefore, we sought to find a novel marker based on the above to predict prognosis in patients with resectable CRC. Methods: A total of 702 patients from Hubei Cancer Hospital were included. The whole population was randomly divided into training (n = 491) and testing (n = 211) cohorts. Next, we established a new index based on direct bilirubin, indirect bilirubin and LDH levels. Chi-square tests, Kaplan-Meier survival analyses, and Cox regression analyses were used to evaluate prognosis. The prediction accuracies of models for overall survival (OS) and disease-free survival (DFS) were estimated through Harrell’s concordance index (C-index) and the Brier score. Results: The median DFS duration was 32 months (range: 0–72.6 months), whereas the median OS duration was 35 months (range: 0 months–73.8 months). In addition, a new indicator, (DIR.LDH) (HR: 1.433; 95% CI, 1.069–1.920) could independently predict outcomes in CRC patients. Moreover, the module based on DIR. LDH was found to have exceptional performance for predicting OS and DFS. The C-index of the nomogram for OS was 0.802 (95% CI, 0.76–0.85) in the training cohort and 0.829 (95% CI, 0.77–0.89) in the testing cohort. The C-index of the nomogram for DFS was 0.774 (95% CI, 0.74–0.81) in the training cohort and 0.775 (95% CI, 0.71–0.84) in the testing cohort. Conclusion: We successfully established a novel module to guide clinical decision-making for CRC.
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Affiliation(s)
- Yifei Ma
- Department of Gastrointestinal Oncology Surgery, Hubei Cancer Hospital, Wuhan, China.,Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan, China.,Colorectal Cancer Clinical Research Center of Wuhan, Wuhan, China
| | - Lulu Shi
- Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan, China.,Colorectal Cancer Clinical Research Center of Wuhan, Wuhan, China
| | - Ping Lu
- Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan, China.,Colorectal Cancer Clinical Research Center of Wuhan, Wuhan, China.,Department of Abdominal Oncology, Hubei Cancer Hospital, Wuhan, China
| | - Shuang Yao
- Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan, China.,Colorectal Cancer Clinical Research Center of Wuhan, Wuhan, China
| | - Hongli Xu
- Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan, China.,Colorectal Cancer Clinical Research Center of Wuhan, Wuhan, China.,Department of Abdominal Oncology, Hubei Cancer Hospital, Wuhan, China
| | - Junjie Hu
- Department of Gastrointestinal Oncology Surgery, Hubei Cancer Hospital, Wuhan, China.,Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan, China.,Colorectal Cancer Clinical Research Center of Wuhan, Wuhan, China
| | - Xin Liang
- Department of Gastrointestinal Oncology Surgery, Hubei Cancer Hospital, Wuhan, China.,Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan, China.,Colorectal Cancer Clinical Research Center of Wuhan, Wuhan, China
| | - Xinjun Liang
- Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan, China.,Colorectal Cancer Clinical Research Center of Wuhan, Wuhan, China.,Department of Abdominal Oncology, Hubei Cancer Hospital, Wuhan, China
| | - Shaozhong Wei
- Department of Gastrointestinal Oncology Surgery, Hubei Cancer Hospital, Wuhan, China.,Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan, China.,Colorectal Cancer Clinical Research Center of Wuhan, Wuhan, China
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Jain A, Bhardwaj V. Therapeutic resistance in pancreatic ductal adenocarcinoma: Current challenges and future opportunities. World J Gastroenterol 2021; 27:6527-6550. [PMID: 34754151 PMCID: PMC8554400 DOI: 10.3748/wjg.v27.i39.6527] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/22/2021] [Accepted: 08/30/2021] [Indexed: 02/06/2023] Open
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is the third leading cause of cancer-related deaths in the United States. Although chemotherapeutic regimens such as gemcitabine+ nab-paclitaxel and FOLFIRINOX (FOLinic acid, 5-Fluroruracil, IRINotecan, and Oxaliplatin) significantly improve patient survival, the prevalence of therapy resistance remains a major roadblock in the success of these agents. This review discusses the molecular mechanisms that play a crucial role in PDAC therapy resistance and how a better understanding of these mechanisms has shaped clinical trials for pancreatic cancer chemotherapy. Specifically, we have discussed the metabolic alterations and DNA repair mechanisms observed in PDAC and current approaches in targeting these mechanisms. Our discussion also includes the lessons learned following the failure of immunotherapy in PDAC and current approaches underway to improve tumor's immunological response.
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Affiliation(s)
- Aditi Jain
- The Jefferson Pancreas, Biliary and Related Cancer Center, Department of Surgery, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA 19107, United States
| | - Vikas Bhardwaj
- Department of Pharmaceutical Sciences, Jefferson College of Pharmacy, Thomas Jefferson University, Philadelphia, PA 19107, United States
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Batra A, Tang PA, Cheung WY. Prognostic Significance of Disease Control at 12 Weeks in Patients With Advanced Pancreatic Cancer Receiving FOLFIRINOX as First-line Chemotherapy. Am J Clin Oncol 2021; 44:519-525. [PMID: 34366400 DOI: 10.1097/coc.0000000000000856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The POLO (Pancreas Cancer Olaparib Ongoing) trial demonstrated improvement in progression-free survival (PFS) with olaparib maintenance in advanced pancreatic cancer (APC) patients with germline BRCA1/2 mutations who had disease control after 16 weeks of platinum-based first-line therapy. However, in the real-world, the first assessment is usually performed at 12 weeks. Therefore, this study aimed to identify the proportion of real-world patients with APC that have disease control at 12 weeks (DC12) after FOLFIRINOX, assess any associations of baseline variables with DC12, and to determine the effect of DC12 on PFS and overall survival (OS). METHODS APC patients treated with first-line FOLFIRINOX from 2011 to 2018 in Alberta, Canada, were identified. We conducted an analysis of baseline characteristics to identify factors associated with DC12 and to compare the PFS and OS of patients with DC12 to those with earlier disease progression. RESULTS We identified 165 APC patients treated with FOLFIRINOX with unknown BRCA1/2 status, of which 56% were men, and the median age at diagnosis was 59 years (interquartile range, 38 to 75 y). Of these, 72 (44%) had DC12. Lower serum carbohydrate antigen 19.9 and normal serum albumin were associated with a higher likelihood of DC12. The PFS and OS of patients with DC12 was significantly higher than those with earlier progression (9.3 vs. 2.5 mo; hazard ratio, 0.22; 95% confidence interval, 0.15-0.32; P<0.001; 21.6 vs. 8.9 mo; hazard ratio, 0.35; 95% confidence interval, 0.25-0.49; P<0.0001). CONCLUSION Less than half of real-world patients treated with first-line FOLFIRINOX have DC12. Patients with APC who have higher carbohydrate antigen 19.9 and low albumin are less likely to have DC12. DC12 is significantly associated with longer PFS and OS.
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Affiliation(s)
- Atul Batra
- Department of Medical Oncology, Tom Baker Cancer Center, Calgary, AB, Canada
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Patricia A Tang
- Department of Medical Oncology, Tom Baker Cancer Center, Calgary, AB, Canada
| | - Winson Y Cheung
- Department of Medical Oncology, Tom Baker Cancer Center, Calgary, AB, Canada
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Long Term Survival With Regorafenib: REALITY (Real Life in Italy) Trial - A GISCAD Study. Clin Colorectal Cancer 2021; 20:e253-e262. [PMID: 34429245 DOI: 10.1016/j.clcc.2021.07.008] [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: 02/21/2021] [Revised: 07/06/2021] [Accepted: 07/13/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Regorafenib is a key agent in metastatic colorectal cancer (mCRC), but no validated factors predicting longer survival are available. PATIENTS AND METHODS REALITY was a retrospective multicenter trial in regorafenib-treated mCRC patients with overall survival (OS) ≥ 6 months. We aimed to assess the association between clinical parameters and outcome to define a panel identifying long term survivors among regorafenib candidates. Primary and secondary endpoints were OS and progression free survival (PFS), respectively. Statistical analysis was performed with MedCalc (survival distribution: Kaplan-Meier; survival comparison: log-rank test; independent role of significant variables at univariate analysis: logistic regression). RESULTS Hundred regorafenib-treated mCRC patients with OS ≥ 6 months were enrolled. Median OS was 11.5 m (95%CI:9.60-12.96); median PFS was 4.2 months (95% CI:3.43-43.03). The absence of liver progression and of dose and/or schedule changes during the first 4 cycles (mainly for good tolerability) were independently correlated at multivariate analysis with OS (Exp(b)1.8869, P= .0277and Exp(b)2.2000, P = .0313) and PFS (Exp(b)2.1583, P = .0065 and Exp(b)2.3036, P= .0169). Patients with neither of these variables had a significantly improved OS (n = 14, 20.8 months; 95% CI:12.967-55.267) versus others (n = 86, 10 months; 95% CI:8.367-12.167; HR = 0.4902, P = .0045) and PFS (11.3 months, 95%CI:4.267-35.8 vs. 3.9 months, 95% CI:3.167-43.033; HR = 0.4648, P = .0086). CONCLUSION These 2 factors might allow clinicians to better identify patients more likely to benefit from regorafenib. Toxicity management remains crucial.
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12
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Cheng C, Tan H, Wang N, Chen L, Meng Z, Chen Z, Feng Y. Functional inhibition of lactate dehydrogenase suppresses pancreatic adenocarcinoma progression. Clin Transl Med 2021; 11:e467. [PMID: 34185423 PMCID: PMC8238920 DOI: 10.1002/ctm2.467] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 06/01/2021] [Accepted: 06/07/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Pancreatic adenocarcinoma (PAAD) a highly lethal malignancy. The current use of clinical parameters may not accurately predict the clinical outcome, which further renders the unsatisfactory therapeutic outcome. METHODS In this study, we retrospectively analyzed the clinical-pathological characteristics and prognosis of 253 PAAD patients. Univariate, multivariate, and Kaplan-Meier survival analyses were conducted to assess risk factors and clinical outcomes. For functional study, we performed bidirectional genetic manipulation of lactate dehydrogenase A (LDHA) in PAAD cell lines to measure PAAD progression by both in vitro and in vivo assays. RESULTS LDHA is particularly overexpressed in PAAD tissues and elevated serum LDHA-transcribed isoenzymes-5 (LDH-5) was associated with poorer patients' clinical outcomes. Genetic overexpression of LDHA promoted the proliferation and invasion in vitro, and tumor growth and metastasis in vivo in murine PAAD orthotopic models, while knockdown of LDHA exhibited opposite effects. LDHA-induced L-lactate production was responsible for the LDHA-facilitated PAAD progression. Mechanistically, LDHA overexpression reduced the phosphorylation of metabolic regulator AMPK and promoted the downstream mTOR phosphorylation in PAAD cells. Inhibition of mTOR repressed the LDHA-induced proliferation and invasion. A natural product berberine was selected as functional inhibitor of LDHA, which reduced activity and expression of the protein in PAAD cells. Berberine inhibited PAAD cells proliferation and invasion in vitro, and suppressed tumor progression in vivo. The restoration of LDHA attenuated the suppressive effect of berberine on PAAD. CONCLUSIONS Our findings suggest that LDHA may be a novel biomarker and potential therapeutic target of human PAAD.
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Affiliation(s)
- Chien‐shan Cheng
- Department of Integrative OncologyFudan University Shanghai Cancer CenterShanghaiChina
- Department of Oncology, Shanghai Medical CollegeFudan UniversityShanghaiChina
- Li Ka Shing Faculty of MedicineSchool of Chinese Medicine, The University of Hong KongHong KongChina
| | - Hor‐Yue Tan
- Li Ka Shing Faculty of MedicineSchool of Chinese Medicine, The University of Hong KongHong KongChina
| | - Ning Wang
- Li Ka Shing Faculty of MedicineSchool of Chinese Medicine, The University of Hong KongHong KongChina
| | - Lianyu Chen
- Department of Integrative OncologyFudan University Shanghai Cancer CenterShanghaiChina
- Department of Oncology, Shanghai Medical CollegeFudan UniversityShanghaiChina
| | - Zhiqiang Meng
- Department of Integrative OncologyFudan University Shanghai Cancer CenterShanghaiChina
- Department of Oncology, Shanghai Medical CollegeFudan UniversityShanghaiChina
| | - Zhen Chen
- Department of Integrative OncologyFudan University Shanghai Cancer CenterShanghaiChina
- Department of Oncology, Shanghai Medical CollegeFudan UniversityShanghaiChina
| | - Yibin Feng
- Li Ka Shing Faculty of MedicineSchool of Chinese Medicine, The University of Hong KongHong KongChina
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Huang W, Liu P, Zong M, Chen QQ, Zhou H, Kong H, Xie WP. Combining Lactate Dehydrogenase and Fibrinogen: Potential Factors to Predict Therapeutic Efficacy and Prognosis of Patients with Small-Cell Lung Cancer. Cancer Manag Res 2021; 13:4299-4307. [PMID: 34103985 PMCID: PMC8178611 DOI: 10.2147/cmar.s300153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 05/10/2021] [Indexed: 01/10/2023] Open
Abstract
Background A growing interest exists in identifying reliable and low-cost biomarkers or factors that could predict the therapeutic response, prognosis, recurrence, and survival in small-cell lung cancer (SCLC). This study aimed to investigate the better predictors of chemotherapy efficacy and prognosis in patients with SCLC receiving first-line chemotherapy and radiotherapy. Materials and Methods This study retrospectively retrieved the medical records of patients with SCLC treated with first-line platinum-based chemotherapy and radiotherapy from January 2016 to June 2019 in the First Affiliated Hospital of Nanjing Medical University. Plasma biochemical parameters, clinical features, and overall survival (OS) time were collected. The independent effects of plasma parameters on patient survival were assessed by conducting univariate and multivariate Cox regression analyses. The optimal cut-off values of independent risk factors in the ROC curve and Kaplan–Meier survival analysis were determined using MedCalc software. Results Statistically significant differences in lactate dehydrogenase (LDH) and fibrinogen (Fbg) were found between the complete remission + partial remission group and the non-responders, which consisted of stable-disease and progressive-disease groups, after first-line chemotherapy. Multivariate Cox regression analysis showed that LDH and Fbg were independent risk factors in predicting PFS (LDH HR: 1.013, 95% CI: 1.002–1.030, P = 0.037; Fbg HR: 1.622, 95% CI: 1.094–2.526, P = 0.017) and OS (LDH HR: 1.021, 95% CI: 1.008–1.034, P = 0.001; Fbg HR: 2.168, 95% CI: 1.324–3.550, P = 0.002). The AUC of LDH and Fbg was 0.77 and 0.745, respectively. The cut-off value of LDH and Fbg in predicting OS was 263 U/L and 4.03 g/L. When these two data were combined, the AUC reached 0.832, better than that of LDH and Fbg alone. The objective response rate (ORR) and OS were significantly different among these three different groups according to the addition of the assigned value (P < 0.05). Conclusion Combined retreatment serum LDH and Fbg levels may be a better potential biomarker for predicting the clinical efficacy of chemotherapy and the prognosis of individuals with SCLC. Combining these two parameters could improve prediction efficacy.
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Affiliation(s)
- Wen Huang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China
| | - Ping Liu
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China
| | - Min Zong
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China
| | - Qian-Qian Chen
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China
| | - Hong Zhou
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China
| | - Hui Kong
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China
| | - Wei-Ping Xie
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China
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Uei H, Tokuhashi Y. Prognostic scoring system for metastatic spine tumors derived from hepatocellular carcinoma. J Orthop Surg (Hong Kong) 2020; 28:2309499019899167. [PMID: 32114893 DOI: 10.1177/2309499019899167] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
PURPOSE The prognosis of hepatocellular carcinoma (HCC) has recently improved, and so clinicians have greater opportunity to treat HCC-derived spinal metastases. Therefore, predicting life expectancy is important for determining the optimal treatment strategy for such tumors. This study aimed to investigate the prognostic factors for HCC-derived metastatic spine tumors and to develop a scoring system for predicting life expectancy in such cases. METHODS The posttreatment survival time and factors that might influence it were investigated in 62 patients with HCC-derived metastatic spine tumors who were treated at our department (surgery: 27 patients and conservative treatment: 35 patients), and a prognostic scoring system for predicting life expectancy was developed by combining the factors that significantly influenced survival. RESULTS In the univariate analyses, sex, the patient's general condition, the presence/absence of major internal organ metastasis, the total revised Tokuhashi score, the serum albumin level, Child-Pugh class, spinal surgery, and bone-modifying agent (BMA) treatment were found to influence the posttreatment survival time. These factors were subjected to multivariate analysis, and a novel scoring system for predicting life expectancy based on the patient's general condition, the serum albumin level (or Child-Pugh class), and BMA treatment was developed. In the retrospective analysis, the concordance rate between the patients' life expectancy and actual survival times was 90.3%. CONCLUSION The patient's general condition, the serum albumin level (or Child-Pugh class), and BMA treatment influenced the posttreatment survival times of patients with HCC-derived metastatic spine tumors. A prognostic scoring system based on these factors was proposed.
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Affiliation(s)
- Hiroshi Uei
- Department of Orthopaedic Surgery, School of Medicine, Nihon University, Tokyo, Japan
| | - Yasuaki Tokuhashi
- Department of Orthopaedic Surgery, School of Medicine, Nihon University, Tokyo, Japan
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15
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Sun L, Wang D, Zhang M, Jin Y, Jin B, Xu H, Du S, Xu Y, Zhao H, Lu X, Sang X, Zhong S, Yang H, Mao Y. Preoperative Immune Prognostic Index Can Predict the Clinical Outcomes of Patients with Gallbladder Cancer: Single-Center Experience. Cancer Manag Res 2020; 12:12137-12150. [PMID: 33269006 PMCID: PMC7701162 DOI: 10.2147/cmar.s271044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 11/10/2020] [Indexed: 12/14/2022] Open
Abstract
PURPOSE The immune prognostic index (IPI) has been used as a prognostic biomarker in various cancers. However, the prognostic value of the IPI in gallbladder cancer remains to be determined. PATIENTS AND METHODS This study included 139 patients who were diagnosed with gallbladder cancer after surgical resection from 2003 to 2017. We used a Kaplan-Meier curve analysis to evaluate the overall survival (OS). Cox proportional hazards regression methodology was used to identify significant independent prognostic factors. Prognostic nomograms for predicting OS were established to achieve superior discriminatory abilities. The prognostic nomograms were verified according to the concordance index, calibration curves, and decision curve analyses in the training cohort and validation cohort. RESULTS Of all 139 patients, 87 (62.6%) patients accepted R0 resection, 32% and 68% were stratified into the good and poor IPI group, respectively. The median OS was 55.9 (range, 5.93-182.7) months in the good IPI group and 15.47 (range, 0.29-190.37) months in the poor IPI group (P < 0.001). In the multivariate Cox model, the IPI was an independent predictor of OS along with the CA19-9, curative resection, and postoperative chemoradiotherapy. A nomogram based on these factors was efficient in predicting 1-, 3-, and 5-year survival probabilities. The nomogram showed higher sensitivity and specificity than the current cancer TNM staging system in the training cohort and validation cohort. CONCLUSION The IPI is an independent prognostic factor in gallbladder cancer. Our IPI-based nomogram can serve as a useful and convenient prognostic tool for gallbladder cancer.
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Affiliation(s)
- Lejia Sun
- Department of Liver Surgery, Peking Union Medical College (PUMC) Hospital, PUMC & Chinese Academy of Medical Sciences, Beijing100730, People’s Republic of China
| | - Dongyue Wang
- Peking Union Medical College (PUMC), PUMC & Chinese Academy of Medical Sciences, Beijing100730, People’s Republic of China
| | - Mengyuan Zhang
- Peking Union Medical College (PUMC), PUMC & Chinese Academy of Medical Sciences, Beijing100730, People’s Republic of China
| | - Yukai Jin
- Department of Liver Surgery, Peking Union Medical College (PUMC) Hospital, PUMC & Chinese Academy of Medical Sciences, Beijing100730, People’s Republic of China
| | - Bao Jin
- Department of Liver Surgery, Peking Union Medical College (PUMC) Hospital, PUMC & Chinese Academy of Medical Sciences, Beijing100730, People’s Republic of China
| | - Haifeng Xu
- Department of Liver Surgery, Peking Union Medical College (PUMC) Hospital, PUMC & Chinese Academy of Medical Sciences, Beijing100730, People’s Republic of China
| | - Shunda Du
- Department of Liver Surgery, Peking Union Medical College (PUMC) Hospital, PUMC & Chinese Academy of Medical Sciences, Beijing100730, People’s Republic of China
| | - Yiyao Xu
- Department of Liver Surgery, Peking Union Medical College (PUMC) Hospital, PUMC & Chinese Academy of Medical Sciences, Beijing100730, People’s Republic of China
| | - Haitao Zhao
- Department of Liver Surgery, Peking Union Medical College (PUMC) Hospital, PUMC & Chinese Academy of Medical Sciences, Beijing100730, People’s Republic of China
| | - Xin Lu
- Department of Liver Surgery, Peking Union Medical College (PUMC) Hospital, PUMC & Chinese Academy of Medical Sciences, Beijing100730, People’s Republic of China
| | - Xinting Sang
- Department of Liver Surgery, Peking Union Medical College (PUMC) Hospital, PUMC & Chinese Academy of Medical Sciences, Beijing100730, People’s Republic of China
| | - Shouxian Zhong
- Department of Liver Surgery, Peking Union Medical College (PUMC) Hospital, PUMC & Chinese Academy of Medical Sciences, Beijing100730, People’s Republic of China
| | - Huayu Yang
- Department of Liver Surgery, Peking Union Medical College (PUMC) Hospital, PUMC & Chinese Academy of Medical Sciences, Beijing100730, People’s Republic of China
| | - Yilei Mao
- Department of Liver Surgery, Peking Union Medical College (PUMC) Hospital, PUMC & Chinese Academy of Medical Sciences, Beijing100730, People’s Republic of China
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Lisanti C, Basile D, Parnofiello A, Bertoli E, Andreotti VJ, Garattini SK, Bartoletti M, Cattaneo M, Di Nardo P, Bonotto M, Casagrande M, Da Ros L, Cinausero M, Foltran L, Pella N, Buonadonna A, Aprile G, Fasola G, Puglisi F. The SENECA study: Prognostic role of serum biomarkers in older patients with metastatic colorectal cancer. J Geriatr Oncol 2020; 11:1268-1273. [PMID: 32576519 DOI: 10.1016/j.jgo.2020.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/27/2020] [Accepted: 06/03/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Aging induces meaningful changes in the immune system and inflammation response with increase in monocyte-lymphocyte ratio (MLR) and serum lactate dehydrogenase (LDH) levels. Aim of this study was to explore the prognostic role of MLR and LDH levels in older patients (pts) with metastatic colorectal cancer (mCRC). METHODS We conducted a retrospective analysis of a consecutive cohort of 168 older (>70 years) patients with mCRC. The prognostic impact of MLR and LDH levels on overall survival (OS) was investigated through uni-and multivariate Cox regression analyses. Moreover, we categorized patients into three groups according to MLR and LDH levels (group 1: MLR-low and LDH-low; group 2: MLR-high or LDH-high; group 3: MLR-high and LDH-high). RESULTS By univariate analysis, high LDH level (HR 1.74, 95% CI 1.05-2.90) and high MLR level (HR 2.19, 95% CI 1.48-3.44) were significantly associated with a worse OS. Conversely, primary tumor resection and left-sidedness were significantly associated with a longer OS. By multivariate analysis, high LDH level (HR 2.00, 95% CI 1.13-3.55) and high MLR level (HR 2.99, 95% CI 1.68-5.33) were independent prognostic factors of worse prognosis. Compared to group 1, a shorter survival was reported for patients included in group 2 (HR 1.97, 95% CI 1.21-3.23 in univariate; HR 2.54, 95% CI 1.43-4.51 in multivariate) or in group 3 (HR 2.42, 95% CI 24-4.74, p = .010 in univariate; HR 5.59, 95% CI 2.15-14.54 in multivariate) CONCLUSIONS: High baseline levels of LDH, MLR or both are independent unfavorable prognostic factors in older patients treated with first-line chemotherapy for mCRC.
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Affiliation(s)
- Camilla Lisanti
- Department of Medicine (DAME), University of Udine, Udine, IT, Italy; Department of Medical Oncology, Unit of medical oncology and cancer prevention, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, IT, Italy
| | - Debora Basile
- Department of Medicine (DAME), University of Udine, Udine, IT, Italy; Department of Medical Oncology, Unit of medical oncology and cancer prevention, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, IT, Italy.
| | - Annamaria Parnofiello
- Department of Medicine (DAME), University of Udine, Udine, IT, Italy; Department of Medical Oncology, Unit of medical oncology and cancer prevention, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, IT, Italy
| | - Elisa Bertoli
- Department of Medicine (DAME), University of Udine, Udine, IT, Italy; Department of Oncology, ASUIUD Santa Maria della Misericordia, Udine, IT, Italy
| | - Victoria Josephine Andreotti
- Department of Medicine (DAME), University of Udine, Udine, IT, Italy; Department of Oncology, ASUIUD Santa Maria della Misericordia, Udine, IT, Italy
| | - Silvio Ken Garattini
- Department of Medicine (DAME), University of Udine, Udine, IT, Italy; Department of Oncology, ASUIUD Santa Maria della Misericordia, Udine, IT, Italy
| | - Michele Bartoletti
- Department of Medicine (DAME), University of Udine, Udine, IT, Italy; Department of Medical Oncology, Unit of medical oncology and cancer prevention, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, IT, Italy
| | - Monica Cattaneo
- Department of Medicine (DAME), University of Udine, Udine, IT, Italy; Department of Oncology, ASUIUD Santa Maria della Misericordia, Udine, IT, Italy
| | - Paola Di Nardo
- Department of Medical Oncology, Unit of medical oncology and cancer prevention, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, IT, Italy
| | - Marta Bonotto
- Department of Oncology, ASUIUD Santa Maria della Misericordia, Udine, IT, Italy
| | | | - Lucia Da Ros
- Department of Medical Oncology, Unit of medical oncology and cancer prevention, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, IT, Italy
| | - Marika Cinausero
- Department of Oncology, ASUIUD Santa Maria della Misericordia, Udine, IT, Italy
| | - Luisa Foltran
- Department of Medical Oncology, Unit of medical oncology and cancer prevention, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, IT, Italy
| | - Nicoletta Pella
- Department of Oncology, ASUIUD Santa Maria della Misericordia, Udine, IT, Italy
| | - Angela Buonadonna
- Department of Medical Oncology, Unit of medical oncology and cancer prevention, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, IT, Italy
| | - Giuseppe Aprile
- Department of Oncology, San Bortolo General Hospital, Azienda ULSS8 Berica, Vicenza, Italy
| | - Gianpiero Fasola
- Department of Oncology, ASUIUD Santa Maria della Misericordia, Udine, IT, Italy
| | - Fabio Puglisi
- Department of Medicine (DAME), University of Udine, Udine, IT, Italy; Department of Medical Oncology, Unit of medical oncology and cancer prevention, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, IT, Italy
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17
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Maulat C, Canivet C, Touraine C, Gourgou S, Napoleon B, Palazzo L, Flori N, Piessen G, Guibert P, Truant S, Assenat E, Buscail L, Bournet B, Muscari F. A New Score to Predict the Resectability of Pancreatic Adenocarcinoma: The BACAP Score. Cancers (Basel) 2020; 12:cancers12040783. [PMID: 32218346 PMCID: PMC7226323 DOI: 10.3390/cancers12040783] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 03/20/2020] [Accepted: 03/22/2020] [Indexed: 12/13/2022] Open
Abstract
Surgery remains the only curative treatment for pancreatic ductal adenocarcinoma (PDAC). Therefore, a predictive score for resectability on diagnosis is needed. A total of 814 patients were included between 2014 and 2017 from 15 centers included in the BACAP (the national Anatomo-Clinical Database on Pancreatic Adenocarcinoma) prospective cohort. Three groups were defined: resectable (Res), locally advanced (LA), and metastatic (Met). Variables were analyzed and a predictive score was devised. Of the 814 patients included, 703 could be evaluated: 164 Res, 266 LA, and 273 Met. The median ages of the patients were 69, 71, and 69, respectively. The median survival times were 21, 15, and nine months, respectively. Six criteria were significantly associated with a lower probability of resectability in multivariate analysis: venous/arterial thrombosis (p = 0.017), performance status 1 (p = 0.032) or ≥ 2 (p = 0.010), pain (p = 0.003), weight loss ≥ 8% (p = 0.019), topography of the tumor (body/tail) (p = 0.005), and maximal tumor size 20-33 mm (p < 0.013) or >33 mm (p < 0.001). The BACAP score was devised using these criteria (http://jdlp.fr/resectability/) with an accuracy of 81.17% and an area under the receive operating characteristic (ROC) curve of 0.82 (95% confidence interval (CI): 0.78; 0.86). The presence of pejorative criteria or a BACAP score < 50% indicates that further investigations and even neoadjuvant treatment might be warranted. Trial registration: NCT02818829.
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Affiliation(s)
- Charlotte Maulat
- The Digestive Surgery and Liver Transplantation Department, Toulouse University Hospital, 31400 Toulouse, France;
- INSERM U1037, The Toulouse Cancer Research Center, Toulouse University, 31100 Toulouse, France; (L.B.); (B.B.)
- Correspondence: ; Tel.: +33-561-322-741
| | - Cindy Canivet
- The Gastroenterology and Pancreatology Department, Toulouse University Hospital, 31400 Toulouse, France;
| | - Célia Touraine
- Biometrics Unit, Montpellier Cancer Institute, University of Montpellier, 34000 Montpellier, France; (C.T.); (S.G.)
| | - Sophie Gourgou
- Biometrics Unit, Montpellier Cancer Institute, University of Montpellier, 34000 Montpellier, France; (C.T.); (S.G.)
| | - Bertrand Napoleon
- The Jean Mermoz private hospital, Ramsay Général de Santé, 69008 Lyon, France;
| | | | - Nicolas Flori
- The Gastroenterology Department, Montpellier Cancer Institute, University of Montpellier, 34000 Montpellier, France;
| | - Guillaume Piessen
- Department of Digestive and Oncological Surgery, Lille University Hospital, 59000 Lille, France;
- CANTHER laboratory “Cancer Heterogeneity, Plasticity and Resistance to Therapies” UMR-S1277 INSERM, Team “Mucins, Cancer and Drug Resistance”, 59000 Lille, France
| | | | - Stéphanie Truant
- Department of Digestive Surgery and Transplantations, Lille University Hospital, 59000 Lille, France;
| | - Eric Assenat
- The Saint Eloi Hospital, University Hospital, 34000 Montpellier, France;
| | - Louis Buscail
- INSERM U1037, The Toulouse Cancer Research Center, Toulouse University, 31100 Toulouse, France; (L.B.); (B.B.)
- The Gastroenterology and Pancreatology Department, Toulouse University Hospital, 31400 Toulouse, France;
| | - Barbara Bournet
- INSERM U1037, The Toulouse Cancer Research Center, Toulouse University, 31100 Toulouse, France; (L.B.); (B.B.)
- The Gastroenterology and Pancreatology Department, Toulouse University Hospital, 31400 Toulouse, France;
| | - Fabrice Muscari
- The Digestive Surgery and Liver Transplantation Department, Toulouse University Hospital, 31400 Toulouse, France;
- INSERM U1037, The Toulouse Cancer Research Center, Toulouse University, 31100 Toulouse, France; (L.B.); (B.B.)
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Dell'Aquila E, Fulgenzi CAM, Minelli A, Citarella F, Stellato M, Pantano F, Russano M, Cursano MC, Napolitano A, Zeppola T, Vincenzi B, Tonini G, Santini D. Prognostic and predictive factors in pancreatic cancer. Oncotarget 2020; 11:924-941. [PMID: 32206189 PMCID: PMC7075465 DOI: 10.18632/oncotarget.27518] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 02/17/2020] [Indexed: 12/13/2022] Open
Abstract
Pancreatic cancer is one of the leading causes of cancer death worldwide. Its high mortality rate has remained unchanged for years. Radiotherapy and surgery are considered standard treatments in early and locally advanced stages. Chemotherapy is the only option for metastatic patients. Two treatment regimens, i. e. the association of 5-fluorouracil- irinotecan-oxaliplatin (FOLFIRINOX) and the association of nab-paclitaxel with gemcitabine, have been shown to improve outcomes for metastatic pancreatic adenocarcinoma patients. However, there are not standardized predictive biomarkers able to identify patients who benefit most from treatments. CA19-9 is the most studied prognostic biomarker, its predictive role remains unclear. Other clinical, histological and molecular biomarkers are emerging in prognostic and predictive settings. The aim of this review is to provide an overview of prognostic and predictive markers used in clinical practice and to explore the most promising fields of research in terms of treatment selection and tailored therapy in pancreatic cancer.
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Affiliation(s)
| | | | - Alessandro Minelli
- Department of Medical Oncology, University Campus Bio-Medico, Rome 00128, Italy
| | - Fabrizio Citarella
- Department of Medical Oncology, University Campus Bio-Medico, Rome 00128, Italy
| | - Marco Stellato
- Department of Medical Oncology, University Campus Bio-Medico, Rome 00128, Italy
| | - Francesco Pantano
- Department of Medical Oncology, University Campus Bio-Medico, Rome 00128, Italy
| | - Marco Russano
- Department of Medical Oncology, University Campus Bio-Medico, Rome 00128, Italy
| | | | - Andrea Napolitano
- Department of Medical Oncology, University Campus Bio-Medico, Rome 00128, Italy
| | - Tea Zeppola
- Department of Medical Oncology, University Campus Bio-Medico, Rome 00128, Italy
| | - Bruno Vincenzi
- Department of Medical Oncology, University Campus Bio-Medico, Rome 00128, Italy
| | - Giuseppe Tonini
- Department of Medical Oncology, University Campus Bio-Medico, Rome 00128, Italy
| | - Daniele Santini
- Department of Medical Oncology, University Campus Bio-Medico, Rome 00128, Italy
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19
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Tai D, Choo SP, Chew V. Rationale of Immunotherapy in Hepatocellular Carcinoma and Its Potential Biomarkers. Cancers (Basel) 2019; 11:E1926. [PMID: 31816940 PMCID: PMC6966558 DOI: 10.3390/cancers11121926] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 11/27/2019] [Accepted: 11/29/2019] [Indexed: 12/24/2022] Open
Abstract
Hepatocellular carcinoma (HCC), the most common type of liver cancer, is derived mostly from a background of chronic inflammation. Multiple immunotherapeutic strategies have been evaluated in HCC, with some degree of success, particularly with immune checkpoint blockade (ICB). Despite the initial enthusiasm, treatment benefit is only appreciated in a modest proportion of patients (response rate to single agent ~20%). Therapy-induced immune-related adverse events (irAEs) and economic impact are pertinent considerations with ICB. It is imperative that a deeper understanding of its mechanisms of action either as monotherapy or in combination with other therapeutic agents is needed. We herein discuss the latest developments in the immunotherapeutic approaches for HCC, the potential predictive biomarkers., and the rationale for combination therapies. We also outline promising future immunotherapeutic strategies for HCC patients.
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Affiliation(s)
- David Tai
- National Cancer Centre, Singapore 169610, (NCCS), Singapore; (D.T.); (S.P.C.)
| | - Su Pin Choo
- National Cancer Centre, Singapore 169610, (NCCS), Singapore; (D.T.); (S.P.C.)
- Curie Oncology, Mount Elizabeth Novena Specialist Centre, Singapore 329563, Singapore
| | - Valerie Chew
- Translational Immunology Institute (TII), SingHealth-DukeNUS Academic Medical Centre, Singapore 169856, Singapore
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20
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Rosati G, Del Gaudio N, Scarano E, Cifarelli RA, Altucci L, Bilancia D. Unexpected and durable response with regorafenib in a metastatic colorectal cancer patient without KDR mutation: A case report. Medicine (Baltimore) 2018; 97:e11178. [PMID: 29924031 PMCID: PMC6023677 DOI: 10.1097/md.0000000000011178] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
RATIONALE Regorafenib is an oral multikinase inhibitor and is approved as salvage therapy in the standard treatment of advanced colorectal cancer (CRC). Due to its limited efficacy, toxicity profile, and cost, it is necessary to identify those patients who may have the most benefit from regorafenib. In a previous case report, kinase insert domain receptor (KDR) mutation has been associated with exceptional clinical response (CR) in an elderly patient treated with a low dose of regorafenib; thus, it was hypothesized that it could represent a new predictive marker of drug response. PATIENT CONCERNS A heavily pretreated 67-year-old man with a wide peripancreatic recurrence of colon carcinoma and liver metastases was subjected to treatment with regorafenib. DIAGNOSES After 3 months of therapy, a computed tomography scan showed an impressive reduction of disease. INTERVENTIONS Regorafenib was given at full doses (160 mg/die for 21 days, every 4 weeks). OUTCOMES A lasting response without relevant toxicity. No KDR mutation relief was detected. After 13 months from the start of treatment, the patient died after the diagnosis of encephalic metastases. LESSONS Regorafenib can lead to an unexpected and durable CR with consistent progression-free survival and overall survival benefit even in patients affected by polychemotherapy refractory metastatic CRC. Further studies are needed to establish the benefit of KDR mutation as predictive marker for regorafenib sensitivity for patients with CRC. We include a detailed revision of prognostic and predictive factors of clinical outcome identified in literature to optimize the use of regorafenib in this setting.
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Affiliation(s)
| | - Nunzio Del Gaudio
- Department of Biochemistry, Biophysics and General Pathology, University of Campania “Luigi Vanvitelli”, Napoli
| | | | | | - Lucia Altucci
- Department of Biochemistry, Biophysics and General Pathology, University of Campania “Luigi Vanvitelli”, Napoli
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21
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Gao S, Wu M, Chen Y, Lou W, Zhou G, Li J, Yu T, Zhou Y, Liu L, Wang X. Lactic dehydrogenase to albumin ratio in prediction of unresectable pancreatic cancer with intervention chemotherapy. Future Oncol 2018; 14:1377-1386. [PMID: 29848124 DOI: 10.2217/fon-2017-0556] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
AIM To validate the prognostic value of lactic dehydrogenase to albumin ratio (LAR) in patients with unresectable pancreatic cancer treated by intervention chemotherapy. MATERIALS & METHODS There were 139 patients retrospectively analyzed in this study. The survival was depicted with Kaplan-Meier curves and calculated by log-rank test. We used Cox proportional hazards regression model with univariate and multivariate analyses, and integrated all independent risk factors to establish the nomogram. RESULTS Patient with higher LAR group had poorer overall survival (OS). The Tumor, Node, Metastasis stage, carcinoembryonic antigen and LAR have been shown to be independent prognostic indicators for OS. The nomogram indicated superior predictive accuracy for OS. CONCLUSION The preoperative LAR can be a prognostic indicator for unresectable pancreatic cancer patients with interventional therapy.
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Affiliation(s)
- Shanshan Gao
- Shanghai Institute of Medical Imaging, Shanghai 200032, PR China.,Department of Interventional Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, PR China
| | - Mengfei Wu
- Department of Interventional Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, PR China
| | - Yi Chen
- Shanghai Institute of Medical Imaging, Shanghai 200032, PR China.,Department of Interventional Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, PR China
| | - Wenhui Lou
- Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, PR China
| | - Guofeng Zhou
- Shanghai Institute of Medical Imaging, Shanghai 200032, PR China.,Department of Interventional Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, PR China
| | - Junhao Li
- Shanghai Institute of Medical Imaging, Shanghai 200032, PR China.,Department of Interventional Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, PR China
| | - Tianzhu Yu
- Department of Interventional Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, PR China
| | - Yang Zhou
- Shanghai Institute of Medical Imaging, Shanghai 200032, PR China.,Department of Interventional Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, PR China
| | - Lingxiao Liu
- Shanghai Institute of Medical Imaging, Shanghai 200032, PR China.,Department of Interventional Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, PR China
| | - Xiaolin Wang
- Shanghai Institute of Medical Imaging, Shanghai 200032, PR China.,Department of Interventional Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, PR China
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22
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Wang Y, Xiao X, Wang T, Li L, Zhu Y, Xu H, Chu Y, Jiao F, Cui J, Wang L. A Survival Model in Locally Advanced and Metastatic Pancreatic Ductal Adenocarcinoma. J Cancer 2018; 9:1301-1307. [PMID: 29675111 PMCID: PMC5907678 DOI: 10.7150/jca.23984] [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: 11/23/2017] [Accepted: 02/28/2018] [Indexed: 12/13/2022] Open
Abstract
The prognostic role of serum LDH, CA19-9, CRP and ALB in PDAC patients are controversial. In contrast to single factor, there is much less information about the prognostic value of the combination of the four factors in locally advanced and metastatic PDAC patients. It's essential to set up a survival model with the combination of tumor metabolism, tumor biomarker, systemic inflammation and nutritional status to eliminate the prognostic inaccuracy in single biomarker. 94 advanced PDAC patients who received palliative chemotherapy from 2009 to 2017 were recruited for this study. The predictive value of pretreatment serum LDH, CA19-9, CRP and ALB levels for OS were evaluated, and the same as combination of the four factors. It was confirmed that serum LDH, CA19-9, CRP and ALB levels were independent prognostic factors for OS by multivariate analyses. The results of Kaplan-Meier analyses revealed that serum LDH, CA19-9, CRP, ALB levels as well as the combination of the four factors were correlated with OS. It's concluded that the combination of the pretreatment serum LDH, CA19-9, CRP and ALB levels is a prognostic factor for advanced PDAC patients.
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Affiliation(s)
- Yi Wang
- Department of Oncology, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai Cancer Institute, Shanghai, China, 200127.,Department of Oncology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine (originally named "Shanghai First People's Hospital"), Shanghai, China, 201620
| | - Xiuying Xiao
- Department of Oncology, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai Cancer Institute, Shanghai, China, 200127
| | - Tianyi Wang
- Department of Oncology, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai Cancer Institute, Shanghai, China, 200127
| | - Lin Li
- Department of Oncology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine (originally named "Shanghai First People's Hospital"), Shanghai, China, 201620
| | - Yue Zhu
- Department of Oncology, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai Cancer Institute, Shanghai, China, 200127
| | - Haiyan Xu
- Department of Oncology, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai Cancer Institute, Shanghai, China, 200127
| | - Yuening Chu
- Department of Oncology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine (originally named "Shanghai First People's Hospital"), Shanghai, China, 201620
| | - Feng Jiao
- Department of Oncology, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai Cancer Institute, Shanghai, China, 200127
| | - Jiujie Cui
- Department of Oncology, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai Cancer Institute, Shanghai, China, 200127
| | - Liwei Wang
- Department of Oncology, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai Cancer Institute, Shanghai, China, 200127
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23
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Ulivi P, Marisi G, Passardi A. Relationship between hypoxia and response to antiangiogenic therapy in metastatic colorectal cancer. Oncotarget 2018; 7:46678-46691. [PMID: 27081084 PMCID: PMC5216829 DOI: 10.18632/oncotarget.8712] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 03/31/2016] [Indexed: 12/22/2022] Open
Abstract
Colorectal cancer remains a major public health problem worldwide. Despite the introduction of antiangiogenic drugs for the treatment of metastatic disease, a large number of issues remains unresolved. In particular, studies on predictive biomarkers of response and pathways of resistance to these agents are lacking, making it difficult to accurately select candidates for treatment. Hypoxia is the prime driving force for tumor angiogenesis and a vicious cycle between hypoxia and angiogenesis can be observed in tumors. Anti-angiogenic drugs act inhibiting tumor vasculature and, as consequence, inducing hypoxia. However, hypoxia could, in turn, induce an increase of metastatic potential of cells and a series of phenomena that could induce drug resistance. In the present review biological mechanisms of hypoxia and its relation with angiogenesis, and resistance to antiangiogenic therapy will be discussed. Moreover, data from clinical trials on antiangiogenic drugs in metastatic colorectal cancer will be reviewed, and the role of hypoxia in monitoring the response to treatment will be analysed. Combination strategies using anti-angiogenic and hypoxia inhibiting drugs are also discussed as they constitute promising field of research.
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Affiliation(s)
- Paola Ulivi
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Giorgia Marisi
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Alessandro Passardi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
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24
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Liu X, Zhang W, Yin W, Xiao Y, Zhou C, Hu Y, Geng S. The prognostic value of the serum neuron specific enolase and lactate dehydrogenase in small cell lung cancer patients receiving first-line platinum-based chemotherapy. Medicine (Baltimore) 2017; 96:e8258. [PMID: 29145241 PMCID: PMC5704786 DOI: 10.1097/md.0000000000008258] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The aim of this study was to investigate the associations of serum levels of neuron-specific enolase (NSE), pro-gastrin releasing peptide (ProGRP), and lactate dehydrogenase (LDH) with clinical response and survival in small cell lung cancer (SCLC) patients receiving first-line platinum-based chemotherapy.One hundred thirty-six patients with SCLC were recruited in this study. All the patients received first-line platinum-based chemotherapy. Clinical efficacy was assessed according to Response Evaluation Criteria in Solid Tumors v1.1 criteria. Serum samples were collected from SCLC patients before chemotherapy. NSE, ProGRP, and LDH levels were measured by commercial electrochemiluminescence immunoassay, enzyme-linked immune sorbent assay, and kinetic spectrophotometric method, respectively.Overall response rate was 71.3% with 97 patients who achieved complete response (CR) + partial response (PR). NSE and LDH level declined in patients who achieved CR + PR compared with patients in stable disease (SD) and progress disease (PD). Multivariate logistic regression analysis revealed that NSE > 50.324 ng/mL, stage ED, and distant metastases were independent risk factors for patients achieving CR + PR, and chemotherapy > 4 cycles was an independent protective factor in predicting CR + PR. Receiver operating characteristic (ROC) curves presented that expression of NSE, ProGRP, and LDH are of good predicting value for patients achieving CR + PR. Patients with a higher level of NSE and LDH presented worse progression-free survival and overall survival. In addition, multivariate Cox regression analysis showed that NSE level > 50.324 ng/mL and distant metastasis were independently correlated with worse OS.Serum NSE and LDH could be promising biomarkers for predicting therapy response and survival of SCLC patients receiving first-line platinum-based chemotherapy.
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25
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First-line FOLFIRI and bevacizumab in patients with advanced colorectal cancer prospectively stratified according to serum LDH: final results of the GISCAD (Italian Group for the Study of Digestive Tract Cancers) CENTRAL (ColorEctalavastiNTRiAlLdh) trial. Br J Cancer 2017; 117:1099-1104. [PMID: 28926529 PMCID: PMC5674092 DOI: 10.1038/bjc.2017.234] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 06/12/2017] [Accepted: 06/28/2017] [Indexed: 12/27/2022] Open
Abstract
Background: Previous findings suggested that bevacizumab might be able to improve response rate (RR) in colorectal cancer patients with high lactic dehydrogenase (LDH) basal levels. Methods: We conducted a phase II trial to prospectively ascertain whether bevacizumab in combination with FOLFIRI could have an improved clinical activity in patients with high LDH serum levels. Primary end point of the study was RR; secondary end points were median overall survival and median progression-free survival (mPFS). Results: A total of 81 patients were enrolled. No difference in terms of ORR (39% vs 31% for low vs high LDH level stratum, P=0.78) and mPFS (14.16 vs 10.29 months, HR: 1.07, 95% CI: 0.51–2.24, P=0.83) between the strata was observed, whereas overall survival (OS) was significantly longer for patients with low LDH (24.85 vs 15.14 months, HR: 4.08, 95% CI: 1.14–14.61, P=0.0004). In a not-pre-planned exploratory analysis using different cut-off ranges for LDH, we observed RR up to 70%, with no improvement in progression-free survival or OS. Conclusions: The CENTRAL trial failed to demonstrate that high LDH levels were related to a significantly improved RR in patients receiving first-line FOLFIRI and bevacizumab. The LDH serum levels should then no further be investigated as a predictive factor in this setting.
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26
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Liu L, He Y, Ge G, Li L, Zhou P, Zhu Y, Tang H, Huang Y, Li W, Zhang L. Lactate dehydrogenase and creatine kinase as poor prognostic factors in lung cancer: A retrospective observational study. PLoS One 2017; 12:e0182168. [PMID: 28767733 PMCID: PMC5540491 DOI: 10.1371/journal.pone.0182168] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 07/13/2017] [Indexed: 02/05/2023] Open
Abstract
PURPOSE Circulating molecules play important roles in lung cancer diagnosis. In addition, plasma lactate dehydrogenase (LDH) and creatine kinase (CK) have been shown to be closely related to tumor progression in breast cancer, prostate cancer, and colonel cancer. However, the relationships between LDH and CK levels with metastasis occurrence and the survival status of lung cancer patients remain unclear. EXPERIMENTAL DESIGN A total of 1142 lung cancer patients were enrolled in this study and were separated into negative or positive groups, according to the plasma levels of CK or LDH. Patients in both groups were assessed for clinical characteristics, metastasis occurrence, and survival status. The Cox regression model was then introduced to confirm whether CK and LDH could act as independent factors for predicting a poor prognosis. RESULTS The results indicated that CK had a close relationship with bone (p < 0.05) and lymph node (p < 0.05) metastases. In addition, LDH was strongly related with bone (p < 0.05), adrenal gland (p < 0.05), and lymph node (p < 0.05) metastases. CK and LDH were also correlated with the survival status of the lung cancer patients (all p < 0.001). According to specific histological classification analysis, it was found that CK was closely related to the survival status of adenocarcinoma (ADC) and squamous cell carcinoma (SCC) patients, while LDH was only correlated with that of ADC patients. Cox regression analysis confirmed that CK and LDH could act as independent factors for predicting a poor prognosis in ADC but not SCC patients. CONCLUSIONS For the first time, our study confirmed the role of CK in metastasis occurrence and the survival status of lung cancer patients. In addition, it also demonstrated that CK and LDH could be used as independent factors to predict a poor prognosis in ADC patients. The identification of CK and LDH will play important roles in lung cancer diagnosis and poor outcome prediction in the future.
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Affiliation(s)
- Lei Liu
- Laboratory of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- Key Laboratory of Transplantation Engineering and Immunology, Ministry of Health, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Ying He
- West China Medical School, Sichan University, Cheng Du, Sichuan Province, China
| | - Ge Ge
- West China Medical School, Sichan University, Cheng Du, Sichuan Province, China
| | - Lei Li
- Department of Respiratory, West China Hospital, Sichuan University, Cheng Du, Sichuan Province, China
| | - Ping Zhou
- Department of Respiratory, West China Hospital, Sichuan University, Cheng Du, Sichuan Province, China
| | - Yihan Zhu
- Laboratory of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- Key Laboratory of Transplantation Engineering and Immunology, Ministry of Health, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Huairong Tang
- Health Management Center, West China Hospital, Sichuan University, Cheng Du, China
| | - Yan Huang
- Health Management Center, West China Hospital, Sichuan University, Cheng Du, China
| | - Weimin Li
- Department of Respiratory, West China Hospital, Sichuan University, Cheng Du, Sichuan Province, China
- * E-mail: (ZL); (WL)
| | - Li Zhang
- Laboratory of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- Key Laboratory of Transplantation Engineering and Immunology, Ministry of Health, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- * E-mail: (ZL); (WL)
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27
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Zheng C, Wu Z, Tian L, Li D, Wang X, He Y, He Y, Jin W, Li M, Zhu Q, Shang T, Zhang H. Long Noncoding RNA AK12348 is Involved in the Regulation of Myocardial Ischaemia-Reperfusion Injury by Targeting PARP and Caspase-3. Heart Lung Circ 2017; 27:e51-e58. [PMID: 29398472 DOI: 10.1016/j.hlc.2017.04.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 04/11/2017] [Accepted: 04/15/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUD Recently long non-coding RNAs (lncRNAs) have attracted attention in several biomedical fields. The purpose of this study is to investigate the profile of myocardial lncRNAs and their potential roles in myocardial ischaemia-reperfusion injury (IRI). METHODS EdgeR bioconductor package was used to screen differentially expressed lncRNAs in myocardial IRI, and lncRNA AK12348 was selected. The mRNA levels of lncRNA AK12348 in normal and anoxia/reoxygenation (A/R) cardiomyocytes were determined by qRT-PCR. After transfection with siRNA-lncRNA, AK12348, LDH release and cell apoptotic rates in normal and A/R cardiomyocytes were determined. The protein expression values of PARP and Caspase-3 were also determined by western blotting. RESULTS The relative level of lncRNA AK12348, LDH release and cell apoptotic rate in A/R cardiomyocytes was significantly higher than that in normal cardiomyocytes. After transfection with siRNA-lncRNA AK12348, LDH release and cell apoptotic rates in A/R cardiomyocytes were reduced, while the values in normal cardiomyocytes had almost no change. The protein expression values of PARP and Caspase-3 in A/R cardiomyocytes were much higher than the Control. After knockdown of lncRNA AK12348, the values decreased. CONCLUSION Long non-coding RNAs AK12348 could be potential therapeutic targets for the treatment of myocardial IRI.
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Affiliation(s)
- Chengfei Zheng
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ziheng Wu
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lu Tian
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Donglin Li
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaohui Wang
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yunjun He
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yangyan He
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Wei Jin
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ming Li
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Qianqian Zhu
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Tao Shang
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Hongkun Zhang
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
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28
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Serum lactate dehydrogenase predicts prognosis and correlates with systemic inflammatory response in patients with advanced pancreatic cancer after gemcitabine-based chemotherapy. Sci Rep 2017; 7:45194. [PMID: 28345594 PMCID: PMC5366928 DOI: 10.1038/srep45194] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 02/20/2017] [Indexed: 12/21/2022] Open
Abstract
Serum lactate dehydrogenase (LDH) concentrations correlate with tumor progression and poor outcome. We evaluated the predictive value of serum LDH level for overall survival (OS) of patients with advanced pancreatic cancer after gemcitabine-based chemotherapy. We retrospectively enrolled 364 patients with locally advanced or metastatic pancreatic adenocarcinoma who were then allocated to training (n = 139) and validation cohorts (n = 225). We evaluated the association between serum LDH levels and OS as well as with markers of systemic inflammation, including neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and lymphocyte/monocyte ratio (LMR). Kaplan–Meier analyses revealed that low serum LDH levels in the training cohort significantly correlated with longer OS. Multivariate analysis identified the serum LDH levels as an independent prognostic predictor of OS (p = 0.005). Serum LDH levels correlated positively with NLR and PLR and correlated negatively with LMR. Similar results were obtained for the validation cohort, except that multivariate analysis identified the serum LDH level as a significant prognostic predictor and only a statistical trend for OS (p = 0.059). We conclude that serum LDH levels were associated with the systemic inflammatory response and served as a significant prognostic predictor of OS. Serum LDH levels predicted OS in patients with advanced pancreatic cancer after gemcitabine-based palliative chemotherapy.
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Martinez-Useros J, Li W, Cabeza-Morales M, Garcia-Foncillas J. Oxidative Stress: A New Target for Pancreatic Cancer Prognosis and Treatment. J Clin Med 2017; 6:jcm6030029. [PMID: 28282928 PMCID: PMC5372998 DOI: 10.3390/jcm6030029] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 02/15/2017] [Accepted: 03/06/2017] [Indexed: 01/17/2023] Open
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal types of tumors, and its incidence is rising worldwide. Survival can be improved when tumors are detected at an early stage; however, this cancer is usually asymptomatic, and the disease only becomes apparent after metastasis. Several risk factors are associated to this disease. Chronic pancreatitis, diabetes, and some infectious disease are the most relevant risk factors. Incidence of PDAC has increased in the last decades. It is hypothesized it could be due to other acquired risk habits, like smoking, high alcohol intake, and obesity. Indeed, adipose tissue is a dynamic endocrine organ that secretes different pro-inflammatory cytokines, enzymes, and other factors that activate oxidative stress. Reactive oxygen species caused by oxidative stress, damage DNA, proteins, and lipids, and produce several toxic and high mutagenic metabolites that could modify tumor behavior, turning it into a malignant phenotype. Anti-oxidant compounds, like vitamins, are considered protective factors against cancer. Here, we review the literature on oxidative stress, the molecular pathways that activate or counteract oxidative stress, and potential treatment strategies that target reactive oxygen species suitable for this kind of cancer.
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Affiliation(s)
- Javier Martinez-Useros
- Translational Oncology Division, OncoHealth Institute, Health Research Institute, University Hospital Fundación Jiménez Díaz-UAM, 28040 Madrid, Spain.
| | - Weiyao Li
- Translational Oncology Division, OncoHealth Institute, Health Research Institute, University Hospital Fundación Jiménez Díaz-UAM, 28040 Madrid, Spain.
| | | | - Jesus Garcia-Foncillas
- Translational Oncology Division, OncoHealth Institute, Health Research Institute, University Hospital Fundación Jiménez Díaz-UAM, 28040 Madrid, Spain.
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Zhang X, Guo M, Fan J, Lv Z, Huang Q, Han J, Wu F, Hu G, Xu J, Jin Y. Prognostic significance of serum LDH in small cell lung cancer: A systematic review with meta-analysis. Cancer Biomark 2016; 16:415-23. [PMID: 27062698 DOI: 10.3233/cbm-160580] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Lactare dehydrogenase (LDH) has been proven to be a prognostic and a potential pro-tumor factor in patients with lung cancer. But the prognostic value of serum LDH in small cell lung cancer (SCLC) has not been quantified systematically. OBJECTIVE Thus, this study was to evaluate the correlations between serum LDH and overall survival of SLCLC by systematic review with meta-analysis. METHODS PubMed, EMBASE, Cochrane Library, Web of Science databases were searched from inception to October 2014 and references in those publications would be included if the association between serum LDH and overall survival of SCLC can be derived. Quality assessment and data extraction were performed in the articles selected according to inclusion and exclusion criteria. RESULTS Twenty-eight studies including 4785 patients with SCLC were deemed eligible. Pooled results showed that SCLC patients with elevated LDH levels were associated with an increased hazard ratio (HR 1.45, 95%CI 1.27∼ 1.66) of overall survival. CONCLUSIONS The study suggests significant correlations between elevated serum LDH levels and poor overall survival in patients with SCLC. And serum LDH levels can be measured combining with other tools for assessing the risk stratification and prognosis of SCLC, which shows directions for treatments of SCLC.
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Affiliation(s)
- Xiuxiu Zhang
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Jining No.1 People's Hospital, Jining, Shandong, China
| | - Mengfei Guo
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jinshuo Fan
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhilei Lv
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qi Huang
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jieli Han
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Feng Wu
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Guorong Hu
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Juanjuan Xu
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yang Jin
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Li S, Yang Q, Wang H, Wang Z, Zuo D, Cai Z, Hua Y. Prognostic significance of serum lactate dehydrogenase levels in Ewing's sarcoma: A meta-analysis. Mol Clin Oncol 2016; 5:832-838. [PMID: 28105365 DOI: 10.3892/mco.2016.1066] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 08/12/2016] [Indexed: 11/05/2022] Open
Abstract
A number of studies have investigated the role of serum lactate dehydrogenase (LDH) levels in patients with Ewing's sarcoma, although these have yielded inconsistent and inconclusive results. Therefore, the present study aimed to systematically review the published studies and conduct a meta-analysis to assess its prognostic value more precisely. Cohort studies assessing the prognostic role of LDH levels in patients with Ewing's sarcoma were included. A pooled hazard ratio (HR) with 95% confidence intervals (CIs) of overall survival (OS) or 5-year disease-free survival (DFS) was used to assess the prognostic role of the levels of serum LDH. Nine studies published between 1980 and 2014, with a total of 1,412 patients with Ewing's sarcoma, were included. Six studies, with a total of 644 patients, used OS as the primary endpoint and four studies, with 795 patients, used 5-year DFS. Overall, the pooled HR evaluating high LDH levels was 2.90 (95% CI: 2.09-4.04) for OS and 2.40 (95% CI: 1.93-2.98) for 5-year DFS. This meta-analysis demonstrates that high levels of serum LDH are associated with lower OS and 5-year DFS rates in patients with Ewing's sarcoma. Therefore, serum LDH levels are an effective biomarker of Ewing's sarcoma prognosis.
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Affiliation(s)
- Suoyuan Li
- Department of Orthopedics, Shanghai General Hospital, Nanjing Medical University, Shanghai, P.R. China
| | - Qing Yang
- Department of Orthopedics, Fudan University-Affiliated Zhongshan Hospital, Qingpu Branch, Shanghai, P.R. China
| | - Hongsheng Wang
- Department of Orthopedics, Shanghai 10th People's Hospital, School of Medicine Tongji University, Shanghai, P.R. China
| | - Zhuoying Wang
- Department of Orthopedics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
| | - Dongqing Zuo
- Department of Orthopedics, Shanghai 10th People's Hospital, School of Medicine Tongji University, Shanghai, P.R. China
| | - Zhengdong Cai
- Department of Orthopedics, Shanghai General Hospital, Nanjing Medical University, Shanghai, P.R. China
| | - Yingqi Hua
- Department of Orthopedics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
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Park I, Choi SJ, Kim YS, Ahn HK, Hong J, Sym SJ, Park J, Cho EK, Lee JH, Shin YJ, Shin DB. Prognostic Factors for Risk Stratification of Patients with Recurrent or Metastatic Pancreatic Adenocarcinoma Who Were Treated with Gemcitabine-Based Chemotherapy. Cancer Res Treat 2016; 48:1264-1273. [PMID: 27034148 PMCID: PMC5080812 DOI: 10.4143/crt.2015.250] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 03/14/2016] [Indexed: 01/05/2023] Open
Abstract
PURPOSE The aim of this study was to verify prognostic factors including sarcopenia in patients with recurrent or metastatic pancreatic cancer receiving gemcitabine-based chemotherapy. MATERIALS AND METHODS Medical records and computed tomography scan of consecutive patients treated with palliative gemcitabine-based chemotherapy from 2008 to 2014 were reviewed. The lumbar skeletal muscle index at third lumbar spine level was computed, and together with clinicolaboratory factors, univariate and multivariable analyses for overall survival (OS) were performed. RESULTS A total of 88 patients were found. Median age was 65 years, and male patients were predominant (67.0%). Most patients had initially metastatic disease (72.7%), and gemcitabine monotherapy was administered in 29 patients (33.0%) while gemcitabine plus erlotinib was administered in 59 patients (67.0%). Seventy-six patients (86.3%) had sarcopenia. With a median follow-up period of 44.3 months (range, 0.6 to 44.3 months), median OS was 5.35 months (95% confidence interval [CI], 4.11 to 6.59). In univariate and multivariable analysis, high carcinoembryonic antigen level (hazard ratio [HR], 4.18; 95% CI, 1.95 to 8.97; p < 0.001), initially metastatic disease (HR, 3.37; 95% CI, 1.55 to 7.32; p=0.002), sarcopenia (HR, 2.97; 95% CI, 1.20 to 7.36; p=0.019), neutrophilia (HR, 2.94; 95% CI, 1.27 to 6.79; p=0.012), and high lactate dehydrogenase level (HR, 1.96; 95% CI, 1.07 to 3.58; p=0.029) were identified as independent prognostic factors for OS. CONCLUSION Five independent prognostic factors in patients with recurrent or metastatic pancreatic cancer who received gemcitabine-based chemotherapy were identified. These findings may be helpful in prediction of prognosis in clinical practice and can be used as a stratification factor for clinical trials.
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Affiliation(s)
- Inkeun Park
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Seung Joon Choi
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Korea
| | - Young Saing Kim
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Hee Kyung Ahn
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Junshik Hong
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Sun Jin Sym
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Jinny Park
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Eun Kyung Cho
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Jae Hoon Lee
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Yong Ju Shin
- Department of Preventive Medicine, Gachon University College of Medicine, Incheon, Korea
| | - Dong Bok Shin
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
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Zhang Y, Xu T, Wang Y, Zhang H, Zhao Y, Yang X, Cao Y, Yang W, Niu H. Prognostic Role of Lactate Dehydrogenase Expression in Urologic Cancers: A Systematic Review and Meta-Analysis. Oncol Res Treat 2016; 39:592-604. [DOI: 10.1159/000449138] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 08/08/2016] [Indexed: 11/19/2022]
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Del Prete M, Giampieri R, Loupakis F, Prochilo T, Salvatore L, Faloppi L, Bianconi M, Bittoni A, Aprile G, Zaniboni A, Falcone A, Scartozzi M, Cascinu S. Prognostic clinical factors in pretreated colorectal cancer patients receiving regorafenib: implications for clinical management. Oncotarget 2016; 6:33982-92. [PMID: 26334693 PMCID: PMC4741819 DOI: 10.18632/oncotarget.5053] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 08/04/2015] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND We assessed the impact on survival of angiogenesis and inflammation-related factors, particularly LDH serum levels, platelet, neutrophil and lymphocyte counts, and neutrophil-to-lymphocyte ratio (NLR), in metastatic colorectal cancer patients receiving regorafenib monotherapy. METHODS LDH serum levels, neutrophil, lymphocyte and platelet counts were collected at the start of regorafenib monotherapy. Cut-off values were calculated by ROC curve analysis. Survival analyses were performed by Kaplan-Meier method, and multivariate analysis by Cox method. RESULTS A total of 208 patients were eligible for analysis. Among factors who were related with worse overall survival and who maintained their role at the multivariate analysis, high platelet count (Exp(b):1.4963, 95% CI:1.0130-2.2103, p = 0.0439) and high neutrophil/lymphocyte ratio (Exp(b):1.6963, 95% CI:1.0757-2.6751, p = 0.0237) were those who more deeply were related to worse overall survival. High lymphocyte count (Exp(b):0.4527, 95% CI:0.2801-0.7316, p = 0.0013) was correlated with improved overall survival. CONCLUSIONS High neutrophil, high platelet, low lymphocyte count and/or high NLR may represent negative prognostic factors in patients receiving regorafenib monotherapy. It is advisable that these factors are taken into account in the design of subsequent trials in colorectal cancer patients receiving this drug.
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Affiliation(s)
- Michela Del Prete
- Medical Oncology, AO Ospedali Riuniti-Università Politecnica delle Marche, Ancona, Italy
| | - Riccardo Giampieri
- Medical Oncology, AO Ospedali Riuniti-Università Politecnica delle Marche, Ancona, Italy
| | - Fotios Loupakis
- Medical Oncology, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | | | - Lisa Salvatore
- Medical Oncology, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Luca Faloppi
- Medical Oncology, AO Ospedali Riuniti-Università Politecnica delle Marche, Ancona, Italy
| | - Maristella Bianconi
- Medical Oncology, AO Ospedali Riuniti-Università Politecnica delle Marche, Ancona, Italy
| | - Alessandro Bittoni
- Medical Oncology, AO Ospedali Riuniti-Università Politecnica delle Marche, Ancona, Italy
| | - Giuseppe Aprile
- Medical Oncology, Azienda Ospedaliero-Universitaria "S. Maria della Misericordia", Udine, Italy
| | | | - Alfredo Falcone
- Medical Oncology, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Mario Scartozzi
- Medical Oncology, Azienda Ospedaliero-Universitaria di Cagliari, Monserrato, Cagliari, Italy
| | - Stefano Cascinu
- Medical Oncology, AO Ospedali Riuniti-Università Politecnica delle Marche, Ancona, Italy
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Gill KS, Fernandes P, O'Donovan TR, McKenna SL, Doddakula KK, Power DG, Soden DM, Forde PF. Glycolysis inhibition as a cancer treatment and its role in an anti-tumour immune response. Biochim Biophys Acta Rev Cancer 2016; 1866:87-105. [PMID: 27373814 DOI: 10.1016/j.bbcan.2016.06.005] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 06/29/2016] [Accepted: 06/30/2016] [Indexed: 12/23/2022]
Abstract
Increased glycolysis is the main source of energy supply in cancer cells that use this metabolic pathway for ATP generation. Altered energy metabolism is a biochemical fingerprint of cancer cells that represents one of the "hallmarks of cancer". The immune system can prevent tumour growth by eliminating cancer cells but this editing process ultimately results in poorly immunogenic cells remaining allowing for unchallenged tumour growth. In this review we look at the glycolysis pathway as a target for cancer treatments. We also examine the interplay between the glycolysis modulation and the immune response as an anti-cancer therapy.
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Affiliation(s)
- Kheshwant S Gill
- Cork Cancer Research Centre, Western Gateway Building, University College Cork, Cork, Ireland; Cardiothoracic Surgery Department, Cork University Hospital, Cork, Ireland
| | - Philana Fernandes
- Cork Cancer Research Centre, Western Gateway Building, University College Cork, Cork, Ireland
| | - Tracey R O'Donovan
- Cork Cancer Research Centre, Western Gateway Building, University College Cork, Cork, Ireland
| | - Sharon L McKenna
- Cork Cancer Research Centre, Western Gateway Building, University College Cork, Cork, Ireland
| | | | - Derek G Power
- Cork Cancer Research Centre, Western Gateway Building, University College Cork, Cork, Ireland; Department of Medical Oncology, Mercy University Hospital, Grenville Place, Cork, Ireland
| | - Declan M Soden
- Cork Cancer Research Centre, Western Gateway Building, University College Cork, Cork, Ireland
| | - Patrick F Forde
- Cork Cancer Research Centre, Western Gateway Building, University College Cork, Cork, Ireland.
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Hu KY, Wang DG, Liu PF, Cao YW, Wang YH, Yang XC, Hu CX, Sun LJ, Niu HT. Targeting of MCT1 and PFKFB3 influences cell proliferation and apoptosis in bladder cancer by altering the tumor microenvironment. Oncol Rep 2016; 36:945-51. [DOI: 10.3892/or.2016.4884] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 02/26/2016] [Indexed: 11/06/2022] Open
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Faloppi L, Del Prete M, Casadei Gardini A, Santini D, Silvestris N, Bianconi M, Giampieri R, Valgiusti M, Brunetti O, Bittoni A, Andrikou K, Lai E, Dessì A, Cascinu S, Scartozzi M. The correlation between LDH serum levels and clinical outcome in advanced biliary tract cancer patients treated with first line chemotherapy. Sci Rep 2016; 6:24136. [PMID: 27063994 PMCID: PMC4827080 DOI: 10.1038/srep24136] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 03/21/2016] [Indexed: 12/16/2022] Open
Abstract
LDH may represent an indirect marker of neo-angiogenesis and worse prognosis in many tumour types. We assessed the correlation between LDH and clinical outcome for biliary tract cancer (BTC) patients treated with first-line chemotherapy. Overall, 114 advanced BTC patients treated with first-line gemcitabine and cisplatin were included. Patients were divided into two groups (low vs. high LDH), according to pre-treatment LDH values. Patients were also classified according to pre- and post-treatment variation in LDH serum levels (increased vs. decreased). Median progression free survival (PFS) was 5.0 and 2.6 months respectively in patients with low and high pre-treatment LDH levels (p = 0.0042, HR = 0.56, 95% CI: 0.37–0.87). Median overall survival (OS) was 7.7 and 5.6 months (low vs. high LDH) (p = 0.324, HR = 0.81, 95% CI: 0.54–1.24). DCR was 71% vs. 43% (low vs. high LDH) (p = 0.002). In 38 patients with decreased LDH values after treatment, PFS and OS were respectively 6.2 and 12.1 months, whereas in 76 patients with post-treatment increased LDH levels, PFS and OS were respectively 3.0 and 5.1 months (PFS: p = 0.0009; HR = 0.49; 95% IC: 0.33–0.74; OS: p < 0.0001; HR = 0.42; 95% IC: 0.27–0.63). Our data seem to suggest that LDH serum level may predict clinical outcome in BTC patients receiving first-line chemotherapy.
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Affiliation(s)
- Luca Faloppi
- Department of Medical Oncology, AOU "Ospedali Riuniti" - Università Politecnica delle Marche, Ancona, Italy.,Medical Oncology, University Hospital, University of Cagliari, Cagliari, Italy
| | - Michela Del Prete
- Department of Medical Oncology, AOU "Ospedali Riuniti" - Università Politecnica delle Marche, Ancona, Italy
| | - Andrea Casadei Gardini
- IRCCS, Istituto Scientifico Romagnolo per lo Studio e la cura dei Tumori, Meldola, Italy
| | - Daniele Santini
- Department of Medical Oncology, Campus Bio-Medico University of Rome, Roma, Italy
| | - Nicola Silvestris
- Medical Oncology Unit, Cancer Institute "Giovanni Paolo II", Bari, Italy
| | - Maristella Bianconi
- Department of Medical Oncology, AOU "Ospedali Riuniti" - Università Politecnica delle Marche, Ancona, Italy
| | - Riccardo Giampieri
- Department of Medical Oncology, AOU "Ospedali Riuniti" - Università Politecnica delle Marche, Ancona, Italy
| | - Martina Valgiusti
- IRCCS, Istituto Scientifico Romagnolo per lo Studio e la cura dei Tumori, Meldola, Italy
| | - Oronzo Brunetti
- Medical Oncology Unit, Cancer Institute "Giovanni Paolo II", Bari, Italy
| | - Alessandro Bittoni
- Department of Medical Oncology, AOU "Ospedali Riuniti" - Università Politecnica delle Marche, Ancona, Italy
| | - Kalliopi Andrikou
- Department of Medical Oncology, AOU "Ospedali Riuniti" - Università Politecnica delle Marche, Ancona, Italy
| | - Eleonora Lai
- Medical Oncology, University Hospital, University of Cagliari, Cagliari, Italy
| | - Alessandra Dessì
- Medical Oncology, University Hospital, University of Cagliari, Cagliari, Italy
| | - Stefano Cascinu
- Department of Medical Oncology, AOU "Ospedali Riuniti" - Università Politecnica delle Marche, Ancona, Italy
| | - Mario Scartozzi
- Medical Oncology, University Hospital, University of Cagliari, Cagliari, Italy
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Wulaningsih W, Holmberg L, Garmo H, Malmstrom H, Lambe M, Hammar N, Walldius G, Jungner I, Ng T, Van Hemelrijck M. Serum lactate dehydrogenase and survival following cancer diagnosis. Br J Cancer 2015; 113:1389-96. [PMID: 26469834 PMCID: PMC4815785 DOI: 10.1038/bjc.2015.361] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Revised: 09/14/2015] [Accepted: 09/18/2015] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND There is evidence that high level of serum lactate dehydrogenase (LDH) is associated with poorer overall survival in several malignancies, but its link to cancer-specific survival is unclear. METHODS A total of 7895 individuals diagnosed with cancer between 1986 and 1999 were selected for this study. Multivariable Cox proportional hazards regression was used to assess overall and cancer-specific death by the z-score and clinical categories of serum LDH prospectively collected within 3 years before diagnosis. Site-specific analysis was performed for major cancers. Analysis was repeated by different lag times between LDH measurements and diagnosis. RESULTS At the end of follow-up, 5799 participants were deceased. Hazard ratios (HRs) and 95% confidence intervals (CIs) for overall and cancer-specific death in the multivariable model were 1.43 (1.31-1.56) and 1.46 (1.32-1.61), respectively, for high compared with low prediagnostic LDH. Site-specific analysis showed high LDH to correlate with an increased risk of death from prostate, pulmonary, colorectal, gastro-oesophageal, gynaecological and haematological cancers. Serum LDH assessed within intervals closer to diagnosis was more strongly associated with overall and cancer-specific death. CONCLUSIONS Our findings demonstrated an inverse association of baseline serum LDH with cancer-specific survival, corroborating its role in cancer progression.
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Affiliation(s)
- Wahyu Wulaningsih
- Division of Cancer Studies, Cancer Epidemiology Group, King's College London, Research Oncology, 3rd Floor, Bermondsey Wing, Guy's Hospital, London SE1 9RT, UK
| | - Lars Holmberg
- Division of Cancer Studies, Cancer Epidemiology Group, King's College London, Research Oncology, 3rd Floor, Bermondsey Wing, Guy's Hospital, London SE1 9RT, UK
- Department of Surgical Sciences, Uppsala University Hospital, Uppsala 751 85, Sweden
- Regional Cancer Centre, Uppsala 751 85, Sweden
| | - Hans Garmo
- Division of Cancer Studies, Cancer Epidemiology Group, King's College London, Research Oncology, 3rd Floor, Bermondsey Wing, Guy's Hospital, London SE1 9RT, UK
- Regional Cancer Centre, Uppsala 751 85, Sweden
| | - Håkan Malmstrom
- Department of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm 171 77, Sweden
| | - Mats Lambe
- Regional Cancer Centre, Uppsala 751 85, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm 171 77, Sweden
| | - Niklas Hammar
- Department of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm 171 77, Sweden
- AstraZeneca R&D, Mölndal 431 50, Sweden
| | - Göran Walldius
- Department of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm 171 77, Sweden
| | - Ingmar Jungner
- Department of Medicine, Clinical Epidemiological Unit, Karolinska Institutet and CALAB Research, Stockholm 171 77, Sweden
| | - Tony Ng
- Richard Dimbleby Department of Cancer Research, Randall Division and Division of Cancer Studies, King's College London, London SE1 1UL, UK
| | - Mieke Van Hemelrijck
- Division of Cancer Studies, Cancer Epidemiology Group, King's College London, Research Oncology, 3rd Floor, Bermondsey Wing, Guy's Hospital, London SE1 9RT, UK
- Department of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm 171 77, Sweden
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Impact of Pre-Treatment Lactate Dehydrogenase Levels on Prognosis and Bevacizumab Efficacy in Patients with Metastatic Colorectal Cancer. PLoS One 2015; 10:e0134732. [PMID: 26244985 PMCID: PMC4526665 DOI: 10.1371/journal.pone.0134732] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 07/08/2015] [Indexed: 11/22/2022] Open
Abstract
Background To investigate the impact of pre-treatment lactate dehydrogenase (LDH) levels on the outcome of patients with metastatic colorectal cancer treated with first-line chemotherapy with or without the anti-VEGF monoclonal antibody, bevacizumab, in a phase III prospective multicentre randomized ITACa (Italian Trial in Advanced Colorectal Cancer) trial. Methods Three hundred and seventy patients enrolled onto the ITACa first-line trial were considered for this study, 176 receiving chemotherapy (either FOLFIRI or FOLFOX) plus bevacizumab and 194 receiving chemotherapy only. Pre-treatment LDH levels were evaluated to identify a potential correlation with progression-free survival (PFS), overall survival (OS) and objective response rate. Results Information on pre-treatment LDH levels was available for 344 patients. High LDH levels were predictive of a lower median PFS (8.1 months vs. 9.2 months, p< 0.0001) and median OS (16.1 months vs. 25.2 months, p< 0.0001) in the overall population. In the chemotherapy plus bevacizumab group, median PFS was 9.1 and 9.8 months in patients with high LDH and low LDH, respectively (p= 0.073), whereas in the chemotherapy-only arm it was 6.9 and 9.1 months, respectively (p < 0.0001). In patients with high LDH, the addition of bevacizumab to chemotherapy led to a reduction in the rate of progressive disease (16.4 vs. 30.5%, p= 0.081) and to a prolonged PFS (p= 0.028). Conclusion A high LDH value was confirmed as a marker of poor prognosis. Bevacizumab reduced the progressive disease rate and improved PFS in the high-LDH subgroup, making serum LDH a potentially effective an easily available and marker to select patients who benefit from bevacizumab. Trial Registration NCT01878422 ClinicalTrials.gov
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Treatment, Outcomes, and Clinical Trial Participation in Elderly Patients With Metastatic Pancreas Adenocarcinoma. Clin Colorectal Cancer 2015; 14:269-76.e1. [PMID: 26072442 DOI: 10.1016/j.clcc.2015.05.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 03/29/2015] [Accepted: 05/15/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND Pancreas adenocarcinoma has a median age at diagnosis of 71 years. Limited studies have focused on the treatment of elderly patients with pancreas cancer. PATIENTS AND METHODS An analysis of systemic therapy use, clinical trial participation, and overall outcomes of 237 patients with metastatic pancreas adenocarcinoma ≥ 75 years of age evaluated at Memorial Sloan-Kettering Cancer Center between 2005 and 2013 was undertaken. RESULTS Median overall survival was 7 months for the entire study population. A total of 197 (83%) patients received systemic therapy, which was significantly associated with longer overall survival (P < .01). No significant difference was detected in survival between age groups 75 to 79, 80 to 84, and ≥ 85 years of age among those who received systemic therapy (P = .49). Seventy-seven (32%) patients participated in a clinical trial of whom 13 (5%) patients were enrolled in a therapeutic trial, including no patients aged ≥ 85 years. Multivariate analysis demonstrated that presence of liver metastases (P < .001), performance status (P < .001), and number of systemic agents (P < .001) were significantly associated with survival. CONCLUSION Receipt of systemic therapy was associated with longer survival in elderly patients ≥ 75 years of age with metastatic pancreas adenocarcinoma. Therapeutic clinical trial participation among these patients was low and future development of prognostic models for appropriate patient selection is warranted.
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Xue P, Zhu L, Wan Z, Huang W, Li N, Chen D, Hu J, Yang H, Wang L. A prognostic index model to predict the clinical outcomes for advanced pancreatic cancer patients following palliative chemotherapy. J Cancer Res Clin Oncol 2015; 141:1653-60. [PMID: 25792009 PMCID: PMC4534499 DOI: 10.1007/s00432-015-1953-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 03/06/2015] [Indexed: 12/18/2022]
Abstract
Purpose To establish a prognostic index model for advanced pancreatic cancer patients receiving palliative chemotherapy based on clinical variables. Methods The clinical data of 118 patients with advanced pancreatic cancer who received palliative chemotherapy between January 2006 and August 2013 in our center were retrospectively analyzed. Prognostic factors for overall survival were identified using Cox proportional hazards model. A prognostic index model was established by these pretreatment factors to predict prognosis. Kaplan–Meier estimation and log-rank test were performed to compare the overall survival difference between low-risk and high-risk group of patients. Results Median overall survival time for all patients was 8.8 months [95 % confidence interval (CI) 7.0–10.6 months]. Multivariate analysis identified ECOG score = 2 (hazard ratio 2.03; 95 % CI 1.07–3.85; P = 0.030), CA19-9 levels of ≥1000 U/mL (hazard ratio 2.07; 95 % CI 1.09–3.92; P = 0.026), and CRP levels of ≥5 mg/L (hazard ratio 2.05; 95 % CI 1.06–3.96; P = 0.033) as independent poor prognostic factors for overall survival. For the three factors, ECOG score = 2, CA19-9 levels of ≥1000 U/mL, and CRP levels of ≥5 mg/L were allocated 1 point each. There were 84 (71.2 %) patients allocated to low-risk group with total score 0–1 point, and 34 (28.8 %) patients were categorized as high-risk group with total scores 2–3 points. The median overall survival for low-risk group and high-risk group was 9.9 months (95 % CI 6.8–13.0) and 5.3 months (95 % CI 4.1–6.5), respectively (hazard ratio 0.27; 95 % CI 0.14–0.52; P < 0.001). The estimated 1-year survival rates for low-risk group and high-risk group were 40.5 and 5.9 %, respectively (P < 0.05). Conclusions A novel prognostic index model based on three clinical parameters was established to predict the prognosis of patients with advanced pancreatic cancer receiving palliative chemotherapy.
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Affiliation(s)
- Peng Xue
- Nanjing Medical University, Nanjing, Jiangsu, China
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Wilcox CM, Kim H, Seay T, Varadarajulu S. Choice of plastic or metal stent for patients with jaundice with pancreaticobiliary malignancy using simple clinical tools: a prospective evaluation. BMJ Open Gastroenterol 2015; 2:e000014. [PMID: 26462270 PMCID: PMC4599157 DOI: 10.1136/bmjgast-2014-000014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 11/03/2014] [Accepted: 11/04/2014] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND AND AIM Although plastic stents have been recommended for patients with pancreaticobiliary malignancy and an expected survival of less than 6 months, no study has developed criteria to assess survival which could then determine the choice of stent for biliary decompression. The aim of the study was to determine the utility of simple clinical tools in deciding whether to place a plastic or metal stent in patients with malignant obstructive jaundice. METHODS At presentation for endoscopic retrograde cholangiopancreatography for suspected malignant distal bile duct obstruction, prospectively patients with Karnofsky score of <80 and/or metastatic disease to the liver underwent placement of 10-French plastic stents while patients with a Karnofsky score of ≥80 underwent placement of self-expandable metal stents (SEMS). Long-term stent patency and mortality was determined. RESULTS 98 patients (mean age 66.5 years; 62.2% male) were enrolled with 67 (68.4%) receiving plastic stents and 31 (31.6%) uncovered SEMS. Overall, patients receiving plastic stents had a median survival of 2.8 months compared with 11.6 months for metallic stents (p<0.0001). Patients with a Karnofsky score <80 or liver metastases had very poor survival of 3.1 and 1.8 months, respectively. The overall reintervention rate was 42% for those receiving plastic stents and 19% for metallic stents. CONCLUSIONS The decision whether to place a plastic stent or SEMS for patients with distal malignant obstructive jaundice may be based on simple clinical tools resulting in low rates of reintervention.
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Affiliation(s)
- C Mel Wilcox
- Division of Gastroenterology and Hepatology , University of Alabama at Birmingham , Birmingham, Alabama , USA
| | - Hwasoon Kim
- Division of Gastroenterology and Hepatology , University of Alabama at Birmingham , Birmingham, Alabama , USA
| | - Toni Seay
- Division of Gastroenterology and Hepatology , University of Alabama at Birmingham , Birmingham, Alabama , USA
| | - Shyam Varadarajulu
- Division of Gastroenterology and Hepatology , University of Alabama at Birmingham , Birmingham, Alabama , USA
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The clinicopathologic importance of serum lactic dehydrogenase in patients with gastric cancer. DISEASE MARKERS 2014; 2014:140913. [PMID: 25530656 PMCID: PMC4235976 DOI: 10.1155/2014/140913] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 09/04/2014] [Indexed: 12/22/2022]
Abstract
Background. To explore possible correlation between serum lactate dehydrogenase (SLDH) levels and gastric cancer. Materials and Methods. We retrospectively reviewed 365 patients with gastric cancer. The correlation of SLDH levels with clinicopathologic features and survival rate was studied. Results. SLDH levels were closely associated with the pathological (p) T stage (P = 0.011), metastasis (P = 0.012), pTNM stage (P = 0.001), and recurrence (P = 0.012). Moreover, we found a significant SLDH level difference among Borrmann type (P = 0.027), pT stage (P = 0.004), lymph node metastasis (P = 0.027), metastasis (P < 0.001), pTNM stage (P = 0.006), and recurrence (P = 0.002). In addition, we detected a significant SLDH level difference between alive and dead subgroups (P = 0.001). In addition, both univariate analysis and multivariate analysis showed that high SLDH levels were independent prognostic factor. For the subgroup with normal LDH (median point of 157.0 U/L), we detected that the subset with SLDH levels ≥157 U/L (158–245 U/L) showed poorer OS (P = 0.005) and DFS (P = 0.01) than that of ≤157 subgroup. Conclusions. Our results suggest that high SLDH level could be an independent poor prognostic biomarker. Gastric cancer patients with relative high SLDH level (158–245 U/L) were prone to develop a shorter OS and DFS.
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Talekar M, Boreddy SR, Singh A, Amiji M. Tumor aerobic glycolysis: new insights into therapeutic strategies with targeted delivery. Expert Opin Biol Ther 2014; 14:1145-59. [PMID: 24762115 DOI: 10.1517/14712598.2014.912270] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Cancer cells acclimatize to the harsh tumor microenvironment by altering cellular metabolism in favor of aerobic glycolysis. This process provides a source of energy and also generates essential components for macromolecular biosynthesis, which enables cellular survival. As the dependence of cancer cells on glycolysis affects tumorigenesis, it has become an attractive target for therapeutic intervention. Several preclinical studies have shown the effectiveness of using biological targets from the glycolytic pathway for anticancer therapy. AREAS COVERED This review provides an insight into the glycolytic pathway, highlighting potential targets for glycolytic inhibition. We then discuss recent advancement in delivery strategies that have the potential to circumvent some of the problems posed by current glycolytic inhibitors, enabling resurrection of abandoned therapeutic agents. EXPERT OPINION Targeting the glycolysis pathway is a tactical approach for cancer therapy. However, the current nonspecific therapeutic strategies have several drawbacks such as poor bioavailability, unfavorable pharmacokinetic profile and associated nonspecific toxicity, thereby limiting preclinical investigation. In recent years, nanoparticle systems have received recognition for the delivery of therapeutic agents directly to the tumor tissue. Thus, it is envisaged that this strategy can be expanded for the delivery of current glycolytic inhibitors specifically to tumor tissues providing improved anticancer activity.
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Affiliation(s)
- Meghna Talekar
- Northeastern University, Pharmaceutical Sciences , 360 Huntington Avenue, 140 The Fenway Building, Boston, MA 02115 , USA
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Philipp AB, Nagel D, Stieber P, Lamerz R, Thalhammer I, Herbst A, Kolligs FT. Circulating cell-free methylated DNA and lactate dehydrogenase release in colorectal cancer. BMC Cancer 2014; 14:245. [PMID: 24708595 PMCID: PMC4021086 DOI: 10.1186/1471-2407-14-245] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 04/03/2014] [Indexed: 12/15/2022] Open
Abstract
Background Hypermethylation of DNA is an epigenetic alteration commonly found in colorectal cancer (CRC) and can also be detected in blood samples of cancer patients. Methylation of the genes helicase-like transcription factor (HLTF) and hyperplastic polyposis 1 (HPP1) have been proposed as prognostic, and neurogenin 1 (NEUROG1) as diagnostic biomarker. However the underlying mechanisms leading to the release of these genes are unclear. This study aimed at examining the possible correlation of the presence of methylated genes NEUROG1, HLTF and HPP1 in serum with tissue breakdown as a possible mechanism using serum lactate dehydrogenase (LDH) as a surrogate marker. Additionally the prognostic impact of these markers was examined. Methods Pretherapeutic serum samples from 259 patients from all cancer stages were analyzed. Presence of hypermethylation of the genes HLTF, HPP1, and NEUROG1 was examined using methylation-specific quantitative PCR (MethyLight). LDH was determined using an UV kinetic test. Results Hypermethylation of HLTF and HPP1 was detected significantly more often in patients with elevated LDH levels (32% vs. 12% [p = 0.0005], and 68% vs. 11% [p < 0.0001], respectively). Also, higher LDH values correlated with a higher percentage of a fully methylated reference in a linear fashion (Spearman correlation coefficient 0.18 for HLTF [p = 0.004]; 0.49 [p < .0001] for HPP1). No correlation between methylation of NEUROG1 and LDH was found in this study. Concerning the clinical characteristics, high levels of LDH as well as methylation of HLTF and HPP1 were significantly associated with larger and more advanced stages of CRC. Accordingly, these three markers were correlated with significantly shorter survival in the overall population. Moreover, all three identified patients with a worse prognosis in the subgroup of stage IV patients. Conclusions We were able to provide evidence that methylation of HLTF and especially HPP1 detected in serum is strongly correlated with cell death in CRC using LDH as surrogate marker. Additionally, we found that prognostic information is given by both HLTF and HPP1 as well as LDH. In sum, determining the methylation of HLTF and HPP1 in serum might be useful in order to identify patients with more aggressive tumors.
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Affiliation(s)
| | | | | | | | | | | | - Frank T Kolligs
- Department of Medicine II, Ludwig-Maximilians-Universität München, Marchioninistr, 15, 81377 Munich, Germany.
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Chen J, Sun MX, Hua YQ, Cai ZD. Prognostic significance of serum lactate dehydrogenase level in osteosarcoma: a meta-analysis. J Cancer Res Clin Oncol 2014; 140:1205-10. [PMID: 24682390 DOI: 10.1007/s00432-014-1644-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 03/09/2014] [Indexed: 01/02/2023]
Abstract
BACKGROUND A number of studies have investigated the role of serum lactate dehydrogenase (LDH) level in patients with osteosarcoma but have yielded inconsistent and inconclusive results. Thus, we conducted a meta-analysis to assess its prognostic value more precisely. METHODS Systematic computerized searches of PubMed, Embase and Web of Science databases were performed. The pooled hazard ratio (HR) with 95 % confidence intervals (95 % CI) of overall survival was used to assess the prognostic role of serum LDH level. RESULTS Ten studies published between 1997 and 2013 with a total of 943 osteosarcoma patients were included. Overall, the pooled HR for all ten eligible studies evaluating high LDH level on overall survival was 1.92(95 % CI 1.53-2.40). Sensitivity analysis suggested that the pooled HR was stable and omitting a single study did not change the significance of the pooled HR. Funnel plots and Egger's tests revealed there was some possibility of publication bias risk in the meta-analysis. CONCLUSION This meta-analysis shows that high serum LDH level is obviously associated with lower overall survival rate in patients with osteosarcoma, and it is an effective biomarker of prognosis.
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Affiliation(s)
- Jian Chen
- Department of Orthopaedics, Shanghai First People's Hospital, Nanjing Medical University, Shanghai, 200072, China,
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Serum levels of LDH, CEA, and CA19-9 have prognostic roles on survival in patients with metastatic pancreatic cancer receiving gemcitabine-based chemotherapy. Cancer Chemother Pharmacol 2014; 73:1163-71. [DOI: 10.1007/s00280-014-2450-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 03/11/2014] [Indexed: 11/26/2022]
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Cui J, Shi M, Xie D, Wei D, Jia Z, Zheng S, Gao Y, Huang S, Xie K. FOXM1 promotes the warburg effect and pancreatic cancer progression via transactivation of LDHA expression. Clin Cancer Res 2014; 20:2595-606. [PMID: 24634381 DOI: 10.1158/1078-0432.ccr-13-2407] [Citation(s) in RCA: 176] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE The transcription factor Forkhead box protein M1 (FOXM1) plays critical roles in cancer development and progression. However, the regulatory role and underlying mechanisms of FOXM1 in cancer metabolism are unknown. In this study, we characterized the regulation of aerobic glycolysis by FOXM1 and its impact on pancreatic cancer metabolism. EXPERIMENTAL DESIGN The effect of altered expression of FOXM1 on expression of glycolytic enzymes and tumor development and progression was examined using animal models of pancreatic cancer. Also, the underlying mechanisms of altered pancreatic cancer glycolysis were analyzed using in vitro molecular biology. The clinical relevance of aberrant metabolism caused by dysregulated FOXM1 signaling was determined using pancreatic tumor and normal pancreatic tissue specimens. RESULTS We found that FOXM1 did not markedly change the expression of most glycolytic enzymes except for phosphoglycerate kinase 1 (PGK-1) and lactate dehydrogenase A (LDHA). FOXM1 and LDHA were overexpressed concomitantly in pancreatic tumors and cancer cell lines. Increased expression of FOXM1 upregulated the expression of LDHA at both the mRNA and protein level and elevated LDH activity, lactate production, and glucose utilization, whereas reduced expression of FOXM1 did the opposite. Further studies demonstrated that FOXM1 bound directly to the LDHA promoter region and regulated the expression of the LDHA gene at the transcriptional level. Also, elevated FOXM1-LDHA signaling increased the pancreatic cancer cell growth and metastasis. CONCLUSIONS Dysregulated expression and activation of FOXM1 play important roles in aerobic glycolysis and tumorigenesis in patients with pancreatic cancer via transcriptional regulation of LDHA expression.
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Affiliation(s)
- Jiujie Cui
- Authors' Affiliations: Shanghai Key Laboratory of Pancreatic Diseases Research; Department of Oncology, Shanghai Jiaotong University Affiliated First People's Hospital; Department of General Surgery, Shanghai Jiaotong University Affiliated Ruijin Hospital; Department of Oncology and Tumor Institute, Shanghai East Hospital, Tongji University School of Medicine, Shanghai; Hainan Provincial Key Laboratory of Carcinogenesis and Intervention, Pathology Department of Affiliated Hospital, Hainan Medical College, Haikou, People's Republic of China; Departments of Gastroenterology, Hepatology, and Nutrition; and Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TexasAuthors' Affiliations: Shanghai Key Laboratory of Pancreatic Diseases Research; Department of Oncology, Shanghai Jiaotong University Affiliated First People's Hospital; Department of General Surgery, Shanghai Jiaotong University Affiliated Ruijin Hospital; Department of Oncology and Tumor Institute, Shanghai East Hospital, Tongji University School of Medicine, Shanghai; Hainan Provincial Key Laboratory of Carcinogenesis and Intervention, Pathology Department of Affiliated Hospital, Hainan Medical College, Haikou, People's Republic of China; Departments of Gastroenterology, Hepatology, and Nutrition; and Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TexasAuthors' Affiliations: Shanghai Key Laboratory of Pancreatic Diseases Research; Department of Oncology, Shanghai Jiaotong University Affiliated First People's Hospital; Department of General Surgery, Shanghai Jiaotong University Affiliated Ruijin Hospital; Department of Oncology and Tumor Institute, Shanghai East Hospital, Tongji University School of Medicine, Shanghai; Hainan Provincial Key Laboratory of Carcinogenesis and Intervention, Pathology Department of Affiliated Hospital, Hainan Medical College, Haikou, People's Republic of China; Departments of Gastroenterology, Hepatology, and Nutrition; and Neurosurg
| | - Min Shi
- Authors' Affiliations: Shanghai Key Laboratory of Pancreatic Diseases Research; Department of Oncology, Shanghai Jiaotong University Affiliated First People's Hospital; Department of General Surgery, Shanghai Jiaotong University Affiliated Ruijin Hospital; Department of Oncology and Tumor Institute, Shanghai East Hospital, Tongji University School of Medicine, Shanghai; Hainan Provincial Key Laboratory of Carcinogenesis and Intervention, Pathology Department of Affiliated Hospital, Hainan Medical College, Haikou, People's Republic of China; Departments of Gastroenterology, Hepatology, and Nutrition; and Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TexasAuthors' Affiliations: Shanghai Key Laboratory of Pancreatic Diseases Research; Department of Oncology, Shanghai Jiaotong University Affiliated First People's Hospital; Department of General Surgery, Shanghai Jiaotong University Affiliated Ruijin Hospital; Department of Oncology and Tumor Institute, Shanghai East Hospital, Tongji University School of Medicine, Shanghai; Hainan Provincial Key Laboratory of Carcinogenesis and Intervention, Pathology Department of Affiliated Hospital, Hainan Medical College, Haikou, People's Republic of China; Departments of Gastroenterology, Hepatology, and Nutrition; and Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Dacheng Xie
- Authors' Affiliations: Shanghai Key Laboratory of Pancreatic Diseases Research; Department of Oncology, Shanghai Jiaotong University Affiliated First People's Hospital; Department of General Surgery, Shanghai Jiaotong University Affiliated Ruijin Hospital; Department of Oncology and Tumor Institute, Shanghai East Hospital, Tongji University School of Medicine, Shanghai; Hainan Provincial Key Laboratory of Carcinogenesis and Intervention, Pathology Department of Affiliated Hospital, Hainan Medical College, Haikou, People's Republic of China; Departments of Gastroenterology, Hepatology, and Nutrition; and Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TexasAuthors' Affiliations: Shanghai Key Laboratory of Pancreatic Diseases Research; Department of Oncology, Shanghai Jiaotong University Affiliated First People's Hospital; Department of General Surgery, Shanghai Jiaotong University Affiliated Ruijin Hospital; Department of Oncology and Tumor Institute, Shanghai East Hospital, Tongji University School of Medicine, Shanghai; Hainan Provincial Key Laboratory of Carcinogenesis and Intervention, Pathology Department of Affiliated Hospital, Hainan Medical College, Haikou, People's Republic of China; Departments of Gastroenterology, Hepatology, and Nutrition; and Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Daoyan Wei
- Authors' Affiliations: Shanghai Key Laboratory of Pancreatic Diseases Research; Department of Oncology, Shanghai Jiaotong University Affiliated First People's Hospital; Department of General Surgery, Shanghai Jiaotong University Affiliated Ruijin Hospital; Department of Oncology and Tumor Institute, Shanghai East Hospital, Tongji University School of Medicine, Shanghai; Hainan Provincial Key Laboratory of Carcinogenesis and Intervention, Pathology Department of Affiliated Hospital, Hainan Medical College, Haikou, People's Republic of China; Departments of Gastroenterology, Hepatology, and Nutrition; and Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Zhiliang Jia
- Authors' Affiliations: Shanghai Key Laboratory of Pancreatic Diseases Research; Department of Oncology, Shanghai Jiaotong University Affiliated First People's Hospital; Department of General Surgery, Shanghai Jiaotong University Affiliated Ruijin Hospital; Department of Oncology and Tumor Institute, Shanghai East Hospital, Tongji University School of Medicine, Shanghai; Hainan Provincial Key Laboratory of Carcinogenesis and Intervention, Pathology Department of Affiliated Hospital, Hainan Medical College, Haikou, People's Republic of China; Departments of Gastroenterology, Hepatology, and Nutrition; and Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Shaojiang Zheng
- Authors' Affiliations: Shanghai Key Laboratory of Pancreatic Diseases Research; Department of Oncology, Shanghai Jiaotong University Affiliated First People's Hospital; Department of General Surgery, Shanghai Jiaotong University Affiliated Ruijin Hospital; Department of Oncology and Tumor Institute, Shanghai East Hospital, Tongji University School of Medicine, Shanghai; Hainan Provincial Key Laboratory of Carcinogenesis and Intervention, Pathology Department of Affiliated Hospital, Hainan Medical College, Haikou, People's Republic of China; Departments of Gastroenterology, Hepatology, and Nutrition; and Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Yong Gao
- Authors' Affiliations: Shanghai Key Laboratory of Pancreatic Diseases Research; Department of Oncology, Shanghai Jiaotong University Affiliated First People's Hospital; Department of General Surgery, Shanghai Jiaotong University Affiliated Ruijin Hospital; Department of Oncology and Tumor Institute, Shanghai East Hospital, Tongji University School of Medicine, Shanghai; Hainan Provincial Key Laboratory of Carcinogenesis and Intervention, Pathology Department of Affiliated Hospital, Hainan Medical College, Haikou, People's Republic of China; Departments of Gastroenterology, Hepatology, and Nutrition; and Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Suyun Huang
- Authors' Affiliations: Shanghai Key Laboratory of Pancreatic Diseases Research; Department of Oncology, Shanghai Jiaotong University Affiliated First People's Hospital; Department of General Surgery, Shanghai Jiaotong University Affiliated Ruijin Hospital; Department of Oncology and Tumor Institute, Shanghai East Hospital, Tongji University School of Medicine, Shanghai; Hainan Provincial Key Laboratory of Carcinogenesis and Intervention, Pathology Department of Affiliated Hospital, Hainan Medical College, Haikou, People's Republic of China; Departments of Gastroenterology, Hepatology, and Nutrition; and Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Keping Xie
- Authors' Affiliations: Shanghai Key Laboratory of Pancreatic Diseases Research; Department of Oncology, Shanghai Jiaotong University Affiliated First People's Hospital; Department of General Surgery, Shanghai Jiaotong University Affiliated Ruijin Hospital; Department of Oncology and Tumor Institute, Shanghai East Hospital, Tongji University School of Medicine, Shanghai; Hainan Provincial Key Laboratory of Carcinogenesis and Intervention, Pathology Department of Affiliated Hospital, Hainan Medical College, Haikou, People's Republic of China; Departments of Gastroenterology, Hepatology, and Nutrition; and Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Stavraka C, Pinato DJ, Turnbull SJ, Flynn MJ, Forster MD, O'Cathail SM, Babar S, Seckl MJ, Kristeleit RS, Blagden SP. Developing an objective marker to optimize patient selection and predict survival benefit in early-phase cancer trials. Cancer 2013; 120:262-70. [PMID: 24399418 DOI: 10.1002/cncr.28381] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 08/16/2013] [Accepted: 08/20/2013] [Indexed: 11/08/2022]
Abstract
BACKGROUND Several prognostic indices have been devised to optimize patient selection for phase 1 oncology trials with no consensus as to the optimal score and none qualifying as a marker of treatment response. METHODS Multivariate predictors of overall survival (OS) were tested on 118 referred patients to develop the Hammersmith Score (HS). The score's ability to predict OS, progression-free survival (PFS), and 90-day mortality (90DM) was compared with other prognostic indices. Changes in HS were recalculated during treatment. RESULTS Albumin<35 g/L, lactate dehydrogenase>450 U/L, and sodium<135 mmol/L emerged as independent prognostic factors. These were used with equal weighting to devise the HS, a compound prognostic index ranging from 0 to 3. High (HS=2-3) score predicted worse OS (hazard ratio [HR]=6.5, P<.001), PFS (HR=2.8, P=.01), and 90DM (OR=9.0, P<.001). HS was a more accurate multivariate predictor of OS (HR=6.4, P<.001, C-index=0.72), PFS (HR=2.7, P=.03), and 90DM (area under the ROC curve 0.703) compared with other scores. Worsening of the HS during treatment predicted for shorter OS (P<.001). HS retained prognostic and predictive ability following external validation. CONCLUSIONS HS is a simple, validated index to optimize patient selection and predict survival benefit from phase 1 oncology treatments. Prospective validation is ongoing.
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Affiliation(s)
- Chara Stavraka
- Department of Experimental Medicine, Imperial College London, Hammersmith Hospital, London, United Kingdom
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Giessen C, Fischer von Weikersthal L, Laubender RP, Stintzing S, Modest DP, Schalhorn A, Schulz C, Heinemann V. Evaluation of prognostic factors in liver-limited metastatic colorectal cancer: a preplanned analysis of the FIRE-1 trial. Br J Cancer 2013; 109:1428-36. [PMID: 23963138 PMCID: PMC3776986 DOI: 10.1038/bjc.2013.475] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 06/24/2013] [Accepted: 07/23/2013] [Indexed: 02/07/2023] Open
Abstract
Background: Liver-limited disease (LLD) denotes a specific subgroup of metastatic colorectal cancer (mCRC) patients. Patients and Methods: A total of 479 patients with unresectable mCRC from an irinotecan-based randomised phase III trial were evaluated. Patients with LLD and non-LLD and hepatic resection were differentiated. Based on baseline patient characteristic, prognostic factors for hepatic resection were evaluated. Furthermore, prognostic factors for median overall survival (OS) were estimated via Cox regression in LLD patients. Results: Secondary liver resection was performed in 38 out of 479 patients (resection rate: 7.9%). Prognostic factors for hepatic resection were LLD, lactate dehydrogenase (LDH), node-negative primary, alkaline phosphatase (AP) and Karnofsky performance status (PS). Median OS was significantly increased after hepatic resection (48 months), whereas OS in LLD (17 months) and non-LLD (19 months) was comparable in non-resected patients. With the inapplicability of Koehne's risk classification in LLD patients, a new score based on only the independent prognostic factors LDH and white blood cell (WBC) provided markedly improved information on the outcome. Conclusion: Patients undergoing hepatic resection showed favourable long-term survival, whereas non-resected LLD patients and non-LLD patients did not differ with regard to progression-free survival and OS. The LDH levels and WBC count were confirmed as prognostic factors and provide a useful and simple score for OS-related risk stratification also in LLD.
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Affiliation(s)
- C Giessen
- Department of Medical Oncology, Klinikum Grosshadern and Comprehensive Cancer Center, University of Munich, Marchioninistrasse 15, 81377 Munich, Germany
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