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Kabil MF, Badary OA, Bier F, Mousa SA, El-Sherbiny IM. A comprehensive review on lipid nanocarrier systems for cancer treatment: fabrication, future prospects and clinical trials. J Liposome Res 2024; 34:135-177. [PMID: 37144339 DOI: 10.1080/08982104.2023.2204372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 04/02/2023] [Indexed: 05/06/2023]
Abstract
Over the last few decades, cancer has been considered a clinical challenge, being among the leading causes of mortality all over the world. Although many treatment approaches have been developed for cancer, chemotherapy is still the most utilized in the clinical setting. However, the available chemotherapeutics-based treatments have several caveats including their lack of specificity, adverse effects as well as cancer relapse and metastasis which mainly explains the low survival rate of patients. Lipid nanoparticles (LNPs) have been utilized as promising nanocarrier systems for chemotherapeutics to overcome the challenges of the currently applied therapeutic strategies for cancer treatment. Loading chemotherapeutic agent(s) into LNPs improves drug delivery at different aspects including specific targeting of tumours, and enhancing the bioavailability of drugs at the tumour site through selective release of their payload, thus reducing their undesired side effects on healthy cells. This review article delineates an overview of the clinical challenges in many cancer treatments as well as depicts the role of LNPs in achieving optimal therapeutic outcomes. Moreover, the review contains a comprehensive description of the many LNPs categories used as nanocarriers in cancer treatment to date, as well as the potential of LNPs for future applications in other areas of medicine and research.
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Affiliation(s)
- Mohamed Fawzi Kabil
- Nanomedicine Research Labs, Center for Materials Science (CMS), Zewail City of Science and Technology, Giza, Egypt
| | - Osama A Badary
- Clinical Pharmacy Department, Faculty of Pharmacy, The British University in Egypt, El-Shorouk City, Egypt
| | - Frank Bier
- AG Molekulare Bioanalytik und Bioelektronik, Institut für Biochemie und Biologie, Universität Potsdam Karl-Liebknecht-Straße 24/25, Potsdam (OT Golm), Germany
| | - Shaker A Mousa
- Pharmaceutical Research Institute, Albany College of Pharmacy and Health Sciences, Rensselaer, NY, USA
| | - Ibrahim M El-Sherbiny
- Nanomedicine Research Labs, Center for Materials Science (CMS), Zewail City of Science and Technology, Giza, Egypt
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Weeraddana P, Dmitriev M, Thomas T, Gao W, Weerasooriya N, Sandeep F. Case Report of Painless Obstructive Jaundice: A Rare First Presentation of Small-Cell Lung Cancer. Cureus 2023; 15:e35561. [PMID: 37007420 PMCID: PMC10060124 DOI: 10.7759/cureus.35561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2023] [Indexed: 03/02/2023] Open
Abstract
Small-cell lung cancer (SCLC) is a very aggressive type of lung cancer that is of neuroendocrine origin. Because of the high levels of circulating tumor cells, it has a very high rate of metastasis. Obstructive jaundice as the initial manifestation of small cell lung carcinoma is rare. Most of the cases are due to extrahepatic cholestasis by biliary duct obstruction. The biliary duct obstruction may be secondary to metastasis to lymph nodes or pancreatic head metastasis. Obstructive jaundice secondary to intrahepatic cholestasis is even rarer. A 75-year-old male presented to the emergency department (ED) with a complaint of new-onset painless jaundice that his dentist incidentally detected. Examination revealed a mass in the right upper quadrant (RUQ) of the abdomen. Computed tomography (CT) angiography of the abdomen, pancreas, and pelvis shows innumerable hepatic hypodensities highly suspicious for metastatic disease. However, there was no extrahepatic dilatation or pancreatic mass. He was diagnosed with diffuse metastasis of small cell lung carcinoma (SCLC) by needle biopsy of the liver. He developed acute kidney injury and liver damage and thus compromised chemotherapy for SCLC. Later, the patient chose comfort care and passed away the next day. To our knowledge, this is the second reported case of SCLC initially presenting as obstructive jaundice secondary intrahepatic cholestasis by diffuse liver metastases.
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Carpentier J, Pavlyk I, Mukherjee U, Hall PE, Szlosarek PW. Arginine Deprivation in SCLC: Mechanisms and Perspectives for Therapy. LUNG CANCER (AUCKLAND, N.Z.) 2022; 13:53-66. [PMID: 36091646 PMCID: PMC9462517 DOI: 10.2147/lctt.s335117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 08/23/2022] [Indexed: 06/15/2023]
Abstract
Arginine deprivation has gained increasing traction as a novel and safe antimetabolite strategy for the treatment of several hard-to-treat cancers characterised by a critical dependency on arginine. Small cell lung cancer (SCLC) displays marked arginine auxotrophy due to inactivation of the rate-limiting enzyme argininosuccinate synthetase 1 (ASS1), and as a consequence may be targeted with pegylated arginine deiminase or ADI-PEG20 (pegargiminase) and human recombinant pegylated arginases (rhArgPEG, BCT-100 and pegzilarginase). Although preclinical studies reveal that ASS1-deficient SCLC cell lines are highly sensitive to arginine-degrading enzymes, there is a clear disconnect with the clinic with minimal activity seen to date that may be due in part to patient selection. Recent studies have explored resistance mechanisms to arginine depletion focusing on tumor adaptation, such as ASS1 re-expression and autophagy, stromal cell inputs including macrophage infiltration, and tumor heterogeneity. Here, we explore how arginine deprivation may be combined strategically with novel agents to improve SCLC management by modulating resistance and increasing the efficacy of existing agents. Moreover, recent work has identified an intriguing role for targeting arginine in combination with PD-1/PD-L1 immune checkpoint inhibitors and clinical trials are in progress. Thus, future studies of arginine-depleting agents with chemoimmunotherapy, the current standard of care for SCLC, may lead to enhanced disease control and much needed improvements in long-term survival for patients.
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Affiliation(s)
- Joséphine Carpentier
- Centre for Cancer Biomarkers and Biotherapeutics, Barts Cancer Institute, Queen Mary University of London, London, EC1M 6BQ, UK
| | - Iuliia Pavlyk
- Centre for Cancer Biomarkers and Biotherapeutics, Barts Cancer Institute, Queen Mary University of London, London, EC1M 6BQ, UK
| | - Uma Mukherjee
- Department of Medical Oncology, Barts Health NHS Trust, St. Bartholomew’s Hospital, London, EC1A 7BE, UK
| | - Peter E Hall
- Department of Medical Oncology, Barts Health NHS Trust, St. Bartholomew’s Hospital, London, EC1A 7BE, UK
| | - Peter W Szlosarek
- Centre for Cancer Biomarkers and Biotherapeutics, Barts Cancer Institute, Queen Mary University of London, London, EC1M 6BQ, UK
- Department of Medical Oncology, Barts Health NHS Trust, St. Bartholomew’s Hospital, London, EC1A 7BE, UK
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Lang C, Egger F, Alireza Hoda M, Saeed Querner A, Ferencz B, Lungu V, Szegedi R, Bogyo L, Torok K, Oberndorfer F, Klikovits T, Schwendenwein A, Boettiger K, Renyi-Vamos F, Hoetzenecker K, Schelch K, Megyesfalvi Z, Dome B. Lymphocyte-to-monocyte ratio is an independent prognostic factor in surgically treated small cell lung cancer: an international multicenter analysis. Lung Cancer 2022; 169:40-46. [DOI: 10.1016/j.lungcan.2022.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 05/11/2022] [Accepted: 05/16/2022] [Indexed: 01/10/2023]
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Tully KM, Tendler S, Carter LM, Sharma SK, Samuels ZV, Mandleywala K, Korsen JA, Delos Reyes AM, Piersigilli A, Travis WD, Sen T, Pillarsetty N, Poirier JT, Rudin CM, Lewis JS. Radioimmunotherapy Targeting Delta-like Ligand 3 in Small Cell Lung Cancer Exhibits Antitumor Efficacy with Low Toxicity. Clin Cancer Res 2022; 28:1391-1401. [PMID: 35046060 PMCID: PMC8976830 DOI: 10.1158/1078-0432.ccr-21-1533] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 10/18/2021] [Accepted: 01/13/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE Small cell lung cancer (SCLC) is an exceptionally lethal form of lung cancer with limited treatment options. Delta-like ligand 3 (DLL3) is an attractive therapeutic target as surface expression is almost exclusive to tumor cells. EXPERIMENTAL DESIGN We radiolabeled the anti-DLL3 mAb SC16 with the therapeutic radioisotope, Lutetium-177. [177Lu]Lu-DTPA-CHX-A"-SC16 binds to DLL3 on SCLC cells and delivers targeted radiotherapy while minimizing radiation to healthy tissue. RESULTS [177Lu]Lu-DTPA-CHX-A"-SC16 demonstrated high tumor uptake with DLL3-target specificity in tumor xenografts. Dosimetry analyses of biodistribution studies suggested that the blood and liver were most at risk for toxicity from treatment with high doses of [177Lu]Lu-DTPA-CHX-A"-SC16. In the radioresistant NCI-H82 model, survival studies showed that 500 μCi and 750 μCi doses of [177Lu]Lu-DTPA-CHX-A"-SC16 led to prolonged survival over controls, and 3 of the 8 mice that received high doses of [177Lu]Lu-DTPA-CHX-A"-SC16 had pathologically confirmed complete responses (CR). In the patient-derived xenograft model Lu149, all doses of [177Lu]Lu-DTPA-CHX-A"-SC16 markedly prolonged survival. At the 250 μCi and 500 μCi doses, 5 of 10 and 7 of 9 mice demonstrated pathologically confirmed CRs, respectively. Four of 10 mice that received 750 μCi of [177Lu]Lu-DTPA-CHX-A"-SC16 demonstrated petechiae severe enough to warrant euthanasia, but the remaining 6 mice demonstrated pathologically confirmed CRs. IHC on residual tissues from partial responses confirmed retained DLL3 expression. Hematologic toxicity was dose-dependent and transient, with full recovery within 4 weeks. Hepatotoxicity was not observed. CONCLUSIONS Together, the compelling antitumor efficacy, pathologic CRs, and mild and transient toxicity profile demonstrate strong potential for clinical translation of [177Lu]Lu-DTPA-CHX-A"-SC16.
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Affiliation(s)
- Kathryn M. Tully
- Department of Pharmacology, Weill Cornell Medical School, New York, NY, USA
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Salomon Tendler
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - Lukas M. Carter
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sai Kiran Sharma
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Zachary V. Samuels
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Komal Mandleywala
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Joshua A. Korsen
- Department of Pharmacology, Weill Cornell Medical School, New York, NY, USA
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Alessandra Piersigilli
- Laboratory of Comparative Pathology, Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine, and The Rockefeller University, New York, NY USA
| | - William D. Travis
- Department of Thoracic Pathology, Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - Triparna Sen
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY USA
| | | | - John T. Poirier
- Perlmutter Cancer Center, New York University Langone Health, New York, NY USA
| | - Charles M. Rudin
- Department of Pharmacology, Weill Cornell Medical School, New York, NY, USA
- Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - Jason S. Lewis
- Department of Pharmacology, Weill Cornell Medical School, New York, NY, USA
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Kabil MF, Nasr M, Ibrahim IT, Hassan YA, El-Sherbiny IM. New repurposed rolapitant in nanovesicular systems for lung cancer treatment: Development, in-vitro assessment and in-vivo biodistribution study. Eur J Pharm Sci 2022; 171:106119. [PMID: 34998905 DOI: 10.1016/j.ejps.2022.106119] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 11/14/2021] [Accepted: 01/03/2022] [Indexed: 12/20/2022]
Abstract
Lung cancer is characterized by poor prognosis, and is considered a serious disease that causes a significant mortality. The available conventional chemotherapeutic agents suffer from several limitations; hence, new drug molecules are constantly being sought. In the current study, lipid nanovesicles (LNVs) were selected as a colloidal vehicle for encapsulation of the FDA-approved drug; rolapitant (RP), which is used particularly for the treatment of nausea and vomiting, but is repurposed for the treatment of lung cancer in the current work. RP was loaded into various LNVs (liposomes, ethosomes and transethosomes) using the thin film hydration method, and the LNVs were evaluated for particle size, zeta potential, entrapment efficiency (EE%), storage stability and surface morphology. Besides, the in-vitro drug release, in-vitro cytotoxicity on A549 lung cancer cells, nebulization performance using next generation impactor (NGI), and the in-vivo biodistribution behaviour were evaluated. The selected ethosomal and transethosomal vesicles displayed a particle size less than 400 nm, a positive charge, and EE% exceeding 90% for RP, with a sustained release pattern over 15 days. The in-vivo biodistribution results proved the high lung deposition potential of RP-LNVs with a considerable safety. Besides, the developed RP-LNVs were able to reach the metastatic organs of lung cancer, hence they were proven promising as a possible treatment modality for lung cancer.
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Affiliation(s)
- Mohamed Fawzi Kabil
- Nanomedicine Labs, Center for Materials Science, Zewail City of Science and Technology, 6th of October City, 12578, Giza, Egypt
| | - Maha Nasr
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
| | - Ismail T Ibrahim
- Labeled compound department, Hot lab. Center, Atomic energy authority, Inshas, Egypt
| | - Yasser A Hassan
- Department of Pharmaceutics, Faculty of Pharmacy, Delta University for Science and Technology, Gamasa, Egypt
| | - Ibrahim M El-Sherbiny
- Nanomedicine Labs, Center for Materials Science, Zewail City of Science and Technology, 6th of October City, 12578, Giza, Egypt.
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Gao Y, Dong Y, Zhou Y, Chen G, Hong X, Zhang Q. Peripheral Tumor Location Predicts a Favorable Prognosis in Patients with Resected Small Cell Lung Cancer. Int J Clin Pract 2022; 2022:4183326. [PMID: 36605462 PMCID: PMC9718634 DOI: 10.1155/2022/4183326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 11/08/2022] [Accepted: 11/09/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Small cell lung cancer (SCLC) is an aggressive malignancy. Surgical resection is currently only recommended for clinical stage I patients who have been carefully staged. The clinical outcomes of patients with resected SCLCs vary because the disease is highly heterogeneous, suggesting that selected patients could be considered for surgical resection depending on their clinical and/or molecular characteristics. METHODS We collected data on a retrospective cohort of 119 limited-stage SCLC patients who underwent lobectomy with mediastinal lymph node dissection from March 2013 to March 2020 at Harbin Medical University Cancer Hospital. Correlations were derived using Fisher's exact test. Models of 2-year and 3-year survival were evaluated by deriving the area under receiver operating characteristic curves. Kaplan-Meier and Cox regression analyses were used to evaluate significant differences between the survival curves and hazard ratios. RESULTS The median disease-free survival (DFS) was 35.9 months (range 0.9-105.3 months), and the median overall survival (OS) was 45.2 months (range 4.8-105.3 months). Univariate analysis showed that TNM stage was significantly correlated with DFS and OS. The 2-year disease-free rates of patients with stage I, II, and III disease were 76.4%, 50.5%, and 36.1%, respectively, and the 3-year OS rates were 75.9%, 57.7%, and 34.4%, respectively. In pN + patients, multiple (or multiple-station) lymph node involvement significantly increased recurrence and reduced survival compared with patients with single or single-station metastases. Patients with peripheral SCLCs evidenced significantly better DFS and OS than did patients with central tumors. Multivariate analysis showed that TNM stage and tumor location were independently prognostic in Chinese patients with resected limited-stage SCLC. A combination of TNM stage and tumor location was helpful for prognosis. CONCLUSIONS TNM stage and tumor location were independently prognostic in Chinese patients with resected SCLCs. Patient stratification by tumor location should inform the therapeutic strategy. The role of surgical resection for limited-stage SCLC patients must be reevaluated, as this may be appropriate for some patients.
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Affiliation(s)
- Yina Gao
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Yangyang Dong
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Yingxu Zhou
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Gongyan Chen
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Xuan Hong
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Qingyuan Zhang
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
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Pedersen S, Hansen JB, Maltesen RG, Szejniuk WM, Andreassen T, Falkmer U, Kristensen SR. Identifying metabolic alterations in newly diagnosed small cell lung cancer patients. Metabol Open 2021; 12:100127. [PMID: 34585134 PMCID: PMC8455369 DOI: 10.1016/j.metop.2021.100127] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/07/2021] [Accepted: 09/14/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Small cell lung cancer (SCLC) is a malignant disease with poor prognosis. At the time of diagnosis most patients are already in a metastatic stage. Current diagnosis is based on imaging, histopathology, and immunohistochemistry, but no blood-based biomarkers have yet proven to be clinically successful for diagnosis and screening. The precise mechanisms of SCLC are not fully understood, however, several genetic mutations, protein and metabolic aberrations have been described. We aim at identifying metabolite alterations related to SCLC and to expand our knowledge relating to this aggressive cancer. METHODS A total of 30 serum samples of patients with SCLC, collected at the time of diagnosis, and 25 samples of healthy controls were included in this study. The samples were analyzed with nuclear magnetic resonance spectroscopy. Multivariate, univariate and pathways analyses were performed. RESULTS Several metabolites were identified to be altered in the pre-treatment serum samples of small-cell lung cancer patients compared to healthy individuals. Metabolites involved in tricarboxylic acid cycle (succinate: fold change (FC) = 2.4, p = 0.068), lipid metabolism (LDL triglyceride: FC = 1.3, p = 0.001; LDL-1 triglyceride: FC = 1.3, p = 0.012; LDL-2 triglyceride: FC = 1.4, p = 0.009; LDL-6 triglyceride: FC = 1.5, p < 0.001; LDL-4 cholesterol: FC = 0.5, p = 0.007; HDL-3 free cholesterol: FC = 0.7, p = 0.002; HDL-4 cholesterol FC = 0.8, p < 0.001; HDL-4 apolipoprotein-A1: FC = 0.8, p = 0.005; HDL-4 apolipoprotein-A2: FC ≥ 0.7, p ≤ 0.001), amino acids (glutamic acid: FC = 1.7, p < 0.001; glutamine: FC = 0.9, p = 0.007, leucine: FC = 0.8, p < 0.001; isoleucine: FC = 0.8, p = 0.016; valine: FC = 0.9, p = 0.032; lysine: FC = 0.8, p = 0.004; methionine: FC = 0.8, p < 0.001; tyrosine: FC = 0.7, p = 0.002; creatine: FC = 0.9, p = 0.030), and ketone body metabolism (3-hydroxybutyric acid FC = 2.5, p < 0.001; acetone FC = 1.6, p < 0.001), among other, were found deranged in SCLC. CONCLUSIONS This study provides novel insight into the metabolic disturbances in pre-treatment SCLC patients, expanding our molecular understanding of this malignant disease.
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Affiliation(s)
- Shona Pedersen
- Department of Basic Medical Science, College of Medicine, Qatar University, QU Health, Doha, Qatar
| | | | - Raluca Georgiana Maltesen
- Translational Radiation Biology and Oncology Laboratory, Centre for Cancer Research, Westmead Institute of Medical Research, Westmead, 2145, Australia
| | - Weronika Maria Szejniuk
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Department of Oncology, Aalborg University Hospital, Aalborg, Denmark
| | - Trygve Andreassen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ursula Falkmer
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Department of Oncology, Aalborg University Hospital, Aalborg, Denmark
| | - Søren Risom Kristensen
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
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Farmer LE, Goradia RU, Lakhi NA. Pitfalls and challenges in managing neuroendocrine carcinoma of gynecological origin: A case series and brief review. Clin Case Rep 2021; 9:e04224. [PMID: 34084514 PMCID: PMC8142416 DOI: 10.1002/ccr3.4224] [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: 04/15/2020] [Revised: 01/29/2021] [Accepted: 03/30/2021] [Indexed: 11/12/2022] Open
Abstract
Due to gynecologic tract (gNET) rarity, gynecologists may not have a strong index of suspicion for which to diagnose these tumors ultimately causing misdiagnoses and potential mismanagement. Gynecologists should be wary of diagnostic pitfalls.
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Affiliation(s)
- Lauren E. Farmer
- Department of Obstetrics and GynecologyNew York Medical CollegeValhallaNYUSA
- Department of Obstetrics and GynecologyDuke University HospitalDurhamNCUSA
| | - Rutmi U. Goradia
- Department of Obstetrics and GynecologyNew York Medical CollegeValhallaNYUSA
| | - Nisha A. Lakhi
- Department of Obstetrics and GynecologyNew York Medical CollegeValhallaNYUSA
- Department of Obstetrics and GynecologyRichmond University Medical CenterStaten IslandNYUSA
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Schwendenwein A, Megyesfalvi Z, Barany N, Valko Z, Bugyik E, Lang C, Ferencz B, Paku S, Lantos A, Fillinger J, Rezeli M, Marko-Varga G, Bogos K, Galffy G, Renyi-Vamos F, Hoda MA, Klepetko W, Hoetzenecker K, Laszlo V, Dome B. Molecular profiles of small cell lung cancer subtypes: therapeutic implications. Mol Ther Oncolytics 2021; 20:470-483. [PMID: 33718595 PMCID: PMC7917449 DOI: 10.1016/j.omto.2021.02.004] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Small cell lung cancer (SCLC; accounting for approximately 13%-15% of all lung cancers) is an exceptionally lethal malignancy characterized by rapid doubling time and high propensity to metastasize. In contrast to the increasingly personalized therapies in other types of lung cancer, SCLC is still regarded as a homogeneous disease and the prognosis of SCLC patients remains poor. Recently, however, substantial progress has been made in our understanding of SCLC biology. Advances in genomics and development of new preclinical models have facilitated insights into the intratumoral heterogeneity and specific genetic alterations of this disease. This worldwide resurgence of studies on SCLC has ultimately led to the development of novel subtype-specific classifications primarily based on the neuroendocrine features and distinct molecular profiles of SCLC. Importantly, these biologically distinct subtypes might define unique therapeutic vulnerabilities. Herein, we summarize the current knowledge on the molecular profiles of SCLC subtypes with a focus on their potential clinical implications.
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Affiliation(s)
- Anna Schwendenwein
- Department of Thoracic Surgery, Comprehensive Cancer Center Vienna, Medical University of Vienna, 1090 Vienna, Austria
| | - Zsolt Megyesfalvi
- Department of Thoracic Surgery, Comprehensive Cancer Center Vienna, Medical University of Vienna, 1090 Vienna, Austria
- Department of Thoracic Surgery, National Institute of Oncology-Semmelweis University, 1122 Budapest, Hungary
- National Koranyi Institute of Pulmonology, 1121 Budapest, Hungary
| | - Nandor Barany
- Department of Thoracic Surgery, Comprehensive Cancer Center Vienna, Medical University of Vienna, 1090 Vienna, Austria
- National Koranyi Institute of Pulmonology, 1121 Budapest, Hungary
- 1st Department of Pathology and Experimental Cancer Research, Semmelweis University, 1085 Budapest, Hungary
| | - Zsuzsanna Valko
- Department of Thoracic Surgery, Comprehensive Cancer Center Vienna, Medical University of Vienna, 1090 Vienna, Austria
- National Koranyi Institute of Pulmonology, 1121 Budapest, Hungary
| | - Edina Bugyik
- National Koranyi Institute of Pulmonology, 1121 Budapest, Hungary
| | - Christian Lang
- Department of Thoracic Surgery, Comprehensive Cancer Center Vienna, Medical University of Vienna, 1090 Vienna, Austria
| | - Bence Ferencz
- Department of Thoracic Surgery, National Institute of Oncology-Semmelweis University, 1122 Budapest, Hungary
- National Koranyi Institute of Pulmonology, 1121 Budapest, Hungary
| | - Sandor Paku
- 1st Department of Pathology and Experimental Cancer Research, Semmelweis University, 1085 Budapest, Hungary
| | - Andras Lantos
- National Koranyi Institute of Pulmonology, 1121 Budapest, Hungary
| | - Janos Fillinger
- Department of Thoracic Surgery, National Institute of Oncology-Semmelweis University, 1122 Budapest, Hungary
- National Koranyi Institute of Pulmonology, 1121 Budapest, Hungary
| | - Melinda Rezeli
- Department of Biomedical Engineering, Lund University, 221 00 Lund, Sweden
| | - Gyorgy Marko-Varga
- Department of Biomedical Engineering, Lund University, 221 00 Lund, Sweden
| | - Krisztina Bogos
- National Koranyi Institute of Pulmonology, 1121 Budapest, Hungary
| | - Gabriella Galffy
- Torokbalint County Institute of Pulmonology, 2045 Torokbalint, Hungary
| | - Ferenc Renyi-Vamos
- Department of Thoracic Surgery, National Institute of Oncology-Semmelweis University, 1122 Budapest, Hungary
- National Koranyi Institute of Pulmonology, 1121 Budapest, Hungary
| | - Mir Alireza Hoda
- Department of Thoracic Surgery, Comprehensive Cancer Center Vienna, Medical University of Vienna, 1090 Vienna, Austria
| | - Walter Klepetko
- Department of Thoracic Surgery, Comprehensive Cancer Center Vienna, Medical University of Vienna, 1090 Vienna, Austria
| | - Konrad Hoetzenecker
- Department of Thoracic Surgery, Comprehensive Cancer Center Vienna, Medical University of Vienna, 1090 Vienna, Austria
| | - Viktoria Laszlo
- Department of Thoracic Surgery, Comprehensive Cancer Center Vienna, Medical University of Vienna, 1090 Vienna, Austria
- Department of Thoracic Surgery, National Institute of Oncology-Semmelweis University, 1122 Budapest, Hungary
- National Koranyi Institute of Pulmonology, 1121 Budapest, Hungary
| | - Balazs Dome
- Department of Thoracic Surgery, Comprehensive Cancer Center Vienna, Medical University of Vienna, 1090 Vienna, Austria
- Department of Thoracic Surgery, National Institute of Oncology-Semmelweis University, 1122 Budapest, Hungary
- National Koranyi Institute of Pulmonology, 1121 Budapest, Hungary
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Baena J, Modrego A, Zeaiter A, Kahatt C, Alfaro V, Jimenez-Aguilar E, Mazarico JM, Paz-Ares L. Lurbinectedin in the treatment of relapsed small cell lung cancer. Future Oncol 2021; 17:2279-2289. [PMID: 33736462 DOI: 10.2217/fon-2020-1212] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Lurbinectedin is a marine-derived drug that inhibits transcription, a process that is frequently dysregulated in small cell lung cancer. The activity of lurbinectedin has been studied in many solid tumors, showing not only promising results but also a favorable safety profile. In relapsed small cell lung cancer, the drug has shown encouraging activity both as a single agent and in combination with doxorubicin, paclitaxel or irinotecan. The USA FDA has recently granted accelerated approval to lurbinectedin monotherapy in this setting. This article provides an update on available data and ongoing studies of lurbinectedin in small cell lung cancer, including Phase I combination trials, the basket Phase II trial and the ATLANTIS Phase III trial.
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Affiliation(s)
- Javier Baena
- Department of Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, 28041, Spain.,H12O-CNIO Lung Cancer Clinical Research Unit, Instituto de Investigación Sanitaria Hospital Universitario 12 de Octubre, Spanish National Cancer Research Center, Madrid, 28029, Spain
| | - Andrea Modrego
- Department of Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, 28041, Spain
| | - Ali Zeaiter
- Clinical Development, PharmaMar, Madrid, 28770, Spain
| | - Carmen Kahatt
- Clinical Development, PharmaMar, Madrid, 28770, Spain
| | | | - Elizabeth Jimenez-Aguilar
- Department of Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, 28041, Spain.,H12O-CNIO Lung Cancer Clinical Research Unit, Instituto de Investigación Sanitaria Hospital Universitario 12 de Octubre, Spanish National Cancer Research Center, Madrid, 28029, Spain
| | - Jose María Mazarico
- Department of Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, 28041, Spain.,H12O-CNIO Lung Cancer Clinical Research Unit, Instituto de Investigación Sanitaria Hospital Universitario 12 de Octubre, Spanish National Cancer Research Center, Madrid, 28029, Spain
| | - Luis Paz-Ares
- Department of Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, 28041, Spain.,H12O-CNIO Lung Cancer Clinical Research Unit, Instituto de Investigación Sanitaria Hospital Universitario 12 de Octubre, Spanish National Cancer Research Center, Madrid, 28029, Spain.,Cancer Networking Biomedical Research Center, Madrid, 28029, Spain.,Faculty of Medicine, Complutense University, Madrid, 28040, Spain
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Cortinovis D, Bidoli P, Canova S, Colonese F, Gemelli M, Lavitrano ML, Banna GL, Liu SV, Morabito A. Novel Cytotoxic Chemotherapies in Small Cell Lung Carcinoma. Cancers (Basel) 2021; 13:1152. [PMID: 33800236 PMCID: PMC7962524 DOI: 10.3390/cancers13051152] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/24/2021] [Accepted: 03/03/2021] [Indexed: 01/08/2023] Open
Abstract
Small cell lung cancer (SCLC) is one of the deadliest thoracic neoplasms, in part due to its fast doubling time and early metastatic spread. Historically, cytotoxic chemotherapy consisting of platinum-etoposide or anthracycline-based regimens has demonstrated a high response rate, but early chemoresistance leads to a poor prognosis in advanced SCLC. Only a fraction of patients with limited-disease can be cured by chemo-radiotherapy. Given the disappointing survival rates in advanced SCLC, new cytotoxic agents are eagerly awaited. Unfortunately, few novel chemotherapy drugs have been developed in the latest decades. This review describes the results and potential application in the clinical practice of novel chemotherapy agents for SCLC.
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Affiliation(s)
- Diego Cortinovis
- Department Medical Oncology—ASST-Monza Ospedale San Gerardo, via Pergolesi 33, 20090 Monza, Italy; (P.B.); (S.C.); (F.C.); (M.G.)
| | - Paolo Bidoli
- Department Medical Oncology—ASST-Monza Ospedale San Gerardo, via Pergolesi 33, 20090 Monza, Italy; (P.B.); (S.C.); (F.C.); (M.G.)
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy;
| | - Stefania Canova
- Department Medical Oncology—ASST-Monza Ospedale San Gerardo, via Pergolesi 33, 20090 Monza, Italy; (P.B.); (S.C.); (F.C.); (M.G.)
| | - Francesca Colonese
- Department Medical Oncology—ASST-Monza Ospedale San Gerardo, via Pergolesi 33, 20090 Monza, Italy; (P.B.); (S.C.); (F.C.); (M.G.)
| | - Maria Gemelli
- Department Medical Oncology—ASST-Monza Ospedale San Gerardo, via Pergolesi 33, 20090 Monza, Italy; (P.B.); (S.C.); (F.C.); (M.G.)
| | | | - Giuseppe Luigi Banna
- Department of Oncology, Portsmouth Hospitals University NHS Trust, Cosham, Portsmouth PO6 3LY, UK;
| | - Stephen V. Liu
- Lombardi Comprehensive Cancer Center, Georgetown University, 3800 Reservoir Road NW, Washington, DC 20007, USA;
| | - Alessandro Morabito
- SC Oncologia Medica Toraco-Polmonare, IRCCS Istituto Nazionale dei Tumori, Fondazione Pascale, 80100 Napoli, Italy;
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13
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Wang Y, Zou S, Zhao Z, Liu P, Ke C, Xu S. New insights into small-cell lung cancer development and therapy. Cell Biol Int 2020; 44:1564-1576. [PMID: 32281704 PMCID: PMC7496722 DOI: 10.1002/cbin.11359] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 02/24/2020] [Accepted: 04/11/2020] [Indexed: 12/24/2022]
Abstract
Small‐cell lung cancer (SCLC) accounts for approximately 15% of lung cancer cases; however, it is characterized by easy relapse and low survival rate, leading to one of the most intractable diseases in clinical practice. Despite decades of basic and clinical research, little progress has been made in the management of SCLC. The current standard first‐line regimens of SCLC still remain to be cisplatin or carboplatin combined with etoposide, and the adverse events of chemotherapy are by no means negligible. Besides, the immunotherapy on SCLC is still in an early stage and novel studies are urgently needed. In this review, we describe SCLC development and current therapy, aiming at providing useful advices on basic research and clinical strategy.
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Affiliation(s)
- Yuwen Wang
- Department of Burn and Plastic Surgery, Shenzhen Longhua District Central Hospital, Affiliated Central Hospital of Shenzhen Longhua District, Guangdong Medical University, Shenzhen, Guangdong, China
| | - Songyun Zou
- Department of Burn and Plastic Surgery, Shenzhen Longhua District Central Hospital, Affiliated Central Hospital of Shenzhen Longhua District, Guangdong Medical University, Shenzhen, Guangdong, China
| | - Zhuyun Zhao
- Department of Burn and Plastic Surgery, Shenzhen Longhua District Central Hospital, Affiliated Central Hospital of Shenzhen Longhua District, Guangdong Medical University, Shenzhen, Guangdong, China
| | - Po Liu
- Department of Burn and Plastic Surgery, Shenzhen Longhua District Central Hospital, Affiliated Central Hospital of Shenzhen Longhua District, Guangdong Medical University, Shenzhen, Guangdong, China
| | - Changneng Ke
- Department of Burn and Plastic Surgery, Shenzhen Longhua District Central Hospital, Affiliated Central Hospital of Shenzhen Longhua District, Guangdong Medical University, Shenzhen, Guangdong, China
| | - Shi Xu
- Department of Burn and Plastic Surgery, Shenzhen Longhua District Central Hospital, Affiliated Central Hospital of Shenzhen Longhua District, Guangdong Medical University, Shenzhen, Guangdong, China.,Division of Respiratory Medicine, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China
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Wang S, Zimmermann S, Parikh K, Mansfield AS, Adjei AA. Current Diagnosis and Management of Small-Cell Lung Cancer. Mayo Clin Proc 2019; 94:1599-1622. [PMID: 31378235 DOI: 10.1016/j.mayocp.2019.01.034] [Citation(s) in RCA: 157] [Impact Index Per Article: 31.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 01/05/2019] [Accepted: 01/31/2019] [Indexed: 12/25/2022]
Abstract
Small-cell lung cancer (SCLC) is an aggressive disease with distinct pathological, clinical, and molecular characteristics from non-small-cell lung cancer. SCLC has high metastatic potential, resulting in a clinically poor prognosis. Early concurrent chemo-radiation is the standard of care for limited-stage SCLC (LS-SCLC). Prophylactic cranial irradiation (PCI) is recommended for patients with LS-SCLC without progression of disease after initial therapy. A combination of etoposide and cisplatin or carboplatin remains the mainstay of first-line treatment for ES-SCLC, with the addition of atezolizumab, now becoming standard. Most SCLCs initially respond to therapy but almost invariably recur. Topotecan and amrubicin (in Japan) remain the primary chemotherapy options for relapsed SCLC. Immunotherapy, including nivolumab with or without ipilimumab, is now available for refractory disease. In general, the poor prognosis of SCLC has not improved significantly for more than 3 decades. Recently, next-generation molecular profiling studies have identified new therapeutic targets for SCLC. A variety of proapoptotic agents, compounds capitalizing on DNA-repair defects, immunotherapy agents, and antibody-drug conjugates are being evaluated in SCLC, with a number of them showing early promise.
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Affiliation(s)
- Shuhang Wang
- Peking University Cancer Hospital, Beijing, China
| | - Stefan Zimmermann
- Département d'Oncologie, service d'Immuno-Oncologie, CHUV, Lausanne, Switzerland
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15
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Mei S, Gibbs J, Economos K, Lee YC, Kanis MJ. Clinical comparison between neuroendocrine and endometrioid type carcinoma of the uterine corpus. J Gynecol Oncol 2019; 30:e58. [PMID: 31074241 PMCID: PMC6543113 DOI: 10.3802/jgo.2019.30.e58] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 12/28/2018] [Accepted: 01/24/2019] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE To compare the clinicopathologic features and survival outcomes of neuroendocrine tumor of the uterine corpus (NET-U) to endometrioid type endometrial carcinoma (EC). METHODS From 1993 to 2012, the Surveillance, Epidemiology and End Results cancer registry was queried for women diagnosed with EC or NET-U. Data regarding stage, grade, presence of extra-uterine disease, lymph node metastasis, receipt of adjuvant radiation, surgical intervention and overall survival (OS) was extracted. Chi-square tests, t-tests and Kaplan Meir curves were used for statistical analysis. RESULTS A total of 98,363 patients were identified: 98,245 with EC and 118 with NET-U. The mean age at diagnosis for EC was 61.7 years and 64.8 years for NET-U (p=0.01). NET-U cases were more likely to be poorly differentiated (97.0% vs. 15.6%; p≤0.01) and have nodal metastasis (56.4% vs. 11.1%; p≤0.01) when compared to EC. Presence of extrapelvic disease at the time of diagnosis was observed more frequently in NET-U compared to EC, 49.1% vs. 4.8%, respectively (odds ratio=18; 95% confidence interval=13.1-27.2; p≤0.01). Significant improvement in OS was observed in NET-U patient who received radiation (OS: 7.7 vs. 3.3 years; p≤0.01) or underwent surgical management (5.6 vs. 0.9 years; p≤0.01). The OS for EC was 14.4 vs. 4.6 years for NET-U (p≤0.01). CONCLUSION NET-U represents an aggressive form of uterine malignancy. When compared to EC, patients with NET-U present at more advanced stage, have more frequent extra-uterine disease and lower OS.
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Affiliation(s)
- Shirley Mei
- Division of Gynecologic Oncology, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Jennifer Gibbs
- Division of Gynecologic Oncology, SUNY Downstate Medical Center, Brooklyn, NY, USA.
| | - Katherine Economos
- Division of Gynecologic Oncology, New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, USA
| | - Yi Chun Lee
- Division of Gynecologic Oncology, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Margaux J Kanis
- Division of Gynecologic Oncology, SUNY Downstate Medical Center, Brooklyn, NY, USA
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16
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Clinicopathologic features, incidence, and survival trends of gynecologic neuroendocrine tumors: a SEER database analysis. Am J Obstet Gynecol 2019; 221:53.e1-53.e6. [PMID: 30849352 DOI: 10.1016/j.ajog.2019.02.052] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 02/24/2019] [Accepted: 02/27/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND Primary gynecologic neuroendocrine tumors are uncommon malignant neoplasms associated with poor prognosis. Clinically, these tumors present a significant challenge because of the lack of standardized management guidelines. OBJECTIVE The objective of this study is to evaluate the clinicopathologic features, incidence, and survival trends in gynecologic neuroendocrine tumors. MATERIALS AND METHODS The Surveillance, Epidemiology and End Results (SEER) cancer registry was queried for women diagnosed with primary gynecologic neuroendocrine tumors from 1987 to 2012. Data regarding stage, grade, presence of extrauterine disease, receipt of adjuvant radiation, surgical intervention, incidence, and overall survival were extracted. Patients were classified as having early-stage disease (International Federation of Gynecology and Obstetrics Stage I/II) or advanced-stage disease (Stage III/IV). Extrauterine disease was defined as either regional or distant metastasis. χ2 Tests, Pearson correlation, and Kaplan-Meier curves were used for statistical analysis. RESULTS In all, 559 cases of gynecologic neuroendocrine tumors were identified during the study period: 242 cervical, 160 ovarian, 118 uterine, and 39 vulvar/vaginal. The majority of patients in all subsets of gynecologic neuroendocrine tumors presented with poorly differentiated tumors, extrauterine disease spread, and advanced-stage disease. Poorly differentiated tumors represented 65.0% of cervical tumors, 45.3% of ovarian tumors, and 57.4% of uterine tumors. Extrauterine disease at the time of diagnosis was present in the case of 66.9% of cervical tumors, 83.5% of ovarian tumors, and 83.6% of uterine tumors. The overall incidence of gynecologic neuroendocrine tumors increased 4-fold during the study period, from 0.3 in 1987 to 1.30 per million in 2012. The study period was divided into two 13-year periods (1987-1999 and 2000-2012) for time trend mean survival analysis. We observed no significant change in overall survival across all gynecologic neuroendocrine tumor subtypes. The mean survival time of cervical neuroendocrine tumors was 74.3 vs 45.4 months (P = .31), ovarian neuroendocrine tumors 47.8 vs 41.2 months (P = .56), and uterine neuroendocrine tumors 42.9 vs 47.7 months (P = .44) for each time period, respectively. CONCLUSION Neuroendocrine tumors of the gynecologic tract are uncommon aggressive malignancies. These poorly differentiated tumors present at advanced stage, with a high incidence of extrauterine disease. Despite 25 years of advances in cancer therapy, we observed no improvement in overall survival.
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Extended topoisomerase 1 inhibition through liposomal irinotecan results in improved efficacy over topotecan and irinotecan in models of small-cell lung cancer. Anticancer Drugs 2018; 28:1086-1096. [PMID: 28857767 DOI: 10.1097/cad.0000000000000545] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Liposomal irinotecan (irinotecan liposome injection, nal-IRI), a liposomal formulation of irinotecan, is designed for extended circulation relative to irinotecan and for exploiting discontinuous tumor vasculature for enhanced drug delivery to tumors. Following tumor deposition, nal-IRI is taken up by phagocytic cells followed by irinotecan release and conversion to its active metabolite, SN-38. Sustained inhibition of topoisomerase 1 by extended SN-38 exposure as a result of delivery by nal-IRI is hypothesized to enable superior antitumor activity compared with traditional topoisomerase 1 inhibitors such as conventional irinotecan and topotecan. We evaluated the antitumor activity of nal-IRI compared with irinotecan and topotecan in preclinical models of small-cell lung cancer (SCLC) including in a model pretreated with carboplatin and etoposide, a first-line regimen used in SCLC. Nal-IRI demonstrated antitumor activity in xenograft models of SCLC at clinically relevant dose levels, and resulted in complete or partial responses in DMS-53, DMS-114, and NCI-H1048 cell line-derived models as well as in three patient-derived xenograft models. The antitumor activity of nal-IRI was superior to that of topotecan in all models tested, which generally exhibited limited control of tumor growth and was superior to irinotecan in four out of five models. Further, nal-IRI demonstrated antitumor activity in tumors that progressed following treatment with topotecan or irinotecan, and demonstrated significantly greater antitumor activity than both topotecan and irinotecan in NCI-H1048 tumors that had progressed on previous carboplatin plus etoposide treatment. These results support the clinical development of nal-IRI in patients with SCLC.
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18
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Patrice GI, Lester-Coll NH, Yu JB, Amdahl J, Delea TE, Patrice SJ. Cost-Effectiveness of Thoracic Radiation Therapy for Extensive-Stage Small Cell Lung Cancer Using Evidence From the Chest Radiotherapy Extensive-Stage Small Cell Lung Cancer Trial (CREST). Int J Radiat Oncol Biol Phys 2017; 100:97-106. [PMID: 29029885 DOI: 10.1016/j.ijrobp.2017.08.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 08/10/2017] [Accepted: 08/28/2017] [Indexed: 12/11/2022]
Abstract
PURPOSE The Chest Radiotherapy Extensive-Stage Small Cell Lung Cancer Trial (CREST) showed that adding thoracic radiation therapy (TRT) to the standard treatment (ST) paradigm of chemotherapy and prophylactic cranial irradiation improves overall survival and progression-free survival (PFS) in patients with extensive-stage small cell lung cancer (ES-SCLC). We evaluated the cost-effectiveness of adding TRT to ST in ES-SCLC patients. METHODS AND MATERIALS A cost-utility analysis was performed comparing TRT plus ST versus ST alone. The base-case time horizon was 24 months, consistent with the maximum PFS reported in the CREST. Overall survival was partitioned into 2 health states: PFS and postprogression survival. The proportion of patients in each health state over time was estimated by fitting parametric probability distributions to the CREST survival data. Costs were from a US health care payer perspective, and utilities were derived from the literature. Incremental cost-effectiveness ratios (ICERs) were calculated per quality-adjusted life-year (QALY) using a 3% discount rate. Sensitivity analyses addressed uncertainty in key variables. RESULTS In the base-case analysis, adding TRT to ST was both cost saving and more effective, thereby strongly dominating ST alone. At willingness-to-pay thresholds of $50,000/QALY, $100,000/QALY, and $200,000/QALY, TRT was preferred 68%, 81%, and 96% of the time, respectively. In the lifetime scenario analysis, the TRT ICER increased to $194,726/QALY. CONCLUSIONS By use of the actual follow-up interval reported in the CREST, adding TRT to ST strongly dominates a strategy of ST alone in ES-SCLC patients. Since the long-term survival benefit of TRT is small relative to ongoing costs of progressive metastatic disease, we estimate less favorable ICERs for TRT over a lifetime horizon.
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Affiliation(s)
| | - Nataniel H Lester-Coll
- Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut
| | - James B Yu
- Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut; Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale University School of Medicine, New Haven, Connecticut
| | | | | | - Stephen J Patrice
- Osprey Center for Decision Sciences, Osprey, Florida; 21st Century Oncology, Venice, Florida.
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Kurishima K, Watanabe H, Ishikawa H, Satoh H, Hizawa N. Modified glasgow prognostic score in patients with small-cell lung cancer. Mol Clin Oncol 2017; 7:121-124. [PMID: 28685088 DOI: 10.3892/mco.2017.1261] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 03/17/2017] [Indexed: 11/06/2022] Open
Abstract
Systemic inflammatory response, which represents the presence of cachexia, is observed often in patients with lung cancer. To evaluate the prognostic significance of the presence of a systemic inflammatory response in small cell lung cancer (SCLC) patients, a retrospective study using modified Glasgow prognostic Score (mGPS) was performed. This score is composed of serum albumin and C-reactive protein levels. All the patients with SCLC who were diagnosed in Tsukuba University Hospital, Tsukuba Medical Center Hospital and Mito Medical Center between April 1999 and July 2016 were included in this study. During the study period, 332 patients with SCLC were consecutively admitted to these hospitals. Among them, 54 (16.9%) had mGPS=1, and 73 (22.9%) had mGPS=2. Male sex, advanced stage, poor performance status and no chemotherapy were unfavorable prognostic factors in uni- and multivariate-analysis. In addition, the presence of a systemic inflammatory response was confirmed as an unfavorable prognostic factor. In patients with SCLC, an existing systemic inflammatory response adversely affected the outcome. The patient's extent of disease as well as medical conditions including systemic inflammatory response must be taken into consideration when deciding whether to offer a standard therapy that may increase treatment-associated mortality.
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Affiliation(s)
- Koichi Kurishima
- Division of Respiratory Medicine, Tsukuba Medical Center Hospital, Tsukuba, Ibaraki 305-8558, Japan
| | - Hiroko Watanabe
- Division of Respiratory Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Hiroichi Ishikawa
- Division of Respiratory Medicine, Tsukuba Medical Center Hospital, Tsukuba, Ibaraki 305-8558, Japan
| | - Hiroaki Satoh
- Division of Respiratory Medicine, Mito Medical Center, University of Tsukuba, Tsukuba, Ibaraki 310-0015, Japan
| | - Nobuyuki Hizawa
- Division of Respiratory Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
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El-Sherbiny IM, Elbaz NM, Sedki M, Elgammal A, Yacoub MH. Magnetic nanoparticles-based drug and gene delivery systems for the treatment of pulmonary diseases. Nanomedicine (Lond) 2017; 12:387-402. [PMID: 28078950 DOI: 10.2217/nnm-2016-0341] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Magnetic nanoparticles (MNPs) have gained much attention due to their unique properties such as biocompatibility and biodegradability as well as magnetic and heat-medicated characteristics. Due to these inherent properties, MNPs have been widely used in various biomedical applications including targeted drug delivery and hyperthermia-based therapy. Hyperthermia is a promising approach for the thermal activation therapy of several diseases, including pulmonary diseases. Additionally, due to their large loading capacity and controlled release ability, several MNP-based drug delivery systems have been emerged for treatment of cystic fibrosis and lung cancer. This review provides an overview on the unique properties of MNPs and magnetic-mediated hyperthermia with emphasis on the recent biomedical applications of MNPs in treatment of both lung cancer and cystic fibrosis.
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Affiliation(s)
- Ibrahim M El-Sherbiny
- Nanomaterials Laboratory, Center for Materials Science, Zewail City of Science & Technology, 6th October City, 12588 Giza, Egypt
| | - Nancy M Elbaz
- Nanomaterials Laboratory, Center for Materials Science, Zewail City of Science & Technology, 6th October City, 12588 Giza, Egypt
| | - Mohammed Sedki
- Nanomaterials Laboratory, Center for Materials Science, Zewail City of Science & Technology, 6th October City, 12588 Giza, Egypt
| | - Abdulaziz Elgammal
- Nanomaterials Laboratory, Center for Materials Science, Zewail City of Science & Technology, 6th October City, 12588 Giza, Egypt
| | - Magdi H Yacoub
- Harefield Heart Science Centre, National Heart & Lung Institute, Imperial College, London, UK
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Hong X, Xu Q, Yang Z, Wang M, Yang F, Gao Y, Zhou F, Wang L, Liu B, Chen G. The value of prognostic factors in Chinese patients with small cell lung cancer: A retrospective study of 999 patients. CLINICAL RESPIRATORY JOURNAL 2016; 12:433-447. [PMID: 27460525 DOI: 10.1111/crj.12534] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 11/10/2015] [Accepted: 07/17/2016] [Indexed: 01/16/2023]
Abstract
INTRODUCTION Little is known about the prognostic factors for small cell lung cancer (SCLC) in Chinese patients. OBJECTIVE The aim of this retrospective study was to improve our understanding of overall survival (OS) and progression-free survival (PFS) prognostic factors in Chinese patients with SCLC. METHODS A retrospective analysis of 999 SCLC cases was performed. Patient characteristics, treatments, and laboratory data, including platelet counts and serum lactate dehydrogenase (LDH) and serum sodium levels, were collected. Potential prognostic factors for OS and PFS were evaluated by univariate and multivariate analyses. RESULTS The median OS and PFS were 10.6 and 7.0 months, respectively. The multivariate Cox proportional hazards model was used to identify stage, serum LDH, and several therapy-relevant factors, including the initial chemotherapy regimen, number of initial chemotherapy cycles, and combination therapy, as independent prognostic factors for OS. Furthermore, female sex, normal LDH levels, a response to therapy, receiving six cycles of initial chemotherapy, and receiving chemotherapy combined with radiotherapy and/or surgery were favorable prognostic factors for PFS. In addition, patients with hyponatremia had a worse OS; therefore, hyponatremia could not influence survival when a good response to therapy was achieved, and it failed to predict PFS. CONCLUSIONS This study demonstrated that several factors, including patient, tumor, and treatment characteristics and serum LDH levels are independent prognostic factors for OS and PFS in Chinese patients with SCLC. The identification of such factors will help physicians compare different populations and to interpret the contribution of treatment to differences in survival among groups.
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Affiliation(s)
- Xuan Hong
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, People's Republic of China
| | - Qingyong Xu
- Department of Radiation Oncology, Harbin Medical University Cancer Hospital, Harbin, People's Republic of China
| | - Zhaoyang Yang
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, People's Republic of China
| | - Meng Wang
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, People's Republic of China
| | - Fang Yang
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, People's Republic of China
| | - Yina Gao
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, People's Republic of China
| | - Fengrui Zhou
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, People's Republic of China
| | - Lei Wang
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, People's Republic of China
| | - Bao Liu
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, People's Republic of China
| | - Gongyan Chen
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, People's Republic of China
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Hong X, Cui B, Wang M, Yang Z, Wang L, Xu Q. Systemic Immune-inflammation Index, Based on Platelet Counts and Neutrophil-Lymphocyte Ratio, Is Useful for Predicting Prognosis in Small Cell Lung Cancer. TOHOKU J EXP MED 2016; 236:297-304. [PMID: 26250537 DOI: 10.1620/tjem.236.297] [Citation(s) in RCA: 209] [Impact Index Per Article: 26.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Small cell lung cancer (SCLC) is an aggressive disease characterized by rapid growth and metastases. It has been recognized that the inflammation of the microenvironment plays a critical role in the development of malignancies. However, little is known about the role of multiple inflammatory and hematological markers in the prognosis of SCLC. The aim of this study was to determine the clinical significance of pre-treatment inflammation-based scores and characteristics as prognostic indicators for the survival of SCLC patients. A retrospective analysis of 919 SCLC cases was performed. Patients' characteristics and hematologic tests data at initial diagnosis were collected. The univariate analysis of all SCLC patients indicated that favorable prognostic factors were age ˂ 70 years, non-smokers, good performance status, limited disease and response to treatment. Moreover, univariate analysis of inflammation-based scores and other blood parameters showed that neutrophil-lymphocyte ratio ≥ 5, platelet-lymphocyte ratio ≥ 250, systemic immune-inflammation index (SII) ≥ 1,600 × 10(9)/L, prognostic nutritional index (albumin + 5 × lymphocyte) < 45, and elevated serum lactate dehydrogenase (LDH) predicted poor prognosis in SCLC patients. SII represents the score that is calculated as follows: platelet count × neutrophil count/lymphocyte count. In the multivariate analysis, SII, together with serum LDH, stage and response to therapy, were associated with overall survival (OS). This study demonstrated that the combination of platelet count and neutrophil-lymphocyte ratio could help to predict poor prognosis in SCLC. Our findings will facilitate the understanding of survival differences in SCLC patients in clinical practice.
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Affiliation(s)
- Xuan Hong
- Department of Medical Oncology, Harbin Medical University Cancer Hospital
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23
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von Pawel J, Jotte R, Spigel DR, O'Brien ME, Socinski MA, Mezger J, Steins M, Bosquée L, Bubis J, Nackaerts K, Trigo JM, Clingan P, Schütte W, Lorigan P, Reck M, Domine M, Shepherd FA, Li S, Renschler MF. Randomized Phase III Trial of Amrubicin Versus Topotecan As Second-Line Treatment for Patients With Small-Cell Lung Cancer. J Clin Oncol 2014; 32:4012-9. [DOI: 10.1200/jco.2013.54.5392] [Citation(s) in RCA: 209] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose Amrubicin, a third-generation anthracycline and potent topoisomerase II inhibitor, showed promising activity in small-cell lung cancer (SCLC) in phase II trials. This phase III trial compared the safety and efficacy of amrubicin versus topotecan as second-line treatment for SCLC. Patients and Methods A total of 637 patients with refractory or sensitive SCLC were randomly assigned at a ratio of 2:1 to 21-day cycles of amrubicin 40 mg/m2 intravenously (IV) on days 1 to 3 or topotecan 1.5 mg/m2 IV on days 1 to 5. Primary end point was overall survival (OS); secondary end points included overall response rate (ORR), progression-free survival (PFS), and safety. Results Median OS was 7.5 months with amrubicin versus 7.8 months with topotecan (hazard ratio [HR], 0.880; P = .170); in refractory patients, median OS was 6.2 and 5.7 months, respectively (HR, 0.77; P = .047). Median PFS was 4.1 months with amrubicin and 3.5 months with topotecan (HR, 0.802; P = .018). ORR was 31.1% with amrubicin and 16.9% with topotecan (odds ratio, 2.223; P < .001). Grade ≥ 3 treatment-emergent adverse events in the amrubicin and topotecan arms were: neutropenia (41% v 54%; P = .004), thrombocytopenia (21% v 54%; P < .001), anemia (16% v 31%; P < .001), infections (16% v 10%; P = .043), febrile neutropenia (10% v 3%; P = .003), and cardiac disorders (5% v 5%; P = .759); transfusion rates were 32% and 53% (P < .001), respectively. NQO1 polymorphisms did not influence safety outcomes. Conclusion Amrubicin did not improve survival when compared with topotecan in the second-line treatment of patients with SCLC. OS did not differ significantly between treatment groups, although an improvement in OS was noted in patients with refractory disease treated with amrubicin.
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Affiliation(s)
- Joachim von Pawel
- Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National
| | - Robert Jotte
- Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National
| | - David R. Spigel
- Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National
| | - Mary E.R. O'Brien
- Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National
| | - Mark A. Socinski
- Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National
| | - Jörg Mezger
- Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National
| | - Martin Steins
- Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National
| | - Léon Bosquée
- Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National
| | - Jeffrey Bubis
- Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National
| | - Kristiaan Nackaerts
- Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National
| | - José M. Trigo
- Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National
| | - Philip Clingan
- Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National
| | - Wolfgang Schütte
- Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National
| | - Paul Lorigan
- Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National
| | - Martin Reck
- Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National
| | - Manuel Domine
- Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National
| | - Frances A. Shepherd
- Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National
| | - Shaoyi Li
- Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National
| | - Markus F. Renschler
- Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National
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Kuriakose S, Umadevi N, Mathew S, Supriya N, Aravindan K, Smitha D, Amritha Malini G. Neuroendocrine carcinoma of the cervix presenting as intractable hyponatremic seizures due to paraneoplastic SIADH-a rare case report and brief review of the literature. Ecancermedicalscience 2014; 8:450. [PMID: 25114722 PMCID: PMC4118728 DOI: 10.3332/ecancer.2014.450] [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: 01/29/2014] [Indexed: 11/23/2022] Open
Abstract
Herein is presented an interesting case of small-cell neuroendocrine carcinoma of the cervix which initially manifests as seizures due to hyponatremia caused by paraneoplastic syndrome of inappropriate anti diuretic hormone (SIADH). Awareness of a paraneoplastic syndrome at presentation can lead to early diagnosis and early initiation of treatment. The management is also unique in that it combines treating the paraneoplastic aspects as well as targeting the tumour itself. Multimodality treatment gives the best outcome in this aggressive tumour.
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Affiliation(s)
- Santhosh Kuriakose
- Government Medical College, Medical College P.O., Kozhikode, Kerala 673001, India
| | - N Umadevi
- Government Medical College, Medical College P.O., Kozhikode, Kerala 673001, India
| | - Sheela Mathew
- Government Medical College, Medical College P.O., Kozhikode, Kerala 673001, India
| | - Nk Supriya
- Government Medical College, Medical College P.O., Kozhikode, Kerala 673001, India
| | - Kp Aravindan
- Government Medical College, Medical College P.O., Kozhikode, Kerala 673001, India
| | - Ds Smitha
- Government Medical College, Medical College P.O., Kozhikode, Kerala 673001, India
| | - G Amritha Malini
- Government Medical College, Medical College P.O., Kozhikode, Kerala 673001, India
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25
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Sheth S, Shende D, Arneja S. Small cell neuroendocrine carcinoma of cervix and leiomyoma between the vagina and rectum. J OBSTET GYNAECOL 2014; 35:314-5. [PMID: 25058833 DOI: 10.3109/01443615.2014.940295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- S Sheth
- Breach Candy Hospital, Saifee Hospital, Sir Hurkisondas Hospital and Sheth Maternity and Gynaecological Nursing Home
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The clinical significance of cytology versus histology-based diagnosis in small cell lung cancer: a retrospective study. Lung Cancer 2014; 85:186-90. [PMID: 24854403 DOI: 10.1016/j.lungcan.2014.04.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Revised: 04/21/2014] [Accepted: 04/28/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the clinical significance of cytology versus histology-based diagnosis among patients diagnosed with small cell lung cancer (SCLC). MATERIALS AND METHODS Retrospective analysis of medical records of 443 patients with histologically or cytologically confirmed small cell lung carcinoma (SCLC) was performed. All patients received platinum-based chemotherapy regimens. Survival data (overall survival) were compared between patients with histology or cytology-based diagnosis in the overall study population as well as after stratification of patients according to disease stage (limited or extensive) at the time of diagnosis. RESULTS Distribution of demographics and clinicopathological characteristics among the two groups ("histology" and "cytology") was similar. No statistically significant differences in the survival curves between the "histology" and "cytology" groups were found in the overall study population (log rank test, p=0.237), as well as in the subgroup of patients with limited disease (log rank test, p=0.474). In contrast, patients with histology-based diagnosis had a statistically significant longer survival as compared to those with cytology-based diagnosis in the extensive disease subgroup (log rank test, p=0.031), but this association was not retained after adjusting the analysis for demographics and clinical characteristics via a Cox regression model (HR=1.18, 95% CI: 0.96-1.44, p=0.110). CONCLUSION The results of our study suggest that the type of diagnostic modality employed (histology or cytology-based) for the establishment of a diagnosis of SCLC may not have a significant effect on the overall survival of patients. Further studies are warranted to further investigate this important, yet rather unexplored, issue.
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27
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Amini A, Byers LA, Welsh JW, Komaki RU. Progress in the management of limited-stage small cell lung cancer. Cancer 2013; 120:790-8. [PMID: 24327434 DOI: 10.1002/cncr.28505] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Revised: 10/30/2013] [Accepted: 11/04/2013] [Indexed: 12/25/2022]
Abstract
Approximately 15% of lung cancer cases are of the small cell subtype, but this variant is highly aggressive and is often diagnosed at advanced stages. Outcomes after current treatment regimens have been poor, with 5-year survival rates as low as 25% for patients with limited-stage disease. Advances in therapy for small cell lung cancer have included the development of more effective chemotherapeutic agents and radiation techniques. For example, hyperfractionated radiotherapy given early in the course of the disease can reduce local recurrence and extend survival. Other technologic advances in radiation planning and delivery such as intensity-modulated radiotherapy, image-guided adaptive radiotherapy, and 4-dimensional computed tomography/positron emission tomography have facilitated the design of treatment volumes that closely conform to the shape of the tumor, which allows higher radiation doses to be given while minimizing radiation-induced toxicity to adjacent structures. Future improvements in outcomes will require clarifying the molecular basis for this disease.
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Affiliation(s)
- Arya Amini
- Department, of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas; University of California at Irvine School of Medicine, Irvine, California
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28
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Liu S, Zhang G, Li C, Chen X, Wang S, Wang M, Cai L. Prognostic factors and survival of patients with small cell lung cancer in a northeastern Chinese population. Thorac Cancer 2013; 4:143-152. [PMID: 28920194 DOI: 10.1111/j.1759-7714.2012.00149.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND This study presents the characteristics and treatment of small cell lung cancer (SCLC) and an analysis of the factors that impact survival in northeastern Chinese populations, among both smokers and non-smokers. METHODS A retrospective review was performed using 485 Chinese patients diagnosed with pathologically confirmed SCLC diagnoses between January 2001 and December 2007. Data on patient characteristics, treatment patterns, and outcome information was collected systematically. Univariate analysis and the Cox multivariate regression model were used to evaluate prognostic factors. RESULTS Median survival time was 16 months in all patients, 31 months in limited stage (LS) patients, and 10 months in extensive-stage (ES) patients. Never-smoking patients (P= 0.0368) with good performance status (PS) (P= 0.0044) or with normal lactate dehydrogenase (LDH) levels (P < 0.0001), demonstrated superior survival rates. Multivariate analysis identified that cycles of chemotherapy, PS, LDH levels, recurrence or progression, and clinical stage were each independent prognostic factors applicable to all patients. In LS-SCLC, cycles of chemotherapy were the only prognostic indicator; however, cycles of chemotherapy, LDH levels, and recurrence or progression, were all significant factors in ES-SCLC. CONCLUSION Cycles of chemotherapy, PS, LDH levels, recurrence or progression, and clinical stage were proved to be independent prognostic factors for SCLC with variant value based on the SCLC tumor stage.
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Affiliation(s)
- Sha Liu
- Fourth Department of Medical Oncology, Third Affiliated Hospital, Harbin Medical University, Harbin, China Department of Thoracic Surgery, Third Affiliated Hospital, Harbin Medical University, Harbin, China Department of Radiotherapy, Affiliated Hospital, Hainan Medical College, Haikou, China
| | - Guoli Zhang
- Fourth Department of Medical Oncology, Third Affiliated Hospital, Harbin Medical University, Harbin, China Department of Thoracic Surgery, Third Affiliated Hospital, Harbin Medical University, Harbin, China Department of Radiotherapy, Affiliated Hospital, Hainan Medical College, Haikou, China
| | - Chunhong Li
- Fourth Department of Medical Oncology, Third Affiliated Hospital, Harbin Medical University, Harbin, China Department of Thoracic Surgery, Third Affiliated Hospital, Harbin Medical University, Harbin, China Department of Radiotherapy, Affiliated Hospital, Hainan Medical College, Haikou, China
| | - Xuesong Chen
- Fourth Department of Medical Oncology, Third Affiliated Hospital, Harbin Medical University, Harbin, China Department of Thoracic Surgery, Third Affiliated Hospital, Harbin Medical University, Harbin, China Department of Radiotherapy, Affiliated Hospital, Hainan Medical College, Haikou, China
| | - Shun Wang
- Fourth Department of Medical Oncology, Third Affiliated Hospital, Harbin Medical University, Harbin, China Department of Thoracic Surgery, Third Affiliated Hospital, Harbin Medical University, Harbin, China Department of Radiotherapy, Affiliated Hospital, Hainan Medical College, Haikou, China
| | - Mingkun Wang
- Fourth Department of Medical Oncology, Third Affiliated Hospital, Harbin Medical University, Harbin, China Department of Thoracic Surgery, Third Affiliated Hospital, Harbin Medical University, Harbin, China Department of Radiotherapy, Affiliated Hospital, Hainan Medical College, Haikou, China
| | - Li Cai
- Fourth Department of Medical Oncology, Third Affiliated Hospital, Harbin Medical University, Harbin, China Department of Thoracic Surgery, Third Affiliated Hospital, Harbin Medical University, Harbin, China Department of Radiotherapy, Affiliated Hospital, Hainan Medical College, Haikou, China
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A Phase I Study of Pomalidomide (CC-4047) in Combination with Cisplatin and Etoposide in Patients with Extensive-Stage Small-Cell Lung Cancer. J Thorac Oncol 2013; 8:423-8. [DOI: 10.1097/jto.0b013e318282707b] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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30
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McCann GA, Boutsicaris CE, Preston MM, Backes FJ, Eisenhauer EL, Fowler JM, Cohn DE, Copeland LJ, Salani R, O'Malley DM. Neuroendocrine carcinoma of the uterine cervix: The role of multimodality therapy in early-stage disease. Gynecol Oncol 2013; 129:135-9. [DOI: 10.1016/j.ygyno.2013.01.014] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Revised: 01/02/2013] [Accepted: 01/16/2013] [Indexed: 10/27/2022]
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Li B, Wang C, Zhang Y, Zhao XY, Huang B, Wu PF, Li Q, Li H, Liu YS, Cao LY, Dai WM, Fang WG, Shang DS, Cao L, Zhao WD, Chen YH. Elevated PLGF contributes to small-cell lung cancer brain metastasis. Oncogene 2012; 32:2952-62. [DOI: 10.1038/onc.2012.313] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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32
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Zhao H, Zhu L, Jin Y, Ji H, Yan X, Zhu X. miR-375 is highly expressed and possibly transactivated by achaete-scute complex homolog 1 in small-cell lung cancer cells. Acta Biochim Biophys Sin (Shanghai) 2012; 44:177-82. [PMID: 22172490 DOI: 10.1093/abbs/gmr110] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
In this study, we identified five miRNAs highly expressed in the small-cell lung cancer (SCLC) cell line NCI-H209. Among them, the expression levels of miR-375 were dramatically elevated in all SCLC cell lines examined, coincident with the expression of the transcription factor achaete-scute complex homolog 1 (ASCL1). Moreover, miR-375 was upregulated and correlated with ASCL1 in the cell lines generated from mouse SCLC-like tumors as well. Dual-luciferase assays further showed that ASCL1 activated the expression of miR-375 by binding to the three E-box elements in the miR-375 promoter. These results imply a role of ASCL1 in SCLC via the upregulation of miR-375.
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Affiliation(s)
- Huijie Zhao
- State Key Laboratory of Cell Biology, Institute of Biochemistry and Cell Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, China
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Arginine deiminase PEG20 inhibits growth of small cell lung cancers lacking expression of argininosuccinate synthetase. Br J Cancer 2011; 106:324-32. [PMID: 22134507 PMCID: PMC3261683 DOI: 10.1038/bjc.2011.524] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Background: Some cancers have been shown to lack expression of argininosuccinate synthetase (ASS), an enzyme required for the synthesis of arginine and a possible biomarker of sensitivity to arginine deprivation. Arginine deiminase (ADI) is a microbial enzyme capable of efficiently depleting peripheral blood arginine. Methods: Argininosuccinate synthetase expression was assessed in human small cell lung cancer (SCLC) by immunohistochemistry (IHC), with expression also assessed in a panel of 10 human SCLC by qRT-PCR and western blot. Proliferation assays and analyses of apoptosis and autophagy assessed the effect of pegylated ADI (ADI-PEG20) in vitro. The in vivo efficacy of ADI-PEG20 was determined in mice bearing SCLC xenografts. Results: Approximately 45% of SCLC tumours and 50% of cell lines assessed were negative for ASS. Argininosuccinate synthetase-deficient SCLC cells demonstrated sensitivity to ADI-PEG20, which was associated with the induction of autophagy and caspase-independent cell death. Arginine deiminase-PEG20 treatment of ASS-negative SCLC xenografts caused significant, dose-dependent inhibition of tumour growth of both small and established tumours. Conclusion: These results suggest a role for ADI-PEG20 in the treatment of SCLC, and a clinical trial exploring this therapeutic approach in patients with ASS-negative SCLC by IHC has now been initiated.
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Abstract
Confined to one side of the chest, limited stage small cell lung cancer is treated with a combination of chemotherapy and radiotherapy, yet has a long-term survival rate of only 15%. Extensive stage disease has initial response rates to chemotherapy exceeding 70%. However, the disease almost invariably progresses and becomes fatal. Many recent clinical trials have failed to show superiority of newer chemotherapeutics or targeted therapies compared with the standard chemotherapy backbone of platinum plus etoposide. Numerous promising targeted therapies and other agents are still in development.
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Gardner GJ, Reidy-Lagunes D, Gehrig PA. Neuroendocrine tumors of the gynecologic tract: A Society of Gynecologic Oncology (SGO) clinical document. Gynecol Oncol 2011; 122:190-8. [PMID: 21621706 DOI: 10.1016/j.ygyno.2011.04.011] [Citation(s) in RCA: 194] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2011] [Revised: 04/12/2011] [Accepted: 04/12/2011] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Neuroendocrine tumors of the gynecologic tract are rare, and pose a significant clinical challenge because of the tumor heterogeneity and lack of standardized guidelines for treatment. This manuscript summarizes the available literature concerning these tumors in an effort to provide the clinician a framework from which to guide patient management. METHODS MEDLINE was searched for all research articles published in English between January 1, 1966 and March 1, 2011 in which the studied population included women diagnosed with neuroendocrine tumors of the gynecologic tract. Although preference was given to prospective studies, studies were not limited by design or by numbers of subjects given the limited availability of reports. RESULTS Most, but not all, neuroendocrine tumors of the gynecologic tract have an aggressive clinical course and those of the cervix histologically and clinically share similarities with small cell lung cancer. Cumulative data supports a multi-modality therapeutic strategy. A proposed management algorithm for neuroendocrine carcinomas of the cervix is outlined. For less frequent disease sites including the adnexa, uterus, vagina and vulva, as well as well differentiated carcinoid tumors, surgical resection is appropriate in selected cases. Etoposide/platinum based chemotherapy is used for neuroendocrine carcinomas but not for well differentiated carcinoid tumors. Well differentiated carcinoid and atypical carcinoid tumors should be managed similar to gastroenteropancreatic NETs (GEP-NETs). CONCLUSIONS Most neuroendocrine tumors of the gynecologic tract require a multi-modality therapeutic approach, determined by extent of disease and primary organ of involvement. Pathologic diagnosis is critical to guide therapy.
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Affiliation(s)
- Ginger J Gardner
- Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
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Fiebiger W, Olszewski U, Ulsperger E, Geissler K, Hamilton G. In vitro cytotoxicity of novel platinum-based drugs and dichloroacetate against lung carcinoid cell lines. Clin Transl Oncol 2011; 13:43-9. [PMID: 21239354 DOI: 10.1007/s12094-011-0615-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Chemotherapy for advanced well-differentiated carcinoids is characterised by low response rates and short duration of responses. The present study aimed to assess the in vitro activity of novel platinum-based chemotherapeutic drugs in combination with dichloroacetate (DCA), a sensitiser to apoptosis, against lung carcinoid cell lines. METHODS Three permanent cell lines (UMC-11, H727 and H835) were exposed to 14 different established cytotoxic drugs and the novel platinum-based compounds as satraplatin, JM118 and picoplatin in combination with DCA, and viability of the cells was measured using a tetrazoliumbased dye assay. RESULTS With exception of the highly chemoresistant UMC- 11 line, the carcinoid cell lines (H727, H835) were sensitive to the majority of chemotherapeutics in vitro. Among the platinum-based drugs, carboplatin and oxaliplatin showed highest efficacy. H835 cells growing as multicellular spheroids were 2.7-8.7-fold more resistant to picoplatin, satraplatin and its metabolite compared to single cell suspensions. DCA (10 mM) inhibited the growth of UMC- 11 cells by 22% and sensitised these highly resistant cells to carboplatin, satraplatin and JM118 1.4-2.4-fold. CONCLUSION The highly resistant UMC-11 lung carcinoid cells are sensitive to carboplatin, oxaliplatin and the satraplatin metabolite JM118, but multicellular spheroidal growth, as observed in the H835 cell line and pulmonary tumourlets, seems to increase chemoresistance markedly. The activity of carboplatin and JM118 is significantly and specifically increased in combination with the apoptosis sensitiser DCA that promotes mitochondrial respiration over aerobic glycolysis. In summary, among the novel platinum drugs satraplatin has the potential for treatment of lung carcinoids and DCA potentiates the cytotoxicity of selected platinum drugs.
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Affiliation(s)
- Wolfgang Fiebiger
- Department of Internal Medicine I, Division of Oncology, St. Poelten Hospital, St. Poelten, Austria
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Jenkinson MD, Haylock B, Shenoy A, Husband D, Javadpour M. Management of cerebral metastasis: Evidence-based approach for surgery, stereotactic radiosurgery and radiotherapy. Eur J Cancer 2011; 47:649-55. [DOI: 10.1016/j.ejca.2010.11.033] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2010] [Accepted: 11/30/2010] [Indexed: 10/18/2022]
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Miles EF, Jacimore LL, Nelson JW. Aggressive Palliation in Extensive Stage Small Cell Lung Cancer, Practice Guidelines versus Clinical Practice: A Case Report and Review of the Literature. LUNG CANCER INTERNATIONAL 2011; 2011:659807. [PMID: 26316931 PMCID: PMC4437404 DOI: 10.4061/2011/659807] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/21/2011] [Accepted: 03/18/2011] [Indexed: 12/25/2022]
Abstract
Small cell lung cancer (SCLC) constitutes approximately 16% of all primary lung cancers, with more than 35,000 new cases per year. Two-thirds of patients present with extensive stage disease (ES-SCLC) due to a tendency to metastasize early. Outcomes remain poor, with a median survival of approximately 10 months and a two-year overall survival of <10%. Current recommendations call for combination chemotherapy alone in patients without localized symptoms. Thoracic radiation therapy following a good clinical response is controversial. We report on a patient with ES-SCLC that had an excellent response to chemotherapy and underwent whole brain radiotherapy for a known brain metastasis and consolidative radiotherapy to the thorax. His latest follow-up demonstrates only a stable residual pulmonary nodule and no evidence of active metastatic disease. ES-SCLC is a relatively common presentation with a variable burden of metastatic disease. In the absence of randomized trials demonstrating the efficacy of thoracic radiation therapy, the community radiation oncologist is placed in a difficult position when addressing these patients, particularly those with otherwise good performance status and a good response to initial systemic chemotherapy. More research in this area is sorely needed to help guide treatment recommendations.
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Affiliation(s)
- Edward F Miles
- Division of Radiation Oncology, Department of Radiology, Naval Medical Center Portsmouth, 620 John Paul Jones Circle, Portsmouth, VA 23708, USA
| | - Laura L Jacimore
- Division of Radiation Oncology, Nash General Hospital, 2460 Curtis Ellis Drive, Rocky Mount, NC 27804, USA
| | - John W Nelson
- Division of Radiation Oncology, Department of Radiology, Naval Medical Center Portsmouth, 620 John Paul Jones Circle, Portsmouth, VA 23708, USA
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