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Lu H, Ye Q, Zheng C, Fan L, Xia X. Efficacy and safety analysis of TACE + sunitinib vs. sunitinib in the treatment of unresectable advanced renal cell carcinoma: a retrospective study. BMC Cancer 2023; 23:270. [PMID: 36964538 PMCID: PMC10037847 DOI: 10.1186/s12885-023-10754-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 03/20/2023] [Indexed: 03/26/2023] Open
Abstract
BACKGROUND Since renal cell carcinoma(RCC) is insensitive to conventional chemoradiotherapy, molecularly targeted drugs are commonly used treatments for unresectable advanced RCC. The aim of this study was to explore the efficacy and safety of TACE + sunitinib vs. sunitinib in the treatment of unresectable advanced RCC. METHODS This study included 98 patients with unresectable advanced RCC who were treated in Union Hospital from January 2015 to December 2018, and they met the criteria. They were divided into two groups: TACE + Sunitinib group (N = 47) and Sunitinib group (N = 51). We conducted a retrospective study to analyze the efficacy and safety of the two groups of patients. RESULTS (1)TACE + Sunitinib group: 4 patients (8.5%) achieved CR, 27 patients (57.5%) achieved PR, 9 patients (19.1%) achieved SD, and 7 patients (14.9%) achieved PD. Sunitinib group, 0 patients (0%) achieved CR, 20 patients (39.2%) achieved PR, 14 patients (27.5%) achieved SD, and 17 patients (33.3%) achieved PD. (P = 0.017) (2)ORR: TACE + sunitinib group, 66.0%; sunitinib group, 39.2%. (P = 0.009) (3)DCR: TACE + sunitinib group, 85.1%; sunitinib group, 66.7%. (P = 0.038) (4) In the TACE + sunitinib group, mPFS was 15.6 months, mOS was 35.0 months; in the sunitinib group, the mPFS was 10.9 months, mOS was 25.7 months. (P < 0.001) (5) The incidence of abdominal pain, fever, and vomiting was higher in the TACE + sunitinib group than in the sunitinib group (abdominal pain: 55.3% vs. 13.7%; fever: 61.7% vs. 7.8%; vomiting: 40.4% vs. 19.6%; P < 0.05). The technical success rate of TACE in TACE + Sunitinib group is 100%. CONCLUSIONS The TACE + sunitinib group had higher ORR and DCR, longer OS and PFS than the sunitinib alone group. TACE combined with sunitinib can play a complementary role and is a safe and effective treatment for advanced RCC.
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Affiliation(s)
- Haohao Lu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, Wuhan, 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Qing Ye
- Huazhong University of Science and Technology Hospital, Luoyu Road #1037, Wuhan, 430071, China
| | - Chuansheng Zheng
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, Wuhan, 430022, China.
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China.
| | - Li Fan
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
- Department of Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, Wuhan, 430022, China
| | - Xiangwen Xia
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, Wuhan, 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
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Cheng QW, Shen HL, Dong ZH, Zhang QQ, Wang YF, Yan J, Wang YS, Zhang NG. Pneumocystis jirovecii diagnosed by next-generation sequencing of bronchoscopic alveolar lavage fluid: A case report and review of literature. World J Clin Cases 2023; 11:866-873. [PMID: 36818625 PMCID: PMC9928697 DOI: 10.12998/wjcc.v11.i4.866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 12/22/2022] [Accepted: 01/09/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The advent of molecular targeted agents and immune checkpoint inhibitors has greatly improved the treatment of advanced renal cell carcinoma (RCC), thus significantly improving patient survival. The incidence of rare drug-related adverse events has gained increased attention.
CASE SUMMARY We report a patient with advanced RCC treated with multiple lines of molecular targeted agents and immune checkpoint inhibitors, who developed a pulmonary infection after treatment with everolimus in combination with lenvatinib. Determining the pathogenic organism was difficult, but it was eventually identified as Pneumocystis jirovecii by next-generation sequencing (NGS) of bronchoscopic alveolar lavage fluid (BALF) and successfully treated with trimethoprim-sulfamethoxazole.
CONCLUSION Rare pulmonary infections caused by molecular targeted agents are not uncommon in clinical practice, but their diagnosis is difficult. Evaluating BALF with NGS is a good method for rapid diagnosis of such infections.
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Affiliation(s)
- Qing-Wei Cheng
- Department of Oncology, The Sixth Division Hospital, Xinjiang Production and Construction Corps, Wujiaqu 831300, Xinjiang Uygur Autonomous Regions, China
| | - Hong-Li Shen
- Department of Oncology, The Sixth Division Hospital, Xinjiang Production and Construction Corps, Wujiaqu 831300, Xinjiang Uygur Autonomous Regions, China
| | - Zhi-Hui Dong
- Department of Oncology, The Sixth Division Hospital, Xinjiang Production and Construction Corps, Wujiaqu 831300, Xinjiang Uygur Autonomous Regions, China
| | - Qian-Qian Zhang
- Department of Oncology, The Sixth Division Hospital, Xinjiang Production and Construction Corps, Wujiaqu 831300, Xinjiang Uygur Autonomous Regions, China
| | - Ya-Fen Wang
- Department of Oncology, The Sixth Division Hospital, Xinjiang Production and Construction Corps, Wujiaqu 831300, Xinjiang Uygur Autonomous Regions, China
| | - Jin Yan
- Department of Oncology, The Sixth Division Hospital, Xinjiang Production and Construction Corps, Wujiaqu 831300, Xinjiang Uygur Autonomous Regions, China
| | - Yu-Sheng Wang
- Department of Gastrointestinal Oncology, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan 030013, Shanxi Province, China
| | - Ning-Gang Zhang
- Department of Gastrointestinal Oncology, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan 030013, Shanxi Province, China
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Sun H, Zheng J, Xiao J, Yue J, Shi Z, Xuan Z, Chen C, Zhao Y, Tang W, Ye S, Li J, Deng Q, Zhang L, Zhu F, Shao C. TOPK/PBK is phosphorylated by ERK2 at serine 32, promotes tumorigenesis and is involved in sorafenib resistance in RCC. Cell Death Dis 2022; 13:450. [PMID: 35546143 PMCID: PMC9095598 DOI: 10.1038/s41419-022-04909-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 04/18/2022] [Accepted: 05/03/2022] [Indexed: 12/14/2022]
Abstract
TOPK/PBK (T-LAK Cell-Originated Protein Kinase) is a serine/threonine kinase that is highly expressed in a variety of human tumors and is associated with poor prognosis in many types of human malignancies. Its activation mechanism is not yet fully understood. A bidirectional signal transduced between TOPK and ERK2 (extracellular signal-regulated kinase 2) has been reported, with ERK2 able to phosphorylate TOPK at the Thr9 residue. However, mutated TOPK at Thr9 cannot repress cellular transformation. In the present study, Ser32 was revealed to be a novel phosphorylated site on TOPK that could be activated by ERK2. Phospho-TOPK (S32) was found to be involved in the resistance of renal cell carcinoma (RCC) to sorafenib. Herein, combined a TOPK inhibitor with sorafenib could promoted the apoptosis of sorafenib-resistant RCC. High expression of HGF/c-met contributes to activation of p-TOPK (S32) during the development of sorafenib resistance in RCC. The current research presents a possible mechanism of sorafenib resistance in RCC and identifies a potential diagnostic marker for predicting sorafenib resistance in RCC, providing a valuable supplement for the clinically targeted treatment of advanced RCC.
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Affiliation(s)
- Huimin Sun
- Central Laboratory, Xiang'an Hospital of Xiamen University, Xiamen, 361102, Fujian, China
- The Key Laboratory for Endocrine-Related Cancer precision Medicine of Xiamen, Xiamen, 361102, Fujian, China
| | - Jianzhong Zheng
- School of Medicine, Xiamen University, Xiamen, 361102, Fujian, China
- Department of Urology, Xiang'an Hospital of Xiamen University, Xiamen, 361102, Fujian, China
| | - Juanjuan Xiao
- Cancer Research Institute, the Affiliated Hospital of Guilin Medical University, Guilin, 541001, Guangxi, China
- Guangxi Health Commission Key Laboratory of Novel Onco-Kinases in Target Therapy, the Affiliated Hospital of Guilin Medical University, Guilin, 541001, Guangxi, China
| | - Juntao Yue
- Department of Urology, 985th hospital of PLA, Taiyuan, 030002, Shanxi, China
| | - Zhiyuan Shi
- School of Medicine, Xiamen University, Xiamen, 361102, Fujian, China
- Department of Urology, Xiang'an Hospital of Xiamen University, Xiamen, 361102, Fujian, China
| | - Zuodong Xuan
- School of Medicine, Xiamen University, Xiamen, 361102, Fujian, China
- Department of Urology, Xiang'an Hospital of Xiamen University, Xiamen, 361102, Fujian, China
| | - Chen Chen
- School of Medicine, Xiamen University, Xiamen, 361102, Fujian, China
- Department of Urology, Xiang'an Hospital of Xiamen University, Xiamen, 361102, Fujian, China
| | - Yue Zhao
- School of Medicine, Xiamen University, Xiamen, 361102, Fujian, China
- Department of Urology, Xiang'an Hospital of Xiamen University, Xiamen, 361102, Fujian, China
| | - Wenbin Tang
- School of Medicine, Xiamen University, Xiamen, 361102, Fujian, China
- Department of Urology, Xiang'an Hospital of Xiamen University, Xiamen, 361102, Fujian, China
| | - Shaopei Ye
- School of Medicine, Xiamen University, Xiamen, 361102, Fujian, China
- Department of Urology, Xiang'an Hospital of Xiamen University, Xiamen, 361102, Fujian, China
| | - Jinxin Li
- School of Medicine, Xiamen University, Xiamen, 361102, Fujian, China
- Department of Urology, Xiang'an Hospital of Xiamen University, Xiamen, 361102, Fujian, China
| | - Qiumin Deng
- The Key Laboratory for Endocrine-Related Cancer precision Medicine of Xiamen, Xiamen, 361102, Fujian, China
- School of Medicine, Xiamen University, Xiamen, 361102, Fujian, China
| | - Lei Zhang
- Department of Public healthy, Xiamen University, Xiamen, 361102, Fujian, China
| | - Feng Zhu
- Cancer Research Institute, the Affiliated Hospital of Guilin Medical University, Guilin, 541001, Guangxi, China.
- Guangxi Health Commission Key Laboratory of Novel Onco-Kinases in Target Therapy, the Affiliated Hospital of Guilin Medical University, Guilin, 541001, Guangxi, China.
- Guangxi Key Laboratory of Molecular Medicine in Liver Injury and Repair, the Affiliated Hospital of Guilin Medical University, Guilin, 541001, Guangxi, China.
| | - Chen Shao
- Department of Urology, Xiang'an Hospital of Xiamen University, Xiamen, 361102, Fujian, China.
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