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Niinimäki P, Siuko M, Tynninen O, Kivelä TT, Uusitalo M. Cutaneous squamous cell carcinoma of the eyelid in northern latitudes, a 25-year experience in Finland. Acta Ophthalmol 2024; 102:535-543. [PMID: 38057922 DOI: 10.1111/aos.15819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/10/2023] [Accepted: 11/06/2023] [Indexed: 12/08/2023]
Abstract
PURPOSE To evaluate the incidence, clinical features, diagnostic challenges, management and prognosis of cutaneous squamous cell carcinoma of the eyelid (ecSCC) in southern Finland, northern Europe, latitude 62° N. METHODS Patients were identified from the Finnish Cancer Registry and the Helsinki University Hospital databases during a 25-year period (1998-2022). Age, sex, location, clinical and histopathological diagnosis, treatment and outcome were retrieved. RESULTS Cutaneous squamous cell carcinoma of the eyelid (ecSCC) was diagnosed in 58 patients. The mean age-standardized incidence was 1.03 per 100 000. Median age at the time of histopathological diagnosis was 79 (range 55-93) years; sex ratio was 0.52. Clinical diagnosis in the referral was ecSCC in only three patients. The most frequent misdiagnosis (38%) was basal cell carcinoma (BCC). One or more of the known risk factors (smoking, history of extensive sun exposure, systemic immunosuppression and previous in situ cSCC/cSCC) were documented in 71% of the patients. More than one third (38%) of the patients developed in situ SCC elsewhere on the skin; one third (31%) of the patients had invasive cSCC elsewhere. During the median follow-up time of 24 months, three patients experienced local recurrence, four patients developed metastatic disease (median 19 months) and two patients died of metastatic ecSCC. CONCLUSION The estimated incidence of ecSCC in Finland (predominantly white Caucasian) was higher than in a previous study from Europe. Clinical diagnosis of ecSCC is difficult and often misdiagnosed as BCC. Immunosuppression as a risk factor should noticed. Recurrences of ecSCC, which may be lethal, were infrequent.
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Affiliation(s)
- Paula Niinimäki
- Department of Ophthalmology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Mika Siuko
- Department of Ophthalmology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Olli Tynninen
- Department of Pathology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Tero T Kivelä
- Department of Ophthalmology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Marita Uusitalo
- Department of Ophthalmology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Corchado-Cobos R, García-Sancha N, González-Sarmiento R, Pérez-Losada J, Cañueto J. Cutaneous Squamous Cell Carcinoma: From Biology to Therapy. Int J Mol Sci 2020; 21:ijms21082956. [PMID: 32331425 PMCID: PMC7216042 DOI: 10.3390/ijms21082956] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 04/18/2020] [Accepted: 04/20/2020] [Indexed: 12/13/2022] Open
Abstract
Cutaneous squamous cell carcinoma (CSCC) is the second most frequent cancer in humans and its incidence continues to rise. Although CSCC usually display a benign clinical behavior, it can be both locally invasive and metastatic. The signaling pathways involved in CSCC development have given rise to targetable molecules in recent decades. In addition, the high mutational burden and increased risk of CSCC in patients under immunosuppression were part of the rationale for developing the immunotherapy for CSCC that has changed the therapeutic landscape. This review focuses on the molecular basis of CSCC and the current biology-based approaches of targeted therapies and immune checkpoint inhibitors. Another purpose of this review is to explore the landscape of drugs that may induce or contribute to the development of CSCC. Beginning with the pathogenetic basis of these drug-induced CSCCs, we move on to consider potential therapeutic opportunities for overcoming this adverse effect.
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Affiliation(s)
- Roberto Corchado-Cobos
- Instituto de Biología Molecular y Celular del Cáncer (IBMCC)-Centro de Investigación del cáncer (CIC)-CSIC, Laboratory 7, 37007 Salamanca, Spain; (R.C.-C.); (N.G.-S.); (J.P.-L.)
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Complejo Asistencial Universitario de Salamanca, Hospital Virgen de la Vega, 37007 Salamanca, Spain;
| | - Natalia García-Sancha
- Instituto de Biología Molecular y Celular del Cáncer (IBMCC)-Centro de Investigación del cáncer (CIC)-CSIC, Laboratory 7, 37007 Salamanca, Spain; (R.C.-C.); (N.G.-S.); (J.P.-L.)
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Complejo Asistencial Universitario de Salamanca, Hospital Virgen de la Vega, 37007 Salamanca, Spain;
| | - Rogelio González-Sarmiento
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Complejo Asistencial Universitario de Salamanca, Hospital Virgen de la Vega, 37007 Salamanca, Spain;
- Molecular Medicine Unit, Department of Medicine, University of Salamanca, 37007 Salamanca, Spain
| | - Jesús Pérez-Losada
- Instituto de Biología Molecular y Celular del Cáncer (IBMCC)-Centro de Investigación del cáncer (CIC)-CSIC, Laboratory 7, 37007 Salamanca, Spain; (R.C.-C.); (N.G.-S.); (J.P.-L.)
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Complejo Asistencial Universitario de Salamanca, Hospital Virgen de la Vega, 37007 Salamanca, Spain;
| | - Javier Cañueto
- Instituto de Biología Molecular y Celular del Cáncer (IBMCC)-Centro de Investigación del cáncer (CIC)-CSIC, Laboratory 7, 37007 Salamanca, Spain; (R.C.-C.); (N.G.-S.); (J.P.-L.)
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Complejo Asistencial Universitario de Salamanca, Hospital Virgen de la Vega, 37007 Salamanca, Spain;
- Department of Dermatology, Complejo Asistencial Universitario de Salamanca, 37007 Salamanca, Spain
- Correspondence: ; Tel.: +34-923-291-100 (ext. 55574)
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Darido C, Georgy SR, Cullinane C, Partridge DD, Walker R, Srivastava S, Roslan S, Carpinelli MR, Dworkin S, Pearson RB, Jane SM. Stage-dependent therapeutic efficacy in PI3K/mTOR-driven squamous cell carcinoma of the skin. Cell Death Differ 2017; 25:1146-1159. [PMID: 29238073 DOI: 10.1038/s41418-017-0032-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 10/13/2017] [Accepted: 10/30/2017] [Indexed: 12/16/2022] Open
Abstract
Cutaneous squamous cell carcinoma (SCC) is a recurrent cancer that is prevalent in predisposed subjects such as immunosuppressed patients and patients being treated for other malignancies. Model systems to trial therapies at different stages of SCC development are lacking, therefore precluding efficient therapeutic interventions. Here, we have disrupted the expression of the tumor suppressor GRHL3 to induce loss of PTEN and activation of the PI3K/mTOR signaling pathway in mice and human skin, promoting aggressive SCC development. We then examined the potential for targeting PI3K/mTOR and an oncogenic driver miR-21, alone and in combination, for the prevention and treatment of SCC during the initiation, promotion/progression and establishment stages. Treatment with PI3K/mTOR inhibitors completely prevented tumor initiation, and these inhibitors significantly delayed the course of papilloma progression to malignancy. However, established SCC did not undergo any growth regression, indicating that this therapy is ineffective in established cancers. Mechanistically, the resistant SCCs displayed increased miR-21 expression in mice and humans where antagonists of miR-21 rescued expression levels of GRHL3/PTEN, but the combination of miR-21 antagonism with PI3K/mTOR inhibition resulted in acquired SCC resistance in part via c-MYC and OCT-4 upregulation. In conclusion, our data provide molecular evidence for the efficacy of targeting oncogenic drivers of SCC during the initiation and promotion stages and indicate that combination therapy may induce an aggressive phenotype when applied in the establishment stage.
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Affiliation(s)
- Charbel Darido
- Monash University Central Clinical School, Prahran, VIC, 3004, Australia. .,Division of Cancer Research, Peter MacCallum Cancer Centre, Grattan Street, Parkville, VIC, 3052, Australia. .,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, 3052, Australia.
| | - Smitha R Georgy
- Monash University Central Clinical School, Prahran, VIC, 3004, Australia
| | - Carleen Cullinane
- Division of Cancer Research, Peter MacCallum Cancer Centre, Grattan Street, Parkville, VIC, 3052, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, 3052, Australia
| | - Darren D Partridge
- Monash University Central Clinical School, Prahran, VIC, 3004, Australia
| | - Rachael Walker
- Division of Cancer Research, Peter MacCallum Cancer Centre, Grattan Street, Parkville, VIC, 3052, Australia
| | - Seema Srivastava
- Monash University Central Clinical School, Prahran, VIC, 3004, Australia
| | - Suraya Roslan
- Division of Cancer Research, Peter MacCallum Cancer Centre, Grattan Street, Parkville, VIC, 3052, Australia
| | | | - Sebastian Dworkin
- Department of Biochemistry and Molecular Biology, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Richard B Pearson
- Division of Cancer Research, Peter MacCallum Cancer Centre, Grattan Street, Parkville, VIC, 3052, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, 3052, Australia.,Department of Physiology, Anatomy and Microbiology, LaTrobe University, Bundoora, VIC, 3086, Australia.,Department of Biochemistry and Molecular Biology, Monash University, Clayton, VIC, 3168, Australia
| | - Stephen M Jane
- Monash University Central Clinical School, Prahran, VIC, 3004, Australia.,Department of Hematology, Alfred Hospital, Prahran, VIC, 3004, Australia
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Wu JH, Cohen DN, Rady PL, Tyring SK. BRAF inhibitor-associated cutaneous squamous cell carcinoma: new mechanistic insight, emerging evidence for viral involvement and perspectives on clinical management. Br J Dermatol 2017; 177:914-923. [PMID: 28129674 DOI: 10.1111/bjd.15348] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2017] [Indexed: 12/18/2022]
Abstract
Mutations in the BRAF proto-oncogene occur in the majority of cutaneous melanomas. The commonly detected valine (V) to glutamate (E) mutation (V600E) is known to drive melanomagenesis and has thus been the target of two highly selective chemotherapeutic agents: vemurafenib and dabrafenib. While BRAF inhibitor therapy has revolutionized the treatment of metastatic melanoma, unanticipated cutaneous toxicities, including the development of cutaneous squamous cell carcinomas (cSCCs), are frequently reported and hinder therapeutic durability. However, the mechanisms by which BRAF inhibitors induce cutaneous neoplasms are poorly understood, thus posing a challenge for specific therapies. In this review, we summarize the clinical and molecular profiles of BRAF inhibitor-associated cSCCs, with a focus on factors that may contribute to disease pathogenesis. In particular, we discuss the emerging evidence pointing towards viral involvement in BRAF inhibitor-induced cutaneous neoplasms and offer new perspectives on future therapeutic interventions. Continued clinical and mechanistic studies along this line will not only allow for better understanding of the pathogenic progression of BRAF inhibitor-induced cSCCs, but will also lead to development of new therapeutic and preventative options for patients receiving targeted cancer therapy.
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Affiliation(s)
- J H Wu
- Baylor College of Medicine, Houston, TX, U.S.A.,Department of Dermatology, University of Texas Health Science Center at Houston, Houston, TX, U.S.A
| | - D N Cohen
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX, U.S.A
| | - P L Rady
- Department of Dermatology, University of Texas Health Science Center at Houston, Houston, TX, U.S.A
| | - S K Tyring
- Department of Dermatology, University of Texas Health Science Center at Houston, Houston, TX, U.S.A
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Youssef M, Cuddihy A, Darido C. Long-Lived Epidermal Cancer-Initiating Cells. Int J Mol Sci 2017; 18:E1369. [PMID: 28654000 PMCID: PMC5535862 DOI: 10.3390/ijms18071369] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 06/15/2017] [Accepted: 06/21/2017] [Indexed: 01/09/2023] Open
Abstract
Non-melanomatous skin cancers (NMSCs), which include basal and squamous cell carcinoma (BCC and SCC respectively), represent a significant burden on the population, as well as an economic load to the health care system; yet treatments of these preventable cancers remain ineffective. Studies estimate that there has been a 2-fold increase in the incidence of NMSCs between the 1960s and 1980s. The increase in cases of NMSCs, as well as the lack of effective treatments, makes the need for novel therapeutic approaches all the more necessary. To rationally develop more targeted treatments for NMSCs, a better understanding of the cell of origin, in addition to the underlying pathophysiological mechanisms that govern the development of these cancers, is urgently required. Research over the past few years has provided data supporting both a "bottom up" and "top down" mechanism of tumourigenesis. The "bottom up" concept involves a cancer stem cell originating in the basal compartment of the skin, which ordinarily houses the progenitor cells that contribute towards wound healing and normal cell turnover of overlying epidermal skin layers. The "top down" concept involves a more differentiated cell undergoing genetic modifications leading to dedifferentiation, giving rise to cancer initiating cells (CICs). This review explores both concepts, to paint a picture of the skin SCC cell of origin, the underlying biology, and also how this knowledge might be exploited to develop novel therapies.
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Affiliation(s)
- Marina Youssef
- Department of Medicine, Monash University Central Clinical School, Prahran, VIC 3004, Australia.
| | - Andrew Cuddihy
- Division of Cancer Research, Peter MacCallum Cancer Centre, Grattan Street, Parkville, VIC 3052, Australia.
| | - Charbel Darido
- Department of Medicine, Monash University Central Clinical School, Prahran, VIC 3004, Australia.
- Division of Cancer Research, Peter MacCallum Cancer Centre, Grattan Street, Parkville, VIC 3052, Australia.
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC 3052, Australia.
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Selmer J, Skov T, Spelman L, Weedon D. Squamous cell carcinoma and keratoacanthomas are biologically distinct and can be diagnosed by light microscopy: a review. Histopathology 2016; 69:535-41. [DOI: 10.1111/his.13018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Johan Selmer
- Medical Department; LEO Pharma; Ballerup Denmark
| | - Torsten Skov
- Medical Department; LEO Pharma; Ballerup Denmark
| | - Lynda Spelman
- Queensland Institute of Dermatology and Veracity Clinical Research; Brisbane Australia
| | - David Weedon
- Sullivan Nicolaides Pathology; Brisbane Australia
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Cantariño N, Fernández-Figueras MT, Valero V, Musulén E, Malinverni R, Granada I, Goldie SJ, Martín-Caballero J, Douet J, Forcales SV, Buschbeck M. A cellular model reflecting the phenotypic heterogeneity of mutant HRAS driven squamous cell carcinoma. Int J Cancer 2016; 139:1106-16. [PMID: 27074337 DOI: 10.1002/ijc.30139] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 01/07/2016] [Indexed: 12/28/2022]
Abstract
Squamous cell carcinomas have a range of histopathological manifestations. The parameters that determine this clinically observed heterogeneity are not fully understood. Here, we report the generation of a cell culture model that reflects part of this heterogeneity. We have used the catalytic subunit of human telomerase hTERT and large T to immortalize primary UV-unexposed keratinocytes. Then, mutant HRAS G12V has been introduced to transform these immortal keratinocytes. When injected into immunosuppressed mice, transformed cells grew as xenografts with distinct histopathological characteristics. We observed three major tissue architectures: solid, sarcomatoid and cystic growth types, which were primarily composed of pleomorphic and basaloid cells but in some cases displayed focal apocrine differentiation. We demonstrate that the cells generated represent different stages of skin cancerogenesis and as such can be used to identify novel tumor-promoting alterations such as the overexpression of the PADI2 oncogene in solid-type SCC. Importantly, the cultured cells maintain the characteristics from the xenograft they were derived from while being amenable to manipulation and analysis. The availability of cell lines representing different clinical manifestations opens a new tool to study the stochastic and deterministic factors that cause case-to-case heterogeneity despite departing from the same set of oncogenes and the same genetic background.
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Affiliation(s)
- Neus Cantariño
- Institute of Predictive and Personalized Medicine of Cancer, Campus Can Ruti, Badalona, Spain
| | | | - Vanesa Valero
- Institute of Predictive and Personalized Medicine of Cancer, Campus Can Ruti, Badalona, Spain.,Josep Carreras Leukaemia Research Institute (IJC), Campus ICO - Germans Trias I Pujol, (IJC), Campus Can Ruti, Badalona, Spain
| | - Eva Musulén
- Department Of Pathology, Hospital Universitari Germans Trias I Pujol, Campus Can Ruti, Badalona, Spain
| | - Roberto Malinverni
- Institute of Predictive and Personalized Medicine of Cancer, Campus Can Ruti, Badalona, Spain.,Josep Carreras Leukaemia Research Institute (IJC), Campus ICO - Germans Trias I Pujol, (IJC), Campus Can Ruti, Badalona, Spain
| | - Isabel Granada
- Josep Carreras Leukaemia Research Institute (IJC), Campus ICO - Germans Trias I Pujol, (IJC), Campus Can Ruti, Badalona, Spain.,Department of Hematology, Instituto Catalán De Oncología (ICO) - Hospital Universitari Germans Trias I Pujol, Universitat Autònoma De Barcelona, Campus Can Ruti, Badalona, Spain
| | - Stephen J Goldie
- Li KaShing Centre, Cancer Research UK Cambridge Research Institute, Robinson Way, Cambridge, CB2 0RE, United Kingdom
| | | | - Julien Douet
- Josep Carreras Leukaemia Research Institute (IJC), Campus ICO - Germans Trias I Pujol, (IJC), Campus Can Ruti, Badalona, Spain
| | - Sonia-Vanina Forcales
- Institute of Predictive and Personalized Medicine of Cancer, Campus Can Ruti, Badalona, Spain
| | - Marcus Buschbeck
- Institute of Predictive and Personalized Medicine of Cancer, Campus Can Ruti, Badalona, Spain.,Josep Carreras Leukaemia Research Institute (IJC), Campus ICO - Germans Trias I Pujol, (IJC), Campus Can Ruti, Badalona, Spain
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Wick MR, Gru AA. Metastatic melanoma: Pathologic characterization, current treatment, and complications of therapy. Semin Diagn Pathol 2016; 33:204-18. [PMID: 27234321 DOI: 10.1053/j.semdp.2016.04.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Metastatic melanoma (MM) has the potential to involve virtually any anatomical site, and it also has a wide spectrum of histological appearances. General clinicopathologic data pertaining to MM are presented in this review, together with a discussion of its differential diagnosis and therapy. "Biological" agents used in the treatment of melanoma are considered, along with the pathological features of the complications that they may cause.
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Affiliation(s)
- Mark R Wick
- Division of Surgical Pathology & Cytopathology, University of Virginia Medical Center, Charlottesville, Virginia.
| | - Alejandro A Gru
- Division of Surgical Pathology & Cytopathology, University of Virginia Medical Center, Charlottesville, Virginia
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