1
|
Wilmas KM, Nguyen QB, Patel J, Silapunt S, Migden MR. Treatment of advanced cutaneous squamous cell carcinoma: a Mohs surgery and dermatologic oncology perspective. Future Oncol 2021; 17:4971-4982. [PMID: 34608809 DOI: 10.2217/fon-2021-0901] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Locally advanced or metastatic cutaneous squamous cell carcinoma no longer amenable to surgical resection or primary radiation therapy requires an alternative approach to treatment. Until 2018, management consisted of limited systemic chemotherapies, which carried marginal clinical benefit. The introduction of immunotherapy with anti-PD-1 antibodies resulted in alternative treatment options for advanced cutaneous squamous cell carcinoma with substantial antitumor activity, durable response and acceptable safety profile. The field of immunotherapeutics continues to expand with adjuvant, neoadjuvant and intralesional studies currently in progress. Herein, the authors discuss their approach for the treatment of advanced cutaneous squamous cell carcinoma from the perspective of a Mohs surgeon and a dermatologic oncologist.
Collapse
Affiliation(s)
- Kelly M Wilmas
- Department of Dermatology, The University of Texas McGovern Medical School at Houston, Houston, TX, USA
| | - Quoc-Bao Nguyen
- Department of Dermatology, The University of Texas McGovern Medical School at Houston, Houston, TX, USA
| | - Jigar Patel
- Department of Dermatology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sirunya Silapunt
- Department of Dermatology, The University of Texas McGovern Medical School at Houston, Houston, TX, USA
| | - Michael R Migden
- Departments of Dermatology & Head & Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|
2
|
Petersen ET, Ahmed SR, Chen L, Silapunt S, Migden MR. Review of systemic agents in the treatment of advanced cutaneous squamous cell carcinoma. Future Oncol 2019; 15:3171-3184. [PMID: 31382778 DOI: 10.2217/fon-2019-0158] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Advanced cutaneous squamous cell carcinoma (cSCC) accounts for only 5% of all cases of cSCC but up to 60% of disease related deaths. Historically, this disease has lacked effective treatment options due to a combination of poor response rate, poor response durability and significant treatment-associated morbidity. Autumn of 2018 marked the first time ever that an agent received US FDA approval for advanced cSCC and the future is looking much brighter for this previously neglected patient population. The purpose of this article is to review the various systemic treatment options for advanced cSCC moving from the past to the present, highlighting their relative merits and shortcomings, and to briefly speculate on future developments in the field of advanced cSCC.
Collapse
Affiliation(s)
- Erik T Petersen
- University of Texas MD Anderson Cancer Center, Department of Dermatology, Mohs and Dermasurgery Unit, Houston, TX 77030, USA
| | - Saqib R Ahmed
- University of Texas MD Anderson Cancer Center, Department of Dermatology, Mohs and Dermasurgery Unit, Houston, TX 77030, USA
| | - Leon Chen
- University of Texas McGovern Medical School Department of Dermatology, Houston, TX 77030, USA
| | - Sirunya Silapunt
- University of Texas McGovern Medical School Department of Dermatology, Houston, TX 77030, USA
| | - Michael R Migden
- University of Texas MD Anderson Cancer Center, Department of Dermatology, Mohs and Dermasurgery Unit, Houston, TX 77030, USA.,University of Texas MD Anderson Cancer Center Department of Head & Neck Surgery, Houston, TX 77030, USA
| |
Collapse
|
3
|
Dickinson SE, Wondrak GT. TLR4 in skin cancer: From molecular mechanisms to clinical interventions. Mol Carcinog 2019; 58:1086-1093. [PMID: 31020719 DOI: 10.1002/mc.23016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 03/22/2019] [Accepted: 03/29/2019] [Indexed: 12/15/2022]
Abstract
The health and economic burden imposed by skin cancer is substantial, creating an urgent need for the development of improved molecular strategies for its prevention and treatment. Cutaneous exposure to solar ultraviolet (UV) radiation is a causative factor in skin carcinogenesis, and TLR4-dependent inflammatory dysregulation is an emerging key mechanism underlying detrimental effects of acute and chronic UV exposure. Direct and indirect TLR4 activation, upstream of inflammatory signaling, is elicited by a variety of stimuli, including pathogen-associated molecular patterns (such as lipopolysaccharide) and damage-associated molecular patterns (such as HMGB1) that are formed upon exposure to environmental stressors, such as solar UV. TLR4 involvement has now been implicated in major types of skin malignancies, including nonmelanoma skin cancer, melanoma and Merkel cell carcinoma. Targeted molecular interventions that positively or negatively modulate TLR4 signaling have shown promise in translational, preclinical, and clinical investigations that may benefit skin cancer patients in the near future.
Collapse
Affiliation(s)
- Sally E Dickinson
- Department of Pharmacology, College of Medicine and The University of Arizona Cancer Center, University of Arizona, Tucson, Arizona
| | - Georg T Wondrak
- Department of Pharmacology and Toxicology, College of Pharmacy and The University of Arizona Cancer Center, University of Arizona, Tucson, Arizona
| |
Collapse
|
4
|
Koelsche C, Stichel D, Griewank KG, Schrimpf D, Reuss DE, Bewerunge-Hudler M, Vokuhl C, Dinjens WNM, Petersen I, Mittelbronn M, Cuevas-Bourdier A, Buslei R, Pfister SM, Flucke U, Mechtersheimer G, Mentzel T, von Deimling A. Genome-wide methylation profiling and copy number analysis in atypical fibroxanthomas and pleomorphic dermal sarcomas indicate a similar molecular phenotype. Clin Sarcoma Res 2019; 9:2. [PMID: 30809375 PMCID: PMC6375211 DOI: 10.1186/s13569-019-0113-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 02/05/2019] [Indexed: 12/14/2022] Open
Abstract
Background Atypical fibroxanthomas (AFX) and pleomorphic dermal sarcomas (PDS) are lesions of the skin with overlapping histologic features and unspecific molecular traits. PDS behaves aggressive compared to AFX. Thus, a precise delineation, although challenging in some instances, is relevant. Methods We examined the value of DNA-methylation profiling and copy number analysis for separating these tumors. DNA-methylation data were generated from 17 AFX and 15 PDS using the Illumina EPIC array. These were compared with DNA-methylation data generated from 196 tumors encompassing potential histologic mimics like cutaneous squamous carcinomas (cSCC; n = 19), basal cell carcinomas (n = 10), melanoma metastases originating from the skin (n = 11), leiomyosarcomas (n = 11), angiosarcomas of the skin and soft tissue (n = 11), malignant peripheral nerve sheath tumors (n = 19), dermatofibrosarcomas protuberans (n = 13), extraskeletal myxoid chondrosarcomas (n = 9), myxoid liposarcomas (n = 14), schwannomas (n = 10), neurofibromas (n = 21), alveolar (n = 19) and embryonal (n = 17) rhabdomyosarcomas as well as undifferentiated pleomorphic sarcomas (n = 12). Results DNA-methylation profiling did not separate AFX from PDS. The DNA-methylation profiles of the other cases, however, were distinct from AFX/PDS. They reliably assigned to subtype-specific DNA-methylation clusters, although overlap occurred between some AFX/PDS and cSCC. Copy number profiling revealed alterations in a similar frequency and distribution between AFX and PDS. They involved losses of 9p (22/32) and 13q (25/32). Gains frequently involved 8q (8/32). Notably, a homozygous deletion of CDKN2A was more frequent in PDS (6/15) than in AFX (2/17), whereas amplifications were non-recurrent and overall rare (5/32). Conclusions Our findings support the concept that AFX and PDS belong to a common tumor spectrum. We could demonstrate the diagnostic value of DNA-methylation profiling to delineating AFX/PDS from potential mimics. However, the assessment of certain histologic features remains crucial for separating PDS from AFX.
Collapse
Affiliation(s)
- Christian Koelsche
- 1Department of General Pathology, Institute of Pathology, Heidelberg University Hospital, Im Neuenheimer Feld 224, 69120 Heidelberg, Baden-Württemberg Germany
| | - Damian Stichel
- 2Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Im Neuenheimer Feld 224, 69120 Heidelberg, Baden-Württemberg Germany.,3Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), Heidelberg, Baden-Württemberg Germany.,4German Cancer Consortium (DKTK), Core Center Heidelberg, Heidelberg, Baden-Württemberg Germany
| | - Klaus G Griewank
- 5Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK), Essen, North Rhine-Westphalia Germany.,Dermatopathologie bei Mainz, Nieder-Olm, Rhineland-Palatinate Germany
| | - Daniel Schrimpf
- 2Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Im Neuenheimer Feld 224, 69120 Heidelberg, Baden-Württemberg Germany.,3Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), Heidelberg, Baden-Württemberg Germany.,4German Cancer Consortium (DKTK), Core Center Heidelberg, Heidelberg, Baden-Württemberg Germany
| | - David E Reuss
- 2Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Im Neuenheimer Feld 224, 69120 Heidelberg, Baden-Württemberg Germany.,3Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), Heidelberg, Baden-Württemberg Germany.,4German Cancer Consortium (DKTK), Core Center Heidelberg, Heidelberg, Baden-Württemberg Germany
| | - Melanie Bewerunge-Hudler
- 4German Cancer Consortium (DKTK), Core Center Heidelberg, Heidelberg, Baden-Württemberg Germany.,7Genomics and Proteomics Core Facility, Microarray Unit, German Cancer Research Center (DKFZ), Heidelberg, Baden-Württemberg Germany
| | - Christian Vokuhl
- 8Department of Pediatric Pathology, University Hospital of Schleswig-Holstein, Kiel, Schleswig-Holstein Germany
| | - Winand N M Dinjens
- 9Department of Pathology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Iver Petersen
- Institute of Pathology, SRH Poliklinik Gera GmbH, Gera, Germany
| | - Michel Mittelbronn
- Luxembourg Centre of Neuropathology (LCNP), Luxembourg City, Luxembourg.,12Laboratoire National de Santé (LNS), Dudelange, Luxembourg.,13Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Luxembourg City, Luxembourg.,14NORLUX Neuro-Oncology Laboratory, Luxembourg Institute of Health (LIH), Luxembourg City, Luxembourg
| | | | - Rolf Buslei
- 15Institute of Pathology, Sozialstiftung Bamberg, Bamberg, Germany
| | - Stefan M Pfister
- 4German Cancer Consortium (DKTK), Core Center Heidelberg, Heidelberg, Baden-Württemberg Germany.,16Hopp Childrens Cancer Center at the NCT Heidelberg (KiTZ), Heidelberg, Germany.,17Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, Baden-Württemberg Germany.,18Department of Pediatric Oncology, Hematology and Immunology, University of Heidelberg, Heidelberg, Baden-Württemberg Germany
| | - Uta Flucke
- 19Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Gunhild Mechtersheimer
- 1Department of General Pathology, Institute of Pathology, Heidelberg University Hospital, Im Neuenheimer Feld 224, 69120 Heidelberg, Baden-Württemberg Germany
| | - Thomas Mentzel
- Dermatopathology Bodensee, Friedrichshafen, Baden-Württemberg Germany
| | - Andreas von Deimling
- 2Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Im Neuenheimer Feld 224, 69120 Heidelberg, Baden-Württemberg Germany.,3Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), Heidelberg, Baden-Württemberg Germany.,4German Cancer Consortium (DKTK), Core Center Heidelberg, Heidelberg, Baden-Württemberg Germany
| |
Collapse
|
5
|
Dickinson SE, Wondrak GT. TLR4-directed Molecular Strategies Targeting Skin Photodamage and Carcinogenesis. Curr Med Chem 2019; 25:5487-5502. [DOI: 10.2174/0929867324666170828125328] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 06/30/2017] [Accepted: 06/30/2017] [Indexed: 01/16/2023]
Abstract
Background:
Exposure to solar ultraviolet (UV) radiation is a causative factor in
skin photodamage and carcinogenesis, and inflammatory dysregulation is a key mechanism
underlying detrimental effects of acute and chronic UV exposure. The health and economic
burden of skin cancer treatment is substantial, creating an increasingly urgent need for the development
of improved molecular strategies for photoprotection and photochemoprevention.
Methods:
A structured search of bibliographic databases for peer-reviewed research literature
revealed 139 articles including our own that are presented and critically evaluated in this
TLR4-directed review.
Objective:
To understand the molecular role of Toll-like receptor 4 (TLR4) as a key regulator
of skin anti-microbial defense, wound healing, and cutaneous tumorigenic inflammation. The
specific focus of this review is on recent published evidence suggesting that TLR4 represents
a novel molecular target for skin photoprotection and cancer photochemoprevention.
Results:
Cumulative experimental evidence indicates that pharmacological and genetic antagonism
of TLR4 suppresses UV-induced inflammatory signaling involving the attenuation
of cutaneous NF-κB and AP-1 stress signaling observable in vitro and in vivo. TLR4-directed
small molecule pharmacological antagonists [including eritoran, (+)-naloxone, ST2825, and
resatorvid] have now been identified as a novel class of molecular therapeutics. TLR4 antagonists
are in various stages of preclinical and clinical development for the modulation of
dysregulated TLR4-dependent inflammatory signaling that may also contribute to skin photodamage
and photocarcinogenesis in human populations.
Conclusion:
Future research should explore the skin photoprotective and photochemopreventive
efficacy of topical TLR4 antagonism if employed in conjunction with other molecular
strategies including sunscreens.
Collapse
Affiliation(s)
- Sally E. Dickinson
- Department of Pharmacology, College of Medicine and The University of Arizona Cancer Center, University of Arizona, Tucson, AZ 85724, United States
| | - Georg T. Wondrak
- Department of Pharmacology and Toxicology, College of Pharmacy and The University of Arizona Cancer Center, University of Arizona, Tucson, AZ 85724, United States
| |
Collapse
|
6
|
Update on the Use and Treatment of Targeted Molecular Inhibitors for Locally Advanced and Metastatic Non-Melanoma Skin Cancers. Dermatol Surg 2016; 42 Suppl 1:S49-56. [PMID: 26730974 DOI: 10.1097/dss.0000000000000573] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Targeting specific molecular pathway inhibitors has provided a successful approach to the management of selected patients with advanced non-melanoma skin cancer (NMSC). Clinical trials and case studies have provided a rationale for their use in clinical settings. OBJECTIVE To review the current approaches to the use of targeted molecular inhibitors for locally advanced and metastatic squamous cell carcinoma, basal cell carcinoma, and dermatofibrosarcoma protuberans. METHODS Literature review of the current use of molecular inhibitors in the treatment of NMSCs, including case studies, reports, and clinical trials. CONCLUSION The development of molecular pathway inhibitors for the treatment of advanced and metastatic NMSC has increased survival rates and improved clinical outcomes in selected patients with advanced disease.
Collapse
|
7
|
Dickinson SE, Janda J, Criswell J, Blohm-Mangone K, Olson ER, Liu Z, Barber C, Petricoin EF, Calvert VS, Einspahr J, Dickinson JE, Stratton SP, Curiel-Lewandrowski C, Saboda K, Hu C, Bode AM, Dong Z, Alberts DS, Timothy Bowden G. Inhibition of Akt Enhances the Chemopreventive Effects of Topical Rapamycin in Mouse Skin. Cancer Prev Res (Phila) 2016; 9:215-24. [PMID: 26801880 DOI: 10.1158/1940-6207.capr-15-0419] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 01/01/2016] [Indexed: 11/16/2022]
Abstract
The PI3Kinase/Akt/mTOR pathway has important roles in cancer development for multiple tumor types, including UV-induced nonmelanoma skin cancer. Immunosuppressed populations are at increased risk of aggressive cutaneous squamous cell carcinoma (SCC). Individuals who are treated with rapamycin (sirolimus, a classical mTOR inhibitor) have significantly decreased rates of developing new cutaneous SCCs compared with those that receive traditional immunosuppression. However, systemic rapamycin use can lead to significant adverse events. Here, we explored the use of topical rapamycin as a chemopreventive agent in the context of solar-simulated light (SSL)-induced skin carcinogenesis. In SKH-1 mice, topical rapamycin treatment decreased tumor yields when applied after completion of 15 weeks of SSL exposure compared with controls. However, applying rapamycin during SSL exposure for 15 weeks, and continuing for 10 weeks after UV treatment, increased tumor yields. We also examined whether a combinatorial approach might result in more significant tumor suppression by rapamycin. We validated that rapamycin causes increased Akt (S473) phosphorylation in the epidermis after SSL, and show for the first time that this dysregulation can be inhibited in vivo by a selective PDK1/Akt inhibitor, PHT-427. Combining rapamycin with PHT-427 on tumor prone skin additively caused a significant reduction of tumor multiplicity compared with vehicle controls. Our findings indicate that patients taking rapamycin should avoid sun exposure, and that combining topical mTOR inhibitors and Akt inhibitors may be a viable chemoprevention option for individuals at high risk for cutaneous SCC.
Collapse
Affiliation(s)
- Sally E Dickinson
- The University of Arizona Cancer Center, Tucson, Arizona. Department of Pharmacology, The University of Arizona, Tucson, Arizona.
| | - Jaroslav Janda
- The University of Arizona Cancer Center, Tucson, Arizona
| | - Jane Criswell
- The University of Arizona Cancer Center, Tucson, Arizona
| | | | - Erik R Olson
- The University of Arizona Cancer Center, Tucson, Arizona
| | - Zhonglin Liu
- Department of Medical Imaging, The University of Arizona, Tucson, Arizona
| | - Christy Barber
- Department of Medical Imaging, The University of Arizona, Tucson, Arizona
| | - Emanuel F Petricoin
- Center for Applied Proteomics and Molecular Medicine, George Mason University, Manassas, Virginia
| | - Valerie S Calvert
- Center for Applied Proteomics and Molecular Medicine, George Mason University, Manassas, Virginia
| | - Janine Einspahr
- The University of Arizona Cancer Center, Tucson, Arizona. Department of Medicine, The University of Arizona, Tucson, Arizona
| | - Jesse E Dickinson
- Arizona Water Science Center, U.S. Geological Survey, Tucson, Arizona
| | - Steven P Stratton
- The University of Arizona Cancer Center, Tucson, Arizona. Department of Medicine, The University of Arizona, Tucson, Arizona
| | - Clara Curiel-Lewandrowski
- The University of Arizona Cancer Center, Tucson, Arizona. Department of Medicine, The University of Arizona, Tucson, Arizona
| | | | - Chengcheng Hu
- The University of Arizona Cancer Center, Tucson, Arizona
| | - Ann M Bode
- Department of Molecular Medicine and Biopharmaceutical Sciences, The Hormel Institute, The University of Minnesota, Austin, Minnesota
| | - Zigang Dong
- Department of Molecular Medicine and Biopharmaceutical Sciences, The Hormel Institute, The University of Minnesota, Austin, Minnesota
| | - David S Alberts
- The University of Arizona Cancer Center, Tucson, Arizona. Department of Medicine, The University of Arizona, Tucson, Arizona
| | - G Timothy Bowden
- The University of Arizona Cancer Center, Tucson, Arizona. Department of Medicine, The University of Arizona, Tucson, Arizona. Department of Cellular and Molecular Medicine, The University of Arizona, Tucson, Arizona
| |
Collapse
|
8
|
Al-Rohil RN, Tarasen AJ, Carlson JA, Wang K, Johnson A, Yelensky R, Lipson D, Elvin JA, Vergilio JA, Ali SM, Suh J, Miller VA, Stephens PJ, Ganesan P, Janku F, Karp DD, Subbiah V, Mihm MC, Ross JS. Evaluation of 122 advanced-stage cutaneous squamous cell carcinomas by comprehensive genomic profiling opens the door for new routes to targeted therapies. Cancer 2015; 122:249-57. [PMID: 26479420 DOI: 10.1002/cncr.29738] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 09/14/2015] [Accepted: 09/23/2015] [Indexed: 12/29/2022]
Abstract
BACKGROUND The authors hypothesized that comprehensive genomic profiling of advanced-stage cutaneous squamous cell carcinoma (cSCC) could identify genomic-derived drug targets of therapy for patients with conventional therapy-resistant disease. METHODS Comprehensive genomic profiling of 315 cancer genes was applied to 50 ng of DNA from 122 cSCC cases for the evaluation of all classes of genomic alterations (GAs). Clinically relevant genomic alterations (CRGAs) were defined as those identifying anticancer drugs on the market or in registered clinical trials. RESULTS There were 21 women (17%) and 101 men (83%) with a median age of 64.9 years (range, 21-87 years). Eleven cSCC cases (9%) were histologic AJCC grade 1, 69 (57%) were grade 2, and 42 (34%) were grade 3. The primary cSCC was used for sequencing in 77 cases (63%). Metastatic lesions were sequenced in 37% of cases. There were 1120 total GAs identified (average of 9.2 GAs per tumor), with 100% of cases harboring at least 1 alteration. Of the 122 cSCCs, 107 (88%) harbored at least 1 CRGA (2.5 CRGAs per cSCC) includingNOTCH1 (43%); patched 1 (PTCH1) (11%); BRCA2 (10%); HRAS (8%); ataxia telangiectasia mutated (ATM) (7%); erb-B2 receptor tyrosine kinase 4 (ERBB4) (7%); neurofibromatosis type 1 (NF1) (7%); erb-B2 receptor tyrosine kinase 2 (ERBB2) (6%); phosphatidylinositol-4,5-bisphosphate 3-kinase, catalytic subunit alpha (PIK3CA) (6%); cyclin D1 (CCND1) (6%); epidermal growth factor receptor (EGFR) (5%); and F-box and WD repeat domain containing 7, E3 ubiquitin protein ligase (FBXW7) (5%). CONCLUSIONS In the current study, approximately 88% of patients with cSCC were found to harbor clinically relevant GAs that have the potential to guide the treatment of patients with advanced-stage tumors with targeted therapeutic agents. Cancer 2016;122:249-257. © 2015 American Cancer Society.
Collapse
Affiliation(s)
- Rami N Al-Rohil
- Department of Pathology and Laboratory Medicine, Albany Medical College, Albany, New York.,Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Investigational Cancer Therapeutics (Phase 1 Clinical Trials Program), The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ashley J Tarasen
- Department of Pathology and Laboratory Medicine, Albany Medical College, Albany, New York
| | - J Andrew Carlson
- Department of Pathology and Laboratory Medicine, Albany Medical College, Albany, New York
| | - Kai Wang
- Foundation Medicine Inc, Cambridge, Massachusetts
| | | | | | - Doron Lipson
- Foundation Medicine Inc, Cambridge, Massachusetts
| | | | | | - Siraj M Ali
- Foundation Medicine Inc, Cambridge, Massachusetts
| | - James Suh
- Foundation Medicine Inc, Cambridge, Massachusetts
| | | | | | - Prasanth Ganesan
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Investigational Cancer Therapeutics (Phase 1 Clinical Trials Program), The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Filip Janku
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Investigational Cancer Therapeutics (Phase 1 Clinical Trials Program), The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Daniel D Karp
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Investigational Cancer Therapeutics (Phase 1 Clinical Trials Program), The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Vivek Subbiah
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Investigational Cancer Therapeutics (Phase 1 Clinical Trials Program), The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Martin C Mihm
- Department of Dermatology, Harvard Medical School, Boston, Massachusetts
| | - Jeffrey S Ross
- Department of Pathology and Laboratory Medicine, Albany Medical College, Albany, New York.,Foundation Medicine Inc, Cambridge, Massachusetts
| |
Collapse
|
9
|
Papakostas D, Stockfleth E. Topical treatment of basal cell carcinoma with the immune response modifier imiquimod. Future Oncol 2015; 11:2985-90. [PMID: 26450707 DOI: 10.2217/fon.15.192] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Imiquimod, a TLR7 agonist, is a novel immune response modifier currently widely used in the treatment of actinic keratoses (in situ squamous cell carcinoma). Imiquimod has revolutionized the treatment of field cancerization and has been approved for the treatment of superficial basal cell carcinoma with the recommendation of a 6-week treatment strategy, offering an alternative to surgery or other destructive treatment strategies.
Collapse
Affiliation(s)
- Dimitrios Papakostas
- Department of Dermatology & Venerology, A Syggros Hospital, University of Athens, Medical School, 5, I. Dragoumi Str. 16121 Athens, Greece
| | - Eggert Stockfleth
- Department of Dermatology, Venerology & Allergology, Catholic Clinic Bochum, St Josef Hospital, Ruhr University Bochum, Gudrunstrasse 56, 44971 Bochum, Germany
| |
Collapse
|
10
|
Nowotarski SL, Feith DJ, Shantz LM. Skin Carcinogenesis Studies Using Mouse Models with Altered Polyamines. CANCER GROWTH AND METASTASIS 2015; 8:17-27. [PMID: 26380554 PMCID: PMC4558889 DOI: 10.4137/cgm.s21219] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 06/30/2015] [Accepted: 07/01/2015] [Indexed: 12/16/2022]
Abstract
Nonmelanoma skin cancer (NMSC) is a major health concern worldwide. With increasing numbers in high-risk groups such as organ transplant recipients and patients taking photosensitizing medications, the incidence of NMSC continues to rise. Mouse models of NMSC allow us to better understand the molecular signaling cascades involved in skin tumor development in order to identify novel therapeutic strategies. Here we review the models designed to determine the role of the polyamines in NMSC development and maintenance. Elevated polyamines are absolutely required for tumor growth, and dysregulation of their biosynthetic and catabolic enzymes has been observed in NMSC. Studies using mice with genetic alterations in epidermal polyamines suggest that they play key roles in tumor promotion and epithelial cell survival pathways, and recent clinical trials indicate that pharmacological inhibitors of polyamine metabolism show promise in individuals at high risk for NMSC.
Collapse
Affiliation(s)
- Shannon L Nowotarski
- Department of Biochemistry, The Pennsylvania State University Berks College, Reading, PA, USA
| | - David J Feith
- University of Virginia Cancer Center and Department of Medicine, Hematology and Oncology, University of Virginia, Charlottesville, VA, USA
| | - Lisa M Shantz
- Department of Cellular and Molecular Physiology, The Pennsylvania State University College of Medicine, Hershey, PA, USA
| |
Collapse
|
11
|
Karanian M, Pérot G, Coindre JM, Chibon F, Pedeutour F, Neuville A. Fluorescence in situ hybridization analysis is a helpful test for the diagnosis of dermatofibrosarcoma protuberans. Mod Pathol 2015; 28:230-7. [PMID: 25081750 DOI: 10.1038/modpathol.2014.97] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 05/17/2014] [Accepted: 05/18/2014] [Indexed: 11/09/2022]
Abstract
Cytogenetically, most dermatofibrosarcoma protuberans are characterized by chromosomal rearrangements resulting in the collagen type-1 alpha 1 (COL1A1)-platelet-derived growth factor β (PDGFB) fusion gene. This abnormality can be detected by fluorescence in situ hybridization (FISH) analysis in routine practice. The aim of this study was to evaluate the role of the FISH analysis in the diagnosis of dermatofibrosarcoma protuberans. A FISH analysis was prospectively and systematically performed on a series of 448 consecutive tumor specimens. All cases were reviewed by two independent pathologists and classified in three categories according to the probability of a DFSP diagnosis before molecular analyses. Cases were classified as certain when dermatofibrosarcoma protuberans was the only possible diagnosis. Those cases for which dermatofibrosarcoma protuberans remained the first diagnosis, but other differential diagnosis existed, were regarded as probable. When dermatofibrosarcoma protuberans was considered a differential diagnosis, they were labeled as possible. The final diagnosis was supported by clinicopathological findings and results of FISH analyses. Immunohistochemical analysis of CD34 was systematically performed, and additional markers when necessary. The cases (n=37) with a non-interpretable FISH were excluded. For the 185 certain tumors specimens: 178 (96%) FISH analyses showed a PDGFB/COL1A1 rearrangement, 7 (4%) were negative. For the 114 probable tumors specimens: 104 (91%) FISH analyses were positive and 10 (9%) were negative leading to a new diagnosis in 8 cases. For the 112 possible cases: 91 (81%) FISH analyses were negative and 21 (19%) were positive. Of the 21 cases, initial diagnoses included unclassified sarcoma, myxofibrosarcoma, dermatofibroma, reactive lesion, solitary fibrous tumor, perineurioma, benign nerve sheath tumor, and undifferentiated spindle cell tumor without malignant evidence. FISH analysis has been helpful for confirming the diagnosis of dermatofibrosarcoma protuberans in 25% (104/411) of cases and necessary for the diagnosis of dermatofibrosarcoma protuberans in 5% (21/411) of cases.
Collapse
Affiliation(s)
- Marie Karanian
- 1] Department of Pathology, Institut Bergonié, Bordeaux, France [2] INSERM U916, Bordeaux, France [3] Université de Bordeaux, Bordeaux, France
| | - Gaëlle Pérot
- 1] Department of Pathology, Institut Bergonié, Bordeaux, France [2] INSERM U916, Bordeaux, France
| | - Jean-Michel Coindre
- 1] Department of Pathology, Institut Bergonié, Bordeaux, France [2] INSERM U916, Bordeaux, France [3] Université de Bordeaux, Bordeaux, France
| | - Frédéric Chibon
- 1] Department of Pathology, Institut Bergonié, Bordeaux, France [2] INSERM U916, Bordeaux, France
| | - Florence Pedeutour
- Laboratoire de Génétique des Tumeurs Solides, Institute for Research on Cancer and Aging (IRCAN), University Hospital of Nice, Bordeaux, France
| | - Agnès Neuville
- 1] Department of Pathology, Institut Bergonié, Bordeaux, France [2] INSERM U916, Bordeaux, France [3] Université de Bordeaux, Bordeaux, France
| |
Collapse
|
12
|
Nardi G, Lhiaubet-Vallet V, Miranda MA. Photosensitization by Imatinib. A Photochemical and Photobiological Study of the Drug and Its Substructures. Chem Res Toxicol 2014; 27:1990-5. [DOI: 10.1021/tx500328q] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Giacomo Nardi
- Instituto de Tecnología
Química UPV-CSIC, Universitat Politècnica de València, Avda
de los Naranjos s/n, 46022 Valencia, Spain
| | - Virginie Lhiaubet-Vallet
- Instituto de Tecnología
Química UPV-CSIC, Universitat Politècnica de València, Avda
de los Naranjos s/n, 46022 Valencia, Spain
| | - Miguel A. Miranda
- Instituto de Tecnología
Química UPV-CSIC, Universitat Politècnica de València, Avda
de los Naranjos s/n, 46022 Valencia, Spain
| |
Collapse
|
13
|
Manoukian MAC, Ott SV, Rajadas J, Inayathullah M. Polymeric Nanoparticles to Combat Squamous Cell Carcinomas in Patients with Dystrophic Epidermolysis Bullosa. ACTA ACUST UNITED AC 2014; 4:15-24. [PMID: 25506404 DOI: 10.2174/1877912304666140708184013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Skin cancer is the leading cause of malignancy in the United States, with Basal Cell Carcinoma, Squamous Cell Carcinoma , and Melanoma being the three most common diagnoses, respectively. Squamous Cell Carcinoma (SCC) is a particular concern for patients suffering from Dystrophic Epidermolysis Bullosa (DEB), a disease that affects the production and function of collagen VII, a protein that forms the anchoring fibrils which bind the epidermis to the dermis. Patients with DEB suffer from chronic blistering and wounds that have impaired healing capabilities, often leading to the development of SCC and eventual mortality. Nanomedicine is playing an increasing role in the delivery of effective therapeutics to combat a wide range of diseases, including the imaging and treatment of SCC. In this review, we discuss the role of nanoparticles in the treatment of SCC with an emphasis on PLGA nanoparticles and SCCs found in patients suffering from DEB, and address recent patents that are pertinent to the development of novel nanomedical therapeutics.
Collapse
Affiliation(s)
- Martin A C Manoukian
- Department of Dermatology, Stanford University School of Medicine, Stanford, CA - 94305, USA.,Biomaterials and Advanced Drug Delivery Laboratory, Stanford University School of Medicine, Stanford, CA - 94304, USA
| | - Susanne V Ott
- Biomaterials and Advanced Drug Delivery Laboratory, Stanford University School of Medicine, Stanford, CA - 94304, USA
| | - Jayakumar Rajadas
- Biomaterials and Advanced Drug Delivery Laboratory, Stanford University School of Medicine, Stanford, CA - 94304, USA
| | - Mohammed Inayathullah
- Biomaterials and Advanced Drug Delivery Laboratory, Stanford University School of Medicine, Stanford, CA - 94304, USA
| |
Collapse
|
14
|
Brinkhuizen T, Weijzen CAH, Eben J, Thissen MR, van Marion AM, Lohman BG, Winnepenninckx VJL, Nelemans PJ, van Steensel MAM. Immunohistochemical analysis of the mechanistic target of rapamycin and hypoxia signalling pathways in basal cell carcinoma and trichoepithelioma. PLoS One 2014; 9:e106427. [PMID: 25181405 PMCID: PMC4152244 DOI: 10.1371/journal.pone.0106427] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Accepted: 07/30/2014] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Basal cell carcinoma (BCC) is the most common cancer in Caucasians. Trichoepithelioma (TE) is a benign neoplasm that strongly resembles BCC. Both are hair follicle (HF) tumours. HFs are hypoxic microenvironments, therefore we hypothesized that hypoxia-induced signalling pathways could be involved in BCC and TE as they are in other human malignancies. Hypoxia-inducible factor 1 (HIF1) and mechanistic/mammalian target of rapamycin (mTOR) are key players in these pathways. OBJECTIVES To determine whether HIF1/mTOR signalling is involved in BCC and TE. METHODS We used immunohistochemical staining of formalin-fixed paraffin-embedded BCC (n = 45) and TE (n = 35) samples to assess activity of HIF1, mTORC1 and their most important target genes. The percentage positive tumour cells was assessed manually in a semi-quantitative manner and categorized (0%, <30%, 30-80% and >80%). RESULTS Among 45 BCC and 35 TE examined, expression levels were respectively 81% and 57% (BNIP3), 73% and 75% (CAIX), 79% and 86% (GLUT1), 50% and 19% (HIF1α), 89% and 88% (pAKT), 55% and 61% (pS6), 15% and 25% (pMTOR), 44% and 63% (PHD2) and 44% and 49% (VEGF-A). CAIX, Glut1 and PHD2 expression levels were significantly higher in TE when only samples with at least 80% expression were included. CONCLUSIONS HIF and mTORC1 signalling seems active in both BCC and TE. There are no appreciable differences between the two with respect to pathway activity. At this moment immunohistochemical analyses of HIF, mTORC1 and their target genes does not provide a reliable diagnostic tool for the discrimination of BCC and TE.
Collapse
Affiliation(s)
- Tjinta Brinkhuizen
- Department of Dermatology, Maastricht University Medical Centre, Maastricht, the Netherlands
- GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands
- * E-mail:
| | - Chantal A. H. Weijzen
- Department of Dermatology, Maastricht University Medical Centre, Maastricht, the Netherlands
- GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Jonathan Eben
- Department of Pathology, Maastricht University Medical Centre, Maastricht, the Netherlands
- GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Monique R. Thissen
- Department of Dermatology, Maastricht University Medical Centre, Maastricht, the Netherlands
- GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | | | - Björn G. Lohman
- Department of Pathology, Laurentius Hospital, Roermond, the Netherlands
| | - Véronique J. L. Winnepenninckx
- Department of Pathology, Maastricht University Medical Centre, Maastricht, the Netherlands
- GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Patty J. Nelemans
- Department of Epidemiology, Maastricht University Medical Centre, Maastricht, the Netherlands
- GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Maurice A. M. van Steensel
- Department of Dermatology, Maastricht University Medical Centre, Maastricht, the Netherlands
- Department of Clinical Genetics, Maastricht University Medical Centre, Maastricht, the Netherlands
- GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands
- Institute of Medical Biology, Immunos, Singapore, Singapore
| |
Collapse
|
15
|
Parikh SA, Patel VA, Ratner D. Advances in the management of cutaneous squamous cell carcinoma. F1000PRIME REPORTS 2014; 6:70. [PMID: 25165569 PMCID: PMC4126542 DOI: 10.12703/p6-70] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Cutaneous squamous cell carcinoma is one of the most common non-melanoma skin cancers worldwide. While most cutaneous squamous cell carcinomas are easily managed, there is a high-risk subset of tumors that can cause severe morbidity and mortality. Tumor characteristics as well as patient characteristics contribute to the classification of cutaneous squamous cell carcinomas as low-risk vs. high-risk. Advances in the treatment of cutaneous squamous cell carcinomas largely relate to the management of this high-risk subset. Surgical and non-surgical management options, including newer targeted molecular therapies, will be discussed here. Larger, multicenter studies are needed to determine the exact significance of individual risk factors with respect to aggressive clinical behavior and the risks of metastasis and death, as well as the role of surgical and adjuvant therapies in patients with high-risk cutaneous squamous cell carcinomas.
Collapse
Affiliation(s)
- Sonal A. Parikh
- Columbia University Department of Dermatology161 Fort Washington Ave. 12th FloorNew York, NY 10032, USA
| | - Vishal A. Patel
- Columbia University Department of Dermatology161 Fort Washington Ave. 12th FloorNew York, NY 10032, USA
| | - Desiree Ratner
- Mount Sinai Beth Israel Cancer Center West325 W. 15th streetNew York, NY 10011, USA
| |
Collapse
|
16
|
Abstract
Cutaneous malignancies can manifest as isolated and sporadic tumors as well as multiple and disseminated tumors. In the latter case they often point to a genetic disease, which either can be restricted to the skin exclusively or also involve extracutaneous organs in the context of a hereditary tumor syndrome. Such hereditary tumor syndromes are clinically and genetically very heterogeneous. Therefore, the prevailing specific skin tumors play an important diagnostic role in the case of complex symptom constellations. Elucidation of the genetic basis of rare monogenetically inherited disorders and syndromes can contribute to a better understanding of the pathogenesis of frequently occurring cutaneous malignancies because the mutated genes often encode proteins, which have a key position in metabolic signaling pathways that are of high significance for the development of targeted therapies. Here we provide an overview of genodermatoses, which are associated with basal cell carcinomas, sebaceous carcinomas, keratoacanthomas, squamous cell carcinomas and malignant melanomas.
Collapse
|
17
|
Micali G, Lacarrubba F, Bhatt K, Nasca MR. Medical approaches to non-melanoma skin cancer. Expert Rev Anticancer Ther 2013; 13:1409-1421. [DOI: 10.1586/14737140.2013.856759] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
|