1
|
Buttigliero C, Tucci M, Vignani F, Scagliotti GV, Di Maio M. Molecular biomarkers to predict response to neoadjuvant chemotherapy for bladder cancer. Cancer Treat Rev 2017; 54:1-9. [PMID: 28135623 DOI: 10.1016/j.ctrv.2017.01.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 01/03/2017] [Accepted: 01/04/2017] [Indexed: 12/30/2022]
Abstract
Cystectomy is the gold standard for treatment of localized muscle-invasive bladder cancer. However, about 50% of patients develop metastases within 2years after cystectomy and subsequently die for the disease. Neoadjuvant cisplatin-based chemotherapy before cystectomy improves the overall survival in patients with muscle-invasive bladder cancer, and pathological response to neoadjuvant treatment (downstaging to ⩽pT1 at cystectomy) is a strong predictor of better disease-specific survival. Nevertheless, some patients do not benefit from neoadjuvant therapy. The identification of reliable biomarkers that could enable the clinicians to identify patients who will really benefit from neoadjuvant chemotherapy is a major issue. This approach could lead to individualized therapy, in order to optimize the chance of response, avoiding the impact of neoadjuvant treatment on quality of life and the delay of cystectomy in non-responder patients. However, no molecular predictive biomarkers have shown clinical utility. This paper aims to review currently available data about biomarkers predictive of response to neoadjuvant chemotherapy in muscle-invasive bladder cancer.
Collapse
Affiliation(s)
- Consuelo Buttigliero
- Division of Medical Oncology, Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Regione Gonzole 10, 10043 Orbassano, Turin, Italy
| | - Marcello Tucci
- Division of Medical Oncology, Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Regione Gonzole 10, 10043 Orbassano, Turin, Italy
| | - Francesca Vignani
- Division of Medical Oncology, Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Regione Gonzole 10, 10043 Orbassano, Turin, Italy
| | - Giorgio V Scagliotti
- Division of Medical Oncology, Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Regione Gonzole 10, 10043 Orbassano, Turin, Italy.
| | - Massimo Di Maio
- Division of Medical Oncology, Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Regione Gonzole 10, 10043 Orbassano, Turin, Italy
| |
Collapse
|
2
|
Jeong YM, Li H, Kim SY, Park WJ, Yun HY, Baek KJ, Kwon NS, Jeong JH, Myung SC, Kim DS. Photo-activated 5-hydroxyindole-3-acetic acid induces apoptosis of prostate and bladder cancer cells. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2011; 103:50-6. [DOI: 10.1016/j.jphotobiol.2011.01.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Revised: 12/21/2010] [Accepted: 01/10/2011] [Indexed: 10/18/2022]
|
3
|
Bellmunt J, Albiol S, Suárez C, Albanell J. Optimizing therapeutic strategies in advanced bladder cancer: Update on chemotherapy and the role of targeted agents. Crit Rev Oncol Hematol 2009; 69:211-22. [DOI: 10.1016/j.critrevonc.2008.06.002] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2008] [Revised: 05/30/2008] [Accepted: 06/05/2008] [Indexed: 11/25/2022] Open
|
4
|
Grandinetti CA, Goldspiel BR. Sorafenib and sunitinib: novel targeted therapies for renal cell cancer. Pharmacotherapy 2007; 27:1125-44. [PMID: 17655513 DOI: 10.1592/phco.27.8.1125] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Renal cell cancer (RCC) is a relatively uncommon malignancy, with 51,190 cases expected to be diagnosed in 2007. Localized disease is curable by surgery; however, locally advanced or metastatic disease is not curable in most cases and, until recently, had a limited response to drug treatment. Historically, biologic response modifiers or immunomodulating agents were tested in clinical trials based on observations that some cases of RCC can spontaneously regress. High-dose aldesleukin is approved by the United States Food and Drug Administration as a treatment for advanced RCC; however, the drug is associated with a high frequency of severe adverse effects. Responses have been observed with low-dose aldesleukin and interferon alfa, but with little effect on overall survival. Sorafenib and sunitinib are novel therapies that target growth factor receptors known to be activated by the hypoxia-inducible factor and the Ras-Raf/MEK/ERK pathways. These pathways are important in the pathophysiology of RCC. Sorafenib and sunitinib have shown antitumor activity as first- and second-line therapy in patients with cytokine-refractory metastatic RCC who have clear-cell histology. Although complete responses are not common, both drugs promote disease stabilization and increase progression-free survival. This information suggests that disease stabilization may be an important determinant for response in RCC and possibly other cancers. Sorafenib and sunitinib are generally well tolerated and are considered first- and second-line treatment options for patients with advanced clear cell RCC. In addition, sorafenib and sunitinib have shown promising results in initial clinical trials evaluating antitumor activity in patients who are refractory to other antiangiogenic therapy. The most common toxicities with both sorafenib and sunitinib are hand-foot syndrome, rash, fatigue, hypertension, and diarrhea. Research is directed toward defining the optimal use of these new agents.
Collapse
Affiliation(s)
- Cheryl A Grandinetti
- Pharmaceutical Management Branch, Cancer Therapy Evaluation Program, National Cancer Institute, Rockville, Maryland 20852, USA.
| | | |
Collapse
|
5
|
Zhu Y, Kong C, Zeng Y, Sun Z, Gao H. Expression of lung resistance-related protein in transitional cell carcinoma of bladder. Urology 2004; 63:694-8. [PMID: 15072883 DOI: 10.1016/j.urology.2003.11.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2003] [Accepted: 11/12/2003] [Indexed: 01/12/2023]
Abstract
OBJECTIVES To determine the role of lung resistance-related protein (LRP) in intrinsic multidrug-resistance (MDR) of bladder cancer. METHODS The study group consisted of 66 patients with newly diagnosed primary bladder cancer. No patient had been treated preoperatively with either radiotherapy or chemotherapy. Reverse transcriptase-polymerase chain reaction was performed to measure LRP, multidrug resistance-associated protein 1 (MDR1), and MRP1 mRNA expression. The expression of LRP, p53 proteins, and p63 proteins was examined by immunohistochemistry. We analyzed the correlation of LRP with the above indexes and the clinical pathologic parameters. RESULTS The expression rate of LRP mRNA (63.6%) was the greatest among the three MDR markers in primary bladder cancer without exposure to chemotherapy. The LRP mRNA level was significantly greater in normal bladder tissue than in transitional cell carcinoma bladder tissue (P <0.01) and in superficial cancer than in invasive cancer (P = 0.013). LRP mRNA expression showed no association with either MDR1 or MRP1, but close correlation with the LRP level (P = 0.001). LRP was associated with low-grade (P <0.01) and low-stage (P <0.05) cancer but had no association with tumor suppressor p53 or p63. CONCLUSIONS The grade and stage-related expression pattern of LRP indicates that it may be a predictive index for intrinsic MDR in early bladder cancer. Anticancer drugs out of the MDR spectrum of LRP may be more effective for patients with early bladder cancer.
Collapse
Affiliation(s)
- Yuyan Zhu
- Department of Urology, First Clinical College and First Affiliated Hospital, China Medical University, Shenyang, People's Republic of China
| | | | | | | | | |
Collapse
|
6
|
Bellmunt J, de Wit R, Albiol S, Tabernero J, Albanell J, Baselga J. New drugs and new approaches in metastatic bladder cancer. Crit Rev Oncol Hematol 2003; 47:195-206. [PMID: 12900012 DOI: 10.1016/s1040-8428(03)00082-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
The median survival of patients with metastatic cancer of the urothelium who receive best supportive care only in 4-6 months. With the introduction of combination chemotherapy regimens including cisplatin and methotrexate for the management of metastatic urothelial cancer, median overall survival has doubled. Nevertheless, death due to cancer ultimately occurs in more than 80% of these patients, thus more effective therapy is required. The new available treatment modalities range from new combinations of conventional chemotherapeutic agents to combinations incorporating novel drugs like gemcitabine and the taxanes. These new combinations incorporate the new active agents in two, three or multiple drug combinations, administered either in one regimen or sequentially in various combinations and schedules intended to improve the outcome of bladder cancer patients. Ongoing phase III studies will help to define the role of these new combinations in the treatment of advanced bladder cancer. The improved understanding of the molecular biology of urothelial malignancies is helping to define the role of new prognostic indices that can direct the most appropriate choice of treatment for advanced disease. In addition, advances in the molecular biology of urothelial malignancies may allow identification of specific genetic lesions and biochemical pathways upon which future therapeutic approaches can be focused. The integration of newer biologic agents, probably to supplement rather than to supplant chemotherapeutic drugs, should be a primary direction of research with the objective to interfere with multiple aspects of bladder cancer progression.
Collapse
Affiliation(s)
- J Bellmunt
- Hospital General Universitari Vall d'Hebron, P. Vall d'Hebron 119-129, 08035 Barcelona, Spain.
| | | | | | | | | | | |
Collapse
|
7
|
Zurita AJ, Diestra JE, Condom E, García del Muro X, Scheffer GL, Scheper RJ, Pérez J, Germà-Lluch JR, Izquierdo MA. Lung resistance-related protein as a predictor of clinical outcome in advanced testicular germ-cell tumours. Br J Cancer 2003; 88:879-86. [PMID: 12644825 PMCID: PMC2377094 DOI: 10.1038/sj.bjc.6600803] [Citation(s) in RCA: 34] [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] [Indexed: 12/25/2022] Open
Abstract
This study was undertaken to investigate the expression and predictive value for outcome of multidrug resistance-associated (MDR) proteins P-glycoprotein (Pgp), MRP1, BCRP, and LRP, in advanced testicular germ-cell tumours (TGCT). Paraffin-embedded sections from 56 previously untreated patients with metastatic TGCT were immunostained for Pgp, MRP1, BCRP, and LRP. All patients received platinum-based chemotherapy after orchidectomy. Immunostaining was related to clinicopathological parameters, response to chemotherapy, and outcome. Strong and intermediate expressions of the different MDR-related proteins were: 27 and 41% (Pgp), 54 and 37% (MRP1), 86 and 7% (BCRP), and 14 and 29% (LRP). P-glycoprotein and MRP1 associated, respectively, to low AFP (P=0.026) and high LDH levels (P=0.014), whereas LRP expression associated with high beta-hCG levels (P=0.003) and stage IV tumours (P=0.029). No correlation was found between Pgp, MRP1, and BCRP expression and response to chemotherapy and survival. In contrast, patients with LRP-positive tumours (strong or intermediate expression) had shorter progression-free (P=0.0006) and overall survival (P=0.0116) than LRP-negative patients, even after individual log-rank adjustments by statistically associated variables. Our data suggest that a positive LRP immunostaining at the time of diagnosis in metastatic TGCT is associated with an adverse clinical outcome.
Collapse
Affiliation(s)
- A J Zurita
- Department of Medical Oncology and Laboratory of Translational Research, Institut Català d'Oncologia, Av Gran Via Km 2.7, 08907 Barcelona, Spain
| | - J E Diestra
- Department of Medical Oncology and Laboratory of Translational Research, Institut Català d'Oncologia, Av Gran Via Km 2.7, 08907 Barcelona, Spain
| | - E Condom
- Department of Pathology, Ciutat Sanitària i Universitària de Bellvitge, Feixa Llarga s/n, 08907 Barcelona, Spain
| | - X García del Muro
- Department of Medical Oncology and Laboratory of Translational Research, Institut Català d'Oncologia, Av Gran Via Km 2.7, 08907 Barcelona, Spain
| | - G L Scheffer
- Department of Pathology, Free University Hospital, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands
| | - R J Scheper
- Department of Medical Oncology and Laboratory of Translational Research, Institut Català d'Oncologia, Av Gran Via Km 2.7, 08907 Barcelona, Spain
| | - J Pérez
- Department of Medical Oncology and Laboratory of Translational Research, Institut Català d'Oncologia, Av Gran Via Km 2.7, 08907 Barcelona, Spain
| | - J R Germà-Lluch
- Department of Medical Oncology and Laboratory of Translational Research, Institut Català d'Oncologia, Av Gran Via Km 2.7, 08907 Barcelona, Spain
| | - M A Izquierdo
- Department of Medical Oncology and Laboratory of Translational Research, Institut Català d'Oncologia, Av Gran Via Km 2.7, 08907 Barcelona, Spain
- Department of Medical Oncology, Institut Català d'Oncologia, Av. Gran Via, Km 2.7, Hospitalet de Llobregat, 08907 Barcelona, Spain. E-mail:
| |
Collapse
|
8
|
Albiol S, Bellmunt J. [Advanced bladder cancer: new therapeutic strategies]. Med Clin (Barc) 2003; 120:68-77. [PMID: 12570917 DOI: 10.1016/s0025-7753(03)73604-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
9
|
Sato K, Komatsu K, Maeda Y, Ueno S, Koshida K, Namiki M. Case of mediastinal seminoma with testicular microlithiasis. Int J Urol 2002; 9:114-6. [PMID: 12028303 DOI: 10.1046/j.1442-2042.2002.00431.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Testicular microlithiasis is a rare condition in which calcified concretions fill the lumina of the seminiferous tubules. We report the case of a 19-year-old Japanese man with mediastinal seminoma, normal testicular physical findings and bilateral testicular microlithiasis seen on ultrasonography. Testicular needle biopsy demonstrated multiple laminated calcifications within the seminiferous tubules without any signals of a viable germ cell tumor. To our knowledge, this is only the sixth reported case of extragonadal germ cell tumor with testicular microlithiasis.
Collapse
Affiliation(s)
- Koji Sato
- Department of Urology, Graduate School of Medicine, Kanazawa University, Takaramachi, Japan
| | | | | | | | | | | |
Collapse
|
10
|
Abstract
Cancer chemotherapy is the principal approach for urogenital cancers. However, the acquisition of resistance to anticancer agents is a critical factor that limits the successful treatment of malignancies. The multidrug resistant (MDR) phenotype has been widely recognized in cancer chemotherapy in urogenital tumors and the mechanisms underlying MDR have also been extensively studied. One of the principle mechanisms in MDR is caused by the overexpression of P-glycoprotein (P-gp), encoded by the multidrug resistance gene (MDR1). It functions as an ATP-dependent active efflux pump of chemotherapeutic agents in human cancer cells. Recently, other drug resistance proteins, including multidrug resistance-associated protein (MRP1) and cMOAT (or MRP2), were also identified from multidrug resistant cells. A functional analysis of MRP1 has shown that MRP1 may have the potential to act as a transporter of glutathione conjugates, which has been known as a central detoxification pathway in anticancer agents. Furthermore, several other resistance-related proteins (e.g. glutathione S-transferase, metallothionein, thioredoxin, topoisomerase I, II, O6-alkylguanine-DNA methyltransferase, etc.) have been found to be up- or down-regulated in resistant cells and these molecules are believed to contribute to the resistant phenotype as well. Based on the molecular characteristics identified in MDR, several experimental and clinical approaches have been studied to overcome MDR. One of these strategies is to reverse MDR by using such P-gp inhibitors as verapamil and cyclosporine A. In this review, we summarize the recent advances in MDR-related molecules and clinical trials to circumvent MDR in urogenital carcinomas.
Collapse
Affiliation(s)
- S Naito
- Department of Urology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
| | | | | |
Collapse
|