1
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de Vries LH, Lodewijk L, Ververs T, Poot AJ, van Rooij R, Brosens LAA, de Krijger RR, Rinkes IHMB, Vriens MR, de Keizer B. Sentinel lymph node detection in thyroid carcinoma using [ 68Ga]Ga-tilmanocept PET/CT: a proof-of-concept study. Eur J Nucl Med Mol Imaging 2024; 51:512-520. [PMID: 37773437 PMCID: PMC10774182 DOI: 10.1007/s00259-023-06449-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 09/17/2023] [Indexed: 10/01/2023]
Abstract
PURPOSE Sentinel lymph node (SLN) biopsy is rarely used for thyroid carcinoma staging. This is due to challenges associated with conventional Tc-99m-labeled tracers, often producing a large hotspot at the injection site, potentially hiding nearby SLNs (shine-through effect). The aim of this study was to demonstrate the feasibility and effectiveness of SLN visualization using the new PET tracer [68Ga]Ga-tilmanocept. METHODS Patients with thyroid carcinoma underwent ultrasound-guided peritumoral injection of [68Ga]Ga-tilmanocept and ICG-[99mTc]Tc-nanocolloid. [68Ga]Ga-tilmanocept PET/CT scans were conducted at 15 min and 60 min post-injection to visualize the SLNs. SLN biopsy was performed using ICG-[99mTc]TC-nanocolloid for intraoperative identification. The corresponding lymph node level was resected for reference. RESULTS Seven differentiated thyroid carcinoma (DTC) and 3 medullary thyroid carcinoma (MTC) patients were included, of which 6 were clinically node-negative. The median number of SLNs detected on [68Ga]Ga-tilmanocept PET/CT and resected was 3 (range 1-4) and 3 (range 1-5), respectively. Eight SLNs were found on PET/CT in the central compartment and 19 in the lateral compartment. The SLN procedure detected (micro)metastases in all patients except one. Seventeen of 27 pathologically assessed SLNs were positive, 8 negative, and 2 did not contain lymph node tissue, which led to upstaging in 5 out of 6 clinically node-negative patients. CONCLUSIONS [68Ga]Ga-tilmanocept PET/CT identified SLNs in all patients, mainly in the lateral neck. The SLNs were successfully surgically detected and resected using ICG-[99mTc]Tc-nanocolloid. This technique has the potential to improve neck staging, enabling more personalized treatment of thyroid cancer according to the lymph node status. TRIAL REGISTRATION 2021-002470-42 (EudraCT).
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Affiliation(s)
- Lisa H de Vries
- Department of Surgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Lutske Lodewijk
- Department of Surgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Tessa Ververs
- Department of Pharmacy, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
- Department of Nuclear Medicine and Radiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Alex J Poot
- Department of Nuclear Medicine and Radiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Rob van Rooij
- Department of Nuclear Medicine and Radiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Lodewijk A A Brosens
- Department of Pathology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Ronald R de Krijger
- Department of Pathology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
- Department of Pathology, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
| | - Inne H M Borel Rinkes
- Department of Surgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Menno R Vriens
- Department of Surgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Bart de Keizer
- Department of Nuclear Medicine and Radiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
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2
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Gupta P, Herring B, Kumar N, Telange R, Garcia-Buntley SS, Caceres TW, Colantonio S, Williams F, Kurup P, Carter AM, Lin D, Chen H, Rose B, Jaskula-Sztul R, Mukhtar S, Reddy S, Bibb JA. Faulty Metabolism: A Potential Instigator of an Aggressive Phenotype in Cdk5-dependent Medullary Thyroid Carcinoma. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.06.13.544755. [PMID: 37398342 PMCID: PMC10312670 DOI: 10.1101/2023.06.13.544755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Mechanistic modeling of cancers such as Medullary Thyroid Carcinoma (MTC) to emulate patient-specific phenotypes is challenging. The discovery of potential diagnostic markers and druggable targets in MTC urgently requires clinically relevant animal models. Here we established orthotopic mouse models of MTC driven by aberrantly active Cdk5 using cell-specific promoters. Each of the two models elicits distinct growth differences that recapitulate the less or more aggressive forms of human tumors. The comparative mutational and transcriptomic landscape of tumors revealed significant alterations in mitotic cell cycle processes coupled with the slow-growing tumor phenotype. Conversely, perturbation in metabolic pathways emerged as critical for aggressive tumor growth. Moreover, an overlapping mutational profile was identified between mouse and human tumors. Gene prioritization revealed putative downstream effectors of Cdk5 which may contribute to the slow and aggressive growth in the mouse MTC models. In addition, Cdk5/p25 phosphorylation sites identified as biomarkers for Cdk5-driven neuroendocrine tumors (NETs) were detected in both slow and rapid onset models and were also histologically present in human MTC. Thus, this study directly relates mouse and human MTC models and uncovers vulnerable pathways potentially responsible for differential tumor growth rates. Functional validation of our findings may lead to better prediction of patient-specific personalized combinational therapies.
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Affiliation(s)
- Priyanka Gupta
- Department of Translational Neuroscience, University of Arizona School of Medicine in Phoenix, Phoenix, AZ 85004-2230, USA
| | - Brendon Herring
- Department of Surgery, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL 35233, USA
| | - Nilesh Kumar
- Department of Biology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Rahul Telange
- Department of Hematology, St Jude Children’s Research Hospital, Memphis, TN 38105, USA
| | - Sandra S. Garcia-Buntley
- Cancer Research Technology Program, Antibody Characterization Lab, Frederick National Laboratory for Cancer Research, Frederick, MD, 21702, USA
| | - Tessa W. Caceres
- Cancer Research Technology Program, Antibody Characterization Lab, Frederick National Laboratory for Cancer Research, Frederick, MD, 21702, USA
| | - Simona Colantonio
- Cancer Research Technology Program, Antibody Characterization Lab, Frederick National Laboratory for Cancer Research, Frederick, MD, 21702, USA
| | - Ford Williams
- Department of Surgery, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL 35233, USA
| | - Pradeep Kurup
- Department of Surgery, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL 35233, USA
| | - Angela M. Carter
- Department of Surgery, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL 35233, USA
| | - Diana Lin
- Department of Pathology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL 35233, USA
| | - Herbert Chen
- Department of Surgery, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL 35233, USA
| | - Bart Rose
- Department of Surgery, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL 35233, USA
| | - Renata Jaskula-Sztul
- Department of Surgery, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL 35233, USA
| | - Shahid Mukhtar
- Department of Biology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Sushanth Reddy
- Department of Surgery, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL 35233, USA
| | - James A. Bibb
- Department of Translational Neuroscience, University of Arizona School of Medicine in Phoenix, Phoenix, AZ 85004-2230, USA
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3
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de Vries LH, Lodewijk L, de Keizer B, Borel Rinkes IH, Vriens MR. Sentinel lymph node detection in thyroid carcinoma using 68Ga-tilmanocept PET/CT: a proof-of-concept study protocol. Future Oncol 2022; 18:3493-3499. [PMID: 36069284 DOI: 10.2217/fon-2022-0165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Sentinel lymph node biopsy (SLNB) is a diagnostic staging procedure. The procedure aims to identify the first draining lymph node(s), which are most likely to contain metastases. SLNB is applied in various cancers, but not currently in thyroid carcinoma. However, treatment strategies are changing, making SLNB clinically relevant. SLNB may lead to more accurate staging, prevent unnecessary treatment and help achieve earlier curation. 68Ga-tilmanocept PET/computed tomography (CT) can better localize sentinel lymph nodes (SLNs) near the primary tumor than planar scintigraphy and single-photon emission computed tomography (SPECT)/CT. This paper describes the rationale and design of a study investigating SLNB using 68Ga-tilmanocept PET/CT and indocyanine-green-99mTc-nanocolloid in ten differentiated and medullary thyroid carcinoma patients. Localization and number of SLNs, pathology result, optimal scan protocol, surgical time and surgeon's experience are examined. Clinical Trial Registration: 2021-002470-42 (EudraCT).
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Affiliation(s)
- Lisa H de Vries
- Department of Surgery, University Medical Center Utrecht, Utrecht, 3584 CX, The Netherlands
| | - Lutske Lodewijk
- Department of Surgery, University Medical Center Utrecht, Utrecht, 3584 CX, The Netherlands
| | - Bart de Keizer
- Department of Radiology & Nuclear Medicine, University Medical Center Utrecht, Utrecht, 3584 CX, The Netherlands
| | - Inne Hm Borel Rinkes
- Department of Surgery, University Medical Center Utrecht, Utrecht, 3584 CX, The Netherlands
| | - Menno R Vriens
- Department of Surgery, University Medical Center Utrecht, Utrecht, 3584 CX, The Netherlands
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4
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Haddad RI, Bischoff L, Ball D, Bernet V, Blomain E, Busaidy NL, Campbell M, Dickson P, Duh QY, Ehya H, Goldner WS, Guo T, Haymart M, Holt S, Hunt JP, Iagaru A, Kandeel F, Lamonica DM, Mandel S, Markovina S, McIver B, Raeburn CD, Rezaee R, Ridge JA, Roth MY, Scheri RP, Shah JP, Sipos JA, Sippel R, Sturgeon C, Wang TN, Wirth LJ, Wong RJ, Yeh M, Cassara CJ, Darlow S. Thyroid Carcinoma, Version 2.2022, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2022; 20:925-951. [PMID: 35948029 DOI: 10.6004/jnccn.2022.0040] [Citation(s) in RCA: 131] [Impact Index Per Article: 65.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Differentiated thyroid carcinomas is associated with an excellent prognosis. The treatment of choice for differentiated thyroid carcinoma is surgery, followed by radioactive iodine ablation (iodine-131) in select patients and thyroxine therapy in most patients. Surgery is also the main treatment for medullary thyroid carcinoma, and kinase inhibitors may be appropriate for select patients with recurrent or persistent disease that is not resectable. Anaplastic thyroid carcinoma is almost uniformly lethal, and iodine-131 imaging and radioactive iodine cannot be used. When systemic therapy is indicated, targeted therapy options are preferred. This article describes NCCN recommendations regarding management of medullary thyroid carcinoma and anaplastic thyroid carcinoma, and surgical management of differentiated thyroid carcinoma (papillary, follicular, Hürthle cell carcinoma).
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Affiliation(s)
| | | | - Douglas Ball
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
| | | | | | | | | | - Paxton Dickson
- St. Jude Children's Research Hospital/The University of Tennessee Health Science Center
| | - Quan-Yang Duh
- UCSF Helen Diller Family Comprehensive Cancer Center
| | | | | | | | | | - Shelby Holt
- UT Southwestern Simmons Comprehensive Cancer Center
| | - Jason P Hunt
- Huntsman Cancer Institute at the University of Utah
| | | | | | | | - Susan Mandel
- Abramson Cancer Center at the University of Pennsylvania
| | - Stephanie Markovina
- Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
| | | | | | - Rod Rezaee
- Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
| | | | - Mara Y Roth
- Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance
| | | | | | - Jennifer A Sipos
- The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | | | - Cord Sturgeon
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University
| | | | | | | | - Michael Yeh
- UCLA Jonsson Comprehensive Cancer Center; and
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5
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Bai Y, Niu D, Yao Q, Lin D, Kakudo K. Updates in the advances of sporadic medullary thyroid carcinoma: from the molecules to the clinic. Gland Surg 2020; 9:1847-1856. [PMID: 33224860 DOI: 10.21037/gs-2019-catp-21] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Medullary thyroid carcinoma (MTC) is a rare neuroendocrine malignancy that originates in parafollicular cells. It is well-known that a quarter of MTC are involved in hereditary multiple endocrine neoplasia type 2 syndromes, whereas most MTC are sporadic. Unlike the commonly encountered gastrointestinal or pulmonary neuroendocrine tumors, most sporadic MTCs have distinct genetic alterations featured by somatic changes of either Rearranged during Transfection (RET) or RAS point mutation. The increasing application of next-generation sequencing, whole-exome sequencing, and other molecular detection techniques enables us to understand MTC comprehensively concerning its detailed molecular changes and their clinical correlations. This article reviews the advances in genetic alterations and their prognostic impact in sporadic MTC among different populations and discusses the associated tumor immune microenvironments and the potential role of immunotherapy targeting PD-L1/PD-1 in treating MTC. Furthermore, the current multikinase inhibitor targeting therapy for sporadic MTC has been summarized here and its efficacy and drug toxicity are discussed. Updates in advance of the role of calcitonin/procalcitonin/calcitonin-related polypeptide alpha (CALCA) gene transcripts in diagnosing and handling MTC are also mentioned. The treatment of advanced MTC is still challenging and might require a combination of several modalities.
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Affiliation(s)
- Yanhua Bai
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Pathology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Dongfeng Niu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Pathology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Qian Yao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Pathology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Dongmei Lin
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Pathology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Kennichi Kakudo
- Department of Pathology and Thyroid Disease Center, Izumi City General Hospital, Izumi, Japan
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6
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Giardino E, Catalano R, Barbieri AM, Treppiedi D, Mangili F, Spada A, Arosio M, Mantovani G, Peverelli E. Cofilin is a mediator of RET-promoted medullary thyroid carcinoma cell migration, invasion and proliferation. Mol Cell Endocrinol 2019; 495:110519. [PMID: 31352037 DOI: 10.1016/j.mce.2019.110519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 05/27/2019] [Accepted: 07/24/2019] [Indexed: 11/20/2022]
Abstract
Medullary thyroid carcinoma (MTC) is a rare neuroendocrine tumor that originates from parafollicular thyroid C cells and accounts for 5% of thyroid cancers. In inherited cases of MTC, and in about 40% of sporadic cases, activating mutations of the receptor tyrosine kinase proto-oncogene RET are found. Constitutively active RET triggers signaling pathways involved in cell proliferation, survival and motility, but the mechanisms underlying malignant transformation of C-cells have been only partially elucidated. Cofilin is a key regulator of actin cytoskeleton dynamics. A crucial role of cofilin in tumor development, progression, invasion and metastasis has been demonstrated in different human cancers, but no data are available in MTC. Interestingly, RET activation upregulates cofilin gene expression. The aim of this study was to investigate cofilin contribution in invasiveness and growth of MTC cells, and its relevance in the context of mutant RET signaling. We found that cofilin transfection in human MTC cell line TT significantly increased migration (178 ± 44%, p < 0.001), invasion (165 ± 28%, p < 0.01) and proliferation (146 ± 18%, p < 0.001), accompanied by an increase of ERK1/2 phosphorylation (2.23-fold) and cyclin D1 levels (1.43-fold). Accordingly, all these responses were significantly reduced after genetic silencing of cofilin (-55 ± 10% migration, p < 0.001, -41 ± 8% invasion, p < 0.001, -17 ± 3% proliferation, p < 0.001). These results have been confirmed in primary cells cultures obtained from human MTCs. The inhibition of constitutively active RET in TT cells by both the RET pharmacological inhibitor RPI-1 and the transfection of dominant negative RET mutant (RETΔTK) resulted in a reduction of cofilin expression (-37 ± 8%, p < 0.001 and -31 ± 16%, p < 0.01, respectively). Furthermore, RPI-1 inhibitory effects on TT cell migration (-57 ± 13%, p < 0.01), but not on cell proliferation, were completely abolished in cells transfected with cofilin. In conclusion, these data indicate that an unbalanced cofilin expression, induced by oncogenic RET, contributes to promote MTC invasiveness and growth, suggesting the possibility of targeting cofilin pathway for more effective treatment of MTC.
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Affiliation(s)
- E Giardino
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - R Catalano
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; PhD Program in Endocrinological Sciences, Sapienza University of Rome, Rome, Italy
| | - A M Barbieri
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - D Treppiedi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - F Mangili
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - A Spada
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - M Arosio
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - G Mantovani
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - E Peverelli
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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7
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de Vries LH, Lodewijk L, Willems SM, Dreijerink KMA, de Keizer B, van Diest PJ, Schepers A, Bonenkamp HJ, van Engen-van Grunsven IACH, Kruijff S, van Hemel BM, Links TP, Nieveen van Dijkum EJM, van Eeden S, Valk GD, Borel Rinkes IHM, Vriens MR. SSTR2A expression in medullary thyroid carcinoma is correlated with longer survival. Endocrine 2018; 62:639-647. [PMID: 30128959 PMCID: PMC6244936 DOI: 10.1007/s12020-018-1706-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 07/27/2018] [Indexed: 12/23/2022]
Abstract
PURPOSE Medullary thyroid carcinoma (MTC) derives from the parafollicular C-cells of the thyroid gland. Somatostatin receptors (SSTRs) are expressed in various neuroendocrine tumours including MTC. The aim of this study was to evaluate SSTR2A as a prognostic factor for MTC, to study distribution of SSTR2A expression within tumours and to compare expression of SSTR2A between primary tumours and corresponding lymph node metastases. METHODS Patients who underwent surgery between 1988 and 2014 for MTC from five tertiary referral centres in The Netherlands were included. In total, primary tumours of 114 patients and lymph node metastases of 34 patients were analysed for expression of SSTR2A using a tissue microarray, and correlated with clinicopathological variables and survival. RESULTS The mean age of patients was 45.5 years (SD 16.2), 55 patients were male (49.5%). Primary tumours of 58 patients (50.9%) showed SSTR2A expression. In multivariate Cox-regression analysis, SSTR2A positivity correlated independently with better overall survival (OS) (HR 0.3; 95% CI 0.1-1.0). In stage IV MTC patients, 10-year survival rates for SSTR2A-negative and positive patients were 43% and 96%, respectively. In 53.9% of patients with lymph node metastases, expression in primary tumour and lymph node metastases differed. CONCLUSION SSTR2A expression is correlated with longer OS in MTC, especially for stage IV patients, suggesting that SSTR2A expression might be a useful prognostic factor in MTC. The SSTR2A status of the primary MTC does not predict expression in lymph node metastases.
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Affiliation(s)
- Lisa H de Vries
- Department of Surgery, University Medical Centre Utrecht, Heidelberglaan 100, 3584CX, Utrecht, The Netherlands
| | - Lutske Lodewijk
- Department of Surgery, University Medical Centre Utrecht, Heidelberglaan 100, 3584CX, Utrecht, The Netherlands
| | - Stefan M Willems
- Department of Pathology, University Medical Centre Utrecht, Heidelberglaan 100, 3584CX, Utrecht, The Netherlands
| | - Koen M A Dreijerink
- Department of Endocrine Oncology, University Medical Centre Utrecht, Heidelberglaan 100, 3584CX, Utrecht, The Netherlands
| | - Bart de Keizer
- Department of Radiology, University Medical Centre Utrecht, Heidelberglaan 100, 3584CX, Utrecht, The Netherlands
| | - Paul J van Diest
- Department of Pathology, University Medical Centre Utrecht, Heidelberglaan 100, 3584CX, Utrecht, The Netherlands
| | - Abbey Schepers
- Department of Surgery, Leiden University Medical Centre, Albinusdreef 2, 2333ZA, Leiden, The Netherlands
| | - Han J Bonenkamp
- Department of Surgery, Radboud University Medical Centre, Geert Grooteplein 8, 6525GA, Nijmegen, The Netherlands
| | | | - Schelto Kruijff
- Department of Surgery, University Medical Centre Groningen, Hanzeplein 1, 9700RB, Groningen, The Netherlands
| | - Bettien M van Hemel
- Department of Pathology, University Medical Centre Groningen, Hanzeplein 1, 9700RB, Groningen, The Netherlands
| | - Thera P Links
- Department of Internal Medicine, University Medical Centre Groningen, Hanzeplein 1, 9700RB, Groningen, The Netherlands
| | - Els J M Nieveen van Dijkum
- Department of Surgery, Academic Medical Centre Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
| | - Susanne van Eeden
- Department of Pathology, Academic Medical Centre Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
| | - Gerlof D Valk
- Department of Endocrine Oncology, University Medical Centre Utrecht, Heidelberglaan 100, 3584CX, Utrecht, The Netherlands
| | - Inne H M Borel Rinkes
- Department of Surgery, University Medical Centre Utrecht, Heidelberglaan 100, 3584CX, Utrecht, The Netherlands
| | - Menno R Vriens
- Department of Surgery, University Medical Centre Utrecht, Heidelberglaan 100, 3584CX, Utrecht, The Netherlands.
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8
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Lodewijk L, Willems SM, Dreijerink KMA, de Keizer B, van Diest PJ, Schepers A, Morreau H, Bonenkamp HJ, Van Engen-van Grunsven IACH, Kruijff S, van Hemel BM, Links TP, Nieveen van Dijkum E, van Eeden S, Valk GD, Borel Rinkes IHM, Vriens MR. The theranostic target prostate-specific membrane antigen is expressed in medullary thyroid cancer. Hum Pathol 2018; 81:245-254. [PMID: 30055186 DOI: 10.1016/j.humpath.2018.06.035] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 06/30/2018] [Accepted: 06/30/2018] [Indexed: 01/25/2023]
Affiliation(s)
- Lutske Lodewijk
- University Medical Center Utrecht, Department of Surgery, 3584CX Utrecht, The Netherlands
| | - Stefan M Willems
- University Medical Center Utrecht, Department of Pathology, 3584CX Utrecht, The Netherlands
| | - Koen M A Dreijerink
- University Medical Center Utrecht, Department of Endocrine Oncology, 3584CX Utrecht, The Netherlands
| | - Bart de Keizer
- University Medical Center Utrecht, Department of Radiology, 3584CX Utrecht, The Netherlands
| | - Paul J van Diest
- University Medical Center Utrecht, Department of Pathology, 3584CX Utrecht, The Netherlands
| | - Abbey Schepers
- Leiden University Medical Center, Department of Surgery, 2333ZA Leiden, The Netherlands
| | - Hans Morreau
- Leiden University Medical Center, Department of Pathology, 2333ZA Leiden, The Netherlands
| | - Han J Bonenkamp
- Radboud University Medical Center, Department of Surgery, Nijmegen 6525GA, The Netherlands
| | | | - Schelto Kruijff
- University Medical Center Groningen, Department of Surgery, 9700RB, Groningen, The Netherlands
| | - Bettien M van Hemel
- University Medical Center Groningen, Department of Pathology, 9700RB, Groningen, The Netherlands
| | - Thera P Links
- University Medical Center Groningen, Department of Internal Medicine, 9700RB, Groningen, The Netherlands
| | - Els Nieveen van Dijkum
- Academic Medical Center Amsterdam, Department of Surgery, 1105AZ, Amsterdam, The Netherlands
| | - Susanne van Eeden
- Academic Medical Center Amsterdam, Department of Pathology, 1105AZ, Amsterdam, The Netherlands
| | - Gerlof D Valk
- University Medical Center Utrecht, Department of Endocrine Oncology, 3584CX Utrecht, The Netherlands
| | - Inne H M Borel Rinkes
- University Medical Center Utrecht, Department of Surgery, 3584CX Utrecht, The Netherlands
| | - Menno R Vriens
- University Medical Center Utrecht, Department of Surgery, 3584CX Utrecht, The Netherlands.
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9
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Lodewijk L, van Diest P, van der Groep P, Ter Hoeve N, Schepers A, Morreau J, Bonenkamp J, van Engen-van Grunsven A, Kruijff S, van Hemel B, Links T, Nieveen van Dijkum E, van Eeden S, Valk G, Borel Rinkes I, Vriens M. Expression of HIF-1α in medullary thyroid cancer identifies a subgroup with poor prognosis. Oncotarget 2018; 8:28650-28659. [PMID: 28404916 PMCID: PMC5438680 DOI: 10.18632/oncotarget.15622] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 01/24/2017] [Indexed: 01/16/2023] Open
Abstract
Background Medullary thyroid cancer (MTC) comprises only 4% of all thyroid cancers and originates from the parafollicular C-cells. HIF-1α expression has been implied as an indicator of worse prognosis in various solid tumors. However, whether expression of HIF-1α is a prognosticator in MTC remained unclear. Our aim was to evaluate the prognostic value of HIF-1α in patients with MTC. Methods All patients with MTC who were operated on between 1988 and 2014 in five tertiary referral centers in The Netherlands were included. A tissue microarray was constructed in which 111 primary tumors could be analyzed for expression of HIF-1α, CAIX, Glut-1, VEGF and CD31 and correlated with clinicopathologic variables and survival. Results The mean age of patients was 46.3 years (SD 15.6), 59 (53.2%) were male. Of the 111 primary tumors, 49 (44.1%) were HIF-1α negative and 62 (55.9%) were HIF-1α positive. Positive HIF-1α expression was an independent negative indicator for progression free survival (PFS) in multivariate cox regression analysis (HR 3.1; 95% CI 1.3 – 7.3). Five-years survival decreased from 94.0% to 65.9% for the HIF-1α positive group (p=0.007). Even within the group of patients with TNM-stage IV disease, HIF-1α positivity was associated with a worse prognosis, shown by a decrease in 5-years survival of 88.0% to 49.3% (p=0.020). Conclusion Expression of HIF-1α is strongly correlated with adverse prognosis of MTC. This could open up new ways for targeted systemic therapy of MTC.
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Affiliation(s)
- Lutske Lodewijk
- University Medical Center Utrecht, Department of Surgery, 3584CX Utrecht, The Netherlands
| | - Paul van Diest
- University Medical Center Utrecht, Department of Pathology, 3584CX Utrecht, The Netherlands
| | - Petra van der Groep
- University Medical Center Utrecht, Department of Pathology, 3584CX Utrecht, The Netherlands
| | - Natalie Ter Hoeve
- University Medical Center Utrecht, Department of Pathology, 3584CX Utrecht, The Netherlands
| | - Abbey Schepers
- Leiden University Medical Center, Department of Surgery, 2333ZA Leiden, The Netherlands
| | - Johannes Morreau
- Leiden University Medical Center, Department of Pathology, 2333ZA Leiden, The Netherlands
| | - Johannes Bonenkamp
- Radboud University Medical Center, Department of Surgery, Nijmegen 6525GA, The Netherlands
| | | | - Schelto Kruijff
- University Medical Center Groningen, Department of Surgery, 9700 RB, Groningen, The Netherlands
| | - Bettien van Hemel
- University Medical Center Groningen, Department of Pathology, 9700 RB, Groningen, The Netherlands
| | - Thera Links
- University Medical Center Groningen, Department of Internal Medicine, 9700 RB, Groningen, The Netherlands
| | - Els Nieveen van Dijkum
- Academic Medical Center Amsterdam, Department of Surgery, 1105 AZ, Amsterdam, The Netherlands
| | - Susanne van Eeden
- Academic Medical Center Amsterdam, Department of Pathology, 1105 AZ, Amsterdam, The Netherlands
| | - Gerlof Valk
- University Medical Center Utrecht, Department of Endocrine Oncology, 3584CX Utrecht, The Netherlands
| | - Inne Borel Rinkes
- University Medical Center Utrecht, Department of Surgery, 3584CX Utrecht, The Netherlands
| | - Menno Vriens
- University Medical Center Utrecht, Department of Surgery, 3584CX Utrecht, The Netherlands
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Priya SR, Dravid CS, Digumarti R, Dandekar M. Targeted Therapy for Medullary Thyroid Cancer: A Review. Front Oncol 2017; 7:238. [PMID: 29057215 PMCID: PMC5635342 DOI: 10.3389/fonc.2017.00238] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Accepted: 09/19/2017] [Indexed: 12/16/2022] Open
Abstract
Medullary thyroid cancers (MTCs) constitute between 2 and 5% of all thyroid cancers. The 10-year overall survival (OS) rate of patients with localized disease is around 95% while that of patients with regional stage disease is about 75%. Only 20% of patients with distant metastases at diagnosis survive 10 years which is significantly lower than for differentiated thyroid cancers. Cases with regional metastases at presentation have high recurrence rates. Adjuvant external radiation confers local control but not improved OS. The management of residual, recurrent, or metastatic disease till a few years ago was re-surgery with local measures such as radiation. Chemotherapy was used with marginal benefit. The development of targeted therapy has brought in a major advantage in management of such patients. Two drugs—vandetanib and cabozantinib—have been approved for use in progressive or metastatic MTC. In addition, several drugs acting on other steps of the molecular pathway are being investigated with promising results. Targeted radionuclide therapy also provides an effective treatment option with good quality of life. This review covers the rationale of targeted therapy for MTC, present treatment options, drugs and methods under investigation, as well as an outline of the adverse effects and their management.
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Affiliation(s)
- S R Priya
- Head Neck Surgery, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, India.,Tata Memorial Centre, Mumbai, India
| | - Chandra Shekhar Dravid
- Head Neck Surgery, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, India.,Tata Memorial Centre, Mumbai, India
| | - Raghunadharao Digumarti
- Tata Memorial Centre, Mumbai, India.,Medical Oncology, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, India
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11
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Ozer B, Sezerman OU. A novel analysis strategy for integrating methylation and expression data reveals core pathways for thyroid cancer aetiology. BMC Genomics 2015; 16 Suppl 12:S7. [PMID: 26678064 PMCID: PMC4682414 DOI: 10.1186/1471-2164-16-s12-s7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background Recently, a wide range of diseases have been associated with changes in DNA methylation levels, which play a vital role in gene expression regulation. With ongoing developments in technology, attempts to understand disease mechanism have benefited greatly from epigenetics and transcriptomics studies. In this work, we have used expression and methylation data of thyroid carcinoma as a case study and explored how to optimally incorporate expression and methylation information into the disease study when both data are available. Moreover, we have also investigated whether there are important post-translational modifiers which could drive critical insights on thyroid cancer genetics. Results In this study, we have conducted a threshold analysis for varying methylation levels to identify whether setting a methylation level threshold increases the performance of functional enrichment. Moreover, in order to decide on best-performing analysis strategy, we have performed data integration analysis including comparison of 10 different analysis strategies. As a result, combining methylation with expression and using genes with more than 15% methylation change led to optimal detection rate of thyroid-cancer associated pathways in top 20 functional enrichment results. Furthermore, pooling the data from different experiments increased analysis confidence by improving the data range. Consequently, we have identified 207 transcription factors and 245 post-translational modifiers with more than 15% methylation change which may be important in understanding underlying mechanisms of thyroid cancer. Conclusion While only expression or only methylation information would not reveal both primary and secondary mechanisms involved in disease state, combining expression and methylation led to a better detection of thyroid cancer-related genes and pathways that are found in the recent literature. Moreover, focusing on genes that have certain level of methylation change improved the functional enrichment results, revealing the core pathways involved in disease development such as; endocytosis, apoptosis, glutamatergic synapse, MAPK, ErbB, TGF-beta and Toll-like receptor pathways. Overall, in addition to novel analysis framework, our study reveals important thyroid-cancer related mechanisms, secondary molecular alterations and contributes to better knowledge of thyroid cancer aetiology.
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12
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Kramer ER, Liss B. GDNF-Ret signaling in midbrain dopaminergic neurons and its implication for Parkinson disease. FEBS Lett 2015; 589:3760-72. [DOI: 10.1016/j.febslet.2015.11.006] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 10/29/2015] [Accepted: 11/03/2015] [Indexed: 12/11/2022]
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13
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Gilloteaux J, Pardhan D. Crinophagy in Thyroid Follicular and Parafollicular Cells of Male Obese Zucker Rat. Ultrastruct Pathol 2015; 39:255-69. [PMID: 25867801 DOI: 10.3109/01913123.2015.1014611] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Comparison between lean (Fa/?) and obese (fa/fa) young adult male Zucker rat thyroids reveals that obese rats display larger clusters of parafollicular cells than the lean ones with a lesser blood supply. Fa/? thyroid typically shows single or "twin" C cells in follicles; fa/fa parafollicular cells appear with three functional aspects. Crinophagy is found in the fa/fa C cells amassing numerous aberrant calcitonin-containing vesicles among which lysosomes build these autophagic bodies by capturing vesicle contents, other organelles and, fusing with each other, increase their size. Other C cells contain many secretory vesicles but show few or no crinophagic structures. Another parafollicular cell type is revealed with scant organelles and highly contrasted secretory vesicles, different from calcitonin. Hypercalcemia of fa/fa rats corresponds to increased C cells population with accrued calcitonin production but a low calcitonin plasma level - verified by others - is likely caused by crinophagy of the altered vesicles. In addition, the T thyrocytes of fa/fa rats exhibit crinophagy bodies; this can confirm their hypothyroidism. Possibly, the known leptin mutation along with other unknown paracrine secretions alter both T and C thyrocytes' functions of the fa/fa rats, allowing high intracellular calcium and lower pH favoring autophagocytosis. Other longitudinal, interdisciplinary studies should further clarify the complex paracrine interactions existing between these endocrine structures because this animal model could be useful to understand human defects, such as the metabolic syndrome that involves obesity, cardiovascular, renal, hepatic, non-insulin dependent diabetes mellitus (NIDDM), hypothyroidism defects, as well as the etiology of thyroid medullary tumors.
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Affiliation(s)
- Jacques Gilloteaux
- Department of Anatomical Sciences, St George's University School of Medicine, KB Taylor Global Scholar's Programme at Northumbria University , Newcastle upon Tyne , UK
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14
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Lkhoyaali S, Benhmida S, Ait Elhaj M, Layachi M, Bensouda Y, Errihani H. [Targeted therapy in thyroid cancer: Towards a treatment card]. ACTA ACUST UNITED AC 2015; 63:1-6. [PMID: 25555494 DOI: 10.1016/j.patbio.2014.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 11/17/2014] [Indexed: 11/26/2022]
Abstract
Thyroid cancer is an uncommon cancer. Molecular biology plays a vital role in its development. Chemotherapy showed unsatisfactory results in advanced stages where surgery and iodine therapy are not appropriate. These last ten years have been marked by a major advance in understanding the molecular features of this cancer and therapeutic correlations, moreover, clinical trials have focused on the treatment of this disease on metastatic stages and led to a significant therapeutic panel targeting angiogenesis, mutations frequently found in cervical cancer: RET, BRAF, RAS... these are the motesanib, axitinib, sunitinib, pazopanib, vandetanib, cabozotinib and sorafenib. The last three molecules have already the autorisation of FDA and EMA. In this review, we will put the item on oncogenetic characteristics of thyroid carcinoma as well as new targeted therapies in patients refractory to conventional treatment.
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Affiliation(s)
- S Lkhoyaali
- Service d'oncologie médicale, institut national d'oncologie Moulay-Abdellah, rue Lamfadel-Cherkaoui Rabat Institut, BP 6527, 10000 Rabat, Maroc.
| | - S Benhmida
- Service d'oncologie médicale, institut national d'oncologie Moulay-Abdellah, rue Lamfadel-Cherkaoui Rabat Institut, BP 6527, 10000 Rabat, Maroc
| | - M Ait Elhaj
- Service d'oncologie médicale, institut national d'oncologie Moulay-Abdellah, rue Lamfadel-Cherkaoui Rabat Institut, BP 6527, 10000 Rabat, Maroc
| | - M Layachi
- Service d'oncologie médicale, institut national d'oncologie Moulay-Abdellah, rue Lamfadel-Cherkaoui Rabat Institut, BP 6527, 10000 Rabat, Maroc
| | - Y Bensouda
- Service d'oncologie médicale, institut national d'oncologie Moulay-Abdellah, rue Lamfadel-Cherkaoui Rabat Institut, BP 6527, 10000 Rabat, Maroc
| | - H Errihani
- Service d'oncologie médicale, institut national d'oncologie Moulay-Abdellah, rue Lamfadel-Cherkaoui Rabat Institut, BP 6527, 10000 Rabat, Maroc
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15
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Colombo JR, Wein RO. Cabozantinib for progressive metastatic medullary thyroid cancer: a review. Ther Clin Risk Manag 2014; 10:395-404. [PMID: 24920914 PMCID: PMC4043815 DOI: 10.2147/tcrm.s46041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Medullary thyroid cancer is uncommon and patients typically present with advanced disease. Treatment options for patients with progressive, metastatic medullary thyroid cancer had been limited until recently. Tyrosine kinase inhibitors have garnered increasing interest in this subset of patients. The US Food and Drug Administration recently approved cabozantinib, a tyrosine kinase inhibitor, after promising results were shown in a large Phase III clinical trial. This review summarizes the clinical pharmacology, clinical trials, and safety data for cabozantinib and concludes with a discussion of possible future directions for the treatment of medullary thyroid cancer.
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Affiliation(s)
- Joshua R Colombo
- Department of Otolaryngology, Head and Neck Surgery, Tufts Medical Center, Boston, MA, USA
| | - Richard O Wein
- Department of Otolaryngology, Head and Neck Surgery, Tufts Medical Center, Boston, MA, USA
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16
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Mazumdar M, Adhikary A, Chakraborty S, Mukherjee S, Manna A, Saha S, Mohanty S, Dutta A, Bhattacharjee P, Ray P, Chattopadhyay S, Banerjee S, Chakraborty J, Ray AK, Sa G, Das T. Targeting RET to induce medullary thyroid cancer cell apoptosis: an antagonistic interplay between PI3K/Akt and p38MAPK/caspase-8 pathways. Apoptosis 2013; 18:589-604. [PMID: 23329180 DOI: 10.1007/s10495-013-0803-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Mutations in REarranged during Transfection (RET) receptor tyrosine, followed by the oncogenic activation of RET kinase is responsible for the development of medullary thyroid carcinoma (MTC) that responds poorly to conventional chemotherapy. Targeting RET, therefore, might be useful in tailoring surveillance of MTC patients. Here we showed that theaflavins, the bioactive components of black tea, successfully induced apoptosis in human MTC cell line, TT, by inversely modulating two molecular pathways: (i) stalling PI3K/Akt/Bad pathway that resulted in mitochondrial transmembrane potential (MTP) loss, cytochrome-c release and activation of the executioner caspases-9 and -3, and (ii) upholding p38MAPK/caspase-8/caspase-3 pathway via inhibition of Ras/Raf/ERK. Over-expression of either constitutively active myristoylated-Akt-cDNA (Myr-Akt-cDNA) or dominant-negative-caspase-8-cDNA (Dn-caspase-8-cDNA) partially blocked theaflavin-induced apoptosis, while co-transfection of Myr-Akt-cDNA and Dn-caspase-8-cDNA completely eradicated the effect of theaflavins thereby negating the possibility of existence of other pathways. A search for the upstream signaling revealed that theaflavin-induced disruption of lipid raft caused interference in anchorage of RET in lipid raft that in turn stalled phosphorylation of Ras and PI3Kinase. In such anti-survival cellular micro-environment, pro-apoptotic signals were triggered to culminate into programmed death of MTC cell. These findings not only unveil a hitherto unexplained mechanism underlying theaflavin-induced MTC death, but also validate RET as a promising and potential target for MTC therapy.
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Affiliation(s)
- Minakshi Mazumdar
- Division of Molecular Medicine, Bose Institute, P-1/12, Calcutta Improvement Trust Road, Scheme VII M, Kolkata, West Bengal, 700 054, India
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17
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Harry BL, Smith ML, Burton JR, Dasari A, Eckhardt SG, Diamond JR. Medullary thyroid cancer and pseudocirrhosis: case report and literature review. ACTA ACUST UNITED AC 2013; 19:e36-41. [PMID: 22328846 DOI: 10.3747/co.19.840] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Pseudocirrhosis is a rare form of liver disease that can cause clinical symptoms and radiographic signs of cirrhosis; however, its histologic features suggest a distinct pathologic process. In the setting of cancer, hepatic metastases and systemic chemotherapy are suspected causes of pseudocirrhosis. Here, we present a patient with medullary thyroid carcinoma metastatic to the liver who developed pseudocirrhosis while on maintenance sunitinib after receiving 5-fluorouracil, leucovorin, and oxaliplatin (folfox) in combination with sunitinib. Cirrhotic change in liver morphology was accompanied by diffusely infiltrative carcinomatous disease resembling the primary tumor. We discuss the diagnosis of pseudocirrhosis in this case and review the literature regarding pseudocirrhosis in cancer.
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Affiliation(s)
- B L Harry
- Medical Scientist Training Program, University of Colorado at Denver, Anschutz Medical Campus, Aurora, CO, U.S.A
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18
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Chhim RF, Shelton CM, Christensen ML. Recent new drug approvals, part 2: drugs undergoing active clinical studies in children. J Pediatr Pharmacol Ther 2013; 18:14-38. [PMID: 23616733 DOI: 10.5863/1551-6776-18.1.14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The objective of this 2-part review is to provide information about drugs that have been recently approved by the US Food and Drug Administration. Part 1 reviewed recently approved drugs with pediatric indications. Part 2 reviews drugs recently approved only in adults and have published or ongoing studies in children.
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Affiliation(s)
- Rebecca F Chhim
- Departments of Clinical Pharmacy ; Le Bonheur Children's Hospital, Memphis, Tennessee
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Zygulska AL, Krzemieniecki K, Sowa-Staszczak A. The Use of Sorafenib in the Thyroid Cancer. EUROPEAN ENDOCRINOLOGY 2013; 9:28-31. [PMID: 30349607 DOI: 10.17925/ee.2013.09.01.28] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 01/27/2013] [Indexed: 12/18/2022]
Abstract
There are not effective therapies for metastatic unresectable, non-RAI-avid thyroid carcinomas. Fortunately, thyroid carcinomas represent a promising paradigm for targeted therapy due to the presence of activing mutations of genes coding the kinase tyrosines which are involved in all functions of cancer cells (such as: growth or invasion). In this paper an efficacy and toxicity of sorafenib, one of the multi-kinase inhibitors in thyroid carcinomas treatment is presented.
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Affiliation(s)
- Aneta L Zygulska
- Senior Lecturer, Endocrinological Department, University Hospital, Cracow, Poland
| | | | - Anna Sowa-Staszczak
- Associate Professor, Endocrinological Department, University Hospital, Cracow, Poland
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Abstract
When present in thyroid, amyloid is an attribute almost always restricted to medullary thyroid carcinoma. Scant studies in the literature have demonstrated this finding in other thyroid pathologies as papillary thyroid carcinoma, amyloid goiter, and other benign entities. From our experience in thyroid pathology, we analyzed cases on which the stroma contained deposits of amorphous, acellular, and eosinophilic material characteristic of amyloid. Congo red stain on suspicious cases was performed; clinicopathologic investigation was done when results were positive. Seven patients with amyloid infiltration in the thyroid, in association with papillary thyroid carcinoma, and in 4 cases of benign pathologies were found in our own review. The association of amyloid and thyroid is discussed herein, including cases of systemic amyloidosis, malignancies, benign diseases, and thyroid goiter, from our practice and from the available literature.
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22
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Greenman Y, Grafi-Cohen M, Sharon O, Knoll E, Kohen F, Stern N, Somjen D. Anti-proliferative effects of a novel isoflavone derivative in medullary thyroid carcinoma: an in vitro study. J Steroid Biochem Mol Biol 2012; 132:256-61. [PMID: 22776298 DOI: 10.1016/j.jsbmb.2012.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2012] [Revised: 06/25/2012] [Accepted: 06/27/2012] [Indexed: 11/30/2022]
Abstract
Currently available treatments for patients with medullary thyroid carcinoma (MTC) with residual or recurrent disease after primary surgery have low efficacy rates. In view of the possible role of estrogen in the development of thyroid neoplasia, we explored whether proliferation of the human MTC TT cell line, might be curbed by carboxy-daidzein-tBoc (cD-tBoc), a novel isoflavone derivative. Estrogen receptor (ER) α mRNA expression in TT cells was more abundant than ERβ, with a ratio of 48:1. Estradiol-17β (E2) increased DNA synthesis in a dose dependent manner. [(3)H]-thymidine incorporation was also stimulated by the ERβ agonist DPN and the ERα agonist PPT. cD-tBoc inhibited TT cell growth as assessed by thymidine incorporation, XTT assay, and microscopic analysis of culture wells. Creatine kinase specific activity, a marker of the modulatory effects of estrogen on cell energy metabolism, was likewise inhibited. The inhibitory effect of cD-tBoc on [(3)H]-thymidine incorporation could be blocked by the ERβ antagonist PTHPP but not by the ERα antagonist MPP, suggesting that the antiproliferative effect of cD-tBoc on these cells is mediated through ERβ. Furthermore, cD-tBoc potently increased apoptosis and cell necrosis. Co-incubation with the antiapoptotic agent Z-VAD-FMK reversed the growth inhibitory effect elicited by cD-tBoc. These results support the hypothesis that estrogens are involved in the proliferation of MTC. The potent anti-proliferative effects mediated by isoflavone derivatives in the human MTC cell line TT suggest and that this property may be utilized to design effective anti-neoplastic agents.
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Affiliation(s)
- Yona Greenman
- Institute of Endocrinology, Metabolism and Hypertension, Tel-Aviv Sourasky Medical Center and the Sackler Faculty of Medicine, Tel-Aviv University, Israel.
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Thyroid cancer: molecular aspects and new therapeutic strategies. J Thyroid Res 2012; 2012:847108. [PMID: 22848860 PMCID: PMC3403487 DOI: 10.1155/2012/847108] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Accepted: 05/13/2012] [Indexed: 11/17/2022] Open
Abstract
Despite that thyroid cancer accounts for over 90% of tumors that arise from the endocrine system, these tumors barely represent 2% of solid tumors in adults. Many entities are grouped under the general term of thyroid cancer, and they differ in histological features as well as molecular and clinical behavior. Thus, the prognosis for patients with thyroid cancer ranges from a survival rate of >97% at 5 years, in the case of differentiated thyroid tumors sensitive to radioactive iodine, to a 4-month median survival for anaplastic tumors. The high vascularity in these tumors and the important role that oncogenic mutations may have in the RAS/RAF/MEK pathway and oncogenicity (as suggested by activating mutations and rearrangements of the RET gene) have led to the development of multitarget inhibitors in different histological subgroups of patients. The correct molecular characterization of patients with thyroid cancer is thought to be a key aspect for the future clinical management of these patients.
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Molè D, Gentilin E, Gagliano T, Tagliati F, Bondanelli M, Pelizzo MR, Rossi M, Filieri C, Pansini G, degli Uberti EC, Zatelli MC. Protein kinase C: a putative new target for the control of human medullary thyroid carcinoma cell proliferation in vitro. Endocrinology 2012; 153:2088-98. [PMID: 22374978 DOI: 10.1210/en.2011-1988] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
We investigate the role of protein kinase C (PKC) in the control of medullary thyroid carcinoma (MTC) cell proliferation by a PKC inhibitor, Enzastaurin, in human MTC primary cultures and in the TT cell line. We found that PKC inhibition reduces cell proliferation by inducing caspase-mediated apoptosis and blocks the stimulatory effect of IGF-I on calcitonin secretion. Enzastaurin reduces PKCβII (Thr500) phosphorylation, indicating a direct involvement of this isoform as well as the phosphorylated levels of Akt (Ser 473) and glycogen synthase kinase (Ser9), PKC pathway downstream targets and pharmacodynamic markers for PKC inhibition. PKCβII and PKCδ enzyme isoforms expression and localization were investigated. These data indicate that in vitro PKC is involved in the control of human MTC proliferation and survival by modulating apoptosis, with a mechanism that implicates PKCβII inhibition and translocation in different subcellular compartments. Targeting PKC may represent a useful therapeutic approach for controlling MTC proliferation.
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Affiliation(s)
- Daniela Molè
- Section of Endocrinology, Department of Biomedical Sciences and Advanced Therapies, University of Ferrara, Via Savonarola 9, 44121 Ferrara, Italy
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Rudrapatna VA, Cagan RL, Das TK. Drosophila cancer models. Dev Dyn 2011; 241:107-18. [PMID: 22038952 DOI: 10.1002/dvdy.22771] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2011] [Indexed: 01/20/2023] Open
Abstract
Cancer is driven by complex genetic and cellular mechanisms. Recently, the Drosophila community has become increasingly interested in exploring cancer issues. The Drosophila field has made seminal contributions to many of the mechanisms that are fundamental to the cancer process; several of these mechanisms have already been validated in vertebrates. Less well known are the Drosophila field's early direct contributions to the cancer field: some of the earliest tumor suppressors were identified in flies. In this review, we identify major contributions that Drosophila studies have made toward dissecting the pathways and mechanisms underlying tumor progression. We also highlight areas, such as drug discovery, where we expect Drosophila studies to make a major scientific impact in the future.
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Affiliation(s)
- Vivek A Rudrapatna
- Department of Developmental and Regenerative Biology, Mount Sinai School of Medicine, New York, New York 10029, USA
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Interplay between Ret and Fap-1 regulates CD95-mediated apoptosis in medullary thyroid cancer cells. Biochem Pharmacol 2011; 82:778-88. [DOI: 10.1016/j.bcp.2011.06.037] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 05/27/2011] [Accepted: 06/22/2011] [Indexed: 01/08/2023]
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London C, Mathie T, Stingle N, Clifford C, Haney S, Klein MK, Beaver L, Vickery K, Vail DM, Hershey B, Ettinger S, Vaughan A, Alvarez F, Hillman L, Kiselow M, Thamm D, Higginbotham ML, Gauthier M, Krick E, Phillips B, Ladue T, Jones P, Bryan J, Gill V, Novasad A, Fulton L, Carreras J, McNeill C, Henry C, Gillings S. Preliminary evidence for biologic activity of toceranib phosphate (Palladia(®)) in solid tumours. Vet Comp Oncol 2011; 10:194-205. [PMID: 22236194 DOI: 10.1111/j.1476-5829.2011.00275.x] [Citation(s) in RCA: 161] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The purpose of this study was to provide an initial assessment of the potential biologic activity of toceranib phosphate (Palladia®, Pfizer Animal Health, Madison, NJ, USA) in select solid tumours in dogs. Cases in which toceranib was used to treat dogs with apocrine gland anal sac adenocarcinoma (AGASACA), metastatic osteosarcoma (OSA), thyroid carcinoma, head and neck carcinoma and nasal carcinoma were included. Clinical benefit (CB) was observed in 63/85 (74%) dogs including 28/32 AGASACA [8 partial response (PR), 20 stable disease (SD)], 11/23 OSAs (1 PR and 10 SD), 12/15 thyroid carcinomas (4 PR and 8 SD), 7/8 head and neck carcinomas [1 complete response (CR), 5 PR and 1 SD] and 5/7 (1 CR and 4 SD) nasal carcinomas. For dogs experiencing CB, the median dose of toceranib was 2.8 mg kg(-1) , 36/63 (58.7%) were dosed on a Monday/Wednesday/Friday basis and 47/63 (74.6%) were treated 4 months or longer. Although these data provide preliminary evidence that toceranib exhibits CB in dogs with certain solid tumours, future prospective studies are necessary to define its true activity.
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Affiliation(s)
- C London
- Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA.
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28
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Samadi AK, Mukerji R, Shah A, Timmermann BN, Cohen MS. A novel RET inhibitor with potent efficacy against medullary thyroid cancer in vivo. Surgery 2011; 148:1228-36; discussion 1236. [PMID: 21134556 DOI: 10.1016/j.surg.2010.09.026] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2010] [Accepted: 09/16/2010] [Indexed: 12/01/2022]
Abstract
BACKGROUND Most medullary thyroid carcinomas (MTC) recur or progress despite curative resection. Current targeted therapies show promise but lack durable efficacy and tolerability. The purpose of this study was to build on previous in vitro work and evaluate withaferin A (WA), a novel RET inhibitor, in a metastatic murine model of MTC. METHODS A total of 5 million DRO-81-1 human MTC cells injected in the left posterior neck of nu/nu mice generated metastases uniformly to the liver, spleen, and/or lungs. Treatment with WA (8 mg/kg/day, intraperitoneally, for 21 days) was started for neoplasms > 100 mm(3). Endpoints were survival, neoplasm > 15,00 mm(3), decreased body weight, or body score (all measured three times/wk). RESULTS All controls (saline; n = 5) died or deteriorated from metastatic disease by 7 weeks postinjection. All treated animals were alive (WA; n = 5), having tumor regression and growth delay without toxicity or weight loss at 6 weeks posttreatment (P < .01). Tumor cells treated with WA demonstrated inhibition of total and phospho-RET levels by Western blot analysis in a dose-dependent manner (almost complete inhibition with treatment of 5 μM WA) as well as potent inhibition of phospho-ERK and phospho-Akt levels. CONCLUSION WA is a novel natural-product RET-inhibitor with efficacy in a metastatic murine model of MTC. Further long-term efficacy/toxicity studies are warranted to evaluate this compound for clinical translation.
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Affiliation(s)
- Abbas K Samadi
- Department of Surgery, The University of Kansas Medical Center, Kansas City, KS, USA
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29
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Iwase Y, Maitani Y. Octreotide-Targeted Liposomes Loaded with CPT-11 Enhanced Cytotoxicity for the Treatment of Medullary Thyroid Carcinoma. Mol Pharm 2010; 8:330-7. [DOI: 10.1021/mp100380y] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Yuko Iwase
- Institute of Medicinal Chemistry, Hoshi University, Ebara 2-4-41, Shinagawa, Tokyo 142-8501, Japan
| | - Yoshie Maitani
- Institute of Medicinal Chemistry, Hoshi University, Ebara 2-4-41, Shinagawa, Tokyo 142-8501, Japan
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30
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Abstract
Although neuroendocrine tumors are rare, the more common types such as gastrointestinal and pancreatic carcinoids, medullary thyroid cancers, and small cell lung cancers have been studied in detail during the last few years. Data published thus far indicate that multiple signaling pathways are involved in these cancers. Recent focus has been on developing novel therapeutics by targeting specific signaling pathways. This article details several of the signaling mechanisms that have been discovered to play a role in the development and progression of neuroendocrine tumors. The therapeutic options developed to address the various pathways, including their specific mechanisms of actions, are also discussed.
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Affiliation(s)
- Barbara Zarebczan
- Endocrine Surgery Research Laboratories, Department of Surgery, University of Wisconsin Carbone Cancer Center, Madison, WI 53705, USA
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31
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Medullary thyroid carcinoma relapse reversed with dichloroacetate: A case report. Oncol Lett 2010; 1:889-891. [PMID: 22966401 DOI: 10.3892/ol_00000158] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2010] [Accepted: 06/15/2010] [Indexed: 02/01/2023] Open
Abstract
A 51-year-old male patient diagnosed with medullary thyroid carcinoma (MTC) in 2001, with progression to lung metastases following adriamycin therapy, was then successfully treated with dimethyltriazenoimidazole carboximide. He remained in partial remission for 7 years following numerous chemotherapy attempts to induce partial remission. In October 2008, the patient, then 58 years old, relapsed with numerous tumors throughout his central body. On December 1, 2008, the tumor marker for MTC, calcitonin, was at 38,611 pg/ml, i.e., much higher than the norm of <20 pg/ml. Since all other chemotherapy attempts had failed, he was ineligible for any new studies. Subsequently, the patient was immediately started on 10 mg/kg of dichloroacetate (DCA). By April 2009, the calcitonin level was reduced to 2,000 pg/ml. In May 2009, a new positron emission tomography showed a dramatic reduction in all tumor locations. The patient presently remains in remission and continues receiving the same dosage of DCA, with his tumor marker remaining stable in laboratory data since November 2009.
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32
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Abstract
BACKGROUND Multiple endocrine neoplasia type II (MEN2) is a rare but aggressive cancer for which no effective treatment currently exists. A Drosophila model was developed to identify novel genetic modifier loci of oncogenic RET, as well as to provide a whole animal system to rapidly identify compounds that suppressed RET-dependent MEN2. ZD6474 (Vandetanib), currently in phase III trials, suppressed tumorigenesis in MEN2 model flies, demonstrating for the first time the effectiveness of a Drosophila-based whole animal model for identifying therapeutically useful compounds. SUMMARY Clinical data suggest that drug mono-therapy for MEN2 and other cancers typically yield only moderate benefits as patients develop drug resistance and suffer from drug-induced pathway feedback. Combinations of drugs that target different nodes of the oncogenic pathway are an effective way to prevent resistance as well as feedback. Identifying the optimal drug-dose combinations for therapy poses a significant challenge in existing mouse models. Fly models offer a means to quickly and effectively identify drug combinations that are well tolerated and potently suppress the MEN2 phenotype. This approach may also identify differences in therapeutic responses between the two subtypes of MEN2--MEN2A and MEN2B--providing additional therapeutic insights. CONCLUSIONS Fly models have proven useful for identifying known drugs as well as novel compounds that, as single agents or in combinations, effectively suppress the MEN2 syndrome. These findings validate the use of fly models for both drug discovery as well as identification of useful drug combinations. In the future, rapid pairing of new genomic information with increasingly complex fly models will aid us in efforts to further tailor drug treatments toward personalized medicine.
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Affiliation(s)
- Tirtha Das
- Department of Developmental and Regenerative Biology, Mount Sinai School of Medicine, New York, New York 10029, USA
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33
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Petrova M, Mihaylova Z, Fakirova A. Sorafenib in metastatic MTC - a case report and minireview of the literature. Int Med Case Rep J 2010; 3:55-8. [PMID: 23754889 PMCID: PMC3658222 DOI: 10.2147/imcrj.s9384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Medullary thyroid cancer (MTC) is a rare and only surgically treatable disease with early development of metastases and bad prognosis. Due to the lack of efficient systemic treatment, new strategies and approaches are needed to better the patients' outcome. One of the most promising treatment options is the use of tyrosine multikinase inhibitors, which appear to have some effect on the disease progression with tolerable toxicity. Most of them affect many key pathways in the cancer genesis and have proven their effect in different malignancies. We report a case of a young patient with metastatic MTC treated successfully for two months with sorafenib.
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Affiliation(s)
- Mila Petrova
- Hematology and Oncology Department, Medical Military Academy, Sofia, Bulgaria
| | - Zhasmina Mihaylova
- Hematology and Oncology Department, Medical Military Academy, Sofia, Bulgaria
| | - Albena Fakirova
- Pathology Department, Medical Military Academy, Sofia, Bulgaria
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34
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Grozinsky-Glasberg S, Rubinfeld H, Nordenberg Y, Gorshtein A, Praiss M, Kendler E, Feinmesser R, Grossman AB, Shimon I. The rapamycin-derivative RAD001 (everolimus) inhibits cell viability and interacts with the Akt-mTOR-p70S6K pathway in human medullary thyroid carcinoma cells. Mol Cell Endocrinol 2010; 315:87-94. [PMID: 19815051 DOI: 10.1016/j.mce.2009.09.027] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2009] [Revised: 09/24/2009] [Accepted: 09/24/2009] [Indexed: 01/07/2023]
Abstract
Over-expression of the proto-oncogene Akt/PKB has been demonstrated in some neuroendocrine tumor models. Akt may activate downstream proteins such as mTOR and p70S6K, inducing tumor proliferation. The rapamycin-derivative RAD001, everolimus, interacts with this pathway by antagonizing mTOR, but its effects on neuroendocrine tumors are largely unknown. We explored the mechanism of action of RAD001 on cell proliferation, hormonal secretion and on Akt/mTOR/p70S6K pathway activation, in a human medullary thyroid carcinoma (MTC) cell-line (TT) and in cells derived from human MTCs. Treatment with RAD001 significantly inhibited cell viability in a dose- and time-dependent fashion, and diminished phosphorylation of Akt downstream targets, mTOR and p70S6K, in both TT cell-line and cultured human MTCs. Akt phosphorylation was not affected by RAD001. RAD001 induced cell-cycle arrest in the G(0)/G(1) phase in TT cells, but had no effect on apoptosis. Moreover, RAD001 did not affect calcitonin and carcinoembryonic antigen secretion in TT cells and in human MTCs. RAD001 seems to have potent anti-proliferative effect in human MTC cells, which suggest that clinical trials of this agent are of considerable interest.
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