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Ke F, Wang N, Zhang X, Liu R, Ren T, Ke J, Yang J, Yan H, Ma J. Enhancement of vincristine sensitivity in retinoblastoma through Janus kinase inhibition by ruxolitinib. Anticancer Drugs 2024; 35:615-622. [PMID: 38742728 DOI: 10.1097/cad.0000000000001615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Chemotherapy remains the main approach conserving vision during the treatment of retinoblastoma, the most prevalent eye cancer in children. Unfortunately, the development of chemoresistance stands as the primary reason for treatment failure. Within this study, we showed that prolonged exposure to vincristine led to heightened expression of JAK1 and JAK2 in retinoblastoma cells, while the other members of the JAK family exhibited no such changes. Employing a genetic intervention, we demonstrated the efficacy of depleting either JAK1 or JAK2 in countering vincristine-resistant retinoblastoma cells. In addition, the dual depletion of both JAK1 and JAK2 produced a more potent inhibitory outcome compared to the depletion of either gene alone. We further demonstrated that ruxolitinib, a small molecular inhibitor of JAK1/2, effectively reduced viability and colony formation in vincristine-resistant retinoblastoma cells. It also acts synergistically with vincristine in retinoblastoma cells regardless of inherent cellular and genetic heterogeneity. The effectiveness of ruxolitinib as standalone treatment against chemoresistant retinoblastoma, as well as its combination with vincristine, was validated in multiple retinoblastoma mouse models. Importantly, mice exhibited favorable tolerance to ruxolitinib administration. We confirmed that the underlying mechanism of ruxolitinib's action in chemoresistant retinoblastoma cells is the inhibition of Janus kinase/signal transducer and activator of transcription (JAK/STAT) signaling. Our study reveals that the underlying mechanism driving ruxolitinib's impact on chemoresistant retinoblastoma cells is the inhibition of JAK/STAT signaling. This study reveals the contribution of JAK1/2 to the development of chemoresistance in retinoblastoma and underscores the effectiveness of targeting JAK1/2 as a strategy to sensitize retinoblastoma to chemotherapy.
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Affiliation(s)
- Feng Ke
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing
| | - Nan Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing
| | - Xuan Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing
| | - Rui Liu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing
| | - Tingting Ren
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing
| | | | - Jianye Yang
- Institute of Clinical Medicine, Renmin Hospital, Hubei University of Medicine, Shiyan, China
| | - Haihan Yan
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing
| | - Jianmin Ma
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing
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Singh A, Raval V, Sedaghat A, Kaliki S. Evolving criteria for group E retinoblastoma: impact on outcomes. CANADIAN JOURNAL OF OPHTHALMOLOGY 2024:S0008-4182(24)00139-X. [PMID: 38830602 DOI: 10.1016/j.jcjo.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 04/13/2024] [Accepted: 05/06/2024] [Indexed: 06/05/2024]
Abstract
OBJECTIVE To assess the impact of evolving criteria for group E retinoblastoma on ocular survival outcomes. DESIGN A retrospective observational study. METHODS Single-institution consecutive case series of patients with advanced intraocular retinoblastoma (groups D and E) were classified based on International Intraocular Retinoblastoma Classification (IIRC) and International Classification of Retinoblastoma (ICRB) criteria. The main outcomes measured were ocular survival, frequency of histopathologic risk factors (HRF), and the need for adjuvant therapy. RESULTS A total of 332 eyes of 298 patients were classified into group D (150, 45%) and E eyes (182, 55%) based on IIRC criteria. ICRB classification resulted in upstaging of 57 group D eyes (17%) to group E. Eyes that were upstaged to group E from D in the ICRB classification (E1) differed significantly, with a greater proportion undergoing primary enucleation (17 of 57, 30%) than those that were not (10 of 93, 11%) (p = 0.003). Similar significant differences were observed between group E2 and E3 eyes (p < 0.0001). Ocular survival according to Kaplan-Meier estimates at 12 months of 79%, 59%, 49%, and 1% differed significantly between all groups (ICRB D, E1, E2, and E3, respectively). CONCLUSION Proposed new subgrouping of group E eyes into E1, E2, and E3 based on clinical criteria is based upon natural history of tumor progression and is predictive of ocular survival. Preservation of the existing lower boundaries for group E by ICRB and IIRC offers the possibility of reanalyzing existing published data.
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Affiliation(s)
- Arun Singh
- Ophthalmic Oncology, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
| | - Vishal Raval
- The Operation Eyesight Universal Institute for Eye Cancer, LV Prasad Eye Institute, Hyderabad, India
| | - Ahad Sedaghat
- The Operation Eyesight Universal Institute for Eye Cancer, LV Prasad Eye Institute, Hyderabad, India
| | - Swathi Kaliki
- The Operation Eyesight Universal Institute for Eye Cancer, LV Prasad Eye Institute, Hyderabad, India.
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Bakal K, Raval V, Gattu SK, Palkonda VAR, Kaliki S. Primary Subretinal Seeding in Retinoblastoma: Clinical Presentation and Treatment Outcomes. Ocul Oncol Pathol 2023; 9:32-39. [PMID: 38376084 PMCID: PMC10821785 DOI: 10.1159/000530497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/23/2023] [Indexed: 02/21/2024] Open
Abstract
Introduction The aim of this study was to describe the clinical features and treatment outcomes of primary subretinal seeding (SRS) in patients with intraocular retinoblastoma (RB). Methods Descriptive analysis of primary SRS in 47 patients (50 eyes) with RB was performed. Results Mean age was 19 months (range, 2-72 months), and 55% (n = 26) of the subjects were male. At presentation, the SRS involved two or more quadrants in 88% of eyes. Most seeds appeared yellowish gray (66%) and round to oval in shape (48%). Two-thirds of SRS were seen posterior to the equator and within 5 mm from the main tumor. Associated features included subretinal fluid in 50 eyes (100%), total retinal detachment in 28 eyes (56%), and vitreous seeds in 20 eyes (40%). Treatment included intravenous chemotherapy (IVC) (n = 47; 94%), enucleation (n = 2; 4%), and intra-arterial chemotherapy (n = 1; 2%). SRS treatment included adjunct use of focal transpupillary thermotherapy and/or cryotherapy (n = 20; 40%). Retinal tumor control was achieved in 36 eyes (76%) with 32 eyes (78%) showing a type 3 regression pattern, while SRS completely regressed in 24 (48%) eyes, partially in 15 (30%) and worsened in 2 (4%) eyes. Over a mean follow-up of 30 months (range, 3-68 months), SRS recurrence was noted in 12 eyes (29%), globe salvage was achieved in 39 eyes (78%), and 1 (4%) patient died of presumed metastasis. Conclusion Primary SRS pose a therapeutic challenge during RB treatment. The SRS responds moderately to systemic IVC, with one-third cases showing SRS recurrence and one-fifth ultimately requiring enucleation.
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Affiliation(s)
- Komal Bakal
- The Operation Eyesight Universal Institute for Eye Cancer, L V Prasad Eye Institute, Hyderabad, India
| | - Vishal Raval
- The Operation Eyesight Universal Institute for Eye Cancer, L V Prasad Eye Institute, Hyderabad, India
| | | | | | - Swathi Kaliki
- The Operation Eyesight Universal Institute for Eye Cancer, L V Prasad Eye Institute, Hyderabad, India
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Naseripour M, Mirshahi R, Kasraei H, Sedaghat A, Azimi F. Spotlight on Targeted Chemotherapy in Retinoblastoma: Safety, Efficacy, and Patient Outcomes. Onco Targets Ther 2022; 15:1545-1561. [PMID: 36579184 PMCID: PMC9792108 DOI: 10.2147/ott.s370878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022] Open
Abstract
As the most common primary intraocular malignancy of childhood, retinoblastoma (RB) has had a complex journey in its management, following a course from enucleation as the first life-saving treatment to numerous globe-salvaging therapies during the last century. Currently, this potentially lethal disease has achieved high survival rates owing to multidisciplinary management and the introduction of neoadjuvant and multimodal chemotherapy. Therefore, the goal of treatment is shifting toward conserving the globe and vision as much as possible. Up until recently, many advanced cases of RB were enucleated primarily; however, targeted chemotherapy via the ophthalmic artery and management of intraocular seeding by local administration of chemotherapeutic agents have revolutionized the globe-conserving therapies. The added benefit of avoiding systemic complications of cytotoxic drugs resulted in these methods gaining popularity, and they are becoming a main part of care in many referral centers. Initially, there were some safety concerns regarding these approaches; however, increasing experience has shown that these modalities are relatively safe procedures and many complications can be averted by changing the choice of the drug and using some prophylactic measures. It is hoped that, in the near future, with advances in early diagnosis and patient-targeted molecular therapies, as well as gene-editing techniques, the patient's vision can be saved even in advanced RB.
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Affiliation(s)
- Masood Naseripour
- Eye Research Center, The Five Senses Health Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran,Stem Cell and Regenerative Medicine Research Center, Iran University of Medical Sciences, Tehran, Iran,Correspondence: Masood Naseripour, Department of Ophthalmology, Iran University of Medical Sciences (IUMS), Rassoul Akram Hospital, Niayesh Ave, 14455-364, Tehran, Iran, Fax +98 21 66509162, Email
| | - Reza Mirshahi
- Eye Research Center, The Five Senses Health Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran,Stem Cell and Regenerative Medicine Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hengameh Kasraei
- Eye Research Center, The Five Senses Health Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Ahad Sedaghat
- Eye Research Center, The Five Senses Health Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Azimi
- Eye Research Center, The Five Senses Health Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
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Nor A, Diana T, Tengku FA, Sarina S, Khairy St S, Azhany Y, Nor Hayati O. AN IN VIVO STUDY OF INTRAVITREAL RANIBIZUMAB FOLLOWING SUBRETINAL INOCULATION OF RB CELLS IN RABBITS EYES. CESKA A SLOVENSKA OFTALMOLOGIE : CASOPIS CESKE OFTALMOLOGICKE SPOLECNOSTI A SLOVENSKE OFTALMOLOGICKE SPOLECNOSTI 2022; 78:112-120. [PMID: 35760582 DOI: 10.31348/2022/13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
AIM This study aimed to determine the effects of a single intravitreal ranibizumab injection in rabbits induced with retinoblastoma (RB). MATERIAL AND METHODS RB was induced in six New Zealand white rabbits by subretinal injection of a cultured WERI-RBb-1 cell line into the right eye. After six weeks, Group A (n = 3) was given intravitreal ranibizumab injection (0.3mg in 0.03ml) and Group B (n = 3) was the control. Baseline and serial clinical examinations were performed on days 1, 3, 6, 12, 15, 18 and 21. The right eyes were enucleated for both groups on day 21 for histopathological examination. RESULTS The rabbits in both groups developed intraocular lesions which was detectable clinically at one-week post-tumor inoculation. The tumor grew slowly without spontaneous regression. After the animals in Group A were given an intravitreal ranibizumab injection, regression of the tumor was detected clinically, while the tumor in Group B continued to grow slowly. Histopathological findings confirmed the presence of a tumor that closely resembled features of poorly differentiated human RB cells. At the end of 21 days, the size of the tumor was larger in Group B in comparison to Group A. However, the treated group also developed a focal area of retinal hyperplasia. There was no significant side effect of ranibizumab injection except temporary high intraocular pressure immediately post-injection, which was relieved after paracentesis. CONCLUSIONS Intravitreal ranibizumab is a potential treatment for RB. It is an effective therapy with a tolerable safety profile in this animal experimental study.
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