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Sun Z, Wang C, Zhao Y, Ling Q. CAR-T cell therapy in advanced thyroid cancer: from basic to clinical. Front Immunol 2024; 15:1411300. [PMID: 38911868 PMCID: PMC11190081 DOI: 10.3389/fimmu.2024.1411300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 05/27/2024] [Indexed: 06/25/2024] Open
Abstract
The majority of patients with thyroid cancer can attain a favorable prognosis with a comprehensive treatment program based on surgical treatment. However, the current treatment options for advanced thyroid cancer are still limited. In recent years, chimeric antigen receptor-modified T-cell (CAR-T) therapy has received widespread attention in the field of oncology treatment. It has achieved remarkable results in the treatment of hematologic tumors. However, due to the constraints of multiple factors, the therapeutic efficacy of CAR-T therapy for solid tumors, including thyroid cancer, has not yet met expectations. This review outlines the fundamental structure and treatment strategies of CAR-T cells, provides an overview of the advancements in both preclinical investigations and clinical trials focusing on targets associated with CAR-T cell therapy in treating thyroid cancer, and discusses the challenges and solutions to CAR-T cell therapy for thyroid cancer. In conclusion, CAR-T cell therapy is a promising therapeutic approach for thyroid cancer, and we hope that our review will provide a timely and updated study of CAR-T cell therapy for thyroid cancer to advance the field.
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Li H, Zhou X, Wang G, Hua D, Li S, Xu T, Dong M, Cui X, Yang X, Wu Y, Cai M, Liao X, Zhang T, Yang Z, Du Y, Li X. CAR-T Cells Targeting TSHR Demonstrate Safety and Potent Preclinical Activity Against Differentiated Thyroid Cancer. J Clin Endocrinol Metab 2022; 107:1110-1126. [PMID: 34751400 DOI: 10.1210/clinem/dgab819] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Chimeric antigen receptor T cells (CAR-Ts) have demonstrated remarkable efficacy in hematological cancers but have not yet translated in treating solid tumors. The significant hurdles limiting CAR-T therapy were from a paucity of differentially expressed cell surface molecules on solid tumors that can be safely targeted. Here, we present TSH receptor (TSHR) as a putative target for CAR-T therapy of differentiated thyroid cancer (DTC). METHODS We undertook a large-scale screen on thyroid cancer tissues and multiple internal organs through bioinformatical analysis and immunohistochemistry to date TSHR expression. Using 3 previously described monoclonal antibodies, we generated 3 third-generation CAR-Ts. We tested anti-TSHR CAR-T in vitro activity by T-cell function and killing assay. Then we tested preclinical therapeutical efficacy in a xenograft mouse model of DTC and analyzed mice's physical conditions and histological abnormalities to evaluate anti-TSHR CAR-T's safety. RESULTS TSHR is highly and homogeneously expressed on 90.8% (138/152) of papillary thyroid cancer, 89.2% (33/37) of follicular thyroid cancer, 78.2% (18/23) of cervical lymph node metastases, and 86.7% of radioactive iodine resistance diseases. We developed 3 novel anti-TSHR CAR-Ts from monoclonal antibodies M22, K1-18, and K1-70; all 3 CAR-Ts mediate significant antitumor activity in vitro. Among these, we demonstrate that K1-70 CAR-T can have therapeutical efficacy in vivo, and no apparent toxicity has been observed. CONCLUSION TSHR is a latent target antigen of CAR-T therapy for DTC. Anti-TSHR CAR-T could represent a therapeutic option for patients with locoregional relapsed or distant metastases of thyroid cancer and should be tested in carefully designed clinical trials.
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Affiliation(s)
- Hanning Li
- Department of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
- Laboratory of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
- Laboratory of General Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
| | - Xiang Zhou
- College of Life Science and Health, Wuhan University of Science and Technology, Wuhan, Hubei, 430065, People's Republic of China
| | - Ge Wang
- Department of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
- Laboratory of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
- Laboratory of General Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
| | - Dongyu Hua
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
| | - Shuyu Li
- Department of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
- Laboratory of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
- Laboratory of General Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
| | - Tao Xu
- Department of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
- Laboratory of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
- Laboratory of General Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
- Department of Obstetrics and Gynecology, Cancer Biology research center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
| | - Menglu Dong
- Department of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
- Laboratory of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
- Laboratory of General Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
| | - Xiaoqing Cui
- Department of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
- Laboratory of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
- Laboratory of General Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
| | - Xue Yang
- Department of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
- Laboratory of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
- Laboratory of General Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
| | - Yonglin Wu
- Department of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
- Laboratory of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
- Laboratory of General Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
| | - Miaomiao Cai
- College of Life Science and Health, Wuhan University of Science and Technology, Wuhan, Hubei, 430065, People's Republic of China
| | - Xinghua Liao
- College of Life Science and Health, Wuhan University of Science and Technology, Wuhan, Hubei, 430065, People's Republic of China
| | - Tongcun Zhang
- College of Life Science and Health, Wuhan University of Science and Technology, Wuhan, Hubei, 430065, People's Republic of China
| | - Zhifang Yang
- Department of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
- Laboratory of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
- Laboratory of General Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
| | - Yaying Du
- Department of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
- Laboratory of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
- Laboratory of General Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
| | - Xingrui Li
- Department of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
- Laboratory of Thyroid and Breast Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
- Laboratory of General Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei 430030, People's Republic of China
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Mekraksakit P, Rattanawong P, Karnchanasorn R, Kanitsoraphan C, Leelaviwat N, Poonsombudlert K, Kewcharoen J, Dejhansathit S, Samoa R. PROGNOSIS OF DIFFERENTIATED THYROID CARCINOMA IN PATIENTS WITH GRAVES DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS. Endocr Pract 2019; 25:1323-1337. [PMID: 31412224 DOI: 10.4158/ep-2019-0201] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Objective: It is still controversial whether differentiated thyroid carcinoma (DTC) in patients with Graves disease (GD) can be more aggressive than non-Graves DTC. We conducted a systematic review and meta-analysis to examine the association between GD and prognosis in patients with DTC. Methods: We comprehensively searched the databases of MEDLINE and EMBASE from inception to March 2019. We included published studies that compared the risk of mortality and prognosis between DTC patients with GD and those with non-GD. Data from each study were combined using the random-effects model. Results: Twenty-five studies from February 1988 to May 2018 were included (987 DTC patients with GD and 2,064 non-Graves DTC patients). The DTC patients with GD had a significantly higher risk of associated multifocality/multicentricity (odds ratio, 1.45; 95% confidence interval, 1.04 to 2.02; I2, 6.5%; P = .381) and distant metastasis at the time of cancer diagnosis (odds ratio, 2.19; 95% confidence interval, 1.08 to 4.47; I2, 0.0%; P = .497), but this was not associated with DTC-related mortality and recurrence/persistence during follow-up. Conclusion: Our meta-analysis demonstrates a statistically significant increased risk of multifocality/multicentricity and distant metastasis at the time of cancer diagnosis in DTC patients with GD than those without GD. Abbreviations: CI = confidence interval; DTC = differentiated thyroid carcinoma; GD = Graves disease; LN = lymph node; OR = odds ratio; PTC = papillary thyroid carcinoma; TC = thyroid carcinoma; TSAb = thyroid-stimulating antibody; TSH = thyroid-stimulating hormone.
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Zheng H, Xu J, Hao S, Liu X, Ning J, Song X, Jiang L, Liu Z. Expression of BANCR promotes papillary thyroid cancer by targeting thyroid stimulating hormone receptor. Oncol Lett 2018; 16:2009-2015. [PMID: 30034553 DOI: 10.3892/ol.2018.8810] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 08/23/2017] [Indexed: 12/28/2022] Open
Abstract
Papillary thyroid carcinoma (PTC) is the most common form of non-medullary thyroid cancer, accounting for ~80% of all cases of thyroid cancer. The aim of the present study was to explore the role of BRAF-activated long noncoding RNA (BANCR) in the development of PTC. Using reverse transcription-quantitative polymerase chain reaction (RT-qPCR), the mRNA expression levels of BANCR, thyroid-stimulating hormone receptor (TSHR) and cyclin D1 between PTC and benign control thyroid nodule tissue samples from 60 patients were determined. Using RT-qPCR and western blot analysis, the expression levels of TSHR and cyclin D1 mRNA and protein were determined in cells transfected with BANCR-small interfering (si)RNA. An MTT assay and flow cytometry were used to analyze the effect of BANCR knockdown on the proliferation and cell cycle distribution of IHH-4 PTC cells. The expression of BANCR, TSHR and cyclin D1 was increased in the PTC group compared with the control group based on the RT-qPCR data. The transfection of IHH-4 cells with BANCR-siRNA induced the inhibition of TSHR and cyclin D1 expression compared with a transfection control. In addition, the proliferation of the IHH-4 cells transfected with BANCR-siRNA was suppressed, relative to the transfection control, and cells arrested in the G0/G1 phase, potentially due to the inhibition of the expression of cyclin D1. The data suggested that the expression of BANCR may promote the development of malignant thyroid nodules via the modulation of TSHR expression and its downstream effector, cyclin D1.
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Affiliation(s)
- Haitao Zheng
- Department of Thyroid Surgery, Yantai Yuhuangding Hospital, Yantai, Shangdong 264099, P.R. China
| | - Jie Xu
- Department of Thyroid Surgery, Yantai Yuhuangding Hospital, Yantai, Shangdong 264099, P.R. China
| | - Shaolong Hao
- Department of Thyroid Surgery, Yantai Yuhuangding Hospital, Yantai, Shangdong 264099, P.R. China
| | - Xincheng Liu
- Department of Thyroid Surgery, Yantai Yuhuangding Hospital, Yantai, Shangdong 264099, P.R. China
| | - Jinrao Ning
- Department of Thyroid Surgery, Yantai Yuhuangding Hospital, Yantai, Shangdong 264099, P.R. China
| | - Xicheng Song
- Department of Ear, Nose and Throat & Head and Neck Surgery, Yantai Yuhuangding Hospital, Yantai, Shangdong 264099, P.R. China
| | - Lixin Jiang
- Department of Thyroid Surgery, Yantai Yuhuangding Hospital, Yantai, Shangdong 264099, P.R. China
| | - Zongying Liu
- Department of Laboratory, People's Hospital of Pingyi County, Pingyi, Shangdong 273399, P.R. China
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Tavares C, Coelho MJ, Eloy C, Melo M, da Rocha AG, Pestana A, Batista R, Ferreira LB, Rios E, Selmi-Ruby S, Cavadas B, Pereira L, Sobrinho Simões M, Soares P. NIS expression in thyroid tumors, relation with prognosis clinicopathological and molecular features. Endocr Connect 2018; 7:78-90. [PMID: 29298843 PMCID: PMC5754505 DOI: 10.1530/ec-17-0302] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Accepted: 11/09/2017] [Indexed: 02/05/2023]
Abstract
Thyroid cancer therapy is based on surgery followed by radioiodine treatment. The incorporation of radioiodine by cancer cells is mediated by sodium iodide symporter (NIS) (codified by the SLC5A5 gene), that is functional only when targeted to the cell membrane. We aimed to evaluate if NIS expression in thyroid primary tumors would be helpful in predicting tumor behavior, response to therapy and prognosis. NIS expression was addressed by qPCR and immunohistochemistry. In order to validate our data, we also studied SLC5A5 expression on 378 primary papillary thyroid carcinomas from The Cancer Genome Atlas (TCGA) database. In our series, SLC5A5 expression was lower in carcinomas with vascular invasion and with extrathyroidal extension and in those harboring BRAFV600E mutation. Analysis of SLC5A5 expression from TCGA database confirmed our results. Furthermore, it showed that larger tumors, with locoregional recurrences and/or distant metastases or harboring RAS, BRAF and/or TERT promoter (TERTp) mutations presented significantly less SLC5A5 expression. Regarding immunohistochemistry, 12/211 of the cases demonstrated NIS in the membrane of tumor cells, those cases showed variable outcomes concerning therapy success, prognosis and all but one were wild type for BRAF, NRAS and TERTp mutations. SLC5A5 mRNA lower expression is associated with features of aggressiveness and with key genetic alterations involving BRAF, RAS and TERTp. Mutations in these genes seem to decrease protein expression and its targeting to the cell membrane. SLC5A5 mRNA expression is more informative than NIS immunohistochemical expression regarding tumor aggressiveness and prognostic features.
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Affiliation(s)
- Catarina Tavares
- Instituto de Investigação e Inovação em Saúde (i3S)Porto, Portugal
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP)Porto, Portugal
- Medical Faculty of the University of PortoPorto, Portugal
| | - Maria João Coelho
- Instituto de Investigação e Inovação em Saúde (i3S)Porto, Portugal
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP)Porto, Portugal
- Institute of Biomedical Sciences of Abel Salazar (ICBAS)Porto, Portugal
| | - Catarina Eloy
- Instituto de Investigação e Inovação em Saúde (i3S)Porto, Portugal
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP)Porto, Portugal
- Medical Faculty of the University of PortoPorto, Portugal
| | - Miguel Melo
- Instituto de Investigação e Inovação em Saúde (i3S)Porto, Portugal
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP)Porto, Portugal
- Department of EndocrinologyDiabetes and Metabolism, University and Hospital Center of Coimbra, Coimbra, Portugal
- Medical FacultyUniversity of Coimbra, Coimbra, Portugal
| | - Adriana Gaspar da Rocha
- Instituto de Investigação e Inovação em Saúde (i3S)Porto, Portugal
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP)Porto, Portugal
- Public Health UnitACeS Baixo Mondego, Coimbra, Portugal
| | - Ana Pestana
- Instituto de Investigação e Inovação em Saúde (i3S)Porto, Portugal
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP)Porto, Portugal
- Medical Faculty of the University of PortoPorto, Portugal
| | - Rui Batista
- Instituto de Investigação e Inovação em Saúde (i3S)Porto, Portugal
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP)Porto, Portugal
- Medical Faculty of the University of PortoPorto, Portugal
| | - Luciana Bueno Ferreira
- Instituto de Investigação e Inovação em Saúde (i3S)Porto, Portugal
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP)Porto, Portugal
- Medical Faculty of the University of PortoPorto, Portugal
| | - Elisabete Rios
- Instituto de Investigação e Inovação em Saúde (i3S)Porto, Portugal
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP)Porto, Portugal
- Medical Faculty of the University of PortoPorto, Portugal
- Department of PathologyMedical Faculty of the University of Porto, Porto, Portugal
- Department of PathologyHospital de S. João, Porto, Portugal
| | - Samia Selmi-Ruby
- Inserm UMR-S1052CNRS UMR5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France
| | - Bruno Cavadas
- Instituto de Investigação e Inovação em Saúde (i3S)Porto, Portugal
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP)Porto, Portugal
- Institute of Biomedical Sciences of Abel Salazar (ICBAS)Porto, Portugal
| | - Luísa Pereira
- Instituto de Investigação e Inovação em Saúde (i3S)Porto, Portugal
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP)Porto, Portugal
- Medical Faculty of the University of PortoPorto, Portugal
| | - Manuel Sobrinho Simões
- Instituto de Investigação e Inovação em Saúde (i3S)Porto, Portugal
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP)Porto, Portugal
- Medical Faculty of the University of PortoPorto, Portugal
- Department of PathologyMedical Faculty of the University of Porto, Porto, Portugal
- Department of PathologyHospital de S. João, Porto, Portugal
| | - Paula Soares
- Instituto de Investigação e Inovação em Saúde (i3S)Porto, Portugal
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP)Porto, Portugal
- Medical Faculty of the University of PortoPorto, Portugal
- Department of PathologyMedical Faculty of the University of Porto, Porto, Portugal
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Abstract
The morbidity of thyroid cancer is increasing gradually year by year, showing an increasing tendency in nationality, sex, age, tumor size, and tumor staging. The changes of thyroid cell genes, signaling pathways, and related molecular dysfunction promote the occurrence, development, invasion, and metastasis of thyroid cancer. Surgical operation, radioiodine, and endocrinotherapy models can achieve a better prognosis for most patients with thyroid cancer. Although targeted therapeutic drugs bring possible therapeutic opportunities for refractory thyroid cancer, there is a great gap between their predictive value and their actual efficacy. Currently, there is still no completely effective drug for the treatment. Based on the signaling pathways, the "reclaim therapy" for residual tumor and systemic intervention aims to increase anticancer ability and to encourage new directions and thoughts in the treatment of refractory thyroid cancer.
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Rowe CW, Paul JW, Gedye C, Tolosa JM, Bendinelli C, McGrath S, Smith R. Targeting the TSH receptor in thyroid cancer. Endocr Relat Cancer 2017; 24:R191-R202. [PMID: 28351942 DOI: 10.1530/erc-17-0010] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 03/28/2017] [Indexed: 12/31/2022]
Abstract
Recent advances in the arena of theranostics have necessitated a re-examining of previously established fields. The existing paradigm of therapeutic thyroid-stimulating hormone receptor (TSHR) targeting in the post-surgical management of differentiated thyroid cancer using levothyroxine and recombinant human thyroid-stimulating hormone (TSH) is well understood. However, in an era of personalized medicine, and with an increasing awareness of the risk profile of longstanding pharmacological hyperthyroidism, it is imperative clinicians understand the molecular basis and magnitude of benefit for individual patients. Furthermore, TSHR has been recently re-conceived as a selective target for residual metastatic thyroid cancer, with pilot data demonstrating effective targeting of nanoparticles to thyroid cancers using this receptor as a target. This review examines the evidence for TSHR signaling as an oncogenic pathway and assesses the evidence for ongoing TSHR expression in thyroid cancer metastases. Priorities for further research are highlighted.
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Affiliation(s)
- Christopher W Rowe
- Department of EndocrinologyJohn Hunter Hospital, Newcastle, Australia
- School of Medicine and Public HealthUniversity of Newcastle, Newcastle, Australia
- Hunter Medical Research InstituteNewcastle, New South Wales, Australia
| | - Jonathan W Paul
- School of Medicine and Public HealthUniversity of Newcastle, Newcastle, Australia
- Hunter Medical Research InstituteNewcastle, New South Wales, Australia
| | - Craig Gedye
- Hunter Medical Research InstituteNewcastle, New South Wales, Australia
- Department of Medical OncologyCalvary Mater Newcastle, Waratah, Australia
- School of Biomedical Sciences and PharmacyUniversity of Newcastle, Newcastle, Australia
| | - Jorge M Tolosa
- School of Medicine and Public HealthUniversity of Newcastle, Newcastle, Australia
- Hunter Medical Research InstituteNewcastle, New South Wales, Australia
| | - Cino Bendinelli
- School of Medicine and Public HealthUniversity of Newcastle, Newcastle, Australia
- Department of SurgeryJohn Hunter Hospital, Newcastle, Australia
| | - Shaun McGrath
- Department of EndocrinologyJohn Hunter Hospital, Newcastle, Australia
- School of Medicine and Public HealthUniversity of Newcastle, Newcastle, Australia
| | - Roger Smith
- Department of EndocrinologyJohn Hunter Hospital, Newcastle, Australia
- School of Medicine and Public HealthUniversity of Newcastle, Newcastle, Australia
- Hunter Medical Research InstituteNewcastle, New South Wales, Australia
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8
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Server EA, Kirgezen T, Celebi OO, Yildiz M, Yigit O, Cermik TF. How does radioactive iodine affect the nose? Laryngoscope 2017; 127:2698-2702. [PMID: 28498633 DOI: 10.1002/lary.26652] [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: 02/16/2017] [Revised: 03/30/2017] [Accepted: 04/04/2017] [Indexed: 11/07/2022]
Abstract
OBJECTIVES/HYPOTHESIS To determine the effect of radioactive iodine (RAI) treatment on the nasal mucosa and nasal functions. STUDY DESIGN Prospective clinical study. METHODS This study included 41 patients (31 female and 10 male) who were treated with RAI for papillary thyroid carcinoma. A visual analogue scale (VAS) was used for subjective evaluation of nasal symptoms. The saccharine test, nasal Schirmer test, and acoustic rhinometry were used for objective evaluation of nasal functions. All tests were administered at baseline (before RAI treatment), and then 1 month and 1 year post-RAI treatment. Only 21 of the patients could be evaluated after 1 year of treatment and were included in the study's analysis. RESULTS VAS obstruction and dryness scores 1 month and 1 year post-RAI were significantly higher than the baseline scores (P < .05 and P < .05, respectively). Mean cross-sectional area values 1 month and 1 year post-RAI did not differ significantly from baseline values (P > .05 and P > .05, respectively). Schirmer test results 1 month and 1 year post-RAI treatment were significantly lower than at baseline (P < .05 and P < .05, respectively). Saccharine test results 1 month and 1 year post-RAI were significantly higher than at baseline (P < .05). CONCLUSIONS RAI treatment can adversely affect the nasal mucosa. Nasal dryness and obstruction can occur immediately after RAI treatment. Additional research is warranted to further elucidate the effects of RAI treatment on nasal function. LEVEL OF EVIDENCE 4. Laryngoscope, 127:2698-2702, 2017.
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Affiliation(s)
- Ela Araz Server
- Department of Otorhinolaryngology/Head and Neck Surgery, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Tolga Kirgezen
- Department of Otorhinolaryngology/Head and Neck Surgery, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Ozlem Onerci Celebi
- Department of Otorhinolaryngology/Head and Neck Surgery, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Muhammet Yildiz
- Department of Otorhinolaryngology/Head and Neck Surgery, Gumuşhane State Hospital, Gumuşhane, Turkey
| | - Ozgur Yigit
- Department of Otorhinolaryngology/Head and Neck Surgery, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Tevfik Fikret Cermik
- Department of Nuclear Medicine, Istanbul Training and Research Hospital, Istanbul, Turkey
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Dotan I, Roche PJR, Paliouras M, Mitmaker EJ, Trifiro MA. Engineering Multi-Walled Carbon Nanotube Therapeutic Bionanofluids to Selectively Target Papillary Thyroid Cancer Cells. PLoS One 2016; 11:e0149723. [PMID: 26901566 PMCID: PMC4762941 DOI: 10.1371/journal.pone.0149723] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 02/04/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The incidence of papillary thyroid carcinoma (PTC) has risen steadily over the past few decades as well as the recurrence rates. It has been proposed that targeted ablative physical therapy could be a therapeutic modality in thyroid cancer. Targeted bio-affinity functionalized multi-walled carbon nanotubes (BioNanofluid) act locally, to efficiently convert external light energy to heat thereby specifically killing cancer cells. This may represent a promising new cancer therapeutic modality, advancing beyond conventional laser ablation and other nanoparticle approaches. METHODS Thyroid Stimulating Hormone Receptor (TSHR) was selected as a target for PTC cells, due to its wide expression. Either TSHR antibodies or Thyrogen or purified TSH (Thyrotropin) were chemically conjugated to our functionalized Bionanofluid. A diode laser system (532 nm) was used to illuminate a PTC cell line for set exposure times. Cell death was assessed using Trypan Blue staining. RESULTS TSHR-targeted BioNanofluids were capable of selectively ablating BCPAP, a TSHR-positive PTC cell line, while not TSHR-null NSC-34 cells. We determined that a 2:1 BCPAP cell:α-TSHR-BioNanofluid conjugate ratio and a 30 second laser exposure killed approximately 60% of the BCPAP cells, while 65% and >70% of cells were ablated using Thyrotropin- and Thyrogen-BioNanofluid conjugates, respectively. Furthermore, minimal non-targeted killing was observed using selective controls. CONCLUSION A BioNanofluid platform offering a potential therapeutic path for papillary thyroid cancer has been investigated, with our in vitro results suggesting the development of a potent and rapid method of selective cancer cell killing. Therefore, BioNanofluid treatment emphasizes the need for new technology to treat patients with local recurrence and metastatic disease who are currently undergoing either re-operative neck explorations, repeated administration of radioactive iodine and as a last resort external beam radiation or chemotherapy, with fewer side effects and improved quality of life.
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Affiliation(s)
- Idit Dotan
- Lady Davis Institute for Medical Research-Jewish General Hospital, Montreal, QC, Canada
- Department of Medicine, McGill University, Montreal, QC, Canada
| | - Philip J. R. Roche
- Lady Davis Institute for Medical Research-Jewish General Hospital, Montreal, QC, Canada
| | - Miltiadis Paliouras
- Lady Davis Institute for Medical Research-Jewish General Hospital, Montreal, QC, Canada
- Department of Medicine, McGill University, Montreal, QC, Canada
- Department of Surgery, McGill University, Montreal, QC, Canada
| | - Elliot J. Mitmaker
- Lady Davis Institute for Medical Research-Jewish General Hospital, Montreal, QC, Canada
- Department of Surgery, McGill University, Montreal, QC, Canada
| | - Mark A. Trifiro
- Lady Davis Institute for Medical Research-Jewish General Hospital, Montreal, QC, Canada
- Department of Medicine, McGill University, Montreal, QC, Canada
- Division of Endocrinology, Jewish General Hospital, Montreal, QC, Canada
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Al-Rasheed MM, Alzahrani AS, Macadam A, Overall A, Gard P, Dzimiri N. The potential role of the sodium iodide symporter gene polymorphism in the development of differentiated thyroid cancer. Gene 2015; 572:163-8. [PMID: 26160439 DOI: 10.1016/j.gene.2015.07.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 06/05/2015] [Accepted: 07/02/2015] [Indexed: 01/09/2023]
Abstract
The sodium iodide symporter (NIS) (solute carrier family 5; SLC5A), mediates the active transport of iodine anion (I(-)) into thyroid follicular cells to facilitate thyroid hormone biosynthesis. Considering its fundamental role in thyroid function, our objective in this study is to explore its potential involvement in the pathogenesis of differentiated thyroid cancer (DTC). Following a preliminary sequencing of the gene in a representative sample of the general population, five variants, (1) rs45602038, (2) rs4808708, (3) rs4808709, (4) rs7250346 and (5) rs12327843, were selected for a larger population-based association study consisting of 507 cases and 597 controls, of which only the rs45602038_TT [Odds ratio (95% confidence interval)=1.90 (1.26-2.88); p=0.002] was associated with disease following adjustment for other confounders using the multivariate analysis. Furthermore, a 5-mer haplotype CGAGT constructed from the five studied SNPs conferred a significant risk (χ(2)=10.98; p=0.0009) for DTC. This association trickled down through shorter derivatives, with the 4-mer haplotype CGAG (χ(2)=13.25; p=0.0003) displaying the most significant association and the 3-mer GAG (χ(2)=11.80; p=0.0006) being equally strongly linked to the disease. Comparison of the flanking derivatives of the primary 5-mer haplotype also indicated that the 3-mer CGA (χ(2)=4.04; p=0.045) constructed from SNP block 1-3 was a lot weaker than that of the AGT (χ(2)=6.73; p=0.0095) constructed from the blocks 3-5 from the other end of the gene. Put together, these data implicate the three nucleotide changes at the rs4808708, rs4808709 and rs7250346 loci (blocks 2-4) as the core for this relationship.
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Affiliation(s)
- Maha M Al-Rasheed
- Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; King Faisal Specialist Hospital and Research Centre, P.O. Box 3354, Riyadh 11211, Saudi Arabia; School of Pharmacy and Biomolecular Sciences, University of Brighton, Brighton BN2 4GJ, UK.
| | - Ali S Alzahrani
- King Faisal Specialist Hospital and Research Centre, P.O. Box 3354, Riyadh 11211, Saudi Arabia.
| | - Angela Macadam
- School of Pharmacy and Biomolecular Sciences, University of Brighton, Brighton BN2 4GJ, UK.
| | - Andrew Overall
- School of Pharmacy and Biomolecular Sciences, University of Brighton, Brighton BN2 4GJ, UK.
| | - Paul Gard
- School of Pharmacy and Biomolecular Sciences, University of Brighton, Brighton BN2 4GJ, UK.
| | - Nduna Dzimiri
- King Faisal Specialist Hospital and Research Centre, P.O. Box 3354, Riyadh 11211, Saudi Arabia.
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TSH signaling overcomes B-RafV600E-induced senescence in papillary thyroid carcinogenesis through regulation of DUSP6. Neoplasia 2015; 16:1107-20. [PMID: 25499223 PMCID: PMC4309262 DOI: 10.1016/j.neo.2014.10.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 10/06/2014] [Accepted: 10/13/2014] [Indexed: 01/09/2023] Open
Abstract
B-RafV600E oncogene mutation occurs most commonly in papillary thyroid carcinoma (PTC) and is associated with tumor initiation. However, a genetic modification by B-RafV600E in thyrocytes results in oncogene-induced senescence (OIS). In the present study, we explored the factors involved in the senescence overcome program in PTC. First of all, we observed down-regulation of p-extracellular signal-regulated kinases 1/2 and up-regulation of dual specific phosphatase 6 (DUSP6) in the PTC with B-RafV600E mutation. DUSP6 overexpression in vitro induced extracellular signal-regulated kinases 1/2 dephosphorylation and inhibited B-RafV600E–induced senescence in thyrocytes. Although DUSP6 protein was degraded by B-RafV600E–induced reactive oxygen species (ROS), thyroid-stimulating hormone (TSH) stabilized DUSP6 protein by increasing Mn superoxide dismutase expression and inhibited B-RafV600E–induced senescence. Although serum TSH was not increased, its receptor was markedly upregulated in PTC with B-RafV600E. Furthermore, TSH together with DUSP6 reactivated Ras signaling, resulted in activation of Ras/AKT/glycogen synthase kinase 3β, and stabilized c-Myc protein by inhibiting its degradation. These observations led us to conclude that increased TSH signaling overcomes OIS and is essential for B-RafV600E–induced papillary thyroid carcinogenesis.
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Differential transcriptional and protein expression of thyroid-stimulating hormone receptor in ovarian carcinomas. Int J Gynecol Cancer 2015; 24:851-6. [PMID: 24844218 DOI: 10.1097/igc.0000000000000139] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE Thyroid-stimulating hormone (TSH) regulates normal thyroid function by binding to its receptor (thyroid-stimulating hormone receptor -TSHR) that is expressed at the surface of thyroid cells. Recently, it has been demonstrated that TSHR is abundantly expressed in several tissues apart from the thyroid, among them the normal ovarian surface epithelium. The role of TSHR expression outside the thyroid is not completely understood. The current study examines possible alterations of TSHR expression in ovarian carcinomas and its implication in ovarian carcinogenesis. MATERIALS AND METHODS Quantitative real-time polymerase chain reaction and immunohistochemistry analysis of TSHR expression were performed in 34 ovarian carcinoma specimens and 10 normal ovarian tissues (controls). RESULTS Significant reduction in TSHR messenger RNA (mRNA) expression was detected in ovarian carcinomas (mean [SD]: 0.518 [0.0934] vs normal, 49.4985 [89.1626]; P < 0.001, Mann-Whitney U test), whereas TSHR protein levels were significantly increased (percentage of positive cells: cancer, 73.55% [20.09%], vs normal, 54.54% [21.14%]; intensity: cancer, 2.52 [0.508], vs normal 1 [0]; P = 0.012, Mann-Whitney U test). No significant differences in TSHR mRNA were found according to history of thyroid disease. CONCLUSIONS Our study describes for the first time alterations in TSHR expression both at mRNA and protein levels in ovarian carcinomas. The discrepancy between the decreased levels of the TSHR mRNA and the increased protein expression has already been described in thyroid carcinomas and might be due to alterations in its degradation by the ubiquitin system or other unknown mechanisms. Further analysis could elucidate the role of these findings in ovarian carcinogenesis.
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Anastasilakis AD, Ruggeri RM, Polyzos SA, Makras P, Molyva D, Campennì A, Gkiomisi A, Balaris C, Fotiadis PP, Tuccari G, Papachatzopoulos S. Coexistence of Graves' disease, papillary thyroid carcinoma and unilateral benign struma ovarii: case report and review of the literature. Metabolism 2013; 62:1350-6. [PMID: 23806737 DOI: 10.1016/j.metabol.2013.05.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 05/18/2013] [Accepted: 05/20/2013] [Indexed: 11/16/2022]
Abstract
BACKGROUND Struma ovarii is a rare cause of hyperthyroidism, while coexistence with Graves' disease has been scarcely reported. PATIENT FINDINGS We report a patient with Graves' disease and unilateral benign functioning struma ovarii, accompanied by ascites, pleural effusion and elevated cancer antigen-125 (CA-125) levels. In subsequent thyroidectomy, incidental papillary thyroid carcinoma was also identified. The functionality of struma ovarii tissue in our patient was supported by the immunohistochemical identification of TSH receptors (TSHR), which may stimulate growth and thyroid hormone production in the presence of circulating TSHR stimulating antibodies (TSHR-Ab). REVIEW OF THE LITERATURE A systematic review of reported cases of coexistent Graves' disease and struma ovarii was performed. CONCLUSIONS The diagnosis of struma ovarii may be masked by Graves' disease and, therefore, be delayed for several years. Furthermore, ascites, pleural effusion and increased CA-125 may result from a benign struma ovarii. The presence of TSHR in the struma ovarii tissue along with their absence in the surrounding ovarian tissue indirectly suggests that struma ovarii is functional. It is unclear whether TSHR-Ab play a role in the development of thyroid carcinomas in such patients.
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Diagnostic and Therapeutic Approaches to Radioactive Iodine Refractory Differentiated Thyroid Cancer. ACTA ACUST UNITED AC 2012. [DOI: 10.3342/kjorl-hns.2012.55.7.403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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