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Minervini G, Pennuto M, Tosatto SCE. The pVHL neglected functions, a tale of hypoxia-dependent and -independent regulations in cancer. Open Biol 2020; 10:200109. [PMID: 32603638 PMCID: PMC7574549 DOI: 10.1098/rsob.200109] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The von Hippel–Lindau protein (pVHL) is a tumour suppressor mainly known for its role as master regulator of hypoxia-inducible factor (HIF) activity. Functional inactivation of pVHL is causative of the von Hippel–Lindau disease, an inherited predisposition to develop different cancers. Due to its impact on human health, pVHL has been widely studied in the last few decades. However, investigations mostly focus on its role in degrading HIFs, whereas alternative pVHL protein–protein interactions and functions are insistently surfacing in the literature. In this review, we analyse these almost neglected functions by dissecting specific conditions in which pVHL is proposed to have differential roles in promoting cancer. We reviewed its role in regulating phosphorylation as a number of works suggest pVHL to act as an inhibitor by either degrading or promoting downregulation of specific kinases. Further, we summarize hypoxia-dependent and -independent pVHL interactions with multiple protein partners and discuss their implications in tumorigenesis.
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Affiliation(s)
- Giovanni Minervini
- Department of Biomedical Sciences, University of Padova, Viale G. Colombo 3, 35121 Padova, Italy
| | - Maria Pennuto
- Department of Biomedical Sciences, University of Padova, Viale G. Colombo 3, 35121 Padova, Italy.,Veneto Institute of Molecular Medicine, Via Orus 2, 35129 Padova, Italy
| | - Silvio C E Tosatto
- Department of Biomedical Sciences, University of Padova, Viale G. Colombo 3, 35121 Padova, Italy
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Abstract
There has been a recent expansion of therapeutic options in metastatic renal cell carcinoma (RCC) targeted at the vascular endothelial growth factor and mammalian target of rapamycin pathways, which are fundamental to the biology of RCC. These treatment options have similarities in antitumor effect but also important differences in regards to clinical effects, toxicity and patient populations in which they have been investigated. Further, issues regarding the role of debulking nephrectomy, timing of therapy, and appropriate sequencing of agents have emerged as clinically relevant. There are thus potentially many different treatment approaches to each metastatic RCC patient. This review discusses how to integrate the available data regarding targeted therapy in metastatic RCC into personalized cancer care.
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Affiliation(s)
- Brian I. Rini
- From the Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Institute, Glickman Urological and Kidney Institute, Cleveland, OH
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Abstract
Considerable progress has been made in the treatment of patients with renal cell carcinoma, with innovative surgical and systemic strategies revolutionising the management of this disease. In localised disease, partial nephrectomy for small tumours and radical nephrectomy for large tumours continue to be the gold-standard treatments, with emphasis on approaches that have reduced invasiveness and preserve renal function. Additionally, cytoreductive nephrectomy is often indicated before the start of systemic treatment in patients with metastatic disease as part of integrated management strategy. The effectiveness of immunotherapy, although previously widely used for treatment of metastatic renal cell carcinoma, is still controversial, and is mainly reserved for patients with good prognostic factors. Development of treatments that have specific targets in relevant biological pathways has been the main advance in treatment. Targeted drugs, including inhibitors of the vascular endothelial growth factor and mammalian target of rapamycin pathways, have shown robust effectiveness and offer new therapeutic options for the patients with metastatic disease.
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Affiliation(s)
- Brian I Rini
- Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA
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Sex differences in renal cell cancer presentation and survival: an analysis of the National Cancer Database, 1993-2004. J Urol 2008; 179:1709-13; discussion 1713. [PMID: 18343430 DOI: 10.1016/j.juro.2008.01.024] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2007] [Indexed: 01/16/2023]
Abstract
PURPOSE We analyzed patterns of disease presentation and outcome of renal cell carcinomas by gender using data from the National Cancer Database during a 10-year period. We hypothesized that women presented with lower stage disease and had increased survival than men due to increased imaging. MATERIALS AND METHODS The National Cancer Database is a nationwide oncology data set that currently captures approximately 75% of all newly diagnosed cancer cases from more than 1,400 facility based cancer registries in the United States annually since 1985. The National Cancer Database was queried for adults with renal cell carcinoma diagnosed between 1993 and 2004. Cases were examined according to gender in relation to mean age, American Joint Committee on Cancer stage, histology, grade, tumor size, mortality and race. RESULTS We identified a total of 236,930 patients with renal cell carcinoma diagnosed between 1993 and 2004 from the National Cancer Database. A total of 89,243 (37.7%) were female and 147,687 (62.3%) were male. Mean age was greater in females (64.3) than in males (62.9) (p <0.001). Women had a higher percentage of stage I tumors (54.1% vs 48.5%, p <0.001). Progressive stage migration was documented in men and women. A trend toward increased survival was noted in women relative to men that did not reach statistical significance. CONCLUSIONS Results from this study show a ratio of 1.65 of renal cell carcinoma for males compared to females. Women are more likely than men to have stage I tumors. Both men and women have demonstrated stage migration, although women more so than men.
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Wenzel C, Locker GJ, Schmidinger M, Mader R, Kramer G, Marberger M, Rauchenwald M, Zielinski CC, Steger GG. Capecitabine in the treatment of metastatic renal cell carcinoma failing immunotherapy. Am J Kidney Dis 2002; 39:48-54. [PMID: 11774101 DOI: 10.1053/ajkd.2002.29879] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Capecitabine is a novel fluoropyrimidine carbamate, orally administered and selectively activated to fluorouracil by a sequential triple-enzyme pathway in liver and tumor cells. This prospective trial aims to evaluate the therapeutic effects and systemic toxicities of capecitabine in patients with metastatic renal cell carcinoma in which immunotherapy failed. Twenty-six patients (median age, 58 years; range, 47 to 76 years) with disease in which first- or second-line immunotherapy treatment failed entered the trial. Median time of observation was 13+ months (range, 3 to 25+ months). Capecitabine was administered in the outpatient setting orally at a dose of 2,500 mg/m2/d divided into two daily doses for 14 days, followed by 7 days of rest. This schedule was repeated in 3-week intervals. Twenty-six patients are now assessable for toxicity, and 23 patients, for response. We observed a partial response to treatment in 2 patients (8.7%), minor response in 5 patients (21.7%), stable disease in 13 patients (56.5%), and continued disease progression despite treatment in only 3 patients (13.1%). Outpatient capecitabine therapy was well tolerated, and World Health Organization (WHO) grade III toxicity in these 26 patients consisted of hand-foot syndrome in 2 patients (7.7%) and anemia in 1 patient (3.8%). We did not observe WHO grade IV toxicity. Oral capecitabine appears to be a promising treatment with a favorable toxicity profile in patients with advanced renal cell carcinoma and should be evaluated in first- and second-line treatment schedules as monotherapy, as well as in combination with immunotherapy agents.
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Affiliation(s)
- Catharina Wenzel
- Department of Internal Medicine I, Division of Oncology, the Ludwig Boltzmann Institute for Clinical Oncology, University Hospital of Vienna, Austria
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6
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Canobbio L, Miglietta L, Boccardo F. Medical treatment of advanced renal cell carcinoma: present options and future directions. Cancer Treat Rev 1996; 22:85-104. [PMID: 8665566 DOI: 10.1016/s0305-7372(96)90029-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The treatment of patients with metastatic renal cell carcinoma (MRCC) continues to be disappointing. A large number of hormones, chemotherapeutic agents and combinations have been tested with poor and non-reproducible results. Among the immunological treatments investigated in MRCC, the best results have been claimed with interferons (IFNs) and interleukin-2 (IL-2) and, although no randomized studies have shown higher activity than cytotoxic drugs, hormones or even no treatment, many oncologists feel it justified to consider these biologic agents the treatment of choice for this disease. Of patients treated with alpha-IFN, 15-20% achieve an objective remission and 3-5% achieve a long-lasting complete response. No substantial increase of the therapeutic activity of alpha-IFN was produced by combination with chemotherapeutic agents and gamma-IFN or tumour necrosis factor. High doses of IL-2 with or without lymphokine-activated killer cells led to successful results in about 20-30% of patients with 5-10% complete responses. More recently, less toxic regimens with lower doses of IL-2 alone or combined with alpha-IFN produce similar response rates. Many studies have clarified the importance of prognostic factors in patient selection for response and survival during treatments with IFNs and IL-2. Good performance status, a long interval from diagnosis to treatment, and only one site of disease seem to be the most important predictors for survival. Both IFNs and IL-2 appear to possess encouraging antitumour activity in patients with favourable prognostic factors, but further studies are needed to identify the treatment of choice, the optimal dose regimen and route of administration in this subgroup of patients. Patients with poor prognosis should be encouraged to enter controlled studies aimed to evaluate investigational drugs and new therapeutic methods.
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Affiliation(s)
- L Canobbio
- Department of Medical Oncology II, National Institute for Cancer Research, Genova, Italy
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Abstract
Twenty-five renal cell carcinomas were assayed for estrogen and progesterone receptor levels. Estrogen specific binding was present in only 4 patients (16%) and progesterone specific binding in 7 patients (28%). In all cases these receptors were present in very low titers, less than 10 fm/mg. We believe that earlier reports citing significant estrogen and progesterone binding activity may reflect high levels of nonspecific protein binding.
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Affiliation(s)
- W L Orovan
- Department of Pathology, McMaster University, Hamilton, Ontario, Canada
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Correlation between steroid hormone receptors and response to medroxyprogesterone acetate therapy in renal cell carcinoma: results of a long-term study. World J Urol 1989. [DOI: 10.1007/bf00328109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Kjaer M. The role of medroxyprogesterone acetate (MPA) in the treatment of renal adenocarcinoma. Cancer Treat Rev 1988; 15:195-209. [PMID: 2974757 DOI: 10.1016/0305-7372(88)90003-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- M Kjaer
- Department of Oncology ONB, Finsen Institute, Righospitalet, Copenhagen, Denmark
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Maggioni A, Longo G, Tombolini P, Coppi F, Austoni E, Pisani E. Risultati a Distanza Dell'Ormonoterapia Del Carcinoma Renale (Mo). Urologia 1988. [DOI: 10.1177/039156038805500118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | | | | | | | | | - E. Pisani
- Istituto di Urologia dell'Università degli Studi di Milano - Direttore:
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Jakse G, Müller-Holzner E. Hormone receptors in renal cancer: an overview. SEMINARS IN SURGICAL ONCOLOGY 1988; 4:161-4. [PMID: 3055160 DOI: 10.1002/ssu.2980040304] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The current literature concerning hormone receptors in renal cell cancer is reviewed. Our own results of histochemical determination of estrogen receptors by means of monoclonal antibodies are presented. Based on the studies that have been reviewed and the differing results of the receptor assays, we conclude that there is a very limited basis to apply hormone therapy in renal cell cancer. However, the new immunohisto-chemical methods should be used to resolve the question about the hormone dependency of renal carcinoma.
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Affiliation(s)
- G Jakse
- Department of Urology, University of Innsbruck Medical School, Austria
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Pizzocaro G, Piva L, Salvioni R, Di Fronzo G, Ronchi E, Miodini P. Adjuvant medroxyprogesterone acetate and steroid hormone receptors in category M0 renal cell carcinoma. An interim report of a prospective randomized study. J Urol 1986; 135:18-21. [PMID: 2934557 DOI: 10.1016/s0022-5347(17)45501-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
From July 1, 1979 to June 30, 1983, 136 consecutive patients with category M0 renal cell cancer who had undergone transperitoneal radical nephrectomy at 5 centers entered a prospective randomized trial to compare 500 mg. adjuvant medroxyprogesterone 3 times a week for 1 year to no treatment. Sex steroid hormone receptors also were studied in the renal tumor and in the surrounding healthy parenchyma with the dextran-coated charcoal technique. After a median followup period of 3 years (range 13 to 60 months) 30 of 121 evaluable patients (24.8 per cent) experienced relapse, usually in the lung or bones. Relapses occurred in 15 of 58 evaluable patients in the adjuvant treatment group (25.8 per cent) and 15 of 63 evaluable controls (23.8 per cent). The disease recurred more frequently (35.1 per cent) in the 57 patients with no receptors in the tumor than in the 45 with at least 1 receptor (17.8 per cent). These results were independent of adjuvant therapy. After a median 3-year followup, adjuvant medroxyprogesterone acetate was of no therapeutic benefit in patients who had undergone radical nephrectomy and the side effects of the therapy were evident in more than 50 per cent of the patients.
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Ronchi E, Pizzocaro G, Miodini P, Piva L, Salvioni R, Di Fronzo G. Steroid hormone receptors in normal and malignant human renal tissue: relationship with progestin therapy. JOURNAL OF STEROID BIOCHEMISTRY 1984; 21:329-35. [PMID: 6238209 DOI: 10.1016/0022-4731(84)90287-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Documented hormone dependence of renal tumors in animal models, hypothetical hormonal environment of human kidney neoplasms and their controversial response to endocrine therapy prompted us to undertake a prospective multicentric cooperative study to evaluate the hormone-dependence/responsiveness of renal tumors. Patients with renal carcinoma were stratified according to the TNM classification and after nephrectomy were treated with high-dose medroxyprogesterone acetate (MPA). Specimens of tumor and healthy surrounding kidney tissue were studied for titration of steroid receptor proteins (78 for androgen, AR, 89 for estrogen, ER, and progestin, PgR). Their true receptor nature was estimated. Very low titers (on an average less than 10 fmol/mg protein) were found, especially for ER and PgR in neoplastic samples. Occurrence rate of AR was low for both tissues (less than 20%), whereas ER and PgR were detected at a higher frequency in healthy parenchyma than in tumor tissue (42.2 vs 23.3% and 30.7 vs 11.2%, respectively). AR was moderately affected by metastatic status of the disease and by sex. All three steroid receptors were simultaneously detected in normal tissue in 11.7% of cases and in tumor tissue in only 3.8%. No significant correlation between receptor status in the tumor and clinical response to hormone therapy was found. In 27 cases who received adjuvant MPA therapy, relapses were respectively 43.8 and 18.2% in the patients with negative receptors or with at least one detectable receptor. In metastatic renal carcinoma, stabilization of the disease with MPA was achieved more frequently in receptor-negative patients. Therefore, we conclude that the receptor assay is not a valid tool to select renal carcinoma patients for therapy with MPA.
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