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Luo Z, Jiao B, Xu Q, He W, Zhao H, Liu Y, Chen H, Guan Y, Zhang G, Jiang Z. Do patients with metastatic renal cell carcinoma obtain survival benefits from cytoreductive nephrectomy? A population-based study. J Cancer Res Clin Oncol 2023; 149:9657-9670. [PMID: 37231275 DOI: 10.1007/s00432-023-04885-x] [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: 04/07/2023] [Accepted: 05/19/2023] [Indexed: 05/27/2023]
Abstract
PURPOSE This study aimed to explore the value of cytoreductive nephrectomy (CN) and develop nomograms to predict the prognosis of metastatic renal cell carcinoma (mRCC) patients with receiving radiology therapy or/and chemotherapy (RT/&CT). METHODS Clinical data of patients with mRCC between 2010 and 2015 were collected from the Surveillance, Epidemiology, and End Results (SEER) database. Prognostic nomograms were constructed to predict the overall survival (OS) and cancer-specific survival (CSS) probability for 1-, 3-, and 5- years in patients with mRCC. A series of validation methods were used to validate the accuracy and reliability of the model, including area under the receiver operating curve (AUC), consistency index (C-index), calibration curve, and decision curve analysis (DCA). RESULTS 1394 patients were enrolled in this study. All patients were randomly divided into the training cohort (n = 976) and the validation cohort (n = 418). In the training cohort, multivariate Cox regression analysis suggested that pathology grade, histology type, T stage, N stage, surgery, and distant metastasis were independent risk factors for OS and CSS. The AUC and C-index were both over 0.65 in both cohorts, indicating that the nomograms for OS and CSS had satisfactory discriminative power. The calibration curves revealed that the predictive nomograms had a good consistency between the observed and the predicted survival. CONCLUSION This study provided evidence that mRCC patients underwent RT/&CT could gain survival benefits from CN. The prognostic nomogram constructed in our study is reliable and practical, may help guide clinical strategies in the treatment of mRCC.
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Affiliation(s)
- Zhenkai Luo
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Binbin Jiao
- Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 266000, China
| | - Qianwen Xu
- Department of Pediatrics, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, 266318, China
| | - Weifeng He
- Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 266000, China
| | - Hang Zhao
- Peking University, China-Japan Friendship School Clinical Medicine, Beijing, 100029, China
- Department of Urology, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Yuhao Liu
- Peking University, China-Japan Friendship School Clinical Medicine, Beijing, 100029, China
- Department of Urology, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Haijie Chen
- Peking University, China-Japan Friendship School Clinical Medicine, Beijing, 100029, China
- Department of Urology, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Yunfan Guan
- Peking University, China-Japan Friendship School Clinical Medicine, Beijing, 100029, China
- Department of Urology, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Guan Zhang
- Department of Urology, China-Japan Friendship Hospital, Beijing, 100029, China.
| | - Zhaoqiang Jiang
- Department of Urology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, 450003, China
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Zeng Y, Zhu S, Wang Z, Chen J, Dai J, Liu Z, Sun G, Liang J, Zhang X, Wang Z, Zhao J, Ni Y, Yang J, Wang M, Wei Q, Li X, Chen N, Li Z, Wang X, Shen Y, Yao J, Huang R, Liu J, Cai D, Zeng H, Shen P. Multidisciplinary Team (MDT) Discussion Improves Overall Survival Outcomes for Metastatic Renal Cell Carcinoma Patients. J Multidiscip Healthc 2023; 16:503-513. [PMID: 36865786 PMCID: PMC9971520 DOI: 10.2147/jmdh.s393457] [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: 10/21/2022] [Accepted: 02/17/2023] [Indexed: 02/25/2023] Open
Abstract
Purpose Multidisciplinary team (MDT) discussion is a widely used model to manage patients diagnosed with cancer. However, there has been no direct evidence to prove its effect on the prognosis of metastatic renal cell carcinoma (mRCC) patients, so this study explored the impact of MDT discussion on mRCC patient survival. Methods The clinical data of 269 mRCC patients were retrospectively collected from 2012 to 2021. The cases were grouped into the MDT and non-MDT groups, then subgroup analysis was performed according to different histology types, as well as exploring the role of MDT in patients who have undergone multiple-line therapy. Overall survival (OS) and progression free survival (PFS) were set as the study endpoint. Results Approximately half (48.0%, 129/269) of the patients were in the MDT group, with univariable survival analyses showing these patients had remarkably longer median OS (MDT group: 73.7 months; non-MDT group: 33.2 months, hazard ratio (HR): 0.423 (0.288, 0.622), p<0.001) and longer median PFS (MDT group: 16.9 months, non-MDT group: 12.7 months, HR: 0.722 (0.542, 0.962), p=0.026). Furthermore, MDT management resulted in longer survival for both ccRCC and non-ccRCC subgroups. Patients in the MDT group were more likely to receive multi-line therapy (MDT group: 79/129, 61.2% vs non-MDT group: 56/140, 40.0%, p<0.001), and within this patient group, MDT management still resulted in longer OS (MDT group: 94.0 months; non-MDT group: 43.5 months, p=0.009). Conclusion MDT is associated with prolonged overall survival in mRCC independent of histology, ensuring that patients receive better management and precise treatment.
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Affiliation(s)
- Yuhao Zeng
- Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Sha Zhu
- Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Zilin Wang
- Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Junru Chen
- Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Jindong Dai
- Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Zhenhua Liu
- Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Guangxi Sun
- Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Jiayu Liang
- Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Xingming Zhang
- Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Zhipeng Wang
- Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Jinge Zhao
- Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Yuchao Ni
- Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Jiyu Yang
- Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Minghao Wang
- Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Qiang Wei
- Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Xiang Li
- Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Ni Chen
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Zhiping Li
- Department of Oncology, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Xin Wang
- Department of Oncology, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Yali Shen
- Department of Oncology, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Jin Yao
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Rui Huang
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Jiyan Liu
- Department of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Diming Cai
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Hao Zeng
- Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Pengfei Shen
- Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China,Correspondence: Pengfei Shen; Hao Zeng, Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, People’s Republic of China, Email ;
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Johnston H, Deal AM, Morgan KP, Patel B, Milowsky MI, Rose TL. Dose Intensity in Real-World Patients with Metastatic Renal Cell Carcinoma Taking Vascular Endothelial Growth Factor Receptor Tyrosine Kinase Inhibitors. Clin Genitourin Cancer 2023; 21:357-365. [PMID: 37012148 DOI: 10.1016/j.clgc.2023.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/12/2023] [Accepted: 02/13/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND Tyrosine kinase inhibitors (TKIs) that target the vascular endothelial growth factor receptor (VEGFR) are oral therapies used to treat metastatic renal cell carcinoma (mRCC). VEGFR TKI treatment is often complicated by dose-limiting adverse events (AE). We sought to describe dose intensity and clinical outcomes in a real-world cohort of patients treated with VEGFR TKIs to better characterize dosing patterns and toxicity management compared with previously reported clinical trials. MATERIALS AND METHODS We conducted a retrospective chart review of sequential patients with mRCC treated with VEGFR TKIs at 1 academic medical center from 2014 to 2021. RESULTS 139 patients (75% male, 75% white, median age 63 years) were treated with 185 VEGFR TKIs in our real-world cohort. Per International Metastatic RCC Database Consortium criteria, 24% had good risk, 54% intermediate risk, and 22% poor risk mRCC. With their first VEGFR TKI, median relative dose intensity (RDI) was 79%. 52% of patients required a dose reduction, 11% discontinued treatment due to AEs, 15% visited the ED, and 13% were hospitalized for treatment-related adverse events. Cabozantinib had the highest rate of dose reductions (72%) but a low rate of discontinuation (7%). Real-world patients consistently had lower RDI than reported clinical trials with more frequent dose reductions, fewer drug discontinuations, shorter progression-free survival, and shorter overall survival. CONCLUSION Real-world patients were less able to tolerate VEGFR TKIs compared to patients treated on clinical trials. Low real-world RDI, high dose reductions, and low overall discontinuation rates can inform patient counseling prior to treatment initiation and during therapy.
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Kazama A, Anraku T, Kuroki H, Shirono Y, Murata M, Bilim V, Ugolkov A, Saito K, Tomita Y. Development of patient‑derived tumor organoids and a drug testing model for renal cell carcinoma. Oncol Rep 2021; 46:226. [PMID: 34468011 PMCID: PMC8424486 DOI: 10.3892/or.2021.8177] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 07/26/2021] [Indexed: 12/13/2022] Open
Abstract
The selection of effective therapeutic agents is critical for improving the survival of patients with renal cell carcinoma (RCC). The aim of the present study was to develop an ex vivo drug testing assay using patient-derived tumor organoid (TO) cultures. For this purpose, surgical tumor specimens were obtained from 20 patients with RCC. TOs were developed ex vivo from freshly resected RCC tumors, and their histopathological and molecular characteristics were evaluated using histological staining and whole-exome sequencing (WES). Using a cell viability assay, the therapeutic efficacy of standard of care tyrosine kinase inhibitors in RCC TOs was determined. It was found that TOs recapitulated the histological features of primary RCC tumors. Using WES, a strong concordance was identified at the genetic level between the primary tumors and their corresponding TOs. Using patient-derived TO models, a prototype of an ex vivo drug testing assay was developed, and it was found that RCC TOs exhibited differential responses to sunitinib, pazopanib, cabozantinib, axitinib and sorafenib treatment. On the whole, although the predictive value of the current assay has to be tested and validated in future clinical studies, the findings of the present study demonstrate a novel approach for ex vivo drug testing in patient-derived TO models, which may have potential for use in the personalized treatment of cancer patients.
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Affiliation(s)
- Akira Kazama
- Department of Urology, Division of Molecular Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951‑8510, Japan
| | - Tsutomu Anraku
- Department of Urology, Division of Molecular Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951‑8510, Japan
| | - Hiroo Kuroki
- Department of Urology, Division of Molecular Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951‑8510, Japan
| | - Yuko Shirono
- Department of Urology, Division of Molecular Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951‑8510, Japan
| | - Masaki Murata
- Department of Urology, Division of Molecular Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951‑8510, Japan
| | - Vladimir Bilim
- Department of Urology, Division of Molecular Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951‑8510, Japan
| | | | - Kazuhide Saito
- Department of Urology, Division of Molecular Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951‑8510, Japan
| | - Yoshihiko Tomita
- Department of Urology, Division of Molecular Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951‑8510, Japan
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Muroni MR, Ribback S, Sotgiu G, Kroeger N, Saderi L, Angius A, Cossu-Rocca P, De Miglio MR. Prognostic Impact of Membranous/Nuclear Epidermal Growth Factor Receptor Localization in Clear Cell Renal Cell Carcinoma. Int J Mol Sci 2021; 22:ijms22168747. [PMID: 34445451 PMCID: PMC8395723 DOI: 10.3390/ijms22168747] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/10/2021] [Accepted: 08/11/2021] [Indexed: 01/10/2023] Open
Abstract
EGFR is overexpressed in the majority of clear cell renal cell carcinomas (CCRCCs). Although EGFR deregulation was found to be of great significance in CCRCC biology, the EGFR overexpression is not associated with EGFR-targeted therapy responsiveness. Moreover, the prognostic role of EGFR expression remains controversial. In the present study, we evaluated the role played by EGFR overexpression in CCRCC and its prognostic significance associated with different immunohistochemical localization patterns. In our study, the Total Score (TS) related to membranous-cytoplasmic EGFR expression showed a significant correlation with grade, pathologic stage (pT), and Stage, Size, Grade, and Necrosis (SSIGN) score, and a negative correlation with nuclear EGFR expression. No significant correlations were shown between nuclear EGFR and clinic-pathological features. Additionally, a correlation between SGLT1 expression levels and pT was described. Multivariate analysis identifies pT and SSIGN score as independent prognostic factors for CCRCC. A significantly increased survival rate was found in the case of positive expression of nuclear EGFR and SGLT1. Based on our findings, SGLT1 and nuclear EGFR overexpression defines a subgroup of CCRCC patients with good prognosis. Membranous-cytoplasmic EGFR expression was shown to be a poor prognostic factor and could define a CCRCC subgroup with poor prognosis that should be responsive to anti-EGFR therapies.
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Affiliation(s)
- Maria Rosaria Muroni
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via P. Manzella, 4, 07100 Sassari, Italy; (M.R.M.); (G.S.); (L.S.); (P.C.-R.)
| | - Silvia Ribback
- Institut fuer Pathologie, Universitaetsmedizin Greifswald, Friedrich-Loeffler-Str. 23e, 17475 Greifswald, Germany;
| | - Giovanni Sotgiu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via P. Manzella, 4, 07100 Sassari, Italy; (M.R.M.); (G.S.); (L.S.); (P.C.-R.)
| | - Nils Kroeger
- Klinik und Poliklinik fuer Urologie, Universitaetsmedizin Greifswald, Sauerbruchstr, 17475 Greifswald, Germany;
| | - Laura Saderi
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via P. Manzella, 4, 07100 Sassari, Italy; (M.R.M.); (G.S.); (L.S.); (P.C.-R.)
| | - Andrea Angius
- Istituto di Ricerca Genetica e Biomedica (IRGB), CNR, Cittadella Universitaria di Cagliari, 09042 Monserrato, Italy
- Correspondence: (A.A.); (M.R.D.M.); Tel.: +39-0706754543 (A.A.); +39-079228016 (M.R.D.M.)
| | - Paolo Cossu-Rocca
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via P. Manzella, 4, 07100 Sassari, Italy; (M.R.M.); (G.S.); (L.S.); (P.C.-R.)
- Surgical Pathology Unit, Department of Diagnostic Services, “Giovanni Paolo II” Hospital, ASSL Olbia-ATS Sardegna, 07026 Olbia, Italy
| | - Maria Rosaria De Miglio
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via P. Manzella, 4, 07100 Sassari, Italy; (M.R.M.); (G.S.); (L.S.); (P.C.-R.)
- Correspondence: (A.A.); (M.R.D.M.); Tel.: +39-0706754543 (A.A.); +39-079228016 (M.R.D.M.)
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Bai D, Chen S, Feng H, Yin A, Lu J, Ma Y, Sugiyama H. Integrated analysis of immune-related gene subtype and immune index for immunotherapy in clear cell renal cell carcinoma. Pathol Res Pract 2021; 225:153557. [PMID: 34329838 DOI: 10.1016/j.prp.2021.153557] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/12/2021] [Accepted: 07/17/2021] [Indexed: 12/13/2022]
Abstract
Clear cell renal cell carcinoma (ccRCC) is the most common type of renal cell carcinoma (RCC) with high immunogenicity. Research on immune-related gene (IRG) is of great significance in ccRCC in identifying new therapeutic targets and improving patient prognosis. In this study, the IRG patterns of ccRCC were investigated and correlated these patterns with tumor microenvironment infiltrating characteristics in immunotherapy. Moreover, an IRG score was constructed to quantify the pattern of individual tumors through the principal component analysis algorithm. Two distinct molecular subtypes (C1 and C2) were identified based on the IRGs expression profile. Subtype C1 was characterized with significantly high level of immune-checkpoint, immune score, stromal score, showed high drug sensitivity in Sorafenib, Sunitinib, Cisplatin, Vinblastine, Vinorelbine, Vorinostat, and Gemcitabine. Cytokine-cytokine receptor pathway, chemokine signaling pathway, and JAK signaling pathways were found enriched in the subtype C1 account for the poor prognosis. Subtype C2 was linked to a better survival outcome. By using the Connective Map database, subtype specific small molecular drugs identified that could facilitate the treatment of ccRCC patients. In addition, A immune index that used to evaluated the immune modification patterns and further validated in the other types RCC dataset, such as papillary renal cell carcinoma (pRCC) and chromophobe renal cell carcinoma (chRCC). Together, this study identified two distinct molecular subtypes with immune index, aid to the treatment of ccRCC and enhancing our cognition of the tumor microenvironment infiltration characterization in ccRCC immunotherapy.
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Affiliation(s)
- Dan Bai
- Frontiers Science Center for Flexible Electronics (FSCFE), Institute of Flexible Electronics (IFE), MIIT Key Laboratory of Flexible Electronics (KLoFE), Northwestern Polytechnical University, Xi'an, China 710072; Research and Development Institute of Northwestern Polytechnical University in Shenzhen, Northwestern Polytechnical University, Xi'an, China 518057; Xi'an Key Laboratory of Special Medicine and Health Engineering, Northwestern Polytechnical University, Xi'an, China 710129; Research institute of Xi'an Jiaotong University (Zhejiang), Hangzhou, China 311215.
| | - Suna Chen
- Frontiers Science Center for Flexible Electronics (FSCFE), Institute of Flexible Electronics (IFE), MIIT Key Laboratory of Flexible Electronics (KLoFE), Northwestern Polytechnical University, Xi'an, China 710072
| | - Huhu Feng
- Frontiers Science Center for Flexible Electronics (FSCFE), Institute of Flexible Electronics (IFE), MIIT Key Laboratory of Flexible Electronics (KLoFE), Northwestern Polytechnical University, Xi'an, China 710072
| | - Aiping Yin
- The Division of Nephrology, The 1st Hospital of Xi'an Jiaotong University, Xi'an, China 710065
| | - Juncheng Lu
- School of Material Science and Engineering (MSE), Northwestern Polytechnical University, Xi'an, China 710072
| | - Yiran Ma
- School of Chemistry and Chemical Engineering, Northwestern Polytechnical University, Xi'an, China 710072
| | - Hiroshi Sugiyama
- Department of Chemistry, Graduate School of Science, Kyoto University, Kyoto, Japan 606-8502; Institute for Integrated Cell-Material Sciences (iCeMS), Kyoto University, Kyoto, Japan 606-8502.
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Spyropoulou D, Tsiganos P, Dimitrakopoulos FI, Tolia M, Koutras A, Velissaris D, Lagadinou M, Papathanasiou N, Gkantaifi A, Kalofonos H, Kardamakis D. Radiotherapy and Renal Cell Carcinoma: A Continuing Saga. In Vivo 2021; 35:1365-1377. [PMID: 33910814 PMCID: PMC8193295 DOI: 10.21873/invivo.12389] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 03/26/2021] [Accepted: 03/31/2021] [Indexed: 11/10/2022]
Abstract
Renal cell carcinoma (RCC) is one of the most aggressive malignancies of the genito-urinary tract, having a poor prognosis especially in patients with metastasis. Surgical resection remains the gold standard for localized renal cancer disease, with radiotherapy (RT) receiving much skepticism during the last decades. However, many studies have evaluated the role of RT, and although renal cancer is traditionally considered radio-resistant, technological advances in the RT field with regards to modern linear accelerators, as well as advanced RT techniques have resulted in breakthrough therapeutic outcomes. Additionally, the combination of RT with immune checkpoint inhibitors and targeted agents may maximize the clinical benefit. This review article focuses on the role of RT in the therapeutic management of renal cell carcinoma.
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Affiliation(s)
- Despoina Spyropoulou
- Department of Radiation Oncology, University of Patras Medical School, Patras, Greece;
| | - Panagiotis Tsiganos
- Clinical Radiology Laboratory, Department of Medicine, University of Patras, Patras, Greece
| | - Foteinos-Ioannis Dimitrakopoulos
- Division of Oncology, Department of Medicine, University Hospital of Patras, Patras, Greece
- Clinical and Molecular Oncology Laboratory, Medical School, University of Patras, Patras, Greece
| | - Maria Tolia
- Radiotherapy Department, University Hospital Heraklion, University of Crete Medical School, Heraklion, Greece
| | - Angelos Koutras
- Division of Oncology, Department of Medicine, University Hospital of Patras, Patras, Greece
| | - Dimitris Velissaris
- Emergency Department and Internal Medicine Department, University Hospital of Patras, Patras, Greece
| | - Maria Lagadinou
- Emergency Department University Hospital of Patras, Patras, Greece
| | | | - Areti Gkantaifi
- Radiotherapy Department, Interbalkan Medical Center, Thessaloniki, Greece
| | - Haralabos Kalofonos
- Division of Oncology, Department of Medicine, University Hospital of Patras, Patras, Greece
| | - Dimitrios Kardamakis
- Department of Radiation Oncology, University of Patras Medical School, Patras, Greece
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Carcinoma a cellule renali metastatico: evidenze real-world da un ampio database amministrativo italiano. GLOBAL & REGIONAL HEALTH TECHNOLOGY ASSESSMENT 2021; 8:1-7. [PMID: 36627861 PMCID: PMC9616181 DOI: 10.33393/grhta.2021.2178] [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: 08/06/2020] [Accepted: 12/15/2020] [Indexed: 01/13/2023] Open
Abstract
Purpose: To assess the healthcare resources’ consumption and integrated costs of patients with renal cancer and new metastasis (mRCC), in the perspective of the Italian National Health System (NHS). Methods: From the ReS database, through the administrative data record linkage, adults with a primary/secondary hospital (ordinary/daily admissions) diagnosis (ICD9-CM code) of renal cancer and lymph node and/or distant metastases in the same hospital discharge (index date) were selected in 2015. Metastases were defined new if they were absent in the 2 previous years. Patients were described in terms of gender, age (mean ± SD) and comorbidities of interest. The 2-year survival and annual pharmacological treatments, hospitalization, outpatient specialist services and costs were analysed. Results: Out of >6 million adults in the 2015 ReS database, 133 (2.1 × 100,000) were hospitalized with a diagnosis of RCC and metastasis. Patients with new metastases were 63.2% (1.4 × 100,000; 73.8% males; mean age 68 ± 13). Hypertension was the most common comorbidity (70.2% of mRCC patients). The 2-year survival of mRCC patients was 26.2%. During 1-year follow-up, at least a drug was prescribed to 88.1% of mRCC patients (on average € 12,095/patient), 91.7% were hospitalized (€ 8,897/patient) and 82.1% entrusted the outpatient specialist care (€ 1,075/patient). The mean overall expenditure for the NHS was € 22,067 per capita. Conclusions: This study shows the mRCC burden on the Italian real clinical practice and its economic impact in the perspective of the NHS. Real-world analyses prove to be useful to concretely estimate the overall healthcare responsibility on patients affected by mRCC.
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Tian X, Zhang S, Zhang Q, Kang L, Ma C, Feng L, Li S, Li J, Yang L, Liu J, Qi Z, Shen Y. Resveratrol inhibits tumor progression by down-regulation of NLRP3 in renal cell carcinoma. J Nutr Biochem 2020; 85:108489. [PMID: 32827663 DOI: 10.1016/j.jnutbio.2020.108489] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 06/04/2020] [Accepted: 08/05/2020] [Indexed: 01/16/2023]
Abstract
Renal cell carcinoma (RCC) is one of the most common urologic malignant tumors. Current chemotherapy is not effective in RCC and results in some side effects. Resveratrol (RSV) has been reported to exert antitumor effects in some cancer cells; however the mechanism is not fully understood. Herein, we aimed to determine the anticancer effect of RSV on RCC and further explore the underlying molecular mechanism in this process. We found that RSV inhibited tumor cells proliferation, migration and invasion and increased apoptosis of RCC either in vivo or in vitro. RSV significantly down-regulated expressions of NLRP3 and its downstream genes. Inhibition of NLRP3 by NLRP3 small interfering RNA mimicked the effects of RSV on RCC cells. These results suggested that RSV could exert antitumor effect by depressing activity of NLRP3, and NLRP3 would be a promising clinical therapeutic strategy for RCC.
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Affiliation(s)
- Xixi Tian
- Department of Microbiology, School of Laboratory Medicine, Tianjin Medical University, Tianjin 300203, China
| | - Shengzheng Zhang
- Department of Histology and Embryology, School of Medicine, Nankai University, Tianjin 300071, China
| | - Qiong Zhang
- Department of Microbiology, School of Laboratory Medicine, Tianjin Medical University, Tianjin 300203, China
| | - Licheng Kang
- Department of Histology and Embryology, School of Medicine, Nankai University, Tianjin 300071, China
| | - Changzhen Ma
- Department of Histology and Embryology, School of Medicine, Nankai University, Tianjin 300071, China
| | - Lifeng Feng
- Department of Histology and Embryology, School of Medicine, Nankai University, Tianjin 300071, China
| | - Shengyu Li
- Department of Microbiology, School of Laboratory Medicine, Tianjin Medical University, Tianjin 300203, China
| | - Jing Li
- Department of Histology and Embryology, School of Medicine, Nankai University, Tianjin 300071, China
| | - Liang Yang
- Department of Histology and Embryology, School of Medicine, Nankai University, Tianjin 300071, China
| | - Jie Liu
- Department of Histology and Embryology, School of Medicine, Nankai University, Tianjin 300071, China
| | - Zhi Qi
- Department of Histology and Embryology, School of Medicine, Nankai University, Tianjin 300071, China; National Clinical Research Center of Kidney Diseases, Beijing, 100853, China.
| | - Yanna Shen
- Department of Microbiology, School of Laboratory Medicine, Tianjin Medical University, Tianjin 300203, China.
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10
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Identification of the Potential Prognostic Markers from the miRNA-lncRNA-mRNA Interactions for Metastatic Renal Cancer via Next-Generation Sequencing and Bioinformatics. Diagnostics (Basel) 2020; 10:diagnostics10040228. [PMID: 32316228 PMCID: PMC7235743 DOI: 10.3390/diagnostics10040228] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 04/06/2020] [Accepted: 04/14/2020] [Indexed: 12/18/2022] Open
Abstract
The survival rate in patients with metastatic renal cell carcinoma (RCC) is low. In addition, metastatic RCC resists traditional treatment. Therefore, identification of novel biomarkers, signaling pathways, and therapeutic targets is an important issue. The aim of the present study is to identify novel prognostic markers from the miRNA-mediated network for the regulation of metastasis of RCC. To address this issue, the RNA of human RCC cell lines, 786-O and ACHN, derived from primary and metastatic sites, respectively, were collected and subjected to RNA sequencing and small RNA sequencing. The bioinformatic analysis revealed that the pathways of the genes with different expressions were related to tumor progression, and identified miRNA and miRNA-long non-coding RNA (lncRNA) interactions, and mRNA. The results revealed that the expressions of seven miRNAs were associated with the overall survival rate of patients with RCC. Furthermore, the expressions of two lncRNA and three protein-coding genes (mRNA) were significantly associated with the increased or decreased disease-free survival rate. Although the detailed regulatory mechanism between miRNAs and targeted genes was not fully understood, our findings present novel prognostic markers and novel insight on miRNA-mediated pathways for metastatic RCC.
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11
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Mikhaylenko DS, Klimov AV, Matveev VB, Samoylova SI, Strelnikov VV, Zaletaev DV, Lubchenko LN, Alekseev BY, Nemtsova MV. Case of Hereditary Papillary Renal Cell Carcinoma Type I in a Patient With a Germline MET Mutation in Russia. Front Oncol 2020; 9:1566. [PMID: 32039030 PMCID: PMC6985093 DOI: 10.3389/fonc.2019.01566] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 12/24/2019] [Indexed: 12/24/2022] Open
Abstract
Hereditary papillary renal carcinoma (HPRC) is a rare autosomal dominant disease characterized by the development of multiple papillary type I renal cell carcinomas. This hereditary kidney cancer form is caused by activating mutations in MET. Descriptions of patients with HPRC are scarce in the world literature, and no cases have been described in open sources in Russia. Here, we describe a 28-year-old female Russian patient with 7 and 10 primary papillary renal cell carcinomas in the left and right kidneys, respectively. The patient did not have a family history of any of the known hereditary cancer syndromes. A comprehensive medical examination was performed in 2016 including computed tomography and pathomorphological analysis. The observed tumors were resected in a two-step surgical treatment. In February 2019, no sign of disease progression was detected in follow-up medical examination. Molecular genetic analysis revealed the germline heterozygous missense variant in MET: c.3328G>A (p.V1110I; CM990852). We have discussed the biological effects of the detected mutation and the utility of DNA diagnostics for treating patients with HPRC.
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Affiliation(s)
- Dmitry S Mikhaylenko
- Laboratory of Medical Genetics, Institute of Molecular Medicine, Scientific Biotechnological Park of Biomedicine, Sechenov University, Moscow, Russia.,Laboratory of Pathology and Molecular Genetics, N. Lopatkin Institute of Urology and Interventional Radiology - Branch of the National Medical Research Center of Radiology, Moscow, Russia.,Laboratory of Epigenetics, Research Centre for Medical Genetics Named After Academician N. P. Bochkov, Moscow, Russia
| | - Alexey V Klimov
- Department of Urology, Institute of Clinical Oncology, N. N. Blokhin National Medical Research Center of Oncology, Moscow, Russia
| | - Vsevolod B Matveev
- Department of Urology, Institute of Clinical Oncology, N. N. Blokhin National Medical Research Center of Oncology, Moscow, Russia
| | - Svetlana I Samoylova
- Laboratory of Medical Genetics, Institute of Molecular Medicine, Scientific Biotechnological Park of Biomedicine, Sechenov University, Moscow, Russia.,Laboratory of Pathology and Molecular Genetics, N. Lopatkin Institute of Urology and Interventional Radiology - Branch of the National Medical Research Center of Radiology, Moscow, Russia
| | - Vladimir V Strelnikov
- Laboratory of Epigenetics, Research Centre for Medical Genetics Named After Academician N. P. Bochkov, Moscow, Russia
| | - Dmitry V Zaletaev
- Laboratory of Medical Genetics, Institute of Molecular Medicine, Scientific Biotechnological Park of Biomedicine, Sechenov University, Moscow, Russia.,Laboratory of Epigenetics, Research Centre for Medical Genetics Named After Academician N. P. Bochkov, Moscow, Russia
| | - Ludmila N Lubchenko
- Department of Urology, Institute of Clinical Oncology, N. N. Blokhin National Medical Research Center of Oncology, Moscow, Russia
| | - Boris Y Alekseev
- Laboratory of Pathology and Molecular Genetics, N. Lopatkin Institute of Urology and Interventional Radiology - Branch of the National Medical Research Center of Radiology, Moscow, Russia
| | - Marina V Nemtsova
- Laboratory of Medical Genetics, Institute of Molecular Medicine, Scientific Biotechnological Park of Biomedicine, Sechenov University, Moscow, Russia.,Laboratory of Epigenetics, Research Centre for Medical Genetics Named After Academician N. P. Bochkov, Moscow, Russia
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12
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Gui D, Peng W, Jiang W, Huang G, Liu G, Ye Z, Wang Y, Xu Z, Fu J, Luo S, Zhao Y. Ubiquitin-specific peptidase 46 (USP46) suppresses renal cell carcinoma tumorigenesis through AKT pathway inactivation. Biochem Biophys Res Commun 2019; 519:689-696. [PMID: 31542232 DOI: 10.1016/j.bbrc.2019.09.036] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 09/10/2019] [Indexed: 12/18/2022]
Abstract
USP46, a member of the ubiquitin-specific protease family, plays essential roles in cancer cell proliferation and metastasis and is used as a candidate target for cancer therapeutics. However, the effects of USP46 on renal cell carcinoma (RCC) and its underlying molecular mechanism remain unknown. In this study, the predictive and prognostic relevance of USP46 in RCC, patient-derived primary tissues, and normal liver tissues obtained from the TCGA dataset were analyzed for the USP46 mRNA levels or prognostic relevance. Gain-of-function or loss-of-function assays were used to evaluate the vital roles of USP46 in tumor cell proliferation and cell migration. As a result, the USP46 expression level in RCC is highly decreased compared to normal tissues, and the Kaplan-Meier curve showed that USP46 high expression patients had good prognoses. Functionally, the forced expression of USP46 significantly restrained tumor cell proliferation, colony formation, and cell migration. The shRNA mediated USP46 knockdown cells exhibited the opposite results. We further showed that ectopically expressed USP46 obviously inhibited the AKT signaling pathway in cancer cells, while USP46 depletion caused a dramatic increase in AKT activity reflected by phosphorylation in the serine and threonine residues of AKT or downstream p70S6K1. Importantly, MK2206, a specific AKT inhibitor, completely counteracted the effects on cell proliferation, cell migration, and AKT activity in the USP46 depletion cells. We thus revealed a novel mechanism of USP46 regulation in RCC, and our data indicate that USP46 is a tumor suppressor in RCC via AKT signaling pathway inactivation.
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Affiliation(s)
- Dingwen Gui
- Department of Urology, Huangshi Central Hospital (Affiliated Hospital of Hubei Polytechnic University), Edong Healthcare Group, Huangshi, Hubei, 435000, PR China; Hubei Key Laboratory of Kidney Disease Pathogenesis and Intervention, Huangshi, Hubei, 435000, PR China.
| | - Wei Peng
- Department of Urology, Huangshi Central Hospital (Affiliated Hospital of Hubei Polytechnic University), Edong Healthcare Group, Huangshi, Hubei, 435000, PR China; Hubei Key Laboratory of Kidney Disease Pathogenesis and Intervention, Huangshi, Hubei, 435000, PR China
| | - Weidong Jiang
- Department of Urology, Huangshi Central Hospital (Affiliated Hospital of Hubei Polytechnic University), Edong Healthcare Group, Huangshi, Hubei, 435000, PR China; Hubei Key Laboratory of Kidney Disease Pathogenesis and Intervention, Huangshi, Hubei, 435000, PR China
| | - Geng Huang
- Department of Urology, Huangshi Central Hospital (Affiliated Hospital of Hubei Polytechnic University), Edong Healthcare Group, Huangshi, Hubei, 435000, PR China; Hubei Key Laboratory of Kidney Disease Pathogenesis and Intervention, Huangshi, Hubei, 435000, PR China
| | - Gang Liu
- Department of Urology, Huangshi Central Hospital (Affiliated Hospital of Hubei Polytechnic University), Edong Healthcare Group, Huangshi, Hubei, 435000, PR China; Hubei Key Laboratory of Kidney Disease Pathogenesis and Intervention, Huangshi, Hubei, 435000, PR China
| | - Zhihua Ye
- Department of Urology, Huangshi Central Hospital (Affiliated Hospital of Hubei Polytechnic University), Edong Healthcare Group, Huangshi, Hubei, 435000, PR China; Hubei Key Laboratory of Kidney Disease Pathogenesis and Intervention, Huangshi, Hubei, 435000, PR China
| | - Yang Wang
- Department of Urology, Huangshi Central Hospital (Affiliated Hospital of Hubei Polytechnic University), Edong Healthcare Group, Huangshi, Hubei, 435000, PR China; Hubei Key Laboratory of Kidney Disease Pathogenesis and Intervention, Huangshi, Hubei, 435000, PR China
| | - Zuwei Xu
- Department of Urology, Huangshi Central Hospital (Affiliated Hospital of Hubei Polytechnic University), Edong Healthcare Group, Huangshi, Hubei, 435000, PR China; Hubei Key Laboratory of Kidney Disease Pathogenesis and Intervention, Huangshi, Hubei, 435000, PR China
| | - Jinlun Fu
- Department of Urology, Huangshi Central Hospital (Affiliated Hospital of Hubei Polytechnic University), Edong Healthcare Group, Huangshi, Hubei, 435000, PR China; Hubei Key Laboratory of Kidney Disease Pathogenesis and Intervention, Huangshi, Hubei, 435000, PR China
| | - Shuai Luo
- Department of Urology, Huangshi Central Hospital (Affiliated Hospital of Hubei Polytechnic University), Edong Healthcare Group, Huangshi, Hubei, 435000, PR China; Hubei Key Laboratory of Kidney Disease Pathogenesis and Intervention, Huangshi, Hubei, 435000, PR China
| | - Yunfei Zhao
- Department of Urology, Huangshi Central Hospital (Affiliated Hospital of Hubei Polytechnic University), Edong Healthcare Group, Huangshi, Hubei, 435000, PR China; Hubei Key Laboratory of Kidney Disease Pathogenesis and Intervention, Huangshi, Hubei, 435000, PR China
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