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Taşçi Y, Aksoy E, Taşkın HE, Aliyev S, Moore H, Ağcaoğlu O, Birsen O, Siperstein A, Berber E. A comparison of laparoscopic radiofrequency ablation versus systemic therapy alone in the treatment of breast cancer metastasis to the liver. HPB (Oxford) 2013; 15:789-93. [PMID: 24028270 PMCID: PMC3791118 DOI: 10.1111/hpb.12133] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Accepted: 04/29/2013] [Indexed: 12/12/2022]
Abstract
OBJECTIVES There is controversy about the roles of locoregional therapies in patients with liver metastases from breast cancer (LMBC). The aim of this study was to analyse survival after laparoscopic radiofrequency ablation (RFA) of LMBC and to compare this with survival in patients receiving systemic therapy (ST) alone. METHODS During 1996-2011, 24 patients who had failed to respond or had shown an incomplete response to ST underwent laparoscopic RFA for LMBC. Outcomes in these patients were compared with those in 32 patients with LMBC matched by tumour size and number, but treated with ST alone. Clinical parameters and overall survival were compared using t-tests, chi-squared tests and Kaplan-Meier analysis. RESULTS The groups were similar in hormone receptor status and chemotherapy exposure. In the laparoscopic RFA and ST groups, respectively, the mean ± standard deviation size of the dominant liver tumour and the number of tumours per patient were 3.7 ± 0.4 cm and 2.4 ± 0.4 cm, and 2.6 ± 0.4 tumours and 3.3 ± 0.4 tumours, respectively. These differences were not significant. At a median follow-up of 20 months in the laparoscopic RFA group, 42% of patients were found to have developed local liver recurrence, 63% had developed new liver disease and 38% had developed extrahepatic disease. Overall survival after the diagnosis of liver metastasis was 47 months in the laparoscopic RFA group and 9 months in the ST-only group (P = 0.0001). Five-year survival after the diagnosis of liver metastasis was 29% in the RFA group and 0% in the ST-only group. CONCLUSIONS This is the first study to compare outcomes in RFA and ST, respectively, in LMBC. The results show that survival after laparoscopic RFA plus ST is better than that after ST alone.
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Affiliation(s)
- Yunus Taşçi
- Department of Endocrine Surgery, Cleveland Clinic FoundationCleveland, OH, USA
| | - Erol Aksoy
- Department of Endocrine Surgery, Cleveland Clinic FoundationCleveland, OH, USA
| | - Halit Eren Taşkın
- Department of Endocrine Surgery, Cleveland Clinic FoundationCleveland, OH, USA
| | - Shamil Aliyev
- Department of Endocrine Surgery, Cleveland Clinic FoundationCleveland, OH, USA
| | - Halle Moore
- Taussig Cancer Institute, Cleveland Clinic FoundationCleveland, OH, USA
| | - Orhan Ağcaoğlu
- Department of Endocrine Surgery, Cleveland Clinic FoundationCleveland, OH, USA
| | - Onur Birsen
- Department of Endocrine Surgery, Cleveland Clinic FoundationCleveland, OH, USA
| | - Allan Siperstein
- Department of Endocrine Surgery, Cleveland Clinic FoundationCleveland, OH, USA
| | - Eren Berber
- Department of Endocrine Surgery, Cleveland Clinic FoundationCleveland, OH, USA
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Vanderbeeken MC, Aftimos PG, Awada A. Topoisomerase Inhibitors in Metastatic Breast Cancer: Overview of Current Practice and Future Development. CURRENT BREAST CANCER REPORTS 2013. [DOI: 10.1007/s12609-012-0098-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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van de Ven R, Reurs AW, Wijnands PGJTB, van Wetering S, Kruisbeek AM, Hooijberg E, Scheffer GL, Scheper RJ, de Gruijl TD. Exposure of CD34+ precursors to cytostatic anthraquinone-derivatives induces rapid dendritic cell differentiation: implications for cancer immunotherapy. Cancer Immunol Immunother 2012; 61:181-191. [PMID: 21874304 PMCID: PMC11028503 DOI: 10.1007/s00262-011-1039-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2011] [Accepted: 05/10/2011] [Indexed: 12/31/2022]
Abstract
Appropriate activation of dendritic cells (DC) is essential for successful active vaccination and induction of cell-mediated immunity. The scarcity of precursor cells, as well as long culture methods, have hampered wide-scale application of DC vaccines derived from CD34(+) precursors, despite their suggested superior efficacy over the more commonly applied monocyte-derived DC (MoDC). Here, employing the CD34(+)/CD14(+) AML-derived human DC progenitor cell line MUTZ3, we show that cytostatic anthraquinone-derivatives (i.e., the anthracenedione mitoxantrone and the related anthracyclin doxorubicin) induce rapid differentiation of CD34(+) DC precursors into functional antigen-presenting cells (APC) in a three-day protocol. The drugs were found to act specifically on CD34(+), and not on CD14(+) DC precursors. Importantly, these observations were confirmed for primary CD34(+) and CD14(+) DC precursors from peripheral blood. Mitoxantrone-generated DC were fully differentiated within three days and after an additional 24 h of maturation, were as capable as standard 9-day differentiated and matured DC to migrate toward the lymph node-homing chemokines CCL19 and CCL21, to induce primary allogeneic T cell proliferation, and to prime functional MART1-specific CD8(+) T lymphocytes. Our finding that anthraquinone-derivatives like mitoxantrone support rapid high-efficiency differentiation of DC precursors may have consequences for in vitro production of DC vaccines as well as for novel immunochemotherapy strategies.
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Affiliation(s)
- Rieneke van de Ven
- Department of Pathology, VU University Medical Center, de Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
- Division of Immunotherapy, Medical Oncology Laboratory, VU University Medical Center, de Boelelaan 1117-CCA 2.44, 1081 HV, Amsterdam, The Netherlands
| | - Anneke W Reurs
- Department of Pathology, VU University Medical Center, de Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
- DCPrime B.V, De Boelelaan 1085 (W&N), 1081 HV, Amsterdam, The Netherlands
| | - Pepijn G J T B Wijnands
- Department of Pathology, VU University Medical Center, de Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
- DCPrime B.V, De Boelelaan 1085 (W&N), 1081 HV, Amsterdam, The Netherlands
| | | | - Ada M Kruisbeek
- DCPrime B.V, De Boelelaan 1085 (W&N), 1081 HV, Amsterdam, The Netherlands
| | - Erik Hooijberg
- Department of Pathology, VU University Medical Center, de Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - George L Scheffer
- Department of Pathology, VU University Medical Center, de Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Rik J Scheper
- Department of Pathology, VU University Medical Center, de Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
- DCPrime B.V, De Boelelaan 1085 (W&N), 1081 HV, Amsterdam, The Netherlands
| | - Tanja D de Gruijl
- Division of Immunotherapy, Medical Oncology Laboratory, VU University Medical Center, de Boelelaan 1117-CCA 2.44, 1081 HV, Amsterdam, The Netherlands.
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Suzuki E, Furuse J, Ikeda M, Ishii H, Okusaka T, Nakachi K, Mitsunaga S, Ueno H, Morizane C. A Phase I/II Study of Combined Chemotherapy with Mitoxantrone and Uracil/Tegafur for Advanced Hepatocellular Carcinoma. Jpn J Clin Oncol 2011; 41:328-333. [DOI: 10.1093/jjco/hyq219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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