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Li T, Kuang T, Yang Z, Zhang Q, Zhang W, Fan Y. Co-treatment With Everolimus, an mTOR-Specific Antagonist, or Downregulation of ELK1 Enhances the Sensitivity of Pancreatic Cancer Cells to Genistein. Front Cell Dev Biol 2021; 9:633035. [PMID: 34540820 PMCID: PMC8448347 DOI: 10.3389/fcell.2021.633035] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 08/06/2021] [Indexed: 12/24/2022] Open
Abstract
Genistein is a natural isoflavone with pharmacological or potentially anti-tumor properties. However, the resistance of cancer cells to genistein remains a major obstacle. This study focused on the mechanism implicated in the resistance of pancreatic cancer (PC) cells to genistein and the mechanism of action. First, key molecules and signaling pathways related to genistein resistance in PC cells were explored using bioinformatics tools. DEP domain containing MTOR interacting protein (DEPTOR), a typical inhibitor of the mammalian target of rapamycin (mTOR) signaling, was predicted to be poorly expressed in the genistein-resistant PC cells. Thereafter, genistein-resistant PC cells (Panc-1 and PaCa) were constructed. Altered expression of DEPTOR was introduced in cells, and everolimus (ELM), an mTOR-specific antagonist, was administrated in cells as well to examine their roles in genistein resistance. The cell apoptosis was examined in vitro and in vivo in mouse xenograft tumors. The upstream regulator of DEPTOR was predicted via bioinformatic tools. The bioinformatic analyses showed that the PI3K/AKT/mTOR signaling pathway was activated in the setting of DEPTOR downregulation in genistein-resistant PC cells. DEPTOR overexpression reduced the 50% inhibiting concentration (IC50) of genistein in PC cells and suppressed mTOR phosphorylation, and it increased caspase-3 activity, LDH release and apoptosis in PC cells. ELM treatment enhanced the sensitivity of PC cells to genistein in vitro and it strengthened the tumor-eliminating role of genistein in mice. ETS transcription factor ELK1 (ELK1), a transcription factor that negatively regulated DEPTOR transcription, was suppressed by genistein. Upregulation of ELK1 suppressed DEPTOR transcription and reduced the genistein sensitivity of cells, and it also blocked the genistein-sensitizing roles of ELM in PC cells. In conclusion, this study demonstrated that ELK1 reduces DEPTOR transcription, leading to mTOR phosphorylation and the drug resistance of PC cells.
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Affiliation(s)
- Tianyu Li
- Department of Integrated Traditional Chinese Medicine and Western Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Tiantao Kuang
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Zhaoshuo Yang
- Department of Integrated Traditional Chinese Medicine and Western Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Qiqi Zhang
- Department of Integrated Traditional Chinese Medicine and Western Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Wen Zhang
- Department of Integrated Traditional Chinese Medicine and Western Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yue Fan
- Department of Integrated Traditional Chinese Medicine and Western Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.,Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, China
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Ekman S, Griesinger F, Baas P, Chao D, Chouaid C, O'Donnell JC, Penrod JR, Daumont M, Lacoin L, McKenney A, Khovratovich M, Munro REJ, Durand-Zaleski I, Johnsen SP. I-O Optimise: a novel multinational real-world research platform in thoracic malignancies. Future Oncol 2019; 15:1551-1563. [DOI: 10.2217/fon-2019-0025] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Aim: To describe I-O Optimise, a multinational program providing real-world insights into lung cancer management. Materials & methods: Real-world data source selection for I-O Optimise followed a structured approach focused on population coverage, key variable capture, continuous/consistent data availability, record duration and data latency, and database expertise. Results: As of 31 October 2018, seven real-world data sources were included in I-O Optimise, providing data on characteristics, treatment patterns and clinical outcomes from more than 45,000 patients/year with non-small-cell lung cancer, small-cell lung cancer and mesothelioma across Denmark, Norway, Portugal, Spain, Sweden and the UK. Conclusion: The ongoing I-O Optimise initiative has the potential to provide a broad, robust and dynamic research platform to continually address numerous research objectives in the lung cancer arena.
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Affiliation(s)
- Simon Ekman
- Department of Oncology, Karolinska University Hospital, Stockholm, Sweden
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Frank Griesinger
- Department of Haematology & Oncology, University Department Internal Medicine-Oncology, Pius-Hospital, Medical Campus University of Oldenburg, Oldenburg, Germany
| | - Paul Baas
- Department of Thoracic Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - David Chao
- Department of Oncology, Royal Free Hospital, London, UK
| | - Christos Chouaid
- Pneumology Unit, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - John C O'Donnell
- Worldwide Health Economics & Outcomes Research, Bristol-Myers Squibb, Princeton, NJ, USA
| | - John R Penrod
- Worldwide Health Economics & Outcomes Research, Bristol-Myers Squibb, Princeton, NJ, USA
| | - Melinda Daumont
- Worldwide Health Economics & Outcomes Research, Bristol-Myers Squibb, Braine-l'Alleud, Belgium
| | - Laure Lacoin
- Worldwide Health Economics & Outcomes Research, Bristol-Myers Squibb, Braine-l'Alleud, Belgium
| | | | | | | | - Isabelle Durand-Zaleski
- URC Eco IdF, Unité de Recherche Clinique en Économie de la Santé d'Ile de France, AP-HP Paris, Paris, France
| | - Søren Paaske Johnsen
- Danish Center for Clinical Health Services Research, Aalborg University, Aalborg, Denmark
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Dejust S, Morland D, Bruna-Muraille C, Eymard JC, Yazbek G, Savoye AM, Papathanassiou D. Everolimus-induced pulmonary toxicity: Findings on 18F-FDG PET/CT imaging. Medicine (Baltimore) 2018; 97:e12518. [PMID: 30290608 PMCID: PMC6200531 DOI: 10.1097/md.0000000000012518] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The everolimus-exemestane combination is indicated in advanced breast cancer treatment and usually well tolerated. The objective of the study was to determine the frequency of everolimus lung side effects and investigate their imaging characteristics on positron emission tomography with 18F-fluoro-deoxy-glucose combined with computerized tomography (F-FDG PET/CT).Our single-center retrospective descriptive study systematically included all patients with metastatic breast cancer treated by this combination (n = 29 representing 57 F-FDG PET/CT). Number of segments involved was quantified. Maximum standardized uptake value (SUVmax), average standardized uptake value (SUVmean), metabolic target volume (MTV), and total lesion glycolysis (TLG) were measured. Severe pneumopathy was studied by subgroup analysis.Pleuroparenchymal anomalies rate detected on F-FDG PET/CT was 62%. Alveolar-interstitial lesions were mainly observed (89%) and affected 2.8 segments (0.5-11.5) with a median of 2 segments. S7 and S10 were the most involved segments with SUVmax 3.9 (1.3-8.8) and SUVmean 2.2 (0.7-4.9). Statistically significant difference (P = .02) was found with number of segment involved to characterize severe pneumopathy (average of 6.3 segments [2.5-11.5] vs 1.9 segments [0.5-8] for interstitial lung disease) but not with SUVmax, SUVmean, MTV, TLG (P = .14, 0.22, 0.22, and 0.17, respectively).The F-FDG PET/CT could highlight pulmonary everolimus side effects, with a typical imaging pattern: alveolar-interstitial opacities associated with moderate uptake, more or less extensive, mainly affecting the lower lobes. Rarely, a pseudotumoral aspect may be detected, corresponding to a pitfall. MTV or TLG showed a tendency to differentiate severe pneumopathy vs interstitial lung disease but no statistically significant differences was observed contrarily to the number of segments involved. Further studies are necessary to determine if the F-FDG PET/CT could early predict adverse effects of mTOR inhibitors.
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Affiliation(s)
| | - David Morland
- Department of Nuclear Medicine, Jean Godinot Institut
- Laboratory of Biophysics, University of Reims
| | | | | | | | | | - Dimitri Papathanassiou
- Department of Nuclear Medicine, Jean Godinot Institut
- Laboratory of Biophysics, University of Reims
- Research Center in Information and Communication Sciences and Technologies, EA 3804, University of Reims, Reims, France
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Parisi M, Pelletier C, Cherepanov D, Broder MS. Outcomes research examining treatments, quality of life and costs in HER2-negative and triple-negative metastatic breast cancer: a systematic literature review. J Comp Eff Res 2018; 7:67-83. [DOI: 10.2217/cer-2017-0027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Aim: With the aggregation of real-world data in healthcare, opportunities for outcomes research are growing. In this study, we summarize published literature examining comparative effectiveness research (CER), treatment patterns, quality of life (QoL) and costs in HER2-negative and triple-negative (TN) metastatic breast cancer (mBC). Methods: PubMed (2010–January 2016) and four conferences (2013–January 2016) were searched using MeSH/keywords, including mBC, QoL, morbidity and therapeutics. Studies relating to CER, treatment patterns, QoL, costs or treatment appropriateness in US patients with HER2-negative/TN mBC were included in the review. Results: Of 1782 identified records, 33 studies met full inclusion criteria: seven related to CER, 18 to treatment patterns, one to treatment appropriateness/navigation, two to QoL and five to costs. Studies varied in objectives, designs and outcomes. Study designs included retrospective chart reviews (52%), retrospective secondary database analyses (27%), economic models (12%), physician surveys (6%) and patient surveys (3%). 25 studies reported results on HER2-negative mBC, six on TN mBC and two on both subtypes. The most common end points examined were treatment patterns, overall survival and progression-free survival. Conclusion: Outcomes research in HER2-negative mBC in the USA was limited, specifically among TN patients, indicating an opportunity for further research in this high unmet need population. Endpoints and treatment options varied, thus, it is difficult to draw summary conclusions about these studies. Outcomes research examining real-world data in mBC has increased in recent years, and may continue to grow with the implementation of new policy programs.
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Affiliation(s)
- Monika Parisi
- Celgene Corporation, 86 Morris Ave, Summit, NJ 07901, USA
| | | | - Dasha Cherepanov
- Partnership for Health Analytic Research, LLC, 280 S. Beverly Drive, Beverly Hills, CA 90212, USA
| | - Michael S Broder
- Partnership for Health Analytic Research, LLC, 280 S. Beverly Drive, Beverly Hills, CA 90212, USA
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Tang DH, Li N, Du EX, Peeples M, Chu L, Xie J, Barghout V. First-line treatment disruption among post-menopausal women with HR+/HER2- metastatic breast cancer: a retrospective US claims study. Curr Med Res Opin 2017; 33:2137-2143. [PMID: 28994315 DOI: 10.1080/03007995.2017.1390447] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE This study assessed disruption of first-line treatments initiated after the approval of the first CDK 4/6 inhibitor, palbociclib, among post-menopausal women with HR+/HER2- metastatic breast cancer (mBC) in the US. METHODS Post-menopausal women with HR+/HER2- mBC who initiated first-line endocrine therapy or chemotherapy (index therapy) between February 3, 2015 (palbociclib approval date) and February 29, 2016 (end of data) were identified from the Symphony Source Lx database. Patients were required to have continuous quarterly activity (defined as ≥1 pharmacy or medical claim) for 12 months prior to and 1 month after the initiation of the index therapy (index date). Treatment disruption was defined as a treatment gap of ≥60 days or adding an agent after the original therapy. Kaplan-Meier analyses were conducted to estimate treatment disruption rates during the 6 months following the index date. Patients without treatment disruption were censored at the end of continuous quarterly activity or end of data. RESULTS A total of 8,160 and 2,153 eligible patients initiated endocrine therapy or chemotherapy as their first-line mBC treatment, with a median follow-up of 6.7 and 7.6 months, respectively. The three most prevalent metastatic sites were bone (28.1-42.2%), liver (8.8-17.3%), and lung (8.6-9.5%). Overall, 37.7% (n = 3,074) of patients receiving endocrine therapy and 86.1% (n = 1,852) of patients receiving chemotherapy encountered treatment disruption at 6 months (log-rank test p < .05). CONCLUSIONS Treatment disruption rates of first-line therapies were sub-optimal among post-menopausal women with HR+/HER2- mBC, primarily driven by chemotherapy users. New therapies or interventions are needed to reduce treatment disruption in this patient population.
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Affiliation(s)
- Derek H Tang
- a Novartis Pharmaceuticals Corporation , East Hanover , NJ , USA
| | - Nanxin Li
- b Analysis Group, Inc. , Boston , MA , USA
| | - Ella X Du
- c Analysis Group, Inc. , Los Angeles , CA , USA
| | | | - Lihao Chu
- c Analysis Group, Inc. , Los Angeles , CA , USA
| | - Jipan Xie
- c Analysis Group, Inc. , Los Angeles , CA , USA
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Li N, Du EX, Chu L, Peeples M, Xie J, Barghout V, Tang DH. Real-world palbociclib dosing patterns and implications for drug costs in the treatment of HR+/HER2- metastatic breast cancer. Expert Opin Pharmacother 2017; 18:1167-1178. [DOI: 10.1080/14656566.2017.1351947] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Nanxin Li
- Analysis Group, Inc., Boston, MA, USA
| | - Ella X. Du
- Analysis Group, Inc., Los Angeles, CA, USA
| | - Lihao Chu
- Analysis Group, Inc., Los Angeles, CA, USA
| | | | - Jipan Xie
- Analysis Group, Inc., Los Angeles, CA, USA
| | | | - Derek H. Tang
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
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