1
|
Confocal Microscopy Predicts the Risk of Recurrence and Malignant Transformation of Mucocutaneous Neurofibromas in NF-1: An Observational Study. Dermatol Res Pract 2018; 2018:6938130. [PMID: 30271432 PMCID: PMC6151241 DOI: 10.1155/2018/6938130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 07/15/2018] [Accepted: 07/24/2018] [Indexed: 11/17/2022] Open
Abstract
From 2005 to 2010, 20 consecutive patients with fully manifested neurofibromatosis type 1 (NF1) underwent elective neurofibroma resection at our institution (Departments of Plastic Surgery and of Odontostomatology). Specimens were photographed under optical microscope and confocal laser scanning microscopy (CLSM) with ultra-high accuracy of detail, including depth of field. Patients were followed up for a minimum of 4 years and up to a maximum of 12 years, postsurgery. While all nonrecurring lesions showed intense fluorescence, six of the seven lesions with absence of fluorescence under CLSM recurred at a mean of 5.5 years after surgical excision. Among the re-excised lesions, 3 were diagnosed as malignant at the subsequent removal. Despite the limitation of a small cohort, CLSM appears to be a simple and low-cost technique to differentiate forms of neurofibromas with low and high risk of recurrence and malignant degeneration.
Collapse
|
2
|
Abstract
Proteus syndrome (PS) is a postnatal mosaic overgrowth disorder, progressive and disfiguring. It is clinically diagnosed according to the criteria reported by Biesecker
et al. We describe the case of a 49-year-old woman who presented with a 10-year history of pauci-symptomatic infiltrating plaque lesions on the sole and lateral margin of the left foot, which had been diagnosed as a keloid. The patient had a positive history for advanced melanoma and a series of subtle clinical signs, such as asymmetric face, scoliosis, multiple lipomas on the trunk, linear verrucous epidermal nevi, and hyperpigmented macules with a mosaic distribution. Even if the clinical presentation was elusive, she had enough criteria to be diagnosed with PS. This case describes the first evidence, to the best of our knowledge, of pauci-symptomatic PS in adulthood, reports its rare association with advanced melanoma, and illustrates the importance of even minor cutaneous clinical signs, especially when atypical, in formulating the diagnosis of a complex cutaneous condition such as this.
Collapse
Affiliation(s)
- Michelangelo Vestita
- Section of Plastic and Reconstructive Surgery, Department of Emergency and Organ Transplantation, University of Bari, Bari, 70124, Italy.,Section of Dermatology, Department of Biomedical Sciences and Clinical Oncology, University of Bari, Bari, 70124, Italy
| | - Angela Filoni
- Section of Dermatology, Department of Biomedical Sciences and Clinical Oncology, University of Bari, Bari, 70124, Italy
| | - Nicola Arpaia
- Section of Dermatology, Miulli Regional Hospital, Bari, 70021, Italy
| | - Grazia Ettorre
- Section of Dermatology, Department of Biomedical Sciences and Clinical Oncology, University of Bari, Bari, 70124, Italy
| | - Domenico Bonamonte
- Section of Dermatology, Department of Biomedical Sciences and Clinical Oncology, University of Bari, Bari, 70124, Italy
| |
Collapse
|
3
|
Guida M, Tommasi S, Strippoli S, Natalicchio MI, De Summa S, Pinto R, Cramarossa A, Albano A, Pisconti S, Aieta M, Ridolfi R, Azzariti A, Guida G, Lorusso V, Colucci G. The search for a melanoma-tailored chemotherapy in the new era of personalized therapy: a phase II study of chemo-modulating temozolomide followed by fotemustine and a cooperative study of GOIM (Gruppo Oncologico Italia Meridionale). BMC Cancer 2018; 18:552. [PMID: 29747595 PMCID: PMC5946485 DOI: 10.1186/s12885-018-4479-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 05/02/2018] [Indexed: 01/05/2023] Open
Abstract
Background It is frequently asked whether chemotherapy can still play a role in metastatic melanoma considering the effectiveness of the available drugs today, including antiCTLA4/antiPD1 immunotherapy and antiBRAF/antiMEK inhibitors. However, only approximately half of patients respond to these drugs, and the majority progress after 6–11 months. Therefore, a need for other therapeutic options is still very much apparent. We report the first large trial of a sequential full dose of fotemustine (FM) preceded by a low dose of temozolomide (TMZ) as a chemo-modulator in order to inactivate the DNA repair action of O(6)-methylguanine DNA-methyltransferase (MGMT). Primary endpoints were overall response and safety. We also evaluated specific biological parameters aiming to tailor these chemotherapies to selected patients. Methods A total of 69 consecutive patients were enrolled. The main features included a median age of 60 years (21–81) and M1c stage, observed in 74% of the patients, with brain metastases in 15% and high LDH levels in 42% of the patients. The following schedule was used: oral TMZ 100 mg/m2 on days 1 and 2 and FM iv 100 mg/m2 on day 2, 4 h after TMZ; A translational study aiming to analyse MGMT methylation status and base-excision repair (BER) gene expression was performed in a subset of 14 patients. Results We reported an overall response rate of 30.3% with 3 complete responses and a disease control rate of 50.5%. The related toxicity rate was low and mainly of haematological types. Although our population had a very poor prognosis, we observed a PFS of 6 months and an OS of 10 months. A non-significant correlation with response was found with the mean expression level of the three genes involved in the BER pathway (APE1, XRCC1 and PARP1), whereas no association was found with MGMT methylation status. Conclusion This schedule could represent a good alternative for patients who are not eligible for immune or targeted therapy or whose previous therapies have failed. Trial registration EUDRACT 2009–016487-36l; date of registration 23 June 2010. Electronic supplementary material The online version of this article (10.1186/s12885-018-4479-2) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Michele Guida
- Medical Oncology Department, National Cancer Research Centre "Giovanni Paolo II", Via O. Flacco, 65, 70124, Bari, Italy.
| | - Stefania Tommasi
- Molecular Genetics Laboratory and Radiology, National Cancer Research Centre "Giovanni Paolo II", Via O. Flacco, 65, 70124, Bari, Italy
| | - Sabino Strippoli
- Medical Oncology Department, National Cancer Research Centre "Giovanni Paolo II", Via O. Flacco, 65, 70124, Bari, Italy
| | - Maria Iole Natalicchio
- Laboratory of Molecular Oncology of Solid Tumors and Pharmacogenomics, Ospedali Riuniti, Viale Pinto, 1, 71122, Foggia, Italy
| | - Simona De Summa
- Molecular Genetics Laboratory and Radiology, National Cancer Research Centre "Giovanni Paolo II", Via O. Flacco, 65, 70124, Bari, Italy
| | - Rosamaria Pinto
- Molecular Genetics Laboratory and Radiology, National Cancer Research Centre "Giovanni Paolo II", Via O. Flacco, 65, 70124, Bari, Italy
| | - Antonio Cramarossa
- Radiology Department, National Cancer Research Centre "Giovanni Paolo II", Bari, Italy
| | - Anna Albano
- Medical Oncology Department, National Cancer Research Centre "Giovanni Paolo II", Via O. Flacco, 65, 70124, Bari, Italy
| | - Salvatore Pisconti
- Medical Oncology Department, San Giuseppe Moscati Hospital, Via per Martina Franca, 74010, Statte, Taranto, Italy
| | - Michele Aieta
- Medical Oncology Department, National Institute of Cancer, Via Padre Pio, 1. 85028 Rionero in Vulture, Potenza, Italy
| | - Ruggiero Ridolfi
- Medical Oncology Department, National Cancer Institute of Romagna (IRST), Via Piero Maroncelli, 40. 47014 Meldola, Forlì, Italy
| | - Amalia Azzariti
- Clinical and Preclinical Pharmacology Laboratory, National Cancer Research Centre "Giovanni Paolo II", Via O. Flacco, 65, 70124, Bari, Italy
| | - Gabriella Guida
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Piazza Giulio Cesare, 1, 70124, Bari, Italy
| | - Vito Lorusso
- Medical Oncology Department, National Cancer Research Centre "Giovanni Paolo II", Via O. Flacco, 65, 70124, Bari, Italy
| | - Giusepe Colucci
- Medical Oncology Department, National Cancer Research Centre "Giovanni Paolo II", Via O. Flacco, 65, 70124, Bari, Italy
| |
Collapse
|
4
|
Iannelli A, Ciancio F, Annoscia P, Vestita M, Perrotta RE, Giudice G, De Robertis M. Abdominoplasty with "Scarpa Fascia" preservation: Case Report. Int J Surg Case Rep 2018; 47:100-103. [PMID: 29754033 PMCID: PMC5994735 DOI: 10.1016/j.ijscr.2018.04.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 04/29/2018] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Abdominoplasty is one of the most performed operations in Plastic Surgery in the world. Postoperative seroma is one of the most frequently cited complications in literature. The aim of this study is to propose our experience with abdominoplasty with Scarpa Fascia preservationand compare it with recent scientific literature. PRESENTATION OF CASE We present the case of a 55-year-old woman underwent bariatric surgery in 2014, after which she lost 55kg of weight. We decided to perform an abdominoplasty with transposition of the umbilicus and preservation of the Scarpa Fascia. In fact, this technique seems to have a positive impact on reducing seroma formation, reducing the amount of drained fluids and the drainage time. DISCUSSION The saving of the adipose-fascial layer according to different Authors would allow the reduction of the volume of drained fluid, of the time spent by the drains and the average hospital stay. CONCLUSION The abdominoplasty with the Scarpa Fascia preservation is a safe, repeatable technique with good aesthetic results. The saving of deep adipose tissue allows to reduce the time and the quantity of drained liquids. In our experience patient undergoing this technique has shorter hospital stays with no complications.
Collapse
Affiliation(s)
- Antonio Iannelli
- Department of Plastic and Reconstructive Surgery, University of Bari, Italy
| | - Francesco Ciancio
- Department of Plastic and Reconstructive Surgery, University of Bari, Italy.
| | - Paolo Annoscia
- Department of Plastic and Reconstructive Surgery, University of Bari, Italy
| | | | | | - Giuseppe Giudice
- Department of Plastic and Reconstructive Surgery, University of Bari, Italy
| | | |
Collapse
|
5
|
Nacchiero E, Vestita M, Robusto F, Maruccia M, Annoscia P, Giudice G. Surgical management of tumor-positive interval node in melanoma patients: An observational study. Medicine (Baltimore) 2018; 97:e0584. [PMID: 29718857 PMCID: PMC6392795 DOI: 10.1097/md.0000000000010584] [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 presence of interval nodes (IN) in melanoma is testified in several studies and sometimes these lymph nodes can contain metastatic disease. Currently there are no guidelines about the management of patients with tumor-positive INs.We enrolled all patients affected by melanoma who underwent sentinel lymph node biopsy (SLNB) in a single institution. All patients with tumor-positive IN underwent the lymphadenectomy of the subsequent draining lymphatic field. Prognosis of IN+-patients was compared with subjects with positive SLNB in usual field through Kaplan-Meier and multivariate Cox regression analysis.Overall 596 subjects underwent lymphoscintigraphy and one or more INs were identified in 94 (15.8%) patients. The mean number of sentinel lymph nodes (SNs) identified per patient was significantly higher in patients with INs. Macrometastasis were more common in patients with INs. Matched pair analysis testified a statistically significant better prognosis in patients with positive-INs when compared with patients with positive SNs in usual side with the same demographic and clinical characteristics. These findings were confirmed both in analysis of 10-year recurrence-free period, then in 10-years overall survival analysis.Lymphadenectomy of the lymphatic draining field beyond positive-IN testify has proved to be a safe procedure that may improve prognosis in melanoma patients with tumor-positive INs. The better prognosis of patients with tumor-positive INs undergoing lymphadenectomy may be justified by the earlier treatment of lymphatic metastases. Further multicentric comparative studies are needed to evaluate possible impact of this procedure on prognosis of melanoma patients.
Collapse
|
6
|
Giudice G, Vestita M, Robusto F, Annoscia P, Ciancio F, Nacchiero E. Breast cancer cutaneous metastases mimicking Papilloma Cutis Lymphostatica. Biopsy to avoid pitfalls. Int J Surg Case Rep 2018; 46:31-33. [PMID: 29674005 PMCID: PMC6000767 DOI: 10.1016/j.ijscr.2018.03.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 03/19/2018] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION Secondary lymphedema is the most frequent long-term complication of axillary lymphadenectomy. It can result in complication as erysipelas, warts, Papilloma Cutis Lymphostatica (PCL), or angiosarcomas. Moreover, in women affected by breast cancer an accurate differential diagnosis among these conditions or complication related to radiation dermatitis or cutaneous metastasis is essential. PRESENTATION OF CASE We report the case of a 60-year-old postmenopausal Caucasian woman affected by secondary lymphedema following complete mastectomy for breast cancer. The patient after surgery was treated with radiotherapy, chemotherapy and hormone therapy, developing a lympedema of left arm after few months. These lesions had clinical typical features of PCL, but histopathological analysis revealed dermo-hypodermic metastasis of breast carcinoma. DISCUSSION The presence of skin lesions in secondary lymphedema after oncological lymphadenectomy requires an accurate differential diagnosis. In fact, these lesions can emulate degenerative or infective skin diseases; anyway, in patients affected by secondary lymphedema other less common conditions - as PLC, nodular-type lichen myxedematosus or Gottron's carcinoid papillomatosis - should be taken into account. CONCLUSION Our case reports the possibility that metastases of breast cancer might also mimic these conditions.
Collapse
Affiliation(s)
- Giuseppe Giudice
- Department of Plastic and Reconstructive Surgery, University of Bari, Italy
| | | | - Fabio Robusto
- Department of Plastic and Reconstructive Surgery, University of Bari, Italy
| | - Paolo Annoscia
- Department of Plastic and Reconstructive Surgery, University of Bari, Italy
| | - Francesco Ciancio
- Department of Plastic and Reconstructive Surgery, University of Bari, Italy.
| | - Eleonora Nacchiero
- Department of Plastic and Reconstructive Surgery, University of Bari, Italy
| |
Collapse
|
7
|
Maruccia M, Elia R, Nacchiero E, Vestita M, Giudice G. Reply to "melanoma pattern of care in ontario: A call for strategic alignment of multidisciplinary care)". J Surg Oncol 2018; 117:1611-1612. [PMID: 29448298 DOI: 10.1002/jso.25007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 01/10/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Michele Maruccia
- Section of Plastic and Reconstructive Surgery, Department of Emergency and Organ Transplantation, University of Bari, 11, Piazza Giulio Cesare, Bari, 70124, Italy
| | - Rossella Elia
- Section of Plastic and Reconstructive Surgery, Department of Emergency and Organ Transplantation, University of Bari, 11, Piazza Giulio Cesare, Bari, 70124, Italy
| | - Eleonora Nacchiero
- Section of Plastic and Reconstructive Surgery, Department of Emergency and Organ Transplantation, University of Bari, 11, Piazza Giulio Cesare, Bari, 70124, Italy
| | - Michelangelo Vestita
- Section of Plastic and Reconstructive Surgery, Department of Emergency and Organ Transplantation, University of Bari, 11, Piazza Giulio Cesare, Bari, 70124, Italy
| | - Giuseppe Giudice
- Section of Plastic and Reconstructive Surgery, Department of Emergency and Organ Transplantation, University of Bari, 11, Piazza Giulio Cesare, Bari, 70124, Italy
| |
Collapse
|
8
|
Giudice G, Robusto F, Vestita M, Annoscia P, Elia R, Nacchiero E. Single-stage excision and sentinel lymph node biopsy in cutaneous melanoma in selected patients: a retrospective case-control study. Melanoma Res 2017; 27:573-579. [PMID: 28574976 DOI: 10.1097/cmr.0000000000000370] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Sometimes, diagnostic excision of a primary melanoma would already necessitate skin grafting or transposition skin flaps, especially in areas with an esthetic or functional importance. The utility of sentinel lymph node biopsy (SLNB) after skin reconstruction is controversial. We carried out a single-institution retrospective case-control study. In patients with a wide primary lesion at high clinical-dermatoscopic suspicion for invasive melanoma in anatomical region in which a reconstruction with a skin graft or a flap is required, we proposed the performance of a confocal microscopy examination and an incisional biopsy of the primary lesion. If these diagnostic methodologies confirmed the suspicion of melanoma, lymphatic mapping was performed before the wide excision (WE) of the primary lesion, and WE and SLNB were performed during the same operative procedure. The database evaluation showed 496 patients who had undergone a previous complete local excision and a subsequent SLNB (two-stage group), whereas 61 patients underwent WE and SLNB during the same surgical time (one-stage group). Histological results of the excisional biopsy confirmed the diagnosis of melanoma in all patients of the one-stage group. The false-negative rate was lower in the one-stage group (5.5%) than in the two-stage group (16.7%). Patients of the two groups showed a similar recurrence-free and overall survival period even when corrected for clinic-demographical variables. The concomitant execution of SLNB and WE after confocal microscopy examination and incisional biopsy appears to be a safe and accurate procedure in patients with a wide primary melanoma that requires a skin flaps or a skin graft to cover the residual defect.
Collapse
Affiliation(s)
- Giuseppe Giudice
- aDepartment of Plastic and Reconstructive Surgery, Policlinico di Bari, Bari bDepartment of Clinical Pharmacology and Epidemiology, Mario Negri Sud Foundation, Santa Maria Imbaro, Italy
| | | | | | | | | | | |
Collapse
|
9
|
Cutaneous Metastases of Melanoma Affecting Exclusively Skin Graft Donor and Receiving Sites: A Novel Clinical Presentation. Dermatol Surg 2017; 44:464-466. [PMID: 28858934 DOI: 10.1097/dss.0000000000001283] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
10
|
Garrisi VM, Strippoli S, De Summa S, Pinto R, Perrone A, Guida G, Azzariti A, Guida M, Stefania T. Proteomic profile and in silico analysis in metastatic melanoma with and without BRAF mutation. PLoS One 2014; 9:e112025. [PMID: 25437182 PMCID: PMC4249853 DOI: 10.1371/journal.pone.0112025] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 10/11/2014] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Selective inhibitors of BRAF, vemurafenib and dabrafenib are the standard of care for metastatic melanoma patients with BRAF V600, while chemotherapy continued to be widely used in BRAF wild type patients. MATERIALS AND METHODS In order to discover novel candidate biomarkers predictive to treatment, serum of 39 metastatic melanoma vemurafenib (n = 19) or chemotherapy (n = 20) treated patients at baseline, at disease control and at progression, were analyzed using SELDI-TOF technology. In silico analysis was used to identify more significant peaks. RESULTS In patients with different BRAF status, we found 5 peptides significantly deregulated, with the down-regulation of the m/z 9176 peak strongly associated with BRAF mutation. At baseline as predictive biomarkers we identified 2 peptides - m/z 6411, 4075 - as significantly up-regulated in responders to chemotherapy and 4 peaks - m/z 5900, 12544, 49124 and 11724 - significantly up-regulated in longer vs shorter responders to vemurafenib. After response, 3 peptides (m/z 4658, 18639, and 9307) resulted significantly down regulated while 3 peptides m/z 9292, 7765 and 9176 appeared up-regulated respectively in chemotherapy and vemurafenib responder patients. In vemurafenib treated patients, 16 peaks appeared deregulated at progression compared to baseline time. In silico analysis identified proteins involved in invasiveness (SLAIN1) and resistance (ABCC12) as well as in the pathway of detoxification (NQO1) and apoptosis (RBM10, TOX3, MTEFD1, TSPO2). Proteins associated with the modulation of neuronal plasticity (RIN1) and regulatory activity factors of gene transcription (KLF17, ZBTB44) were also highlighted. CONCLUSION Our exploratory study highlighted some factors that deserve to be further investigated in order to provide a framework for improving melanoma treatment management through the development of biomarkers which could act as the strongest surrogates of the key biological events in stage IV melanoma.
Collapse
Affiliation(s)
- Vito Michele Garrisi
- National Cancer Research Centre, Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Sabino Strippoli
- National Cancer Research Centre, Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Simona De Summa
- National Cancer Research Centre, Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Rosamaria Pinto
- National Cancer Research Centre, Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Antonella Perrone
- National Cancer Research Centre, Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Gabriella Guida
- Dept. of Basic Medical Sciences, Faculty of Medicine and Surgery, School of Medicine, University of Bari, Bari, Italy
| | - Amalia Azzariti
- National Cancer Research Centre, Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Michele Guida
- National Cancer Research Centre, Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Tommasi Stefania
- National Cancer Research Centre, Istituto Tumori “Giovanni Paolo II”, Bari, Italy
- * E-mail:
| |
Collapse
|
11
|
Tomicic MT, Aasland D, Naumann SC, Meise R, Barckhausen C, Kaina B, Christmann M. Translesion polymerase η is upregulated by cancer therapeutics and confers anticancer drug resistance. Cancer Res 2014; 74:5585-96. [PMID: 25125662 DOI: 10.1158/0008-5472.can-14-0953] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
DNA repair processes are a key determinant of the sensitivity of cancer cells to DNA-damaging chemotherapeutics, which may induce certain repair genes as a mechanism to promote resistance. Here, we report the results of a screen for repair genes induced in cancer cells treated with DNA crosslinking agents, which identified the translesion polymerase η (PolH) as a p53-regulated target acting as one defense against interstrand crosslink (ICL)-inducing agents. PolH was induced by fotemustine, mafosfamide, and lomustine in breast cancer, glioma, and melanoma cells in vitro and in vivo, with similar inductions observed in normal cells such as lymphocytes and diploid fibroblasts. PolH contributions to the protection against ICL-inducing agents were evaluated by its siRNA-mediated attenuation in cells, which elevated sensitivity to these drugs in all tumor cell models. Conversely, PolH overexpression protected cancer cells against these drugs. PolH attenuation reduced repair of ICL lesions as measured by host cell reactivation assays and enhanced persistence of γH2AX foci. Moreover, we observed a strong accumulation of PolH in the nucleus of drug-treated cells along with direct binding to damaged DNA. Taken together, our findings implicated PolH in ICL repair as a mechanism of cancer drug resistance and normal tissue protection.
Collapse
Affiliation(s)
- Maja T Tomicic
- Department of Toxicology, University Medical Center Mainz, Mainz, Germany
| | - Dorthe Aasland
- Department of Toxicology, University Medical Center Mainz, Mainz, Germany
| | - Steffen C Naumann
- Department of Toxicology, University Medical Center Mainz, Mainz, Germany
| | - Ruth Meise
- Department of Toxicology, University Medical Center Mainz, Mainz, Germany
| | | | - Bernd Kaina
- Department of Toxicology, University Medical Center Mainz, Mainz, Germany
| | - Markus Christmann
- Department of Toxicology, University Medical Center Mainz, Mainz, Germany.
| |
Collapse
|
12
|
Gatti A, di Meo N, Stinco G, Malagoli M, Bonin S, Trevisan G. The role of O6-methylguanine-DNA methyltransferase in a long-surviving metastatic melanoma. J Cutan Med Surg 2014; 18:60-2. [PMID: 24377476 DOI: 10.2310/7750.2013.13045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Brain metastases commonly occur in patients with metastatic melanoma and are associated with a poor prognosis. Only a few chemotherapeutic agents have been shown to be potentially active. Resistance to chemotherapy is one of the main limitations to treatment. A key mechanism of resistance is O6-methylguanine-DNA methyltransferase (MGMT). The methylation of its promotor could inhibit the activity of this enzyme; consequently, it is very important to evaluate the methylation status of all available specimens. CASE REPORT We report the case of a long-surviving patient in whom combination treatment with an alkylating agent inhibiting MGMT, such as temozolomide, was useful in clinical control of the disease.
Collapse
|
13
|
|