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Heabah NAEG, Darwish SA, Ibrahim FMK. Prognostic significance of annexin A2 and tumor associated macrophages (TAMs) in metastatic renal cell carcinoma and their relation to Sunitinib resistance. J Immunoassay Immunochem 2024; 45:1-19. [PMID: 38018145 DOI: 10.1080/15321819.2023.2285501] [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] [Indexed: 11/30/2023]
Abstract
Sunitinib, an antiangiogenic tyrosine kinase inhibitor, is the main treatment for metastatic renal cell carcinoma (mRCC). Development of resistance is a major obstacle against therapy success. The aim of this study was to assess annexin A2 and CD163+ tumor associated macrophages (TAMs) immunohistochemical expression in 50 mRCC cases as regard to patients' prognosis and Sunitinib response. Also, to assess the correlation between annexin A2 and TAMs expression. High annexin A2 expression and TAMs density were associated with serum calcium level (P = 0.024 and 0.037, respectively), larger tumor size (P < 0.001), high tumor grade (P = 0.014 and <0.001, respectively), and the presence of tumor necrosis (P < 0.001). High annexin A2 and TAMs expressions were related to shorter patients' overall survival (P = 0.009 and 0.001, respectively) and progression-free survival (P = 0.003 and 0.001, respectively). Annexin A2 was correlated with TAMs density (r = 0.890). Annexin A2 and TAMs are associated with poor prognostic parameters in mRCC patients, including high nuclear grade, increased tumor size, and the presence of tumor necrosis, together with shorter patients' survivals and poor response to Sunitinib. Annexin A2 expression is correlated with TAMs density suggesting immunomodulatory role of annexin A2.
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Affiliation(s)
| | - Sara A Darwish
- Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Fatma MKh Ibrahim
- Pathology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
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Arabi TZ, Fawzy NA, Sabbah BN, Ouban A. Claudins in genitourinary tract neoplasms: mechanisms, prognosis, and therapeutic prospects. Front Cell Dev Biol 2023; 11:1308082. [PMID: 38188015 PMCID: PMC10771851 DOI: 10.3389/fcell.2023.1308082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 12/11/2023] [Indexed: 01/09/2024] Open
Abstract
Genitourinary (GU) cancers are among the most prevalent neoplasms in the world, with bladder cancers constituting 3% of global cancer diagnoses. However, several pathogenetic mechanisms remain controversial and unclear. Claudins, for example, have been shown to play a significant role in several cancers of the human body. Their role in GU cancers has not been extensively studied. Aberrant expression of claudins -1, -2, -3, -4, -7, and -11 has been expressed in urothelial cell carcinomas. In prostate cancers, altered levels of claudins -1, -2, -3, -4, and -5 have been reported. Furthermore, the levels of claudins -1, -2, -3, -4, -6, -7, -8, and -10 have been studied in renal cell carcinomas. Specifically, claudins -7 and -8 have proven especially useful in differentiating between chromophobe renal cell carcinomas and oncocytomas. Several of these claudins also correlate with clinicopathologic parameters and prognosis in GU cancers. Although mechanisms underpinning aberrant expression of claudins in GU cancers are unclear, epigenetic changes, tumor necrosis factor-ɑ, and the p63 protein have been implicated. Claudins also provide therapeutic value through tailored immunotherapy via molecular subtyping and providing therapeutic targets, which have shown positive outcomes in preclinical studies. In this review, we aim to summarize the literature describing aberrant expression of claudins in urothelial, prostatic, and renal cell carcinomas. Then, we describe the mechanisms underlying these changes and the therapeutic value of claudins. Understanding the scope of claudins in GU cancers paves the way for several diagnostic, prognostic, and therapeutic innovations.
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Affiliation(s)
| | | | | | - Abderrahman Ouban
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
- Department of Pathology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
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Lu H, Ye Q, Zheng C, Fan L, Xia X. Efficacy and safety analysis of TACE + sunitinib vs. sunitinib in the treatment of unresectable advanced renal cell carcinoma: a retrospective study. BMC Cancer 2023; 23:270. [PMID: 36964538 PMCID: PMC10037847 DOI: 10.1186/s12885-023-10754-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 03/20/2023] [Indexed: 03/26/2023] Open
Abstract
BACKGROUND Since renal cell carcinoma(RCC) is insensitive to conventional chemoradiotherapy, molecularly targeted drugs are commonly used treatments for unresectable advanced RCC. The aim of this study was to explore the efficacy and safety of TACE + sunitinib vs. sunitinib in the treatment of unresectable advanced RCC. METHODS This study included 98 patients with unresectable advanced RCC who were treated in Union Hospital from January 2015 to December 2018, and they met the criteria. They were divided into two groups: TACE + Sunitinib group (N = 47) and Sunitinib group (N = 51). We conducted a retrospective study to analyze the efficacy and safety of the two groups of patients. RESULTS (1)TACE + Sunitinib group: 4 patients (8.5%) achieved CR, 27 patients (57.5%) achieved PR, 9 patients (19.1%) achieved SD, and 7 patients (14.9%) achieved PD. Sunitinib group, 0 patients (0%) achieved CR, 20 patients (39.2%) achieved PR, 14 patients (27.5%) achieved SD, and 17 patients (33.3%) achieved PD. (P = 0.017) (2)ORR: TACE + sunitinib group, 66.0%; sunitinib group, 39.2%. (P = 0.009) (3)DCR: TACE + sunitinib group, 85.1%; sunitinib group, 66.7%. (P = 0.038) (4) In the TACE + sunitinib group, mPFS was 15.6 months, mOS was 35.0 months; in the sunitinib group, the mPFS was 10.9 months, mOS was 25.7 months. (P < 0.001) (5) The incidence of abdominal pain, fever, and vomiting was higher in the TACE + sunitinib group than in the sunitinib group (abdominal pain: 55.3% vs. 13.7%; fever: 61.7% vs. 7.8%; vomiting: 40.4% vs. 19.6%; P < 0.05). The technical success rate of TACE in TACE + Sunitinib group is 100%. CONCLUSIONS The TACE + sunitinib group had higher ORR and DCR, longer OS and PFS than the sunitinib alone group. TACE combined with sunitinib can play a complementary role and is a safe and effective treatment for advanced RCC.
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Affiliation(s)
- Haohao Lu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, Wuhan, 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Qing Ye
- Huazhong University of Science and Technology Hospital, Luoyu Road #1037, Wuhan, 430071, China
| | - Chuansheng Zheng
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, Wuhan, 430022, China.
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China.
| | - Li Fan
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
- Department of Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, Wuhan, 430022, China
| | - Xiangwen Xia
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, Wuhan, 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
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Bazarbashi S, Alzahrani A, Aljubran A, Elshenawy M, Mostafa Gad A, Maraiki F, Alzannan N, Elhassan T, Badran A. Combining Sunitinib and Bevacizumab for the Management of Advanced Renal Cell Carcinoma: A Phase I/II Trial. Oncologist 2023; 28:e254-e262. [PMID: 36648325 PMCID: PMC10166178 DOI: 10.1093/oncolo/oyac261] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 11/18/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Tyrosine kinase inhibitors remain a cornerstone in managing metastatic clear cell renal cell carcinoma (RCC). The 4 weeks on/2 weeks off intermittent sunitinib schedule could result in rebound angiogenesis and tumor progression in the 2-week rest period. We propose using bevacizumab during this period for continuous antiangiogenic effects. METHOD This was a phase I/II study of patients with advanced clear cell RCC. Sunitinib was given 50 mg daily on a 4-week on/2-week off schedule. Bevacizumab was given on day 29 of each sunitinib cycle. The bevacizumab starting dose was 5 mg/kg, and the dose was escalated to 10 mg if there was no dose-limiting toxicity. The primary endpoints were response rate and progression-free survival (PFS). RESULTS Twenty-five patients were recruited. The study was closed prematurely because of poor accrual. No dose-limiting toxicity was observed with 5 mg bevacizumab. One patient achieved a complete response, and 12 achieved a partial response (52% response rate). At a median follow-up of 42.2 months (95%, confidence interval (CI) 32.9 to 51.4), the median PFS duration was 16.5 months (95% CI 4.1-28.8), and the median overall survival time was 33.3 months (95% CI 19.4-47.3). Twenty-two patients (88%) had at least one grade 3 or 4 toxicity; the most common were thrombocytopenia (32%), lymphopenia (32%), hypertension (28%), and fatigue (24%). CONCLUSION Continuous angiogenesis blockade by adding bevacizumab to the sunitinib on/off regimen for advanced RCC yields significant antitumor activity with manageable increased toxicity.
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Affiliation(s)
- Shouki Bazarbashi
- Medical Oncology, Oncology Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Ahmed Alzahrani
- Medical Oncology, Oncology Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Ali Aljubran
- Medical Oncology, Oncology Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Mahmoud Elshenawy
- Medical Oncology, Oncology Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.,Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Menoufia University, Shebin El Kom, Egypt
| | - Ahmed Mostafa Gad
- Medical Oncology, Oncology Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.,Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Fatima Maraiki
- Department of Pharmacy, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Noura Alzannan
- Research Unit, Oncology Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Tusneem Elhassan
- Research Unit, Oncology Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Ahmed Badran
- Medical Oncology, Oncology Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.,Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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AL-Shammary AA, Hassan SUN, Alshammari FS, Alshammari MRR. A mixed-method analysis to identify the current focus, trends, and gaps in health science research in Saudi Arabia. Front Public Health 2023; 10:1028361. [PMID: 36711418 PMCID: PMC9880175 DOI: 10.3389/fpubh.2022.1028361] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 12/29/2022] [Indexed: 01/15/2023] Open
Abstract
Background The identification of current gaps in high-impact medical research in Saudi Arabia has international significance due to the trend of collaborative research in the field of health and medicine and the focus on knowledge-sharing. The purpose of this study is to assess the current focus, gaps, and priorities in health research in Saudi Arabia. Methods We employed a mixed-method research approach to achieve research objectives. (1) a systematic review of scientific research studies that are published between January 2020 to January 2022 in the top fifty Q1 medical science journals (2) a cross-sectional survey collected data from professionals employed in various organizations including the Ministry of Health (MoH), Ministry of Education (MoE), health organizations and universities, and the health industry. The close-ended survey questions inquired about the broad and specific areas of ongoing health research projects by these researchers and organizations in Saudi Arabia. Results The literature search on databases identified Science Direct (n = 741), Pub Med (n = 244) and Google Scholar (n = 15,600). After screening, (n = 26) original studies were selected for detailed evaluation and synthesis. Among these (n = 7) studied infectious diseases, (n = 7) cancer, and cardiac disease (n = 5). These studies focused on the etiology, treatment management and therapy outcomes of these health conditions. The survey was completed by (n = 384) respondents from these organizations. Most of the ongoing research projects focus on clinical sciences (27%) followed by basic sciences (24%) and public health research (24%) and a limited number of researchers were involved in healthcare management (2%) and informatics (2%). Most research focused on kidney and liver disorders (80%), obesity (74%), diabetes (74%), hormonal diseases (64%), and infectious disease (66%); it is equally important to design and fund research in some of the neglected areas including reproductive health (3%), physical and mental disabilities (1%). Conclusion Findings suggest that current gaps in original research from Saudi Arabia are in healthcare service quality, reproductive health, physical and mental disabilities and health informatics. Researchers and funding agencies and international collaborative projects should prioritize these areas.
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Affiliation(s)
- Asma Ayyed AL-Shammary
- Department of Public Health, College of Public Health and Health Informatics, University of Ha'il, Ha'il, Saudi Arabia
| | - Sehar un-Nisa Hassan
- Department of Public Health, College of Public Health and Health Informatics, University of Ha'il, Ha'il, Saudi Arabia,*Correspondence: Sehar un-Nisa Hassan ✉
| | - Fahad Saud Alshammari
- Department of Health Management, College of Public Health and Health Informatics, University of Ha'il, Ha'il, Saudi Arabia
| | - Modi Rataan Rifai Alshammari
- Department of Health Informatics, College of Public Health and Health Informatics, University of Ha'il, Ha'il, Saudi Arabia
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