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Duke ES, Bradford D, Sinha AK, Mishra-Kalyani PS, Lerro CC, Rivera D, Wearne E, Miller CP, Leighton J, Sabit H, Zhao H, Lane A, Scepura B, Pazdur R, Singh H, Kluetz PG, Donoghue M, Drezner N. US Food and Drug Administration Approval Summary: Eflornithine for High-Risk Neuroblastoma After Prior Multiagent, Multimodality Therapy. J Clin Oncol 2024; 42:3047-3057. [PMID: 38917371 PMCID: PMC11365752 DOI: 10.1200/jco.24.00546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 05/22/2024] [Accepted: 06/18/2024] [Indexed: 06/27/2024] Open
Abstract
On December 13, 2023, the US Food and Drug Administration (FDA) approved eflornithine (IWILFIN, US WorldMeds) to reduce the risk of relapse in adult and pediatric patients with high-risk neuroblastoma who have demonstrated at least a partial response to prior multiagent, multimodality therapy including anti-GD2 immunotherapy. The approval was based on an externally controlled trial (ECT) consisting of a single-arm trial, study 3(b), compared with an external control (EC) derived from a National Cancer Institute/Children's Oncology Group-sponsored clinical trial (Study ANBL0032) and supported by confirmatory evidence. In the protocol-specified primary analysis, the event-free survival hazard ratio (HR) was 0.48 (95% CI, 0.27 to 0.85) and overall survival HR was 0.32 (95% CI, 0.15 to 0.70). The most common adverse reactions (≥5%) were hearing loss, otitis media, pyrexia, pneumonia, and diarrhea. Notably, this is the first oncology drug approval which relies on an ECT as the primary clinical data to support substantial evidence of effectiveness. This was made possible by a distinctly high-quality, comparable EC data set with consistent treatment effect estimations demonstrated in multiple sensitivity and supportive analyses. Eflornithine's manageable safety profile and strong nonclinical and mechanistic data provided further support for the approval, and the evidentiary package was evaluated in the context of high unmet need in a rare, life-threatening cancer.
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Affiliation(s)
- Elizabeth S Duke
- Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD
| | - Diana Bradford
- Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD
| | - Arup K Sinha
- Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD
| | | | - Catherine C Lerro
- Oncology Center of Excellence, US Food and Drug Administration, Silver Spring, MD
| | - Donna Rivera
- Oncology Center of Excellence, US Food and Drug Administration, Silver Spring, MD
| | - Emily Wearne
- Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD
| | - Claudia P Miller
- Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD
| | - John Leighton
- Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD
| | - Hairat Sabit
- Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD
| | - Hong Zhao
- Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD
| | - Ashley Lane
- Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD
| | - Barbara Scepura
- Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD
| | - Richard Pazdur
- Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD
| | - Harpreet Singh
- Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD
- Oncology Center of Excellence, US Food and Drug Administration, Silver Spring, MD
| | - Paul G Kluetz
- Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD
- Oncology Center of Excellence, US Food and Drug Administration, Silver Spring, MD
| | - Martha Donoghue
- Oncology Center of Excellence, US Food and Drug Administration, Silver Spring, MD
| | - Nicole Drezner
- Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD
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2
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Magnier O, Schiff I, Cristante J, Chabre O, Veloso M, Bosson JL, Defachelles AS, Cordero C, Cao CD, Thebaud E, Drui D, Berlanga P, Dumont B, Chastagner P, Tandonnet J, Gambart M, Jannier S, Pluchart C, Andry L, Laithier V, Klein S, Carausu L, Akbaraly T, Probert J, Habert-Dantigny R, Plantaz D. Adolescent- and adult-onset neuroblastic tumor: A retrospective multicenter observational study of patients diagnosed in France between 2000 and 2020. Pediatr Blood Cancer 2024; 71:e31074. [PMID: 38778452 DOI: 10.1002/pbc.31074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 04/27/2024] [Accepted: 04/30/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Adult- and adolescent-onset neuroblastomas are rare, with no established therapy. In addition, rare pheochromocytomas may harbor neuroblastic components. This study was designed to collect epidemiological, diagnostic and therapeutic data in order to better define the characteristics of malignant peripheral neuroblastic tumors (MPNT) and composite pheochromocytomas (CP) with MPNT. PROCEDURE Fifty-nine adults and adolescents (aged over 15 years) diagnosed with a peripheral or composite neuroblastic tumor, who were treated in one of 17 institutions between 2000 and 2020, were retrospectively studied. RESULTS Eighteen patients with neuroblastoma (NB) or ganglioneuroblastoma (GNB) had locoregional disease, and 28 patients had metastatic stage 4 NB. Among the 13 patients with CP, 12 had locoregional disease. Fifty-eight percent of the population were adolescents and young adults under 24 years of age. The probability of 5-year event-free survival (EFS) was 40% (confidence interval: 27%-53%). CONCLUSIONS Outcomes were better for patients with localized tumor than for patients with metastases. For patients with localized tumor, in terms of survival, surgical treatment was the best therapeutic option. Multimodal treatment with chemotherapy, surgery, radiotherapy, and immunotherapy-based maintenance allowed long-term survival for some patients. Adolescent- and adult-onset neuroblastoma appeared to have specific characteristics associated with poorer outcomes compared to pediatric neuroblastoma. Nevertheless, complete disease control improved survival. The presence of a neuroblastic component in pheochromocytoma should be considered when making therapeutic management decisions. The development of specific tools/resources (Tumor Referral Board, Registry, biology, and trials with new agents or strategies) may help to improve outcomes for patients.
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Affiliation(s)
- Orlane Magnier
- Cancer and Blood Diseases Department, Medical Oncology, Grenoble Alpes University Hospital, Grenoble, France
| | - Isabelle Schiff
- Pediatric Oncology and Hematology Department, Grenoble Alpes University, Grenoble, France
| | - Justine Cristante
- Endocrinology Department, Grenoble Alpes University, Grenoble, France
| | - Olivier Chabre
- Endocrinology Department, Grenoble Alpes University, Grenoble, France
| | - Melanie Veloso
- Public Health and Biostatistics, Grenoble Alpes University Hospital, Grenoble, France
| | - Jean-Luc Bosson
- Public Health and Biostatistics, Grenoble Alpes University Hospital, Grenoble, France
| | | | - Camille Cordero
- Pediatric Oncology Department, Curie Institute, Paris, France
| | - Christine Do Cao
- Department of Endocrinology, Diabetology, and Metabolism, Lille University Hospital, Lille, France
| | - Estelle Thebaud
- Pediatric Oncology Department, Nantes University Hospital, Nantes, France
| | - Delphine Drui
- Endocrinology Department, Nantes University Hospital, Nantes, France
| | - Pablo Berlanga
- Pediatric and AYA Oncology Department, Gustave Roussy Institute, Paris, France
| | | | - Philippe Chastagner
- Pediatric Oncology and Hematology Department, Nancy University Hospital, Nancy, France
| | - Julie Tandonnet
- Pediatric Oncology Department, Bordeaux University Hospital, Bordeaux, France
| | - Marion Gambart
- Pediatric Oncology and Hematology Department, Toulouse University Hospital, Toulouse, France
| | - Sarah Jannier
- Pediatric Oncology Department, Strasbourg University Hospital, Strasbourg, France
| | - Claire Pluchart
- Pediatric Oncology and Hematology Department, Reims University Hospital, Reims, France
| | - Leslie Andry
- Pediatric Oncology Department, Amiens University Hospital, Amiens, France
| | - Véronique Laithier
- Pediatric Oncology Department, Besançon University Hospital, Besançon, France
| | - Sébastien Klein
- Pediatric Oncology Department, Besançon University Hospital, Besançon, France
| | - Liana Carausu
- Pediatric Oncology and Hematology Department, Brest University Hospital, Brest, France
| | - Tasmine Akbaraly
- Pediatric Oncology Department, Montpellier University Hospital, Montpellier, France
| | - Jamie Probert
- Pediatric Oncology and Hematology Department, Rennes University Hospital, Rennes, France
| | - Raphaelle Habert-Dantigny
- Cancer and Blood Diseases Department, Medical Oncology, Palliative Care Unit, Grenoble Alpes University, Grenoble, France
| | - Dominique Plantaz
- Pediatric Oncology and Hematology Department, Grenoble Alpes University, Grenoble, France
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3
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Gökçek-Saraç Ç, Çetin E, Ateş K, Özen Ş, Karakurt S. Different duration of exposure to a pulsed magnetic field can cause changes in mRNA expression of apoptotic genes in oleic acid-treated neuroblastoma cells. Int J Radiat Biol 2024; 100:1471-1480. [PMID: 39088733 DOI: 10.1080/09553002.2024.2386968] [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: 01/10/2024] [Revised: 06/20/2024] [Accepted: 07/22/2024] [Indexed: 08/03/2024]
Abstract
PURPOSE Neuroblastoma, a prevalent childhood tumor, poses significant challenges in therapeutic interventions, especially for high-risk cases. This study aims to fill a crucial gap in our understanding of neuroblastoma treatment by investigating the potential molecular impacts of short- and long-term pulsed magnetic field exposure on the neuronal apoptosis mechanism in an in vitro model of neuroblastoma treated with oleic acid (OA). MATERIALS AND METHODS Cells were cultured and divided into six following experimental groups: (I) Nontreated group (NT); (II) OA-treated group (OA); (III) Group treated with OA after being exposed to the pulsed magnetic field for 15-min (15 min PEMF + OA); (IV) Group treated with OA after being exposed to the pulsed magnetic field for 12 h (12 h PEMF + OA); (V) Group exposed to the pulsed magnetic field for 15 min (15 min PEMF); and (VI) Group exposed to the pulsed magnetic field for 12 h (12 h PEMF). Cell viability, rates of apoptosis, and mRNA levels of key apoptotic genes (TP53, Bcl2, Bax, and Caspase-3) were assessed. RESULTS Significant reductions in cell viability were observed, particularly in the group treated with OA following long-term pulsed magnetic field exposure. Flow cytometry revealed elevated apoptosis rates, notably in the early stages of apoptosis. qRT-PCR analysis demonstrated increased expression of cleaved Caspase-3, Bax/Bcl2 ratio, and TP53 in cells treated with OA following long-term pulsed magnetic field exposure, signifying enhanced apoptotic pathways. CONCLUSIONS The findings indicate that long-term pulsed magnetic field exposure and OA treatment exhibit potential synergistic effects leading to the induction of apoptosis in SH-SY5Y cells. We have concluded that stimulations of pulsed magnetic field have the potential to serve as an adjuvant therapy for oleic acid-based treatment of neuroblastoma.
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Affiliation(s)
- Çiğdem Gökçek-Saraç
- Department of Biomedical Engineering, Faculty of Engineering, Akdeniz University, Antalya, Turkey
| | - Ebru Çetin
- Department of Biomedical Engineering, Faculty of Engineering, Akdeniz University, Antalya, Turkey
| | - Kayhan Ateş
- Department of Electrical and Electronics Engineering, Faculty of Engineering, Akdeniz University, Antalya, Turkey
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Şükrü Özen
- Department of Electrical and Electronics Engineering, Faculty of Engineering, Akdeniz University, Antalya, Turkey
| | - Serdar Karakurt
- Department of Biochemistry, Faculty of Science, Selçuk University, Konya, Turkey
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4
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Maya-González C, Delgado-Vega AM, Taylan F, Lagerstedt Robinson K, Hansson L, Pal N, Fagman H, Puls F, Wessman S, Stenman J, Georgantzi K, Fransson S, Díaz De Ståhl T, Ek T, Palmer R, Tesi B, Kogner P, Martinsson T, Nordgren A. Occurrence of cancer in Marfan syndrome: Report of two patients with neuroblastoma and review of the literature. Am J Med Genet A 2024:e63812. [PMID: 38990105 DOI: 10.1002/ajmg.a.63812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 06/15/2024] [Accepted: 06/25/2024] [Indexed: 07/12/2024]
Abstract
Marfan syndrome (MFS) is an autosomal dominant connective tissue disorder caused by pathogenic variants in FBN1, with a hitherto unknown association with cancer. Here, we present two females with MFS who developed pediatric neuroblastoma. Patient 1 presented with neonatal MFS and developed an adrenal neuroblastoma with unfavorable tumor genetics at 10 months of age. Whole genome sequencing revealed a germline de novo missense FBN1 variant (NP_000129.3:p.(Asp1322Asn)), resulting in intron 32 inclusion and exon 32 retention. Patient 2 was diagnosed with classic MFS, caused by a germline de novo frameshift variant in FBN1 (NP_000129.3:p.(Cys805Ter)). At 18 years, she developed high-risk neuroblastoma with a somatic ALK pathogenic variant (NP_004295.2:p.(Arg1275Gln)). We identified 32 reported cases of MFS with cancer in PubMed, yet none with neuroblastoma. Among patients, we observed an early cancer onset and high frequency of MFS complications. We also queried cancer databases for somatic FBN1 variants, finding 49 alterations reported in PeCan, and variants in 2% of patients in cBioPortal. In conclusion, we report the first two patients with MFS and neuroblastoma and highlight an early age at cancer diagnosis in reported patients with MFS. Further epidemiological and functional studies are needed to clarify the growing evidence linking MFS and cancer.
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Affiliation(s)
- Carolina Maya-González
- Department of Molecular Medicine and Surgery, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
| | - Angelica Maria Delgado-Vega
- Department of Molecular Medicine and Surgery, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
| | - Fulya Taylan
- Department of Molecular Medicine and Surgery, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
| | - Kristina Lagerstedt Robinson
- Department of Molecular Medicine and Surgery, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
| | - Lina Hansson
- Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Niklas Pal
- Department of Pediatric Oncology, Astrid Lindgren Children's Hospital, Stockholm, Sweden
| | - Henrik Fagman
- Department of Laboratory Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Clinical Pathology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Florian Puls
- Department of Clinical Pathology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Sandra Wessman
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Pathology and Cancer Diagnostics, Karolinska University Hospital, Stockholm, Sweden
| | - Jakob Stenman
- Department of Pediatric Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Kleopatra Georgantzi
- Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Susanne Fransson
- Department of Laboratory Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Clinical Genetics and Genomics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Teresita Díaz De Ståhl
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Pathology and Cancer Diagnostics, Karolinska University Hospital, Stockholm, Sweden
| | - Torben Ek
- Children Cancer Center, Queen Silvia Children's Hospital, Gothenburg, Sweden
| | - Ruth Palmer
- Department of Medical Biochemistry and Cell Biology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Bianca Tesi
- Department of Molecular Medicine and Surgery, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Per Kogner
- Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Tommy Martinsson
- Department of Laboratory Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Clinical Genetics and Genomics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ann Nordgren
- Department of Molecular Medicine and Surgery, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
- Department of Clinical Genetics and Genomics, Karolinska University Hospital, Stockholm, Sweden
- Department of Laboratory Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Clinical Genetics and Genomics, Sahlgrenska University Hospital, Gothenburg, Sweden
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5
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Chu Y, Nayyar G, Tian M, Lee DA, Ozkaynak MF, Ayala-Cuesta J, Klose K, Foley K, Mendelowitz AS, Luo W, Liao Y, Ayello J, Behbehani GK, Riddell S, Cripe T, Cairo MS. Efficiently targeting neuroblastoma with the combination of anti-ROR1 CAR NK cells and N-803 in vitro and in vivo in NB xenografts. MOLECULAR THERAPY. ONCOLOGY 2024; 32:200820. [PMID: 38933492 PMCID: PMC11201149 DOI: 10.1016/j.omton.2024.200820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 05/02/2024] [Accepted: 05/22/2024] [Indexed: 06/28/2024]
Abstract
The prognosis for children with recurrent and/or refractory neuroblastoma (NB) is dismal. The receptor tyrosine kinase-like orphan receptor 1 (ROR1), which is highly expressed on the surface of NB cells, provides a potential target for novel immunotherapeutics. Anti-ROR1 chimeric antigen receptor engineered ex vivo expanded peripheral blood natural killer (anti-ROR1 CAR exPBNK) cells represent this approach. N-803 is an IL-15 superagonist with enhanced biological activity. In this study, we investigated the in vitro and in vivo anti-tumor effects of anti-ROR1 CAR exPBNK cells with or without N-803 against ROR1+ NB models. Compared to mock exPBNK cells, anti-ROR1 CAR exPBNK cells had significantly enhanced cytotoxicity against ROR1+ NB cells, and N-803 further increased cytotoxicity. High-dimensional analysis revealed that N-803 enhanced Stat5 phosphorylation and Ki67 levels in both exPBNK and anti-ROR1 CAR exPBNK cells with or without NB cells. In vivo, anti-ROR1 CAR exPBNK plus N-803 significantly (p < 0.05) enhanced survival in human ROR1+ NB xenografted NSG mice compared to anti-ROR1 CAR exPBNK alone. Our results provide the rationale for further development of anti-ROR1 CAR exPBNK cells plus N-803 as a novel combination immunotherapeutic for patients with recurrent and/or refractory ROR1+ NB.
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Affiliation(s)
- Yaya Chu
- Department of Pediatrics, New York Medical College, Valhalla, NY 10595, USA
| | - Gaurav Nayyar
- Department of Pediatrics, New York Medical College, Valhalla, NY 10595, USA
| | - Meijuan Tian
- Department of Pediatrics, New York Medical College, Valhalla, NY 10595, USA
| | - Dean A. Lee
- Department of Pediatric Hem/Onc/BMT, Nationwide Children’s Hospital, Columbus, OH 43205, USA
| | - Mehmet F. Ozkaynak
- Department of Pediatrics, New York Medical College, Valhalla, NY 10595, USA
| | | | - Kayleigh Klose
- Department of Pediatrics, New York Medical College, Valhalla, NY 10595, USA
| | - Keira Foley
- Department of Pediatrics, New York Medical College, Valhalla, NY 10595, USA
| | | | - Wen Luo
- Department of Pediatrics, New York Medical College, Valhalla, NY 10595, USA
| | - Yanling Liao
- Department of Pediatrics, New York Medical College, Valhalla, NY 10595, USA
| | - Janet Ayello
- Department of Pediatrics, New York Medical College, Valhalla, NY 10595, USA
| | - Gregory K. Behbehani
- Department of Internal Medicine, Division of Hematology, the Ohio State University; Columbus, OH 43210, USA
| | - Stanley Riddell
- Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Tim Cripe
- Department of Pediatric Hem/Onc/BMT, Nationwide Children’s Hospital, Columbus, OH 43205, USA
| | - Mitchell S. Cairo
- Department of Pediatrics, New York Medical College, Valhalla, NY 10595, USA
- Department of Medicine, New York Medical College, Valhalla, NY 10595, USA
- Department of Microbiology, Immunology and Pathology, New York Medical College, Valhalla, NY 10595, USA
- Department of Cell Biology and Anatomy, New York Medical College, Valhalla, NY 10595, USA
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6
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Khan D, Sagar S, Shamim SA, Kaushik P, Kumar R. An Unusual Occurrence of Metastases to Multiple Muscles in Neuroblastoma. Indian J Nucl Med 2024; 39:222-223. [PMID: 39291061 PMCID: PMC11404728 DOI: 10.4103/ijnm.ijnm_37_23] [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: 03/19/2023] [Revised: 04/18/2023] [Accepted: 05/06/2023] [Indexed: 09/19/2024] Open
Abstract
Neuroblastoma presenting with multiple muscles and subcutaneous tissue metastases is rarely reported in the literature. We would like to highlight such infrequent occurrences for increasing the clinical acumen of the medical fraternity with an aim to deliver proper therapy to patients.
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Affiliation(s)
- Dikhra Khan
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sambit Sagar
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Shamim Ahmed Shamim
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Prateek Kaushik
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Rakesh Kumar
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
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7
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Mlakar V, Dupanloup I, Gonzales F, Papangelopoulou D, Ansari M, Gumy-Pause F. 17q Gain in Neuroblastoma: A Review of Clinical and Biological Implications. Cancers (Basel) 2024; 16:338. [PMID: 38254827 PMCID: PMC10814316 DOI: 10.3390/cancers16020338] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/09/2024] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
Neuroblastoma (NB) is the most frequent extracranial solid childhood tumor. Despite advances in the understanding and treatment of this disease, the prognosis in cases of high-risk NB is still poor. 17q gain has been shown to be the most frequent genomic alteration in NB. However, the significance of this remains unclear because of its high frequency and association with other genetic modifications, particularly segmental chromosomal aberrations, 1p and 11q deletions, and MYCN amplification, all of which are also associated with a poor clinical prognosis. This work reviewed the evidence on the clinical and biological significance of 17q gain. It strongly supports the significance of 17q gain in the development of NB and its importance as a clinically relevant marker. However, it is crucial to distinguish between whole and partial chromosome 17q gains. The most important breakpoints appear to be at 17q12 and 17q21. The former distinguishes between whole and partial chromosome 17q gain; the latter is a site of IGF2BP1 and NME1 genes that appear to be the main oncogenes responsible for the functional effects of 17q gain.
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Affiliation(s)
- Vid Mlakar
- Cansearch Research Platform for Pediatric Oncology and Hematology, Faculty of Medicine, Department of Pediatrics, Gynecology and Obstetrics, University of Geneva, Rue Michel Servet 1, 1211 Geneva, Switzerland; (I.D.); (F.G.); (D.P.); (M.A.); (F.G.-P.)
| | - Isabelle Dupanloup
- Cansearch Research Platform for Pediatric Oncology and Hematology, Faculty of Medicine, Department of Pediatrics, Gynecology and Obstetrics, University of Geneva, Rue Michel Servet 1, 1211 Geneva, Switzerland; (I.D.); (F.G.); (D.P.); (M.A.); (F.G.-P.)
- Swiss Institute of Bioinformatics, Amphipôle, Quartier UNIL-Sorge, 1015 Lausanne, Switzerland
| | - Fanny Gonzales
- Cansearch Research Platform for Pediatric Oncology and Hematology, Faculty of Medicine, Department of Pediatrics, Gynecology and Obstetrics, University of Geneva, Rue Michel Servet 1, 1211 Geneva, Switzerland; (I.D.); (F.G.); (D.P.); (M.A.); (F.G.-P.)
- Division of Pediatric Oncology and Hematology, Department of Women, Child and Adolescent, University Geneva Hospitals, Rue Willy-Donzé 6, 1205 Geneva, Switzerland
| | - Danai Papangelopoulou
- Cansearch Research Platform for Pediatric Oncology and Hematology, Faculty of Medicine, Department of Pediatrics, Gynecology and Obstetrics, University of Geneva, Rue Michel Servet 1, 1211 Geneva, Switzerland; (I.D.); (F.G.); (D.P.); (M.A.); (F.G.-P.)
- Division of Pediatric Oncology and Hematology, Department of Women, Child and Adolescent, University Geneva Hospitals, Rue Willy-Donzé 6, 1205 Geneva, Switzerland
| | - Marc Ansari
- Cansearch Research Platform for Pediatric Oncology and Hematology, Faculty of Medicine, Department of Pediatrics, Gynecology and Obstetrics, University of Geneva, Rue Michel Servet 1, 1211 Geneva, Switzerland; (I.D.); (F.G.); (D.P.); (M.A.); (F.G.-P.)
- Division of Pediatric Oncology and Hematology, Department of Women, Child and Adolescent, University Geneva Hospitals, Rue Willy-Donzé 6, 1205 Geneva, Switzerland
| | - Fabienne Gumy-Pause
- Cansearch Research Platform for Pediatric Oncology and Hematology, Faculty of Medicine, Department of Pediatrics, Gynecology and Obstetrics, University of Geneva, Rue Michel Servet 1, 1211 Geneva, Switzerland; (I.D.); (F.G.); (D.P.); (M.A.); (F.G.-P.)
- Division of Pediatric Oncology and Hematology, Department of Women, Child and Adolescent, University Geneva Hospitals, Rue Willy-Donzé 6, 1205 Geneva, Switzerland
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8
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Valles-Colomer M, Manghi P, Cumbo F, Masetti G, Armanini F, Asnicar F, Blanco-Miguez A, Pinto F, Punčochář M, Garaventa A, Amoroso L, Ponzoni M, Corrias MV, Segata N. Neuroblastoma is associated with alterations in gut microbiome composition subsequent to maternal microbial seeding. EBioMedicine 2024; 99:104917. [PMID: 38104504 PMCID: PMC10731604 DOI: 10.1016/j.ebiom.2023.104917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 11/21/2023] [Accepted: 12/01/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND Neuroblastoma is the most frequent extracranial solid tumour in children, accounting for ∼15% of deaths due to cancer in childhood. The most common clinical presentation are abdominal tumours. An altered gut microbiome composition has been linked to multiple cancer types, and reported in murine models of neuroblastoma. Whether children with neuroblastoma display alterations in gut microbiome composition remains unexplored. METHODS We assessed gut microbiome composition by shotgun metagenomic profiling in an observational cross-sectional study on 288 individuals, consisting of patients with a diagnosis of neuroblastoma at disease onset (N = 63), healthy controls matching the patients on the main covariates of microbiome composition (N = 94), healthy siblings of the patients (N = 13), mothers of patients (N = 59), and mothers of the controls (N = 59). We examined taxonomic and functional microbiome composition and mother-infant strain transmission patterns. FINDINGS Patients with neuroblastoma displayed alterations in gut microbiome composition characterised by reduced microbiome richness, decreased relative abundances of 18 species (including Phocaeicola dorei and Bifidobacterium bifidum), enriched protein fermentation and reduced carbohydrate fermentation potential. Using machine learning, we could successfully discriminate patients from controls (AUC = 82%). Healthy siblings did not display such alterations but resembled the healthy control group. No significant differences in maternal microbiome composition nor mother-to-offspring transmission were detected. INTERPRETATION Patients with neuroblastoma display alterations in taxonomic and functional gut microbiome composition, which cannot be traced to differential maternal seeding. Follow-up research should include investigating potential causal links. FUNDING Italian Ministry of Health Ricerca Corrente and Ricerca Finalizzata 5 per mille (to MPonzoni); Fondazione Italiana Neuroblastoma (to MPonzoni); European Research Council (ERC-StG project MetaPG-716575 and ERC-CoG microTOUCH-101045015 to NS); the European H2020 program ONCOBIOME-825410 project (to NS); the National Cancer Institute of the National Institutes of Health 1U01CA230551 (to NS); the Premio Internazionale Lombardia e Ricerca 2019 (to NS); the MIUR Progetti di Ricerca di Rilevante Interesse Nazionale (PRIN) Bando 2017 Grant 2017J3E2W2 (to NS); EMBO ALTF 593-2020 and Knowledge Generation Project from the Spanish Ministry of Science and Innovation (PID2022-139328OA-I00) (to MV-C).
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Affiliation(s)
- Mireia Valles-Colomer
- Department CIBIO, University of Trento, Trento, Italy; MELIS Department, Pompeu Fabra University, Barcelona, Spain.
| | - Paolo Manghi
- Department CIBIO, University of Trento, Trento, Italy
| | - Fabio Cumbo
- Department CIBIO, University of Trento, Trento, Italy
| | | | | | | | | | | | | | | | | | - Mirco Ponzoni
- Laboratory of Experimental Therapies in Oncology, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Maria Valeria Corrias
- Laboratory of Experimental Therapies in Oncology, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Nicola Segata
- Department CIBIO, University of Trento, Trento, Italy; Department of Experimental Oncology, IEO European Institute of Oncology IRCCS, Milan, Italy.
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9
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Hymel E, Degarege A, Fritch J, Farazi E, Napit K, Coulter D, Schmidt C, Watanabe-Galloway S. Agricultural exposures and risk of childhood neuroblastoma: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:113193-113204. [PMID: 37858025 DOI: 10.1007/s11356-023-30315-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 10/03/2023] [Indexed: 10/21/2023]
Abstract
While neuroblastoma accounts for an estimated 8% of childhood cancers, it causes about 15% of childhood cancer deaths in the United States. The role of agricultural exposures in the development of neuroblastoma is unclear. We conducted a systematic review and meta-analysis of studies examining the relationship between agricultural exposures and neuroblastoma. MEDLINE, EMBASE, Scopus, and Google Scholar were searched in February 2022, identifying 742 publications. Seventeen articles met the inclusion criteria; all were published between 1985 and 2020 and included 14 case-control, one cross-sectional, and two cohort studies. Random and fixed effects models were used to calculate summary odds ratios (sORs) and 95% confidence intervals (CIs). An increased odds of developing neuroblastoma with parental exposure to any pesticides (sOR = 1.25, 95% CI: 1.03-1.48; 4 studies), insecticides (sOR = 1.55, 95% CI: 1.19-1.91; 3 studies), and residential exposure to crops/vegetables (sOR = 1.04, 95% CI: 1.01-1.06; 2 studies) was seen. Heterogeneity was low in all analyses, and no publication bias was evident. No significant associations were found with agricultural occupations, herbicides, and agricultural dusts. The studies were limited by exposure measurements and small sample sizes. Further studies are needed to explore mechanisms in the development of neuroblastoma in children with parental agricultural exposures, especially pesticides, and to improve methods of measuring agricultural-related exposures.
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Affiliation(s)
- Emma Hymel
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE, 68198, USA.
| | - Abraham Degarege
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Jordan Fritch
- Pediatric Hematology & Oncology, Sanford Children's Hospital, Sioux Falls, SD, USA
| | - Evi Farazi
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Krishtee Napit
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Don Coulter
- Department of Pediatrics, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Cynthia Schmidt
- McGoogan Health Sciences Library, University of Nebraska Medical Center, Omaha, NE, USA
| | - Shinobu Watanabe-Galloway
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE, 68198, USA
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10
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Feng L, Zhang S, Lu X, Yang X, Kan Y, Wang C, Zhang H, Wang W, Yang J. An Optimal Radiomics Nomogram Based on 18F-FDG PET/CT for Identifying Event-Free Survival in Pediatric Neuroblastoma. Acad Radiol 2023; 30:2309-2320. [PMID: 37393177 DOI: 10.1016/j.acra.2023.06.004] [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: 04/18/2023] [Revised: 05/13/2023] [Accepted: 06/02/2023] [Indexed: 07/03/2023]
Abstract
RATIONALE AND OBJECTIVES To investigate whether the 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) radiomics features that combine tumor and bone marrow can more accurately identify event-free survival (EFS) in pediatric neuroblastoma. MATERIALS AND METHODS A total of 126 patients with neuroblastoma were retrospectively included and randomly divided into the training and validation cohorts (7:3 ratio). Radiomics features were extracted to develop a tumor- and bone marrow-based radiomics risk score (RRS). The Kaplan-Meier method was used to evaluate the effectiveness of RRS in EFS risk stratification. Univariate and multivariate Cox regression analyses were used to determine independent clinical risk factors and construct the clinical models. The conventional PET model was constructed based on conventional PET parameters, and the noninvasive combined model integrated the RRS and the noninvasive independent clinical risk factors. The performance of the models was evaluated using C-index, calibration curves, and decision curve analysis (DCA). RESULTS A total of 15 radiomics features were selected to build the RRS. According to Kaplan-Meier analysis, there was a significant difference in EFS between the low-risk and high-risk groups as defined by the value of RRS (P < .05). The noninvasive combined model combining RRS and the International Neuroblastoma Risk Group stage achieved the best prognostic prediction of EFS, with a C-index of 0.810 and 0.783 in the training and validation cohorts, respectively. The calibration curves and DCA indicated that the noninvasive combined model had good consistency and clinical utility. CONCLUSION The 18F-FDG PET/CT-based radiomics of neuroblastoma allows a reliable evaluation of EFS. The performance of the noninvasive combined model was superior to the clinical and conventional PET models.
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Affiliation(s)
- Lijuan Feng
- Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, 95 Yong An Road, Xi Cheng District, Beijing 100050, China (L.F., S.Z., X.L., X.Y., Y.K., W.W., J.Y.)
| | - Shuxin Zhang
- Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, 95 Yong An Road, Xi Cheng District, Beijing 100050, China (L.F., S.Z., X.L., X.Y., Y.K., W.W., J.Y.)
| | - Xia Lu
- Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, 95 Yong An Road, Xi Cheng District, Beijing 100050, China (L.F., S.Z., X.L., X.Y., Y.K., W.W., J.Y.)
| | - Xu Yang
- Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, 95 Yong An Road, Xi Cheng District, Beijing 100050, China (L.F., S.Z., X.L., X.Y., Y.K., W.W., J.Y.)
| | - Ying Kan
- Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, 95 Yong An Road, Xi Cheng District, Beijing 100050, China (L.F., S.Z., X.L., X.Y., Y.K., W.W., J.Y.)
| | - Chao Wang
- SinoUnion Healthcare Inc., Beijing, China (C.W.)
| | - Hui Zhang
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China (H,Z,)
| | - Wei Wang
- Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, 95 Yong An Road, Xi Cheng District, Beijing 100050, China (L.F., S.Z., X.L., X.Y., Y.K., W.W., J.Y.)
| | - Jigang Yang
- Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, 95 Yong An Road, Xi Cheng District, Beijing 100050, China (L.F., S.Z., X.L., X.Y., Y.K., W.W., J.Y.).
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11
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Li M, Duan X, Li C, You D, Liu L. A novel clinical tool and risk stratification system for predicting the event-free survival of neuroblastoma patients: A TARGET-based study. Medicine (Baltimore) 2023; 102:e34925. [PMID: 37746942 PMCID: PMC10519501 DOI: 10.1097/md.0000000000034925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 07/11/2023] [Accepted: 08/03/2023] [Indexed: 09/26/2023] Open
Abstract
Neuroblastoma (NB), considered the most common non-intracranial solid tumor in children, accounts for nearly 8% of pediatric malignancies. This study aimed to develop a simple and practical nomogram to predict event-free survival (EFS) in NB patients and establish a new risk stratification system. In this study, 763 patients primarily diagnosed with NB in the Therapeutically Applicable Research to Generate Effective Treatments (TARGET) database were included and randomly assigned to a training set (70%) and a validation set (30%) in a 7:3 ratio. First, the independent prognostic factors of EFS for NB patients were identified through univariate and multivariate Cox regression analyses. Second, a nomogram was created based on these factors and was validated for calibration capability, discriminative, and clinical significance by C-curves, receiver operating characteristic (ROC) curves, and decision curve analysis. Finally, a new risk stratification system was established for NB patients based on the nomogram. The univariate Cox analysis demonstrated that NB patients with age at diagnosis >318 days, International Neuroblastoma Staging System (INSS) stage 4, DNA diploidy, MYCN amplification status, and children oncology group (COG) high-risk group had a relatively poor prognosis. However, according to the multivariate Cox regression analysis, only age, INSS stage, and DNA ploidy were independent predictive factors in NB patients regarding EFS, and a nomogram was created based on these factors. The area under the curve (AUC) values of the ROC curves for the 3-, 5-, and 10-year EFS of this nomogram were 0.681, 0.706, and 0.720, respectively. Additionally, the AUC values of individual independent prognostic factors of EFS were lower than those of the nomogram, suggesting that the developed nomogram had a higher predictive reliability for prognosis. In addition, a new risk stratification system was developed to better stratify NB patients and provide clinical practitioners with a better reference for clinical decision-making. NB patients' EFS could be predicted more accurately and easily through the constructed nomogram and event-occurrence risk stratification system, allowing clinicians to better differentiate NB patients and establish individualized treatment plans to maximize patient benefits.
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Affiliation(s)
- Mingzhen Li
- Department of Radiation Oncology, China-Japan Union Hospital of Jilin University, Nanguan District, Changchun, Jilin, People’s Republic of China
| | - Xiaoying Duan
- Department of Acupuncture and moxibustion, Second Hospital of Jilin University, Nanguan District, Changchun, Jilin, People’s Republic of China
| | - Chunyan Li
- Department of Endocrinology, The Affiliated Hospital of Beihua University, Chuanying District, Jilin, People’s Republic of China
| | - Di You
- Department of Anesthesiology, China-Japan Union Hospital of Jilin University, Nanguan District, Changchun, Jilin, People’s Republic of China
| | - Linlin Liu
- Department of Radiation Oncology, China-Japan Union Hospital of Jilin University, Nanguan District, Changchun, Jilin, People’s Republic of China
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12
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Bhardwaj N, Rohilla M, Trehan A, Bansal D, Kakkar N, Srinivasan R. MYCN amplification and International Neuroblastoma Risk Group stratification on fine-needle aspiration biopsy and their correlation to survival in neuroblastoma. J Clin Pathol 2023; 76:599-605. [PMID: 35414524 DOI: 10.1136/jclinpath-2022-208177] [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: 01/20/2022] [Accepted: 03/25/2022] [Indexed: 11/03/2022]
Abstract
AIMS Risk stratification as per the International Neuroblastoma Risk Group (INRG) stratification is important for management of neuroblastoma. INRG incorporates various parameters including histological category as per the International Neuroblastoma Pathology Classification (INPC) and MYCN amplification, which were evaluated in fine needle aspiration biopsy (FNAB) samples of neuroblastoma patients to ascertain their impact in our population. METHODS This was a retrospective study including 60 neuroblastoma cases diagnosed on FNAB, staged and stratified by INRG. Mitosis Karyorrhexis Index (MKI), INPC morphological category and MYCN status by fluorescence in situ hybridisation (n=46) were evaluated and correlated to outcome. RESULTS The mean age was 29 months (21 days to 9 years) with 27 and 33 children ≥18 months; male: female ratio of 1.6: 1; INRG stage-30(M), 20(L2), 2(L1) and 2(MS); INRG-36 high-risk, 13 intermediate-risk and 11 low-risk categories, respectively. MKI was high, intermediate and low in 39, 4 and 7 cases, respectively. INPC morphological type included 2 ganglioneuroblastomas and 58 neuroblastomas, graded further as 25 undifferentiated and 33 poorly differentiated tumours. MYCN was amplified in 48% (22/46) cases and correlated with undifferentiated morphology (p=0.01). At a mean follow-up of 469 (7-835) days, 22/50 were disease free and 28/50 had relapsed/died. The overall survival correlated with age (p=0.03), stage (p=0.01), INRG group (p=0.0001) and tumour grade (p=0.036). MYCN status independently did not correlate with age (p=0.5), INRG stage (p=0.2) and overall survival (p=0.4). CONCLUSION FNAB is a complete modality for diagnosing neuroblastoma and providing all information required for risk stratification as per INRG including MKI, MYCN amplification, INPC category. Our cohort with predominant high-risk neuroblastoma cases highlights regional variation.
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Affiliation(s)
- Neha Bhardwaj
- Pathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Manish Rohilla
- Cytology & Gynecological Pathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Amita Trehan
- Department of Pediatrics (Hematology-Oncology Division), Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Deepak Bansal
- Department of Pediatrics (Hematology-Oncology Division), Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Nandita Kakkar
- Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Radhika Srinivasan
- Cytology & Gynecological Pathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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13
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Magnier O, Chabre O, Schiff I, Sartelet H, Combaret V, Roux J, Sturm N, Berthozat C, Pavillet J, Plantaz D. Management of a Composite Pheochromocytoma (Pheochromocytoma/Neuroblastoma) in Adult Patient Recurring After Several Years: A Complex Case Report. J Adolesc Young Adult Oncol 2023; 12:604-610. [PMID: 36169643 DOI: 10.1089/jayao.2022.0059] [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: 11/13/2022] Open
Abstract
Pheochromocytoma/neuroblastoma composite tumors are rare entities for which little is known. We report an atypical case of a 39-year-old man with secondary bone locations of a composite tumor, 7 years after resection of adrenal neuroblastoma, with constitutional alteration of SWI/SNF-related, matrix-associated, actin-dependent regulator of chromatin, subfamily A, member 4 whose role is unknown. The diagnosis of a peripheral neuroblastic tumor in adulthood is difficult and even more so when it is a composite tumor. In the absence of a standard of care, management is varied and discussions about treatment modalities for these patients are complex.
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Affiliation(s)
- Orlane Magnier
- Department of Medical Oncology, Cancer and Blood Diseases, Grenoble Alpes University Hospital, Grenoble, France
| | - Olivier Chabre
- Department of Endocrinology, Grenoble Alpes University Hospital, Grenoble, France
| | - Isabelle Schiff
- Department of Pediatric Onco-Immuno-Hematology, Grenoble Alpes University Hospital, Grenoble, France
| | - Hervé Sartelet
- Department of Pathology, Grenoble Alpes University Hospital, Grenoble, France
- Department of Biopathology, Nancy University Hospital, University of Lorraine, Nancy, France
| | - Valérie Combaret
- Translational Research Laboratory, Léon Bérard Centre, Lyon, France
| | - Julie Roux
- Department of Nuclear Medicine, Grenoble Alpes University Hospital, Grenoble, France
| | - Nathalie Sturm
- Department of Biopathology, Grenoble Alpes University Hospital, Grenoble, France
| | - Claudine Berthozat
- Department of Medical Oncology, Cancer and Blood Diseases, Grenoble Alpes University Hospital, Grenoble, France
| | - Julien Pavillet
- Department of Medical Oncology, Cancer and Blood Diseases, Grenoble Alpes University Hospital, Grenoble, France
| | - Dominique Plantaz
- Department of Pediatric Onco-Immuno-Hematology, Grenoble Alpes University Hospital, Grenoble, France
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14
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Rahavi SM, Aletaha M, Farrokhi A, Lorentzian A, Lange PF, Maxwell CA, Lim CJ, Reid GSD. Adaptation of the Th-MYCN Mouse Model of Neuroblastoma for Evaluation of Disseminated Disease. Int J Mol Sci 2023; 24:12071. [PMID: 37569447 PMCID: PMC10419036 DOI: 10.3390/ijms241512071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/23/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
High-risk neuroblastoma remains a profound clinical challenge that requires eradication of neuroblastoma cells from a variety of organ sites, including bone marrow, liver, and CNS, to achieve a cure. While preclinical modeling is a powerful tool for the development of novel cancer therapies, the lack of widely available models of metastatic neuroblastoma represents a significant barrier to the development of effective treatment strategies. To address this need, we report a novel luciferase-expressing derivative of the widely used Th-MYCN mouse. While our model recapitulates the non-metastatic neuroblastoma development seen in the parental transgenic strain, transplantation of primary tumor cells from disease-bearing mice enables longitudinal monitoring of neuroblastoma growth at distinct sites in immune-deficient or immune-competent recipients. The transplanted tumors retain GD2 expression through many rounds of serial transplantation and are sensitive to GD2-targeted immune therapy. With more diverse tissue localization than is seen with human cell line-derived xenografts, this novel model for high-risk neuroblastoma could contribute to the optimization of immune-based treatments for this deadly disease.
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Affiliation(s)
- Seyed M. Rahavi
- Michael Cuccione Childhood Cancer Research Program, BC Children’s Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada
| | - Maryam Aletaha
- Michael Cuccione Childhood Cancer Research Program, BC Children’s Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada
| | - Ali Farrokhi
- Michael Cuccione Childhood Cancer Research Program, BC Children’s Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada
- Department of Pediatrics, University of British Columbia, 950 W28th Avenue, Vancouver, BC V5Z 4H4, Canada
| | - Amanda Lorentzian
- Michael Cuccione Childhood Cancer Research Program, BC Children’s Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada
| | - Philipp F. Lange
- Michael Cuccione Childhood Cancer Research Program, BC Children’s Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada
- Department of Pathology, University of British Columbia, 950 W28th Avenue, Vancouver, BC V5Z 4H4, Canada
| | - Christopher A. Maxwell
- Michael Cuccione Childhood Cancer Research Program, BC Children’s Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada
- Department of Pediatrics, University of British Columbia, 950 W28th Avenue, Vancouver, BC V5Z 4H4, Canada
| | - Chinten James Lim
- Michael Cuccione Childhood Cancer Research Program, BC Children’s Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada
- Department of Pediatrics, University of British Columbia, 950 W28th Avenue, Vancouver, BC V5Z 4H4, Canada
| | - Gregor S. D. Reid
- Michael Cuccione Childhood Cancer Research Program, BC Children’s Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada
- Department of Pediatrics, University of British Columbia, 950 W28th Avenue, Vancouver, BC V5Z 4H4, Canada
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15
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Li M, Duan X, You D, Liu L. Construction of a novel clinical nomogram to predict cancer-specific survival in patients with primary malignant adrenal tumors: a large population-based retrospective study. Front Med (Lausanne) 2023; 10:1184607. [PMID: 37305122 PMCID: PMC10249662 DOI: 10.3389/fmed.2023.1184607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 05/08/2023] [Indexed: 06/13/2023] Open
Abstract
Background Primary malignant adrenal tumors were rare and had a poor prognosis. This investigation aimed to create a useful clinical prediction nomogram to anticipate cancer-specific survival (CSS) of patients with a primary malignant adrenal tumor. Method This study included 1748 patients with malignant adrenal tumor diagnoses subjects from 2000 to 2019. These subjects were allocated randomly into training (70%) and validation (30%) cohorts. Patients with adrenal tumors underwent univariate and multivariate Cox regression analyses to identify the CSS-independent predictive biomarkers. Therefore, a nomogram was created depending on those predictors, and calibration curves, receiver operating characteristic (ROC) curves, and decision curve analysis (DCA) were used to assess the calibration capacity of the nomogram, discriminative power, and clinical efficiency, respectively. Afterward, a risk system for categorizing patients with adrenal tumors was established. Result The univariate and multivariate Cox analysis demonstrated the CSS-independent predictive factors, including age, tumor stage, size, histological type, and surgery. As a result, a nomogram was developed using these variables. For the 3-, 5-, and 10-year CSS of this nomogram, the values of the area under the curve (AUC) of the ROC curves were 0.829, 0.827, and 0.822, respectively. Furthermore, the AUC values of the nomogram were higher than those of the individual independent prognostic components of CSS, indicating that the nomogram had stronger prognostic prediction reliability. A novel risk stratification method was created to further improve patient stratification and give clinical professionals a better reference for clinical decision-making. Conclusion Through the developed nomogram and risk stratification method, the CSS of patients with malignant adrenal tumors could be predicted more precisely, assisting physicians to differentiate patients better and creating personalized treatment strategies to optimize patient benefits.
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Affiliation(s)
- Mingzhen Li
- Department of Radiation Oncology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Xiaoying Duan
- Department of Acupuncture and Moxibustion, Second Hospital of Jilin University, Changchun, China
| | - Di You
- Department of Anesthesiology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Linlin Liu
- Department of Radiation Oncology, China-Japan Union Hospital of Jilin University, Changchun, China
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16
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Lynch JD, Tomboc PJ. Neuroblastoma Masquerading as a Septic Hip Infection in a Three-Year-Old. Cureus 2023; 15:e36350. [PMID: 37082496 PMCID: PMC10111876 DOI: 10.7759/cureus.36350] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2023] [Indexed: 03/21/2023] Open
Abstract
Metastatic neuroblastoma to the bone and septic joint shares the same incidence in age and clinical symptomology. Here we discuss a three-year-old male who presented with anemia, persistent hip pain, and a refusal to bear weight. A thorough evaluation based on a broad differential diagnosis allowed for an expedient diagnosis of metastatic neuroblastoma. The timely diagnosis allowed for rapid enrolment in a children's oncology group (COG) clinical trial for advanced neuroblastoma. The patient tolerated the therapy without adverse events and remains in remission.
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17
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Shah HJ, Ruppell E, Bokhari R, Aland P, Lele VR, Ge C, McIntosh LJ. Current and upcoming radionuclide therapies in the direction of precision oncology: A narrative review. Eur J Radiol Open 2023; 10:100477. [PMID: 36785643 PMCID: PMC9918751 DOI: 10.1016/j.ejro.2023.100477] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 11/30/2022] [Accepted: 12/13/2022] [Indexed: 02/01/2023] Open
Abstract
As new molecular tracers are identified to target specific receptors, tissue, and tumor types, opportunities arise for the development of both diagnostic tracers and their therapeutic counterparts, termed "theranostics." While diagnostic tracers utilize positron emitters or gamma-emitting radionuclides, their theranostic counterparts are typically bound to beta and alpha emitters, which can deliver specific and localized radiation to targets with minimal collateral damage to uninvolved surrounding structures. This is an exciting time in molecular imaging and therapy and a step towards personalized and precise medicine in which patients who were either without treatment options or not candidates for other therapies now have expanded options, with tangible data showing improved outcomes. This manuscript explores the current state of theranostics, providing background, treatment specifics, and toxicities, and discusses future potential trends.
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Affiliation(s)
- Hina J. Shah
- Department of Radiology, Division of Nuclear Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA,Department of Imaging, Dana-Farber Cancer Institute, Boston, MA 02115, USA,Corresponding author at: Department of Radiology, Division of Nuclear Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA.
| | - Evan Ruppell
- Department of Radiology, University of Massachusetts Chan Medical School, Memorial Health Care, Worcester, MA 01655, USA
| | - Rozan Bokhari
- Department of Radiology, Beth Israel Lahey Health, Burlington, MA 01803, USA
| | - Parag Aland
- In-charge Nuclear Medicine and PET/CT, Infinity Medical Centre, Mumbai, Maharashtra 400015, India
| | - Vikram R. Lele
- Chief, Department of Nuclear Medicine and PET/CT, Jaslok Hospital and Research Centre, Mumbai, Maharashtra 400026, India
| | - Connie Ge
- University of Massachusetts Chan Medical School, Worcester, MA 01655, USA
| | - Lacey J. McIntosh
- Division of Oncologic and Molecular Imaging, University of Massachusetts Chan Medical School / Memorial Health Care, Worcester, MA 0165, USA
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Nutraceutical Preventative and Therapeutic Potential in Neuroblastoma: From Pregnancy to Early Childhood. Life (Basel) 2022; 12:life12111762. [DOI: 10.3390/life12111762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 10/26/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022] Open
Abstract
Neuroblastoma (NB) is a highly malignant embryonic extracranial solid tumor that arises from sympathoadrenal neuroblasts of neural crest origin. In addition to genetic factors, NB has been linked to maternal exposure to a variety of substances during pregnancy. Recent interest in the potential of nutrients to prevent cancer and reduce malignancy has resulted in the identification of several nutraceuticals including resveratrol, curcumin, and molecular components of garlic, which together with certain vitamins may help to prevent NB development. As NBs arise during fetal development and progress during early childhood, specific NB inhibiting nutraceuticals and vitamins could enhance the preventative influence of maternal nutrition and breast feeding on the development and early progression of NB. In this article, we review NB inhibitory nutraceuticals and vitamins, their mechanisms of action and expound their potential as maternal nutritional supplements to reduce NB development and progression during fetal growth and early childhood, whilst at the same time enhancing maternal, fetal, and infant health.
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Castle JT, Levy BE, Rodeberg DA. Abdominal Tumors. Surg Clin North Am 2022; 102:715-737. [DOI: 10.1016/j.suc.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Rufini V, Triumbari EKA, Garganese MC. Imaging adrenal medulla. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00014-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Chiaino E, Micucci M, Budriesi R, Mattioli LB, Marzetti C, Corsini M, Frosini M. Hibiscus Flower and Olive Leaf Extracts Activate Apoptosis in SH-SY5Y Cells. Antioxidants (Basel) 2021; 10:antiox10121962. [PMID: 34943065 PMCID: PMC8750347 DOI: 10.3390/antiox10121962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/02/2021] [Accepted: 12/03/2021] [Indexed: 01/15/2023] Open
Abstract
Compounds of natural origin may constitute an interesting tool for the treatment of neuroblastoma, the most prevalent extracranial solid tumor in children. PRES is a commercially available food supplement, composed of a 13:2 (w/w) extracts mix of Olea europaea L. leaves (OE) and Hibiscus sabdariffa L. flowers (HS). Its potential towards neuroblastoma is still unexplored and was thus investigated in human neuroblastoma SH-SY5Y cells. PRES decreased the viability of cells in a concentration-dependent fashion (24 h IC50 247.2 ± 31.8 µg/mL). Cytotoxicity was accompanied by an increase in early and late apoptotic cells (AV-PI assay) and sub G0/G1 cells (cell cycle analysis), ROS formation, reduction in mitochondrial membrane potential, and caspases activities. The ROS scavenger N-acetyl-L-cysteine reverted the cytotoxic effects of PRES, suggesting a key role played by ROS in PRES-mediated SH-SY5Y cell death. Finally, the effects of OE and HS extracts were singularly tested and compared to those of the corresponding mixture. OE- or HS-mediated cytotoxicity was always significantly lower than that caused by PRES, suggesting a synergic effect. In conclusion, the present findings highlight the potential of PRES for the treatment of neuroblastoma and offers the basis for a further characterization of the mechanisms underlying its effects.
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Affiliation(s)
- Elda Chiaino
- Dipartimento di Scienze della Vita, Università di Siena, Via Aldo Moro 2, 53100 Siena, Italy;
| | - Matteo Micucci
- Dipartimento di Farmacia e Biotecnologie, Alma Mater Studiorum-Università di Bologna, Via Belmeloro, 40126 Bologna, Italy; (M.M.); (R.B.); (L.B.M.)
- UniCamillus-Saint Camillus International University of Health Sciences, Via di Sant’Alessandro, 800131 Rome, Italy
| | - Roberta Budriesi
- Dipartimento di Farmacia e Biotecnologie, Alma Mater Studiorum-Università di Bologna, Via Belmeloro, 40126 Bologna, Italy; (M.M.); (R.B.); (L.B.M.)
| | - Laura Beatrice Mattioli
- Dipartimento di Farmacia e Biotecnologie, Alma Mater Studiorum-Università di Bologna, Via Belmeloro, 40126 Bologna, Italy; (M.M.); (R.B.); (L.B.M.)
| | | | - Maddalena Corsini
- Dipartimento di Biotecnologie Chimica e Farmacia, Università di Siena, Via Aldo Moro 2, 53100 Siena, Italy;
| | - Maria Frosini
- Dipartimento di Scienze della Vita, Università di Siena, Via Aldo Moro 2, 53100 Siena, Italy;
- Correspondence: ; Tel.: +390577-235-355
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Schaafsma E, Jiang C, Cheng C. B cell infiltration is highly associated with prognosis and an immune-infiltrated tumor microenvironment in neuroblastoma. JOURNAL OF CANCER METASTASIS AND TREATMENT 2021; 7. [PMID: 34458583 PMCID: PMC8389852 DOI: 10.20517/2394-4722.2021.72] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Aim Neuroblastoma is the most common extracranial solid tumor in children. Recent advances in immunotherapy Approaches, including in neuroblastoma, have shown the important role of the immune system in mounting an effective anti-tumor response. In this study, we aimed to provide a comprehensive investigation of immune cell infiltration in neuroblastoma utilizing a large number of gene expression datasets. Methods We inferred immune cell infiltration using an established immune inference method and evaluated the association between immune cell abundance and patient prognosis as well as common chromosomal abnormalities found in neuroblastoma. In addition, we evaluated co-infiltration patterns among distinct immune cell types. Results The infiltration of naïve B cells, NK cells, and CD8+ T cells was associated with improved patient prognosis. Naïve B cells were the most consistent indicator of prognosis and associated with an active immune tumor microenvironment. Patients with high B cell infiltration showed high co-infiltration of other immune cell types and the enrichment of immune-related pathways. The presence of high B cell infiltration was associated with both recurrence-free and overall survival, even after adjusting for clinical variables. Conclusion In this study, we have provided a comprehensive evaluation of immune cell infiltration in neuroblastoma using gene expression data. We propose an important role for B cells in the neuroblastoma tumor microenvironment and suggest that B cells can be used as a prognostic biomarker to predict recurrence-free and overall survival independently of currently utilized prognostic variables.
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Affiliation(s)
- Evelien Schaafsma
- Department of Molecular and Systems Biology, Dartmouth College, Hanover, NH 03755, USA.,Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, NH 03756, USA
| | - Chongming Jiang
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Chao Cheng
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, NH 03756, USA.,Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA.,Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX 77030, USA.,The Institute for Clinical and Translational Research, Baylor College of Medicine, Houston TX, 77030, USA
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Voglino V, Persano G, Crocoli A, Castellano A, Serra A, Giordano U, Natali GL, Di Paolo PL, Martucci C, Stracuzzi A, Inserra A. Hemorrhage During Induction Chemotherapy in Neuroblastoma: Additional Risk Factors in High-Risk Patients. Front Pediatr 2021; 9:761896. [PMID: 34869118 PMCID: PMC8635199 DOI: 10.3389/fped.2021.761896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 10/11/2021] [Indexed: 12/14/2022] Open
Abstract
Background: Neuroblastoma is the most common solid extracranial tumor in children. Patients affected by neuroblastoma are stratified into low, intermediate, and high risk in terms of event-free and overall survival. Some high-risk patients have an additional risk of acute hemorrhagic complications during induction chemotherapy. Aim: To find easily and rapidly assessed parameters that help clinicians identify those patients affected by high-risk neuroblastoma who have an additional risk of hemorrhagic complications. Methods: The clinical notes of patients diagnosed with high-risk neuroblastoma from January 2013 until February 2021 were retrospectively reviewed. Clinical, demographic and laboratory data, biological characteristics of the tumor, and information about treatment and hospital stay were identified. Results: In the examined period, 44 patients were diagnosed with high-risk neuroblastoma. Four of these patients had hemorrhagic complications within 2-7 days after the initiation of induction chemotherapy; two patients had hemothorax, one patient had hemoperitoneum and one patient had hemothorax and hemoperitoneum. The patient with isolated hemoperitoneum was treated with blood components transfusions, clotting factors and colloids infusions; the three patients with hemothorax underwent thoracostomy tube placement and respiratory support. At initial presentation, patients who suffered from hemorrhagic complications had a higher degree of hypertension (stage 2, p = 0.0003), higher levels of LDH (median 3,745 U/L, p = 0.009) and lower levels of hemoglobin (mean 7.6 gr/dl, p = 0.0007) compared to other high-risk patients. Conclusions: A subgroup of "additional" high-risk patients can be identified within the high-risk neuroblastoma patients based on mean arterial pressure, LDH levels and hemoglobin levels at presentation. Further studies to define cut-off values and optimal management strategies for these patients are needed.
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Affiliation(s)
- Valerio Voglino
- Surgical Oncology-General and Thoracic Surgery Unit, Department of Surgery, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Giorgio Persano
- Surgical Oncology-General and Thoracic Surgery Unit, Department of Surgery, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Alessandro Crocoli
- Surgical Oncology-General and Thoracic Surgery Unit, Department of Surgery, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Aurora Castellano
- Onco-Hematology Unit, Department of Onco-Hematology and Gene Therapy, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Annalisa Serra
- Onco-Hematology Unit, Department of Onco-Hematology and Gene Therapy, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Ugo Giordano
- Sport and Hypertension Medicine Unit, Department of Cardiac Surgery, Cardiology, Heart and Lung Transplant, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Gian Luigi Natali
- Radiology Unit, Department of Diagnostic Imaging, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Pier Luigi Di Paolo
- Radiology Unit, Department of Diagnostic Imaging, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Cristina Martucci
- Surgical Oncology-General and Thoracic Surgery Unit, Department of Surgery, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Alessandra Stracuzzi
- Pathology Unit, Department of Laboratories, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Alessandro Inserra
- Surgical Oncology-General and Thoracic Surgery Unit, Department of Surgery, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
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