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Germanà E, Pepe L, Pizzimenti C, Ballato M, Pierconti F, Tuccari G, Ieni A, Giuffrè G, Fadda G, Fiorentino V, Martini M. Programmed Cell Death Ligand 1 (PD-L1) Immunohistochemical Expression in Advanced Urothelial Bladder Carcinoma: An Updated Review with Clinical and Pathological Implications. Int J Mol Sci 2024; 25:6750. [PMID: 38928456 PMCID: PMC11203574 DOI: 10.3390/ijms25126750] [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: 05/12/2024] [Revised: 06/17/2024] [Accepted: 06/18/2024] [Indexed: 06/28/2024] Open
Abstract
The management of advanced bladder carcinoma involves a multidisciplinary approach, but the prognosis remains poor for many patients. The immune system plays a crucial role in this disease, influencing both tumor development and response to treatment, and exploiting the immune system against the tumor can be a valuable strategy to destroy neoplastic cells. This is the biological principle underlying Bacillus Calmette-Guérin (BCG) use and, more recently, immune checkpoint inhibitors (ICIs), like PD-1 (programmed death-1)/PD-L1 (programmed death-ligand 1) inhibitors. In fact, one of the best studied immune checkpoints is represented by the PD-1/PD-L1 axis, which is a well-known immune escape system adopted by neoplastic bladder cells. PD-L1 expression has been associated with a higher pathologic stage and has shown prognostic value in bladder carcinoma. Interestingly, high-grade bladder cancers tend to express higher levels of PD-1 and PD-L1, suggesting a potential role of such an axis in mediating disease progression. Immunotherapy with PD-1 and PD-L1 inhibitors has therefore emerged as a valuable treatment option and has shown efficacy in advanced bladder cancer patients, with high PD-L1 expression levels associated with better treatment responses. Our review aims to provide a comprehensive overview of the role of PD-L1 in advanced bladder cancer, focusing on its implications for treatment decisions and the prediction of treatment response. Overall, our work aims to contribute to the understanding of PD-L1 as a predictive biomarker and highlight its role in shaping therapeutic approaches for advanced bladder cancer.
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Affiliation(s)
- Emanuela Germanà
- Department of Biomedical, Dental, Morphological and Functional Imaging Sciences, University of Messina, 98125 Messina, Italy;
| | - Ludovica Pepe
- Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, 98125 Messina, Italy; (L.P.); (M.B.); (G.T.); (A.I.); (G.G.); (G.F.)
| | | | - Mariagiovanna Ballato
- Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, 98125 Messina, Italy; (L.P.); (M.B.); (G.T.); (A.I.); (G.G.); (G.F.)
| | - Francesco Pierconti
- Department of Women, Children and Public Health Sciences, Catholic University of the Sacred Heart, Agostino Gemelli IRCCS University Hospital Foundation, 00168 Rome, Italy;
| | - Giovanni Tuccari
- Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, 98125 Messina, Italy; (L.P.); (M.B.); (G.T.); (A.I.); (G.G.); (G.F.)
| | - Antonio Ieni
- Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, 98125 Messina, Italy; (L.P.); (M.B.); (G.T.); (A.I.); (G.G.); (G.F.)
| | - Giuseppe Giuffrè
- Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, 98125 Messina, Italy; (L.P.); (M.B.); (G.T.); (A.I.); (G.G.); (G.F.)
| | - Guido Fadda
- Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, 98125 Messina, Italy; (L.P.); (M.B.); (G.T.); (A.I.); (G.G.); (G.F.)
| | - Vincenzo Fiorentino
- Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, 98125 Messina, Italy; (L.P.); (M.B.); (G.T.); (A.I.); (G.G.); (G.F.)
| | - Maurizio Martini
- Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, 98125 Messina, Italy; (L.P.); (M.B.); (G.T.); (A.I.); (G.G.); (G.F.)
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Lim KYY, Chu K, Rajarubendra N, Huang J, Pook D, Manohar P, Harper M, Donnellan S, Ranasinghe W. Patterns of chemotherapy use in muscle-invasive bladder cancer in a tertiary centre. Bladder (San Franc) 2023; 10:e21200013. [PMID: 38163008 PMCID: PMC10754695 DOI: 10.14440/bladder.2023.872] [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: 10/13/2023] [Revised: 11/27/2023] [Accepted: 11/28/2023] [Indexed: 01/03/2024] Open
Abstract
Objectives Although neoadjuvant chemotherapy (NAC) has been demonstrated to have significant benefits to survival in patients with muscle-invasive bladder cancer (MIBC), the current utilization of NAC in Australia is unknown. The aim of this study was to evaluate the patterns of neoadjuvant and adjuvant chemotherapy (AC) use in patients undergoing cystectomy for MIBC at a large tertiary institution in Australia. Methods A retrospective study was conducted using data of patients who underwent a radical cystectomy (RC) at a high-volume centre for MIBC between 2011 and 2021. Results Of 69 patients who had a cystectomy for ≥ pT2 bladder cancer, 73.9% were eligible for NAC. However, of those eligible, only five patients received NAC (9.8%). Of the total patients who were eligible for AC, only 44.4% received postoperative chemotherapy. Common reasons for the lack of uptake were due to patients being unfit or declining treatment. There was no difference in progression-free survival or overall survival in those who received NAC and AC. Conclusions The majority of patients undergoing RC for MIBC received AC compared to NAC, reflecting the real-world challenge of NAC uptake. This highlights the need for ongoing improvements in selection and usage of NAC and less reliance of AC utilization post RC.
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Affiliation(s)
- Kylie Yen-Yi Lim
- Department of Urology, Monash Health, Casey, VIC, Australia
- School of Clinical Sciences, Monash University, Clayton, VIC, Australia
| | - Kevin Chu
- Department of Urology, Monash Health, Casey, VIC, Australia
| | | | - James Huang
- Department of Urology, Monash Health, Casey, VIC, Australia
| | - David Pook
- Department of Oncology, Monash Health, Clayton, VIC, Australia
| | - Paul Manohar
- Department of Urology, Monash Health, Casey, VIC, Australia
| | - Matthew Harper
- Department of Urology, Monash Health, Casey, VIC, Australia
| | | | - Weranja Ranasinghe
- Department of Urology, Monash Health, Casey, VIC, Australia
- Department of Anatomy and Developmental Biology, Monash University, Clayton, VIC, Australia
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Wang Y, Qu H, Xu B, Wu J, Lu K, Liu C, Chen S, Chen M. Expression of FOXA1 Is Associated with the Tumor-Infiltrating M2 Macrophage, Cytotoxic T Lymphocyte, and Effect of Chemotherapy in Bladder Cancer. Urol Int 2023; 107:58-63. [PMID: 34706362 PMCID: PMC9909707 DOI: 10.1159/000519129] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 07/21/2021] [Indexed: 01/29/2023]
Abstract
PURPOSE Cisplatin-containing combination chemotherapy has been the standard of care since the late 1980s, but the response rate is <50%. Studies have shown that the efficiency of chemotherapy differs among molecular subtypes of bladder cancer. In this study, we aimed to correlate FOXA1, a marker for differentiation of the basal and luminal subtypes, with tumor immune cell infiltration and the effect of chemotherapy in bladder cancer. MATERIALS AND METHODS Eighty-three patients with bladder cancer treated with chemotherapy were reviewed. Clinicopathological variables for each case were recorded. FOXA1, M2 tumor-associated macrophage (TAM), dendritic cell (DC), and cytotoxic T lymphocyte (CTL) were examined by immunohistochemistry. The relationship between FOXA1, immune cell infiltration, and clinical response to chemotherapy was assessed. RESULTS The overall objective response rate was 34%. The objective response rate for tumors with lower FOXA1 expression was 58% and for tumors with higher FOXA1 expression was 12%. Tumors with infiltrated M2 TAM proportion <3% had a higher objective response rate compared with infiltrated M2 TAM proportion >3% tumors (46% vs. 21%, p = 0.02). Tumors with infiltrated CTL proportion >5% had a higher objective response rate compared with infiltrated CTL proportion <5% tumors (50% vs. 17%, p = 0.002). DCs showed no significant differences. We found that the objective response rate for tumors with lower FOXA1 expression, proportion <3% M2 TAM infiltration, and proportion >5% CTL infiltration is 82%. Lower FOXA1 expression was associated with low M2 TAM infiltration and high CTL infiltration. CONCLUSIONS Thus, we showed that in patients with bladder cancer who received chemotherapy, the higher clinical response rate is associated with low FOXA1 expression, low M2 TAM infiltration, and high CTL infiltration.
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Affiliation(s)
- Yiduo Wang
- Department of Urology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China, .,Institute of Urology, Surgical Research Center, Southeast University Medical School, Nanjing, China,
| | - Huan Qu
- Health Management Center, Zhongda Hospital, Southeast University, Nanjing, China
| | - Bin Xu
- Department of Urology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China,Institute of Urology, Surgical Research Center, Southeast University Medical School, Nanjing, China
| | - Jianping Wu
- Department of Urology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China,Institute of Urology, Surgical Research Center, Southeast University Medical School, Nanjing, China
| | - Kai Lu
- Department of Urology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China,Institute of Urology, Surgical Research Center, Southeast University Medical School, Nanjing, China
| | - Chunhui Liu
- Department of Urology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China,Institute of Urology, Surgical Research Center, Southeast University Medical School, Nanjing, China
| | - Shuqiu Chen
- Department of Urology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China,Institute of Urology, Surgical Research Center, Southeast University Medical School, Nanjing, China
| | - Ming Chen
- Department of Urology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China,Institute of Urology, Surgical Research Center, Southeast University Medical School, Nanjing, China,*Ming Chen,
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De Carlo C, Valeri M, Rudini N, Zucali PA, Cieri M, Elefante GM, D’antonio F, Hurle R, Giordano L, Bressan A, Lazzeri M, Perrino M, Guazzoni G, Terracciano LM, Colombo P. Intratumoral Switch of Molecular Phenotype and Overall Survival in Muscle Invasive Bladder Cancer. Cancers (Basel) 2022; 14:cancers14133256. [PMID: 35805028 PMCID: PMC9265094 DOI: 10.3390/cancers14133256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/23/2022] [Accepted: 06/29/2022] [Indexed: 02/06/2023] Open
Abstract
In recent years, immunohistochemical protein expression was studied as a surrogate to the molecular classification of bladder cancer, although no tissue biomarkers are available for clinical use to predict survival or the response to neoadjuvant chemotherapy (CT) in UC, as the literature produced conflicting results. This retrospective study included TURB specimens harboring foci of HG pT2 muscle-invasive bladder carcinoma (MIBC) from 251 patients who subsequently underwent radical cystectomy. We performed immunohistochemical analysis on tumor samples, for relevant gene-expression-based markers for basal type (CD44, CK5/6) and luminal type (CK20 and pPARγ). Piescore, investigated in both non-muscle-invasive (NMI) and muscle-invasive (MI) components of the tumor, divided basal and luminal UC-types when at least three of the four markers were consistent with a specific phenotype, mixed types if one/two luminal and basal markers were present simultaneously, and neu-like types when all four markers investigated were negative. Eighteen selected cases were also investigated with RT-PCR to validate, and to increase the specificity of, the immunohistochemical results. We observe an immunophenotypical difference in the NMI and MI components in 96/251 UC patients (38.25%): half of tumors (44/96 cases) have a transition to basal, 36.46% (35/96 cases) to neu-like, 12.5% (12/96 cases) to mixed, and 5.2% (5/96 cases) to luminal phenotypes. Mixed tumors in the NMI component are more likely to change phenotype than other groups, particularly compared with basal tumors, which demonstrate greater stability (only 8/96 cases, p < 0.00001). The transition of luminal tumors to basal display a better OS compared with the transition toward neu-like tumors (p = 0.027). Overall, the phenotypical switch does not affect lymphovascular invasion, pT, DFS, or OS compared with non-switched cases. In the MI component, the presence of CD44 expression, irrespective of score-related phenotype, shows a protective effect in papillary-type UC (OS p = 0.008, HR 0.453, PFS p = 0.07, HR 0.599), and in UC naïve for CT (p = 0.0479). Piescore immunophenotyping reveals an intratumoral phenotypical transition between the NMI and MI components of the same tumor. The molecular change is a common event in the mixed and luminal categories, but not in basal tumors, which show better phenotypical stability. This phenomenon could partially explain the sensitivity of a subset of luminal UC to chemotherapy: good responders could be “non-real” luminal UC, which acquire nasal markers, such as CD44.
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Affiliation(s)
- Camilla De Carlo
- Department of Pathology, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy; (C.D.C.); (M.V.); (N.R.); (M.C.); (G.M.E.); (A.B.); (L.M.T.)
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy; (P.A.Z.); (F.D.); (G.G.)
| | - Marina Valeri
- Department of Pathology, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy; (C.D.C.); (M.V.); (N.R.); (M.C.); (G.M.E.); (A.B.); (L.M.T.)
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy; (P.A.Z.); (F.D.); (G.G.)
| | - Noemi Rudini
- Department of Pathology, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy; (C.D.C.); (M.V.); (N.R.); (M.C.); (G.M.E.); (A.B.); (L.M.T.)
| | - Paolo Andrea Zucali
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy; (P.A.Z.); (F.D.); (G.G.)
- Department of Oncology, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy;
| | - Miriam Cieri
- Department of Pathology, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy; (C.D.C.); (M.V.); (N.R.); (M.C.); (G.M.E.); (A.B.); (L.M.T.)
| | - Grazia Maria Elefante
- Department of Pathology, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy; (C.D.C.); (M.V.); (N.R.); (M.C.); (G.M.E.); (A.B.); (L.M.T.)
| | - Federica D’antonio
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy; (P.A.Z.); (F.D.); (G.G.)
- Department of Oncology, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy;
| | - Rodolfo Hurle
- Department of Urology, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy; (R.H.); (M.L.)
| | - Laura Giordano
- Biostatistic Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy;
| | - Alessandra Bressan
- Department of Pathology, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy; (C.D.C.); (M.V.); (N.R.); (M.C.); (G.M.E.); (A.B.); (L.M.T.)
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy; (P.A.Z.); (F.D.); (G.G.)
| | - Massimo Lazzeri
- Department of Urology, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy; (R.H.); (M.L.)
| | - Matteo Perrino
- Department of Oncology, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy;
| | - Giorgio Guazzoni
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy; (P.A.Z.); (F.D.); (G.G.)
- Department of Urology, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy; (R.H.); (M.L.)
| | - Luigi Maria Terracciano
- Department of Pathology, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy; (C.D.C.); (M.V.); (N.R.); (M.C.); (G.M.E.); (A.B.); (L.M.T.)
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy; (P.A.Z.); (F.D.); (G.G.)
| | - Piergiuseppe Colombo
- Department of Pathology, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy; (C.D.C.); (M.V.); (N.R.); (M.C.); (G.M.E.); (A.B.); (L.M.T.)
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy; (P.A.Z.); (F.D.); (G.G.)
- Correspondence: ; Tel.: +39-0282244707
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Isali I, McClellan P, Calaway A, Prunty M, Abbosh P, Mishra K, Ponsky L, Markt S, Psutka SP, Bukavina L. Gene network profiling in muscle-invasive bladder cancer: A systematic review and meta-analysis. Urol Oncol 2022; 40:197.e11-197.e23. [PMID: 35039218 PMCID: PMC10123538 DOI: 10.1016/j.urolonc.2021.11.003] [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: 09/12/2021] [Revised: 10/17/2021] [Accepted: 11/02/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Determining meta-analysis of transcriptional profiling of muscle-invasive bladder cancer (MIBC) through Gene Expression Omnibus (GEO) datasets has not been investigated. This study aims to define gene expression profiles in MIBC and to identify potential candidate genes and pathways. OBJECTIVES To review and evaluate gene expression studies in MIBC through publicly available RNA sequencing (RNA-Seq) and microarray data in order to identify potential prognostic and therapeutic targets for MIBC. METHODS A systematic literature search of the Ovid MEDLINE, PubMed, and Wiley Cochrane Central Register of Controlled Trials databases was performed using the terms "gene," "gene expression," and "bladder cancer" January 1, 1990 through March 2021 focused on populations with MIBC. RESULTS In the final analysis, GEO datasets were included. Fixed effect model was employed in the meta-analysis. Gene networking connections and gene-set functional analyses of the identified genes as differentially expressed in MIBC were performed using ImaGEO and GeneMANIA software. A heatmap for the upregulated and downregulated genes was generated along with the correlated pathways. CONCLUSION A total of 9 genes were reported in this analysis. Six genes were reported as upregulated (ProTα, SPINT1, UBE2E1, RAB25, KPNB1, HDAC1) and 3 genes as downregulated (NUP188, IPO13, NUP124). Genes were found to be involved in "ubiquitin mediated proteolysis," "protein processing in endoplasmic reticulum," "transcriptional misregulation in cancer," and "RNA transport" pathways.
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Affiliation(s)
- Ilaha Isali
- Department of Urology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH
| | - Phillip McClellan
- Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, OH
| | - Adam Calaway
- Department of Urology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH; Case Comprehensive Cancer Center, Case Western Reserve School of Medicine, Cleveland, OH
| | - Megan Prunty
- Department of Urology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH
| | - Phillip Abbosh
- Department of Urology, Fox Chase Cancer Center, Philadelphia, PA
| | - Kirtishri Mishra
- Department of Urology, Fox Chase Cancer Center, Philadelphia, PA
| | - Lee Ponsky
- Department of Urology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH; Case Comprehensive Cancer Center, Case Western Reserve School of Medicine, Cleveland, OH
| | - Sarah Markt
- Department of Population and Quantitative Health Science, Case Western Reserve School of Medicine, Cleveland, OH
| | - Sarah P Psutka
- Department of Urology, University of Washington School of Medicine, Seattle, WA
| | - Laura Bukavina
- Department of Urology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH; Case Comprehensive Cancer Center, Case Western Reserve School of Medicine, Cleveland, OH.
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Gómez Caamaño A, García Vicente AM, Maroto P, Rodríguez Antolín A, Sanz J, Vera González MA, Climent MÁ. Management of Localized Muscle-Invasive Bladder Cancer from a Multidisciplinary Perspective: Current Position of the Spanish Oncology Genitourinary (SOGUG) Working Group. Curr Oncol 2021; 28:5084-5100. [PMID: 34940067 PMCID: PMC8700266 DOI: 10.3390/curroncol28060428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/15/2021] [Accepted: 11/17/2021] [Indexed: 11/30/2022] Open
Abstract
This review presents challenges and recommendations on different aspects related to the management of patients with localized muscle-invasive bladder cancer (MIBC), which were discussed by a group of experts of a Spanish Oncology Genitourinary (SOGUG) Working Group within the framework of the Genitourinary Alliance project (12GU). It is necessary to clearly define which patients are candidates for radical cystectomy and which are candidates for undergoing bladder-sparing procedures. In older patients, it is necessary to include a geriatric assessment and evaluation of comorbidities. The pathological report should include a classification of the histopathological variant of MIBC, particularly the identification of subtypes with prognostic, molecular and therapeutic implications. Improvement of clinical staging, better definition of prognostic groups based on molecular subtypes, and identification of biomarkers potentially associated with maximum benefit from neoadjuvant chemotherapy are areas for further research. A current challenge in the management of MIBC is improving the selection of patients likely to be candidates for immunotherapy with checkpoint inhibitors in the neoadjuvant setting. Optimization of FDG-PET/CT reliability in staging of MIBC and the selection of patients is necessary, as well as the design of prospective studies aimed to compare the value of different imaging techniques in parallel.
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Affiliation(s)
- Antonio Gómez Caamaño
- Department of Radiation Oncology, Hospital Clínico Universitario de Santiago, 15706 Santiago de Compostela, Spain
| | | | | | | | - Julián Sanz
- Clínica Universidad de Navarra, 31008 Pamplona, Spain;
| | | | - Miguel Ángel Climent
- Medical Oncology Service, Fundación Instituto Valenciano de Oncología, 46009 Valencia, Spain;
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Abdominal Sacrocolpopexy for Repair of Pelvic Organ Prolapse After Radical Cystectomy. Female Pelvic Med Reconstr Surg 2019; 25:218-221. [DOI: 10.1097/spv.0000000000000536] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Steele TM, Talbott GC, Sam A, Tepper CG, Ghosh PM, Vinall RL. Obatoclax, a BH3 Mimetic, Enhances Cisplatin-Induced Apoptosis and Decreases the Clonogenicity of Muscle Invasive Bladder Cancer Cells via Mechanisms That Involve the Inhibition of Pro-Survival Molecules as Well as Cell Cycle Regulators. Int J Mol Sci 2019; 20:ijms20061285. [PMID: 30875757 PMCID: PMC6470498 DOI: 10.3390/ijms20061285] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 03/06/2019] [Accepted: 03/08/2019] [Indexed: 12/13/2022] Open
Abstract
Several studies by our group and others have determined that expression levels of Bcl-2 and/or Bcl-xL, pro-survival molecules which are associated with chemoresistance, are elevated in patients with muscle invasive bladder cancer (MI-BC). The goal of this study was to determine whether combining Obatoclax, a BH3 mimetic which inhibits pro-survival Bcl-2 family members, can improve responses to cisplatin chemotherapy, the standard of care treatment for MI-BC. Three MI-BC cell lines (T24, TCCSuP, 5637) were treated with Obatoclax alone or in combination with cisplatin and/or pre-miR-34a, a molecule which we have previously shown to inhibit MI-BC cell proliferation via decreasing Cdk6 expression. Proliferation, clonogenic, and apoptosis assays confirmed that Obatoclax can decrease cell proliferation and promote apoptosis in a dose-dependent manner. Combination treatment experiments identified Obatoclax + cisplatin as the most effective treatment. Immunoprecipitation and Western analyses indicate that, in addition to being able to inhibit Bcl-2 and Bcl-xL, Obatoclax can also decrease cyclin D1 and Cdk4/6 expression levels. This has not previously been reported. The combined data demonstrate that Obatoclax can inhibit cell proliferation, promote apoptosis, and significantly enhance the effectiveness of cisplatin in MI-BC cells via mechanisms that likely involve the inhibition of both pro-survival molecules and cell cycle regulators.
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Affiliation(s)
- Thomas M Steele
- Department of Pharmaceutical & Biomedical Sciences, California Northstate University College of Pharmacy (CNUCOP), Elk Grove, CA 95757, USA.
- VA Northern California Health Care System (VANCHCS), Sacramento, CA 95655, USA.
- Department of Urologic Surgery, University of California, Davis, School of Medicine, Sacramento, CA 95817, USA.
| | - George C Talbott
- Department of Pharmaceutical & Biomedical Sciences, California Northstate University College of Pharmacy (CNUCOP), Elk Grove, CA 95757, USA.
| | - Anhao Sam
- Department of Pharmaceutical & Biomedical Sciences, California Northstate University College of Pharmacy (CNUCOP), Elk Grove, CA 95757, USA.
| | - Clifford G Tepper
- Department of Biochemistry and Molecular Medicine, University of California, Davis, School of Medicine, Sacramento, CA 95817, USA.
| | - Paramita M Ghosh
- VA Northern California Health Care System (VANCHCS), Sacramento, CA 95655, USA.
- Department of Urologic Surgery, University of California, Davis, School of Medicine, Sacramento, CA 95817, USA.
- Department of Biochemistry and Molecular Medicine, University of California, Davis, School of Medicine, Sacramento, CA 95817, USA.
| | - Ruth L Vinall
- Department of Pharmaceutical & Biomedical Sciences, California Northstate University College of Pharmacy (CNUCOP), Elk Grove, CA 95757, USA.
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Klapheke A, Yap SA, Pan K, Cress RD. Sociodemographic disparities in chemotherapy treatment and impact on survival among patients with metastatic bladder cancer. Urol Oncol 2018; 36:308.e19-308.e25. [PMID: 29628318 PMCID: PMC5960436 DOI: 10.1016/j.urolonc.2018.03.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 03/06/2018] [Accepted: 03/12/2018] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To evaluate how socioeconomic status and other demographic factors are associated with the receipt of chemotherapy and subsequent survival in patients diagnosed with metastatic bladder cancer. METHODS Using data from the California Cancer Registry, we identified 3,667 patients diagnosed with metastatic urothelial carcinoma of the urinary bladder between 1988 and 2014. The characteristics of patients who did and did not receive chemotherapy as part of the first course of treatment were compared using chi-square tests. Logistic regression was used to identify predictors of chemotherapy treatment. Fine and Gray competing-risks regression and Cox proportional hazards regression were used to estimate bladder cancer-specific and all-cause mortality, respectively. RESULTS Less than half (46.3%) of patients received chemotherapy. Patients from the lowest socioeconomic quintile were half as likely to have chemotherapy as those from highest quintile (odds ratio = 0.5, 95% CI: 0.4, 0.7). Unmarried patients were significantly less likely to receive treatment (odds ratio = 0.6, 95% CI: 0.5, 0.7). Not receiving chemotherapy was associated with greater mortality from bladder cancer (subdistribution hazard ratio = 1.4, 95% CI: 1.3, 1.5) and from all causes (hazard ratio = 2.0, 95% CI: 1.8, 2.1). CONCLUSIONS We found clear disparities in chemotherapy treatment and survival with respect to socioeconomic and marital status. Future studies should explore the possible reasons why patients with low socioeconomic status and who are unmarried are less likely to have chemotherapy.
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Affiliation(s)
- Amy Klapheke
- Public Health Institute, Cancer Registry of Greater California, Sacramento, CA; Department of Public Health Sciences, University of California Davis, Davis, CA.
| | - Stanley A Yap
- Department of Urology, University of California Davis, Sacramento, CA; University of California Davis Comprehensive Cancer Center, Sacramento, CA
| | | | - Rosemary D Cress
- Public Health Institute, Cancer Registry of Greater California, Sacramento, CA; Department of Public Health Sciences, University of California Davis, Davis, CA
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Zhang S, Gao F, Xue C, Zhang N, Gao F, Li S, Wen J. The application of wrapping ureter by a pedicled gastrocolic omentum flap combined with an artificial external scaffold to prevent stoma stenosis in rabbit after ureterocutaneostomy. Int Urol Nephrol 2016; 49:255-261. [PMID: 27987129 DOI: 10.1007/s11255-016-1475-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 12/03/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To evaluate the feasibility and possibility of wrapping ureter by a pedicled gastrocolic omentum flap combined with an artificial ureter external scaffold to prevent stoma stenosis in rabbit after ureterocutaneostomy. METHODS Forty male New Zealand rabbits were involved in this study. For application of ureterocutaneostomy, the right ureter was wrapped by a pedicled gastrocolic omentum flap and combined with application of an artificial external scaffold, which served as experimental side. Traditional ureterocutaneostomy was applied in left ureter (control side). All rabbits were killed after 1 month, and the kidney, ureter and abdominal segment ureter were collected to study the morphological and pathological changes by using HE staining, Masson staining, immunohistochemistry staining and microvessel density (MVD) study. RESULTS HE staining showed that renal medullary tubular dilatation, large number of collagen deposition, renal glomerular and renal tubular atrophy. Glomerular vascular leaves and interstitial fibrosis were detected in the kidney of control side. However, these abnormities in the kidney of experimental side were significantly alleviated compared to control side. The hydronephrosis and ureterectasia in the experimental side were dramatically attenuated compared to control side. Fibrosis in ureter around stoma and stoma stenosis were prevented by wrapping ureter by a pedicled gastrocolic omentum flap combined with an artificial external scaffold. CONCLUSION In this study, we have demonstrated that wrapping ureter by a pedicled gastrocolic omentum flap combined with an artificial external scaffold is capable of preventing stoma stenosis in rabbit after ureterocutaneostomy, which provided a new method and theoretical basis for clinical application in the future.
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Affiliation(s)
- Shigeng Zhang
- Department of Urology, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88# Jiefang Road, Hangzhou, 310009, Zhejiang, China
| | - Fei Gao
- Department of Urology, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88# Jiefang Road, Hangzhou, 310009, Zhejiang, China
| | - Chong Xue
- Department of Urology, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88# Jiefang Road, Hangzhou, 310009, Zhejiang, China
| | - Nan Zhang
- Department of Urology, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88# Jiefang Road, Hangzhou, 310009, Zhejiang, China
| | - Feng Gao
- Department of Urology, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88# Jiefang Road, Hangzhou, 310009, Zhejiang, China
| | - Shaojiang Li
- Department of Urology, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88# Jiefang Road, Hangzhou, 310009, Zhejiang, China
| | - Jiaming Wen
- Department of Urology, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88# Jiefang Road, Hangzhou, 310009, Zhejiang, China.
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Cavanaugh A, Juengst B, Sheridan K, Danella JF, Williams H. Combined inhibition of heat shock proteins 90 and 70 leads to simultaneous degradation of the oncogenic signaling proteins involved in muscle invasive bladder cancer. Oncotarget 2016; 6:39821-38. [PMID: 26556859 PMCID: PMC4741863 DOI: 10.18632/oncotarget.5496] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 10/22/2015] [Indexed: 12/21/2022] Open
Abstract
Heat shock protein 90 (HSP90) plays a critical role in the survival of cancer cells including muscle invasive bladder cancer (MIBC). The addiction of tumor cells to HSP90 has promoted the development of numerous HSP90 inhibitors and their use in clinical trials. This study evaluated the role of inhibiting HSP90 using STA9090 (STA) alone or in combination with the HSP70 inhibitor VER155008 (VER) in several human MIBC cell lines. While both STA and VER inhibited MIBC cell growth and migration and promoted apoptosis, combination therapy was more effective. Therefore, the signaling pathways involved in MIBC were systematically interrogated following STA and/or VER treatments. STA and not VER reduced the expression of proteins in the p53/Rb, PI3K and SWI/SWF pathways. Interestingly, STA was not as effective as VER or combination therapy in degrading proteins involved in the histone modification pathway such as KDM6A (demethylase) and EP300 (acetyltransferase) as predicted by The Cancer Genome Atlas (TCGA) data. This data suggests that dual HSP90 and HSP70 inhibition can simultaneously disrupt the key signaling pathways in MIBC.
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Affiliation(s)
- Alice Cavanaugh
- Weis Center for Research, Geisinger Health System, Danville, PA, USA
| | - Brendon Juengst
- Penn State University, Department of Plant Biology, State College, PA, USA
| | - Kathleen Sheridan
- Weis Center for Research, Geisinger Health System, Danville, PA, USA
| | - John F Danella
- Department of Urology, Geisinger Health System, Danville, PA, USA
| | - Heinric Williams
- Weis Center for Research, Geisinger Health System, Danville, PA, USA.,Department of Urology, Geisinger Health System, Danville, PA, USA
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12
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Yang Y, Deng S, Zeng Q, Hu W, Chen T. Highly stable selenadiazole derivatives induce bladder cancer cell apoptosis and inhibit cell migration and invasion through the activation of ROS-mediated signaling pathways. Dalton Trans 2016; 45:18465-18475. [PMID: 27711726 DOI: 10.1039/c6dt02045c] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Herein highly stable selenadiazole derivatives were synthesized and found to be able to induce bladder cancer cell apoptosis and inhibit cell migration and invasion through the activation of ROS-mediated pathways.
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Affiliation(s)
- Yahui Yang
- Department of Chemistry
- Jinan University Guangzhou 510632
- China
| | - Shulin Deng
- Department of Chemistry
- Jinan University Guangzhou 510632
- China
| | - Qinsong Zeng
- Department of Urology
- General Hospital of Guangzhou Military Command of PLA
- Guangzhou 510010
- China
| | - Weilie Hu
- Department of Urology
- General Hospital of Guangzhou Military Command of PLA
- Guangzhou 510010
- China
| | - Tianfeng Chen
- Department of Chemistry
- Jinan University Guangzhou 510632
- China
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Pokuri VK, Syed JR, Yang Z, Field EP, Cyriac S, Pili R, Levine EG, Azabdaftari G, Trump DL, Guru K, George S. Predictors of Complete Pathologic Response (pT0) to Neoadjuvant Chemotherapy in Muscle-invasive Bladder Carcinoma. Clin Genitourin Cancer 2015; 14:e59-65. [PMID: 26508364 DOI: 10.1016/j.clgc.2015.09.013] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 09/17/2015] [Accepted: 09/25/2015] [Indexed: 10/22/2022]
Abstract
UNLABELLED No predictors of a complete pathologic response (pT0) to neoadjuvant chemotherapy (NAC) in muscle-invasive bladder carcinoma have been established. We performed a retrospective analysis of 50 patients to identify potential predictors. Our results showed that the presence of additional transitional cell variants on pathologic examination (mixed tumors) predicted against pT0, suggesting the avoidance of NAC and its morbidity in these patients with mixed tumors. BACKGROUND Randomized trials have supported the use of cisplatin-based neoadjuvant chemotherapy (NAC) in muscle-invasive bladder carcinoma (MIBC) owing to the survival advantage, which has correlated with downstaging of the cancer to pT0. Only 30% to 40% of patients receiving NAC have attained a pT0 response at cystectomy; the remaining have either residual disease or progression. We aimed to identify the factors that could predict a pT0 response to NAC. PATIENTS AND METHODS Of 336 patients who had undergone robotic cystectomy at our institute from May 2007 to March 2014, we identified 50 patients who had undergone NAC for MIBC. We conducted a retrospective study, dividing these 50 patients into 2 groups, those with and without a pT0. Factors, including age, histologic features, hydronephrosis at initial presentation, and chemotherapy type, were examined by both univariate and multivariate logistic regression analysis. RESULTS Of the 50 patients, 14 (28%) had pT0 at cystectomy, 20 (40%) had progressive disease, and 16 (32%) had residual disease. The median age was 67.5 years, the median glomerular filtration rate at presentation was 87.5 mL/min, the patients had undergone a median of 3 NAC cycles, and the median time from the end of chemotherapy to surgery was 4 weeks. The odds of a pT0 response for pure urothelial carcinoma (UC) were approximately 11 times greater relative to cancers with transitional cell variant histologic features or mixed tumors (odds ratio 0.09, 95% confidence interval 0.021-0.380; P = .0011), including squamous, glandular differentiation, small cell, micropapillary, sarcomatoid, nested component, lymphoepithelioma-like, and plasmacytoid variants. CONCLUSION The presence of pure UC favored a pT0 response to NAC compared with those with variant histologic features or mixed tumors. These potential predictors warrant prospective validation to allow the ideal selection of patients for NAC.
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Affiliation(s)
- Venkata K Pokuri
- Department of Medical Oncology, Roswell Park Cancer Institute, Buffalo, NY.
| | - Johar R Syed
- Department of Urologic Oncology, Roswell Park Cancer Institute, Buffalo, NY
| | - Zhengyu Yang
- Department of Biostatistics and Bioinformatics, Roswell Park Cancer Institute, Buffalo, NY
| | - Erinn P Field
- Department of Urologic Oncology, Roswell Park Cancer Institute, Buffalo, NY
| | - Susanna Cyriac
- Department of Pathology, Case Western Reserve University, Cleveland, OH
| | - Roberto Pili
- Department of Medical Oncology, Indiana University Simon Cancer Center, Indianapolis, IN
| | - Ellis Glenn Levine
- Department of Medical Oncology, Roswell Park Cancer Institute, Buffalo, NY
| | | | - Donald L Trump
- Department of Medical Oncology, Inova Comprehensive Cancer Research Institute, Falls Church, VA
| | - Khurshid Guru
- Department of Urologic Oncology, Roswell Park Cancer Institute, Buffalo, NY
| | - Saby George
- Department of Medical Oncology, Roswell Park Cancer Institute, Buffalo, NY
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Nishikawa M, Miyake H, Behnsawy HM, Fujisawa M. Significance of 4E-binding protein 1 as a therapeutic target for invasive urothelial carcinoma of the bladder. Urol Oncol 2015; 33:166.e9-15. [PMID: 25618298 DOI: 10.1016/j.urolonc.2014.12.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 12/12/2014] [Accepted: 12/12/2014] [Indexed: 12/22/2022]
Abstract
BACKGROUND To evaluate the expression of multiple molecular markers involved in the mammalian target of rapamycin (mTOR) signaling pathway in human muscle-invasive bladder cancer (BC) and to assess the therapeutic efficacies of mTOR inhibitors in human BC KoTCC-1 cells. METHODS Expression levels of 5 markers, including PTEN, phosphorylated (p)-Akt, p-mTOR, p-p70 ribosomal S6 kinase, and p-4E-binding protein 1 (4E-BP1), were measured in radical cystectomy specimens from 49 patients with muscle-invasive BC by immunohistochemical staining. We then analyzed the effects of treatment with temsirolimus or Ku-0063794, a dual inhibitor of mTOR complex 1 (C1) and mTOR complex 2 (C2), on changes in the growth and expression profiles of 5 mTOR-associated markers in KoTCC-1 cells. RESULTS During the follow-up period of this study, disease recurred in 27 patients (55.1%), and of several factors examined, the expression level of p-4E-BP1 in addition to the pathological T stage was independently related to recurrence-free survival on multivariate analysis. Although the growth of KoTCC-1 cells was inhibited by both temsirolimus and Ku-0063794 in dose-dependent manners, treatment with Ku-0063794 resulted in a marked decrease in the expression of p-4E-BP1 in KoTCC-1 cells compared with that with temsirolimus. Furthermore, the growth-inhibitory effect of both mTOR inhibitors was shown to be proportional to the expression levels of p-4E-BP1. CONCLUSIONS The phosphorylation status of 4E-BP1 appeared to be correlated with the prognosis of patients with muscle-invasive BC following radical cystectomy as well as the sensitivities of BC cells to mTOR inhibitors; therefore, the inactivation of 4E-BP1 using Ku-0063794 may be a promising novel approach for muscle-invasive BC.
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Affiliation(s)
- Masatomo Nishikawa
- Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hideaki Miyake
- Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.
| | - Hosny M Behnsawy
- Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan; Department of Urology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Masato Fujisawa
- Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan
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15
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Clinical applications of capillary electrophoresis coupled to mass spectrometry in biomarker discovery: Focus on bladder cancer. Proteomics Clin Appl 2013; 7:779-93. [DOI: 10.1002/prca.201300038] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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