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Tran DH, Shanley R, Giubellino A, Tang PH, Koozekanani DD, Yuan J, Dusenbery K, Domingo-Musibay E. Radiation and systemic immunotherapy for metastatic uveal melanoma: a clinical retrospective review. Front Oncol 2024; 14:1406872. [PMID: 39026970 PMCID: PMC11254688 DOI: 10.3389/fonc.2024.1406872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 05/27/2024] [Indexed: 07/20/2024] Open
Abstract
Introduction Metastatic uveal melanoma (mUM) is a difficult to treat disease. The liver is the primary site of metastasis in most patients, though uveal melanoma spreads widely in advanced disease. The only FDA approved immunotherapy medication for metastatic uveal melanoma is the HLA-A02:01 restricted bispecific T cell engager drug, Tebentafusp. Checkpoint inhibitor strategies and combination approaches have been tried with some limited success. We describe our experience treating patients at the University of Minnesota. Methods Patients were included if they had biopsy-confirmed mUM. Twenty-five (25) patients meeting the criteria were identified. Medical records were reviewed and data extracted for patient baseline characteristics and response to treatments. Results Median time to metastasis from the time of local therapy to the eye was 14.2 months (IQR; 9.3-22.0), and first site of metastasis was liver in 92% of patients. Two patients (8%) did not receive systemic therapy or radiation therapy for metastatic disease. Twenty-three (92%) patients received systemic therapy, 13 patients (52%) received ipilimumab-nivolumab as the first-line, while 4 patients (16%) received pembrolizumab. Landmark survival analysis by receipt of systemic therapy and radiation therapy treatments within 6 months of biopsy confirmed diagnosis is shown. Twenty patients (80%) received systemic therapy within 6 months of mUM diagnosis. Thirteen patients (52%) received liver directed radiation therapy within 6 months of mUM diagnosis. Discussion Within our cohort, there was no overall survival benefit for patients receiving treatment of metastatic disease within 6 months of mUM diagnosis, versus those electing later or no treatment at all. There was remarkable clinical activity of ipilimumab and nivolumab in a subset of patients with mUM, in agreement with prior studies, and metastatic PD-L1 positive tumors were associated with a prolonged survival.
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Affiliation(s)
- Danielle H. Tran
- University of Minnesota Medical School, Minneapolis, MN, United States
- Department of Medicine, University of Washington, Seattle, WA, United States
| | - Ryan Shanley
- Biostatistics Core, University of Minnesota Masonic Cancer Center, Minneapolis, MN, United States
| | - Alessio Giubellino
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, United States
| | - Peter H. Tang
- Department of Ophthalmology, Storm Eye Institute, Medical University of South Carolina, Charleston, SC, United States
- Department of Ophthalmology & Visual Neurosciences, University of Minnesota, Minneapolis, MN, United States
| | - Dara D. Koozekanani
- Department of Ophthalmology & Visual Neurosciences, University of Minnesota, Minneapolis, MN, United States
| | - Jianling Yuan
- Department of Radiation Oncology, University of Minnesota, Minneapolis, MN, United States
| | - Kathryn Dusenbery
- Department of Radiation Oncology, University of Minnesota, Minneapolis, MN, United States
| | - Evidio Domingo-Musibay
- Department of Medicine, Division of Hematology and Oncology, University of Minnesota, Minneapolis, MN, United States
- Department of Medical Oncology, Allina Health Cancer Institute, Minneapolis, MN, United States
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Synoradzki KJ, Paduszyńska N, Solnik M, Toro MD, Bilmin K, Bylina E, Rutkowski P, Yousef YA, Bucolo C, Zweifel SA, Reibaldi M, Fiedorowicz M, Czarnecka AM. From Molecular Biology to Novel Immunotherapies and Nanomedicine in Uveal Melanoma. Curr Oncol 2024; 31:778-800. [PMID: 38392052 PMCID: PMC10887618 DOI: 10.3390/curroncol31020058] [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: 10/10/2023] [Revised: 12/09/2023] [Accepted: 12/19/2023] [Indexed: 02/24/2024] Open
Abstract
Molecular biology studies of uveal melanoma have resulted in the development of novel immunotherapy approaches including tebentafusp-a T cell-redirecting bispecific fusion protein. More biomarkers are currently being studied. As a result, combined immunotherapy is being developed as well as immunotherapy with bifunctional checkpoint inhibitory T cell engagers and natural killer cells. Current trials cover tumor-infiltrating lymphocytes (TIL), vaccination with IKKb-matured dendritic cells, or autologous dendritic cells loaded with autologous tumor RNA. Another potential approach to treat UM could be based on T cell receptor engineering rather than antibody modification. Immune-mobilizing monoclonal T cell receptors (TCR) against cancer, called ImmTAC TM molecules, represent such an approach. Moreover, nanomedicine, especially miRNA approaches, are promising for future trials. Finally, theranostic radiopharmaceuticals enabling diagnosis and therapy with the same molecule bring hope to this research.
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Affiliation(s)
- Kamil J. Synoradzki
- Environmental Laboratory of Pharmacological and Toxicological Research, Mossakowski Medical Research Institute, Polish Academy of Sciences, 5 Pawinskiego Str., 02-106 Warsaw, Poland;
| | - Natalia Paduszyńska
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland; (N.P.); (M.S.)
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 5 Roentgen Str., 02-781 Warsaw, Poland; (E.B.); (P.R.)
| | - Malgorzata Solnik
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland; (N.P.); (M.S.)
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 5 Roentgen Str., 02-781 Warsaw, Poland; (E.B.); (P.R.)
| | - Mario Damiano Toro
- Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 1 Chmielna Str., 20-079 Lublin, Poland;
- Eye Clinic, Public Health Department, Federico II University, Via Pansini 5, 80131 Naples, Italy
| | - Krzysztof Bilmin
- Research and Development Centre Novasome Sp. z o.o., 51-423 Wrocław, Poland;
| | - Elżbieta Bylina
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 5 Roentgen Str., 02-781 Warsaw, Poland; (E.B.); (P.R.)
- Department of Clinical Trials, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 5 Roentgen Str., 02-781 Warsaw, Poland; (E.B.); (P.R.)
| | - Yacoub A. Yousef
- Department of Surgery (Ophthalmology), King Hussein Cancer Centre, Amman 11941, Jordan;
| | - Claudio Bucolo
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via S. Sofia 97, 95123 Catania, Italy;
| | - Sandrine Anne Zweifel
- Department of Ophthalmology, University Hospital Zurich, 8091 Zurich, Switzerland;
- Faculty of Human Medicine, University of Zurich, 8032 Zurich, Switzerland
| | - Michele Reibaldi
- Department of Surgical Sciences, Eye Clinic Section, Citta della Salute e della Scienza, Turin University, 10122 Turin, Italy;
| | - Michal Fiedorowicz
- Small Animal Magnetic Resonance Imaging Laboratory, Mossakowski Medical Research Institute, Polish Academy of Sciences, 5 Pawinskiego Str., 02-106 Warsaw, Poland
| | - Anna M. Czarnecka
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 5 Roentgen Str., 02-781 Warsaw, Poland; (E.B.); (P.R.)
- Department of Experimental Pharmacology, Mossakowski Medical Research Institute, Polish Academy of Sciences, 5 Pawinskiego Str., 02-106 Warsaw, Poland
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Khan SA, Almalki WH, Arora S, Kesharwani P. Recent approaches for the treatment of uveal melanoma: Opportunities and challenges. Crit Rev Oncol Hematol 2024; 193:104218. [PMID: 38040071 DOI: 10.1016/j.critrevonc.2023.104218] [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: 10/11/2023] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 12/03/2023] Open
Abstract
Uveal melanoma (UM) is the most prevalent primary intraocular cancer in adult population. Primary methods for treatment of UM involves surgery Proton Beam Therapy (PBT), Plaque Brachytherapy, phototherapy, and Charged Particle Radiation Therapy (CPT). It has been found that approximately 50 % of patients diagnosed with UM ultimately experience development of metastatic disease. Furthermore, it has been identified that majority of the patient experience metastasis in liver with a prevalence of 95 %. Management of metastatic UM (MUM) involves various therapeutic modalities, including systemic chemotherapy, molecular targeted therapy, immunotherapy and liver directed interventions. We outline gene mutation in UM and addresses various treatment modalities, including molecular targeted therapy, miRNA-based therapy, and immunotherapy. Additionally, inclusion of ongoing clinical trials aimed at developing novel therapeutic options for management of UM are also mentioned.
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Affiliation(s)
- Sauban Ahmed Khan
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi 110062, India
| | - Waleed H Almalki
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Swaranjeet Arora
- Department of Finance and Management, Lal Bahadur Shastri Institute of Management, 11/07 Dwarka Sector 11, Near Metro Station, New Delhi, Delhi 110075, India
| | - Prashant Kesharwani
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi 110062, India.
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Lescot T, Lebel-Cormier MA, Seniwal B, Gros-Louis P, Bellerive C, Landreville S, Beaulieu L, Fortin MA. Tumor Shape-Specific Brachytherapy Implants by 3D-Printing, Precision Radioactivity Painting, and Biomedical Imaging. Adv Healthc Mater 2023; 12:e2300528. [PMID: 37536742 DOI: 10.1002/adhm.202300528] [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: 02/17/2023] [Revised: 07/18/2023] [Indexed: 08/05/2023]
Abstract
In brachytherapy (BT), or internal radiation therapy, cancer is treated by radioactive implants. For instance, episcleral plaques (EPs) for the treatment of uveal melanoma, are designed according to generic population approximations. However, more personalized implants can enhance treatment precision through better adjustment of dose profiles to the contours of cancerous tissues. An original approach integrating biomedical imaging, 3D printing, radioactivity painting, and biomedical imaging, is developed as a workflow for the development of tumor shape-specific BT implants. First, computer-aided design plans of EP are prepared according to guidelines prescribed by the Collaborative Ocular Melanoma Study protocol. Polyetheretherketone (PEEK), a high-performance polymer suitable for permanent implants, is used to 3D-print plaques and the geometrical accuracy of the printed design is evaluated by imaging. The possibility to modulate the dose distribution in a tridimensional manner is demonstrated by painting the inner surfaces of the EPs with radioactive 103Pd, followed by dose profile measurements. The possibility to modulate dose distributions generated by these 3D-printed plaques through radioactivity painting is therefore confirmed. Ex vivo surgical tests on human eyeballs are performed as an assessment of manipulation ease. Overall, this work provides a solution for the fabrication of tumor-specific radioactive implants requiring higher dose precision.
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Affiliation(s)
- Théophraste Lescot
- Département de Génie des Mines, de la Métallurgie et des Matériaux and Centre de recherche sur les matériaux avancés (CERMA), Université Laval, Québec, G1V 0A6, Canada
- Axe Médecine Régénératrice, Centre de Recherche du Centre Hospitalier Universitaire (CHU) de Québec-Université Laval, Québec, G1V 4G2, Canada
- Centre de Recherche sur le Cancer (CRC) de l'Université Laval, Québec, G1R 3S3, Canada
| | - Marie-Anne Lebel-Cormier
- Centre de Recherche sur le Cancer (CRC) de l'Université Laval, Québec, G1R 3S3, Canada
- Département de Physique, de Génie Physique et d'Optique, Université Laval, Québec, G1V 0A6, Canada
- Service de physique médicale et radioprotection and Axe Oncologie, Centre de Recherche du Centre Hospitalier Universitaire de Québec-Université Laval, Québec, G1L 3L5, Canada
| | - Baljeet Seniwal
- Département de Génie des Mines, de la Métallurgie et des Matériaux and Centre de recherche sur les matériaux avancés (CERMA), Université Laval, Québec, G1V 0A6, Canada
- Axe Médecine Régénératrice, Centre de Recherche du Centre Hospitalier Universitaire (CHU) de Québec-Université Laval, Québec, G1V 4G2, Canada
- Centre de Recherche sur le Cancer (CRC) de l'Université Laval, Québec, G1R 3S3, Canada
| | - Philippe Gros-Louis
- Axe Médecine Régénératrice, Centre de Recherche du Centre Hospitalier Universitaire (CHU) de Québec-Université Laval, Québec, G1V 4G2, Canada
- Centre de Recherche sur le Cancer (CRC) de l'Université Laval, Québec, G1R 3S3, Canada
- Centre Universitaire d'Ophtalmologie (CUO) and Centre de Recherche du CHU de Québec-Université Laval, Hôpital du Saint-Sacrement, Québec, G1S 4L8, Canada
| | - Claudine Bellerive
- Axe Médecine Régénératrice, Centre de Recherche du Centre Hospitalier Universitaire (CHU) de Québec-Université Laval, Québec, G1V 4G2, Canada
- Centre Universitaire d'Ophtalmologie (CUO) and Centre de Recherche du CHU de Québec-Université Laval, Hôpital du Saint-Sacrement, Québec, G1S 4L8, Canada
| | - Solange Landreville
- Axe Médecine Régénératrice, Centre de Recherche du Centre Hospitalier Universitaire (CHU) de Québec-Université Laval, Québec, G1V 4G2, Canada
- Centre de Recherche sur le Cancer (CRC) de l'Université Laval, Québec, G1R 3S3, Canada
- Centre Universitaire d'Ophtalmologie (CUO) and Centre de Recherche du CHU de Québec-Université Laval, Hôpital du Saint-Sacrement, Québec, G1S 4L8, Canada
| | - Luc Beaulieu
- Centre de Recherche sur le Cancer (CRC) de l'Université Laval, Québec, G1R 3S3, Canada
- Département de Physique, de Génie Physique et d'Optique, Université Laval, Québec, G1V 0A6, Canada
- Service de physique médicale et radioprotection and Axe Oncologie, Centre de Recherche du Centre Hospitalier Universitaire de Québec-Université Laval, Québec, G1L 3L5, Canada
| | - Marc-André Fortin
- Département de Génie des Mines, de la Métallurgie et des Matériaux and Centre de recherche sur les matériaux avancés (CERMA), Université Laval, Québec, G1V 0A6, Canada
- Axe Médecine Régénératrice, Centre de Recherche du Centre Hospitalier Universitaire (CHU) de Québec-Université Laval, Québec, G1V 4G2, Canada
- Centre de Recherche sur le Cancer (CRC) de l'Université Laval, Québec, G1R 3S3, Canada
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Tan Y, Lu Y, Chen S, Zou C, Qin B. Immunotherapy for ocular melanoma: a bibliometric and visualization analysis from 1991 to 2022. Front Oncol 2023; 13:1161759. [PMID: 37324010 PMCID: PMC10265996 DOI: 10.3389/fonc.2023.1161759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/16/2023] [Indexed: 06/17/2023] Open
Abstract
Background In recent years, new therapeutic options to overcome the mechanisms of tumor immune suppression be effective in the treatment of cutaneous melanoma. These approaches have also been applied in ocular melanoma. The aim of this study is to present the current status and research hotspots of immunotherapy for ocular melanoma from a bibliometric perspective and to explore the field of immunotherapy for malignant ocular melanoma research. Methods In this study, the Web of Science Core Collection database (WoSCC) and Pubmed were selected to search the literature related to immunotherapy of ocular melanoma. Using VOSviewer, CiteSpace, the R package "bibliometrix," and the bibliometric online platform through the construction and visualization of bibliometric networks, the country/region, institution, journal, author, and keywords were analyzed to predict the most recent trends in research pertaining to ocular melanoma and immunotherapy. Results A total of 401 papers and 144 reviews related to immunotherapy of ocular melanoma were included. The United States is the main driver of research in the field, ranking first in terms of the number of publications, total citations, and H-index. The UNIVERSITY OF TEXAS SYSTEM is the most active institution, contributing the most papers. Jager, Martine is the most prolific author, and Carvajal, Richard is the most frequently cited author. CANCERS is the most published journal in the field and J CLIN ONCOL is the most cited journal. In addition to ocular melanoma and immunotherapy, the most popular keywords were "uveal melanoma" and "targeted therapy". According to keyword co-occurrence and burst analysis, uveal melanoma, immunotherapy, melanoma, metastases, bap1, tebentafusp, bioinformatics, conjunctival melanoma, immune checkpoint inhibitors, ipilimumab, pembrolizumab, and other research topics appear to be at the forefront of this field's research and have the potential to remain a hot research topic in the future. Conclusion This is the first bibliometric study in the last 30 years to comprehensively map the knowledge structure and trends in the field of research related to ocular melanoma and immunotherapy. The results comprehensively summarize and identify research frontiers for scholars studying immunotherapy associated with ocular melanoma.
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Affiliation(s)
- Yao Tan
- Shenzhen Aier Eye Hospital, Aier Eye Hospital, Jinan University, Shenzhen, China
| | - Yijie Lu
- Shenzhen Aier Eye Hospital, Aier Eye Hospital, Jinan University, Shenzhen, China
| | - Sheng Chen
- Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Affiliated Hospital of Jinan University, Shenzhen, China
| | - Chang Zou
- Shenzhen Aier Eye Hospital, Aier Eye Hospital, Jinan University, Shenzhen, China
- Shenzhen Aier Ophthalmic Technology Institute, Shenzhen, China
- School of Life and Health Sciences, The Chinese University of Kong Hong, Shenzhen, Guangdong, China
| | - Bo Qin
- Shenzhen Aier Eye Hospital, Aier Eye Hospital, Jinan University, Shenzhen, China
- Shenzhen Aier Ophthalmic Technology Institute, Shenzhen, China
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Alphonse AS, Benifa JVB, Muaad AY, Chola C, Heyat MBB, Murshed BAH, Abdel Samee N, Alabdulhafith M, Al-antari MA. A Hybrid Stacked Restricted Boltzmann Machine with Sobel Directional Patterns for Melanoma Prediction in Colored Skin Images. Diagnostics (Basel) 2023; 13:diagnostics13061104. [PMID: 36980412 PMCID: PMC10047753 DOI: 10.3390/diagnostics13061104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 03/17/2023] Open
Abstract
Melanoma, a kind of skin cancer that is very risky, is distinguished by uncontrolled cell multiplication. Melanoma detection is of the utmost significance in clinical practice because of the atypical border structure and the numerous types of tissue it can involve. The identification of melanoma is still a challenging process for color images, despite the fact that numerous approaches have been proposed in the research that has been done. In this research, we present a comprehensive system for the efficient and precise classification of skin lesions. The framework includes preprocessing, segmentation, feature extraction, and classification modules. Preprocessing with DullRazor eliminates skin-imaging hair artifacts. Next, Fully Connected Neural Network (FCNN) semantic segmentation extracts precise and obvious Regions of Interest (ROIs). We then extract relevant skin image features from ROIs using an enhanced Sobel Directional Pattern (SDP). For skin image analysis, Sobel Directional Pattern outperforms ABCD. Finally, a stacked Restricted Boltzmann Machine (RBM) classifies skin ROIs. Stacked RBMs accurately classify skin melanoma. The experiments have been conducted on five datasets: Pedro Hispano Hospital (PH2), International Skin Imaging Collaboration (ISIC 2016), ISIC 2017, Dermnet, and DermIS, and achieved an accuracy of 99.8%, 96.5%, 95.5%, 87.9%, and 97.6%, respectively. The results show that a stack of Restricted Boltzmann Machines is superior for categorizing skin cancer types using the proposed innovative SDP.
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Affiliation(s)
- A. Sherly Alphonse
- School of Computer Science and Engineering, Vellore Institute of Technology, Chennai 600127, India
| | - J. V. Bibal Benifa
- Department of Studies in Computer Science and Engineering, Indian Institute of Information Technology, Kottayam 686635, India
- Correspondence: (J.V.B.B.); (M.A.); (M.A.A.-a.)
| | - Abdullah Y. Muaad
- Department of Studies in Computer Science, University of Mysore, Manasagangothri, Mysore 570006, India
| | - Channabasava Chola
- Department of Studies in Computer Science and Engineering, Indian Institute of Information Technology, Kottayam 686635, India
| | - Md Belal Bin Heyat
- IoT Research Center, College of Computer Science and Software Engineering, Shenzhen University, Shenzhen 518060, China
| | | | - Nagwan Abdel Samee
- Department of Information Technology, College of Computer and Information Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Maali Alabdulhafith
- Department of Information Technology, College of Computer and Information Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
- Correspondence: (J.V.B.B.); (M.A.); (M.A.A.-a.)
| | - Mugahed A. Al-antari
- Department of Artificial Intelligence, College of Software and Convergence Technology, Daeyang AI Center, Sejong University, Seoul 05006, Republic of Korea
- Correspondence: (J.V.B.B.); (M.A.); (M.A.A.-a.)
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Cui Y, Yin S, Qin X, Jiao W, Ren A, Wang F, Zhao B. Advances in the treatment of intraocular malignancies: A literature review. Front Med (Lausanne) 2022; 9:975565. [PMID: 36330064 PMCID: PMC9624174 DOI: 10.3389/fmed.2022.975565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 08/17/2022] [Indexed: 11/29/2022] Open
Abstract
Intraocular malignant tumors including primary and metastatic tumors, are mainly found in Retina and uvea, and very few cases originate from the sclera and optic nerve. Intraocular tumors can endanger the patient's vision and even life, and proper treatment is vital. There have been several traditional treatments for intraocular tumors, such as radiotherapy, chemotherapy and surgery. In recent years, new methods have been developed in clinical applications including anti-VEGF and gene therapy. This paper aims to provide a timely review about recent progress in the treatment of intraocular malignant tumor.
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Affiliation(s)
- Yanyan Cui
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Shan Yin
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xuejiao Qin
- The Second Hospital of Shandong University, Jinan, China
| | - Wanzhen Jiao
- Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Anqi Ren
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Fei Wang
- Shengli Oilfield Central Hospital, Dongying, China
| | - Bojun Zhao
- Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- *Correspondence: Bojun Zhao
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8
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Zhang H, Li X, You P, Song X, Fan Q, Tao X, Qu Y. Highly tumoricidal efficiency of non-oxidized MXene-Ti3C2Tx quantum dots on human uveal melanoma. Front Bioeng Biotechnol 2022; 10:1028470. [PMID: 36277391 PMCID: PMC9582440 DOI: 10.3389/fbioe.2022.1028470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 09/26/2022] [Indexed: 12/02/2022] Open
Abstract
Uveal melanoma (UM) is a highly malignant intraocular tumor with poor prognosis. Current topical ophthalmic therapies purpose to conserve the eye and useful vision. Due to the risks and limited clinical benefits, the topical treatments of UM remain challenging and complex. In this study, newly developed non-oxidized MXene-Ti3C2Tx quantum dots (NMQDs-Ti3C2Tx) are proposed for UM treatment. Surprisingly, NMQDs-Ti3C2Tx shows significant tumor-killing effects on UM cells in a dose-dependent manner and causes severe necrosis near the injection site on the xenograft UM tumor model. Moreover, NMQDs-Ti3C2Tx exhibits excellent biocompatibility with normal retina pigment epithelium (RPE) cells and does not cause any damage in C57BL/6 mice eyes. Mechanistically, NMQDs-Ti3C2Tx inhibits the proliferation, invasion, and migration of UM cells via its desirable reactive oxygen species (ROS) generation ability, which causes lipid peroxidation and mitophagy, triggering cell ferroptosis. Furthermore, NMQDs-Ti3C2Tx is detected accumulating in autolysosomes which exacerbates cell death. This work provides new light on the topical treatment of UM.
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Affiliation(s)
- Huankai Zhang
- Department of Ophthalmology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, China
| | - Xuesong Li
- State Key Laboratory of Crystal Materials, Shandong University, Jinan, China
| | - Pan You
- Department of Cell Biology, School of Basic Medical Sciences, Shandong University, Jinan, China
| | - Xian Song
- Department of Ophthalmology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, China
| | - Qian Fan
- Department of Ophthalmology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, China
| | - Xutang Tao
- State Key Laboratory of Crystal Materials, Shandong University, Jinan, China
| | - Yi Qu
- Department of Ophthalmology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, China
- *Correspondence: Yi Qu,
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Solnik M, Paduszyńska N, Czarnecka AM, Synoradzki KJ, Yousef YA, Chorągiewicz T, Rejdak R, Toro MD, Zweifel S, Dyndor K, Fiedorowicz M. Imaging of Uveal Melanoma—Current Standard and Methods in Development. Cancers (Basel) 2022; 14:cancers14133147. [PMID: 35804919 PMCID: PMC9265106 DOI: 10.3390/cancers14133147] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/06/2022] [Accepted: 06/13/2022] [Indexed: 11/19/2022] Open
Abstract
Simple Summary Uveal melanoma is the most prevalent intraocular tumor in adults, derived from melanocytes; the liver is the most common site of its metastases. Due to troublesome tumor localization, different imaging techniques are utilized in diagnostics, i.e., fundus imaging (FI), ultrasonography (US), optical coherence tomography (OCT), single-photon emission computed tomography (SPECT), positron emission tomography/computed tomography (PET/CT), magnetic resonance imaging (MRI), fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA), or fundus autofluorescence (FAF). Specialists eagerly use these techniques, but sometimes the precision and quality of the obtained images are imperfect, raising diagnostic doubts and prompting the search for new ones. In addition to analyzing the currently utilized methods, this review also introduces experimental techniques that may be adapted to clinical practice in the future. Moreover, we raise the topic and present a perspective for personalized medicine in uveal melanoma treatment. Abstract Uveal melanoma is the most common primary intraocular malignancy in adults, characterized by an insidious onset and poor prognosis strongly associated with tumor size and the presence of distant metastases, most commonly in the liver. Contrary to most tumor identification, a biopsy followed by a pathological exam is used only in certain cases. Therefore, an early and noninvasive diagnosis is essential to enhance patients’ chances for early treatment. We reviewed imaging modalities currently used in the diagnostics of uveal melanoma, including fundus imaging, ultrasonography (US), optical coherence tomography (OCT), single-photon emission computed tomography (SPECT), fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA), fundus autofluorescence (FAF), as well as positron emission tomography/computed tomography (PET/CT) or magnetic resonance imaging (MRI). The principle of imaging techniques is briefly explained, along with their role in the diagnostic process and a summary of their advantages and limitations. Further, the experimental data and the advancements in imaging modalities are explained. We describe UM imaging innovations, show their current usage and development, and explain the possibilities of utilizing such modalities to diagnose uveal melanoma in the future.
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Affiliation(s)
- Małgorzata Solnik
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland; (M.S.); (N.P.)
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 5 Roentgen Str., 02-781 Warsaw, Poland;
| | - Natalia Paduszyńska
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland; (M.S.); (N.P.)
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 5 Roentgen Str., 02-781 Warsaw, Poland;
| | - Anna M. Czarnecka
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 5 Roentgen Str., 02-781 Warsaw, Poland;
- Department of Experimental Pharmacology, Mossakowski Medical Research Institute, Polish Academy of Sciences, 5 Pawinskiego Str., 02-106 Warsaw, Poland
| | - Kamil J. Synoradzki
- Department of Experimental Pharmacology, Mossakowski Medical Research Institute, Polish Academy of Sciences, 5 Pawinskiego Str., 02-106 Warsaw, Poland
- Small Animal Magnetic Resonance Imaging Laboratory, Mossakowski Medical Research Institute, Polish Academy of Sciences, 5 Pawinskiego Str., 02-106 Warsaw, Poland;
- Correspondence:
| | - Yacoub A. Yousef
- Department of Surgery (Ophthalmology), King Hussein Cancer Centre, Amman 11941, Jordan;
| | - Tomasz Chorągiewicz
- Department of General and Pediatric Ophthalmology, Medical University of Lublin, Chmielna 1, 20-079 Lublin, Poland; (T.C.); (R.R.); (M.D.T.)
| | - Robert Rejdak
- Department of General and Pediatric Ophthalmology, Medical University of Lublin, Chmielna 1, 20-079 Lublin, Poland; (T.C.); (R.R.); (M.D.T.)
| | - Mario Damiano Toro
- Department of General and Pediatric Ophthalmology, Medical University of Lublin, Chmielna 1, 20-079 Lublin, Poland; (T.C.); (R.R.); (M.D.T.)
- Eye Clinic, Public Health Department, Federico II University, via Pansini 5, 80131 Naples, Italy
| | - Sandrine Zweifel
- Department of Ophthalmology, University of Zurich, 8091 Zurich, Switzerland;
| | - Katarzyna Dyndor
- Department of Radiography, Medical University of Lublin, 8 Jaczewskiego Str., 20-090 Lublin, Poland;
| | - Michał Fiedorowicz
- Small Animal Magnetic Resonance Imaging Laboratory, Mossakowski Medical Research Institute, Polish Academy of Sciences, 5 Pawinskiego Str., 02-106 Warsaw, Poland;
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10
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Combination of Immune Checkpoint Inhibitors and Liver-Specific Therapies in Liver-Metastatic Uveal Melanoma: Can We Thus Overcome Its High Resistance? Cancers (Basel) 2021; 13:cancers13246390. [PMID: 34945010 PMCID: PMC8699813 DOI: 10.3390/cancers13246390] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/11/2021] [Accepted: 12/15/2021] [Indexed: 01/10/2023] Open
Abstract
Uveal Melanoma (UM) is a rare disease; however, it is the most common primary intraocular malignant tumor in adults. Hematogenous metastasis, occurring in up to 50% of cases, mainly to the liver (90%), is associated with poor clinical course and treatment failure. In contrast to dramatic benefits of immunotherapy in many tumor entities, as seen in cutaneous melanoma, immune checkpoint inhibitors (ICI) do not achieve comparable results in Metastatic UM (MUM). The aim of this study was to investigate whether the combination of ICI with liver-directed therapies provides a potential survival benefit for those affected. This retrospective, single-center study, including n = 45 patients with MUM, compared the effect of combining ICI with liver-directed therapy ("Cohort 1") with respect to standard therapies ("Cohort 2") on overall survival (OS). Our results revealed a significant survival difference between Cohort 1 (median OS 22.5 months) and Cohort 2 (median OS 11.4 months), indicating that this combination may enhance the efficacy of immunotherapy and thus provide a survival benefit. There is an urgent need for randomized, prospective trials addressing the combination of liver-directed therapies and various strategies of immunotherapy (such as ICI; IMCgp100; personalized vaccines) in order to establish regimens which finally improve the prognosis of patients with MUM.
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11
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Beasley AB, Isaacs TW, Vermeulen T, Freeman J, DeSousa JL, Bhikoo R, Hennessy D, Reid A, Chen FK, Bentel J, McKay D, Conway RM, Pereira MR, Mirzai B, Calapre L, Erber WN, Ziman MR, Gray ES. Analysis of Circulating Tumour Cells in Early-Stage Uveal Melanoma: Evaluation of Tumour Marker Expression to Increase Capture. Cancers (Basel) 2021; 13:5990. [PMID: 34885099 PMCID: PMC8657240 DOI: 10.3390/cancers13235990] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 11/23/2021] [Accepted: 11/24/2021] [Indexed: 01/07/2023] Open
Abstract
(1) Background: The stratification of uveal melanoma (UM) patients into prognostic groups is critical for patient management and for directing patients towards clinical trials. Current classification is based on clinicopathological and molecular features of the tumour. Analysis of circulating tumour cells (CTCs) has been proposed as a tool to avoid invasive biopsy of the primary tumour. However, the clinical utility of such liquid biopsy depends on the detection rate of CTCs. (2) Methods: The expression of melanoma, melanocyte, and stem cell markers was tested in a primary tissue microarray (TMA) and UM cell lines. Markers found to be highly expressed in primary UM were used to either immunomagnetically isolate or immunostain UM CTCs prior to treatment of the primary lesion. (3) Results: TMA and cell lines had heterogeneous expression of common melanoma, melanocyte, and stem cell markers. A multi-marker panel of immunomagnetic beads enabled isolation of CTCs in 37/43 (86%) patients with UM. Detection of three or more CTCs using the multi-marker panel, but not MCSP alone, was a significant predictor of shorter progression free (p = 0.040) and overall (p = 0.022) survival. (4) Conclusions: The multi-marker immunomagnetic isolation protocol enabled the detection of CTCs in most primary UM patients. Overall, our results suggest that a multi-marker approach could be a powerful tool for CTC separation for non-invasive prognostication of UM.
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Affiliation(s)
- Aaron B. Beasley
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia; (A.B.B.); (J.F.); (A.R.); (M.R.P.); (L.C.); (M.R.Z.)
- Centre for Precision Health, Edith Cowan University, Joondalup, WA 6027, Australia
| | - Timothy W. Isaacs
- Perth Retina, Subiaco, WA 6008, Australia;
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, Perth, WA 6000, Australia; (J.-L.D.); (R.B.); (F.K.C.)
- Department of Ophthalmology, Royal Perth Hospital, Perth, WA 6000, Australia;
| | - Tersia Vermeulen
- Anatomical Pathology, PathWest Laboratory Medicine, Fiona Stanley Hospital, Murdoch, WA 6150, Australia; (T.V.); (J.B.)
- Anatomical Pathology, PathWest Laboratory Medicine, Royal Perth Hospital, Perth, WA 6000, Australia
| | - James Freeman
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia; (A.B.B.); (J.F.); (A.R.); (M.R.P.); (L.C.); (M.R.Z.)
| | - Jean-Louis DeSousa
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, Perth, WA 6000, Australia; (J.-L.D.); (R.B.); (F.K.C.)
- Department of Ophthalmology, Royal Perth Hospital, Perth, WA 6000, Australia;
| | - Riyaz Bhikoo
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, Perth, WA 6000, Australia; (J.-L.D.); (R.B.); (F.K.C.)
- Department of Ophthalmology, Royal Perth Hospital, Perth, WA 6000, Australia;
| | - Doireann Hennessy
- Department of Ophthalmology, Royal Perth Hospital, Perth, WA 6000, Australia;
| | - Anna Reid
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia; (A.B.B.); (J.F.); (A.R.); (M.R.P.); (L.C.); (M.R.Z.)
- Centre for Precision Health, Edith Cowan University, Joondalup, WA 6027, Australia
| | - Fred K. Chen
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, Perth, WA 6000, Australia; (J.-L.D.); (R.B.); (F.K.C.)
- Department of Ophthalmology, Royal Perth Hospital, Perth, WA 6000, Australia;
| | - Jacqueline Bentel
- Anatomical Pathology, PathWest Laboratory Medicine, Fiona Stanley Hospital, Murdoch, WA 6150, Australia; (T.V.); (J.B.)
| | - Daniel McKay
- Royal Victorian Eye & Ear Hospital, Melbourne, VIC 3000, Australia;
| | - R. Max Conway
- Ocular Oncology Unit, Sydney Eye Hospital and The Kinghorn Cancer Centre, Sydney, NSW 2000, Australia;
- Save Sight Institute, The University of Sydney, Sydney, NSW 2000, Australia
| | - Michelle R. Pereira
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia; (A.B.B.); (J.F.); (A.R.); (M.R.P.); (L.C.); (M.R.Z.)
| | - Bob Mirzai
- School of Biomedical Sciences, University of Western Australia, Perth, WA 6000, Australia; (B.M.); (W.N.E.)
| | - Leslie Calapre
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia; (A.B.B.); (J.F.); (A.R.); (M.R.P.); (L.C.); (M.R.Z.)
- Centre for Precision Health, Edith Cowan University, Joondalup, WA 6027, Australia
| | - Wendy N. Erber
- School of Biomedical Sciences, University of Western Australia, Perth, WA 6000, Australia; (B.M.); (W.N.E.)
| | - Melanie R. Ziman
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia; (A.B.B.); (J.F.); (A.R.); (M.R.P.); (L.C.); (M.R.Z.)
- School of Biomedical Sciences, University of Western Australia, Perth, WA 6000, Australia; (B.M.); (W.N.E.)
| | - Elin S. Gray
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia; (A.B.B.); (J.F.); (A.R.); (M.R.P.); (L.C.); (M.R.Z.)
- Centre for Precision Health, Edith Cowan University, Joondalup, WA 6027, Australia
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12
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Hassan MK, Fleury E, Shamonin D, Fonk LG, Marinkovic M, Jaarsma-Coes MG, Luyten GP, Webb A, Beenakker JW, Stoel B. An Automatic Framework to Create Patient-specific Eye Models From 3D Magnetic Resonance Images for Treatment Selection in Patients With Uveal Melanoma. Adv Radiat Oncol 2021; 6:100697. [PMID: 34660938 PMCID: PMC8503565 DOI: 10.1016/j.adro.2021.100697] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/26/2020] [Accepted: 03/25/2021] [Indexed: 12/14/2022] Open
Abstract
PURPOSE The optimal treatment strategy for uveal melanoma (UM) relies on many factors, the most important being tumor size and location. Building on recent developments in high-resolution 3D ocular magnetic resonance imaging (MRI), we developed an automatic image-processing framework to create patient-specific eye models and to subsequently determine the full 3D tumor shape and size automatically. METHODS AND MATERIALS From 15 patients with UM, 3D inversion-recovery gradient-echo (T1-weighted) and 3D fat-suppressed spin-echo (T2-weighted) images were acquired with a 7T MRI scanner. First, the sclera and cornea were segmented from the T2-weighted image by mesh-fitting. The T1- and T2-weighted images were then coregistered. From the registered T1-weighted image, the lens, vitreous body, retinal detachment, and tumor were segmented. Fuzzy C-means clustering was used to differentiate the tumor from retinal detachments. The tumor model was verified and (if needed) edited by an ophthalmic MRI specialist. Subsequently, the prominence and largest basal diameter of the tumor were measured automatically based on the verified contours. These results were compared with manual assessments on the original images and with ultrasound measurements to show the errors in manual analysis. RESULTS The framework successfully created an eye model fully automatically in 12 cases. In these cases, a Dice similarity coefficient (mean surface distance) of 97.7%±0.84% (0.17±0.11 mm) was achieved for the sclera, 96.8%±1.05% (0.20±0.06 mm) for the vitreous body, 91.6%±4.83% (0.15±0.06 mm) for the lens, and 86.0%±7.4% (0.35±0.27 mm) for the tumor. The manual assessments deviated, on average, 0.39±0.31 mm in prominence and 1.7±1.22 mm in basal diameter from the automatic measurements. CONCLUSIONS The described framework combined information from T1- and T2-weighted images to accurately determine tumor boundaries in 3D. The proposed process may have a direct effect on clinical workflow, as it enables an accurate 3D assessment of tumor dimensions, which directly influences therapy selection.
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Affiliation(s)
| | - Emmanuelle Fleury
- Department of Radiation Oncology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Radiation Oncology, HollandPTC, Delft, The Netherlands
| | - Denis Shamonin
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Lorna Grech Fonk
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Marina Marinkovic
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Myriam G. Jaarsma-Coes
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Gregorius P.M. Luyten
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Andrew Webb
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jan-Willem Beenakker
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Berend Stoel
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
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13
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Proietti I, Skroza N, Filippi L, Bernardini N, Mambrin A, Tolino E, Rossi G, Marchesiello A, Marraffa F, Volpe S, Bagni O, Potenza C. Long-Term Maintained Response to Selective Internal Radiation Therapy in an Oligometastatic Uveal Melanoma Patient Treated with Concomitant Anti-PD-1 Therapy. Life (Basel) 2021; 11:692. [PMID: 34357064 PMCID: PMC8307638 DOI: 10.3390/life11070692] [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: 06/07/2021] [Revised: 07/06/2021] [Accepted: 07/08/2021] [Indexed: 12/16/2022] Open
Abstract
Uveal melanoma (UM) is a primary neoplasm of the eye arising from the melanocytes residing in the iris, ciliary body or choroid. It is the most frequent intraocular malignancy and often determines metastases at distant sites, with a peculiar tropism for the liver. Metastatic UM has a poor prognosis, as any treatment affects the natural course of this fatal disease. Herein, we report a case of a UM metastatic to the liver in a 54 year-old female patient, initially treated with nivolumab without success. The patient was then scheduled for selective internal radiation therapy (SIRT) while continuing immunotherapy. This combination led to a complete and durable response and the patient is currently free of disease, two years after the diagnosis of the hepatic metastases. The association between SIRT and immunotherapy (IT) has very promising perspectives for metastatic UM, especially considering the disappointing or contradictory results of classic chemotherapies, IT alone and targeted therapies. Furthermore, this combination has been shown to have a good security profile. However, further studies are needed to confirm the efficacy of associating SIRT and IT and to clarify some unsolved problems, such as the timing of administration of these two therapies.
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Affiliation(s)
- Ilaria Proietti
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy; (N.S.); (N.B.); (A.M.); (E.T.); (G.R.); (A.M.); (F.M.); (S.V.); (C.P.)
| | - Nevena Skroza
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy; (N.S.); (N.B.); (A.M.); (E.T.); (G.R.); (A.M.); (F.M.); (S.V.); (C.P.)
| | - Luca Filippi
- Department of Nuclear Medicine, “Santa Maria Goretti” Hospital, Via Antonio Canova, 04100 Latina, Italy; (L.F.); (O.B.)
| | - Nicoletta Bernardini
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy; (N.S.); (N.B.); (A.M.); (E.T.); (G.R.); (A.M.); (F.M.); (S.V.); (C.P.)
| | - Alessandra Mambrin
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy; (N.S.); (N.B.); (A.M.); (E.T.); (G.R.); (A.M.); (F.M.); (S.V.); (C.P.)
| | - Ersilia Tolino
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy; (N.S.); (N.B.); (A.M.); (E.T.); (G.R.); (A.M.); (F.M.); (S.V.); (C.P.)
| | - Giovanni Rossi
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy; (N.S.); (N.B.); (A.M.); (E.T.); (G.R.); (A.M.); (F.M.); (S.V.); (C.P.)
| | - Anna Marchesiello
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy; (N.S.); (N.B.); (A.M.); (E.T.); (G.R.); (A.M.); (F.M.); (S.V.); (C.P.)
| | - Federica Marraffa
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy; (N.S.); (N.B.); (A.M.); (E.T.); (G.R.); (A.M.); (F.M.); (S.V.); (C.P.)
| | - Salvatore Volpe
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy; (N.S.); (N.B.); (A.M.); (E.T.); (G.R.); (A.M.); (F.M.); (S.V.); (C.P.)
| | - Oreste Bagni
- Department of Nuclear Medicine, “Santa Maria Goretti” Hospital, Via Antonio Canova, 04100 Latina, Italy; (L.F.); (O.B.)
| | - Concetta Potenza
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy; (N.S.); (N.B.); (A.M.); (E.T.); (G.R.); (A.M.); (F.M.); (S.V.); (C.P.)
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14
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Wang JZ, Lin V, Toumi E, Wang K, Zhu H, Conway RM, Madigan MC, Murray M, Cherepanoff S, Zhou F, Shu W. Development of new therapeutic options for the treatment of uveal melanoma. FEBS J 2021; 288:6226-6249. [PMID: 33838075 DOI: 10.1111/febs.15869] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/17/2021] [Accepted: 04/08/2021] [Indexed: 12/13/2022]
Abstract
Uveal melanoma (UM) is the most common primary intraocular malignancy in adults. Important cytogenetic and genetic risk factors for the development of UM include chromosome 3 monosomy, mutations in the guanine nucleotide-binding proteins GNAQ/GNA11, and loss of the BRACA1-associated protein 1 (BAP 1). Most primary UMs are treated conservatively with radiotherapy, but enucleation is necessary for large tumours. Despite the effectiveness of local control, up to 50% of UM patients develop metastasis for which there are no effective therapies. Attempts to utilise the targeted therapies that have been developed for the treatment of other cancers, including a range of signal transduction pathway inhibitors, have rarely produced significant outcomes in UM. Similarly, the application of immunotherapies that are effective in cutaneous melanoma to treat UM have also been disappointing. Other approaches that have been initiated involve proteasomal inhibitors and histone deacetylase inhibitors which are approved for the treatment of other cancers. Nevertheless, there have been occasional positive outcomes from these treatments in UM. Moreover, combination approaches in UM have also yielded some positive developments. It would be valuable to identify how to apply such therapies efficiently in UM, potentially via individualised tumour profiling. It would also be important to characterise UM tumours to differentiate the potential drivers of progression from those in other types of cancers. The recent identification of novel kinases and metastatic genes in UM tumours makes the development of new UM-specific treatments feasible.
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Affiliation(s)
- Janney Z Wang
- Faculty of Medicine and Health, Sydney Pharmacy School, The University of Sydney, NSW, Australia
| | - Vivian Lin
- Faculty of Medicine, The University of New South Wales, Sydney, NSW, Australia
| | - Elsa Toumi
- Faculty of Medicine, The University of New South Wales, Sydney, NSW, Australia
| | - Ke Wang
- Key Laboratory of Nuclear Medicine, Ministry of Health, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi, China
| | - Hong Zhu
- Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China
| | - R Max Conway
- Ocular Oncology Unit, Sydney Eye Hospital and The Kinghorn Cancer Centre, NSW, Australia.,Save Sight Institute, The University of Sydney, NSW, Australia
| | - Michele C Madigan
- Save Sight Institute, The University of Sydney, NSW, Australia.,School of Optometry and Vision Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Michael Murray
- Discipline of Pharmacology, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Svetlana Cherepanoff
- SydPath, Department of Anatomical Pathology, St Vincent's Hospital, Darlinghurst, NSW, Australia
| | - Fanfan Zhou
- Faculty of Medicine and Health, Sydney Pharmacy School, The University of Sydney, NSW, Australia
| | - Wenying Shu
- Faculty of Medicine and Health, Sydney Pharmacy School, The University of Sydney, NSW, Australia.,Department of Pharmacy, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, China
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15
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Monosomy 3 Influences Epithelial-Mesenchymal Transition Gene Expression in Uveal Melanoma Patients; Consequences for Liquid Biopsy. Int J Mol Sci 2020; 21:ijms21249651. [PMID: 33348918 PMCID: PMC7767066 DOI: 10.3390/ijms21249651] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/13/2020] [Accepted: 12/14/2020] [Indexed: 12/12/2022] Open
Abstract
Despite outstanding advances in diagnosis and the treatment of primary uveal melanoma (UM), nearly 50% of UM patients develop metastases via hematogenous dissemination, driven by the epithelial-mesenchymal transition (EMT). Despite the failure in UM to date, a liquid biopsy may offer a feasible non-invasive approach for monitoring metastatic disease progression and addressing protracted dormancy. To detect circulating tumor cells (CTCs) in UM patients, we evaluated the mRNA expression of EMT-associated transcription factors in CD45-depleted blood fraction, using qRT-PCR. ddPCR was employed to assess UM-specific GNA11, GNAQ, PLCβ4, and CYSLTR2 mutations in plasma DNA. Moreover, microarray analysis was performed on total RNA isolated from tumor tissues to estimate the prognostic value of EMT-associated gene expression. In total, 42 primary UM and 11 metastatic patients were enrolled. All CD45-depleted samples were negative for CTC when compared to the peripheral blood fraction of 60 healthy controls. Tumor-specific mutations were detected in the plasma of 21.4% patients, merely, in 9.4% of primary UM, while 54.5% in metastatic patients. Unsupervised hierarchical clustering of differentially expressed EMT genes showed significant differences between monosomy 3 and disomy 3 tumors. Newly identified genes can serve as non-invasive prognostic biomarkers that can support therapeutic decisions.
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16
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Roelofsen CDM, Wierenga APA, van Duinen S, Verdijk RM, Bleeker J, Marinkovic M, Luyten GPM, Jager MJ. Five Decades of Enucleations for Uveal Melanoma in One Center: More Tumors with High Risk Factors, No Improvement in Survival over Time. Ocul Oncol Pathol 2020; 7:133-141. [PMID: 33981696 DOI: 10.1159/000509918] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 06/05/2020] [Indexed: 12/18/2022] Open
Abstract
Background In order to improve medical care for uveal melanoma (UM) patients, we need to monitor disease and survival to guide our research efforts. We analyzed the data of UM patients who underwent an enucleation at the Leiden University Medical Center over the last five decades and investigated trends in patient and tumor characteristics and survival. Methods Data were collected from charts and pathology reports from all patients who underwent an enucleation for UM between 1973 and 2019 (n = 1,212), of which 1,066 were primary enucleations; data were analyzed according to five time periods: 1973-1979 (n = 209), 1980-1989 (n = 148), 1990-1999 (n = 174), 2000-2009 (n = 280), and 2010-2019 (n = 401). Results Over time, mean patient age at the time of enucleation for UM increased from 54.9 to 64.7 years (p < 0.001), more tumors showed histopathological involvement of the ciliary body (p < 0.001), and were classified in a high TNM/AJCC class (p < 0.001). Overall, the 5- and 10-year UM-related survival rates were 0.68 and 0.59, respectively. Over time, survival showed no change in patients with tumors in AJCC stages I or III, with recently a slightly worse survival in stage II UM (p = 0.02). Conclusion Between 1973 and 2019, we found similar rates of UM-related survival following enucleation, although we noticed a strong increase in more unfavorable patient and tumor characteristics over time, such as an older age and larger tumor size. The lack of improvement indicates that more research should take place to develop adjuvant treatments to prevent metastases and efficient treatments once metastases develop.
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Affiliation(s)
- Christine D M Roelofsen
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands.,Department of Emergency Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Annemijn P A Wierenga
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Sjoerd van Duinen
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Robert M Verdijk
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands.,Department of Pathology, Section Ophthalmic Pathology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Jaco Bleeker
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Marina Marinkovic
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Gregorius P M Luyten
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Martine J Jager
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
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17
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Singh L, Singh MK, Kenney MC, Jager MJ, Rizvi MA, Meel R, Lomi N, Bakhshi S, Sen S, Kashyap S. Prognostic significance of PD-1/PD-L1 expression in uveal melanoma: correlation with tumor-infiltrating lymphocytes and clinicopathological parameters. Cancer Immunol Immunother 2020; 70:1291-1303. [PMID: 33136179 DOI: 10.1007/s00262-020-02773-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 10/19/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND To understand how to improve the effect of immune checkpoint inhibitors in uveal melanoma (UM), we need a better understanding of the expression of PD-1 and PD-L1, their relation with the presence of tumor-infiltrating lymphocytes (TILs), and their prognostic relevance in UM patients. MATERIALS AND METHODS Expression of PD-1 and PD-L1 was assessed in 71 UM tissue samples by immunohistochemistry and quantitative real-time PCR (qRT-PCR), and further validated by western blotting. The effect of interferon gamma (IFN-γ) on PD-1/PD-L1 expression was determined on four UM cell lines. RESULTS Immunoreactivity of PD-1 was found in 30/71 cases and of PD-L1 in 44/71 UM samples. Tumor-infiltrating lymphocytes were found in 46% of UM tissues. PD-1 was expressed on TILs while tumor cells expressed PD-L1. UM with and without TILs showed expression of PD-1 in 69% and 18% cases, respectively (p = 0.001). Similarly, PD-L1 was found in 75% of UM with TILs and in 50% of cases without TILs, respectively (p = 0.03). DFS rate were lower in patients with TILs with expression of PD-1 and PD-L1, but the rate of DFS was higher with expression of PD-L1 in patients without TILs. After treatment of UM cell lines with IFN-γ, PD-1 expression was induced in all UM cell lines whereas PD-L1 expression was found at a lower level in untreated cells, while expression also increased following treatment with IFN-γ. CONCLUSION Our study suggests that increased infiltration with TILs promotes the aggressive behavior and suppresses the immune response of UM cells, thereby inhibiting immunotherapy.
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Affiliation(s)
- Lata Singh
- Department of Ocular Pathology, Dr. R P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.,Department of Ophthalmology, Gavin Herbert Eye Institute, University of California, Irvine, USA.,Biosciences, Jamia Millia Islamia, New Delhi, India
| | - Mithalesh Kumar Singh
- Department of Ocular Pathology, Dr. R P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Maria Cristina Kenney
- Department of Ophthalmology, Gavin Herbert Eye Institute, University of California, Irvine, USA
| | - Martine J Jager
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Rachna Meel
- Department of Ophthalmology, Dr. R. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Neiwete Lomi
- Department of Ophthalmology, Dr. R. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Sameer Bakhshi
- Department of Medical Oncology, All India Institute of Medical Sciences, IRCH, New Delhi, India
| | - Seema Sen
- Department of Ocular Pathology, Dr. R P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Seema Kashyap
- Department of Ocular Pathology, Dr. R P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
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18
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Li Y, Shi J, Yang J, Ge S, Zhang J, Jia R, Fan X. Uveal melanoma: progress in molecular biology and therapeutics. Ther Adv Med Oncol 2020; 12:1758835920965852. [PMID: 33149769 PMCID: PMC7586035 DOI: 10.1177/1758835920965852] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 09/16/2020] [Indexed: 12/15/2022] Open
Abstract
Uveal melanoma (UM) is the most common intraocular malignancy in adults. So far, no systemic therapy or standard treatment exists to reduce the risk of metastasis and improve overall survival of patients. With the increased knowledge regarding the molecular pathways that underlie the oncogenesis of UM, it is expected that novel therapeutic approaches will be available to conquer this disease. This review provides a summary of the current knowledge of, and progress made in understanding, the pathogenesis, genetic mutations, epigenetics, and immunology of UM. With the advent of the omics era, multi-dimensional big data are publicly available, providing an innovation platform to develop effective targeted and personalized therapeutics for UM patients. Indeed, recently, a great number of therapies have been reported specifically for UM caused by oncogenic mutations, as well as other etiologies. In this review, special attention is directed to advancements in targeted therapies. In particular, we discuss the possibilities of targeting: GNAQ/GNA11, PLCβ, and CYSLTR2 mutants; regulators of G-protein signaling; the secondary messenger adenosine diphosphate (ADP)-ribosylation factor 6 (ARF6); downstream pathways, such as those involving mitogen-activated protein kinase/MEK/extracellular signal-related kinase, protein kinase C (PKC), phosphoinositide 3-kinase/Akt/mammalian target of rapamycin (mTOR), Trio/Rho/Rac/Yes-associated protein, and inactivated BAP1; and immune-checkpoint proteins cytotoxic T-lymphocyte antigen 4 and programmed cell-death protein 1/programmed cell-death ligand 1. Furthermore, we conducted a survey of completed and ongoing clinical trials applying targeted and immune therapies for UM. Although drug combination therapy based on the signaling pathways involved in UM has made great progress, targeted therapy is still an unmet medical need.
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Affiliation(s)
- Yongyun Li
- Department of Ophthalmology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Jiahao Shi
- Department of Ophthalmology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Jie Yang
- Department of Ophthalmology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Shengfang Ge
- Department of Ophthalmology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Jianming Zhang
- National Research Center for Translational Medicine, Shanghai State Key Laboratory of Medical Genomics, Rui-Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Renbing Jia
- Department of Ophthalmology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Huangpu District, Shanghai 200001, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, 200001, China
| | - Xianqun Fan
- Department of Ophthalmology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Huangpu District, Shanghai 200001, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, 833 Zhizaoju Road, Huangpu District, Shanghai 200001, China
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19
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Cichorek M, Ronowska A, Dzierzbicka K, Gensicka-Kowalewska M, Deptula M, Pelikant-Malecka I. Chloroacridine derivatives as potential anticancer agents which may act as tricarboxylic acid cycle enzyme inhibitors. Biomed Pharmacother 2020; 130:110515. [PMID: 34321163 DOI: 10.1016/j.biopha.2020.110515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 07/03/2020] [Accepted: 07/07/2020] [Indexed: 10/23/2022] Open
Abstract
PURPOSE This paper concerns the cytotoxicity of 9-chloro-1-nitroacridine (1a) and 9-chloro-4-methyl-1-nitroacridine (1b) against two biologically different melanoma forms: melanotic and amelanotic. Melanomas are tumors characterized by high heterogeneity and poor susceptibility to chemotherapies. Among new analogs synthesized by us, compound 1b exhibited the highest anticancer potency. Because of that, in this study, we analyzed the mechanism of action for 1a and its 4-methylated derivative, 1b, against a pair of biological melanoma forms, with regard to proliferation, cell death mechanism and energetic state. METHODS Cytotoxicity was evaluated by XTT assay. Cell death was estimated by plasma membrane structure changes (phosphatidylserine externalization), caspase activation, and ROS presence. The energetic state of cells was estimated based on NAD and ATP levels, and the activity of tricarboxylic acid cycle enzymes (pyruvate dehydrogenase complex, aconitase, isocitrate dehydrogenase). RESULTS The chloroacridines affect biological forms of melanoma in different ways. Amelanotic (Ab) melanoma (with inhibited melanogenesis and higher malignancy) was particularly sensitive to the action of the chloroacridines. The Ab melanoma cells died through apoptosis and through death without caspase activation. Diminished activity of TAC enzymes was noticed among Ab melanoma cells together with ATP/NAD depletion, especially in the case of 1b. CONCLUSION Our data show that the biological forms of the tumors responded to 1a and its 4-methylated analog in different ways. 1a and 1b could be inducers of regulated melanoma cell death, especially the amelanotic form. Although the mechanism of the cell death is not fully understood, 1b may act by interfering with the TAC enzymes and blocking specific pathways leading to tumor growth. This could encourage further investigation of its anticancer activity, especially against the amelanotic form of melanoma.
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Affiliation(s)
- Miroslawa Cichorek
- Department of Embryology, Medical University of Gdansk, Debinki 1 St. PL, 80-210, Gdansk, Poland.
| | - Anna Ronowska
- Department of Laboratory Medicine, Medical University of Gdansk, Debinki 7 St. PL, 80-211, Gdansk, Poland
| | - Krystyna Dzierzbicka
- Department of Organic Chemistry, Gdansk University of Technology, Narutowicza St. 11/12. PL, 80-233, Gdansk, Poland
| | - Monika Gensicka-Kowalewska
- Department of Organic Chemistry, Gdansk University of Technology, Narutowicza St. 11/12. PL, 80-233, Gdansk, Poland
| | - Milena Deptula
- Department of Embryology, Medical University of Gdansk, Debinki 1 St. PL, 80-210, Gdansk, Poland
| | - Iwona Pelikant-Malecka
- Department of Biochemistry, Medical University of Gdansk, Debinki 1 St. PL, 80-210, Gdansk, Poland; Department of Medical Laboratory Diagnostics, Central Bank of Frozen Tissues and Genetic Specimens, Medical University of Gdansk, Biobanking and Biomolecular Resources Research Infrastructure Poland, Debinki 7 St. PL, 80-211, Gdansk, Poland
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20
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Bitencourt FBCSN, Bitencourt AGV, Chojniak MMM, Souza JO, Castro DG, Pellizzon ACA, Chojniak R. Response Evaluation of Choroidal Melanoma After Brachytherapy Using Diffusion-Weighted Magnetic Resonance Imaging (DW-MRI): Preliminary Findings. Front Oncol 2020; 10:825. [PMID: 32509587 PMCID: PMC7248391 DOI: 10.3389/fonc.2020.00825] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 04/28/2020] [Indexed: 02/03/2023] Open
Abstract
Purpose: To evaluate the role of diffusion-weighted magnetic resonance imaging (DW-MRI) in the assessment of therapeutic response in patients with choroidal melanoma treated with brachytherapy. Materials and Methods: We performed a prospective, unicentric study which included patients with choroidal melanoma and indication for brachytherapy. Three DW-MRI examinations were proposed for each patient, one before and two after treatment. The apparent diffusion coefficient (ADC) value was calculated on DW-MRI and compared with local tumor control assessed by ophthalmologic follow-up. Results: From 07/2018 to 06/2019, 19 patients were recruited, 13 of whom underwent follow-up examinations. Patients' ages ranged from 24 to 78 years and 52.9% were male. At the ocular ultrasound, the mean tumor thickness and diameter were 6.3 and 11.5 mm, respectively. Two patients (15.4%) showed signs of tumor progression during follow-up (7 and 9 months after treatment). There was no statistically significant difference in tumor size between MR before and after treatment, however, there was a significant reduction in mean ADC in patients with progression (p = 0.02). Conclusion: DW-MRI is a promising method for monitoring patients with choroidal melanoma; reduction in the mean ADC values between pre-treatment MRI and the first post-treatment MRI may be related to the lack of response to brachytherapy and increased risk of disease progression.
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Affiliation(s)
| | | | | | - Juliana O Souza
- Imaging Department, A.C.Camargo Cancer Center, São Paulo, Brazil
| | - Douglas G Castro
- Radiation Oncology Department, A.C.Camargo Cancer Center, São Paulo, Brazil
| | | | - Rubens Chojniak
- Imaging Department, A.C.Camargo Cancer Center, São Paulo, Brazil
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21
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Wu MY, Lai TT, Liao WT, Li CJ. Clinicopathological and prognostic significance and molecular mechanisms governing uveal melanoma. Ther Adv Med Oncol 2020; 12:1758835920917566. [PMID: 32550863 PMCID: PMC7281640 DOI: 10.1177/1758835920917566] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 03/11/2020] [Indexed: 12/15/2022] Open
Abstract
Uveal melanoma (UM) is the most common primary intraocular malignancy in
adults. Although UM and cutaneous melanoma are derived from
melanocytes, UM differs clinically and biologically from its more
common skin counterparts. More than half of primary UMs metastasize.
However, there is currently no effective treatment for metastatic UM.
Therefore, studying mutations related to the metastasis, growth,
proliferation, and survival of UM can help researchers understand its
pathogenesis and metastatic mechanism, thereby leading to a more
effective treatment. In addition, we provide an overview of the recent
basic and clinical studies to provide a strong foundation for
developing novel anti-carcinogenesis targets for future
interventions.
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Affiliation(s)
- Meng-Yu Wu
- Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei Department of Emergency Medicine, School of Medicine, Tzu Chi University, Hualien
| | - Tzu-Ting Lai
- Department of Ophthalmology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan
| | - Wan-Ting Liao
- Institute of Medicine, Chung Shan Medical University, Taichung Chinese Medicine Department, Show Chwan Memorial Hospital, Changhua
| | - Chia-Jung Li
- Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, No.386, Dazhong 1st Road, Zuoying District, Kaohsiung City 81362 Institute of BioPharmaceutical sciences, National Sun Yat-sen University, Kaohsiung
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22
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Rowcroft A, Loveday BPT, Thomson BNJ, Banting S, Knowles B. Systematic review of liver directed therapy for uveal melanoma hepatic metastases. HPB (Oxford) 2020; 22:497-505. [PMID: 31791894 DOI: 10.1016/j.hpb.2019.11.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 10/29/2019] [Accepted: 11/04/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Uveal melanoma (UM) is a rare malignancy with a propensity for metastasis to the liver. Systemic chemotherapy is typically ineffective in these patients with liver metastases and overall survival is poor. There are no evidence-based guidelines for management of UM liver metastases. The aim of this study was to review the evidence for management of UM liver metastases. METHODS A systematic review of English literature publications was conducted across Ovid Medline, Ovid MEDLINE and Cochrane CENTRAL databases until April 2019. The primary outcome was overall survival, with disease free survival as a secondary outcome. RESULTS 55 studies were included in the study, with 2446 patients treated overall. The majority of these studies were retrospective, with 17 of 55 including comparative data. Treatment modalities included surgery, isolated hepatic perfusion (IHP), hepatic artery infusion (HAI), transarterial chemoembolization (TACE), selective internal radiotherapy (SIRT) and Immunoembolization (IE). Survival varied greatly between treatments and between studies using the same treatments. Both surgery and liver-directed treatments were shown to have benefit in selected patients. CONCLUSION Predominantly retrospective and uncontrolled studies suggest that surgery and locoregional techniques may prolong survival. Substantial variability in patient selection and study design makes comparison of data and formulation of recommendations challenging.
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Affiliation(s)
- Alistair Rowcroft
- Department of Surgery, Royal Melbourne Hospital, Melbourne, Victoria, Australia; Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Benjamin P T Loveday
- Department of Surgery, Royal Melbourne Hospital, Melbourne, Victoria, Australia; Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Department of Surgery, University of Auckland, Auckland, New Zealand
| | - Benjamin N J Thomson
- Department of Surgery, Royal Melbourne Hospital, Melbourne, Victoria, Australia; Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Department of Surgery, University of Melbourne, Melbourne, Australia
| | - Simon Banting
- Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Brett Knowles
- Department of Surgery, Royal Melbourne Hospital, Melbourne, Victoria, Australia; Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
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23
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Tan S, Yang H, Xue S, Qiao J, Salarian M, Hekmatyar K, Meng Y, Mukkavilli R, Pu F, Odubade OY, Harris W, Hai Y, Yushak ML, Morales-Tirado VM, Mittal P, Sun PZ, Lawson D, Grossniklaus HE, Yang JJ. Chemokine receptor 4 targeted protein MRI contrast agent for early detection of liver metastases. SCIENCE ADVANCES 2020; 6:eaav7504. [PMID: 32083172 PMCID: PMC7007242 DOI: 10.1126/sciadv.aav7504] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 11/22/2019] [Indexed: 05/22/2023]
Abstract
Liver metastases often progress from primary cancers including uveal melanoma (UM), breast, and colon cancer. Molecular biomarker imaging is a new non-invasive approach for detecting early stage tumors. Here, we report the elevated expression of chemokine receptor 4 (CXCR4) in liver metastases in UM patients and metastatic UM mouse models, and development of a CXCR4-targeted MRI contrast agent, ProCA32.CXCR4, for sensitive MRI detection of UM liver metastases. ProCA32.CXCR4 exhibits high relaxivities (r 1 = 30.9 mM-1 s-1, r 2 = 43.2 mM-1 s-1, 1.5 T; r 1 = 23.5 mM-1 s-1, r 2 = 98.6 mM-1 s-1, 7.0 T), strong CXCR4 binding (K d = 1.10 ± 0.18 μM), CXCR4 molecular imaging capability in metastatic and intrahepatic xenotransplantation UM mouse models. ProCA32.CXCR4 enables detecting UM liver metastases as small as 0.1 mm3. Further development of the CXCR4-targeted imaging agent should have strong translation potential for early detection, surveillance, and treatment stratification of liver metastases patients.
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Affiliation(s)
- Shanshan Tan
- Department of Chemistry, Georgia State University, Atlanta, GA 30303, USA
| | - Hua Yang
- Department of Ophthalmology, Emory University, Atlanta, GA 30322, USA
| | - Shenghui Xue
- InLighta Biosciences LLC, Atlanta, GA 30303, USA
| | - Jingjuan Qiao
- Department of Chemistry, Georgia State University, Atlanta, GA 30303, USA
| | - Mani Salarian
- Department of Chemistry, Georgia State University, Atlanta, GA 30303, USA
| | - Khan Hekmatyar
- Bioimaging Research Center, University of Georgia, Athens, GA 30602, USA
| | - Yuguang Meng
- Yerkes National Primate Research Center, Emory University, Atlanta, GA 30329, USA
| | - Rao Mukkavilli
- Department of Biology, Georgia State University, Atlanta, GA 30303, USA
| | - Fan Pu
- Department of Chemistry, Georgia State University, Atlanta, GA 30303, USA
| | | | - Wayne Harris
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA 30322, USA
| | - Yan Hai
- Department of Mathematics and Statistics, Georgia State University, Atlanta, GA 30303, USA
| | - Melinda L. Yushak
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA 30322, USA
| | | | - Pardeep Mittal
- Department of Radiology and Imaging, Augusta University, Augusta, GA 30912, USA
| | - Phillip Z. Sun
- Yerkes National Primate Research Center, Emory University, Atlanta, GA 30329, USA
| | - David Lawson
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA 30322, USA
| | | | - Jenny J. Yang
- Department of Chemistry, Georgia State University, Atlanta, GA 30303, USA
- Center for Diagnostics and Therapeutics, Georgia State University, Atlanta, GA 30303, USA
- Corresponding author.
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24
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Beasley AB, Bentel J, Allcock RJN, Vermeulen T, Calapre L, Isaacs T, Ziman MR, Chen FK, Gray ES. Low-Pass Whole-Genome Sequencing as a Method of Determining Copy Number Variations in Uveal Melanoma Tissue Samples. J Mol Diagn 2020; 22:429-434. [PMID: 31978561 DOI: 10.1016/j.jmoldx.2019.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 11/26/2019] [Accepted: 12/11/2019] [Indexed: 12/25/2022] Open
Abstract
Analysis of specific somatic copy number alterations (SCNAs) using multiplex ligation-dependent probe amplification (MLPA) is used routinely as a prognostic test for uveal melanoma (UM). This technique requires relatively large amounts of input DNA, unattainable from many small fine-needle aspirate biopsy specimens. Herein, we compared the use of MLPA with whole-genome amplification (WGA) combined with low-pass whole-genome sequencing (LP-WGS) for detection of SCNA profiles in UM biopsy specimens. DNA was extracted from 21 formalin-fixed, paraffin-embedded UM samples and SCNAs were assessed using MLPA and WGA followed by LP-WGS. Cohen's κ was used to assess the concordance of copy number calls of each individual chromosome arm for each patient. MLPA and WGA/LP-WGS detection of SCNAs in chromosomes 1p, 3, 6, and 8 were compared and found to be highly concordant with a Cohen's κ of 0.856 (bias-corrected and accelerated 95% CI, 0.770-0.934). Only 13 of 147 (8.8%) chromosomal arms investigated resulted in discordant calls, predominantly SCNAs detected by WGA/LP-WGS but not MLPA. These results indicate that LP-WGS might be a suitable alternative or adjunct to MLPA for the detection of SCNAs associated with prognosis of UM, for cases with limiting tissue or DNA yields.
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Affiliation(s)
- Aaron B Beasley
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Jacqueline Bentel
- Department of Anatomical Pathology, PathWest Laboratory Medicine, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - Richard J N Allcock
- School of Biomedical Sciences, University of Western Australia, Crawley, Western Australia, Australia
| | - Tersia Vermeulen
- Department of Anatomical Pathology, PathWest Laboratory Medicine, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - Leslie Calapre
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Timothy Isaacs
- Perth Retina, Subiaco, Western Australia, Australia; Lions Eye Institute, Nedlands, Western Australia, Australia; Centre for Ophthalmology and Visual Science, University of Western Australia, Crawley, Western Australia, Australia; Department of Ophthalmology, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Melanie R Ziman
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia; School of Biomedical Sciences, University of Western Australia, Crawley, Western Australia, Australia
| | - Fred K Chen
- Lions Eye Institute, Nedlands, Western Australia, Australia; Centre for Ophthalmology and Visual Science, University of Western Australia, Crawley, Western Australia, Australia; Department of Ophthalmology, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Elin S Gray
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia; Centre for Ophthalmology and Visual Science, University of Western Australia, Crawley, Western Australia, Australia.
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25
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Bindewald-Wittich A, Swenshon T, Carasco E, Dreyhaupt J, Willerding GD. Blue-Light Fundus Autofluorescence Imaging following Ruthenium-106 Brachytherapy for Choroidal Melanoma. Ophthalmologica 2020; 243:303-315. [PMID: 31940652 DOI: 10.1159/000504715] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 11/08/2019] [Indexed: 11/19/2022]
Abstract
PURPOSE To describe changes in blue-light fundus autofluorescence (FAF) and corresponding alterations in optical coherence tomography (OCT) within the irradiation field after ruthenium-106 brachytherapy (RBT) for choroidal melanoma. METHODS Consecutive patients with choroidal melanoma were included in a retrospective case series. Patients were treated with RBT at a single institution. As part of their routine examination patients underwent multimodal imaging including ultrasonography, fundus photography, OCT, and FAF imaging (excitation = 488 nm). FAF images were analysed for changes within the irradiation field. RESULTS 31 patients (mean age 65.7 years) were treated with RBT for unilateral choroidal melanoma. Mean tumour height before therapy was 2.7 mm (SD 1.0). Mean follow-up time was 23.3 months (SD 13.3). Main FAF characteristics attributable to RBT emerged as increased FAF with speckled decreased FAF (FAF mottling) within the irradiation field and a rim of increased FAF at its border. OCT scans demonstrated loss of the ellipsoid zone and the external limiting membrane, thinning of the neurosensory retina, and alterations of the retinal pigment epithelium like clumping, migration, and atrophy. CONCLUSIONS FAF changes in the irradiation field after RBT of choroidal melanomas follow a characteristic pattern that correlates with distinct OCT alterations. FAF and OCT imaging give additional information to monitor effects of RBT and, therefore, complement multimodal imaging techniques after plaque therapy.
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Affiliation(s)
- Almut Bindewald-Wittich
- Augenheilkunde Heidenheim MVZ GmbH, Heidenheim, Germany.,Department of Ophthalmology, University of Bonn, Bonn, Germany
| | - Tomasz Swenshon
- Department of Ophthalmology, DRK Kliniken Berlin Westend, Berlin, Germany
| | - Eva Carasco
- Department of Ophthalmology, DRK Kliniken Berlin Westend, Berlin, Germany
| | - Jens Dreyhaupt
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
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Fodor K, Dobos N, Schally A, Steiber Z, Olah G, Sipos E, Szekvolgyi L, Halmos G. The targeted LHRH analog AEZS-108 alters expression of genes related to angiogenesis and development of metastasis in uveal melanoma. Oncotarget 2020; 11:175-187. [PMID: 32010430 PMCID: PMC6968782 DOI: 10.18632/oncotarget.27431] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 12/29/2019] [Indexed: 02/06/2023] Open
Abstract
Uveal melanoma (UM) is the most common malignant tumor of the eye. Recently, we have established that 46% of UM specimens express LHRH receptors. This finding supports the idea of a LHRH receptor-targeted therapy of UM patients. Cytotoxic analog of LHRH, AEZS-108 exhibits effective anti-cancer activity in LHRH-receptor positive cancers. AEZS-108 is a hybrid molecule, composed of a synthetic peptide carrier and the cytotoxic doxorubicin (DOX). In the present study, we investigated AEZS-108 induced cytotoxicity and the altered mRNA expression profile of regulatory factors related to angiogenesis and metastasis in LHRH receptor positive OCM3 cells. Our results show that AEZS-108 upregulates the expression of MASPIN/SERPINB5 tumor suppressor gene, which is downregulated in normal uvea and UM specimens independently from the LHRH receptor-ligand interaction. AEZS-108 also substantially downregulates hypoxia-inducible factor 1 alpha (HIF1A) expression. In order to investigate the mechanism of the induction of MASPIN by AEZS-108, OCM3 cells were treated with free DOX, D-Lys6 LHRH analog, or AEZS-108. qRT- PCR analysis revealed in OCM3 cells that AEZS-108 is a more potent inducer of MASPIN than free DOX. In conclusion, we show for the first time that AEZS-108 has a major impact in the regulation of angiogenesis thus plays a potential role in tumor suppression. Taken together, our results support the development of novel therapeutic strategies for UM focusing on LHRH receptors.
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Affiliation(s)
- Klara Fodor
- University of Debrecen, Department of Biopharmacy, Debrecen, Hungary
| | - Nikoletta Dobos
- University of Debrecen, Department of Biopharmacy, Debrecen, Hungary
| | - Andrew Schally
- Veterans Affairs Medical Center, Endocrine, Polypeptide and Cancer Insitute, Miami, FL, USA.,University of Miami, Miller School of Medicine, Department of Pathology and Department of Medicine, Divisions of Oncology and Endocrinology, Sylvester Comprehensive Center, Miami, FL, USA
| | - Zita Steiber
- University of Debrecen, Department of Ophthalmology, Debrecen, Hungary
| | - Gabor Olah
- University of Debrecen, Department of Biopharmacy, Debrecen, Hungary
| | - Eva Sipos
- University of Debrecen, Department of Biopharmacy, Debrecen, Hungary
| | - Lorant Szekvolgyi
- University of Debrecen, Faculty of Medicine, Department of Biochemistry and Molecular Biology, MTA-DE Momentum, Genome Architecture and Recombination Research Group, Debrecen, Hungary
| | - Gabor Halmos
- University of Debrecen, Department of Biopharmacy, Debrecen, Hungary.,Veterans Affairs Medical Center, Endocrine, Polypeptide and Cancer Insitute, Miami, FL, USA
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Violanti SS, Bononi I, Gallenga CE, Martini F, Tognon M, Perri P. New Insights into Molecular Oncogenesis and Therapy of Uveal Melanoma. Cancers (Basel) 2019; 11:E694. [PMID: 31109147 PMCID: PMC6562554 DOI: 10.3390/cancers11050694] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 05/14/2019] [Accepted: 05/15/2019] [Indexed: 12/15/2022] Open
Abstract
Uveal melanoma (UM), which is the most common cancer of the eye, was investigated in recent years by many teams in the field of biomedical sciences and eye clinicians. New knowledge was acquired on molecular pathways found to be dysregulated during the multistep process of oncogenesis, whereas novel therapeutic approaches gave significant results in the clinical applications. Uveal melanoma-affected patients greatly benefited from recent advances of the research in this eye cancer. Tumour biology, genetics, epigenetics and immunology contributed significantly in elucidating the role of different genes and related pathways during uveal melanoma onset/progression and UM treatments. Indeed, these investigations allowed identification of new target genes and to develop new therapeutic strategies/compounds to cure this aggressive melanoma of the eye. Unfortunately, the advances reported in the treatment of cutaneous melanoma have not produced analogous benefits in metastatic uveal melanoma. Nowadays, no systemic adjuvant therapy has been shown to improve overall survival or reduce the risk of metastasis. However, the increasing knowledge of this disease, and the encouraging results seen in clinical trials, offer promise for future effective therapies. Herein, different pathways/genes involved in uveal melanoma onset/progression were taken into consideration, together with novel therapeutic approaches.
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Affiliation(s)
- Sara Silvia Violanti
- Department of Biomedical Sciences and Specialized Surgeries, School of Medicine, University of Ferrara and Eye Unit of University Hospital of Ferrara, 44124 Ferrara, Italy.
| | - Ilaria Bononi
- Department of Morphology, Surgery and Experimental Medicine, Section of Pathology, Oncology and Experimental Biology, School of Medicine, University of Ferrara, 44121 Ferrara, Italy.
| | - Carla Enrica Gallenga
- Department of Biomedical Sciences and Specialized Surgeries, School of Medicine, University of Ferrara and Eye Unit of University Hospital of Ferrara, 44124 Ferrara, Italy.
| | - Fernanda Martini
- Department of Morphology, Surgery and Experimental Medicine, Section of Pathology, Oncology and Experimental Biology, School of Medicine, University of Ferrara, 44121 Ferrara, Italy.
| | - Mauro Tognon
- Department of Morphology, Surgery and Experimental Medicine, Section of Pathology, Oncology and Experimental Biology, School of Medicine, University of Ferrara, 44121 Ferrara, Italy.
| | - Paolo Perri
- Department of Biomedical Sciences and Specialized Surgeries, School of Medicine, University of Ferrara and Eye Unit of University Hospital of Ferrara, 44124 Ferrara, Italy.
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28
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Uveal melanoma: physiopathology and new in situ-specific therapies. Cancer Chemother Pharmacol 2019; 84:15-32. [DOI: 10.1007/s00280-019-03860-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 05/02/2019] [Indexed: 12/12/2022]
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29
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Jiang Z, Liu F. Butyrophilin-Like 9 (BTNL9) Suppresses Invasion and Correlates with Favorable Prognosis of Uveal Melanoma. Med Sci Monit 2019; 25:3190-3198. [PMID: 31039142 PMCID: PMC6505059 DOI: 10.12659/msm.914074] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background Uveal melanoma (UM) is the most common intraocular malignancy, and the prognosis of patients with advanced stage of UM is very dismal. The T cell receptor ectopic expression of butyrophilin-like 9 (BTNL9) has been observed in several types of cancers, but the expression and clinical significance of BTNL9 in UM is unclear. Material/Methods In our study, we detected the expression of BTNL9 in 6 pairs of UM tissues and adjacent tissues using quantitative real-time polymerase chain reaction (qRT-PCR), and further investigated BTNL9 expression with immunohistochemistry (IHC) in a retrospective cohort consisted of 62 UM patients. The correlations between BNTL9 expression and clinicopathological factors were analyzed with Fisher’s test, and the prognostic significance of BTNL9 was evaluated with univariate analysis and multivariate analysis. Using experiments in vitro, we investigated the function of BTNL9 in UM proliferation and invasion. Results BTNL9 mRNAs in adjacent tissues were remarkably higher than in UM tissues. The percentages of BTNL9 low expression and high expression were 56.45% and 43.55%, respectively. High expression of BTNL9 was significantly associated with favorable prognosis of UM. BTNL9 expression was identified as a prognostic biomarker predicting better outcome of UM patients. Moreover, BTNL9 could suppress invasion instead of proliferation in melanoma cell line. Conclusions BTNL9 was a favorable prognostic factor of UM and it could suppress invasion of UM, suggesting that BTNL9 detection could help stratify high-risk patients with UM after operation and guide more precise surveillance and treatment.
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Affiliation(s)
- Zhongming Jiang
- Department of Ophthalmology, LinYi Central Hospital, Linyi, Shandong, China (mainland)
| | - Fei Liu
- Department of Clinical Laboratory, Jining No.1 People's Hospital, Jining, Shandong, China (mainland)
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30
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Immunohistochemical Expression of ABCB5 as a Potential Prognostic Factor in Uveal Melanoma. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9071316] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Uveal melanoma represents the most common primary intraocular malignancy in adults; it may arise in any part of the uveal tract, with choroid and ciliary bodies being the most frequent sites of disease. In the present paper we studied ABCB5 expression levels in patients affected by uveal melanoma, both with and without metastasis, in order to evaluate if ABCB5 is associated with a higher risk of metastatic disease and can be used as a poor prognostic factor in uveal melanoma. The target population consisted of 23 patients affected by uveal melanoma with metastasis and 32 without metastatic disease. A high expression of ABCB5 was seen in patients with metastasis (14/23, 60.9%), compared to that observed in patients without metastasis (13/32, 40.6%). In conclusion, we found that ABCB5 expression levels were correlated with faster metastatic progression and poorer prognosis, indicating their role as a prognostic factor in uveal melanoma.
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31
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Roelofs K, Weis E. Tele-Oncology: A Validation Study of Choroidal and Iris Nevi. Ocul Oncol Pathol 2018; 5:298-302. [PMID: 31367594 DOI: 10.1159/000494977] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 10/30/2018] [Indexed: 02/03/2023] Open
Abstract
Background/Aims To evaluate teleophthalmological assessment of choroidal and iris nevi (tele-oncology) compared to traditional in-person clinical evaluation for detection of either axial or basal growth. Methods This is a validation study. All 97 eyes of 99 patients were evaluated with an in-person ocular oncology visit utilizing standard testing, and subsequently had a tele-oncology evaluation with the standardized tests. The tele-oncology reviewer was blinded to the in-person examination findings. The primary study outcome was detection of nevus growth on tele-oncology compared to in-person clinical examination. Results Patients had a mean age of 61 years and the majority had nevi located in the choroid (n = 87; 88%). The most common diagnosis was a low-risk nevus (n = 38; 44%). By tele-oncology assessment, 11 eyes showed growth. Ten of these patients had growth confirmed on in-person clinical examination. Resultantly, tele-oncology assessment of choroidal and iris nevi growth had a sensitivity of 100%, specificity of 99%, positive predictive value (PPV) of 91%, and negative predictive value (NPV) of 100%. Conclusions The results of this study suggest that tele-oncology is a safe platform for monitoring choroidal and iris nevi for growth, with excellent sensitivity, specificity, PPV, and NPV.
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Affiliation(s)
- Kelsey Roelofs
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Ezekiel Weis
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Alberta, Canada.,Department of Surgery, University of Calgary, Calgary, Alberta, Canada
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Maziarz M, Leyme A, Marivin A, Luebbers A, Patel PP, Chen Z, Sprang SR, Garcia-Marcos M. Atypical activation of the G protein Gα q by the oncogenic mutation Q209P. J Biol Chem 2018; 293:19586-19599. [PMID: 30352874 DOI: 10.1074/jbc.ra118.005291] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 10/15/2018] [Indexed: 12/22/2022] Open
Abstract
The causative role of G protein-coupled receptor (GPCR) pathway mutations in uveal melanoma (UM) has been well-established. Nearly all UMs bear an activating mutation in a GPCR pathway mediated by G proteins of the Gq/11 family, driving tumor initiation and possibly metastatic progression. Thus, targeting this pathway holds therapeutic promise for managing UM. However, direct targeting of oncogenic Gαq/11 mutants, present in ∼90% of UMs, is complicated by the belief that these mutants structurally resemble active Gαq/11 WT. This notion is solidly founded on previous studies characterizing Gα mutants in which a conserved catalytic glutamine (Gln-209 in Gαq) is replaced by leucine, which leads to GTPase function deficiency and constitutive activation. Whereas Q209L accounts for approximately half of GNAQ mutations in UM, Q209P is as frequent as Q209L and also promotes oncogenesis, but has not been characterized at the molecular level. Here, we characterized the biochemical and signaling properties of Gαq Q209P and found that it is also GTPase-deficient and activates downstream signaling as efficiently as Gαq Q209L. However, Gαq Q209P had distinct molecular and functional features, including in the switch II region of Gαq Q209P, which adopted a conformation different from that of Gαq Q209L or active WT Gαq, resulting in altered binding to effectors, Gβγ, and regulators of G-protein signaling (RGS) proteins. Our findings reveal that the molecular properties of Gαq Q209P are fundamentally different from those in other active Gαq proteins and could be leveraged as a specific vulnerability for the ∼20% of UMs bearing this mutation.
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Affiliation(s)
- Marcin Maziarz
- From the Department of Biochemistry, Boston University School of Medicine, Boston, Massachusetts 02118
| | - Anthony Leyme
- From the Department of Biochemistry, Boston University School of Medicine, Boston, Massachusetts 02118
| | - Arthur Marivin
- From the Department of Biochemistry, Boston University School of Medicine, Boston, Massachusetts 02118
| | - Alex Luebbers
- From the Department of Biochemistry, Boston University School of Medicine, Boston, Massachusetts 02118
| | - Prachi P Patel
- From the Department of Biochemistry, Boston University School of Medicine, Boston, Massachusetts 02118
| | - Zhe Chen
- the Department of Biophysics, University of Texas Southwestern Medical Center, Dallas, Texas 75390, and
| | - Stephen R Sprang
- the Center for Biomolecular Structure and Dynamics, University of Montana, Missoula, Montana 59812
| | - Mikel Garcia-Marcos
- From the Department of Biochemistry, Boston University School of Medicine, Boston, Massachusetts 02118,
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33
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Yan B, Fu T, Liu Y, Wei W, Dai H, Fang W, Wang F. 99mTc-3PRGD2 single-photon emission computed tomography/computed tomography for the diagnosis of choroidal melanoma: A preliminary STROBE-compliant observational study. Medicine (Baltimore) 2018; 97:e12441. [PMID: 30290601 PMCID: PMC6200507 DOI: 10.1097/md.0000000000012441] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Recent successes in monitoring and diagnosing a variety of tumors using Tc-PEG4-E[PEG4-c(RGDfK)]2 (Tc-3PRGD2) single-photon emission computed tomography (SPECT) imaging encouraged us to expand the use of this tracer. This case-control study aimed to evaluate the feasibility of Tc-3PRGD2 imaging for detecting choroidal melanoma (CM) and for monitoring tumor response to plaque brachytherapy (PB). Ten consecutive patients with CM who underwent Tc-3PRGD2 imaging before and 3 months after PB were reviewed. The tumor-to-occipital bone (T/O) and mirrored contralateral normal tissue-to-occipital bone (N/O) ratios were calculated by region of interest analysis at baseline and 3 months post-PB. T/O values were compared between patients with CM with comorbid secondary retinal detachment (RD) and those without RD. The relationship between T/O value and tumor volume was also investigated. Tc-3PRGD2 SPECT/CT showed focal uptake in CM. The mean T/O ratio before PB was 1.90 ± 1.26 and the mean N/O ratio was 0.80 ± 0.21 (P = .02). The Tc-3PRGD2 concentrations in 5 patients with CM with RD were higher (T/O = 2.69 ± 1.39) than in those without secondary RD (T/O = 1.10 ± 0.18) (P = .008). T/O ratios at 3 months post-PB were significantly lower than that at baseline (1.23 ± 0.59, P = .03). There was a linear relationship between T/O and tumor volume (y-hat = 0.028 + 0.003x, R = 0.768, P = .001). The 95% confidence interval for the (T/O)/volume ratio was 0.002 to 0.005. Tc-3PRGD2 imaging is a feasible modality for the diagnosis of CM. Furthermore, follow-up for at least 20 months after PB indicated that coanalysis of Tc-3PRGD2 imaging and tumor volume may provide a promising prognostic predictor in patients with CM.
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Affiliation(s)
- Bing Yan
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology
- Department of Nuclear Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Tong Fu
- Institute of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany
- Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing
| | - Yueming Liu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University
| | - Wenbin Wei
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University
| | - Haojie Dai
- Department of Nuclear Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Wei Fang
- Cardiovascular Institute & Fu Wai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Feng Wang
- Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing
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Weis E, Roelofs K, Larocque M, Murtha A. Gene Expression Profiling as an Adjunctive Measure to Guide the Management of Indeterminate, High-Risk Choroidal Melanocytic Lesions: A Pilot Study. Ocul Oncol Pathol 2018; 5:102-109. [PMID: 30976587 DOI: 10.1159/000490252] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 05/18/2018] [Indexed: 11/19/2022] Open
Abstract
Purpose To describe our early experience with gene expression profiling (GEP) assessment for juxtafoveal, subfoveal, and peripapillary indeterminate high-risk melanocytic lesions to assist in making early treatment decisions in patients who did not feel comfortable with either close observation or definitive treatment. Methods A prospective cohort of patients with indeterminate lesions who underwent GEP were enrolled. Nonparametric statistical analysis was utilized given the small sample size. Results Fifteen patients were included in this series. Six (40%) were class 1A and 9 (60%) class 1B. Class 1A and 1B lesions had a median of three and four clinical risk factors, respectively (p = 0.27). There was no statistically significant difference for the largest basal diameter between the classes (p = 0.31); however, class 1B lesions were thicker than class 1A lesions (p = 0.03). None of the class 1A lesions showed definite growth or metastasis over a mean follow-up period of 17.1 ± 1.8 months from fine needle aspiration biopsy. All class 1B patients opted for plaque brachytherapy, and to date none of these patients have developed metastasis, with a mean follow-up of 18.7 ± 8.4 months. Conclusion There may be a role for GEP assessment in high-risk, indeterminate, posteriorly located choroidal lesions to assist in treatment planning.
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Affiliation(s)
- Ezekiel Weis
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Alberta, Canada.,Department of Surgery, University of Calgary, Calgary, Alberta, Canada
| | - Kelsey Roelofs
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Matthew Larocque
- Division of Medical Physics, Department of Oncology, University of Alberta, Edmonton, Alberta, Canada
| | - Albert Murtha
- Department of Oncology, University of Alberta, Edmonton, Alberta, Canada
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Liu S, Song W, Liu F, Zhang J, Zhu S. Antitumor efficacy of VP22-CD/5-FC suicide gene system mediated by lentivirus in a murine uveal melanoma model. Exp Eye Res 2018; 172:144-151. [DOI: 10.1016/j.exer.2018.04.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 03/15/2018] [Accepted: 04/12/2018] [Indexed: 12/22/2022]
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Boone BA, Perkins S, Bandi R, Santos E, McCluskey K, Bartlett DL, Pingpank JF. Hepatic artery infusion of melphalan in patients with liver metastases from ocular melanoma. J Surg Oncol 2018; 117:940-946. [PMID: 29878390 DOI: 10.1002/jso.24984] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Accepted: 12/18/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND OBJECTIVES Ocular melanoma has a predilection for liver metastases. Systemic treatment is ineffective and the optimal regional therapy approach is poorly defined. Isolated hepatic perfusion (IHP) with melphalan has emerged as a viable treatment option, however a subset of patients are not candidates for this treatment. We therefore sought to determine if melphalan could be safely administered via the hepatic artery for these patients. METHODS A retrospective review of patients treated with hepatic artery infusion (HAI) of melphalan was undertaken. All patients had contraindications to IHP and were without other therapy options. Melphalan infusion was repeated every four weeks with consideration for dose escalation in the absence of toxicity or significant disease progression. RESULTS Fourteen patients were treated with HAI of melphalan from 2010 to 2015. All patients had hepatic dysfunction or prohibitive tumor volume precluding IHP. There were no procedure-related complications. Three patients (21%) died within 30 days and the median survival was 2.9 months. Elevated baseline bilirubin > 2.5 mg/dL was associated with worse overall survival (0.93 vs 6.3 months, P < 0.05). CONCLUSION HAI of melphalan is safe and feasible for patients with metastatic ocular melanoma. Further study to determine the optimal utilization of this treatment approach is warranted.
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Affiliation(s)
- Brian A Boone
- Division of Surgical Oncology, Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Samantha Perkins
- Division of Surgical Oncology, Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Rupal Bandi
- Division of Surgical Oncology, Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Ernesto Santos
- Department of Radiology, Memorial Sloan Kettering, New York, New York
| | - Kevin McCluskey
- Department of Radiology, West Virginia University, Morgantown, West Virginia
| | - David L Bartlett
- Division of Surgical Oncology, Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - James F Pingpank
- Division of Surgical Oncology, Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
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Liu Y, Huo Y, Wang D, Tai Y, Li J, Pang D, Zhang Y, Zhao W, Du N, Huang Y. MiR-216a-5p/Hexokinase 2 axis regulates uveal melanoma growth through modulation of Warburg effect. Biochem Biophys Res Commun 2018; 501:885-892. [PMID: 29763606 DOI: 10.1016/j.bbrc.2018.05.069] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 05/11/2018] [Indexed: 12/18/2022]
Abstract
Hexokinase-2 (HK2), the initial as well as the rate-limiting step in glycolysis, is overexpressed in many human cancers, and correlates with poor clinical outcomes. Aerobic glycolysis is a hallmark of cancer, and drugs targeting its enzymes, including HK2, are being developed. However, the mechanisms of HK2 inhibition and the physiological significance of the HK2 inhibitors in cancer cells are rarely reported. Here, we show that microRNA-216a-5p (miR-216a-5p) inhibits HK2 expression by directly targeting its 3'-UTR in uveal melanoma cells. Through inhibition of HK2, miR-216a-5p dampens glycolysis by reducing HK activity, glucose uptake, lactate production, ATP generation, extracellular acidification rate (ECAR), and increasing oxygen consumption rate (OCR) in uveal melanoma cells. Importantly, glycolysis regulated by miR-216a-5p is critical for its regulating uveal melanoma tumor growth both in vitro and in vivo. miR-216a-5p expression is negatively correlated with HK2 expression and predicts better outcome in uveal melanoma patients. Our findings provide clues regarding the role of miR-216a-5p as a tumor suppressor in uveal melanoma through the inhibition of HK2. Targeting HK2 through miR-216a-5p could be a promising therapeutic strategy in uveal melanoma.
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Affiliation(s)
- Ying Liu
- Department of Ophthalmology, Chinese PLA General Hospital, Beijing, 100853, China; School of Medicine, Nankai University, Tianjin, 300071, China; Department of Ophthalmology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, 121000, China.
| | - Yan Huo
- Department of Ophthalmology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Dajiang Wang
- Department of Ophthalmology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Yanhong Tai
- Department of Pathology, 307 PLA Hospital, Beijing, 100853, China
| | - Jie Li
- Department of Pathology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Dongbo Pang
- Department of Ophthalmology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, 121000, China
| | - Yan Zhang
- Department of Radiology, Affiliated Hospital of Guizhou Medical University, Guiyang, PR China
| | - Wei Zhao
- Department of Oncology, The General Hospital of the PLA Rocket Force, Beijing, 100088, China.
| | - Nan Du
- Department of Oncology, Chinese PLA General Hospital, Beijing, 100853, China.
| | - Yifei Huang
- Department of Ophthalmology, Chinese PLA General Hospital, Beijing, 100853, China.
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Regional therapies for locoregionally advanced and unresectable melanoma. Clin Exp Metastasis 2018; 35:495-502. [DOI: 10.1007/s10585-018-9890-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Accepted: 04/16/2018] [Indexed: 02/04/2023]
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He J, Li Y, Wang Y, Zhang H, Ge S, Fan X. Targeted silencing of the ADP-ribosyltransferase 3 gene inhibits the migration ability of melanoma cells. Oncol Lett 2018; 15:7053-7059. [PMID: 29725430 PMCID: PMC5920432 DOI: 10.3892/ol.2018.8252] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Accepted: 01/10/2018] [Indexed: 12/12/2022] Open
Abstract
Melanoma is the most common primary intraocular malignancy and metastasis of melanoma to other organs often results in a poor prognosis. ADP-ribosyltransferase 3 (ART3) is involved in cell division and DNA repair. However, its biological function in melanoma remains unclear. In the present study, it was identified that ART3 is highly expressed in melanoma cells and melanoma tissues compared with the normal RPE cell line, and adjacent normal tissue, respectively. Small interfering RNA and short hairpin RNA were used to silence ART3 gene expression, and the results revealed that the silencing of ART3 inhibits the migratory ability of melanoma cells. The present study indicates that ART3 serves a notable role in the metastasis of melanoma and provides a potential therapeutic target for this disease.
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Affiliation(s)
- Jie He
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R. China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R. China
| | - Yongyun Li
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R. China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R. China
| | - Ying Wang
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R. China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R. China
| | - He Zhang
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R. China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R. China
| | - Shengfang Ge
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R. China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R. China
| | - Xianqun Fan
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R. China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R. China
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Angi M, Kalirai H, Prendergast S, Simpson D, Hammond DE, Madigan MC, Beynon RJ, Coupland SE. In-depth proteomic profiling of the uveal melanoma secretome. Oncotarget 2018; 7:49623-49635. [PMID: 27391064 PMCID: PMC5226534 DOI: 10.18632/oncotarget.10418] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 06/09/2016] [Indexed: 12/23/2022] Open
Abstract
Uveal melanoma (UM), the most common primary intraocular tumour in adults, is characterised by a high frequency of metastases to the liver, typically with a fatal outcome. Proteins secreted from cancer cells (‘secretome’) are biologically important molecules thought to contribute to tumour progression. We examined the UM secretome by applying a label-free nanoLCMS/MS proteomic approach to profile proteins secreted into culture media by primary UM tumours with a high− (HR; n = 11) or low− (LR; n = 4) metastatic risk, compared to normal choroidal melanocytes (NCM) from unaffected post-mortem eyes. Across the three groups, 1843 proteins were identified at a 1% false discovery rate; 758 of these by at least 3 unique peptides, and quantified. The majority (539/758, 71%) of proteins were classified as secreted either by classical (144, 19%), non-classical (43, 6%) or exosomal (352, 46%) mechanisms. Bioinformatic analyzes showed that the secretome composition reflects biological differences and similarities of the samples. Ingenuity® pathway analysis of the secreted protein dataset identified abundant proteins involved in cell proliferation-, growth- and movement. Hepatic fibrosis/hepatic stellate cell activation and the mTORC1-S6K signalling axis were among the most differentially regulated biological processes in UM as compared with NCM. Further analysis of proteins upregulated ≥ 2 in HR-UM only, identified exosomal proteins involved in extracellular matrix remodelling and cancer cell migration/invasion; as well as classically secreted proteins, possibly representing novel biomarkers of metastatic disease. In conclusion, UM secretome analysis identifies novel proteins and pathways that may contribute to metastatic development at distant sites, particularly in the liver.
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Affiliation(s)
- Martina Angi
- Liverpool Ocular Oncology Research Group, Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Helen Kalirai
- Liverpool Ocular Oncology Research Group, Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Samuel Prendergast
- Liverpool Ocular Oncology Research Group, Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Deborah Simpson
- Centre for Proteome Research, Institute of Integrative Biology, University of Liverpool, Liverpool, UK
| | - Dean E Hammond
- Department of Cellular and Molecular Physiology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Michele C Madigan
- School of Optometry, University of New South Wales, New South Wales, Australia.,Save Sight Institute, Ophthalmology, University of Sydney, New South Wales, Australia
| | - Robert J Beynon
- Centre for Proteome Research, Institute of Integrative Biology, University of Liverpool, Liverpool, UK
| | - Sarah E Coupland
- Liverpool Ocular Oncology Research Group, Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
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Afzal MZ, Mabaera R, Shirai K. Metastatic uveal melanoma showing durable response to anti-CTLA-4 and anti-PD-1 combination therapy after experiencing progression on anti-PD-1 therapy alone. J Immunother Cancer 2018; 6:13. [PMID: 29433557 PMCID: PMC5809910 DOI: 10.1186/s40425-018-0322-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 01/26/2018] [Indexed: 12/15/2022] Open
Abstract
Background Uveal melanoma accounts for 85% of the ocular melanomas and has an increased risk of hematogenous spread, most commonly to the liver. After curative intent therapy like surgery and radiation, fifty percent of patients present with distant metastasis. Metastatic uveal melanoma (MUM) does not harbor typically targetable mutations, e.g., BRAF as in cutaneous melanoma. As a result, there is no proven therapy for MUM. Various chemotherapy and immunotherapy regimens have been tried and only partial response (PR) is the best that has been achieved in most of the cases. Here, we present a case of MUM treated with combination immune checkpoint therapy (ipilimumab and nivolumab) following the progression with single-agent nivolumab and demonstrating a durable response without recurrence more than 22 months from the last treatment. Case Presentation A 72-year-old Caucasian man presented with ciliary body melanoma of the left eye and underwent curative-intent enucleation but six months later developed diffuse hepatic metastases. He initially was treated with nivolumab 3 mg/kg every two weeks for four cycles but restaging scan showed a significant progression of the disease with increasing LDH. With the FDA approval for the combination of nivolumab 1mg/kg with Ipilimumab 3 mg/kg every three weeks for metastatic melanoma, this combination was given for four cycles with continuous rise in LDH to 993 unit/L (110-220 unit/L) until finishing cycle four of the treatment. Three weeks later, maintainence nivolumab 3mg/kg was initiated but two weeks later, he developed grade 4 liver toxicity with ALT 1565 unit/L (0-55 unit/L). A presumptive diagnosis of autoimmune hepatitis was made, nivolumab was stopped and oral prednisone 1mg/kg was started with quick resolution of elevated transaminases. Restaging abdominal MRI one month after the first and last dose of maintenance nivolumab showed PR and continuous shrinkage of the metastatic lesions with no hypermetabolic activity even on PET/CT. He is 22 months' post-treatment and continues to do well without any evidence of active disease. Conclusion Although, limited response has been shown to single agent immune checkpoint inhibitors and chemotherapy, our patient showed durable response with anti-CTLA-4 and anti-PD-1 combination therapy in MUM.
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Affiliation(s)
- Muhammad Zubair Afzal
- Department of Hospital Medicine, Dartmouth-Hitchcock Medical Center, One Medical Center Dr., Lebanon, NH, 03756, USA
| | - Rodwell Mabaera
- Hematology/Oncology, Norris cotton Cancer Center, One Medical Center Dr., Lebanon, NH, 03756, USA
| | - Keisuke Shirai
- Hematology/Oncology, Norris cotton Cancer Center, One Medical Center Dr., Lebanon, NH, 03756, USA.
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The mTOR inhibitor Everolimus synergizes with the PI3K inhibitor GDC0941 to enhance anti-tumor efficacy in uveal melanoma. Oncotarget 2018; 7:23633-46. [PMID: 26988753 PMCID: PMC5029652 DOI: 10.18632/oncotarget.8054] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 02/29/2016] [Indexed: 12/26/2022] Open
Abstract
Uveal melanoma (UM) is the most frequent malignant ocular tumor in adults. While the primary tumor is efficiently treated by surgery and/or radiotherapy, about one third of UM patients develop metastases, for which no effective treatment is currently available. The PKC, MAPK and PI3K/AKT/mTOR signaling cascades have been shown to be associated with tumor growth. However, none of the compounds against those pathways results in tumor regression when used as single agents. To identify more effective therapeutic strategies for UM patients, we performed a combination screen using seven targeted agents inhibiting PKC, MEK, AKT, PI3K and mTOR in a panel of ten UM cell lines, representative of the UM disease. We identified a strong synergy between the mTOR inhibitor Everolimus and the PI3K inhibitor GDC0941. This combination resulted in an increase in apoptosis in several UM cell lines compared to monotherapies and enhanced the anti-tumor effect of each single agent in two patient-derived xenografts. Furthermore, we showed that the synergism between the two drugs was associated with the relief by GDC0491 of a reactivation of AKT induced by Everolimus. Altogether, our results highlight a novel and effective combination strategy, which could be beneficial for UM patients.
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Kines RC, Varsavsky I, Choudhary S, Bhattacharya D, Spring S, McLaughlin R, Kang SJ, Grossniklaus HE, Vavvas D, Monks S, MacDougall JR, de Los Pinos E, Schiller JT. An Infrared Dye-Conjugated Virus-like Particle for the Treatment of Primary Uveal Melanoma. Mol Cancer Ther 2017; 17:565-574. [PMID: 29242243 DOI: 10.1158/1535-7163.mct-17-0953] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 12/01/2017] [Accepted: 12/08/2017] [Indexed: 11/16/2022]
Abstract
The work outlined herein describes AU-011, a novel recombinant papillomavirus-like particle (VLP) drug conjugate and its initial evaluation as a potential treatment for primary uveal melanoma. The VLP is conjugated with a phthalocyanine photosensitizer, IRDye 700DX, that exerts its cytotoxic effect through photoactivation with a near-infrared laser. We assessed the anticancer properties of AU-011 in vitro utilizing a panel of human cancer cell lines and in vivo using murine subcutaneous and rabbit orthotopic xenograft models of uveal melanoma. The specificity of VLP binding (tumor targeting), mediated through cell surface heparan sulfate proteoglycans (HSPG), was assessed using HSPG-deficient cells and by inclusion of heparin in in vitro studies. Our results provide evidence of potent and selective anticancer activity, both in vitro and in vivo AU-011 activity was blocked by inhibiting its association with HSPG using heparin and using cells lacking surface HSPG, indicating that the tumor tropism of the VLP was not affected by dye conjugation and cell association is critical for AU-011-mediated cytotoxicity. Using the uveal melanoma xenograft models, we observed tumor uptake following intravenous (murine) and intravitreal (rabbit) administration and, after photoactivation, potent dose-dependent tumor responses. Furthermore, in the rabbit orthotopic model, which closely models uveal melanoma as it presents in the clinic, tumor treatment spared the retina and adjacent ocular structures. Our results support further clinical development of this novel therapeutic modality that might transform visual outcomes and provide a targeted therapy for the early-stage treatment of patients with this rare and life-threatening disease. Mol Cancer Ther; 17(2); 565-74. ©2017 AACR.
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Affiliation(s)
| | | | | | | | | | | | - Shin J Kang
- Emory Eye Center, Emory University, Atlanta, Georgia
| | | | - Demetrios Vavvas
- Angiogenesis Laboratory Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts
| | | | | | | | - John T Schiller
- Laboratory of Cellular Oncology, NCI, NIH, Bethesda, Maryland
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Zheng X, Tang H, Zhao X, Sun Y, Jiang Y, Liu Y. Long non-coding RNA FTH1P3 facilitates uveal melanoma cell growth and invasion through miR-224-5p. PLoS One 2017; 12:e0184746. [PMID: 29095823 PMCID: PMC5667836 DOI: 10.1371/journal.pone.0184746] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 08/30/2017] [Indexed: 12/14/2022] Open
Abstract
Growing evidences indicated that Long noncoding RNAs (lncRNAs) played important roles in tumor initiation and progression. However, the function and mechnism of lncRNA ferritin heavy chain 1 pseudogene 3 (FTH1P3) remain unknown in uveal melanoma. We showed that the expression level of FTH1P3 was upregulated in uveal melanoma cell lines and tissues. Elevated expression of FTH1P3 promoted uveal melanoma cell proliferation, cell cycle and migration. Moreover, we found that FTH1P3 was a direct target gene of miR-224-5p in uveal melanoma cell. Overexpression of FTH1P3 suppressed miR-224-5p expression and promoted the expression of Rac1 and Fizzled 5, which were the direct target genes of miR-224-5p. Furthermore, we showed that miR-224-5p expression level was downregulated in uveal melanoma cell lines and tissues. FTH1P3 expression was inversely correlated with the miR-224-5p expression in uveal melanoma tissues. Ectopic expression of miR-224-5p decreased uveal melanoma cell proliferation, cell cycle and migration. Elevated expression of FTH1P3 enhanced uveal melanoma cell proliferation and migration by inhibiting miR-224-5p expression. These results suggest that lncRNA FTH1P3 plays a crucial role in uveal melanoma. Investigation of the underlying mechanism may be a target for the treatment of uveal melanoma.
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Affiliation(s)
- Xiaoli Zheng
- Department of Ophthalmology, Liaocheng People's Hospital, Liaocheng, Shandong, China
- * E-mail:
| | - Hongwei Tang
- Department of Ophthalmology, Liaocheng People's Hospital, Liaocheng, Shandong, China
| | - Xiaofeng Zhao
- Joint Laboratory for Translational Medicine, Liaocheng People's Hospital, Liaocheng, Shandong, China
| | - Yamei Sun
- Institute Pasteur of Shanghai Chinese Academy of Science, Shanghai, China
| | - Yanfang Jiang
- Genetic Diagnosis Center, The First Hospital of Jilin University, Changchun, China
| | - Yonghua Liu
- Department of Ophthalmology, Liaocheng People's Hospital, Liaocheng, Shandong, China
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45
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In vitro and in vivo anti-uveal melanoma activity of JSL-1, a novel HDAC inhibitor. Cancer Lett 2017; 400:47-60. [DOI: 10.1016/j.canlet.2017.04.028] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 04/08/2017] [Accepted: 04/14/2017] [Indexed: 12/27/2022]
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46
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Irenaeus S, Schiza A, Mangsbo SM, Wenthe J, Eriksson E, Krause J, Sundin A, Ahlström H, Tötterman TH, Loskog A, Ullenhag GJ. Local irradiation does not enhance the effect of immunostimulatory AdCD40L gene therapy combined with low dose cyclophosphamide in melanoma patients. Oncotarget 2017; 8:78573-78587. [PMID: 29108250 PMCID: PMC5667983 DOI: 10.18632/oncotarget.19750] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 06/19/2017] [Indexed: 12/16/2022] Open
Abstract
Background AdCD40L is an immunostimulatory gene therapy under evaluation for advanced melanoma, including ocular melanoma. Herein, we present the final data of a Phase I/IIa trial using AdCD40L alone or in combination with low dose cyclophosphamide +/- radiation therapy. Methods AdCD40L is a replication-deficient adenovirus carrying the gene for CD40 ligand (CD40L). Twenty-four patients with advanced melanoma were enrolled and treated with AdCD40L monotherapy, or combined with cyclophosphamide +/- single fraction radiotherapy. The patients were monitored for 10 weeks using immunological and radiological evaluations and thereafter for survival. Results AdCD40L treatment was safe and well tolerated both alone and in combination with cyclophosphamide as well as local radiotherapy. Four out of twenty-four patients had >1 year survival. Addition of cyclophosphamide was beneficial but adding radiotherapy did not further extend survival. High initial plasma levels of IL12 and MIP3b correlated to overall survival, whereas IL8 responses post-treatment correlated negatively with survival. Interestingly, antibody reactions to the virus correlated negatively with post IL6 and pre IL1b levels in blood. Conclusions AdCD40L was safely administered to patients and effect was improved by cyclophosphamide but not by radiotherapy. Immune activation profile at baseline may predict responders better than shortly after treatment.
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Affiliation(s)
- Sandra Irenaeus
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, 751 85, Uppsala, Sweden.,Department of Oncology, Uppsala University Hospital, 751 85, Uppsala, Sweden
| | - Aglaia Schiza
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, 751 85, Uppsala, Sweden.,Department of Oncology, Uppsala University Hospital, 751 85, Uppsala, Sweden
| | - Sara M Mangsbo
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, 751 85, Uppsala, Sweden
| | - Jessica Wenthe
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, 751 85, Uppsala, Sweden
| | - Emma Eriksson
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, 751 85, Uppsala, Sweden
| | - Johan Krause
- Department of Radiology, Uppsala University Hospital, 751 85, Uppsala, Sweden
| | - Anders Sundin
- Department of Radiology, Uppsala University Hospital, 751 85, Uppsala, Sweden.,Department of Surgical Sciences, Uppsala University, 751 85, Uppsala, Sweden
| | - Håkan Ahlström
- Department of Radiology, Uppsala University Hospital, 751 85, Uppsala, Sweden.,Department of Surgical Sciences, Uppsala University, 751 85, Uppsala, Sweden
| | - Thomas H Tötterman
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, 751 85, Uppsala, Sweden
| | - Angelica Loskog
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, 751 85, Uppsala, Sweden
| | - Gustav J Ullenhag
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, 751 85, Uppsala, Sweden.,Department of Oncology, Uppsala University Hospital, 751 85, Uppsala, Sweden
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Gezgin G, Luk SJ, Cao J, Dogrusöz M, van der Steen DM, Hagedoorn RS, Krijgsman D, van der Velden PA, Field MG, Luyten GPM, Szuhai K, Harbour JW, Jordanova ES, Heemskerk MHM, Jager MJ. PRAME as a Potential Target for Immunotherapy in Metastatic Uveal Melanoma. JAMA Ophthalmol 2017; 135:541-549. [PMID: 28448663 DOI: 10.1001/jamaophthalmol.2017.0729] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Importance Uveal melanoma (UM) is an intraocular primary malignant neoplasm that often gives rise to metastatic disease for which there are no effective therapies. A substantial proportion of UMs express the cancer-testis antigen PRAME (preferentially expressed antigen in melanoma), which can potentially be targeted by adoptive T-cell therapy. Objective To determine whether there may be a rationale for PRAME-directed T-cell therapy for metastatic UM. Design, Setting, and Participants An experimental study using a retrospective cohort of 64 patients with UM (median follow-up, 62 months) was conducted from January 8, 2015, to November 20, 2016, at the Leiden University Medical Center. Clinical, histopathologic, and genetic parameters were compared between 64 PRAME-positive and PRAME-negative UMs. HLA class I restricted, PRAME-specific T cells were stimulated with UM cell lines to measure their antigen-specific reactivity against these cell lines, which were analyzed for PRAME expression by real-time quantitative polymerase chain reaction. Uveal melanoma metastases from 16 unrelated patients were assessed for PRAME expression by messenger RNA fluorescence in situ hybridization and for HLA class I expression by immunofluorescence staining. Main Outcomes and Measures Interferon γ production for antigen-specific reactivity and detection of PRAME and HLA class I expression in primary and metastatic UM. Results Of the 64 patients in the study (31 women and 33 men; mean [SD] age at the time of enucleation, 60.6 [15.6] years), PRAME expression was negative in 35 primary UMs and positive in 29 primary UMs. Positive PRAME expression was associated with a high largest basal diameter (15.0 vs 12.0 mm; P = .005), ciliary body involvement (59% vs 26%; P = .008), and amplification of chromosome 8q (66% vs 23%; P = .002). PRAME-specific T cells reacted against 4 of 7 UM cell lines, demonstrating that T-cell reactivity correlated with PRAME expression. Metastatic UM samples were positive for PRAME messenger RNA in 11 of 16 patients and for HLA class I in 10 of 16 patients, with 8 of 16 patients demonstrating coexpression of both PRAME and HLA class I. Conclusions and Relevance PRAME is expressed in many primary and metastatic UMs, and about half of the metastatic UMs coexpress PRAME and HLA class I. The finding that PRAME-specific T cells in this study reacted against PRAME-positive UM cell lines suggests a potential role for PRAME-directed immunotherapy for selected patients with metastatic UM.
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Affiliation(s)
- Gülçin Gezgin
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
| | - Sietse J Luk
- Department of Haematology, Leiden University Medical Center, Leiden, the Netherlands
| | - Jinfeng Cao
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands3Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, China
| | - Mehmet Dogrusöz
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
| | - Dirk M van der Steen
- Department of Haematology, Leiden University Medical Center, Leiden, the Netherlands
| | - Renate S Hagedoorn
- Department of Haematology, Leiden University Medical Center, Leiden, the Netherlands
| | - Daniëlle Krijgsman
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Matthew G Field
- Bascom Palmer Eye Institute, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida
| | - Gregorius P M Luyten
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
| | - Karoly Szuhai
- Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, the Netherlands
| | - J William Harbour
- Bascom Palmer Eye Institute, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida
| | - Ekaterina S Jordanova
- Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands7Center for Gynecological Oncology Amsterdam, Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, the Netherlands
| | - Mirjam H M Heemskerk
- Department of Haematology, Leiden University Medical Center, Leiden, the Netherlands
| | - Martine J Jager
- Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands
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Mahendraraj K, Shrestha S, Lau CS, Chamberlain RS. Ocular melanoma-when you have seen one, you have not seen them all: a clinical outcome study from the Surveillance, Epidemiology and End Results (SEER) database (1973-2012). Clin Ophthalmol 2017; 11:153-160. [PMID: 28115829 PMCID: PMC5221652 DOI: 10.2147/opth.s120530] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Ocular melanoma (OM) comprises <5% of all melanomas. Uveal melanoma (UM) is the most common subtype of OM, while conjunctival melanoma (CM) is rare and differs significantly from UM. The purpose of this study is to evaluate a large cohort of OM patients to differentiate demographic, pathologic, and clinical factors between these two neoplasms, which may affect treatment and outcomes. METHODS The Surveillance, Epidemiology, and End Results database (1973-2012) was used to extract demographic and clinical data on 8,165 OM patients (92.1% UM and 7.9% CM). RESULTS Both CM and UM were most prevalent among Caucasian males in the seventh decade of life. UM patients presented more often with localized disease (90.9% vs 81.2, P<0.01). Surgery (42.8%), radiation (43.0%), or combined surgery and radiation (7.0%) were used in the treatment of UM, while CM was treated almost exclusively with surgery (88.7%). Mean overall survival was longer (15.4 vs 14.6 years; P<0.01) and mortality rates were lower in patients (38.8% vs 46.1%; P<0.01) with CM. CONCLUSION Despite presenting with more advanced disease than UM, CM is associated with an increased overall survival. Surgery is the primary therapy for CM, whereas radiotherapy is the primary therapy for UM and is associated with prolonged survival.
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Affiliation(s)
| | - Sneha Shrestha
- Department of Surgery, Saint Barnabas Medical Center, Livingston, NJ, USA
| | - Christine Sm Lau
- Department of Surgery, Saint Barnabas Medical Center, Livingston, NJ, USA; Saint George's University School of Medicine, Grenada, West Indies
| | - Ronald S Chamberlain
- Department of Surgery, Saint Barnabas Medical Center, Livingston, NJ, USA; Saint George's University School of Medicine, Grenada, West Indies; Department of Surgery, Banner MD Anderson Cancer Center, Gilbert, AZ, USA; Department of Surgery, Rutgers University, New Jersey Medical School, Newark, NJ, USA
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49
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Carvajal RD, Schwartz GK, Tezel T, Marr B, Francis JH, Nathan PD. Metastatic disease from uveal melanoma: treatment options and future prospects. Br J Ophthalmol 2017; 101:38-44. [PMID: 27574175 PMCID: PMC5256122 DOI: 10.1136/bjophthalmol-2016-309034] [Citation(s) in RCA: 249] [Impact Index Per Article: 35.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 08/01/2016] [Accepted: 08/08/2016] [Indexed: 12/12/2022]
Abstract
Uveal melanoma represents ∼85% of all ocular melanomas and up to 50% of patients develop metastatic disease. Metastases are most frequently localised to the liver and, as few patients are candidates for potentially curative surgery, this is associated with a poor prognosis. There is currently little published evidence for the optimal management and treatment of metastatic uveal melanoma and the lack of effective therapies in this setting has led to the widespread use of systemic treatments for patients with cutaneous melanoma. Uveal and cutaneous melanomas are intrinsically different diseases and so dedicated management strategies and therapies for uveal melanoma are much needed. This review explores the biology of uveal melanoma and how this relates to ongoing trials of targeted therapies in the metastatic disease setting. In addition, we consider the options to optimise patient management and care.
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Affiliation(s)
- Richard D Carvajal
- Division of Hematology/Oncology, Columbia University Medical Center, New York, USA
| | - Gary K Schwartz
- Division of Hematology/Oncology, Columbia University Medical Center, New York, USA
| | - Tongalp Tezel
- Department of Ophthalmology, Columbia University Medical Center, New York, USA
| | - Brian Marr
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Jasmine H Francis
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Paul D Nathan
- Division of Cancer Services, Mt Vernon Cancer Centre, Northwood, UK
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Mahendraraj K, Lau CS, Lee I, Chamberlain RS. Trends in incidence, survival, and management of uveal melanoma: a population-based study of 7,516 patients from the Surveillance, Epidemiology, and End Results database (1973-2012). Clin Ophthalmol 2016; 10:2113-2119. [PMID: 27822007 PMCID: PMC5087706 DOI: 10.2147/opth.s113623] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Uveal melanoma (UM) is the most common primary intraocular malignancy, despite comprising <5% of all melanomas. To date, relatively few case series of UM have been published. Moreover, the factors influencing survival remain largely unknown. This study sought to analyze the impact of demographics, histology, clinical presentation, and treatments on the clinical outcomes of UM in a large modern nationwide patient cohort. Methods Demographics and clinical data were abstracted on 277,120 histologically confirmed melanoma patients from the Surveillance, Epidemiology, and End Results database between 1973 and 2012. Results A total of 7,516 cases of UM represented 3.2% of all recorded cases of melanoma. The mean age-adjusted incidence was 5.1 per million (95% CI 4.2–6.1) and was higher in males (5.9, CI =4.4–7.6) compared to females (4.5, CI =3.3–5.8), P<0.001. UM occurred most commonly in the sixth decade of life (61.4±15) and among Caucasians (94.7%). A total of 52.3% of cases were reported in the Western US (35.7% in California). The initial diagnoses in 65.2% of cases were by histopathology, followed by clinical diagnosis (18.8%) and radiographic imaging (16.0%). The percentage of UM cases managed by surgery alone decreased by 69.4% between the 1973–1977 and 2006–2012 time periods, concomitant with a 62% increase in primary radiotherapy, P<0.001. The UM mean overall and cancer-specific 5-year relative survival rates were 79.8%±5.8% and 76%±5.3%, respectively. The mean 5-year cancer-specific survival rate (76%) remained stable during the study period between 1973 and 2012. The mean survival for patients treated with primary radiotherapy was significantly improved compared to those treated with surgery alone (15.4±0.4 vs 13.6±0.3, P<0.001). Multivariate analysis identified male sex (odds ratio [OR] 1.1, CI =1.0–1.3), age >50 years (OR 4.0, CI =3.4–4.6), distant metastases (OR 8.6, CI =4.7–15), and primary surgical treatment (OR 2.6, CI =2.0–3.3) as independently associated with increased mortality, P<0.005. Conversely, patients identified as Hispanic (OR 0.6, CI =0.5–0.8) and patients receiving radiation treatment (OR 0.5, CI =0.4–0.7) were independently associated with reduced mortality, P<0.005. Conclusion UM remains a rare form of melanoma that occurs primarily in Caucasian patients older than 50 years. More than two-thirds of UM patients are curatively treated with primary radiotherapy as opposed to surgery, which has resulted in a significant improvement in both overall survival and cancer-specific survival. Despite this shift in management strategy, the mean 5-year cancer-specific survival rate remained relatively unchanged during the study period. Male sex, older age, distant disease, and primary surgical therapy rather than radiotherapy are associated with an increased risk of mortality.
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Affiliation(s)
| | - Christine Sm Lau
- Department of Surgery, Saint Barnabas Medical Center, Livingston, NJ, USA; St George's University School of Medicine, Grenada, West Indies
| | - Injoon Lee
- St George's University School of Medicine, Grenada, West Indies
| | - Ronald S Chamberlain
- Department of Surgery, Saint Barnabas Medical Center, Livingston, NJ, USA; St George's University School of Medicine, Grenada, West Indies; Department of Surgery, New Jersey Medical School, Rutgers University, Newark, NJ, USA
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