1
|
Arias-Diaz AE, Ferreiro-Pantin M, Barbazan J, Perez-Beliz E, Ruiz-Bañobre J, Casas-Arozamena C, Muinelo-Romay L, Lopez-Lopez R, Vilar A, Curiel T, Abal M. Ascites-Derived Organoids to Depict Platinum Resistance in Gynaecological Serous Carcinomas. Int J Mol Sci 2023; 24:13208. [PMID: 37686015 PMCID: PMC10487816 DOI: 10.3390/ijms241713208] [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: 05/16/2023] [Revised: 07/28/2023] [Accepted: 08/19/2023] [Indexed: 09/10/2023] Open
Abstract
Gynaecological serous carcinomas (GSCs) constitute a distinctive entity among female tumours characterised by a very poor prognosis. In addition to late-stage diagnosis and a high rate of recurrent disease associated with massive peritoneal carcinomatosis, the systematic acquisition of resistance to first-line chemotherapy based on platinum determines the unfavourable outcome of GSC patients. To explore the molecular mechanisms associated with platinum resistance, we generated patient-derived organoids (PDOs) from liquid biopsies of GSC patients. PDOs are emerging as a relevant preclinical model system to assist in clinical decision making, mainly from tumoural tissue and particularly for personalised therapeutic options. To approach platinum resistance in a GSC context, proficient PDOs were generated from the ascitic fluid of ovarian, primary peritoneal and uterine serous carcinoma patients in platinum-sensitive and platinum-resistant clinical settings from the uterine aspirate of a uterine serous carcinoma patient, and we also induced platinum resistance in vitro in a representative platinum-sensitive PDO. Histological and immunofluorescent characterisation of these ascites-derived organoids showed resemblance to the corresponding original tumours, and assessment of platinum sensitivity in these preclinical models replicated the clinical setting of the corresponding GSC patients. Differential gene expression profiling of a panel of 770 genes representing major canonical cancer pathways, comparing platinum-sensitive and platinum-resistant PDOs, revealed cellular response to DNA damage stimulus as the principal biological process associated with the acquisition of resistance to the first-line therapy for GSC. Additionally, candidate genes involved in regulation of cell adhesion, cell cycles, and transcription emerged from this proof-of-concept study. In conclusion, we describe the generation of PDOs from liquid biopsies in the context of gynaecological serous carcinomas to explore the molecular determinants of platinum resistance.
Collapse
Affiliation(s)
- Andrea Estrella Arias-Diaz
- Translational Medical Oncology Group (Oncomet), Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela (SERGAS), Trav. Choupana s/n, 15706 Santiago de Compostela, Spain; (A.E.A.-D.); (M.F.-P.); (J.B.); (J.R.-B.); (C.C.-A.); (L.M.-R.); (R.L.-L.); (T.C.)
- Department of Medicine, Universidade de Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain
| | - Miriam Ferreiro-Pantin
- Translational Medical Oncology Group (Oncomet), Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela (SERGAS), Trav. Choupana s/n, 15706 Santiago de Compostela, Spain; (A.E.A.-D.); (M.F.-P.); (J.B.); (J.R.-B.); (C.C.-A.); (L.M.-R.); (R.L.-L.); (T.C.)
| | - Jorge Barbazan
- Translational Medical Oncology Group (Oncomet), Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela (SERGAS), Trav. Choupana s/n, 15706 Santiago de Compostela, Spain; (A.E.A.-D.); (M.F.-P.); (J.B.); (J.R.-B.); (C.C.-A.); (L.M.-R.); (R.L.-L.); (T.C.)
- Centro de Investigacion Biomedica en Red de Cancer (CIBERONC), Monforte de Lemos 3-5, 28029 Madrid, Spain
| | - Edurne Perez-Beliz
- Department of Pathology, University Hospital of Santiago de Compostela (SERGAS), Trav. Choupana s/n, 15706 Santiago de Compostela, Spain;
| | - Juan Ruiz-Bañobre
- Translational Medical Oncology Group (Oncomet), Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela (SERGAS), Trav. Choupana s/n, 15706 Santiago de Compostela, Spain; (A.E.A.-D.); (M.F.-P.); (J.B.); (J.R.-B.); (C.C.-A.); (L.M.-R.); (R.L.-L.); (T.C.)
- Centro de Investigacion Biomedica en Red de Cancer (CIBERONC), Monforte de Lemos 3-5, 28029 Madrid, Spain
| | - Carlos Casas-Arozamena
- Translational Medical Oncology Group (Oncomet), Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela (SERGAS), Trav. Choupana s/n, 15706 Santiago de Compostela, Spain; (A.E.A.-D.); (M.F.-P.); (J.B.); (J.R.-B.); (C.C.-A.); (L.M.-R.); (R.L.-L.); (T.C.)
- Centro de Investigacion Biomedica en Red de Cancer (CIBERONC), Monforte de Lemos 3-5, 28029 Madrid, Spain
| | - Laura Muinelo-Romay
- Translational Medical Oncology Group (Oncomet), Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela (SERGAS), Trav. Choupana s/n, 15706 Santiago de Compostela, Spain; (A.E.A.-D.); (M.F.-P.); (J.B.); (J.R.-B.); (C.C.-A.); (L.M.-R.); (R.L.-L.); (T.C.)
- Centro de Investigacion Biomedica en Red de Cancer (CIBERONC), Monforte de Lemos 3-5, 28029 Madrid, Spain
| | - Rafael Lopez-Lopez
- Translational Medical Oncology Group (Oncomet), Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela (SERGAS), Trav. Choupana s/n, 15706 Santiago de Compostela, Spain; (A.E.A.-D.); (M.F.-P.); (J.B.); (J.R.-B.); (C.C.-A.); (L.M.-R.); (R.L.-L.); (T.C.)
- Centro de Investigacion Biomedica en Red de Cancer (CIBERONC), Monforte de Lemos 3-5, 28029 Madrid, Spain
| | - Ana Vilar
- Department of Gynecology, University Hospital of Santiago de Compostela (SERGAS), Trav. Choupana s/n, 15706 Santiago de Compostela, Spain;
| | - Teresa Curiel
- Translational Medical Oncology Group (Oncomet), Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela (SERGAS), Trav. Choupana s/n, 15706 Santiago de Compostela, Spain; (A.E.A.-D.); (M.F.-P.); (J.B.); (J.R.-B.); (C.C.-A.); (L.M.-R.); (R.L.-L.); (T.C.)
- Centro de Investigacion Biomedica en Red de Cancer (CIBERONC), Monforte de Lemos 3-5, 28029 Madrid, Spain
| | - Miguel Abal
- Translational Medical Oncology Group (Oncomet), Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela (SERGAS), Trav. Choupana s/n, 15706 Santiago de Compostela, Spain; (A.E.A.-D.); (M.F.-P.); (J.B.); (J.R.-B.); (C.C.-A.); (L.M.-R.); (R.L.-L.); (T.C.)
- Centro de Investigacion Biomedica en Red de Cancer (CIBERONC), Monforte de Lemos 3-5, 28029 Madrid, Spain
| |
Collapse
|
2
|
Ferraro S, Panteghini M. Making new biomarkers a reality: the case of serum human epididymis protein 4. Clin Chem Lab Med 2020; 57:1284-1294. [PMID: 30511925 DOI: 10.1515/cclm-2018-1111] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 10/31/2018] [Indexed: 01/01/2023]
Abstract
Background Measurement of human epididymis protein 4 (HE4) in serum has recently been proposed for clinical use in the framework of ovarian cancer (OvCa). We sought to retrace the translational phase and the clinical implementation steps boosting HE4's clinical value and discuss the effects of its introduction on the diagnostic and management pathways. Methods Meta-analyses of running evidence have preliminarily suggested that HE4 may overcome carbohydrate antigen 125 (CA125) in identifying OvCa, showing however several gaps that need to be considered, i.e. definition of biomarker diagnostic performance in the early detection of OvCa, added diagnostic value, biological and lifestyle factors of variation, and optimal interpretative criteria. Investigation of the influencing factors has shown that renal impairment represents a major limitation for HE4's diagnostic power. On the other hand, the demonstration of the substantial equivalence of results obtained by commercially available assays allows recommending harmonized thresholds for diagnostic purpose, even if the study of HE4's biological variation has clarified that the longitudinal interpretation of the biomarker changes according to the reference change value could be more appropriate. Summary We used HE4 as an example for describing the long and bumpy road for making a new biomarker a reality, and the issues that should be checked and the information that should be provided in moving a novel biomarker from its discovery to an effective clinical adoption.
Collapse
Affiliation(s)
- Simona Ferraro
- UOC Patologia Clinica, Ospedale "Luigi Sacco", Via GB Grassi 74, 20157 Milano, Italy.,Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy
| | - Mauro Panteghini
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy
| |
Collapse
|
3
|
Rustin G, Vergote I, Micha JP, Duska LR, Reed N, Bendell J, Spitz D, Dark G, Hoch U, Tagliaferri M, Hannah AL, Garcia AA. A multicenter, open-label, expanded phase 2 study to evaluate the safety and efficacy of etirinotecan pegol, a polymer conjugate of irinotecan, in women with recurrent platinum-resistant or refractory ovarian cancer. Gynecol Oncol 2017; 147:276-282. [PMID: 28935273 DOI: 10.1016/j.ygyno.2017.08.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 08/15/2017] [Accepted: 08/24/2017] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Etirinotecan pegol (EP) is a novel polyethylene glycol conjugated form of irinotecan with documented activity in platinum-resistant ovarian cancer (PROC). We report the results of the expanded portion of a phase II study of EP in patients with PROC who received prior pegylated liposomal doxorubicin (PLD) or who were unable to receive it. METHODS This multicenter, open-label, phase II study evaluated EP q21d for PROC. The primary endpoint was objective response rate (ORR) by Response Evaluation Criteria in Solid Tumors version 1.0. Secondary endpoints included progression-free survival (PFS), overall survival (OS), and safety. Patient populations evaluated included a modified intent-to-treat (mITT) group consisting of all patients who received at least one dose and with measurable disease and a primary efficacy (pEFF) group (subset of the mITT population who received prior PLD). RESULTS One hundred thirty-nine patients were enrolled. Of the 132 patients in the mITT group, 20 achieved an ORR (15.2%; 95% CI 9.5-22.4); median PFS and OS were 4.4 months and 10.2 months, respectively. In the pEFF group (n=104), 15 patients (14.4%; 95% CI 8.3-22.7) achieved an ORR; median PFS and OS were 4.4 months and 10.9 months, respectively. The most common grade 3/4 toxicities were diarrhea (20%), abdominal pain (17%), vomiting (14%), dehydration (13%), and nausea (13%). Severe diarrhea was reduced to 15% with strict adherence to screening and management guidelines. CONCLUSIONS This study confirms the activity and safety of single-agent EP in patients with PROC, including patients who received prior PLD. Further evaluation earlier in the disease course and in combination is warranted.
Collapse
Affiliation(s)
- G Rustin
- Mount Vernon Hospital, Middlesex, United Kingdom
| | - I Vergote
- Universitair Ziekenhuis Leuven, Leuven, Belgium
| | - J P Micha
- Gynecologic Oncology Associates, Newport Beach, CA, USA
| | - L R Duska
- University of Virginia Health System, Division of Gynecologic Oncology, Charlottesville, VA, USA
| | - N Reed
- Beatson West of Scotland Cancer Centre, Gartnavel General Hospital, Glasgow, United Kingdom
| | - J Bendell
- Tennessee Oncology, PLLC, Sarah Cannon Research Institute, Nashville, TN, USA
| | - D Spitz
- Palm Beach Cancer Institute, West Palm Beach, FL, USA
| | - G Dark
- Freemen Hospital, High Heaton, Newcastle-upon-Tyne, United Kingdom
| | - U Hoch
- Nektar Therapeutics, San Francisco, CA, USA
| | | | - A L Hannah
- Nektar Therapeutics, San Francisco, CA, USA
| | - A A Garcia
- USC Norris Comprehensive Cancer Center and Hospital, Los Angeles, CA, USA; LSU Stanley S. Scott Cancer Center, New Orleans, LA, USA.
| |
Collapse
|
4
|
ElNaggar AC, Saini U, Naidu S, Wanner R, Sudhakar M, Fowler J, Nagane M, Kuppusamy P, Cohn DE, Selvendiran K. Anticancer potential of diarylidenyl piperidone derivatives, HO-4200 and H-4318, in cisplatin resistant primary ovarian cancer. Cancer Biol Ther 2017; 17:1107-1115. [PMID: 27415751 DOI: 10.1080/15384047.2016.1210733] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
We have previously developed a novel class of bi-functional compounds based on a diarylidenyl-piperidone (DAP) backbone conjugated to an N-hydroxypyrroline (-NOH; a nitroxide precursor) group capable of selectively inhibiting STAT3 activation, translocation, and DNA binding activity. HO-4200 and H-4318 are 2 such derivatives capable of inducing apoptosis in ovarian cancer cells through this mechanism and demonstrated efficacy in platinum resistant primary ovarian cancer cell populations and tumor tissues. The improved absorption and cellular uptake of HO-4200 by cancer cells was determined using optical and electron paramagnetic resonance spectrometry. Treatment of ovarian cancer cells with HO-4200 and H-4318 resulted in cleavage of caspase proteins 3, 7, and 9, as well as PARP and inhibition of the pro-survival protein, Bcl-xL, resulting in significantly decreased cell survival and increased apoptosis. HO-4200 and H-4318 significantly inhibit fatty acid synthase (FAS) and pSTAT3 and decreased the expression of STAT3 target proteins: Survivin, c-myc, Bcl-xl, Bcl-2, cyclin D1/D2, and VEGF were suppressed as analyzed using quantitative real time PCR. In addition, HO-4200 and H-4318 significantly inhibited migration/invasion, in primary ovarian cancer cell populations isolated from primary and recurrent ovarian cancer patients. Treatment of freshly collected human ovarian tumor sections with HO-4200 demonstrated significant suppression of pSTAT3 Tyr 705, angiogenesis (VEFG), and markers of proliferation (Ki-67) in ex vivo models. We have shown, for the first time, that the DAP compounds, HO-4200 and H-4318, inhibit cell migration/invasion and induce apoptosis by targeting FAS/STAT3 in human ovarian cancer cells, including primary ovarian cancer cell populations and tumor tissues. Therefore, our results highlight the clinical anti-cancer potential of HO-4200 and H-4318.
Collapse
Affiliation(s)
- Adam C ElNaggar
- a Division of Gynecologic Oncology , The Ohio State University Comprehensive Cancer Center- Arthur G. James Cancer Hospital and Richard J. Solve Research Institute , Columbus , OH , USA
| | - Uksha Saini
- b Division of Gynecologic Oncology , Comprehensive Cancer Center and Solid Tumor Biology Program, The Ohio State University Wexner Medical Center , Columbus , OH , USA
| | - Shan Naidu
- b Division of Gynecologic Oncology , Comprehensive Cancer Center and Solid Tumor Biology Program, The Ohio State University Wexner Medical Center , Columbus , OH , USA
| | - Ross Wanner
- b Division of Gynecologic Oncology , Comprehensive Cancer Center and Solid Tumor Biology Program, The Ohio State University Wexner Medical Center , Columbus , OH , USA
| | - Millie Sudhakar
- b Division of Gynecologic Oncology , Comprehensive Cancer Center and Solid Tumor Biology Program, The Ohio State University Wexner Medical Center , Columbus , OH , USA
| | | | - Masaki Nagane
- c Department of Radiology , Dartmouth College Geisel School of Medicine , Hanover , NH , USA
| | - Periannan Kuppusamy
- c Department of Radiology , Dartmouth College Geisel School of Medicine , Hanover , NH , USA
| | - David E Cohn
- a Division of Gynecologic Oncology , The Ohio State University Comprehensive Cancer Center- Arthur G. James Cancer Hospital and Richard J. Solve Research Institute , Columbus , OH , USA
| | - Karuppaiyah Selvendiran
- b Division of Gynecologic Oncology , Comprehensive Cancer Center and Solid Tumor Biology Program, The Ohio State University Wexner Medical Center , Columbus , OH , USA
| |
Collapse
|
5
|
Pradhan L, Thakur B, Srivastava R, Ray P, Bahadur D. Assessing Therapeutic Potential of Magnetic Mesoporous Nanoassemblies for Chemo-Resistant Tumors. Theranostics 2016; 6:1557-72. [PMID: 27446490 PMCID: PMC4955055 DOI: 10.7150/thno.15231] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 04/28/2016] [Indexed: 12/28/2022] Open
Abstract
Smart drug delivery system with strategic drug distribution is the future state-of-the-art treatment for any malignancy. To investigate therapeutic potential of such nanoparticle mediated delivery system, we examined the efficacy of dual drug-loaded, pH and thermo liable lipid coated mesoporous iron oxide-based magnetic nanoassemblies (DOX:TXL-LMMNA) in mice bearing both drug sensitive (A2780(S)) and drug resistant (A2780-CisR) ovarian cancer tumor xenografts. In presence of an external AC magnetic field (ACMF), DOX:TXL-LMMNA particles disintegrate to release encapsulated drug due to hyperthermic temperatures (41-45 ºC). In vivo bio distribution study utilizing the optical and magnetic properties of DOX:TXL-LMMNA particles demonstrated minimum organ specific toxicity. Noninvasive bioluminescence imaging of mice bearing A2780(S) tumors and administered with DOX-TXL-LMMNA followed by the application of ACMF revealed 65% less luminescence signal and 80% mice showed complete tumor regression within eight days. A six months follow-up study revealed absence of relapse in 70% of the mice. Interestingly, the A2780-CisR tumors which did not respond to drug alone (DOX:TXL) showed 80% reduction in luminescence and tumor volume with DOX:TXL-LMMNA after thermo-chemotherapy within eight days. Cytotoxic effect of DOX:TXL-LMMNA particles was more pronounced in A2780-CisR cells than in their sensitive counterpart. Thus these novel stimuli sensitive nanoassemblies hold great promise for therapy resistant malignancies and future clinical applications.
Collapse
Affiliation(s)
- Lina Pradhan
- 1. Centre for Research in Nanotechnology and Sciences, IIT Bombay, Mumbai, 400076,India
- 4. Department of Metallurgical Engineering and Materials Science, IIT Bombay, Mumbai, 400076 India
| | - Bhushan Thakur
- 2. Advance Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Kharghar, Navi Mumbai, 410210, India
| | - Rohit Srivastava
- 3. Department of Biosciences and Bioengineering, IIT Bombay, Mumbai, 400076, India
| | - Pritha Ray
- 2. Advance Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Kharghar, Navi Mumbai, 410210, India
| | - Dhirendra Bahadur
- 4. Department of Metallurgical Engineering and Materials Science, IIT Bombay, Mumbai, 400076 India
| |
Collapse
|
6
|
Granata A, Nicoletti R, Perego P, Iorio E, Krishnamachary B, Benigni F, Ricci A, Podo F, Bhujwalla ZM, Canevari S, Bagnoli M, Mezzanzanica D. Global metabolic profile identifies choline kinase alpha as a key regulator of glutathione-dependent antioxidant cell defense in ovarian carcinoma. Oncotarget 2016; 6:11216-30. [PMID: 25796169 PMCID: PMC4484451 DOI: 10.18632/oncotarget.3589] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 02/19/2015] [Indexed: 12/27/2022] Open
Abstract
Epithelial Ovarian Cancer (EOC) "cholinic phenotype", characterized by increased intracellular phosphocholine content sustained by over-expression/activity of choline kinase-alpha (ChoKα/CHKA), is a metabolic cellular reprogramming involved in chemoresistance with still unknown mechanisms.By stable CHKA silencing and global metabolic profiling here we demonstrate that CHKA knockdown hampers growth capability of EOC cell lines both in vitro and in xenotransplant in vivo models. It also affected antioxidant cellular defenses, decreasing glutathione and cysteine content while increasing intracellular levels of reactive oxygen species, overall sensitizing EOC cells to current chemotherapeutic regimens. Natural recovering of ChoKα expression after its transient silencing rescued the wild-type phenotype, restoring intracellular glutathione content and drug resistance. Rescue and phenocopy of siCHKA-related effects were also obtained by artificial modulation of glutathione levels. The direct relationship among CHKA expression, glutathione intracellular content and drug sensitivity was overall demonstrated in six different EOC cell lines but notably, siCHKA did not affect growth capability, glutathione metabolism and/or drug sensitivity of non-tumoral immortalized ovarian cells. The "cholinic phenotype", by recapitulating EOC addiction to glutathione content for the maintenance of the antioxidant defense, can be therefore considered a unique feature of cancer cells and a suitable target to improve chemotherapeutics efficacy.
Collapse
Affiliation(s)
- Anna Granata
- Unit of Molecular Therapies, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Roberta Nicoletti
- Unit of Molecular Therapies, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Paola Perego
- Molecular Pharmacology, Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Egidio Iorio
- Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità, Rome, Italy
| | - Balaji Krishnamachary
- Division of Cancer Imaging Research, In Vivo Cellular and Molecular Imaging Center, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Fabio Benigni
- Division of Oncology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Alessandro Ricci
- Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità, Rome, Italy
| | - Franca Podo
- Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità, Rome, Italy
| | - Zaver M Bhujwalla
- Division of Cancer Imaging Research, In Vivo Cellular and Molecular Imaging Center, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Silvana Canevari
- Unit of Molecular Therapies, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Marina Bagnoli
- Unit of Molecular Therapies, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Delia Mezzanzanica
- Unit of Molecular Therapies, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| |
Collapse
|
7
|
Pathak HB, Zhou Y, Sethi G, Hirst J, Schilder RJ, Golemis EA, Godwin AK. A Synthetic Lethality Screen Using a Focused siRNA Library to Identify Sensitizers to Dasatinib Therapy for the Treatment of Epithelial Ovarian Cancer. PLoS One 2015; 10:e0144126. [PMID: 26637171 PMCID: PMC4670180 DOI: 10.1371/journal.pone.0144126] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 11/15/2015] [Indexed: 02/07/2023] Open
Abstract
Molecular targeted therapies have been the focus of recent clinical trials for the treatment of patients with recurrent epithelial ovarian cancer (EOC). The majority have not fared well as monotherapies for improving survival of these patients. Poor bioavailability, lack of predictive biomarkers, and the presence of multiple survival pathways can all diminish the success of a targeted agent. Dasatinib is a tyrosine kinase inhibitor of the Src-family kinases (SFK) and in preclinical studies shown to have substantial activity in EOC. However, when evaluated in a phase 2 clinical trial for patients with recurrent or persistent EOC, it was found to have minimal activity. We hypothesized that synthetic lethality screens performed using a cogently designed siRNA library would identify second-site molecular targets that could synergize with SFK inhibition and improve dasatinib efficacy. Using a systematic approach, we performed primary siRNA screening using a library focused on 638 genes corresponding to a network centered on EGFR, HER2, and the SFK-scaffolding proteins BCAR1, NEDD9, and EFS to screen EOC cells in combination with dasatinib. We followed up with validation studies including deconvolution screening, quantitative PCR to confirm effective gene silencing, correlation of gene expression with dasatinib sensitivity, and assessment of the clinical relevance of hits using TCGA ovarian cancer data. A refined list of five candidates (CSNK2A1, DAG1, GRB2, PRKCE, and VAV1) was identified as showing the greatest potential for improving sensitivity to dasatinib in EOC. Of these, CSNK2A1, which codes for the catalytic alpha subunit of protein kinase CK2, was selected for additional evaluation. Synergistic activity of the clinically relevant inhibitor of CK2, CX-4945, with dasatinib in reducing cell proliferation and increasing apoptosis was observed across multiple EOC cell lines. This overall approach to improving drug efficacy can be applied to other targeted agents that have similarly shown poor clinical activity.
Collapse
Affiliation(s)
- Harsh B. Pathak
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, Kansas, United States of America
- University of Kansas Cancer Center, Kansas City, Kansas, United States of America
- * E-mail:
| | - Yan Zhou
- Biostatistics and Bioinformatics Facility, Fox Chase Cancer Center, Philadelphia, Pennsylvania, United States of America
| | - Geetika Sethi
- Department of Biochemistry and Molecular Biology, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Jeff Hirst
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, Kansas, United States of America
| | - Russell J. Schilder
- Department of Gynecologic Medical Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America
| | - Erica A. Golemis
- Molecular Therapeutics Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania, United States of America
| | - Andrew K. Godwin
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, Kansas, United States of America
- University of Kansas Cancer Center, Kansas City, Kansas, United States of America
| |
Collapse
|
8
|
Vargas HA, Burger IA, Goldman DA, Miccò M, Sosa RE, Weber W, Chi DS, Hricak H, Sala E. Volume-based quantitative FDG PET/CT metrics and their association with optimal debulking and progression-free survival in patients with recurrent ovarian cancer undergoing secondary cytoreductive surgery. Eur Radiol 2015; 25:3348-53. [PMID: 25916387 DOI: 10.1007/s00330-015-3729-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 02/05/2015] [Accepted: 03/20/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Our aim was to evaluate the associations between quantitative (18)F-fluorodeoxyglucose positron-emission tomography (FDG-PET) uptake metrics, optimal debulking (OD) and progression-free survival (PFS) in patients with recurrent ovarian cancer undergoing secondary cytoreductive surgery. METHODS Fifty-five patients with recurrent ovarian cancer underwent FDG-PET/CT within 90 days prior to surgery. Standardized uptake values (SUVmax), metabolically active tumour volumes (MTV), and total lesion glycolysis (TLG) were measured on PET. Exact logistic regression, Kaplan-Meier curves and the log-rank test were used to assess associations between imaging metrics, OD and PFS. RESULTS MTV (p = 0.0025) and TLG (p = 0.0043) were associated with OD; however, there was no significant association between SUVmax and debulking status (p = 0.83). Patients with an MTV above 7.52 mL and/or a TLG above 35.94 g had significantly shorter PFS (p = 0.0191 for MTV and p = 0.0069 for TLG). SUVmax was not significantly related to PFS (p = 0.10). PFS estimates at 3.5 years after surgery were 0.42 for patients with an MTV ≤ 7.52 mL and 0.19 for patients with an MTV > 7.52 mL; 0.46 for patients with a TLG ≤ 35.94 g and 0.15 for patients with a TLG > 35.94 g. CONCLUSION FDG-PET metrics that reflect metabolic tumour burden are associated with optimal secondary cytoreductive surgery and progression-free survival in patients with recurrent ovarian cancer. KEY POINTS • Both TLG and MTV were associated with optimal tumour debulking. • There was no significant association between SUVmax and tumour debulking status. • Patients with higher MTV and/or TLG had significantly shorter PFS. • SUVmax was not significantly related to PFS.
Collapse
Affiliation(s)
- H A Vargas
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Av, room C278, New York, NY, 10065, USA.
| | - I A Burger
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Av, room C278, New York, NY, 10065, USA
| | - D A Goldman
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, 1275 York Av, New York, NY, 10065, USA
| | - M Miccò
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Av, room C278, New York, NY, 10065, USA
| | - R E Sosa
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Av, room C278, New York, NY, 10065, USA
| | - W Weber
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Av, room C278, New York, NY, 10065, USA
| | - D S Chi
- Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Av, New York, NY, 10065, USA
| | - H Hricak
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Av, room C278, New York, NY, 10065, USA
| | - E Sala
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Av, room C278, New York, NY, 10065, USA
| |
Collapse
|
9
|
Brunckhorst MK, Xu Y, Lu R, Yu Q. Angiopoietins promote ovarian cancer progression by establishing a procancer microenvironment. THE AMERICAN JOURNAL OF PATHOLOGY 2015; 184:2285-96. [PMID: 25043619 DOI: 10.1016/j.ajpath.2014.05.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 04/16/2014] [Accepted: 05/06/2014] [Indexed: 02/03/2023]
Abstract
Despite decades of research, the survival rate of ovarian cancer patients is largely unchanged. Current chemotherapeutic drugs are effective only transiently because patients with advanced disease eventually develop resistance. Thus, there is a pressing need for identifying novel therapeutic targets in ovarian cancer. Mounting evidence suggests that angiopoietins (Angpts) may play an essential role in cancer progression; however, the expression profiles and biological effects of Angpts on ovarian cancer remain largely unknown. Here, we show that, compared with their normal counterparts, expressions of Angpt1, Angpt2, and Angpt4 are increased in ovarian cancer cells and tissues and that human ovarian cancer cells also express the Angpt receptor Tie-2-receptor tyrosine kinase. We show that increased expression of Angpt1, Angpt2, or Angpt4 promotes intraperitoneal growth of ovarian cancers and shortens survival of the experimental mice. We further show, for the first time, that Angpts promote accumulation of cancer-associated fibroblasts and tumor angiogenesis in the ovarian cancer microenvironment, as well as enhance ovarian cancer cell proliferation and invasion in vivo. In addition, we establish a novel function of Angpts in promoting proliferation and invasion and inducing Tie-2 and extracellular signal-regulated kinase 1/2 activation in ovarian cancer-associated fibroblasts. Taken together, these data suggest that the Angpt-Tie-2 functional axis is an important player in ovarian cancer progression and an attractive target for ovarian cancer therapy.
Collapse
Affiliation(s)
- Melissa K Brunckhorst
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Yin Xu
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Rong Lu
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Qin Yu
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, New York.
| |
Collapse
|
10
|
Yamaguchi T, Kurita T, Nishio K, Tsukada J, Hachisuga T, Morimoto Y, Iwai Y, Izumi H. Expression of BAF57 in ovarian cancer cells and drug sensitivity. Cancer Sci 2015; 106:359-66. [PMID: 25611552 PMCID: PMC4409878 DOI: 10.1111/cas.12612] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 01/09/2015] [Accepted: 01/12/2015] [Indexed: 01/01/2023] Open
Abstract
The SMARCE1 (SWI / SNF-related, matrix-associated, and actin-dependent regulator of chromatin, subfamily e, member 1) encodes BAF57 protein. Previously, we reported that BAF57 is a predictive marker of endometrial carcinoma. In this study, we investigated BAF57 expression in ovarian cancer cell lines and their sensitivities to cisplatin, doxorubicin, paclitaxel, and 5-fluorouracil. BAF57 expression was strongly correlated with sensitivities to cisplatin, doxorubicin, and 5-fluorouracil in 10 ovarian cancer cell lines. Paclitaxel sensitivity was also correlated with BAF57 expression, but without significance. In A2780 ovarian cancer cells, knockdown of BAF57 using specific siRNA increased cell cycle arrest at G1 phase and the sensitivities to these anticancer agents. cDNA microarray analysis of A2780 cells transfected with BAF57 siRNA showed that 134 genes were positively regulated by BAF57, including ATP-binding cassette, sub-family G (WHITE), member 2 (ABCG2) encoding breast cancer resistance protein (BCRP). We confirmed that knockdown of BAF57 decreased BCRP expression in ovarian cancer cells by Western blot analysis, and that ABCG2 gene expression might be regulated transcriptionally. These results suggested that BAF57 is involved in ovarian cancer cell growth and sensitivity to anticancer agents, and that BAF57 may be a target for ovarian cancer therapy.
Collapse
Affiliation(s)
- Takahiro Yamaguchi
- Hematology, University of Occupational and Environmental Health, Kitakyushu, Japan
| | | | | | | | | | | | | | | |
Collapse
|
11
|
Quarta A, Bernareggi D, Benigni F, Luison E, Nano G, Nitti S, Cesta MC, Di Ciccio L, Canevari S, Pellegrino T, Figini M. Targeting FR-expressing cells in ovarian cancer with Fab-functionalized nanoparticles: a full study to provide the proof of principle from in vitro to in vivo. NANOSCALE 2015; 7:2336-2351. [PMID: 25504081 DOI: 10.1039/c4nr04426f] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Efficient targeting in tumor therapies is still an open issue: systemic biodistribution and poor specific accumulation of drugs weaken efficacy of treatments. Engineered nanoparticles are expected to bring benefits by allowing specific delivery of drug to the tumor or acting themselves as localized therapeutic agents. In this study we have targeted epithelial ovarian cancer with inorganic nanoparticles conjugated to a human antibody fragment against the folate receptor over-expressed on cancer cells. The conjugation approach is generally applicable. Indeed several types of nanoparticles (either magnetic or fluorescent) were engineered with the fragment, and their biological activity was preserved as demonstrated by biochemical methods in vitro. In vivo studies with mice bearing orthotopic and subcutaneous tumors were performed. Elemental and histological analyses showed that the conjugated magnetic nanoparticles accumulated specifically and were retained at tumor sites longer than the non-conjugated nanoparticles.
Collapse
Affiliation(s)
- Alessandra Quarta
- Nanoscience Institute of CNR, National Nanotechnology Laboratory, via Arnesano, 73100, Lecce, Italy
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
The folate receptor as a rational therapeutic target for personalized cancer treatment. Drug Resist Updat 2014; 17:89-95. [DOI: 10.1016/j.drup.2014.10.002] [Citation(s) in RCA: 249] [Impact Index Per Article: 24.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 08/29/2014] [Accepted: 10/05/2014] [Indexed: 12/27/2022]
|
13
|
Staropoli N, Ciliberto D, Botta C, Fiorillo L, Grimaldi A, Lama S, Caraglia M, Salvino A, Tassone P, Tagliaferri P. Pegylated liposomal doxorubicin in the management of ovarian cancer: a systematic review and metaanalysis of randomized trials. Cancer Biol Ther 2014; 15:707-20. [PMID: 24658024 PMCID: PMC4049787 DOI: 10.4161/cbt.28557] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 03/09/2014] [Accepted: 03/16/2014] [Indexed: 02/06/2023] Open
Abstract
Ovarian cancer is the leading cause of death among gynecological tumors. Carboplatin/paclitaxel represents the cornerstone of front-line treatment. Instead, there is no consensus for management of recurrent/progressive disease, in which pegylated liposomal doxorubicin (PLD) ± carboplatin is widely used. We performed a systematic review and metaanalysis to evaluate impact of PLD-based compared with no-PLD-based regimens in the ovarian cancer treatment. Data were extracted from randomized trials comparing PLD-based treatment to any other regimens in the January 2000-January 2013 time-frame. Study end-points were overall survival (OS), progression free survival (PFS), response rate (RR), CA125 response, and toxicity. Hazard ratios (HRs) of OS and PFS, with 95% CI, odds ratios (ORs) of RR and risk ratios of CA125 response and grade 3-4 toxicity, were extracted. Data were pooled using fixed and random effect models for selected endpoints. Fourteen randomized trials for a total of 5760 patients were selected and included for the final analysis, which showed no OS differences for PLD-based compared with other regimens (pooled HR: 0.94; 95% CI: 0.88-1.02; P = 0.132) and a significant PFS benefit of PLD-based schedule (HR: 0.91; 95% CI: 0.86-0.96; P = 0.001), particularly in second-line (HR: 0.85; 95% CI: 0.75-0.91) and in platinum-sensitive (HR: 0.83; 95% CI: 0.74-0.94) subgroups. This work confirmed the peculiar tolerability profile of this drug, moreover no difference was observed for common hematological toxicities and for RR, CA125 response. PLD-containing regimens do not improve OS when compared with any other schedule in all phases of disease. A marginal PFS advantage is observed only in platinum-sensitive setting and second-line treatment.
Collapse
Affiliation(s)
- Nicoletta Staropoli
- Medical Oncology Unit; Department of Experimental and Clinical Medicine; Magna Græcia University and T. Campanella Cancer Center; Catanzaro, Italy
| | - Domenico Ciliberto
- Medical Oncology Unit; Department of Experimental and Clinical Medicine; Magna Græcia University and T. Campanella Cancer Center; Catanzaro, Italy
| | - Cirino Botta
- Medical Oncology Unit; Department of Experimental and Clinical Medicine; Magna Græcia University and T. Campanella Cancer Center; Catanzaro, Italy
| | - Lucia Fiorillo
- Medical Oncology Unit; Department of Experimental and Clinical Medicine; Magna Græcia University and T. Campanella Cancer Center; Catanzaro, Italy
| | - Anna Grimaldi
- Department of Biochemistry; Biophysics and General Pathology; Second University of Naples; Naples, Italy
| | - Stefania Lama
- Department of Biochemistry; Biophysics and General Pathology; Second University of Naples; Naples, Italy
| | - Michele Caraglia
- Department of Biochemistry; Biophysics and General Pathology; Second University of Naples; Naples, Italy
| | - Angela Salvino
- Medical Oncology Unit; Department of Experimental and Clinical Medicine; Magna Græcia University and T. Campanella Cancer Center; Catanzaro, Italy
| | - Pierfrancesco Tassone
- Medical Oncology Unit; Department of Experimental and Clinical Medicine; Magna Græcia University and T. Campanella Cancer Center; Catanzaro, Italy
| | - Pierosandro Tagliaferri
- Medical Oncology Unit; Department of Experimental and Clinical Medicine; Magna Græcia University and T. Campanella Cancer Center; Catanzaro, Italy
| |
Collapse
|
14
|
Fuller ES, Howell VM. Culture models to define key mediators of cancer matrix remodeling. Front Oncol 2014; 4:57. [PMID: 24724052 PMCID: PMC3971193 DOI: 10.3389/fonc.2014.00057] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 03/11/2014] [Indexed: 11/18/2022] Open
Abstract
High grade serous epithelial ovarian cancer (HG-SOC) is one of the most devastating gynecological cancers affecting women worldwide, with a poor survival rate despite clinical treatment advances. HG-SOC commonly metastasizes within the peritoneal cavity, primarily to the mesothelial cells of the omentum, which regulate an extracellular matrix rich in collagens type I, III, and IV along with laminin, vitronectin, and fibronectin. Cancer cells depend on their ability to penetrate and invade secondary tissue sites to spread, however a detailed understanding of the molecular mechanisms underlying these processes remain largely unknown. Given the high metastatic potential of HG-SOC and the associated poor clinical outcome, it is extremely important to identify the pathways and the components of which that are responsible for the progression of this disease. In vitro methods of recapitulating human disease processes are the critical first step in such investigations. In this context, establishment of an in vitro “tumor-like” micro-environment, such as 3D culture, to study early disease and metastasis of human HG-SOC is an important and highly insightful method. In recent years, many such methods have been established to investigate the adhesion and invasion of human ovarian cancer cell lines. The aim of this review is to summarize recent developments in ovarian cancer culture systems and their use to investigate clinically relevant findings concerning the key players in driving human HG-SOC.
Collapse
Affiliation(s)
- Emily Suzanne Fuller
- Bill Walsh Translational Cancer Research Laboratory, Kolling Institute of Medical Research, Royal North Shore Hospital, University of Sydney , St. Leonards, NSW , Australia
| | - Viive Maarika Howell
- Bill Walsh Translational Cancer Research Laboratory, Kolling Institute of Medical Research, Royal North Shore Hospital, University of Sydney , St. Leonards, NSW , Australia
| |
Collapse
|
15
|
Rockall AG, Avril N, Lam R, Iannone R, Mozley PD, Parkinson C, Bergstrom D, Sala E, Sarker SJ, McNeish IA, Brenton JD. Repeatability of quantitative FDG-PET/CT and contrast-enhanced CT in recurrent ovarian carcinoma: test-retest measurements for tumor FDG uptake, diameter, and volume. Clin Cancer Res 2014; 20:2751-60. [PMID: 24573555 DOI: 10.1158/1078-0432.ccr-13-2634] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Repeatability of baseline FDG-PET/CT measurements has not been tested in ovarian cancer. This dual-center, prospective study assessed variation in tumor 2[18F]fluoro-2-deoxy-D-glucose (FDG) uptake, tumor diameter, and tumor volume from sequential FDG-PET/CT and contrast-enhanced computed tomography (CECT) in patients with recurrent platinum-sensitive ovarian cancer. EXPERIMENTAL DESIGN Patients underwent two pretreatment baseline FDG-PET/CT (n = 21) and CECT (n = 20) at two clinical sites with different PET/CT instruments. Patients were included if they had at least one target lesion in the abdomen with a standardized uptake value (SUV) maximum (SUVmax) of ≥ 2.5 and a long axis diameter of ≥ 15 mm. Two independent reading methods were used to evaluate repeatability of tumor diameter and SUV uptake: on site and at an imaging clinical research organization (CRO). Tumor volume reads were only performed by CRO. In each reading set, target lesions were independently measured on sequential imaging. RESULTS Median time between FDG-PET/CT was two days (range 1-7). For site reads, concordance correlation coefficients (CCC) for SUVmean, SUVmax, and tumor diameter were 0.95, 0.94, and 0.99, respectively. Repeatability coefficients were 16.3%, 17.3%, and 8.8% for SUVmean, SUVmax, and tumor diameter, respectively. Similar results were observed for CRO reads. Tumor volume CCC was 0.99 with a repeatability coefficient of 28.1%. CONCLUSIONS There was excellent test-retest repeatability for FDG-PET/CT quantitative measurements across two sites and two independent reading methods. Cutoff values for determining change in SUVmean, SUVmax, and tumor volume establish limits to determine metabolic and/or volumetric response to treatment in platinum-sensitive relapsed ovarian cancer.
Collapse
Affiliation(s)
- Andrea G Rockall
- Authors' Affiliations: Department of Radiology, St. Bartholomew's Hospital/Barts Health NHS Trust; Department of Medical Oncology, St Bartholomew's Hospital/Barts Health NHS Trust; Department of Nuclear Medicine, Barts Cancer Institute; Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London; Departments of Oncology and Radiology, Cambridge University Hospitals Foundation Trust; Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre; NIHR Cambridge Biomedical Research Centre; and Cambridge Experimental Cancer Medicine Centre, Cambridge, United Kingdom; Merck and Co, Whitehouse Station; Sanofi, Bridgewater, New Jersey; and Merck Imaging, West Point, Pennsylvania
| | - Norbert Avril
- Authors' Affiliations: Department of Radiology, St. Bartholomew's Hospital/Barts Health NHS Trust; Department of Medical Oncology, St Bartholomew's Hospital/Barts Health NHS Trust; Department of Nuclear Medicine, Barts Cancer Institute; Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London; Departments of Oncology and Radiology, Cambridge University Hospitals Foundation Trust; Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre; NIHR Cambridge Biomedical Research Centre; and Cambridge Experimental Cancer Medicine Centre, Cambridge, United Kingdom; Merck and Co, Whitehouse Station; Sanofi, Bridgewater, New Jersey; and Merck Imaging, West Point, Pennsylvania
| | - Raymond Lam
- Authors' Affiliations: Department of Radiology, St. Bartholomew's Hospital/Barts Health NHS Trust; Department of Medical Oncology, St Bartholomew's Hospital/Barts Health NHS Trust; Department of Nuclear Medicine, Barts Cancer Institute; Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London; Departments of Oncology and Radiology, Cambridge University Hospitals Foundation Trust; Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre; NIHR Cambridge Biomedical Research Centre; and Cambridge Experimental Cancer Medicine Centre, Cambridge, United Kingdom; Merck and Co, Whitehouse Station; Sanofi, Bridgewater, New Jersey; and Merck Imaging, West Point, Pennsylvania
| | - Robert Iannone
- Authors' Affiliations: Department of Radiology, St. Bartholomew's Hospital/Barts Health NHS Trust; Department of Medical Oncology, St Bartholomew's Hospital/Barts Health NHS Trust; Department of Nuclear Medicine, Barts Cancer Institute; Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London; Departments of Oncology and Radiology, Cambridge University Hospitals Foundation Trust; Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre; NIHR Cambridge Biomedical Research Centre; and Cambridge Experimental Cancer Medicine Centre, Cambridge, United Kingdom; Merck and Co, Whitehouse Station; Sanofi, Bridgewater, New Jersey; and Merck Imaging, West Point, Pennsylvania
| | - P David Mozley
- Authors' Affiliations: Department of Radiology, St. Bartholomew's Hospital/Barts Health NHS Trust; Department of Medical Oncology, St Bartholomew's Hospital/Barts Health NHS Trust; Department of Nuclear Medicine, Barts Cancer Institute; Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London; Departments of Oncology and Radiology, Cambridge University Hospitals Foundation Trust; Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre; NIHR Cambridge Biomedical Research Centre; and Cambridge Experimental Cancer Medicine Centre, Cambridge, United Kingdom; Merck and Co, Whitehouse Station; Sanofi, Bridgewater, New Jersey; and Merck Imaging, West Point, Pennsylvania
| | - Christine Parkinson
- Authors' Affiliations: Department of Radiology, St. Bartholomew's Hospital/Barts Health NHS Trust; Department of Medical Oncology, St Bartholomew's Hospital/Barts Health NHS Trust; Department of Nuclear Medicine, Barts Cancer Institute; Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London; Departments of Oncology and Radiology, Cambridge University Hospitals Foundation Trust; Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre; NIHR Cambridge Biomedical Research Centre; and Cambridge Experimental Cancer Medicine Centre, Cambridge, United Kingdom; Merck and Co, Whitehouse Station; Sanofi, Bridgewater, New Jersey; and Merck Imaging, West Point, PennsylvaniaAuthors' Affiliations: Department of Radiology, St. Bartholomew's Hospital/Barts Health NHS Trust; Department of Medical Oncology, St Bartholomew's Hospital/Barts Health NHS Trust; Department of Nuclear Medicine, Barts Cancer Institute; Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London; Departments of Oncology and Radiology, Cambridge University Hospitals Foundation Trust; Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre; NIHR Cambridge Biomedical Research Centre; and Cambridge Experimental Cancer Medicine Centre, Cambridge, United Kingdom; Merck and Co, Whitehouse Station; Sanofi, Bridgewater, New Jersey; and Merck Imaging, West Point, Pennsylvania
| | - Donald Bergstrom
- Authors' Affiliations: Department of Radiology, St. Bartholomew's Hospital/Barts Health NHS Trust; Department of Medical Oncology, St Bartholomew's Hospital/Barts Health NHS Trust; Department of Nuclear Medicine, Barts Cancer Institute; Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London; Departments of Oncology and Radiology, Cambridge University Hospitals Foundation Trust; Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre; NIHR Cambridge Biomedical Research Centre; and Cambridge Experimental Cancer Medicine Centre, Cambridge, United Kingdom; Merck and Co, Whitehouse Station; Sanofi, Bridgewater, New Jersey; and Merck Imaging, West Point, Pennsylvania
| | - Evis Sala
- Authors' Affiliations: Department of Radiology, St. Bartholomew's Hospital/Barts Health NHS Trust; Department of Medical Oncology, St Bartholomew's Hospital/Barts Health NHS Trust; Department of Nuclear Medicine, Barts Cancer Institute; Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London; Departments of Oncology and Radiology, Cambridge University Hospitals Foundation Trust; Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre; NIHR Cambridge Biomedical Research Centre; and Cambridge Experimental Cancer Medicine Centre, Cambridge, United Kingdom; Merck and Co, Whitehouse Station; Sanofi, Bridgewater, New Jersey; and Merck Imaging, West Point, Pennsylvania
| | - Shah-Jalal Sarker
- Authors' Affiliations: Department of Radiology, St. Bartholomew's Hospital/Barts Health NHS Trust; Department of Medical Oncology, St Bartholomew's Hospital/Barts Health NHS Trust; Department of Nuclear Medicine, Barts Cancer Institute; Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London; Departments of Oncology and Radiology, Cambridge University Hospitals Foundation Trust; Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre; NIHR Cambridge Biomedical Research Centre; and Cambridge Experimental Cancer Medicine Centre, Cambridge, United Kingdom; Merck and Co, Whitehouse Station; Sanofi, Bridgewater, New Jersey; and Merck Imaging, West Point, Pennsylvania
| | - Iain A McNeish
- Authors' Affiliations: Department of Radiology, St. Bartholomew's Hospital/Barts Health NHS Trust; Department of Medical Oncology, St Bartholomew's Hospital/Barts Health NHS Trust; Department of Nuclear Medicine, Barts Cancer Institute; Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London; Departments of Oncology and Radiology, Cambridge University Hospitals Foundation Trust; Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre; NIHR Cambridge Biomedical Research Centre; and Cambridge Experimental Cancer Medicine Centre, Cambridge, United Kingdom; Merck and Co, Whitehouse Station; Sanofi, Bridgewater, New Jersey; and Merck Imaging, West Point, PennsylvaniaAuthors' Affiliations: Department of Radiology, St. Bartholomew's Hospital/Barts Health NHS Trust; Department of Medical Oncology, St Bartholomew's Hospital/Barts Health NHS Trust; Department of Nuclear Medicine, Barts Cancer Institute; Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London; Departments of Oncology and Radiology, Cambridge University Hospitals Foundation Trust; Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre; NIHR Cambridge Biomedical Research Centre; and Cambridge Experimental Cancer Medicine Centre, Cambridge, United Kingdom; Merck and Co, Whitehouse Station; Sanofi, Bridgewater, New Jersey; and Merck Imaging, West Point, Pennsylvania
| | - James D Brenton
- Authors' Affiliations: Department of Radiology, St. Bartholomew's Hospital/Barts Health NHS Trust; Department of Medical Oncology, St Bartholomew's Hospital/Barts Health NHS Trust; Department of Nuclear Medicine, Barts Cancer Institute; Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London; Departments of Oncology and Radiology, Cambridge University Hospitals Foundation Trust; Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre; NIHR Cambridge Biomedical Research Centre; and Cambridge Experimental Cancer Medicine Centre, Cambridge, United Kingdom; Merck and Co, Whitehouse Station; Sanofi, Bridgewater, New Jersey; and Merck Imaging, West Point, PennsylvaniaAuthors' Affiliations: Department of Radiology, St. Bartholomew's Hospital/Barts Health NHS Trust; Department of Medical Oncology, St Bartholomew's Hospital/Barts Health NHS Trust; Department of Nuclear Medicine, Barts Cancer Institute; Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London; Departments of Oncology and Radiology, Cambridge University Hospitals Foundation Trust; Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre; NIHR Cambridge Biomedical Research Centre; and Cambridge Experimental Cancer Medicine Centre, Cambridge, United Kingdom; Merck and Co, Whitehouse Station; Sanofi, Bridgewater, New Jersey; and Merck Imaging, West Point, PennsylvaniaAuthors' Affiliations: Department of Radiology, St. Bartholomew's Hospital/Barts Health NHS Trust; Department of Medical Oncology, St Bartholomew's Hospital/Barts Health NHS Trust; Department of Nuclear Medicine, Barts Cancer Institute; Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London; Departments of Oncology and Radiology, Cambridge University Hospitals Foundation Trust; Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre; NIHR Cambridge
| |
Collapse
|
16
|
Surgical intervention in relapsed ovarian cancer is beneficial: pro. Ann Oncol 2013; 24 Suppl 10:x33-34. [DOI: 10.1093/annonc/mdt466] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
|
17
|
Vici P, Sergi D, Pizzuti L, Mariani L, Arena MG, Barba M, Maugeri-Saccà M, Vincenzoni C, Vizza E, Corrado G, Paoletti G, Tomao F, Tomao S, Giannarelli D, Di Lauro L. Gemcitabine-oxaliplatin (GEMOX) as salvage treatment in pretreated epithelial ovarian cancer patients. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2013; 32:49. [PMID: 23927758 PMCID: PMC3750635 DOI: 10.1186/1756-9966-32-49] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 08/07/2013] [Indexed: 12/27/2022]
Abstract
Background Currently, no clearly superior management strategy exists for recurrent, platinum-resistant ovarian cancer. We tested the efficacy and safety of gemcitabine combined with oxaliplatin (GEMOX) in a multicentre phase II clinical trial. Methods Forty one patients with recurrent, platinum-resistant ovarian cancer were enrolled. Prior to study entry, all the participants had received at least one platinum-based regimen. Gemcitabine was administered at 1000 mg/m2 as protracted infusion (100 min) on day 1, and oxaliplatin at the dose of 100 mg/m2 on day 2 in a 2 hour infusion. Cycles were repeated every two weeks. Results We observed an overall response rate of 37% [95% Confidence Interval (CI), 22.3–51.7]. Objective responses plus disease stabilization (clinical benefit) occurred in 78% of patients. Median progression-free survival was 6.8 months (95% CI, 5.8–7.8), and median overall survival was 16.5 months (95% CI, 12.2–20.8). Median time to self-reported symptom relief, which was described by 22 out of 27 symptomatic patients (81.5%), was 4 weeks (range, 2–8). Grade 4 neutropenia and febrile neutropenia were observed in 2 (5%) and 1 (2.5%) patients, while grade 3 anemia was encountered in 2 (5%) patients, respectively. The most common adverse effects of any grade were gastrointestinal symptoms, fatigue and neutropenia. Nine patients (22%) experienced mild allergic reaction to oxaliplatin, with no treatment discontinuation. Conclusions In our cohort of recurrent, platinum-resistant ovarian cancer patients, GEMOX showed encouraging activity and manageable toxicity. Under circumstances requiring a rapid disease control, this combination regimen may offer a particularly viable option, particularly in heavily pretreated patients.
Collapse
|