1
|
Naik KY, Bustamante D, Kaleem A, Brockhoff HC. A rapidly growing nasal mass. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 138:586-593. [PMID: 39191635 DOI: 10.1016/j.oooo.2024.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 06/19/2024] [Accepted: 07/07/2024] [Indexed: 08/29/2024]
Affiliation(s)
- Keyur Y Naik
- Head and Neck Oncologic and Microvascular Reconstructive Surgery, High Desert Oral and Facial Surgery, El Paso, Texas.
| | - Daniel Bustamante
- El Paso Children's Hospital, Division of Anatomic and Clinical Pathology, Pediatric Pathology and Hematopathology, El Paso, Texas
| | - Arshad Kaleem
- El Paso Head and Neck and Oncologic and Microvascular Reconstructive, Texas Tech University Health Sciences Center of El Paso, El Paso, Texas
| | - Hans C Brockhoff
- El Paso Head and Neck and Oncologic and Microvascular Reconstructive, Texas Tech University Health Sciences Center of El Paso, El Paso, Texas
| |
Collapse
|
2
|
Yu L, Deng Y, Wang X, Santos C, Davis IJ, Earp HS, Liu P. Co-targeting JAK1/STAT6/GAS6/TAM signaling improves chemotherapy efficacy in Ewing sarcoma. Nat Commun 2024; 15:5292. [PMID: 38906855 PMCID: PMC11192891 DOI: 10.1038/s41467-024-49667-2] [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: 09/14/2023] [Accepted: 06/14/2024] [Indexed: 06/23/2024] Open
Abstract
Ewing sarcoma is a pediatric bone and soft tissue tumor treated with chemotherapy, radiation, and surgery. Despite intensive multimodality therapy, ~50% patients eventually relapse and die of the disease due to chemoresistance. Here, using phospho-profiling, we find Ewing sarcoma cells treated with chemotherapeutic agents activate TAM (TYRO3, AXL, MERTK) kinases to augment Akt and ERK signaling facilitating chemoresistance. Mechanistically, chemotherapy-induced JAK1-SQ phosphorylation releases JAK1 pseudokinase domain inhibition allowing for JAK1 activation. This alternative JAK1 activation mechanism leads to STAT6 nuclear translocation triggering transcription and secretion of the TAM kinase ligand GAS6 with autocrine/paracrine consequences. Importantly, pharmacological inhibition of either JAK1 by filgotinib or TAM kinases by UNC2025 sensitizes Ewing sarcoma to chemotherapy in vitro and in vivo. Excitingly, the TAM kinase inhibitor MRX-2843 currently in human clinical trials to treat AML and advanced solid tumors, enhances chemotherapy efficacy to further suppress Ewing sarcoma tumor growth in vivo. Our findings reveal an Ewing sarcoma chemoresistance mechanism with an immediate translational value.
Collapse
Affiliation(s)
- Le Yu
- Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
- Department of Biochemistry and Biophysics, The University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Yu Deng
- Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
- Department of Biochemistry and Biophysics, The University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Xiaodong Wang
- Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
- Center for Integrative Chemical Biology and Drug Discovery, Division of Chemical Biology and Medicinal Chemistry, Eshelman School of Pharmacy, The University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Charlene Santos
- Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Ian J Davis
- Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
- Department of Genetics, The University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
- Department of Pediatrics, The University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - H Shelton Earp
- Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
- Department of Medicine and Pharmacology, The University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Pengda Liu
- Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
- Department of Biochemistry and Biophysics, The University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
| |
Collapse
|
3
|
Soeroso NN, Ramadhani N, Tarigan SP. Ewing sarcoma with intra thoracic and multiple extra thoracic metastases in a young adult male: A case report. Int J Surg Case Rep 2024; 118:109642. [PMID: 38653170 PMCID: PMC11063494 DOI: 10.1016/j.ijscr.2024.109642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 04/03/2024] [Accepted: 04/17/2024] [Indexed: 04/25/2024] Open
Abstract
INTRODUCTION Primary chest wall tumors arise from muscle, fat, blood vessels, the nerve sheath, cartilage, or bone of the chest wall. One of the chest wall sarcomas is Ewing Sarcoma (ES), first described in 1921 by James Ewing, which is a highly aggressive bone and soft-tissue cancer. This case report aimed to present an Ewing Sarcoma with intra thoracic and multiple extra thoracic metastases in young adult male patient. PRESENTATION OF CASE We describe a unique case of metastatic of ewing's sarcoma in a 23-year-old male that showed a mass on the right lower posterior lung with pleural effusion, which was initially thought to be lung tumor that metastasized to the pleura. A thoracic CT scan showed a lobulated soft tissue mass on the right posterolateral thoracic wall, or pleura, with an expansion of soft tissue mass on the rib. Thoracal MRI showed tumor in the posterior right lower thoracic wall area, metastases of the left lateral rib, and right pleural effusion with atelectasis in the right inferior lobe of the lung. The patient also underwent a bone scan, scheduled for palliative radiotherapy and chemotherapy, and consulted to oncology surgeon. DISCUSSION Ewing sarcoma is a small, round, blue-cell mesenchymal malignancy. ES mainly affects children, adolescents, and young adults, with >1.5 cases per million children. Males are slightly more affected than females (sex ratio of 3:2). The definitive diagnosis requires biopsy proof (achieved by fine needle or core biopsy). The most common regions of metastasis are the lungs, pleural cavity, skeletal system, bone marrow, or combinations of these. CONCLUSION The 5-year survival rate is approximately 70 % when there is no metastasis; this rate falls to around 30 % when metastasis is present.
Collapse
Affiliation(s)
- Noni Novisari Soeroso
- Thoracic Oncology Division, Department of Pulmonology & Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Chairuddin P. Lubis Universitas Sumatera Utara Hospital, Jl. Dr. Mansur No. 5, Medan, 20155, Indonesia.
| | - Nurul Ramadhani
- Department of Pulmonology & Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Haji Adam Malik General Hospital, Jl. Dr. Mansur No. 5, Medan, 20155, Indonesia
| | - Setia Putra Tarigan
- Department of Pulmonology & Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Haji Adam Malik General Hospital, Jl. Dr. Mansur No. 5, Medan, 20155, Indonesia
| |
Collapse
|
4
|
Spiguel MH, Schuch LF, Kovalski LN, Ribeiro JT, Só BB, Silveira FM, Vargas PA, Martins MAT, Zanella VG, Aleixo PB, Wagner VP, Martins MD. Ewing's sarcoma of the head and neck: A systematic review. Oral Dis 2024; 30:1784-1792. [PMID: 37392420 DOI: 10.1111/odi.14644] [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: 02/01/2023] [Revised: 05/22/2023] [Accepted: 05/31/2023] [Indexed: 07/03/2023]
Abstract
OBJECTIVE The aim of the present study was to conduct a systematic review of head and neck Ewing sarcoma (ES) concerning patients' demographic and clinical features, histopathological findings, treatment, follow-up, and survival rate. MATERIALS AND METHODS An electronic search was undertaken in four databases. Articles describing case reports or case series were included. Outcomes were evaluated by the Kaplan-Meier method along with Cox regression. RESULTS The search yielded 186 studies describing 227 ES cases. The mean age was 22.7 years, and males were slightly more affected. Interestingly, more than half the cases were diagnosed up to 20 years. The respiratory tract was the most reported site, followed by the jawbones. Clinically, symptomatic swelling or nodules were described, with a mean duration of 4 months. Management involved multimodal treatment regimens. Local recurrence, lymph node and distant metastasis were observed in 10.7%, 12.6%, and 20.3% of cases, respectively. Statistical analysis revealed that older patients with distant metastasis had a lower overall survival rate (p < 0.05). CONCLUSION This study provides an overall view of head and neck ES that can assist oral and maxillofacial pathologists with the diagnosis and extend the knowledge of surgeons and oncologists about this condition.
Collapse
Affiliation(s)
- Monica Hermann Spiguel
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Lauren Frenzel Schuch
- Department of Oral Diagnosis, Piracicaba School of Dentistry, Universidade Estadual de Campinas, Piracicaba, Brazil
| | - Luan Nathiel Kovalski
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Julia Turra Ribeiro
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Bruna Barcelos Só
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Felipe Martins Silveira
- Molecular Pathology Area, School of Dentistry, Universidad de la República (UDELAR), Montevideo, Uruguay
| | - Pablo Agustin Vargas
- Department of Oral Diagnosis, Piracicaba School of Dentistry, Universidade Estadual de Campinas, Piracicaba, Brazil
| | - Marco Antonio Trevizani Martins
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Department of Oral Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Virgílio Gonzales Zanella
- Head and Neck Surgery Department, Hospital Santa Rita, Complexo Hospitalar Santa Casa, Porto Alegre, Brazil
| | - Pedro Bandeira Aleixo
- Pathology Department, Hospital Santa Rita, Complexo Hospitalar Santa Casa, Porto Alegre, Brazil
| | - Vivian Petersen Wagner
- Academic Unit of Oral and Maxillofacial Medicine and Pathology, Department of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Manoela Domingues Martins
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Department of Oral Diagnosis, Piracicaba School of Dentistry, Universidade Estadual de Campinas, Piracicaba, Brazil
| |
Collapse
|
5
|
Rechl V, Ranft A, Bhadri V, Brichard B, Collaud S, Cyprova S, Eich H, Ek T, Gelderblom H, Hardes J, Haveman LM, Hartmann W, Hauser P, Heesen P, Jürgens H, Kanerva J, Kühne T, Raciborska A, Rascon J, Streitbürger A, Uhlenbruch Y, Timmermann B, Kersting J, Pham MT, Dirksen U. Factors Influencing the Outcome of Patients with Primary Ewing Sarcoma of the Sacrum. Sarcoma 2024; 2024:4751914. [PMID: 38524902 PMCID: PMC10960648 DOI: 10.1155/2024/4751914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/29/2024] [Accepted: 03/04/2024] [Indexed: 03/26/2024] Open
Abstract
Background Ewing sarcoma (EwS) is a rare and highly malignant bone tumor primarily affecting children, adolescents, and young adults. The pelvis, trunk, and lower extremities are the most common sites, while EwS of the sacrum as a primary site is very rare, and only few studies focusing on this location are published. Due to the anatomical condition, local treatment is challenging in sacral malignancies. We analyzed factors that might influence the outcome of patients suffering from sacral EwS. Methods We retrospectively analyzed data of the GPOH EURO-E.W.I.N.G 99 trial and the EWING 2008 trial, with a cohort of 124 patients with localized or metastatic sacral EwS. The study endpoints were overall survival (OS) and event-free survival (EFS). OS and EFS were calculated using the Kaplan-Meier method, and univariate comparisons were estimated using the log-rank test. Hazard ratios (HRs) with respective 95% confidence intervals (CIs) were estimated in a multivariable Cox regression model. Results The presence of metastases (3y-EFS: 0.33 vs. 0.68; P < 0.001; HR = 3.4, 95% CI 1.7 to 6.6; 3y-OS: 0.48 vs. 0.85; P < 0.001; HR = 4.23, 95% CI 1.8 to 9.7), large tumor volume (≥200 ml) (3y-EFS: 0.36 vs. 0.69; P=0.02; HR = 2.1, 95% CI 1.1 to 4.0; 3y-OS: 0.42 vs. 0.73; P=0.04; HR = 2.1, 95% CI 1.03 to 4.5), and age ≥18 years (3y-EFS: 0.41 vs. 0.60; P=0.02; HR = 2.6, 95% CI 1.3 to 5.2; 3y-OS: 0.294 vs. 0.59; P=0.01; HR = 2.92, 95% CI 1.29 to 6.6) were revealed as adverse prognostic factors. Conclusion Young age seems to positively influence patients` survival, especially in patients with primary metastatic disease. In this context, our results support other studies, stating that older age has a negative impact on survival. Tumor volume, metastases, and the type of local therapy modality have an impact on the outcome of sacral EwS. Level of evidence: Level 2. This trial is registered with NCT00020566 and NCT00987636.
Collapse
Affiliation(s)
- Victor Rechl
- Pediatrics III, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Andreas Ranft
- Pediatrics III, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- German Cancer Consortium, Partnersite, Essen, Germany
| | - Vivek Bhadri
- Chris O'Brien Lifehouse, Camperdown, Australia
- Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Benedicte Brichard
- Cliniques Universitaires Saint Luc, Department of Pediatric Hematology and Oncology, Université Catholique de Louvain, Brussels, Belgium
| | - Stephane Collaud
- Lung Clinic, Department of Thoracic Surgery, Cologne Merheim Hospital, University of Witten/Herdecke, Witten, Germany
| | - Sona Cyprova
- Charles University, Motol Child Ren's Hospital, Prague, Czech Republic
| | - Hans Eich
- Radiotherapy and Radiooncology, University Hospital Muenster, West German Cancer Center Network, Muenster, Germany
| | - Torben Ek
- Childhood Cancer Center Queen Silvia Children's Hospital, Gothenburg, Sweden
| | - Hans Gelderblom
- Leiden University Medical Center, Department of Medical Oncology, Leiden, NL, USA
| | - Jendrik Hardes
- German Cancer Consortium, Partnersite, Essen, Germany
- Clinic of Tumororthopedics, University Hospital Essen, West German Cancer Centre, Essen, Germany
| | - Lianne M. Haveman
- Princess Máxima Center for Pediatric Oncology, Department of Solid Tumors, Utrecht, Netherlands
| | - Wolfgang Hartmann
- Gerhard Domagk Institute for Pathology, University Hospital Muenster, West German Cancer Center Network, Muenster, Germany
| | - Peter Hauser
- Velkey László Child's, Health Center, Borsod-Abaúj-Zemplén County University Teaching Hospital, Miskolc, Hungary
| | - Philip Heesen
- Pediatrics III, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Heribert Jürgens
- Department of Pediatric Hematology and Oncology, University Children's Hospital Münster, West German Cancer Center Network, Münster, Germany
| | - Jukka Kanerva
- HUS Helsinki University Hospital, New Children's Hospital, Div. Hematology and Stem Cell Transplantation, Helsinki, Finland
| | - Thomas Kühne
- Department of Oncology/Hematology, University Children's Hospital Basel, Basel, Switzerland
| | - Anna Raciborska
- Mother and Child Institute, Department of Oncology and Surgical Oncology for Children and Youth, Warsaw, Poland
| | - Jelena Rascon
- Center for Pediatric Oncology and Hematology, Vilnius University Hospital Santaros Klinikos, Vilnius University, Vilnius, Lithuania
- Clinics of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Arne Streitbürger
- German Cancer Consortium, Partnersite, Essen, Germany
- Clinic of Tumororthopedics, University Hospital Essen, West German Cancer Centre, Essen, Germany
| | - Yasmin Uhlenbruch
- Patient Representative, St. Josef's Hospital Bochum, University Hospital, Bochum, Germany
| | - Beate Timmermann
- German Cancer Consortium, Partnersite, Essen, Germany
- Clinic for Particle Therapy, West German Proton Beam Centre, University Hospital Essen, West German Cancer Centre, German Cancer Research Centre (DKTK), Essen, Germany
| | - Josephine Kersting
- Pediatrics III, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- German Cancer Consortium, Partnersite, Essen, Germany
| | - Minh Thanh Pham
- Pediatrics III, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Uta Dirksen
- Pediatrics III, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- German Cancer Consortium, Partnersite, Essen, Germany
| |
Collapse
|
6
|
Ramamurthy A, Connolly EA, Mar J, Lewin J, Bhadri VA, Phillips MB, Winstanley M, Orme LM, Grimison P, Connor J, Lazarakis S, Hong AM, Omer N, Cayrol J. High-dose chemotherapy for Ewing sarcoma and Rhabdomyosarcoma: A systematic review by the Australia and New Zealand sarcoma association clinical practice guidelines working party. Cancer Treat Rev 2024; 124:102694. [PMID: 38325070 DOI: 10.1016/j.ctrv.2024.102694] [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: 10/25/2023] [Revised: 01/24/2024] [Accepted: 01/29/2024] [Indexed: 02/09/2024]
Abstract
INTRODUCTION Patients with high-risk or metastatic Ewing sarcoma (ES) and rhabdomyosarcoma (RMS) have a guarded prognosis. High-dose chemotherapy (HDT) with autologous stem cell transplant (ASCT) has been evaluated as a treatment option to improve outcomes. However, survival benefits remain unclear, and treatment is associated with severe toxicities. METHODS A systematic review was conducted, using the population, intervention, comparison outcome (PICO) model, to evaluate whether utilization of HDT/ASCT impacts the outcome of patients with ES and RMS compared to standard chemotherapy alone, as part of first line treatment or in the relapse setting. Medline, Embase and Cochrane Central were queried for publications from 1990 to October 2022 that evaluated event-free survival (EFS), overall survival (OS), and toxicities. Each study was screened by two independent reviewers for suitability. A qualitative synthesis of the results was performed. RESULTS Of 1,172 unique studies screened, 41 studies were eligible for inclusion with 29 studies considering ES, 10 studies considering RMS and 2 studies considering both. In ES patients with high-risk localised disease who received HDT/ASCT after VIDE chemotherapy, consolidation with melphalan-based HDT/ASCT as first line therapy conveyed an EFS and OS benefit over standard chemotherapy consolidation. Efficacy of HDT/ASCT using a VDC/IE backbone, which is now standard care, has not been established. Survival benefits are not confirmed for ES patients with metastatic disease at initial diagnosis. For relapsed/refractory ES, four retrospective studies report improvement in outcomes with HDT/ASCT with the greatest evidence in patients who demonstrate a treatment response before HDT, and in patients under the age of 14. In RMS, there is no proven survival benefit of HDT/ASCT in primary localised, metastatic or relapsed disease. CONCLUSION Prospective randomised trials are required to determine the utility of HDT/ASCT in ES and RMS. Selected patients with relapsed ES could be considered for HDT/ASCT.
Collapse
Affiliation(s)
- Ashika Ramamurthy
- Concord Repatriation General Hospital, Sydney Local Health District, Concord, NSW 2139, Australia
| | - Elizabeth A Connolly
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW 2006 Australia; Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
| | - Jasmine Mar
- Australia and New Zealand Sarcoma Association, Parkville, Victoria 3010, Australia
| | - Jeremy Lewin
- Department of Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia; Victorian Adolescent & Young Adult Cancer Service, Melbourne, VIC 3000, Australia
| | - Vivek A Bhadri
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW 2006 Australia; Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
| | - Marianne B Phillips
- Department Oncology, Haematology and Tissue & Cellular Therapies, Perth Children's Hospital, WA 6009, Australia; Telethon Kids Institute, Perth, WA 6009, Australia
| | - Mark Winstanley
- Starship Paediatric Blood and Cancer Centre, Central Auckland 1142, New Zealand
| | - Lisa M Orme
- Victorian Adolescent & Young Adult Cancer Service, Melbourne, VIC 3000, Australia; Children's Cancer Centre, The Royal Children's Hospital Melbourne, VIC 3000, Australia; Department of Paediatrics, The University of Melbourne, Parkville VIC 3052 Australia
| | - Peter Grimison
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW 2006 Australia; Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
| | - Joanna Connor
- Te Pūriri o Te Ora, Auckland Regional Cancer and Blood Service, Auckland Hospital, Grafton, 1050, New Zealand
| | - Smaro Lazarakis
- Health Sciences Library, Royal Melbourne Hospital, Parkville, Victoria 3010, Australia
| | - Angela M Hong
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW 2006 Australia; Department of Radiation Oncology, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia.
| | - Natacha Omer
- Oncology Services Group, Children's Health Queensland Hospital and Health Service, South Brisbane, QLD 4101, Australia; Frazer Institute, Faculty of Medicine, The University of Queensland, Woolloongabba, QLD, Australia
| | - Julie Cayrol
- Children's Cancer Centre, The Royal Children's Hospital Melbourne, VIC 3000, Australia; Department of Paediatrics, The University of Melbourne, Parkville VIC 3052 Australia; Murdoch Children's Research Institute, Melbourne, Australia
| |
Collapse
|
7
|
Cederberg KB, Iyer RS, Chaturvedi A, McCarville MB, McDaniel JD, Sandberg JK, Shammas A, Sharp SE, Nadel HR. Imaging of pediatric bone tumors: A COG Diagnostic Imaging Committee/SPR Oncology Committee White Paper. Pediatr Blood Cancer 2023; 70 Suppl 4:e30000. [PMID: 36250990 PMCID: PMC10661611 DOI: 10.1002/pbc.30000] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 08/30/2022] [Indexed: 11/08/2022]
Abstract
Malignant primary bone tumors are uncommon in the pediatric population, accounting for 3%-5% of all pediatric malignancies. Osteosarcoma and Ewing sarcoma comprise 90% of malignant primary bone tumors in children and adolescents. This paper provides consensus-based recommendations for imaging in children with osteosarcoma and Ewing sarcoma at diagnosis, during therapy, and after therapy.
Collapse
Affiliation(s)
- Kevin B. Cederberg
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Ramesh S. Iyer
- Department of Radiology, Seattle Children’s Hospital, Seattle, WA
| | - Apeksha Chaturvedi
- Division of Pediatric Radiology, Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY
| | - MB McCarville
- Department of Diagnostic Imaging, St Jude Children’s Research Hospital, Memphis, TN
| | - Janice D. McDaniel
- Department of Pediatric Interventional Radiology, Akron Children’s Hospital, Akron, OH and Department of Radiology, Northeast Ohio Medical University, Rootstown, OH
| | - Jesse K. Sandberg
- Department of Pediatric Radiology, Lucile Packard Children’s Hospital, Stanford University, Stanford, CA
| | - Amer Shammas
- Division of Nuclear Medicine, Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, OH, Canada
| | - Susan E. Sharp
- Department of Radiology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Helen R. Nadel
- Department of Pediatric Radiology, Lucile Packard Children’s Hospital, Stanford University, Stanford, CA
| |
Collapse
|
8
|
Agnoletto C, Pignochino Y, Caruso C, Garofalo C. Exosome-Based Liquid Biopsy Approaches in Bone and Soft Tissue Sarcomas: Review of the Literature, Prospectives, and Hopes for Clinical Application. Int J Mol Sci 2023; 24:ijms24065159. [PMID: 36982236 PMCID: PMC10048895 DOI: 10.3390/ijms24065159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/28/2023] [Accepted: 03/03/2023] [Indexed: 03/30/2023] Open
Abstract
The knowledge of exosome impact on sarcoma development and progression has been implemented in preclinical studies thanks to technological advances in exosome isolation. Moreover, the clinical relevance of liquid biopsy is well established in early diagnosis, prognosis prediction, tumor burden assessment, therapeutic responsiveness, and recurrence monitoring of tumors. In this review, we aimed to comprehensively summarize the existing literature pointing out the clinical relevance of detecting exosomes in liquid biopsy from sarcoma patients. Presently, the clinical utility of liquid biopsy based on exosomes in patients affected by sarcoma is under debate. The present manuscript collects evidence on the clinical impact of exosome detection in circulation of sarcoma patients. The majority of these data are not conclusive and the relevance of liquid biopsy-based approaches in some types of sarcoma is still insufficient. Nevertheless, the utility of circulating exosomes in precision medicine clearly emerged and further validation in larger and homogeneous cohorts of sarcoma patients is clearly needed, requiring collaborative projects between clinicians and translational researchers for these rare cancers.
Collapse
Affiliation(s)
| | - Ymera Pignochino
- Department of Clinical and Biological Sciences, University of Torino, 10043 Torino, Italy
- Candiolo Cancer Instute, FPO-IRCCS, 10060 Torino, Italy
| | - Chiara Caruso
- Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy
| | - Cecilia Garofalo
- Advanced Translational Research Laboratory, Immunology and Molecular Oncology Diagnostic Unit, Veneto Institute of Oncology IOV-IRCCS, 35127 Padua, Italy
| |
Collapse
|
9
|
Chodyla M, Barbato F, Dirksen U, Kirchner J, Schaarschmidt BM, Schweiger B, Forsting M, Herrmann K, Umutlu L, Grueneisen J. Utility of Integrated PET/MRI for the Primary Diagnostic Work-Up of Patients with Ewing Sarcoma: Preliminary Results. Diagnostics (Basel) 2022; 12:diagnostics12102278. [PMID: 36291967 PMCID: PMC9600118 DOI: 10.3390/diagnostics12102278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 11/23/2022] Open
Abstract
Background: This study was conducted to evaluate the clinical applicability of integrated PET/MRI for staging and monitoring the effectiveness of neoadjuvant chemotherapy in Ewing sarcoma patients. Methods: A total of 11 juvenile patients with confirmed Ewing sarcoma, scheduled for induction polychemotherapy, were prospectively enrolled for a PET/MR examination before, during and after the end of treatment. Two experienced physicians analysed the imaging datasets. They were asked to perform a whole-body staging in all three examinations and to define treatment response according to the RECIST1.1 and PERCIST criteria for each patient. Results: In eight patients lymph node and/or distant metastases were detected at initial diagnosis. According to the reference standard, three patients achieved complete response, six patients partial response, and one patient showed stable disease while another patient showed progressive disease. RECIST1.1 categorized the response to treatment in 5/11 patients correctly and showed a tendency to underestimate the response to treatment in the remaining six patients. PERCIST defined response to treatment in 9/11 patients correctly and misclassified two patients with a PR as CR. Conclusion: PET/MRI may serve as a valuable imaging tool for primary staging and response assessment of juvenile patients with Ewing sarcoma to induction chemotherapy, accompanied by a reasonable radiation dose for the patient.
Collapse
Affiliation(s)
- Michal Chodyla
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen, Germany
| | - Francesco Barbato
- Clinic of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen, Germany
| | - Uta Dirksen
- Clinic for Pediatrics III, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen, Germany
| | - Julian Kirchner
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Dusseldorf, D-40225 Dusseldorf, Germany
| | - Benedikt M. Schaarschmidt
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen, Germany
| | - Bernd Schweiger
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen, Germany
| | - Michael Forsting
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen, Germany
| | - Ken Herrmann
- Clinic of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen, Germany
| | - Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen, Germany
| | - Johannes Grueneisen
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen, Germany
- Correspondence: ; Tel.: +49-(0)-201-723-1501
| |
Collapse
|
10
|
Ye C, Wei W, Tang X, Li F, Xin B, Chen Q, Wei H, He S, Xiao J. Sacral Ewing sarcoma with rib, lung, and multifocal skull metastases: A rare case report and review of treatments. Front Oncol 2022; 12:933579. [PMID: 36172156 PMCID: PMC9511402 DOI: 10.3389/fonc.2022.933579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 08/15/2022] [Indexed: 11/13/2022] Open
Abstract
Ewing sarcoma (ES) rarely derives from the sacrum or mobile spine. The discovery of primary ES with multimetastatic involvements is exceedingly less frequent in clinical practice. A 23-year-old man with initial primary sacral ES developed metastases of rib, lung, and multifocal skull after receiving surgical intervention and series of adjuvant therapies. We provide this very rare case consisting of its clinical features, imaging findings, treatments, and outcomes. Therapeutic modalities of ES are also reviewed in previous published articles. The prognosis of metastatic ES remains dismal; effective therapeutic modalities for ES require multidisciplinary collaboration, with more high-quality clinical trials to promote the optimal protocols.
Collapse
Affiliation(s)
- Chen Ye
- School of Health Science and Technology, University of Shanghai for Science and Technology, Shanghai, China
- Spinal Tumor Center, Department of Orthopaedic Oncology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Wei Wei
- School of Health Science and Technology, University of Shanghai for Science and Technology, Shanghai, China
- Spinal Tumor Center, Department of Orthopaedic Oncology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Xuebin Tang
- Department of Orthopaedics, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Feng Li
- Department of Orthopaedics, the 943rd Hospital of Joint Logistics Support Force of People's Liberation Army, Wuwei, China
| | - Baoquan Xin
- School of Health Science and Technology, University of Shanghai for Science and Technology, Shanghai, China
- Spinal Tumor Center, Department of Orthopaedic Oncology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Qianqian Chen
- School of Health Science and Technology, University of Shanghai for Science and Technology, Shanghai, China
| | - Haifeng Wei
- School of Health Science and Technology, University of Shanghai for Science and Technology, Shanghai, China
- Spinal Tumor Center, Department of Orthopaedic Oncology, Changzheng Hospital, Second Military Medical University, Shanghai, China
- Department of Orthopaedics, No.905 Hospital of People's Liberation Army Navy, Second Military Medical University, Shanghai, China
- *Correspondence: Haifeng Wei, ; Shaohui He, ; Jianru Xiao,
| | - Shaohui He
- Spinal Tumor Center, Department of Orthopaedic Oncology, Changzheng Hospital, Second Military Medical University, Shanghai, China
- Department of Orthopaedics, No.905 Hospital of People's Liberation Army Navy, Second Military Medical University, Shanghai, China
- *Correspondence: Haifeng Wei, ; Shaohui He, ; Jianru Xiao,
| | - Jianru Xiao
- School of Health Science and Technology, University of Shanghai for Science and Technology, Shanghai, China
- Spinal Tumor Center, Department of Orthopaedic Oncology, Changzheng Hospital, Second Military Medical University, Shanghai, China
- Department of Orthopaedics, No.905 Hospital of People's Liberation Army Navy, Second Military Medical University, Shanghai, China
- *Correspondence: Haifeng Wei, ; Shaohui He, ; Jianru Xiao,
| |
Collapse
|
11
|
Violon F, Burns R, Mihoubi F, Audard V, Biau D, Feydy A, Larousserie F. Intramedullary, periosteal, and extraskeletal Ewing sarcomas: retrospective study of a series of 126 cases in a reference center. Skeletal Radiol 2022; 51:1659-1670. [PMID: 35179621 DOI: 10.1007/s00256-021-03983-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 12/16/2021] [Accepted: 12/25/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate the proportion of extraskeletal, periosteal, and intramedullary Ewing sarcomas among musculoskeletal Ewing sarcomas. MATERIAL AND METHOD Our single-center retrospective study included patients with musculoskeletal Ewing sarcoma diagnosed between 2005 and 2019 in our pathology center (cases from our adult bone tumor referral center and adult and pediatric cases referred for review). Recurrences, metastases, and visceral Ewing sarcomas were excluded. Intramedullary Ewing sarcomas were defined by involvement of the medullary cavity. Periosteal cases were defined by involvement of the subperiosteal area without extension to the medullary cavity. Extraskeletal cases were defined by the absence of involvement of the bone tissue and the subperiosteal area. RESULTS Our series included 126 patients with musculoskeletal Ewing sarcoma, including 118 skeletal Ewing sarcomas (93.7%) and 8 extraskeletal Ewing sarcomas (6.3%). Of the 118 skeletal Ewing sarcomas 112 were intramedullary (88.9%) and 6 were periosteal (4.8%). Extraskeletal Ewing sarcomas were more common in women and in patients older than 40 (p < 0.05). DISCUSSION The 6.3% proportion of extraskeletal Ewing sarcoma is lower than the median of 30% estimated from the literature. This difference could be explained by an overestimation of extraskeletal Ewing sarcomas of the chest wall (Askin tumors), an underestimation of periosteal cases confused with extraskeletal cases, and the presence of "Ewing-like" soft tissue sarcomas in previous series. Because of its prognostic and therapeutic impact, the distinction of morphologic subtypes requires the cooperation of experienced radiologists and pathologists.
Collapse
Affiliation(s)
- F Violon
- Service de Pathologie, Hôpital Cochin, AP‑HP, Paris, France.,Faculté de Médecine de Nancy, Université de Lorraine, Nancy, France
| | - R Burns
- Service de Radiologie, Hôpital Cochin, AP-HP, Paris, France.,Université de Paris, Paris, France
| | - F Mihoubi
- Service de Radiologie, Hôpital Cochin, AP-HP, Paris, France
| | - V Audard
- Service de Pathologie, Hôpital Cochin, AP‑HP, Paris, France
| | - D Biau
- Université de Paris, Paris, France.,Service de Chirurgie Orthopédique, Hôpital Cochin, AP-HP, Paris, France
| | - A Feydy
- Service de Radiologie, Hôpital Cochin, AP-HP, Paris, France.,Université de Paris, Paris, France
| | - F Larousserie
- Service de Pathologie, Hôpital Cochin, AP‑HP, Paris, France. .,Université de Paris, Paris, France.
| |
Collapse
|
12
|
PEGylated talazoparib enhances therapeutic window of its combination with temozolomide in Ewing sarcoma. iScience 2022; 25:103725. [PMID: 35098099 PMCID: PMC8783091 DOI: 10.1016/j.isci.2021.103725] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 11/14/2021] [Accepted: 12/30/2021] [Indexed: 11/24/2022] Open
Abstract
Current therapy is ineffective for relapsed and metastatic Ewing sarcoma (EwS) owing to development of drug resistance. Macromolecular prodrugs potentially lead to lower drug exposure in normal tissues and reduced toxicity. We evaluated the efficacy of PEGylated talazoparib (PEG∼TLZ), a PARP1 inhibitor, alone or in combination with the DNA-alkylating agent temozolomide (TMZ) in EwS and other pediatric tumors using conventional testing or single-mouse trial (SMT). A single dose of PEG∼TLZ (10 μmol/kg on day 0) combined with 5 daily doses of TMZ (40 mg/kg starting on day 3/4) produced minimal toxicity, and the combination achieved maintained complete response in EwS and glioblastoma models. The SMT trial with the 3-day interval between PEG∼TLZ and TMZ resulted in objective responses in EwS and other xenografts. Thus, PEG∼TLZ + TMZ demonstrated a broad range of activity in pediatric solid tumor models. Furthermore, the therapeutic window of PEG∼TLZ + TMZ was enhanced compared with the free-TLZ combination. Nanoparticle-formulated drugs minimize drug-induced toxicity PEG∼TLZ enhances in vivo activity of TMZ in pediatric tumor xenografts A 3-day interval between each drug's administration widens the therapeutic window A single IV dose of PEG∼TLZ is advantageous for treating infants/young children
Collapse
|
13
|
Haveman LM, van Ewijk R, van Dalen EC, Breunis WB, Kremer LC, van den Berg H, Dirksen U, Merks JH. High-dose chemotherapy followed by autologous haematopoietic cell transplantation for children, adolescents, and young adults with first recurrence of Ewing sarcoma. Cochrane Database Syst Rev 2021; 9:CD011406. [PMID: 34472084 PMCID: PMC8411193 DOI: 10.1002/14651858.cd011406.pub2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Ewing sarcoma is a solid tumour, which is the second most common primary bone malignancy in children, often occurring in the long bones and pelvis. An incidence rate of 4.5 per million a year is reported, with a peak incidence of 11 per million at the age of 12 years. Despite more intensive chemotherapy, 30% to 40% of young people with Ewing sarcoma will have recurrence of the disease. Less than 30% of young people with a recurrence of Ewing sarcoma are alive at 24 months, and less than 10% are alive at 48 months. High-dose chemotherapy (HDC), followed by autologous haematopoietic cell transplantation (AHCT), is used in a variety of paediatric groups with diverse solid tumours. The hypothesis is that HDC regimens may overcome resistance to standard polychemotherapy, and this way may eradicate minimal residual disease, leading to improved survival after a first recurrence of disease. OBJECTIVES To assess the efficacy of HDC with AHCT versus conventional chemotherapy in improving event-free survival, overall survival, quality-adjusted survival, and progression-free survival in children, adolescents, and young adults with first recurrence of Ewing sarcoma, and to determine the toxicity of the treatment. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, conference proceedings from the SIOP, ASPHO, CTOS, ASBMT, EBMT, and EMSOS, and two trial registries in January 2020. We also searched reference lists of relevant articles and review articles. SELECTION CRITERIA We planned to include randomised controlled trials (RCTs) or (historical) controlled clinical trials (CCTs) comparing the effectiveness of HDC plus AHCT with conventional chemotherapy for children, adolescents, and young adults (up to 30 years old at the date of diagnostic biopsy) with a first recurrence of Ewing sarcoma. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. MAIN RESULTS We did not identify any eligible studies. AUTHORS' CONCLUSIONS Since we did not identify any eligible studies, we are unable to draw any conclusions about the efficacy and toxicity of HDC with AHCT versus conventional chemotherapy in children, adolescents, and young adults with a first recurrence of Ewing sarcoma. Further high-quality research is urgently needed.
Collapse
Affiliation(s)
- Lianne M Haveman
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
| | - Roelof van Ewijk
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
| | | | - Willemijn B Breunis
- Department of Paediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Department of Oncology and Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Leontien Cm Kremer
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
- Department of Paediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Henk van den Berg
- Department of Paediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Uta Dirksen
- Pediatrics III, Sarcoma Centre, West German Cancer Centre, University Hospital Essen, Essen, Germany
| | - Johannes Hm Merks
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
- Department of Paediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| |
Collapse
|
14
|
Haveman LM, van Ewijk R, van Dalen EC, Breunis WB, Kremer LC, van den Berg H, Dirksen U, Merks JH. High-dose chemotherapy followed by autologous haematopoietic cell transplantation for children, adolescents, and young adults with primary metastatic Ewing sarcoma. Cochrane Database Syst Rev 2021; 9:CD011405. [PMID: 34472082 PMCID: PMC8428235 DOI: 10.1002/14651858.cd011405.pub2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Ewing sarcomas are solid tumours of the bone and soft tissue, that usually affect children, adolescents, and young adults. The incidence is about three cases per million a year, with a peak incidence at 12 years of age. Metastatic disease is detected in about 20 % to 30% of people, and is typically found in the lungs, bone, bone marrow, or a combination of these. Presence of metastatic disease at diagnosis (primary metastatic disease) is the most important adverse prognostic factor, and is associated with a five-year survival lower than 30%. High-dose chemotherapy (HDC) followed by autologous haematopoietic cell transplantation (AHCT) is used in various solid tumours with unfavourable prognoses in children, adolescents, and young adults. It has also been used as rescue after multifocal radiation of metastases. The hypothesis is that HDC regimens may overcome the resistance to standard multidrug chemotherapy and improve survival rates. OBJECTIVES To assess the effects of high-dose chemotherapy with autologous haematopoietic cell transplantation compared with conventional chemotherapy in improving event-free survival, overall survival, quality-adjusted survival, and progression-free survival in children, adolescents, and young adults with primary metastatic Ewing sarcoma, and to determine the toxicity of the treatment. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, conference proceedings from major international cancer-related conferences, and ongoing trial registers until January 2020. We also searched reference lists of included articles and review articles. SELECTION CRITERIA We included randomised controlled trials (RCTs) or (historical) controlled clinical trials (CCTs) comparing the effectiveness of HDC and AHCT with conventional chemotherapy for children, adolescents, and young adults (younger than 30 years at the date of diagnostic biopsy) with primary metastatic Ewing sarcoma. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. MAIN RESULTS We identified one RCT, which investigated the effects of HDC with AHCT versus conventional chemotherapy with whole lung irradiation (WLI) in people with Ewing sarcoma metastasised to the lungs only at diagnosis. Only a selection of the participants were eligible for our review (N = 267: HDC with AHCT group N = 134; control group N = 133). There may be no difference in event-free survival between the two treatment groups (hazard ratio (HR) 0.83, 95% confidence interval (CI) 0.59 to 1.17; low-certainty evidence). We downgraded one level each because of study limitations and imprecision. Overall survival and toxicity were not reported separately for the participants eligible for this review, while quality-adjusted survival and progression-free survival were not reported at all. We did not identify any studies that addressed children, adolescents, and young adults with Ewing sarcoma with metastases to other locations. AUTHORS' CONCLUSIONS In people with Ewing sarcoma with primary metastases to locations other than the lungs, there is currently no evidence from RCTs or CCTs to determine the efficacy of HDC with AHCT compared to conventional chemotherapy. Based on low-certainty evidence from one study (267 participants), there may be no difference in event-free survival between children, adolescents, and young adults with primary pulmonary metastatic Ewing sarcoma who receive HDC with AHCT and those who receive conventional chemotherapy with WLI. Further high-quality research is needed. Results are anticipated for the EuroEwing 2008R3 study, in which the effects of HDC with treosulfan and melphalan followed by AHCT on survival, in people with Ewing sarcoma with metastatic disease to bone, other sites, or both were explored. Achieving high-quality studies in a selection of people with rare sarcoma requires long-term, multi-centre, international participant inclusion.
Collapse
Affiliation(s)
- Lianne M Haveman
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
| | - Roelof van Ewijk
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
| | | | - Willemijn B Breunis
- Department of Oncology and Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Leontien Cm Kremer
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
- Department of Paediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Henk van den Berg
- Department of Paediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Uta Dirksen
- Pediatrics III, Sarcoma Centre, West German Cancer Centre, University Hospital Essen, Essen, Germany
| | - Johannes Hm Merks
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
- Department of Paediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| |
Collapse
|
15
|
Zhang L, Xiong L, Wu LM, Shen WH, Zhou P, Lian CL, Zhang WT, Wu SG. The patterns of distant metastasis and prognostic factors in patients with primary metastatic Ewing sarcoma of the bone. J Bone Oncol 2021; 30:100385. [PMID: 34401227 PMCID: PMC8355910 DOI: 10.1016/j.jbo.2021.100385] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 07/21/2021] [Accepted: 07/21/2021] [Indexed: 10/25/2022] Open
Abstract
Background Ewing sarcoma (ES) of bone is accounting for the second most common type of primary bone cancer in children and adolescents. However, the patterns of distant metastasis (DM) and the effect of the sites of DM on survival outcomes were not investigated. Aims This study aimed to investigate the patterns of DM and the prognostic factors related to outcomes in primary metastatic ES of the bone. Methods Patients who were diagnosed with primary metastatic ES between 2010 and 2018 were identified from the Surveillance, Epidemiology, and End Results database. Kaplan-Meier analysis, log-rank tests, and Cox proportional-hazards regression models were used for statistical analyses. Results We identified 277 patients in this study and 95.3% of them (n = 264) receiving chemotherapy. A total of 371 sites of DM were observed. Lung was the most common distant metastatic site (n = 182, 49.1%), followed by bone (n = 139, 37.5%), distant lymph node (n = 26, 7.0%), liver (n = 14, 3.8%), and brain (n = 10, 2.7%). Three-year cause-specific survival (CSS) was 56.1% in the entire cohort. Older age (hazard ratio [HR] 2.210, P < 0.001) and bone metastasis (HR 1.903, P = 0.002) were the independent prognostic factors associated with inferior CSS. Similar results were found in those with bone-only metastasis (n = 80) or lung-only metastasis (n = 117), which showed that patients with bone-only metastasis had an inferior CSS compared to those with metastases only to the lung (HR 1.926, P = 0.005). Conclusions Lung and bone are the most frequently distant metastatic sites in patients with primary metastatic ES of bone. Bone metastasis is an independent risk factor for inferior survival.
Collapse
Affiliation(s)
- Lei Zhang
- Department of Orthopaedic Surgery, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen 361000, People's Republic of China
| | - Lu Xiong
- Medical Center, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou 570311, People's Republic of China
| | - Li-Mei Wu
- Department of Anesthesiology, The First Affiliated Hospital of Xiamen University, Xiamen 361003, People's Republic of China
| | - Wen-Hui Shen
- Department of Orthopaedic Surgery, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen 361000, People's Republic of China
| | - Ping Zhou
- Department of Radiation Oncology, The First Affiliated Hospital of Xiamen University, Xiamen 361003, People's Republic of China
| | - Chen-Lu Lian
- Department of Radiation Oncology, The First Affiliated Hospital of Xiamen University, Xiamen 361003, People's Republic of China
| | - Wen-Tong Zhang
- Department of Orthopaedic Surgery, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen 361000, People's Republic of China
| | - San-Gang Wu
- Department of Radiation Oncology, The First Affiliated Hospital of Xiamen University, Xiamen 361003, People's Republic of China
| |
Collapse
|
16
|
Salah S, To YH, Khozouz O, Ismail T, Yaser S, Alnsour A, Shahin O, Sultan I, Abuhijlih R, Halalsheh H, Abuhijla F, Lewin J. Irinotecan and temozolomide chemotherapy in paediatric and adult populations with relapsed Ewing Sarcoma. Clin Transl Oncol 2021; 23:757-763. [PMID: 32761317 DOI: 10.1007/s12094-020-02466-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 07/23/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Irinotecan and temozolomide (IT) is a widely used regimen for relapsed Ewing sarcoma (ES), although studies are largely limited to paediatric populations. METHODS We retrospectively reviewed paediatric (< 18 years) and adult patients (≥ 18 years) treated with salvage IT at two institutions. Haematologic toxicities were graded according to common terminology criteria of adverse events. Survival was estimated by the Kaplan-Meier method and compared by the Log Rank test. RESULTS Fifty-three patients were treated with IT from Jan, 2010 to Dec, 2018 (n = 16 paediatric; n = 37 adult). IT was given as second-line (n = 34; 64%) or ≥ third-line (n = 19; 36%). There was no difference in ≥ grade 3/4 haematologic toxicity between paediatrics and adults (31% vs. 35% respectively; p = 0.76). The frequency of diarrhoea of any grade was similar (38% in each group). Of 43 patients assessable for response, 12 (28%) had objective response (1 CR, 11 PR), 12 (28%) stable disease and 19 (44%) disease progression. Objective response rate did not differ between the two groups (36% in paediatrics vs. 25% in adults; p = 0.47). Median PFS was superior in paediatrics vs. adults (7.4 vs. 2.2 months, p = 0.039). CONCLUSION Irinotecan and temozolomide (IT) chemotherapy has activity for relapsed ES, with favourable toxicity and equally observed objective responses in the paediatric and adult populations. The observed superior PFS for the paediatric cohort requires further confirmation in future studies.
Collapse
Affiliation(s)
- S Salah
- King Hussein Cancer Centre, Amman, Jordan
| | - Y H To
- Peter MacCallum Cancer Centre, Melbourne, Australia
| | - O Khozouz
- King Hussein Cancer Centre, Amman, Jordan
| | - T Ismail
- King Hussein Cancer Centre, Amman, Jordan
| | - S Yaser
- King Hussein Cancer Centre, Amman, Jordan
| | - A Alnsour
- King Hussein Cancer Centre, Amman, Jordan
| | - O Shahin
- King Hussein Cancer Centre, Amman, Jordan
- UT MD Anderson Cancer Centre, Huston, TX, USA
| | - I Sultan
- King Hussein Cancer Centre, Amman, Jordan
| | | | | | - F Abuhijla
- King Hussein Cancer Centre, Amman, Jordan
| | - J Lewin
- Peter MacCallum Cancer Centre, Melbourne, Australia.
- ONTrac at Peter Mac Victorian Adolescent and Young Adult Cancer Service, Melbourne, Australia.
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia.
| |
Collapse
|
17
|
Hesla AC, Papakonstantinou A, Tsagkozis P. Current Status of Management and Outcome for Patients with Ewing Sarcoma. Cancers (Basel) 2021; 13:1202. [PMID: 33801953 PMCID: PMC7998375 DOI: 10.3390/cancers13061202] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/26/2021] [Accepted: 02/27/2021] [Indexed: 12/16/2022] Open
Abstract
Ewing sarcoma is the second most common bone sarcoma in children after osteosarcoma. It is a very aggressive malignancy for which systemic treatment has greatly improved outcome for patients with localized disease, who now see survival rates of over 70%. However, for the quarter of patients presenting with metastatic disease, survival is still dismal with less than 30% of patients surviving past 5 years. Patients with disease relapse, local or distant, face an even poorer prognosis with an event-free 5-year survival rate of only 10%. Unfortunately, Ewing sarcoma patients have not yet seen the benefit of recent years' technical achievements such as next-generation sequencing, which have enabled researchers to study biological systems at a level never seen before. In spite of large multinational studies, treatment of Ewing sarcoma relies entirely on chemotherapeutic agents that have been largely unchanged for decades. As many promising modern therapies, including monoclonal antibodies, small molecules, and immunotherapy, have been disappointing to date, there is no clear candidate as to which drug should be investigated in the next large-scale clinical trial. However, the mechanisms driving tumor development in Ewing sarcoma are slowly unfolding. New entities of Ewing-like tumors, with fusion transcripts that are related to the oncogenic EWSR1-FLI1 fusion seen in the majority of Ewing tumors, are being mapped. These tumors, although sharing much of the same morphologic features as classic Ewing sarcoma, behave differently and may require a different treatment. There are also controversies regarding local treatment of Ewing sarcoma. The radiosensitive nature of the disease and the tendency for Ewing sarcoma to arise in the axial skeleton make local treatment very challenging. Surgical treatment and radiotherapy have their pros and cons, which may give rise to different treatment strategies in different centers around the world. This review article discusses some of these controversies and reproduces the highlights from recent publications with regard to diagnostics, systemic treatment, and surgical treatment of Ewing sarcoma.
Collapse
|
18
|
Brady EJ, Hameed M, Tap WD, Hwang S. Imaging features and clinical course of undifferentiated round cell sarcomas with CIC-DUX4 and BCOR-CCNB3 translocations. Skeletal Radiol 2021; 50:521-529. [PMID: 32840647 PMCID: PMC8436215 DOI: 10.1007/s00256-020-03589-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/14/2020] [Accepted: 08/16/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To describe the pre-treatment imaging features and clinical course of undifferentiated round cell sarcomas with CIC-DUX4 and BCOR-CCNB3 translocations. MATERIALS AND METHODS In this retrospective study, several pre-treatment imaging features (tumor location, size, enhancement pattern, necrosis, flow voids, calcification, and FDG avidity) and the clinical course of patients were evaluated. RESULTS In 12 patients with CIC-DUX4 sarcomas (median age, 24 years; range, 12-75), sarcomas were located in the soft tissue (n = 10), bone (n = 1), and lungs (n = 1). On MRI, all 10 CIC-DUX4 sarcomas presented as a large necrotic mass (mean size 6.7 cm, range 2.3-11.3) with 100% demonstrating contrast enhancement, 60% showing flow voids, and 20% demonstrating fluid-fluid levels. On PET, the mean SUVmax was 13.2 (range, 8.5-18.1). Among 12 patients with follow-up, 3 died within a year of diagnosis. The most common site of metastases was the lungs (5/12). In 5 patients with BCOR-CCNB3 sarcomas (median age, 14 years; range, 2-17), sarcomas were located in the spine (n = 2), femur (n = 1), tibia (n = 1), and pelvis (n = 1). On radiograph or CT, 2 were lytic, 3 were sclerotic. Soft tissue calcifications occurred in 40% of BCOR-CCNB3 sarcomas. On MRI, all 3 BCOR-CCNB3 tumors enhanced with 33% demonstrating flow voids and 66% exhibiting necrosis. On PET, the mean SUVmax was 6.3 (range 5.7-6.9). CONCLUSION CIC-DUX4 sarcomas often present as necrotic and hypermetabolic soft tissue masses while sarcomas with BCOR-CCNB3 translocations are vascular bone lesions with necrosis at imaging. CIC-DUX4 sarcomas are clinically more aggressive than BCOR-CCNB3 sarcomas.
Collapse
Affiliation(s)
- Emily J Brady
- Department of Radiology, New York Presbyterian/Weill Cornell, 525 East 68th St, Box 141, New York, NY, 10065, USA
| | - Meera Hameed
- Department of Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA
| | - William D Tap
- Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA
| | - Sinchun Hwang
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA.
| |
Collapse
|
19
|
Tarek N, Said R, Andersen CR, Suki TS, Foglesong J, Herzog CE, Tannir NM, Patel S, Ratan R, Ludwig JA, Daw NC. Primary Ewing Sarcoma/Primitive Neuroectodermal Tumor of the Kidney: The MD Anderson Cancer Center Experience. Cancers (Basel) 2020; 12:cancers12102927. [PMID: 33050651 PMCID: PMC7599660 DOI: 10.3390/cancers12102927] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/30/2020] [Accepted: 10/05/2020] [Indexed: 02/03/2023] Open
Abstract
Limited information exists on the clinical behavior of the Ewing sarcoma family of tumors (ESFT) of the kidney. We reviewed the records of 30 patients (aged 8-69 years) with ESFT of the kidney seen at our institution between 1990 and 2013. We analyzed the event-free survival (EFS) and overall survival (OS) for associations with patient demographics, disease group, tumor size, tumor thrombus, and treatment. Six patients (20%) had tumors confined to the kidney (Group I), seven (23.3%) had local tumor extension beyond the kidney (Group II), and 17 (56.7%) had distant metastasis at diagnosis (Group III). Twenty-five (83.3%) patients underwent radical (19 upfront, five delayed) or partial (one upfront) nephrectomy, 25 (83.3%) chemotherapy and four (13.3%) radiotherapy. The 4-year EFS and OS were 43% (95% CI, 26-61%) and 63% (95% CI, 46-81%), respectively. EFS and OS were significantly associated with disease group and chemotherapy (p < 0.039). The presence of tumor thrombus in renal vein and/or inferior vena cava was associated with worse EFS (p = 0.053). Patients with disease confined to the kidney treated with nephrectomy and adjuvant chemotherapy have favorable outcomes. Local tumor extension beyond the kidney, tumor thrombus, and distant metastasis are unfavorable factors that warrant intensification or novel approaches of therapy.
Collapse
Affiliation(s)
- Nidale Tarek
- Department of Pediatrics, the University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (T.S.S.); (J.F.); (C.E.H.)
- Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut 1107, Lebanon
- Correspondence: (N.T.); (N.C.D.); Tel.: +1-713-792-6620 (N.C.D.)
| | - Rabih Said
- Department of Investigational Cancer Therapeutics, the University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
| | - Clark R. Andersen
- Department of Biostatistics, the University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
| | - Tina S. Suki
- Department of Pediatrics, the University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (T.S.S.); (J.F.); (C.E.H.)
| | - Jessica Foglesong
- Department of Pediatrics, the University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (T.S.S.); (J.F.); (C.E.H.)
- Division of Hematology, Oncology, Neuro-Oncology & Stem Cell Transplant, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL 60611, USA
| | - Cynthia E. Herzog
- Department of Pediatrics, the University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (T.S.S.); (J.F.); (C.E.H.)
| | - Nizar M. Tannir
- Department of Genitourinary Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
| | - Shreyaskumar Patel
- Department of Sarcoma Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (S.P.); (R.R.); (J.A.L.)
| | - Ravin Ratan
- Department of Sarcoma Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (S.P.); (R.R.); (J.A.L.)
| | - Joseph A. Ludwig
- Department of Sarcoma Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (S.P.); (R.R.); (J.A.L.)
| | - Najat C. Daw
- Department of Pediatrics, the University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (T.S.S.); (J.F.); (C.E.H.)
- Correspondence: (N.T.); (N.C.D.); Tel.: +1-713-792-6620 (N.C.D.)
| |
Collapse
|
20
|
Federico SM, Pappo AS, Sahr N, Sykes A, Campagne O, Stewart CF, Clay MR, Bahrami A, McCarville MB, Kaste SC, Santana VM, Helmig S, Gartrell J, Shelat A, Brennan RC, Hawkins D, Godwin K, Bishop MW, Furman WL, Stewart E. A phase I trial of talazoparib and irinotecan with and without temozolomide in children and young adults with recurrent or refractory solid malignancies. Eur J Cancer 2020; 137:204-213. [PMID: 32795876 DOI: 10.1016/j.ejca.2020.06.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 06/04/2020] [Accepted: 06/11/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Talazoparib combined with irinotecan and temozolomide demonstrated efficacy in a murine Ewing sarcoma model. Based on these data, we conducted a phase I trial of talazoparib and irinotecan with/without temozolomide in paediatric patients with recurrent/refractory solid malignancies. PATIENTS AND METHODS Cohorts of 3-6 patients with recurrent/refractory solid malignancies received escalating doses of oral talazoparib and intravenous irinotecan (arm A) and oral talazoparib, oral temozolomide and intravenous irinotecan (arm B) in a 3 + 3 design. Talazoparib was administered on days 1-6, and intravenous irinotecan and oral temozolomide were administered on days 2-6, of a 21-day course. Serum for talazoparib and irinotecan pharmacokinetics was obtained during course 1. UGT1A1 polymorphism and Schlafen family member 11 (SLFN11) immunohistochemical staining were performed. RESULTS Forty-one patients (20 males; median age, 14.6 years; 24 with recurrent disease) were evaluable for dose escalation. Twenty-nine and 12 patients were treated on arm A and arm B, respectively, for a total of 208 courses. The most common diagnosis was Ewing sarcoma (53%). The most common ≥grade III haematologic toxicities in arms A and B included neutropenia (78% and 31%, respectively) and thrombocytopenia (42% and 31%, respectively). In arms A and B, febrile neutropenia (24% and 14%, respectively) and diarrhoea (21% and 7%, respectively) were the most common ≥grade III non-hematologic toxicities. Six patients (Ewing sarcoma [5 patients] and synovial sarcoma [1 patient]) had a response (1 with a complete response, 5 with a partial response). The objective response rates were 10.3% (arm A) and 25% (arm B). Pharmacokinetic testing demonstrated no evidence of drug-drug interaction between talazoparib and irinotecan. UGT1A1 was not related to response. SLFN11 positivity was associated with best response to therapy. CONCLUSIONS The combination of talazoparib and irinotecan with/without temozolomide is feasible and active in Ewing sarcoma, and further investigation is warranted.
Collapse
Affiliation(s)
- Sara M Federico
- Departments of Oncology, St. Jude Children's Research Hospital, Memphis, TN 38105, USA; The Departments of Pediatrics, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38103, USA.
| | - Alberto S Pappo
- Departments of Oncology, St. Jude Children's Research Hospital, Memphis, TN 38105, USA; The Departments of Pediatrics, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38103, USA
| | - Natasha Sahr
- Departments of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN 38105, USA
| | - April Sykes
- Departments of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN 38105, USA
| | - Olivia Campagne
- Departments of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, TN 38105, USA
| | - Clinton F Stewart
- Departments of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, TN 38105, USA
| | - Michael R Clay
- Departments of Pathology, St. Jude Children's Research Hospital, Memphis, TN 38105, USA
| | - Armita Bahrami
- Departments of Pathology, St. Jude Children's Research Hospital, Memphis, TN 38105, USA
| | - Mary B McCarville
- Departments of Radiological Sciences, St. Jude Children's Research Hospital, Memphis, TN 38105, USA
| | - Sue C Kaste
- Departments of Radiological Sciences, St. Jude Children's Research Hospital, Memphis, TN 38105, USA
| | - Victor M Santana
- Departments of Oncology, St. Jude Children's Research Hospital, Memphis, TN 38105, USA; The Departments of Pediatrics, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38103, USA
| | - Sara Helmig
- Departments of Oncology, St. Jude Children's Research Hospital, Memphis, TN 38105, USA; The Departments of Pediatrics, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38103, USA
| | - Jessica Gartrell
- Departments of Oncology, St. Jude Children's Research Hospital, Memphis, TN 38105, USA
| | - Anang Shelat
- Departments of Chemical Biology and Therapeutics, St. Jude Children's Research Hospital, Memphis, TN 38105, USA
| | - Rachel C Brennan
- Departments of Oncology, St. Jude Children's Research Hospital, Memphis, TN 38105, USA; The Departments of Pediatrics, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38103, USA
| | - Dana Hawkins
- Departments of Oncology, St. Jude Children's Research Hospital, Memphis, TN 38105, USA
| | - Kimberly Godwin
- Departments of Oncology, St. Jude Children's Research Hospital, Memphis, TN 38105, USA
| | - Michael W Bishop
- Departments of Oncology, St. Jude Children's Research Hospital, Memphis, TN 38105, USA; The Departments of Pediatrics, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38103, USA
| | - Wayne L Furman
- Departments of Oncology, St. Jude Children's Research Hospital, Memphis, TN 38105, USA; The Departments of Pediatrics, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38103, USA
| | - Elizabeth Stewart
- Departments of Oncology, St. Jude Children's Research Hospital, Memphis, TN 38105, USA; Departments of Developmental Neurobiology, St. Jude Children's Research Hospital, Memphis, TN 38105, USA; The Departments of Pediatrics, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38103, USA
| |
Collapse
|
21
|
Ewing sarcoma family of tumors-derived small extracellular vesicle proteomics identify potential clinical biomarkers. Oncotarget 2020; 11:2995-3012. [PMID: 32821345 PMCID: PMC7415402 DOI: 10.18632/oncotarget.27678] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 06/20/2020] [Indexed: 01/03/2023] Open
Abstract
PURPOSE Ewing Sarcoma Family of Tumors (ESFT), the second most common pediatric osseous malignancy, are characterized by the pathognomonic chromosomal EWS-ETS translocation. Outside of tumor biopsy, no clinically relevant ESFT biomarkers exist. Additionally, tumor burden assessment at diagnosis, monitoring of disease responsiveness to therapy, and detection of disease recurrence are limited to radiographic imaging. To identify new, clinically relevant biomarkers we evaluated the proteome of a subset of ESFT-derived small extracellular vesicles (sEVs). MATERIALS AND METHODS We performed the first high quality proteomic study of ESFT-derived sEVs from 5 ESFT cell lines representing the most common EWS-ETS fusion types and identified 619 proteins composing the core ESFT sEV proteome. We compared these core proteins to databases of common plasma-based proteins and sEV-associated proteins found within healthy plasma to identify proteins unique or enriched within ESFT. RESULTS From these analyses, two membrane bound proteins with biomarker potential were selected, CD99/MIC2 and NGFR, to develop a liquid-based assay enriching of ESFT-associated sEVs and detection of sEV mRNA cargo (i.e., EWS-ETS transcripts). We employed this immuno-enrichment approach to diagnosis of ESFT utilizing plasma (250 μl) from both localized and metastatic ESFT pediatric patients and cancer-free controls, and showed significant diagnostic power [AUC = 0.92, p = 0.001 for sEV numeration, with a PPV = 1.00, 95% CI = (0.63, 1.00) and a NPV = 0.67, 95% CI = (0.30, 0.93)]. CONCLUSIONS In this study, we demonstrate utilization of circulating ESFT-associated sEVs in pediatric patients as a source of minimally invasive diagnostic and potentially prognostic biomarkers.
Collapse
|
22
|
Targeting BCL-2 proteins in pediatric cancer: Dual inhibition of BCL-XL and MCL-1 leads to rapid induction of intrinsic apoptosis. Cancer Lett 2020; 482:19-32. [DOI: 10.1016/j.canlet.2020.02.041] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 02/28/2020] [Accepted: 02/28/2020] [Indexed: 01/15/2023]
|
23
|
Baldwin P, Likhotvorik R, Baig N, Cropper J, Carlson R, Kurmasheva R, Sridhar S. Nanoformulation of Talazoparib Increases Maximum Tolerated Doses in Combination With Temozolomide for Treatment of Ewing Sarcoma. Front Oncol 2019; 9:1416. [PMID: 31921673 PMCID: PMC6928193 DOI: 10.3389/fonc.2019.01416] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 11/28/2019] [Indexed: 12/26/2022] Open
Abstract
The Pediatric Preclinical Testing Program previously identified the PARP inhibitor talazoparib (TLZ) as a means to potentiate temozolomide (TMZ) activity for the treatment of Ewing sarcoma. However, the combination of TLZ and TMZ has been toxic in both preclinical and clinical testing, necessitating TMZ dose reduction to ~15% of the single agent maximum tolerated dose. We have synthesized a nanoparticle formulation of talazoparib (NanoTLZ) to be administered intravenously in an effort to modulate the toxicity profile of this combination treatment. Results in Ewing sarcoma xenograft models are presented to demonstrate the utility of this delivery method both alone and in combination with TMZ. NanoTLZ reduced gross toxicity and had a higher maximum tolerated dose than oral TLZ. The dose of TMZ did not have to be reduced when combined with NanoTLZ as was required when combined with oral TLZ. This indicated the NanoTLZ delivery system may be advantageous in decreasing the systemic toxicity associated with the combination of oral TLZ and TMZ.
Collapse
Affiliation(s)
- Paige Baldwin
- Department of Bioengineering, Northeastern University, Boston, MA, United States
| | | | - Nabeela Baig
- Greehey Children's Cancer Research Institute, San Antonio, TX, United States
| | - Jodie Cropper
- Greehey Children's Cancer Research Institute, San Antonio, TX, United States
| | - Ruth Carlson
- Greehey Children's Cancer Research Institute, San Antonio, TX, United States
| | - Raushan Kurmasheva
- Greehey Children's Cancer Research Institute, San Antonio, TX, United States.,Department of Molecular Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Srinivas Sridhar
- Department of Bioengineering, Northeastern University, Boston, MA, United States.,Department of Physics, Northeastern University, Boston, MA, United States.,Division of Radiation Oncology, Harvard Medical School, Boston, MA, United States
| |
Collapse
|
24
|
Fernandez KS, Turski ML, Shah AT, Bastian BC, Horvai A, Hardee S, Sweet-Cordero EA. Ewing sarcoma in a child with neurofibromatosis type 1. Cold Spring Harb Mol Case Stud 2019; 5:mcs.a004580. [PMID: 31645347 PMCID: PMC6824249 DOI: 10.1101/mcs.a004580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 08/28/2019] [Indexed: 12/02/2022] Open
Abstract
We report here on a case of Ewing sarcoma (ES) occurring in a child with neurofibromatosis type 1. The sarcoma had an EWSR1-ERG translocation as well as loss of the remaining wild-type allele of NF1. Loss of the NF1 wild-type allele in the tumor suggests that activation of the Ras pathway contributed to its evolution. Review of available public data suggests that secondary mutations in the Ras pathway are found in ∼3% of ESs. This case suggests that Ras pathway activation may play a role in tumor progression in a subset of ESs.
Collapse
Affiliation(s)
- Karen S Fernandez
- Division of Hematology/Oncology, Valley Children's Hospital, Madera, California 93636, USA
| | - Michelle L Turski
- Molecular Oncology Initiative, University of California, San Francisco, San Francisco, California 94158, USA
| | - Avanthi Tayi Shah
- Division of Hematology and Oncology, Department of Pediatrics, University of California, San Francisco, San Francisco, California 94158, USA
| | - Boris C Bastian
- Departments of Dermatology and Pathology, University of California, San Francisco, San Francisco, California 94158, USA
| | - Andrew Horvai
- Department of Pathology, University of California, San Francisco, San Francisco, California 94158, USA
| | - Steven Hardee
- Division of Pathology, Valley Children's Hospital, Madera, California 93636, USA
| | - E Alejandro Sweet-Cordero
- Division of Hematology and Oncology, Department of Pediatrics, University of California, San Francisco, San Francisco, California 94158, USA
| |
Collapse
|
25
|
Abstract
Among the various genes that can be rearranged in soft tissue neoplasms associated with nonrandom chromosomal translocations, EWSR1 is the most frequent one to partner with other genes to generate recurrent fusion genes. This leads to a spectrum of clinically and pathologically diverse mesenchymal and nonmesenchymal neoplasms, variably manifesting as small round cell, spindle cell, clear cell or adipocytic tumors, or tumors with distinctive myxoid stroma. This review summarizes the growing list of mesenchymal neoplasms that are associated with EWSR1 gene rearrangements.
Collapse
Affiliation(s)
- Khin Thway
- Sarcoma Unit, Royal Marsden Hospital, The Royal Marsden NHS Foundation Trust, 203 Fulham Road, London SW3 6JJ, UK.
| | - Cyril Fisher
- Department of Musculoskeletal Pathology, Royal Orthopaedic Hospital NHS Foundation Trust, Robert Aitken Institute for Clinical Research, University of Birmingham, Birmingham B15 2TT, UK
| |
Collapse
|
26
|
Jha AK, Neupane P, Pradhan M, Sharma KS, Shrestha S, Sigdel PR, Smeland S, Bruland ØS. Ewing Sarcoma in Nepal Treated With Combined Chemotherapy and Definitive Radiotherapy. J Glob Oncol 2019; 5:1-10. [PMID: 30917070 PMCID: PMC6449078 DOI: 10.1200/jgo.19.00015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To our knowledge, we conducted the first prospective oncologic clinical trial in Nepal aimed at providing state-of-the-art chemotherapy to patients with Ewing sarcoma. The efficacy of external-beam radiotherapy (RT) as the sole local treatment modality was explored and deemed justified as a result of the lack of available advanced tumor-orthopedic services in Nepal. PATIENTS AND METHODS Twenty patients, 11 female and 9 male patients between the ages of 6 and 37 years, with newly diagnosed Ewing sarcoma were enrolled. Neoadjuvant combination chemotherapy, comprising well-established drug combinations, was administered in five courses before external-beam RT, during which one course of etoposide and ifosfamide was given. After RT, six additional chemotherapy courses were scheduled. RESULTS RT was tolerated well, providing rapid symptom relief and local tumor control, with no pathologic fractures observed among the 15 patients who received such treatment. Eleven patients completed the entire treatment protocol; seven patients were under continued follow-up, with no evidence of disease in six patients at a median follow-up time of 2.3 years (range, 1.3 to 3.1 years) and one patient alive but with a regional recurrence. Four patients experienced metastatic relapse and died as a result of their disease. Three treatment-related deaths linked to toxicity from chemotherapy occurred. Four of the six patients who refused to complete the treatment protocol and were lost to follow-up experienced progressive disease and were assumed dead. CONCLUSION This study was feasible with RT as the sole local treatment modality in combination with chemotherapy. As a result of the high number of patients lost to follow-up, no firm conclusions can be drawn, but the majority of the patients who completed treatment obtained durable long-term remissions.
Collapse
Affiliation(s)
| | | | - Manohar Pradhan
- Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | | | | | | | - Sigbjørn Smeland
- Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Øyvind S Bruland
- Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
27
|
Argüello Ramírez V, Rico Nava A, Gutiérrez Ruiz F, Martínez Rentería DA, Pliego Maldonado R, Espinosa Soberanes JA. Tumor de Askin. Caso radiológico. REVISTA DE LA FACULTAD DE MEDICINA 2019. [DOI: 10.22201/fm.24484865e.2019.62.2.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Nuevamente el estudio radiográfico demuestra ser de gran utilidad. En esta ocasión se muestra el diagnóstico de un interesante caso de una rara neoplasia confirmada por otro estudio de imagenología.
Collapse
Affiliation(s)
- Verónica Argüello Ramírez
- Universidad Nacional Autónoma de México (UNAM) Facultad de Medicina. Médico residente de Imagenología Diagnóstica y Terapéutica / Hospital Central Norte Pemex. Ciudad de México, México
| | - Araceli Rico Nava
- Petróleos Mexicanos (PEMEX), Hospital Central Norte Pemex, Servicio de Radiología e Imagen. Ciudad de México, México
| | - Francisco Gutiérrez Ruiz
- Petróleos Mexicanos (PEMEX), Hospital Central Norte Pemex, Servicio de Radiología e Imagen. Ciudad de México, México
| | | | - Roberto Pliego Maldonado
- Petróleos Mexicanos (PEMEX), Hospital Central Norte, Jefe del Servicio de Radiología e Imagen. Ciudad de México, México
| | | |
Collapse
|
28
|
Majeed SS, Muhammad HA, Ali JS, Khudhair HH, Said A, Arif SO, Murad KM, Gendari AH, Muhsin BM, Mohammed SA, Mula-Hussain L. Treatment Outcomes of Pediatric Patients With Ewing Sarcoma in a War-Torn Nation: A Single-Institute Experience From Iraq. J Glob Oncol 2019; 5:1-9. [PMID: 30707662 PMCID: PMC6426536 DOI: 10.1200/jgo.18.00122] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Ewing sarcoma (ES) is a relatively rare, highly malignant tumor of the musculoskeletal system. It is the second most common malignant bone tumor in children and adolescents in the age group of 5 to 20 years. The aim of this study was to identify the treatment outcomes of pediatric patients with ES in Sulaimani governorate, Iraq. PATIENTS AND METHODS This was a retrospective study that reviewed the medical records of pediatric patients with ES who were managed between 2009 and 2015, with follow-up until late 2017. Patient- and tumor-related factors were correlated with clinical outcomes. RESULTS A total of 31 pediatric patients with ES were included in this study. All the patients received chemotherapy and radiotherapy, whereas only 14 patients underwent surgical resection and just eight had free surgical margins. The median age at diagnosis was 13 years, 58% were male, and 42% were female. The presenting symptoms at diagnosis were mostly pain (67.7%) and palpable mass (25.8%). The primary tumor was located in the extremities (51.6%), the thoracic cage (19.4%), the pelvis (16.1%), and the lumbar vertebrae (12.9%). Approximately two thirds of the patients (61.3%) had localized disease at the time of presentation. The 5-year overall survival was 19%, and the 5-year recurrence-free survival was 34%. CONCLUSION Clinical outcomes of ES in pediatric patients in our war-torn nation, Iraq, are still markedly inferior to the published outcomes from stable, developed nations. Additional large and multicenter national studies are required. Diagnostic and therapeutic measures need improvement, and multidisciplinary and comprehensive cancer-integrated approaches are vital for better outcomes.
Collapse
Affiliation(s)
| | - Hawzheen A Muhammad
- Komar University of Science and Technology, Sulaimani, Kurdistan, Iraq.,University of Sulaimani, Sulaimani, Kurdistan, Iraq
| | - Jalil S Ali
- Zhianawa Cancer Center, Sulaimani, Kurdistan, Iraq
| | | | - Ayah Said
- University of Toronto, Toronto, Ontario, Canada
| | - Shkar O Arif
- Zhianawa Cancer Center, Sulaimani, Kurdistan, Iraq
| | | | - Ali H Gendari
- Mosul Oncology and Nuclear Medicine Hospital, Mosul, Ninevah, Iraq
| | | | | | | |
Collapse
|
29
|
Hotfilder M, Mallela N, Seggewiß J, Dirksen U, Korsching E. Defining a Characteristic Gene Expression Set Responsible for Cancer Stem Cell-Like Features in a Sub-Population of Ewing Sarcoma Cells CADO-ES1. Int J Mol Sci 2018; 19:ijms19123908. [PMID: 30563222 PMCID: PMC6321634 DOI: 10.3390/ijms19123908] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 11/26/2018] [Accepted: 12/04/2018] [Indexed: 12/20/2022] Open
Abstract
One of the still open questions in Ewing sarcoma, a rare bone tumor with weak therapeutic options, is to identify the tumor-driving cell (sub) population and to understand the specifics in the biological network of these cells. This basic scientific insight might foster the development of more specific therapeutic target patterns. The experimental approach is based on a side population (SP) of Ewing cells, based on the model cell line CADO-ES1. The SP is established by flow cytometry and defined by the idea that tumor stem-like cells can be identified by the time-course in clearing a given artificial dye. The SP was characterized by a higher colony forming activity, by a higher differentiation potential, by higher resistance to cytotoxic drugs, and by morphology. Several SP and non-SP cell fractions and bone marrow-derived mesenchymal stem cell reference were analyzed by short read sequencing of the full transcriptome. The double-differential analysis leads to an altered expression structure of SP cells centered around the AP-1 and APC/c complex. The SP cells share only a limited proportion of the full mesenchymal stem cell stemness set of genes. This is in line with the expectation that tumor stem-like cells share only a limited subset of stemness features which are relevant for tumor survival.
Collapse
Affiliation(s)
- Marc Hotfilder
- Department of Pediatric Hematology and Oncology, University Hospital Münster, 48149 Münster, Germany.
| | - Nikhil Mallela
- Institute of Bioinformatics, Faculty of Medicine, University of Münster, 48149 Münster, Germany.
| | - Jochen Seggewiß
- Institute of Human Genetics, Faculty of Medicine, University of Münster, 48149 Münster, Germany.
| | - Uta Dirksen
- University Hospital Essen, Pediatrics III, Hematology and Oncology, West German Cancer Centre, 45147 Essen, Germany.
| | - Eberhard Korsching
- Institute of Bioinformatics, Faculty of Medicine, University of Münster, 48149 Münster, Germany.
| |
Collapse
|
30
|
Huang T, Li F, Yan Z, Ma Y, Xiong F, Cai X, Zhang Q, Liu F, Dong J. Effectiveness of 18F-FDG PET/CT in the diagnosis, staging and recurrence monitoring of Ewing sarcoma family of tumors: A meta-analysis of 23 studies. Medicine (Baltimore) 2018; 97:e13457. [PMID: 30508968 PMCID: PMC6283220 DOI: 10.1097/md.0000000000013457] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND To investigate the value of positron emission tomography (PET) and PET/computed tomography (CT) using fluorine-18-fluorodeoxyglucose (F-FDG) in the diagnosis, staging, restaging and recurrence monitoring of Ewing sarcoma family of tumors (ESFTs), a meta-analysis was performed through systematically searching PubMed, Embase, and Cochrane Central library to retrieve articles. METHODS After screening and diluting out the articles that met inclusion criteria to be used for statistical analysis the pooled evaluation indexes including sensitivity, specificity, and diagnostic odd ratio (DOR) as well as the summary receiver operating characteristic curve (SROC) were calculated involving diagnostic data (true positive, false positive, false negative, and true negative) extracted from original studies. RESULTS Screening determined that out of 2007, 23 studies involving a total of 524 patients were deemed viable for inclusion in the meta-analysis. The results of the analysis showed that the sensitivity and specificity were at 86% and 80%, respectively. Additionally, a satisfactory accuracy of F-FDG PET and PET/CT was observed in detecting ESFT recurrence, lung metastasis, and osseous metastasis. CONCLUSION This meta-analysis suggests that F-FDG PET and PET/CT with an extremely high accuracy could be considered a valuable method for detecting distant metastasis and post-operational recurrence of ESFT, which might have a profound impact on the development of treatment protocols for ESFT.
Collapse
Affiliation(s)
- Tao Huang
- Department of Orthopaedics, Yantai Shan Hospital, Yantai
| | - Feng Li
- Department of Orthopaedics, Zhangqiu District People's Hospital of Jinan City, Zhangqiu District, Jinan City, Shandong Province, China
| | - Zexing Yan
- Department of Trauma Surgery, University of Regensburg, Regensburg
| | - Yupeng Ma
- Department of Orthopaedics, Yantai Shan Hospital, Yantai
| | - Fei Xiong
- Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, University Hospital of Munich (LMU), Campus Großhadern, Munich, Germany
| | - Xia Cai
- Department of Orthopaedics, Zhangqiu District People's Hospital of Jinan City, Zhangqiu District, Jinan City, Shandong Province, China
| | - Qingyu Zhang
- Department of Orthopaedics, Qilu Hospital, Shandong University
| | - Fanxiao Liu
- Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, University Hospital of Munich (LMU), Campus Großhadern, Munich, Germany
- Department of Orthopaedics, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Jinlei Dong
- Department of Orthopaedics, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| |
Collapse
|
31
|
Louati S, Senhaji N, Chbani L, Bennis S. EWSR1 Rearrangement and CD99 Expression as Diagnostic Biomarkers for Ewing/PNET Sarcomas in a Moroccan Population. DISEASE MARKERS 2018; 2018:7971019. [PMID: 30319719 PMCID: PMC6167566 DOI: 10.1155/2018/7971019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 08/16/2018] [Accepted: 08/18/2018] [Indexed: 11/23/2022]
Abstract
Ewing sarcoma/primitive neuroectodermal tumor (Ewing/PNET sarcomas or EPS) are a group of round cell tumors. Malignant round cell tumors form a large and diverse group that includes rhabdomyosarcoma, synovial sarcoma, non-Hodgkin's lymphoma, neuroblastoma, hepatoblastoma, Wilm's tumor, desmoplastic small round cell tumor, and other morphologically similar entities. Differential diagnosis of Ewing sarcoma/primitive neuroectodermal tumor (Ewing/PNET sarcomas or EPS) is difficult. In addition to morphology and immunohistochemistry (IHC), differential diagnosis of these tumors is based on molecular analysis of the EWSR1 gene rearrangement using fluorescent in situ hybridization (FISH) technique. We investigated the diagnostic value of combined CD99 immunostaining and EWSR1 t(22q12) alteration using a dual-color, break-apart rearrangement probe in forty-one formalin-fixed paraffin-embedded (FFPE) tissue samples from pediatric and adult patients diagnosed with EPS. IHC was performed in all cases using the CD99 antibody and showed a positivity of 92.7% in the enrolled cases (38/41) followed by FISH analysis where 48.8% of the cases (20/41) were rearranged. Sensitivity and specificity for IHC assays were 88% and 58%, respectively. Notably, FISH had a sensitivity of 100% and a specificity of 87%. In addition, CD99 positivity was found to correlate with EWSR1 rearrangement (p < 0.05). This report shows that FISH has better sensitivity and specificity than IHC in the Moroccan population, and supports its combination with CD99 immunostaining as diagnostic biomarkers for this rare malignant entity."
Collapse
Affiliation(s)
- Sara Louati
- Bioactive Molecules, Structure and Functions Laboratory, Faculty of Sciences and Techniques, Sidi Mohamed ben Abdellah University of Fez, Morocco
- Pathological Anatomy and Molecular Pathology Department, Hassan II University Hospital of Fez, Morocco
| | - Nadia Senhaji
- Bioactive Molecules, Structure and Functions Laboratory, Faculty of Sciences and Techniques, Sidi Mohamed ben Abdellah University of Fez, Morocco
| | - Laila Chbani
- Pathological Anatomy and Molecular Pathology Department, Hassan II University Hospital of Fez, Morocco
- Biomedical and Translational Research Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohamed ben Abdellah University of Fez, Morocco
| | - Sanae Bennis
- Pathological Anatomy and Molecular Pathology Department, Hassan II University Hospital of Fez, Morocco
- Biomedical and Translational Research Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohamed ben Abdellah University of Fez, Morocco
| |
Collapse
|
32
|
Yin X, Sun J, Zhang H, Wang S. Comprehensive analysis of multi Ewing sarcoma microarray datasets identifies several prognosis biomarkers. Mol Med Rep 2018; 18:4229-4238. [PMID: 30221671 PMCID: PMC6172382 DOI: 10.3892/mmr.2018.9432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 07/25/2018] [Indexed: 11/27/2022] Open
Abstract
Ewing sarcoma (ES) is a common primary malignancy in children and adolescents. Progression of treatment methods hasn't contributed a lot to the imrovement of prognosis. To identify potential prognostic biomarkers, a meta-analysis pipeline of multi-gene expression datasets for ES from the Gene Expression Omnibus (GEO) was performed. Three datasets were screened and differential expression genes (DEGs) in ES samples compared with normal tissues were identified through limma package and subjected to network analysis. As a result, 1,470 DEGs were obtained which were mainly involved in biological processes associated with immune response and transcription regulation. Network analysis obtained 22 core genes with high network degree and fold change. Kaplan-Meier analysis based on ES datasets from The Cancer Genome Atlas identified five genes, including glycogen phosphorylase, muscle-associated, myocyte-specific enhancer factor 2C, tripartite motif containing 63, budding uninhibited by benzimidazoses1 and Ras GTPase-activating protein 1, whose altered expression profiles are significantly associated with survival. Changes of their expression values were further confirmed through RT-qPCR in ES cell and normal cell lines. Those genes may be considered as potential prognostic biomarkers of ES and should be helpful for its early diagnosis and treatment.
Collapse
Affiliation(s)
- Xuqing Yin
- Department of Traumatic Orthopaedics, Central Hospital of Zibo, Zibo, Shandong 255036, P.R. China
| | - Jiubo Sun
- Department of Radiation Oncology, Central Hospital of Zibo, Zibo, Shandong 255036, P.R. China
| | - Haiyang Zhang
- Department of Microinvasive Othopaedics, Central Hospital of Zibo, Zibo, Shandong 255036, P.R. China
| | - Shuai Wang
- Department of Spine Surgery, Jining No. 1 People's Hospital, Jining, Shandong 272000, P.R. China
| |
Collapse
|
33
|
Johnsen B, Fasmer KE, Boye K, Rosendahl K, Trovik C, Biermann M, Aukland SM. Added value of 18F-FDG PET-CT in staging of Ewing sarcoma in children and young adults. Eur J Hybrid Imaging 2018. [DOI: 10.1186/s41824-018-0031-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
34
|
Minas TZ, Surdez D, Javaheri T, Tanaka M, Howarth M, Kang HJ, Han J, Han ZY, Sax B, Kream BE, Hong SH, Çelik H, Tirode F, Tuckermann J, Toretsky JA, Kenner L, Kovar H, Lee S, Sweet-Cordero EA, Nakamura T, Moriggl R, Delattre O, Üren A. Combined experience of six independent laboratories attempting to create an Ewing sarcoma mouse model. Oncotarget 2018; 8:34141-34163. [PMID: 27191748 PMCID: PMC5470957 DOI: 10.18632/oncotarget.9388] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 05/05/2016] [Indexed: 12/17/2022] Open
Abstract
Ewing sarcoma (ES) involves a tumor-specific chromosomal translocation that produces the EWS-FLI1 protein, which is required for the growth of ES cells both in vitro and in vivo. However, an EWS-FLI1-driven transgenic mouse model is not currently available. Here, we present data from six independent laboratories seeking an alternative approach to express EWS-FLI1 in different murine tissues. We used the Runx2, Col1a2.3, Col1a3.6, Prx1, CAG, Nse, NEFL, Dermo1, P0, Sox9 and Osterix promoters to target EWS-FLI1 or Cre expression. Additional approaches included the induction of an endogenous chromosomal translocation, in utero knock-in, and the injection of Cre-expressing adenovirus to induce EWS-FLI1 expression locally in multiple lineages. Most models resulted in embryonic lethality or developmental defects. EWS-FLI1-induced apoptosis, promoter leakiness, the lack of potential cofactors, and the difficulty of expressing EWS-FLI1 in specific sites were considered the primary reasons for the failed attempts to create a transgenic mouse model of ES.
Collapse
Affiliation(s)
- Tsion Zewdu Minas
- Department of Oncology, Georgetown University Medical Center, Washington, DC, United States of America
| | - Didier Surdez
- Genetics and Biology of Cancers Unit, Institut Curie Research Center, PSL Research University, Île-de-France, Paris, France.,INSERM U830, Institut Curie Research Center, Île-de-France, Paris, France
| | | | - Miwa Tanaka
- Division of Carcinogenesis, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Michelle Howarth
- Division of Hematology and Oncology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Hong-Jun Kang
- Department of Pathology and Laboratory Medicine, Tulane University School of Medicine, New Orleans, LA, United States of America
| | - Jenny Han
- Department of Oncology, Georgetown University Medical Center, Washington, DC, United States of America
| | - Zhi-Yan Han
- Genetics and Biology of Cancers Unit, Institut Curie Research Center, PSL Research University, Île-de-France, Paris, France.,INSERM U830, Institut Curie Research Center, Île-de-France, Paris, France
| | - Barbara Sax
- Ludwig Boltzmann Institute for Cancer Research, Vienna, Austria
| | - Barbara E Kream
- Department of Medicine, and Genetics and Genome Sciences, University of Connecticut Health Science Center, Farmington, CT, United States of America
| | - Sung-Hyeok Hong
- Department of Oncology, Georgetown University Medical Center, Washington, DC, United States of America
| | - Haydar Çelik
- Department of Oncology, Georgetown University Medical Center, Washington, DC, United States of America
| | - Franck Tirode
- Genetics and Biology of Cancers Unit, Institut Curie Research Center, PSL Research University, Île-de-France, Paris, France.,INSERM U830, Institut Curie Research Center, Île-de-France, Paris, France
| | - Jan Tuckermann
- Institute of Comparative Molecular Endocrinology (CME), University of Ulm, Ulm, Germany
| | - Jeffrey A Toretsky
- Department of Oncology, Georgetown University Medical Center, Washington, DC, United States of America
| | - Lukas Kenner
- Ludwig Boltzmann Institute for Cancer Research, Vienna, Austria.,Clinical Institute of Pathology, Medical University of Vienna, Vienna, Austria.,Department of Pathology of Laboratory Animals (UPLA), University of Veterinary Medicine, Vienna, Austria
| | - Heinrich Kovar
- Department of Pediatrics, Medical University of Vienna, Vienna, Austria.,Children´s Cancer Research Institute, St. Anna Kinderkrebsforschung, Vienna, Austria
| | - Sean Lee
- Department of Pathology and Laboratory Medicine, Tulane University School of Medicine, New Orleans, LA, United States of America
| | - E Alejandro Sweet-Cordero
- Division of Hematology and Oncology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Takuro Nakamura
- Division of Carcinogenesis, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Richard Moriggl
- Ludwig Boltzmann Institute for Cancer Research, Vienna, Austria.,Institute of Animal Breeding and Genetics, University of Veterinary Medicine, Vienna, Austria.,Medical University of Vienna, Vienna, Austria
| | - Olivier Delattre
- Genetics and Biology of Cancers Unit, Institut Curie Research Center, PSL Research University, Île-de-France, Paris, France.,INSERM U830, Institut Curie Research Center, Île-de-France, Paris, France.,Unité de génétique somatique, Institut Curie, Île-de-France, Paris, France
| | - Aykut Üren
- Department of Oncology, Georgetown University Medical Center, Washington, DC, United States of America
| |
Collapse
|
35
|
Wineland AM, Turpin B, Gupta A, de Alarcon A. Ewing Sarcoma in the cervical trachea of a pediatric patient: A case report and review of the literature. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2018. [DOI: 10.1016/j.epsc.2017.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
36
|
Grünewald TGP. [Functional genomics of Ewing sarcoma]. DER PATHOLOGE 2017; 38:198-201. [PMID: 28849372 DOI: 10.1007/s00292-017-0332-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Ewing sarcoma is a highly aggressive bone or soft-tissue tumor mostly occurring in children and adolescents. Conventional multi-modal therapies are associated with considerable acute and chronic toxicity. Thus, more effective and in particular less toxic therapeutic strategies are urgently required. Despite the fact that Ewing sarcoma is characterized by specific EWSR1-ETS gene fusions, the resulting fusion oncoproteins are not suitable for targeted therapy due to their low immunogenicity and the ubiquitous expression of their constituents. However, functional genomics revealed several EWSR1-ETS target genes, which are only minimally expressed in normal tissues, and which could serve as surrogate-targets for (immuno-)therapeutic approaches. Moreover, functional genomic analyses yielded first mechanistic explanations for the relatively high incidence of Ewing sarcoma in Europeans, and first studies are exploring the value of circulating free DNA and/or exosomal mRNA of EWSR1-ETS fusion oncogenes as minimal-residual-disease markers in Ewing sarcoma. This review summarizes key contributions to these aspects and gives a perspective on their medical relevance.
Collapse
Affiliation(s)
- T G P Grünewald
- Max-Eder Nachwuchsgruppe für Pädiatrische Sarkombiologie, Pathologisches Institut, Medizinische Fakultät, LMU München, Thalkirchner Str. 36, 80337, München, Deutschland.
| |
Collapse
|
37
|
Kriegsmann K, Heilig C, Cremer M, Novotny P, Kriegsmann M, Bruckner T, Müller-Tidow C, Egerer G, Wuchter P. Successful collection of peripheral blood stem cells upon VIDE chemomobilization in sarcoma patients. Eur J Haematol 2017; 99:459-464. [DOI: 10.1111/ejh.12960] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2017] [Indexed: 02/05/2023]
Affiliation(s)
| | - Christoph Heilig
- Department of Medicine V; Heidelberg University; Heidelberg Germany
| | - Martin Cremer
- Department of Medicine V; Heidelberg University; Heidelberg Germany
| | - Philipp Novotny
- Department of Medicine V; Heidelberg University; Heidelberg Germany
| | - Mark Kriegsmann
- Institute of Pathology; Heidelberg University; Heidelberg Germany
| | - Thomas Bruckner
- Institute of Medical Biometry und Informatics; Heidelberg University; Heidelberg Germany
| | | | - Gerlinde Egerer
- Department of Medicine V; Heidelberg University; Heidelberg Germany
| | - Patrick Wuchter
- Department of Medicine V; Heidelberg University; Heidelberg Germany
- Institute of Transfusion Medicine and Immunology; Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
| |
Collapse
|
38
|
Frank JA, Ranft A, Paulussen M, Juergens H, Kruseova J, Bauer S, Niggli F, Reichardt P, Dirksen U. Results for patients with sarcoma not otherwise specified and other diagnoses than Ewing sarcoma treated according to the Euro-EWING 99 trial. Pediatr Blood Cancer 2017; 64. [PMID: 28436593 DOI: 10.1002/pbc.26524] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Revised: 01/28/2017] [Accepted: 02/16/2017] [Indexed: 11/09/2022]
Abstract
BACKGROUND Euro-EWING 99 trial of the European Ewing tumor Working Initiative of National Groups (EE99) was an international phase III study in patients with Ewing sarcoma. The German Society of Pediatric Oncology and Hematology (GPOH) data center registered and followed patients with other diagnoses than Ewing sarcoma who were treated according to the EE99 protocol in an additional non-Ewing database. PROCEDURE Data of 27 patients with other diagnoses than Ewing sarcoma treated according to the EE99 protocol were analyzed. Patients had miscellaneous histologic diagnoses, the majority were diagnosed with sarcoma not otherwise specified (NOS) arising in bone and soft tissue (63%). RESULTS The median age at diagnosis was 16.9 years (range 4.5-41.4). Localized disease was diagnosed in 61.5% of the patients and 38.5% had distant metastases at time of primary diagnosis. The median follow-up time was 3.7 years (range 0.5-9.5). Patients with localized disease showed a 3-year event-free survival (EFS) of 68%, compared to 3-year EFS of 20% in patients with metastases (P = 0.042). Three-year EFS for patients with sarcoma NOS was 52%, patients with localized and metastatic disease showed 3-year EFS of 66 and 20%, respectively. CONCLUSION EFS in patients with other diagnoses than Ewing sarcoma treated according to EE99 was significantly higher in patients with localized than metastatic disease. Sarcomas of soft tissue and bone that cannot be classified to current diagnostic categories constitute a therapeutic challenge.
Collapse
Affiliation(s)
- Judith Amalie Frank
- Department of Pediatric Hematology and Oncology, University Hospital Muenster, Westfalian Wilhelms University, Muenster, Germany
| | - Andreas Ranft
- Department of Pediatric Hematology and Oncology, University Hospital Muenster, Westfalian Wilhelms University, Muenster, Germany
| | - Michael Paulussen
- Vestische Kinder- und Jugendklinik, Datteln, University Witten/Herdecke, Datteln, Germany
| | - Heribert Juergens
- Department of Pediatric Hematology and Oncology, University Hospital Muenster, Westfalian Wilhelms University, Muenster, Germany
| | - Jarmila Kruseova
- Department of Pediatric Hematology and Oncology, University Hospital Motol, Prague, Czech Republic
| | - Sebastian Bauer
- Sarcoma Center, West German Cancer Center, Universtitatsklinikum Essen, Essen, Germany
| | - Felix Niggli
- Department of Oncology, University Children's Hospital Zurich, Zurich, Switzerland
| | - Peter Reichardt
- Department of Interdisciplinary Oncology, HELIOS Klinikum Berlin-Buch, Berlin, Germany
| | - Uta Dirksen
- Department of Pediatric Hematology and Oncology, University Hospital Muenster, Westfalian Wilhelms University, Muenster, Germany
| |
Collapse
|
39
|
López F, Lund VJ, Suárez C, Snyderman CH, Saba NF, Robbins KT, Vander Poorten V, Strojan P, Mendenhall WM, Rinaldo A, Ferlito A. The Impact of Histologic Phenotype in the Treatment of Sinonasal Cancer. Adv Ther 2017; 34:2181-2198. [PMID: 28871554 DOI: 10.1007/s12325-017-0605-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Indexed: 01/04/2023]
Abstract
The management of sinonasal cancer is a challenge due to its low occurrence and anatomical and significant diversity of histological types. The therapeutic modality used should be tailored individually according to the histology, tumour stage, molecular profile and previous treatments. The clinical management of sinonasal cancer has improved greatly owing to developments in endoscopic surgery and precision radiotherapy. Complete surgical resection is the mainstay of sinonasal malignancies' management but multimodality therapy is associated with improved outcomes in certain histologies. The recognition of various histological types with biological behaviours more suitable for non-surgical modalities has allowed treatment protocols to become more tailored to the disease. In this review we aim to describe and to summarise the current data guiding the management of sinonasal cancer with emphasis on phenotypic variation.
Collapse
Affiliation(s)
- Fernando López
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.
- Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias and CIBERONC, ISCIII, Oviedo, Spain.
| | - Valerie J Lund
- Professorial Unit, Ear Institute, University College London, London, UK
| | - Carlos Suárez
- Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias and CIBERONC, ISCIII, Oviedo, Spain
| | - Carl H Snyderman
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Nabil F Saba
- Department of Hematology and Medical Oncology, The Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - K Thomas Robbins
- Division of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, ILL, USA
| | - Vincent Vander Poorten
- Otorhinolaryngology-Head and Neck Surgery and Department of Oncology, Section Head and Neck Oncology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Primož Strojan
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
| | - William M Mendenhall
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL, USA
| | | | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group, Padua, Italy
| |
Collapse
|
40
|
Steinestel K, Grünewald TGP, Hartmann W. [The role of focal adhesions in Ewing's sarcoma]. DER PATHOLOGE 2017; 38:169-171. [PMID: 28939918 DOI: 10.1007/s00292-017-0354-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- K Steinestel
- Institut für Pathologie und Molekularpathologie, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Deutschland. .,Gerhard-Domagk-Institut für Pathologie, Universitätsklinikum Münster, Münster, Deutschland.
| | - T G P Grünewald
- Max-Eder-Nachwuchsgruppe für Pädiatrische Sarkombiologie, Pathologisches Institut, Medizinische Fakultät, LMU München, München, Deutschland
| | - W Hartmann
- Gerhard-Domagk-Institut für Pathologie, Universitätsklinikum Münster, Münster, Deutschland
| |
Collapse
|
41
|
Krakorova DA, Kubackova K, Dusek L, Tomas T, Janicek P, Tucek S, Prausova J, Kiss I, Zambo I. Advantages in Prognosis of Adult Patients with Ewing Sarcoma: 11-years Experiences and Current Treatment Management. Pathol Oncol Res 2017; 24:623-630. [DOI: 10.1007/s12253-017-0291-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 08/09/2017] [Indexed: 01/23/2023]
|
42
|
Rellinger EJ, Padmanabhan C, Qiao J, Appert A, Waterson AG, Lindsley CW, Beauchamp RD, Chung DH. ML327 induces apoptosis and sensitizes Ewing sarcoma cells to TNF-related apoptosis-inducing ligand. Biochem Biophys Res Commun 2017; 491:463-468. [PMID: 28716733 DOI: 10.1016/j.bbrc.2017.07.050] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 07/08/2017] [Indexed: 01/06/2023]
Abstract
Ewing sarcomas are rare mesenchymal-derived bone and soft tissue tumors in children. Afflicted children with distant metastases have poor survival despite aggressive therapeutics. Epithelial-to-mesenchymal transition in epithelial carcinomas is associated with loss of E-cadherin and resistance to apoptosis. ML327 is a novel small molecule that we have previously shown to reverse epithelial-to-mesenchymal transition features in both epithelial and neural crest-derived cancers. Herein, we sought to evaluate the effects of ML327 on mesenchymal-derived Ewing sarcoma cells, hypothesizing that ML327 initiates growth arrest and sensitizes to TNF-related apoptosis-inducing ligand. ML327 induced protein expression changes, increased E-cadherin and decreased vimentin, consistent with partial induction of mesenchymal-to-epithelial transition in multiple Ewing Sarcoma cell lines (SK-N-MC, TC71, and ES-5838). Induction of epithelial features was associated with apoptosis, as demonstrated by PARP and Caspase 3 cleavage by immunoblotting. Cell cycle analysis validated these findings by marked induction of the subG0 cell population. In vitro combination treatment with TRAIL demonstrated additive induction of apoptotic markers. Taken together, these findings establish a rationale for further in vivo trials of ML327 in cells of mesenchymal origin both alone and in combination with TRAIL.
Collapse
Affiliation(s)
- Eric J Rellinger
- Section of Surgical Sciences, Department of Surgery, United States; Department of Pediatric Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, United States
| | | | - Jingbo Qiao
- Section of Surgical Sciences, Department of Surgery, United States; Department of Pediatric Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, United States
| | - Andrew Appert
- Department of Pediatric Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, United States
| | - Alex G Waterson
- Department of Pharmacology, Vanderbilt Institute of Chemical Biology, United States
| | - Craig W Lindsley
- Department of Pharmacology, Vanderbilt Institute of Chemical Biology, United States
| | - R Daniel Beauchamp
- Section of Surgical Sciences, Department of Surgery, United States; Department of Cancer Biology, United States; Department of Cell and Developmental Biology, United States
| | - Dai H Chung
- Section of Surgical Sciences, Department of Surgery, United States; Department of Cancer Biology, United States; Department of Pediatric Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, United States.
| |
Collapse
|
43
|
WeiΔ LM, Hugle M, Fulda S. Eribulin alone or in combination with the PLK1 inhibitor BI 6727 triggers intrinsic apoptosis in Ewing sarcoma cell lines. Oncotarget 2017; 8:52445-52456. [PMID: 28881742 PMCID: PMC5581041 DOI: 10.18632/oncotarget.17190] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 03/02/2017] [Indexed: 11/25/2022] Open
Abstract
In this study, we investigated the molecular mechanisms of eribulin-induced cell death and its therapeutic potential in combination with the PLK1 inhibitor BI 6727 in Ewing sarcoma (ES). Here, we show that eribulin triggers cell death in a dose-dependent manner in a panel of ES cell lines. In addition, eribulin at subtoxic, low nanomolar concentrations acts in concert with BI 6727 to induce cell death and to suppress long-term clonogenic survival. Mechanistic studies reveal that eribulin monotherapy at cytotoxic concentrations and co-treatment with eribulin at subtoxic concentrations together with BI 6727 arrest cells in the M phase of the cell cycle prior to the onset of cell death. This mitotic arrest is followed by increased phosphorylation of BCL-2 and BCL-xL as well as downregulation of MCL-1, suggesting inactivation of these antiapoptotic BCL-2 family proteins. Consistently, eribulin monotherapy and eribulin/BI 6727 co-treatment trigger activation of BAX, a key proapoptotic BCL-2 family protein, and increase proteolytic activation of caspase-9 and -3. Importantly, overexpression of BCL-2 or addition of the broad-range caspase inhibitor zVAD.fmk significantly rescue eribulin- as well as eribulin/BI 6727-induced cell death. Together, these findings demonstrate that eribulin induces cell death via the intrinsic pathway of apoptosis in ES cells, both alone at cytotoxic concentrations and in combination with BI 6727 at subtoxic concentrations. Thus, our study highlights the therapeutic potential of eribulin for the treatment of ES alone or in rational combination therapies.
Collapse
Affiliation(s)
- Lilly Magdalena WeiΔ
- Institute for Experimental Cancer Research in Pediatrics, Goethe-University, Frankfurt, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Manuela Hugle
- Institute for Experimental Cancer Research in Pediatrics, Goethe-University, Frankfurt, Germany
| | - Simone Fulda
- Institute for Experimental Cancer Research in Pediatrics, Goethe-University, Frankfurt, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
| |
Collapse
|
44
|
van Egmond-van Dam JC, Bekkering WP, Bramer JAM, Beishuizen A, Fiocco M, Dijkstra PDS. Functional outcome after surgery in patients with bone sarcoma around the knee; results from a long-term prospective study. J Surg Oncol 2017; 115:1028-1032. [PMID: 28384378 PMCID: PMC5516165 DOI: 10.1002/jso.24618] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 02/03/2017] [Accepted: 03/01/2017] [Indexed: 11/18/2022]
Abstract
Background and Objectives In a previous conducted study functional outcome of young patients with bone sarcoma located around the knee was longitudinally evaluated during the first 2 years postoperatively. Functional outcome improved significantly over the first 2 years. The purpose of this descriptive study was to evaluate the functional outcome of these patients at long‐term follow‐up of 7 years. Methods Functional outcome was assessed with the TESS, MSTS, Baecke questionnaire, and three functional performance tests: time up and down stairs (TUDS), various walking activities (VWA), and the 6‐min walking test (6MWT). Linear Mixed Model has been employed for the repeated measurements. Results Twenty patients of the original study (n = 44) participated in the current study. Fifteen limb‐salvage and five ablative surgery patients, median follow‐up 7.4 years (6.8‐8.0) (CI 95%), mean age 22.3 years (18.2‐31.6). Between 2 and 7 years after surgery, 8 limb‐salvage patients (53%) encountered surgery related complications. Questionnaires and functional performance tests showed no significant difference in functional outcome between 2 years and 7 years after surgery (P < 0.05). Conclusions Between 2 years and follow‐up at average 7 years after surgery no further improvements were noticed at young patients with a bone sarcoma located around the knee.
Collapse
Affiliation(s)
- Janneke C van Egmond-van Dam
- Department of Orthopedics, Rehabilitation & Physical Therapy, Leiden University Medical Centre, Leiden, Netherlands
| | - W Peter Bekkering
- Department of Orthopedics, Rehabilitation & Physical Therapy, Leiden University Medical Centre, Leiden, Netherlands.,Department of Orthopedic Surgery, Academic Medical Center University of Amsterdam, Amsterdam, Netherlands
| | - Jos A M Bramer
- Department of Orthopedic Surgery, Academic Medical Center University of Amsterdam, Amsterdam, Netherlands
| | - Auke Beishuizen
- Department of Pediatric Oncology/Hematology, Erasmus MC University Medical Center-Sophia Children's Hospital, Rotterdam, Netherlands
| | - Marta Fiocco
- Mathematical Institute Leiden University, Leiden, Netherlands.,Department of Medical Statistics and Bioinformatics, Leiden University Medical Centre, Leiden, Netherlands
| | - P D Sander Dijkstra
- Department of Orthopedics, Rehabilitation & Physical Therapy, Leiden University Medical Centre, Leiden, Netherlands
| |
Collapse
|
45
|
Keizer MP, Kamp AM, Aarts C, Geisler J, Caron HN, van de Wetering MD, Wouters D, Kuijpers TW. The High Prevalence of Functional Complement Defects Induced by Chemotherapy. Front Immunol 2016; 7:420. [PMID: 27799929 PMCID: PMC5066094 DOI: 10.3389/fimmu.2016.00420] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 09/27/2016] [Indexed: 01/08/2023] Open
Abstract
Introduction To date, oncology patients are more dependent on non-cellular host defense against pathogens due to intensive (chemo)therapy-related bone marrow suppression. Since data on complement functionality in oncology patients are limited, we aimed to investigate the innate complement function in relation to the type of malignancy and therapy in a longitudinal cohort of patients. Methods A large single-center, prospective non-intervention study was conducted, in which blood samples were taken from patients before, during, and after treatment with chemotherapy and/or subsequent admittance for (febrile) neutropenia. Results/findings Analysis of 48 patients showed a high percentage of defects in complement activity of the alternative pathway (19.1%), the classical pathway (4.3%), or both (42.6%). Post hoc analysis of six different treatment protocols with more than three patients each showed distinct effects of specific therapies. Whereas patients treated according to the Ewing, EpSSG-rhabdomyosarcoma, or SIOP CNS germ cell tumor protocol showed no defects, patients treated according to the ALL-11 (leukemia), the EURAMOS I (osteosarcoma), or the ACNS (medulloblastoma) protocols showed an almost universal reduction in complement function. Although we could not explain the reduced complement functionality under all conditions, a strong effect was observed following high-dose methotrexate or ifosfamide. Conclusion Acquired complement defects were commonly observed in more than 50% of oncology patients, some of which associated with certain chemotherapeutic drugs. Additional studies are needed to determine the clinical and therapeutic context of complement defects and their possible effect on treatment outcome or the increased risk of infection.
Collapse
Affiliation(s)
- Mischa P Keizer
- Sanquin Research and Landsteiner Laboratory AMC, Department of Immunopathology, University of Amsterdam, Amsterdam, Netherlands; Academic Medical Center (AMC), Emma Children's Hospital, University of Amsterdam, Amsterdam, Netherlands
| | - Angela M Kamp
- Sanquin Research and Landsteiner Laboratory AMC, Department of Immunopathology, University of Amsterdam , Amsterdam , Netherlands
| | - Cathelijn Aarts
- Sanquin Research and Landsteiner Laboratory AMC, Department of Immunopathology, University of Amsterdam , Amsterdam , Netherlands
| | - Judy Geisler
- Sanquin Research and Landsteiner Laboratory AMC, Department of Blood Cell Research, University of Amsterdam , Amsterdam , Netherlands
| | - Huib N Caron
- Academic Medical Center (AMC), Emma Children's Hospital, University of Amsterdam , Amsterdam , Netherlands
| | - Marianne D van de Wetering
- Academic Medical Center (AMC), Emma Children's Hospital, University of Amsterdam , Amsterdam , Netherlands
| | - Diana Wouters
- Sanquin Research and Landsteiner Laboratory AMC, Department of Immunopathology, University of Amsterdam , Amsterdam , Netherlands
| | - Taco W Kuijpers
- Academic Medical Center (AMC), Emma Children's Hospital, University of Amsterdam, Amsterdam, Netherlands; Sanquin Research and Landsteiner Laboratory AMC, Department of Blood Cell Research, University of Amsterdam, Amsterdam, Netherlands
| |
Collapse
|
46
|
Sinonasal Malignancies of Anterior Skull Base: Histology-driven Treatment Strategies. Otolaryngol Clin North Am 2016; 49:183-200. [PMID: 26614837 DOI: 10.1016/j.otc.2015.09.012] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The advances in endoscopy have revolutionized the management of sinonasal and skull base lesions. Many complex cancers that traditionally required open approaches are now amenable to purely endoscopic endonasal resection, providing less invasive surgery with lower morbidity but with comparable oncologic outcomes in terms of survival rates. This article discusses the current evidence for the multimodal management of sinonasal and anterior skull base cancers focusing on the different treatment protocols driven by histologic subtypes.
Collapse
|
47
|
Abstract
Since its foundation by remarkably talented and insightful individuals, prominently including Pepper Dehner, pediatric soft tissue tumor pathology has developed at an immense rate. The morphologic classification of tumoral entities has extensively been corroborated, but has also evolved with refinement or realignment of these classifications, through accruing molecular data, with many derivative ancillary diagnostic assays now already well-established. Tumors of unclear histogenesis, classically morphologically undifferentiated, are prominent amongst pediatric sarcomas, however, the classes of undifferentiated round- or spindle-cell-tumors-not-otherwise-specified are being dismantled gradually with the identification of their molecular underpinnings. Within recent years, for example, numerous subcategories of 'Ewing-like' round cell sarcoma have emerged. Such advances have provided the basis for novel diagnostic and prognostic sub-classifications. Efforts at defining cell- or lineage-of-origin for several tumor types have produced interesting insights especially for rhabdomyosarcoma. The remarkably early onset of pediatric sarcomas defies the theory necessitating stochastic accumulation of several somatic mutations for cancer development and indeed, these tumors may be remarkably genomically stable, often belying their aggressive nature. Much is coming to light recently regarding the role of epigenetic modifications in the evolution of these sarcomas. Indeed the morphologic features of embryonal tumors generally (not just sarcomas) may be highly reminiscent of arrested differentiation, and given the tight epigenetic regulation of cell fate determination and cell identity maintenance, a theory of epigenetically-driven oncogenesis sits easily with these tumors. The age-delimited distinct biologies of 'pediatric' and adult GIST are intriguing, particularly, the SDH-deficient 'pediatric' form, driven by a metabolic defect, but resulting in epigenetic dysregulation with genome-wide DNA methylation changes. There is little doubt that many of the gaps in our understanding of pediatric sarcoma biology will be filled by a deeper appreciation of the role of dysregulated epigenetics including chromatin biology, perhaps best exemplified in malignant rhabdoid tumor. The field of pediatric soft tissue tumor pathology grows ever more interesting. Importantly though, it must be emphasized, that none of this progress could have occurred, or indeed continue, without the initial step of accurate diagnosis, founded solidly on morphology - thank you Pepper for your unparalleled contributions to this field! The opportunity to be your apprentice for five years has been a bigger and more positive influence than words can express.
Collapse
Affiliation(s)
- Maureen O'Sullivan
- National Children's Research Centre, Crumlin, Dublin, Ireland; Our Lady's Children's Hospital Crumlin, Dublin, Ireland; Trinity College, Dublin, Ireland.
| |
Collapse
|
48
|
Town J, Pais H, Harrison S, Stead LF, Bataille C, Bunjobpol W, Zhang J, Rabbitts TH. Exploring the surfaceome of Ewing sarcoma identifies a new and unique therapeutic target. Proc Natl Acad Sci U S A 2016; 113:3603-8. [PMID: 26979953 PMCID: PMC4822608 DOI: 10.1073/pnas.1521251113] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The cell surface proteome of tumors mediates the interface between the transformed cells and the general microenvironment, including interactions with stromal cells in the tumor niche and immune cells such as T cells. In addition, the cell surface proteome of individual cancers defines biomarkers for that tumor type and potential proteins that can be the target of antibody-mediated therapy. We have used next-generation deep RNA sequencing (RNA-seq) coupled to an in-house database of genes encoding cell surface proteins (herein referred to as the surfaceome) as a tool to define a cell surface proteome of Ewing sarcoma compared with progenitor mesenchymal stem cells. This subtractive RNA-seq analysis revealed a specific surfaceome of Ewing and showed unexpectedly that the leucine-rich repeat and Ig domain protein 1 (LINGO1) is expressed in over 90% of Ewing sarcoma tumors, but not expressed in any other somatic tissue apart from the brain. We found that the LINGO1 protein acts as a gateway protein internalizing into the tumor cells when engaged by antibody and can carry antibody conjugated with drugs to kill Ewing sarcoma cells. Therefore, LINGO1 is a new, unique, and specific biomarker and drug target for the treatment of Ewing sarcoma.
Collapse
Affiliation(s)
- Jennifer Town
- Medical Research Council Molecular Haematology Unit, Weatherall Institute for Molecular Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DS, United Kingdom
| | - Helio Pais
- Medical Research Council Molecular Haematology Unit, Weatherall Institute for Molecular Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DS, United Kingdom
| | - Sally Harrison
- Leeds Institute of Molecular Medicine, St. James's Hospital, Leeds LS9 7TF, United Kingdom
| | - Lucy F Stead
- Leeds Institute of Molecular Medicine, St. James's Hospital, Leeds LS9 7TF, United Kingdom
| | - Carole Bataille
- Chemistry Research Laboratory, Department of Chemistry, University of Oxford, Oxford OX1 3AT, United Kingdom
| | - Wilawan Bunjobpol
- Medical Research Council Molecular Haematology Unit, Weatherall Institute for Molecular Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DS, United Kingdom
| | - Jing Zhang
- Medical Research Council Molecular Haematology Unit, Weatherall Institute for Molecular Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DS, United Kingdom
| | - Terence H Rabbitts
- Medical Research Council Molecular Haematology Unit, Weatherall Institute for Molecular Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DS, United Kingdom;
| |
Collapse
|
49
|
Hesla AC, Tsagozis P, Jebsen N, Zaikova O, Bauer H, Brosjö O. Improved Prognosis for Patients with Ewing Sarcoma in the Sacrum Compared with the Innominate Bones: The Scandinavian Sarcoma Group Experience. J Bone Joint Surg Am 2016; 98:199-210. [PMID: 26842410 DOI: 10.2106/jbjs.o.00362] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Treatment of Ewing sarcoma of the pelvic bones remains one of the most difficult tasks in the treatment of bone sarcomas. Whether surgery or radiation therapy is the best local treatment is still a matter of debate. The aim of the present study was to compare sacral and nonsacral sites with regard to the treatment and outcome of pelvic Ewing sarcomas. METHODS Patients with Ewing sarcoma of the osseous pelvis diagnosed between 1986 and 2011 were identified through the Scandinavian Sarcoma Group registry. Data regarding tumor size, local treatment (surgery or radiation therapy), metastatic disease, surgical margins, local recurrence, and overall survival were analyzed. RESULTS Of the 117 patients examined, eighty-eight had tumors in the innominate bones and twenty-nine, in the sacrum. Radiation therapy was the sole local treatment for 40% of the innominate bone tumors in contrast to 79% of the sacral tumors. The five-year disease-free survival rate in the latter group (66%) was greater than that in the group with tumors in the innominate bones (40%) (p = 0.02 adjusted for size). CONCLUSIONS Disease-free survival among patients with Ewing sarcoma was improved when the tumor was localized in the sacrum compared with the innominate bones, where these tumors are generally larger. Local radiation therapy alone appears to result in good local tumor control and may be the treatment of choice for sacral tumors.
Collapse
Affiliation(s)
- Asle Charles Hesla
- Department of Orthopaedic Surgery, Karolinska University Hospital, Solna, Sweden
| | - Panagiotis Tsagozis
- Department of Orthopaedic Surgery, Karolinska University Hospital, Solna, Sweden
| | - Nina Jebsen
- Department of Oncology, Haukeland University Hospital, Bergen, Norway
| | - Olga Zaikova
- Department of Orthopaedic Surgery, Norwegian Radium Hospital, Oslo, Norway
| | - Henrik Bauer
- Department of Orthopaedic Surgery, Karolinska University Hospital, Solna, Sweden
| | - Otte Brosjö
- Department of Orthopaedic Surgery, Karolinska University Hospital, Solna, Sweden
| |
Collapse
|
50
|
Merchant MS, Bernstein D, Amoako M, Baird K, Fleisher TA, Morre M, Steinberg SM, Sabatino M, Stroncek DF, Venkatasan AM, Wood BJ, Wright M, Zhang H, Mackall CL. Adjuvant Immunotherapy to Improve Outcome in High-Risk Pediatric Sarcomas. Clin Cancer Res 2016; 22:3182-91. [PMID: 26823601 DOI: 10.1158/1078-0432.ccr-15-2550] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 01/02/2016] [Indexed: 01/28/2023]
Abstract
PURPOSE Patients with metastatic or relapsed pediatric sarcomas receive cytotoxic regimens that induce high remission rates associated with profound lymphocyte depletion, but ultimately few survive long term. We administered adjuvant immunotherapy to patients with metastatic and recurrent pediatric sarcomas in an effort to improve outcomes. EXPERIMENTAL DESIGN Mononuclear cells were collected via apheresis, and tumor lysate was acquired via percutaneous biopsy at enrollment. Participants received standard antineoplastic therapy, followed by autologous lymphocytes, tumor lysate/keyhole limpet hemocyanin-pulsed dendritic cell vaccinations ± recombinant human IL7. Primary outcomes were toxicity and vaccine responses. Secondary outcomes were immune reconstitution, event-free survival, and overall survival (OS). RESULTS Forty-three patients enrolled and 29 received immunotherapy. The regimen was well tolerated. Intent-to-treat analysis demonstrated 5-year OS of 51% with significant differences based upon histologic group (63% vs. 0% for Ewing/rhabdomyosarcoma vs. other sarcomas) and response to standard therapy (74% no residual disease vs. 0% residual disease). Five-year intent-to-treat OS of patients with newly diagnosed metastatic Ewing/rhabdomyosarcoma was 77%, higher than previously reported in this population and higher than observed in a similar group treated with an earlier adjuvant immunotherapy regimen (25% 5-year OS). T-cell responses to autologous tumor lysate were identified in 62% of immunotherapy recipients, and survival was higher in those patients (73% 5-year OS with vs. 37% without immune response, P = 0.017). Immune reconstitution, measured by CD4 count recovery, was significantly enhanced in subjects treated with recombinant human IL7. CONCLUSIONS Adjuvant immunotherapy may improve survival in patients with metastatic pediatric sarcoma. Clin Cancer Res; 22(13); 3182-91. ©2016 AACR.
Collapse
Affiliation(s)
- Melinda S Merchant
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, NIH Clinical Center, Bethesda, Maryland
| | - Donna Bernstein
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, NIH Clinical Center, Bethesda, Maryland
| | - Martha Amoako
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, NIH Clinical Center, Bethesda, Maryland
| | - Kristin Baird
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, NIH Clinical Center, Bethesda, Maryland
| | - Thomas A Fleisher
- Department of Laboratory Medicine, NIH Clinical Center, Bethesda, Maryland
| | | | - Seth M Steinberg
- Department of Biostatistics and Data Management, Center for Cancer Research, National Cancer Institute, NIH Clinical Center, Bethesda, Maryland
| | - Marianna Sabatino
- Department of Transfusion Medicine, NIH Clinical Center, Bethesda, Maryland
| | - Dave F Stroncek
- Department of Transfusion Medicine, NIH Clinical Center, Bethesda, Maryland
| | | | - Bradford J Wood
- Radiology and Imaging Science, NIH Clinical Center, Bethesda, Maryland
| | - Matthew Wright
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, NIH Clinical Center, Bethesda, Maryland
| | - Hua Zhang
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, NIH Clinical Center, Bethesda, Maryland
| | - Crystal L Mackall
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, NIH Clinical Center, Bethesda, Maryland.
| |
Collapse
|