1
|
Wright A, Desai M, Bolan CW, Badawy M, Guccione J, Rao Korivi B, Pickhardt PJ, Mellnick VM, Lubner MG, Chen L, Elsayes KM. Extraskeletal Ewing Sarcoma from Head to Toe: Multimodality Imaging Review. Radiographics 2022; 42:1145-1160. [PMID: 35622491 DOI: 10.1148/rg.210226] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Extraskeletal Ewing sarcoma (EES) is a rare subtype in the Ewing sarcoma family of tumors (ESFT), which also includes Ewing sarcoma of bone (ESB) and, more recently, primitive neuroectodermal tumors. Although these tumors often have different manifestations, they are grouped on the basis of common genetic translocation and diagnosis from specific molecular and immunohistochemical features. While the large majority of ESFT cases occur in children and in bones, approximately 25% originate outside the skeleton as EES. Importantly, in the adult population these extraskeletal tumors are more common than ESB. Imaging findings of EES tumors are generally nonspecific, with some variation based on location and the tissues involved. A large tumor with central necrosis that does not cross the midline is typical. Despite often nonspecific findings, imaging plays an important role in the evaluation and management of ESFT, with MRI frequently the preferred imaging modality for primary tumor assessment and local staging. Chest CT and fluorine 18 fluorodeoxyglucose PET/CT are most sensitive for detecting lung and other distant or nodal metastases. Management often involves chemotherapy with local surgical excision, when possible. A multidisciplinary treatment approach should be used given the propensity for large tumor size and local invasion, which can make resection difficult. Despite limited data, outcomes are similar to those of other ESFT cases, with 5-year survival exceeding 80%. However, with metastatic disease, the long-term prognosis is poor. ©RSNA, 2022.
Collapse
Affiliation(s)
- Alexandra Wright
- From the Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX 77030 (A.W., M.B., B.R.K., K.M.E.); Department of Radiology, Mayo Clinic, Jacksonville, Fla (M.D., C.W.B.); Department of Radiology, The University of Texas Health Science Center at Houston, Tex (J.G.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (P.J.P., M.G.L.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (V.M.M.); and Department of Laboratory Medicine and Pathology, Mayo Clinic, Scottsdale, Ariz (L.C.)
| | - Madhura Desai
- From the Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX 77030 (A.W., M.B., B.R.K., K.M.E.); Department of Radiology, Mayo Clinic, Jacksonville, Fla (M.D., C.W.B.); Department of Radiology, The University of Texas Health Science Center at Houston, Tex (J.G.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (P.J.P., M.G.L.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (V.M.M.); and Department of Laboratory Medicine and Pathology, Mayo Clinic, Scottsdale, Ariz (L.C.)
| | - Candice W Bolan
- From the Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX 77030 (A.W., M.B., B.R.K., K.M.E.); Department of Radiology, Mayo Clinic, Jacksonville, Fla (M.D., C.W.B.); Department of Radiology, The University of Texas Health Science Center at Houston, Tex (J.G.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (P.J.P., M.G.L.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (V.M.M.); and Department of Laboratory Medicine and Pathology, Mayo Clinic, Scottsdale, Ariz (L.C.)
| | - Mohamed Badawy
- From the Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX 77030 (A.W., M.B., B.R.K., K.M.E.); Department of Radiology, Mayo Clinic, Jacksonville, Fla (M.D., C.W.B.); Department of Radiology, The University of Texas Health Science Center at Houston, Tex (J.G.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (P.J.P., M.G.L.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (V.M.M.); and Department of Laboratory Medicine and Pathology, Mayo Clinic, Scottsdale, Ariz (L.C.)
| | - Jeffrey Guccione
- From the Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX 77030 (A.W., M.B., B.R.K., K.M.E.); Department of Radiology, Mayo Clinic, Jacksonville, Fla (M.D., C.W.B.); Department of Radiology, The University of Texas Health Science Center at Houston, Tex (J.G.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (P.J.P., M.G.L.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (V.M.M.); and Department of Laboratory Medicine and Pathology, Mayo Clinic, Scottsdale, Ariz (L.C.)
| | - Brinda Rao Korivi
- From the Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX 77030 (A.W., M.B., B.R.K., K.M.E.); Department of Radiology, Mayo Clinic, Jacksonville, Fla (M.D., C.W.B.); Department of Radiology, The University of Texas Health Science Center at Houston, Tex (J.G.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (P.J.P., M.G.L.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (V.M.M.); and Department of Laboratory Medicine and Pathology, Mayo Clinic, Scottsdale, Ariz (L.C.)
| | - Perry J Pickhardt
- From the Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX 77030 (A.W., M.B., B.R.K., K.M.E.); Department of Radiology, Mayo Clinic, Jacksonville, Fla (M.D., C.W.B.); Department of Radiology, The University of Texas Health Science Center at Houston, Tex (J.G.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (P.J.P., M.G.L.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (V.M.M.); and Department of Laboratory Medicine and Pathology, Mayo Clinic, Scottsdale, Ariz (L.C.)
| | - Vincent M Mellnick
- From the Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX 77030 (A.W., M.B., B.R.K., K.M.E.); Department of Radiology, Mayo Clinic, Jacksonville, Fla (M.D., C.W.B.); Department of Radiology, The University of Texas Health Science Center at Houston, Tex (J.G.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (P.J.P., M.G.L.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (V.M.M.); and Department of Laboratory Medicine and Pathology, Mayo Clinic, Scottsdale, Ariz (L.C.)
| | - Meghan G Lubner
- From the Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX 77030 (A.W., M.B., B.R.K., K.M.E.); Department of Radiology, Mayo Clinic, Jacksonville, Fla (M.D., C.W.B.); Department of Radiology, The University of Texas Health Science Center at Houston, Tex (J.G.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (P.J.P., M.G.L.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (V.M.M.); and Department of Laboratory Medicine and Pathology, Mayo Clinic, Scottsdale, Ariz (L.C.)
| | - Longwen Chen
- From the Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX 77030 (A.W., M.B., B.R.K., K.M.E.); Department of Radiology, Mayo Clinic, Jacksonville, Fla (M.D., C.W.B.); Department of Radiology, The University of Texas Health Science Center at Houston, Tex (J.G.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (P.J.P., M.G.L.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (V.M.M.); and Department of Laboratory Medicine and Pathology, Mayo Clinic, Scottsdale, Ariz (L.C.)
| | - Khaled M Elsayes
- From the Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX 77030 (A.W., M.B., B.R.K., K.M.E.); Department of Radiology, Mayo Clinic, Jacksonville, Fla (M.D., C.W.B.); Department of Radiology, The University of Texas Health Science Center at Houston, Tex (J.G.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (P.J.P., M.G.L.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (V.M.M.); and Department of Laboratory Medicine and Pathology, Mayo Clinic, Scottsdale, Ariz (L.C.)
| |
Collapse
|
2
|
Bouhani M, Sassi I, Zemni I, Sahraoui G, Bouida A, Slimene M, Rahal K. Intraabdominal lesser sac metastasis from Ewing's sarcoma: An exceptional localization. SAGE Open Med Case Rep 2021; 9:2050313X211022426. [PMID: 34158949 PMCID: PMC8182168 DOI: 10.1177/2050313x211022426] [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: 01/27/2021] [Accepted: 05/11/2021] [Indexed: 11/23/2022] Open
Abstract
Ewing's sarcoma/primitive neuroectodermal tumor is rare and aggressive with a poor prognosis. Intraabdominal metastases are an uncommon condition. Metastasis in the lesser sac is an exceptional occurrence. To the best of our knowledge, this location has not been described previously. We report a case of a 15-year-old patient treated for Ewing's sarcoma of the left arm 6 years back. She had developed a suspicious mass in the lesser sac 6 years following her primary tumor. The histopathologic exam revealed a tumor with "small round cells" that were positive for CD99, confirming the relapse of Ewing's sarcoma. The relapse was successfully managed with chemotherapy and surgery. Intraabdominal, extraintestinal masses in patients treated previously for Ewing's sarcoma should be considered as Ewing's sarcoma relapse in the differential diagnosis. We fully describe the management of this atypical relapse, with different components of clinical, radiological, and histological findings.
Collapse
Affiliation(s)
- Malek Bouhani
- Department of Oncologic Surgery,
Salah Azaiz Institute, Tunis, Tunisia
- DUniversité de Tunis El Manar,
Faculté de Médecine de Tunis, Tunis, Tunisie
| | - Imen Sassi
- Department of Oncologic Surgery,
Salah Azaiz Institute, Tunis, Tunisia
- DUniversité de Tunis El Manar,
Faculté de Médecine de Tunis, Tunis, Tunisie
| | - Ines Zemni
- Department of Oncologic Surgery,
Salah Azaiz Institute, Tunis, Tunisia
- DUniversité de Tunis El Manar,
Faculté de Médecine de Tunis, Tunis, Tunisie
| | - Ghada Sahraoui
- DUniversité de Tunis El Manar,
Faculté de Médecine de Tunis, Tunis, Tunisie
- DDepartment of anatomopathology,
Salah Azaiz Institute, Tunis, Tunisia
| | - Amine Bouida
- Department of Oncologic Surgery,
Salah Azaiz Institute, Tunis, Tunisia
- DUniversité de Tunis El Manar,
Faculté de Médecine de Tunis, Tunis, Tunisie
| | - Maher Slimene
- Department of Oncologic Surgery,
Salah Azaiz Institute, Tunis, Tunisia
- DUniversité de Tunis El Manar,
Faculté de Médecine de Tunis, Tunis, Tunisie
| | - Khaled Rahal
- Department of Oncologic Surgery,
Salah Azaiz Institute, Tunis, Tunisia
- DUniversité de Tunis El Manar,
Faculté de Médecine de Tunis, Tunis, Tunisie
| |
Collapse
|
3
|
Haveman LM, Ranft A, Vd Berg H, Smets A, Kruseova J, Ladenstein R, Brichard B, Paulussen M, Kuehne T, Juergens H, Klco-Brosius S, Dirksen U, Merks JHM. The relation of radiological tumor volume response to histological response and outcome in patients with localized Ewing Sarcoma. Cancer Med 2019; 8:1086-1094. [PMID: 30790456 PMCID: PMC6434194 DOI: 10.1002/cam4.2002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 01/08/2019] [Accepted: 01/10/2019] [Indexed: 12/19/2022] Open
Abstract
Background Magnetic resonance imaging (MRI) is the modality of choice for local staging and response evaluation of Ewing sarcoma (EwS). Aim of this study was to determine the relevance of tumor volume response (TVR) in relation to histological response (HisRes) and survival, in order to evaluate if early modification of chemotherapy might be indicated in patients with inadequate TVR. Methods Three dimensional (3D)‐tumor volume data at diagnosis, during early induction phase (1‐3 courses of chemotherapy; n = 195) and/or late induction phase (4‐6 courses; n = 175) from 241 localized patients were retrospectively analyzed. A distinction was made between adequate response (reduction ≥67%) and inadequate response (reduction <67% or progression). Correlations between TVR, HisRes, event free survival (EFS), and overall survival (OS) were analyzed using chi‐square tests, log‐rank tests, and the Cox‐regression model. Results Early adequate TVR, noted in 41% of patients, did not correlate with EFS (P = 0.92) or OS (P = 0.38). During late induction phase 62% of patients showed an adequate TVR. EFS for patients with late adequate TVR was better (78%) than for those with inadequate late TVR (61%) (P = 0.01); OS was 80% and 69% (P = 0.26), respectively. No correlation was found between TVR and HisRes. Multivariate analysis showed that poor HisRes, pelvic location and late inadequate TVR were associated with poor outcome. Conclusions Early inadequate TVR does not predict adverse outcome; therefore, changing the treatment to second line chemotherapy is not indicated in case of inadequate early TVR. Late adequate TVR and good HisRes correlate with better EFS; patients with late inadequate TVR might benefit from augmented therapy.
Collapse
Affiliation(s)
- Lianne M Haveman
- Emma Children's Hospital, Department of Pediatric Oncology, Academic Medical Center, Amsterdam, The Netherlands.,Prinses Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Andreas Ranft
- Department of Pediatric Hematology and Oncology, University of Essen, Essen, Germany.,Coordinating Center for Clinical Trials, Muenster, Germany
| | - Henk Vd Berg
- Emma Children's Hospital, Department of Pediatric Oncology, Academic Medical Center, Amsterdam, The Netherlands
| | - Anne Smets
- Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Jarmila Kruseova
- Department of Pediatric Oncology, University Hospital Motol, Prague, Czech Republic
| | | | - Benedicte Brichard
- Saint Luc University Hospital, Department of Pediatric Hematology and Oncology, University of Louvain, Datteln, Belgium
| | - Michael Paulussen
- Witten/Herdecke University, Vestische Kinder- und Jugendklinik, Datteln, Germany
| | - Thomas Kuehne
- Department of Pediatric Oncology and Haematology, University Children Hospital, Basel, Switzerland
| | - Heribert Juergens
- Coordinating Center for Clinical Trials, Muenster, Germany.,Department of Pediatric Hematology and Oncology, University Children's Hospital, Muenster, Germany
| | - Stephanie Klco-Brosius
- Department of Pediatric Hematology and Oncology, University of Essen, Essen, Germany.,Coordinating Center for Clinical Trials, Muenster, Germany
| | - Uta Dirksen
- Department of Pediatric Hematology and Oncology, University of Essen, Essen, Germany.,Coordinating Center for Clinical Trials, Muenster, Germany
| | - Johannes H M Merks
- Emma Children's Hospital, Department of Pediatric Oncology, Academic Medical Center, Amsterdam, The Netherlands
| |
Collapse
|
4
|
Cheng L, Pandya PH, Liu E, Chandra P, Wang L, Murray ME, Carter J, Ferguson M, Saadatzadeh MR, Bijangi-Visheshsaraei K, Marshall M, Li L, Pollok KE, Renbarger JL. Integration of genomic copy number variations and chemotherapy-response biomarkers in pediatric sarcoma. BMC Med Genomics 2019; 12:23. [PMID: 30704460 PMCID: PMC6357363 DOI: 10.1186/s12920-018-0456-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background While most pediatric sarcomas respond to front-line therapy, some bone sarcomas do not show radiographic response like soft-tissue sarcomas (rhabdomyosarccomas) but do show 90% necrosis. Though, new therapies are urgently needed to improve survival and quality of life in pediatric patients with sarcomas. Complex chromosomal aberrations such as amplifications and deletions of DNA sequences are frequently observed in pediatric sarcomas. Evaluation of copy number variations (CNVs) associated with pediatric sarcoma patients at the time of diagnosis or following therapy offers an opportunity to assess dysregulated molecular targets and signaling pathways that may drive sarcoma development, progression, or relapse. The objective of this study was to utilize publicly available data sets to identify potential predictive biomarkers of chemotherapeutic response in pediatric Osteosarcoma (OS), Rhabdomyosarcoma (RMS) and Ewing’s Sarcoma Family of Tumors (ESFTs) based on CNVs following chemotherapy (OS n = 117, RMS n = 64, ESFTs n = 25 tumor biopsies). Methods There were 206 CNV profiles derived from pediatric sarcoma biopsies collected from the public databases TARGET and NCBI-Gene Expression Omnibus (GEO). Through our comparative genomic analyses of OS, RMS, and ESFTs and 22,255 healthy individuals called from the Database of Genomic Variants (DGV), we identified CNVs (amplifications and deletions) pattern of genomic instability in these pediatric sarcomas. By integrating CNVs of Cancer Cell Line Encyclopedia (CCLE) identified in the pool of genes with drug-response data from sarcoma cell lines (n = 27) from Cancer Therapeutics Response Portal (CTRP) Version 2, potential predictive biomarkers of therapeutic response were identified. Results Genes associated with survival and/recurrence of these sarcomas with statistical significance were found on long arm of chromosome 8 and smaller aberrations were also identified at chromosomes 1q, 12q and x in OS, RMS, and ESFTs. A pool of 63 genes that harbored amplifications and/or deletions were frequently associated with recurrence across OS, RMS, and ESFTs. Correlation analysis of CNVs from CCLE with drug-response data of CTRP in 27 sarcoma cell lines, 33 CNVs out of 63 genes correlated with either sensitivity or resistance to 17 chemotherapies from which actionable CNV signatures such as IGF1R, MYC, MAPK1, ATF1, and MDM2 were identified. These CNV signatures could potentially be used to delineate patient populations that will respond versus those that will not respond to a particular chemotherapy. Conclusions The large-scale analyses of CNV-drug screening provides a platform to evaluate genetic alterations across aggressive pediatric sarcomas. Additionally, this study provides novel insights into the potential utilization of CNVs as not only prognostic but also as predictive biomarkers of therapeutic response. Information obtained in this study may help guide and prioritize patient-specific therapeutic options in pediatric bone and soft-tissue sarcomas. Electronic supplementary material The online version of this article (10.1186/s12920-018-0456-5) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Lijun Cheng
- Department of Biomedical Informatics, College of Medicine, Ohio State University, Columbus, OH, 43210, USA
| | - Pankita H Pandya
- Herman B Wells Center for Pediatric Research, Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, IN, 46202, USA.,Division of Hematology/Oncology, Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, IN, 46202, USA
| | - Enze Liu
- Department of Biomedical Informatics, College of Medicine, Ohio State University, Columbus, OH, 43210, USA.,Center for Computational Biology and Bioinformatics, School of Medicine, Indiana University, Indianapolis, IN, 46202, USA
| | - Pooja Chandra
- Center for Computational Biology and Bioinformatics, School of Medicine, Indiana University, Indianapolis, IN, 46202, USA
| | - Limei Wang
- Department of Biomedical Informatics, College of Medicine, Ohio State University, Columbus, OH, 43210, USA
| | - Mary E Murray
- Division of Hematology/Oncology, Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, IN, 46202, USA
| | - Jacquelyn Carter
- Division of Hematology/Oncology, Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, IN, 46202, USA
| | - Michael Ferguson
- Division of Hematology/Oncology, Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, IN, 46202, USA
| | - Mohammad Reza Saadatzadeh
- Herman B Wells Center for Pediatric Research, Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, IN, 46202, USA.,Division of Hematology/Oncology, Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, IN, 46202, USA
| | - Khadijeh Bijangi-Visheshsaraei
- Herman B Wells Center for Pediatric Research, Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, IN, 46202, USA.,Division of Hematology/Oncology, Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, IN, 46202, USA
| | - Mark Marshall
- Division of Hematology/Oncology, Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, IN, 46202, USA
| | - Lang Li
- Department of Biomedical Informatics, College of Medicine, Ohio State University, Columbus, OH, 43210, USA. .,Herman B Wells Center for Pediatric Research, Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, IN, 46202, USA.
| | - Karen E Pollok
- Herman B Wells Center for Pediatric Research, Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, IN, 46202, USA. .,Division of Hematology/Oncology, Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, IN, 46202, USA. .,Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN, 46202, USA.
| | - Jamie L Renbarger
- Herman B Wells Center for Pediatric Research, Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, IN, 46202, USA. .,Division of Hematology/Oncology, Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, IN, 46202, USA. .,Center for Computational Biology and Bioinformatics, School of Medicine, Indiana University, Indianapolis, IN, 46202, USA. .,Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN, 46202, USA. .,Indiana Institute of Personalized Medicine, Indiana University, Indianapolis, IN, 46202, USA.
| |
Collapse
|
5
|
Zhang P, Samuel G, Crow J, Godwin AK, Zeng Y. Molecular assessment of circulating exosomes toward liquid biopsy diagnosis of Ewing sarcoma family of tumors. Transl Res 2018; 201:136-153. [PMID: 30031766 PMCID: PMC6424494 DOI: 10.1016/j.trsl.2018.05.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 05/18/2018] [Accepted: 05/27/2018] [Indexed: 12/16/2022]
Abstract
Ewing sarcoma was first described in 1921 in the Proceedings of the New York Pathological Society by an eminent American pathologist from Cornell named James R. Ewing as a "diffuse endothelioma of bone." Since this initial description, more has been discovered regarding Ewing sarcoma and in the 1980's both Ewing sarcoma and peripheral primitive neuroectodermal tumors due to their similar features and shared identical genetic abnormality were grouped into a class of cancers entitled Ewing sarcoma family of tumors (ESFTs). Ewing sarcoma is the second most common pediatric osseous malignancy followed by osteosarcoma, with highest incidence among 10-20 years old. Ewing sarcoma is consistently associated with chromosomal translocation and functional fusion of the EWSR1 gene to any of several structurally related transcription factor genes of the E26 transformation-specific family. These tumor-specific molecular rearrangements are useful for primary diagnosis, may provide prognostic information, and present potential therapeutic targets. Therefore, ways to rapidly and efficiently detect these defining genomic alterations are of clinical relevance. Within the past decade, liquid biopsies including extracellular vesicles (EVs), have emerged as a promising alternative and/or complimentary approach to standard tumor biopsies. It was recently reported that fusion mRNAs from tumor-specific chromosome translocations can be detected in Ewing sarcoma cell-derived exosomes. Within this review, we overview the current advances in Ewing sarcoma and the opportunities and challenges in exploiting circulating exosomes, primarily small bioactive EVs (30-180 nm), as developing sources of biomarkers for diagnosis and therapeutic response monitoring in children and young adult patients with ESFT.
Collapse
Affiliation(s)
- Peng Zhang
- Department of Chemistry, University of Kansas, Lawrence, Kansas
| | - Glenson Samuel
- Division of Hematology, Oncology and Bone Marrow Transplant, Children's Mercy Hospitals & Clinics, Kansas City, Missouri
| | - Jennifer Crow
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, Kansas
| | - Andrew K Godwin
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, Kansas; University of Kansas Cancer Center, Kansas City, Kansas.
| | - Yong Zeng
- Department of Chemistry, University of Kansas, Lawrence, Kansas; University of Kansas Cancer Center, Kansas City, Kansas.
| |
Collapse
|
6
|
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
|
7
|
Fidaleo M, De Paola E, Paronetto MP. The RNA helicase A in malignant transformation. Oncotarget 2017; 7:28711-23. [PMID: 26885691 PMCID: PMC5053757 DOI: 10.18632/oncotarget.7377] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 01/29/2016] [Indexed: 12/12/2022] Open
Abstract
The RNA helicase A (RHA) is involved in several steps of RNA metabolism, such as RNA processing, cellular transit of viral molecules, ribosome assembly, regulation of transcription and translation of specific mRNAs. RHA is a multifunctional protein whose roles depend on the specific interaction with different molecular partners, which have been extensively characterized in physiological situations. More recently, the functional implication of RHA in human cancer has emerged. Interestingly, RHA was shown to cooperate with both tumor suppressors and oncoproteins in different tumours, indicating that its specific role in cancer is strongly influenced by the cellular context. For instance, silencing of RHA and/or disruption of its interaction with the oncoprotein EWS-FLI1 rendered Ewing sarcoma cells more sensitive to genotoxic stresses and affected tumor growth and maintenance, suggesting possible therapeutic implications. Herein, we review the recent advances in the cellular functions of RHA and discuss its implication in oncogenesis, providing a perspective for future studies and potential translational opportunities in human cancer.
Collapse
Affiliation(s)
- Marco Fidaleo
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy.,Laboratory of Cellular and Molecular Neurobiology, CERC, Fondazione Santa Lucia, Rome, Italy
| | - Elisa De Paola
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy.,Laboratory of Cellular and Molecular Neurobiology, CERC, Fondazione Santa Lucia, Rome, Italy
| | - Maria Paola Paronetto
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy.,Laboratory of Cellular and Molecular Neurobiology, CERC, Fondazione Santa Lucia, Rome, Italy
| |
Collapse
|
8
|
Advances in chromosomal translocations and fusion genes in sarcomas and potential therapeutic applications. Cancer Treat Rev 2017; 63:61-70. [PMID: 29247978 DOI: 10.1016/j.ctrv.2017.12.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 12/01/2017] [Indexed: 12/12/2022]
Abstract
Chromosomal translocations and fusion genes are very common in human cancer especially in subtypes of sarcomas, such as rhabdomyosarcoma, Ewing's sarcoma, synovial sarcoma and liposarcoma. The discovery of novel chromosomal translocations and fusion genes in different tumors are due to the advancement of next-generation sequencing (NGS) technologies such as whole genome sequencing. Recently, many novel chromosomal translocations and gene fusions have been identified in different types of sarcoma through NGS approaches. In addition to previously known sarcoma fusion genes, these novel specific fusion genes and associated molecular events represent important targets for novel therapeutic approaches in the treatment of sarcomas. This review focuses on recent advances in chromosomal translocations and fusion genes in sarcomas and their potential therapeutic applications in the treatment of sarcomas.
Collapse
|
9
|
Tudor-Green B, Fonseca FP, Gomez RS, Brennan PA. Current update on the diagnosis and management of head and neck hard tissue sarcomas. J Oral Pathol Med 2017; 46:667-673. [DOI: 10.1111/jop.12573] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2017] [Indexed: 12/29/2022]
Affiliation(s)
- Ben Tudor-Green
- Department of Plastic and Reconstructive Surgery; Royal Devon & Exeter Hospital; Exeter UK
- Department of Oral and Maxillofacial Surgery; Queen Alexandra Hospital; Portsmouth UK
| | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology; School of Dentistry; Universidade Federal de Minas Gerais; Belo Horizonte Brazil
| | - Ricardo S. Gomez
- Department of Oral Surgery and Pathology; School of Dentistry; Universidade Federal de Minas Gerais; Belo Horizonte Brazil
| | - Peter A. Brennan
- Department of Oral and Maxillofacial Surgery; Queen Alexandra Hospital; Portsmouth UK
| |
Collapse
|
10
|
Tricoli JV, Bleyer A, Anninga J, Barr R. The Biology of AYA Cancers. CANCER IN ADOLESCENTS AND YOUNG ADULTS 2017. [DOI: 10.1007/978-3-319-33679-4_3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
11
|
Haveman LM, Breunis WB, Cohen JF, van Dalen EC, Owers EC, Dirksen U, Kremer LCM, Jürgens H, van den Berg H, Merks JHM. Fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) for detecting metastases of Ewing sarcoma. Hippokratia 2016. [DOI: 10.1002/14651858.cd012133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Lianne M Haveman
- Emma Children's Hospital/Academic Medical Center; Department of Paediatric Oncology; PO Box 22660 Amsterdam Netherlands 1100 DD
| | - Willemijn B Breunis
- Emma Children's Hospital/Academic Medical Center; Department of Paediatric Oncology; PO Box 22660 Amsterdam Netherlands 1100 DD
| | - Jérémie F Cohen
- Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS), Inserm UMR1153, Paris Descartes University; Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé); Paris France
- Academic Medical Center; Department of Clinical Epidemiology, Biostatistics and Bioinformatics; PO Box 22660 Amsterdam Netherlands 1100 DD
| | - Elvira C van Dalen
- Emma Children's Hospital/Academic Medical Center; Department of Paediatric Oncology; PO Box 22660 Amsterdam Netherlands 1100 DD
| | - Emilia C Owers
- Academic Medical Center; Department of Nuclear Medicine; PO Box 22660 Amsterdam Netherlands 1100 DD
| | - Uta Dirksen
- Universitätsklinikum Münster; Paediatric Haematology and Oncology; Universitätsklinikum Münster Münster Germany 48149
| | - Leontien CM Kremer
- Emma Children's Hospital/Academic Medical Center; Department of Paediatric Oncology; PO Box 22660 Amsterdam Netherlands 1100 DD
| | - Heribert Jürgens
- Universitätsklinikum Münster; Paediatric Haematology and Oncology; Universitätsklinikum Münster Münster Germany 48149
| | - Henk van den Berg
- Emma Children's Hospital/Academic Medical Center; Department of Paediatric Oncology; PO Box 22660 Amsterdam Netherlands 1100 DD
| | - Johannes HM Merks
- Emma Children's Hospital/Academic Medical Center; Department of Paediatric Oncology; PO Box 22660 Amsterdam Netherlands 1100 DD
| |
Collapse
|
12
|
Redini F, Heymann D. Bone Tumor Environment as a Potential Therapeutic Target in Ewing Sarcoma. Front Oncol 2015; 5:279. [PMID: 26779435 PMCID: PMC4688361 DOI: 10.3389/fonc.2015.00279] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 11/27/2015] [Indexed: 12/18/2022] Open
Abstract
Ewing sarcoma is the second most common pediatric bone tumor, with three cases per million worldwide. In clinical terms, Ewing sarcoma is an aggressive, rapidly fatal malignancy that mainly develops not only in osseous sites (85%) but also in extra-skeletal soft tissue. It spreads naturally to the lungs, bones, and bone marrow with poor prognosis in the two latter cases. Bone lesions from primary or secondary (metastases) tumors are characterized by extensive bone remodeling, more often due to osteolysis. Osteoclast activation and subsequent bone resorption are responsible for the clinical features of bone tumors, including pain, vertebral collapse, and spinal cord compression. Based on the “vicious cycle” concept of tumor cells and bone resorbing cells, drugs, which target osteoclasts, may be promising agents as adjuvant setting for treating bone tumors, including Ewing sarcoma. There is also increasing evidence that cellular and molecular protagonists present in the bone microenvironment play a part in establishing a favorable “niche” for tumor initiation and progression. The purpose of this review is to discuss the potential therapeutic value of drugs targeting the bone tumor microenvironment in Ewing sarcoma. The first part of the review will focus on targeting the bone resorbing function of osteoclasts by means of bisphosphonates or drugs blocking the pro-resorbing cytokine receptor activator of NF-kappa B ligand. Second, the role of this peculiar hypoxic microenvironment will be discussed in the context of resistance to chemotherapy, escape from the immune system, or neo-angiogenesis. Therapeutic interventions based on these specificities could be then proposed in the context of Ewing sarcoma.
Collapse
Affiliation(s)
- Françoise Redini
- INSERM UMR_S 957, Nantes, France; Equipe labellisée Ligue contre le Cancer 2012, Nantes, France; Laboratoire de Physiopathologie de la Résorption osseuse et Thérapie des tumeurs osseuses primitives, Faculté de Médecine, Nantes, France
| | - Dominique Heymann
- INSERM UMR_S 957, Nantes, France; Equipe labellisée Ligue contre le Cancer 2012, Nantes, France; Laboratoire de Physiopathologie de la Résorption osseuse et Thérapie des tumeurs osseuses primitives, Faculté de Médecine, Nantes, France; CHU Hôtel-Dieu, Nantes, France
| |
Collapse
|
13
|
Jamitzky S, Krueger AC, Janneschuetz S, Piepke S, Kailayangiri S, Spurny C, Rossig C, Altvater B. Insulin-like growth factor-1 receptor (IGF-1R) inhibition promotes expansion of human NK cells which maintain their potent antitumor activity against Ewing sarcoma cells. Pediatr Blood Cancer 2015; 62:1979-85. [PMID: 26131572 DOI: 10.1002/pbc.25619] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 05/08/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND Patients with primary metastatic or relapsed Ewing sarcomas (EwS) have a poor prognosis. While inhibitory insulin-like growth factor 1 receptor (IGF-1R)-specific antibodies have shown single agent activity in some patients with refractory disease, effective therapeutic targeting will rely on optimal combinations with conventional or innovative therapies. Specifically, combination of inhibitory IGF-1R antibodies with adoptive transfer of activated natural killer (NK) cells may have therapeutic benefit in EwS without adding toxicity. PROCEDURE We investigated the in vitro effects of IGF-1R targeting on the immunological profile of EwS cells and on the survival and tumor targeting capacity of K-562-activated NK cells. RESULTS IGF-1R inhibition reliably reduced EwS cell viability without affecting expression of immune-modulatory and MHC molecules. In NK cells, we observed a significant superior expansion following in vitro activation in the presence of IGF-1R-specific antibodies, while expression of differentiation markers and activating receptors remained unaffected. Activated NK cells coincubated with EwS cells showed potent degranulation responses unaffected by IGF-1R inhibition. These findings were reproducible in a stimulator cell-free NK cell expansion system, suggesting that direct effects of IGF-R1 antibodies on the IGF-R1 pathway in NK cells induce their activation and expansion. CONCLUSIONS Activated human NK cells respond to IGF-1R inhibition with superior expansion kinetics while maintaining potent antitumor responses against EwS. Combination of adoptive NK cell transfer with IGF-1R targeting may be an efficient means to eliminate minimal residual disease after conventional therapy and thereby rescue patients at the highest risk of relapse.
Collapse
Affiliation(s)
- Silke Jamitzky
- Department of Pediatric Hematology and Oncology, University Childreńs Hospital Muenster, Muenster, Germany
| | - Andrea-Caroline Krueger
- Department of Pediatric Hematology and Oncology, University Childreńs Hospital Muenster, Muenster, Germany
| | - Saskia Janneschuetz
- Department of Pediatric Hematology and Oncology, University Childreńs Hospital Muenster, Muenster, Germany
| | | | - Sareetha Kailayangiri
- Department of Pediatric Hematology and Oncology, University Childreńs Hospital Muenster, Muenster, Germany
| | - Christian Spurny
- Department of Pediatric Hematology and Oncology, University Childreńs Hospital Muenster, Muenster, Germany
| | - Claudia Rossig
- Department of Pediatric Hematology and Oncology, University Childreńs Hospital Muenster, Muenster, Germany.,Cells-in-Motion Cluster of Excellence (EXC 1003-CiM), University of Muenster, Muenster, Germany
| | - Bianca Altvater
- Department of Pediatric Hematology and Oncology, University Childreńs Hospital Muenster, Muenster, Germany
| |
Collapse
|
14
|
Ewing sarcoma of the posterior fossa in an adolescent girl. Case Rep Med 2014; 2014:439830. [PMID: 25614743 PMCID: PMC4295441 DOI: 10.1155/2014/439830] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 12/08/2014] [Indexed: 11/18/2022] Open
Abstract
Medulloblastoma, astrocytoma, and ependymoma represent the most common infratentorial tumors in childhood, while Ewing sarcomas in that localization are extremely rare. A large left infratentorial space-occupying lesion was diagnosed in a 12-year-old girl with signs of increased intracranial pressure. Following total tumor resection, histological and molecular examination revealed Ewing sarcoma with rearranged EWSR-1 gene. The patient achieved complete remission following adjuvant chemotherapy and radiotherapy according to Euro-EWING 2008 treatment protocol. Intracranial Ewing sarcoma, although rare, should be an important differential diagnosis of intracranial tumors in childhood which requires aggressive multimodal treatment.
Collapse
|
15
|
Owens C, Abbott LS, Gupta AA. Optimal management of Ewing sarcoma family of tumors: recent developments in systemic therapy. Paediatr Drugs 2013; 15:473-92. [PMID: 23760780 DOI: 10.1007/s40272-013-0037-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The Ewing sarcoma family of tumors (ESFT) is defined by cell surface expression of CD99 and a translocation involving EWS and an ETS partner. Cytotoxic chemotherapy remains the benchmark of first- and second-line therapy, and although the majority of patients with localized disease are cured, almost one third of patients relapse or progress from their disease. Moreover, cure remains elusive in most patients who present with distant metastases. In recent years, the ESFT literature has been dominated by reports of attempts at modulating the insulin-like growth factor (IGF) receptor (IGFR). Unfortunately, three phase II studies examining inhibiting antibodies to IGFR-1 published disappointing results. Whether these results were due to failure to modulate the pathway or other limitations in study design and/or patient selection remain unclear. Other novel strategies currently being investigated in ESFT include tyrosine kinase, mammalian target of rapamycin (mTOR), and poly(ADP-ribose) polymerase (PARP) inhibitors.
Collapse
Affiliation(s)
- Cormac Owens
- The Division of Hematology/Oncology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON, M5G 1N6, Canada,
| | | | | |
Collapse
|
16
|
Redini F, Odri GA, Picarda G, Gaspar N, Heymann MF, Corradini N, Heymann D. Drugs targeting the bone microenvironment: new therapeutic tools in Ewing's sarcoma? Expert Opin Emerg Drugs 2013; 18:339-52. [PMID: 23957761 DOI: 10.1517/14728214.2013.823948] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Ewing's sarcoma (ES) is the second most frequent malignant primary bone tumour in children, adolescents and young adults. The overall survival is 60 - 70% at 5 years but still very poor for patients with metastases, disease relapse or for those not responding to chemotherapy. For these high risk patients, new therapeutic approaches are needed beyond conventional therapies (chemotherapy, surgery and radiation) such as targeted therapies. AREAS COVERED Transcriptomic and genomic analyses in ES have revealed alterations in genes that control signalling pathways involved in many other cancer types. To set up more specific approaches, it is reasonable to think that the particular microenvironment of these bone tumours is essential for their initiation and progression, including in ES. To support this hypothesis, preclinical studies using drugs targeting bone cells (bisphosphonate zoledronate, anti-receptor activator of NF-κB ligand strategies) showed promising results in animal models. This review will discuss the new targeted therapeutic options in ES, focusing more particularly on the ones modulating the bone microenvironment. EXPERT OPINION Targeting the microenvironment represents a new option for patients with ES. The proof-of-concept has been demonstrated in preclinical studies using relevant animal models, especially for zoledronate, which induced a strong inhibition of tumour progression in an orthotopic bone model.
Collapse
Affiliation(s)
- Francoise Redini
- INSERM, UMR-957, Equipe Ligue Contre le Cancer 2012 , Nantes, F-44035, France.
| | | | | | | | | | | | | |
Collapse
|
17
|
Murphey MD, Senchak LT, Mambalam PK, Logie CI, Klassen-Fischer MK, Kransdorf MJ. From the Radiologic Pathology Archives: Ewing Sarcoma Family of Tumors: Radiologic-Pathologic Correlation. Radiographics 2013; 33:803-31. [DOI: 10.1148/rg.333135005] [Citation(s) in RCA: 170] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
|