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Cohen E, Bozonnat A, Battistella M, Calvani J, Vignon-Pennamen MD, Rivet J, Moins-Teisserenc H, Ta VA, Ram-Wolff C, Bouaziz JD, Mahevas T, Bagot M, Mourah S, Louveau B, Sicre de Fontbrune F, Peffault de Latour R, de Masson A, Battesti G. Severe relapses of cutaneous T-cell lymphoma after treatment of chronic graft-versus-host disease with ruxolitinib. J Eur Acad Dermatol Venereol 2024; 38:e32-e34. [PMID: 37561935 DOI: 10.1111/jdv.19408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/03/2023] [Indexed: 08/12/2023]
Affiliation(s)
- Elisabeth Cohen
- Department of Dermatology, APHP, Saint-Louis Hospital, Paris, France
- INSERM U1160, Institut de Recherche Saint-Louis, Paris, France
| | - Alizée Bozonnat
- Department of Dermatology, APHP, Saint-Louis Hospital, Paris, France
- Université Paris Cité, Paris, France
| | - Maxime Battistella
- Université Paris Cité, Paris, France
- Department of Pathology, APHP, Saint-Louis Hospital, Paris, France
- INSERM U976, Institut de Recherche Saint-Louis, Paris, France
| | - Julien Calvani
- Université Paris Cité, Paris, France
- Department of Pathology, APHP, Saint-Louis Hospital, Paris, France
- INSERM U976, Institut de Recherche Saint-Louis, Paris, France
| | | | - Jacqueline Rivet
- Department of Pathology, APHP, Saint-Louis Hospital, Paris, France
| | - Hélène Moins-Teisserenc
- INSERM U1160, Institut de Recherche Saint-Louis, Paris, France
- Université Paris Cité, Paris, France
- Hematology Laboratory, APHP, Saint-Louis Hospital, Paris, France
| | - Van-Anh Ta
- INSERM U1160, Institut de Recherche Saint-Louis, Paris, France
| | | | - Jean-David Bouaziz
- Department of Dermatology, APHP, Saint-Louis Hospital, Paris, France
- Université Paris Cité, Paris, France
- INSERM U976, Institut de Recherche Saint-Louis, Paris, France
| | - Thibault Mahevas
- Department of Dermatology, APHP, Saint-Louis Hospital, Paris, France
| | - Martine Bagot
- Department of Dermatology, APHP, Saint-Louis Hospital, Paris, France
- Université Paris Cité, Paris, France
- INSERM U976, Institut de Recherche Saint-Louis, Paris, France
| | - Samia Mourah
- Université Paris Cité, Paris, France
- INSERM U976, Institut de Recherche Saint-Louis, Paris, France
- Pharmacology and Solid Tumor Genomics, APHP, Saint-Louis Hospital, Paris, France
| | - Baptiste Louveau
- Université Paris Cité, Paris, France
- INSERM U976, Institut de Recherche Saint-Louis, Paris, France
- Pharmacology and Solid Tumor Genomics, APHP, Saint-Louis Hospital, Paris, France
| | | | | | - Adèle de Masson
- Department of Dermatology, APHP, Saint-Louis Hospital, Paris, France
- Université Paris Cité, Paris, France
- INSERM U976, Institut de Recherche Saint-Louis, Paris, France
| | - Gilles Battesti
- Department of Dermatology, APHP, Saint-Louis Hospital, Paris, France
- Université Paris Cité, Paris, France
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Quadri I, Reneau JC, Hanel W, Chung CG. Advancements in the treatment of mycosis fungoides and Sézary syndrome: monoclonal antibodies, immunotherapies, and Janus kinase inhibitors. Front Immunol 2023; 14:1291259. [PMID: 38022633 PMCID: PMC10654973 DOI: 10.3389/fimmu.2023.1291259] [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: 09/08/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Mycosis fungoides (MF) and Sézary syndrome (SS) are forms of cutaneous T cell lymphoma (CTCL) that pose significant challenges in their clinical management, particularly in refractory and advanced-stage disease. With the emergence of novel therapeutic modalities however, there are increasing opportunities to exploit the current understanding of pathophysiologic mechanisms of MF/SS for treatment. This review summarizes recent advances in the treatment of MF/SS, with a focus on monoclonal antibodies, immunotherapies, and Janus kinase (JAK) inhibitors, including ongoing clinical trials.
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Affiliation(s)
- Iman Quadri
- The Ohio State University College of Medicine, Columbus, OH, United States
| | - John C. Reneau
- Division of Hematology, The Ohio State University Wexner Medical Center and The James and Solove Research Center and Cancer Hospital, Columbus, OH, United States
| | - Walter Hanel
- Division of Hematology, The Ohio State University Wexner Medical Center and The James and Solove Research Center and Cancer Hospital, Columbus, OH, United States
| | - Catherine G. Chung
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH, United States
- Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, OH, United States
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Morgenroth S, Roggo A, Pawlik L, Dummer R, Ramelyte E. What Is New in Cutaneous T Cell Lymphoma? Curr Oncol Rep 2023; 25:1397-1408. [PMID: 37874473 PMCID: PMC10640416 DOI: 10.1007/s11912-023-01464-8] [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] [Accepted: 09/25/2023] [Indexed: 10/25/2023]
Abstract
PURPOSE OF REVIEW This review focuses on updates in prognosis, pathogenesis, and treatment of cutaneous T cell lymphoma (CTCL). RECENT FINDINGS Cohort studies indicate imaging may be necessary in early-stage CTCL. Risk factors for progression of CTCL have been identified. Interactions between malignant cells and the tumor microenvironment (TME) and the skin microbiome advance the understanding of pathogenesis and tumor cell dissemination. Studies support a hypothesis of circulating malignant tumor cells. MicroRNA (miR) influence tumor progression and prognosis; the IL22-STAT3-CCL20 cascade may be a novel target. IL-4, IL-5, and IL-31 cytokines are relevant for pruritus and could be targets for therapeutic interventions. Systemic therapies, such as JAK inhibitors, targeted antibodies, and checkpoint inhibitors, show promise in advanced stages. Allogenic hematopoietic stem cell transplantation provides a potential curative option for patients. Further investigations of prognosis and translational research are necessary to improve stratification of patients for treatment.
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Affiliation(s)
- Sarah Morgenroth
- Department of Dermatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Andrea Roggo
- Department of Dermatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Laura Pawlik
- Department of Dermatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Reinhard Dummer
- Department of Dermatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Egle Ramelyte
- Department of Dermatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
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Khodadoust MS, Mou E, Kim YH. Integrating novel agents into the treatment of advanced mycosis fungoides and Sézary syndrome. Blood 2023; 141:695-703. [PMID: 36379025 DOI: 10.1182/blood.2020008241] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/04/2022] [Accepted: 10/31/2022] [Indexed: 11/16/2022] Open
Abstract
Agents targeting the unique biology of mycosis fungoides and Sézary syndrome are quickly being incorporated into clinical management. With these new therapies, we are now capable of inducing more durable responses and even complete remissions in advanced disease, outcomes which were exceedingly rare with prior therapies. Yet, even this new generation of therapies typically produce objective responses in only a minority of patients. As our therapeutic options increase, we are now challenged with selecting treatments from a growing list of options. To gain the full benefit of these novel agents, we must develop strategies to match treatments for the patients most likely to benefit from them. Here, we consider both the current approaches to treatment selection based on clinical features and the future of molecular biomarker-guided therapy for patients with this heterogeneous disease.
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Affiliation(s)
- Michael S Khodadoust
- Division of Oncology, Stanford University, Stanford, CA
- Department of Dermatology, Stanford University, Stanford, CA
| | - Eric Mou
- Division of Hematology, Oncology, and Blood & Marrow Transplantation, University of Iowa, Iowa City, IA
| | - Youn H Kim
- Division of Oncology, Stanford University, Stanford, CA
- Department of Dermatology, Stanford University, Stanford, CA
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5
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Piccaluga PP, Cascianelli C, Inghirami G. Tyrosine kinases in nodal peripheral T-cell lymphomas. Front Oncol 2023; 13:1099943. [PMID: 36845713 PMCID: PMC9946040 DOI: 10.3389/fonc.2023.1099943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/26/2023] [Indexed: 02/11/2023] Open
Abstract
Nodal peripheral T-cell lymphomas (PTCL) are uncommon and heterogeneous tumors characterized by a dismal prognosis. Targeted therapy has been proposed. However, reliable targets are mostly represented by a few surface antigens (e.g., CD52 and CD30), chemokine receptors (e.g., CCR4), and epigenetic gene expression regulation. In the last two decades, however, several studies have supported the idea that tyrosine kinase (TK) deregulation might be relevant for both the pathogenesis and treatment of PTCL. Indeed, they can be expressed or activated as a consequence of their involvement in genetic lesions, such as translocations, or by ligand overexpression. The most striking example is ALK in anaplastic large-cell lymphomas (ALCL). ALK activity is necessary to support cell proliferation and survival, and its inhibition leads to cell death. Notably, STAT3 was found to be the main downstream ALK effector. Other TKs are consistently expressed and active in PTCLs, such as PDGFRA, and members of the T-cell receptor signaling family, such as SYK. Notably, as in the case of ALK, STAT proteins have emerged as key downstream factors for most of the involved TK.
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Affiliation(s)
- Pier Paolo Piccaluga
- Biobank of Research, IRCCS Azienda Opedaliera-Universitaria di Bologna, Bologna, Italy
- Department of Experimental, Diagnostic, and Specialty Medicine, School of Medicine, University of Bologna, Bologna, Italy
| | - Chiara Cascianelli
- Biobank of Research, IRCCS Azienda Opedaliera-Universitaria di Bologna, Bologna, Italy
| | - Giorgio Inghirami
- Immunopathology and Hematopathology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, United States
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Fay CJ, Awh KC, LeBoeuf NR, Larocca CA. Harnessing the immune system in the treatment of cutaneous T cell lymphomas. Front Oncol 2023; 12:1071171. [PMID: 36713518 PMCID: PMC9878398 DOI: 10.3389/fonc.2022.1071171] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 12/01/2022] [Indexed: 01/15/2023] Open
Abstract
Cutaneous T cell lymphomas are a rare subset of non-Hodgkin's lymphomas with predilection for the skin with immunosuppressive effects that drive morbidity and mortality. We are now appreciating that suppression of the immune system is an important step in the progression of disease. It should come as no surprise that therapies historically and currently being used to treat these cancers have immune modulating functions that impact disease outcomes. By understanding the immune effects of our therapies, we may better develop new agents that target the immune system and improve combinatorial treatment strategies to limit morbidity and mortality of these cancers. The immune modulating effect of therapeutic drugs in use and under development for cutaneous T cell lymphomas will be reviewed.
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Shimshak S, Sokumbi O, Isaq N, Goyal A, Comfere N. A Practical Guide to the Diagnosis, Evaluation, and Treatment of Cutaneous T-Cell Lymphoma. Dermatol Clin 2023; 41:209-229. [DOI: 10.1016/j.det.2022.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Rodriguez-Sevilla JJ, Salido M, Rodriguez-Rivera M, Sanchez-Gonzalez B, Gallardo F, Pujol RM, Colomo L. PCM1::JAK2 fusion associates with an atypical form of mycosis fungoides. Virchows Arch 2022; 481:967-973. [PMID: 35786767 DOI: 10.1007/s00428-022-03372-x] [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: 11/23/2021] [Revised: 05/28/2022] [Accepted: 06/24/2022] [Indexed: 12/14/2022]
Abstract
Deregulation of JAK-STAT pathway seems to be relevant in mycosis fungoides (MFs). We report the case of a 23-year-old woman diagnosed of atypical MF carrying isolated PCM1::JAK2 fusion and eosinophilia. The disease was refractory to common treatments and progressed increasing the number of large CD30 positive T-cells. After progression, treatment with brentuximab vedotin was decided and decreased the proportion of large cells, but the low-grade component persisted, and the skin lesions worsened. Immunohistochemical expression of p-STAT3 detected in most tumor cells demonstrated the abnormal activation of JAK-STAT pathway. Very few cases of mature T-cell lymphomas carrying PCM1::JAK2 gene fusion have been reported to date, and we review previous cases described with this alteration. Described cases shared similar clinicopathological features and low genetic complexity, and the presence of PCM1::JAK2 fusion associates with a distinctive form of the disease.
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Affiliation(s)
- Juan Jose Rodriguez-Sevilla
- Department of Hematology, Hospital del Mar, Institute Hospital del Mar d'Investigacions Mediques (IMIM), Barcelona, Spain
| | - Marta Salido
- Department of Pathology, Hospital del Mar, Institute Hospital del Mar d'Investigacions Mediques (IMIM), Barcelona, Spain
| | - Maria Rodriguez-Rivera
- Department of Pathology, Hospital del Mar, Institute Hospital del Mar d'Investigacions Mediques (IMIM), Barcelona, Spain
| | - Blanca Sanchez-Gonzalez
- Department of Hematology, Hospital del Mar, Institute Hospital del Mar d'Investigacions Mediques (IMIM), Barcelona, Spain
| | - Fernando Gallardo
- Department of Dermatology, Hospital del Mar, Institute Hospital del Mar d'Investigacions Mediques (IMIM), Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
| | - Ramon Maria Pujol
- Department of Dermatology, Hospital del Mar, Institute Hospital del Mar d'Investigacions Mediques (IMIM), Barcelona, Spain.,Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Luis Colomo
- Department of Pathology, Hospital del Mar, Institute Hospital del Mar d'Investigacions Mediques (IMIM), Barcelona, Spain. .,Universitat Pompeu Fabra, Barcelona, Spain.
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Molecular pathogenesis of Cutaneous T cell Lymphoma: Role of chemokines, cytokines, and dysregulated signaling pathways. Semin Cancer Biol 2022; 86:382-399. [PMID: 34906723 DOI: 10.1016/j.semcancer.2021.12.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/03/2021] [Accepted: 12/08/2021] [Indexed: 01/27/2023]
Abstract
Cutaneous T cell lymphomas (CTCLs) are a heterogeneous group of lymphoproliferative neoplasms that exhibit a wide spectrum of immune-phenotypical, clinical, and histopathological features. The biology of CTCL is complex and remains elusive. In recent years, the application of next-generation sequencing (NGS) has evolved our understanding of the pathogenetic mechanisms, including genetic aberrations and epigenetic abnormalities that shape the mutational landscape of CTCL and represent one of the important pro-tumorigenic principles in CTCL initiation and progression. Still, identification of the major pathophysiological pathways including genetic and epigenetic components that mediate malignant clonal T cell expansion has not been achieved. This is of prime importance given the role of malignant T cell clones in fostering T helper 2 (Th2)-bias tumor microenvironment and fueling progressive immune dysregulation and tumor cell growth in CTCL patients, manifested by the secretion of Th2-associated cytokines and chemokines. Alterations in malignant cytokine and chemokine expression patterns orchestrate the inflammatory milieu and influence the migration dynamics of malignant clonal T cells. Here, we highlight recent insights about the molecular mechanisms of CTCL pathogenesis, emphasizing the role of cytokines, chemokines, and associated downstream signaling networks in driving immune defects, malignant transformation, and disease progression. In-depth characterization of the CTCL immunophenotype and tumoral microenvironment offers a facile opportunity to expand the therapeutic armamentarium of CTCL, an intractable malignant skin disease with poor prognosis and in dire need of curative treatment approaches.
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Genetics Abnormalities with Clinical Impact in Primary Cutaneous Lymphomas. Cancers (Basel) 2022; 14:cancers14204972. [PMID: 36291756 PMCID: PMC9599538 DOI: 10.3390/cancers14204972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/04/2022] [Accepted: 10/04/2022] [Indexed: 11/18/2022] Open
Abstract
Simple Summary The genetic landscape of cutaneous T-cell lymphomas analyzed by sequencing high throughput techniques shows a heterogeneous somatic mutational profile and genomic copy number variations in the TCR signaling effectors, the NF-κB elements, DNA damage/repair elements, JAK/STAT pathway elements and epigenetic modifiers. A mutational and genomic stratification of these patients provides new opportunities for the development or repurposing of (personalized) therapeutic strategies. The genetic heterogeneity in cutaneous B-cell lymphoma parallels with the specific subtype. Damaging mutations in primary cutaneous diffuse large B-cell lymphoma of the leg type, involving MYD88 gene, or BCL6 and MYC translocations or CDKN2A deletions are useful for diagnostic purposes. The more indolent forms, as the primary cutaneous lymphoma of follicle center cell (somatic mutations in TNFRSF14 and 1p36 deletions) and the cutaneous lymphoproliferative disorder of the marginal zone cells (FAS gene), present with a more restricted pattern of genetic alterations. Abstract Primary cutaneous lymphomas comprise a heterogeneous group of extranodal non-Hodgkin lymphomas (NHL) that arise from skin resident lymphoid cells and are manifested by specific lymphomatous cutaneous lesions with no evidence of extracutaneous disease at the time of diagnosis. They may originate from mature T-lymphocytes (70% of all cases), mature B-lymphocytes (25–30%) or, rarely, NK cells. Cutaneous T-cell lymphomas (CTCL) comprise a heterogeneous group of T-cell malignancies including Mycosis Fungoides (MF) the most frequent subtype, accounting for approximately half of CTCL, and Sézary syndrome (SS), which is an erythrodermic and leukemic subtype characterized by significant blood involvement. The mutational landscape of MF and SS by NGS include recurrent genomic alterations in the TCR signaling effectors (i.e., PLCG1), the NF-κB elements (i.e., CARD11), DNA damage/repair elements (TP53 or ATM), JAK/STAT pathway elements or epigenetic modifiers (DNMT3). Genomic copy number variations appeared to be more prevalent than somatic mutations. Other CTCL subtypes such as primary cutaneous anaplastic large cell lymphoma also harbor genetic alterations of the JAK/STAT pathway in up to 50% of cases. Recently, primary cutaneous aggressive epidermotropic T-cell lymphoma, a rare fatal subtype, was found to contain a specific profile of JAK2 rearrangements. Other aggressive cytotoxic CTCL (primary cutaneous γδ T-cell lymphomas) also show genetic alterations in the JAK/STAT pathway in a large proportion of patients. Thus, CTCL patients have a heterogeneous genetic/transcriptional and epigenetic background, and there is no uniform treatment for these patients. In this scenario, a pathway-based personalized management is required. Cutaneous B-cell lymphoma (CBCL) subtypes present a variable genetic profile. The genetic heterogeneity parallels the multiple types of specialized B-cells and their specific tissue distribution. Particularly, many recurrent hotspot and damaging mutations in primary cutaneous diffuse large B-cell lymphoma of the leg type, involving MYD88 gene, or BCL6 and MYC translocations and BLIMP1 or CDKN2A deletions are useful for diagnostic and prognostic purposes for this aggressive subtype from other indolent CBCL forms.
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Dippel E, Assaf C, Becker JC, von Bergwelt-Baildon M, Bernreiter S, Cozzio A, Eich HT, Elsayad K, Follmann M, Grabbe S, Hillen U, Klapper W, Klemke CD, Loquai C, Meiss F, Mitteldorf C, Wehkamp U, Nashan D, Nicolay JP, Oschlies I, Schlaak M, Stranzenbach R, Moritz R, Stoll C, Vag T, Weichenthal M, Wobser M, Stadler R. S2k-Leitlinie - Kutane Lymphome (ICD10 C82-C86): Update 2021. J Dtsch Dermatol Ges 2022; 20:537-555. [PMID: 35446484 DOI: 10.1111/ddg.14706_g] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
| | - Chalid Assaf
- Klinik für Dermatologie und Venerologie, Helios Klinikum Krefeld
| | | | | | | | - Antonio Cozzio
- Klinik für Dermatologie, Venerologie und Allergologie, Kantonsspital St. Gallen
| | - Hans T Eich
- Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Münster
| | - Khaled Elsayad
- Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Münster
| | | | | | - Uwe Hillen
- Klinik für Dermatologie, Universitätsklinikum Essen
| | - Wolfram Klapper
- Institut für Pathologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - Claus-Detlev Klemke
- Hautklinik, Städtisches Klinikum Karlsruhe, Akademisches Lehrkrankenhaus der Universität Freiburg, Karlsruhe
| | | | - Frank Meiss
- Klinik für Dermatologie und Venerologie, Universitätsklinik Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg
| | - Christina Mitteldorf
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen
| | - Ulrike Wehkamp
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | | | - Jan P Nicolay
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinik Mannheim
| | - Ilske Oschlies
- Institut für Pathologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - Max Schlaak
- Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin
| | - René Stranzenbach
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum der Ruhr-Universität Bochum
| | - Rose Moritz
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Halle
| | | | - Tibor Vag
- Nuklearmedizinische Klinik, Klinikum Rechts der Isar, Technische Universität München
| | - Michael Weichenthal
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - Marion Wobser
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg
| | - Rudolf Stadler
- Klinik für Dermatologie, Venerologie, Allergologie und Phlebologie, Johannes Wesling Universitätsklinikum Minden, Universitätsklinikum der Ruhr-Universität Bochum
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12
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Dippel E, Assaf C, Becker JC, von Bergwelt-Baildon M, Bernreiter S, Cozzio A, Eich HT, Elsayad K, Follmann M, Grabbe S, Hillen U, Klapper W, Klemke CD, Loquai C, Meiss F, Mitteldorf C, Wehkamp U, Nashan D, Nicolay JP, Oschlies I, Schlaak M, Stranzenbach R, Moritz R, Stoll C, Vag T, Weichenthal M, Wobser M, Stadler R. S2k-Guidelines - Cutaneous lymphomas (ICD10 C82 - C86): Update 2021. J Dtsch Dermatol Ges 2022; 20:537-554. [PMID: 35446497 PMCID: PMC9325452 DOI: 10.1111/ddg.14706] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Edgar Dippel
- Department of Dermatology, Hospital Ludwigshafen, Germany
| | - Chalid Assaf
- Department of Dermatology and Venereology, Helios Hospital Krefeld, Germany
| | - Jürgen C Becker
- West German Tumor Center, University Hospital Essen, Germany
| | | | | | - Antonio Cozzio
- Department of Dermatology, Venereology and Allergology, Canton Hospital St. Gallen, Switzerland
| | - Hans T Eich
- Department of Radiation Therapy and Radio-Oncology, University Hospital Münster, Germany
| | - Khaled Elsayad
- Department of Radiation Therapy and Radio-Oncology, University Hospital Münster, Germany
| | | | - Stephan Grabbe
- Department of Dermatology, University Hospital Mainz, Germany
| | - Uwe Hillen
- Department of Dermatology, University Hospital Essen, Germany
| | - Wolfram Klapper
- Institute of Pathology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Claus-Detlev Klemke
- Department of Dermatology, Municipal Hospital of Karlsruhe, Academic Teaching Hospital for the University of Freiburg, Karlsruhe, Germany
| | - Carmen Loquai
- Department of Dermatology, University Hospital Mainz, Germany
| | - Frank Meiss
- Department of Dermatology and Venereology, University Hospital Freiburg, medical Faculty, Albert-Ludwigs University Freiburg, Germany
| | - Christina Mitteldorf
- Department of Dermatology, Venereology and Allergology, University Hospital Göttingen, Germany
| | - Ulrike Wehkamp
- Department of Dermatology, Venereology and Allergology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Dorothee Nashan
- Department of Dermatology, Dortmund Hospital GmbH, Dortmund, Germany
| | - Jan P Nicolay
- Department of Dermatology, Venereology and Allergology, University Hospital Mannheim, Germany
| | - Ilske Oschlies
- Institute of Pathology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Max Schlaak
- Charité - Universitätsmedizin Berlin, Department of Dermatology, Venereology and Allergology, Berlin, Germany
| | - René Stranzenbach
- Department of Dermatology, Venereology and Allergology, University Hospital at Ruhr University Bochum, Germany
| | - Rose Moritz
- Department for Dermatology, University Hospital Halle, Germany
| | | | - Tibor Vag
- Department of Nuclear Medicine, Technical University of Munich, Germany
| | - Michael Weichenthal
- Department of Dermatology, Venereology and Allergology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Marion Wobser
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Germany
| | - Rudolf Stadler
- Department of Dermatology, Venereology, Allergology, and Phlebology, Johannes Wesling University Hospital Minden, University Hospital at Ruhr University Bochum, Germany
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Wind SS, Jansen MAA, Rijsbergen M, van Esdonk MJ, Ziagkos D, Cheng WC, Niemeyer-van der Kolk T, Korsten J, Gruszka A, Schmitz-Rohmer D, Bonnel D, Legouffe R, Barré F, Bekkenk MW, de Haas ERM, Quint KD, Rolli M, Streefkerk HJ, Burggraaf J, Vermeer MH, Rissmann R. Topical Bimiralisib Shows Meaningful Cutaneous Drug Levels in Healthy Volunteers and Mycosis Fungoides Patients but No Clinical Activity in a First-in-Human, Randomized Controlled Trial. Cancers (Basel) 2022; 14:1510. [PMID: 35326659 PMCID: PMC8946662 DOI: 10.3390/cancers14061510] [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: 12/17/2021] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 12/04/2022] Open
Abstract
Mycosis fungoides (MF) is a subtype of CTCL with a low incidence and high medical need for novel treatments. The objective of this randomized, placebo-controlled, double-blinded, first-in-human study was to evaluate safety, efficacy, cutaneous and systemic pharmacokinetics (PK) of topical bimiralisib in healthy volunteers (HVs) and MF patients. In this trial, a total of 6 HVs and 19 early-stage MF patients were treated with 2.0% bimiralisib gel and/or placebo. Drug efficacy was assessed by the Composite Assessment of Index Lesion Severity (CAILS) score, supported by objective measuring methods to quantify lesion severity. PK blood samples were collected frequently and cutaneous PK was investigated in skin punch biopsies on the last day of treatment. Local distribution of bimiralisib in HVs showed a mean exposure of 2.54 µg/g in the epidermis. A systemic concentration was observed after application of a target dose of 2 mg/cm2 on 400 cm2, with a mean Cavg of 0.96 ng/mL. Systemic exposure of bimiralisib was reached in all treated MF patients, and normalized plasma concentrations showed a 144% increased exposure compared to HVs, with an observed mean Cavg of 4.49 ng/mL and a mean cutaneous concentration of 5.3 µg/g. No difference in CAILS or objective lesion severity quantification upon 42 days of once-daily treatment was observed in the MF patient group. In general, the treatment was well tolerated in terms of local reactions as well as systemic adverse events. In conclusion, we showed that topical bimiralisib treatment leads to (i) meaningful cutaneous drug levels and (ii) well-tolerated systemic drug exposure in MF patients and (iii) a lack of clinical efficacy, in need of further exploration due to numerous unknown factors, before depreciation of topical bimiralisib as a novel therapeutic drug for CTCLs.
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Affiliation(s)
- Selinde S. Wind
- Centre for Human Drug Research, 2333 CL Leiden, The Netherlands; (S.S.W.); (M.A.A.J.); (M.R.); (M.J.v.E.); (D.Z.); (W.C.C.); (T.N.-v.d.K.); (J.B.)
- Department of Dermatology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (K.D.Q.); (M.H.V.)
| | - Manon A. A. Jansen
- Centre for Human Drug Research, 2333 CL Leiden, The Netherlands; (S.S.W.); (M.A.A.J.); (M.R.); (M.J.v.E.); (D.Z.); (W.C.C.); (T.N.-v.d.K.); (J.B.)
| | - Melanie Rijsbergen
- Centre for Human Drug Research, 2333 CL Leiden, The Netherlands; (S.S.W.); (M.A.A.J.); (M.R.); (M.J.v.E.); (D.Z.); (W.C.C.); (T.N.-v.d.K.); (J.B.)
| | - Michiel J. van Esdonk
- Centre for Human Drug Research, 2333 CL Leiden, The Netherlands; (S.S.W.); (M.A.A.J.); (M.R.); (M.J.v.E.); (D.Z.); (W.C.C.); (T.N.-v.d.K.); (J.B.)
| | - Dimitrios Ziagkos
- Centre for Human Drug Research, 2333 CL Leiden, The Netherlands; (S.S.W.); (M.A.A.J.); (M.R.); (M.J.v.E.); (D.Z.); (W.C.C.); (T.N.-v.d.K.); (J.B.)
| | - Wing C. Cheng
- Centre for Human Drug Research, 2333 CL Leiden, The Netherlands; (S.S.W.); (M.A.A.J.); (M.R.); (M.J.v.E.); (D.Z.); (W.C.C.); (T.N.-v.d.K.); (J.B.)
| | - Tessa Niemeyer-van der Kolk
- Centre for Human Drug Research, 2333 CL Leiden, The Netherlands; (S.S.W.); (M.A.A.J.); (M.R.); (M.J.v.E.); (D.Z.); (W.C.C.); (T.N.-v.d.K.); (J.B.)
| | - John Korsten
- Charles River Laboratories Den Bosch B.V., 5231 DD Den Bosch, The Netherlands; (J.K.); (A.G.)
| | - Agnieszka Gruszka
- Charles River Laboratories Den Bosch B.V., 5231 DD Den Bosch, The Netherlands; (J.K.); (A.G.)
| | | | - David Bonnel
- MS Imaging Department, ImaBiotech, 59120 Lille, France; (D.B.); (R.L.); (F.B.)
| | - Raphael Legouffe
- MS Imaging Department, ImaBiotech, 59120 Lille, France; (D.B.); (R.L.); (F.B.)
| | - Florian Barré
- MS Imaging Department, ImaBiotech, 59120 Lille, France; (D.B.); (R.L.); (F.B.)
| | - Marcel W. Bekkenk
- Amsterdam University Medical Centers, 1105 AZ Amsterdam, The Netherlands;
| | | | - Koen D. Quint
- Department of Dermatology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (K.D.Q.); (M.H.V.)
| | - Melanie Rolli
- PIQUR Therapeutics AG, 4057 Basel, Switzerland; (D.S.-R.); (M.R.); (H.J.S.)
| | | | - Jacobus Burggraaf
- Centre for Human Drug Research, 2333 CL Leiden, The Netherlands; (S.S.W.); (M.A.A.J.); (M.R.); (M.J.v.E.); (D.Z.); (W.C.C.); (T.N.-v.d.K.); (J.B.)
- Department of Dermatology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (K.D.Q.); (M.H.V.)
- Leiden Academic Centre for Drug Research, Leiden University, 2333 CC Leiden, The Netherlands
| | - Maarten H. Vermeer
- Department of Dermatology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (K.D.Q.); (M.H.V.)
| | - Robert Rissmann
- Centre for Human Drug Research, 2333 CL Leiden, The Netherlands; (S.S.W.); (M.A.A.J.); (M.R.); (M.J.v.E.); (D.Z.); (W.C.C.); (T.N.-v.d.K.); (J.B.)
- Department of Dermatology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (K.D.Q.); (M.H.V.)
- Leiden Academic Centre for Drug Research, Leiden University, 2333 CC Leiden, The Netherlands
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Karagianni F, Piperi C, Casar B, de la Fuente-Vivas D, García-Gómez R, Lampadaki K, Pappa V, Papadavid E. Combination of Resminostat with Ruxolitinib Exerts Antitumor Effects in the Chick Embryo Chorioallantoic Membrane Model for Cutaneous T Cell Lymphoma. Cancers (Basel) 2022; 14:cancers14041070. [PMID: 35205818 PMCID: PMC8870185 DOI: 10.3390/cancers14041070] [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: 01/25/2022] [Revised: 02/13/2022] [Accepted: 02/16/2022] [Indexed: 01/27/2023] Open
Abstract
Simple Summary The combination of Resminostat (HDACi) and Ruxolitinib (JAKi) exerted cytotoxic effects and inhibited proliferation of CTCL cell lines (MyLa, SeAx) in vitro. The aim of the present study was to validate their antitumor effects in vivo using the chick embryo chorioallantoic membrane (CAM) model, which allows quick and efficient monitoring of tumor growth, migration, invasion, and metastatic potential. The drug combination exhibited a significant inhibition of primary tumor size, and inhibited intravasation and extravasation of tumor cells to the liver and lung. It also exerted an inhibitory effect in the migration and invasion of tumor cells and significantly reduced key signaling pathway activation. Our data demonstrate that the CAM assay could be employed as a preclinical in vivo model in CTCL for pharmacological testing, and that the combination of Resminostat and Ruxolitinib exerts significant antitumor effects in CTCL progression that need to be further evaluated in a clinical setting. Abstract The combination of Resminostat (HDACi) and Ruxolitinib (JAKi) exerted cytotoxic effects and inhibited proliferation of CTCL cell lines (MyLa, SeAx) in previously published work. A xenograft tumor formation was produced by implanting the MyLa or SeAx cells on top of the chick embryo chorioallantoic membrane (CAM). The CAM assay protocol was developed to monitor the metastatic properties of CTCL cells and the effects of Resminostat and/or Ruxolitinib in vivo. In the spontaneous CAM assays, Resminostat and Ruxolitinib treatment inhibited the cell proliferation (p < 0.001) of MyLa and SeAx, and induced cell apoptosis (p < 0.005, p < 0.001, respectively). Although monotherapies reduced the size of primary tumors in the metastasis CAM assay, the drug combination exhibited a significant inhibition of primary tumor size (p < 0.0001). Furthermore, the combined treatment inhibited the intravasation of MyLa (p < 0.005) and SeAx cells (p < 0.0001) in the organs, as well as their extravasation to the liver (p < 0.0001) and lung (p < 0.0001). The drug combination also exerted a stronger inhibitory effect in migration (p < 0.0001) rather in invasion (p < 0.005) of both MyLa and SeAx cells. It further reduced p-p38, p-ERK, p-AKT, and p-STAT in MyLa cells, while it decreased p-ERK and p-STAT in SeAx cells in CAM tumors. Our data demonstrated that the CAM assay could be employed as a preclinical in vivo model in CTCL for pharmacological testing. In agreement with previous in vitro data, the combination of Resminostat and Ruxolitinib was shown to exert antitumor effects in CTCL in vivo.
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Affiliation(s)
- Fani Karagianni
- National Center of Rare Diseases-Cutaneous Lymphoma—Member of EuroBloodNet, Second Department of Dermatology and Venereal Diseases, Attikon University General Hospital, National and Kapodistrian University of Athens, 124 62 Athens, Greece; (F.K.); (K.L.)
| | - Christina Piperi
- Department of Biological Chemistry, Medical School of Athens, National and Kapodistrian University of Athens, 115 27 Athens, Greece;
| | - Berta Casar
- Instituto de Biomedicina y Biotecnología de Cantabria, Consejo Superior de Investigaciones Científicas (CSIC)-Universidad de Cantabria, 39011 Santander, Spain; (D.d.l.F.-V.); (R.G.-G.)
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: (B.C.); (E.P.)
| | - Dalia de la Fuente-Vivas
- Instituto de Biomedicina y Biotecnología de Cantabria, Consejo Superior de Investigaciones Científicas (CSIC)-Universidad de Cantabria, 39011 Santander, Spain; (D.d.l.F.-V.); (R.G.-G.)
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Rocío García-Gómez
- Instituto de Biomedicina y Biotecnología de Cantabria, Consejo Superior de Investigaciones Científicas (CSIC)-Universidad de Cantabria, 39011 Santander, Spain; (D.d.l.F.-V.); (R.G.-G.)
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Kyriaki Lampadaki
- National Center of Rare Diseases-Cutaneous Lymphoma—Member of EuroBloodNet, Second Department of Dermatology and Venereal Diseases, Attikon University General Hospital, National and Kapodistrian University of Athens, 124 62 Athens, Greece; (F.K.); (K.L.)
| | - Vasiliki Pappa
- 2nd Department of Internal Medicine—Propaedeutic and Research Unit, National and Kapodistrian University of Athens, Medical School of Athens, University General Hospital Attikon, 124 62 Athens, Greece;
| | - Evangelia Papadavid
- National Center of Rare Diseases-Cutaneous Lymphoma—Member of EuroBloodNet, Second Department of Dermatology and Venereal Diseases, Attikon University General Hospital, National and Kapodistrian University of Athens, 124 62 Athens, Greece; (F.K.); (K.L.)
- Correspondence: (B.C.); (E.P.)
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15
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Kołkowski K, Trzeciak M, Sokołowska-Wojdyło M. Safety and Danger Considerations of Novel Treatments for Atopic Dermatitis in Context of Primary Cutaneous Lymphomas. Int J Mol Sci 2021; 22:13388. [PMID: 34948183 PMCID: PMC8703592 DOI: 10.3390/ijms222413388] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/05/2021] [Accepted: 12/06/2021] [Indexed: 12/24/2022] Open
Abstract
The impact of new and emerging therapies on the microenvironment of primary cutaneous lymphomas (PCLs) has been recently raised in the literature. Concomitantly, novel treatments are already used or registered (dupilumab, upadacitinib) and others seem to be added to the armamentarium against atopic dermatitis. Our aim was to review the literature on interleukins 4, 13, 22, and 31, and JAK/STAT pathways in PCLs to elucidate the safety of using biologics (dupilumab, tralokinumab, fezakinumab, nemolizumab) and small molecule inhibitors (upadacitinib, baricitinib, abrocitinib, ruxolitinib, tofacitinib) in the treatment of atopic dermatitis. We summarized the current state of knowledge on this topic based on the search of the PubMed database and related references published before 21 October 2021. Our analysis suggests that some of the mentioned agents (dupilumab, ruxolitinib) and others may have a direct impact on the progression of cutaneous lymphomas. This issue requires further study and meticulous monitoring of patients receiving these drugs to ensure their safety, especially in light of the FDA warning on tofacitinib. In conclusion, in the case of the rapid progression of atopic dermatitis/eczema, especially in patients older than 40 years old, there is a necessity to perform a biopsy followed by a very careful pathological examination.
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Affiliation(s)
- Karol Kołkowski
- Dermatological Students Scientific Association, Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdansk, 80-214 Gdansk, Poland
| | - Magdalena Trzeciak
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdansk, 80-214 Gdansk, Poland; (M.T.); (M.S.-W.)
| | - Małgorzata Sokołowska-Wojdyło
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdansk, 80-214 Gdansk, Poland; (M.T.); (M.S.-W.)
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16
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Wobser M, Roth S, Appenzeller S, Houben R, Schrama D, Goebeler M, Geissinger E, Rosenwald A, Maurus K. Targeted Deep Sequencing of Mycosis Fungoides Reveals Intracellular Signaling Pathways Associated with Aggressiveness and Large Cell Transformation. Cancers (Basel) 2021; 13:5512. [PMID: 34771672 PMCID: PMC8582785 DOI: 10.3390/cancers13215512] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/19/2021] [Accepted: 10/29/2021] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Large-cell transformation (LCT) of mycosis fungoides (MF) has been associated with a higher risk of relapse and progression and, consequently, restricted prognosis. Its molecular pathogenesis has not been elucidated yet. MATERIALS AND METHODS In order to address molecular mechanisms of LCT, we performed hybrid capture panel-based sequencing of skin biopsies from 10 patients suffering from MF with LCT versus 17 patients without LCT including follow-up biopsies during clinical course, respectively (51 samples in total). The analyzed patients were attributed to three different groups based on the presence of LCT and clinical behavior. RESULTS While indolent MF cases without LCT did not show pathogenic driver mutations, a high rate of oncogenic alterations was detected in patients with LCT and aggressive clinical courses. Various genes of different oncogenic signaling pathways, including the MAPK and JAK-STAT signaling pathways, as well as epigenetic modifiers were affected. A high inter-individual and distinctive intra-individual mutation diversity was observed. Oncogenic RAS mutations were exclusively detected in patients with LCT. CONCLUSION Our data demonstrate that LCT transition of MF is associated with increased frequency of somatic mutations in cancer-associated genes. In particular, the activation of RAS signaling-together with epigenetic dysregulation-may crucially contribute to the molecular pathogenesis of the LCT phenotype, thus conveying its adverse clinical behavior.
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Affiliation(s)
- Marion Wobser
- Venereology and Allergology and Skin Cancer Center, Department of Dermatology, University Hospital Würzburg, 97080 Würzburg, Germany; (M.W.); (R.H.); (D.S.); (M.G.)
| | - Sabine Roth
- Comprehensive Cancer Center Mainfranken, University Hospital of Würzburg, 97080 Würzburg, Germany; (S.R.); (A.R.)
- Institute of Pathology, University of Würzburg, 97080 Würzburg, Germany; (S.A.); (E.G.)
| | - Silke Appenzeller
- Institute of Pathology, University of Würzburg, 97080 Würzburg, Germany; (S.A.); (E.G.)
| | - Roland Houben
- Venereology and Allergology and Skin Cancer Center, Department of Dermatology, University Hospital Würzburg, 97080 Würzburg, Germany; (M.W.); (R.H.); (D.S.); (M.G.)
| | - David Schrama
- Venereology and Allergology and Skin Cancer Center, Department of Dermatology, University Hospital Würzburg, 97080 Würzburg, Germany; (M.W.); (R.H.); (D.S.); (M.G.)
| | - Matthias Goebeler
- Venereology and Allergology and Skin Cancer Center, Department of Dermatology, University Hospital Würzburg, 97080 Würzburg, Germany; (M.W.); (R.H.); (D.S.); (M.G.)
| | - Eva Geissinger
- Institute of Pathology, University of Würzburg, 97080 Würzburg, Germany; (S.A.); (E.G.)
- Pathology Practice, 85049 Ingolstadt, Germany
| | - Andreas Rosenwald
- Comprehensive Cancer Center Mainfranken, University Hospital of Würzburg, 97080 Würzburg, Germany; (S.R.); (A.R.)
- Institute of Pathology, University of Würzburg, 97080 Würzburg, Germany; (S.A.); (E.G.)
| | - Katja Maurus
- Comprehensive Cancer Center Mainfranken, University Hospital of Würzburg, 97080 Würzburg, Germany; (S.R.); (A.R.)
- Institute of Pathology, University of Würzburg, 97080 Würzburg, Germany; (S.A.); (E.G.)
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17
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García-Díaz N, Casar B, Alonso-Alonso R, Quevedo L, Rodríguez M, Ruso-Julve F, Esteve-Codina A, Gut M, Gru AA, González-Vela MC, Gut I, Rodriguez-Peralto JL, Varela I, Ortiz-Romero PL, Piris MA, Vaqué JP. PLCγ1/PKCθ Downstream Signaling Controls Cutaneous T-Cell Lymphoma Development And Progression. J Invest Dermatol 2021; 142:1391-1400.e15. [PMID: 34687742 DOI: 10.1016/j.jid.2021.09.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 09/07/2021] [Accepted: 09/08/2021] [Indexed: 01/25/2023]
Abstract
Developing mechanistic rationales can improve the clinical management of cutaneous T-cell lymphomas (CTCL). There is considerable genetic and biological evidence of a malignant network of signaling mechanisms, highly influenced by deregulated TCR/PLCγ1 activity, controlling the biology of these lesions. In addition, activated STAT3 is associated with clinical progression, although the alterations responsible for this have not been fully elucidated. Here we studied PLCγ1-dependent mechanisms that can mediate STAT3 activation and control tumor growth and progression. Downstream of PLCγ1, the pharmacological inhibition and genetic knockdown of PKCθ inhibited STAT3 activation, impaired proliferation, and promoted apoptosis in CTCL cells. A PKCθ-dependent transcriptome in MF/SS cells revealed potential effector genes controlling cytokine signaling, TP53, and actin cytoskeleton dynamics. Consistently, an in vivo chicken embryo model xenografted with MF cells showed that PKCθ blockage abrogates tumor growth and spread to distant organs. Finally, the expression of a number of PKCθ target genes, found in MF cells, significantly correlated with that of PRKCQ (PKCθ) in 81 human MF samples. In summary, PKCθ can play a central role in the activation of malignant CTCL mechanisms via multiple routes, including, but not restricted to, STAT3. These mechanisms may, in turn, serve as targets for specific therapies.
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Affiliation(s)
- Nuria García-Díaz
- Molecular Biology Department, Universidad de Cantabria-Instituto de Investigación Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - Berta Casar
- Instituto de Biomedicina y Biotecnología de Cantabria, Universidad de Cantabria-CSIC, Santander, Spain
| | | | - Laura Quevedo
- Instituto de Biomedicina y Biotecnología de Cantabria, Universidad de Cantabria-CSIC, Santander, Spain
| | - Marta Rodríguez
- Pathology Department, Fundación Jiménez Díaz, CIBERONC, Madrid, Spain
| | - Fulgencio Ruso-Julve
- Molecular Biology Department, Universidad de Cantabria-Instituto de Investigación Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - Anna Esteve-Codina
- CNAG-CRG, Centre for Genomic Regulation (CRG), Barcelona Institute of Science and Technology (BIST), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Marta Gut
- CNAG-CRG, Centre for Genomic Regulation (CRG), Barcelona Institute of Science and Technology (BIST), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Alejandro A Gru
- Department of Pathology, School of Medicine, University of Virginia, Charlottesville, Virginia, USA; Department of Dermatology, School of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | | | - Ivo Gut
- CNAG-CRG, Centre for Genomic Regulation (CRG), Barcelona Institute of Science and Technology (BIST), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - José Luis Rodriguez-Peralto
- Department of Pathology, Hospital 12 de Octubre, institute i+12, CIBERONC, Medical School, University Complutense, Madrid, Spain
| | - Ignacio Varela
- Instituto de Biomedicina y Biotecnología de Cantabria, Universidad de Cantabria-CSIC, Santander, Spain
| | - Pablo Luis Ortiz-Romero
- Department of Dermatology, Hospital 12 de Octubre, institute i+12, CIBERONC, Medical School, University Complutense, Madrid, Spain
| | - Miguel A Piris
- Pathology Department, Fundación Jiménez Díaz, CIBERONC, Madrid, Spain
| | - José Pedro Vaqué
- Molecular Biology Department, Universidad de Cantabria-Instituto de Investigación Marqués de Valdecilla, IDIVAL, Santander, Spain.
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18
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Sugaya M. Clinical Guidelines and New Molecular Targets for Cutaneous Lymphomas. Int J Mol Sci 2021; 22:ijms222011079. [PMID: 34681738 PMCID: PMC8537763 DOI: 10.3390/ijms222011079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 12/14/2022] Open
Abstract
Primary cutaneous lymphomas are heterogenous lymphoproliferative disorders. Some patients show rapid progression and the need for treatment of advanced disease is still unmet. The frequency of each subtype of cutaneous lymphoma varies among different ethnic groups, as do the medical systems found in different countries. It is important to know the differences in clinical guidelines in different areas of the world. Although current monochemotherapy with gemcitabine or pegylated liposomal doxorubicin is temporarily effective for mycosis funogides (MF) and Sézary syndrome (SS)-representative types of cutaneous lymphomas-the duration of response is usually limited. Therefore, treatment strategies targeting tumor-specific molecules have been developed. Molecular targets for MS/SS are currently CD30, CCR4, CD25, CD52, and histone deacetylases, most of which are surface molecules specifically expressed on tumor cells. As a result of advances in research techniques, different kinds of genomic alterations in MF/SS have been revealed. Molecular targets for MS/SS in the near future would be CD158k, JAK, PIK3, the mammalian target of rapamycin, and microRNAs, most of which mediate intracellular signaling pathways. Personalized therapy based on the detection of the genetic signatures of tumors and inhibition of the most suitable target molecules constitutes a future treatment strategy for MF/SS.
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Affiliation(s)
- Makoto Sugaya
- Department of Dermatology, International University of Health and Welfare, Chiba 286-8520, Japan
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19
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Genetic and epigenetic insights into cutaneous T-cell lymphoma. Blood 2021; 139:15-33. [PMID: 34570882 DOI: 10.1182/blood.2019004256] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 01/30/2021] [Indexed: 11/20/2022] Open
Abstract
Primary cutaneous T-cell lymphomas (CTCL) constitute a heterogeneous group of non-Hodgkin T-cell lymphomas that present in the skin. In recent years significant progress has been made in the understanding of the pathogenesis of CTCL. Progress in CTCL classifications combined with technical advances, in particular next generation sequencing (NGS), enabled a more detailed analysis of the genetic and epigenetic landscape and transcriptional changes in clearly defined diagnostic entities. These studies not only demonstrated extensive heterogeneity between different CTCL subtypes but also identified recurrent alterations that are highly characteristic for diagnostic subgroups of CTCL. The identified alterations in particular involve epigenetic remodelling, cell cycle regulation, and the constitutive activation of targetable, oncogenic pathways. In this respect, aberrant JAK-STAT signaling is a recurrent theme, however not universal for all CTCL and with seemingly different underlaying causes in different entities. A number of the mutated genes identified are potentially actionable targets for the development of novel therapeutic strategies. Moreover, these studies have produced an enormous amount of information that will be critically important for the further development of improved diagnostic and prognostic biomarkers that can assist in the clinical management of CTCL patients. In the present review the main findings of these studies in relation to their functional impact on the malignant transformation process are discussed for different subtypes of CTCL.
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20
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González-Rincón J, Garcia-Vela JA, Gómez S, Fernández-Cuevas B, Nova-Gurumeta S, Pérez-Sanz N, Alcoceba M, González M, Anguita E, López-Jiménez J, González-Barca E, Yáñez L, Pérez-Persona E, de la Serna J, Fernández-Zarzoso M, Deben G, Peñalver FJ, Fernández MC, de Oteyza JP, Andreu MÁ, Ruíz-Guinaldo MÁ, Paz-Arias R, García-Malo MD, Recasens V, Collado R, Córdoba R, Navarro-Matilla B, Sánchez-Beato M, García-Marco JA. Genomic mutation profile in progressive chronic lymphocytic leukemia patients prior to first-line chemoimmunotherapy with FCR and rituximab maintenance (REM). PLoS One 2021; 16:e0257353. [PMID: 34506616 PMCID: PMC8432772 DOI: 10.1371/journal.pone.0257353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 08/24/2021] [Indexed: 11/18/2022] Open
Abstract
Chronic Lymphocytic Leukemia (CLL) is the most prevalent leukemia in Western countries and is notable for its variable clinical course. This variability is partly reflected by the mutational status of IGHV genes. Many CLL samples have been studied in recent years by next-generation sequencing. These studies have identified recurrent somatic mutations in NOTCH1, SF3B1, ATM, TP53, BIRC3 and others genes that play roles in cell cycle, DNA repair, RNA metabolism and splicing. In this study, we have taken a deep-targeted massive sequencing approach to analyze the impact of mutations in the most frequently mutated genes in patients with CLL enrolled in the REM (rituximab en mantenimiento) clinical trial. The mutational status of our patients with CLL, except for the TP53 gene, does not seem to affect the good results obtained with maintenance therapy with rituximab after front-line FCR treatment.
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Affiliation(s)
- Julia González-Rincón
- Lymphoma Research Group, Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDPHISA), Madrid, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | | | - Sagrario Gómez
- Lymphoma Research Group, Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDPHISA), Madrid, Spain
| | - Belén Fernández-Cuevas
- Hematology Department, Hospital Universitario Puerta de Hierro-Majadahonda and Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA), Madrid, Spain
| | - Sara Nova-Gurumeta
- Hematology Department, Hospital Universitario Puerta de Hierro-Majadahonda and Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA), Madrid, Spain
| | - Nuria Pérez-Sanz
- Hematology Department, Hospital Universitario Puerta de Hierro-Majadahonda and Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA), Madrid, Spain
| | - Miguel Alcoceba
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Hematology, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Marcos González
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Hematology, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Eduardo Anguita
- Hematology, Hospital Clínico San Carlos, IdISSC, UCM, Madrid, Spain
| | | | - Eva González-Barca
- Hematology, Institut Català d’Oncologia, IDIBELL, L’Hospitalet de LLobregat, Spain
| | - Lucrecia Yáñez
- Hematology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | - Rosa Collado
- Citogenetics and molecular biology laboratory, Consorcio Hospital General Universitario, Valencia, Spain
| | - Raúl Córdoba
- Hematology, Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - Belén Navarro-Matilla
- Hematology Department, Hospital Universitario Puerta de Hierro-Majadahonda and Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA), Madrid, Spain
| | - Margarita Sánchez-Beato
- Lymphoma Research Group, Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDPHISA), Madrid, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- * E-mail: (MSB); (JAGM)
| | - José A. García-Marco
- Hematology Department, Hospital Universitario Puerta de Hierro-Majadahonda and Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA), Madrid, Spain
- * E-mail: (MSB); (JAGM)
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Nihal M, Wu J, Stonesifer CJ, Daniels J, Choi J, Geskin L, Rook AH, Wood GS. Epigenetic Regulation of Apoptosis in Cutaneous T-Cell Lymphoma: Implications for Therapy with Methotrexate, Jak Inhibitors, and Resveratrol. J Invest Dermatol 2021; 142:493-496.e7. [PMID: 34358529 DOI: 10.1016/j.jid.2021.06.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 06/22/2021] [Accepted: 06/27/2021] [Indexed: 01/12/2023]
Affiliation(s)
- Minakshi Nihal
- Department of Dermatology, The School of Medicine and Public Health, University of Wisconsin and William S. Middleton VAMC, Madison, Wisconsin, USA.
| | - Jianqiang Wu
- Department of Dermatology, The School of Medicine and Public Health, University of Wisconsin and William S. Middleton VAMC, Madison, Wisconsin, USA
| | - Connor J Stonesifer
- Department of Dermatology, Irving Medical Center, Columbia University, New York, New York, USA
| | - Jay Daniels
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Jaehyuk Choi
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Larisa Geskin
- Department of Dermatology, Irving Medical Center, Columbia University, New York, New York, USA
| | - Alain H Rook
- Department of Dermatology, Penn Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Gary S Wood
- Department of Dermatology, The School of Medicine and Public Health, University of Wisconsin and William S. Middleton VAMC, Madison, Wisconsin, USA
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22
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Xu S, Foss F. New nonchemotherapy treatment options for cutaneous T-cell lymphomas. Expert Rev Anticancer Ther 2021; 21:1017-1028. [PMID: 33554707 DOI: 10.1080/14737140.2021.1882859] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The most common types of CTCL are mycosis fungoides (MF) and Sézary syndrome (SS). In both MF and SS, complete responses to treatment are uncommon. Recent developments and understanding of the biology of MF/SS have led to novel agents which may offer prolonged responses with less toxicity compared to conventional chemotherapy approaches. AREAS COVERED In this review, we discuss the efficacy and safety of new nonchemotherapy treatment options including antibody agents, small molecule inhibitors, fusion proteins, and CAR T-cell therapy. We also reflect on older immunomodulatory treatments including retinoids and histone deacetylase inhibitors. EXPERT OPINION Patients with MF/SS who require systemic therapy often progress through multiple agents sequentially, thus the need for additional novel agents in the treatment armamentarium. Antibody-based therapies such as alemtuzumab are highly effective in the blood compartment of disease, while brentuximab vedotin has shown higher activity in skin and lymph nodes. Checkpoint inhibitors may play a role in treating MF/SS but may induce hyperprogression, and engineered T cells and bispecific antibodies recruiting immune effectors are being developed and may show promise in the future.
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Affiliation(s)
- Suzanne Xu
- Yale University School of Medicine, New Haven, United States
| | - Francine Foss
- Hematology and Stem Cell Transplantation, Yale University School of Medicine, New Haven, United States
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JAK inhibition synergistically potentiates BCL2, BET, HDAC, and proteasome inhibition in advanced CTCL. Blood Adv 2021; 4:2213-2226. [PMID: 32437546 DOI: 10.1182/bloodadvances.2020001756] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 04/08/2020] [Indexed: 12/14/2022] Open
Abstract
Cutaneous T-cell lymphoma (CTCL) is a malignancy of skin-homing T lymphocytes that is more likely to involve the peripheral blood in advanced stages. For such patients with advanced disease, there are few available systemic treatment options, and prognosis remains poor. Exome sequencing studies of CTCL have suggested therapeutic targets, including within the JAK/STAT pathway, but JAK inhibition strategies may be limited by patient-specific mutational status. Because our recent research has highlighted the potential roles of single and combination approaches specifically using BCL2, bromodomain and extra-terminal domain (BET), and histone deacetylase (HDAC) inhibition, we aimed to investigate the effects of JAK inhibition on CTCL cells and established CTCL cell lines when paired with these and other targeting agents. Peripheral blood malignant CTCL isolates exhibited differential responses to JAK inhibition, with JAK2 expression levels negatively correlating to 50% inhibitory concentration (IC50) values. Regardless of single-agent sensitivity, JAK inhibition potentiated malignant cell cytotoxicity in combination with BCL2, BET, HDAC, or proteasome inhibition. Combination inhibition of JAK and BCL2 showed the strongest potentiation of CTCL cytotoxicity, driven by both intrinsic and extrinsic apoptosis pathways. JAK inhibition decreased expression of BCL2 in the high-responder samples, suggesting a putative mechanism for this combination activity. These results indicate that JAK inhibition may have major effects on CTCL cells, and that combination strategies using JAK inhibition may allow for more generalized cytotoxic effects against the malignant cells from patients with CTCL. Such preclinical assessments help inform prioritization for combination targeted drug approaches for clinical utilization in the treatment of CTCL.
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Fasouli ES, Katsantoni E. JAK-STAT in Early Hematopoiesis and Leukemia. Front Cell Dev Biol 2021; 9:669363. [PMID: 34055801 PMCID: PMC8160090 DOI: 10.3389/fcell.2021.669363] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 04/20/2021] [Indexed: 12/14/2022] Open
Abstract
Hematopoietic stem cells (HSCs) produce all the terminally differentiated blood cells and are controlled by extracellular signals from the microenvironment, the bone marrow (BM) niche, as well as intrinsic cell signals. Intrinsic signals include the tightly controlled action of signaling pathways, as the Janus kinase-signal transducer and activator of transcription (JAK-STAT) pathway. Activation of JAK-STAT leads to phosphorylation of members of the STAT family to regulate proliferation, survival, and self-renewal of HSCs. Mutations in components of the JAK-STAT pathway are linked with defects in HSCs and hematologic malignancies. Accumulating mutations in HSCs and aging contribute to leukemia transformation. Here an overview of hematopoiesis, and the role of the JAK-STAT pathway in HSCs and in the promotion of leukemic transformation is presented. Therapeutic targeting of JAK-STAT and clinical implications of the existing research findings are also discussed.
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Affiliation(s)
- Eirini Sofia Fasouli
- Basic Research Center, Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Eleni Katsantoni
- Basic Research Center, Biomedical Research Foundation, Academy of Athens, Athens, Greece
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Mycosis Fungoides and Sézary Syndrome: An Integrative Review of the Pathophysiology, Molecular Drivers, and Targeted Therapy. Cancers (Basel) 2021; 13:cancers13081931. [PMID: 33923722 PMCID: PMC8074086 DOI: 10.3390/cancers13081931] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 12/29/2022] Open
Abstract
Simple Summary In the last few years, the field of cutaneous T-cell lymphomas has experienced major advances. In the context of an active translational and clinical research field, next-generation sequencing data have boosted our understanding of the main molecular mechanisms that govern the biology of these entities, thus enabling the development of novel tools for diagnosis and specific therapy. Here, we focus on mycosis fungoides and Sézary syndrome; we review essential aspects of their pathophysiology, provide a rational mechanistic interpretation of the genomic data, and discuss the current and upcoming therapies, including the potential crosstalk between genomic alterations and the microenvironment, offering opportunities for targeted therapies. Abstract Primary cutaneous T-cell lymphomas (CTCLs) constitute a heterogeneous group of diseases that affect the skin. Mycosis fungoides (MF) and Sézary syndrome (SS) account for the majority of these lesions and have recently been the focus of extensive translational research. This review describes and discusses the main pathobiological manifestations of MF/SS, the molecular and clinical features currently used for diagnosis and staging, and the different therapies already approved or under development. Furthermore, we highlight and discuss the main findings illuminating key molecular mechanisms that can act as drivers for the development and progression of MF/SS. These seem to make up an orchestrated constellation of genomic and environmental alterations generated around deregulated T-cell receptor (TCR)/phospholipase C, gamma 1, (PLCG1) and Janus kinase/ signal transducer and activator of transcription (JAK/STAT) activities that do indeed provide us with novel opportunities for diagnosis and therapy.
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Rendón-Serna N, Correa-Londoño LA, Velásquez-Lopera MM, Bermudez-Muñoz M. Cell signaling in cutaneous T-cell lymphoma microenvironment: promising targets for molecular-specific treatment. Int J Dermatol 2021; 60:1462-1480. [PMID: 33835479 DOI: 10.1111/ijd.15451] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 12/31/2020] [Accepted: 01/12/2021] [Indexed: 01/01/2023]
Abstract
Cutaneous T-cell lymphomas (CTCL) result from the infiltration and proliferation of a population of T cells in the skin, inducing changes in the activity of both T cells and surrounding skin cells. In the CTCL microenvironment, cell interactions mediated by cell signaling pathways are altered. Defining changes in cell signaling enables to understand T-cell deregulations in the CTCL microenvironment and thus the progression of the disease. Moreover, characterizing signaling networks activated in CTCL stages can lead to consider new molecular biomarkers and therapeutic targets. Focusing on mycosis fungoides (MF), the most frequent variant of CTCL, and Sézary syndrome (SS), its leukemic variant, this review highlights recent molecular and genetic findings revealing modifications of key signaling pathways involved in (1) cell proliferation, cell growth, and cell survival such as MAP kinases and PI3K/Akt; (2) immune responses derived from TCR, TLR, JAK/STAT, and NF-kB; and (3) changes in tissue conditions such as extracellular matrix remodeling, hypoxia, and angiogenesis. Alterations in these signaling networks promote malignant T-cell proliferation and survival, T-cell migration, inflammation, and suppression of immune regulation of malignant T cells, making a skin microenvironment that allows disease progression. Targeting key proteins of these signaling pathways, using molecules already available and used in research, in clinical trials, and with other disease indications, can open the way to different therapeutic options in CTCL treatment.
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Affiliation(s)
- Natalia Rendón-Serna
- Instituto de Biología, Universidad de Antioquia, Medellin, Colombia.,Centro de Investigaciones Dermatológicas CIDERM, Facultad de Medicina, Universidad De Antioquia, Medellin, Colombia
| | - Luis A Correa-Londoño
- Centro de Investigaciones Dermatológicas CIDERM, Facultad de Medicina, Universidad De Antioquia, Medellin, Colombia
| | - Margarita M Velásquez-Lopera
- Centro de Investigaciones Dermatológicas CIDERM, Facultad de Medicina, Universidad De Antioquia, Medellin, Colombia
| | - Maria Bermudez-Muñoz
- Instituto de Biología, Universidad de Antioquia, Medellin, Colombia.,Centro de Investigaciones Dermatológicas CIDERM, Facultad de Medicina, Universidad De Antioquia, Medellin, Colombia
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Karagianni F, Piperi C, Mpakou V, Spathis A, Foukas PG, Dalamaga M, Pappa V, Papadavid E. Ruxolitinib with resminostat exert synergistic antitumor effects in Cutaneous T-cell Lymphoma. PLoS One 2021; 16:e0248298. [PMID: 33705488 PMCID: PMC7951910 DOI: 10.1371/journal.pone.0248298] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 02/23/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The combination of JAK/STAT and HDAC inhibitors exerted beneficial effects in haematological malignancies, presenting promising therapeutic CTCL targets. We aim to investigate the efficacy of JAK1/2i ruxolitinib in combination with HDACi resminostat in CTCL in vitro. MATERIAL & METHODS Non-toxic concentrations of ruxolitinib and/or resminostat were administered to MyLa (MF) and SeAx (SS) cells for 24h. Cytotoxicity, cell proliferation and apoptosis were estimated through MTT, BrdU/7AAD and Annexin V/PI assay. Multi-pathway analysis was performed to investigate the effect of JAK1/2i and/or HDACi on JAK/STAT, Akt/mTOR and MAPK signalling pathways. RESULTS Both drugs and their combination were cytotoxic in MyLa (p<0.05) and in SeAx cell line (p<0.001), inhibited proliferation of MyLa (p<0.001) and SeAx (p<0.001) at 24h, compared to untreated cells. Moreover, combined drug treatment induced apoptosis after 24h (p<0.001) in MyLa, and SeAx (p<0.001). The combination of drugs had a strong synergistic effect with a CI<1. Importantly, the drugs' combination inhibited phosphorylation of STAT3 (p<0.001), Akt (p<0.05), ERK1/2 (p<0.001) and JNK (p<0.001) in MyLa, while it reduced activation of Akt (p<0.05) and JNK (p<0.001) in SeAx. CONCLUSION The JAKi/HDACi combination exhibited substantial anti-tumor effects in CTCL cell lines, and may represent a promising novel therapeutic modality for CTCL patients.
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Affiliation(s)
- Fani Karagianni
- 2nd Department of Dermatology and Venereal Diseases, NKUA, Athens, Greece
- * E-mail:
| | | | - Vassiliki Mpakou
- Second Department of Internal Medicine and Research Institute, Attikon University General Hospital, NKUA, Athens, Greece
| | - Aris Spathis
- Second Department of Pathology, National and Kapodistrian University of Athens, Athens, Greece
| | - Periklis G. Foukas
- Second Department of Pathology, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Dalamaga
- 2nd Department of Dermatology and Venereal Diseases, NKUA, Athens, Greece
- Department of Biological Chemistry, NKUA, Athens, Greece
| | - Vasiliki Pappa
- Second Department of Internal Medicine and Research Institute, Attikon University General Hospital, NKUA, Athens, Greece
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Jimura N, Fujii K, Qiao Z, Tsuchiya R, Yoshimatsu Y, Kondo T, Kanekura T. Kinome profiling analysis identified Src pathway as a novel therapeutic target in combination with histone deacetylase inhibitors for cutaneous T-cell lymphoma. J Dermatol Sci 2021; 101:194-201. [PMID: 33531202 DOI: 10.1016/j.jdermsci.2021.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 12/26/2020] [Accepted: 01/13/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Histone deacetylase inhibitors (HDACi) are used to treat patients with cutaneous T-cell lymphoma (CTCL), but they show limited efficacy. Hence, combination therapies should be explored to enhance the effectiveness of HDACis. OBJECTIVE This study was conducted to identify novel therapeutic targets that can be combined with HDACis for treating CTCL. METHODS We performed a global kinome profiling assay of three CTCL cell lines (HH, MJ, and Hut78) with three HDACis (romidepsin, vorinostat, and belinostat) using the PamChip® microarray. The three cell lines were co-treated with romidepsin and an inhibitor against the tyrosine kinase pathway. RESULTS Principal component analysis revealed that kinome expression patterns were mainly related to the cell origin and were not affected by the drugs. Few kinases were commonly activated by the HDACis. Most identified kinases were Src-associated molecules, such as annexin A2, embryonal Fyn-associated substrate, and progesterone receptor. Phosphorylated Src was not observed in any untreated cell lines, whereas Src phosphorylation was detected in two of the three cell lines after HDACi treatment. Ponatinib, a Src inhibitor, significantly enhanced romidepsin-induced apoptosis not only in HH, MJ, and Hut78 cells, but also in Myla and SeAx CTCL cell lines. CONCLUSION The Src pathway is a possible target for combination therapy involving HDACis for CTCL.
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Affiliation(s)
- Nozomi Jimura
- Department of Dermatology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan; Division of Rare Cancer Research, National Cancer Center Research Institute, Tokyo, Japan
| | - Kazuyasu Fujii
- Department of Dermatology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan; Division of Rare Cancer Research, National Cancer Center Research Institute, Tokyo, Japan.
| | - Zhiwei Qiao
- Division of Rare Cancer Research, National Cancer Center Research Institute, Tokyo, Japan
| | - Ryuto Tsuchiya
- Division of Rare Cancer Research, National Cancer Center Research Institute, Tokyo, Japan
| | - Yuki Yoshimatsu
- Division of Rare Cancer Research, National Cancer Center Research Institute, Tokyo, Japan
| | - Tadashi Kondo
- Division of Rare Cancer Research, National Cancer Center Research Institute, Tokyo, Japan; Department of Innovative Seeds Evaluation, National Cancer Center Research Institute, Tokyo, Japan
| | - Takuro Kanekura
- Department of Dermatology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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JAK3 Is Expressed in the Nucleus of Malignant T Cells in Cutaneous T Cell Lymphoma (CTCL). Cancers (Basel) 2021; 13:cancers13020280. [PMID: 33466582 PMCID: PMC7828698 DOI: 10.3390/cancers13020280] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/19/2020] [Accepted: 01/11/2021] [Indexed: 12/15/2022] Open
Abstract
Simple Summary JAK3 plays an important role in the pathogenesis of cutaneous T cell lymphoma. JAK3 belongs to the Janus kinase family of receptor-associated tyrosine kinases located in cytoplasm adjacent to the plasma membrane. In this study, we show that JAK3 can also be ectopically expressed in the nucleus in CTCL cell lines and primary cells from CTCL patients. Importantly, JAK3 interacts with the nuclear protein RNA polymerase II and phosphorylates Histone H3. Thus, our data provide first evidence for nuclear expression of JAK3 and interactions with key nuclear proteins in malignant T cells suggesting a novel non-canonical role in CTCL. Abstract Perturbation in JAK-STAT signaling has been reported in the pathogenesis of cutaneous T cell lymphoma (CTCL). JAK3 is predominantly associated with the intra-cytoplasmic part of IL-2Rγc located in the plasma membrane of hematopoietic cells. Here we demonstrate that JAK3 is also ectopically expressed in the nucleus of malignant T cells. We detected nuclear JAK3 in various CTCL cell lines and primary malignant T cells from patients with Sézary syndrome, a leukemic variant of CTCL. Nuclear localization of JAK3 was independent of its kinase activity whereas STAT3 had a modest effect on nuclear JAK3 expression. Moreover, JAK3 nuclear localization was only weakly affected by blockage of nuclear export. An inhibitor of the nuclear export protein CRM1, Leptomycin B, induced an increased expression of SOCS3 in the nucleus, but only a weak increase in nuclear JAK3. Importantly, immunoprecipitation experiments indicated that JAK3 interacts with the nuclear protein POLR2A, the catalytic subunit of RNA Polymerase II. Kinase assays showed tyrosine phosphorylation of recombinant human Histone H3 by JAK3 in vitro—an effect which was blocked by the JAK inhibitor (Tofacitinib citrate). In conclusion, we provide the first evidence of nuclear localization of JAK3 in malignant T cells. Our findings suggest that JAK3 may have a cytokine-receptor independent function in the nucleus of malignant T cells, and thus a novel non-canonical role in CTCL.
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30
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Epigenetic Silencing of Tumor Suppressor miR-124 Directly Supports STAT3 Activation in Cutaneous T-Cell Lymphoma. Cells 2020; 9:cells9122692. [PMID: 33333886 PMCID: PMC7765332 DOI: 10.3390/cells9122692] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/03/2020] [Accepted: 12/07/2020] [Indexed: 12/12/2022] Open
Abstract
Increasing evidence supports a potential role for STAT3 as a tumor driver in cutaneous T-cell lymphomas (CTCL). The mechanisms leading to STAT3 activation are not fully understood; however, we recently found that miR-124, a known STAT3 regulator, is robustly silenced in MF tumor-stage and CTCL cells. Objective: We studied here whether deregulation of miR-124 contributes to STAT3 pathway activation in CTCL. Methods: We measured the effect of ectopic mir-124 expression in active phosphorylated STAT3 (p-STAT3) levels and evaluated the transcriptional impact of miR-124-dependent STAT3 pathway regulation by expression microarray analysis. Results: We found that ectopic expression of miR-124 results in massive downregulation of activated STAT3 in different CTCL lines, which resulted in a significant alteration of genetic signatures related with gene transcription and proliferation such as MYC and E2F. Conclusions: Our study highlights the importance of the miR-124/STAT3 axis in CTCL and demonstrates that the STAT3 pathway is regulated through epigenetic mechanisms in these cells. Since deregulated STAT3 signaling has a major impact on CTCL initiation and progression, a better understanding of the molecular basis of the miR-124/STAT3 axis may provide useful information for future personalized therapies.
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Trochopoulos AGX, Zaharieva MM, Marinova MH, Yoncheva K, Tibi IPE, Berger MR, Konstantinov SM. Antineoplastic effect of a novel nanosized curcumin on cutaneous T cell lymphoma. Oncol Lett 2020; 20:304. [PMID: 33093913 PMCID: PMC7573878 DOI: 10.3892/ol.2020.12167] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 08/11/2020] [Indexed: 12/19/2022] Open
Abstract
Cutaneous T cell lymphomas (CTCLs) are a group of heterogeneous, life-threatening, extra-nodal and lymphoproliferative T cell neoplasms. Since chronic inflammation serves a key role in CTCL progression, curcumin, a natural pigment with proven anti-inflammatory and antineoplastic properties, as well as minimal toxicity, may be used as a therapeutic agent. In the present study, two formulations of curcumin (standard ethanolic and a Pluronic®P-123/F-127 micellar solution) were compared regarding their cytotoxic efficacy and speed of internalization in three CTCL cell lines, namely HuT-78, HH and MJ. In addition, the modulating effect of curcumin on selected proteins involved in the proliferation and progression of the disease was determined. The results indicated the superiority of the Pluronic®P-123/F-127 micellar curcumin over the standard ethanol solution in terms of cellular internalization efficiency as determined by spectrophotometric analysis. Notably, the presence of commonly used media components, such as phenol red, may interfere when interpreting the cytotoxicity of curcumin, due to their overlapping absorbance peaks. Therefore, it was concluded that phenol red-free media are superior over media with phenol red in order to correctly measure the cytotoxic efficacy and cell penetration of curcumin. Depending on the cell line, the IC50 values of micellar curcumin varied from 29.76 to 1.24 µΜ, with HH cells demonstrating the highest sensitivity. This cell line had the lowest expression levels of the Wilms' tumor-1 transcription factor. Performing western blot analyses of treated and untreated CTCL cells, selective signal transduction changes were recorded for the first time, thus making curcumin nano-formulation an attractive and prospective option with therapeutic relevance for CTCL as a rare orphan disease.
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Affiliation(s)
- Antonios G X Trochopoulos
- Department of Pharmacology, Pharmacotherapy and Toxicology, Faculty of Pharmacy, Medical University of Sofia, 1000 Sofia, Bulgaria
| | - Maya M Zaharieva
- Department of Infectious Microbiology, Institute of Microbiology 'Stephan Angeloff', Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria
| | - Mirela H Marinova
- Department of Pharmacology, Pharmacotherapy and Toxicology, Faculty of Pharmacy, Medical University of Sofia, 1000 Sofia, Bulgaria
| | - Krasimira Yoncheva
- Department of Pharmaceutical Technology and Biopharmaceutics, Faculty of Pharmacy, Medical University of Sofia, 1000 Sofia, Bulgaria
| | - Ivanka Pencheva-El Tibi
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Medical University of Sofia, 1000 Sofia, Bulgaria
| | - Martin R Berger
- Unit of Toxicology and Chemotherapy, German Cancer Research Center, D-69120 Heidelberg, Germany
| | - Spiro M Konstantinov
- Department of Pharmacology, Pharmacotherapy and Toxicology, Faculty of Pharmacy, Medical University of Sofia, 1000 Sofia, Bulgaria
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Brouwer IJ, Out-Luiting JJ, Vermeer MH, Tensen CP. Cucurbitacin E and I target the JAK/STAT pathway and induce apoptosis in Sézary cells. Biochem Biophys Rep 2020; 24:100832. [PMID: 33102814 PMCID: PMC7569298 DOI: 10.1016/j.bbrep.2020.100832] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/21/2020] [Accepted: 10/02/2020] [Indexed: 02/08/2023] Open
Abstract
Cutaneous T-cell lymphomas and leukemias (CTCLs) are a heterogeneous group of extranodal non-Hodgkin's lymphomas. These are characterized by an accumulation of malignant CD4+ T-lymphocytes in the skin, lymph nodes, and peripheral blood. Novel treatment options are needed for patients who progress to advanced stage disease. Cucurbitacin I has previously shown promising results in Sézary syndrome (Sz). A plethora of cucurbitacins, however, have not yet been tested in CTCL. Herein, we investigated the effect of cucurbitacin E and I in two CTCL cell lines. We show that both cucurbitacins decrease viability and cause apoptosis in these cell lines, although HuT-78 was more affected than SeAx (IC50 of 17.38 versus 22.01 μM for cucurbitacin E and 13.36 versus 24.47 μM for cucurbitacin I). Moreover, both cucurbitacins decrease viability of primary cells of a Sz patient (56.46% for cucurbitacin E and 59.07% for cucurbitacin I). Furthermore, while JAK2 inhibition leads to decreased viability in SeAx cells (IC50 of 9.98 and 29.15 μM for AZD1480 and ruxolitinib respectively), both JAK1 and JAK3 do not. This suggests that JAK2 has a preferential role in promoting survival. Western blotting in SeAx cells revealed that both cucurbitacins inhibit STAT3 activation (P < 0.0001), while only cucurbitacin I inhibits STAT5 activation (P = 0.05). This suggests that STAT3 plays a preferential role in the mechanism of action of these cucurbitacins. Nevertheless, a role of STAT5 and JAK2 cannot be excluded and should be explored further. This knowledge could contribute to the development of effective therapies for CTCL and other malignancies involving dysfunction of the JAK/STAT pathway. Cucurbitacin E and I decrease viability and cause apoptosis in Sézary cell lines Both cucurbitacins decrease viability of primary cells of a Sézary patient STAT3 appears to play a role in the mechanism of action of cucurbitacin E and I
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Affiliation(s)
- Isabella J Brouwer
- Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Jacoba J Out-Luiting
- Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Maarten H Vermeer
- Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Cornelis P Tensen
- Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands
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Identification of tipifarnib sensitivity biomarkers in T-cell acute lymphoblastic leukemia and T-cell lymphoma. Sci Rep 2020; 10:6721. [PMID: 32317694 PMCID: PMC7174413 DOI: 10.1038/s41598-020-63434-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 03/27/2020] [Indexed: 01/14/2023] Open
Abstract
Patients diagnosed with T-cell leukemias and T-cell lymphomas (TCLs) still have a poor prognosis and an inadequate response to current therapies, highlighting the need for targeted treatments. We have analyzed the potential therapeutic value of the farnesyltransferase inhibitor, tipifarnib, in 25 TCL cell lines through the identification of genomic and/or immunohistochemical markers of tipifarnib sensitivity. More than half of the cell lines (60%) were considered to be sensitive. Tipifarnib reduced cell viability in these T-cell leukemia and TCL cell lines, induced apoptosis and modified the cell cycle. A mutational study showed TP53, NOTCH1 and DNMT3 to be mutated in 84.6%, 69.2% and 30.0% of sensitive cell lines, and in 62.5%, 0% and 0% of resistant cell lines, respectively. An immunohistochemistry study showed that p-ERK and RelB were associated as potential biomarkers of tipifarnib sensitivity and resistance, respectively. Data from RNA-seq show that tipifarnib at IC50 after 72 h downregulated a great variety of pathways, including those controlling cell cycle, metabolism, and ribosomal and mitochondrial activity. This study establishes tipifarnib as a potential therapeutic option in T-cell leukemia and TCL. The mutational state of NOTCH1, p-ERK and RelB could serve as potential biomarkers of tipifarnib sensitivity and resistance.
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Insights Into the Molecular and Cellular Underpinnings of Cutaneous T Cell Lymphoma. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2020; 93:111-121. [PMID: 32226341 PMCID: PMC7087059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Cutaneous T cell lymphoma (CTCL) is a rare malignancy of skin-homing T lymphocytes. Advances in whole exome sequencing have identified a vast number of both single nucleotide variants (SNVs) and genomic copy number alterations (GCNAs) as driver mutations present in CTCL cells. These alterations cluster within several key pathways - T cell/NF-κB/JAK-STAT activation, cell cycle dysregulation/apoptosis, and DNA structural dysregulation affecting gene expression - allowing the maintenance of a population of proliferating, activated malignant T lymphocytes. While much of the clinical spectrum, genetic alterations, and oncogenic behavior of CTCL have been elucidated, little is known about the etiology that underlies CTCL malignant transformation and progression. Herein, we review the epidemiology, clinical presentation, and pathophysiology of CTCL to provide a perspective on CTCL pathogenesis. We outline a series of alterations by which mature, activated T lymphocytes are endowed with apoptosis resistance and cutaneous persistence. Subsequent genomic alterations including the loss of chromosomal structural controls further promote proliferation and constitutive T cell activation. CTCL cells are both malignant cells and highly functional T cells that can have major cutaneous and immunologic effects on the patient, including the suppression of cell-mediated immunity that facilitates malignant cell expansion. A deeper understanding of the molecular and cellular underpinnings of CTCL can help guide clinical management as well as inform prognosis and therapeutic discovery.
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Walia R, Yeung CCS. An Update on Molecular Biology of Cutaneous T Cell Lymphoma. Front Oncol 2020; 9:1558. [PMID: 32039026 PMCID: PMC6987372 DOI: 10.3389/fonc.2019.01558] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 12/23/2019] [Indexed: 12/21/2022] Open
Abstract
Cutaneous T cell lymphomas represent a heterogenous group of lymphoproliferative disorders defined by clonal proliferation of T cells present in the skin. The latest WHO classification in 2016 and WHO-EORTC classification in 2018 has updated the classification of these entities based on the molecular profile. Research in the field of molecular genetics of CTCL has allowed a better understanding of the biology of these tumors and has helped to identify potential targets for therapy that can be tailored to individual patients. In this review, we discuss the latest developments in the molecular profile of CTCLs including biomarkers for diagnosis, prognosis, and potential therapeutic targets. We have also touched upon the utility of various molecular diagnostic modalities. For the purpose of this review, we researched papers in PubMed indexed journals in English literature published in the past 20 years using keywords CTCL, mycosis fungoides, molecular profile, molecular diagnosis, whole genome profile, genomic landscape, TCR clonality.
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Affiliation(s)
- Ritika Walia
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
| | - Cecilia C S Yeung
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States.,Department of Pathology, University of Washington, Seattle, WA, United States
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Xin P, Xu X, Deng C, Liu S, Wang Y, Zhou X, Ma H, Wei D, Sun S. The role of JAK/STAT signaling pathway and its inhibitors in diseases. Int Immunopharmacol 2020; 80:106210. [PMID: 31972425 DOI: 10.1016/j.intimp.2020.106210] [Citation(s) in RCA: 422] [Impact Index Per Article: 105.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 12/19/2019] [Accepted: 01/08/2020] [Indexed: 02/09/2023]
Abstract
The JAK/STAT signaling pathway is an universally expressed intracellular signal transduction pathway and involved in many crucial biological processes, including cell proliferation, differentiation, apoptosis, and immune regulation. It provides a direct mechanism for extracellular factors-regulated gene expression. Current researches on this pathway have been focusing on the inflammatory and neoplastic diseases and related drug. The mechanism of JAK/STAT signaling is relatively simple. However, the biological consequences of the pathway are complicated due to its crosstalk with other signaling pathways. In addition, there is increasing evidence indicates that the persistent activation of JAK/STAT signaling pathway is closely related to many immune and inflammatory diseases, yet the specific mechanism remains unclear. Therefore, it is necessary to study the detailed mechanisms of JAK/STAT signaling in disease formation to provide critical reference for clinical treatments of the diseases. In this review, we focus on the structure of JAKs and STATs, the JAK/STAT signaling pathway and its negative regulators, the associated diseases, and the JAK inhibitors for the clinical therapy.
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Affiliation(s)
- Ping Xin
- College of Pharmacy, Harbin Medical University-Daqing, Daqing 163319, China
| | - Xiaoyun Xu
- College of Pharmacy, Harbin Medical University-Daqing, Daqing 163319, China
| | - Chengjie Deng
- College of Pharmacy, Harbin Medical University-Daqing, Daqing 163319, China
| | - Shuang Liu
- College of Pharmacy, Harbin Medical University-Daqing, Daqing 163319, China
| | - Youzhi Wang
- Department of Medicinal Chemistry, School of Pharmacy, China Pharmaceutical University, Nanjing 210009, China
| | - Xuegang Zhou
- College of Pharmacy, Harbin Medical University-Daqing, Daqing 163319, China
| | - Hongxing Ma
- Clinical Laboratory Department, Najing Lishui People's Hospital, Zhongda Hospital Lishui Branch, Southeast University, Najing 211200, China
| | - Donghua Wei
- College of Pharmacy, Harbin Medical University-Daqing, Daqing 163319, China
| | - Shiqin Sun
- College of Pharmacy, Harbin Medical University-Daqing, Daqing 163319, China.
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Pérez C, Mondéjar R, García-Díaz N, Cereceda L, León A, Montes S, Durán Vian C, Pérez Paredes MG, González-Morán A, Alegre de Miguel V, Sanz Anquela JM, Frias J, Limeres MA, González LM, Martín Dávila F, Beltrán M, Mollejo M, Méndez JR, González MA, González García J, López R, Gómez A, Izquierdo F, Ramos R, Camacho C, Rodriguez-Pinilla SM, Martínez N, Vaqué JP, Ortiz-Romero PL, Piris MA. Advanced-stage mycosis fungoides: role of the signal transducer and activator of transcription 3, nuclear factor-κB and nuclear factor of activated T cells pathways. Br J Dermatol 2019; 182:147-155. [PMID: 31049933 DOI: 10.1111/bjd.18098] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND The malignant mechanisms that control the development of cutaneous T-cell lymphoma (CTCL) are beginning to be identified. Recent evidence suggests that disturbances in specific intracellular signalling pathways, such as RAS-mitogen-activated protein kinase, T-cell receptor (TCR)-phospholipase C gamma 1 (PLCG1)-nuclear factor of activated T cells (NFAT) and Janus kinase (JAK)-signal transducer and activator of transcription (STAT), may play an essential role in the pathogenesis of CTCL. OBJECTIVES To investigate the mechanisms controlling disease development and progression in mycosis fungoides (MF), the most common form of CTCL. METHODS We collected 100 samples that were submitted for diagnosis of, or a second opinion regarding, MF between 2001 and 2018, 80% of which were in the early clinical stages of the disease. Formalin-fixed paraffin-embedded tissues were used for histological review and to measure the expression by immunohistochemistry of surrogate markers of activation of the TCR-PLCG1-NFAT, JAK-STAT and NF-κB pathways. Folliculotropism and large-cell transformation were also examined. RESULTS NFAT and nuclear factor kappa B (NF-κB) markers showed a comparable activation status in early and advanced stages, while STAT3 activation was more frequent in advanced stages and was associated with large-cell transformation. Consistently with this observation, STAT3 activation occurred in parallel with MF progression in two initially MF-negative cases. A significant association of NFAT with NF-κB markers was also found, reflecting a common mechanism of activation in the two pathways. Genomic studies identified nine mutations in seven genes known to play a potential role in tumorigenesis in T-cell leukaemia/lymphoma, including PLCG1, JAK3 and STAT3, which underlies the activation of these key cell-survival pathways. A higher mutational allele frequency was detected in advanced stages. CONCLUSIONS Our results show that STAT3 is activated in advanced cases and is associated with large-cell transformation, while the activation of NFAT and NF-κB is maintained throughout the disease. These findings could have important diagnostic and therapeutic implications. What's already known about this topic? Mycosis fungoides is characterized by a clonal expansion of T cells in the skin. The mechanisms controlling disease development and progression are not fully understood. What does this study add? An association of the nuclear factor of activated T cells and nuclear factor kappa B pathways was found, which could reflect a common mechanism of activation. These pathways were activated in early and advanced stages at the same level. Signal transducer and activator of transcription 3 activation was associated with large-cell transformation and was more frequent in advanced stages. A genomic analysis of cutaneous T-cell lymphoma-associated genes was performed. Nine mutations were detected. What is the translational message? These results could have important implications for the treatment of MF in the near future.
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Affiliation(s)
- C Pérez
- Translational Hematopathology, Instituto de Investigación Marqués de Valdecilla, IDIVAL, Santander, Spain.,Centro de Investigación Biomédica en Red Cáncer, Madrid, Spain
| | - R Mondéjar
- Translational Hematopathology, Instituto de Investigación Marqués de Valdecilla, IDIVAL, Santander, Spain.,Centro de Investigación Biomédica en Red Cáncer, Madrid, Spain.,Service of Pathology, Fundación Jiménez Díaz University Hospital, Madrid, Spain
| | - N García-Díaz
- Departamento de Biología Molecular, Universidad de Cantabria, Infección, Inmunidad y Patología Digestive, Instituto de Investigación Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - L Cereceda
- Centro de Investigación Biomédica en Red Cáncer, Madrid, Spain.,Service of Pathology, Fundación Jiménez Díaz University Hospital, Madrid, Spain
| | - A León
- Pathology Service, Marqués de Valdecilla University Hospital, Santander, Spain
| | - S Montes
- Centro de Investigación Biomédica en Red Cáncer, Madrid, Spain.,Pathology Service, Marqués de Valdecilla University Hospital, Santander, Spain
| | - C Durán Vian
- Dermatology Service, Marqués de Valdecilla University Hospital, Santander, Spain
| | - M G Pérez Paredes
- Dermatology Service, Marqués de Valdecilla University Hospital, Santander, Spain
| | - A González-Morán
- Dermatology Service, Complejo Hospitalario de Ávila, Ávila, Spain
| | - V Alegre de Miguel
- Dermatology Service, Hospital General Universitario de Valencia, Valencia, Spain
| | - J M Sanz Anquela
- Cancer Registry and Pathology Department, Hospital Universitario Príncipe de Asturias and Department of Medicine and Medical Specialties, Faculty of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - J Frias
- Dermatology Service, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - M A Limeres
- Pathology Department, Hospital Universitario de Gran Canaria Doctor Negrín, Gran Canaria, Canarias, Spain
| | - L M González
- Pathology Service, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - F Martín Dávila
- Pathology Service, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - M Beltrán
- Pathology Service, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - M Mollejo
- Pathology Service, Complejo Hospitalario de Toledo, Toledo, Spain
| | - J R Méndez
- Pathology Service, Centro Médico de Asturias, Asturias, Spain
| | - M A González
- Pathology Service, Hospital San Pedro de Alcántara, Cáceres, Spain
| | - J González García
- Pathology Service, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - R López
- Pathology Service, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - A Gómez
- Pathology Service, Hospital de la Marina Baixa, Alicante, Spain
| | - F Izquierdo
- Pathology Service, Complejo Asistencial Universitario de León, León, Spain
| | - R Ramos
- Pathology Service, University Hospital Son Espases, Palma de Mallorca, Spain
| | - C Camacho
- Pathology Service, C.H.U. Insular - Materno Infantil, Gran Canarias, Spain
| | - S M Rodriguez-Pinilla
- Centro de Investigación Biomédica en Red Cáncer, Madrid, Spain.,Service of Pathology, Fundación Jiménez Díaz University Hospital, Madrid, Spain
| | - N Martínez
- Translational Hematopathology, Instituto de Investigación Marqués de Valdecilla, IDIVAL, Santander, Spain.,Centro de Investigación Biomédica en Red Cáncer, Madrid, Spain
| | - J P Vaqué
- Departamento de Biología Molecular, Universidad de Cantabria, Infección, Inmunidad y Patología Digestive, Instituto de Investigación Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - P L Ortiz-Romero
- Centro de Investigación Biomédica en Red Cáncer, Madrid, Spain.,Dermatology Service, Hospital 12 de Octubre, Institute i+12 Medical School, University Complutense, Centro de Investigación Biomédica en Red Cáncer, Madrid, Spain
| | - M A Piris
- Centro de Investigación Biomédica en Red Cáncer, Madrid, Spain.,Service of Pathology, Fundación Jiménez Díaz University Hospital, Madrid, Spain
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Li Y, Wang X, Li Y, Ma R, Zhao Z, Ren J, Men J. Early changes in gene expression of the entire pathological process in Cutaneous T-cell lymphoma. J Cell Biochem 2019; 120:17472-17480. [PMID: 31106473 DOI: 10.1002/jcb.29011] [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: 10/28/2018] [Revised: 04/13/2019] [Accepted: 04/18/2019] [Indexed: 11/08/2022]
Abstract
In this study, we aimed to explore the time-course relating to the pathological progression of Cutaneous T-cell lymphoma (CTCL) and to identify the early changes in gene expression. The raw microarray data of CTCL was downloaded from the Gene Expression Omnibus database and a weighted gene coexpression network analysis was performed. A total of 2183 genes that positively correlated with the time course of CTCL development were identified in as part of the turquoise module as well as 1096 genes negatively correlated with the time course of CTCL development, which was identified in the blue module. To better understand the effects of these genes on prognosis, we further performed the Spearman correlation analysis, univariate Cox regression analysis, and Kaplan-Meier survival analysis. We identified 10 differentially expressed genes whose expression was significantly associated with prognosis in patients with CTCL. Our findings can help our understanding of the underlying mechanisms of CTCL as well as the development of novel drugs.
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Affiliation(s)
- Yang Li
- Precision Medicine Center, Tianjin Medical University General Hospital, Tianjin, China
| | - Xin Wang
- Precision Medicine Center, Tianjin Medical University General Hospital, Tianjin, China
| | - Yonggang Li
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Rui Ma
- Precision Medicine Center, Tianjin Medical University General Hospital, Tianjin, China
| | - Zilong Zhao
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Jing Ren
- Precision Medicine Center, Tianjin Medical University General Hospital, Tianjin, China
| | - Jianlong Men
- Precision Medicine Center, Tianjin Medical University General Hospital, Tianjin, China
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TÜRK C, OKAY M, TÜRK S, TEMİRCİ ES, JAVAD O, AKSU S, SAYINALP N, HAZNEDAROĞLU İC. The impact of JAK/STAT inhibitor ruxolitinib on the genesis of lymphoproliferative diseases. Turk J Med Sci 2019; 49:661-674. [PMID: 30997981 PMCID: PMC7018380 DOI: 10.3906/sag-1807-152] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background/aim Ruxolitinib, a JAK/STAT signaling pathway inhibitor targeted drug, has been approved for the controlling of disease symptoms and splenomegaly in patients with myeloproliferative neoplastic diseases. Recently, it has been proposed that ruxolitinib-induced JAK/STAT pathway inhibition in myelofibrosis is associated with an elevated frequency of aggressive B-cell lymphomas. However, the biological basis and significance of this pharmacobiological adverse event is unknown. The aim of this bioinformatics study is to detect any possible confounding effects of ruxolitinib on the genesis of lymphoproliferative disorders. Materials and methods The gene expression data were retrieved from the E-MTAB-783 Cancer Genome Project database. Gene expression data for all available genes in 26 cell lines belonging to various types of lymphomas were chosen for use in this in silico analysis. Results We identified genes that were significant in developing resistance to ruxolitinib in lymphoma cell lines. Conclusion Based on the results of our present study, ruxolitinib may potentially lead to the pathological expression of the transcription factors important in lymphoma genesis, neoplastic commitment on the progenitor lymphoid cells, inhibition of repressor transcriptions protective for lymphoma development, inhibition of apoptosis, promotion of neoplastic proliferation, transcriptional activation, and proliferation of malignant neoplastic B cells.
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Affiliation(s)
- Can TÜRK
- Department of Medical Microbiology, Faculty of Medicine, Lokman Hekim University, AnkaraTurkey
- * To whom correspondence should be addressed. E-mail:
| | - Müfide OKAY
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, AnkaraTurkey
| | - Seyhan TÜRK
- Department of Biochemistry, Faculty of Pharmacy, Hacettepe University, AnkaraTurkey
| | - Elif Sena TEMİRCİ
- Department of Molecular Biology and Genetics, Faculty of Science, Bilkent University, AnkaraTurkey
| | - Osama JAVAD
- Department of Molecular Biology and Genetics, Faculty of Science, Bilkent University, AnkaraTurkey
| | - Salih AKSU
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, AnkaraTurkey
| | - Nilgün SAYINALP
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, AnkaraTurkey
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Ciechanowicz P, Rakowska A, Sikora M, Rudnicka L. JAK-inhibitors in dermatology: current evidence and future applications. J DERMATOL TREAT 2018; 30:648-658. [DOI: 10.1080/09546634.2018.1546043] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Piotr Ciechanowicz
- Department of Dermatology, Medical University of Warsaw, Koszykowa 82a, Warsaw 00-008, Poland
| | - Adriana Rakowska
- Department of Dermatology, Medical University of Warsaw, Koszykowa 82a, Warsaw 00-008, Poland
| | - Mariusz Sikora
- Department of Dermatology, Medical University of Warsaw, Koszykowa 82a, Warsaw 00-008, Poland
| | - Lidia Rudnicka
- Department of Neuropeptides, Mossakowski Medical Research Centre Polish Academy of Science, Warsaw, Poland
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Oncogenic activation of the STAT3 pathway drives PD-L1 expression in natural killer/T-cell lymphoma. Blood 2018; 132:1146-1158. [PMID: 30054295 DOI: 10.1182/blood-2018-01-829424] [Citation(s) in RCA: 209] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 07/17/2018] [Indexed: 12/11/2022] Open
Abstract
Mature T-cell lymphomas, including peripheral T-cell lymphoma (PTCL) and extranodal NK/T-cell lymphoma (NKTL), represent a heterogeneous group of non-Hodgkin lymphomas with dismal outcomes and limited treatment options. To determine the extent of involvement of the JAK/STAT pathway in this malignancy, we performed targeted capture sequencing of 188 genes in this pathway in 171 PTCL and NKTL cases. A total of 272 nonsynonymous somatic mutations in 101 genes were identified in 73% of the samples, including 258 single-nucleotide variants and 14 insertions or deletions. Recurrent mutations were most frequently located in STAT3 and TP53 (15%), followed by JAK3 and JAK1 (6%) and SOCS1 (4%). A high prevalence of STAT3 mutation (21%) was observed specifically in NKTL. Novel STAT3 mutations (p.D427H, E616G, p.E616K, and p.E696K) were shown to increase STAT3 phosphorylation and transcriptional activity of STAT3 in the absence of cytokine, in which p.E616K induced programmed cell death-ligand 1 (PD-L1) expression by robust binding of activated STAT3 to the PD-L1 gene promoter. Consistent with these findings, PD-L1 was overexpressed in NKTL cell lines harboring hotspot STAT3 mutations, and similar findings were observed by the overexpression of p.E616K and p.E616G in the STAT3 wild-type NKTL cell line. Conversely, STAT3 silencing and inhibition decreased PD-L1 expression in STAT3 mutant NKTL cell lines. In NKTL tumors, STAT3 activation correlated significantly with PD-L1 expression. We demonstrated that STAT3 activation confers high PD-L1 expression, which may promote tumor immune evasion. The combination of PD-1/PD-L1 antibodies and STAT3 inhibitors might be a promising therapeutic approach for NKTL, and possibly PTCL.
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JAK Pseudokinase Domain Variants Highlight nRTK VUSs Identified with Next-Generation Sequencing in Solid Tumor Patients. Pathol Oncol Res 2018; 25:817-818. [PMID: 29862471 DOI: 10.1007/s12253-018-0443-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 05/30/2018] [Indexed: 01/12/2023]
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43
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Dippel E, Assaf C, Becker JC, von Bergwelt-Baildon M, Beyer M, Cozzio A, Eich HT, Follmann M, Grabbe S, Hillen U, Klapper W, Klemke CD, Lamos C, Loquai C, Meiß F, Mestel D, Nashan D, Nicolay JP, Oschlies I, Schlaak M, Stoll C, Vag T, Weichenthal M, Wobser M, Stadler R. S2k-Leitlinie - Kutane Lymphome Update 2016 - Teil 2: Therapie und Nachsorge (ICD10 C82 - C86). J Dtsch Dermatol Ges 2018; 16:112-123. [PMID: 29314698 DOI: 10.1111/ddg.13401_g] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
| | - Chalid Assaf
- Klinik für Dermatologie und Venerologie, Helios Klinikum Krefeld
| | | | | | - Marc Beyer
- Klinik für Dermatologie, Venerologie und Allergologie, Charité, Universitätsmedizin Berlin
| | - Antonio Cozzio
- Klinik für Dermatologie, Venerologie und Allergologie, Kantonsspital St. Gallen
| | - Hans Theodor Eich
- Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Münster
| | | | | | - Uwe Hillen
- Klinik für Dermatologie, Universitätsklinikum Essen
| | - Wolfram Klapper
- Institut für Pathologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - Claus-Detlev Klemke
- Hautklinik, Städtisches Klinikum Karlsruhe, Akademisches Lehrkrankenhaus der Universität Freiburg, Karlsruhe
| | | | | | - Frank Meiß
- Klinik für Dermatologie und Venerologie, Universitätsklinik Freiburg
| | | | | | - Jan P Nicolay
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinik Mannheim
| | - Ilske Oschlies
- Institut für Pathologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - Max Schlaak
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsklinik Köln
| | | | - Tibor Vag
- Nuklearmedizinische Klinik, Klinikum rechts der Isar, Technische Universität München
| | - Michael Weichenthal
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - Marion Wobser
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg
| | - Rudolf Stadler
- Klinik für Dermatologie, Venerologie, Allergologie und Phlebologie, Johannes Wesling Universitätsklinikum Minden, Universitätsklinikum der Ruhr-Universität Bochum
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Dippel E, Assaf C, Becker JC, von Bergwelt-Baildon M, Beyer M, Cozzio A, Eich HT, Follmann M, Grabbe S, Hillen U, Klapper W, Klemke CD, Lamos C, Loquai C, Meiß F, Mestel D, Nashan D, Nicolay JP, Oschlies I, Schlaak M, Stoll C, Vag T, Weichenthal M, Wobser M, Stadler R. S2k Guidelines - Cutaneous Lymphomas Update 2016 - Part 2: Treatment and Follow-up (ICD10 C82 - C86). J Dtsch Dermatol Ges 2017; 16:112-122. [DOI: 10.1111/ddg.13401] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Edgar Dippel
- Department of Dermatology; Ludwigshafen Medical Center; Ludwigshafen Germany
| | - Chalid Assaf
- Department of Dermatology and Venereology; Helios Medical Center; Krefeld Germany
| | - Jürgen C. Becker
- West German Tumor Center; University Medical Center; Essen Germany
| | | | - Marc Beyer
- Department of Dermatology, Venereology and Allergology; Charité University Medicine; Berlin Germany
| | - Antonio Cozzio
- Department of Dermatology, Venereology and Allergology; Canton Hospital; St. Gallen Switzerland
| | - Hans Theodor Eich
- Department of Radiation Oncology; University Medical Center; Münster Germany
| | | | - Stephan Grabbe
- Department of Dermatology; University Medicine; Mainz Germany
| | - Uwe Hillen
- Department of Dermatology; University Medical Center; Essen Germany
| | - Wolfram Klapper
- Institute of Pathology; Schleswig-Holstein University Medical Center; Kiel Germany
| | - Claus-Detlev Klemke
- Department of Dermatology, Karlsruhe Medical Center; Academic Teaching Hospital of the University of Freiburg; Karlsruhe Germany
| | - Cristina Lamos
- Department of Dermatology; Ludwigshafen Medical Center; Ludwigshafen Germany
| | - Carmen Loquai
- Department of Dermatology; University Medicine; Mainz Germany
| | - Frank Meiß
- Department of Dermatology and Venereology; University Medical Center; Freiburg Germany
| | - Dominik Mestel
- Pallas Kliniken AG; Center for Dermatology; Winterthur Switzerland
| | - Dorothee Nashan
- Department of Dermatology; Dortmund Medical Center; Dortmund Germany
| | - Jan P. Nicolay
- Department of Dermatology, Venereology and Allergology; University Medical Center; Mannheim Germany
| | - Ilske Oschlies
- Institute of Pathology; Schleswig-Holstein University Medical Center; Kiel Germany
| | - Max Schlaak
- Department of Dermatology and Venereology; University Medical Center; Cologne Germany
| | - Christoph Stoll
- Rehabilitation and Follow-up Treatment Center; Herzoghöhe Bayreuth Germany
| | - Tibor Vag
- Department of Nuclear Medicine; University Medical Center rechts der Isar; Technical University of Munich; Germany
| | - Michael Weichenthal
- Department of Dermatology, Venereology and Allergology; Schleswig-Holstein University Hospital; Campus in Kiel Germany
| | - Marion Wobser
- Department of Dermatology, Venereology and Allergology; University Medical Center; Würzburg Germany
| | - Rudolf Stadler
- Department of Dermatology, Venereology, Allergology and Phlebology, Johannes Wesling Medical Center, Minden, Germany (University Hospital of Ruhr University, Bochum, Germany)
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45
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Laribi K, Lemaire P, Sandrini J, Baugier de Materre A. Advances in the understanding and management of T-cell prolymphocytic leukemia. Oncotarget 2017; 8:104664-104686. [PMID: 29262669 PMCID: PMC5732835 DOI: 10.18632/oncotarget.22272] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 08/27/2017] [Indexed: 12/02/2022] Open
Abstract
T-prolymphocytic leukemia (T-PLL) is a rare T-cell neoplasm with an aggressive clinical course. Leukemic T-cells exhibit a post-thymic T-cell phenotype (Tdt-, CD1a-, CD5+, CD2+ and CD7+) and are generally CD4+/CD8-, but CD4+/CD8+ or CD8+/CD4- T-PLL have also been reported. The hallmark of T-PLL is the rearrangement of chromosome 14 involving genes for the subunits of the T-cell receptor (TCR) complex, leading to overexpression of the proto-oncogene TCL1. In addition, molecular analysis shows that T-PLL exhibits substantial mutational activation of the IL2RG-JAK1-JAK3-, STAT5B axis. T-PLL patients have a poor prognosis, due to a poor response to conventional chemotherapy. Monoclonal antibody therapy with antiCD52-alemtuzumab has considerably improved outcomes, but the responses to treatment are transient; hence, patients who achieve a response to therapy are considered for stem cell transplantation (SCT). This combined approach has extended the median survival to four years or more. Nevertheless, new approaches using well-tolerated therapies that target growth and survival signals are needed for most patients unable to receive intensive chemotherapy.
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Affiliation(s)
- Kamel Laribi
- Department of Hematology, Centre Hospitalier du Mans, Le Mans, France
| | - Pierre Lemaire
- Laboratory of Biology and Hematology, Centre Hospitalier du Mans, Le Mans, France
| | - Jeremy Sandrini
- Laboratory of Anatomopathology, Centre Hospitalier du Mans, Le Mans, France
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46
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Manso R, Sánchez-Beato M, González-Rincón J, Gómez S, Rojo F, Mollejo M, García-Cosio M, Menárguez J, Piris MA, Rodríguez-Pinilla SM. Mutations in the JAK/STAT pathway genes and activation of the pathway, a relevant finding in nodal Peripheral T-cell lymphoma. Br J Haematol 2017; 183:497-501. [PMID: 29076126 DOI: 10.1111/bjh.14984] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Rebeca Manso
- Pathology Department, Fundación Jiménez Díaz, UAM, Madrid, Spain
| | | | - Julia González-Rincón
- Instituto Investigación Sanitaria Puerta de Hierro-Majadahonda (IDIPHIM), Madrid, Spain.,Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Madrid, Spain
| | - Sagrario Gómez
- Instituto Investigación Sanitaria Puerta de Hierro-Majadahonda (IDIPHIM), Madrid, Spain
| | - Federico Rojo
- Pathology Department, Fundación Jiménez Díaz, UAM, Madrid, Spain
| | - Manuela Mollejo
- Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Madrid, Spain.,Pathology Department, Hospital Universitario Virgen de la Salud, Toledo, Spain
| | - Mónica García-Cosio
- Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Madrid, Spain.,Pathology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Javier Menárguez
- Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Madrid, Spain.,Pathology Department, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - Miguel A Piris
- Pathology Department, Fundación Jiménez Díaz, UAM, Madrid, Spain.,Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Madrid, Spain
| | - Socorro M Rodríguez-Pinilla
- Pathology Department, Fundación Jiménez Díaz, UAM, Madrid, Spain.,Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Madrid, Spain
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47
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Fusion of the genes ataxin 2 like, ATXN2L, and Janus kinase 2, JAK2, in cutaneous CD4 positive T-cell lymphoma. Oncotarget 2017; 8:103775-103784. [PMID: 29262599 PMCID: PMC5732765 DOI: 10.18632/oncotarget.21790] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 09/21/2017] [Indexed: 11/29/2022] Open
Abstract
Acquired mutations were recently described in cutaneous T-cell lymphomas for the JAK1, JAK3, STAT3, and STAT5B genes of the JAK-STAT pathway. In the present study, RNA-sequencing of a primary cutaneous CD4 positive T-cell lymphoma carrying a three-way t(9;13;16)(p24;q34;p11) chromosome translocation showed that JAK2 from chromosome band 9p24 was rearranged and fused to a novel partner gene, ATXN2L, from 16p11. RT-PCR together with Sanger sequencing verified the presence of the ATXN2L-JAK2 fusion transcript. The ATXN2L-JAK2 fusion gene would code for a chimeric protein containing all domains of ATXN2L and the catalytic domain of the JAK2 tyrosine kinase. The ATXN2L-JAK2 chimeric protein could lead to constitutive activation of the downstream JAK-STAT signaling pathway in a manner similar to that seen for other JAK2 fusion proteins.
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48
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Abstract
OPINION STATEMENT Cutaneous T cell lymphomas (CTCLs) are non-Hodgkin lymphomas of skin homing T cells. Although early-stage disease may be limited to the skin, tumor cells in later stage disease can populate the blood, the lymph nodes, and the visceral organs. Unfortunately, there are few molecular biomarkers to guide diagnosis, staging, or treatment of CTCL. Diagnosis of CTCL can be challenging and requires the synthesis of clinical findings, histopathology, and T cell clonality studies; however, none of these tests are entirely sensitive or specific for CTCL. Treatment of CTCL is often empiric and is not typically based on specific molecular alterations, as is common in other cancers. In part, limitations in diagnosis and treatment selection reflect the limited insight into the genetic basis of CTCL. Recent next-generation sequencing has revolutionized our understanding of the mutational landscape in this disease. These analyses have uncovered ultraviolet radiation and recombination activating gene (RAG) endonucleases as important mutagens. Furthermore, these studies have revealed potentially targetable oncogenic mutations in the T cell receptor complex, NF-κB, and JAK-STAT signaling pathways. Collectively, these somatic mutations drive lymphomagenesis via cancer-promoting changes in proliferation, apoptosis, and T cell effector function. We expect that these genetic findings will launch a new era of precision medicine in CTCL.
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49
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Mondejar R, Pérez C, Onaindia A, Martinez N, González-Rincón J, Pisonero H, Vaqué JP, Cereceda L, Santibañez M, Sánchez-Beato M, Piris MA. Molecular basis of targeted therapy in T/NK-cell lymphoma/leukemia: A comprehensive genomic and immunohistochemical analysis of a panel of 33 cell lines. PLoS One 2017; 12:e0177524. [PMID: 28505169 PMCID: PMC5432176 DOI: 10.1371/journal.pone.0177524] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 04/29/2017] [Indexed: 12/13/2022] Open
Abstract
T and NK-cell lymphoma is a collection of aggressive disorders with unfavorable outcome, in which targeted treatments are still at a preliminary phase. To gain deeper insights into the deregulated mechanisms promoting this disease, we searched a panel of 31 representative T-cell and 2 NK-cell lymphoma/leukemia cell lines for predictive markers of response to targeted therapy. To this end, targeted sequencing was performed alongside the expression of specific biomarkers corresponding to potentially activated survival pathways. The study identified TP53, NOTCH1 and DNMT3A as the most frequently mutated genes. We also found common alterations in JAK/STAT and epigenetic pathways. Immunohistochemical analysis showed nuclear accumulation of MYC (in 85% of the cases), NFKB (62%), p-STAT (44%) and p-MAPK (30%). This panel of cell lines captures the complexity of T/NK-cell lymphoproliferative processes samples, with the partial exception of AITL cases. Integrated mutational and immunohistochemical analysis shows that mutational changes cannot fully explain the activation of key survival pathways and the resulting phenotypes. The combined integration of mutational/expression changes forms a useful tool with which new compounds may be assayed.
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Affiliation(s)
- Rufino Mondejar
- Cancer Genomics Laboratory, Instituto de Investigación Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - Cristina Pérez
- Cancer Genomics Laboratory, Instituto de Investigación Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - Arantza Onaindia
- Pathology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Nerea Martinez
- Cancer Genomics Laboratory, Instituto de Investigación Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - Julia González-Rincón
- Lymphoma Research Group (Medical Oncology Service) Oncohematology Area, Instituto Investigación Sanitaria Puerta de Hierro-Majadahonda (IDIPHIM), Madrid, Spain
| | - Helena Pisonero
- Cancer Genomics Laboratory, Instituto de Investigación Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - Jose Pedro Vaqué
- Cancer Genomics Laboratory, Instituto de Investigación Marqués de Valdecilla, IDIVAL, Santander, Spain
- Instituto de Biomedicina y Biotecnología de Cantabria, IBBTEC (CSIC, Universidad de Cantabria), Departamento de Biología Molecular, Universidad de Cantabria, Santander, Spain
| | - Laura Cereceda
- Cancer Genomics Laboratory, Instituto de Investigación Marqués de Valdecilla, IDIVAL, Santander, Spain
| | | | - Margarita Sánchez-Beato
- Lymphoma Research Group (Medical Oncology Service) Oncohematology Area, Instituto Investigación Sanitaria Puerta de Hierro-Majadahonda (IDIPHIM), Madrid, Spain
| | - Miguel Angel Piris
- Cancer Genomics Laboratory, Instituto de Investigación Marqués de Valdecilla, IDIVAL, Santander, Spain
- Pathology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
- * E-mail:
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50
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Langerhans, plasmacytoid dendritic and myeloid-derived suppressor cell levels in mycosis fungoides vary according to the stage of the disease. Virchows Arch 2017; 470:575-582. [DOI: 10.1007/s00428-017-2107-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Revised: 01/14/2017] [Accepted: 03/09/2017] [Indexed: 01/28/2023]
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