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Pinto Á, Miranda J, Pertejo A, Álvarez-Maestro M, González-Peramato P, Aguilera A, García E, Trilla L, Gámez Á, Espinosa E. Different outcomes among patients with intermediate-risk metastastic renal cell carcinoma treated with first-line tyrosine-kinase inhibitors. Clin Transl Oncol 2024; 26:532-537. [PMID: 37505371 DOI: 10.1007/s12094-023-03274-7] [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: 05/08/2023] [Accepted: 07/03/2023] [Indexed: 07/29/2023]
Abstract
INTRODUCTION Systemic therapy of patients with metastatic renal cell carcinoma (mRCC) has improved in the past years, with the advent of new immunotherapy-based combinations as a standard treatment option for first-line therapy. Nevertheless, particularly in good-risk patients by IMDC criteria, tyrosine-kinase inhibitors (TKI) may remain as an option for some patients. We reviewed our experience with TKI as first-line therapy for mRCC patients, trying to identify subgroups of patients that may still benefit from this strategy. MATERIAL AND METHODS All patients with mRCC treated with first-line TKI, and adequate follow-up, in University Hospital La Paz (Madrid, Spain) between 2007 and 2020 were analyzed. Patients treated inside a clinical trial were excluded from this analysis. RESULTS A total of 90 patients treated with first-line TKI were included. Regarding IMDC criteria, 33 patients (36.7%) were good-risk, 41 patients (45.5%) intermediate-risk, and 16 patients (17.8%) poor-risk. With a median follow-up of 49 months, the median overall survival (OS) for good, intermediate, and poor-risk patients was 54, 24, and 16 months (p = 0.004). When intermediate-risk was divided into patients with 1 or 2 risk factors, differences in OS were also statistically significant: patients with 1 risk factor had a median OS of 33 months, while patients with 2 risk factors had a median OS of 16 months, the same as poor-risk patients (p = 0.003). In the multivariate analysis, trying to find out which of the IMDC factors had a more remarkable weight in the prognosis of the patients, both ECOG and hemoglobin levels by themselves were significantly associated with OS. CONCLUSION In our group of patients, survival outcomes were different among patients with intermediate-risk with 1 or 2 risk factors by IMDC criteria. These could help select patients that may benefit from first-line treatment with a TKI, particularly in settings with difficult access to novel therapies, such as immunotherapy-based combinations.
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Affiliation(s)
- Álvaro Pinto
- Medical Oncology Department, University Hospital La Paz-IdiPAZ, Paseo Castellana 261, 28046, Madrid, Spain.
| | - Jesús Miranda
- Medical Oncology Department, QuironSalud University Hospital, Madrid, Spain
| | - Ana Pertejo
- Medical Oncology Department, University Hospital La Paz-IdiPAZ, Paseo Castellana 261, 28046, Madrid, Spain
| | | | | | - Alfredo Aguilera
- Urology Department, University Hospital La Paz-IdiPAZ, Madrid, Spain
| | - Eugenia García
- Pathology Department, University Hospital La Paz-IdiPAZ, Madrid, Spain
| | - Lucía Trilla
- Molecular Oncology and Pathology Lab, University Hospital La Paz-IdiPAZ, Madrid, Spain
| | - Ángelo Gámez
- Molecular Oncology and Pathology Lab, University Hospital La Paz-IdiPAZ, Madrid, Spain
| | - Enrique Espinosa
- Medical Oncology Department, University Hospital La Paz-IdiPAZ, Paseo Castellana 261, 28046, Madrid, Spain
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Fukushima H, Turkbey B, Pinto PA, Furusawa A, Choyke PL, Kobayashi H. Near-Infrared Photoimmunotherapy (NIR-PIT) in Urologic Cancers. Cancers (Basel) 2022; 14:cancers14122996. [PMID: 35740662 PMCID: PMC9221010 DOI: 10.3390/cancers14122996] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/12/2022] [Accepted: 06/14/2022] [Indexed: 11/16/2022] Open
Abstract
Near-infrared photoimmunotherapy (NIR-PIT) is a novel molecularly-targeted therapy that selectively kills cancer cells by systemically injecting an antibody-photoabsorber conjugate (APC) that binds to cancer cells, followed by the application of NIR light that drives photochemical transformations of the APC. APCs are synthesized by selecting a monoclonal antibody that binds to a receptor on a cancer cell and conjugating it to IRDye700DX silica-phthalocyanine dye. Approximately 24 h after APC administration, NIR light is delivered to the tumor, resulting in nearly-immediate necrotic cell death of cancer cells while causing no harm to normal tissues. In addition, NIR-PIT induces a strong immunologic effect, activating anti-cancer immunity that can be further boosted when combined with either immune checkpoint inhibitors or immune suppressive cell-targeted (e.g., regulatory T cells) NIR-PIT. Currently, a global phase III study of NIR-PIT in recurrent head and neck squamous cell carcinoma is ongoing. The first APC and NIR laser systems were approved for clinical use in September 2020 in Japan. In the near future, the clinical applications of NIR-PIT will expand to other cancers, including urologic cancers. In this review, we provide an overview of NIR-PIT and its possible applications in urologic cancers.
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Affiliation(s)
- Hiroshi Fukushima
- Molecular Imaging Branch, Center for Cancer Research, National Cancer Institute (NIH), Bethesda, MD 20892, USA; (H.F.); (B.T.); (A.F.); (P.L.C.)
| | - Baris Turkbey
- Molecular Imaging Branch, Center for Cancer Research, National Cancer Institute (NIH), Bethesda, MD 20892, USA; (H.F.); (B.T.); (A.F.); (P.L.C.)
| | - Peter A. Pinto
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute (NIH), Bethesda, MD 20892, USA;
| | - Aki Furusawa
- Molecular Imaging Branch, Center for Cancer Research, National Cancer Institute (NIH), Bethesda, MD 20892, USA; (H.F.); (B.T.); (A.F.); (P.L.C.)
| | - Peter L. Choyke
- Molecular Imaging Branch, Center for Cancer Research, National Cancer Institute (NIH), Bethesda, MD 20892, USA; (H.F.); (B.T.); (A.F.); (P.L.C.)
| | - Hisataka Kobayashi
- Molecular Imaging Branch, Center for Cancer Research, National Cancer Institute (NIH), Bethesda, MD 20892, USA; (H.F.); (B.T.); (A.F.); (P.L.C.)
- Correspondence: ; Tel.: +1-240-858-3069; Fax: +1-240-541-4527
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Epigenetic inactivation of ACAT1 promotes epithelial-mesenchymal transition of clear cell renal cell carcinoma. Genes Genomics 2022; 44:487-497. [PMID: 34985712 DOI: 10.1007/s13258-021-01211-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 12/20/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Acetyl-CoA acyltransferase 1 (ACAT1) is a key enzyme catalyzing the production of mitochondrial ketone bodies. We have shown that ACAT1 is down-regulated in kidney renal clear cell carcinoma (KIRC) previously. OBJECTIVE To investigate the reasons for downregulation of ACAT1 in KIRC and explore the underlying mechanisms involved in metastatic inhibition regulated by ACAT1. METHODS The Gene Expression Omnibus (GEO) database was queried for meta-analysis of ACAT1 mRNA expression in KIRC. The UALCAN website was used to compare the methylation levels of the ACAT1 promoter region in KIRC and normal tissues. RT-qPCR was used to quantitate ACAT1 transcription levels. The GCBI and Tarbase V.8 databases were used to predict miRNAs that may target the mRNA of ACAT1. The correlation between mRNA expression of ACAT1, MMP7 (matrix metallopeptidase 7), CDH1 (E-cadherin), EpCAM (epithelial cell adhesion molecule), and VIM (vimentin) was analyzed. Extracellular MMP7 protein was quantitated using an ELISA assay. RESULTS The methylation level of the ACAT1 promoter region in KIRC was significantly higher than that in the normal kidney tissues. The ACAT1 mRNA expression in the KIRC cell lines was restored after treatment with 5-aza-dC (p < 0.05). MiR-21-5p is a conserved microRNA targeting ACAT1. It is expressed at a significantly higher level in KIRC than in normal tissues (p < 0.001). MiR-21-5p miRNA expression negatively correlates with ACAT1 mRNA expression. The expression of miR-21-5p is higher at the T3-T4 stages and in the histologic grades G3-G4. Patients with high miR-21-5p expression tended to have lower overall survival, suggesting that miR-21-5p could serve as a potentially valuable diagnostic biomarker for KIRC (AUC = 0.957; p < 0.001). A mimetic of miR-21-5p inhibited the expression of ACAT1 mRNA and protein. In addition, ACAT1 mRNA expression positively correlates with CDH1 and EpCAM but is negatively correlated with VIM. Overexpression of ACAT1 suppresses the secretion of MMP7 in KIRC cells. CONCLUSION Expression of ACAT1 in KIRC is controlled at two levels, firstly by the hypermethylation of the ACAT1 promoter region and secondly by overexpression of miR-21-5p. Downregulation of ACAT1 expression correlates with epithelial-mesenchymal transition (EMT).
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Zhang R, Wang W, Aimudula A, Lu S, Lu P, Aihaiti R, Bao Y. Quaking I-5 protein inhibits invasion and migration of kidney renal clear cell carcinoma via inhibiting epithelial-mesenchymal transition suppression through the regulation of microRNA 200c. Transl Androl Urol 2021; 10:3800-3814. [PMID: 34804823 PMCID: PMC8575590 DOI: 10.21037/tau-21-833] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/20/2021] [Indexed: 11/06/2022] Open
Abstract
Background It has been demonstrated that quaking I-5 protein (QKI-5) plays crucial roles in the metastasis of various kinds of cancers. However, the function and mechanism of QKI-5 in kidney renal clear cell carcinoma (KIRC) metastasis remains unclear. Therefore, this study aimed to explore the mechanism of QKI-5 in the metastasis of KIRC. Methods The expression of QKI-5 was detected using real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) and western blot in KIRC tissues and different cell lines. Immunohistochemical staining was used to detect the quantity of QKI-5 in primary and metastases of KIRC. Cell migration and invasion were measured using wound healing and transwell assays respectively. The quantity of epithelial mesenchymal transition marker proteins was detected using western blot and immunofluorescence staining. The interaction of QKI-5 via microRNA 200c (miR-200c) was confirmed using dual luciferase reporter assay. Results Although QKI-5 was significantly more likely to be downregulated in KIRC tissues than that in normal Kidney tissues, it was dramatically elevated in metastatic KIRC tumors. Upregulation of QKI-5 promoted cell migration and invasion and elevated the expression of epithelial-mesenchymal transition (EMT) marker proteins, including vimentin, snail and slug, while it was downregulated for E-cadherin. Furthermore, a dual luciferase reporter assay demonstrated that QKI-5 was a direct target of miR-200c, and that miR-200c could reverse the effect of QKI-5 on cell migration, invasion, and expression of EMT marker proteins. Conclusions Our results revealed that downregulation of QKI-5 by miR-200c attenuated KIRC migration and invasion via the EMT process, indicating that QKI-5 may be a potential therapeutic target and a key indicator of KIRC progression.
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Affiliation(s)
- Ruili Zhang
- Cancer Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Wenguang Wang
- Department of Urology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Ainiwaer Aimudula
- Cancer Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Songmei Lu
- Cancer Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Pengfei Lu
- Cancer Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Remila Aihaiti
- Cancer Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Yongxing Bao
- Cancer Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
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Agarwala V, Ramaswamy A, Joshi A, Patil VM, Noronha V, Menon S, Popat BP, Sable N, Prabhash K. Treatment outcomes of metastatic nonclear cell renal cell carcinoma: A single institution retrospective analysis. South Asian J Cancer 2020; 7:226-230. [PMID: 30430089 PMCID: PMC6190394 DOI: 10.4103/sajc.sajc_22_18] [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] [Indexed: 12/31/2022] Open
Abstract
Introduction: Nonclear cell (NCC) metastatic renal cell carcinoma (mRCC) is a biologically heterogeneous entity. We report the outcomes of NCC mRCC treated with first-line vascular endothelial growth factor (VEGF) inhibitors or mammalian target of rapamycin (mTOR) inhibitors at our institute. This is first such report from India. Methods: This is a retrospective analysis of the 40 consecutive patients of NCC mRCC treated between January 2013 and June 2015 in routine clinical practice at our institute. The primary endpoint analyzed was overall survival (OS) with respect to the type of first-line treatment and tumor histology. Results: The most common histological subtype was papillary in 25 patients (62.5%) followed by sarcomatoid in six (15%), chromophobe in 5 (12.5%), translocation-associated in one patient, and other nonspecified in three patients. First-line treatment was sorafenib in 14 (35%), sunitinib in 9 (22.5%), pazopanib in 8 (20%), everolimus in seven (17.5%), and best-supportive care (BSC) in two (5%) patients. Partial response, stable disease, and progression was observed in six (15%), 13 (32.5%), and nine (22.5%) cases, respectively, as the best response to first-line treatment. The median OS was 11.7 months and median event-free survival was 6.1 months in the whole cohort. The median OS in months for different first-line treatments were as follows: sorafenib (16.2), sunitinib (11.7), pazopanib (not reached, mean-23.9 ± 6.0), everolimus (4.1) and BSC (0.6) and for different histological subtypes were as follows: papillary (9.8), chromophobe (not reached, mean-30.3 ± 8.4), sarcomatoid (4.1), and others (7.9). Conclusions: Chromophobe histology has a better outcome compared to other histological subtypes, and anti-VEGF tyrosine kinase inhibitors are preferable first-line agents compared to mTOR inhibitors.
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Affiliation(s)
- Vivek Agarwala
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Anant Ramaswamy
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Amit Joshi
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Vijay Maruti Patil
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Vanita Noronha
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Santosh Menon
- Department of Pathology, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - B Palak Popat
- Department of Radiodiagnosis, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Nilesh Sable
- Department of Radiodiagnosis, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Kumar Prabhash
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
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6
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Carlo MI, Mukherjee S, Mandelker D, Vijai J, Kemel Y, Zhang L, Knezevic A, Patil S, Ceyhan-Birsoy O, Huang KC, Redzematovic A, Coskey DT, Stewart C, Pradhan N, Arnold AG, Hakimi AA, Chen YB, Coleman JA, Hyman DM, Ladanyi M, Cadoo KA, Walsh MF, Stadler ZK, Lee CH, Feldman DR, Voss MH, Robson M, Motzer RJ, Offit K. Prevalence of Germline Mutations in Cancer Susceptibility Genes in Patients With Advanced Renal Cell Carcinoma. JAMA Oncol 2019; 4:1228-1235. [PMID: 29978187 DOI: 10.1001/jamaoncol.2018.1986] [Citation(s) in RCA: 114] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Importance Identification of patients with hereditary renal cell carcinoma (RCC) is important for cancer screening and, in patients with advanced disease, for guiding treatment. The prevalence of cancer-related germline mutations in patients with advanced RCC and the phenotypes associated with some rare mutations are unknown. Objectives To examine the prevalence of germline mutations in both known RCC predisposition genes and other cancer-associated genes and to identify clinical and pathologic factors associated with germline mutations. Design, Setting, and Participants In this cohort study conducted from October 1, 2015, to July 31, 2017, 254 of 267 patients with advanced (American Joint Committee on Cancer stage III or IV) RCC who were seen in medical oncology or urology clinics agreed to germline sequencing and disclosure of results under an institutional protocol of matched tumor-germline DNA sequencing. Main Outcomes and Measures Mutation prevalence and spectrum in patients with advanced RCC were determined. Clinical characteristics were assessed by mutation status. Results Of the 254 patients (median age [range], 56 [13-79] years; 179 [70.5%] male; 211 [83.1%] non-Hispanic white), germline mutations were identified in 41 (16.1%); 14 (5.5%) had mutations in syndromic RCC-associated genes (7 in FH, 3 in BAP1, and 1 each in VHL, MET, SDHA, and SDHB). The most frequent mutations were CHEK2 (n = 9) and FH (n = 7). Of genes not previously associated with RCC risk, CHEK2 was overrepresented in patients compared with the general population, with an odds ratio of RCC of 3.0 (95% CI, 1.3-5.8; P = .003). Patients with non-clear cell RCC were significantly more likely to have an RCC-associated gene mutation (9 [11.7%] of 74 vs 3 [1.7%] of 177; P = .001), and 8 (10.0%) had a mutation in a gene that could guide therapy. Of patients with mutations in RCC-associated genes, 5 (35.7%) failed to meet current clinical guidelines for genetic testing. Conclusions and Relevance Of patients with non-clear cell RCC, more than 20% had a germline mutation, of which half had the potential to direct systemic therapy. Current referral criteria for genetic testing did not identify a substantial portion of patients with mutations, supporting the role of a more inclusive sequencing approach.
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Affiliation(s)
- Maria I Carlo
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Semanti Mukherjee
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.,Sloan Kettering Institute, New York, New York
| | - Diana Mandelker
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Joseph Vijai
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.,Sloan Kettering Institute, New York, New York
| | | | - Liying Zhang
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Andrea Knezevic
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sujata Patil
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ozge Ceyhan-Birsoy
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kuo-Cheng Huang
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - Devyn T Coskey
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Carolyn Stewart
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Nisha Pradhan
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Angela G Arnold
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - A Ari Hakimi
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ying-Bei Chen
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jonathan A Coleman
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - David M Hyman
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Marc Ladanyi
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Karen A Cadoo
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Michael F Walsh
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Zsofia K Stadler
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Chung-Han Lee
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Darren R Feldman
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Martin H Voss
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Mark Robson
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Robert J Motzer
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kenneth Offit
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.,Sloan Kettering Institute, New York, New York
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Carlo MI, Khan N, Zehir A, Patil S, Ged Y, Redzematovic A, Coskey DT, Hyman DM, Ladanyi M, Chen YB, Robson M, Hakimi AA, Lee CH, Feldman DR, Gao J, Chakravarty D, Motzer RJ, Voss MH. Comprehensive Genomic Analysis of Metastatic Non-Clear-Cell Renal Cell Carcinoma to Identify Therapeutic Targets. JCO Precis Oncol 2019; 3:1800372. [PMID: 32914011 DOI: 10.1200/po.18.00372] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2018] [Indexed: 12/27/2022] Open
Abstract
PURPOSE Non-clear-cell renal cell carcinoma (nccRCC) encompasses approximately 20% of renal cell carcinomas and includes subtypes that vary in clinical and molecular biology. Compared with clear cell renal cell carcinoma, nccRCC demonstrates limited sensitivity to conventional vascular endothelial growth factor- and mammalian target of rapamycin-directed agents, indicating a need for better therapies. Characterizing the genomic landscape of metastatic nccRCC variants may help define novel therapeutic strategies. PATIENTS AND METHODS We retrospectively analyzed tumor tissue from patients with metastatic nccRCC who consented to genomic analysis of their tumor and germline DNA. A hybridization capture-based assay was used to identify single nucleotide variants and small insertions and deletions across more than 340 cancer-associated genes with germline comparison. Clinical actionability of somatic mutations was assessed using OncoKB levels of evidence. Microsatellite instability (MSI) in the tumor was investigated. RESULTS Of 116 patients included in the analysis, 57 (49%) presented with de novo metastatic disease, and 59 (51%) presented with localized disease that later metastasized. Subtype classifications included unclassified (n = 41; 35%), papillary (n = 26; 22%), chromophobe (n = 17; 15%), translocation associated (n = 13; 11%), and other (n = 19; 16%). Of all tumors, 15 (13%) had putative driver somatic alterations amenable to targeted therapies, including alterations in MET, TSC1/2, and an ALK translocation. Of 45 patients who had germline testing, 11 (24%) harbored mutations, seven of which could potentially guide therapy. Of 115 available tumors for analysis, two (1.7%) had high and six (5%) had intermediate MSI status. CONCLUSION The mutation profiles of metastatic nccRCC vary by subtype. Comprehensive analysis of somatic mutations, germline mutations, and MSI, interpreted via an annotated precision oncology knowledge base, identified potentially targetable alterations in 22% of patients, which merits additional investigation.
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Affiliation(s)
- Maria I Carlo
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - Nabeela Khan
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - Ahmet Zehir
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - Sujata Patil
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - Yasser Ged
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | | | - David M Hyman
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - Marc Ladanyi
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - Ying-Bei Chen
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - Mark Robson
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - A Ari Hakimi
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - Chung-Han Lee
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Jianjiong Gao
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | | | - Martin H Voss
- Memorial Sloan Kettering Cancer Center, New York, NY
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8
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Martín A, Puente J, Pinto A, Gajate P, Gordoa TA, Grande E, Herrero A, Maximiano C, Garrido M, Gallegos I, Villalobos ML, García-Donas J, Caviedes E, García I, Espinosa J, Aguado C, Arranz JA, García L, Rodriguez JF, Casinello J, Rodriguez L. Real-World Outcome of 173 Metastatic Non-Clear Cell Renal Cell Carcinoma (nccRCC) Cases: The Experience of the Center Group for Genitourinary Tumors. KIDNEY CANCER 2019. [DOI: 10.3233/kca-180045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Almudena Martín
- Department of Medical Oncology, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Javier Puente
- Department of Medical Oncology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), CIBERONC, Madrid, Spain
| | - Alvaro Pinto
- Department of Medical Oncology, Hospital Universitario La Paz, Madrid, Spain
| | - Pablo Gajate
- Department of Medical Oncology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Teresa Alonso Gordoa
- Department of Medical Oncology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Enrique Grande
- Department of Medical Oncology, MD Anderson Cancer Center Madrid, Madrid, Spain
| | - Ana Herrero
- Department of Medical Oncology, OncoHealth Institute, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Constanza Maximiano
- Department of Medical Oncology, Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, Spain
| | - María Garrido
- Department of Medical Oncology, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain
| | - Isabel Gallegos
- Department of Medical Oncology, Hospital General de Segovia, Segovia, Spain
| | - Ma Laura Villalobos
- Department of Medical Oncology, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | - Jesús García-Donas
- Department of Medical Oncology, HM Hospitales – Centro Integral Oncológico HM Clara Campal, Madrid, Spain
| | - Edinson Caviedes
- Department of Medical Oncology, GenesisCare Madrid, Hospital La Milagrosa, Madrid, Spain
| | - Iciar García
- Department of Medical Oncology, Hospital Virgen de la Salud, Toledo, Spain
| | - Javier Espinosa
- Department of Medical Oncology, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - Carlos Aguado
- Department of Medical Oncology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), CIBERONC, Madrid, Spain
| | - José Angel Arranz
- Department of Medical Oncology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Lourdes García
- Department of Medical Oncology, Hospital General de Segovia, Segovia, Spain
| | - Juan Francisco Rodriguez
- Department of Medical Oncology, HM Hospitales – Centro Integral Oncológico HM Clara Campal, Madrid, Spain
| | - Javier Casinello
- Department of Medical Oncology, Hospital Universitario de Guadalajara, Guadalajara, Spain
| | - Laura Rodriguez
- Department of Medical Oncology, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
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9
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Liu F, Zhang S, Yin M, Guo L, Xu M, Wang Y. Nobiletin inhibits hypoxia-induced epithelial-mesenchymal transition in renal cell carcinoma cells. J Cell Biochem 2019; 120:2039-2046. [PMID: 30203502 DOI: 10.1002/jcb.27511] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 07/25/2018] [Indexed: 01/24/2023]
Abstract
Hypoxia is a universal characteristic of solid tumor and involving cancer metastasis via epithelial-mesenchymal transition (EMT). Nobiletin (3',4',5,6,7,8-hexamethoxyflavone), a dietary polymethoxylated flavonoid found in citrus fruits, has been reported to have anticancer effects. However, the possible role of nobiletin in renal cell carcinoma (RCC) remains unclear. Thus, the aim of this study was to identify the effect of nobiletin on hypoxia-induced EMT in RCC cells. We found that nobiletin significantly inhibited the migration and invasion induced by hypoxia in RCC cells. In addition, nobiletin reversed the hypoxia-induced EMT process in RCC cells. Furthermore, nobiletin suppressed the activation of NF-κB and Wnt/β-catenin signaling pathways in hypoxia-stimulated RCC cells. In conclusion, these findings demonstrate that nobiletin inhibits hypoxia-induced EMT in human RCC cells via the inactivation of the NF-κB and Wnt/β-catenin signaling pathways.
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Affiliation(s)
- Feng Liu
- Department of Nephrology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Siqi Zhang
- Department of Nephrology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Min Yin
- Department of Nephrology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Lihua Guo
- Department of Nephrology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Mingzhu Xu
- Department of Nephrology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Yonggang Wang
- Department of Urology, China-Japan Union Hospital of Jilin University, Changchun, China
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10
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Bergerot CD, Battle D, Bergerot PG, Dizman N, Jonasch E, Hammers HJ, George DJ, Bex A, Ljungberg B, Pal SK, Staehler MD. Sources of Frustration Among Patients Diagnosed With Renal Cell Carcinoma. Front Oncol 2019; 9:11. [PMID: 30723705 PMCID: PMC6349746 DOI: 10.3389/fonc.2019.00011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 01/03/2019] [Indexed: 01/05/2023] Open
Abstract
Despite numerous therapeutic advances in renal cell carcinoma (RCC), little is known about patients' perspectives on cancer care. An international survey was conducted to identify points of frustration associated with cancer care reported by patients with RCC. Data were obtained from an online survey, conducted from April 1 to June 15, 2017, through social media and patient networking platforms. This survey obtained baseline demographic, clinicopathologic, and treatment-related information. Open-ended questions accessed sources of frustration in cancer-related care and patients' suggestions for amelioration. Responses were categorized and reviewed by independent reviewers. A qualitative analysis was performed and the Kruskal-Wallis test was used to define associations between baseline characteristics and sources of frustration. Among 450 patients surveyed, 71.5% reported sources of frustration, classified as either emotional (48.4%) or practical (23.1%). The most common were fear of recurrence/progression (15.8%), distrust of their cancer care system (12.9%), and lack of appropriate information (9.8%). Female gender and non-clear cell histology were associated with both types of frustration, and older age was linked to practical sources of frustration. Patients suggested solutions included greater compassion among health care practitioners (20.7%), better access to information (15.1%) and research to improve their chances of being cured (14.7%). Sources of frustration related to emotional and practical causes were identified amongst patients with RCC. Certain demographic and clinical characteristics were associated with more sources of frustration. This study provides the first characterization of specific ways to improve the patient experience by addressing common frustrations.
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Affiliation(s)
- Cristiane Decat Bergerot
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Dena Battle
- Kidney Cancer Research Alliance (KCCure), Alexandria, VA, United States
| | - Paulo Gustavo Bergerot
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Nazli Dizman
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Eric Jonasch
- University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Hans J Hammers
- University of Texas Southwestern Medical Cancer Center, Dallas, TX, United States
| | - Daniel J George
- Duke University Medical Center, Duke Cancer Institute, Durham, NC, United States
| | - Axel Bex
- Division of Surgical Oncology, Department of Urology, Netherlands Cancer Center, Amsterdam, Netherlands
| | - Borje Ljungberg
- Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden
| | - Sumanta Kumar Pal
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
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11
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De Giorgi U, Cartenì G, Giannarelli D, Basso U, Galli L, Cortesi E, Caserta C, Pignata S, Sabbatini R, Bearz A, Buti S, Lo Re G, Berruti A, Bracarda S, Cognetti F, Rastelli F, Fornarini G, Porta C, Turci D, Sternberg CN, Procopio G. Safety and efficacy of nivolumab for metastatic renal cell carcinoma: real-world results from an expanded access programme. BJU Int 2018; 123:98-105. [DOI: 10.1111/bju.14461] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Ugo De Giorgi
- Department of Medical Oncology; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) - IRCCS; Meldola Italy
| | - Giacomo Cartenì
- Department of Medical Oncology; Azienda Ospedaliero-Universitaria “A. Cardarelli”; Napoli Italy
| | - Diana Giannarelli
- Department of Statistics; Regina Elena National Cancer Institute - IRCCS; Rome Italy
| | - Umberto Basso
- Medical Oncology Unit 1; Department of Clinical and Experimental Oncology; Istituto Oncologico Veneto IOV - IRCCS; Padova Italy
| | - Luca Galli
- Department of Medical Oncology; Azienda Ospedaliero-Universitaria Pisana Spedali Riuniti S. Chiara; Pisa Italy
| | - Enrico Cortesi
- Department of Medical Oncology; Policlinico Umberto I; Roma Italy
| | - Claudia Caserta
- Department of Medical Oncology; Azienda Ospedaliero-Universitaria di Santa Maria; Terni Italy
| | - Sandro Pignata
- Department of Uro-Gynaecological Oncology; Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”; Napoli Italy
| | - Roberto Sabbatini
- Department of Oncology and Hematology; Azienda Ospedaliero-Universitaria Policlinico di Modena; Modena Italy
| | - Alessandra Bearz
- Department of Medical Oncology; Istituto Nazionale Tumori - IRCCS; Aviano Italy
| | - Sebastiano Buti
- Medical Oncology Unit; Azienda Ospedaliero-Universitaria di Parma; Parma Italy
| | - Giovanni Lo Re
- Department of Medical Oncology; CRO Pordenone-S.Vito Oncology; CRO - IRCCS; Aviano Italy
| | - Alfredo Berruti
- Department of Medical Oncology; ASST Spedali Civili di Brescia; Brescia Italy
| | | | - Francesco Cognetti
- Department of Medical Oncology; Regina Elena National Cancer Institute - IRCCS; Rome Italy
| | | | - Giuseppe Fornarini
- Department of Medical Oncology; Azienda Ospedaliero-Universitaria San Martino IST - IRCCS; Genova Italy
| | - Camillo Porta
- University of Pavia and IRCCS San Matteo University Hospital Foundation; Pavia Italy
- IRCCS San Matteo University Hospital Foundation; Pavia Italy
| | - Daniele Turci
- Department of Medical Oncology; Ospedale Santa Maria delle Croci; Ravenna Italy
| | - Cora N. Sternberg
- Department of Medical Oncology; San Camillo Forlanini Hospital; Roma Italy
| | - Giuseppe Procopio
- Department of Medical Oncology; Istituto Nazionale Tumori - IRCCS; Milano Italy
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12
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Jung KS, Lee SJ, Park SH, Lee JL, Lee SH, Lim JY, Kang JH, Lee S, Rha SY, Lee KH, Kim HY, Lim HY. Pazopanib for the Treatment of Non-clear Cell Renal Cell Carcinoma: A Single-Arm, Open-Label, Multicenter, Phase II Study. Cancer Res Treat 2018; 50:488-494. [PMID: 28546525 PMCID: PMC5912146 DOI: 10.4143/crt.2016.584] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 05/16/2017] [Indexed: 01/04/2023] Open
Abstract
PURPOSE The optimal treatment strategy for patients with metastatic non-clear cell type renal cell carcinoma (nccRCC) remains unclear. Although several inhibitors of vascular endothelial growth factor have recently shown efficacy against nccRCC, the clinical benefit of pazopanib in nccRCC has not been analyzed. We therefore designed a single-arm, open-label, phase II study to determine the efficacy and safety of pazopanib in patients with nccRCC. MATERIALS AND METHODS Patientswith locally advanced or metastatic nccRCC, exceptfor collecting duct or sarcomatoid type, received 800 mg/day of pazopanib daily until progression of disease or intolerable toxicity. One cyclewas defined as 4weeks and tumorresponsewas evaluated every two cycles. The primary objective was overall response rate (ORR). RESULTS A total of 29 eligible patients were enrolled at nine centers in Korea from December 2012 and September 2014. The median age of the patients was 58 years (range, 27 to 76 years) and 21 patients (72%) were male. Regarding histology type, 19 patients had papillary, three had chromophobe, two had unclassified and five had unknown non-clear cell type. Of 28 evaluable patients, eight achieved a confirmed partial response with ORR of 28%. The median progression-free survival was 16.5 months (95% confidence interval, 10.9 to 22.1) and median overall survival was not reached. Sixteen patients (55%) experienced treatment-related toxicity of grade 3 or more, but most adverse events were overcome through dose reduction and delay. CONCLUSION In this prospective phase II study, pazopanib demonstrated promising activity and tolerable safety profile in patients with metastatic nccRCC.
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Affiliation(s)
- Ki Sun Jung
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Su Jin Lee
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Se Hoon Park
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae-Lyun Lee
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Se-Hoon Lee
- Division of Hematology and Oncology, Seoul National University Hospital, Seoul, Korea
| | - Jae Yun Lim
- Division of Hematology and Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jung Hun Kang
- Division of Hematology and Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Suee Lee
- Division of Hematology and Oncology, Dong-A University Medical Center, Busan, Korea
| | - Sun Young Rha
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Kyung Hee Lee
- Division of Oncology-Hematology, Department of Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Ho Young Kim
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Ho Yeong Lim
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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13
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Wang X, Hao B, Xu C, Zhao X, Liu C, Chu X, Lv Y, Zhao Y, Zhang S, Wang P, Wang Y. Involvement of erbB4 and tumor marker genes in renal carcinoma regulatory network. Saudi J Biol Sci 2018; 24:1787-1791. [PMID: 29551924 PMCID: PMC5851941 DOI: 10.1016/j.sjbs.2017.11.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 11/03/2017] [Accepted: 11/06/2017] [Indexed: 12/25/2022] Open
Abstract
Background Renal carcinoma is a common urologic tumor, and there is no ideal tumor marker for clinical diagnosis except for imaging diagnosis. This study aims to screen the serum tumor markers closely related with the benign and malignant of renal carcinoma out and chart out the regulatory network that involves renal carcinoma-related genes. Methods Based on 96 pathologically diagnosed renal cancer patients, factors strongly linked to renal carcinoma character were selected using Fisher discriminant analysis. The Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) databases were utilized to manipulate function annotation of erbB4 and the selected genes and pathway analysis. Results Four essential tumor markers CYFRA21-1, CA125, VHL and HIF-1β were successfully screened out. Using GO and KEGG databases, the regulatory network of renal cancer cell escaping apoptosis was charted out on the basis of erbB4 signaling pathway. Conclusion Serum tumor marker genes play a certain part in the genesis and development of renal carcinoma. We preliminarily illustrated the molecular mechanism of these markers to predict tumor, laying a foundation for further exploration in renal carcinoma.
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Affiliation(s)
- Xiaofu Wang
- The Second Affiliated Hospital of Zhengzhou University (Institute of Urinary Surgery of Zhengzhou University; the Calculosis Diagnostic and Therapeutic Center of Henan Province), China
| | - Bin Hao
- The Second Affiliated Hospital of Zhengzhou University (Institute of Urinary Surgery of Zhengzhou University; the Calculosis Diagnostic and Therapeutic Center of Henan Province), China
| | - Changbao Xu
- The Second Affiliated Hospital of Zhengzhou University (Institute of Urinary Surgery of Zhengzhou University; the Calculosis Diagnostic and Therapeutic Center of Henan Province), China
| | - Xinghua Zhao
- The Second Affiliated Hospital of Zhengzhou University (Institute of Urinary Surgery of Zhengzhou University; the Calculosis Diagnostic and Therapeutic Center of Henan Province), China
| | - Changwei Liu
- The Second Affiliated Hospital of Zhengzhou University (Institute of Urinary Surgery of Zhengzhou University; the Calculosis Diagnostic and Therapeutic Center of Henan Province), China
| | - Xiaohan Chu
- The Second Affiliated Hospital of Zhengzhou University (Institute of Urinary Surgery of Zhengzhou University; the Calculosis Diagnostic and Therapeutic Center of Henan Province), China
| | - Yuan Lv
- The Second Affiliated Hospital of Zhengzhou University (Institute of Urinary Surgery of Zhengzhou University; the Calculosis Diagnostic and Therapeutic Center of Henan Province), China
| | - Yongli Zhao
- The Second Affiliated Hospital of Zhengzhou University (Institute of Urinary Surgery of Zhengzhou University; the Calculosis Diagnostic and Therapeutic Center of Henan Province), China
| | - Shengwei Zhang
- The Second Affiliated Hospital of Zhengzhou University (Institute of Urinary Surgery of Zhengzhou University; the Calculosis Diagnostic and Therapeutic Center of Henan Province), China
| | - Pengsen Wang
- The Second Affiliated Hospital of Zhengzhou University (Institute of Urinary Surgery of Zhengzhou University; the Calculosis Diagnostic and Therapeutic Center of Henan Province), China
| | - Youzhi Wang
- The Second Affiliated Hospital of Zhengzhou University (Institute of Urinary Surgery of Zhengzhou University; the Calculosis Diagnostic and Therapeutic Center of Henan Province), China
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14
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Hsieh JJ, Le V, Cao D, Cheng EH, Creighton CJ. Genomic classifications of renal cell carcinoma: a critical step towards the future application of personalized kidney cancer care with pan-omics precision. J Pathol 2018; 244:525-537. [PMID: 29266437 DOI: 10.1002/path.5022] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 12/10/2017] [Accepted: 12/13/2017] [Indexed: 12/17/2022]
Abstract
Over the past 20 years, classifications of kidney cancer have undergone major revisions based on morphological refinements and molecular characterizations. The 2016 WHO classification of renal tumors recognizes more than ten different renal cell carcinoma (RCC) subtypes. Furthermore, the marked inter- and intra-tumor heterogeneity of RCC is now well appreciated. Nevertheless, contemporary multi-omics studies of RCC, encompassing genomics, transcriptomics, proteomics, and metabolomics, not only highlight apparent diversity but also showcase and underline commonality. Here, we wish to provide an integrated perspective concerning the future 'functional' classification of renal cancer by bridging gaps among morphology, biology, multi-omics, and therapeutics. This review focuses on recent progress and elaborates the potential value of contemporary pan-omics approaches with a special emphasis on cancer genomics unveiled through next-generation sequencing technology, and how an integrated multi-omics approach might impact precision-based personalized kidney cancer care in the near future. Copyright © 2017 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
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Affiliation(s)
- James J Hsieh
- Molecular Oncology, Department of Medicine, Siteman Cancer Center, Washington University, St Louis, MO, USA
| | - Valerie Le
- Molecular Oncology, Department of Medicine, Siteman Cancer Center, Washington University, St Louis, MO, USA
| | - Dengfeng Cao
- Department of Pathology, Washington University, St Louis, MO, USA
| | - Emily H Cheng
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Chad J Creighton
- Human Genome Sequencing Center, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
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15
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Dong Y, Manley BJ, Becerra MF, Redzematovic A, Casuscelli J, Tennenbaum DM, Reznik E, Han S, Benfante N, Chen YB, Arcila ME, Aras O, Voss MH, Feldman DR, Motzer RJ, Fabbri N, Healey JH, Boland PJ, Chawla M, Durack JC, Lee CH, Coleman JA, Russo P, Hakimi AA, Cheng EH, Hsieh JJ. Tumor Xenografts of Human Clear Cell Renal Cell Carcinoma But Not Corresponding Cell Lines Recapitulate Clinical Response to Sunitinib: Feasibility of Using Biopsy Samples. Eur Urol Focus 2017; 3:590-598. [PMID: 28753786 PMCID: PMC5608640 DOI: 10.1016/j.euf.2016.08.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Revised: 07/07/2016] [Accepted: 08/10/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Parallel development of preclinical models that recapitulate treatment response observed in patients is central to the advancement of personalized medicine. OBJECTIVE To evaluate the use of biopsy specimens to develop patient-derived xenografts and the use of corresponding cell lines from renal cell carcinoma (RCC) tumors for the assessment of histopathology, genomics, and treatment response. DESIGN, SETTING, AND PARTICIPANTS A total of 74 tumor specimens from 66 patients with RCC were implanted into immunocompromised NOD-SCID IL2Rg-/- mice. Four cell lines generated from patients' specimens with clear cell pathology were used for comparative studies. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Preclinical models were established and assessed. Engraftment rates were analyzed using chi-square testing. Analysis of variance (two-way analysis of variance) was conducted to assess tumor growth. RESULTS AND LIMITATIONS Overall, 33 RCC mouse xenograft models were generated with an overall engraftment rate of 45% (33 of 74). Tumor biopsies engrafted comparably with surgically resected tumors (58% vs 41%; p=0.3). Xenograft tumors and their original tumors showed high fidelity in regard to histology, mutation status, copy number change, and targeted therapy response. Engraftment rates from metastatic tumors were higher but not more significant than primary tumors (54% vs 34%; p=0.091). Our engraftment rate using metastases or biopsies was comparable with recent reports using resected primary tumors. In stark contrast to corresponding cell lines, all tested xenografts recapitulated patients' clinical response to sunitinib. CONCLUSIONS Patient-derived xenograft models can be effectively established from tumor biopsies. Preclinical xenograft models but not matched cell lines reflected clinical responses to sunitinib. PATIENT SUMMARY Matched patient-derived clear cell renal cell carcinoma xenografts and cell lines from responsive and refractory patients treated with sunitinib were established and evaluated for pharmacologic response to anti-vascular endothelial growth factor treatment. Both models accurately reflected the genetic characteristics of original tumors, but only xenografts recapitulated drug responses observed in patients. These models could serve as a powerful platform for precision medicine.
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Affiliation(s)
- Yiyu Dong
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Brandon J Manley
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Maria F Becerra
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Almedina Redzematovic
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jozefina Casuscelli
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Daniel M Tennenbaum
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ed Reznik
- Computational Biology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Song Han
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Nicole Benfante
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ying-Bei Chen
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Maria E Arcila
- Computational Biology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Omer Aras
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Martin H Voss
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Darren R Feldman
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Robert J Motzer
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Nicola Fabbri
- Orthopedics Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - John H Healey
- Orthopedics Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Patrick J Boland
- Orthopedics Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Mohit Chawla
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jeremy C Durack
- Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Chung-Han Lee
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jonathan A Coleman
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Paul Russo
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - A Ari Hakimi
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Emily H Cheng
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - James J Hsieh
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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16
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Comparative Genomic Profiling of Matched Primary and Metastatic Tumors in Renal Cell Carcinoma. Eur Urol Focus 2017; 4:986-994. [PMID: 29066084 DOI: 10.1016/j.euf.2017.09.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 09/07/2017] [Accepted: 09/30/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND Next-generation sequencing (NGS) studies of matched pairs of primary and metastatic tumors in renal cell carcinoma (RCC) have been limited to small cohorts. OBJECTIVE To evaluate the discordance in somatic mutations between matched primary and metastatic RCC tumors. DESIGN, SETTING, AND PARTICIPANTS Primary tumor (P), metastasis (M), and germline DNA from 60 patients with RCC was subjected to NGS with a targeted exon capture-based assay of 341 cancer-associated genes. Somatic mutations were called using a validated pipeline. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Mutations were classified as shared (S) or private (Pr) in relation to each other within individual P-M pairs. The concordance score was calculated as (S-Pr)/(S+Pr). To calculate enrichment of Pr/S mutations for a particular gene, we calculated a two-sided p value from a binomial model for each gene with at least ten somatic mutation events, and also implemented a separate permutation test procedure. We adjusted p values for multiple hypothesis testing using the Benjamini-Hochberg procedure. The mutation discordance was calculated using Mann-Whitney U tests according to gene mutations or metastatic sites. RESULTS AND LIMITATIONS Twenty-one pairs (35%) showed Pr mutations in both P and M samples. Of the remaining 39 pairs (65%), 14 (23%) had Pr mutations specific to P samples, 12 (20%) had Pr mutations to M samples, and 13 (22%) had identical somatic mutations. No individual gene mutation was preferentially enriched in either P or M samples. P-M pairs with SETD2 mutations demonstrated higher discordance than pairs with wild-type SETD2. We observed that patients who received therapy before sampling of the P or M tissue had higher concordance of mutations for P-M pairs than patients who did not (Mann-Whitney p=0.088). CONCLUSIONS Our data show mutation discordance within matched P-M RCC tumor pairs. As most contemporary precision medicine trials do not differentiate mutations detected in P and M tumors, the prognostic and predictive value of mutations in P versus M tumors warrants further investigation. PATIENT SUMMARY In this study we evaluated the concordance of mutations between matched primary and metastatic tumors for 60 kidney cancer patients using a panel of 341 cancer genes. Forty-seven patients carried nonidentical cancer gene mutations within their matched primary-metastatic pair. The mutation profile of the primary tumor alone could compromise precision in selecting effective targeted therapies and result in suboptimal clinical outcomes.
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17
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Casuscelli J, Weinhold N, Gundem G, Wang L, Zabor EC, Drill E, Wang PI, Nanjangud GJ, Redzematovic A, Nargund AM, Manley BJ, Arcila ME, Donin NM, Cheville JC, Thompson RH, Pantuck AJ, Russo P, Cheng EH, Lee W, Tickoo SK, Ostrovnaya I, Creighton CJ, Papaemmanuil E, Seshan VE, Hakimi AA, Hsieh JJ. Genomic landscape and evolution of metastatic chromophobe renal cell carcinoma. JCI Insight 2017; 2:92688. [PMID: 28614790 PMCID: PMC5470887 DOI: 10.1172/jci.insight.92688] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 05/16/2017] [Indexed: 12/31/2022] Open
Abstract
Chromophobe renal cell carcinoma (chRCC) typically shows ~7 chromosome losses (1, 2, 6, 10, 13, 17, and 21) and ~31 exonic somatic mutations, yet carries ~5%-10% metastatic incidence. Since extensive chromosomal losses can generate proteotoxic stress and compromise cellular proliferation, it is intriguing how chRCC, a tumor with extensive chromosome losses and a low number of somatic mutations, can develop lethal metastases. Genomic features distinguishing metastatic from nonmetastatic chRCC are unknown. An integrated approach, including whole-genome sequencing (WGS), targeted ultradeep cancer gene sequencing, and chromosome analyses (FACETS, OncoScan, and FISH), was performed on 79 chRCC patients including 38 metastatic (M-chRCC) cases. We demonstrate that TP53 mutations (58%), PTEN mutations (24%), and imbalanced chromosome duplication (ICD, duplication of ≥ 3 chromosomes) (25%) were enriched in M-chRCC. Reconstruction of the subclonal composition of paired primary-metastatic chRCC tumors supports the role of TP53, PTEN, and ICD in metastatic evolution. Finally, the presence of these 3 genomic features in primary tumors of both The Cancer Genome Atlas kidney chromophobe (KICH) (n = 64) and M-chRCC (n = 35) cohorts was associated with worse survival. In summary, our study provides genomic insights into the metastatic progression of chRCC and identifies TP53 mutations, PTEN mutations, and ICD as high-risk features.
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Affiliation(s)
- Jozefina Casuscelli
- Department of Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Urology, Ludwig-Maximilians University, Munich, Germany
| | | | | | | | | | | | - Patricia I. Wang
- Department of Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | | | - Almedina Redzematovic
- Department of Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Medicine, and
| | - Amrita M. Nargund
- Department of Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Brandon J. Manley
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | | | | | | | | | | | - Paul Russo
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Emily H. Cheng
- Department of Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Pathology
| | | | | | | | - Chad J. Creighton
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas, USA
| | | | | | - A. Ari Hakimi
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - James J. Hsieh
- Molecular Oncology, Department of Medicine, Siteman Cancer Center, Washington University, St. Louis, Missouri, USA
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18
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Lee CH, Gundem G, Lee W, Chen YB, Cross JR, Dong Y, Redzematovic A, Mano R, Wei EY, Cheng EH, Srinivasan R, Oschwald D, Hakimi AA, Dunphy MP, Linehan WM, Papaemmanuil E, Hsieh JJ. Persistent Severe Hyperlactatemia and Metabolic Derangement in Lethal SDHB-Mutated Metastatic Kidney Cancer: Clinical Challenges and Examples of Extreme Warburg Effect. JCO Precis Oncol 2017; 1:PO.16.00007. [PMID: 35172488 PMCID: PMC9797236 DOI: 10.1200/po.16.00007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
To describe the unique clinical features, determine the genomics, and investigate the metabolic derangement of an extremely rare form of a hereditary lethal kidney cancer syndrome. Patients and Methods Three patients with lethal kidney cancer (age 19, 20, and 37 years) exhibiting persistent (1 to 3 months) extremely high levels of blood lactate (> 5 mM) despite normal oxygen perfusion, highly avid tumors on [18F]fluorodeoxyglucose positron emission tomography (PET), and pleomorphic histopathologic features were identified and treated in a single institute. Integrated studies including whole-genome sequencing (WGS), targeted sequencing, immunohistochemistry, cell-based assays, and 18F-glutamine PET imaging were performed to investigate this rare kidney cancer syndrome. Results All three patients with kidney cancer were initially given various diagnoses as a result of diverse tumor histopathology and atypical clinical presentations. The correct diagnoses of these SDHB-mutated renal cell carcinomas were first made based on cancer genomics. Genomic studies of the blood and tumors of these patients identified three different kinds of germline loss-of-function mutations in the SDHB gene and the common loss of heterozygosity in the remaining SDHB allele thorough somatic chromosome 1p deletion. In one patient, WGS revealed that a germline mutation of SDHB coupled with loss of heterozygosity was the sole genetic event. Cancer evolution analysis of SDHB tumors based on WGS demonstrated that SDHB in kidney epithelium fulfills the Knudson two-hit criteria as a major tumor suppressor gene. SDHB -/- tumor cells displayed increase in glucose uptake and lactate production, alteration in mitochondrial architecture, and defect in oxidative respiration. 18F-Glutamine PET imaging studies demonstrated increased glutamine metabolism. Conclusion SDHB-deficient metastatic renal cell carcinoma is a rare, aggressive form of kidney cancer that manifests with clinical evidence of a severe Warburg effect, and genomic studies demonstrated two genetic hits at SDHB genes during kidney tumorigenesis.
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Affiliation(s)
- Chung-Han Lee
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Gunes Gundem
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - William Lee
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Ying-Bei Chen
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Justin R. Cross
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Yiyu Dong
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Almedina Redzematovic
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Roy Mano
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Elizabeth Y. Wei
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Emily H. Cheng
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Ramaprasad Srinivasan
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Dayna Oschwald
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - A. Ari Hakimi
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Mark P. Dunphy
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - W. Marston Linehan
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - Elli Papaemmanuil
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
| | - James J. Hsieh
- Chung-Han Lee, Gunes Gundem, William
Lee, Ying-Bei Chen, Justin R. Cross,
Yiyu Dong, Almedina Redzematovic, Roy
Mano, Elizabeth Y. Wei, Emily H. Cheng,
A. Ari Hakimi, Mark P. Dunphy, and Elli
Papaemmanuil, Memorial Sloan Kettering Cancer Center; Dayna
Oschwald, New York Genome Center, New York, NY; James J.
Hsieh, Washington University School of Medicine, St Louis, MO; and
Ramaprasad Srinivasan and W. Marston Linehan,
National Cancer Institute, Bethesda, MD
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19
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Liu X, Fiocco M, Swen JJ, Guchelaar HJ. Assessment of ethnic differences in sunitinib outcome between Caucasian and Asian patients with metastatic renal cell carcinoma: a meta-analysis. Acta Oncol 2017; 56:582-589. [PMID: 27924664 DOI: 10.1080/0284186x.2016.1265666] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND An increasing number of studies have reported ethnic differences in sunitinib outcome in metastatic renal cell carcinoma (mRCC) patients. However, a comprehensive analysis is still lacking. Therefore, we systematically collected available published data and performed a meta-analysis to compare sunitinib efficacy and toxicity in Asian and Caucasian mRCC patients. METHODS Data were extracted from published results from clinical trials, expanded access program and real-world clinical practice. Progression-free survival (or time to tumor progression), overall survival, objective response rate and adverse events were used as endpoints to evaluate the differences of sunitinib outcome between the two ethnicities. For adverse events, we focused the following clinically relevant side effects: diarrhea, fatigue, mucositis/stomatitis, hand-foot syndrome, hypertension, leukopenia, neutropenia and thrombocytopenia. RESULTS A total of 33 publications including 9977 patients were available for meta-analysis. The efficacy of sunitinib in Asian patients was similar to that in Caucasian patients. However, Asian patients showed a higher incidence of all grades toxicity of hand-foot syndrome, > grade 2 fatigue, > grade 2 hand-foot syndrome and > grade 2 thrombocytopenia. CONCLUSION Ethnic differences in adverse events of sunitinib in mRCC patients existed and dose adjustment in Asian patients may be considered.
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Affiliation(s)
- Xiaoyan Liu
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands
- Institute of Clinical Pharmacology, Qilu Hospital of Shandong University, Jinan, China
| | - Marta Fiocco
- Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands
| | - Jesse J. Swen
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| | - Henk-Jan Guchelaar
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands
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20
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Hsieh JJ, Manley BJ, Khan N, Gao J, Carlo MI, Cheng EH. Overcome tumor heterogeneity-imposed therapeutic barriers through convergent genomic biomarker discovery: A braided cancer river model of kidney cancer. Semin Cell Dev Biol 2017; 64:98-106. [PMID: 27615548 PMCID: PMC5522717 DOI: 10.1016/j.semcdb.2016.09.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 09/07/2016] [Indexed: 12/13/2022]
Abstract
Tumor heterogeneity, encompassing genetic, epigenetic, and microenvironmental variables, is extremely complex and presents challenges to cancer diagnosis and therapy. Genomic efforts on genetic intratumor heterogeneity (G-ITH) confirm branched evolution, support the trunk-branch cancer model, and present a seemingly insurmountable obstacle to conquering cancers. G-ITH is conspicuous in clear cell renal cell carcinoma (ccRCC), where its presence complicates identification and validation of biomarkers and thwarts efforts in advancing precision cancer therapeutics. However, long-term clinical benefits on targeted therapy are not uncommon in metastatic ccRCC patients, implicating that there are underlying constraints during ccRCC evolution, which in turn force a nonrandom sequence of parallel gene/pathway/function/phenotype convergence within individual tumors. Accordingly, we proposed a "braided cancer river model" depicting ccRCC evolution, which deduces cancer development based on multiregion tumor genomics of exceptional mTOR inhibitor (mTORi) responders. Furthermore, we employ an outlier case to explore the river model and highlight the importance of "Five NGS Matters: Number, Frequency, Position, Site and Time" in assessing cancer genomics for precision medicine. This mutable cancer river model may capture clinically significant phenotype-convergent events, predict vulnerability/resistance mechanisms, and guide effective therapeutic strategies. Our model originates from studying exceptional responders in ccRCC, which warrants further refinement and future validation concerning its applicability to other cancer types. The goal of this review is employing kidney cancer as an example to illustrate critical issues concerning tumor heterogeneity.
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Affiliation(s)
- James J Hsieh
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, United States.
| | - Brandon J Manley
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065, United States
| | - Nabeela Khan
- Department of Medicine, State University of New York Downstate Medical Center, Brooklyn, NY11203, United States
| | - JianJiong Gao
- Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, United States
| | - Maria I Carlo
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, United States
| | - Emily H Cheng
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY 10065, United States; Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, United States
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21
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Hsieh JJ, Purdue MP, Signoretti S, Swanton C, Albiges L, Schmidinger M, Heng DY, Larkin J, Ficarra V. Renal cell carcinoma. Nat Rev Dis Primers 2017; 3:17009. [PMID: 28276433 PMCID: PMC5936048 DOI: 10.1038/nrdp.2017.9] [Citation(s) in RCA: 1557] [Impact Index Per Article: 222.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Renal cell carcinoma (RCC) denotes cancer originated from the renal epithelium and accounts for >90% of cancers in the kidney. The disease encompasses >10 histological and molecular subtypes, of which clear cell RCC (ccRCC) is most common and accounts for most cancer-related deaths. Although somatic VHL mutations have been described for some time, more-recent cancer genomic studies have identified mutations in epigenetic regulatory genes and demonstrated marked intra-tumour heterogeneity, which could have prognostic, predictive and therapeutic relevance. Localized RCC can be successfully managed with surgery, whereas metastatic RCC is refractory to conventional chemotherapy. However, over the past decade, marked advances in the treatment of metastatic RCC have been made, with targeted agents including sorafenib, sunitinib, bevacizumab, pazopanib and axitinib, which inhibit vascular endothelial growth factor (VEGF) and its receptor (VEGFR), and everolimus and temsirolimus, which inhibit mechanistic target of rapamycin complex 1 (mTORC1), being approved. Since 2015, agents with additional targets aside from VEGFR have been approved, such as cabozantinib and lenvatinib; immunotherapies, such as nivolumab, have also been added to the armamentarium for metastatic RCC. Here, we provide an overview of the biology of RCC, with a focus on ccRCC, as well as updates to complement the current clinical guidelines and an outline of potential future directions for RCC research and therapy.
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Affiliation(s)
- James J. Hsieh
- Molecular Oncology, Department of Medicine, Siteman Cancer Center, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8069, St. Louis, Missouri, USA
| | - Mark P. Purdue
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Sabina Signoretti
- Department of Pathology, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Charles Swanton
- Francis Crick Institute, UCL Cancer Institute, CRUK Lung Cancer Centre of Excellence, London, UK
| | - Laurence Albiges
- Department of Cancer Medicine, Institut Gustave Roussy, Villejuif, France
| | - Manuela Schmidinger
- Department of Medicine I, Clinical Division of Oncology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Daniel Y. Heng
- Department of Medical Oncolgy, Tom Baker Cancer Center, Calgary, Alberta, Canada
| | - James Larkin
- Department of Medical Oncology, Royal Marsden NHS Foundation Trust, London, UK
| | - Vincenzo Ficarra
- Department of Experimental and Clinical Medical Sciences - Urologic Clinic, University of Udine, Italy
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22
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Affiliation(s)
- Toni K Choueiri
- From the Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston (T.K.C.); and the Department of Medicine, Genitourinary Oncology Service, Memorial Sloan Kettering Cancer Center, New York (R.J.M.)
| | - Robert J Motzer
- From the Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston (T.K.C.); and the Department of Medicine, Genitourinary Oncology Service, Memorial Sloan Kettering Cancer Center, New York (R.J.M.)
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23
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Paulucci DJ, Sfakianos JP, Skanderup AJ, Kan K, Tsao CK, Galsky MD, Hakimi AA, Badani KK. Genomic differences between black and white patients implicate a distinct immune response to papillary renal cell carcinoma. Oncotarget 2017; 8:5196-5205. [PMID: 28029648 PMCID: PMC5354901 DOI: 10.18632/oncotarget.14122] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 11/22/2016] [Indexed: 12/25/2022] Open
Abstract
Significant disparities in survival, incidence and possibly response to current therapies exist between black and white patients with renal cell carcinoma (RCC). Recent genomic evidence to account for these disparities has been reported for clear cell RCC. However, racial disparities at the genomic level for papillary RCC (pRCC) which is a genetically distinct and less responsive histologic subtype of RCC have not been reported. Using The Cancer Genome Atlas (TCGA) data, the present study assessed gene-level expression, somatic mutation and pathway differences between 58 black and 58 white patients with pRCC propensity matched on age, gender and pathologic T stage. Distinct tumor biology with differential expression patterns were observed in black vs. white patients with pRCC. Specifically, significance analysis of microarrays was applied to TCGA gene expression data and identified 163 genes and 120 genes overexpressed in black and white patients, respectively (FDR q<0.05). Gene Set Enrichment Analysis identified 62 gene sets enriched (p<0.10) in blacks. Enrichment of immune immune system pathways were noted in black patients. These included the B cell receptor signaling pathway, the NOD-like receptor signaling pathway and genes involved in defensins. The VEGF pathway was also more significant in black patients. CRYBB2, a gene associated with the WNT pathway was overexpressed in Black patients. While our data requires validation, these findings suggest that race may have implications for distinct immune responses to cancer and that the use of immunotherapies, and VEGFR inhibitors to target these pathways may improve survival in black patients with advanced pRCC.
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Affiliation(s)
- David J. Paulucci
- Department of Urology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
| | - John P. Sfakianos
- Department of Urology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
| | - Anders J. Skanderup
- Computational Biology Program, Sloan Kettering Institute for Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Kathleen Kan
- Department of Urology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
| | - Che-Kai Tsao
- Department of Medicine, Division of Hematology/Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Matthew D. Galsky
- Department of Medicine, Division of Hematology/Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - A. Ari Hakimi
- Department of Surgery—Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ketan K. Badani
- Department of Urology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
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24
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Beisland C, Johannesen TB, Klepp O, Axcrona U, Torgersen KM, Kowalski J, Solli O, Sandin R, Oldenburg J. Overall survival in renal cell carcinoma after introduction of targeted therapies: a Norwegian population-based study. Onco Targets Ther 2017; 10:371-385. [PMID: 28144152 PMCID: PMC5248939 DOI: 10.2147/ott.s123061] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND This population-wide retrospective, non-interventional registry study assessed changes in overall survival (OS) and factors influencing OS in Norwegian patients with renal cell carcinoma (RCC). METHODS Two population-wide health registries were used to identify all RCC patients with (mRCC) or without metastases diagnosed before (2002-2005) and after (2006-2008 and 2009-2011) introduction of targeted therapies. Median OS was estimated using Kaplan-Meier method. Cox proportional hazards regression modeling was used to identify prognostic factors. RESULTS Overall, 5,463 patients were diagnosed with RCC during 2002-2005 (n=1,898), 2006-2008 (n=1,631), and 2009-2011 (n=1,934); of these, 1,678 (31%) had mRCC. Patients diagnosed in 2009-2011 and 2006-2008 had significant (P<0.001) improvements in OS versus those diagnosed in 2002-2005: median OS, not reached and not reached versus 82.0 months in RCC; 14.0 and 12.0 months versus 9.0 months in mRCC. Similarly, OS improvements were seen in the primary and elderly (≥75 years) mRCC populations. Median OS was comparable (12 months) between clear cell and papillary mRCC, but it was longer (24.0 months) for chromophobe mRCC. Multivariate regression analyses showed that younger age, previous nephrectomy, and 1 or more prescriptions of targeted therapy were significantly associated with longer OS in mRCC patients. CONCLUSION OS increased in RCC and mRCC patients in Norway between 2002 and 2011 following introduction of targeted therapies.
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Affiliation(s)
- Christian Beisland
- Department of Urology, Haukeland University Hospital
- Department of Clinical Medicine, University of Bergen, Bergen
| | | | | | - Ulrika Axcrona
- Department of Pathology, Oslo University Hospital, the Norwegian Radium Hospital, Oslo
| | | | | | | | | | - Jan Oldenburg
- Department of Oncology, Akershus University Hospital, Lørenskog
- Medical Faculty, University of Oslo, Oslo, Norway
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25
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Kumbla RA, Figlin RA, Posadas EM. Recent Advances in the Medical Treatment of Recurrent or Metastatic Renal Cell Cancer. Drugs 2016; 77:17-28. [DOI: 10.1007/s40265-016-0665-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Open-label phase 2 trial of first-line everolimus monotherapy in patients with papillary metastatic renal cell carcinoma: RAPTOR final analysis. Eur J Cancer 2016; 69:226-235. [DOI: 10.1016/j.ejca.2016.08.004] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 08/01/2016] [Accepted: 08/09/2016] [Indexed: 01/12/2023]
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27
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Chen YB, Xu J, Skanderup AJ, Dong Y, Brannon AR, Wang L, Won HH, Wang PI, Nanjangud GJ, Jungbluth AA, Li W, Ojeda V, Hakimi AA, Voss MH, Schultz N, Motzer RJ, Russo P, Cheng EH, Giancotti FG, Lee W, Berger MF, Tickoo SK, Reuter VE, Hsieh JJ. Molecular analysis of aggressive renal cell carcinoma with unclassified histology reveals distinct subsets. Nat Commun 2016; 7:13131. [PMID: 27713405 PMCID: PMC5059781 DOI: 10.1038/ncomms13131] [Citation(s) in RCA: 125] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 09/05/2016] [Indexed: 12/12/2022] Open
Abstract
Renal cell carcinomas with unclassified histology (uRCC) constitute a significant portion of aggressive non-clear cell renal cell carcinomas that have no standard therapy. The oncogenic drivers in these tumours are unknown. Here we perform a molecular analysis of 62 high-grade primary uRCC, incorporating targeted cancer gene sequencing, RNA sequencing, single-nucleotide polymorphism array, fluorescence in situ hybridization, immunohistochemistry and cell-based assays. We identify recurrent somatic mutations in 29 genes, including NF2 (18%), SETD2 (18%), BAP1 (13%), KMT2C (10%) and MTOR (8%). Integrated analysis reveals a subset of 26% uRCC characterized by NF2 loss, dysregulated Hippo–YAP pathway and worse survival, whereas 21% uRCC with mutations of MTOR, TSC1, TSC2 or PTEN and hyperactive mTORC1 signalling are associated with better clinical outcome. FH deficiency (6%), chromatin/DNA damage regulator mutations (21%) and ALK translocation (2%) distinguish additional cases. Altogether, this study reveals distinct molecular subsets for 76% of our uRCC cohort, which could have diagnostic and therapeutic implications. A subset of renal cell carcinomas have uncertain histology and are aggressive in nature. Here, the authors examine this group of unclassified renal cancers using genomics techniques and identify further subclasses of the tumours that have differing prognoses.
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Affiliation(s)
- Ying-Bei Chen
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Jianing Xu
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Anders Jacobsen Skanderup
- Computational Biology Program, Sloan Kettering Institute for Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Yiyu Dong
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - A Rose Brannon
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Lu Wang
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Helen H Won
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Patricia I Wang
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Gouri J Nanjangud
- Molecular Cytogenetics Laboratory, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Achim A Jungbluth
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Wei Li
- Cell Biology Program, Sloan Kettering Institute for Cancer Research, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Virginia Ojeda
- Cell Biology Program, Sloan Kettering Institute for Cancer Research, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - A Ari Hakimi
- Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Martin H Voss
- Department of Medicine, Genitourinary Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Nikolaus Schultz
- Computational Biology Program, Sloan Kettering Institute for Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Robert J Motzer
- Department of Medicine, Genitourinary Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Paul Russo
- Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Emily H Cheng
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA.,Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Filippo G Giancotti
- Cell Biology Program, Sloan Kettering Institute for Cancer Research, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - William Lee
- Computational Biology Program, Sloan Kettering Institute for Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.,Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Michael F Berger
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA.,Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Satish K Tickoo
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Victor E Reuter
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - James J Hsieh
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA.,Department of Medicine, Genitourinary Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA.,Department of Medicine, Weill Cornell Medical College, 1300 York Ave, New York, New York 10065, USA
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28
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Tornberg SV, Nisen H, Visapää H, Kilpeläinen TP, Järvinen R, Mirtti T, Kantonen I, Simpanen J, Bono P, Taari K, Järvinen P. Outcome of surgery for patients with renal cell carcinoma and tumour thrombus in the era of modern targeted therapy. Scand J Urol 2016; 50:380-6. [DOI: 10.1080/21681805.2016.1217558] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Manley BJ, Hsieh JJ. Sarcomatoid renal cell carcinoma: genomic insights from sequencing of matched sarcomatous and carcinomatous components. Transl Cancer Res 2016; 5:S160-S165. [PMID: 29167760 DOI: 10.21037/tcr.2016.07.30] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Brandon J Manley
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - James J Hsieh
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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30
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Rimar KJ, Meeks JJ, Kuzel TM. Anti-programmed Death Receptor 1 Blockade Induces Clinical Response in a Patient With Metastatic Collecting Duct Carcinoma. Clin Genitourin Cancer 2016; 14:e431-4. [DOI: 10.1016/j.clgc.2016.02.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 02/15/2016] [Indexed: 01/18/2023]
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31
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Dougherty BJ, Fields DP, Mitchell GS. Mammalian target of rapamycin is required for phrenic long-term facilitation following severe but not moderate acute intermittent hypoxia. J Neurophysiol 2015. [PMID: 26224775 DOI: 10.1152/jn.00539.2015] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Phrenic long-term facilitation (pLTF) is a persistent increase in phrenic nerve activity after acute intermittent hypoxia (AIH). Distinct cell-signaling cascades give rise to pLTF depending on the severity of hypoxemia within hypoxic episodes. Moderate AIH (mAIH; three 5-min episodes, PaO2 ∼35-55 mmHG) elicits pLTF by a serotonin (5-HT)-dependent mechanism that requires new synthesis of brain-derived neurotrophic factor (BDNF), activation of its high-affinity receptor (TrkB), and ERK MAPK signaling. In contrast, severe AIH (sAIH; three 5-min episodes, PaO2 ∼25-30 mmHG) elicits pLTF by an adenosine-dependent mechanism that requires new TrkB synthesis and Akt signaling. Although both mechanisms require spinal protein synthesis, the newly synthesized proteins are distinct, as are the neurochemicals inducing plasticity (serotonin vs. adenosine). In many forms of neuroplasticity, new protein synthesis requires translational regulation via mammalian target of rapamycin (mTOR) signaling. Since Akt regulates mTOR activity, we hypothesized that mTOR activity is necessary for sAIH- but not mAIH-induced pLTF. Phrenic nerve activity in anesthetized, paralyzed, and ventilated rats was recorded before, during, and 60 min after mAIH or sAIH. Rats were pretreated with intrathecal injections of 20% DMSO (vehicle controls) or rapamycin (0.1 mM, 12 μl), a selective mTOR complex 1 inhibitor. Consistent with our hypothesis, rapamycin blocked sAIH- but not mAIH-induced pLTF. Thus spinal mTOR activity is required for adenosine-dependent (sAIH) but not serotonin-dependent (mAIH) pLTF, suggesting that distinct mechanisms regulate new protein synthesis in these forms of spinal neuroplasticity.
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Affiliation(s)
- Brendan J Dougherty
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin; and
| | - Daryl P Fields
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin; and Department of Physical Therapy, University of Florida, Gainesville, Florida
| | - Gordon S Mitchell
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin; and Department of Physical Therapy, University of Florida, Gainesville, Florida
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