1
|
Antonarakis ES, Shui IM, Zaidi O, Bernauer M, Gratzke C. Current Treatment Paradigms and Clinical Outcomes in Oligometastatic Prostate Cancer Patients: A Targeted Literature Review. Eur Urol Oncol 2024; 7:1280-1292. [PMID: 38964996 DOI: 10.1016/j.euo.2024.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 05/10/2024] [Accepted: 06/07/2024] [Indexed: 07/06/2024]
Abstract
CONTEXT Prostate cancer is the most common noncutaneous malignancy among men in the USA and Europe. There is no consensus definition of oligometastatic prostate cancer (omPC), which is often considered in two subgroups, synchronous (de novo) and metachronous (oligorecurrent), and may include patients with a low metastatic disease burden. OBJECTIVE To summarize the epidemiology, disease definitions, mortality/survival outcomes, and treatment characteristics in both clinical trial and real-world settings among patients with synchronous, metachronous, and mixed-subtype (ie, synchronous and metachronous or undefined type) omPC, as well as low burden disease states. EVIDENCE ACQUISITION We searched MEDLINE and Embase to identify publications reporting on epidemiology, disease definitions, clinical outcomes, and treatment characteristics of omPC. Gray literature sources (eg, ClinicalTrials.gov) were searched for ongoing trials. EVIDENCE SYNTHESIS We identified 105 publications. Disease definitions varied across publications and omPC subtypes on the number and location of lesions, type of imaging used, and type of oligometastatic disease. Most studies defined omPC as five or fewer metastatic lesions. Data on the epidemiology of omPC were limited. Mortality rates and overall survival tended to be worse among synchronous versus metachronous omPC cohorts. Progression-free survival was generally longer among synchronous than among metachronous omPC cohorts but was more similar at longer time points. A summary of ongoing clinical trials investigating a variety of local, metastasis-directed, and systemic therapies in men with omPC is also provided. CONCLUSIONS Definitions of oligometastatic disease depend on the imaging technique used. Epidemiologic data for omPC are scarce. Survival rates differ between synchronous and metachronous cohorts, and heterogeneous treatment patterns result in varied outcomes. Ongoing clinical trials using modern imaging techniques are awaited and needed. PATIENT SUMMARY Definitions of oligometastatic prostate cancer (omPC) vary depending on the imaging technique used. Different treatment patterns lead to different outcomes. Robust omPC epidemiologic data are lacking.
Collapse
|
2
|
Mosoh DA. Widely-targeted in silico and in vitro evaluation of veratrum alkaloid analogs as FAK inhibitors and dual targeting of FAK and Hh/SMO pathways for cancer therapy: A critical analysis. Int J Biol Macromol 2024; 281:136201. [PMID: 39368576 DOI: 10.1016/j.ijbiomac.2024.136201] [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: 04/27/2024] [Revised: 09/26/2024] [Accepted: 09/29/2024] [Indexed: 10/07/2024]
Abstract
Focal Adhesive Kinase (FAK), a key player in aggressive cancers, mediates signals crucial for progression, invasion, and metastasis. Despite advances in targeted therapies, drug resistance is still a challenge, and survival rates remain low, particularly for late-stage patients, emphasizing the need for innovative cancer therapeutics. Cyclopamine, a veratrum alkaloid, has shown promising anti-tumor properties, but the search for more potent analogs with enhanced affinity for the biological target continues. This study employs a hybrid virtual screening approach combining pharmacophore model-based virtual screening (PB-VS) and docking-based virtual screening (DB-VS) to identify potential inhibitors of the FAK catalytic domain. PB-VS on the PubChem database yielded a set of hits, which were then docked with the FAK catalytic domain in two stages (1st and 2nd DB-VS). Hits were ranked based on docking scores and interactions with the active site. The top three compounds underwent molecular dynamics simulations, alongside two control compounds (SMO inhibitor(s) and FAK inhibitor(s)), to assess stability through RMSD, RMSF, Rg, and SASA analyses. ADMET properties were evaluated, and compounds were filtered based on drug-likeness criteria. Molecular dynamics simulations demonstrated the stability of compounds when complexed with the FAK catalytic domain. Compounds 16 (-25 kcal/mol), 87 (-27.47 kcal/mol), and 88 (-18.94 kcal/mol) exhibited comparable docking scores, interaction profiles, stability, and binding energies, indicating their potential as lead candidates. However, further validation and optimization through quantitative structure-activity relationship (QSAR) studies are essential to refine their efficacy and therapeutic potential. The in vitro cell-based assay demonstrated that compound 101PF, a FAK inhibitor, significantly inhibited the proliferation and migration of A549 cells. However, the results regarding the combined effects of FAK and SMO inhibitors were inconclusive, highlighting the need for further investigation. This study contributes to developing more effective anti-cancer drugs by improving the understanding of potential cyclopamine-based veratrum alkaloid analogs with enhanced interactions with the FAK catalytic domain.
Collapse
Affiliation(s)
- Dexter Achu Mosoh
- Centre for Biodiversity Exploration and Conservation (CBEC), 15, Kundan Residency, 4th Mile Mandla Road, Tilhari, Jabalpur, M.P 482021, India; Indian Institute of Technology Gandhinagar, Palaj Campus, Gujarat 382355, India; School of Sciences, Sanjeev Agrawal Global Educational (SAGE) University, Bhopal, M.P 462022, India; Prof. Wagner A. Vendrame's Laboratory, Environmental Horticulture Department, University of Florida, Institute of Food and Agricultural Sciences, 2550 Hull Rd., Gainesville, FL 32611, USA.
| |
Collapse
|
3
|
Chen CY, Huang TH, Lee LW, Lung J, Ou YC, Hung CH, Chuang HC, Chen MC, Wang TY. Prognostic factors of early recurrence after complete cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. World J Clin Cases 2024; 12:6057-6069. [PMID: 39328856 PMCID: PMC11326106 DOI: 10.12998/wjcc.v12.i27.6057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 06/25/2024] [Accepted: 07/15/2024] [Indexed: 07/29/2024] Open
Abstract
BACKGROUND Although cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) offer the potential for long-term survival in peritoneal carcinomatosis, outcomes following CRS/HIPEC vary significantly. AIM To identify the clinical factors associated with progression-free survival (PFS) after complete CRS/HIPEC in patients with colorectal/high-grade appendiceal, ovarian, and gastric cancers. METHODS We retrospectively evaluated the risk of recurrence within 1 year after CRS/HIPEC and its impact on overall survival (OS) in patients recruited between 2015 and 2020. Logistic regression models were used to assess the prognostic factors for the risk of recurrence within 1 year. Kaplan-Meier survival curves and Cox proportional hazards models were used to evaluate the association between recurrence and OS. RESULTS Of the 80 enrolled patients, 39 had an unfavorable PFS (< 1 year) and 41 had a favorable PFS (≥ 1 year). Simple logistic models revealed that the patients with a completeness of cytoreduction score of 0 (CC-0) or length of CRS ≤ 6 h had a favorable PFS [odds ratio (OR) = 0.141, P = 0.004; and OR = 0.361, P = 0.027, respectively]. In multiple logistic regression, achieving CC-0 was the strongest prognostic factor for a favorable PFS (OR = 0.131, P = 0.005). A peritoneal cancer index score > 12 was associated with a lower rate of achieving CC-0 (P = 0.027). The favorable PFS group had a significantly longer OS (median 81.7 mo vs 17.0 mo, P < 0.001). CONCLUSION Achieving CC-0 was associated with a lower early recurrence rate and improved long-term survival. This study underscores the importance of selecting appropriate candidates for CRS/HIPEC to manage peritoneal carcinomatosis.
Collapse
Affiliation(s)
- Chao-Yu Chen
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Department of Early Childhood Care and Education, Shu-Zen Junior College of Medicine and Management, Kaohsiung 821, Taiwan
| | - Tzu-Hao Huang
- Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
| | - Li-Wen Lee
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Jrhau Lung
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Department of Medical Research and Development, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
| | - Yu-Che Ou
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
| | - Chien-Hui Hung
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Huei-Chieh Chuang
- Department of Anatomic Pathology, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
| | - Min-Chi Chen
- Department of Public Health, Chang Gung University, Taoyuan 333, Taiwan
| | - Ting-Yao Wang
- Department of Early Childhood Care and Education, Shu-Zen Junior College of Medicine and Management, Kaohsiung 821, Taiwan
- Division of Hematology and Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
| |
Collapse
|
4
|
Palma DA, Giuliani ME, Correa RJM, Schneiders FL, Harrow S, Guckenberger M, Zhang T, Bahig H, Senthi S, Chung P, Olson R, Lock M, Raman S, Bauman GS, Lok BH, Laba JM, Glicksman RM, Nguyen TK, Lang P, Helou J, Goodman CD, Mendez LC, van Rossum PSN, Warner A, Gaede S, Allan AL. A randomized phase III trial of stereotactic ablative radiotherapy for patients with up to 10 oligometastases and a synchronous primary tumor (SABR-SYNC): study protocol. BMC Palliat Care 2024; 23:223. [PMID: 39244532 PMCID: PMC11380777 DOI: 10.1186/s12904-024-01548-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Accepted: 08/16/2024] [Indexed: 09/09/2024] Open
Abstract
BACKGROUND Emerging randomized data, mostly from phase II trials, have suggested that patients with oligometastatic cancers may benefit from ablative treatments such as stereotactic ablative radiotherapy (SABR). However, phase III data testing this paradigm are lacking, and many studies have examined SABR in the setting of metachronous oligometastatic disease. The goal of the SABR-SYNC trial is to assess the effect of SABR in patients with oligometastatic cancers and a synchronous primary tumor. METHODS One hundred and eighty patients will be randomized in a 1:2 ratio between standard of care (SOC) palliative-intent treatments vs. SOC + ablative therapy (SABR preferred) to all sites of known disease. Randomization will be stratified based on histology and number of metastases at enrollment. SABR may be delivered in 1-, 3- and 5-fraction regimens, with recommended doses of 20 Gy, 30 Gy, and 35 Gy, respectively. Non-SABR local modalities (e.g. surgery, thermal ablation, conventional radiation) may be used for treatment of the primary or metastases at the discretion of the treating physicians, if those modalities are clinically preferred. The primary endpoint is overall survival, and secondary endpoints include progression-free survival, time to development of new metastatic lesions, time to initiation of next systemic therapy, quality of life, and toxicity. Translational endpoints include assessment of circulating tumor DNA and immunological predictors of outcomes. DISCUSSION SABR-SYNC will provide phase III data to assess the impact of SABR on overall survival in a population of patients with synchronous oligometastases. The translational component will attempt to identify novel prognostic and predictive biomarkers to aid in clinical decision making. TRIAL REGISTRATION Clinicaltrials.gov NCT05717166 (registration date: Feb. 8, 2023).
Collapse
Affiliation(s)
- David A Palma
- Department of Oncology, London Health Sciences Centre, Western University, 800 Commissioners Rd. E, London, ON, N6A 5W9, Canada.
| | - Meredith E Giuliani
- Department of Radiation Oncology, University of Toronto, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Rohann J M Correa
- Department of Oncology, London Health Sciences Centre, Western University, 800 Commissioners Rd. E, London, ON, N6A 5W9, Canada
| | - Famke L Schneiders
- Department of Radiation Oncology, Amsterdam UMC, Amsterdam, The Netherlands
| | | | | | - Tina Zhang
- Department of Radiation Oncology, BC Cancer, Vancouver, BC, Canada
| | - Houda Bahig
- Department of Radiation Oncology, Centre Hospitalier de L'Université de Montréal, Montréal, QC, Canada
| | | | - Peter Chung
- Department of Radiation Oncology, University of Toronto, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Robert Olson
- Department of Radiation Oncology, BC Cancer, Prince George, British Columbia, Canada
| | - Michael Lock
- Department of Oncology, London Health Sciences Centre, Western University, 800 Commissioners Rd. E, London, ON, N6A 5W9, Canada
| | - Srinivas Raman
- Department of Radiation Oncology, University of Toronto, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Glenn S Bauman
- Department of Oncology, London Health Sciences Centre, Western University, 800 Commissioners Rd. E, London, ON, N6A 5W9, Canada
| | - Benjamin H Lok
- Department of Radiation Oncology, University of Toronto, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Joanna M Laba
- Department of Oncology, London Health Sciences Centre, Western University, 800 Commissioners Rd. E, London, ON, N6A 5W9, Canada
| | - Rachel M Glicksman
- Department of Radiation Oncology, University of Toronto, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Timothy K Nguyen
- Department of Oncology, London Health Sciences Centre, Western University, 800 Commissioners Rd. E, London, ON, N6A 5W9, Canada
| | - Pencilla Lang
- Department of Oncology, London Health Sciences Centre, Western University, 800 Commissioners Rd. E, London, ON, N6A 5W9, Canada
| | - Joelle Helou
- Department of Oncology, London Health Sciences Centre, Western University, 800 Commissioners Rd. E, London, ON, N6A 5W9, Canada
| | - Christopher D Goodman
- Department of Oncology, London Health Sciences Centre, Western University, 800 Commissioners Rd. E, London, ON, N6A 5W9, Canada
| | - Lucas C Mendez
- Department of Oncology, London Health Sciences Centre, Western University, 800 Commissioners Rd. E, London, ON, N6A 5W9, Canada
| | | | - Andrew Warner
- Department of Oncology, London Health Sciences Centre, Western University, 800 Commissioners Rd. E, London, ON, N6A 5W9, Canada
| | - Stewart Gaede
- Department of Oncology, London Health Sciences Centre, Western University, 800 Commissioners Rd. E, London, ON, N6A 5W9, Canada
| | - Alison L Allan
- Department of Oncology, London Health Sciences Centre, Western University, 800 Commissioners Rd. E, London, ON, N6A 5W9, Canada
| |
Collapse
|
5
|
Joo B, Kim JH, Ahn SG, Park M, Suh SH, Ahn SJ. De novo versus recurrent metastatic breast cancer affects the extent of brain metastases. J Neurooncol 2024; 169:309-316. [PMID: 38865012 DOI: 10.1007/s11060-024-04735-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 06/01/2024] [Indexed: 06/13/2024]
Abstract
PURPOSE We aimed to identify factors associated with the extent of brain metastases in patients with breast cancer to help distinguish brain oligometastases (1-4 brain metastases) from extensive metastases (5 or more brain metastases). METHODS This retrospective observational study included 100 female patients diagnosed with brain metastases from breast cancer at a single institution between January 2011 and April 2022. Patient demographics and tumor characteristics were compared between the brain oligometastases group and the extensive metastases group. Multivariable logistic regression analysis was performed to determine the independent factors, including age at initial diagnosis, initial stage, breast cancer subtype, detection time of brain metastases, and de novo or recurrent status of the metastatic disease. In a subgroup analysis of patients with brain oligometastases, demographic and tumor characteristics were compared between patients with single and two-four brain metastases. RESULTS Of the 100 patients, 56 had brain oligometastases, while 44 had extensive brain metastases. The multivariable logistic regression analysis revealed that only the de novo/recurrent status of metastatic breast cancer was significantly associated with the extent of brain metastasis (p = 0.023). In the subgroup analysis of 56 patients with brain oligometastases, those diagnosed at an earlier stage were more likely to have a single brain metastasis (p = 0.008). CONCLUSION Patients with de novo metastatic breast cancer are more likely to develop extensive brain metastases than those with recurrent metastatic breast cancer. This insight could influence the development of tailored approaches for monitoring and treating brain metastases, supporting the potential advantages of routine brain screening for patients newly diagnosed with stage IV breast cancer.
Collapse
Affiliation(s)
- Bio Joo
- Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Jee Hung Kim
- Division of Medical Oncology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sung Gwe Ahn
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Mina Park
- Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Sang Hyun Suh
- Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Sung Jun Ahn
- Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea.
| |
Collapse
|
6
|
Mattes MD. Overview of Radiation Therapy in the Management of Localized and Metastatic Prostate Cancer. Curr Urol Rep 2024; 25:181-192. [PMID: 38861238 DOI: 10.1007/s11934-024-01217-5] [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] [Accepted: 06/05/2024] [Indexed: 06/12/2024]
Abstract
PURPOSE OF REVIEW The goal is to describe the evolution of radiation therapy (RT) utilization in the management of localized and metastatic prostate cancer. RECENT FINDINGS Long term data for a variety of hypofractionated definitive RT dose-fractionation schemes has matured, allowing patients and providers many standard-of-care options to choose from. Post-prostatectomy, adjuvant RT has largely been replaced by an early salvage approach. Multiparametric MRI and PSMA PET have enabled increasingly targeted RT delivery to the prostate and oligometastatic tumors. Areas of active investigation include determining the value of proton beam therapy and perirectal spacers, and optimally incorporate genomic tumor profiling and next generation hormonal therapies with RT in the curative setting. The use of radiation therapy to treat prostate cancer is rapidly evolving. In the coming years, there will be continued improvements in a variety of areas to enhance the value of RT in multidisciplinary prostate cancer management.
Collapse
Affiliation(s)
- Malcolm D Mattes
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08901, USA.
| |
Collapse
|
7
|
Chen T, Xu J, Xia B, Wang H, Shen Y. Evaluation of secondary cytoreduction surgery in platinum-resistant ovarian cancer patients within three-line recurrent: a multicenter, randomized controlled study. J Gynecol Oncol 2024; 35:e22. [PMID: 37945326 PMCID: PMC10792204 DOI: 10.3802/jgo.2024.35.e22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/10/2023] [Accepted: 10/15/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Epithelial ovarian cancer is the leading cause of death among gynecological malignancies. Platinum resistance remains a dilemma and bottleneck in treatment, and salvage chemotherapy has limited effectiveness. Recently, the role of secondary cytoreductive surgery (SCS) in patients with platinum-resistant recurrent ovarian cancer (ROC) has caused attention especially in patients with oligometastases. However, there is neither high-quality evidence-based evidence nor standardized criteria for selecting SCS for patients with platinum-resistant ROC until now. METHODS This multicenter, randomized, controlled clinical trial is to evaluate the value of SCS and to clarify reliable criteria of utilizing SCS in women with ROC, which is led by Gynecologic Oncology Group, Women's Hospital, Zhejiang University School of Medicine. Recruitment has started on January 1st, 2023, and is scheduled to end in December 2026. One hundred and forty participants with platinum-resistant ROC who meet the "RSCS criteria" will be randomized assigned at a ratio of 1:1 to either the experimental arm or the standard arm. Patients in the experimental arm will receive SCS followed by non-platinum single agent chemotherapy (paclitaxel, gemcitabine or liposomal adriamycin) for at least 4 cycles while patients in the standard arm will be provided with only non-platinum single agent chemotherapy. The primary outcome is progression-free survival. The secondary outcomes are overall survival, adverse events and health-related cancer-specific quality of life. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05633199.
Collapse
Affiliation(s)
- Tingting Chen
- Department of Gynecology and Oncology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Zhejiang Provincial Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Junfen Xu
- Department of Gynecology and Oncology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Zhejiang Provincial Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Bairong Xia
- Department of Gynecology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Hui Wang
- Department of Gynecology and Oncology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Zhejiang Provincial Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Hangzhou, Zhejiang, China
| | - Yuanming Shen
- Department of Gynecology and Oncology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Zhejiang Provincial Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Hangzhou, Zhejiang, China.
| |
Collapse
|
8
|
Santorsola M, Capuozzo M, Savarese G, Ianniello M, Petrillo N, Casillo M, Sabbatino F, Perri F, Ferrara F, Zovi A, Berretta M, Granata V, Nasti G, Ottaiano A. Oligo-Metastatic Disease in Oncology: Exploring the Limits and the Potential of Genetic Assessment. Genes (Basel) 2023; 14:2131. [PMID: 38136953 PMCID: PMC10742616 DOI: 10.3390/genes14122131] [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: 11/07/2023] [Revised: 11/24/2023] [Accepted: 11/25/2023] [Indexed: 12/24/2023] Open
Abstract
Oligo-metastatic disease (OMD) in the field of oncology denotes a distinct subset of metastatic tumors characterized by less aggressive biological behavior and extended survival times in comparison to their widely metastatic counterparts. While there is a general consensus regarding the existence of OMD, there remains a lack of widely accepted criteria for its a priori identification at the time of presentation. This review delves into the concept of OMD, placing a particular emphasis on the significance of understanding the limitations and potential of genetic assessments. It explores how these aspects are crucial in advancing our comprehension of this phenomenon. In a rapidly advancing era of precision medicine, understanding the intricacies of OMD opens up exciting possibilities for tailored treatment approaches. By elucidating the genetic underpinnings and dynamic nature of this condition, we stand to improve patient outcomes and potentially shift the paradigm of metastatic cancer management.
Collapse
Affiliation(s)
- Mariachiara Santorsola
- Istituto Nazionale Tumori di Napoli, IRCCS “G. Pascale”, Via Mariano Semmola, 80131 Napoli, Italy; (M.S.); (F.P.); (V.G.); (G.N.)
| | | | - Giovanni Savarese
- AMES, Centro Polidiagnostico Strumentale srl, Via Padre Carmine Fico 24, 80013 Casalnuovo Di Napoli, Italy; (G.S.); (M.I.); (N.P.); (M.C.)
| | - Monica Ianniello
- AMES, Centro Polidiagnostico Strumentale srl, Via Padre Carmine Fico 24, 80013 Casalnuovo Di Napoli, Italy; (G.S.); (M.I.); (N.P.); (M.C.)
| | - Nadia Petrillo
- AMES, Centro Polidiagnostico Strumentale srl, Via Padre Carmine Fico 24, 80013 Casalnuovo Di Napoli, Italy; (G.S.); (M.I.); (N.P.); (M.C.)
| | - Marika Casillo
- AMES, Centro Polidiagnostico Strumentale srl, Via Padre Carmine Fico 24, 80013 Casalnuovo Di Napoli, Italy; (G.S.); (M.I.); (N.P.); (M.C.)
| | - Francesco Sabbatino
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy;
| | - Francesco Perri
- Istituto Nazionale Tumori di Napoli, IRCCS “G. Pascale”, Via Mariano Semmola, 80131 Napoli, Italy; (M.S.); (F.P.); (V.G.); (G.N.)
| | - Francesco Ferrara
- Hospital Pharmacist Manager, Pharmaceutical Department, Asl Napoli 3 Sud, Via Dell’amicizia 22, 80035 Nola, Italy;
| | - Andrea Zovi
- Hospital Pharmacist, Ministry of Health, Viale Giorgio Ribotta 5, 00144 Rome, Italy;
| | - Massimiliano Berretta
- Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy;
| | - Vincenza Granata
- Istituto Nazionale Tumori di Napoli, IRCCS “G. Pascale”, Via Mariano Semmola, 80131 Napoli, Italy; (M.S.); (F.P.); (V.G.); (G.N.)
| | - Guglielmo Nasti
- Istituto Nazionale Tumori di Napoli, IRCCS “G. Pascale”, Via Mariano Semmola, 80131 Napoli, Italy; (M.S.); (F.P.); (V.G.); (G.N.)
| | - Alessandro Ottaiano
- Istituto Nazionale Tumori di Napoli, IRCCS “G. Pascale”, Via Mariano Semmola, 80131 Napoli, Italy; (M.S.); (F.P.); (V.G.); (G.N.)
| |
Collapse
|
9
|
Capuozzo M, Ferrara F, Santorsola M, Zovi A, Ottaiano A. Circulating Tumor Cells as Predictive and Prognostic Biomarkers in Solid Tumors. Cells 2023; 12:2590. [PMID: 37998325 PMCID: PMC10670669 DOI: 10.3390/cells12222590] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 11/25/2023] Open
Abstract
Circulating tumor cells (CTCs) have emerged as pivotal biomarkers with significant predictive and prognostic implications in solid tumors. Their presence in peripheral blood offers a non-invasive window into the dynamic landscape of cancer progression and treatment response. This narrative literature review synthesizes the current state of knowledge surrounding the multifaceted role of CTCs in predicting clinical outcomes and informing prognosis across a spectrum of solid tumor malignancies. This review delves into the evolving landscape of CTC-based research, emphasizing their potential as early indicators of disease recurrence, metastatic potential, and therapeutic resistance. Moreover, we have underscored the dynamic nature of CTCs and their implications for personalized medicine. A descriptive and critical analysis of CTC detection methodologies, their clinical relevance, and their associated challenges is also presented, with a focus on recent advancements and emerging technologies. Furthermore, we examine the integration of CTC-based liquid biopsies into clinical practice, highlighting their role in guiding treatment decisions, monitoring treatment efficacy, and facilitating precision oncology. This review highlights the transformative impact of CTCs as predictive and prognostic biomarkers in the management of solid tumors by promoting a deeper understanding of the clinical relevance of CTCs and their role in advancing the field of oncology.
Collapse
Affiliation(s)
| | | | - Mariachiara Santorsola
- Istituto Nazionale Tumori di Napoli, IRCCS “G. Pascale”, Via M. Semmola, 80131 Naples, Italy;
| | - Andrea Zovi
- Ministry of Health, Viale Giorgio Ribotta 5, 00144 Rome, Italy;
| | - Alessandro Ottaiano
- Istituto Nazionale Tumori di Napoli, IRCCS “G. Pascale”, Via M. Semmola, 80131 Naples, Italy;
| |
Collapse
|
10
|
Ottaiano A, De Luca A, Santorsola M, Scognamiglio G, Di Mauro A, Chiodini P, Lambiase M, Sacco A, Petrillo A, Granata V, Fusco R, Mercadante E, Martucci N, De Luca G, Rocca AL, Celentano E, Crispo A, Di Gennaro P, Tatangelo F, Ferrara G, Izzo F, Belli A, Patrone R, Delrio P, Rega D, De Franciscis S, Muto P, Ravo V, Di Franco R, Borzillo V, Santagata S, Rea G, Castaldo D, Pace U, De Feo G, Scala S, Nasti G, Normanno N. Oligo-metastatic neoPlasms from the gastro-intestinal tract: iDentIfiCaTIon of cliNical and molecular drivers: the PREDICTION study. BMC Cancer 2023; 23:1010. [PMID: 37858132 PMCID: PMC10588113 DOI: 10.1186/s12885-023-11479-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 10/04/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Metastatic disease in tumors originating from the gastrointestinal tract can exhibit varying degrees of tumor burden at presentation. Some patients follow a less aggressive disease course, characterized by a limited number of metastatic sites, referred to as "oligo-metastatic disease" (OMD). The precise biological characteristics that define the oligometastatic behavior remain uncertain. In this study, we present a protocol designed to prospectively identify OMD, with the aim of proposing novel therapeutic approaches and monitoring strategies. METHODS The PREDICTION study is a monocentric, prospective, observational investigation. Enrolled patients will receive standard treatment, while translational activities will involve analysis of the tumor microenvironment and genomic profiling using immunohistochemistry and next-generation sequencing, respectively. The first primary objective (descriptive) is to determine the prevalence of biological characteristics in OMD derived from gastrointestinal tract neoplasms, including high genetic concordance between primary tumors and metastases, a significant infiltration of T lymphocytes, and the absence of clonal evolution favoring specific driver genes (KRAS and PIK3CA). The second co-primary objective (analytic) is to identify a prognostic score for true OMD, with a primary focus on metastatic colorectal cancer. The score will comprise genetic concordance (> 80%), high T-lymphocyte infiltration, and the absence of clonal evolution favoring driver genes. It is hypothesized that patients with true OMD (score 3+) will have a lower rate of progression/recurrence within one year (20%) compared to those with false OMD (80%). The endpoint of the co-primary objective is the rate of recurrence/progression at one year. Considering a reasonable probability (60%) of the three factors occurring simultaneously in true OMD (score 3+), using a significance level of α = 0.05 and a test power of 90%, the study requires a minimum enrollment of 32 patients. DISCUSSION Few studies have explored the precise genetic and biological features of OMD thus far. In clinical settings, the diagnosis of OMD is typically made retrospectively, as some patients who undergo intensive treatment for oligometastases develop polymetastatic diseases within a year, while others do not experience disease progression (true OMD). In the coming years, the identification of true OMD will allow us to employ more personalized and comprehensive strategies in cancer treatment. TRIAL REGISTRATION ClinicalTrials.gov ID NCT05806151.
Collapse
Grants
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
- L4/8 Italian Government, Ministry of Health, Ricerca Corrente 2022
Collapse
Affiliation(s)
| | | | | | | | | | - Paolo Chiodini
- Section of Statistics, Department of Mental Health and Public Medicine, Università degli Studi della Campania Luigi Vanvitelli, Napoli, 80138, Italy
| | - Matilde Lambiase
- Istituto Nazionale Tumori, IRCCS "G. Pascale", Napoli, 80131, Italy
| | - Alessandra Sacco
- Istituto Nazionale Tumori, IRCCS "G. Pascale", Napoli, 80131, Italy
| | | | - Vincenza Granata
- Istituto Nazionale Tumori, IRCCS "G. Pascale", Napoli, 80131, Italy
| | - Roberta Fusco
- Istituto Nazionale Tumori, IRCCS "G. Pascale", Napoli, 80131, Italy
| | | | - Nicola Martucci
- Istituto Nazionale Tumori, IRCCS "G. Pascale", Napoli, 80131, Italy
| | - Giuseppe De Luca
- Istituto Nazionale Tumori, IRCCS "G. Pascale", Napoli, 80131, Italy
| | | | - Egidio Celentano
- Istituto Nazionale Tumori, IRCCS "G. Pascale", Napoli, 80131, Italy
| | - Anna Crispo
- Istituto Nazionale Tumori, IRCCS "G. Pascale", Napoli, 80131, Italy
| | | | | | - Gerardo Ferrara
- Istituto Nazionale Tumori, IRCCS "G. Pascale", Napoli, 80131, Italy
| | - Francesco Izzo
- Istituto Nazionale Tumori, IRCCS "G. Pascale", Napoli, 80131, Italy
| | - Andrea Belli
- Istituto Nazionale Tumori, IRCCS "G. Pascale", Napoli, 80131, Italy
| | - Renato Patrone
- Istituto Nazionale Tumori, IRCCS "G. Pascale", Napoli, 80131, Italy
| | - Paolo Delrio
- Istituto Nazionale Tumori, IRCCS "G. Pascale", Napoli, 80131, Italy
| | - Daniela Rega
- Istituto Nazionale Tumori, IRCCS "G. Pascale", Napoli, 80131, Italy
| | | | - Paolo Muto
- Istituto Nazionale Tumori, IRCCS "G. Pascale", Napoli, 80131, Italy
| | - Vincenzo Ravo
- Istituto Nazionale Tumori, IRCCS "G. Pascale", Napoli, 80131, Italy
| | | | | | - Sara Santagata
- Istituto Nazionale Tumori, IRCCS "G. Pascale", Napoli, 80131, Italy
| | - Giuseppina Rea
- Istituto Nazionale Tumori, IRCCS "G. Pascale", Napoli, 80131, Italy
| | - Daniela Castaldo
- Istituto Nazionale Tumori, IRCCS "G. Pascale", Napoli, 80131, Italy
| | - Ugo Pace
- Istituto Nazionale Tumori, IRCCS "G. Pascale", Napoli, 80131, Italy
| | | | - Stefania Scala
- Istituto Nazionale Tumori, IRCCS "G. Pascale", Napoli, 80131, Italy
| | - Guglielmo Nasti
- Istituto Nazionale Tumori, IRCCS "G. Pascale", Napoli, 80131, Italy
| | - Nicola Normanno
- Istituto Nazionale Tumori, IRCCS "G. Pascale", Napoli, 80131, Italy
| |
Collapse
|
11
|
Ottaiano A, Santorsola M, Circelli L, Ianniello M, Casillo M, Petrillo N, Sabbatino F, Cascella M, Perri F, Capuozzo M, Albino V, Granata V, Izzo F, Di Mauro A, Berretta M, Ruggiero R, Gualillo O, Sirica R, Nasti G, Savarese G. BRAF p.V600E mutation as a molecular boundary between genuine oligo-repeated and poly-metastatic disease in colorectal cancer. Neoplasia 2023; 44:100930. [PMID: 37634281 PMCID: PMC10475497 DOI: 10.1016/j.neo.2023.100930] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/22/2023] [Accepted: 08/22/2023] [Indexed: 08/29/2023]
Affiliation(s)
- Alessandro Ottaiano
- Istituto Nazionale Tumori di Napoli, IRCCS "G. Pascale", Via Mariano Semmola, 80131 Napoli, Italy.
| | - Mariachiara Santorsola
- Istituto Nazionale Tumori di Napoli, IRCCS "G. Pascale", Via Mariano Semmola, 80131 Napoli, Italy
| | - Luisa Circelli
- Istituto Nazionale Tumori di Napoli, IRCCS "G. Pascale", Via Mariano Semmola, 80131 Napoli, Italy
| | - Monica Ianniello
- AMES, Centro Polidiagnostico Strumentale Srl, Via Padre Carmine Fico 24, 80013 Casalnuovo Di Napoli, Italy
| | - Marika Casillo
- AMES, Centro Polidiagnostico Strumentale Srl, Via Padre Carmine Fico 24, 80013 Casalnuovo Di Napoli, Italy
| | - Nadia Petrillo
- AMES, Centro Polidiagnostico Strumentale Srl, Via Padre Carmine Fico 24, 80013 Casalnuovo Di Napoli, Italy
| | - Francesco Sabbatino
- Oncology Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Salerno, Italy
| | - Marco Cascella
- Istituto Nazionale Tumori di Napoli, IRCCS "G. Pascale", Via Mariano Semmola, 80131 Napoli, Italy
| | - Francesco Perri
- Istituto Nazionale Tumori di Napoli, IRCCS "G. Pascale", Via Mariano Semmola, 80131 Napoli, Italy
| | | | - Vittorio Albino
- Istituto Nazionale Tumori di Napoli, IRCCS "G. Pascale", Via Mariano Semmola, 80131 Napoli, Italy
| | - Vincenza Granata
- Istituto Nazionale Tumori di Napoli, IRCCS "G. Pascale", Via Mariano Semmola, 80131 Napoli, Italy
| | - Francesco Izzo
- Istituto Nazionale Tumori di Napoli, IRCCS "G. Pascale", Via Mariano Semmola, 80131 Napoli, Italy
| | - Annabella Di Mauro
- Istituto Nazionale Tumori di Napoli, IRCCS "G. Pascale", Via Mariano Semmola, 80131 Napoli, Italy
| | - Massimiliano Berretta
- Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy
| | - Raffaella Ruggiero
- AMES, Centro Polidiagnostico Strumentale Srl, Via Padre Carmine Fico 24, 80013 Casalnuovo Di Napoli, Italy
| | - Oreste Gualillo
- SERGAS (Servizo Galego de Saude) and NEIRID Lab (Neuroendocrine Interactions in Rheumatology and Inflammatory Diseases), Research Laboratory 9, IDIS (Instituto de Investigación Sanitaria de Santiago), Santiago University Clinical Hospital, Santiago de Compostela, Spain
| | - Roberto Sirica
- AMES, Centro Polidiagnostico Strumentale Srl, Via Padre Carmine Fico 24, 80013 Casalnuovo Di Napoli, Italy
| | - Guglielmo Nasti
- Istituto Nazionale Tumori di Napoli, IRCCS "G. Pascale", Via Mariano Semmola, 80131 Napoli, Italy
| | - Giovanni Savarese
- AMES, Centro Polidiagnostico Strumentale Srl, Via Padre Carmine Fico 24, 80013 Casalnuovo Di Napoli, Italy
| |
Collapse
|