Aberrant Expression of Long Non Coding RNA HOTAIR and De-Regulation of the Paralogous 13 HOX Genes Are Strongly Associated with Aggressive Behavior of Gastro-Entero-Pancreatic Neuroendocrine Tumors

Gastro-entero-pancreatic neuroendocrine neoplasms (GEP-NENs) - Current literature review of diagnostics and therapy. What has changed in the management?

<b>Introduction:</b> Gastro-entero-pancreatic neuroendocrine neoplasms (GEP-NENs) are malignancies originating from cells of the diffuse endocrine system. They are rare and localize in the upper and lower parts of the gastrointestinal tract and in the pancreas. Despite such a varied location, GEP-NENs are considered a common group of neoplasms due to the fact of their similar morphology and ability to secrete peptide hormones and biologically active amines. They are associated with clinical manifestations specific to the substances produced by a particular neoplasm. The classification of GEP-NENs is constantly systematized and updated based on their differentiation and grading. The development of available diagnostic and treatment methods for these tumors has made significant progress over the past 10 years and is still ongoing.<b>Aim:</b> In the following paper, we review the diagnostics and treatment of GEP-NENs, taking into account the latest molecular, immunological, or gene-based methods. Imaging methods using markers for receptors allow for high diagnostic sensitivity<b>Methods:</b> Medical databases were searched for the latest information. The authors also sought confirmation of the content of a particular publication in another publications, so as to present the most reliable information possible.<b>Results:</b> Research results revealed that the diagnostics and treatment of GEP-NENs have significantly advanced in recent years. Surgical interventions, especially minimally invasive techniques, have shown efficacy in treating GEP-NENs, with specific therapies such as somatostatin analogs, chemotherapy, and peptide receptor radionuclide therapy demonstrating promising outcomes. The evolution of diagnostic methods, including imaging techniques and biomarker testing, has contributed to improved patient care and prognosis.<b>Conclusions:</b> The increasing incidence of GEP-NENs is attributed to enhanced diagnostic capabilities rather than a rise in population prevalence. The study emphasizes the importance of ongoing research to identify specific markers for early detection and targeted therapies to further enhance the effectiveness of treating these rare and heterogeneous malignancies. The findings suggest a positive trajectory in the management of GEP-NENs, with future prospects focused on personalized and targeted treatment approaches.

A gastric neuroendocrine carcinoma with good prognosis after chemotherapy combined with immunotherapy: A case report (CARE-compliant)

INTRODUCTION

Gastric neuroendocrine carcinoma (GNENs), as a highly malignant gastrointestinal tumor, is characterized by easy postoperative metastasis, and its prognosis has always been poor compared to other gastrointestinal tumors. Due to its rarity, there have been few case reports and studies on it. As of now, there is no clear diagnosis and treatment sequence and guidelines. In this report, we present a case of GNENs that underwent first-line treatment after surgery. The patient achieved an excellent prognosis and survival after a combination of chemotherapy resistance and immunotherapy. This report aims to provide valuable reference and guidance for the treatment of GNENs in the future. Therefore, we conducted a literature review on GNENs.

PATIENT CONCERNS

A 61-year-old man was admitted to the hospital with complaints of upper abdominal distension and discomfort that had been persistent for 1 month. During the endoscopy examination, a 2.5 cm irregular deep mucosal defect was observed at the center of the gastric angle. The defect appeared covered with dirty moss, had a hard texture, and exhibited a tendency to bleed upon contact.

DIAGNOSIS

Biopsy results confirmed the presence of a medium to poorly differentiated adenocarcinoma in the gastric horn. Subsequently, the patient underwent surgery, and the removed specimen was diagnosed as GNENs.

INTERVENTION

Postoperative chemotherapy combined with immunotherapy.

OUTCOME

The patient in this case achieved a good prognosis and extremely long survival [overall survival > 3 years+] after receiving first-line treatment, which included chemotherapy, drug resistance and immunotherapy, and is currently in good health condition. The tumor is not sensitive to the standard EP regimen for neuroendocrine carcinoma, but after being replaced with oxaliplatin based regimen combined with immunotherapy, partial response was obtained, indicating a synergistic effect between chemotherapy and immunity. After treatment, it remained stable for a considerable period of time.

CONCLUSION

Immunotherapy, as a new mode of cancer treatment can provide new guidance and ideas for the treatment of GNENs.

Dampening HOTAIR sensitizes the gastric cancer cells to oxaliplatin through miR-195-5p and ABCG2 pathway

Long non-coding RNAs (lncRNA) have an extensive role in the progression and chemoresistance of gastric cancer (GC). Deeply study the regulatory role of lncRNAs could provide potential therapeutic targets. The aim of this study is to explore the regulatory role of HOTAIR in the progression and oxaliplatin resistance of GC. The expression of HOTAIR in GC and cell lines were detected by using qRT-PCR. Cell proliferation and apoptosis were analysed by CCK-8, EdU incorporation and flow cytometry. Luciferase reporter assay was used to identify the interaction between HOTAIR and ABCG2 (ATP-binding cassette (ABC) superfamily G member 2, ABCG2) via miR-195-5p. The regulatory functions were verified by using molecular biology experiments. HOTAIR was significantly overexpressed in GC and associated with poor prognosis. Knock-down of HOTAIR inhibited the GC cells proliferation and oxaliplatin resistance, while overexpression of HOTAIR showed opposite functions. Further studies found that HOTAIR acted as a competing endogenous RNA (ceRNA) to absorb miR-195-5p and elevated the expression of ABCG2, which leads to resistance of GC cells to oxaliplatin. Taken together, our findings demonstrated that HOTAIR regulates ABCG2 induced resistance of GC to oxaliplatin through miR-195-5p signalling and illustrate the great potential of developing new therapeutic targets for GC patients.

The uprise of RNA biology in neuroendocrine neoplasms: altered splicing and RNA species unveil translational opportunities

Neuroendocrine neoplasms (NENs) comprise a highly heterogeneous group of tumors arising from the diffuse neuroendocrine system. NENs mainly originate in gastrointestinal, pancreatic, and pulmonary tissues, and despite being rare, show rising incidence. The molecular mechanisms underlying NEN development are still poorly understood, although recent studies are unveiling their genomic, epigenomic and transcriptomic landscapes. RNA was originally considered as an intermediary between DNA and protein. Today, compelling evidence underscores the regulatory relevance of RNA processing, while new RNA molecules emerge with key functional roles in core cell processes. Indeed, correct functioning of the interrelated complementary processes comprising RNA biology, its processing, transport, and surveillance, is essential to ensure adequate cell homeostasis, and its misfunction is related to cancer at multiple levels. This review is focused on the dysregulation of RNA biology in NENs. In particular, we survey alterations in the splicing process and available information implicating the main RNA species and processes in NENs pathology, including their role as biomarkers, and their functionality and targetability. Understanding how NENs precisely (mis)behave requires a profound knowledge at every layer of their heterogeneity, to help improve NEN management. RNA biology provides a wide spectrum of previously unexplored processes and molecules that open new avenues for NEN detection, classification and treatment. The current molecular biology era is rapidly evolving to facilitate a detailed comprehension of cancer biology and is enabling the arrival of personalized, predictive and precision medicine to rare tumors like NENs.

Advances in the Diagnosis and Therapeutic Management of Gastroenteropancreatic Neuroendocrine Neoplasms (GEP-NENs)

Neuroendocrine neoplasms (NENs) are an increasingly common cause of neoplastic diseases. One of the largest groups of NENs are neoplasms localized to the gastroenteropancreatic system, which are known as gastroenteropancreatic NENs (GEP-NENs). Because of nonspecific clinical symptoms, GEP-NEN patient diagnosis and, consequently, their treatment, might be difficult and delayed. This situation has forced researchers all over the world to continue progress in the diagnosis and treatment of patients with GEP-NENs. Our review is designed to present the latest reports on the laboratory diagnostic techniques, imaging tests and surgical and nonsurgical treatment strategies used for patients with these rare neoplasms. We paid particular attention to the nuclear approach, the use of which has been applied to GEP-NEN patient diagnosis, and to nonsurgical and radionuclide treatment strategies. Recent publications were reviewed in search of reports on new strategies for effective disease management. Attention was also paid to those studies still in progress, but with successful results. A total of 248 papers were analyzed, from which 141 papers most relevant to the aim of the study were selected. Using these papers, we highlight the progress in the development of diagnostic and treatment strategies for patients with GEP-NENs.

Phenotypic Changes of LncRNA Hotair in Non-Small-Cell Lung Cancer and Its Clinical Application

Non-small-cell lung cancer (NSCLC) is one of the main causes of death of malignant tumors of the respiratory system. At present, the clinical demand for biomarkers for predicting and diagnosing the disease is increasing. Overexpression of LncRNA Hotair (Homeobox transcriptional antisense intergenic RNA) has been previously reported to be associated with poor prognosis and high mortality in different malignancies. qRT-PCR results showed that the expression of LncRNA Hotair in tumor tissue and serum of patients with non-small-cell lung cancer was significantly upregulated. Clinicopathological correlation analysis showed that the upregulation of LncRNA Hotair expression was closely related to lymph node metastasis and tumor lymph node metastasis (TNM) stage (P < 0.05). The results showed that transfection of pcDNA3.1-Hotair could promote the expression of LncRNA Hotair in NSCLC, while transfection of Si-Hotair could reduce the expression level of LncRNA Hotair, hinder the migration and invasion of cancer cells, and promote cell apoptosis. After transfection of Si-Hotair, molecular markers related to migration, the level of E-cadherin and Bax, increased and the level of vimentin, Bcl-2, MMP-3, VEGF, Ki-67 and PCNA decreased. This shows that the proliferation and migration of A549 cells are promoted and LncRNA Hotair deletion can inhibit the proliferation and migration of lung cancer cells. These results show that the expression level of LncRNA Hotair of NSCLC cell lines can promote the invasion and migration of NSCLC, and its expression has a significant correlation with Lymph node metastasis, tumor size, and TNM stage. Therefore, this target is of great significance for the clinical diagnosis and treatment of NSCLC.

The Role of lncRNAs in Rare Tumors with a Focus on HOX Transcript Antisense RNA (HOTAIR)

Rare cancers are identified as those with an annual incidence of fewer than 6 per 100,000 persons and includes both epithelial and stromal tumors from different anatomical areas. The advancement of analytical methods has produced an accurate molecular characterization of most human cancers, suggesting a “molecular classification” that has allowed the establishment of increasingly personalized therapeutic strategies. However, the limited availability of rare cancer samples has resulted in very few therapeutic options for these tumors, often leading to poor prognosis. Long non coding RNAs (lncRNAs) are a class of non-coding RNAs mostly involved in tumor progression and drug response. In particular, the lncRNA HOX transcript antisense RNA (HOTAIR) represents an emergent diagnostic, prognostic and predictive biomarker in many human cancers. The aim of this review is to highlight the role of HOTAIR in rare cancers, proposing it as a new biomarker usable in the management of these tumors.