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Andrzejewska M, Czarny J, Derwich K. Latest Advances in the Management of Pediatric Gastrointestinal Stromal Tumors. Cancers (Basel) 2022; 14:4989. [PMID: 36291774 PMCID: PMC9599787 DOI: 10.3390/cancers14204989] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/28/2022] [Accepted: 10/10/2022] [Indexed: 11/21/2022] Open
Abstract
Gastrointestinal stromal tumor is the most common mesenchymal neoplasm of the gastrointestinal tract, usually found in elderly adults. It is infrequent among pediatric patients and usually differs biologically from adult-type diseases presenting mutations of KIT and PDGFR genes. In this population, more frequent is the wild-type GIST possessing SDH, TRK, RAS, NF1 mutations, among others. Both tumor types require individualized treatment with kinase inhibitors that are still being tested in the pediatric population due to the different neoplasm biology. We review the latest updates to the management of pediatric gastrointestinal tumors with a particular focus on the advances in molecular biology of the disease that enables the definition of possible resistance. Emerging treatment with kinase inhibitors that could serve as targeted therapy is discussed, especially with multikinase inhibitors of higher generation, the effectiveness of which has already been confirmed in the adult population.
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Affiliation(s)
- Marta Andrzejewska
- Faculty of Medicine, Poznan University of Medical Sciences, 61-701 Poznan, Poland or
| | - Jakub Czarny
- Faculty of Medicine, Poznan University of Medical Sciences, 61-701 Poznan, Poland or
| | - Katarzyna Derwich
- Department of Pediatric Oncology, Hematology and Transplantology, Institute of Pediatrics, Poznan University of Medical Sciences, 60-355 Poznan, Poland
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Lai Y, Chang H, Chen H, Chang G, Chen JJW. Peruvoside is a novel Src inhibitor that suppresses NSCLC cell growth and motility by downregulating multiple Src-EGFR-related pathways. Am J Cancer Res 2022; 12:2576-2593. [PMID: 35812056 PMCID: PMC9251685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 05/11/2022] [Indexed: 06/15/2023] Open
Abstract
The tyrosine kinase Src plays an essential role in the progression of many cancers and is involved in several epidermal growth factor receptor (EGFR)-mediated signalling pathways. To improve the efficacy of lung cancer treatments, this study aimed to identify novel compounds that can disrupt the Src-EGFR interaction and that are less dependent on EGFR status with wild-type and mutations than other compounds. We used the Src pY419 ELISA as the platform to screen a compound library of more than 400 plant-derived active ingredients and identified peruvoside as a candidate Src-EGFR crosstalk inhibitor. The effects of peruvoside were evaluated by western blotting, cell function assays, combination Index (CI)-isobologram analyses and in vivo experiments. Peruvoside significantly suppressed the phosphorylation of Src, EGFR, and signal transducer and activator of transcription 3 (STAT3) in a dose- and time-dependent manner and somewhat suppressed their protein expression. Cell function assays revealed that peruvoside inhibited the proliferation, invasion, migration, and colony formation of lung cancer cells in vitro and tumour growth in vivo. Furthermore, peruvoside sensitized gefitinib-resistant tumour cells (A549, PC9/gef and H1975) to gefitinib treatment, indicating that peruvoside may exert synergistic effects when used in combination with established therapeutic agents. Our data also demonstrated that the inhibitory effects of peruvoside on lung cancer progression might be attributed to its ability to regulate Src, phosphoinositide 3-kinase (PI3K), c-Jun N-terminal kinase (JNK), Paxillin, p130cas, and EGFR. Our findings suggest that peruvoside suppresses non-small-cell lung carcinoma (NSCLC) malignancy by downregulating multiple Src-related pathways and could serve as a potential base molecule for developing new anticancer drugs and therapeutic strategies for lung cancer.
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Affiliation(s)
- Yihua Lai
- Institute of Biomedical Sciences, National Chung Hsing UniversityTaichung, Taiwan
- Rheumatic Diseases Research Center, China Medical University HospitalTaichung, Taiwan
- College of Medicine, China Medical UniversityTaichung, Taiwan
- Rheumatology and Immunology Center, China Medical University HospitalTaichung, Taiwan
| | - Hsiuhui Chang
- Institute of Biomedical Sciences, National Chung Hsing UniversityTaichung, Taiwan
| | - Hueiwen Chen
- Graduate Institute of Toxicology, National Taiwan University College of MedicineTaipei, Taiwan
| | - Geechen Chang
- Division of Pulmonary Medicine, Department of Internal Medicine, Chung Shan Medical University HospitalTaichung, Taiwan
- School of Medicine, Chung Shan Medical UniversityTaichung, Taiwan
| | - Jeremy JW Chen
- Institute of Biomedical Sciences, National Chung Hsing UniversityTaichung, Taiwan
- Biotechnology Center, National Chung Hsing UniversityTaichung, Taiwan
- Institute of Molecular Biology, National Chung Hsing UniversityTaichung, Taiwan
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3
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Al-Share B, Alloghbi A, Al Hallak MN, Uddin H, Azmi A, Mohammad RM, Kim SH, Shields AF, Philip PA. Gastrointestinal stromal tumor: a review of current and emerging therapies. Cancer Metastasis Rev 2021; 40:625-641. [PMID: 33876372 DOI: 10.1007/s10555-021-09961-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 03/29/2021] [Indexed: 02/07/2023]
Abstract
Gastrointestinal stromal tumors (GIST) are rare neoplasms arising from the interstitial cell of Cajal in the gastrointestinal tract. Two thirds of GIST in adult patients have c-Kit mutation and smaller fractions have platelet derived growth factor receptor alpha (PDGFRA) mutation. Surgery is the only curative treatment for localized disease. Imatinib improves survival when used adjuvantly and in advanced disease. Several targeted therapies have also improved survival in GIST patients after progression on imatinib including sunitinib and regorafenib. Recently, United States Federal and Drug Administration (FDA) approved two new tyrosine kinase inhibitors for the treatment of heavily pretreated advanced/unresectable GIST including avapritinib (a selective inhibitor for PDGFRA exon 18 mutation including D842V mutations) and ripretinib (a broad-spectrum kinase inhibitor of c-Kit and PDGFRA). In this article, we will provide a comprehensive review of GIST including the current standard of care treatment and exploring future paradigm shifts in therapy.
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Affiliation(s)
- Bayan Al-Share
- Department of Oncology, Karmanos Cancer Institute, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Abdulrahman Alloghbi
- Department of Oncology, Karmanos Cancer Institute, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Mohammed Najeeb Al Hallak
- Department of Oncology, Karmanos Cancer Institute, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Hafiz Uddin
- Department of Oncology, Karmanos Cancer Institute, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Asfar Azmi
- Department of Oncology, Karmanos Cancer Institute, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Ramzi M Mohammad
- Department of Oncology, Karmanos Cancer Institute, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Steve H Kim
- Department of Oncology, Karmanos Cancer Institute, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Anthony F Shields
- Department of Oncology, Karmanos Cancer Institute, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Philip A Philip
- Department of Oncology, Karmanos Cancer Institute, School of Medicine, Wayne State University, Detroit, MI, USA.
- Department of Pharmacology, School of Medicine, Wayne State University, Detroit, MI, USA.
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4
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Li Y, An ZJ, Tan BB, Zhao Q, Fan LQ, Zhao XF. Research status and progress of drug resistance in gastrointestinal stromal tumors. Shijie Huaren Xiaohua Zazhi 2020; 28:999-1003. [DOI: 10.11569/wcjd.v28.i20.999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Targeted drug therapy is another effective treatment for gastrointestinal stromal tumors (GISTs) in addition to surgical treatment, which has significantly improved the prognosis of GIST patients, but drug resistance in some patients is still a tough problem in clinical work. This article reviews the mechanism of primary and secondary drug resistance in first-line treatment of GIST patients and the progress of second-line and third-line treatment, and describes the current problems faced by drug-resistant GIST patients and the direction of future efforts.
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Affiliation(s)
- Yong Li
- Department of General Surgery, the Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
| | - Zhao-Jie An
- Department of General Surgery, the Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
| | - Bi-Bo Tan
- Department of General Surgery, the Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
| | - Qun Zhao
- Department of General Surgery, the Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
| | - Li-Qiao Fan
- Department of General Surgery, the Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
| | - Xue-Feng Zhao
- Department of General Surgery, the Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
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Schroeder BA, Kohli K, O'Malley RB, Kim TS, Jones RL, Pierce RH, Pollack SM. Durable tumor regression in highly refractory metastatic KIT/PDGFRA wild-type GIST following treatment with nivolumab. Oncoimmunology 2020; 9:1710064. [PMID: 32002307 PMCID: PMC6959429 DOI: 10.1080/2162402x.2019.1710064] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 11/03/2019] [Accepted: 12/05/2019] [Indexed: 12/28/2022] Open
Abstract
Gastrointestinal stromal tumor (GIST) is a devastating disease, especially in the setting of metastasis. The natural progression of GIST has been significantly altered by the development of small molecule tyrosine kinase inhibitors (TKIs), including imatinib, sunitinib, and regorafenib, all of which are FDA approved. However, TKIs are not always well-tolerated, and the refractory disease continues to be a problem. For these reasons, alternative treatments are needed. In this report, we discuss a patient with metastatic wild-type (WT) GIST refractory to multiple TKIs, but with a durable clinical response to the anti-programmed cell death protein 1 (PD-1) antibody, nivolumab. This report suggests that continued research evaluating checkpoint inhibitors in GIST is warranted.
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Affiliation(s)
- Brett A Schroeder
- Clinical Research Division, Fred Hutchison Cancer Research Center, Seattle, WA, USA.,Department of Medicine, Virginia Mason Medical Center, Seattle, WA, USA
| | - Karan Kohli
- Clinical Research Division, Fred Hutchison Cancer Research Center, Seattle, WA, USA
| | - Ryan B O'Malley
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - Theresa S Kim
- Clinical Research Division, Fred Hutchison Cancer Research Center, Seattle, WA, USA
| | - Robin L Jones
- Sarcoma Unit, Royal Marsden Hospital and Institute of Cancer Research, London, UK
| | - Robert H Pierce
- Clinical Research Division, Fred Hutchison Cancer Research Center, Seattle, WA, USA
| | - Seth M Pollack
- Clinical Research Division, Fred Hutchison Cancer Research Center, Seattle, WA, USA.,Department of Medicine, University of Washington, Seattle, WA, USA
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Brzozowska M, Wierzba W, Szafraniec-Buryło S, Czech M, Połowinczak-Przybyłek J, Potemski P, Śliwczyński A. Real-World Evidence of Patient Outcome Following Treatment of Advanced Gastrointestinal Stromal Tumor (GIST) with Imatinib, Sunitinib, and Sorafenib in Publicly Funded Health Care in Poland. Med Sci Monit 2019; 25:3846-3853. [PMID: 31121600 PMCID: PMC6543874 DOI: 10.12659/msm.914517] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background This study aimed to undertake an analysis of ten years of real-world evidence (RWE) on overall survival (OS) following treatment of advanced gastrointestinal stromal tumor (GIST) with imatinib, sunitinib, and sorafenib using data from the Polish National Health Fund. Material/Methods Data from the Polish National Health Fund, the sole Polish public payer, identified 1,641 patients with advanced GIST who were treated with imatinib (n=1047), sunitinib (n=457), and sorafenib (n=137). The differences in overall survival (OS) were analyzed. Results For patients with advanced GIST, the median follow-up time for patients treated with imatinib was 71 months (95% CI, 64.8–79.2), the median OS was 56.9 months (95% CI, 50.4–61.2), with survival at 12 months (89.5%), 24 months (77.9%), 36 months (66.9%), and 60 months (48.4%). The median follow-up time for patients treated with sunitinib was 41.4 months (95% CI, 34.6–49.3), the median OS was 22.8 months (95% CI, 19.2–26.8), with survival at 12 months (68.2%), 24 months (47.1%), and 36 months (31%). The median follow-up time for patients treated with sorafenib was 17.4 months (95% CI, 14.6–22.9), the median OS was 16.9 months (95% CI, 13.7–24.3), with survival at 12 months (61.9%), at 24 months (36.2%), and at 36 months (16.8%). Conclusions Real-world data collected in a ten-year period confirmed the effectiveness of the use of imatinib, sunitinib, or sorafenib for the treatment of advanced GIST and was comparable with the findings from clinical trials.
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Affiliation(s)
- Melania Brzozowska
- Department of Drug Economics, National Health Fund, Central Office, Warsaw, Poland.,Division of Quality Services, Procedures and Medical Standards, Medical University of Łódź, Łódź, Poland
| | - Waldemar Wierzba
- UHE Satellite Campus in Warsaw, University of Humanities and Economics in Łódź, Warsaw, Poland
| | | | - Marcin Czech
- Department of Pharmacoeconomics, Institute of Mother and Child, Warsaw, Poland
| | | | - Piotr Potemski
- Copernicus Memorial Hospital, Comprehensive Cancer Center and Traumatology, Medical University of Łódź, Łódź, Poland
| | - Andrzej Śliwczyński
- Division of Quality Services, Procedures and Medical Standards, Medical University of Łódź, Łódź, Poland.,Department of Health Services, National Health Fund, Central Office, Warsaw, Poland
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Mazzocca A, Napolitano A, Silletta M, Spalato Ceruso M, Santini D, Tonini G, Vincenzi B. New frontiers in the medical management of gastrointestinal stromal tumours. Ther Adv Med Oncol 2019; 11:1758835919841946. [PMID: 31205499 PMCID: PMC6535752 DOI: 10.1177/1758835919841946] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 03/13/2019] [Indexed: 12/11/2022] Open
Abstract
The tyrosine kinase inhibitor (TKI) imatinib has radically changed the natural history of KIT-driven gastrointestinal stromal tumours (GISTs). Approved second-line and third-line medical therapies are represented by the TKIs sunitinib and regorafenib, respectively. While imatinib remains the cardinal drug for patients with GISTs, novel therapies are being developed and clinically tested to overcome the mechanisms of resistance after treatments with the approved TKI, or to treat subsets of GISTs driven by rarer molecular events. Here, we review the therapy of GISTs, with a particular focus on the newest drugs in advanced phases of clinical testing that might soon change the current therapeutic algorithm.
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Affiliation(s)
| | | | | | | | | | | | - Bruno Vincenzi
- Medical Oncology, Università Campus Bio-Medico, Via Alvaro del Portillo 200, Rome, Italy
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