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Hofvander J, Qiu A, Lee K, Bilenky M, Carles A, Cao Q, Moksa M, Steif J, Su E, Sotiriou A, Goytain A, Hill LA, Singer S, Andrulis IL, Wunder JS, Mertens F, Banito A, Jones KB, Underhill TM, Nielsen TO, Hirst M. Synovial Sarcoma Chromatin Dynamics Reveal a Continuum in SS18:SSX Reprograming. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.05.14.594262. [PMID: 38798672 PMCID: PMC11118320 DOI: 10.1101/2024.05.14.594262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Synovial sarcoma (SyS) is an aggressive soft-tissue malignancy characterized by a pathognomonic chromosomal translocation leading to the formation of the SS18::SSX fusion oncoprotein. SS18::SSX associates with mammalian BAF complexes suggesting deregulation of chromatin architecture as the oncogenic driver in this tumour type. To examine the epigenomic state of SyS we performed comprehensive multi-omics analysis on 52 primary pre-treatment human SyS tumours. Our analysis revealed a continuum of epigenomic states across the cohort at fusion target genes independent of rare somatic genetic lesions. We identify cell-of-origin signatures defined by enhancer states and reveal unexpected relationships between H2AK119Ub1 and active marks. The number of bivalent promoters, dually marked by the repressive H3K27me3 and activating H3K4me3 marks, has strong prognostic value and outperforms tumor grade in predicting patient outcome. Finally, we identify SyS defining epigenomic features including H3K4me3 expansion associated with striking promoter DNA hypomethylation in which SyS displays the lowest mean methylation level of any sarcoma subtype. We explore these distinctive features as potential vulnerabilities in SyS and identify H3K4me3 inhibition as a promising therapeutic strategy.
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Affiliation(s)
- Jakob Hofvander
- Department of Microbiology and Immunology, Michael Smith Laboratories, UBC, Vancouver, Canada
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver, Canada
- Division of Clinical Genetics, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Alvin Qiu
- Department of Microbiology and Immunology, Michael Smith Laboratories, UBC, Vancouver, Canada
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, UBC, Vancouver, Canada
| | - Kiera Lee
- Department of Microbiology and Immunology, Michael Smith Laboratories, UBC, Vancouver, Canada
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, UBC, Vancouver, Canada
| | - Misha Bilenky
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver, Canada
| | - Annaïck Carles
- Department of Microbiology and Immunology, Michael Smith Laboratories, UBC, Vancouver, Canada
| | - Qi Cao
- Department of Microbiology and Immunology, Michael Smith Laboratories, UBC, Vancouver, Canada
| | - Michelle Moksa
- Department of Microbiology and Immunology, Michael Smith Laboratories, UBC, Vancouver, Canada
| | - Jonathan Steif
- Department of Microbiology and Immunology, Michael Smith Laboratories, UBC, Vancouver, Canada
| | - Edmund Su
- Department of Microbiology and Immunology, Michael Smith Laboratories, UBC, Vancouver, Canada
| | - Afroditi Sotiriou
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany
- National Center for Tumor Diseases (NCT), NCT Heidelberg, Germany
- Soft-Tissue Sarcoma Junior Research Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Faculty of Biosciences, University of Heidelberg, Germany
| | - Angela Goytain
- Department of Pathology and Laboratory Medicine, UBC, Vancouver, Canada
| | - Lesley A Hill
- Department of Cellular and Physiological Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sam Singer
- Sarcoma Biology Laboratory, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Irene L Andrulis
- University Musculoskeletal Oncology Unit, Mount Sinai Hospital, Toronto, Canada
| | - Jay S Wunder
- Lunefeld-Tanenbaum Research Institute, Sinai Health System and Department of Molecular Genetics, University of Toronto, Toronto, Canada
| | - Fredrik Mertens
- Division of Clinical Genetics, Lund University and Skåne University Hospital, Lund, Sweden
| | - Ana Banito
- Hopp Children's Cancer Center (KiTZ), Heidelberg, Germany
- National Center for Tumor Diseases (NCT), NCT Heidelberg, Germany
- Soft-Tissue Sarcoma Junior Research Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Kevin B Jones
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah, United States of America
- Department of Oncological Sciences, Huntsman Cancer Institute, Salt Lake City, Utah, United States of America
| | - T Michael Underhill
- Department of Cellular and Physiological Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Torsten O Nielsen
- Department of Pathology and Laboratory Medicine, UBC, Vancouver, Canada
| | - Martin Hirst
- Department of Microbiology and Immunology, Michael Smith Laboratories, UBC, Vancouver, Canada
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver, Canada
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Revia S, Budzinska MA, Bogatyrova O, Neumann F, Zimmermann A, Amendt C, Albers J. DNA-Dependent Protein Kinase Inhibitor Peposertib Potentiates the Cytotoxicity of Topoisomerase II Inhibitors in Synovial Sarcoma Models. Cancers (Basel) 2023; 16:189. [PMID: 38201616 PMCID: PMC10778103 DOI: 10.3390/cancers16010189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/25/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024] Open
Abstract
Synovial sarcoma is a rare and highly aggressive subtype of soft tissue sarcoma. The clinical challenge posed by advanced or metastatic synovial sarcoma, marked by limited treatment options and suboptimal outcomes, necessitates innovative approaches. The topoisomerase II (Topo II) inhibitor doxorubicin has remained the cornerstone systemic treatment for decades, and there is pressing need for improved therapeutic strategies for these patients. This study highlights the potential to enhance the cytotoxic effects of doxorubicin within well-characterized synovial sarcoma cell lines using the potent and selective DNA-PK inhibitor, peposertib. In vitro investigations unveil a p53-mediated synergistic anti-tumor effect when combining doxorubicin with peposertib. The in vitro findings were substantiated by pronounced anti-tumor effects in mice bearing subcutaneously implanted tumors. A well-tolerated regimen for the combined application was established using both pegylated liposomal doxorubicin (PLD) and unmodified doxorubicin. Notably, the combination of PLD and peposertib displayed enhanced anti-tumor efficacy compared to unmodified doxorubicin at equivalent doses, suggesting an improved therapeutic window-a critical consideration for clinical translation. Efficacy studies in two patient-derived xenograft models of synovial sarcoma, accurately reflecting human metastatic disease, further validate the potential of this combined therapy. These findings align with previous evidence showcasing the synergy between DNA-PK inhibition and Topo II inhibitors in diverse tumor models, including breast and ovarian cancers. Our study extends the potential utility of combined therapy to synovial sarcoma.
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Affiliation(s)
- Steffie Revia
- Research Unit Oncology, Merck Healthcare KGaA, Frankfurter Str. 250, 64293 Darmstadt, Germany; (S.R.)
| | | | - Olga Bogatyrova
- Research Unit Oncology, Merck Healthcare KGaA, Frankfurter Str. 250, 64293 Darmstadt, Germany; (S.R.)
| | - Felix Neumann
- Research Unit Oncology, Merck Healthcare KGaA, Frankfurter Str. 250, 64293 Darmstadt, Germany; (S.R.)
| | - Astrid Zimmermann
- Research Unit Oncology, Merck Healthcare KGaA, Frankfurter Str. 250, 64293 Darmstadt, Germany; (S.R.)
| | - Christiane Amendt
- Research Unit Oncology, Merck Healthcare KGaA, Frankfurter Str. 250, 64293 Darmstadt, Germany; (S.R.)
| | - Joachim Albers
- Research Unit Oncology, Merck Healthcare KGaA, Frankfurter Str. 250, 64293 Darmstadt, Germany; (S.R.)
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Kawai A, Ishihara M, Nakamura T, Kitano S, Iwata S, Takada K, Emori M, Kato K, Endo M, Matsumoto Y, Kakunaga S, Sato E, Miyahara Y, Morino K, Tanaka S, Takahashi S, Matsuo F, Matsumine A, Kageyama S, Ueda T. Safety and Efficacy of NY-ESO-1 Antigen-Specific T-Cell Receptor Gene-Transduced T Lymphocytes in Patients with Synovial Sarcoma: A Phase I/II Clinical Trial. Clin Cancer Res 2023; 29:5069-5078. [PMID: 37792433 PMCID: PMC10722137 DOI: 10.1158/1078-0432.ccr-23-1456] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 09/20/2023] [Accepted: 10/02/2023] [Indexed: 10/05/2023]
Abstract
PURPOSE To determine, for patients with advanced or recurrent synovial sarcoma (SS) not suitable for surgical resection and resistant to anthracycline, the safety and efficacy of the infusion of autologous T lymphocytes expressing NY-ESO-1 antigen-specific T-cell receptor (TCR) gene and siRNA to inhibit the expression of endogenous TCR (product code: TBI-1301). PATIENTS AND METHODS Eligible Japanese patients (HLA-A*02:01 or *02:06, NY-ESO-1-positive tumor expression) received cyclophosphamide 750 mg/m2 on days -3 and -2 (induction period) followed by a single dose of 5×109 (±30%) TBI-1301 cells as a divided infusion on days 0 and 1 (treatment period). Primary endpoints were safety-related (phase I) and efficacy-related [objective response rate (ORR) by RECIST v1.1/immune-related RECIST (irRECIST); phase II]. Safety- and efficacy-related secondary endpoints were considered in both phase I/II parts. RESULTS For the full analysis set (N = 8; phase I, n = 3; phase II, n = 5), the ORR was 50.0% (95% confidence interval, 15.7-84.3) with best overall partial response in four of eight patients according to RECIST v1.1/irRECIST. All patients experienced adverse events and seven of eight patients (87.5%) had adverse drug reactions, but no deaths were attributed to adverse events. Cytokine release syndrome occurred in four of eight patients (50.0%), but all cases recovered with prespecified treatment. Immune effector cell-associated neurotoxicity syndrome, replication-competent retrovirus, and lymphocyte clonality were absent. CONCLUSIONS Adoptive immunotherapy with TBI-1301 to selectively target NY-ESO-1-positive tumor cells appears to be a promising strategy for the treatment of advanced or recurrent SS with acceptable toxicity.
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Affiliation(s)
- Akira Kawai
- Department of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan
| | | | - Tomoki Nakamura
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Mie, Japan
| | - Shigehisa Kitano
- Department of Advanced Medical Development, The Cancer Institute Hospital of JFCR, Tokyo, Japan
| | - Shintaro Iwata
- Department of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Kohichi Takada
- Department of Medical Oncology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Makoto Emori
- Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Koji Kato
- Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Makoto Endo
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshihiro Matsumoto
- Department of Orthopedic Surgery, Fukushima Medical University, Fukushima, Japan
| | - Shigeki Kakunaga
- Department of Orthopaedic Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Eiichi Sato
- Department of Pathology, Institute of Medical Science, Tokyo Medical University, Tokyo, Japan
| | - Yoshihiro Miyahara
- Department of Personalized Cancer Immunotherapy, Mie University Graduate School of Medicine, Mie, Japan
| | | | | | | | | | - Akihiko Matsumine
- Department of Orthopaedics and Rehabilitation Medicine, University of Fukui, Fukui, Japan
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Sacchetti F, Alsina AC, Muratori F, Scoccianti G, Neri E, Kaya H, Sabah D, Capanna R, Campanacci DA. Tumor size and surgical margins are important prognostic factors of synovial sarcoma - A retrospective study. J Orthop 2023; 42:74-79. [PMID: 37533628 PMCID: PMC10391603 DOI: 10.1016/j.jor.2023.07.002] [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] [Received: 04/10/2023] [Revised: 06/28/2023] [Accepted: 07/06/2023] [Indexed: 08/04/2023] Open
Abstract
Background Synovial Sarcoma (SS) is a rare soft tissue sarcoma. Mean time to get a SS diagnosis from the onset of symptoms is 10 years, furthermore, SS is associated with late metastasis. Surgery is the main treatment option, whose quality deeply affects SS outcomes, and it can be associated to preoperative or post-operative radiotherapy. Chemotherapy is considered very effective in Children, while in adults its efficacy is still under debate. The aim of this study was to investigate the oncologic results in SS treatment and to identify the risk factors for local and systemic control of the disease. Methods From 1994 to 2018, 211 patients affected by SS were treated in 3 Referral Centres of Orthopaedic Oncology. One hundred seventy-seven patients were included in the study, the median follow-up length was 96 months (5-374). Results Overall Survival on the Kaplan Meier Analyses was 80%, 70% and 56% at 5, 10 and 20 years. In multivariate analyses, OS correlated with tumour size and negative surgical margins. Chemotherapy use wasn't associated with better survival although patients who underwent CT had bigger and more aggressive tumours. Conclusions Our findings suggests that surgery with negative margins is the most important factor in Synovial Sarcoma. Adjuvant treatments as chemotherapy and radiation therapy didn't change the disease's course.
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Affiliation(s)
| | - Andac Celasun Alsina
- Ege University, Faculty of Medicine, Department of Orthopedics and Traumatology, Turkey
| | | | | | | | - Huseyin Kaya
- Ege University, Faculty of Medicine, Department of Orthopedics and Traumatology, Turkey
| | - Dundar Sabah
- Ege University, Faculty of Medicine, Department of Orthopedics and Traumatology, Turkey
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McCool A, Turner C, Turner S, Heppner P, Saran F. Primary intraventricular synovial sarcoma of the brain with recurrence - case presentation. BMC Neurol 2022; 22:447. [PMID: 36456921 PMCID: PMC9713988 DOI: 10.1186/s12883-022-02975-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 11/08/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND We report a case of recurrent primary intraventricular synovial sarcoma of the brain with no extracranial primary, initially reported as a haemangiopericytoma. We believe this is the first reported case of primary intraventricular synovial sarcoma at this site. CASE PRESENTATION A 27-year-old male presented to hospital with a new onset of seizures. Imaging revealed a left ventricular trigone mass with surrounding oedema. He underwent a left occipito-temporal craniotomy and resection with the histology reported as haemangiopericytoma. Resection was followed by adjuvant radiation treatment. Seven years later follow-up imaging revealed a 4 mm contrast enhancing lesion in the previous surgical bed. The patient underwent resection. Histological analysis of the recurrence revealed a spindle cell tumour with a SS18 gene rearrangement consistent with synovial sarcoma. Retrospective fluorescent in-situ hybridisation analysis of original histology also revealed a SS18 gene rearrangement consistent with a diagnosis of synovial sarcoma. CONCLUSION Synovial sarcoma should be included as part of the differential diagnosis for patients presenting with intraventricular spindle cell tumours in the brain.
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Affiliation(s)
- Anna McCool
- grid.414055.10000 0000 9027 2851Department of Radiation Oncology Cancer & Blood Research, Auckland City Hospital, Level 12, Building 1, 1023 Auckland, New Zealand
| | - Clinton Turner
- grid.414055.10000 0000 9027 2851Anatomical Pathology, Auckland City Hospital, Labplus, Auckland, New Zealand
| | - Sarah Turner
- grid.414055.10000 0000 9027 2851Department of Radiation Oncology Cancer & Blood Research, Auckland City Hospital, Level 12, Building 1, 1023 Auckland, New Zealand
| | - Peter Heppner
- grid.414055.10000 0000 9027 2851Department of Neurosurgery, Auckland City Hospital, Auckland, New Zealand
| | - Frank Saran
- grid.414055.10000 0000 9027 2851Department of Radiation Oncology Cancer & Blood Research, Auckland City Hospital, Level 12, Building 1, 1023 Auckland, New Zealand
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Carroll C, Patel N, Gunsoy NB, Stirnadel-Farrant HA, Pokras S. Meta-analysis of pazopanib and trabectedin effectiveness in previously treated metastatic synovial sarcoma (second-line setting and beyond). Future Oncol 2022; 18:3651-3665. [PMID: 36399116 DOI: 10.2217/fon-2022-0348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background: This study examined the efficacy/effectiveness of pazopanib and trabectedin in previously treated metastatic synovial sarcoma (mSS). Materials & methods: A literature search identified studies (2002-2019) reporting outcomes of pazopanib and trabectedin in previously treated mSS, including median overall survival (mOS) and overall response rate (ORR). A meta-analysis was conducted and sensitivity analyses examined outcomes by agent (pazopanib/trabectedin), study type (clinical trial [CT] or real-world [RW]) and sample size. Results: Sixteen studies were included (pazopanib: n = 7; trabectedin: n = 9). Pooled mOS was 10.4 months and was consistent across agents and in RW and CT (pazopanib: 10.3; trabectedin: 10.4; CT: 10.8; RW: 9.9). ORR results were more variable (pooled ORR: 14.7%). ORR was consistently higher for RW (17.7%) than for CT (9.5%) and for pazopanib (18.9%) compared with trabectedin (12.3%). Conclusion: Poor outcomes across agents and settings highlight a need for novel treatments with improved efficacy. This study serves as a benchmark for efficacy estimates in this rare disease.
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Affiliation(s)
| | - Nashita Patel
- Oncology Clinical Development, GSK, Stevenage, Hertfordshire, SG1 2NY, UK
| | - Necdet B Gunsoy
- Value Evidence & Outcomes, GSK, Uxbridge, Middlesex, UB11 1BT, UK
| | | | - Shibani Pokras
- Value Evidence & Outcomes, GSK, Collegeville, PA 19426, USA
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Jiang S, Hu Y, Zhou Y, Tang G, Cui W, Wang X, Chen B, Hu Z, Xu B. miRNAs as Biomarkers and Possible Therapeutic Strategies in Synovial Sarcoma. Front Pharmacol 2022; 13:881007. [PMID: 36003502 PMCID: PMC9394702 DOI: 10.3389/fphar.2022.881007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
Synovial sarcoma (SS) is an epithelial-differentiated malignant stromal tumor that has the highest incidence in young people and can occur almost anywhere in the body. Many noncoding RNAs are involved in the occurrence, development, or pathogenesis of SS. In particular, the role of MicroRNAs (miRNAs) in SS is receiving increasing attention. MiRNA is a noncoding RNA abundant in cells and extracellular serums. Increasing evidence suggests that miRNA has played a significant role in the incidence and development of tumors in recent years, including sarcomas. Previous studies show that various sarcomas have their unique miRNA expression patterns and that various miRNA expression profiles can illustrate the classes of miRNAs that may elicit cancer-relevant activities in specific sarcoma subtypes. Furthermore, SS has been reported to have the most number of differentially expressed miRNAs, which indicated that miRNA is linked to SS. In fact, according to many publications, miRNAs have been shown to have a role in the development and appearance of SS in recent years, according to many publications. Since many studies showing that various miRNAs have a role in the development and appearance of SS in recent years have not been systematically summarized, we summarize the recent studies on the relationship between miRNA and SS in this review. For example, miR-494 promotes the development of SS via modulating cytokine gene expression. The role of miR-494-3p as a tumor suppressor is most likely linked to the CXCR4 (C-X-C chemokine receptor 4) regulator, although the exact mechanism is unknown. Our review aims to reveal in detail the potential biological value and clinical significance of miRNAs for SS and the potential clinical value brought by the association between SS and miRNAs.
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Affiliation(s)
- Shaowei Jiang
- Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ying Hu
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
- School of Pharmacy, Anhui Medical University, Hefei, China
| | - Yi Zhou
- The First Clinical Medical College of Anhui Medical University, Hefei, China
| | - Guozheng Tang
- The First Clinical Medical College of Anhui Medical University, Hefei, China
- Department of Orthopedics, Lu’an People’s Hospital, Lu’an, China
| | - Wenxu Cui
- The First Clinical Medical College of Anhui Medical University, Hefei, China
| | - Xinyi Wang
- The First Clinical Medical College of Anhui Medical University, Hefei, China
| | - Bangjie Chen
- The First Clinical Medical College of Anhui Medical University, Hefei, China
| | - Zuhong Hu
- The First Clinical Medical College of Anhui Medical University, Hefei, China
| | - Bing Xu
- Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- *Correspondence: Bing Xu,
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Primary pulmonary synovial sarcoma. JTCVS OPEN 2022; 10:404-414. [PMID: 36004273 PMCID: PMC9390693 DOI: 10.1016/j.xjon.2022.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 02/16/2022] [Indexed: 11/30/2022]
Abstract
Objective Primary pulmonary synovial sarcoma (PPSS) is extremely rare. This study aims to identify the clinicopathologic and therapeutic factors determining survival in PPSS. Methods We performed a retrospective analysis of 121 patients from the Surveillance, Epidemiology, and End Results Database as well as 12 patients from our own institution diagnosed with PPSS. Patient survival was evaluated using the Kaplan-Meier method. Results The median survival time for 12 PPSS patients in our institution was 78 months. Postoperative chemotherapy (P = .027 for overall survival and P = .035 for disease-specific survival) was associated with superior survival, whereas pneumonectomy (P = .011 for overall survival and P = .006 for disease-specific survival) was associated with worse survival. Single lobe involvement (P = .022) and the absence of lymph node involvement (P = .045) were associated with improved disease-specific survival and overall survival, respectively. In the Surveillance, Epidemiology, and End Results Database, the median survival time was 23 months. Significantly superior survival was observed in patients with earlier American Joint Committee on Cancer stage (Ⅰ-Ⅱ) (P < .001 for both overall survival and disease-specific survival). Patients who were diagnosed within the recent decade did not achieve a better survival (P = .599 for overall survival and P = .596 for disease-specific survival). Conclusions PPSS was aggressive with a very poor prognosis. The seventh American Joint Committee on Cancer stage might aid in predicting survival. Pneumonectomy and lymph node involvement might be associated with worse survival, whereas single lobe involvement and postoperative chemotherapy might be associated with improved survival.
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Lanzi C, Cassinelli G. Combinatorial strategies to potentiate the efficacy of HDAC inhibitors in fusion-positive sarcomas. Biochem Pharmacol 2022; 198:114944. [DOI: 10.1016/j.bcp.2022.114944] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/02/2022] [Accepted: 02/02/2022] [Indexed: 12/12/2022]
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Pang K, Guo X, Jiang Y, Xu L, Ling L, Li Z. Case Report: Primary Intraosseous Poorly Differentiated Synovial Sarcoma of the Femur. Front Oncol 2022; 12:754131. [PMID: 35372059 PMCID: PMC8966429 DOI: 10.3389/fonc.2022.754131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 02/09/2022] [Indexed: 01/24/2023] Open
Abstract
Primary intraosseous poorly differentiated synovial sarcoma is exceedingly rare. Here, we present a case of primary intraosseous poorly differentiated synovial sarcoma from the proximal femur in a 16-year-old girl. The case was initially misdiagnosed, but the correct diagnosis of synovial sarcoma was eventually confirmed by fluorescence in situ hybridization and next-generation sequencing. We review the literature pertaining to synovial sarcoma and show that this case is the second molecularly proven intraosseous poorly differentiated synovial sarcoma in the literature. Recognition of intraosseous synovial sarcoma composed of small round cells is imperative in order to avoid misdiagnosis of the tumor as Ewing sarcoma and other small round-cell tumors, all of which have markedly different clinical management.
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Affiliation(s)
- Ke Pang
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, China,Hunan Key Laboratory of Tumor Models and Individualized Medicine, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xiaoning Guo
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yi Jiang
- Department of Pathology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Lina Xu
- Department of Pathology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Lin Ling
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, China,*Correspondence: Lin Ling, ; Zhihong Li,
| | - Zhihong Li
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, China,Hunan Key Laboratory of Tumor Models and Individualized Medicine, The Second Xiangya Hospital of Central South University, Changsha, China,*Correspondence: Lin Ling, ; Zhihong Li,
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11
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Nomogram to Predict Overall and Cancer-Specific Survival in Patients with Synovial Sarcoma in the Extremities: A Population-Based Study. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:4748628. [PMID: 35720922 PMCID: PMC9205689 DOI: 10.1155/2022/4748628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 04/26/2022] [Accepted: 05/04/2022] [Indexed: 11/18/2022]
Abstract
Background Synovial sarcoma is a rare disease, and synovial sarcoma that first appears in the extremities accounts for more than 80% of cases. We established two nomograms to predict the overall survival (OS) and cancer-specific survival (CSS) rates of patients with synovial sarcoma. Methods A total of 227 patients diagnosed with synovial sarcoma in the extremities between 2010 and 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate Cox analyses were performed to explore independent prognostic factors and to create two separate nomograms for OS and CSS. The C-index, the area under the curve (AUC), calibration curve, decision curve analysis (DCA), and Kaplan-Meier (KM) curve were used to evaluate the column line graphs and analyze prognostic factors. Results Age, Stage M, and surgery were identified as independent prognostic factors for OS and CSS. The ROC curve showed good discriminative power for the nomogram. Calibration curves and DCA curves showed that the nomogram had a satisfactory ability to predict OS and CSS. The KM curve showed that chemotherapy alone did not affect patient survival. Conclusion Age, Stage M, and surgery are variables that affect OS and CSS in patients with synovial sarcoma in the extremities. Two nomograms were established based on the above variables to provide patients with more accurate individual survival predictions and to help physicians make appropriate clinical decisions.
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Khalili N, Askari E, Khalili N, Daneshvar-Kakhki A, Sadr M, Haseli S, Pourabdollah Toutkaboni M. Primary Pleuropulmonary Synovial Sarcoma: Report of Two Cases and a Comprehensive Review of the Literature. Cancer Invest 2021; 40:268-281. [PMID: 34726558 DOI: 10.1080/07357907.2021.2001484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Primary sarcomas of the lung represent less than 0.5% of all primary lung tumors and comprise a heterogeneous group of malignancies including synovial sarcoma (SS). Primary pleuropulmonary SS has non-specific presentations, such as chest pain, shortness of breath and cough, and its associated imaging features resemble those of other intrathoracic malignancies. The diagnosis of these tumors needs to be confirmed by cytogenetic and molecular studies. Here, we describe two rare cases of primary pleuropulmonary SS who were admitted to our hospital. We also provide a concise review of clinical, radiological, and histopathological characteristics of pleuropulmonary SS after exploring 168 studies (415 corresponding patients) that were identified through a literature search.
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Affiliation(s)
- Neda Khalili
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Askari
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nastaran Khalili
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Aboulghasem Daneshvar-Kakhki
- Lung Transplantation Research Center (LTRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Makan Sadr
- Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sara Haseli
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mihan Pourabdollah Toutkaboni
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
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13
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Ye W, Freeman MH, Craig JC, Rohde SL. Synovial sarcoma of the head and neck masquerading as a vagal schwannoma. OTOLARYNGOLOGY CASE REPORTS 2021. [DOI: 10.1016/j.xocr.2021.100342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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14
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Epidemiological Trends of Head and Neck Cancer: A Population-Based Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:1738932. [PMID: 34337000 PMCID: PMC8294963 DOI: 10.1155/2021/1738932] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 06/01/2021] [Accepted: 06/22/2021] [Indexed: 01/12/2023]
Abstract
Background Over the past decades, lots of advance have occurred in the prevention, diagnosis, and treatment of head and neck cancer (HNC). However, the contemporaneous incidence and survival trends, on the basis of population-based registry, have not been reported. Methods The HNC cancer cases were accessed from the Surveillance, Epidemiology, and End Results (SEER) database. The incidence trend was analyzed by joinpoint analysis, with the survival trend being analyzed by period analysis of relative survival rate (RSR) and Kaplan-Meier analyses. Cox regression analysis was performed to identify the prognostic factors for overall survival. Results The general incidence trend of HNC increases slightly, with an average annual percentage change of 0.6%, along with five fluctuating segments. The improvement of net survival over the past decades was showed by increasing 60-month RSR, from 54.1% to 56.0% to 60.9% to 66.8%, which was further confirmed by Kaplan-Meier analyses. Moreover, disparities in incidence and survival patterns can be observed in different subgroups. Conclusion A fluctuating incidence pattern and an ever-improving survival were observed in HNC over time.
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15
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Mitchell G, Pollack SM, Wagner MJ. Targeting cancer testis antigens in synovial sarcoma. J Immunother Cancer 2021; 9:jitc-2020-002072. [PMID: 34083416 PMCID: PMC8183285 DOI: 10.1136/jitc-2020-002072] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2021] [Indexed: 02/02/2023] Open
Abstract
Synovial sarcoma (SS) is a rare cancer that disproportionately affects children and young adults. Cancer testis antigens (CTAs) are proteins that are expressed early in embryonic development, but generally not expressed in normal tissue. They are aberrantly expressed in many different cancer types and are an attractive therapeutic target for immunotherapies. CTAs are expressed at high levels in SS. This high level of CTA expression makes SS an ideal cancer for treatment strategies aimed at harnessing the immune system to recognize aberrant CTA expression and fight against the cancer. Pivotal clinical trials are now underway, with the potential to dramatically alter the landscape of SS management and treatment from current standards of care. In this review, we describe the rationale for targeting CTAs in SS with a focus on NY-ESO-1 and MAGE-A4, the current state of vaccine and T-cell receptor-based therapies, and consider emerging opportunities for future development.
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Affiliation(s)
| | - Seth M Pollack
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.,Oncology, University of Washington, Seattle, Washington, USA.,Lurie Cancer Center, Northwestern University, Chicago, Illinois, USA
| | - Michael J Wagner
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA .,Oncology, University of Washington, Seattle, Washington, USA
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16
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Hashimoto Y, Tome Y, Oshiro H, Aoki Y, Maehara H, Nishida K. Reconstruction of the elbow using pedicle joint freezing after wide excision for soft tissue sarcoma: A case report. Mol Clin Oncol 2021; 14:115. [PMID: 33903821 PMCID: PMC8060848 DOI: 10.3892/mco.2021.2277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 03/19/2021] [Indexed: 11/05/2022] Open
Abstract
A 35-year-old man presented with a four-year history of a growing mass on the anterior aspect of his left elbow. Magnetic resonance imaging revealed a soft tissue tumor in the brachialis muscle extending to the cubital fossa. Following an open biopsy, the tumor was diagnosed as a monophasic fibrous synovial sarcoma. After neoadjuvant chemotherapy, the patient underwent wide excision and reconstruction of the elbow joint with a pedicle frozen autograft. At the final follow-up four years after surgery, the elbow range of motion was 0-120˚. Although there were signs of osteoarthritis, there was no narrowing of the joint -, and the patient experienced only mild pain. To the best of our knowledge, the present case report is the first to describe wide tumor excision and reconstruction using a pedicle frozen autograft of the elbow. This method should be considered after excision of malignant bone and soft tissue tumors, especially in non-weight-bearing joints. Further cases have to be evaluated to understand the complications and long-term prognosis of this procedure.
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Affiliation(s)
- Yuta Hashimoto
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0125, Japan
| | - Yasunori Tome
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0125, Japan
| | - Hiromichi Oshiro
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0125, Japan
| | - Yusuke Aoki
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0125, Japan
| | - Hiroki Maehara
- Department of Hyperbaric Medicine, University of the Ryukyus Hospital, Nishihara, Okinawa 903-0125, Japan
| | - Kotaro Nishida
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0125, Japan
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17
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Aytekin MN, Öztürk R, Amer K, Yapar A. Epidemiology, incidence, and survival of synovial sarcoma subtypes: SEER database analysis. J Orthop Surg (Hong Kong) 2021; 28:2309499020936009. [PMID: 32618221 DOI: 10.1177/2309499020936009] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Synovial sarcoma (SyS) is a rare malignancy that is typically located on the limbs and occurs predominantly in adolescents. A study in a large population for SyS comparing subtypes has not yet been reported. METHODS National Cancer Institute's Surveillance, Epidemiology, and End Results database was queried for patients diagnosed with SyS between January 1975 and December 2016. Patients were classified demographically according to gender, age, race/ethnicity, and marital status, and they were also classified by tumors, subtypes, localization, grade, year of diagnosis, laterality, type of treatment, and follow-up results. RESULTS A total of 3228 patients were included, with a mean age of 39.3 ± 18.8 (range: 1-94), of which 1521 (47.1%) were females and 1707 (52.9%) were males. According to its subtypes, 47.2% were SyS not otherwise specified, 32.3% were spindle cell, 19.9% were biphasic, and 0.6% were epithelioid type. The overall survival period is 138.0 (95% confidence interval: 113.2-162.8) months. Survival duration was found to be significantly different between groups according to gender (log-rank test; p < 0.001), age groups (log-rank test; p < 0.001), race (log-rank test; p = 0.001), marital status (log-rank test; p < 0.001), tumor subtypes (log-rank test; p < 0.001), tumor location (log-rank test; p < 0.001), tumor laterality (log-rank test; p < 0.001), date of diagnosis (log-rank test; p = 0.025), tumor grade (log-rank test; p < 0.001), historic stage (log-rank test; p < 0.001), state of chemotherapy (log-rank test; p < 0.001), state of radiotherapy (log-rank test; p < 0.001), presence of metastasis (log-rank test; p < 0.001), and total number of malignant tumors (log-rank test; p < 0.001). CONCLUSION Male gender, being colored individual, being over 35 years at the time of diagnosis, epithelioid type, non-head and neck region localization is associated with poor prognosis. While radiotherapy improves survival, benefit of chemotherapy is unclear. LEVEL OF EVIDENCE III retrospective analysis.
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Affiliation(s)
- Mahmut Nedim Aytekin
- Department of Orthopedics and Traumatology, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Recep Öztürk
- Department of Orthopedics and Traumatology, Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Kamil Amer
- Department of Orthopaedics, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Aliekber Yapar
- Department of Orthopedics and Traumatology, Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
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18
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Tetta C, Rocca M, Salone M, Longhi A, Ferrari C, Londero F, Parise G, Parise O, Giugliano A, Maessen JG, La Meir M, Gelsomino S. Predictors of lung recurrence and disease-specific mortality after pulmonary metastasectomy for soft tissue sarcoma. Surg Oncol 2021; 37:101532. [PMID: 33639455 DOI: 10.1016/j.suronc.2021.101532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/06/2020] [Accepted: 02/07/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND We identified prognostic factors in a 30-year series of STS treated at a single Institution, using an advanced statistical approach. METHODS From June 1988 to July 2019, 164 patients were referred to Rizzoli Orthopedic Hospital, Bologna, Italy) for STS lung metastasectomy (LMTS). The endpoints were lung metastasis recurrence (LMR) and lung metastasis-specific mortality (LMSM). The analysis included directed acyclic graphs, cubic splines, and a competing risk model in order to minimize bias. RESULTS The 10- and 15- year LMR cumulative incidence were 0.77 (0.76-0.78) whereas 10- and 15- year freedom from LMSM were 0.60 [0.51-0.70] and 0.56 [0.47-0.67], respectively. The malignant peripheral nerve sheath tumor (MPNST) histotype (SHR 4.12 [2.05-8.27]), a disease-free interval (DFI) up to 68 months (HR from 2 [1.7-2.2] to 1.5 [1.1-1.9]) and a LM size ≥4 mm (3.1 [2.1-4.4]) predicted LMR. Myxofibrosarcoma (HR 2.52[1.64-3.86]), synovial sarcoma (2.53[1.22-5.23]), adjuvant chemotherapy (2.01[1.11-3.61]), DFI between 2 months and 20 months (HR from 1.5 [1.1-2.3] to 1.3 [1.1-1.7] and primary tumor size a primary tumor size comprised between 3.6 cm and 10 cm predicted LMSM. A sharp increase in LMSM was observed with a tumor size from ≥20 cm. CONCLUSIONS Our analysis corrected by potential confounders allowed us to identify specific histotypes and DFI intervals as predictors of both LMR and LMSM. Tumor size adjuvant chemotherapy adversely affected LM-related survival. Our findings need to be confirmed by larger randomized studies.
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Affiliation(s)
| | | | | | | | | | - Francesco Londero
- Cardiovascular Research Institute Maastricht - CARIM, Maastricht University Medical Center, the Netherlands
| | - Gianmarco Parise
- Cardiovascular Research Institute Maastricht - CARIM, Maastricht University Medical Center, the Netherlands
| | - Orlando Parise
- Cardiovascular Research Institute Maastricht - CARIM, Maastricht University Medical Center, the Netherlands
| | | | - Jos G Maessen
- Cardiovascular Research Institute Maastricht - CARIM, Maastricht University Medical Center, the Netherlands
| | - Mark La Meir
- Cardiovascular Research Institute Maastricht - CARIM, Maastricht University Medical Center, the Netherlands
| | - Sandro Gelsomino
- Cardiovascular Research Institute Maastricht - CARIM, Maastricht University Medical Center, the Netherlands.
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19
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BNCT for primary synovial sarcoma. Appl Radiat Isot 2020; 169:109407. [PMID: 33444907 DOI: 10.1016/j.apradiso.2020.109407] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 08/18/2020] [Accepted: 09/01/2020] [Indexed: 01/17/2023]
Abstract
Synovial sarcoma is a rare tumor requiring new treatment methods. A 46-year-old woman with primary monophasic synovial sarcoma in the left thigh involving the sciatic nerve, declining surgery because of potential dysfunction of the affected limbs, received two courses of BNCT. The tumor thus reduced was completely resected with no subsequent recurrence. The patient is now able to walk unassisted, and no local recurrence has been observed, demonstrating the applicability of BNCT as adjuvant therapy for synovial sarcoma. Further study and analysis with more experience accumulation are needed to confirm the real impact of BNCT efficacy for its application to synovial sarcoma.
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20
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Seo SW, Kim J, Son J, Lim S. Evaluation of conditional treatment effects of adjuvant treatments on patients with synovial sarcoma using Bayesian subgroup analysis. BMC Med Inform Decis Mak 2020; 20:320. [PMID: 33272256 PMCID: PMC7712601 DOI: 10.1186/s12911-020-01305-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 10/26/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The impact of adjuvant chemotherapy or radiation therapy on the survival of patients with synovial sarcoma (SS), which is a rare soft-tissue sarcoma, remains controversial. Bayesian statistical approaches and propensity score matching can be employed to infer treatment effects using observational data. Thus, this study aimed to identify the individual treatment effects of adjuvant therapies on the overall survival of SS patients and recognize subgroups of patients who can benefit from specific treatments using Bayesian subgroup analyses. METHODS We analyzed data from patients with SS obtained from the surveillance, epidemiology, and end results (SEER) public database. These data were collected between 1984 and 2014. The treatment effects of chemotherapy and radiation therapy on overall survival were evaluated using propensity score matching. Subgroups that could benefit from radiation therapy or chemotherapy were identified using Bayesian subgroup analyses. RESULTS Based on a stratified Kaplan-Meier curve, chemotherapy exhibited a positive average causal effect on survival in patients with SS, whereas radiation therapy did not. The optimal subgroup for chemotherapy includes the following covariates: older than 20 years, male, large tumor (longest diameter > 5 cm), advanced stage (SEER 3), extremity location, and spindle cell type. The optimal subgroup for radiation therapy includes the following covariates: older than 20 years, male, large tumor (longest diameter > 5 cm), early stage (SEER 1), extremity location, and biphasic type. CONCLUSION In this study, we identified high-risk patients whose variables include age (age > 20 years), gender, tumor size, tumor location, and poor prognosis without adjuvant treatment. Radiation therapy should be considered in the early stages for high-risk patients with biphasic types. Conversely, chemotherapy should be considered for late-stage high-risk SS patients with spindle cell types.
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Affiliation(s)
- Sung Wook Seo
- Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Jisoo Kim
- Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jihye Son
- Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sungbin Lim
- Department of Industrial Engineering, Artificial Intelligence Graduate School, UNIST, Ulsan, Korea
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21
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Hernandez Tejada FN, Zamudio A, Marques-Piubelli ML, Cuglievan B, Harrison D. Advances in the Management of Pediatric Sarcomas. Curr Oncol Rep 2020; 23:3. [PMID: 33196879 DOI: 10.1007/s11912-020-00995-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The prognosis of pediatric patients who present with metastatic or recurrent sarcomas remains poor. In this review, we summarize the advances in the management of metastatic and relapsed pediatric sarcoma by highlighting recent and future clinical trials. RECENT FINDINGS Research into the identification of novel therapies for refractory pediatric sarcomas continues to advance. Outcomes have not improved in several decades underlying a need for improved understanding of the biology behind these tumors and the identification of novel therapeutic molecular targets that can be exploited pharmacologically. Multiple challenges remain for novel therapy in sarcomas such as the selection of effective targets, management of toxicities, and the tumor microenvironment. Many unique challenges remain in the treatment of patients with refractory pediatric sarcomas. Multiple strategies and targets are under investigation that hold promise.
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Affiliation(s)
- Fiorela N Hernandez Tejada
- Division of Pediatrics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Alejandro Zamudio
- Division of Pediatrics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Mario L Marques-Piubelli
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Branko Cuglievan
- Division of Pediatrics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Douglas Harrison
- Division of Pediatrics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA.
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22
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Khan Y, Carey-Smith R, Taylor M, Woodhouse J, Jacques A, Wood D, Long A. Treatment and outcomes for synovial sarcoma patients in Western Australia: the role of neoadjuvant chemoradiotherapy. Cancer Rep (Hoboken) 2020; 3:e1268. [PMID: 32881345 PMCID: PMC7941415 DOI: 10.1002/cnr2.1268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/09/2020] [Accepted: 06/22/2020] [Indexed: 12/12/2022] Open
Abstract
Background This is a retrospective review of synovial sarcoma (SS) patients treated over the last 12 years in Western Australia (WA). SS is both chemo and radiotherapy sensitive. Results of trials in adjuvant chemotherapy are conflicting and there is limited support for neoadjuvant chemotherapy. The use of combined chemoradiotherapy is based on institutional preferences. Aim We reviewed the outcomes for SS patients treated in WA over a 12 year period focusing on patients who received neoadjuvant chemoradiotherapy (NACRT). Methods Patient details including demographics, histopathology, treatment details, were obtained from the WA sarcoma database (2006‐2018). Progression free survival (PFS) and overall survival (OS) were derived for whole cohort. Results Twenty seven patients were identified with SS with equal gender incidence. Median age of the cohort was 36 (14‐76) years. The most common primary site of disease was extremity (81.5%). 22/27 patients presented with only localized disease and 59.2% of these received neo‐adjuvant treatment. Of those who received neoadjuvant treatment, 56.2% had NACRT, while 25.0% and 18.7% of patients had chemotherapy and radiotherapy respectively. Mesna, doxorubicin, ifosfamide, dacarbazine (MAID) was the most commonly used chemotherapy regimen as neoadjuvant or adjuvant treatment while ifosfamide (93.7%) was the most commonly used chemotherapy drug in any setting. There was no reported case of disease progression in group of patients who received NACRT apart from one patient who had oligometastatic disease at diagnosis. Median OS of the whole cohort was 38 months while median PFS was 24 months. Bone marrow toxicity was the most commonly reported high grade toxicity in NACRT group (55.5%) but there were no treatment related deaths. Conclusion NACRT is not widely adopted and treatment is based on institutional preferences, however our data shows that NACRT is a feasible therapy option. NACRT should be evaluated prospectively in a randomized trial.
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Affiliation(s)
- Yasir Khan
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Richard Carey-Smith
- Department of Orthopaedics, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.,Perth Orthopaedic & Sports Medicine Centre, West Perth, Western Australia, Australia.,Faculty of Medicine, The University of Western Australia, Perth, Western Australia, Australia
| | - Mandy Taylor
- Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Jennifer Woodhouse
- Hollywood Functional Rehab Clinic, Nedlands, Western Australia, Australia
| | - Angela Jacques
- Department of Research, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.,Institute for Health Research, The University of Notre Dame, Fremantle, Western Australia, Australia
| | - David Wood
- Faculty of Medicine, The University of Western Australia, Perth, Western Australia, Australia
| | - Anne Long
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
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23
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Xiong L, Chen Z, Zhou Y, Li H, Xiao T. The survival and prognosis analysis of synovial sarcoma subtypes: a Surveillance, Epidemiology, and End Results population-based analysis. INTERNATIONAL ORTHOPAEDICS 2020; 44:2779-2786. [PMID: 32880003 DOI: 10.1007/s00264-020-04708-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 07/03/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE By comparing epidemiologic and prognostic data of synovial sarcoma subtypes, this study aims to clarify the difference in prognosis and risk factors among different synovial sarcoma subtypes. METHODS In total, 1692 patients with synovial sarcoma in the USA who were diagnosed during 1975 through 2016 and retrieved from the Surveillance, Epidemiology, and End Results (SEER) program were studied. RESULTS There were statistically significant differences in the distribution of age and race among three synovial sarcoma subtypes, while no major differences in the distribution of sex, tumor stage, and tumour size were found. The highest five and ten year survival rates were found in the biphasic subtype (69%, 60%), followed by the monophasic subtype (59%, 49%), and lowest in the epithelioid subtype (32%, 26%). Age and SEER historic stage were the two demographic factors that found to have statistically significant impact on survival in all subtypes. Radiation was found to be protective in the monophasic subtype (HR 0.61, p < 0.001). CONCLUSION Among different synovial sarcoma subtypes, the biphasic subtype favoured the best survival, while the epithelioid cell subtype was associated with the worst. Male and black race were independently associated with worse survival only in the monophasic subtype. Radiotherapy could provide significant benefit for patients with the monophasic synovial sarcoma.
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Affiliation(s)
- Liang Xiong
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.,Orthopedic Biomedical Materials Engineering Laboratory of Hunan Province, Changsha, 410011, Hunan, China
| | - Zhuoyuan Chen
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.,Orthopedic Biomedical Materials Engineering Laboratory of Hunan Province, Changsha, 410011, Hunan, China
| | - You Zhou
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.,Orthopedic Biomedical Materials Engineering Laboratory of Hunan Province, Changsha, 410011, Hunan, China
| | - Hui Li
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China. .,Orthopedic Biomedical Materials Engineering Laboratory of Hunan Province, Changsha, 410011, Hunan, China.
| | - Tao Xiao
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China. .,Orthopedic Biomedical Materials Engineering Laboratory of Hunan Province, Changsha, 410011, Hunan, China. .,Orthopedic Biomedical Materials Institute of Central South University, Changsha, 410011, Hunan, China.
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24
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Kogushi K, LoPresti M, Ikeda S. Systematic literature review of clinical outcomes in adults with metastatic or advanced synovial sarcoma. Future Oncol 2020; 16:2997-3013. [PMID: 32851862 DOI: 10.2217/fon-2020-0575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background: Synovial sarcoma (SS) is a rare, aggressive soft tissue sarcoma with a poor prognosis after metastasis. The objective of this study was to conduct a systematic review of the clinical evidence for therapeutic options for adults with metastatic or advanced SS. Materials & methods: Relevant databases were searched with predefined keywords. Results: Thirty-nine publications reported clinical data for systemic treatment and other interventions. Data on survival outcomes varied but were generally poor (progression-free survival: 1.0-7.7 months; overall survival: 6.7-29.2 months) for adults with metastatic and advanced SS. A high frequency of neutropenia with systemic treatment and low quality of life post-progression were reported. Conclusion: Reported evidence suggests poor outcomes in adults with metastatic and advanced SS and the need for the development of new treatment modalities.
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Affiliation(s)
- Kentaro Kogushi
- Graduate School of Medicine, International University of Health and Welfare, Tokyo Perfecture, 4-1-26 Akasaka, Minato City, Tokyo, 107-8402, Japan.,Medical Affairs, Otsuka Pharmaceutical Co., Ltd., Shinagawa Grand Central Tower, 2-16-4 Konan, Minato-ku, Tokyo, 108-8242, Japan
| | - Michael LoPresti
- INTAGE Healthcare Inc., 13F Ochanomizu SolaCity 4-6, Kanda-Surugadai, Chiyoda-ku, Tokyo, 101-0062, Japan
| | - Shunya Ikeda
- Graduate School of Medicine, International University of Health and Welfare, Tokyo Perfecture, 4-1-26 Akasaka, Minato City, Tokyo, 107-8402, Japan
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25
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Wang Y, Lu M, Zhou Y, Zhou S, Yu X, Tang F, Luo Y, Zhang W, Duan H, Min L, Tu C. The Efficacy and Safety of Apatinib in Advanced Synovial Sarcoma: A Case Series of Twenty-One Patients in One Single Institution. Cancer Manag Res 2020; 12:5255-5264. [PMID: 32669874 PMCID: PMC7335867 DOI: 10.2147/cmar.s254296] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 06/11/2020] [Indexed: 02/05/2023] Open
Abstract
Background Synovial sarcoma (SS) is a highly aggressive soft-tissue sarcoma (STS) with poor prognosis. Tyrosine kinase inhibitor (TKI) has shown a promising impact on advanced STS patients. This study aimed to evaluate the efficacy and safety of apatinib, an oral multi-TKI, which especially inhibited vascular endothelial growth factor receptor, as second-line therapy for patients with advanced SS. Patients and Methods This retrospective analysis included 21 advanced SS patients, who had a poor response to anthracycline-based chemotherapy alone or combined with ifosfamide at least one cycle. All the patients received an apatinib containing regimen between May 2016 and October 2019 in our institution. Apatinib 500–750 mg (250 mg for patients younger than 10) was given daily. Tumor responses were assessed by response evaluation criteria in solid tumors. Survival analysis was performed by the Kaplan–Meier test, and a safety profile was recorded. Results The median follow-up was 15.2 months (95% CI, 12.2-NE). Nine (42.9%) patients had partial response (PR), and eight (38.1%) had stable disease. The median progression-free survival (PFS) was 13.1 months (95% CI, 6.7-NE). The 6- and 12-month PFS rates were 76.2% (95% CI, 60.0–96.8) and 55.4% (95% CI, 37.3–82.3), respectively. Additionally, the median overall survival (OS) was 15.5 months (95% CI, 10.7-NE). The 6- and 12-month OS rates were 81.0% (95% CI, 65.8, 99.6) and 64.9% (95% CI, 46.9–90.0), respectively. Moreover, the objective response rate was 42.9% (9/21) for advanced SS patients. The disease control rate was 81.0% (17/21). For the nine patients with the best response of PR, the median duration of response was 7.7 months. Conclusion Apatinib was proved to be a potential second-line treatment option for advanced SS patients with chemo-resistance. Apatinib showed promising efficacy and acceptable safety profile in advanced SS, with considerable OS and particularly PFS. Indeed, further multicenter studies with a longer follow-up time are needed to fully determine the clinical application of apatinib in advanced SS.
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Affiliation(s)
- Yitian Wang
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, People's Republic of China
| | - Minxun Lu
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, People's Republic of China
| | - Yong Zhou
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, People's Republic of China
| | - Sisi Zhou
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, People's Republic of China
| | - Xinzhu Yu
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, People's Republic of China
| | - Fan Tang
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, People's Republic of China
| | - Yi Luo
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, People's Republic of China
| | - Wenli Zhang
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, People's Republic of China
| | - Hong Duan
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, People's Republic of China
| | - Li Min
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, People's Republic of China
| | - Chongqi Tu
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, People's Republic of China
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Synovial Sarcoma of the Hand. Case Rep Pathol 2020; 2020:8491864. [PMID: 32566346 PMCID: PMC7293724 DOI: 10.1155/2020/8491864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 03/11/2020] [Accepted: 03/12/2020] [Indexed: 12/31/2022] Open
Abstract
The incidence of synovial sarcoma is 1.548 per 1,000,000. Synovial sarcoma localized to the palmar surface should, therefore, be considered extremely rare. This report documents a 34-year-old male with a right hand mass that had been present for a few years, continuing to grow in size. The mass was located at the palm and extended from the mid-third metacarpal to involve all digits except the thumb. The mass was determined to be monophasic synovial sarcoma on histopathologic exam. Fluorescence in situ hybridization for SYT gene rearrangement was positive in 72% of cells. Resection of the mass was followed by radiation and chemotherapy. The patient had a long-term follow-up of 3.5 years with no evidence of any local recurrence of the tumor. This report increases awareness of this extremely rare malignancy—an awareness that is crucial for early diagnosis and improved survival rates. It is more common at younger ages but it can occur at any age, so it should be suspected and included in the differential diagnosis, especially when evaluating slow growing, nonresolving hand lesions.
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Farkas A, Lirette ST, Al Hmada Y, Collier AB, Barr J, Vijayakumar S, Vijayakumar V. Single-Institution Experience of Synovial Sarcoma. South Med J 2020; 113:16-19. [PMID: 31897493 DOI: 10.14423/smj.0000000000001054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate the patient population and outcomes of synovial sarcoma at a single institution. METHODS A retrospective review of the medical records of 28 patients with synovial sarcoma diagnosed from 1992 to 2017 was performed. Demographics, staging, disease location, treatment, and response to treatment were reviewed. RESULTS Individuals with larger tumors at the time of presentation had an increased risk of death. An additional factor associated with poor prognosis in synovial sarcoma was increasing patient age. The patient population had a higher rate of nonextremity disease and lower overall survival when compared with national averages. CONCLUSIONS Nonextremity disease and large size of tumor at presentation may have contributed to the disparity in institutional outcomes from the national averages. The advanced presentation of synovial sarcoma remains a significant challenge in improving patient survival.
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Affiliation(s)
- Amy Farkas
- From the Departments of Radiology, Data Science, Pathology, Pediatric Oncology, Orthopedic Surgery, and Radiation Oncology, University of Mississippi Medical Center, Jackson
| | - Seth T Lirette
- From the Departments of Radiology, Data Science, Pathology, Pediatric Oncology, Orthopedic Surgery, and Radiation Oncology, University of Mississippi Medical Center, Jackson
| | - Youssef Al Hmada
- From the Departments of Radiology, Data Science, Pathology, Pediatric Oncology, Orthopedic Surgery, and Radiation Oncology, University of Mississippi Medical Center, Jackson
| | - Anderson B Collier
- From the Departments of Radiology, Data Science, Pathology, Pediatric Oncology, Orthopedic Surgery, and Radiation Oncology, University of Mississippi Medical Center, Jackson
| | - Jennifer Barr
- From the Departments of Radiology, Data Science, Pathology, Pediatric Oncology, Orthopedic Surgery, and Radiation Oncology, University of Mississippi Medical Center, Jackson
| | - Srinivasan Vijayakumar
- From the Departments of Radiology, Data Science, Pathology, Pediatric Oncology, Orthopedic Surgery, and Radiation Oncology, University of Mississippi Medical Center, Jackson
| | - Vani Vijayakumar
- From the Departments of Radiology, Data Science, Pathology, Pediatric Oncology, Orthopedic Surgery, and Radiation Oncology, University of Mississippi Medical Center, Jackson
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Hamza A, Gidley PW, Learned KO, Hanna EY, Bell D. Uncommon tumors of temporomandibular joint: An institutional experience and review. Head Neck 2020; 42:1859-1873. [PMID: 32040228 DOI: 10.1002/hed.26106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 12/31/2019] [Accepted: 01/28/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The temporomandibular joint (TMJ) harbors a myriad of pathologic alterations including arthritides and benign and malignant neoplasms. METHODS Herein, we describe our institutional experience of some uncommon and unusual synovial pathologies of the TMJ along with a review of literature. We searched through the archives of department of pathology and institutional electronic medical record for specimens of TMJ between 1999 and 2019. Hematoxylin and eosin slides were reviewed and data (final diagnosis, age, gender, clinical presentation, tumor size, treatment modality, recurrence, and vital status) were collected. RESULTS A total of seven cases were identified including four cases of synovial chrondromatosis; and one case each of tenosynovial giant cell tumor, localized type, tenosynovial giant cell tumor, diffuse type, and synovial sarcoma. CONCLUSIONS The article emphasizes on the clinical, radiologic, pathologic, and molecular features of these uncommon entities. The differential diagnosis of each entity is also discussed. Current updates in the management are also reviewed.
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Affiliation(s)
- Ameer Hamza
- Department of Pathology, University of Texas M. D. Anderson Cancer Center, Houston, Texas
| | - Paul W Gidley
- Department of Head and Neck Surgery, University of Texas M. D. Anderson Cancer Center, Houston, Texas
| | - Kim O Learned
- Department of Neuroradiology, University of Texas M. D. Anderson Cancer Center, Houston, Texas
| | - Ehab Y Hanna
- Department of Head and Neck Surgery, University of Texas M. D. Anderson Cancer Center, Houston, Texas
| | - Diana Bell
- Department of Pathology, University of Texas M. D. Anderson Cancer Center, Houston, Texas.,Department of Head and Neck Surgery, University of Texas M. D. Anderson Cancer Center, Houston, Texas
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29
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Wang J, Kok HK, Bayat I. Synovial sarcoma mimicking a traumatic pseudoaneurysm in the upper extremity. BMJ Case Rep 2019; 12:12/11/e232135. [PMID: 31776154 DOI: 10.1136/bcr-2019-232135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Synovial sarcomas are a rare but aggressive malignancy that primarily affects young patients. Diagnosis is often difficult and delayed due to its insidious onset, heterogenous presentation and mimicry of other pathologies. We present the case of a patient with a history of a slow-growing left arm mass that arose after a traumatic fracture of the humerus. Multimodal imaging was undertaken and reported the mass as being consistent with a vascular malformation of the brachial artery. The patient underwent surgical repair of the artery and intraoperative biopsies confirmed a diagnosis of synovial sarcoma. This case highlights the importance of maintaining suspicion for soft-tissue sarcomas in young patients presenting with a mass, and demonstrates the way in which these tumours may mimic other pathologies both clinically and radiologically. Early referral to a specialist sarcoma centre is key for further investigative workup.
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Affiliation(s)
- Judy Wang
- Vascular Surgery, Northern Hospital, Epping, Victoria, Australia
| | - Hong Kuan Kok
- Radiology, Northern Hospital, Epping, Victoria, Australia
| | - Iman Bayat
- Vascular Surgery, Northern Hospital, Epping, Victoria, Australia
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30
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Wang S, Liu Y, Feng Y, Zhang J, Swinnen J, Li Y, Ni Y. A Review on Curability of Cancers: More Efforts for Novel Therapeutic Options Are Needed. Cancers (Basel) 2019; 11:E1782. [PMID: 31766180 PMCID: PMC6896199 DOI: 10.3390/cancers11111782] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 11/01/2019] [Accepted: 11/04/2019] [Indexed: 02/07/2023] Open
Abstract
Cancer remains a major cause of death globally. Given its relapsing and fatal features, curing cancer seems to be something hardly possible for the majority of patients. In view of the development in cancer therapies, this article summarizes currently available cancer therapeutics and cure potential by cancer type and stage at diagnosis, based on literature and database reviews. Currently common cancer therapeutics include surgery, chemotherapy, radiotherapy, targeted therapy, and immunotherapy. However, treatment with curative intent by these methods are mainly eligible for patients with localized disease or treatment-sensitive cancers and therefore their contributions to cancer curability are relatively limited. The prognosis for cancer patients varies among different cancer types with a five-year relative survival rate (RSR) of more than 80% in thyroid cancer, melanoma, breast cancer, and Hodgkin's lymphoma. The most dismal prognosis is observed in patients with small-cell lung cancer, pancreatic cancer, hepatocellular carcinoma, oesophagal cancer, acute myeloid leukemia, non-small cell lung cancer, and gastric cancer with a five-year RSR ranging between 7% and 28%. The current review is intended to provide a general view about how much we have achieved in curing cancer as regards to different therapies and cancer types. Finally, we propose a small molecule dual-targeting broad-spectrum anticancer strategy called OncoCiDia, in combination with emerging highly sensitive liquid biopsy, with theoretical curative potential for the management of solid malignancies, especially at the micro-cancer stage.
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Affiliation(s)
- Shuncong Wang
- KU Leuven, Campus Gasthuisberg, Faculty of Medicine, 3000 Leuven, Belgium; (S.W.); (Y.L.); (Y.F.); (J.S.)
| | - Yewei Liu
- KU Leuven, Campus Gasthuisberg, Faculty of Medicine, 3000 Leuven, Belgium; (S.W.); (Y.L.); (Y.F.); (J.S.)
| | - Yuanbo Feng
- KU Leuven, Campus Gasthuisberg, Faculty of Medicine, 3000 Leuven, Belgium; (S.W.); (Y.L.); (Y.F.); (J.S.)
| | - Jian Zhang
- Laboratories of Translational Medicine, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing 210028, China;
| | - Johan Swinnen
- KU Leuven, Campus Gasthuisberg, Faculty of Medicine, 3000 Leuven, Belgium; (S.W.); (Y.L.); (Y.F.); (J.S.)
| | - Yue Li
- Shanghai Key Laboratory of Molecular Imaging, Shanghai University of Medicine and Health Sciences, Shanghai 201318, China
| | - Yicheng Ni
- KU Leuven, Campus Gasthuisberg, Faculty of Medicine, 3000 Leuven, Belgium; (S.W.); (Y.L.); (Y.F.); (J.S.)
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31
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Hale R, Sandakly S, Shipley J, Walters Z. Epigenetic Targets in Synovial Sarcoma: A Mini-Review. Front Oncol 2019; 9:1078. [PMID: 31681608 PMCID: PMC6813544 DOI: 10.3389/fonc.2019.01078] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 09/30/2019] [Indexed: 01/25/2023] Open
Abstract
Synovial Sarcomas (SS) are a type of Soft Tissue Sarcoma (STS) and represent 8-10% of all STS cases. Although SS can arise at any age, it typically affects younger individuals aged 15-35 and is therefore part of both pediatric and adult clinical practices. SS occurs primarily in the limbs, often near joints, but can present anywhere. It is characterized by the recurrent pathognomonic chromosomal translocation t(X;18)(p11.2;q11.2) that most frequently fuses SSX1 or SSX2 genes with SS18. This leads to the expression of the SS18-SSX fusion protein, which causes disturbances in several interacting multiprotein complexes such as the SWItch/Sucrose Non-Fermentable (SWI/SNF) complex, also known as the BAF complex and the Polycomb Repressive Complex 1 and 2 (PRC1 and PRC2). Furthermore, this promotes widespread epigenetic rewiring, leading to aberrant gene expression that drives the pathogenesis of SS. Good prognoses are characterized predominantly by small tumor size and young patient age. Whereas, high tumor grade and an increased genomic complexity of the tumor constitute poor prognostic factors. The current therapeutic strategy relies on chemotherapy and radiotherapy, the latter of which can lead to chronic side effects for pediatric patients. We will focus on the known roles of SWI/SNF, PRC1, and PRC2 as the main effectors of the SS18-SSX-mediated genome modifications and we present existing biological rationale for potential therapeutic targets and treatment strategies.
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Affiliation(s)
- Ryland Hale
- Translational Epigenomics Team, Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Sami Sandakly
- Sarcoma Molecular Pathology Team, Divisions of Molecular Pathology and Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom
| | - Janet Shipley
- Sarcoma Molecular Pathology Team, Divisions of Molecular Pathology and Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom
| | - Zoë Walters
- Translational Epigenomics Team, Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
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Chen X, Pan J, Wang S, Hong S, Hong S, He S. The Epidemiological Trend of Acute Myeloid Leukemia in Childhood: a Population-Based Analysis. J Cancer 2019; 10:4824-4835. [PMID: 31598153 PMCID: PMC6775523 DOI: 10.7150/jca.32326] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Accepted: 06/26/2019] [Indexed: 12/18/2022] Open
Abstract
Acute myeloid leukemia (AML) is the fifth most common malignancy in children, and the prognosis for AML in children remains relatively poor. However, its incidence and survival trends based on a large sample size have not been reported. Children diagnosed with AML between 1975 and 2014 were accessed from the Surveillance, Epidemiology, and End Results database. Incidence and survival trends were evaluated by age-adjusted incidence and relative survival rates (RSRs) and Kaplan-Meier analyses. Cox regression was performed to identify independent risk factors for child AML death. The overall incidence of AML in childhood increased each decade between 1975 and 2014, with the total age-adjusted incidence increasing from 5.766 to 6.615 to 7.478 to 7.607 per 1,000,000 persons. In addition, the relative survival rates of AML in childhood improved significantly, with 5-year RSRs increasing from 22.40% to 39.60% to 55.50% to 68.30% over the past four decades (p < 0.0001). Furthermore, survival disparities among different races and socioeconomic statuses have continued to widen over the past four decades. Multivariate Cox regression analyses showed a higher risk of death in Black patients (HR = 1.245, 95% CI: 1.077-1.438, p = 0.003) with Whites as a reference. These results may help predict future trends for AML in childhood, better design clinical trials by eliminating disparities, and ultimately improve clinical management and outcome.
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Affiliation(s)
- Xuanwei Chen
- Department of Pediatric, Guangdong Provincial People's Hospital and Guangdong Academy of Medical Science, Guangzhou 510080, Guangdong, China
| | - Jianwei Pan
- Department of Pediatric, Guangdong Provincial People's Hospital and Guangdong Academy of Medical Science, Guangzhou 510080, Guangdong, China
| | - Shuncong Wang
- Theragnostic Laboratory, Department of Imaging and Pathology, Biomedical Sciences Group, KU Leuven, Herestraat 49, Leuven 3000, Belgium
| | - Shandie Hong
- Department of Neonatal Intensive Care, Chaozhou People's Hospital, Chaozhou 521000, Guangdong, China
| | - Shunrong Hong
- Department of Radiology, Puning People's Hospital, Puning 515300, Guangdong, China
| | - Shaoru He
- Department of Pediatric, Guangdong Provincial People's Hospital and Guangdong Academy of Medical Science, Guangzhou 510080, Guangdong, China
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Lanzi C, Dal Bo L, Favini E, Tortoreto M, Beretta GL, Arrighetti N, Zaffaroni N, Cassinelli G. Overactive IGF1/Insulin Receptors and NRASQ61R Mutation Drive Mechanisms of Resistance to Pazopanib and Define Rational Combination Strategies to Treat Synovial Sarcoma. Cancers (Basel) 2019; 11:cancers11030408. [PMID: 30909453 PMCID: PMC6468361 DOI: 10.3390/cancers11030408] [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: 02/05/2019] [Revised: 03/08/2019] [Accepted: 03/18/2019] [Indexed: 12/15/2022] Open
Abstract
Pazopanib is approved for treatment of advanced soft tissue sarcomas, but primary and secondary drug resistance limits its clinical utility. We investigated the molecular mechanisms mediating pazopanib resistance in human synovial sarcoma (SS) models. We found reduced cell sensitivity to pazopanib associated with inefficient inhibition of the two critical signaling nodes, AKT and ERKs, despite strong inhibition of the main drug target, PDGFRα. In the CME-1 cell line, overactivation of IGF1 and Insulin receptors (IGF1R/InsR) sustained AKT activation and pazopanib resistance, which was overcome by a combination treatment with the double IGF1R/InsR inhibitor BMS754807. In the highly pazopanib resistant MoJo cell line, NRASQ61R mutation sustained constitutive ERK activation. Transfection of the NRAS mutant in the pazopanib sensitive SYO-1 cell line increased the drug IC50. MoJo cells treatment with pazopanib in combination with the MEK inhibitor trametinib restored ERK inhibition, synergistically inhibited cell growth, and induced apoptosis. The combination significantly enhanced the antitumor efficacy against MoJo orthotopic xenograft abrogating growth in 38% of mice. These findings identified two different mechanisms of intrinsic pazopanib resistance in SS cells, supporting molecular/immunohistochemical profiling of tumor specimens as a valuable approach to selecting patients who may benefit from rational drug combinations.
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Affiliation(s)
- Cinzia Lanzi
- Department of Applied Research and Technological Development, Molecular Pharmacology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Amadeo 42, 20133 Milan, Italy.
| | - Laura Dal Bo
- Department of Applied Research and Technological Development, Molecular Pharmacology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Amadeo 42, 20133 Milan, Italy.
| | - Enrica Favini
- Department of Applied Research and Technological Development, Molecular Pharmacology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Amadeo 42, 20133 Milan, Italy.
| | - Monica Tortoreto
- Department of Applied Research and Technological Development, Molecular Pharmacology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Amadeo 42, 20133 Milan, Italy.
| | - Giovanni Luca Beretta
- Department of Applied Research and Technological Development, Molecular Pharmacology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Amadeo 42, 20133 Milan, Italy.
| | - Noemi Arrighetti
- Department of Applied Research and Technological Development, Molecular Pharmacology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Amadeo 42, 20133 Milan, Italy.
| | - Nadia Zaffaroni
- Department of Applied Research and Technological Development, Molecular Pharmacology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Amadeo 42, 20133 Milan, Italy.
| | - Giuliana Cassinelli
- Department of Applied Research and Technological Development, Molecular Pharmacology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Amadeo 42, 20133 Milan, Italy.
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Perry JA, Seong BKA, Stegmaier K. Biology and Therapy of Dominant Fusion Oncoproteins Involving Transcription Factor and Chromatin Regulators in Sarcomas. ANNUAL REVIEW OF CANCER BIOLOGY-SERIES 2019. [DOI: 10.1146/annurev-cancerbio-030518-055710] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A third of soft tissue sarcomas have been shown to carry recurrent, characteristic chromosomal translocations, many of which generate fusion proteins that act as dominant transcription factors or as chromatin regulators. With routine use of massively parallel sequencing and advances in technology for the study of epigenetics and protein complexes, the last decade has seen a marked advancement in the identification of novel fusions and in our understanding of the mechanisms by which they contribute to the malignant state. Moreover, with new approaches in chemistry, such as the strategy of targeted protein degradation, we are now better poised to address these previously intractable targets. In this review, we describe three of the most common fusion-driven sarcomas (Ewing sarcoma, alveolar rhabdomyosarcoma, and synovial sarcoma), mechanistic themes emerging across these diseases, and novel approaches to their targeting.
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Affiliation(s)
- Jennifer A. Perry
- Department of Pediatric Oncology, Dana-Farber Cancer Institute and Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02215, USA
| | - Bo Kyung Alex Seong
- Department of Pediatric Oncology, Dana-Farber Cancer Institute and Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02215, USA
| | - Kimberly Stegmaier
- Department of Pediatric Oncology, Dana-Farber Cancer Institute and Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02215, USA
- The Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
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35
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Ioannidis A, Koutserimpas C, Papatsoris A, Argyrou A, Deliveliotis H, Velimezis G, Dimopoulos AM. Monophasic synovial sarcoma as a cause of obstructive ileus: A case report. Mol Clin Oncol 2018; 10:185-187. [PMID: 30655996 DOI: 10.3892/mco.2018.1768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 10/30/2018] [Indexed: 01/14/2023] Open
Abstract
Synovial sarcoma is a high-grade soft tissue sarcoma, divided histologically into 3 types: Monophasic, biphasic and poorly differentiated. An extremely rare case of obstructive ileus due to monophasic synovial sarcoma in a 54-year-old male patient is reported in the present study. The patient presented to the emergency department with signs and symptoms of obstructive ileus. Computer Tomography (CT)scan showed a pelvic mass (20×17×12 cm) causing obstruction at the sigmoid colon. An exploratory laparotomy through a midline incision was performed. The described mass was unresectable as it was infiltrating major vessels. Therefore, a diverting loop descending colostomy and biopsy of the solid mass were performed. Pathological examination revealed a monophasic synovial sarcoma. The patient was referred to the Department of Oncology and started treatment with doxorubicin and ifosfamide.
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Affiliation(s)
- Argyrios Ioannidis
- Second Department of Surgery, Sismanoglio General Hospital of Athens, 15126 Athens, Greece
| | - Christos Koutserimpas
- Department of Orthopedics and Traumatology, '251' Hellenic Air Force General Hospital of Athens, 11525 Athens, Greece
| | - Athanasios Papatsoris
- Second University Department of Urology, National and Kapodistrian University of Athens School of Medicine, Sismanoglio General Hospital of Athens, 15126 Athens, Greece
| | - Alexandra Argyrou
- Department of Basic Medical Sciences, Laboratory of Biology, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Haralampos Deliveliotis
- Second University Department of Urology, National and Kapodistrian University of Athens School of Medicine, Sismanoglio General Hospital of Athens, 15126 Athens, Greece
| | - Georgios Velimezis
- Second Department of Surgery, Sismanoglio General Hospital of Athens, 15126 Athens, Greece
| | - Athanasios-Meletios Dimopoulos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens School of Medicine, Alexandra Hospital, 11528 Athens, Greece
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Riedel RF, Jones RL, Italiano A, Bohac C, Thompson JC, Mueller K, Khan Z, Pollack SM, Van Tine BA. Systemic Anti-Cancer Therapy in Synovial Sarcoma: A Systematic Review. Cancers (Basel) 2018; 10:cancers10110417. [PMID: 30388821 PMCID: PMC6267101 DOI: 10.3390/cancers10110417] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 10/29/2018] [Accepted: 10/30/2018] [Indexed: 12/14/2022] Open
Abstract
Synovial sarcoma (SS) is an aggressive malignancy which accounts for approximately 5–10% of all soft-tissue sarcomas. SS has pathologic and genomic characteristics that define it as a distinct subtype of soft tissue sarcoma (STS). STS subtypes continue to be recognized as distinct entities with specific characteristics, including differential chemo-sensitivity. The objective of this study was to conduct a descriptive review of current data on survival outcomes of systemic anti-cancer therapy specific to SS. A systematic literature review was conducted, using a custom search strategy to search EMBASE, Medline and CENTRAL for clinical trials and observational studies reporting overall survival (OS), progression-free survival (PFS) and/or response for cohorts of at least 50 SS patients. We identified 28 studies meeting these criteria, 25 of which were retrospective studies. Only three prospective studies were identified. Survival reports varied widely between studies based on the population, in particular on the disease stage, and reporting was heterogeneous in terms of the time points reported on. For patients with localized disease, reports of five-year PFS ranged from 26% to 80.7% and five-year OS from 40% to 90.7%, whereas five-year OS for patients with metastatic disease was very low at around 10%; and in one case, 0% was reported. Only four of the included publications reported outcomes by type of systemic anti-cancer therapy received. Our study draws attention to the fact that additional prospective studies to better define the most appropriate treatment for SS in all stages and lines of therapy are still needed.
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Affiliation(s)
- Richard F Riedel
- Duke Cancer Institute, Duke University Health System, Durham, NC 27710, USA.
| | - Robin L Jones
- The Royal Marsden NHS Foundation Trust, Institute of Cancer Research, London SM2 5NG, UK.
| | - Antoine Italiano
- Department of Medical Oncology, Institute Bergonié, 33000 Bordeaux, France.
| | - Chet Bohac
- Immune Design Corporation, San Francisco, CA 94080, USA.
| | | | | | - Zaeem Khan
- ICON Epidemiology, ICON plc, Vancouver, BC V6B 1P1, Canada.
| | - Seth M Pollack
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA 98109, USA.
| | - Brian A Van Tine
- Division of Medical Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO 63110, USA.
- Siteman Cancer Center, St. Louis, MO 63110, USA.
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37
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Luk SJ, van der Steen DM, Hagedoorn RS, Jordanova ES, Schilham MW, Bovée JV, Cleven AH, Falkenburg JF, Szuhai K, Heemskerk MH. PRAME and HLA Class I expression patterns make synovial sarcoma a suitable target for PRAME specific T-cell receptor gene therapy. Oncoimmunology 2018; 7:e1507600. [PMID: 30524904 PMCID: PMC6279314 DOI: 10.1080/2162402x.2018.1507600] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 07/30/2018] [Accepted: 08/01/2018] [Indexed: 01/14/2023] Open
Abstract
Synovial sarcoma expresses multiple cancer testis antigens that could potentially be targeted by T-cell receptor (TCR) gene therapy. In this study we investigated whether PRAME-TCR-gene therapy could be an effective treatment for synovial sarcoma by investigating the potential of PRAME-specific T-cells to recognize sarcoma cells and by evaluating the expression patterns of PRAME and HLA class I (HLA-I) in synovial sarcoma tumor samples. All PRAME expressing sarcoma cell lines, including 2 primary synovial sarcoma cell cultures (passage < 3), were efficiently recognized by PRAME-specific T-cells. mRNA FISH demonstrated that PRAME was expressed in all synovial sarcoma samples, mostly in an homogeneous pattern. Immunohistochemistry demonstrated low HLA-I baseline expression in synovial sarcoma, but its expression was elevated in specific areas of the tumors, especially in biphasic components of biphasic synovial sarcoma. In 5/11 biphasic synovial sarcoma patients and in 1/17 monophasic synovial sarcoma patients, elevated HLA-I on tumor cells was correlated with infiltration of T-cells in these specific areas. In conclusion, low-baseline expression of HLA-I in synovial sarcoma is elevated in biphasic areas and in areas with densely infiltrating T-cells, which, in combination with homogeneous and high PRAME expression, makes synovial sarcoma potentially a suitable candidate for PRAME-specific TCR-gene therapy.
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Affiliation(s)
- Sietse J Luk
- Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands
| | - Dirk M van der Steen
- Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands
| | - Renate S Hagedoorn
- Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands
| | - Ekaterina S Jordanova
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands.,Center for Gynecological Oncology Amsterdam, Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, The Netherlands
| | - Marco W Schilham
- Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Judith Vmg Bovée
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Arjen Hg Cleven
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Karoly Szuhai
- Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, The Netherlands
| | - Mirjam Hm Heemskerk
- Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands
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38
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Abstract
OPINION STATEMENT Synovial sarcoma (SS) is a rare, yet highly malignant, type of soft tissue sarcoma (STS), for which survival has not improved significantly during the past years. In this review, we focus on systemic treatment in adults. Compared to other STS, SS are relatively chemosensitive. Ifosfamide and ifosfamide combinations are active in different lines of treatment. In high-risk extremity and chest wall STS, neoadjuvant doxorubicin and ifosfamide has shown as much activity as high-dose ifosfamide. There are indications that combination chemotherapy with doxorubicin and ifosfamide in this setting improves outcome. In the first-line metastatic setting, combination treatment with doxorubicin and ifosfamide is a preferred option in fit patients, while in other patients, sequential doxorubicin and ifosfamide can be considered. In second and later lines, pazopanib and trabectedin have shown activity. Many new approaches to treat metastatic SS are currently under investigation, both preclinical as well as clinical, including other receptor tyrosine kinase inhibitors, epigenetic modulators, compounds interfering with DNA damage response (DDR), and immunotherapy.
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Affiliation(s)
- Ingrid M E Desar
- Department of Medical Oncology, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands
| | | | - Winette T A van der Graaf
- Department of Medical Oncology, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands.
- The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London, UK.
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