1
|
Fröhlich A, Welter J, Witzel I, Voppichler J, Fehr MK. Does an Autoimmune Disorder Following Ovarian Cancer Diagnosis Affect Prognosis? Curr Oncol 2024; 31:4613-4623. [PMID: 39195327 DOI: 10.3390/curroncol31080344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Revised: 08/10/2024] [Accepted: 08/11/2024] [Indexed: 08/29/2024] Open
Abstract
We investigated whether developing an autoimmune disorder (AID) following a high-grade epithelial ovarian cancer diagnosis improves overall survival. This retrospective study included data from women treated for high-grade serous, endometrioid, or transitional cell ovarian, fallopian tube, or peritoneal cancer FIGO stage III or IV at a Swiss cantonal gynecological cancer center (2008-2023). We used Kaplan-Meier estimates and the Cox proportional hazards model using time-varying covariates for the survival function estimation. In all, 9 of 128 patients developed an AID following a cancer diagnosis. The median time from cancer diagnosis to AID was 2 years (IQR 2-5). These women survived for a median of 3031 days (IQR 1765-3963) versus 972 days (IQR 568-1819) for those who did not develop an AID (p = 0.001). The median overall survival of nine women with a pre-existing AID was 1093 days (IQR 716-1705), similar to those who never had an AID. The multivariate analyses showed older age (p = 0.003, HR 1.04, 95% CI 1.013-1.064) was associated with a poorer prognosis, and developing an AID after a cancer diagnosis was associated with longer survival (p = 0.033, HR 0.113, 95% CI 0.015-0.837). Clinical manifestations of autoimmune disorders following ovarian cancer diagnoses were associated with better overall survival (8 versus 2.7 years), indicating an overactive immune response may improve cancer control.
Collapse
Affiliation(s)
- Anaïs Fröhlich
- Department of Obstetrics and Gynecology, Spital Thurgau AG, 8501 Frauenfeld, Switzerland
| | - JoEllen Welter
- Department of Obstetrics and Gynecology, Spital Thurgau AG, 8501 Frauenfeld, Switzerland
| | - Isabell Witzel
- Department of Gynecology, University Hospital Zürich, University of Zurich, 8091 Zurich, Switzerland
| | - Julia Voppichler
- Department of Obstetrics and Gynecology, Spital Thurgau AG, 8501 Frauenfeld, Switzerland
| | - Mathias K Fehr
- Department of Obstetrics and Gynecology, Spital Thurgau AG, 8501 Frauenfeld, Switzerland
| |
Collapse
|
2
|
Farhana A, Yusuf N, Rasheed Z. Editorial: Cancer genetics and epigenetics: theranostic targets and mechanisms. Front Genet 2024; 15:1446474. [PMID: 39130752 PMCID: PMC11310138 DOI: 10.3389/fgene.2024.1446474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2024] [Accepted: 07/03/2024] [Indexed: 08/13/2024] Open
Affiliation(s)
- Aisha Farhana
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka, Aljouf Province, Saudi Arabia
| | - Nabiha Yusuf
- Department of Dermatology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Zafar Rasheed
- Department of Pathology, College of Medicine, Qassim University, Buraidah, Qassim, Saudi Arabia
| |
Collapse
|
3
|
Harutyunyan L, Manvelyan E, Karapetyan N, Bardakhchyan S, Jilavyan A, Tamamyan G, Avagyan A, Safaryan L, Zohrabyan D, Movsisyan N, Avinyan A, Galoyan A, Sargsyan M, Harutyunyan M, Nersoyan H, Stepanyan A, Galstyan A, Danielyan S, Muradyan A, Jilavyan G. A Survival Analysis of Patients with Recurrent Epithelial Ovarian Cancer Based on Relapse Type: A Multi-Institutional Retrospective Study in Armenia. Curr Oncol 2024; 31:1323-1334. [PMID: 38534933 PMCID: PMC10968888 DOI: 10.3390/curroncol31030100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/11/2024] [Accepted: 02/27/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Annually, approximately 200 new ovarian cancer cases are diagnosed in Armenia, which is considered an upper-middle-income country. This study aimed to summarize the survival outcomes of patients with relapsed ovarian cancer in Armenia based on the type of recurrence, risk factors, and choice of systemic treatment. METHODS This retrospective case-control study included 228 patients with relapsed ovarian cancer from three different institutions. RESULTS The median age of the patients was 55. The median follow-up times from relapse and primary diagnosis were 21 and 48 months, respectively. The incidence of platinum-sensitive relapse was 81.6% (186), while platinum-resistant relapse was observed in only 18.4% (42) of patients. The median post-progression survival of the platinum-sensitive group compared to the platinum-resistant group was 54 vs. 25 months (p < 0.001), respectively, while the median survival after relapse was 25 vs. 13 months, respectively; three- and five-year post-progression survival rates in these groups were 31.2% vs. 23.8%, and 15.1% vs. 9.5%, respectively (p = 0.113). CONCLUSIONS Overall, despite new therapeutic approaches, ovarian cancer continues to be one of the deadly malignant diseases affecting women, especially in developing countries with a lack of resources, where chemotherapy remains the primary available systemic treatment for the majority of patients. Low survival rates demonstrate the urgent need for more research focused on this group of patients with poor outcomes.
Collapse
Affiliation(s)
- Lilit Harutyunyan
- Department of General Oncology, Yerevan State Medical University after M. Heratsi, 2 Koryun St., Yerevan 0025, Armenia; (N.K.); (A.A.); (N.M.); (A.M.); (G.J.)
- Oncology Clinic, Mikaelyan Institute of Surgery, Ezras Hasratian 9, Yerevan 0052, Armenia; (A.A.); (A.G.); (M.S.)
| | - Evelina Manvelyan
- Department of Reproductive Biology, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA;
| | - Nune Karapetyan
- Department of General Oncology, Yerevan State Medical University after M. Heratsi, 2 Koryun St., Yerevan 0025, Armenia; (N.K.); (A.A.); (N.M.); (A.M.); (G.J.)
- Clinic of Adults’ Oncology and Chemotherapy at Yeolyan Hematology and Oncology Center, 7 Nersisyan St., Yerevan 0014, Armenia; (S.B.); (L.S.); (D.Z.); (M.H.)
- Immune Oncology Research Institute, 7 Nersisyan St., Yerevan 0014, Armenia;
- Yeolyan Hematology and Oncology Center, 7 Nersisyan St., Yerevan 0014, Armenia;
| | - Samvel Bardakhchyan
- Clinic of Adults’ Oncology and Chemotherapy at Yeolyan Hematology and Oncology Center, 7 Nersisyan St., Yerevan 0014, Armenia; (S.B.); (L.S.); (D.Z.); (M.H.)
- Immune Oncology Research Institute, 7 Nersisyan St., Yerevan 0014, Armenia;
- Yeolyan Hematology and Oncology Center, 7 Nersisyan St., Yerevan 0014, Armenia;
| | - Aram Jilavyan
- National Center of Oncology of Armenia, 76 Fanarjyan St., Yerevan 0052, Armenia; (A.J.); (H.N.); (A.S.); (A.G.)
- Department of Gynecologic Oncology, National Center of Oncology of Armenia, 76 Fanarjyan St., Yerevan 0052, Armenia
| | - Gevorg Tamamyan
- Immune Oncology Research Institute, 7 Nersisyan St., Yerevan 0014, Armenia;
- Yeolyan Hematology and Oncology Center, 7 Nersisyan St., Yerevan 0014, Armenia;
- Pediatric Cancer and Blood Disorders Center of Armenia, 7 Nersisyan St., Yerevan 0014, Armenia
- Pediatric Oncology and Hematology Department, Yerevan State Medical University after M. Heratsi, 2 Koryun St., Yerevan 0025, Armenia
| | - Armen Avagyan
- Department of General Oncology, Yerevan State Medical University after M. Heratsi, 2 Koryun St., Yerevan 0025, Armenia; (N.K.); (A.A.); (N.M.); (A.M.); (G.J.)
- Oncology Clinic, Mikaelyan Institute of Surgery, Ezras Hasratian 9, Yerevan 0052, Armenia; (A.A.); (A.G.); (M.S.)
| | - Liana Safaryan
- Clinic of Adults’ Oncology and Chemotherapy at Yeolyan Hematology and Oncology Center, 7 Nersisyan St., Yerevan 0014, Armenia; (S.B.); (L.S.); (D.Z.); (M.H.)
- Yeolyan Hematology and Oncology Center, 7 Nersisyan St., Yerevan 0014, Armenia;
| | - Davit Zohrabyan
- Clinic of Adults’ Oncology and Chemotherapy at Yeolyan Hematology and Oncology Center, 7 Nersisyan St., Yerevan 0014, Armenia; (S.B.); (L.S.); (D.Z.); (M.H.)
- Yeolyan Hematology and Oncology Center, 7 Nersisyan St., Yerevan 0014, Armenia;
| | - Narine Movsisyan
- Department of General Oncology, Yerevan State Medical University after M. Heratsi, 2 Koryun St., Yerevan 0025, Armenia; (N.K.); (A.A.); (N.M.); (A.M.); (G.J.)
- Oncology Clinic, Mikaelyan Institute of Surgery, Ezras Hasratian 9, Yerevan 0052, Armenia; (A.A.); (A.G.); (M.S.)
- Anesthesiology and Intensive Care Department, Yerevan State Medical University after M. Heratsi, 2 Koryun St., Yerevan 0025, Armenia
- Armenian Association for the Study of Pain, 12 Kievyan Str. Apt. 20, Yerevan 0028, Armenia
| | - Anna Avinyan
- Oncology Clinic, Mikaelyan Institute of Surgery, Ezras Hasratian 9, Yerevan 0052, Armenia; (A.A.); (A.G.); (M.S.)
| | - Arevik Galoyan
- Oncology Clinic, Mikaelyan Institute of Surgery, Ezras Hasratian 9, Yerevan 0052, Armenia; (A.A.); (A.G.); (M.S.)
| | - Mariam Sargsyan
- Oncology Clinic, Mikaelyan Institute of Surgery, Ezras Hasratian 9, Yerevan 0052, Armenia; (A.A.); (A.G.); (M.S.)
- Immune Oncology Research Institute, 7 Nersisyan St., Yerevan 0014, Armenia;
| | - Martin Harutyunyan
- Clinic of Adults’ Oncology and Chemotherapy at Yeolyan Hematology and Oncology Center, 7 Nersisyan St., Yerevan 0014, Armenia; (S.B.); (L.S.); (D.Z.); (M.H.)
- Yeolyan Hematology and Oncology Center, 7 Nersisyan St., Yerevan 0014, Armenia;
| | - Hasmik Nersoyan
- National Center of Oncology of Armenia, 76 Fanarjyan St., Yerevan 0052, Armenia; (A.J.); (H.N.); (A.S.); (A.G.)
- Clinical Research and Cancer Registry Department, National Center of Oncology after V.A. Fanarjian, 76 Fanarjyan St., Yerevan 0052, Armenia
| | - Arevik Stepanyan
- National Center of Oncology of Armenia, 76 Fanarjyan St., Yerevan 0052, Armenia; (A.J.); (H.N.); (A.S.); (A.G.)
- Clinical Research and Cancer Registry Department, National Center of Oncology after V.A. Fanarjian, 76 Fanarjyan St., Yerevan 0052, Armenia
| | - Armenuhi Galstyan
- National Center of Oncology of Armenia, 76 Fanarjyan St., Yerevan 0052, Armenia; (A.J.); (H.N.); (A.S.); (A.G.)
- Diagnostic Service of the National Center of Oncology, 76 Fanarjyan St., Yerevan 0052, Armenia
| | - Samvel Danielyan
- Yeolyan Hematology and Oncology Center, 7 Nersisyan St., Yerevan 0014, Armenia;
| | - Armen Muradyan
- Department of General Oncology, Yerevan State Medical University after M. Heratsi, 2 Koryun St., Yerevan 0025, Armenia; (N.K.); (A.A.); (N.M.); (A.M.); (G.J.)
| | - Gagik Jilavyan
- Department of General Oncology, Yerevan State Medical University after M. Heratsi, 2 Koryun St., Yerevan 0025, Armenia; (N.K.); (A.A.); (N.M.); (A.M.); (G.J.)
- National Center of Oncology of Armenia, 76 Fanarjyan St., Yerevan 0052, Armenia; (A.J.); (H.N.); (A.S.); (A.G.)
- Department of Gynecologic Oncology, National Center of Oncology of Armenia, 76 Fanarjyan St., Yerevan 0052, Armenia
| |
Collapse
|
4
|
Zebic DS, Tjokrowidjaja A, Francis KE, Friedlander M, Gebski V, Lortholary A, Joly F, Hasenburg A, Mirza M, Denison U, Cecere SC, Ferrero A, Pujade-Lauraine E, Lee CK. Discordance between GCIG CA-125 progression and RECIST progression in the CALYPSO trial of patients with platinum-sensitive recurrent ovarian cancer. Br J Cancer 2024; 130:425-433. [PMID: 38097739 PMCID: PMC10844635 DOI: 10.1038/s41416-023-02528-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 11/10/2023] [Accepted: 11/27/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND CA-125 alone is widely used to diagnose progressive disease (PD) in platinum-sensitive recurrent ovarian cancer (PSROC) on chemotherapy. However, there are increasing concerns regarding its accuracy. We assessed concordance between progression defined by CA-125 and RECIST using data from the CALYPSO trial. METHODS We computed concordance rates for PD by CA-125 and RECIST to determine the positive (PPV) and negative predictive values (NPV). RESULTS Of 769 (79%) evaluable participants, 387 had CA-125 PD, where only 276 had concordant RECIST PD (PPV 71%, 95% CI 67-76%). For 382 without CA-125 PD, 255 had RECIST PD but 127 did not (NPV 33%, 95% CI 29-38). There were significant differences in NPV according to baseline CA-125 (≤100 vs >100: 42% vs 25%, P < 0.001); non-measurable vs measurable disease (51% vs 26%, P < 0.001); and platinum-free-interval (>12 vs 6-12 months: 41% vs 14%, P < 0.001). We observed falling CA-125 levels in 78% of patients with RECIST PD and CA-125 non-PD. CONCLUSION Approximately 2 in 3 women with PSROC have RECIST PD but not CA-125 PD by GCIG criteria. Monitoring CA-125 levels alone is not reliable for detecting PD. Further research is required to investigate the survival impact of local therapy in radiological detected early asymptomatic PD.
Collapse
Affiliation(s)
- Danka Sinikovic Zebic
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, NSW, 2050, Australia.
- Department of Medical Oncology, St George Hospital, Kogarah, NSW, 2217, Australia.
| | - Angelina Tjokrowidjaja
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, NSW, 2050, Australia
- Department of Medical Oncology, St George Hospital, Kogarah, NSW, 2217, Australia
| | - Katherine Elizabeth Francis
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, NSW, 2050, Australia
- Department of Medical Oncology, South East Regional Hospital, Bega, NSW, 2550, Australia
| | - Michael Friedlander
- Department of Medical Oncology, Prince of Wales Hospital, Randwick, NSW, 2031, Australia
| | - Val Gebski
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, NSW, 2050, Australia
| | | | - Florence Joly
- Centre François Baclesse, Caen and GINECO, Caen, France
| | - Annette Hasenburg
- Department of Gynecology and Obstetrics, University Medical Center, Mainz and AGO, Mainz, Germany
| | - Mansoor Mirza
- Rigshospitalet-Copenhagen University Hospital, Copenhagen and NSGO, Copenhagen, Denmark
| | - Ursula Denison
- Institute for gynaecological oncology und senology - Karl Landsteiner, Vienna and AGO Austria, Vienna, Austria
| | - Sabrina Chiara Cecere
- Oncologia Clinica Sperimentale Uro-Ginecologica, Istituto Nazionale Tumori - IRCCS- Fondazione G.Pascale, Napoli and MITO Italia, Napoli, Italy
| | - Annamaria Ferrero
- Academic Division Gynaecology, Mauriziano Hospital, University of Torino, and MaNGO, Torino, Italy
| | | | - Chee Khoon Lee
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, NSW, 2050, Australia
- Department of Medical Oncology, St George Hospital, Kogarah, NSW, 2217, Australia
| |
Collapse
|
5
|
Fawzy MS, Ibrahiem AT, Osman DM, Almars AI, Alshammari MS, Almazyad LT, Almatrafi NDA, Almazyad RT, Toraih EA. Angio-Long Noncoding RNA MALAT1 (rs3200401) and MIAT (rs1061540) Gene Variants in Ovarian Cancer. EPIGENOMES 2024; 8:5. [PMID: 38390896 PMCID: PMC10885055 DOI: 10.3390/epigenomes8010005] [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: 11/22/2023] [Revised: 01/04/2024] [Accepted: 01/23/2024] [Indexed: 02/24/2024] Open
Abstract
The genotyping of long non-coding RNA (lncRNA)-related single-nucleotide polymorphisms (SNPs) could be associated with cancer risk and/or progression. This study aimed to analyze the angiogenesis-related lncRNAs MALAT1 (rs3200401) and MIAT (rs1061540) variants in patients with ovarian cancer (OC) using "Real-Time allelic discrimination polymerase chain reaction" in 182 formalin-fixed paraffin-embedded (FFPE) samples of benign, borderline, and primary malignant ovarian tissues. Differences in the genotype frequencies between low-grade ovarian epithelial tumors (benign/borderline) and malignant tumors and between high-grade malignant epithelial tumors and malignant epithelial tumors other than high-grade serous carcinomas were compared. Odds ratios (ORs)/95% confidence intervals were calculated as measures of the association strength. Additionally, associations of the genotypes with the available pathological data were analyzed. The heterozygosity of MALAT1 rs3200401 was the most common genotype (47.8%), followed by C/C (36.3%). Comparing the study groups, no significant differences were observed regarding this variant. In contrast, the malignant epithelial tumors had a higher frequency of the MIAT rs1061540 C/C genotype compared to the low-grade epithelial tumor cohorts (56.7% vs. 37.6, p = 0.031). The same genotype was significantly higher in high-grade serous carcinoma than its counterparts (69.4% vs. 43.8%, p = 0.038). Multivariate Cox regression analysis showed that the age at diagnosis was significantly associated with the risk of OC development. In contrast, the MIAT T/T genotype was associated with a low risk of malignant epithelial tumors under the homozygote comparison model (OR = 0.37 (0.16-0.83), p = 0.017). Also, MIAT T allele carriers were less likely to develop high-grade serous carcinoma under heterozygote (CT vs. CC; OR = 0.33 (0.12-0.88), p = 0.027) and homozygote (TT vs. CC; OR = 0.26 (0.07-0.90), p = 0.034) comparison models. In conclusion, our data provide novel evidence for a potential association between the lncRNA MIAT rs1061540 and the malignant condition of ovarian cancer, suggesting the involvement of such lncRNAs in OC development.
Collapse
Affiliation(s)
- Manal S Fawzy
- Department of Biochemistry, Faculty of Medicine, Northern Border University, Arar 73213, Saudi Arabia
- Unit of Medical Research and Postgraduate Studies, Faculty of Medicine, Northern Border University, Arar 73213, Saudi Arabia
| | - Afaf T Ibrahiem
- Department of Pathology, Faculty of Medicine, Northern Border University, Arar 73213, Saudi Arabia
| | - Dalia Mohammad Osman
- Department of Medical Laboratories Technology, Faculty of Applied Medical Sciences, Northern Border University, Arar 73213, Saudi Arabia
| | - Amany I Almars
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Hematology Research Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | | | | | | | - Renad Tariq Almazyad
- Faculty of Applied Medical Sciences, Northern Border University, Arar 73213, Saudi Arabia
| | - Eman A Toraih
- Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA
| |
Collapse
|
6
|
Wang T, Zhang M, Khan M, Li J, Wu X, Ma T, Li Y. Cryptotanshinone suppresses ovarian cancer via simultaneous inhibition of glycolysis and oxidative phosphorylation. Biomed Pharmacother 2024; 170:115956. [PMID: 38039759 DOI: 10.1016/j.biopha.2023.115956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 11/23/2023] [Accepted: 11/27/2023] [Indexed: 12/03/2023] Open
Abstract
Ovarian cancer is one of the most lethal cancers in female reproductive system due to heterogeneity and lack of effective treatment. Targeting aerobic glycolysis, a predominant energy metabolism of cancer cells has been recognized a novel strategy to overcome cancer cell growth. However, the capability of cancer cells to undergo metabolic reprogramming guarantees their survival even when glycolysis is inhibited. Here in this study, we have shown that Cryptotanshinone (CT), a lipid-soluble bioactive anticancer molecule of Salvia miltiorrhiza, inhibits both glycolysis and oxidative phosphorylation (OXPHOS) in ovarian cancer cells leading to growth suppression and apoptosis induction. Our mechanistic study revealed that CT decreased glucose uptake and lactate production, and inhibited the kinase activity of LDHA and HK2. The molecular docking study showed that CT could directly bind with GLUT1, LDHA, HK2, PKM2 and complex-1. The immunoblotting data showed that CT decreased the expression of aberrantly activated glycolytic proteins includingGLUT1, LDHA, HK2, and PKM2. Besides, we found that CT inhibited mitochondrial ComplexⅠ activity, decreased the ratio of NAD+/NADH, and suppressed the generation of ATP and induced activation of AMPK, which controls energy-reducing processes. These in vitro findings were further validated using xenograft model. The findings of in vivo studies were in line with in vitro studies. Taken together, CT effectively suppressed glycolysis and OXPHOS, inhibited growth and induced apoptosis in ovarian cancer cells both in vitro and in vivo study models.
Collapse
Affiliation(s)
- Tong Wang
- School of Medicine & Holistic Integrative Medicine, Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Mengmeng Zhang
- School of Medicine & Holistic Integrative Medicine, Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Muhammad Khan
- Cancer Research Lab, Institute of Zoology, University of the Punjab, Quaid-e-Azam Campus, Lahore, Pakistan.
| | - Jingjing Li
- School of Medicine & Holistic Integrative Medicine, Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Xiao Wu
- School of Medicine & Holistic Integrative Medicine, Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Tonghui Ma
- School of Medicine & Holistic Integrative Medicine, Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nanjing 210023, China.
| | - Yongming Li
- School of Medicine & Holistic Integrative Medicine, Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nanjing 210023, China.
| |
Collapse
|
7
|
Shi Y, Xiao D, Li S, Liu S, Zhang Y. Cost-effectiveness of maintenance niraparib with an individualized starting dosage in patients with platinum-sensitive recurrent ovarian cancer in China. Front Pharmacol 2023; 14:1198585. [PMID: 37576812 PMCID: PMC10416097 DOI: 10.3389/fphar.2023.1198585] [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: 04/01/2023] [Accepted: 07/18/2023] [Indexed: 08/15/2023] Open
Abstract
Objective: Niraparib improved survival in platinum-sensitive recurrent ovarian cancer (PSROC) patients versus routine surveillance, accompanied by increased costs. Based on the NORA trial, we evaluated for the first time the cost-effectiveness of maintenance niraparib with individualized starting dosage (ISD) in China. Methods: A Markov model was developed to simulate the costs and health outcomes of each strategy. The total costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs) were measured. One-way and probabilistic sensitivity analysis were performed to estimate model robustness. Scenario analyses were also conducted. Results: Compared to routine surveillance, niraparib additionally increased QALYs by 0.59 and 0.30 in populations with and without germline BRCA (gBRCA) mutations, with incremental costs of $10,860.79 and $12,098.54, respectively. The ICERs of niraparib over routine surveillance were $18,653.67/QALY and $39,212.99/QALY. At a willingness-to-pay (WTP) threshold of $37,488/QALY, the ISD enhanced the likelihood of cost-effectiveness from 9.35% to 30.73% in the gBRCA-mutated group and from 0.77% to 11.74% in the non-gBRCA mutated population. The probability of niraparib being cost-effective in the region with the highest per capita Gross Domestic Product (GDP) in China was 74.23% and 76.10% in the gBRCA-mutated and non-gBRCA mutated population, respectively. Niraparib was 100% cost-effective for National Basic Medical Insurance beneficiaries under the above WTP thresholds. Conclusion: Compared to routine surveillance, the ISD of niraparib for maintenance treatment of PSROC is cost-effective in the gBRCA-mutated population and more effective but costly in the non-gBRCA mutated patients. The optimized niraparib price, economic status, and health insurance coverage may benefit the economic outcome.
Collapse
Affiliation(s)
- Yin Shi
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- The Hunan Institute of Pharmacy Practice and Clinical Research, Changsha, China
| | - Di Xiao
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- The Hunan Institute of Pharmacy Practice and Clinical Research, Changsha, China
| | - Shuishi Li
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Department of General Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Shao Liu
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- The Hunan Institute of Pharmacy Practice and Clinical Research, Changsha, China
| | - Yu Zhang
- Department of Gynecology, Xiangya Hospital, Central South University, Changsha, China
- Gynecological Oncology Research and Engineering Center of Hunan Province, Changsha, China
| |
Collapse
|
8
|
Zhao J, Liu L, Zhao W, Lv C, Zhang N, Jia X, Zhang Z. miR-141-3p accelerates ovarian cancer progression and promotes M2-like macrophage polarization by targeting the Keap1-Nrf2 pathway. Open Med (Wars) 2023; 18:20230729. [PMID: 37333452 PMCID: PMC10276613 DOI: 10.1515/med-2023-0729] [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: 02/13/2023] [Revised: 05/03/2023] [Accepted: 05/08/2023] [Indexed: 06/20/2023] Open
Abstract
The miR-141-3p has been reported to participate in regulating autophagy and tumor-stroma interactions in ovarian cancer (OC). We aim to investigate whether miR-141-3p accelerates the progression of OC and its effect on macrophage 2 polarization by targeting the Kelch-like ECH-associated protein1-Nuclear factor E2-related factor2 (Keap1-Nrf2) pathway. SKOV3 and A2780 cells were transfected with miR-141-3p inhibitor and negative control to confirm the regulation of miR-141-3p on OC development. Moreover, the growth of tumors in xenograft nude mice treated by cells transfected with miR-141-3p inhibitor was established to further testify the role of miR-141-3p in OC. The expression of miR-141-3p was higher in OC tissue compared with non-cancerous tissue. Downregulation of miR-141-3p inhibited the proliferation, migration, and invasion of ovarian cells. Furthermore, miR-141-3p inhibition also suppressed M2-like macrophage polarization and in vivo OC progression. Inhibition of miR-141-3p significantly enhanced the expression of Keap1, the target gene of miR-141-3p, and thus downregulated Nrf2, while activation of Nrf2 reversed the reduction in M2 polarization by miR-141-3p inhibitor. Collectively, miR-141-3p contributes to tumor progression, migration, and M2 polarization of OC by activating the Keap1-Nrf2 pathway. Inhibition of miR-141-3p attenuates the malignant biological behavior of ovarian cells by inactivating the Keap1-Nrf2 pathway.
Collapse
Affiliation(s)
- Jingyun Zhao
- Department of Reproductive Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, Hebei, China
| | - Leilei Liu
- Department of Obstetrics, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, Hebei, China
| | - Wei Zhao
- Department of Gynecology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, Hebei, China
| | - Cuiting Lv
- Department of Reproductive Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, Hebei, China
| | - Na Zhang
- Department of Reproductive Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, Hebei, China
| | - Xinzhuan Jia
- Department of Reproductive Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, Hebei, China
| | - Zhengmao Zhang
- Department of Gynecology, The Fourth Hospital of Hebei Medical University, No. 12 Jiankang Road, Shijiazhuang, 050011, Hebei, China
| |
Collapse
|
9
|
Englisz A, Smycz-Kubańska M, Mielczarek-Palacz A. Evaluation of the Potential Diagnostic Utility of the Determination of Selected Immunological and Molecular Parameters in Patients with Ovarian Cancer. Diagnostics (Basel) 2023; 13:diagnostics13101714. [PMID: 37238197 DOI: 10.3390/diagnostics13101714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/28/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
Ovarian cancer is one of the most serious challenges in modern gynaecological oncology. Due to its non-specific symptoms and the lack of an effective screening procedure to detect the disease at an early stage, ovarian cancer is still marked by a high mortality rate among women. For this reason, a great deal of research is being carried out to find new markers that can be used in the detection of ovarian cancer to improve early diagnosis and survival rates of women with ovarian cancer. Our study focuses on presenting the currently used diagnostic markers and the latest selected immunological and molecular parameters being currently investigated for their potential use in the development of new diagnostic and therapeutic strategies.
Collapse
Affiliation(s)
- Aleksandra Englisz
- The Doctoral School, Medical University of Silesia, 40-055 Katowice, Poland
| | - Marta Smycz-Kubańska
- Department of Immunology and Serology, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, 40-055 Katowice, Poland
| | - Aleksandra Mielczarek-Palacz
- Department of Immunology and Serology, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, 40-055 Katowice, Poland
| |
Collapse
|
10
|
Győrffy B. Discovery and ranking of the most robust prognostic biomarkers in serous ovarian cancer. GeroScience 2023:10.1007/s11357-023-00742-4. [PMID: 36856946 PMCID: PMC10400493 DOI: 10.1007/s11357-023-00742-4] [Citation(s) in RCA: 142] [Impact Index Per Article: 142.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 01/25/2023] [Indexed: 03/02/2023] Open
Abstract
Progress in ovarian cancer treatment lags behind other tumor types. With diagnosis usually at an advanced stage, there is a high demand for reliable prognostic biomarkers capable of the selection of effective chemo- and targeted therapies. Our goal was to establish a large-scale transcriptomic database and use it to uncover and rank survival-associated genes. Ovarian cancer cohorts with transcriptome-level gene expression data and clinical follow-up were identified from public repositories. All samples were normalized and entered into an integrated database. Cox univariate survival analysis was performed for all genes and was followed by multivariate analysis for selected genes involving clinical and pathological variables. False discovery rate was computed for multiple hypothesis testing and a 1% cutoff was used to determine statistical significance. The complete integrated database comprises 1816 samples from 17 datasets. Altogether, 2468 genes were correlated to progression-free survival (PFS), and 704 genes were correlated with overall survival (OS). The most significant genes were WBP1L, ASAP3, CNNM2, and NCAPH2 for progression-free survival and CSE1L, NUAK1, ALPK2, and SHKBP1 for overall survival. Genes significant for PFS were also preferentially significant for predicting OS as well. All data including HR and p values as well as the used cutoff values for all genes for both PFS and OS are provided to enable the ranking of future biomarker candidates across all genes. Our results help to prioritize genes and to neglect those which are most likely to fail in studies aiming to establish new clinically useful biomarkers and therapeutic targets in serous ovarian cancer.
Collapse
Affiliation(s)
- Balázs Győrffy
- Dept. of Bioinformatics, Semmelweis University, Tuzolto U. 7-9, 1094, Budapest, Hungary.
| |
Collapse
|
11
|
Rucaparib cocrystal: Improved solubility and bioavailability over camsylate. Int J Pharm 2023; 631:122461. [PMID: 36462737 DOI: 10.1016/j.ijpharm.2022.122461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 10/31/2022] [Accepted: 11/27/2022] [Indexed: 12/03/2022]
Abstract
Rucaparib (Ruc) is a drug used to treat advanced ovarian cancer associated with deleterious BRCA mutations. Its commercial form, the camsylate salt (Ruc-Cam), suffers from poor aqueous solubility and thus causes low and erratic oral bioavailability. In this work, we aimed to improve the oral exposure of Ruc through cocrystallization. Liquid-assisted grinding, slurry, and solvent evaporation methods were employed to prepare new solid forms of Ruc. Cocrystals of rucaparib-theophylline monohydrate (Ruc-Thp MH), rucaparib-maltol (Ruc-Mal), and rucaparib-ethyl maltol (Ruc-Emal) were obtained. Powder X-ray diffraction, Fourier transform infrared spectroscopy, thermogravimetric analysis, differential scanning calorimetry, and dynamic vapor sorption were utilized to characterize these multi-component systems. All cocrystals dissolve faster than Ruc-Cam at pH 2.0 and 4.5, and Ruc-Thp MH displays the highest apparent solubility in pH 4.5 and 6.8 buffers. Pharmacokinetic studies in rats show that Ruc-Thp MH exhibits 2.4 times the Cmax and 1.4 times the AUC0-24h at a single dose compared with Ruc-Cam. The enhanced solubility and bioavailability of Ruc-Thp MH showcase the power of cocrystallization in addressing absorption issues in drug development.
Collapse
|
12
|
Ali FT, Soliman RM, Hassan NS, Ibrahim AM, El-Gizawy MM, Mandoh AAY, Ibrahim EA. Sensitivity and specificity of microRNA-204, CA125, and CA19.9 as biomarkers for diagnosis of ovarian cancer. PLoS One 2022; 17:e0272308. [PMID: 35921382 PMCID: PMC9348731 DOI: 10.1371/journal.pone.0272308] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 07/18/2022] [Indexed: 11/28/2022] Open
Abstract
Background Ovarian cancer is usually detected at later stages and no effective screening approach, has been identified. Therefore, sensitive and specific biomarkers for detecting ovarian cancer are urgently needed. Objective This study aimed to investigate the efficacy of six biomarkers for the early clinical diagnosis of ovarian cancer. Subjects & methods The study included 120 patients (benign ovarian tumors and early and late ovarian carcinoma) and 30 control healthy volunteers. MiRNA-204, CA125, CA19.9, hepcidin, microfibril-associated glycoprotein 2, and ferroportin levels were determined in all patients and control volunteers. Results The combined area under the receiver operating characteristic curves for miRNA-204, CA125, and CA19.9 were 0.938, 1.000, and 0.998 for benign tumors and early and late ovarian carcinomas, respectively. The sensitivities of miRNA-204, CA125, and CA19.9 were 98.04%, 100.00%, and 96.19% and the specificities were 58.33%, 62.50%, and 57.78%, respectively. Conclusion The positive predictivity of miRNA-204, CA125, and CA19.9 for ovarian cancer is high (59.57%, 58.24%, and 61.67%, respectively). Thus, the combination of these three biomarkers is a good diagnostic tool for ovarian cancer.
Collapse
Affiliation(s)
- Fahmy T. Ali
- Faculty of Science, Department of Biochemistry, Ain Shams University, Cairo, Egypt
| | - Reham M. Soliman
- Faculty of Science, Department of Biochemistry, Ain Shams University, Cairo, Egypt
| | - Nahla S. Hassan
- Faculty of Science, Department of Biochemistry, Ain Shams University, Cairo, Egypt
- * E-mail:
| | - Ahmed M. Ibrahim
- Faculty of Medicine, Department of Medicine, Ain Shams University, Cairo, Egypt
| | - Mayada M. El-Gizawy
- Medical Physiology Department, Medical Division, National Research Center, Giza, Egypt
| | - Abd Allah Y. Mandoh
- Department of Molecular Biology and Cytogenics, Armed Forces Central Laboratory and Blood Bank, Cairo, Egypt
| | - Ehab A. Ibrahim
- Faculty of Science, Department of Biochemistry, Ain Shams University, Cairo, Egypt
| |
Collapse
|
13
|
Ko YH, Jeong M, Jang DS, Choi JH. Gomisin L1, a Lignan Isolated from Schisandra Berries, Induces Apoptosis by Regulating NADPH Oxidase in Human Ovarian Cancer Cells. Life (Basel) 2021; 11:life11080858. [PMID: 34440602 PMCID: PMC8398161 DOI: 10.3390/life11080858] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/19/2021] [Accepted: 08/19/2021] [Indexed: 01/06/2023] Open
Abstract
The fruits of Schisandra chinensis (Schisandra berries) are used as health food supplements and popular food ingredients in East Asia. Lignans, major and characteristic polyphenol compounds of Schisandra berries, possess various biological activities, including hepatoprotective and anticancer effects. However, the biological activities of gomisin L1, a lignan isolated from Schisandra berries, are less to be investigated. In this study, the antitumor activity of gomisin L1 and its underlying molecular mechanism in human ovarian cancer cells were investigated. Gomisin L1 exhibited potent cytotoxic activity against A2780 and SKOV3 ovarian cancer cells. Flow cytometry analysis revealed that the growth inhibitory effects of gomisin L1 were mediated by the induction of apoptosis. Furthermore, gomisin L1 induced an increase in intracellular reactive oxygen species (ROS) levels, and the antioxidant N-acetyl cysteine significantly negated gomisin L1-induced cell death. Moreover, inhibition of NADPH oxidase (NOX) using an inhibitor and siRNA attenuated gomisin L1-induced death of, and ROS production in, human ovarian cancer cells. Taken together, these data indicate that the lignan gomisin L1 from Schisandra berries induces apoptotic cell death by regulating intracellular ROS production via NOX.
Collapse
Affiliation(s)
- Young Hyun Ko
- Division of Molecular Biology, College of Pharmacy, Kyung Hee University, Seoul 02447, Korea; (Y.H.K.); (M.J.)
| | - Miran Jeong
- Division of Molecular Biology, College of Pharmacy, Kyung Hee University, Seoul 02447, Korea; (Y.H.K.); (M.J.)
| | - Dae Sik Jang
- Department of Biomedical and Pharmaceutical Sciences, Kyung Hee University, Seoul 02447, Korea;
| | - Jung-Hye Choi
- Division of Molecular Biology, College of Pharmacy, Kyung Hee University, Seoul 02447, Korea; (Y.H.K.); (M.J.)
- Department of Biomedical and Pharmaceutical Sciences, Kyung Hee University, Seoul 02447, Korea;
- Correspondence:
| |
Collapse
|