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Armstrong A, Joseph P, Nagaraj A, Nagel C, Nakayama J, Waggoner S, Zanotti K, DiFeo A, Narla G. The use of novel PP2A activators in combination withPARP inhibitor for the treatment of high-grade serous ovarian cancer. Gynecol Oncol 2017. [DOI: 10.1016/j.ygyno.2017.03.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Wiechert A, Saygin C, Thiagarajan P, Hale J, Michener C, DiFeo A, Lathia J, Reizes O. Development and validation of a fluorescent reporter system for ovarian cancer stem cells. Gynecol Oncol 2016. [DOI: 10.1016/j.ygyno.2016.04.424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Calura E, Paracchini L, Fruscio R, DiFeo A, Ravaggi A, Peronne J, Martini P, Sales G, Beltrame L, Bignotti E, Tognon G, Milani R, Clivio L, Dell'Anna T, Cattoretti G, Katsaros D, Sartori E, Mangioni C, Ardighieri L, D'Incalci M, Marchini S, Romualdi C. A prognostic regulatory pathway in stage I epithelial ovarian cancer: new hints for the poor prognosis assessment. Ann Oncol 2016; 27:1511-9. [PMID: 27194815 DOI: 10.1093/annonc/mdw210] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 05/11/2016] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Clinical and pathological parameters of patients with epithelial ovarian cancer (EOC) do not thoroughly predict patients' outcome. Despite the good outcome of stage I EOC compared with that of stages III and IV, the risk assessment and treatments are almost the same. However, only 20% of stage I EOC cases relapse and die, meaning that only a proportion of patients need intensive treatment and closer follow-up. Thus, the identification of cell mechanisms that could improve outcome prediction and rationalize therapeutic options is an urgent need in the clinical practice. PATIENTS AND METHODS We have gathered together 203 patients with stage I EOC diagnosis, from whom snap-frozen tumor biopsies were available at the time of primary surgery before any treatment. Patients, with a median follow-up of 7 years, were stratified into a training set and a validation set. RESULTS AND CONCLUSIONS Integrated analysis of miRNA and gene expression profiles allowed to identify a prognostic cell pathway, composed of 16 miRNAs and 10 genes, wiring the cell cycle, 'Activins/Inhibins' and 'Hedgehog' signaling pathways. Once validated by an independent technique, all the elements of the circuit resulted associated with overall survival (OS) and progression-free survival (PFS), in both univariate and multivariate models. For each patient, the circuit expressions have been translated into an activation state index (integrated signature classifier, ISC), used to stratify patients into classes of risk. This prediction reaches the 89.7% of sensitivity and 96.6% of specificity for the detection of PFS events. The prognostic value was then confirmed in the external independent validation set in which the PFS events are predicted with 75% sensitivity and 94.7% specificity. Moreover, the ISC shows higher classification performance than conventional clinical classifiers. Thus, the identified circuit enhances the understanding of the molecular mechanisms lagging behind stage I EOC and the ISC improves our capabilities to assess, at the time of diagnosis, the patient risk of relapse.
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Affiliation(s)
- E Calura
- Department of Biology, University of Padova, Padova
| | - L Paracchini
- Department of Oncology, IRCCS 'Mario Negri' Institute for Pharmacological Research
| | - R Fruscio
- Clinic of Obstetrics and Gynaecology, University of Milano-Bicocca, San Gerardo Hospital, Monza MaNGO Group, Milano, Italy
| | - A DiFeo
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, USA
| | - A Ravaggi
- Division of Gynaecologic Oncology, 'Angelo Nocivelli' Institute of Molecular Medicine
| | - J Peronne
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, USA
| | - P Martini
- Department of Biology, University of Padova, Padova
| | - G Sales
- Department of Biology, University of Padova, Padova
| | - L Beltrame
- Department of Oncology, IRCCS 'Mario Negri' Institute for Pharmacological Research
| | - E Bignotti
- Division of Gynaecologic Oncology, 'Angelo Nocivelli' Institute of Molecular Medicine
| | - G Tognon
- Department of Obstetrics and Gynaecology, Spedali Civili of Brescia, University of Brescia, Brescia
| | - R Milani
- Clinic of Obstetrics and Gynaecology, University of Milano-Bicocca, San Gerardo Hospital, Monza
| | - L Clivio
- Department of Oncology, IRCCS 'Mario Negri' Institute for Pharmacological Research
| | - T Dell'Anna
- Clinic of Obstetrics and Gynaecology, University of Milano-Bicocca, San Gerardo Hospital, Monza
| | - G Cattoretti
- Anatomo-pathology Unit, University of Milan-Bicocca, San Gerardo Hospital, Monza
| | - D Katsaros
- MaNGO Group, Milano, Italy Department of Surgical Science and Gynecology, Azienda Ospedaliero Universitaria, Città della Salute, presidio S.Anna, University of Torino, Torino
| | - E Sartori
- Division of Gynaecologic Oncology, 'Angelo Nocivelli' Institute of Molecular Medicine
| | - C Mangioni
- MaNGO Group, Milano, Italy A.O. della Provincia di Lecco - P.O.A Manzoni, Lecco
| | - L Ardighieri
- Department of Molecular and Translational Medicine, 'Angelo Nocivelli' Institute for Molecular Medicine Department of Pathology, Spedali Civili of Brescia, University of Brescia, Brescia, Italy
| | - M D'Incalci
- Department of Oncology, IRCCS 'Mario Negri' Institute for Pharmacological Research MaNGO Group, Milano, Italy
| | - S Marchini
- Department of Oncology, IRCCS 'Mario Negri' Institute for Pharmacological Research
| | - C Romualdi
- Department of Biology, University of Padova, Padova
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Petrillo M, Zannoni GF, Beltrame L, Martinelli E, DiFeo A, Paracchini L, Craparotta I, Mannarino L, Vizzielli G, Scambia G, D'Incalci M, Romualdi C, Marchini S. Identification of high-grade serous ovarian cancer miRNA species associated with survival and drug response in patients receiving neoadjuvant chemotherapy: a retrospective longitudinal analysis using matched tumor biopsies. Ann Oncol 2016; 27:625-34. [PMID: 26782955 DOI: 10.1093/annonc/mdw007] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 01/07/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Neoadjuvant chemotherapy (NACT) has been recognized as a reliable therapeutic strategy in patients with unresectable advanced epithelial ovarian cancer (EOC). The molecular events leading to platinum (Pt) response in NACT settings have hitherto not been explored. In the present work, longitudinal changes of miRNA expression profile were investigated to identify miRNA families with prognostic role in high-grade serous EOC patients who received the NACT regimen. PATIENTS AND METHODS One hundred sixty-four matched tumor biopsies taken at initial laparoscopic evaluation and at interval-debulking surgery (IDS) after four courses of Pt-based therapy were selected from 82 stage IIIC-IV high-grade serous-EOC patients that were judged unsuitable for complete primary debulking and subjected the NACT protocol. miRNA profiling by microarray, real-time PCR and immuno-histochemical staining for Smad2 phosphorylation (P-Smad2) were used for data analysis. RESULTS Analysis revealed that 369 miRNAs were differentially expressed in matched biopsies (referred to as DEMs). DEMs were not scattered across the genome, but clustered into families: miR-199, let-7, miR-30, miR-181 and miR-29. Multivariate analysis showed that miR-199a-3p, miR-199a-5p, miR-181a-5p and let-7g-5p associated with overall and progression-free survival (P < 0.05); miR-199a-3p, miR-199a-5p and miR-181a-5p associated with residual tumor volume and Pt-free interval (P < 0.05). Immuno-histochemical staining confirmed an enrichment of P-Smad2, a marker of transforming growth factor-β activation, in tumors from patients with shorter PFS and OS, and with high levels of expression of miR-181a-5p (P < 0.05). Kaplan-Meier curves plotting concomitant expression of P-Smad2 and miR-181a-5p show significant differences in PFS and OS compared with those depicting the expression of each biomarker alone (P < 0.001). CONCLUSIONS This study describes several miRNA families with a prognostic role in the NACT setting. It also confirms that concomitant analysis of P-Smad2 and miR-181a-5p in surgical samples may be capable of identifying those ovarian cancer patients with poor outcome and little chance of response to Pt-based NACT.
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Affiliation(s)
- M Petrillo
- Department of Obstetrics and Gynaecology, Division of Gynaecologic Oncology
| | - G F Zannoni
- Department of Human Pathology, Catholic University of the Sacred Heart, Rome
| | - L Beltrame
- Department of Oncology, IRCCS Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy
| | - E Martinelli
- Department of Human Pathology, Catholic University of the Sacred Heart, Rome
| | - A DiFeo
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - L Paracchini
- Department of Oncology, IRCCS Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy
| | - I Craparotta
- Department of Oncology, IRCCS Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy
| | - L Mannarino
- Department of Oncology, IRCCS Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy
| | - G Vizzielli
- Department of Obstetrics and Gynaecology, Division of Gynaecologic Oncology
| | - G Scambia
- Department of Obstetrics and Gynaecology, Division of Gynaecologic Oncology
| | - M D'Incalci
- Department of Oncology, IRCCS Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy
| | - C Romualdi
- Department of Biology, University of Padova, Padova, Italy
| | - S Marchini
- Department of Oncology, IRCCS Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy
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Singh S, Joseph P, Nagaraj A, Armstrong A, Resnick K, Zanotti K, Waggoner S, Narla G, DiFeo A. Small molecule activators of protein phosphatase 2A for the treatment of endometrial cancer. Gynecol Oncol 2015. [DOI: 10.1016/j.ygyno.2015.01.523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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DiFeo A, Sennet R, Huang F, Levine D, Kalir T, van de Rijn M, Dottino P, Martignetti J. KLF6-SV1 is a novel uterine leiomyosarcoma gene: From transgenic mouse model to human disease. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bradley W, Dottino P, Rahaman J, DiFeo A, Martignetti J. The tumor suppressor KLF6, lost in a majority of ovarian cancer cases, represses VEGF expression levels. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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DiFeo A, Narla G, Camacho-Vanegas O, Nishio H, Rose SL, Buller RE, Friedman SL, Walsh MJ, Martignetti JA. E-cadherin is a novel transcriptional target of the KLF6 tumor suppressor. Oncogene 2006; 25:6026-31. [PMID: 16702959 DOI: 10.1038/sj.onc.1209611] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The tumor suppressor KLF6 is a member of the Krüppel-like family of transcription factors, which has been implicated in the pathogenesis of several human carcinomas. Uncovering the transcriptional targets relevant for its tumorigenic properties, including cellular proliferation and invasion, will be essential to understanding possible mechanisms by which KLF6 and its antagonistic splice form, KLF6-SV1, regulate this development. To begin defining possible metastatic-related pathways, we analysed the effect of KLF6 dysregulation on a recognized suppressor of cellular invasion, E-cadherin. Targeted KLF6 reduction in an ovarian cancer cell line, SKOV-3, resulted in a 50% reduction of E-cadherin expression (P<0.01) and conversely, KLF6-SV1 silencing upregulated E-cadherin approximately fivefold (P<0.0001). These changes resulted from KLF6 directly transactivating the E-cadherin promoter as demonstrated by luciferase promoter assay and chromatin immunoprecipitation (ChIP). KLF6-mediated changes in E-cadherin levels were accompanied by downstream changes in both the subcellular localization of beta-catenin and c-myc expression levels. Moreover, and consistent with these experimental findings, patient-derived epithelial ovarian tumors with low KLF6 and high KLF6-SV1 expression ratios had significantly decreased E-cadherin expression (P<0.0001). These combined findings highlight the E-cadherin pathway as a novel and functionally important mediator by which changes in KLF6 and KLF6-SV1 can directly alter ovarian tumor invasion and metastasis.
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Affiliation(s)
- A DiFeo
- Department of Human Genetics, The Mount Sinai School of Medicine, New York, NY 10029, USA
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