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Valakos D, Klagkou E, Kokkalis A, Polyzos A, Kyrilis FL, Banos A, Vatsellas G, Pliatska M, Ford E, Stravopodis DJ, Thanos D. Combinatorial targeting of a specific EMT/MET network by macroH2A variants safeguards mesenchymal identity. PLoS One 2023; 18:e0288005. [PMID: 37432970 DOI: 10.1371/journal.pone.0288005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 06/16/2023] [Indexed: 07/13/2023] Open
Abstract
Generation of induced pluripotent stem cells from specialized cell types provides an excellent model to study how cells maintain their stability, and how they can change identity, especially in the context of disease. Previous studies have shown that chromatin safeguards cell identity by acting as a barrier to reprogramming. We investigated mechanisms by which the histone macroH2A variants inhibit reprogramming and discovered that they work as gate keepers of the mesenchymal cell state by blocking epithelial transition, a step required for reprogramming of mouse fibroblasts. More specifically, we found that individual macroH2A variants regulate the expression of defined sets of genes, whose overall function is to stabilize the mesenchymal gene expression program, thus resisting reprogramming. We identified a novel gene network (MSCN, mesenchymal network) composed of 63 macroH2A-regulated genes related to extracellular matrix, cell membrane, signaling and the transcriptional regulators Id2 and Snai2, all of which function as guardians of the mesenchymal phenotype. ChIP-seq and KD experiments revealed a macroH2A variant-specific combinatorial targeting of the genes reconstructing the MSCN, thus generating robustness in gene expression programs to resist cellular reprogramming.
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Affiliation(s)
- Dimitrios Valakos
- Biomedical Research Foundation, Academy of Athens, Athens, Greece
- Section of Biochemistry and Molecular Biology, Department of Biology, School of Science, National and Kapodistrian University of Athens (NKUA), Zografou, Athens, Greece
| | - Eleftheria Klagkou
- Biomedical Research Foundation, Academy of Athens, Athens, Greece
- Section of Biochemistry and Molecular Biology, Department of Biology, School of Science, National and Kapodistrian University of Athens (NKUA), Zografou, Athens, Greece
| | - Antonis Kokkalis
- Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | | | - Fotis L Kyrilis
- Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Aggelos Banos
- Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | | | - Maria Pliatska
- Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Ethan Ford
- Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Dimitrios J Stravopodis
- Section of Cell Biology and Biophysics, Department of Biology, School of Science, National and Kapodistrian University of Athens (NKUA), Zografou, Athens, Greece
| | - Dimitris Thanos
- Biomedical Research Foundation, Academy of Athens, Athens, Greece
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2
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Zampetidis CP, Galanos P, Angelopoulou A, Zhu Y, Polyzou A, Karamitros T, Kotsinas A, Lagopati N, Mourkioti I, Mirzazadeh R, Polyzos A, Garnerone S, Mizi A, Gusmao EG, Sofiadis K, Gál Z, Larsen DH, Pefani DE, Demaria M, Tsirigos A, Crosetto N, Maya-Mendoza A, Papaspyropoulos A, Evangelou K, Bartek J, Papantonis A, Gorgoulis VG. A recurrent chromosomal inversion suffices for driving escape from oncogene-induced senescence via subTAD reorganization. Mol Cell 2021; 81:4907-4923.e8. [PMID: 34793711 DOI: 10.1016/j.molcel.2021.10.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 01/14/2021] [Revised: 07/14/2021] [Accepted: 10/16/2021] [Indexed: 12/12/2022]
Abstract
Oncogene-induced senescence (OIS) is an inherent and important tumor suppressor mechanism. However, if not removed timely via immune surveillance, senescent cells also have detrimental effects. Although this has mostly been attributed to the senescence-associated secretory phenotype (SASP) of these cells, we recently proposed that "escape" from the senescent state is another unfavorable outcome. The mechanism underlying this phenomenon remains elusive. Here, we exploit genomic and functional data from a prototypical human epithelial cell model carrying an inducible CDC6 oncogene to identify an early-acquired recurrent chromosomal inversion that harbors a locus encoding the circadian transcription factor BHLHE40. This inversion alone suffices for BHLHE40 activation upon CDC6 induction and driving cell cycle re-entry of senescent cells, and malignant transformation. Ectopic overexpression of BHLHE40 prevented induction of CDC6-triggered senescence. We provide strong evidence in support of replication stress-induced genomic instability being a causative factor underlying "escape" from oncogene-induced senescence.
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Affiliation(s)
- Christos P Zampetidis
- Molecular Carcinogenesis Group, Department of Histology and Embryology, Faculty of Medicine, National Kapodistrian University of Athens, 11527 Athens, Greece
| | - Panagiotis Galanos
- Genome Integrity Group, Danish Cancer Society Research Center, 2100 Copenhagen, Denmark.
| | - Andriani Angelopoulou
- Molecular Carcinogenesis Group, Department of Histology and Embryology, Faculty of Medicine, National Kapodistrian University of Athens, 11527 Athens, Greece
| | - Yajie Zhu
- Translational Epigenetics Group, Institute of Pathology, University Medical Center Göttingen, 37075 Göttingen, Germany
| | - Aikaterini Polyzou
- Molecular Carcinogenesis Group, Department of Histology and Embryology, Faculty of Medicine, National Kapodistrian University of Athens, 11527 Athens, Greece
| | - Timokratis Karamitros
- Unit of Bioinformatics and Applied Genomics, Department of Microbiology, Hellenic Pasteur Institute, 11521 Athens, Greece
| | - Athanassios Kotsinas
- Molecular Carcinogenesis Group, Department of Histology and Embryology, Faculty of Medicine, National Kapodistrian University of Athens, 11527 Athens, Greece
| | - Nefeli Lagopati
- Molecular Carcinogenesis Group, Department of Histology and Embryology, Faculty of Medicine, National Kapodistrian University of Athens, 11527 Athens, Greece
| | - Ioanna Mourkioti
- Molecular Carcinogenesis Group, Department of Histology and Embryology, Faculty of Medicine, National Kapodistrian University of Athens, 11527 Athens, Greece
| | - Reza Mirzazadeh
- Science for Life Laboratory, Division of Genome Biology, Department of Medical Biochemistry and Biophysics, Karolinska Institute, 171 77 Solna, Stockholm, Sweden
| | - Alexandros Polyzos
- Sanford I. Weill Department of Medicine, Sandra and Edward Meyer Cancer Center, Weill Cornell Medicine, New York, NY 10065, USA
| | - Silvano Garnerone
- Science for Life Laboratory, Division of Genome Biology, Department of Medical Biochemistry and Biophysics, Karolinska Institute, 171 77 Solna, Stockholm, Sweden
| | - Athanasia Mizi
- Translational Epigenetics Group, Institute of Pathology, University Medical Center Göttingen, 37075 Göttingen, Germany
| | - Eduardo G Gusmao
- Translational Epigenetics Group, Institute of Pathology, University Medical Center Göttingen, 37075 Göttingen, Germany
| | - Konstantinos Sofiadis
- Translational Epigenetics Group, Institute of Pathology, University Medical Center Göttingen, 37075 Göttingen, Germany
| | - Zita Gál
- Nucleolar Stress and Disease Group, Danish Cancer Society Research Center, 2100 Copenhagen, Denmark
| | - Dorthe H Larsen
- Nucleolar Stress and Disease Group, Danish Cancer Society Research Center, 2100 Copenhagen, Denmark
| | | | - Marco Demaria
- University of Groningen (RUG), European Research Institute for the Biology of Aging (ERIBA), University Medical Center Groningen (UMCG), 9713 AV Groningen, the Netherlands
| | | | - Nicola Crosetto
- Science for Life Laboratory, Division of Genome Biology, Department of Medical Biochemistry and Biophysics, Karolinska Institute, 171 77 Solna, Stockholm, Sweden
| | - Apolinar Maya-Mendoza
- DNA Replication and Cancer Group, Danish Cancer Society Research Center, 2100 Copenhagen, Denmark
| | - Angelos Papaspyropoulos
- Molecular Carcinogenesis Group, Department of Histology and Embryology, Faculty of Medicine, National Kapodistrian University of Athens, 11527 Athens, Greece
| | - Konstantinos Evangelou
- Molecular Carcinogenesis Group, Department of Histology and Embryology, Faculty of Medicine, National Kapodistrian University of Athens, 11527 Athens, Greece
| | - Jiri Bartek
- Genome Integrity Group, Danish Cancer Society Research Center, 2100 Copenhagen, Denmark; Science for Life Laboratory, Division of Genome Biology, Department of Medical Biochemistry and Biophysics, Karolinska Institute, 171 77 Solna, Stockholm, Sweden.
| | - Argyris Papantonis
- Translational Epigenetics Group, Institute of Pathology, University Medical Center Göttingen, 37075 Göttingen, Germany; Center for Molecular Medicine Cologne (CMMC), University of Cologne, 50931 Cologne, Germany.
| | - Vassilis G Gorgoulis
- Molecular Carcinogenesis Group, Department of Histology and Embryology, Faculty of Medicine, National Kapodistrian University of Athens, 11527 Athens, Greece; Biomedical Research Foundation, Academy of Athens, 11527 Athens, Greece; Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine & Health, University of Manchester, M20 4GJ Manchester, UK; Center for New Biotechnologies and Precision Medicine, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; Faculty of Health and Medical Sciences, University of Surrey, Surrey GU2 7YH, UK.
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3
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Taka S, Nikopoulou C, Polyzos A, Megremis S, Skevaki CL, Roumpedaki E, Trochoutsou A, Thanos D, Papadopoulos NG. Effects of cryopreservation on antiviral responses of primary airway epithelial cells. Allergy 2020; 75:1486-1489. [PMID: 31879965 DOI: 10.1111/all.14163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 12/12/2019] [Accepted: 12/18/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Styliani Taka
- Allergy Department 2nd Pediatric Clinic National and Kapodistrian University of Athens Athens Greece
| | | | | | - Spyridon Megremis
- Allergy Department 2nd Pediatric Clinic National and Kapodistrian University of Athens Athens Greece
- Division of Infection, Inflammation and Respiratory Medicine University of Manchester Manchester UK
| | - Chrysanthi L. Skevaki
- Allergy Department 2nd Pediatric Clinic National and Kapodistrian University of Athens Athens Greece
- Institute of Laboratory Medicine Philipps Universität Marburg Marburg Germany
- German Center for Lung Research (DZL) Marburg Universities of Giessen and Marburg Lung Center (UGMLC) Philipps Universität Marburg Marburg Germany
- German Center for Lung Research (DZL) Marburg Germany
| | - Eirini Roumpedaki
- Allergy Department 2nd Pediatric Clinic National and Kapodistrian University of Athens Athens Greece
| | - Aikaterini Trochoutsou
- Allergy Department 2nd Pediatric Clinic National and Kapodistrian University of Athens Athens Greece
| | - Dimitris Thanos
- Biomedical Research Foundation Academy of Athens Athens Greece
| | - Nikolaos G. Papadopoulos
- Allergy Department 2nd Pediatric Clinic National and Kapodistrian University of Athens Athens Greece
- Division of Infection, Inflammation and Respiratory Medicine University of Manchester Manchester UK
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Kosmidis S, Polyzos A, Harvey L, Youssef M, Denny CA, Dranovsky A, Kandel ER. RbAp48 Protein Is a Critical Component of GPR158/OCN Signaling and Ameliorates Age-Related Memory Loss. Cell Rep 2019; 25:959-973.e6. [PMID: 30355501 PMCID: PMC7725275 DOI: 10.1016/j.celrep.2018.09.077] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 06/25/2018] [Accepted: 09/24/2018] [Indexed: 10/28/2022] Open
Abstract
Precisely deciphering the molecular mechanisms of age-related memory loss is crucial to create appropriate therapeutic interventions. We have previously shown that the histone-binding protein RbAp48/Rbbp4 is a molecular determinant of Age-Related Memory Loss. By exploring how this protein regulates the genomic landscape of the hippocampal circuit, we find that RbAp48 controls the expression of BDNF and GPR158 proteins, both critical components of osteocalcin (OCN) signaling in the mouse hippocampus. We show that inhibition of RbAp48 in the hippocampal formation inhibits OCN's beneficial functions in cognition and causes deficits in discrimination memory. In turn, disruption of OCN/GPR158 signaling leads to the downregulation of RbAp48 protein, mimicking the discrimination memory deficits observed in the aged hippocampus. We also show that activation of the OCN/GPR158 pathway increases the expression of RbAp48 in the aged dentate gyrus and rescues age-related memory loss.
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Affiliation(s)
- Stylianos Kosmidis
- Department of Neuroscience, Columbia University, New York, NY 10032, USA; Howard Hughes Medical Institute, Columbia University, New York, NY 10032, USA; New York State Psychiatric Institute, New York, NY 10032, USA; Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY 10032, USA
| | - Alexandros Polyzos
- Biomedical Research Foundation of the Academy of Athens, 115 27 Athens, Greece; Department of Medicine, Weill Cornell Medical College, New York, NY 10065, USA
| | - Lucas Harvey
- Department of Neuroscience, Columbia University, New York, NY 10032, USA; Howard Hughes Medical Institute, Columbia University, New York, NY 10032, USA; New York State Psychiatric Institute, New York, NY 10032, USA; Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY 10032, USA
| | - Mary Youssef
- Department of Psychiatry, Columbia University, New York, NY 10032, USA
| | - Christine A Denny
- Department of Psychiatry, Columbia University, New York, NY 10032, USA; Division of Systems Neuroscience, New York State Psychiatric Institute (NYSPI)/Research Foundation for Mental Hygiene, Inc. (RFMH), New York, NY 10032, USA
| | - Alex Dranovsky
- New York State Psychiatric Institute, New York, NY 10032, USA; Department of Psychiatry, Columbia University, New York, NY 10032, USA
| | - Eric R Kandel
- Department of Neuroscience, Columbia University, New York, NY 10032, USA; New York State Psychiatric Institute, New York, NY 10032, USA; Kavli Institute for Brain Science, Columbia University, New York, NY 10032, USA; Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY 10032, USA.
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5
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Nicolaides NC, Polyzos A, Koniari E, Lamprokostopoulou A, Papageorgiou I, Golfinopoulou E, Papathanasiou C, Sertedaki A, Thanos D, Chrousos GP, Charmandari E. Transcriptomics in tissue glucocorticoid sensitivity. Eur J Clin Invest 2019; 49:e13129. [PMID: 31091335 DOI: 10.1111/eci.13129] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 03/03/2019] [Accepted: 05/13/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Synthetic glucocorticoids are widely used in the treatment of several inflammatory, autoimmune and lymphoproliferative disorders. However, considerable variation in response to therapeutic doses of glucocorticoids has been documented among individuals. The aim of our study was to identify novel glucocorticoid sensitivity-determining genes using genome-wide expression profiling in healthy subjects. METHODS One hundred one healthy subjects [mean age ± standard error of the mean (SEM); 26.52 ± 0.50 years] were given 0.25 mg dexamethasone at midnight, and serum cortisol concentrations were determined at 08:00 hours the following morning. Subjects were stratified into the 10% most glucocorticoid-sensitive and 10% most glucocorticoid-resistant according to the serum cortisol concentrations. Genomic DNA, RNA and plasma samples were obtained in the 22 subjects one month later. RESULTS Transcriptomic analysis showed variability between glucocorticoid-resistant and glucocorticoid-sensitive subjects. One hundred thirty-three genes were upregulated and 49 downregulated in the glucocorticoid-resistant compared to the glucocorticoid-sensitive group. Further analysis revealed differences between 3 glucocorticoid-resistant and 3 glucocorticoid-sensitive subjects. The majority of the 1058 upregulated genes and 1139 downregulated genes were found to participate in telomere maintenance, systemic lupus erythematosus and Alzheimer's disease. Interestingly, Synuclein A, a key molecule in Parkinson's disease, was upregulated in the subgroup of glucocorticoid-sensitive subjects. CONCLUSIONS We have identified differences in tissue sensitivity to glucocorticoids among healthy subjects at the transcriptomic level. These differences are associated with differential expression of genes related to autoimmune and neurological disorders.
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Affiliation(s)
- Nicolas C Nicolaides
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece.,Division of Endocrinology and Metabolism, Center for Clinical, Experimental Surgery & Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Alexandros Polyzos
- Institute of Molecular Biology, Genetics and Biotechnology, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Eleni Koniari
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Agaristi Lamprokostopoulou
- Division of Endocrinology and Metabolism, Center for Clinical, Experimental Surgery & Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Ifigeneia Papageorgiou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Eleni Golfinopoulou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Chrysanthi Papathanasiou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Amalia Sertedaki
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Dimitris Thanos
- Institute of Molecular Biology, Genetics and Biotechnology, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - George P Chrousos
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece.,Division of Endocrinology and Metabolism, Center for Clinical, Experimental Surgery & Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Evangelia Charmandari
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece.,Division of Endocrinology and Metabolism, Center for Clinical, Experimental Surgery & Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
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Rampias T, Kontos CK, Polyzos A, Giotakis A, Giotakis E, Scorilas A, Kirodimos E, Foukas P, Psyrri A. Translating transcriptome to immunophenotype in head and neck squamous cell carcinoma (HNSCC) to identify pathways promoting T-cell infiltration. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e17542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e17542 Background: We sought to analyze the transcriptional landscape of HNSCC in an attempt to identify tumor-intrinsic oncogenic pathways that appear to mediate T-cell infiltration of tumor tissue. In this direction, we employ a methodology that integrates histopathology data of the tumor microenvironment with its corresponding transcriptome. Methods: 32 frozen HNSCCs were subjected to RNA-seq and corresponding FFPE were scored for plasma cells, tertiary lymphoid structures and CD8a+ TILs (center, invasive margin). RNA-seq data were analyzed to identify differentially expressed genes (DEGs) between tumors scored by immunohistochemistry (IHC) as CD8a high and CD8a low. Gene ontology analysis (GO) was performed based on DEGs > 1.5 fold expression change between CD8a high and CD8a low groups. Candidate genes were investigated by hierarchical clustering in TCGA RNA-seq data and further validated by IHC and quantitative RT-PCR in our cohort. Results: 32 HNSCCs were either scored as CD8a high or CD8a low based on IHC detection of CD8a+ cells in invasive margin of tumors. Comparative analysis of mRNA expression data between CD8a high and CD8a low groups in our cohort revealed that Muc1/16 overexpression and glycosylation was highly enriched in T cell infiltrated group of tumors. This finding was further validated using antibodies that detect glycosylated epitopes for both mucins. Analysis of TCGA RNA-seq data indicated that Muc1/16 overexpressing tumors share signatures of early keratinocyte differentiation and stem cell identity and co-express high levels of enzymes that promote Muc1/16 glycosylation. Interestingly, loss of CDH1 and acquisition of epithelial mesenchymal transition (EMT) markers in the cluster of Muc1/16 overexpressing tumors is strongly correlated with elevated CD8a, IDO1, CD274 and CXCL10 mRNA levels (P < 0.0001). Conclusions: Muc1/16 overexpressing tumors represent a very immunogenic HNSCC cluster. Previous studies have shown that mucins 1 and 16 in cancer cells expose glycosylated-specific epitopes that are recognized by T cells as cancer antigens. To this end, MUC1/16 expression may serve as predictive biomarkers for response to immunotherapy and MUC-targeted immunotherapy may function as an attractive partner to checkpoint inhibitors in HNSCC.
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Affiliation(s)
| | - Christos K. Kontos
- University General Hospital “Attikon”, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexandros Polyzos
- Biomedical Research Foundation of the Academy of Athens (BRFAA), Athens, Greece
| | - Aris Giotakis
- Athens General Hospital “Hippokration”, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelos Giotakis
- General Hospital “Hippokration”, National and Kapodistrian University of Athens, Athens, Greece
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Boukovinas I, Lypas G, Liontos M, Andreadis C, Papandreou C, Papakotoulas P, Aravantinos G, Bournakis E, Karageorgopoulou S, Maragkouli E, Ziras N, Kakolyris S, Athanasiadis I, Linardou E, Koumarianou A, Kalofonos C, Pentheroudakis G, Korantzis I, Christodoulou C, Kosmidis P, Daliani D, Ardavanis A, Koumakis G, Bankousli I, Makrantonakis P, Kesisis G, Nikolaou M, Diamantidou E, Tsoukalas N, Xanthakis I, Fassas A, Barbounis V, Anagnostopoulos A, Polyzos A, Athanasiadis A, Syrios I, Peroukidis S, Mpompolaki I, Baka S, Androulakis N, Georgoulias V, Emmanouilidis C, Mavroudis D, Sgouros I, Stathopoulos C, Katopodi O, Varthalitis I, Sarikaki P, Saloustros E, Saridaki Z. Access to Genetic Testing Impacts Oncologists´ Decisions on Ovarian Cancer Personalized Treatment: Lessons Learned From a National Program in Greece. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.55800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: State health insurance authorities in Greece do not reimburse genetic testing for cancer predisposition. The Hellenic Society of Medical Oncology has launched and carries out a national program covering genetic testing for BRCA1/2 mutations detection, with the financial support of pharmaceutical industry. Aim: This analysis evaluates how, during this program, access to genetic testing transformed the oncologists' therapeutic approach toward their ovarian cancer patients and how the results impacted treatment decisions concerning PARP inhibitors. Adoption of testing by healthy relatives and timing of testing in the disease continuum were also evaluated. Methods: Adult patients with high-grade epithelial ovarian carcinoma, irrespectively of family history or age at diagnosis were eligible for this program. Genetic counseling was recommended before testing, and both were offered at no financial cost. First degree family members of pathogenic mutation carriers were also offered free counseling and testing. Results: From March 2015 through January 2018, 708 patients were enrolled and tested. One hundred and forty seven (20.7%) mutation carriers were identified, 102 (14.4%) in BRCA1 and 45 (6.3%) in BRCA2 gene. Testing was more often pursued at initial diagnosis (61%) than at recurrence (39%), as recorded for 409 patients with available relevant information. During the 1st year of the program, average monthly tests performed were 25.1, while during the 3rd year this number increased to 34.3 tests per month. Among patients who tested positive for deleterious BRCA1/2 mutations, relapse was reported in 58 patients, 94.8% of which (n= 55) received treatment with the PARP inhibitor olaparib as per its indication. Family members of 21 patients (14.3%), out of the 147 who tested positive, received genetic counseling and testing for the mutation identified in the context of the program. Conclusion: Free access to genetic testing for BRCA1/2 for ovarian cancer patients and genetic consultation facilitates testing uptake, affects common clinical practice & has major impact on patients and their families. Still, diffusion of genetic information and broader testing of family members require further efforts by the oncological community.
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Affiliation(s)
- I. Boukovinas
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - G. Lypas
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - M. Liontos
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - C. Andreadis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - C. Papandreou
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - P. Papakotoulas
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - G. Aravantinos
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - E. Bournakis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - S. Karageorgopoulou
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - E. Maragkouli
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - N. Ziras
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - S. Kakolyris
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - I. Athanasiadis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - E. Linardou
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - A. Koumarianou
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - C. Kalofonos
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - G. Pentheroudakis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - I. Korantzis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - C. Christodoulou
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - P. Kosmidis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - D. Daliani
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - A. Ardavanis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - G. Koumakis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - I. Bankousli
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - P. Makrantonakis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - G. Kesisis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - M. Nikolaou
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - E. Diamantidou
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - N. Tsoukalas
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - I. Xanthakis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - A. Fassas
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - V. Barbounis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - A. Anagnostopoulos
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - A. Polyzos
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - A. Athanasiadis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - I. Syrios
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - S. Peroukidis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - I. Mpompolaki
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - S. Baka
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - N. Androulakis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - V. Georgoulias
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - C. Emmanouilidis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - D. Mavroudis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - I. Sgouros
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - C. Stathopoulos
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - O. Katopodi
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - I. Varthalitis
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - P. Sarikaki
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - E. Saloustros
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
| | - Z. Saridaki
- Hellenic Society of Medical Oncology, Athens, Greece: 2Hellenic Society of Medical Oncology, Thessaloniki, Greece: 3Hellenic Society of Medical Oncology, Larisa, Greece
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8
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Alissafi T, Hatzioannou A, Mintzas K, Barouni RM, Banos A, Sormendi S, Polyzos A, Xilouri M, Wielockx B, Gogas H, Verginis P. Autophagy orchestrates the regulatory program of tumor-associated myeloid-derived suppressor cells. J Clin Invest 2018; 128:3840-3852. [PMID: 29920188 DOI: 10.1172/jci120888] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [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: 03/05/2018] [Accepted: 06/14/2018] [Indexed: 02/03/2023] Open
Abstract
Myeloid-derived suppressor cells (MDSCs) densely accumulate into tumors and potently suppress antitumor immune responses, promoting tumor development. Targeting MDSCs in tumor immunotherapy has been hampered by lack of understanding of the molecular pathways that govern MDSC differentiation and function. Herein, we identify autophagy as a crucial pathway for MDSC-mediated suppression of antitumor immunity. Specifically, MDSCs in patients with melanoma and mouse melanoma exhibited increased levels of functional autophagy. Ablation of autophagy in myeloid cells markedly delayed tumor growth and endowed antitumor immune responses. Notably, tumor-infiltrating autophagy-deficient monocytic MDSCs (M-MDSCs) demonstrated impaired suppressive activity in vitro and in vivo, whereas transcriptome analysis revealed substantial differences in genes related to lysosomal function. Accordingly, autophagy-deficient M-MDSCs exhibited impaired lysosomal degradation, thereby enhancing surface expression of MHC class II molecules, resulting in efficient activation of tumor-specific CD4+ T cells. Finally, targeting of the membrane-associated RING-CH1 (MARCH1) E3 ubiquitin ligase that mediates the lysosomal degradation of MHC II in M-MDSCs attenuated their suppressive function, and resulted in markedly decreased tumor volume followed by development of a robust antitumor immunity. Collectively, these findings depict autophagy as a molecular target of MDSC-mediated suppression of antitumor immunity.
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Affiliation(s)
- Themis Alissafi
- Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | | | | | | | - Aggelos Banos
- Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Sundary Sormendi
- Department of Clinical Pathobiochemistry, Institute for Clinical Chemistry and Laboratory Medicine and Department of Internal Medicine, University Dresden, Dresden, Germany
| | | | - Maria Xilouri
- Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Ben Wielockx
- Department of Clinical Pathobiochemistry, Institute for Clinical Chemistry and Laboratory Medicine and Department of Internal Medicine, University Dresden, Dresden, Germany
| | - Helen Gogas
- First Department of Medicine, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
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9
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Fragopoulou AF, Polyzos A, Papadopoulou M, Sansone A, Manta AK, Balafas E, Kostomitsopoulos N, Skouroliakou A, Chatgilialoglu C, Georgakilas A, Stravopodis DJ, Ferreri C, Thanos D, Margaritis LH. Hippocampal lipidome and transcriptome profile alterations triggered by acute exposure of mice to GSM 1800 MHz mobile phone radiation: An exploratory study. Brain Behav 2018; 8:e01001. [PMID: 29786969 PMCID: PMC5991598 DOI: 10.1002/brb3.1001] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 03/29/2018] [Accepted: 04/02/2018] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The widespread use of wireless devices during the last decades is raising concerns about adverse health effects of the radiofrequency electromagnetic radiation (RF-EMR) emitted from these devices. Recent research is focusing on unraveling the underlying mechanisms of RF-EMR and potential cellular targets. The "omics" high-throughput approaches are powerful tools to investigate the global effects of RF-EMR on cellular physiology. METHODS In this work, C57BL/6 adult male mice were whole-body exposed (nExp = 8) for 2 hr to GSM 1800 MHz mobile phone radiation at an average electric field intensity range of 4.3-17.5 V/m or sham-exposed (nSE = 8), and the RF-EMR effects on the hippocampal lipidome and transcriptome profiles were assessed 6 hr later. RESULTS The data analysis of the phospholipid fatty acid residues revealed that the levels of four fatty acids [16:0, 16:1 (6c + 7c), 18:1 9c, eicosapentaenoic acid omega-3 (EPA, 20:5 ω3)] and the two fatty acid sums of saturated and monounsaturated fatty acids (SFA and MUFA) were significantly altered (p < 0.05) in the exposed group. The observed changes indicate a membrane remodeling response of the tissue phospholipids after nonionizing radiation exposure, reducing SFA and EPA, while increasing MUFA residues. The microarray data analysis demonstrated that the expression of 178 genes changed significantly (p < 0.05) between the two groups, revealing an impact on genes involved in critical biological processes, such as cell cycle, DNA replication and repair, cell death, cell signaling, nervous system development and function, immune system response, lipid metabolism, and carcinogenesis. CONCLUSIONS This study provides preliminary evidence that mobile phone radiation induces hippocampal lipidome and transcriptome changes that may explain the brain proteome changes and memory deficits previously shown by our group.
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Affiliation(s)
- Adamantia F. Fragopoulou
- Department of Cell Biology and BiophysicsFaculty of BiologyUniversity of AthensZografouAthensGreece
- Department of Women’s and Children’s HealthKarolinska InstitutetStockholmSweden
| | - Alexandros Polyzos
- Institute of Molecular Biology, Genetics and BiotechnologyBiomedical Research FoundationAcademy of AthensAthensGreece
- Present address:
Joan and Sanford I. Weill Department of MedicineWeill Cornell Medical CollegeNew York10065New York
| | - Maria‐Despoina Papadopoulou
- Institute of Molecular Biology, Genetics and BiotechnologyBiomedical Research FoundationAcademy of AthensAthensGreece
| | - Anna Sansone
- Consiglio Nazionale delle RicercheISOFBolognaItaly
| | - Areti K. Manta
- Department of Cell Biology and BiophysicsFaculty of BiologyUniversity of AthensZografouAthensGreece
| | - Evangelos Balafas
- Laboratory Animal FacilitiesCenter of Clinical, Experimental Surgery and Translational ResearchBiomedical Research FoundationAcademy of AthensAthensGreece
| | - Nikolaos Kostomitsopoulos
- Laboratory Animal FacilitiesCenter of Clinical, Experimental Surgery and Translational ResearchBiomedical Research FoundationAcademy of AthensAthensGreece
| | | | - Chryssostomos Chatgilialoglu
- Consiglio Nazionale delle RicercheISOFBolognaItaly
- Institute of Nanoscience and Nanotechnology (INN)NCSR DemokritosAthensGreece
| | - Alexandros Georgakilas
- DNA Damage LaboratoryDepartment of PhysicsSchool of Applied Mathematical and Physical SciencesNational Technical University of Athens (NTUA)AthensGreece
| | - Dimitrios J. Stravopodis
- Department of Cell Biology and BiophysicsFaculty of BiologyUniversity of AthensZografouAthensGreece
| | | | - Dimitris Thanos
- Institute of Molecular Biology, Genetics and BiotechnologyBiomedical Research FoundationAcademy of AthensAthensGreece
| | - Lukas H. Margaritis
- Department of Cell Biology and BiophysicsFaculty of BiologyUniversity of AthensZografouAthensGreece
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Tsavaris N, Kosmas C, Polyzos A, Genatas K, Vadiaka M, Paliaros P, Dimitrakopoulos A, Rokana S, Karatzas G, Vachiotis P, Fotiadis K. Leucovorin + 5-Fluorouracil plus Dipyridamole in Leucovorin + 5-Fluorouracil-Pretreated Patients with Advanced Colorectal Cancer: A Pilot Study of Three Different Dipyridamole Regimens. Tumori 2018; 87:303-7. [PMID: 11765178 DOI: 10.1177/030089160108700505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 11/16/2022]
Abstract
Dipyridamole, an inhibitor of nucleoside transport, increases the activity of 5-fluorouracil in a dose-dependent manner. The purpose of the present study was to determine whether dipyridamole with 5-fluorouracil and leucovorin gave an improved therapeutic outcome. Sixty patients entered in the present pilot study had previously received 5-fluorouracil (450 mg/m2) and leucovorin (100 mg/m2), every week, and relapsed during this treatment, which ended at least 6 weeks prior to study entry. Dipyridamole was administered at three different dosing schedules (DS) and methods of administration in three groups of patients. DS I: dipyridamole, 30 mg/m2 in normal saline solution, in 90 min iv infusion, followed by leucovorin, 100 mg/m2 iv push, followed by 5-fluorouracil, 450 mg/m2 in normal saline solution, in 60 min iv infusion, dipyridamole tablets (75 mg) every 12 hrs, continuously during the time of chemotherapy. DS II: dipyridamole, 50 mg/m2 in normal saline solution, in 90 min iv infusion, and the rest was the same as DS I. DS III: without oral dipyridamole, patients received dipyridamole (50 mg/m2) iv in the same manner as in DS I and II. Treatment was continued until tumor progression or unacceptable toxicity. All patients (n = 60) entered in the present study were assessable for response and toxicity. No complete response was observed. No patient at DS I responded, whereas 2 patients at DS II and 3 at DS III had a partial response (P <0.1). Stable disease was found with DS I (n = 1), DS II (n = 8) and DS III (n = 9) (P <0.01). More patients progressed at DS I (n = 19) than at DS II (n = 10) and DS III (n = 8) (P <0.0007). The median duration of response was 11 weeks (range, 8-16). Time to progression was 17 weeks for DS I, 15 weeks (range, 10-19) for DS II, and 14 weeks (range, 11-21) for DS III (P = 0.43). Median survival did not differ significantly between DS I (29 weeks; range, 14-48), DS II (31.5 weeks; range, 17-63) and DS III (36 weeks; range, 16-58) (P = 0.2). Neutropenia was most severe with DS I (grade 2, P <0.01) and DS II (grade 1, P <0.05) and nausea/vomiting with DS I (grade 0, P < 0.0005, grade 1, P <0.0002, grade 2, P <0.02) and DS III (grade 3, P <0.0009). Diarrhea was most severe in DS II (grade 3, P <0.005). Mucositis was increased in DS II (grade 0, P <0.008), anorexia in DS II (grade 0, P <0.032) and fatigue in DS I (grade 0, P <0.003). More patients in DS I than with the other two DS experienced headache (P <0.044). According to the response achieved at DS III (15% partial response and 45% stable disease) and the toxicity which was well tolerated mainly in this DS (except for nausea and vomiting grade 3, P <0.009), it can be stated that DS III is the appropriate dose and the simplest schedule of administration (administration of dipyridamole during therapy only). In conclusion, it appears that dipyridamole might still have a role in enhancing the clinical activity of drugs involved in the inhibition of the thymidylate synthetase biochemical pathway and its activity in combination with these agents (5-fluorouracil + leucovorin) as frontline treatment should therefore be explored in future phase II studies.
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Affiliation(s)
- N Tsavaris
- Department of Pathophysiology Oncologic Unit, University of Athens, School of Medicine, Laiko Hospital Athens, Greece.
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Czyz ML, Weragoda GK, Monaghan R, Connell TU, Brzozowski M, Scully AD, Burton J, Lupton DW, Polyzos A. A visible-light photocatalytic thiolation of aryl, heteroaryl and vinyl iodides. Org Biomol Chem 2018; 16:1543-1551. [DOI: 10.1039/c8ob00238j] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
A method for the light-driven synthesis of aryl and vinyl alkyl thioethers from a range of C(sp2)–I bonds is reported.
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Affiliation(s)
| | | | - R. Monaghan
- School of Chemistry
- The University of Melbourne
- Melbourne
- Australia
- Department of Chemistry
| | | | | | | | - J. Burton
- CSIRO Manufacturing
- Clayton
- Australia
- School of Chemistry
- Monash University
| | - D. W. Lupton
- School of Chemistry
- Monash University
- Clayton 3800
- Australia
| | - A. Polyzos
- CSIRO Manufacturing
- Clayton
- Australia
- Department of Chemistry
- Durham University
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12
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Vakrakou AG, Polyzos A, Kapsogeorgou EK, Thanos D, Manoussakis MN. Perturbation of transcriptome in non-neoplastic salivary gland epithelial cell lines derived from patients with primary Sjögren's syndrome. Data Brief 2017; 17:194-199. [PMID: 29876386 PMCID: PMC5988450 DOI: 10.1016/j.dib.2017.12.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 12/05/2017] [Accepted: 12/07/2017] [Indexed: 11/26/2022] Open
Abstract
The data presented here are related to the research article titled “Impaired anti-inflammatory activity of PPARγ in the salivary epithelia of Sjögren's syndrome patients imposed by intrinsic NF-κB activation” (Vakrakou et al., Journal of Autoimmunity, in press, 2017). In the cited manuscript, using comparative analyses of salivary gland biopsy specimens and ductal salivary gland epithelial cell (SGEC) lines from SS patients and disease controls, we have demonstrated that the ductal epithelia of SS patients display constitutively reduced PPARγ expression, transcriptional activity and anti-inflammatory function that were associated with cell-autonomously activated NF-κB and IL-1β pathways in these cells. Herein, the comparative transcriptome analysis of SGEC lines is presented. We show that the ductal epithelia of SS patients with severe lymphoepithelial lesions manifest constitutive perturbation in various inflammation- and metabolism related signaling pathways.
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Affiliation(s)
- Aigli G Vakrakou
- Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Hellenic Pasteur Institute, Laboratory of Molecular Immunology, Athens, Greece
| | | | - Efstathia K Kapsogeorgou
- Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitris Thanos
- Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Menelaos N Manoussakis
- Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Hellenic Pasteur Institute, Laboratory of Molecular Immunology, Athens, Greece.,Joint Academic Rheumatology Program, National and Kapodistrian University of Athens, Athens, Greece
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13
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Vakrakou AG, Polyzos A, Kapsogeorgou EK, Thanos D, Manoussakis MN. Impaired anti-inflammatory activity of PPARγ in the salivary epithelia of Sjögren's syndrome patients imposed by intrinsic NF-κB activation. J Autoimmun 2017; 86:62-74. [PMID: 29033144 DOI: 10.1016/j.jaut.2017.09.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [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: 06/07/2017] [Revised: 09/14/2017] [Accepted: 09/14/2017] [Indexed: 12/19/2022]
Abstract
Sjögren's syndrome (SS) patients manifest inflammation in the salivary glands (SG) and evidence of persistent intrinsic activation of ductal SG epithelial cells (SGEC), demonstrable in non-neoplastic SGEC lines derived from patients (SS-SGEC). The peroxisome-proliferator-activated receptor-γ (PPARγ) mediates important anti-inflammatory activities in epithelial cells. Herein, the comparative analysis of SG biopsies and SGEC lines obtained from SS patients and controls had revealed constitutively reduced PPARγ expression, transcriptional activity and anti-inflammatory function in the ductal epithelia of SS patients that were associated with cell-autonomously activated NF-κB and IL-1β pathways. Transcriptome profiling analysis revealed several differentially expressed proinflammatory and metabolism-related gene sets in SS-SGEC lines. These aberrations largely correlated with the severity of histopathologic lesions, the disease activity and the occurrence of adverse manifestations in SS patients studied, a fact which corroborates the key role of the persistently-activated epithelia in the pathogenesis of both local and systemic features of this disease. The treatment of control SGEC lines with PPARγ agonists was found to diminish the NF-κB activation and apoptosis induced by proinflammatory agents. In addition, the in-vitro application of PPARγ agonists and pharmacologic inhibitors of IL-1β and NF-κB had significant beneficial effects on SS-SGEC lines, such as the restoration of PPARγ functions and the reduction of their intrinsic activation, a fact which may advocate the future clinical study of the above agents as therapeutic modalities for SS.
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Affiliation(s)
- Aigli G Vakrakou
- Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; Hellenic Pasteur Institute, Laboratory of Molecular Immunology, Athens, Greece
| | | | - Efstathia K Kapsogeorgou
- Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitris Thanos
- Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Menelaos N Manoussakis
- Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; Hellenic Pasteur Institute, Laboratory of Molecular Immunology, Athens, Greece; Joint Academic Rheumatology Program, National and Kapodistrian University of Athens, Athens, Greece.
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14
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Maragkos C, Grapsa D, Koumakis G, Polyzos A, Syrigos K. Safety and efficacy of bevacizumab in "fragile" patients with advanced non-small cell lung cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx091.041] [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: 11/13/2022] Open
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15
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Petrakis TG, Komseli ES, Papaioannou M, Vougas K, Polyzos A, Myrianthopoulos V, Mikros E, Trougakos IP, Thanos D, Branzei D, Townsend P, Gorgoulis VG. Erratum to 'Exploring and exploiting the systemic effects of deregulated replication licensing' [Seminars in Cancer Biology 37-38C, (2016) 3-15]. Semin Cancer Biol 2017; 43:180. [PMID: 28254408 DOI: 10.1016/j.semcancer.2017.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Theodoros G Petrakis
- Molecular Carcinogenesis Group, Department of Histology and Embryology, School of Medicine, University of Athens, Athens, Greece
| | - Eirini-Stavroula Komseli
- Molecular Carcinogenesis Group, Department of Histology and Embryology, School of Medicine, University of Athens, Athens, Greece
| | - Marilena Papaioannou
- Molecular Carcinogenesis Group, Department of Histology and Embryology, School of Medicine, University of Athens, Athens, Greece
| | - Kostas Vougas
- Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | | | | | - Emmanuel Mikros
- Department of Pharmaceutical Chemistry, School of Pharmacy, University of Athens, Athens, Greece
| | - Ioannis P Trougakos
- Department of Cell Biology and Biophysics, Faculty of Biology, University of Athens, Athens, Greece
| | - Dimitris Thanos
- Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Dana Branzei
- FIRC (Fondazione Italiana per la Ricerca sul Cancro) Institute of Molecular Oncology (IFOM), Milan, Italy
| | - Paul Townsend
- Faculty Institute of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Vassilis G Gorgoulis
- Molecular Carcinogenesis Group, Department of Histology and Embryology, School of Medicine, University of Athens, Athens, Greece; Biomedical Research Foundation of the Academy of Athens, Athens, Greece; Faculty Institute of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
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16
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Papadimitriou E, Pantazaka E, Castana P, Tsalios T, Polyzos A, Beis D. Pleiotrophin and its receptor protein tyrosine phosphatase beta/zeta as regulators of angiogenesis and cancer. Biochim Biophys Acta Rev Cancer 2016; 1866:252-265. [DOI: 10.1016/j.bbcan.2016.09.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 09/26/2016] [Accepted: 09/28/2016] [Indexed: 02/06/2023]
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17
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Katsaounis P, Kentepozidis N, Kotsakis A, Polyzos A, Vamvakas L, Bakogiorgos M, Boukovinas I, Hartabilas E, Prinarakis E, Skaltsi T, Georgoulias V, Souglakos J. Nab-paclitaxel as second line treatment in advanced gastric cancer: A HORG multicenter phase II study. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw371.43] [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: 11/12/2022] Open
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18
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Nikolaou M, Saloustros E, Polyzos A, Christophyllakis C, Kentepozidis N, Vamvakas L, Kalbakis K, Agelaki S, Georgoulias V, Mavroudis D. Final results of weekly paclitaxel and carboplatin plus bevacizumab as first-line treatment of triple-negative breast cancer. A multicenter phase I-II trial by the Hellenic Oncology Research Group. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw365.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Trompouki E, Piragyte I, Polyzos A, Yin N. The Homeobox transcription factor HLX1 is essential for hematopoietic development. Exp Hematol 2016. [DOI: 10.1016/j.exphem.2016.06.047] [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: 11/27/2022]
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Kentepozidis N, Economopoulou P, Christofyllakis C, Chelis L, Polyzos A, Vardakis N, Koinis F, Vamvakas L, Katsaounis P, Kalbakis K, Nikolaou C, Georgoulias V, Kotsakis A. Salvage treatment with irinotecan/cisplatin versus pemetrexed/cisplatin in patients with non-small cell lung cancer pre-treated with a non-platinum-based regimen in the first-line setting: a randomized phase II study of the Hellenic Oncology Research Group (HORG). Clin Transl Oncol 2016; 19:317-325. [PMID: 27492015 DOI: 10.1007/s12094-016-1532-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 07/12/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Platinum-based chemotherapy is the standard front-line treatment for patients with advanced non-small cell lung cancer (NSCLC). However, non-platinum combinations of third-generation chemotherapeutic agents are considered an alternative therapeutic option for patients who cannot tolerate the toxic effects of platinum compounds. In this study, the efficacy and toxicity of the combination of irinotecan plus cisplatin (IC) was compared to pemetrexed plus cisplatin (PC) regimen, in platinum-naïve patients with advanced NSCLC, who had been previously treated with the combination of a taxane plus gemcitabine. PATIENTS AND METHODS A total of 124 patients with locally advanced or metastatic NSCLC were randomly assigned to either irinotecan 110 mg/m2 on day 1 and 100 mg/m2 on day 8 plus cisplatin 80 mg/m2 on day 8 every 3 weeks (IC arm) or pemetrexed 500 mg/m2 plus cisplatin 80 mg/m2 on day 1 every 3 weeks (PC arm). The primary endpoint of the study was the overall response rate (ORR). RESULTS The ORR and median progression-free survival (PFS) in the IC arm were 18 % and 3.3 months, respectively, while in the PC arm were 19 % and 4.2 months (p = ns). Median overall survival (OS) was significantly higher in patients with PC (6.9 vs. 10.9; p = 0.013). PC regimen had a better toxicity profile compared to IC, with a statistically significant lower incidence of grade 3/4 neutropenia (3 vs. 31 %; p = 0.0001) and diarrhea (1.6 vs. 14.7 %, p = 0.018). CONCLUSIONS In patients with advanced NSCLC pretreated with docetaxel/gemcitabine, the combination of pemetrexed/cisplatin is associated with increased OS and is better tolerated than the combination of irinotecan/cisplatin and should be considered as a valid therapeutic option for platinum-naive, previously treated patients. CLINICALTRIALS. GOV IDENTIFIER NCT00614965.
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Affiliation(s)
- N Kentepozidis
- Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - P Economopoulou
- Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - Ch Christofyllakis
- Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - L Chelis
- Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - A Polyzos
- Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - N Vardakis
- Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - F Koinis
- Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - L Vamvakas
- Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - P Katsaounis
- Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - K Kalbakis
- Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - Ch Nikolaou
- Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - V Georgoulias
- Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - A Kotsakis
- Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece.
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Matikas A, Kentepozidis Ν, Ardavanis A, Vaslamatzis M, Polyzos A, Emmanouilides C, Katsaounis P, Koinis F, Xynogalos S, Christopoulou A, Ziras N, Tegos T, Prinarakis E, Hatzidaki D, Georgoulias V, Kotsakis A. Efficacy and tolerance of frontline bevacizumab-based chemotherapy for advanced non-small cell lung cancer patients: a multicenter, phase IV study of the Hellenic Oncology Research Group (HORG). Cancer Chemother Pharmacol 2016; 78:369-76. [PMID: 27335027 DOI: 10.1007/s00280-016-3094-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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: 05/08/2016] [Accepted: 06/14/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The addition of bevacizumab to the first-line chemotherapy of advanced non-small cell lung cancer (NSCLC) of non-squamous histology has been shown to improve survival. A multicenter, single-arm, phase IV study was conducted in order to evaluate the efficacy and toxicity of frontline bevacizumab-based chemotherapy regimens in real life. METHODS Patients with previously untreated recurrent or metastatic non-squamous, NSCLC, with no contraindications for bevacizumab, were enrolled. Bevacizumab (15 mg/kg every 3 weeks) was administered in combination with both platinum- and non-platinum-based chemotherapy doublets or with single-agent chemotherapy plus bevacizumab. Treatment with bevacizumab was continued until disease progression. The primary end point of the study was the safety profile of bevacizumab regimens, whereas the secondary end points included overall survival, progression-free survival, and overall response rate. RESULTS From February 2010 to April 2014, a total of 314 patients were enrolled in the study; the median age was 63, 74.8 % were men, 95.9 % had a performance status of 0-1, 90.4 % had metastatic disease, and 94.3 % had adenocarcinoma. Grade ≥3 neutropenia occurred in 11.5 % of the patients, 1.3 % experienced febrile neutropenia, 2.6 % grade ≥3 thrombocytopenia, 2.8 % thromboembolism, and 1.6 % severe bleeding. Treatment discontinuation occurred in 7.0 % of patients because of adverse events. There were three toxic deaths. Median progression-free survival was 7.7 months, and median overall survival was 17.6 months. CONCLUSION The combination of bevacizumab with chemotherapy in the first-line setting of NSCLC is safe and active when used in appropriately selected patients. CLINICALTRIALS. GOV IDENTIFIER NCT01934465.
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Affiliation(s)
- A Matikas
- Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - Ν Kentepozidis
- Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - A Ardavanis
- Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - M Vaslamatzis
- Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - A Polyzos
- Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - Ch Emmanouilides
- Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - P Katsaounis
- Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - F Koinis
- Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - S Xynogalos
- Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - A Christopoulou
- Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - N Ziras
- Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - Th Tegos
- Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - E Prinarakis
- Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - D Hatzidaki
- Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - V Georgoulias
- Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - A Kotsakis
- Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece.
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Petrakis TG, Komseli ES, Papaioannou M, Vougas K, Polyzos A, Myrianthopoulos V, Mikros E, Trougakos IP, Thanos D, Branzei D, Townsend P, Gorgoulis VG. Exploring and exploiting the systemic effects of deregulated replication licensing. Semin Cancer Biol 2016; 37-38:3-15. [DOI: 10.1016/j.semcancer.2015.12.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 12/10/2015] [Accepted: 12/15/2015] [Indexed: 02/07/2023]
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Nicolaides NC, Lamprokostopoulou A, Polyzos A, Kino T, Katsantoni E, Triantafyllou P, Christophoridis A, Katzos G, Dracopoulou M, Sertedaki A, Chrousos GP, Charmandari E. Transient generalized glucocorticoid hypersensitivity. Eur J Clin Invest 2015; 45:1306-15. [PMID: 26479047 DOI: 10.1111/eci.12554] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 10/15/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND Transient generalized glucocorticoid hypersensitivity is a rare disorder characterized by increased tissue sensitivity to glucocorticoids and compensatory hypo-activation of the hypothalamic-pituitary-adrenal axis. The condition itself and the underlying molecular mechanisms have not been elucidated. OBJECTIVE To present the clinical manifestations, endocrinologic evaluation and transcriptomic profile in a patient with transient generalized glucocorticoid hypersensitivity. DESIGN AND RESULTS A 9-year-old girl presented with an 8-month history of clinical manifestations suggestive of Cushing syndrome. Endocrinologic evaluation revealed undetectable 08:00 h ACTH (<1 pg/mL) and cortisol (0·025 μg/dL) concentrations, which remained decreased throughout the 24-h period and did not respond to stimulation with ovine CRH. The disease gradually resolved spontaneously over the ensuing 3 months. Sequencing of the human glucocorticoid receptor gene revealed no mutations or polymorphisms. Western blot analysis in peripheral blood mononuclear cells revealed equal protein expression of hGRα of the patient in the disease and postresolution phases compared with a control subject. Transcriptomic analysis in peripheral blood mononuclear cells in the disease and postresolution phases identified 903 differentially expressed genes. Of these, 106 genes were up-regulated and 797 were down-regulated in the disease compared with the resolution phase. Bioinformatics analysis on the differentially expressed gene networks revealed Nuclear Factor-κB as the predominant transcription factor influencing the expression of the majority of differentially expressed genes. CONCLUSIONS Our findings indicate that a transient postreceptor defect, or a virus- or bacterium-encoded molecule, may have enhanced glucocorticoid signal transduction, leading to transient generalized glucocorticoid hypersensitivity and hypo-activation of the HPA axis.
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Affiliation(s)
- Nicolas C Nicolaides
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, University of Athens Medical School, 'Aghia Sophia' Children's Hospital, Athens, Greece.,Division of Endocrinology and Metabolism, Clinical Research Center, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Agaristi Lamprokostopoulou
- Division of Endocrinology and Metabolism, Clinical Research Center, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Alexandros Polyzos
- Institute of Molecular Biology, Genetics and Biotechnology, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Tomoshige Kino
- Unit on Molecular Hormone Action, Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Eleni Katsantoni
- Division of Hematology, Clinical Research Center, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | | | | | - George Katzos
- First Pediatric Department, Aristotle University Medical School, Thessaloniki, Greece
| | - Maria Dracopoulou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, University of Athens Medical School, 'Aghia Sophia' Children's Hospital, Athens, Greece
| | - Amalia Sertedaki
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, University of Athens Medical School, 'Aghia Sophia' Children's Hospital, Athens, Greece
| | - George P Chrousos
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, University of Athens Medical School, 'Aghia Sophia' Children's Hospital, Athens, Greece.,Division of Endocrinology and Metabolism, Clinical Research Center, Biomedical Research Foundation of the Academy of Athens, Athens, Greece.,Saudi Diabetes Study Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Evangelia Charmandari
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, University of Athens Medical School, 'Aghia Sophia' Children's Hospital, Athens, Greece.,Division of Endocrinology and Metabolism, Clinical Research Center, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
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Kotsakis A, Kentepozidis N, Emmanouilidis C, Polyzos A, Agelidou A, Vaslamatzis M, Chandrinos V, Agelaki S, Vamvakas L, Kalbakis K, Katsaounis P, Stoltidis D, Nintos G, Hatzidaki D, Vetsika EK, Mavroudis D, Georgoulias V. Sequential administration of vinorelbine plus cisplatin and bevacizumab followed by docetaxel plus gemcitabine and bevacizumab compared to docetaxel plus cisplatin and bevacizumab regimen as first-line therapy for advanced or metastatic non-squamous non-small cell lung cancer: A multicenter randomized phase II trial of the Hellenic Oncology Research Group (HORG). Lung Cancer 2015; 88:57-62. [PMID: 25662596 DOI: 10.1016/j.lungcan.2015.01.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 10/10/2014] [Revised: 01/13/2015] [Accepted: 01/17/2015] [Indexed: 12/25/2022]
Abstract
OBJECTIVES To compare the activity and tolerance of the consecutive administration of four active chemotherapeutic agents in combination with bevacizumab to a bevacizumab- and platinum-based chemotherapy doublet as front-line treatment in patients with non-squamous NSCLC. PATIENTS AND METHODS Patients with advanced/metastatic NSCLC, performance status of 0-2 and normal organ function were randomized to receive either 3 cycles every 3 weeks of cisplatin 80 mg/m(2) (day 1), oral vinorelbine 60 mg/m(2) (days 1 and 8) and bevacizumab 15 mg/kg (day 1) every 3 weeks (VCB regimen) followed by 3 cycles of docetaxel (75 mg/m(2), day 1), gemcitabine (1100 mg/m(2), days 1 and 8) and bevacizumab 15 mg/kg (day 1) (DGB regimen) (arm A) or 6 cycles of cisplatin 80 mg/m(2), docetaxel 75 mg/m(2) and bevacizumab 15 mg/kg on day 1 (DCB regimen; arm B) every 3 weeks. RESULTS Thirty-eight and 39 patients were enrolled in arm A and B, respectively. The study did not meet its primary endpoint since, the ORR was 39.5% (95% CI: 23.9-55.0%; 1CR and 14 PR) and 46.2% (95% CI: 30.5-61.8%; 2 CR and 16 PR) in arm A and B, respectively (p=0.554). There was no significant difference in terms of response duration (7.4 versus 4.7 months in arm A and B, respectively; p=0.697), progression-free survival (5.8 versus 5.5 months, respectively; p=0.540) and overall survival (16.9 versus 10.9 months; p=0.390). No difference was recorded between the two arms regarding the toxicity profile. There were two drug-related deaths in arm B. CONCLUSION Sequential therapy of VCB followed by DGB is a feasible and well-tolerated regimen but failed to show any superiority over the standard DCB regimen.
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Affiliation(s)
- A Kotsakis
- On behalf of the Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece.
| | - N Kentepozidis
- On behalf of the Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - Ch Emmanouilidis
- On behalf of the Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - A Polyzos
- On behalf of the Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - A Agelidou
- On behalf of the Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - M Vaslamatzis
- On behalf of the Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - V Chandrinos
- On behalf of the Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - S Agelaki
- On behalf of the Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - L Vamvakas
- On behalf of the Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - K Kalbakis
- On behalf of the Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - P Katsaounis
- On behalf of the Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - D Stoltidis
- On behalf of the Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - G Nintos
- On behalf of the Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - D Hatzidaki
- On behalf of the Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - E K Vetsika
- On behalf of the Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - D Mavroudis
- On behalf of the Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
| | - V Georgoulias
- On behalf of the Lung Cancer Working Group of the Hellenic Oncology Research Group (HORG), 55 Lomvardou Street, 11471, Athens, Greece
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Paronis E, Samara A, Polyzos A, Spyropoulos C, Kostomitsopoulos NG. Maternal weight as an alternative determinant of the gestational day of Wistar rats housed in individually-ventilated cages. Lab Anim 2014; 49:188-95. [DOI: 10.1177/0023677214562846] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
One of the commonly used animal models in fertility, developmental and neurobiological studies is the laboratory rat. The early recognition of rat pregnancy and confirmation of the exact embryonic day are vital. The aim of this study was to investigate the correlation of maternal weight at the time of conception to its increase throughout gestation, aiming to develop a mathematical model, which can be used for the determination of the exact day of pregnancy, set the threshold, and monitor pregnancy from the onset. We studied a total of 173 Wistar rats with a mean body weight of 238.22 ± 34.9 g. After 72 h at the male’s cages, we considered as Day 0 (D0) the day in which a copulatory plug or sperm was found during the vaginal smear examination. After that period the female animals were transferred into their cages, and weight monitoring started 14 days (D14) after D0, until parturition. Based on the statistical analysis, there is a correlation between maternal body weight at D0 and maternal body weight from D14 to D19. Moreover, the average weight gain from D14 to D19 is positively correlated to initial female body weight, while there is no correlation between each pregnant animal’s weight from D14 to D19 and litter size. A mathematical model was developed as a tool for the verification of the day of pregnancy. In conclusion, continuous monitoring of maternal weight after D14 can be a reliable method for the recognition of pregnancy and determination of the exact gestational day.
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Affiliation(s)
- E Paronis
- Laboratory Animal Facilities, Center of Experimental Surgery
| | - A Samara
- Laboratory of Endocrinology and Metabolism, Centre of Clinical Research
| | - A Polyzos
- Institute of Molecular Biology, Genetics and Biotechnology, Biomedical Research Foundation, Academy of Athens (BRFAA), Athens, Greece
| | - C Spyropoulos
- Laboratory Data Analysis, National Technical University of Athens, Applied Mathematics and Physical Science, Athens, Greece
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Karampeazis A, Vamvakas L, Kentepozidis N, Agelaki S, Kotsakis A, Polyzos A, Milaki G, Christophyllakis C, Matikas A, Kouroussis C, Mavroudis D, Georgoulias V. Gemcitabine combined with carboplatin in the first-line of treatment of elderly patients with non-small-cell lung cancer: A multicenter phase II trial by the Hellenic Oncology Research Group (HORG). J Geriatr Oncol 2014. [DOI: 10.1016/j.jgo.2014.09.057] [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: 10/24/2022]
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Tryfonidis K, Boukovinas I, Xenidis N, Christophyllakis C, Papakotoulas P, Politaki E, Malamos N, Polyzos A, Kakolyris S, Georgoulias V, Mavroudis D. A multicenter phase I-II study of docetaxel plus epirubicin plus bevacizumab as first-line treatment in women with HER2-negative metastatic breast cancer. Breast 2013; 22:1171-7. [PMID: 24091128 DOI: 10.1016/j.breast.2013.08.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 07/01/2013] [Accepted: 08/29/2013] [Indexed: 12/21/2022] Open
Abstract
PURPOSE To assess the efficacy and toxicity of docetaxel (D) plus epirubicin (E) in combination with bevacizumab (B) [DEB regimen] as front-line treatment in patients with metastatic breast cancer (MBC). PATIENTS AND METHODS Women with previously untreated HER2-negative MBC received B (15 mg/kg), E (75 mg/m2) and D (75 mg/m2) with prophylactic G-CSF support every 3 weeks (q3w) for up to 9 cycles followed by B (15 mg/kg q3w) until disease progression. Primary endpoint was the overall response rate (ORR). Circulating tumor cells (CTCs) were evaluated using the CellSearch system at different time points during therapy. RESULTS Eighty-three women were enrolled with median age 62 years, performance status 0-1 in 93%, triple negative disease in 12% and liver metastases in 47%. In an intention to treat analysis, complete response was achieved in 13 (15.7%) and partial response in 42 (50.6%) (overall response rate 66.3%; 95% CI 56.09-76.44%). The median time to progression was 20.1 months and the 1-year overall survival rate 82.3%. Grade 3-4 neutropenia occurred in 37%, febrile neutropenia in 10%, anemia in 4%, thrombocytopenia in 2% and diarrhea in 2% of patients. There were two deaths possibly related to study treatment (sigmoid perforation n = 1; sudden death n = 1). Moreover, one patient developed pulmonary embolism and another one myocardial infarction while on treatment. Although DEB administration significantly reduced the proportion of patients presenting CTCs, the detection of ≥5 or ≥1 CTCs before treatment initiation was significantly associated with worse progression-free survival (p = 0.001 and p = 0.004) and overall survival (p = 0.001 and p = 0.027), respectively. CONCLUSIONS The DEB regimen is a very active but also potentially toxic combination in MBC. Detection of CTCs before treatment is associated with worse outcome. CLINICALTRIALSGOV NCT00705315.
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Affiliation(s)
- K Tryfonidis
- Hellenic Oncology Research Group, 55 Lombardou Street, 11474 Athens, Greece(1)
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Vamvakas L, Karampeazis A, Agelaki S, Kentepozidis N, Polyzos A, Kotsakis A, Kalbakis K, Christofyllakis C, Kontopodis E, Pallis A, Georgoulias V. Carboplatin plus gemcitabine as first-line treatment in eldelry patients with non-small-cell lung cancer: Preliminary results of a multicenter phase ii trial by the Hellenic Oncology Researsch Group (HORG). J Geriatr Oncol 2013. [DOI: 10.1016/j.jgo.2013.09.039] [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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Polyzos A, Tsavaris N, Kosmas C, Gogas H, Toufexi H, Kosmidis C, Markopoulos C, Giannopoulos A, Papadopoulos O, Stamatiadis D, Kouraklis G. Full Dose Paclitaxel Plus Vinorelbine as Salvage Chemotherapy in Anthracycline-Resistant Advanced Breast Cancer: A Phase II Study. J Chemother 2013; 15:607-12. [PMID: 14998089 DOI: 10.1179/joc.2003.15.6.607] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [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: 10/31/2022]
Abstract
This phase II trial studied the efficacy and toxicity of full dose paclitaxel plus vinorelbine, as salvage chemotherapy in patients with metastatic breast cancer resistant to anthracyclines. Patients received vinorelbine (30 mg/m2) followed 1 hour later by full dose paclitaxel (175 mg/m2) every 3 weeks for a maximum of 8 cycles or until disease progression. Because of the heavy pretreatment of the patients, prophylactic granulocyte-colony stimulating factor (5 microg/kg) was administered daily for 5-10 days. To minimize potentially cumulative neurotoxicity due to both agents, amifostine was given prior to chemotherapy. Thirty-four patients: 8 with tumors primary resistant and 26 with tumors recurring within 3-6 months after anthracycline treatment, were evaluable for efficacy and toxicity. Objective responses occurred in 11 patients [32%; 95% confidence interval (CI): 16.3-47.7%), all partial responses. Responses were observed in lung and liver. The median response duration was 4 months (range 3-7), median time to progression was 5 months (range 3-9) and median overall survival was 8 months (range 4-24). Neutropenia was dose limiting (35% grade 3-4 toxicity). The left ventricular ejection fraction, measured and followed in 18 patients, fell less than 20% below baseline level in 9 patients (50%), but only one patient developed congestive cardiac failure. The paclitaxel-vinorelbine regimen was moderately tolerated and moderately effective in poor prognosis breast cancer patients with visceral metastases and tumors resistant to anthracyclines. The combination at these doses and schedules should be considered in the design of regimens for advanced breast cancer.
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Affiliation(s)
- A Polyzos
- Medical Oncology Unit, Laikon General Hospital, Athens University School of Medicine, 17 Agiou Thoma Street, Goudi, Athens, Greece
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Kosmas C, Tsavaris N, Mylonakis N, Tsakonas G, Gassiamis A, Skopelitis H, Polyzos A, Malamos N, Karabelis A. Docetaxel-Ifosfamide Combination in Patients with Advanced Breast Cancer Failing Prior Anthracycline- Based Regimens: Results of a Phase I-II Study. J Chemother 2013; 19:322-31. [PMID: 17594929 DOI: 10.1179/joc.2007.19.3.322] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 10/31/2022]
Abstract
The established clinical activity of docetaxel and ifosfamide as single agents in anthracycline pre-treated breast cancer, led us to conduct a phase I-II study to define the maximum tolerated dose (MTD), dose-limiting toxicities (DLTs), and clinical activity of the docetaxel+ifosfamide combination in this setting. Patients with histologically confirmed metastatic breast cancer, after failure on prior anthracycline-based chemotherapy, were treated at successive dose levels (DLs) in cohorts of 3-6 with escalated doses of docetaxel 70-100 mg/m(2) over 1 h on day 1 followed by ifosfamide 5-6 g/m(2) divided over days 1+2 (2.5-3.0 g/m(2)/day over 1 h), every 21 days. G-CSF was added once dose-limiting neutropenia was encountered at a certain DL and planned to be incorporated prophylactically in subsequent higher DLs. Between March 1997 and December 2002, 65 patients with a median age of 57 years (range, 32-72) and performance status (WHO) of 1 (range, 0-2) were treated at 5 DLs as follows; 21 in phase I DLs (DL1: 3, DL2: 6, DL3: 3, DL4: 6, and DL5: 3) and the remaining 44 were treated at DL4 (total of 50 patients at DL4), which was defined as the level for phase II testing. All patients were assessable for toxicity and 62 for response. DLT (with the addition of G-CSF after DL2) was reached at DL5 with 2/3 initial patients developing febrile neutropenia. Clinical response rates (RRs), on an intention-to-treat basis, in phase II were: 56%; (95% CI, 42.2-69.7%); 4 CRs, 24 PRs, 10 SD and 12 PD. The median response duration was 7 mo (3-24 mo), median TTP 6.5 mo (0.1-26 mo), and median OS 13 mo (0.1-33 mo). Grade 3/4 toxicities included: neutropenia in 72% of patients, with 60% developing grade 4 neutropenia (<or=7 days) and in 10% of these febrile neutropenia, while no grade 3/4 thrombocytopenia was observed. Other toxicities included peripheral neuropathy grade 2 only in 10%, grade 1/2 reversible CNS toxicity in 16%, no renal toxicity, grade 2 myalgias in 8%, grade 3 diarrhea in 8%, skin/nail toxicity in 14%, and grade 2 fluid retention in 2% of patients. One patient in the study treated at phase II died as a result of acute liver failure after the first cycle. The present phase I-II study has determined the feasibility, defined the MTD and demonstrated the encouraging activity of the docetaxel-ifosfamide combination in the phase II part of the study. Therefore, future randomized phase III studies versus single-agent docetaxel or combinations of the latter with other active agents are warranted.
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Affiliation(s)
- C Kosmas
- Department of Medicine, 2nd Division of Medical Oncology, Metaxa Cancer Hospital, Piraeus, Greece
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Polyzos A, Kouraklis G, Giannopoulos A, Bramis J, Delladetsima JK, Sfikakis PP. Irinotecan as Salvage Chemotherapy for Advanced Small Bowel Adenocarcinoma: A Series of Three Patients. J Chemother 2013; 15:503-6. [PMID: 14598944 DOI: 10.1179/joc.2003.15.5.503] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [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: 10/31/2022]
Abstract
Small bowel adenocarcinoma (SBA) is a relatively rare disease. Because of its rarity the role of chemotherapy either as adjuvant or for advanced disease has not been clearly defined. Therefore any information, including case reports, is warranted. We report on three patients with adenocarcinoma of the jejunum and ileum. Two patients with positive lymph nodes received postoperative adjuvant chemotherapy with 5-fluorouracil-folinic acid (5FU-FA) for 12 months but they developed metastatic disease 3 and 8 months later, respectively. The third patient was initially treated with the same agents but for metastatic disease. All patients were subsequently treated for tumor recurrence with irinotecan 350 mg/m2 i.v. every 3 weeks as salvage chemotherapy supported by Granulocyte Colony Stimulating Factor (GCSF) for 5 days. Two patients achieved a minor response and had a dramatic improvement of their symptoms. Their survival times after irinotecan administration were 14 and 6 months with an overall survival after primary diagnosis of 29 and 27 months, respectively. The third patient who had a tumor refractory to 5FU-FA progressed also on irinotecan and had an 8-month overall survival. Although conclusions cannot be drawn regarding the role of adjuvant chemotherapy in SBA, it seems reasonable to extrapolate from large bowel carcinoma experience. Irinotecan seems to have some degree of activity in the treatment of SBA but further studies are warranted.
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Affiliation(s)
- A Polyzos
- Medical Oncology Unit, Laikon General Hospital, Athens University School of Medicine, Athens, Greece
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Mavroudis D, Malamos N, Boukovinas I, Kakolyris S, Kourousis C, Athanasiadis A, Ziras N, Makrantonakis P, Polyzos A, Christophylakis C, Georgoulias V. Abstract P1-13-09: A multicenter randomized study comparing the dose dense G-CSF-supported sequential administration of FEC followed by docetaxel versus paclitaxel as adjuvant chemotherapy in women with axillary lymph node positive breast cancer. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p1-13-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose: To compare the efficacy of dose dense docetaxel versus paclitaxel following FEC as adjuvant chemotherapy in node positive early breast cancer.
Patients and treatment: Women 18–75 years old with histologically confirmed HER2-negative invasive breast carcinoma surgically resected with at least one infiltrated axillary lymph node and absence of metastatic disease were randomized to receive 4 cycles of fluorouracil (700mg/m2), epirubicin (75mg/m2), cyclophosphamide (700mg/m2) followed by 4 cycles of either docetaxel (75mg/m2) or paclitaxel (175mg/m2). All chemotherapy cycles were administered every 14 days with G-CSF support. Stratification was based on menopausal status, number of involved nodes and hormone receptor expression. The primary endpoint of the study was to compare the disease-free survival (DFS) at 3 years and 239 patients were scheduled to enroll on each arm.
Results: Between 2004–2007, 481 women were randomized and received FEC followed by docetaxel (arm A; n=240) or paclitaxel (arm B; n=241). The median age was 55 years in both arms, premenopausal status 31.3% versus 32.8%, more than 10 involved axillary nodes in 12.9% versus 12.4%, histological grade 3 tumor in 36.3% versus 35.3% and hormone receptor negative disease in 14.6% versus 12% of patients in arms A and B, respectively. After a median follow up of 56.3 and 55.6 months (p = 0.3) for arms A and B, respectively, there were 42 (17.5%) versus 47 (19.5%) disease relapses (p = 0.5) and 20 (8.3%) versus 22 (9.1%) disease-related deaths (p = 0.7), respectively. The 3-year DFS rates were 88.1% versus 87.3% for arms A and B, respectively. Toxicity included grade 2–4 neutropenia in 31% versus 21% (p = 0.01), thrombocytopenia 3.5% versus 0.8% (p = 0.06), febrile neutropenia 2.1% versus 1.2% (p = 0.5), diarrhea 3.7% versus 2.5% (p = 0.4), neurotoxicity 2.9% versus 4.6% (p = 0.3) of patients in arms A and B, respectively. There were no toxic deaths.
Conclusion: The dose dense administration with G-CSF support of FEC followed by either docetaxel or paclitaxel as adjuvant chemotherapy in women with node positive early breast cancer is well tolerated and results in a similar 3-year DFS rate.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P1-13-09.
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Affiliation(s)
- D Mavroudis
- Hellenic Oncology Research Group (HORG), Athens, Greece
| | - N Malamos
- Hellenic Oncology Research Group (HORG), Athens, Greece
| | - I Boukovinas
- Hellenic Oncology Research Group (HORG), Athens, Greece
| | - S Kakolyris
- Hellenic Oncology Research Group (HORG), Athens, Greece
| | - C Kourousis
- Hellenic Oncology Research Group (HORG), Athens, Greece
| | | | - N Ziras
- Hellenic Oncology Research Group (HORG), Athens, Greece
| | | | - A Polyzos
- Hellenic Oncology Research Group (HORG), Athens, Greece
| | | | - V Georgoulias
- Hellenic Oncology Research Group (HORG), Athens, Greece
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Pallis A, Vamvakas L, Karampeazis A, Polyzos A, Agelaki S, Kentepozidis N, Boukovinas I, Kotsakis A, Papadimitraki E, Koinis F, Georgoulias V. A phase II study of the combination of bevacizumab with cytotoxic chemotherapy, as first line treatment, in older patients with advanced/metastatic NSCLC (non-squamous). J Geriatr Oncol 2012. [DOI: 10.1016/j.jgo.2012.10.071] [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: 10/27/2022]
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Koumati E, Palassopoulou M, Matsouka P, Polyzos A, Dalekos GN, Zachou K. Multiple autoimmune propensity and B-non-hodgkin lymphoma: cause or effect? Autoimmune Dis 2011; 2011:841325. [PMID: 21687651 PMCID: PMC3112510 DOI: 10.4061/2011/841325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2011] [Accepted: 03/01/2011] [Indexed: 11/24/2022] Open
Abstract
We report a case of multiple autoimmunity consisting of the presence of autoimmune haemolytic anaemia (AIHA), antimitochondrial antibodies (AMAs), and antiphospholipid antibodies (APLAbs) as the presenting manifestations of an extrahepatic B-non-Hodgkin lymphoma (B-NHL) in a 63-year-old woman. The patient presented with fatigue attributed to severe AIHA. Due to increased serum IgM and γ-GT levels, an investigation for AMA was performed, which proved positive with anti-M2 specificity. A prolongation of activated partial thromboplastin time (aPTT) led to the determination of APLAbs (lupus anticoagulant and other APLAbs) which were also positive. Bone marrow biopsy in combination with immmunohistochemical studies established the diagnosis of lymphoplasmacytic B-NHL. Ten months later, B-NHL was in remission while AMA and APLAbs were still positive. In conclusion, we documented the coexistence of multiple autoimmune reactions together with B-NHL highlighting the possible common pathogenetic pathways of the two entities.
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Affiliation(s)
- E Koumati
- Department of Medicine and Research Laboratory of Internal Medicine, School of Medicine, University of Thessaly, Biopolis, Mezourlo, 41110 Larissa, Greece
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Athanasiadis A, Boukovinas I, Sfakianaki M, Saridaki Z, Papadaki C, Tzardi M, Androulakis NE, Polyzos A, Georgoulias V, Sougklakos I. Folinic acid, 5-fluorouracil, irinotecan (FOLFIRI) plus chemoradiation (CRT) with 5-fluorouracil (5FU) as adjuvant treatment for patients with operable gastric cancer (OGC): A feasibility study with pharmacogenetic analysis. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
44 Background: To evaluate the efficacy and safety of FOLFIRI plus CRT with 5FU as adjuvant treatment for patients with OGC. Methods: Patients received treatment with FOLFIRI (irinotrecan 150 mg/m2, d1, LV 200 mg/m2, d1+2 and 5FU [400 mg/m2/d bolus and 600 mg/m2/d, 22 h infusion, d1+2]) for 2 15-day cycles followed by RT (45Gy) with 5FU continuous infusion (325 mg/m2/d in the 1st and 5th week) administration. Eight additional cycles of FOLFIRI were administered after the completion of CRT. BRCA1, ERCC1, XPD, TOPO-I, TOPO-IIA and B and TS mRNA expression was determined in the primary tumor where available. Results: The median age of the 171 enrolled patients was 62 years, 114 (66%) were males, 136 (79%) had R0 resections and 152 (89%) had at least a D1 resection. Treatment was completed as per protocol in 107 (63%) of the patients. CRT was completed in all but 5 (3%) patients. The median rate of drug exposure was 93% for irinotecan, 87% for 5FU and 91% for LV. The most common grade 3/4 adverse events were neutropenia (32%), febrile neutropenia (3.5%) and diarrhea (7%). After a median follow-up of 45.7 months 84 had relapsed and 70 were deceased. The median disease-free survival (DFS) was 30 months (95% CI: 18-41 months), while the projected median overall survival (mOS) was 53.7 months (95% CI: 30-77 months). The recurrence free probability at 5 years was 44% while the probability of survival at 5 years was 46%. From the studied pharmacogenetic markers only TS low expression was correlated with a trend towards improved DFS and OS in patients with R0 resections. Conclusions: These results show that the administration of FOLFIRI plus CRT with 5FU as adjuvant treatment in OGC is a feasible approach with acceptable toxicity and challenging efficacy which merits further evaluation in a randomized trial. No significant financial relationships to disclose.
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Affiliation(s)
- A. Athanasiadis
- Hellenic Oncology Research Group (HORG), Athens, Greece; Hellenic Oncology Research Group (HORG), Thessaloniki, Greece; University of Crete, Heraklion, Greece; Laboratory of Pathology, University General Hospital of Heraklion, Heraklion, Greece; Hellenic Oncology Research Group (HORG), Heraklion, Greece
| | - I. Boukovinas
- Hellenic Oncology Research Group (HORG), Athens, Greece; Hellenic Oncology Research Group (HORG), Thessaloniki, Greece; University of Crete, Heraklion, Greece; Laboratory of Pathology, University General Hospital of Heraklion, Heraklion, Greece; Hellenic Oncology Research Group (HORG), Heraklion, Greece
| | - M. Sfakianaki
- Hellenic Oncology Research Group (HORG), Athens, Greece; Hellenic Oncology Research Group (HORG), Thessaloniki, Greece; University of Crete, Heraklion, Greece; Laboratory of Pathology, University General Hospital of Heraklion, Heraklion, Greece; Hellenic Oncology Research Group (HORG), Heraklion, Greece
| | - Z. Saridaki
- Hellenic Oncology Research Group (HORG), Athens, Greece; Hellenic Oncology Research Group (HORG), Thessaloniki, Greece; University of Crete, Heraklion, Greece; Laboratory of Pathology, University General Hospital of Heraklion, Heraklion, Greece; Hellenic Oncology Research Group (HORG), Heraklion, Greece
| | - C. Papadaki
- Hellenic Oncology Research Group (HORG), Athens, Greece; Hellenic Oncology Research Group (HORG), Thessaloniki, Greece; University of Crete, Heraklion, Greece; Laboratory of Pathology, University General Hospital of Heraklion, Heraklion, Greece; Hellenic Oncology Research Group (HORG), Heraklion, Greece
| | - M. Tzardi
- Hellenic Oncology Research Group (HORG), Athens, Greece; Hellenic Oncology Research Group (HORG), Thessaloniki, Greece; University of Crete, Heraklion, Greece; Laboratory of Pathology, University General Hospital of Heraklion, Heraklion, Greece; Hellenic Oncology Research Group (HORG), Heraklion, Greece
| | - N. E. Androulakis
- Hellenic Oncology Research Group (HORG), Athens, Greece; Hellenic Oncology Research Group (HORG), Thessaloniki, Greece; University of Crete, Heraklion, Greece; Laboratory of Pathology, University General Hospital of Heraklion, Heraklion, Greece; Hellenic Oncology Research Group (HORG), Heraklion, Greece
| | - A. Polyzos
- Hellenic Oncology Research Group (HORG), Athens, Greece; Hellenic Oncology Research Group (HORG), Thessaloniki, Greece; University of Crete, Heraklion, Greece; Laboratory of Pathology, University General Hospital of Heraklion, Heraklion, Greece; Hellenic Oncology Research Group (HORG), Heraklion, Greece
| | - V. Georgoulias
- Hellenic Oncology Research Group (HORG), Athens, Greece; Hellenic Oncology Research Group (HORG), Thessaloniki, Greece; University of Crete, Heraklion, Greece; Laboratory of Pathology, University General Hospital of Heraklion, Heraklion, Greece; Hellenic Oncology Research Group (HORG), Heraklion, Greece
| | - I. Sougklakos
- Hellenic Oncology Research Group (HORG), Athens, Greece; Hellenic Oncology Research Group (HORG), Thessaloniki, Greece; University of Crete, Heraklion, Greece; Laboratory of Pathology, University General Hospital of Heraklion, Heraklion, Greece; Hellenic Oncology Research Group (HORG), Heraklion, Greece
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Vamvakas L, Athanasiadis A, Karampeazis A, Kakolyris S, Polyzos A, Kouroussis C, Ziras N, Kalbakis K, Georgoulias V, Souglakos J. Clinical outcome of elderly patients with metastatic colorectal cancer treated with FOLFOXIRI versus FOLFIRI: Subgroup analysis of a randomized phase III trial from the Hellenic Oncology Research Group (HORG). Crit Rev Oncol Hematol 2010; 76:61-70. [DOI: 10.1016/j.critrevonc.2009.08.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2009] [Revised: 05/21/2009] [Accepted: 08/11/2009] [Indexed: 01/08/2023] Open
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Xenidis N, Kotsakis A, Kalykaki A, Christophyllakis C, Giassas S, Kentepozidis N, Polyzos A, Chelis L, Vardakis N, Vamvakas L, Georgoulias V, Kakolyris S. Etoposide plus cisplatin followed by concurrent chemo-radiotherapy and irinotecan plus cisplatin for patients with limited-stage small cell lung cancer: A multicenter phase II study. Lung Cancer 2010; 68:450-4. [DOI: 10.1016/j.lungcan.2009.08.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2009] [Revised: 08/11/2009] [Accepted: 08/12/2009] [Indexed: 11/25/2022]
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Polyzos A, Kalbakis K, Giassas S, Kalykaki A, Vardakis NK, Bozionelou V, Saloustros ES, Kontopodis E, Mavroudis D, Georgoulias V. Salvage treatment in metastatic breast cancer (MBC) with weekly paclitaxel (P) plus biweekly bevacizumab (B). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e11503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Ziras N, Polyzos A, Xenidis N, Kalykaki A, Androulakis NE, Papakotoulas P, Kentepozidis NK, Makrantonakis P, Xynogalos S, Sougklakos I. CAPIRI plus bevacizumab (CAPIRI-B) versus FOLFIRI plus bevacizumab (FOLFIRI-B) for the treatment of patients with metastatic colorectal cancer (mCRC). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.3542] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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40
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Mavroudis D, Boukovinas I, Christophyllakis C, Xenidis N, Papakotoulas P, Malamos NA, Kakolyris S, Polyzos A, Georgoulias V. A phase I/II study of docetaxel/epirubicin/bevacizumab (DEB) as first-line therapy for metastatic, HER2-negative breast cancer (MBC). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.1116] [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: 11/20/2022] Open
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41
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Karampeazis A, Vamvakas L, Pallis AG, Christophyllakis C, Kentepozidis NK, Chandrinos V, Polyzos A, Athanasiadis A, Milaki G, Georgoulias V. Docetaxel (D) plus gemcitabine (G) compared with G in elderly patients with advanced non-small cell lung cancer (NSCLC): Preliminary results of a randomized phase III Hellenic Oncology Research Group trial. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.7605] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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42
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Tsavaris N, Kosmas C, Papadoniou N, Kopterides P, Kopteridis P, Tsigritis K, Dokou A, Sarantonis J, Skopelitis H, Tzivras M, Gennatas K, Polyzos A, Papastratis G, Karatzas G, Papalambros A. CEA and CA-19.9 serum tumor markers as prognostic factors in patients with locally advanced (unresectable) or metastatic pancreatic adenocarcinoma: a retrospective analysis. J Chemother 2010; 21:673-80. [PMID: 20071292 DOI: 10.1179/joc.2009.21.6.673] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Most pancreatic adenocarcinoma patients present with locally advanced or metastatic disease at diagnosis. in this retrospective study the authors evaluated the prognostic significance of the CEA and CA-19.9 serum tumor markers in advanced (unresectable) pancreatic cancer in correlation to other prognostic factors (demographic data, clinical parameters, treatment modality) and survival time using univariate and multivariate methods, in 215 patients with locally advanced (unresectable) or metastatic pancreatic adenocarcinoma. median survival was 29.0 weeks, with 21.9% of patients surviving 36 weeks. Among 24 potential prognostic variables, 19 were associated with shorter survival. Multivariate analysis indicated that ten factors had a significant independent effect on survival: chemotherapy, surgery, tumor localization, elevated C-reactive protein, elevated CeA, CA 19-9 (>30 x nl), jaundice at diagnosis, weight loss >10%, distant metastases, and Karnofsky performance status. Patients who had only palliative therapy had a hazard ratio of 8.94 versus those who underwent palliative surgery and chemotherapy. Although certain clinical, biochemical and biological factors remain important predictors of survival in patients with advanced pancreatic cancer, CA-19.9 serum tumor marker levels retain independent prognostic value for poor survival.
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Affiliation(s)
- N Tsavaris
- Oncology Unit, Department of Pathophysiology, Laikon General Hospital, Athens University School of Medicine, Athens, Greece
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Mavroudis D, Papakotoulas P, Ardavanis A, Syrigos K, Kakolyris S, Ziras N, Kouroussis C, Malamos N, Polyzos A, Christophyllakis C, Kentepozidis N, Georgoulias V. Randomized phase III trial comparing docetaxel plus epirubicin versus docetaxel plus capecitabine as first-line treatment in women with advanced breast cancer. Ann Oncol 2009; 21:48-54. [PMID: 19906761 DOI: 10.1093/annonc/mdp498] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The purpose of this study was to compare docetaxel plus epirubicin versus docetaxel plus capecitabine combinations as front-line treatment in women with advanced breast cancer (ABC). PATIENTS AND METHODS Previously untreated patients with ABC were randomly assigned to receive docetaxel 75 mg/m(2) plus epirubicin 75 mg/m(2) (DE) on day 1 or docetaxel 75 mg/m(2) on day 1 plus capecitabine 950 mg/m(2) orally twice daily on days 1-14 (DC) in 21-day cycles. Previous anthracycline-based (neo)-adjuvant chemotherapy was allowed if completed >1 year before enrollment. The primary objective of the study was to compare time to disease progression (TTP). RESULTS One hundred and thirty-six women were treated on each arm and median TTP was 10.6 versus 11.0 months (P = 0.7), for DE and DC, respectively. According to RECIST criteria we observed 15 (11%) versus 11 (8%) complete responses and 55 (40%) versus 61 (45%) partial responses (P = 0.8), with DE and DC, respectively. Severe toxicity included grade 3-4 neutropenia (57% versus 46%; P = 0.07), febrile neutropenia (11% versus 8%; P = 0.4), hand-foot syndrome (0% versus 4%; P = 0.02), grade 2-3 anemia (20% versus 7%; P = 0.001) and asthenia (12% versus 6%; P = 0.09) with DE and DC, respectively. CONCLUSIONS The DE and DC regimens have similar efficacy but different toxicity. Either regimen can be used as front-line treatment of ABC.
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Affiliation(s)
- D Mavroudis
- Department of Medical Oncology, University Hospital of Heraklion, 71110 Heraklion, PO Box 1352, Crete, Greece.
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Karapanagiotou E, Dilana K, Boura P, Gratsias I, Polyzos A, Syrigos K. 9045 Serum metastin is not involved in metastatic potential of non-small cell lung cancer (NSCLC). EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71758-6] [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: 11/26/2022] Open
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45
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Gogas H, Metaxas Y, Polyzos A, Mantzourani M, Antoniadis A, Floudas C, Fountzilas G, Pectasides D, Tsoutsos D, Spyropoulou-Vlachou M. Evaluation of IL-10 polymorphisms in high-risk melanoma patients receiving adjuvant interferon. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.9049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9049 Background: Attempts to identify patients who benefit from adjuvant treatment of interferon alfa-2b (IFN) have been disappointing. Interleukin-10 polymorphisms have been implicated with the prognosis of patients with advanced melanoma and associated with response to biochemotherapy. Several polymorphisms have been found within the IL-10 gene. We evaluated three IL-10 Single Nucleotide Polymorphisms (SNPs) in high-risk melanoma patients enrolled in a study of two regimens of high-dose IFN and compared the distribution of SNPs found in healthy controls. Methods: We genotyped DNA from peripheral blood of 280 stage IIb, IIc and III melanoma patients and 288 healthy controls for 592 C/A, 819 C/T and 1082 G/A with PCR and pyrosequencing technology (Biotage, Uppsala, Sweden). Results: At a median follow up of 56.3 months (95% CI 47.4–63.7), 147 patients have recurred and 94 have died. The median DFS was 53 months and the median OS 86 months. There were no statistically significant differences in the incidence of IL-10 polymorphisms between the melanoma patients and healthy controls. The incidence of these polymorphisms is presented in table . RFS and OS did not differ significantly between the alleles of these polymorphisms (p=0.88 and p=0.55 for 592 C/A, p=0.84 and p=0.68 for 819 C/T and p=0.26 and p=0.30 for 1082 G/A respectively). Conclusions: No SNP studied was correlated with improved RFS and OS in this high-risk group of melanoma patients. [Table: see text] [Table: see text]
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Affiliation(s)
- H. Gogas
- University of Athens, Athens, Greece; Aristotle Univeristy of Thessaloniki, Thessaloniki, Greece; University of Athens, Athens, Greece; Department of Plastic Surgery, General Hospital of Athens, Athens, Greece; National Tissue Typing Center, General Hospital of Athens, Greece
| | - Y. Metaxas
- University of Athens, Athens, Greece; Aristotle Univeristy of Thessaloniki, Thessaloniki, Greece; University of Athens, Athens, Greece; Department of Plastic Surgery, General Hospital of Athens, Athens, Greece; National Tissue Typing Center, General Hospital of Athens, Greece
| | - A. Polyzos
- University of Athens, Athens, Greece; Aristotle Univeristy of Thessaloniki, Thessaloniki, Greece; University of Athens, Athens, Greece; Department of Plastic Surgery, General Hospital of Athens, Athens, Greece; National Tissue Typing Center, General Hospital of Athens, Greece
| | - M. Mantzourani
- University of Athens, Athens, Greece; Aristotle Univeristy of Thessaloniki, Thessaloniki, Greece; University of Athens, Athens, Greece; Department of Plastic Surgery, General Hospital of Athens, Athens, Greece; National Tissue Typing Center, General Hospital of Athens, Greece
| | - A. Antoniadis
- University of Athens, Athens, Greece; Aristotle Univeristy of Thessaloniki, Thessaloniki, Greece; University of Athens, Athens, Greece; Department of Plastic Surgery, General Hospital of Athens, Athens, Greece; National Tissue Typing Center, General Hospital of Athens, Greece
| | - C. Floudas
- University of Athens, Athens, Greece; Aristotle Univeristy of Thessaloniki, Thessaloniki, Greece; University of Athens, Athens, Greece; Department of Plastic Surgery, General Hospital of Athens, Athens, Greece; National Tissue Typing Center, General Hospital of Athens, Greece
| | - G. Fountzilas
- University of Athens, Athens, Greece; Aristotle Univeristy of Thessaloniki, Thessaloniki, Greece; University of Athens, Athens, Greece; Department of Plastic Surgery, General Hospital of Athens, Athens, Greece; National Tissue Typing Center, General Hospital of Athens, Greece
| | - D. Pectasides
- University of Athens, Athens, Greece; Aristotle Univeristy of Thessaloniki, Thessaloniki, Greece; University of Athens, Athens, Greece; Department of Plastic Surgery, General Hospital of Athens, Athens, Greece; National Tissue Typing Center, General Hospital of Athens, Greece
| | - D. Tsoutsos
- University of Athens, Athens, Greece; Aristotle Univeristy of Thessaloniki, Thessaloniki, Greece; University of Athens, Athens, Greece; Department of Plastic Surgery, General Hospital of Athens, Athens, Greece; National Tissue Typing Center, General Hospital of Athens, Greece
| | - M. Spyropoulou-Vlachou
- University of Athens, Athens, Greece; Aristotle Univeristy of Thessaloniki, Thessaloniki, Greece; University of Athens, Athens, Greece; Department of Plastic Surgery, General Hospital of Athens, Athens, Greece; National Tissue Typing Center, General Hospital of Athens, Greece
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Boukovinas I, Androulakis N, Polyzos A, Vardakis N, Amarantidis K, Bozionelou V, Kouroussis C, Giassas S, Christophyllakis C, Mavroudis D. A randomized phase II trial of irinotecan plus oxaliplatin versus oxaliplatin, fluorouracil (5 FU), leukovorin (LV) as first-line treatment in advanced gastric cancer. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.4536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4536 Background: To compare the efficacy and tolerance of two oxaliplatin-based regimens as first-line treatment of advanced gastric cancer. Methods: Chemotherapy-naïve patients with measurable recurrent or metastatic gastric adenocarcinoma, PS (ECOG) 0–2 and adequate organ functions were randomly assigned to receive either irinotecan 200mg/m2 and oxaliplatin 80mg/m2 (IO), every 21 days or oxaliplatin 85mg/m2 on day 1, 5-FU 400 mg/m2 (over 1 hour infusion) + 600mg/m2 (over 22 hours infusion) on days 1 and 2, leucovorin (LV) 200mg/m2 on days 1 and 2 (FOLFOX4) every 2 weeks. Study endpoints: Overall Response Rate (ORR), Toxicity Time to Progression (TTP) and Survival (S). Results: 138 patients were enrolled and all were evaluable for response. Median number of cycles administered was 5.5 (range 1–10) for IO and 7 (range 1–18) for FOLFOX4. In an intent-to treat analysis the ORR (RR+CR) was 29.4% for IO arm and 34.3 % for FOLFOX4 arm (p= 0.587). The median response duration was 5.63 months (mo) for IO arm and 6,6mo for FOLFOX4 arm. Median TTP was 4.2mo and 6,1mo for IO and FOLFOX4 arm respectively (p= 0.012). Median OS was 9.4mo for IO and 11.97mo for FOLFOX4 (p= 0.456). Toxicity was acceptable, with one toxic death in each arm. Grade 3–4 vomiting (7.3%), diarrhea (11.8%), neutropenia (22%) and febrile neutropenia (5.9%) occurred more frequently in IO arm, while anaemia (4.3%) and grade II neurotoxicity (11.4%) was more frequent in FOLFOX4 arm. Conclusions: Both regimens are well tolerated and active in advanced gastric cancer. Based on the TTP and toxicity profile, the FOLFOX4 regimen merits to be further evaluated in prospective phase III trials. No significant financial relationships to disclose.
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Affiliation(s)
| | | | - A. Polyzos
- Hellenic Oncology Research Group, Athens, Greece
| | - N. Vardakis
- Hellenic Oncology Research Group, Athens, Greece
| | | | | | | | - S. Giassas
- Hellenic Oncology Research Group, Athens, Greece
| | | | - D. Mavroudis
- Hellenic Oncology Research Group, Athens, Greece
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Terpos E, Kiagia M, Karapanagiotou EM, Charpidou A, Dilana KD, Nasothimiou E, Harrington KJ, Polyzos A, Syrigos KN. The clinical significance of serum markers of bone turnover in NSCLC patients: surveillance, management and prognostic implications. Anticancer Res 2009; 29:1651-1657. [PMID: 19443381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The purpose of this study was to investigate various serum markers of bone turnover in non-small cell lung cancer patients (NSCLC) in the presence or absence of bone metastasis. Our retrospective study included 79 newly diagnosed NSCLC patients. Group A included 51 patients with bone metastasis and group B included 28 patients that never developed bone metastasis. The measurement of bone formation markers, bone resorptive markers and osteoclastogenesis markers as well as routine biochemical analysis was determined. Patients with bone metastasis had an increase in receptor activator of nuclear factor kappaB ligand, osteopontin and osteoprotegerin. Patients who later developed bone metastasis had decreased osteocalcin and tartrate-resistant acid phosphatase isoform 5b levels (TRACP-5b). We also found an unusually low TRACP-5b/RANKL ratio for patients who have or later developed metastasis. In patients that never developed bone metastases, cross-linked carboxy-terminal telopeptide of type I collagen was increased. Positive correlations were found between osteopontin and TRACP-5b, and also between bone alkaline phosphatase with osteocalcin and TRACP-5b. In conclusion, serum markers of bone turnover may be able to determine the time-to-tumor progression, metastatic potential and overall survival of the NSCLC patient. In addition, they may contribute to a more accurate follow-up and tailored treatment options.
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Affiliation(s)
- Evangelos Terpos
- Athens University School of Medicine, Oncology Unit, Third Department of Medicine, Building Z, Sotiria General Hospital, Mesogion 152, Athens 115 27, Greece
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Markopoulos MC, Lagadas AA, Alexandrou P, Giannakopoulos KC, Polyzos A. Prolonged disease free survival with aggressive adjuvant chemotherapy in a case of large cell neuroendocrine carcinoma of the uterine cervix. J BUON 2009; 14:322-323. [PMID: 19650188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Kakolyris S, Souglakos J, Polyzos A, Ardavanis A, Ziras N, Athanasiadis A, Varthalitis I, Amarantidis K, Tsousis S, Vamvakas L, Vardakis N, Georgoulias V. Modified CAPOX (capecitabine plus oxaliplatin) regimen every two weeks as second-line treatment in patients with advanced colorectal cancer previously treated with irinotecan-based frontline therapy: a multicenter phase II study. Oncology 2008; 74:31-6. [PMID: 18544957 DOI: 10.1159/000138977] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2007] [Accepted: 10/11/2007] [Indexed: 11/19/2022]
Abstract
BACKGROUND To evaluate the efficacy and tolerance of capecitabine (CAP) given every other week and biweekly oxaliplatin (OX; modified CAPOX regimen) in patients with advanced colorectal cancer previously treated with irinote- can-based frontline chemotherapy. METHODS Sixty-seven patients were enrolled; the median age was 62 years and 62 (92.5%) had a performance status (ECOG) of 0-1. OX and CAP were administered at the dose of 100 mg/m(2) on day 1 and 2,000 mg/m(2) on days 1-7, respectively, every 2 weeks. RESULTS A total of 429 treatment cycles were administered. Grade 3/4 neutropenia and thrombocytopenia were observed in 4 (6%) and 2 (3%) patients, respectively. Febrile neutropenia complicated 1 treatment cycle. The main nonhematologic toxicities were grade 2/3 peripheral sensory neurotoxicity (10% of patients) and grade 3/4 diarrhea (7%). In an intention-to-treat analysis, 3 (4.5%) complete and 13 (19.4%) partial responses (overall response rate 24%) were observed. Seventeen (24.5%) patients had stable and 27 (40.3%) progressive disease. The median time to tumor progression and overall survival were 5 months and 11.3 months, respectively. CONCLUSIONS The results indicate that the modified CAPOX regimen is safe and effective as salvage treatment in patients with advanced colorectal cancer who were previously treated with irinotecan-based frontline therapy.
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Affiliation(s)
- S Kakolyris
- Department of Medical Oncology, University General Hospital of Alexandroupolis, Alexandroupolis, Greece
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Boukovinas I, Souglakos J, Hatzidaki D, Kakolyris S, Ziras N, Vamvakas L, Polyzos A, Geroyianni A, Agelidou A, Agelaki S, Kalbakis K, Kotsakis A, Mavroudis D, Georgoulias V. Docetaxel plus gemcitabine as front-line chemotherapy in elderly patients with lung adenocarcinomas: a multicenter phase II study. Lung Cancer 2008; 63:77-82. [PMID: 18508158 DOI: 10.1016/j.lungcan.2008.04.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2008] [Revised: 04/04/2008] [Accepted: 04/09/2008] [Indexed: 12/27/2022]
Abstract
BACKGROUND The docetaxel/gemcitabine (DG) combination is an active and well-tolerated regimen against non-small cell lung cancer (NSCLC). A phase II study was conducted in order to evaluate its efficacy in elderly patients with lung adenocarcinomas. METHODS Chemotherapy-naive patients, aged > or =70 years, with locally advanced or metastatic lung adenocarcinomas and performance status (PS) < or =2 (ECOG) received gemcitabine 1100 mg/m(2) (days 1+8) and docetaxel 100 mg/m(2) (day 8) with rhG-CSF support. RESULTS Seventy-seven patients were enrolled. One (1.3%) complete and 23 (29.9%) partial responses were achieved (intention to treat analysis: ORR 31.2%; 95% CI 20.82-41.51%) whereas tumor growth control was achieved in 53.3% of patients. The median TTP was 4.1 months, the median overall survival 9.4 months and the 1- and 2-year survival rate 37.9% and 10.7%, respectively. Grade 3-4 neutropenia occurred in 18.2% and febrile neutropenia in 3 (3.9%) patients. Non-haematological toxicity was mild with grade 2-3 asthenia occurring in 22.1% patients. CONCLUSIONS The DG regimen is an active and well-tolerated front-line chemotherapy for elderly patients with lung adenocarcinomas and merits further evaluation in prospective randomized trials.
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Affiliation(s)
- I Boukovinas
- 2nd Department of Medical Oncology, Theagenion Anticancer Hospital, Thessaloniki, Greece.
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