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Sharon CE, Tortorello GN, Ma KL, Huang AC, Xu X, Giles LR, McGettigan S, Kreider K, Schuchter LM, Mathew AJ, Amaravadi RK, Gimotty PA, Miura JT, Karakousis GC, Mitchell TC. Corrigendum to 'Long-term outcomes to neoadjuvant pembrolizumab based on pathological response for patients with resectable stage III/IV cutaneous melanoma': [Annals of Oncology 34 (2023) 806-812]. Ann Oncol 2024:S0923-7534(24)00076-0. [PMID: 38614876 DOI: 10.1016/j.annonc.2024.03.002] [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: 04/15/2024] Open
Affiliation(s)
- C E Sharon
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia
| | - G N Tortorello
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia
| | - K L Ma
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia
| | - A C Huang
- Department of Medicine and Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - X Xu
- Department of Pathology and Laboratory Medicine
| | - L R Giles
- Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia; Department of Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - S McGettigan
- Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia; Department of Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - K Kreider
- Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia; Department of Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - L M Schuchter
- Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia; Department of Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - A J Mathew
- Department of Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - R K Amaravadi
- Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia; Department of Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - P A Gimotty
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - J T Miura
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia; Department of Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - G C Karakousis
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia; Department of Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - T C Mitchell
- Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia; Department of Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
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Sharon CE, Tortorello GN, Ma KL, Huang AC, Xu X, Giles LR, McGettigan S, Kreider K, Schuchter LM, Mathew AJ, Amaravadi RK, Gimotty PA, Miura JT, Karakousis GC, Mitchell TC. Long-term outcomes to neoadjuvant pembrolizumab based on pathological response for patients with resectable stage III/IV cutaneous melanoma. Ann Oncol 2023; 34:806-812. [PMID: 37414215 DOI: 10.1016/j.annonc.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 06/12/2023] [Accepted: 06/20/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND While neoadjuvant immunotherapy for melanoma has shown promising results, the data have been limited by a relatively short follow-up time, with most studies reporting 2-year outcomes. The goal of this study was to determine long-term outcomes for stage III/IV melanoma patients treated with neoadjuvant and adjuvant programmed cell death receptor 1 (PD-1) inhibition. PATIENTS AND METHODS This is a follow-up study of a previously published phase Ib clinical trial of 30 patients with resectable stage III/IV cutaneous melanoma who received one dose of 200 mg IV neoadjuvant pembrolizumab 3 weeks before surgical resection, followed by 1 year of adjuvant pembrolizumab. The primary outcomes were 5-year overall survival (OS), 5-year recurrence-free survival (RFS), and recurrence patterns. RESULTS We report updated results at 5 years of follow-up with a median follow-up of 61.9 months. No deaths occurred in patients with a major pathological response (MPR, <10% viable tumor) or complete pathological response (pCR, no viable tumor) (n = 8), compared to a 5-year OS of 72.8% for the remainder of the cohort (P = 0.12). Two of eight patients with a pCR or MPR had a recurrence. Of the patients with >10% viable tumor remaining, 8 of 22 patients (36%) had a recurrence. Additionally, the median time to recurrence was 3.9 years for patients with ≤10% viable tumor and 0.6 years for patients with >10% viable tumor (P = 0.044). CONCLUSIONS The 5-year results from this trial represent the longest follow-up of a single-agent neoadjuvant PD-1 trial to date. Response to neoadjuvant therapy continues to be an important prognosticator with regard to OS and RFS. Additionally, recurrences in patients with pCR occur later and are salvageable, with a 5-year OS of 100%. These results demonstrate the long-term efficacy of single-agent neoadjuvant/adjuvant PD-1 blockade in patients with a pCR and the importance of long-term follow-up for these patients. TRIAL REGISTRATION Clinicaltrials.gov, NCT02434354.
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Affiliation(s)
- C E Sharon
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia
| | - G N Tortorello
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia
| | - K L Ma
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia
| | - A C Huang
- Department of Medicine and Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - X Xu
- Departments of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia
| | - L R Giles
- Medicine, Hospital of the University of Pennsylvania, Philadelphia; Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - S McGettigan
- Medicine, Hospital of the University of Pennsylvania, Philadelphia; Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - K Kreider
- Medicine, Hospital of the University of Pennsylvania, Philadelphia; Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - L M Schuchter
- Medicine, Hospital of the University of Pennsylvania, Philadelphia; Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - A J Mathew
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - R K Amaravadi
- Medicine, Hospital of the University of Pennsylvania, Philadelphia; Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - P A Gimotty
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - J T Miura
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia; Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - G C Karakousis
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia; Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - T C Mitchell
- Medicine, Hospital of the University of Pennsylvania, Philadelphia; Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
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Abstract
BACKGROUND Quality indicators (QIs) are formal ways to track health care performance and outcomes, guide quality improvement, and identify gaps in care delivery. We developed twelve quality indicators for achalasia management which cover the domains of patient education, diagnosis, and treatment of achalasia. AIM To determine adherence to established quality indicators for achalasia management. METHODS We performed a retrospective, multicenter evaluation of care patterns for adult patients greater than 18 years old with newly diagnosed achalasia from January 2018 to May 2020. A balanced random patient sample was obtained at four large academic medical centers. Independent electronic health record chart abstraction was performed using a standardized form to determine adherence to applicable QIs. Pooled and de-identified data were analyzed to identify gaps in care. RESULTS A total of 120 patients were included and the overall adherence to applicable quality indicators across all centers was 86%. The median follow-up for all patients from time of diagnosis to end of study was 511 days. Clinicians adhered to all applicable quality indicators in 49 patients (39%). The quality indicator domain with the poorest adherence was patient education (67%), with 50% of patients having had a documented discussion of the risks of gastroesophageal reflux disease following surgical or endoscopic myotomy. CONCLUSIONS Gaps in the quality of achalasia care delivery were identified, the largest of which relates to patient education about treatment risks. These findings highlight a potential area for future quality improvement studies and form the basis for developing fully specified quality measures.
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Affiliation(s)
- Emily Romanoff
- Department of Internal Medicine, Duke University School of Medicine, Durham, NC, 27708, USA
| | - Justin Zhuo
- Department of Medicine, Stanford University, Stanford, CA, 94305, USA
| | - Annsa C Huang
- Division of Gastroenterology, UCSF, San Francisco, CA, 94143, USA
| | - Deron Amador
- Division of Gastroenterology, OHSU, Portland, OR, 97239, USA
| | - Fouad Otaki
- Division of Gastroenterology, OHSU, Portland, OR, 97239, USA
| | - Afrin N Kamal
- Department of Medicine, Division of Gastroenterology and Hepatology, Stanford, CA, 94305, USA
| | - Priya Kathpalia
- Division of Gastroenterology, UCSF, San Francisco, CA, 94143, USA
| | - David A Leiman
- Division of Gastroenterology, Duke University, Durham, NC, 27708, USA.
- Duke Clinical Research Institute, Durham, NC, 27708, USA.
- Division of Gastroenterology, Duke University School of Medicine, 200 Morris Street, Suite 6524, Durham, NC, 27701, USA.
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Huang AC, Dodge JL, Yao FY, Mehta N. National Experience on Waitlist Outcomes for Down-Staging of Hepatocellular Carcinoma: High Dropout Rate in All-Comers. Clin Gastroenterol Hepatol 2022; 21:1581-1589. [PMID: 36038129 DOI: 10.1016/j.cgh.2022.08.023] [Citation(s) in RCA: 1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 07/26/2022] [Accepted: 08/16/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS The United Network for Organ Sharing (UNOS) grants priority listing for liver transplant for patients with hepatocellular carcinoma after successful down-staging to Milan criteria. We evaluated the national experience on down-staging by comparing 2 down-staging groups: tumor burden meeting UNOS down-staging (UNOS-DS) inclusion criteria, and all-comers (AC)-DS with initial tumor burden beyond UNOS-DS criteria vs patients always within Milan criteria. METHODS We performed a retrospective analysis of the UNOS database of 23,398 patients listed for liver transplant who had submitted a hepatocellular carcinoma Model for End-Stage Liver Disease exception application from 2010 to 2019, classified as always within Milan (n = 20,579), UNOS-DS (n = 2151), and AC-DS (n = 668). RESULTS The 2-year cumulative probabilities of dropout were 19% for Milan, 25% for UNOS-DS (P < .001), and 30% for AC-DS (P < .001). In multivariate analysis of the down-staging groups, factors predicting dropout included Model for End-Stage Liver Disease at listing (hazard ratio [HR], 1.06; P < .001) and initial total tumor diameter (HR, 1.04; P = .002). Compared with α-fetoprotein (AFP) level ≤20 ng/mL, AFP levels of 21 to 100, 101 to 1000, and greater than 1000 ng/mL were associated with a higher risk of dropout (HRs, 1.63, 2.06, and 4.58, respectively; P < .001). A subset of all-comers with AFP levels greater than 100 ng/mL had a 2-year probability of dropout of 52% vs 26% for all others beyond Milan criteria (P < .001). CONCLUSIONS All-comers had a significantly higher risk for waitlist dropout compared with the UNOS-DS and Milan groups after initial successful down-staging to Milan criteria. In particular, the subgroup of AC-DS with an AFP level greater than 100 ng/mL had a greater than 50% probability of dropout in the next 2 years. These observations suggest a high likelihood of failure when expanding the indications for down-staging.
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Affiliation(s)
- Annsa C Huang
- Division of Gastroenterology/Hepatology, Department of Medicine, University of California San Francisco, San Francisco, California
| | - Jennifer L Dodge
- Division of Gastroenterology, Department of Medicine, University of Southern California, Los Angeles, California; Department of Preventive Medicine, University of Southern California, Los Angeles, California
| | - Francis Y Yao
- Division of Gastroenterology/Hepatology, Department of Medicine, University of California San Francisco, San Francisco, California; Department of Surgery, University of California San Francisco, San Francisco, California
| | - Neil Mehta
- Division of Gastroenterology/Hepatology, Department of Medicine, University of California San Francisco, San Francisco, California.
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Huang AC, Mehta N, Dodge JL, Yao FY, Terrault NA. Direct-acting antivirals do not increase the risk of hepatocellular carcinoma recurrence after local-regional therapy or liver transplant waitlist dropout. Hepatology 2018; 68:449-461. [PMID: 29476694 PMCID: PMC6097892 DOI: 10.1002/hep.29855] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [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: 11/09/2017] [Revised: 01/03/2018] [Accepted: 02/02/2018] [Indexed: 02/06/2023]
Abstract
UNLABELLED Whether direct-acting antivirals (DAAs) increase the risk of hepatocellular carcinoma (HCC) recurrence after tumor-directed therapy is controversial. We sought to determine the impact of DAA therapy on HCC recurrence after local-regional therapy (LRT) and waitlist dropout among liver transplant (LT) candidates with HCC. We performed a retrospective cohort study of 149 LT candidates with hepatitis C virus (HCV) and HCC at a single center from 2014 through 2016. Cumulative incidence of HCC recurrence post-LRT and waitlist dropout was estimated by the DAA group. Factors associated with each outcome were evaluated using competing risks regression. A propensity score stabilized inverse probability weighting approach was used to account for differences in baseline characteristics between groups. The no DAA group (n = 87) had more severe cirrhosis and lower rates of complete radiologic tumor response after LRT than those treated with DAA (n = 62) but had similar alpha-fetoprotein and tumor burden at listing. Cumulative incidence of HCC recurrence within 1 year of complete response after LRT was 47.0% in the DAA group and 49.8% in the no DAA group (P = 0.93). In adjusted competing risk analysis using weighted propensity score modeling, risk of HCC recurrence was similar in the DAA group compared to those without DAA (hazard ratio [HR], 0.91; 95% confidence interval [CI], 0.58-1.42; P = 0.67). Patients treated with DAAs had lower risk of waitlist dropout due to tumor progression or death compared to the no DAA group in adjusted weighted analysis (HR, 0.30; 95% CI 0.13-0.69; P = 0.005). CONCLUSION In LT candidates with HCV and HCC with initial complete response to LRT, DAA use is not associated with increased risk of HCC recurrence but rather is associated with reduced risk of waitlist dropout due to tumor progression or death. (Hepatology 2018).
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Affiliation(s)
- Annsa C. Huang
- Department of Medicine, Division of Gastroenterology/Hepatology, University of California San Francisco, San Francisco, CA
| | - Neil Mehta
- Department of Medicine, Division of Gastroenterology/Hepatology, University of California San Francisco, San Francisco, CA
| | - Jennifer L. Dodge
- Department of Surgery, University of California San Francisco, San Francisco, CA
| | - Francis Y. Yao
- Department of Medicine, Division of Gastroenterology/Hepatology, University of California San Francisco, San Francisco, CA,Department of Surgery, University of California San Francisco, San Francisco, CA
| | - Norah A. Terrault
- Department of Medicine, Division of Gastroenterology/Hepatology, University of California San Francisco, San Francisco, CA,Department of Surgery, University of California San Francisco, San Francisco, CA
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Chien YH, Peng SF, Yang CC, Lee NC, Tsai LK, Huang AC, Su SC, Tseng CC, Hwu WL. Long-term efficacy of miglustat in paediatric patients with Niemann-Pick disease type C. J Inherit Metab Dis 2013; 36:129-37. [PMID: 22476655 DOI: 10.1007/s10545-012-9479-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2012] [Revised: 03/07/2012] [Accepted: 03/12/2012] [Indexed: 10/28/2022]
Abstract
Niemann-Pick disease type C (NP-C) is a rare inherited neurovisceral disease characterized by progressive neurological manifestations. Oral miglustat was first approved for the treatment of children and adults with NP-C in Europe in 2009. There are still relatively few published data on the long-term efficacy and safety of miglustat in patients with NP-C in clinical practice. We report the effects of up to 6 years of treatment with miglustat 100 mg t.i.d. in five children. Overall, 3/5 patients displayed progressive dysphagia before starting miglustat, and 4/5 showed marked cognitive and/or motor impairment. The mean age at treatment start was 11.6 years, and the median (range) duration of therapy so far is 4 (4.1 to 6.1) years. No treatment dose alterations were required, but therapy was interrupted for 1-3 months at least once in all patients due to supply issues. Swallowing function was stabilised during miglustat therapy, with no significant increase in Han dysphagia scale or aspiration-penetration index scores among four evaluable patients (p > 0.05). Scores on the mini-mental state examination indicated an improvement in cognitive function during the first 3-6 months of miglustat therapy, followed by stabilisation up to 5 years. Ambulatory function remained stable for at least the first 2 years of treatment in most patients, but there was a trend towards deterioration thereafter, possibly related to treatment interruptions. The safety/tolerability profile of miglustat was similar to previous clinical studies, although reports of gastrointestinal disturbances were rare. Overall, miglustat appeared to stabilise key parameters of neurological disease progression.
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Affiliation(s)
- Y H Chien
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
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Grünfeld JP, Hwu WL, Van Keimpema L, Alamovitch S, Zivna M, Brown EJ, Chien YH, Lee NC, Chiang SC, Dobrovolny R, Huang AC, Yeh HY, Chao MC, Lin SJ, Kitagawa T, Desnick RJ, Hsu LW, Nevens F, Vanslembrouck R, Van Oijen GH, Hoffmann AL, Dekker HM, De Man RA, Drenth JPH, Plaisier E, Favrole P, Prost C, Chen Z, Van Agrmael T, Marro B, Ronco P, Hulkova H, Matignon M, Hodanova K, Vylet'al P, Kalbacova M, Baresova V, Sikora J, Blazkova H, Zivny J, Ivanek R, Stranecky V, Sovova J, Claes K, Lerut E, Fryns JP, Hart PS, Hart TC, Adams JN, Pawtowski A, Clemessy M, Gasc JM, Gubler MC, Antignac C, Elleder M, Kapp K, Grimbert P, Bleyer AJ, Kmoch S, Schlöndorff JS, Becker DJ, Tsukaguchi H, Uschinski AL, Higgs HN, Henderson JM, Pollak MR. More on Clinical Renal GeneticsNewborn screening for Fabry disease in Taiwan reveals a high incidence of the later-onset mutation c.936+919G>A (IVS4+919G>A). Hum Mutat 30: 1397–1405, 2009Lanreotide reduces the volume of polycystic liver: A randomized, double-blind, placebo-controlled trial. Gastroenterology 137: 1661–1668, 2009Cerebrovascular disease related to COL4A1 mutations in HANAC syndrome. Neurology 73: 1873–1882, 2009Dominant renin gene mutations associated with early-onset hyperuricemia, anemia, and chronic renal failure. Am J Hum Genet 85: 204–213, 2009Mutations in the formin gene INF2 cause focal segmental glomerulosclerosis. Nat Genet 42: 72–76, 2009. Clin J Am Soc Nephrol 2010; 5:563-7. [DOI: 10.2215/cjn.01720210] [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: 11/23/2022]
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Hwu WL, Chien YH, Lee NC, Chiang SC, Dobrovolny R, Huang AC, Yeh HY, Chao MC, Lin SJ, Kitagawa T, Desnick RJ, Hsu LW. More on Clinical Renal Genetics. Clin J Am Soc Nephrol 2010. [DOI: 10.2215/01.cjn.0000927096.41084.77] [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: 03/29/2023]
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Abstract
Radiotherapy is the modality of choice for the treatment of nasopharyngeal carcinoma (NPC). However, systemic chemotherapy has recently been found to play an increasing role in the treatment of advanced or metastatic disease. The status of drug resistance gene expression that has crucial impact on chemotherapy has not been fully addressed for patients with NPC. In this study, we examined the expression of multidrug resistance 1 (MDR-1) and glutathione-S-transferase-Pi (GST-Pi) in primary, recurrent, and metastatic NPC using results of immunohistochemical examinations. The results were correlated with the expression of Epstein-Barr virus (EBV) latent protein, latent membrane protein 1 (LMP1), and clinicopathologic features, including stage, histopathologic types, and survival rates. MDR-1 protein expression was detected in 18 (12.6%) of 143 patients with primary NPC, 14 (32.6%) of 43 with recurrent NPC, and O (0%) of 20 with metastatic NPC, whereas 83 (58%) of 143 patients with primary NPC, 30 (69.8%) of 43 with recurrent NPC, and 13 (65%) of 20 with metastatic NPC expressed GST-Pi. EBV-LMP1 was expressed in 59 (41.3%) of 143 patients with primary NPC, 23 (53.5%) of 43 with recurrent NPC, and 9 (45%) of 20 with metastatic NPC. Simultaneous expression of MDR1 and GST-Pi was observed in 13 (72.2%) of 18 patients with primary NPC and 12 (85.7%) of 14 with recurrent NPC. The expression of LMP1 was detected in only 6 of the 13 patients with primary NPC and 6 of the 12 with recurrent NPC. We concluded that the expression of GST-Pi was more frequent in NPC tumor tissues than the expression of MDR-1. The expression of MDR-1 correlated with clinicopathologic features of primary NPC, including the histopathologic types and survival rates, but not with disease stage. The expression of GST-Pi did not correlate with clinicopathologic features. The expression of MDR-1 and GST-Pi did not correlate with expression of EBV-LMP1 for patients with NPC.
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Affiliation(s)
- C L Chen
- Department of Pathology, China Medical College Hospital, Taichung, Taiwan
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Chiang J, Huang YW, Chen ML, Wang SY, Huang AC, Chen YJ. Comparison of anti-leukemic immunity against U937 cells in endurance athletes versus sedentary controls. Int J Sports Med 2000; 21:602-7. [PMID: 11156283 DOI: 10.1055/s-2000-8477] [Citation(s) in RCA: 5] [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: 10/16/2022]
Abstract
To examine whether endurance athletes have higher anti-leukemic immunity than sedentary controls or not, we isolated peripheral blood mononuclear cells (MNC) from cyclists and sedentary controls to prepare conditioned media (CM) with various doses of phytohemagglutinin (PHA). The proliferation-inhibiting and differentiation-inducing activities of these PHA-MNC-CM on human leukemic U937 cells were investigated. Our results show that the growth inhibition activity of cyclists' PHA-MNC-CM were higher than that of controls. The dosage of PHA used to prepare MNC-CM to achieve about 90% growth inhibition was 5 microg/ml in the control group and was 2 microg/ml in the athletes group. The differentiation-inducing effects were evaluated by morphological scoring, superoxide production, and monocyte-associated antigen expression (CD14 and CD68). These three parameters all demonstrated the differentiation-inducing effect of MNC-CM increased with increasing dose of PHA. These effects were significantly greater in the athletic when compared to the sedentary control group at all doses of PHA. The levels of TNF-alpha and IFN-gamma PHA-MNC-CM increased in a PHA dose-dependent manner and were much higher in the athletic group when compared to the controls. We conclude that the capacity of endurance athletes to activate anti-leukemic immunity is significantly higher than that of sedentary controls.
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Affiliation(s)
- J Chiang
- Graduate Institute of Sport Coaching Science, Chinese Culture University, Taipei, Taiwan
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Haugh JM, Huang AC, Wiley HS, Wells A, Lauffenburger DA. Internalized epidermal growth factor receptors participate in the activation of p21(ras) in fibroblasts. J Biol Chem 1999; 274:34350-60. [PMID: 10567412 DOI: 10.1074/jbc.274.48.34350] [Citation(s) in RCA: 122] [Impact Index Per Article: 4.9] [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: 11/06/2022] Open
Abstract
Regulated activation of the highly conserved Ras GTPase is a central event in the stimulation of cell proliferation, motility, and differentiation elicited by receptor tyrosine kinases, such as the epidermal growth factor receptor (EGFR). In fibroblasts, this involves formation and membrane localization of Shc.Grb2.Sos complexes, which increases the rate of Ras guanine nucleotide exchange. In order to control Ras-mediated cell responses, this activity is regulated by receptor down-regulation and a feedback loop involving the dual specificity kinase mitogen-activated protein kinase/extracellular signal-regulated kinase kinase (MEK). We investigated the role of EGFR endocytosis in the regulation of Ras activation. Of fundamental interest is whether activated receptors in endosomes can participate in the stimulation of Ras guanine nucleotide exchange, because the constitutive membrane localization of Ras may affect its compartmentalization. By exploiting the differences in postendocytic signaling of two EGFR ligands, epidermal growth factor and transforming growth factor-alpha, we found that activated EGFR located at the cell surface and in internal compartments contribute equally to the membrane recruitment and tyrosine phosphorylation of Shc in NR6 fibroblasts expressing wild-type EGFR. Importantly, both the rate of Ras-specific guanine nucleotide exchange and the level of Ras-GTP were depressed to near basal values on the time scale of receptor trafficking. Using the selective MEK inhibitor PD098059, we were able to block the feedback desensitization pathway and maintain activation of Ras. Under these conditions, the generation of Ras-GTP was not significantly affected by the subcellular location of activated EGFR. In conjunction with our previous analysis of the phospholipase C pathway in the same cell line, this suggests a selective continuation of specific signaling activities and cessation of others upon receptor endocytosis.
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Affiliation(s)
- J M Haugh
- Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
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Abstract
Topical nicotinamide (niacinamide) has demonstrable preventive activity against photocarcinogenesis in mice. To better understand how this vitamin prevents ultraviolet (UV) carcinogenesis, we tested systemic administration of another form of the vitamin, niacin, and its capacity to elevate cutaneous nicotinamide-adenine dinucleotide (NAD) content as well as to decrease photoimmunosuppression and photocarcinogenesis. BALB/cAnNTacfBR mice were fed the AIN-76A diet supplemented with 0%, 0.1%, 0.5%, or 1.0% niacin throughout the experiment. UV irradiation consisted of five 30-minute exposures per week to banks of six FS40 Westinghouse sunlamps for 22 weeks in the carcinogenesis experiments, yielding a total cumulative dose of approximately 1.41 x 10(6) Jm-2 of UV-B radiation. Dietary supplementation with 0.1%, 0.5%, or 1.0% niacin reduced the control incidence of skin cancer from 68% to 60%, 48%, and 28%, respectively, at 26.5 weeks after the first UV treatment. Two potential mechanisms by which niacin prevents tumor formation were identified. Photoimmunosuppression, critical for photocarcinogenesis, is measured by a passive transfer assay. Syngeneic, antigenic tumor challenges grew to an average of 91.6 +/- 19.7, 79.8 +/- 11.5, 41.9 +/- 11.7, or 13.2 +/- 4.1 mm2 in naive recipients of splenocytes from UV-irradiated mice treated with 0%, 0.1%, 0.5%, or 1.0% niacin supplementation, respectively, demonstrating niacin prevention of immunosuppression. Niacin supplementation elevated skin NAD content, which is known to modulate the function of DNA strand scission surveillance proteins p53 and poly(ADP-ribose) polymerase, two proteins critical in cellular responses to UV-induced DNA damage. These results clearly demonstrate a dose-dependent preventive effect of oral niacin on photocarcinogenesis and photoimmunosuppression and establish the capacity of oral niacin to elevate skin NAD levels.
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Affiliation(s)
- H L Gensler
- Arizona Cancer Center, Department of Radiation Oncology, University of Arizona College of Medicine, Tucson 85724, USA
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Jacobson EL, Shieh WM, Huang AC. Mapping the role of NAD metabolism in prevention and treatment of carcinogenesis. Mol Cell Biochem 1999; 193:69-74. [PMID: 10331640] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Studies presented here show that cellular NAD, which we hypothesize to be the relevant biomarker of niacin status, is significantly lower in humans than in the commonly studied animal models of carcinogenesis. We show that nicotinamide and the resulting cellular NAD concentration modulate expression of the tumor suppressor protein, p53, in human breast, skin, and lung cells. Studies to determine the optimal NAD concentrations for responding to DNA damage in breast epithelial cells reveal that DNA damage appears to stimulate NAD biosynthesis and that recovery from DNA damage occurs several hours earlier in the presence of higher NAD or in cells undergoing active NAD biosynthesis. Finally, analyses of normal human skin tissue from individuals diagnosed with actinic keratoses or squamous cell carcinomas show that NAD content of the skin is inversely correlated with the malignant phenotype. Since NAD is important in modulating ADP-ribose polymer metabolism, cyclic ADP-ribose synthesis, and stress response proteins, such as p53, following DNA damage, understanding how NAD metabolism is regulated in the human has important implications in developing both prevention and treatment strategies in carcinogenesis.
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Affiliation(s)
- E L Jacobson
- Department of Clinical Sciences, University of Kentucky, Lexington 40506-0286, USA
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Shau H, Huang AC, Faris M, Nazarian R, de Vellis J, Chen W. Thioredoxin peroxidase (natural killer enhancing factor) regulation of activator protein-1 function in endothelial cells. Biochem Biophys Res Commun 1998; 249:683-6. [PMID: 9731197 DOI: 10.1006/bbrc.1998.9129] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Thioredoxin peroxidase-1 (TxP-1), originally cloned as natural killer enhancing factor-B, belongs to a highly conserved antioxidant family. Tumor necrosis factor-alpha (TNF) activates the expression of activator protein-1 (AP-1) responsive genes. We show here that over-expression of TxP-1 blocks TNF-induced AP-1 activation in endothelial ECV304 cells, which was demonstrated by three independent experimental protocols: electromobility shift assay with AP-1 oligonucleotide probe; reporter gene expression with AP-1 binding site, and interleukin-8 production, which is dependent on AP-1. These results are consistent with the role of TxP-1 as an antioxidant and the previous reports that TNF-induced reactive oxygen species were responsible for AP-1 activation.
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Affiliation(s)
- H Shau
- Division of Surgical Oncology, UCLA School of Medicine 90095, USA.
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Abstract
The antiallergic activities of synthetic acrophylline [1] and acrophyllidine [2] have been demonstrated. Both compounds 1 and 2 at 30 mumol/kg reduced the plasma leakage in mouse ear in a passive cutaneous anaphylactic (PCA) reaction. In addition, compound 1 suppressed mast cell degranulation in a dose-dependent manner, while compound 2 at 100 microM produced no significant inhibition of the release of preformed inflammatory mediators. These results suggest that the antiallergic effect of compound 1 probably occurs through the suppression of mast cell degranulation, and that of compound 2 by protection of the vasculature against challenge by mediators of inflammation.
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Affiliation(s)
- A C Huang
- Graduate Institute of Pharmaceutical Chemistry, China Medical College, Taichung, Taiwan
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