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Hayashi T, Tateishi K, Matsuyama S, Iwashita H, Miyake Y, Oshima A, Honma H, Sasame J, Takabayashi K, Sugino K, Hirata E, Udaka N, Matsushita Y, Kato I, Hayashi H, Nakamura T, Ikegaya N, Takayama Y, Sonoda M, Oka C, Sato M, Isoda M, Kato M, Uchiyama K, Tanaka T, Muramatsu T, Miyake S, Suzuki R, Takadera M, Tatezuki J, Ayabe J, Suenaga J, Matsunaga S, Miyahara K, Manaka H, Murata H, Yokoyama T, Tanaka Y, Shuto T, Ichimura K, Kato S, Yamanaka S, Cahill DP, Fujii S, Shankar GM, Yamamoto T. Intraoperative Integrated Diagnostic System for Malignant Central Nervous System Tumors. Clin Cancer Res 2024; 30:116-126. [PMID: 37851071 DOI: 10.1158/1078-0432.ccr-23-1660] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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] [Received: 06/07/2023] [Revised: 08/19/2023] [Accepted: 10/16/2023] [Indexed: 10/19/2023]
Abstract
PURPOSE The 2021 World Health Organization (WHO) classification of central nervous system (CNS) tumors uses an integrated approach involving histopathology and molecular profiling. Because majority of adult malignant brain tumors are gliomas and primary CNS lymphomas (PCNSL), rapid differentiation of these diseases is required for therapeutic decisions. In addition, diffuse gliomas require molecular information on single-nucleotide variants (SNV), such as IDH1/2. Here, we report an intraoperative integrated diagnostic (i-ID) system to classify CNS malignant tumors, which updates legacy frozen-section (FS) diagnosis through incorporation of a qPCR-based genotyping assay. EXPERIMENTAL DESIGN FS evaluation, including GFAP and CD20 rapid IHC, was performed on adult malignant CNS tumors. PCNSL was diagnosed through positive CD20 and negative GFAP immunostaining. For suspected glioma, genotyping for IDH1/2, TERT SNV, and CDKN2A copy-number alteration was routinely performed, whereas H3F3A and BRAF SNV were assessed for selected cases. i-ID was determined on the basis of the 2021 WHO classification and compared with the permanent integrated diagnosis (p-ID) to assess its reliability. RESULTS After retrospectively analyzing 153 cases, 101 cases were prospectively examined using the i-ID system. Assessment of IDH1/2, TERT, H3F3AK27M, BRAFV600E, and CDKN2A alterations with i-ID and permanent genomic analysis was concordant in 100%, 100%, 100%, 100%, and 96.4%, respectively. Combination with FS and intraoperative genotyping assay improved diagnostic accuracy in gliomas. Overall, i-ID matched with p-ID in 80/82 (97.6%) patients with glioma and 18/19 (94.7%) with PCNSL. CONCLUSIONS The i-ID system provides reliable integrated diagnosis of adult malignant CNS tumors.
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Affiliation(s)
- Takahiro Hayashi
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Kensuke Tateishi
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
- Laboratory of Biopharmaceutical and Regenerative Science, Graduate School of Medical Science, Yokohama City University, Yokohama, Japan
| | - Shinichiro Matsuyama
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Hiromichi Iwashita
- Department of Pathology, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Yohei Miyake
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Akito Oshima
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Hirokuni Honma
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Jo Sasame
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Katsuhiro Takabayashi
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Kyoka Sugino
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
- Laboratory of Biopharmaceutical and Regenerative Science, Graduate School of Medical Science, Yokohama City University, Yokohama, Japan
| | - Emi Hirata
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Naoko Udaka
- Department of Diagnostic Pathology, Yokohama City University Hospital, Yokohama, Japan
| | - Yuko Matsushita
- Department of Brain Disease Translational Research, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Ikuma Kato
- Department of Molecular Pathology, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Hiroaki Hayashi
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
- Department of Pediatrics, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Taishi Nakamura
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
- Department of Neurosurgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Naoki Ikegaya
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Yutaro Takayama
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Masaki Sonoda
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Chihiro Oka
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Mitsuru Sato
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Masataka Isoda
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Miyui Kato
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
- Laboratory of Biopharmaceutical and Regenerative Science, Graduate School of Medical Science, Yokohama City University, Yokohama, Japan
| | - Kaho Uchiyama
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
- Laboratory of Biopharmaceutical and Regenerative Science, Graduate School of Medical Science, Yokohama City University, Yokohama, Japan
| | - Tamon Tanaka
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Toshiki Muramatsu
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Shigeta Miyake
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Ryosuke Suzuki
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Department of Neurosurgery, Odawara Municipal Hospital, Odawara, Japan
| | - Mutsumi Takadera
- Department of Neurosurgery, Yokohama City Minato Red Cross Hospital, Yokohama, Japan
- Department of Neurosurgery, Yokosuka Kyosai Hospital, Yokosuka, Japan
| | - Junya Tatezuki
- Department of Neurosurgery, Yokohama City Minato Red Cross Hospital, Yokohama, Japan
| | - Junichi Ayabe
- Department of Neurosurgery, Yokosuka Kyosai Hospital, Yokosuka, Japan
| | - Jun Suenaga
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Shigeo Matsunaga
- Department of Neurosurgery, Yokohama Rosai Hospital, Yokohama, Japan
| | - Kosuke Miyahara
- Department of Neurosurgery, National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - Hiroshi Manaka
- Department of Neurosurgery, Yokohama Minami Kyosai Hospital, Yokohama, Japan
| | - Hidetoshi Murata
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | | | - Yoshihide Tanaka
- Department of Neurosurgery, Yokosuka Kyosai Hospital, Yokosuka, Japan
| | - Takashi Shuto
- Department of Neurosurgery, Yokohama Rosai Hospital, Yokohama, Japan
| | - Koichi Ichimura
- Department of Brain Disease Translational Research, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Shingo Kato
- Department of Clinical Cancer Genomics, Yokohama City University, Yokohama, Japan
| | - Shoji Yamanaka
- Department of Diagnostic Pathology, Yokohama City University Hospital, Yokohama, Japan
| | - Daniel P Cahill
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Satoshi Fujii
- Department of Diagnostic Pathology, Yokohama City University Hospital, Yokohama, Japan
- Department of Molecular Pathology, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Ganesh M Shankar
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Tetsuya Yamamoto
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
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Ikegaya N, Hayashi T, Higashijima T, Takayama Y, Sonoda M, Iwasaki M, Miyake Y, Sato M, Tateishi K, Suenaga J, Yamamoto T. Arteries Around the Superior Limiting Sulcus: Motor Complication Avoidance in Insular and Insulo-Opercular Surgery. Oper Neurosurg (Hagerstown) 2023; 25:e308-e314. [PMID: 37966479 DOI: 10.1227/ons.0000000000000879] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/21/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Insulo-opercular surgery can cause ischemic motor complications. A source of this is the arteries around the superior limiting sulcus (SLS), which reach the corona radiata, but the detailed anatomy remains unclear. To characterize arteries around the SLS including the long insular arteries (LIAs) and long medullary arteries, we classified them and examined their distribution in relation to the SLS, which helps reduce the risk of ischemia. METHODS Twenty adult cadaveric hemispheres were studied. Coronal brain slices were created perpendicular to the SLS representing insular gyri (anterior short, middle short, posterior short, anterior long, and posterior long). The arteries within 10-mm proximity of the SLS that reached the corona radiata were excavated and classified by the entry point. RESULTS A total of 122 arteries were identified. Sixty-three (52%), 20 (16%), and 39 (32%) arteries penetrated the insula (LIAs), peak of the SLS, and operculum (long medullary arteries), respectively. 100 and six (87%) arteries penetrated within 5 mm of the peak of the SLS. The arteries were distributed in the anterior short gyrus (19%), middle short gyrus (17%), posterior short gyrus (20%), anterior long gyrus (19%), and posterior long gyrus (25%). Seven arteries (5.7%) had anastomoses after they penetrated the parenchyma. CONCLUSION Approximately 90% of the arteries that entered the parenchyma and reached the corona radiata were within a 5-mm radius of the SLS in both the insula and operculum side. This suggests that using the SLS as a landmark during insulo-opercular surgery can decrease the chance of ischemia.
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Affiliation(s)
- Naoki Ikegaya
- Department of Neurosurgery, Yokohama City University Graduate school of medicine, Yokohama , Japan
| | - Takahiro Hayashi
- Department of Neurosurgery, Yokohama City University Graduate school of medicine, Yokohama , Japan
| | - Takefumi Higashijima
- Department of Neurosurgery, Yokohama City University Medical center, Yokohama , Japan
| | - Yutaro Takayama
- Department of Neurosurgery, Yokohama City University Graduate school of medicine, Yokohama , Japan
| | - Masaki Sonoda
- Department of Neurosurgery, Yokohama City University Graduate school of medicine, Yokohama , Japan
| | - Masaki Iwasaki
- Department of Neurosurgery, National Center Hospital, National Center of Neurology and Psychiatry (NCNP), Kodaira , Japan
| | - Yohei Miyake
- Department of Neurosurgery, Yokohama City University Graduate school of medicine, Yokohama , Japan
| | - Mitsuru Sato
- Department of Neurosurgery, Yokohama City University Graduate school of medicine, Yokohama , Japan
| | - Kensuke Tateishi
- Department of Neurosurgery, Yokohama City University Graduate school of medicine, Yokohama , Japan
| | - Jun Suenaga
- Department of Neurosurgery, Yokohama City University Graduate school of medicine, Yokohama , Japan
| | - Tetsuya Yamamoto
- Department of Neurosurgery, Yokohama City University Graduate school of medicine, Yokohama , Japan
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Araki T, Kanda S, Ide T, Sonehara K, Komatsu M, Tateishi K, Minagawa T, Kiniwa Y, Kawakami S, Nomura S, Okuyama R, Hanaoka M, Koizumi T. Antiplatelet drugs may increase the risk for checkpoint inhibitor-related pneumonitis in advanced cancer patients. ESMO Open 2023; 8:102030. [PMID: 37852033 PMCID: PMC10774871 DOI: 10.1016/j.esmoop.2023.102030] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 07/31/2023] [Accepted: 09/20/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Immune checkpoint inhibitors (ICIs) are indicated for various cancers and are the mainstay of cancer immunotherapy. They are often associated with ICI-related pneumonitis (CIP), however, hindering a favorable clinical course. Recently, non-oncology concomitant drugs have been reported to affect the efficacy and toxicity of ICIs; however, the association between these drugs and the risk for CIP is uncertain. The aim of this study was to assess the impact of baseline concomitant drugs on CIP incidence in ICI-treated advanced cancer patients. PATIENTS AND METHODS This was a single-center retrospective study that included a cohort of 511 patients with advanced cancer (melanoma and non-small-cell lung, head and neck, genitourinary, and other types of cancer) treated with ICIs. Univariable analysis was conducted to identify baseline co-medications associated with CIP incidence. A propensity score matching analysis was used to adjust for potential CIP risk factors, and multivariable analysis was carried out to assess the impact of the identified co-medications on CIP risk. RESULTS Forty-seven (9.2%) patients developed CIP. In these patients, the organizing pneumonia pattern was the dominant radiological phenotype, and 42.6% had grade ≥3 CIP, including one patient with grade 5. Of the investigated baseline co-medications, the proportion of antiplatelet drugs (n = 50, 9.8%) was higher in patients with CIP (23.4% versus 8.4%). After propensity score matching, the CIP incidence was higher in patients with baseline antiplatelet drugs (22% versus 6%). Finally, baseline antiplatelet drug use was demonstrated to increase the risk for CIP incidence regardless of cancer type (hazard ratio, 3.46; 95% confidence interval 1.21-9.86). CONCLUSIONS An association between concomitant antiplatelet drug use at baseline and an increased risk for CIP was seen in our database. This implies the importance of assessing concomitant medications for CIP risk management.
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Affiliation(s)
- T Araki
- First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - S Kanda
- Department of Hematology and Medical Oncology, Shinshu University School of Medicine, Matsumoto, Japan.
| | - T Ide
- Department of Pharmacy, Shinshu University School of Medicine, Matsumoto, Japan
| | - K Sonehara
- First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - M Komatsu
- First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - K Tateishi
- First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - T Minagawa
- Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Y Kiniwa
- Department of Dermatology, Shinshu University School of Medicine, Matsumoto, Japan
| | - S Kawakami
- Department of Radiology, Shinshu University School of Medicine, Matsumoto, Japan
| | - S Nomura
- Department of Biostatistics and Bioinformatics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - R Okuyama
- Department of Dermatology, Shinshu University School of Medicine, Matsumoto, Japan
| | - M Hanaoka
- First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - T Koizumi
- Department of Hematology and Medical Oncology, Shinshu University School of Medicine, Matsumoto, Japan
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Tateishi K, Miyake Y, Nakamura T, Iwashita H, Hayashi T, Oshima A, Honma H, Hayashi H, Sugino K, Kato M, Satomi K, Fujii S, Komori T, Yamamoto T, Cahill DP, Wakimoto H. Genetic alterations that deregulate RB and PDGFRA signaling pathways drive tumor progression in IDH2-mutant astrocytoma. Acta Neuropathol Commun 2023; 11:186. [PMID: 38012788 PMCID: PMC10680361 DOI: 10.1186/s40478-023-01683-x] [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: 08/18/2023] [Accepted: 11/02/2023] [Indexed: 11/29/2023] Open
Abstract
In IDH-mutant astrocytoma, IDH2 mutation is quite rare and biological mechanisms underlying tumor progression in IDH2-mutant astrocytoma remain elusive. Here, we report a unique case of IDH2 mutant astrocytoma, CNS WHO grade 3 that developed tumor progression. We performed a comprehensive genomic and epigenomic analysis for primary and recurrent tumors and found that both tumors harbored recurrent IDH2R172K and TP53R248W mutation with CDKN2A/B hemizygous deletion. We also found amplifications of CDK4 and MDM2 with PDGFRA gain in the recurrent tumor and upregulated protein expressions of these genes. We further developed, for the first time, a xenograft mouse model of IDH2R172K and TP53R248W mutant astrocytoma from the recurrent tumor, but not from the primary tumor. Consistent with parent recurrent tumor cells, amplifications of CDK4 and MDM2 and PDGFRA gain were found, while CDKN2A/B was identified as homozygous deletion in the xenografts, qualifying for integrated diagnosis of astrocytoma, IDH2-mutant, CNS WHO grade 4. Cell viability assay found that CDK4/6 inhibitor and PDGFR inhibitor potently decreased cell viability in recurrent tumor cells, as compared to primary tumor cells. These findings suggest that gene alterations that activate retinoblastoma (RB) signaling pathways and PDGFR may drive tumor progression and xenograft formation in IDH2-mutant astrocytoma, which is equivalent to progressive IDH1-mutant astrocytoma. Also, our findings suggest that these genomic alterations may represent therapeutic targets in IDH2-mutant astrocytoma.
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Affiliation(s)
- Kensuke Tateishi
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa, Yokohama, 2360004, Japan.
- Laboratory of Biopharmaceutical and Regenerative Science, Graduate School of Medical Science, Yokohama City University, Yokohama, Japan.
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan.
| | - Yohei Miyake
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa, Yokohama, 2360004, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Taishi Nakamura
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa, Yokohama, 2360004, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Hiromichi Iwashita
- Department of Pathology, Yokohama City University Hospital, Yokohama, Japan
- Department of Diagnostic Pathology, Yokohama City University Hospital, Yokohama, Japan
| | - Takahiro Hayashi
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa, Yokohama, 2360004, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Akito Oshima
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa, Yokohama, 2360004, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Hirokuni Honma
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa, Yokohama, 2360004, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Hiroaki Hayashi
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
- Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Kyoka Sugino
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa, Yokohama, 2360004, Japan
- Laboratory of Biopharmaceutical and Regenerative Science, Graduate School of Medical Science, Yokohama City University, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Miyui Kato
- Laboratory of Biopharmaceutical and Regenerative Science, Graduate School of Medical Science, Yokohama City University, Yokohama, Japan
- Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Kaishi Satomi
- Department of Pathology, Kyorin University School of Medicine, Tokyo, Japan
| | - Satoshi Fujii
- Department of Diagnostic Pathology, Yokohama City University Hospital, Yokohama, Japan
- Department of Molecular Pathology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Takashi Komori
- Department of Laboratory Medicine and Pathology (Neuropathology), Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
| | - Tetsuya Yamamoto
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa, Yokohama, 2360004, Japan
| | - Daniel P Cahill
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA
- Translational-Neurooncology Laboratory, Brain Tumor Research Center, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Hiroaki Wakimoto
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA
- Translational-Neurooncology Laboratory, Brain Tumor Research Center, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
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Iida Y, Suenaga J, Shimizu N, Shizawa K, Suzuki R, Miyake S, Akimoto T, Hori S, Tateishi K, Nakai Y, Yamamoto T. Transvenous embolization for an intraosseous clival arteriovenous fistula via a proper access route guiding a three-dimensional fusion image: illustrative case. J Neurosurg Case Lessons 2023; 6:CASE23492. [PMID: 37903421 PMCID: PMC10618065 DOI: 10.3171/case23492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 09/27/2023] [Indexed: 11/01/2023]
Abstract
BACKGROUND Intraosseous clival arteriovenous fistulas (AVFs), in which the shunt drains extracranially from the posterior and anterior condylar veins rather than from the cavernous sinus (CS), are rare. Targeting embolization of an intraosseous clival AVF is challenging because of its complex venous and skull base anatomy; therefore, a therapeutic strategy based on detailed preoperative radiological findings is required to achieve a favorable outcome. Here, the authors report the successful targeted embolization of an intraosseous clival AVF using an ingenious access route. OBSERVATIONS A 74-year-old woman presented with left-sided visual impairment, oculomotor nerve palsy, and right facial pain. A fusion image of three-dimensional rotational angiography and cone-beam computed tomography revealed a left CS dural AVF and a right intraosseous clival AVF. The shunt flow of the clival AVF drained extracranially from the posterior and anterior condylar veins via the intraosseous venous route. Transvenous embolization was performed by devising suboccipital, posterior condylar, and intraosseous access routes. The symptoms resolved after the bilateral AVFs were treated. LESSONS Accurate diagnosis and proper transvenous access based on detailed intraosseous and craniocervical venous information obtained from advanced imaging modalities are key to resolving intraosseous clival AVF.
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Wu D, Liu D, Tateishi K, Qi F, Yang F, Ke C, You H. Understanding the molecular pathogenesis of primary central nervous system lymphoma by experimental animal models. J Cell Physiol 2023; 238:2191-2205. [PMID: 37642377 DOI: 10.1002/jcp.31107] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 08/02/2023] [Accepted: 08/11/2023] [Indexed: 08/31/2023]
Abstract
Primary central nervous system lymphoma (PCNSL) is a rare and invasive diffuse large B cell lymphoma confined in central nervous system (CNS). The effort to press forward the translational progress has been frustrated by the insufficient understanding of immunophenotype of CNS and tumor genetic alterations of PCNSL, and the lack of validated diagnostic biomarkers. Researchers now have a variety of PCNSL animal models at their disposal that resemble the morphology and immunophenotype of PCNSL, however, a careful and detailed re-examination of these animal models is needed to clarify the differences in genetic alterations, migration capability, and immune status. In this review, we present the knowledge about the phenotypic and genotypic features of PCNSL tumor cells, and compile the preclinical animal models of PCNSL with regard to various injection sites, cell origins, recipient animals, and immune status, and elaborate on the tropism and migration of tumor cells and novel therapeutic strategies for PCNSL. We envisage that the selection of suitable animal models will serve as a well-defined preclinical system to understand the molecular pathogenesis of PCNSL, thereby galvanizing the development of novel and potent therapeutic approaches.
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Affiliation(s)
- Di Wu
- Department of Basic Medicine, School of Medicine, Foshan University, Foshan, Guangdong, China
| | - Dahai Liu
- Department of Basic Medicine, School of Medicine, Foshan University, Foshan, Guangdong, China
| | - Kensuke Tateishi
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Fei Qi
- Department of Pulmonary and Critical Care Medicine, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Fang Yang
- Department of Basic Medicine, School of Medicine, Foshan University, Foshan, Guangdong, China
| | - Chao Ke
- State Key Laboratory of Oncology in South China, Department of Neurosurgery and Neuro-oncology, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Hua You
- Laboratory for Excellence in Systems Biomedicine of Pediatric Oncology, Department of Pediatric Hematology and Oncology, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
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7
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Yang H, Xun Y, Ke C, Tateishi K, You H. Extranodal lymphoma: pathogenesis, diagnosis and treatment. Mol Biomed 2023; 4:29. [PMID: 37718386 PMCID: PMC10505605 DOI: 10.1186/s43556-023-00141-3] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 08/18/2023] [Indexed: 09/19/2023] Open
Abstract
Approximately 30% of lymphomas occur outside the lymph nodes, spleen, or bone marrow, and the incidence of extranodal lymphoma has been rising in the past decade. While traditional chemotherapy and radiation therapy can improve survival outcomes for certain patients, the prognosis for extranodal lymphoma patients remains unsatisfactory. Extranodal lymphomas in different anatomical sites often have distinct cellular origins, pathogenic mechanisms, and clinical manifestations, significantly influencing their diagnosis and treatment. Therefore, it is necessary to provide a comprehensive summary of the pathogenesis, diagnosis, and treatment progress of extranodal lymphoma overall and specifically for different anatomical sites. This review summarizes the current progress in the common key signaling pathways in the development of extranodal lymphomas and intervention therapy. Furthermore, it provides insights into the pathogenesis, diagnosis, and treatment strategies of common extranodal lymphomas, including gastric mucosa-associated lymphoid tissue (MALT) lymphoma, mycosis fungoides (MF), natural killer/T-cell lymphoma (nasal type, NKTCL-NT), and primary central nervous system lymphoma (PCNSL). Additionally, as PCNSL is one of the extranodal lymphomas with the worst prognosis, this review specifically summarizes prognostic indicators and discusses the challenges and opportunities related to its clinical applications. The aim of this review is to assist clinical physicians and researchers in understanding the current status of extranodal lymphomas, enabling them to make informed clinical decisions that contribute to improving patient prognosis.
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Affiliation(s)
- Hua Yang
- Department of Basic Medicine and Biomedical Engineering, School of Medicine, Foshan University, Foshan, 528000, China
| | - Yang Xun
- Department of Basic Medicine and Biomedical Engineering, School of Medicine, Foshan University, Foshan, 528000, China
| | - Chao Ke
- Department of Neurosurgery and Neuro-Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
| | - Kensuke Tateishi
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, 2360004, Japan
| | - Hua You
- Laboratory for Excellence in Systems Biomedicine of Pediatric Oncology, Department of Pediatric Hematology and Oncology, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, 401122, China.
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8
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Hayashi H, Iwashita H, Tateishi K. [Circumscribed Astrocytic Gliomas]. No Shinkei Geka 2023; 51:884-891. [PMID: 37743340 DOI: 10.11477/mf.1436204830] [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] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
In the fifth edition central nervous system tumours volume of the WHO Classification of Tumours series, gliomas, glioneuronal tumors, and neuronal tumors are divided into six groups. The term "circumscribed" is used to refer to a relatively contained growth pattern, as compared to other inherently "diffuse" tumors. Circumscribed astrocytic gliomas include six types: pilocytic astrocytoma, high-grade astrocytoma with piloid features, pleomorphic xanthoastrocytoma, subependymal giant cell astrocytoma, chordoid glioma, and astroblastoma, MN1-altered. The vast majority of circumscribed astrocytic gliomas harbor genetic alterations in the mitogen-activated protein kinase pathway. Here, we review the circumscribed astrocytic gliomas, including etiology, clinical and imaging features, pathology and molecular genetics, treatment, and prognosis. This study will lead to better understanding of these newly classified tumors.
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Affiliation(s)
- Hiroaki Hayashi
- Department of Pediatrics, Yokohama City University Graduate School of Medicine
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9
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Nakata S, Murai J, Okada M, Takahashi H, Findlay TH, Malebranche K, Parthasarathy A, Miyashita S, Gabdulkhaev R, Benkimoun I, Druillennec S, Chabi S, Hawkins E, Miyahara H, Tateishi K, Yamashita S, Yamada S, Saito T, On J, Watanabe J, Tsukamoto Y, Yoshimura J, Oishi M, Nakano T, Imamura M, Imai C, Yamamoto T, Takeshima H, Sasaki AT, Rodriguez FJ, Nobusawa S, Varlet P, Pouponnot C, Osuka S, Pommier Y, Kakita A, Fujii Y, Raabe EH, Eberhart CG, Natsumeda M. Epigenetic upregulation of Schlafen11 renders
WNT- and SHH-activated medulloblastomas sensitive to cisplatin. Neuro Oncol 2023; 25:899-912. [PMID: 36273330 PMCID: PMC10158119 DOI: 10.1093/neuonc/noac243] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 07/07/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Intensive chemotherapeutic regimens with craniospinal irradiation have greatly improved survival in medulloblastoma patients. However, survival markedly differs among molecular subgroups and their biomarkers are unknown. Through unbiased screening, we found Schlafen family member 11 (SLFN11), which is known to improve response to DNA damaging agents in various cancers, to be one of the top prognostic markers in medulloblastomas. Hence, we explored the expression and functions of SLFN11 in medulloblastoma. METHODS SLFN11 expression for each subgroup was assessed by immunohistochemistry in 98 medulloblastoma patient samples and by analyzing transcriptomic databases. We genetically or epigenetically modulated SLFN11 expression in medulloblastoma cell lines and determined cytotoxic response to the DNA damaging agents cisplatin and topoisomerase I inhibitor SN-38 in vitro and in vivo. RESULTS High SLFN11 expressing cases exhibited significantly longer survival than low expressing cases. SLFN11 was highly expressed in the WNT-activated subgroup and in a proportion of the SHH-activated subgroup. While WNT activation was not a direct cause of the high expression of SLFN11, a specific hypomethylation locus on the SLFN11 promoter was significantly correlated with high SLFN11 expression. Overexpression or deletion of SLFN11 made medulloblastoma cells sensitive and resistant to cisplatin and SN-38, respectively. Pharmacological upregulation of SLFN11 by the brain-penetrant histone deacetylase-inhibitor RG2833 markedly increased sensitivity to cisplatin and SN-38 in SLFN11-negative medulloblastoma cells. Intracranial xenograft studies also showed marked sensitivity to cisplatin by SLFN11-overexpression in medulloblastoma cells. CONCLUSIONS High SLFN11 expression is one factor which renders favorable outcomes in WNT-activated and a subset of SHH-activated medulloblastoma possibly through enhancing response to cisplatin.
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Affiliation(s)
- Satoshi Nakata
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Neurosurgery, Gunma University, Maebashi, Japan
| | - Junko Murai
- Institute for Advanced Biosciences, Keio University, Tsuruoka, Japan
| | - Masayasu Okada
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
| | - Haruhiko Takahashi
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
- Division of Neurosurgery, Department of Clinical Neuroscience, Faculty of Medicine University of Miyazaki, Miyazaki, Japan
| | - Tyler H Findlay
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Kristen Malebranche
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Akhila Parthasarathy
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Satoshi Miyashita
- Department of System Pathology for Neurological Disorders, Brain Research Institute, Niigata University, Niigata, Japan
| | - Ramil Gabdulkhaev
- Department of Pathology, Brain Research Institute Niigata University, Niigata, Japan
| | - Ilan Benkimoun
- Department of Neuropathology, GHU Paris-Psychiatrie Et Neurosciences, Sainte-Anne Hospital, Paris, France
| | - Sabine Druillennec
- Institut Curie, Centre de Recherche, F-91405, Orsay, France
- INSERM U1021, Centre Universitaire, F-91405, Orsay, France
- CNRS UMR 3347, Centre Universitaire, F-91405, Orsay, France
- Université Paris-Saclay, F-91405, Orsay, France
- Equipe Labellisée Ligue Nationale Contre le Cancer, F-91405, Orsay, France
| | - Sara Chabi
- Institut Curie, Centre de Recherche, F-91405, Orsay, France
- INSERM U1021, Centre Universitaire, F-91405, Orsay, France
- CNRS UMR 3347, Centre Universitaire, F-91405, Orsay, France
- Université Paris-Saclay, F-91405, Orsay, France
- Equipe Labellisée Ligue Nationale Contre le Cancer, F-91405, Orsay, France
| | - Eleanor Hawkins
- Institut Curie, Centre de Recherche, F-91405, Orsay, France
- INSERM U1021, Centre Universitaire, F-91405, Orsay, France
- CNRS UMR 3347, Centre Universitaire, F-91405, Orsay, France
- Université Paris-Saclay, F-91405, Orsay, France
- Equipe Labellisée Ligue Nationale Contre le Cancer, F-91405, Orsay, France
| | - Hiroaki Miyahara
- Department of Neuropathology, Institute for Medical Science of Aging, Aichi Medical University, Nagakute, Japan
| | - Kensuke Tateishi
- Department of Neurosurgery, Yokohama City University, Yokohama, Japan
| | - Shinji Yamashita
- Division of Neurosurgery, Department of Clinical Neuroscience, Faculty of Medicine University of Miyazaki, Miyazaki, Japan
| | - Shiori Yamada
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
| | - Taiki Saito
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
| | - Jotaro On
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
| | - Jun Watanabe
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
| | - Yoshihiro Tsukamoto
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
| | - Junichi Yoshimura
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
| | - Makoto Oishi
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
| | - Toshimichi Nakano
- Department of Radiology and Radiation Oncology Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Masaru Imamura
- Department of Pediatrics, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Chihaya Imai
- Department of Pediatrics, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Tetsuya Yamamoto
- Department of Neurosurgery, Yokohama City University, Yokohama, Japan
| | - Hideo Takeshima
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
- Division of Neurosurgery, Department of Clinical Neuroscience, Faculty of Medicine University of Miyazaki, Miyazaki, Japan
| | - Atsuo T Sasaki
- Institute for Advanced Biosciences, Keio University, Tsuruoka, Japan
- Department of Internal Medicine, Department of Cancer Biology, University of Cincinnati College of Medicine, Columbus, Ohio, USA
| | - Fausto J Rodriguez
- Department of Neurosurgery, Brain Tumor Center at UC Gardner Neuroscience Institute, Cincinnati, Ohio, USA
| | | | - Pascale Varlet
- Department of Neuropathology, GHU Paris-Psychiatrie Et Neurosciences, Sainte-Anne Hospital, Paris, France
| | - Celio Pouponnot
- Institut Curie, Centre de Recherche, F-91405, Orsay, France
- INSERM U1021, Centre Universitaire, F-91405, Orsay, France
- CNRS UMR 3347, Centre Universitaire, F-91405, Orsay, France
- Université Paris-Saclay, F-91405, Orsay, France
- Equipe Labellisée Ligue Nationale Contre le Cancer, F-91405, Orsay, France
| | - Satoru Osuka
- Department of Neurosurgery, School of Medicine and O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Alabama, USA
| | - Yves Pommier
- Developmental Therapeutics Branch, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, USA
| | - Akiyoshi Kakita
- Department of Pathology, Brain Research Institute Niigata University, Niigata, Japan
| | - Yukihiko Fujii
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
| | - Eric H Raabe
- Department of Pediatric Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Charles G Eberhart
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Manabu Natsumeda
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
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10
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Oka C, Miyake Y, Tateishi K, Kawabata Y, Iwashita H, Yamamoto T. Thigh leiomyosarcoma-derived brain metastasis with intracerebral hematoma: A case report and literature review. Surg Neurol Int 2023; 14:80. [PMID: 37025533 PMCID: PMC10070302 DOI: 10.25259/sni_113_2023] [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: 02/04/2023] [Accepted: 02/22/2023] [Indexed: 03/06/2023] Open
Abstract
Background:
Brain metastases with hematoma are clinically important as they indicate the potential for rapid neurological deterioration. Non-uterine leiomyosarcoma-derived brain metastases are particularly rare, and their clinical features, including the bleeding rate, are unclear. Herein, we present a rare case of thigh leiomyosarcoma-derived brain metastasis with intratumoral hematoma and review previous case reports.
Case Description:
A 68-year-old man with a right thigh leiomyosarcoma presented with multiple brain metastases. The patient received stereotactic radiotherapy; however, he reported sudden right-sided hemiparesis. We found a right frontal irradiated lesion with intratumoral hemorrhage and performed gross total tumor resection. Histopathological examination showed highly atypical cells with prominent necrosis and hemorrhage. Abnormal thin-walled vessels were prominent within the brain tumor, and vascular endothelial growth factor was diffusely expressed immunohistopathologically. To date, 11 cases of brain metastasis from non-uterine leiomyosarcoma, including the present case, have been reported. Of note, six patients had hemorrhage. Three out of six patients presented with hemorrhage before therapeutic intervention, three cases were from residual sites after surgery or radiation.
Conclusion:
More than half the patients with non-uterine leiomyosarcoma-derived brain metastases presented with intracerebral hemorrhage. Furthermore, these patients are at risk of developing rapid neurological deterioration due to intracerebral hemorrhage.
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Affiliation(s)
- Chihiro Oka
- Department of Neurosurgery, Yokohama City University, Yokohama, Japan
| | - Yohei Miyake
- Department of Neurosurgery, Yokohama City University, Yokohama, Japan
| | - Kensuke Tateishi
- Department of Neurosurgery, Yokohama City University, Yokohama, Japan
| | - Yusuke Kawabata
- Department of Orthopedics, Yokohama City University, Yokohama, Japan
| | | | - Tetsuya Yamamoto
- Department of Neurosurgery, Yokohama City University, Yokohama, Japan
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11
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Miyake Y, Tateishi K, Oshima A, Hongo T, Satomi K, Ichimura K, Kato A, Iwashita H, Utsunomiya D, Yamamoto T. A case of midbrain germinoma: A literature review for radiographic and clinical features. Neurooncol Adv 2023; 5:vdad043. [PMID: 37215953 PMCID: PMC10195201 DOI: 10.1093/noajnl/vdad043] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023] Open
Affiliation(s)
- Yohei Miyake
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Kensuke Tateishi
- Corresponding author: Kensuke Tateishi, MD, PhD, Department of Neurosurgery, Yokohama City University, 3-9 Fukuura, Kanazawa, Yokohama 2360004, Japan ()
| | - Akito Oshima
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Takeshi Hongo
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Kaishi Satomi
- Department of Pathology, Kyorin University School of Medicine, Tokyo, Japan
| | - Koichi Ichimura
- Deparment of Brain Disease Translational Research, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Ayumi Kato
- Department of Radiology, Yokohama City University Hospital, Yokohama, Japan
| | - Hiromichi Iwashita
- Department of Pathology, Yokohama City University Hospital, Yokohama, Japan
| | - Daisuke Utsunomiya
- Department of Radiology, Yokohama City University Hospital, Yokohama, Japan
| | - Tetsuya Yamamoto
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
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Ohba S, Teranishi T, Hirayama A, Hitachi K, Yamaguchi H, Natsumeda M, Tateishi K, Mukherjee J, Pieper R, Hirose Y. CBMS-1 TARGETING GLUTAMINE METABOLISM IN IDH-MUTANT GLIOMAS. Neurooncol Adv 2022. [DOI: 10.1093/noajnl/vdac167.001] [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: 12/05/2022] Open
Abstract
Abstract
IDH-wildtype and IDH-mutant glioma have different genetical and metabolic background although their histological appearances are similar. To reveal the difference in metabolites between IDH-wildtype and IDH-mutant glioma, two artificial cell lines made from normal human astrocyte, NHAE6E7hTERTRas (IDH-wildtype) and NHAE6E7hTERTIDHmut (IDH-mutant), were investigated. Capillary electrophoresis- and ion chromatography-coupled mass spectrometry revealed the lower amount of glutamine, glutamate and 2-oxoglutarate in NHAE6E7hTERTIDHmut cells than NHAE6E7hTERTRas cells. Pharmacological or genetical inhibition of GLUD1 which converts glutamate to 2-oxoglutarate, suppressed proliferation of the cells by inducing ROS and apoptosis in NHAE6E7hTERTIDHmut cells. ROS inhibitor, NAC suppressed GLUD1 inhibitor-induced ROS, apoptosis, and cytotoxicity in NHAE6E7hTERTIDHmut cells, revealing that cytotoxicity by GLUD1 inhibitor was at least partially due to the inhibitor-induced ROS. Exogeneous dimethyl 2-oxoglutarate rescued the cytotoxicity by GLUD1 inhibitor, suggesting decreased 2-oxoglutarate was associated with GLUD1 inhibitor-induced cytotoxicity. Mutant IDH1 overexpressed glioma cell line showed similar sensitivity to GLUD1 inhibitor to NHAE6E7hTERTIDHmut, which suggested that the difference of sensitivity to GLUD1 inhibitor was due to the status of mutant IDH. In conclusion, GLUD1 inhibitor will be new therapeutic options for IDH-mutant glioma.
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Affiliation(s)
- Shigeo Ohba
- Department of Neurosurgery, Fujita Health University , Toyoake , Japan
| | - Takao Teranishi
- Department of Neurosurgery, Fujita Health University , Toyoake , Japan
| | - Akiyoshi Hirayama
- Institute for Advanced Biosciences, Keio University , Tsuruoka , Japan
| | - Keisuke Hitachi
- Division for Therapies against Intractable Diseases, Institute for Comprehensive Medical Science, Fujita Health University , Toyoake , Japan
| | - Hisateru Yamaguchi
- Department of Physiological Chemistry Faculty of Medicine, Fujita Health University , Toyoake , Japan
| | - Manabu Natsumeda
- Department of Neurosurgery, Brain Research Institute, Niigata University , Niigata , Japan
| | - Kensuke Tateishi
- Department of Medical Life Science, Graduate School of Medical Life Science, Yokohama City University , Yokohama , Japan
| | - Joydeep Mukherjee
- Department of Neurological Surgery, University of California, San Francisco , San Francisco , USA
| | - Russell Pieper
- Department of Neurological Surgery, University of California, San Francisco , San Francisco , USA
| | - Yuichi Hirose
- Department of Neurosurgery, Fujita Health University , Toyoake , Japan
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13
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Sasaki N, Kume S, Tateishi K, Nakamura T, Ibayashi K, Yamagishi Y, Saito K, Kobayashi K, Matsushita Y, Hibiya Y, Kitahara M, Suzuki S, Nagano R, Yamashita S, Nakatomi H, Shiokawa Y, Ichimura K, Nagane M. GEN-13 PAIRED MUTATIONAL ANALYSIS IN SECONDARY NERVOUS SYSTEM LYMPHOMA AND PCNSL SYSTEMIC RELAPSE REVEALS DRIVER MUTATION CANDIDATES IN THE CENTRAL NERVOUS SYSTEM. Neurooncol Adv 2022. [DOI: 10.1093/noajnl/vdac167.014] [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: 12/05/2022] Open
Abstract
Abstract
Primary central nervous system lymphoma (PCNSL) is an aggressive extranodal non-Hodgkin lymphoma confined to the brain, eyes, and the spinal cord. The mechanism of central nervous system (CNS) tropism in PCNSL has not been fully elucidated. Diffuse large B cell lymphomas (DLBCLs) occasionally present with distant recurrence, which can involve inside and outside the CNS. Secondary central nervous system lymphomas (SCNSLs) are CNS relapse of systemic lymphoma. PCNSLs also rarely present with systemic relapse. We have previously reported in our study of whole exome sequencing that PCNSLs harbor frequent mutations in genes of B cell receptor pathway members and aberrant somatic hypermutation (aSHM) target genes. Although several genetic alterations were identified as more frequent in PCNSLs compared with systemic lymphomas, specific genetic alterations which serve as the driver for CNS tropism in PCNSLs has not been identified. In order to search for mutations which might serve as driver mutations in the CNS, we have performed targeted sequencing in paired samples from patients with recurrent lymphomas, either SCNSLs or PCNSL systemic relapses, using Ion Torrent multiplex PCR. Mutational profiles were compared between the primary and recurrent tumor. Six cases (four SCNSL cases and two PCNSL systemic relapse cases) were analyzed. Of note, in the SCNSL cases, several de novo mutations were enriched only among the recurrent CNS tumors. Among these mutations, BTG2 mutations were observed in 3/4 (75%), and B2M and KLHL14 mutations were observed in 2/4 (50%) cases. In the two PCNSL systemic relapse cases, KMT2D mutations were enriched only in the recurrent systemic tumors. It is suggested that these de novo mutations in the recurrent CNS tumors might serve as driver mutations in the CNS. Further analysis in larger cohorts, and functional studies are required in order to validate these findings.
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Affiliation(s)
- Nobuyoshi Sasaki
- Department of Neurosurgery, Kyorin University Faculty of Medicine
| | - Satoshi Kume
- Department of Neurosurgery, Akiru Municipal Medical Center
| | | | | | | | - Yuki Yamagishi
- Department of Neurosurgery, Kyorin University Faculty of Medicine
| | - Kuniaki Saito
- Department of Neurosurgery, Kyorin University Faculty of Medicine
| | | | - Yuko Matsushita
- Department of Brain Disease Translational Research, Juntendo University Facility of Medicine
| | - Yuko Hibiya
- Department of Brain Disease Translational Research, Juntendo University Facility of Medicine
| | - Mai Kitahara
- Department of Brain Tumor Translational Research, National Cancer Center Research Institute
| | - Saki Suzuki
- Department of Neurosurgery, Kyorin University Faculty of Medicine
| | - Reiko Nagano
- Department of Epigenomics, National Cancer Center Research Institute
| | - Satoshi Yamashita
- Department of Informatics and Biotechnology Engineering, Maebashi Institute of Technology
| | | | | | - Koichi Ichimura
- Department of Brain Disease Translational Research, Juntendo University Facility of Medicine
| | - Motoo Nagane
- Department of Neurosurgery, Kyorin University Faculty of Medicine
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14
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Yoshii Y, Hihara F, Matsumoto H, Igarashi C, Tachibana T, Shinada M, Ming-Rong Z, Oshima A, Sato H, Narita Y, Kurihara H, Yamamoto T, Higashi T, Tateishi K. ET-7 EVALUATION OF HYPOXIA-TARGETING RADIOPHARMACEUTICAL64CU-ATSM FOR PET MONITORING WITH LOCAL THERAPY IN HIGH-GRADE GLIOMA MODEL. Neurooncol Adv 2022. [DOI: 10.1093/noajnl/vdac167.019] [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: 12/05/2022] Open
Abstract
Abstract
World Health Organization (WHO)-defined central nervous system (CNS) grade 4 high-grade gliomas (HGGs) are highly aggressive brain cancers characterized by the presence of hypoxia within a rapidly-growing tumor mass. Due to invasion to the surrounding brain parenchyma, these tumors commonly recur locally, despite aggressive surgical resection, and new therapeutic approaches are required for local tumor control. Here, we show a positron emission tomography (PET) integrated local therapy (PETx), to target HGGs. This technique consists of a one-step local theranostic application, followed by PET monitoring, with a hypoxia-targeting radiopharmaceutical 64Cu-diacetyl-bis (N4-methylthiosemicarbazone) (64Cu-ATSM). We examined the safety and therapeutic potential of 64Cu-ATSM PETx for HGG patient-derived xenograft (PDX) tumors, which recapitulated the parent tumor phenotype of high expression of hypoxia-inducible factor-1α and BNIP3, biomarkers of tissue hypoxia. Biodistribution, dosimetry, and toxicity studies of 64Cu-ATSM local administration determined the maximum tolerated dose (MTD) to be 3.7 MBq in mouse. PETx using the MTD dose of 64Cu-ATSM indicated high tumor penetration, distribution, and retention of 64Cu-ATSM in PDX tumors, as compared to sham-treated mice. The 64Cu-ATSM PETx promoted DNA double-strand breaks, followed by apoptosis in tumors, and extensively prolonged overall survival with tolerable systemic toxicity. These findings indicate the potential of 64Cu-ATSM PETx to induce high uptake in the hypoxic tumor microenvironment, and strong therapeutic effects in PDX models. These findings establish 64Cu-ATSM PETx as a potential novel theranostic approach to facilitate local control of WHO CNS grade 4 HGGs.
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Affiliation(s)
- Yukie Yoshii
- National Institutes for Quantum Science and Technology , Chiba , Japan
| | - Fukiko Hihara
- National Institutes for Quantum Science and Technology , Chiba , Japan
| | - Hiroki Matsumoto
- National Institutes for Quantum Science and Technology , Chiba , Japan
| | - Chika Igarashi
- National Institutes for Quantum Science and Technology , Chiba , Japan
| | - Tomoko Tachibana
- National Institutes for Quantum Science and Technology , Chiba , Japan
| | - Mitsuhiro Shinada
- National Institutes for Quantum Science and Technology , Chiba , Japan
| | - Zhang Ming-Rong
- National Institutes for Quantum Science and Technology , Chiba , Japan
| | - Akito Oshima
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine , Yokohama , Japan
| | - Hidemitsu Sato
- Department of Neurosurgery, Kanagawa Cancer Center , Yokohama , Japan
| | - Yoshitaka Narita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital , Tokyo , Japan
| | - Hiroaki Kurihara
- Department of Radiology and IVR, Kanagawa Cancer Center , Yokohama , Japan
| | - Tetsuya Yamamoto
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine , Yokohama , Japan
| | - Tatsuya Higashi
- National Institutes for Quantum Science and Technology , Chiba , Japan
| | - Kensuke Tateishi
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine , Yokohama , Japan
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15
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Tateishi K, Sasame J, Naoki I, Natsumeda M, Kawazu M, Wakimoto H, Cahill D, Yamamoto T. EXTH-03. HSP90 INHIBITION OVERCOMES RESISTANCE TO MOLECULAR TARGETED THERAPY IN BRAFV600E MUTANT HIGH-GRADE GLIOMA. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac209.802] [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] Open
Abstract
Abstract
INTRODUCTION
Molecular targeted therapy using BRAF and/or MEK inhibitors has been applied to BRAFV600E mutant high-grade gliomas (HGGs); however, the therapeutic effect is limited by the emergence of drug resistance.
METHODS
We established multiple paired BRAFV600E mutant HGG patient-derived xenograft (PDX) models based on tissues collected prior to and at relapse after molecular targeted therapy. Using these models, we dissected treatment resistant mechanisms for molecular targeted therapy and explored therapeutic targets to overcome resistance in BRAFV600E HGG models in vitro and in vivo.
RESULTS
We found that, despite causing no major genetic and epigenetic changes, BRAF and/or MEK inhibitor treatment deregulated multiple negative feedback mechanisms, which led to the re-activation of the MAPK pathway through c-Raf and AKT signaling. This altered oncogenic signaling primarily mediated resistance to molecular targeted therapy in BRAFV600E mutant HGG. To overcome this resistance mechanism, we performed a high-throughput drug screening to identify therapeutic agents that potently induce additive cytotoxicity with BRAF and MEK inhibitors. We discovered that HSP90 inhibition combined with BRAF/MEK inhibition coordinately deactivated the MAPK and AKT/mTOR pathways, and subsequently induced apoptosis via dephosphorylation of GSK3β (Ser9) and inhibition of Bcl-2 family proteins. This mediated potent cytotoxicity in vitro and in vivo in refractory models with acquired resistance to molecular-targeted therapy.
CONCLUSIONS
The combination of an HSP90 inhibitor with BRAF or MEK inhibitors can overcome the limitations of the current therapeutic strategies for BRAFV600E mutant HGG.
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Affiliation(s)
- Kensuke Tateishi
- Department of Neurosurgery, Yokohama City University , Yokohama , Japan
| | - Jo Sasame
- Department of Neurosurgery, Yokohama City University , Yokohama , Japan
| | - Ikegaya Naoki
- Department of Neurosurgery, Yokohama City University , Yokohama , Japan
| | - Manabu Natsumeda
- Department of Neurosurgery, Niigata University , Niigata , Japan
| | | | - Hiroaki Wakimoto
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School , Boston, MA , USA
| | - Daniel Cahill
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School , Boston, MA , USA
| | - Tetsuya Yamamoto
- Department of Neurosurgery, Yokohama City University , Yokohama , Japan
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16
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Yokouchi H, Mizugaki H, Ikezawa Y, Morita R, Tateishi K, Yokoo K, Sumi T, Kikuchi H, Nakamura A, M. kobayashi, Aso M, Tsukita Y, Yoshiike F, Furuta M, Tanaka H, Sekikawa M, Hachiya T, Nakamura K, Kitamura Y. 335P Real-world data of first-line treatment with pembrolizumab for non-small cell lung cancer with high PD-L1 expression (HOT/NJLCG2001). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.373] [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: 12/05/2022] Open
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17
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Ohgaki F, Shimizu N, Suenaga J, Tateishi K, Ikegaya N, Suzuki R, Yamamura K, Yamamoto T. Availability of tracheal shift in the chest X-ray image as pre-treatment evaluation of mechanical thrombectomy. Neuroradiol J 2022; 35:627-633. [PMID: 35581955 PMCID: PMC9513920 DOI: 10.1177/19714009221084237] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The use of mechanical thrombectomy (MT) for treatment of acute large vessel occlusion has recently increased. Prompt and timely guiding catheter (GC) induction is necessary to improve prognosis of MT and reduce the time for recanalization. However, difficulties in GC induction are encountered in some patients. This GC induction depends mainly on the aortic arch structure. Therefore, this study focused on assessing presence of tracheal shift on chest X-ray images as pre-treatment evaluation method for GC induction due to its wide availability as an indicator for status of the mediastinum. METHODS We retrospectively examined 33 patients who underwent MT at our facilities between April 2017 and March 2021. The patients were divided into two groups according to presence or absence of tracheal shift on chest X-ray images. Background characteristics and treatment courses in these two groups were compared. RESULTS Among 33 patients, tracheal shift was observed on the chest X-ray images of 14 patients. Furthermore, tracheal shift was positively correlated with the time of GC induction (32.9 min vs. 11.6 min, [p < 0.05]) and the female sex (p = 0.03). Additionally, tracheal shift exhibited correlations with multiple risk factors of atherosclerosis (p = 0.04). CONCLUSIONS In patients with tracheal shift, GC induction could be expectedly difficult. Therefore, advanced disinfection of the right upper arm and affected side of the neck during MT in preparation for changing an approach route is required.
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Affiliation(s)
- Fukutaro Ohgaki
- Department of Neurosurgery,
Graduate School of Medicine, School of Medicine, Yokohama City
University, Yokohama, Japan
| | - Nobuyuki Shimizu
- Department of Neurosurgery,
Graduate School of Medicine, School of Medicine, Yokohama City
University, Yokohama, Japan
| | - Jun Suenaga
- Department of Neurosurgery,
Graduate School of Medicine, School of Medicine, Yokohama City
University, Yokohama, Japan
| | - Kensuke Tateishi
- Department of Neurosurgery,
Graduate School of Medicine, School of Medicine, Yokohama City
University, Yokohama, Japan
| | - Naoki Ikegaya
- Department of Neurosurgery,
Graduate School of Medicine, School of Medicine, Yokohama City
University, Yokohama, Japan
| | - Ryosuke Suzuki
- Department of Neurosurgery,
Graduate School of Medicine, School of Medicine, Yokohama City
University, Yokohama, Japan
| | - Koji Yamamura
- Department of Neurosurgery, Nishiarai Hospital, Tokyo, Japan
| | - Tetsuya Yamamoto
- Department of Neurosurgery,
Graduate School of Medicine, School of Medicine, Yokohama City
University, Yokohama, Japan
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18
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Sasame J, Ikegaya N, Kawazu M, Natsumeda M, Hayashi T, Isoda M, Satomi K, Tomiyama A, Oshima A, Honma H, Miyake Y, Takabayashi K, Nakamura T, Ueno T, Matsushita Y, Iwashita H, Kanemaru Y, Murata H, Ryo A, Terashima K, Yamanaka S, Fujii Y, Mano H, Komori T, Ichimura K, Cahill DP, Wakimoto H, Yamamoto T, Tateishi K. HSP90 inhibition overcomes resistance to molecular targeted therapy in BRAFV600E mutant high-grade glioma. Clin Cancer Res 2022; 28:2425-2439. [PMID: 35344043 DOI: 10.1158/1078-0432.ccr-21-3622] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 02/07/2022] [Accepted: 03/22/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE Molecular targeted therapy using BRAF and/or MEK inhibitors has been applied to BRAFV600E mutant high-grade gliomas (HGGs); however, the therapeutic effect is limited by the emergence of drug resistance. EXPERIMENTAL DESIGN We established multiple paired BRAFV600E mutant HGG patient-derived xenograft (PDX) models based on tissues collected prior to and at relapse after molecular targeted therapy. Using these models, we dissected treatment resistant mechanisms for molecular targeted therapy and explored therapeutic targets to overcome resistance in BRAFV600E HGG models in vitro and in vivo. RESULTS We found that, despite causing no major genetic and epigenetic changes, BRAF and/or MEK inhibitor treatment deregulated multiple negative feedback mechanisms, which led to the re-activation of the MAPK pathway through c-Raf and AKT signaling. This altered oncogenic signaling primarily mediated resistance to molecular targeted therapy in BRAFV600E mutant HGG. To overcome this resistance mechanism, we performed a high-throughput drug screening to identify therapeutic agents that potently induce additive cytotoxicity with BRAF and MEK inhibitors. We discovered that HSP90 inhibition combined with BRAF/MEK inhibition coordinately deactivated the MAPK and AKT/mTOR pathways, and subsequently induced apoptosis via dephosphorylation of GSK3β (Ser9) and inhibition of Bcl-2 family proteins. This mediated potent cytotoxicity in vitro and in vivo in refractory models with acquired resistance to molecular-targeted therapy. CONCLUSIONS The combination of an HSP90 inhibitor with BRAF or MEK inhibitors can overcome the limitations of the current therapeutic strategies for BRAFV600E mutant HGG.
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Affiliation(s)
- Jo Sasame
- Yokohama City University, Yokohama, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | - Toshihide Ueno
- National Cancer Center Research Institute, Tokyo, Tokyo, Japan
| | | | | | | | | | | | - Keita Terashima
- National Center For Child Health and Development, Tokyo, Japan
| | | | - Yukihiko Fujii
- Brain Research Institute, Niigata University, Niigata, Niigata, Japan
| | | | | | | | - Daniel P Cahill
- Massachusetts General Hospital / Harvard Medical School, Boston, MA, United States
| | - Hiroaki Wakimoto
- Massachusetts General Hospital, Harvard Medical School, Boston, United States
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19
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Hongo T, Nakamura T, Miyake A, Kato I, Tateishi K, Yamanaka S, Yamamoto T. Evaluation of Tumor Cell Infiltration to the Skull in Dermatofibrosarcoma Protuberans of the Scalp: Case Report and Literature Review. NMC Case Rep J 2022; 8:287-293. [PMID: 35079477 PMCID: PMC8769418 DOI: 10.2176/nmccrj.cr.2020-0297] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 10/19/2020] [Indexed: 11/25/2022] Open
Abstract
Dermatofibrosarcoma protuberans (DFSP) originates from the dermal layer of the skin; the optimum treatment is an extended marginal resection. We describe a case of DFSP of the scalp with a skull invasive defect that was thoroughly examined pathologically to determine the optimum length of surgical margins. The tumor cells infiltrated up to 26 mm into the dermal tissues, whereas no infiltrating tumor cells were present in the skull, indicating the combination of marginal resection of the dermal tissues and lower of the skull can be a clinically relevant strategy for treatment of DFSP cases with skull invasion.
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Affiliation(s)
- Takeshi Hongo
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Kanagawa, Japan
| | - Taishi Nakamura
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Kanagawa, Japan
| | - Akio Miyake
- Department of Pathology, Yokohama City University Hospital, Yokohama, Kanagawa, Japan
| | - Ikuma Kato
- Department of Pathology, Yokohama City University Hospital, Yokohama, Kanagawa, Japan.,Department of Pathology, Yokohama City University, Yokohama, Kanagawa, Japan
| | - Kensuke Tateishi
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Kanagawa, Japan
| | - Shoji Yamanaka
- Department of Pathology, Yokohama City University Hospital, Yokohama, Kanagawa, Japan
| | - Tetsuya Yamamoto
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Kanagawa, Japan
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20
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Kamogawa M, Ikegaya N, Miyake Y, Hayashi T, Murata H, Tateishi K, Yamamoto T. Verbal and memory deficits caused by aphasic status epilepticus after resection of a left temporal lobe glioma. Surg Neurol Int 2022; 12:614. [PMID: 34992930 PMCID: PMC8720448 DOI: 10.25259/sni_1120_2021] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 11/21/2021] [Indexed: 12/28/2022] Open
Abstract
Background: Nonconvulsive status epilepticus (NCSE) is induced by common neurosurgical conditions, for example, trauma, stroke, tumors, and surgical interventions in the brain. The aggressiveness of the treatment for NCSE depends on its neurological prognosis. Aphasic status epilepticus (ASE) is a subtype of focal NCSE without consciousness impairment. The impact of ASE on neurological prognosis is poorly documented. We describe a case of postoperative ASE resulting in verbal and memory deficits. Case Description: A 54-year-old, right-handed man with focal impaired awareness seizures underwent partial resection for a left temporal lobe tumor. No neurological deficits were observed immediately after surgery. Three days later, however, a focal to bilateral tonic-clonic seizure (FBTCS) occurred, followed by aphasia. Electroencephalography revealed 1.5 Hz left-sided periodic discharges. He was diagnosed with ASE. Multiple anti-seizure drugs were ineffective for the resolution of the patient’s verbal disturbance. Nine days after the FBTCS, deep sedation with intravenous anesthetics was performed and the ASE stopped. Thereafter, his symptoms gradually improved. However, the prolonged ASE resulted in verbal and memory deficits. Automated hippocampal volumetry revealed an approximate decrease of 20% on the diseased side on magnetic resonance imaging 3 months after surgery. Conclusion: Prolonged ASE can induce verbal and memory deficits. Early intervention with intravenous anesthetics is required to obtain a favorable neurological prognosis.
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Affiliation(s)
- Misaki Kamogawa
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Naoki Ikegaya
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Yohei Miyake
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Takahiro Hayashi
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Hidetoshi Murata
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Kensuke Tateishi
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Tetsuya Yamamoto
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
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21
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Ohki D, Tsuji Y, Yamazawa S, Ushiku T, Tateishi K. Gastrointestinal: Esophageal adenocarcinoma arising from circumferential ectopic gastric mucosa: A case report. J Gastroenterol Hepatol 2022; 37:47. [PMID: 34279045 DOI: 10.1111/jgh.15602] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/23/2021] [Accepted: 06/26/2021] [Indexed: 12/09/2022]
Affiliation(s)
- D Ohki
- Department of Endoscopy and Endoscopic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Y Tsuji
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - S Yamazawa
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - T Ushiku
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - K Tateishi
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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22
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Otomo Y, Ikegaya N, Oshima A, Matsumoto S, Udaka N, Chang CC, Tateishi K, Murata H, Yamamoto T. Superficial siderosis and nonobstructive hydrocephalus due to subependymoma in the ventricle: An illustrative case report. Surg Neurol Int 2021; 12:631. [PMID: 35350828 PMCID: PMC8942190 DOI: 10.25259/sni_868_2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 08/28/2021] [Accepted: 12/14/2021] [Indexed: 12/15/2022] Open
Abstract
Background: Intraventricular tumors can generally result in obstructive hydrocephalus as they grow. Rarely, however, some intraventricular tumors develop superficial siderosis (SS) and trigger hydrocephalus, even though the tumor has hardly grown. Here, we present an illustrative case of SS and nonocclusive hydrocephalus caused by subependymoma of the lateral ventricles. Case Description: A 78-year-old man with an intraventricular tumor diagnosed 7 years ago had been suffering from gait disturbance for 2 years. He also developed cognitive impairment. Intraventricular tumors showed little growth on annual magnetic resonance imaging (MRI). MRI T2-star weighted images (T2*WI) captured small intratumoral hemorrhages from the beginning of the follow-up. Three years before, at the same time as the onset of ventricular enlargement, T2*WI revealed low intensity in the whole tumor and cerebral surface. Subsequent follow-up revealed that this hemosiderin deposition had spread to the brain stem and cerebellar surface, and the ventricles had expanded further. Cerebrospinal fluid (CSF) examination revealed xanthochromia. The tumor was completely removed en bloc. Histopathological findings were consistent with those of subependymoma. Although CSF findings improved, SS and hydrocephalus did not improve. Therefore, the patient underwent a lumboperitoneal shunt for CSF diversion after tumor resection. Conclusion: Some intraventricular tumors cause SS and nonobstructive hydrocephalus due to microbleeding, even in the absence of tumor growth. T2*WI and, if necessary, timely CSF examination can allow identification of presymptomatic SS. This follow-up strategy may provide a favorable course by facilitating early intervention in patients with intraventricular lesions, not just subependymomas.
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Affiliation(s)
- Yuta Otomo
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Naoki Ikegaya
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Akito Oshima
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Shutaro Matsumoto
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Naoko Udaka
- Department of Pathology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Chia-Cheng Chang
- Department of Neurosurgery, Iemasa Neurosurgical Clinic, Yokohama, Kanagawa, Japan
| | - Kensuke Tateishi
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Hidetoshi Murata
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Tetsuya Yamamoto
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
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23
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Tateishi K, Miyake Y, Nakamura T, Sasame J, Hayashi T, Oshima A, Honma H, Ikegaya N, Yamamoto T. ET-1 Translational research platform for malignant brain tumors. Neurooncol Adv 2021. [PMCID: PMC8648230 DOI: 10.1093/noajnl/vdab159.014] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Introduction: The standard therapy for malignant brain tumors includes surgery and combination therapy with radiation and chemotherapy, but to provide individualized treatment based on the biological and molecular genetic background of the tumor, integrate genetic information with various functional data are required. In this study, we present an overview of our integrated approaches for translational research and clinical management. Methods: In glioma, pre-and intra-operative clinical information, including intraoperative genetic diagnosis, and intraoperative rapid immunohistochemistry is obtained, then a multidisciplinary treatment approach is started based on these integrated data. Specimens collected intraoperatively are cryopreserved for future analysis, and primary cultured cells are routinely collected. The cultured cells are transplanted into the brain of immunodeficient mice to establish patient-derived xenograft model (PDX). Genetic screening, such as IDH, TERT, BRAF, H3F3A mutation and MGMT methylation analysis are routinely assessed within a few days after surgery and used as information for integrated diagnosis. In case of PDX establishment or recurrence, we perform whole exon sequencing or comprehensive genomic assessment to identify genetic abnormalities. If genomic alterations for possible molecular targeted therapy are identified, we assess drug sensitivity test in vitro and in vivo, which are utilized for research to develop optimal molecular targeted therapy. The results, such as the therapeutic effects of molecular targeted drugs, are used for clinical applications. Results: Since the platform was established, we have treated a total of 286 patients, including 189 gliomas and 37 central nervous system lymphomas based on the integrated information. We are currently collecting clinical data to examine if this integrated approach could provide clinical benefit.Conclusion: The translational research system for malignant brain tumors plays an important role in the promotion of clinical and basic research.
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Affiliation(s)
- Kensuke Tateishi
- Department of Neurosurgery, Yokohama City University, Yokohama, Japan
| | - Yohei Miyake
- Department of Neurosurgery, Yokohama City University, Yokohama, Japan
| | - Taishi Nakamura
- Department of Neurosurgery, Yokohama City University, Yokohama, Japan
| | - Jo Sasame
- Department of Neurosurgery, Yokohama City University, Yokohama, Japan
| | - Takahiro Hayashi
- Department of Neurosurgery, Yokohama City University, Yokohama, Japan
| | - Akito Oshima
- Department of Neurosurgery, Yokohama City University, Yokohama, Japan
| | - Hirokuni Honma
- Department of Neurosurgery, Yokohama City University, Yokohama, Japan
| | - Naoki Ikegaya
- Department of Neurosurgery, Yokohama City University, Yokohama, Japan
| | - Tetsuya Yamamoto
- Department of Neurosurgery, Yokohama City University, Yokohama, Japan
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24
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Sasame J, Ikegaya N, Miyake Y, Hayashi T, Oshima A, Homma H, Isoda M, Takabayashi K, Yamamoto T, Tateishi K. SPDR-1 HSP90 inhibition overcomes resistant to molecular targeted therapy in BRAFV600E mutant glioblastoma. Neurooncol Adv 2021. [PMCID: PMC8648250 DOI: 10.1093/noajnl/vdab159.010] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
The BRAFV600E mutation results in the constitutive activation of downstream mitogen activated protein kinase (MAPK) pathway that promotes tumor growth. Recently, molecular targeted therapy using BRAF/MEK inhibitor has been reported for BRAFV600E mutant high-grade glioma, but the therapeutic effect is limited by the emergence of drug resistance. Herein, we established paired BRAFV600E mutant glioblastoma (GBM) patient-derived xenograft (PDX) models, which were derived from tumors at prior to and recurrence after molecular targeted therapy. These PDX models were found to extensively recapitulate the histology, genetic abnormalities, and even the clinical course of the patients. Furthermore, BRAF/MEK inhibitor gradually caused resistance in cell lines derived from specimens that initially responded to molecular targeted therapy. In this study, genomic and epigenomic changes had little effect on the resistance mechanism. On the other hand, we found that hyperactivation of the MAPK pathway through c-Raf and the AKT/mTOR pathway primarily caused resistance to molecular targeted therapy in BRAFV600E mutant GBM. Through a high throughput drug screening, we find that HSP90 inhibitor with BRAF/MEK inhibitor coordinately deactivates MAPK pathway and AKT/mTOR pathway, and mediates potent toxicity in vitro and in vivo in refractory and acquired resistant models. These findings support that this therapeutic approach can overcome the limitation of current molecular targeted therapy in BRAFV600E mutant GBM.
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Affiliation(s)
- Jo Sasame
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Naoki Ikegaya
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Yohei Miyake
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Takahiro Hayashi
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Akito Oshima
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Hirokuni Homma
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Masataka Isoda
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Katsuhiro Takabayashi
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Tetsuya Yamamoto
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Kensuke Tateishi
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
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25
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Isoda M, Tateishi K, Sasame J, Hayashi T, Miyake Y, Oshima A, Honma H, Yamamoto T. ET-8 Integrated diagnostic approach to predict prognosis for malignant gliomas. Neurooncol Adv 2021. [PMCID: PMC8648208 DOI: 10.1093/noajnl/vdab159.018] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Previous studies indicated that MGMT promoter methylation status with IDH and TERT promotor mutation are major prognostic factors in glioma. In addition to these molecular features, we have been assessing drug sensitivity against several chemotherapeutic agents, including temozolomide (TMZ). Here, we examined if this combined information could strongly predict drug sensitivity and the prognosis in glioma patients. One hundred and twenty-five IDH wild-type gliomas (WHO grade III and grade IV) were included in this study and retrospectively analyzed. Among them, we focused on 37 patients with partial surgical resection and biopsy to assess radiological difference on MRI. The primary cultured tumor cells were exposed with several compounds for 72 hours, then ATP based cell viability assay was performed. The favorable radiological therapeutic effect was found in 6 out of 8 (75%) with MGMT promoter methylated cases, while unfavorable in 23 of 29 (79.3%) with MGMT promoter unmethylated cases (p=0.008). The drug screening assay demonstrated that 7 of 10 cases with favorable TMZ sensitivity in vitro showed response on MRI, whereas 22 of 27 (81.5%) cases with TMZ resistance in vitro indicated tumor progression (p=0.006). Of note, all 5 cases with sensitive to TMZ and methylated MGMT promoter demonstrated favorable radiological response (p=0.002). These 5 cases tended to survive longer (median survival time, 697 days) as compared to others (median survival time, 391 days, p=0.13). These data indicate that integrated approach with genomic assessment and drug screening test may predict therapeutic response to chemotherapy and contribute selecting optimal therapy in glioma patients.
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Affiliation(s)
- Masataka Isoda
- Department of Neurosurgery, Yokohama City University, Kanagawa, Japan
| | - Kensuke Tateishi
- Department of Neurosurgery, Yokohama City University, Kanagawa, Japan
| | - Jo Sasame
- Department of Neurosurgery, Yokohama City University, Kanagawa, Japan
| | - Takahiro Hayashi
- Department of Neurosurgery, Yokohama City University, Kanagawa, Japan
| | - Youhei Miyake
- Department of Neurosurgery, Yokohama City University, Kanagawa, Japan
| | - Akito Oshima
- Department of Neurosurgery, Yokohama City University, Kanagawa, Japan
| | - Hirokuni Honma
- Department of Neurosurgery, Yokohama City University, Kanagawa, Japan
| | - Tetsuya Yamamoto
- Department of Neurosurgery, Yokohama City University, Kanagawa, Japan
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26
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Kanda M, Tateishi K, Nakagomi A, Iwahana T, Okada S, Kuwabara H, Kobayashi Y, Inoue T. Relationship of early intensive- or coronary care unit admission and post-discharge performance of activities of daily living in patients with acute decompensated heart failure. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1009] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The management of acute decompensated heart failure (ADHF) often requires intensive care. However, the effects of early intensive care unit (ICU)/coronary care unit (CCU) admission on activities of daily living (ADL) in ADHF patients have not been precisely evaluated. Thus, we assessed whether early ICU entry can improve post-discharge ADL performance in these patients.
Methods and results
ADHF patients (New York Heart Association I–III) admitted on emergency between April 1, 2014, and December 31, 2018, were selected from the Diagnosis Procedure Combination database and divided into ICU/CCU (ICU) and general ward (GW) groups according to the hospitalization type on admission day 1. The propensity score was calculated to create matched cohorts where treatment assignment (ICU/CCU admission) is independent of measured baseline confounding factors including ADL at admission. The primary outcome was post-ADL defined according to the Barthel index (BI) at discharge. Secondary outcomes included length of stay (LOS) and total hospitalization cost (expense). Overall, 12,231 patients were eligible, and propensity score matching created 2,985 pairs. After matching, post-ADL was significantly higher in the ICU group (GW 71.5±35.3 vs. ICU 78.2±31.2, P<0.001, difference in mean 6.7 (95% CI 5.1–8.4) points). After matching, LOS was significantly shorter and expenses were significantly higher in the ICU group. Subanalyses showed that patients with low ADL at admission (BI<60) mainly benefited from early ICU/CCU entry.
Conclusions
Early ICU/CCU entry was beneficially associated with post-ADL in patients with emergency ADHF admission. ADL at admission might serve as a useful criterion for ICU admission.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Kanda
- Chiba University Graduate School of Medicine, Department of Cardiology, Chiba, Japan
| | - K Tateishi
- Chiba University Graduate School of Medicine, Department of Cardiology, Chiba, Japan
| | - A Nakagomi
- Harvard T. H. Chan School of Public Health, Takemi Program in International Health, Boston, United States of America
| | - T Iwahana
- Chiba University Graduate School of Medicine, Department of Cardiology, Chiba, Japan
| | - S Okada
- Chiba University Graduate School of Medicine, Department of Cardiology, Chiba, Japan
| | - H Kuwabara
- Chiba University Hospital, Department of Healthcare Management Research Center, Chiba, Japan
| | - Y Kobayashi
- Chiba University Graduate School of Medicine, Department of Cardiology, Chiba, Japan
| | - T Inoue
- Chiba University Hospital, Department of Healthcare Management Research Center, Chiba, Japan
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27
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Tateishi K, Kondo Y, Saito Y, Kitahara H, Kobayashi Y. Implantable cardioverter-defibrillator therapy after resuscitation from cardiac arrest in vasospastic angina. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0690] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Patients with vasospastic angina (VSA) who are resuscitated from sudden cardiac arrest (SCA) are at high risk of recurrent cardiovascular events. However, there are no recommendations for implantable cardioverter-defibrillator (ICD) therapy in the VSA and SCA patient guidelines.
Purpose
This study investigated the prognostic impact of ICD therapy on patients with VSA and SCA.
Methods
The present multi-center registry included 280 patients who were resuscitated from SCA and received ICD implantation as secondary prophylaxis. The patients were divided into two groups according to the presence of VSA. The primary endpoint was a composite of all-cause death and appropriate ICD therapy, including appropriate anti-tachycardia pacing and shock for recurrent ventricular arrhythmias.
Results
Of 280 patients, 51 (18%) had VSA. Among those without VSA, ischemic cardiomyopathy was the leading cause of SCA (38%), followed by non-ischemic cardiomyopathies and Brugada syndrome (Table 1). During the median follow-up period of 3.8 years, 23 (8%) patients died, and 72 (26%) underwent appropriate ICD therapy. The incidence of the primary endpoint was not significantly different between patients with and without VSA (24% vs 33%, p=0.19). Further, the incidence of the primary endpoint was not significantly different among the etiologies (Figure 1)
Conclusions
In a cohort of patients who underwent ICD implantation as secondary prophylaxis, long-term clinical outcomes were comparable between those with VSA and those with other cardiac diseases after SCA. The results suggest that ICD therapy may be considered in patients with VSA and those with other etiologies after resuscitation from SCA.
Funding Acknowledgement
Type of funding sources: None. Table 1. Patient characteristics and outcomesFigure 1. Incidence of the primary endpoint
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Affiliation(s)
- K Tateishi
- Chiba University Hospital, Cardiology, Chiba, Japan
| | - Y Kondo
- Chiba University Hospital, Cardiology, Chiba, Japan
| | - Y Saito
- Chiba University Hospital, Cardiology, Chiba, Japan
| | - H Kitahara
- Chiba University Hospital, Cardiology, Chiba, Japan
| | - Y Kobayashi
- Chiba University Hospital, Cardiology, Chiba, Japan
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28
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Kobayashi M, Mizugaki H, Ikezawa Y, Morita R, Tateishi K, Yokoo K, Sumi T, Kikuchi H, Nagano Y, Nakamura A, Aso M, Kimura N, Yoshiike F, Furuta M, Tanaka H, Sekikawa M, Hachiya T, Fujita Y, Oizumi S. P16.05 Real World Data of First-Line Treatment With Pembrolizumab for Highly PD-L1-Expressing NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.344] [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: 10/20/2022]
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29
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Nakamura A, Mizugaki H, Ikezawa Y, Morita R, Tateishi K, Yokoo K, Sumi T, Kikuchi H, Kitamura Y, Morita M, Aso M, Tsukita Y, Yoshiike F, Furuta M, Tanaka H, Sekikawa M, Hachiya T, Nakamura K, Yokouchi H. 1306P Real-world data of first-line treatment with pembrolizumab for highly PD-L1 expressing NSCLC (HOT/NJLCG2001). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1908] [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: 11/25/2022] Open
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30
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Natsumeda M, Miyahara H, Yoshimura J, Nakata S, Nozawa T, Ito J, Kanemaru Y, Watanabe J, Tsukamoto Y, Okada M, Oishi M, Hirato J, Wataya T, Ahsan S, Tateishi K, Yamamoto T, Rodriguez FJ, Takahashi H, Hovestadt V, Suva ML, Taylor MD, Eberhart CG, Fujii Y, Kakita A. GLI3 Is Associated With Neuronal Differentiation in SHH-Activated and WNT-Activated Medulloblastoma. J Neuropathol Exp Neurol 2021; 80:129-136. [PMID: 33249504 DOI: 10.1093/jnen/nlaa141] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Glioma-associated oncogene homolog 3 (GLI3), whose main function is to inhibit GLI1, has been associated with neuronal differentiation in medulloblastoma. However, it is not clear what molecular subtype(s) show increased GLI3 expression. GLI3 levels were assessed by immunohistochemistry in 2 independent cohorts, including a total of 88 cases, and found to be high in both WNT- and SHH-activated medulloblastoma. Analysis of bulk mRNA expression data and single cell RNA sequencing studies confirmed that GLI1 and GLI3 are highly expressed in SHH-activated medulloblastoma, whereas GLI3 but not GLI1 is highly expressed in WNT-activated medulloblastoma. Immunohistochemical analysis has shown that GLI3 is expressed inside the neuronal differentiated nodules of SHH-activated medulloblastoma, whereas GLI1/2 are expressed in desmoplastic areas. In contrast, GLI3 is diffusely expressed in WNT-activated medulloblastoma, whereas GLI1 is suppressed. Our data suggest that GLI3 may be a master regulator of neuronal differentiation and morphology in these subgroups.
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Affiliation(s)
- Manabu Natsumeda
- From the Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
| | - Hiroaki Miyahara
- Department of Pediatrics, Oita University Faculty of Medicine, Yufu, Japan.,Department of Neuropathology, Institute for Medical Science of Aging, Aichi Medical University, Japan
| | - Junichi Yoshimura
- From the Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
| | - Satoshi Nakata
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Takanori Nozawa
- From the Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
| | - Junko Ito
- From the Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan.,Department of Pathology, Brain Research Institute, Niigata University
| | - Yu Kanemaru
- From the Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
| | - Jun Watanabe
- From the Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
| | - Yoshihiro Tsukamoto
- From the Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
| | - Masayasu Okada
- From the Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
| | - Makoto Oishi
- From the Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
| | - Junko Hirato
- Department of Pathology, Public Tomioka General Hospital, Tomioka, Japan.,Department of Human Pathology, Gunma University, Maebashi, Japan
| | - Takafumi Wataya
- Department of Human Pathology, Gunma University, Maebashi, Japan
| | - Sama Ahsan
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Kensuke Tateishi
- Department of Neurosurgery, Yokohama City University, Yokohama, Japan
| | - Tetsuya Yamamoto
- Department of Neurosurgery, Yokohama City University, Yokohama, Japan
| | - Fausto J Rodriguez
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Hitoshi Takahashi
- Department of Pathology, Brain Research Institute, Niigata University
| | - Volker Hovestadt
- Department of Pathology and Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusettes.,Broad Institute of Harvard and MIT, Cambridge, Massachusettes
| | - Mario L Suva
- Department of Pathology and Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusettes.,Broad Institute of Harvard and MIT, Cambridge, Massachusettes
| | - Michael D Taylor
- Department of Neurosurgery, Hospital for Sick Children, Toronto, Canada
| | | | - Yukihiko Fujii
- From the Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
| | - Akiyoshi Kakita
- Department of Pathology, Brain Research Institute, Niigata University
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31
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Abstract
In this review, I summarized the biology of gliomas. Through past clinical and basic studies, I reviewed the evidence of the cell of origin of gliomas and the presence of brain tumor-initiating cells in gliomas, which are driven by multiple genomic alterations. In addition, the complicated tumor heterogeneity and neuronal-glioma network were studied. These mechanisms may underlie the treatment resistance and poor prognosis and support the identification of novel therapeutic targets for gliomas.
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Affiliation(s)
- Kensuke Tateishi
- Department of Neurosurgery, Yokohama City University School of Medicine
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32
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Miller JJ, Fink A, Banagis JA, Nagashima H, Subramanian M, Lee CK, Melamed L, Tummala SS, Tateishi K, Wakimoto H, Cahill DP. Sirtuin activation targets IDH-mutant tumors. Neuro Oncol 2021; 23:53-62. [PMID: 32710757 DOI: 10.1093/neuonc/noaa180] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Isocitrate dehydrogenase (IDH)-mutant tumors exhibit an altered metabolic state and are critically dependent upon nicotinamide adenine dinucleotide (NAD+) for cellular survival. NAD+ steady-state levels can be influenced by both biosynthetic and consumptive processes. Here, we investigated activation of sirtuin (SIRT) enzymes, which consume NAD+ as a coenzyme, as a potential mechanism to reduce cellular NAD+ levels in these tumors. METHODS The effect of inhibition or activation of sirtuin activity, using (i) small molecules, (ii) clustered regularly interspaced short palindromic repeat/CRISPR associated protein 9 gene editing, and (iii) inducible overexpression, was investigated in IDH-mutant tumor lines, including patient-derived IDH-mutant glioma lines. RESULTS We found that Sirt1 activation led to marked augmentation of NAD+ depletion and accentuation of cytotoxicity when combined with inhibition of nicotinamide phosphoribosyltransferase (NAMPT), consistent with the enzymatic activity of SIRT1 as a primary cellular NAD+ consumer in IDH-mutant cells. Activation of Sirt1 through either genetic overexpression or pharmacologic Sirt1-activating compounds (STACs), an existing class of well-tolerated drugs, led to inhibition of IDH1-mutant tumor cell growth. CONCLUSIONS Activation of Sirt1 can selectively target IDH-mutant tumors. These findings indicate that relatively nontoxic STACs, administered either alone or in combination with NAMPT inhibition, could alter the growth trajectory of IDH-mutant gliomas while minimizing toxicity associated with cytotoxic chemotherapeutic regimens.
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Affiliation(s)
- Julie J Miller
- Center for Neuro-Oncology, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Translational Neuro-Oncology Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Alexandria Fink
- Translational Neuro-Oncology Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jack A Banagis
- Translational Neuro-Oncology Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Hiroaki Nagashima
- Translational Neuro-Oncology Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Megha Subramanian
- Translational Neuro-Oncology Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Christine K Lee
- Translational Neuro-Oncology Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Lisa Melamed
- Translational Neuro-Oncology Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Shilpa S Tummala
- Translational Neuro-Oncology Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Kensuke Tateishi
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan.,Division of Brain Tumor Translational Research, National Cancer Center Institute, Tokyo, Japan
| | - Hiroaki Wakimoto
- Translational Neuro-Oncology Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Daniel P Cahill
- Translational Neuro-Oncology Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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33
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Miyake S, Suenaga J, Nakamura T, Akimoto T, Suzuki R, Ohtake M, Takase H, Tateishi K, Shimizu N, Murata H, Funakoshi K, Sawamura Y, Yamamoto T. Practical Arachnoid Anatomy for the Technical Consideration of Galen Complex Dissection: Cadaveric and Clinical Evaluation. World Neurosurg 2021; 151:e372-e378. [PMID: 33887497 DOI: 10.1016/j.wneu.2021.04.041] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 04/09/2021] [Accepted: 04/10/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND The occipital transtentorial approach (OTA) is a very useful but challenging approach to expose the pineal region because the deep-seated arachnoid membranes usually fold and extend over the great vein of Galen (GVG), leading to dense and poor visibility. In addition, the practical aspects of arachnoid anatomy are not well understood. We aimed to develop a safe surgical procedure for the OTA according to the practical aspects of arachnoid anatomy. METHODS The procedure is shown through an illustrative video of surgery and cadaver. Five cadavers were analyzed for their arachnoid structures and the surgical procedures via the OTA, in strict compliance with legal and ethical requirements. RESULTS All cadavers showed a 2-layered arachnoid structure-one belonging to the occipital lobe, and the other to the cerebellum. According to our cadaveric analysis, the arachnoid attachment of the tentorial apex can be peeled bluntly, with an average distance of 10.2 mm. For our clinical presentation, a pineal tumor with hydrocephalus was detected in a 14-year-old boy. While using the OTA and expanding the deep surgical field, we detached the membrane from the tentorial apex and bluntly peeled it to reveal the deep veins. Finally, gross total removal of the tumor was achieved. CONCLUSIONS A 2-layered arachnoid structure interposes the GVG from above and below the tentorium. The arachnoid membrane below the tentorium can be peeled off bluntly from the GVG to the attachment bundle limited by the penetrating veins. This detachment technique is useful for safe enlargement of the surgical field for the OTA.
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Affiliation(s)
- Shigeta Miyake
- Department of Neurosurgery, Yokohama City University, Yokohama, Japan
| | - Jun Suenaga
- Department of Neurosurgery, Yokohama City University, Yokohama, Japan.
| | - Taishi Nakamura
- Department of Neurosurgery, Yokohama City University, Yokohama, Japan
| | - Taisuke Akimoto
- Department of Neurosurgery, Yokohama City University, Yokohama, Japan
| | - Ryosuke Suzuki
- Department of Neurosurgery, Yokohama City University, Yokohama, Japan
| | - Makoto Ohtake
- Department of Neurosurgery, Yokohama City University, Yokohama, Japan
| | - Hajime Takase
- Department of Neurosurgery, Yokohama City University, Yokohama, Japan
| | - Kensuke Tateishi
- Department of Neurosurgery, Yokohama City University, Yokohama, Japan
| | - Nobuyuki Shimizu
- Department of Neurosurgery, Yokohama City University, Yokohama, Japan
| | - Hidetoshi Murata
- Department of Neurosurgery, Yokohama City University, Yokohama, Japan
| | - Kengo Funakoshi
- Department of Neuroanatomy, Yokohama City University, Yokohama, Japan
| | | | - Tetsuya Yamamoto
- Department of Neurosurgery, Yokohama City University, Yokohama, Japan
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34
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Miyake Y, Fujii K, Nakamaura T, Ikegaya N, Matsushita Y, Gobayashi Y, Iwashita H, Udaka N, Kumagai J, Murata H, Takemoto Y, Yamanaka S, Ichimura K, Tateishi K, Yamamoto T. IDH-Mutant Astrocytoma With Chromosome 19q13 Deletion Manifesting as an Oligodendroglioma-Like Morphology. J Neuropathol Exp Neurol 2021; 80:247-253. [PMID: 33432322 DOI: 10.1093/jnen/nlaa161] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Partial deletions in chromosomes 1p and 19q are found in a subset of astrocytic tumors; however, it remains unclear how these alterations affect their histological features and prognosis. Herein, we present 3 cases of isocitrate dehydrogenase (IDH)-mutant astrocytoma with chromosome 19q13 deletion. In the first case, the primary tumor harbored an IDH1 mutation with chromosome 1p/19q partial deletions, which covered 19q13 and exhibited a durable initial response to radiotherapy and temozolomide (TMZ) treatment. However, the tumor lost the chromosome 1p/19q partial deletions at recurrence and became resistant to TMZ. Histologically, an oligodendroglioma-like feature was found in the primary tumor but not in the recurrent tumor. Capicua transcriptional repressor (CIC), located on 19q13, was less expressed in the primary tumor but was highly expressed in the recurrent tumor. Similar histological findings were observed in 2 other astrocytic tumors with IDH1 or IDH2 mutations. These tumors also had chromosome 19q13 deletion, including the CIC gene, weakly expressed CIC, and oligodendroglioma-like morphology. These tumors recurred at 6 and 32 months, respectively. These findings suggest that IDH-mutant astrocytoma with chromosome 19q13 partial deletion, including the CIC gene, may induce an oligodendroglioma-like phenotype, but the clinical prognosis may not be similar to that of genetically defined oligodendroglioma.
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Affiliation(s)
- Yohei Miyake
- From the Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Keita Fujii
- From the Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan.,Department of Neurosurgery, Yokohama City Minato Red Cross Hospital, Yokohama, Japan
| | - Taishi Nakamaura
- From the Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Naoki Ikegaya
- From the Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Yuko Matsushita
- From the Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan.,Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo, Japan
| | | | - Hiromichi Iwashita
- Department of Pathology, Yokohama City University Hospital, Yokohama, Japan
| | - Naoko Udaka
- Department of Pathology, Yokohama City University Hospital, Yokohama, Japan
| | - Jiro Kumagai
- Department of Pathology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan
| | - Hidetoshi Murata
- From the Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Yasunori Takemoto
- Department of Neurosurgery, Yokohama City Minato Red Cross Hospital, Yokohama, Japan
| | - Shoji Yamanaka
- Department of Pathology, Yokohama City University Hospital, Yokohama, Japan
| | - Koichi Ichimura
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo, Japan
| | - Kensuke Tateishi
- From the Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Tetsuya Yamamoto
- From the Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
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35
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Sasame J, Tateishi K, Ikegaya N, Miyake Y, Miyake S, Nakamura T, Yamamoto T. HGG-51. PAIRED EPITHELIOID GLIOBLASTOMA PATIENT DERIVED XENOGRAFT MODELS WITH/WITHOUT MOLECULAR TARGET THERAPY. Neuro Oncol 2020. [PMCID: PMC7715391 DOI: 10.1093/neuonc/noaa222.331] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Epithelioid glioblastoma (E-GBM) predominantly arises at younger age and promotes dismal prognosis. Because of its rare etiology, pathological and genetical characterization of E-GBM remains elusive. Herein, we report 2 patient-derived E-GBM xenograft (PDX) models from young adult patients (YMG62 and YMG89) with BRAFV600E and TERT promoter mutation. The YMG62 patient received dabrafenib with trametinib, while YMG89 patient received dabrafenib monotherapy after recurrence with Stupp regimen. These molecular target therapies were initially responded, but gradually became resistant (YMG62R and YMG89R) and resulted in lethal. Treatment resistant cells were collected from CSF. These primary cells were propagated at multiple passage in vitro. Paired PDX models were established from initial and recurrent cells. All PDX tumors were preferentially disseminated and negative expression of GFAP, which were recapitulated to the patient characteristics. BRAF and MEK inhibitor moderately suppressed cell viability of YMG62 and YMG89 in vitro. However, BRAF and MEK inhibitor became resistant at recurrence in vitro. Western blotting indicated retained phospho-MEK expression after BRAF/MEK inhibitor treatment in recurrent cells, which implies crucial role of MEK activation for tumor maintenance in BRAFV600E mutant E-GBM. Together, paired E-GBM PDX models with/without molecular target therapy recapitulate patient characteristics, which may contribute to elucidate tumor biology and establish novel therapeutic target in E-GBM.
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Affiliation(s)
- Jo Sasame
- Department of Neurosurgery Yokohama City University, Yokohama, Kanagawa, Japan
| | - Kensuke Tateishi
- Department of Neurosurgery Yokohama City University, Yokohama, Kanagawa, Japan
| | - Naoki Ikegaya
- Department of Neurosurgery Yokohama City University, Yokohama, Kanagawa, Japan
| | - Yohei Miyake
- Department of Neurosurgery Yokohama City University, Yokohama, Kanagawa, Japan
| | - Shigeta Miyake
- Department of Neurosurgery Yokohama City University, Yokohama, Kanagawa, Japan
| | - Taishi Nakamura
- Department of Neurosurgery Yokohama City University, Yokohama, Kanagawa, Japan
| | - Tetsuya Yamamoto
- Department of Neurosurgery Yokohama City University, Yokohama, Kanagawa, Japan
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36
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Tateishi K, Miyake Y, Kawazu M, Nakamura T, Sasaki N, Sasame J, Yoshii Y, Wakimoto H, Nagane M, Ichimura K, Yamamoto T. CBMS-04 Novel xenograft model to clarify tumor progressive mechanism and therapeutic target in primary central nervous system lymphoma. Neurooncol Adv 2020. [PMCID: PMC7699075 DOI: 10.1093/noajnl/vdaa143.015] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Primary central nervous system lymphoma (PCNSL) is a rare lymphoma of the central nervous system and has a dismal prognosis despite intensive chemotherapy. Recent genomic analyses have identified recurrent genetic alterations in Primary central nervous system lymphoma (PCNSL). However, lack of clinically representative PCNSL models has diminished our understanding of the pathogenic mechanisms of those genetic events. Here, we established 14 patient-derived orthotopic xenografts (PDOXs). Comprehensive analysis showed that PDOXs faithfully retained the phenotypic, metabolic, and genetic features with 100 % concordance of MYD88 and CD79B mutations present in immuno-competent PCNSL patients. Notably, orthotopic xenograft formation was consistently dependent on deregulated signaling through the RelA/p65-hexokinase 2 (HK-2) axis. MYD88/CD79B mutations and Pin1 activation, or LMP1 and Pin1 activation, converge on the RelA/p65-HK-2 signaling in immunocompetent and EBV-positive PCNSL, respectively. Genetic and pharmacological inhibition of this key signaling axis potently suppressed PCNSL tumor growth in vitro and in vivo. Additionally, our models further offer a platform for predicting clinical chemotherapeutics efficacy. Therefore, our models provide critical insights into pathogenic mechanisms and therapeutic discovery in PCNSL.
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Affiliation(s)
| | - Yohei Miyake
- Department of Neurosurgery, Yokohama City University
| | | | | | | | - Jo Sasame
- Department of Neurosurgery, Yokohama City University
| | - Yukie Yoshii
- Department of Neurosurgery, Yokohama City University
| | | | - Motoo Nagane
- Department of Neurosurgery, Yokohama City University
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37
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Hayashi T, Tateishi K, Ikegaya N, Udaka N, Sasame J, Miyake Y, Okabe T, Minamimoto R, Murata H, Utsunomiya D, Yamanaka S, Yamamoto T. CS-03 BRAF V600E mutation mediates FDG-methionine uptake mismatch in polymorphous low-grade neuroepithelial tumor of the young. Neurooncol Adv 2020. [PMCID: PMC7699058 DOI: 10.1093/noajnl/vdaa143.089] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
We present a case of a 14-year old boy with tumor-associated refractory epilepsy. Positron emission tomography imaging demonstrated a region with heterogeneous high 11 C-methionine uptake and a region with homogenous low 18 F- fluorodeoxyglucose uptake within the tumor. Histopathological and genomic analyses confirmed the tumor as BRAF V600E-mutated PLNTY (polymorphous low-grade neuroepithelial tumor of the young). Within the high-methionine-uptake region, we observed increased protein levels of L-type amino acid transporter 1 (LAT1) and constituents of the mitogen-activated protein kinase (MAPK) pathway. We also found that LAT1 expression was linked to BRAF V600E mutation and subsequent activation of MAPK signaling. Pharmacological inhibition of the MAPK pathway suppressed LAT1 expression and cell viability in PLNTY cells. Collectively, our results indicate that BRAF V600E mutation-activated MAPK signaling induces specific metabolic alterations in PLNTY, and may represent an attractive target in the treatment of the disease.
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Affiliation(s)
- Takahiro Hayashi
- The Department of Neurosurgery, Yokohama City University, Kanagawa, Japan
| | - Kensuke Tateishi
- The Department of Neurosurgery, Yokohama City University, Kanagawa, Japan
| | - Naoki Ikegaya
- The Department of Neurosurgery, Yokohama City University, Kanagawa, Japan
| | - Naoko Udaka
- The Department of Neurosurgery, Yokohama City University, Kanagawa, Japan
| | - Jo Sasame
- The Department of Neurosurgery, Yokohama City University, Kanagawa, Japan
| | - Yohei Miyake
- The Department of Neurosurgery, Yokohama City University, Kanagawa, Japan
| | - Tetsuhiko Okabe
- The Department of Neurosurgery, Yokohama City University, Kanagawa, Japan
| | - Ryogo Minamimoto
- The Department of Neurosurgery, Yokohama City University, Kanagawa, Japan
| | - Hidetoshi Murata
- The Department of Neurosurgery, Yokohama City University, Kanagawa, Japan
| | - Daisuke Utsunomiya
- The Department of Neurosurgery, Yokohama City University, Kanagawa, Japan
| | - Syoji Yamanaka
- The Department of Neurosurgery, Yokohama City University, Kanagawa, Japan
| | - Tetsuya Yamamoto
- The Department of Neurosurgery, Yokohama City University, Kanagawa, Japan
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38
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Sasame J, Tateishi K, Ikegaya N, Miyake Y, Nakamura T, Udaka N, Yamanaka S, Yamamoto T. SPDR-01 Paired epithelioid glioblastoma patient-derived xenograft models to evaluate resistant mechanism for molecular target therapy. Neurooncol Adv 2020. [PMCID: PMC7699076 DOI: 10.1093/noajnl/vdaa143.020] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Epithelioid glioblastoma (E-GBM) arises at younger age, commonly disseminates to cerebrospinal fluid, and results in dismal prognosis. About half of E-GBM harbors BRAF V600E mutation, thus BRAF/MEK inhibitors are expected to be specifically sensitive to E-GBM like other BRAF V600E mutant carcinomas. However, therapeutic effect is limited by the emergence of drug resistance. To overcome this issue, it is crucial to elucidate the treatment resistance mechanisms by clinically representative models. Herein, we establish 2 paired E-GBM patient-derived xenograft (PDX) models from young adult patients (YMG62 and YMG89) with BRAF V600E, TERT promoter mutations and CDKN2A homozygous deletions. The YMG62 patient received dabrafenib with trametinib, while YMG89 patient received dabrafenib monotherapy after recurrence with standard treatment. The YMG62 patient was refractory to combination therapy. The YMG89 patient was initially responded to dabrafenib, but gradually became resistant and the 2 patients died due to CNS dissemination. Paired PDX models were established from tumors prior and after molecular target therapy. All PDXs were formed as CNS dissemination model, which were recapitulated to the patient characteristics. BRAF/MEK inhibitors strongly suppressed cell viability in primary tumor (YMG89P). However, BRAF/MEK inhibitors became resistant in recurrent tumor (YMG89R). YMG62 paired PDXs were resistant to molecular target therapy. Western blotting indicated retained MAPK signaling pathway and/or increased AKT phosphorylation after BRAF/MEK inhibitors treatment in refractory and recurrent cells, which indicates crucial role of re-activation in the MAPK signaling pathway and/or PI3 kinase pathway for tumor maintenance in BRAF V600E mutant E-GBM. We have done high throughput drug screening to identify compounds to overcome resistant to molecular target therapy. Our established E-GBM paired PDX models recapitulate patient characteristics, which may uncover treatment resistant mechanism and novel therapeutic target in E-GBM.
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Affiliation(s)
- Jo Sasame
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Kensuke Tateishi
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Naoki Ikegaya
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Yohei Miyake
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Taishi Nakamura
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Naoko Udaka
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Shoji Yamanaka
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - Tetsuya Yamamoto
- Department of Neurosurgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
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Gupta M, Burns E, Georgantas N, Thierauf J, Nayyar N, Burns R, Velarde J, Brastianos P, Dietrich J, Marble H, Lennerz J, Romero J, Tateishi K, Cahill D, Shankar G. BIOM-54. A RAPID GENOTYPING PANEL FOR SENSITIVE AND SPECIFIC SEGREGATION OF CNS PATHOLOGIES. Neuro Oncol 2020. [DOI: 10.1093/neuonc/noaa215.051] [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: 11/14/2022] Open
Abstract
Abstract
Primary central nervous system lymphoma (PCNSL) remains challenging to diagnose due to nonspecific clinical and radiologic features and low diagnostic yields of cerebrospinal fluid (CSF) studies. We sought to characterize the diagnostic approach of suspected PCNSL, in order to improve clinical workflow. We first reviewed 1,007 new brain lesions of unknown etiology that included PCNSL in the radiologic differential diagnosis. The most common final diagnoses included high-grade glioma (28.2%) and PCNSL (14.6%). Diagnostic biopsies were frequently performed for high-grade glioma (100%) and PCNSL (94.4%), while CSF was frequently sampled for PCNSL (78.7%). We next identified 159 patients with an established new diagnosis of PCNSL. CSF studies were non-diagnostic in 86.7% of cases, whereas biopsy was positive in 93%. However, intraoperative histopathology was inconclusive for PNCSL in 54.5%, likely contributing to 22% of patients undergoing surgical resection. These challenges resulted in 12 days median time to treatment initiation, and readmission for further workup or treatment initiation in 27% of patients. These results indicated the need for a rapid, sensitive and specific platform to segregate PCNSL and glioma using CSF and tissue samples. We developed a qPCR-based assay to genotype the MYD88 L265P hotspot mutation from CSF and plasma within 80 minutes of sample acquisition. Results were concordant with orthogonal DNA sequencing in extracts from 87 archived specimens, with detection limits of 490pg of input genomic DNA and 0.15% mutant allele frequency. When performed simultaneously with assays for TERT promoter, IDH1/2, H3F3A and BRAF point mutations, the resulting panel accurately segregated PCNSL and adult diffuse glioma molecular diagnoses in 87 archived specimens and 19 prospective liquid biopsies, including cases of lymphoma and glioma. We propose that inclusion of targeted analysis of these mutually exclusive recurrent molecular alterations characterizing gliomas and PCNSL will facilitate rapid, sensitive diagnosis from solid and liquid biopsies.
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Affiliation(s)
- Mihir Gupta
- Massachusetts General Hospital, Boston, MA, USA
| | - Evan Burns
- Massachusetts General Hospital, Boston, MA, USA
| | | | | | - Naema Nayyar
- Massachusetts General Hospital, Foxborough, MA, USA
| | - Ryan Burns
- Massachusetts General Hospital, Boston, MA, USA
| | | | | | - Jorg Dietrich
- Department of Neurology, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | | | | | | | - Kensuke Tateishi
- Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Daniel Cahill
- Department of Neurosurgery, Translational Neuro-Oncology Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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40
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Nagashima H, Lee C, Tateishi K, Higuchi F, Subramanian M, Rafferty S, Melamed L, Miller J, Wakimoto H, Cahill D. TAMI-20. POLY(ADP-RIBOSE) GLYCOHYDROLASE INHIBITION SEQUESTERS NAD+ TO POTENTIATE THE METABOLIC LETHALITY OF ALKYLATING CHEMOTHERAPY IN IDH MUTANT TUMOR CELLS. Neuro Oncol 2020. [DOI: 10.1093/neuonc/noaa215.909] [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: 11/13/2022] Open
Abstract
Abstract
Mutations in IDH1 or IDH2 characterize the majority of diffuse infiltrative gliomas of younger adulthood. DNA alkylator chemotherapy has proven to be an effective treatment for IDH mutant glioma, yet recurrences remain frequent and improved treatments are needed. Upon exposure of cancer cells to DNA alkylating agents, poly(ADP-ribose) polymerases (PARPs) catalyze the transient oligomerization of nicotinamide adenine dinucleotide (NAD+) into poly-ADP-ribose (PAR) chain-assemblies, which stimulate the DNA damage response. Here, we find that, in IDH mutant glioma cells, alkylator-induced cytotoxicity is dramatically augmented by pharmacologic inhibition or genetic knockout of the PAR breakdown enzyme poly(ADP-ribose) glycohydrolase (PARG). Mechanistically, we show this augmentation is driven by a metabolic state pairing amplified alkylator-induced DNA damage with catastrophic depletion of NAD+. IDH mutant cancer cells have low basal levels of NAD+, rendering them vulnerable to prolonged NAD+ depletion. Either of two clinically-utilized monofunctional alkylators, procarbazine (PCZ) or temozolomide (TMZ), when exposed to multiple IDH mutant lines, activated PARP conversion of cellular NAD+ monomers into polymerized PAR. Subsequent PAR breakdown and recycling of NAD+ monomers was then halted by concomitant PARG inactivation, amplifying PARylation-mediated DNA damage signaling and critically depleting free NAD+, resulting in profound cytotoxicity. This effect was partially reversed by NAD+ rescue supplementation, confirming the key contribution of metabolic stress. Combined alkylator treatment and PARG inhibition in vivo maximized both NAD+ depletion and cytotoxicity in an endogenous IDH mutant cancer model. Thus, alkyating DNA damaging agents expose a metabolic liability in IDH mutant cancers, and subsequent targeted blockade of PAR breakdown and NAD+ metabolite recovery can exploit this vulnerability to provide genotype-specific therapeutic benefit.
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Affiliation(s)
- Hiroaki Nagashima
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Christine Lee
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Kensuke Tateishi
- Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Fumi Higuchi
- Department of Neurosurgery, Dokkyo Medical University, Shimotsuga, Japan
| | | | - Seamus Rafferty
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | | | - Hiroaki Wakimoto
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Daniel Cahill
- Department of Neurosurgery, Translational Neuro-Oncology Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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41
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Takahashi S, Takahashi M, Kinoshita M, Miyake M, Kawaguchi R, Shinojima N, Mukasa A, Saito K, Nagane M, Otani R, Ueki K, Tanaka S, Hata N, Nishikawa R, Arita H, Nonaka M, Tamura K, Tateishi K, Uda T, Fukai J, Okita Y, Tsuyuguchi N, Kanemura Y, Kobayashi K, Sese J, Ichimura K, Narita Y, Hamamoto R. NIMG-29. DEVELOPING AUTOMATIC SEGMENTATION METHOD FOR BRAIN TUMOR MR IMAGES THAT CAN BE USED AT MULTIPLE FACILITIES. Neuro Oncol 2020. [DOI: 10.1093/neuonc/noaa215.642] [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: 11/12/2022] Open
Abstract
Abstract
BACKGROUND
Manual segmentation of brain tumor images from a large volume of MR images generated in clinical routines is difficult and time-consuming. Hence, it is imperative to develop a machine learning model for automated segmentation of brain tumor images.
PURPOSE
Machine learning models for automated MR image segmentation of gliomas may be useful. However, the image differences among facilities cause performance degradation and impede successful automatic segmentation. In this study, we proposed a method to solve this issue.
METHODS
We used the data from the Multimodal Brain Tumor Image Segmentation Benchmark (BraTS) and the Japanese cohort (JC) datasets collected from 10 facilities. Three models for tumor segmentation were developed. The BraTS model was trained on the BraTS dataset, and the JC model was trained on the JC dataset; whereas, the Fine-tuning model was a fine-tuned BraTS model using the JC dataset.
RESULTS
MR images of 544 patients were obtained for the JC dataset. Half of the JC dataset was used for independent testing. The Dice coefficient score of the JC model for the JC dataset was 0.779± 0.137, whereas that of the BraTS model was remarkably lower (0.717 ± 0.207). The mean of the Fine-tuning models for the JC dataset was 0.769 ± 0.138. There was a significant difference between the BraTS and JC models (P < 0.0001) and the BraTS and Fine-tuning models (P = 0.002); however, no significant difference was observed between the JC and Fine-tuning models (P = 0.673).
CONCLUSIONS
Application of the BraTS model to heterogeneous datasets can significantly reduce its performance; however, fine-tuning can solve this issue. Since our fine-tuning method only requires less than 20 cases, this methodology is particularly useful for a facility where there are a few glioma cases.
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Affiliation(s)
- Satoshi Takahashi
- Division of Molecular Modification and Cancer Biology, National Cancer Center Research Institute, Bunkyoku, Tokyo, Japan
| | - Masamichi Takahashi
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Manabu Kinoshita
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Mototaka Miyake
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan
| | - Risa Kawaguchi
- Division of Molecular Modification and Cancer Biology, National Cancer Center Research Institute, Tokyo, Japan
| | - Naoki Shinojima
- Department of Neurosurgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Akitake Mukasa
- Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kuniaki Saito
- Department of Neurosurgery, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Motoo Nagane
- Department of Neurosurgery, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Ryohei Otani
- Department of Neurosurgery, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan
| | - Keisuke Ueki
- Department of Neurosurgery, Dokkyo Medical University, Shimotsuga, Japan
| | - Shota Tanaka
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Nobuhiro Hata
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ryo Nishikawa
- Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Hideyuki Arita
- Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masahiro Nonaka
- Saitama Medical University International Medical Center, Saitama, Japan
| | - Kaoru Tamura
- Tokyo Medical and Dental University, Tokyo, Japan
| | - Kensuke Tateishi
- Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | | | - Junya Fukai
- Department of Neurological Surgery, Wakayama Medical University, Wakayama, Japan
| | | | | | - Yonehiro Kanemura
- Department of Biomedical Research and Innovation, Institute for Clinical Research, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Kazuma Kobayashi
- Division of Molecular Modification and Cancer Biology, National Cancer Center Research Institute, Tokyo, Japan
| | - Jun Sese
- Division of Molecular Modification and Cancer Biology, National Cancer Center Research Institute, Tokyo, Japan
| | - Kouichi Ichimura
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo, Japan
| | - Yoshitaka Narita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Ryuji Hamamoto
- Division of Molecular Modification and Cancer Biology, National Cancer Center Research Institute, Tokyo, Japan
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Saito Y, Mori N, Saito K, Matsuoka T, Tateishi K, Kitahara H, Fujimoto Y, Kobayashi Y. Greater coronary lipid core plaque assessed by near-infrared spectroscopy intravascular ultrasound in patients with elevated xanthine oxidoreductase: a mechanistic insight. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1297] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Elevated serum uric acid level was reportedly associated with greater coronary lipid plaque. Xanthine oxidoreductase (XOR) is a rate-limiting enzyme in purine metabolism and believed to play important roles in coronary atherosclerosis. However, the relation of XOR to coronary lipid plaque and its mechanism are unclear.
Purpose
The aim of this study was to assess the impact of XOR on coronary lipid plaque and the associated factors with XOR in coronary artery disease (CAD).
Methods
Patients with stable CAD undergoing elective percutaneous coronary intervention under near-infrared spectroscopy intravascular ultrasound (NIRS-IVUS) guidance were prospectively enrolled. They were divided into three groups according to serum XOR activities; low, normal, and high. Coronary lipid core plaques in non-target vessels were evaluated by NIRS-IVUS with lipid core burden index (LCBI) and a maximum LCBI in 4 mm (maxLCBI4mm). Systemic endothelial function and inflammation were assessed with reactive hyperemia index (RHI) and high-sensitivity C-reactive protein, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio.
Results
Of 68 patients, 26, 31, and 11 were classified as low, normal, and high XOR activity groups. LCBI (474.4±171.6 vs. 347.4±181.6 vs. 294.0±155.9, p=0.04) and maxLCBI4mm (102.1±56.5 vs. 65.6±48.5 vs. 55.6±37.8, p=0.04) were significantly higher in high XOR group than in normal and low XOR groups. Although RHI was significantly correlated with body mass index, diabetes, current smoking, and high-density lipoprotein cholesterol, no relation was found between XOR activity and RHI (Figure). There were also no relations between XOR activity and high-sensitivity C-reactive protein, neutrophil-to-lymphocyte ratio, or platelet-to-lymphocyte ratio (Figure).
Conclusion
Elevated XOR activity was associated with greater coronary lipid plaque in patients with stable CAD, without significant relations to systemic endothelial function and inflammation.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- Y Saito
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - N Mori
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - K Saito
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - T Matsuoka
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - K Tateishi
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - H Kitahara
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - Y Fujimoto
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - Y Kobayashi
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
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43
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Kato K, Tateishi K, Saito Y, Kitahara H, Fujimoto Y, Kobayashi Y. Comparison of clinical characteristics between patients with microvascular and epicardial coronary artery spasm. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1281] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Coronary functional abnormalities including both epicardial and microvascular coronary artery spasm represent an important role responsible for myocardial ischemia in patients with angina and nonobstructive coronary artery disease. However, clinical characteristics associated with microvascular spasm (MVS) have not been fully evaluated.
Purpose
The aim of this study was to assess differences in clinical features between patients with MVS and epicardial coronary spasm.
Methods
A total of 732 consecutive patients with suspected angina who presented nonobstructive coronary arteries and underwent intracoronary acetylcholine provocation test were retrospectively enrolled in this study. Epicardial coronary spasm was defined as total or subtotal occlusion of epicardial coronary arteries accompanied by chest pain and/or ischemic electrocardiographic changes in response to acetylcholine provocation test. MVS was diagnosed when chest pain and/or ischemic electrocardiographic changes developed after administration of acetylcholine in the absence of epicardial coronary spasm. Clinical characteristics were compared between patients with MVS and epicardial coronary spasm.
Results
Of all patients, 83 patients (11%) had MVS, 367 (50%) had epicardial coronary spasm, and the other patients (39%) showed neither MVS nor epicardial coronary spasm. Patients with MVS tended to be older (65.6±12.7 vs. 63.0±12.3 years, P=0.088) and were more frequently female (60.2% vs. 41.1%, P=0.0016) in comparison with patients with epicardial coronary spasm. Patients with MVS were less likely to be smokers (8.6% vs. 22.9%, P=0.0018), while there were no significant differences in the other coronary risk factors such as hypertension, dyslipidemia, and diabetes mellitus. Serum uric acid were significantly lower in patients with MVS (4.9±1.1 vs. 5.4±1.3 mg/dl, P=0.0018).
Conclusion
Our study demonstrated that patients with MVS had distinctive clinical background from those with epicardial coronary spasm, suggesting different mechanisms may involve the development of MVS.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- K Kato
- Chiba University Graduate School of Medicine, Chiba, Japan
| | - K Tateishi
- Chiba University Graduate School of Medicine, Chiba, Japan
| | - Y Saito
- Chiba University Graduate School of Medicine, Chiba, Japan
| | - H Kitahara
- Chiba University Graduate School of Medicine, Chiba, Japan
| | - Y Fujimoto
- Chiba University Graduate School of Medicine, Chiba, Japan
| | - Y Kobayashi
- Chiba University Graduate School of Medicine, Chiba, Japan
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44
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Kato K, Tateishi K, Saito Y, Kitahara H, Fujimoto Y, Kobayashi Y. Age-related differences and vascular function test findings in patients with vasospastic angina. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1575] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Vasospastic angina (VSA) accounts for the majority of angina cases with no epicardial stenosis and develops amongawide range of age, which is reportedly induced by coronary functional abnormalities including endothelial dysfunction and smooth muscle hypercontraction. However, the relation of noninvasive vascular function tests to VSA remains to be fully elucidated.
Purpose
The aim of this study was to assess differences in clinical characteristics and findings from noninvasive vascular function tests among groups by age in patients with VSA.
Methods
We enrolled a total of 732 patients with angina who underwent intracoronary acetylcholine provocation test. VSA was defined as total or subtotal occlusion of epicardial coronary arteries accompanied by chest pain and/or ischemic electrocardiographic changes in response to acetylcholine administration. Patients with VSA were divided into 3 groups by age (young [<50 years], intermediate [50–64 years], and elderly group [≥65 years]). Noninvasive vascular function test findings such as ankle-brachial index (ABI), brachial-ankle pulse wave velocity (baPWV), andpercentage of mean arterial pressure (%MAP) were compared among groups by age in patients with VSA.
Results
Of all patients, 367 (50.1%) were diagnosed as VSA with intracoronary acetylcholine test, including 66 (18.0%), 113 (30.8%), and 188 (51.2%) patients in the young, intermediate, and elderly groups. Among groups by age, there was no significant difference in gender (female, 31.8% vs. 40.7% vs. 44.7%, P=0.19). Patients in the young group were more often smokers and alcohol drinkers than those in the intermediate and elderly groups, while the prevalence of hypertension, dyslipidemia, and diabetes were lower in younger patients. A history of percutaneous coronary intervention was less frequently found in the young group compared tothe intermediate and elderly groups (7.6% vs. 16.8% vs. 20.7%, P=0.033). The baPWV was higher in the elderly group (1424±232 vs. 1537±247 vs. 1774±358 cm/s, P<0.0001), while there was no difference in ABI between the 3 groups. %MAP at arms was significantly and progressively decreased with an increase in age (54.0±4.5% vs. 53.0±2.6% vs. 51.2±2.8%, P<0.0001).
Conclusion
Our study demonstrated that there were distinct age-related differences in clinical characteristics of patients with VSA. The higher %MAP in younger patients suggests that more impaired endothelial dysfunction may play a role in the development of VSA in this age group.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- K Kato
- Chiba University Graduate School of Medicine, Chiba, Japan
| | - K Tateishi
- Chiba University Graduate School of Medicine, Chiba, Japan
| | - Y Saito
- Chiba University Graduate School of Medicine, Chiba, Japan
| | - H Kitahara
- Chiba University Graduate School of Medicine, Chiba, Japan
| | - Y Fujimoto
- Chiba University Graduate School of Medicine, Chiba, Japan
| | - Y Kobayashi
- Chiba University Graduate School of Medicine, Chiba, Japan
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45
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Tateishi K, Miyake Y, Kawazu M, Sasaki N, Nakamura T, Sasame J, Yoshii Y, Ueno T, Miyake A, Watanabe J, Matsushita Y, Shiba N, Udaka N, Ohki K, Fink AL, Tummala SS, Natsumeda M, Ikegaya N, Nishi M, Ohtake M, Miyazaki R, Suenaga J, Murata H, Aoki I, Miller JJ, Fujii Y, Ryo A, Yamanaka S, Mano H, Cahill DP, Wakimoto H, Chi AS, Batchelor TT, Nagane M, Ichimura K, Yamamoto T. A Hyperactive RelA/p65-Hexokinase 2 Signaling Axis Drives Primary Central Nervous System Lymphoma. Cancer Res 2020; 80:5330-5343. [PMID: 33067267 DOI: 10.1158/0008-5472.can-20-2425] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 09/08/2020] [Accepted: 09/29/2020] [Indexed: 11/16/2022]
Abstract
Primary central nervous system lymphoma (PCNSL) is an isolated type of lymphoma of the central nervous system and has a dismal prognosis despite intensive chemotherapy. Recent genomic analyses have identified highly recurrent mutations of MYD88 and CD79B in immunocompetent PCNSL, whereas LMP1 activation is commonly observed in Epstein-Barr virus (EBV)-positive PCNSL. However, a lack of clinically representative preclinical models has hampered our understanding of the pathogenic mechanisms by which genetic aberrations drive PCNSL disease phenotypes. Here, we establish a panel of 12 orthotopic, patient-derived xenograft (PDX) models from both immunocompetent and EBV-positive PCNSL and secondary CNSL biopsy specimens. PDXs faithfully retained their phenotypic, metabolic, and genetic features, with 100% concordance of MYD88 and CD79B mutations present in PCNSL in immunocompetent patients. These models revealed a convergent functional dependency upon a deregulated RelA/p65-hexokinase 2 signaling axis, codriven by either mutated MYD88/CD79B or LMP1 with Pin1 overactivation in immunocompetent PCNSL and EBV-positive PCNSL, respectively. Notably, distinct molecular alterations used by immunocompetent and EBV-positive PCNSL converged to deregulate RelA/p65 expression and to drive glycolysis, which is critical for intracerebral tumor progression and FDG-PET imaging characteristics. Genetic and pharmacologic inhibition of this key signaling axis potently suppressed PCNSL growth in vitro and in vivo. These patient-derived models offer a platform for predicting clinical chemotherapeutics efficacy and provide critical insights into PCNSL pathogenic mechanisms, accelerating therapeutic discovery for this aggressive disease. SIGNIFICANCE: A set of clinically relevant CNSL xenografts identifies a hyperactive RelA/p65-hexokinase 2 signaling axis as a driver of progression and potential therapeutic target for treatment and provides a foundational preclinical platform. GRAPHICAL ABSTRACT: http://cancerres.aacrjournals.org/content/canres/80/23/5330/F1.large.jpg.
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Affiliation(s)
- Kensuke Tateishi
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan. .,Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Yohei Miyake
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan.,Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Masahito Kawazu
- Division of Cellular Signaling, National Cancer Center Research Institute, Tokyo, Japan
| | - Nobuyoshi Sasaki
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo, Japan.,Department of Neurosurgery, Kyorin University Graduate School of Medicine, Mitaka, Tokyo, Japan
| | - Taishi Nakamura
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan.,Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Jo Sasame
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan.,Neurosurgical-Oncology Laboratory, Yokohama City University, Yokohama, Japan
| | - Yukie Yoshii
- National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Toshihide Ueno
- Division of Cellular Signaling, National Cancer Center Research Institute, Tokyo, Japan
| | - Akio Miyake
- Department of Pathology, Yokohama City University Hospital, Yokohama, Japan
| | - Jun Watanabe
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
| | - Yuko Matsushita
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo, Japan
| | - Norio Shiba
- Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Naoko Udaka
- Department of Pathology, Yokohama City University Hospital, Yokohama, Japan
| | - Kentaro Ohki
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Alexandria L Fink
- Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts.,Translational-Neurooncology Laboratory, Brain Tumor Research Center, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts
| | - Shilpa S Tummala
- Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts.,Translational-Neurooncology Laboratory, Brain Tumor Research Center, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts
| | - Manabu Natsumeda
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
| | - Naoki Ikegaya
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Mayuko Nishi
- Department of Microbiology, Graduate School of Medicine, Yokohama City University Hospital, Yokohama, Japan
| | - Makoto Ohtake
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Ryohei Miyazaki
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Jun Suenaga
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Hidetoshi Murata
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Ichio Aoki
- National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Julie J Miller
- Translational-Neurooncology Laboratory, Brain Tumor Research Center, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts.,Stephen E. and Catherine Papas Center for Neuro-Oncology, Division of Hematology/Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Yukihiko Fujii
- Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan
| | - Akihide Ryo
- Department of Microbiology, Graduate School of Medicine, Yokohama City University Hospital, Yokohama, Japan
| | - Shoji Yamanaka
- Department of Pathology, Yokohama City University Hospital, Yokohama, Japan
| | - Hiroyuki Mano
- Division of Cellular Signaling, National Cancer Center Research Institute, Tokyo, Japan
| | - Daniel P Cahill
- Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts.,Translational-Neurooncology Laboratory, Brain Tumor Research Center, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts
| | - Hiroaki Wakimoto
- Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts.,Translational-Neurooncology Laboratory, Brain Tumor Research Center, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts
| | | | - Tracy T Batchelor
- Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Motoo Nagane
- Department of Neurosurgery, Kyorin University Faculty of Medicine, Mitaka, Tokyo, Japan
| | - Koichi Ichimura
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo, Japan
| | - Tetsuya Yamamoto
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
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Nagashima H, Lee C, Tateishi K, Higuchi F, Subramanian M, Rafferty S, Melamed L, Miller J, Wakimoto H, Cahill D. Poly(ADP-ribose) glycohydrolase inhibition sequesters NAD+ to potentiate the metabolic lethality of alkylating chemotherapy in IDH mutant tumor cells. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)31100-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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47
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Tateishi K, Ikegaya N, Udaka N, Sasame J, Hayashi T, Miyake Y, Okabe T, Minamimoto R, Murata H, Utsunomiya D, Yamanaka S, Yamamoto T. BRAF V600E mutation mediates FDG-methionine uptake mismatch in polymorphous low-grade neuroepithelial tumor of the young. Acta Neuropathol Commun 2020. [PMID: 32811569 DOI: 10.1186/s40478-020-01023-3.pmid:32811569;pmcid:pmc7436956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023] Open
Abstract
We present a case of a 14-year old boy with tumor-associated refractory epilepsy. Positron emission tomography imaging demonstrated a region with heterogeneous high 11C-methionine uptake and a region with homogenous low 18F-fluorodeoxyglucose uptake within the tumor. Histopathological and genomic analyses confirmed the tumor as BRAF V600E-mutated polymorphous low-grade neuroepithelial tumor of the young (PLNTY). Within the high-methionine-uptake region, we observed increased protein levels of L-type amino acid transporter 1 (LAT1), a major transporter of methionine; c-Myc; and constituents of the mitogen-activated protein kinase (MAPK) pathway. We also found that LAT1 expression was linked to the BRAF V600E mutation and subsequent activation of MAPK signaling and c-Myc. Pharmacological and genetic inhibition of the MAPK pathway suppressed c-Myc and LAT1 expression in BRAF V600E-mutated PLNTY and glioblastoma cells. The BRAF inhibitor dabrafenib moderately suppressed cell viability in PLNTY. Collectively, our results indicate that BRAF V600E mutation-activated MAPK signaling and downstream c-Myc induces specific metabolic alterations in PLNTY, and may represent an attractive target in the treatment of the disease.
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Affiliation(s)
- Kensuke Tateishi
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa, Yokohama, 2360004, Japan.
| | - Naoki Ikegaya
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa, Yokohama, 2360004, Japan
| | - Naoko Udaka
- Department of Pathology, Yokohama City University Hospital, Yokohama, Japan
| | - Jo Sasame
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa, Yokohama, 2360004, Japan
| | - Takahiro Hayashi
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa, Yokohama, 2360004, Japan
| | - Yohei Miyake
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa, Yokohama, 2360004, Japan
| | - Tetsuhiko Okabe
- Department of Radiology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Ryogo Minamimoto
- Departmento of Radiology, Division of Nuclear Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hidetoshi Murata
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa, Yokohama, 2360004, Japan
| | - Daisuke Utsunomiya
- Department of Radiology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Shoji Yamanaka
- Department of Pathology, Yokohama City University Hospital, Yokohama, Japan
| | - Tetsuya Yamamoto
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa, Yokohama, 2360004, Japan
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48
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Tateishi K, Ikegaya N, Udaka N, Sasame J, Hayashi T, Miyake Y, Okabe T, Minamimoto R, Murata H, Utsunomiya D, Yamanaka S, Yamamoto T. BRAF V600E mutation mediates FDG-methionine uptake mismatch in polymorphous low-grade neuroepithelial tumor of the young. Acta Neuropathol Commun 2020; 8:139. [PMID: 32811569 PMCID: PMC7436956 DOI: 10.1186/s40478-020-01023-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 08/12/2020] [Indexed: 02/06/2023] Open
Abstract
We present a case of a 14-year old boy with tumor-associated refractory epilepsy. Positron emission tomography imaging demonstrated a region with heterogeneous high 11C-methionine uptake and a region with homogenous low 18F-fluorodeoxyglucose uptake within the tumor. Histopathological and genomic analyses confirmed the tumor as BRAF V600E-mutated polymorphous low-grade neuroepithelial tumor of the young (PLNTY). Within the high-methionine-uptake region, we observed increased protein levels of L-type amino acid transporter 1 (LAT1), a major transporter of methionine; c-Myc; and constituents of the mitogen-activated protein kinase (MAPK) pathway. We also found that LAT1 expression was linked to the BRAF V600E mutation and subsequent activation of MAPK signaling and c-Myc. Pharmacological and genetic inhibition of the MAPK pathway suppressed c-Myc and LAT1 expression in BRAF V600E-mutated PLNTY and glioblastoma cells. The BRAF inhibitor dabrafenib moderately suppressed cell viability in PLNTY. Collectively, our results indicate that BRAF V600E mutation-activated MAPK signaling and downstream c-Myc induces specific metabolic alterations in PLNTY, and may represent an attractive target in the treatment of the disease.
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49
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Nagashima H, Lee CK, Tateishi K, Higuchi F, Subramanian M, Rafferty S, Melamed L, Miller JJ, Wakimoto H, Cahill DP. Poly(ADP-ribose) Glycohydrolase Inhibition Sequesters NAD + to Potentiate the Metabolic Lethality of Alkylating Chemotherapy in IDH-Mutant Tumor Cells. Cancer Discov 2020; 10:1672-1689. [PMID: 32606138 DOI: 10.1158/2159-8290.cd-20-0226] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 05/31/2020] [Accepted: 06/24/2020] [Indexed: 11/16/2022]
Abstract
NAD+ is an essential cofactor metabolite and is the currency of metabolic transactions critical for cell survival. Depending on tissue context and genotype, cancer cells have unique dependencies on NAD+ metabolic pathways. PARPs catalyze oligomerization of NAD+ monomers into PAR chains during cellular response to alkylating chemotherapeutics, including procarbazine or temozolomide. Here we find that, in endogenous IDH1-mutant tumor models, alkylator-induced cytotoxicity is markedly augmented by pharmacologic inhibition or genetic knockout of the PAR breakdown enzyme PAR glycohydrolase (PARG). Both in vitro and in vivo, we observe that concurrent alkylator and PARG inhibition depletes freely available NAD+ by preventing PAR breakdown, resulting in NAD+ sequestration and collapse of metabolic homeostasis. This effect reversed with NAD+ rescue supplementation, confirming the mechanistic basis of cytotoxicity. Thus, alkylating chemotherapy exposes a genotype-specific metabolic weakness in tumor cells that can be exploited by PARG inactivation. SIGNIFICANCE: Oncogenic mutations in the isocitrate dehydrogenase genes IDH1 or IDH2 initiate diffuse gliomas of younger adulthood. Strategies to maximize the effectiveness of chemotherapy in these tumors are needed. We discover alkylating chemotherapy and concurrent PARG inhibition exploits an intrinsic metabolic weakness within these cancer cells to provide genotype-specific benefit.See related commentary by Pirozzi and Yan, p. 1629.This article is highlighted in the In This Issue feature, p. 1611.
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Affiliation(s)
- Hiroaki Nagashima
- Translational Neuro-Oncology Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.,Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Christine K Lee
- Translational Neuro-Oncology Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.,Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Kensuke Tateishi
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Fumi Higuchi
- Department of Neurosurgery, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Megha Subramanian
- Translational Neuro-Oncology Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Seamus Rafferty
- Translational Neuro-Oncology Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Lisa Melamed
- Translational Neuro-Oncology Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Julie J Miller
- Translational Neuro-Oncology Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. .,Division of Neuro-Oncology, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Hiroaki Wakimoto
- Translational Neuro-Oncology Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. .,Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Daniel P Cahill
- Translational Neuro-Oncology Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. .,Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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50
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Miyazaki R, Murata H, Sato M, Ueno R, Ikegaya N, Matsumoto S, Abe H, Nagao K, Shimizu N, Tateishi K, Suenaga J, Yamamoto T. Incision Edge "Lifting Method" in Cerebral Bypass Surgery: A Novel Optional Technique for Narrow or Thin Recipient Arteries. World Neurosurg 2020; 141:196-202. [PMID: 32561485 DOI: 10.1016/j.wneu.2020.06.077] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Cerebral bypass surgery, such as the superficial temporal artery-middle cerebral artery bypass, is one of the essential procedures for cerebral revascularization. However, very narrow or thin blood vessels will increase the risk of anastomotic problems, such as occurs in Moyamoya disease. For such vessels, we have devised a "lifting method" in the recipient arteriotomy. In the present study, we have introduced this novel optional technique and evaluated its effects. METHODS The lifting method is a procedure of lifting the incision edge of a linear incision on the recipient vessel to widen the ostium. We attempted the lifting method in 23 consecutive patients (41 arteries) and, as a historical control, compared the results with those from the conventional method in 25 consecutive patients (37 arteries) for the previous 3 years. We compared patient age, years of surgical experience, recipient vessel diameter, anastomotic events, and final patency. As a subanalysis, the same evaluations were performed separately for patients with Moyamoya disease. Furthermore, the time required for the lifting procedure was measured retrospectively. RESULTS The incidence of anastomotic events with the conventional method was 13.5% overall and 19% in those with Moyamoya disease. No adverse events occurred with the lifting method (P < 0.05). No statistically significant differences were found for the other factors, including final patency between the 2 groups. The time required for the lifting procedure averaged 1 minute, 15 seconds. CONCLUSIONS Use of the lifting method widens and secures the ostium in a recipient vessel and greatly facilitates operability. We have found it to be a foolproof method enabling safe and reliable anastomosis even with narrow or thin vessels.
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Affiliation(s)
- Ryohei Miyazaki
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hidetoshi Murata
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
| | - Mitsuru Sato
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Ryu Ueno
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Naoki Ikegaya
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Shutaro Matsumoto
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hiroyuki Abe
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kagemichi Nagao
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Nobuyuki Shimizu
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kensuke Tateishi
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Jun Suenaga
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Tetsuya Yamamoto
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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