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De Smedt J, Aura C, Van Kelst S, Janssen L, Marasigan V, Boecxstaens V, Stas M, Bogaerts K, Belmans A, Cleynen I, Vanderschueren D, Vandenberghe K, Bechter O, Nikkels A, Strobbe T, Emri G, Lambrechts D, Garmyn M. Clinical and genetic determinants of vitamin D receptor expression in cutaneous melanoma patients. Melanoma Res 2024; 34:125-133. [PMID: 38348498 PMCID: PMC10906192 DOI: 10.1097/cmr.0000000000000929] [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: 03/31/2023] [Accepted: 09/02/2023] [Indexed: 03/02/2024]
Abstract
Decrease of vitamin D receptor (VDR) expression is observed in melanocytic naevi and melanoma compared to normal skin. Little is known about factors influencing VDR expression in cutaneous melanoma (CM). We investigated the correlation of VDR expression in CM with 25-hydroxy vitamin D (25OHD) levels, demographic/clinical parameters, genetic variants of VDR and pathology of the primary tumor. Demographic/clinical parameters were recorded in 407 prospectively recruited CM patients of a multi-center controlled study (ViDMe trial). We determined VDR expression both in the nucleus and in the cytoplasm by semi-quantitative assessment in CM tissue using histochemistry in 279 patients, expressed in percentages and histoscore (H-score). Genomic DNA from 332 patients was extracted to genotype thirteen VDR single nucleotide polymorphisms (SNPs) using TaqMan. VDR expression in CM tissue from 279 patients was correlated with clinical/demographic parameters and 25OHD levels (univariable and multivariable analysis), VDR SNPs (univariable analysis) and pathology parameters of primary CM tissue (univariable analysis). Cytoplasmic VDR expression was increased in patients who stated to have a high sun exposure during their life compared to patients with low sun exposure (p H-score,univariable : 0.001, p H-score,multivariable : 0.004). The A allele of the genetic VDR polymorphism Fok1 was associated with a higher expression of the VDR in the cytoplasm (p cytoplasmic, univariable : 0.001 and p H-score, univariable : 0.02). In the primary tumor, presence of mitosis (p nucleus,%, univariable : 0.002) and perineural invasion (p nucleus,%,univariable : 0.03) were significantly associated with low nuclear VDR expression. ClinicalTrials.gov Identifier: NCT01748448.
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Affiliation(s)
- Julie De Smedt
- Laboratory of Dermatology, Department of Oncology, KU Leuven, UZ Leuven, Leuven, Belgium
| | - Claudia Aura
- Conway Institute of Biomolecular and Biomedical Research, Pathology, University College Dublin, Dublin
| | - Sofie Van Kelst
- Laboratory of Dermatology, Department of Oncology, KU Leuven, UZ Leuven, Leuven, Belgium
| | - Laudine Janssen
- Laboratory of Dermatology, Department of Oncology, KU Leuven, UZ Leuven, Leuven, Belgium
| | - Vivien Marasigan
- Department of Surgery, South Infirmary Victoria University Hospital, Cork, Ireland
| | - Veerle Boecxstaens
- Oncological and Vascular Access Surgery, Department of Surgical Oncology
| | - Marguerite Stas
- Oncological and Vascular Access Surgery, Department of Surgical Oncology
| | - Kris Bogaerts
- Leuven Biostatistics and Statistical Bioinformatics Centre (L-BioStat)
| | - Ann Belmans
- Leuven Biostatistics and Statistical Bioinformatics Centre (L-BioStat)
| | - Isabelle Cleynen
- Laboratory for Complex Genetics, Department of Human Genetics, KU Leuven
| | - Dirk Vanderschueren
- Clinical and Experimental Endocrinology, Department of Chronical Illness and Metabolism, KU Leuven, UZ Leuven
| | | | - Oliver Bechter
- Laboratory of Experimental Oncology (LEO), Department of Oncology, KU Leuven, UZ Leuven, Leuven
| | - Arjen Nikkels
- Department of Dermatology, CHU Sart Tilman, University of Liège, Liège
| | - Tinne Strobbe
- Department of Dermatology, Imeldaziekenhuis, Bonheiden, Belgium
| | - Gabriella Emri
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Dieter Lambrechts
- Laboratory for Translational Genetics, Department of Oncology, KU Leuven
- Center for Cancer Biology (VIB), Leuven, Belgium
| | - Marjan Garmyn
- Laboratory of Dermatology, Department of Oncology, KU Leuven, UZ Leuven, Leuven, Belgium
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2
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Reijers SJM, Davies E, Grünhagen DJ, Fiore M, Honore C, Rastrelli M, Vassos N, Podleska LE, Niethard M, Jakob J, Perhavec A, Duarte C, González F, Deroose JP, Stas M, Boecxstaens V, Schrage Y, Snow H, Algarra SM, Said HM, Ortega DYG, Martin K, Mattsson J, Djafarrian R, Di Lorenzo G, Colombo C, Gronchi A, Matter M, Verhoef C, Bagge RO, Hohenberger P, Hayes AJ, van Houdt WJ. Variation in response rates to isolated limb perfusion in different soft-tissue tumour subtypes: an international multi-centre study. Eur J Cancer 2023; 190:112949. [PMID: 37453241 DOI: 10.1016/j.ejca.2023.112949] [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: 03/29/2023] [Revised: 05/11/2023] [Accepted: 06/13/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the response rates of different extremity soft-tissue sarcoma subtypes (eSTS) after isolated limb perfusion (ILP), based on an international multi-centre study. MATERIALS AND METHODS The retrospective cohort comprised eSTS patients from 17 specialised ILP centres that underwent melphalan-based ILP, with or without recombinant human tumour necrosis factor (rhTNFα) (TM-ILP and M-ILP, respectively). Response was measured on imaging (magnetic resonance imaging) and/or clinical response, for which M-ILPs were excluded. RESULTS A total of 1109 eSTS patients were included. The three most common histological subtypes were undifferentiated pleomorphic sarcoma (17%, n = 184), synovial sarcoma (16%, n = 175) and myxofibrosarcoma (8%, n = 87). rhTNFα was used in 93% (TM-ILP) and resulted in a significantly better overall response rate (ORR, p = 0.031) and complete responses (CR, p < 0.001) in comparison to M-ILP, without significant differences among histological subgroups. The ORR of TM-ILP was 68%, including 17% CR. Also, 80% showed progressive disease. Significantly higher response rates were shown for Kaposi sarcoma (KS) with 42% CR and 96% ORR (both p < 0.001), and significantly higher CR rates for angiosarcoma (AS, 45%, p < 0.001) and clear cell sarcoma (CCS, 31%, p = 0.049). ILP was followed by resection ≤ 6 months in 80% of the patients. The overall limb salvage rate was 88%, without significant differences among histological subgroups, but was significantly higher for ILP responders compared to non-responders (93% versus 76%, p < 0.001). CONCLUSION ILP resulted in high response and LRS among all eSTS subtypes, however, with significant differences between subtypes with most promising results for KS, AS and CCS.
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Affiliation(s)
- Sophie J M Reijers
- Department of Surgical Oncology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands.
| | - Emma Davies
- Department of Surgical Oncology, Royal Marsden Hospital, 203 Fulham Rd., SW3 6JJ London, UK.
| | - Dirk J Grünhagen
- Department of Surgical Oncology, Erasmus Medical Center, Doctor Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands.
| | - Marco Fiore
- Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133 Milan, Italy.
| | - Charles Honore
- Department of Surgical Oncology, Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, 94805 Villejuif, France.
| | - Marco Rastrelli
- Department of Surgery Oncology and Gastroenterology, University of Padova, Via VIII Febbraio, 2, 35122 Padua, Italy; Department of Surgical Oncology, Istituto Oncologico Veneto (IOV), Via Gattamelata, 64, 35128 Padua, Italy.
| | - Nikolaos Vassos
- Division of Surgical Oncology, Mannheim University Medical Center, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.
| | - Lars E Podleska
- Department of Orthopaedic Oncology and Soft Tissue Sarcoma, Essen University Hospital, Hufelandstraße 55, 45147 Essen, Germany.
| | - Maya Niethard
- Department of Surgical Oncology, Helios Klinikum Berlin-Buch, Schwanebecker Ch 50, 13125 Berlin, Germany; Department of Orthopedic Surgery, University Medicine Greifswald, Fleischmannstraße 6, 17489 Greifswald, Germany.
| | - Jens Jakob
- Department of Orthopaedic Oncology and Soft Tissue Sarcoma, Essen University Hospital, Hufelandstraße 55, 45147 Essen, Germany.
| | - Andraz Perhavec
- Department of Surgical Oncology, Institute of Oncology Ljubljana, Zaloška cesta 2, 1000 Ljubljana, Slovenia.
| | - Carlos Duarte
- Department of Surgical Oncology, Instituto Nacional de Cancerología, Cl. 1 #9-85, Bogota, Colombia.
| | - Felipe González
- Department of Surgical Oncology, Instituto Nacional de Cancerología, Cl. 1 #9-85, Bogota, Colombia.
| | - Jan P Deroose
- Department of Surgical Oncology, Martini Ziekenhuis, Van Swietenplein 1, 9728 NT Groningen, the Netherlands.
| | - Marguerite Stas
- Department of Surgical Oncology, Universitair Ziekenhuis Leuven, Herestraat 49, 3000 Leuven, Belgium.
| | - Veerle Boecxstaens
- Department of Surgical Oncology, Universitair Ziekenhuis Leuven, Herestraat 49, 3000 Leuven, Belgium.
| | - Yvonne Schrage
- Department of Surgical Oncology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands.
| | - Hayden Snow
- Department of Surgical Oncology, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC 3000. Australia.
| | - Salvador Martín Algarra
- Department of Medical Oncology, Clínica Universidad de Navarra, Av. de Pío XII, 36, 31008 Pamplona, Spain.
| | - Hector Martinez Said
- Department of Surgical Oncology, National Cancer Institute Mexico, Av. San Fernando 22, Belisario Domínguez Secc 16, Tlalpan, 14080 Mexico City, Mexico.
| | - Dorian Yarih Garcia Ortega
- Department of Surgical Oncology, National Cancer Institute Mexico, Av. San Fernando 22, Belisario Domínguez Secc 16, Tlalpan, 14080 Mexico City, Mexico.
| | - Karla Martin
- Department of Surgical Oncology, National Cancer Institute Mexico, Av. San Fernando 22, Belisario Domínguez Secc 16, Tlalpan, 14080 Mexico City, Mexico.
| | - Jan Mattsson
- Department of Surgery, Sahlgrenska University Hospital, Blå stråket 5, 413 45 Gothenburg, Sweden; Institute of Clinical Sciences, Sahlgrenska Academy at Gothenburg University, Medicinaregatan 3, 413 90 Gothenburg, Sweden.
| | - Reza Djafarrian
- Department of Visceral Surgery, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland.
| | - Giorgia Di Lorenzo
- Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133 Milan, Italy.
| | - Chiara Colombo
- Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133 Milan, Italy.
| | - Alessandro Gronchi
- Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133 Milan, Italy.
| | - Maurice Matter
- Department of Visceral Surgery, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland.
| | - Cornelis Verhoef
- Department of Surgical Oncology, Erasmus Medical Center, Doctor Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands.
| | - Roger Olofsson Bagge
- Department of Surgery, Sahlgrenska University Hospital, Blå stråket 5, 413 45 Gothenburg, Sweden; Institute of Clinical Sciences, Sahlgrenska Academy at Gothenburg University, Medicinaregatan 3, 413 90 Gothenburg, Sweden.
| | - Peter Hohenberger
- Division of Surgical Oncology, Mannheim University Medical Center, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.
| | - Andrew J Hayes
- Department of Surgical Oncology, Royal Marsden Hospital, 203 Fulham Rd., SW3 6JJ London, UK.
| | - Winan J van Houdt
- Department of Surgical Oncology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands.
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3
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De Smedt J, Van Kelst S, Janssen L, Marasigan V, Boecxstaens V, Stas M, Vanderschueren D, Guler I, Bogaerts K, Vandenberghe K, Bechter O, Billen J, Nikkels A, Strobbe T, Emri G, Lambrechts D, Garmyn M. Determinants of 25-hydroxyvitamin D Status in a Cutaneous Melanoma Population. Acta Derm Venereol 2022; 102:adv00692. [PMID: 35312026 PMCID: PMC9609978 DOI: 10.2340/actadv.v102.262] [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] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2022] [Indexed: 12/12/2022] Open
Abstract
Vitamin D status is influenced by well-known determinants, but factors associated with low 25-hydroxyvitamin D levels in the cutaneous melanoma population are not well defined. The aim of this study was to confirm the well-known determinants and to assess new determinants for 25-hydroxyvitamin D levels in a cutaneous melanoma population. In a prospectively included cohort of 387 patients with cutaneous melanoma the association of 25-hydroxyvitamin D levels with sex, age, body mass index, time of blood withdrawal, Fitzpatrick phototype, vitamin D supplementation, score for intensity of lifetime sun exposure, smoking, education level, hair and skin colour, eye colour, total number of benign naevi, freckles and parameters of chronic sun damage was investigated. In addition, 25-hydroxyvitamin D levels were correlated with pathological parameters of the primary tumour and melanoma stage (8th edition of the American Joint Committee on Cancer (AJCC). Univariate and multivariate logistic regressions were performed using R software. The following factors had a significant effect on vitamin D status: body mass index, seasonal time of blood sampling, vitamin D supplementation, and a subtype of skin, and hair colour.
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Affiliation(s)
- Julie De Smedt
- School of Biomedical sciences, Department of Oncology, Catholic University of Leuven, Herestraat 49, 3000 Leuven, Belgium.
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4
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Brochez L, Baurain JF, Del Marmol V, Nikkels A, Kruse V, Sales F, Stas M, Van Laethem A, Garmyn M. Recommendations for skin cancer consultation and surgery during COVID-19 pandemic. J Eur Acad Dermatol Venereol 2020; 34:1876-1878. [PMID: 32789960 PMCID: PMC7436227 DOI: 10.1111/jdv.16772] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/10/2020] [Accepted: 06/15/2020] [Indexed: 11/28/2022]
Abstract
Linked articles: COVID‐19 SPECIAL FORUM. J Eur Acad Dermatol Venereol 2020; 34: e433–e466.
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Affiliation(s)
- L Brochez
- Dermatology, University Hospital Gent, Ghent, Belgium
| | - J F Baurain
- Centre du Cancer, Cu Saint-Luc/UCL, Brussels, Belgium
| | - V Del Marmol
- Dermatology, Hôspital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - A Nikkels
- Dermatology, CHU du Sart Tilman, University of Liège, Liège, Belgium
| | - V Kruse
- Oncology, University Hospital Gent, Ghent, Belgium
| | - F Sales
- Surgery, Bordet Institute, Brussels, Belgium
| | - M Stas
- Oncological Surgery, University Hospital Leuven, Leuven, Belgium
| | - A Van Laethem
- Dermatology, University Hospital Leuven, Leuven, Belgium
| | - M Garmyn
- Dermatology, University Hospital Leuven, Leuven, Belgium
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5
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Pinelli F, Pittiruti M, Van Boxtel T, Barone G, Biffi R, Capozzoli G, Crocoli A, Elli S, Elisei D, Fabiani A, Garrino C, Graziano U, Montagnani L, Prato AP, Scoppettuolo G, Zadra N, Zanaboni C, Zerla P, Konstantinou E, Jones M, Rosay H, Simcock L, Stas M, Pepe G. GAVeCeLT-WoCoVA Consensus on subcutaneously anchored securement devices for the securement of venous catheters: Current evidence and recommendations for future research. J Vasc Access 2020. [PMID: 32613887 DOI: 10.1177/1129729820924568.] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Subcutaneously anchored securement devices (or subcutaneous engineered securement devices) have been introduced recently into the clinical practice, but the number of published studies is still scarce. The Italian Group of Long-Term Central Venous Access Devices (GAVeCeLT)-in collaboration with WoCoVA (World Congress on Vascular Access)-has developed a Consensus about the effectiveness, safety, and cost-effectiveness of such devices. METHODS After the definition of a panel of experts, a systematic collection and review of the literature on subcutaneously anchored securement devices was performed. The panel has been divided in two working groups, one focusing on adult patients and the other on children and neonates. RESULTS Although the quality of evidence is generally poor, since it is based mainly on non-controlled prospective studies, the panel has concluded that subcutaneously anchored securement devices are overall effective in reducing the risk of dislodgment and they appear to be safe in all categories of patients, being associated only with rare and negligible local adverse effects; cost-effectiveness is demonstrated-or highly likely-in specific populations of patients with long-term venous access and/or at high risk of dislodgment. CONCLUSION Subcutaneously anchored securement is a very promising strategy for avoiding dislodgment. Further studies are warranted, in particular for the purpose of defining (a) the best management of the anchoring device so to avoid local problems, (b) the patient populations in which it may be considered highly cost-effective and even mandatory, (c) the possible benefit in terms of reduction of other catheter-related complications such as venous thrombosis and/or infection, and-last but not least-(d) their impact on the workload and stress level of nurses taking care of the devices.
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Affiliation(s)
- Fulvio Pinelli
- Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | | | | | | | | | | | | | - Stefano Elli
- Azienda Ospedaliera San Gerardo, Lombardia, Italy
| | | | - Adam Fabiani
- Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy
| | | | - Ugo Graziano
- Santobono Pausilipon Azienda Ospedaliera Pediatrica, Napoli, Italy
| | | | - Alessio Pini Prato
- Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | | | | | | | - Pietro Zerla
- ASST Melegnano e della Martesana, Vizzolo Predabissi, Italy
| | | | - Matt Jones
- East Kent Hospitals University NHS Foundation Trust, Kent, UK
| | | | - Liz Simcock
- University College London Hospitals NHS Foundation Trust, London, UK
| | | | - Gilda Pepe
- University Hospital Agostino Gemelli, Rome, Italy
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6
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Pinelli F, Pittiruti M, Van Boxtel T, Barone G, Biffi R, Capozzoli G, Crocoli A, Elli S, Elisei D, Fabiani A, Garrino C, Graziano U, Montagnani L, Prato AP, Scoppettuolo G, Zadra N, Zanaboni C, Zerla P, Konstantinou E, Jones M, Rosay H, Simcock L, Stas M, Pepe G. GAVeCeLT-WoCoVA Consensus on subcutaneously anchored securement devices for the securement of venous catheters: Current evidence and recommendations for future research. J Vasc Access 2020; 22:716-725. [PMID: 32613887 DOI: 10.1177/1129729820924568] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [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
Background: Subcutaneously anchored securement devices (or subcutaneous engineered securement devices) have been introduced recently into the clinical practice, but the number of published studies is still scarce. The Italian Group of Long-Term Central Venous Access Devices (GAVeCeLT)—in collaboration with WoCoVA (World Congress on Vascular Access)—has developed a Consensus about the effectiveness, safety, and cost-effectiveness of such devices. Methods: After the definition of a panel of experts, a systematic collection and review of the literature on subcutaneously anchored securement devices was performed. The panel has been divided in two working groups, one focusing on adult patients and the other on children and neonates. Results: Although the quality of evidence is generally poor, since it is based mainly on non-controlled prospective studies, the panel has concluded that subcutaneously anchored securement devices are overall effective in reducing the risk of dislodgment and they appear to be safe in all categories of patients, being associated only with rare and negligible local adverse effects; cost-effectiveness is demonstrated—or highly likely—in specific populations of patients with long-term venous access and/or at high risk of dislodgment. Conclusion: Subcutaneously anchored securement is a very promising strategy for avoiding dislodgment. Further studies are warranted, in particular for the purpose of defining (a) the best management of the anchoring device so to avoid local problems, (b) the patient populations in which it may be considered highly cost-effective and even mandatory, (c) the possible benefit in terms of reduction of other catheter-related complications such as venous thrombosis and/or infection, and—last but not least—(d) their impact on the workload and stress level of nurses taking care of the devices.
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Affiliation(s)
- Fulvio Pinelli
- Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | | | | | | | | | | | | | - Stefano Elli
- Azienda Ospedaliera San Gerardo, Lombardia, Italy
| | | | - Adam Fabiani
- Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy
| | | | - Ugo Graziano
- Santobono Pausilipon Azienda Ospedaliera Pediatrica, Napoli, Italy
| | | | - Alessio Pini Prato
- Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | | | | | | | - Pietro Zerla
- ASST Melegnano e della Martesana, Vizzolo Predabissi, Italy
| | | | - Matt Jones
- East Kent Hospitals University NHS Foundation Trust, Kent, UK
| | | | - Liz Simcock
- University College London Hospitals NHS Foundation Trust, London, UK
| | | | - Gilda Pepe
- University Hospital Agostino Gemelli, Rome, Italy
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7
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Bosisio FM, Antoranz A, van Herck Y, Bolognesi MM, Marcelis L, Chinello C, Wouters J, Magni F, Alexopoulos L, Stas M, Boecxstaens V, Bechter O, Cattoretti G, van den Oord J. Functional heterogeneity of lymphocytic patterns in primary melanoma dissected through single-cell multiplexing. eLife 2020; 9:53008. [PMID: 32057296 PMCID: PMC7053517 DOI: 10.7554/elife.53008] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [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: 10/23/2019] [Accepted: 02/14/2020] [Indexed: 01/08/2023] Open
Abstract
In melanoma, the lymphocytic infiltrate is a prognostic parameter classified morphologically into 'brisk', 'non-brisk' and 'absent' entailing a functional association that has never been proved. Recently, it has been shown that lymphocytic populations can be very heterogeneous, and that anti-PD-1 immunotherapy supports activated T cells. Here, we characterize the immune landscape in primary melanoma by high-dimensional single-cell multiplex analysis in tissue sections (MILAN technique) followed by image analysis, RT-PCR and shotgun proteomics. We observed that the brisk and non-brisk patterns are heterogeneous functional categories that can be further sub-classified into active, transitional or exhausted. The classification of primary melanomas based on the functional paradigm also shows correlation with spontaneous regression, and an improved prognostic value when compared to that of the brisk classification. Finally, the main inflammatory cell subpopulations that are present in the microenvironment associated with activation and exhaustion and their spatial relationships are described using neighbourhood analysis.
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Affiliation(s)
- Francesca Maria Bosisio
- Laboratory of Translational Cell and Tissue Research, KU Leuven, Leuven, Belgium.,Pathology, Department of Medicine & Surgery, Università degli studi di Milano-Bicocca, Milan, Italy
| | - Asier Antoranz
- ProtATonce Ltd, Athens, Greece.,National Technical University of Athens, Athens, Greece
| | | | | | - Lukas Marcelis
- Laboratory of Translational Cell and Tissue Research, KU Leuven, Leuven, Belgium
| | - Clizia Chinello
- Pathology, Department of Medicine & Surgery, Università degli studi di Milano-Bicocca, Milan, Italy
| | - Jasper Wouters
- Laboratory of Translational Cell and Tissue Research, KU Leuven, Leuven, Belgium
| | - Fulvio Magni
- Pathology, Department of Medicine & Surgery, Università degli studi di Milano-Bicocca, Milan, Italy
| | - Leonidas Alexopoulos
- ProtATonce Ltd, Athens, Greece.,National Technical University of Athens, Athens, Greece
| | | | | | - Oliver Bechter
- Laboratory of Experimental Oncology, KU Leuven, Leuven, Belgium
| | - Giorgio Cattoretti
- Pathology, Department of Medicine & Surgery, Università degli studi di Milano-Bicocca, Milan, Italy
| | - Joost van den Oord
- Laboratory of Translational Cell and Tissue Research, KU Leuven, Leuven, Belgium
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8
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Schoffski P, Van Renterghem B, Cornillie J, Wang Y, Gebreyohannes YK, Lee CJ, Wellens J, Vanleeuw U, Nysen M, Hompes D, Stas M, Sinnaeve F, Wafa H, Topal B, Verbelen T, Debiec-Rychter M, Sciot R, Wozniak A. XenoSarc: A comprehensive platform of patient-derived xenograft (PDX) models of soft tissue sarcoma (STS) for early drug testing. J Glob Oncol 2019. [DOI: 10.1200/jgo.2019.5.suppl.37] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
37 Background: STS is a family of rare, heterogeneous tumors with > 70 subtypes. There is an urgent need for reliable preclinical models, especially for orphan subtypes of STS, given the limited treatment options. Methods: A panel of PDX models was established by s.c. implantation of fresh tumor specimens in athymic NMRI mice. Growing pieces of tumor were re-transplanted to next generations of mice. At each passage fragments were collected for histological/molecular characterization. A model was considered “established” after observing stable features for at least 2 passages. Ex-mouse tissue samples were stored, characterized by immunohistochemistry/flow cytometry and used for in vitro drug testing. Results: Between 2011-2019, 329 samples from 301 consenting patients were transplanted; 56 models are established, 16 additional models are in early passaging. Clinical information about donor and tumor (including sensitivity to standard and experimental agents) is available. The platform includes models of dedifferentiated lipo- (10 models), myxofibro- (8), leiomyo- (7), synovial (2), intimal (2), CIC-positive round cell (1), mesenchymal chondro- (1), extraskeletal osteo- (1), myxoid lipo- (1), myxoinflammatory fibroblastic (1), rhabdomyo- (2) and high-grade undifferentiated pleomorphic sarcoma (7), as well as GIST (8), MPNST (4) and epithelioid hemangioendothelioma (1). Models are well-characterized, with molecular information on copy number changes (low-coverage whole genome sequencing) and gene expression profile (RNA-Seq) available. We also constructed tissue microarrays from the xenografts which are used for target identification and model selection for preclinical studies. Xenografts are available for in vivo testing of novel agents, and results already served as a rationale for a number of prospective clinical trials. Conclusions: XenoSarc offers opportunities for studying the biology of a variety of sarcoma subtypes including ultra-rare entities and is a valuable tool for early drug screening in preparation of clinical STS trials. The platform is well maintained and continuously expanded, and available to collaborators from academia and industry.
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Affiliation(s)
- Patrick Schoffski
- Leuven Cancer Institute, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | | | - Jasmien Cornillie
- Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, and Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium
| | | | - Yemarshet Kelemework Gebreyohannes
- Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, and Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium
| | | | - Jasmien Wellens
- Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, and Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium
| | - Ulla Vanleeuw
- Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, and Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium
| | | | - Daphne Hompes
- Department of Surgical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Marguerite Stas
- Department of Surgical Oncology, KU Leuven and University Hospitals, Leuven, Belgium
| | | | - Hazem Wafa
- University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | | | - Tom Verbelen
- University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | | | - Raf Sciot
- Department of Pathology, KU Leuven and University Hospitals Leuven, Leuven, Belgium
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Balthazar T, Scheurwegs C, Stas M, Budts W. Rare cause of cerebrovascular event. Acta Cardiol 2019; 74:363-364. [PMID: 30259791 DOI: 10.1080/00015385.2018.1494794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Tim Balthazar
- Department of Cardiology, University Hospitals Leuven, Leuven, Belgium
| | | | - Marguerite Stas
- Department of Surgical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Werner Budts
- Department of Cardiology, University Hospitals Leuven, Leuven, Belgium
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10
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Marasigan V, Güvenç C, Oord JJ, Stas M, Boecxstaens V, Bechter O, Wolter P, Lambrechts D, Garmyn M. Solar Lentigines are Associated with Better Outcome in Cutaneous Melanoma. Acta Derm Venereol 2019; 99:1154-1159. [PMID: 31314121 DOI: 10.2340/00015555-3270] [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: 11/16/2022] Open
Abstract
The rising incidence of cutaneous melanoma and its stable high mortality rates despite innovative cancer care, require better prediction of the clinical outcome. In a large cutaneous melanoma population we explored whether the known clinical risk factors for melanoma susceptibility (nevus phenotype, phototype, family and personal history of melanoma and sun damage) affect melanoma outcomes. A total of 1,530 melanoma patients were included. Multivariable analysis adjusted for age, gender, melanoma stage, localization and subtype showed that familial melanoma, solar lentigines on head and neck, the back of hands, arms and shoulders were associated with a better relapse free survival. The presence of atypical naevi was associated with an increased risk of relapse. After Bonferroni correction, the correlation between presence of solar lentigines on the back of the hands and arms remained the most robust and significant prognostic factor for the relapse free survival in cutaneous melanoma patients.
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Affiliation(s)
- Vivien Marasigan
- Department of Dermatology, University Hospitals Leuven, Herestraat 49, BE-3000 Leuven, Belgium
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11
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Schoffski P, Timmermans I, Hompes D, Stas M, Boecxstaens V, De Leyn P, Coosemans W, Van Raemdonck D, Hauben E, Sciot R, Clement PM, Bechter OE, Beuselinck B, Woei-A-Jin FJSH, Dumez H, Wessels T. Clinical presentation, natural history and therapeutic approach in patients with solitary fibrous tumor: A retrospective analysis. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e22522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e22522 Background: Solitary fibrous tumor (SFT), a rare variant of soft tissue sarcoma (STS), is characterized by the presence of a NAB2-STAT6 fusion. Given the orphan character of SFT we performed a retrospective analysis. Methods: We retrospectively reviewed all patients (pts) with SFT treated in our institution between 12/1990 - 09/2017. Results: We identified 94 SFT pts (incl. hemangiopericytoma) with a med. follow-up for 4.7 yrs. Common anatomic sites were chest (33%), abdomen (21.3%), brain (12.8%) and extremities (9.6%). The symptomatology at diagnosis was variable. Only 6.4% presented with synchronous metastasis. Hypoglycemia (Doege-Potter syndrome) was seen in 2.1% of cases. A resection of the primary SFT was done in 86 pts (91.5%), their disease-free survival was 35.5 mo and 43% stayed SFT-free during follow-up. Local recurrence occurred in 26.7% of cases, associated with a med. overall survival (OS) of 45.1 mo. Metachronous metastasis was seen in 30.2% of pts, occurring after a med. follow-up of 36 mo. Med. OS after diagnosis of metastasis was 19.0 mo. Systemic therapy was given to 92.9% of pts with inoperable/metastatic disease. The most common 1st line therapy was doxorubicin single agent (57.7% of pts), achieving responses in 13.3% of pts. 2nd line therapies included ifosfamide and pazopanib (31.3% of pts each), 3rd line treatment was very heterogeneous. Conclusions: SFT is an orphan malignancy with a variable clinical course, low incidence of distant spread at first diagnosis but considerable risk of local failure and metachronous metastasis. Surgery is the only curative option at diagnosis, time of relapse and in case of resectable metastasis. Palliative systemic therapy is considered in pts with inoperable/metastatic disease but achieves low response rates. The natural course and survival outcomes of SFT cases treated with palliative intent tend to be better than in non-selected STS pts.
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Affiliation(s)
- Patrick Schoffski
- Leuven Cancer Institute, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | | | - Daphne Hompes
- Department of Surgical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Marguerite Stas
- Department of Surgical Oncology, KU Leuven and University Hospitals, Leuven, Belgium
| | | | | | | | | | | | - Raf Sciot
- Department of Pathology, KU Leuven and University Hospitals Leuven, Leuven, Belgium
| | - Paul M. Clement
- Department of Oncology, KU Leuven, Leuven Cancer Institute, Leuven, Belgium
| | - Oliver Edgar Bechter
- Department of General Medical Oncology Leuven Cancer Institute, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Benoit Beuselinck
- University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium
| | | | - Herlinde Dumez
- Department of General Medical Oncology Leuven Cancer Institute, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Tim Wessels
- University Hospitals Leuven, Leuven, Belgium
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12
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Cornillie J, Wozniak A, Li H, Wang Y, Boeckx B, Gebreyohannes YK, Wellens J, Vanleeuw U, Hompes D, Stas M, Sinnaeve F, Wafa H, Lambrechts D, Debiec-Rychter M, Sciot R, Schöffski P. Establishment and Characterization of Histologically and Molecularly Stable Soft-tissue Sarcoma Xenograft Models for Biological Studies and Preclinical Drug Testing. Mol Cancer Ther 2019; 18:1168-1178. [PMID: 30962320 DOI: 10.1158/1535-7163.mct-18-1045] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 01/13/2019] [Accepted: 04/01/2019] [Indexed: 11/16/2022]
Abstract
Soft-tissue sarcomas (STS) represent a heterogeneous group of rare, malignant tumors of mesenchymal origin. Reliable in vivo sarcoma research models are scarce. We aimed to establish and characterize histologically and molecularly stable patient-derived xenograft (PDX) models from a broad variety of STS subtypes. A total of 188 fresh tumor samples from consenting patients with localized or advanced STS were transplanted subcutaneously in NMRI-nu/nu-immunodeficient mice. Once tumor growth was observed, the material was passaged to a next generation of mice. A patient-derived tumor sample was considered "successfully engrafted" whenever the sample was transplanted to passage 1. A PDX model was considered "established" when observing stable morphologic and molecular features for at least two passages. With every passage, histologic and molecular analyses were performed. Specific genomic alterations and copy-number profile were assessed by FISH and low coverage whole-genome sequencing. The tumor engraftment rate was 32% (61/188) and 188 patient samples generated a total of 32 PDX models, including seven models of myxofibrosarcoma, five dedifferentiated liposarcoma, five leiomyosarcoma, three undifferentiated pleomorphic sarcoma, two malignant peripheral nerve sheet tumor models, and single models of synovial sarcoma and some other (ultra)rare subtypes. Seventeen additional models are in early stages of engraftment (passage 1-2). Histopathologic and molecular features were compared with the original donor tumor and were stable throughout passaging. The platform is used for studies on sarcoma biology and suited for in vivo preclinical drug testing as illustrated by a number of completed and ongoing laboratory studies.
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Affiliation(s)
- Jasmien Cornillie
- Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, and Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium
| | - Agnieszka Wozniak
- Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, and Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium
| | - Haifu Li
- Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, and Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium
| | - Yannick Wang
- Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, and Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium
| | - Bram Boeckx
- Laboratory for Translational Genetics, KU Leuven, Leuven, Belgium.,VIB Center for Cancer Biology, Leuven, Belgium
| | - Yemarshet K Gebreyohannes
- Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, and Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium
| | - Jasmien Wellens
- Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, and Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium.
| | - Ulla Vanleeuw
- Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, and Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium
| | - Daphne Hompes
- Department of Surgical Oncology, KU Leuven and University Hospitals Leuven, Leuven, Belgium
| | - Marguerite Stas
- Department of Surgical Oncology, KU Leuven and University Hospitals Leuven, Leuven, Belgium
| | - Friedl Sinnaeve
- Department of Orthopedic Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Hazem Wafa
- Department of Orthopedic Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Diether Lambrechts
- Laboratory for Translational Genetics, KU Leuven, Leuven, Belgium.,VIB Center for Cancer Biology, Leuven, Belgium
| | - Maria Debiec-Rychter
- Department of Human Genetics, KU Leuven and University Hospitals Leuven, Leuven, Belgium
| | - Raf Sciot
- Department of Pathology, KU Leuven and University Hospitals Leuven, Leuven, Belgium
| | - Patrick Schöffski
- Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, and Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium
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13
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Wozniak A, Cornillie J, Gebreyohannes YK, Wang Y, Wellens J, Vanleeuw U, Hompes D, Stas M, Sinnaeve F, Wafa H, Debiec-Rychter M, Sciot R, Schöffski P. Abstract 1031: XenoSarc: Patient-derived xenograft (PDX) models of soft tissue sarcoma (STS)—an update on a preclinical platform for early drug testing. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-1031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: STS constitutes a rare family of mesenchymal tumors with more than 70 subtypes described. The limited treatment options available for advanced STS underline the need for reliable preclinical models to test novel therapeutic strategies.
Methods: Panel of PDX models was established by subcutaneous implantation of fresh tumor specimens in immunodeficient, athymic nude NMRI mice. Once tumor growth was observed, pieces of tumor were re-transplanted to next generations of animals. At each passage tumor fragments were collected for detailed characterization. A model was considered established after observing stable histological and molecular features for at least two passages.
Results: Between 09/2011 and 11/2017, 228 STS samples from 203 consenting patients treated at University Hospitals Leuven, Belgium, have been transplanted. Thirty-three stable PDX models have been established, maintaining the histopathological and molecular features of the original tumor. Detailed clinical information about a donor patient, including sensitivity to given therapy, is linked to every model. Higher engraftment rate was observed in samples collected from patients who developed metastasis throughout the course of disease (38% vs. 23%, p<0.05). Moreover, patients whose tumor successfully engrafted had significantly poorer overall survival (OS) than those whose tumor did not grow in mice (median OS 83 vs. 259 months; p<0.05). XenoSarc platform includes models of gastrointestinal stromal tumor (6 models), myxofibrosarcoma (6), leiomyosarcoma (5), dedifferentiated liposarcoma (4), malignant peripheral nerve sheath tumor (2), synovial sarcoma (1), pulmonary artery intimal sarcoma (1), CIC-DUX4 fusion-positive round cell sarcoma (1), epithelioid haemangioendothelioma (1), mesenchymal chondrosarcoma (1), pleomorphic rhabdomyosarcoma (1), telangiectatic extraskeletal osteosarcoma (1), and high-grade undifferentiated pleomorphic sarcoma (3). These models are well-characterized, with detailed data on copy number changes and expression profile. In addition we have constructed tissue microarray (TMA), which can be used for target identification. Some of these models have already been successfully used for in vivo testing of novel agents, including both targeted and cytotoxic (pro-)drugs, and results served as a rationale for several prospective clinical trials. In addition, 17 other xenografts are still in early stages of engraftment, not yet fulfilling our criteria of an “established model”.
Conclusion: Our XenoSarc platform contains a number of well-annotated models, characterized by stable histological and molecular features. This platform is a reliable tool for the evaluation of new anticancer treatments for STS and for studying the biology of these rare diseases. The platform is made available to collaborators from academia and industry.
Citation Format: Agnieszka Wozniak, Jasmien Cornillie, Yemarshet K. Gebreyohannes, Yannick Wang, Jasmien Wellens, Ulla Vanleeuw, Daphne Hompes, Marguerite Stas, Friedl Sinnaeve, Hazem Wafa, Maria Debiec-Rychter, Raf Sciot, Patrick Schöffski. XenoSarc: Patient-derived xenograft (PDX) models of soft tissue sarcoma (STS)—an update on a preclinical platform for early drug testing [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 1031.
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Affiliation(s)
| | | | | | - Yannick Wang
- 1KU Leuven and University Hospitals Leuven, Leuven, Belgium
| | | | - Ulla Vanleeuw
- 1KU Leuven and University Hospitals Leuven, Leuven, Belgium
| | | | | | | | - Hazem Wafa
- 2University Hospitals Leuven, Leuven, Belgium
| | | | - Raf Sciot
- 1KU Leuven and University Hospitals Leuven, Leuven, Belgium
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14
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Verduyn C, Morren MA, Stas M, Sinnaeve F, Segers K, Kiekens C. Successful forearm prosthesis fitting in a patient with epidermolysis bullosa dystrophica: Case report. Prosthet Orthot Int 2018; 42:254-257. [PMID: 28726572 DOI: 10.1177/0309364617718410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Epidermolysis bullosa dystrophica is a rare dermatological disease characterized by extreme skin fragility and elevated risk of developing a squamous cell carcinoma. In some cases, amputation of a limb is necessary. Case description and methods: A 37-year-old man with recessive, severe generalized epidermolysis bullosa dystrophica developed a squamous cell carcinoma on the right forearm requiring a below-elbow amputation. Preoperative advice concerning indication and level of amputation was given. Due to potential skin problems, a conventional prosthesis was not feasible. Findings and outcomes: A custom-designed adaptive prosthesis with an upper arm cuff was trialed and was well tolerated. Multiple working tools, attached with a rotation and inclination system, allowed independence and return to work. CONCLUSION Despite multiple potential skin problems of the stump, the patient was successfully fitted with a custom-designed adaptive prosthesis. Preparation for this fitting was done by a comprehensive multidisciplinary patient-centered approach. Clinical relevance Despite severe skin fragility, a patient with epidermolysis bullosa dystrophica was successfully fitted with a custom-designed adaptive upper limb prosthesis allowing good functional outcome. This required a multidisciplinary and patient-centered approach.
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Affiliation(s)
- Carl Verduyn
- 1 Department of Physical and Rehabilitation Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Marie-Anne Morren
- 2 Department of Dermatology, University Hospitals Leuven, Leuven, Belgium.,3 Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - Marguerite Stas
- 4 Department of Surgical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Friedl Sinnaeve
- 5 Department of Orthopaedic Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Katarina Segers
- 6 Department of Plastic, Reconstructive and Aesthetic Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Carlotte Kiekens
- 1 Department of Physical and Rehabilitation Medicine, University Hospitals Leuven, Leuven, Belgium
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15
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Goossens GA, Grumiaux N, Janssens C, Jérôme M, Fieuws S, Moons P, Stas M, Maleux G. SecurAstaP trial: securement with SecurAcath versus StatLock for peripherally inserted central catheters, a randomised open trial. BMJ Open 2018; 8:e016058. [PMID: 29478011 PMCID: PMC5855473 DOI: 10.1136/bmjopen-2017-016058] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES To assess the effect on needed nursing time for dressing change. DESIGN, SETTING, PARTICIPANTS A parallel-group, open-label, randomised controlled trial in patients who are in need for a peripherally inserted central catheter insertion in one teaching hospital in Belgium. The follow-up lasted 180 days or until catheter removal, whatever came first. A computer generated table was used to allocate devices. Randomised patients were 105 adults (StatLock, n=53; SecurAcath, n=52) and primary analysis was based on all patients (n=92) with time measurements (StatLock, n=43; SecurAcath, n=49). INTERVENTIONS StatLock which has to be changed weekly versus SecurAcath which could remain in place for the complete catheter dwell time. MAIN OUTCOME MEASURE Needed time for the dressing change at each dressing change (SecurAcath) or at each dressing change combined with the change of the securement device (StatLock). RESULTS Median time needed for dressing change was 7.3 min (95% CI 6.4 min to 8.3 min) in the StatLock group and in the SecurAcath group 4.3 min (95% CI 3.8 min to 4.9 min) (P<0.0001). The time in the SecurAcath group was reduced with 41% (95% CI 29% to 51%). Incidence rates of migration, dislodgement and catheter-related bloodstream infection were comparable across groups. Pain scores were higher with SecurAcath than with StatLock at insertion (P=0.02) and at removal (P<0.001) and comparable during dressing change (P=0.38) and during dwell time (P=0.995). User-friendliness was scored at insertion and removal. All statements regarding the user-friendliness were scored significantly higher for StatLock than for SecurAcath (P<0.05). Only for the statement regarding the recommending routine use of the device, which was asked at removal, no difference was found between the two devices (P=0.32). CONCLUSION Use of SecurAcath saves time during dressing change compared with StatLock. Training on correct placement and removal of SecurAcath is critical to minimise pain. TRIAL REGISTRATION NUMBER NCT02311127; Pre-results.
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Affiliation(s)
- Godelieve Alice Goossens
- Nursing Centre of Excellence, University Hospitals Leuven, Leuven, Belgium
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Niel Grumiaux
- Department of Nephrology, University Hospitals Leuven, Leuven, Belgium
| | - Christel Janssens
- Nursing Centre of Excellence, University Hospitals Leuven, Leuven, Belgium
| | - Martine Jérôme
- Nursing Centre of Excellence, University Hospitals Leuven, Leuven, Belgium
| | - Steffen Fieuws
- Interuniversity Centre for Biostatistics and Statistical Bioinformatics, KU Leuven, Leuven and Universiteit Hasselt, Leuven, Belgium
| | - Philip Moons
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Marguerite Stas
- Surgical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Geert Maleux
- Interventional Radiology, University Hospitals Leuven, Leuven, Belgium
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Abstract
Introduction The functionality of subcutaneous venous access devices is evaluated at least every time the device is accessed. This evaluation is subjective and actions are only undertaken when blood withdrawal and/or fluid injection become problematic. The function of these devices has rarely been evaluated objectively. The present study tried to find an objective and standardized way to evaluate the withdrawal speed of a newly inserted port. Methods Between October 2001 and December 2002, a prospective randomized study of 3 types of ports was carried out. The ability to infuse heparinized normal saline and to withdraw blood was evaluated by recording the filling time of a 10 ml Vacutainer® tube in 876 newly inserted central venous ports at the end of the surgical procedure. Results The patient groups were comparable in age, gender and insertion procedure characteristics (vein used, position of the port on the body and length of the catheter). The median time needed to fill a 10 ml Vacutainer® tube in all ports was 17.00 sec (range 11.43–63.62 sec). The median filling time for BardPort™ was 16.36 sec (range 13.48–39.00 sec), for Celsite® 18.35 sec (range 12.03–40.00 sec) and for Port-a-cath® 16.43 sec (range 11.43–63–62 sec). A significant difference in filling time was found between the large bore catheters (BardPort™, Port-a-cath®) and the small bore catheter (Celsite®) of 2 seconds median value. Conclusion Measurement of withdrawal speed provides an objective criterion for the quality description of blood withdrawal immediately after insertion. A value of more than 20 seconds for filling a 10 ml Vacutainer® tube could therefore be suggested a useful trigger for further investigation.
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Affiliation(s)
- G A Goossens
- Nursing Department, University Hospitals Leuven, Belgium
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17
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De Smedt J, Van Kelst S, Boecxstaens V, Stas M, Bogaerts K, Vanderschueren D, Aura C, Vandenberghe K, Lambrechts D, Wolter P, Bechter O, Nikkels A, Strobbe T, Emri G, Marasigan V, Garmyn M. Vitamin D supplementation in cutaneous malignant melanoma outcome (ViDMe): a randomized controlled trial. BMC Cancer 2017; 17:562. [PMID: 28835228 PMCID: PMC5569491 DOI: 10.1186/s12885-017-3538-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 08/09/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Previous studies have investigated the protective effect of vitamin D serum levels, at diagnosis and during the follow-up period after treatment, on melanoma outcome. In the present study we assess whether vitamin D supplementation, in the follow-up period after diagnosis and surgical resection of the primary tumor, has a protective effect on relapse of cutaneous malignant melanoma and whether this protective effect correlates with vitamin D levels in serum and Vitamin D Receptor immunoreactivity in the primary tumor. METHODS/DESIGN This study is a multicenter randomized double blind placebo- controlled phase III trial. Patients between the age of 18 and 80 years diagnosed and treated surgically for a melanoma stage IB-III are eligible for randomization in a 1:1 ratio to active treatment or placebo. The study drug is taken each month and consists of either 100,000 International Unit cholecalciferol or arachidis oleum raffinatum used as a placebo. The primary endpoint is relapse free survival. The secondary endpoints are 25 hydroxyvitamin D3 serum levels at diagnosis and at 6 month intervals, melanoma subtype, melanoma site and stage of melanoma at diagnosis according to the 2009 American Joint Committee on Cancer melanoma staging and classification. At randomization a bloodsample is taken for DNA analysis. The study is approved by the local Ethics Committees. DISCUSSION If we can confirm our hypothesis that vitamin D supplementation after removal of the tumor has a protective effect on relapse of cutaneous malignant melanoma we may reduce the burden of CMM at several levels. Patients, diagnosed with melanoma may have a better clinical outcome and improved quality of life. There will be a decrease in health care costs related to treatment of metastatic disease and there will be a decrease in loss of professional years, which will markedly reduce the economic burden of the disease. TRIAL REGISTRATION Clinical Trial.gov, NCT01748448 , 05/12/2012.
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Affiliation(s)
- J. De Smedt
- Laboratory of Dermatology, Department of oncology, KU Leuven, 3000 Leuven, Belgium
- Department of Dermatology, University Hospitals Leuven, 3000 Leuven, Belgium
| | - S. Van Kelst
- Laboratory of Dermatology, Department of oncology, KU Leuven, 3000 Leuven, Belgium
- Department of Dermatology, University Hospitals Leuven, 3000 Leuven, Belgium
| | - V. Boecxstaens
- Oncological and vascular access surgery, Department of surgical oncology, University Hospitals Leuven, 3000 Leuven, Belgium
- Department of oncology, KU Leuven, 3000 Leuven, Belgium
| | - M. Stas
- Oncological and vascular access surgery, Department of surgical oncology, University Hospitals Leuven, 3000 Leuven, Belgium
- Department of oncology, KU Leuven, 3000 Leuven, Belgium
| | - K. Bogaerts
- KU Leuven, Faculty of Medicine, I-BioStat, 3000 Leuven, Belgium
- Hasselt University, I-BioStat, 3590 Diepenbeek, Belgium
| | - D. Vanderschueren
- Clinical and Experimental Endocrinology, Department of Clinical and Experimental Medicine, KU Leuven, 3000 Leuven, Belgium
- Department of Endocrinology, University Hospitals Leuven, 3000 Leuven, Belgium
| | - C. Aura
- Translational Cell & Tissue Research, Department of Imaging & Pathology, KU Leuven, 3000 Leuven, Belgium
- Department of Pathology, University Hospitals of Leuven, 3000 Leuven, Belgium
| | - K. Vandenberghe
- Department of Cardiovascular Sciences, KU Leuven, 3000 Leuven, Belgium
| | - D. Lambrechts
- Laboratory for Translational Genetics, Department of Oncology, KU Leuven, 3000 Leuven, Belgium
- Vesalius Research Center, VIB, 3000 Leuven, Belgium
| | - P. Wolter
- Department of Hematology and Oncology, CHR Verviers East Belgium, 4800 Verviers, Belgium
| | - O. Bechter
- Laboratory of Experimental Oncology (LEO), Department of Oncology, KU Leuven, 3000 Leuven, Belgium
- Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, 3000 Leuven, Belgium
| | - A. Nikkels
- Department of Dermatology, CHU Sart Tilman, University of Liège, 4000 Liège, Belgium
| | - T. Strobbe
- Department of Dermatology, University Hospital Antwerp, 2650 Edegem, Belgium
| | - G. Emri
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, 4012 Hungary
| | - V. Marasigan
- Laboratory of Dermatology, Department of oncology, KU Leuven, 3000 Leuven, Belgium
- Department of Dermatology, University Hospitals Leuven, 3000 Leuven, Belgium
| | - M. Garmyn
- Laboratory of Dermatology, Department of oncology, KU Leuven, 3000 Leuven, Belgium
- Department of Dermatology, University Hospitals Leuven, 3000 Leuven, Belgium
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Wozniak A, Cornillie J, Gebreyohannes YK, Wellens J, Vreys L, Hompes D, Stas M, Sinnaeve F, Debiec-Rychter M, Sciot R, Schöffski P. Abstract 4811: XenoSarc: Patient-derived xenograft (PDX) models of soft tissue sarcoma (STS), an update on a preclinical platform for early drug testing. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-4811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: STS constitutes a rare and very heterogeneous family of mesenchymal tumors. The limited treatment options available for advanced STS underline the need for reliable preclinical models to test novel therapeutic strategies.
Methods: A panel of patient-derived xenografts (PDX) was established by subcutaneous implantation of fresh, surgically resected or biopsied tumor specimens in immunodeficient, athymic nude NMRI mice. Once tumor growth was observed, pieces of tumor were re-transplanted to next generations of mice. At each passage tumor fragments were collected for histopathological and molecular characterization. A model was considered established after observing stable histological and molecular features for at least two passages.
Results: Until now 171 STS samples from consenting patients treated at the University Hospitals, Leuven, Belgium, have been transplanted. Twenty-eight well-characterized, stable PDX models of STS have been established, maintaining the histopathological and molecular features of the original tumor. The detailed clinical information about a donor patient, including sensitivity to standard and experimental drugs, is linked to every model. At this point the XenoSarc platform includes models of gastrointestinal stromal tumor (6 models), myxofibrosarcoma (6), dedifferentiated liposarcoma (3), malignant peripheral nerve sheath tumor (3), synovial sarcoma (1), leiomyosarcoma (4), epithelioid haemangioendothelioma (1), mesenchymal chondrosarcoma (1), pleomorphic rhabdomyosarcoma (1) and high-grade undifferentiated pleomorphic sarcoma (2). From these models we have also available tissue microarray (TMA) as well as data on genomic and/or expression profile including mutations (by RNA-Seq). Some of these models have already been successfully used for in vivo testing of novel agents, including both targeted and cytotoxic (pro-)drugs, and results served as a rationale for several prospective clinical trials. In addition, 24 other xenografts are still in early stages of engraftment, not yet fulfilling our criteria of an “established model”.
Conclusion: Our XenoSarc platform contains a number of well-annotated models, characterized by stable histological and molecular features. This platform is a reliable tool for the evaluation of new anticancer treatments for STS and for studying the biology of these rare diseases. The platform is made available to collaborators from academia and industry.
Citation Format: Agnieszka Wozniak, Jasmien Cornillie, Yemarshet K. Gebreyohannes, Jasmien Wellens, Lise Vreys, Daphne Hompes, Marguerite Stas, Friedl Sinnaeve, Maria Debiec-Rychter, Raf Sciot, Patrick Schöffski. XenoSarc: Patient-derived xenograft (PDX) models of soft tissue sarcoma (STS), an update on a preclinical platform for early drug testing [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4811. doi:10.1158/1538-7445.AM2017-4811
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Affiliation(s)
| | | | | | | | - Lise Vreys
- 1KU Leuven and University Hospitals Leuven, Leuven, Belgium
| | | | | | | | | | - Raf Sciot
- 1KU Leuven and University Hospitals Leuven, Leuven, Belgium
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Wozniak A, Cornillie J, Gebreyohannes YK, Boeckx B, Li H, Van Looy T, Floris G, Wellens J, Vreys L, Hompes D, Stas M, Sinnaeve F, Lambrechts D, Debiec-Rychter M, Sciot R, Schoffski P. Abstract 5197: Patient-derived xenograft (PDX) models of soft tissue sarcoma (STS): a preclinical platform for early drug testing. Cancer Res 2016. [DOI: 10.1158/1538-7445.am2016-5197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: STS constitutes a rare and very heterogeneous family of mesenchymal tumors. The limited treatment options available for advanced STS underline the need for reliable preclinical models to test novel therapeutic strategies.
Methods: A panel of patient-derived xenografts (PDX) was established by subcutaneous implantation of fresh, surgically resected tumor specimens in immunodeficient athymic nude NMRI mice. Once tumor growth was observed, pieces of tumor were re-transplanted to next generations of mice. At each passage tumor fragments were collected for histolopathological and molecular characterization. A model was considered established after observing stable histological and molecular features for at least two passages. To evaluate the stability of the genomic profile we performed low-coverage whole-genome sequencing on DNA isolated from tumors obtained from at least two passages. In addition RNA-seq was used to better characterize the mutational profile of the ex-mouse tumors.
Results: Until now 139 STS samples from consenting patients treated at the University Hospitals, Leuven, Belgium, have been transplanted. Twenty six well-characterized, stable STS PDX models have been established, maintaining the histopathological and molecular features of the original tumor. Seventeen models, analyzed with low-coverage DNA sequencing, showed a stable genomic profile in at least two different tumor passages. At this point the panel includes models of gastrointestinal stromal tumor (6 models), myxofibrosarcoma (5), dedifferentiated liposarcoma (3), malignant peripheral nerve sheath tumor (3), synovial sarcoma (2), leiomyosarcoma (3) epithelioid haemangioendothelioma (1), mesenchymal chondrosarcoma (1) and undifferentiated high grade sarcoma (2). Some of these models have already been successfully used for in vivo testing of novel agents, including both targeted and cytotoxic (pro-)drugs, and results served as a rationale for at least four prospective clinical trials. In addition 22 other xenografts are still in early stages of engraftment, not yet fulfilling our criteria of an “established model”.
Conclusion: Our panel of mesenchymal PDX models is characterized by stable histological and molecular features. These clinically well-annotated models can contribute to reliable preclinical studies for new anticancer treatments for STS. The availability of unique, rare STS xenografts also allows to study the biology of these diseases. The platform is made available to collaborators from academia and industry.
Citation Format: Agnieszka Wozniak, Jasmien Cornillie, Yemarshet K. Gebreyohannes, Bram Boeckx, Haifu Li, Thomas Van Looy, Giuseppe Floris, Jasmien Wellens, Lise Vreys, Daphne Hompes, Marguerite Stas, Friedl Sinnaeve, Diether Lambrechts, Maria Debiec-Rychter, Raf Sciot, Patrick Schoffski. Patient-derived xenograft (PDX) models of soft tissue sarcoma (STS): a preclinical platform for early drug testing. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 5197.
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Affiliation(s)
- Agnieszka Wozniak
- 1Laboratory of Experimental Oncology, Department of Oncology, KU Leuven and Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Jasmien Cornillie
- 1Laboratory of Experimental Oncology, Department of Oncology, KU Leuven and Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Yemarshet K. Gebreyohannes
- 1Laboratory of Experimental Oncology, Department of Oncology, KU Leuven and Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Bram Boeckx
- 2Laboratory of Translational Genetics, Vesalius Research Center, VIB and KU Leuven, Leuven, Belgium
| | - Haifu Li
- 1Laboratory of Experimental Oncology, Department of Oncology, KU Leuven and Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Thomas Van Looy
- 1Laboratory of Experimental Oncology, Department of Oncology, KU Leuven and Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Giuseppe Floris
- 3Department of Pathology, KU Leuven and University Hospitals Leuven, Leuven, Belgium
| | - Jasmien Wellens
- 1Laboratory of Experimental Oncology, Department of Oncology, KU Leuven and Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Lise Vreys
- 1Laboratory of Experimental Oncology, Department of Oncology, KU Leuven and Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Daphne Hompes
- 4Department of Surgical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Marguerite Stas
- 4Department of Surgical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Friedl Sinnaeve
- 4Department of Surgical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Diether Lambrechts
- 2Laboratory of Translational Genetics, Vesalius Research Center, VIB and KU Leuven, Leuven, Belgium
| | - Maria Debiec-Rychter
- 5Department of Human Genetics, KU Leuven and University Hospitals Leuven, Leuven, Belgium
| | - Raf Sciot
- 3Department of Pathology, KU Leuven and University Hospitals Leuven, Leuven, Belgium
| | - Patrick Schoffski
- 1Laboratory of Experimental Oncology, Department of Oncology, KU Leuven and Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
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Bosisio FM, Wilmott JS, Volders N, Mercier M, Wouters J, Stas M, Blokx WA, Massi D, Thompson JF, Scolyer RA, van Baren N, van den Oord JJ. Plasma cells in primary melanoma. Prognostic significance and possible role of IgA. Mod Pathol 2016; 29:347-58. [PMID: 26867783 DOI: 10.1038/modpathol.2016.28] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 11/13/2015] [Accepted: 12/21/2015] [Indexed: 12/20/2022]
Abstract
Melanoma is not only one of the most immunogenic cancers but also one of the most effective cancers at subverting host immunity. The role of T lymphocytes in tumor immunity has been extensively studied in melanoma, whereas less is known about the importance of B lymphocytes. The effects of plasma cells (PCs), in particular, are still obscure. The aim of this study was to characterize pathological features and clinical outcome of primary cutaneous melanomas associated with PCs. Moreover, we investigated the origins of the melanoma-associated PCs. Finally, we studied the outcome of patients with primary melanomas with PCs. We reviewed 710 melanomas to correlate the presence of PCs with histological prognostic markers. Immunohistochemistry for CD138 and heavy and light chains was performed in primary melanomas (PM) and in loco-regional lymph nodes (LN), both metastatic and not metastatic. In three PM and nine LN with frozen material, VDJ-rearrangement was analyzed by Gene Scan Analysis. Survival analysis was performed on a group of 85 primary melanomas >2 mm in thickness. Forty-one cases (3.7%) showed clusters/sheets of PCs. PC-rich melanomas occurred at an older age and were thicker, more often ulcerated and more mitotically active (P<0.05). PCs were polyclonal and often expressed IgA in addition to IgG. In LN, clusters/sheets of IgA+ PCs were found both in the sinuses and subcapsular areas. Analysis of VDJ-rearrangements showed the IgA to be oligoclonal. Melanomas with clusters/sheets of PCs had a significantly worse survival compared with melanomas without PCs while, interestingly, melanomas with sparse PCs were associated with a better clinical outcome (P=0.002). In conclusion, melanomas with sheets/clusters of PCs are associated with worse prognosis. IgG and IgA are the isotypes predominantly produced by these PCs. IgA oligoclonality suggests an antigen-driven response that facilitates melanoma progression by a hitherto unknown mechanism.
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Affiliation(s)
- Francesca M Bosisio
- Laboratory of Translational Cell and Tissue Research, University of Leuven, KUL, Leuven, Belgium.,Università Degli Studi di Milano-Bicocca, Milan, Italy
| | - James S Wilmott
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
| | - Nathalie Volders
- Laboratory of Translational Cell and Tissue Research, University of Leuven, KUL, Leuven, Belgium
| | - Marjorie Mercier
- Ludwig Institute for Cancer Research and de Duve Institute, Université Catholique de Louvain, Brussels, Belgium
| | - Jasper Wouters
- Laboratory of Translational Cell and Tissue Research, University of Leuven, KUL, Leuven, Belgium
| | - Marguerite Stas
- Department of Surgical Oncology, UZ Gasthuisberg and KU Leuven, Leuven, Belgium
| | | | - Daniela Massi
- Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - John F Thompson
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
| | - Richard A Scolyer
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.,Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Nicolas van Baren
- Ludwig Institute for Cancer Research and de Duve Institute, Université Catholique de Louvain, Brussels, Belgium
| | - Joost J van den Oord
- Laboratory of Translational Cell and Tissue Research, University of Leuven, KUL, Leuven, Belgium
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Rogiers A, van den Oord JJ, Garmyn M, Stas M, Kenis C, Wildiers H, Marine JC, Wolter P. Novel Therapies for Metastatic Melanoma: An Update on Their Use in Older Patients. Drugs Aging 2015; 32:821-34. [PMID: 26442859 DOI: 10.1007/s40266-015-0304-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Cutaneous melanoma is the most aggressive form of skin cancer. With age as a risk factor, melanoma is projected to become a substantial healthcare burden. The clinical course of melanoma in older patients is different from that in middle-aged and younger patients: melanomas are thicker, have higher mitotic rates and are more likely to be ulcerated. Older patients also have a higher mortality rate, yet, paradoxically, have a lower rate of lymph node metastases. After decades of no significant progress in the treatment of this devastating disease, novel insights into the mechanisms underlying the pathophysiology of metastatic melanoma have led to new and remarkably efficient therapeutic opportunities. The discovery that about half of all melanomas carry BRAF mutations led to the introduction of targeted therapy with significant improvements in clinical outcomes. Although these drugs appear to be equally effective in older patients, specific considerations regarding adverse events are required. Besides targeted therapy, immunotherapy has emerged as an alternative therapeutic option. Antibodies that block cytotoxic T-lymphocyte antigen 4 (CTLA-4) and programmed cell death protein 1 (PD-1) can induce responses with high durability. Despite an aging immune system, older patients seem to benefit to the same degree from these treatments, apparently without increased toxicity. In this review, we focus on the epidemiology, clinicopathological features, and recent developments of systemic treatment in cutaneous melanoma with regard to older patients.
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Affiliation(s)
- Aljosja Rogiers
- Department of General Medical Oncology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
- Laboratory for Molecular Cancer Biology, Center for the Biology of Disease, VIB, Leuven, Belgium
- Center for Human Genetics, KU Leuven, Leuven, Belgium
| | | | - Marjan Garmyn
- Department of Dermatology, University Hospitals Leuven, Leuven, Belgium
| | - Marguerite Stas
- Department of Surgical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Cindy Kenis
- Department of General Medical Oncology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Hans Wildiers
- Department of General Medical Oncology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Jean-Christophe Marine
- Laboratory for Molecular Cancer Biology, Center for the Biology of Disease, VIB, Leuven, Belgium
- Center for Human Genetics, KU Leuven, Leuven, Belgium
| | - Pascal Wolter
- Department of General Medical Oncology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.
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Li H, Cornillie J, Wozniak A, Van Looy T, Gebreyohannes Y, Wellens J, Vanleeuw U, Hompes D, Stas M, Sinnaeve F, Debiec-Rychter M, Sciot R, Schöffski P. Abstract 1460: Establishment and characterization of a panel of patient-derived soft tissue sarcoma (STS) xenograft models for in vivo testing of novel therapeutic approaches. Tumour Biol 2015. [DOI: 10.1158/1538-7445.am2015-1460] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Wozniak A, Van Looy T, Floris G, Gebreyohannes YK, Wellens J, Li H, Cornillie J, Vanleeuw U, Hompes D, Stas M, Debiec-Rychter M, Sciot R, Schoffski P. Abstract 1461: A panel of patient derived gastrointestinal stromal tumors (GIST) xenograft models for in vivo preclinical drug testing. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-1461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Objective: Most GIST are dependent on the KIT/PDGFRA signaling pathway and therefore can be treated with specific tyrosine kinase inhibitors (TKI). With time GIST develop resistance to TKI. We need reliable models which can be used for preclinical drug testing.
Methods: Patient-derived xenografts were established in nu/nu NMRI mice by subcutaneous implantation of fresh, surgically resected tumor specimens from consenting patients with GIST treated at the University Hospitals Leuven. Once tumor growth was observed, pieces of tumor were re-transplanted to next generations of mice. At each passage tumor fragments were collected for histological and molecular characterization. A model was considered to be established after observing stable histological and molecular features for at least two passages.
Results: At present we have access to five successfully established GIST models, with different KIT mutations and different sensitivity to standard TKI (Table).
Untreated tumors from subsequent passages show morphological and immunohistochemical features resembling the original patient biopsy, verifying the stability of GIST xenografts growth. KIT mutational status has also been confirmed in samples obtained from all models. These models are used for pre-clinical testing of new therapeutic approaches, and current results served as a rationale for at least four prospective clinical trials. If needed, we parallel our patient-derived models with in vitro or in vivo studies using one of the few established GIST cell lines.
Conclusion: Our established GIST xenografts maintain the histological and molecular characteristics of the original patient sample and are a very useful and reliable preclinical platform for testing the new targeted approaches in GIST. The platform is available for collaboration with academic and commercial partners (contact patrick.schoffski@uzleuven.be).
The overview of patients-derived GIST xenograftsModel*KIT mutationIn vivo efficacy [% of relative tumor volume after three weeks]PrimarySecondaryImatinib (50mg/kg, BID)Sunitinib (40mg/kg, QD)UZLX-GIST1p.V560Dn/a2020UZLX-GIST2p.A502_Y503dupn/a17080UZLX-GIST3p.W557_V559delinsFn/a2525UZLX-GIST4p.K558_G565delinsRn/a4520UZLX-GIST9p.P577delp.W557LfsX5, p.D820G250170*models which showed tumor growth for at least two passages; n/a-not applicable
Citation Format: Agnieszka Wozniak, Thomas Van Looy, Giuseppe Floris, Yemarshet K. Gebreyohannes, Jasmien Wellens, Haifu Li, Jasmien Cornillie, Ulla Vanleeuw, Daphne Hompes, Marguerite Stas, Maria Debiec-Rychter, Raf Sciot, Patrick Schoffski. A panel of patient derived gastrointestinal stromal tumors (GIST) xenograft models for in vivo preclinical drug testing. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 1461. doi:10.1158/1538-7445.AM2015-1461
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Affiliation(s)
- Agnieszka Wozniak
- 1Laboratory of Experimental Oncology, Department of Oncology, KU Leuven and Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Thomas Van Looy
- 1Laboratory of Experimental Oncology, Department of Oncology, KU Leuven and Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Giuseppe Floris
- 2Department of Pathology, KU Leuven and University Hospitals, Leuven, Belgium
| | - Yemarshet K. Gebreyohannes
- 1Laboratory of Experimental Oncology, Department of Oncology, KU Leuven and Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Jasmien Wellens
- 1Laboratory of Experimental Oncology, Department of Oncology, KU Leuven and Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Haifu Li
- 1Laboratory of Experimental Oncology, Department of Oncology, KU Leuven and Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Jasmien Cornillie
- 1Laboratory of Experimental Oncology, Department of Oncology, KU Leuven and Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Ulla Vanleeuw
- 1Laboratory of Experimental Oncology, Department of Oncology, KU Leuven and Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Daphne Hompes
- 3Department of Surgical Oncology, KU Leuven and University Hospitals Leuven, Leuven, Belgium
| | - Marguerite Stas
- 3Department of Surgical Oncology, KU Leuven and University Hospitals Leuven, Leuven, Belgium
| | - Maria Debiec-Rychter
- 4Department of Human Genetics, KU Leuven and University Hospitals, Leuven, Belgium
| | - Raf Sciot
- 2Department of Pathology, KU Leuven and University Hospitals, Leuven, Belgium
| | - Patrick Schoffski
- 1Laboratory of Experimental Oncology, Department of Oncology, KU Leuven and Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
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Goossens GA, De Waele Y, Jérôme M, Fieuws S, Janssens C, Stas M, Moons P. Diagnostic accuracy of the Catheter Injection and Aspiration (CINAS) classification for assessing the function of totally implantable venous access devices. Support Care Cancer 2015. [DOI: 10.1007/s00520-015-2839-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Dudek-Perić AM, Ferreira GB, Muchowicz A, Wouters J, Prada N, Martin S, Kiviluoto S, Winiarska M, Boon L, Mathieu C, van den Oord J, Stas M, Gougeon ML, Golab J, Garg AD, Agostinis P. Antitumor immunity triggered by melphalan is potentiated by melanoma cell surface-associated calreticulin. Cancer Res 2015; 75:1603-14. [PMID: 25762540 DOI: 10.1158/0008-5472.can-14-2089] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Accepted: 02/11/2015] [Indexed: 11/16/2022]
Abstract
Systemic chemotherapy generally has been considered immunosuppressive, but it has become evident that certain chemotherapeutic drugs elicit immunogenic danger signals in dying cancer cells that can incite protective antitumor immunity. In this study, we investigated whether locoregionally applied therapies, such as melphalan, used in limb perfusion for melanoma (Mel-ILP) produce related immunogenic effects. In human melanoma biopsies, Mel-ILP treatment upregulated IL1B, IL8, and IL6 associated with their release in patients' locoregional sera. Although induction of apoptosis in melanoma cells by melphalan in vitro did not elicit threshold levels of endoplasmic reticulum and reactive oxygen species stress associated with danger signals, such as induction of cell-surface calreticulin, prophylactic immunization and T-cell depletion experiments showed that melphalan administration in vivo could stimulate a CD8(+) T cell-dependent protective antitumor response. Interestingly, the vaccination effect was potentiated in combination with exogenous calreticulin, but not tumor necrosis factor, a cytokine often combined with Mel-ILP. Our results illustrate how melphalan triggers inflammatory cell death that can be leveraged by immunomodulators such as the danger signal calreticulin.
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Affiliation(s)
- Aleksandra M Dudek-Perić
- Cell Death Research and Therapy Laboratory, Department of Cellular and Molecular Medicine, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Gabriela B Ferreira
- Laboratory of Clinical and Experimental Endocrinology, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium
| | - Angelika Muchowicz
- Department of Immunology, Center of Biostructure Research, Medical University of Warsaw, Warsaw, Poland
| | - Jasper Wouters
- Translational Cell and Tissue Research, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Nicole Prada
- Antiviral Immunity, Biotherapy and Vaccine Unit, Infection and Epidemiology Department, Institute Pasteur, Paris, France
| | - Shaun Martin
- Cell Death Research and Therapy Laboratory, Department of Cellular and Molecular Medicine, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Santeri Kiviluoto
- Laboratory of Molecular and Cellular Signaling, Department of Cellular and Molecular Medicine, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Magdalena Winiarska
- Department of Immunology, Center of Biostructure Research, Medical University of Warsaw, Warsaw, Poland
| | | | - Chantal Mathieu
- Laboratory of Clinical and Experimental Endocrinology, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium
| | - Joost van den Oord
- Translational Cell and Tissue Research, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Marguerite Stas
- Surgical Oncology, Department of Oncology, KU Leuven, Leuven, Belgium
| | - Marie-Lise Gougeon
- Antiviral Immunity, Biotherapy and Vaccine Unit, Infection and Epidemiology Department, Institute Pasteur, Paris, France
| | - Jakub Golab
- Department of Immunology, Center of Biostructure Research, Medical University of Warsaw, Warsaw, Poland. Institute of Physical Chemistry, Polish Academy of Sciences, Warsaw, Poland
| | - Abhishek D Garg
- Cell Death Research and Therapy Laboratory, Department of Cellular and Molecular Medicine, Faculty of Medicine, KU Leuven, Leuven, Belgium.
| | - Patrizia Agostinis
- Cell Death Research and Therapy Laboratory, Department of Cellular and Molecular Medicine, Faculty of Medicine, KU Leuven, Leuven, Belgium.
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Li H, Cornillie J, Wozniak A, Wellens J, Van Looy T, Vanleeuw U, Samson I, Hompes D, Stas M, Sinnaeve F, Debiec-Rychter M, Sciot R, Schöffski P. Establishment and Characterization of a Panel of Patient-Derived Soft Tissue Sarcoma (Sts) Xenograft Models for in Vivo Testing of Novel Therapeutic Approaches. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu354.24] [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: 11/14/2022] Open
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27
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Wozniak A, Van Looy T, Floris G, Gebreyohannes Y, Wellens J, Li H, Cornillie J, Vanleeuw U, Hompes D, Stas M, Sciot R, Debiec-Rychter M, Schöffski P. A Panel of Gastrointestinal Stromal Tumours (Gist) Xenograft Models for in Vivo Preclinical Drug Testing. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu354.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Vanneste L, Wolter P, Van den Oord JJ, Stas M, Garmyn M. Cutaneous adverse effects of BRAF inhibitors in metastatic malignant melanoma, a prospective study in 20 patients. J Eur Acad Dermatol Venereol 2014; 29:61-8. [PMID: 24661317 DOI: 10.1111/jdv.12449] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Accepted: 02/12/2014] [Indexed: 12/21/2022]
Abstract
BACKGROUND BRAF inhibitors frequently cause significant cutaneous adverse reactions. OBJECTIVE To study the timing, prevalence and response to treatment of skin lesions in patients receiving V-raf murine sarcoma viral oncogene homolog B1 (BRAF) inhibitors. METHODS We prospectively studied the cutaneous side-effects of patients with a BRAF mutant (V600E, V600K, V600R) metastatic malignant melanoma treated with a BRAF inhibitor. We systematically registered prevalence, timing of onset and response to treatment. RESULTS Twenty patients were treated for 2-52 weeks with a BRAF inhibitor. Eleven patients on vemurafenib (58%) developed cutaneous side-effects and 10 patients (42%) had more than one cutaneous adverse event. Verrucous papillomas were observed in eight patients (42%), after 1-12 weeks. We diagnosed four keratoacanthomas in two patients (11%) after 6-10 weeks and two squamous cell carcinomas in two patients (11%) after 10-16 weeks. Seven patients (37%) developed a hyperkeratotic, folliculocentric eruption after 2-8 weeks, resolving quickly under topical steroids. Four patients (21%) presented a facial erythema, two patients (11%) a seborrhoeic dermatitis-like eczema on the scalp. Three patients (16%) developed cystic lesions after 2-11 weeks. Three patients (16%) presented a hand-foot skin reaction after 4-6 weeks, which was successfully treated with topical steroids and keratolytics. Hyperkeratosis of the nipples was seen in one patient (5%). We observed phototoxic reactions after UV exposure in five patients (26%) and alopecia in two patients (11%) after 8-10 weeks. One patient on dabrafenib developed curly hairs (24 weeks), keratotic papules (1 and 36 weeks), a keratoacanthoma (4 weeks) and a hand-foot skin reaction (31 weeks). CONCLUSION Multiple cutaneous toxicities were observed in patients under BRAF inhibitors, mostly well controlled with adequate treatment. We recommend a multidisciplinary approach with regular assessments of the skin by a dermatologist. This allows early identification and adequate treatment to avoid premature discontinuation of a life-prolonging therapy.
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Affiliation(s)
- L Vanneste
- Department of Dermatology, University Hospitals Leuven, Leuven, Belgium
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29
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Wouters J, Stas M, Gremeaux L, Govaere O, Van den broeck A, Maes H, Agostinis P, Roskams T, van den Oord JJ, Vankelecom H. The human melanoma side population displays molecular and functional characteristics of enriched chemoresistance and tumorigenesis. PLoS One 2013; 8:e76550. [PMID: 24098529 PMCID: PMC3789681 DOI: 10.1371/journal.pone.0076550] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 08/26/2013] [Indexed: 01/10/2023] Open
Abstract
Melanoma remains the most lethal skin cancer, mainly because of high resistance to therapy. Side population (SP) cells are found in many types of cancer and are usually enriched in therapy-resistant as well as tumorigenic cells. Here, we identified a Hoechst dye-effluxing SP in a large series of human melanoma samples representing different progression phases. The SP size did not change with disease stage but was correlated with the prognostic “Breslow’s depth” in the primary (cutaneous) tumors. When injected into immunodeficient mice, the SP generated larger tumors than the bulk “main population” (MP) melanoma cells in two consecutive generations, and showed tumorigenic capacity at lower cell numbers than the MP. In addition, the SP reconstituted the heterogeneous composition of the human A375 melanoma cell line, and its clonogenic activity was 2.5-fold higher than that of the MP. Gene-expression analysis revealed upregulated expression in the melanoma SP (versus the MP) of genes associated with chemoresistance and anti-apoptosis. Consistent with these molecular characteristics, the SP increased in proportion when A375 cells were exposed to the melanoma standard chemotherapeutic agent dacarbazine, and to the aggravating condition of hypoxia. In addition, the SP showed enhanced expression of genes related to cell invasion and migration, as well as to putative (melanoma) cancer stem cells (CSC) including ABCB1 and JARID1B. ABCB1 immunoreactivity was detected in a number of tumor cells in human melanomas, and in particular in clusters at the invasive front of the primary tumors. Together, our findings support that the human melanoma SP is enriched in tumorigenic and chemoresistant capacity, considered key characteristics of CSC. The melanoma SP may therefore represent an interesting therapeutic target.
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MESH Headings
- ATP Binding Cassette Transporter, Subfamily B
- ATP Binding Cassette Transporter, Subfamily B, Member 1/genetics
- ATP Binding Cassette Transporter, Subfamily B, Member 1/metabolism
- Animals
- Antineoplastic Agents/pharmacology
- Cell Line, Tumor
- Cell Proliferation
- Cell Transformation, Neoplastic/genetics
- Dacarbazine/pharmacology
- Disease Progression
- Drug Resistance, Neoplasm/genetics
- Gene Expression Regulation, Neoplastic
- Humans
- Jumonji Domain-Containing Histone Demethylases/genetics
- Jumonji Domain-Containing Histone Demethylases/metabolism
- Male
- Melanoma/genetics
- Melanoma/metabolism
- Melanoma/pathology
- Mice
- Mice, SCID
- Neoplasm Proteins/genetics
- Neoplasm Proteins/metabolism
- Neoplasm Staging
- Neoplasm Transplantation
- Neoplastic Stem Cells/drug effects
- Neoplastic Stem Cells/metabolism
- Neoplastic Stem Cells/pathology
- Nuclear Proteins/genetics
- Nuclear Proteins/metabolism
- Repressor Proteins/genetics
- Repressor Proteins/metabolism
- Side-Population Cells/drug effects
- Side-Population Cells/metabolism
- Side-Population Cells/pathology
- Skin Neoplasms/genetics
- Skin Neoplasms/metabolism
- Skin Neoplasms/pathology
- Tumor Burden
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Affiliation(s)
- Jasper Wouters
- Translational Cell & Tissue Research, Dept. of Imaging and Pathology, University of Leuven (KU Leuven), Leuven, Belgium
- Research Unit of Stem Cell Research (Lab. of Tissue Plasticity), Cluster Stem Cell Biology and Embryology, Dept. of Development and Regeneration, University of Leuven (KU Leuven), Leuven, Belgium
| | - Marguerite Stas
- Surgical Oncology, Dept. of Oncology, University of Leuven (KU Leuven), Leuven, Belgium
| | - Lies Gremeaux
- Research Unit of Stem Cell Research (Lab. of Tissue Plasticity), Cluster Stem Cell Biology and Embryology, Dept. of Development and Regeneration, University of Leuven (KU Leuven), Leuven, Belgium
| | - Olivier Govaere
- Translational Cell & Tissue Research, Dept. of Imaging and Pathology, University of Leuven (KU Leuven), Leuven, Belgium
| | - Anke Van den broeck
- Research Unit of Stem Cell Research (Lab. of Tissue Plasticity), Cluster Stem Cell Biology and Embryology, Dept. of Development and Regeneration, University of Leuven (KU Leuven), Leuven, Belgium
- Abdominal Surgical Oncology, Dept. of Oncology, University of Leuven (KU Leuven), Leuven, Belgium
| | - Hannelore Maes
- Lab. of Cell Death Research & Therapy, Dept. of Cellular and Molecular Medicine, University of Leuven (KU Leuven), Leuven, Belgium
| | - Patrizia Agostinis
- Lab. of Cell Death Research & Therapy, Dept. of Cellular and Molecular Medicine, University of Leuven (KU Leuven), Leuven, Belgium
| | - Tania Roskams
- Translational Cell & Tissue Research, Dept. of Imaging and Pathology, University of Leuven (KU Leuven), Leuven, Belgium
| | - Joost J. van den Oord
- Translational Cell & Tissue Research, Dept. of Imaging and Pathology, University of Leuven (KU Leuven), Leuven, Belgium
| | - Hugo Vankelecom
- Research Unit of Stem Cell Research (Lab. of Tissue Plasticity), Cluster Stem Cell Biology and Embryology, Dept. of Development and Regeneration, University of Leuven (KU Leuven), Leuven, Belgium
- * E-mail:
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30
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Gao L, Smit MA, van den Oord JJ, Goeman JJ, Verdegaal EME, van der Burg SH, Stas M, Beck S, Gruis NA, Tensen CP, Willemze R, Peeper DS, van Doorn R. Genome-wide promoter methylation analysis identifies epigenetic silencing of MAPK13 in primary cutaneous melanoma. Pigment Cell Melanoma Res 2013; 26:542-54. [PMID: 23590314 DOI: 10.1111/pcmr.12096] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Accepted: 03/11/2013] [Indexed: 02/06/2023]
Abstract
The involvement of epigenetic alterations in the pathogenesis of melanoma is increasingly recognized. Here, we performed genome-wide DNA methylation analysis of primary cutaneous melanoma and benign melanocytic nevus interrogating 14 495 genes using BeadChip technology. This genome-wide view of promoter methylation in primary cutaneous melanoma revealed an array of recurrent DNA methylation alterations with potential diagnostic applications. Among 106 frequently hypermethylated genes, there were many novel methylation targets and tumor suppressor genes. Highly recurrent methylation of the HOXA9, MAPK13, CDH11, PLEKHG6, PPP1R3C, and CLDN11 genes was established. Promoter methylation of MAPK13, encoding p38δ, was present in 67% of primary and 85% of metastatic melanomas. Restoration of MAPK13 expression in melanoma cells exhibiting epigenetic silencing of this gene reduced proliferation, indicative of tumor suppressive functions. This study demonstrates that DNA methylation alterations are widespread in melanoma and suggests that epigenetic silencing of MAPK13 contributes to melanoma progression.
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Affiliation(s)
- Linda Gao
- Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands
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31
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Goossens GA, Jérôme M, Janssens C, Peetermans WE, Fieuws S, Moons P, Verschakelen J, Peerlinck K, Jacquemin M, Stas M. Comparing normal saline versus diluted heparin to lock non-valved totally implantable venous access devices in cancer patients: a randomised, non-inferiority, open trial. Ann Oncol 2013; 24:1892-1899. [PMID: 23553060 DOI: 10.1093/annonc/mdt114] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [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: 12/15/2022] Open
Abstract
BACKGROUND Heparin has been used for years as a locking solution in totally implantable venous access devices. Normal saline (NS) might be a safe alternative for heparin. However, evidence of non-inferiority of NS versus heparin is lacking. PATIENTS AND METHODS We randomly allocated 802 cancer patients with a newly inserted port either to heparin lock (300 U/3 ml) or to NS lock groups in a 1:1 assignment ratio. The primary outcome was the number of functional complications, which was defined as 'easy injection, impossible aspiration' at port access. Secondary outcomes included all functional problems and catheter-related bacteraemia. We hypothesised that NS locks do not cause more functional problems and catheter-related bacteraemia than heparin locks. Non-inferiority is established if the upper limit of the confidence interval (CI) for the relative risk of NS versus heparin is <1.4. RESULTS Three hundred and eighty-two patients from the NS group and 383 from the heparin lock group were included in the analysis. The incidence rate of our primary outcome (easy injection, impossible aspiration) was 3.70% (95% CI 2.91%-4.69%) and 3.92% (95% CI 3.09%-4.96%) of accesses in the NS and heparin groups, respectively. The relative risk was 0.94% (95% CI 0.67%-1.32%). Catheter-related bloodstream infection was 0.03 per 1000 catheter days in the NS group and 0.10 per 1000 catheter days in the heparin group. CONCLUSION NS is a safe and effective locking solution in implantable ports if combined with a strict protocol for device insertion and maintenance.
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Affiliation(s)
- G A Goossens
- Nursing Centre of Excellence, University Hospitals Leuven, Leuven; Department of Public Health and Primary Care, KU Leuven, Leuven.
| | - M Jérôme
- Nursing Centre of Excellence, University Hospitals Leuven, Leuven
| | - C Janssens
- Nursing Centre of Excellence, University Hospitals Leuven, Leuven
| | - W E Peetermans
- Department of Internal Medicine, University Hospitals Leuven, Leuven
| | - S Fieuws
- Interuniversity Centre for Biostatistics and Statistical Bioinformatics, KU Leuven, Leuven; Interuniversity Centre for Biostatistics and Statistical Bioinformatics, Universiteit Hasselt, Hasselt
| | - P Moons
- Department of Public Health and Primary Care, KU Leuven, Leuven
| | - J Verschakelen
- Department of Radiology, University Hospitals Leuven, Leuven
| | - K Peerlinck
- Centre for Molecular and Vascular Biology, KU Leuven, Leuven
| | - M Jacquemin
- Centre for Molecular and Vascular Biology, KU Leuven, Leuven
| | - M Stas
- Department of Surgical Oncology, University Hospitals Leuven, Leuven, Belgium
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Li H, Wozniak A, Van Den Bossche K, Van Looy T, Wellens J, Stas M, Floris G, Friedman L, Debiec-Rychter M, Sciot R, Schoffski P. Efficacy of the phosphoinositol 3 kinase (PI3K) inhibitor GDC-0941 in patient- and cell-line-derived xenografts of dedifferentiated liposarcoma (DDLPS). J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.e13528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e13528 Background: Analysis of primary clinical specimens of DDLPS revealed evidence of AKT activation in 27% of cases (Gutierrez A, et al. Aberrant AKT activation drives well-differentiated liposarcoma. PNAS 2011; 108(39):16386-91). We evaluated the efficacy of the PI3K inhibitor GDC-0941 (GDC) alone and in combination with doxorubicin (DOX) in patient- and cell-line derived DDLPS xenografts with proven PI3K/AKT pathway activation. Methods: NMRI nu/nu mice were either injected bilaterally with 1x107SW872 cells or transplanted with human DDLPS (UZLX-STS3). Animals were randomized to 4 groups (6 mice/group) and treated for two weeks: vehicle, DOX (i.p., 1.2mg/kg/biw), GDC (p.o., 75mg/kg/qd), GDC+DOX (same dose/schedule as single agents). Efficacy was assessed by tumor volume assessment, Western blotting and histological evaluation (H&E). Mitotic and apoptotic effects were confirmed using immunostainings for phospho-histone H3 (p-H3) (for proliferation), and cleaved caspase 3 (CC3) (for apoptosis). Results: GDC and GDC+DOX significantly delayed the growth of both xenografts (74% decrease under GDC and 77% under GDC+DOX in SW872, 67% under GDC and 56% under GDC+DOX in UZLX-STS3, vs. control). GDC and GDC+DOX treatment resulted in reduced mitotic activity and increase in apoptosis, as compared to untreated tumors in both models (Table). The activation of PI3K signaling was nearly completely suppressed in the GDC and GDC+DOX treated groups in SW872, whilea weak activation of the pathway was still observed in UZLX-STS3. Conclusions: GDC-0941 has anti-tumor activity, decreases tumor proliferation and induces apoptosis in DDLPS with PI3K/AKT activation. The GDC+DOX combination did not show additive effect in vivo. [Table: see text]
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Affiliation(s)
- Haifu Li
- Laboratory of Experimental Oncology, Department of Oncology and Department of General Medical Oncology, KU Leuven and University Hospitals, Leuven, Belgium
| | - Agnieszka Wozniak
- Laboratory of Experimental Oncology and Department of General Medical Oncology, KU Leuven and University Hospitals, Leuven, Belgium
| | | | - Thomas Van Looy
- Laboratory of Experimental Oncology and Department of General Medical Oncology, KU Leuven and University Hospitals, Leuven, Belgium
| | - Jasmien Wellens
- Laboratory of Experimental Oncology, Department of Oncology and Department of General Medical Oncology, KU Leuven and University Hospitals, Leuven, Belgium
| | - Marguerite Stas
- Department of Surgical Oncology, KU Leuven and University Hospitals, Leuven, Belgium
| | - Giuseppe Floris
- Department of Pathology, KU Leuven and University Hospitals, Leuven, Belgium
| | | | - Maria Debiec-Rychter
- Department of Human Genetics, KU Leuven and University Hospitals, Leuven, Belgium
| | - Raf Sciot
- Department of Pathology, KU Leuven and University Hospitals, Leuven, Belgium
| | - Patrick Schoffski
- University Hospitals Leuven, Department of General Medical Oncology, KU Leuven, Leuven, Belgium
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T'Seyen S, Bertrand P, Goosens V, Stas M, Verhamme P, Maleux G. Symptomatic tibial vein aneurysm - a diagnostic challenge. VASA 2013; 42:72-6. [PMID: 23385229 DOI: 10.1024/0301-1526/a000239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Stef T'Seyen
- Department of Radiology, University Hospitals Leuven, Belgium
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Goossens GA, Stas M, Moons P. Management of functional complications of totally implantable venous access devices by an advanced practice nursing team: 5 Years of clinical experience. Eur J Oncol Nurs 2012; 16:465-71. [DOI: 10.1016/j.ejon.2011.11.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2011] [Revised: 11/15/2011] [Accepted: 11/26/2011] [Indexed: 11/25/2022]
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35
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Goossens GA, Stas M, Moons P. Management of venous access devices by Advanced Practice Nursing teams: more research needed. Eur J Oncol Nurs 2012; 16:473-4. [PMID: 23039923 DOI: 10.1016/j.ejon.2012.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Godelieve Alice Goossens
- Department of Surgical Oncology, University Hospitals Leuven, Herestraat 49, B-3000 Leuven, Belgium.
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36
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Cipponi A, Mercier M, Seremet T, Baurain JF, Théate I, van den Oord J, Stas M, Boon T, Coulie PG, van Baren N. Neogenesis of lymphoid structures and antibody responses occur in human melanoma metastases. Cancer Res 2012; 72:3997-4007. [PMID: 22850419 DOI: 10.1158/0008-5472.can-12-1377] [Citation(s) in RCA: 191] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Lymphoid neogenesis, or the development of lymphoid structures in nonlymphoid organs, is frequently observed in chronically inflamed tissues, during the course of autoimmune, infectious, and chronic graft rejection diseases, in which a sustained lymphocyte activation occurs in the presence of persistent antigenic stimuli. The presence of such ectopic lymphoid structures has also been reported in primary lung, breast, and germline cancers, but not yet in melanoma. In this study, we observed ectopic lymphoid structures, defined as lymphoid follicles comprising clusters of B lymphocytes and follicular dendritic cells (DC), associated with high endothelial venules (HEV) and clusters of T cells and mature DCs, in 7 of 29 cutaneous metastases from melanoma patients. Some follicles contained germinal centers. In contrast to metastatic lesions, primary melanomas did not host follicles, but many contained HEVs, suggesting an incomplete lymphoid neogenesis. Analysis of the repertoire of rearranged immunoglobulin genes in the B cells of microdissected follicles revealed clonal amplification, somatic mutation and isotype switching, indicating a local antigen-driven B-cell response. Surprisingly, IgA responses were observed despite the nonmucosal location of the follicles. Taken together, our findings show the existence of lymphoid neogenesis in melanoma and suggest that the presence of functional ectopic lymphoid structures in direct contact with the tumor makes the local development of antimelanoma B- and T-cell responses possible.
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Affiliation(s)
- Arcadi Cipponi
- de Duve Institute, Université catholique de Louvain, Bruxelles, Belgium
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Derweduwen AM, Verbeken E, Stas M, Verschakelen J, Coolen J, Verleden G, Wuyts W. Extrapulmonary lymphangioleiomyomatosis: a wolf in sheep's clothing. Thorax 2012; 68:111-3. [PMID: 22863757 DOI: 10.1136/thoraxjnl-2012-201973] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
We present a case of a 32-year-old woman who was diagnosed with lymphangioleiomyomatosis (LAM) after detecting a mass in the upper anterior mediastinum. Two years after presentation another metastatic localisation of LAM occurred in the cervical region. With this article we would like to highlight the fact that there are still a lot of unanswered questions, especially regarding the best management of extrapulmonary LAM.
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Affiliation(s)
- Aurélie Maria Derweduwen
- Unit for Interstitial Lung Diseases, Department of Respiratory Medicine, University Hospital Leuven, Leuven, Belgium.
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Wouters J, Stas M, Govaere O, Van den Eynde K, Vankelecom H, van den Oord JJ. Gene expression changes in melanoma metastases in response to high-dose chemotherapy during isolated limb perfusion. Pigment Cell Melanoma Res 2012; 25:454-65. [PMID: 22486811 DOI: 10.1111/j.1755-148x.2012.01004.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Despite recent advances in melanoma therapy, disseminated melanoma still lacks effective treatment, and recurrence of the tumor frequently occurs, even after high-dose chemotherapy. The mechanisms responsible for this chemoresistance or for the formation of new relapses remain poorly understood. Using a human 'model', in which the isolated limb is perfused with high doses of the chemotherapeutic melphalan (ILP), we identified a five-gene set (ATF3, CYR61, IER5, IL6, and PTGS2) of stress-induced genes that was consistently upregulated after ILP in all in-transit metastatic melanoma samples as well as in three melphalan-treated melanoma cell lines. Early post-ILP relapses retained these elevated expressions, whereas the expression of these genes returned to their original levels in late post-ILP recurrences. In addition, we identified upregulation of these genes in the A375 cell line's side population (SP) and melanospheres, established methods to enrich for candidate cancer stem cells (CSCs), which are considered chemoresistant and tumorigenic, and thus proposed to be responsible for tumor relapse. Our data identify an immediate and short-term upregulation of early stress-responsive genes that are potentially linked to chemoresistance and CSCs.
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Affiliation(s)
- Jasper Wouters
- Translational Cell & Tissue Research, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium.
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Schöffski P, Cerbone L, Wolter P, De Wever I, Samson I, Dumez H, Clement P, Wildiers H, Stas M. Administration of 24-h Intravenous Infusions of Trabectedin in Ambulatory Patients with Mesenchymal Tumors via Disposable Elastomeric Pumps: An Effective and Patient-Friendly Palliative Treatment Option. ACTA ACUST UNITED AC 2012; 35:14-7. [DOI: 10.1159/000335879] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Verbrugge FH, Stas M, Knockaert D, Tousseyn T, Vanderschueren S. Lymph node biopsies in a general internal medicine department: algorithm or individualized decision-making? Acta Clin Belg 2011; 66:274-9. [PMID: 21938982 DOI: 10.2143/acb.66.4.2062568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Lymphadenopathy (LA) imposes a diagnostic challenge in internal medicine. Exclusion of malignancy is the primary concern. METHODS A retrospective case series, including 40 adult patients from the general internal medicine department who underwent lymph node biopsy (LNB) at a single university hospital. Demographics, clinical data and histopathological diagnoses were registered. By means of the latest medical record, we obtained a final diagnosis for each patient and subsequently searched for variables correlated with malignancy. Follow-up was at least one year in 95% of cases. RESULTS The prevalence of malignancy was 58%. Older age (p = 0.02) was significantly correlated with malignancy. The presence of painful lymphadenopathy at clinical examination (p = 0.02) was significantly associated with a benign outcome. No single or combination of baseline variables satisfactorily excluded malignancy. Histopathological analysis correctly predicted malignancy in 93% of cases. In two cases, an initial diagnosis of benign non-specific lymphadenopathy was reversed to non-Hodgkin lymphoma. In one case the pathological diagnosis was inconclusive. CONCLUSION Rather than following a universal algorithm to determine the need for LNB in patients with LA, we call for individualized decision-making in each case, carefully appreciating all available information. Additionally, one should keep in mind that false-negative results occur due to sampling errors. Therefore, a minimal number of cases should end with a final diagnosis of benign non-specific lymphadenopathy. Intensive, multidisciplinary cooperation with surgeon and pathologist is needed. Moreover, clinical follow-up should be at least one year.
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Affiliation(s)
- F H Verbrugge
- Department of General Internal Medicine, University Hospital Gasthuisberg, Leuven, België.
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Goossens GA, Stas M, Jérôme M, Moons P. Systematic review: malfunction of totally implantable venous access devices in cancer patients. Support Care Cancer 2011; 19:883-98. [DOI: 10.1007/s00520-011-1171-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2010] [Accepted: 04/18/2011] [Indexed: 11/25/2022]
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Spatz A, van Kempen LC, Job B, Richon C, Barrois M, Dessen P, Lazar V, Michiels S, Helbling-Leclerc A, Dumay A, Petrella T, Batist G, Stas M, Schadendorf D, van den Oord J, Feunteun J. Abstract 4835: Gonosome-linked expression of PPP2R3B in cutaneous melanoma correlates with distant metastasis free survival. Cancer Res 2011. [DOI: 10.1158/1538-7445.am2011-4835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: A strong adverse male effect for melanoma incidence and survival has been reported. No biological explanation, including hormonal differences, has been identified so far. We hypothesize that this gender difference in incidence and survival involves X-linked tumor suppressor genes and/or oncogenes whose expression is affected by X-chromosome alterations.
Methods: DNA and RNA were extracted from 49 fresh frozen primary melanomas (32 females, 17 males, distant metastasis free survival (DMFS) <3 years or follow up >3 years) and subjected to array-based comparative genomic hybridization. Supervised and unsupervised cluster analyses were performed. X-inactivation was studied by Xist RNA in situ hybridization and androgen receptor methylation-sensitive PCR. The expression of a candidate X-linked gene was analyzed by quantitative PCR and correlated with DMFS in uni- and multivariate analyses.
Results: Supervised cluster analyses revealed distinct DNA signatures associated with clinical and histopathological characteristics. Unsupervised clustering identified three groups of which one was composed of predominantly female patients (10/13) and associated with the worst DMFS. This group was characterized by loss of one X-chromosome in 7 of the 13 patients. Loss of X correlated with poor DMFS of female patients (logrank p=0.009). Intriguingly, the lost X chromosome was systematically the inactivated copy. Among the 17 males, Y-chromosome loss correlated with DMFS (logrank p=0.015). We found that the PPP2R3B gene, located within one of the pseudoautosomal regions and thus not inactivated on the inactive X in females, is lost from the Y in males. PPP2R3B encodes a regulatory subunit of protein phosphatase 2 that may negatively control cell proliferation via targets such as CDC6 or RB. Quantitative analysis of PPP2R3B mRNA expression in an independent sample set of melanomas revealed a strong correlation between decreased levels of PPP2R3B expression and poor DMFS irrespective of gender in multivariate analysis (p=0.0007).
Conclusion: Our analyses reveal a specific pattern of X and Y chromosome losses that are associated with melanoma progression. PPP2R3B is a potential gonosome-linked tumor suppressor gene, whose loss of expression correlates with poor DMFS.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 4835. doi:10.1158/1538-7445.AM2011-4835
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Affiliation(s)
- Alan Spatz
- 1McGill University, Montreal, Quebec, Canada
| | | | | | | | | | | | | | | | | | - Anne Dumay
- 2Institut Gustave Roussy, Villejuif, France
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Goossens E, Goossens GA, Stas M, Janssens C, Jérôme M, Moons P. Sensory Perceptions of Patients With Cancer Undergoing Surgical Insertion of a Totally Implantable Venous Access Device: A Qualitative, Exploratory Study. Oncol Nurs Forum 2010; 38:E20-6. [DOI: 10.1188/11.onf.e20-e26] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Marasigan V, Ivanova A, Stas M, van den Oord J, Garmyn M. FC6 Association of melanoma risk factors with body site, histological subtype, and primary melanoma count in a Flemish melanoma population (Belgium). Melanoma Res 2010. [DOI: 10.1097/01.cmr.0000382808.60322.8e] [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]
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Schöffski P, Cerbone L, Stas M, Wolter P, Dumez H, Clement P, Wildiers H, Paridaens R, van Oosterom A. 9425 Administration of 24-hour intravenous infusions of trabectedin (Yondelis®) every 3 weeks in ambulatory patients with mesenchymal tumors via the disposable elastomeric pump Baxter LV10: a feasible, convenient, effective and patient-friendly palliative treatment option. European Journal of Cancer Supplements 2009. [DOI: 10.1016/s1359-6349(09)72013-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Schoeffski P, Cerbone L, Wolter P, Stas M, Dumez H, Clement P, Wildiers H, Paridaens R, van Oosterom AT. Administration of 24-hour intravenous infusions of trabectedin every 3 weeks in ambulatory patients with mesenchymal tumors via disposable elastomeric pumps. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e13530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e13530 Background: Patients (pts) with sarcoma whose disease progresses after standard chemotherapy have poor outcome. In this setting, DNA- transcription-interacting cytotoxic agent trabectedin (TRA) is efficacious and marketed in Europe. It is administered as 24-h i.v. infusion q3w with steroid co-medication. To overcome the inconvenience of hospitalization for drug delivery TRA is now given in Leuven via disposable elastomeric pumps, which facilitate ambulatory treatment and are compatible with the drug. Material and Methods: Heavily pre-treated pts with sarcoma were offered chemotherapy with TRA 1.5 mg/m2 as 24-h i.v. infusion via port catheter, either during hospitalization using electronic pumps or as outpatients using the Baxter LV10 disposable pump (drug dissolved in 267 ml NaCl 0.9%). Co-medication consisted of antiemetics and dexamethasone 2x4 mg days -1,1,2,3. Results: Between 09/07–12/08 28 pts were treated, and 21 (75%) elected outpatient therapy (9 F, 12 M, med. age 49 yrs, range 19–68). Common diagnoses included leiomyo- (5), lipo- (4), synovial (2) and myxofibrosarcomas. Pts had previous primary surgery (17), adjuvant RT (4) and surgery for relapse/metastasis (7). They had local relapse (2), distant metastasis (12) or both (7) when starting TRA, 19 had received previous chemotherapy with a med. number of 2 prior lines (range, 0–5). We administered 130 cycles of TRA in 21 pts, with a med. number of 3 cycles/patient (range, 1–24). Dose reductions were done in 60 cycles, mainly due to laborabory events. Best response (RECIST) was 3 confirmed PR, 1 PR pending confirmation, 6 SD, 11 PD. Grade 3/4 (CTC) AEs were limited to one case each of hemorrhage and lung embolism, other AEs were in line with published TRA experience. One port catheter contamination required replacement, one catheter tip thrombosis occurred and one extravasation due to needle dislocation was observed. Conclusions: Outpatient administration of TRA as 24-h infusion via port catheter using Baxter LV10 pumps is preferred by 3/4 pts, is feasible, safe, effective, cost-efficient and should be considered routine practice in this clinical setting. [Table: see text]
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Affiliation(s)
- P. Schoeffski
- University Hospitals of Leuven, Leuven, Belgium; University Hospital Leuven/San Camillo Forlanini Hospital, Leuven/Rome, Belgium
| | - L. Cerbone
- University Hospitals of Leuven, Leuven, Belgium; University Hospital Leuven/San Camillo Forlanini Hospital, Leuven/Rome, Belgium
| | - P. Wolter
- University Hospitals of Leuven, Leuven, Belgium; University Hospital Leuven/San Camillo Forlanini Hospital, Leuven/Rome, Belgium
| | - M. Stas
- University Hospitals of Leuven, Leuven, Belgium; University Hospital Leuven/San Camillo Forlanini Hospital, Leuven/Rome, Belgium
| | - H. Dumez
- University Hospitals of Leuven, Leuven, Belgium; University Hospital Leuven/San Camillo Forlanini Hospital, Leuven/Rome, Belgium
| | - P. Clement
- University Hospitals of Leuven, Leuven, Belgium; University Hospital Leuven/San Camillo Forlanini Hospital, Leuven/Rome, Belgium
| | - H. Wildiers
- University Hospitals of Leuven, Leuven, Belgium; University Hospital Leuven/San Camillo Forlanini Hospital, Leuven/Rome, Belgium
| | - R. Paridaens
- University Hospitals of Leuven, Leuven, Belgium; University Hospital Leuven/San Camillo Forlanini Hospital, Leuven/Rome, Belgium
| | - A. T. van Oosterom
- University Hospitals of Leuven, Leuven, Belgium; University Hospital Leuven/San Camillo Forlanini Hospital, Leuven/Rome, Belgium
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Baurain J, Stas M, Hammouch F, Gillain A, Feyens A, Van Baren N, Tromme I, Van Wijck R, Garmyn M, Coulie PG. Association of primary melanoma ulceration and clinical benefit of adjuvant vaccination with tumor-specific antigenic peptides. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.3022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3022 Background: Therapeutic vaccination of metastatic melanoma patients with detectable disease is followed by tumor regression in ±10% of the patients, mostly with locoregional disease. Considering the absence of an effective treatment to prevent relapses of cutaneous melanoma, we have applied a multipeptide vaccine in the adjuvant setting. Methods and Results: We treated 45 HLA-A2-positive melanoma patients with no evidence of disease but at high risk of relapse. They received 5 vaccines every 3 weeks, then one every 3 months over 2 years. A first group (n=14) received 4 antigenic peptides derived from MAGE-A3, NA17, gp100 and Tyrosinase, emulsified independently in 4x1ml of Montanide ISA51. A second group (n=16) received the 4 peptides emulsified together in 1x1ml of Montanide. A third group (n= 15) received the 4 peptides alone. Forty-one patients were eligible for immune response analysis after 5 injections. A T-cell response to at least one peptide was detected in 21/27 patients vaccinated with Montanide, but in none of 14 vaccinated with peptides alone. Median follow-up time was 24 months ±10 months (SD). Relapse free survival (RFS) at 18 months was 37% for all the patients and no significant difference was observed between patients vaccinated with or without Montanide: 41% and 27%, respectively. Median distant metastasis-free survival time (DMFS) was doubled for patients vaccinated with vs without Montanide (p=0.132). Multivariate analysis for various prognostic factors including sex, age, PS, vaccine type, or immune response suggested that the ulceration of the primary tumor was associated with a better clinical course following vaccination (HR=0.295 with IC95%: 0.09–0.97). Conclusions: Vaccination with mutiple peptides in Montanide is well tolerated and elicits specific immune responses. Patients vaccinated with peptides in Montanide have a prolonged RFS and DMFS compared to whose vaccinated with peptides alone. Patients who had an ulcerated primary tumor seem to benefit more from this adjuvant vaccine. These results warrant further evaluation of such vaccines in a randomized trial with the ulceration of the primary tumor as a stratification factor. No significant financial relationships to disclose.
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Affiliation(s)
- J. Baurain
- Université Catholique de Louvain, Bruxelles, Belgium; UZ Leuven, Leuven, Belgium; Ludwig Institute for Cancer Research, Brussels, Belgium
| | - M. Stas
- Université Catholique de Louvain, Bruxelles, Belgium; UZ Leuven, Leuven, Belgium; Ludwig Institute for Cancer Research, Brussels, Belgium
| | - F. Hammouch
- Université Catholique de Louvain, Bruxelles, Belgium; UZ Leuven, Leuven, Belgium; Ludwig Institute for Cancer Research, Brussels, Belgium
| | - A. Gillain
- Université Catholique de Louvain, Bruxelles, Belgium; UZ Leuven, Leuven, Belgium; Ludwig Institute for Cancer Research, Brussels, Belgium
| | - A. Feyens
- Université Catholique de Louvain, Bruxelles, Belgium; UZ Leuven, Leuven, Belgium; Ludwig Institute for Cancer Research, Brussels, Belgium
| | - N. Van Baren
- Université Catholique de Louvain, Bruxelles, Belgium; UZ Leuven, Leuven, Belgium; Ludwig Institute for Cancer Research, Brussels, Belgium
| | - I. Tromme
- Université Catholique de Louvain, Bruxelles, Belgium; UZ Leuven, Leuven, Belgium; Ludwig Institute for Cancer Research, Brussels, Belgium
| | - R. Van Wijck
- Université Catholique de Louvain, Bruxelles, Belgium; UZ Leuven, Leuven, Belgium; Ludwig Institute for Cancer Research, Brussels, Belgium
| | - M. Garmyn
- Université Catholique de Louvain, Bruxelles, Belgium; UZ Leuven, Leuven, Belgium; Ludwig Institute for Cancer Research, Brussels, Belgium
| | - P. G. Coulie
- Université Catholique de Louvain, Bruxelles, Belgium; UZ Leuven, Leuven, Belgium; Ludwig Institute for Cancer Research, Brussels, Belgium
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Verhamme P, Jerome M, Goossens G, Devis J, Maleux G, Stas M. A pilot trial of microplasmin in patients with long-term venous access catheter thrombosis. J Thromb Thrombolysis 2009; 28:477-81. [DOI: 10.1007/s11239-009-0310-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2008] [Accepted: 01/30/2009] [Indexed: 11/24/2022]
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Abstract
AIM To examine and report the quality of life together with the level of disability of cancer patients who underwent therapeutic ilio-inguinal lymphadenectomy. MATERIALS AND METHODS The complete files of 62 patients who underwent 66 procedures between January 1990 and November 2006 were obtained and analysed retrospectively. Data concerning postoperative complications, presence and extent of lymphoedema, physical symptoms, duration of disability, daily life and social activities were collected through a specific questionnaire and reviewed. RESULTS Early postoperative complications occurred in 36% of cases. Sixty-five percent of patients developed some degree of postoperative lymphoedema. Twenty patients suffered at least one episode of erysipelas. Median postoperative disability was 4 months (range 1.5 to 24 months). Among the active population, 8 patients (18%) never returned to work. Postoperative quality of life was good or very good for most patients, with acceptable limitation in daily activities. CONCLUSION Ilio-inguinal lymphadenectomy is the only radical procedure able to provide long-term tumour control and maintain a good to very good quality of life, thus providing a real possibility of returning to work.
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Affiliation(s)
- F. Brouns
- Department of Surgical Oncology,University Hospitals Leuven, Belgium
| | - P. Donceel
- Department of Insurance,Environmental and Occupational Medicine, University Hospitals Leuven, Belgium
| | - M. Stas
- Department of Surgical Oncology,University Hospitals Leuven, Belgium
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Abstract
A retrospective analysis was performed of 46 cases of sarcoma treated in our institution between 1989 and 2007 that occurred in a previously irradiated area. Eight male and 38 female patients had received radiotherapy, mainly for breast cancer and genitourinary tumours. The interval between irradiation and the diagnosis of sarcoma ranged from 1 to 54 years (median 15 y). The most common clinical findings were a mass, pain and skin dislocation. Angiosarcoma and sarcoma non-otherwise-specified were the most common histological types. Surgical resection was performed in 34 patients (74%) and 5-year survival was 45% when a radical resection was obtained. No 5-year survival was noticed after non-radical resection and in the absence of surgery. Stage and location of the sarcoma were other prognostic factors. Overall 5-year survival was 27% for the whole group.
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Affiliation(s)
- S. De Smet
- Department of Surgical Oncology, Leuven University Hospital, Leuven, Belgium
| | - L. Vandermeeren
- Department of Surgical Oncology, Leuven University Hospital, Leuven, Belgium
| | - M.-R. Christiaens
- Multidisciplinary Breast Centre, Leuven University Hospital, Leuven, Belgium
| | - I. Samson
- Department of Orthopaedic surgery, Leuven University Hospital, Leuven, Belgium
| | - M. Stas
- Department of Surgical Oncology, Leuven University Hospital, Leuven, Belgium
| | | | - I. De Wever
- Department of Surgical Oncology, Leuven University Hospital, Leuven, Belgium
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