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Gao Y, Zang L, Ye Y, Ma F, Kang M, Zheng K, Kang Y, Wang H, Xu C. Immunotherapy combined with targeted therapy in advanced small cell carcinoma of the ovary of hypercalcemic type: A case of overall survival lasting for over 5 years. Eur J Obstet Gynecol Reprod Biol 2024:S0301-2115(24)00168-4. [PMID: 38604920 DOI: 10.1016/j.ejogrb.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/08/2024] [Accepted: 04/05/2024] [Indexed: 04/13/2024]
Abstract
Small cell carcinoma of the ovary, hypercalcemic type (SCCOHT) is a rare but highly aggressive ovarian malignant neoplasm lacking a unified clinical management process. Most patients are diagnosed at an advanced stage and have an extremely poor prognosis with an overall probability of survival less than 10 %. Here, we describe the case of a patient with advanced SCCOHT achieved a survival of over 5 years after receiving multiple cycles of immunotherapy combined with anti-angiogenic therapy or CDK4/6 inhibitors. At the same time, we also summarized the case reports and clinical trials of immunotherapy in SCCOHT.
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Affiliation(s)
- Yi Gao
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China; Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai 200011, China
| | - Li Zang
- The Second Hospital of Tianjin Medical University, Tianjin Key Laboratory of Urology, Tianjin 300211, China
| | - Yingfei Ye
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China; Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai 200011, China
| | - Fenghua Ma
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China
| | - Mingyi Kang
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China
| | - Kewei Zheng
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China
| | - Yu Kang
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China; Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai 200011, China.
| | - Haitao Wang
- The Second Hospital of Tianjin Medical University, Tianjin Key Laboratory of Urology, Tianjin 300211, China.
| | - Congjian Xu
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China; Department of Obstetrics and Gynecology of Shanghai Medical School, Fudan University, Shanghai 200032, China; Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai 200011, China.
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2
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Altmann J, Schmitt W, Bashian N, Sehouli J. A dramatic response to checkpoint inhibitor in a woman with small cell carcinoma of the hypercalcemic type of the ovary. Gynecol Oncol 2024; 181:99-101. [PMID: 38150838 DOI: 10.1016/j.ygyno.2023.12.016] [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: 08/03/2023] [Revised: 12/04/2023] [Accepted: 12/18/2023] [Indexed: 12/29/2023]
Abstract
OBJECTIVE We present the rare case of a 21 year old woman with small cell carcinoma of the right ovary of the hypercalcemic type with dramatic response to checkpoint inhibitor. METHODS Case report. RESULTS AND CONCLUSIONS Our patient, a 22-year old woman with small cell carcinoma of the hypercalcemic type with hepatic metastases, is currently 43 months under treatment with pembrolizumab. Last MRI revealed no viable liver metastases nor other signs of recurrence. This is the longest survival of a patient with small cell carcinoma of the ovary under therapy with checkpoint inhibitors reported in the literature so far. With this report we emphasize the importance of immunohistological testing for PD-L 1. Treating clinicians should keep off-label use of immune checkpoint blockade in mind when treating this highly aggressive tumor if all other treatment options fail.
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Affiliation(s)
- J Altmann
- European Competence Center for Ovarian Cancer (EKZE), Department of Gynecology with Center of Oncological Surgery, Charité University Hospital Berlin, Germany.
| | - W Schmitt
- Department of Pathology, Charité University Hospital Berlin, Germany
| | - N Bashian
- Department of Radiology, Charité University Hospital Berlin, Germany
| | - J Sehouli
- European Competence Center for Ovarian Cancer (EKZE), Department of Gynecology with Center of Oncological Surgery, Charité University Hospital Berlin, Germany
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3
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Gao Y, Zheng K, Kang M, Xu J, Ning Y, Hu W, Li K, Kang Y, Xu C. Establishment and characterization of a novel cell line ( SCCOHT-CH-1) and PDX models derived from Chinese patients of small cell ovarian carcinoma of the hypercalcemic type. Hum Cell 2023; 36:2214-2227. [PMID: 37535222 PMCID: PMC10587334 DOI: 10.1007/s13577-023-00966-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 07/31/2023] [Indexed: 08/04/2023]
Abstract
Small cell carcinoma of the ovary hypercalcemic type (SCCOHT) is a rare and aggressive malignancy that poses a significant clinical challenge due to its grim prognosis. Unfortunately, only three SCCOHT cell lines are currently available for scientific research. In this study, we have successfully established a novel SCCOHT cell line from a recurrent lesion of a SCCOHT patient, named SCCOHT-CH-1. We comprehensively characterized the novel cell line by employing techniques such as morphological observation, CCK-8 assay, Transwell assay, clone formation assay, short tandem repeat sequence (STR) analysis, karyotype analysis, immunohistochemical staining, western blot assay, and xenograft tumor formation assay. SCCOHT-CH-1 cells were small circular and had a unique STR profile. The population-doubling time of SCCOHT-CH-1 was 33.02 h. The cell line showed potential migratory and invasive ability. Compared with another SCCOHT cell line COV434, SCCOHT-CH-1 exhibited higher expression of AKT, VIM, and CCND1. At the same time, SCCOHT-CH-1 has the ability of tumorigenesis in vivo. We also successfully constructed three patient-derived xenograft (PDX) models of SCCOHT, which were pathologically diagnosed to be consistent with the primary tumor, accompanied by loss of SAMRCA4 protein expression. The establishment of SCCOHT-CH-1 cell line and PDX models from Chinese people represent a pivotal step toward unraveling the molecular mechanism of SCCOHT and fostering the development of targeted interventions to tackle this challenging malignancy.
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Affiliation(s)
- Yi Gao
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200011, China
| | - Kewei Zheng
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200011, China
| | - Mingyi Kang
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200011, China
| | - Jing Xu
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200011, China
| | - Yan Ning
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200011, China
| | - Weiguo Hu
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200011, China
| | - Ke Li
- Cancer Institute, Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
| | - Yu Kang
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200011, China.
| | - Congjian Xu
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200011, China.
- Department of Obstetrics and Gynecology of Shanghai Medical School, Fudan University, Shanghai, 200032, China.
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, 200011, China.
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4
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Wens FSPL, Hulsker CCC, Fiocco M, Zsiros J, Smetsers SE, de Krijger RR, van der Steeg AFW, Zweemer RP, Baas IO, Roes EM, Looijenga LHJ, Gerestein CG, Mavinkurve-Groothuis AMC. Small Cell Carcinoma of the Ovary, Hypercalcemic Type ( SCCOHT): Patient Characteristics, Treatment, and Outcome-A Systematic Review. Cancers (Basel) 2023; 15:3794. [PMID: 37568608 PMCID: PMC10417391 DOI: 10.3390/cancers15153794] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Small-cell carcinoma of the ovary, hypercalcemic type (SCCOHT) is a rare aggressive ovarian malignancy mainly affecting children, adolescents, and young adults. Since the discovery of mutations in the SMARCA4 gene in 2014, SCCOHT has become the subject of extensive investigation. However, international uniform treatment guidelines for SCCOHT are lacking and the outcome remains poor. The aim of this systematic review is to generate an overview of all reported patients with SCCOHT from 1990 onwards, describing the clinical presentation, genetic characteristics, treatment, and outcome. METHODS A systematic search was performed in the databases Embase, Medline, Web of Science, and Cochrane for studies that focus on SCCOHT. Patient characteristics and treatment data were extracted from the included studies. Survival was estimated using Kaplan-Meier's methodology. To assess the difference between survival, the log-rank test was used. To quantify the effect of the FIGO stage, the Cox proportional hazard regression model was estimated. The chi-squared test was used to study the association between the FIGO stage and the surgical procedures. RESULTS Sixty-seven studies describing a total of 306 patients were included. The median patient age was 25 years (range 1-60 years). The patients mostly presented with non-specific symptoms such as abdominal pain and sometimes showed hypercalcemia and elevated CA-125. A great diversity in the diagnostic work-up and therapeutic approaches was reported. The chemotherapy regimens were very diverse, all containing a platinum-based (cisplatin or carboplatin) backbone. Survival was strongly associated with the FIGO stage at diagnosis. CONCLUSIONS SCCOHT is a rare and aggressive ovarian cancer, with a poor prognosis, and information on adequate treatment for this cancer is lacking. The testing of mutations in SMARCA4 is crucial for an accurate diagnosis and may lead to new treatment options. Harmonization and international collaboration to obtain high-quality data on diagnostic investigations, treatment, and outcome are warranted to be able to develop international treatment guidelines to improve the survival chances of young women with SCCOHT.
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Affiliation(s)
- Francis S. P. L. Wens
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (F.S.P.L.W.); (C.C.C.H.); (M.F.); (J.Z.); (S.E.S.); (R.R.d.K.); (A.F.W.v.d.S.); (L.H.J.L.)
| | - Caroline C. C. Hulsker
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (F.S.P.L.W.); (C.C.C.H.); (M.F.); (J.Z.); (S.E.S.); (R.R.d.K.); (A.F.W.v.d.S.); (L.H.J.L.)
| | - Marta Fiocco
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (F.S.P.L.W.); (C.C.C.H.); (M.F.); (J.Z.); (S.E.S.); (R.R.d.K.); (A.F.W.v.d.S.); (L.H.J.L.)
- Mathematical Institute, Leiden University, 2311 EZ Leiden, The Netherlands
- Biomedical Data Science Department, Section Medical Statistics, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - József Zsiros
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (F.S.P.L.W.); (C.C.C.H.); (M.F.); (J.Z.); (S.E.S.); (R.R.d.K.); (A.F.W.v.d.S.); (L.H.J.L.)
| | - Stephanie E. Smetsers
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (F.S.P.L.W.); (C.C.C.H.); (M.F.); (J.Z.); (S.E.S.); (R.R.d.K.); (A.F.W.v.d.S.); (L.H.J.L.)
| | - Ronald R. de Krijger
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (F.S.P.L.W.); (C.C.C.H.); (M.F.); (J.Z.); (S.E.S.); (R.R.d.K.); (A.F.W.v.d.S.); (L.H.J.L.)
- Department of Pathology, University Medical Center Utrecht, 3584 CG Utrecht, The Netherlands
| | - Alida F. W. van der Steeg
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (F.S.P.L.W.); (C.C.C.H.); (M.F.); (J.Z.); (S.E.S.); (R.R.d.K.); (A.F.W.v.d.S.); (L.H.J.L.)
| | - Ronald P. Zweemer
- Department of Gynecologic Oncology, Division of Imaging and Oncology, University Medical Center Utrecht, 3584 CG Utrecht, The Netherlands; (R.P.Z.); (C.G.G.)
| | - Inge O. Baas
- Department of Medical Oncology, University Medical Center Utrecht, 3584 CG Utrecht, The Netherlands;
| | - Eva Maria Roes
- Department of Gynecologic Oncology, Erasmus Medical Center Cancer Institute, 3015 GD Rotterdam, The Netherlands;
| | - Leendert H. J. Looijenga
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (F.S.P.L.W.); (C.C.C.H.); (M.F.); (J.Z.); (S.E.S.); (R.R.d.K.); (A.F.W.v.d.S.); (L.H.J.L.)
| | - Cornelis G. Gerestein
- Department of Gynecologic Oncology, Division of Imaging and Oncology, University Medical Center Utrecht, 3584 CG Utrecht, The Netherlands; (R.P.Z.); (C.G.G.)
| | - Annelies M. C. Mavinkurve-Groothuis
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (F.S.P.L.W.); (C.C.C.H.); (M.F.); (J.Z.); (S.E.S.); (R.R.d.K.); (A.F.W.v.d.S.); (L.H.J.L.)
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5
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Herold N, Schmolling J, Ernst C, Ataseven B, Blümcke B, Schömig‐Markiefka B, Heikaus S, Göhring U, Engel C, Lampe B, Rhiem K, Harter P, Hauke J, Schmutzler RK, Hahnen E. Pathogenic germline variants in SMARCA4 and further cancer predisposition genes in early onset ovarian cancer. Cancer Med 2023; 12:15256-15260. [PMID: 37345881 PMCID: PMC10417158 DOI: 10.1002/cam4.6214] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 05/19/2023] [Accepted: 05/27/2023] [Indexed: 06/23/2023] Open
Abstract
To assess the role of germline pathogenic variants (PVs) in SMARCA4 and further established ovarian cancer (OC) predisposition genes in early onset OC, we investigated a clinical cohort of 206 unrelated OC index patients with an age at diagnosis of OC ≤40 years using an extended panel of 24 (candidate) cancer predisposition genes. PVs in established OC predisposition genes were most frequent in patients with high grade serous OC (21/62, 33.9%), comparatively rare in patients with epithelial OC other than high grade serous (5/74, 6.8%) or borderline ovarian tumours (2/39, 5.1%) and absent in mucinous OC (0/27). We demonstrate that germline PVs in SMARCA4 unlikely predispose for early onset OC other than SCCOHT.
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Affiliation(s)
- Natalie Herold
- Center for Familial Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), Medical FacultyUniversity of Cologne and University Hospital CologneCologneGermany
| | - Johanna Schmolling
- Center for Familial Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), Medical FacultyUniversity of Cologne and University Hospital CologneCologneGermany
| | - Corinna Ernst
- Center for Familial Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), Medical FacultyUniversity of Cologne and University Hospital CologneCologneGermany
| | - Beyhan Ataseven
- Department of Gynecology & Gynecologic OncologyKliniken Essen‐Mitte (KEM)EssenGermany
- Medical School and University Medical Center East Westphalia‐Lippe, Klinikum Lippe, Academic Department of Gynecology, Gynecologic Oncology and ObstetricsBielefeld UniversityDetmoldGermany
| | - Britta Blümcke
- Center for Familial Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), Medical FacultyUniversity of Cologne and University Hospital CologneCologneGermany
| | | | - Sebastian Heikaus
- Department of PathologyKliniken Essen‐Mitte (KEM) Evang. Huyssens‐Stiftung/Knappschaft GmbHEssenGermany
| | - Uwe‐Jochen Göhring
- Department of Gynecology and ObstetricsJohanniter KrankenhausBonnGermany
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and EpidemiologyUniversity of LeipzigLeipzigGermany
| | - Björn Lampe
- Department of Gynecology and ObstetricsDiakonie KaiserswerthDüsseldorfGermany
| | - Kerstin Rhiem
- Center for Familial Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), Medical FacultyUniversity of Cologne and University Hospital CologneCologneGermany
| | - Philipp Harter
- Department of Gynecology & Gynecologic OncologyKliniken Essen‐Mitte (KEM)EssenGermany
| | - Jan Hauke
- Center for Familial Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), Medical FacultyUniversity of Cologne and University Hospital CologneCologneGermany
| | - Rita K. Schmutzler
- Center for Familial Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), Medical FacultyUniversity of Cologne and University Hospital CologneCologneGermany
| | - Eric Hahnen
- Center for Familial Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), Medical FacultyUniversity of Cologne and University Hospital CologneCologneGermany
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6
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Abstract
Small cell carcinoma of the ovary, hypercalcemic type (SCCOHT) is a highly aggressive malignant tumor affecting predominantly young adults and adolescents with an average age of 23.9 at time of diagnosis. Up to two thirds of patients have paraneoplastic hypercalcemia. The molecular signature of these tumors is SMARCA4 mutations, with somatic and germline pathogenic variants previously described. We report a case of a previously healthy one-year-old girl who was noticed to have mild anemia and an abdominal mass during a well-child visit. Further laboratory testing revealed hypercalcemia. A computerized tomography scan showed a left-sided ovarian mass (9.3 x 7.3 x 7 cm). The resection specimen showed a large ovarian tumor with solid tan-yellow cut surfaces and small foci of necrosis. Microscopically, the tumor was composed of sheets of small, hyperchromatic epithelioid cells with focal rhabdoid large cell morphology. The tumor cells were strongly and diffusely positive for WT1 (N-terminal antibodies) with focal EMA and Pan-keratin positivity. Absent SMARCA4 (BRG1) protein expression by immunohistochemistry ultimately established the diagnosis of small cell carcinoma of the ovary, hypercalcemic type. To our knowledge, this is the youngest patient reported in the literature.
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Affiliation(s)
- Doaa Atwi
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Michael R Quinton
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Ryan M Kiser
- Jimmy Everest Section of Pediatric Hematology/Oncology, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Hanumantha R Pokala
- Jimmy Everest Section of Pediatric Hematology/Oncology, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Laura M Rooms
- Jimmy Everest Section of Pediatric Hematology/Oncology, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Zhongxin Yu
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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7
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Andrianteranagna M, Cyrta J, Masliah-Planchon J, Nemes K, Corsia A, Leruste A, Holdhof D, Kordes U, Orbach D, Corradini N, Entz-Werle N, Pierron G, Castex MP, Brouchet A, Weingertner N, Ranchère D, Fréneaux P, Delattre O, Bush J, Leary A, Frühwald MC, Schüller U, Servant N, Bourdeaut F. SMARCA4-deficient rhabdoid tumours show intermediate molecular features between SMARCB1-deficient rhabdoid tumours and small cell carcinomas of the ovary, hypercalcaemic type. J Pathol 2021; 255:1-15. [PMID: 33999421 DOI: 10.1002/path.5705] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 04/19/2021] [Accepted: 05/12/2021] [Indexed: 11/11/2022]
Abstract
Extracranial rhabdoid tumours (ECRTs) are an aggressive malignancy of infancy and early childhood. The vast majority of cases demonstrate inactivation of SMARCB1 (ECRTSMARCB1 ) on a background of a remarkably stable genome, a low mutational burden, and no other recurrent mutations. Rarely, ECRTs can harbour the alternative inactivation of SMARCA4 (ECRTSMARCA4 ) instead of SMARCB1. However, very few ECRTSMARCA4 cases have been published to date, and a systematic characterization of ECRTSMARCA4 is missing from the literature. In this study, we report the clinical, pathological, and genomic features of additional cases of ECRTSMARCA4 and show that they are comparable to those of ECRTSMARCB1. We also assess whether ECRTSMARCB1 , ECRTSMARCA4 , and small cell carcinomas of the ovary, hypercalcaemic type (SCCOHT) represent distinct or overlapping entities at a molecular level. Using DNA methylation and transcriptomics-based tumour classification approaches, we demonstrate that ECRTSMARCA4 display molecular features intermediate between SCCOHT and ECRTSMARCB1 ; however, ECRTSMARCA4 appear to be more closely related to SCCOHT by DNA methylation. Conversely, both transcriptomics and DNA methylation show a larger gap between SCCOHT and ECRTSMARCB1 , potentially supporting their continuous separate classification. Lastly, we show that ECRTSMARCA4 display concomitant lack of SMARCA4 (BRG1) and SMARCA2 (BRM) expression at the protein level, similar to what is seen in SCCOHT. Overall, these results expand our knowledge on this rare tumour type and explore the similarities and differences among entities from the 'rhabdoid tumour' spectrum. © 2021 The Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
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Affiliation(s)
- Mamy Andrianteranagna
- INSERM, U830, Pediatric Translational Research, PSL Research University, Institut Curie, Paris, France.,INSERM, U900, Paris, France.,MINES ParisTech, PSL Research University, CBIO-Centre for Computational Biology, Paris, France
| | - Joanna Cyrta
- Department of Pathology, Institut Curie, PSL Research University, Paris, France
| | - Julien Masliah-Planchon
- Genetics Unit, Department of Tumor Biology, Institut Curie, PSL Research University, Paris, France
| | - Karolina Nemes
- Paediatrics and Adolescent Medicine, Swabian Children's Cancer Center, University Medical Center Augsburg, Augsburg, Germany
| | - Alice Corsia
- INSERM, U830, Pediatric Translational Research, PSL Research University, Institut Curie, Paris, France
| | - Amaury Leruste
- INSERM, U830, Pediatric Translational Research, PSL Research University, Institut Curie, Paris, France
| | - Dörthe Holdhof
- Department of Pediatric Hematology and Oncology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany.,Research Institute Children's Cancer Center Hamburg, Hamburg, Germany
| | - Uwe Kordes
- Department of Pediatric Hematology and Oncology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Daniel Orbach
- SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), PSL Research University, Institut Curie, Paris, France
| | - Nadège Corradini
- Centre Léon Bérard, Institut d'Hématologie et d'Oncologie pédiatrique, Lyon, France
| | - Natacha Entz-Werle
- Pediatric and Adolescent Oncology, IHOP, Centre Léon Bérard, Lyon, France
| | - Gaëlle Pierron
- Genetics Unit, Department of Tumor Biology, Institut Curie, PSL Research University, Paris, France
| | - Marie-Pierre Castex
- Department of Pediatric and Adolescent Unity Oncology, Toulouse University Hospital, Toulouse, France
| | - Anne Brouchet
- Department of Pathology, Insititut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Noëlle Weingertner
- Department of Pathology, Strasbourg University Hospital, Strasbourg, France
| | | | - Paul Fréneaux
- Department of Pathology, Institut Curie, PSL Research University, Paris, France
| | - Olivier Delattre
- Genetics Unit, Department of Tumor Biology, Institut Curie, PSL Research University, Paris, France
| | - Jonathan Bush
- Division of Anatomical Pathology, British Columbia Children's Hospital and Women's Hospital and Health Center, Vancouver, BC, Canada
| | - Alexandra Leary
- Gynecological Cancer Unit, Department of Medicine, Gustave Roussy, Villejuif, France.,INSERM U981, Gustave Roussy, Villejuif, France
| | - Michael C Frühwald
- Paediatrics and Adolescent Medicine, Swabian Children's Cancer Center, University Medical Center Augsburg, Augsburg, Germany
| | - Ulrich Schüller
- Department of Pediatric Hematology and Oncology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany.,Research Institute Children's Cancer Center Hamburg, Hamburg, Germany.,Institute of Neuropathology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Nicolas Servant
- INSERM, U900, Paris, France.,MINES ParisTech, PSL Research University, CBIO-Centre for Computational Biology, Paris, France.,Institut Curie, PSL Research University, Paris, France
| | - Franck Bourdeaut
- INSERM, U830, Pediatric Translational Research, PSL Research University, Institut Curie, Paris, France.,SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), PSL Research University, Institut Curie, Paris, France
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8
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Karnezis AN, Chen SY, Chow C, Yang W, Hendricks WPD, Ramos P, Briones N, Mes-Masson AM, Bosse T, Gilks CB, Trent JM, Weissman B, Huntsman DG, Wang Y. Re-assigning the histologic identities of COV434 and TOV-112D ovarian cancer cell lines. Gynecol Oncol 2021; 160:568-578. [PMID: 33328126 PMCID: PMC10039450 DOI: 10.1016/j.ygyno.2020.12.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 12/05/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The development of effective cancer treatments depends on the availability of cell lines that faithfully recapitulate the cancer in question. This study definitively re-assigns the histologic identities of two ovarian cancer cell lines, COV434 (originally described as a granulosa cell tumour) and TOV-112D (originally described as grade 3 endometrioid carcinoma), both of which were recently suggested to represent small cell carcinoma of the ovary, hypercalcemic type (SCCOHT), based on their shared gene expression profiles and sensitivity to EZH2 inhibitors. METHODS For COV434 and TOV-112D, we re-reviewed the original pathology slides and obtained clinical follow-up on the patients, when available, and performed immunohistochemistry for SMARCA4, SMARCA2 and additional diagnostic markers on the original formalin-fixed, paraffin-embedded (FFPE) clinical material, when available. For COV434, we further performed whole exome sequencing and validated SMARCA4 mutations by Sanger sequencing. We studied the growth of the cell lines at baseline and upon re-expression of SMARCA4 in vitro for both cell lines and evaluated the serum calcium levels in vivo upon injection into immunodeficient mice for COV434 cells. RESULTS The available morphological, immunohistochemical, genetic, and clinical features indicate COV434 is derived from SCCOHT, and TOV-112D is a dedifferentiated carcinoma. Transplantation of COV434 into mice leads to increased serum calcium level. Re-expression of SMARCA4 in either COV434 and TOV-112D cells suppressed their growth dramatically. CONCLUSIONS COV434 represents a bona fide SCCOHT cell line. TOV-112D is a dedifferentiated ovarian carcinoma cell line.
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MESH Headings
- Animals
- Carcinoma, Ovarian Epithelial/diagnosis
- Carcinoma, Ovarian Epithelial/drug therapy
- Carcinoma, Ovarian Epithelial/genetics
- Carcinoma, Ovarian Epithelial/pathology
- Carcinoma, Small Cell/diagnosis
- Carcinoma, Small Cell/drug therapy
- Carcinoma, Small Cell/genetics
- Carcinoma, Small Cell/pathology
- Cell Dedifferentiation/genetics
- Cell Line, Tumor/drug effects
- Cell Line, Tumor/pathology
- DNA Helicases/analysis
- DNA Helicases/deficiency
- DNA Helicases/genetics
- Enhancer of Zeste Homolog 2 Protein/antagonists & inhibitors
- Female
- Gene Expression Profiling
- Humans
- Mice
- Nuclear Proteins/analysis
- Nuclear Proteins/deficiency
- Nuclear Proteins/genetics
- Ovarian Neoplasms/diagnosis
- Ovarian Neoplasms/drug therapy
- Ovarian Neoplasms/genetics
- Ovarian Neoplasms/pathology
- Transcription Factors/analysis
- Transcription Factors/deficiency
- Transcription Factors/genetics
- Exome Sequencing
- Xenograft Model Antitumor Assays
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Affiliation(s)
- Anthony N Karnezis
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada; Department of Pathology and Laboratory Medicine, University of California, Davis Medical Center, Sacramento, CA, USA
| | - Shary Yuting Chen
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada; Department of Molecular Oncology, British Columbia Cancer Research Institute, Vancouver, BC, Canada
| | - Christine Chow
- Genetic Pathology Evaluation Centre, Vancouver General Hospital and University of British Columbia, Vancouver, BC, Canada
| | - Winnie Yang
- Department of Molecular Oncology, British Columbia Cancer Research Institute, Vancouver, BC, Canada
| | - William P D Hendricks
- Division of Integrated Cancer Genomics, Translational Genomics Research Institute (TGen), Phoenix, AZ, USA
| | - Pilar Ramos
- Division of Integrated Cancer Genomics, Translational Genomics Research Institute (TGen), Phoenix, AZ, USA
| | - Natalia Briones
- Division of Integrated Cancer Genomics, Translational Genomics Research Institute (TGen), Phoenix, AZ, USA
| | - Anne-Marie Mes-Masson
- Centre de recherche du Centre hospitalier de l'Université de Montréal and Institut du cancer de Montréal, Montreal, QC, Canada; Department of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Tjalling Bosse
- Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands
| | - C Blake Gilks
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Jeffrey M Trent
- Division of Integrated Cancer Genomics, Translational Genomics Research Institute (TGen), Phoenix, AZ, USA
| | - Bernard Weissman
- Department of Pathology and Laboratory Medicine, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - David G Huntsman
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada; Department of Molecular Oncology, British Columbia Cancer Research Institute, Vancouver, BC, Canada; Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada.
| | - Yemin Wang
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada; Department of Molecular Oncology, British Columbia Cancer Research Institute, Vancouver, BC, Canada.
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9
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Orlando KA, Douglas AK, Abudu A, Wang Y, Tessier-Cloutier B, Su W, Peters A, Sherman LS, Moore R, Nguyen V, Negri GL, Colborne S, Morin GB, Kommoss F, Lang JD, Hendricks WP, Raupach EA, Pirrotte P, Huntsman DG, Trent JM, Parker JS, Raab JR, Weissman BE. Re-expression of SMARCA4/BRG1 in small cell carcinoma of ovary, hypercalcemic type ( SCCOHT) promotes an epithelial-like gene signature through an AP-1-dependent mechanism. eLife 2020; 9:59073. [PMID: 33355532 PMCID: PMC7813545 DOI: 10.7554/elife.59073] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 12/22/2020] [Indexed: 12/12/2022] Open
Abstract
Small cell carcinoma of the ovary, hypercalcemic type (SCCOHT) is a rare and aggressive form of ovarian cancer. SCCOHT tumors have inactivating mutations in SMARCA4 (BRG1), one of the two mutually exclusive ATPases of the SWI/SNF chromatin remodeling complex. To address the role that BRG1 loss plays in SCCOHT tumorigenesis, we performed integrative multi-omic analyses in SCCOHT cell lines +/- BRG1 reexpression. BRG1 reexpression induced a gene and protein signature similar to an epithelial cell and gained chromatin accessibility sites correlated with other epithelial originating TCGA tumors. Gained chromatin accessibility and BRG1 recruited sites were strongly enriched for transcription-factor-binding motifs of AP-1 family members. Furthermore, AP-1 motifs were enriched at the promoters of highly upregulated epithelial genes. Using a dominant-negative AP-1 cell line, we found that both AP-1 DNA-binding activity and BRG1 reexpression are necessary for the gene and protein expression of epithelial genes. Our study demonstrates that BRG1 reexpression drives an epithelial-like gene and protein signature in SCCOHT cells that depends upon by AP-1 activity.
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Affiliation(s)
- Krystal Ann Orlando
- Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, United States.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, United States
| | - Amber K Douglas
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, United States
| | - Aierken Abudu
- Department of Microbiology and Molecular Genetics, Michigan State University, East Lansing, United States
| | - Yemin Wang
- Department of Pathology and Laboratory Medicine, University of British Columbia and Department of Molecular Oncology, British Columbia Cancer Research Institute, Vancouver, Canada
| | - Basile Tessier-Cloutier
- Department of Pathology and Laboratory Medicine, University of British Columbia and Department of Molecular Oncology, British Columbia Cancer Research Institute, Vancouver, Canada.,Department of Molecular Oncology, British Columbia Cancer Research Institute, Vancouver, Canada
| | - Weiping Su
- Division of Neuroscience, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, United States
| | - Alec Peters
- Division of Neuroscience, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, United States
| | - Larry S Sherman
- Division of Neuroscience, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, United States.,Department Cell, Developmental and Cancer Biology, Oregon Health & Science University, Portland, United States
| | - Rayvon Moore
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, United States
| | - Vinh Nguyen
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, United States.,Curriculum in Toxicology and Environmental Medicine, University of North Carolina at Chapel Hill, Chapel Hill, United States
| | - Gian Luca Negri
- Michael Smith Genome Science Centre, British Columbia Cancer Research Institute, Vancouver, Canada
| | - Shane Colborne
- Michael Smith Genome Science Centre, British Columbia Cancer Research Institute, Vancouver, Canada
| | - Gregg B Morin
- Michael Smith Genome Science Centre, British Columbia Cancer Research Institute, Vancouver, Canada.,Department of Medical Genetics, University of British Columbia, Vancouver, Canada
| | | | - Jessica D Lang
- Division of Integrated Cancer Genomics, Translational Genomics Research Institute (TGen), Phoenix, United States
| | - William Pd Hendricks
- Division of Integrated Cancer Genomics, Translational Genomics Research Institute (TGen), Phoenix, United States
| | - Elizabeth A Raupach
- Division of Integrated Cancer Genomics, Translational Genomics Research Institute (TGen), Phoenix, United States
| | - Patrick Pirrotte
- Collaborative Center for Translational Mass Spectrometry, Translational Genomics Research Institute (TGen), Phoenix, United States
| | - David G Huntsman
- Department of Pathology and Laboratory Medicine, University of British Columbia and Department of Molecular Oncology, British Columbia Cancer Research Institute, Vancouver, Canada.,Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada
| | - Jeffrey M Trent
- Division of Integrated Cancer Genomics, Translational Genomics Research Institute (TGen), Phoenix, United States
| | - Joel S Parker
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, United States.,Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, United States
| | - Jesse R Raab
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, United States.,Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, United States
| | - Bernard E Weissman
- Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, United States.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, United States
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10
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Pressey JG, Dandoy CE, Pater LE, Sroga Rios J, Sisson R, Dasgupta R, Szabo S. Small cell carcinoma of the ovary hypercalcemic type ( SCCOHT): Comprehensive management of a newly diagnosed young adult. Gynecol Oncol 2020; 158:538-546. [PMID: 32654763 DOI: 10.1016/j.ygyno.2020.06.160] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 11/18/2022]
Abstract
SCCOHT is an aggressive malignancy linked to alterations of SMARCA4. We describe the diagnosis and therapy of a 32 year old who received multi-agent chemotherapy and underwent a second look operation with HIPEC followed by high-dose chemotherapy with stem cell transplant. Supportive care, oncofertility, and genetic counseling are described.
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Affiliation(s)
- Joseph G Pressey
- Department of Pediatrics, University of Cincinnati College of Medicine, United States of America; Division of Oncology, Cincinnati Children's Hospital Medical Center, United States of America.
| | - Christopher E Dandoy
- Department of Pediatrics, University of Cincinnati College of Medicine, United States of America; Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, United States of America
| | - Luke E Pater
- Department of Radiation Oncology, University of Cincinnati College of Medicine, United States of America
| | - Julie Sroga Rios
- Department of Obstetrics & Gynecology, University of Cincinnati College of Medicine, United States of America
| | - Rebecca Sisson
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, United States of America
| | - Roshni Dasgupta
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, United States of America
| | - Sara Szabo
- Department of Pathology, University of Cincinnati College of Medicine, United States of America; Division of Pathology, Cincinnati Children's Hospital Medical Center, United States of America
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11
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Abstract
The SWI/SNF (mating type SWItch/Sucrose NonFermentable) chromatin remodeling complexes interact with histones and transcription factors to modulate chromatin structure and control gene expression. These evolutionarily conserved multisubunit protein complexes are involved in regulating many biological functions, such as differentiation and cell proliferation. Genomic studies have revealed frequent mutations of genes encoding multiple subunits of the SWI/SNF complexes in a wide spectrum of cancer types, including gynecologic cancers. These SWI/SNF mutations occur at different stages of tumor development and are restricted to unique histologic types of gynecologic cancers. Thus, SWI/SNF mutations have to function in the appropriate tissue and cell context to promote gynecologic cancer initiation and progression. In this review, we summarize the current knowledge of SWI/SNF mutations in the development of gynecologic cancers to provide insights into both molecular pathogenesis and possible treatment implications for these diseases.
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Affiliation(s)
- Yemin Wang
- Department of Molecular Oncology, British Columbia Cancer Research Centre, Vancouver, British Columbia V5Z 1L3, Canada; , , .,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V6T 2B5, Canada; .,Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, British Columbia V6Z 2K8, Canada
| | - Lien Hoang
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V6T 2B5, Canada;
| | - Jennifer X Ji
- Department of Molecular Oncology, British Columbia Cancer Research Centre, Vancouver, British Columbia V5Z 1L3, Canada; , , .,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V6T 2B5, Canada;
| | - David G Huntsman
- Department of Molecular Oncology, British Columbia Cancer Research Centre, Vancouver, British Columbia V5Z 1L3, Canada; , , .,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V6T 2B5, Canada; .,Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, British Columbia V6Z 2K8, Canada
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12
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Phoolcharoen N, Woodard T, James D, Patel D, Roder S, Holman D, Salcedo M, Frumovitz M, Gershenson D, Schmeler K. Successful pregnancy following chemotherapy in a survivor of small cell carcinoma of the ovary, hypercalcemic type ( SCCOHT): A case report and review of literature. Gynecol Oncol Rep 2020; 32:100576. [PMID: 32405521 DOI: 10.1016/j.gore.2020.100576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 04/18/2020] [Accepted: 04/22/2020] [Indexed: 11/20/2022] Open
Abstract
Small cell carcinoma of the ovary hypercalcemic type (SCCOHT) is a rare neoplasm that mostly affects young women. The chances of future fertility in women are limited due to the aggressive nature of SCCOHT and need for adjuvant therapy. We report the case of a 26y woman with stage IA SCCOHT who had a successful pregnancy following surgery and chemotherapy.
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13
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Connor YD, Miao D, Lin DI, Hayne C, Howitt BE, Dalrymple JL, DeLeonardis KR, Hacker MR, Esselen KM, Shea M. Germline mutations of SMARCA4 in small cell carcinoma of the ovary, hypercalcemic type and in SMARCA4-deficient undifferentiated uterine sarcoma: Clinical features of a single family and comparison of large cohorts. Gynecol Oncol 2020; 157:106-114. [PMID: 31954538 DOI: 10.1016/j.ygyno.2019.10.031] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 10/23/2019] [Accepted: 10/28/2019] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Small cell carcinoma of the ovary, hypercalcemic type (SCCOHT) and SMARCA4-deficient undifferentiated uterine sarcoma (SMARCA4-DUS) are rare and aggressive tumors, primarily affecting pre- and perimenopausal women. Inactivating SMARCA4 mutations are thought to be the driving molecular events in the majority of these tumors. Here, we report the clinical course of a family with germline SMARCA4 mutation and compare large cohorts of these rare tumor types. METHODS We extracted clinico-pathological medical record data for the family with germline SMARCA4 mutation. Clinico-genomic data from SCCOHT and SMARCA4-DUS cohorts were retrospectively extracted from the archives of a large CLIA-certified reference molecular laboratory. RESULTS We identified a single family with an inherited germline SMARCA4 mutation, in which two different family members developed either SCCOHT or SMARCA4-DUS, both of whom died within one year of diagnosis, despite aggressive surgical, chemotherapy and immunotherapy treatment. Retrospective comparative analysis of large SCCOHT (n = 48) and SMARCA4-DUS (n = 17) cohorts revealed that SCCOHT patients were younger (median age: 28.5 vs. 49.0) and more likely to have germline SMARCA4 alterations (37.5% vs. 11.8%) than SMARCA4-DUS patients. CONCLUSIONS Growing understanding of the role SMARCA4 plays in the pathogenesis of these rare cancers may inform recommended genetic testing and counseling in families with these tumor types.
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Affiliation(s)
- Yamicia D Connor
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Diana Miao
- Department of Gynecology and Obstetrics, Johns Hopkins Medicine, Baltimore, MD, USA
| | | | - Cynthia Hayne
- Harvard Medical School, Boston, MA, USA; Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Brooke E Howitt
- Department of Pathology, Stanford University, Stanford, CA, USA
| | - John L Dalrymple
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Kimberly R DeLeonardis
- Department of Internal Medicine, Division of Medical Oncology, Beth Israel Deaconess Medical Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Michele R Hacker
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Katharine M Esselen
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Meghan Shea
- Department of Internal Medicine, Division of Medical Oncology, Beth Israel Deaconess Medical Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
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14
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Li R, Zhou T, Chen S, Li N, Cai Z, Ling Y, Feng Z. Small cell carcinoma of the ovary, hypercalcemic type ( SCCOHT): a challenge for clinicopathological diagnosis. Int J Clin Exp Pathol 2019; 12:2166-2172. [PMID: 31934039 PMCID: PMC6949608] [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] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 04/25/2019] [Indexed: 06/10/2023]
Abstract
Small cell carcinoma of the ovary, hypercalcemic type (SCCOHT) is an extremely aggressive ovarian tumor, with a poor prognosis and high mortality for young women. This paper aims to inform clinical physicians of new clinical improvements and further understanding of SCCOHT. Two cases diagnosed with SCCOHT from our medical database were reconfirmed and immunohistochemically stained with vimentin, CK, EMA, S-100, ER, PR, and SMARCA4. Diffuse small, round cells with scant cytoplasms, small nucleoli, hyperchromatic nuclei, and active nuclear divisions were detected in the microscopy. The immunohistochemical markers indicated minor positive but notably were SMARCA4 negative, which led to the final diagnosis. SCCOHT is a rare and lethal ovarian tumor in young women. The loss of SMARCA4 or the presence of SMARCA2 is a specific marker for the disease. Susceptibility to CDK4/6 inhibitors associated with downregulation of SMARCA4 targeted cyclin D1 may be a probable therapeutical mechanism for the disease.
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Affiliation(s)
- Ran Li
- Department of Pathology, The First Affiliated Hospital of Bengbu Medical College, Bengbu Medical CollegeBengbu, Anhui, P. R. China
| | - Ting Zhou
- Department of Pathology, The First Affiliated Hospital of Bengbu Medical College, Bengbu Medical CollegeBengbu, Anhui, P. R. China
| | - Shaohua Chen
- Department of Pathology, The First Affiliated Hospital of Bengbu Medical College, Bengbu Medical CollegeBengbu, Anhui, P. R. China
| | - Nan Li
- Department of Pathology, The First Affiliated Hospital of Bengbu Medical College, Bengbu Medical CollegeBengbu, Anhui, P. R. China
| | - Zhaogen Cai
- Department of Pathology, The First Affiliated Hospital of Bengbu Medical College, Bengbu Medical CollegeBengbu, Anhui, P. R. China
| | - Yunzhi Ling
- Department of Anesthesiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu Medical CollegeBengbu, Anhui, P. R. China
| | - Zhenzhong Feng
- Department of Pathology, The First Affiliated Hospital of Bengbu Medical College, Bengbu Medical CollegeBengbu, Anhui, P. R. China
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15
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Bourgoin R, Cornelis F, Masliah-Planchon J, Genestie C, Laé M. [ SCCOHT/ovarian rhabdoid tumor: A case report]. Ann Pathol 2019; 39:357-63. [PMID: 30928254 DOI: 10.1016/j.annpat.2019.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 02/04/2019] [Accepted: 02/10/2019] [Indexed: 11/23/2022]
Abstract
We report the case of a 22-year-old patient with acute abdominopelvic pain. The diagnosis of hypercalcemic small cell carcinoma (SCCOHT)/ovarian rhabdoid tumor has been made. Small cell carcinoma of hypercalcemic type is a rare and aggressive tumor that occurs in young women. The diagnosis of this tumor and the management must be rapid in view of its aggressiveness. Through this observation, we specify the epidemiological, diagnostic, molecular aspects and discussions about its name.
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16
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Fahiminiya S, Sabbaghian N, Albrecht S, Nadaf J, Callegaro-Filho D, Foulkes WD. Ovarian small cell carcinoma in one of a pair of monozygous twins. Fam Cancer 2019; 18:161-3. [PMID: 30284660 DOI: 10.1007/s10689-018-0108-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
One of a pair of monozygous twins was diagnosed and died of small cell carcinoma of the ovary of hypercalcemic type (SCCOHT) at the age of 30 years. Her sister remained unaffected and was very concerned about her risk for developing SCCOHT. By performing comprehensive molecular analysis using whole exome sequencing (WES) approach, we showed that the deceased twin's tumour has bi-allelic somatic genetic defects (a pathogenic frameshift deletion in SMARCA4 and LOH on chr19p). Results of WES of constitutional DNA from her unaffected sister were confirmatory. Based on our findings, we concluded that the living twin is not at risk for SCCOHT and does not need to consider preventive oophorectomy.
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17
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Qin Q, Ajewole VB, Sheu TG, Donohue R, Singh M. Successful treatment of a stage IIIC small-cell carcinoma of the ovary hypercalcemic subtype using multi-modality therapeutic approach. Ecancermedicalscience 2018; 12:832. [PMID: 29910829 PMCID: PMC5985749 DOI: 10.3332/ecancer.2018.832] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Indexed: 12/22/2022] Open
Abstract
Small-cell carcinoma of the ovary, hypercalcemic type (SCCOHT) is a rare but highly undifferentiated, aggressive malignancy that primarily affects young women. Due to its early onset, unclear familial history and vague presenting symptoms, most SCCOHT patients present late with advanced disease. The prognosis is extremely poor, with <10% disease-free survival for advanced stages. Although several therapeutic regimens have been proposed, to date there is no consensus on the optimal strategy. Here, we describe a successful case of advanced-stage SCCOHT of the left ovary treated with cytoreductive surgery, semi-intense chemotherapy, high-dose consolidative chemotherapy, autologous hematopoietic stem cell transplantation and pelvic radiation with long-term survival. Given the almost universal mortality of advanced SCCOHT in long-term follow-up, we believe this case highlights the importance of prompt diagnosis when a young patient presents with abdominal swelling and hypercalcemia as well as early, aggressive, combined modality treatment. This case is also especially remarkable given the patient underwent fertility preservation surgery, which is not recommended by most of the current literature. However, as therapies improve and more young patients may survive SCCOHT, the question of fertility will increase in relevance. We believe the pros and cons of conservation should be discussed in detail with the patient.
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Affiliation(s)
- Qian Qin
- Department of Internal Medicine, Houston Methodist Hospital, Houston, TX 77030, USA
| | - Veronica B Ajewole
- Houston Methodist Cancer Centre, Houston Methodist Hospital, Houston, TX 77030, USA.,Department of Pharmacy Practice, Texas Southern University College of Pharmacy and Health Sciences, Houston, TX 77004, USA
| | - Tiffany G Sheu
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX 77030, USA
| | - Rachel Donohue
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX 77030, USA
| | - Monisha Singh
- Houston Methodist Cancer Centre, Houston Methodist Hospital, Houston, TX 77030, USA
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18
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Witkowski L, Donini N, Byler-Dann R, Knost JA, Albrecht S, Berchuck A, McCluggage WG, Hasselblatt M, Foulkes WD. The hereditary nature of small cell carcinoma of the ovary, hypercalcemic type: two new familial cases. Fam Cancer 2018; 16:395-399. [PMID: 27866340 PMCID: PMC5487815 DOI: 10.1007/s10689-016-9957-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Small cell carcinoma of the ovary, hypercalcemic type, (SCCOHT) is the most common undifferentiated ovarian cancer in women aged under 40 years. SCCOHT is a monogenic disease, characterized by germline and somatic SMARCA4 mutations. Recent studies have stressed its morphological and clinical similarity to malignant rhabdoid tumours, which are usually caused by mutations in the related gene, SMARCB1. While familial tumours are rare, the incidence of germline mutations is relatively high, with up to 43% of SCCOHTs and 35% of rhabdoid tumours caused by germline mutations in SMARCA4 and SMARCB1, respectively. We report two new familial cases of SCCOHT. Affected members in both families and the associated tumours were found to carry SMARCA4 germline and somatic mutations, respectively, leading to loss of SMARCA4 protein expression in the tumours. Despite the rarity of familial SCCOHT, the high incidence of germline mutations is important to note, as without a family history of the disease, the hereditary nature of SCCOHT may be missed, especially if the mutation was inherited from the father or acquired de novo. The similarity between SCCOHT and rhabdoid tumours should be recognized, as infant carriers of SMARCA4 mutations may be at risk for these tumours in addition to SCCOHT.
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Affiliation(s)
- Leora Witkowski
- Department of Human Genetics, McGill University, Montreal, QC, Canada.,Lady Davis Institute and Segal Cancer Center, Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC, H3T 1E2, Canada
| | - Nancy Donini
- College of Medicine at Peoria, University of Illinois, Peoria, IL, USA
| | | | | | - Steffen Albrecht
- Department of Pathology, McGill University, Montreal, QC, Canada
| | | | - W Glenn McCluggage
- Department of Pathology, Belfast Health and Social Care Trust, Belfast, UK
| | - Martin Hasselblatt
- Institute of Neuropathology, University Hospital Münster, Münster, Germany
| | - William D Foulkes
- Department of Human Genetics, McGill University, Montreal, QC, Canada. .,Lady Davis Institute and Segal Cancer Center, Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC, H3T 1E2, Canada. .,Department of Medical Genetics and Cancer Research Program, Research Institute, McGill University Health Centre, Montreal, QC, Canada.
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19
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Wang Y, Chen SY, Karnezis AN, Colborne S, Santos ND, Lang JD, Hendricks WP, Orlando KA, Yap D, Kommoss F, Bally MB, Morin GB, Trent JM, Weissman BE, Huntsman DG. The histone methyltransferase EZH2 is a therapeutic target in small cell carcinoma of the ovary, hypercalcaemic type. J Pathol 2017; 242:371-383. [PMID: 28444909 DOI: 10.1002/path.4912] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 03/31/2017] [Accepted: 04/10/2017] [Indexed: 12/31/2022]
Abstract
Small cell carcinoma of the ovary, hypercalcaemic type (SCCOHT) is a rare but aggressive and untreatable malignancy affecting young women. We and others recently discovered that SMARCA4, a gene encoding the ATPase of the SWI/SNF chromatin-remodelling complex, is the only gene recurrently mutated in the majority of SCCOHT. The low somatic complexity of SCCOHT genomes and the prominent role of the SWI/SNF chromatin-remodelling complex in transcriptional control of genes suggest that SCCOHT cells may rely on epigenetic rewiring for oncogenic transformation. Herein, we report that approximately 80% (19/24) of SCCOHT tumour samples have strong expression of the histone methyltransferase EZH2 by immunohistochemistry, with the rest expressing variable amounts of EZH2. Re-expression of SMARCA4 suppressed the expression of EZH2 in SCCOHT cells. In comparison to other ovarian cell lines, SCCOHT cells displayed hypersensitivity to EZH2 shRNAs and two selective EZH2 inhibitors, GSK126 and EPZ-6438. EZH2 inhibitors induced cell cycle arrest, apoptosis, and cell differentiation in SCCOHT cells, along with the induction of genes involved in cell cycle regulation, apoptosis, and neuron-like differentiation. EZH2 inhibitors suppressed tumour growth and improved the survival of mice bearing SCCOHT xenografts. Therefore, our data suggest that loss of SMARCA4 creates a dependency on the catalytic activity of EZH2 in SCCOHT cells and that pharmacological inhibition of EZH2 is a promising therapeutic strategy for treating this disease. Copyright © 2017 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
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Affiliation(s)
- Yemin Wang
- Department of Pathology and Laboratory Medicine, University of British Columbia and Department of Molecular Oncology, British Columbia Cancer Research Centre, Vancouver, BC, Canada
| | - Shary Yuting Chen
- Department of Pathology and Laboratory Medicine, University of British Columbia and Department of Molecular Oncology, British Columbia Cancer Research Centre, Vancouver, BC, Canada
| | - Anthony N Karnezis
- Department of Pathology and Laboratory Medicine, University of British Columbia and Department of Molecular Oncology, British Columbia Cancer Research Centre, Vancouver, BC, Canada
| | - Shane Colborne
- Michael Smith Genome Science Centre, British Columbia Cancer Agency, Vancouver, BC, Canada
| | - Nancy Dos Santos
- Department of Experimental Therapeutics, British Columbia Cancer Research Centre, Vancouver, BC, Canada
| | - Jessica D Lang
- Division of Integrated Cancer Genomics, Translational Genomics Research Institute (TGen), Phoenix, AZ, USA
| | - William Pd Hendricks
- Division of Integrated Cancer Genomics, Translational Genomics Research Institute (TGen), Phoenix, AZ, USA
| | - Krystal A Orlando
- Department of Pathology and Laboratory Medicine and Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Damian Yap
- Department of Pathology and Laboratory Medicine, University of British Columbia and Department of Molecular Oncology, British Columbia Cancer Research Centre, Vancouver, BC, Canada
| | - Friedrich Kommoss
- Department of Pathology and Laboratory Medicine, University of British Columbia and Department of Molecular Oncology, British Columbia Cancer Research Centre, Vancouver, BC, Canada
| | - Marcel B Bally
- Department of Experimental Therapeutics, British Columbia Cancer Research Centre, Vancouver, BC, Canada
| | - Gregg B Morin
- Department of Experimental Therapeutics, British Columbia Cancer Research Centre, Vancouver, BC, Canada.,Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada
| | - Jeffrey M Trent
- Division of Integrated Cancer Genomics, Translational Genomics Research Institute (TGen), Phoenix, AZ, USA
| | - Bernard E Weissman
- Department of Pathology and Laboratory Medicine and Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - David G Huntsman
- Department of Pathology and Laboratory Medicine, University of British Columbia and Department of Molecular Oncology, British Columbia Cancer Research Centre, Vancouver, BC, Canada.,Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada
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20
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Ghazi A, Ayaz A, Hamid T, Farooq MU, Islam N. Small cell carcinoma of the ovary hypercalcemic type ( SCCOHT): A rare case after in vitro fertilization (IVF). Pak J Med Sci 2017; 33:241-244. [PMID: 28367208 PMCID: PMC5368318 DOI: 10.12669/pjms.331.11634] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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] [Indexed: 11/15/2022] Open
Abstract
Small cell carcinoma of the ovary, hypercalcemic type (SCCOHT) is a very rare and lethal tumor, mostly affecting young women, with aggressive clinical course. It has a worse prognosis in younger women and most of them died within two years of diagnosis. We are reporting a unique case of SCCOHT in a 35 years old, nulliparous lady with primary infertility in which symptomatic hypercalcemia was a presenting feature of her cancer. She was completely healthy before third cycle of IVF. Within two months of her third IVF cycle, she developed SCCOHT with a very rapid and aggressive course of disease and fatal outcome. Patient died within one month of her first symptom presentation (3 months after IVF cycle).
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Affiliation(s)
- Ahmed Ghazi
- Ahmed Ghazi, MBBS, Saudi board. Department of Gyne Oncology, King Abdullah Medical City (KAMC-HC), Makkah, Saudi Arabia
| | - Aqueela Ayaz
- Aqueela Ayaz, MBBS, FCPS. Department of Gyne Oncology, King Abdullah Medical City (KAMC-HC), Makkah, Saudi Arabia
| | - Tahira Hamid
- Tahira Hamid, MBBS, FCPS. Department of Laboratory & Blook Bank, King Abdullah Medical City (KAMC-HC), Makkah, Saudi Arabia
| | - Mian Usman Farooq
- Mian Usman Farooq, MBBS, MBA, MSc. Department of Strategic Planning and Institutional Advancement, King Abdullah Medical City (KAMC-HC), Makkah, Saudi Arabia
| | - Nikita Islam
- Nikita Islam, MBBS, MD, MRCOG. Department of Gyne Oncology, King Abdullah Medical City (KAMC-HC), Makkah, Saudi Arabia
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21
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Fahiminiya S, Witkowski L, Nadaf J, Carrot-Zhang J, Goudie C, Hasselblatt M, Johann P, Kool M, Lee RS, Gayden T, Roberts CWM, Biegel JA, Jabado N, Majewski J, Foulkes WD. Molecular analyses reveal close similarities between small cell carcinoma of the ovary, hypercalcemic type and atypical teratoid/rhabdoid tumor. Oncotarget 2016; 7:1732-40. [PMID: 26646792 PMCID: PMC4811493 DOI: 10.18632/oncotarget.6459] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [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: 09/09/2015] [Accepted: 11/16/2015] [Indexed: 01/04/2023] Open
Abstract
Small cell carcinoma of the ovary, hypercalcemic type (SCCOHT) is the most common undifferentiated ovarian malignancy diagnosed in women under age 40. We and others recently determined that germline and/or somatic deleterious mutations in SMARCA4 characterize SCCOHT. Alterations in this gene, or the related SWI/SNF chromatin remodeling gene SMARCB1, have been previously reported in atypical teratoid/rhabdoid tumors (ATRTs) and malignant rhabdoid tumors (MRTs). To further describe the somatic landscape of SCCOHT, we performed whole exome sequencing on 14 tumors and their matched normal tissues and compared their genomic alterations with those in ATRT and ovarian high grade serous carcinoma (HGSC). We confirmed that SMARCA4 is the only recurrently mutated gene in SCCOHT, and show that recurrent allelic imbalance is observed exclusively on chromosome 19p, where SMARCA4 resides. By comparing genomic alterations between SCCOHT, ATRT and HGSC, we demonstrate that SCCOHTs, like ATRTs, have a remarkably simple genome and harbor significantly fewer somatic protein-coding mutations and chromosomal alterations than HGSC. Furthermore, a comparison of global DNA methylation profiles of 45 SCCOHTs, 65 ATRTs, and 92 HGSCs demonstrates a strong epigenetic correlation between SCCOHT and ATRT. Our results further confirm that the genomic and epigenomic signatures of SCCOHT are more similar to those of ATRT than HGSC, supporting our previous hypothesis that SCCOHT is a rhabdoid tumor and should be renamed MRT of the ovary. Furthermore, we conclude that SMARCA4 inactivation is the main cause of SCCOHT, and that new distinct therapeutic approaches should be developed to specifically target this devastating tumor.
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Affiliation(s)
- Somayyeh Fahiminiya
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada.,McGill University and Génome Québec Innovation Centre, Montreal, Quebec, Canada
| | - Leora Witkowski
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada
| | - Javad Nadaf
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada.,McGill University and Génome Québec Innovation Centre, Montreal, Quebec, Canada
| | - Jian Carrot-Zhang
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada.,McGill University and Génome Québec Innovation Centre, Montreal, Quebec, Canada
| | - Catherine Goudie
- Department of Pediatrics, McGill University, Montreal, Quebec, Canada
| | - Martin Hasselblatt
- Institute of Neuropathology, University Hospital Münster, Münster, Germany
| | - Pascal Johann
- Pediatric Hematology and Oncology, University Hospital Heidelberg, Heidelberg, Germany
| | - Marcel Kool
- Division of Pediatric Neuro-Oncology, German Cancer Research Center DKFZ, Heidelberg, Germany.,German Cancer Consortium (DKTK), Core Center Heidelberg, Heidelberg, Germany
| | - Ryan S Lee
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Tenzin Gayden
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada.,Department of Pediatrics, McGill University, Montreal, Quebec, Canada
| | - Charles W M Roberts
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Current affiliation: Comprehensive Cancer Center and Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Jaclyn A Biegel
- Department of Pediatrics, Keck School of Medicine of USC, Los Angeles, California, USA
| | - Nada Jabado
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada.,Department of Pediatrics, McGill University, Montreal, Quebec, Canada
| | - Jacek Majewski
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada.,McGill University and Génome Québec Innovation Centre, Montreal, Quebec, Canada
| | - William D Foulkes
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada.,Department of Medical Genetics, Lady Davis Institute and Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.,Department of Medical Genetics, Research Institute, McGill University Health Centre, Montreal, Quebec, Canada
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22
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Otte A, Rauprich F, von der Ohe J, Yang Y, Kommoss F, Feuerhake F, Hillemanns P, Hass R. c-Met inhibitors attenuate tumor growth of small cell hypercalcemic ovarian carcinoma ( SCCOHT) populations. Oncotarget 2016; 6:31640-58. [PMID: 26436697 PMCID: PMC4741630 DOI: 10.18632/oncotarget.5151] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 09/18/2015] [Indexed: 01/01/2023] Open
Abstract
A cellular model (SCCOHT-1) of the aggressive small cell hypercalcemic ovarian carcinoma demonstrated constitutive chemokine and growth factor production including HGF. A simultaneous presence of c-Met in 41% SCCOHT-1 cells suggested an autocrine growth mechanism. Expression of c-Met was also observed at low levels in the corresponding BIN-67 cell line (6.5%) and at high levels in ovarian adenocarcinoma cells (NIH:OVCAR-3 (84.4%) and SK-OV-3 (99.3%)). Immunohistochemistry of c-Met expression in SCCOHT tumors revealed a heterogeneous distribution between undetectable levels and 80%. Further characterization of SCCOHT-1 and BIN-67 cells by cell surface markers including CD90 and EpCAM demonstrated similar patterns with differences to the ovarian adenocarcinoma cells. HGF stimulation of SCCOHT-1 cells was associated with c-Met phosphorylation at Tyr1349 and downstream Thr202/Tyr204 phosphorylation of p44/42 MAP kinase. This HGF-induced signaling cascade was abolished by the c-Met inhibitor foretinib. Cell cycle analysis after foretinib treatment demonstrated enhanced G2 accumulation and increasing apoptosis within 72 h. Moreover, the IC50 of foretinib revealed 12.4 nM in SCCOHT-1 cells compared to 411 nM and 481 nM in NIH:OVCAR-3 and SK-OV-3 cells, respectively, suggesting potential therapeutic effects. Indeed, SCCOHT-1 and BIN-67 tumor xenografts in NODscid mice exhibited an approximately 10-fold and 5-fold reduced tumor size following systemic application of foretinib, respectively. Furthermore, foretinib-treated tumors revealed a significantly reduced vascularization and little if any c-Met-mediated signal transduction. Similar findings of reduced proliferative capacity and declined tumor size were observed after siRNA-mediated c-Met knock-down in SCCOHT-1 cells demonstrating that in vivo inhibition of these pathways contributed to an attenuation of SCCOHT tumor growth.
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Affiliation(s)
- Anna Otte
- Biochemistry and Tumor Biology Laboratory, Department of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany
| | - Finn Rauprich
- Biochemistry and Tumor Biology Laboratory, Department of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany
| | - Juliane von der Ohe
- Biochemistry and Tumor Biology Laboratory, Department of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany
| | - Yuanyuan Yang
- Biochemistry and Tumor Biology Laboratory, Department of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany
| | - Friedrich Kommoss
- Synlab MVZ Pathologie Mannheim GmbH, Referral Center for Gynecopathology, Mannheim, Germany
| | | | - Peter Hillemanns
- Biochemistry and Tumor Biology Laboratory, Department of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany
| | - Ralf Hass
- Biochemistry and Tumor Biology Laboratory, Department of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany
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23
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Witkowski L, Goudie C, Ramos P, Boshari T, Brunet JS, Karnezis AN, Longy M, Knost JA, Saloustros E, McCluggage WG, Stewart CJR, Hendricks WPD, Cunliffe H, Huntsman DG, Pautier P, Levine DA, Trent JM, Berchuck A, Hasselblatt M, Foulkes WD. The influence of clinical and genetic factors on patient outcome in small cell carcinoma of the ovary, hypercalcemic type. Gynecol Oncol 2016; 141:454-460. [PMID: 26975901 DOI: 10.1016/j.ygyno.2016.03.013] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Revised: 03/09/2016] [Accepted: 03/10/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Small cell carcinoma of the ovary, hypercalcemic type (SCCOHT) is an aggressive tumor, with long term survival at ~30% in early stage disease. SCCOHT is caused by germline and somatic SMARCA4 mutations, but the effect of the mutation type on patients remains unknown. Furthermore, the rarity of SCCOHT has resulted in varied treatment, with no standardized protocols. We analyzed 293 cases to determine the effect of treatment modalities and SMARCA4 mutations on patient diagnosis and outcome. METHODS In 293 SCCOHT patients we collected information on age and stage at diagnosis, treatment modality (surgery, chemotherapy, radiotherapy, and/or high-dose chemotherapy with autologous stem cell rescue (HDC-aSCR)), SMARCA4 mutation origin (germline/somatic), and overall survival. Cox analysis and log-rank tests were performed on 257 cases with available survival data. RESULTS The strongest prognostic factors were stage at diagnosis (p=2.72e-15) and treatment modality (p=3.87e-13). For FIGO stages II-IV, 5-year survival was 71% for patients who received HDC-aSCR, compared to 25% in patients who received conventional chemotherapy alone following surgery (p=0.002). Patients aged ≥40 had a worse outcome than younger patients (p=0.04). Twenty-six of 60 tested patients carried a germline SMARCA4 mutation, including all patients diagnosed <15years; carriers presented at a younger age than non-carriers (p=0.02). CONCLUSIONS Stage at diagnosis is the most significant prognostic factor in SCCOHT and consolidation with HDC-aSCR may provide the best opportunity for long-term survival. The large fraction of SMARCA4 germline mutations carriers warrants genetic counseling for all patients.
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Affiliation(s)
- Leora Witkowski
- Department of Human Genetics, McGill University, Montreal, QC, Canada
| | - Catherine Goudie
- Department of Pediatrics, McGill University, Montreal, QC, Canada
| | - Pilar Ramos
- Integrated Cancer Genomics Division, Translational Genomics Research Institute, Phoenix, AZ, USA
| | - Talia Boshari
- Lady Davis Institute and Segal Cancer Center, Jewish General Hospital, Montreal, QC, Canada
| | | | | | - Michel Longy
- Cancer Genetics Unit & INSERM U916, Institut Bergonié, Université de Bordeaux, Bordeaux, France
| | | | - Emmanouil Saloustros
- Hereditary Cancer Clinic, Department of Medical Oncology, University Hospital of Heraklion, Heraklion, Greece
| | - W Glenn McCluggage
- Department of Pathology, Belfast Health and Social Care Trust, Belfast, United Kingdom
| | - Colin J R Stewart
- Department of Histopathology, King Edward Memorial Hospital, Perth, Australia
| | - William P D Hendricks
- Integrated Cancer Genomics Division, Translational Genomics Research Institute, Phoenix, AZ, USA
| | - Heather Cunliffe
- Department of Pathology, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | | | - Patricia Pautier
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - Douglas A Levine
- Department of Surgery, Memorial Sloan Kettering Cancer Center, NY, New York, USA
| | - Jeffrey M Trent
- Integrated Cancer Genomics Division, Translational Genomics Research Institute, Phoenix, AZ, USA
| | | | - Martin Hasselblatt
- Institute of Neuropathology, University Hospital Münster, Münster, Germany
| | - William D Foulkes
- Department of Human Genetics, McGill University, Montreal, QC, Canada; Lady Davis Institute and Segal Cancer Center, Jewish General Hospital, Montreal, QC, Canada; Department of Medical Genetics and Cancer Research Program, Research Institute, McGill University Health Centre, Montreal, QC, Canada.
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24
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Bailey S, Murray MJ, Witkowski L, Hook E, Hasselblatt M, Crawford R, Foulkes WD, Tischkowitz M, Nicholson JC. Biallelic somatic SMARCA4 mutations in small cell carcinoma of the ovary, hypercalcemic type ( SCCOHT). Pediatr Blood Cancer 2015; 62:728-30. [PMID: 25307865 DOI: 10.1002/pbc.25279] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 08/25/2014] [Indexed: 01/15/2023]
Abstract
Small cell carcinoma of the ovary, hypercalcemic type (SCCOHT) is a rare, aggressive tumor that primarily affects young women. SCCOHT has recently been identified as a monogenic disorder caused by germline and/or somatic SMARCA4 mutations. We describe a 15-year-old Caucasian female with a SCCOHT harboring a previously unreported somatic mutation in the SMARCA4 gene (c.1757delA; p.K586.fs) with loss of heterozygosity. No germline mutation was identified. Subsequent immunohistochemical staining confirmed loss of SMARCA4 protein. These molecular findings will aid with SCCOHT diagnosis through immunohistochemical staining for SMARCA4 and in the future may have implications for the management of this disease.
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Affiliation(s)
- Shivani Bailey
- Department of Paediatric Haematology and Oncology, Addenbrooke's Hospital, Cambridge, UK
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