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Pan R, Zhao J, Yao J, Gao Y, Liao L. Selenomethionine Suppress the Progression of Poorly Differentiated Thyroid Cancer via LncRNA NONMMUT014201/miR-6963-5p/Srprb Pathway. Comb Chem High Throughput Screen 2024; 27:CCHTS-EPUB-136867. [PMID: 38173060 DOI: 10.2174/0113862073286006231228070738] [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: 10/24/2023] [Revised: 12/11/2023] [Accepted: 12/23/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Poorly differentiated thyroid cancer (PDTC) is a special type of thyroid cancer that threatens the life of the patients. Unfortunately, there are no effective treatments for PDTC right now, so it is urgent to search for new efficacious drugs. This experiment was designed to elucidate the effects of selenomethionine (SeMet) on PDTC in vitro and vivo. METHODS A xenograft animal model was used to assay the volume and weight of PDTC. LncRNA NOMMMUT014201 expression was detected by fluorescence in situ hybridization and Real-time quantitative PCR (qRT-PCR). In vitro experiments were carried on in WRO cells. The Cell Counting Kit-8 assay was performed to test the effect of SeMet on the proliferation of cells. And the migration and invasion of WRO cells by the wound-healing assay, Transwell migration and invasion assays. The cell apoptosis was measured by flow cytometry. In addition, genes related to proliferation, migration, invasion and apoptosis were detected through qRT-PCR and Western Blot. RESULTS SeMet inhibited the proliferation, migration and invasion and promoted the apoptosis of WRO cells in a dose-dependent manner. Then vivo, SeMet significantly suppressed the volume and weight of PDTC. And SeMet downregulated the expressions of Ki67, PCNA, MMP2, MMP9 and BCL2, but upregulated that of BAX and Cleaved-Caspase 3. Moreover, SeMet upregulated the level of LncRNA NOMMMUT014201 both vivo and in vitro. In addition, repression of LncRNA NOMMMUT014201 removed the inhibition effect of SeMet on WRO cell growth significantly (p<0.05). Further investigation showed that LncRNA NOMMMUT014201 downregulated the expression of miR-6963-5p in PDTC cells, but miR-6963-5p inhibited the level of Srprb. In addition, sh-LncRNA NOMMMUT014201 enhanced the proliferation, migration and invasion but inhibited the apoptosis of WRO cells. However, inhibited miR-6963-5p or overexpressed Srprb relieved the effects of sh-LncRNA NOMMMUT014201on WRO cells. CONCLUSION Collectively, SeMet inhibits the growth of PDTC in a dose-dependent manner through LncRNA NONMMUT014201/miR-6963-5p/Srprb signal pathway, thus suggesting that SeMet might be a potential drug for PDTC treatment.
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Affiliation(s)
- Rongfang Pan
- Department of Endocrinology and Metabology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan 250014, China
| | - Junyu Zhao
- Department of Endocrinology and Metabology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Shandong Institute of Nephrology, Jinan 250014, Shandong, China
| | - Jinming Yao
- Department of Endocrinology and Metabology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Shandong Institute of Nephrology, Jinan 250014, Shandong, China
| | - Yanyan Gao
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong, China
| | - Lin Liao
- Department of Endocrinology and Metabology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan 250014, China
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Gill SM, Hassan A, Bashir H, Shafiq W. I-131 Avid Tumor Thrombus in a Case of Poorly Differentiated Thyroid Cancer. Mol Imaging Radionucl Ther 2023; 32:178-180. [PMID: 37337877 DOI: 10.4274/mirt.galenos.2023.81567] [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: 06/21/2023] Open
Abstract
Intravenous tumor extension is a well-recognized phenomenon occurring in various malignancies but is a relatively rare entity in thyroid carcinoma. In patients with poorly differentiated thyroid cancer (pDTC), I-131 avid superior vena cava tumor (SVC) thrombus at initial presentation is infrequent and potential life threatening. Tumor thrombus can form either due to direct vascular extension of the primary mass or by hematogenous spread. Hybrid nuclear imaging can differentiate the two entities, which can impact the treatment plan of the patient. We present images of an interesting case of evolution of SVC thrombus in a 46-year-old woman with diagnosed pDTC over the span of two years.
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Affiliation(s)
- Sana Munir Gill
- Shaukat Khanum Memorial Cancer Hospital and Research Centre, Department of Nuclear Medicine, Lahore, Pakistan
| | - Aamna Hassan
- Shaukat Khanum Memorial Cancer Hospital and Research Centre, Department of Nuclear Medicine, Lahore, Pakistan
| | - Humayun Bashir
- Shaukat Khanum Memorial Cancer Hospital and Research Centre, Department of Nuclear Medicine, Lahore, Pakistan
| | - Waqas Shafiq
- Shaukat Khanum Memorial Cancer Hospital and Research Centre, Department of Nuclear Medicine, Lahore, Pakistan
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Ciappuccini R, Saguet-Rysanek V, Giffard F, Licaj I, Dorbeau M, Clarisse B, Poulain L, Bardet S. PSMA Expression in Differentiated Thyroid Cancer: Association With Radioiodine, 18FDG Uptake, and Patient Outcome. J Clin Endocrinol Metab 2021; 106:3536-3545. [PMID: 34331544 DOI: 10.1210/clinem/dgab563] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Little is known about prostate-specific membrane antigen (PSMA) expression in patients with cervical involvement of differentiated thyroid cancer (DTC). OBJECTIVE We investigated PSMA expression in neck persistent/recurrent disease (PRD) using immunohistochemistry and the association with radioiodine (RAI) or 18-fluorodeoxyglucose (18FDG) uptake, and patient outcome. DESIGN, SETTING, AND PATIENTS Data from 44 consecutive DTC patients who underwent neck reoperation from 2006 to 2018 in a comprehensive cancer center. MAIN OUTCOME MEASURE(S) Immunostaining was performed with vascular endothelial marker CD31 and PSMA. PSMA expression was quantified using the immunoreactive score (IRS). RAI and 18FDG uptake were assessed before surgery using posttherapeutic RAI scintigraphy and 18FDG positron emission tomography with computed tomography. Mean follow-up after reintervention was 6.5 ± 3.7 years. RESULTS Thirty patients (68%) showed at least 1 PSMA-positive lesion (IRS ≥ 2) with similar proportions in RAI-positive and RAI-negative patients (75% vs 66%). In RAI-negative patients, however, the proportion of PSMA-positive disease (79% vs 25%, P < 0.01) and the mean IRS (4.0 vs 1.0, P = 0.01) were higher in 18FDG-positive than in 18FDG-negative patients. Furthermore, mean IRS was higher in patients ≥ 55 years, large primary tumors (>40 mm) or aggressive subtypes, and was correlated with structural disease at last follow-up. Strong PSMA expression (IRS ≥ 9) was associated with shorter progression-free survival (PFS). CONCLUSIONS Our findings show that PSMA expression was present in two-thirds of patients with neck PRD, that it was related to poor prognostic factors and that very high expression was associated with poorer PFS. This preliminary study may offer new perspectives for the management of RAI-refractory DTC.
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Affiliation(s)
- Renaud Ciappuccini
- Department of Nuclear Medicine and Thyroid Unit, Comprehensive Cancer Centre François Baclesse, 14000 Caen, France
- Normandie University, UNICAEN, INSERM U1086 ANTICIPE (Interdisciplinary Research Unit for Cancers Prevention and Treatment), 14000 Caen, France
| | | | - Florence Giffard
- Normandie University, UNICAEN, INSERM U1086 ANTICIPE (Interdisciplinary Research Unit for Cancers Prevention and Treatment), 14000 Caen, France
- UNICANCER, Comprehensive Cancer Centre François Baclesse, 14000 Caen, France
| | - Idlir Licaj
- Normandie University, UNICAEN, INSERM U1086 ANTICIPE (Interdisciplinary Research Unit for Cancers Prevention and Treatment), 14000 Caen, France
- Department of Clinical Research, Comprehensive Cancer Centre François Baclesse, 14000 Caen, France
- Department of Community Medicine, Faculty of Health Sciences, The UiT Arctic University of Norway, 9010 Tromsø, Norway
| | - Marine Dorbeau
- Department of Pathology, Comprehensive Cancer Centre François Baclesse, 14000 Caen, France
| | - Bénédicte Clarisse
- Department of Clinical Research, Comprehensive Cancer Centre François Baclesse, 14000 Caen, France
| | - Laurent Poulain
- Normandie University, UNICAEN, INSERM U1086 ANTICIPE (Interdisciplinary Research Unit for Cancers Prevention and Treatment), 14000 Caen, France
- UNICANCER, Comprehensive Cancer Centre François Baclesse, 14000 Caen, France
| | - Stéphane Bardet
- Department of Nuclear Medicine and Thyroid Unit, Comprehensive Cancer Centre François Baclesse, 14000 Caen, France
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Bellini MI, Biffoni M, Patrone R, Borcea MC, Costanzo ML, Garritano T, Melcarne R, Menditto R, Metere A, Scorziello C, Summa M, Ventrone L, D’Andrea V, Giacomelli L. Poorly Differentiated Thyroid Carcinoma: Single Centre Experience and Review of the Literature. J Clin Med 2021; 10:jcm10225258. [PMID: 34830540 PMCID: PMC8623499 DOI: 10.3390/jcm10225258] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/05/2021] [Accepted: 11/11/2021] [Indexed: 11/21/2022] Open
Abstract
There is controversy in the literature regarding a distinct subset of thyroid carcinoma whose histologically classification falls between well-differentiated and anaplastic carcinomas, previously identified as ‘poorly differentiated thyroid carcinoma’ (PDTC), or ‘insular carcinoma’, in view of the peculiar morphological characteristics of the cell groupings. The correct diagnosis and treatment of this entity have important prognostic and therapeutic significance. In this review, we describe the epidemiology, diagnosis, and management of PDTC and report our single centre experience to add to the limited evidence existing in the literature.
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Affiliation(s)
- Maria Irene Bellini
- Azienda Ospedaliera San Camillo Forlanini, 00152 Rome, Italy
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.B.); (M.C.B.); (M.L.C.); (T.G.); (R.M.); (R.M.); (C.S.); (M.S.); (L.V.); (V.D.); (L.G.)
- Correspondence:
| | - Marco Biffoni
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.B.); (M.C.B.); (M.L.C.); (T.G.); (R.M.); (R.M.); (C.S.); (M.S.); (L.V.); (V.D.); (L.G.)
| | - Renato Patrone
- ICTUS, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy;
| | - Maria Carola Borcea
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.B.); (M.C.B.); (M.L.C.); (T.G.); (R.M.); (R.M.); (C.S.); (M.S.); (L.V.); (V.D.); (L.G.)
| | - Maria Ludovica Costanzo
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.B.); (M.C.B.); (M.L.C.); (T.G.); (R.M.); (R.M.); (C.S.); (M.S.); (L.V.); (V.D.); (L.G.)
| | - Tiziana Garritano
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.B.); (M.C.B.); (M.L.C.); (T.G.); (R.M.); (R.M.); (C.S.); (M.S.); (L.V.); (V.D.); (L.G.)
| | - Rossella Melcarne
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.B.); (M.C.B.); (M.L.C.); (T.G.); (R.M.); (R.M.); (C.S.); (M.S.); (L.V.); (V.D.); (L.G.)
| | - Rosa Menditto
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.B.); (M.C.B.); (M.L.C.); (T.G.); (R.M.); (R.M.); (C.S.); (M.S.); (L.V.); (V.D.); (L.G.)
| | - Alessio Metere
- General Surgery Department, Ospedale dei Castelli (O.D.C.), Via Nettunense Km 11,5, 00040 Rome, Italy;
| | - Chiara Scorziello
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.B.); (M.C.B.); (M.L.C.); (T.G.); (R.M.); (R.M.); (C.S.); (M.S.); (L.V.); (V.D.); (L.G.)
| | - Marco Summa
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.B.); (M.C.B.); (M.L.C.); (T.G.); (R.M.); (R.M.); (C.S.); (M.S.); (L.V.); (V.D.); (L.G.)
| | - Luca Ventrone
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.B.); (M.C.B.); (M.L.C.); (T.G.); (R.M.); (R.M.); (C.S.); (M.S.); (L.V.); (V.D.); (L.G.)
| | - Vito D’Andrea
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.B.); (M.C.B.); (M.L.C.); (T.G.); (R.M.); (R.M.); (C.S.); (M.S.); (L.V.); (V.D.); (L.G.)
| | - Laura Giacomelli
- Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.B.); (M.C.B.); (M.L.C.); (T.G.); (R.M.); (R.M.); (C.S.); (M.S.); (L.V.); (V.D.); (L.G.)
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Grawe F, Cahya A, Fabritius MP, Beyer L, Wenter V, Ruebenthaler J, Geyer T, Burgard C, Bartenstein P, Ilhan H, Spitzweg C, Todica A. Course of Disease and Clinical Management of Patients with Poorly Differentiated Thyroid Carcinoma. Cancers (Basel) 2021; 13:cancers13215309. [PMID: 34771473 PMCID: PMC8582377 DOI: 10.3390/cancers13215309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/18/2021] [Accepted: 10/19/2021] [Indexed: 11/23/2022] Open
Abstract
Simple Summary Poorly differentiated thyroid carcinoma (PDTC) represents a rare but aggressive variant of thyroid carcinoma and contributes to a significant proportion of thyroid carcinoma-associated deaths. Studies on PDTC are rare; therefore, we aim to assess the clinical course of these patients, evaluate the prognostic value of response to initial radioiodine therapy and identify risk factors for poor prognosis to optimize the clinical management of patients with PDCT. Abstract Background: In patients with poorly differentiated thyroid carcinoma, the clinical course and prognostic value of response to initial radioiodine therapy is evaluated. Methods: In 47 patients, clinical and imaging features were analyzed. Patients were stratified in no (NED), biochemical (B-ED) and structural evidence of disease (S-ED) assessed at the first diagnostic control and its impact on survival was evaluated. Further, possible risk factors for a shorter disease-specific survival rate (DSS) were analyzed. Results: In total, 17/47 patients consisted of NED, 10/47 were B-ED and 20/47 S-ED patients. At the last follow-up, 18/47 patients were NED, 2/47 patients B-ED and 27/47 patients S-ED. The median survival time was only reached for the S-ED group (median 3.9 years, 95%CI 2.8–5.1 years) and was not reached in the B-ED and NED groups. Metastases were diagnosed by a 18F-FDG-PET/CT scan in all cases and a multivariate analysis showed that the PET-positivity of metastases was the only significant predictor of DSS (p = 0.036). Conclusion: The response to initial surgery and radioiodine therapy in PDTC patients can achieve an excellent outcome and a further follow-up should be refined based on findings at the first diagnostic control. However, patients with an incomplete response and metastatic patients who become mostly radioiodine refractory show a significantly shorter survival, which makes accurate staging by 18F-FDG-PET/CT imaging crucial.
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Affiliation(s)
- Freba Grawe
- Department of Nuclear Medicine, University Hospital, LMU Munich, 81377 Munich, Germany; (F.G.); (A.C.); (L.B.); (V.W.); (C.B.); (P.B.); (H.I.)
| | - Atika Cahya
- Department of Nuclear Medicine, University Hospital, LMU Munich, 81377 Munich, Germany; (F.G.); (A.C.); (L.B.); (V.W.); (C.B.); (P.B.); (H.I.)
| | - Matthias P. Fabritius
- Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany; (M.P.F.); (J.R.); (T.G.)
| | - Leonie Beyer
- Department of Nuclear Medicine, University Hospital, LMU Munich, 81377 Munich, Germany; (F.G.); (A.C.); (L.B.); (V.W.); (C.B.); (P.B.); (H.I.)
| | - Vera Wenter
- Department of Nuclear Medicine, University Hospital, LMU Munich, 81377 Munich, Germany; (F.G.); (A.C.); (L.B.); (V.W.); (C.B.); (P.B.); (H.I.)
| | - Johannes Ruebenthaler
- Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany; (M.P.F.); (J.R.); (T.G.)
| | - Thomas Geyer
- Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany; (M.P.F.); (J.R.); (T.G.)
| | - Caroline Burgard
- Department of Nuclear Medicine, University Hospital, LMU Munich, 81377 Munich, Germany; (F.G.); (A.C.); (L.B.); (V.W.); (C.B.); (P.B.); (H.I.)
| | - Peter Bartenstein
- Department of Nuclear Medicine, University Hospital, LMU Munich, 81377 Munich, Germany; (F.G.); (A.C.); (L.B.); (V.W.); (C.B.); (P.B.); (H.I.)
- Comprehensive Cancer Center (CCC LMU) and Interdisciplinary Center for Thyroid Carcinoma (ISKUM), University Hospital, LMU Munich, 81377 Munich, Germany;
| | - Harun Ilhan
- Department of Nuclear Medicine, University Hospital, LMU Munich, 81377 Munich, Germany; (F.G.); (A.C.); (L.B.); (V.W.); (C.B.); (P.B.); (H.I.)
- Comprehensive Cancer Center (CCC LMU) and Interdisciplinary Center for Thyroid Carcinoma (ISKUM), University Hospital, LMU Munich, 81377 Munich, Germany;
| | - Christine Spitzweg
- Comprehensive Cancer Center (CCC LMU) and Interdisciplinary Center for Thyroid Carcinoma (ISKUM), University Hospital, LMU Munich, 81377 Munich, Germany;
- Department of Internal Medicine IV, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Andrei Todica
- Department of Nuclear Medicine, University Hospital, LMU Munich, 81377 Munich, Germany; (F.G.); (A.C.); (L.B.); (V.W.); (C.B.); (P.B.); (H.I.)
- Comprehensive Cancer Center (CCC LMU) and Interdisciplinary Center for Thyroid Carcinoma (ISKUM), University Hospital, LMU Munich, 81377 Munich, Germany;
- Correspondence:
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Nilsson JN, Siikanen J, Hedman C, Juhlin CC, Ihre Lundgren C. Pre-Therapeutic Measurements of Iodine Avidity in Papillary and Poorly Differentiated Thyroid Cancer Reveal Associations with Thyroglobulin Expression, Histological Variants and Ki-67 Index. Cancers (Basel) 2021; 13:3627. [PMID: 34298840 DOI: 10.3390/cancers13143627] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/16/2021] [Accepted: 07/17/2021] [Indexed: 12/29/2022] Open
Abstract
Papillary thyroid cancer (PTC) and poorly differentiated thyroid cancer (PDTC) are treated with radioiodine to reduce recurrence and to treat the spread of disease. Adequate iodine accumulation in cancer tissue, iodine avidity, is important for treatment effect. This study investigated which clinical and histological tumour characteristics correlate with avidity. To quantify avidity in cancer tissue, tracer amounts of iodine-131 were given to 45 patients with cytologically confirmed thyroid cancer. At pathology grossing, representative samples of tumour and lymph nodes were taken and subjected to radioactivity quantification ex vivo to determine avidity. Afterwards, samples underwent extended pathology work-up and analysis. We found that tumoural Tg expression and Ki-67 index were correlated with avidity, whereas tumour size and pT stage were not. The histological variant of thyroid cancer was also correlated with iodine avidity. Variants associated with worse clinical prognoses displayed lower avidity than variants with better prognoses. This work provides new information on which tumours have low iodine avidity. Lower avidity in aggressive histological PTC variants may explain their overall poorer prognoses. Our findings also suggest that radioiodine dosage could be adapted to Tg expression, Ki-67 index or histological variant instead of pT stage, potentially improving the efficacy of radioiodine therapy.
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Dierks C, Seufert J, Aumann K, Ruf J, Klein C, Kiefer S, Rassner M, Boerries M, Zielke A, la Rosee P, Meyer PT, Kroiss M, Weißenberger C, Schumacher T, Metzger P, Weiss H, Smaxwil C, Laubner K, Duyster J, von Bubnoff N, Miething C, Thomusch O. Combination of Lenvatinib and Pembrolizumab Is an Effective Treatment Option for Anaplastic and Poorly Differentiated Thyroid Carcinoma. Thyroid 2021; 31:1076-1085. [PMID: 33509020 PMCID: PMC8290324 DOI: 10.1089/thy.2020.0322] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [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: 12/16/2022]
Abstract
Background: Anaplastic thyroid carcinoma (ATC) and metastatic poorly differentiated thyroid carcinomas (PDTCs) are rare aggressive malignancies with poor overall survival (OS) despite extensive multimodal therapy. These tumors are highly proliferative, with frequently increased tumor mutational burden (TMB) compared with differentiated thyroid carcinomas, and elevated programmed death ligand 1 (PD-L1) levels. These tumor properties implicate responsiveness to antiangiogenic and antiproliferative multikinase inhibitors such as lenvatinib, and immune checkpoint inhibitors such as pembrolizumab. Patients and Methods: In a retrospective study, we analyzed six patients with metastatic ATC and two patients with PDTC, who received a combination therapy of lenvatinib and pembrolizumab. Lenvatinib was started at 14-24 mg daily and combined with pembrolizumab at a fixed dose of 200 mg every three weeks. Maximum treatment duration with this combination was 40 months, and 3 of 6 ATC patients are still on therapy. Patient tumors were characterized by whole-exome sequencing and PD-L1 expression levels (tumor proportion score [TPS] 1-90%). Results: Best overall response (BOR) within ATCs was 66% complete remissions (4/6 CR), 16% stable disease (1/6 SD), and 16% progressive disease (1/6 PD). BOR within PDTCs was partial remission (PR 2/2). The median progression-free survival was 17.75 months for all patients, and 16.5 months for ATCs, with treatment durations ranging from 1 to 40 months (1, 4, 11, 15, 19, 25, 27, and 40 months). Grade III/IV toxicities developed in 4 of 8 patients, requiring dose reduction/discontinuation of lenvatinib. The median OS was 18.5 months, with three ATC patients being still alive without relapse (40, 27, and 19 months) despite metastatic disease at the time of treatment initiation (UICC and stage IVC). All patients with long-term (>2 years) or complete responses (CRs) had either increased TMB or a PD-L1 TPS >50%. Conclusions: Our results implicate that the combination of lenvatinib and pembrolizumab might be safe and effective in patients with ATC/PDTC and can result in complete and long-term remissions. The combination treatment is now being systematically examined in a phase II clinical trial (Anaplastic Thyroid Carcinoma Lenvatinib Pembrolizumab [ATLEP]) in ATC/PDTC patients.
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Affiliation(s)
- Christine Dierks
- Department of Hematology and Oncology, KIM IV, Faculty of Medicine, University Halle-Wittenberg, Halle, Germany
- Department of Hematology and Oncology, University of Freiburg, Freiburg, Germany
| | - Jochen Seufert
- Division of Endocrinology and Diabetology, Department of Medicine II, University of Freiburg, Freiburg, Germany
| | - Konrad Aumann
- Institute of Pathology, University of Freiburg, Germany
| | - Juri Ruf
- Department of Nuclear Medicine, University of Freiburg, Germany
| | - Claudius Klein
- Department of Hematology and Oncology, University of Freiburg, Freiburg, Germany
- Institute of Pathology, University of Freiburg, Germany
- Department of Nuclear Medicine, University of Freiburg, Germany
| | - Selina Kiefer
- Institute of Pathology, University of Freiburg, Germany
| | - Michael Rassner
- Department of Hematology and Oncology, University of Freiburg, Freiburg, Germany
| | - Melanie Boerries
- German Cancer Research Center (DKFZ), Heidelberg, Germany
- Comprehensive Cancer Center Freiburg (CCCF), University Medical Center, University of Freiburg, Freiburg, Germany
- Institute of Medical Bioinformatics and Systems Medicine and Institute of Molecular Medicine and Cell Research; Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Andreas Zielke
- Outcomes Research Unit, Department of Endocrine Surgery, Endocrine Center Stuttgart, Diakonie Klinikum Stuttgart, Stuttgart, Germany
| | - Paul la Rosee
- Klinikum Villingen-Schwenningen, Hämatologie/Onkologie, Villingen-Schwenningen, Germany
| | - Philipp Tobias Meyer
- Department of Nuclear Medicine, University of Freiburg, Germany
- German Cancer Consortium (DKTK), Partner Site Freiburg, Freiburg, Germany
| | - Matthias Kroiss
- Division of Endocrinology/Diabetology, Department of Internal Medicine, University Hospital Würzburg, Würzburg, Germany
- Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
| | | | | | - Patrick Metzger
- Institute of Medical Bioinformatics and Systems Medicine and Institute of Molecular Medicine and Cell Research; Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Faculty of Biology, University of Freiburg, Freiburg, Germany
| | | | - Constantin Smaxwil
- Outcomes Research Unit, Department of Endocrine Surgery, Endocrine Center Stuttgart, Diakonie Klinikum Stuttgart, Stuttgart, Germany
| | - Katharina Laubner
- Division of Endocrinology and Diabetology, Department of Medicine II, University of Freiburg, Freiburg, Germany
| | - Justus Duyster
- Department of Hematology and Oncology, University of Freiburg, Freiburg, Germany
| | - Nikolas von Bubnoff
- Department of Hematology and Oncology, University of Freiburg, Freiburg, Germany
- Department of Hematology/Oncology, University of Luebeck, Luebeck, Germany
| | - Cornelius Miething
- Department of Hematology and Oncology, University of Freiburg, Freiburg, Germany
- German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), Partner Site Freiburg, Freiburg, Germany
| | - Oliver Thomusch
- Department of General and Visceral Surgery, University Hospital Freiburg, Freiburg, Germany
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Zhang M, Lei S, Chen Y, Wu Y, Ye H. The role of lymph node status in cancer-specific survival and decision-making of postoperative radiotherapy in poorly differentiated thyroid cancer: a population-based study. Am J Transl Res 2021; 13:383-390. [PMID: 33527032 PMCID: PMC7847507] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 11/14/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE This study aimed to investigate the prognostic value of lymph node (LN) status for patients with poorly differentiated thyroid cancer (PDTC), and to develop a reliable nomogram to predict the 3-, 5- and 10-year cancer-specific survival (CSS) and assist the decision-making of postoperative radiotherapy (PORT). METHODS The Surveillance, Epidemiology, and End Results (SEER) database was utilized to screen eligible patients who were diagnosed between 2004 and 2016. The optimal values of age, metastatic lymph node ratio (LNR), and the number of metastatic lymph nodes (MLN) were determined and incorporated into the construction of a nomogram. The performance of the model was evaluated by generating a calibration curve and calculating the consistency index (C-index). Based on the nomogram, patients were classified into three risk cohorts. The prognostic efficacy of PORT was evaluated in each cohort. RESULTS A total of 522 PDTC patients were included in this study. The LN status-associated parameters (MLN and LNR) were independent risk factors for CSS of PDTC patients. Based on MLN, LNR, and other clinical characteristics (age and T stage), an individualized nomogram was constructed that showed an acceptable predictive performance. Furthermore, we proposed a novel risk-classification system to stratify PDTC patients and to assess the prognostic efficacy of PORT. Only patients in high-risk cohort were found eligible to benefit from PORT. CONCLUSION LN status is statistically associated with the prognosis of PDTC patients. In addition, the individualized nomogram may be a significant tool to assist the evaluation of patients' long-term prognosis and to guide the decision-making for PORT.
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Affiliation(s)
- Maojie Zhang
- Clinical Medical College, Guizhou Medical UniversityGuiyang 550001, Guizhou, China
- Department of Thyroid Surgery, The Affiliated Hospital of Guizhou Medical UniversityGuiyang 550001, Guizhou, China
| | - Siyi Lei
- Clinical Medical College, Guizhou Medical UniversityGuiyang 550001, Guizhou, China
| | - Yuanyi Chen
- Guizhou First People’s HospitalGuiyang, China
| | - Yuzhou Wu
- Gui Hang Group Guiyang 300 HospitalGuiyang, China
| | - Hui Ye
- Department of Thyroid Surgery, The Affiliated Hospital of Guizhou Medical UniversityGuiyang 550001, Guizhou, China
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9
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Luo Y, Jiang H, Xu W, Wang X, Ma B, Liao T, Wang Y. Clinical, Pathological, and Molecular Characteristics Correlating to the Occurrence of Radioiodine Refractory Differentiated Thyroid Carcinoma: A Systematic Review and Meta-Analysis. Front Oncol 2020; 10:549882. [PMID: 33117686 PMCID: PMC7561400 DOI: 10.3389/fonc.2020.549882] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 08/21/2020] [Indexed: 01/22/2023] Open
Abstract
Background: Recently, radioiodine refractory differentiated thyroid cancer (RR-DTC) has received increasing attention due to its poor prognosis. The roles of clinical, pathological, and molecular features in the development of RR-DTC remain controversial and require additional investigation. This study aimed to evaluate the association between these risk factors and the occurrence of RR-DTC. Methods: We performed a systematic search for relevant literature following the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) in PubMed, EMBASE, Medline, SCOPUS, and Web of Science up to the July 15, 2020. Observational studies that investigated the risk factors for RR-DTC were included. Fixed- or random-effects models were used to calculate pooled odds ratios (ORs) or mean differences (MD) with corresponding 95% confidence intervals. Results: We included 13 eligible studies incorporating 1,431 cases, of which 603 were patients with RR-DTC. The pooled analysis indicated that four parameters significantly increased the risk of RR-DTC: extrathyroidal extension (ETE) (OR: 2.28, 95% CI: 1.43–3.64, I2 = 14%), BRAFV600E mutation (OR: 3.60, 95% CI: 1.74–7.46, I2 = 69%), TERT promoter mutation (OR: 9.84, 95% CI: 3.60–26.89, I2 = 61%) and high-risk histological subtype (OR: 1.94, 95% CI: 1.15–3.27, I2 = 15%), including tall cell variant papillary thyroid carcinoma (PTC), sclerosing diffuse PTC, hobnail variant PTC, follicular thyroid carcinoma (FTC) (including Hürthle cell), and poorly differentiated thyroid carcinoma (PDTC). However, there was no statistical significance regarding sex, age, tumor size, multifocality, or lateral lymph node metastasis. Subgroup and sensitivity analyses were conducted to further confirm the robustness of the results. Conclusions: Histological subtype, ETE, BRAFV600E mutation, and TERT promoter mutation could be considered clinicopathological factors and biomarkers. They could assist in risk stratification, prognostic prediction, and individual therapy options for RR-DTC.
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Affiliation(s)
- Yi Luo
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Hongyi Jiang
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Weibo Xu
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xiao Wang
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Ben Ma
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Tian Liao
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yu Wang
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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10
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Pecce V, Verrienti A, Abballe L, Carletti R, Grani G, Falcone R, Ramundo V, Durante C, Di Gioia C, Russo D, Filetti S, Sponziello M. Loss of Function SETD2 Mutations in Poorly Differentiated Metastases from Two Hürthle Cell Carcinomas of the Thyroid. Cancers (Basel) 2020; 12:cancers12071892. [PMID: 32674319 PMCID: PMC7409075 DOI: 10.3390/cancers12071892] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 06/23/2020] [Revised: 07/10/2020] [Accepted: 07/11/2020] [Indexed: 02/06/2023] Open
Abstract
Hürthle cell carcinomas (HCC) are rare differentiated thyroid cancers that display low avidity for radioactive iodine and respond poorly to kinase inhibitors. Here, using next-generation sequencing, we analyzed the mutational status of primary tissue and poorly differentiated metastatic tissue from two HCC patients. In both cases, metastatic tissues harbored a mutation of SETD2, each resulting in loss of the SRI and WW domains of SETD2, a methyltransferase that trimethylates H3K36 (H3K36me3) and also interacts with p53 to promote its stability. Functional studies of the novel p.D1890fs6* mutation (case 1) revealed significantly reduced H3K36me3 levels in SETD2-mutated tissue and primary cell cultures and decreased levels of the active form of p53. Restoration of SETD2-wildtype expression in the SETD2-mutant cells significantly reduced the expression of four well-known stemness markers (OCT-4, SOX2, IPF1, Goosecoid). These findings suggest potential roles for SETD2 loss-of-function mutations in HCC progression, possibly involving p53 destabilization and promotion of stemness. Their prevalence and potential treatment implications in thyroid cancer, especially HCC, require further study.
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Affiliation(s)
- Valeria Pecce
- Department of Translational and Precision Medicine, “Sapienza” University of Rome, 00161 Rome, Italy; (V.P.); (A.V.); (L.A.); (G.G.); (R.F.); (V.R.); (C.D.); (S.F.)
| | - Antonella Verrienti
- Department of Translational and Precision Medicine, “Sapienza” University of Rome, 00161 Rome, Italy; (V.P.); (A.V.); (L.A.); (G.G.); (R.F.); (V.R.); (C.D.); (S.F.)
| | - Luana Abballe
- Department of Translational and Precision Medicine, “Sapienza” University of Rome, 00161 Rome, Italy; (V.P.); (A.V.); (L.A.); (G.G.); (R.F.); (V.R.); (C.D.); (S.F.)
| | - Raffaella Carletti
- Department of Radiological, Oncological and Pathological Sciences, “Sapienza” University of Rome, 00161 Rome, Italy; (R.C.); (C.D.G.)
| | - Giorgio Grani
- Department of Translational and Precision Medicine, “Sapienza” University of Rome, 00161 Rome, Italy; (V.P.); (A.V.); (L.A.); (G.G.); (R.F.); (V.R.); (C.D.); (S.F.)
| | - Rosa Falcone
- Department of Translational and Precision Medicine, “Sapienza” University of Rome, 00161 Rome, Italy; (V.P.); (A.V.); (L.A.); (G.G.); (R.F.); (V.R.); (C.D.); (S.F.)
| | - Valeria Ramundo
- Department of Translational and Precision Medicine, “Sapienza” University of Rome, 00161 Rome, Italy; (V.P.); (A.V.); (L.A.); (G.G.); (R.F.); (V.R.); (C.D.); (S.F.)
| | - Cosimo Durante
- Department of Translational and Precision Medicine, “Sapienza” University of Rome, 00161 Rome, Italy; (V.P.); (A.V.); (L.A.); (G.G.); (R.F.); (V.R.); (C.D.); (S.F.)
| | - Cira Di Gioia
- Department of Radiological, Oncological and Pathological Sciences, “Sapienza” University of Rome, 00161 Rome, Italy; (R.C.); (C.D.G.)
| | - Diego Russo
- Department of Health Sciences, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy;
| | - Sebastiano Filetti
- Department of Translational and Precision Medicine, “Sapienza” University of Rome, 00161 Rome, Italy; (V.P.); (A.V.); (L.A.); (G.G.); (R.F.); (V.R.); (C.D.); (S.F.)
| | - Marialuisa Sponziello
- Department of Translational and Precision Medicine, “Sapienza” University of Rome, 00161 Rome, Italy; (V.P.); (A.V.); (L.A.); (G.G.); (R.F.); (V.R.); (C.D.); (S.F.)
- Correspondence:
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11
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Iñiguez-Ariza NM, Jasim S, Ryder MM, Chintakuntlawar AV, Morris JC, Hilger CR, Menefee ME, Smallridge RC, Karlin NJ, Alcaino C, Bible KC. Foundation One Genomic Interrogation of Thyroid Cancers in Patients With Metastatic Disease Requiring Systemic Therapy. J Clin Endocrinol Metab 2020; 105:5839873. [PMID: 32421817 PMCID: PMC7263749 DOI: 10.1210/clinem/dgaa246] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 05/14/2020] [Indexed: 01/16/2023]
Abstract
CONTEXT Clinical applications of genomic assessment of thyroid cancers are rapidly evolving. OBJECTIVES, DESIGN, AND SETTING We studied tumor samples from patients with imminently threatening and rare thyroid cancers to identify genomic alterations that might correlate with outcomes and/or be productively therapeutically targetable. PATIENT CONTEXT Progressive and metastatic, and/or rare, thyroid cancers were studied, 2012 to 2016, at Mayo Clinic sites. INTERVENTION The intervention was Foundation One tumor interrogation. MAIN OUTCOME MEASURES Main outcome measures included genomic alterations, patient characteristics, and overall survival. RESULTS Samples from 55 patients were evaluated: 20 anaplastic thyroid cancers (ATCs) (36%), 25 radioactive iodine-refractory differentiated thyroid cancers (DTCs)/poorly differentiated thyroid cancers (PDTCs) (45%; 14 papillary thyroid cancer [PTCs], 6 PDTCs, 5 Hürthle cell cancers), 8 medullary thyroid cancers (MTCs) (15%), and 2 others (a spindle epithelial tumor with thymus-like differentiation, and a primary thyroid sarcoma). Overall, 72% of DTCs, 79% of ATCs, and 75% of MTCs were deemed to have potentially productively targetable alterations. The most commonly encountered mutation was of TERT promoter (56% of DTCs, 68% of ATCs)-but this is not presently targetable. Targetable BRAFV600E mutations were found in 40% of DTCs/PDTCs (83% of PTCs) and 32% of ATCs; of MTCs, 75% had targetable RET mutations, and 25% HRAS mutations. Of patient tumors with nonmutated BRAFV600E, 53% of DTC/PDTCs and 69% of ATCs had other potentially productively targetable mutations. Genomic alterations in our series of poor prognosis metastatic DTC/PDTCs also closely resembled those seen in ATC. CONCLUSIONS Whereas genomic interrogation of favorable prognosis thyroid cancer seems ill advised, potentially productively targetable mutations were demonstrated in the majority of tumors from patients with metastatic thyroid cancers requiring systemic therapy, suggesting a rationale for the selective application of this technology.
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Affiliation(s)
- Nicole M Iñiguez-Ariza
- Division of Endocrinology, Diabetes, Metabolism, & Nutrition, Mayo Clinic, Rochester, Minnesota
- Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Sina Jasim
- Division of Endocrinology, Diabetes, Metabolism, & Nutrition, Mayo Clinic, Rochester, Minnesota
- Division of Endocrinology, Metabolism and Lipid Research, Washington University, School of Medicine, St Louis, Missouri
| | - Mabel M Ryder
- Division of Endocrinology, Diabetes, Metabolism, & Nutrition, Mayo Clinic, Rochester, Minnesota
- Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota
| | | | - John C Morris
- Division of Endocrinology, Diabetes, Metabolism, & Nutrition, Mayo Clinic, Rochester, Minnesota
- Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota
| | | | | | - Robert C Smallridge
- Division of Endocrinology, Diabetes, Metabolism, & Nutrition, Mayo Clinic, Jacksonville, Florida
| | - Nina J Karlin
- Division of Medical Oncology, Mayo Clinic, Phoenix, Arizona
| | - Constanza Alcaino
- Department of Physiology and Biomedical Engineering, Enteric Neuroscience Program, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Keith C Bible
- Division of Endocrinology, Metabolism and Lipid Research, Washington University, School of Medicine, St Louis, Missouri
- Correspondence and Reprint Requests: Keith C. Bible, MD, PhD, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.
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12
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Kohler H, Latteyer S, Hönes GS, Theurer S, Liao XH, Christoph S, Zwanziger D, Schulte JH, Kero J, Undeutsch H, Refetoff S, Schmid KW, Führer D, Moeller LC. Increased Anaplastic Lymphoma Kinase Activity Induces a Poorly Differentiated Thyroid Carcinoma in Mice. Thyroid 2019; 29:1438-1446. [PMID: 31526103 PMCID: PMC8935483 DOI: 10.1089/thy.2018.0526] [Citation(s) in RCA: 5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Background: Radioiodine refractory dedifferentiated thyroid cancer is a major clinical challenge. Anaplastic lymphoma kinase (ALK) mutations with increased ALK activity, especially fusion genes, have been suggested to promote thyroid carcinogenesis, leading to development of poorly differentiated thyroid carcinoma (PDTC) and anaplastic thyroid carcinoma. To determine the oncogenic potential of increased ALK activity in thyroid carcinogenesis in vivo, we studied mice with thyrocyte-specific expression of a constitutively active ALK mutant. Methods: Mice carrying a Cre-activated allele of a constitutively active ALK mutant (F1174L) were crossed with mice expressing tamoxifen-inducible Cre recombinase (CreERT2) under the control of the thyroglobulin (Tg) gene promoter to achieve thyrocyte-specific expression of the ALK mutant (ALKF1174L mice). Survival, thyroid hormone serum concentration, and tumor development were recorded. Thyroids and lungs were studied histologically. To maintain euthyroidism despite dedifferentiation of the thyroid, a cohort was substituted with levothyroxine (LT4) through drinking water. Results: ALKF1174L mice developed massively enlarged thyroids, which showed an early loss of normal follicular architecture 12 weeks after tamoxifen injection. A significant decrease in Tg and Nkx-2.1 expression as well as impaired thyroid hormone synthesis confirmed dedifferentiation. Histologically, the mice developed a carcinoma resembling human PDTC with a predominantly trabecular/solid growth pattern and an increased mitotic rate. The tumors showed extrathyroidal extension into the surrounding strap muscles and developed lung metastases. Median survival of ALKF1174L mice was significantly reduced to five months after tamoxifen injection. Reduced Tg expression and loss of follicular structure led to hypothyroidism with elevated thyrotropin (TSH). To test whether TSH stimulation played a role in thyroid carcinogenesis, we kept ALKF1174L mice euthyroid by LT4 substitution. These mice developed PDTC with identical histological features compared with hypothyroid mice, demonstrating that PDTC development was due to increased ALK activity and not dependent on TSH stimulation. Conclusion: Expression of a constitutively activated ALK mutant in thyroids of mice leads to development of metastasizing thyroid cancer resembling human PDTC. These results demonstrate in vivo that increased ALK activity is a driver mechanism in thyroid carcinogenesis.
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Affiliation(s)
- Hannah Kohler
- Department of Endocrinology, Diabetes and Metabolism, University of Duisburg-Essen, Essen, Germany
| | - Soeren Latteyer
- Department of Endocrinology, Diabetes and Metabolism, University of Duisburg-Essen, Essen, Germany
| | - Georg Sebastian Hönes
- Department of Endocrinology, Diabetes and Metabolism, University of Duisburg-Essen, Essen, Germany
| | - Sarah Theurer
- Institute of Pathology, University of Duisburg-Essen, Essen, Germany
| | - Xiao-Hui Liao
- Department of Medicine, The University of Chicago, Chicago, Illinois
| | - Sandra Christoph
- Clinic for Bone Marrow Transplants, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Denise Zwanziger
- Department of Endocrinology, Diabetes and Metabolism, University of Duisburg-Essen, Essen, Germany
| | - Johannes H. Schulte
- Pediatric Oncology and Hematology, Charité University Medicine, Berlin, Germany
| | - Jukka Kero
- Department of Pediatrics, Turku Center for Disease Modeling, Institute of Biomedicine, University of Turku, Turku, Finland
- Research Centre for Integrative Physiology and Pharmacology, Turku Center for Disease Modeling, Institute of Biomedicine, University of Turku, Turku, Finland
| | - Hendrik Undeutsch
- Research Centre for Integrative Physiology and Pharmacology, Turku Center for Disease Modeling, Institute of Biomedicine, University of Turku, Turku, Finland
| | - Samuel Refetoff
- Department of Medicine, The University of Chicago, Chicago, Illinois
- Department of Pediatrics, The University of Chicago, Chicago, Illinois
- Committee on Genetics, The University of Chicago, Chicago, Illinois
| | - Kurt W. Schmid
- Institute of Pathology, University of Duisburg-Essen, Essen, Germany
| | - Dagmar Führer
- Department of Endocrinology, Diabetes and Metabolism, University of Duisburg-Essen, Essen, Germany
| | - Lars C. Moeller
- Department of Endocrinology, Diabetes and Metabolism, University of Duisburg-Essen, Essen, Germany
- Address correspondence to: Lars C. Moeller, MD, Department of Endocrinology, Diabetes and Metabolism, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, Essen 45147, Germany
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13
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Ferrari SM, Fallahi P, Galdiero MR, Ruffilli I, Elia G, Ragusa F, Paparo SR, Patrizio A, Mazzi V, Varricchi G, Marone G, Antonelli A. Immune and Inflammatory Cells in Thyroid Cancer Microenvironment. Int J Mol Sci 2019; 20:E4413. [PMID: 31500315 PMCID: PMC6769504 DOI: 10.3390/ijms20184413] [Citation(s) in RCA: 127] [Impact Index Per Article: 25.4] [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] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 08/30/2019] [Accepted: 09/05/2019] [Indexed: 12/22/2022] Open
Abstract
A hallmark of cancer is the ability of tumor cells to avoid immune destruction. Activated immune cells in tumor microenvironment (TME) secrete proinflammatory cytokines and chemokines which foster the proliferation of tumor cells. Specific antigens expressed by cancer cells are recognized by the main actors of immune response that are involved in their elimination (immunosurveillance). By the recruitment of immunosuppressive cells, decreasing the tumor immunogenicity, or through other immunosuppressive mechanisms, tumors can impair the host immune cells within the TME and escape their surveillance. Within the TME, cells of the innate (e.g., macrophages, mast cells, neutrophils) and the adaptive (e.g., lymphocytes) immune responses are interconnected with epithelial cancer cells, fibroblasts, and endothelial cells via cytokines, chemokines, and adipocytokines. The molecular pattern of cytokines and chemokines has a key role and could explain the involvement of the immune system in tumor initiation and progression. Thyroid cancer-related inflammation is an important target for diagnostic procedures and novel therapeutic strategies. Anticancer immunotherapy, especially immune checkpoint inhibitors, unleashes the immune system and activates cytotoxic lymphocytes to kill cancer cells. A better knowledge of the molecular and immunological characteristics of TME will allow novel and more effective immunotherapeutic strategies in advanced thyroid cancer.
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Affiliation(s)
- Silvia Martina Ferrari
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (S.M.F.); (I.R.); (G.E.); (F.R.); (S.R.P.); (A.P.); (V.M.)
| | - Poupak Fallahi
- Department of Translational Research and of New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy;
| | - Maria Rosaria Galdiero
- Department of Translational Medical Sciences and Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, 80138 Naples, Italy; (M.R.G.); (G.V.); (G.M.)
- WAO Center of Excellence, 80138 Naples, Italy
| | - Ilaria Ruffilli
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (S.M.F.); (I.R.); (G.E.); (F.R.); (S.R.P.); (A.P.); (V.M.)
| | - Giusy Elia
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (S.M.F.); (I.R.); (G.E.); (F.R.); (S.R.P.); (A.P.); (V.M.)
| | - Francesca Ragusa
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (S.M.F.); (I.R.); (G.E.); (F.R.); (S.R.P.); (A.P.); (V.M.)
| | - Sabrina Rosaria Paparo
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (S.M.F.); (I.R.); (G.E.); (F.R.); (S.R.P.); (A.P.); (V.M.)
| | - Armando Patrizio
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (S.M.F.); (I.R.); (G.E.); (F.R.); (S.R.P.); (A.P.); (V.M.)
| | - Valeria Mazzi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (S.M.F.); (I.R.); (G.E.); (F.R.); (S.R.P.); (A.P.); (V.M.)
| | - Gilda Varricchi
- Department of Translational Medical Sciences and Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, 80138 Naples, Italy; (M.R.G.); (G.V.); (G.M.)
- WAO Center of Excellence, 80138 Naples, Italy
| | - Gianni Marone
- Department of Translational Medical Sciences and Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, 80138 Naples, Italy; (M.R.G.); (G.V.); (G.M.)
- WAO Center of Excellence, 80138 Naples, Italy
- Institute of Experimental Endocrinology and Oncology “Gaetano Salvatore” (IEOS), National Research Council (CNR), 80131 Naples, Italy
| | - Alessandro Antonelli
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (S.M.F.); (I.R.); (G.E.); (F.R.); (S.R.P.); (A.P.); (V.M.)
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14
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Shobab L, Gomes-Lima C, Zeymo A, Feldman R, Jonklaas J, Wartofsky L, Burman KD. Clinical, Pathological, and Molecular Profiling of Radioactive Iodine Refractory Differentiated Thyroid Cancer. Thyroid 2019; 29:1262-1268. [PMID: 31319763 DOI: 10.1089/thy.2019.0075] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background: Six to 20% of thyroid cancer (TC) patients develop distant metastases, and one-third become radioiodine refractory (RAIR). Available targeted therapies increase progression-free survival but are associated with toxicities. This study aims to characterize clinical, pathological, and molecular profiles of patients with RAIR TC. Methods: Data of TC patients seen during 2013-2017 at two tertiary care centers were retrospectively analyzed. Patients were considered RAIR according to American Thyroid Association guidelines. The control cohort was sex matched and age matched and had either regression or stable disease (by Response Evaluation Criteria in Solid Tumors) on follow-up at least three years after initial therapy. Molecular profiles on a subset of RAIR patients were reviewed. Results: Compared with 22 matched controls, 54 RAIR patients had an average age of 57 years (standard deviation [SD] = 13), 56% were male (41% in the control group); the average tumor size was 4 cm (SD = 2.5); tumors were multifocal in 54%, with involved surgical margins in 42%, focal invasion in 79%, and extrathyroidal extension (ETE) in 61%. Sixty-six percent had distant metastases at initial presentation with metastases to the lungs in 85%, bone in 56%, both sites in 43%, brain in 9%, and liver in 4%. There were no statistically significant differences between RAIR and controls in tumor size, focal invasion, ETE, and histology. The RAIR group received a higher cumulative radioactive iodine (RAI) dose and number of therapies compared with the controls (518 mCi vs. 302 mCi, p = 0.002 and 2.2 vs. 1.3 treatments, p = 0.001). Overall, patients >46 years had 4.5 times higher odds ratio (OR) of being RAIR; white race/ethnicity was associated with a reduced OR of RAIR disease (OR 0.33, p = 0.079). Molecular profiling data in the RAIR subgroup indicated that 50% of patients harbored mutations in the RAS/RAF pathway (11/22). Among 19 patients with a more extensive molecular panel, median tumor mutational burden was 5 megabase (range 3-16) and 26% (5/19) exhibited strong PD-L1 positivity. Conclusion: Among patients with metastatic differentiated thyroid carcinomas, patients with RAIR have similar histopathological and clinical characteristics as patients with RAI avid cancer. The risk of having RAIR TC is increased at age ≥46 and reduced in Caucasians.
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Affiliation(s)
- Leila Shobab
- MedStar Washington Hospital Center, Division of Endocrinology, Washington, District of Columbia
| | - Cristiane Gomes-Lima
- MedStar Washington Hospital Center, Division of Endocrinology, Washington, District of Columbia
| | - Alexander Zeymo
- Medstar Health Research Institute, Department of Research Biostatistics, Washington, District of Columbia
| | | | - Jacqueline Jonklaas
- MedStar Georgetown University Hospital, Division of Endocrinology, Washington, District of Columbia
| | - Leonard Wartofsky
- MedStar Washington Hospital Center, Division of Endocrinology, Washington, District of Columbia
| | - Kenneth D Burman
- MedStar Washington Hospital Center, Division of Endocrinology, Washington, District of Columbia
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Walczyk A, Kopczyński J, Gąsior-Perczak D, Pałyga I, Kowalik A, Chrapek M, Hejnold M, Góźdź S, Kowalska A. Poorly differentiated thyroid cancer in the context of the revised 2015 American Thyroid Association Guidelines and the Updated American Joint Committee on Cancer/Tumor-Node-Metastasis Staging System (eighth edition). Clin Endocrinol (Oxf) 2019; 91:331-339. [PMID: 30525210 DOI: 10.1111/cen.13910] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Revised: 11/06/2018] [Accepted: 12/02/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Poorly differentiated thyroid cancer (PDTC) is a rare, but aggressive thyroid cancer (TC) and a main cause of death from non-anaplastic follicular cell-derived TC. Assessing the risk of PDTC-related death and the risk of recurrence is important for clinicians. The recent American Thyroid Association (ATA) 2015 guidelines and the updated 8th edition of the American Joint Committee on Cancer/Tumor-Node-Metastasis (AJCC/TNM) staging system should support clinicians in the management approach to PDTC patients. PATIENTS Forty-six consecutive PDTC patients treated in a single oncologic centre, 2000-2017. MEASUREMENTS Retrospective analysis of TNM stage, initial risk, response-to-therapy categories, follow-up and final disease status incorporating the ATA 2015 criteria and the 8th AJCC/TNM staging system. Disease-specific survival (DSS) using the Kaplan-Meier method. RESULTS Of the 46 PDTC 21 (45.6%) were ATA high risk (HR), 22 (47.8%), 17 (37%) and seven (15.2%) were TNM stages I, II, and III-IV, respectively. During a median follow-up of 55.5 months, two (4.3%) patients were recurrent, 18 (39.1%) died of PDTC. The 5-/10-year DSS were 65/57%, respectively. According to the AJCC/TNM, the 5-/10-year DSS of I, II, and III-IV stage were 83/83%; 77/55%, and 0/0%, respectively. According to the 2015 ATA initial risk, the 5-/10-year DSS were 91/72% for ATA intermediate risk and 38/38% for ATA HR patients. CONCLUSIONS In PDTC patients, the updated AJCC/TNM staging system accurately predicts a high risk of death in stage III-IV, whereas it seems to be inadequate for predicting a very low or low risk of death expected for differentiated TC in stage I-II. The ATA initial HR may be also used to predict a high risk of PDTC-related death.
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Affiliation(s)
- Agnieszka Walczyk
- Department of Endocrinology, Holycross Cancer Center, Kielce, Poland
| | - Janusz Kopczyński
- Department of Surgical Pathology, Holycross Cancer Center, Kielce, Poland
| | | | - Iwona Pałyga
- Department of Endocrinology, Holycross Cancer Center, Kielce, Poland
| | - Artur Kowalik
- Department of Molecular Diagnostics, Holycross Cancer Center, Kielce, Poland
| | - Magdalena Chrapek
- Faculty of Mathematics and Natural Sciences, Department of Probability Theory and Statistics Institute of Mathematics, Jan Kochanowski University, Kielce, Poland
| | - Maria Hejnold
- Department of Surgical Pathology, Holycross Cancer Center, Kielce, Poland
| | - Stanisław Góźdź
- Department of Clinical Oncology, Holycross Cancer Center, Kielce, Poland
- The Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Aldona Kowalska
- Department of Endocrinology, Holycross Cancer Center, Kielce, Poland
- The Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
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Shang H, Wang S, Yao J, Guo C, Dong J, Liao L. Salidroside inhibits migration and invasion of poorly differentiated thyroid cancer cells. Thorac Cancer 2019; 10:1469-1478. [PMID: 31120636 PMCID: PMC6558470 DOI: 10.1111/1759-7714.13096] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 02/06/2019] [Revised: 04/29/2019] [Accepted: 05/03/2019] [Indexed: 12/15/2022] Open
Abstract
Background No effective treatment is currently available for poorly differentiated thyroid cancer which is resistant to radioiodine, especially with migration and invasion. A great number of researches have revealed the anticancer effects of salidroside, but none have studied the effects of salidroside on thyroid cancer. This study aimed to investigate the effect of salidroside on migration and invasion of poorly differentiated thyroid cancer cells. Methods The effects of salidroside on migration, invasion and apoptosis of poorly differentiated thyroid cancer WRO cells and normal thyroid follicular epithelial Nthy‐ori 3‐1 cells were measured by wound‐healing assay, transwell migration/invasion assay and flow cytometry, respectively. The expression levels of MMP2 and MMP9 at RNA and protein levels in WRO cells were detected by qRT‐PCR and western blot. The phosphorylation levels of Janus kinase 2 (JAK2), signal transducer and activator of transcription 3 (STAT3) and the apoptosis‐related protein levels of Bax, cleaved caspase 3 and Bcl‐2 were assessed by western blot. Results Salidroside significantly suppressed migration/invasion and induced apoptosis in poorly differentiated thyroid cancer WRO cells. We further illustrated that salidroside significantly inhibited expressions of MMP2 and MMP9 at mRNA and protein levels and the phosphorylation activation of JAK2/STAT3 in WRO cells. In addition, salidroside increased expressions of pro‐apoptotic factors (Bax and cleaved caspase 3) and decreased expression of anti‐apoptotic factor (Bcl‐2) significantly in WRO cells. Conclusion The present study demonstrates that salidroside inhibits migration and invasion of WRO cells (a kind of poorly differentiated cancer cell line) significantly, which might be via suppressing JAK2‐STAT3 signaling pathway.
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Affiliation(s)
- Hongxia Shang
- Division of Endocrinology, Department of Medicine, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, China
| | - Shengnan Wang
- Shandong Provincial Qianfoshan Hospital, the First Hospital Affiliated with Shandong First Medical University, Jinan, China
| | - Jinming Yao
- Division of Endocrinology, Department of Medicine, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, China
| | - Congcong Guo
- Division of Endocrinology, Department of Medicine, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, China
| | - Jianjun Dong
- Division of Endocrinology, Department of Medicine, Qilu Hospital of Shandong University, Jinan, China
| | - Lin Liao
- Division of Endocrinology, Department of Medicine, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, China
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17
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Wächter S, Wunderlich A, Roth S, Mintziras I, Maurer E, Hoffmann S, Verburg FA, Fellinger SA, Holzer K, Bartsch DK, Di Fazio P. Individualised Multimodal Treatment Strategies for Anaplastic and Poorly Differentiated Thyroid Cancer. J Clin Med 2018; 7:E115. [PMID: 29762469 PMCID: PMC5977154 DOI: 10.3390/jcm7050115] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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: 04/16/2018] [Revised: 05/08/2018] [Accepted: 05/09/2018] [Indexed: 02/07/2023] Open
Abstract
The prognosis of anaplastic (ATC) and poorly differentiated thyroid cancer (PDTC) is poor, due to their radioiodine refractoriness (RAI-R), high metastatic potential and current lack of effective treatment strategies. We aimed to examine the efficacy of the tyrosine kinase inhibitors (TKIs) sorafenib and selumetinib and the histone deacetylase inhibitor (HDACI) panobinostat in patient-derived tumor tissue (PDTT) of ATCs/PDTCs, the expression of sodium iodide symporter (NIS) and radioiodine up-take (RAI-U). High Mobility Group AT-Hook 2 (HMGA2) and associated miRNAs expression was correlated with the clinical course of the patients. Inhibitory effects of panobinostat, sorafenib and selumetinib were measured by real time cell analyser xCELLigence in five PDTTs and human foreskin fibroblasts (HF) used as control. Expression of NIS, HMGA2 and associated miRNAs hsa-let-7f-5p, hsa-let-7b-5p, hsa-miR-146b-5p and hsa-miR-146b-3p was performed by RT-qPCR and Western blot. RAI-U was performed by Gamma Counter with I-131. Panobinostat showed the strongest cytotoxic effect (10 nM) in all PDTTs and HF and caused a significant over-expression of NIS transcript. TKIs were able to up-regulate NIS transcript in patient 5 and in HF. RAI-U was up-regulated after 24 h of treatment with TKIs and panobinostat in all PDTT and HF, except in patient 5. Selumetinib caused a significant suppression of HMGA2 in PDTT 1, 2, 4, 5 and HF; whereas sorafenib caused no change of HMGA2 expression. Panobinostat suppressed significantly HMGA2 in PDTT 2, 4 and HF. The expression of miRNAs hsa-let-7f-5p, has-let-7b-5p hsa-miR-146b-5p and hsa-miR-146b-3p was modulated heterogeneously. NIS protein level was over-expressed in three PDTTs (patients 1, 3 and 4) after 24 h of treatment with selumetinib, sorafenib and in particular with panobinostat. HF showed a stable NIS protein level after treatment. Panobinostat showed the strongest cytotoxicity in all treated PDTTs at the lowest dosage in comparison with TKI. All three compounds were able to modulate differently NIS, HMGA2 and related miRNAs. These factors represent valuable markers in PDTT for new treatment strategies for patients suffering from ATC/PDTC. Thus, the establishment of PDTT could be a useful tool to test the efficacy of compounds and to develop new and individualised multimodal treatment options for PDTCs and ATCs.
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Affiliation(s)
- Sabine Wächter
- Department of Visceral, Thoracic and Vascular Surgery, Philipps University Marburg, Baldingerstrasse, D-35043 Marburg, Germany.
| | - Annette Wunderlich
- Department of Visceral, Thoracic and Vascular Surgery, Philipps University Marburg, Baldingerstrasse, D-35043 Marburg, Germany.
| | - Silvia Roth
- Department of Visceral, Thoracic and Vascular Surgery, Philipps University Marburg, Baldingerstrasse, D-35043 Marburg, Germany.
| | - Ioannis Mintziras
- Department of Visceral, Thoracic and Vascular Surgery, Philipps University Marburg, Baldingerstrasse, D-35043 Marburg, Germany.
| | - Elisabeth Maurer
- Department of Visceral, Thoracic and Vascular Surgery, Philipps University Marburg, Baldingerstrasse, D-35043 Marburg, Germany.
| | - Sebastian Hoffmann
- Department of Visceral, Thoracic and Vascular Surgery, Philipps University Marburg, Baldingerstrasse, D-35043 Marburg, Germany.
| | - Frederik A Verburg
- Department of Nuclear Medicine, Philipps University Marburg, Baldingerstrasse, D-35043 Marburg, Germany.
| | - Sebastian A Fellinger
- Department of Nuclear Medicine, Philipps University Marburg, Baldingerstrasse, D-35043 Marburg, Germany.
| | - Katharina Holzer
- Department of Visceral, Thoracic and Vascular Surgery, Philipps University Marburg, Baldingerstrasse, D-35043 Marburg, Germany.
| | - Detlef K Bartsch
- Department of Visceral, Thoracic and Vascular Surgery, Philipps University Marburg, Baldingerstrasse, D-35043 Marburg, Germany.
| | - Pietro Di Fazio
- Department of Visceral, Thoracic and Vascular Surgery, Philipps University Marburg, Baldingerstrasse, D-35043 Marburg, Germany.
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Romei C, Tacito A, Molinaro E, Piaggi P, Cappagli V, Pieruzzi L, Matrone A, Viola D, Agate L, Torregrossa L, Ugolini C, Basolo F, De Napoli L, Curcio M, Ciampi R, Materazzi G, Vitti P, Elisei R. Clinical, pathological and genetic features of anaplastic and poorly differentiated thyroid cancer: A single institute experience. Oncol Lett 2018; 15:9174-9182. [PMID: 29805648 PMCID: PMC5958691 DOI: 10.3892/ol.2018.8470] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 09/02/2017] [Accepted: 01/22/2018] [Indexed: 01/11/2023] Open
Abstract
Anaplastic (ATC) and poorly differentiated thyroid cancer (PDTC) are very aggressive cancers whose histological diagnosis is not always straightforward. Clinical, pathological and genetic features may be useful to improve the identification of these rare histotypes. In the present study the clinical, pathological and genetic features of two groups of ATC (n=21) and PDTC (n=21) patients were analyzed. Clinical data were retrieved from a computerized database. The oncogenic profiles were studied using the Sanger sequencing method of a selected series of oncogenes and/or tumor suppressor genes known to be altered in these tumors. The presence of macrophages in both series of tissues was evaluated by immunohistochemistry. Patients with ATC were older and affected by a more advanced disease at diagnosis than those with PDTC. The median survival was significantly shorter in ATC compared with PDTC patients (P=0.0014). ATC showed a higher prevalence of TP53 and TERT mutations (10/21, 47.6% and 9/21, 42.8%, respectively) while TERT and BRAF mutations were the most prevalent in the PDTC group (7/21, 33.3% and 4/23, 19% respectively). Genetic heterogeneity (i.e., >2 mutations) was more frequent in ATC (10/21, 28.6%) compared with in PDTC (3/21, 4.7%) (P=0.03). Macrophages were more frequently present in ATC, particularly in those cases with TP53 mutations. In conclusion, these data indicate that ATC and PDTC may be characterized by different clinical, pathological and genetic profiles. In particular ATC, but not PDTC, were positive for TP53 and PTEN alterations. Complex mutations were also found in ATC but not in PDTC. Moreover, genetic heterogeneity was more frequent in ATC than PDTC. Finally, TP53 mutation and the accumulation of several mutations correlated with a shorter survival time.
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Affiliation(s)
- Cristina Romei
- Endocrine Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, I-56124 Pisa, Italy
| | - Alessia Tacito
- Endocrine Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, I-56124 Pisa, Italy
| | - Eleonora Molinaro
- Endocrine Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, I-56124 Pisa, Italy
| | - Paolo Piaggi
- Endocrine Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, I-56124 Pisa, Italy
| | - Virginia Cappagli
- Endocrine Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, I-56124 Pisa, Italy
| | - Letizia Pieruzzi
- Endocrine Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, I-56124 Pisa, Italy
| | - Antonio Matrone
- Endocrine Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, I-56124 Pisa, Italy
| | - David Viola
- Endocrine Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, I-56124 Pisa, Italy
| | - Laura Agate
- Endocrine Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, I-56124 Pisa, Italy
| | - Liborio Torregrossa
- Department of Surgical, Medical and Molecular Pathology, University Hospital of Pisa, I-56124 Pisa, Italy
| | - Clara Ugolini
- Department of Surgical, Medical and Molecular Pathology, University Hospital of Pisa, I-56124 Pisa, Italy
| | - Fulvio Basolo
- Department of Surgical, Medical and Molecular Pathology, University Hospital of Pisa, I-56124 Pisa, Italy
| | - Luigi De Napoli
- Department of Surgical, Medical and Molecular Pathology, University Hospital of Pisa, I-56124 Pisa, Italy
| | - Michele Curcio
- Division of Transfusion Medicine and Transplant Biology, University Hospital of Pisa, I-56124 Pisa, Italy
| | - Raffaele Ciampi
- Endocrine Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, I-56124 Pisa, Italy
| | - Gabriele Materazzi
- Department of Surgical, Medical and Molecular Pathology, University Hospital of Pisa, I-56124 Pisa, Italy
| | - Paolo Vitti
- Endocrine Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, I-56124 Pisa, Italy
| | - Rossella Elisei
- Endocrine Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, I-56124 Pisa, Italy
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Liu L, Li D, Wang H, Yang X, Yu Y, Gao M. Multifocality predicts poor outcome of patients with insular thyroid cancer: a clinicopathological study. Int J Clin Exp Pathol 2015; 8:11212-11217. [PMID: 26617844 PMCID: PMC4637659] [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] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Accepted: 08/26/2015] [Indexed: 06/05/2023]
Abstract
Insular thyroid carcinoma (ITC) is a rare type of thyroid malignancy whose aggressiveness and propensity to local recurrence differentiate it from other thyroid malignancies. However, data pertaining to its clinical characteristics is still lacking. In this study, we retrospectively analyzed 10 ITC patients treated and followed in Tianjin Medical University Cancer Institute and Hospital during Apr 2007 to Aug 2010, and compared the clinical and pathological characteristics and long-term follow-up with 2220 patients with papillary thyroid carcinoma (PTC). These ten ITC cases comprised 7 women and 3 men, of whom 6 patients are multifocal ITC (mITC) and showed cervical lymph node metastasis to the lateral compartment, while the other 4 solitary ITC (sITC) had regional metastasis confined to level VI or even no cervical metastasis. The ITC group had more frequent retrosternal metastasis (40% vs. 7.5%), recurrent laryngeal nerve invasion (40% vs. 4.4%), esophageal invasion (50% vs. 1.9%), a higher proportion of distant metastasis (50% vs. 3.2%), and vascular invasion (50% vs. 1.0%). While the presence of lymph node metastasis showed no significant difference. Interestingly, although patients with ITC are lacking in number to perform survival analysis, we still noticed that all the four sITC patients (4/4, 100%) have survived much longer (at least 45 months) than those who have multinodularity (mITC, 5/6, 83.3%). Our results indicated that ITC is an aggressive disease and the presence of multifocality might be a risk factor for long time survival of ITC patients.
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Affiliation(s)
- Lei Liu
- Department of Otorhinolaryngology, Tianjin Third Central HospitalTianjin, China
| | - Dapeng Li
- Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for CancerTianjin, China
- Key Laboratory of Cancer Prevention and TherapyTianjin, China
| | - Hailing Wang
- Department of Diagnostic and Therapeutic Ultrasonography, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for CancerTianjin, China
- Key Laboratory of Cancer Prevention and TherapyTianjin, China
| | - Xiaoyong Yang
- Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for CancerTianjin, China
- Key Laboratory of Cancer Prevention and TherapyTianjin, China
| | - Yang Yu
- Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for CancerTianjin, China
- Key Laboratory of Cancer Prevention and TherapyTianjin, China
| | - Ming Gao
- Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for CancerTianjin, China
- Key Laboratory of Cancer Prevention and TherapyTianjin, China
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Abstract
Besides its classical role in bone and calcium homeostasis, 1,25-dihydroxyvitamin D3 (1,25(OH)2D3), the active form of vitamin D, has many non-classical effects; antiproliferative, anti-apoptotic and prodifferentiating effects of 1,25(OH)2D3 have been described in several tumour types in preclinical models. This review focuses on the insights gained in the elucidation of the role of 1,25(OH)2D3 in the normal thyroid and in the pathogenesis, progression and treatment of thyroid cancer, the most common endocrine malignancy. An increasing amount of observations points towards a role for impaired 1,25(OH)2D3-VDR signalling in the occurrence and progression of thyroid cancer, and a potential for structural analogues in the multimodal treatment of dedifferentiated iodine-resistant thyroid cancer. A role for vitamin D in thyroid-related autoimmunity is less convincing and needs further study. Altered 1,25(OH)2D3-VDR signalling does not influence normal thyroid development nor thyrocyte function, but does affect C-cell function, at least in rodents. If these findings also apply to humans deserves further study.
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Affiliation(s)
- Isabelle Clinckspoor
- Laboratory of Clinical and Experimental Endocrinology, KU Leuven, Bus 902, Herestraat 49, 3000 Leuven, Belgium
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