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Qu L, Ding S, Long Q, Zheng S, Chen ZS, Yi W. Editorial: DNA methylation, tumor microenvironment and their effects in immunotherapy and drug resistance in thoracic tumors. Front Immunol 2024; 15:1357278. [PMID: 38288309 PMCID: PMC10822968 DOI: 10.3389/fimmu.2024.1357278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 01/04/2024] [Indexed: 01/31/2024] Open
Affiliation(s)
- Limeng Qu
- Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Shirong Ding
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Qian Long
- Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center For Breast Disease In Hunan Province, Changsha, China
| | - Shaoquan Zheng
- Department of Breast Surgery, Breast Disease Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhe-Sheng Chen
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St John’s University, Queens, NY, United States
| | - Wenjun Yi
- Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center For Breast Disease In Hunan Province, Changsha, China
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Chen L, Chen F, Niu H, Li J, Pu Y, Yang C, Wang Y, Huang R, Li K, Lei Y, Huang Y. Chimeric Antigen Receptor (CAR)-T Cell Immunotherapy Against Thoracic Malignancies: Challenges and Opportunities. Front Immunol 2022; 13:871661. [PMID: 35911706 PMCID: PMC9334018 DOI: 10.3389/fimmu.2022.871661] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/14/2022] [Indexed: 11/13/2022] Open
Abstract
Different from surgery, chemical therapy, radio-therapy and target therapy, Chimeric antigen receptor-modified T (CAR-T) cells, a novel adoptive immunotherapy strategy, have been used successfully against both hematological tumors and solid tumors. Although several problems have reduced engineered CAR-T cell therapeutic outcomes in clinical trials for the treatment of thoracic malignancies, including the lack of specific antigens, an immunosuppressive tumor microenvironment, a low level of CAR-T cell infiltration into tumor tissues, off-target toxicity, and other safety issues, CAR-T cell treatment is still full of bright future. In this review, we outline the basic structure and characteristics of CAR-T cells among different period, summarize the common tumor-associated antigens in clinical trials of CAR-T cell therapy for thoracic malignancies, and point out the current challenges and new strategies, aiming to provide new ideas and approaches for preclinical experiments and clinical trials of CAR-T cell therapy for thoracic malignancies.
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Affiliation(s)
- Long Chen
- Department of PET/CT Center, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Kunming, China
| | - Fukun Chen
- Department of Nuclear Medicine, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Kunming, China
| | - Huatao Niu
- Department of Neurosurgery, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Kunming, China
| | - Jindan Li
- Department of PET/CT Center, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Kunming, China
| | - Yongzhu Pu
- Department of PET/CT Center, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Kunming, China
| | - Conghui Yang
- Department of PET/CT Center, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Kunming, China
| | - Yue Wang
- Department of PET/CT Center, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Kunming, China
| | - Rong Huang
- Department of PET/CT Center, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Kunming, China
| | - Ke Li
- Department of Cancer Biotherapy Center, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Kunming, China
- *Correspondence: Yunchao Huang, ; Yujie Lei, ; Ke Li,
| | - Yujie Lei
- Department of Thoracic Surgery I, Key Laboratory of Lung Cancer of Yunnan Province, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Kunming, China
- *Correspondence: Yunchao Huang, ; Yujie Lei, ; Ke Li,
| | - Yunchao Huang
- Department of Thoracic Surgery I, Key Laboratory of Lung Cancer of Yunnan Province, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Kunming, China
- *Correspondence: Yunchao Huang, ; Yujie Lei, ; Ke Li,
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Gantzer J, Davidson G, Vokshi B, Weingertner N, Bougoüin A, Moreira M, Lindner V, Lacroix G, Mascaux C, Chenard MP, Bertucci F, Davidson I, Kurtz JE, Sautès-Fridman C, Fridman WH, Malouf GG. OUP accepted manuscript. Oncologist 2022; 27:501-511. [PMID: 35278076 PMCID: PMC9177113 DOI: 10.1093/oncolo/oyac040] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 01/14/2022] [Indexed: 11/14/2022] Open
Abstract
Background Thoracic SMARCA4-deficient undifferentiated tumors (SMARCA4-UT) are aggressive neoplasms. Data linking BAF alterations with tumor microenvironment (TME) and efficacy of immune checkpoint inhibitors (ICI) are contradictory. The TME of SMARCA4-UT and their response to ICI are unknown. Materials and Methods Patients diagnosed with SMARCA4-UT in our institution were included. Immunostainings for tertiary lymphoid structures (TLS), immune cell markers, and checkpoints were assessed. Validation was performed using an independent transcriptome dataset including SMARCA4-UT, non–small cell lung cancers (NSCLC) with/without SMARCA4 mutations, and unclassified thoracic sarcomas (UTS). CXCL9 and PD-L1 expressions were assessed in NSCLC and thoracic fibroblast cell lines, with/without SMARCA4 knockdown, treated with/without interferon gamma. Results Nine patients were identified. All samples but one showed no TLS, consistent with an immune desert TME phenotype. Four patients received ICI as part of their treatment, but the only one who responded, had a tumor with a TLS and immune-rich TME. Unsupervised clustering of the validation cohort using immune cell scores identified 2 clusters associated with cell ontogeny and immunity (cluster 1 enriched for NSCLC independently of SMARCA4 status (n = 9/10; P = .001); cluster 2 enriched for SMARCA4-UT (n = 11/12; P = .005) and UTS (n = 5/5; P = .0005). SMARCA4 loss-of-function experiments revealed interferon-induced upregulation of CXCL9 and PD-L1 expression in the NSCLC cell line with no effect on the thoracic fibroblast cell line. Conclusion SMARCA4-UT mainly have an immune desert TME with limited efficacy to ICI. TME of SMARCA4-driven tumors varies according to the cell of origin questioning the interplay between BAF alterations, cell ontogeny and immunity.
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Affiliation(s)
- Justine Gantzer
- Corresponding author: Justine Gantzer, Department of Medical Oncology, Strasbourg-Europe Cancer Institute (ICANS), 17 rue Albert Calmette, 67033 Strasbourg, France. Tel: +33 3 68 76 72 25;
| | - Guillaume Davidson
- Department of Cancer and Functional Genomics, INSERM UMR_S1258, Institute of Genetics and of Molecular and Cellular Biology, Illkirch, France
| | - Bujamin Vokshi
- Department of Cancer and Functional Genomics, INSERM UMR_S1258, Institute of Genetics and of Molecular and Cellular Biology, Illkirch, France
| | - Noëlle Weingertner
- Fédération de Médecine Translationnelle (FMTS), Strasbourg, France
- Department of Pathology, University Hospital, Strasbourg, France
| | - Antoine Bougoüin
- Centre de recherche des Cordeliers, INSERM, Université de Paris, Sorbonne Université, Team 13- Complement, Inflammation and Cancer, Équipe labellisée Ligue contre le cancer, Paris, France
| | - Marco Moreira
- Centre de recherche des Cordeliers, INSERM, Université de Paris, Sorbonne Université, Team 13- Complement, Inflammation and Cancer, Équipe labellisée Ligue contre le cancer, Paris, France
| | - Véronique Lindner
- Fédération de Médecine Translationnelle (FMTS), Strasbourg, France
- Department of Pathology, University Hospital, Strasbourg, France
| | - Guillaume Lacroix
- Centre de recherche des Cordeliers, INSERM, Université de Paris, Sorbonne Université, Team 13- Complement, Inflammation and Cancer, Équipe labellisée Ligue contre le cancer, Paris, France
| | - Céline Mascaux
- Department of Pneumology, University Hospital, Strasbourg, France
- University of Strasbourg, Inserm UMR_S 1113, IRFAC, Laboratory Streinth (STress REsponse and INnovative THerapy against cancer), Strasbourg, France
| | - Marie-Pierre Chenard
- Fédération de Médecine Translationnelle (FMTS), Strasbourg, France
- Department of Pathology, University Hospital, Strasbourg, France
| | - François Bertucci
- Department of Medical Oncology, Cancer Research Center of Marseille (CRCM), INSERM U1068, CNRS UMR7258, Institut Paoli Calmettes, Aix-Marseille University, Marseille, France
| | - Irwin Davidson
- Department of Cancer and Functional Genomics, INSERM UMR_S1258, Institute of Genetics and of Molecular and Cellular Biology, Illkirch, France
| | - Jean-Emmanuel Kurtz
- Department of Medical Oncology, Strasbourg-Europe Cancer Institute (ICANS), Strasbourg, France
- Fédération de Médecine Translationnelle (FMTS), Strasbourg, France
| | - Catherine Sautès-Fridman
- Centre de recherche des Cordeliers, INSERM, Université de Paris, Sorbonne Université, Team 13- Complement, Inflammation and Cancer, Équipe labellisée Ligue contre le cancer, Paris, France
| | | | - Gabriel G Malouf
- Gabriel G. Malouf, Department of Medical Oncology, Strasbourg-Europe Cancer Institute (ICANS), 17 rue Albert Calmette, 67033 Strasbourg, France. Tel: +33 3 68 76 72 17;
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Remon J, Facchinetti F, Besse B. The efficacy of immune checkpoint inhibitors in thoracic malignancies. Eur Respir Rev 2021; 30:200387. [PMID: 34615702 PMCID: PMC9489136 DOI: 10.1183/16000617.0387-2020] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 02/18/2021] [Indexed: 01/22/2023] Open
Abstract
The advent of immune checkpoint inhibitors (ICIs) has rapidly transformed the treatment paradigm for multiple cancer types, including thoracic malignancies. In advanced non-small cell lung cancer (NSCLC), ICIs have shifted treatment paradigm and improved overall survival reaching almost one-third of patients alive at 5 years. ICIs therapies have also modified the therapeutic strategy in first-line setting in metastatic small-cell lung cancer (SCLC) patients as well as in malignant pleural mesothelioma (MPM) improving the overall survival compared with standard treatment. This phenomenon is of huge relevance as both SCLC and MPM were considered orphan diseases without any significant improvement in the therapeutic strategy in the first-line setting during the last 15 years. In this review, we aim to review the efficacy of ICI in thoracic malignancies either in monotherapy or in combination, according to predictive biomarkers, and to the US Food and Drug Administration and the European Medicines Agency approvals of treatment strategies. We address the efficacy of these agents, especially in NSCLC according to PD-L1 expression and histologic subtype.
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Affiliation(s)
- Jordi Remon
- Dept of Medical Oncology, Centro Integral Oncológico Clara Campal (HM-CIOCC), Hospital HM Delfos, HM Hospitales, Barcelona, Spain
| | - Francesco Facchinetti
- Université Paris-Saclay, Institut Gustave Roussy, Inserm, Biomarqueurs Prédictifs et Nouvelles Stratégies Thérapeutiques en Oncologie, Villejuif, France
| | - Benjamin Besse
- Dept of Cancer Medicine, Gustave Roussy Cancer Campus, Villejuif, France
- Université Paris-Saclay, Paris, France
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Otsubo K, Sakai H, Kimura H, Miyazawa T, Marushima H, Kojima K, Furuya N, Mineshita M, Chosokabe M, Koike J, Saji H. Thoracic mesenchymal malignant tumors and programed cell death ligand-1 status: Clinicopathologic and prognostic analysis of eight pulmonary sarcomatoid carcinomas and eight malignant mesotheliomas. Thorac Cancer 2021; 12:3169-3176. [PMID: 34655161 PMCID: PMC8636199 DOI: 10.1111/1759-7714.14177] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/14/2021] [Accepted: 09/16/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The current study aimed to evaluate the significance of clinicopathological factors, particularly the immunohistochemistry of programed cell death ligand-1 (PD-L1), in eight cases each of pulmonary sarcomatoid carcinoma (PSC) and malignant pleural mesothelioma (MPM) at our hospital. METHODS From January 2004 to December 2020, a total of 16 consecutive patients (eight with PSC and eight with MPM diagnosed via surgical resection or biopsy) were included in this study. After retrospectively reviewing the patient characteristics, the associations between PD-L1 status and age, sex, stage, histological type, and prognosis were investigated. RESULTS PD-L1-positive staining was observed in four (50%) PSC cases and one (12.5%) MPM case. Among the four PD-L1-positive PSC cases, two showed high PD-L1 expression in the vimentin-positive sarcomatoid compartment. Moreover, among those with PSC, two survived for about 10 years, whereas the others died within 5 years. No clear correlation was found between PD-L1 expression and prognosis. Among the patients with MPM, four survived for more than 2 years, with the longest being 9 years. Among MPM cases who received nivolumab, one patient with positive PD-L1 staining in the sarcomatoid survived, whereas the other with negative PD-L1 staining did not. CONCLUSION The present study showed that sarcomatoid carcinoma had a higher PD-L1 expression compared to non-small-cell lung cancer and that both PSC and MPM tended to exhibit PD-L1 positivity in the sarcomatoid compartment. Moreover, while immune checkpoint inhibitors may somewhat prolong the prognosis of both tumors, further studies with a larger cohort are necessary to confirm our results.
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Affiliation(s)
- Kanji Otsubo
- Departments of Chest SurgerySt. Marianna University School of MedicineKawasakiJapan
| | - Hiroki Sakai
- Departments of Chest SurgerySt. Marianna University School of MedicineKawasakiJapan
| | - Hiroyuki Kimura
- Departments of Chest SurgerySt. Marianna University School of MedicineKawasakiJapan
| | - Tomoyuki Miyazawa
- Departments of Chest SurgerySt. Marianna University School of MedicineKawasakiJapan
| | - Hideki Marushima
- Departments of Chest SurgerySt. Marianna University School of MedicineKawasakiJapan
| | - Koji Kojima
- Departments of Chest SurgerySt. Marianna University School of MedicineKawasakiJapan
| | - Naoki Furuya
- Division of Respiratory Medicine, Department of Internal MedicineSt. Marianna University School of MedicineKawasakiJapan
| | - Masamichi Mineshita
- Division of Respiratory Medicine, Department of Internal MedicineSt. Marianna University School of MedicineKawasakiJapan
| | - Motohiro Chosokabe
- Department of PathologySt. Marianna University School of MedicineKawasakiJapan
| | - Junki Koike
- Department of PathologySt. Marianna University School of MedicineKawasakiJapan
| | - Hisashi Saji
- Departments of Chest SurgerySt. Marianna University School of MedicineKawasakiJapan
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Chen T, Wang Y, Goetz L, Corey Z, Dougher MC, Smith JD, Fox EJ, Freiberg AS, Flemming D, Fanburg-Smith JC. Novel fusion sarcomas including targetable NTRK and ALK. Ann Diagn Pathol 2021; 54:151800. [PMID: 34464935 DOI: 10.1016/j.anndiagpath.2021.151800] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 07/16/2021] [Accepted: 07/16/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Challenging emerging entities with distinctive molecular signatures may benefit from algorithms for diagnostic work-up. METHODS Fusion sarcomas (2020-2021, during pandemic) were diagnosed by clinicoradiology, morphology, phenotype, and next-generation sequencing (NGS). RESULTS Six fusion sarcomas in two males and four females involved the chest-wall, neck, or extremities; ages ranged 2-73, median 18 years. Sizes ranged 5.3-25.0, median 9.1 cm. These include high grade 1) TPR-NTRK1 of proximal femur with a larger rounded soft tissue mass, previously considered osteosarcoma yet without convincing tumor matrix. A pathologic fracture necessitated emergency hemipelvectomy (NED) and 2) novel KANK1-NTRK2 sarcoma of bone and soft tissue with spindled pleomorphic to epithelioid features (AWD metastases). 3) Novel ERC1-ALK unaligned fusion, a low grade infiltrative deep soft tissue hand sarcoma with prominent-vascularity, myopericytoid/lipofibromatosis-like ovoid cells, and collagenized stroma, was successfully treated with ALK-inhibitor (Crizotinib), avoiding amputation. These NTRK and ALK tumors variably express S100 and CD34 and were negative for SOX10. 4) and 5) CIC-DUX4 round cell tumors (rapid metastases/demise), one with COVID superinfection, were previously treated as Ewing sarcoma. These demonstrated mild pleomorphism and necrosis, variable myxoid change and CD99 reactivity, and a distinctive dot-like-Golgi WT1 immunostaining pattern. 6) A chest wall/thoracic round cell sarcoma, focal CD34/ keratins/CK7, revealed nuclear-STAT6, STAT6-NAB2 by NGS, confirming malignant solitary fibrous tumor, intermediate-risk-stratification (AWD metastases). CONCLUSIONS Recent fusion sarcomas include new KANK1-NTRK2 and ERC1-ALK, the latter successfully treated by targeted-therapy. ALK/NTRK fusion partners TPR and KANK1 suggest unusual high-grade morphology/behavior. Clinicoradiologic, morphologic, and phenotypic algorithms can prompt molecular-targeted immunostains or NGS for final classification and promising inhibitor therapy.
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Affiliation(s)
- Tiane Chen
- Penn State Health/Milton S. Hershey Medical Center/Penn State College of Medicine, United States of America; Penn State Health/Milton S. Hershey Medical Center/Penn State College of Medicine, Department of Pathology, United States of America
| | - Ying Wang
- Penn State Health/Milton S. Hershey Medical Center/Penn State College of Medicine, United States of America; Penn State Health/Milton S. Hershey Medical Center/Penn State College of Medicine, Department of Pathology, United States of America
| | - Lianna Goetz
- Penn State Health/Milton S. Hershey Medical Center/Penn State College of Medicine, United States of America; Penn State Health/Milton S. Hershey Medical Center/Penn State College of Medicine, Department of Pathology, United States of America
| | - Zachary Corey
- Penn State Health/Milton S. Hershey Medical Center/Penn State College of Medicine, United States of America
| | - Meaghan C Dougher
- Penn State Health/Milton S. Hershey Medical Center/Penn State College of Medicine, United States of America
| | | | - Edward J Fox
- Penn State Health/Milton S. Hershey Medical Center/Penn State College of Medicine, United States of America; Penn State Health/Milton S. Hershey Medical Center/Penn State College of Medicine, Department of Orthopaedics, United States of America
| | - Andrew S Freiberg
- Penn State Health/Milton S. Hershey Medical Center/Penn State College of Medicine, United States of America; Penn State Health/Milton S. Hershey Medical Center/Penn State College of Medicine, Department of Pediatrics, United States of America
| | - Donald Flemming
- Penn State Health/Milton S. Hershey Medical Center/Penn State College of Medicine, United States of America; Penn State Health/Milton S. Hershey Medical Center/Penn State College of Medicine, Department of Radiology, United States of America
| | - Julie C Fanburg-Smith
- Penn State Health/Milton S. Hershey Medical Center/Penn State College of Medicine, United States of America; Penn State Health/Milton S. Hershey Medical Center/Penn State College of Medicine, Department of Pathology, United States of America; Penn State Health/Milton S. Hershey Medical Center/Penn State College of Medicine, Department of Orthopaedics, United States of America; Penn State Health/Milton S. Hershey Medical Center/Penn State College of Medicine, Department of Pediatrics, United States of America.
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Carcamo B, Bista R, Wilson H, Reddy P, Pacheco J. Rapid Response to Lorlatinib in a Patient With TFG-ROS1 Fusion Positive Inflammatory Myofibroblastic Tumor of the Chest Wall Metastatic to the Brain and Refractory to First and Second Generation ROS1 Inhibitors. J Pediatr Hematol Oncol 2021; 43:e718-e722. [PMID: 34157012 DOI: 10.1097/mph.0000000000002185] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 02/24/2021] [Indexed: 12/12/2022]
Abstract
Most inflammatory myofibroblastic tumors (IMTs) harbor ALK fusions but oncogene fusions involving ROS1, RET, NTRK, and PDGFR also occur. The recognition that most IMTs harbor receptor tyrosine kinase fusions has provided a rationale for the use of tyrosine kinase inhibitors to target these oncogenic drivers in advanced IMTs. Crizotinib has been effective in ALK and ROS1-positive IMTs but resistance eventually develops. Here we report the successful use of lorlatinib in a patient with heavily pretreated ROS1-positive IMT of the chest wall with acquired crizotinib-resistance and metastasis to the brain.
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Affiliation(s)
- Benjamin Carcamo
- Department of Pediatrics, Division of Pediatric Hematology and Oncology, Paul L. Foster School of Medicine, Texas Tech University Health Science Center El Paso, El Paso
- El Paso Children's Hospital, El Paso, TX
| | - Ranjan Bista
- Department of Pediatrics, Division of Pediatric Hematology and Oncology, Paul L. Foster School of Medicine, Texas Tech University Health Science Center El Paso, El Paso
- El Paso Children's Hospital, El Paso, TX
| | - Harry Wilson
- Department of Pediatrics, Division of Pediatric Hematology and Oncology, Paul L. Foster School of Medicine, Texas Tech University Health Science Center El Paso, El Paso
| | | | - Jose Pacheco
- University of Colorado Cancer Center, Anschutz Medical Campus, Aurora CO
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Murakami E, Akamatsu H, Shimokawa T, Wada K, Yamamoto N. Furosemide versus mannitol in Japanese patients with thoracic malignancy who received cisplatin-based chemotherapy using short hydration: study protocol for a randomised controlled trial. BMJ Open 2019; 9:e029057. [PMID: 31831529 PMCID: PMC6924869 DOI: 10.1136/bmjopen-2019-029057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Cisplatin (CDDP) is a key drug for various thoracic malignancies. To avoid renal toxicity of CDDP, mannitol is routinely used, but it sometimes causes phlebitis which damages patients' quality of life. Furosemide is another widely used option for diuresis administered more quickly. To date, previous comparisons of these diuretics have lacked statistical significance owing to study design. We therefore undertake a randomised phase II comparative study of furosemide and mannitol in CDDP-based chemotherapy using short hydration. METHODS AND ANALYSIS This is a two-arm, prospective, randomised, single-centre, open-label phase II study. The primary endpoint is set as the proportion of patients who experienced any grade of 'creatinine increase' using the Common Terminology Criteria for Adverse Events V.4.0, during the first cycle. Secondary endpoints are: the proportion of patients who experienced ≥grade 2 of creatinine increase during the first cycle, any grade and ≥grade 2 of creatinine increase after the completion of fourth cycle, and the proportion of patients with phlebitis. Enrolled in this trial will be 105 patients. ETHICS AND DISSEMINATION This study was approved by the Wakayama Medical University Institutional Review Board on 30 March 2018 study (approval number: 2258). Patients have been enrolled since May 2018. As the study will complete accrual in March 2021, results will be published by 2021. This study will provide important information about the utility of furosemide compared with mannitol to protect against nephrotoxicity. TRIAL REGISTRATION NUMBER UMIN000031910.
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Affiliation(s)
- Eriko Murakami
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Hiroaki Akamatsu
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Toshio Shimokawa
- Clinical Study Support Center, Wakayama Medical University Hospital, Wakayama, Japan
| | - Kiyoko Wada
- Department of Nursing, Wakayama Medical University, Wakayama, Japan
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9
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Camidge DR. A rational approach to the development of drug combinations in thoracic oncology. Clin Adv Hematol Oncol 2019; 17:430-432. [PMID: 31449509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- D R Camidge
- University of Colorado Anschutz Medical Campus, Denver, Colorado
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10
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Iihara H, Shimokawa M, Gomyo T, Fujita Y, Yoshida T, Funaguchi N, Minato K, Kaito D, Osawa T, Yamada M, Hirose C, Suzuki A, Ohno Y. Clinical trial protocol of doublet therapy and olanzapine for carboplatin-induced nausea and vomiting in patients with thoracic cancer: a multicentre phase II trial. BMJ Open 2019; 9:e028056. [PMID: 31278102 PMCID: PMC6615793 DOI: 10.1136/bmjopen-2018-028056] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Adding neurokinin-1 receptor antagonist (NK1RA) to 5-hydroxytryptamine-3 receptor antagonist and dexamethasone (DEX) improved carboplatin (CBDCA)-induced chemotherapy-induced nausea and vomiting (CINV) in patients with thoracic cancer. NK1RAs with high-drug cost are raising medical expenses. Olanzapine (OLZ) is less expensive and can be expected to have an excellent effect on CINV. This phase II trial aimed at evaluating the efficacy and safety of 5 mg OLZ plus granisetron (GRN) and DEX in CBDCA combination therapy with area under curve (AUC) ≥5 mg/mL/min for the prevention of nausea and vomiting in patients with thoracic cancer. METHODS AND ANALYSIS This is an open-label, single-arm, multicentre, phase II trial. Patients who receive CBDCA-based therapies (AUC ≥5) and have never been administered moderate to high emetogenic chemotherapy will be enrolled. All patients will receive a combination of GRN, DEX and OLZ. The primary endpoint is complete response (CR) rate, defined as the absence of emetic episodes and no use of rescue medication for 120 hours after the initiation of CBDCA. Forty-eight patients are required based on our hypothesis that this regimen can improve CR rate from 65% (null hypothesis) to 80% (alternative hypothesis) with a one-sided type I error of 0.1 and a power of 0.8. We set the target sample size at 50 considering dropouts. ETHICS AND DISSEMINATION The study protocol was approved by the institutional review board at each of the participating centres. Data will be presented at international conferences and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER UMIN000031267.
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Affiliation(s)
- Hirotoshi Iihara
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
- Laboratory of Pharmacy Practice and Social Science, Gifu Pharmaceutical University, Gifu, Japan
| | - Mototsugu Shimokawa
- Cancer Biostatistics Laboratory, Clinical Research Institute, National Hospital Organization Kyusyu Cancer Center, Fukuoka, Japan
| | - Takenobu Gomyo
- Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yukiyoshi Fujita
- Division of Pharmacy, Gunma Prefectural Cancer Center, Ohta, Japan
| | - Tsutomu Yoshida
- Department of Respiratory Medicine and Medical Oncology, Gifu Municipal Hospital, Gifu, Japan
| | - Norihiko Funaguchi
- Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
- Department of Respiratory Medicine, Asahi University Hospital, Gifu, Japan
| | - Koichi Minato
- Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Gifu, Japan
| | - Daizo Kaito
- Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Tomohiro Osawa
- Department of Pharmacy, Gifu Municipal Hospital, Gifu, Japan
| | - Momoko Yamada
- Department of Pharmacy, Asahi University Hospital, Gifu, Japan
| | - Chiemi Hirose
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | - Akio Suzuki
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | - Yasushi Ohno
- Department of Cardiology and Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
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11
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Gui X, Li H, Song G, Shao B, Jiang H. Long term use of bevacizumab in the treatment of triple negative breast cancer with giant tumor in chest wall: A case report. Medicine (Baltimore) 2018; 97:e13410. [PMID: 30508942 PMCID: PMC6283199 DOI: 10.1097/md.0000000000013410] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Triple-negative breast cancer (TNBC) is associated with unfavorable prognosis due to lack of targeted agents. Bevacizumab, an anti-angiogenic monoclonal antibody against vascular endothelial growth factor A, has shown clinical effects in patients with TNBC. PATIENT CONCERNS We reported a 49-year-old woman presenting with a giant breast tumor. DIAGNOSES Stage IV TNBC with chest wall metastasis. INTERVENTIONS The patient underwent long-term use of bevacizumab combined with chemotherapy. OUTCOMES The patient was on follow-up for 46 months, a remarkable improvement of the chest wall cutaneous lesion was observed. LESSONS Bevacizumab may provide benefits for TNBC patients with chest wall metastasis.
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12
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Kapdagli M, Erus S, Tanju S, Dilege S. Extensive chest wall resection, reconstruction and right pneumonectomy in a 24-week pregnant patient. Lung Cancer 2018; 122:7-9. [PMID: 30032848 DOI: 10.1016/j.lungcan.2018.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 04/29/2018] [Accepted: 05/09/2018] [Indexed: 11/19/2022]
Abstract
A 23-year-old pregnant patient was evaluated with a mass lesion located on the right sided chest wall. A MRI of the chest showed a lesion of approximately 18 × 16 × 17.5 cm originating from ribs. A tru-cut biopsy revealed the diagnosis of chondrosarcoma. The patient underwent an extended chest wall resection, reconstruction and right pneumonectomy operation in the 24th gestation week. After the recovery period, two cycles of chemotherapy were administrated. The patient delivered a healthy baby in 34th week of her pregnancy.
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Affiliation(s)
| | - Suat Erus
- Koç University School of Medicine, Istanbul, Turkey
| | - Serhan Tanju
- Koç University School of Medicine, Istanbul, Turkey
| | - Sukru Dilege
- Koç University School of Medicine, Istanbul, Turkey
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13
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Tavecchio L, Bedini AV, Lanocita R, Patelli GL, Donati I, Ravasi G. Long-Term Infusion in Cancer Chemotherapy with the Groshong Catheter via the Inferior Vena Cava. Tumori 2018; 82:372-5. [PMID: 8890973 DOI: 10.1177/030089169608200415] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims and background Vascular access through a vein draining into the superior vena cava is commonly used for long-term infusion of drugs inr cancer chemotherapy; prolonged cannulation of the inferior vena cava is generally considered as having an excessively high complication rate. Methods Prolonged cisplatin infusion via the inferior vena cava by means of a Groshong catheter was evaluated in 20 consecutive patients with thoracic malignancies showing evidence of superior vena cava infiltration or obstruction. Results We achieved 1,291 catheter days for our survey with a mean duration of vascular access of 64.5 days per patient and a mean duration of infusion time of 40 days. There were 2 complications, a catheter obstruction after a 7-day rest period and an ileo-femoral thrombosis 6 days after catheter placement. Conclusions Our experience compared favourably with the results obtained by long-term central venous access via the supraumbilical route, and demonstrated the reliability and safety of this approach in cases where the superior vena cava cannulation is technically difficult or impossible.
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Affiliation(s)
- L Tavecchio
- Department of Thoracic Surgery, National Cancer Institute, Milan, Italy
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14
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Iñiguez-Ariza NM, Stan MN, Bible KC. Effect of thyroid hormone suppression on control of advanced well-differentiated thyroid cancer. Endocrine 2018; 59:228-229. [PMID: 29094258 DOI: 10.1007/s12020-017-1464-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 10/21/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Nicole M Iñiguez-Ariza
- Mayo Clinic Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Rochester, MN, USA
| | - Marius N Stan
- Mayo Clinic Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Rochester, MN, USA
| | - Keith C Bible
- Mayo Clinic Division of Medical Oncology, Rochester, MN, USA.
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15
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Das RR, Sami A, Seth R, Nandan D, Kabra SK, Suri V. Thoracic neuroblastoma presenting as recurrent empyema. Natl Med J India 2014; 27:84-85. [PMID: 25471760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Neuroblastoma is the most common intra-abdominal and extracranial solid tumour in children, accounting for 7%-8% of all childhood cancers. It is a malignant tumour of the autonomic nervous system derived from the neural crest. Most children with neuroblastoma have distant metastatic disease at the time of diagnosis. Pulmonary metastasis at the time of diagnosis is rare, and rarer is the presence of associated pleural effusion. We present the case of a child with recurrent empyema, who was diagnosed to have a thoracic neuroblastoma.
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Affiliation(s)
- Rashmi Ranjan Das
- All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India - Department of Paediatrics
| | - Abdus Sami
- All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India - Department of Paediatrics
| | - Rachna Seth
- All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India - Department of Paediatrics
| | - Devki Nandan
- All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India - Department of Paediatrics
| | - Sushil K Kabra
- All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India - Department of Paediatrics
| | - Vaishali Suri
- All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India - Department of Pathology
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16
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Jakopovic M, Thomas A, Lopez-Chavez A. From platinum compounds to targeted therapies in advanced thoracic malignancies. Anticancer Res 2014; 34:477-482. [PMID: 24403504] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Improved understanding of the molecular mechanisms involved in development, growth and spread of cancer have led to develpment of targeted therapies for many cancers. Based on their superior tolerability and efficacy, targeted therapies with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) or crizotinib are preferred first-line treatments over platinum-based chemotherapies in patients whose tumours harbour EGFR-activating mutations and anaplastic lymphoma kinase (ALK) translocations, respectively. Active areas of research in EGFR-mutant and ALK-translocated NSCLC include identification of mechanisms of resistance and overcoming them. Therapeutic targeting of several other targets including ROS, RET and discoidin domain receptor 2 (DDR2) tyrosine kinases are in early phases of clinical evaluation. Despite the advances in tumour genomic sequencing, a substantial fraction of patients with non-small cell lung cancer (NSCLC) do not have any targetable genetic alteration. Ongoing research is focused on identifying mechanisms of carcinogenesis in these patients. Targeted therapies in small cell lung cancer (SCLC) and thymic malignancies have not yielded meaningful clinical benefits, and platinum-based therapies remain the cornerstone of treating patients with advanced disease.
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Affiliation(s)
- Marko Jakopovic
- Oregon Health and Sciences University 3181 SW Sam Jackson Park Rd, Portland, OR, U.S.A.
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17
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Hasegawa K, Matsui T, Aoyagi H, Yoshida T, Kaneko J, Maejima S. [A case of chest wall recurrence after mastectomy for breast cancer that showed response to chemotherapy]. Gan To Kagaku Ryoho 2013; 40:2378-2380. [PMID: 24394118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We report a case of a 55-year-old woman who underwent mastectomy and axillary lymph node dissection for right breast cancer( T2N1cM0) 7 years previously. She had been experiencing chest pain for 1 year. Ultrasonography( US) showed a low echoic mass, 1 cm in diameter, near the rib in the right breast (class 5).Magnetic resonance imaging (MRI) and positron emission tomography( PET)-computed tomography( CT) scans revealed an 8-cm wide, segmentally enhancing soft tissue lesion and enhanced lymph nodes at the right edge of the sternum. Under the diagnosis of local recurrence, the patient received chemotherapy consisting of adriamycin and cyclophosphamide( AC) and docetaxel. Definite improvement in chest wall metastasis was observed following this treatment. By changing the treatment to endocrine therapy, the disease has been effectively controlled.
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18
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Hoca A, Yildiz M, Ozyigit G. Evaluation of the effects of mediastinal radiation therapy on autonomic nervous system. Med Oncol 2012; 29:3581-6. [PMID: 22528518 DOI: 10.1007/s12032-012-0237-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Accepted: 04/06/2012] [Indexed: 11/26/2022]
Abstract
In this prospective study, the effects of mediastinal radiation therapy (RT) on autonomic nervous system (ANS) were investigated by heart rate variability (HRV) analysis that is accepted as a non-invasive indicator of ANS. Study was performed with the eligible patients had a histopathologically confirmed diagnosis of malignant disease with no known congestive heart failure, coronary heart disease, hypertension, valvular cardiac disease or arrhythmia history. Electrocardiograms of 14 voluntary patients were recorded for duration of 5 min just before and after irradiation for the first and the 15th fractions. ANS-related HRV analysis parameters were calculated as which were recommended by Task Force of ESC/NASPE (Circulation 93:1043-1065, 1996). HRV parameters that belong to pre- and post-RT treatment of patients were compared statistically. We found that there is not effect of single-dose radiation on HRV parameter. The mean RRI (782.29 ± 115.65-738.93 ± 111.01, P < 0.014) and HF power of HRVs PSD (156.94 ± 229.37-60.71 ± 77.99, P < 0.045) decreased, and LF/HF ratio (1.38 ± 0.79-2.03 ± 1.25, P < 0.039) increased significantly with 28-Gy external radiation dose. As the effect of cumulative dose was investigated on HRV parameters, the above changes were continued to increase with 30-Gy external radiation dose. We found that mediastinal RT involving heart directly in the radiation field decreased vagal and sympathetic ANS activities, and autonomic balance shifted toward sympathetic dominance.
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Affiliation(s)
- Ayse Hoca
- Department of Biomedical Engineering, Engineering Faculty, Baskent University, Ankara, Turkey.
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19
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Adam Z, Matýšková M, Tomíška M, Rehák Z, Koukalová R, Křikavová L, Pour L, Krejčí M, Szturz P, Zahradová L, Mechl M, Moulis M, Vaníček J, Neuman C, Navrátil M, Veselý K, Hájek R, Mayer J. [Six-year follow-up of a patient with multiple angiomatosis involving skeleton, thoracic and abdominal cavities and the gut wall]. Klin Onkol 2012; 25:47-62. [PMID: 22348220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUNDS Multiple angiomatosis is a rare disease causing angiomatous lesions in multiple organs and tissues with a risk of life-threatening haemorrhage. OBSERVATION A young man was diagnosed with multiple angiomatosis at the age of 28 after two years of back and abdominal pain. Laparotomy revealed multiple spongy lesions mostly within the retroperitoneal space. Also, an involvement of the gut wall, bones and mediastinum was evident. After 6 years of treatment, the disease has been stabilized. Bone pain ceased with a significant contribution of zoledronate. Using CT and MR imaging, the effectiveness of antiangiogenic drugs was evaluated. Furthermore, treatment response was evaluated using laboratory values for coagulation and blood count, as angiomatous proliferation is known to be associated with disseminated intravascular coagulation and anaemia. RESULTS Baseline laboratory examination revealed elevated D-dimer (more than 20 µg/mL), low fibrinogen (1.4 g/L), and the presence of fibrin monomers. After treatment with 6 mil. IU of interferon-alpha thrice weekly, there was only partial improvement in D-dimer (17.2 µg/mL) and fibrinogen (1.5 g/L) concentrations but fibrin monomers remained positive. After thalidomide (100 mg daily), D-dimer decreased to 6.1 µg/mL and fibrinogen levels increased to 1.9 g/L with the disappearance of fibrin monomers. CT scanning showed significant regression of angiomatous lesions. Progressive neuropathy was the reason to lower the dose of thalidomide by half and this caused D-dimer to rise again. Switching to lenalidomide 10 mg daily led to an increase in D-dimer to 10.8 µg/mL and decrease in haemoglobin concentration to 124 g/L. Fibrin monomers became positive again. Combined therapy with thalidomide (50 mg/day) and lenalidomide (10 mg days 1-21 in 28-day cycles) has led to stabilisation of the disease. Median concentration of haemoglobin increased to 131 (84-141) g/l. The median of D-dimer decreased to 9.3 (8.0-17) µg/mL. CONCLUSION Thalidomide in the dose of 100 mg daily led to better stabilisation of the disease than interferon-alpha. However, lowering the dose because of adverse effects failed to be effective sufficiently. Lenalidomide 10 mg daily was well-tolerated but insufficient to improve D-dimer and haemoglobin concentrations. Therefore, for further treatment we have decided to use the combination of lenalidomide and thalidomide in doses of 10 mg and 50 mg, respectively because both drugs have desirable antiangiogenic activities with different adverse effect profiles. On this therapy, the patients disease has been stable for 9 months.
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Affiliation(s)
- Z Adam
- Interní hematoonkologická klinika, LF MU a FN Brno.
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Tamiya M, Kuhara H, Hirashima T, Kondo Y, Santo M, Morishita N, Suzuki H, Sasada S, Okamoto N, Kobayashi M, Kawase I. Hypersensitivity reactions associated with platinum-containing antineoplastic agents for thoracic malignancies. Anticancer Res 2011; 31:4525-4528. [PMID: 22199326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Recently, the use of platinum-containing antineoplastic agents for extended periods has increased. In this study, we determined the relationship between the hypersensitivity reactions to cisplatin or carboplatin and the frequency of administration among patients with thoracic malignancies. The study included 255 patients with thoracic malignancies who were treated with chemotherapy containing cisplatin or carboplatin in our institution between April 2007 and October 2008. A total of 89 patients received a median of 3 courses of cisplatin and 140 patients a median of 4 courses of carboplatin. A median of 6 courses of cisplatin plus carboplatin was administered to a further 26 patients. The total incidence of hypersensitivity reactions was 1.96%. Patients who were treated with <6 courses of platinum-containing antineoplastic agent did not experience any hypersensitivity reaction, but one patient, who was administered with 6 courses of platinum-containing antineoplastic agent experienced a hypersensitivity reaction (0.44%), as did four patients who were administered ≥7 courses (13.8%). Univariate and multivariate analyses indicated that the number of courses of platinum-containing antineoplastic agents was significantly correlated to the incidence of hypersensitivity reactions to these agents.
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Affiliation(s)
- Motohiro Tamiya
- Department of Thoracic Malignancy, Osaka Prefectural Hospital Organization Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino 3-7-1 Habikino city, Osaka 583-8588, Japan.
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21
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Stephenson JT, Song K, Avansino JR, Mesher A, Waldhausen JHT. Novel titanium constructs for chest wall reconstruction in children. J Pediatr Surg 2011; 46:1005-10. [PMID: 21616271 DOI: 10.1016/j.jpedsurg.2010.12.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Revised: 12/06/2010] [Accepted: 12/11/2010] [Indexed: 11/18/2022]
Abstract
PURPOSE We have previously reported the use of the vertical expandable prosthetic titanium rib (VEPTR) for treatment of thoracic dystrophy. This report describes our experience with this device and other novel titanium constructs for chest wall reconstruction. METHODS This is a retrospective chart review of all children and adolescents undergoing chest wall reconstruction with titanium constructs between December 2005 and May 2010. RESULTS Six patients have undergone chest wall reconstruction with VEPTR or other titanium constructs. Four had chest wall resection for primary malignancy, 1 had metastatic chest wall tumor resection, and 1 had congenital chest wall deformity. There were no immediate complications, and all patients have exhibited excellent respiratory function with no scoliosis. CONCLUSIONS Chest wall reconstruction after tumor resection or for primary chest wall deformities can be effectively accomplished with VEPTR and other customized titanium constructs. Goals should be durable protection of intrathoracic organs and preservation of thoracic volume and function throughout growth. Careful preoperative evaluation and patient-specific planning are important aspects of successful reconstruction.
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Affiliation(s)
- Jacob T Stephenson
- Division of Pediatric Surgery, Seattle Children's Hospital University of Washington School of Medicine, PO Box 5371/ WW7753 Seattle, Washington 98105, USA
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Lopes G, Chopra A, Kukutschka J, Portillo P, Bharwani L, Chang A. Pemetrexed in the treatment of thoracic malignancies: a single centre experience in Singapore. Singapore Med J 2011; 52:190-194. [PMID: 21451928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
INTRODUCTION This study aimed to examine the efficacy and toxicity of pemetrexed in Singapore. METHODS We conducted a retrospective review of patients treated with pemetrexed between July 2005 and November 2007. RECIST was used to assess the efficacy independent of the treating physician's assessment, and NCI CTC-AE version 3.0 was used to describe adverse events. RESULTS 37 patients had non-small-cell lung cancer (NSCLC) and six had malignant pleural mesothelioma. Those with NSCLC had a median age of 60 and an ECOG PS of 0-1, and they were predominantly male, ethnic Chinese and smokers. A median of two cycles were delivered (total 95; range 1-12). Grade 3/4 toxicity was rare. Five (14 percent) patients had an objective response (one complete, four partial) and 13 (35 percent) had stable disease. Median time to treatment failure was 1.86 months (95% confidence interval [CI] 0-6.5). Median overall survival was 18.6 months (95% CI 12.6-27.7). Median age of patients with mesothelioma was 46.5 (range 29-73) years. Five men and one woman received a median of four (total 30, range 1-15) cycles of pemetrexed in combination with cisplatin. Three patients had a partial response, two had stable disease and one had disease progression. Grade 3/4 toxicities were as follows: leucopenia, neutropenia and thrombocytopenia in one patient. CONCLUSION The results of this retrospective study and literature review show that pemetrexed is safe and efficacious in the treatment of Asian patients with NSCLC and mesothelioma.
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Affiliation(s)
- G Lopes
- Johns Hopkins Singapore International Medical Centre, Johns Hopkins University School of Medicine, 11 Jalan Tan Tock Seng, Level 1, Singapore 308433.
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Kosaka M, Koizumi T, Fukushima T, Wada Y, Agatsuma T, Yokoyama T, Kanda S, Kubo K, Shimojo H, Horie S, Asano N. Mantle cell lymphoma mainly involving thoracic lesions: two case reports. Intern Med 2011; 50:1477-81. [PMID: 21757833 DOI: 10.2169/internalmedicine.50.5335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Most mantle cell lymphoma patients show remarkable disseminated disease at the initial diagnosis. We describe two cases of mantle cell lymphoma mainly involving thoracic lesions at the initial presentation of the disease. The clinical presentations were right hilar lymphadenopathy in one case and right pleural thickness in the other. The diagnosis of mantle cell lymphoma was confirmed by immunohistochemistry, including CD5, CD20, and cyclin D1, and the presence of t(11 ; 14)(q13 ; q32) by fluorescence in situ hybridization. These thoracic manifestations at the initial diagnosis should be taken into consideration for the clinical spectrum of mantle cell lymphoma.
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MESH Headings
- Aged
- Antigens, CD20/metabolism
- Antineoplastic Combined Chemotherapy Protocols
- CD5 Antigens/metabolism
- Chromosomes, Human, Pair 11/genetics
- Chromosomes, Human, Pair 14/genetics
- Cyclin D1/metabolism
- Humans
- Immunohistochemistry
- In Situ Hybridization, Fluorescence
- Lymphoma, Mantle-Cell/diagnosis
- Lymphoma, Mantle-Cell/drug therapy
- Lymphoma, Mantle-Cell/genetics
- Lymphoma, Mantle-Cell/metabolism
- Male
- Thoracic Neoplasms/diagnosis
- Thoracic Neoplasms/drug therapy
- Thoracic Neoplasms/genetics
- Thoracic Neoplasms/metabolism
- Tomography, X-Ray Computed
- Translocation, Genetic
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Affiliation(s)
- Makoto Kosaka
- The First Department of Internal Medicine, Shinshu University School of Medicine, Japan
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Ichinose Y. [Thorax/lung and mediastinum, pleura cancer-current status and future for molecular targeting drugs-]. Gan To Kagaku Ryoho 2010; 37:1458. [PMID: 20860095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- Yukito Ichinose
- Department of Thoracic Oncology, Institute for Clinical Research, National Kyushu Cancer Center, Minami-ku, Fukuoka, Japan
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25
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Papi A, Ferreri AM, Rocchi P, Guerra F, Orlandi M. Epigenetic modifiers as anticancer drugs: effectiveness of valproic acid in neural crest-derived tumor cells. Anticancer Res 2010; 30:535-540. [PMID: 20332466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Valproic acid (VPA) is an established drug in the long-term therapy of epilepsy. Recently, VPA has demonstrated antitumor activity as a histone deacetylase (HDAC) inhibitor. In this study, the anticancer properties of VPA on neural crest-derived human tumor cell lines G361 melanoma, U87MG glioblastoma and SKNMC Askin tumor cells were investigated. The effect of VPA on cell growth, apoptotic activity and invasive ability were evaluated. Firstly, VPA induced cell growth inhibition and apoptotic activity, as demonstrated by sulforhodamine B protein assay, annexin V assay and by Western blot analysis for Bcl2 and Bax expression levels, in all three cell lines. In addition, VPA led to a decrease of HDAC-1 protein level, as assessed by Western blot analysis. Treatment with VPA caused a decrease in the invasive ability of all three cell lines. Since the invasion process involves a complex system of tightly regulated proteases, matrix metalloproteinases (MMPs) and their tissue-specific inhibitors (TIMPs), the effect of VPA on MMP and TIMP expressions was analysed. Exposure to VPA resulted in a decrease of MMP2 and MMP9 activity and expression level, as assesssed by gelatin zymography and Western blot analysis. In addition, exposure to VPA led to enhanced expression of TIMP1, as assessed by Western blot. Taken together, our results, besides providing further evidence that VPA may represent a promising therapeutic strategy in cancer treatment, may help in the design of new protocols geared at the treatment of neural crest-derived tumors.
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Affiliation(s)
- Alessio Papi
- Department of Experimental Evolutive Biology, University of Bologna, 40126 Bologna, Italy
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Kim A, Gillespie A, Dombi E, Goodwin A, Goodspeed W, Fox E, Balis FM, Widemann BC. Characteristics of children enrolled in treatment trials for NF1-related plexiform neurofibromas. Neurology 2009; 73:1273-9. [PMID: 19841379 PMCID: PMC2764415 DOI: 10.1212/wnl.0b013e3181bd1326] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To describe the characteristics of children enrolled in treatment trials for neurofibromatosis type 1 (NF1)-related plexiform neurofibroma (PN), PN tumor burden, PN-related complications, and treatment outcomes and to highlight the differences between characteristics of children with NF1 vs children with cancers entered on early phase drug trials. METHODS Pre-enrollment characteristics and complications of PN were retrospectively analyzed in a cohort of 59 children with NF1-related PN treated on 1 of 7 clinical trials at the NIH between 1996 and 2007. Outcome was analyzed in a subset of 19 patients enrolled in phase I trials. Comparisons to children with cancer were made from a similar analysis performed recently. RESULTS The median age at enrollment was 8 years. The median PN volume was 555 mL. Most patients had no prior chemotherapy or radiation, but nearly half had previous surgery for PN. PN-associated complications and NF1 manifestations were common, including pain (53%), other tumors (18%), and hypertension (8%). Investigational drug therapy was well tolerated. A median of 10 treatment cycles was administered. Patients with NF1-related PN were younger, had better performance score, had less prior therapy, and remained on study longer than cancer patients. CONCLUSIONS Children with NF1-related plexiform neurofibroma (PN) enrolled in clinical trials had large tumors with substantial morbidity. Clinical trials in these children provide information about drug tolerance, cumulative toxicity, and pharmacokinetics in a younger population than early phase pediatric cancer trials. This report may aid in the evaluation of the applicability of traditional pediatric cancer trial designs and endpoints for NF1-related PN.
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Affiliation(s)
- A Kim
- National Cancer Institute, Pediatric Oncology Branch, NIH, Bethesda, MD 20892, USA.
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Sawada Y, Fujii T, Takahashi H, Yokoyama G, Matsubayashi RN, Inoue Y, Uesugi N, Momosaki S, Toh U, Shirouzu K. [A case of triple negative chest wall recurrent breast cancer treated with capecitabine and docetaxel combination therapy (XT therapy)]. Gan To Kagaku Ryoho 2009; 36:815-817. [PMID: 19461184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
A 59-year-old woman underwent modified radical mastectomy for left breast cancer 9 years earlier. This time, a chest wall recurrence was found. A chest CT showed a chest wall tumor and lymph node metastases. PET images showed increased uptake in chest wall tumor and lymph nodes. The serum tumor markers have also elevated. Open biopsy of chest wall tumor was performed, and the tumor was diagnosed as invasive ductal carcinoma[ER(-), Pg R (-), HER2 score(0)]. Combination chemotherapy with capecitabine and docetaxel was initiated. After 7 courses of treatment, a marked response has been seen. Capecitabine and docetaxel combination therapy are considered useful for treatment of triple negative recurrent breast cancer.
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Affiliation(s)
- Yu Sawada
- Breast Care Center, Clinical Research Institute, National Hospital Organization, Kyushu Medical Center
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28
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Smith R, Marson B, Smith M, Rangarajan S. Incidental finding of Hodgkin's disease following initial presentation with traumatic haematoma in the thoracic inlet. Haemophilia 2008; 14:610-2. [PMID: 18218014 DOI: 10.1111/j.1365-2516.2007.01640.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hauer J, Graubner U, Konstantopoulos N, Schmidt S, Pfluger T, Schmid I. Effective treatment of kaposiform hemangioendotheliomas associated with Kasabach-Merritt phenomenon using four-drug regimen. Pediatr Blood Cancer 2007; 49:852-4. [PMID: 16411198 DOI: 10.1002/pbc.20750] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We report a case of a 6-month-old girl suffering from a kaposiform hemangioendothelioma of the chest wall, associated with Kasabach-Merritt phenomenon. Despite rapid intervention with cortisone and interferon alpha the tumor led to a life-threatening clinical condition with progressive growth and consumption coagulopathy under therapy. Because therapy for kaposiform hemangioendotheliomas with a single anti-angiogenic or anti-proliferative agent has not been reported to be very successful, we administered vincristine, combined with cyclophosphamide, actinomycin D, and methotrexate in a critically ill patient. After six cycles of the applied four-drug regiment, the infant was in remission, which has been maintained for 5 months since stopping therapy.
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Affiliation(s)
- Julia Hauer
- Pediatric Haematoloy/Oncology, Dr. v. Haunersches Kinderspital, LMU-University Munich, Munich, Germany.
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Hosoi H, Iehara T, Tsuchiya K, Misawa A, Miyaji M, Yagyu S, Koizumi M, Nishimura T, Tokiwa K, Iwai N, Yanagisawa A, Sugimoto T. Continuous remission in an infant with chest wall malignant rhabdoid tumor after relapse. J Pediatr Surg 2007; 42:E9-12. [PMID: 17923188 DOI: 10.1016/j.jpedsurg.2007.07.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Malignant rhabdoid tumor (MRT) is a highly aggressive tumor that occurs in infancy or childhood. The prognosis, especially in infants, is very poor. Here we report the long-term survival of a 5-month-old boy with MRT that arose from the chest wall. After total resection of the tumor, the patient was given 4 cycles of doxorubicin, vincristine, and cyclophosphamide, alternating with ifosfamide and etoposide. After 18 months off therapy, he had a local recurrence at the same site. After a second total resection, he was given additional chemotherapy with 30.6-Gy local irradiation. No further recurrence has been observed for 5 years since the second complete remission. Currently, he is alive and well at 7.5 years post-onset. Our experience in this case suggests a fundamental strategy of successful treatment of this highly malignant pediatric tumor: (1) complete resection of the localized tumor, (2) intensive multiagent chemotherapy for the minimal disseminated disease, and (3) radiotherapy for local control of the disease.
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Affiliation(s)
- Hajime Hosoi
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan.
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Thatcher N, Manegold C. Achieving survival improvement in thoracic tumours: from therapeutic strategy management to pharmacogenomics. Lung Cancer 2007; 57 Suppl 2:S1-2. [PMID: 17686439 DOI: 10.1016/s0169-5002(07)00362-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
BACKGROUND AND AIMS It has been reported that gastric gastrointestinal stromal tumours (GIST) are aggressive, rare and difficult to treat. Some have advocated radical resection as the only potential cure. We present data to support treatment of gastric GISTs with a limited surgical approach and minimal morbidity. Furthermore, we propose that surveillance for recurrence is unnecessary based upon the follow-up of a cohort of patients with gastric GISTs. METHODS Database and case notes analysis of 20 patients diagnosed with gastric GIST (1998-2004) and managed by one surgeon in a single centre over seven years. Main outcome measures were inpatient adverse events, positive resection margins and symptom free survival. OUTCOMES Three cases have been managed with surveillance only. Successful resection was performed in 17 patients without mortality. No patient had positive margins on histological assessment. Fifteen out of seventeen samples were positive for the c-Kit proto-oncogene (CD117) and 14117 positive for CD34. Only two patients required en-bloc resections due to the tumour size and involvement of adjacent structures. One patient developed metastatic disease during follow-up of 19-86 months. CONCLUSIONS We recommend local excision of gastric GISTs to allow macroscopically clear margins. This policy then allows symptomatic follow-up due to the indolent nature of the majority of the tumours resected. A tailored follow-up with endoscopy and radiological imaging has been advocated by others but appears unnecessary in most cases. Imatinib (anti c-Kit) can now be offered to patients presenting with recurrent GIST, if further surgery is deemed inappropriate.
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Affiliation(s)
- V Sujendran
- Department of Upper Gl Surgery and Pathology, The John Radcliffe Hospital, Headington, Oxford, UK.
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33
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Bock S. [German Society of Pneumology and Respiratory Medicine--thoracic oncology in Germany--Update 2007]]. Pneumologie 2007; 61:347-8. [PMID: 17566950 DOI: 10.1055/s-2007-982587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Reddy RM, Yeow WS, Chua A, Nguyen DM, Baras A, Ziauddin MF, Shamimi-Noori SM, Maxhimer JB, Schrump DS, Nguyen DM. Rapid and profound potentiation of Apo2L/TRAIL-mediated cytotoxicity and apoptosis in thoracic cancer cells by the histone deacetylase inhibitor Trichostatin A: the essential role of the mitochondria-mediated caspase activation cascade. Apoptosis 2007; 12:55-71. [PMID: 17136498 DOI: 10.1007/s10495-006-0484-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Apo2L/TRAIL is actively investigated as a novel targeted agent to directly induce apoptosis of susceptible cancer cells. Apo2L/TRAIL-refractory cells can be sensitized to the cytotoxic effect of this ligand by cytotoxic chemotherapeutics. The aim of this study was to evaluate the in vitro tumoricidal activity of the Apo2L/TRAIL + Trichostatin A in cultured thoracic cancer cells and to elucidate the molecular basis of the synergistic cytotoxicity of this combination. Concurrent exposure of cultured cancer cells to sublethal concentrations of Apo2L/TRAIL and Trichostatin A resulted in profound enhancement of Apo2L/TRAIL-mediated cytotoxicity in all cell lines regardless of their intrinsic susceptibility to this ligand. This combination was not toxic to primary normal cells. While Apo2L/TRAIL alone or Trichostatin A alone mediated < 20% cell death, 60 to 90% of cancer cells were apoptotic following treatment with TSA + Apo2L/TRAIL combinations. Complete translocation of Bax from the cytosol to the mitochondria compartment was mainly observed in combination-treated cells and this was correlated with robust elevation of caspase 9 proteolytic activity indicative of activation of the mitochondria apoptogenic effect. Profound TSA + Apo2L/TRAIL-mediated cytotoxicity and apoptosis were completely abrogated by either Bcl2 over-expression or by the selective caspase 9 inhibitor, highlighting the essential role of mitochondria-dependent apoptosis signaling cascade in this process. Moreover, increased caspase 8 activity observed in cells treated with the TSA + Apo2L/TRAIL combination was completely suppressed by Bcl-2 over-expression or by the selective caspase 9 inhibitor indicating that the elevated caspase 8 activity in combination-treated cells was secondary to a mitochondria-mediated amplification feedback loop of caspase activation. These finding form the basis for further development of HDAC inhibitors + Apo2L/TRAIL combination as novel targeted therapy for thoracic malignancies.
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Affiliation(s)
- Rishindra M Reddy
- Section of Thoracic Oncology, Surgery Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
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Robbens C, Vanwyck R, Wilms G, Sciot R, Debiec-Rychter M. An extrarenal rhabdoid tumor of the cervical spine with bony involvement. Skeletal Radiol 2007; 36:341-5. [PMID: 16602014 DOI: 10.1007/s00256-006-0104-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2005] [Revised: 01/12/2006] [Accepted: 01/23/2006] [Indexed: 02/02/2023]
Abstract
A case of a histologically proven rhabdoid tumor of the cervical spine in a 19-year-old Caucasian male is presented. Primary extrarenal rhabdoid tumors are very rare. When the central nervous system is involved, the tumor usually is located in the brain. Only three cases of primary spinal rhabdoid tumor have been reported. This case is the first reported extradural rhabdoid tumor of the spinal canal and the first case of a rhabdoid tumor located in the spinal canal with bony involvement.
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Affiliation(s)
- C Robbens
- Department of Radiology, U.Z. Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium.
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36
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Kitazono I, Saigenji H. [Long-term survival of malignant fibrous histiocytoma of the chest wall by multidisciplinary treatment]. Kyobu Geka 2007; 60:221-4. [PMID: 17352141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
We report a case of malignant fibrous histiocytoma (MFH) of the chest wall. A 70-year-old man admitted for recurrent chest wall tumor diagnosed for MFH histologically and resected 7 months and 13 months before admission. Chest computed tomography (CT) revealed a tumor located at right posterior chest wall. In May 1997, resection of the tumor was done (the 3rd operation), but metastasis to the ribs (the 4th operation), subcutaneous tissue (the 5th operation), and local recurrence (the 6th operation) was found within 4 years postoperatively. Resection was done for each metastasis, and postoperative radiotherapy (66 Gy) and chemotherapy (CYVADIC) were done. The patient is doing well without apparent recurrence 57 months after last surgery, and survives 113 months after initial surgery. Multidisciplinary treatment may provide longer survival for patients with MFH of the chest wall.
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Affiliation(s)
- Iwao Kitazono
- Department of Cardiovascular Surgery, Kagoshima City Hospital, Kagoshima, Japan
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Abstract
OBJECTIVE Chemotherapy used on paediatric oncology patients often causes disturbances in dental development. Aim of this case report is to present the late effects of chemotherapy on dental development in a patient treated for neuroblastoma at early age. DESIGN Case report. RESULTS This paper presents a female patient treated at early age with surgery and chemotherapy for a neuroblastoma (stage IVS) in the right thorax and massive liver metastases. The examination of the patient at age 11.7 years showed microdontia of six teeth. In three of them size and form of the crown were affected, while in the other three the size was reduced but the form was not affected. CONCLUSIONS Chemotherapy on children treated for neuroblastoma can adversely influence tooth development. This has to be taken into consideration by the dentist when monitoring the development of the dentition and occlusion.
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Affiliation(s)
- D Remmers
- Department of Orthodontics and Oral Biology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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Venkitaraman R, George MK, Ramanan SG, Sagar TG. A single institution experience of combined modality management of extra skeletal Ewings sarcoma. World J Surg Oncol 2007; 5:3. [PMID: 17217537 PMCID: PMC1781071 DOI: 10.1186/1477-7819-5-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2006] [Accepted: 01/11/2007] [Indexed: 11/12/2022] Open
Abstract
Background Extraskeletal Ewings sarcoma are rare tumors for which there is no consensus on optimal management. Methods A retrospective review of the clinical features, treatment and outcome of patients with extraskeletal Ewings sarcoma who reported to a single institution between January 1992 – December 2003 is reported. Results A total of 19 patients with extraskeletal Ewings sarcoma were identified. Of these, 4 patients had metastatic disease at presentation and 15 patients with non-metastatic disease received combined modality treatment with primary combination chemotherapy followed by local treatment with radiotherapy or surgery. Disease free survival and overall survival for patients with non metastatic disease after combined modality treatment were 60% and 30% respectively. The significant predictors for prolonged disease free survival and overall survival were high haemoglobin(p = 0.002), low lactate dehydrogenase (p = 0.028), chemotherapy with Vincristine, Adriamycin, Cyclophosphamide, Ifosfamide and Etoposide regime (p = 0.008) and complete response to chemotherapy (p = 0.001). Conclusion Aggressive combination chemotherapy followed by complete surgery or radiotherapy to a dose of more than 50 Gy is essential to confer optimal outcome for patients with extraskeletal ewings sarcoma.
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Affiliation(s)
| | - Mathew K George
- Division of Medical Oncology, Royal Darwin Hopsital, Casuarina, Australia
| | - S Ganapathy Ramanan
- Division of Medical Oncology, Cancer Institute(WIA), Adyar, Chennai, 400036, India
| | - TG Sagar
- Division of Medical Oncology, Royal Darwin Hopsital, Casuarina, Australia
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Thomas P, Michelet P, Barlesi F, Thirion X, Doddoli C, Giudicelli R, Fuentes P. Impact of blood transfusions on outcome after pneumonectomy for thoracic malignancies. Eur Respir J 2006; 29:565-70. [PMID: 17079259 DOI: 10.1183/09031936.00059506] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The aim of the present study was to determine the risk factors and impact on outcome of blood transfusions following pneumonectomy for thoracic malignancies. A retrospective analysis of 432 consecutive patients was carried out, of whom 183 (42.4%) were transfused post-operatively. The associations between blood transfusions and 20 variables were assessed by univariate and multivariate analysis. Survival analysis included log-rank test and Cox regression model. Patient age, neoadjuvant treatment, completion pneumonectomy and extended procedures were independent predictors of transfusion. It was found that 30-day mortality increased significantly from 2.4% (no transfusion) to 10.9 and 21.9% (<or=2 and >2 red blood cell packs, respectively). Blood transfusion was the strongest predictor of 30-day mortality (odds ratio (OR) 10; 95% confidence interval (CI): 3.7-27), respiratory failure (OR 19.2; 95% CI 7.4-49.4) and infectious complications (OR 3; 95% CI 1.5-6.2). In the 367 lung cancer patients, a significantly lower 5-yr survival was observed in univariate analysis of transfused patients (27.8+/-5.4% versus 39.4+/-4.5%). In a Cox regression analysis, blood transfusion was no longer found to be significant. A dose-related correlation is suggested between blood transfusion and early mortality through an increase of infectious and respiratory complications. In contrast, blood transfusion had no independent adverse impact on long-term survival.
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Affiliation(s)
- P Thomas
- Faculty of Medicine, Université de la Méditerranée, Marseille, France.
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Tamura T, Minami H, Yamada Y, Yamamoto N, Shimoyama T, Murakami H, Horiike A, Fujisaka Y, Shinkai T, Tahara M, Kawada K, Ebi H, Sasaki Y, Jiang H, Saijo N. A phase I dose-escalation study of ZD6474 in Japanese patients with solid, malignant tumors. J Thorac Oncol 2006; 1:1002-9. [PMID: 17409986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
INTRODUCTION ZD6474 (vandetanib) is an orally available inhibitor of vascular endothelial growth factor receptor, epidermal growth factor receptor, and RET receptor tyrosine kinase activity. This study assessed the safety and tolerability of escalating doses of ZD6474 in Japanese patients with solid, malignant tumors. METHODS Adult patients with solid tumors refractory to standard therapy received a once-daily oral dose of ZD6474 (100-400 mg) in 28-day cycles, until disease progression or unacceptable toxicity was observed. RESULTS Eighteen patients were treated at doses of 100 mg (n = 3), 200 mg (n = 6), 300 mg (n = 6), and 400 mg (n = 3). Dose-limiting toxicities at the completion of cycle 2 were hypertension (n = 3), diarrhea (n = 1), headache (n = 1), toxic skin eruption (n = 1), and alanine aminotransferase increase (n = 1). A dose of 400 mg/day was considered to exceed the maximum tolerated dose (MTD). Toxicities were manageable with dose interruption and/or reduction. Objective tumor response was observed in four of nine patients with non-small cell lung cancer (NSCLC) at doses of either 200 or 300 mg. Terminal half-life was about 90-115 hours. Plasma trough concentrations achieved steady-state conditions after approximately 1 month of daily dosing. CONCLUSIONS It was concluded that a dose of 400 mg/day was considered to exceed the MTD, and doses for phase II study were thought to be not more than 300 mg/day. The objective response observed in some NSCLC patients is encouraging for further studies in this tumor type.
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Abstract
We report the case of a 42 year-old woman with myasthenia gravis associated with a malignant thymoma. Despite surgery, chemotherapy and radiotherapy, the thymoma showed soft tissues, pleural and mediastinic progression. Unexpectedly, a complete remission of the thymoma was confirmed by FDG-PET after four cycles of immunoglobulins, administered as treatment for a myasthenic crisis. To our knowledge this is the first case report of complete remission of a malignant thymoma with immunoglobulin therapy.
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Abstract
Radiation may be used as adjuvant or primary therapy in a variety of tumors in the chest, abdomen and pelvis. Therapeutic radiation affects not only malignant tumors but also surrounding normal tissues. The risk of injury depends on the size, number and frequency of radiation fractions, volume of irradiated tissue, duration of treatment, and method of radiation delivery. Concomitant chemotherapy can act synergistically to produce injury. Other predisposing factors include infection, prior surgery and chronic illness like hypertension, diabetes mellitus and atherosclerosis. Radiation changes vary, based on the target organ and the time from completion of therapy. While most serious complications related to radiotherapy are relatively uncommon, given the number of patients that are treated and the relatively long latency period for development of radiation changes, follow-up imaging studies frequently have findings that should be recognized as radiation related. Familiarity with the spectrum of imaging findings after radiation injury permits differentiation from other etiologies such as recurrent malignancy. The following will discuss imaging findings that may be seen during imaging surveillance in patients with malignancy affecting the chest, abdomen and pelvis.
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Affiliation(s)
- R Iyer
- Departments of Diagnostic Radiology, University of Texas, MD Anderson Cancer Center, Houston, TX 77030, USA.
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Affiliation(s)
- A Baldi
- Department of Biochemistry and Biophysic F Cedrangolo, Section of Anatomic Pathology, Second University of Naples, Naples, Italy
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Ziauddin MF, Yeow WS, Maxhimer JB, Baras A, Chua A, Reddy RM, Tsai W, Cole GW, Schrump DS, Nguyen DM. Valproic acid, an antiepileptic drug with histone deacetylase inhibitory activity, potentiates the cytotoxic effect of Apo2L/TRAIL on cultured thoracic cancer cells through mitochondria-dependent caspase activation. Neoplasia 2006; 8:446-57. [PMID: 16820090 PMCID: PMC1601472 DOI: 10.1593/neo.05823] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Inhibitors of histone deacetylases have been shown to enhance the sensitivity of cancer cells to tumor necrosis factor-related apoptosis-inducing ligand TRAIL-mediated cytotoxicity. Valproic acid (VA), a commonly used antiepileptic agent whose pharmacokinetics and toxicity profiles are well described, is a histone deacetylase inhibitor. This project aims to evaluate if VA can potentiate Apo2L/TRAIL-mediated cytotoxicity in cultured thoracic cancer cells and to elucidate the underlying molecular mechanism responsible for this effect. VA sensitized cultured thoracic cancer cells to Apo2L/TRAIL, as indicated by a 4-fold to a >20-fold reduction of Apo2L/TRAIL IC50 values in combination-treated cells. Although VA (0.5-5 mM) or Apo2L/TRAIL (20 ng/ml) induced less than 20% cell death, VA + Apo2L/TRAIL combinations caused 60% to 90% apoptosis of cancer cells. Moreover, substantial activation of caspases 8, 9, and 3, which was observed only in cells treated with the drug combination, was completely suppressed by Bcl2 overexpression or by the caspase 9 inhibitor. Both the caspase 9 inhibitor and Bcl2 completely abrogated the substantial cytotoxicity and apoptosis induced by this combination, thus highlighting the pivotal role of the type II pathway in this process. These findings provide a rationale for the development of VA and Apo2L/TRAIL combination as a novel molecular therapeutic for thoracic cancers.
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Affiliation(s)
- M Firdos Ziauddin
- Section of Thoracic Oncology, Surgery Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
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Kilçiksiz S, Gökçe T, Somali I, Duransoy A, Aydin A, Yiğit S. Combined administration of ethodolac, ascorbic acid and radiotherapy as adjuvant therapies in an extrathoracic desmoid tumor with gross postoperative residual disease; case report and review of the literature. J BUON 2006; 11:355-8. [PMID: 17309163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
A 37-year-old man was admitted with an extrathoracic desmoid tumor invading the brachial plexus. Magnetic resonance imaging (MRI) of the thorax demonstrated a 20 x 9 x 14 cm mass in the supraclavicular fossa, axillary fossa and the right side of the chest. It invaded the brachial plexus and circumscribed the subclavian and axillary arteries concentrically. Biopsy revealed desmoid tumor which was resected subtotally with the brachial plexus. The gross residual mass was treated postoperatively with radiotherapy (60 Gy) which resulted in major regression of the mass. Following radiotherapy, ethodolac with ascorbic acid were administered. The tumor was clinically indiscernible 35 months post-radiotherapy. This case shows the high effectiveness of radiotherapy along with less toxic medical treatment modalities in instances where local control is hard to achieve with surgery and highlights the importance of using multidisciplinary treatments to maintain good functional results.
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Affiliation(s)
- S Kilçiksiz
- Department of Radiation Oncology, Atatürk Training and Research Hospital, Izmir, Turkey.
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Nguyen DM, Yeow WS, Ziauddin MF, Baras A, Tsai W, Reddy RM, Chua A, Cole GW, Schrump DS. The Essential Role of the Mitochondria-Dependent Death-Signaling Cascade in Chemotherapy-Induced Potentiation of Apo2L/TRAIL Cytotoxicity in Cultured Thoracic Cancer Cells. Cancer J 2006; 12:257-73. [PMID: 16925970 DOI: 10.1097/00130404-200607000-00004] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Despite adequately expressing functional receptors for tumor necrosis factor receptor apoptosis-inducing ligand (TRAIL), many cultured tumor cells are refractory to the cytotoxic effect of this ligand. Cytotoxic chemotherapeutic drugs have been shown to synergize with Apo2L/TRAIL to mediate apoptosis in cancer cells. The main goal of this study was to evaluate the effect of either cisplatin or paclitaxel, two common used chemotherapeutic agents for solid tumors, on enhancing Apo2L/TRAIL cytotoxicity in a panel-cultured thoracic cancer cells and to examine the role of the mitochondria-dependent caspase activation cascade in mediating apoptosis of combination-treated cells. METHODS Cultured thoracic cancer cells were treated with cisplatin/Apo2L/TRAIL or paclitaxel/Apo2L/TRAIL sequential combinations in vitro. Cell viability and apoptosis were determined by 4,5-dimethylthiazo-2-yl)-2,5-diphenyl tetrazolium bromide and terminal deoxynucleotidyltransferase-mediated dUTP nick end labeling assays. Stable transfectants expressing high levels of Bcl-2 were created by retroviral gene transfer. Specific proteolytic activity of caspases 3, 6, 8, and 9 were measured by commercially available kits using fluorescent substrates. RESULTS All cell lines preferentially expressed high levels of DR4 and/or DR5 and low levels of DcR1/DcR2; all of which were not altered by chemotherapeutic drug treatments. Pretreatment of these cancer cells with sublethal concentrations of either cisplatin or paclitaxel increased their susceptibility to Apo2L/TRAIL by twofold to >20-fold. Profound synergistic induction of apoptosis was observed in combination-treated cells. Viability of primary normal cells was affected by neither Apo2L/TRAIL nor the combinations of chemotherapy and Apo2L/TRAIL. Overexpression of Bcl-2 or inhibition of caspase 9 activity completely abrogated combination-induced cytotoxicity and apoptosis, indicating the essential role of the mitochondria-dependent death signaling cascade in this process. Robust activation of caspase 8 in combination-treated cells was completely suppressed either by Bcl-2 overexpression or by blocking of the activity of the mitochondria-regulated caspase 9, thus identifying the amplification feedback loop as the source of elevated caspase 8 activity. Finally, mitochondria-mediated amplification of caspase 8 activity was indispensable for complete caspase activation and full execution of apoptosis, because suppression of its activity using the selective caspase 6 inhibitor (located downstream of the caspase 3 but upstream of the caspase 8 in the feedback loop) resulted in profound suppression of not only caspase 8 activity but also those of caspases 9 and 3, as well as complete protection of cancer cells from combination-induced cytotoxicity. CONCLUSION Cisplatin or paclitaxel synergistically interacts with Apo2L/TRAIL to mediate profound induction of apoptosis. The mitochondria-dependent caspase activation cascade and the amplification feedback loop are essential for the complete execution of the cell death program. Furthermore, our data identify mitochondria as the direct target for the development of more refined strategies to enhance the therapeutic effect of Apo2L/TRAIL as an anticancer agent.
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Affiliation(s)
- Dao M Nguyen
- Section of Thoracic Oncology, Surgery Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.
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Dhruva A, Cheng J, Kwong M, Luce JA, Abrams DI. Contrasts, conflicts, and change: A case in cultural oncology. J Support Oncol 2006; 4:301-4. [PMID: 16805333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Affiliation(s)
- Anand Dhruva
- Hematology-Oncology Division, San Francisco General Hospital, San Francisco, CA 94110, USA.
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Abstract
Acute esophageal toxicity (AET) is a common complication and dose-limiting toxicity in thoracic radiotherapy. Previous studies demonstrated several clinical and dosimetric parameters of AET in patients with lung cancer. However, there are few reports dealing with these variables in intra-thoracic malignancies, including lung cancer and other thoracic malignancy. The purpose of this study was to evaluate the clinical and dosimetric factors associated with AET in patients with intra-thoracic malignancies. We examined 61 patients with intra-thoracic malignancies treated with radiotherapy: 34 patients with non-small-cell lung cancer (55%), 9 cases with small-cell lung cancer (15%), 7 cases with thymic cancer (11%), 4 thymomas (7%), 2 malignant lymphomas (3%), one seminoma (2%), one liposarcoma (2%), and 3 cases of other malignancies (5%). Radiotherapy was performed with a median dose of 60 Gray (Gy) (range 40-67 Gy). AET was graded according to the Radiation Therapy Oncology Group (RTOG) criteria. The following parameters were analyzed with respect to associations with AET by univariate and multivariate analyses: age, gender, thoracic surgery before radiotherapy, concurrent chemotherapy, duration of radiotherapy, maximum esophageal dose, mean esophageal dose, and percentage of esophageal volume receiving from 10 Gy (V10) to 65 Gy (V65), in 5-Gy increments. 43 patients (70%) developed AET: 36 patients (59%) with AET of RTOG Grade 1, 7 patients (11%) with Grade 2, and no patients (0%) with Grade 3 or worse. On multivariate analysis, V35 > 30% was the most statistically significant factor associated with mild AET (p = 0.013). Our findings provide a better understanding of the factors related to AET, and might be useful in designing a treatment plan to prevent severe esophageal toxicity.
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Affiliation(s)
- Ken Takeda
- Department of Radiology, National Hospital Organization Sendai Medical Center, Japan.
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Abstract
Both lung cancer and mesothelioma are malignancies with increasing incidence, and both are primarily due to inhalation of an external carcinogen. The occurence of both diseases is expected to rise worldwide, although a stabilisation and/or decrease may be anticipated in some developed countries. There are other common similarities to both cancers, including the median age of their patients, the advanced stage at presentation, the outcome and the treatments given. This review focuses on the available evidence of a novel antifolate agent, pemetrexed, in the treatment of both of these thoracic malignancies. Current status, persisting controversies and future developments are discussed.
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Domşa I, Crişan D, Olinici CD. Retroperitoneal synovial sarcoma. Rom J Morphol Embryol 2006; 47:187-91. [PMID: 17106529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Retroperitoneal synovial sarcomas are very rare. The authors describe a 39-year-old male with a primary retroperitoneal synovial sarcoma showing a monophasic pattern. Immunohistochemically, the tumor cells were positive for cytokeratin AE1/AE3, epithelial membrane antigen, vimentin, S-100 protein, CD99 and calretinin. The differential diagnosis, clinical evolution and principles of treatment are shortly discussed.
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Affiliation(s)
- I Domşa
- Department of Pathology, Railroad Hospital, Cluj-Napoca
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