1
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Vandaele T, Van Slambrouck J, Schöffski P, Dumez H, Weynand B, Sciot R, Barbarossa A, Provoost AL, Van de Voorde K, Debaveye Y, Bouneb S, Nafteux P, Ceulemans LJ. Extensive surgical resections for rare pleural neoplasms: a single-center experience with a yolk sac tumor and synovial sarcoma. World J Surg Oncol 2024; 22:96. [PMID: 38622623 PMCID: PMC11021014 DOI: 10.1186/s12957-024-03367-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 03/28/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Pleural neoplasms are rare and can be subdivided into pleural metastasis and primary pleural neoplasms. Non-mesothelioma primary pleural neoplasms are a diverse group of extremely rare pathologies. CASE PRESENTATION In this case series, we describe the presentation and management of two rare primary pleural neoplasms. A first case describes a primary pleural yolk sac tumor treated with neoadjuvant chemotherapy, extended pleurectomy decortication, and hyperthermic intrathoracic chemotherapy. In a second case we describe the management of a primary pleural synovial sarcoma by neoadjuvant chemotherapy and extrapleural pneumonectomy. A complete resection was obtained in both cases and the post-operative course was uncomplicated. No signs of tumor recurrence were noted during follow-up in the first patient. In the second patient a local recurrence was diagnosed 6 months after surgery. CONCLUSION Neo-adjuvant chemotherapy followed by extensive thoracic surgery, including hyperthermic intrathoracic chemotherapy, is a feasible treatment strategy for non-mesothelioma primary pleural neoplasms, but careful follow-up is required.
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Affiliation(s)
- Tom Vandaele
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium.
- Department of Chronic Diseases and Metabolism, Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium.
| | - Jan Van Slambrouck
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Chronic Diseases and Metabolism, Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium
| | - Patrick Schöffski
- Department of Oncology, University Hospitals Leuven, Leuven, Belgium
- Department of Oncology, Laboratory of experimental Oncology, KU Leuven, Leuven, Belgium
| | - Herlinde Dumez
- Department of Oncology, University Hospitals Leuven, Leuven, Belgium
- Department of Oncology, Laboratory of experimental Oncology, KU Leuven, Leuven, Belgium
| | - Birgit Weynand
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
- Department of Imaging and Pathology, Laboratory of translational cell and tissue research, KU Leuven, Leuven, Belgium
| | - Raf Sciot
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
- Department of Imaging and Pathology, Laboratory of translational cell and tissue research, KU Leuven, Leuven, Belgium
| | - Annalisa Barbarossa
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Chronic Diseases and Metabolism, Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium
| | - An-Lies Provoost
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Chronic Diseases and Metabolism, Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium
| | | | - Yves Debaveye
- Department of Intensive care, University Hospitals Leuven, Leuven, Belgium
- Department of cellular and molecular medicine, Laboratory of Intensive care, KU Leuven, Leuven, Belgium
| | - Sofian Bouneb
- Department of Anesthesiology, University Hospitals Leuven, Leuven, Belgium
- Department of cardiovascular science, Laboratory of anesthesiology and algology, KU Leuven, Leuven, Belgium
| | - Philippe Nafteux
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Chronic Diseases and Metabolism, Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium
| | - Laurens J Ceulemans
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Chronic Diseases and Metabolism, Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium
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2
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Herrtwich A, Sciot R, Ernst C. Myopericytoma in an Infant-Imaging Characteristics of a Rare but Benign Entity. J Belg Soc Radiol 2024; 108:3. [PMID: 38312148 PMCID: PMC10836187 DOI: 10.5334/jbsr.3441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 12/19/2023] [Indexed: 02/06/2024] Open
Abstract
Teaching point: Myopericytoma is a rare soft tissue tumor but should be considered in the differential diagnosis of infants with a fast-growing perivascular tumor.
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Affiliation(s)
| | - Raf Sciot
- Department of Pathology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Caroline Ernst
- Department of Pediatric Radiology, UZ Brussels, VUB, Brussels, Belgium
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3
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Nikoghosyan A, Sciot R, Jacobs SA, Verhaaren BFJ. Is Neuroradiology Complementary to Histopathology in Central Nervous System Tumors with an Alteration of the BCOR Gene? Clin Neuroradiol 2023:10.1007/s00062-023-01367-y. [PMID: 38129591 DOI: 10.1007/s00062-023-01367-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 11/12/2023] [Indexed: 12/23/2023]
Affiliation(s)
- A Nikoghosyan
- Department of Radiology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - R Sciot
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | - S A Jacobs
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - B F J Verhaaren
- Department of Radiology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.
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4
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Koshyk O, Dehner CA, van den Hout MFCM, Bempt IV, Sciot R, Huang HY, Agaimy A, Din NU, Klubíčková N, Mosaieby E, Skálová A, Michalová K, Schöffski P, Oliveira AM, Halling KC, Gupta S, Gross JM, Nin JWM, Michal M, Folpe AL, Kosemehmetoglu K, Torres-Mora J, Michal M. EWSR1::POU2AF3(COLCA2) Sarcoma: An Aggressive, Polyphenotypic Sarcoma With a Head and Neck Predilection. Mod Pathol 2023; 36:100337. [PMID: 37742928 DOI: 10.1016/j.modpat.2023.100337] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/25/2023] [Accepted: 09/15/2023] [Indexed: 09/26/2023]
Abstract
EWSR1::POU2AF3 (COLCA2) sarcomas are a recently identified group of undifferentiated round/spindle cell neoplasms with a predilection for the head and neck region. Herein, we report our experience with 8 cases, occurring in 5 men and 3 women (age range, 37-74 years; median, 60 years). Tumors involved the head/neck (4 cases), and one each the thigh, thoracic wall, fibula, and lung. Seven patients received multimodal therapy; 1 patient was treated only with surgery. Clinical follow-up (8 patients; range, 4-122 months; median, 32 months) showed 5 patients with metastases (often multifocal, with a latency ranging from 7 to 119 months), and 3 of them also with local recurrence. The median local recurrence-free and metastasis-free survival rates were 24 months and 29 months, respectively. Of the 8 patients, 1 died of an unknown cause, 4 were alive with metastatic disease, 1 was alive with unresectable local disease, and 2 were without disease. The tumors were composed of 2 morphologic subgroups: (1) relatively bland tumors consisting of spindled to stellate cells with varying cellularity and fibromyxoid stroma (2 cases) and (2) overtly malignant tumors composed of nests of "neuroendocrine-appearing" round cells surrounded by spindled cells (6 cases). Individual cases in the second group showed glandular, osteogenic, or rhabdomyoblastic differentiation. Immunohistochemical results included CD56 (4/4 cases), GFAP (5/8), SATB2 (4/6), keratin (AE1/AE3) (5/8), and S100 protein (4/7). RNA sequencing identified EWSR1::POU2AF3 gene fusion in all cases. EWSR1 gene rearrangement was confirmed by fluorescence in situ hybridization in 5 cases. Our findings confirm the head/neck predilection and aggressive clinical behavior of EWSR1::POU2AF3 sarcomas and widen the morphologic spectrum of these rare lesions to include relatively bland spindle cell tumors and tumors with divergent differentiation.
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Affiliation(s)
- Olena Koshyk
- Department of Pathology, Charles University, Faculty of Medicine in Plzeň, Czech Republic; Medical Laboratory CSD, Ltd, Kyiv, Ukraine
| | - Carina A Dehner
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota; Department of Pathology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Mari F C M van den Hout
- Department of Pathology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Isabelle Vanden Bempt
- Department for Human Genetics, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Raf Sciot
- Department of Pathology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Hsuan-Ying Huang
- Department of Anatomical Pathology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, Taiwan
| | - Abbas Agaimy
- Institute of Pathology, Friedrich-Alexander University Erlangen-Nürnberg, University Hospital, Erlangen, Germany
| | - Nasir Ud Din
- Section of Histopathology, Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Natálie Klubíčková
- Department of Pathology, Charles University, Faculty of Medicine in Plzeň, Czech Republic; Bioptical Laboratory, Ltd, Plzeň, Czech Republic
| | - Elaheh Mosaieby
- Department of Pathology, Charles University, Faculty of Medicine in Plzeň, Czech Republic; Bioptical Laboratory, Ltd, Plzeň, Czech Republic
| | - Alena Skálová
- Department of Pathology, Charles University, Faculty of Medicine in Plzeň, Czech Republic; Bioptical Laboratory, Ltd, Plzeň, Czech Republic
| | - Květoslava Michalová
- Department of Pathology, Charles University, Faculty of Medicine in Plzeň, Czech Republic; Bioptical Laboratory, Ltd, Plzeň, Czech Republic
| | - Patrick Schöffski
- Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium; Department of Oncology, KU Leuven, Laboratory of Experimental Oncology, Leuven, Belgium
| | - Andre M Oliveira
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Kevin C Halling
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Sounak Gupta
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - John M Gross
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Johanna W M Nin
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Michal Michal
- Department of Pathology, Charles University, Faculty of Medicine in Plzeň, Czech Republic; Bioptical Laboratory, Ltd, Plzeň, Czech Republic
| | - Andrew L Folpe
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | | | - Jorge Torres-Mora
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Michael Michal
- Department of Pathology, Charles University, Faculty of Medicine in Plzeň, Czech Republic; Bioptical Laboratory, Ltd, Plzeň, Czech Republic.
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5
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Cornelis S, Sciot R, Degreef I. Flexor carpi radialis tendon tear due to scaphoid osteoid osteoma: A case report. Hand Surg Rehabil 2023; 42:459-461. [PMID: 37499796 DOI: 10.1016/j.hansur.2023.06.012] [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] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 06/22/2023] [Accepted: 06/23/2023] [Indexed: 07/29/2023]
Abstract
Osteoid osteoma is a benign osteoblastic tumor with a low incidence. Due to its uncommon and often confusing clinical presentation, accurate diagnosis is frequently significantly delayed. We report a case of a 56-year old right-handed woman with a history of increasing pain in her right scaphotrapeziotrapezoidal (STT) joint and distal flexor carpi radialis (FCR). Due to its confusing clinical presentation, the diagnosis of a parosteal osteoid osteoma in the scaphoid and a rupture of the FCR, presenting as a Mannerfelt like lesion, was delayed for 1 year. The patient was treated with surgical exploration and excision. At follow-up, the patient recovered with complete resolution of pain and resumed daily life activities after 2 weeks. A high index of suspicion remains the key point in the diagnosis of osteoid osteoma, certainly in cases of unusual clinical presentation and anatomic localization as presented in this case.
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Affiliation(s)
- Steven Cornelis
- Orthopaedic Department - Institute for Orthopaedic Research and Training (IORT), Leuven University Hospitals, Leuven, Belgium.
| | - Raf Sciot
- Pathology Department, Leuven University Hospitals, Leuven, Belgium
| | - Ilse Degreef
- Orthopaedic Department, Leuven University Hospitals, Leuven, Belgium
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6
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Verbeek S, Sciot R, Debiec-Rychter M, Labarque V, Meyns B, Cools B. Case report: Cardiac intimal sarcoma in a young child. Front Pediatr 2023; 11:1238847. [PMID: 37818167 PMCID: PMC10560764 DOI: 10.3389/fped.2023.1238847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 09/11/2023] [Indexed: 10/12/2023] Open
Abstract
Undifferentiated mesenchymal tumors from the intimal layer (intimal sarcomas) are rare within the ventricles and exceptional in children. A rare case of an intimal sarcoma located in the right ventricle in a young child is presented with need for urgent surgical resection due to mechanical flow obstruction. Tumor cells showed amplification of MDM2 gene and a homozygous loss of CDKN2A on 9p21. A review of the literature regarding primary cardiac malignancies and intimal sarcoma in children is provided.
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Affiliation(s)
- Sanne Verbeek
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | - Raf Sciot
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | | | - Veerle Labarque
- Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Bart Meyns
- Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Bjorn Cools
- Department of Pediatric and Congenital Cardiology, University Hospitals Leuven, Leuven, Belgium
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7
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De Sutter L, Wozniak A, Verreet J, Vanleeuw U, De Cock L, Linde N, Drechsler C, Esdar C, Sciot R, Schöffski P. Anti-tumor efficacy of the novel KIT inhibitor IDRX-42 (formerly M4205) in patient- and cell line-derived xenograft models of gastrointestinal stromal tumor (GIST). Clin Cancer Res 2023:726922. [PMID: 37223931 DOI: 10.1158/1078-0432.ccr-22-3822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 03/17/2023] [Accepted: 05/19/2023] [Indexed: 05/25/2023]
Abstract
BACKGROUND The majority of GIST are driven by constitutively activated KIT/PDGFRA kinases and are susceptible to treatment with tyrosine kinase inhibitors. During treatment, most of these tumors will develop secondary mutations in KIT or PDGFRA inducing drug resistance, so there is an unmet need for novel therapies. We tested the efficacy of IDRX-42, a novel selective KIT inhibitor with high activity towards the most relevant KIT mutations, in 4 GIST xenograft models. METHODS NMRI nu/nu mice were transplanted with patient-derived GIST xenograft models UZLX-GIST9 (KIT:p.P577del;W557LfsX5;D820G), UZLX-GIST2B (KIT:p.A502_Y503dup), UZLX-GIST25 (KIT:p.K642E) and the cell-line derived model GIST882 (KIT:p.K642E). Mice were treated daily with vehicle (control), imatinib (100mg/kg), sunitinib (20mg/kg), avapritinib (5mg/kg), or IDRX-42 (10mg/kg, 25mg/kg). Efficacy was assessed by tumor volume evolution, histopathology, grading of histological response and immunohistochemistry. The Kruskal-Wallis and Wilcoxon Matched Pairs tests were used for statistical analysis, with p<0.05 considered as significant. RESULTS IDRX-42 (25mg/kg) caused tumor volume shrinkage in UZLX-GIST25, GIST882 and UZLX-GIST2B, with a relative decrease to 45.6%, 57.3% and 35.1% on the last day as compared to baseline, and tumor growth delay (160.9%) compared to control in UZLX-GIST9. Compared to controls, IDRX-42 (25mg/kg) induced a significant decrease in mitosis. In UZLX-GIST25 and GIST882 grade 2-4 HR with myxoid degeneration was observed in all IDRX-42 (25mg/kg)-treated tumors. CONCLUSION IDRX-42 showed significant antitumor activity in patient- and cell line-derived GIST xenograft models. The novel kinase inhibitor induced volumetric responses, decreased mitotic activity and had antiproliferative effects. In models with KIT exon 13 mutation IDRX-42 induced characteristic myxoid degeneration.
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Affiliation(s)
| | | | | | | | | | - Nina Linde
- Merck HealthCare KGaA, Darmstadt, Germany
| | | | | | - Raf Sciot
- KU Leuven and University Hospitals Leuven, Leuven, Belgium
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8
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Panovska D, Nazari P, Cole B, Creemers PJ, Derweduwe M, Solie L, Van Gassen S, Claeys A, Verbeke T, Cohen EF, Tolstorukov MY, Saeys Y, Van der Planken D, Bosisio FM, Put E, Bamps S, Clement PM, Verfaillie M, Sciot R, Ligon KL, De Vleeschouwer S, Antoranz A, De Smet F. Single-cell molecular profiling using ex vivo functional readouts fuels precision oncology in glioblastoma. Cell Mol Life Sci 2023; 80:147. [PMID: 37171617 PMCID: PMC11071868 DOI: 10.1007/s00018-023-04772-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/06/2023] [Accepted: 03/29/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND Functional profiling of freshly isolated glioblastoma (GBM) cells is being evaluated as a next-generation method for precision oncology. While promising, its success largely depends on the method to evaluate treatment activity which requires sufficient resolution and specificity. METHODS Here, we describe the 'precision oncology by single-cell profiling using ex vivo readouts of functionality' (PROSPERO) assay to evaluate the intrinsic susceptibility of high-grade brain tumor cells to respond to therapy. Different from other assays, PROSPERO extends beyond life/death screening by rapidly evaluating acute molecular drug responses at single-cell resolution. RESULTS The PROSPERO assay was developed by correlating short-term single-cell molecular signatures using mass cytometry by time-of-flight (CyTOF) to long-term cytotoxicity readouts in representative patient-derived glioblastoma cell cultures (n = 14) that were exposed to radiotherapy and the small-molecule p53/MDM2 inhibitor AMG232. The predictive model was subsequently projected to evaluate drug activity in freshly resected GBM samples from patients (n = 34). Here, PROSPERO revealed an overall limited capacity of tumor cells to respond to therapy, as reflected by the inability to induce key molecular markers upon ex vivo treatment exposure, while retaining proliferative capacity, insights that were validated in patient-derived xenograft (PDX) models. This approach also allowed the investigation of cellular plasticity, which in PDCLs highlighted therapy-induced proneural-to-mesenchymal (PMT) transitions, while in patients' samples this was more heterogeneous. CONCLUSION PROSPERO provides a precise way to evaluate therapy efficacy by measuring molecular drug responses using specific biomarker changes in freshly resected brain tumor samples, in addition to providing key functional insights in cellular behavior, which may ultimately complement standard, clinical biomarker evaluations.
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Affiliation(s)
- Dena Panovska
- Department of Imaging and Pathology, KU Leuven, Herestraat 49, Box 1032, Leuven, Belgium
| | - Pouya Nazari
- Department of Imaging and Pathology, KU Leuven, Herestraat 49, Box 1032, Leuven, Belgium
| | - Basiel Cole
- Department of Imaging and Pathology, KU Leuven, Herestraat 49, Box 1032, Leuven, Belgium
| | - Pieter-Jan Creemers
- Department of Imaging and Pathology, KU Leuven, Herestraat 49, Box 1032, Leuven, Belgium
| | - Marleen Derweduwe
- Department of Imaging and Pathology, KU Leuven, Herestraat 49, Box 1032, Leuven, Belgium
| | - Lien Solie
- Department of Imaging and Pathology, KU Leuven, Herestraat 49, Box 1032, Leuven, Belgium
- Department of Neurosurgery, University Hospitals (UZ) Leuven, Leuven, Belgium
- Laboratory of Experimental Neurosurgery and Neuroanatomy, Department of Neurosciences, Leuven Brain Institute (LBI), KU Leuven, Leuven, Belgium
| | - Sofie Van Gassen
- Data Mining and Modeling for Biomedicine Group, VIB Inflammation Research Center, Ghent University, Ghent, Belgium
- Department of Applied Mathematics, Computer Science and Statistics, Ghent University, Ghent, Belgium
| | - Annelies Claeys
- Department of Imaging and Pathology, KU Leuven, Herestraat 49, Box 1032, Leuven, Belgium
| | - Tatjana Verbeke
- Department of Imaging and Pathology, KU Leuven, Herestraat 49, Box 1032, Leuven, Belgium
| | - Elizabeth F Cohen
- Department of Informatics and Analytics, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Michael Y Tolstorukov
- Department of Informatics and Analytics, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Yvan Saeys
- Data Mining and Modeling for Biomedicine Group, VIB Inflammation Research Center, Ghent University, Ghent, Belgium
- Department of Applied Mathematics, Computer Science and Statistics, Ghent University, Ghent, Belgium
| | | | - Francesca M Bosisio
- Department of Imaging and Pathology, KU Leuven, Herestraat 49, Box 1032, Leuven, Belgium
| | - Eric Put
- Neurosurgery Department, Faculty of Medicine and Life Sciences UHasselt, Hasselt, Belgium
| | - Sven Bamps
- Neurosurgery Department, Faculty of Medicine and Life Sciences UHasselt, Hasselt, Belgium
| | - Paul M Clement
- Department of Oncology, KU Leuven/UZ Leuven, Leuven, Belgium
| | - Michiel Verfaillie
- Europaziekenhuizen, Cliniques de l'Europe, Sint-Elisabeth, Brussels, Belgium
| | - Raf Sciot
- Department of Imaging and Pathology, KU Leuven, Herestraat 49, Box 1032, Leuven, Belgium
| | - Keith L Ligon
- Department of Informatics and Analytics, Dana-Farber Cancer Institute, Boston, MA, USA
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA
- Department of Pathology, Harvard Medical School, Boston, MA, USA
| | - Steven De Vleeschouwer
- Department of Neurosurgery, University Hospitals (UZ) Leuven, Leuven, Belgium
- Laboratory of Experimental Neurosurgery and Neuroanatomy, Department of Neurosciences, Leuven Brain Institute (LBI), KU Leuven, Leuven, Belgium
| | - Asier Antoranz
- Department of Imaging and Pathology, KU Leuven, Herestraat 49, Box 1032, Leuven, Belgium
| | - Frederik De Smet
- Department of Imaging and Pathology, KU Leuven, Herestraat 49, Box 1032, Leuven, Belgium.
- Leuven Institute for single-cell omics (LISCO), Leuven, Belgium.
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9
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De Langhe E, Van Loo S, Malengier-Devlies B, Metzemaekers M, Staels F, Vandenhaute J, Berghen N, Sciot R, Corveleyn A, Tšuiko O, Gouwy M, Lenaerts J, Verschueren P, Wouters CH, Proost P, Matthys P, Legius E, Schrijvers R. TET2-Driver and NLRC4-Passenger Variants in Adult-Onset Autoinflammation. N Engl J Med 2023; 388:1626-1629. [PMID: 37099347 DOI: 10.1056/nejmc2212928] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Affiliation(s)
| | | | | | | | | | | | | | - Raf Sciot
- University Hospitals Leuven, Leuven, Belgium
| | | | - Olga Tšuiko
- University Hospitals Leuven, Leuven, Belgium
| | | | | | | | | | | | | | - Eric Legius
- University Hospitals Leuven, Leuven, Belgium
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10
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Decraene B, Vanmechelen M, Clement P, Daisne JF, Vanden Bempt I, Sciot R, Garg AD, Agostinis P, De Smet F, De Vleeschouwer S. Cellular and molecular features related to exceptional therapy response and extreme long-term survival in glioblastoma. Cancer Med 2023. [PMID: 36776000 DOI: 10.1002/cam4.5681] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 01/17/2023] [Accepted: 01/31/2023] [Indexed: 02/14/2023] Open
Abstract
Glioblastoma Multiforme (GBM) remains the most common malignant primary brain tumor with a dismal prognosis that rarely exceeds beyond 2 years despite extensive therapy, which consists of maximal safe surgical resection, radiotherapy, and/or chemotherapy. Recently, it has become clear that GBM is not one homogeneous entity and that both intra-and intertumoral heterogeneity contributes significantly to differences in tumoral behavior which may consequently be responsible for differences in survival. Strikingly and in spite of its dismal prognosis, small fractions of GBM patients seem to display extremely long survival, defined as surviving over 10 years after diagnosis, compared to the large majority of patients. Although the underlying mechanisms for this peculiarity remain largely unknown, emerging data suggest that still poorly characterized both cellular and molecular factors of the tumor microenvironment and their interplay probably play an important role. We hereby give an extensive overview of what is yet known about these cellular and molecular features shaping extreme long survival in GBM.
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Affiliation(s)
- B Decraene
- KU Leuven, Laboratory for Precision Cancer Medicine, Translational Cell and Tissue Research Unit, Leuven, Belgium.,KU Leuven Department of Neurosciences, Experimental Neurosurgery and Neuroanatomy Research Group, Leuven, Belgium.,Department of Neurosurgery, University Hospitals Leuven, Leuven, Belgium
| | - M Vanmechelen
- KU Leuven, Laboratory for Precision Cancer Medicine, Translational Cell and Tissue Research Unit, Leuven, Belgium.,Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - P Clement
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - J F Daisne
- Radiation Oncology Department, University Hospitals Leuven, Leuven, Belgium
| | - I Vanden Bempt
- Department of Human Genetics, University Hospitals Leuven, Leuven, Belgium
| | - R Sciot
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | - A D Garg
- KU Leuven, VIB Center for Cancer Biology Research, Leuven, Belgium
| | - P Agostinis
- KU Leuven, Laboratory of Cell Stress & Immunity (CSI), Department of Cellular & Molecular Medicine, Leuven, Belgium
| | - F De Smet
- KU Leuven, Laboratory for Precision Cancer Medicine, Translational Cell and Tissue Research Unit, Leuven, Belgium
| | - S De Vleeschouwer
- KU Leuven Department of Neurosciences, Experimental Neurosurgery and Neuroanatomy Research Group, Leuven, Belgium.,Department of Neurosurgery, University Hospitals Leuven, Leuven, Belgium.,KU Leuven, Leuven Brain Institute (LBI), Leuven, Belgium
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11
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Aukema SM, Glaser S, van den Hout MFCM, Dahlum S, Blok MJ, Hillmer M, Kolarova J, Sciot R, Schott DA, Siebert R, Stumpel CTRM. Molecular characterization of an embryonal rhabdomyosarcoma occurring in a patient with Kabuki syndrome: report and literature review in the light of tumor predisposition syndromes. Fam Cancer 2023; 22:103-118. [PMID: 35856126 PMCID: PMC9829644 DOI: 10.1007/s10689-022-00306-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 07/05/2022] [Indexed: 01/13/2023]
Abstract
Kabuki syndrome is a well-recognized syndrome characterized by facial dysmorphism and developmental delay/intellectual disability and in the majority of patients a germline variant in KMT2D is found. As somatic KMT2D variants can be found in 5-10% of tumors a tumor predisposition in Kabuki syndrome is discussed. So far less than 20 patients with Kabuki syndrome and a concomitant malignancy have been published. Here we report on a female patient with Kabuki syndrome and a c.2558_2559delCT germline variant in KMT2D who developed an embryonal rhabdomyosarcoma (ERMS) at 10 years. On tumor tissue we performed DNA-methylation profiling and exome sequencing (ES). Copy number analyses revealed aneuploidies typical for ERMS including (partial) gains of chromosomes 2, 3, 7, 8, 12, 15, and 20 and 3 focal deletions of chromosome 11p. DNA methylation profiling mapped the case to ERMS by a DNA methylation-based sarcoma classifier. Sequencing suggested gain of the wild-type KMT2D allele in the trisomy 12. Including our patient literature review identified 18 patients with Kabuki syndrome and a malignancy. Overall, the landscape of malignancies in patients with Kabuki syndrome was reminiscent of that of the pediatric population in general. Histopathological and molecular data were only infrequently reported and no report included next generation sequencing and/or DNA-methylation profiling. Although we found no strong arguments pointing towards KS as a tumor predisposition syndrome, based on the small numbers any relation cannot be fully excluded. Further planned studies including profiling of additional tumors and long term follow-up of KS-patients into adulthood could provide further insights.
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Affiliation(s)
- Sietse M Aukema
- Department of Clinical Genetics, Maastricht University Medical Centre (MUMC+), PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
| | - Selina Glaser
- Institute of Human Genetics, Ulm University and Ulm University Medical Center, Ulm, Germany
| | - Mari F C M van den Hout
- Department of Pathology, Research Institute GROW, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Sonja Dahlum
- Institute of Human Genetics, Ulm University and Ulm University Medical Center, Ulm, Germany
| | - Marinus J Blok
- Department of Clinical Genetics, Maastricht University Medical Centre (MUMC+), PO Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - Morten Hillmer
- Institute of Human Genetics, Ulm University and Ulm University Medical Center, Ulm, Germany
| | - Julia Kolarova
- Institute of Human Genetics, Ulm University and Ulm University Medical Center, Ulm, Germany
| | - Raf Sciot
- Department of Pathology, University Hospital, University of Leuven, 3000, Louvain, Belgium
| | - Dina A Schott
- Department of Clinical Genetics, Maastricht University Medical Centre (MUMC+), PO Box 5800, 6202 AZ, Maastricht, The Netherlands
- Department of Pediatrics, Zuyderland Medical Center, Heerlen, The Netherlands
| | - Reiner Siebert
- Institute of Human Genetics, Ulm University and Ulm University Medical Center, Ulm, Germany
| | - Constance T R M Stumpel
- Department of Clinical Genetics, Maastricht University Medical Centre (MUMC+), PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
- Department of Clinical Genetics and GROW-School for Oncology & Developmental Biology, Maastricht University Medical Center+, Maastricht, The Netherlands.
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12
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Verheggen K, Bhattacharya N, Verhaert M, Goossens B, Sciot R, Verhaert P. HistoSnap: A Novel Software Tool to Extract m/z-Specific Images from Large MSHC Datasets. Methods Mol Biol 2023; 2688:15-26. [PMID: 37410280 DOI: 10.1007/978-1-0716-3319-9_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
We describe an informatics tool for comfortable browsing through highly complex, multi-gigabyte mass spectrometry histochemistry (MSHC) datasets, via clever ion-specific image extraction.The package is developed particularly for the untargeted localization/discovery of biomolecules such as endogenous (neuro)secretory peptides on histological sections of biobanked formaldehyde-fixed paraffin-embedded (FFPE) samples straight from tissue banks.Atmospheric pressure-MALDI-Orbitrap MSHC data of sections through human pituitary adenomas in which two well-known human neuropeptides are detected are used as an example to demonstrate the key features of the novel software, named HistoSnap.
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Affiliation(s)
| | | | - Marthe Verhaert
- ProteoFormiX, Beerse, Belgium
- Department of Medical Oncology at Institute Jules Bordet, Brussels, Belgium
| | | | - Raf Sciot
- ProteoFormiX, Beerse, Belgium
- Translational Tissue and Cell Research Unit, Department of Imaging and Pathology, University Hospital, Leuven, Belgium
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13
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Bhattacharya N, Nagornov K, Verheggen K, Verhaert M, Sciot R, Verhaert P. MS1-Based Data Analysis Approaches for FFPE Tissue Imaging of Endogenous Peptide Ions by Mass Spectrometry Histochemistry (MSHC). Methods Mol Biol 2023; 2688:187-202. [PMID: 37410294 DOI: 10.1007/978-1-0716-3319-9_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
Ambiguous reports in the literature exist regarding the use and usefulness of formalin-fixed paraffin-embedded (FFPE) tissues in mass spectrometry imaging (MSI). Especially for the study of endogenous (non-tryptic) peptides, several studies have concluded that MSI on archived FFPE tissue bank samples is virtually impossible. We here illustrate that by employing a variant of MSI, called mass spectrometry histochemistry (MSHC), biomolecular tissue localization data are obtained that unequivocally comprise endogenous peptides. We here discuss different informatics steps in a data analysis workflow to help filter peptide-related features out of large and complex datasets generated by atmospheric pressure matrix-assisted laser desorption/ionization high-resolution (Orbitrap mass analyzer) MSHC. These include, in addition to accurate mass measurements, Kendrick mass defect filtering and isotopic distribution scrutiny.
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Affiliation(s)
| | | | | | - Marthe Verhaert
- ProteoFormiX, Beerse, Belgium
- Department of Medical Oncology at Institute Jules Bordet, Brussels, Belgium
| | - Raf Sciot
- Department of Pathology, University Hospital Leuven, Leuven, Belgium
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14
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Mennens F, Van Herck Y, Sciot R, Vanden Bempt I, Boecxstaens V, Garmyn M, Bechter O. Melanoma cell plasticity poses diagnostic challenges: a case series. Melanoma Res 2022; 32:428-439. [PMID: 36125893 DOI: 10.1097/cmr.0000000000000852] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Phenotype switching is an emerging concept in melanoma research and deals with the cancer cell plasticity. In this paper, we present five cases of patients with metastatic malignant melanoma where the tumor underwent dramatic morphological and immunohistochemical changes thereby mimicking other types of malignancies. The diagnosis of melanoma in all these cases was based on the mutational profile of the tumor assessed by next-generation sequencing compared to the primary lesion or local regional lymph nodes. These cases highlight the importance of thorough diagnostic measures in patients with metastatic melanoma who show progressive disease and where basic pathological assessment shows a diagnostic discrepancy.
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Affiliation(s)
| | | | | | | | | | - Maria Garmyn
- Dermatology, University Hospitals Leuven, Leuven, Belgium
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15
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Decraene B, Antoranz A, Verbeke T, Vanmechelen M, Nazari P, Solie L, Dubroja N, Derweduwe M, Spans L, Bempt IV, Sciot R, De Smet F, De Vleeschouwer S. TMIC-37. SINGLE-CELL CHARACTERIZATION OF THE IMMUNE LANDSCAPE OF EXTREME LONG-TERM SURVIVORS WITH MALIGNANT GLIOMA. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac209.1081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Glioblastoma Multiforme (GBM) remains the most common malignant primary brain tumor with a dismal prognosis that rarely exceeds beyond two years despite extensive therapy, which consists of maximal safe surgical resection, radiotherapy and/or chemotherapy. Recently, it has become clear that GBM is not one homogeneous entity and that both intra-and intertumoral heterogeneity contribute significantly to differences in tumoral behavior which may consequently be responsible for differences in survival. Strikingly and despite its dismal prognosis, small fractions of GBM patients seem to display extreme extended survival compared to the large majority of patients. The underlying mechanisms for this peculiarity remain largely unknown however, even though emerging data suggest that both cancer cell-autonomous and microenvironmental factors and their interplay probably play an important role. We used high-dimensional, multiplexed immunohistochemistry to spatially, and cytometry by time-of-flight to quantitively, characterize the cell constitution and interactions within the tumor microenvironment (TME) in 21 extreme long-term survivors (living over 10 year) and 42 deeply matched controls and therefore short-term survivors (living under 1.5 year) on a single cell level. For all tumors (epi)genetic data was also collected. We identified a high level of both inter-and intrapatient heterogeneity defined by several distinct tumoral niches, as well as described interactions within these niches and with the surrounding infiltrating immune cells of the TME in GBM. Finally, by linking patient characteristics with the heterogeneous immune composition we are able to create an immune stratification that can be linked to patient survival in GBM. Therefore, this study is an essential initial step towards strategies to alter the TME in a favorable way with a personalized modulation strategy.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Raf Sciot
- University Hospitals Leuven & KU Leuven , Leuven , USA
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16
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De Visser Y, Panovska D, Cole B, Hermans L, Martinez AA, Nazari P, Van Trimpont M, Derweduwe M, Claeys A, De Vleeschouwer S, Solie L, Clement P, Sciot R, Verfaillie M, Daenekindt T, Bamps S, Van Vlierberghe P, De Smet F. BIOM-16. A MULTI-OMIC, FUNCTIONAL PRECISION ONCOLOGY METHOD TO IDENTIFY RESPONSIVE GLIOBLASTOMA TUMOR CELLS AT SINGLE CELL RESOLUTION. Neuro Oncol 2022. [PMCID: PMC9661181 DOI: 10.1093/neuonc/noac209.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Glioblastoma remains a highly malignant and intrinsically resistant brain tumor. Despite intensive research through which numerous potential druggable targets were identified, virtually all clinical trials of the past 20 years failed to improve the outcome for the vast majority of GBM patients. However, the identification of small subgroups of patients that showed an exceptional response across several trials, implies that, when selected more carefully, some GBM patients could probably still benefit from these therapies. Identifying these patients requires that suitable biomarkers are identified. In this project, we reassessed the molecular mechanisms of ten actionable compounds (selected from previously failed trials but for which exceptional responders had been observed) in a set of carefully selected patient-derived cell lines that were sensitive/resistant to the selected therapies. Moreover, to deal with tumor heterogeneity, we used a multi-omic functional precision oncology approach, combining scRNA-seq and CyTOF, to identify drug-specific biomarkers by comparing control and treated samples at single-cell resolution. By subsequently correlating the molecular signatures to eventual cytotoxicity profiles, we could identify intrinsically responsive tumor cells at the single-cell level within hours following drug exposure. Overall, this work lays the foundation for an actionable functional diagnostic assay that could help to identify eligible GBM patients in future clinical trials.
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17
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Georgiesh T, Aggerholm-Pedersen N, Schöffski P, Zhang Y, Napolitano A, Bovée JVMG, Hjelle Å, Tang G, Spalek M, Nannini M, Swanson D, Baad-Hansen T, Sciot R, Hesla AC, Huang P, Dorleijn D, Haugland HK, Lacambra M, Skoczylas J, Pantaleo MA, Haas RL, Meza-Zepeda LA, Haller F, Czarnecka AM, Loong H, Jebsen NL, van de Sande M, Jones RL, Haglund F, Timmermans I, Safwat A, Bjerkehagen B, Boye K. Validation of a novel risk score to predict early and late recurrence in solitary fibrous tumour. Br J Cancer 2022; 127:1793-1798. [PMID: 36030294 PMCID: PMC9643389 DOI: 10.1038/s41416-022-01959-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 08/08/2022] [Accepted: 08/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Current risk models in solitary fibrous tumour (SFT) were developed using cohorts with short follow-up and cannot reliably identify low-risk patients. We recently developed a novel risk model (G-score) to account for both early and late recurrences. Here, we aimed to validate the G-score in a large international cohort with long-term follow-up. METHODS Data were collected from nine sarcoma referral centres worldwide. Recurrence-free interval (RFi) was the primary endpoint. RESULTS The cohort comprised 318 patients with localised extrameningeal SFTs. Disease recurrence occurred in 96 patients (33%). The estimated 5-year RFi rate was 72%, and the 10-year RFi rate was 52%. G-score precisely predicted recurrence risk with estimated 10-year RFi rate of 84% in low risk, 54% in intermediate risk and 36% in high risk (p < 0.001; C-index 0.691). The mDemicco (p < 0.001; C-index 0.749) and SalasOS (p < 0.001; C-index 0.674) models also predicted RFi but identified low-risk patients less accurate with 10-year RFi rates of 72% and 70%, respectively. CONCLUSIONS G-score is a highly significant predictor of early and late recurrence in SFT and is superior to other models to predict patients at low risk of relapse. A less intensive follow-up schedule could be considered for patients at low recurrence risk according to G-score.
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Affiliation(s)
- Tatiana Georgiesh
- Department of Pathology, Oslo University Hospital, Oslo, Norway
- Department of Tumour Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
| | | | - Patrick Schöffski
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Yifan Zhang
- Department of Oncology-Pathology, Karolinska Institutet and Clinical Pathology and Cancer Diagnostics, Karolinska University Hospital, Stockholm, Sweden
| | - Andrea Napolitano
- Sarcoma Unit, The Royal Marsden Hospital and The Institute of Cancer Research, London, UK
| | - Judith V M G Bovée
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Åse Hjelle
- Department of Oncology, Haukeland University Hospital, Bergen, Norway
| | - Gordon Tang
- Department of Clinical Oncology, Prince of Wales Hospital, Hong Kong SAR, China
| | - Mateusz Spalek
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Margherita Nannini
- Division of Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - David Swanson
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Thomas Baad-Hansen
- Department of Orthopedic Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Raf Sciot
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | - Asle C Hesla
- Department of Molecular Medicine and Surgery, Karolinska Institutet and Clinical Orthopaedics, Karolinska University Hospital, Stockholm, Sweden
| | - Paul Huang
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
| | - Desiree Dorleijn
- Department of Orthopedic Surgery, Bone and Soft Tissue Tumor Unit, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Maribel Lacambra
- Department of Clinical Oncology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jacek Skoczylas
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Maria A Pantaleo
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Rick L Haas
- Department of Radiotherapy, the Netherlands Cancer Institute, Amsterdam, The Netherlands and Department of Radiotherapy, the Leiden University Medical Center, Leiden, The Netherlands
| | - Leonardo A Meza-Zepeda
- Department of Tumour Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
- Department of Core Facilities, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
| | - Florian Haller
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Anna M Czarnecka
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Herbert Loong
- Department of Clinical Oncology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Nina L Jebsen
- Department of Oncology, Haukeland University Hospital, Bergen, Norway
| | - Michiel van de Sande
- Department of Orthopedic Surgery, Bone and Soft Tissue Tumor Unit, Leiden University Medical Center, Leiden, The Netherlands
| | - Robin L Jones
- Sarcoma Unit, The Royal Marsden Hospital and The Institute of Cancer Research, London, UK
| | - Felix Haglund
- Department of Oncology-Pathology, Karolinska Institutet and Clinical Pathology and Cancer Diagnostics, Karolinska University Hospital, Stockholm, Sweden
| | - Iris Timmermans
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Akmal Safwat
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Bodil Bjerkehagen
- Department of Pathology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kjetil Boye
- Department of Tumour Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway.
- Department of Oncology, Oslo University Hospital, Oslo, Norway.
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18
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Parik S, Fernández-García J, Lodi F, De Vlaminck K, Derweduwe M, De Vleeschouwer S, Sciot R, Geens W, Weng L, Bosisio FM, Bergers G, Duerinck J, De Smet F, Lambrechts D, Van Ginderachter JA, Fendt SM. GBM tumors are heterogeneous in their fatty acid metabolism and modulating fatty acid metabolism sensitizes cancer cells derived from recurring GBM tumors to temozolomide. Front Oncol 2022; 12:988872. [PMID: 36338708 PMCID: PMC9635944 DOI: 10.3389/fonc.2022.988872] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 08/16/2022] [Indexed: 07/30/2023] Open
Abstract
Glioblastoma is a highly lethal grade of astrocytoma with very low median survival. Despite extensive efforts, there is still a lack of alternatives that might improve these prospects. We uncovered that the chemotherapeutic agent temozolomide impinges on fatty acid synthesis and desaturation in newly diagnosed glioblastoma. This response is, however, blunted in recurring glioblastoma from the same patient. Further, we describe that disrupting cellular fatty acid homeostasis in favor of accumulation of saturated fatty acids such as palmitate synergizes with temozolomide treatment. Pharmacological inhibition of SCD and/or FADS2 allows palmitate accumulation and thus greatly augments temozolomide efficacy. This effect was independent of common GBM prognostic factors and was effective against cancer cells from recurring glioblastoma. In summary, we provide evidence that intracellular accumulation of saturated fatty acids in conjunction with temozolomide based chemotherapy induces death in glioblastoma cells derived from patients.
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Affiliation(s)
- Sweta Parik
- Laboratory of Cellular Metabolism and Metabolic Regulation, VIB-KU Leuven Center for Cancer Biology, VIB, Leuven, Belgium
- Laboratory of Cellular Metabolism and Metabolic Regulation, Department of Oncology, KU Leuven and Leuven Cancer Institute (LKI), Leuven, Belgium
- Laboratory of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium
- Myeloid Cell Immunology Laboratory, VIB Center for Inflammation Research, Brussels, Belgium
| | - Juan Fernández-García
- Laboratory of Cellular Metabolism and Metabolic Regulation, VIB-KU Leuven Center for Cancer Biology, VIB, Leuven, Belgium
- Laboratory of Cellular Metabolism and Metabolic Regulation, Department of Oncology, KU Leuven and Leuven Cancer Institute (LKI), Leuven, Belgium
| | - Francesca Lodi
- Laboratory for Translational Genetics, VIB-KU Leuven Center for Cancer Biology, VIB, Leuven, Belgium
- Laboratory for Translational Genetics, Department of Human Genetics, KU Leuven, Leuven, Belgium
| | - Karen De Vlaminck
- Laboratory of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium
- Myeloid Cell Immunology Laboratory, VIB Center for Inflammation Research, Brussels, Belgium
| | - Marleen Derweduwe
- Laboratory for Precision Cancer Medicine, Translational Cell and Tissue Research, Department of Imaging & Pathology, KU Leuven, Leuven, Belgium
| | | | - Raf Sciot
- Department of Pathology, University Hospital Leuven, KU Leuven, Leuven, Belgium
| | - Wietse Geens
- Department of Neurosurgery, UZ Brussel, Jette, Belgium
| | - Linqian Weng
- Laboratory of Tumor Microenvironment and Therapeutic Resistance, VIB-KU Leuven Center for Cancer Biology, VIB, Leuven, Belgium
| | - Francesca Maria Bosisio
- Department of Pathology, University Hospital Leuven, KU Leuven, Leuven, Belgium
- Laboratory of Translational Cell & Tissue Research Department of Pathology, University Hospital Leuven, Leuven, Belgium
| | - Gabriele Bergers
- Laboratory of Tumor Microenvironment and Therapeutic Resistance, VIB-KU Leuven Center for Cancer Biology, VIB, Leuven, Belgium
- Department of Neurological Surgery, UCSF Comprehensive Cancer Center, University of California San Francisco (UCSF), San Francisco, CA, United States
| | | | - Frederick De Smet
- Laboratory for Precision Cancer Medicine, Translational Cell and Tissue Research, Department of Imaging & Pathology, KU Leuven, Leuven, Belgium
| | - Diether Lambrechts
- Laboratory for Translational Genetics, VIB-KU Leuven Center for Cancer Biology, VIB, Leuven, Belgium
- Laboratory for Translational Genetics, Department of Human Genetics, KU Leuven, Leuven, Belgium
| | - Jo A. Van Ginderachter
- Laboratory of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium
- Myeloid Cell Immunology Laboratory, VIB Center for Inflammation Research, Brussels, Belgium
| | - Sarah-Maria Fendt
- Laboratory of Cellular Metabolism and Metabolic Regulation, VIB-KU Leuven Center for Cancer Biology, VIB, Leuven, Belgium
- Laboratory of Cellular Metabolism and Metabolic Regulation, Department of Oncology, KU Leuven and Leuven Cancer Institute (LKI), Leuven, Belgium
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19
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De Sutter L, Wozniak A, Verreet J, Vanleeuw U, De Cock L, Linde N, Drechsler C, Esdar C, Sciot R, Schoeffski P. 1514P Anti-tumor effects of the novel KIT mutant inhibitor M4205 in gastrointestinal stromal tumor (GIST) xenograft models. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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20
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Van Renterghem B, Wozniak A, Castro PG, Franken P, Pencheva N, Sciot R, Schöffski P. Enapotamab Vedotin, an AXL-Specific Antibody-Drug Conjugate, Demonstrates Antitumor Efficacy in Patient-Derived Xenograft Models of Soft Tissue Sarcoma. Int J Mol Sci 2022; 23:7493. [PMID: 35886842 PMCID: PMC9322120 DOI: 10.3390/ijms23147493] [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: 05/30/2022] [Revised: 06/28/2022] [Accepted: 07/04/2022] [Indexed: 11/16/2022] Open
Abstract
Doxorubicin (doxo) remains the standard of care for patients with advanced soft tissue sarcoma (STS), even though response rates to doxo are only around 14% to 18%. We evaluated enapotamab vedotin (EnaV), an AXL-specific antibody-drug conjugate (ADC), in a panel of STS patient-derived xenografts (PDX). Eight models representing multiple STS subtypes were selected from our STS PDX platform (n = 45) by AXL immunostaining on archived passages. Models were expanded by unilateral transplantation of tumor tissue into the left flank of 20 NMRI nu/nu mice. Once tumors were established, mice were randomized into an EnaV treatment group, or a group treated with isotype control ADC. Treatment efficacy was assessed by tumor volume evaluation, survival analysis, and histological evaluation of tumors, and associated with AXL expression. EnaV demonstrated significant tumor growth delay, regression, and/or prolonged survival compared to isotype control ADC in 5/8 STS PDX models investigated. Experimental passages of responding models were all found positive for AXL at varying levels, but no linear relationship could be identified between the level of expression and level of response to EnaV. One model was found negative for AXL on experimental passage and did not respond to EnaV. This study provides a preclinical rationale for the evaluation of AXL-targeting ADCs in the treatment of AXL-expressing sarcomas.
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Affiliation(s)
- Britt Van Renterghem
- Laboratory of Experimental Oncology, Catholic University of Leuven, 3000 Leuven, Belgium; (B.V.R.); (A.W.)
| | - Agnieszka Wozniak
- Laboratory of Experimental Oncology, Catholic University of Leuven, 3000 Leuven, Belgium; (B.V.R.); (A.W.)
| | | | - Patrick Franken
- Genmab, 3584 Utrecht, The Netherlands; (P.G.C.); (P.F.); (N.P.)
| | - Nora Pencheva
- Genmab, 3584 Utrecht, The Netherlands; (P.G.C.); (P.F.); (N.P.)
| | - Raf Sciot
- Department of Pathology, University Hospitals Leuven, Catholic University of Leuven, 3000 Leuven, Belgium;
| | - Patrick Schöffski
- Laboratory of Experimental Oncology, Catholic University of Leuven, 3000 Leuven, Belgium; (B.V.R.); (A.W.)
- Department of General Medical Oncology, University Hospitals Leuven, 3000 Leuven, Belgium
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21
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Nys C, Lee YL, Roose H, Mertens F, De Pauw E, Kobayashi H, Sciot R, Bex M, Versyck G, De Vleeschouwer S, Van Loon J, Laporte E, Vankelecom H. Exploring stem cell biology in pituitary tumors and derived organoids. Endocr Relat Cancer 2022; 29:427-450. [PMID: 35521774 DOI: 10.1530/erc-21-0374] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 04/22/2022] [Indexed: 11/08/2022]
Abstract
Pituitary tumorigenesis is highly prevalent and causes major endocrine disorders. Hardly anything is known on the behavior of the local stem cells in this pathology. Here, we explored the stem cells' biology in mouse and human pituitary tumors using transcriptomic, immunophenotyping and organoid approaches. In the prolactinoma-growing pituitary of dopamine receptor D2 knock-out mice, the stem cell population displays an activated state in terms of proliferative activity and distinct cytokine/chemokine phenotype. Organoids derived from the tumorous glands' stem cells recapitulated these aspects of the stem cells' activation nature. Upregulated cytokines, in particular interleukin-6, stimulated the stem cell-derived organoid development and growth process. In human pituitary tumors, cells typified by expression of stemness markers, in particular SOX2 and SOX9, were found present in a wide variety of clinical tumor types, also showing a pronounced proliferative status. Organoids efficiently developed from human tumor samples, displaying a stemness phenotype as well as tumor-specific expression fingerprints. Transcriptomic analysis revealed fading of cytokine pathways at organoid development and passaging, but their reactivation did not prove capable of rescuing early organoid expansion and passageability arrest. Taken together, our study revealed and underscored an activated phenotype of the pituitary-resident stem cells in tumorigenic glands and tumors. Our findings pave the way to defining the functional position of the local stem cells in pituitary tumor pathogenesis, at present barely known. Deeper insight can lead to more efficient and targeted clinical management, currently still not satisfactorily.
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Affiliation(s)
- Charlotte Nys
- Laboratory of Tissue Plasticity in Health and Disease, Cluster of Stem Cell and Developmental Biology, Department of Development and Regeneration, KU Leuven (University of Leuven), Leuven, Belgium
| | - Yu-Lun Lee
- Laboratory of Tissue Plasticity in Health and Disease, Cluster of Stem Cell and Developmental Biology, Department of Development and Regeneration, KU Leuven (University of Leuven), Leuven, Belgium
| | - Heleen Roose
- Laboratory of Tissue Plasticity in Health and Disease, Cluster of Stem Cell and Developmental Biology, Department of Development and Regeneration, KU Leuven (University of Leuven), Leuven, Belgium
| | - Freya Mertens
- Laboratory of Tissue Plasticity in Health and Disease, Cluster of Stem Cell and Developmental Biology, Department of Development and Regeneration, KU Leuven (University of Leuven), Leuven, Belgium
- Department of Imaging and Pathology, UZ Leuven (University Hospitals Leuven), Leuven, Belgium
| | - Ellen De Pauw
- Laboratory of Tissue Plasticity in Health and Disease, Cluster of Stem Cell and Developmental Biology, Department of Development and Regeneration, KU Leuven (University of Leuven), Leuven, Belgium
| | - Hiroto Kobayashi
- Laboratory of Tissue Plasticity in Health and Disease, Cluster of Stem Cell and Developmental Biology, Department of Development and Regeneration, KU Leuven (University of Leuven), Leuven, Belgium
- Department of Anatomy and Structural Science, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Raf Sciot
- Department of Imaging and Pathology, UZ Leuven (University Hospitals Leuven), Leuven, Belgium
| | - Marie Bex
- Department of Endocrinology, UZ Leuven (University Hospitals Leuven), Leuven, Belgium
| | - Georges Versyck
- Department of Neurosurgery, UZ Leuven (University Hospitals Leuven), Leuven, Belgium
| | | | - Johannes Van Loon
- Department of Neurosurgery, UZ Leuven (University Hospitals Leuven), Leuven, Belgium
| | - Emma Laporte
- Laboratory of Tissue Plasticity in Health and Disease, Cluster of Stem Cell and Developmental Biology, Department of Development and Regeneration, KU Leuven (University of Leuven), Leuven, Belgium
| | - Hugo Vankelecom
- Laboratory of Tissue Plasticity in Health and Disease, Cluster of Stem Cell and Developmental Biology, Department of Development and Regeneration, KU Leuven (University of Leuven), Leuven, Belgium
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22
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De Sutter L, Wozniak A, Verreet J, Vanleeuw U, De Cock L, Linde N, Drechsler C, Esdar C, Sciot R, Schöffski P. Abstract 2666: Anti-tumor effects of the novel KIT mutant inhibitor M4205 in patient-derived gastrointestinal stromal tumor (GIST) xenograft models. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-2666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The majority of GISTs are driven by constitutively activated KIT/PDGFRA kinases and susceptible to treatment with tyrosine kinase inhibitors such as imatinib, sunitinib and regorafenib. During treatment most tumors will develop heterogeneous secondary mutations in KIT or PDGFRA inducing drug resistance, so there is an unmet need for novel therapies. We tested the efficacy of M4205, a novel specific KIT inhibitor with high activity towards the most relevant KIT mutations, in patient-derived GIST xenograft models.
Methods: NMRI nu/nu mice (n=146) were transplanted with patient-derived GIST xenograft models UZLX-GIST9 (KIT:p.P577del;W557LfsX5;D820G) known to be resistant to both imatinib and sunitinib, with the dose-dependent imatinib-sensitive and sunitinib-sensitive models UZLX-GIST2B (KIT:p.A502_Y503dup), UZLX-GIST25 (KIT: p.K642E) and the cell-line derived model GIST882 (KIT: p.K642E)*. Mice were treated daily with vehicle (control), imatinib (100mg/kg), avapritinib (5mg/kg), sunitinib (20mg/kg), or M4205 (10mg/kg, 25mg/kg). Efficacy was assessed by tumor volume evolution, histopathology [hematoxilin & eosine staining (H&E)] and immunohistochemistry [Ki-67, phospho-Histone H3 (pHH3), cleaved PARP]. Histologic response (HR) was graded as previously described°. Mann Whitney U and Wilcoxon Matched Pairs tests were used for statistical analysis, with p<0.05 considered as significant.
Results: M4205 (25mg/kg) caused tumor volume shrinkage in UZLX-GIST2B, -GIST25 and GIST882 with relative decrease to 45.6%, 35.1% and 57.3% on the last day as compared to baseline. In UZLX-GIST9 tumor growth to 132.4% was observed in M4205 (25mg/kg)-treated tumors as compared to baseline. In all models we observed significant smaller tumor volumes in M4205 (25mg/kg)-treated tumors compared to control, and this antitumor activity was superior to imatinib in UZLX-GIST9, -GIST2B and GIST882, and to sunitinib in -GIST25. Compared to controls, M4205 (25mg/kg) induced a significant decrease in mitosis (H&E) in all models, confirmed on pHH3 and Ki-67 immunostainings in three models. In -GIST25 and GIST882 grade 2-4 HR with myxoid degeneration was observed in all tumors. All treatments were well tolerated.
Conclusion: M4205 has significant antitumor activity in patient- and cell line-derived GIST xenograft models. The novel kinase inhibitor induces volumetric responses, decreases mitotic activity, has antiproliferative effects and in models with KIT exon 13 mutation leads to characteristic myxoid degeneration. * Cornillie et al. Mol Cancer Ther 2019; 18(6):1168-1178 ° Agaram et al. Clin Cancer Res 2007; 13:170-81
Citation Format: Luna De Sutter, Agnieszka Wozniak, Jasper Verreet, Ulla Vanleeuw, Lore De Cock, Nina Linde, Christine Drechsler, Christina Esdar, Raf Sciot, Patrick Schöffski. Anti-tumor effects of the novel KIT mutant inhibitor M4205 in patient-derived gastrointestinal stromal tumor (GIST) xenograft models [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2666.
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23
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Wozniak A, De Sutter L, De Cock L, Van Renterghem B, Lee CJ, Wang Y, Vanleeuw U, Verbeeck K, Hompes D, Sinnaeve F, Wafa H, Topal B, Jaekers J, Van Raemdonck D, Debiec-Rychter M, Sciot R, Schöffski P. Abstract 3100: XenoSarc: patient-derived xenograft (PDX) models of soft tissue sarcoma (STS) and their histopathological and molecular characterization. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-3100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
STS constitutes a family of rare mesenchymal tumors with more than 70 subtypes described. The limited treatment options available for advanced STS patients underline the need for reliable preclinical models to test new therapeutic approaches. We established a panel of PDX models (XenoSarc) by subcutaneous implantation of fresh tumor specimens in athymic mice (nu/nu NRMI). Once tumor growth was observed, pieces of tumor were re-transplanted to next generations of animals. At each passage tumor fragments were collected for histopathological and molecular characterization. In an ongoing effort 493 STS samples from 414 consenting patients treated at the University Hospitals, Leuven (Belgium) have been transplanted. A total of 67 PDX models from 20 STS subtypes have been established, meaning they have stable morphological, immunohistochemical and genetic characteristics over at least 2 passages. The PDX platform includes more common STS subtypes such as myxofibrosarcoma (n=12 models), gastrointestinal stromal tumors (9), dedifferentiated liposarcoma (10), and leiomyosarcoma (8), as well as models from ultra-rare subtypes, e.g. pulmonary intimal sarcoma, extraskeletal osteosarcoma, mesenchymal chondrosarcoma, myxoinflammatory fibroblastic sarcoma and others. All relevant details about the donor patient and tumor characteristics, including sensitivity to the standard treatments, are known for every model. The models are well-characterized, with availability of molecular information on genomic profile (by low-coverage whole genome sequencing), and expression profile (by RNA sequencing). Xenografts are accompanied by ready to use tissue microarrays (TMA) from the models, which can be exploited for target identification and model selection for preclinical studies. Ex-mouse material can also be used to establish primary cell cultures and 3D organoids for in vitro screening purposes. The XenoSarc platform offers opportunities for studying the biology of various sarcoma subtypes including ultra-rare entities and was found to be a very reliable tool for early drug screening in STS in preparation of clinical testing of novel compounds. The platform is available for collaborative preclinical projects with academic and industrial partners.
Citation Format: Agnieszka Wozniak, Luna De Sutter, Lore De Cock, Britt Van Renterghem, Che-Jui Lee, Yannick Wang, Ulla Vanleeuw, Kimberly Verbeeck, Daphne Hompes, Friedl Sinnaeve, Hazem Wafa, Baki Topal, Joris Jaekers, Dirk Van Raemdonck, Maria Debiec-Rychter, Raf Sciot, Patrick Schöffski. XenoSarc: patient-derived xenograft (PDX) models of soft tissue sarcoma (STS) and their histopathological and molecular characterization [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 3100.
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24
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Messiaen J, Antoranz A, Van Herck Y, Verhaaren B, Nazari P, Sebastian I, Milli G, Bosisio F, Pey J, Bempt IV, Sciot R, Jacobs S, De Smet F. HGG-56. Spatial mapping of the tumor micro-environment in pediatric glioma. Neuro Oncol 2022. [PMCID: PMC9165297 DOI: 10.1093/neuonc/noac079.271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
High-grade glioma are the main cause of cancer-related death in children. The highly heterogeneous composition of the tumor cells and their interactions with the tumor micro-environment (TME), contribute substantially to the poor response to treatment and the high levels of morbidity and mortality. Here, we used high-dimensional, multiplexed immunohistochemistry to map the single-cell tissue architecture of 26 pediatric glioma samples covering 8 histologic diagnoses, allowing us to determine the spatial distribution of the various tumoral subtypes and how these interact with their local immune-microenvironment. Overall, this analysis showed that tumor grade anti-correlated with the amount of infiltrating cytotoxic T-lymphocytes (CTLs), which were typically more exhausted in the higher grade tumors. In addition, tumor associated macrophages were primarily infiltrating from the blood and presented an M2-like anti-inflammatory phenotype which became more extended with tumor grade. Using the spatial information, possible cell-cell interactions could be determined. In lower grade glioma, we observed an increased activation level of CTLs that were closely located to neighboring T-helper cells. In pediatric glioblastoma, on the other hand, CTLs, even though they were located close to a T-helper cell, could only minimally be activated, and showed more extended exhaustion when residing further away. Additionally, the activation of the CTLs was associated to the distance to the closest PD-L1 positive macrophage in pilocytic astrocytoma and desmoplastic infantile ganglioglioma. In conclusion, with the use of multiplex immunohistochemistry, we are able to study the tumor and TME of pediatric glioma in depth on a single-cell and spatial level, which allows us to further study the heterogeneous landscape of these tumors.
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Affiliation(s)
- Julie Messiaen
- Department of Pediatrics, University Hospitals Leuven , Leuven , Belgium
- Laboratory for Precision Cancer Medicine, Translational cell- and tissue research, Department of Imaging and Pathology, KU Leuven , Leuven , Belgium
| | - Asier Antoranz
- Laboratory for Precision Cancer Medicine, Translational cell- and tissue research, Department of Imaging and Pathology, KU Leuven , Leuven , Belgium
| | - Yannick Van Herck
- Department of Oncology, University Hospitals Leuven , Leuven , Belgium
- Department of Oncology, KU Leuven , Leuven , Belgium
| | - Ben Verhaaren
- Department of Radiology, University Hospitals Leuven , Leuven , Belgium
| | - Pouya Nazari
- Laboratory for Precision Cancer Medicine, Translational cell- and tissue research, Department of Imaging and Pathology, KU Leuven , Leuven , Belgium
| | - Ivey Sebastian
- Laboratory for Precision Cancer Medicine, Translational cell- and tissue research, Department of Imaging and Pathology, KU Leuven , Leuven , Belgium
| | - Giorgia Milli
- Translational cell- and tissue research, Department of Imaging and Pathology, KU Leuven , Leuven , Belgium
| | - Francesca Bosisio
- Translational cell- and tissue research, Department of Imaging and Pathology, KU Leuven , Leuven , Belgium
- Department of Pathology, University Hospitals Leuven , Leuven , Belgium
| | - Jon Pey
- Laboratory for Precision Cancer Medicine, Translational cell- and tissue research, Department of Imaging and Pathology, KU Leuven , Leuven , Belgium
| | - Isabelle Vanden Bempt
- Department of Human Genetics, University Hospitals Leuven , Leuven , Belgium
- Department of Human Genetics, KU Leuven , Leuven , Belgium
| | - Raf Sciot
- Translational cell- and tissue research, Department of Imaging and Pathology, KU Leuven , Leuven , Belgium
- Department of Pathology, University Hospitals Leuven , Leuven , Belgium
| | - Sandra Jacobs
- Department of Pediatric Hematology-Oncology, Department of Pediatrics, University Hospitals Leuven , Leuven , Belgium
- Department of Pediatric Oncology, KU Leuven , Leuven , Belgium
| | - Frederik De Smet
- Laboratory for Precision Cancer Medicine, Translational cell- and tissue research, Department of Imaging and Pathology, KU Leuven , Leuven , Belgium
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25
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Messiaen J, Claeys A, Shetty A, Spans L, Derweduwe M, Uyttebroeck A, Depreitere B, Bempt IV, Sciot R, Ligon K, Jones D, Jacobs S, De Smet F. OTHR-39. Extraneural spreading of a diffuse leptomeningeal glioneuronal tumor in a child: patient-derived models show sensitivity to vinblastin and trametinib. Neuro Oncol 2022. [PMCID: PMC9164998 DOI: 10.1093/neuonc/noac079.577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Diffuse leptomeningeal glioneuronal tumors (DLGNT) are rare neoplasms of the central nervous system. We describe the generation of patient-derived models from a DLGNT that metastasized to the peritoneal cavity via a ventriculoperitoneal shunt in a child. The original tumor contained a KIAA1549:BRAF fusion with a chromosome 1p deletion and corresponded with methylation subclass DLGNT-MC-2 From a sample of ascitic fluid, metastatic tumoral cells could be extracted and expanded ex vivo into a long-term cell culture model. This patient-derived cell line (PDCL) showed mixed morphological phenotypes and expressed MAP2 and SYP. The KIAA1549:BRAF fusion was preserved and the PDCL still corresponded to the original methylation subclass DLGNT-MC-2. Whole-genome sequencing showed additional mutations potentially contributing to the malignant behavior of the tumor. Cytotoxic assays performed on the PDCL indicated high sensitivity to vinblastine and trametinib (MEK-inhibitor) and intermediate sensitivity to DRD/ClpP-modulators. The PDCL underwent viral transduction to induce GFP-fLux positivity and was intraperitoneally injected into immunocompromised mice. A mouse model could be generated, with the growth of a peritoneal tumor in a localized manner. The cells grown from the mouse tumor were again put into culture and were afterwards subjected to the same treatments as the PDCL. This confirmed a similar profile, with high sensitivity to vinblastin and trametinib and an intermediate sensitivity to the DRD/ClpP-modulators. In conclusion, we were able to generate patient-derived models from a metastatic DLGNT, which recapitulate the molecular characteristics of the original tumor. The models showed high sensitivity to vinblastin and targeted therapy with MEK-inhibition, but further studies are necessary to define the adequate treatment for this kind of tumor.
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Affiliation(s)
- Julie Messiaen
- Department of Pediatrics, University Hospitals Leuven , Leuven , Belgium
- Laboratory for Precision Cancer Medicine, Translational Cell and Tissue Research, Department of Imaging and Pathology, KU Leuven , Leuven , Belgium
| | - Annelies Claeys
- Laboratory for Precision Cancer Medicine, Translational Cell and Tissue Research, Department of Imaging and Pathology, KU Leuven , Leuven , Belgium
| | - Aniket Shetty
- Center for Patient Derived Models, Dana-Farber Cancer Institute , Boston, MA , USA
| | - Lien Spans
- Department of Human Genetics, University Hospitals Leuven , Leuven , Belgium
| | - Marleen Derweduwe
- Laboratory for Precision Cancer Medicine, Translational Cell and Tissue Research, Department of Imaging and Pathology, KU Leuven , Leuven , Belgium
| | - Anne Uyttebroeck
- Department of Pediatric Oncology, KU Leuven , Leuven , Belgium
- Department of Pediatric Hematology-Oncology, Department of Pediatrics, University Hospitals Leuven , Leuven , Belgium
| | - Bart Depreitere
- Research Group Experimental Neurosurgery and Neuroanatomy, Department of Neurosciences, KU Leuven , Leuven , Belgium
- Department of Neurosurgery, University Hospitals Leuven , Leuven , Belgium
| | - Isabelle Vanden Bempt
- Department of Human Genetics, KU Leuven , Leuven , Belgium
- Department of Human Genetics, University Hospitals Leuven , Leuven , Belgium
| | - Raf Sciot
- Translational Cell and Tissue Research, Department of Imaging and Pathology, KU Leuven , Leuven , Belgium
- Department of Pathology, University Hospitals Leuven , Leuven , Belgium
| | - Keith Ligon
- Department of Oncologic Pathology, Dana-Farber Cancer Institute, Harvard Medical School , Boston, MA , USA
- Center for Patient Derived Models, Dana-Farber Cancer Institute , Boston, MA , USA
| | - David Jones
- Hopp Children′s Cancer Center at the NCT Heidelberg (KiTZ) , Heidelberg , Germany
- Division of Pediatric Neuro-oncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - Sandra Jacobs
- Department of Pediatric Oncology, KU Leuven , Leuven , Belgium
- Department of Pediatric Hematology-Oncology, Department of Pediatrics, University Hospitals Leuven , Leuven , Belgium
| | - Frederik De Smet
- Laboratory for Precision Cancer Medicine, Translational Cell and Tissue Research, Department of Imaging and Pathology, KU Leuven , Leuven , Belgium
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26
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Lee CJ, Modave E, Boeckx B, Kasper B, Aamdal S, Leahy MG, Rutkowski P, Bauer S, Debiec-Rychter M, Sciot R, Lambrechts D, Wozniak A, Schöffski P. Correlation of Immunological and Molecular Profiles with Response to Crizotinib in Alveolar Soft Part Sarcoma: An Exploratory Study Related to the EORTC 90101 "CREATE" Trial. Int J Mol Sci 2022; 23:ijms23105689. [PMID: 35628499 PMCID: PMC9145625 DOI: 10.3390/ijms23105689] [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: 05/02/2022] [Revised: 05/11/2022] [Accepted: 05/12/2022] [Indexed: 02/06/2023] Open
Abstract
Alveolar soft part sarcoma (ASPS) is a rare subtype of soft tissue sarcoma characterized by an unbalanced translocation, resulting in ASPSCR1-TFE3 fusion that transcriptionally upregulates MET expression. The European Organization for Research and Treatment of Cancer (EORTC) 90101 “CREATE” phase II trial evaluated the MET inhibitor crizotinib in ASPS patients, achieving only limited antitumor activity. We performed a comprehensive molecular analysis of ASPS tissue samples collected in this trial to identify potential biomarkers correlating with treatment outcome. A tissue microarray containing 47 ASPS cases was used for the characterization of the tumor microenvironment using multiplex immunofluorescence. DNA isolated from 34 available tumor samples was analyzed to detect recurrent gene copy number alterations (CNAs) and mutations by low-coverage whole-genome sequencing and whole-exome sequencing. Pathway enrichment analysis was used to identify diseased-associated pathways in ASPS sarcomagenesis. Kaplan–Meier estimates, Cox regression, and the Fisher’s exact test were used to correlate histopathological and molecular findings with clinical data related to crizotinib treatment, aiming to identify potential factors associated with patient outcome. Tumor microenvironment characterization showed the presence of PD-L1 and CTLA-4 in 10 and 2 tumors, respectively, and the absence of PD-1 in all specimens. Apart from CD68, other immunological markers were rarely expressed, suggesting a low level of tumor-infiltrating lymphocytes in ASPS. By CNA analysis, we detected a number of broad and focal alterations. The most common alteration was the loss of chromosomal region 1p36.32 in 44% of cases. The loss of chromosomal regions 1p36.32, 1p33, 1p22.2, and 8p was associated with shorter progression-free survival. Using whole-exome sequencing, 13 cancer-associated genes were found to be mutated in at least three cases. Pathway enrichment analysis identified genetic alterations in NOTCH signaling, chromatin organization, and SUMOylation pathways. NOTCH4 intracellular domain dysregulation was associated with poor outcome, while inactivation of the beta-catenin/TCF complex correlated with improved outcome in patients receiving crizotinib. ASPS is characterized by molecular heterogeneity. We identify genetic aberrations potentially predictive of treatment outcome during crizotinib therapy and provide additional insights into the biology of ASPS, paving the way to improve treatment approaches for this extremely rare malignancy.
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Affiliation(s)
- Che-Jui Lee
- Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, 3000 Leuven, Belgium; (C.-J.L.); (A.W.)
| | - Elodie Modave
- VIB Center for Cancer Biology, VIB and Department of Human Genetics, KU Leuven, 3000 Leuven, Belgium; (E.M.); (B.B.); (D.L.)
| | - Bram Boeckx
- VIB Center for Cancer Biology, VIB and Department of Human Genetics, KU Leuven, 3000 Leuven, Belgium; (E.M.); (B.B.); (D.L.)
| | - Bernd Kasper
- Sarcoma Unit, Interdisciplinary Tumor Center, Mannheim University Medical Center, 68167 Mannheim, Germany;
| | - Steinar Aamdal
- Department of Oncology, Oslo University Hospital, 0315 Oslo, Norway;
| | | | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 00-001 Warsaw, Poland;
| | - Sebastian Bauer
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, 45147 Essen, Germany;
| | - Maria Debiec-Rychter
- Department of Human Genetics, University Hospitals Leuven, KU Leuven, 3000 Leuven, Belgium;
| | - Raf Sciot
- Department of Pathology, University Hospitals Leuven, KU Leuven, 3000 Leuven, Belgium;
| | - Diether Lambrechts
- VIB Center for Cancer Biology, VIB and Department of Human Genetics, KU Leuven, 3000 Leuven, Belgium; (E.M.); (B.B.); (D.L.)
| | - Agnieszka Wozniak
- Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, 3000 Leuven, Belgium; (C.-J.L.); (A.W.)
| | - Patrick Schöffski
- Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, 3000 Leuven, Belgium; (C.-J.L.); (A.W.)
- Department of General Medical Oncology, Leuven Cancer Institute, University Hospitals Leuven, KU Leuven, 3000 Leuven, Belgium
- Correspondence: ; Tel.: +32-1634-1019
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27
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Van Renterghem B, Wozniak A, Tarantola L, Casazza A, Wellens J, Nysen M, Vanleeuw U, Lee CJ, Reyns G, Sciot R, Kindt N, Schöffski P. Enhanced Antitumor Efficacy of PhAc-ALGP-Dox, an Enzyme-Activated Doxorubicin Prodrug, in a Panel of THOP1-Expressing Patient-Derived Xenografts of Soft Tissue Sarcoma. Biomedicines 2022; 10:biomedicines10040862. [PMID: 35453612 PMCID: PMC9025547 DOI: 10.3390/biomedicines10040862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/29/2022] [Accepted: 04/04/2022] [Indexed: 12/10/2022] Open
Abstract
Despite poor response rates and dose-limiting cardiotoxicity, doxorubicin (doxo) remains the standard-of-care for patients with advanced soft tissue sarcoma. We evaluated the efficacy of two tetrapeptidic doxo prodrugs (PhAc-ALGP-Dox or CBR-049 and CBR-050) that are locally activated by enzymes expressed in the tumor environment, in ten sarcoma patient-derived xenografts. Xenograft models were selected based on expression of the main activating enzyme, i.e., thimet oligopeptidase (THOP1). Mice were either randomized to vehicle, doxo, CBR-049 and CBR-050 or control, doxo, aldoxorubicin (aldoxo) and CBR-049. Treatment efficacy was assessed by tumor volume measurement and histological assessment of ex-mouse tumors. CBR-049 showed significant tumor growth delay compared to control in all xenografts investigated and was superior compared to doxo in all but one. At the same time, CBR-049 showed comparable efficacy to aldoxo but the latter was found to have a complex safety profile in mice. CBR-050 demonstrated tumor growth delay compared to control in one xenograft but was not superior to doxo. For both experimental prodrugs, strong immunostaining for THOP1 was found to predict better antitumor efficacy. The prodrugs were well tolerated without any adverse events, even though molar doses were 17-fold higher than those administered and tolerated for doxo.
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Affiliation(s)
- Britt Van Renterghem
- Laboratory of Experimental Oncology, Catholic University of Leuven, 3000 Leuven, Belgium; (B.V.R.); (A.W.); (L.T.); (J.W.); (M.N.); (U.V.); (C.-J.L.)
| | - Agnieszka Wozniak
- Laboratory of Experimental Oncology, Catholic University of Leuven, 3000 Leuven, Belgium; (B.V.R.); (A.W.); (L.T.); (J.W.); (M.N.); (U.V.); (C.-J.L.)
| | - Ludovica Tarantola
- Laboratory of Experimental Oncology, Catholic University of Leuven, 3000 Leuven, Belgium; (B.V.R.); (A.W.); (L.T.); (J.W.); (M.N.); (U.V.); (C.-J.L.)
| | - Andrea Casazza
- CoBioRes, Campus Gasthuisberg, Catholic University of Leuven, 3000 Leuven, Belgium; (A.C.); (G.R.); (N.K.)
| | - Jasmien Wellens
- Laboratory of Experimental Oncology, Catholic University of Leuven, 3000 Leuven, Belgium; (B.V.R.); (A.W.); (L.T.); (J.W.); (M.N.); (U.V.); (C.-J.L.)
| | - Madita Nysen
- Laboratory of Experimental Oncology, Catholic University of Leuven, 3000 Leuven, Belgium; (B.V.R.); (A.W.); (L.T.); (J.W.); (M.N.); (U.V.); (C.-J.L.)
| | - Ulla Vanleeuw
- Laboratory of Experimental Oncology, Catholic University of Leuven, 3000 Leuven, Belgium; (B.V.R.); (A.W.); (L.T.); (J.W.); (M.N.); (U.V.); (C.-J.L.)
| | - Che-Jui Lee
- Laboratory of Experimental Oncology, Catholic University of Leuven, 3000 Leuven, Belgium; (B.V.R.); (A.W.); (L.T.); (J.W.); (M.N.); (U.V.); (C.-J.L.)
| | - Geert Reyns
- CoBioRes, Campus Gasthuisberg, Catholic University of Leuven, 3000 Leuven, Belgium; (A.C.); (G.R.); (N.K.)
| | - Raf Sciot
- Department of Pathology, University Hospitals Leuven, 3000 Leuven, Belgium;
| | - Nele Kindt
- CoBioRes, Campus Gasthuisberg, Catholic University of Leuven, 3000 Leuven, Belgium; (A.C.); (G.R.); (N.K.)
| | - Patrick Schöffski
- Laboratory of Experimental Oncology, Catholic University of Leuven, 3000 Leuven, Belgium; (B.V.R.); (A.W.); (L.T.); (J.W.); (M.N.); (U.V.); (C.-J.L.)
- Department of General Medical Oncology, University Hospitals Leuven, 3000 Leuven, Belgium
- Correspondence:
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Van Hese L, De Vleeschouwer S, Theys T, Larivière E, Solie L, Sciot R, Siegel TP, Rex S, Heeren RM, Cuypers E. Towards real-time intraoperative tissue interrogation for REIMS-guided glioma surgery. J Mass Spectrom Adv Clin Lab 2022; 24:80-89. [PMID: 35572786 PMCID: PMC9095887 DOI: 10.1016/j.jmsacl.2022.04.004] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 04/27/2022] [Accepted: 04/27/2022] [Indexed: 11/17/2022] Open
Abstract
REIMS can differentiate glioblastoma from normal brain with 99.2% sensitivity. Starting from 5% glioblastoma, REIMS showed a 100% correct classification rate. Low-grade gliomas can be identified with a 97.5% sensitivity.
Introduction Objectives Methods Results Conclusion
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Affiliation(s)
- Laura Van Hese
- Maastricht MultiModal Molecular Imaging (M4I) Institute, Division of Imaging Mass Spectrometry, Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of Anaesthesiology, UZ Leuven; Department of Cardiovascular Sciences, KU Leuven, 3000 Leuven, Belgium
| | - Steven De Vleeschouwer
- Department of Neurosurgery, Laboratory for Experimental Neurosurgery and Neuroanatomy, UZ Leuven, KU Leuven, 3000 Leuven, Belgium
| | - Tom Theys
- Department of Neurosurgery, Laboratory for Experimental Neurosurgery and Neuroanatomy, UZ Leuven, KU Leuven, 3000 Leuven, Belgium
| | - Emma Larivière
- Department of Neurosurgery, Laboratory for Experimental Neurosurgery and Neuroanatomy, UZ Leuven, KU Leuven, 3000 Leuven, Belgium
| | - Lien Solie
- Department of Neurosurgery, Laboratory for Experimental Neurosurgery and Neuroanatomy, UZ Leuven, KU Leuven, 3000 Leuven, Belgium
| | - Raf Sciot
- Department of Pathology, University Hospitals Leuven, KU Leuven, 3000 Leuven, Belgium
| | - Tiffany Porta Siegel
- Maastricht MultiModal Molecular Imaging (M4I) Institute, Division of Imaging Mass Spectrometry, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Steffen Rex
- Department of Anaesthesiology, UZ Leuven; Department of Cardiovascular Sciences, KU Leuven, 3000 Leuven, Belgium
| | - Ron M.A. Heeren
- Maastricht MultiModal Molecular Imaging (M4I) Institute, Division of Imaging Mass Spectrometry, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Eva Cuypers
- Maastricht MultiModal Molecular Imaging (M4I) Institute, Division of Imaging Mass Spectrometry, Maastricht University, 6229 ER Maastricht, The Netherlands
- Corresponding author at: M4I Institute, Division of Imaging Mass Spectrometry, Universiteitssingel 50, 6229 ER Maastricht, The Netherlands.
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Bos S, Daniëls L, Michaux L, Vanden Bempt I, Vermeer S, Woei-A-Jin FSH, Schöffski P, Weynand B, Sciot R, Declercq S, Ceulemans LJ, Godinas L, Verleden GM, Van Raemdonck DE, Dupont LJ, Vos R. Case Report: An Unusual Course of Angiosarcoma After Lung Transplantation. Front Immunol 2022; 12:789851. [PMID: 35046948 PMCID: PMC8761760 DOI: 10.3389/fimmu.2021.789851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 12/07/2021] [Indexed: 11/25/2022] Open
Abstract
A 35-year-old woman underwent bilateral lung transplantation for primary ciliary dyskinesia and developed vascular tumors over a slow time course. Initial presentation of non-specific vascular tumors in the lungs and liver for up to 6 years after transplantation evolved toward bilateral ovarian angiosarcoma. Tumor analysis by haplotyping and human leukocyte antigen typing showed mixed donor chimerism, proving donor origin of the tumoral lesions. In retrospect, the donor became brain dead following neurosurgical complications for a previously biopsy-proven cerebral hemangioma, which is believed to have been a precursor lesion of the vascular malignancy in the recipient. Donor-transmitted tumors should always be suspected in solid organ transplant recipients in case of uncommon disease course or histology, and proper tissue-based diagnosis using sensitive techniques should be pursued.
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Affiliation(s)
- Saskia Bos
- Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium.,Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Liesbeth Daniëls
- Histocompatibility and Immunogenetics Laboratory (HILA), Red Cross-Flanders, Mechelen, Belgium
| | - Lucienne Michaux
- Center for Human Genetics, University Hospitals Leuven, Leuven, Belgium
| | | | - Sascha Vermeer
- Center for Human Genetics, University Hospitals Leuven, Leuven, Belgium
| | - Fj Sherida H Woei-A-Jin
- Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, KU Leuven, Leuven, Belgium
| | - Patrick Schöffski
- Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, KU Leuven, Leuven, Belgium
| | - Birgit Weynand
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | - Raf Sciot
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | - Sabine Declercq
- Department of Pathology, ZNA Middelheim Hospital, Antwerp, Belgium
| | - Laurens J Ceulemans
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of CHROMETA, Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium
| | - Laurent Godinas
- Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium.,Department of CHROMETA, Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium
| | - Geert M Verleden
- Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium.,Department of CHROMETA, Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium
| | - Dirk E Van Raemdonck
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of CHROMETA, Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium
| | - Lieven J Dupont
- Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium.,Department of CHROMETA, Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium
| | - Robin Vos
- Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium.,Department of CHROMETA, Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium
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30
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Kemps PG, Picarsic J, Durham BH, Hélias-Rodzewicz Z, Hiemcke-Jiwa L, van den Bos C, van de Wetering MD, van Noesel CJM, van Laar JAM, Verdijk RM, Flucke UE, Hogendoorn PCW, Woei-A-Jin FJSH, Sciot R, Beilken A, Feuerhake F, Ebinger M, Möhle R, Fend F, Bornemann A, Wiegering V, Ernestus K, Méry T, Gryniewicz-Kwiatkowska O, Dembowska-Baginska B, Evseev DA, Potapenko V, Baykov VV, Gaspari S, Rossi S, Gessi M, Tamburrini G, Héritier S, Donadieu J, Bonneau-Lagacherie J, Lamaison C, Farnault L, Fraitag S, Jullié ML, Haroche J, Collin M, Allotey J, Madni M, Turner K, Picton S, Barbaro PM, Poulin A, Tam IS, El Demellawy D, Empringham B, Whitlock JA, Raghunathan A, Swanson AA, Suchi M, Brandt JM, Yaseen NR, Weinstein JL, Eldem I, Sisk BA, Sridhar V, Atkinson M, Massoth LR, Hornick JL, Alexandrescu S, Yeo KK, Petrova-Drus K, Peeke SZ, Muñoz-Arcos LS, Leino DG, Grier DD, Lorsbach R, Roy S, Kumar AR, Garg S, Tiwari N, Schafernak KT, Henry MM, van Halteren AGS, Abla O, Diamond EL, Emile JF. ALK-positive histiocytosis: a new clinicopathologic spectrum highlighting neurologic involvement and responses to ALK inhibition. Blood 2022; 139:256-280. [PMID: 34727172 PMCID: PMC8759533 DOI: 10.1182/blood.2021013338] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 10/18/2021] [Indexed: 11/20/2022] Open
Abstract
ALK-positive histiocytosis is a rare subtype of histiocytic neoplasm first described in 2008 in 3 infants with multisystemic disease involving the liver and hematopoietic system. This entity has subsequently been documented in case reports and series to occupy a wider clinicopathologic spectrum with recurrent KIF5B-ALK fusions. The full clinicopathologic and molecular spectra of ALK-positive histiocytosis remain, however, poorly characterized. Here, we describe the largest study of ALK-positive histiocytosis to date, with detailed clinicopathologic data of 39 cases, including 37 cases with confirmed ALK rearrangements. The clinical spectrum comprised distinct clinical phenotypic groups: infants with multisystemic disease with liver and hematopoietic involvement, as originally described (Group 1A: 6/39), other patients with multisystemic disease (Group 1B: 10/39), and patients with single-system disease (Group 2: 23/39). Nineteen patients of the entire cohort (49%) had neurologic involvement (7 and 12 from Groups 1B and 2, respectively). Histology included classic xanthogranuloma features in almost one-third of cases, whereas the majority displayed a more densely cellular, monomorphic appearance without lipidized histiocytes but sometimes more spindled or epithelioid morphology. Neoplastic histiocytes were positive for macrophage markers and often conferred strong expression of phosphorylated extracellular signal-regulated kinase, confirming MAPK pathway activation. KIF5B-ALK fusions were detected in 27 patients, whereas CLTC-ALK, TPM3-ALK, TFG-ALK, EML4-ALK, and DCTN1-ALK fusions were identified in single cases. Robust and durable responses were observed in 11/11 patients treated with ALK inhibition, 10 with neurologic involvement. This study presents the existing clinicopathologic and molecular landscape of ALK-positive histiocytosis and provides guidance for the clinical management of this emerging histiocytic entity.
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Affiliation(s)
- Paul G Kemps
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Jennifer Picarsic
- Division of Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Benjamin H Durham
- Human Oncology and Pathogenesis Program, Department of Medicine, and
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Zofia Hélias-Rodzewicz
- Department of Pathology, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne, France
- EA4340-Biomarqueurs et Essais Cliniques en Cancérologie et Onco-Hématologie, Versailles Saint-Quentin-en-Yvelines University, Boulogne, France
| | | | - Cor van den Bos
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pediatric Oncology, Emma Children's Hospital, and
| | - Marianne D van de Wetering
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pediatric Oncology, Emma Children's Hospital, and
| | - Carel J M van Noesel
- Department of Pathology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Jan A M van Laar
- Department of Internal Medicine and Immunology, and
- Section of Clinical Immunology, Department of Immunology, and
| | - Robert M Verdijk
- Department of Pathology, Erasmus Medical Center University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Uta E Flucke
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - F J Sherida H Woei-A-Jin
- Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium
| | - Raf Sciot
- Department of Pathology, University Hospitals Leuven, Katholieke Universiteit Leuven, Leuven, Belgium
| | | | | | - Martin Ebinger
- Department I - General Pediatrics, Children's Hospital, Hematology and Oncology
| | | | - Falko Fend
- Department of Pathology and Neuropathology and Comprehensive Cancer Center, University Hospital Tuebingen, Tuebingen, Germany
| | - Antje Bornemann
- Department of Pathology and Neuropathology and Comprehensive Cancer Center, University Hospital Tuebingen, Tuebingen, Germany
| | - Verena Wiegering
- Department of Oncology, Hematology and Stem Cell Transplantation, University Children's Hospital Würzburg, Würzburg, Germany
| | - Karen Ernestus
- Department of Pathology, University of Würzburg and Comprehensive Cancer Center Mainfranken, Würzburg, Germany
| | - Tina Méry
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Klinikum Chemnitz, Chemnitz, Germany
| | | | | | - Dmitry A Evseev
- Dmitriy Rogachev National Center for Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Vsevolod Potapenko
- Department of Hematology and Oncology, Municipal Educational Hospital N°31, Saint Petersburg, Russia
- Department of Bone Marrow Transplantation and
| | - Vadim V Baykov
- Department of Pathology, Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia
| | - Stefania Gaspari
- Department of Hematology/Oncology, Cell and Gene Therapy, Bambino Gesù Children's Hospital Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Sabrina Rossi
- Pathology Unit, Laboratories Department, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | | | - Gianpiero Tamburrini
- Department of Pediatric Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Sébastien Héritier
- Department of Pediatric Hematology and Oncology, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jean Donadieu
- EA4340-Biomarqueurs et Essais Cliniques en Cancérologie et Onco-Hématologie, Versailles Saint-Quentin-en-Yvelines University, Boulogne, France
- Department of Pediatric Hematology and Oncology, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | - Claire Lamaison
- Department of Pathology, Rennes University Hospital, Rennes, France
| | - Laure Farnault
- Department of Hematology, La Conception, University Hospital of Marseille, Marseille, France
| | - Sylvie Fraitag
- Department of Pathology, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Marie-Laure Jullié
- Department of Pathology, University Hospital of Bordeaux, Bordeaux, France
| | - Julien Haroche
- Department of Internal Medicine, University Hospital La Pitié-Salpêtrière Paris, French National Reference Center for Histiocytoses, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Matthew Collin
- Newcastle upon Tyne Hospitals, Newcastle upon Tyne, United Kingdom
| | | | - Majid Madni
- Department of Pediatric Hematology and Oncology, Nottingham University Hospitals, Nottingham, United Kingdom
| | | | - Susan Picton
- Department of Pediatric Oncology, Leeds Children's Hospital, Leeds, United Kingdom
| | - Pasquale M Barbaro
- Department of Hematology, Queensland Children's Hospital, Brisbane, QLD, Australia
| | - Alysa Poulin
- Department of Pathology and Laboratory Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Ingrid S Tam
- Department of Pathology and Laboratory Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Dina El Demellawy
- Department of Pathology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Brianna Empringham
- Department of Hematology/Oncology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - James A Whitlock
- Department of Hematology/Oncology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | | | - Amy A Swanson
- Division of Anatomic Pathology, Mayo Clinic Rochester, Rochester, MN
| | - Mariko Suchi
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI
| | - Jon M Brandt
- Department of Pediatric Oncology, Hospital Sisters Health System St Vincent Children's Hospital, Green Bay, WI
| | - Nabeel R Yaseen
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Joanna L Weinstein
- Department of Hematology, Oncology and Stem Cell Transplantation, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Irem Eldem
- Department of Pediatric Hematology and Oncology, St Louis Children's Hospital, Washington University in St Louis, St Louis, MO
| | - Bryan A Sisk
- Department of Pediatric Hematology and Oncology, St Louis Children's Hospital, Washington University in St Louis, St Louis, MO
| | - Vaishnavi Sridhar
- Department of Pediatric Hematology and Oncology, Carilion Children's Pediatric Hematology and Oncology, Roanoke, VA
| | - Mandy Atkinson
- Department of Pediatric Hematology and Oncology, Carilion Children's Pediatric Hematology and Oncology, Roanoke, VA
| | - Lucas R Massoth
- Department of Pathology, Massachusetts General Hospital, and
| | - Jason L Hornick
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Sanda Alexandrescu
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
- Department of Pathology, Boston Children's Hospital, Boston, MA
| | - Kee Kiat Yeo
- Department of Pediatric Oncology, Dana Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA
| | | | - Stephen Z Peeke
- Department of Hematology and Medical Oncology, Maimonides Medical Center, Brooklyn, NY
| | - Laura S Muñoz-Arcos
- Department of Internal Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
| | - Daniel G Leino
- Division of Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - David D Grier
- Division of Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Robert Lorsbach
- Division of Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Somak Roy
- Division of Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Ashish R Kumar
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | | | | | | | - Michael M Henry
- Center for Cancer and Blood Disorders, Phoenix Children's Hospital, Phoenix, AZ
| | - Astrid G S van Halteren
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands; and
| | - Oussama Abla
- Department of Hematology/Oncology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Eli L Diamond
- Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Jean-François Emile
- Department of Pathology, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne, France
- EA4340-Biomarqueurs et Essais Cliniques en Cancérologie et Onco-Hématologie, Versailles Saint-Quentin-en-Yvelines University, Boulogne, France
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Lee CJ, Modave E, Boeckx B, Stacchiotti S, Rutkowski P, Blay JY, Debiec-Rychter M, Sciot R, Lambrechts D, Wozniak A, Schöffski P. Histopathological and Molecular Profiling of Clear Cell Sarcoma and Correlation with Response to Crizotinib: An Exploratory Study Related to EORTC 90101 "CREATE" Trial. Cancers (Basel) 2021; 13:cancers13236057. [PMID: 34885165 PMCID: PMC8657105 DOI: 10.3390/cancers13236057] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/23/2021] [Accepted: 11/28/2021] [Indexed: 11/20/2022] Open
Abstract
Simple Summary Clear cell sarcoma (CCSA) is a rare subtype of soft tissue sarcoma characterized by EWSR1 rearrangement and subsequent MET upregulation. The European Organisation for Research and Treatment of Cancer 90101 phase II trial evaluated the MET inhibitor crizotinib in CCSA but resulted in only sporadic responses. The aim of this exploratory study was to identify the molecular alterations potentially relevant for the treatment outcome by using archival CCSA samples and trial-related clinical data. We characterized MET signaling and revealed an infrequent activation of MET, which may explain the lack of response to crizotinib in the disease cohort. Based on sequencing analyses, we discovered copy number alterations, mutations and dysregulated pathways with potentially predictive or prognostic values for patients’ outcomes. This work describes the molecular heterogeneity in CCSA and provides deep insight into the biology of this ultra-rare malignancy, which may potentially lead to better therapeutic approaches. Abstract Clear cell sarcoma (CCSA) is characterized by a chromosomal translocation leading to EWSR1 rearrangement, resulting in aberrant transcription of multiple genes, including MET. The EORTC 90101 phase II trial evaluated the MET inhibitor crizotinib in CCSA but resulted in only sporadic responses. We performed an in-depth histopathological and molecular analysis of archival CCSA samples to identify alterations potentially relevant for the treatment outcome. Immunohistochemical characterization of MET signaling was performed using a tissue microarray constructed from 32 CCSA cases. The DNA from 24 available tumor specimens was analyzed by low-coverage whole-genome sequencing and whole-exome sequencing for the detection of recurrent copy number alterations (CNAs) and mutations. A pathway enrichment analysis was performed to identify the pathways relevant for CCSA tumorigenesis. Kaplan–Meier estimates and Fisher’s exact test were used to correlate the molecular findings with the clinical features related to crizotinib treatment, aiming to assess a potential association with the outcomes. The histopathological analysis showed the absence of a MET ligand and MET activation, with the presence of MET itself in most of cases. However, the expression/activation of MET downstream molecules was frequently observed, suggesting the role of other receptors in CCSA signal transduction. Using sequencing, we detected a number of CNAs at the chromosomal arm and region levels. The most common alteration was a gain of 8q24.21, observed in 83% of the cases. The loss of chromosomes 9q and 12q24 was associated with shorter survival. Based on exome sequencing, 40 cancer-associated genes were found to be mutated in more than one sample, with SRGAP3 and KMT2D as the most common alterations (each in four cases). The mutated genes encoded proteins were mainly involved in receptor tyrosine kinase signaling, polymerase-II transcription, DNA damage repair, SUMOylation and chromatin organization. Disruption in chromatin organization was correlated with longer progression-free survival in patients receiving crizotinib. Conclusions: The infrequent activation of MET may explain the lack of response to crizotinib observed in the majority of cases in the clinical trial. Our work describes the molecular heterogeneity in CCSA and provides further insight into the biology of this ultra-rare malignancy, which may potentially lead to better therapeutic approaches for CCSA.
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Affiliation(s)
- Che-Jui Lee
- Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, 3000 Leuven, Belgium; (C.-J.L.); (A.W.)
| | - Elodie Modave
- VIB Center for Cancer Biology, VIB and Department of Human Genetics, KU Leuven, 3000 Leuven, Belgium; (E.M.); (B.B.); (D.L.)
| | - Bram Boeckx
- VIB Center for Cancer Biology, VIB and Department of Human Genetics, KU Leuven, 3000 Leuven, Belgium; (E.M.); (B.B.); (D.L.)
| | - Silvia Stacchiotti
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, 120133 Milano, Italy;
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 00001 Warsaw, Poland;
| | - Jean-Yves Blay
- Department of Medical Oncology, Centre Centre Léon Bérard & Université Claude Bernard Lyon I, 69008 Lyon, France;
| | - Maria Debiec-Rychter
- Department of Human Genetics, University Hospitals Leuven, KU Leuven, 3000 Leuven, Belgium;
| | - Raf Sciot
- Department of Pathology, University Hospitals Leuven, KU Leuven, 3000 Leuven, Belgium;
| | - Diether Lambrechts
- VIB Center for Cancer Biology, VIB and Department of Human Genetics, KU Leuven, 3000 Leuven, Belgium; (E.M.); (B.B.); (D.L.)
| | - Agnieszka Wozniak
- Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, 3000 Leuven, Belgium; (C.-J.L.); (A.W.)
| | - Patrick Schöffski
- Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, 3000 Leuven, Belgium; (C.-J.L.); (A.W.)
- Department of General Medical Oncology, Leuven Cancer Institute, University Hospitals Leuven, 3000 Leuven, Belgium
- Correspondence: ; Tel.: +32-16-341019
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32
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Dermawan JK, Azzato EM, Billings SD, Fritchie KJ, Aubert S, Bahrami A, Barisella M, Baumhoer D, Blum V, Bode B, Aesif SW, Bovée JVMG, Dickson BC, van den Hout M, Lucas DR, Moch H, Oaxaca G, Righi A, Sciot R, Sumathi V, Yoshida A, Rubin BP. YAP1-TFE3-fused hemangioendothelioma: a multi-institutional clinicopathologic study of 24 genetically-confirmed cases. Mod Pathol 2021; 34:2211-2221. [PMID: 34381186 DOI: 10.1038/s41379-021-00879-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/21/2021] [Accepted: 07/22/2021] [Indexed: 11/09/2022]
Abstract
YAP1-TFE3-fused hemangioendothelioma is an extremely rare malignant vascular tumor. We present the largest multi-institutional clinicopathologic study of YAP1-TFE3-fused hemangioendothelioma to date. The 24 cases of YAP1-TFE3-fused hemangioendothelioma showed a female predominance (17 female, 7 male) across a wide age range (20-78 years old, median 44). Tumors were most commonly located in soft tissue (50%), followed by bone (29%), lung (13%), and liver (8%), ranging from 3 to 115 mm in size (median 40 mm). About two-thirds presented with multifocal disease, including 7 cases with distant organ metastasis. Histopathologically, we describe three dominant architectural patterns: solid sheets of coalescing nests, pseudoalveolar and (pseudo)vasoformative pattern, and discohesive strands and clusters of cells set in a myxoid to myxohyaline stroma. These patterns were present in variable proportions across different tumors and often coexisted within the same tumor. The dominant cytomorphology (88%) was large epithelioid cells with abundant, glassy eosinophilic to vacuolated cytoplasm, prominent nucleoli and well-demarcated cell borders. Multinucleated or binucleated cells, prominent admixed erythrocytic and lymphocytic infiltrates, and intratumoral fat were frequently present. Immunohistochemically, ERG, CD31, and TFE3 were consistently expressed, while expression of CD34 (83%) and cytokeratin AE1/AE3 (20%) was variable. CAMTA1 was negative in all but one case. All cases were confirmed by molecular testing to harbor YAP1-TFE3 gene fusions: majority with YAP1 exon 1 fused to TFE3 exon 4 (88%), or less commonly, TFE3 exon 6 (12%). Most patients (88%) were treated with primary surgical resection. Over a follow-up period of 4-360 months (median 36 months) in 17 cases, 35% of patients remained alive without disease, and 47% survived many years with stable, albeit multifocal and/or metastatic disease. Five-year progression-free survival probability was 88%. We propose categorizing YAP1-TFE3-fused hemangioendothelioma as a distinct disease entity given its unique clinical and histopathologic characteristics in comparison to conventional epithelioid hemangioendothelioma.
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Affiliation(s)
- Josephine K Dermawan
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Elizabeth M Azzato
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Steven D Billings
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Karen J Fritchie
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Sebastien Aubert
- Department of Pathology, Institut de Pathologie, University of Lille, Lille, France
| | - Armita Bahrami
- Department of Pathology, Emory University, Atlanta, GA, USA
| | - Marta Barisella
- Struttura Complessa Anatomia Patologica, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Daniel Baumhoer
- Bone Tumor Reference Center at the Institute of Medical Genetics and Pathology, University Hospital and University of Basel, Basel, Switzerland
| | - Veronika Blum
- FMH Medical Oncology, Luzerner Kantonsspital, Luzern, Switzerland
| | - Beata Bode
- Pathology Institute Enge and University of Zurich, Zurich, Switzerland
| | - Scott W Aesif
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Judith V M G Bovée
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Brendan C Dickson
- Department of Pathology and Laboratory Medicine, Sinai Health System, Toronto, ON, Canada
| | - Mari van den Hout
- Department of Pathology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - David R Lucas
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Holger Moch
- Department of Pathology and Molecular Pathology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Gabriel Oaxaca
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | | | - Raf Sciot
- Department of Pathology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Vaiyapuri Sumathi
- Department of Musculoskeletal Pathology, Robert Aitken Institute of Clinical Research, University of Birmingham, Birmingham, UK
| | - Akihiko Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan
| | - Brian P Rubin
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA.
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Abstract
Osteochondrolipomas, a very rare combination of chondroid and osseous differentiation within lipomas, are typically found in the neck and head area. We present the case of an osteochondrolipoma in the thigh of a 54-year-old female, with matching histological and cytological correlation. To the best of our knowledge, this atypical location has only been reported once in the literature.
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Affiliation(s)
- Renaud Debras
- Department of Orthopaedic Surgery, Pathology and Surgical Oncology University Hospitals Leuven, KU Leuven, Herestraat 39, 3000 Leuven, Belgium
| | - Raf Sciot
- Department of Orthopaedic Surgery, Pathology and Surgical Oncology University Hospitals Leuven, KU Leuven, Herestraat 39, 3000 Leuven, Belgium
| | - Daphne Hompes
- Department of Orthopaedic Surgery, Pathology and Surgical Oncology University Hospitals Leuven, KU Leuven, Herestraat 39, 3000 Leuven, Belgium
| | - Friedl Sinnaeve
- Department of Orthopaedic Surgery, Pathology and Surgical Oncology University Hospitals Leuven, KU Leuven, Herestraat 39, 3000 Leuven, Belgium
| | - Hazem Wafa
- Department of Orthopaedic Surgery, Pathology and Surgical Oncology University Hospitals Leuven, KU Leuven, Herestraat 39, 3000 Leuven, Belgium
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34
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Panovska D, Shetty A, Derweduwe M, Claeys A, Van der Voordt M, Smets T, Versele M, Monaco G, De Moor B, Chaltin P, Clement P, Ligon K, De Vleeschouwer S, Sciot R, Pey J, Antoranz A, De Smet F. TMOD-22. DIFFERENTIAL DRUG SENSITIVITY ANALYSIS IN PAIRED PATIENT-DERIVED CELL LINES OF GLIOBLASTOMA. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab196.883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Glioblastoma (GBM) remains the most aggressive adult brain tumour with dismal prognosis. Even when treated by the most optimal standard-of-care modalities, disease progression remains consistently inevitable. Understanding how tumours evolve from a newly diagnosed to a recurrent setting is therefore critical, but research models to functionally test how therapeutic interventions evolve accordingly remain scarce. Here, we describe our efforts to develop paired models including newly diagnosed and recurrent GBM cell lines derived from the same patients. Overall, we collected 50 tumour samples originating from 24 patients at different time points in their treatment scheme. This resulted in the generation of 27 models overall, from which 18 originated from 9 patients at different timepoints. The latter were subsequently investigated extensively. First, using genomic profiling, we consistently observed an increase in mutational burden and chromosomal aberrations in the recurrent samples, while transcriptomic profiling showed that tumour subtypes evolved in a very patient-specific way. A large fraction of the recurrent models showed resistance to temozolomide (TMZ), which coincided with a downregulation of DNA repair (MMR) pathways or mutations. Half of the tested models also acquired resistance to radiation therapy. Next to standard-of-care therapy, we investigated several small molecule inhibitors that are currently in clinical evaluation, which also showed differential sensitivity. Overall, the developed paired cell lines recapitulate the most important features related to tumour recurrence, and offer the opportunity for more elaborate dependency screening efforts.
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Affiliation(s)
| | | | | | | | | | | | | | - Giovanni Monaco
- Center for Innovation and Stimulation of Drug Discovery, Leuven, Belgium
| | | | | | | | - Keith Ligon
- Dana-Farber Cancer Institute, Boston, MA, USA
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35
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Panovska D, Antoranz A, Creemers PJ, Derweduwe M, Nasari P, Orlando G, Van Gassen S, Claeys A, Verbeke T, Solie L, Sciot R, Clement P, Van der Planken D, Verfaillie M, Rousseau F, Schymkowitz J, Saeys Y, Ligon K, De Vleeschouwer S, De Smet F. EXTH-20. SINGLE-CELL DRUG ACTIVITY MAPPING IN GLIOBLASTOMA IDENTIFIES EXTENDED DRUG RESPONSE HETEROGENEITY AND THERAPY-INDUCED CELLULAR PLASTICITY. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab196.659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Glioblastoma (GBM) remains a highly malignant and incurable brain tumour. The inability to achieve clinical improvements in GBM treatment can be attributed to the excessive heterogeneity and plasticity of GBM cells, which is reflected by the presence of various cellular states within each tumour. How each of these tumour cell subtypes respond to therapy remains largely unknown. In this work, we developed a functional diagnostic analysis pipeline to measure therapeutic activity in GBM tumour cells at single-cell resolution using mass cytometry by time-of-flight (CyTOF). By applying an optimised GBM-specific and therapy-tailored antibody panel, we measured therapeutic activity upon exposure to ionising radiation (RT) or a small molecule MDM2 inhibitor (AMG232) in a cohort of patient-derived GBM cell lines (n=14). As such, extended heterogeneity in drug responsiveness was reflected by diverse degrees of alterations in cell cycle progression and apoptotic signalling, in addition to shifts in tumoral phenotypic states implying therapy-induced plasticity. A similar approach was used to measure drug activity in freshly resected tumour samples (n=18) harvested from different tumour regions (core or invasive front) within hours following surgery. Accordingly, we identified highly variable fractions of responsive tumour and microenvironmental cell populations in a patient-specific way. The ability to measure drug activity at single-cell resolution in a patient-tailored manner by applying a genotype-agnostic method, paves the way for advanced precision cancer medicine in GBM by offering a novel approach to more precisely select eligible patients for prospective clinical trials.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Keith Ligon
- Dana-Farber Cancer Institute, Boston, MA, USA
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36
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Messiaen J, Nasari P, Van Herck Y, Verhaaren B, Sebastian I, Milli G, Bosisio F, Pey J, De Vleeschouwer S, De Vloo P, Depreitere B, Vanden Bempt I, Sciot R, Antoranz A, Jacobs S, De Smet F. PATH-21. THE SINGLE-CELL PATHOLOGY LANDSCAPE OF PEDIATRIC GLIOMA. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab196.473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
High-grade glioma are the main cause of cancer-related death in children. Despite extensive research, their prognosis remains poor with very few treatment options. This can be attributed to the highly heterogeneous and plastic nature of glioma tumor cells and their interactions with the microenvironment, although quantitative data are still largely missing. Here, we used high-dimensional, multiplexed immunohistochemistry to map the spatial, single-cell tissue architecture of 31 pediatric glioma samples covering 9 histologic diagnoses. This novel approach allowed us to map the spatial distribution of the various tumoral subtypes, which typically occur in specific tumoral niches, and how these interact with their local immune-microenvironment. Finally, by aligning these findings to the clinical data of the patients and comparing these to adult glioblastoma, we are now able to more precisely describe the heterogeneous landscape of pediatric glioma at single-cell resolution.
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37
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Vanmechelen M, Beckervordersandforth J, Pey J, Antoranz A, Nasari P, Pantano D, Bevers S, Leunissen D, Moors W, Messiaen J, Sebastian I, Milli G, Van Herck Y, Geens E, Verduin M, Hoosemans L, Claeys A, Derweduwe M, Zurhausen A, Bosisio F, Eekers D, Weyns F, Daenekindt T, Van Eyken P, Goovers M, Hovinga K, De Vleeschouwer S, Clement P, Broen M, Vooijs M, Sciot R, Hoeben A, Speel EJ, De Smet F. PATH-20. SPATIAL MAPPING OF THERAPY-INDUCED, PATHOLOGICAL CHANGES IN GLIOBLASTOMA AT SINGLE-CELL RESOLUTION. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab196.472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Glioblastoma (GBM) remains a highly malignant, intrinsically resistant and inevitably recurring brain tumor with dismal prognosis. The aggressiveness and lack of effective GBM treatments can be attributed to the highly heterogeneous and plastic nature of GBM tumor cells, which easily confer resistance to standard-of-care (SOC) therapy. While tumor progression has also been attributed to interactions with the tumor microenvironment, quantitative data describing these interactions are still largely missing. Here, we used high-dimensional, multiplexed immunohistochemistry to map evolutions in the spatial, single-cell tissue architecture of 120 paired adult GBM tumor samples derived from 60 patients at diagnosis (ND) and upon recurrence (REC) following SOC treatment. We mapped the spatial distribution of a multitude of GBM tumoral subtypes across this multicentric cohort, through which we identified a high level of heterogeneity defined by specific tumoral niches within and across patients and which evolved when subjected to SOC therapy. In addition, we describe the relationship of the various tumoral niches with their local immune-infiltrates, highlighting an even more immunosuppressive environment following SOC resistance. Finally, by aligning these findings to the observed genomic aberrations and the clinical data of the patients, we are now able to more precisely describe the heterogeneous landscape of glioblastoma and how it evolves under SOC treatment at spatial, single-cell resolution.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Marc Vooijs
- Maastricht University, Maastricht, Netherlands
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38
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Wilssens NO, Den Hondt M, Duponselle J, Sciot R, Hompes D, Nevens THG. An uncommon presentation of a cutaneous angiosarcoma. Acta Chir Belg 2021; 121:351-353. [PMID: 32019461 DOI: 10.1080/00015458.2020.1722926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Cutaneous angiosarcoma (cAS) is a rare and aggressive malignant vascular tumor, which mostly occurs in the head and neck region. The outcome of cAS is poor and timely diagnosis is paramount, but often delayed because of the slow onset and the variance in presentation. This paper reports on a case of an 88-year old woman who presented with a persisting "hematoma" in the left retro-auricular region. Although considered at initial differential diagnosis, no signs of malignancy were identified in histopathology and imaging in the diagnostic work-up. At first, short-term follow-up showed no progression of the lesion. But 3 months after the first presentation additional biopsies were taken, because of rapid expansion of the lesion. The initial histopathological findings were most consistent with a benign vascular lesion, with signs of hemorrhage and reactive inflammation. However, the additional immunohistochemical analysis showed the presence of MYC oncoprotein, which confirmed the clinical suspicion of angiosarcoma. Because size and location of the lesion rendered complete resection unattainable, radiotherapy was commenced, but no significant volume reduction could be achieved. Therefore, palliative irradiation was initiated. The patient passed away 1 month later. Clinical diagnosis is often difficult and little is known about imaging of cAS. Histology and immunohistochemistry can be misleading, as cAS are easily mistaken for other lesions. Most studies report that multimodality treatment with surgery and radiotherapy is preferable, but this can be challenging in the head & neck region.
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Affiliation(s)
- Nicholas O. Wilssens
- Department of Plastic & Reconstructive Surgery, University Hospitals, KU Leuven, Leuven, Belgium
| | - Margot Den Hondt
- Department of Plastic & Reconstructive Surgery, University Hospitals, KU Leuven, Leuven, Belgium
| | - Jolien Duponselle
- Department of Plastic & Reconstructive Surgery, University Hospitals, KU Leuven, Leuven, Belgium
| | - Raf Sciot
- Department of Pathology, University Hospitals, KU Leuven, Leuven, Belgium
| | - Daphne Hompes
- Department of Oncological Surgery, University Hospitals, KU Leuven, Leuven, Belgium
| | - Thomas H. G. Nevens
- Department of Plastic & Reconstructive Surgery, University Hospitals, KU Leuven, Leuven, Belgium
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Lee CJ, Schöffski P, Modave E, van Wezel T, Boeckx B, Sufliarsky J, Gelderblom H, Blay JY, Debiec-Rychter M, Sciot R, Bovée JVMG, Lambrechts D, Wozniak A. Comprehensive Molecular Analysis of Inflammatory Myofibroblastic Tumors Reveals Diverse Genomic Landscape and Potential Predictive Markers for Response to Crizotinib. Clin Cancer Res 2021; 27:6737-6748. [PMID: 34551905 DOI: 10.1158/1078-0432.ccr-21-1165] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/25/2021] [Accepted: 09/16/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE The European Organization for Research and Treatment of Cancer (EORTC) clinical phase II trial 90101 "CREATE" showed high antitumor activity of crizotinib, an inhibitor of anaplastic lymphoma kinase (ALK)/ROS1, in patients with advanced inflammatory myofibroblastic tumor (IMFT). However, recent findings suggested that other molecular targets in addition to ALK/ROS1 might also contribute to the sensitivity of this kinase inhibitor. We therefore performed an in-depth molecular characterization of archival IMFT tissue, collected from patients enrolled in this trial, with the aim to identify other molecular alterations that could play a role in the response to crizotinib. EXPERIMENTAL DESIGN Twenty-four archival IMFT samples were used for histopathological assessment and DNA/RNA evaluation to identify gene fusions, copy-number alterations (CNA), and mutations in the tumor tissue. Results were correlated with clinical parameters to assess a potential association between molecular findings and clinical outcomes. RESULTS We found 12 ALK fusions with 11 different partners in ALK-positive IMFT cases by Archer analysis whereas we did not identify any ROS1-rearranged tumor. One ALK-negative patient responding to crizotinib was found to have an ETV6-NTRK fusion in the tumor specimen. The CNA profile and mutational landscape of IMFT revealed extensive molecular heterogeneity. Loss of chromosome 19 (25% of cases) and PIK3CA mutations (9% of cases) were associated with shorter progression-free survival in patients receiving crizotinib. CONCLUSIONS We identified multiple genetic alterations in archival IMFT material and provide further insight into the molecular profile of this ultra-rare, heterogeneous malignancy, which may potentially translate into novel treatment approaches for this orphan disease.
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Affiliation(s)
- Che-Jui Lee
- Department of Oncology, Laboratory of Experimental Oncology, KU Leuven, Leuven, Belgium
| | - Patrick Schöffski
- Department of Oncology, Laboratory of Experimental Oncology, KU Leuven, Leuven, Belgium.,Department of General Medical Oncology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - Elodie Modave
- Center for Cancer Biology, VIB, Leuven, Belgium.,Department of Human Genetics, Laboratory of Translational Genetics, KU Leuven, Leuven, Belgium
| | - Tom van Wezel
- Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands
| | - Bram Boeckx
- Center for Cancer Biology, VIB, Leuven, Belgium.,Department of Human Genetics, Laboratory of Translational Genetics, KU Leuven, Leuven, Belgium
| | | | - Hans Gelderblom
- Department of Medical Oncology, Leiden University Medical Center, Leiden, the Netherlands
| | - Jean-Yves Blay
- Department of Medical Oncology, Center Léon Bérard/Université Claude Bernard Lyon Institute, Lyon, France
| | - Maria Debiec-Rychter
- Department of Human Genetics, Laboratory for Genetics of Malignant Disorders, KU Leuven, Belgium
| | - Raf Sciot
- Department of Pathology, University Hospitals Leuven and KU Leuven, Leuven, Belgium
| | - Judith V M G Bovée
- Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands
| | - Diether Lambrechts
- Center for Cancer Biology, VIB, Leuven, Belgium.,Department of Human Genetics, Laboratory of Translational Genetics, KU Leuven, Leuven, Belgium
| | - Agnieszka Wozniak
- Department of Oncology, Laboratory of Experimental Oncology, KU Leuven, Leuven, Belgium.
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40
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De Kegel D, Musigazi GU, Menichetti A, Hellings PW, Sciot R, Demaerel P, Famaey N, Vander Sloten J, Depreitere B. Investigation of tissue level tolerance for cerebral contusion in a controlled cortical impact porcine model. Traffic Inj Prev 2021; 22:616-622. [PMID: 34477471 DOI: 10.1080/15389588.2021.1957856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 07/09/2021] [Accepted: 07/16/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Cerebral contusions (CC) represent a frequent lesion in traumatic brain injury, with potential morbidity from mass effect and tissue loss. Better understanding of the mechanical etiology will help to improve head protection. The goal of this study is to investigate the threshold for mechanical impact parameters to induce CC in an in vivo porcine controlled cortical impact model. METHODS Thirty-four adult male pigs underwent craniotomy and controlled cortical impact with a hemispherical tip on intact dura under general anesthesia. Peak impact depth varied between 1.1 and 12.6 mm, and impact velocity between 0.4 and 2.2 m/s while the dwell time was kept at 200 ms. Two days following impact, the animals underwent magnetic resonance (MR) imaging of the brain, and were subsequently sacrificed for brain extraction. CC damage was investigated by magnetic resonance imaging and histology. RESULTS All animals recovered from the impact without overt neurological deficit. Provoked injuries were histologically confirmed to be CC. Decreasing probability of cortical damage and white matter edema volume was observed with decreasing impact depth and velocity. No CC could be demonstrated below a product of impact depth and velocity of 0.8 mm*m/s, whereas the probability for CC was one third below 15 mm*m/s. The threshold for CC development as estimated from the current series of experiments, was situated at an impact depth of 2.0 mm and impact velocity of 0.4 m/s. CONCLUSION Mechanical thresholds for CC development could be explored in the current porcine controlled cortical impact model. Findings will be used to further refine a cerebral contusion porcine model with volumetric histology data in light of future finite element cerebral contusion validation studies.
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Affiliation(s)
| | | | | | | | - Raf Sciot
- Translation Cell and Tissue Research, KULeuven, Leuven, Belgium
| | | | - Nele Famaey
- Biomechanics section, KULeuven, Heverlee, Belgium
| | | | - Bart Depreitere
- Experimental Neurosurgery and Neuroanatomy, KULeuven, Leuven, Belgium
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41
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Schöffski P, Kubickova M, Wozniak A, Blay JY, Strauss SJ, Stacchiotti S, Switaj T, Bücklein V, Leahy MG, Italiano A, Isambert N, Debiec-Rychter M, Sciot R, Lee CJ, Speetjens FM, Nzokirantevye A, Neven A, Kasper B. Long-term efficacy update of crizotinib in patients with advanced, inoperable inflammatory myofibroblastic tumour from EORTC trial 90101 CREATE. Eur J Cancer 2021; 156:12-23. [PMID: 34392187 DOI: 10.1016/j.ejca.2021.07.016] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [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: 07/02/2021] [Accepted: 07/10/2021] [Indexed: 01/26/2023]
Abstract
PURPOSE European Organisation for Research and Treatment of Cancer (EORTC) 90101 (CREATE) was a prospective, multicentric, non-randomised, open-label phase II basket trial to assess the efficacy and safety of crizotinib in patients with different types of cancers, including advanced inflammatory myofibroblastic tumour (IMT) with or without anaplastic lymphoma kinase (ALK) rearrangements. Here, we report updated results with long-term follow-up. PATIENTS/METHODS After central reference pathology, eligible ALK-positive and ALK-negative patients with advanced/metastatic IMT deemed incurable with surgery, radiotherapy or systemic therapy received oral crizotinib 250 mg twice daily. The ALK status was assessed centrally using immunohistochemistry and fluorescence in situ hybridisation. The primary end-point was the proportion of patients who achieved an objective response (i.e. complete or partial response). If ≥6 ALK-positive patients achieved a confirmed response, the trial would be deemed successful. RESULTS At data cut-off on 28th January 2021, we performed the final analysis of this trial. Of the 20 eligible and treated patients (19 of whom were evaluable for efficacy), with a median follow-up of 50 months, five were still on crizotinib treatment (4/12 ALK-positive and 1/8 ALK-negative patients). The updated objective response rate (ORR) was 66.7% (95% confidence interval [CI] 34.9-90.1%) in ALK-positive patients and 14.3% (95% CI 0.0-57.9%) in ALK-negative patients. In the ALK-positive and ALK-negative patients, the median progression-free survival was 18.0 months (95% CI 4.0-NE) and 14.3 months (95% CI 1.2-31.1), respectively; 3-year overall survival rates were 83.3% (95% CI 48.2-95.6) and 34.3% (95% CI 4.8-68.5). Safety results were consistent with previously reported data. CONCLUSION These updated results confirm previous findings that crizotinib is effective, with durable responses, in patients with locally advanced or metastatic ALK-positive IMT. With further follow-up after the original primary analysis, the ORR increased, as patients derived long-term benefit and some responses converted from stable disease to partial responses. CLINICAL TRIAL NUMBER EORTC 90101, NCT01524926.
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Affiliation(s)
- Patrick Schöffski
- Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Department of Oncology, KU Leuven, Laboratory of Experimental Oncology, Leuven, Belgium; Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, Leuven, Belgium.
| | | | - Agnieszka Wozniak
- Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, Leuven, Belgium
| | - Jean-Yves Blay
- Department of Medical Oncology, Centre Léon Bérard/Université Claude Bernard Lyon Institute, Lyon, France
| | - Sandra J Strauss
- Department of Oncology, University College London Hospitals NHS Trust, London, UK
| | - Silvia Stacchiotti
- Department of Medical Oncology, IRCCS Fondazione Istituto Nazionale Tumori, Milano, Italy
| | - Tomasz Switaj
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland
| | - Veit Bücklein
- Klinikum der Universität München, Medizinische Klinik III, Campus Grosshadern, Munich, Germany
| | | | | | - Nicolas Isambert
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | | | - Raf Sciot
- Department of Pathology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Che-Jui Lee
- Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Department of Oncology, KU Leuven, Laboratory of Experimental Oncology, Leuven, Belgium
| | - Frank M Speetjens
- Department of Medical Oncology, Leiden University Medical Center, Leiden, Netherlands
| | | | - Anouk Neven
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Bernd Kasper
- Sarcoma Unit, Mannheim University Medical Center, University of Heidelberg, Mannheim, Germany
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Schöffski P, Timmermans I, Wildiers H, Dumez H, Hompes D, Christiaens M, Sciot R, Laenen A, Lee CJ, Meyskens T. Retrospective Analysis of the Clinical Presentation, Treatment and Outcome of Angiosarcoma in a Sarcoma Referral Center. Oncol Res Treat 2021; 44:322-332. [PMID: 33946082 DOI: 10.1159/000516000] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 03/18/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Angiosarcoma (AS) is a rare subtype of soft tissue sarcoma. We performed a retrospective analysis of patient characteristics, treatments and prognostic factors in patients treated in a single sarcoma center. METHODS We reviewed records of patients treated between 1987 and 2018, categorized in 7 different subtypes according to tissue of origin and underlying risk factors. The Kaplan-Meier method was used to estimate overall survival (OS); the Cox proportional hazards model was used to study prognostic variables. RESULTS Among 134 patients, 30% had radiation-induced, 31% primary soft tissue, 24% cutaneous, 5% breast, 4% bone, 2% lymphedema-associated and 4% unknown primary AS. Key patient/disease characteristics varied between subgroups. The median OS was 22.0 months for the entire cohort, with 28.9% with a 5-year survival. Metastasis at diagnosis was seen in 23% of patients; 38% developed metachronous metastasis. Sixty-six (49%) patients received systemic therapy; common first-line treatments were doxorubicin (48%) and paclitaxel (39%), without a significant difference in OS between agents. Younger age, breast/radiation-induced AS, primary surgery and palliative chemotherapy were associated with better OS. Synchronous metastasis, soft tissue/unknown primary location correlated with poor survival. CONCLUSION AS is a very heterogeneous sarcoma subtype, with substantial variability in clinical presentation and survival among patient subsets. Prognosis is poor, and there is no difference in outcome comparing the 2 most frequently used chemotherapy agents in the first line, paclitaxel and doxorubicin.
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Affiliation(s)
- Patrick Schöffski
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Iris Timmermans
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Hans Wildiers
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Herlinde Dumez
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Daphne Hompes
- Department of Surgical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Melissa Christiaens
- Department of Radiotherapy/Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Raf Sciot
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | - Annouschka Laenen
- Leuven Center of Biostatistics and Statistic Bioinformatics, KU Leuven, Leuven, Belgium
| | - Che-Jui Lee
- Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, Leuven, Belgium
| | - Thomas Meyskens
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
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43
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Dejaegher J, Solie L, Hunin Z, Sciot R, Capper D, Siewert C, Van Cauter S, Wilms G, van Loon J, Ectors N, Fieuws S, Pfister SM, Van Gool SW, De Vleeschouwer S. DNA methylation based glioblastoma subclassification is related to tumoral T-cell infiltration and patient survival. Neuro Oncol 2021; 23:240-250. [PMID: 33130898 DOI: 10.1093/neuonc/noaa247] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Histologically classified glioblastomas (GBM) can have different clinical behavior and response to therapy, for which molecular subclassifications have been proposed. We evaluated the relationship of epigenetic GBM subgroups with immune cell infiltrations, systemic immune changes during radiochemotherapy, and clinical outcome. METHODS 450K genome-wide DNA methylation was assessed on tumor tissue from 93 patients with newly diagnosed GBM, treated with standard radiochemotherapy and experimental immunotherapy. Tumor infiltration of T cells, myeloid cells, and Programmed cell death protein 1 (PD-1) expression were evaluated. Circulating immune cell populations and selected cytokines were assessed on blood samples taken before and after radiochemotherapy. RESULTS Forty-two tumors had a mesenchymal, 27 a receptor tyrosine kinase (RTK) II, 17 RTK I, and 7 an isocitrate dehydrogenase (IDH) DNA methylation pattern. Mesenchymal tumors had the highest amount of tumor-infiltrating CD3+ and CD8+ T cells and IDH tumors the lowest. There were no significant differences for CD68+ cells, FoxP3+ cells, and PD-1 expression between groups. Systemically, there was a relative increase of CD8+ T cells and CD8+ PD-1 expression and a relative decrease of CD4+ T cells after radiochemotherapy in all subgroups except IDH tumors. Overall survival was the longest in the IDH group (median 36 mo), intermediate in RTK II tumors (27 mo), and significantly lower in mesenchymal and RTK I groups (15.5 and 16 mo, respectively). CONCLUSIONS Methylation based stratification of GBM is related to T-cell infiltration and survival, with IDH and mesenchymal tumors representing both ends of a spectrum. DNA methylation profiles could be useful in stratifying patients for immunotherapy trials.
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Affiliation(s)
- Joost Dejaegher
- Research Group Experimental Neurosurgery and Neuroanatomy, KU Leuven, Leuven, Belgium and Leuven Brain Institute, Leuven, Belgium
| | - Lien Solie
- Research Group Experimental Neurosurgery and Neuroanatomy, KU Leuven, Leuven, Belgium and Leuven Brain Institute, Leuven, Belgium
| | - Zoé Hunin
- Research Group Experimental Neurosurgery and Neuroanatomy, KU Leuven, Leuven, Belgium and Leuven Brain Institute, Leuven, Belgium
| | - Raf Sciot
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | - David Capper
- Charité‒Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; Berlin Institute of Health, Department of Neuropathology, Berlin, Germany.,German Cancer Consortium (DKTK), Partner Site Berlin, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Christin Siewert
- German Cancer Consortium, Partner Site Berlin, German Cancer Research Center, Heidelberg, Germany
| | - Sofie Van Cauter
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium.,Department of Medical Imaging, Ziekenhuis Oost Limburg, Genk, Belgium
| | - Guido Wilms
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | - Johan van Loon
- Research Group Experimental Neurosurgery and Neuroanatomy, KU Leuven, Leuven, Belgium and Leuven Brain Institute, Leuven, Belgium
| | - Nadine Ectors
- Biobank, University Hospitals Leuven, Leuven, Belgium
| | - Steffen Fieuws
- Interuniversity Center for Biostatistics and Statistical Bioinformatics, KU Leuven, University of Leuven and University of Hasselt, Leuven, Belgium
| | - Stefan M Pfister
- Hopp Children's Cancer Center Heidelberg, German Cancer Research Center and German Cancer Consortium, and University Hospital Heidelberg, Heidelberg, Germany
| | | | - Steven De Vleeschouwer
- German Cancer Consortium, Partner Site Berlin, German Cancer Research Center, Heidelberg, Germany
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44
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Schöffski P, Vander Borght S, Vanden Bempt I, Jentjens S, Vandecaveye V, Sciot R, De Hertogh G, Christiaens M, Wolthuis A. Curative, Organ-Sparing, Multimodal, Perioperative Treatment of a Young Patient with a Rectoanal Inflammatory Myofibroblastic Tumor. Oncol Res Treat 2021; 44:269-275. [PMID: 33895750 DOI: 10.1159/000515710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 03/01/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION We report the case of a young female patient with a technically resectable, nonmetastatic, rectoanal, anaplastic lymphoma kinase gene (ALK)-translocated inflammatory myofibroblastic tumor (IMFT). CASE PRESENTATION The patient was successfully treated preoperatively with the tyrosine kinase inhibitor (TKI) crizotinib, to downsize the primary tumor, followed by sphincter-sparing surgery, and adjuvant radiotherapy and crizotinib. She is now in follow-up with good sphincter function and with no evidence of active disease. CONCLUSION Pre- and postoperative treatment administration of crizotinib can be given with curative intent to patients with locally advanced, nonmetastatic IMFTs to avoid mutilating surgery.
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Affiliation(s)
- Patrick Schöffski
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Sara Vander Borght
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium.,Department of Human Genetics, University Hospitals Leuven, Leuven, Belgium
| | | | - Sander Jentjens
- Department of Nuclear Medicine, University Hospitals Leuven, Leuven, Belgium
| | | | - Raf Sciot
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | - Gert De Hertogh
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | - Melissa Christiaens
- Department of Radiotherapy/Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Albert Wolthuis
- Department of Abdominal Surgery, University Hospitals Leuven, Leuven, Belgium
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45
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Bos S, Daniëls L, Michaux L, Bempt IV, Vermeer S, Woei-A-Jin S, Schöffski P, Weynand B, Sciot R, Declercq S, Van Raemdonck D, Ceulemans L, Dupont L, Verleden G, Vos R. An Unusual Course of Donor-Transmitted Angiosarcoma after Lung Transplantation. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.2044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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46
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Pombo Antunes AR, Scheyltjens I, Lodi F, Messiaen J, Antoranz A, Duerinck J, Kancheva D, Martens L, De Vlaminck K, Van Hove H, Kjølner Hansen SS, Bosisio FM, Van der Borght K, De Vleeschouwer S, Sciot R, Bouwens L, Verfaillie M, Vandamme N, Vandenbroucke RE, De Wever O, Saeys Y, Guilliams M, Gysemans C, Neyns B, De Smet F, Lambrechts D, Van Ginderachter JA, Movahedi K. Single-cell profiling of myeloid cells in glioblastoma across species and disease stage reveals macrophage competition and specialization. Nat Neurosci 2021; 24:595-610. [PMID: 33782623 DOI: 10.1038/s41593-020-00789-y] [Citation(s) in RCA: 254] [Impact Index Per Article: 84.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 12/22/2020] [Indexed: 01/08/2023]
Abstract
Glioblastomas are aggressive primary brain cancers that recur as therapy-resistant tumors. Myeloid cells control glioblastoma malignancy, but their dynamics during disease progression remain poorly understood. Here, we employed single-cell RNA sequencing and CITE-seq to map the glioblastoma immune landscape in mouse tumors and in patients with newly diagnosed disease or recurrence. This revealed a large and diverse myeloid compartment, with dendritic cell and macrophage populations that were conserved across species and dynamic across disease stages. Tumor-associated macrophages (TAMs) consisted of microglia- or monocyte-derived populations, with both exhibiting additional heterogeneity, including subsets with conserved lipid and hypoxic signatures. Microglia- and monocyte-derived TAMs were self-renewing populations that competed for space and could be depleted via CSF1R blockade. Microglia-derived TAMs were predominant in newly diagnosed tumors, but were outnumbered by monocyte-derived TAMs following recurrence, especially in hypoxic tumor environments. Our results unravel the glioblastoma myeloid landscape and provide a framework for future therapeutic interventions.
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Affiliation(s)
- Ana Rita Pombo Antunes
- Myeloid Cell Immunology Lab, VIB Center for Inflammation Research, Brussels, Belgium.,Laboratory of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Isabelle Scheyltjens
- Myeloid Cell Immunology Lab, VIB Center for Inflammation Research, Brussels, Belgium.,Laboratory of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Francesca Lodi
- Laboratory of Translational Genetics, Department of Human Genetics, KU Leuven, Leuven, Belgium.,VIB-KU Leuven Center for Cancer Biology, VIB, Leuven, Belgium
| | - Julie Messiaen
- Laboratory for Precision Cancer Medicine, Translational Cell and Tissue Research Unit, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Asier Antoranz
- Laboratory for Precision Cancer Medicine, Translational Cell and Tissue Research Unit, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | | | | | - Liesbet Martens
- Laboratory of Myeloid Cell Ontogeny and Functional Specialization, VIB Center for Inflammation Research, Ghent, Belgium.,Department of Biomedical Molecular Biology, Ghent University, Ghent, Belgium.,Laboratory of Myeloid Cell Heterogeneity and Function, VIB Center for Inflammation Research, Ghent, Belgium
| | - Karen De Vlaminck
- Myeloid Cell Immunology Lab, VIB Center for Inflammation Research, Brussels, Belgium.,Laboratory of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Hannah Van Hove
- Myeloid Cell Immunology Lab, VIB Center for Inflammation Research, Brussels, Belgium.,Laboratory of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Signe Schmidt Kjølner Hansen
- Myeloid Cell Immunology Lab, VIB Center for Inflammation Research, Brussels, Belgium.,Laboratory of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Francesca Maria Bosisio
- Translational Cell and Tissue Research Unit, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | | | - Steven De Vleeschouwer
- Department of Neurosurgery, UZ Leuven, Leuven, Belgium.,Laboratory for Experimental Neurosurgery and Neuroanatomy, Department of Neurosciences and Leuven Brain Institute (LBI), KU Leuven, Leuven, Belgium
| | - Raf Sciot
- Translational Cell and Tissue Research Unit, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Luc Bouwens
- Cell Differentiation Lab, Vrije Universiteit Brussel, Brussels, Belgium
| | - Michiel Verfaillie
- Department of Neurosurgery, Europe Hospitals Saint Elisabeth, Ukkel, Belgium
| | - Niels Vandamme
- Data Mining and Modeling for Biomedicine, VIB Center for Inflammation Research, Ghent, Belgium.,Department of Applied Mathematics, Computer Science and Statistics, Ghent University, Ghent, Belgium
| | - Roosmarijn E Vandenbroucke
- VIB Center for Inflammation Research, Gent, Belgium.,Department of Biomedical Molecular Biology, Ghent University, Ghent, Belgium
| | - Olivier De Wever
- Cancer Research Institute Ghent (CRIG), Ghent University, Ghent, Belgium.,Laboratory for Experimental Cancer Research, Ghent University, Ghent, Belgium
| | - Yvan Saeys
- Data Mining and Modeling for Biomedicine, VIB Center for Inflammation Research, Ghent, Belgium.,Department of Applied Mathematics, Computer Science and Statistics, Ghent University, Ghent, Belgium
| | - Martin Guilliams
- Laboratory of Myeloid Cell Ontogeny and Functional Specialization, VIB Center for Inflammation Research, Ghent, Belgium.,Department of Biomedical Molecular Biology, Ghent University, Ghent, Belgium
| | - Conny Gysemans
- Clinical and Experimental Endocrinology (CEE), KU Leuven, Leuven, Belgium
| | - Bart Neyns
- Department of Medical Oncology, UZ Brussels, Brussels, Belgium
| | - Frederik De Smet
- Laboratory for Precision Cancer Medicine, Translational Cell and Tissue Research Unit, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Diether Lambrechts
- Laboratory of Translational Genetics, Department of Human Genetics, KU Leuven, Leuven, Belgium.,VIB-KU Leuven Center for Cancer Biology, VIB, Leuven, Belgium
| | - Jo A Van Ginderachter
- Myeloid Cell Immunology Lab, VIB Center for Inflammation Research, Brussels, Belgium.,Laboratory of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Kiavash Movahedi
- Myeloid Cell Immunology Lab, VIB Center for Inflammation Research, Brussels, Belgium. .,Laboratory of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium.
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47
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Kyriazoglou A, Timmermans I, De Cock L, Laenen A, Dumez H, Sinnaeve F, Wafa H, Hompes D, Van Raemdonck D, De Leyn P, Sciot R, Hauben E, Debiec-Rychter M, Vandenbempt I, Schöffski P. Management of Synovial Sarcoma in a Tertiary Referral Center: A Retrospective Analysis of 134 Patients. Oncol Res Treat 2021; 44:232-241. [PMID: 33756486 DOI: 10.1159/000515112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 02/08/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Synovial sarcomas (SS) are malignant mesenchymal neoplasms that account for about 10% of all sarcomas. Complete surgical excision is the mainstay of primary treatment for localized disease, but SS have a high tendency for local relapse and metastases. Metastatic disease is commonly treated with systemic chemotherapy. METHODS We designed a retrospective analysis to describe the clinical presentation, course of treatment, outcome, and prognosis of patients with SS. Univariate and multivariate analyses were performed for potential prognostic factors. RESULTS We identified 134 patients treated between 1987 and 2018, with a cutoff date of December 2018. Demographics, disease characteristics, treatment, and survival rates were collected and analyzed. The median overall survival (mOS) from the date of diagnosis was 96.7 months. The median progression-free survival was 6.37 months. Disease-free survival was 26 months. Age over 65 years was found to be a prognostic factor with statistically significant value in the univariate analysis regarding mOS (p = 0.015) and mOS after local relapse (p = 0.0228). CONCLUSIONS Even though our study is limited by the retrospective nature of the analysis, it adds an important amount of clinical data regarding the treatment and outcome of SS.
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Affiliation(s)
| | - Iris Timmermans
- Department of Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Lore De Cock
- Department of Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Annouschka Laenen
- Department of Biostatistics, Catholic University of Leuven, Leuven, Belgium
| | - Herlinde Dumez
- Department of Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Friedl Sinnaeve
- Department of Orthopedic Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Hazem Wafa
- Department of Orthopedic Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Daphne Hompes
- Department of Surgical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Dirk Van Raemdonck
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Paul De Leyn
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Raf Sciot
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | - Esther Hauben
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | | | | | - Patrick Schöffski
- Department of Medical Oncology, University Hospitals Leuven, Leuven, Belgium
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48
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Abstract
Murine Double Minute Clone 2, located at 12q15, is an oncogene that codes for an oncoprotein of which the association with p53 was discovered 30 years ago. The most important function of MDM2 is to control p53 activity; it is in fact the best documented negative regulator of p53. Mutations of the tumor suppressor gene p53 represent the most frequent genetic change in human cancers. By overexpressing MDM2, cancer cells have another means to block p53. The sarcomas in which MDM2 amplification is a hallmark are well-differentiated liposarcoma/atypical lipomatous tumor, dedifferentiated liposarcoma, intimal sarcoma, and low-grade osteosarcoma. The purpose of this review is to summarize the typical clinical, histopathological, immunohistochemical, and genetic features of these tumors.
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Affiliation(s)
- Raf Sciot
- Department of Pathology, University Hospital, University of Leuven, 3000 Leuven, Belgium
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49
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Staessens S, François O, Desender L, Vanacker P, Dewaele T, Sciot R, Vanhoorelbeke K, Andersson T, De Meyer SF. Detailed histological analysis of a thrombectomy-resistant ischemic stroke thrombus: a case report. Thromb J 2021; 19:11. [PMID: 33618719 PMCID: PMC7901204 DOI: 10.1186/s12959-021-00262-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 02/03/2021] [Indexed: 11/21/2022] Open
Abstract
Background Mechanical removal of a thrombus by thrombectomy can be quite challenging. For reasons that are not fully understood, some thrombi require multiple passes to achieve successful recanalization, whereas other thrombi are efficiently removed in a single pass. Since first pass success is associated with better clinical outcome, it is important to better understand the nature of thrombectomy resistant thrombi. The aim of this study was therefore to characterize the cellular and molecular composition of a thrombus that was very hard to retrieve via mechanical thrombectomy. Case presentation In a patient that was admitted with a right middle cerebral artery M1-occlusion, 11 attempts using various thrombectomy devices and techniques were required for removal of the thrombus. This peculiar case provided a rare opportunity to perform an in-depth histopathological study of a difficult to retrieve thrombus. Thrombus material was histologically analyzed using hematoxylin and eosin, Martius Scarlet Blue stain (red blood cells and fibrin), Feulgen stain (DNA), von Kossa stain (calcifications) and immunohistochemical analysis of von Willebrand factor, platelets, leukocytes and neutrophil extracellular traps. Histological analysis revealed abnormally high amounts of extracellular DNA, leukocytes, von Willebrand factor and calcifications. Extracellular DNA stained positive for markers of leukocytes and NETs, suggesting that a significant portion of DNA is derived from neutrophil extracellular traps. Conclusion In this unique case of a nearly thrombectomy-resistant stroke thrombus, our study showed an atypical composition compared to the common structural features found in ischemic stroke thrombi. The core of the retrieved thrombus consisted of extracellular DNA that colocalized with von Willebrand factor and microcalcifications. These results support the hypothesis that von Willebrand factor, neutrophil extracellular traps and microcalcifications contribute to mechanical thrombectomy resistance. Such information is important to identify novel targets in order to optimize technical treatment protocols and techniques to increase first pass success rates.
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Affiliation(s)
- Senna Staessens
- Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, E. Sabbelaan 53, 8500, Kortrijk, Belgium
| | | | - Linda Desender
- Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, E. Sabbelaan 53, 8500, Kortrijk, Belgium
| | - Peter Vanacker
- Department of Neurology, AZ Groeninge, Kortrijk, Belgium.,Department of Neurology, University Hospitals Antwerp, Antwerp, Belgium.,Department of Translational Neuroscience, University of Antwerp, Antwerp, Belgium
| | - Tom Dewaele
- Department of Medical Imaging, AZ Groeninge, Kortrijk, Belgium
| | - Raf Sciot
- Department of Pathology, University Hospitals KU Leuven, Leuven, Belgium
| | - Karen Vanhoorelbeke
- Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, E. Sabbelaan 53, 8500, Kortrijk, Belgium
| | - Tommy Andersson
- Department of Medical Imaging, AZ Groeninge, Kortrijk, Belgium.,Departments of Neuroradiology, Karolinska University Hospital, and Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Simon F De Meyer
- Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, E. Sabbelaan 53, 8500, Kortrijk, Belgium.
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50
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Abstract
Intraosseous schwannomas represent an extremely rare subgroup of schwannomas, accounting for <1% of all primary bone tumors. They mostly occur in the mandible, the maxilla, the sacrum, and they are also seen in long bones. We herein report a rare presentation of an intraosseous schwannoma in the glenoid of a 49-year-old patient. She complained of shoulder pain and was referred to the orthopaedic oncologist after detection of a suspicious lesion on imaging. Biopsy revealed benign spindle cells and immunohistochemistry was positive for S100. Because of the rarity of these intraosseous schwannomas it is important to recognize their radiological and histological features and make a differential diagnosis with other lytic tumors. Only if these characteristics are recognized, correct treatment can be given with definite curettage and bone grafting and correct follow-up with avoidance of unnecessary adjuvant therapy.
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Affiliation(s)
- Pieter Reyniers
- University Hospitals Leuven Campus Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium
| | - Hazem Wafa
- University Hospitals Leuven Campus Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium
| | - Friedl Sinnaeve
- University Hospitals Leuven Campus Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium
| | - Philippe Debeer
- University Hospitals Leuven Campus Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium
| | - Raf Sciot
- University Hospitals Leuven Campus Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium
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