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Moreno L, Weston R, Owens C, Valteau-Couanet D, Gambart M, Castel V, Zwaan CM, Nysom K, Gerber N, Castellano A, Laureys G, Ladenstein R, Rössler J, Makin G, Murphy D, Morland B, Vaidya S, Thebaud E, van Eijkelenburg N, Tweddle DA, Barone G, Tandonnet J, Corradini N, Chastagner P, Paillard C, Bautista FJ, Gallego Melcon S, De Wilde B, Marshall L, Gray J, Burchill SA, Schleiermacher G, Chesler L, Peet A, Leach MO, McHugh K, Hayes R, Jerome N, Caron H, Laidler J, Fenwick N, Holt G, Moroz V, Kearns P, Gates S, Pearson ADJ, Wheatley K. Bevacizumab, Irinotecan, or Topotecan Added to Temozolomide for Children With Relapsed and Refractory Neuroblastoma: Results of the ITCC-SIOPEN BEACON-Neuroblastoma Trial. J Clin Oncol 2024:JCO2300458. [PMID: 38190578 DOI: 10.1200/jco.23.00458] [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] [Received: 02/28/2023] [Revised: 07/25/2023] [Accepted: 10/05/2023] [Indexed: 01/10/2024] Open
Abstract
PURPOSE Outcomes for children with relapsed and refractory high-risk neuroblastoma (RR-HRNB) remain dismal. The BEACON Neuroblastoma trial (EudraCT 2012-000072-42) evaluated three backbone chemotherapy regimens and the addition of the antiangiogenic agent bevacizumab (B). MATERIALS AND METHODS Patients age 1-21 years with RR-HRNB with adequate organ function and performance status were randomly assigned in a 3 × 2 factorial design to temozolomide (T), irinotecan-temozolomide (IT), or topotecan-temozolomide (TTo) with or without B. The primary end point was best overall response (complete or partial) rate (ORR) during the first six courses, by RECIST or International Neuroblastoma Response Criteria for patients with measurable or evaluable disease, respectively. Safety, progression-free survival (PFS), and overall survival (OS) time were secondary end points. RESULTS One hundred sixty patients with RR-HRNB were included. For B random assignment (n = 160), the ORR was 26% (95% CI, 17 to 37) with B and 18% (95% CI, 10 to 28) without B (risk ratio [RR], 1.52 [95% CI, 0.83 to 2.77]; P = .17). Adjusted hazard ratio for PFS and OS were 0.89 (95% CI, 0.63 to 1.27) and 1.01 (95% CI, 0.70 to 1.45), respectively. For irinotecan ([I]; n = 121) and topotecan (n = 60) random assignments, RRs for ORR were 0.94 and 1.22, respectively. A potential interaction between I and B was identified. For patients in the bevacizumab-irinotecan-temozolomide (BIT) arm, the ORR was 23% (95% CI, 10 to 42), and the 1-year PFS estimate was 0.67 (95% CI, 0.47 to 0.80). CONCLUSION The addition of B met protocol-defined success criteria for ORR and appeared to improve PFS. Within this phase II trial, BIT showed signals of antitumor activity with acceptable tolerability. Future trials will confirm these results in the chemoimmunotherapy era.
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Affiliation(s)
- Lucas Moreno
- Vall d'Hebron University Hospital, Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | - Guy Makin
- Central Manchester and Manchester Children's University Hospitals NHS Trust, Manchester, United Kingdom
| | - Dermot Murphy
- NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
| | - Bruce Morland
- Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom
| | - Sucheta Vaidya
- The Royal Marsden NHS Foundation Trust & Institute for Cancer Research, London, United Kingdom
| | | | | | - Deborah A Tweddle
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, United Kingdom
| | | | | | | | | | | | | | | | | | - Lynley Marshall
- The Royal Marsden NHS Foundation Trust & Institute for Cancer Research, London, United Kingdom
| | - Juliet Gray
- University Hospital Southampton, Southampton, United Kingdom
| | | | | | - Louis Chesler
- The Royal Marsden NHS Foundation Trust & Institute for Cancer Research, London, United Kingdom
| | - Andrew Peet
- Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom
| | - Martin O Leach
- The Royal Marsden NHS Foundation Trust & Institute for Cancer Research, London, United Kingdom
| | - Kieran McHugh
- Great Ormond Street Hospital, London, United Kingdom
| | | | - Neil Jerome
- The Royal Marsden NHS Foundation Trust & Institute for Cancer Research, London, United Kingdom
| | | | | | | | - Grace Holt
- University of Birmingham, Birmingham, United Kingdom
| | | | - Pamela Kearns
- University of Birmingham, Birmingham, United Kingdom
| | - Simon Gates
- University of Birmingham, Birmingham, United Kingdom
| | - Andrew D J Pearson
- The Royal Marsden NHS Foundation Trust & Institute for Cancer Research, London, United Kingdom
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Brookes MJ, Roundhill EA, Jeys L, Parry M, Burchill SA, Rankin KS. Reply to: Comment on: Membrane-type 1 matrix metalloproteinase as predictor of survival and candidate therapeutic target in Ewing sarcoma. Pediatr Blood Cancer 2023; 70:e30206. [PMID: 36651715 DOI: 10.1002/pbc.30206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 01/19/2023]
Affiliation(s)
- Marcus J Brookes
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- North of England Bone and Soft Tissue Tumour Service, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Elizabeth A Roundhill
- Children's Cancer Research Group, Leeds Institute of Medical Research, St. James's University Hospital, Leeds, UK
| | - Lee Jeys
- Royal Orthopaedic Hospital NHS Foundation Trust, Northfield, Birmingham, UK
| | - Michael Parry
- Royal Orthopaedic Hospital NHS Foundation Trust, Northfield, Birmingham, UK
| | - Susan A Burchill
- Children's Cancer Research Group, Leeds Institute of Medical Research, St. James's University Hospital, Leeds, UK
| | - Kenneth S Rankin
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- North of England Bone and Soft Tissue Tumour Service, Royal Victoria Infirmary, Newcastle upon Tyne, UK
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Brookes MJ, Roundhill EA, Jeys L, Parry M, Burchill SA, Rankin KS. Membrane-type 1 matrix metalloproteinase as predictor of survival and candidate therapeutic target in Ewing sarcoma. Pediatr Blood Cancer 2022; 69:e29959. [PMID: 36106829 DOI: 10.1002/pbc.29959] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 08/08/2022] [Accepted: 08/09/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Ewing sarcoma (ES) is the second most common primary bone malignancy, with an urgent need for new treatments. ES is associated with high rates of progression and relapse, driven by drug-resistant cells capable of migration, self-renewal and single-cell tumorigenesis, termed cancer stem-like cells (CSCs). Membrane-type 1 matrix metalloproteinase (MT1-MMP) is a membrane-bound proteolytic enzyme, which, via direct and indirect mechanisms, digests four of the main types of collagen. This can be hijacked in malignancy for invasion and metastasis, with high expression predicting decreased survival in multiple cancers. In this study, we have examined the hypothesis that MT1-MMP is expressed by ES cells and explored the relationship between expression and outcomes. PROCEDURE MT1-MMP expression in ES established cell lines, primary patient-derived cultures and daughter ES-CSCs was characterised by RNA sequencing, Western blotting, immunocytochemistry and flow cytometry. Immunohistochemistry was used to detect MT1-MMP in tumour biopsies, and the relationship between expression, event-free and overall survival examined. RESULTS MT1-MMP was detected at both RNA and protein levels in five of six established cell lines, all primary cultures (n = 25) and all daughter ES-CSCs (n = 7). Immunohistochemistry of treatment-naïve biopsy tissue demonstrated that high MT1-MMP expression predicted decreased event-free and overall survival (p = .017 and .036, respectively; n = 47); this was not significant in multivariate analysis. CONCLUSIONS MT1-MMP is expressed by ES cells, including ES-CSCs, making it a candidate therapeutic target. The level of MT1-MMP expression at diagnosis may be considered as a prognostic biomarker if validated by retrospective analysis of a larger cohort of clinical trial samples.
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Affiliation(s)
- Marcus J Brookes
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.,North of England Bone and Soft Tissue Tumour Service, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Elizabeth A Roundhill
- Children's Cancer Research Group, Leeds Institute of Medical Research, St. James's University Hospital, Leeds, UK
| | - Lee Jeys
- Royal Orthopaedic Hospital NHS Foundation Trust, Northfield, Birmingham, UK
| | - Michael Parry
- Royal Orthopaedic Hospital NHS Foundation Trust, Northfield, Birmingham, UK
| | - Susan A Burchill
- Children's Cancer Research Group, Leeds Institute of Medical Research, St. James's University Hospital, Leeds, UK
| | - Kenneth S Rankin
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.,North of England Bone and Soft Tissue Tumour Service, Royal Victoria Infirmary, Newcastle upon Tyne, UK
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McNae M, Roundhill EA, Burchill SA, Bayliss RW. Abstract 2015: The Aurora kinases are a potential therapeutic target in Ewing sarcoma. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-2015] [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
The poor survival rates and limited treatment options for patients with relapsed/metastatic Ewing sarcoma (ES) highlights the need for more personalized targeted therapeutic approaches. In this project, we have investigated the prognostic potential of Aurora kinase expression in ES patients and evaluated the activity of Aurora kinase inhibitors in ES cell lines and patient derived cultures.
The prognostic value of Aurora kinase A (AURKA), Aurora kinase B (AURKB) and Aurora kinase C (AURKC) was determined through interrogation of the online GSE17618 dataset using Cox models and Kaplan Meier plots. RNA seq data was obtained from the CCRG dataset for expression analysis (Roundhill et al., 2021, Cell Oncol, 44(5), 1065-85). Viable cell number was determined using the trypan blue exclusion assay on the Vi-CELL XR. Cells were treated with increasing concentrations of inhibitor (Table 1) or DMSO vehicle control for 48h. Protein was extracted after 48h for western blotting.
In ES patients, high RNA expression of AURKA and AURKB is associated with a 5- and 3-fold increased risk of death respectively (n=42). Risk of an event was increased 3- or 2-fold with high expression of AURKA or AURKB respectively (n=42). High AURKC expression was not prognostic. Expression of AURKA and AURKB was confirmed at the RNA level in ES cell lines and patient derived cultures, and at the protein level in cell lines. Aurora kinase inhibitors (Table 1) decreased viable cell number of ES cell lines and patient derived cultures. Western blotting confirmed a decrease in AURKA and MYC-C expression with increasing concentration of inhibitor. AMG900 was the most potent inhibitor in TC32 cells (Table 1) and decreased viable cell number of patient derived cultures (n=5, p<0.01).
High expression of AURKA or AURKB mRNA predicts poor outcome for ES patients. Inhibitors of these kinases reduce viable cell number of both ES cell lines and patient derived cultures. We are currently investigating the mechanism of action.
Table 1. Summary of the effect of Aurora kinase inhibitors in TC32 ES cells. Aurora Kinase Inhibitor Concentration Range Used (nM) Target Kinases(IC50, nM) EC50 TC32 Cells (nM) (n=3) P value (EC50 AMG900 vs EC50 another inhibitor) References AMG900 1.25-50 AurA (5), AurB (4), AurC (1) + 10 kinases 1.57 N/A Payton et al., 2010, Cancer Res, 70(23), 9846-54 MLN8237 5-300 AurA (1.2), AurB (396.5) + 22 kinases 29.48 0.0468 Manfredi et al., 2011, Clin Cancer Res, 17(24), 7614-24 CCT137690 5-300 AurA (15), AurB (25), AurC (19) + 3 kinases 97.56 0.0004 Bavetsias et al., 2010, J Med Chem, 53(14), 5213-28 LY3295668 31.25-1000 AurA (0.8) AurB (1038)AurC (98) + 2 kinases Not able to calculate N/A Gong et al., 2019, Cancer Discov, 9(2), 248-263 EC50 values were calculated by nonlinear regression (GraphPad PRISM). Statistical differences between EC50 of AMG900 and the EC50 of other inhibitors were evaluated using two-way ANOVA and Tukey’s multiple comparisons test. IC50 - half maximal inhibitory concentration, EC50 - half maximal effective concentration
Citation Format: Molly McNae, Elizabeth A. Roundhill, Susan A. Burchill, Richard W. Bayliss. The Aurora kinases are a potential therapeutic target in Ewing sarcoma [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 2015.
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Moreno L, Weston R, Viprey V, Tchirkov A, Corrias M, Lammens T, Gray J, Owens C, Laidler J, Gambart M, Castel V, Van Eijkelenburg N, Nysom K, Laureys G, Castellano A, Gerber NU, Ladenstein RL, Valteau Couanet D, Wheatley K, Burchill SA. Predicting outcomes with circulating adrenergic neuroblastoma mRNAs in children with relapsed and refractory neuroblastoma: A BEACON-Neuroblastoma biomarker study. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.10039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10039 Background: Children with relapsed and refractory neuroblastoma (RR-NBL) have poor outcomes. Early identification of children at greatest risk of relapse could mean timelier modifications of treatment to improve outcomes. High levels of adrenergic neuroblastoma mRNAs in blood of children with stage M neuroblastoma receiving frontline treatment predict poor outcome (Viprey PMID: 24590653). Since these markers have not been thoroughly studied in the RR-NBL population, we have prospectively evaluated the prognostic potential of the adrenergic neuroblastoma mRNAs paired-like homeobox 2B (PHOX2B ) and tyrosine hydroxylase (TH) in blood from children with RR-NBL treated in the BEACON-Neuroblastoma trial (NCT02308527). Methods: Blood samples collected at baseline from 88 children were analysed by reverse transcriptase polymerase chain reaction (RTqPCR) for PHOX2B and TH mRNAs. The prognostic power of these mRNAs was evaluated using Kaplan-Meier survival curves and Cox proportional hazards regression. Progression-free (PFS) and overall survival (OS) were calculated from the date that the blood sample was taken at screening to the date of an event; progression, disease recurrence, death or censored alive at the last clinical evaluation. Results: Of the children in this cohort, 58 (66%) had relapsed and 30 (34%) had refractory disease. Twenty-three (26%) had MYC-N amplified tumours. TH and PHOX2B mRNAs were detected in 55% and 60% of blood samples respectively; the correlation coefficient between TH and PHOX2B was 0.75. Higher levels of TH, PHOX2B mRNAs or both combined were associated with reduced PFS and OS (Table). For TH, median PFS for children with TH levels below the median was 12 months (95%CI, 4.6–13 months) versus 5.5 months (95%CI, 1.8–9.4 months) for those children with TH levels above the median. For PHOX2B, median PFS for children with PHOX2B levels below the median was 11.5 months (95%CI, 7.6–34 months), compared to 5.7 months (95%CI, 1.8–10.5 months) where levels were above the median. Conclusions: TH and PHOX2B mRNAs in blood collected at baseline identify children with refractory or relapsed neuroblastoma at greatest risk of progression or death. In the RR-NBL setting, this simple blood test could be used to stratify treatment strategies. Clinical trial information: NCT02308527. [Table: see text]
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Affiliation(s)
- Lucas Moreno
- Division of Pediatric Oncology & Hematology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Rebekah Weston
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom, Birmingham, United Kingdom
| | - Virginie Viprey
- Leeds Institute of Medical Research, University of Leeds, Leeds, United Kingdom
| | - Andrei Tchirkov
- Cytogénétique Médicale CHU Estaing, Clermont-Ferrand, France
| | | | - Tim Lammens
- Department of Pediatric Hematoloy-Oncology and Stem Cell Transplantation, Ghent University Hospital, Ghent, Belgium
| | - Juliet Gray
- University of Southampton, Southampten, United Kingdom
| | | | - Jennifer Laidler
- University of Birmingham, Cancer Research Clinical Trials Unit, Birmingham, United Kingdom
| | | | - Victoria Castel
- Hospital Universiario y Politecnico La Fe Valencia, Valencia, Spain
| | | | - Karsten Nysom
- Department of Pediatrics and Adolescent Medicine, University Hospital Rigshospitalet, Copenhagen, Denmark
| | | | | | | | - Ruth Lydia Ladenstein
- St. Anna Children's Hospital and St. Anna Kinderkrebsforschung, Department of Paediatrics, Medical University Vienna, Vienna, Austria
| | | | | | - Susan A Burchill
- Children's Cancer Research Group, St James's University Hospital, Leeds, United Kingdom
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Merugu S, Chen L, Gavens E, Gabra H, Brougham M, Makin G, Ng A, Murphy D, Gabriel AS, Robinson ML, Wright JH, Burchill SA, Humphreys A, Bown N, Jamieson D, Tweddle DA. Detection of Circulating and Disseminated Neuroblastoma Cells Using the ImageStream Flow Cytometer for Use as Predictive and Pharmacodynamic Biomarkers. Clin Cancer Res 2019; 26:122-134. [DOI: 10.1158/1078-0432.ccr-19-0656] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 08/13/2019] [Accepted: 10/18/2019] [Indexed: 11/16/2022]
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Fultang L, Gamble LD, Gneo L, Berry AM, Egan SA, De Bie F, Yogev O, Eden GL, Booth S, Brownhill S, Vardon A, McConville CM, Cheng PN, Norris MD, Etchevers HC, Murray J, Ziegler DS, Chesler L, Schmidt R, Burchill SA, Haber M, De Santo C, Mussai F. Macrophage-Derived IL1β and TNFα Regulate Arginine Metabolism in Neuroblastoma. Cancer Res 2019; 79:611-624. [PMID: 30545920 PMCID: PMC6420118 DOI: 10.1158/0008-5472.can-18-2139] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 10/19/2018] [Accepted: 12/05/2018] [Indexed: 12/18/2022]
Abstract
Neuroblastoma is the most common childhood solid tumor, yet the prognosis for high-risk disease remains poor. We demonstrate here that arginase 2 (ARG2) drives neuroblastoma cell proliferation via regulation of arginine metabolism. Targeting arginine metabolism, either by blocking cationic amino acid transporter 1 (CAT-1)-dependent arginine uptake in vitro or therapeutic depletion of arginine by pegylated recombinant arginase BCT-100, significantly delayed tumor development and prolonged murine survival. Tumor cells polarized infiltrating monocytes to an M1-macrophage phenotype, which released IL1β and TNFα in a RAC-alpha serine/threonine-protein kinase (AKT)-dependent manner. IL1β and TNFα established a feedback loop to upregulate ARG2 expression via p38 and extracellular regulated kinases 1/2 (ERK1/2) signaling in neuroblastoma and neural crest-derived cells. Proteomic analysis revealed that enrichment of IL1β and TNFα in stage IV human tumor microenvironments was associated with a worse prognosis. These data thus describe an immune-metabolic regulatory loop between tumor cells and infiltrating myeloid cells regulating ARG2, which can be clinically exploited. SIGNIFICANCE: These findings illustrate that cross-talk between myeloid cells and tumor cells creates a metabolic regulatory loop that promotes neuroblastoma progression.
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Affiliation(s)
- Livingstone Fultang
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Laura D Gamble
- Children's Cancer Institute, University of New South Wales, Sydney, Australia
| | - Luciana Gneo
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Andrea M Berry
- Children's Cancer Research Group, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Sharon A Egan
- School of Veterinary Medicine and Science, Sutton Bonington Campus, University of Nottingham, Nottingham, UK
| | - Fenna De Bie
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Orli Yogev
- The Institute of Cancer Research, London, UK
| | - Georgina L Eden
- Children's Cancer Institute, University of New South Wales, Sydney, Australia
| | - Sarah Booth
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Samantha Brownhill
- Children's Cancer Research Group, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Ashley Vardon
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Carmel M McConville
- Institute of Cancer Genomic Sciences, University of Birmingham, Birmingham, Birmingham, UK
| | | | - Murray D Norris
- Children's Cancer Institute, University of New South Wales, Sydney, Australia
| | | | - Jayne Murray
- Children's Cancer Institute, University of New South Wales, Sydney, Australia
| | - David S Ziegler
- Children's Cancer Institute, University of New South Wales, Sydney, Australia
| | | | | | - Susan A Burchill
- Children's Cancer Research Group, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Michelle Haber
- Children's Cancer Institute, University of New South Wales, Sydney, Australia
| | - Carmela De Santo
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Francis Mussai
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK.
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Corrias MV, Parodi S, Tchirkov A, Lammens T, Vicha A, Pasqualini C, Träger C, Yáñez Y, Dallorso S, Varesio L, Luksch R, Laureys G, Valteau-Couanet D, Canete A, Pöetschger U, Ladenstein R, Burchill SA. Event-free survival of infants and toddlers enrolled in the HR-NBL-1/SIOPEN trial is associated with the level of neuroblastoma mRNAs at diagnosis. Pediatr Blood Cancer 2018; 65:e27052. [PMID: 29603574 DOI: 10.1002/pbc.27052] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 01/25/2018] [Accepted: 02/22/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND The purpose of this study was to evaluate whether levels of neuroblastoma mRNAs in bone marrow and peripheral blood from stage M infants (≤12 months of age at diagnosis, MYCN amplified) and toddlers (between 12 and 18 months, any MYCN status) predict event-free survival (EFS). METHODS Bone marrow aspirates and peripheral blood samples from 97 infants/toddlers enrolled in the European High-Risk Neuroblastoma trial were collected at diagnosis in PAXgene™ blood RNA tubes. Samples were analyzed by reverse transcription quantitative polymerase chain reaction according to standardized procedures. RESULTS Bone marrow tyrosine hydroxylase (TH) or paired-like homeobox 2b (PHOX2B) levels in the highest tertile were associated with worse EFS; hazard ratios, adjusted for age and MYCN status, were 1.5 and 1.8 respectively. Expression of both TH and PHOX2B in the highest tertile predicted worse outcome (p = 0.015), and identified 20 (23%) infants/toddlers with 5-year EFS of 20% (95%CI: 4%-44%). Prognostic significance was maintained after adjusting for over-fitting bias (p = 0.038), age and MYCN status. In peripheral blood, PHOX2B levels in the highest tertile predicted a two-fold increased risk of an event (p = 0.032), and identified 23 (34%) infants/toddlers with 5-year EFS of 29% (95%CI: 12%-48%). Time-dependent receiver operating characteristic analysis confirmed the prognostic value of combined TH and PHOX2B in bone marrow and of PHOX2B in peripheral blood during the first year of follow-up. CONCLUSIONS High levels of bone marrow TH and PHOX2B and of peripheral blood PHOX2B at diagnosis allow early identification of a group of high-risk infant and toddlers with neuroblastoma who may be candidates for alternative treatments. Integration with additional biomarkers, as well as validation in additional international trials is warranted.
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Affiliation(s)
- Maria V Corrias
- Unit of Experimental Therapy in Oncology, Istituto Giannina Gaslini, Genoa, Italy
| | - Stefano Parodi
- Unit of Experimental Therapy in Oncology, Istituto Giannina Gaslini, Genoa, Italy
| | - Andrei Tchirkov
- CHU Clermont-Ferrand, Service de Cytogénétique Médicale and Université Clermont Auvergne, Clermont-Ferrand, France
| | - Tim Lammens
- Department of Pediatric Hematology/Oncology, Ghent University Hospital, Ghent, Belgium
| | - Ales Vicha
- Department of Pediatric Hematology and Oncology, 2nd Medical Faculty Charles University and Faculty Hospital Motol, Prague, Czech Republic
| | - Claudia Pasqualini
- Department of Child and Adolescent Cancer, Institut Gustave Roussy, Villejuif, France
| | - Catarina Träger
- Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Yania Yáñez
- Oncología Pediátrica, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Sandro Dallorso
- Unit of Experimental Therapy in Oncology, Istituto Giannina Gaslini, Genoa, Italy
| | - Luigi Varesio
- Unit of Experimental Therapy in Oncology, Istituto Giannina Gaslini, Genoa, Italy
| | - Roberto Luksch
- Department of Pediatric Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Genevieve Laureys
- Department of Pediatric Hematology/Oncology, Ghent University Hospital, Ghent, Belgium
| | | | - Adela Canete
- Oncología Pediátrica, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Ulrike Pöetschger
- Department of Pediatric Oncology, CCRI/St. Anna Children's Hospital, Vienna, Austria
| | - Ruth Ladenstein
- Department of Pediatric Oncology, CCRI/St. Anna Children's Hospital, Vienna, Austria
| | - Susan A Burchill
- Children's Cancer Research Group, Leeds Institute of Cancer and Pathology, Leeds, United Kingdom
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Bosch MC, Roundhill EA, Droop AP, Parry M, Jeys L, Burchill SA. Abstract 3696: RNAseq of patient-derived cancer stem-like cells and exosomes provides new insights into Ewing's sarcoma. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-3696] [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
Cancer stem-like cells (CSCs) are responsible for disease progression and relapse (Schatton et al, Bioessays 2009, 31:1038-49). Therefore, the eradication of Ewing's sarcoma (ES)-CSCs is expected to improve outcome for patients. Since the transfer of exosome cargo between cells drives ES progression (Ventura et al, Oncogene, 2016, 35:3944-54) or can be exploited as biomarker (Miller et al, Biology of the Cell 2013, 105:289-303; Tsugita et al, PLoS ONE 2013, 8:e77416) we have characterized primary patient-derived ES, paired ES-CSCs, and the exosomal cargo from these cultures to identify potential prognostic biomarkers of risk and targets for the development of new treatments.
Methods
ES taken at diagnosis and resection were collected following patient consent (GenoEwing; IRAS-167880). ES-CSCs were isolated using a functional self-renewing assay. EWSR1 translocations were confirmed by FISH using a break-apart probe and RT-PCR. Exosomes were collected after incubation of cultures in serum-free media for 48h, isolated using exoEasy Maxi kit (Qiagen) and characterized by Nanoparticle tracking, Western blot and flow cytometry. The expression of the ES-marker CD99 was investigated by immunocytochemistry, Western blot and flow cytometry. RNA was extracted from ES cells and paired exosomes using the miRNeasy Micro kit (Qiagen) and RNA quality confirmed employing the Agilent Bioanalyser. Total RNA libraries were prepared and sequenced using the HiSeq3000 (Illumina®). Reads were processed using fqtools (Droop, Bioinformatics 2016, 32:1883-4), aligned by STAR (Dobin et al, Bioinformatics 2013, 29:15-21) and differential expression was determined by DESeq2 (Anders et al, Genome Biology 2010, 11:R106). Genes were ranked on adjusted p value and log2 fold change; candidates were validated by RTqPCR.
Results
ES patient-derived cells expressed CD99 and contained an EWSR1 gene translocation (23/23). The median size of isolated ES exosomes was 84nm (range 32-132nm). Exosomes were enriched for small RNA (53±5% in exosomes vs 12±3% in cells). The optimal protein panel to identify ES exosomes is CD81, CD63 and TSG-101; CD9 was not detected. Consistent with the exosomal cell of origin, expression of CD99 was detected in 71-79% of isolated vesicles.
The RNA profile of parental cultures and daughter ES-CSCs was compared and two genes with increased expression in ES-CSCs were validated by RTqPCR (p<0.0001). Using a novel experimental approach in ES, we have sequenced the total RNA profile of paired exosomes from patient-derived ES cultures and confirmed the expression of CD99 and one putative ES-CSC biomarker in exosomes.
Conclusions
For the first time, we have sequenced paired exosomes and patient-derived ES cells to identify a potential prognostic biomarker and novel target for therapy.
Work funded by University of Leeds, Ewing's Sarcoma Research Trust (ESRT) and Bone Cancer Research Trust (BCRT).
Citation Format: Mariona Chicón Bosch, Elizabeth A. Roundhill, Alastair P. Droop, Michael Parry, Lee Jeys, Susan A. Burchill. RNAseq of patient-derived cancer stem-like cells and exosomes provides new insights into Ewing's sarcoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 3696.
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Affiliation(s)
| | | | | | - Michael Parry
- 3The Royal Orthopaedic Hospital, Birmingham, United Kingdom
| | - Lee Jeys
- 3The Royal Orthopaedic Hospital, Birmingham, United Kingdom
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Alsiary R, Brownhill SC, Brüning-Richardson A, Hutson R, Griffin N, Morrison EE, Bond J, Burchill SA, Bell SM. Expression analysis of the MCPH1/BRIT1 and BRCA1 tumor suppressor genes and telomerase splice variants in epithelial ovarian cancer. Gene 2018; 672:34-44. [PMID: 29860064 DOI: 10.1016/j.gene.2018.05.113] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 05/27/2018] [Accepted: 05/30/2018] [Indexed: 10/14/2022]
Abstract
AIMS The aim of this study was to explore the correlation of hTERT splice variant expression with MCPH1/BRIT1 and BRCA1 expression in epithelial ovarian cancer (EOC) samples. BACKGROUND Telomerase activation can contribute to the progression of tumors and the development of cancer. However, the regulation of telomerase activity remains unclear. MCPH1 (also known as BRIT1, BRCT-repeat inhibitor of hTERT expression) and BRCA1 are tumor suppressor genes that have been linked to telomerase expression. METHODS qPCR was used to investigate telomerase splice variants, MCPH1/BRIT1 and BRCA1 expression in EOC tissue and primary cultures. RESULTS The wild type α+/β+ hTERT variant was the most common splice variant in the EOC samples, followed by α+/β- hTERT, a dominant negative regulator of telomerase activity. EOC samples expressing high total hTERT demonstrated significantly lower MCPH1/BRIT1 expression in both tissue (p = 0.05) and primary cultures (p = 0.03). We identified a negative correlation between MCPH1/BRIT1 and α+/β+ hTERT (p = 0.04), and a strong positive association between MCPH1/BRIT1 and both α-/β+ hTERT and α-/β- hTERT (both p = 0.02). A positive association was observed between BRCA1 and α-/β+ hTERT and α-/β- hTERT expression (p = 0.003 and p = 0.04, respectively). CONCLUSIONS These findings support a regulatory effect of MCPH1/BRIT1 and BRCA1 on telomerase activity, particularly the negative association between MCPH1/BRIT1 and the functional form of hTERT (α+/β+).
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Affiliation(s)
- Rawiah Alsiary
- Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, St. James's University Hospital, Leeds LS9 7TF, UK
| | - Samantha C Brownhill
- Leeds Institute of Cancer and Pathology, University of Leeds, St. James's University Hospital Leeds, LS9 7TF, UK
| | - Anke Brüning-Richardson
- Leeds Institute of Cancer and Pathology, University of Leeds, St. James's University Hospital Leeds, LS9 7TF, UK
| | - Richard Hutson
- Institute of Oncology, Leeds Teaching Hospitals NHS Trust, Leeds LS9 7TF, UK
| | - Nicholas Griffin
- Department of Histopathology, Leeds Teaching Hospitals NHS Trust, Leeds LS9 7TF, UK
| | - Ewan E Morrison
- Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, St. James's University Hospital, Leeds LS9 7TF, UK
| | - Jacquelyn Bond
- Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, St. James's University Hospital, Leeds LS9 7TF, UK
| | - Susan A Burchill
- Leeds Institute of Cancer and Pathology, University of Leeds, St. James's University Hospital Leeds, LS9 7TF, UK
| | - Sandra M Bell
- Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, St. James's University Hospital, Leeds LS9 7TF, UK.
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Burchill SA, Beiske K, Shimada H, Ambros PF, Seeger R, Tytgat GAM, Brock PR, Haber M, Park JR, Berthold F. Recommendations for the standardization of bone marrow disease assessment and reporting in children with neuroblastoma on behalf of the International Neuroblastoma Response Criteria Bone Marrow Working Group. Cancer 2017; 123:1095-1105. [PMID: 27984660 DOI: 10.1002/cncr.30380] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [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: 05/16/2016] [Revised: 07/24/2016] [Accepted: 08/15/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND The current study was conducted to expedite international standardized reporting of bone marrow disease in children with neuroblastoma and to improve equivalence of care. METHODS A multidisciplinary International Neuroblastoma Response Criteria Bone Marrow Working Group was convened by the US National Cancer Institute in January 2012 with representation from Europe, North America, and Australia. Practical transferable recommendations to standardize the reporting of bone marrow disease were developed. RESULTS To the authors' knowledge, the current study is the first to comprehensively present consensus criteria for the collection, analysis, and reporting of the percentage area of bone marrow parenchyma occupied by tumor cells in trephine-biopsies. The quantitative analysis of neuroblastoma content in bone marrow aspirates by immunocytology and reverse transcriptase-quantitative polymerase chain reaction are revised. The inclusion of paired-like homeobox 2b (PHOX2B) for immunohistochemistry and reverse transcriptase-quantitative polymerase chain reaction is recommended. Recommendations for recording bone marrow response are provided. The authors endorse the quantitative assessment of neuroblastoma cell content in bilateral core needle biopsies-trephines and aspirates in all children with neuroblastoma, with the exception of infants, in whom the evaluation of aspirates alone is advised. It is interesting to note that 5% disease is accepted as an internationally achievable level for disease assessment. CONCLUSIONS The quantitative assessment of neuroblastoma cells is recommended to provide data from which evidence-based numerical criteria for the reporting of bone marrow response can be realized. This is particularly important in the minimal disease setting and when neuroblastoma detection in bone marrow is intermittent, where clinical impact has yet to be validated. The wide adoption of these harmonized criteria will enhance the ability to compare outcomes from different trials and facilitate collaborative trial design. Cancer 2017;123:1095-1105. © 2016 American Cancer Society.
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Affiliation(s)
- Susan A Burchill
- Children's Cancer Research Group, Leeds Institute of Cancer and Pathology, St James's University Hospital, Leeds, United Kingdom
| | - Klaus Beiske
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo and Department of Pathology, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Hiroyuki Shimada
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, California
| | - Peter F Ambros
- CCRI, Children's Cancer Research Institute, Vienna, Austria
| | - Robert Seeger
- The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, California
| | | | - Penelope R Brock
- Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom
| | - Michelle Haber
- Children's Cancer Institute for Medical Research, Cancer Research Centre, Sydney, New South Wales, Australia
| | - Julie R Park
- Department of Pediatrics, School of Medicine, University of Washington, Seattle Children's Hospital, Seattle, Washington
| | - Frank Berthold
- Department of Pediatric Oncology and Hematology, Center for Integrated Oncology, University of Cologne, Cologne, Germany
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Moreno L, Laidler J, Moroz V, Owens C, Rubie H, Berlanga P, Castellano A, Nysom K, Ladenstein RL, Rossler J, Zwaan CM, Elliott M, Makin G, Murphy D, Burchill SA, Jerome N, Rousseau RF, Kearns P, Wheatley K, Pearson ADJ. A randomised phase IIb trial of BEvACizumab added to Temozolomide ± IrinOtecan for children with refractory/relapsed Neuroblastoma - BEACON-Neuroblastoma, a European Innovative Therapies for Children with Cancer (ITCC) - International Society of Paediatric Oncology Europe Neuroblastoma Group (SIOPEN) trial. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.tps10082] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Lucas Moreno
- CNIO, Spanish National Cancer Research Centre, Madrid, Spain
| | - Jennifer Laidler
- University of Birmingham, Cancer Research Clinical Trials Unit, Birmingham, United Kingdom
| | - Veronica Moroz
- University of Birmingham, Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | | | | | - Pablo Berlanga
- Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | | | | | | | | | | | - Martin Elliott
- Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Guy Makin
- School of Cancer Sciences, University of Manchester, Manchester, United Kingdom
| | - Dermot Murphy
- Royal Hospital for Sick Children, Glasgow, United Kingdom
| | - Susan A Burchill
- Children's Cancer Research Group, St James's University Hospital, Leeds, United Kingdom
| | - Neil Jerome
- Cancer Research UK Cancer Imaging Centre, The Institute of Cancer Research, London, United Kingdom
| | | | - Pamela Kearns
- University of Birmingham, Birmingham, United Kingdom
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Shaw LA, Gaffney AP, Payne HL, Burchill SA. Abstract 3098: Canonical Wnt signaling is activated during the initiation of the migratory phenotype of Ewing's sarcoma family of tumors (ESFT). Cancer Res 2014. [DOI: 10.1158/1538-7445.am2014-3098] [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
Activation of canonical and noncanonical Wnt signaling pathways in the initiation of the Ewing's sarcoma family of tumors (ESFT) migratory phenotype has been investigated using an in vitro model of ESFT.
Human embryonic stem (hES) cells transfected with a doxycycline-inducible expression vector containing EWS-FLI1 (hES-EWS-FLI1) have been investigated. Expression of EWS-FLI1 was confirmed by RT-qPCR and western blot, and induction of cell surface CD99 and EWS-FLI1 target gene expression analyzed by flow cytometry and RT-qPCR, respectively. Migration was assessed following seeding of cell spheroids onto gelatin-coated plates. The pixel count of the migrated area was calculated at 72h and expressed relative to the pixel count at 0h to give relative migration (RM). Changes in the actin cytoskeleton were examined by phalloidin staining and immunofluorescence microscopy. Viable cell number was measured using the trypan blue exclusion assay. Expression of components (n=91) of the Wnt signaling pathway were analyzed using TaqMan® WNT Pathway arrays (Applied Biosystems). Activity of canonical Wnt signaling was quantified using a lentiviral TCF-luciferase reporter assay and noncanonical Wnt signaling using a Rac1 pull-down assay.
Expression of EWS-FLI1 RNA and protein was induced in hES-EWS-FLI1+ cells after 72h exposure to doxycycline (5µg/ml). Induction of EWS-FLI1 was tolerated by hES cells and had no effect on viable cell number. However, these cells grew as a substrate adherent monolayer, in contrast to the hES-EWS-FLI1- cells that retained the colony-phenotype reminiscent of the parent hES cells. hES-EWS-FLI1+ cells had fewer cell-cell adhesions and produced filopodia that were absent in hES-EWS-FLI1- cells. Interestingly, migration of hES-EWS-FLI1+ cells was significantly increased compared to that of hES-EWS-FLI1- cells (RM= 2 compared to 30, p<0.01). Expression of CD99 (p<0.01) and other EWS-FLI1 target genes including CAV1 (p<0.05), IGF1 (p<0.01) and NR0B1 (p<0.0001) were significantly increased in hES-EWS-FLI1+ cells. Components (n=8) of the Wnt signaling pathway were also differentially expressed in hES-EWS-FLI1+ cells. Importantly canonical Wnt signaling was increased two-fold in hES-EWS-FLI1+ cells, within 72 hours of EWS-FLI1 expression. There was a ten-fold increase in the activation of canonical Wnt signaling following treatment of hES-EWS-FLI1+ cells with recombinant Wnt3A (200ng/ml, 24 hours) compared to that in hES-EWS-FLI1- cells (1X compared to 11X, p<0.05). In contrast, the activity of the noncanonical Wnt signaling pathway was not increased in hES-EWS-FLI1+ cells and these cells did not respond to the noncanonical ligand Wnt5A.
In conclusion, activation of the canonical Wnt signaling pathway may be an important step in the initiation of ESFT. Targeting this pathway could be a useful approach to prevent relapse and metastasis.
Citation Format: Lucy A. Shaw, Andrew P. Gaffney, Helen L. Payne, Susan A. Burchill. Canonical Wnt signaling is activated during the initiation of the migratory phenotype of Ewing's sarcoma family of tumors (ESFT). [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 3098. doi:10.1158/1538-7445.AM2014-3098
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Viprey VF, Gregory WM, Corrias MV, Tchirkov A, Swerts K, Vicha A, Dallorso S, Brock P, Luksch R, Valteau-Couanet D, Papadakis V, Laureys G, Pearson AD, Ladenstein R, Burchill SA. Neuroblastoma mRNAs predict outcome in children with stage 4 neuroblastoma: a European HR-NBL1/SIOPEN study. J Clin Oncol 2014; 32:1074-83. [PMID: 24590653 DOI: 10.1200/jco.2013.53.3604] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2024] Open
Abstract
PURPOSE To evaluate the hypothesis that detection of neuroblastoma mRNAs by reverse transcriptase quantitative polymerase chain reaction (RTqPCR) in peripheral blood (PB) and bone marrow aspirates (BM) from children with stage 4 neuroblastoma are clinically useful biomarkers of risk. METHODS RTqPCR for paired-like homeobox 2b (PHOX2B), tyrosine hydroxylase (TH), and doublecortin (DCX) mRNA in PB and BM of children enrolled onto the High-Risk Neuroblastoma Trial-1 of the European Society of Pediatric Oncology Neuroblastoma Group (HR-NBL1/SIOPEN) was performed at diagnosis and after induction therapy. RESULTS High levels of TH, PHOX2B, or DCX mRNA in PB or BM at diagnosis strongly predicted for worse event-free survival (EFS) and overall survival (OS) in a cohort of 290 children. After induction therapy, high levels of these mRNAs predicted worse EFS and OS in BM but not in PB. Combinations of mRNAs in BM did not add to the predictive power of any single mRNA. However, in the original (n = 182) and validation (n = 137) PB cohorts, high TH (log10TH > 0.8) or high PHOX2B (log10PHOX2B > 0.28) identify 19% of children as ultrahigh risk, with 5-year EFS and OS rates of 0%; OS rate was 25% (95% CI, 16% to 36%) and EFS rate was 38% (95% CI, 28% to 49%) in the remaining children. The magnitude of reduction in mRNA level between diagnosis and postinduction therapy in BM or PB was not of additional predictive value. CONCLUSION High levels of TH and PHOX2B mRNA in PB at diagnosis objectively identify children with ultrahigh-risk disease who may benefit from novel treatment approaches. The level of TH, PHOX2B, and DCX mRNA in BM and/or PB at diagnosis might contribute to an algorithm to improve stratification of children for treatment.
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Affiliation(s)
- Virginie F Viprey
- Virginie F. Viprey and Susan A. Burchill, Leeds Institute of Cancer and Pathology; Walter M. Gregory, Clinical Trials Research Unit, University of Leeds, Leeds; Penelope Brock, Great Ormond Street Hospital, London; Andrew D. Pearson, Institute of Cancer Research/Royal Marsden National Health Service Foundation Trust, Sutton, United Kingdom; Maria V. Corrias and Sandro Dallorso, Gaslini Institute, Genoa; Roberto Luksch, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milano, Italy; Andrei Tchirkov, Centre Hospitalier Universitaire Clermont-Ferrand and Clermont Université, Université d'Auvergne, Clermont-Ferrand; Dominique Valteau-Couanet, Institut Gustave Roussy, Villejuif, France; Katrien Swerts and Genevieve Laureys, University Hospital Ghent, Ghent, Belgium; Ales Vicha, Charles University and University Hospital Motol, Prague, Czech Republic; Vassilios Papadakis, Agia Sofia Children's Hospital, Athens, Greece; and Ruth Ladenstein, Children's Cancer Research Institute/St Anna Children's Hospital, Vienna, Austria
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Roundhill EA, Burchill SA. Detection and characterisation of multi-drug resistance protein 1 (MRP-1) in human mitochondria. Br J Cancer 2012; 106:1224-33. [PMID: 22353810 PMCID: PMC3304412 DOI: 10.1038/bjc.2012.40] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [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: 09/06/2011] [Revised: 01/04/2012] [Accepted: 01/17/2012] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Overexpression of plasma membrane multi-drug resistance protein 1 (MRP-1) can lead to multidrug resistance. In this study, we describe for the first time the expression of mitochondrial MRP-1 in untreated human normal and cancer cells and tissues. METHODS MRP-1 expression and subcellular localisation in normal and cancer cells and tissues was examined by differential centrifugation and western blotting, and immunofluorescence microscopy. Viable mitochondria were isolated and MRP-1 efflux activity measured using the calcein-AM functional assay. MRP-1 expression was increased using retroviral infection and specific overexpression confirmed by RNA array. Cell viability was determined by trypan blue exclusion and annexin V-propidium iodide labelling of cells. RESULTS MRP-1 was detected in the mitochondria of cancer and normal cells and tissues. The efflux activity of mitochondrial MRP-1 was more efficient (55-64%) than that of plasma membrane MRP-1 (11-22%; P<0.001). Induced MRP-1 expression resulted in a preferential increase in mitochondrial MRP-1, suggesting selective targeting to this organelle. Treatment with a non-lethal concentration of doxorubicin (0.85 nM, 8 h) increased mitochondrial and plasma membrane MRP-1, increasing resistance to MRP-1 substrates. For the first time, we have identified MRP-1 with efflux activity in human mitochondria. CONCLUSION Mitochondrial MRP-1 may be an exciting new therapeutic target where historically MRP-1 inhibitor strategies have limited clinical success.
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Affiliation(s)
- E A Roundhill
- Children's Cancer Research Group, Leeds Institute of Molecular Medicine, St. James's University Hospital, Beckett Street, Leeds LS9 7TF, UK.
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Roundhill EA, Burchill SA. Abstract B79: Multidrug resistance protein 1 (MRP-1) is expressed in the mitochondria of normal and cancer cells and may play a role in intrinsic drug resistance of ESFT cells. Mol Cancer Ther 2011. [DOI: 10.1158/1535-7163.targ-11-b79] [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
Overexpression of plasma membrane MRP-1 can lead to multidrug resistance. In this study we describe for the first time the expression of mitochondrial MRP-1 in untreated human normal and cancer cells and tissues and investigate the functional significance of mitochondrial MRP-1 with a view to identifying a new therapeutic starategy.
MRP-1 expression and subcellular localisation in normal and cancer cells and tissues was examined by differential centrifugation and western blotting, and immunofluorescence microscopy. Protein extracts were de-glycosylated using the Protein Deglycosylation Mix (NEB). Viable mitochondria were isolated and MRP-1 efflux activity measured using the calcein-AM functional assay. MRP-1 expression was increased by retroviral infection and specific overexpression confirmed by RNA array. Cell viability was determined by trypan blue exclusion and annexin V-PI labelling of cells. Mitochondrial membranes were solubilised by incubation with increasing concentrations of the detergent digitonin and MRP-1 localisation within the mitochondria evaluated by Western blot; protein markers of the mitochondrial outer and inner membranes, the matrix and intermembrane space were used to confirm localisation within the mitochondria.
For the first time we have detected MRP-1 in the mitochondria of untreated cancer and normal cells and tissues by Western blot and confirmed these findings by immunofluorescence and confocal microscopy. The size of the MRP-1 protein in the mitochondria of cancer and normal cells was between 150–250 kDa, reflecting differences in glycosylation. The efflux activity of mitochondrial MRP-1 was more efficient (55–64%) than plasma membrane MRP-1 (11–22%; p<0.001). Specific overexpression of MRP-1 in TC-32 cells by retroviral infection induced a preferential increase in mitochondrial MRP-1 (150%), resulting in an 85% increase in MRP-1 efflux activity (p<0.0001), suggesting selective targeting to this organelle. This was associated with an increase in the IC50 of the MRP-1 substrates vincristine (4.5nM to 14.7nM; p<0.001) and etoposide (101.7nM to 121.6nM (p<0.001) but not the non MRP-1 substrate actinomycin D (0.5nM). Treatment with a non-lethal concentration of doxorubicin (0.85nM, 8h) increased mitochondrial and plasma membrane MRP-1, increasing resistance to MRP-1 substrates.
The glycosylation of MRP-1 and the efflux of calcein-F from whole mitochondria are consistent with localisation of MRP-1 to the outer mitochondrial membrane. This was confirmed by the increased expression of MRP-1 protein in the mitochondrial supernatant after treatment with digitonin and centrifugation. The expression pattern of MRP-1 was similar to that of porin, an outer mitochondrial membrane marker. Analysis of the MRP-1 sequence (using Predator and MitoProtII) failed to reveal published mitochondrial targeting sequences, and so we are currently investigating the mechanism of MRP-1 transport to the mitochondria to identify a druggable therapeutic target.
MRP-1 expressed in the outer mitochondrial membrane has increased efflux activity compared to plasma membrane MRP-1, and so represents an exciting new therapeutic target where historically conventional MRP-1 inhibitor strategies targeting plasma membrane MRP-1 have had limited clinical success.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2011 Nov 12-16; San Francisco, CA. Philadelphia (PA): AACR; Mol Cancer Ther 2011;10(11 Suppl):Abstract nr B79.
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Smith DG, Magwere T, Burchill SA. Oxidative stress and therapeutic opportunities: focus on the Ewing's sarcoma family of tumors. Expert Rev Anticancer Ther 2011; 11:229-49. [PMID: 21342042 DOI: 10.1586/era.10.224] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Reactive oxygen species (ROS) are highly reactive by-products of energy production that can have detrimental as well as beneficial effects. Unchecked, high levels of ROS result in an imbalance of cellular redox state and oxidative stress. High levels of ROS have been detected in most cancers, where they promote tumor development and progression. Many anticancer agents work by further increasing cellular levels of ROS, to overcome the antioxidant detoxification capacity of the cancer cell and induce cell death. However, adaptation of the level of cellular antioxidants can lead to drug resistance. The challenge for the design of effective cancer therapeutics exploiting oxidative stress is to tip the cellular redox balance to induce ROS-dependent cell death but without increasing the antioxidant activity of the cancer cell or inducing toxicity in normal cells.
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Affiliation(s)
- Danielle G Smith
- Leeds Institute of Molecular Medicine, St James's University Hospital, Beckett Street, Leeds LS9 7TF, UK
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White DE, Burchill SA. Fenretinide-dependent upregulation of death receptors through ASK1 and p38α enhances death receptor ligand-induced cell death in Ewing's sarcoma family of tumours. Br J Cancer 2010; 103:1380-90. [PMID: 20877355 PMCID: PMC2990598 DOI: 10.1038/sj.bjc.6605896] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [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] [Indexed: 02/08/2023] Open
Abstract
Background: Sustained p38MAPK phosphorylation upregulates p75 neurotrophin (p75NTR) and induces apoptosis in Ewing's sarcoma family of tumours (ESFT). As fenretinide induces ESFT death through sustained p38MAPK phosphorylation, we hypothesised that this may be effected through upregulation of death receptors (DRs) and that treatment of fenretinide plus DR ligands may enhance apoptosis. Methods: DR expression was determined by flow cytometry. Trypan blue exclusion assays, caspase-8 flow cytometry and immunoblotting for Bid were used to measure cell death. Results: Fenretinide upregulated cell surface expression of tumour necrosis factor-related apoptosis-inducing ligand (TRAIL) receptors, FAS and p75NTR, in an ASK1- and p38α-dependent manner. Cotreatment with fenretinide and DR ligands resulted in synergistic death compared with either agent alone; caspase-8 and Bid were cleaved in a time-dependent manner. Fenretinide did not increase DR expression in non-malignant cells. Furthermore, fenretinide, TRAIL or a combination of both agents was non-cytotoxic to non-malignant cells. Etoposide and actinomycin D increased expression of all DRs examined, whereas vincristine increased FAS alone. Only actinomycin D and TRAIL, and etoposide with TRAIL or FasL, enhanced death compared with either agent alone. Conclusion: The synergistic death observed with fenretinide and DR ligands suggests that this combination may be an attractive strategy for the treatment of ESFT.
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Affiliation(s)
- D E White
- Candlelighter's Children's Cancer Research Group, Section of Experimental Oncology, Leeds Institute of Molecular Medicine, St. James's University Hospital, Beckett Street, Leeds, UK.
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Coulthard LR, White DE, Jones DL, McDermott MF, Burchill SA. p38(MAPK): stress responses from molecular mechanisms to therapeutics. Trends Mol Med 2009; 15:369-79. [PMID: 19665431 DOI: 10.1016/j.molmed.2009.06.005] [Citation(s) in RCA: 439] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2009] [Revised: 06/11/2009] [Accepted: 06/11/2009] [Indexed: 12/11/2022]
Abstract
The p38(MAPK) protein kinases affect a variety of intracellular responses, with well-recognized roles in inflammation, cell-cycle regulation, cell death, development, differentiation, senescence and tumorigenesis. In this review, we examine the regulatory and effector components of this pathway, focusing on their emerging roles in biological processes involved in different pathologies. We summarize how this pathway has been exploited for the development of therapeutics and discuss the potential obstacles of targeting this promiscuous protein kinase pathway for the treatment of different diseases. Furthermore, we discuss how the p38(MAPK) pathway might be best exploited for the development of more effective therapeutics with minimal side effects in a range of specific disease settings.
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Affiliation(s)
- Lydia R Coulthard
- NIHR - Leeds Musculoskeletal Biomedical Research Unit, St James's University Hospital, Leeds, LS9 7TF, UK
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21
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Beiske K, Burchill SA, Cheung IY, Hiyama E, Seeger RC, Cohn SL, Pearson ADJ, Matthay KK. Consensus criteria for sensitive detection of minimal neuroblastoma cells in bone marrow, blood and stem cell preparations by immunocytology and QRT-PCR: recommendations by the International Neuroblastoma Risk Group Task Force. Br J Cancer 2009; 100:1627-37. [PMID: 19401690 PMCID: PMC2696761 DOI: 10.1038/sj.bjc.6605029] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2008] [Revised: 02/16/2009] [Accepted: 03/17/2009] [Indexed: 01/23/2023] Open
Abstract
Disseminating disease is a predictive and prognostic indicator of poor outcome in children with neuroblastoma. Its accurate and sensitive assessment can facilitate optimal treatment decisions. The International Neuroblastoma Risk Group (INRG) Task Force has defined standardised methods for the determination of minimal disease (MD) by immunocytology (IC) and quantitative reverse transcriptase-polymerase chain reaction (QRT-PCR) using disialoganglioside G(D2) and tyrosine hydroxylase mRNA respectively. The INRG standard operating procedures (SOPs) define methods for collecting, processing and evaluating bone marrow (BM), peripheral blood (PB) and peripheral blood stem cell harvest by IC and QRT-PCR. Sampling PB and BM is recommended at diagnosis, before and after myeloablative therapy and at the end of treatment. Peripheral blood stem cell products should be analysed at the time of harvest. Performing MD detection according to INRG SOPs will enable laboratories throughout the world to compare their results and thus facilitate quality-controlled multi-centre prospective trials to assess the clinical significance of MD and minimal residual disease in heterogeneous patient groups.
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Affiliation(s)
- K Beiske
- Department of Pathology, Oslo University Hospital, Oslo, Norway.
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22
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Proctor A, Brownhill SC, Burchill SA. The promise of telomere length, telomerase activity and its regulation in the translocation-dependent cancer ESFT; clinical challenges and utility. Biochim Biophys Acta Mol Basis Dis 2009; 1792:260-74. [PMID: 19264125 DOI: 10.1016/j.bbadis.2009.02.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2009] [Revised: 02/19/2009] [Accepted: 02/20/2009] [Indexed: 01/12/2023]
Abstract
The Ewing's sarcoma family of tumours (ESFT) are diagnosed by EWS-ETS gene translocations. The resulting fusion proteins play a role in both the initiation and maintenance of these solid aggressive malignant tumours, suppressing cellular senescence and increasing cell proliferation and survival. EWS-ETS fusion proteins have altered transcriptional activity, inducing expression of a number of different target genes including telomerase. Up-regulation of hTERT is most likely responsible for the high levels of telomerase activity in primary ESFT, although telomerase activity and expression of hTERT are not predictive of outcome. However levels of telomerase activity in peripheral blood may be useful to monitor response to some therapeutics. Despite high levels of telomerase activity, telomeres in ESFT are frequently shorter than those of matched normal cells. Uncertainty about the role that telomerase and regulators of its activity play in the maintenance of telomere length in normal and cancer cells, and lack of studies examining the relationship between telomerase activity, regulators of its activity and their clinical significance in patient samples have limited their introduction into clinical practice. Studies in clinical samples using standardised assays are critical to establish how telomerase and regulators of its activity might best be exploited for patient benefit.
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Affiliation(s)
- Andrew Proctor
- Cancer Research UK Clinical Centre, Leeds Institute of Molecular Medicine, St James's University Hospital, Beckett Street, Leeds LS9 7TF, UK
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23
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Dalal S, Burchill SA. Preclinical evaluation of vascular-disrupting agents in Ewing's sarcoma family of tumours. Eur J Cancer 2009; 45:713-22. [PMID: 19136249 DOI: 10.1016/j.ejca.2008.11.045] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2008] [Revised: 11/21/2008] [Accepted: 11/24/2008] [Indexed: 02/08/2023]
Abstract
The effects of the tubulin-binding vascular-disrupting agents (VDAs), combretastatin A4 phosphate (CA4P), OXi4503/CA1P and OXi8007, in subcutaneous mouse models of the Ewing's sarcoma family of tumours (ESFTs) have been investigated alone and in combination with doxorubicin. Delay in subcutaneous tumour growth was observed following treatment of mice with multiple doses of OXi4503/CA1P but not with CA4P or OXi8007. A single dose of OXi4503/CA1P caused complete shutdown of vasculature by 24h and extensive haemorrhagic necrosis by 48h. However, a viable rim of proliferating cells remained, which repopulated the tumour within 10 days following the withdrawal of treatment. Combined treatment with doxorubicin 1h prior to administration of OXi4503/CA1P enhanced the effects of OXi4503/CA1P causing a synergistic delay in tumour growth (p<0.001). This study demonstrates that OXi4503/CA1P is a potent VDA in ESFT and in combination with conventional cytotoxic agents represents a promising treatment strategy for this tumour group.
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Affiliation(s)
- Surita Dalal
- Candlelighter's Children's Cancer Research Group, Cancer Research UK Clinical Centre, Leeds Institute of Molecular Medicine, St. James's University Hospital, Beckett Street, Leeds, West Yorkshire LS9 7TF, UK.
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24
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Viprey VF, Lastowska MA, Corrias MV, Swerts K, Jackson MS, Burchill SA. Minimal disease monitoring by QRT-PCR: guidelines for identification and systematic validation of molecular markers prior to evaluation in prospective clinical trials. J Pathol 2008; 216:245-52. [PMID: 18702176 DOI: 10.1002/path.2406] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Real-time RT-PCR (QRT-PCR) is a sensitive method for the detection of minimal disease (MD) and may improve monitoring of disease status and stratification of patients for therapy. Where tumour-specific mRNAs have not been identified, the selection of which target(s) is(are) optimal for the detection of MD remains a challenge. This reflects the heterogeneity of tumour cells, the stability of mRNAs and low-level of transcription in cells of the normal haemopoietic compartments. The aim of this study was to establish for the first time guidelines for the systematic prioritization of potential markers of MD detected by QRT-PCR prior to evaluation in multicentre prospective clinical outcome studies. We combined microarray analysis, ESTs gene expression profiles, improved probe-sets sequence annotation, and previously described standard operating procedures for QRT-PCR analysis to identify and prioritize potential markers of MD. Using this methodology, we identified 49 potential markers of MD in neuroblastoma (NB), of which 11 were associated with neuronal function. We found that, in addition to TH, Phox2B and DCX mRNA may be useful targets for the detection of MD in children with NB. This same strategy could be exploited to select MD markers of other solid tumours from the large number of potential targets identified by microarray gene expression profiles.
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Affiliation(s)
- V F Viprey
- Candlelighter's Children's Cancer Research Group, Leeds Institute of Molecular Medicine, Section of Experimental Oncology, St. James's University Hospital, Leeds, UK.
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25
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Magwere T, Myatt SS, Burchill SA. Manipulation of oxidative stress to induce cell death in Ewing’s sarcoma family of tumours. Eur J Cancer 2008; 44:2276-87. [DOI: 10.1016/j.ejca.2008.06.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2008] [Revised: 05/22/2008] [Accepted: 06/13/2008] [Indexed: 10/21/2022]
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26
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White DE, Burchill SA. BAY 11-7082 induces cell death through NF-kappaB-independent mechanisms in the Ewing's sarcoma family of tumours. Cancer Lett 2008; 268:212-24. [PMID: 18471963 DOI: 10.1016/j.canlet.2008.03.045] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2008] [Revised: 03/27/2008] [Accepted: 03/28/2008] [Indexed: 10/22/2022]
Abstract
The role of NF-kappaB in the Ewing's sarcoma family of tumours (ESFT) and their response to fenretinide has been investigated. Basal levels of phosphorylated NF-kappaB were low in all ESFT cells. BAY 11-7082 decreased cell viability, which was accompanied by caspase-3 cleavage. This was independent of the increase in reactive oxygen species, p38(MAPK) phosphorylation and expression of NF-kappaB target proteins. NF-kappaB knockdown did not induce death under normal growth conditions, but did reduce TNFalpha-dependent cell survival. Fenretinide-induced apoptosis was independent of NF-kappaB. BAY 11-7082-induced cell death through an NF-kappaB-independent mechanism and enhanced cell death when combined with fenretinide.
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Affiliation(s)
- Danielle E White
- Candlelighter's Children's Cancer Research Group, Leeds Institute of Molecular Medicine, Cancer Research UK Clinical Centre, St James's University Hospital, Leeds, UK.
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27
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Roberts P, Burchill SA, Brownhill S, Cullinane CJ, Johnston C, Griffiths MJ, McMullan DJ, Bown NP, Morris SP, Lewis IJ. Ploidy and karyotype complexity are powerful prognostic indicators in the Ewing's sarcoma family of tumors: a study by the United Kingdom Cancer Cytogenetics and the Children's Cancer and Leukaemia Group. Genes Chromosomes Cancer 2008; 47:207-20. [PMID: 18064647 DOI: 10.1002/gcc.20523] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Ewing's sarcoma family tumors (ESFT) are characterized by the presence of EWSR1-ETS fusion genes. Secondary chromosome changes are frequently described, although their clinical significance is not clear. In this study, we have collected and reviewed abnormal karyotypes from 88 patients with primary ESFT and a rearrangement of 22q12. Secondary changes were identified in 80% (70/88) of tumors at diagnosis. Multivariate analysis showed a worse overall and relapse free survival (RFS) for those with a complex karyotype (overall survival, P = 0.005; RFS, P = 0.04), independent of metastatic disease. Univariate survival analysis showed that a chromosome number above 50 or a complex karyotype was associated with a worse overall survival (>50 chromosomes, P = 0.05; complex karyotype, P = 0.04). There was no association between type of cytogenetic abnormality and the presence of metastatic disease at diagnosis. Univariate and multivariate survival analysis of a small subgroup with trisomy 20 indicated that trisomy 20 was associated with a worse overall and RFS. There was no difference in outcome associated with other recurrent trisomies (2, 5, 7, 8, or 12) or the common recurrent secondary structural rearrangements (deletions of 1p36, 9p12, 17p13, and 16q, and gain of 1q), although numbers were small. These data demonstrate the continued value of cytogenetics as a genome-wide screen in ESFT and illustrates the potential importance of secondary chromosome changes for stratification of patients for risk. Specifically, karyotype complexity appears to be a powerful predictor of prognosis, and the presence of trisomy 20 may be a marker of a more aggressive subset of this group.
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Affiliation(s)
- Paul Roberts
- Department of Cytogenetics, St James's University Hospital, Beckett Street, Leeds LS9 7TF, UK.
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28
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Myatt SS, Burchill SA. The sensitivity of the Ewing's sarcoma family of tumours to fenretinide-induced cell death is increased by EWS-Fli1-dependent modulation of p38MAPK activity. Oncogene 2007; 27:985-96. [PMID: 17700534 DOI: 10.1038/sj.onc.1210705] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [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: 11/09/2022]
Abstract
The Ewing's sarcoma family of tumours (ESFT) are small round cell tumours characterized by the non-random EWS-ETS gene rearrangements. We have previously demonstrated that ESFT are highly sensitive to fenretinide-induced death, effected in part through a reactive oxygen species (ROS)-dependent pathway. Here, we demonstrate for the first time that the sensitivity of ESFT cells to fenretinide-induced cell death is decreased following downregulation of the oncogenic fusion protein EWS-Fli1; siRNA targeting EWS-Fli1 attenuated fenretinide-induced cell death in cell lines expressing EWS-Fli1, but not EWS-ERG. This decrease in cell death was independent of the level of ROS produced following exposure to fenretinide, but was effected through EWS-Fli1-dependent modulation of p38(MAPK) activity. Furthermore, inhibition of p38(MAPK) activity and knockdown of EWS-Fli1 reduced fenretinide-induced mitochondrial permeabilization, cytochrome c release, caspase and PARP cleavage, consistent with the hypothesis that p38(MAPK) is critical for activation of the death cascade by fenretinide in ESFT cells. These data demonstrate that expression of EWS-Fli1 enhances fenretinide-induced cell death in ESFT and that this is effected at least in part through modulation of p38(MAPK) activity.
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MESH Headings
- Antineoplastic Agents/pharmacology
- Apoptosis/drug effects
- Blotting, Western
- Caspases/metabolism
- Cell Proliferation/drug effects
- Cytochromes c/metabolism
- Down-Regulation
- Electroporation
- Fenretinide/pharmacology
- Flow Cytometry
- Gene Expression Regulation, Enzymologic
- Humans
- Membrane Potentials/drug effects
- Mitochondria/drug effects
- Mitochondria/metabolism
- Oncogene Proteins, Fusion/antagonists & inhibitors
- Oncogene Proteins, Fusion/genetics
- Oncogene Proteins, Fusion/metabolism
- Poly(ADP-ribose) Polymerases/metabolism
- Proto-Oncogene Protein c-fli-1/antagonists & inhibitors
- Proto-Oncogene Protein c-fli-1/genetics
- Proto-Oncogene Protein c-fli-1/metabolism
- RNA, Small Interfering/pharmacology
- RNA-Binding Protein EWS
- Reactive Oxygen Species/metabolism
- Reverse Transcriptase Polymerase Chain Reaction
- Sarcoma, Ewing/drug therapy
- Sarcoma, Ewing/metabolism
- Sarcoma, Ewing/pathology
- Transcription Factors/metabolism
- Tumor Cells, Cultured
- p38 Mitogen-Activated Protein Kinases/metabolism
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Affiliation(s)
- S S Myatt
- Candlelighter's Children's Cancer Research Laboratory, Cancer Research UK Clinical Centre, St James's University Hospital, Leeds, UK
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29
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Abstract
Chromosome 9p21 gene copy number in Ewing's sarcoma family of tumour (ESFT) cell lines and primary ESFT has been evaluated using Multiplex Ligation-dependent probe amplification, and the clinical significance of CDKN2A loss and p16/p14ARF expression investigated. Homozygous deletion of CDKN2A was identified in 4/9 (44%) of ESFT cell lines and 4/42 (10%) primary ESFT; loss of one copy of CDKN2A was identified in a further 2/9 (22%) cell lines and 2/42 (5%) tumours. CDKN2B was co-deleted in three (33%) cell lines and two (5%) tumours. Co-deletion of the MTAP gene was observed in 1/9 (11%) cell lines and 3/42 (7%) tumours. No correlation was observed between CDKN2A deletion and clinical parameters. However, co-expression of high levels of p16/p14ARF mRNA predicted a poor event-free survival (P=0.046, log-rank test). High levels of p16/p14ARF mRNA did not correlate with high expression of p16 protein. Furthermore, p16 protein expression did not predict event-free or overall survival. Methylation is not a common mechanism of p16 gene silencing in ESFT. These studies demonstrate that loss (homozygous deletion or single copy) of CDKN2A was not prognostically significant in primary ESFT. However, high levels of p16/p14ARF mRNA expression were predictive of a poor event-free survival and should be investigated further.
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MESH Headings
- Bone Neoplasms/genetics
- Bone Neoplasms/mortality
- Bone Neoplasms/pathology
- Cell Line, Tumor
- Chromosome Mapping
- Chromosomes, Human, Pair 9
- Cyclin-Dependent Kinase Inhibitor p16/deficiency
- Cyclin-Dependent Kinase Inhibitor p16/genetics
- DNA, Neoplasm/genetics
- DNA, Neoplasm/isolation & purification
- Gene Deletion
- Genes, p16
- Humans
- Prognosis
- RNA, Neoplasm/genetics
- RNA, Neoplasm/isolation & purification
- Reverse Transcriptase Polymerase Chain Reaction
- Sarcoma, Ewing/genetics
- Sarcoma, Ewing/mortality
- Sarcoma, Ewing/pathology
- Survival Analysis
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Affiliation(s)
- S C Brownhill
- Candlelighter's Children's Cancer Research Laboratory, St. James's University Hospital, Beckett Street, LS9 7TF Leeds, UK.
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30
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Łastowska M, Viprey V, Santibanez-Koref M, Wappler I, Peters H, Cullinane C, Roberts P, Hall AG, Tweddle DA, Pearson ADJ, Lewis I, Burchill SA, Jackson MS. Identification of candidate genes involved in neuroblastoma progression by combining genomic and expression microarrays with survival data. Oncogene 2007; 26:7432-44. [PMID: 17533364 DOI: 10.1038/sj.onc.1210552] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Identifying genes, whose expression is consistently altered by chromosomal gains or losses, is an important step in defining genes of biological relevance in a wide variety of tumour types. However, additional criteria are needed to discriminate further among the large number of candidate genes identified. This is particularly true for neuroblastoma, where multiple genomic copy number changes of proven prognostic value exist. We have used Affymetrix microarrays and a combination of fluorescent in situ hybridization and single nucleotide polymorphism (SNP) microarrays to establish expression profiles and delineate copy number alterations in 30 primary neuroblastomas. Correlation of microarray data with patient survival and analysis of expression within rodent neuroblastoma cell lines were then used to define further genes likely to be involved in the disease process. Using this approach, we identify >1000 genes within eight recurrent genomic alterations (loss of 1p, 3p, 4p, 10q and 11q, 2p gain, 17q gain, and the MYCN amplicon) whose expression is consistently altered by copy number change. Of these, 84 correlate with patient survival, with the minimal regions of 17q gain and 4p loss being enriched significantly for such genes. These include genes involved in RNA and DNA metabolism, and apoptosis. Orthologues of all but one of these genes on 17q are overexpressed in rodent neuroblastoma cell lines. A significant excess of SNPs whose copy number correlates with survival is also observed on proximal 4p in stage 4 tumours, and we find that deletion of 4p is associated with improved outcome in an extended cohort of tumours. These results define the major impact of genomic copy number alterations upon transcription within neuroblastoma, and highlight genes on distal 17q and proximal 4p for downstream analyses. They also suggest that integration of discriminators, such as survival and comparative gene expression, with microarray data may be useful in the identification of critical genes within regions of loss or gain in many human cancers.
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Affiliation(s)
- M Łastowska
- Institute of Human Genetics, University of Newcastle upon Tyne, Newcastle upon Tyne, UK
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31
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Viprey VF, Corrias MV, Kagedal B, Oltra S, Swerts K, Vicha A, Ladenstein R, Burchill SA. Standardisation of operating procedures for the detection of minimal disease by QRT-PCR in children with neuroblastoma: Quality assurance on behalf of SIOPEN-R-NET. Eur J Cancer 2007; 43:341-50. [PMID: 17023157 DOI: 10.1016/j.ejca.2006.08.007] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [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: 05/31/2006] [Revised: 07/14/2006] [Accepted: 08/02/2006] [Indexed: 11/30/2022]
Abstract
The clinical utility of detecting minimal residual disease (MRD) in children with neuroblastoma (NB) by quantitative reverse transcriptase polymerase chain reaction (QRT-PCR) is not clear. This in part reflects the lack of uniform methodology for analysis and reporting. Reference laboratories across Europe have therefore established standard operating procedures (SOPs) for the detection of NB cells by QRT-PCR. Haemopoietic samples are collected into PAXgene blood RNA tubes, which stabilise mRNA for 48 h at room temperature and more than 6 months at -80 degrees C. Tyrosine hydroxylase (TH) was selected as the target for NB cell detection, expression is normalised to beta2-microglobulin and reported using the DeltaDeltaCt method. The sensitivity of QRT-PCR increased from 58% to 90% following the development of SOPs. A robust, transferable, objective method for the detection of NB cells by QRT-PCR has been defined to improve the power and consistency of studies on MRD in children with NB.
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Affiliation(s)
- Virginie F Viprey
- Children's Cancer Research Laboratory, Cancer Research UK Clinical Centre, St James's University Hospital, Beckett Street, Leeds LS9 7TF, United Kingdom
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32
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Abstract
Transfer of new anticancer agents from bench to clinical trial takes in excess of 10 years and costs up to US $500 million. Despite this massive commitment, many more new agents fail in the clinical trials than are successful. The poor performance of many investigational anticancer agents in the clinic implies that the preclinical models used to evaluate them are flawed, inappropriately used or the information they generate is misinterpreted. This article reviews current practice and the range of preclinical models available. The author provides a personal perspective on what information is needed and how in the future this might best be obtained from preclinical models to more effectively inform the transfer of novel, active agents into clinical practice.
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Affiliation(s)
- Susan A Burchill
- Candlelighter's Children's Cancer Research Laboratory, Leeds University, UK.
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33
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Beiske K, Ambros PF, Burchill SA, Cheung IY, Swerts K. Detecting minimal residual disease in neuroblastoma patients-the present state of the art. Cancer Lett 2005; 228:229-40. [PMID: 15951104 DOI: 10.1016/j.canlet.2005.02.053] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2005] [Accepted: 02/05/2005] [Indexed: 11/27/2022]
Abstract
While cyto- and histological screening of bone marrow samples are still accepted as the gold standard for initial staging of neuroblastoma patients, these applications are insufficient during or after therapy because it is not always possible to detect tumour cell infiltration below the level of 1% by morphology alone. For monitoring of minimal residual disease, techniques offering a considerably higher sensitivity have been developed. Immunocytology, RT-PCR and flow cytometry are most frequently used, but differ with regard to targets (single cells, RNA transcripts), measured parameters (tumour cell number, antigen expression, cytomorphology, cytogenetic aberrations, level/number of RNA transcripts), specificity (uni-/multi-parameter analysis) and sensitivity (number of investigated cells). The pros and cons of these methods are reviewed. Precise quantification of residual tumour cells in bone marrow and blood may show a future impact on risk grouping and therapeutic strategies for patients with disseminated disease, but the potential clinical application of these techniques has to be preceded by thorough standardisation and validation in multi-centre studies.
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Affiliation(s)
- Klaus Beiske
- Department of Pathology, Rikshospitalet, Sognsvannsveien 23, N-0027 Oslo, Norway.
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34
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Dalal S, Berry AM, Cullinane CJ, Mangham DC, Grimer R, Lewis IJ, Johnston C, Laurence V, Burchill SA. Vascular endothelial growth factor: a therapeutic target for tumors of the Ewing's sarcoma family. Clin Cancer Res 2005; 11:2364-78. [PMID: 15788688 DOI: 10.1158/1078-0432.ccr-04-1201] [Citation(s) in RCA: 96] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE We have reported previously that intratumoral microvessel density (MVD) is a significant prognostic indicator of event-free survival in the Ewing's sarcoma family of tumors (ESFT). Here, the angiogenic growth factor expression profile and its relationship with MVD has been investigated in ESFT. EXPERIMENTAL DESIGN AND RESULTS Using ESFT model systems, the potential of these factors as therapeutic targets has been evaluated. A significant correlation (P = 0.02) was observed between vascular endothelial growth factor (VEGF) expression and MVD, consistent with the hypothesis that VEGF regulates the development of microvessels in ESFT. There was no correlation between MVD and any of the other growth factors studied. All six ESFT cell lines studied produced and secreted VEGF; five of six cell lines also secreted placental growth factor, one cell line (A673) at high levels. Tumor conditioned medium induced proliferation of human umbilical vein endothelial cells. Expression of VEGF receptors Flt-1 and Flk-1/KDR was heterogeneous across the cell lines. Both receptor tyrosine kinase inhibitors SU6668 (targets Flk-1/KDR, platelet-derived growth factor receptor-beta, and fibroblast growth factor receptor 1) and SU5416 (targets Flk-1/KDR) as well as anti-VEGF agents rhuMAb-VEGF (bevacizumab) and VEGF Trap delayed s.c. growth of ESFT in mice compared with untreated groups: SU6668 (100 mg/kg/d), SU5416 (25 mg/kg/d), rhuMAb-VEGF (10 mg/kg twice weekly), and VEGF Trap (2.5 or 25 mg/kg twice weekly). CONCLUSIONS These data suggest that VEGF is the single most important regulator of angiogenesis in ESFT and may be exploited for therapeutic advantage.
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Affiliation(s)
- Surita Dalal
- Candlelighter's Children's Cancer Research Laboratory, Cancer Research UK Clinical Centre, St. James's University Hospital, Leeds LS9 7TF, United Kingdom.
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35
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Abstract
PURPOSE There is an urgent need for new therapeutic strategies in Ewing's sarcoma family of tumors (ESFT). In this study, we have evaluated the effect of fenretinide [N-(4-hydroxyphenyl)retinamide] in ESFT models. EXPERIMENTAL DESIGN The effect of fenretinide on viable cell number and apoptosis of ESFT cell lines and spheroids and growth of s.c. ESFT in nu/nu mice was investigated. The role of the stress-activated kinases p38(MAPK) and c-Jun NH(2)-terminal kinase in fenretinide-induced death was investigated by Western blot and inhibitor experiments. Accumulation of reactive oxygen species (ROS) and changes in mitochondrial transmembrane potential were investigated by flow cytometry. RESULTS Fenretinide induced cell death in all ESFT cell lines examined in a dose- and time-dependent manner. ESFT cells were more sensitive to fenretinide than the neuroblastoma cell lines examined. Furthermore, fenretinide induced cell death in ESFT spheroids and delayed s.c. ESFT growth in mice. p38(MAPK) was activated within 15 minutes of fenretinide treatment and was dependent on ROS accumulation. Inhibition of p38(MAPK) activity partially rescued fenretinide-mediated cell death in ESFT but not in SH-SY5Y neuroblastoma cells. c-Jun NH(2)-terminal kinase was activated after 4 hours and was dependent on ROS accumulation but not on activation of p38(MAPK). After 8 hours, fenretinide induced mitochondrial depolarization (Deltapsi(m)) and release of cytochrome c into the cytoplasm in a ROS- and p38(MAPK)-dependent manner. CONCLUSIONS These data show that the high sensitivity of ESFT cells to fenretinide is dependent in part on the rapid and sustained activation of p38(MAPK). The efficacy of fenretinide in preclinical models demands the evaluation of fenretinide as a potential therapeutic agent in ESFT.
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Affiliation(s)
- Stephen S Myatt
- Candlelighter's Children's Cancer Research Laboratory, Cancer Research UK Clinical Centre, Leeds, United Kingdom
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36
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Patel K, Whelan PJ, Prescott S, Brownhill SC, Johnston CF, Selby PJ, Burchill SA. The Use of Real-Time Reverse Transcription-PCR for Prostate-Specific Antigen mRNA to Discriminate between Blood Samples from Healthy Volunteers and from Patients with Metastatic Prostate Cancer. Clin Cancer Res 2004; 10:7511-9. [PMID: 15569981 DOI: 10.1158/1078-0432.ccr-04-0166] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE A clinical role for nonquantitative reverse transcription-PCR (RT-PCR) using prostate-specific antigen in blood samples from patients with prostate cancer remains undefined. Assay variation and detection of prostate-specific antigen mRNA illegitimate transcription may explain inconsistent results between studies. Defining levels of prostate-specific antigen mRNA expression in blood samples from healthy volunteers and patients with prostate cancer would allow cutoffs to be established to distinguish the two groups. EXPERIMENTAL DESIGN Quantitative real-time RT-PCR for prostate-specific antigen mRNA was established and levels of prostate-specific antigen mRNA measured in bloods samples from healthy volunteers (n=21) and patients with localized (n=27) and metastatic (n=40) prostate cancer. RESULTS Levels of prostate-specific antigen mRNA were significantly higher in blood samples from patients with metastatic prostate cancer than in blood samples from patients with localized prostate cancer (P <0.001) or in blood samples from healthy volunteers (P <0.01); levels between patients with localized prostate cancer and healthy volunteers were no different. Assay sensitivity to detect patients with metastatic prostate cancer was 68% with specificity of 95%. In patients with newly diagnosed metastatic prostate cancer, monitoring response to hormonal therapy was possible with this assay. No correlation between levels of prostate-specific antigen mRNA and serum prostate-specific antigen protein levels was found, suggesting that prostate-specific antigen mRNA and serum prostate-specific antigen protein levels reflect different features of prostate cancer, i.e., circulating tumor cells and total tumor bulk, respectively. CONCLUSIONS Quantitative RT-PCR discriminates patients with metastatic prostate cancer from healthy volunteers and patients with localized prostate cancer but cannot discriminate patients with localized prostate cancer from healthy volunteers. A role for quantitative RT-PCR has been identified in the assessment and monitoring of patients with metastatic prostate cancer.
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Affiliation(s)
- Kinnari Patel
- Cancer Research U.K. Clinical Centre and Department of Urology, St. James's University Hospital, Leeds, Yorkshire, United Kingdom
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37
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Riley RD, Heney D, Jones DR, Sutton AJ, Lambert PC, Abrams KR, Young B, Wailoo AJ, Burchill SA. A systematic review of molecular and biological tumor markers in neuroblastoma. Clin Cancer Res 2004; 10:4-12. [PMID: 14734444 DOI: 10.1158/1078-0432.ccr-1051-2] [Citation(s) in RCA: 145] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The aim of this study was to conduct a systematic review, and where possible meta-analyses, of molecular and biological tumor markers described in neuroblastoma, and to establish an evidence-based perspective on their clinical value for the screening, diagnosis, prognosis, and monitoring of patients. EXPERIMENTAL DESIGN A well-defined, reproducible search strategy was used to identify the relevant literature from 1966 to February 2000. RESULTS A total of 428 papers studying the use of 195 different tumor markers in neuroblastoma were identified. Small sample sizes, poor statistical reporting, large heterogeneity across studies (e.g., in cutoff levels), and publication bias limited meta-analysis to the area of prognosis only; MYCN, chromosome 1p, DNA index, vanillylmandelic acid:homovanillic acid ratio, CD44, Trk-A, neuron-specific enolase, lactate dehydrogenase, ferritin, and multidrug resistance were all identified as potentially important prognostic tools. CONCLUSIONS This systematic review forms a knowledge base of the tumor markers studied thus far in neuroblastoma, and has identified some of the most important prognostic markers, which should be considered in future research and treatment strategies. Importantly, the review has also highlighted some general problems across primary tumor marker studies, in particular poor and heterogeneous reporting. These need to be addressed to allow better clinical interpretation and enable more appropriate evidence-based reviews in the future. In particular, collaboration of cancer research groups is needed to enable bigger sample sizes, standardize methods of analysis and reporting, and facilitate the pooling of individual patient data.
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Affiliation(s)
- Richard D Riley
- Departments of Health Sciences, Medical Education, University of Leicester, Leicester.
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38
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Williamson AJK, Dibling BC, Boyne JR, Selby P, Burchill SA. Basic fibroblast growth factor-induced cell death is effected through sustained activation of p38MAPK and up-regulation of the death receptor p75NTR. J Biol Chem 2004; 279:47912-28. [PMID: 15310753 DOI: 10.1074/jbc.m409035200] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Basic fibroblast growth factor (bFGF) induces cell death in cells of the Ewing's sarcoma family of tumors in vivo and in vitro. In this study we demonstrate that this is dependent on the rapid and sustained activation of p38(MAPK), in contrast to the transient activation of p38(MAPK) associated with bFGF-induced cell proliferation. Stem cell factor-induced survival of TC-32 cells was also associated with transient activation of p38(MAPK). Inhibition of p38(MAPK) by SB202190 and p38(MAPK) small interfering RNA reduces bFGF-induced death in TC-32 cells, consistent with the hypothesis that activation of p38(MAPK) is essential for induction of death by bFGF. This appears to be dependent on sustained activation of p38(MAPK), demonstrated by inhibition of bFGF-induced cell death following addition of SB202190 to TC-32 cells 5 min after exposure to bFGF (20 ng/ml) and activation of p38(MAPK). Prolonged activation of p38(MAPK) is accompanied by a rapid and sustained phosphorylation of Ras and ERK; inhibition of ERK phosphorylation using the MEK-1 inhibitor PD98059 rescued approximately 30% of cells from bFGF-induced death suggesting ERK plays a secondary role in the induction of death. This hypothesis is supported by observations in the A673 cell line; bFGF induced sustained activation of ERK and transient activation of p38(MAPK), which was not associated with cell death. These data demonstrate that sustained activation of p38(MAPK) is essential for activation of the death cascade following exposure of Ewing's sarcoma family of tumors cells to bFGF and provide evidence that activation of p38(MAPK) results in an up-regulation of the death receptor p75(NTR).
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Affiliation(s)
- Andrew J K Williamson
- Candlelighter's Children's Cancer Research Laboratory, Cancer Research UK Clinical Centre, St. James's University Hospital, Leeds LS9 7TF, United Kingdom
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39
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Abstract
Despite advances in the treatment of neuroblastoma (NBL), recurrence and metastases continue to pose major problems in clinical management. The relation between micrometastases and the development of secondary disease is not fully understood. However, accurate methods to detect low numbers of tumour cells may allow the evaluation of their role in the disease process, and by implication the possible benefits of eliminating them. Although there is substantial evidence for the increased sensitivity of current molecular methods for the detection of NBL cells compared with more conventional cytology, the clinical relevance and usefulness of detecting this disease remain controversial. The primary goal of current translational research must be to evaluate the clinical relevance of micrometastatic disease detected by these methods in multicentre prospective clinical outcome studies. Only then can the clinical usefulness of these methods be defined so that they may be introduced into relevant clinical practice.
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Affiliation(s)
- S A Burchill
- Children's Cancer Research Laboratory, Cancer Research UK Clinical Centre, St James's University Hospital, Beckett Street, Leeds LS9 7TF, UK.
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40
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Abstract
Fibroblast growth factor receptor 3 (FGFR3) is one of four high-affinity tyrosine kinase receptors for the FGF family of ligands, frequently associated with growth arrest and induction of differentiation. The extracellular immunoglobulin (IgG)-like domains II and III are responsible for ligand binding; alternative usage of exons IIIb and IIIc of the Ig-like domain III determining the ligand-binding specificity of the receptor. By reverse transcriptase polymerase chain reaction (RT–PCR) a novel FGFR3IIIc variant FGFR3IIIS, expressed in a high proportion of tumours and tumour cell lines but rarely in normal tissues, has been identified. Unlike recently described nonsense transcripts of FGFR3, the coding region of FGFR3IIIS remains in-frame producing a novel protein. The protein product is coexpressed with FGFR3IIIc in the membrane and soluble cell fractions; expression in the soluble fraction is decreased after exposure to bFGF but not aFGF. Knockout of FGFR3IIIS using antisense has a growth-inhibitory effect in vitro, suggesting a dominant-negative function for FGFR3IIIS inhibiting FGFR3-induced growth arrest. In summary, alternative splicing of the FGFR3 Ig-domain III represents a mechanism for the generation of receptor diversity. FGFR3IIIS may regulate FGF and FGFR trafficking and function, possibly contributing to the development of a malignant phenotype.
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MESH Headings
- Alternative Splicing
- Blotting, Southern
- Cell Division/drug effects
- DNA Primers
- Exons/genetics
- Fibroblast Growth Factor 1/pharmacology
- Fibroblast Growth Factor 2/pharmacology
- Gene Expression Regulation, Neoplastic
- Humans
- Immunoglobulins/genetics
- Neoplasms/genetics
- Neoplasms/metabolism
- Neoplasms/pathology
- Oligonucleotides, Antisense/pharmacology
- Phosphorylation
- Polymerase Chain Reaction
- Protein Isoforms
- Protein-Tyrosine Kinases
- RNA, Messenger/genetics
- RNA, Messenger/metabolism
- Receptor, Fibroblast Growth Factor, Type 3
- Receptors, Fibroblast Growth Factor/genetics
- Receptors, Fibroblast Growth Factor/metabolism
- Tissue Distribution
- Tumor Cells, Cultured
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Affiliation(s)
- L-M Sturla
- Candlelighter's Children's Cancer Research Laboratory, Cancer Research UK Clinical Centre, St. James's University Hospital, Beckett Street, Leeds LS9 7TF, UK
| | - A E Merrick
- Candlelighter's Children's Cancer Research Laboratory, Cancer Research UK Clinical Centre, St. James's University Hospital, Beckett Street, Leeds LS9 7TF, UK
| | - S A Burchill
- Candlelighter's Children's Cancer Research Laboratory, Cancer Research UK Clinical Centre, St. James's University Hospital, Beckett Street, Leeds LS9 7TF, UK
- Candlelighter's Children's Cancer Research Laboratory, Cancer Research UK Clinical Centre, St. James's University Hospital, Beckett Street, Leeds LS9 7TF, UK. E-mail:
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41
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Riley RD, Burchill SA, Abrams KR, Heney D, Lambert PC, Jones DR, Sutton AJ, Young B, Wailoo AJ, Lewis IJ. A systematic review and evaluation of the use of tumour markers in paediatric oncology: Ewing's sarcoma and neuroblastoma. Health Technol Assess 2003; 7:1-162. [PMID: 12633526 DOI: 10.3310/hta7050] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- R D Riley
- Department of Epidemiology and Public Health, University of Leicester, UK
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42
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Riley RD, Abrams KR, Sutton AJ, Lambert PC, Jones DR, Heney D, Burchill SA. Reporting of prognostic markers: current problems and development of guidelines for evidence-based practice in the future. Br J Cancer 2003; 88:1191-8. [PMID: 12698183 PMCID: PMC2747576 DOI: 10.1038/sj.bjc.6600886] [Citation(s) in RCA: 103] [Impact Index Per Article: 4.9] [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] [Indexed: 01/22/2023] Open
Abstract
Prognostic markers help to stratify patients for treatment by identifying patients with different risks of outcome (e.g. recurrence of disease), and are important tools in the management of cancer and many other diseases. Systematic review and meta-analytical approaches to identifying the most valuable prognostic markers are needed because (sometimes conflicting) evidence relating to markers is often published across a number of studies. To investigate the practicality of this approach, an empirical investigation of a systematic review of tumour markers for neuroblastoma was performed; 260 studies of prognostic markers were identified, which considered 130 different markers. The reporting of these studies was often inadequate, in terms of both statistical analysis and presentation, and there was considerable heterogeneity for many important clinical/statistical factors. These problems restricted both the extraction of data and the meta-analysis of results from the primary studies, limiting feasibility of the evidence-based approach.Guidelines for reporting the results of primary prognostic marker studies in cancer, and other diseases, are given in order to facilitate both the interpretation of individual studies and the undertaking of systematic reviews, meta-analysis and, ultimately, evidence-based practice. General availability of full individual patient data is a necessary step forward and would overcome the majority of problems encountered, including poorly reported summary statistics and variability in cutoff level, outcome assessed and adjustment factors used. It would also limit the problem of reporting bias, although publication bias will remain a concern until studies are prospectively registered. Such changes in practice would help important evidence-based reviews to be conducted in order to establish the most appropriate prognostic markers for clinical use, which should ultimately improve patient care.
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Affiliation(s)
- R D Riley
- Department of Epidemiology and Public Health, University of Leicester, Leicester, UK.
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43
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Abstract
The identification of the non-random chromosome rearrangements between the EWS gene on chromosome 22q12 and members of the ETS gene family in Ewing's sarcoma, peripheral primitive neuroectodermal tumour, Askin tumour, and neuroepithelioma has been a key advance in understanding their common histogenesis and defining the Ewing's sarcoma family of tumours (ESFT). In addition to improvements in diagnosis and potentially the stratification of patients for risk, biological investigations of these gene fusions may define targets for much needed therapeutic strategies to eliminate minimal residual disease or metastatic disease. Insight into their relation with other oncogenic events in ESFT will advance risk group analysis and ultimately may improve clinical management and survival for patients with this disease.
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Affiliation(s)
- S A Burchill
- Candlelighter's Children's Cancer Research Laboratory, Cancer Research UK Clinical Centre, St James's University Hospital, Beckett Street, Leeds LS9 7TF, UK.
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44
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Michelagnoli MP, Burchill SA, Cullinane C, Selby PJ, Lewis IJ. Myogenin--a more specific target for RT-PCR detection of rhabdomyosarcoma than MyoD1. Med Pediatr Oncol 2003; 40:1-8. [PMID: 12426678 DOI: 10.1002/mpo.10201] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND MyoD1 and myogenin are differentially expressed in early myogenesis and have been identified in rhabdomyosarcoma (RMS). This study evaluates reverse transcriptase-polymerase chain reaction (RT-PCR) for MyoD1 and myogenin mRNA as diagnostic markers of RMS, and the potential application of this method for the detection of small volume disease in bone marrow (BM) and peripheral blood (PB). PROCEDURE Expression of MyoD1 and myogenin mRNA was examined by RT-PCR in RMSs (9 alveolar RMS, 10 embryonal RMS, 1 pleomorphic RMS), and 21 other paediatric tumor samples (10 neuroblastoma, 10 Ewing sarcomas, and 1 Sarcoma (not otherwise specified) (S(NOS)). BM (n = 19) and PB (n = 22) samples from the same RMS study population were also examined for MyoD1 and myogenin mRNA expression. RESULTS Positive expression of both markers was demonstrated in adult muscle, but not in normal PB. Myogenin mRNA was expressed in 16/18 and MyoD1 mRNA in 12/12 RMSs studied. Myogenin was not expressed in 10/10 neuroblastomas, but was present in 2/10 Ewing sarcomas. However, MyoD1 mRNA was detected in 10/10 Ewing sarcomas and 7/10 neuroblastomas. Myogenin mRNA was detected in two BM samples from children with histologically negative BM and in 1/22 PB samples. Detection of MyoD1 mRNA in BM and PB was compromised by the amplification of a similar sized, non-specific product. CONCLUSIONS Myogenin mRNA is a more specific marker than MyoD1 for the diagnosis of RMS. Myogenin mRNA is potentially a useful target for the assessment of small volume disease in RMS.
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Affiliation(s)
- Maria P Michelagnoli
- Candlelighter's Children's Cancer Research Laboratory, St. James's University Hospital, Leeds, United Kingdom.
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45
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Riley RD, Burchill SA, Abrams KR, Heney D, Sutton AJ, Jones DR, Lambert PC, Young B, Wailoo AJ, Lewis IJ. A systematic review of molecular and biological markers in tumours of the Ewing's sarcoma family. Eur J Cancer 2003; 39:19-30. [PMID: 12504654 DOI: 10.1016/s0959-8049(02)00500-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The aims of this study were to perform the first systematic review of molecular and biological tumour markers in tumours of the Ewing's sarcoma family (ESFT), and evaluate the current evidence for their clinical use. A well-defined, reproducible search strategy was used to identify the relevant literature from 1966 to February 2000. Papers were independently assessed for tumour markers used in the screening, diagnosis, prognosis or monitoring of patients with ESFT. Eighty-four papers studying the use of 70 different tumour markers in ESFT's were identified. Low-quality, inconsistent reporting limited meta-analysis to that of prognostic data for 28 markers. Patients with tumours lacking S-100 protein expression have a better overall survival (OS) (hazard ratio (HR)=0.41, 95% confidence interval (CI) 0.19, 0.89) than those with expression; patients with high levels of serum LDH had a worse OS and disease-free survival (DFS) (OS: HR=2.92, CI 2.16, 3.94, DFS: HR=3.38, 95% CI 2.28, 4.99); patients with localised disease and tumours expressing type 1 EWS-FLI1 fusion transcripts had an improved DFS compared with those with other fusion transcript types (HR=0.17, 95% CI 0.079, 0.37). The knowledge base formed should facilitate more informative future research. Improved statistical reporting and large, multicentre prospective studies are advocated.
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Affiliation(s)
- R D Riley
- Department of Epidemiology and Public Health, University of Leicester, 22-28 Princess Road West, Leicester LE1 6TP, UK.
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46
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Abstract
Basic fibroblast growth factor (bFGF) is a potent mitogen for a number of different cell types. Its over-expression has been implicated in transformation and malignant progression. The use of bFGF to treat malignancy is therefore counterintuitive. However, recent studies have shown bFGF-induces cell death in some tumour types. This mini review will summarise the most recent findings on bFGF-induced cell death and discuss its potential mechanism of action.
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Affiliation(s)
- S A Burchill
- Candlelighter's Children's Cancer Research Laboratory, ICRF Cancer Medicine Research Unit, St James's University Hospital, Beckett Street, Leeds LS9 7TF, United Kingdom.
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47
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Westwood G, Dibling BC, Cuthbert-Heavens D, Burchill SA. Basic fibroblast growth factor (bFGF)-induced cell death is mediated through a caspase-dependent and p53-independent cell death receptor pathway. Oncogene 2002; 21:809-24. [PMID: 11850809 DOI: 10.1038/sj.onc.1205128] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2001] [Revised: 10/18/2001] [Accepted: 10/30/2001] [Indexed: 11/09/2022]
Abstract
The mechanism of bFGF-induced cell death in tumours of the Ewing's sarcoma family (ESFT) has been investigated. bFGF-induces phosphorylation of FGFr 1 and activation of Ras/ERK in ESFT cells that die when exposed to bFGF. Induction of cell death was associated with activation of both initiator (caspases-2, -8 and -10) and effector (caspases-3, -6 and -7) caspases. Moreover, the general caspase inhibitor Z-VAD-FMK protected cells from bFGF-induced cell death. After treatment with bFGF, a loss of mitochondrial transmembrane potential was accompanied by down-regulation of Bcl-2. However, the observed cell death was not associated with release of cytochrome c from the mitochondria. Furthermore, expression of wild-type p53 was not required for bFGF-induced cell death. These observations suggest that bFGF-induced cell death may be mediated through a cell death receptor mechanism, supported by up-regulation of the p75 neurotrophin receptor. bFGF-induced cell death was associated with up-regulation of p21 and p53, down-regulation of PCNA and cyclin A and a decrease in active pRb1, changes consistent with accumulation of cells in G1. These data demonstrate that bFGF-induced cell death is effected through a caspase-dependent and p53-independent mechanism, that may be mediated through a cell death receptor pathway.
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Affiliation(s)
- Georgina Westwood
- Candlelighter's Children's Cancer Research Unit, ICRF Cancer Medicine Research Unit, St James's University Hospital, Beckett Street, Leeds LS9 7TF, UK
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48
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Burchill SA, Perebolte L, Johnston C, Top B, Selby P. Comparison of the RNA-amplification based methods RT-PCR and NASBA for the detection of circulating tumour cells. Br J Cancer 2002; 86:102-9. [PMID: 11857020 PMCID: PMC2746547 DOI: 10.1038/sj.bjc.6600014] [Citation(s) in RCA: 21] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2001] [Revised: 08/15/2001] [Accepted: 10/15/2001] [Indexed: 11/12/2022] Open
Abstract
Increasingly, reverse transcriptase polymerase chain reaction (RT-PCR) is used to detect clinically significant tumour cells in blood or bone marrow. This may result in a redefinition of disease-free and clinical relapse. However, its clinical utility may be limited by lack of automation or reproducibility. Recent studies have suggested nucleic acid sequence-based amplification of target RNA may be more robust. In this study, nucleic acid sequence-based amplification was established to detect melanoma, colorectal and prostate cancer cells. Nucleic acid sequence-based amplification and RT-PCR both successfully amplified target RNA in peripheral blood samples from patients with melanoma and colorectal cancer, but only RT-PCR detected PSA in blood samples from patients with prostate cancer. There was relatively good agreement between sample replicates analyzed by RT-PCR (Kappa values of one for tyrosinase, 0.67 for CK-20 and one for PSA), but less agreement when analyzed by nucleic acid sequence-based amplification. This may limit the routine use of NASBA for the detection of clinically significant disease. In summary, RT-PCR appears at present to be the most reliable and reproducible method for the detection of low-level disease in cancer patients, although prospective studies are warranted to assess the clinical utility of different molecular diagnostic methods.
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Affiliation(s)
- S A Burchill
- Children's Cancer Research Laboratory, St. James's University Hospital, Leeds LS9 7TF, UK.
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49
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Burchill SA, Lewis IJ, Abrams KR, Riley R, Imeson J, Pearson AD, Pinkerton R, Selby P. Circulating neuroblastoma cells detected by reverse transcriptase polymerase chain reaction for tyrosine hydroxylase mRNA are an independent poor prognostic indicator in stage 4 neuroblastoma in children over 1 year. J Clin Oncol 2001; 19:1795-801. [PMID: 11251011 DOI: 10.1200/jco.2001.19.6.1795] [Citation(s) in RCA: 90] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE In this prospective, multicenter study, the independent prognostic power of neuroblastoma cells detected by reverse transcriptase polymerase chain reaction (RT-PCR) for tyrosine hydroxylase (TH) mRNA was evaluated. PATIENTS AND METHODS The clinical significance of disease detected by RT-PCR in peripheral blood from children at diagnosis was compared with established prognostic markers [ie, age, lactate dehydrogenase (LDH), neuron-specific enolase, ferritin, and MYCN gene amplification] by multivariate analysis. The value of disease detection by RT-PCR during treatment and follow-up was also examined. RESULTS TH mRNA was detected in peripheral blood from 33 of 49 (67%) children with stage 4 neuroblastoma > 1 year old at diagnosis and was a significant predictive factor for overall survival [hazard ratio (HR) = 2.40, 95% confidence interval (CI) 1.19 to 4.84, P =.014) and event-free survival (HR = 2.09, 95% CI 1.06 to 4.17, P =.034) in a multivariate analysis. Detection of disease in blood from clinically disease-free children was related to increased risk of death (HR 2.54, 95% CI 1.42 to 4.55, P =.0014). CONCLUSION TH mRNA in peripheral blood of children with neuroblastoma is a poor prognostic indicator, reflecting the propensity for dissemination via the bloodstream. When combined with a serum LDH > 1500 IU/L, this is the most powerful poor prognostic model at diagnosis for children > 1 year old with stage 4 disease. The detection of TH mRNA in peripheral blood from clinically disease-free children is related to increased risk of relapse and death.
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Affiliation(s)
- S A Burchill
- Candlelighter's Children's Cancer Research Laboratory, Imperial Cancer Research Fund Cancer Medicine Research Unit, St James's University Hospital, Leeds, United Kingdom.
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50
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Burchill SA, Kinsey SE, Picton S, Roberts P, Pinkerton CR, Selby P, Lewis IJ. Minimal residual disease at the time of peripheral blood stem cell harvest in patients with advanced neuroblastoma. Med Pediatr Oncol 2001; 36:213-9. [PMID: 11464888 DOI: 10.1002/1096-911x(20010101)36:1<213::aid-mpo1052>3.0.co;2-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Despite treatment with high-dose myeloblative chemotherapy and peripheral blood stem cell (PBSC) rescue, a high proportion of children with neuroblastoma relapse and die. Re-infusion of PBSC contaminated with tumour at the time of autologous transplantation may play a significant role in this relapse. In this study the frequency of tumour contamination in PB from children with neuroblastoma has been investigated. PROCEDURE Minimal residual disease was measured using RT-PCR for tyrosine hydroxylase (TH) mRNA in PBSCs from patients with advanced neuroblastoma. PBSCs from 18 patients in complete clinical remission were studied. RESULTS Studies in other cancers have suggested minimal contamination of PBSCs with tumour cells; TH mRNA was detected by RT-PCR in 50% (9/18) of PBSC harvests. Seventy-seven percent (7/9) of patients with TH mRNA in PBSC died of disease compared to 44% (4/9) who were TH mRNA-negative. CONCLUSIONS Therefore, the presence of TH mRNA in PBSCs appeared to be associated with an unfavourable outcome, although this was not statistically significant. In summary, RT-PCR for TH mRNA is a sensitive method for the identification of tumour cells in PBSC harvest. The presence of TH mRNA in PBSC harvest may reflect disease status and be associated with an unfavourable outcome, although long-term clinical outcome studies in a larger patient cohort are required.
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MESH Headings
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/genetics
- Child
- Child, Preschool
- Combined Modality Therapy
- Hematopoietic Stem Cell Mobilization
- Hematopoietic Stem Cell Transplantation/adverse effects
- Humans
- Infant
- Life Tables
- Neoplasm Proteins/genetics
- Neoplasm, Residual
- Neoplastic Cells, Circulating
- Neuroblastoma/blood
- Neuroblastoma/drug therapy
- Neuroblastoma/mortality
- Neuroblastoma/pathology
- Neuroblastoma/therapy
- RNA, Messenger/blood
- RNA, Messenger/genetics
- RNA, Neoplasm/blood
- RNA, Neoplasm/genetics
- Remission Induction
- Reverse Transcriptase Polymerase Chain Reaction
- Sensitivity and Specificity
- Survival Analysis
- Transplantation, Autologous/adverse effects
- Treatment Outcome
- Tumor Cells, Cultured/chemistry
- Tyrosine 3-Monooxygenase/genetics
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Affiliation(s)
- S A Burchill
- Candlelighter's Children's Cancer Research Laboratory, St. James's University Hospital, Leeds, United Kingdom.
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