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Garrido MP, Fredes AN, Lobos-González L, Valenzuela-Valderrama M, Vera DB, Romero C. Current Treatments and New Possible Complementary Therapies for Epithelial Ovarian Cancer. Biomedicines 2021; 10:77. [PMID: 35052757 PMCID: PMC8772950 DOI: 10.3390/biomedicines10010077] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 12/07/2021] [Accepted: 12/13/2021] [Indexed: 12/17/2022] Open
Abstract
Epithelial ovarian cancer (EOC) is one of the deadliest gynaecological malignancies. The late diagnosis is frequent due to the absence of specific symptomatology and the molecular complexity of the disease, which includes a high angiogenesis potential. The first-line treatment is based on optimal debulking surgery following chemotherapy with platinum/gemcitabine and taxane compounds. During the last years, anti-angiogenic therapy and poly adenosine diphosphate-ribose polymerases (PARP)-inhibitors were introduced in therapeutic schemes. Several studies have shown that these drugs increase the progression-free survival and overall survival of patients with ovarian cancer, but the identification of patients who have the greatest benefits is still under investigation. In the present review, we discuss about the molecular characteristics of the disease, the recent evidence of approved treatments and the new possible complementary approaches, focusing on drug repurposing, non-coding RNAs, and nanomedicine as a new method for drug delivery.
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Affiliation(s)
- Maritza P. Garrido
- Laboratorio de Endocrinología y Biología de la Reproducción, Hospital Clínico Universidad de Chile, Santiago 8380456, Chile; (A.N.F.); (D.B.V.)
- Departamento de Obstetricia y Ginecología, Facultad de Medicina, Universidad de Chile, Santiago 8380453, Chile
| | - Allison N. Fredes
- Laboratorio de Endocrinología y Biología de la Reproducción, Hospital Clínico Universidad de Chile, Santiago 8380456, Chile; (A.N.F.); (D.B.V.)
| | - Lorena Lobos-González
- Centro de Medicina Regenerativa, Facultad de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago 7710162, Chile;
| | - Manuel Valenzuela-Valderrama
- Laboratorio de Microbiología Celular, Instituto de Investigación y Postgrado, Facultad de Ciencias de la Salud, Universidad Central de Chile, Santiago 8320000, Chile;
| | - Daniela B. Vera
- Laboratorio de Endocrinología y Biología de la Reproducción, Hospital Clínico Universidad de Chile, Santiago 8380456, Chile; (A.N.F.); (D.B.V.)
| | - Carmen Romero
- Laboratorio de Endocrinología y Biología de la Reproducción, Hospital Clínico Universidad de Chile, Santiago 8380456, Chile; (A.N.F.); (D.B.V.)
- Departamento de Obstetricia y Ginecología, Facultad de Medicina, Universidad de Chile, Santiago 8380453, Chile
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Meiners J, Jansen K, Gorbokon N, Büscheck F, Luebke AM, Kluth M, Hube-Magg C, Höflmayer D, Weidemann S, Fraune C, Möller K, Bernreuther C, Lebok P, Menz A, Jacobsen F, Clauditz T, Sauter G, Uhlig R, Wilczak W, Izbicki J, Perez D, Minner S, Burandt E, Krech T, Marx A, Simon R, Steurer S. Angiotensin-Converting Enzyme 2 Protein Is Overexpressed in a Wide Range of Human Tumour Types: A Systematic Tissue Microarray Study on >15,000 Tumours. Biomedicines 2021; 9:biomedicines9121831. [PMID: 34944647 PMCID: PMC8698714 DOI: 10.3390/biomedicines9121831] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/24/2021] [Accepted: 11/30/2021] [Indexed: 02/07/2023] Open
Abstract
Angiotensin-converting enzyme 2 (ACE2) is a regulator in the renin-angiotensin system. ACE2 expression was analysed immunohistochemically in 15,306 samples from 119 tumour types and in 608 samples of 76 normal tissue types. In normal tissue, ACE2 was most abundant in testis and corpus luteum, kidney, small intestine and capillaries of selected organs. At least an occasional weak ACE2 positivity of tumour cells was seen in 83 of 119 (70%) tumour types. ACE2 tumour cell positivity was particularly frequent in papillary (94%) and clear cell (86%) renal cell carcinoma, colorectal adenocarcinoma (81%), mucinous ovarian cancer (61%), cholangiocarcinoma (58%), hepatocellular carcinoma (56%), and in adenocarcinomas of the stomach (47%), pancreas (42%), and the lung (35%). ACE2-positive capillaries were found in 409/12,644 (3%) of analysable tumours, most frequently in tumours with endocrine/neuroendocrine activity. Presence of ACE2-positive capillaries was linked to low stage in papillary thyroid cancer and low grade in neuroendocrine neoplasms. In conclusion, ACE2 expression can occur both in tumour cells and tumour-associated capillaries in a broad variety of different tumour types at highly variable frequencies.
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Affiliation(s)
- Jan Meiners
- General, Visceral and Thoracic Surgery Department and Clinic, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (J.M.); (K.J.); (J.I.); (D.P.)
| | - Kristina Jansen
- General, Visceral and Thoracic Surgery Department and Clinic, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (J.M.); (K.J.); (J.I.); (D.P.)
| | - Natalia Gorbokon
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Franziska Büscheck
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Andreas M. Luebke
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Martina Kluth
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Claudia Hube-Magg
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Doris Höflmayer
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Sören Weidemann
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Christoph Fraune
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Katharina Möller
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Christian Bernreuther
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Patrick Lebok
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Anne Menz
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Frank Jacobsen
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Till Clauditz
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Guido Sauter
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Ria Uhlig
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Waldemar Wilczak
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Jakob Izbicki
- General, Visceral and Thoracic Surgery Department and Clinic, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (J.M.); (K.J.); (J.I.); (D.P.)
| | - Daniel Perez
- General, Visceral and Thoracic Surgery Department and Clinic, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (J.M.); (K.J.); (J.I.); (D.P.)
| | - Sarah Minner
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Eike Burandt
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
| | - Till Krech
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
- Clinical Centre Osnabrueck, Institute of Pathology, 49074 Osnabrueck, Germany
| | - Andreas Marx
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
- Department of Pathology, Academic Hospital Fuerth, 90766 Fuerth, Germany
| | - Ronald Simon
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
- Correspondence: ; Tel.: +49-40-7410-57214
| | - Stefan Steurer
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany; (N.G.); (F.B.); (A.M.L.); (M.K.); (C.H.-M.); (D.H.); (S.W.); (C.F.); (K.M.); (C.B.); (P.L.); (A.M.); (F.J.); (T.C.); (G.S.); (R.U.); (W.W.); (S.M.); (E.B.); (T.K.); (A.M.); (S.S.)
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van Dam MA, Vuijk FA, Stibbe JA, Houvast RD, Luelmo SAC, Crobach S, Shahbazi Feshtali S, de Geus-Oei LF, Bonsing BA, Sier CFM, Kuppen PJK, Swijnenburg RJ, Windhorst AD, Burggraaf J, Vahrmeijer AL, Mieog JSD. Overview and Future Perspectives on Tumor-Targeted Positron Emission Tomography and Fluorescence Imaging of Pancreatic Cancer in the Era of Neoadjuvant Therapy. Cancers (Basel) 2021; 13:6088. [PMID: 34885196 PMCID: PMC8656821 DOI: 10.3390/cancers13236088] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/25/2021] [Accepted: 11/28/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Despite recent advances in the multimodal treatment of pancreatic ductal adenocarcinoma (PDAC), overall survival remains poor with a 5-year cumulative survival of approximately 10%. Neoadjuvant (chemo- and/or radio-) therapy is increasingly incorporated in treatment strategies for patients with (borderline) resectable and locally advanced disease. Neoadjuvant therapy aims to improve radical resection rates by reducing tumor mass and (partial) encasement of important vascular structures, as well as eradicating occult micrometastases. Results from recent multicenter clinical trials evaluating this approach demonstrate prolonged survival and increased complete surgical resection rates (R0). Currently, tumor response to neoadjuvant therapy is monitored using computed tomography (CT) following the RECIST 1.1 criteria. Accurate assessment of neoadjuvant treatment response and tumor resectability is considered a major challenge, as current conventional imaging modalities provide limited accuracy and specificity for discrimination between necrosis, fibrosis, and remaining vital tumor tissue. As a consequence, resections with tumor-positive margins and subsequent early locoregional tumor recurrences are observed in a substantial number of patients following surgical resection with curative intent. Of these patients, up to 80% are diagnosed with recurrent disease after a median disease-free interval of merely 8 months. These numbers underline the urgent need to improve imaging modalities for more accurate assessment of therapy response and subsequent re-staging of disease, thereby aiming to optimize individual patient's treatment strategy. In cases of curative intent resection, additional intra-operative real-time guidance could aid surgeons during complex procedures and potentially reduce the rate of incomplete resections and early (locoregional) tumor recurrences. In recent years intraoperative imaging in cancer has made a shift towards tumor-specific molecular targeting. Several important molecular targets have been identified that show overexpression in PDAC, for example: CA19.9, CEA, EGFR, VEGFR/VEGF-A, uPA/uPAR, and various integrins. Tumor-targeted PET/CT combined with intraoperative fluorescence imaging, could provide valuable information for tumor detection and staging, therapy response evaluation with re-staging of disease and intraoperative guidance during surgical resection of PDAC. METHODS A literature search in the PubMed database and (inter)national trial registers was conducted, focusing on studies published over the last 15 years. Data and information of eligible articles regarding PET/CT as well as fluorescence imaging in PDAC were reviewed. Areas covered: This review covers the current strategies, obstacles, challenges, and developments in targeted tumor imaging, focusing on the feasibility and value of PET/CT and fluorescence imaging for integration in the work-up and treatment of PDAC. An overview is given of identified targets and their characteristics, as well as the available literature of conducted and ongoing clinical and preclinical trials evaluating PDAC-targeted nuclear and fluorescent tracers.
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Affiliation(s)
- Martijn A. van Dam
- Department of Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (F.A.V.); (J.A.S.); (R.D.H.); (B.A.B.); (C.F.M.S.); (P.J.K.K.); (J.B.); (A.L.V.); (J.S.D.M.)
| | - Floris A. Vuijk
- Department of Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (F.A.V.); (J.A.S.); (R.D.H.); (B.A.B.); (C.F.M.S.); (P.J.K.K.); (J.B.); (A.L.V.); (J.S.D.M.)
| | - Judith A. Stibbe
- Department of Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (F.A.V.); (J.A.S.); (R.D.H.); (B.A.B.); (C.F.M.S.); (P.J.K.K.); (J.B.); (A.L.V.); (J.S.D.M.)
| | - Ruben D. Houvast
- Department of Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (F.A.V.); (J.A.S.); (R.D.H.); (B.A.B.); (C.F.M.S.); (P.J.K.K.); (J.B.); (A.L.V.); (J.S.D.M.)
| | - Saskia A. C. Luelmo
- Department of Medical Oncology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands;
| | - Stijn Crobach
- Department of Pathology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands;
| | | | - Lioe-Fee de Geus-Oei
- Department of Radiology, Section of Nuclear Medicine, University Medical Center Leiden, 2333 ZA Leiden, The Netherlands;
- Biomedical Photonic Imaging Group, University of Twente, 7522 NB Enschede, The Netherlands
| | - Bert A. Bonsing
- Department of Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (F.A.V.); (J.A.S.); (R.D.H.); (B.A.B.); (C.F.M.S.); (P.J.K.K.); (J.B.); (A.L.V.); (J.S.D.M.)
| | - Cornelis F. M. Sier
- Department of Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (F.A.V.); (J.A.S.); (R.D.H.); (B.A.B.); (C.F.M.S.); (P.J.K.K.); (J.B.); (A.L.V.); (J.S.D.M.)
- Percuros B.V., 2333 CL Leiden, The Netherlands
| | - Peter J. K. Kuppen
- Department of Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (F.A.V.); (J.A.S.); (R.D.H.); (B.A.B.); (C.F.M.S.); (P.J.K.K.); (J.B.); (A.L.V.); (J.S.D.M.)
| | | | - Albert D. Windhorst
- Department of Radiology, Section of Nuclear Medicine, Amsterdam UMC, Location VUmc, 1081 HV Amsterdam, The Netherlands;
| | - Jacobus Burggraaf
- Department of Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (F.A.V.); (J.A.S.); (R.D.H.); (B.A.B.); (C.F.M.S.); (P.J.K.K.); (J.B.); (A.L.V.); (J.S.D.M.)
- Centre for Human Drug Research, 2333 CL Leiden, The Netherlands
| | - Alexander L. Vahrmeijer
- Department of Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (F.A.V.); (J.A.S.); (R.D.H.); (B.A.B.); (C.F.M.S.); (P.J.K.K.); (J.B.); (A.L.V.); (J.S.D.M.)
| | - J. Sven D. Mieog
- Department of Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (F.A.V.); (J.A.S.); (R.D.H.); (B.A.B.); (C.F.M.S.); (P.J.K.K.); (J.B.); (A.L.V.); (J.S.D.M.)
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Völkel C, De Wispelaere N, Weidemann S, Gorbokon N, Lennartz M, Luebke AM, Hube-Magg C, Kluth M, Fraune C, Möller K, Bernreuther C, Lebok P, Clauditz TS, Jacobsen F, Sauter G, Uhlig R, Wilczak W, Steurer S, Minner S, Krech RH, Dum D, Krech T, Marx AH, Simon R, Burandt E, Menz A. Cytokeratin 5 and cytokeratin 6 expressions are unconnected in normal and cancerous tissues and have separate diagnostic implications. Virchows Arch 2021; 480:433-447. [PMID: 34559291 PMCID: PMC8986736 DOI: 10.1007/s00428-021-03204-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 09/08/2021] [Accepted: 09/10/2021] [Indexed: 12/13/2022]
Abstract
Cytokeratins (CKs) 5 and 6 are functionally unrelated but often analyzed together using bispecific antibodies in diagnostic immunohistochemistry. To better understand the diagnostic utility of CK5 or CK6 alone, tissue microarrays with > 15,000 samples from 120 different tumor types as well as 608 samples of 76 different normal tissues were analyzed by immunohistochemistry. In normal tissues, both CKs occurred in the squamous epithelium; CK5 dominated in basal and CK6 in suprabasal layers. CK5 (not CK6) stained basal cells in various other organs. Within tumors, both CK5 and CK6 were seen in > 95% of squamous cell carcinomas, but other tumor entities showed different results: CK5 predominated in urothelial carcinoma and mesothelioma, but CK6 in adenocarcinomas. Joint analysis of both CK5 and CK6 obscured the discrimination of epithelioid mesothelioma (100% positive for CK5 alone and for CK5/6) from adenocarcinoma of the lung (12.8% positive for CK5 alone; 23.7% positive for CK5/6). CK5 and CK6 expressions were both linked to high grade, estrogen receptor, and progesterone receptor negativity in breast cancer (p < 0.0001 each), grade/stage progression in urothelial cancer (p < 0.0001), and RAS mutations in colorectal cancer (p < 0.01). Useful diagnostic properties which are commonly attributed to CK5/6 antibodies such as basal cell staining in the prostate, distinction of adenocarcinoma of the lung from squamous cell carcinoma and epithelioid mesothelioma, and identification of basal-type features in urothelial cancer are solely driven by CK5. At least for the purpose of distinguishing thoracic tumors, monospecific CK5 antibodies may be better suited than bispecific CK5/6 antibodies.
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Affiliation(s)
- Cosima Völkel
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Noémi De Wispelaere
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.,General, Visceral and Thoracic Surgery Department and Clinic, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sören Weidemann
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Natalia Gorbokon
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Maximilian Lennartz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Andreas M Luebke
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Claudia Hube-Magg
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Martina Kluth
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Christoph Fraune
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Katharina Möller
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Christian Bernreuther
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Patrick Lebok
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Till S Clauditz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Frank Jacobsen
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Guido Sauter
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Ria Uhlig
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Waldemar Wilczak
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Stefan Steurer
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Sarah Minner
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Rainer H Krech
- Institute of Pathology, Clinical Center Osnabrueck, Osnabrueck, Germany
| | - David Dum
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Till Krech
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.,Institute of Pathology, Clinical Center Osnabrueck, Osnabrueck, Germany
| | - Andreas H Marx
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.,Department of Pathology, Academic Hospital Fuerth, Fuerth, Germany
| | - Ronald Simon
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
| | - Eike Burandt
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Anne Menz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
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55
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Reuss JE, Gosa L, Liu SV. Antibody Drug Conjugates in Lung Cancer: State of the Current Therapeutic Landscape and Future Developments. Clin Lung Cancer 2021; 22:483-499. [PMID: 34420859 DOI: 10.1016/j.cllc.2021.07.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 07/16/2021] [Indexed: 12/23/2022]
Abstract
While both targeted therapy and immunotherapy-based strategies have emerged as frontline standard-of-care for patients with advanced lung cancer, acquired resistance and disease progression remain inevitable in most cases. Chemotherapy is a common salvage option in this scenario, but is limited by a relatively narrow therapeutic index. The emergence of antibody-drug conjugates (ADCs) offer an appealing alternative. ADCs couple the specificity of a monoclonal antibody with the cytotoxic effects of chemotherapy to facilitate the targeted delivery of cytotoxic payloads directly to cancer cells. Here, we review the general structure and function of ADCs, followed by a discussion of emerging ADCs in lung cancer and the future applications of this increasingly relevant class of novel agents.
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Affiliation(s)
- Joshua E Reuss
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC.
| | - Laura Gosa
- Georgetown University School of Medicine, Georgetown University, Washington, DC
| | - Stephen V Liu
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
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56
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Yeo D, Castelletti L, van Zandwijk N, Rasko JEJ. Hitting the Bull's-Eye: Mesothelin's Role as a Biomarker and Therapeutic Target for Malignant Pleural Mesothelioma. Cancers (Basel) 2021; 13:3932. [PMID: 34439085 PMCID: PMC8391149 DOI: 10.3390/cancers13163932] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/28/2021] [Accepted: 07/29/2021] [Indexed: 12/16/2022] Open
Abstract
Malignant pleural mesothelioma (MPM) is an aggressive cancer with limited treatment options and poor prognosis. MPM originates from the mesothelial lining of the pleura. Mesothelin (MSLN) is a glycoprotein expressed at low levels in normal tissues and at high levels in MPM. Many other solid cancers overexpress MSLN, and this is associated with worse survival rates. However, this association has not been found in MPM, and the exact biological role of MSLN in MPM requires further exploration. Here, we discuss the current research on the diagnostic and prognostic value of MSLN in MPM patients. Furthermore, MSLN has become an attractive immunotherapy target in MPM, where better treatment strategies are urgently needed. Several MSLN-targeted monoclonal antibodies, antibody-drug conjugates, immunotoxins, cancer vaccines, and cellular therapies have been tested in the clinical setting. The biological rationale underpinning MSLN-targeted immunotherapies and their potential to improve MPM patient outcomes are reviewed.
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Affiliation(s)
- Dannel Yeo
- Li Ka Shing Cell & Gene Therapy Program, The University of Sydney, Camperdown, NSW 2050, Australia; (D.Y.); (L.C.)
- Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia;
- Cell and Molecular Therapies, Royal Prince Alfred Hospital, Sydney Local Health District (SLHD), Camperdown, NSW 2050, Australia
| | - Laura Castelletti
- Li Ka Shing Cell & Gene Therapy Program, The University of Sydney, Camperdown, NSW 2050, Australia; (D.Y.); (L.C.)
- Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia;
- Cell and Molecular Therapies, Royal Prince Alfred Hospital, Sydney Local Health District (SLHD), Camperdown, NSW 2050, Australia
| | - Nico van Zandwijk
- Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia;
- Cell and Molecular Therapies, Royal Prince Alfred Hospital, Sydney Local Health District (SLHD), Camperdown, NSW 2050, Australia
- Concord Repatriation General Hospital, Sydney Local Health District (SLHD), Concord, NSW 2139, Australia
| | - John E. J. Rasko
- Li Ka Shing Cell & Gene Therapy Program, The University of Sydney, Camperdown, NSW 2050, Australia; (D.Y.); (L.C.)
- Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia;
- Cell and Molecular Therapies, Royal Prince Alfred Hospital, Sydney Local Health District (SLHD), Camperdown, NSW 2050, Australia
- Gene and Stem Cell Therapy Program, Centenary Institute, The University of Sydney, Camperdown, NSW 2050, Australia
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