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Popova E, Tkachev S, Reshetov I, Timashev P, Ulasov I. Imaging Hallmarks of Sarcoma Progression Via X-ray Computed Tomography: Beholding the Flower of Evil. Cancers (Basel) 2022; 14:cancers14205112. [PMID: 36291896 PMCID: PMC9600487 DOI: 10.3390/cancers14205112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/13/2022] [Accepted: 10/15/2022] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Sarcomas represent the largest group of rare solid tumors that arise from mesenchymal stem cells and are a leading cause of cancer death in individuals younger than 20 years of age. There is an immediate need for the development of an algorithm for the early accurate diagnosis of sarcomas due to the high rate of diagnostic inaccuracy, which reaches up to 30%. X-ray computed tomography is a non-invasive imaging technique used to obtain detailed internal images of the human or animal body in clinical practice and preclinical studies. We summarized the main imaging features of soft tissue and bone sarcomas, and noted the development of new molecular markers to reach tumor type-specific imaging. Also, we demonstrated the possibility of the use X-ray computed microtomography for non-destructive 3D visualization of sarcoma progression in preclinical studies. Finding correlations between X-ray computed tomography modalities and the results of the histopathological specimen examination may significantly increase the accuracy of diagnostics, which leads to the initiation of appropriate management in a timely manner and, consequently, to improved outcomes. Abstract Sarcomas are a leading cause of cancer death in individuals younger than 20 years of age and represent the largest group of rare solid tumors. To date, more than 100 morphological subtypes of sarcomas have been described, among which epidemiology, clinical features, management, and prognosis differ significantly. Delays and errors in the diagnosis of sarcomas limit the number of effective therapeutic modalities and catastrophically worsen the prognosis. Therefore, the development of an algorithm for the early accurate diagnosis of sarcomas seems to be as important as the development of novel therapeutic advances. This literature review aims to summarize the results of recent investigations regarding the imaging of sarcoma progression based on the use of X-ray computed tomography (CT) in preclinical studies and in current clinical practice through the lens of cancer hallmarks. We attempted to summarize the main CT imaging features of soft-tissue and bone sarcomas. We noted the development of new molecular markers with high specificity to antibodies and chemokines, which are expressed in particular sarcoma subtypes to reach tumor type-specific imaging. We demonstrate the possibility of the use of X-ray computed microtomography (micro-CT) for non-destructive 3D visualization of solid tumors by increasing the visibility of soft tissues with X-ray scattering agents. Based on the results of recent studies, we hypothesize that micro-CT enables the visualization of neovascularization and stroma formation in sarcomas at high-resolution in vivo and ex vivo, including the novel techniques of whole-block and whole-tissue imaging. Finding correlations between CT, PET/CT, and micro-CT imaging features, the results of the histopathological specimen examination and clinical outcomes may significantly increase the accuracy of soft-tissue and bone tumor diagnostics, which leads to the initiation of appropriate histotype-specific management in a timely manner and, consequently, to improved outcomes.
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Affiliation(s)
- Elena Popova
- World-Class Research Centre “Digital Biodesign and Personalized Healthcare”, Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Sergey Tkachev
- World-Class Research Centre “Digital Biodesign and Personalized Healthcare”, Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Igor Reshetov
- University Clinical Hospital No. 1, I. M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University), 119991 Moscow, Russia
| | - Peter Timashev
- World-Class Research Centre “Digital Biodesign and Personalized Healthcare”, Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Ilya Ulasov
- Group of Experimental Biotherapy and Diagnostic, Institute for Regenerative Medicine, World-Class Research Centre “Digital Biodesign and Personalized Healthcare”, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
- Correspondence: ; Tel.: +7-901-797-5406
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Delinassios JG, Hoffman RM. The cancer-inhibitory effects of proliferating tumor-residing fibroblasts. Biochim Biophys Acta Rev Cancer 2021; 1877:188673. [PMID: 34953931 DOI: 10.1016/j.bbcan.2021.188673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/09/2021] [Accepted: 12/17/2021] [Indexed: 11/19/2022]
Abstract
Initiation, local progression, and metastasis of cancer are associated with specific morphological, molecular, and functional changes in the extracellular matrix and the fibroblasts within the tumor microenvironment (TME). In the early stages of tumor development, fibroblasts are an obstacle that cancer cells must surpass or nullify to progress. Thus, in early tumor progression, specific signaling from cancer cells activates bio-pathways, which abolish the innate anticancer properties of fibroblasts and convert a high proportion of them to tumor-promoting cancer-associated fibroblasts (CAFs). Following this initial event, a wide spectrum of gene expression changes gradually leads to the development of a stromal fibroblast population with complex heterogeneity, creating fibroblast subtypes with characteristic profiles, which may alternate between being tumor-promotive and tumor-suppressive, topologically and chronologically in the TME. These fibroblast subtypes form the tumor's histological landscape including areas of cancer growth, inflammation, angiogenesis, invasion fronts, proliferating and non-proliferating fibroblasts, cancer-cell apoptosis, fibroblast apoptosis, and necrosis. These features reflect general deregulation of tissue homeostasis within the TME. This review discusses fundamental and current knowledge that has established the existence of anticancer fibroblasts within the various interacting elements of the TME. It is proposed that the maintenance of fibroblast proliferation is an essential parameter for the activation of their anticancer capacity, similar to that by which normal fibroblasts would be activated in wound repair, thus maintaining tissue homeostasis. Encouragement of research in this direction may render new means of cancer therapy and a greater understanding of tumor progression.
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Affiliation(s)
- John G Delinassios
- International Institute of Anticancer Research, 1(st) km Kapandritiou-Kalamou Rd., Kapandriti, 19014 Attica, Greece.
| | - Robert M Hoffman
- Department of Surgery, University of California, 9300 Campus Point Drive, La Jolla, CA 92037, USA; AntiCancer Inc., 7917 Ostrow St, San Diego, CA 92111, USA.
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3
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Aoki Y, Yamamoto J, Tome Y, Hamada K, Masaki N, Inubushi S, Tashiro Y, Bouvet M, Endo I, Nishida K, Hoffman RM. Over-methylation of Histone H3 Lysines Is a Common Molecular Change Among the Three Major Types of Soft-tissue Sarcoma in Patient-derived Xenograft (PDX) Mouse Models. Cancer Genomics Proteomics 2021; 18:715-721. [PMID: 34697064 DOI: 10.21873/cgp.20292] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/21/2021] [Accepted: 09/07/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND/AIM Sarcomas are considered a heterogeneous disease with incomplete understanding of its molecular basis. In the present study, to further understand general molecular changes in sarcoma, patient-derived xenograft (PDX) mouse models of the three most common soft-tissue sarcomas: myxofibrosarcoma, undifferentiated pleomorphic sarcoma (UPS) and liposarcoma were established and the methylation status of histone H3 lysine marks was studied. MATERIALS AND METHODS Immunoblotting and immunohistochemical staining were used to quantify the extent of methylation of histone H3K4me3 and histone H3K9me3. RESULTS In all 3 sarcoma types in PDX models, histone H3K4me3 and H3K9me3 were found highly over-methylated compared to normal muscle tissue. CONCLUSION Histone H3 lysine over-methylation may be a general basis of malignancy of the major sarcoma types.
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Affiliation(s)
- Yusuke Aoki
- AntiCancer Inc, San Diego, CA, U.S.A.,Department of Surgery, University of California San Diego, La Jolla, CA, U.S.A.,Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Nishihara, Japan
| | - Jun Yamamoto
- AntiCancer Inc, San Diego, CA, U.S.A.,Department of Surgery, University of California San Diego, La Jolla, CA, U.S.A.,Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yasunori Tome
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Nishihara, Japan;
| | - Kazuyuki Hamada
- AntiCancer Inc, San Diego, CA, U.S.A.,Department of Surgery, University of California San Diego, La Jolla, CA, U.S.A
| | - Noriyuki Masaki
- AntiCancer Inc, San Diego, CA, U.S.A.,Department of Surgery, University of California San Diego, La Jolla, CA, U.S.A
| | - Sachiko Inubushi
- Department of Breast and Endocrine Surgery, Kobe University Graduate School of Medicine, Hyogo, Japan
| | | | - Michael Bouvet
- Department of Surgery, University of California San Diego, La Jolla, CA, U.S.A
| | - Itaru Endo
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kotaro Nishida
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Nishihara, Japan
| | - Robert M Hoffman
- AntiCancer Inc, San Diego, CA, U.S.A.; .,Department of Surgery, University of California San Diego, La Jolla, CA, U.S.A
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Color-Coded Imaging of the Tumor Microenvironment (TME) in Human Patient-Derived Orthotopic Xenograft (PDOX) Mouse Models. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1329:163-179. [PMID: 34664239 DOI: 10.1007/978-3-030-73119-9_9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
The tumor microenvironment (TME) contains stromal cells in a complex interaction with cancer cells. This relationship has become better understood with the use of fluorescent proteins for in vivo imaging, originally developed by our laboratories. Spectrally distinct fluorescent proteins can be used for color-coded imaging of the complex interaction of the tumor microenvironment in the living state using cancer cells expressing a fluorescent protein of one color and host mice expressing another color fluorescent protein. Cancer cells engineered in vitro to express a fluorescent protein were orthotopically implanted into transgenic mice expressing a fluorescent protein of a different color. Confocal microscopy was then used for color-coded imaging of the TME. Color-coded imaging of the TME has enabled us to discover that stromal cells are necessary for metastasis. Patient-derived orthotopic xenograft (PDOX) tumors were labeled by first passaging them orthotopically through transgenic nude mice expressing either green, red, or cyan fluorescent protein in order to label the stromal cells of the tumor. The colored stromal cells become stably associated with the PDOX tumors through multiple passages in transgenic colored nude mice or noncolored nude mice. The fluorescent protein-expressing stromal cells included cancer-associated fibroblasts (CAFs) and tumor-associated macrophages (TAMs). Using this model, specific cancer cell or stromal cell targeting by potential therapeutics can be visualized. Color-coded imaging enabled the visualization of apparent fusion of cancer and stromal cells. Color-coded imaging is a powerful tool visualizing the interaction of cancer and stromal cells during cancer progression and treatment.
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Oshiro H, Tome Y, Miyake K, Higuchi T, Sugisawa N, Kanaya F, Nishida K, Hoffman RM. An mTOR and VEGFR inhibitor combination arrests a doxorubicin resistant lung metastatic osteosarcoma in a PDOX mouse model. Sci Rep 2021; 11:8583. [PMID: 33883561 PMCID: PMC8060249 DOI: 10.1038/s41598-021-87553-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 03/22/2021] [Indexed: 12/11/2022] Open
Abstract
In order to identify more effective therapy for recalcitrant osteosarcoma, we evaluated the efficacy of an mTOR-VEGFR inhibitor combination on tumor growth in a unique osteosarcoma patient-derived orthotopic xenograft (PDOX) mouse model derived from the lung metastasis of an osteosarcoma patient who failed doxorubicin therapy. We also determined the efficacy of this inhibitor combination on angiogenesis using an in vivo Gelfoam fluorescence angiogenesis mouse model implanted with osteosarcoma patient-derived cells (OS-PDCs). PDOX models were randomly divided into five groups of seven nude mice. Group 1, control; Group 2, doxorubicin (DOX); Group 3, everolimus (EVE, an mTOR and VEGF inhibitor); Group 4, pazopanib (PAZ, a VEGFR inhibitor); Group 5, EVE-PAZ combination. Tumor volume and body weight were monitored 2 times a week. The in vivo Gelfoam fluorescence angiogenesis assay was performed with implanted OS-PDCs. The nude mice with implanted Gelfoam and OSPDCs also were divided into the four therapeutic groups and vessel length was monitored once a week. The EVE-PAZ combination suppressed tumor growth in the osteosarcoma PDOX model and decreased the vessel length ratio in the in vivo Gelfoam fluorescent angiogenesis model, compared with all other groups (p < 0.05). There was no significant body-weight loss in any group. Only the EVE-PAZ combination caused tumor necrosis. The present study demonstrates that a combination of an mTOR-VEGF inhibitor and a VEGFR inhibitor was effective for a DOX-resistant lung-metastatic osteosarcoma PDOX mouse model, at least in part due to strong anti-angiogenesis efficacy of the combination.
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Affiliation(s)
- Hiromichi Oshiro
- AntiCancer Inc., 7917 Ostrow Street, San Diego, CA, 92122, USA.,Department of Surgery, University of California, San Diego, CA, USA.,Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara-cho, Nakagami-gun, Okinawa, 903-0215, Japan
| | - Yasunori Tome
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara-cho, Nakagami-gun, Okinawa, 903-0215, Japan.
| | - Kentaro Miyake
- AntiCancer Inc., 7917 Ostrow Street, San Diego, CA, 92122, USA.,Department of Surgery, University of California, San Diego, CA, USA
| | - Takashi Higuchi
- AntiCancer Inc., 7917 Ostrow Street, San Diego, CA, 92122, USA.,Department of Surgery, University of California, San Diego, CA, USA
| | - Norihiko Sugisawa
- AntiCancer Inc., 7917 Ostrow Street, San Diego, CA, 92122, USA.,Department of Surgery, University of California, San Diego, CA, USA
| | - Fuminori Kanaya
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara-cho, Nakagami-gun, Okinawa, 903-0215, Japan
| | - Kotaro Nishida
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara-cho, Nakagami-gun, Okinawa, 903-0215, Japan
| | - Robert M Hoffman
- AntiCancer Inc., 7917 Ostrow Street, San Diego, CA, 92122, USA. .,Department of Surgery, University of California, San Diego, CA, USA.
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Amirghasemi F, Adjei-Sowah E, Pockaj BA, Nikkhah M. Microengineered 3D Tumor Models for Anti-Cancer Drug Discovery in Female-Related Cancers. Ann Biomed Eng 2021; 49:1943-1972. [PMID: 33403451 DOI: 10.1007/s10439-020-02704-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 12/01/2020] [Indexed: 12/17/2022]
Abstract
The burden of cancer continues to increase in society and negatively impacts the lives of numerous patients. Due to the high cost of current treatment strategies, there is a crucial unmet need to develop inexpensive preclinical platforms to accelerate the process of anti-cancer drug discovery to improve outcomes in cancer patients, most especially in female patients. Many current methods employ expensive animal models which not only present ethical concerns but also do not often accurately predict human physiology and the outcomes of anti-cancer drug responsiveness. Conventional treatment approaches for cancer generally include systemic therapy after a surgical procedure. Although this treatment technique is effective, the outcome is not always positive due to various complex factors such as intratumor heterogeneity and confounding factors within the tumor microenvironment (TME). Patients who develop metastatic disease still have poor prognosis. To that end, recent efforts have attempted to use 3D microengineered platforms to enhance the predictive power and efficacy of anti-cancer drug screening, ultimately to develop personalized therapies. Fascinating features of microengineered assays, such as microfluidics, have led to the advancement in the development of the tumor-on-chip technology platforms, which have shown tremendous potential for meaningful and physiologically relevant anti-cancer drug discovery and screening. Three dimensional microscale models provide unprecedented ability to unveil the biological complexities of cancer and shed light into the mechanism of anti-cancer drug resistance in a timely and resource efficient manner. In this review, we discuss recent advances in the development of microengineered tumor models for anti-cancer drug discovery and screening in female-related cancers. We specifically focus on female-related cancers to draw attention to the various approaches being taken to improve the survival rate of women diagnosed with cancers caused by sex disparities. We also briefly discuss other cancer types like colon adenocarcinomas and glioblastoma due to their high rate of occurrence in females, as well as the high likelihood of sex-biased mutations which complicate current treatment strategies for women. We highlight recent advances in the development of 3D microscale platforms including 3D tumor spheroids, microfluidic platforms as well as bioprinted models, and discuss how they have been utilized to address major challenges in the process of drug discovery, such as chemoresistance, intratumor heterogeneity, drug toxicity, etc. We also present the potential of these platform technologies for use in high-throughput drug screening approaches as a replacements of conventional assays. Within each section, we will provide our perspectives on advantages of the discussed platform technologies.
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Affiliation(s)
- Farbod Amirghasemi
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, 85287-9709, USA
| | - Emmanuela Adjei-Sowah
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, 85287-9709, USA
| | - Barbara A Pockaj
- Division of Surgical Oncology and Endocrine Surgery, Department of Surgery, Mayo Clinic, Phoenix, AZ, USA
| | - Mehdi Nikkhah
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, 85287-9709, USA. .,Biodesign Virginia G. Piper Center for Personalized Diagnostics, Arizona State University, Tempe, AZ, USA.
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7
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Yang Q, Yin H, Xu T, Zhu D, Yin J, Chen Y, Yu X, Gao J, Zhang C, Chen Y, Gao Y. Engineering 2D Mesoporous Silica@MXene-Integrated 3D-Printing Scaffolds for Combinatory Osteosarcoma Therapy and NO-Augmented Bone Regeneration. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2020; 16:e1906814. [PMID: 32108432 DOI: 10.1002/smll.201906814] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 01/19/2020] [Indexed: 06/10/2023]
Abstract
The rising concerns of the recurrence and bone deficiency in surgical treatment of malignant bone tumors have raised an urgent need of the advance of multifunctional therapeutic platforms for efficient tumor therapy and bone regeneration. Herein, the construction of a multifunctional biomaterial system is reported by the integration of 2D Nb2 C MXene wrapped with S-nitrosothiol (RSNO)-grafted mesoporous silica with 3D-printing bioactive glass (BG) scaffolds (MBS). The near infrared (NIR)-triggered photonic hyperthermia of MXene in the NIR-II biowindow and precisely controlled nitric oxide (NO) release are coordinated for multitarget ablation of bone tumors to enhance localized osteosarcoma treatment. The in situ formed phosphorus and calcium components degraded from BG scaffold promote bone-regeneration bioactivity, augmented by sufficient blood supply triggered by on-demand NO release. The tunable NO generation plays a crucial role in sequential adjuvant tumor ablation, combinatory promotion of coupled vascularization, and bone regeneration. This study demonstrates a combinatory osteosarcoma ablation and a full osseous regeneration as enabled by the implantation of MBS. The design of multifunctional scaffolds with the specific features of controllable NO release, highly efficient photothermal conversion, and stimulatory bone regeneration provides an intriguing biomaterial platform for the diversified treatment of bone tumors.
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Affiliation(s)
- Qianhao Yang
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, P. R. China
| | - Haohao Yin
- State Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai, 200050, P. R. China
| | - Tianming Xu
- Department of Orthopedics, No. 455 Hospital of PLA, The Second Military Medical University, Shanghai, 200052, P. R. China
| | - Daoyu Zhu
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, P. R. China
| | - Junhui Yin
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, P. R. China
- Institute of Microsurgery on Extremities, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, P. R. China
| | - Yixuan Chen
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, P. R. China
| | - Xiaowei Yu
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, P. R. China
| | - Junjie Gao
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, P. R. China
| | - Changqing Zhang
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, P. R. China
- Institute of Microsurgery on Extremities, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, P. R. China
| | - Yu Chen
- State Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai, 200050, P. R. China
| | - Youshui Gao
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, P. R. China
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Igarashi K, Kawaguchi K, Murakami T, Miyake K, Kiyuna T, Miyake M, Hiroshima Y, Higuchi T, Oshiro H, Nelson SD, Dry SM, Li Y, Yamamoto N, Hayashi K, Kimura H, Miwa S, Singh SR, Tsuchiya H, Hoffman RM. Patient-derived orthotopic xenograft models of sarcoma. Cancer Lett 2019; 469:332-339. [PMID: 31639427 DOI: 10.1016/j.canlet.2019.10.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 10/15/2019] [Accepted: 10/17/2019] [Indexed: 12/15/2022]
Abstract
Sarcoma is a rare and recalcitrant malignancy. Although immune and novel targeted therapies have been tested on many cancer types, few sarcoma patients have had durable responses with such therapy. Doxorubicin and cisplatinum are still first-line chemotherapy after four decades. Our laboratory has established the patient-derived orthotopic xenograft (PDOX) model using surgical orthotopic implantation (SOI). Many promising results have been obtained using the sarcoma PDOX model for identifying effective approved drugs and experimental therapeutics, as well as combinations of them for individual patients. In this review, we present our laboratory's experience with PDOX models of sarcoma, and the ability of the PDOX models to identify effective approved agents, as well as experimental therapeutics.
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Affiliation(s)
- Kentaro Igarashi
- AntiCancer, Inc, San Diego, CA, USA; Department of Surgery, University of California, San Diego, CA, USA; Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Kei Kawaguchi
- AntiCancer, Inc, San Diego, CA, USA; Department of Surgery, University of California, San Diego, CA, USA
| | - Takashi Murakami
- AntiCancer, Inc, San Diego, CA, USA; Department of Surgery, University of California, San Diego, CA, USA
| | - Kentaro Miyake
- AntiCancer, Inc, San Diego, CA, USA; Department of Surgery, University of California, San Diego, CA, USA
| | - Tasuku Kiyuna
- AntiCancer, Inc, San Diego, CA, USA; Department of Surgery, University of California, San Diego, CA, USA
| | - Masuyo Miyake
- AntiCancer, Inc, San Diego, CA, USA; Department of Surgery, University of California, San Diego, CA, USA
| | - Yukihiko Hiroshima
- AntiCancer, Inc, San Diego, CA, USA; Department of Surgery, University of California, San Diego, CA, USA
| | - Takashi Higuchi
- AntiCancer, Inc, San Diego, CA, USA; Department of Surgery, University of California, San Diego, CA, USA; Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Hiromichi Oshiro
- AntiCancer, Inc, San Diego, CA, USA; Department of Surgery, University of California, San Diego, CA, USA
| | - Scott D Nelson
- Department of Pathology, University of California, Los Angeles, CA, USA
| | - Sarah M Dry
- Department of Pathology, University of California, Los Angeles, CA, USA
| | - Yunfeng Li
- Department of Pathology, University of California, Los Angeles, CA, USA
| | - Norio Yamamoto
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Katsuhiro Hayashi
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Hiroaki Kimura
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Shinji Miwa
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Shree Ram Singh
- Basic Research Laboratory, National Cancer Institute, Frederick, MD, USA.
| | - Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan.
| | - Robert M Hoffman
- AntiCancer, Inc, San Diego, CA, USA; Department of Surgery, University of California, San Diego, CA, USA.
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9
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Tome Y, Kiyuna T, Uehara F, Bouvet M, Tsuchiya H, Kanaya F, Hoffman RM. Imaging the interaction of α v integrin-GFP in osteosarcoma cells with RFP-expressing host stromal cells and tumor-scaffold collagen in the primary and metastatic tumor microenvironment. J Cell Biochem 2019; 120:283-289. [PMID: 30145815 DOI: 10.1002/jcb.27353] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 06/28/2018] [Indexed: 12/27/2022]
Abstract
Human osteosarcoma 143B cells were previously stably transfected with an αv integrin green flourescent protein (GFP) vector. 143B cells expressing αv integrin-GFP were transplanted orthotopically in the tibia of transgenic nude mice ubiquitously expressing red fluorescent protein (RFP). The primary tumors acquired RFP-expressing stroma and were passaged orthotopically in the tibia in noncolored nude mice, which maintained the RFP stroma. The interaction of αv integrin-GFP expression in 143B cells with RFP-expressing host stromal cells was observed by confocal microscopy using the Olympus FV1000. Collagen fibers were imaged simultaneously in reflectance mode. The RFP-expressing stroma included cancer-associated fibroblasts (CAFs) and tumor-associated macrophages (TAMs) which persisted even 3 weeks after passage to nontransgenic nude mice. CAFs expressing RFP were aligned between collagen fibers and cancer cells expressing αv integrin-GFP. Six weeks after transplantation, pulmonary metastases expressing αv integrin-GFP could be identified. TAMs expressing RFP accompanied metastasized osteosarcoma cells expressing αv integrin-GFP in the lung. The current study demonstrates the importance of αv integrin interaction with stromal elements in osteosarcoma.
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Affiliation(s)
- Yasunori Tome
- AntiCancer, Inc, San Diego, California
- Department of Surgery, University of California, San Diego, California
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Tasuku Kiyuna
- AntiCancer, Inc, San Diego, California
- Department of Surgery, University of California, San Diego, California
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Fuminari Uehara
- AntiCancer, Inc, San Diego, California
- Department of Surgery, University of California, San Diego, California
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Michael Bouvet
- Department of Surgery, University of California, San Diego, California
| | - Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - Fuminori Kanaya
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Robert M Hoffman
- AntiCancer, Inc, San Diego, California
- Department of Surgery, University of California, San Diego, California
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10
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Kawaguchi K, Miyake K, Han Q, Li S, Tan Y, Igarashi K, Kiyuna T, Miyake M, Higuchi T, Oshiro H, Zhang Z, Razmjooei S, Wangsiricharoen S, Bouvet M, Singh SR, Unno M, Hoffman RM. Oral recombinant methioninase (o-rMETase) is superior to injectable rMETase and overcomes acquired gemcitabine resistance in pancreatic cancer. Cancer Lett 2018; 432:251-259. [DOI: 10.1016/j.canlet.2018.06.016] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 06/05/2018] [Accepted: 06/12/2018] [Indexed: 01/06/2023]
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11
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Jung B, Hong S, Kim SC, Hwang C. In Vivo Observation of Endothelial Cell-Assisted Vascularization in Pancreatic Cancer Xenograft Engineering. Tissue Eng Regen Med 2018; 15:275-285. [PMID: 30603553 PMCID: PMC6171679 DOI: 10.1007/s13770-018-0113-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 12/10/2017] [Accepted: 01/02/2018] [Indexed: 02/07/2023] Open
Abstract
In this study, for better understanding of patient-derived xenograft (PDX) generation, angiogenic characteristics during PDX cancerous tissue generation was investigated with different initial cell seeding conditions in the hydrogel. We monitored the angiogenic changes during the formation of in vivo cancer cell line xenografts induced by endothelial cells. Our in vivo cancer tissue formation system was designed with the assistance of tissue engineering technology to mimic patient-derived xenograft formation. Endothelial cells and MIA PaCa-2 pancreatic carcinoma cells were encapsulated in fibrin gel at different mixing configurations and subcutaneously implanted into nude mice. To investigate the effect of the initial cancerous cell distribution in the fibrin gel, MIA PaCa-2 cells were encapsulated as a homogeneous cell distribution or as a cell aggregate, with endothelial cells homogeneously distributed in the fibrin gel. Histological observation of the explanted tissues after different implantation periods revealed three different stages: isolated vascular tubes, leaky blood vessels, and mature cancerous tissue formation. The in vivo engineered cancerous tissues had leaky blood vessels with low expression of the vascular tight junction marker CD31. Under our experimental conditions, complex cancer-like tissue formation was most successful when tumorous cells and endothelial cells were homogeneously mixed in the fibrin gel. The present study implies that tumorous xenograft tissue formation can be achieved with a low number of initial cells and that effective vascularization conditions can be attained with a limited volume of patient-derived cancer tissue. Endothelial cell-assisted vascularization can be a potent choice for the effective development of vascularized cancerous tissues for studying patient-derived xenografts, cancer angiogenesis, cancer metastasis, and anticancer drugs.
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Affiliation(s)
- Boyoung Jung
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505 South Korea
- University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505 South Korea
| | - Soyoung Hong
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505 South Korea
| | - Song Cheol Kim
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505 South Korea
- Division of Hepato-Biliary and Pancreatic Surgery, Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505 South Korea
| | - Changmo Hwang
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505 South Korea
- University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505 South Korea
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12
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Igarashi K, Kawaguchi K, Kiyuna T, Miyake K, Miyake M, Li Y, Nelson SD, Dry SM, Singh AS, Elliott IA, Russell TA, Eckardt MA, Yamamoto N, Hayashi K, Kimura H, Miwa S, Tsuchiya H, Eilber FC, Hoffman RM. Temozolomide regresses a doxorubicin-resistant undifferentiated spindle-cell sarcoma patient-derived orthotopic xenograft (PDOX): precision-oncology nude-mouse model matching the patient with effective therapy. J Cell Biochem 2018; 119:6598-6603. [PMID: 29737543 DOI: 10.1002/jcb.26792] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 02/16/2018] [Indexed: 12/15/2022]
Abstract
Undifferentiated spindle-cell sarcoma (USCS) is a recalcitrant cancer, resistant to conventional chemotherapy. A patient with high-grade USCS from a striated muscle was implanted orthotopically in the right biceps femoris muscle of mice to establish a patient-derived orthotopic xenograft (PDOX) model. The PDOX models were randomized into the following groups when tumor volume reached 100 mm3 : G1, control without treatment; G2, doxorubicin (DOX) (3 mg/kg, intraperitoneal [i.p.] injection, weekly, for 2 weeks); G3, temozolomide (TEM) (25 mg/kg, p.o., daily, for 14 days). Tumor size and body weight were measured with calipers and a digital balance twice a week. TEM significantly inhibited tumor volume growth compared to the untreated control and the DOX-treated group on day 14 after treatment initiation: control (G1): 343 ± 78 mm3 ; DOX (G2): 308 ± 31 mm3 , P = 0.272; TEM (G3): 85 ± 21 mm3 , P < 0.0001. TEM significantly regressed the tumor volume compared to day 0 (P = 0.019). There were no animal deaths in any group. The body weight of treated mice was not significantly different in any group. Tumors treated with DOX were comprised of spindle-shaped viable cells without apparent necrosis or inflammatory changes. In contrast, tumors treated with TEM showed extensive tumor necrosis. The present study demonstrates the potential power of matching the patient with an effective drug and saving the patient needless toxicity from ineffective drugs.
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Affiliation(s)
- Kentaro Igarashi
- AntiCancer, Inc., San Diego, California.,Department of Surgery, University of California, San Diego, California.,Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Kei Kawaguchi
- AntiCancer, Inc., San Diego, California.,Department of Surgery, University of California, San Diego, California
| | - Tasuku Kiyuna
- AntiCancer, Inc., San Diego, California.,Department of Surgery, University of California, San Diego, California
| | - Kentaro Miyake
- AntiCancer, Inc., San Diego, California.,Department of Surgery, University of California, San Diego, California
| | - Masuyo Miyake
- AntiCancer, Inc., San Diego, California.,Department of Surgery, University of California, San Diego, California
| | - Yunfeng Li
- Department of Pathology, University of California, Los Angeles, California
| | - Scott D Nelson
- Department of Pathology, University of California, Los Angeles, California
| | - Sarah M Dry
- Department of Pathology, University of California, Los Angeles, California
| | - Arun S Singh
- Division of Hematology-Oncology, University of California, Los Angeles, California
| | - Irmina A Elliott
- Division of Surgical Oncology, University of California, Los Angeles, California
| | - Tara A Russell
- Division of Surgical Oncology, University of California, Los Angeles, California
| | - Mark A Eckardt
- Department of Surgery, Yale School of Medicine, New Haven, Connecticut
| | - Norio Yamamoto
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Katsuhiro Hayashi
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Hiroaki Kimura
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Shinji Miwa
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Fritz C Eilber
- Division of Surgical Oncology, University of California, Los Angeles, California
| | - Robert M Hoffman
- AntiCancer, Inc., San Diego, California.,Department of Surgery, University of California, San Diego, California
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13
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Igarashi K, Kawaguchi K, Li S, Han Q, Tan Y, Gainor E, Kiyuna T, Miyake K, Miyake M, Higuchi T, Oshiro H, Singh AS, Eckardt MA, Nelson SD, Russell TA, Dry SM, Li Y, Yamamoto N, Hayashi K, Kimura H, Miwa S, Tsuchiya H, Eilber FC, Hoffman RM. Recombinant methioninase combined with doxorubicin (DOX) regresses a DOX-resistant synovial sarcoma in a patient-derived orthotopic xenograft (PDOX) mouse model. Oncotarget 2018; 9:19263-19272. [PMID: 29721200 PMCID: PMC5922394 DOI: 10.18632/oncotarget.24996] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 03/15/2018] [Indexed: 01/09/2023] Open
Abstract
Synovial sarcoma (SS) is a recalcitrant subgroup of soft tissue sarcoma (STS). A tumor from a patient with high grade SS from a lower extremity was grown orthotopically in the right biceps femoris muscle of nude mice to establish a patient-derived orthotopic xenograft (PDOX) mouse model. The PDOX mice were randomized into the following groups when tumor volume reached approximately 100 mm3: G1, control without treatment; G2, doxorubicin (DOX) (3 mg/kg, intraperitoneal [i.p.] injection, weekly, for 2 weeks; G3, rMETase (100 unit/mouse, i.p., daily, for 2 weeks); G4 DOX (3mg/kg), i.p. weekly, for 2 weeks) combined with rMETase (100 unit/mouse, i.p., daily, for 2 weeks). On day 14 after treatment initiation, all therapies significantly inhibited tumor growth compared to untreated control, except DOX: (DOX: p = 0.48; rMETase: p < 0.005; DOX combined with rMETase < 0.0001). DOX combined with rMETase was significantly more effective than both DOX alone (p < 0.001) and rMETase alone (p < 0.05). The relative body weight on day 14 compared with day 0 did not significantly differ between any treatment group or untreated control. The results indicate that r-METase can overcome DOX-resistance in this recalcitrant disease.
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Affiliation(s)
- Kentaro Igarashi
- AntiCancer, Inc., San Diego, California, USA.,Department of Surgery, University of California, San Diego, California, USA.,Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Kei Kawaguchi
- AntiCancer, Inc., San Diego, California, USA.,Department of Surgery, University of California, San Diego, California, USA
| | - Shukuan Li
- AntiCancer, Inc., San Diego, California, USA
| | | | - Yuying Tan
- AntiCancer, Inc., San Diego, California, USA
| | | | - Tasuku Kiyuna
- AntiCancer, Inc., San Diego, California, USA.,Department of Surgery, University of California, San Diego, California, USA
| | - Kentaro Miyake
- AntiCancer, Inc., San Diego, California, USA.,Department of Surgery, University of California, San Diego, California, USA
| | - Masuyo Miyake
- AntiCancer, Inc., San Diego, California, USA.,Department of Surgery, University of California, San Diego, California, USA
| | - Takashi Higuchi
- AntiCancer, Inc., San Diego, California, USA.,Department of Surgery, University of California, San Diego, California, USA
| | - Hiromichi Oshiro
- AntiCancer, Inc., San Diego, California, USA.,Department of Surgery, University of California, San Diego, California, USA
| | - Arun S Singh
- Division of Hematology-Oncology, University of California, Los Angeles, CA, USA
| | - Mark A Eckardt
- Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - Scott D Nelson
- Department of Pathology, University of California, Los Angeles, CA, USA
| | - Tara A Russell
- Division of Surgical Oncology, University of California, Los Angeles, CA, USA
| | - Sarah M Dry
- Department of Pathology, University of California, Los Angeles, CA, USA
| | - Yunfeng Li
- Department of Pathology, University of California, Los Angeles, CA, USA
| | - Norio Yamamoto
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Katsuhiro Hayashi
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Hiroaki Kimura
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Shinji Miwa
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Fritz C Eilber
- Division of Surgical Oncology, University of California, Los Angeles, CA, USA
| | - Robert M Hoffman
- AntiCancer, Inc., San Diego, California, USA.,Department of Surgery, University of California, San Diego, California, USA
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14
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Recombinant methioninase effectively targets a Ewing's sarcoma in a patient-derived orthotopic xenograft (PDOX) nude-mouse model. Oncotarget 2018; 8:35630-35638. [PMID: 28404944 PMCID: PMC5482604 DOI: 10.18632/oncotarget.15823] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 01/11/2017] [Indexed: 01/08/2023] Open
Abstract
Methionine dependence is due to the overuse of methionine for aberrant transmethylation reactions in cancer. Methionine dependence may be the only general metabolic defect in cancer. In order to exploit methionine dependence for therapy, our laboratory previously cloned L-methionine α-deamino-γ-mercaptomethane lyase [EC 4.4.1.11]). The cloned methioninase, termed recombinant methioninase, or rMETase, has been tested in mouse models of human cancer cell lines. Ewing's sarcoma is recalcitrant disease even though development of multimodal therapy has improved patients'outcome. Here we report efficacy of rMETase against Ewing's sarcoma in a patient-derived orthotopic xenograft (PDOX) model. The Ewing's sarcoma was implanted in the right chest wall of nude mice to establish a PDOX model. Eight Ewing's sarcoma PDOX mice were randomized into untreated control group (n = 4) and rMETase treatment group (n = 4). rMETase (100 units) was injected intraperitoneally (i.p.) every 24 hours for 14 consecutive days. All mice were sacrificed on day-15, 24 hours after the last rMETase administration. rMETase effectively reduced tumor growth compared to untreated control. The methionine level both of plasma and supernatants derived from sonicated tumors was lower in the rMETase group. Body weight did not significantly differ at any time points between the 2 groups. The present study is the first demonstrating rMETase efficacy in a PDOX model, suggesting potential clinical development, especially in recalcitrant cancers such as Ewing's sarcoma.
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15
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Igarashi K, Kawaguchi K, Kiyuna T, Miyake K, Miyake M, Singh AS, Eckardt MA, Nelson SD, Russell TA, Dry SM, Li Y, Yamamoto N, Hayashi K, Kimura H, Miwa S, Tsuchiya H, Singh SR, Eilber FC, Hoffman RM. Tumor-targeting Salmonella typhimurium A1-R is a highly effective general therapeutic for undifferentiated soft tissue sarcoma patient-derived orthotopic xenograft nude-mouse models. Biochem Biophys Res Commun 2018; 497:1055-1061. [PMID: 29481803 DOI: 10.1016/j.bbrc.2018.02.174] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Accepted: 02/23/2018] [Indexed: 10/24/2022]
Abstract
Undifferentiated soft tissue sarcoma (USTS) is a recalcitrant and heterogeneous subgroup of soft tissue sarcoma with high risk of metastasis and recurrence. Due to heterogeneity of USTS, there is no reliably effective first-line therapy. We have generated tumor-targeting Salmonella typhimurium A1-R (S. typhimurium A1-R), which previously showed strong efficacy on single patient-derived orthotopic xenograft (PDOX) models of Ewing's sarcoma and follicular dendritic cell sarcoma. In the present study, tumor resected from 4 patients with a biopsy-proven USTS (2 undifferentiated pleomorphic sarcoma [UPS], 1 undifferentiated sarcoma not otherwise specified [NOS] and 1 undifferentiated spindle cell sarcoma [USS]) were grown orthotopically in the biceps femoris muscle of mice to establish PDOX models. One USS model and one UPS model were doxorubicin (DOX) resistant. One UPS and the NOS model were partially sensitive to DOX. DOX is first-line therapy for these diseases. S. typhimurium A1-R arrested tumor growth all 4 models. In addition to arresting tumor growth in each case, S. typhimurium A1-R was significantly more efficacious than DOX in each case, thereby surpassing first-line therapy. These results suggest that S. typhimurium A1-R can be a general therapeutic for USTS and possibly sarcoma in general.
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Affiliation(s)
- Kentaro Igarashi
- AntiCancer, Inc., San Diego, CA, USA; Department of Surgery, University of California, San Diego, CA, USA; Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Kei Kawaguchi
- AntiCancer, Inc., San Diego, CA, USA; Department of Surgery, University of California, San Diego, CA, USA
| | - Tasuku Kiyuna
- AntiCancer, Inc., San Diego, CA, USA; Department of Surgery, University of California, San Diego, CA, USA
| | - Kentaro Miyake
- AntiCancer, Inc., San Diego, CA, USA; Department of Surgery, University of California, San Diego, CA, USA
| | - Masuyo Miyake
- AntiCancer, Inc., San Diego, CA, USA; Department of Surgery, University of California, San Diego, CA, USA
| | - Arun S Singh
- Division of Hematology-Oncology, University of California, Los Angeles, CA, USA
| | - Mark A Eckardt
- Department of Surgery, Yale School of Medicine, New Haven, CT, USA
| | - Scott D Nelson
- Department of Pathology, University of California, Los Angeles, CA, USA
| | - Tara A Russell
- Division of Surgical Oncology, University of California, Los Angeles, CA, USA
| | - Sarah M Dry
- Department of Pathology, University of California, Los Angeles, CA, USA
| | - Yunfeng Li
- Department of Pathology, University of California, Los Angeles, CA, USA
| | - Norio Yamamoto
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Katsuhiro Hayashi
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Hiroaki Kimura
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Shinji Miwa
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Shree Ram Singh
- Basic Research Laboratory, National Cancer Institute, Frederick, MD, USA.
| | - Fritz C Eilber
- Division of Surgical Oncology, University of California, Los Angeles, CA, USA.
| | - Robert M Hoffman
- AntiCancer, Inc., San Diego, CA, USA; Department of Surgery, University of California, San Diego, CA, USA.
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16
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Kiyuna T, Murakami T, Tome Y, Kawaguchi K, Igarashi K, Miyake K, Kanaya F, Singh A, Eilber FC, Hoffman RM. Analysis of Stroma Labeling During Multiple Passage of a Sarcoma Imageable Patient-Derived Orthotopic Xenograft (iPDOX) in Red Fluorescent Protein Transgenic Nude Mice. J Cell Biochem 2017; 118:3367-3371. [PMID: 28300287 PMCID: PMC5550328 DOI: 10.1002/jcb.25991] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 03/14/2017] [Indexed: 12/21/2022]
Abstract
A patient-derived orthotopic xenograft (PDOX) model of undifferentiated pleomorphic sarcoma (UPS) was previously established that acquired red fluorescent protein (RFP)-expressing stroma by growth in an RFP transgenic nude mouse. In the present study, an imageable PDOX model (iPDOX) of UPS was established by orthotopic implantation in the biceps femoris of transgenic RFP nude mice. After the tumors grew to a diameter of 10 mm, they were harvested and the brightest portion of the tumors were subsequently orthotopically transplanted to both RFP and non-colored nude mice. The UPS PDOX tumor was again transplanted to RFP transgenic and non-colored nude mice, and finally a 3rd passage was made in the same manner. Five UPS tumors from each passage in both RFP and non-colored mouse models were harvested. The FV1,000 confocal microscope was used to visualize and quantitate the RFP area of the resected tumors. The average percent fluorescent area in the first passage of RFP mice was 34 ± 22%; in the second passage, 34 ± 20%; and 36 ± 11% in the third passage of RFP transgenic nude mice. The average tumor RFP area in the first passage from RFP mice to non-colored mice was 20 ± 7%; in the second passage, 28 ± 11%; in the third passage was 27 ± 13%. The present results demonstrate the extensive and stable acquisition of stroma by the UPS-tumor growing orthotopically in transgenic RFP nude mice (iPDOX). This model can be used for screening for effective drugs for individual patients and drug discovery. J. Cell. Biochem. 118: 3367-3371, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Tasuku Kiyuna
- AntiCancer Inc., San Diego, CA
- Department of Surgery, University of California, San Diego, CA
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Takashi Murakami
- AntiCancer Inc., San Diego, CA
- Department of Surgery, University of California, San Diego, CA
| | - Yasunori Tome
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Kei Kawaguchi
- AntiCancer Inc., San Diego, CA
- Department of Surgery, University of California, San Diego, CA
| | - Kentaro Igarashi
- AntiCancer Inc., San Diego, CA
- Department of Surgery, University of California, San Diego, CA
| | - Kentaro Miyake
- AntiCancer Inc., San Diego, CA
- Department of Surgery, University of California, San Diego, CA
| | - Fuminori Kanaya
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Arun Singh
- Division of Hematology-Oncology, University of California, Los Angeles, CA
| | - Fritz C. Eilber
- Division of Surgical Oncology, University of California, Los Angeles, CA
| | - Robert M. Hoffman
- AntiCancer Inc., San Diego, CA
- Department of Surgery, University of California, San Diego, CA
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17
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Kawaguchi K, Murakami T, Suetsugu A, Kiyuna T, Igarashi K, Hiroshima Y, Zhao M, Zhang Y, Bouvet M, Clary BM, Unno M, Hoffman RM. High-efficacy targeting of colon-cancer liver metastasis with Salmonella typhimurium A1-R via intra-portal-vein injection in orthotopic nude-mouse models. Oncotarget 2017; 8:19065-19073. [PMID: 27683127 PMCID: PMC5386670 DOI: 10.18632/oncotarget.12227] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 09/02/2016] [Indexed: 01/09/2023] Open
Abstract
Liver metastasis is the main cause of colon cancer-related death and is a recalcitrant disease. We report here the efficacy and safety of intra-portal-vein (iPV) targeting of Salmonella typhimurium A1-R on colon cancer liver metastasis in a nude-mouse orthotopic model. Nude mice with HT29 human colon cancer cells, expressing red fluorescent protein (RFP) (HT29-RFP), growing in the liver were administered S. typhimurium A1-R by either iPV (1×104 colony forming units (CFU)/100 μl) or, for comparison, intra-venous injection (iv; 5×107 CFU/100 μl). Similar amounts of bacteria were delivered to the liver with the two doses, indicating that iPV delivery is 5×103 times more efficient than iv delivery. Treatment efficacy was evaluated by tumor fluorescent area (mm2) and total fluorescence intensity. Tumor fluorescent area and fluorescence intensity highly correlated (p<0.0001). iPV treatment was more effective compared to both untreated control and iv treatment (p<0.01 and p<0.05, respectively with iPV treatment with S. typhimurium arresting metastatic growth). There were no significant differences in body weight between all groups. The results of this study suggest that S. typhimurium A1-R administered iPV has potential for peri-operative adjuvant treatment of colon cancer liver metastasis.
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Affiliation(s)
- Kei Kawaguchi
- AntiCancer, Inc., San Diego, California, USA.,Department of Surgery, University of California San Diego, San Diego, California, USA.,Department of Surgery, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | | | | | | | | | | | - Ming Zhao
- AntiCancer, Inc., San Diego, California, USA
| | - Yong Zhang
- AntiCancer, Inc., San Diego, California, USA
| | - Michael Bouvet
- Department of Surgery, University of California San Diego, San Diego, California, USA
| | - Bryan M Clary
- Department of Surgery, University of California San Diego, San Diego, California, USA
| | - Michiaki Unno
- Department of Surgery, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Robert M Hoffman
- AntiCancer, Inc., San Diego, California, USA.,Department of Surgery, University of California San Diego, San Diego, California, USA
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18
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CRISPR/Cas9-Mediated Deletion of Foxn1 in NOD/SCID/IL2rg -/- Mice Results in Severe Immunodeficiency. Sci Rep 2017; 7:7720. [PMID: 28798321 PMCID: PMC5552779 DOI: 10.1038/s41598-017-08337-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 07/11/2017] [Indexed: 12/17/2022] Open
Abstract
Immunodeficient mice engrafted with either normal or cancerous human cells are widely used in basic and translational research. In particular, NOD/SCID/IL2rg−/− mice can support the growth of various types of human cancer cells. However, the hairs of these mice interfere with the observation and imaging of engrafted tissues. Therefore, novel hairless strains exhibiting comparable immunodeficiency would be beneficial. Recently, the CRISPR/Cas9 system has been used for efficient multiplexed genome editing. In the present study, we generated a novel strain of nude NOD/SCID/IL2rg−/− (NSIN) mice by knocking out Foxn1 from NOD/SCID/IL2rg−/− (NSI) mice using the CRISPR/Cas9 system. The NSIN mice were deficient in B, T, and NK cells and not only showed impaired T cell reconstitution and thymus regeneration after allogeneic bone marrow nucleated cell transplantation but also exhibited improved capacity to graft both leukemic and solid tumor cells compared with NSI, NOG, and NDG mice. Moreover, the NSIN mice facilitated the monitoring and in vivo imaging of both leukemia and solid tumors. Therefore, our NSIN mice provide a new platform for xenograft mouse models in basic and translational research.
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19
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Russell TA, Eckardt MA, Murakami T, Elliott IA, Kawaguchi K, Kiyuna T, Igarashi K, Li Y, Crompton JG, Graham DS, Dry SM, Bernthal N, Yanagawa J, Kalbasi A, Federman N, Chmielowski B, Singh AS, Hoffman RM, Eilber FC. Clinical Factors That Affect the Establishment of Soft Tissue Sarcoma Patient-Derived Orthotopic Xenografts: A University of California, Los Angeles, Sarcoma Program Prospective Clinical Trial. JCO Precis Oncol 2017; 2017. [PMID: 30613825 DOI: 10.1200/po.17.00071] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Purpose Given the diverse and aggressive nature of soft tissue sarcomas (STSs), a need exists for more-precise therapy. Patient-derived orthotopic xenografts (PDOXs) provide a unique platform for personalized treatment. Thus, identification of patient and treatment factors that predict PDOX establishment is important. This study assessed the feasibility of incorporating PDOXs into the clinical setting and identifying factors associated with PDOX establishment. Patients and Methods From May 2015 to May 2016, 107 patients with biopsy-proven or potential STS were enrolled. Tumor samples were obtained intraoperatively and orthotopically implanted into nude mice in the corresponding anatomic location. PDOXs were considered established after engraftment and serial passage. Factors associated with establishment were analyzed by logistic regression and time to establishment by time-to-event analysis. Results Only high-grade tumors established (32 of 72 [44.4%]). The establishment rate (ER) varied by neoadjuvant therapy and treatment response, with the highest ER among untreated high-grade tumors (26 of 42 [61.9%]). Tumors exposed to radiation preoperatively did not establish (zero of 11 [0%]), and tumors exposed to neoadjuvant chemotherapy had a lower ER(31.9%) than untreated tumors. Only STSs with minimal pathologic response to neoadjuvant treatment (≤ 30%) established a PDOX (six of 18 [33.3%]). Median establishment time was 54 days, which varied by neoadjuvant therapy but was not statistically significant (P = .180). Conclusion To our knowledge, in the largest STS PDOX study to date, we demonstrate a 62% ER among untreated high-grade tumors with a median establishment time of 54 days. Neoadjuvant therapy, particularly radiation, and pathologic response to treatment were associated with a reduced rate of PDOX establishment.
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Affiliation(s)
- Tara A Russell
- Tara A. Russell, Irmina A. Elliott, Yungfeng Li, Joseph G. Crompton, Danielle S. Graham, Sarah M. Dry, Nicholas Bernthal, Jane Yanagawa, Anusha Kalbasi, Noah Federman, Bartosz Chmielowski, Arun S. Singh, and Fritz C. Eilber, University of California, Los Angeles; Tara A. Russell, Veterans Affairs Los Angeles Health Services Research & Development Center of Innovation, Los Angeles, CA; Mark A. Eckardt, Yale School of Medicine, New Haven, CT; Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, AntiCancer; and Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, University of California, San Diego, San Diego, CA
| | - Mark A Eckardt
- Tara A. Russell, Irmina A. Elliott, Yungfeng Li, Joseph G. Crompton, Danielle S. Graham, Sarah M. Dry, Nicholas Bernthal, Jane Yanagawa, Anusha Kalbasi, Noah Federman, Bartosz Chmielowski, Arun S. Singh, and Fritz C. Eilber, University of California, Los Angeles; Tara A. Russell, Veterans Affairs Los Angeles Health Services Research & Development Center of Innovation, Los Angeles, CA; Mark A. Eckardt, Yale School of Medicine, New Haven, CT; Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, AntiCancer; and Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, University of California, San Diego, San Diego, CA
| | - Takashi Murakami
- Tara A. Russell, Irmina A. Elliott, Yungfeng Li, Joseph G. Crompton, Danielle S. Graham, Sarah M. Dry, Nicholas Bernthal, Jane Yanagawa, Anusha Kalbasi, Noah Federman, Bartosz Chmielowski, Arun S. Singh, and Fritz C. Eilber, University of California, Los Angeles; Tara A. Russell, Veterans Affairs Los Angeles Health Services Research & Development Center of Innovation, Los Angeles, CA; Mark A. Eckardt, Yale School of Medicine, New Haven, CT; Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, AntiCancer; and Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, University of California, San Diego, San Diego, CA
| | - Irmina A Elliott
- Tara A. Russell, Irmina A. Elliott, Yungfeng Li, Joseph G. Crompton, Danielle S. Graham, Sarah M. Dry, Nicholas Bernthal, Jane Yanagawa, Anusha Kalbasi, Noah Federman, Bartosz Chmielowski, Arun S. Singh, and Fritz C. Eilber, University of California, Los Angeles; Tara A. Russell, Veterans Affairs Los Angeles Health Services Research & Development Center of Innovation, Los Angeles, CA; Mark A. Eckardt, Yale School of Medicine, New Haven, CT; Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, AntiCancer; and Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, University of California, San Diego, San Diego, CA
| | - Kei Kawaguchi
- Tara A. Russell, Irmina A. Elliott, Yungfeng Li, Joseph G. Crompton, Danielle S. Graham, Sarah M. Dry, Nicholas Bernthal, Jane Yanagawa, Anusha Kalbasi, Noah Federman, Bartosz Chmielowski, Arun S. Singh, and Fritz C. Eilber, University of California, Los Angeles; Tara A. Russell, Veterans Affairs Los Angeles Health Services Research & Development Center of Innovation, Los Angeles, CA; Mark A. Eckardt, Yale School of Medicine, New Haven, CT; Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, AntiCancer; and Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, University of California, San Diego, San Diego, CA
| | - Tasuku Kiyuna
- Tara A. Russell, Irmina A. Elliott, Yungfeng Li, Joseph G. Crompton, Danielle S. Graham, Sarah M. Dry, Nicholas Bernthal, Jane Yanagawa, Anusha Kalbasi, Noah Federman, Bartosz Chmielowski, Arun S. Singh, and Fritz C. Eilber, University of California, Los Angeles; Tara A. Russell, Veterans Affairs Los Angeles Health Services Research & Development Center of Innovation, Los Angeles, CA; Mark A. Eckardt, Yale School of Medicine, New Haven, CT; Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, AntiCancer; and Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, University of California, San Diego, San Diego, CA
| | - Kentaro Igarashi
- Tara A. Russell, Irmina A. Elliott, Yungfeng Li, Joseph G. Crompton, Danielle S. Graham, Sarah M. Dry, Nicholas Bernthal, Jane Yanagawa, Anusha Kalbasi, Noah Federman, Bartosz Chmielowski, Arun S. Singh, and Fritz C. Eilber, University of California, Los Angeles; Tara A. Russell, Veterans Affairs Los Angeles Health Services Research & Development Center of Innovation, Los Angeles, CA; Mark A. Eckardt, Yale School of Medicine, New Haven, CT; Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, AntiCancer; and Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, University of California, San Diego, San Diego, CA
| | - Yungfeng Li
- Tara A. Russell, Irmina A. Elliott, Yungfeng Li, Joseph G. Crompton, Danielle S. Graham, Sarah M. Dry, Nicholas Bernthal, Jane Yanagawa, Anusha Kalbasi, Noah Federman, Bartosz Chmielowski, Arun S. Singh, and Fritz C. Eilber, University of California, Los Angeles; Tara A. Russell, Veterans Affairs Los Angeles Health Services Research & Development Center of Innovation, Los Angeles, CA; Mark A. Eckardt, Yale School of Medicine, New Haven, CT; Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, AntiCancer; and Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, University of California, San Diego, San Diego, CA
| | - Joseph G Crompton
- Tara A. Russell, Irmina A. Elliott, Yungfeng Li, Joseph G. Crompton, Danielle S. Graham, Sarah M. Dry, Nicholas Bernthal, Jane Yanagawa, Anusha Kalbasi, Noah Federman, Bartosz Chmielowski, Arun S. Singh, and Fritz C. Eilber, University of California, Los Angeles; Tara A. Russell, Veterans Affairs Los Angeles Health Services Research & Development Center of Innovation, Los Angeles, CA; Mark A. Eckardt, Yale School of Medicine, New Haven, CT; Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, AntiCancer; and Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, University of California, San Diego, San Diego, CA
| | - Danielle S Graham
- Tara A. Russell, Irmina A. Elliott, Yungfeng Li, Joseph G. Crompton, Danielle S. Graham, Sarah M. Dry, Nicholas Bernthal, Jane Yanagawa, Anusha Kalbasi, Noah Federman, Bartosz Chmielowski, Arun S. Singh, and Fritz C. Eilber, University of California, Los Angeles; Tara A. Russell, Veterans Affairs Los Angeles Health Services Research & Development Center of Innovation, Los Angeles, CA; Mark A. Eckardt, Yale School of Medicine, New Haven, CT; Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, AntiCancer; and Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, University of California, San Diego, San Diego, CA
| | - Sarah M Dry
- Tara A. Russell, Irmina A. Elliott, Yungfeng Li, Joseph G. Crompton, Danielle S. Graham, Sarah M. Dry, Nicholas Bernthal, Jane Yanagawa, Anusha Kalbasi, Noah Federman, Bartosz Chmielowski, Arun S. Singh, and Fritz C. Eilber, University of California, Los Angeles; Tara A. Russell, Veterans Affairs Los Angeles Health Services Research & Development Center of Innovation, Los Angeles, CA; Mark A. Eckardt, Yale School of Medicine, New Haven, CT; Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, AntiCancer; and Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, University of California, San Diego, San Diego, CA
| | - Nicholas Bernthal
- Tara A. Russell, Irmina A. Elliott, Yungfeng Li, Joseph G. Crompton, Danielle S. Graham, Sarah M. Dry, Nicholas Bernthal, Jane Yanagawa, Anusha Kalbasi, Noah Federman, Bartosz Chmielowski, Arun S. Singh, and Fritz C. Eilber, University of California, Los Angeles; Tara A. Russell, Veterans Affairs Los Angeles Health Services Research & Development Center of Innovation, Los Angeles, CA; Mark A. Eckardt, Yale School of Medicine, New Haven, CT; Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, AntiCancer; and Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, University of California, San Diego, San Diego, CA
| | - Jane Yanagawa
- Tara A. Russell, Irmina A. Elliott, Yungfeng Li, Joseph G. Crompton, Danielle S. Graham, Sarah M. Dry, Nicholas Bernthal, Jane Yanagawa, Anusha Kalbasi, Noah Federman, Bartosz Chmielowski, Arun S. Singh, and Fritz C. Eilber, University of California, Los Angeles; Tara A. Russell, Veterans Affairs Los Angeles Health Services Research & Development Center of Innovation, Los Angeles, CA; Mark A. Eckardt, Yale School of Medicine, New Haven, CT; Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, AntiCancer; and Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, University of California, San Diego, San Diego, CA
| | - Anusha Kalbasi
- Tara A. Russell, Irmina A. Elliott, Yungfeng Li, Joseph G. Crompton, Danielle S. Graham, Sarah M. Dry, Nicholas Bernthal, Jane Yanagawa, Anusha Kalbasi, Noah Federman, Bartosz Chmielowski, Arun S. Singh, and Fritz C. Eilber, University of California, Los Angeles; Tara A. Russell, Veterans Affairs Los Angeles Health Services Research & Development Center of Innovation, Los Angeles, CA; Mark A. Eckardt, Yale School of Medicine, New Haven, CT; Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, AntiCancer; and Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, University of California, San Diego, San Diego, CA
| | - Noah Federman
- Tara A. Russell, Irmina A. Elliott, Yungfeng Li, Joseph G. Crompton, Danielle S. Graham, Sarah M. Dry, Nicholas Bernthal, Jane Yanagawa, Anusha Kalbasi, Noah Federman, Bartosz Chmielowski, Arun S. Singh, and Fritz C. Eilber, University of California, Los Angeles; Tara A. Russell, Veterans Affairs Los Angeles Health Services Research & Development Center of Innovation, Los Angeles, CA; Mark A. Eckardt, Yale School of Medicine, New Haven, CT; Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, AntiCancer; and Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, University of California, San Diego, San Diego, CA
| | - Bartosz Chmielowski
- Tara A. Russell, Irmina A. Elliott, Yungfeng Li, Joseph G. Crompton, Danielle S. Graham, Sarah M. Dry, Nicholas Bernthal, Jane Yanagawa, Anusha Kalbasi, Noah Federman, Bartosz Chmielowski, Arun S. Singh, and Fritz C. Eilber, University of California, Los Angeles; Tara A. Russell, Veterans Affairs Los Angeles Health Services Research & Development Center of Innovation, Los Angeles, CA; Mark A. Eckardt, Yale School of Medicine, New Haven, CT; Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, AntiCancer; and Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, University of California, San Diego, San Diego, CA
| | - Arun S Singh
- Tara A. Russell, Irmina A. Elliott, Yungfeng Li, Joseph G. Crompton, Danielle S. Graham, Sarah M. Dry, Nicholas Bernthal, Jane Yanagawa, Anusha Kalbasi, Noah Federman, Bartosz Chmielowski, Arun S. Singh, and Fritz C. Eilber, University of California, Los Angeles; Tara A. Russell, Veterans Affairs Los Angeles Health Services Research & Development Center of Innovation, Los Angeles, CA; Mark A. Eckardt, Yale School of Medicine, New Haven, CT; Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, AntiCancer; and Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, University of California, San Diego, San Diego, CA
| | - Robert M Hoffman
- Tara A. Russell, Irmina A. Elliott, Yungfeng Li, Joseph G. Crompton, Danielle S. Graham, Sarah M. Dry, Nicholas Bernthal, Jane Yanagawa, Anusha Kalbasi, Noah Federman, Bartosz Chmielowski, Arun S. Singh, and Fritz C. Eilber, University of California, Los Angeles; Tara A. Russell, Veterans Affairs Los Angeles Health Services Research & Development Center of Innovation, Los Angeles, CA; Mark A. Eckardt, Yale School of Medicine, New Haven, CT; Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, AntiCancer; and Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, University of California, San Diego, San Diego, CA
| | - Fritz C Eilber
- Tara A. Russell, Irmina A. Elliott, Yungfeng Li, Joseph G. Crompton, Danielle S. Graham, Sarah M. Dry, Nicholas Bernthal, Jane Yanagawa, Anusha Kalbasi, Noah Federman, Bartosz Chmielowski, Arun S. Singh, and Fritz C. Eilber, University of California, Los Angeles; Tara A. Russell, Veterans Affairs Los Angeles Health Services Research & Development Center of Innovation, Los Angeles, CA; Mark A. Eckardt, Yale School of Medicine, New Haven, CT; Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, AntiCancer; and Takashi Murakami, Kei Kawaguchi, Tasuku Kiyuna, Kentaro Igarashi, and Robert M. Hoffman, University of California, San Diego, San Diego, CA
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20
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Igarashi K, Kawaguchi K, Murakami T, Kiyuna T, Miyake K, Yamamoto N, Hayashi K, Kimura H, Nelson SD, Dry SM, Li Y, Singh AS, Miwa S, Odani A, Eilber FC, Tsuchiya H, Hoffman RM. A novel anionic-phosphate-platinum complex effectively targets an undifferentiated pleomorphic sarcoma better than cisplatinum and doxorubicin in a patient-derived orthotopic xenograft (PDOX). Oncotarget 2017; 8:63353-63359. [PMID: 28968995 PMCID: PMC5609927 DOI: 10.18632/oncotarget.18806] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 05/12/2017] [Indexed: 01/02/2023] Open
Abstract
A patient high-grade undifferentiated pleomorphic soft-tissue sarcoma (UPS) from a striated muscle was previously orthotopically implanted in the right biceps femoris muscle of nude mice to establish a patient-derived orthotopic xenograft (PDOX) nude-mouse model. In the present study, two weeks after orthotopic transplantation of the UPS, mice were treated intraperitoneally with cisplatinum (CDDP), doxorubicin (DOX) or a novel anionic-phosphate-platinum compound 3Pt. Treatments were repeated weekly for a total of 3 times. Six weeks after transplantation, all mice were sacrificed and evaluated. After two weeks treatment, tumor sizes were as follows: control (G1): 2208.3 mm3; CDDP (G2): 841.8±3 mm3, p=0.0001; DOX (G3): 693.1±3 mm3, p=6.56E-7; 3Pt (G4): 333.7±1 mm3, p=4.8E-8. 3Pt showed significantly more efficacy compared to other therapy drugs tested: CDDP (p=0.0002), DOX (p=0.001). There were no animal deaths in any of the four groups. The present results suggest 3Pt is a promising new candidate for UPS since it was demonstrated to be effective in a PDOX model.
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Affiliation(s)
- Kentaro Igarashi
- AntiCancer, Inc., San Diego, California, USA.,Department of Surgery, University of California, San Diego, California, USA.,Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Kei Kawaguchi
- AntiCancer, Inc., San Diego, California, USA.,Department of Surgery, University of California, San Diego, California, USA
| | - Takashi Murakami
- AntiCancer, Inc., San Diego, California, USA.,Department of Surgery, University of California, San Diego, California, USA
| | - Tasuku Kiyuna
- AntiCancer, Inc., San Diego, California, USA.,Department of Surgery, University of California, San Diego, California, USA
| | - Kentaro Miyake
- AntiCancer, Inc., San Diego, California, USA.,Department of Surgery, University of California, San Diego, California, USA
| | - Norio Yamamoto
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Katsuhiro Hayashi
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Hiroaki Kimura
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Scott D Nelson
- Department of Pathology, University of California, Los Angeles, California, USA
| | - Sarah M Dry
- Department of Pathology, University of California, Los Angeles, California, USA
| | - Yunfeng Li
- Department of Pathology, University of California, Los Angeles, California, USA
| | - Arun S Singh
- Division of Hematology-Oncology, University of California, Los Angeles, California, USA
| | - Shinji Miwa
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Akira Odani
- Division of Pharmaceutical Sciences, Kanazawa University, Kanazawa, Japan
| | - Fritz C Eilber
- Division of Surgical Oncology, University of California, Los Angeles, California, USA
| | - Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Robert M Hoffman
- AntiCancer, Inc., San Diego, California, USA.,Department of Surgery, University of California, San Diego, California, USA
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21
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Kawaguchi K, Igarashi K, Murakami T, Kiyuna T, Nelson SD, Dry SM, Li Y, Russell TA, Singh AS, Chmielowski B, Unno M, Eilber FC, Hoffman RM. Combination of gemcitabine and docetaxel regresses both gastric leiomyosarcoma proliferation and invasion in an imageable patient-derived orthotopic xenograft (iPDOX) model. Cell Cycle 2017; 16:1063-1069. [PMID: 28426279 PMCID: PMC5499841 DOI: 10.1080/15384101.2017.1314406] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 03/23/2017] [Accepted: 03/27/2017] [Indexed: 02/08/2023] Open
Abstract
Gastric leiomyosarcoma is a recalcitrant cancer and the chemotherapy strategy is controversial. The present study used a patient-derived orthotopic xenograft (PDOX) nude mouse model of gastric leiomyosarcoma to identify an effective therapeutic regimen to develop individualized precision medicine for this disease. The gastric leiomyosarcoma obtained from a patient was first grown in transgenic nude mice ubiquitously expressing red fluorescent protein (RFP) to stably label the tumor stroma. The RFP-expressing tumor was then passaged orthotopically in the gastric wall of non-transgenic nude mice to establish an imageable PDOX (iPDOX) model. The bright fluorescent tumor was readily imaged over time to determine drug efficacy. Four weeks after implantation, 70 PDOX nude mice were divided into 7 groups: control without treatment (n = 10); doxorubicin (DOX) (2.4 mg/kg, intraperitoneally (i.p.), once a week for 2 weeks, n = 10); gemcitabine (GEM)/ docetaxel (DOC) (GEM: 100 mg/kg, DOC: 20 mg/kg, i.p., once a week for 2 weeks, n = 10); cyclophosphamide (CPA) (140 mg/kg, i.p., once a week for 2 weeks, n = 10); temozolomide (TEM) (25 mg/kg, orally, daily for 14 consecutive days, n = 10); yondelis (YON) (0.15 mg/kg, i.v., once a week for 2 weeks, n = 10); pazopanib (PAZ) (100 mg/kg, orally, daily for 14 consecutive days, n = 10). On day 14 from initiation of treatment, all treatments except PAZ significantly inhibited tumor growth compared with untreated control (DOX: p < 0.01, GEM/DOC: p < 0.01, CPA: p < 0.01, TEM: p < 0.01, YON: p < 0.01) on day 14 after initiation. In addition, only GEM/DOC was more significantly effective than DOX (p < 0.05). GEM/DOC could regress the leimyosarcoma in the PDOX model and has important clinical potential for precision individual treatment of leiomyosarcoma patients.
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Affiliation(s)
- Kei Kawaguchi
- AntiCancer, Inc., San Diego, CA, USA
- Department of Surgery, University of California, San Diego, CA, USA
- Department of Surgery, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Kentaro Igarashi
- AntiCancer, Inc., San Diego, CA, USA
- Department of Surgery, University of California, San Diego, CA, USA
| | - Takashi Murakami
- AntiCancer, Inc., San Diego, CA, USA
- Department of Surgery, University of California, San Diego, CA, USA
| | - Tasuku Kiyuna
- AntiCancer, Inc., San Diego, CA, USA
- Department of Surgery, University of California, San Diego, CA, USA
| | - Scott D. Nelson
- Department of Pathology, University of California, Los Angeles, CA, USA
| | - Sarah M. Dry
- Department of Pathology, University of California, Los Angeles, CA, USA
| | - Yunfeng Li
- Department of Pathology, University of California, Los Angeles, CA, USA
| | - Tara A. Russell
- Division of Surgical Oncology, University of California, Los Angeles, CA, USA
| | - Arun S. Singh
- Division of Hematology-Oncology, University of California, Los Angeles, CA, USA
- PDOX Inc., San Diego, CA, USA
| | - Bartosz Chmielowski
- Division of Hematology-Oncology, University of California, Los Angeles, CA, USA
| | - Michiaki Unno
- Department of Surgery, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Fritz C. Eilber
- Division of Surgical Oncology, University of California, Los Angeles, CA, USA
- PDOX Inc., San Diego, CA, USA
| | - Robert M. Hoffman
- AntiCancer, Inc., San Diego, CA, USA
- Department of Surgery, University of California, San Diego, CA, USA
- PDOX Inc., San Diego, CA, USA
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22
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Igarashi K, Kawaguchi K, Murakami T, Kiyuna T, Miyake K, Singh AS, Nelson SD, Dry SM, Li Y, Yamamoto N, Hayashi K, Kimura H, Miwa S, Tsuchiya H, Eilber FC, Hoffman RM. High Efficacy of Pazopanib on an Undifferentiated Spindle-Cell Sarcoma Resistant to First-Line Therapy Is Identified With a Patient-Derived Orthotopic Xenograft (PDOX) Nude Mouse Model. J Cell Biochem 2017; 118:2739-2743. [DOI: 10.1002/jcb.25923] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 02/03/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Kentaro Igarashi
- AntiCancer, Inc.; San Diego California
- Department of Surgery; University of California; San Diego California
- Department of Orthopedic Surgery; Kanazawa University; Kanazawa Japan
| | - Kei Kawaguchi
- AntiCancer, Inc.; San Diego California
- Department of Surgery; University of California; San Diego California
| | - Takashi Murakami
- AntiCancer, Inc.; San Diego California
- Department of Surgery; University of California; San Diego California
| | - Tasuku Kiyuna
- AntiCancer, Inc.; San Diego California
- Department of Surgery; University of California; San Diego California
| | - Kentaro Miyake
- AntiCancer, Inc.; San Diego California
- Department of Surgery; University of California; San Diego California
| | - Arun S. Singh
- Division of Hematology-Oncology; University of California; Los Angeles California
| | - Scott D. Nelson
- Department of Pathology; University of California; Los Angeles California
| | - Sarah M. Dry
- Department of Pathology; University of California; Los Angeles California
| | - Yunfeng Li
- Department of Pathology; University of California; Los Angeles California
| | - Norio Yamamoto
- Department of Orthopedic Surgery; Kanazawa University; Kanazawa Japan
| | - Katsuhiro Hayashi
- Department of Orthopedic Surgery; Kanazawa University; Kanazawa Japan
| | - Hiroaki Kimura
- Department of Orthopedic Surgery; Kanazawa University; Kanazawa Japan
| | - Shinji Miwa
- Department of Orthopedic Surgery; Kanazawa University; Kanazawa Japan
| | - Hiroyuki Tsuchiya
- Department of Orthopedic Surgery; Kanazawa University; Kanazawa Japan
| | - Fritz C. Eilber
- Division of Surgical Oncology; University of California; Los Angeles California
| | - Robert M. Hoffman
- AntiCancer, Inc.; San Diego California
- Department of Surgery; University of California; San Diego California
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23
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Murakami T, Kiyuna T, Kawaguchi K, Igarashi K, Singh AS, Hiroshima Y, Zhang Y, Zhao M, Miyake K, Nelson SD, Dry SM, Li Y, DeLong JC, Lwin TM, Chishima T, Tanaka K, Bouvet M, Endo I, Eilber FC, Hoffman RM. The irony of highly-effective bacterial therapy of a patient-derived orthotopic xenograft (PDOX) model of Ewing's sarcoma, which was blocked by Ewing himself 80 years ago. Cell Cycle 2017; 16:1046-1052. [PMID: 28296559 DOI: 10.1080/15384101.2017.1304340] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
William B. Coley developed bacterial therapy of cancer more than 100 years ago and had clinical success. James Ewing, a very famous cancer pathologist for whom the Ewing sarcoma is named, was Coley's boss at Memorial Hospital in New York and terminated Coley's bacterial therapy of cancer. A tumor from a patient with soft-tissue Ewing's sarcoma, who failed doxorubicin (DOX) therapy, was previously implanted in nude mice to establish a patient-derived orthotopic xenograft (PDOX) model. In the present study, the Ewing's sarcoma PDOX was treated with tumor-targeting S. typhimurium A1-R expressing green fluorescent (GFP), alone and in combination with DOX. S. typhimurium A1-R-GFP was detected in the tumors after intratumor (i.t.) or intravenous (i.v.) injection. The combination of S. typhimurium A1-R and DOX significantly reduced tumor weight (37.8 ± 15.6 mg) compared to the untreated control (73.8 ± 10.1 mg, P < 0.01). S. typhimurium A1-R monotherapy-treated tumors tended to be smaller (50.9 ± 17.8 mg, P = 0.051). DOX monotherapy did not show efficacy (66.3 ± 26.4 mg, P = 0.82), as was the case with the patient. The PDOX model faithfully replicated the DOX resistance the Ewing's sarcoma had in the patient. S. typhimurium A1-R converted the Ewing's sarcoma from DOX resistant to sensitive. One can only wonder how bacterial therapy and immunotherapy of cancer would have developed over the past 80 years if Ewing did not stop Coley.
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Affiliation(s)
- Takashi Murakami
- a AntiCancer, Inc. , San Diego , CA , USA.,b Department of Surgery , University of California , San Diego , CA , USA.,c Department of Gastroenterological Surgery , Graduate School of Medicine, Yokohama City University , Yokohama , Japan
| | | | | | | | - Arun S Singh
- d Division of Hematology-Oncology , University of California , Los Angeles , CA , USA
| | - Yukihiko Hiroshima
- c Department of Gastroenterological Surgery , Graduate School of Medicine, Yokohama City University , Yokohama , Japan
| | - Yong Zhang
- a AntiCancer, Inc. , San Diego , CA , USA
| | - Ming Zhao
- a AntiCancer, Inc. , San Diego , CA , USA
| | - Kentaro Miyake
- a AntiCancer, Inc. , San Diego , CA , USA.,b Department of Surgery , University of California , San Diego , CA , USA.,c Department of Gastroenterological Surgery , Graduate School of Medicine, Yokohama City University , Yokohama , Japan
| | - Scott D Nelson
- e Department of Pathology , University of California , Los Angeles , CA , USA
| | - Sarah M Dry
- e Department of Pathology , University of California , Los Angeles , CA , USA
| | - Yunfeng Li
- e Department of Pathology , University of California , Los Angeles , CA , USA
| | - Jonathan C DeLong
- b Department of Surgery , University of California , San Diego , CA , USA
| | - Thinzar M Lwin
- b Department of Surgery , University of California , San Diego , CA , USA
| | - Takashi Chishima
- c Department of Gastroenterological Surgery , Graduate School of Medicine, Yokohama City University , Yokohama , Japan
| | - Kuniya Tanaka
- c Department of Gastroenterological Surgery , Graduate School of Medicine, Yokohama City University , Yokohama , Japan
| | - Michael Bouvet
- b Department of Surgery , University of California , San Diego , CA , USA
| | - Itaru Endo
- c Department of Gastroenterological Surgery , Graduate School of Medicine, Yokohama City University , Yokohama , Japan
| | - Fritz C Eilber
- f Division of Surgical Oncology , University of California , Los Angeles , CA , USA
| | - Robert M Hoffman
- a AntiCancer, Inc. , San Diego , CA , USA.,b Department of Surgery , University of California , San Diego , CA , USA
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24
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Igarashi K, Kawaguchi K, Kiyuna T, Murakami T, Miwa S, Nelson SD, Dry SM, Li Y, Singh A, Kimura H, Hayashi K, Yamamoto N, Tsuchiya H, Eilber FC, Hoffman RM. Patient-derived orthotopic xenograft (PDOX) mouse model of adult rhabdomyosarcoma invades and recurs after resection in contrast to the subcutaneous ectopic model. Cell Cycle 2017; 16:91-94. [PMID: 27830986 PMCID: PMC5270546 DOI: 10.1080/15384101.2016.1252885] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 10/19/2016] [Indexed: 12/21/2022] Open
Abstract
Rhabdomyosarcoma (RMS) is a rare mesenchymal tumor. The aim of the present study was to develop a patient-derived orthotopic xenograft (PDOX) mouse model of RMS and compare the PDOX model to a subcutaneous (s.c.)-transplant model. A patient RMS from a striated muscle was grown orthotopically in the right biceps femoris muscle and right quadriceps muscle of nude mice to establish a PDOX model, as well as under the skin to establish an s.c. MODEL PDOX tumors grew at a statistically-significant faster rate compared to the s.c. tumors. Recurrence after surgical resection occurred only in PDOX tumors, not in the s.c. MODEL Histologically, only the PDOX model was shown to be invasive. In conclusion, these results indicate that the PDOX model of adult RMS is malignant and the subcutaneous model is benign. These results emphasize that a proper tumor microenvironment is necessary for patient-like behavior of a tumor in a mouse model.
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Affiliation(s)
- Kentaro Igarashi
- a AntiCancer, Inc. , San Diego , CA , USA
- b Department of Surgery , University of California , San Diego , CA , USA
- c Department of orthopedic Surgery , Kanazawa University , Kanazawa , Japa
| | - Kei Kawaguchi
- a AntiCancer, Inc. , San Diego , CA , USA
- b Department of Surgery , University of California , San Diego , CA , USA
| | - Tasuku Kiyuna
- a AntiCancer, Inc. , San Diego , CA , USA
- b Department of Surgery , University of California , San Diego , CA , USA
| | - Takashi Murakami
- a AntiCancer, Inc. , San Diego , CA , USA
- b Department of Surgery , University of California , San Diego , CA , USA
| | - Shinji Miwa
- c Department of orthopedic Surgery , Kanazawa University , Kanazawa , Japa
| | - Scott D Nelson
- d Department of Pathology , University of California , Los Angeles , CA , USA
| | - Sarah M Dry
- d Department of Pathology , University of California , Los Angeles , CA , USA
| | - Yunfeng Li
- d Department of Pathology , University of California , Los Angeles , CA , USA
| | - Arun Singh
- e Division of Hematology-Oncology, University of California , Los Angeles , CA , USA
| | - Hiroaki Kimura
- c Department of orthopedic Surgery , Kanazawa University , Kanazawa , Japa
| | - Katsuhiro Hayashi
- c Department of orthopedic Surgery , Kanazawa University , Kanazawa , Japa
| | - Norio Yamamoto
- c Department of orthopedic Surgery , Kanazawa University , Kanazawa , Japa
| | - Hiroyuki Tsuchiya
- c Department of orthopedic Surgery , Kanazawa University , Kanazawa , Japa
| | - Fritz C Eilber
- f Division of Surgical Oncology, University of California , Los Angeles , CA , USA
| | - Robert M Hoffman
- a AntiCancer, Inc. , San Diego , CA , USA
- b Department of Surgery , University of California , San Diego , CA , USA
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