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Kong F, Zhao L, Wang N, Zhang D, Wang Z, Mei Q, Yu Y, Jia Y. The FJQR Has Synergistic Effect with Fluoropyrimidine in the Maintenance Treatment for HER-2 Negative Gastric Cancer. Recent Pat Anticancer Drug Discov 2024; 19:165-175. [PMID: 38214356 DOI: 10.2174/1574892818666230522161742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 02/26/2023] [Accepted: 04/05/2023] [Indexed: 01/13/2024]
Abstract
INTRODUCTION Maintenance therapy aimed to strengthen the first-line chemotherapy and improve quality of life is needed for gastric cancer (GC). Currently, many clinical studies have confirmed the important role of fluoropyrimidine in the maintenance stage. Our team has created patented prescriptions "Fuzheng jiedu Quyu Method" recipe (FJQR), which was considered as an adjuvant therapeutic scheme (reduce toxicity and increase the efficacy of chemotherapy). This study aimed to evaluate the efficacy and safety of FJQR combined with fluoropyrimidine as a maintenance treatment in HER-2 negative GC patients. METHODS We performed the analysis of 129 patients with HER-2 negative GC who entered the maintenance stage in our hospital and Tianjin Cancer Hospital between January 2018 and December 2020. Out of the 129 eligible patients, 64 were categorized into the maintenance treatment group with FJQR+fluoropyrimidine, and 65 patients were assigned to the control group if they received fluoropyrimidine alone. Capecitabine was orally 1000mg/m2, Qd, half an hour after meals, and FGQR was 15g Bid after capecitabine. The primary endpoint was progression-free survival (PFS). The secondary endpoints were overall survival (OS), overall remission rate (ORR), quality of Life (QOL), TCM syndrome and safety. RESULTS The mPFS in the treatment group was significantly prolonged compared with the control group (6.3 vs. 5.0 months, p = 0.03), while the mOS was not substantially improved (11.4 vs. 10.5 months, p = 0.38). Gastrointestinal symptoms and pain became better in the treatment group. The number of distant metastatic organs, first-line chemotherapy cycles, and lymph node metastasis were independent risk predictors for PFS. Blood stasis syndrome may be the protective factor. In terms of safety, treatment-related adverse events (AEs) in the treatment group were relatively lighter, and the incidence of grade III-IV AEs could be significantly reduced. CONCLUSION FJQR and fluoropyrimidine have synergistic effects as maintenance treatment in HER-2 negative GC, with good efficacy and safety.
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Affiliation(s)
- Fanming Kong
- Department of Oncology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Nankai District, 300193, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, 300193, Tianjin, China
| | - Lu Zhao
- Department of Oncology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Nankai District, 300193, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, 300193, Tianjin, China
| | - Na Wang
- Department of Oncology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Nankai District, 300193, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, 300193, Tianjin, China
| | - Dou Zhang
- Department of Oncology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Nankai District, 300193, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, 300193, Tianjin, China
| | - Ziwei Wang
- Department of Oncology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Nankai District, 300193, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, 300193, Tianjin, China
| | - Qingyun Mei
- Department of Oncology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Nankai District, 300193, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, 300193, Tianjin, China
| | - Yongchao Yu
- Department of Oncology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Nankai District, 300193, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, 300193, Tianjin, China
| | - Yingjie Jia
- Department of Oncology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Nankai District, 300193, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, 300193, Tianjin, China
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Yang J, Zhao S, Su J, Liu S, Wu Z, Ma W, Tang M, Wu J, Mao E, Han L, Liu M, Zhang J, Cao L, Shao J, Shang Y. Comprehensive genomic profiling reveals prognostic signatures and insights into the molecular landscape of colorectal cancer. Front Oncol 2023; 13:1285508. [PMID: 38023196 PMCID: PMC10680082 DOI: 10.3389/fonc.2023.1285508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 10/26/2023] [Indexed: 12/01/2023] Open
Abstract
Background Colorectal cancer (CRC) is a prevalent malignancy with diverse molecular characteristics. The NGS-based approach enhances our comprehension of genomic landscape of CRC and may guide future advancements in precision oncology for CRC patients. Method In this research, we conducted an analysis using Next-Generation Sequencing (NGS) on samples collected from 111 individuals who had been diagnosed with CRC. We identified somatic and germline mutations and structural variants across the tumor genomes through comprehensive genomic profiling. Furthermore, we investigated the landscape of driver mutations and their potential clinical implications. Results Our findings underscore the intricate heterogeneity of genetic alterations within CRC. Notably, BRAF, ARID2, KMT2C, and GNAQ were associated with CRC prognosis. Patients harboring BRAF, ARID2, or KMT2C mutations exhibited shorter progression-free survival (PFS), whereas those with BRAF, ARID2, or GNAQ mutations experienced worse overall survival (OS). We unveiled 80 co-occurring and three mutually exclusive significant gene pairs, enriched primarily in pathways such as TP53, HIPPO, RTK/RAS, NOTCH, WNT, TGF-Beta, MYC, and PI3K. Notably, co-mutations of BRAF/ALK, BRAF/NOTCH2, BRAF/CREBBP, and BRAF/FAT1 correlated with worse PFS. Furthermore, germline AR mutations were identified in 37 (33.33%) CRC patients, and carriers of these variants displayed diminished PFS and OS. Decreased AR protein expression was observed in cases with AR germline mutations. A four-gene mutation signature was established, incorporating the aforementioned prognostic genes, which emerged as an independent prognostic determinant in CRC via univariate and multivariate Cox regression analyses. Noteworthy BRAF and ARID2 protein expression decreases detected in patients with their respective mutations. Conclusion The integration of our analyses furnishes crucial insights into CRC's molecular characteristics, drug responsiveness, and the construction of a four-gene mutation signature for predicting CRC prognosis.
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Affiliation(s)
- Jinwei Yang
- Second Department of General Surgery, The First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
- Institute of Neuroscience, Kunming Medical University, Kunming, China
| | - Sihui Zhao
- Second Department of General Surgery, The First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Junyan Su
- Department of Scientific Research Projects, Beijing ChosenMed Clinical Laboratory Co. Ltd., Beijing, China
| | - Siyao Liu
- Department of Scientific Research Projects, Beijing ChosenMed Clinical Laboratory Co. Ltd., Beijing, China
| | - Zaozao Wu
- Second Department of General Surgery, The First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Wei Ma
- Institute of Neuroscience, Kunming Medical University, Kunming, China
| | - Ming Tang
- Department of Pathology, The First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Jingcui Wu
- Second Department of General Surgery, The First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Erdong Mao
- Second Department of General Surgery, The First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Li Han
- Department of Scientific Research Projects, Beijing ChosenMed Clinical Laboratory Co. Ltd., Beijing, China
| | - Mengyuan Liu
- Department of Scientific Research Projects, Beijing ChosenMed Clinical Laboratory Co. Ltd., Beijing, China
| | - Jiali Zhang
- Department of Scientific Research Projects, Beijing ChosenMed Clinical Laboratory Co. Ltd., Beijing, China
| | - Lei Cao
- Department of Scientific Research Projects, Beijing ChosenMed Clinical Laboratory Co. Ltd., Beijing, China
| | - Jingyi Shao
- Department of Reproductive Medicine, The First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Yun Shang
- Second Department of General Surgery, The First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
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Zhang Z, Lei Y, Wang D, Yang L, Lou C. Case Report: A case of advanced duodenal adenocarcinoma in complete remission after chemotherapy combined with targeted therapy and radiotherapy. Front Oncol 2022; 12:968110. [PMID: 36353566 PMCID: PMC9638098 DOI: 10.3389/fonc.2022.968110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 09/12/2022] [Indexed: 12/02/2022] Open
Abstract
Duodenal adenocarcinoma (DA) is an extremely rare and highly aggressive malignant tumor of the digestive system. Due to the lack of specific clinical characteristics, it is easy to misdiagnosis and miss diagnosis, and the lack of specific consensus and recommendation for treatment, so it often refers to stomach cancer and colorectal cancer. Now, we report a case of a patient with advanced DA who achieved complete remission (CR) after undergoing chemoradiotherapy combined with targeted therapy. The patient was pathologically diagnosed with DA after radical surgery in October 2020, and he failed to undergo adjuvant chemotherapy on time due to the COVID-19 outbreak. The patient found multiple lymph node liver and abdominal metastases 6 months after the operation. Considering the progression of the disease, XELOX regimen (oxaliplatin + capecitabine) chemotherapy was given for 1 cycle. After 1 cycle of treatment, the tumor markers remained elevated; the carcinoembryonic antigen (CEA) was 5.03 ng/ml (0–5 ng/ml), and the carbohydrate antigen 19-9 (CA19-9) was 747.30 U/ml (0–37 U/ml). The patient also developed intolerable capecitabine-related treatment-related adverse events (TRAEs), namely, hand–foot syndrome. For the above reasons, capecitabine was replaced as S-1 at cycle 2, and the chemotherapy regimen became SOX (oxaliplatin + S-1); bevacizumab injection was also added to the SOX regimen, and it was further treated regularly for 7 cycles with the regimen of SOX plus bevacizumab. Liver metastases showed a continuous narrowing trend throughout the treatment period; tumor markers also showed a downward trend. Finally, the patient achieved complete remission (CR) at cycle 7. After completion of chemotherapy, radiotherapy was administered to the resistant metastatic lymph nodes present in the patient’s abdominal cavity for a total of 10 times. However, the patient developed severe bone marrow suppression and obstructive jaundice during the course of radiotherapy and finally failed to complete the radiotherapy plan. Currently, the patient continued maintenance therapy with bevacizumab and S-1 and showed no recurrence or metastasis after review. In this case of advanced DA, we referred to both CRC and gastric cancer in the treatment regimen of the patient. At the same time, targeted drugs and radiotherapy were also added to the basis of chemotherapy, which has no clear consensus recommendation or case for reference in the treatment of advanced DA. Thankfully, the patient’s disease was controlled and remained stable after treatment with this regimen. Therefore, for patients with advanced DA who lack standardized treatment regimens and guidelines, the combination of chemotherapy with targeted therapy and radiotherapy may be one of the effective treatment modalities.
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Ramzy GM, Boschung L, Koessler T, Delucinge-Vivier C, Docquier M, McKee TA, Rubbia-Brandt L, Nowak-Sliwinska P. FOLFOXIRI Resistance Induction and Characterization in Human Colorectal Cancer Cells. Cancers (Basel) 2022; 14:4812. [PMID: 36230735 DOI: 10.3390/cancers14194812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 11/17/2022] Open
Abstract
FOLFOXIRI, i.e., the combination of folinic acid, 5-fluorouracil, oxaliplatin, and irinotecan, is a first-line treatment for colorectal carcinoma (CRC), yet non-personalized and aggressive. In this study, to mimic the clinical situation of patients diagnosed with advanced CRC and exposed to a chronic treatment with FOLFOXIRI, we have generated the CRC cell clones chronically treated with FOLFOXIRI. A significant loss in sensitivity to FOLFOXIRI was obtained in all four cell lines, compared to their treatment-naïve calls, as shown in 2D cultures and heterotypic 3D co-cultures. Acquired drug resistance induction was observed through morphometric changes in terms of the organization of the actin filament. Bulk RNA sequencing revealed important upregulation of glucose transporter family 5 (GLUT5) in SW620 resistant cell line, while in the LS174T-resistant cell line, a significant downregulation of protein tyrosine phosphatase receptor S (PTPRS) and oxoglutarate dehydrogenase-like gene (OGDHL). This acquired resistance to FOLFOXIRI was overcome with optimized low-dose synergistic drug combinations (ODCs) acting via the Ras-Raf-MEK-ERK pathway. The ODCs inhibited the cell metabolic activity in SW620 and LS174T 3Dcc, respectively by up to 82%.
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Riedesser JE, Ebert MP, Betge J. Precision medicine for metastatic colorectal cancer in clinical practice. Ther Adv Med Oncol 2022; 14:17588359211072703. [PMID: 35237350 PMCID: PMC8882813 DOI: 10.1177/17588359211072703] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 12/17/2021] [Indexed: 12/22/2022] Open
Abstract
Globally, metastatic colorectal cancer is one of the leading causes for cancer-related death. Treatment limited to conventional chemotherapeutics extended life for only a few months. However, advances in surgical approaches and medical treatment regimens have greatly increased survival, even leading to long-term remission in selected patients. Advances in multiomics analysis of tumors have built a foundation for molecular-targeted therapies. Furthermore, immunotherapies are on the edge of revolutionizing oncological practice. This review summarizes recent advances in the growing toolbox of personalized treatment for patients with metastatic colorectal cancer. We provide an overview of current multimodal therapy and explain novel immunotherapy and targeted therapy approaches in detail. We emphasize clinically relevant therapies, such as inhibitors of MAPK signaling, and give recommendations for clinical practice. Finally, we describe the potential predictive impact of molecular subtypes and provide an outlook on novel concepts, such as functional precision medicine.
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Affiliation(s)
- Julian E. Riedesser
- Junior Clinical Cooperation Unit Translational
Gastrointestinal Oncology and Preclinical Models, German Cancer Research
Center (DKFZ), Heidelberg, Germany
| | - Matthias P. Ebert
- Department of Medicine II, University Medical
Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim,
GermanyMannheim Cancer Center, University Medical Center Mannheim, Medical
Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Johannes Betge
- Junior Clinical Cooperation Unit Translational
Gastrointestinal Oncology and Preclinical Models, German Cancer Research
Center (DKFZ), Im Neuenheimer Feld 580, Heidelberg 69120, GermanyDKFZ-Hector
Cancer Institute at University Medical Center Mannheim, Mannheim,
Germany.Department of Medicine II, University Medical Center Mannheim,
Medical Faculty Mannheim, Heidelberg University, Mannheim, GermanyMannheim
Cancer Center, University Medical Center Mannheim, Medical Faculty Mannheim,
Heidelberg University, Mannheim, Germany
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Zhang T, Ning WW, Zhang J, Xu FJ, Wang XQ, Li ZB, Xie M. Nonylphenol regulates TL1A through the AhR/HDAC2/HNF4α pathway in endothelial cells to promote the angiogenesis of colorectal cancer. Toxicol Appl Pharmacol 2021; 436:115854. [PMID: 34974051 DOI: 10.1016/j.taap.2021.115854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 12/17/2021] [Accepted: 12/26/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Colorectal cancer (CRC) is one of the most malignant cancers worldwide. Nonylphenol (NP) is an endocrine-disruptor chemical and plays an important role in the development of cancers. However, the effects of NP on CRC remain unclear. In this study, we aimed to investigate the potential mechanisms of NP in the pathogenesis of CRC. METHODS The levels of AhR, TL1A and HDAC2 in CRC tissues and endothelial cells were assessed by RT-qPCR or western blot. CHIP and dual luciferase reporter assays were used to confirm the interaction between AhR and HDAC2, or HNF4α and TL1A. The CCK8, would healing and tube formation assays were conducted to evaluate the proliferation, migration and angiogenesis of HUVECs. Western blot determined HNF4α protein and HNF4α acetylation levels. The secreted TL1A protein was detected by ELISA. The angiogenesis-related factor CD31 was tested by IHC. RESULTS The expression level of AhR was significantly up-regulated in CRC tissues and endothelial cells. Moreover, NP activated the AhR pathway mediated colorectal endothelial cell angiogenesis and proliferation, while TL1A overexpression resisted these effects caused by NP. Besides, NP was found to modulate HNF4α deacetylation through AhR/HDAC2 to inhibit TL1A. Furthermore, in vivo experiments proved that NP regulated CRC growth and angiogenesis via AhR/HDAC2/HNF4α/TL1A axis. CONCLUSION This study revealed that NP promoted CRC growth and angiogenesis through AhR/HDAC2/HNF4α/TL1A pathway and could be a new therapeutic target for CRC treatment.
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Kim TW, Taieb J, Gurary EB, Lerman N, Cui K, Yoshino T. Olaparib with or without bevacizumab or bevacizumab and 5-fluorouracil in advanced colorectal cancer: Phase III LYNK-003. Future Oncol 2021; 17:5013-5022. [PMID: 34779646 DOI: 10.2217/fon-2021-0899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Oxaliplatin-based chemotherapy with a regimen such as FOLFOX with or without targeted therapy is a standard of care option for advanced colorectal cancer; however, long-term exposure to oxaliplatin is associated with cumulative toxicity. Growing evidence suggests maintenance therapy with a less intensive regimen after platinum-based induction therapy can provide continuing benefit with reduced toxicity. We describe the rationale and design of the Phase III LYNK-003 trial, which will evaluate the efficacy and safety of olaparib with or without bevacizumab compared with 5-fluoruracil plus bevacizumab in patients with unresectable or metastatic colorectal cancer that has not progressed on an induction course of FOLFOX plus bevacizumab. The primary end point is progression-free survival by independent central review; secondary end points include overall survival, objective response, duration of response and safety. Clinical trial registration: NCT04456699.
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Affiliation(s)
- Tae Won Kim
- Department of Oncology, Asan Medical Center, University of Ulsan, Seoul 05505, South Korea
| | - Julien Taieb
- Georges Pompidou European Hospital, SIRIC-CARPEM, Université de Paris, Paris 75015, France
| | - Ellen B Gurary
- Oncology Late Stage Development, Merck & Co., Inc., Kenilworth, NJ 07033, USA
| | - Nati Lerman
- Oncology Late Stage Development, Merck & Co., Inc., Kenilworth, NJ 07033, USA
| | - Karen Cui
- Late Development Oncology, Oncology R&D, AstraZeneca, Gaithersburg, MD 20878, USA
| | - Takayuki Yoshino
- Department of Gastrointestinal Medicine, National Cancer Center Hospital East, Kashiwa 277-8577, Japan
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Jin M, Zhang H, Yang J, Zheng Z, Liu K. Expression mode and prognostic value of FXYD family members in colon cancer. Aging (Albany NY) 2021; 13:18404-18422. [PMID: 34270462 PMCID: PMC8351680 DOI: 10.18632/aging.203290] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 06/29/2021] [Indexed: 12/13/2022]
Abstract
The FXYD gene family comprises seven members that encode a class of small-membrane proteins characterized by an FXYD motif and interact with Na+/K+-ATPase. Until now, the expression patterns and prognostic roles of the FXYD family in colon cancer (CC) have not been systematically reported. Gene expression, methylation, clinicopathological features and the prognoses of CC patients were obtained from The Cancer Genome Atlas (TCGA) database. The expression feature and prognostic values of FXYD members were identified. Gene set enrichment analysis (GSEA) was performed to explore the potential mechanism underlying the function of the FXYD family in CC. Tumor Immune Estimation Resource (TIMER) and CIBERSORT analysis were used to assess the correlations between FXYD family members and tumor immune infiltrating cells (TIICs). FXYD family members were differentially expressed in CC except for FXYD2. FXYD2, FXYD3 and FXYD4 were revealed as independent prognostic factors for recurrence, while FXYD3 and FXYD7 were identified as prognostic factors for survival according to univariate and multivariate analyses with Cox regression. GSEA revealed that FXYD family members were involved in complicated biological functions underlying cancer progression. TIMER and CIBERSORT analyses showed significant associations between FXYD family genes and TIICs. The present study comprehensively revealed the expression mode and prognostic value of FXYD members in CC, providing insights for further study of the FXYD family as potential clinical biomarkers in CC.
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Affiliation(s)
- Ming Jin
- The Affiliated Lihuili Hospital, Ningbo University, Ningbo, China
| | - Hui Zhang
- Department of Radiation Oncology, The Affiliated Lihuili Hospital, Ningbo University, Ningbo, China
| | - Jun Yang
- Ningbo Diagnostic Pathology Center, Ningbo, China
| | - Zhen Zheng
- Department of Radiation Oncology, The Affiliated Lihuili Hospital, Ningbo University, Ningbo, China
| | - Kaitai Liu
- Department of Radiation Oncology, The Affiliated Lihuili Hospital, Ningbo University, Ningbo, China
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Cainap C, Ungur RA, Bochis OV, Achimas P, Vlad C, Havasi A, Vidrean A, Farcas A, Tat T, Gherman A, Piciu A, Bota M, Constantin AM, Pop LA, Maniu D, Crisan O, Cioban CV, Balacescu O, Coza O, Balacescu L, Marta MM, Dronca E, Cainap S. Partnering bevacizumab with irinotecan as first line-therapy of metastatic colorectal cancer improves progression free survival-A retrospective analysis. PLoS One 2021; 16:e0248922. [PMID: 33909622 PMCID: PMC8081186 DOI: 10.1371/journal.pone.0248922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 03/08/2021] [Indexed: 12/24/2022] Open
Abstract
Colorectal cancer remains one of the most frequent malignancies (third place at both genders) worldwide in the last decade, owing to significant changes in modern dietary habits. Approximately half of the patients develop metastases during the course of their disease. The available therapeutic armamentarium is constantly evolving, raising questions regarding the best approach for improving survival. Bevacizumab remains one of the most widely used therapies for treating metastatic colorectal cancer and can be used after progression. This study aimed to identify the best chemotherapy partner for bevacizumab after progression. We performed a retrospective analysis of patients with metastatic colorectal cancer who were treated with bevacizumab as first- and second-line chemotherapy. Data were collected for 151 patients, 40 of whom were treated with double-dose bevacizumab after the first progression. The two standard chemotherapy regimens combined with bevacizumab were FOLFIRI/CAPIRI and FOLFOX4/CAPEOX. The initiation of first-line treatment with irinotecan-based chemotherapy improved progression-free survival and time to treatment failure but not overall survival. After the first progression, retreatment with the same regimen as that used in the induction phase was the best approach for improving overall survival (median overall survival: 46.5 vs. 27.0 months for the same vs. switched strategy, respectively). No correlations were observed between the dose intensity of irinotecan, oxaliplatin, 5-fluorouracil, or bevacizumab and the overall survival, progression-free survival in the first-/second-line treatment, and time to treatment failure. Interaction between an irinotecan-based regimen as a second-line treatment and double-dose bevacizumab after progression was associated with an improved overall survival (p = 0.06). Initiating systemic treatment with an irinotecan-based regimen in combination with bevacizumab improved the progression-free survival in the first-line treatment and time to treatment failure. In terms of overall survival, bevacizumab treatment after the first progression is better partnered with the same regimen as that used in the induction phase.
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Affiliation(s)
- Calin Cainap
- Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania
- Department of Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Rodica Ana Ungur
- Department of Medical Specialties, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
- * E-mail:
| | | | - Patriciu Achimas
- Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania
- Department of Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Catalin Vlad
- Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania
- Department of Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Andrei Havasi
- Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania
| | | | - Anca Farcas
- Department of Medical Specialties, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Tiberiu Tat
- Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania
| | - Alexandra Gherman
- Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania
- Department of Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Andra Piciu
- Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania
- Department of Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Madalina Bota
- Department of Mother and Child, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Anne-Marie Constantin
- Department of Morphological Sciences, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Laura Ancuta Pop
- Department of Molecular Sciences, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Dana Maniu
- Faculty of Physics, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Ovidiu Crisan
- Faculty of Pharmacy, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cosmin Vasile Cioban
- Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | | | - Ovidiu Coza
- Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania
- Department of Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | | | - Monica Mihaela Marta
- Department of Medical Education, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Eleonora Dronca
- Department of Molecular Sciences, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Simona Cainap
- Department of Mother and Child, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Căinap C, Bochiş OV, Vlad C, Popita R, Achimaş-Cadariu P, Havasi A, Vidrean A, Dranca A, Piciu A, Constantin AM, Tat T, Dana M, Crişan O, Cioban CV, Bălăcescu O, Coza O, Bălăcescu L, Marta MM, Bota M, Căinap S. Doubling the Dose of Bevacizumab Beyond Progression in Metastatic Colorectal Cancer-the Experience of a Tertiary Cancer Center. Front Pharmacol 2021; 12:487316. [PMID: 33776758 PMCID: PMC7991840 DOI: 10.3389/fphar.2021.487316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 01/20/2021] [Indexed: 12/27/2022] Open
Abstract
Background: Colorectal cancer (CRC) is the third most common cancer in Europe, with an annual increase in incidence ranging between 0.4 and 3.6% in various countries. Although the development of CRC was extensively studied, limited number of new therapies were developed in the last few years. Bevacizumab is frequently used as first- and second-line therapy for management of metastatic CRC (mCRC). The aim of this study is to present our experience with using bevacizumab beyond disease progression at different dosage levels in mCRC patients, in terms of overall survival, progression-free survival, time to treatment failure, and toxicities. Methods: We performed a consecutive retrospective analysis of patients with confirmed mCRC who were treated with bevacizumab at "Prof Dr. Ion Chiricuta" Institute of Oncology, Cluj-Napoca, Romania. We included patients who had received bevacizumab as first- or second-line therapy and further stratified them according to the dose administered as a second-line (either standard dose of 5 mg/kg every 2 weeks or 7.5 mg/kg every 3 weeks, or double dose of 10 mg/kg every 2 weeks or 15 mg/kg every 3 weeks–depending on the classical chemotherapy partner). All patients had received bevacizumab beyond progression (BYP) which is defined as continuing bevacizumab administration through second-line treatment despite disease progression. In each group, we evaluated the prognostic factors that influenced survival and treatment outcome. Results: One hundred and fifty-one (151) patients were included in the study. Themedian age of patients receiving double dose bevacizumab (DDB) and standard dose bevacizumab (SDB) was 58 years (range 41–71) and 57 years (range 19–75), respectively. The median overall survival in the DDB group was 41 months (range 27–49) compared to 25 months (range 23–29) in the SDB group (p = 0.01 log-rank test). First-line oxaliplatin-based treatment was used more frequently regardless of group, while irinotecan-based more frequently used as a second-line treatment (p = 0.014). Both oxaliplatin- and irinotecan-based regimens were found to be suitable partners for BYP. Statistical analysis revealed that dose intensity, primary tumor location, and cumulative exposure to BYP had significant influence on survival. Conclusion: Doubling the dose of bevacizumab after first progression may improve survival in mCRC patients. Increasing bevacizumab dose intensity could override the prognostic impact of primary tumor location in patients receiving double the dose of bevacizumab after first disease progression.
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Affiliation(s)
- Călin Căinap
- "Prof Dr Ion Chiricuta" Institute of Oncology, Cluj-Napoca, Romania.,Department of Oncology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | | | - Cătălin Vlad
- "Prof Dr Ion Chiricuta" Institute of Oncology, Cluj-Napoca, Romania.,Department of Oncology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Raluca Popita
- "Prof Dr Ion Chiricuta" Institute of Oncology, Cluj-Napoca, Romania.,Department of Surgical Specialities, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Patriciu Achimaş-Cadariu
- "Prof Dr Ion Chiricuta" Institute of Oncology, Cluj-Napoca, Romania.,Department of Oncology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Andrei Havasi
- "Prof Dr Ion Chiricuta" Institute of Oncology, Cluj-Napoca, Romania
| | - Andreea Vidrean
- "Prof Dr Ion Chiricuta" Institute of Oncology, Cluj-Napoca, Romania
| | - Alexandra Dranca
- "Prof Dr Ion Chiricuta" Institute of Oncology, Cluj-Napoca, Romania
| | - Andra Piciu
- "Prof Dr Ion Chiricuta" Institute of Oncology, Cluj-Napoca, Romania.,Department of Oncology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Anne-Marie Constantin
- Department of Morphological Sciences, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Tiberiu Tat
- "Prof Dr Ion Chiricuta" Institute of Oncology, Cluj-Napoca, Romania.,Department of Anesthesia and Intensive Care I, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Maniu Dana
- Faculty of Physics, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Ovidiu Crişan
- Faculty of Pharmacy, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cosmin Vasile Cioban
- Faculty of Dental Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ovidiu Bălăcescu
- "Prof Dr Ion Chiricuta" Institute of Oncology, Cluj-Napoca, Romania
| | - Ovidiu Coza
- "Prof Dr Ion Chiricuta" Institute of Oncology, Cluj-Napoca, Romania.,Department of Oncology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | | | - Monica Mihaela Marta
- Department of Medical Education, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Madalina Bota
- Department of Mother and Child, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Simona Căinap
- Department of Mother and Child, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
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11
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Fu X, Zhang Y, Chang L, Hui D, Jia R, Liu N, Zhang H, Han G, Han Z, Li Y, Liu H, Zhu H, Li Q. The JPJDF has Synergistic Effect with Fluoropyrimidine in the Maintenance Therapy for Metastatic Colorectal Cancer. Recent Pat Anticancer Drug Discov 2020; 15:257-269. [PMID: 32679021 DOI: 10.2174/1574892815666200717141205] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/20/2020] [Accepted: 06/24/2020] [Indexed: 02/07/2023]
Abstract
Background:
Maintenance chemotherapeutic regimen with low toxicity is needed for
metastatic colorectal cancer. A recent patent has been issued on the spleen-strengthening and detoxification
prescription (JPJDF), a traditional Chinese herbal medicinal formula with anti-angiogenesis
effect. The clinical effect of JPJDF on the maintenance treatment of advanced colorectal cancer
has not been evaluated.
Objective:
This study aims to evaluate the effectiveness and safety of JPJDF in combination with
fluoropyrimidine compared to fluoropyrimidine alone as maintenance therapy for metastatic colorectal
cancer.
Methods:
We applied a prospective, randomized, double-blinded, single center clinical study design.
A total of 137 patients with advanced colorectal cancer were recruited. Patients received either
Fluoropyrimidine (Flu-treated group, n = 68), or Fluoropyrimidine plus JPJDF (Flu-F-treated
group, n = 69) as maintenance treatment after 6-cycle of FOLFOX4 or FOLFORI induction treatment.
The primary endpoints were Progression-Free Survival (PFS) and Overall Survival (OS).
The secondary endpoints were safety, Performance Status (PS) score and other symptoms.
Results:
The endpoint of disease progression was observed in 91.7% of patients. The PFS was 5.0
months and 3.0 months in the Flu-F-treated and Flu-treated groups, respectively. The OS was 15.0
months and 9.0 months in the Flu-F-treated and Flu-treated groups, respectively. Some common
symptoms, such as hypodynamia, anepithymia, dizziness and tinnitus and shortness of breath, were
improved in the Flu-F-treated group. There was no significant difference in the common adverse reactions
between the two groups.
Conclusion:
JPJDF and fluoropyrimidine have synergistic effect in the maintenance treatment of
mCRC.
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Affiliation(s)
- Xiaoling Fu
- Department of Oncology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, No. 110, Ganhe Road, Shanghai 200437, China
| | - Yanbo Zhang
- Department of Oncology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, No. 528, Zhangheng Road, Shanghai 201203, China
| | - Lisheng Chang
- Department of Oncology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, No. 528, Zhangheng Road, Shanghai 201203, China
| | - Dengcheng Hui
- Department of Oncology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, No. 528, Zhangheng Road, Shanghai 201203, China
| | - Ru Jia
- Department of Oncology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, No. 528, Zhangheng Road, Shanghai 201203, China
| | - Ningning Liu
- Department of Oncology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, No. 528, Zhangheng Road, Shanghai 201203, China
| | - Huayue Zhang
- Department of Oncology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, No. 110, Ganhe Road, Shanghai 200437, China
| | - Gang Han
- Department of Surgery, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, No. 528, Zhangheng Road, Shanghai 201203, China
| | - Zhifen Han
- Department of Oncology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, No. 528, Zhangheng Road, Shanghai 201203, China
| | - Yuan Li
- Department of Oncology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, No. 110, Ganhe Road, Shanghai 200437, China
| | - Hui Liu
- Department of Oncology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, No. 528, Zhangheng Road, Shanghai 201203, China
| | - Huirong Zhu
- Department of Oncology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, No. 528, Zhangheng Road, Shanghai 201203, China
| | - Qi Li
- Department of Oncology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, No. 528, Zhangheng Road, Shanghai 201203, China
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12
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Ilan Y, Spigelman Z. Establishing patient-tailored variability-based paradigms for anti-cancer therapy: Using the inherent trajectories which underlie cancer for overcoming drug resistance. Cancer Treat Res Commun 2020; 25:100240. [PMID: 33246316 DOI: 10.1016/j.ctarc.2020.100240] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/30/2020] [Accepted: 11/16/2020] [Indexed: 06/11/2023]
Abstract
Drug resistance is a major obstacle for successful therapy of many malignancies and is affecting the loss of response to chemotherapy and immunotherapy. Tumor-related compensatory adaptation mechanisms contribute to the development of drug resistance. Variability is inherent to biological systems and altered patterns of variability are associated with disease conditions. The marked intra and inter patient tumor heterogeneity, and the diverse mechanism contributing to drug resistance in different subjects, which may change over time even in the same patient, necessitate the development of personalized dynamic approaches for overcoming drug resistance. Altered dosing regimens, the potential role of chronotherapy, and drug holidays are effective in cancer therapy and immunotherapy. In the present review we describe the difficulty of overcoming drug resistance in a dynamic system and present the use of the inherent trajectories which underlie cancer development for building therapeutic regimens which can overcome resistance. The establishment of a platform wherein patient-tailored variability signatures are used for overcoming resistance for ensuing long term sustainable improved responses is presented.
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Affiliation(s)
- Yaron Ilan
- Department of Medicine, Hebrew University-Hadassah Medical Center, Jerusalem, Israel.
| | - Zachary Spigelman
- Department of Hematology and Oncology, Lahey Hospital and Beth Israel Medical Center, MA, USA
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13
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Chevalier H, Vienot A, Lièvre A, Edeline J, El Hajbi F, Peugniez C, Vernerey D, Meurisse A, Hammel P, Neuzillet C, Borg C, Turpin A. FOLFIRINOX De-Escalation in Advanced Pancreatic Cancer: A Multicenter Real-Life Study. Oncologist 2020; 25:e1701-e1710. [PMID: 32886823 DOI: 10.1634/theoncologist.2020-0577] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 08/06/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Our study describes the feasibility and efficacy of a first-line FOLFIRINOX (5-fluorouracil [5FU], folinic acid, irinotecan, and oxaliplatin) induction chemotherapy (CT) followed by de-escalation as a maintenance strategy for advanced pancreatic cancer. MATERIALS AND METHODS This multicenter retrospective study was conducted from January 2011 to December 2018. FOLFIRINOX de-escalation was defined as stopping oxaliplatin and/or irinotecan after at least four cycles of FOLFIRINOX, without evidence of disease progression. Maintenance schedules were fluoropyrimidine monotherapy (intravenous or oral [capecitabine]), FOLFOX (5FU, oxaliplatin), or FOLFIRI (5FU, irinotecan). Primary endpoint was overall survival (OS). Secondary endpoints were first progression-free survival (PFS1), second progression-free survival (PFS2), and toxicity. RESULTS Among 321 patients treated with FOLFIRINOX, 147 (45.8%) were included. Median OS was 16.1 months (95% confidence interval [CI], 13.7-20.3) and median PFS1 was 9.4 months (95% CI, 8.5-10.4). The preferred maintenance regimen was FOLFIRI in 66 (45%) patients versus 5FU monotherapy in 52 (35%) and FOLFOX in 25 (17%) patients. Among 118 patients who received maintenance CT with FOLFIRI or 5FU, there was no difference in PFS1 (median, 9.0 vs. 10.1 months, respectively; p = .33) or OS (median, 16.6 vs. 18.7 months; p = .86) between the two maintenance regimens. Reintroduction of FOLFIRINOX was performed in 20.2% of patients, with a median PFS2 of 2.8 months (95% CI, 2.0-22.3). The rates of grade 3-4 toxicity were significantly higher with FOLFIRI maintenance CT than with 5FU (41% vs. 22%; p = .03), especially for neuropathy (73% vs. 9%). CONCLUSION 5FU monotherapy maintenance appeared to be as effective as FOLFIRI, in a FOLFIRINOX de-escalation strategy, which is largely used in France. IMPLICATIONS FOR PRACTICE FOLFIRINOX de-escalation and maintenance is a feasible strategy in advanced pancreatic cancer that decreases chemotherapy toxicity to improve both survival and quality of life. Survivals in patients with maintenance therapy are clinically meaningful. Fluoropyrimidine monotherapy maintenance seems to be as efficient as FOLFIRI and should be a reference arm in future pancreatic cancer maintenance trials.
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Affiliation(s)
| | - Angélique Vienot
- Department of Medical Oncology, Besançon University Hospital, Besançon, France
- Oncology Multidisciplinary Research Group (GERCOR), Paris, France
| | - Astrid Lièvre
- Chemistry Oncogenesis Stress Signaling (COSS), Unité Mixte de Recherche (UMR)_S 1242, Department of Gastroenterology, Rennes University Hospital
| | - Julien Edeline
- Oncology Department, Cancer Institute Eugène Marquis, Rennes 1 University
- Nutrition, Metabolism, and Cancer (NuMeCan), Institut National de la Recherche Agronomique (INRA), INSERM, Rennes 1 University, Rennes, France
| | - Farid El Hajbi
- Department of Medical Oncology, Oscar Lambret Center, Lille, France
| | - Charlotte Peugniez
- Department of Medical Oncology, Saint Vincent de Paul Hospital, Lille, France
| | - Dewi Vernerey
- Methodological and Quality of Life in Oncology Unit, EA 3181, Besançon University Hospital, Besançon, France
- Oncology Multidisciplinary Research Group (GERCOR), Paris, France
| | - Aurélia Meurisse
- Methodological and Quality of Life in Oncology Unit, EA 3181, Besançon University Hospital, Besançon, France
| | - Pascal Hammel
- Oncology Multidisciplinary Research Group (GERCOR), Paris, France
- Department of Digestive Oncology, Beaujon University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Clichy, France
- University Paris 7, Denis Diderot, Clichy, France
| | - Cindy Neuzillet
- Oncology Multidisciplinary Research Group (GERCOR), Paris, France
- Department of Medical Oncology, Curie Institute, Versailles Saint-Quentin University, Saint Cloud, France
| | - Christophe Borg
- Department of Medical Oncology, Besançon University Hospital, Besançon, France
- Oncology Multidisciplinary Research Group (GERCOR), Paris, France
| | - Anthony Turpin
- Oncology Multidisciplinary Research Group (GERCOR), Paris, France
- Department of Medical Oncology, Lille University Hospital, Lille, France
- UMR9020 - UMR-S 1277 - Canther - Cancer Heterogeneity, Plasticity, and Resistance to Therapies, Institut Pasteur de Lille, CNRS, INSERM, Centre Hospitalier Universitaire (CHU) Lille, Lille University, Lille, France
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14
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Onodera R, Nihei S, Kimura T, Tomita T, Kudo K. Severe proteinuria during the administration of bevacizumab plus mFOLFOX6 in a colorectal cancer patient after kidney transplantation: a case report. J Pharm Health Care Sci 2020. [DOI: 10.1186/s40780-020-00175-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Bevacizumab (BEV) leads to proteinuria and renal damage. It is not clear whether the administration of immunosuppressive drugs after renal transplantation affects the safety of BEV administration. We report a case of severe proteinuria caused by BEV plus 5-fluorouracil, levofolinate, and oxaliplatin (mFOLFOX6) in a patient who had previously undergone kidney transplantation and the administration of tacrolimus.
Case presentation
The patient was a 67-year-old man with a history of diabetes and hypertension. He developed chronic renal failure 14 years earlier and underwent right kidney transplantation from a living donor followed by the administration of tacrolimus and mycophenolate mofetil for immunosuppression. After kidney transplantation, the patient was diagnosed with colorectal cancer with multiple lung and liver metastases and received BEV plus mFOLFOX6. After 5 cycles, proteinuria was observed, with a urinary protein concentration of > 300 mg/dL (urine protein creatinine ratio: 3.5), and after 16 cycles, the urinary protein concentration was > 1000 mg/dL (urine protein creatinine ratio: 7.1). Subsequently, BEV was discontinued, and only mFOLFOX6 administration was continued. Tacrolimus continued to be administered during chemotherapy. There was no association between serum tacrolimus concentration and proteinuria.
Conclusions
In this case, BEV administration caused severe proteinuria without affecting blood levels of tacrolimus. Patients with risk factors for renal impairment should be carefully evaluated for the risks and benefits of BEV administration.
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15
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Hu H, Liu X, Cai W, Wu D, Xu J, Yuan Y. A Retrospective Exploration of Targeted Maintenance Therapy in Advanced Colorectal Cancer: Based on the Background of Chinese Patient Assistance Program. Front Oncol 2020; 10:522. [PMID: 32391263 PMCID: PMC7190810 DOI: 10.3389/fonc.2020.00522] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 03/23/2020] [Indexed: 01/04/2023] Open
Abstract
Background: Maintenance therapy with bevacizumab (Bev) in patients with colorectal cancer (CRC) provides progression-free survival (PFS) benefits. However, the role of maintenance therapy with an anti-EGFR monoclonal antibody has not been established. Methods: Eligible CRC patients were assigned to maintenance therapy with cetuximab (Cet; Cet group) or Bev (Bev group). PFS, the duration of maintenance therapy, and safety were analyzed. Cox multivariate regression analyses were performed to determine independent prognostic factors. Results: A total of 143 eligible patients were assigned to the Cet (n = 79) or Bev (n = 64) groups. In the Cet group, all patients had KRAS wild-type. The baseline characteristics were well-balanced between the two groups, except for a higher percentage of patients with a left-sided primary tumor in the Cet group than in the Bev group (86.1 vs. 62.5%, P < 0.0001). The median PFS was not significantly different between the Cet group and the Bev group: 5.9 months (95% CI 2.30–9.50) vs. 7.0 months (95% CI 3.69–10.31) (HR 1.17, 95% CI 0.77–1.79, P = 0.45). The median duration of maintenance therapy in the Cet group was shorter than that in the Bev group: 4.0 months (95% CI 1.94–5.99) vs. 4.8 months (95% CI 2.68–6.98) (HR 0.90, 95% CI 0.61–1.33; P = 0.59). The subgroup analyses showed that the median PFS for the first maintenance therapy and the second maintenance therapy were 3.2 months (95% CI 1.69–4.78) and 5.2 months (95% CI 1.58–8.83), respectively (HR 0.89, 95% CI 0.44–1.81; P = 0.75). Conclusions: This study suggests that maintenance therapy with Cet or Bev can be considered an appropriate option following induction chemotherapy for selected patients with advanced CRC. Multiple maintenance therapy seems to confer survival benefits in advanced CRC. Maintenance therapy with Cet after first-line induction chemotherapy seems to be associated with greater survival benefits.
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Affiliation(s)
- Hanguang Hu
- Departments of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xue Liu
- Departments of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wen Cai
- Departments of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Dehao Wu
- Cancer Institute (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Junxi Xu
- Departments of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ying Yuan
- Departments of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Cancer Institute (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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16
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Rajagopal T, Talluri S, Akshaya R, Dunna NR. HOTAIR LncRNA: A novel oncogenic propellant in human cancer. Clin Chim Acta 2020; 503:1-18. [DOI: 10.1016/j.cca.2019.12.028] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 12/27/2019] [Accepted: 12/30/2019] [Indexed: 02/08/2023]
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17
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Ren L, Zhu D, Benson AB, Nordlinger B, Koehne CH, Delaney CP, Kerr D, Lenz HJ, Fan J, Wang J, Gu J, Li J, Shen L, Tsarkov P, Tejpar S, Zheng S, Zhang S, Gruenberger T, Qin X, Wang X, Zhang Z, Poston GJ, Xu J. Shanghai international consensus on diagnosis and comprehensive treatment of colorectal liver metastases (version 2019). Eur J Surg Oncol 2020; 46:955-966. [PMID: 32147426 DOI: 10.1016/j.ejso.2020.02.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 02/17/2020] [Indexed: 12/17/2022] Open
Abstract
The liver is the most common anatomical site for hematogenous metastases from colorectal cancer. Therefore effective treatment of liver metastases is one of the most challenging elements in the management of colorectal cancer. However, there is rare available clinical consensus or guideline only focusing on colorectal liver metastases. After six rounds of discussion by 195 clinical experts of the Shanghai International Consensus Expert Group on Colorectal Liver Metastases (SINCE) from 29 countries or regions, the Shanghai Consensus has been finally completed, based on current research and expert experience. The consensus emphasized the principle of multidisciplinary team, provided detailed diagnosis approaches, and guided precise local and systemic treatments. This Shanghai Consensus might be of great significance to standardized diagnosis and treatment of colorectal liver metastases all over the world.
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Affiliation(s)
- Li Ren
- Department of Colorectal Surgery, Colorectal Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Dexiang Zhu
- Department of Colorectal Surgery, Colorectal Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Al B Benson
- Division of Hematology/Oncology, Northwestern Medical Group, Chicago, USA
| | - Bernard Nordlinger
- Surgery Department, Hospital Ambroise-Pare, Boulogne-Billancourt, France
| | | | - Conor P Delaney
- Department of Colorectal Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - David Kerr
- Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Heinz-Josef Lenz
- Division of Medical Oncology, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jia Fan
- Department of Liver Surgery and Transplantation, Liver Cancer Institute, Zhongshan Hospital, Key Laboratory of Carcinogenesis and Cancer Invasion of Ministry of Education, Fudan University, Shanghai, China
| | - Jianping Wang
- Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jin Gu
- Department of Colorectal Surgery, Peking University Cancer Hospital, Beijing, China; Department of Colorectal Surgery, Peking University Shougang Hospital, Beijing, China
| | - Jin Li
- Department of Oncology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Lin Shen
- Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis and Translational Research, Peking University Cancer Hospital and Institute, Beijing, China
| | - Petrv Tsarkov
- Clinic of Colorectal and Minimally Invasive Surgery, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Sabine Tejpar
- Department of Gastroenterology, University Hospitals Leuven, Leuven, Belgium
| | - Shu Zheng
- Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Suzhan Zhang
- Department of Surgical Oncology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | | | - Xinyu Qin
- Department of Colorectal Surgery, Colorectal Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xishan Wang
- Department of Colorectal Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhongtao Zhang
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center of Digestive Diseases, Beijing, China
| | - Graeme John Poston
- Surgery Department, Aintree University Hospital, School of Translational Studies, University of Liverpool, Liverpool, UK.
| | - Jianmin Xu
- Department of Colorectal Surgery, Colorectal Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, China.
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18
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Liu X, Chu Y, Wang D, Weng Y, Jia Z. MAPK-mediated upregulation of fibrinogen-like protein 2 promotes proliferation, migration, and invasion of colorectal cancer cells. Cell Biol Int 2019; 43:1483-1491. [PMID: 31286589 DOI: 10.1002/cbin.11198] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 07/05/2019] [Indexed: 01/24/2023]
Abstract
Fibrinogen-like protein 2 (FGL2) has been reported to play a key role in the development of human cancers. However, it is still unmasked whether FGL2 plays a potential role in colorectal carcinogenesis. In this study, the messenger RNA and protein expression levels were measured by quantitative real-time polymerase chain reaction and western blot. Cell counting kit-8 assay, transwell migration, and invasion assay were carried out to evaluate the proliferation, migration, and invasion of LOVO and SW620 cells. FGL2 was upregulated in colorectal cancer (CRC) tissues, as well as cell lines. Mitogen-activated protein kinase (MAPK) signaling was activated in CRC tissues and cell lines. FGL2 was confirmed to be downregulated by MAPK signaling inhibitor U0126. Further, we determined that knockdown of FGL2 caused a reduction of proliferation, migration, and invasion in LOVO and SW620 cells. Consistently, treatment of LOVO and SW620 cells with U0126 led to a decrease in cell proliferation, migration, and invasion. However, these changes initiated by U0126 were abolished by FGL2 overexpression. To conclude, MAPK-mediated upregulation of FGL2 promotes the proliferation, migration, and invasion of CRC cells.
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Affiliation(s)
- Xiaochuan Liu
- Department of Gastroenterology, Meitan General Hospital, 100028 Peking, China
| | - Yunxiang Chu
- Department of Gastroenterology, Meitan General Hospital, 100028 Peking, China
| | - Dongsheng Wang
- Department of Gastroenterology, Meitan General Hospital, 100028 Peking, China
| | - Yan Weng
- Department of Gastroenterology, Meitan General Hospital, 100028 Peking, China
| | - Zhiwei Jia
- Department of Gastroenterology, Meitan General Hospital, 100028 Peking, China
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Ji X, Pang C, Tang Y, Teng Y, Li D, Ma H, Yang D, Wang D. Maintenance Versus Intermittent Strategies in the Treatment of Metastatic Colorectal Cancer: A Meta-Analysis from Another Angle. Adv Ther 2019; 36:2838-2848. [PMID: 31432462 DOI: 10.1007/s12325-019-01059-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Considering the differences in overall survival (OS) and progression-free survival (PFS), treatment options for metastatic colorectal cancer (mCRC) are still inconclusive. We carried out a meta-analysis of maintenance and intermittent strategies for the treatment of mCRC aiming at providing an accurate estimation of different treatments in increasing the chance and duration of survival. METHODS PubMed, Embase and CNKI were systematically searched. The pooled hazard ratio (HR) and 95% confidence interval (CI) were counted. We used STATA 12.0 and RevMan 5.2 for statistical analyses. RESULTS A total of six publications with a population of 1975 mCRC patients were included in our meta-analysis. Analysis of OS revealed a statistically significant benefit associated with maintenance therapy (HR: 0.86, 95% CI 0.75-0.98, P = 0.02). Comparing maintenance therapy with an intermittent strategy, the first progression-free survival (PFS1) showed no significant difference (HR, 0.77; 95% CI 0.48-1.24, P = 0.29), but maintenance therapy improved the second progression-free survival (PFS2) significantly (HR, 0.66; 95% CI 0.54-0.81, P < 0.001). Sensitivity analysis was carried out to assess the stability of results. No publication bias was detected during analysis. CONCLUSION Compared with the maintenance strategy, first-line chemotherapy that was completely stopped until disease progression did not benefit mCRC patients in terms of OS and PFS2. Therefore, a maintenance strategy is a good option for individualized mCRC patients.
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Affiliation(s)
- Xiaohui Ji
- Chongqing University Cancer Hospital and Chongqing Cancer Institute and Chongqing Cancer Hospital and Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing, 400030, China.
| | - Caishuang Pang
- Graduate School of Chongqing Medical University, NO. 1, Medical School Road, Chongqing, 400016, China
| | - Ying Tang
- Chongqing University Cancer Hospital and Chongqing Cancer Institute and Chongqing Cancer Hospital and Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing, 400030, China
| | - Yan Teng
- Chongqing University Cancer Hospital and Chongqing Cancer Institute and Chongqing Cancer Hospital and Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing, 400030, China
| | - Dairong Li
- Chongqing University Cancer Hospital and Chongqing Cancer Institute and Chongqing Cancer Hospital and Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing, 400030, China
| | - Huiwen Ma
- Chongqing University Cancer Hospital and Chongqing Cancer Institute and Chongqing Cancer Hospital and Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing, 400030, China
| | - Dan Yang
- Chongqing University Cancer Hospital and Chongqing Cancer Institute and Chongqing Cancer Hospital and Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing, 400030, China
| | - Donglin Wang
- Chongqing University Cancer Hospital and Chongqing Cancer Institute and Chongqing Cancer Hospital and Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing, 400030, China
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Abstract
Image-guided ablation is performed by percutaneously introducing ablation probes to deliver energy into a tumor to destroy it in a controlled and localized fashion. Ablation modalities can be broadly classified as thermal or non-thermal based on the mechanism of tumor destruction and are performed using different types of image guidance for planning, delivering and follow-up of the treatment. Ablation is performed in a minimally invasive fashion, providing greater residual organ preservation with minimal morbidity to the patient. Image-guided ablation is being used in the clinic for the treatment of primary and metastatic tumors, and this article reviews state of the art for the treatment of malignancies in the liver, lung, kidney and musculoskeletal tissue.
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Affiliation(s)
- Fourat Ridouani
- Memorial Sloan Kettering Cancer Center, Department of Radiology, New York, USA
| | - Govindarajan Srimathveeravalli
- University of Massachusetts, Institute for Applied Life Sciences, Department of Mechanical and Industrial Engineering, Amherst, USA.
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Ren Y, Zhao C, He Y, Xu H, Min X. Long non-coding RNA bladder cancer-associated transcript 2 contributes to disease progression, chemoresistance and poor survival of patients with colorectal cancer. Oncol Lett 2019; 18:2050-2058. [PMID: 31423277 DOI: 10.3892/ol.2019.10487] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 02/20/2019] [Indexed: 12/27/2022] Open
Abstract
Colorectal cancer (CRC) is one of the leading causes of cancer-associated mortality worldwide. Long non-coding RNAs (lncRNAs) have been revealed to modulate various biological cell processes, and are involved in the initiation and progression of different diseases, including CRC. However, the role of lncRNA bladder cancer-associated transcript 2 (BLACAT2) in CRC has not been defined. The present study aimed to investigate the role of BLACAT2 in CRC. The present study measured the expression levels of BLACAT2 in CRC cells and tissues by reverse-transcription-quantitative polymerase chain reaction, and associations among BLACAT2 expression levels, important clinicopathological parameters and patient survival were statistically evaluated. The functional role of BLACAT2 in metastasis, proliferation and drug resistance was also detected. BLACAT2 was overexpressed in CRC cells and tissues, and high BLACAT2 expression was associated with larger tumor size, and more advanced lymph node (N), metastasis (M) and tumor-NM stages. Additionally, survival analysis demonstrated that patients with high BLACAT2 expression exhibited poor overall survival. Notably, high BLACAT2 expression was identified as an independent risk factor for overall survival. Migration and invasion assays revealed that BLACAT2 promoted migration and invasion, respectively. In addition, overexpression of BLACAT2 increased colony numbers and optical density values of CRC cells in a colony formation assay and an MTT assay, respectively. Furthermore, BLACAT2 levels were significantly increased in 5-fluorouracil-resistant cells, and overexpression of BLACAT2 was markedly associated with a low cell inhibition rate. In conclusion, BLACAT2 overexpression may contribute to the metastasis, proliferation and chemoresistance of CRC cells, and high BLACAT2 expression may be a promising prognostic marker for patients with CRC.
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Affiliation(s)
- Yongjun Ren
- Department of Interventional Radiology, Sichuan Key Laboratory of Medical Imaging, The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
| | - Caixia Zhao
- Department of Oncology, Nanchong Central Hospital, Nanchong, Sichuan 637000, P.R. China
| | - Yi He
- Department of Gastrointestinal Surgery, The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
| | - Hao Xu
- Department of Interventional Radiology, Sichuan Key Laboratory of Medical Imaging, The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
| | - Xuli Min
- Department of Interventional Radiology, Sichuan Key Laboratory of Medical Imaging, The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
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Rebersek M, Mesti T, Boc M, Ocvirk J. Molecular biomarkers and histological parameters impact on survival and response to first- line systemic therapy of metastatic colorectal cancer patients. Radiol Oncol 2019; 53:85-95. [PMID: 30840593 PMCID: PMC6411021 DOI: 10.2478/raon-2019-0013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 09/20/2018] [Indexed: 12/27/2022] Open
Abstract
Background Histological parameters of primary tumour and nodal metastases are prognostic factors for survival of operable colorectal (CRC) patients, but not predictive for response rate of systemic therapy. KRAS mutations in codons 12 and 13 were first recognized as a predictive factor for resistance to anti-EGFR monoclonal antibodies. Not all patients with wild-type KRAS (wtKRAS) respond to anti-EGFR antibody treatment. Additional mechanisms of resistance may activate mutations of the other main EGFR effectors pathway, such as other mutations in RAS gene, mutations in P13K and PTEN expression. Patients and methods In the prospective study prognostic and predictive impact of histological parameters of primary tumour, KRAS and BRAF mutations on overall survival (OS) and objective response (OR) rate of metastatic CRC (mCRC) patients treated with 1st line systemic therapy were analysed. We additionally retrospectively analysed other mutations in RAS genes and their impact on survival and time to progression. Results From November 2010 to December 2012, we enrolled 154 patients in the study, 95 men and 59 women. Mutations in KRAS gene and V600E BRAF gene were found in 42% and in 3% of patients, respectively. Median OS of the patients with T1, T2 and T3 tumour was 65.4 months (95% CI, 55.7-75.6) while in patients with T4 tumour, lymphangiosis, vascular and perineural invasion it has not been reached yet. Median OS of the patients with G1, G2 and G3 of tumour differentiation was 65.6 (95% CI, 53.7-77.5) and 25.3 months (95% CI, 16.6-34.1), respectively. Median OS of the patients with stage N0, N1 and N2 was 65.6 (95% CI, 56.4-74.8) and 58.0 months (95% CI, 21.9-94.2), respectively. Median OS of wtKRAS and mutated KRAS patients was 56.5 (95% CI, 48.2-64.9) and 58 months (95% CI, 52.6-63.4), respectively. Median OS of mutated codon 12 and codon 13 patients was 57 (95% CI, 50.9-64.4) and 44 months (95% CI, 40.1-48.4), respectively. Median OS of wtBRAF and of mutated BRAF patients was 59.2 (95% CI, 52.5-65.9) and 27.6 months (95% CI, 12.6-42.5), respectively. wtKRAS significantly affected the response to the first systemic therapy (p = 0.028), while other parameters did not affected it, p= 0.07. In 14 patients (17%), additional mutations in NRAS gene, codon 61 and codon 146 were found. Median OS of wtNRAS, codon 61 and 146 patients was 67.1 months (50.3-67.6) while median OS of mutated NRAS patients has not been reached yet (p = 0.072). Median time to progression of wtNRAS, codon 61 and 146 patients was 11.7 months (10.4-14.5) while median time to progression of mutated NRAS patients was 7.9 months (6.1-11.0), (p = 0.025). Conclusions Mutated BRAF, N2 and G3 of primary tumour were poor prognostic factors for OS in mCRC patients. wtKRAS significantly affected the response to the first line systemic therapy. Histological parameters included in the analysis and mutated BRAF did not affect significantly the efficacy of 1st line systemic therapy in mCRC patients.
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Affiliation(s)
- Martina Rebersek
- Department of Medical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Tanja Mesti
- Department of Medical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Marko Boc
- Department of Medical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Janja Ocvirk
- Department of Medical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia
- Assoc. Prof. Janja Ocvirk, M.D., Ph.D., Department of Medical Oncology, Institute of Oncology Ljubljana, Zaloska 2, SI-1000 Ljubljana, Slovenia. Phone: +386 1 5879 285
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Kaveh S, Ebrahimi P, Rezapour A, Mozafari M, Sayehmiri K. Bevacizumab and erlotinib versus bevacizumab for colorectal cancer treatment: systematic review and meta-analysis. Int J Clin Pharm 2019; 41:30-41. [PMID: 30610548 DOI: 10.1007/s11096-018-0754-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 11/08/2018] [Indexed: 12/25/2022]
Abstract
Background Improving the survival of patients diagnosed with metastatic colorectal cancer requires the use of chemotherapy to be managed with minimum adverse effects. Randomized control trials (RCTs) have shown promising results with a combination of bevacizumab and erlotinib to block two important tumor growth pathways, namely vascular endothelial growth factor and epidermal growth factor receptor. Aim of the Review We aimed to examine the efficacy and safety of the combination of bevacizumab and erlotinib with bevacizumab alone in the maintenance treatment of metastatic colorectal cancer, by examining PFS, OS, overall response rate (ORR), and toxicity. This study performed a systematic review meta-analysis using existing randomized clinical trial. Methods Randomized controlled trials were systematically reviewed from PubMed, Cochrane library, SCOPUS, CRD, and Google scholar databases. After evaluating the quality of studies through the Cochrane checklist, data of the relevant studies were extracted. This meta-analysis included outcomes of overall survival, progression-free survival of the disease through the hazard ratio, and the upper and lower confidence intervals for the third and fourth degree side effects of relative risk. To perform the meta-analysis for both types of survival, two fixed and random effect models were used. Results A total of three trials, providing data of 682 patients who received maintenance treatment, were included in this meta-analysis. Conclusion The combination of bevacizumab and erlotinib significantly increased the overall survival compared to using bevacizumab alone [HR = 0.78, 95% CI 0.66-0.93]. This combination, effectively increased progression-free survival [HR = 0.81, 95% CI 0.7-0.93] too. The side effects of diarrhea and grade III rash were more frequent in the group administered bevacizumab plus erlotinib. The combination of bevacizumab and erlotinib, in the maintenance treatment of metastatic colorectal cancer, significantly improved the overall survival and progression-free survival of patients, and the resulting side effects were easily treatable.
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24
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Xu J, Fan J, Qin X, Cai J, Gu J, Wang S, Wang X, Zhang S, Zhang Z. Chinese guidelines for the diagnosis and comprehensive treatment of colorectal liver metastases (version 2018). J Cancer Res Clin Oncol 2018; 145:725-736. [PMID: 30542791 DOI: 10.1007/s00432-018-2795-1] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 11/12/2018] [Indexed: 12/12/2022]
Abstract
The liver is the most common anatomical site for hematogenous metastases of colorectal cancer, and colorectal liver metastases is one of the most difficult and challenging points in the treatment of colorectal cancer. To improve the diagnosis and comprehensive treatment in China, the Guidelines have been edited and revised several times since 2008, including the overall evaluation, personalized treatment goals and comprehensive treatments, to prevent the occurrence of liver metastases, improve the resection rate of liver metastases and survival. The revised Guideline includes the diagnosis and follow-up, prevention, MDT effect, surgery and local ablative treatment, neoadjuvant and adjuvant therapy, and comprehensive treatment, and with advanced experience, latest results, detailed content, and strong operability.
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Affiliation(s)
- Jianmin Xu
- Department of Colorectal Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
- Colorectal Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, China.
- Shanghai Engineering Research Center of Colorectal Cancer Minimally Invasive, Shanghai, China.
| | - Jia Fan
- Department of Liver Surgery, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China
- Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai, China
| | - Xinyu Qin
- Department of Colorectal Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
- Colorectal Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Engineering Research Center of Colorectal Cancer Minimally Invasive, Shanghai, China
| | - Jianqiang Cai
- Department of Hepatobiliary Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jin Gu
- Gastrointestinal Cancer Center, Peking University Cancer Hospital, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Beijing, China
- Peking-Tsinghua Center for Life Sciences, Beijing, China
- Peking University Shougang Hospital, Beijing, China
| | - Shan Wang
- Department of Gastroenterological Surgery, Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, Beijing, China
| | - Xishan Wang
- Department of Colorectal Surgery, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Suzhan Zhang
- Cancer Institute, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, Hangzhou, Zhejiang, China
- The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Zhongtao Zhang
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Cancer Invasion and Metastasis Research and National Clinical Research Center for Digestive Diseases, Beijing, China
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Zhang W, Wang F, Hu X, Liang J, Liu B, Guan Q, Liu S. Inhibition of colorectal cancer liver metastasis in BALB/c mice following intratumoral injection of oncolytic herpes simplex virus type 2 for the induction of specific antitumor immunity. Oncol Lett 2018; 17:815-822. [PMID: 30655834 PMCID: PMC6313052 DOI: 10.3892/ol.2018.9720] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 09/05/2018] [Indexed: 02/06/2023] Open
Abstract
Liver metastasis represents the most prominent metastasis of colorectal cancer (CRC) and is the leading cause of CRC mortality, making the early prevention of this event very important. While current CRC therapies include surgery, radiotherapy and chemotherapy, no effective treatment option for CRC liver metastasis (CRLM) exists. Furthermore, the effects of currently available metastatic CRC drugs are frequently limited by their toxicity and side effects. Oncolytic herpes simplex virus type 2 (oHSV2) selectively infects tumor cells and also induces an antitumor immune response. The present study investigated the cytopathic effects of oHSV2 on CT-26 cells in vitro and tested its inhibitory effect on CRLM. In vitro experimental data demonstrated that oHSV2 effectively inhibited the growth of CT-26 cells. In vivo study data demonstrated that treatment with oHSV2 alone slowed the growth of subcutaneous xenograft tumors without inducing weight loss and also inhibited CRLM by increasing the numbers of cluster of differentiation (CD)4+ T, CD8+ T and natural killer cells. In summary, oHSV2 shows potential as a safe and effective therapeutic agent for inhibiting the metastasis of CT-26 CRC cells to the liver.
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Affiliation(s)
- Wen Zhang
- Department of Immunology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, P.R. China
| | - Feifei Wang
- Department of Immunology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, P.R. China.,Inner Mongolia University For Nationalities, Tongliao, Inner Mongolia 028000, P.R. China
| | - Xiao Hu
- State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, P.R. China
| | - Jing Liang
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, P.R. China
| | - Binlei Liu
- Department of Immunology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, P.R. China.,Hubei Provincial Cooperative, Innovation Center of Industrial Fermentation, Hubei University of Technology, Wuhan, Hubei 30068, P.R. China
| | - Qi Guan
- Department of Hematology and Oncology, The Second Clinical Medical School of Inner Mongolia University for Nationalities, Yakeshi, Inner Mongolia 022150, P.R. China
| | - Shangmei Liu
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, P.R. China
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Aranda E, García-Alfonso P, Benavides M, Sánchez Ruiz A, Guillén-Ponce C, Safont M, Alcaide J, Gómez A, López R, Manzano J, Méndez Ureña M, Sastre J, Rivera F, Grávalos C, García T, Martín-Valadés J, Falcó E, Navalón M, González Flores E, Ma García Tapiador A, Ma López Muñoz A, Barrajón E, Reboredo M, García Teijido P, Viudez A, Cárdenas N, Díaz-Rubio E. First-line mFOLFOX plus cetuximab followed by mFOLFOX plus cetuximab or single-agent cetuximab as maintenance therapy in patients with metastatic colorectal cancer: Phase II randomised MACRO2 TTD study. Eur J Cancer 2018; 101:263-272. [DOI: 10.1016/j.ejca.2018.06.024] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 06/21/2018] [Accepted: 06/24/2018] [Indexed: 01/07/2023]
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Petrioli R, Francini E, Cherri S, Torre P, Fiaschi AI, Miano ST, Marrelli D, Rovello F, Francini G. Capecitabine Plus Oxaliplatin and Bevacizumab, Followed by Maintenance Treatment With Capecitabine and Bevacizumab for Patients Aged > 75 Years With Metastatic Colorectal Cancer. Clin Colorectal Cancer 2018; 17:e663-9. [PMID: 30153975 DOI: 10.1016/j.clcc.2018.07.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 06/28/2018] [Accepted: 07/02/2018] [Indexed: 01/16/2023]
Abstract
BACKGROUND The aim of the present study was to evaluate the efficacy and safety of the combination of CAPOX-Bev (capecitabine [Cap] plus oxaliplatin and bevacizumab [Bev]), followed by maintenance Cap and Bev, for patients with metastatic colorectal cancer (mCRC) and aged > 75 years. PATIENTS AND METHODS The regimen consisted of intravenous oxaliplatin 130 to 100 mg/m2 on day 1, oral Cap 750 to 1000 mg/m2 twice daily on days 1 to 14, and Bev 7.5 mg/kg on day 1, every 3 weeks. After 4 cycles of CAPOX-Bev, the patients without evidence of disease progression received maintenance treatment with Cap 1000 to 1250 mg/m2 twice daily on days 1 to 14 and Bev 7.5 mg/kg on day 1, every 3 weeks, until disease progression or unacceptable toxicity. The primary endpoint was the 9-month disease control rate. Progression-free survival (PFS), overall survival (OS), and safety were the secondary endpoints. RESULTS Overall, 36 patients were enrolled from March 2012 to April 2017 at our institution. After completion of CAPOX/Bev, 15 patients (41.7%) had a partial response, 18 (50.0%) had stable disease, and 3 (8.3%) had progressive disease. Thirty-three patients (91.7%) received the Cap/Bev regimen as maintenance treatment for a median of 8.6 cycles (range, 3-14 cycles). The 9-month DCR was 58.3% (95% confidence interval [CI], 40.8-74.5), the median PFS was 8.8 months (95% CI, 6.7-10.3 months), and the median OS was 20.8 months (95% CI, 16.1-25.4 months). With the CAPOX/Bev regimen, the most common grade 3 toxicity included neutropenia (11.1%), diarrhea (5.5%), nausea/vomiting (2.8%), and fatigue (2.8%). Grade 3 neurotoxicity was not observed. With Cap/Bev maintenance therapy, grade 3 hand-foot syndrome was observed in 2 patients (6.0%). CONCLUSION CAPOX/Bev, followed by Cap/Bev as maintenance treatment, is safe and effective in terms of PFS and OS for elderly patients aged > 75 years with mCRC.
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Ba-Sang DZ, Long ZW, Teng H, Zhao XP, Qiu J, Li MS. A network meta-analysis on the efficacy of sixteen targeted drugs in combination with chemotherapy for treatment of advanced/metastatic colorectal cancer. Oncotarget 2018; 7:84468-84479. [PMID: 27806321 PMCID: PMC5356673 DOI: 10.18632/oncotarget.12994] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 10/02/2016] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE A network meta-analysis was conducted comparing the short-term efficacies of 16 targeted drugs in combination with chemotherapy for treatment of advanced/metastatic colorectal cancer (CRC). RESULTS Twenty-seven RCTs were ultimately incorporated into this network meta-analysis. Compared with chemotherapy alone, bevacizumab + chemotherapy, panitumumab + chemotherapy and conatumumab + chemotherapy had higher PR rate. Bevacizumab + chemotherapy, cetuximab + chemotherapy, panitumumab + chemotherapy, trebananib + chemotherapy and conatumumab + chemotherapy had higher ORR rate in comparison to chemotherapy alone. Furthermore, bevacizumab + chemotherapy had higher DCR rate than chemotherapy alone. The results of our cluster analysis showed that chemotherapy combined with bevacizumab, cetuximab, panitumumab, conatumumab, ganitumab, or brivanib + cetuximab had better efficacies for the treatment of advanced/metastatic CRC in comparison to chemotherapy alone. MATERIALS AND METHODS Electronic databases were comprehensively searched for potential and related randomized controlled trials (RCTs). Direct and indirect evidence were incorporated for evaluation of stable disease (SD), progressive disease (PD), complete response (CR), partial response (PR), disease control rate (DCR) and overall response ratio (ORR) by calculating odds ratio (OR) and 95% confidence intervals (CI), and using the surface under the cumulative ranking curve (SUCRA). CONCLUSIONS These results indicated that bevacizumab + chemotherapy, panitumumab + chemotherapy, conatumumab + chemotherapy and brivanib + cetuximab + chemotherapy may have better efficacies for the treatment of advanced/metastatic CRC.
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Affiliation(s)
- Dan-Zeng Ba-Sang
- Department of Oncology, Shigatse People's Hospital, Shigatse 857000, Tibet, P. R. China
| | - Zi-Wen Long
- Department of Gastric Cancer and Soft-Tissue Sarcoma Surgery, Fudan university Shanghai Cancer Center, Shanghai 200032, P. R. China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P. R. China
| | - Hao Teng
- Department of Oncology, Shigatse People's Hospital, Shigatse 857000, Tibet, P. R. China
| | - Xu-Peng Zhao
- Department of Oncology, Shigatse People's Hospital, Shigatse 857000, Tibet, P. R. China
| | - Jian Qiu
- Department of Oncology, Shigatse People's Hospital, Shigatse 857000, Tibet, P. R. China
| | - Ming-Shan Li
- Department of Oncology, Shigatse People's Hospital, Shigatse 857000, Tibet, P. R. China
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Grávalos C, Carrato A, Tobeña M, Rodriguez-Garrote M, Soler G, Vieitez JM, Robles L, Valladares-Ayerbes M, Polo E, Limón ML, Safont MJ, Martínez de Castro E, García-Alfonso P, Aranda E. A Randomized Phase II Study of Axitinib as Maintenance Therapy After First-line Treatment for Metastatic Colorectal Cancer. Clin Colorectal Cancer 2018; 17:e323-e329. [PMID: 29551560 DOI: 10.1016/j.clcc.2018.02.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 02/12/2018] [Indexed: 12/16/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate the efficacy and safety of maintenance therapy with axitinib versus placebo following induction therapy in patients with metastatic colorectal cancer (mCRC). PATIENTS AND METHODS In this double-blinded, phase II trial, patients with mCRC who had not progressed after 6 to 8 months of first-line chemotherapy were randomized to receive axitinib (5 mg twice a day) (arm A) or placebo (arm B). RESULTS Forty-nine patients were included: 25 in arm A and 24 in arm B. The median follow-up was 26.07 months (95% confidence interval [CI], 18.44-31.73 months). Progression-free survival (PFS) rate at 6 months was 40.00% (95% CI, 21.28%-58.12%) in the axitinib arm versus 8.33% (95% CI, 1.44%-23.30%) in the placebo arm (P = .0141). The median PFS was statistically significantly longer in the axitinib group than in the placebo group (4.96 vs. 3.16 months; hazard ratio, 0.46; 95% CI, 0.25-0.86; P = .0116). Median overall survival was also longer in the axitinib arm but did not reach statistical significance (27.61 vs. 19.99 months; hazard ratio, 0.68; 95% CI, 0.31-1.48; P = .3279). Grade 3 to 4 treatment-related toxicities were experienced by 7 patients (28%) in cohort A and 1 patient (4%) in cohort B (P = .0488). The most frequent grade 3 to 4 treatment-related toxicities were hypertension, diarrhea, and asthenia. There were no toxic deaths. The study was prematurely closed because of slow recruitment. CONCLUSIONS In our study, maintenance treatment with axitinib monotherapy showed a significant increase in PFS and a good safety profile. Axitinib should be further explored as a possible option for first-line chemotherapy maintenance treatment in patients with mCRC.
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Affiliation(s)
- Cristina Grávalos
- Department of Medical Oncology, University Hospital 12 De Octubre, Madrid, Spain.
| | - Alfredo Carrato
- Department of Medical Oncology, Ramon y Cajal University Hospital, IRYCIS CIBERONC, Madrid, Spain
| | - María Tobeña
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Gemma Soler
- Department of Medical Oncology, ICO Hospital Duran i Reynals, Hospitalet, Spain
| | - José Mª Vieitez
- Department of Medical Oncology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Luis Robles
- Department of Medical Oncology, University Hospital 12 De Octubre, Madrid, Spain
| | | | - Eduardo Polo
- Department of Medical Oncology, Hospital Miguel Servet, Zaragoza, Spain
| | - Mª Luisa Limón
- Department of Medical Oncology, Hospital Universitario Virgen del Rocio, Sevilla, Spain
| | - Mª José Safont
- Department of Medical Oncology, Hospital General Universitario Valencia, Valencia, Spain
| | - Eva Martínez de Castro
- Department of Medical Oncology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Pilar García-Alfonso
- Department of Medical Oncology, Hospital General Universitario Gregorio Marañon, Madrid, Spain
| | - Enrique Aranda
- Department of Medical Oncology, IMIBIC. University Hospital Reina Sofia, CIBERONC Instituto de Salud Carlos III, Cordoba, Spain
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30
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Chongxi R, Hongchen W, Jiangchun L, Sheng L. Continuum of care strategy in metastatic colorectal cancer: a review. Colorectal Cancer 2017. [DOI: 10.2217/crc-2017-0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Treatment of human metastatic colorectal cancer (mCRC) has changed remarkably in the past two decades. The use of novel therapies and more complex treatment strategies have contributed to progressively increase the median life expectancy of patients up to approximately 30 months. Although traditional cytotoxic chemotherapy and newer targeted therapy are now available for use in treating patients with mCRC, the optimal treatment strategy remains unknown. In recent years, there has been a treatment paradigm shift for mCRC patients with the emergence of the concept of ‘continuum of care’ as the optimal palliative therapy strategy. It is based on the concept whereby patients are exposed throughout the course of their disease to different active drugs; the therapy is personalized according to the need for rapid response, the burden of disease and molecular subtype status, such as RAS, BRAF, MMR and HER2. Drugs are often reintroduced if they demonstrated activity in a previous line of therapy, and most importantly, maintenance chemotherapy and/or intermittent therapy are considered. This review details available data for the use of the continuum of care strategy in mCRC, in which the strategy has provided significant clinical benefit in clinical studies. As our understanding advances, optimal treatment strategy for the patients with mCRC should still be individualized.
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Affiliation(s)
- Ren Chongxi
- Department of Oncology, Cangzhou Clinical College of Integrated Traditional Chinese & Western Medicine of Hebei Medical University, Cangzhou 061000, China
| | - Wang Hongchen
- Department of Oncology, Cangzhou Clinical College of Integrated Traditional Chinese & Western Medicine of Hebei Medical University, Cangzhou 061000, China
| | - Li Jiangchun
- Department of Oncology, Cangzhou Clinical College of Integrated Traditional Chinese & Western Medicine of Hebei Medical University, Cangzhou 061000, China
| | - Li Sheng
- Department of Oncology, Cangzhou Clinical College of Integrated Traditional Chinese & Western Medicine of Hebei Medical University, Cangzhou 061000, China
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Boudrias-Dalle E, Cloutier M, Harvey M, Leblanc G, Besner-Morin O, Adam JP. Durable complete remission following anti-EGFR antibodies in recurrent metastatic colorectal cancer. J Oncol Pharm Pract 2017; 25:239-243. [PMID: 28950807 DOI: 10.1177/1078155217730130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this case report, we describe a patient who remains in complete remission two years after the discontinuation of anti-EGFR monotherapy as a third-line treatment, accompanied by persistent severe hypomagnesemia. A 45-year-old Caucasian woman with mCRC started chemotherapy with weekly cetuximab. After ten months of treatment, the therapy was stopped because the patient had persistent grade III hypomagnesemia despite amiloride, oral, and intravenous magnesium. A month later, the patient was switched to panitumumab 6 mg/kg every two weeks for four additional months to avoid weekly visits to the clinic. Following discontinuation of panitumumab, PET scans remain negative to this day, two years after anti-EGFR therapy discontinuation. No factor has been identified to explain the complete and sustained response experienced by this patient. Hypomagnesemia is a common adverse effect of anti-EGFR therapy that can lead to treatment interruption and discontinuation if severe. This case highlights the importance of pursuing anti-EGFR therapy when a response is observed in spite of severe hypomagnesemia. It also provides preliminary information that anti-EGFR therapy could be stopped after a complete response is obtained.
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Affiliation(s)
| | - Magali Cloutier
- 1 Faculty of pharmacy, University of Montreal, Montréal, QC, Canada
| | - Marjorie Harvey
- 1 Faculty of pharmacy, University of Montreal, Montréal, QC, Canada
| | - Guy Leblanc
- 2 Department of Surgery, 60301 Maisonneuve-Rosemont Hospital , University of Montreal, Montreal, Canada
| | - Olivier Besner-Morin
- 3 Department of Pharmacy, 60301 Maisonneuve Rosemont Hospital , Montréal, QC, Canada
| | - Jean-Philippe Adam
- 4 Department of Pharmacy, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada.,5 Centre de recherche du Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
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Zhuang YW, Wu CE, Zhou JY, Chen X, Wu J, Jiang S, Peng HY, Zou X, Liu JY, Wu DP, Gong T, Qi MH, Xue T, Liu SL, Cai H. Solasodine inhibits human colorectal cancer cells through suppression of the AKT/glycogen synthase kinase-3β/β-catenin pathway. Cancer Sci 2017; 108:2248-2264. [PMID: 28803443 PMCID: PMC5666038 DOI: 10.1111/cas.13354] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 08/08/2017] [Accepted: 08/09/2017] [Indexed: 02/06/2023] Open
Abstract
Solasodine is a main active component isolated from Solanum incanum L. that performs a wide range of functions containing anti‐oxidant, anti‐infection, and neurogenesis promotion. In this study, we explored the influence of solasodine on three types of human colorectal cancer (CRC) cell lines. The results show that solasodine prohibited CRC cell proliferation dose‐ and time‐dependently and impeded CRC cell motility by downregulating MMPs. Solasodine was also found to fuel caspase‐cascade reaction and increase the ratio between Bax and Bcl‐2 so as to induce CRC cell apoptosis. When cells were pretreated with AKT activator (insulin‐like growth factor‐1) followed by solasodine, the solasodine‐induced apoptosis was partially abrogated by insulin‐like growth factor‐1. Moreover, solasodine hindered tumor development and stimulated similar mechanisms in vivo. In general, our study provides the first evidence that solasodine has a suppressive effect on CRC cells and that this agent may be a novel therapeutic drug for CRC treatment.
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Affiliation(s)
- Yu-Wen Zhuang
- Department of Integrated Traditional and Western Medicine, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China.,The First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, China.,Jiangsu Province Hospital of TCM, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, china
| | - Cun-En Wu
- The First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, China.,Jiangsu Province Hospital of TCM, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, china
| | - Jin-Yong Zhou
- The First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, China.,Jiangsu Province Hospital of TCM, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, china
| | - Xu Chen
- The First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, China.,Jiangsu Province Hospital of TCM, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, china
| | - Jian Wu
- The First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, China.,Jiangsu Province Hospital of TCM, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, china
| | - Shan Jiang
- Division of Membrane Dynamics, Department of Physiology and Cell Biology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hai-Yan Peng
- The First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, China.,Jiangsu Province Hospital of TCM, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, china
| | - Xi Zou
- Jiangsu Province Hospital of TCM, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, china
| | - Jia-Yun Liu
- Jiangsu Province Hospital of TCM, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, china
| | - Da-Peng Wu
- Jiangsu Province Hospital of TCM, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, china
| | - Tao Gong
- Nanjing Hospital of Traditional Chinese Medicine, Nanjing, China
| | - Ming-Hao Qi
- Jiangsu Province Hospital of TCM, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, china
| | - Tian Xue
- Jiangsu Province Hospital of TCM, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, china
| | - Shen-Lin Liu
- Jiangsu Province Hospital of TCM, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, china
| | - Hui Cai
- Department of Integrated Traditional and Western Medicine, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China
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Shang HS, Liu JY, Lu HF, Chiang HS, Lin CH, Chen A, Lin YF, Chung JG. Casticin induced apoptotic cell death and altered associated gene expression in human colon cancer colo 205 cells. Environ Toxicol 2017; 32:2041-2052. [PMID: 27862857 DOI: 10.1002/tox.22381] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 10/24/2016] [Accepted: 10/24/2016] [Indexed: 06/06/2023]
Abstract
Casticin, a polymethoxyflavone, derived from natural plant Fructus Viticis exhibits biological activities including anti-cancer characteristics. The anti-cancer and alter gene expression of casticin on human colon cancer cells and the underlying mechanisms were investigated. Flow cytometric assay was used to measure viable cell, cell cycle and sub-G1 phase, reactive oxygen species (ROS) and Ca2+ productions, level of mitochondria membrane potential (ΔΨm ) and caspase activity. Western blotting assay was used to detect expression of protein level associated with cell death. Casticin induced cell morphological changes, decreased cell viability and induced G2/M phase arrest in colo 205 cells. Casticin increased ROS production but decreased the levels of ΔΨm , and Ca2+ , increased caspase-3, -8, and -9 activities. The cDNA microarray indicated that some of the cell cycle associated genes were down-regulated such as cyclin-dependent kinase inhibitor 1A (CDKN1A) (p21, Cip1) and p21 protein (Cdc42/Rac)-activated kinase 3 (PAK3). TNF receptor-associated protein 1 (TRAP1), CREB1 (cAMP responsive element binding protein 1) and cyclin-dependent kinase inhibitor 1B (CDKN1B) (p27, Kip1) genes were increased but matrix metallopeptidase 2 (MMP-2), toll-like receptor 4 (TLR4), PRKAR2B (protein kinase, cAMP-dependent, regulatory, type II, bet), and CaMK4 (calcium/calmodulin-dependent protein kinase IV) genes were inhibited. Results suggest that casticin induced cell apoptosis via the activation of the caspase- and/or mitochondria-dependent signaling cascade, the accumulation of ROS and altered associated gene expressions in colo 205 human colon cancer cells.
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Affiliation(s)
- Hung-Sheng Shang
- Graduate Institute of Clinical of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Jia-You Liu
- Department of Clinical Pathology, Cheng-Hsin General Hospital, Taipei, Taiwan
| | - Hsu-Feng Lu
- Department of Clinical Pathology, Cheng-Hsin General Hospital, Taipei, Taiwan
- Department of Restaurant, Hotel and Institutional Management, Fu-Jen Catholic University, New Taipei city, Taiwan
| | - Han-Sun Chiang
- Graduate Institute of Basic Medicine, Fu-Jen Catholic University, New Taipei city, Taiwan
| | - Chia-Hain Lin
- Department of Chinese Medicine Resources, China Medical University, Taichung, Taiwan
| | - Ann Chen
- Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yuh-Feng Lin
- Graduate Institute of Clinical of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Division of Nephrology, Department of Medicine, Shuang Ho Hospital, New Taipei City, Taiwan
| | - Jing-Gung Chung
- Department of Biological Science and Technology, China Medical University, Taichung, Taiwan
- Department of Biotechnology, Asia University, Taichung, Taiwan
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Gong H, Wen H, Zhu X, Lian Y, Yang X, Qian Z, Zhu J. High expression of long non-coding RNA ZEB1-AS1 promotes colorectal cancer cell proliferation partially by suppressing p15 expression. Tumour Biol 2017; 39:1010428317705336. [PMID: 28618933 DOI: 10.1177/1010428317705336] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
This study aims to investigate the function of long non-coding RNA ZEB1-AS1, reveal its molecular mechanism in colorectal cancer cell growth, and evaluate its clinical significance in colorectal cancer patients. ZEB1-AS1 has reported in the development of several cancers, but the biological role of it in colorectal cancer has not been discussed. In this report, ZEB1-AS1 expression level was measured with quantitative real-time polymerase chain reaction in 63 pairs of colorectal cancer tissues and paired adjacent non-tumor colorectal tissues. The relationship between ZEB1-AS1 expression and overall survival was analyzed by virtue of Kaplan-Meier analysis. Subsequently, small interfering RNA or lentivirus vector-mediated lncRNA ZEB1-AS1 was transfected into colorectal cancer cell lines. Cell viability and apoptosis were examined. Later, nude mouse transplantation experiment was conducted to evaluate the effect of ZEB1-AS1 on colorectal cancer development in vivo. It turns out that ZEB1-AS1 is upregulated in colorectal cancer tissues and its expression is significantly associated with overall survival rate and recurrence-free survival. Upregulation of ZEB1-AS1 colorectal cancer promotes cell proliferation and inhibits cell apoptosis. In addition, cell cycle inhibitory protein p15 participates in the oncogenic function of ZEB1-AS1. Collectively, ZEB1-AS1 has asignificant effect on colorectal cancer pathological process and serves as a valuable prognostic biomarker for colorectal cancer.
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Affiliation(s)
- Huangbo Gong
- 1 The Second Clinical Medical College of Nanjing Medical University, Nanjing, China.,2 Pancreas Center, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hao Wen
- 2 Pancreas Center, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xuhui Zhu
- 3 Huadong Medical Institute of Biotechniques, Nanjing, China
| | - Yifan Lian
- 1 The Second Clinical Medical College of Nanjing Medical University, Nanjing, China
| | - Xiaojun Yang
- 2 Pancreas Center, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zhuyin Qian
- 2 Pancreas Center, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jin Zhu
- 3 Huadong Medical Institute of Biotechniques, Nanjing, China.,4 Department of Pathology, Key Laboratory of Antibody Technique of the Ministry of Health, Nanjing Medical University (NJMU), Nanjing, China
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Du C, Huang D, Peng Y, Yao Y, Zhao Y, Yang Y, Wang H, Cao L, Zhu WG, Gu J. 5-Fluorouracil targets histone acetyltransferases p300/CBP in the treatment of colorectal cancer. Cancer Lett 2017; 400:183-93. [PMID: 28465257 DOI: 10.1016/j.canlet.2017.04.033] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 03/17/2017] [Accepted: 04/21/2017] [Indexed: 12/14/2022]
Abstract
Although 5-fluorouracil (5-FU) is known to interfere with the synthesis of ribonucleic acid and deoxyribonucleic acid, the mechanism underlying its therapeutic efficacy in colorectal cancer (CRC) has not been fully elucidated. We aimed to investigate the influence of 5-FU on histone acetylation, a well-established anti-cancer target, to reveal novel pharmacological effects of 5-FU and their significance for CRC therapy. Results demonstrated that 5-FU induces global histone de-acetylation in multiple CRC cell lines. We identified that 5-FU reduces the binding ability of histone acetyltransferases p300 and CBP to chromatin, and induces their degradation through lysosome. Further work revealed that the degradation of p300/CBP induced by 5-FU was dependent on chaperone-mediated autophagy, mediated by heat-shock cognate protein 70 kDa (hsc70) and lysosomal-associated membrane protein 2A (LAMP2A). Moreover, the degradation of p300/CBP is relevant to cellular resistance to 5-FU, since blocking the degradation enhances 5-FU's cytotoxicity in CRC cells. From clinical data, we demonstrated that low expression of p300/CBP in CRC tissue was closely associated with poor clinical response to 5-FU based-chemotherapy, based on the analysis of 262 colorectal samples from the patients receiving 5-FU treatment: compared to cases with high expression of p300/CBP, those with low expression had lower long-term disease-free survival rate and increased early-progression. These results elucidate a novel pharmacological effect of 5-FU involving global histone de-acetylation by promoting the degradation of p300/CBP, and highlights p300 and CBP as promising predictors of chemo-sensitivity to 5-FU treatment.
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36
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Neuzillet C, Rousseau B, Kocher H, Bourget P, Tournigand C. Unravelling the pharmacologic opportunities and future directions for targeted therapies in gastro-intestinal cancers Part 1: GI carcinomas. Pharmacol Ther 2017; 174:145-172. [PMID: 28223233 DOI: 10.1016/j.pharmthera.2017.02.028] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Until the 1990s, cytotoxic chemotherapy has been the cornerstone of medical therapy for gastrointestinal (GI) cancers. Better understanding of the molecular biology of cancer cell has led to the therapeutic revolution of targeted therapies, i.e. monoclonal antibodies or small molecule inhibitors directed against proteins that are specifically overexpressed or mutated in cancer cells. These agents being more specific to cancer cells were expected to be less toxic than cytotoxic agents. Targeted agents have provided clinical benefit in many GI cancer types. For example, antiangiogenics and anti-EGFR therapies have significantly improved survival of patients affected by metastatic colorectal cancer and have deeply changed the therapeutic strategy in this disease. However, their effects have sometimes been disappointing, due to intrinsic or acquired resistance mechanisms (e.g., RAS mutation for anti-EGFR therapies), or to an activity restricted to some tumour settings (e.g., lack of activity in other cancer types, or on the microscopic residual disease in adjuvant setting). Many studies are negative in overall population but positive in some specific patient subgroups (e.g., trastuzumab in HER2-positive gastric cancer), illustrating the importance of patient selection and early identification of predictive biomarkers of response to these therapies. We propose a comprehensive two-part review providing a panoramic approach of the successes and failures of targeted agents in GI cancers to unravel the pharmacologic opportunities and future directions for these agents in GI oncology. In this first part, we will focus on adenocarcinomas and squamous cell carcinomas, for which targeted therapies are mostly used in combination with chemotherapy.
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Affiliation(s)
- Cindy Neuzillet
- INSERM UMR1149, Bichat-Beaujon University Hospital (AP-HP - PRES Paris 7 Diderot), 46 rue Henri Huchard, 75018 Paris, and 100 boulevard du Général Leclerc, 92110 Clichy, France; Department of Medical Oncology, Henri Mondor University Hospital, AP-HP, Paris Est Créteil University (UPEC), 51 avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France; Tumour Biology Laboratory, Barts Cancer Institute, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, United Kingdom; Barts and The London HPB Centre, The Royal London Hospital, Whitechapel, London, E1 1BB, United Kingdom.
| | - Benoît Rousseau
- Department of Medical Oncology, Henri Mondor University Hospital, AP-HP, Paris Est Créteil University (UPEC), 51 avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - Hemant Kocher
- Tumour Biology Laboratory, Barts Cancer Institute, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, United Kingdom; Barts and The London HPB Centre, The Royal London Hospital, Whitechapel, London, E1 1BB, United Kingdom
| | - Philippe Bourget
- Department of Clinical Pharmacy, Necker-Enfants Malades University Hospital, 149 Rue de Sèvres, 75015 Paris, France
| | - Christophe Tournigand
- Department of Medical Oncology, Henri Mondor University Hospital, AP-HP, Paris Est Créteil University (UPEC), 51 avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
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Chen T, Yang P, Wang H, He ZY. Silence of long noncoding RNA PANDAR switches low-dose curcumin-induced senescence to apoptosis in colorectal cancer cells. Onco Targets Ther 2017; 10:483-491. [PMID: 28176943 PMCID: PMC5268331 DOI: 10.2147/ott.s127547] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Long noncoding RNAs (lncRNAs) are emerging as having multiple roles in cancer progression. However, roles of lncRNAs in chemotherapy for colorectal cancer (CRC) remain unclear. This study investigated the biological functions of lncRNA PANDAR in CRC cells treated with curcumin chemotherapy. Herein, we identified that PANDAR expression was not notably differential in CRC tissues compared with the corresponding normal tissues. Consistently, in vitro experiments revealed that knockdown of PANDAR could not change the proliferation, apoptosis, or senescence of CRC cells. Further analyses showed that low-dose curcumin could induce senescence in CRC cells without affecting cell apoptosis. Moreover, expression of PANDAR was increased in curcumin-treated CRC cells. Furthermore, silencing PANDAR in curcumin-treated cells increased apoptosis and greatly attenuated senescence possibly by stimulating the expression of PUMA. Together, these findings indicate that knockdown of lncRNA PANDAR switches curcumin-induced senescence to apoptosis, which may be potentially valuable in CRC therapy.
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Affiliation(s)
- Tao Chen
- Department of General Surgery, The Second Clinical Medical College of Nanjing Medical University
| | - Peng Yang
- Department of General Surgery, The Second Clinical Medical College of Nanjing Medical University
| | - Hui Wang
- Department of General Surgery, The Second Clinical Medical College of Nanjing Medical University
| | - Zhen-Yu He
- Department of General Surgery, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
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De Rosa M, Rega D, Costabile V, Duraturo F, Niglio A, Izzo P, Pace U, Delrio P. The biological complexity of colorectal cancer: insights into biomarkers for early detection and personalized care. Therap Adv Gastroenterol 2016; 9:861-886. [PMID: 27803741 PMCID: PMC5076770 DOI: 10.1177/1756283x16659790] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Colorectal cancer has been ranked the third and second most prevalent of all cancers in men and women, respectively, and it represents the fourth most common cause of cancer deaths. In 2012, there were 1.4 million estimated cases of colorectal cancer worldwide, and 700,000 estimated deaths, which implies significant impact on public health, especially in economically-developed countries. In recent years, there has been an increase in the number of tumors, although this has been accompanied by decreased mortality, due to more appropriate and available information, earlier diagnosis, and improvements in treatment. Colorectal cancers are characterized by great genotypic and phenotypic heterogeneity, including tumor microenvironment and interactions between healthy and cancer cells. All of these traits confer a unique peculiarity to each tumor, which can thus be considered as an individual disease. Well conducted molecular and clinical characterization of each colorectal cancer is essential with a view to the implementation of precision oncology, and thus personalized care. This last aims at standardization of therapeutic plans chosen according to the genetic background of each specific neoplasm, to increase overall survival and reduce treatment side effects. Thus, prognostic and predictive molecular biomarkers assume a critical role in the characterization of colorectal cancer and in the determination of the most appropriate therapy.
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Affiliation(s)
| | - Daniela Rega
- Colorectal Surgical Oncology-Abdominal Oncology Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, ‘Fondazione Giovanni Pascale’ IRCCS, I-80131 Naples, Italy
| | - Valeria Costabile
- Department of Molecular Medicine and Medical Biotechnology, University of Naples ‘Federico II ’, I-80131 Naples, Italy
| | - Francesca Duraturo
- Department of Molecular Medicine and Medical Biotechnology, University of Naples ‘Federico II ’, I-80131 Naples, Italy
| | - Antonello Niglio
- Colorectal Surgical Oncology-Abdominal Oncology Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, ‘Fondazione Giovanni Pascale’ IRCCS, I-80131 Naples, Italy
| | - Paola Izzo
- Department of Molecular Medicine and Medical Biotechnology, University of Naples ‘Federico II ’, I-80131 Naples, Italy
| | - Ugo Pace
- Colorectal Surgical Oncology-Abdominal Oncology Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, ‘Fondazione Giovanni Pascale’ IRCCS, I-80131 Naples, Italy
| | - Paolo Delrio
- Colorectal Surgical Oncology-Abdominal Oncology Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, ‘Fondazione Giovanni Pascale’ IRCCS, I-80131 Naples, Italy
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Ju H, Xing W, Yang J, Zheng Y, Jia X, Zhang B, Ren H. An effective cytokine adjuvant vaccine induces autologous T-cell response against colon cancer in an animal model. BMC Immunol 2016; 17:31. [PMID: 27669687 PMCID: PMC5037582 DOI: 10.1186/s12865-016-0172-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Accepted: 09/20/2016] [Indexed: 12/20/2022] Open
Abstract
Background Despite recent advances in early detection and improvements in chemotherapy for colon cancer, the patients still face poor prognosis of postoperative recurrence and metastasis, the median survival for patients with metastatic colorectal cancer is approximately 22–24 months. Some immunotherapeutic approaches had been attempted in colon cancer patients to significantly increase overall survival. A vaccine based approach has shown a novel direction for colon cancer prevention and therapy. Methods In this study, the experiments were designed including prevention and therapeutic stages in order to attain effect against tumor recurrence in clinical settings. The anti-tumor efficacy of a novel cytokine adjuvant vaccine that contained cytokines GM-CSF and IL-2 and inactivated colon CT26.WT whole cell antigen was evaluated in BALB/c mouse tumor models by measuring tumor growth post vaccination and the survival time of tumor-bearing mice, analyzing the expression and distribution of CD4, CD8, CD11c, CD80, CD86 and CD83 positive cells in control and treated mice by flow cytometry and immunochemistry. The tumor-specific cytotoxic T cells (CTL) were analyzed by tumor proliferation and the lactic dehydrogenates (LDH) release assays. IFN-γ, IL-2 and GM-CSF secretion in serum was assayed by ELISA. Results Our results suggested that cytokine adjuvant vaccine significantly inhibited tumor growth and extended the survival period at least 160d. It was found that the levels of CD8 + T and the tumor-specific cytotoxicity were significantly higher in prevention and treatment group vaccinated by cytokine adjuvant vaccine. CD8 + T cells play a key role in anti-tumor response. Conclusions The novel GM-CSF and IL-2 based adjuvant vaccine effectively activated autologous T-cell response and represented a promising immunotherapeutic approach for patients with colon cancer. Electronic supplementary material The online version of this article (doi:10.1186/s12865-016-0172-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Huanyu Ju
- Department of Immunology, Harbin Medical University, 157 Baojian Road, Harbin, 150081, China.,Infection and Immunity, Key Laboratory of Heilongjiang Province, Harbin, 150081, China
| | - Wenjing Xing
- Department of Immunology, Harbin Medical University, 157 Baojian Road, Harbin, 150081, China.,Infection and Immunity, Key Laboratory of Heilongjiang Province, Harbin, 150081, China
| | - Jinfeng Yang
- Department of Immunology, Harbin Medical University, 157 Baojian Road, Harbin, 150081, China.,Infection and Immunity, Key Laboratory of Heilongjiang Province, Harbin, 150081, China
| | - Yang Zheng
- Department of Immunology, Harbin Medical University, 157 Baojian Road, Harbin, 150081, China.,Infection and Immunity, Key Laboratory of Heilongjiang Province, Harbin, 150081, China
| | - Xiuzhi Jia
- Department of Immunology, Harbin Medical University, 157 Baojian Road, Harbin, 150081, China.,Infection and Immunity, Key Laboratory of Heilongjiang Province, Harbin, 150081, China
| | - Benning Zhang
- Department of Immunology, Harbin Medical University, 157 Baojian Road, Harbin, 150081, China.,Infection and Immunity, Key Laboratory of Heilongjiang Province, Harbin, 150081, China
| | - Huan Ren
- Department of Immunology, Harbin Medical University, 157 Baojian Road, Harbin, 150081, China. .,Infection and Immunity, Key Laboratory of Heilongjiang Province, Harbin, 150081, China.
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Luo ZF, Zhao D, Li XQ, Cui YX, Ma N, Lu CX, Liu MY, Zhou Y. Clinical significance of HOTAIR expression in colon cancer. World J Gastroenterol 2016; 22:5254-5259. [PMID: 27298568 PMCID: PMC4893472 DOI: 10.3748/wjg.v22.i22.5254] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Revised: 04/22/2016] [Accepted: 05/04/2016] [Indexed: 02/06/2023] Open
Abstract
AIM: To detect the expression of the long noncoding RNA HOTAIR in colon cancer and analyze its relationship with clinicopathological parameters of colon cancer.
METHODS: Total RNA was extracted from 80 colon cancer tissues and matched tumor-adjacent normal colon tissues and reverse transcribed. Quantitative polymerase chain reaction was used to detect the expression of HOTAIR. The relationship between the expression of HOTAIR and clinicopathological parameters of colon cancer was analyzed.
RESULTS: The expression of HOTAIR was significantly higher in colon cancer tissues than in matched tumor-adjacent normal colon tissues (P < 0.05). HOTAIR expression was significantly higher in cases with lymph node metastasis than in those without metastasis; in lowly differentiated and undifferentiated cases than in highly and moderately differentiated cases; and in stages III + IV cases than in stages I + II cases (P < 0.05).
CONCLUSION: HOTAIR expression is upregulated in colon cancer, suggesting that HOTAIR plays an important role in the tumorigenesis, development and metastasis of colon cancer. HOTAIR may act as an oncogene and represents a new molecular target for the treatment of colon cancer.
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Fu M, Song Y, Wen Z, Lu X, Cui L. Inositol Hexaphosphate and Inositol Inhibit Colorectal Cancer Metastasis to the Liver in BALB/c Mice. Nutrients 2016; 8:nu8050286. [PMID: 27187454 PMCID: PMC4882699 DOI: 10.3390/nu8050286] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 04/20/2016] [Accepted: 05/04/2016] [Indexed: 01/14/2023] Open
Abstract
Inositol hexaphosphate (IP6) and inositol (Ins), naturally occurring carbohydrates present in most mammals and plants, inhibit the growth of numerous cancers both in vitro and in vivo. In this study, we first examined the anti-metastatic effects of IP6 and Ins using a liver metastasis model of colorectal cancer (CRC) in BALB/c mice. CT-26 cells were injected into the splenic capsule of 48 BALB/c mice. The mice were then randomly divided into four groups: IP6, Ins, IP6 + Ins and normal saline control (n = 12 per group). IP6 and/or Ins (80 mg/kg each, 0.2 mL/day) were injected into the gastrointestinal tracts of the mice on the second day after surgery. All mice were sacrificed after 20 days, and the tumor inhibition rates were determined. The results demonstrated that the tumor weights of liver metastases and the tumor inhibition rates were reduced in the experimental groups compared to the control group and that treatment with the combination of IP6 and Ins resulted in greater inhibition of tumor growth than treatment with either compound alone. These findings suggest that IP6 and Ins prevent the development and metastatic progression of colorectal cancer to the liver in mice by altering expression of the extracellular matrix proteins collagen IV, fibronectin and laminin; the adhesion factor receptor integrin-β1; the proteolytic enzyme matrix metalloproteinase 9; and the angiogenic factors vascular endothelial growth factor, basic fibroblast growth factor, and transforming growth factor beta in the tumor metastasis microenvironment. In conclusion, IP6 and Ins inhibited the development and metastatic progression of colorectal cancer to the liver in BALB/c mice, and the effect of their combined application was significantly greater than the effect of either compound alone. This evidence supports further testing of the combined application of IP6 and Ins for the prevention of colorectal cancer metastasis to the liver in clinical studies.
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Affiliation(s)
- Min Fu
- Department of Public Health, Qingdao University Medical College, Qingdao 266021, China.
| | - Yang Song
- Department of Public Health, Qingdao University Medical College, Qingdao 266021, China.
| | - Zhaoxia Wen
- School of Nursing, Qingdao University Medical College, Qingdao 266021, China.
| | - Xingyi Lu
- Basic Medical College, Qingdao University, Qingdao 266021, China.
| | - Lianhua Cui
- Department of Public Health, Qingdao University Medical College, Qingdao 266021, China.
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Kim JS, Kim YG, Park EJ, Kim B, Lee HK, Hong JT, Kim Y, Han SB. Cell-based Immunotherapy for Colorectal Cancer with Cytokine-induced Killer Cells. Immune Netw 2016; 16:99-108. [PMID: 27162526 PMCID: PMC4853502 DOI: 10.4110/in.2016.16.2.99] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 02/11/2016] [Accepted: 02/16/2016] [Indexed: 02/08/2023] Open
Abstract
Colorectal cancer is the third leading cancer worldwide. Although incidence and mortality of colorectal cancer are gradually decreasing in the US, patients with metastatic colorectal cancer have poor prognosis with an estimated 5-year survival rate of less than 10%. Over the past decade, advances in combination chemotherapy regimens for colorectal cancer have led to significant improvement in progression-free and overall survival. However, patients with metastatic disease gain little clinical benefit from conventional therapy, which is associated with grade 3~4 toxicity with negative effects on quality of life. In previous clinical studies, cell-based immunotherapy using dendritic cell vaccines and sentinel lymph node T cell therapy showed promising therapeutic results for metastatic colorectal cancer. In our preclinical and previous clinical studies, cytokine-induced killer (CIK) cells treatment for colorectal cancer showed favorable responses without toxicities. Here, we review current treatment options for colorectal cancer and summarize available clinical studies utilizing cell-based immunotherapy. Based on these studies, we recommend the use CIK cell therapy as a promising therapeutic strategy for patients with metastatic colorectal cancer.
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Affiliation(s)
- Ji Sung Kim
- College of Pharmacy, Chungbuk National University, Cheongju 28644, Korea
| | - Yong Guk Kim
- College of Pharmacy, Chungbuk National University, Cheongju 28644, Korea
| | - Eun Jae Park
- College of Pharmacy, Chungbuk National University, Cheongju 28644, Korea
| | - Boyeong Kim
- College of Pharmacy, Chungbuk National University, Cheongju 28644, Korea
| | - Hong Kyung Lee
- College of Pharmacy, Chungbuk National University, Cheongju 28644, Korea
| | - Jin Tae Hong
- College of Pharmacy, Chungbuk National University, Cheongju 28644, Korea
| | - Youngsoo Kim
- College of Pharmacy, Chungbuk National University, Cheongju 28644, Korea
| | - Sang-Bae Han
- College of Pharmacy, Chungbuk National University, Cheongju 28644, Korea
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Ballatori E, Palazzo S, Ruggeri B, Morale D, Filice A, Oriolo C, Vergati A, Napoletano M, Mazzoni I. On the New Payment-by-Results Method for Determining the Fair Price of New Drugs. An Application in Oncology. Global & Regional Health Technology Assessment 2016; 3:GRHTA.5000233. [DOI: 10.5301/grhta.5000233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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