1
|
McAloney CA, Makkawi R, Budhathoki Y, Cannon MV, Franz EM, Gross AC, Cam M, Vetter TA, Duhen R, Davies AE, Roberts RD. Host-derived growth factors drive ERK phosphorylation and MCL1 expression to promote osteosarcoma cell survival during metastatic lung colonization. Cell Oncol (Dordr) 2024; 47:259-282. [PMID: 37676378 PMCID: PMC10899530 DOI: 10.1007/s13402-023-00867-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2023] [Indexed: 09/08/2023] Open
Abstract
PURPOSE For patients with osteosarcoma, disease-related mortality most often results from lung metastasis-a phenomenon shared with many solid tumors. While established metastatic lesions behave aggressively, very few of the tumor cells that reach the lung will survive. By identifying mechanisms that facilitate survival of disseminated tumor cells, we can develop therapeutic strategies that prevent and treat metastasis. METHODS We analyzed single cell RNA-sequencing (scRNAseq) data from murine metastasis-bearing lungs to interrogate changes in both host and tumor cells during colonization. We used these data to elucidate pathways that become activated in cells that survive dissemination and identify candidate host-derived signals that drive activation. We validated these findings through live cell reporter systems, immunocytochemistry, and fluorescent immunohistochemistry. We then validated the functional relevance of key candidates using pharmacologic inhibition in models of metastatic osteosarcoma. RESULTS Expression patterns suggest that the MAPK pathway is significantly elevated in early and established metastases. MAPK activity correlates with expression of anti-apoptotic genes, especially MCL1. Niche cells produce growth factors that increase ERK phosphorylation and MCL1 expression in tumor cells. Both early and established metastases are vulnerable to MCL1 inhibition, but not MEK inhibition in vivo. Combining MCL1 inhibition with chemotherapy both prevented colonization and eliminated established metastases in murine models of osteosarcoma. CONCLUSION Niche-derived growth factors drive MAPK activity and MCL1 expression in osteosarcoma, promoting metastatic colonization. Although later metastases produce less MCL1, they remain dependent on it. MCL1 is a promising target for clinical trials in both human and canine patients.
Collapse
Affiliation(s)
- Camille A McAloney
- Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
- Center for Childhood Cancers and Blood Diseases, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Rawan Makkawi
- Knight Cancer Institute's, Cancer Early Detection Advanced Research Center, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA
| | - Yogesh Budhathoki
- Center for Childhood Cancers and Blood Diseases, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- Molecular, Cellular, and Developmental Biology Program, The Ohio State University, Columbus, OH, USA
| | - Matthew V Cannon
- Center for Childhood Cancers and Blood Diseases, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Emily M Franz
- Center for Childhood Cancers and Blood Diseases, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- Molecular, Cellular, and Developmental Biology Program, The Ohio State University, Columbus, OH, USA
| | - Amy C Gross
- Center for Childhood Cancers and Blood Diseases, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Maren Cam
- Center for Childhood Cancers and Blood Diseases, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Tatyana A Vetter
- Center for Gene Therapy, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University, Columbus, OH, USA
| | - Rebekka Duhen
- Knight Cancer Institute's, Cancer Early Detection Advanced Research Center, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA
| | - Alexander E Davies
- Knight Cancer Institute's, Cancer Early Detection Advanced Research Center, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA.
| | - Ryan D Roberts
- Center for Childhood Cancers and Blood Diseases, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
- Division of Pediatric Hematology, Oncology, and BMT, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA.
- The Ohio State University James Comprehensive Cancer Center, Columbus, OH, USA.
| |
Collapse
|
2
|
Lilienthal I, Herold N. Targeting Molecular Mechanisms Underlying Treatment Efficacy and Resistance in Osteosarcoma: A Review of Current and Future Strategies. Int J Mol Sci 2020; 21:ijms21186885. [PMID: 32961800 PMCID: PMC7555161 DOI: 10.3390/ijms21186885] [Citation(s) in RCA: 145] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/13/2020] [Accepted: 09/15/2020] [Indexed: 12/12/2022] Open
Abstract
Osteosarcoma is the most common primary malignant bone tumour in children and adolescents. Due to micrometastatic spread, radical surgery alone rarely results in cure. Introduction of combination chemotherapy in the 1970s, however, dramatically increased overall survival rates from 20% to approximately 70%. Unfortunately, large clinical trials aiming to intensify treatment in the past decades have failed to achieve higher cure rates. In this review, we revisit how the heterogenous nature of osteosarcoma as well as acquired and intrinsic resistance to chemotherapy can account for stagnation in therapy improvement. We summarise current osteosarcoma treatment strategies focusing on molecular determinants of treatment susceptibility and resistance. Understanding therapy susceptibility and resistance provides a basis for rational therapy betterment for both identifying patients that might be cured with less toxic interventions and targeting resistance mechanisms to sensitise resistant osteosarcoma to conventional therapies.
Collapse
Affiliation(s)
- Ingrid Lilienthal
- Division of Paediatric Oncology, Department of Women’s and Children’s Health, Karolinska Institutet, SE-171 76 Stockholm, Sweden
- Correspondence: (I.L.); (N.H.); Tel.: +46-(0)8-52483204 (I.L. & N.H.)
| | - Nikolas Herold
- Division of Paediatric Oncology, Department of Women’s and Children’s Health, Karolinska Institutet, SE-171 76 Stockholm, Sweden
- Paediatric Oncology, Astrid Lindgren’s Children Hospital, Karolinska University Hospital, SE-171 76 Stockholm, Sweden
- Correspondence: (I.L.); (N.H.); Tel.: +46-(0)8-52483204 (I.L. & N.H.)
| |
Collapse
|
3
|
Abstract
In this chapter, we will review studies of HER2 in osteosarcoma and discuss the controversies that have existed in this field. Our present understanding of HER2 in the context of osteosarcoma is that it is expressed on a subset of patient samples, but that expression is not prognostic. We will review the two trials that have been conducted in osteosarcoma which have targeted HER2. Use of an antibody, trastuzumab, did not suggest activity, but a smaller study using HER2-targeted CAR T cells suggested activity may be present. A trial of an antibody-drug conjugate targeting HER2 for recurrent osteosarcoma is under consideration. Trials targeting other surface proteins for the treatment of osteosarcoma have occurred or are in development. Indeed, this leads us to discuss in a broader fashion therapeutic approaches to targeting surface proteins. It is hoped that some of these approaches will lead to new effective therapies for patients with osteosarcoma.
Collapse
|
4
|
Advanced development of ErbB family-targeted therapies in osteosarcoma treatment. Invest New Drugs 2018; 37:175-183. [DOI: 10.1007/s10637-018-0684-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Accepted: 10/16/2018] [Indexed: 01/06/2023]
|
5
|
Wang SL, Zhong GX, Wang XW, Yu FQ, Weng DF, Wang XX, Lin JH. Prognostic significance of the expression of HER family members in primary osteosarcoma. Oncol Lett 2018; 16:2185-2194. [PMID: 30008917 PMCID: PMC6036504 DOI: 10.3892/ol.2018.8931] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 04/25/2018] [Indexed: 12/13/2022] Open
Abstract
The prognosis of patients with metastatic osteosarcoma is poor and has shown no significant improvement in nearly 20 years. The human epidermal growth factor (EGF) receptor (HER) family is frequently overexpressed in the majority of human carcinomas, and is involved in promoting the proliferation and survival of cancer cells. However, the role of EGFR and HER-2 expression in osteosarcoma survival remains controversial and no previous study has simultaneously investigated the association of the expression of all the four HER family members with the prognostic significance of osteosarcoma. Therefore, the present study investigated the expression levels of the complete members of the HER family in osteosarcoma specimens, as well as their associations with the clinicopathological parameters, progression-free survival (PFS) and overall survival (OS) time of patients with osteosarcoma. The expression of HER family members was detected in osteosarcoma tumor specimens from 60 patients using immunohistochemistry. The association of the expression of HER receptors in osteosarcoma with clinicopathological parameters was analyzed using χ2 test and Fishers exact test. Survival analyses were evaluated by Kaplan-Meier method and Cox proportional hazards regression model. Overall, 18 (30%), 13 (22%), 23 (38%) and 19 (32%) patients presented with high expression of EGFR, HER-2, HER-3 and HER-4, respectively, and the co-expression of 2, 3 and all 4 members of the HER family was observed. High expression of EGFR and HER-4 was associated with distant metastasis. High HER-3 expression was significantly associated with an advanced Enneking stage and distant metastasis. Multivariate analysis demonstrated that the expression of EGFR, HER-3, HER-4, EGFR/HER-3, EGFR/HER-4 and HER-3/HER-4 was an independent predictor of poor PFS and OS time in osteosarcoma patients with stage I–IIB disease. In patients with stage IIB osteosarcoma, the expression of HER-4 and EGFR/HER-4 demonstrated a more significant effect on PFS and OS time. In conclusion, therapies targeting EGFR, HER-3 and HER-4 may provide promising strategies for primary osteosarcoma.
Collapse
Affiliation(s)
- Sheng-Lin Wang
- Department of Orthopedics, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, P.R. China
| | - Guang-Xian Zhong
- Department of Orthopedics, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, P.R. China
| | - Xin-Wen Wang
- Department of Orthopedics, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, P.R. China
| | - Feng-Qiang Yu
- Department of Orthopedics, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, P.R. China
| | - Dan-Feng Weng
- Department of Pathology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, P.R. China
| | - Xin-Xing Wang
- Department of Pathology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, P.R. China
| | - Jian-Hua Lin
- Department of Orthopedics, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, P.R. China.,Central Laboratory, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, P.R. China
| |
Collapse
|
6
|
Wu H, Muscato NE, Gonzalez A, Shyr Y. An EGFR and AKT Signaling Pathway was Identified with Mediation Model in Osteosarcomas Clinical Study. Biomark Insights 2017. [DOI: 10.1177/117727190700200035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Identification of correlation pattern and signal pathway among biomarkers in patients has become increasingly interesting for its potential values in diagnosis, treatment and prognosis. EGFR and p-AKT signaling in osteosarcoma (OS) patients were analyzed for its relationship with cancer cell proliferation maker, Ki-67, using causal procedures and statistical tests. A total of 69 patients were collected who present to Vanderbilt University Medical Center with newly diagnosed, previously untreated osteosarcomas during the clinical study period 1994 through 2003. Tissue microarrays were constructed for EGFR, p-AKT and Ki-67. The mediation model was constructed with structural equation model (SEM) for the causal analysis of the three biomarkers in osteosarcoma patients. The results suggested a mediating effect of p-AKT for the causal relationship between EGFR and Ki-67. The study also found significant associations between EGFR and Ki-67 (p = 0.002), EGFR and p-AKT (p = 0.027), and p-AKT and Ki-67 controlling EGFR (p = 0.004). After the impact of EGFR on Ki-67 was accounted for by p-AKT, the relation between EGFR and Ki-67 was no longer significant (p = 0.381). The mediating effect was confirmed with Sobel test (p < 0.001) and Goodman (I) test (p < 0.001). The study indicated that a mediation model could be an approach to exploring the correlation pattern of EGFR and AKT signal pathway for cancer cell proliferation in OS patients in clinical study.
Collapse
Affiliation(s)
- Huiyun Wu
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN 37232-6848, U.S.A
| | - Nicole E. Muscato
- Department of Pathology, Vanderbilt University Medical Center, Nashville, TN 37232-6848, U.S.A
| | - Adriana Gonzalez
- Department of Pathology, Vanderbilt University Medical Center, Nashville, TN 37232-6848, U.S.A
| | - Yu Shyr
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN 37232-6848, U.S.A
| |
Collapse
|
7
|
Abstract
Osteosarcoma is the most common primary malignant bone tumor in Egypt. Ezrin is involved in cell adhesion to the extracellular matrix and in cell-cell interactions facilitating metastasis. HER2/neu is overexpressed in breast cancer and other types of cancer. This study aimed to assess the expression of ezrin and HER2/neu in 57 primary osteosarcoma cases and to correlate their expression with the available clinicopathologic parameters and the overall, metastasis-free and event-free survival. Both ezrin and HER2/neu were not expressed in the normal bone and they were upregulated in 82.5% and 71.9% of osteosarcoma, respectively. Positive ezrin expression was significantly associated with young age (below 25 y) (P=0.01), high grade (P=0.001), and short survival time (P=0.0001). Positive HER2/neu expression was significantly associated with high-grade osteosarcoma (P=0.04). Membranous HER2/neu expression was the only factor that showed significant impact on metastasis-free (P=0.002) and event-free survival (P=0.002). Ezrin was significantly correlated with HER2/neu expression (P=0.02). Advanced stage (P=0.0001), metastasis (P=0.0001), and recurrence (P=0.01) were the factors affecting the overall survival of osteosarcoma patients. Ezrin and HER2/neu are overexpressed and coexpressed in osteosarcoma with adverse prognostic features such as high grade. Membranous pattern of HER2/neu seems to be more important than the cytoplasmic pattern because of its impact on metastasis-free and event-free survival. Therefore, ezrin and HER2/neu could be potential prognostic markers and treatment targets for osteosarcoma.
Collapse
|
8
|
Tieken C, Verboom MC, Ruf W, Gelderblom H, Bovée JVMG, Reitsma PH, Cleton-Jansen AM, Versteeg HH. Tissue factor associates with survival and regulates tumour progression in osteosarcoma. Thromb Haemost 2016; 115:1025-33. [PMID: 26763081 DOI: 10.1160/th15-07-0541] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 12/02/2015] [Indexed: 01/10/2023]
Abstract
Osteosarcoma is the most common primary malignant bone tumour. Patients often develop lung metastasis and have a poor prognosis despite extensive chemotherapy and surgical resections. Tissue Factor is associated with poor clinical outcome in a wide range of cancer types, and promotes angiogenesis and metastasis. The role of Tissue Factor in OS tumourigenesis is unknown. Fifty-three osteosarcoma pre-treatment biopsies and four osteosarcoma cell lines were evaluated for Tissue Factor expression, and a possible association with clinical parameters was investigated. Tissue Factor function was inhibited in an osteosarcoma cell line (143B) by shRNA knockdown or specific antibodies, and pro-tumourigenic gene expression, proliferation, matrigel invasion and transwell migration was examined. 143B cells were implanted in mice in the presence of Tissue Factor-blocking antibodies, and tumour volume, micro-vessel density and metastases in the lung were evaluated. Tissue Factor was highly expressed in 73.6 % of osteosarcoma biopsies, and expression associated significantly with disease-free survival. Tissue Factor was expressed in all four investigated cell lines. Tissue Factor was knocked down in 143B cells, which led to reduced expression of IL-8, CXCL-1, SNAIL and MMP2, but not MMP9. Tissue Factor knockdown or inhibition with antibodies reduced matrigel invasion. Tissue Factor antibodies limited 143B tumour growth in vivo, and resulted in decreased intra-tumoural micro-vessel density. Furthermore, lung metastasis from the primary tumour was significantly reduced. Thus, Tissue Factor expression in osteosarcoma reduces metastasis-free survival in patients, and increases pro-tumourigenic behaviour both in vitro and in vivo.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Henri H Versteeg
- Henri H. Versteeg, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands, Tel.: +31 715263872, Fax: +31 71526755, E-mail:
| |
Collapse
|
9
|
Abstract
Osteosarcoma is the most common malignant bone tumor in children and characterized by aggressive biologic behavior of metastatic propensity to the lung. Change of treatment paradigm brings survival benefit; however, 5-year survival rate is still low in patients having metastastatic foci at diagnosis for a few decades. Metastasis-associated protein (MTA) family is a group of ubiquitously expressed coregulators, which influences on tumor invasiveness or metastasis. MTA1 has been investigated in various cancers including osteosarcoma, and its overexpression is associated with high-risk features of cancers. In this review, we described various molecular studies of osteosarcoma, especially associated with MTA1.
Collapse
Affiliation(s)
- Sung Sun Kim
- Department of Pathology, Chonnam National University Medical School, 160, Baekseo-ro, Dong-gu, Gwangju, 501-757, Korea,
| | | |
Collapse
|
10
|
Wang H, Yang Q, Fu Z, Zuo D, Hua Y, Cai Z. ErbB receptors as prognostic and therapeutic drug targets in bone and soft tissue sarcomas. Cancer Invest 2014; 32:533-42. [PMID: 25347730 DOI: 10.3109/07357907.2014.964409] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
ErbB receptors have been intensely studied to understand their importance in cancer biology and as therapeutic targets, and many ErbB inhibitors are now used in the clinical setting. A large number of studies have been conducted to examine the expression of ErbB family members in bone and soft tissue sarcomas, including osteosarcomas, synovial sarcomas, Ewing sarcomas, rhabdomyosarcomas, and so on. Nevertheless, the clinical implications of ErbB receptors remain elusive. To illustrate the potential of ErbB family members as prognostic and therapeutic drug targets in bone and soft tissue sarcomas, we summarized the molecular evidence and observations from clinical and basic trials.
Collapse
Affiliation(s)
- Hongsheng Wang
- 1Department of Orthopedics, Shanghai 1st People's Hospital, Shanghai Jiaotong University, Shanghai, China
| | | | | | | | | | | |
Collapse
|
11
|
Abstract
The major goals of translational research in osteosarcoma entail the identification of prognostic factors and therapeutic targets. Given the relevance of epidermal growth factor receptor pathway to breast cancer and the finding that HER-2 was expressed in a proportion of osteosarcoma, it was reasonable to investigate this pathway further. Investigations of HER-2 in osteosarcoma have led to the publication of numerous conflicting reports with regard to the level and prognostic value of HER-2 expression, which are reviewed and discussed. Numerous lessons provided by this research experience are described. This pathway has also been explored as a therapeutic target with at least one study of trastuzumab for the treatment of osteosarcoma completed. Other studies utilizing alternative approaches to target the HER-2 receptor for the treatment of osteosarcoma have been considered.
Collapse
|
12
|
Gorlick S, Barkauskas DA, Krailo M, Piperdi S, Sowers R, Gill J, Geller D, Randall RL, Janeway K, Schwartz C, Grier H, Meyers PA, Gorlick R, Bernstein M, Marina N. HER-2 expression is not prognostic in osteosarcoma; a Children's Oncology Group prospective biology study. Pediatr Blood Cancer 2014; 61:1558-64. [PMID: 24753182 PMCID: PMC4288578 DOI: 10.1002/pbc.25074] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 03/20/2014] [Indexed: 01/03/2023]
Abstract
BACKGROUND Since the initial reports of human epidermal growth factor receptor 2 (HER-2) expression as being prognostic in osteosarcoma, numerous small studies varying in the interpretation of the immunohistochemical (IHC) staining patterns have produced conflicting results. The Children's Oncology Group therefore embarked on a prospective biology study in a larger sample of patients to define in osteosarcoma the prognostic value of HER-2 expression using the methodology employed in the initial North American study describing an association between HER-2 expression and outcome. PROCEDURE The analytic patient population was comprised of 149 patients with newly diagnosed osteosarcoma, 135 with localized disease and 14 with metastatic disease, all of whom had follow up clinical data. Paraffin embedded material from the diagnostic biopsy was stained with CB11 antibody and scored by two independent observers. Correlation of HER-2 IHC score and demographic variables was analyzed using a Fisher's exact test and correlation with survival using a Kaplan-Meier analysis. RESULTS No association was found with HER-2 status and any of the demographic variables tested including the presence or absence of metastatic disease at diagnosis. No association was found between HER-2 status and either event free survival or overall survival in the patients with localized disease. CONCLUSION HER-2 expression is not prognostic in osteosarcoma in the context of this large prospective study. HER-2 expression cannot be used as a basis for stratification of therapy. Identification of potential prognostic factors should occur in the context of large multi-institutional biology studies.
Collapse
Affiliation(s)
- Sarah Gorlick
- Department of Pediatrics, The Children’s Hospital at Montefiore and the Albert Einstein College of Medicine, Bronx, New York
| | - Donald A. Barkauskas
- Department of Preventive Medicine, University of Southern California, Los Angeles, California
| | - Mark Krailo
- Department of Preventive Medicine, University of Southern California, Los Angeles, California
| | - Sajida Piperdi
- Department of Pediatrics, The Children’s Hospital at Montefiore and the Albert Einstein College of Medicine, Bronx, New York
| | - Rebecca Sowers
- Department of Pediatrics, The Children’s Hospital at Montefiore and the Albert Einstein College of Medicine, Bronx, New York
| | - Jonathan Gill
- Department of Pediatrics, The Children’s Hospital at Montefiore and the Albert Einstein College of Medicine, Bronx, New York
| | - David Geller
- Department of Orthopaedic Surgery, Montefiore Medical Center and the Children’s Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY
| | - R. Lor Randall
- Sarcoma Services, Huntsman Cancer Institute & Primary Children’s Hospital, University
of Utah, Salt Lake City, UT
| | - Katherine Janeway
- Department of Pediatric Hematology-Oncology, Dana Farber Cancer Institute and Children’s Hospital, Boston, Massachusetts
| | - Cindy Schwartz
- Division of Pediatric Hematology-Oncology, Hasbro Children’s Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Holcombe Grier
- Department of Pediatric Hematology-Oncology, Dana Farber Cancer Institute and Children’s Hospital, Boston, Massachusetts
| | - Paul A. Meyers
- Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Richard Gorlick
- Department of Pediatrics, The Children’s Hospital at Montefiore and the Albert Einstein College of Medicine, Bronx, New York,Department of Molecular Pharmacology, The Albert Einstein College of Medicine, Bronx, New York,Correspondence to: Richard Gorlick, Department of Pediatrics, the Children’s Hospital at Montefiore, 3415 Bainbridge Avenue, Rosenthal Room 300, Bronx, NY 10467.
| | - Mark Bernstein
- Division of Hematology-Oncology, IWK Health Center, Halifax, Nova Scotia, Canada
| | - Neyssa Marina
- Division of Hematology-Oncology, Stanford University Medical Center & Lucile Packard Children’s Hospital, Stanford, California
| |
Collapse
|
13
|
HER2/neu: an increasingly important therapeutic target. Part 2: Distribution of HER2/neu overexpression and gene amplification by organ, tumor site and histology. ACTA ACUST UNITED AC 2014. [DOI: 10.4155/cli.14.62] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
14
|
Pediatric solid tumors: embryonal cell oncogenesis. Mol Oncol 2013. [DOI: 10.1017/cbo9781139046947.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
|
15
|
Update on Targets and Novel Treatment Options for High-Grade Osteosarcoma and Chondrosarcoma. Hematol Oncol Clin North Am 2013; 27:1021-48. [DOI: 10.1016/j.hoc.2013.07.012] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
|
16
|
Zhu L, McManus MM, Hughes DPM. Understanding the Biology of Bone Sarcoma from Early Initiating Events through Late Events in Metastasis and Disease Progression. Front Oncol 2013; 3:230. [PMID: 24062983 PMCID: PMC3775316 DOI: 10.3389/fonc.2013.00230] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Accepted: 08/21/2013] [Indexed: 12/27/2022] Open
Abstract
The two most common primary bone malignancies, osteosarcoma (OS), and Ewing sarcoma (ES), are both aggressive, highly metastatic cancers that most often strike teens, though both can be found in younger children and adults. Despite distinct origins and pathogenesis, both diseases share several mechanisms of progression and metastasis, including neovascularization, invasion, anoikis resistance, chemoresistance, and evasion of the immune response. Some of these processes are well-studies in more common carcinoma models, and the observation from adult diseases may be readily applied to pediatric bone sarcomas. Neovascularization, which includes angiogenesis and vasculogenesis, is a clear example of a process that is likely to be similar between carcinomas and sarcomas, since the responding cells are the same in each case. Chemoresistance mechanisms also may be similar between other cancers and the bone sarcomas. Since OS and ES are mesenchymal in origin, the process of epithelial-to-mesenchymal transition is largely absent in bone sarcomas, necessitating different approaches to study progression and metastasis in these diseases. One process that is less well-studied in bone sarcomas is dormancy, which allows micrometastatic disease to remain viable but not growing in distant sites – typically the lungs – for months or years before renewing growth to become overt metastatic disease. By understanding the basic biology of these processes, novel therapeutic strategies may be developed that could improve survival in children with OS or ES.
Collapse
Affiliation(s)
- Limin Zhu
- Department of Pediatrics - Research, UT MD Anderson Cancer Center , Houston, TX , USA
| | | | | |
Collapse
|
17
|
Wang TF, Wang H, Peng AF, Luo QF, Liu ZL, Zhou RP, Gao S, Zhou Y, Chen WZ. Inhibition of fatty acid synthase suppresses U-2 OS cell invasion and migration via downregulating the activity of HER2/PI3K/AKT signaling pathway in vitro. Biochem Biophys Res Commun 2013; 440:229-34. [PMID: 24041695 DOI: 10.1016/j.bbrc.2013.09.024] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 09/05/2013] [Indexed: 02/08/2023]
Abstract
FASN plays an important role in the malignant phenotype of various tumors. Our previous studies show that inhibition FASN could induce apoptosis and inhibit proliferation in human osteosarcoma (OS) cell in vivo and vitro. The aim in this study was to investigate the effect of inhibition FASN on the activity of HER2/PI3K/AKT axis and invasion and migration of OS cell. The expression of FASN, HER2 and p-HER2(Y1248) proteins was detected by immunohistochemistry in OS tissues from 24 patients with pulmonary metastatic disease, and the relationship between FASN and p-HER2 as well as HER2 was investigated. The results showed that there was a positive correlation between FASN and HER2 as well as p-HER2 protein expression. The U-2 OS cells were transfected with either the FASN specific RNAi plasmid or the negative control RNAi plasmid. FASN mRNA was measured by RT-PCR. Western blot assays was performed to examine the protein expression of FASN, HER2, p-HER2(Y1248), PI3K, Akt and p-Akt (Ser473). Migration and invasion of cells were investigated by wound healing and transwell invasion assays. The results showed that the activity of HER2/PI3K/AKT signaling pathway was suppressed by inhibiting FASN. Meanwhile, the U-2OS cells migration and invasion were also impaired by inhibiting the activity of FASN/HER2/PI3K/AKT. Our results indicated that inhibition of FASN suppresses OS cell invasion and migration via down-regulation of the "HER2/PI3K/AKT" axis in vitro. FASN blocker may be a new therapeutic strategy in OS management.
Collapse
Affiliation(s)
- Tao Fang Wang
- Department of Orthopedics, First Affiliated Hospital of Nanchang University, Jiangxi, PR China
| | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Jullien N, Dieudonné FX, Habel N, Marty C, Modrowski D, Patino A, Lecanda F, Sévère N, Marie PJ. ErbB3 silencing reduces osteosarcoma cell proliferation and tumor growth in vivo. Gene 2013; 521:55-61. [DOI: 10.1016/j.gene.2013.03.031] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Accepted: 03/07/2013] [Indexed: 12/22/2022]
|
19
|
Davicioni E, Wai DH, Anderson MJ. Diagnostic and Prognostic Sarcoma Signatures. Mol Diagn Ther 2012; 12:359-74. [DOI: 10.1007/bf03256302] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
20
|
Ebb D, Meyers P, Grier H, Bernstein M, Gorlick R, Lipshultz SE, Krailo M, Devidas M, Barkauskas DA, Siegal GP, Ferguson WS, Letson GD, Marcus K, Goorin A, Beardsley P, Marina N. Phase II trial of trastuzumab in combination with cytotoxic chemotherapy for treatment of metastatic osteosarcoma with human epidermal growth factor receptor 2 overexpression: a report from the children's oncology group. J Clin Oncol 2012; 30:2545-51. [PMID: 22665540 DOI: 10.1200/jco.2011.37.4546] [Citation(s) in RCA: 171] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Despite efforts to intensify chemotherapy, survival for patients with metastatic osteosarcoma remains poor. Overexpression of human epidermal growth factor receptor 2 (HER2) in osteosarcoma has been shown to predict poor therapeutic response and decreased survival. This study tests the safety and feasibility of delivering biologically targeted therapy by combining trastuzumab with standard chemotherapy in patients with metastatic osteosarcoma and HER2 overexpression. PATIENTS AND METHODS Among 96 evaluable patients with newly diagnosed metastatic osteosarcoma, 41 had tumors that were HER2-positive by immunohistochemistry. All patients received chemotherapy with cisplatin, doxorubicin, methotrexate, ifosfamide, and etoposide. Dexrazoxane was administered with doxorubicin to minimize the risk of cardiotoxicity from treatment with trastuzumab and anthracycline. Only patients with HER2 overexpression received concurrent therapy with trastuzumab given for 34 consecutive weeks. RESULTS The 30-month event-free and overall survival rates for patients with HER2 overexpression treated with chemotherapy and trastuzumab were 32% and 59%, respectively. For patients without HER2 overexpression, treated with chemotherapy alone, the 30-month event-free and overall survival rates were 32% and 50%, respectively. There was no clinically significant short-term cardiotoxicity in patients treated with trastuzumab and doxorubicin. CONCLUSION Despite intensive chemotherapy plus trastuzumab for patients with HER2-positive disease, the outcome for all patients was poor, with no significant difference between the HER2-positive and HER2-negative groups. Although our findings suggest that trastuzumab can be safely delivered in combination with anthracycline-based chemotherapy and dexrazoxane, its therapeutic benefit remains uncertain. Definitive assessment of trastuzumab's potential role in treating osteosarcoma would require a randomized study of patients with HER2-positive disease.
Collapse
Affiliation(s)
- David Ebb
- Massachusetts General Hospital, Boston, MA, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Ma Q, Zhou Y, Ma B, Chen X, Wen Y, Liu Y, Fan Q, Qiu X. The clinical value of CXCR4, HER2 and CD44 in human osteosarcoma: A pilot study. Oncol Lett 2012; 3:797-801. [PMID: 22740996 DOI: 10.3892/ol.2012.558] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2011] [Accepted: 12/13/2011] [Indexed: 01/07/2023] Open
Abstract
The biological markers CXCR4, HER2 and CD44 are involved in tumor growth and the homing of cancer cells to distant sites. The aim of this retrospective, case-control study was to evaluate whether the expression of CXCR4, HER2 and CD44 correlated with poor prognosis. Expression levels of CXCR4, HER2 and CD44 were evaluated by immunohistochemical staining in paraffin-embedded tissue sections of malignant primary osteosarcoma and related metastatic carcinoma from 63 patients, at a median follow-up of 5.5 years (range 1-10 years). Associations between these parameters and clinical features were examined. Of the 63 specimens, there were 38 HER2-positive, 57 CXCR4-positive and 62 CD44-positive cases. There were 36 cases of HER2 and CXCR4 co-expression, 38 cases of HER2 and CD44 co-expression and 56 cases of CXCR4 and CD44 co-expression. A total of 33 cases were CXCR4, HER2 and CD44 co-positive. Surface expression of CXCR4, HER2 and CD44 was high in the selected tissue samples, and CD44 was the most highly expressed. We observed a significant trend for a higher frequency of the expression of the three biomarkers in high-grade compared to low-grade osteosarcoma. Our results suggest a pivotal role of CXCR4, HER2 and CD44 expression as a prognostic factor of malignant human osteosarcoma. A larger study is ongoing to confirm these results.
Collapse
Affiliation(s)
- Qiong Ma
- Orthopaedic Oncology Institute of Chinese PLA, Tangdu Hospital, The Fourth Military Medical University, Xi'an 710038, P.R. China
| | | | | | | | | | | | | | | |
Collapse
|
22
|
Baumhoer D, Smida J, Specht K, Bink K, Quintanilla-Martinez L, Rosemann M, Siggelkow H, Nathrath WB, Atkinson MJ, Bielack S, Jundt G, Nathrath M. Aberrant expression of the human epidermal growth factor receptor 2 oncogene is not a common feature in osteosarcoma. Hum Pathol 2011; 42:859-66. [DOI: 10.1016/j.humpath.2010.09.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2010] [Revised: 09/14/2010] [Accepted: 09/23/2010] [Indexed: 10/18/2022]
|
23
|
Yarber JL, Agulnik M. Targeted therapies in bone sarcomas: current approach and future directions. Expert Opin Investig Drugs 2011; 20:973-9. [PMID: 21510829 DOI: 10.1517/13543784.2011.577064] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Bone sarcomas are rare malignancies and once advanced, there is limited response to current chemotherapeutic regimens. Targeted therapies could have substantial impact on these diseases. AREAS COVERED Specific molecular targets of bone sarcomas are reviewed along with the various targeted therapies that have potential to change the outcome of these chemotherapy resistant diseases. EXPERT OPINION There are promising pathways identified that targeted inhibitors could provide better treatment options for metastatic bone sarcomas. There is a strong need for continued Phase II and III clinical trials investigating these molecularly targeted therapies.
Collapse
Affiliation(s)
- Jessica Lee Yarber
- Northwestern Memorial Hospital, Internal Medicine, Chicago, IL 60611, USA.
| | | |
Collapse
|
24
|
Geller DS, Gorlick R. HER-2 targeted treatment of osteosarcoma: the challenges of developing targeted therapy and prognostic factors for rare malignancies. Expert Opin Pharmacother 2010; 11:51-61. [PMID: 20001429 DOI: 10.1517/14656560903419614] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
IMPORTANCE OF THE FIELD Despite the substantial success realized treating osteosarcoma with chemotherapy, metastatic disease or refractory/recurrent disease continue to frustrate patients and clinicians. The failure to improve outcomes with treatment intensification indicates the need for new approaches, such as the introduction of targeted therapy. The application of trastuzumab (Herceptin((R))) in the setting of HER-2 positive osteosarcoma is reflective of this concept. AREAS COVERED IN THIS REVIEW This review summarizes reports from 1996 to the present which focus on HER-2 expression and its prognostic relevance in the setting of osteosarcoma. WHAT THE READER WILL GAIN The prognostic value of HER-2 remains controversial, and both standard methodologies for assessing expression and the effectiveness of HER-2 directed therapy in this patient population have yet to be established. TAKE HOME MESSAGE The relative rarity of the disease makes larger prospective studies difficult in terms of both time and coordination. The feasibility of defining therapy specifically for a subpopulation of patients afflicted with a rare cancer, such as osteosarcoma, can be conceptually questioned.
Collapse
Affiliation(s)
- David S Geller
- Montefiore Medical Center, Department of Orthopaedic Surgery, 3400 Bainbridge Avenue, Bronx, NY 10467, USA.
| | | |
Collapse
|
25
|
Abstract
Osteosarcoma is the most common bone tumor seen in the pediatric and adolescent age group. Survival rates in osteosarcoma have improved considerably from 20 to 65% since the 1980s with the advent of multiagent chemotherapy. Further improvement in survival has not been achieved owing to lack of well-validated prognostic markers and better therapeutic agents. Markers involved with angiogenesis, cell adhesion, apoptosis and cell cycle have been shown recently to play an important role in osteosarcoma growth, differentiation and metastasis. Over the coming years, the new molecular markers may be able not only to prognosticate osteosarcoma patients at baseline but also to serve as therapeutic targets and thereby improve survival rates further. Noninvasive imaging methods in osteosarcoma such as PET-CT and dynamic contrast enhanced and diffusion-weighted MRI hold a lot of promise as surrogate methods for prognostication and response assessment.
Collapse
Affiliation(s)
- Sameer Bakhshi
- Department of Medical Oncology, Dr B R A Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | | |
Collapse
|
26
|
Hughes DPM. Strategies for the targeted delivery of therapeutics for osteosarcoma. Expert Opin Drug Deliv 2010; 6:1311-21. [PMID: 19761419 DOI: 10.1517/17425240903280422] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Conventional therapy for osteosarcoma has reached a plateau of 60 - 70%, a 5-year survival rate that has changed little in two decades, highlighting the need for new approaches. OBJECTIVE To review the alternative means of delivering effective therapy for osteosarcoma that reach beyond the central venous catheter. METHODS Drawing on the author's own experiences providing care to high-risk osteosarcoma patients and reviewing the last two decades of literature describing sarcoma therapy, available information is summarized about potential osteosarcoma treatments that deliver therapy by a less conventional route. RESULTS/CONCLUSIONS Intra-arterial chemotherapy has a limited impact on survival, but may help to achieve a better limb salvage. Intrapleural chemotherapy is important for managing malignant effusions. The development of inhalation therapies, treatments that target new bone formation such as bisphosphonates, chemically targeted radiation and antibody-based therapies all have potential to improve osteosarcoma therapy.
Collapse
Affiliation(s)
- Dennis P M Hughes
- The Children's Cancer Hospital at MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 853, Houston, TX 77030, USA.
| |
Collapse
|
27
|
Abstract
Osteosarcoma is the most common malignant primary bone tumor in childhood. Despite multiagent chemotherapy and aggressive surgical resection, 30% of patients with localized disease and 80% of patients with metastatic disease at diagnosis will relapse. Survival for these patients has remained unchanged over the past 20 years. A number of novel agents in various stages of development hold promise for improving therapy for patients with osteosarcoma. This article will focus on novel therapeutic approaches, including agents targeting signal-transduction pathways, inhibitors of the tumor microenvironment and immunomodulatory agents, as well as overcoming resistance mechanisms and the use of novel delivery mechanisms.
Collapse
Affiliation(s)
- Kathleen O'Day
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, The Children's Hospital at Montefiore, 3415 Bainbridge Avenue, Rosenthal 3rd floor, Bronx, NY 10467, USA.
| | | |
Collapse
|
28
|
Abstract
BACKGROUND There is controversy regarding the patterns and prognostic significance of Her-2/neu and p-53 expression in osteosarcoma. Further, their combined expression has not been studied. PROCEDURE Prechemotherapy biopsy specimens of 63 osteosarcoma patients from June 2004 to August 2006 were analyzed for Her-2/neu and p-53 using immunohistochemistry and compared with grade, stage, and morphologic subtype of tumor. RESULTS There were 59 high-grade tumors; 32 of 63 had metastases. Histopathologic types included 36 of 63 osteoblastic and 18 of 63 chondroblastic subtypes. Male sex (P=0.045) and chondroblastic type (P=0.004) were associated with metastatic disease. Her-2/neu cytoplasmic staining was seen in 30 of 63 (47.1%) cases, 4 of 30 had additional membranous staining, 17 of 30 were metastatic, and 29 of 30 were high-grade tumors. Staining grade was 3+ in 10 of 30 samples whereas staining intensity 3+ was observed in 26 of 30 samples. Her-2/neu 3+ staining grade was significantly associated with chondroblastic subtype (6/18, P=0.026). P-53 staining was seen in 20 of 63 (31.74%) cases (all high grade), of which 11 were metastatic. Staining grades 3+ and 4+ were seen in 16 of 20 samples whereas staining intensity 3+ in 13 of 20 samples. P-53 expression was higher in chondroblastic (7/18, P value was not significant) and fibroblastic (3/3, P<0.05) subtypes. Coexpression of Her-2/neu and p-53 was seen in 10 cases (15.87%); 3 of 10 cases showed Her-2/neu membranous staining (P=0.01). CONCLUSIONS Her-2/neu (47.1%), p-53 (31.74%), and their combined expression (15.87%) were not related to grade or stage of tumor. Chondroblastic subtype was associated with staining grade 3+ of Her-2/neu staining whereas coexpression of Her-2/neu and p-53 was significantly associated with membranous Her-2/neu staining.
Collapse
|
29
|
Abstract
Osteosarcoma is the most common primary tumor of bone and accounts for approximately 19% of all malignant tumors of bone. It is the third most common malignant tumor in teenagers. More than twenty years ago, the advent of a multidisciplinary approach that combined multi-agent chemotherapy and limb-sparing surgery greatly improved the survival rate of patients with osteosarcoma. Unfortunately, since that time, survival rates have not dramatically improved. To date, the most powerful predictors of outcome have remained the ability to detect metastatic disease at diagnosis and the histopathologic response of the tumor to preoperative chemotherapy. Presently, 80% of patients who do not have distant metastases at initial diagnosis will become long-term survivors. Unfortunately, this means that approximately 20% of patients who do not present with metastases at diagnosis will not survive. This group of patients appears to be resistant to current treatment as attempts to intensify therapy after surgery for patients with a poor histopathologic response has not significantly improved survival rates. It is these patients that are in the greatest need of additional clinically relevant markers for prognosis and who can be most helped by molecular analysis. While steady progress has been made in the identification of genetic alterations in osteosarcoma, no individual molecular marker has thus far been demonstrated to have a better prognostic significance in the treatment of osteosarcomas than the current clinical markers. Thus there is clearly a need to employ new comprehensive analysis technologies to develop significantly more informative classification systems and to identify new therapeutic targets.
Collapse
Affiliation(s)
- Colin Kong
- Center For Molecular Medicine, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030
| | | |
Collapse
|
30
|
Siegel HJ, Pressey JG. Current concepts on the surgical and medical management of osteosarcoma. Expert Rev Anticancer Ther 2008; 8:1257-69. [PMID: 18699764 DOI: 10.1586/14737140.8.8.1257] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Although advances have been made in both surgical and medical management of patients with osteosarcoma, the overall survival of patients with osteosarcoma has remained constant, with no substantial improvement in the past 15 years. Advances in imaging have had a substantial impact on surgical planning and staging. These advances have, in turn, had a major impact on the surgeon's ability to perform limb-sparing surgery. Surgical techniques have improved in terms of instrumentation, modularity of implants and availability. Limb salvage has proven to be an acceptable method of treatment both with respect to oncologic and functional outcome in those patients where a wide resection may be achieved. The use of massive allografts has been largely replaced with the use of modern oncologic endoprostheses. Biologic targets that will enable new therapies to have maximum effect on tumor cells while minimizing toxicity to the host tissues need to be identified.
Collapse
Affiliation(s)
- Herrick J Siegel
- University of Alabama at Birmingham, Orthopedic Specialties Building, 1313 13th St South, Suite 211, Birmingham, AL 35205, USA.
| | | |
Collapse
|
31
|
Yalçin B, Gedikoğlu G, Kutluk T, Varan A, Akyüz C, Büyükpamukçu M. C-erbB-2 expression and prognostic significance in osteosarcoma. Pediatr Blood Cancer 2008; 51:222-7. [PMID: 18421709 DOI: 10.1002/pbc.21576] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND C-erbB-2 is postulated as a prognostic biological marker for osteosarcoma (OST). We investigated c-erbB-2 expression status in osteosarcomas and its prognostic significance. PROCEDURE Archival pre-treatment tumor biopsies of 79 cases were stained by immunohistochemical (IHC) methods with CB11 antibody for cell-membrane specific c-erbB-2 expression. Relation with different variables was examined and survival rates were calculated. RESULTS Median age was 13 years (7-17). Distant metastases were detected in 8 (10.1%) cases at initial diagnosis. 36/79 (45.6%) patients had positive c-erbB-2 staining by IHC. There was no significant difference between c-erbB-2 expression and presence of distant metastases at initial diagnosis or during follow-up, gender, age groups, tumor size, tumor sites, serum alkaline phosphatase, and lactate dehydrogenase levels. At a median follow-up of 67.4 months (9.2-246.1), 36 cases died, 20 were alive, and 23 abandoned treatment. For 58 cases without initial metastases who underwent definitive surgery, 5-year event-free (EFS) and overall survival (OS) rates were 50% and 62.1% in cases negative for c-erbB-2 expression, and 22.4% and 32.3% in cases positive for c-erbB-2 expression, respectively (EFS, P = 0.044; OS, P = 0.029). Five-year EFS and OS rates were significantly higher in cases with a tumor size <10 cm. Cox regression analyses revealed that only size persisted as a prognostic factor for EFS. C-erbB-2 expression status didn't appear as an independent prognostic factor. CONCLUSIONS Overexpression of c-erbB-2 in OST was not correlated with metastatic potential. No independent prognostic significance was detected. The results do not support directed therapies for c-erbB-2 in OST.
Collapse
Affiliation(s)
- Bilgehan Yalçin
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, 06100 Ankara, Turkey.
| | | | | | | | | | | |
Collapse
|
32
|
Abstract
Biologicals are defined as agents that are either uniquely or partially tumor-specific. Great expectations were raised by the success in agents that target a specific genetic translocation: all-trans retinoic acid, targeting the chronic myeloid leukemia retinoic acid receptor in acute promyelocytic leukemia and imatinib, a small molecule targeting the BCR-ABL translocation in chronic myeloid leukemia (CML). Thus far, the search for similar "druggable" genetic targets in pediatric cancers has not yet resulted in such dramatic results. The rarity of pediatric cancer as well as ethical considerations necessitate that the agents for testing be carefully and rigorously selected. Biologicals present an additional challenge, as they often do not lend themselves to in vitro testing. Early approaches to specific targeting of solid tumors utilized monoclonal antibodies. The microenvironment provides an interesting new biological approach to treating tumors and alteration of the host immune response provides another avenue. Biological agents are a step forward in supportive care to reduce the hematological toxicity of high-dose chemotherapy and to manage the frequent infectious complications.
Collapse
Affiliation(s)
- Bharat Agarwal
- Department of Pediatric Hematology and Oncology, B.J. Wadia Hospital for Children, Institute of Child Health and Research Centre, Mumbai, India.
| |
Collapse
|
33
|
Sarcomas of Bone. Oncology 2007. [DOI: 10.1007/0-387-31056-8_57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
34
|
Molecular and Immunohistochemical Analysis of ERBB2 Expression in Correlation With Proliferation Rate in Synovial Sarcoma. ACTA ACUST UNITED AC 2007; 16:211-7. [DOI: 10.1097/pdm.0b013e3180621995] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
35
|
Wen YH, Koeppen H, Garcia R, Chiriboga L, Tarlow BD, Peters BA, Eigenbrot C, Yee H, Steiner G, Greco MA. Epidermal growth factor receptor in osteosarcoma: expression and mutational analysis. Hum Pathol 2007; 38:1184-91. [PMID: 17509661 DOI: 10.1016/j.humpath.2007.01.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2006] [Revised: 12/29/2006] [Accepted: 01/03/2007] [Indexed: 12/23/2022]
Abstract
Activation of intracellular mitogenic signal transduction pathways driven by the ErbB family of receptor tyrosine kinases has been implicated in the development and/or progression of a variety of cancers. Studies on ErbB receptors in osteosarcoma have focused on HER-2 and have produced conflicting results with few studies evaluating the expression of the epidermal growth factor receptor (EGFR). In this study, we determined the level of expression of EGFR and the mutational status of the EGFR receptor in a subset of osteosarcoma tumor samples as well as in a series of established bone tumor-derived cell lines. EGFR protein expression was detected in the form of strong membranous staining by immunohistochemistry in 21 (57%) of 37 cases analyzed. Six of 12 (50%) osteosarcoma cell lines revealed moderate to high expression levels of EGFR. Two somatic alterations (E829E and R831C) were identified in the cytoplasmic domain of the EGFR gene in 1 of 10 tumor samples. The significance of these findings for the pathobiology of osteosarcomas will be investigated further.
Collapse
Affiliation(s)
- Yong Hannah Wen
- Department of Pathology, New York University School of Medicine, New York, NY 10016, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
|
37
|
Rozeman LB, Cleton-Jansen AM, Hogendoorn PCW. Pathology of primary malignant bone and cartilage tumours. INTERNATIONAL ORTHOPAEDICS 2006; 30:437-44. [PMID: 16944143 PMCID: PMC3172744 DOI: 10.1007/s00264-006-0212-x] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2006] [Accepted: 06/14/2006] [Indexed: 10/24/2022]
Abstract
Bone- and cartilage-forming tumours (osteosarcomas and chondrosarcomas) are rare malignant neoplasms. These tumours are clinically aggressive and often need extensive local and/or systemic treatment. Whereas no other treatment but surgery is currently available for chondrosarcomas, osteosarcomas show an approximately 50-80% response rate to adjuvant chemotherapy. Surgical removal of these tumours is currently mostly performed with limb salvage, but amputation may be required in some cases. In addition, the tumours have a risk of local recurrences adversely affecting the prognosis compared to the primary tumour. In this report we will mainly focus on two of the most prevalent malignant bone tumours, conventional osteosarcoma and conventional chondrosarcoma, and use these to illustrate the problems with the diagnosis of bone sarcomas in general.
Collapse
Affiliation(s)
- L. B. Rozeman
- Department of Pathology, Leiden University Medical Center, L1-Q, P.O. Box 9600, 2300 RC Leiden, The Netherlands
| | - A. M. Cleton-Jansen
- Department of Pathology, Leiden University Medical Center, L1-Q, P.O. Box 9600, 2300 RC Leiden, The Netherlands
| | - P. C. W. Hogendoorn
- Department of Pathology, Leiden University Medical Center, L1-Q, P.O. Box 9600, 2300 RC Leiden, The Netherlands
| |
Collapse
|
38
|
Willmore-Payne C, Holden JA, Zhou H, Gupta D, Hirschowitz S, Wittwer CT, Layfield LJ. Evaluation of Her-2/neu gene status in osteosarcoma by fluorescence in situ hybridization and multiplex and monoplex polymerase chain reactions. Arch Pathol Lab Med 2006; 130:691-8. [PMID: 16683887 DOI: 10.5858/2006-130-691-eongsi] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT Previous reports suggest that the human epidermal growth factor 2 (HER-2/neu) receptor may be overexpressed in osteosarcoma. OBJECTIVE To determine whether osteosarcomas have amplifications of the HER-2/neu gene. DESIGN We studied a series of osteosarcomas by fluorescence in situ hybridization (FISH) and by 2 real-time polymerase chain reaction assays that measure the amount of HER-2/neu DNA relative to a control gene. The HER-2/ neu monoplex and multiplex assays were capable of identifying those cases of breast cancer that were known to overexpress HER-2/neu as assessed by FISH. We initially studied 21 cases of osteosarcoma by FISH analysis (using a technique that included a probe for chromosome 17), 11 of which had their HER-2/neu gene amplification status previously reported. RESULTS None of these osteosarcoma cases showed HER-2/neu amplification by our FISH analysis and subsequent quantitative (multiplex) polymerase chain reaction. Apparent expression of HER-2/neu protein was observed in several of the cases but the immunoreactivity was localized to the cytoplasm and was not membranous in character. An additional 35 osteosarcoma specimens were subjected to monoplex polymerase chain reaction analysis, and amplifiable DNA was recovered from 19 specimens (54%). None of these samples had HER-2/neu amplification by monoplex PCR analysis and only one case had membranous immunoreactivity graded as 1+. CONCLUSION Although a small subset of osteosarcomas had weak noncircumferential membranous immunoreactivity for HER-2/neu protein, no osteosarcomas demonstrated positive (2+ or 3+) immunoreactivity for HER-2/ neu protein and none showed HER-2/neu gene amplification by either FISH or polymerase chain reaction.
Collapse
Affiliation(s)
- Carlynn Willmore-Payne
- Department of Pathology, University of Utah Health Sciences Center, Salt Lake City, UT 84132, USA
| | | | | | | | | | | | | |
Collapse
|
39
|
Somers GR, Gupta AA, Doria AS, Ho M, Pereira C, Shago M, Thorner PS, Zielenska M. Pediatric undifferentiated sarcoma of the soft tissues: a clinicopathologic study. Pediatr Dev Pathol 2006; 9:132-42. [PMID: 16822084 DOI: 10.2350/08-05-0098.1] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2005] [Accepted: 11/21/2005] [Indexed: 11/20/2022]
Abstract
Pediatric undifferentiated soft tissue sarcomas represent a major challenge for pathologists and clinicians. The goal of this study was to identify cases that warranted this diagnosis by current standards of analysis and then determine if there are clinicopathological commonalities that may be useful for diagnosis, management, and prognosis. Eighteen potential patients were identified using the institutional pathology database. Three cases were reclassified as specific sarcomas, and 2 cases had insufficient material for molecular analysis, leaving 13 cases for pathological review and 12 patients for radiological and clinical review. There were 7 males and 6 females. The median age at diagnosis was 11 years (1 month to 16 years). Tumors commonly involved the trunk (7 of 13; 54%) and ranged in size from 1.7 to 14.5 cm (mean, 6.7 cm). Eleven patients received ifosfamide/etoposide chemotherapy and 4 received irradiation. Five-year event-free and overall survival (EFS and OS) rates were 54% and 74%, respectively. The predominant histological pattern was round to plump spindled cells forming sheets (9 of 13; 69%) and severe atypia was associated with decreased survival (P = 0.048). Immunohistochemistry showed positivity for vimentin (92%), CD117 (92%), and vascular endothelial growth factor (69%), and 8% to 23% showed focal positivity for epithelial, neural, or myogenic markers. Tumors were uniformly negative for translocations associated with pediatric sarcomas. The presence of certain common morphological and immunohistochemical features in the absence of specific molecular genetic abnormalities allows for a diagnosis of pediatric undifferentiated soft tissue sarcoma; however, whether this group of neoplasms forms a unique category of tumors or a common precursor pathway for a number of different sarcomas awaits further study.
Collapse
Affiliation(s)
- Gino R Somers
- Division of Pathology, Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada.
| | | | | | | | | | | | | | | |
Collapse
|
40
|
Abstract
Current therapy for osteosarcoma successfully treats 60% to 70% of patients. Attempts to identify patients who will respond poorly to therapy has focused on the use of new biologic markers or microarray cluster analysis. New potential therapeutic targets, including growth factors, chemokines, transcription factors, and angiogenic factors, are being evaluated for their roles in osteosarcoma. These new targets may provide mechanisms to treat the patients who would respond poorly to standard therapy.
Collapse
Affiliation(s)
- James B Hayden
- Department of Orthopedics and Rehabilitation, Oregon Health & Science University, Portland, 97239, USA
| | | |
Collapse
|
41
|
Abstract
Osteosarcoma is a primary bone malignancy generally affecting the young, with 60% of cases occurring before the age of 25 years and the peak incidence at 15 years. Survival has improved over the past several decades, with non- metastatic disease having an approximately 70% chance of long-term survival. Unfortunately, patients with metastatic disease at diagnosis or those who have recurrent disease have a dismal prognosis, with approximately 20% surviving long term. In this review article we describe several new therapies in development for osteosarcoma. These include immune-based therapies, strategies to inhibit tumor growth, radiotherapy, and the introduction of new chemotherapies and targets.
Collapse
Affiliation(s)
- Rajaram Nagarajan
- Pediatric Epidemiology and Clinical Research, University of Minnesota, Mayo Mail Code 484, 420 Delaware Street SE, Minneapolis, MN 55455, USA.
| | | | | |
Collapse
|
42
|
|
43
|
Abstract
Adult oncologists and their research colleagues have "led the charge" in the war on cancer. Their efforts have generated effective new chemotherapies that target cancer causing molecular alterations. It is hoped that these successes will be repeated within the pediatric oncology community. Testing whether molecular targeted therapies of adult cancers are also effective against childhood cancers might allow the rapid introduction of these exciting new agents into the pediatric clinic. However, it is imperative that we do not introduce blindly these agents into the pediatric population. We must ensure that molecular targets in adult cancers also fulfill a number of important criteria within the pediatric disease. This review addresses the issues surrounding the identification of molecular targets in pediatric cancers by focusing on studies of the ERBB2 oncogene.
Collapse
Affiliation(s)
- Richard J Gilbertson
- Department of Developmental Neurobiology, St. Jude Children's Research Hospital, 332 N. Lauderdale Street, Memphis, Tennessee 38105, USA.
| |
Collapse
|
44
|
Scotlandi K, Manara MC, Hattinger CM, Benini S, Perdichizzi S, Pasello M, Bacci G, Zanella L, Bertoni F, Picci P, Serra M. Prognostic and therapeutic relevance of HER2 expression in osteosarcoma and Ewing's sarcoma. Eur J Cancer 2005; 41:1349-61. [PMID: 15913990 DOI: 10.1016/j.ejca.2005.03.015] [Citation(s) in RCA: 103] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2004] [Revised: 03/02/2005] [Accepted: 03/04/2005] [Indexed: 11/23/2022]
Abstract
Expression of HER2 was evaluated by immunohistochemical techniques in 84 osteosarcoma (OS) and 113 Ewing's sarcoma (ES) paraffin-embedded tumour biopsies. HER2 gene status was also assessed in a panel of cell lines as well as in vitro efficacy of trastuzumab (a humanised antibody directed against HER2) as single agent or in combination with the insulin-like growth factor I receptor (IGF-IR) IR3 antibody. Overexpression of HER2 was present in 32% of OS and 16% of ES and was significantly associated with the increased expression of P-glycoprotein, a surface molecule responsible for multidrug resistance. Event-free survival analyses revealed a prognostic value for HER2 and/or P-glycoprotein expression in OS, but not in ES. However, despite its prognostic relevance, no therapeutic effectiveness was observed pre-clinically for trastuzumab-driven therapy, in both OS or ES cell lines, unless the antibody was associated with anti-IGF-IR targeting strategies. Therefore, the therapeutic potential of trastuzumab in these neoplasms may be better exploited in combined treatments with anti-IGF-IR approaches.
Collapse
MESH Headings
- ATP Binding Cassette Transporter, Subfamily B, Member 1/metabolism
- Adolescent
- Adult
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Humanized
- Antineoplastic Agents/therapeutic use
- Bone Neoplasms/drug therapy
- Bone Neoplasms/genetics
- Bone Neoplasms/metabolism
- Cell Line, Tumor
- Disease-Free Survival
- Drug Resistance, Neoplasm/genetics
- Gene Expression/genetics
- Genes, erbB-2
- Humans
- Immunohistochemistry
- In Situ Hybridization, Fluorescence
- Neoplasm Recurrence, Local/genetics
- Oncogene Proteins v-erbB/metabolism
- Osteosarcoma/drug therapy
- Osteosarcoma/genetics
- Osteosarcoma/metabolism
- Receptor, IGF Type 1/metabolism
- Sarcoma, Ewing/drug therapy
- Sarcoma, Ewing/genetics
- Sarcoma, Ewing/metabolism
- Trastuzumab
- Treatment Outcome
Collapse
Affiliation(s)
- Katia Scotlandi
- Laboratorio di Ricerca Oncologica, Istituti Ortopedici Rizzoli, Via di Barbiano 1/10, 40136 Bologna, Italy.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Somers GR, Ho M, Zielenska M, Squire JA, Thorner PS. HER2 amplification and overexpression is not present in pediatric osteosarcoma: a tissue microarray study. Pediatr Dev Pathol 2005; 8:525-32. [PMID: 16211448 DOI: 10.1007/s10024-005-0044-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2005] [Accepted: 06/19/2005] [Indexed: 11/27/2022]
Abstract
The HER2 gene, located on 17q, encodes a 185-kD transmembrane tyrosine kinase receptor. Amplification of this gene with overexpression of the gene product occurs in about 30% of cases of breast cancer and is considered to be a poor prognostic indicator for this tumor. Results for HER2 expression in osteosarcoma are controversial, with some studies reporting up to 61% of positive cases and others reporting only negative results. Further, expression of HER2 is reported to be a favorable prognostic indicator by some groups and unfavorable by others. The present study used tissue microarrays containing 34 samples of osteosarcoma from 18 patients to analyze HER2 expression by immunohistochemistry and gene copy number by chromogenic in situ hybridization. The microarray included 13 pretreatment biopsies, 11 posttreatment resection specimens, and 10 resected metastases and comprised 18 osteoblastic, 6 chondroblastic, 5 fibroblastic, and 5 mixed subtypes. HER2 protein expression was seen in 4 of 34 (12%) tumor samples that originated from 2 of 18 patients (11%). The staining pattern was consistently weak and focal, and immunohistochemical overexpression of the HER2 protein, defined as complete membrane positivity, was never observed. Further, the presence of HER2 gene amplification was not detected in any osteosarcoma by chromogenic in situ hybridization. Therefore, therapies based on antibodies directed against the HER2 protein are unlikely to have much value in the treatment of pediatric osteosarcomas. From a technical standpoint, this study also demonstrates the value of tissue microarrays in screening tumors at the protein and gene levels using conventional light microscopy.
Collapse
Affiliation(s)
- Gino R Somers
- Department of Pediatric Laboratory Medicine, Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
| | | | | | | | | |
Collapse
|
46
|
Abstract
Osteosarcoma is the most common primary malignant bone tumor in children and adolescents. Despite significant clinical improvements over the past several decades through the use of combination chemotherapy and surgery, patients with metastatic or recurrent disease continue to have a very poor prognosis. Therefore, there is a continued need to study and understand the basic biology of osteosarcoma in order to devise more targeted and rational therapeutic strategies and ultimately to improve survival for these patients. This article reviews several aspects of osteosarcoma biology where data exist to suggest that specific pathways may play a role in the pathogenesis of this tumor. These areas include host genetic predispositions, tumor cytogenetics, molecular genetics (including the Rb, p53, RECQ helicase, and telomere pathways), and metastatic factors (ezrin, annexin 2, chemokine receptor 4, Fas/FasL pathways) that may contribute to both the initiation and the progression of tumor formation. Understanding the mechanisms of and interactions between the various molecular pathways that play a role in osteosarcoma pathogenesis may eventually lead to a more rational strategy for devising therapies targeted specifically toward these pathways.
Collapse
Affiliation(s)
- Lisa L Wang
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas 77030, USA.
| |
Collapse
|
47
|
Olsen RJ, Lydiatt WM, Koepsell SA, Lydiatt D, Johansson SL, Naumann S, Bridge JA, Neff JR, Hinrichs SH, Tarantolo SR. C-erb-B2 (HER2/neu) expression in synovial sarcoma of the head and neck. Head Neck 2005; 27:883-92. [PMID: 16158422 DOI: 10.1002/hed.20267] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Synovial sarcoma is a malignant mesenchymal tumor composed of varying proportions of spindle and epithelial cell components. Because of the histologic and immunohistochemical similarity of synovial sarcoma to epithelial carcinomas, we hypothesized that the human epithelial growth factor receptor 2 (C-erb-B2, also termed HER2/neu) may contribute to the tumor phenotype and provide a new therapeutic target for this soft tissue tumor. METHODS Three head and neck, one chest wall, and seven extremity synovial sarcomas were evaluated for C-erb-B2 (HER2/neu) expression by immunohistochemistry, Western immunoblotting, and fluorescence in situ hybridization (FISH). RESULTS The head and neck cases demonstrated immunohistochemically strong positive staining, whereas tumors from other anatomic locations showed neither positive nor cytoplasmic restricted staining. Antigen-targeted antibody therapy (trastuzumab) was initiated in two patients. CONCLUSIONS These results demonstrate that C-erb-B2 (HER2/neu) may play a role in the tumorigenesis of synovial sarcoma; and, therefore, antigrowth factor therapies may provide a previously unrecognized pharmaceutical approach to soft tissue tumors. The data also suggest that although synovial sarcoma of the head and neck and synovial sarcoma of the extremities have similar morphologic features, they may be clinically and mechanistically distinct entities.
Collapse
MESH Headings
- Adult
- Aged
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Humanized
- Antineoplastic Agents/therapeutic use
- Blotting, Western
- Child
- Female
- Genes, erbB-2
- Head and Neck Neoplasms/drug therapy
- Head and Neck Neoplasms/genetics
- Head and Neck Neoplasms/metabolism
- Head and Neck Neoplasms/pathology
- Humans
- Immunohistochemistry
- In Situ Hybridization, Fluorescence
- Male
- Middle Aged
- Receptor, ErbB-2/metabolism
- Sarcoma, Synovial/drug therapy
- Sarcoma, Synovial/genetics
- Sarcoma, Synovial/metabolism
- Sarcoma, Synovial/pathology
- Trastuzumab
Collapse
Affiliation(s)
- Randall J Olsen
- Department of Pathology and Laboratory Medicine, Baylor College of Medicine, Houston, Texas, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Hogendoorn PCW, Collin F, Daugaard S, Dei Tos AP, Fisher C, Schneider U, Sciot R. Changing concepts in the pathological basis of soft tissue and bone sarcoma treatment. Eur J Cancer 2004; 40:1644-54. [PMID: 15251152 DOI: 10.1016/j.ejca.2004.04.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2004] [Accepted: 04/07/2004] [Indexed: 11/21/2022]
Abstract
Though soft tissue sarcomas are rare considerable progress has been made in the clinical and biological understanding of these neoplasms. This has led to the launch of a new WHO classification of soft tissue tumours in 2002, which integrate morphological data with tumour specific (cyto-) genetics. Moreover worldwide consensus has grown how to predict clinical behaviour based on a specific grading system and which specific types of tumours seem not to obey these rules. As a consequence entry criteria for multi-institute prospective trials have changed over the last few years. The recent identification of tumour specific drug targets by immunohistochemistry has had impact on specimen requirements and handling as well as laboratory standards. These changes in concepts, classification, and processing of soft tissue sarcomas have had impact on patient selection and treatment and formats of multi-institute trials.
Collapse
Affiliation(s)
- Pancras C W Hogendoorn
- Departments of Pathology, Leiden University Medical Centre, Building 1, L1-Q, P.O. Box 9600, Leiden, The Netherlands.
| | | | | | | | | | | | | |
Collapse
|
49
|
|