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Tarhini AA. Adjuvant Therapy of Melanoma. Hematol Oncol Clin North Am 2021; 35:73-84. [PMID: 33759774 DOI: 10.1016/j.hoc.2020.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
as adjuvant therapy for high-risk melanoma was extensively studied in regimens that varied by dosage, route of administration, formulation, and therapy duration. The high-dose regimen (HDI) showed significant improvements in relapse-free survival (RFS) in 3 trials and overall survival (OS) in 2. Ipilimumab at 3 mg/kg demonstrated significant OS benefits compared with HDI and less toxicity compared with ipilimumab at 10 mg/kg. More recently, the standard of care has changed in favor of nivolumab and pembrolizumab and BRAF-MEK inhibitors dabrafenib plus trametinib (for BRAF mutated melanoma), based on significant RFS benefits and more favorable toxicity profiles.
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Affiliation(s)
- Ahmad A Tarhini
- Department of Cutaneous Oncology, Moffitt Cancer Center and Research Institute, 10920 McKinley Drive, Tampa, FL 33612, USA; Department of Immunology, Moffitt Cancer Center and Research Institute, 10902 USF Magnolia Drive, Tampa, FL 33612, USA.
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2
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Akil H, Rouanet J, Viallard C, Besse S, Auzeloux P, Chezal JM, Miot-Noirault E, Quintana M, Degoul F. Targeted Radionuclide Therapy Decreases Melanoma Lung Invasion by Modifying Epithelial-Mesenchymal Transition-Like Mechanisms. Transl Oncol 2019; 12:1442-1452. [PMID: 31421458 PMCID: PMC6704444 DOI: 10.1016/j.tranon.2019.07.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 07/17/2019] [Accepted: 07/18/2019] [Indexed: 12/14/2022] Open
Abstract
Melanin-radiolabeled molecules for targeted radionuclide therapy (TRT) provide a promising approach for the treatment of pigmented melanoma. Among these radiolabeled molecules, the iodinated melanin-specific binding molecule ([131I]ICF01012) has shown a significant antitumor effect on metastatic melanoma preclinical models. We report herein that [131I]ICF01012 decreases the epithelial-mesenshymal transition-like (EMT-like) markers in both in vivo and in vitro three-dimensional (3D) melanoma spheroid models. [131I]ICF01012 spheroids irradiation resulted in reduced clonogenic capacity of all pigmented spheroids accompanied by increased protein expression levels of phosphorylated H2A.X, p53 and its downstream target p21. In addition, [131I]ICF01012 treatment leads to a significant increase of cell pigmentation as demonstrated in SK-MEL3 human xenograft model. We also showed that [131I]ICF01012 decreases the size and the number of melanoma lung colonies in the syngeneic murine B16BL6 in vivo model assessing its potentiality to kill circulating tumor cells. Taken together, these results indicate that [131I]ICF01012 reduces metastatic capacity of melanoma cells presumably through EMT-like reduction and cell differentiation induction.
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Affiliation(s)
- Hussein Akil
- UMR 1240 INSERM, University of Clermont Auvergne, Clermont-Ferrand, France.
| | - Jacques Rouanet
- UMR 1240 INSERM, University of Clermont Auvergne, Clermont-Ferrand, France; Department of Dermatology and Oncodermatology, CHU Estaing, Clermont-Ferrand, France; Centre Jean Perrin, Clermont-Ferrand, France.
| | - Claire Viallard
- UMR 1240 INSERM, University of Clermont Auvergne, Clermont-Ferrand, France.
| | - Sophie Besse
- UMR 1240 INSERM, University of Clermont Auvergne, Clermont-Ferrand, France.
| | - Philippe Auzeloux
- UMR 1240 INSERM, University of Clermont Auvergne, Clermont-Ferrand, France.
| | - Jean-Michel Chezal
- UMR 1240 INSERM, University of Clermont Auvergne, Clermont-Ferrand, France.
| | | | - Mercedes Quintana
- UMR 1240 INSERM, University of Clermont Auvergne, Clermont-Ferrand, France.
| | - Françoise Degoul
- UMR 1240 INSERM, University of Clermont Auvergne, Clermont-Ferrand, France.
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3
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Krayem M, Sabbah M, Najem A, Wouters A, Lardon F, Simon S, Sales F, Journe F, Awada A, Ghanem GE, Van Gestel D. The Benefit of Reactivating p53 under MAPK Inhibition on the Efficacy of Radiotherapy in Melanoma. Cancers (Basel) 2019; 11:E1093. [PMID: 31374895 PMCID: PMC6721382 DOI: 10.3390/cancers11081093] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 07/25/2019] [Accepted: 07/30/2019] [Indexed: 12/15/2022] Open
Abstract
Radiotherapy (RT) in patients with melanoma historically showed suboptimal results, because the disease is often radioresistant due to various mechanisms such as scavenging free radicals by thiols, pigmentary machinery, or enhanced DNA repair. However, radiotherapy has been utilized as adjuvant therapy after the complete excision of primary melanoma and lymph nodes to reduce the rate of nodal recurrences in high-risk patients. The resistance of melanoma cells to radiotherapy may also be in relation with the constitutive activation of the MAPK pathway and/or with the inactivation of p53 observed in about 90% of melanomas. In this study, we aimed to assess the potential benefit of adding RT to BRAF-mutated melanoma cells under a combined p53 reactivation and MAPK inhibition in vitro and in a preclinical animal model. We found that the combination of BRAF inhibition (vemurafenib, which completely shuts down the MAPK pathway), together with p53 reactivation (PRIMA-1Met) significantly enhanced the radiosensitivity of BRAF-mutant melanoma cells. This was accompanied by an increase in both p53 expression and activity. Of note, we found that radiation alone markedly promoted both ERK and AKT phosphorylation, thus contributing to radioresistance. The combination of vemurafenib and PRIMA-1Met caused the inactivation of both MAPK kinase and PI3K/AKT pathways. Furthermore, when combined with radiotherapy, it was able to significantly enhance melanoma cell radiosensitivity. Interestingly, in nude mice bearing melanoma xenografts, the latter triple combination had not only a synergistic effect on tumor growth inhibition, but also a potent control on tumor regrowth in all animals after finishing the triple combination therapy. RT alone had only a weak effect. In conclusion, we provide a basis for a strategy that may overcome the radioresistance of BRAF-mutated melanoma cells to radiotherapy. Whether this will translate into a rational to use radiotherapy in the curative setting in BRAF-mutated melanoma patients deserves consideration.
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Affiliation(s)
- Mohammad Krayem
- Laboratory of Oncology and Experimental Surgery, Institut Jules Bordet, Université Libre de Bruxelles, Rue Héger-Bordet 1, 1000 Brussels, Belgium.
- Department of Radiation Oncology, Institut Jules Bordet, Université libre de Bruxelles, 1000 Brussels, Belgium.
| | - Malak Sabbah
- Laboratory of Oncology and Experimental Surgery, Institut Jules Bordet, Université Libre de Bruxelles, Rue Héger-Bordet 1, 1000 Brussels, Belgium
| | - Ahmad Najem
- Laboratory of Oncology and Experimental Surgery, Institut Jules Bordet, Université Libre de Bruxelles, Rue Héger-Bordet 1, 1000 Brussels, Belgium
| | - An Wouters
- Center for Oncological Research (CORE), University of Antwerp, 2610 Wilrijk, Belgium
| | - Filip Lardon
- Center for Oncological Research (CORE), University of Antwerp, 2610 Wilrijk, Belgium
| | - Stephane Simon
- Department of Radiation Oncology, Institut Jules Bordet, Université libre de Bruxelles, 1000 Brussels, Belgium
| | - François Sales
- Laboratory of Oncology and Experimental Surgery, Institut Jules Bordet, Université Libre de Bruxelles, Rue Héger-Bordet 1, 1000 Brussels, Belgium
| | - Fabrice Journe
- Laboratory of Oncology and Experimental Surgery, Institut Jules Bordet, Université Libre de Bruxelles, Rue Héger-Bordet 1, 1000 Brussels, Belgium
- Department of Human Anatomy and Experimental Oncology, Université de Mons (UMons), Research Institute for Health Sciences and Technology, 7000 Mons, Belgium
| | - Ahmad Awada
- Laboratory of Oncology and Experimental Surgery, Institut Jules Bordet, Université Libre de Bruxelles, Rue Héger-Bordet 1, 1000 Brussels, Belgium
- Department of Internal Medicine, Institut Jules Bordet, Université Libre de Bruxelles, 1000 Brussels, Belgium
| | - Ghanem E Ghanem
- Laboratory of Oncology and Experimental Surgery, Institut Jules Bordet, Université Libre de Bruxelles, Rue Héger-Bordet 1, 1000 Brussels, Belgium
| | - Dirk Van Gestel
- Department of Radiation Oncology, Institut Jules Bordet, Université libre de Bruxelles, 1000 Brussels, Belgium
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Biau J, Chautard E, Berthault N, de Koning L, Court F, Pereira B, Verrelle P, Dutreix M. Combining the DNA Repair Inhibitor Dbait With Radiotherapy for the Treatment of High Grade Glioma: Efficacy and Protein Biomarkers of Resistance in Preclinical Models. Front Oncol 2019; 9:549. [PMID: 31275862 PMCID: PMC6593092 DOI: 10.3389/fonc.2019.00549] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 06/05/2019] [Indexed: 12/23/2022] Open
Abstract
High grade glioma relapses occur often within the irradiated volume mostly due to a high resistance to radiation therapy (RT). Dbait (which stands for DNA strand break bait) molecules mimic DSBs and trap DNA repair proteins, thereby inhibiting repair of DNA damage induced by RT. Here we evaluate the potential of Dbait to sensitize high grade glioma to RT. First, we demonstrated the radiosensitizer properties of Dbait in 6/9 tested cell lines. Then, we performed animal studies using six cell derived xenograft and five patient derived xenograft models, to show the clinical potential and applicability of combined Dbait+RT treatment for human high grade glioma. Using a RPPA approach, we showed that Phospho-H2AX/H2AX and Phospho-NBS1/NBS1 were predictive of Dbait efficacy in xenograft models. Our results provide the preclinical proof of concept that combining RT with Dbait inhibition of DNA repair could be of benefit to patients with high grade glioma.
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Affiliation(s)
- Julian Biau
- Centre de Recherche, Institut Curie, PSL Research University, Paris, France.,UMR3347, CNRS, Orsay, France.,U1021, INSERM, Orsay, France.,Research Department, Université Paris Sud, Orsay, France.,INSERM, U1240 IMoST, Université Clermont Auvergne, Clermont Ferrand, France.,Radiotherapy Department, Centre Jean Perrin, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Emmanuel Chautard
- INSERM, U1240 IMoST, Université Clermont Auvergne, Clermont Ferrand, France.,Pathology Department, Centre Jean Perrin, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Nathalie Berthault
- Centre de Recherche, Institut Curie, PSL Research University, Paris, France.,UMR3347, CNRS, Orsay, France.,U1021, INSERM, Orsay, France.,Research Department, Université Paris Sud, Orsay, France
| | - Leanne de Koning
- Laboratory of Proteomic Mass Spectrometry, Centre de Recherche, Institut Curie, Paris, France.,Department of Translational Research, Institut Curie, PSL Research University, Paris, France
| | - Frank Court
- GReD Laboratory, CNRS UMR 6293, INSERM U1103, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Bruno Pereira
- Biostatistics Department, DRCI, Clermont-Ferrand Hospital, Clermont-Ferrand, France
| | - Pierre Verrelle
- Centre de Recherche, Institut Curie, PSL Research University, Paris, France.,Radiotherapy Department, Centre Jean Perrin, Université Clermont Auvergne, Clermont-Ferrand, France.,U1196, INSERM, UMR9187, CNRS, Orsay, France.,Radiotherapy Department, Institut Curie Hospital, Paris, France
| | - Marie Dutreix
- Centre de Recherche, Institut Curie, PSL Research University, Paris, France.,UMR3347, CNRS, Orsay, France.,U1021, INSERM, Orsay, France.,Research Department, Université Paris Sud, Orsay, France
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5
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HDAC2 Inhibitor Valproic Acid Increases Radiation Sensitivity of Drug-Resistant Melanoma Cells. Med Sci (Basel) 2019; 7:medsci7030051. [PMID: 30909413 PMCID: PMC6473314 DOI: 10.3390/medsci7030051] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 03/15/2019] [Accepted: 03/18/2019] [Indexed: 01/22/2023] Open
Abstract
Resistance to anticancer drugs limits the effectiveness of chemotherapy in cancers. Melanoma cell lines B16F10C and A375C (parental) and B16F10R and A375R (drug-resistant sublines) were used to test radiation sensitization potential of valproic acid (VPA), an inhibitor of Histone deacetylase2 (HDAC2) and LDN193189 (BMP inhibitor). Inhibitors of other signaling pathways were tested for cross-resistance with the resistant cell lines. Cells were pretreated with low concentrations of VPA/ LDN193189 and exposed to 2 Gy radiation for radiation sensitization experiments. Assays-3-(4,5-Dimethylthiazol-2-yl)-2,5-Diphenyltetrazolium Bromide (MTT), live/dead, clonogenic, and melanin estimation were performed to test the effects of radiation sensitization. Interactions of VPA and HDAC2 were studied in silico. Dose-dependent growth inhibition was observed with all tested drugs. Radiation sensitization of melanoma cells with low dose of VPA induced synergistic cell death, decreased clonogenicity, and decreased melanin content. In silico docking showed two stable interactions between Arg39 of HDAC2 and VPA. In conclusion, pretreatment with low doses of VPA has a potential for sensitizing melanoma cells to low doses of radiation. The binding of VPA to HDAC2 reverses the drug resistance in melanoma and induces the cell death. Sensitization effects of VPA can be used for targeting drug-resistant cancers.
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6
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Anderson NH, Arcaro JB. Twice-daily Radiation for Metastatic Malignant Melanoma: A Different Approach Resulting in a Significant Response. Cureus 2019; 11:e4161. [PMID: 31065467 PMCID: PMC6497186 DOI: 10.7759/cureus.4161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The aim of this study was to discern an abscopal effect by modifying the delivery of radiation for metastatic malignant melanoma. The effect would be directly evident with visible/radiographic regression of the disease and indirectly shown with an overall extension in survival and potential cure. Patients with locally advanced, metastatic palpable, or radiographic visible metastatic malignant melanoma were treated with twice-daily radiation therapy using a dose range of 100-135 centigray (cGy) per fraction. A 100% complete response/continued regression with no recurrence was achieved within the region of delivery for every patient so treated. Of those alive at three years, few demonstrate a progression of the disease. These results were achieved without the use of immunotherapy, created few side effects, and were accomplished at a fraction of the alternative’s cost. Evidence of an immune-mediated response (abscopal effect) was commonly seen. Treatment was administered within acceptable dose ranges, historically used twice daily for other malignancies known to be sensitive to the effects of radiation.
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Affiliation(s)
- Norman H Anderson
- Radiation Oncology, Robert Boissoneault Oncology Institute, Ocala, USA
| | - Julie B Arcaro
- Radiation Oncology, Robert Boissoneault Oncology Institute, Ocala, USA
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7
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Cho JH, Lee HJ, Ko HJ, Yoon BI, Choe J, Kim KC, Hahn TW, Han JA, Choi SS, Jung YM, Lee KH, Lee YS, Jung YJ. The TLR7 agonist imiquimod induces anti-cancer effects via autophagic cell death and enhances anti-tumoral and systemic immunity during radiotherapy for melanoma. Oncotarget 2018; 8:24932-24948. [PMID: 28212561 PMCID: PMC5421900 DOI: 10.18632/oncotarget.15326] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 01/23/2017] [Indexed: 12/31/2022] Open
Abstract
Toll-like receptor (TLR) ligands are strongly considered immune-adjuvants for cancer immunotherapy and have been shown to exert direct anti-cancer effects. This study was performed to evaluate the synergistic anti-cancer and anti-metastatic effects of the TLR7 agonist imiquimod (IMQ) during radiotherapy for melanoma. The pretreatment of B16F10 or B16F1 cells with IMQ combined with γ-ionizing radiation (IR) led to enhanced cell death via autophagy, as demonstrated by increased expression levels of autophagy-related genes, and an increased number of autophagosomes in both cell lines. The results also confirmed that the autophagy process was accelerated via the reactive oxygen species (ROS)-mediated MAPK and NF-κB signaling pathway in the cells pretreated with IMQ combined with IR. Mice subcutaneously injected with melanoma cells showed a reduced tumor growth rate after treatment with IMQ and IR. Treatment with 3-methyladenine (3-MA), ameliorated the anti-cancer effect of IMQ combined with IR. Additionally, the combination therapy enhanced anti-cancer immunity, as demonstrated by an increased number of CD8+ T cells and decreased numbers of regulatory T cells (Treg) and myeloid-derived suppressor cells (MDSCs) in the tumor lesions. Moreover, the combination therapy decreased the number of metastatic nodules in the lungs of mice that were injected with B16F10 cells via the tail vein. In addition, the combination therapy enhanced systemic anti-cancer immunity by increasing the abundances of T cell populations expressing IFN-γ and TNF-α. Therefore, these findings suggest that IMQ could serve as a radiosensitizer and immune booster during radiotherapy for melanoma patients.
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Affiliation(s)
- Jeong Hyun Cho
- Department of Biological Sciences, Kangwon National University, Chuncheon, Republic of Korea
| | - Hyo-Ji Lee
- Department of Biological Sciences, Kangwon National University, Chuncheon, Republic of Korea
| | - Hyun-Jeong Ko
- College of Pharmacy, Kangwon National University, Chuncheon, Republic of Korea
| | - Byung-Il Yoon
- Department of Veterinary Medicine, Kangwon National University, Chuncheon, Republic of Korea
| | - Jongseon Choe
- Department of Microbiology, School of Medicine, Kangwon National University, Chuncheon, Republic of Korea
| | - Keun-Cheol Kim
- Department of Biological Sciences, Kangwon National University, Chuncheon, Republic of Korea
| | - Tae-Wook Hahn
- Department of Veterinary Medicine, Kangwon National University, Chuncheon, Republic of Korea
| | - Jeong A Han
- Department of Biochemistry and Molecular Biology, School of Medicine, Kangwon National University, Chuncheon, Republic of Korea
| | - Sun Shim Choi
- Department of Medical Biotechnology, College of Biomedical Science, Kangwon National University, Chuncheon, Republic of Korea
| | - Young Mee Jung
- Department of Chemistry, Kangwon National University, Chuncheon, Republic of Korea
| | - Kee-Ho Lee
- Division of Radiation Cancer Research, Korea Institute of Radiological and Medical Sciences, Nowon-gu, Seoul, Republic of Korea
| | - Yun-Sil Lee
- Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seodaemun-gu, Seoul, Republic of Korea
| | - Yu-Jin Jung
- Department of Biological Sciences, Kangwon National University, Chuncheon, Republic of Korea
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8
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Ow TJ, Grethlein SJ, Schmalbach CE. Do you know your guidelines? Diagnosis and management of cutaneous head and neck melanoma. Head Neck 2018; 40:875-885. [PMID: 29485688 DOI: 10.1002/hed.25074] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 12/06/2017] [Indexed: 01/09/2023] Open
Abstract
The following article is the next installment of the series "Do You Know Your Guidelines?" presented by the Education Committee of the American Head and Neck Society. Guidelines for the prevention, diagnosis, workup, and management of cutaneous melanoma are reviewed in an evidence-based fashion.
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Affiliation(s)
- Thomas J Ow
- Department of Otorhinolaryngology - Head and Neck Surgery, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
| | - Sara Jo Grethlein
- Department of Medicine, Hematology/Oncology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Cecelia E Schmalbach
- Department of Otolaryngology - Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana
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Minutilli E, Feliciani C. Adjuvant Therapy for Resected Stage III Melanoma Patients: High-Dose Interferon-Alpha versus Ipilimumab Combined with Kinases Inhibitors. TUMORI JOURNAL 2018; 98:185-90. [DOI: 10.1177/030089161209800202] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
High-dose interferon-alpha remains the first-line treatment in the adjuvant therapy of metastatic melanoma. More recently, high-dose pegylated interferon-alpha-2b has been approved by the US Food and Drug Administration. Actually, an adjuvant therapy alternative to high-dose interferon-alpha is represented by ipilimumab. Moreover, combination therapy of IFN-alpha or ipilimumab with tyrosine kinase inhibitors has been proved in patients with specific mutations. It is mandatory to understand what the best adjuvant treatment is for resected metastatic melanoma patients, particularly at stage III-N1, in terms of overall survival rather than recurrence-free survival. The ECOG 1609 clinical trial compared high-dose interferon-alpha and ipilimumab alone or combined with tyrosine kinase inhibitors for the treatment of early metastatic melanoma. In the past, ECOG 1684, 1690 and 1694 trials showed improvement in recurrence-free survival more than overall survival for high-risk melanoma patients (stage IIB-III) treated with high-dose interferon-alpha, whereas more recently the EORTC 18991 trial reported successful therapeutic results in terms of recurrence-free survival rather than overall survival for stage III-N1 melanoma patients treated with high-dose pegylated interferon-alpha-2b. Toxicity was more acceptable within one year of treatment. Randomized trials have demonstrated that ipilimumab as second-line therapy is able to increase dose-dependent overall survival rates in advanced melanoma patients despite severe but reversible immune-related adverse events. Old tyrosine kinase inhibitors have been used in combination with interferon for the treatment of advanced melanoma patients with moderate benefits and increased toxicity, but new selective drugs seem to be more efficacious. Early metastatic melanoma patients (stage III-N1) should be the principal subset to be treated with the most suitable adjuvant therapy to achieve the best overall survival. New schedules have to be tested with high-dose interferon-alpha and ipilimumab alone or combined with tyrosine kinase inhibitors while waiting for results from ECOG 1609.
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10
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The influence of postoperative lymph node radiation therapy on overall survival of patients with stage III melanoma, a National Cancer Database analysis. Melanoma Res 2018; 26:595-603. [PMID: 27575390 DOI: 10.1097/cmr.0000000000000292] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Recently, TROG 02.01 results showed that in stage III melanoma patients with nodal metastasis, adjuvant radiation to lymph node basin after nodal dissection improves lymph node field relapse without an overall survival (OS) benefit. However, this trial was neither designed nor powered to detect an OS difference. In the present study, we analyzed patients in the National Cancer Database (NCDB) with stage III melanoma with pathologically involved nodes and compared survival outcomes of adjuvant radiation and no-radiation cohorts. Inclusion criteria were as follows: age at least 18 years; diagnosed 2003-2011; surgery to regional lymph nodes; pathologically involved lymph nodes; and American Joint Committee on Cancer stage (IIIA-C). We used propensity score matching analysis to compare the OS of patients with similar baseline demographic, clinical, and pathologic characteristics who received adjuvant radiation and no adjuvant radiation. Overall, 912 patients were analyzed with an average age at diagnosis of 54.4 years and a median follow-up time of 5.5 years. In this cohort, the 5-year OS was 69.0, 51.1, and 30.6% for stage IIIA, IIIB, and IIIC, respectively. On propensity score-adjusted multivariate analysis, we found that adjuvant radiation had no statistically significant impact on OS (hazard ratio: 1.09, 95% confidence interval: 0.75-1.58, P=0.640). Furthermore, age older than 60 years, number of nodes, increasing pathologic stage, and absence of immunotherapy correlated with worse OS. In this NCDB analysis, we found that the adjuvant radiotherapy for node-positive, stage III melanoma patients did not improve OS. This is consistent with TROG 02.01; however, there may be patient selection bias not accounted for by the NCDB.
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11
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Park SJ, Heo K, Choi C, Yang K, Adachi A, Okada H, Yoshida Y, Ohno T, Nakano T, Takahashi A. Carbon ion irradiation abrogates Lin28B-induced X-ray resistance in melanoma cells. JOURNAL OF RADIATION RESEARCH 2017; 58:765-771. [PMID: 28482074 PMCID: PMC5710593 DOI: 10.1093/jrr/rrx022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 03/06/2017] [Indexed: 05/25/2023]
Abstract
The Lin28/let-7 axis plays an important role in tumor initiation and developmental processes. Lin28B is upregulated in a variety of cancers, and its overexpression enhances cancer cell proliferation and radioresistance through the suppression of let-7 micro RNA expression. In this study, we investigated the role of the Lin28/let7 axis as a target for radiosensitization of melanoma cancer cells. The overexpression of Lin28B reduced mature let-7 microRNA expression in melanoma cell lines, and enhanced the sphere-forming ability of melanoma cell lines, which is a characteristic of cancer stem cell (CSC) populations. Interestingly, Lin28B-overexpressed melanoma cells were more resistant to X-ray irradiation than control cells, and Lin28B-induced radioresistance was abolished after carbon ion irradiation. Consistent with these results, Lin28B overexpression reduced the numbers of γH2A.X foci after X-ray irradiation, whereas carbon ion irradiation had no such effect. Our results suggest that a carbon ion beam is more effective than an X-ray beam in terms of killing cancer cells, possibly due to elimination of CSC populations.
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Affiliation(s)
- Seong-Joon Park
- Gunma University Heavy Ion Medical Center, 3–39-22 Showa-machi, Maebashi 371–8511, Gunma, Japan
- Dongnam Institute of Radiological & Medical Sciences, Jwadong-gil 40, Gijang-gun, Busan 619-953, Republic of Korea
| | - Kyu Heo
- Dongnam Institute of Radiological & Medical Sciences, Jwadong-gil 40, Gijang-gun, Busan 619-953, Republic of Korea
| | - Chulwon Choi
- Dongnam Institute of Radiological & Medical Sciences, Jwadong-gil 40, Gijang-gun, Busan 619-953, Republic of Korea
| | - Kwangmo Yang
- Dongnam Institute of Radiological & Medical Sciences, Jwadong-gil 40, Gijang-gun, Busan 619-953, Republic of Korea
| | - Akiko Adachi
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3–39-22 Showa-machi, Maebashi 371–8511, Gunma, Japan
| | - Hiroko Okada
- Gunma University Initiative for Advanced Research, 3–39-22 Showa-machi, Maebashi 371–8511, Gunma, Japan
| | - Yukari Yoshida
- Gunma University Heavy Ion Medical Center, 3–39-22 Showa-machi, Maebashi 371–8511, Gunma, Japan
| | - Tatsuya Ohno
- Gunma University Heavy Ion Medical Center, 3–39-22 Showa-machi, Maebashi 371–8511, Gunma, Japan
| | - Takashi Nakano
- Gunma University Heavy Ion Medical Center, 3–39-22 Showa-machi, Maebashi 371–8511, Gunma, Japan
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3–39-22 Showa-machi, Maebashi 371–8511, Gunma, Japan
| | - Akihisa Takahashi
- Gunma University Heavy Ion Medical Center, 3–39-22 Showa-machi, Maebashi 371–8511, Gunma, Japan
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12
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Ipilimumab and Stereotactic Radiosurgery Versus Stereotactic Radiosurgery Alone for Newly Diagnosed Melanoma Brain Metastases. Am J Clin Oncol 2017; 40:444-450. [PMID: 26017484 DOI: 10.1097/coc.0000000000000199] [Citation(s) in RCA: 135] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND We compared the safety and efficacy of ipilimumab and stereotactic radiosurgery (SRS) to SRS alone for newly diagnosed melanoma brain metastases (MBM). MATERIALS AND METHODS We reviewed records of newly diagnosed MBM patients treated with SRS from 2009 to 2013. The primary endpoint of overall survival (OS), and secondary endpoints of local control, distant intracranial failure, and radiation necrosis were compared using Kaplan-Meier method. Univariate and multivariate analysis were performed using the Cox proportional hazards method. RESULTS Fifty-four consecutive MBM patients were identified, with 20 (37.0%) receiving ipilimumab within 4 months of SRS. Ipilimumab-treated and non-ipilimumab-treated patients had similar baseline characteristics. No difference in symptomatic radiation necrosis or hemorrhage was identified between cohorts. Compared with patients in the nonipilimumab group, 1 year local control (71.4% vs. 92.3%, P=0.40) and intracranial control (12.7% vs. 29.1%, P=0.59) were also statistically similar. The ipilimumab cohort also had no difference in 1-year OS (37.1% vs. 38.5%, P=0.84). Patients administered ipilimumab within 14 days of SRS had higher 1-year (42.9%) and 2-year OS (42.9%) relative to ipilimumab delivered >14 days (33.8%, 16.9%) and SRS alone (38.5%, 25.7%) but these difference were not statistically significant. Univariate analysis and multivariate analysis both confirmed single brain metastasis, controlled primary, and active systemic disease as predictors for OS. CONCLUSIONS Use of ipilimumab within 4 months of SRS seems to be safe, with no increase in radiation necrosis or hemorrhage; however, our retrospective institutional experience with this treatment regimen was not associated with improved outcomes.
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Zubatkina I, Ivanov P. Early imaging radioresponsiveness of melanoma brain metastases as a predictor of patient prognosis. J Neurosurg 2017; 129:354-365. [PMID: 28841116 DOI: 10.3171/2017.1.jns162075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The aim of this study was to analyze the early radiological response of melanoma brain metastases to single high-dose irradiation and to reveal possible correlations between tumor radioresponsiveness and patient clinical outcomes. METHODS The authors performed a retrospective analysis of the medical data for all patients with melanoma brain metastases who had undergone Gamma Knife radiosurgery (GKRS) and follow-up MRI examinations with standard protocols at regular 2- to 3-month intervals. Volumetric measurements of the metastases on pretreatment and initial posttreatment images were performed to assess the rate of early radiological response. Patients were divided into 2 groups according to the rate of response, and overall survival, local control, and the appearance of new metastases in the brain were compared in these groups using the long-rank test. Univariate and multivariate analyses were performed to identify predictors of clinical outcomes. RESULTS After retrospective analysis of 298 melanoma brain metastases in 78 patients, the authors determined that early radiological responses of these metastases to GKRS differ considerably and can be divided into 2 distinct groups. One group of tumors underwent rapid shrinkage after radiosurgery, whereas the other showed minor fluctuations in size (rapid- and slow-response groups, respectively). Median survival for patients with a slow response was 15.2 months compared with 6.3 months for those with a rapid response (p < 0.0001). In the multivariate analysis, improved overall survival was associated with a slow response to radiosurgery (p < 0.0001), stable systemic disease (p = 0.001), and a higher Karnofsky Performance Scale score (p = 0.001). Stratification by Recursive Partitioning Analysis, score index for radiosurgery, and diagnosis-specific Graded Prognostic Assessment classes further confirmed the difference in overall survival for patients with a slow versus rapid radiation response. Local recurrence was observed in 11% of patients with a rapid response and in 6% of patients with a slow response, at a median of more than 8 months after radiosurgery. New brain metastases were diagnosed in 67% of patients with a slow response at a median of 8.6 months after radiosurgery and in 82% of patients with a rapid response at a considerably earlier median time of 2.7 months. In the multivariate analysis, a longer time to the development of new brain metastases was associated with a slow response (p = 0.012), stable systemic disease (p = 0.034), and a single brain metastasis (p = 0.030). CONCLUSIONS Melanoma brain metastases show different early radioresponsiveness to radiosurgery. Rapid shrinkage of brain metastases is associated with poor patient prognosis, which may indicate more aggressive biological behavior of this tumor phenotype.
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Affiliation(s)
- Irina Zubatkina
- 1Department of Radiosurgery, Stereotactic Radiotherapy and General Oncology Clinic MIBS; and
| | - Pavel Ivanov
- 1Department of Radiosurgery, Stereotactic Radiotherapy and General Oncology Clinic MIBS; and.,2Department of Neurooncology, Polenov Russian Scientific Research Institute of Neurosurgery, Branch of Federal Almazov North-West Medical Research Centre, Saint Petersburg, Russia
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Hultborn R, Sand J, Kinhult S, Lundgren L, Stierner U, Turesson I, Albertsson P. Accelerated or conventional whole brain irradiation of malignant melanoma. Acta Oncol 2017; 56:1021-1023. [PMID: 28075181 DOI: 10.1080/0284186x.2016.1275777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 12/14/2016] [Accepted: 12/18/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Ragnar Hultborn
- a Department of Oncology , Sahlgrenska Academy, Sahlgrenska University Hospital , Gothenburg , Sweden
| | - Johanna Sand
- a Department of Oncology , Sahlgrenska Academy, Sahlgrenska University Hospital , Gothenburg , Sweden
| | - Sara Kinhult
- b Department of Oncology , Skane University Hospital , Lund , Sweden
| | - Lotta Lundgren
- b Department of Oncology , Skane University Hospital , Lund , Sweden
| | - Ulrika Stierner
- a Department of Oncology , Sahlgrenska Academy, Sahlgrenska University Hospital , Gothenburg , Sweden
| | - Ingela Turesson
- c Department of Immunology, Genetics and Pathology, Section of Experimental and Clinical Oncology , Uppsala University , Uppsala , Sweden
| | - Per Albertsson
- a Department of Oncology , Sahlgrenska Academy, Sahlgrenska University Hospital , Gothenburg , Sweden
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Coelho P, Silva L, Faria I, Vieria M, Monteiro A, Pinto G, Prudêncio C, Fernandes R, Soares R. Adipocyte Secretome Increases Radioresistance of Malignant Melanocytes by Improving Cell Survival and Decreasing Oxidative Status. Radiat Res 2017; 187:581-588. [PMID: 28362167 DOI: 10.1667/rr14551.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Radiotherapy is a treatment option for the majority of malignancies. However, because melanoma is known to be radioresistant, the use of ionizing radiation as an adjuvant therapy in cutaneous melanoma patients is ineffective. Obesity has now been recognized as a risk factor for melanoma. High adiposity is generally associated with a more pro-oxidative status. Oxidative stress is a major player in radiation therapy and also a common link between obesity and cancer. Several adipocyte-released proteins are known to have a role in controlling cellular growth and pro-survival signaling. For that reason, we investigated the influence of 3T3-L1 mature adipocyte secretome in B16-F10 malignant melanocyte radiosensitivity. We evaluated B16-F10 cell survival and redox homeostasis when exposed to four daily doses of ionizing radiation (2 Gy per day) up to a total of 8 Gy in a medical linear accelerator. B16-F10 melanocytes exhibited slight alterations in survival, catalase activity, nitrative stress and total oxidant concentration after the first 2 Gy irradiation. The motility of the melanocytes was also delayed by ionizing radiation. Subsequent irradiations of the malignant melanocytes led to more prominent reductions in overall survival. Remarkably, 3T3-L1 adipocyte-secreted molecules were able to increase the viability and migration of melanocytes, as well as lessen the pro-oxidant burden induced by both the single and cumulative X-ray doses. In vitro adipocyte-released factors protected B16-F10 malignant melanocytes from both oxidative stress and loss of viability triggered by radiation, enhancing the radioresistant phenotype of these cells with a concomitant activation of the AKT signaling pathway. These results both help to elucidate how obesity influences melanoma radioresistance and support the usage of conventional medical linear accelerators as a valid model for the in vitro radiobiological study of tumor cell lines.
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Affiliation(s)
- Pedro Coelho
- a Department of Biochemistry, Faculty of Medicine, University of Porto, Portugal.,b Instituto de Inovação e Investigação em Saúde, University of Porto, Portugal.,c Ciências Químicas e Biomoléculas, CISA
| | - Liliana Silva
- b Instituto de Inovação e Investigação em Saúde, University of Porto, Portugal.,c Ciências Químicas e Biomoléculas, CISA
| | - Isabel Faria
- d Radioterapia, Escola Superior de Tecnologia da Saúde do Porto, Instituto Politécnico do Porto, Portugal
| | - Mónica Vieria
- b Instituto de Inovação e Investigação em Saúde, University of Porto, Portugal.,c Ciências Químicas e Biomoléculas, CISA
| | - Armanda Monteiro
- e Serviço de Radioterapia, Centro Hospitalar de São João, Porto, Portugal
| | - Gabriela Pinto
- e Serviço de Radioterapia, Centro Hospitalar de São João, Porto, Portugal
| | - Cristina Prudêncio
- b Instituto de Inovação e Investigação em Saúde, University of Porto, Portugal.,c Ciências Químicas e Biomoléculas, CISA
| | - Rúben Fernandes
- b Instituto de Inovação e Investigação em Saúde, University of Porto, Portugal.,c Ciências Químicas e Biomoléculas, CISA
| | - Raquel Soares
- a Department of Biochemistry, Faculty of Medicine, University of Porto, Portugal.,b Instituto de Inovação e Investigação em Saúde, University of Porto, Portugal
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Wang XH, Long ZW. Correlations of EGF G1380A, bFGF C754G and VEGF T460C polymorphisms with malignant melanoma susceptibility and prognosis: A case-control study. Gene 2017; 617:44-53. [PMID: 28219779 DOI: 10.1016/j.gene.2017.02.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 02/14/2017] [Accepted: 02/16/2017] [Indexed: 01/24/2023]
Abstract
This case-control study aims to investigate the correlations of EGF G1380A, bFGF C754G and VEGF T460C polymorphisms with the susceptibility and prognosis of malignant melanoma. A total of 153 patients with multiple primary melanomas were collected as the case group and another 170 healthy individuals were selected as the control group. ELISA and PCR-RFLP were performed to test the serum level of VEGF and to analyze the genotype as well as allele frequencies of VEGF T460C, EGF G1380A, and bFGF C754G, respectively. The patients were assigned into complete remission (CR), partial remission (PR) and non-remission groups after treatment. HE and CD34 staining were conducted in tissue samples of CR and PR patients. Event-free survival (EFS) and overall survival (OS) were measured. AA genotype of EGF G1380A and GG genotype of bFGF C754G had higher frequency distribution in the case group than the control group. Patients with AA genotype of EGF G1380 and GG genotype of bFGF C754G had an elevated VEGF level in comparison to other genotypes. Patients with GA+GG genotypes of EGF G1380A and CG+CC genotypes of bFGF C754G had higher EFS and OS than those with AA genotype and those with GG genotype, respectively. According to the haplotype analysis, the case group had a notably higher frequency of TAG and CAG along with while lower frequency of TGG and CGC compared with the control group. Logistic regression analysis revealed that the polymorphisms of EGF G1380A and bFGF C754G as well as the haploid TAG increased the susceptibility of malignant melanoma. The results indicated that EGF G1380A and bFGF C754G gene polymorphisms were associated with the susceptibility and prognosis of malignant melanoma, and that the polymorphisms of EGF G1380A and bFGF C754G as well as the haploid TAG increased the susceptibility of malignant melanoma.
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Affiliation(s)
- Xin-Hua Wang
- Department of Dermatology, Shigatse People's Hospital, Shigatse 857000, P.R. China
| | - Zi-Wen Long
- Department of Dermatology, Shigatse People's Hospital, Shigatse 857000, P.R. China; Department of Gastric Cancer and Soft-Tissue Sarcoma Sugery, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China.
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Binenbaum Y, Ben-David G, Gil Z, Slutsker YZ, Ryzhkov MA, Felsteiner J, Krasik YE, Cohen JT. Cold Atmospheric Plasma, Created at the Tip of an Elongated Flexible Capillary Using Low Electric Current, Can Slow the Progression of Melanoma. PLoS One 2017; 12:e0169457. [PMID: 28103270 PMCID: PMC5245832 DOI: 10.1371/journal.pone.0169457] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 12/16/2016] [Indexed: 12/22/2022] Open
Abstract
Introduction Cold Atmospheric Plasma Jet (CAPJ), with ion temperature close to room temperature, has tremendous potential in biomedical engineering, and can potentially offer a therapeutic option that allows cancer cell elimination without damaging healthy tissue. We developed a hand-held flexible device for the delivery of CAPJ to the treatment site, with a modified high-frequency pulse generator operating at a RMS voltage of <1.2 kV and gas flow in the range 0.3–3 l/min. The aims of our study were to characterize the CAPJ emitted from the device, and to evaluate its efficacy in elimination of cancer cells in-vitro and in-vivo. Methods and Results The power delivered by CAPJ was measured on a floating or grounded copper target. The power did not drastically change over distances of 0–14 mm, and was not dependent on the targets resistance. Temperature of CAPJ-treated target was 23°-36° C, and was dependent on the voltage applied. Spectroscopy indicated that excited OH- radicals were abundant both on dry and wet targets, placed at different distances from the plasma gun. An in-vitro cell proliferation assay demonstrated that CAPJ treatment of 60 seconds resulted in significant reduction in proliferation of all cancer cell lines tested, and that CAPJ activated medium was toxic to cancer cells. In-vivo, we treated cutaneous melanoma tumors in nude mice. Tumor volume was significantly decreased in CAPJ-treated tumors relatively to controls, and high dose per fraction was more effective than low dose per fraction treatment. Importantly, pathologic examination revealed that normal skin was not harmed by CAPJ treatment. Conclusion This preliminary study demonstrates the efficacy of flexible CAPJ delivery system against melanoma progression both in-vitro and in-vivo. It is envisioned that adaptation of CAPJ technology for different kinds of neoplasms use may provide a new modality for the treatment of solid tumors.
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Affiliation(s)
- Y. Binenbaum
- Laboratory of Applied Cancer Research, Rambam Healthcare Campus, Haifa, Israel
| | - G. Ben-David
- Laboratory of Applied Cancer Research, Rambam Healthcare Campus, Haifa, Israel
| | - Z. Gil
- Laboratory of Applied Cancer Research, Rambam Healthcare Campus, Haifa, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Ya. Z. Slutsker
- Laboratory of Plasma Physics, Physics Department, Technion-Israel Institute of Technology, Haifa, Israel
| | - M. A. Ryzhkov
- Laboratory of Plasma Physics, Physics Department, Technion-Israel Institute of Technology, Haifa, Israel
| | - J. Felsteiner
- Laboratory of Plasma Physics, Physics Department, Technion-Israel Institute of Technology, Haifa, Israel
| | - Ya. E. Krasik
- Laboratory of Plasma Physics, Physics Department, Technion-Israel Institute of Technology, Haifa, Israel
| | - J. T. Cohen
- Laboratory of Applied Cancer Research, Rambam Healthcare Campus, Haifa, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- * E-mail:
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Chowdhary M, Patel KR, Danish HH, Lawson DH, Khan MK. BRAF inhibitors and radiotherapy for melanoma brain metastases: potential advantages and disadvantages of combination therapy. Onco Targets Ther 2016; 9:7149-7159. [PMID: 28003758 PMCID: PMC5161425 DOI: 10.2147/ott.s119428] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Melanoma is an aggressive malignancy that frequently spreads to the brain, resulting in rapid deterioration in both quality and quantity of life. Historically, treatment options for melanoma brain metastases (MBM) have predominantly consisted of surgery and radiotherapy. While these options can help provide local control, the majority of patients still develop intracranial progression. Indeed, novel therapeutic options, including molecularly targeted agents and immunotherapy, have improved outcomes and are now changing the role of radiotherapy. Up to 50% of melanomas contain an activating BRAF mutation, resulting in hyperactive cellular proliferation and survival. Drugs that target BRAF have been introduced for the treatment of metastatic melanoma and offer hope in improving disease outcomes; however, many of these trials either excluded or had a limited amount of patients with MBM. Recent studies have revealed that melanoma cell lines become more radiosensitive following BRAF inhibition, thus providing a potential synergistic mechanism when combining BRAF inhibitor (BRAFi) and radiotherapy. However, neurotoxicity concerns also exist with this combination. This article reviews the efficacy and limitations of BRAFi therapy for MBM, describes current evidence for combining BRAFis with radiation, discusses the rationale and evidence for combination modalities, and highlights emerging clinical trials specifically investigating this combination in MBM.
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Affiliation(s)
- Mudit Chowdhary
- Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, GA
- Department of Radiation Oncology, Rush University Medical Center, Chicago, IL
| | - Kirtesh R Patel
- Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, GA
| | - Hasan H Danish
- Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, GA
| | - David H Lawson
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Mohammad K Khan
- Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, GA
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Phan J, Sio TT, Nguyen TP, Takiar V, Gunn GB, Garden AS, Rosenthal DI, Fuller CD, Morrison WH, Beadle B, Ma D, Zafereo ME, Hutcheson KA, Kupferman ME, William WN, Frank SJ. Reirradiation of Head and Neck Cancers With Proton Therapy: Outcomes and Analyses. Int J Radiat Oncol Biol Phys 2016; 96:30-41. [DOI: 10.1016/j.ijrobp.2016.03.053] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 03/23/2016] [Accepted: 03/30/2016] [Indexed: 12/22/2022]
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20
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Kim MM, Parmar H, Cao Y, Pramanik P, Schipper M, Hayman J, Junck L, Mammoser A, Heth J, Carter CA, Oronsky A, Knox SJ, Caroen S, Oronsky B, Scicinski J, Lawrence TS, Lao CD. Whole Brain Radiotherapy and RRx-001: Two Partial Responses in Radioresistant Melanoma Brain Metastases from a Phase I/II Clinical Trial: A TITE-CRM Phase I/II Clinical Trial. Transl Oncol 2016; 9:108-113. [PMID: 27084426 PMCID: PMC4833892 DOI: 10.1016/j.tranon.2015.12.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 12/22/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND: Kim et al. report two patients with melanoma metastases to the brain that responded to treatment with RRx-001 and whole brain radiotherapy (WBRT) without neurologic or systemic toxicity in the context of a phase I/II clinical trial. RRx-001 is an reactive oxygen and reactive nitrogen species (ROS/RNS)-dependent systemically nontoxic hypoxic cell radiosensitizer with vascular normalizing properties under investigation in patients with various solid tumors including those with brain metastases. SIGNIFICANCE: Metastatic melanoma to the brain is historically associated with poor outcomes and a median survival of 4 to 5 months. WBRT is a mainstay of treatment for patients with multiple brain metastases, but no significant therapeutic advances for these patients have been described in the literature. To date, candidate radiosensitizing agents have failed to demonstrate a survival benefit in patients with brain metastases, and in particular, no agent has demonstrated improved outcome in patients with metastatic melanoma. Kim et al. report two patients with melanoma metastases to the brain that responded to treatment with novel radiosensitizing agent RRx-001 and WBRT without neurologic or systemic toxicity in the context of a phase I/II clinical trial.
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Affiliation(s)
- Michelle M Kim
- University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA.
| | - Hemant Parmar
- University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA
| | - Yue Cao
- University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA
| | - Priyanka Pramanik
- University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA
| | - Matthew Schipper
- University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA
| | - James Hayman
- University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA
| | - Larry Junck
- University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA
| | - Aaron Mammoser
- University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA
| | - Jason Heth
- University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA
| | - Corey A Carter
- Walter Reed National Military Medical Center, 8901 Wisconsin Ave, Bethesda, MD, 20889, USA
| | - Arnold Oronsky
- InterWest Partners, 2710 Sand Hill Rd #200, Menlo Park, CA, 94025, USA
| | - Susan J Knox
- Stanford University School of Medicine, Radiation Oncology, 875 Blake Wilbur Dr Clinic D, Stanford, CA, 94305, USA
| | - Scott Caroen
- EpicentRx Inc., 800W El Camino Real, Suite 180, Mountain View, CA, 94040, USA
| | - Bryan Oronsky
- EpicentRx Inc., 800W El Camino Real, Suite 180, Mountain View, CA, 94040, USA
| | - Jan Scicinski
- EpicentRx Inc., 800W El Camino Real, Suite 180, Mountain View, CA, 94040, USA
| | - Theodore S Lawrence
- University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA
| | - Christopher D Lao
- University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA
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Nishiya AT, Massoco CO, Felizzola CR, Perlmann E, Batschinski K, Tedardi MV, Garcia JS, Mendonça PP, Teixeira TF, Zaidan Dagli ML. Comparative Aspects of Canine Melanoma. Vet Sci 2016; 3:vetsci3010007. [PMID: 29056717 PMCID: PMC5644618 DOI: 10.3390/vetsci3010007] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 01/26/2016] [Accepted: 02/01/2016] [Indexed: 12/12/2022] Open
Abstract
Melanomas are malignant neoplasms originating from melanocytes. They occur in most animal species, but the dog is considered the best animal model for the disease. Melanomas in dogs are most frequently found in the buccal cavity, but the skin, eyes, and digits are other common locations for these neoplasms. The aim of this review is to report etiological, epidemiological, pathological, and molecular aspects of melanomas in dogs. Furthermore, the particular biological behaviors of these tumors in the different body locations are shown. Insights into the therapeutic approaches are described. Surgery, chemotherapy, radiotherapy, immunotherapy, and the outcomes after these treatments are presented. New therapeutic perspectives are also depicted. All efforts are geared toward better characterization and control of malignant melanomas in dogs, for the benefit of these companion animals, and also in an attempt to benefit the treatment of human melanomas.
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Affiliation(s)
- Adriana Tomoko Nishiya
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, Av. Prof. Dr. Orlando Marques de Paiva, 87, CEP 05508-270, São Paulo, Brazil.
| | - Cristina Oliveira Massoco
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, Av. Prof. Dr. Orlando Marques de Paiva, 87, CEP 05508-270, São Paulo, Brazil.
| | - Claudia Ronca Felizzola
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, Av. Prof. Dr. Orlando Marques de Paiva, 87, CEP 05508-270, São Paulo, Brazil.
- Surgical Oncology Rua Antônio Alves Magan, 124, CEP 01251-150, São Paulo, Brazil.
| | - Eduardo Perlmann
- Department of Surgery, School of Veterinary Medicine and Animal Science, University of São Paulo, CEP 05508-270, São Paulo, Brazil.
| | - Karen Batschinski
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, Av. Prof. Dr. Orlando Marques de Paiva, 87, CEP 05508-270, São Paulo, Brazil.
| | - Marcello Vannucci Tedardi
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, Av. Prof. Dr. Orlando Marques de Paiva, 87, CEP 05508-270, São Paulo, Brazil.
| | - Jéssica Soares Garcia
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, Av. Prof. Dr. Orlando Marques de Paiva, 87, CEP 05508-270, São Paulo, Brazil.
| | - Priscila Pedra Mendonça
- Department of Surgery, School of Veterinary Medicine and Animal Science, University of São Paulo, CEP 05508-270, São Paulo, Brazil.
| | - Tarso Felipe Teixeira
- Pathology Veterinary Medicine, FEPI Itajubá University Center, Dr. Antonio Braga Filho Street, 687, Itajubá, 37.501-002 Minas Gerais, Brazil.
| | - Maria Lucia Zaidan Dagli
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, Av. Prof. Dr. Orlando Marques de Paiva, 87, CEP 05508-270, São Paulo, Brazil.
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Mohr A, Chaudhri N, Hassel JC, Federspil PA, Vanoni V, Debus J, Jensen AD. Raster-scanned intensity-controlled carbon ion therapy for mucosal melanoma of the paranasal sinus. Head Neck 2015; 38 Suppl 1:E1445-51. [DOI: 10.1002/hed.24256] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2015] [Indexed: 01/18/2023] Open
Affiliation(s)
- Angela Mohr
- Department of Radiation Oncology; University of Heidelberg; INF 400 Heidelberg Germany
| | - Naved Chaudhri
- Department of Medical Physics; Heidelberg Ion Beam Therapy Center, University of Heidelberg; INF 400 Heidelberg Germany
| | - Jessica C. Hassel
- Department of Dermatology; University of Heidelberg; INF 400 Heidelberg Germany
| | - Philippe A. Federspil
- Department of Otorhinolaryngology, Department of Radiation Oncology; University of Heidelberg; INF 400 Heidelberg Germany
| | - Valentina Vanoni
- Department of Radiation Oncology; University of Heidelberg; INF 400 Heidelberg Germany
| | - Jürgen Debus
- Department of Radiation Oncology; University of Heidelberg; INF 400 Heidelberg Germany
| | - Alexandra D. Jensen
- Department of Radiation Oncology; University of Heidelberg; INF 400 Heidelberg Germany
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Goyal S, Silk AW, Tian S, Mehnert J, Danish S, Ranjan S, Kaufman HL. Clinical Management of Multiple Melanoma Brain Metastases: A Systematic Review. JAMA Oncol 2015; 1:668-76. [PMID: 26181286 PMCID: PMC5726801 DOI: 10.1001/jamaoncol.2015.1206] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
IMPORTANCE The treatment of multiple brain metastases (MBM) from melanoma is controversial and includes surgical resection, stereotactic radiosurgery (SRS), and whole-brain radiation therapy (WBRT). Several new classes of agents have revolutionized the treatment of metastatic melanoma, allowing some subsets of patients to have long-term survival. Given this, management of MBM from melanoma is continually evolving. OBJECTIVE To review the current evidence regarding the treatment of MBM from melanoma. EVIDENCE REVIEW The PubMed database was searched using combinations of search terms and synonyms for melanoma, brain metastases, radiation, chemotherapy, immunotherapy, and targeted therapy published between January 1, 1995, and January 1, 2015. Articles were selected for inclusion on the basis of targeted keyword searches, manual review of bibliographies, and whether the article was a clinical trial, large observational study, or retrospective study focusing on melanoma brain metastases. Of 2243 articles initially identified, 110 were selected for full review. Of these, the most pertinent 73 articles were included. FINDINGS Patients with newly diagnosed MBM can be treated with various modalities, either alone or in combination. Level 1 evidence supports the use of SRS alone, WBRT, and SRS with WBRT. Although the addition of WBRT to SRS improves the overall brain relapse rate, WBRT has no significant impact on overall survival and has detrimental neurocognitive outcomes. Cytotoxic chemotherapy has largely been ineffective; targeted therapies and immunotherapies have been reported to have high response rates and deserve further attention in larger clinical trials. Further studies are needed to fully evaluate the efficacy of these novel regimens in combination with radiation therapy. CONCLUSIONS AND RELEVANCE At this time, the standard management for patients with MBM from melanoma includes SRS, WBRT, or a combination of both. Emerging data exist to support the notion that SRS in combination with targeted therapies or immune therapy may obviate the need for WBRT; prospective studies are required to fully evaluate the efficacy of these novel regimens in combination with radiation therapy.
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Affiliation(s)
- Sharad Goyal
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School
| | - Ann W. Silk
- Division of Medical Oncology, Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School
| | - Sibo Tian
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School
| | - Janice Mehnert
- Division of Medical Oncology, Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School
| | - Shabbar Danish
- Division of Surgical Oncology, Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School
| | - Sinthu Ranjan
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School
| | - Howard L. Kaufman
- Division of Surgical Oncology, Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School
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Patel KR, Lawson DH, Kudchadkar RR, Carthon BC, Oliver DE, Okwan-Duodu D, Ahmed R, Khan MK. Two heads better than one? Ipilimumab immunotherapy and radiation therapy for melanoma brain metastases. Neuro Oncol 2015; 17:1312-21. [PMID: 26014049 DOI: 10.1093/neuonc/nov093] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 05/03/2015] [Indexed: 12/15/2022] Open
Abstract
Melanoma is an aggressive malignancy with a deplorable penchant for spreading to the brain. While focal therapies such as surgery and stereotactic radiosurgery can help provide local control, the majority of patients still develop intracranial progression. Novel therapeutic combinations to improve outcomes for melanoma brain metastases (MBM) are clearly needed. Ipilimumab, the anticytotoxic T-lymphocyte-associated antigen 4 monoclonal antibody, has been shown to improve survival in patients with metastatic melanoma, but many of these trials either excluded or had very few patients with MBM. This article will review the efficacy and limitations of ipilimumab therapy for MBM, describe the current evidence for combining ipilimumab with radiation therapy, illustrate potential mechanisms for synergy, and discuss emerging clinical trials specifically investigating this combination in MBM.
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Affiliation(s)
- Kirtesh R Patel
- Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (K.R.P., D.O.-D., M.K.K.); Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (D.H.L., R.R.K., B.C.C.); School of Medicine, Emory University, Atlanta, Georgia (D.E.O.); Emory Vaccine Center and Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, Georgia (R.A.)
| | - David H Lawson
- Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (K.R.P., D.O.-D., M.K.K.); Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (D.H.L., R.R.K., B.C.C.); School of Medicine, Emory University, Atlanta, Georgia (D.E.O.); Emory Vaccine Center and Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, Georgia (R.A.)
| | - Ragini R Kudchadkar
- Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (K.R.P., D.O.-D., M.K.K.); Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (D.H.L., R.R.K., B.C.C.); School of Medicine, Emory University, Atlanta, Georgia (D.E.O.); Emory Vaccine Center and Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, Georgia (R.A.)
| | - Bradley C Carthon
- Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (K.R.P., D.O.-D., M.K.K.); Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (D.H.L., R.R.K., B.C.C.); School of Medicine, Emory University, Atlanta, Georgia (D.E.O.); Emory Vaccine Center and Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, Georgia (R.A.)
| | - Daniel E Oliver
- Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (K.R.P., D.O.-D., M.K.K.); Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (D.H.L., R.R.K., B.C.C.); School of Medicine, Emory University, Atlanta, Georgia (D.E.O.); Emory Vaccine Center and Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, Georgia (R.A.)
| | - Derick Okwan-Duodu
- Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (K.R.P., D.O.-D., M.K.K.); Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (D.H.L., R.R.K., B.C.C.); School of Medicine, Emory University, Atlanta, Georgia (D.E.O.); Emory Vaccine Center and Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, Georgia (R.A.)
| | - Rafi Ahmed
- Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (K.R.P., D.O.-D., M.K.K.); Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (D.H.L., R.R.K., B.C.C.); School of Medicine, Emory University, Atlanta, Georgia (D.E.O.); Emory Vaccine Center and Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, Georgia (R.A.)
| | - Mohammad K Khan
- Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (K.R.P., D.O.-D., M.K.K.); Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (D.H.L., R.R.K., B.C.C.); School of Medicine, Emory University, Atlanta, Georgia (D.E.O.); Emory Vaccine Center and Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, Georgia (R.A.)
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25
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Fang Y, Chen X, Bai Q, Qin C, Mohamud AO, Zhu Z, Ball TW, Ruth CM, Newcomer DR, Herrick EJ, Nicholl MB. IL-9 inhibits HTB-72 melanoma cell growth through upregulation of p21 and TRAIL. J Surg Oncol 2015; 111:969-74. [PMID: 25988864 DOI: 10.1002/jso.23930] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 04/14/2015] [Indexed: 01/01/2023]
Abstract
BACKGROUND IL-9 is a pleiotropic cytokine produced mainly by Th9 cells. IL-9 may have an anti-proliferative role in murine melanoma, however, its effect on human melanoma is unknown. METHODS We examined the effects of IL-9 on proliferation and apoptosis in four human melanoma cell lines, HTB-65, HTB-72, CRL-11147, and SK-Mel-5. Clonogenic assay, PCNA staining, Quick Cell Proliferation assay, TUNEL staining and caspase-3 activity assay were used to assess proliferation and apoptosis, as appropriate. RESULTS We found that IL-9 decreased the percentage of colonies of HTB-72 and SK-Mel-5 cells but not that of HTB-65 or CRL-11147 cells. PCNA mRNA, PCNA+ cells, PCNA staining intensity, and the OD value of HTB-72 melanoma cells were consistently decreased in the present of IL-9. IL-9 also increased TUNEL+ cells and the relative caspase-3 activity in HTB-72 melanoma cells. We further investigated the possible molecular mechanisms using RT-PCR and immunohistochemical staining. The anti-proliferative effect of IL-9 on HTB-72 cells correlated with higher expression of anti-proliferative molecule p21. Its pro-apoptotic effect on HTB-72 cells correlated with higher expression of the pro-apoptotic molecule TRAIL. CONCLUSIONS IL-9 inhibits melanoma HTB-72 cell growth by upregulation of p21 and TRAIL. Understanding the interactions between IL-9 and melanoma may help direct strategies for cytokine-based immunotherapy development.
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Affiliation(s)
- Yujiang Fang
- Department of Microbiology & Immunology, Des Moines University, Des Moines, Iowa.,Department of Surgery, University of Missouri School of Medicine, Columbia, Missouri.,Ellis Fischel Cancer Center, University of Missouri School of Medicine, Columbia, Missouri
| | - Xuhui Chen
- Department of Microbiology & Immunology, Des Moines University, Des Moines, Iowa.,Department of Surgery, Luohu Hospital, Shenzhen, China
| | - Qian Bai
- Department of Surgery, University of Missouri School of Medicine, Columbia, Missouri
| | - Chenglu Qin
- Department of Surgery, University of Missouri School of Medicine, Columbia, Missouri.,Department of Gynecology & Obstetrics, Luohu Hospital, Shenzhen, China
| | - Abdimalik O Mohamud
- Department of Surgery, University of Missouri School of Medicine, Columbia, Missouri
| | - Ziwen Zhu
- Department of Surgery, University of Missouri School of Medicine, Columbia, Missouri
| | - Tyler W Ball
- Department of Surgery, University of Missouri School of Medicine, Columbia, Missouri
| | - Caleb M Ruth
- Department of Surgery, University of Missouri School of Medicine, Columbia, Missouri
| | - Dylan R Newcomer
- Department of Surgery, University of Missouri School of Medicine, Columbia, Missouri
| | - Elizabeth J Herrick
- Department of Surgery, University of Missouri School of Medicine, Columbia, Missouri
| | - Michael B Nicholl
- Department of Surgery, University of Missouri School of Medicine, Columbia, Missouri.,Ellis Fischel Cancer Center, University of Missouri School of Medicine, Columbia, Missouri
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26
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Modulation of radiochemoimmunotherapy-induced B16 melanoma cell death by the pan-caspase inhibitor zVAD-fmk induces anti-tumor immunity in a HMGB1-, nucleotide- and T-cell-dependent manner. Cell Death Dis 2015; 6:e1761. [PMID: 25973681 PMCID: PMC4669707 DOI: 10.1038/cddis.2015.129] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 03/17/2015] [Accepted: 04/06/2015] [Indexed: 12/31/2022]
Abstract
One prerequisite that radiotherapy (RT) and chemotherapy (CT) result in anti-tumor immune responses is triggering of immunogenic cell death forms such as necroptosis. The latter is inducible by inhibition of apoptosis with the pan-caspase inhibitor zVAD-fmk. The design of multimodal therapies that overcome melanoma's resistance to apoptosis is a big challenge of oncoimmunology. As hints exist that immune stimulation by hyperthermia (HT) augments the efficacy of melanoma therapies and that tumors can be sensitized for RT with zVAD-fmk, we asked whether combinations of RT with dacarbazine (DTIC) and/or HT induce immunogenic melanoma cell death and how this is especially influenced by zVAD-fmk. Necroptosis was inducible in poorly immunogenic B16-F10 melanoma cells and zVAD-fmk generally increased melanoma cell necrosis concomitantly with the release of HMGB1. Supernatants (SNs) of melanoma cells whose cell death was modulated with zVAD-fmk induced an upregulation of the activation markers CD86 and MHCII on macrophages. The same was seen on dendritic cells (DCs), but only when zVAD-fmk was added to multimodal tumor treatments including DTIC. DCs of MyD88 KO mice and DCs incubated with SNs containing apyrase did not increase the expression of these activation markers on their surface. The in vivo experiments revealed that zVAD-fmk decreases the tumor growth significantly and results in a significantly reduced tumor infiltration of Tregs when added to multimodal treatment of the tumor with RT, DTIC and HT. Further, a significantly increased DC and CD8+ T-cell infiltration into the tumor and in the draining lymph nodes was induced, as well as an increased expression of IFNγ by CD8+ T cells. However, zVAD-fmk did not further reduce tumor growth in MyD88 KO mice, mice treated with apyrase or RAG KO mice. We conclude that HMGB1, nucleotides and CD8+ T cells mediate zVAD-fmk induced anti-melanoma immune reactions in multimodal therapy settings.
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27
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Prognostic Factors for Overall Survival After Radiosurgery for Brain Metastases From Melanoma. Am J Clin Oncol 2014; 37:580-4. [DOI: 10.1097/coc.0b013e318280d7be] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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28
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Huang XY, Zhang SZ, Wang WX. Enhanced antitumor efficacy with combined administration of astragalus and pterostilbene for melanoma. Asian Pac J Cancer Prev 2014; 15:1163-9. [PMID: 24606435 DOI: 10.7314/apjcp.2014.15.3.1163] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Astragalus, a commonly used traditional Chinese medicine, has exhibited antitumor actions in patients. In this study, in vitro and in vivo antitumor effects of astragalus and synergistic antitumor efficacy in combination with pterostilbene were investigated. Melanoma cells were treated with pterostilbene (Pt), graduated doses of astragalus injection (AI), or these in combination. Cell viability was measured using a MTT assay. Released nucleosomes and caspase activity were measured using enzyme-linked immunosorbent assay. Growth inhibition in vitro and in vivo was also assessed. Analysis of variance and t tests were used for statistical analysis. Significant reduction (p<0.05) in cellular proliferation were observed with AI and AI-Pt in a time- and concentration-dependent manner. Apoptosis and caspase-3/7 activity were significantly increased by AI and AI-Pt treatment (p<0.05). In vivo, AI inhibited melanoma tumor growth, with inhibition rates ranging from 36.5 to 62.3%, by inducing apoptosis via up-regulation Bax expression and the Bax/Bcl-2 ratio and down-regulating Bcl-2 expression. AI significantly inhibits the growth of melanoma in vitro and in vivo by inducing apoptosis. These data suggest that combined treatment of astragalus with pterostilbene enhances antitumor efficacy.
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Affiliation(s)
- Xin-Yan Huang
- Dermatology Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China E-mail :
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29
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Biau J, Devun F, Jdey W, Kotula E, Quanz M, Chautard E, Sayarath M, Sun JS, Verrelle P, Dutreix M. A preclinical study combining the DNA repair inhibitor Dbait with radiotherapy for the treatment of melanoma. Neoplasia 2014; 16:835-44. [PMID: 25379020 PMCID: PMC4212251 DOI: 10.1016/j.neo.2014.08.008] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Revised: 08/14/2014] [Accepted: 08/15/2014] [Indexed: 01/05/2023] Open
Abstract
Melanomas are highly radioresistant tumors, mainly due to efficient DNA double-strand break (DSB) repair. Dbait (which stands for DNA strand break bait) molecules mimic DSBs and trap DNA repair proteins, thereby inhibiting repair of DNA damage induced by radiation therapy (RT). First, the cytotoxic efficacy of Dbait in combination with RT was evaluated in vitro in SK28 and 501mel human melanoma cell lines. Though the extent of RT-induced damage was not increased by Dbait, it persisted for longer revealing a repair defect. Dbait enhanced RT efficacy independently of RT doses. We further assayed the capacity of DT01 (clinical form of Dbait) to enhance efficacy of “palliative” RT (10 × 3 Gy) or “radical” RT (20 × 3 Gy), in an SK28 xenografted model. Inhibition of repair of RT-induced DSB by DT01 was revealed by the significant increase of micronuclei in tumors treated with combined treatment. Mice treated with DT01 and RT combination had significantly better tumor growth control and longer survival compared to RT alone with the “palliative” protocol [tumor growth delay (TGD) by 5.7-fold; median survival: 119 vs 67 days] or the “radical” protocol (TGD by 3.2-fold; median survival: 221 vs 109 days). Only animals that received the combined treatment showed complete responses. No additional toxicity was observed in any DT01-treated groups. This preclinical study provides encouraging results for a combination of a new DNA repair inhibitor, DT01, with RT, in the absence of toxicity. A first-in-human phase I study is currently under way in the palliative management of melanoma in-transit metastases (DRIIM trial).
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Affiliation(s)
- Julian Biau
- Institut Curie, Centre de Recherche, Orsay, France ; UMR3347, Centre National de la Recherche Scientifique, Orsay, France ; U1021, Institut National de la Santé et de la Recherche Médicale, Orsay, France ; Université Paris Sud, Orsay, France ; Clermont Université, Université d'Auvergne, EA7283 CREaT, Clermont-Ferrand, France ; Radiotherapy Department, Centre Jean Perrin, Clermont-Ferrand, France
| | - Flavien Devun
- Institut Curie, Centre de Recherche, Orsay, France ; DNA Therapeutics, Evry, France
| | - Wael Jdey
- Institut Curie, Centre de Recherche, Orsay, France ; UMR3347, Centre National de la Recherche Scientifique, Orsay, France ; U1021, Institut National de la Santé et de la Recherche Médicale, Orsay, France ; Université Paris Sud, Orsay, France ; DNA Therapeutics, Evry, France
| | - Ewa Kotula
- Institut Curie, Centre de Recherche, Orsay, France ; UMR3347, Centre National de la Recherche Scientifique, Orsay, France ; U1021, Institut National de la Santé et de la Recherche Médicale, Orsay, France ; Université Paris Sud, Orsay, France ; DNA Therapeutics, Evry, France
| | - Maria Quanz
- Institut Curie, Centre de Recherche, Orsay, France ; DNA Therapeutics, Evry, France
| | - Emmanuel Chautard
- Clermont Université, Université d'Auvergne, EA7283 CREaT, Clermont-Ferrand, France ; Radiotherapy Department, Centre Jean Perrin, Clermont-Ferrand, France
| | | | | | - Pierre Verrelle
- Clermont Université, Université d'Auvergne, EA7283 CREaT, Clermont-Ferrand, France ; Radiotherapy Department, Centre Jean Perrin, Clermont-Ferrand, France
| | - Marie Dutreix
- Institut Curie, Centre de Recherche, Orsay, France ; UMR3347, Centre National de la Recherche Scientifique, Orsay, France ; U1021, Institut National de la Santé et de la Recherche Médicale, Orsay, France ; Université Paris Sud, Orsay, France
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30
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Bourgeois DJ, Singh AK. Single-fraction stereotactic body radiation therapy for sinonasal malignant melanoma. Head Neck 2014; 37:E34-7. [PMID: 24891086 DOI: 10.1002/hed.23788] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/13/2014] [Accepted: 05/28/2014] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND A rare head and neck disease that may benefit from definitive or palliative stereotactic body radiation therapy (SBRT) is sinonasal malignant melanoma. These tumors can be very aggressive and often lead to severe epistaxis and significant mass effect. Results from only a handful of head and neck sinonasal malignant melanoma treated with SBRT are available in the current literature. METHODS The following reports on 2 cases of sinonasal malignant melanoma that recurred postoperatively and were subsequently treated at Roswell Park with SBRT. Both were treated with a single fraction of 15 Gy. RESULTS Nearly instant relief of their chronic epistaxis and complete responses were seen in both patients. One patient is alive and free of disease 7 years after radiation. CONCLUSION These patients with sinonasal malignant melanoma achieved symptomatic relief of severe bleeding and airway issues from single-fraction SBRT. SBRT should be considered as a treatment option in patients with unresectable sinonasal malignant melanoma.
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Affiliation(s)
- Daniel J Bourgeois
- University at Buffalo School of Medicine, Roswell Park Cancer Institute, Buffalo, New York
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31
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Arienti C, Zoli W, Pignatta S, Carloni S, Paganelli G, Ulivi P, Romeo A, Menghi E, Sarnelli A, Medri L, Polico R, Silvestrini R, Tesei A. Efficacy of Different Sequences of Radio- and Chemotherapy in Experimental Models of Human Melanoma. J Cell Physiol 2014; 229:1548-56. [DOI: 10.1002/jcp.24598] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 02/27/2014] [Indexed: 11/05/2022]
Affiliation(s)
- Chiara Arienti
- Biosciences Laboratory; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS; Meldola Italy
| | - Wainer Zoli
- Biosciences Laboratory; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS; Meldola Italy
| | - Sara Pignatta
- Biosciences Laboratory; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS; Meldola Italy
| | - Silvia Carloni
- Biosciences Laboratory; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS; Meldola Italy
| | - Giulia Paganelli
- Biosciences Laboratory; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS; Meldola Italy
| | - Paola Ulivi
- Biosciences Laboratory; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS; Meldola Italy
| | - Antonino Romeo
- Radiotherapy Unit; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS; Meldola Italy
| | - Enrico Menghi
- Medical Physics Unit; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS; Meldola Italy
| | - Anna Sarnelli
- Medical Physics Unit; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS; Meldola Italy
| | - Laura Medri
- Pathology Unit; Morgagni-Pierantoni Hospital; Forlì Italy
| | - Rolando Polico
- Radiotherapy Unit; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS; Meldola Italy
| | - Rosella Silvestrini
- Biosciences Laboratory; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS; Meldola Italy
| | - Anna Tesei
- Biosciences Laboratory; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS; Meldola Italy
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32
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Luo YM, Xia NX, Yang L, Li Z, Yang H, Yu HJ, Liu Y, Lei H, Zhou FX, Xie CH, Zhou YF. CTC1 increases the radioresistance of human melanoma cells by inhibiting telomere shortening and apoptosis. Int J Mol Med 2014; 33:1484-90. [PMID: 24718655 PMCID: PMC4055431 DOI: 10.3892/ijmm.2014.1721] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 03/19/2014] [Indexed: 02/07/2023] Open
Abstract
Melanoma has traditionally been viewed as a radioresistant cancer. However, recent studies suggest that under certain clinical circumstances, radiotherapy may play a significant role in the treatment of melanoma. Previous studies have demonstrated that telomere length is a hallmark of radiosensitivity. The newly discovered mammalian CTC1-STN1-TEN1 (CST) complex has been demonstrated to be an important telomere maintenance factor. In this study, by establishing a radiosensitive/radioresistant human melanoma cell model, MDA-MB-435/MDA-MB-435R, we aimed to investigate the association of CTC1 expression with radiosensitivity in human melanoma cell lines, and to elucidate the possible underlying mechanisms. We found that CTC1 mRNA and protein levels were markedly increased in the MDA-MB-435R cells compared with the MDA-MB-435 cells. Moreover, the downregulation of CTC1 enhanced radiosensitivity, induced DNA damage and promoted telomere shortening and apoptosis in both cell lines. Taken together, our findings suggest that CTC1 increases the radioresistance of human melanoma cells by inhibiting telomere shortening and apoptosis. Thus, CTC1 may be an attractive target gene for the treatment of human melanoma.
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Affiliation(s)
- Y M Luo
- Hubei Cancer Clinical Study Center, Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan University, Wuhan, Hubei, P.R. China
| | - N X Xia
- Hubei Cancer Clinical Study Center, Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan University, Wuhan, Hubei, P.R. China
| | - L Yang
- Hubei Cancer Clinical Study Center, Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan University, Wuhan, Hubei, P.R. China
| | - Z Li
- Hubei Cancer Clinical Study Center, Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan University, Wuhan, Hubei, P.R. China
| | - H Yang
- Hubei Cancer Clinical Study Center, Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan University, Wuhan, Hubei, P.R. China
| | - H J Yu
- Hubei Cancer Clinical Study Center, Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan University, Wuhan, Hubei, P.R. China
| | - Y Liu
- Hubei Cancer Clinical Study Center, Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan University, Wuhan, Hubei, P.R. China
| | - H Lei
- Hubei Cancer Clinical Study Center, Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan University, Wuhan, Hubei, P.R. China
| | - F X Zhou
- Hubei Cancer Clinical Study Center, Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan University, Wuhan, Hubei, P.R. China
| | - C H Xie
- Hubei Cancer Clinical Study Center, Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan University, Wuhan, Hubei, P.R. China
| | - Y F Zhou
- Department of Radiation Oncology and Medical Oncology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, P.R. China
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Long-term stabilization of leptomeningeal disease with whole-brain radiation therapy in a patient with metastatic melanoma treated with vemurafenib: a case report. Melanoma Res 2014; 23:175-8. [PMID: 23358426 DOI: 10.1097/cmr.0b013e32835e589c] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
We present a patient with metastatic BRAF-mutated melanoma who achieved long-term stabilization of leptomeningeal disease (LMD) with sequential whole-brain radiation therapy and vemurafenib. A 53-year-old woman with melanoma that harbored the BRAF V600E mutation and had that metastasized to multiple lymph nodes, lungs, breast, and subcutaneous tissue had developed symptomatic LMD 16 months after starting vemurafenib treatment despite achieving a substantial response at the existing metastatic sites. Vemurafenib was discontinued for 7 days, she received whole-brain radiation therapy (30 Gy in 10 fractions), and 7 days after completing the radiation therapy, she resumed vemurafenib therapy. The neurologic symptoms improved significantly, and a cerebrospinal fluid examination revealed disappearance of melanoma cells. She remained alive with radiologically stable LMD for at least 18 months after the whole-brain radiation therapy.
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Patel PR, Kirkpatrick J, Salama JK, Nelson J, Broadwater G, Allen K, Clough R, Yin FF, Wang Z, Chang Z, Kelsey C, Ghafoori AP. Stereotactic ablative body radiotherapy (SABR) for effective palliation of metastases: factors affecting local control. JOURNAL OF RADIOSURGERY AND SBRT 2014; 3:123-129. [PMID: 29296393 PMCID: PMC5675484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 05/21/2014] [Indexed: 06/07/2023]
Abstract
We analyzed factors associated with inferior local control following stereotactic ablative body radiotherapy (SABR) for palliation of metastases. We reviewed records of patients receiving SABR for metastases at Duke University from 2006-2010. Biologically effective dose (BED) was calculated using the linear-quadratic model. Toxicity was assessed by CTCAE v4.0. The Kaplan-Meier method was used to estimate overall survival (OS) and local control (LC) within subgroups (primary or salvage SABR). Univariate (UVA) and multivariate (MVA) regression analysis was used. Fifty and 33 patients received primary and salvage SABR, respectively. 105 lesions were treated (52 spine, 27 lung, 7 liver, 11 other); 67 primary SABR and 38 salvage. Median clinical follow-up was 11.1 months and 10.3 months with imaging of the treated lesion. One patient received SABR x3 and died from toxicity. 88% of symptomatic patients improved after SABR. 1-year LC and OS were 83% and 50%, respectively. Primary SABR had higher BED and was associated with improved LC on UVA (HR 3.0, p=0.01) and MVA (p=0.02); treatment site and histology were not. SABR results in effective palliation of metastases regardless of prior treatment. In the absence of prior EBRT, SABR can be delivered with higher BED and may be associated with better outcomes.
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Affiliation(s)
- Pretesh R. Patel
- Department Radiation Oncology, Duke University Medical Center, Box 3085, Durham, NC 27710, USA
| | - John Kirkpatrick
- Department Radiation Oncology, Duke University Medical Center, Box 3085, Durham, NC 27710, USA
| | - Joseph K. Salama
- Department Radiation Oncology, Duke University Medical Center, Box 3085, Durham, NC 27710, USA
| | - John Nelson
- Naval Medical Center Portsmouth, John Paul Jones Circle, Portsmouth, VA 23708, USA
| | - Gloria Broadwater
- Biostatistics, Duke University Medical Center, Box 2717 Med Ctr, Hock Plaza, 2424 Erwin Rd, Rm 8023, Durham, NC 27705, USA
| | - Karen Allen
- Department Radiation Oncology, Duke University Medical Center, Box 3085, Durham, NC 27710, USA
| | - Robert Clough
- Department Radiation Oncology, Duke University Medical Center, Box 3085, Durham, NC 27710, USA
| | - Fang-Fang Yin
- Department Radiation Oncology, Duke University Medical Center, Box 3085, Durham, NC 27710, USA
| | - Zhiheng Wang
- Department Radiation Oncology, Duke University Medical Center, Box 3085, Durham, NC 27710, USA
| | - Zheng Chang
- Department Radiation Oncology, Duke University Medical Center, Box 3085, Durham, NC 27710, USA
| | - Christopher Kelsey
- Department Radiation Oncology, Duke University Medical Center, Box 3085, Durham, NC 27710, USA
| | - A. Paiman Ghafoori
- University Medical Center Brackenridge, Austin CyberKnife, 1400 North IH 35, Austin, TX 78701, USA
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The role of radiotherapy in the management of sinonasal melanoma and its impact on patients and healthcare professionals. Eur Arch Otorhinolaryngol 2013; 271:3021-6. [PMID: 24366616 DOI: 10.1007/s00405-013-2868-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 12/16/2013] [Indexed: 01/05/2023]
Abstract
The aim of this paper is discuss the contemporary issues surrounding radiotherapy for sinonasal mucosal melanoma (SNMM). SNMM is a rare disease with a poor prognosis. The particular challenge with regard to radiotherapy for SNMM is that melanoma is a relatively radioresistant tumour in an anatomical site surrounded by important radiosensitive structures. IMRT has been shown to be an effective primary and adjuvant therapy, and is superior to traditional photon radiotherapy techniques. Emerging evidence also supports the role of particle therapy. Protons and carbon ions may provide a superior target dose and less collateral damage than IMRT. Stereotactic radiotherapy has also been used successfully. The introduction of new technology will always be inhibited by financial constraints and concerns about long-term efficacy. The role of the health professional will change commensurate with the introduction of new technology in terms of the knowledge and the clinical skills they must acquire. Working patterns may need to change to manage the competing interests of expanding services and financial cutbacks. In addition to the clinical expertise health professionals provide, they will be charged with the responsibility of finding innovative ways to improve and develop radiotherapy services for SNMM.
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Nikolaishvilli-Feinberg N, Cohen SM, Midkiff B, Zhou Y, Olorvida M, Ibrahim JG, Omolo B, Shields JM, Thomas NE, Groben PA, Kaufmann WK, Miller CR. Development of DNA damage response signaling biomarkers using automated, quantitative image analysis. J Histochem Cytochem 2013; 62:185-96. [PMID: 24309508 DOI: 10.1369/0022155413516469] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The DNA damage response (DDR) coordinates DNA repair with cell cycle checkpoints to ameliorate or mitigate the pathological effects of DNA damage. Automated quantitative analysis (AQUA) and Tissue Studio are commercial technologies that use digitized immunofluorescence microscopy images to quantify antigen expression in defined tissue compartments. Because DDR is commonly activated in cancer and may reflect genetic instability within the lesion, a method to quantify DDR in cancer offers potential diagnostic and/or prognostic value. In this study, both AQUA and Tissue Studio algorithms were used to quantify the DDR in radiation-damaged skin fibroblasts, melanoma cell lines, moles, and primary and metastatic melanomas. Digital image analysis results for three markers of DDR (γH2AX, P-ATM, P-Chk2) correlated with immunoblot data for irradiated fibroblasts, whereas only γH2AX and P-Chk2 correlated with immunoblot data in melanoma cell lines. Melanoma cell lines displayed substantial variation in γH2AX and P-Chk2 expression, and P-Chk2 expression was significantly correlated with radioresistance. Moles, primary melanomas, and melanoma metastases in brain, lung and liver displayed substantial variation in γH2AX expression, similar to that observed in melanoma cell lines. Automated digital analysis of immunofluorescent images stained for DDR biomarkers may be useful for predicting tumor response to radiation and chemotherapy.
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Affiliation(s)
- Nana Nikolaishvilli-Feinberg
- Translational Pathology Laboratory (NNF, SMC, BM, MO, CRM), University of North Carolina School of Medicine, NC, USA
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Squires MH, Delman KA. Current Treatment of Locoregional Recurrence of Melanoma. Curr Oncol Rep 2013; 15:465-72. [DOI: 10.1007/s11912-013-0333-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Wang F, Bing Z, Zhang Y, Ao B, Zhang S, Ye C, He J, Ding N, Ye W, Xiong J, Sun J, Furusawa Y, Zhou G, Yang L. Quantitative proteomic analysis for radiation-induced cell cycle suspension in 92-1 melanoma cell line. JOURNAL OF RADIATION RESEARCH 2013; 54:649-62. [PMID: 23447694 PMCID: PMC3709680 DOI: 10.1093/jrr/rrt010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Melanoma is a malignant tumor with high invasive and metastatic properties. Though radiation is the major therapy for melanoma, its radio-resistance has been shown to severely influence the clinical outcome. So it is imperative to enhance the sensitivity of uveal melanoma cells to radiotherapy. Previously, we found that the cell cycle of 92-1 uveal melanoma cells was suspended and remained unchanged for up to 5 days after exposure to 10 Gy of X-rays, which might be relevant to the high radio-sensitivity of 92-1 cells. To further investigate the cell cycle suspension-associated proteins, we employed two analyses with stable isotope labeling with amino acids in cell culture technology and two-dimensional liquid chromatography tandem mass spectrometry. Cells were incubated for 15 h or 48 h after irradiation with 10 Gy of X-rays. We identified a total of 737 proteins at 15 h (Group A) and 530 proteins at 48 h post-irradiation (Group B). The gene ontology biological pathway was used to obtain a systems level view of proteome changes in 92-1cells under cell cycle suspension. We further selected the significantly changed proteins for investigation of their potential contribution to cell cycle suspension, growth arrest and cell senescence. These proteins are involved in the cell cycle, stress response, glycolysis and the tricarboxylic acid cycle, etc. Our study expected to reveal potential marker proteins associated with cell suspension induced by irradiation, which might contribute to understanding the mechanism beyond the cell cycle suspension.
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Affiliation(s)
- Fengling Wang
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- Biochemistry and Molecular Laboratory, Medical College of Henan University, Henan 475000, China
| | - Zhitong Bing
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - Yanan Zhang
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - Bin Ao
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - Sheng Zhang
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- Graduate School of Chinese Academy of Sciences, Beijing 100049, China
| | - Caiyong Ye
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- Graduate School of Chinese Academy of Sciences, Beijing 100049, China
| | - Jinpeng He
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- Graduate School of Chinese Academy of Sciences, Beijing 100049, China
| | - Nan Ding
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- Graduate School of Chinese Academy of Sciences, Beijing 100049, China
| | - Wenling Ye
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - Jie Xiong
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - Jintu Sun
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - Yoshiya Furusawa
- Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba 263-555, Japan
| | - Guangming Zhou
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- Corresponding author. 509 Nanchang Road, Lanzhou 730000, China. Tel: +86-931-4969164; Fax: +86-931-4969164; E-mail:
| | - Lei Yang
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
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Chiarion-Sileni V, Guida M, Romanini A, Bernengo MG, Ascierto P, Queirolo P, Mandalà M, Maio M, Ferraresi V, Stanganelli I, Testori A, Ridolfi R. Diagnostic and therapeutic approaches in Italian hospitals: adjuvant and metastatic therapy in melanoma. Dermatology 2013; 226 Suppl 1:22-7. [PMID: 23736267 DOI: 10.1159/000348870] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Melanoma incidence and mortality rates are rising in Italy, indicating that more effective treatments are required both in the adjuvant and metastatic settings. We analyzed clinical practices in the adjuvant and metastatic settings by conducting a nationwide survey of clinicians responsible for managing melanoma treatment and follow-up in a representative sample of Italian hospitals. 95% of participating hospitals completed the panel of questions on adjuvant and metastatic treatment, making it likely that these results give a realistic picture of treatment and follow-up of melanoma patients in Italy. In low-volume hospitals (<25 new melanoma diagnoses yearly) adjuvant therapy was significantly more used than in large-volume hospitals for patients in stage III and IV (82 versus 66% and 56 versus 30%, respectively), and only 11% of patients were enrolled in clinical trials. In the metastatic setting dacarbazine was the preferred first-line treatment (32%) followed by polychemotherapy (23%); 12% of patients were enrolled in clinical trials and less than 10% received interleukin-2, usually subcutaneously. The information provided by this study was used by the Italian Melanoma Intergroup to improve the quality of care and to redirect financial resources.
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Affiliation(s)
- Vanna Chiarion-Sileni
- Melanoma and Skin Cancer Unit, Veneto Oncology Institute, IRCCS, Padua, Italy. mgaliz @ tiscali.it
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Synergistic cytotoxicity of radiation and oncolytic Lister strain vaccinia in (V600D/E)BRAF mutant melanoma depends on JNK and TNF-α signaling. Oncogene 2013; 33:1700-12. [PMID: 23624923 DOI: 10.1038/onc.2013.112] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Revised: 01/10/2013] [Accepted: 02/13/2013] [Indexed: 02/07/2023]
Abstract
Melanoma is an aggressive skin cancer that carries an extremely poor prognosis when local invasion, nodal spread or systemic metastasis has occurred. Recent advances in melanoma biology have revealed that RAS-RAF-MEK-ERK signaling has a pivotal role in governing disease progression and treatment resistance. Proof-of-concept clinical studies have shown that direct BRAF inhibition yields impressive responses in advanced disease but these are short-lived as treatment resistance rapidly emerges. Therefore, there is a pressing need to develop new targeted strategies for BRAF mutant melanoma. As such, oncolytic viruses represent a promising cancer-specific approach with significant activity in melanoma. This study investigated interactions between genetically-modified vaccinia virus (GLV-1h68) and radiotherapy in melanoma cell lines with BRAF mutant, Ras mutant or wild-type genotype. Preclinical studies revealed that GLV-1h68 combined with radiotherapy significantly increased cytotoxicity and apoptosis relative to either single agent in (V600D)BRAF/(V600E)BRAF mutant melanoma in vitro and in vivo. The mechanism of enhanced cytotoxicity with GLV-1h68/radiation (RT) was independent of viral replication and due to attenuation of JNK, p38 and ERK MAPK phosphorylation specifically in BRAF mutant cells. Further studies showed that JNK pathway inhibition sensitized BRAF mutant cells to GLV-1h68-mediated cell death, mimicking the effect of RT. GLV-1h68 infection activated MAPK signaling in (V600D)BRAF/(V600E)BRAF mutant cell lines and this was associated with TNF-α secretion which, in turn, provided a prosurvival signal. Combination GLV-1h68/RT (or GLV-1h68/JNK inhibition) caused abrogation of TNF-α secretion. These data provide a strong rationale for combining GLV-1h68 with irradiation in (V600D/E)BRAF mutant tumors.
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Fang Y, Bradley MJ, Cook KM, Herrick EJ, Nicholl MB. A potential role for resveratrol as a radiation sensitizer for melanoma treatment. J Surg Res 2013; 183:645-53. [PMID: 23522452 DOI: 10.1016/j.jss.2013.02.037] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Revised: 02/10/2013] [Accepted: 02/19/2013] [Indexed: 11/15/2022]
Abstract
BACKGROUND Radiotherapy (XRT) is used to improve local control of melanoma and for palliation of metastatic disease. Clinical use of XRT for melanoma is often limited by extent of disease and the relative radioresistance of melanoma may limit the effectiveness of XRT. Our group and others have previously shown that resveratrol (RSV) enhances radiation sensitivity in radioresistant prostate cancer cell lines. MATERIAL AND METHODS In this study, the effects of XRT in combination with RSV on radioresistant melanoma lines, SK-Mel-5 and HTB-65, were evaluated by assessment of proliferation and apoptosis. Clonogenic assay, comparison of proliferating cell nuclear antigen staining, Quick Cell Proliferation assay, terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining and caspase-3 activity assay were used to assess proliferation and apoptosis, as appropriate. RESULTS We found that the percentage of colonies, proliferating cell nuclear antigen + cells and the optical density value of melanoma cells were decreased after addition of RSV to XRT (XRT/RSV). TUNEL + cells and the relative caspase-3 activity in melanoma cells were increased after addition of RSV to XRT (XRT/RSV). We investigated the possible molecular mechanisms of decreased proliferation and increased apoptosis by using reverse transcriptase-polymerase chain reaction and immunohistochemical staining. The anti-proliferative effect of XRT/RSV correlated with decreased expression of pro-proliferative molecule cyclin B, cyclin D, cdk2 and cdk4. The pro-apoptotic effect of XRT/RSV correlated with decreased expression of the anti-apoptotic molecule FLIP, Bcl-2, and survivin. CONCLUSION These data suggest that RSV enhances radiation sensitivity of melanoma cells by inhibiting proliferation and promoting apoptosis. Resveratrol may have a potential role as a radiation sensitizer for melanoma treatment.
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Affiliation(s)
- Yujiang Fang
- Department of Surgery, University of Missouri School of Medicine, Columbia, MO 65212, USA.
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Fox MC, Lao CD, Schwartz JL, Frohm ML, Bichakjian CK, Johnson TM. Management options for metastatic melanoma in the era of novel therapies: a primer for the practicing dermatologist: part II: Management of stage IV disease. J Am Acad Dermatol 2013; 68:13.e1-13; quiz 26-8. [PMID: 23244384 DOI: 10.1016/j.jaad.2012.09.041] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Revised: 09/04/2012] [Accepted: 09/07/2012] [Indexed: 12/01/2022]
Abstract
Part II of this continuing medical education article will discuss the treatment options for stage IV melanoma, including novel therapies, such as ipilimumab and vemurafenib; established therapies, including high-dose interleukin-2, conventional chemotherapy, and biochemotherapy; and additional therapies currently under investigation in the form of clinical trials. The approach to patients with brain metastases will be discussed, as will recommendations for distress screening and defining aspects of palliative care.
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Affiliation(s)
- Matthew C Fox
- Department of Dermatology, University of Michigan Medical School and Comprehensive Cancer Center, Ann Arbor, Michigan, USA.
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Arienti C, Tesei A, Carloni S, Ulivi P, Romeo A, Ghigi G, Menghi E, Sarnelli A, Parisi E, Silvestrini R, Zoli W. SLUG silencing increases radiosensitivity of melanoma cells in vitro. Cell Oncol (Dordr) 2012; 36:131-9. [PMID: 23250725 DOI: 10.1007/s13402-012-0120-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2012] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Melanoma radioresistance has been attributed to the presence of tumor cells with highly efficient DNA damage repair mechanisms. We examined the expression of genes involved in DNA damage repair and DNA damage sensing, and assessed their modulation by SLUG silencing, which is potentially capable of increasing radiosensitivity. METHODS Two melanoma cell lines (M14 and M79) were used to evaluate in vitro radiation-induced cytotoxicity before and after SLUG silencing. mRNA expression levels of BRCA1, ERCC1, DNA-PK, PARP, MGMT, ATM and TGM2 were determined by real-time RT-PCR, and protein expression levels of SLUG, caspase 3, p21, PUMA and pMAPK by Western blotting. RESULTS The cytotoxic effect of radiation was high in M14 and low in M79 cells. SLUG silencing increased the interference of radiation on cell cycle distribution and cell killing by 60 % and 80 % in M79 cells after a 2.4 Gy and 5 Gy radiation dose, respectively. It also led to a significant inhibition of expression of genes involved in DNA damage repair and DNA damage sensing in all cell lines maintained after radiation. An almost total inhibition was observed for TGM2, which is expressed at a high basal level in the most radioresistant cell line (M79). Protein expression of PUMA was induced by radiation and was enhanced after SLUG silencing. CONCLUSIONS Our results reveal a pivotal role of SLUG in regulating a cellular network involved in the response to DNA damage, and highlight the importance of TGM2 in radiosensitivity modulation. SLUG silencing appears to increase radiation sensitivity of the melanoma cells tested.
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Affiliation(s)
- Chiara Arienti
- Biosciences Laboratory, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Via P. Maroncelli 40, Meldola, 47014, Italy
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Jahanshahi P, Nasr N, Unger K, Batouli A, Gagnon GJ. Malignant melanoma and radiotherapy: past myths, excellent local control in 146 studied lesions at Georgetown University, and improving future management. Front Oncol 2012; 2:167. [PMID: 23162795 PMCID: PMC3498619 DOI: 10.3389/fonc.2012.00167] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Accepted: 10/28/2012] [Indexed: 11/13/2022] Open
Abstract
Introduction: Once thought to be radioresistant, emerging cellular and clinical evidence now suggests melanoma can respond to large radiation doses per fraction. Materials and Methods: We conducted a retrospective study of all patients treated with stereotactic radiosurgery and stereotactic body radiotherapy at Georgetown University Hospital from May 2002 through November 2008 and studied the classic extrapolated total dose corrected for volume (ETDvol) model for predicting melanoma tumor response. Region-specific tumor outcomes were categorized by RECIST criteria and local control curves were estimated and analyzed when stratified by ETDvol thresholds by use of the Kaplan–Meier method. Results: Follow-up information was available for 78 lesions (49 intracranial, 8 spinal, and 21 body) with mean follow-up period of 9.2 (range, 2–36) months. 1-year local control rates for intracranial, spinal, and body tumors were 84, 100, and 72%, respectively. Treatments in general were well-tolerated. Increased ETDvol (p < 0.001) among intracranial sites resulted from larger (p < 0.001) doses per fraction combined with smaller (p < 0.001) tumor diameters. Intracranial 6-, 12-, and 24-month local control rates when treated above ETDvol threshold of 230 Gy were all 90 vs. 89, 80, and 53% below this threshold. Body 6- and 12-month local control rates when treated above ETDvol threshold of 100 Gy were 100 and 80% vs. 74 and 59% below this threshold. Discussion: By tailoring to melanoma’s unique radiobiology with large radiation doses per fraction, favorable local control was safely achieved. The ETDvol model combines the important factor of dose per fraction in melanoma treatment with a volume correction factor to predict tumor response. Although limited sample size may have prevented reaching statistical significance for local control improvements using ETDvol thresholds, optimal thresholds may exist to improve future tumor responses and further research is required.
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Affiliation(s)
- Pooya Jahanshahi
- Virginia Commonwealth University School of Medicine Richmond, VA, USA
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Demaria S, Formenti SC. Radiation as an immunological adjuvant: current evidence on dose and fractionation. Front Oncol 2012; 2:153. [PMID: 23112958 PMCID: PMC3481113 DOI: 10.3389/fonc.2012.00153] [Citation(s) in RCA: 220] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Accepted: 10/08/2012] [Indexed: 01/21/2023] Open
Abstract
Ionizing radiation to a cancer site has the ability to convert the irradiated tumor in an immunogenic hub. However, radiation is a complex modifier of the tumor microenvironment and, by itself, is seldom sufficient to induce a therapeutically significant anti-tumor immune response, since it can also activate immune suppressive pathways. While several combinations of local radiation and immunotherapy have been shown in pre-clinical models to induce powerful anti-tumor immunity, the optimal strategy to achieve this effect remains to be defined. When used in vivo, radiation effects on tumors depend on the dose per fraction applied, the number of fractions used, and the total dose. Moreover, the interplay of these three variables is contingent upon the tumor setting studied, both in pre-clinical and clinical applications. To enable repair of the collateral damage to the normal tissue, radiation is usually given in multiple fractions, usually of 2 Gy. Generally, the use of larger fractions is limited to stereotactic applications, whereby optimal immobilization reduces inter- and intrafraction movement and permits a very conformal delivery of dose to the target, with optimal exclusion of normal tissue. Translation of the partnership of radiation and immunotherapy to the clinic requires a careful consideration of the radiation regimens used. To date, little is known on whether different dose/fractionation regimens have a specific impact on the anti-tumor immune response. Most experiments combining the two modalities were conducted with single fractions of radiotherapy. However, there is at least some evidencethat when combined with some specific immunotherapy approaches, the ability of radiation to promote anti-tumor immunity is dependent on the dose and fractionation employed. We critically review the available in vitro and in vivo data on this subject and discuss the potential impact of fractionation on the ability of radiation to synergize with immunotherapy.
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Affiliation(s)
- Sandra Demaria
- Department of Pathology, New York University School of Medicine, NYU Langone Medical Center New York, NY, USA
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Zietman A. The Red Journal's Top 10 Most Downloaded Articles of 2011. Int J Radiat Oncol Biol Phys 2012; 83:1073-4. [DOI: 10.1016/s0360-3016(12)00746-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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