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Kawauchi D, Narita Y. The curse of blood-brain barrier and blood-tumor barrier in malignant brain tumor treatment. Int J Clin Oncol 2025:10.1007/s10147-025-02777-3. [PMID: 40338447 DOI: 10.1007/s10147-025-02777-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2025] [Accepted: 04/24/2025] [Indexed: 05/09/2025]
Abstract
The blood-brain barrier (BBB) is crucial for brain homeostasis but is a major obstacle in delivering anticancer drugs to brain tumors. However, this perspective requires re-evaluation, particularly for malignant brain tumors, such as gliomas and brain metastases. In these aggressive tumors, the BBB undergoes significant alterations, leading to the formation of a more permeable blood-tumor barrier. While this increased permeability allows better drug penetration, heterogeneity in blood-tumor barrier (BTB) integrity across different tumor regions remains a challenge. Additionally, the main challenge in treating brain tumors lies not in BBB penetration but in the lack of effective drugs. Conventional chemotherapies, including temozolomide and nitrosourea agents, have shown limited efficacy, and resistance mechanisms often reduce their long-term benefits. The "BBB curse" has often been blamed for the slow progress in drug development. However, emerging evidence suggests that even larger-molecule therapies, such as antibody-drug conjugates, can successfully target brain tumors. This review aims to critically reassess the roles of the BBB and BTB in brain tumor therapy, highlighting their impact on drug delivery and evaluating the current landscape of chemotherapeutic strategies. Furthermore, it explores new approaches to overcome treatment limitations, emphasizing the need for personalized and targeted therapeutic strategies.
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Affiliation(s)
- Daisuke Kawauchi
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Chuo City, Japan
| | - Yoshitaka Narita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Chuo City, Japan.
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2
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Azab MA, El-Gohary N, Atallah O, Shama M, Ibrahim IA. Perfusion-MRI for differentiating cerebral metastatic lesions and gliomas: An evidence-based review. J Clin Neurosci 2025; 133:111036. [PMID: 39799817 DOI: 10.1016/j.jocn.2025.111036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2024] [Revised: 12/05/2024] [Accepted: 01/04/2025] [Indexed: 01/15/2025]
Abstract
BACKGROUND Lesions affecting the brain are variable and have multiple pathologies. Brain metastasis is a common entity of lesions that can be misleading in diagnosis. Brain metastasis affects the patient's life and survival in about 40% of cases; all patients with metastatic brain lesions are indicated for surgery, so proper diagnosis is crucial for each patient. Non-invasive diagnosis is a promising way to confirm the diagnosis of cerebral metastatic lesions for patients who are not indicated for surgery for medical reasons. To our knowledge, this is the first evidence-based review article regarding utilizing perfusion-MRI for approaching cerebral metastatic lesions. METHODS A comprehensive database search on PubMed/Medline, Scopus and Google Scholar was done by the relevant keywords. Eligibility of articles was done by following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Cochrane risk of bias assessment tool was used to determine the risk of bias among the included studies. RESULTS From 2989 articles, only 31 studies were eligible for the qualitative synthesis. A comprehensive summary of the included study was made according to population, intervention, comparator and outcomes (PICO) method. CONCLUSIONS Diagnosing cerebral metastases, categorizing subtypes, and monitoring their response to treatment is a challenging endeavor for neurosurgeons, neuroradiologists, and oncologists. Technological advances in MRI software as perfusion-based MRIs are designated to facilitate diagnosis and follow-up for patients with cerebral metastases.
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Affiliation(s)
- Mohammed A Azab
- Department of Neurosurgery, Cairo University Hospital, Ciro, Egypt.
| | - Nour El-Gohary
- Department of Neurosurgery, Cairo University Hospital, Ciro, Egypt
| | - Oday Atallah
- Department of Neurosurgery, Carl Von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Mohsen Shama
- Department of Emergency Medicine, KAMC, Mekkah, KSA
| | - Ismail A Ibrahim
- Faculty of Health Sciences, Fenerbahçe University, Istanbul, Turkey
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3
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Zhang S, Huang J, Jiang Z, Tong H, Ma X, Liu Y. Tumor microbiome: roles in tumor initiation, progression, and therapy. MOLECULAR BIOMEDICINE 2025; 6:9. [PMID: 39921821 PMCID: PMC11807048 DOI: 10.1186/s43556-025-00248-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Revised: 01/06/2025] [Accepted: 01/21/2025] [Indexed: 02/10/2025] Open
Abstract
Over the past few years, the tumor microbiome is increasingly recognized for its multifaceted involvement in cancer initiation, progression, and metastasis. With the application of 16S ribosomal ribonucleic acid (16S rRNA) sequencing, the intratumoral microbiome, also referred to as tumor-intrinsic or tumor-resident microbiome, has also been found to play a significant role in the tumor microenvironment (TME). Understanding their complex functions is critical for identifying new therapeutic avenues and improving treatment outcomes. This review first summarizes the origins and composition of these microbial communities, emphasizing their adapted diversity across a diverse range of tumor types and stages. Moreover, we outline the general mechanisms by which specific microbes induce tumor initiation, including the activation of carcinogenic pathways, deoxyribonucleic acid (DNA) damage, epigenetic modifications, and chronic inflammation. We further propose the tumor microbiome may evade immunity and promote angiogenesis to support tumor progression, while uncovering specific microbial influences on each step of the metastatic cascade, such as invasion, circulation, and seeding in secondary sites. Additionally, tumor microbiome is closely associated with drug resistance and influences therapeutic efficacy by modulating immune responses, drug metabolism, and apoptotic pathways. Furthermore, we explore innovative microbe-based therapeutic strategies, such as engineered bacteria, oncolytic virotherapy, and other modalities aimed at enhancing immunotherapeutic efficacy, paving the way for microbiome-centered cancer treatment frameworks.
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Affiliation(s)
- Shengxin Zhang
- Department of Biotherapy, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Jing Huang
- Department of Medical Ultrasound, West China Hospital of Sichuan University, 37 Guoxue Lane, Wuhou District, Chengdu, 610041, Sichuan Province, China
| | - Zedong Jiang
- Department of Biotherapy, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Huan Tong
- Department of Biotherapy, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Xuelei Ma
- Department of Biotherapy, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China.
| | - Yang Liu
- Day Surgery Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P. R. China.
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Zhang XH, Song BL, Yi NB, Zhang GX, Zheng WF, Cheng DB, Qiao ZY, Wang H. Programmable Morphology-Adaptive Peptide Nanoassembly for Enhanced Catalytic Therapy. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2025; 37:e2417089. [PMID: 39686823 DOI: 10.1002/adma.202417089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2024] [Revised: 12/08/2024] [Indexed: 12/18/2024]
Abstract
Nanocatalytic therapy holds significant promise in cancer treatment by exploiting the high oxidative stress within tumor cells. However, efficiently delivering nanocatalytic agents to tumor tissues and maximizing their catalytic activity in situ remain critical challenges. Morphology-adaptive delivery systems, capable of adjusting their physical form in response to physiological conditions, offer unique spatiotemporal control for navigating complex biological environments like the tumor microenvironment. While designing systems that undergo multiple shape transformations often involves complex stimuli-responsive mechanisms, making programmable responses through simple designs highly desirable yet challenging. Here, FeFKC, an innovative adaptive material is introduced that achieves multi-step morphological transformations at the tissue level and amplifies catalytic activity through a straightforward design. As the microenvironmental pH decreases during drug delivery, FeFKC dynamically transitions between single chains, nanoparticles, and nanofibers. This programmable shape-shifting facilitates deep tumor penetration, enhanced cellular uptake, and lysosomal escape, significantly improving its catalytic efficiency in nanocatalytic tumor therapy. In vivo studies demonstrate that FeFKC achieves impressive tumor suppression efficacy of up to 95% without notable biosafety concerns. The findings highlight the potential of adaptive nanomaterials with programmable shape-transforming capabilities to overcome biological barriers and enhance catalytic therapy, opening new avenues for cancer treatment and other complex diseases.
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Affiliation(s)
- Xue-Hao Zhang
- CAS Center for Excellence in Nanoscience, Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, National Center for Nanoscience and Technology (NCNST), Beijing, 100190, China
| | - Ben-Li Song
- CAS Center for Excellence in Nanoscience, Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, National Center for Nanoscience and Technology (NCNST), Beijing, 100190, China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Ning-Bo Yi
- CAS Center for Excellence in Nanoscience, Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, National Center for Nanoscience and Technology (NCNST), Beijing, 100190, China
- School of Chemistry, Chemical Engineering & Life Science, Hubei Key Laboratory of Nanomedicine for Neurodegenerative Diseases, Wuhan University of Technology, No. 122 Luoshi Road, Wuhan, 430070, China
| | - Guang-Xu Zhang
- CAS Center for Excellence in Nanoscience, Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, National Center for Nanoscience and Technology (NCNST), Beijing, 100190, China
| | - Wen-Fu Zheng
- CAS Center for Excellence in Nanoscience, Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, National Center for Nanoscience and Technology (NCNST), Beijing, 100190, China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Dong-Bing Cheng
- School of Chemistry, Chemical Engineering & Life Science, Hubei Key Laboratory of Nanomedicine for Neurodegenerative Diseases, Wuhan University of Technology, No. 122 Luoshi Road, Wuhan, 430070, China
| | - Zeng-Ying Qiao
- CAS Center for Excellence in Nanoscience, Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, National Center for Nanoscience and Technology (NCNST), Beijing, 100190, China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Hao Wang
- CAS Center for Excellence in Nanoscience, Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, National Center for Nanoscience and Technology (NCNST), Beijing, 100190, China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing, 100049, China
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Wu X, Stabile LP, Burns TF. The Emerging Role of Immune Checkpoint Blockade for the Treatment of Lung Cancer Brain Metastases. Clin Lung Cancer 2024; 25:483-501. [PMID: 38991863 DOI: 10.1016/j.cllc.2024.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 04/15/2024] [Accepted: 06/06/2024] [Indexed: 07/13/2024]
Abstract
Lung cancer has the highest incidence of brain metastases (BM) among solid organ cancers. Traditionally whole brain radiation therapy has been utilized for non-small-cell lung cancer (NSCLC) BM treatment, although stereotactic radiosurgery has emerged as the superior treatment modality for most patients. Highly penetrant central nervous system (CNS) tyrosine kinase inhibitors have also shown significant CNS activity in patients harboring select oncogenic drivers. There is emerging evidence that patients without oncogene-driven tumors derive benefit from the use of immune checkpoint inhibitors (ICIs). The CNS activity of ICIs have not been well studied given exclusion of patients with active BM from landmark trials, due to concerns of inadequate CNS penetration and activity. However, studies have challenged the idea of an immune-privileged CNS, given the presence of functional lymphatic drainage within the CNS and destruction of the blood brain barrier by BM. An emerging understanding of the interactions between tumor and CNS immune cells in the BM tumor microenvironment also support a role for immunotherapy in BM treatment. In addition, posthoc analyses of major trials have shown improved intracranial response and survival benefit of regimens with ICIs over chemotherapy (CT) alone for patients with BM. Two prospective phase 2 trials evaluating pembrolizumab monotherapy and atezolizumab plus CT in patients with untreated NSCLC BM also demonstrated significant intracranial responses. This review describes the interplay between CNS immune cells and tumor cells, discusses current evidence for ICI CNS activity from retrospective and prospective studies, and speculates on future directions of investigation.
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Affiliation(s)
- Xiancheng Wu
- Department of Medicine, Division of Internal Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Laura P Stabile
- Department of Pharmacology & Chemical Biology, University of Pittsburgh, Pittsburgh, PA; UPMC Hillman Cancer Center, Pittsburgh, PA
| | - Timothy F Burns
- UPMC Hillman Cancer Center, Pittsburgh, PA; Department of Medicine, Division of Hematology-Oncology, University of Pittsburgh, Pittsburgh, PA.
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Chen F, Xie L, Deng T, Li J. A sequential dual-locked luminescent copper nanocluster probe for tumor cell imaging and killing. Mikrochim Acta 2024; 191:511. [PMID: 39103612 DOI: 10.1007/s00604-024-06591-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 07/23/2024] [Indexed: 08/07/2024]
Abstract
A sequential dual-locked luminescent copper nanoclusters (CuNCs) probe was designed and synthesized for the specific imaging and selective killing of tumor cells. This nanoprobe was prepared by first forming a Fe3+-coupled tannic acid (TA)-stabilized CuNCs (CuNCs-FeIII), which is in quenching state due to the electron transfer between CuNCs and Fe3+, and then coating a protectable layer of hyaluronic acid (HA) on the surface of CuNCs-FeIII to form the final dual-locked nanoprobe (CuNCs-FeIII@HA). When the nanoprobe of CuNCs-FeIII@HA target enter the tumor cells through CD44-HA receptor, HAase will first digest the HA layer of the nanoprobes, and then, GSH over-expressed in tumor cells will reduce Fe3+ to Fe2+, thus restoring the fluorescence emission of CuNCs and at the same time killing the tumor cells with the hydroxyl free radicals (∙OH) produced by the Fenton reaction between Fe2+ and H2O2. This sequential dual-locked luminescent nanoprobe of CuNCs-FeIII@HA has been successfully used for the specific imaging and selective killing of tumor cells.
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Affiliation(s)
- Fei Chen
- State Key Laboratory of Chemo/Bio-Sensing and Chemometrics, College of Chemistry and Chemical Engineering, Hunan University, Changsha, 410082, People's Republic of China
| | - Ling Xie
- State Key Laboratory of Chemo/Bio-Sensing and Chemometrics, College of Chemistry and Chemical Engineering, Hunan University, Changsha, 410082, People's Republic of China
| | - Ting Deng
- Institute of Applied Chemistry, School of Science, Central South University of Forestry and Technology, Changsha, 410004, People's Republic of China.
| | - Jishan Li
- State Key Laboratory of Chemo/Bio-Sensing and Chemometrics, College of Chemistry and Chemical Engineering, Hunan University, Changsha, 410082, People's Republic of China.
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7
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Tang L, Zhang W, Chen L. Brain Radiotherapy Combined with Targeted Therapy for HER2-Positive Breast Cancer Patients with Brain Metastases. BREAST CANCER (DOVE MEDICAL PRESS) 2024; 16:379-392. [PMID: 39071808 PMCID: PMC11278000 DOI: 10.2147/bctt.s460856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 07/11/2024] [Indexed: 07/30/2024]
Abstract
Background Research on the sequencing of brain radiotherapy and targeted chemotherapy after brain metastasis (BM) in HER2-positive breast cancer patients is limited and inconclusive. This study investigated the efficacy of sequential delivery of radiotherapy and targeted therapy in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer with BM. Methods Fifty-seven patients were categorized into two groups: the targeted-radiotherapy group (receiving 2-8 cycles of anti-HER2-targeted therapy followed by radiotherapy after BM) and the radiotherapy-targeted group (undergoing radiotherapy first, followed by regular anti-HER2-targeted therapy). The study endpoints were intracranial progression-free survival (iPFS) and overall survival. Factors associated with intracranial progression and mortality were assessed by univariate and multivariate Cox proportional hazards analysis. Results Patients in the radiotherapy-targeted group had better iPFS (P < 0.001), while there was no significant difference in overall survival between the two groups (P = 0.145). Multivariate Cox analysis showed that different sequential treatment groups were independent prognostic factors for iPFS. In patients with a modified breast graded prognostic assessment score of 3.5-4.0, the median survival time was 26 months in the radiotherapy-targeted group and 22 months in the targeted-radiotherapy group (P = 0.019). Conclusion Overall, radiotherapy followed by targeted therapy may improve survival in HER2-positive breast cancer patients with BM, particularly in those with a modified breast graded prognostic assessment score of 3.5-4.0.
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Affiliation(s)
- Lifeng Tang
- Department of Oncology, Liuzhou People’s Hospital, Liuzhou, Guangxi, 545006, People’s Republic of China
- Department of Radiotherapy, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People’s Republic of China
| | - Wei Zhang
- Department of Radiology, Liuzhou People’s Hospital, Liuzhou, Guangxi, 545006, People’s Republic of China
| | - Long Chen
- Department of Radiotherapy, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People’s Republic of China
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8
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Brown SR, Radcliffe ME, Danner JT, Andújar Cruz WJ, Lackey KH, Park HA, Weinman ST, Kim Y. Extracellular Vesicle-Mediated Modulation of Stem-like Phenotype in Breast Cancer Cells under Fluid Shear Stress. Biomolecules 2024; 14:757. [PMID: 39062471 PMCID: PMC11274421 DOI: 10.3390/biom14070757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 06/21/2024] [Accepted: 06/22/2024] [Indexed: 07/28/2024] Open
Abstract
Circulating tumor cells (CTCs) are some of the key culprits that cause cancer metastasis and metastasis-related deaths. These cells exist in a dynamic microenvironment where they experience fluid shear stress (FSS), and the CTCs that survive FSS are considered to be highly metastatic and stem cell-like. Biophysical stresses such as FSS are also known to cause the production of extracellular vesicles (EVs) that can facilitate cell-cell communication by carrying biomolecular cargos such as microRNAs. Here, we hypothesized that physiological FSS will impact the yield of EV production, and that these EVs will have biomolecules that transform the recipient cells. The EVs were isolated using direct flow filtration with and without FSS from the MDA-MB-231 cancer cell line, and the expression of key stemness-related genes and microRNAs was characterized. There was a significantly increased yield of EVs under FSS. These EVs also contained significantly increased levels of miR-21, which was previously implicated to promote metastatic progression and chemotherapeutic resistance. When these EVs from FSS were introduced to MCF-7 cancer cells, the recipient cells had a significant increase in their stem-like gene expression and CD44+/CD24- cancer stem cell-like subpopulation. There was also a correlated increased proliferation along with an increased ATP production. Together, these findings indicate that the presence of physiological FSS can directly influence the EVs' production and their contents, and that the EV-mediated transfer of miR-21 can have an important role in FSS-existing contexts, such as in cancer metastasis.
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Affiliation(s)
- Spenser R. Brown
- Department of Chemical and Biological Engineering, The University of Alabama, Tuscaloosa, AL 35487, USA (S.T.W.)
| | - Margaret E. Radcliffe
- Department of Chemical and Biological Engineering, The University of Alabama, Tuscaloosa, AL 35487, USA (S.T.W.)
| | - Joseph T. Danner
- Department of Chemical and Biological Engineering, The University of Alabama, Tuscaloosa, AL 35487, USA (S.T.W.)
| | - Wilmer J. Andújar Cruz
- Department of Chemical and Biological Engineering, The University of Alabama, Tuscaloosa, AL 35487, USA (S.T.W.)
| | - Kimberly H. Lackey
- Department of Biological Sciences, The University of Alabama, Tuscaloosa, AL 35487, USA;
| | - Han-A Park
- Department of Human Nutrition and Hospitality Management, The University of Alabama, Tuscaloosa, AL 35487, USA;
| | - Steven T. Weinman
- Department of Chemical and Biological Engineering, The University of Alabama, Tuscaloosa, AL 35487, USA (S.T.W.)
| | - Yonghyun Kim
- Department of Chemical and Biological Engineering, The University of Alabama, Tuscaloosa, AL 35487, USA (S.T.W.)
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Kalashgrani MY, Mousavi SM, Akmal MH, Gholami A, Omidifar N, Chiang WH, Lai CW, Ripaj Uddin M, Althomali RH, Rahman MM. Biosensors for metastatic cancer cell detection. Clin Chim Acta 2024; 559:119685. [PMID: 38663472 DOI: 10.1016/j.cca.2024.119685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 04/21/2024] [Accepted: 04/22/2024] [Indexed: 05/04/2024]
Abstract
Early detection and effective cancer treatment are critical to improving metastatic cancer cell diagnosis and management today. In particular, accurate qualitative diagnosis of metastatic cancer cell represents an important step in the diagnosis of cancer. Today, biosensors have been widely developed due to the daily need to measure different chemical and biological species. Biosensors are utilized to quantify chemical and biological phenomena by generating signals that are directly proportional to the quantity of the analyte present in the reaction. Biosensors are widely used in disease control, drug delivery, infection detection, detection of pathogenic microorganisms, and markers that indicate a specific disease in the body. These devices have been especially popular in the field of metastatic cancer cell diagnosis and treatment due to their portability, high sensitivity, high specificity, ease of use and short response time. This article examines biosensors for metastatic cancer cells. It also studies metastatic cancer cells and the mechanism of metastasis. Finally, the function of biosensors and biomarkers in metastatic cancer cells is investigated.
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Affiliation(s)
| | - Seyyed Mojtaba Mousavi
- Department of Chemical Engineering, National Taiwan University of Science and Technology, Taiwan
| | - Muhammad Hussnain Akmal
- Department of Chemical Engineering, National Taiwan University of Science and Technology, Taiwan
| | - Ahmad Gholami
- Biotechnology Research Center, Shiraz University of Medical Science, Shiraz, Iran
| | - Navid Omidifar
- Department of Pathology, Shiraz University of Medical Sciences, Shiraz 71468-64685, Iran
| | - Wei-Hung Chiang
- Department of Chemical Engineering, National Taiwan University of Science and Technology, Taiwan.
| | - Chin Wei Lai
- Nanotechnology and Catalysis Research Centre (NANOCAT), Level 3, Block A, Institute for Advanced Studies (IAS), Universiti Malaya (UM), 50603 Kuala Lumpur, Malaysia
| | - Md Ripaj Uddin
- Institute of National Analytical Research and Service (INARS), Bangladesh Council of Scientific and Industrial Research (BCSIR), Dhanmondi, Dhaka, Bangladesh
| | - Raed H Althomali
- Department of Chemistry, College of Art and Science, Prince Sattam bin Abdulaziz University, Wadi Al-Dawasir 11991, Al Kharj, Saudi Arabia
| | - Mohammed M Rahman
- Center of Excellence for Advanced Materials Research (CEAMR) & Department of Chemistry, Faculty of Science, King Abdulaziz University, P.O. Box 80203, Jeddah 21589, Saudi Arabia.
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10
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Mahmoodifar S, Pangal DJ, Neman J, Zada G, Mason J, Salhia B, Kaisman-Elbaz T, Peker S, Samanci Y, Hamel A, Mathieu D, Tripathi M, Sheehan J, Pikis S, Mantziaris G, Newton PK. Comparative analysis of the spatial distribution of brain metastases across several primary cancers using machine learning and deep learning models. J Neurooncol 2024; 167:501-508. [PMID: 38563856 DOI: 10.1007/s11060-024-04630-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 03/02/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE Brain metastases (BM) are associated with poor prognosis and increased mortality rates, making them a significant clinical challenge. Studying BMs can aid in improving early detection and monitoring. Systematic comparisons of anatomical distributions of BM from different primary cancers, however, remain largely unavailable. METHODS To test the hypothesis that anatomical BM distributions differ based on primary cancer type, we analyze the spatial coordinates of BMs for five different primary cancer types along principal component (PC) axes. The dataset includes 3949 intracranial metastases, labeled by primary cancer types and with six features. We employ PC coordinates to highlight the distinctions between various cancer types. We utilized different Machine Learning (ML) algorithms (RF, SVM, TabNet DL) models to establish the relationship between primary cancer diagnosis, spatial coordinates of BMs, age, and target volume. RESULTS Our findings revealed that PC1 aligns most with the Y axis, followed by the Z axis, and has minimal correlation with the X axis. Based on PC1 versus PC2 plots, we identified notable differences in anatomical spreading patterns between Breast and Lung cancer, as well as Breast and Renal cancer. In contrast, Renal and Lung cancer, as well as Lung and Melanoma, showed similar patterns. Our ML and DL results demonstrated high accuracy in distinguishing BM distribution for different primary cancers, with the SVM algorithm achieving 97% accuracy using a polynomial kernel and TabNet achieving 96%. The RF algorithm ranked PC1 as the most important discriminating feature. CONCLUSIONS In summary, our results support accurate multiclass ML classification regarding brain metastases distribution.
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Affiliation(s)
- Saeedeh Mahmoodifar
- Department of Physics & Astronomy, University of Southern California, Los Angeles, CA, 90089, USA
| | - Dhiraj J Pangal
- Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Josh Neman
- Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Gabriel Zada
- Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Jeremy Mason
- Catherine & Joseph Aresty Department of Urology, Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
- Convergent Science Institute in Cancer, Michelson Center for Convergent Bioscience, University of Southern California, Los Angeles, CA, 90089, USA
| | - Bodour Salhia
- Department of Translational Genomics Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Tehila Kaisman-Elbaz
- Rose Ella Burkhardt Brain Tumor & Neuro-Oncology Center, Neurological Institute, The Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Selcuk Peker
- Department of Neurosurgery, Koc University School of Medicine, Istanbul, Turkey
| | - Yavuz Samanci
- Department of Neurosurgery, Koc University School of Medicine, Istanbul, Turkey
| | - Andréanne Hamel
- Department of Neurosurgery, Université de Sherbrooke, Centre de recherche du CHUS, QC, Canada
| | - David Mathieu
- Department of Neurosurgery, Université de Sherbrooke, Centre de recherche du CHUS, QC, Canada
| | - Manjul Tripathi
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Jason Sheehan
- Department of Neurological Surgery, University of Virginia, Charlottesville, VA, 22903, USA
| | - Stylianos Pikis
- Department of Neurological Surgery, University of Virginia, Charlottesville, VA, 22903, USA
| | - Georgios Mantziaris
- Department of Neurological Surgery, University of Virginia, Charlottesville, VA, 22903, USA
| | - Paul K Newton
- Department of Aerospace & Mechanical Engineering, Mathematics, Quantitative & Computational Biology, and Lawrence J. Ellison Institute for Transformative Medicine, University of Southern California, Los Angeles, CA, 90089, USA.
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11
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Visonà G, Spiller LM, Hahn S, Hattingen E, Vogl TJ, Schweikert G, Bankov K, Demes M, Reis H, Wild P, Zeiner PS, Acker F, Sebastian M, Wenger KJ. Machine-Learning-Aided Prediction of Brain Metastases Development in Non-Small-Cell Lung Cancers. Clin Lung Cancer 2023; 24:e311-e322. [PMID: 37689579 DOI: 10.1016/j.cllc.2023.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 07/24/2023] [Accepted: 08/01/2023] [Indexed: 09/11/2023]
Abstract
PURPOSE Non-small-cell lung cancer (NSCLC) shows a high incidence of brain metastases (BM). Early detection is crucial to improve clinical prospects. We trained and validated classifier models to identify patients with a high risk of developing BM, as they could potentially benefit from surveillance brain MRI. METHODS Consecutive patients with an initial diagnosis of NSCLC from January 2011 to April 2019 and an in-house chest-CT scan (staging) were retrospectively recruited at a German lung cancer center. Brain imaging was performed at initial diagnosis and in case of neurological symptoms (follow-up). Subjects lost to follow-up or still alive without BM at the data cut-off point (12/2020) were excluded. Covariates included clinical and/or 3D-radiomics-features of the primary tumor from staging chest-CT. Four machine learning models for prediction (80/20 training) were compared. Gini Importance and SHAP were used as measures of importance; sensitivity, specificity, area under the precision-recall curve, and Matthew's Correlation Coefficient as evaluation metrics. RESULTS Three hundred and ninety-five patients compromised the clinical cohort. Predictive models based on clinical features offered the best performance (tuned to maximize recall: sensitivity∼70%, specificity∼60%). Radiomics features failed to provide sufficient information, likely due to the heterogeneity of imaging data. Adenocarcinoma histology, lymph node invasion, and histological tumor grade were positively correlated with the prediction of BM, age, and squamous cell carcinoma histology were negatively correlated. A subgroup discovery analysis identified 2 candidate patient subpopulations appearing to present a higher risk of BM (female patients + adenocarcinoma histology, adenocarcinoma patients + no other distant metastases). CONCLUSION Analysis of the importance of input features suggests that the models are learning the relevant relationships between clinical features/development of BM. A higher number of samples is to be prioritized to improve performance. Employed prospectively at initial diagnosis, such models can help select high-risk subgroups for surveillance brain MRI.
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Affiliation(s)
- Giovanni Visonà
- Empirical Inference, Max-Planck Institute for Intelligent Systems, Tübingen, Germany
| | - Lisa M Spiller
- Goethe University Frankfurt, University Hospital, Institute of Neuroradiology, Frankfurt am Main, Germany
| | - Sophia Hahn
- Goethe University Frankfurt, University Hospital, Institute of Neuroradiology, Frankfurt am Main, Germany
| | - Elke Hattingen
- Goethe University Frankfurt, University Hospital, Institute of Neuroradiology, Frankfurt am Main, Germany; University Cancer Center Frankfurt (UCT), Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany; German Cancer Research Center (DKFZ) Heidelberg, Germany and German Cancer Consortium (DKTK), Partner Site Frankfurt, Mainz, Germany
| | - Thomas J Vogl
- University Cancer Center Frankfurt (UCT), Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany; German Cancer Research Center (DKFZ) Heidelberg, Germany and German Cancer Consortium (DKTK), Partner Site Frankfurt, Mainz, Germany; Goethe University Frankfurt, University Hospital, Department of Diagnostic and Interventional Radiology, Frankfurt am Main, Germany
| | - Gabriele Schweikert
- Division of Computational Biology, School of Life Sciences, University of Dundee, Dundee, UK
| | - Katrin Bankov
- Goethe University Frankfurt, University Hospital, Dr. Senckenberg Institute of Pathology, Frankfurt am Main, Germany
| | - Melanie Demes
- University Cancer Center Frankfurt (UCT), Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany; German Cancer Research Center (DKFZ) Heidelberg, Germany and German Cancer Consortium (DKTK), Partner Site Frankfurt, Mainz, Germany; Goethe University Frankfurt, University Hospital, Dr. Senckenberg Institute of Pathology, Frankfurt am Main, Germany
| | - Henning Reis
- University Cancer Center Frankfurt (UCT), Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany; German Cancer Research Center (DKFZ) Heidelberg, Germany and German Cancer Consortium (DKTK), Partner Site Frankfurt, Mainz, Germany; Goethe University Frankfurt, University Hospital, Dr. Senckenberg Institute of Pathology, Frankfurt am Main, Germany
| | - Peter Wild
- University Cancer Center Frankfurt (UCT), Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany; German Cancer Research Center (DKFZ) Heidelberg, Germany and German Cancer Consortium (DKTK), Partner Site Frankfurt, Mainz, Germany; Goethe University Frankfurt, University Hospital, Dr. Senckenberg Institute of Pathology, Frankfurt am Main, Germany
| | - Pia S Zeiner
- University Cancer Center Frankfurt (UCT), Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany; German Cancer Research Center (DKFZ) Heidelberg, Germany and German Cancer Consortium (DKTK), Partner Site Frankfurt, Mainz, Germany; Goethe University Frankfurt, University Hospital, Edinger Institute, Institute of Neurology, Frankfurt am Main, Germany
| | - Fabian Acker
- University Cancer Center Frankfurt (UCT), Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany; German Cancer Research Center (DKFZ) Heidelberg, Germany and German Cancer Consortium (DKTK), Partner Site Frankfurt, Mainz, Germany; Goethe University Frankfurt, University Hospital, Department of Medicine II, Hematology/Oncology, Frankfurt am Main, Germany
| | - Martin Sebastian
- University Cancer Center Frankfurt (UCT), Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany; German Cancer Research Center (DKFZ) Heidelberg, Germany and German Cancer Consortium (DKTK), Partner Site Frankfurt, Mainz, Germany; Goethe University Frankfurt, University Hospital, Department of Medicine II, Hematology/Oncology, Frankfurt am Main, Germany
| | - Katharina J Wenger
- Goethe University Frankfurt, University Hospital, Institute of Neuroradiology, Frankfurt am Main, Germany; University Cancer Center Frankfurt (UCT), Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany; German Cancer Research Center (DKFZ) Heidelberg, Germany and German Cancer Consortium (DKTK), Partner Site Frankfurt, Mainz, Germany.
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12
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van Grinsven EE, Guichelaar J, Philippens MEP, Siero JCW, Bhogal AA. Hemodynamic imaging parameters in brain metastases patients - Agreement between multi-delay ASL and hypercapnic BOLD. J Cereb Blood Flow Metab 2023; 43:2072-2084. [PMID: 37632255 PMCID: PMC10925872 DOI: 10.1177/0271678x231196989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 07/14/2023] [Accepted: 07/19/2023] [Indexed: 08/27/2023]
Abstract
Arterial spin labeling (ASL) MRI is a routine clinical imaging technique that provides quantitative cerebral blood flow (CBF) information. A related technique is blood oxygenation level-dependent (BOLD) MRI during hypercapnia, which can assess cerebrovascular reactivity (CVR). ASL is weighted towards arteries, whereas BOLD is weighted towards veins. Their associated parameters in heterogeneous tissue types or under different hemodynamic conditions remains unclear. Baseline multi-delay ASL MRI and BOLD MRI during hypercapnia were performed in fourteen patients with brain metastases. In the ROI analysis, the CBF and CVR values were positively correlated in regions showing sufficient reserve capacity (i.e. non-steal regions, rrm = 0.792). Additionally, longer hemodynamic lag times were related to lower baseline CBF (rrm = -0.822) and longer arterial arrival time (AAT; rrm = 0.712). In contrast, in regions exhibiting vascular steal an inverse relationship was found with higher baseline CBF related to more negative CVR (rrm = -0.273). These associations were confirmed in voxelwise analyses. The relationship between CBF, AAT and CVR measures seems to be dependent on the vascular status of the underlying tissue. Healthy tissue relationships do not hold in tissues experiencing impaired or exhausted autoregulation. CVR metrics can possibly identify at-risk areas before perfusion deficiencies become visible on ASL MRI, specifically within vascular steal regions.
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Affiliation(s)
- Eva E van Grinsven
- Department of Neurology & Neurosurgery, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Jamila Guichelaar
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marielle EP Philippens
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jeroen CW Siero
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
- Spinoza Center for Neuroimaging, Amsterdam, Netherlands
| | - Alex A Bhogal
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
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13
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Ishikawa Y, Umezawa R, Yamamoto T, Takahashi N, Takeda K, Suzuki Y, Kishida K, Teramura S, Ito K, Jingu K. Pre-treatment Evaluation of Patients Eligible for Whole Brain Radiation Therapy: The Risk of Hippocampal Metastases in a Retrospective Study of 248 Cases at a Single Institution. Cureus 2023; 15:e49170. [PMID: 38024024 PMCID: PMC10662202 DOI: 10.7759/cureus.49170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 12/01/2023] Open
Abstract
Whole brain radiation therapy (WBRT) is effective for multiple brain metastases (BMs) but may impair neurocognitive function (NCF). The incidence of hippocampal metastasis (HM) is low, and the factors associated with the occurrence of HM remain unclear. This study aimed to assess the occurrence of limbic system metastasis (LSM), including HM, and to analyze the risk of HM. We retrospectively analyzed 248 patients who underwent three-dimensional conformal radiation therapy for BMs between May 2008 and October 2015. Gadolinium-enhanced brain MRI or CT scans were used for diagnosis. Statistical analysis involved assessing clinical factors, including age, gender, primary tumor, number of BMs, and maximum metastasis diameter, in relation to the presence of HMs using logistic regression and receiver operating characteristic (ROC) curve analysis. The median age at treatment was 62 years (range: 11-83 years). Primary lesion sites included the lung (n = 150; 60.5%), breast (n = 45; 18.1%), gastrointestinal tract (n = 18; 7.3%), and bone and soft tissue (n = 2; 0.8%). Histological cancer types included adenocarcinoma (n = 113; 45.6%), squamous cell carcinoma (n = 26; 10.5%), small cell carcinoma (n = 28; 11.3%), invasive ductal carcinoma (n = 35; 14.1%), sarcoma (n = 3; 1.2%), and others (n = 43; 17.3%). MRI or CT scans of the 248 patients were analyzed, indicating a total count of 2,163 brain metastases (median: five metastases per patient). HMs were identified in 18 (7.3%) patients. The most common location for LSMs was the cingulum/cingulate gyrus in 26 (10.5%) patients. In univariate and multivariate analyses, patients with 15 or fewer BMs had a significantly lower incidence of HMs (odds ratio (OR), 0.018 (95% confidence interval (CI), 0.030-0.24)) (p < 0.0001). A maximal tumor size of less than 2 cm significantly increased the incidence of HMs (OR, 13.8 (95%CI, 1.80-105.3)) (p = 0.0003). The presence of cingulum/cingulate gyrus metastases also demonstrated a significant increase in the incidence of HMs (OR, 9.42 (95%CI, 3.30-26.84)) (p < 0.0001). The present study has uncovered a novel association between a high number of metastases in the cingulate gyrus and the development of HMs. Patients with BMs eligible for WBRT with metastases in the cingulate gyrus may be at risk of developing HM.
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Affiliation(s)
- Yojiro Ishikawa
- Division of Radiology, Tohoku Medical and Pharmaceutical University, Sendai, JPN
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, JPN
| | - Rei Umezawa
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, JPN
| | - Takaya Yamamoto
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, JPN
| | - Noriyoshi Takahashi
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, JPN
| | - Kazuya Takeda
- Department of Radiation Oncology, South Miyagi Medical Center, Ogawara, JPN
| | - Yu Suzuki
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, JPN
| | - Keita Kishida
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, JPN
| | - Satoshi Teramura
- Division of Radiology, Tohoku Medical and Pharmaceutical University, Sendai, JPN
| | - Kengo Ito
- Division of Radiology, Tohoku Medical and Pharmaceutical University, Sendai, JPN
| | - Keiichi Jingu
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, JPN
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14
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McCall JR, DeRuiter R, Ross M, Santibanez F, Hingtgen SD, Pinton GF, Dayton PA. Longitudinal 3-D Visualization of Microvascular Disruption and Perfusion Changes in Mice During the Evolution of Glioblastoma Using Super-Resolution Ultrasound. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2023; 70:1401-1416. [PMID: 37756182 DOI: 10.1109/tuffc.2023.3320034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
Glioblastoma is an aggressive brain cancer with a very poor prognosis in which less than 6% of patients survive more than five-year post-diagnosis. The outcome of this disease for many patients may be improved by early detection. This could provide clinicians with the information needed to take early action for treatment. In this work, we present the utilization of a non-invasive, fully volumetric ultrasonic imaging method to assess microvascular change during the evolution of glioblastoma in mice. Volumetric ultrasound localization microscopy (ULM) was used to observe statistically significant ( ) reduction in the appearance of functional vasculature over the course of three weeks. We also demonstrate evidence suggesting the reduction of vascular flow for vessels peripheral to the tumor. With an 82.5% consistency rate in acquiring high-quality vascular images, we demonstrate the possibility of volumetric ULM as a longitudinal method for microvascular characterization of neurological disease.
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15
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Tozuka T, Noro R, Miyanaga A, Nakamichi S, Takeuchi S, Matsumoto M, Kubota K, Kasahara K, Seike M. Osimertinib early dose reduction as a risk to brain metastasis control in EGFR-mutant non-small cell lung cancer. Cancer Med 2023; 12:17731-17739. [PMID: 37691552 PMCID: PMC10524078 DOI: 10.1002/cam4.6393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 07/06/2023] [Accepted: 07/19/2023] [Indexed: 09/12/2023] Open
Abstract
BACKGROUND The epidermal growth factor receptor (EGFR) mutation is a risk factor associated with brain metastases (BMs) in patients with non-small cell lung cancer (NSCLC). This study aimed to evaluate the impact of osimertinib early dose reduction on BM worsening. METHODS We retrospectively analyzed EGFR-mutant NSCLC patients treated with osimertinib as first-line treatment between August 2018 and October 2021. To evaluate the impact of osimertinib early dose reduction, we performed a landmark analysis of patients who achieved disease control at 4 months. Patients were divided into two groups according to whether the osimertinib dose was reduced or not, within 4 months after the start of treatment. We evaluated the time to BMs onset or progression, progression-free survival, and overall survival. RESULTS In total, 62 NSCLC patients with EGFR mutations were analyzed. Thirteen patients experienced early dose reduction of osimertinib treatment. Seven patients received osimertinib 40 mg daily, and six received 80 mg every other day. The most common reason for dose reduction was gastrointestinal toxicity (n = 4), followed by skin rashes (n = 3). The time to BMs onset or progression was significantly shorter in patients who experienced early dose reduction than in those who continued regular treatment (Hazard ratio 4.47, 95% confidence interval, 1.52-13.11). The 1-year cumulative incidence of BM onset or progression was 23.1% in the reduced-dose group and 5.0% in the standard dose group. The risk of worsening BMs with early dose reduction of osimertinib treatment was higher in patients who had BMs before treatment and in younger patients. CONCLUSION Early dose reduction of osimertinib was a risk factor for the worsening of BMs. A higher risk was associated with younger patients and those presenting BMs before treatment.
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Affiliation(s)
- Takehiro Tozuka
- Department of Pulmonary Medicine and Oncology, Graduate School of MedicineNippon Medical SchoolTokyoJapan
| | - Rintaro Noro
- Department of Pulmonary Medicine and Oncology, Graduate School of MedicineNippon Medical SchoolTokyoJapan
| | - Akihiko Miyanaga
- Department of Pulmonary Medicine and Oncology, Graduate School of MedicineNippon Medical SchoolTokyoJapan
| | - Shinji Nakamichi
- Department of Pulmonary Medicine and Oncology, Graduate School of MedicineNippon Medical SchoolTokyoJapan
| | - Susumu Takeuchi
- Department of Pulmonary Medicine and Oncology, Graduate School of MedicineNippon Medical SchoolTokyoJapan
| | - Masaru Matsumoto
- Department of Pulmonary Medicine and Oncology, Graduate School of MedicineNippon Medical SchoolTokyoJapan
| | - Kaoru Kubota
- Department of Pulmonary Medicine and Oncology, Graduate School of MedicineNippon Medical SchoolTokyoJapan
| | - Kazuo Kasahara
- Department of Pulmonary Medicine and Oncology, Graduate School of MedicineNippon Medical SchoolTokyoJapan
| | - Masahiro Seike
- Department of Pulmonary Medicine and Oncology, Graduate School of MedicineNippon Medical SchoolTokyoJapan
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16
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van Grinsven EE, de Leeuw J, Siero JCW, Verhoeff JJC, van Zandvoort MJE, Cho J, Philippens MEP, Bhogal AA. Evaluating Physiological MRI Parameters in Patients with Brain Metastases Undergoing Stereotactic Radiosurgery-A Preliminary Analysis and Case Report. Cancers (Basel) 2023; 15:4298. [PMID: 37686575 PMCID: PMC10487230 DOI: 10.3390/cancers15174298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/17/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
Brain metastases occur in ten to thirty percent of the adult cancer population. Treatment consists of different (palliative) options, including stereotactic radiosurgery (SRS). Sensitive MRI biomarkers are needed to better understand radiotherapy-related effects on cerebral physiology and the subsequent effects on neurocognitive functioning. In the current study, we used physiological imaging techniques to assess cerebral blood flow (CBF), oxygen extraction fraction (OEF), cerebral metabolic rate of oxygen (CMRO2) and cerebrovascular reactivity (CVR) before and three months after SRS in nine patients with brain metastases. The results showed improvement in OEF, CBF and CMRO2 within brain tissue that recovered from edema (all p ≤ 0.04), while CVR remained impacted. We observed a global post-radiotherapy increase in CBF in healthy-appearing brain tissue (p = 0.02). A repeated measures correlation analysis showed larger reductions within regions exposed to higher radiotherapy doses in CBF (rrm = -0.286, p < 0.001), CMRO2 (rrm = -0.254, p < 0.001), and CVR (rrm = -0.346, p < 0.001), but not in OEF (rrm = -0.004, p = 0.954). Case analyses illustrated the impact of brain metastases progression on the post-radiotherapy changes in both physiological MRI measures and cognitive performance. Our preliminary findings suggest no radiotherapy effects on physiological parameters occurred in healthy-appearing brain tissue within 3-months post-radiotherapy. Nevertheless, as radiotherapy can have late side effects, larger patient samples allowing meaningful grouping of patients and longer follow-ups are needed.
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Affiliation(s)
- Eva E. van Grinsven
- Department of Neurology & Neurosurgery, University Medical Center Utrecht Brain Center, Utrecht University, 3584 CX Utrecht, The Netherlands
| | - Jordi de Leeuw
- Department of Radiology, Center for Image Sciences, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands; (J.d.L.); (A.A.B.)
| | - Jeroen C. W. Siero
- Department of Radiology, Center for Image Sciences, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands; (J.d.L.); (A.A.B.)
- Spinoza Center for Neuroimaging, 1105 BK Amsterdam, The Netherlands
| | - Joost J. C. Verhoeff
- Department of Radiation Oncology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands (M.E.P.P.)
| | - Martine J. E. van Zandvoort
- Department of Neurology & Neurosurgery, University Medical Center Utrecht Brain Center, Utrecht University, 3584 CX Utrecht, The Netherlands
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, 3584 CS Utrecht, The Netherlands
| | - Junghun Cho
- Department of Biomedical Engineering, SUNY Buffalo, Buffalo, NY 14228, USA;
| | - Marielle E. P. Philippens
- Department of Radiation Oncology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands (M.E.P.P.)
| | - Alex A. Bhogal
- Department of Radiology, Center for Image Sciences, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands; (J.d.L.); (A.A.B.)
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17
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Chen BT, Jin T, Ye N, Chen SW, Rockne RC, Yoon S, Mambetsariev I, Daniel E, Salgia R. Differential Distribution of Brain Metastases from Non-Small Cell Lung Cancer Based on Mutation Status. Brain Sci 2023; 13:1057. [PMID: 37508989 PMCID: PMC10377121 DOI: 10.3390/brainsci13071057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 07/10/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
Non-small cell lung cancer (NSCLC) has a high rate of brain metastasis. The purpose of this study was to assess the differential distribution of brain metastases from primary NSCLC based on mutation status. Brain MRI scans of patients with brain metastases from primary NSCLC were retrospectively analyzed. Brain metastatic tumors were grouped according to mutation status of their primary NSCLC and the neuroimaging features of these brain metastases were analyzed. A total of 110 patients with 1386 brain metastases from primary NSCLC were included in this study. Gray matter density at the tumor center peaked at ~0.6 for all mutations. The median depths of tumors were 7.9 mm, 8.7 mm and 9.1 mm for EGFR, ALK and KRAS mutation groups, respectively (p = 0.044). Brain metastases for the EGFR mutation-positive group were more frequently located in the left cerebellum, left cuneus, left precuneus and right precentral gyrus. In the ALK mutation-positive group, brain metastases were more frequently located in the right middle occipital gyrus, right posterior cingulate, right precuneus, right precentral gyrus and right parietal lobe. In the KRAS mutation-positive patient group, brain metastases were more frequently located in the posterior left cerebellum. Our study showed differential spatial distribution of brain metastases in patients with NSCLC according to their mutation status. Information regarding distribution of brain metastases is clinically relevant as it could be helpful to guide treatment planning for targeted therapy, and for predicting prognosis.
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Affiliation(s)
- Bihong T Chen
- Department of Diagnostic Radiology, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010, USA
| | - Taihao Jin
- Department of Diagnostic Radiology, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010, USA
| | - Ningrong Ye
- Department of Diagnostic Radiology, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010, USA
| | - Sean W Chen
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center and Beckman Research Institute, Duarte, CA 91010, USA
| | - Russell C Rockne
- Division of Mathematical Oncology, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010, USA
| | - Stephanie Yoon
- Department of Radiation Oncology, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010, USA
| | - Isa Mambetsariev
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center and Beckman Research Institute, Duarte, CA 91010, USA
| | - Ebenezer Daniel
- Department of Diagnostic Radiology, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010, USA
| | - Ravi Salgia
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center and Beckman Research Institute, Duarte, CA 91010, USA
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18
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Guzman G, Pellot K, Reed MR, Rodriguez A. CAR T-cells to treat brain tumors. Brain Res Bull 2023; 196:76-98. [PMID: 36841424 DOI: 10.1016/j.brainresbull.2023.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 01/18/2023] [Accepted: 02/21/2023] [Indexed: 02/25/2023]
Abstract
Tremendous success using CAR T therapy in hematological malignancies has garnered significant interest in developing such treatments for solid tumors, including brain tumors. This success, however, has yet to be mirrored in solid organ neoplasms. CAR T function has shown limited efficacy against brain tumors due to several factors including the immunosuppressive tumor microenvironment, blood-brain barrier, and tumor-antigen heterogeneity. Despite these considerations, CAR T-cell therapy has the potential to be implemented as a treatment modality for brain tumors. Here, we review adult and pediatric brain tumors, including glioblastoma, diffuse midline gliomas, and medulloblastomas that continue to portend a grim prognosis. We describe insights gained from different preclinical models using CAR T therapy against various brain tumors and results gathered from ongoing clinical trials. Furthermore, we outline the challenges limiting CAR T therapy success against brain tumors and summarize advancements made to overcome these obstacles.
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Affiliation(s)
- Grace Guzman
- Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | | | - Megan R Reed
- Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, AR, United States; Department of Biochemistry and Molecular Biology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Analiz Rodriguez
- Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, AR, United States.
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19
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Shi W, Wang Y, Xia W, Liu B, Ni M, Shen J, Bai Y, Weng G, Liu W, Yuan S, Gao X. Brain metastases from small cell lung cancer and non-small cell lung cancer: comparison of spatial distribution and identification of metastatic risk regions. J Neurooncol 2023; 161:97-105. [PMID: 36520380 DOI: 10.1007/s11060-022-04211-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE This study aims to investigate the spatial distribution difference of brain metastases (BM) between small-cell lung cancer (SCLC) and non-small-cell lung cancer (NSCLC) and to identify the metastatic risk in brain regions. METHODS T1-enhanced MR images of 2997 BM from 728 eligible patients with SCLC and NSCLC were retrospectively reviewed by three independent medical institutions in China. All images were spatially normalised according to the Montreal Neurological Institute space, following BM delineation confirmed by three senior radiologists. The brain regions in the normalised images were identified based on the merged Anatomical Automatic Labeling atlas, and all BM locations were mapped onto these brain regions. Two-tailed proportional hypothesis testing was used to compare the BM observed rate with the expected rate based on the region's volume, and metastatic risk regions were finally identified. RESULTS In SCLC and NSCLC, BM was mainly present in the deep white matter (22.51% and 17.96%, respectively), cerebellar hemisphere (9.84% and 7.46%, respectively) and middle frontal gyrus (6.72% and 7.97%, respectively). The cerebellar hemisphere was a high-risk brain region in the SCLC. The precentral gyrus, middle frontal gyrus, paracentral lobule and cerebellar hemisphere were high-risk BM in the NSCLC. The inferior frontal gyrus and the temporal pole were a low-risk brain region in the SCLC and NSCLC, respectively. CONCLUSION The spatial BM distribution between SCLC and NSCLC is similar. Several critical brain regions had relatively low BM frequency in both SCLC and NSCLC, where a low-dose radiation distribution can be delivered due to adequate preoperative evaluations.
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Affiliation(s)
- Wei Shi
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, No. 88 Keling Road, Suzhou New District, Suzhou, 215163, Jiangsu, China.,Jinan Guoke Medical Engineering and Technology Development Co., Ltd., Pharmaceutical Valley New Drug Creation Platform, No. 3 Building, Jinan New District, Jinan, 250101, Shandong, China
| | - Yong Wang
- Shandong Cancer Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.,Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Wei Xia
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, No. 88 Keling Road, Suzhou New District, Suzhou, 215163, Jiangsu, China.,Jinan Guoke Medical Engineering and Technology Development Co., Ltd., Pharmaceutical Valley New Drug Creation Platform, No. 3 Building, Jinan New District, Jinan, 250101, Shandong, China
| | - Baoyan Liu
- Shandong Academy of Occupational Health and Occupational Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Meng Ni
- Shandong Cancer Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.,Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Jingyi Shen
- Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yujun Bai
- Shandong Cancer Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.,Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | | | - Wenju Liu
- Liaocheng People's Hospital, Liaocheng, Shandong, China
| | - Shuanghu Yuan
- Shandong Cancer Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China. .,Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China.
| | - Xin Gao
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, No. 88 Keling Road, Suzhou New District, Suzhou, 215163, Jiangsu, China. .,Jinan Guoke Medical Engineering and Technology Development Co., Ltd., Pharmaceutical Valley New Drug Creation Platform, No. 3 Building, Jinan New District, Jinan, 250101, Shandong, China.
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20
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Khosla AA, Saxena S, Ozair A, Venur VA, Peereboom DM, Ahluwalia MS. Novel Therapeutic Approaches in Neoplastic Meningitis. Cancers (Basel) 2022; 15:119. [PMID: 36612116 PMCID: PMC9817816 DOI: 10.3390/cancers15010119] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/18/2022] [Accepted: 12/23/2022] [Indexed: 12/28/2022] Open
Abstract
Central nervous system (CNS) metastasis from systemic cancers can involve the brain parenchyma, leptomeninges, or the dura. Neoplastic meningitis (NM), also known by different terms, including leptomeningeal carcinomatosis and carcinomatous meningitis, occurs due to solid tumors and hematologic malignancies and is associated with a poor prognosis. The current management paradigm entails a multimodal approach focused on palliation with surgery, radiation, and chemotherapy, which may be administered systemically or directly into the cerebrospinal fluid (CSF). This review focuses on novel therapeutic approaches, including targeted and immunotherapeutic agents under investigation, that have shown promise in NM arising from solid tumors.
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Affiliation(s)
- Atulya Aman Khosla
- Miami Cancer Institute, Baptist Health South Florida, Miami, FL 33176, USA
| | - Shreya Saxena
- Miami Cancer Institute, Baptist Health South Florida, Miami, FL 33176, USA
| | - Ahmad Ozair
- Miami Cancer Institute, Baptist Health South Florida, Miami, FL 33176, USA
- Faculty of Medicine, King George’s Medical University, Lucknow 226003, India
| | - Vyshak Alva Venur
- Fred Hutchinson Cancer Center, University of Washington, Seattle, WA 98109, USA
- University of Washington Cancer Consortium, Seattle, WA 98195, USA
| | - David M. Peereboom
- Cleveland Clinic Lerner College of Medicine, Cleveland Clinic Main Campus, Cleveland, OH 44195, USA
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21
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Chen WW, Chu TSM, Xu L, Zhao CN, Poon WS, Leung GKK, Kong FMS. Immune related biomarkers for cancer metastasis to the brain. Exp Hematol Oncol 2022; 11:105. [PMID: 36527157 PMCID: PMC9756766 DOI: 10.1186/s40164-022-00349-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 07/14/2022] [Indexed: 12/23/2022] Open
Abstract
Brain metastasis accounts for a large number of cancer-related deaths. The host immune system, involved at each step of the metastatic cascade, plays an important role in both the initiation of the brain metastasis and their treatment responses to various modalities, through either local and or systemic effect. However, few reliable immune biomarkers have been identified in predicting the development and the treatment outcome in patients with cancer brain metastasis. Here, we provide a focused perspective of immune related biomarkers for cancer metastasis to the brain and a thorough discussion of the potential utilization of specific biomarkers such as tumor mutation burden (TMB), genetic markers, circulating and tumor-infiltrating immune cells, cytokines, in predicting the brain disease progression and regression after therapeutic intervention. We hope to inspire the field to extend the research and establish practical guidelines for developing and validating immune related biomarkers to provide personalized treatment and improve treatment outcomes in patients with metastatic brain cancers.
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Affiliation(s)
- Wei-Wei Chen
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong, SAR, China
| | - Timothy Shun Man Chu
- Royal Victoria Infirmary, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Queen Victoria Road, Newcastle Upon Tyne, NE1 4LP, UK
- Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, NE1 7RU, UK
| | - LiangLiang Xu
- Department of Clinical Oncology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Cai-Ning Zhao
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong, SAR, China
| | - Wai-Sang Poon
- Neuro-Medical Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
- Department of Surgery, School of Clinical Medicine,LKS Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong, SAR, China
| | - Gilberto Ka-Kit Leung
- Department of Surgery, School of Clinical Medicine,LKS Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong, SAR, China
| | - Feng-Ming Spring Kong
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong, SAR, China.
- Department of Clinical Oncology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
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22
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Hayashi T, Yamamoto N, Kurosawa G, Tajima K, Kondo M, Hiramatsu N, Kato Y, Tanaka M, Yamaguchi H, Kurosawa Y, Yamada H, Fujita N. A Novel High-Throughput Screening Method for a Human Multicentric Osteosarcoma-Specific Antibody and Biomarker Using a Phage Display-Derived Monoclonal Antibody. Cancers (Basel) 2022; 14:cancers14235829. [PMID: 36497311 PMCID: PMC9739802 DOI: 10.3390/cancers14235829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/20/2022] [Accepted: 11/23/2022] [Indexed: 11/29/2022] Open
Abstract
Osteosarcoma is a malignant tumor that produces neoplastic bone or osteoid osteoma. In human multicentric osteosarcoma (HMOS), a unique variant of human osteosarcoma (HOS), multiple bone lesions occur simultaneously or asynchronously before lung metastasis. HMOS is associated with an extremely poor prognosis, and effective treatment options are lacking. Using the proteins in our previously generated HMOS cell lines as antigens, we generated antibodies using a human antibody phage library. We obtained antibody clones recognizing 95 independent antigens and developed a fluorescence probe-based enzyme-linked immunosorbent assay (ELISA) technique capable of evaluating the reactivity of these antibodies by fluorescence intensity, allowing simple, rapid, and high-throughput selection of antibody clones. These results were highly correlated with those using flow cytometry. Subsequently, the HMOS cell lysate was incubated with the antibody, the antigen-antibody complex was recovered with magnetic beads, and the protein bands from electrophoresis were analyzed using liquid chromatography-mass spectrometry (LC/MS). CAVIN1/polymerase I transcript release factor was specifically detected in the HMOS cells. In conclusion, we found via a novel high-throughput screening method that CAVIN1/PTRF is an HMOS-specific cell membrane biomarker and an antigen capable of producing human antibodies. In the future, antibody-drug conjugate targeting of these specific proteins may be promising for clinical applications.
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Affiliation(s)
- Takuma Hayashi
- Department of Orthopedic Surgery, Fujita Health University, Toyoake 470-1192, Japan
| | - Naoki Yamamoto
- Support Office for Bioresource Research, Research Promotion Headquarters, Fujita Health University, Toyoake 470-1192, Japan
- International Center for Cell and Gene Therapy, Research Promotion and Support Headquarters, Fujita Health University, Toyoake 470-1192, Japan
- Correspondence: ; Tel.: +81-562-93-2317
| | - Gene Kurosawa
- International Center for Cell and Gene Therapy, Research Promotion and Support Headquarters, Fujita Health University, Toyoake 470-1192, Japan
| | - Kaori Tajima
- Department of Orthopedic Surgery, Fujita Health University, Toyoake 470-1192, Japan
| | | | - Noriko Hiramatsu
- Support Office for Bioresource Research, Research Promotion Headquarters, Fujita Health University, Toyoake 470-1192, Japan
| | - Yu Kato
- Support Office for Bioresource Research, Research Promotion Headquarters, Fujita Health University, Toyoake 470-1192, Japan
| | - Miho Tanaka
- Center for Joint Research Facilities Support, Research Promotion and Support Headquarters, Fujita Health University, Toyoake 470-1192, Japan
| | - Hisateru Yamaguchi
- Yokkaichi Nursing and Medical Care University, Yokkaichi 512-8045, Japan
| | - Yoshikazu Kurosawa
- Institute for Comprehensive Medical Science, Fujita Health University, Toyoake 470-1192, Japan
| | - Harumoto Yamada
- Department of Orthopedic Surgery, Fujita Health University, Toyoake 470-1192, Japan
| | - Nobuyuki Fujita
- Department of Orthopedic Surgery, Fujita Health University, Toyoake 470-1192, Japan
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23
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Aili Y, Maimaitiming N, Qin H, Ji W, Fan G, Wang Z, Wang Y. Tumor microenvironment and exosomes in brain metastasis: Molecular mechanisms and clinical application. Front Oncol 2022; 12:983878. [PMID: 36338717 PMCID: PMC9631487 DOI: 10.3389/fonc.2022.983878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/28/2022] [Indexed: 12/03/2022] Open
Abstract
Metastasis is one of the important biological features of malignant tumors and one of the main factors responsible for poor prognosis. Although the widespread application of newer clinical technologies and their continuous development have significantly improved survival in patients with brain metastases, there is no uniform standard of care. More effective therapeutic measures are therefore needed to improve prognosis. Understanding the mechanisms of tumor cell colonization, growth, and invasion in the central nervous system is of particular importance for the prevention and treatment of brain metastases. This process can be plausibly explained by the “seed and soil” hypothesis, which essentially states that tumor cells can interact with various components of the central nervous system microenvironment to produce adaptive changes; it is this interaction that determines the development of brain metastases. As a novel form of intercellular communication, exosomes play a key role in the brain metastasis microenvironment and carry various bioactive molecules that regulate receptor cell activity. In this paper, we review the roles and prospects of brain metastatic tumor cells, the brain metastatic tumor microenvironment, and exosomes in the development and clinical management of brain metastases.
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Affiliation(s)
- Yirizhati Aili
- Department of Neurosurgery, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Nuersimanguli Maimaitiming
- Department of Four Comprehensive Internal Medicine, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China
| | - Hu Qin
- Department of Neurosurgery, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Wenyu Ji
- Department of Neurosurgery, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Guofeng Fan
- Department of Neurosurgery, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Zengliang Wang
- Department of Neurosurgery, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- School of Health Management, Xinjiang Medical University, Urumqi, China
- Department of Neurosurgery, Xinjiang Bazhou People’s Hospital, Xinjiang, China
- *Correspondence: Zengliang Wang, ; Yongxin Wang,
| | - Yongxin Wang
- Department of Neurosurgery, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- *Correspondence: Zengliang Wang, ; Yongxin Wang,
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24
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Mahmoodifar S, Pangal DJ, Cardinal T, Craig D, Simon T, Tew BY, Yang W, Chang E, Yu M, Neman J, Mason J, Toga A, Salhia B, Zada G, Newton PK. A quantitative characterization of the spatial distribution of brain metastases from breast cancer and respective molecular subtypes. J Neurooncol 2022; 160:241-251. [DOI: 10.1007/s11060-022-04147-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 09/25/2022] [Indexed: 11/30/2022]
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25
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Epshtein Y, Blau R, Pisarevsky E, Koshrovski-Michael S, Ben-Shushan D, Pozzi S, Shenbach-Koltin G, Fridrich L, Buzhor M, Krivitsky A, Dey P, Satchi-Fainaro R. Polyglutamate-based nanoconjugates for image-guided surgery and post-operative melanoma metastases prevention. Theranostics 2022; 12:6339-6362. [PMID: 36168618 PMCID: PMC9475454 DOI: 10.7150/thno.72941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 07/21/2022] [Indexed: 01/01/2023] Open
Abstract
Rationale: Cutaneous melanoma is the most aggressive and deadliest of all skin malignancies. Complete primary tumor removal augmented by advanced imaging tools and effective post-operative treatment is critical in the prevention of tumor recurrence and future metastases formation. Methods: To meet this challenge, we designed novel polymeric imaging and therapeutic systems, implemented in a two-step theranostic approach. Both are composed of the biocompatible and biodegradable poly(α,L-glutamic acid) (PGA) nanocarrier that facilitates extravasation-dependent tumor targeting delivery. The first system is a novel, fluorescent, Turn-ON diagnostic probe evaluated for the precise excision of the primary tumor during image-guided surgery (IGS). The fluorescence activation of the probe occurs via PGA degradation by tumor-overexpressed cathepsins that leads to the separation of closely-packed, quenched FRET pair. This results in the emission of a strong fluorescence signal enabling the delineation of the tumor boundaries. Second, therapeutic step is aimed to prevent metastases formation with minimal side effects and maximal efficacy. To that end, a targeted treatment containing a BRAF (Dabrafenib - mDBF)/MEK (Selumetinib - SLM) inhibitors combined on one polymeric platform (PGA-SLM-mDBF) was evaluated for its anti-metastatic, preventive activity in combination with immune checkpoint inhibitors (ICPi) αPD1 and αCTLA4. Results: IGS in melanoma-bearing mice led to a high tumor-to-background ratio and reduced tumor recurrence in comparison with mice that underwent surgery under white light (23% versus 33%, respectively). Adjuvant therapy with PGA-SLM-mDBF combined with ICPi, was well-tolerated and resulted in prolonged survival and prevention of peritoneal and brain metastases formation in BRAF-mutated melanoma-bearing mice. Conclusions: The results reveal the great clinical potential of our PGA-based nanosystems as a tool for holistic melanoma treatment management.
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Affiliation(s)
- Yana Epshtein
- Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Rachel Blau
- Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Department of NanoEngineering, University of California, San Diego, 9500 Gilman Drive, Mail Code 0448, La Jolla, CA 92093-0448
| | - Evgeni Pisarevsky
- Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Shani Koshrovski-Michael
- Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Dikla Ben-Shushan
- Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Sabina Pozzi
- Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Gal Shenbach-Koltin
- Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Lidar Fridrich
- Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Marina Buzhor
- Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Adva Krivitsky
- Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Pradip Dey
- Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Ronit Satchi-Fainaro
- Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
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26
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Pangal DJ, Wishart D, Shiroishi MS, Ruzevick J, Carmichael JD, Zada G. Growth hormone secreting pituitary adenomas show distinct extrasellar extension patterns compared to nonfunctional pituitary adenomas. Pituitary 2022; 25:480-485. [PMID: 35334028 DOI: 10.1007/s11102-022-01217-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/10/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Patterns of extension of pituitary adenomas (PA) may vary according to PA subtype. Understanding extrasellar extension patterns in growth hormone PAs (GHPA) vis-a-vis nonfunctional PAs (NFPAs) may provide insights into the biology of GHPA and future treatment avenues. METHODS Preoperative MR imaging (MRI) in 179 consecutive patients treated surgically for NFPA (n = 139) and GHPA (n = 40) were analyzed to determine patterns of extrasellar growth. Extension was divided into two principal directions: cranio-caudal (measured by infrasellar/suprasellar extension), and lateral cavernous sinus invasion (CSI) determined by Knosp grading score of 3-4. Suprasellar extension was defined as tumor extension superior to the tuberculum sellae- dorsum sellae line, and inferior extension as invasion through the sellar floor into the sphenoid sinus or clivus. Categorical analysis was performed using Fisher's exact test. RESULTS GHPAs were overall more likely to remain purely intrasellar compared to NFPA (50% vs 26%, p < 0.001). GHPAs, however, were 7 times more likely to exhibit isolated infrasellar extension compared to NFPA (20% vs 2.8%, p = 0.001). Conversely, NFPAs were twice as likely to exhibit isolated suprasellar extension compared to GHPA (60% vs 28%, p < 0.001), as well as combined suprasellar/infrasellar extension (25% vs 3%, p = 0.011). There were no overall differences in CSI between the two subgroups. DISCUSSION GHPA and NFPA demonstrate distinct extrasellar extension patterns on MRI. GHPAs show proclivity for inferior extension with bony invasion, whereas NFPAs are more likely to exhibit suprasellar extension through the diaphragmatic aperture. These distinctions may have implications into the biology and future treatment of PAs.
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Affiliation(s)
- Dhiraj J Pangal
- USC Brain Tumor Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
- Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Danielle Wishart
- USC Brain Tumor Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Mark S Shiroishi
- USC Brain Tumor Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Division of Neuroradiology, Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jacob Ruzevick
- USC Brain Tumor Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - John D Carmichael
- USC Brain Tumor Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Division of Endocrinology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Gabriel Zada
- USC Brain Tumor Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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27
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Yang G, Xing L, Sun X. Navigate Towards the Immunotherapy Era: Value of Immune Checkpoint Inhibitors in Non-Small Cell Lung Cancer Patients With Brain Metastases. Front Immunol 2022; 13:852811. [PMID: 35422812 PMCID: PMC9001915 DOI: 10.3389/fimmu.2022.852811] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/28/2022] [Indexed: 12/21/2022] Open
Abstract
Brain metastases (BMs) in non-small-cell lung cancer (NSCLC) patients are associated with significant morbidity and poor prognosis. Immune checkpoint inhibitors (ICIs) have resulted in a paradigm shift in the management of advanced NSCLC. However, the value of ICIs in NSCLC patients with BMs remains unclear because patients with BMs are routinely excluded in numerous prospective trials on ICIs. Here, starting from the mechanisms of ICIs for BMs, we will reveal the value of ICIs by reviewing the efficacy and adverse effects of ICIs monotherapy as well as promising combination strategies, such as combinations with chemotherapy, radiotherapy, and anti-angiogenic drugs, etc. In addition, the methods of patient selection and response assessment will be summarized to assist clinical practice and further studies.
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Affiliation(s)
- Guanqun Yang
- Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Ligang Xing
- Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Xiaorong Sun
- Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Nuclear Medicine, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
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28
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Li N, Wang YJ, Zhu FM, Deng ST. Unusual magnetic resonance imaging findings of brain and leptomeningeal metastasis in lung adenocarcinoma: A case report. World J Clin Cases 2022; 10:1723-1728. [PMID: 35211615 PMCID: PMC8855273 DOI: 10.12998/wjcc.v10.i5.1723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/04/2021] [Accepted: 01/08/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Metastatic tumors are the most common malignancies of central nervous system in adults, and the frequent primary lesion is lung cancer. Brain and leptomeningeal metastases are more common in patients with non-small-cell lung cancer harboring epidermal growth factor receptor mutations. However, the coexist of brain metastasis with leptomeningeal metastasis (LM) in isolated gyriform appearance is rare.
CASE SUMMARY We herein presented a case of a 76-year-old male with an established diagnosis as lung adenocarcinoma with gyriform-appeared cerebral parenchymal and leptomeningeal metastases, accompanied by mild peripheral edema and avid contrast enhancement on magnetic resonance imaging. Surgical and pathological examinations confirmed the brain and leptomeningeal metastatic lesions in the left frontal cortex, subcortical white matter and local leptomeninges.
CONCLUSION This case was unique with respect to the imaging findings of focal gyriform appearance, which might be caused by secondary parenchymal brain metastatic tumors invading into the leptomeninges or coexistence with LM. Radiologists should be aware of this uncommon imaging presentation of tumor metastases to the central nervous system.
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Affiliation(s)
- Na Li
- Department of Radiology, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang Province, China
| | - Yu-Jun Wang
- Department of Radiology, Zhejiang Provincial Hospital of Chinese Medicine, Hangzhou 310012, Zhejiang Province, China
| | - Fang-Mei Zhu
- Department of Radiology, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang Province, China
| | - Shui-Tang Deng
- Department of Radiology, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang Province, China
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29
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Cardinal T, Pangal D, Strickland BA, Newton P, Mahmoodifar S, Mason J, Craig D, Simon T, Tew BY, Yu M, Yang W, Chang E, Cabeen RP, Ruzevick J, Toga AW, Neman J, Salhia B, Zada G. Anatomical and topographical variations in the distribution of brain metastases based on primary cancer origin and molecular subtypes: a systematic review. Neurooncol Adv 2022; 4:vdab170. [PMID: 35024611 PMCID: PMC8739649 DOI: 10.1093/noajnl/vdab170] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background While it has been suspected that different primary cancers have varying predilections for metastasis in certain brain regions, recent advances in neuroimaging and spatial modeling analytics have facilitated further exploration into this field. Methods A systematic electronic database search for studies analyzing the distribution of brain metastases (BMs) from any primary systematic cancer published between January 1990 and July 2020 was conducted using PRISMA guidelines. Results Two authors independently reviewed 1957 abstracts, 46 of which underwent full-text analysis. A third author arbitrated both lists; 13 studies met inclusion/exclusion criteria. All were retrospective single- or multi-institution database reviews analyzing over 8227 BMs from 2599 patients with breast (8 studies), lung (7 studies), melanoma (5 studies), gastrointestinal (4 studies), renal (3 studies), and prostate (1 study) cancers. Breast, lung, and colorectal cancers tended to metastasize to more posterior/caudal topographic and vascular neuroanatomical regions, particularly the cerebellum, with notable differences based on subtype and receptor expression. HER-2-positive breast cancers were less likely to arise in the frontal lobes or subcortical region, while ER-positive and PR-positive breast metastases were less likely to arise in the occipital lobe or cerebellum. BM from lung adenocarcinoma tended to arise in the frontal lobes and squamous cell carcinoma in the cerebellum. Melanoma metastasized more to the frontal and temporal lobes. Conclusion The observed topographical distribution of BM likely develops based on primary cancer type, molecular subtype, and genetic profile. Further studies analyzing this association and relationships to vascular distribution are merited to potentially improve patient treatment and outcomes.
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Affiliation(s)
- Tyler Cardinal
- Department of Neurosurgery, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
| | - Dhiraj Pangal
- Department of Neurosurgery, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
| | - Ben A Strickland
- Department of Neurosurgery, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
| | - Paul Newton
- Department of Aerospace and Mechanical Engineering, Mathematics and The Ellison Institute for Transformative Medicine of USC, Los Angeles, California, USA
| | - Saeedeh Mahmoodifar
- Department of Physics & Astronomy, University of Southern California, Los Angeles, California, USA
| | - Jeremy Mason
- Department of Urology, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
| | - David Craig
- Department of Translational Genomics, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
| | - Thomas Simon
- Department of Translational Genomics, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
| | - Ben Yi Tew
- Department of Translational Genomics, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
| | - Min Yu
- Broad Stem Cell Center, University of Southern California, Los Angeles, California, USA
| | - Wensha Yang
- Department of Radiation Oncology, University of Southern California, Los Angeles, California, USA
| | - Eric Chang
- Department of Radiation Oncology, University of Southern California, Los Angeles, California, USA
| | - Ryan P Cabeen
- USC Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, California, USA
| | - Jacob Ruzevick
- Department of Neurosurgery, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
| | - Arthur W Toga
- USC Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, California, USA
| | - Josh Neman
- Department of Neurosurgery, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
| | - Bodour Salhia
- Department of Translational Genomics, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
| | - Gabriel Zada
- Department of Neurosurgery, Keck School of Medicine of University of Southern California, Los Angeles, California, USA
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30
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Sun L, Li B, Wang B, Li J, Li J. Afatinib in the treatment of brain metastases of lung cancer with one rare EGFR mutation: a two-case report. Anticancer Drugs 2022; 33:112-118. [PMID: 34261910 DOI: 10.1097/cad.0000000000001138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Brain metastasis is one of the common distant metastases of lung cancer. The prognosis of patients with brain metastasis is worse and the survival time is shorter. In this report, we described a rare mutation of EGFR G2607A (rs1050171) in two patients over 50 years of age with brain metastasis of lung cancer. These two patients were both treated with afatinib, followed up for 13 months and 45 months respectively. Both patients showed that the tumor subsided, the curative effect was identified as partial response (PR), no recurrence and progress occurred and still being under follow-up. Our study provides a support that afatinib may be a reasonable therapeutic option for patients with brain metastasis of lung cancer.
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Affiliation(s)
| | - Bing Li
- Department of Neurosurgery, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Tianjin Neurosurgical Institute, Tianjin, China
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31
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Blethen KE, Arsiwala TA, Fladeland RA, Sprowls SA, Panchal DM, Adkins CE, Kielkowski BN, Earp LE, Glass MJ, Pritt TA, Cabuyao YM, Aulakh S, Lockman PR. Modulation of the blood-tumor barrier to enhance drug delivery and efficacy for brain metastases. Neurooncol Adv 2021; 3:v133-v143. [PMID: 34859240 PMCID: PMC8633736 DOI: 10.1093/noajnl/vdab123] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The blood-brain barrier is the selectively permeable vasculature of the brain vital for maintaining homeostasis and neurological function. Low permeability is beneficial in the presence of toxins and pathogens in the blood. However, in the presence of metastatic brain tumors, it is a challenge for drug delivery. Although the blood-tumor barrier is slightly leaky, it still is not permissive enough to allow the accumulation of therapeutic drug concentrations in brain metastases. Herein, we discuss the differences between primary brain tumors and metastatic brain tumors vasculature, effects of therapeutics on the blood-tumor barrier, and characteristics to be manipulated for more effective drug delivery.
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Affiliation(s)
- Kathryn E Blethen
- Department of Basic Pharmaceutical Sciences, School of Pharmacy, West Virginia University, Morgantown, West Virginia, USA
| | - Tasneem A Arsiwala
- Department of Basic Pharmaceutical Sciences, School of Pharmacy, West Virginia University, Morgantown, West Virginia, USA
| | - Ross A Fladeland
- Department of Basic Pharmaceutical Sciences, School of Pharmacy, West Virginia University, Morgantown, West Virginia, USA
| | - Samuel A Sprowls
- Department of Basic Pharmaceutical Sciences, School of Pharmacy, West Virginia University, Morgantown, West Virginia, USA
| | - Dhruvi M Panchal
- Department of Basic Pharmaceutical Sciences, School of Pharmacy, West Virginia University, Morgantown, West Virginia, USA.,Department of Chemical and Biomedical Engineering, Benjamin M. Statler College of Engineering and Mineral Resources, West Virginia University, Morgantown, West Virginia, USA
| | - Chris E Adkins
- Department of Pharmaceutical Sciences, School of Pharmacy, South University, Savannah, Georgia, USA
| | - Brooke N Kielkowski
- Department of Basic Pharmaceutical Sciences, School of Pharmacy, West Virginia University, Morgantown, West Virginia, USA
| | - Leland E Earp
- Department of Cancer Cell Biology, School of Medicine, West Virginia University, Morgantown, West Virginia, USA
| | - Morgan J Glass
- Department of Basic Pharmaceutical Sciences, School of Pharmacy, West Virginia University, Morgantown, West Virginia, USA
| | - Trenton A Pritt
- Department of Basic Pharmaceutical Sciences, School of Pharmacy, West Virginia University, Morgantown, West Virginia, USA
| | - Yssabela M Cabuyao
- Department of Basic Pharmaceutical Sciences, School of Pharmacy, West Virginia University, Morgantown, West Virginia, USA
| | - Sonikpreet Aulakh
- Department of Cancer Cell Biology, School of Medicine, West Virginia University, Morgantown, West Virginia, USA
| | - Paul R Lockman
- Department of Basic Pharmaceutical Sciences, School of Pharmacy, West Virginia University, Morgantown, West Virginia, USA
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32
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Yarmoska SK, Alawieh AM, Tomlinson S, Hoang KB. Modulation of the Complement System by Neoplastic Disease of the Central Nervous System. Front Immunol 2021; 12:689435. [PMID: 34671342 PMCID: PMC8521155 DOI: 10.3389/fimmu.2021.689435] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 09/10/2021] [Indexed: 12/28/2022] Open
Abstract
The complement system is a highly conserved component of innate immunity that is involved in recognizing and responding to pathogens. The system serves as a bridge between innate and adaptive immunity, and modulation of the complement system can affect the entire host immune response to a foreign insult. Neoplastic diseases have been shown to engage the complement system in order to evade the immune system, gain a selective growth advantage, and co-opt the surrounding environment for tumor proliferation. Historically, the central nervous system has been considered to be an immune-privileged environment, but it is now clear that there are active roles for both innate and adaptive immunity within the central nervous system. Much of the research on the role of immunological modulation of neoplastic disease within the central nervous system has focused on adaptive immunity, even though innate immunity still plays a critical role in the natural history of central nervous system neoplasms. Here, we review the modulation of the complement system by a variety of neoplastic diseases of the central nervous system. We also discuss gaps in the current body of knowledge and comment on future directions for investigation.
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Affiliation(s)
- Steven K. Yarmoska
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA, United States
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Ali M. Alawieh
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA, United States
| | - Stephen Tomlinson
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC, United States
| | - Kimberly B. Hoang
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA, United States
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33
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Simeon J, Thrush J, Bailey TA. Angiopoietin-like protein 4 is a chromatin-bound protein that enhances mammosphere formation in vitro and experimental triple-negative breast cancer brain and liver metastases in vivo. J Carcinog 2021; 20:8. [PMID: 34447288 PMCID: PMC8356708 DOI: 10.4103/jcar.jcar_20_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 09/30/2020] [Accepted: 01/06/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION: Metastatic progression in triple-negative breast cancer (TNBC) patients occurs primarily because of nuclear reprogramming that includes chromatin remodeling and epigenetic modifications. The existing and most successful chemotherapies available for metastatic TNBC target nuclear proteins or damage DNA. The objectives here are to investigate an undescribed role for the molecular biology of nuclear angiopoietin-like protein 4 (ANGPTL4) and to characterize the effect of ectopic overexpression of ANGPTL4 in the metastatic biology of TNBC. MATERIALS AND METHODS: Lentiviral-mediated transduction was used to overexpress ANGPTL4 in the TNBC cell line MD Anderson–metastatic breast cancer 231. The overexpression of ANGPTL4 was confirmed by western blot and ELISA. Subcellular fractionation, western blot, and immunofluorescence microscopy were used to characterize the intracellular localization of ANGPTL4. Mammosphere culture and the anchorage-independent growth assay analyzed the metastatic potential of the cell line. Xenograft assays assessed the effect of ANGPTL4 overexpression on TNBC metastases in vivo. RESULTS: The ANGPTL4 overexpressing cell line formed larger mammospheres and anchorage-independent colonies in vitro and developed larger primary tumors, more liver metastases, and brain metastatic outgrowth in vivo in comparison to a cell line that expressed endogenous levels of ANGPTL4. ANGPTL4, aurora kinase A (AURKA), a mitotic kinase, and Tat-interacting protein p60 kDa (Tip60), a lysine acetyltransferase, associated with chromatin in the ANGPTL4 overexpressing cells but not in cells that expressed endogenous levels of ANGPTL4. CONCLUSIONS: The ANGPTL4 overexpressing cell line showed in vitro and in vivo activities that suggest that nuclear ANGPTL4, AURKA, and Tip60 may cooperatively modulate TNBC metastases within chromatin-remodeling complexes or DNA-associated machinery.
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Affiliation(s)
- Jodi Simeon
- Department of Biological Sciences, University of Arkansas, Fayetteville, Arkansas, USA.,Department of Cell and Molecular Biology Program, University of Arkansas, Fayetteville, Arkansas, USA
| | - Jessica Thrush
- Department of Biological Sciences, University of Arkansas, Fayetteville, Arkansas, USA.,Department of Honors College, University of Arkansas, Fayetteville, Arkansas, USA
| | - Tameka A Bailey
- Department of Biological Sciences, University of Arkansas, Fayetteville, Arkansas, USA.,Department of Cell and Molecular Biology Program, University of Arkansas, Fayetteville, Arkansas, USA
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Omori H, Shan Q, Takabatake K, Nakano K, Kawai H, Sukegawa S, Tsujigiwa H, Nagatsuka H. The Origin of Stroma Influences the Biological Characteristics of Oral Squamous Cell Carcinoma. Cancers (Basel) 2021; 13:cancers13143491. [PMID: 34298705 PMCID: PMC8305380 DOI: 10.3390/cancers13143491] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/08/2021] [Accepted: 07/09/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Normal stromal cells play a significant role in the progression of cancers but are poorly investigated in oral squamous cell carcinoma (OSCC). In this study, we found that stromal cells derived from the gingival and periodontal ligament tissues could inhibit differentiation and promote the proliferation, invasion, and migration of OSCC both in vitro and in vivo. Furthermore, microarray data suggested that genes, such as CDK1, BUB1B, TOP2A, DLGAP5, BUB1, and CCNB2, probably play a role in influencing the different effects of gingival stromal tissue cells (G-SCs) and periodontal ligament stromal cells (P-SCs) on the progression of OSCC. Therefore, both G-SCs and P-SCs could promote the progression of OSCC, which could be a potential regulatory mechanism in the progression of OSCC. Abstract Normal stromal cells surrounding the tumor parenchyma, such as the extracellular matrix (ECM), normal fibroblasts, mesenchymal stromal cells, and osteoblasts, play a significant role in the progression of cancers. However, the role of gingival and periodontal ligament tissue-derived stromal cells in OSCC progression is unclear. In this study, the effect of G-SCs and P-SCs on the differentiation, proliferation, invasion, and migration of OSCC cells in vitro was examined by Giemsa staining, Immunofluorescence (IF), (3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium) (MTS), invasion, and migration assays. Furthermore, the effect of G-SCs and P-SCs on the differentiation, proliferation, and bone invasion by OSCC cells in vivo was examined by hematoxylin-eosin (HE) staining, immunohistochemistry (IHC), and tartrate-resistant acid phosphatase (TRAP) staining, respectively. Finally, microarray data and bioinformatics analyses identified potential genes that caused the different effects of G-SCs and P-SCs on OSCC progression. The results showed that both G-SCs and P-SCs inhibited the differentiation and promoted the proliferation, invasion, and migration of OSCC in vitro and in vivo. In addition, genes, including CDK1, BUB1B, TOP2A, DLGAP5, BUB1, and CCNB2, are probably involved in causing the different effects of G-SCs and P-SCs on OSCC progression. Therefore, as a potential regulatory mechanism, both G-SCs and P-SCs can promote OSCC progression.
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Affiliation(s)
- Haruka Omori
- Department of Oral Pathology and Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama 700-8525, Japan; (H.O.); (Q.S.); (K.N.); (H.K.); (S.S.); (H.T.); (H.N.)
| | - Qiusheng Shan
- Department of Oral Pathology and Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama 700-8525, Japan; (H.O.); (Q.S.); (K.N.); (H.K.); (S.S.); (H.T.); (H.N.)
| | - Kiyofumi Takabatake
- Department of Oral Pathology and Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama 700-8525, Japan; (H.O.); (Q.S.); (K.N.); (H.K.); (S.S.); (H.T.); (H.N.)
- Correspondence:
| | - Keisuke Nakano
- Department of Oral Pathology and Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama 700-8525, Japan; (H.O.); (Q.S.); (K.N.); (H.K.); (S.S.); (H.T.); (H.N.)
| | - Hotaka Kawai
- Department of Oral Pathology and Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama 700-8525, Japan; (H.O.); (Q.S.); (K.N.); (H.K.); (S.S.); (H.T.); (H.N.)
| | - Shintaro Sukegawa
- Department of Oral Pathology and Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama 700-8525, Japan; (H.O.); (Q.S.); (K.N.); (H.K.); (S.S.); (H.T.); (H.N.)
- Department of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital, Kagawa 760-0065, Japan
| | - Hidetsugu Tsujigiwa
- Department of Oral Pathology and Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama 700-8525, Japan; (H.O.); (Q.S.); (K.N.); (H.K.); (S.S.); (H.T.); (H.N.)
- Department of Life Science, Faculty of Science, Okayama University of Science, Okayama 700-0005, Japan
| | - Hitoshi Nagatsuka
- Department of Oral Pathology and Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama 700-8525, Japan; (H.O.); (Q.S.); (K.N.); (H.K.); (S.S.); (H.T.); (H.N.)
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Hu X, Lou T, Yuan C, Wang Y, Tu X, Wang Y, Zhang T. Effects of lncRNA ANRIL-knockdown on the proliferation, apoptosis and cell cycle of gastric cancer cells. Oncol Lett 2021; 22:621. [PMID: 34267814 PMCID: PMC8258619 DOI: 10.3892/ol.2021.12882] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 06/02/2021] [Indexed: 01/24/2023] Open
Abstract
Gastric cancer is one of the most common types of malignant tumor of the gastrointestinal tract worldwide. Cisplatin (DDP) is a commonly used chemotherapeutic drug in the clinic; however, the resistance of gastric cancer cells to DDP limits its efficacy. In the present study, drug-resistant gastric cancer cell lines were constructed using the stepwise continuous selection method, and the relative expression levels of long non-coding RNA (lncRNA) CDKN2B antisense RNA 1 (ANRIL) and microRNA (miR)-181a-5p were detected using reverse transcription-quantitative PCR. The knockdown of lncRNA ANRIL and miR-181a-5p expression was performed by transfection with shRNA-ANRIL and an miR-181a-5p inhibitor, respectively. Cellular proliferation and sensitivity to DDP were assessed using Cell Counting Kit-8 analysis. Cell apoptosis and cell cycle distribution were assessed using flow cytometry and western blotting. The binding relationships between ANRIL, miR-181a-5p and cyclin G1 (CCNG1) were verified using a dual luciferase reporter assay. The results revealed that the expression levels of miR-181a-5p were downregulated in all drug-resistant cell lines. ANRIL-knockdown inhibited cellular proliferation, and promoted apoptosis and cell cycle arrest; however, following the knockdown of miR-181a-5p, the inhibition of cell cycle arrest was alleviated. Notably, miR-181a-5p, ANRIL and CCNG1 were found to have targeting relationships. In conclusion, the findings of the present study suggested that knocking down the expression of ANRIL inhibited cellular proliferation, and promoted apoptosis and cell cycle arrest. Furthermore, its downstream target, miR-181a-5p, inhibited the proliferation of drug-resistant cells and enhanced their sensitivity to DDP.
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Affiliation(s)
- Xueqian Hu
- Department of Oncology, Ningbo Municipal Hospital of Traditional Chinese Medicine, Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo, Zhejiang 315000, P.R. China
| | - Ting Lou
- Department of Oncology, Ningbo Municipal Hospital of Traditional Chinese Medicine, Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo, Zhejiang 315000, P.R. China
| | - Chunying Yuan
- Department of Oncology, Ningbo Municipal Hospital of Traditional Chinese Medicine, Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo, Zhejiang 315000, P.R. China
| | - Yongsheng Wang
- Department of Oncology, Ningbo Municipal Hospital of Traditional Chinese Medicine, Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo, Zhejiang 315000, P.R. China
| | - Xiaolong Tu
- Department of Oncology, Ningbo Municipal Hospital of Traditional Chinese Medicine, Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo, Zhejiang 315000, P.R. China
| | - Yi Wang
- Department of Oncology, Ningbo Municipal Hospital of Traditional Chinese Medicine, Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo, Zhejiang 315000, P.R. China
| | - Tingsu Zhang
- Department of Oncology, Ningbo Municipal Hospital of Traditional Chinese Medicine, Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo, Zhejiang 315000, P.R. China
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36
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Molley TG, Jalandhra GK, Nemec SR, Tiffany AS, Patkunarajah A, Poole K, Harley BAC, Hung TT, Kilian KA. Heterotypic tumor models through freeform printing into photostabilized granular microgels. Biomater Sci 2021; 9:4496-4509. [PMID: 34008601 PMCID: PMC8282188 DOI: 10.1039/d1bm00574j] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The tissue microenvironment contains a complex assortment of multiple cell types, matrices, and vessel structures, which is difficult to reconstruct in vitro. Here, we demonstrate model tumor microenvironments formed through direct writing of vasculature channels and tumor cell aggregates, within a cell-laden microgel matrix. Photocrosslinkable microgels provide control over local and global mechanics, while enabling the integration of virtually any cell type. Direct writing of a Pluronic sacrificial ink into a stromal cell-microgel suspension is used to form vessel structures for endothelialization, followed by printing of melanoma aggregates. Tumor cells migrate into the prototype vessels as a function of spatial location, thereby providing a measure of invasive potential. The integration of perfusable channels with multiple spatially defined cell types provides new avenues for modelling development and disease, with scope for both fundamental research and drug development efforts.
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Affiliation(s)
- Thomas G Molley
- School of Materials Science and Engineering, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Gagan K Jalandhra
- School of Materials Science and Engineering, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Stephanie R Nemec
- School of Materials Science and Engineering, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Aleczandria S Tiffany
- Department of Chemical and Biomolecular Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Amrutha Patkunarajah
- EMBL Australia Node in Single Molecule Science, School of Medical Sciences, Faculty of Medicine & Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - Kate Poole
- EMBL Australia Node in Single Molecule Science, School of Medical Sciences, Faculty of Medicine & Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - Brendan A C Harley
- Department of Chemical and Biomolecular Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA and Cancer Center at Illinois, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA and Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Tzong-Tyng Hung
- Biological Resources Imaging Laboratory, Mark Wainwright Analytical Centre, University of New South Wales, Sydney, NSW 2052, Australia
| | - Kristopher A Kilian
- School of Materials Science and Engineering, University of New South Wales, Sydney, NSW 2052, Australia. and School of Chemistry, Australian Centre for Nanomedicine, University of New South Wales, Sydney, NSW 2052, Australia
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Brown SR, Bates JC, Avera AD, Kim Y. Relationship between Stemness, Reactive Oxygen Species, and Epithelial-to-Mesenchymal Transition in Model Circulating Tumor Cells. Cells Tissues Organs 2021; 211:282-293. [PMID: 34077929 DOI: 10.1159/000516574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 04/16/2021] [Indexed: 11/19/2022] Open
Abstract
Most cancer deaths are caused by secondary metastasized tumors. The cells that spread these tumors are known as circulating tumor cells (CTCs). They exist in a dynamic environment, including exposure to fluid shear stress (FSS) that makes them susceptible to reactive oxygen species (ROS) generation. There are questions about the similarities of CTCs to cancer stem cells (CSCs) and whether the stem cell-like characteristics of CTCs allow them to proliferate and spread despite the biophysical obstacles during the metastatic process. One of those qualities is the ability to undergo the epithelial-to-mesenchymal transition (EMT). Here, MDA-MB-231 and MCF7 were modeled as CTCs by prolonged exposure to FSS using a spinner flask. They were tested for ROS generation, CSC, EMT, and Hippo pathway gene and protein markers using qRT-PCR and flow cytometry. MDA-MB-231 did not show significant changes in CSC markers, but did show significant changes in ROS, EMT, and Hippo markers (p < 0.05). Similarly, MCF7 showed significant changes in ROS and EMT markers (p < 0.05). Furthermore, both cell lines demonstrated the reverse mesenchymal-to-epithelial transition signature when allowed to recover after FSS. These results suggest that the degree of their stemness or aggressiveness affects their responses to externally applied biophysical forces and demonstrates a potential link between mechanotransduction, the Hippo pathway, and the induction of EMT in breast cancer cells.
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Affiliation(s)
- Spenser R Brown
- Department of Chemical and Biological Engineering, College of Engineering, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Juliana C Bates
- Department of Chemical and Biological Engineering, College of Engineering, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Alexandra D Avera
- Department of Chemical and Biological Engineering, College of Engineering, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Yonghyun Kim
- Department of Chemical and Biological Engineering, College of Engineering, The University of Alabama, Tuscaloosa, Alabama, USA
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38
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Liu YT, Goel S, Kai M, Moran Guerrero JA, Nguyen T, Mai J, Shen H, Ziemys A, Yokoi K. Seed- and Soil-Dependent Differences in Murine Breast Tumor Microenvironments Dictate Anti-PD-L1 IgG Delivery and Therapeutic Efficacy. Pharmaceutics 2021; 13:pharmaceutics13040530. [PMID: 33920216 PMCID: PMC8069710 DOI: 10.3390/pharmaceutics13040530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/06/2021] [Accepted: 04/08/2021] [Indexed: 11/16/2022] Open
Abstract
We sought to determine if Stephen Paget’s “seed and soil” hypothesis of organ-preference patterns of cancer metastasis can explain the development of heterogeneity in a tumor microenvironment (TME) as well as immunotherapeutic delivery and efficacy. We established single-cell-derived clones (clones 1 and 16) from parental 4T1 murine breast cancer cells to create orthotopic primary and liver metastasis models to deconvolute polyclonal complexity cancer cells and the difference in TME-derived heterogeneities. Tumor-bearing mice were treated with anti-PD-L1 IgG or a control antibody, and immunofluorescent imaging and quantification were then performed to evaluate the therapeutic efficacy on tumor growth, the delivery of therapy to tumors, the development of blood vessels, the expression of PD-L1, the accumulation of immune cells, and the amount of coagulation inside tumors. The quantification showed an inverse correlation between the amount of delivered therapy and therapeutic efficacy in parental-cell-derived tumors. In contrast, tumors originating from clone 16 cells accumulated a significantly greater amount of therapy and responded better than clone-1-derived tumors. This difference was greater when tumors grew in the liver than the primary site. A similar trend was found in PD-L1 expression and immune cell accumulation. However, the change in the number of blood vessels was not significant. In addition, the amount of coagulation was more abundant in clone-1-derived tumors when compared to others. Thus, our findings reconfirmed the seed- and soil-dependent differences in PD-L1 expression, therapeutic delivery, immune cell accumulation, and tumor coagulation, which can constitute a heterogeneous delivery and response of immunotherapy in polyclonal tumors growing in different organs.
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39
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Srinivasan ES, Tan AC, Anders CK, Pendergast AM, Sipkins DA, Ashley DM, Fecci PE, Khasraw M. Salting the Soil: Targeting the Microenvironment of Brain Metastases. Mol Cancer Ther 2021; 20:455-466. [PMID: 33402399 PMCID: PMC8041238 DOI: 10.1158/1535-7163.mct-20-0579] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/31/2020] [Accepted: 12/31/2020] [Indexed: 12/14/2022]
Abstract
Paget's "seed and soil" hypothesis of metastatic spread has acted as a foundation of the field for over a century, with continued evolution as mechanisms of the process have been elucidated. The central nervous system (CNS) presents a unique soil through this lens, relatively isolated from peripheral circulation and immune surveillance with distinct cellular and structural composition. Research in primary and metastatic brain tumors has demonstrated that this tumor microenvironment (TME) plays an essential role in the growth of CNS tumors. In each case, the cancerous cells develop complex and bidirectional relationships that reorganize the local TME and reprogram the CNS cells, including endothelial cells, pericytes, astrocytes, microglia, infiltrating monocytes, and lymphocytes. These interactions create a structurally and immunologically permissive TME with malignant processes promoting positive feedback loops and systemic consequences. Strategies to interrupt interactions with the native CNS components, on "salting the soil," to create an inhospitable environment are promising in the preclinical setting. This review aims to examine the general and specific pathways thus far investigated in brain metastases and related work in glioma to identify targetable mechanisms that may have general application across the spectrum of intracranial tumors.
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Affiliation(s)
- Ethan S Srinivasan
- Duke Brain and Spine Metastases Center, Duke University, Durham, North Carolina
| | - Aaron C Tan
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Carey K Anders
- Duke Brain and Spine Metastases Center, Duke University, Durham, North Carolina
| | | | - Dorothy A Sipkins
- Duke Brain and Spine Metastases Center, Duke University, Durham, North Carolina
| | - David M Ashley
- Duke Brain and Spine Metastases Center, Duke University, Durham, North Carolina
| | - Peter E Fecci
- Duke Brain and Spine Metastases Center, Duke University, Durham, North Carolina
| | - Mustafa Khasraw
- Duke Brain and Spine Metastases Center, Duke University, Durham, North Carolina.
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40
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Lei L, Wang WX, Wang D, Lin L, Zhu YC, Wang H, Wang LP, Zhuang W, Fang MY, Wan B, Feng HJ, Xu CW. A real-world study in advanced non-small cell lung cancer with de novo brain metastasis. J Cancer 2021; 12:1467-1473. [PMID: 33531991 PMCID: PMC7847653 DOI: 10.7150/jca.51411] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 12/15/2020] [Indexed: 12/24/2022] Open
Abstract
Brain metastases are the major cause of life-expectancy shortened for patients with lung cancer. The prognostic value of EGFR mutation subtypes and survival benefit of EGFR-tyrosine kinase inhibitors (TKIs) in advanced non-small cell lung cancer (NSCLC) patients with de novo brain metastasis is still not clear. Here, we present a real-world study nation-wide focusing on the prognostic value of genomic and therapeutic factors in overall survival (OS) of those patients. We enrolled a total of 233 patients diagnosed with advanced NSCLC and de novo BM from multi-medical centers across China. The enrolled patients were divided into 4 groups, including EGFR 19del, EGFR L858R, EGFR wild-type, and EGFR unknown groups. The median OS of patients with EGFR mutations and all patients were 29.0 and 25.0 months, respectively. There was significant difference in OS of patients among EGFR 19del (n=76), EGFR L858R (n=94), EGFR wild-type (n=46) and EGFR unknown (n=17) groups (30.5 vs 27.5 vs 16.0 vs 25.0, P=0.025). Patients treated by icotinib showed better OS than gefitinib and erlotinib (31.0 vs 25.5 vs 26.5, P=0.02). There was a difference in OS of patients received the whole-brain radiotherapy (WBRT), stereotactic radiosurgery (SRS), or WBRT+SRS (20.0 vs 31.0 vs 30.0 months, P<0.001), respectively. In multivariate analysis, patients treated with icotinib had superior iPFS benefit than gefitinib and erlotinib (HR=0.86[95%CI (0.74-1.0)], P=0.04). Besides, the histology of non-adenocarcinomas, the number of BM (>3), and extracranial metastases status could have an independent negative impact on the OS of all patients (P<0.001). EGFR mutant NSCLC patients with de novo BM had a better OS than patients with EGFR wild type. Patients treated with icotinib had longer iPFS than gefitinib and erlotinib but not in OS. Non-adenocarcinomas, number of BM (>3) and extracranial metastases were independent negative prognostic factors in iPFS and OS of all patients. Prospective clinical trials are warranted to explore more effective multimodality in this population.
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Affiliation(s)
- Lei Lei
- Department of Chemotherapy, Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou Zhejiang 310022, People's Republic of China
| | - Wen-Xian Wang
- Department of Chemotherapy, Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou Zhejiang 310022, People's Republic of China
| | - Dong Wang
- Department of Respiratory Medicine, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, People's Republic of China
| | - Li Lin
- Department of Oncology, Peking University International Hospital, Beijing 102206, People's Republic of China
| | - You-Cai Zhu
- Department of Thoracic Disease Center, Zhejiang Rongjun Hospital, Jiaxing Zhejiang 314000, People's Republic of China
| | - Hong Wang
- Department of Lung Cancer, The Fifth Medical Center, General Hospital of PLA, Beijing 100071, People's Republic of China
| | - Li-Ping Wang
- Department of Thoracic Oncology, Baotou Cancer Hospital, Baotou Inner Mongolia 014000, People's Republic of China
| | - Wu Zhuang
- Department of Medical Oncology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou Fujian 350014, People's Republic of China
| | - Mei-Yu Fang
- Department of Chemotherapy, Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou Zhejiang 310022, People's Republic of China
| | - Bing Wan
- Department of Respiratory, The Affiliated Jiangning Hopsital of Nanjing Medical University, Nanjing Jiangsu 210002, People's Republic of China
| | - Hui-Jing Feng
- Department of Thoracic Oncology, Shanxi Academy of Medical Sciences, Shanxi Bethune Hospital, Taiyuan Shanxi 030032, People's Republic of China
| | - Chun-Wei Xu
- Department of Respiratory Medicine, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, People's Republic of China
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Singh N, Mishra A, Sahu DK, Jain M, Shyam H, Tripathi RK, Shankar P, Kumar A, Alam N, Jaiswal R, Kumar S. Comprehensive Characterization of Stage IIIA Non-Small Cell Lung Carcinoma. Cancer Manag Res 2020; 12:11973-11988. [PMID: 33244273 PMCID: PMC7685366 DOI: 10.2147/cmar.s279974] [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] [Received: 09/04/2020] [Accepted: 10/16/2020] [Indexed: 12/21/2022] Open
Abstract
Introduction Heterogeneity of non-small cell lung carcinoma (NSCLC) among patients is currently not well studied. Pathologic markers and staging systems have not been a precise predictor of the prognosis of an individual patient. Hence, we hypothesize to develop a transcript-based signature to categorize stage IIIA-NSCLC in lung adenocarcinoma (LUAD) and lung squamous cell carcinoma (LUSC), plus identify markers that could indicate the prognosis of the disease. Methods Human Transcriptome Array 2.0 (HTA) and NanoString nCounter® platform were used for high-throughput gene-expression profiling. Initially, we profiled stage IIIA-NSCLC through HTA and validated through NanoString. Additionally, two metastatic markers SPP1 and CDH2 were validated in 47 NSCLC stage IIIA samples through real-time PCR. Results We observed distinct gene clusters in LUAD and LUSC with down-regulation of six genes and up-regulation of 57 genes through HTA. Ninety-six transcripts were randomly selected after analyzing HTA data and validated on the NanoString platform. We found 40 differentially expressed transcripts that categorized NSCLC into LUAD and LUSC. SPP1 is significantly overexpressed (4.311±1.27 fold in LUAD and 13.41±3.82 fold in LUSC compared to control), and the CDH2 transcript was significantly overexpressed (11.53 ± 4.027-fold compared to control) only in LUSC. Discussion These markers enable us to categorize stage IIIA NSCLC into LUAD and LUSC plus these markers may be helpful to understand the pathophysiology of NSCLC. However, more data required to make these findings useful in general clinical practice.
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Affiliation(s)
- Neetu Singh
- Department of Centre for Advanced Research, King George's Medical University, Lucknow, 226003, India
| | - Archana Mishra
- Department of Surgery, King George's Medical University, Lucknow 226003, India
| | - Dinesh Kumar Sahu
- Department of Centre for Advanced Research, King George's Medical University, Lucknow, 226003, India
| | - Mayank Jain
- Department of Centre for Advanced Research, King George's Medical University, Lucknow, 226003, India
| | - Hari Shyam
- Department of Centre for Advanced Research, King George's Medical University, Lucknow, 226003, India
| | - Ratnesh Kumar Tripathi
- Department of Centre for Advanced Research, King George's Medical University, Lucknow, 226003, India
| | - Pratap Shankar
- Department of Centre for Advanced Research, King George's Medical University, Lucknow, 226003, India
| | - Anil Kumar
- Department of Centre for Advanced Research, King George's Medical University, Lucknow, 226003, India
| | - Nawazish Alam
- Department of Centre for Advanced Research, King George's Medical University, Lucknow, 226003, India
| | - Riddhi Jaiswal
- Department of Pathology, King George's Medical University, Lucknow 226003, India
| | - Shailendra Kumar
- Department of Surgery, King George's Medical University, Lucknow 226003, India
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Balla MMS, Patwardhan S, Melwani PK, Purwar P, Kumar A, Pramesh CS, Laskar S, Pandey BN. Prognosis of metastasis based on age and serum analytes after follow-up of non-metastatic lung cancer patients. Transl Oncol 2020; 14:100933. [PMID: 33188981 PMCID: PMC7670208 DOI: 10.1016/j.tranon.2020.100933] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 10/23/2020] [Accepted: 10/23/2020] [Indexed: 12/24/2022] Open
Abstract
Lower age of non-metastatic patients developed metastasis during follow-up. Higher levels of IL-8 and MMP-9 were observed in these patients. IL-8 and age together improved metastasis prognostic ability.
At the diagnostic stage, metastasis detection is around 75% in the lung cancer patients. Major clinical challenge faced by medical oncologists is the unpredictable metastasis development in non-metastatic patients. The literature regarding the biomarkers/factors prognosticating metastasis in non-metastatic patients during follow-up is very limited. In this pilot study, the levels of serum biomarkers (IL-8, VEGF, MMP-2, MMP-9) were measured at diagnosis stage of non-metastatic lung cancer patients and these observations were evaluated for metastasis development after follow-up of median 29.2 months. After follow-up, ∼40% of these patients developed metastasis. The average age of non-metastatic patients which later developed metastasis, was found to be lower than the patients continued to be non-metastatic. These patients also showed higher levels of IL-8 and MMP-9 than the patients which did not develop metastasis. Analysis of Receiver Operating Characteristic Curves, Youden's Index and positive likelihood ratio values showed better diagnostic ability for IL-8 and MMP-9, which improved when both markers used together. Moreover, patients with age ≤60 years showed higher prognostic ability of metastasis development, which was significantly enhanced when patient age was analysed with IL-8. These results suggest potential of serum analytes (IL-8, MMP-9) and/or patient age in prognosticating the metastasis development in non-metastatic patients.
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Affiliation(s)
- Murali Mohan Sagar Balla
- Radiation Biology & Health Sciences Division, Bhabha Atomic Research Centre, Mumbai 400085, India
| | - Sejal Patwardhan
- Radiation Biology & Health Sciences Division, Bhabha Atomic Research Centre, Mumbai 400085, India; Homi Bhabha National Institute, Anushakti Nagar, Mumbai 400094, India
| | - Pooja Kamal Melwani
- Radiation Biology & Health Sciences Division, Bhabha Atomic Research Centre, Mumbai 400085, India; Homi Bhabha National Institute, Anushakti Nagar, Mumbai 400094, India
| | - Pallavi Purwar
- Tata Memorial Centre, Dr E. Borges Road, Parel, Mumbai 400012, India
| | - Amit Kumar
- Radiation Biology & Health Sciences Division, Bhabha Atomic Research Centre, Mumbai 400085, India; Homi Bhabha National Institute, Anushakti Nagar, Mumbai 400094, India
| | - C S Pramesh
- Homi Bhabha National Institute, Anushakti Nagar, Mumbai 400094, India; Tata Memorial Centre, Dr E. Borges Road, Parel, Mumbai 400012, India
| | - Siddharth Laskar
- Homi Bhabha National Institute, Anushakti Nagar, Mumbai 400094, India; Tata Memorial Centre, Dr E. Borges Road, Parel, Mumbai 400012, India
| | - Badri Narain Pandey
- Radiation Biology & Health Sciences Division, Bhabha Atomic Research Centre, Mumbai 400085, India; Homi Bhabha National Institute, Anushakti Nagar, Mumbai 400094, India.
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miR-876 Inhibits EMT and Liver Fibrosis via POSTN to Suppress Metastasis in Hepatocellular Carcinoma. BIOMED RESEARCH INTERNATIONAL 2020; 2020:1964219. [PMID: 33083453 PMCID: PMC7559219 DOI: 10.1155/2020/1964219] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 07/19/2020] [Accepted: 08/14/2020] [Indexed: 02/06/2023]
Abstract
Background The asymptomatic onset, frequent recurrence, and poor prognosis of hepatocellular carcinoma (HCC) prompted us to identify new therapeutic targets or predictive markers of HCC diagnosis or prognosis. Methods In this study, bioinformatics analysis was used to screen for target miRNAs from the open-access TCGA database. Transwell assays, Western blotting, and qRT-PCR analyses were used to detect cellular functions and gene expression in HCC cells and samples. A nude mouse tumorigenesis model was established to facilitate the observation of HCC progression. Other assays included luciferase reporter assays, IHC, and survival analysis. Results We found that the identified miR-876 from TCGA was expressed at low levels in HCC cell lines and that low miR-876 expression was corrected with liver cirrhosis, tumor thrombus, and TNM stage. Further research revealed that miR-876 regulated cell invasion, EMT, and collagen expression by targeting POSTN expression. miR-876 and POSTN were inversely correlated in HCC samples and associated with EMT status and liver fibrosis in clinical HCC tissues. miR-876 inhibited the liver cancer progression in in vivo animal assays. Finally, both miR-876 and POSTN were risk factors for HCC survival, and HCC patients with combined low miR-876 and high POSTN expression had worse prognosis. Conclusions miR-876 inhibited HCC EMT and fibrosis by targeting POSTN, thus affecting HCC progression and prognosis. miR-876 and POSTN may be useful therapeutic targets or prognostic markers of HCC.
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44
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Hynes WF, Pepona M, Robertson C, Alvarado J, Dubbin K, Triplett M, Adorno JJ, Randles A, Moya ML. Examining metastatic behavior within 3D bioprinted vasculature for the validation of a 3D computational flow model. SCIENCE ADVANCES 2020; 6:eabb3308. [PMID: 32923637 PMCID: PMC7449690 DOI: 10.1126/sciadv.abb3308] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 07/14/2020] [Indexed: 05/02/2023]
Abstract
Understanding the dynamics of circulating tumor cell (CTC) behavior within the vasculature has remained an elusive goal in cancer biology. To elucidate the contribution of hydrodynamics in determining sites of CTC vascular colonization, the physical forces affecting these cells must be evaluated in a highly controlled manner. To this end, we have bioprinted endothelialized vascular beds and perfused these constructs with metastatic mammary gland cells under physiological flow rates. By pairing these in vitro devices with an advanced computational flow model, we found that the bioprinted analog was readily capable of evaluating the accuracy and integrated complexity of a computational flow model, while also highlighting the discrete contribution of hydrodynamics in vascular colonization. This intersection of these two technologies, bioprinting and computational simulation, is a key demonstration in the establishment of an experimentation pipeline for the understanding of complex biophysical events.
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Affiliation(s)
- W. F. Hynes
- Materials Engineering Division, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA
| | - M. Pepona
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
| | - C. Robertson
- Materials Engineering Division, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA
| | - J. Alvarado
- Materials Engineering Division, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA
| | - K. Dubbin
- Materials Engineering Division, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA
| | - M. Triplett
- Materials Engineering Division, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA
| | - J. J. Adorno
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH 43210, USA
| | - A. Randles
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
| | - M. L. Moya
- Materials Engineering Division, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA
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45
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Nephronectin promotes breast cancer brain metastatic colonization via its integrin-binding domains. Sci Rep 2020; 10:12237. [PMID: 32699247 PMCID: PMC7376038 DOI: 10.1038/s41598-020-69242-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 07/07/2020] [Indexed: 12/18/2022] Open
Abstract
This study demonstrates a role for the extracellular matrix protein nephronectin (NPNT) in promoting experimental breast cancer brain metastasis, possibly through enhanced binding to- and migration through brain endothelial cells. With the introduction of more targeted breast cancer treatments, a prolonged survival has resulted during the last decade. Consequently, an increased number of patients develop metastasis in the brain, a challenging organ to treat. We recently reported that NPNT was highly expressed in primary breast cancer and associated with unfavourable prognosis. The current study addresses our hypothesis that NPNT promotes brain metastases through its integrin-binding motifs. SAGE-sequencing revealed that NPNT was significantly up-regulated in human breast cancer tissue compared to pair-matched normal breast tissue. Human brain metastatic breast cancers expressed both NPNT and its receptor, integrin α8β1. Using an open access repository; BreastMark, we found a correlation between high NPNT mRNA levels and poor prognosis for patients with the luminal B subtype. The 66cl4 mouse cell line was used for expression of wild-type and mutant NPNT, which is unable to bind α8β1. Using an in vivo model of brain metastatic colonization, 66cl4-NPNT cells showed an increased ability to form metastatic lesions compared to cells with mutant NPNT, possibly through reduced endothelial adhesion and transmigration.
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46
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Cellular Mechanisms of Circulating Tumor Cells During Breast Cancer Metastasis. Int J Mol Sci 2020; 21:ijms21145040. [PMID: 32708855 PMCID: PMC7404335 DOI: 10.3390/ijms21145040] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/13/2020] [Accepted: 07/14/2020] [Indexed: 12/14/2022] Open
Abstract
Circulating tumor cells (CTCs) are cancer cells that detach from the primary site and travel in the blood stream. A higher number of CTCs increases the risk of breast cancer metastasis, and it is inversely associated with the survival rates of patients with breast cancer. Although the numbers of CTCs are generally low and the majority of CTCs die in circulation, the survival of a few CTCs can seed the development of a tumor at a secondary location. An increasing number of studies demonstrate that CTCs undergo modification in response to the dynamic biophysical environment in the blood due in part to fluid shear stress. Fluid shear stress generates reactive oxygen species (ROS), triggers redox-sensitive cell signaling, and alters the function of intracellular organelles. In particular, the mitochondrion is an important target organelle in determining the metastatic phenotype of CTCs. In healthy cells, mitochondria produce adenosine triphosphate (ATP) via oxidative phosphorylation in the electron transport chain, and during oxidative phosphorylation, they produce physiological levels of ROS. Mitochondria also govern death mechanisms such as apoptosis and mitochondrial permeability transition pore opening to, in order eliminate unwanted or damaged cells. However, in cancer cells, mitochondria are dysregulated, causing aberrant energy metabolism, redox homeostasis, and cell death pathways that may favor cancer invasiveness. In this review, we discuss the influence of fluid shear stress on CTCs with an emphasis on breast cancer pathology, then discuss alterations of cellular mechanisms that may increase the metastatic potentials of CTCs.
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Kudo K, Kawakado K, Kawajiri T, Nishi T, Makimoto G, Tamura T, Kuyama S, Tanimoto M. Dramatic Response of Brain Metastasis from EGFR-mutation-positive NSCLC to Dacomitinib. Intern Med 2020; 59:1739-1740. [PMID: 32296006 PMCID: PMC7434540 DOI: 10.2169/internalmedicine.4449-20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The central nervous system efficacy of dacomitinib, a key agent used in the treatment of epidermal growth factor receptor (EGFR)-mutant non-small-cell lung cancer (NSCLC), is unclear. We herein present our experience in the use of dacomitinib for the treatment of multiple brain metastatic lesions from EGFR-mutation-positive NSCLC in an elderly patient. This case report demonstrates that dacomitinib can be an essential treatment option for patients with brain metastases.
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Affiliation(s)
- Kenichiro Kudo
- Department of Respiratory Medicine, Iwakuni Clinical Center, Japan
| | - Keita Kawakado
- Department of Respiratory Medicine, Iwakuni Clinical Center, Japan
| | - Tomoka Kawajiri
- Department of Respiratory Medicine, Iwakuni Clinical Center, Japan
| | - Tatsuya Nishi
- Department of Respiratory Medicine, Iwakuni Clinical Center, Japan
| | - Go Makimoto
- Department of Respiratory Medicine, Iwakuni Clinical Center, Japan
| | - Tomoki Tamura
- Department of Respiratory Medicine, Iwakuni Clinical Center, Japan
| | - Shoichi Kuyama
- Department of Respiratory Medicine, Iwakuni Clinical Center, Japan
| | - Mitsune Tanimoto
- Department of Respiratory Medicine, Iwakuni Clinical Center, Japan
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Seiler A, Sood AK, Jenewein J, Fagundes CP. Can stress promote the pathophysiology of brain metastases? A critical review of biobehavioral mechanisms. Brain Behav Immun 2020; 87:860-880. [PMID: 31881262 DOI: 10.1016/j.bbi.2019.12.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 12/15/2019] [Accepted: 12/20/2019] [Indexed: 01/20/2023] Open
Abstract
Chronic stress can promote tumor growth and progression through immunosuppressive effects and bi-directional interactions between tumor cells and their microenvironment. β-Adrenergic receptor signaling plays a critical role in mediating stress-related effects on tumor progression. Stress-related mechanisms that modulate the dissemination of tumor cells to the brain have received scant attention. Brain metastases are highly resistant to chemotherapy and contribute considerably to morbidity and mortality in various cancers, occurring in up to 20% of patients in some cancer types. Understanding the mechanisms promoting brain metastasis could help to identify interventions that improve disease outcomes. In this review, we discuss biobehavioral, sympathetic, neuroendocrine, and immunological mechanisms by which chronic stress can impact tumor progression and metastatic dissemination to the brain. The critical role of the inflammatory tumor microenvironment in tumor progression and metastatic dissemination to the brain, and its association with stress pathways are delineated. We also discuss translational implications for biobehavioral and pharmacological interventions.
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Affiliation(s)
- Annina Seiler
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
| | - Anil K Sood
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Josef Jenewein
- Clinic Zugersee, Center for Psychiatry and Psychotherapy, Oberwil-Zug, Switzerland
| | - Christopher P Fagundes
- Department of Psychology, Rice University, Houston, TX, United States; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
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Akpe V, Kim TH, Brown CL, Cock IE. Circulating tumour cells: a broad perspective. J R Soc Interface 2020; 17:20200065. [PMCID: PMC7423436 DOI: 10.1098/rsif.2020.0065] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 07/09/2020] [Indexed: 08/13/2023] Open
Abstract
Circulating tumour cells (CTCs) have recently been identified as valuable biomarkers for diagnostic and prognostic evaluations, as well for monitoring therapeutic responses to treatments. CTCs are rare cells which may be present as one CTC surrounded by approximately 1 million white blood cells and 1 billion red blood cells per millilitre of peripheral blood. Despite the various challenges in CTC detection, considerable progress in detection methods have been documented in recent times, particularly for methodologies incorporating nanomaterial-based platforms and/or integrated microfluidics. Herein, we summarize the importance of CTCs as biological markers for tumour detection, highlight their mechanism of cellular invasion and discuss the various challenges associated with CTC research, including vulnerability, heterogeneity, phenotypicity and size differences. In addition, we describe nanomaterial agents used for electrochemistry and surface plasmon resonance applications, which have recently been used to selectively capture cancer cells and amplify signals for CTC detection. The intrinsic properties of nanomaterials have also recently been exploited to achieve photothermal destruction of cancer cells. This review describes recent advancements and future perspectives in the CTC field.
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Affiliation(s)
- Victor Akpe
- School of Environment and Science, Griffith University, Nathan Campus, Queensland 4111, Australia
- Environmental Futures Research Institute, Griffith University, Nathan Campus, Queensland 4111, Australia
| | - Tak H. Kim
- School of Environment and Science, Griffith University, Nathan Campus, Queensland 4111, Australia
- Environmental Futures Research Institute, Griffith University, Nathan Campus, Queensland 4111, Australia
| | - Christopher L. Brown
- School of Environment and Science, Griffith University, Nathan Campus, Queensland 4111, Australia
- Environmental Futures Research Institute, Griffith University, Nathan Campus, Queensland 4111, Australia
| | - Ian E. Cock
- School of Environment and Science, Griffith University, Nathan Campus, Queensland 4111, Australia
- Environmental Futures Research Institute, Griffith University, Nathan Campus, Queensland 4111, Australia
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50
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Wortman JC, He TF, Rosario A, Wang R, Schmolze D, Yuan Y, Yost SE, Li X, Levine H, Atwal G, Lee P, Yu CC. Occupancy and Fractal Dimension Analyses of the Spatial Distribution of Cytotoxic (CD8+) T Cells Infiltrating the Tumor Microenvironment in Triple Negative Breast Cancer. ACTA ACUST UNITED AC 2020. [DOI: 10.1142/s1793048020500022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Favorable outcomes have been associated with high densities of tumor infiltrating lymphocytes (TILs) such as cytotoxic ([Formula: see text]) T cells. However, the clinical significance of the spatial distribution of TILs is less well understood. We have developed novel statistical techniques to characterize the spatial distribution of TILs at various length scales. These include a box counting method that we call “occupancy” and novel applications of fractal dimensions. We apply these techniques to the spatial distribution of [Formula: see text] T cells in the tumor microenvironment of tissue resected from 35 triple negative breast cancer patients. We find that there is a distinct difference in the spatial distribution of [Formula: see text] T cells between good clinical outcome (no recurrence within at least 5 years of diagnosis) and poor clinical outcome (recurrence within 3 years of diagnosis). The statistical significance of the difference between good and poor outcome in the occupancy, fractal dimension (FD), and FD difference of [Formula: see text] T cells is comparable to that of the [Formula: see text] T cell density. Even when we randomly exclude some of the cells so that the images have the same cell density, we still find that the fractal dimension at short length scales is correlated with cancer recurrence, implying that the actual spatial distribution of [Formula: see text] cells, and not just the [Formula: see text] cell density, is associated with clinical outcome. The occupancy and FD difference indicate that the [Formula: see text] T cells are more spatially dispersed in good outcome and more aggregated in poor outcome. We discuss possible interpretations.
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Affiliation(s)
- Juliana C. Wortman
- Department of Physics and Astronomy, University of California, Irvine 92697, CA, USA
| | - Ting-Fang He
- Cancer Immunotherapeutics & Tumor Immunology, City of Hope Comprehensive Cancer Center and Beckman Research Institute, 1500 East Duarte Road, Duarte 91010, CA, USA
| | - Anthony Rosario
- Cancer Immunotherapeutics & Tumor Immunology, City of Hope Comprehensive Cancer Center and Beckman Research Institute, 1500 East Duarte Road, Duarte 91010, CA, USA
| | - Roger Wang
- Cancer Immunotherapeutics & Tumor Immunology, City of Hope Comprehensive Cancer Center and Beckman Research Institute, 1500 East Duarte Road, Duarte 91010, CA, USA
| | - Daniel Schmolze
- Department of Pathology, City of Hope Comprehensive Cancer Center and Beckman Research Institute, 1500 East Duarte Road, Duarte 91010, CA, USA
| | - Yuan Yuan
- Department of Medical Oncology and Molecular Therapeutics, City of Hope Comprehensive Cancer Center and Beckman Research Institute, 1500 East Duarte Road, Duarte 91010, CA, USA
| | - Susan E. Yost
- Department of Medical Oncology and Molecular Therapeutics, City of Hope Comprehensive Cancer Center and Beckman Research Institute, 1500 East Duarte Road, Duarte 91010, CA, USA
| | - Xuefei Li
- Department of Bioengineering and the Center for Theoretical Biological Physics, Rice University, Houston 77030, TX, USA
| | - Herbert Levine
- Department of Bioengineering and the Center for Theoretical Biological Physics, Rice University, Houston 77030, TX, USA
| | - Gurinder Atwal
- Cold Spring Harbor Laboratory, Cold Spring Harbor, NY 11724, USA
| | - Peter Lee
- Cancer Immunotherapeutics & Tumor Immunology, City of Hope Comprehensive Cancer Center and Beckman Research Institute, 1500 East Duarte Road, Duarte 91010, CA, USA
| | - Clare C. Yu
- Department of Physics and Astronomy, University of California, Irvine 92697, CA, USA
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