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Tian Z, Yao W. Chemotherapeutic drugs for soft tissue sarcomas: a review. Front Pharmacol 2023; 14:1199292. [PMID: 37637411 PMCID: PMC10450752 DOI: 10.3389/fphar.2023.1199292] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 08/03/2023] [Indexed: 08/29/2023] Open
Abstract
Despite the low incidence of soft tissue sarcomas (STSs), hundreds of thousands of new STS cases are diagnosed annually worldwide, and approximately half of them eventually progress to advanced stages. Currently, chemotherapy is the first-line treatment for advanced STSs. There are difficulties in selecting appropriate drugs for multiline chemotherapy, or for combination treatment of different STS histological subtypes. In this study, we first comprehensively reviewed the efficacy of various chemotherapeutic drugs in the treatment of STSs, and then described the current status of sensitive drugs for different STS subtypes. anthracyclines are the most important systemic treatment for advanced STSs. Ifosfamide, trabectedin, gemcitabine, taxanes, dacarbazine, and eribulin exhibit certain activities in STSs. Vinca alkaloid agents (vindesine, vinblastine, vinorelbine, vincristine) have important therapeutic effects in specific STS subtypes, such as rhabdomyosarcoma and Ewing sarcoma family tumors, whereas their activity in other subtypes is weak. Other chemotherapeutic drugs (methotrexate, cisplatin, etoposide, pemetrexed) have weak efficacy in STSs and are rarely used. It is necessary to select specific second- or above-line chemotherapeutic drugs depending on the histological subtype. This review aims to provide a reference for the selection of chemotherapeutic drugs for multi-line therapy for patients with advanced STSs who have an increasingly long survival.
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Affiliation(s)
| | - Weitao Yao
- Department of Orthopedics, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, China
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2
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Setty BA, Gikandi A, DuBois SG. Ewing Sarcoma Drug Therapy: Current Standard of Care and Emerging Agents. Paediatr Drugs 2023:10.1007/s40272-023-00568-9. [PMID: 37014523 DOI: 10.1007/s40272-023-00568-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/06/2023] [Indexed: 04/05/2023]
Abstract
Ewing sarcoma is a translocation-associated sarcoma mainly impacting adolescents and young adults. The classic translocation (EWSR1::FLI1) leads to a fusion oncoprotein that functions as an aberrant transcription factor. As such, the oncogenic driver of this disease has been difficult to target pharmacologically and, therefore, the systemic therapies used to treat patients with Ewing sarcoma have typically been non-selective cytotoxic chemotherapy agents. The current review highlights recent clinical trials from the last decade that provide the evidence base for contemporary drug therapy for patients with Ewing sarcoma, while also highlighting novel therapies under active clinical investigation in this disease. We review recent trials that have led to the establishment of interval-compressed chemotherapy as an international standard for patients with newly diagnosed localized disease. We further highlight recent trials that have shown a lack of demonstrable benefit from high-dose chemotherapy or IGF-1R inhibition for patients with newly diagnosed metastatic disease. Finally, we provide an overview of chemotherapy regimens and targeted therapies used in the management of patients with recurrent Ewing sarcoma.
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Affiliation(s)
- Bhuvana A Setty
- Division of Pediatric Hematology/Oncology/BMT, Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA
| | | | - Steven G DuBois
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA.
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3
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Pascual-Pasto G, Resa-Pares C, Castillo-Ecija H, Aschero R, Baulenas-Farres M, Vila-Ubach M, Burgueño V, Balaguer-Lluna L, Cuadrado-Vilanova M, Olaciregui NG, Martinez-Velasco N, Perez-Jaume S, de Alava E, Tirado OM, Lavarino C, Mora J, Carcaboso AM. Low Bcl-2 is a robust biomarker of sensitivity to nab-paclitaxel in Ewing sarcoma. Biochem Pharmacol 2023; 208:115408. [PMID: 36603685 DOI: 10.1016/j.bcp.2022.115408] [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: 11/10/2022] [Revised: 12/28/2022] [Accepted: 12/29/2022] [Indexed: 01/03/2023]
Abstract
Nanoparticle albumin-bound paclitaxel (nab-paclitaxel) shows potent preclinical anticancer activity in pediatric solid tumors such as Ewing sarcoma, rhabdomyosarcoma and neuroblastoma, but responses in clinical trials have been modest. In this work, we aimed to discover a rational biomarker-based approach to select the right candidate patients for this treatment. We assessed the efficacy of nab-paclitaxel in 27 patient-derived xenografts (PDX), including 14 Ewing sarcomas, five rhabdomyosarcomas and several other pediatric solid tumors. Response rate (partial or complete response) was remarkable in rhabdomyosarcomas (four of five) and Ewing sarcomas (four of 14). We addressed several predictive factors of response to nab-paclitaxel such as the expression of the secreted protein acidic and rich in cysteine (SPARC), chromosomal stability of cancer cells and expression of antiapoptotic members of the B-cell lymphoma-2 (Bcl-2) family of proteins such as Bcl-2, Bcl-xL, Bcl-W and Mcl-1. Protein (immunoblotting) and gene expression of SPARC correlated positively, while immunoblotting and immunohistochemistry expression of Bcl-2 correlated negatively with the efficacy of nab-paclitaxel in Ewing sarcoma PDX. The negative correlation of Bcl-2 immunoblotting signal and activity was especially robust (r = 0.8352; P = 0.0007; Pearson correlation). Consequently, we evaluated pharmacological strategies to inhibit Bcl-2 during nab-paclitaxel treatment. We observed that the Bcl-2 inhibitor venetoclax improved the activity of nab-paclitaxel in highly resistant Bcl-2-expressing Ewing sarcoma PDX. Overall, our results suggest that low Bcl-2 expression could be used to select patients with Ewing sarcoma sensitive to nab-paclitaxel, and Bcl-2 inhibitors could improve the activity of this drug in Bcl-2-expressing Ewing sarcoma.
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Affiliation(s)
- Guillem Pascual-Pasto
- SJD Pediatric Cancer Center Barcelona, Hospital Sant Joan de Deu, Barcelona, Spain; Institut de Recerca Sant Joan de Deu, Barcelona, Spain
| | - Claudia Resa-Pares
- SJD Pediatric Cancer Center Barcelona, Hospital Sant Joan de Deu, Barcelona, Spain; Institut de Recerca Sant Joan de Deu, Barcelona, Spain
| | - Helena Castillo-Ecija
- SJD Pediatric Cancer Center Barcelona, Hospital Sant Joan de Deu, Barcelona, Spain; Institut de Recerca Sant Joan de Deu, Barcelona, Spain
| | - Rosario Aschero
- SJD Pediatric Cancer Center Barcelona, Hospital Sant Joan de Deu, Barcelona, Spain; Institut de Recerca Sant Joan de Deu, Barcelona, Spain
| | - Merce Baulenas-Farres
- SJD Pediatric Cancer Center Barcelona, Hospital Sant Joan de Deu, Barcelona, Spain; Institut de Recerca Sant Joan de Deu, Barcelona, Spain
| | - Monica Vila-Ubach
- SJD Pediatric Cancer Center Barcelona, Hospital Sant Joan de Deu, Barcelona, Spain; Institut de Recerca Sant Joan de Deu, Barcelona, Spain
| | - Victor Burgueño
- SJD Pediatric Cancer Center Barcelona, Hospital Sant Joan de Deu, Barcelona, Spain; Institut de Recerca Sant Joan de Deu, Barcelona, Spain
| | - Leire Balaguer-Lluna
- SJD Pediatric Cancer Center Barcelona, Hospital Sant Joan de Deu, Barcelona, Spain; Institut de Recerca Sant Joan de Deu, Barcelona, Spain
| | - Maria Cuadrado-Vilanova
- SJD Pediatric Cancer Center Barcelona, Hospital Sant Joan de Deu, Barcelona, Spain; Institut de Recerca Sant Joan de Deu, Barcelona, Spain
| | - Nagore G Olaciregui
- SJD Pediatric Cancer Center Barcelona, Hospital Sant Joan de Deu, Barcelona, Spain; Institut de Recerca Sant Joan de Deu, Barcelona, Spain
| | - Nuria Martinez-Velasco
- SJD Pediatric Cancer Center Barcelona, Hospital Sant Joan de Deu, Barcelona, Spain; Institut de Recerca Sant Joan de Deu, Barcelona, Spain
| | - Sara Perez-Jaume
- SJD Pediatric Cancer Center Barcelona, Hospital Sant Joan de Deu, Barcelona, Spain; Institut de Recerca Sant Joan de Deu, Barcelona, Spain
| | - Enrique de Alava
- Institute of Biomedicine of Sevilla (IBiS), Virgen del Rocio University Hospital /CSIC/University of Sevilla/CIBERONC, 41013 Seville, Spain; Department of Normal and Pathological Cytology and Histology, School of Medicine, University of Seville, 41009 Seville, Spain
| | - Oscar M Tirado
- Sarcoma Research Group, Oncobell Program, Institut d'Investigació Biomédica de Bellvitge (IDIBELL)/CIBERONC, Barcelona, Spain
| | - Cinzia Lavarino
- SJD Pediatric Cancer Center Barcelona, Hospital Sant Joan de Deu, Barcelona, Spain; Institut de Recerca Sant Joan de Deu, Barcelona, Spain
| | - Jaume Mora
- SJD Pediatric Cancer Center Barcelona, Hospital Sant Joan de Deu, Barcelona, Spain; Institut de Recerca Sant Joan de Deu, Barcelona, Spain
| | - Angel M Carcaboso
- SJD Pediatric Cancer Center Barcelona, Hospital Sant Joan de Deu, Barcelona, Spain; Institut de Recerca Sant Joan de Deu, Barcelona, Spain.
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4
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Ewing Sarcoma Meets Epigenetics, Immunology and Nanomedicine: Moving Forward into Novel Therapeutic Strategies. Cancers (Basel) 2022; 14:cancers14215473. [PMID: 36358891 PMCID: PMC9658520 DOI: 10.3390/cancers14215473] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/25/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022] Open
Abstract
Simple Summary Ewing Sarcoma treatment is traditionally based on chemotherapy, surgery, and radiotherapy. Although these standard of care regimens are efficient at early disease stages, many patients fail to respond appropriately, which has prompted the search for more efficacious and specific treatments. A deeper understanding of the basic molecular mechanisms underlying the biology of both tumor cells and the tumor microenvironment, as well as advances in drug delivery, has led to the development of different approaches to improve the treatment in Ewing Sarcoma patients. Thus, epigenetic, and immunotherapy-based drugs, along with nanotechnology delivery strategies, represent novel preclinical and clinical studies in the treatment of Ewing Sarcoma. In this review, we provide a comprehensive overview of these emerging therapeutic strategies and summarize the potential of the latest preclinical and clinical trials in Ewing Sarcoma research. Finally, we underline the value and future directions of these new treatments. Abstract Ewing Sarcoma (EWS) is an aggressive bone and soft tissue tumor that mainly affects children, adolescents, and young adults. The standard therapy, including chemotherapy, surgery, and radiotherapy, has substantially improved the survival of EWS patients with localized disease. Unfortunately, this multimodal treatment remains elusive in clinics for those patients with recurrent or metastatic disease who have an unfavorable prognosis. Consistently, there is an urgent need to find new strategies for patients that fail to respond to standard therapies. In this regard, in the last decade, treatments targeting epigenetic dependencies in tumor cells and the immune system have emerged into the clinical scenario. Additionally, recent advances in nanomedicine provide novel delivery drug systems, which may address challenges such as side effects and toxicity. Therefore, therapeutic strategies stemming from epigenetics, immunology, and nanomedicine yield promising alternatives for treating these patients. In this review, we highlight the most relevant EWS preclinical and clinical studies in epigenetics, immunotherapy, and nanotherapy conducted in the last five years.
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Torner F, Nuñez JH, Inarejos Clemente EJ, Garraus M, Suñol M, Martínez AD, Moreno D. Total calcaneal allograft reconstruction of an Ewing's sarcoma in a child: Outcome and review of the literature. Cancer Rep (Hoboken) 2022; 5:e1626. [PMID: 35583247 PMCID: PMC9458496 DOI: 10.1002/cnr2.1626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 04/24/2022] [Accepted: 04/30/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ewing's sarcoma rarely presents in bones of the feet. Surgical management usually includes amputation. Limb sparing surgery is anecdotal. CASE We report the case of a 13-year-old boy with an Ewing sarcoma in his calcaneus who had a calcaneal reconstruction with total calcaneus allograft after induction chemotherapy. CONCLUSIONS At 42 months of follow-up our patient remains disease free and functionally intact. A review of the exceptional limb salvage procedure options for malignant calcaneus tumor was performed.
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Affiliation(s)
- Ferran Torner
- Tumor Unit, Department of Traumatology and Orthopedic Surgery, Hospital Sant Joan de Deu, Universitat De Barcelona, Barcelona, Spain
| | - Jorge H Nuñez
- Pediatric Department of Traumatology and Orthopedic Surgery, Hospital Sant Joan de Deu, Universitat De Barcelona, Barcelona, Spain.,Department of Traumatology and Orthopedic Surgery, University Hospital of Mutua Terrassa, Barcelona, Spain
| | | | - Moira Garraus
- Department of Oncology and Hematology, Hospital Sant Joan de Deu, Universitat De Barcelona, Barcelona, Spain
| | - Mariona Suñol
- Department of Pathology, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - Aníbal D Martínez
- Pediatric Department of Traumatology and Orthopedic Surgery, Hospital Sant Joan de Deu, Universitat De Barcelona, Barcelona, Spain
| | - David Moreno
- Pediatric Department of Traumatology and Orthopedic Surgery, Hospital Sant Joan de Deu, Universitat De Barcelona, Barcelona, Spain
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Koch R, Gelderblom H, Haveman L, Brichard B, Jürgens H, Cyprova S, van den Berg H, Hassenpflug W, Raciborska A, Ek T, Baumhoer D, Egerer G, Eich HT, Renard M, Hauser P, Burdach S, Bovee J, Bonar F, Reichardt P, Kruseova J, Hardes J, Kühne T, Kessler T, Collaud S, Bernkopf M, Butterfaß-Bahloul T, Dhooge C, Bauer S, Kiss J, Paulussen M, Hong A, Ranft A, Timmermann B, Rascon J, Vieth V, Kanerva J, Faldum A, Metzler M, Hartmann W, Hjorth L, Bhadri V, Dirksen U. High-Dose Treosulfan and Melphalan as Consolidation Therapy Versus Standard Therapy for High-Risk (Metastatic) Ewing Sarcoma. J Clin Oncol 2022; 40:2307-2320. [PMID: 35427190 DOI: 10.1200/jco.21.01942] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
PURPOSE Ewing 2008R3 was conducted in 12 countries and evaluated the effect of treosulfan and melphalan high-dose chemotherapy (TreoMel-HDT) followed by reinfusion of autologous hematopoietic stem cells on event-free survival (EFS) and overall survival in high-risk Ewing sarcoma (EWS). METHODS Phase III, open-label, prospective, multicenter, randomized controlled clinical trial. Eligible patients had disseminated EWS with metastases to bone and/or other sites, excluding patients with only pulmonary metastases. Patients received six cycles of vincristine, ifosfamide, doxorubicin, and etoposide induction and eight cycles of vincristine, actinomycin D, and cyclophosphamide consolidation therapy. Patients were randomly assigned to receive additional TreoMel-HDT or no further treatment (control). The random assignment was stratified by number of bone metastases (1, 2-5, and > 5). The one-sided adaptive-inverse-normal-4-stage-design was changed after the first interim analysis via Müller-Schäfer method. RESULTS Between 2009 and 2018, 109 patients were randomly assigned, and 55 received TreoMel-HDT. With a median follow-up of 3.3 years, there was no significant difference in EFS between TreoMel-HDT and control in the adaptive design (hazard ratio [HR] 0.85; 95% CI, 0.55 to 1.32, intention-to-treat). Three-year EFS was 20.9% (95% CI, 11.5 to 37.9) in TreoMel-HDT and 19.2% (95% CI, 10.8 to 34.4) in control patients. The results were similar in the per-protocol collective. Males treated with TreoMel-HDT had better EFS compared with controls: median 1.0 years (95% CI, 0.8 to 2.2) versus 0.6 years (95% CI, 0.5 to 0.9); P = .035; HR 0.52 (0.28 to 0.97). Patients age < 14 years benefited from TreoMel-HDT with a 3-years EFS of 39.3% (95% CI, 20.4 to 75.8%) versus 9% (95% CI, 2.4 to 34); P = .016; HR 0.40 (0.19 to 0.87). These effects were similar in the per-protocol collective. This observation is supported by comparable results from the nonrandomized trial EE99R3. CONCLUSION In patients with very high-risk EWS, additional TreoMel-HDT was of no benefit for the entire cohort of patients. TreoMel-HDT may be of benefit for children age < 14 years.
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Affiliation(s)
- Raphael Koch
- Institute of Biostatistics and Clinical Research, University of Muenster, Muenster, Germany
| | - Hans Gelderblom
- Department of Medical Oncology, Leiden University Medical Center, Leiden, the Netherlands
| | - Lianne Haveman
- Department of Solid Tumors, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Benedicte Brichard
- Department of Pediatric Haematology and Oncology, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Heribert Jürgens
- Department of Pediatric Hematology and Oncology, University Children's Hospital Muenster, Muenster, Germany
| | - Sona Cyprova
- Charles University, Motol Children's Hospital, Prague, Czech Republic
| | - Henk van den Berg
- Department of Pediatrics/Oncology, Emma Children's Hospital, University of Amsterdam, Amsterdam, the Netherlands
| | - Wolf Hassenpflug
- Pediatric Hematology and Oncology, University Hospital Eppendorf, Hamburg, Germany
| | - Anna Raciborska
- Department of Oncology and Surgical Oncology for Children and Youth, Mother and Child Institute, Warsaw, Poland
| | - Torben Ek
- Childhood Cancer Center, Queen Silvia Children's Hospital, Gothenburg, Sweden
| | - Daniel Baumhoer
- Bone Tumor Reference Center at the Institute of Medical Genetics and Pathology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Gerlinde Egerer
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Hans Theodor Eich
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
| | - Marleen Renard
- Pediatric Hematology and Oncology, University Hospital Leuven Gasthuisberg, Leuven Belgium
| | - Peter Hauser
- Head of the Pediatric Oncology and Transplantation Unit, Velkey László Child's Health Center, Borsod-Abaúj-Zemplén County University Teaching Hospital, Miskolc, Hungary.,2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Stefan Burdach
- Department of Pediatrics and Children's Cancer Research Center (CCRC), Technische Universität München, Munich, Germany.,British Columbia Cancer Research Centre, Vancouver, BC, Canada
| | - Judith Bovee
- Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands
| | - Fiona Bonar
- Douglass Hanly Moir Pathology, Macquarie Park, Australia
| | - Peter Reichardt
- Department of Oncology and Palliative Care, Helios Klinikum Berlin-Buch, Berlin, Germany
| | - Jarmila Kruseova
- Charles University, Motol Children's Hospital, Prague, Czech Republic
| | - Jendrik Hardes
- Clinic of Orthopedics, University Hospital Essen, West German Cancer Centre, Essen, Germany
| | - Thomas Kühne
- Department of Oncology and Hematology, University Children's Hospital Basel, Basel, Switzerland
| | - Torsten Kessler
- Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Muenster, Muenster, Germany
| | - Stephane Collaud
- Department of Thoracic Surgery, Ruhrlandklinik, University Hospital Essen, Essen, Germany
| | - Marie Bernkopf
- Department of Pediatrics, St Anna Children's Hospital and Children's Cancer Research Institute, Medical University of Vienna, Vienna, Austria
| | | | - Catharina Dhooge
- Department of Pediatric Hematology, Oncology and Hematopoietic Stem Cell Transplantation, Princess Elisabeth Children's Hospital, Ghent University, Ghent, Belgium
| | - Sebastian Bauer
- Department of Medical Oncology, Sarcoma Center, University of Duisburg-Essen, Essen, Germany.,West German Cancer Centre (WTZ) Network, Essen and Muenster, Germany
| | - János Kiss
- Department of Orthopaedics, Semmelweis University, Budapest, Hungary
| | - Michael Paulussen
- General Pediatrics, Oncology and Hematology, Vestische Kinder und Jugendklinik Datteln, Witten/Herdecke University, Datteln, Germany
| | - Angela Hong
- Chris O'Brien Lifehouse, Camperdown, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia
| | - Andreas Ranft
- West German Cancer Centre (WTZ) Network, Essen and Muenster, Germany.,Paediatrics III, University Hospital Essen, Essen, Germany.,German Consortium for Translational Cancer Research (DKTK), German Cancer Research Centre, Essen, Germany
| | - Beate Timmermann
- West German Cancer Centre (WTZ) Network, Essen and Muenster, Germany.,German Consortium for Translational Cancer Research (DKTK), German Cancer Research Centre, Essen, Germany.,Department of Particle Therapy, University Hospital Essen, West German Proton Therapy Centre Essen (WPE), Essen, Germany
| | - Jelena Rascon
- Center for Pediatric Oncology and Hematology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.,Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
| | - Volker Vieth
- Department of Clinical Radiology, Klinikum Ibbenbüren, Ibbenbüren, Germany
| | - Jukka Kanerva
- Hematology and Stem Cell Transplantation, New Children's Hospital, HUS Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Andreas Faldum
- Institute of Biostatistics and Clinical Research, University of Muenster, Muenster, Germany
| | - Markus Metzler
- Department of Pediatrics, University Hospital Erlangen, Erlangen, Germany
| | - Wolfgang Hartmann
- Division of Translational Pathology, Gerhard-Domagk-Institute of Pathology, University Hospital Muenster, Muenster, Germany
| | - Lars Hjorth
- Department of Clinical Sciences, Skåne University Hospital, Lund, Sweden
| | - Vivek Bhadri
- Department of Medical Oncology, Chris O'Brien Lifehouse, Sydney, Australia.,Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Uta Dirksen
- West German Cancer Centre (WTZ) Network, Essen and Muenster, Germany.,Paediatrics III, University Hospital Essen, Essen, Germany.,German Consortium for Translational Cancer Research (DKTK), German Cancer Research Centre, Essen, Germany
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Wang BC, Xiao BY, Lin GH. Irinotecan plus temozolomide in relapsed Ewing sarcoma: an integrated analysis of retrospective studies. BMC Cancer 2022; 22:349. [PMID: 35361149 PMCID: PMC8969362 DOI: 10.1186/s12885-022-09469-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 03/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prognosis of patients with relapsed Ewing sarcoma is poor. In this study, we aimed to pooled-analyze the efficacy and safety of the combination of irinotecan and temozolomide in treating patients with relapsed Ewing sarcoma. METHODS PubMed, Cochrane CENTRAL, Web of Science, and EMBASE were systematically searched on September 27, 2021. The primary outcomes were rates of objective response and disease control, and the secondary outcomes were toxicities. RESULTS Six retrospective studies with 184 patients were enrolled in the analysis. The median age ranged from 14 to 21. The integrated rates were 44% (95% confidence interval [CI] 31-58) for objective response and 66% (55-77) for disease control. Grade 3-4 neutropenia, thrombocytopenia, and diarrhea occurred in 8% (3-16), 7% (3-11), and 8% (5-10) of chemotherapeutic cycles, respectively. 18% (7-32) and 6% (2-11) of patients suffered grade 3-4 neutropenia and thrombocytopenia after irinotecan plus temozolomide treatment. CONCLUSION Irinotecan plus temozolomide combination chemotherapy showed antitumor activity and an acceptable safety profile in patients with relapsed Ewing sarcoma. More future prospective studies are needed to confirm the retrospective results.
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Affiliation(s)
- Bi-Cheng Wang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, China.
| | - Bo-Ya Xiao
- Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, 200438, China.,Department of Medical Psychology, Faculty of Psychology, Naval Medical University (Second Military Medical University), Shanghai, 200433, China
| | - Guo-He Lin
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, China
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8
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Castillo‐Ecija H, Pascual‐Pasto G, Perez‐Jaume S, Resa‐Pares C, Vila‐Ubach M, Monterrubio C, Jimenez‐Cabaco A, Baulenas‐Farres M, Muñoz‐Aznar O, Salvador N, Cuadrado‐Vilanova M, Olaciregui NG, Balaguer‐Lluna L, Burgueño V, Vicario FJ, Manzanares A, Castañeda A, Santa‐Maria V, Cruz O, Celis V, Morales La Madrid A, Garraus M, Gorostegui M, Vancells M, Carrasco R, Krauel L, Torner F, Suñol M, Lavarino C, Mora J, Carcaboso AM. Prognostic value of patient-derived xenograft engraftment in pediatric sarcomas. J Pathol Clin Res 2021; 7:338-349. [PMID: 33837665 PMCID: PMC8185364 DOI: 10.1002/cjp2.210] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/11/2021] [Accepted: 03/10/2021] [Indexed: 12/19/2022]
Abstract
The goals of this work were to identify factors favoring patient-derived xenograft (PDX) engraftment and study the association between PDX engraftment and prognosis in pediatric patients with Ewing sarcoma, osteosarcoma, and rhabdomyosarcoma. We used immunodeficient mice to establish 30 subcutaneous PDX from patient tumor biopsies, with a successful engraftment rate of 44%. Age greater than 12 years and relapsed disease were patient factors associated with higher engraftment rate. Tumor type and biopsy location did not associate with engraftment. PDX models retained histology markers and most chromosomal aberrations of patient samples during successive passages in mice. Model treatment with irinotecan resulted in significant activity in 20 of the PDXs and replicated the response of rhabdomyosarcoma patients. Successive generations of PDXs responded similarly to irinotecan, demonstrating functional stability of these models. Importantly, out of 68 tumor samples from 51 patients with a median follow-up of 21.2 months, PDX engraftment from newly diagnosed patients was a prognostic factor significantly associated with poor outcome (p = 0.040). This association was not significant for relapsed patients. In the subgroup of patients with newly diagnosed Ewing sarcoma classified as standard risk, we found higher risk of relapse or refractory disease associated with those samples that produced stable PDX models (p = 0.0357). Overall, our study shows that PDX engraftment predicts worse outcome in newly diagnosed pediatric sarcoma patients.
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Liu Y, Yuan Y, Zhang F, Hu K, Qiu J, Hou X, Yan J, Lian X, Sun S, Liu Z, Shen J. Outcome of multidisciplinary treatment of peripheral primitive neuroectodermal tumor. Sci Rep 2020; 10:15656. [PMID: 32973274 PMCID: PMC7519088 DOI: 10.1038/s41598-020-72680-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 09/01/2020] [Indexed: 11/26/2022] Open
Abstract
Peripheral primitive neuroectodermal tumors (PNETs) constitute very rare and aggressive malignancies. To date, there are no standard guidelines for management of peripheral PNETs due to the paucity of cases arising in various body sites. Therapeutic approach is derived from Ewing sarcoma family, which currently remains multimodal. Our study retrospectively analyzed 86 PNET patients from February 1, 1998 to February 1, 2018 at Peking Union Medical College Hospital with an additional 75 patients from review of literature. The clinicopathologic and treatment plans associated with survival was investigated. Surgery, chemotherapy, female sex, small tumor size, no lymph node metastasis, R0 surgical resection, (vincristine + doxorubicin + cyclophosphamide)/(isophosphamide + etoposide) regimen, and more than 10 cycles of chemotherapy were associated with improved overall survival in univariate analysis. Surgery, more than 10 cycles of chemotherapy, and small tumor size were independent prognostic factors for higher overall survival. Our data indicates that multimodal therapy is the mainstay therapeutic approach for peripheral PNET.
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Affiliation(s)
- Yidi Liu
- Department of Radiation Oncology, Peking Union Medical College Hospital. Chinese Academy of Medical Sciences & Peking Union Medical College, No.1 Shuaifuyuan Wangfujing, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Yan Yuan
- Department of Radiation Oncology, Peking Union Medical College Hospital. Chinese Academy of Medical Sciences & Peking Union Medical College, No.1 Shuaifuyuan Wangfujing, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Fuquan Zhang
- Department of Radiation Oncology, Peking Union Medical College Hospital. Chinese Academy of Medical Sciences & Peking Union Medical College, No.1 Shuaifuyuan Wangfujing, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Ke Hu
- Department of Radiation Oncology, Peking Union Medical College Hospital. Chinese Academy of Medical Sciences & Peking Union Medical College, No.1 Shuaifuyuan Wangfujing, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Jie Qiu
- Department of Radiation Oncology, Peking Union Medical College Hospital. Chinese Academy of Medical Sciences & Peking Union Medical College, No.1 Shuaifuyuan Wangfujing, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Xiaorong Hou
- Department of Radiation Oncology, Peking Union Medical College Hospital. Chinese Academy of Medical Sciences & Peking Union Medical College, No.1 Shuaifuyuan Wangfujing, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Junfang Yan
- Department of Radiation Oncology, Peking Union Medical College Hospital. Chinese Academy of Medical Sciences & Peking Union Medical College, No.1 Shuaifuyuan Wangfujing, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Xin Lian
- Department of Radiation Oncology, Peking Union Medical College Hospital. Chinese Academy of Medical Sciences & Peking Union Medical College, No.1 Shuaifuyuan Wangfujing, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Shuai Sun
- Department of Radiation Oncology, Peking Union Medical College Hospital. Chinese Academy of Medical Sciences & Peking Union Medical College, No.1 Shuaifuyuan Wangfujing, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Zhikai Liu
- Department of Radiation Oncology, Peking Union Medical College Hospital. Chinese Academy of Medical Sciences & Peking Union Medical College, No.1 Shuaifuyuan Wangfujing, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Jie Shen
- Department of Radiation Oncology, Peking Union Medical College Hospital. Chinese Academy of Medical Sciences & Peking Union Medical College, No.1 Shuaifuyuan Wangfujing, Dongcheng District, Beijing, 100730, People's Republic of China.
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10
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Martin‐Broto J, Hindi N, Aguiar S, Badilla‐González R, Castro‐Oliden V, Chacón M, Correa‐Generoso R, de Álava E, Donati DM, Eriksson M, Falla‐Jimenez M, German G, Gobo Silva ML, Gouin F, Gronchi A, Haro‐Varas JC, Jiménez‐Brenes N, Kasper B, Lopes de Mello CA, Maki R, Martínez‐Delgado P, Martínez‐Said H, Martinez‐Tlahuel JL, Morales‐Pérez JM, Muñoz‐Casares FC, Nakagawa SA, Ortiz‐Cruz EJ, Palmerini E, Patel S, Moura DS, Stacchiotti S, Sunyach MP, Valverde CM, Waisberg F, Blay J. Sarcoma European and Latin American Network (SELNET) Recommendations on Prioritization in Sarcoma Care During the COVID-19 Pandemic. Oncologist 2020; 25:e1562-e1573. [PMID: 32888360 PMCID: PMC7543334 DOI: 10.1634/theoncologist.2020-0516] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 08/14/2020] [Indexed: 01/12/2023] Open
Abstract
Background The COVID‐19 outbreak has resulted in collision between patients infected with SARS‐CoV‐2 and those with cancer on different fronts. Patients with cancer have been impacted by deferral, modification, and even cessation of therapy. Adaptive measures to minimize hospital exposure, following the precautionary principle, have been proposed for cancer care during COVID‐19 era. We present here a consensus on prioritizing recommendations across the continuum of sarcoma patient care. Material and Methods A total of 125 recommendations were proposed in soft‐tissue, bone, and visceral sarcoma care. Recommendations were assigned as higher or lower priority if they cannot or can be postponed at least 2–3 months, respectively. The consensus level for each recommendation was classified as “strongly recommended” (SR) if more than 90% of experts agreed, “recommended” (R) if 75%–90% of experts agreed and “no consensus” (NC) if fewer than 75% agreed. Sarcoma experts from 11 countries within the Sarcoma European‐Latin American Network (SELNET) consortium participated, including countries in the Americas and Europe. The European Society for Medical Oncology‐Magnitude of clinical benefit scale was applied to systemic‐treatment recommendations to support prioritization. Results There were 80 SRs, 35 Rs, and 10 NCs among the 125 recommendations issued and completed by 31 multidisciplinary sarcoma experts. The consensus was higher among the 75 higher‐priority recommendations (85%, 12%, and 3% for SR, R, and NC, respectively) than in the 50 lower‐priority recommendations (32%, 52%, and 16% for SR, R, and NC, respectively). Conclusion The consensus on 115 of 125 recommendations indicates a high‐level of convergence among experts. The SELNET consensus provides a tool for sarcoma multidisciplinary treatment committees during the COVID‐19 outbreak. Implications for Practice The Sarcoma European‐Latin American Network (SELNET) consensus on sarcoma prioritization care during the COVID‐19 era issued 125 pragmatical recommendations distributed as higher or lower priority to protect critical decisions on sarcoma care during the COVID‐19 pandemic. A multidisciplinary team from 11 countries reached consensus on 115 recommendations. The consensus was lower among lower‐priority recommendations, which shows reticence to postpone actions even in indolent tumors. The European Society for Medical Oncology‐Magnitude of Clinical Benefit scale was applied as support for prioritizing systemic treatment. Consensus on 115 of 125 recommendations indicates a high level of convergence among experts. The SELNET consensus provides a practice tool for guidance in the decisions of sarcoma multidisciplinary treatment committees during the COVID‐19 outbreak. The COVID‐19 pandemic has caused deferral, modification, or cessation of treatment for patients with cancer. This article presents a consensus on prioritizing recommendations across the continuum of sarcoma patient care.
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Affiliation(s)
- Javier Martin‐Broto
- Group of Advanced Therapies and Biomarkers in Sarcoma, Institute of Biomedicine of Seville (IBIS, HUVR, CSIC, Universidad de Sevilla)SevillaSpain
- Department of Medical Oncology, University Hospital Virgen del RocioSevilleSpain
| | - Nadia Hindi
- Group of Advanced Therapies and Biomarkers in Sarcoma, Institute of Biomedicine of Seville (IBIS, HUVR, CSIC, Universidad de Sevilla)SevillaSpain
- Department of Medical Oncology, University Hospital Virgen del RocioSevilleSpain
| | - Samuel Aguiar
- Department of Pelvic Surgery, A.C. Camargo Cancer CenterSão PauloBrazil
| | | | - Victor Castro‐Oliden
- Department of Medical Oncology, Instituto Nacional de Enfermedades NeoplásicasLimaPeru
| | - Matias Chacón
- Department of Medical Oncology, Alexander Fleming Cancer InstituteBuenos AiresArgentina
| | | | - Enrique de Álava
- Pathology Department, University Hospital Virgen del RocíoSevilleSpain
- CIBERONCMadridSpain
- Department of Normal and Pathological Cytology and Histology, School of Medicine, University of SevilleSevilleSpain
| | - Davide María Donati
- Unit of Orthopedic Pathology and Osteoarticular Tissue Regeneration, Rizzoli Orthopedic InstituteBolognaItaly
| | - Mikael Eriksson
- Department of Medical Oncology, Skane University Hospital‐LundLundSweden
| | - Martin Falla‐Jimenez
- Department of Breast and Soft Tissues Surgery, Instituto Nacional de Enfermedades NeoplásicasLimaPeru
| | - Gisela German
- Department of Medical Oncology, Hospital Oncológico ProvincialCórdobaArgentina
| | | | - Francois Gouin
- Department of Orthopedic Surgery, Centre León BérardLyonFrance
| | - Alessandro Gronchi
- Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori and University of MilanMilanItaly
| | | | | | - Bernd Kasper
- Department of Medical Oncology, Mannheim University Medical CenterMannheimGermany
| | | | - Robert Maki
- Department of Medical Oncology, Abramson Cancer Center, University of Pennsylvania Perelman School of MedicinePhiladelphiaPennsylvaniaUSA
| | - Paula Martínez‐Delgado
- Group of Advanced Therapies and Biomarkers in Sarcoma, Institute of Biomedicine of Seville (IBIS, HUVR, CSIC, Universidad de Sevilla)SevillaSpain
| | - Hector Martínez‐Said
- Department of Medical Oncology, Instituto Nacional de CancerologíaMexico CityMexico
| | | | | | | | - Suely A. Nakagawa
- Department of Orthopedics, A.C. Camargo Cancer CenterSão PauloBrazil
| | | | - Emanuela Palmerini
- Department of Medical Oncology, Rizzoli Orthopedic InstituteBolognaItaly
| | - Shreyaskumar Patel
- Department of Melanoma Medical Oncology, University of Texas M. D. Anderson Cancer CenterHoustonTexasUSA
| | - David S. Moura
- Group of Advanced Therapies and Biomarkers in Sarcoma, Institute of Biomedicine of Seville (IBIS, HUVR, CSIC, Universidad de Sevilla)SevillaSpain
| | - Silvia Stacchiotti
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori and University of MilanMilanItaly
| | | | | | - Federico Waisberg
- Department of Medical Oncology, Alexander Fleming Cancer InstituteBuenos AiresArgentina
| | - Jean‐Yves Blay
- Department of Medical Oncology, Centre León BérardLyonFrance
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11
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Oesterheld JE, Reed DR, Setty BA, Isakoff MS, Thompson P, Yin H, Hayashi M, Loeb DM, Smith T, Makanji R, Fridley BL, Wagner LM. Phase II trial of gemcitabine and nab-paclitaxel in patients with recurrent Ewing sarcoma: A report from the National Pediatric Cancer Foundation. Pediatr Blood Cancer 2020; 67:e28370. [PMID: 32386107 PMCID: PMC7771264 DOI: 10.1002/pbc.28370] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/02/2020] [Accepted: 04/13/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND The combination of gemcitabine and docetaxel is often used to treat patients with recurrent sarcoma. Nab-paclitaxel is a taxane modified to improve drug exposure and increase intratumoral accumulation and, in combination with gemcitabine, is standard therapy for pancreatic cancer. Applying the dosages and schedule used for pancreatic cancer, we performed a phase II trial to assess the response rate of gemcitabine and nab-paclitaxel in patients with relapsed Ewing sarcoma. PROCEDURE Using a Simon's two-stage design to identify a response rate of ≥ 35%, patients received nab-paclitaxel 125 mg/m2 followed by gemcitabine 1000 mg/m2 i.v. on days 1, 8, and 15 of four-week cycles. Immunohistochemical analysis of archival tissue was performed to identify possible biomarkers of response. RESULTS Eleven patients from four institutions enrolled, with a median age of 22 years (range, 14-27). Patients were heavily pretreated (median 3 prior regimens, range, 1-7). Thirty-five cycles were administered (median 2, range, 1-8). Accrual was stopped after 11 patients, due to only one confirmed partial response. Two other patients had partial responses after two cycles, but withdrew because of adverse effects or progression before confirmation of continued response. The predominant toxicity was myelosuppression, and four (36%) patients were removed due to hematologic toxicity despite pegfilgrastim and dose reductions. Expression of secreted protein, acidic and rich in cysteine (SPARC) and CAV-1 in archival tumors was not predictive of clinical benefit in this small cohort of patients. CONCLUSIONS In patients with heavily pretreated Ewing sarcoma, the confirmed response rate of 9% was similar to multi-institutional studies of gemcitabine and docetaxel.
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Affiliation(s)
- Javier E. Oesterheld
- Department of Pediatric Hematology, Oncology, Bone Marrow Transplantation, and Palliative Care, Levine Children’s Hospital at Atrium Health, Charlotte, North Carolina
| | - Damon R. Reed
- Department of Interdisciplinary Cancer Management, Moffitt Cancer Center Adolescent and Young Adult Program, Tampa, Florida
| | - Bhuvana A. Setty
- Division of Pediatric Hematology, Oncology and Bone Marrow Transplantation, Nationwide Children’s Hospital, Columbus, Ohio
| | - Michael S. Isakoff
- Center for Cancer and Blood Disorders, Connecticut Children’s Medical Center, Hartford, Connecticut
| | - Patrick Thompson
- Division of Pediatric Hematology-Oncology, University of North Carolina Health Care, Chapel Hill, North Carolina
| | - Hong Yin
- Department of Pathology, Children’s Healthcare of Atlanta, Atlanta, Georgia
| | - Masanori Hayashi
- Department of Pediatrics Hematology-Oncology and Bone Marrow Transplant, Children’s Hospital Colorado, Aurora, Colorado
| | - David M. Loeb
- Department of Pediatrics and Department of Developmental and Molecular Biology, Albert Einstein College of Medicine, New York City, New York
| | - Tiffany Smith
- National Pediatric Cancer Foundation, Tampa, Florida
| | - Rikesh Makanji
- Department of Diagnostic Imaging and Interventional Radiology, Moffitt Cancer Center, Tampa, Florida
| | - Brooke L. Fridley
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, Florida
| | - Lars M. Wagner
- Division of Pediatric Hematology-Oncology, Duke Children’s Hospital and Health Center, Durham, North Carolina
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12
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Castillo-Ecija H, Monterrubio C, Pascual-Pasto G, Gomez-Gonzalez S, Garcia-Dominguez DJ, Hontecillas-Prieto L, Resa-Pares C, Burgueño V, Paco S, Olaciregui NG, Vila-Ubach M, Restrepo-Perdomo C, Cuadrado-Vilanova M, Balaguer-Lluna L, Perez-Jaume S, Castañeda A, Santa-Maria V, Roldan M, Suñol M, de Alava E, Mora J, Lavarino C, Carcaboso AM. Treatment-driven selection of chemoresistant Ewing sarcoma tumors with limited drug distribution. J Control Release 2020; 324:440-449. [PMID: 32497782 DOI: 10.1016/j.jconrel.2020.05.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 04/21/2020] [Accepted: 05/20/2020] [Indexed: 12/18/2022]
Abstract
Ewing sarcoma is a bone and soft tissue tumor predominantly affecting adolescents and young adults. To characterize changes in anticancer drug activity and intratumor drug distribution during the evolution of Ewing sarcomas, we used immunodeficient mice to establish pairs of patient-derived xenografts (PDX) at early (initial diagnosis) and late (relapse or refractory progression) stages of the disease from three patients. Analysis of copy number alterations (CNA) in early passage PDX tissues showed that two tumor pairs established from patients which responded initially to therapy and relapsed more than one year later displayed similar CNAs at early and late stages. For these two patients, PDX established from late tumors were more resistant to chemotherapy (irinotecan) than early counterparts. In contrast, the tumor pair established at refractory progression showed highly dissimilar CNA profiles, and the pattern of response to chemotherapy was discordant with those of relapsed cases. In mice receiving irinotecan infusions, the level of SN-38 (active metabolite of irinotecan) in the intracellular tumor compartment was reduced in tumors at later stages compared to earlier tumors for those pairs bearing similar CNAs, suggesting that distribution of anticancer drug shifted toward the extracellular compartment during clonal tumor evolution. Overexpression of the drug transporter P-glycoprotein in late tumor was likely responsible for this shift in drug distribution in one of the cases.
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Affiliation(s)
- Helena Castillo-Ecija
- Institut de Recerca Sant Joan de Deu, Barcelona 08950, Spain; Pediatric Hematology and Oncology, Hospital Sant Joan de Deu, Barcelona 08950, Spain
| | - Carles Monterrubio
- Institut de Recerca Sant Joan de Deu, Barcelona 08950, Spain; Pediatric Hematology and Oncology, Hospital Sant Joan de Deu, Barcelona 08950, Spain
| | - Guillem Pascual-Pasto
- Institut de Recerca Sant Joan de Deu, Barcelona 08950, Spain; Pediatric Hematology and Oncology, Hospital Sant Joan de Deu, Barcelona 08950, Spain
| | - Soledad Gomez-Gonzalez
- Institut de Recerca Sant Joan de Deu, Barcelona 08950, Spain; Pediatric Hematology and Oncology, Hospital Sant Joan de Deu, Barcelona 08950, Spain
| | - Daniel J Garcia-Dominguez
- Institute of Biomedicine of Sevilla (IBiS), Virgen del Rocio University Hospital/CSIC/University of Sevilla/CIBERONC, Seville 41013, Spain
| | - Lourdes Hontecillas-Prieto
- Institute of Biomedicine of Sevilla (IBiS), Virgen del Rocio University Hospital/CSIC/University of Sevilla/CIBERONC, Seville 41013, Spain
| | - Claudia Resa-Pares
- Institut de Recerca Sant Joan de Deu, Barcelona 08950, Spain; Pediatric Hematology and Oncology, Hospital Sant Joan de Deu, Barcelona 08950, Spain
| | - Victor Burgueño
- Institut de Recerca Sant Joan de Deu, Barcelona 08950, Spain; Pediatric Hematology and Oncology, Hospital Sant Joan de Deu, Barcelona 08950, Spain
| | - Sonia Paco
- Institut de Recerca Sant Joan de Deu, Barcelona 08950, Spain; Pediatric Hematology and Oncology, Hospital Sant Joan de Deu, Barcelona 08950, Spain
| | - Nagore G Olaciregui
- Institut de Recerca Sant Joan de Deu, Barcelona 08950, Spain; Pediatric Hematology and Oncology, Hospital Sant Joan de Deu, Barcelona 08950, Spain
| | - Monica Vila-Ubach
- Institut de Recerca Sant Joan de Deu, Barcelona 08950, Spain; Pediatric Hematology and Oncology, Hospital Sant Joan de Deu, Barcelona 08950, Spain
| | - Camilo Restrepo-Perdomo
- Institut de Recerca Sant Joan de Deu, Barcelona 08950, Spain; Pathology, Hospital Sant Joan de Deu, Barcelona 08950, Spain
| | - Maria Cuadrado-Vilanova
- Institut de Recerca Sant Joan de Deu, Barcelona 08950, Spain; Pediatric Hematology and Oncology, Hospital Sant Joan de Deu, Barcelona 08950, Spain
| | - Leire Balaguer-Lluna
- Institut de Recerca Sant Joan de Deu, Barcelona 08950, Spain; Pediatric Hematology and Oncology, Hospital Sant Joan de Deu, Barcelona 08950, Spain
| | - Sara Perez-Jaume
- Institut de Recerca Sant Joan de Deu, Barcelona 08950, Spain; Pediatric Hematology and Oncology, Hospital Sant Joan de Deu, Barcelona 08950, Spain
| | - Alicia Castañeda
- Institut de Recerca Sant Joan de Deu, Barcelona 08950, Spain; Pediatric Hematology and Oncology, Hospital Sant Joan de Deu, Barcelona 08950, Spain
| | - Vicente Santa-Maria
- Institut de Recerca Sant Joan de Deu, Barcelona 08950, Spain; Pediatric Hematology and Oncology, Hospital Sant Joan de Deu, Barcelona 08950, Spain
| | - Monica Roldan
- Institut de Recerca Sant Joan de Deu, Barcelona 08950, Spain; Pathology, Hospital Sant Joan de Deu, Barcelona 08950, Spain; Confocal Microscopy Unit, Institut Pediàtric de Malalties Rares (IPER), Hospital Sant Joan de Déu, Barcelona 08950, Spain
| | - Mariona Suñol
- Institut de Recerca Sant Joan de Deu, Barcelona 08950, Spain; Pathology, Hospital Sant Joan de Deu, Barcelona 08950, Spain
| | - Enrique de Alava
- Institute of Biomedicine of Sevilla (IBiS), Virgen del Rocio University Hospital/CSIC/University of Sevilla/CIBERONC, Seville 41013, Spain; Department of Normal and Pathological Cytology and Histology, School of Medicine, University of Seville, Seville 41009, Spain
| | - Jaume Mora
- Institut de Recerca Sant Joan de Deu, Barcelona 08950, Spain; Pediatric Hematology and Oncology, Hospital Sant Joan de Deu, Barcelona 08950, Spain
| | - Cinzia Lavarino
- Institut de Recerca Sant Joan de Deu, Barcelona 08950, Spain; Pediatric Hematology and Oncology, Hospital Sant Joan de Deu, Barcelona 08950, Spain
| | - Angel M Carcaboso
- Institut de Recerca Sant Joan de Deu, Barcelona 08950, Spain; Pediatric Hematology and Oncology, Hospital Sant Joan de Deu, Barcelona 08950, Spain.
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13
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Chen J, Cheng R, Fan F, Zheng Y, Li Y, Chen Y, Wang Y. Cranial Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumors: A Retrospective Study Focused on Prognostic Factors and Long-Term Outcomes. Front Oncol 2019; 9:1023. [PMID: 31649882 PMCID: PMC6794714 DOI: 10.3389/fonc.2019.01023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 09/23/2019] [Indexed: 12/04/2022] Open
Abstract
Purpose: Cranial Ewing sarcoma (ES)/peripheral primitive neuroectodermal tumors (pPNETs) are rarely reported because of their extremely low incidence, and the current understanding of these tumors is poor. The purpose of this study was to illustrate the clinical, radiological, and pathological features of cranial ES/pPNETs and to discuss prognostic factors by survival analysis. Methods: A total of 31 patients who were pathologically diagnosed with cranial ES/pPNETs between 2000 and 2019 were enrolled in this study. To identify which parameters were associated with higher progression-free survival (PFS) and overall survival (OS) rates, univariate and multivariate analyses were performed. Results: The mean follow-up period was 24.8 months (range, 1–109 months). Eighteen (58.1%) patients had local recurrence and seven (22.6%) patients had distant metastasis. The results of the univariate analysis suggest that the extent of resection and adjuvant radiotherapy are potential prognostic factors for PFS and OS. Adjuvant chemotherapy was associated with OS (P = 0.027) but not with PFS (P = 0.053). The multivariate analysis revealed that the extent of resection and adjuvant radiotherapy were independent prognostic factors for both PFS and OS. In addition, metastasis was an adverse prognostic factor for OS. Conclusions: Surgical management plays a crucial role in the treatment of cranial ES/pPNETs, and gross total resection should be striven for whenever possible. Post-operative radiotherapy is highly recommended to improve PFS and OS. This study also confirms that metastasis is an adverse prognostic factor for cranial ES/pPNETs.
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Affiliation(s)
- Jun Chen
- Department of Neurosurgery, Xianning Center Hospital, Xianning, China
| | - Ruimin Cheng
- Department of Dermatology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Fanfan Fan
- Department of Neurosurgery, Tongji Medical School, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Yifeng Zheng
- Department of Neurosurgery, Tongji Medical School, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Yakun Li
- Department of Neurosurgery, Tongji Medical School, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Yong Chen
- Department of Neurosurgery, Tongji Medical School, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Wang
- Department of Neurosurgery, Tongji Medical School, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
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14
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Lee DY, Staddon AP, Shabason JE, Sebro R. Phase I and phase II clinical trials in sarcoma: Implications for drug discovery and development. Cancer Med 2019; 8:585-592. [PMID: 30632291 PMCID: PMC6382713 DOI: 10.1002/cam4.1958] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 12/06/2018] [Accepted: 12/10/2018] [Indexed: 02/06/2023] Open
Abstract
Background There has been limited progress in the development of novel therapeutics for the treatment of sarcomas. A review of phase I and II clinical trials for sarcomas may give insight into factors influencing sarcoma drug development. Methods An exhaustive analysis of phase I and II clinical trials testing drugs for human sarcoma patients between 1 January 2000 and 1 June 2018 was performed using the PubMed search engine, the Thomson Web of Science, and the National Clinical Trials registry. Recorded outcomes included tested drugs, tested histological subtypes, whether the drug was initially developed for sarcoma, reported funding sources, and whether studies led to phase III trials. Results Out of 238 studies meeting inclusion criteria, 87% (207 studies) reported funding sources. Of these, 59.9% (124/207) reported industry funding, 52.7% (109/207) reported government funding, and 27.5% (57/207) reported private funding. Only 5% (12/238) of phase I and II trials resulted in phase III trials, with 11 of 12 studies funded by industry. Approximately 90% (214/238) of studies tested drugs that were not initially tested in sarcoma, and 60.1% (143/238) of studies grouped different sarcoma histological subtypes together in the same study. Conclusion Industry has funded the majority of phase I and II sarcoma clinical trials that have led to phase III trials. There was a high rate of drugs approved for other cancers and then secondarily tested in sarcoma. Most trials tended to group different sarcoma subtypes rather than studying each subtype separately.
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Affiliation(s)
- Daniel Y Lee
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Arthur P Staddon
- Pennsylvania Hematology Oncology at Pennsylvania Hospital, Philadelphia, Pennsylvania
| | - Jacob E Shabason
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ronnie Sebro
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Genetics, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania
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