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Vajapeyam S, Brown D, Ziaei A, Wu S, Vezina G, Stern J, Panigrahy A, Patay Z, Tamrazi B, Jones J, Haque S, Enterline D, Cha S, Jones B, Yeom K, Onar-Thomas A, Dunkel I, Fouladi M, Fangusaro J, Poussaint T. ADC Histogram Analysis of Pediatric Low-Grade Glioma Treated with Selumetinib: A Report from the Pediatric Brain Tumor Consortium. AJNR Am J Neuroradiol 2022; 43:455-461. [PMID: 35210278 PMCID: PMC8910799 DOI: 10.3174/ajnr.a7433] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 01/01/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND PURPOSE Selumetinib is a promising MAP (mitogen-activated protein) kinase (MEK) 1/2 inhibitor treatment for pediatric low-grade gliomas. We hypothesized that MR imaging-derived ADC histogram metrics would be associated with survival and response to treatment with selumetinib. MATERIALS AND METHODS Children with recurrent, refractory, or progressive pediatric low-grade gliomas who had World Health Organization grade I pilocytic astrocytoma with KIAA1549-BRAF fusion or the BRAF V600E mutation (stratum 1), neurofibromatosis type 1-associated pediatric low-grade gliomas (stratum 3), or sporadic non-neurofibromatosis type 1 optic pathway and hypothalamic glioma (OPHG) (stratum 4) were treated with selumetinib for up to 2 years. Quantitative ADC histogram metrics were analyzed for total and enhancing tumor volumes at baseline and during treatment. RESULTS Each stratum comprised 25 patients. Stratum 1 responders showed lower values of SD of baseline ADC_total as well as a larger decrease with time on treatment in ADC_total mean, mode, and median compared with nonresponders. Stratum 3 responders showed a greater longitudinal decrease in ADC_total. In stratum 4, higher baseline ADC_total skewness and kurtosis were associated with shorter progression-free survival. When all 3 strata were combined, responders showed a greater decrease with time in ADC_total mode and median. Compared with sporadic OPHG, neurofibromatosis type 1-associated OPHG had lower values of ADC_total mean, mode, and median as well as ADC_enhancement mean and median and higher values of ADC_total skewness and kurtosis at baseline. The longitudinal decrease in ADC_total median during treatment was significantly greater in sporadic OPHG compared with neurofibromatosis type 1-associated OPHG. CONCLUSIONS ADC histogram metrics are associated with progression-free survival and response to treatment with selumetinib in pediatric low-grade gliomas.
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Affiliation(s)
- S. Vajapeyam
- From the Department of Radiology (S.V., T.Y.P.), Boston Children’s Hospital,Harvard Medical School, Boston, Massachusetts
| | - D. Brown
- Department of Radiology (D.B.), Massachusetts General Hospital, Boston, Massachusetts
| | - A. Ziaei
- Department of Radiology (A.Z.), Boston Children’s Hospital, Boston, Massachusetts
| | - S. Wu
- Department of Biostatistics (S.W., A.O.-T.), St Jude Children’s Research Hospital, Memphis, Tennessee
| | - G. Vezina
- Department of Radiology (G.V.), Children’s National Medical Center, Washington, DC
| | - J.S. Stern
- Department of Radiology (J.S.S.), Ann and Robert H Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | - A. Panigrahy
- Department of Radiology (A.P.), Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Z. Patay
- Department of Diagnostic Imaging (Z.P.), St Jude Children’s Research Hospital, Memphis, Tennessee
| | - B. Tamrazi
- Department of Radiology (B.T.), Children’s Hospital Los Angeles, Los Angeles, California
| | - J.Y. Jones
- Department of Radiology (J.Y.J., M.F.), Nationwide Children’s Hospital, Columbus, Ohio
| | - S.S. Haque
- Department of Radiology (S.S.H., I.J.D.), Memorial Sloan Kettering Cancer Center, New York, New York
| | - D.S. Enterline
- Department of Radiology (D.S.E.), Duke University School of Medicine, Durham, North Carolina
| | - S. Cha
- Department of Radiology (S.C.), University of California San Francisco, San Francisco, California
| | - B.V. Jones
- Department of Radiology (B.V.J.), Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - K.W. Yeom
- Department of Radiology (K.W.Y.), Stanford University School of Medicine, Stanford, California
| | - A. Onar-Thomas
- Department of Biostatistics (S.W., A.O.-T.), St Jude Children’s Research Hospital, Memphis, Tennessee
| | - I.J. Dunkel
- Department of Radiology (S.S.H., I.J.D.), Memorial Sloan Kettering Cancer Center, New York, New York
| | - M. Fouladi
- Department of Radiology (J.Y.J., M.F.), Nationwide Children’s Hospital, Columbus, Ohio
| | - J.R. Fangusaro
- Department of Hematology, Oncology, and Stem Cell Transplantation (J.R.F.), Children’s Healthcare of Atlanta and Emory University, Atlanta, Georgia
| | - T.Y. Poussaint
- From the Department of Radiology (S.V., T.Y.P.), Boston Children’s Hospital,Harvard Medical School, Boston, Massachusetts
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Landers SM, Bhalla AD, Ma X, Lusby K, Ingram D, Al Sannaa G, Wang WL, Lazar AJ, Torres KE. AXL Inhibition Enhances MEK Inhibitor Sensitivity in Malignant Peripheral Nerve Sheath Tumors. ACTA ACUST UNITED AC 2020; 4:511-525. [PMID: 33283192 PMCID: PMC7717506 DOI: 10.26502/jcsct.5079091] [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] [Indexed: 11/24/2022]
Abstract
Dysregulation of the receptor tyrosine kinase AXL is known to promote cancer cell growth and survival in many sarcomas, including the rare subtype, malignant peripheral nerve sheath tumors (MPNST). MPNSTs are largely chemoresistant and carry a poor prognosis. AXL is an attractive potential therapeutic target, as it is aberrantly expressed, and its activation may be an early event in MPNST. However, the effect of AXL inhibition on MPNST development and progression is not known. Here, we investigated the role of AXL in MPNST development and the effects of AXL and MEK1/2 co-inhibition on MPNSTs. We used western blotting to examine AXL expression and activation in MPNST cell lines. We analyzed the effects of exogenous growth arrest-specific 6 (GAS6) expression on downstream signaling and the proliferation, migration, and invasion of MPNST cells. The effect of AXL knockdown with or without mitogen-activated protein kinase (MAPK) inhibition on downstream signal transduction and tumorigenesis was also examined in vivo and in vitro. We found that AXL knockdown increased MAPK pathway signaling. This compensation, in turn, abrogated the antitumorigenic effects linked to AXL knockdown in vivo. AXL knockdown, combined with pharmacological MEK inhibition, reduced the proliferation and increased the apoptosis of MPNST cells both in vitro and in vivo. The pharmacological co-inhibition of AXL and MEK1/2 reduced MPNST volumes. Together these findings suggest that AXL inhibition enhances the sensitivity of MPNST to other small molecule inhibitors. We conclude that combination therapy with AXL inhibitor may be a therapeutic option for MPNST.
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Affiliation(s)
- Sharon M. Landers
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Angela D. Bhalla
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - XiaoYan Ma
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Kristelle Lusby
- Department of Surgery, Division of Plastic Surgery, Indianapolis University School of Medicine, Indianapolis, IN, USA
| | - Davis Ingram
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ghadah Al Sannaa
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston TX, USA
| | - Wei-Lien Wang
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Alexander J. Lazar
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Keila E. Torres
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Corresponding Author: Dr. Keila E. Torres, Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA, Tel: (713) 792-4242;
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Vaske OM, Bjork I, Salama SR, Beale H, Tayi Shah A, Sanders L, Pfeil J, Lam DL, Learned K, Durbin A, Kephart ET, Currie R, Newton Y, Swatloski T, McColl D, Vivian J, Zhu J, Lee AG, Leung SG, Spillinger A, Liu HY, Liang WS, Byron SA, Berens ME, Resnick AC, Lacayo N, Spunt SL, Rangaswami A, Huynh V, Torno L, Plant A, Kirov I, Zabokrtsky KB, Rassekh SR, Deyell RJ, Laskin J, Marra MA, Sender LS, Mueller S, Sweet-Cordero EA, Goldstein TC, Haussler D. Comparative Tumor RNA Sequencing Analysis for Difficult-to-Treat Pediatric and Young Adult Patients With Cancer. JAMA Netw Open 2019; 2:e1913968. [PMID: 31651965 PMCID: PMC6822083 DOI: 10.1001/jamanetworkopen.2019.13968] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
IMPORTANCE Pediatric cancers are epigenetic diseases; therefore, considering tumor gene expression information is necessary for a complete understanding of the tumorigenic processes. OBJECTIVE To evaluate the feasibility and utility of incorporating comparative gene expression information into the precision medicine framework for difficult-to-treat pediatric and young adult patients with cancer. DESIGN, SETTING, AND PARTICIPANTS This cohort study was conducted as a consortium between the University of California, Santa Cruz (UCSC) Treehouse Childhood Cancer Initiative and clinical genomic trials. RNA sequencing (RNA-Seq) data were obtained from the following 4 clinical sites and analyzed at UCSC: British Columbia Children's Hospital (n = 31), Lucile Packard Children's Hospital at Stanford University (n = 80), CHOC Children's Hospital and Hyundai Cancer Institute (n = 46), and the Pacific Pediatric Neuro-Oncology Consortium (n = 24). The study dates were January 1, 2016, to March 22, 2017. EXPOSURES Participants underwent tumor RNA-Seq profiling as part of 4 separate clinical trials at partner hospitals. The UCSC either downloaded RNA-Seq data from a partner institution for analysis in the cloud or provided a Docker pipeline that performed the same analysis at a partner institution. The UCSC then compared each participant's tumor RNA-Seq profile with more than 11 000 uniformly analyzed tumor profiles from pediatric and young adult patients with cancer, downloaded from public data repositories. These comparisons were used to identify genes and pathways that are significantly overexpressed in each patient's tumor. Results of the UCSC analysis were presented to clinical partners. MAIN OUTCOMES AND MEASURES Feasibility of a third-party institution (UCSC Treehouse Childhood Cancer Initiative) to obtain tumor RNA-Seq data from patients, conduct comparative analysis, and present analysis results to clinicians; and proportion of patients for whom comparative tumor gene expression analysis provided useful clinical and biological information. RESULTS Among 144 samples from children and young adults (median age at diagnosis, 9 years; range, 0-26 years; 72 of 118 [61.0%] male [26 patients sex unknown]) with a relapsed, refractory, or rare cancer treated on precision medicine protocols, RNA-Seq-derived gene expression was potentially useful for 99 of 144 samples (68.8%) compared with DNA mutation information that was potentially useful for only 34 of 74 samples (45.9%). CONCLUSIONS AND RELEVANCE This study's findings suggest that tumor RNA-Seq comparisons may be feasible and highlight the potential clinical utility of incorporating such comparisons into the clinical genomic interpretation framework for difficult-to-treat pediatric and young adult patients with cancer. The study also highlights for the first time to date the potential clinical utility of harmonized publicly available genomic data sets.
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Affiliation(s)
- Olena M. Vaske
- Department of Molecular, Cell, and Developmental Biology, University of California, Santa Cruz
- University of California, Santa Cruz Genomics Institute, Santa Cruz
| | - Isabel Bjork
- University of California, Santa Cruz Genomics Institute, Santa Cruz
| | - Sofie R. Salama
- University of California, Santa Cruz Genomics Institute, Santa Cruz
- Howard Hughes Medical Institute, University of California, Santa Cruz
| | - Holly Beale
- Department of Molecular, Cell, and Developmental Biology, University of California, Santa Cruz
- University of California, Santa Cruz Genomics Institute, Santa Cruz
| | - Avanthi Tayi Shah
- Division of Hematology and Oncology, Department of Pediatrics, University of California, San Francisco
| | - Lauren Sanders
- University of California, Santa Cruz Genomics Institute, Santa Cruz
| | - Jacob Pfeil
- University of California, Santa Cruz Genomics Institute, Santa Cruz
| | - Du L. Lam
- University of California, Santa Cruz Genomics Institute, Santa Cruz
| | - Katrina Learned
- University of California, Santa Cruz Genomics Institute, Santa Cruz
| | - Ann Durbin
- University of California, Santa Cruz Genomics Institute, Santa Cruz
| | - Ellen T. Kephart
- University of California, Santa Cruz Genomics Institute, Santa Cruz
| | - Rob Currie
- University of California, Santa Cruz Genomics Institute, Santa Cruz
| | - Yulia Newton
- University of California, Santa Cruz Genomics Institute, Santa Cruz
| | - Teresa Swatloski
- University of California, Santa Cruz Genomics Institute, Santa Cruz
| | - Duncan McColl
- University of California, Santa Cruz Genomics Institute, Santa Cruz
| | - John Vivian
- University of California, Santa Cruz Genomics Institute, Santa Cruz
| | - Jingchun Zhu
- University of California, Santa Cruz Genomics Institute, Santa Cruz
| | - Alex G. Lee
- Division of Hematology and Oncology, Department of Pediatrics, University of California, San Francisco
| | - Stanley G. Leung
- Division of Hematology and Oncology, Department of Pediatrics, University of California, San Francisco
| | - Aviv Spillinger
- Division of Hematology and Oncology, Department of Pediatrics, University of California, San Francisco
| | - Heng-Yi Liu
- Division of Hematology and Oncology, Department of Pediatrics, University of California, San Francisco
| | - Winnie S. Liang
- Integrated Cancer Genomics Division, Translational Genomics Research Institute (TGen), Phoenix, Arizona
| | - Sara A. Byron
- Integrated Cancer Genomics Division, Translational Genomics Research Institute (TGen), Phoenix, Arizona
| | | | - Adam C. Resnick
- Center for Data Driven Discovery in Biomedicine, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Norman Lacayo
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
| | - Sheri L. Spunt
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
| | - Arun Rangaswami
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
| | - Van Huynh
- CHOC Children’s Hospital, Hyundai Cancer Institute, Orange, California
| | - Lilibeth Torno
- CHOC Children’s Hospital, Hyundai Cancer Institute, Orange, California
| | - Ashley Plant
- CHOC Children’s Hospital, Hyundai Cancer Institute, Orange, California
| | - Ivan Kirov
- CHOC Children’s Hospital, Hyundai Cancer Institute, Orange, California
| | | | - S. Rod Rassekh
- British Columbia Children’s Hospital Research Institute, British Columbia Children’s Hospital, Vancouver, British Columbia, Canada
| | - Rebecca J. Deyell
- British Columbia Children’s Hospital Research Institute, British Columbia Children’s Hospital, Vancouver, British Columbia, Canada
| | | | - Marco A. Marra
- Canada’s Michael Smith Genome Sciences Centre, BC Cancer, Vancouver, British Columbia, Canada
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Leonard S. Sender
- CHOC Children’s Hospital, Hyundai Cancer Institute, Orange, California
| | - Sabine Mueller
- Department of Neurology, University of California, San Francisco
- Department of Neurosurgery, University of California, San Francisco
- Department of Pediatrics, University of California, San Francisco
| | | | - Theodore C. Goldstein
- University of California, Santa Cruz Genomics Institute, Santa Cruz
- Now with Anthem, Inc, Palo Alto, California
| | - David Haussler
- University of California, Santa Cruz Genomics Institute, Santa Cruz
- Howard Hughes Medical Institute, University of California, Santa Cruz
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Zúñiga-Cerón LF, Saavedra-Torres JS, Zamora-Bastidas TO, Pinzón-Fernández MV. Gliosarcoma in a young patient with neurofibromatosis type 1. Case report. CASE REPORTS 2018. [DOI: 10.15446/cr.v4n2.68234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introducción. La neurofibromatosis tipo 1 (NF1) es una condición autosómica dominante que presenta una expresividad fenotípica variable, con manifestaciones que van desde lesiones cutáneas hasta compromiso funcional. Se manifiesta clínicamente durante la infancia y la adolescencia; su gen codifica una proteína, la neurofibromina, que actúa como un supresor tumoral en condiciones normales regulando, a su vez, otra proteína que estimula el crecimiento y proliferación celular. En caso de alteración se podrían presentar diferentes procesos tumorales como el que se evidencia en un reducido número de casos. Presentación de caso. Paciente masculino de 20 años con NF1, quien presentaba lesiones cutáneas como manchas color café con leche y desarrolló un glioblastoma, lo cual sucede de manera infrecuente. Discusión. Para obtener el diagnóstico confirmado se incluyen métodos de inmunohistoquímica que contribuyen en gran medida al pronóstico puesto que la mediana de supervivencia global de los pacientes de glioblastoma es mayor en pacientes con NF1 que aquellos sin dicha entidad patológica. Conclusión. El diagnóstico temprano de las lesiones favorece un manejo a tiempo de la NF1. Estos pacientes requieren un manejo integral e interdisciplinar para favorecer su rehabilitación total.
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Effector T cell subclasses associate with tumor burden in neurofibromatosis type 1 patients. Cancer Immunol Immunother 2016; 65:1113-21. [PMID: 27448806 PMCID: PMC4995232 DOI: 10.1007/s00262-016-1871-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 07/13/2016] [Indexed: 11/23/2022]
Abstract
Neurofibromatosis type 1 (NF1) is a hereditary tumor syndrome caused by mutations of the NF1 gene and resulting dysregulation of the Ras-pathway. In addition to peripheral nerve tumors, affected tissues include the musculoskeletal and cardiovascular system. The immune system has recently been suggested as a possible modulator NF1-related phenotypes. Therefore, we determined the immune phenotype in NF1 patients and investigated its relationship with the phenotypic severity of NF1-related tumor manifestations. We quantified global leukocytes and lymphocyte subpopulations of peripheral blood from 37 NF1 patients and 21 healthy controls by flow cytometry. To associate immune phenotype with tumor phenotype, all NF1 patients underwent whole-body magnetic resonance imaging and total internal tumor volume was calculated. The immunophenotypes were compared among four NF1 groups with different total internal tumor burdens and between NF1 patients and non-NF1 subjects. We found that NF1 patients show a generalized lymphopenia. Closer analysis revealed that the CD8+/CD27− and CD8+/CD57+ effector T cell fractions strongly increase in NF1 patients with low tumor load and decrease to levels below control in patients with high tumor load. Moreover, increased production of IL2, IFN-γ and TNF-α was found in T cells of NF1 patients upon phorbol-12-myristate acetate (PMA) stimulation compared to healthy controls. The data indicate that decreasing CD8+/CD57+ and CD27− T cell fractions correspond to increasing tumor load in NF1 patients, potentially making these populations useful marker for internal tumor burden.
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Shin DW, Sohn MJ, Kim HS, Lee DJ, Jeon SR, Hwang YJ, Jho EH. Clinical analysis of spinal stereotactic radiosurgery in the treatment of neurogenic tumors. J Neurosurg Spine 2015; 23:429-37. [DOI: 10.3171/2015.1.spine14910] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECT
In this study the authors sought to evaluate clinical outcomes after using stereotactic radiosurgery (SRS) to treat benign and malignant spinal neurogenic tumors.
METHODS
The authors reviewed a total of 66 procedures of spinal SRS performed between 2001 and 2013 for 110 tumors in 58 patients with spinal neurogenic tumors, which included schwannomas, neurofibromas, and malignant peripheral nerve sheath tumors (MPNSTs). The clinical and radiological findings were evaluated in patients with benign neurogenic tumors. For the 4 patients with MPNSTs, the authors reported overall survival and results of additional immunohistochemical staining to predict the survival difference among the patients.
RESULTS
Of the 92 benign neurogenic tumors, 65 tumors that were serially followed up using MRI after SRS showed significant change in mean tumor volume, from a mean of 12.0 ± 2.6 cm3 pre-SRS to 10.8 ± 2.5 cm3 post-SRS (p = 0.027), over an average of 44 months. The local control rate of benign neurogenic tumors was 95.4%. The 34 patients who presented with clinical symptoms of pain showed a significant symptomatic improvement. The initial mean visual analog scale (VAS) score was 6.0 and decreased dramatically to 1.0 after SRS during an average follow-up period of 10.9 months (median of 8.1 months). Although the proportions of transient swelling and loss of intramural enhancement were significantly different among the groups, there was no statistically significant correlation between those 2 factors and local tumor control (p = 0.253 and 0.067, respectively; Fisher’s exact text). Cross-table analysis also indicated that there was no statistically significant relationship between groups with loss of intramural enhancement and transient swelling. The median survival of neurofibromatosis Type 1 (NF1)-related and sporadic MPNSTs was 1.13 and 5.8 years, respectively. Immunohistochemical results showed that S100 was expressed in a sporadic MPNST or neurofibroma, whereas topoisomerase-IIa was expressed in NF1-related MPNSTs.
CONCLUSIONS
SRS is an effective treatment modality for benign neurogenic tumors, while MPNSTs showed heterogeneity in their responses to SRS.
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Affiliation(s)
| | | | | | | | - Sang Ryong Jeon
- 2Department of Neurosurgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul; and
| | - Yoon Joon Hwang
- 4Radiology, Inje University IIsan Paik Hospital, College of Medicine, Goyang
| | - Eek-Hoon Jho
- 5Department of Life Science, The University of Seoul, Korea
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Park SJ, Sawitzki B, Kluwe L, Mautner VF, Holtkamp N, Kurtz A. Serum biomarkers for neurofibromatosis type 1 and early detection of malignant peripheral nerve-sheath tumors. BMC Med 2013; 11:109. [PMID: 23618374 PMCID: PMC3648455 DOI: 10.1186/1741-7015-11-109] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Accepted: 03/08/2013] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Neurofibromatosis type 1 (NF1) is a hereditary tumor syndrome characterized by the development of benign nerve-sheath tumors, which transform to malignant peripheral nerve-sheath tumors (MPNST) in about 8 to 13% of patients with NF1. MPNST are invasive sarcomas with extremely poor prognosis, and their development may correlate with internal tumor load of patients with NF1. Because early identification of patients with NF1 at risk for developing MPNST should improve their clinical outcome, the aim of this study was to identify serum biomarkers for tumor progression in NF1, and to analyze their correlation with tumor type and internal tumor load. METHODS We selected candidate biomarkers for NF1 by manually mining published data sources, and conducted a systematic screen of 56 candidate serum biomarkers using customized antibody arrays. Serum from 104 patients with NF1 with and without MPNST, and from 41 healthy control subjects, was analyzed. Statistical analysis was performed using the non-parametric Mann-Whitney U-test, followed by Bonferroni correction. RESULTS Our analysis identified four markers (epidermal growth factor receptor, interferon-γ, interleukin-6, and tumor necrosis factor-α) for which significantly different serum concentrations were seen in patients with NF1 compared with healthy controls. Two markers (insulin-like growth factor binding protein 1 (IGFBP1) and regulated upon activation, normal T-cell expressed and secreted (RANTES)) showed significantly higher concentrations in patients with NF1 and MPNST compared with patients with NF1 without MPNST. A correlation with internal tumor load was found for IGFBP1. CONCLUSION Our study identified two serum markers with potential for early detection of patients with NF1 at risk for developing MPNST, and four markers that could distinguish between patients with NF1 and healthy subjects. Such markers may be useful as diagnostic tools to support the diagnosis of NF1 and for timely identification of MPNST. Moreover, the data suggest that there is a systemic increase in inflammatory cytokines independently of tumor load in patients with NF1.
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Affiliation(s)
- Su-Jin Park
- Berlin-Brandenburg Center for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, Berlin, 13353, Germany
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Pasmant E, Masliah-Planchon J, Lévy P, Laurendeau I, Ortonne N, Parfait B, Valeyrie-Allanore L, Leroy K, Wolkenstein P, Vidaud M, Vidaud D, Bièche I. Identification of genes potentially involved in the increased risk of malignancy in NF1-microdeleted patients. Mol Med 2010; 17:79-87. [PMID: 20844836 DOI: 10.2119/molmed.2010.00079] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2010] [Accepted: 09/07/2010] [Indexed: 11/06/2022] Open
Abstract
Patients with NF1 microdeletion develop more neurofibromas at a younger age, and have an increased risk of malignant peripheral nerve sheath tumors (MPNSTs). We postulated that the increased risk of malignancy could be due to inactivation, in addition to NF1, of a second tumor suppressor gene located in the typical 1.4-Mb microdeletion found in most of the microdeleted patients. We investigated the expression of NF1, the other 16 protein-coding genes and the 2 microRNAs located in the 1.4-Mb microdeletion by means of real-time quantitative reverse-transcription polymerase chain reaction (RT-PCR) in a large series of human dermal and plexiform neurofibromas and MPNSTs. Five genes were significantly upregulated: OMG and SUZ12 in plexiform neurofibromas and ATAD5, EVI2A and C17orf79 in MPNSTs. More interestingly, two genes were significantly downregulated (RNF135 and CENTA2) in tumor Schwann cells from MPNST biopsies and in MPNST cell lines. This study points to the involvement of several genes (particularly RNF135 and CENTA2) in the increased risk of malignancy observed in NF1-microdeleted patients.
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Affiliation(s)
- Eric Pasmant
- Université Paris Descartes, Faculté des Sciences Pharmaceutiques et Biologiques, Paris, France.
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9
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Miller SJ, Jessen WJ, Mehta T, Hardiman A, Sites E, Kaiser S, Jegga AG, Li H, Upadhyaya M, Giovannini M, Muir D, Wallace MR, Lopez E, Serra E, Nielsen GP, Lazaro C, Stemmer-Rachamimov A, Page G, Aronow BJ, Ratner N. Integrative genomic analyses of neurofibromatosis tumours identify SOX9 as a biomarker and survival gene. EMBO Mol Med 2010; 1:236-48. [PMID: 20049725 PMCID: PMC3378132 DOI: 10.1002/emmm.200900027] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Understanding the biological pathways critical for common neurofibromatosis type 1 (NF1) peripheral nerve tumours is essential, as there is a lack of tumour biomarkers, prognostic factors and therapeutics. We used gene expression profiling to define transcriptional changes between primary normal Schwann cells (n = 10), NF1-derived primary benign neurofibroma Schwann cells (NFSCs) (n = 22), malignant peripheral nerve sheath tumour (MPNST) cell lines (n = 13), benign neurofibromas (NF) (n = 26) and MPNST (n = 6). Dermal and plexiform NFs were indistinguishable. A prominent theme in the analysis was aberrant differentiation. NFs repressed gene programs normally active in Schwann cell precursors and immature Schwann cells. MPNST signatures strongly differed; genes up-regulated in sarcomas were significantly enriched for genes activated in neural crest cells. We validated the differential expression of 82 genes including the neural crest transcription factor SOX9 and SOX9 predicted targets. SOX9 immunoreactivity was robust in NF and MPSNT tissue sections and targeting SOX9 – strongly expressed in NF1-related tumours – caused MPNST cell death. SOX9 is a biomarker of NF and MPNST, and possibly a therapeutic target in NF1.
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Affiliation(s)
- Shyra J Miller
- Division of Experimental Hematology, Cincinnati Children's Hospital, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Differential expression of CCN1/CYR61, CCN3/NOV, CCN4/WISP1, and CCN5/WISP2 in neurofibromatosis type 1 tumorigenesis. J Neuropathol Exp Neurol 2010; 69:60-9. [PMID: 20010302 DOI: 10.1097/nen.0b013e3181c79bff] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The hallmark of neurofibromatosis type 1 is the development of dermal and plexiform neurofibromas. Neurofibromatosis type 1 patients with plexiform neurofibromas are at risk of developing malignant peripheral nerve sheath tumors. We applied a 22,000-oligonucleotide microarray transcriptomic approach to a series of plexiform neurofibromas in comparison with dermal neurofibromas, and results were confirmed with real-time quantitative reverse transcription-polymerase chain reaction. Thirteen genes were upregulated and 10 were downregulated in plexiform neurofibromas. The upregulated genes mainly encode molecules involved in cell adhesion, extracellular matrix, fibrogenesis, and angiogenesis. Several CCN gene family members were dysregulated in neurofibromatosis type 1 tumorigenesis; the angiogenic gene CCN1/CYR61 was specifically upregulated in the plexiform neurofibromas; CCN4/WISP1 was upregulated, and CCN3/NOV and CCN5/WISP2 were downregulated in paired comparisons of plexiform neurofibroma and malignant peripheral nerve sheath tumor from the same patients. CCN1 and CCN3 proteins were detected by immunohistochemistry in neurofibromatosis type 1-associated tumors. Upregulation of S100A8, S100A9, and CD36 was also observed and suggests a role of this pathway in inflammation-associated genesis of plexiform neurofibromas. In summary, a limited number of pathways are potentially involved in plexiform neurofibroma development. Some of the genes identified, particularly CCN1, might be useful diagnostic or prognostic markers or form the basis for novel therapeutic strategies.
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Weiswald LB, Richon S, Validire P, Briffod M, Lai-Kuen R, Cordelières FP, Bertrand F, Dargere D, Massonnet G, Marangoni E, Gayet B, Pocard M, Bieche I, Poupon MF, Bellet D, Dangles-Marie V. Newly characterised ex vivo colospheres as a three-dimensional colon cancer cell model of tumour aggressiveness. Br J Cancer 2009; 101:473-82. [PMID: 19603013 PMCID: PMC2720229 DOI: 10.1038/sj.bjc.6605173] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: New models continue to be required to improve our understanding of colorectal cancer progression. To this aim, we characterised in this study a three-dimensional multicellular tumour model that we named colospheres, directly obtained from mechanically dissociated colonic primary tumours and correlated with metastatic potential. Methods: Colorectal primary tumours (n=203) and 120 paired non-tumoral colon mucosa were mechanically disaggregated into small fragments for short-term cultures. Features of tumours producing colospheres were analysed. Further characterisation was performed using colospheres, generated from a human colon cancer xenograft, and spheroids, formed on agarose by the paired cancer cell lines. Results: Colospheres, exclusively formed by viable cancer cells, were obtained in only 1 day from 98 tumours (47%). Inversely, non-tumoral colonic mucosa never generated colospheres. Colosphere-forming capacity was statistically significantly associated with tumour aggressiveness, according to AJCC stage analysis. Despite a close morphology, colospheres displayed higher invasivity than did spheroids. Spheroids and colospheres migrated into Matrigel but matrix metalloproteinase (MMP)-2 and MMP-9 activity was detected only in colospheres. Mouse subrenal capsule assay revealed the unique tumorigenic and metastatic phenotype of colospheres. Moreover, colospheres and parental xenograft reproduced similar CD44 and CD133 expressions in which CD44+ cells represented a minority subset of the CD133+ population. Conclusion: The present colospheres provide an ex vivo three-dimensional model, potentially useful for studying metastatic process.
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Affiliation(s)
- L-B Weiswald
- IFR71 Sciences du Médicament, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris Descartes, 4 avenue de l'Observatoire, F-75006 Paris, France
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Puget S, Grill J, Valent A, Bieche I, Dantas-Barbosa C, Kauffmann A, Dessen P, Lacroix L, Geoerger B, Job B, Dirven C, Varlet P, Peyre M, Dirks PB, Sainte-Rose C, Vassal G. Candidate Genes on Chromosome 9q33-34 Involved in the Progression of Childhood Ependymomas. J Clin Oncol 2009; 27:1884-92. [DOI: 10.1200/jco.2007.15.4195] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose The molecular pathogenesis of pediatric ependymoma remains unclear. Our study was designed to identify genetic changes implicated in ependymoma progression. Patients and Methods We characterized 59 ependymoma samples (33 at diagnosis and 26 at relapse) using array-comparative genomic hybridization (aCGH). Specific chromosomal imbalances were confirmed by fluorescent in situ hybridization, and candidate genes were assessed by real-time quantitative polymerase chain reaction (qPCR), immunohistochemistry, sequencing, and in vitro functional studies. Results aCGH analysis revealed a significant increase in genomic imbalances on relapse compared with diagnosis, such as gain of 9qter and 1q (54% v 21% and 12% v 0%, respectively) and loss of 6q (27% v 6%). Supervised tumor classification showed that gain of 9qter was associated with tumor recurrence, age older than 3 years, and posterior fossa location. Using a candidate-gene strategy, we found an overexpression of two potential oncogenes at the locus 9qter: Tenascin-C and Notch1. Moreover, Notch pathway analysis (qPCR) revealed overexpression of Notch ligands, receptors, and target genes (Hes-1, Hey2, and c-Myc), and downregulation of Notch repressor Fbxw7. We confirmed by immunohistochemistry the overexpression of Tenascin-C and Hes-1. We detected Notch1 missense mutations in 8.3% of the tumors (only in the posterior fossa location and in case of 9q33-34 gain). Furthermore, inhibition of Notch pathway with a γ-secretase inhibitor impaired the growth of ependymoma stem cell cultures. Conclusion The activation of the Notch pathway and Tenascin-C seem to be important events in ependymoma progression and may represent future targets for therapy. We report, to our knowledge for the first time, recurrent oncogenic mutations in pediatric posterior fossa ependymomas.
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Affiliation(s)
- Stéphanie Puget
- From the Department of Neurosurgery, Hôpital Necker Enfants Malades, Université Paris Descartes; Department of Pediatric Oncology; Centre National de la Recherche Scientifique – Formation de Recherche en Evolution 2939; Unité Propre de Recherche de I'Enseignement Supérieur Equipe d'Accueil 3535; Laboratory of Translational Research, Institut Gustave Roussy, Villejuif; INSERM (L'Institut National de la Santé et de la Recherche Médicale) U745; Department of Pathology, Hôpital Sainte-Anne, Université Paris
| | - Jacques Grill
- From the Department of Neurosurgery, Hôpital Necker Enfants Malades, Université Paris Descartes; Department of Pediatric Oncology; Centre National de la Recherche Scientifique – Formation de Recherche en Evolution 2939; Unité Propre de Recherche de I'Enseignement Supérieur Equipe d'Accueil 3535; Laboratory of Translational Research, Institut Gustave Roussy, Villejuif; INSERM (L'Institut National de la Santé et de la Recherche Médicale) U745; Department of Pathology, Hôpital Sainte-Anne, Université Paris
| | - Alexander Valent
- From the Department of Neurosurgery, Hôpital Necker Enfants Malades, Université Paris Descartes; Department of Pediatric Oncology; Centre National de la Recherche Scientifique – Formation de Recherche en Evolution 2939; Unité Propre de Recherche de I'Enseignement Supérieur Equipe d'Accueil 3535; Laboratory of Translational Research, Institut Gustave Roussy, Villejuif; INSERM (L'Institut National de la Santé et de la Recherche Médicale) U745; Department of Pathology, Hôpital Sainte-Anne, Université Paris
| | - Ivan Bieche
- From the Department of Neurosurgery, Hôpital Necker Enfants Malades, Université Paris Descartes; Department of Pediatric Oncology; Centre National de la Recherche Scientifique – Formation de Recherche en Evolution 2939; Unité Propre de Recherche de I'Enseignement Supérieur Equipe d'Accueil 3535; Laboratory of Translational Research, Institut Gustave Roussy, Villejuif; INSERM (L'Institut National de la Santé et de la Recherche Médicale) U745; Department of Pathology, Hôpital Sainte-Anne, Université Paris
| | - Carmela Dantas-Barbosa
- From the Department of Neurosurgery, Hôpital Necker Enfants Malades, Université Paris Descartes; Department of Pediatric Oncology; Centre National de la Recherche Scientifique – Formation de Recherche en Evolution 2939; Unité Propre de Recherche de I'Enseignement Supérieur Equipe d'Accueil 3535; Laboratory of Translational Research, Institut Gustave Roussy, Villejuif; INSERM (L'Institut National de la Santé et de la Recherche Médicale) U745; Department of Pathology, Hôpital Sainte-Anne, Université Paris
| | - Audrey Kauffmann
- From the Department of Neurosurgery, Hôpital Necker Enfants Malades, Université Paris Descartes; Department of Pediatric Oncology; Centre National de la Recherche Scientifique – Formation de Recherche en Evolution 2939; Unité Propre de Recherche de I'Enseignement Supérieur Equipe d'Accueil 3535; Laboratory of Translational Research, Institut Gustave Roussy, Villejuif; INSERM (L'Institut National de la Santé et de la Recherche Médicale) U745; Department of Pathology, Hôpital Sainte-Anne, Université Paris
| | - Philippe Dessen
- From the Department of Neurosurgery, Hôpital Necker Enfants Malades, Université Paris Descartes; Department of Pediatric Oncology; Centre National de la Recherche Scientifique – Formation de Recherche en Evolution 2939; Unité Propre de Recherche de I'Enseignement Supérieur Equipe d'Accueil 3535; Laboratory of Translational Research, Institut Gustave Roussy, Villejuif; INSERM (L'Institut National de la Santé et de la Recherche Médicale) U745; Department of Pathology, Hôpital Sainte-Anne, Université Paris
| | - Ludovic Lacroix
- From the Department of Neurosurgery, Hôpital Necker Enfants Malades, Université Paris Descartes; Department of Pediatric Oncology; Centre National de la Recherche Scientifique – Formation de Recherche en Evolution 2939; Unité Propre de Recherche de I'Enseignement Supérieur Equipe d'Accueil 3535; Laboratory of Translational Research, Institut Gustave Roussy, Villejuif; INSERM (L'Institut National de la Santé et de la Recherche Médicale) U745; Department of Pathology, Hôpital Sainte-Anne, Université Paris
| | - Birgit Geoerger
- From the Department of Neurosurgery, Hôpital Necker Enfants Malades, Université Paris Descartes; Department of Pediatric Oncology; Centre National de la Recherche Scientifique – Formation de Recherche en Evolution 2939; Unité Propre de Recherche de I'Enseignement Supérieur Equipe d'Accueil 3535; Laboratory of Translational Research, Institut Gustave Roussy, Villejuif; INSERM (L'Institut National de la Santé et de la Recherche Médicale) U745; Department of Pathology, Hôpital Sainte-Anne, Université Paris
| | - Bastien Job
- From the Department of Neurosurgery, Hôpital Necker Enfants Malades, Université Paris Descartes; Department of Pediatric Oncology; Centre National de la Recherche Scientifique – Formation de Recherche en Evolution 2939; Unité Propre de Recherche de I'Enseignement Supérieur Equipe d'Accueil 3535; Laboratory of Translational Research, Institut Gustave Roussy, Villejuif; INSERM (L'Institut National de la Santé et de la Recherche Médicale) U745; Department of Pathology, Hôpital Sainte-Anne, Université Paris
| | - Clemens Dirven
- From the Department of Neurosurgery, Hôpital Necker Enfants Malades, Université Paris Descartes; Department of Pediatric Oncology; Centre National de la Recherche Scientifique – Formation de Recherche en Evolution 2939; Unité Propre de Recherche de I'Enseignement Supérieur Equipe d'Accueil 3535; Laboratory of Translational Research, Institut Gustave Roussy, Villejuif; INSERM (L'Institut National de la Santé et de la Recherche Médicale) U745; Department of Pathology, Hôpital Sainte-Anne, Université Paris
| | - Pascale Varlet
- From the Department of Neurosurgery, Hôpital Necker Enfants Malades, Université Paris Descartes; Department of Pediatric Oncology; Centre National de la Recherche Scientifique – Formation de Recherche en Evolution 2939; Unité Propre de Recherche de I'Enseignement Supérieur Equipe d'Accueil 3535; Laboratory of Translational Research, Institut Gustave Roussy, Villejuif; INSERM (L'Institut National de la Santé et de la Recherche Médicale) U745; Department of Pathology, Hôpital Sainte-Anne, Université Paris
| | - Mathieu Peyre
- From the Department of Neurosurgery, Hôpital Necker Enfants Malades, Université Paris Descartes; Department of Pediatric Oncology; Centre National de la Recherche Scientifique – Formation de Recherche en Evolution 2939; Unité Propre de Recherche de I'Enseignement Supérieur Equipe d'Accueil 3535; Laboratory of Translational Research, Institut Gustave Roussy, Villejuif; INSERM (L'Institut National de la Santé et de la Recherche Médicale) U745; Department of Pathology, Hôpital Sainte-Anne, Université Paris
| | - Peter B. Dirks
- From the Department of Neurosurgery, Hôpital Necker Enfants Malades, Université Paris Descartes; Department of Pediatric Oncology; Centre National de la Recherche Scientifique – Formation de Recherche en Evolution 2939; Unité Propre de Recherche de I'Enseignement Supérieur Equipe d'Accueil 3535; Laboratory of Translational Research, Institut Gustave Roussy, Villejuif; INSERM (L'Institut National de la Santé et de la Recherche Médicale) U745; Department of Pathology, Hôpital Sainte-Anne, Université Paris
| | - Christian Sainte-Rose
- From the Department of Neurosurgery, Hôpital Necker Enfants Malades, Université Paris Descartes; Department of Pediatric Oncology; Centre National de la Recherche Scientifique – Formation de Recherche en Evolution 2939; Unité Propre de Recherche de I'Enseignement Supérieur Equipe d'Accueil 3535; Laboratory of Translational Research, Institut Gustave Roussy, Villejuif; INSERM (L'Institut National de la Santé et de la Recherche Médicale) U745; Department of Pathology, Hôpital Sainte-Anne, Université Paris
| | - Gilles Vassal
- From the Department of Neurosurgery, Hôpital Necker Enfants Malades, Université Paris Descartes; Department of Pediatric Oncology; Centre National de la Recherche Scientifique – Formation de Recherche en Evolution 2939; Unité Propre de Recherche de I'Enseignement Supérieur Equipe d'Accueil 3535; Laboratory of Translational Research, Institut Gustave Roussy, Villejuif; INSERM (L'Institut National de la Santé et de la Recherche Médicale) U745; Department of Pathology, Hôpital Sainte-Anne, Université Paris
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Ambrosini G, Cheema HS, Seelman S, Teed A, Sambol EB, Singer S, Schwartz GK. Sorafenib inhibits growth and mitogen-activated protein kinase signaling in malignant peripheral nerve sheath cells. Mol Cancer Ther 2008; 7:890-6. [PMID: 18413802 DOI: 10.1158/1535-7163.mct-07-0518] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Malignant peripheral nerve sheath tumors (MPNST) are soft-tissue tumors with a very poor prognosis and largely resistant to chemotherapy. MPNSTs are characterized by activation of the Ras pathway by loss of tumor suppressor neurofibromatosis type 1. In view of this, MPNST may be susceptible to inhibition of the activated Ras/Raf/mitogen-activated protein kinase pathway by the B-Raf inhibitor sorafenib. MPNST (MPNST and ST8814) and dedifferentiated liposarcoma (LS141 and DDLS) human tumor cell lines were characterized for Ras activation and B-Raf expression. Tumor cells were treated with sorafenib and examined for growth inhibition, inhibition of phospho-MEK, phospho-ERK, cell cycle arrest, and changes in cyclin D1 and pRb expression. MPNSTs were sensitive to sorafenib at nanomolar concentrations. This appeared to be due to inhibition of phospho-MEK, phospho-ERK, suppression of cyclin D1, and hypophosphorylation of pRb at the CDK4-specific sites, resulting in a G(1) cell cycle arrest. These effects were not seen in the liposarcoma cells, which either did not express B-Raf or showed decreased Ras activation. Small interfering RNA-mediated depletion of B-Raf in MPNSTs also induced a G(1) cell cycle arrest in these cells, with a marked inhibition of cyclin D1 expression and Rb phosphorylation, whereas depletion of C-Raf did not affect either. With growth inhibition at the low nanomolar range, sorafenib, by inhibiting the mitogen-activated protein kinase pathway, may prove to be a novel therapy for patients with MPNST.
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Affiliation(s)
- Grazia Ambrosini
- Laboratory of New Drug Development, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA
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Reuss DE, Deimling AV. Biomarkers for malignant peripheral nerve sheath tumours. ACTA ACUST UNITED AC 2008; 2:801-11. [DOI: 10.1517/17530059.2.7.801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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[Molecular approach of MPNSTs in neurofibromatosis type 1: towards the identification of diagnostic and prognostic markers]. Arch Pediatr 2008; 15:809-11. [PMID: 18582760 DOI: 10.1016/s0929-693x(08)71921-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Valeyrie-Allanore L, Ortonne N, Lantieri L, Ferkal S, Wechsler J, Bagot M, Wolkenstein P. Histopathologically dysplastic neurofibromas in neurofibromatosis 1: diagnostic criteria, prevalence and clinical significance. Br J Dermatol 2008; 158:1008-12. [PMID: 18363759 DOI: 10.1111/j.1365-2133.2008.08494.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Malignant peripheral nerve sheath tumours (MPNSTs) correspond to the most frequent and aggressive neoplasic complications associated with poor prognosis in neurofibromatosis 1. OBJECTIVES To define the dysplastic neurofibroma potentially at risk of transformation and evaluate its prevalence and incidence. METHODS According to our database, we retrospectively included, between 1 March 2000 and 31 August 2004, all patients who had subcutaneous and/or plexiform neurofibromas removed surgically. Tumour specimens were systematically reviewed; dysplastic neurofibroma was defined by the association of high cellularity and the presence of atypical cells. Clinically atypical and histopathologically dysplastic neurofibromas were analysed using Fisher's exact test. In addition, three high-grade MPNSTs were analysed retrospectively for the presence of associated histopathologically dysplastic neurofibroma. RESULTS Among the 89 plexiform and/or subcutaneous neurofibromas surgically removed, high cellularity and cytonuclear atypia were observed in 19% and 17% of cases, respectively. Both criteria were associated in 8.9% of cases (n=8); Mib-1 immunostaining was negative in all cases (n=7). In univariate analysis, only neurological symptoms were significantly associated with dysplasia (P=0.02). Interestingly, dysplastic neurofibroma areas could be identified within or at the periphery of two MPNSTs. CONCLUSIONS The association of hypercellularity and cytonuclear atypia could be considered as a potential histological prognostic factor of transformation leading to increased surveillance.
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Affiliation(s)
- L Valeyrie-Allanore
- Department of Dermatology, National Neurofibromatosis Centre, Paris XII University, Henri-Mondor Hospital, AP-HP, F-94010 Créteil Cedex, France.
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Mantripragada KK, Spurlock G, Kluwe L, Chuzhanova N, Ferner RE, Frayling IM, Dumanski JP, Guha A, Mautner V, Upadhyaya M. High-Resolution DNA Copy Number Profiling of Malignant Peripheral Nerve Sheath Tumors Using Targeted Microarray-Based Comparative Genomic Hybridization. Clin Cancer Res 2008; 14:1015-24. [DOI: 10.1158/1078-0432.ccr-07-1305] [Citation(s) in RCA: 99] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Holtkamp N, Atallah I, Okuducu AF, Mucha J, Hartmann C, Mautner VF, Friedrich RE, Mawrin C, von Deimling A. MMP-13 and p53 in the progression of malignant peripheral nerve sheath tumors. Neoplasia 2007; 9:671-7. [PMID: 17786186 PMCID: PMC1950437 DOI: 10.1593/neo.07304] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2007] [Revised: 06/19/2007] [Accepted: 06/20/2007] [Indexed: 01/01/2023] Open
Abstract
Malignant peripheral nerve sheath tumors (MPNST) are sarcomas with poor prognosis and limited treatment options. Factors contributing to tumor progression are largely unknown. We therefore examined MPNST from 22 neurofibromatosis type 1 (NF1) patients, 14 non-NF1 patients, and 14 neurofibroma patients for matrix metalloproteinase 13 (MMP-13) expression. Because wild-type and mutant p53 were shown to differentially regulate MMP-13 expression, TP53 status and protein levels were also determined. MMP-13 expression was detected in 58% of MPNST and was significantly associated with recurrent MPNST (P = .019). p53 was observed in 78% of MPNST and was found to be strongly associated with MMP-13 expression (P = .005). In contrast, 14 neurofibromas lacked MMP-13 and p53 expressions. TP53 mutations were found in only 11% of MPNST and were associated with high tumor grades (P = .029). No significant association between mutant TP53 and MMP-13 was observed, indicating that other factors drive MMP-13 expression in MPNST. The presence of metastasis was linked to p53Pro(72) polymorphism (P = .041) and shorter survival. In summary, our data suggest that MMP-13 expression in nerve sheath tumors is coupled with malignant progression. Therefore, MMP-13 may serve as a marker for progression and as a therapeutic target.
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Affiliation(s)
- Nikola Holtkamp
- Institute of Neuropathology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
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Lévy P, Ripoche H, Laurendeau I, Lazar V, Ortonne N, Parfait B, Leroy K, Wechsler J, Salmon I, Wolkenstein P, Dessen P, Vidaud M, Vidaud D, Bièche I. Microarray-Based Identification of Tenascin C and Tenascin XB, Genes Possibly Involved in Tumorigenesis Associated with Neurofibromatosis Type 1. Clin Cancer Res 2007; 13:398-407. [PMID: 17202312 DOI: 10.1158/1078-0432.ccr-06-0182] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Neurofibromatosis type 1 (NF1) is an autosomal dominant disorder with a complex variety of clinical manifestations. The hallmark of NF1 is the onset of heterogeneous (dermal or plexiform) benign neurofibromas. Plexiform neurofibromas can give rise to malignant peripheral nerve sheath tumors, which are resistant to conventional therapies. EXPERIMENTAL DESIGN To identify new signaling pathways involved in the malignant transformation of plexiform neurofibromas, we applied a 22,000-oligonucleotide microarray approach to a series of plexiform neurofibromas and malignant peripheral nerve sheath tumors. Changes in the expression of selected genes were then confirmed by real-time quantitative reverse transcription-PCR. RESULTS We identified two tenascin gene family members that were significantly deregulated in both human NF1-associated tumors and NF1-deficient primary cells: Tenascin C (TNC) was up-regulated whereas tenascin XB (TNXB) was down-regulated during tumor progression. TNC activation is mainly due to the up-regulation of large TNC splice variants. Immunohistochemical studies showed that TNC transcripts are translated into TNC protein in TNC-overexpressing tumors. Aberrant transcriptional activation of TNC seems to be principally mediated by activator protein transcription factor complexes. CONCLUSION TNXB and TNC may be involved in the malignant transformation of plexiform neurofibromas. Anti-TNC antibodies, already used successfully in clinical trials to treat malignant human gliomas, may be an appropriate new therapeutic strategy for NF1.
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Affiliation(s)
- Pascale Lévy
- Laboratoire de Génétique Moléculaire-Institut National de la Sante et de la Recherche Medicale U745, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris V, 4 avenue de l'Observatoire, Paris, France
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Abstract
PURPOSE OF REVIEW Many genodermatoses have been linked in recent years to their respective genes. The underlying biology and integrative nature of these genes with other genes and organ systems is beginning to be understood. This paper reviews recent advances in neurocutaneous disorders, ectodermal dysplasias, and the phenomenon of revertant gene mosaicism. RECENT FINDINGS In neurofibromatosis type 1, molecular assays are being developed to distinguish malignant from benign and premalignant lesions. Clinical mutation analysis for the NF1 gene has been problematic; a sensitive new assay using automated comparative sequence analysis may be helpful. Revision of clinical care guidelines is ongoing. New data for the prospective management of optic pathway gliomas is reviewed. The two genes that underlie tuberous sclerosis complex, tuberin and hamartin, lie at the center of an important signal transduction pathway with significant implications for pharmacologic treatment. Issues in genetic counseling for this highly variable disease are updated. Extensive progress has been made in understanding the basis of several forms of ectodermal dysplasia. Disorders caused by mutations in p63 and the connexin and NF-kappaB gene families will be reviewed. Finally, phenotypic in vivo amelioration of genodermatoses via revertant gene mosaicism will be discussed as a possible mechanism to be exploited in directed therapeutic approaches. SUMMARY This paper reviews recent developments in the molecular and biologic bases of neurofibromatosis type 1, tuberous sclerosis, and ectodermal disorders related to p63 and the connexin and NF-kappaB gene families. The concept of revertant gene mosaicism is also discussed as a potential model for gene therapy.
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Affiliation(s)
- Rhonda E Schnur
- Division of Genetics, Department of Pediatrics, Cooper University Hospital/Robert Wood Johnson Medical School, Camden, New Jersey 08103, USA.
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Lévy P, Vidaud D, Leroy K, Laurendeau I, Wechsler J, Bolasco G, Parfait B, Wolkenstein P, Vidaud M, Bièche I. Molecular profiling of malignant peripheral nerve sheath tumors associated with neurofibromatosis type 1, based on large-scale real-time RT-PCR. Mol Cancer 2004; 3:20. [PMID: 15255999 PMCID: PMC493279 DOI: 10.1186/1476-4598-3-20] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2004] [Accepted: 07/15/2004] [Indexed: 11/21/2022] Open
Abstract
Background Neurofibromatosis type 1 (NF1) is an autosomal dominant disorder with a complex range of clinical symptoms. The hallmark of NF1 is the onset of heterogeneous (dermal or plexiform) benign neurofibromas. Plexiform neurofibromas can give rise to malignant peripheral nerve sheath tumors (MPNSTs), and the underlying molecular mechanisms are largely unknown. Results To obtain further insight into the molecular pathogenesis of MPNSTs, we used real-time quantitative RT-PCR to quantify the mRNA expression of 489 selected genes in MPNSTs, in comparison with plexiform neurofibromas. The expression of 28 (5.7%) of the 489 genes was significantly different between MPNSTs and plexiform neurofibromas; 16 genes were upregulated and 12 were downregulated in MPNSTs. The altered genes were mainly involved in cell proliferation (MKI67, TOP2A, CCNE2), senescence (TERT, TERC), apoptosis (BIRC5/Survivin, TP73) and extracellular matrix remodeling (MMP13, MMP9, TIMP4, ITGB4). More interestingly, other genes were involved in the Ras signaling pathway (RASSF2, HMMR/RHAMM) and the Hedgehog-Gli signaling pathway (DHH, PTCH2). Several of the down-regulated genes were Schwann cell-specific (L1CAM, MPZ, S100B, SOX10, ERBB3) or mast cell-specific (CMA1, TPSB), pointing to a depletion and/or dedifferentiation of Schwann cells and mast cells during malignant transformation of plexiform neurofibromas. Conclusion These data suggest that a limited number of signaling pathways, and particularly the Hedgehog-Gli signaling pathway, may be involved in malignant transformation of plexiform neurofibromas. Some of the relevant genes or their products warrant further investigation as potential therapeutic targets in NF1.
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Affiliation(s)
- Pascale Lévy
- Laboratoire de Génétique Moléculaire – UPRES EA 3618, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris V, Paris, France
| | - Dominique Vidaud
- Laboratoire de Génétique Moléculaire – UPRES EA 3618, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris V, Paris, France
| | - Karen Leroy
- Département d'Anatomo-Cytopathologie, AP-HP and Université Paris XII, Hôpital Henri-Mondor, Créteil, France
| | - Ingrid Laurendeau
- Laboratoire de Génétique Moléculaire – UPRES EA 3618, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris V, Paris, France
| | - Janine Wechsler
- Département d'Anatomo-Cytopathologie, AP-HP and Université Paris XII, Hôpital Henri-Mondor, Créteil, France
| | - Giulia Bolasco
- Laboratoire de Génétique Moléculaire – UPRES EA 3618, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris V, Paris, France
| | - Béatrice Parfait
- Laboratoire de Génétique Moléculaire – UPRES EA 3618, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris V, Paris, France
| | - Pierre Wolkenstein
- Département de Dermatologie, AP-HP and Université Paris XII, Hôpital Henri-Mondor, Créteil, France
| | - Michel Vidaud
- Laboratoire de Génétique Moléculaire – UPRES EA 3618, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris V, Paris, France
| | - Ivan Bièche
- Laboratoire de Génétique Moléculaire – UPRES EA 3618, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris V, Paris, France
- Laboratoire d'Oncogénétique – INSERM E0017, Centre René Huguenin, St-Cloud, France
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