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Chen F, Niu J, Wang M, Zhu H, Guo Z. Re-evaluating the risk factors for radiation pneumonitis in the era of immunotherapy. J Transl Med 2023; 21:368. [PMID: 37287014 DOI: 10.1186/s12967-023-04212-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 05/19/2023] [Indexed: 06/09/2023] Open
Abstract
As one of the common complications of radiotherapy, radiation pneumonia (RP) limits the prognosis of patients. Therefore, better identifying the high-risk factors that lead to RP is essential to effectively prevent its occurrence. However, as lung cancer treatment modalities are being replaced and the era of immunotherapy has arrived, literature that reviews the parameters and mode of radiotherapy, chemotherapy drugs, targeted drugs and current hot immune checkpoint inhibitors related to RP is lacking. This paper summarizes the risk factors for radiation pneumonia by retrieving and analysing previously published literature and the results of large clinical trials. The literature primarily included retrospective analyses, including clinical trials in different periods and a part of the literature review. A systematic literature search of Embase, PubMed, Web of Science, and Clinicaltrials.gov was performed for relevant publications up to 6 Dec. 2022. Search keywords include, but are not limited to, "radiation pneumonia", "pneumonia", "risk factors", "immunotherapy", etc. The factors related to RP in this paper include physical parameters of radiotherapy, including V5, V20, and MLD; chemoradiotherapy mode and chemotherapy drugs, including paclitaxel and gemcitabine; EGFR-TKI; ALK inhibitors; antiangiogenic drugs; immune drugs and the underlying disease of the patient. We also introduce the possible mechanism of RP. In the future, we hope that this article not only sounds the alarm for clinicians but also helps to identify a method that can effectively intervene and reduce the occurrence of RP, significantly improve the quality of life and prognosis of patients, and more effectively improve the therapeutic effect of radiation therapy.
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Affiliation(s)
- Feihu Chen
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, 440 Jiyan Road, Jinan, 250117, Shandong, China
| | - Jiling Niu
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, 440 Jiyan Road, Jinan, 250117, Shandong, China
| | - Min Wang
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, 440 Jiyan Road, Jinan, 250117, Shandong, China
| | - Hui Zhu
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, 440 Jiyan Road, Jinan, 250117, Shandong, China.
| | - Zhijun Guo
- Department of Intensive Care Unit, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, 440 Jiyan Road, Jinan, 250117, Shandong, China.
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2
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Zhou F, Qin Y, Liu X, Huang J, Wu B, Zhang Z, Yin Z, Yang J, Zhang S, Jiang K, Yang K. Survival benefit of thoracic radiotherapy plus EGFR-TKIs in patients
with non-oligometastatic advanced non-small-cell lung cancer: a single-center
retrospective study. Ther Adv Med Oncol 2023; 15:17588359231161411. [PMID: 36970112 PMCID: PMC10031612 DOI: 10.1177/17588359231161411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 02/16/2023] [Indexed: 03/23/2023] Open
Abstract
Objectives: The study aims to evaluate the efficacy and safety of thoracic radiotherapy
in epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor
(TKI)-treated patients with stage IV non-small-cell lung cancer (NSCLC). Methods: Patients with non-oligometastatic NSCLC harboring EGFR mutations were
recruited. All patients received the first-generation TKI treatment with or
without radiotherapy. The irradiated sites included primary and/or
metastatic lesions. Of all the patients who underwent thoracic radiotherapy,
some received radiotherapy before EGFR-TKI resistance, others received
radiotherapy after progressive disease. Results: No statistically significant difference was observed in progression-free
survival (PFS) (median 14.7 versus 11.2 months,
p = 0.075) or overall survival (OS) (median 29.6
versus 40.6 months, p = 0.116) between
patients treated with EGFR-TKIs alone and those with additional radiotherapy
to any sites. However, EGFR inhibitors with thoracic radiation significantly
improved OS (median 47.0 versus 31.0 months,
p < 0.001) but not PFS (median 13.9
versus 11.9 months, p = 0.124).
Moreover, longer PFS (median 18.3 versus 8.5 months,
p < 0.001) was achieved in the preemptive thoracic
radiation cohort than in the delayed thoracic radiation cohort. However, OS
was similar between the two cohorts (median 40.6 versus
52.6 months, p = 0.124). The lower incidence rate of grade
1–2 pneumonitis occurred in preemptive radiation cohort (29.8%
versus 75.8%, p < 0.001). Conclusion: Non-oligometastatic NSCLC patients with EGFR mutations benefited from
thoracic radiotherapy while using EGFR inhibitors. Preemptive thoracic
radiotherapy could be a competitive first-line therapeutic option due to
superior PFS and favorable safety.
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Affiliation(s)
| | | | | | - Jing Huang
- Cancer Center, Union Hospital, Tongji Medical
College, Huazhong University of Science and Technology, Wuhan, Hubei,
China
| | - Bian Wu
- Cancer Center, Union Hospital, Tongji Medical
College, Huazhong University of Science and Technology, Wuhan, Hubei,
China
| | - Zhanjie Zhang
- Cancer Center, Union Hospital, Tongji Medical
College, Huazhong University of Science and Technology, Wuhan, Hubei,
China
| | - Zhongyuan Yin
- Cancer Center, Union Hospital, Tongji Medical
College, Huazhong University of Science and Technology, Wuhan, Hubei,
China
| | - Jinsong Yang
- Cancer Center, Union Hospital, Tongji Medical
College, Huazhong University of Science and Technology, Wuhan, Hubei,
China
| | - Sheng Zhang
- Cancer Center, Union Hospital, Tongji Medical
College, Huazhong University of Science and Technology, 1277 Jiefang Avenue,
Wuhan, Hubei 430022, China
| | - Ke Jiang
- Department of Thoracic Surgery, Union
Hospital, Tongji Medical College, Huazhong University of Science and
Technology, 1277 Jiefang Avenue, Wuhan, Hubei 430022, China
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3
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Sami MM, Sherief MH, El-Abaseri TB, El-Sakka AI, El-Serafi AT. Expression of epidermal growth factor receptor and human epidermal growth factor receptor 2 in urothelial bladder carcinoma in an Egyptian cohort: Clinical implication and prognostic significance. Urologia 2023:3915603221150965. [PMID: 36670543 DOI: 10.1177/03915603221150965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Bladder cancer (BC) has a particular importance in Egyptian patients due to aggressive behavior and absence of prognostic markers. OBJECTIVE To evaluate the expression of gene and protein expression of HER2 and epidermal growth factor (EGFR) in Egyptian patients with BC and ultimately to investigate their clinical implication and prognostic significance. MATERIAL AND METHODS The study was carried out on 46 patients with urothelial bladder BC. Tissue were obtained from transurethral resection (N = 22) and radical cystectomy (N = 24) specimens. The original hematoxylin and eosin slides were re-evaluated and the formalin fixed, paraffin-embedded (FFPE) tissues which had sufficient tumor tissue (>75%) and minimal or absent tumor necrosis were selected for immunohistochemistry (IHC) and RNA extraction. Furthermore, five control biopsies were obtained from patients with cystitis. Follow-up data were retrieved from the medical records which included the treatment regimen, disease recurrence and/or progression, and survival. RESULTS EGFR and HER2 protein were overexpressed in 35% and 46% of patients respectively. EGFR was correlated with the tumor size, grade and pathological stage, with a similar trend for HER2. The recurrence rate was higher in patients with expression of any of the markers. Gene expression was significantly higher (10.6-folds) for EGFR and (21-folds) for HER2 in patients with BC in comparison to control patients. Survival analysis showed lower median disease-free survival in association with HER2 protein overexpression. CONCLUSIONS Our data highlighted the prognostic significance of EGFR and HER in BC and proposed their possible use as predictive markers and potential therapeutic targets.
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Affiliation(s)
- Manal M Sami
- Department of Pathology, RAK College of Medical Sciences, RAK Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates.,Department of Pathology, Faculty of Medicine - Suez Canal University, Ismailia, Egypt
| | - Mahmoud H Sherief
- Department of Urology, Faculty of Medicine - Suez Canal University, Ismailia, Egypt
| | - Taghrid B El-Abaseri
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine - Suez Canal University, Ismailia, Egypt
| | - Ahmed I El-Sakka
- Department of Urology, Faculty of Medicine - Suez Canal University, Ismailia, Egypt
| | - Ahmed T El-Serafi
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine - Suez Canal University, Ismailia, Egypt.,Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.,Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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4
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Yang X, Ren H, Xu Y, Peng X, Yu W, Shen Z. Combination of radiotherapy and targeted therapy for HER2-positive breast cancer brain metastases. Eur J Med Res 2023; 28:27. [PMID: 36642742 PMCID: PMC9841677 DOI: 10.1186/s40001-022-00894-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 11/09/2022] [Indexed: 01/17/2023] Open
Abstract
Radiotherapy and targeted therapy are essential treatments for patients with brain metastases from human epidermal growth factor receptor 2 (HER2)-positive breast cancer. However, the combination of radiotherapy and targeted therapy still needs to be investigated, and neurotoxicity induced by radiotherapy for brain metastases has also become an important issue of clinical concern. It remained unclear how to achieve the balance of efficacy and toxicity with the application of new radiotherapy techniques and new targeted therapy drugs. This article reviews the benefits and potential risk of combining radiotherapy and targeted therapy for HER2-positive breast cancer with brain metastases.
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Affiliation(s)
- Xiaojing Yang
- grid.16821.3c0000 0004 0368 8293Department of Oncology, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 600, Yishan Road, Shanghai, 200233 China ,grid.16821.3c0000 0004 0368 8293Department of Radiation Oncology, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hanru Ren
- grid.8547.e0000 0001 0125 2443Department of Orthopedics, Pudong Medical Center, Shanghai Pudong Hospital, Fudan University, Shanghai, China
| | - Yi Xu
- grid.16821.3c0000 0004 0368 8293Department of Oncology, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 600, Yishan Road, Shanghai, 200233 China
| | - Xue Peng
- grid.16821.3c0000 0004 0368 8293Department of Breast Surgery, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenxi Yu
- grid.16821.3c0000 0004 0368 8293Department of Oncology, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 600, Yishan Road, Shanghai, 200233 China
| | - Zan Shen
- grid.16821.3c0000 0004 0368 8293Department of Oncology, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 600, Yishan Road, Shanghai, 200233 China
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5
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Jin N, Xia Y, Gao Q. Combined PARP inhibitors and small molecular inhibitors in solid tumor treatment (Review). Int J Oncol 2023; 62:28. [PMID: 36601757 PMCID: PMC9851129 DOI: 10.3892/ijo.2023.5476] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 09/23/2022] [Indexed: 01/05/2023] Open
Abstract
With the development of precision medicine, targeted therapy has attracted extensive attention. Poly(ADP‑ribose) polymerase inhibitors (PARPi) are critical clinical drugs designed to induce cell death and are major antitumor targeted agents. However, preclinical and clinical data have revealed the limitations of PARPi monotherapy. Therefore, their combination with other targeted drugs has become a research hotspot in tumor treatment. Recent studies have demonstrated the critical role of small molecular inhibitors in multiple haematological cancers and solid tumors via cellular signalling modulation, exhibiting potential as a combined pharmacotherapy. In the present review, studies focused on small molecular inhibitors targeting the homologous recombination pathway were summarized and clinical trials evaluating the safety and efficacy of combined treatment were discussed.
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Affiliation(s)
- Ning Jin
- Key Laboratory of The Ministry of Education, Cancer Biology Research Center, Tongji Hospital, Wuhan, Hubei 430000, P.R. China,Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430000, P.R. China
| | - Yu Xia
- Key Laboratory of The Ministry of Education, Cancer Biology Research Center, Tongji Hospital, Wuhan, Hubei 430000, P.R. China,Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430000, P.R. China,Correspondence to: Professor Qinglei Gao or Professor Yu Xia, Key Laboratory of The Ministry of Education, Cancer Biology Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei 430000, P.R. China, E-mail: , E-mail:
| | - Qinglei Gao
- Key Laboratory of The Ministry of Education, Cancer Biology Research Center, Tongji Hospital, Wuhan, Hubei 430000, P.R. China,Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430000, P.R. China,Correspondence to: Professor Qinglei Gao or Professor Yu Xia, Key Laboratory of The Ministry of Education, Cancer Biology Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei 430000, P.R. China, E-mail: , E-mail:
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6
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An Immunohistochemical Study of Epidermal Growth Factor Receptor in Sebaceous Carcinoma of the Eyelid: A Potential Therapeutic Target. Ophthalmic Plast Reconstr Surg 2022; 38:377-380. [DOI: 10.1097/iop.0000000000002126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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7
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Wang Y, Yin X, Chen L, Yin Z, Zuo Z. Discovery and evaluation of cytisine n-isoflavones as novel egfr/her2 dual inhibitors. Bioorg Chem 2022; 127:105868. [DOI: 10.1016/j.bioorg.2022.105868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 05/06/2022] [Accepted: 05/07/2022] [Indexed: 11/17/2022]
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8
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Hu X, Li G, Wu S. Advances in Diagnosis and Therapy for Bladder Cancer. Cancers (Basel) 2022; 14:cancers14133181. [PMID: 35804953 PMCID: PMC9265007 DOI: 10.3390/cancers14133181] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/19/2022] [Accepted: 06/24/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary The clinical management of bladder cancer has been developing in the past decade, including diagnostic tools and treatment options. Both monotherapy and combination therapy have been undoubtedly upgraded. Multiple diagnostic techniques and therapeutic strategies have been developed to meet the urgent clinical needs, resulting in the emergence of various explorations for cancer diagnosis and therapy. In this review, we mainly focus on the advances in the diagnosis and treatment of bladder cancer. Abstract Bladder cancer (BCa) is one of the most common and expensive urinary system malignancies for its high recurrence and progression rate. In recent years, immense amounts of studies have been carried out to bring a more comprehensive cognition and numerous promising clinic approaches for BCa therapy. The development of innovative enhanced cystoscopy techniques (optical techniques, imaging systems) and tumor biomarkers-based non-invasive urine screening (DNA methylation-based urine test) would dramatically improve the accuracy of tumor detection, reducing the risk of recurrence and progression of BCa. Moreover, intravesical instillation and systemic therapeutic strategies (cocktail therapy, immunotherapy, vaccine therapy, targeted therapy) also provide plentiful measures to break the predicament of BCa. Several exploratory clinical studies, including novel surgical approaches, pharmaceutical compositions, and bladder preservation techniques, emerged continually, which are supposed to be promising candidates for BCa clinical treatment. Here, recent advances and prospects of diagnosis, intravesical or systemic treatment, and novel drug delivery systems for BCa therapy are reviewed in this paper.
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Affiliation(s)
- Xinzi Hu
- Institute of Urology, The Affiliated Luohu Hospital of Shenzhen University, Shenzhen University, Shenzhen 518000, China; (X.H.); (G.L.)
- Department of Urology, South China Hospital, Health Science Center, Shenzhen University, Shenzhen 518116, China
| | - Guangzhi Li
- Institute of Urology, The Affiliated Luohu Hospital of Shenzhen University, Shenzhen University, Shenzhen 518000, China; (X.H.); (G.L.)
- Department of Urology, South China Hospital, Health Science Center, Shenzhen University, Shenzhen 518116, China
| | - Song Wu
- Institute of Urology, The Affiliated Luohu Hospital of Shenzhen University, Shenzhen University, Shenzhen 518000, China; (X.H.); (G.L.)
- Department of Urology, South China Hospital, Health Science Center, Shenzhen University, Shenzhen 518116, China
- Correspondence:
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9
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Cui J, Li L, Yuan S. The Value of Radiotherapy for Advanced Non-Small Cell Lung Cancer With Oncogene Driver-Mutation. Front Oncol 2022; 12:863715. [PMID: 35646640 PMCID: PMC9139486 DOI: 10.3389/fonc.2022.863715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/11/2022] [Indexed: 11/26/2022] Open
Abstract
Due to the widespread use of tyrosine kinase inhibitors (TKIs), which have largely supplanted cytotoxic chemotherapy as the first-line therapeutic choice for patients with advanced non-small cell lung cancer (NSCLC) who have oncogene driver mutations, advanced NSCLC patients with oncogene driver mutations had much long median survival. However, TKIs’ long-term efficacy is harmed by resistance to them. TKIs proved to have a limited potential to permeate cerebrospinal fluid (CSF) as well. Only a small percentage of plasma levels could be found in CSF at usual doses. Therefore, TKIs monotherapy may have a limited efficacy in individuals with brain metastases. Radiation has been demonstrated to reduce TKIs resistance and disrupt the blood-brain barrier (BBB). Previous trials have shown that local irradiation for bone metastases might improve symptoms, in addition, continuous administration of TKIs combined with radiotherapy was linked with beneficial progression-free survival (PFS) and overall survival (OS) for oligometastasis or bone metastasis NSCLC with oncogene driver mutations. The above implied that radiotherapy combined with targeted therapy may have a synergistic impact in patients with advanced oncogene driver-mutated NSCLC. The objective of this article is to discuss the value of radiotherapy in the treatment of those specific individuals.
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Affiliation(s)
- Jinfeng Cui
- Clinical Medical College, Shandong University, Jinan, China
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Shandong Cancer Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Li Li
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Shandong Cancer Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Shuanghu Yuan
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Shandong Cancer Hospital Affiliated to Shandong First Medical University, Jinan, China
- Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, China
- Department of Radiation Oncology, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Shuanghu Yuan,
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10
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Chen D, Ye Y, Guo S, Yao K. Progress in the Research and Targeted Therapy of ErbB/HER Receptors in Urothelial Bladder Cancer. Front Mol Biosci 2022; 8:800945. [PMID: 35004854 PMCID: PMC8735837 DOI: 10.3389/fmolb.2021.800945] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 11/30/2021] [Indexed: 11/19/2022] Open
Abstract
Bladder cancer is a lethal malignancy and a majority of bladder cancer arise from urothelial cells. Infiltration and metastasis are barriers for the radical cystectomy to achieve favored outcome and are the main cause of death. Systemic therapy, including chemotherapy, targeted therapy, and immunotherapy, is fundamental for these patients. erbB/HER receptors are found to be overexpressed in a subgroup of urothelial carcinoma, targeting erbB/HER receptors in these patients was found to be an efficient way in the era of genetic testing. To evaluate the role of erbB/HER receptors in bladder cancer, we reviewed the literature and ongoing clinical trials as regards to this topic to unveil the context of erbB/HER receptors in bladder cancer, which probably help to solidate the theoretical basis and might instruct further research.
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Affiliation(s)
- Dong Chen
- Department of Urology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yunlin Ye
- Department of Urology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Shengjie Guo
- Department of Urology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Kao Yao
- Department of Urology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
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11
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Chien YN, Lin YC, Chang CL, Lin WC, Wu SY. Thoracic surgery improved overall survival in patients with stage IIIB-IV epidermal growth factor receptor-mutant lung adenocarcinoma who received and responded to tyrosine kinase inhibitor treatment. Lung Cancer 2021; 162:29-35. [PMID: 34662782 DOI: 10.1016/j.lungcan.2021.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/20/2021] [Accepted: 10/07/2021] [Indexed: 12/25/2022]
Abstract
PURPOSE No large-scale, prospective, randomized study has evaluated the effect of thoracic surgery on patients with unresectable stage IIIB-IV epidermal growth factor receptor (EGFR)-mutant lung adenocarcinoma who received and responded to EGFR tyrosine kinase inhibitor (TKI) treatment. Therefore, we designed a propensity-score-matched, nationwide, population-based, cohort study to investigate the effects of thoracic surgery on patients with EGFR-mutant lung adenocarcinoma. PATIENTS AND METHODS We included patients with unresectable stage IIIB-IV EGFR-mutant lung adenocarcinoma and categorized them into two groups according to their treatment modalities and compared their outcomes: the case group consisted of patients who underwent thoracic surgery for lung tumors after receiving and responding to EGFR-TKI treatment and the comparison group consisted of patients who received EGFR-TKI treatment alone until tumor progression. Patients in both groups were matched at a ratio of 1:4. RESULTS The matching process yielded a final cohort of 1395 patients (279 and 1,116 in the case and comparison groups, respectively) who were eligible for further analysis. According to multivariable Cox regression analyses, the adjusted hazard ratio (aHR; 95% confidence interval [CI]) for thoracic surgery for lung tumors after EGFR-TKI use and tumor response (group 2) compared with EGFR-TKI treatment alone (group 1) was 0.445 (0.351-0.564). CONCLUSIONS Thoracic surgery prolonged overall survival in patients with unresectable stage IIIB-IV EGFR-mutant lung adenocarcinoma who received and responded to EGFR-TKI treatment.
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Affiliation(s)
- Yu-Ning Chien
- Master Program of Big Data Analysis in Biomedicine, College of Medicine, Fu Jen Catholic University, Taipei, Taiwan
| | - Yi-Chun Lin
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Chia-Lun Chang
- Department of Hemato-Oncology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Wei-Chun Lin
- Division of Chest Medicine, Department of Internal Medicine, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan.
| | - Szu-Yuan Wu
- Department of Food Nutrition and Health Biotechnology, College of Medical and Health Science, Asia University, Taichung, Taiwan; Big Data Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan; Division of Radiation Oncology, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan; Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan; Cancer Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan; Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, Taipei, Taiwan; Centers for Regional Anesthesia and Pain Medicine, Taipei Municipal Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
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12
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Gan K, Gao Y, Liu K, Xu B, Qin W. The Clinical Significance and Prognostic Value of HER2 Expression in Bladder Cancer: A Meta-Analysis and a Bioinformatic Analysis. Front Oncol 2021; 11:653491. [PMID: 34540657 PMCID: PMC8440975 DOI: 10.3389/fonc.2021.653491] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 08/12/2021] [Indexed: 01/29/2023] Open
Abstract
Objective Human Epidermal Growth Factor Receptor 2 (HER2) is highly expressed in multiple malignancies and associated with patients’ prognosis, but its role in bladder cancer (BCa) remains elusive. We conducted this meta-analysis to explore the clinical significance and prognostic value of HER2 in BCa. Methods PubMed was searched for studies published between January 1, 2000 and January 1, 2020. The odds ratios (ORs) and hazard ratios (HRs) with 95% confidence intervals (95%CIs) were used to investigate the relationship between HER2 and BCa pathological features. TCGA was mined for the information regarding as well. Results Our study included 14 articles enrolling 1398 people. Expression of HER2 is higher in bladder cancer than in normal tissues. HER2 over-expression is associated with CIS, multifocal tumor, large tumor size, high tumor stage and grade, lymph node metastasis, progression, recurrence and papillary tumor. We could not find a significant association between HER2 expression and survival time in BCa patients. Conclusions Our meta and bioinformatic analysis indicated that HER2 expression was related to pathological malignancy and poor prognosis in BCa.
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Affiliation(s)
- Kai Gan
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Yue Gao
- Surgical Research Center, Institute of Urology, Medical School of Southeast University, Nanjing, China
| | - Kuangzheng Liu
- Surgical Research Center, Institute of Urology, Medical School of Southeast University, Nanjing, China
| | - Bin Xu
- Surgical Research Center, Institute of Urology, Medical School of Southeast University, Nanjing, China
| | - Weijun Qin
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
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13
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Elbadawy M, Sato Y, Mori T, Goto Y, Hayashi K, Yamanaka M, Azakami D, Uchide T, Fukushima R, Yoshida T, Shibutani M, Kobayashi M, Shinohara Y, Abugomaa A, Kaneda M, Yamawaki H, Usui T, Sasaki K. Anti-tumor effect of trametinib in bladder cancer organoid and the underlying mechanism. Cancer Biol Ther 2021; 22:357-371. [PMID: 34034619 DOI: 10.1080/15384047.2021.1919004] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Bladder cancer (BC), a main neoplasm of urinary tract, is usually inoperable and unresponsive to chemotherapy. As a novel experimental model for muscle-invasive BC, we previously established a culture method of dog BC organoids. In the present study, the detailed in vitro and in vivo anti-tumor effects of trametinib were investigated by using this model. In each BC organoid strain, epidermal growth factor receptor (EGFR)/ERK signaling was upregulated compared with normal bladder cells. Trametinib even at a low concentration inhibited the cell viability of BC organoids and the activation of ERK through decreasing expression of c-Myc, ELK1, SIK1, and PLA2G4A. Trametinib arrested cell cycle of BC with few apoptosis. Dual treatment of BC organoids with trametinib and YAP inhibitor, verteporfin extremely inhibited the cell viability with apoptosis induction. Moreover, trametinib induced basal to luminal differentiation of BC organoids by upregulating luminal markers and downregulating basal ones. In vivo, trametinib decreased the tumor growth of BC organoids in mice and the xenograft-derived organoids from trametinib-administered mice showed enhanced sensitivity to carboplatin due to MSH2 upregulation. Our data suggested a new strategy of trametinib-YAP inhibitor or trametinib-carboplatin combination as a promising treatment of BC.
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Affiliation(s)
- Mohamed Elbadawy
- Laboratory of Veterinary Pharmacology, Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Fuchu, Japan.,Department of Pharmacology, Faculty of Veterinary Medicine, Benha University, Toukh, Egypt
| | - Yomogi Sato
- Laboratory of Veterinary Pharmacology, Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Fuchu, Japan
| | - Takashi Mori
- Laboratory of Veterinary Clinical Oncology, Faculty of Applied Biological Sciences, Gifu University, Gifu, Japan.,Center for Highly Advanced Integration of Nano and Life Sciences, Gifu University (G-CHAIN), Gifu, Japan
| | - Yuta Goto
- Laboratory of Veterinary Pharmacology, Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Fuchu, Japan
| | - Kimika Hayashi
- Laboratory of Veterinary Pharmacology, Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Fuchu, Japan
| | - Megumi Yamanaka
- Laboratory of Veterinary Pharmacology, Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Fuchu, Japan
| | - Daigo Azakami
- Department of Veterinary Clinical Oncology, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Fuchu, Japan
| | - Tsuyoshi Uchide
- Department of Veterinary Surgery, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Fuchu, Japan
| | - Ryuji Fukushima
- Animal Medical Center, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Fuchu, Japan
| | - Toshinori Yoshida
- Laboratory of Veterinary Pathology, Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Fuchu, Japan
| | - Makoto Shibutani
- Laboratory of Veterinary Pathology, Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Fuchu, Japan
| | - Mio Kobayashi
- Laboratory of Veterinary Pathology, Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Fuchu, Japan
| | - Yuta Shinohara
- Laboratory of Veterinary Pharmacology, Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Fuchu, Japan.,Pet Health & Food Division, Iskara Industry CO., LTD, Chuo-ku, Japan
| | - Amira Abugomaa
- Laboratory of Veterinary Pharmacology, Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Fuchu, Japan.,Faculty of Veterinary Medicine, Mansoura University, Mansoura, Egypt
| | - Masahiro Kaneda
- Laboratory of Veterinary Anatomy, Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Fuchu, Japan
| | - Hideyuki Yamawaki
- Laboratory of Veterinary Pharmacology, School of Veterinary Medicine, Kitasato University, Towada, Japan
| | - Tatsuya Usui
- Laboratory of Veterinary Pharmacology, Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Fuchu, Japan
| | - Kazuaki Sasaki
- Laboratory of Veterinary Pharmacology, Department of Veterinary Medicine, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Fuchu, Japan
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14
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Hsu KH, Huang JW, Tseng JS, Chen KW, Weng YC, Yu SL, Yang TY, Huang YH, Chen JJW, Chen KC, Chang GC. Primary Tumor Radiotherapy During EGFR-TKI Disease Control Improves Survival of Treatment Naïve Advanced EGFR-Mutant Lung Adenocarcinoma Patients. Onco Targets Ther 2021; 14:2139-2148. [PMID: 33790577 PMCID: PMC8006910 DOI: 10.2147/ott.s300267] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 03/10/2021] [Indexed: 12/25/2022] Open
Abstract
Background Whether radiotherapy only for primary lung tumor (RTPLT) after epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) therapy improves survival of treatment naïve advanced EGFR-mutant lung adenocarcinoma (LAD) patients with/without polymetastasis. Materials and Methods This was a retrospective, single-center, observational study. Patients with stage IIIB-IV EGFR-mutant LAD with disease control by EGFR-TKI therapy were divided into curative RTPLT, and control, without radiotherapy (WRTPLT) groups. Results A total of 138 patients were enrolled; 46 in the RTPLT group and 92 in the WRTPLT group. Amongst them, 37% had oligometastasis, and 26.1% brain metastasis. The RTPLT group had both significantly longer progression-free survival (PFS) (27.5 months [95% CI 18.1–36.9] vs 10.9 months [95% CI 6.3–15.5], P<0.001) and overall survivor (OS) (NR [95% CI NR-NR] vs 38.0 months [95% CI 31.2–44.8], P<0.001), respectively, when compared to the WRTPLT group. In multivariate analysis, the adjusted HR of radiotherapy on PFS was 0.30 (0.19–0.47) and on OS, 0.11 (0.04–0.30). Patients with oligometastasis had significantly longer PFS than those with polymetastasis with an HR of 0.35 (0.14–0.85), P=0.02. Patients with either oligometastasis or polymetastasis had significant longer PFS when undergoing radiotherapy than those without (both P<0.05). An EGFR-TKI to radiotherapy interval <24 weeks seemed more beneficial (P=0.097). Radiation pneumonitis comprised 32 (69.6%), 12 (26.1%), and two (4.3%) cases of common terminology criteria grade I, II, and III, respectively. Conclusion Curative RTPLT can prolong survival in patients with LAD following EGFR-TKI disease control, both involving oligometastasis and polymetastasis. RTPLT within 24 weeks after EGFR-TKI initiation appeared to be more beneficial with tolerable radiation pneumonitis.
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Affiliation(s)
- Kuo-Hsuan Hsu
- Division of Critical Care and Respiratory Therapy, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.,Institute of Biomedical Sciences, College of Life Sciences, National Chung Hsing University, Taichung, Taiwan
| | - Jing-Wen Huang
- Institute of Biomedical Sciences, College of Life Sciences, National Chung Hsing University, Taichung, Taiwan.,Department of Radiation Oncology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Jeng-Sen Tseng
- Institute of Biomedical Sciences, College of Life Sciences, National Chung Hsing University, Taichung, Taiwan.,Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Kuan-Wen Chen
- Department of Radiation Oncology, Taichung Tzu-Chi Hospital, Buddhist Tzu-Chi Medical Foundation, Taichung, Taiwan
| | - Yih-Chyang Weng
- Radiation Oncology, Nantou Hospital of Ministry of Health and Welfare, Nantou City, Taiwan
| | - Sung-Liang Yu
- Department of Clinical Laboratory Sciences and Medical Biotechnology, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan.,Center of Genomic Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Pathology and Graduate Institute of Pathology, College of Medicine, National Taiwan University, Taipei, Taiwan.,Center for Optoelectronic Biomedicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Tsung-Ying Yang
- Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yen-Hsiang Huang
- Institute of Biomedical Sciences, College of Life Sciences, National Chung Hsing University, Taichung, Taiwan.,Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Jeremy J W Chen
- Institute of Biomedical Sciences, College of Life Sciences, National Chung Hsing University, Taichung, Taiwan
| | - Kun-Chieh Chen
- Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.,Division of Pulmonary Medicine, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Gee-Chen Chang
- Institute of Biomedical Sciences, College of Life Sciences, National Chung Hsing University, Taichung, Taiwan.,Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Pulmonary Medicine, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan
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15
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Review of Experimental Studies to Improve Radiotherapy Response in Bladder Cancer: Comments and Perspectives. Cancers (Basel) 2020; 13:cancers13010087. [PMID: 33396795 PMCID: PMC7795454 DOI: 10.3390/cancers13010087] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/22/2020] [Accepted: 12/22/2020] [Indexed: 01/04/2023] Open
Abstract
Bladder cancer is among the top ten most common cancer types in the world. Around 25% of all cases are muscle-invasive bladder cancer, for which the gold standard treatment in the absence of metastasis is the cystectomy. In recent years, trimodality treatment associating maximal transurethral resection and radiotherapy combined with concurrent chemotherapy is increasingly used as an organ-preserving alternative. However, the use of this treatment is still limited by the lack of biomarkers predicting tumour response and by a lack of targeted radiosensitising drugs that can improve the therapeutic index, especially by limiting side effects such as bladder fibrosis. In order to improve the bladder-preserving treatment, experimental studies addressing these main issues ought to be considered (both in vitro and in vivo studies). Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic reviews, we conducted a literature search in PubMed on experimental studies investigating how to improve bladder cancer radiotherapy with different radiosensitising agents using a comprehensive search string. We made comments on experimental model selection, experimental design and results, formulating the gaps of knowledge still existing: such as the lack of reliable predictive biomarkers of tumour response to chemoradiation according to the molecular tumour subtype and lack of efficient radiosensitising agents specifically targeting bladder tumour cells. We provided guidance to improve forthcoming studies, such as taking into account molecular characteristics of the preclinical models and highlighted the value of using patient-derived xenografts as well as syngeneic models. Finally, this review could be a useful tool to set up new radiation-based combined treatments with an improved therapeutic index that is needed for bladder preservation.
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16
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Huang T, Luo X, Wu B, Peng P, Dai Y, Hu G, Qiu H, Yuan X. Pyrotinib enhances the radiosensitivity of HER2‑overexpressing gastric and breast cancer cells. Oncol Rep 2020; 44:2634-2644. [PMID: 33125154 PMCID: PMC7640366 DOI: 10.3892/or.2020.7820] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 08/31/2020] [Indexed: 02/07/2023] Open
Abstract
The overexpression or amplification of HER2 has been observed in a significant proportion of both gastric cancer (GC) and breast cancer (BC) cases. Pyrotinib is an irreversible dual (EGFR/HER2) tyrosine kinase inhibitor (TKI), newly evaluated for the treatment of HER2-overexpressing cancer types. As radiotherapy (RT) serves a crucial role in controlling the local recurrence of GC and BC, the present study investigated the impact of pyrotinib on the irradiation response. The current results demonstrated that pyrotinib enhanced the radiosensitivity of HER2-overexpressing GC and BC cells in vitro and in vivo. In both NCI-N87 and SKBR3 cells, pyrotinib suppressed the irradiation-induced HER2 nuclear transport. Furthermore, pyrotinib increased DNA damage induced by irradiation in both cancer cell lines. Pyrotinib also enhanced the cytotoxicity of docetaxel, which may provide a novel strategy for potential drug combinations. Thus, pyrotinib is a promising irradiation sensitizer in patients with HER2-overexpressing GC and BC. The present results provide a theoretical foundation for further clinical evaluation of pyrotinib.
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Affiliation(s)
- Tingting Huang
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
| | - Xiaoxiao Luo
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
| | - Bili Wu
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
| | - Ping Peng
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
| | - Yuhong Dai
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
| | - Guangyuan Hu
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
| | - Hong Qiu
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
| | - Xianglin Yuan
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
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17
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Zheng L, Wang Y, Xu Z, Yang Q, Zhu G, Liao XY, Chen X, Zhu B, Duan Y, Sun J. Concurrent EGFR-TKI and Thoracic Radiotherapy as First-Line Treatment for Stage IV Non-Small Cell Lung Cancer Harboring EGFR Active Mutations. Oncologist 2019; 24:1031-e612. [PMID: 31040256 PMCID: PMC6693693 DOI: 10.1634/theoncologist.2019-0285] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 04/06/2019] [Indexed: 12/20/2022] Open
Abstract
LESSONS LEARNED This single-arm, phase II study shows that concurrent EGFR-tyrosine kinase inhibitor plus thoracic radiotherapy as the first-line treatment for stage IV non-small cell lung cancer harboring EGFR active mutations provides long-term control for the primary lung lesion, and 1-year progression-free survival (PFS) rate and median PFS are numerically higher than those of the erlotinib monotherapy.Serious adverse events are acceptable, although grade >3 radiation pneumonitis occurred in 20% of patients. BACKGROUND Studies show effective local control by EGFR-tyrosine kinase inhibitor (TKI) combined with radiotherapy at metastatic sites in advanced lung cancer harboring EGFR active mutations. Salvage local radiotherapy is associated with prolonged progression-free survival (PFS) in local disease during EGFR-TKI treatment. However, no prospective study has been reported on concurrent EGFR-TKI and radiotherapy for primary lung lesions. This study investigated the efficacy and safety of first-line EGFR-TKI combined with thoracic radiotherapy in treating stage IV non-small cell lung cancer (NSCLC) harboring EGFR active mutations. METHODS We conducted a single-arm, phase II clinical trial. Each patient received EGFR-TKI (erlotinib 150 mg or gefitinib 250 mg per day) plus thoracic radiotherapy (54-60 Gy/27-30 F/5.5-6 w) within 2 weeks of beginning EGFR-TKI therapy until either disease progression or intolerable adverse events (AEs) appeared. RESULTS From January 2015 to March 2018, 401 patients were screened, and 10 patients (5 male and 5 female) were eligible. These patients had a median age of 55 years (40-75) and median follow-up of 19.8 months (5.8-34). The 1-year PFS rate was 57.1%, median PFS was 13 months, and median time to progression of irradiated lesion (iTTP) was 20.5 months. Objective response rate (ORR), was 50% and disease control rate (DCR) was 100%. The most common grade ≥3 AEs were radiation pneumonitis (20%) and rash (10%). One patient died after rejecting treatment for pneumonitis. The others received a full, systematic course of glucocorticoid therapy. Pneumonitis was all well controlled and did not relapse. CONCLUSION Concurrent EGFR-TKI plus thoracic radiotherapy as the first-line treatment for stage IV NSCLC harboring EGFR active mutations shows a long-term control of primary lung lesion. The 1-year PFS rate and median PFS of this combined therapy are numerically higher than those of the erlotinib monotherapy. The risk of serious adverse events is acceptable.
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Affiliation(s)
- LinPeng Zheng
- Cancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Yanmei Wang
- Department of Oncology, Ya'an People's Hospital, Ya'an, Sichuan, People's Republic of China
| | - Zihan Xu
- Cancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Qiao Yang
- Cancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Guangkuo Zhu
- Cancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Xing-Yun Liao
- Cancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Xiewan Chen
- Medical English Department, College of Basic Medicine, Army Medical University, Chongqing, People's Republic of China
| | - Bo Zhu
- Cancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Yuzhong Duan
- Cancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, People's Republic of China
| | - Jianguo Sun
- Cancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, People's Republic of China
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18
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Juloori A, Miller JA, Parsai S, Kotecha R, Ahluwalia MS, Mohammadi AM, Murphy ES, Suh JH, Barnett GH, Yu JS, Vogelbaum MA, Rini B, Garcia J, Stevens GH, Angelov L, Chao ST. Overall survival and response to radiation and targeted therapies among patients with renal cell carcinoma brain metastases. J Neurosurg 2019; 132:188-196. [PMID: 30660120 DOI: 10.3171/2018.8.jns182100] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 08/14/2018] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The object of this retrospective study was to investigate the impact of targeted therapies on overall survival (OS), distant intracranial failure, local failure, and radiation necrosis among patients treated with radiation therapy for renal cell carcinoma (RCC) metastases to the brain. METHODS All patients diagnosed with RCC brain metastasis (BM) between 1998 and 2015 at a single institution were included in this study. The primary outcome was OS, and secondary outcomes included local failure, distant intracranial failure, and radiation necrosis. The timing of targeted therapies was recorded. Multivariate Cox proportional-hazards regression was used to model OS, while multivariate competing-risks regression was used to model local failure, distant intracranial failure, and radiation necrosis, with death as a competing risk. RESULTS Three hundred seventy-six patients presented with 912 RCC BMs. Median OS was 9.7 months. Consistent with the previously validated diagnosis-specific graded prognostic assessment (DS-GPA) for RCC BM, Karnofsky Performance Status (KPS) and number of BMs were the only factors prognostic for OS. One hundred forty-seven patients (39%) received vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors (TKIs). Median OS was significantly greater among patients receiving TKIs (16.8 vs 7.3 months, p < 0.001). Following multivariate analysis, KPS, number of metastases, and TKI use remained significantly associated with OS.The crude incidence of local failure was 14.9%, with a 12-month cumulative incidence of 13.4%. TKIs did not significantly decrease the 12-month cumulative incidence of local failure (11.4% vs 14.5%, p = 0.11). Following multivariate analysis, age, number of BMs, and lesion size remained associated with local failure. The 12-month cumulative incidence of radiation necrosis was 8.0%. Use of TKIs within 30 days of SRS was associated with a significantly increased 12-month cumulative incidence of radiation necrosis (10.9% vs 6.4%, p = 0.04). CONCLUSIONS Use of targeted therapies in patients with RCC BM treated with intracranial SRS was associated with improved OS. However, the use of TKIs within 30 days of SRS increases the rate of radiation necrosis without improving local control or reducing distant intracranial failure. Prospective studies are warranted to determine the optimal timing to reduce the rate of necrosis without detracting from survival.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Glen H Stevens
- 4Neurology, Neurological Institute, Cleveland Clinic, Cleveland, Ohio
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19
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Li W, Wang Y, Tan S, Rao Q, Zhu T, Huang G, Li Z, Liu G. Overexpression of Epidermal Growth Factor Receptor (EGFR) and HER-2 in Bladder Carcinoma and Its Association with Patients' Clinical Features. Med Sci Monit 2018; 24:7178-7185. [PMID: 30296252 PMCID: PMC6190725 DOI: 10.12659/msm.911640] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The aim of this study was to determine the expression of EGFR/HER-2 and investigate their association with patients' clinical features in bladder transitional cell carcinoma (BTCC). MATERIAL AND METHODS Immunohistochemistry was utilized in our study to explore the expression of EGFR/HER-2 of 56 human bladder cancer samples and 10 normal bladder samples. RESULTS EGFR and HER-2 expressions were both significantly higher in bladder transitional cell carcinoma (BTCC) than that in non-cancer bladder samples; the EGFR positivity rate was 55.4% among BTCC samples and 37.5% for HER-2a. A statistically significant correlation was also present between the increasing EGFR or HER-2 expression levels and the clinical stages, pathologic grades, and tumor recurrence. The expression level of EGFR increased along with higher clinical stages and pathologic grades of BTCC, and the obviously increased expression of HER-2 was statistically associated with clinical stages and tumor recurrence. In addition, the expression level of HER-2 increased along with the higher clinical stage of BTCC. EGFR expression and HER-2 levels were positively associated in BTCC samples. CONCLUSIONS Our findings demonstrate that high EGFR and HER-2 expressions are dramatically increased in the BTCC tissues and are closely related to the clinical stages, pathologic grades, and tumor recurrence. Therefore, the evaluation of EGFR and HER-2 expression in BTCC may contribute to identifying patients who are at increased risk of disease progression and recurrence.
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Affiliation(s)
- Wei Li
- Department of Surgery, The Second Hospital, University of South China, Hengyang, Hunan, China (mainland)
| | - Youquan Wang
- Department of Surgery, The Second Hospital, University of South China, Hengyang, Hunan, China (mainland)
| | - Shubo Tan
- Department of Surgery, The Second Hospital, University of South China, Hengyang, Hunan, China (mainland)
| | - Qishuo Rao
- Department of Surgery, The Second Hospital, University of South China, Hengyang, Hunan, China (mainland)
| | - Tian Zhu
- Department of Surgery, The Second Hospital, University of South China, Hengyang, Hunan, China (mainland)
| | - Guo Huang
- Department of Surgery, The Second Hospital, University of South China, Hengyang, Hunan, China (mainland)
| | - Zhuo Li
- Department of Urology, Hunan Provincial People's Hospital, Changsha, Hunan, China (mainland)
| | - Guowen Liu
- Department of Surgery, The Second Hospital, University of South China, Hengyang, Hunan, China (mainland)
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20
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Büchser D, Zapatero A, Rogado J, Talaya M, Martín de Vidales C, Arellano R, Bocardo G, Cruz Conde A, Pérez L, Murillo MT. Long-term Outcomes and Patterns of Failure Following Trimodality Treatment With Bladder Preservation for Invasive Bladder Cancer. Urology 2018; 124:183-190. [PMID: 30266376 DOI: 10.1016/j.urology.2018.07.058] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 07/15/2018] [Accepted: 07/25/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To report long-term results on survival, toxicity, and patterns of failure of 3 different organ-sparing strategies for patients with muscle invasive bladder cancer. MATERIALS AND METHODS This is a monoinstitutional prospective analysis of 3 consecutive bladder-sparing protocols combining maximal transurethral resection of bladder tumor (mTURBT), radiotherapy (RT), and cisplatin-based chemotherapy. Protocol 1 consisted of neoadjuvant methotrexate-cisplatin-vinblastine followed by endoscopic re-evaluation and consolidative RT 60 Gy in complete responders. Protocol 2 involved altered-fractionation RT 64.8 Gy and concurrent weekly cisplatin with re-evaluation after 40.8 Gy. Protocol 3 consisted of RT 64.8 Gy with concomitant weekly cisplatin. Nonresponders underwent radical cystectomy. Probabilities for overall survival (OS), cancer-specific survival (CSS), and metastasis-free survival (MFS) were calculated using Kaplan-Meier product limited estimates. A Cox regression multivariate analysis was performed to detect potential risk factors for OS, CSS, and MFS. RESULTS The 10-year bladder preservation rate was 79%. The 10-year OS, CSS, and MFS rates were 43.2%, 76.3% and 79.2%, respectively. There was no statistically significant difference in OS between the different treatment protocols. On multivariate analysis, mTURBT of the bladder and the complete response after induction therapy were independent correlates of improved OS and of MFS. The development of invasive bladder recurrence was independently associated with worse CSS and MFS. CONCLUSION Ten-year results indicate that bladder-sparing treatment is a successful approach for muscle invasive bladder cancer in selected patients. The mTURBT of the bladder tumor and complete response after induction therapy remain the most relevant predictive factors.
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Affiliation(s)
- David Büchser
- Department of Radiation Oncology, Hospital Universitario de La Princesa, Madrid, Spain.
| | - Almudena Zapatero
- Department of Radiation Oncology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Jacobo Rogado
- Department of Radiation Oncology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Marisol Talaya
- Department of Radiation Oncology, Hospital Universitario de La Princesa, Madrid, Spain
| | | | - Ramón Arellano
- Department of Urology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Gloria Bocardo
- Department of Urology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Alfonso Cruz Conde
- Department of Radiation Oncology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Leopoldo Pérez
- Department of Radiation Oncology, Hospital Universitario de La Princesa, Madrid, Spain
| | - María T Murillo
- Department of Radiation Oncology, Hospital Universitario de La Princesa, Madrid, Spain
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21
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Su Z, Tian W, Li J, Wang C, Pan Z, Li D, Hou H. Biological evaluation and molecular docking of Rhein as a multi-targeted radiotherapy sensitization agent of nasopharyngeal carcinoma. J Mol Struct 2017. [DOI: 10.1016/j.molstruc.2017.06.123] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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22
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Vau N, Volavsek M, Blanca A, Montironi R, Raspollini MR, Massari F, Cheng M, Scarpelli M, Lopez-Beltran A. Prospects for precision therapy of bladder urothelial carcinoma. EXPERT REVIEW OF PRECISION MEDICINE AND DRUG DEVELOPMENT 2017. [DOI: 10.1080/23808993.2017.1389273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Nuno Vau
- Urologic Oncology, Champalimaud Clinical Center, Lisbon, Portugal
| | - Metka Volavsek
- Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Ana Blanca
- Maimonides Biomedical Research Institute of Cordoba, Cordoba, Spain
| | - Rodolfo Montironi
- Institute of Pathological Anatomy and Histopathology, School of Medicine, Polytechnic University of the Marche Region (Ancona), United Hospitals, Ancona, Italy
| | - Maria R. Raspollini
- Histopathology and Molecular Diagnostics, University Hospital Careggi, Florence, Italy
| | | | - Monica Cheng
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Marina Scarpelli
- Institute of Pathological Anatomy and Histopathology, School of Medicine, Polytechnic University of the Marche Region (Ancona), United Hospitals, Ancona, Italy
| | - Antonio Lopez-Beltran
- Department of Pathology, Unit of Anatomical Pathology, Department of Surgery, Faculty of Medicine, Cordoba, Spain
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23
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Pedrol E, Garcia-Algar M, Massons J, Nazarenus M, Guerrini L, Martínez J, Rodenas A, Fernandez-Carrascal A, Aguiló M, Estevez LG, Calvo I, Olano-Daza A, Garcia-Rico E, Díaz F, Alvarez-Puebla RA. Optofluidic device for the quantification of circulating tumor cells in breast cancer. Sci Rep 2017. [PMID: 28623262 PMCID: PMC5473916 DOI: 10.1038/s41598-017-04033-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Metastatic cancer patients require a continuous monitoring during the sequential treatment cycles to carefully evaluate their disease evolution. Repetition of biopsies is very invasive and not always feasible. Herein, we design and demonstrate a 3D-flow focusing microfluidic device, where all optics are integrated into the chip, for the fluorescence quantification of CTCs in real samples. To test the chip performance, two cell membrane targets, the epithelial cell adhesion molecule, EpCAM, and the receptor tyrosine-protein kinase, HER2, are selected. The efficiency of the platform is demonstrated on cell lines and in a variety of healthy donors and metastatic-breast cancer patients.
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Affiliation(s)
- Eric Pedrol
- Física i Cristal•lografia de Materials i Nanomaterials and EmaS. Universitat Rovira i Virgili, Carrer Marcel•lí Domingo 1, 43007, Tarragona, Spain
| | - Manuel Garcia-Algar
- Departamento de Química Física e Inorgánica and EmaS, Universitat Rovira i Virgili, Carrer Marcel•lí Domingo 1, 43007, Tarragona, Spain
| | - Jaume Massons
- Física i Cristal•lografia de Materials i Nanomaterials and EmaS. Universitat Rovira i Virgili, Carrer Marcel•lí Domingo 1, 43007, Tarragona, Spain
| | - Moritz Nazarenus
- Departamento de Química Física e Inorgánica and EmaS, Universitat Rovira i Virgili, Carrer Marcel•lí Domingo 1, 43007, Tarragona, Spain
| | - Luca Guerrini
- Departamento de Química Física e Inorgánica and EmaS, Universitat Rovira i Virgili, Carrer Marcel•lí Domingo 1, 43007, Tarragona, Spain
| | - Javier Martínez
- Física i Cristal•lografia de Materials i Nanomaterials and EmaS. Universitat Rovira i Virgili, Carrer Marcel•lí Domingo 1, 43007, Tarragona, Spain
| | - Airan Rodenas
- Física i Cristal•lografia de Materials i Nanomaterials and EmaS. Universitat Rovira i Virgili, Carrer Marcel•lí Domingo 1, 43007, Tarragona, Spain
| | - Ana Fernandez-Carrascal
- Departamento de Química Física e Inorgánica and EmaS, Universitat Rovira i Virgili, Carrer Marcel•lí Domingo 1, 43007, Tarragona, Spain
| | - Magdalena Aguiló
- Física i Cristal•lografia de Materials i Nanomaterials and EmaS. Universitat Rovira i Virgili, Carrer Marcel•lí Domingo 1, 43007, Tarragona, Spain
| | - Laura G Estevez
- Fundacion de Investigacion HM Hospitales, San Bernardo 101, 28015, Madrid, Spain.,Centro Integral Oncologico Clara Campal (CIOCC), Oña 10, 28050, Madrid, Spain
| | - Isabel Calvo
- Fundacion de Investigacion HM Hospitales, San Bernardo 101, 28015, Madrid, Spain.,Centro Integral Oncologico Clara Campal (CIOCC), Oña 10, 28050, Madrid, Spain
| | - Ana Olano-Daza
- Department of Medical Oncology, Hospital Universitario HM Torrelodones, Castillo de Olivares s/n, 28250, Torrelodones, Spain
| | - Eduardo Garcia-Rico
- Fundacion de Investigacion HM Hospitales, San Bernardo 101, 28015, Madrid, Spain. .,Centro Integral Oncologico Clara Campal (CIOCC), Oña 10, 28050, Madrid, Spain. .,Department of Medical Oncology, Hospital Universitario HM Torrelodones, Castillo de Olivares s/n, 28250, Torrelodones, Spain. .,School of Medicine, San Pablo CEU, Calle Julián Romea, 18, 28003, Madrid, Spain.
| | - Francesc Díaz
- Física i Cristal•lografia de Materials i Nanomaterials and EmaS. Universitat Rovira i Virgili, Carrer Marcel•lí Domingo 1, 43007, Tarragona, Spain.
| | - Ramon A Alvarez-Puebla
- Departamento de Química Física e Inorgánica and EmaS, Universitat Rovira i Virgili, Carrer Marcel•lí Domingo 1, 43007, Tarragona, Spain. .,ICREA, Passeig Lluís Companys 23, 08010, Barcelona, Spain.
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24
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Patel R, Barker HE, Kyula J, McLaughlin M, Dillon MT, Schick U, Hafsi H, Thompson A, Khoo V, Harrington K, Zaidi S. An orally bioavailable Chk1 inhibitor, CCT244747, sensitizes bladder and head and neck cancer cell lines to radiation. Radiother Oncol 2017; 122:470-475. [DOI: 10.1016/j.radonc.2016.12.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 12/14/2016] [Accepted: 12/22/2016] [Indexed: 11/24/2022]
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25
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Mantovani FB, Morrison JA, Mutsaers AJ. Effects of epidermal growth factor receptor kinase inhibition on radiation response in canine osteosarcoma cells. BMC Vet Res 2016; 12:82. [PMID: 27245053 PMCID: PMC4888507 DOI: 10.1186/s12917-016-0707-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 05/24/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Radiation therapy is a palliative treatment modality for canine osteosarcoma, with transient improvement in analgesia observed in many cases. However there is room for improvement in outcome for these patients. It is possible that the addition of sensitizing agents may increase tumor response to radiation therapy and prolong quality of life. Epidermal growth factor receptor (EGFR) expression has been documented in canine osteosarcoma and higher EGFR levels have been correlated to a worse prognosis. However, effects of EGFR inhibition on radiation responsiveness in canine osteosarcoma have not been previously characterized. This study examined the effects of the small molecule EGFR inhibitor erlotinib on canine osteosarcoma radiation responses, target and downstream protein expression in vitro. Additionally, to assess the potential impact of treatment on tumor angiogenesis, vascular endothelial growth factor (VEGF) levels in conditioned media were measured. RESULTS Erlotinib as a single agent reduced clonogenic survival in two canine osteosarcoma cell lines and enhanced the impact of radiation in one out of three cell lines investigated. In cell viability assays, erlotinib enhanced radiation effects and demonstrated single agent effects. Erlotinib did not alter total levels of EGFR, nor inhibit downstream protein kinase B (PKB/Akt) activation. On the contrary, erlotinib treatment increased phosphorylated Akt in these osteosarcoma cell lines. VEGF levels in conditioned media increased after erlotinib treatment as a single agent and in combination with radiation in two out of three cell lines investigated. However, VEGF levels decreased with erlotinib treatment in the third cell line. CONCLUSIONS Erlotinib treatment promoted modest enhancement of radiation effects in canine osteosarcoma cells, and possessed activity as a single agent in some cell lines, indicating a potential role for EGFR inhibition in the treatment of a subset of osteosarcoma patients. The relative radioresistance of osteosarcoma cells does not appear to be related to EGFR signalling exclusively. Angiogenic responses to radiation and kinase inhibitors are similarly likely to be multifactorial and require further investigation.
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Affiliation(s)
- Fernanda B Mantovani
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Jodi A Morrison
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Anthony J Mutsaers
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.
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26
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Cahn DB, Ristau BT, Ghiraldi EM, Churilla TM, Geynisman DM, Horwitz EM, Uzzo RG, Smaldone MC. Bladder Preservation Therapy: A Review of the Literature and Future Directions. Urology 2016; 96:54-61. [PMID: 27257135 DOI: 10.1016/j.urology.2016.05.041] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 05/14/2016] [Accepted: 05/23/2016] [Indexed: 11/16/2022]
Abstract
Trimodal bladder preservation therapy (ie, transurethral resection followed by chemoradiotherapy) may be an acceptable treatment alternative to radical cystectomy with urinary diversion in the carefully selected patient with muscle invasive bladder cancer. Although no head-to-head randomized controlled trials have been performed, large retrospective cohort reviews and observational data analyses suggest comparable oncologic outcomes in select patients with the additional benefit of maximizing quality of life and maintaining the patient's native bladder. In this review, we discuss the evolution and clinical outcomes of bladder preservation therapy, highlighting its role in the contemporary management of muscle invasive bladder cancer.
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Affiliation(s)
- David B Cahn
- Department of Urology, Einstein Healthcare Network, Philadelphia, PA.
| | - Benjamin T Ristau
- Department of Surgical Oncology, Division of Urologic Oncology, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA
| | - Eric M Ghiraldi
- Department of Urology, Einstein Healthcare Network, Philadelphia, PA
| | - Thomas M Churilla
- Department of Radiation Oncology, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA
| | - Daniel M Geynisman
- Department of Hematology/Oncology, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA
| | - Eric M Horwitz
- Department of Radiation Oncology, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA
| | - Robert G Uzzo
- Department of Urology, Einstein Healthcare Network, Philadelphia, PA; Department of Surgical Oncology, Division of Urologic Oncology, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA
| | - Marc C Smaldone
- Department of Surgical Oncology, Division of Urologic Oncology, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA
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