1
|
Öztürk SK, Bokhorst JM, Baumann E, Sheahan K, van de Velde CJH, Marijnen CAM, Hospers GAP, Doukas M, Vieth M, Lugli A, Nagtegaal ID. Exploring Intratumoral Budding in Colorectal Cancer Using Computational Pathology: A Biopsy-Based Evaluation. Mod Pathol 2025; 38:100655. [PMID: 39522647 DOI: 10.1016/j.modpat.2024.100655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Revised: 10/08/2024] [Accepted: 11/04/2024] [Indexed: 11/16/2024]
Abstract
Owing to insufficient evidence, tumor budding (TB) is not currently evaluated in colorectal cancer (CRC) biopsies. This study investigates TB in CRC by establishing the value of intratumoral budding (ITB) in resection specimens and assessing the feasibility and clinical value of TB in biopsies. TB was assessed using an algorithm in all cases. In a test cohort of 555 primarily surgically treated CRC patients, we assessed the prognostic impact of ITB compared with peritumoral budding (PTB). The distribution of ITB in the uppermost 5 mm of resection specimens was analyzed to validate TB counting in biopsies. We further validated the prognostic and predictive impact of TB in biopsies of 285 rectal cancer patients, focusing on overall survival and response to neoadjuvant therapy. High-grade TB, whether intratumoral or peritumoral and in biopsies or resections, was associated with advanced pathological stage, lymphatic invasion, infiltrative tumor border, and poor overall survival in the test cohort. Superficial ITBs (0-3 mm from the lumen) accurately predicted the final TB grade based on PTB in 87% of tumors, with 87% of tumors having at least 1 superficial ITB hotspot. ITB (hazard ratio, 3.5; 95% CI, 1.1-10.8) was an independent predictor of overall survival, unlike PTB. In the validation cohort, TB presence in biopsies significantly reduced the likelihood of achieving a pathological complete response (odds ratio, 0.3; 95% CI, 0.1-0.7; P = .007). ITB is as prognostic as PTB, and evaluating both can improve risk stratification in CRC. TB assessment in biopsies can identify poor prognosis and predict response to neoadjuvant therapy.
Collapse
Affiliation(s)
- Sonay Kuş Öztürk
- Department of Pathology, Radboud University Medical Centre, Nijmegen, the Netherlands.
| | - John-Melle Bokhorst
- Department of Pathology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Elias Baumann
- Institute of Tissue Medicine and Pathology, University of Bern, Bern, Switzerland
| | - Kieran Sheahan
- Department of Pathology, St. Vincent's University Hospital, Dublin, Ireland; School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
| | | | - Corrie A M Marijnen
- Department of Radiotherapy, Leiden University Medical Centre, Leiden, the Netherlands; Department of Radiotherapy, Antoni van Leeuwenhoek, Amsterdam, the Netherlands
| | - Geke A P Hospers
- Department of Medical Oncology, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - Michail Doukas
- Department of Pathology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Michael Vieth
- Institute of Pathology, Friedrich-Alexander-University Erlangen-Nuremberg, Klinikum Bayreuth, Bayreuth, Germany
| | - Alessandro Lugli
- Institute of Tissue Medicine and Pathology, University of Bern, Bern, Switzerland
| | - Iris D Nagtegaal
- Department of Pathology, Radboud University Medical Centre, Nijmegen, the Netherlands
| |
Collapse
|
2
|
Petrov K, Ivanov I, Popovska S, Betova T, Kamburova Z. Colorectal Cancer: A Brief and Simplified Analysis of a Complex Disease. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:2034. [PMID: 39768914 PMCID: PMC11727892 DOI: 10.3390/medicina60122034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2024] [Revised: 11/20/2024] [Accepted: 12/06/2024] [Indexed: 01/16/2025]
Abstract
Background and Objectives: This study examined factors influencing the onset and progression of colorectal tumors, including patients' epidemiological data, tumor location (right-sided, left-sided, and rectal), histomorphology, perineural or intraneural invasion, lymph node status, immune reactions, mismatch repair (MMR) status, and commonly observed mutations. Our primary goal was to evaluate their predictive and prognostic value and interactions. Materials and Methods: We analyzed a retrospective cohort of 100 patients with colorectal adenocarcinoma diagnosed between 2020 and 2023, using formalin-fixed paraffin-embedded (FFPE) tumor blocks. The methods included routine H&E microscopy, immunohistochemistry, Next-Generation Sequencing (NGS), and subsequent statistical analysis. Results: The findings showed a median diagnosis age of 70 years, with no gender-specific tumor localization. Right-sided tumors were prevalent, especially among patients with a defective MMR (dMMR), which represented 89% of dMMR cases. MMR status significantly correlated with tumor localization. We observed significant relationships between tumor grade, lymphovascular invasion, and overall tumor stage. Higher tumor grades and stages correlated with increased lymphovascular invasion and lymph node involvement. Interestingly, tumor budding did not correlate with lymph node metastasis but was significantly associated with higher tumor grades. Most BRAF mutations were found in right-sided tumors, indicating a significant correlation with this localization. Conclusions: This study focuses on the diversity of colorectal cancer (CRC) by examining how genetic and histological characteristics vary based on tumor location or other tumor variables.
Collapse
Affiliation(s)
- Krasimir Petrov
- Department of Pathology, Faculty of Medicine, Medical University, 5800 Pleven, Bulgaria
- Department of General and Clinical Pathology, University Multi-profile Hospital for Active Treatment “Georgi Stranski”, 5800 Pleven, Bulgaria
| | - Ivan Ivanov
- Department of Pathology, Faculty of Medicine, Medical University, 5800 Pleven, Bulgaria
- Department of General and Clinical Pathology, University Multi-profile Hospital for Active Treatment “Georgi Stranski”, 5800 Pleven, Bulgaria
| | - Savelina Popovska
- Department of Pathology, Faculty of Medicine, Medical University, 5800 Pleven, Bulgaria
- Department of General and Clinical Pathology, University Multi-profile Hospital for Active Treatment “Georgi Stranski”, 5800 Pleven, Bulgaria
| | - Tatyana Betova
- Department of Pathology, Faculty of Medicine, Medical University, 5800 Pleven, Bulgaria
- Department of General and Clinical Pathology, University Multi-profile Hospital for Active Treatment “Georgi Stranski”, 5800 Pleven, Bulgaria
| | - Zornitsa Kamburova
- Department of Medical Genetics, Faculty of Pharmacy, Medical University, 5800 Pleven, Bulgaria
| |
Collapse
|
3
|
Aherne S, Donnelly M, Ryan ÉJ, Davey MG, Creavin B, McGrath E, McCarthy A, Geraghty R, Gibbons D, Nagtegaal I, Lugli A, Kirsch R, Martin ST, Winter DC, Sheahan K. Tumour budding as a prognostic biomarker in biopsies and resections of neoadjuvant-treated rectal adenocarcinoma. Histopathology 2024; 85:224-243. [PMID: 38629323 DOI: 10.1111/his.15192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 03/02/2024] [Accepted: 03/30/2024] [Indexed: 07/16/2024]
Abstract
BACKGROUND Tumour budding (TB) is a marker of tumour aggressiveness which, when measured in rectal cancer resection specimens, predicts worse outcomes and response to neoadjuvant therapy. We investigated the utility of TB assessment in the setting of neoadjuvant treatment. METHODS AND RESULTS A single-centre, retrospective cohort study was conducted. TB was assessed using the hot-spot International Tumour Budding Consortium (ITBCC) method and classified by the revised ITBCC criteria. Haematoxylin and eosin (H&E) and AE1/AE3 cytokeratin (CK) stains for ITB (intratumoural budding) in biopsies with PTB (peritumoural budding) and ITB (intratumoural budding) in resection specimens were compared. Logistic regression assessed budding as predictors of lymph node metastasis (LNM). Cox regression and Kaplan-Meier analyses investigated their utility as a predictor of disease-free (DFS) and overall (OS) survival. A total of 146 patients were included; 91 were male (62.3%). Thirty-seven cases (25.3%) had ITB on H&E and 79 (54.1%) had ITB on CK assessment of biopsy tissue. In univariable analysis, H&E ITB [odds (OR) = 2.709, 95% confidence interval (CI) = 1.261-5.822, P = 0.011] and CK ITB (OR = 2.165, 95% CI = 1.076-4.357, P = 0.030) predicted LNM. Biopsy-assessed H&E ITB (OR = 2.749, 95% CI = 1.258-6.528, P = 0.022) was an independent predictor of LNM. In Kaplan-Meier analysis, ITB identified on biopsy was associated with worse OS (H&E, P = 0.003, CK: P = 0.009) and DFS (H&E, P = 0.012; CK, P = 0.045). In resection specimens, CK PTB was associated with worse OS (P = 0.047), and both CK PTB and ITB with worse DFS (PTB, P = 0.014; ITB: P = 0.019). In multivariable analysis H&E ITB predicted OS (HR = 2.930, 95% CI = 1.261-6.809) and DFS (HR = 2.072, 95% CI = 1.031-4.164). CK PTB grading on resection also independently predicted OS (HR = 3.417, 95% CI = 1.45-8.053, P = 0.005). CONCLUSION Assessment of TB using H&E and CK may be feasible in rectal cancer biopsy and post-neoadjuvant therapy-treated resection specimens and is associated with LNM and worse survival outcomes. Future management strategies for rectal cancer might be tailored to incorporate these findings.
Collapse
Affiliation(s)
- Susan Aherne
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
- School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
- International Tumour Budding Consortium Funded by the Dutch Cancer Society, Amsterdam, The Netherlands
| | - Mark Donnelly
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
- School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
| | - Éanna J Ryan
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
- School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
| | - Matthew G Davey
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
| | - Ben Creavin
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
- School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
| | - Erinn McGrath
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
- School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
| | - Aoife McCarthy
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
| | - Robert Geraghty
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
| | - David Gibbons
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
- School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
- International Tumour Budding Consortium Funded by the Dutch Cancer Society, Amsterdam, The Netherlands
| | - Iris Nagtegaal
- International Tumour Budding Consortium Funded by the Dutch Cancer Society, Amsterdam, The Netherlands
| | - Alessandro Lugli
- International Tumour Budding Consortium Funded by the Dutch Cancer Society, Amsterdam, The Netherlands
| | - Richard Kirsch
- International Tumour Budding Consortium Funded by the Dutch Cancer Society, Amsterdam, The Netherlands
| | - Sean T Martin
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
- School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
| | - Desmond C Winter
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
- School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
| | - Kieran Sheahan
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
- School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
- International Tumour Budding Consortium Funded by the Dutch Cancer Society, Amsterdam, The Netherlands
| |
Collapse
|
4
|
Pyo JS, Choi JE, Kim NY, Min KW, Kang DW. Prognostic Implications of Intratumoral Budding in Colorectal Cancer: Detailed Analysis Based on Tumor-Infiltrating Lymphocytes. J Clin Med 2023; 13:134. [PMID: 38202141 PMCID: PMC10779795 DOI: 10.3390/jcm13010134] [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: 11/20/2023] [Revised: 12/18/2023] [Accepted: 12/22/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND This study aims to understand the clinical and pathological importance of intratumoral budding (ITB) in colorectal cancer (CRC) and its relationship with tumor-infiltrating lymphocytes (TILs). CRCs can be classified into hot (high immunoscore (IS)) and cold (low IS) tumors. METHODS We investigated the number of ITBs in a hotspot area and categorized them into high-ITB (≥5) and low-ITB (<5) groups. The clinicopathological significance of ITB in human CRCs was evaluated, and a detailed analysis based on tumor-infiltrating lymphocytes (TILs) was also performed. RESULTS High ITB was identified in 59 of 266 CRC cases (22.2%). High ITB significantly correlated with a poorly differentiated tumor, lympho-vascular invasion, perineural invasion, higher pT stage, lymph node metastasis, and higher metastatic lymph node ratio. High ITB was also significantly correlated with a low IS and low CD8-positive lymphocytic infiltrate. The number of ITBs was substantially higher in the low-IS group than in the high-IS group (3.28 ± 3.31 vs. 2.19 ± 2.59; p = 0.005). High ITB significantly correlated with worse overall survival (p = 0.004). In the low-IS group, CRCs with high ITB had a significantly worse prognosis than those with low ITB (p = 0.021). However, there was no significant difference in prognosis between the high- and low-ITB groups in the high-IS group (p = 0.498). CONCLUSIONS Taken together, high ITB was significantly correlated with aggressive tumor behaviors and worse survival in patients with CRCs. In addition, ITB can be useful for the prognostic stratification of CRCs with low IS.
Collapse
Affiliation(s)
- Jung-Soo Pyo
- Department of Pathology, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu-si 11759, Republic of Korea; (J.-S.P.); (K.-W.M.)
| | - Ji Eun Choi
- Department of Pathology, Chungnam National University Sejong Hospital, 20 Bodeum 7-ro, Sejong 30099, Republic of Korea;
| | - Nae Yu Kim
- Department of Internal Medicine, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu-si 11759, Republic of Korea;
| | - Kyueng-Whan Min
- Department of Pathology, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu-si 11759, Republic of Korea; (J.-S.P.); (K.-W.M.)
| | - Dong-Wook Kang
- Department of Pathology, Chungnam National University Sejong Hospital, 20 Bodeum 7-ro, Sejong 30099, Republic of Korea;
- Department of Pathology, Chungnam National University School of Medicine, 266 Munhwa Street, Daejeon 35015, Republic of Korea
| |
Collapse
|
5
|
Kang G, Pyo JS, Kim NY, Kang DW. Clinicopathological Significances and Prognostic Role of Intratumoral Budding in Colorectal Cancers. J Clin Med 2022; 11:jcm11195540. [PMID: 36233405 PMCID: PMC9570640 DOI: 10.3390/jcm11195540] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/05/2022] [Accepted: 09/18/2022] [Indexed: 11/19/2022] Open
Abstract
Background: This study aims to evaluate the clinicopathological significance and prognostic implications of intratumoral budding (ITB) in colorectal cancers (CRCs) through a meta-analysis. Methods: We performed the meta-analysis using 13 eligible studies and investigated the rates of CRCs with high ITB. The correlation between ITB and clinicopathological characteristics, including disease-free survival, was evaluated. Results: The estimated rate of CRCs with high ITB was 0.233 (95% confidence interval (CI) 0.177–0.299) in overall CRCs. High ITB was significantly correlated with tumor grade, lymphatic invasion, perineural invasion, pT stage, and lymph node metastasis. In addition, ITBs were more frequently found in medullary and signet-ring cell carcinomas than in conventional adenocarcinomas and mucinous carcinomas. However, the high ITB rate was not correlated with tumor border, tumor-infiltrating lymphocytes, or microsatellite instability. CRCs with a good response after neoadjuvant therapy revealed a lower rate of high ITB than those with a poor response (hazard ratio (HR) 0.114, 95% CI 0.070–0.179 vs. 0.321, 95% CI 0.204–0.467). In addition, CRCs with high ITB had a worse disease-free survival than those with low ITB (HR 1.426, 95% CI 1.092–1.863). Conclusions: The ITB was significantly correlated with aggressive tumor behaviors and a worse prognosis in CRCs. The detection of ITB, as a histological parameter, can be useful for predicting clinicopathologic features and the prognosis of CRC.
Collapse
Affiliation(s)
- Guhyun Kang
- Department of Pathology, Daehang Hospital, Seoul 06699, Korea
| | - Jung-Soo Pyo
- Department of Pathology, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu-si 11759, Korea
| | - Nae Yu Kim
- Department of Internal Medicine, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu-si 11759, Korea
| | - Dong-Wook Kang
- Department of Pathology, Chungnam National University Sejong Hospital, 20 Bodeum 7-ro, Sejong 30099, Korea
- Department of Pathology, Chungnam National University School of Medicine, 266 Munhwa Street, Daejeon 35015, Korea
- Correspondence: ; Tel.: +82-10-8561-9895
| |
Collapse
|
6
|
Shah AH, Gami AJ, Desai NH, Gandhi JS, Trivedi PP. Tumor budding as a prognostic indicator in colorectal carcinoma: a retrospective study of primary colorectal carcinoma cases in a tertiary care center. Indian J Surg Oncol 2022; 13:459-467. [PMID: 36187533 PMCID: PMC9515303 DOI: 10.1007/s13193-022-01498-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 01/11/2022] [Indexed: 10/19/2022] Open
Abstract
Colorectal carcinoma (CRC) is the third most common cancer worldwide. Along with many established prognostic factors, tumor budding is emerging as a valuable marker of prognosis. Tumor budding is not yet universally reported but it has recently been suggested in guidelines by ITBCC (International Tumor Budding Consensus Conference). Our aim is to study prognostic implications of tumor budding in CRC. Hundred cases of primary CRC specimens were retrospectively studied from January, 2016, to February, 2017. Tumor bud count and other histopathological parameters were evaluated from hematoxyline and eosin (H & E) stained slides. Survival analysis was done using Cox proportional hazards model. Association of tumor budding and cancer-specific survival was found to be statistically significant (P = 0.018 for average tumor budding and P = 0.035 for highest tumor budding) Tumor budding was found to be significantly associated with other clinicopathological parameters such as T stage, N stage, TNM stage, and lymphovascular invasion with p value < 0.05. Tumor budding is a valuable prognostic indictor for primary CRC and also significantly associated with other prognostic parameters. It should be reported routinely as a guide to prognosis and further management of patients.
Collapse
Affiliation(s)
- Ashini H. Shah
- Department of Oncopathology, Gujarat Cancer and Research Institute, Ahmedabad, 380016 Gujarat India
| | - Amisha J. Gami
- Department of Oncopathology, Gujarat Cancer and Research Institute, Ahmedabad, 380016 Gujarat India
| | - Neetal H. Desai
- Department of Oncopathology, Gujarat Cancer and Research Institute, Ahmedabad, 380016 Gujarat India
| | - Jahnavi S. Gandhi
- Department of Oncopathology, Gujarat Cancer and Research Institute, Ahmedabad, 380016 Gujarat India
| | - Priti P. Trivedi
- Department of Oncopathology, Gujarat Cancer and Research Institute, Ahmedabad, 380016 Gujarat India
| |
Collapse
|
7
|
Katoch A, Nayak D, Faheem MM, Kumar A, Sahu PK, Gupta AP, Kumar LD, Goswami A. Natural podophyllotoxin analog 4DPG attenuates EMT and colorectal cancer progression via activation of checkpoint kinase 2. Cell Death Discov 2021; 7:25. [PMID: 33500399 PMCID: PMC7838189 DOI: 10.1038/s41420-021-00405-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/17/2020] [Accepted: 11/13/2020] [Indexed: 02/07/2023] Open
Abstract
Epithelial–mesenchymal transition (EMT) is critical for the metastatic dissemination of cancer cells and contributes to drug resistance. In this study, we observed that epithelial colorectal cancer (CRC) cells transiently exposed to 5-fluorouracil (5-FU) (a chemotherapeutic drug for CRC) as well as 5-FU-resistant cells (5-FU-R) develop EMT characters as evidenced by activation of Vimentin and augmented invasive properties. On the other hand, 4DPG (4′-demethyl-deoxypodophyllotoxin glucoside), a natural podophyllotoxin analog attenuates EMT and invadopodia formation abilities of HCT-116/5-FU-R and SW-620/5-FU-R cells. Treatment with 4DPG restrains Vimentin phosphorylation (Ser38) in 5-FU-R cells, along with downregulation of mesenchymal markers Twist1 and MMP-2 while augmenting the expression of epithelial markers E-cadherin and TIMP-1. Moreover, 4DPG boosts the tumor-suppressor protein, checkpoint kinase 2 (Chk2) via phosphorylation at Thr68 in a dose-dependent manner in 5-FU-R cells. Mechanistically, SiRNA-mediated silencing of Chk2, as well as treatment with Chk2-specific small-molecule inhibitor (PV1019), divulges that 4DPG represses Vimentin activation in a Chk2-dependent manner. Furthermore, immunoprecipitation analysis unveiled that 4DPG prevents complex formation between Vimentin and p53 resulting in the rescue of p53 and its nuclear localization in aggressive 5-FU-R cells. In addition, 4DPG confers suitable pharmacokinetic properties and strongly abrogates tumor growth, polyps formation, and lung metastasis in an orthotopic rat colorectal carcinoma model. In conclusion, our findings demonstrate 4DPG as a targeted antitumor/anti-metastatic pharmacological lead compound to circumvent EMT-associated drug resistance and suggest its clinical benefits for the treatment of aggressive cancers.
Collapse
Affiliation(s)
- Archana Katoch
- Academy of Scientific & Innovative Research (AcSIR), Ghaziabad, 201002, India.,Cancer Pharmacology Division, CSIR-Indian Institute of Integrative Medicine, Canal Road, Jammu, Jammu and Kashmir, 180001, India
| | - Debasis Nayak
- Division of Pharmaceutics and Pharmacology, College of Pharmacy, The Ohio State University, Columbus, OH, 43210, USA
| | - Mir Mohd Faheem
- Cancer Pharmacology Division, CSIR-Indian Institute of Integrative Medicine, Canal Road, Jammu, Jammu and Kashmir, 180001, India.,School of Biotechnology, University of Jammu, Jammu, Jammu and Kashmir, 180006, India
| | - Aviral Kumar
- Cancer Biology, CSIR-Centre for Cellular & Molecular Biology, Hyderabad, Telangana, 500007, India
| | - Promod Kumar Sahu
- Cancer Pharmacology Division, CSIR-Indian Institute of Integrative Medicine, Canal Road, Jammu, Jammu and Kashmir, 180001, India
| | - Ajai Prakash Gupta
- Quality Control and Quality Assurance Division, CSIR-Indian Institute of Integrative Medicine, Jammu, Jammu and Kashmir, 180001, India
| | - Lekha Dinesh Kumar
- Cancer Biology, CSIR-Centre for Cellular & Molecular Biology, Hyderabad, Telangana, 500007, India
| | - Anindya Goswami
- Academy of Scientific & Innovative Research (AcSIR), Ghaziabad, 201002, India. .,Cancer Pharmacology Division, CSIR-Indian Institute of Integrative Medicine, Canal Road, Jammu, Jammu and Kashmir, 180001, India.
| |
Collapse
|