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Wiltink LM, Miah AB, Scholten AN, Haas RL. Unraveling the Myth of Radiation Resistance in Soft Tissue Sarcomas. Semin Radiat Oncol 2024; 34:172-179. [PMID: 38508782 DOI: 10.1016/j.semradonc.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
There is a misconception that sarcomas are resistant to radiotherapy. This manuscript summarizes available (pre-) clinical data on the radiosensitivity of soft tissue sarcomas. Currently, clinical practice guidelines suggest irradiating sarcomas in 1.8-2 Gy once daily fractions. Careful observation of myxoid liposarcomas patients during preoperative radiotherapy led to the discovery of this subtype's remarkable radiosensitivity. It resulted subsequently in an international prospective clinical trial demonstrating the safety of a reduced total dose, yet still delivered with conventional 1.8-2 Gy fractions. In several areas of oncology, especially for tumors of epithelial origin where radiotherapy plays a curative role, the concurrent application of systemic compounds aiming for radiosensitization has been incorporated into routine clinical practice. This approach has also been investigated in sarcomas and is summarized in this manuscript. Observing relatively low α/β ratios after preclinical cellular investigations, investigators have explored hypofractionation with daily doses ranging from 2.85-8.0 Gy per day in prospective clinical studies, and the data are presented. Finally, we summarize work with mouse models and genomic investigations to predict observed responses to radiotherapy in sarcoma patients. Taken together, these data indicate that sarcomas are not resistant to radiation therapy.
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Affiliation(s)
- L M Wiltink
- Department of Radiotherapy, The Leiden University Medical Center, Leiden, The Netherlands.
| | - A B Miah
- Department of Radiotherapy and Physics, The Royal Marsden Hospital and The Institute of Cancer Research, London, UK.
| | - A N Scholten
- Department of Radiotherapy, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
| | - R L Haas
- Department of Radiotherapy, The Leiden University Medical Center, Leiden, The Netherlands; Department of Radiotherapy, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
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Costa A, Gozzellino L, Nannini M, Astolfi A, Pantaleo MA, Pasquinelli G. Preclinical Models of Visceral Sarcomas. Biomolecules 2023; 13:1624. [PMID: 38002306 PMCID: PMC10669128 DOI: 10.3390/biom13111624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 10/30/2023] [Accepted: 11/02/2023] [Indexed: 11/26/2023] Open
Abstract
Visceral sarcomas are a rare malignant subgroup of soft tissue sarcomas (STSs). STSs, accounting for 1% of all adult tumors, are derived from mesenchymal tissues and exhibit a wide heterogeneity. Their rarity and the high number of histotypes hinder the understanding of tumor development mechanisms and negatively influence clinical outcomes and treatment approaches. Although some STSs (~20%) have identifiable genetic markers, as specific mutations or translocations, most are characterized by complex genomic profiles. Thus, identification of new therapeutic targets and development of personalized therapies are urgent clinical needs. Although cell lines are useful for preclinical investigations, more reliable preclinical models are required to develop and test new potential therapies. Here, we provide an overview of the available in vitro and in vivo models of visceral sarcomas, whose gene signatures are still not well characterized, to highlight current challenges and provide insights for future studies.
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Affiliation(s)
- Alice Costa
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Livia Gozzellino
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
| | - Margherita Nannini
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
- Division of Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Annalisa Astolfi
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
| | - Maria Abbondanza Pantaleo
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
- Division of Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Gianandrea Pasquinelli
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
- Division of Pathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
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Lucarelli E, De Vita A, Bellotti C, Frisoni T, Vanni S, Guerrieri AN, Pannella M, Mercatali L, Gambarotti M, Duchi S, Miserocchi G, Maioli M, Liverani C, Ibrahim T. Modeling Myxofibrosarcoma: Where Do We Stand and What Is Missing? Cancers (Basel) 2023; 15:5132. [PMID: 37958307 PMCID: PMC10650645 DOI: 10.3390/cancers15215132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/19/2023] [Accepted: 10/21/2023] [Indexed: 11/15/2023] Open
Abstract
Myxofibrosarcoma (MFS) is a malignant soft tissue sarcoma (STS) that originates in the body's connective tissues. It is characterized by the presence of myxoid (gel-like) and fibrous components and typically affects patients after the fifth decade of life. Considering the ongoing trend of increasing lifespans across many nations, MFS is likely to become the most common musculoskeletal sarcoma in the future. Although MFS patients have a lower risk of developing distant metastases compared with other STS cases, MFS is characterized by a high frequency of local recurrence. Notably, in 40-60% of the patients where the tumor recurs, it does so multiple times. Consequently, patients may undergo multiple local surgeries, removing the risk of potential amputation. Furthermore, because the tumor relapses generally have a higher grade, they exhibit a decreased response to radio and chemotherapy and an increased tendency to form metastases. Thus, a better understanding of MFS is required, and improved therapeutic options must be developed. Historically, preclinical models for other types of tumors have been instrumental in obtaining a better understanding of tumor development and in testing new therapeutic approaches. However, few MFS models are currently available. In this review, we will describe the MFS models available and will provide insights into the advantages and constraints of each model.
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Affiliation(s)
- Enrico Lucarelli
- Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (E.L.); (A.N.G.); (M.P.); (L.M.); (T.I.)
| | - Alessandro De Vita
- Preclinic and Osteoncology Unit, Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (A.D.V.); (S.V.); (G.M.); (C.L.)
| | - Chiara Bellotti
- Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (E.L.); (A.N.G.); (M.P.); (L.M.); (T.I.)
| | - Tommaso Frisoni
- Unit of 3rd Orthopaedic and Traumatologic Clinic Prevalently Oncologic, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy;
| | - Silvia Vanni
- Preclinic and Osteoncology Unit, Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (A.D.V.); (S.V.); (G.M.); (C.L.)
| | - Ania Naila Guerrieri
- Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (E.L.); (A.N.G.); (M.P.); (L.M.); (T.I.)
| | - Micaela Pannella
- Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (E.L.); (A.N.G.); (M.P.); (L.M.); (T.I.)
| | - Laura Mercatali
- Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (E.L.); (A.N.G.); (M.P.); (L.M.); (T.I.)
| | - Marco Gambarotti
- Department of Pathology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (M.G.); (M.M.)
| | - Serena Duchi
- Department of Surgery-ACMD, St. Vincent’s Hospital Melbourne, University of Melbourne, Melbourne, VIC 3065, Australia;
| | - Giacomo Miserocchi
- Preclinic and Osteoncology Unit, Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (A.D.V.); (S.V.); (G.M.); (C.L.)
| | - Margherita Maioli
- Department of Pathology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (M.G.); (M.M.)
| | - Chiara Liverani
- Preclinic and Osteoncology Unit, Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (A.D.V.); (S.V.); (G.M.); (C.L.)
| | - Toni Ibrahim
- Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (E.L.); (A.N.G.); (M.P.); (L.M.); (T.I.)
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Landuzzi L, Ruzzi F, Lollini PL, Scotlandi K. Synovial Sarcoma Preclinical Modeling: Integrating Transgenic Mouse Models and Patient-Derived Models for Translational Research. Cancers (Basel) 2023; 15:cancers15030588. [PMID: 36765545 PMCID: PMC9913760 DOI: 10.3390/cancers15030588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/12/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023] Open
Abstract
Synovial sarcomas (SyS) are rare malignant tumors predominantly affecting children, adolescents, and young adults. The genetic hallmark of SyS is the t(X;18) translocation encoding the SS18-SSX fusion gene. The fusion protein interacts with both the BAF enhancer and polycomb repressor complexes, and either activates or represses target gene transcription, resulting in genome-wide epigenetic perturbations and altered gene expression. Several experimental in in vivo models, including conditional transgenic mouse models expressing the SS18-SSX fusion protein and spontaneously developing SyS, are available. In addition, patient-derived xenografts have been estab-lished in immunodeficient mice, faithfully reproducing the complex clinical heterogeneity. This review focuses on the main molecular features of SyS and the related preclinical in vivo and in vitro models. We will analyze the different conditional SyS mouse models that, after combination with some of the few other recurrent alterations, such as gains in BCL2, Wnt-β-catenin signaling, FGFR family, or loss of PTEN and SMARCB1, have provided additional insight into the mechanisms of synovial sarcomagenesis. The recent advancements in the understanding of SyS biology and improvements in preclinical modeling pave the way to the development of new epigenetic drugs and immunotherapeutic approaches conducive to new treatment options.
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Affiliation(s)
- Lorena Landuzzi
- Experimental Oncology Laboratory, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
- Correspondence: (L.L.); (P.-L.L.); Tel.: +39-051-2094796 (L.L.); +39-051-2094786 (P.-L.L.)
| | - Francesca Ruzzi
- Laboratory of Immunology and Biology of Metastasis, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40126 Bologna, Italy
| | - Pier-Luigi Lollini
- Laboratory of Immunology and Biology of Metastasis, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40126 Bologna, Italy
- Correspondence: (L.L.); (P.-L.L.); Tel.: +39-051-2094796 (L.L.); +39-051-2094786 (P.-L.L.)
| | - Katia Scotlandi
- Experimental Oncology Laboratory, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
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Kerrison WGJ, Ning J, Krasny L, Arthur A, Guljar N, Elms ML, Swain A, Jones RL, Thway K, Huang PH. Characterisation of a Novel Cell Line (ICR-SS-1) Established from a Patient-Derived Xenograft of Synovial Sarcoma. Cells 2022; 11:2418. [PMID: 35954262 PMCID: PMC9368503 DOI: 10.3390/cells11152418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/28/2022] [Accepted: 08/03/2022] [Indexed: 12/04/2022] Open
Abstract
Synovial sarcoma is a rare translocation-driven cancer with poor survival outcomes, particularly in the advanced setting. Previous synovial sarcoma preclinical studies have relied on a small panel of cell lines which suffer from the limitation of genomic and phenotypic drift as a result of being grown in culture for decades. Patient-derived xenografts (PDX) are a valuable tool for preclinical research as they retain many histopathological features of their originating human tumour; however, this approach is expensive, slow, and resource intensive, which hinders their utility in large-scale functional genomic and drug screens. To address some of these limitations, in this study, we have established and characterised a novel synovial sarcoma cell line, ICR-SS-1, which is derived from a PDX model and is amenable to high-throughput drug screens. We show that ICR-SS-1 grows readily in culture, retains the pathognomonic SS18::SSX1 fusion gene, and recapitulates the molecular features of human synovial sarcoma tumours as shown by proteomic profiling. Comparative analysis of drug response profiles with two other established synovial sarcoma cell lines (SYO-1 and HS-SY-II) finds that ICR-SS-1 harbours intrinsic resistance to doxorubicin and is sensitive to targeted inhibition of several oncogenic pathways including the PI3K-mTOR pathway. Collectively, our studies show that the ICR-SS-1 cell line model may be a valuable preclinical tool for studying the biology of anthracycline-resistant synovial sarcoma and identifying new salvage therapies following failure of doxorubicin.
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Vanni S, De Vita A, Gurrieri L, Fausti V, Miserocchi G, Spadazzi C, Liverani C, Cocchi C, Calabrese C, Bongiovanni A, Riva N, Mercatali L, Pieri F, Casadei R, Lucarelli E, Ibrahim T. Myxofibrosarcoma landscape: diagnostic pitfalls, clinical management and future perspectives. Ther Adv Med Oncol 2022; 14:17588359221093973. [PMID: 35782752 PMCID: PMC9244941 DOI: 10.1177/17588359221093973] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 01/12/2022] [Indexed: 12/26/2022] Open
Abstract
Myxofibrosarcoma (MFS) is a common entity of adult soft tissue sarcomas (STS) characterized by a predilection of the extremities and a high local recurrence rate. Originally classified as a myxoid variant of malignant fibrous histiocytoma, this musculoskeletal tumor has been recognized since 2002 as a distinct histotype showing a spectrum of malignant fibroblastic lesions with myxoid stroma, pleomorphism and curvilinear vessels. Currently, the molecular pathogenesis of MFS is still poorly understood and its genomic profile exhibits a complex karyotype with a number of aberrations including amplifications, deletions and loss of function. The diagnosis is challenging due to the unavailability of specific immunohistochemical markers and is based on the analysis of cytomorphologic features. The mainstay of treatment for localized disease is represented by surgical resection, with (neo)-adjuvant radio- and chemotherapy. In the metastatic setting, chemotherapy represents the backbone of treatments, however its role is still controversial and the outcome is very poor. Recent advent of genomic profiling, targeted therapies and larger enrollment of patients in translational and clinical studies, have improved the understanding of biological behavior and clinical outcome of such a disease. This review will provide an overview of current diagnostic pitfalls and clinical management of MFS. Finally, a look at future directions will be discussed.
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Affiliation(s)
- Silvia Vanni
- Osteoncology Unit, Bioscience Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Meldola, Italy
| | - Alessandro De Vita
- Osteoncology Unit, Bioscience Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Via P. Maroncelli 40, Meldola 47014, Forlì-Cesena, Italy
| | - Lorena Gurrieri
- Osteoncology Unit, Bioscience Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Meldola, Italy
| | - Valentina Fausti
- Osteoncology Unit, Bioscience Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Meldola, Italy
| | - Giacomo Miserocchi
- Osteoncology Unit, Bioscience Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Meldola, Italy
| | - Chiara Spadazzi
- Osteoncology Unit, Bioscience Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Meldola, Italy
| | - Chiara Liverani
- Osteoncology Unit, Bioscience Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Meldola, Italy
| | - Claudia Cocchi
- Osteoncology Unit, Bioscience Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Meldola, Italy
| | - Chiara Calabrese
- Osteoncology Unit, Bioscience Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Meldola, Italy
| | - Alberto Bongiovanni
- Osteoncology Unit, Bioscience Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Meldola, Italy
| | - Nada Riva
- Osteoncology Unit, Bioscience Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Meldola, Italy
| | - Laura Mercatali
- Osteoncology Unit, Bioscience Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Meldola, Italy
| | - Federica Pieri
- Pathology Unit, 'Morgagni-Pierantoni' Hospital, Forlì, Italy
| | - Roberto Casadei
- Orthopedic Unit, 'Morgagni-Pierantoni' Hospital, Forlì, Italy
| | - Enrico Lucarelli
- Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Toni Ibrahim
- Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
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Van Renterghem B, Wozniak A, Castro PG, Franken P, Pencheva N, Sciot R, Schöffski P. Enapotamab Vedotin, an AXL-Specific Antibody-Drug Conjugate, Demonstrates Antitumor Efficacy in Patient-Derived Xenograft Models of Soft Tissue Sarcoma. Int J Mol Sci 2022; 23:7493. [PMID: 35886842 PMCID: PMC9322120 DOI: 10.3390/ijms23147493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/28/2022] [Accepted: 07/04/2022] [Indexed: 11/16/2022] Open
Abstract
Doxorubicin (doxo) remains the standard of care for patients with advanced soft tissue sarcoma (STS), even though response rates to doxo are only around 14% to 18%. We evaluated enapotamab vedotin (EnaV), an AXL-specific antibody-drug conjugate (ADC), in a panel of STS patient-derived xenografts (PDX). Eight models representing multiple STS subtypes were selected from our STS PDX platform (n = 45) by AXL immunostaining on archived passages. Models were expanded by unilateral transplantation of tumor tissue into the left flank of 20 NMRI nu/nu mice. Once tumors were established, mice were randomized into an EnaV treatment group, or a group treated with isotype control ADC. Treatment efficacy was assessed by tumor volume evaluation, survival analysis, and histological evaluation of tumors, and associated with AXL expression. EnaV demonstrated significant tumor growth delay, regression, and/or prolonged survival compared to isotype control ADC in 5/8 STS PDX models investigated. Experimental passages of responding models were all found positive for AXL at varying levels, but no linear relationship could be identified between the level of expression and level of response to EnaV. One model was found negative for AXL on experimental passage and did not respond to EnaV. This study provides a preclinical rationale for the evaluation of AXL-targeting ADCs in the treatment of AXL-expressing sarcomas.
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Affiliation(s)
- Britt Van Renterghem
- Laboratory of Experimental Oncology, Catholic University of Leuven, 3000 Leuven, Belgium; (B.V.R.); (A.W.)
| | - Agnieszka Wozniak
- Laboratory of Experimental Oncology, Catholic University of Leuven, 3000 Leuven, Belgium; (B.V.R.); (A.W.)
| | | | - Patrick Franken
- Genmab, 3584 Utrecht, The Netherlands; (P.G.C.); (P.F.); (N.P.)
| | - Nora Pencheva
- Genmab, 3584 Utrecht, The Netherlands; (P.G.C.); (P.F.); (N.P.)
| | - Raf Sciot
- Department of Pathology, University Hospitals Leuven, Catholic University of Leuven, 3000 Leuven, Belgium;
| | - Patrick Schöffski
- Laboratory of Experimental Oncology, Catholic University of Leuven, 3000 Leuven, Belgium; (B.V.R.); (A.W.)
- Department of General Medical Oncology, University Hospitals Leuven, 3000 Leuven, Belgium
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Wang Y, Wozniak A, Cornillie J, Avilés P, Debiec-Rychter M, Sciot R, Schöffski P. Plocabulin, a Novel Tubulin Inhibitor, Has Potent Antitumour Activity in Patient-Derived Xenograft Models of Soft Tissue Sarcoma. Int J Mol Sci 2022; 23:7454. [PMID: 35806460 DOI: 10.3390/ijms23137454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/26/2022] [Accepted: 07/01/2022] [Indexed: 02/01/2023] Open
Abstract
A clinically relevant subset of patients with soft tissue sarcoma presents with either locally advanced or upfront metastatic disease, or will develop distant metastases over time, despite successful treatment of their primary tumour. The currently available systemic agents to treat such advanced cases only provide modest disease control and are not active in all histological subtypes. Thus, there is an unmet need for novel and more efficacious agents to improve the outcome of this rare disease. In the current preclinical in vivo study, we evaluated plocabulin, a novel tubulin inhibitor, in five distinct histological subtypes of soft tissue sarcoma: dedifferentiated liposarcoma, leiomyosarcoma, undifferentiated sarcoma, intimal sarcoma and CIC-rearranged sarcoma. The efficacy was tested in seven patient-derived xenograft models, which were generated by the engraftment of tumour fragments from patients directly into nude mice. The treatment lasted 22 days, and the efficacy of the drug was assessed and compared to the doxorubicin and vehicle groups by volumetric analysis, histopathology and immunohistochemistry. We observed tumour volume control in all the tested histological subtypes. Additionally, in three sarcoma subtypes, extensive central necrosis, associated with significant tumour regression, was seen. This histological response is explained by the drug’s vascular-disruptive properties, reflected by a decreased total vascular area in the xenografts. Our results demonstrate the in vivo efficacy of plocabulin in the preclinical models of soft tissue sarcoma and corroborate the findings of our previous study, which demonstrated similar vascular-disruptive effects in gastrointestinal stromal tumours—another subtype of soft tissue sarcoma. Our data provide a convincing rationale for further clinical exploration of plocabulin in soft tissue sarcomas.
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Schöffski P, Gebreyohannes Y, Van Looy T, Manley P, Growney JD, Squires M, Wozniak A. In Vivo Evaluation of Fibroblast Growth Factor Receptor Inhibition in Mouse Xenograft Models of Gastrointestinal Stromal Tumor. Biomedicines 2022; 10:biomedicines10051135. [PMID: 35625872 PMCID: PMC9138864 DOI: 10.3390/biomedicines10051135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 02/01/2023] Open
Abstract
Advanced gastrointestinal stromal tumors (GIST) are typically treated with tyrosine kinase inhibitors, and imatinib is the most commonly used standard of care in first line treatments. The use of this and other tyrosine kinase inhibitors is associated with objective tumor responses and prolongation of progression-free and overall survival, but the treatment of metastatic disease is non-curative due to the selection or acquisition of secondary mutations and the activation of alternative kinase signaling pathways, leading to resistance and disease progression after an initial response. The present preclinical study evaluated the potential use of the fibroblast growth factor receptor inhibitors infigratinib and dovitinib alone or in combination with the mitogen-activated protein kinase inhibitor binimetinib in mouse models of GIST with different sensitivity or resistance to imatinib. Patient- and cell-line-derived GIST xenografts were established by bilateral, subcutaneous transplantation of human GIST tissue in female adult nu/nu NMRI mice. The mice were treated with dovitinib, infigratinib, or binimetinib, either alone or in combination with imatinib. The safety of treated animals was assessed by well-being inspection and body weight measurement. Antitumor effects were assessed by caliper-based tumor measurement. H&E staining and immunohistochemistry were used for assessing anti-mitotic and pro-apoptotic activity of the experimental treatments. Western blotting was used for assessing effects of the agents on kinase signaling pathways. Anti-angiogenic activity was assessed by measuring tumor vessel density. Dovitinib was found to have antitumor efficacy in GIST xenografts characterized by different imatinib resistance patterns. Dovitinib had better efficacy than imatinib (both at standard and increased dose) and was found to be well tolerated. Dovitinib had better efficacy in a KIT exon 9 mutant model, highlighting a role of patient selection in clinical GIST trials with the agent. In a model with KIT exon 11 and 17 mutations, dovitinib induced tumor necrosis, most likely due to anti-angiogenic effects. Additive effects combining dovitinib with binimetinib were limited.
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Affiliation(s)
- Patrick Schöffski
- Department of General Medical Oncology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
- Research Unit Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, Herestraat 49, 3000 Leuven, Belgium; (Y.G.); (T.V.L.); (A.W.)
- Correspondence: ; Tel.: +32-1634-6900
| | - Yemarshet Gebreyohannes
- Research Unit Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, Herestraat 49, 3000 Leuven, Belgium; (Y.G.); (T.V.L.); (A.W.)
| | - Thomas Van Looy
- Research Unit Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, Herestraat 49, 3000 Leuven, Belgium; (Y.G.); (T.V.L.); (A.W.)
| | - Paul Manley
- Novartis Pharma AG, St. Johann Campus, 4002 Basel, Switzerland; (P.M.); (J.D.G.)
| | - Joseph D. Growney
- Novartis Pharma AG, St. Johann Campus, 4002 Basel, Switzerland; (P.M.); (J.D.G.)
| | - Matthew Squires
- Novartis Pharmaceuticals Corporation, Cambridge, MA 02139, USA;
| | - Agnieszka Wozniak
- Research Unit Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, Herestraat 49, 3000 Leuven, Belgium; (Y.G.); (T.V.L.); (A.W.)
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10
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Van Renterghem B, Wozniak A, Tarantola L, Casazza A, Wellens J, Nysen M, Vanleeuw U, Lee CJ, Reyns G, Sciot R, Kindt N, Schöffski P. Enhanced Antitumor Efficacy of PhAc-ALGP-Dox, an Enzyme-Activated Doxorubicin Prodrug, in a Panel of THOP1-Expressing Patient-Derived Xenografts of Soft Tissue Sarcoma. Biomedicines 2022; 10:biomedicines10040862. [PMID: 35453612 PMCID: PMC9025547 DOI: 10.3390/biomedicines10040862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/29/2022] [Accepted: 04/04/2022] [Indexed: 12/10/2022] Open
Abstract
Despite poor response rates and dose-limiting cardiotoxicity, doxorubicin (doxo) remains the standard-of-care for patients with advanced soft tissue sarcoma. We evaluated the efficacy of two tetrapeptidic doxo prodrugs (PhAc-ALGP-Dox or CBR-049 and CBR-050) that are locally activated by enzymes expressed in the tumor environment, in ten sarcoma patient-derived xenografts. Xenograft models were selected based on expression of the main activating enzyme, i.e., thimet oligopeptidase (THOP1). Mice were either randomized to vehicle, doxo, CBR-049 and CBR-050 or control, doxo, aldoxorubicin (aldoxo) and CBR-049. Treatment efficacy was assessed by tumor volume measurement and histological assessment of ex-mouse tumors. CBR-049 showed significant tumor growth delay compared to control in all xenografts investigated and was superior compared to doxo in all but one. At the same time, CBR-049 showed comparable efficacy to aldoxo but the latter was found to have a complex safety profile in mice. CBR-050 demonstrated tumor growth delay compared to control in one xenograft but was not superior to doxo. For both experimental prodrugs, strong immunostaining for THOP1 was found to predict better antitumor efficacy. The prodrugs were well tolerated without any adverse events, even though molar doses were 17-fold higher than those administered and tolerated for doxo.
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Affiliation(s)
- Britt Van Renterghem
- Laboratory of Experimental Oncology, Catholic University of Leuven, 3000 Leuven, Belgium; (B.V.R.); (A.W.); (L.T.); (J.W.); (M.N.); (U.V.); (C.-J.L.)
| | - Agnieszka Wozniak
- Laboratory of Experimental Oncology, Catholic University of Leuven, 3000 Leuven, Belgium; (B.V.R.); (A.W.); (L.T.); (J.W.); (M.N.); (U.V.); (C.-J.L.)
| | - Ludovica Tarantola
- Laboratory of Experimental Oncology, Catholic University of Leuven, 3000 Leuven, Belgium; (B.V.R.); (A.W.); (L.T.); (J.W.); (M.N.); (U.V.); (C.-J.L.)
| | - Andrea Casazza
- CoBioRes, Campus Gasthuisberg, Catholic University of Leuven, 3000 Leuven, Belgium; (A.C.); (G.R.); (N.K.)
| | - Jasmien Wellens
- Laboratory of Experimental Oncology, Catholic University of Leuven, 3000 Leuven, Belgium; (B.V.R.); (A.W.); (L.T.); (J.W.); (M.N.); (U.V.); (C.-J.L.)
| | - Madita Nysen
- Laboratory of Experimental Oncology, Catholic University of Leuven, 3000 Leuven, Belgium; (B.V.R.); (A.W.); (L.T.); (J.W.); (M.N.); (U.V.); (C.-J.L.)
| | - Ulla Vanleeuw
- Laboratory of Experimental Oncology, Catholic University of Leuven, 3000 Leuven, Belgium; (B.V.R.); (A.W.); (L.T.); (J.W.); (M.N.); (U.V.); (C.-J.L.)
| | - Che-Jui Lee
- Laboratory of Experimental Oncology, Catholic University of Leuven, 3000 Leuven, Belgium; (B.V.R.); (A.W.); (L.T.); (J.W.); (M.N.); (U.V.); (C.-J.L.)
| | - Geert Reyns
- CoBioRes, Campus Gasthuisberg, Catholic University of Leuven, 3000 Leuven, Belgium; (A.C.); (G.R.); (N.K.)
| | - Raf Sciot
- Department of Pathology, University Hospitals Leuven, 3000 Leuven, Belgium;
| | - Nele Kindt
- CoBioRes, Campus Gasthuisberg, Catholic University of Leuven, 3000 Leuven, Belgium; (A.C.); (G.R.); (N.K.)
| | - Patrick Schöffski
- Laboratory of Experimental Oncology, Catholic University of Leuven, 3000 Leuven, Belgium; (B.V.R.); (A.W.); (L.T.); (J.W.); (M.N.); (U.V.); (C.-J.L.)
- Department of General Medical Oncology, University Hospitals Leuven, 3000 Leuven, Belgium
- Correspondence:
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11
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Hemming ML, Bhola P, Loycano MA, Anderson JA, Taddei ML, Doyle LA, Lavrova E, Andersen JL, Klega KS, Benson MR, Crompton BD, Raut CP, George S, Letai A, Demetri GD, Sicinska E. Preclinical modeling of leiomyosarcoma identifies susceptibility to transcriptional CDK inhibitors through antagonism of E2F-driven oncogenic gene expression. Clin Cancer Res 2022; 28:2397-2408. [PMID: 35325095 DOI: 10.1158/1078-0432.ccr-21-3523] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 02/15/2022] [Accepted: 03/22/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE Leiomyosarcoma (LMS) is a neoplasm characterized by smooth muscle differentiation, complex copy-number alterations, tumor suppressor loss and the absence of recurrent driver mutations. Clinical management for advanced disease relies on the use of empiric cytotoxic chemotherapy with limited activity, and novel targeted therapies supported by preclinical research on LMS biology are urgently needed. A lack of fidelity of established LMS cell lines to their mesenchymal neoplasm of origin has limited translational understanding of this disease, and few other preclinical models have been established. Here, we characterize LMS patient derived xenograft (PDX) models of LMS, assessing fidelity to their tumors of origin and performing preclinical evaluation of candidate therapies. EXPERIMENTAL DESIGN We implanted 49 LMS surgical samples into immunocompromised mice. Engrafting tumors were characterized by histology, targeted next-generation sequencing, RNA-seq and ultra-low passage whole-genome sequencing. Candidate therapies were selected based on prior evidence of pathway activation or high-throughput dynamic BH3 profiling. RESULTS We show that LMS PDX maintain the histologic appearance, copy-number alterations and transcriptional program of their parental tumors across multiple xenograft passages. Transcriptionally, LMS PDX co-cluster with paired LMS patient-derived samples and differ primarily in host-related immunologic and microenvironment signatures. We identify susceptibility of LMS PDX to transcriptional CDK inhibition, which disrupts an E2F-driven oncogenic transcriptional program and inhibits tumor growth. CONCLUSIONS Our results establish LMS PDX as valuable preclinical models and identify strategies to discover novel vulnerabilities in this disease. These data support the clinical assessment of transcriptional CDK inhibitors as a therapeutic strategy for LMS patients.
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Affiliation(s)
| | - Patrick Bhola
- Dana-Farber Cancer Institute, Boston, MA, United States
| | | | | | | | - Leona A Doyle
- Brigham and Women's Hospital, Boston, MA, United States
| | | | | | - Kelly S Klega
- Dana-Farber Cancer Institute, Boston, MA, United States
| | | | - Brian D Crompton
- Dana-Farber Cancer Institute and Boston Children's Hospital, Boston, MA, United States
| | - Chandrajit P Raut
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | | | - Anthony Letai
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, United States
| | | | - Ewa Sicinska
- Dana-Farber Cancer Institute, Boston, MA, United States
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12
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O'Sullivan Coyne G, Kummar S, Hu J, Ganjoo K, Chow WA, Do KT, Zlott J, Bruns A, Rubinstein L, Foster JC, Juwara L, Meehan R, Piekarz R, Streicher H, Sharon E, Takebe N, Voth AR, Bottaro D, Costello R, Wright JJ, Doroshow JH, Chen AP. Clinical Activity of Single-Agent Cabozantinib (XL184), a Multi-receptor Tyrosine Kinase Inhibitor, in Patients with Refractory Soft-Tissue Sarcomas. Clin Cancer Res 2022; 28:279-288. [PMID: 34716194 PMCID: PMC8776602 DOI: 10.1158/1078-0432.ccr-21-2480] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/17/2021] [Accepted: 10/26/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE Soft-tissue sarcomas (STS) are a rare, heterogeneous group of mesenchymal tumors. For decades the mainstay of treatment for advanced, unresectable STS has been palliative chemotherapy. High levels of activated MET receptor have been reported in various sarcoma cell lines, together with elevated vascular endothelial growth factor (VEGF) levels in patients with STS, suggesting that dual targeting of the VEGF and MET pathways with the multi-receptor tyrosine kinase inhibitor cabozantinib would result in clinical benefit in this population. PATIENTS AND METHODS We performed an open-label, multi-institution, single-arm phase II trial of single-agent cabozantinib in adult patients with advanced STS and progressive disease after at least 1 standard line of systemic therapy. Patients received 60 mg oral cabozantinib once daily in 28-day cycles, and dual primary endpoints of overall response rate and 6-month progression-free survival (PFS) were assessed. Changes in several circulating biomarkers were assessed as secondary endpoints. RESULTS Six (11.1%; 95% CI, 4.2%-22.6%) of the 54 evaluable patients enrolled experienced objective responses (all partial responses). Six-month PFS was 49.3% (95% CI, 36.2%-67.3%), with a median time on study of 4 cycles (range, 1-99). The most common grade 3/4 adverse events were hypertension (7.4%) and neutropenia (16.7%). Patients' levels of circulating hepatocyte growth factor (HGF), soluble MET, and VEGF-A generally increased after a cycle of therapy, while soluble VEGFR2 levels decreased, regardless of clinical outcome. CONCLUSIONS Cabozantinib single-agent antitumor activity was observed in patients with selected STS histologic subtypes (alveolar soft-part sarcoma, undifferentiated pleomorphic sarcoma, extraskeletal myxoid chondrosarcoma, and leiomyosarcoma) highlighting the biomolecular diversity of STS.
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Affiliation(s)
- Geraldine O'Sullivan Coyne
- Early Clinical Trials Development Program, Division of Cancer Treatment and Diagnosis, NCI, NIH, Bethesda, Maryland
| | - Shivaani Kummar
- Early Clinical Trials Development Program, Division of Cancer Treatment and Diagnosis, NCI, NIH, Bethesda, Maryland
| | - James Hu
- University of Southern California, Los Angeles, California
| | - Kristen Ganjoo
- Stanford Cancer Center, Stanford University, Palo Alto, California
| | | | - Khanh T Do
- Early Clinical Trials Development Program, Division of Cancer Treatment and Diagnosis, NCI, NIH, Bethesda, Maryland
| | - Jennifer Zlott
- Early Clinical Trials Development Program, Division of Cancer Treatment and Diagnosis, NCI, NIH, Bethesda, Maryland
| | - Ashley Bruns
- Early Clinical Trials Development Program, Division of Cancer Treatment and Diagnosis, NCI, NIH, Bethesda, Maryland
| | - Lawrence Rubinstein
- Biometric Research Program, Division of Cancer Treatment and Diagnosis, NCI, NIH, Bethesda, Maryland
| | - Jared C Foster
- Biometric Research Program, Division of Cancer Treatment and Diagnosis, NCI, NIH, Bethesda, Maryland
| | - Lamin Juwara
- Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | - Robert Meehan
- Early Clinical Trials Development Program, Division of Cancer Treatment and Diagnosis, NCI, NIH, Bethesda, Maryland
| | - Richard Piekarz
- Cancer Therapy Evaluation Program, Division of Cancer Treatment and Diagnosis, NCI, NIH, Bethesda, Maryland
| | - Howard Streicher
- Cancer Therapy Evaluation Program, Division of Cancer Treatment and Diagnosis, NCI, NIH, Bethesda, Maryland
| | - Elad Sharon
- Cancer Therapy Evaluation Program, Division of Cancer Treatment and Diagnosis, NCI, NIH, Bethesda, Maryland
| | - Naoko Takebe
- Early Clinical Trials Development Program, Division of Cancer Treatment and Diagnosis, NCI, NIH, Bethesda, Maryland
| | - Andrea Regier Voth
- Applied/Developmental Research Directorate, Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | - Donald Bottaro
- Center for Cancer Research, NCI, NIH, Bethesda, Maryland
| | - Rene Costello
- Center for Cancer Research, NCI, NIH, Bethesda, Maryland
| | - John J Wright
- Cancer Therapy Evaluation Program, Division of Cancer Treatment and Diagnosis, NCI, NIH, Bethesda, Maryland
| | - James H Doroshow
- Center for Cancer Research, NCI, NIH, Bethesda, Maryland
- Division of Cancer Treatment and Diagnosis, NCI, NIH, Bethesda, Maryland
| | - Alice P Chen
- Early Clinical Trials Development Program, Division of Cancer Treatment and Diagnosis, NCI, NIH, Bethesda, Maryland.
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13
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Damerell V, Pepper MS, Prince S. Molecular mechanisms underpinning sarcomas and implications for current and future therapy. Signal Transduct Target Ther 2021; 6:246. [PMID: 34188019 PMCID: PMC8241855 DOI: 10.1038/s41392-021-00647-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 04/18/2021] [Accepted: 05/18/2021] [Indexed: 02/06/2023] Open
Abstract
Sarcomas are complex mesenchymal neoplasms with a poor prognosis. Their clinical management is highly challenging due to their heterogeneity and insensitivity to current treatments. Although there have been advances in understanding specific genomic alterations and genetic mutations driving sarcomagenesis, the underlying molecular mechanisms, which are likely to be unique for each sarcoma subtype, are not fully understood. This is in part due to a lack of consensus on the cells of origin, but there is now mounting evidence that they originate from mesenchymal stromal/stem cells (MSCs). To identify novel treatment strategies for sarcomas, research in recent years has adopted a mechanism-based search for molecular markers for targeted therapy which has included recapitulating sarcomagenesis using in vitro and in vivo MSC models. This review provides a comprehensive up to date overview of the molecular mechanisms that underpin sarcomagenesis, the contribution of MSCs to modelling sarcomagenesis in vivo, as well as novel topics such as the role of epithelial-to-mesenchymal-transition (EMT)/mesenchymal-to-epithelial-transition (MET) plasticity, exosomes, and microRNAs in sarcomagenesis. It also reviews current therapeutic options including ongoing pre-clinical and clinical studies for targeted sarcoma therapy and discusses new therapeutic avenues such as targeting recently identified molecular pathways and key transcription factors.
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Affiliation(s)
- Victoria Damerell
- Division of Cell Biology, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Observatory, Cape Town, South Africa
| | - Michael S Pepper
- Institute for Cellular and Molecular Medicine, Department of Immunology, SAMRC Extramural Unit for Stem Research and Therapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Sharon Prince
- Division of Cell Biology, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Observatory, Cape Town, South Africa.
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14
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Imle R, Kommoss FKF, Banito A. Preclinical In Vivo Modeling of Pediatric Sarcoma-Promises and Limitations. J Clin Med 2021; 10:1578. [PMID: 33918045 DOI: 10.3390/jcm10081578] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 04/05/2021] [Accepted: 04/06/2021] [Indexed: 02/07/2023] Open
Abstract
Pediatric sarcomas are an extremely heterogeneous group of genetically distinct diseases. Despite the increasing knowledge on their molecular makeup in recent years, true therapeutic advancements are largely lacking and prognosis often remains dim, particularly for relapsed and metastasized patients. Since this is largely due to the lack of suitable model systems as a prerequisite to develop and assess novel therapeutics, we here review the available approaches to model sarcoma in vivo. We focused on genetically engineered and patient-derived mouse models, compared strengths and weaknesses, and finally explored possibilities and limitations to utilize these models to advance both biological understanding as well as clinical diagnosis and therapy.
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15
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Kasper B, Achee A, Schuster K, Wilson R, van Oortmerssen G, Gladdy RA, Hemming ML, Huang P, Ingham M, Jones RL, Pollack SM, Reinke D, Sanfilippo R, Schuetze SM, Somaiah N, Van Tine BA, Wilky B, Okuno S, Trent J. Unmet Medical Needs and Future Perspectives for Leiomyosarcoma Patients-A Position Paper from the National LeioMyoSarcoma Foundation (NLMSF) and Sarcoma Patients EuroNet (SPAEN). Cancers (Basel) 2021; 13:886. [PMID: 33672607 PMCID: PMC7924026 DOI: 10.3390/cancers13040886] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/11/2021] [Accepted: 02/15/2021] [Indexed: 02/07/2023] Open
Abstract
As leiomyosarcoma patients are challenged by the development of metastatic disease, effective systemic therapies are the cornerstone of outcome. However, the overall activity of the currently available conventional systemic treatments and the prognosis of patients with advanced or metastatic disease are still poor, making the treatment of this patient group challenging. Therefore, in a joint effort together with patient networks and organizations, namely Sarcoma Patients EuroNet (SPAEN), the international network of sarcoma patients organizations, and the National LeioMyoSarcoma Foundation (NLMSF) in the United States, we aim to summarize state-of-the-art treatments for leiomyosarcoma patients in order to identify knowledge gaps and current unmet needs, thereby guiding the community to design innovative clinical trials and basic research and close these research gaps. This position paper arose from a leiomyosarcoma research meeting in October 2020 hosted by the NLMSF and SPAEN.
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Affiliation(s)
- Bernd Kasper
- Mannheim University Medical Center, University of Heidelberg, 68167 Mannheim, Germany
| | - Annie Achee
- National LeioMyoSarcoma Foundation (NLMSF), Denver, CO 80222, USA;
| | - Kathrin Schuster
- Sarcoma Patients EuroNet, SPAEN, 61200 Wölfersheim, Germany; (K.S.); (R.W.); (G.v.O.)
| | - Roger Wilson
- Sarcoma Patients EuroNet, SPAEN, 61200 Wölfersheim, Germany; (K.S.); (R.W.); (G.v.O.)
| | | | - Rebecca A. Gladdy
- Department of Surgery, Mount Sinai Hospital, Toronto, ON M5G 1XS, Canada;
| | | | - Paul Huang
- Institute of Cancer Research, London SM2 5NG, UK; (P.H.); (R.L.J.)
| | - Matthew Ingham
- Department of Medicine, Columbia University School of Medicine, New York, NY 10032, USA;
| | - Robin L. Jones
- Institute of Cancer Research, London SM2 5NG, UK; (P.H.); (R.L.J.)
- Royal Marsden Hospital, London SW3 6JJ, UK
| | - Seth M. Pollack
- Northwestern Medicine, Feinberg School of Medicine, Chicago, IL 60611, USA;
| | - Denise Reinke
- Sarcoma Alliance for Research through Collaboration (SARC), Ann Arbor, MI 48105, USA;
| | | | - Scott M. Schuetze
- Michigan Medicine Sarcoma Clinic, Rogel Cancer Center, Ann Arbor, MI 48109, USA;
| | - Neeta Somaiah
- Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Care Center, Houston, TX 77030, USA;
| | - Brian A. Van Tine
- Barnes and Jewish Hospital, Washington University in St. Louis, St. Louis, MO 63110, USA;
| | - Breelyn Wilky
- Department of Sarcoma Medical Oncology, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA;
| | - Scott Okuno
- Division of Medical Oncology, Mayo Clinic, Rochester, MN 55905, USA;
| | - Jonathan Trent
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL 33136, USA;
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16
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Igarashi K, Kawaguchi K, Yamamoto N, Hayashi K, Kimura H, Miwa S, Higuchi T, Taniguchi Y, Yonezawa H, Araki Y, Morinaga S, Misra S, Nelson SD, Dry SM, Li Y, Odani A, Singh SR, Tsuchiya H, Hoffman RM. A Novel Anionic-phosphate-platinum Complex Effectively Targets a Cisplatinum-resistant Osteosarcoma in a Patient-derived Orthotopic Xenograft Mouse Model. Cancer Genomics Proteomics 2020; 17:217-223. [PMID: 32345663 DOI: 10.21873/cgp.20182] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 02/19/2020] [Accepted: 02/20/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND/AIM We have previously developed a novel bone-targeting platinum compound, 3Pt, and showed that it has strong inhibitory activity against osteosarcoma cells and orthotopic cell-line xenograft mouse models. In the present report, we compared the efficacy of 3Pt to cisplatinum (CDDP) in a CDDP-resistant relapsed osteosarcoma patient-derived orthotopic xenograft (PDOX) mouse model. PATIENTS AND METHODS The tumor of a patient with osteosarcoma of the distal femur was treated with CDDP-based chemotherapy followed by surgery. The surgical specimen was used to establish a PDOX model. An osteosarcoma cell line was also established from the original patient tumor. Osteosarcoma cell viability was assessed with the WST-8 assay and the IC50 values were calculated. The PDOX models were randomized into three groups: untreated control, CDDP-treated group, and 3Pt-treated group. Tumor size and body weight were measured twice a week. RESULTS 3Pt had a strong concentration-dependent cytocidal effect in vitro. The IC50 value of 3Pt was significantly lower than that of CDDP. On day 14 of the treatment, 3Pt caused a significantly greater tumor growth inhibition compared to the untreated control and CDDP-treated mice. CONCLUSION 3Pt is a promising clinical candidate for the treatment of recalcitrant osteosarcoma.
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Affiliation(s)
- Kentaro Igarashi
- AntiCancer, Inc., San Diego, CA, U.S.A.,Department of Surgery, University of California, San Diego, CA, U.S.A.,Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Kei Kawaguchi
- AntiCancer, Inc., San Diego, CA, U.S.A.,Department of Surgery, University of California, San Diego, CA, U.S.A
| | - Norio Yamamoto
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Katsuhiro Hayashi
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Hiroaki Kimura
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Shinji Miwa
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Takashi Higuchi
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Yuta Taniguchi
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Hirotaka Yonezawa
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Yoshihiro Araki
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Sei Morinaga
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Sweta Misra
- Mouse Cancer Genetics Program, National Cancer Institute, Frederick, MD, U.S.A
| | - Scott D Nelson
- Department of Pathology, University of California, Los Angeles, CA, U.S.A
| | - Sarah M Dry
- Department of Pathology, University of California, Los Angeles, CA, U.S.A
| | - Yunfeng Li
- Department of Pathology, University of California, Los Angeles, CA, U.S.A
| | - Akira Odani
- Division of Pharmaceutical Sciences, Kanazawa University, Kanazawa, Japan
| | - Shree Ram Singh
- Basic Research Laboratory, National Cancer Institute, Frederick, MD, U.S.A.
| | - Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| | - Robert M Hoffman
- AntiCancer, Inc., San Diego, CA, U.S.A. .,Department of Surgery, University of California, San Diego, CA, U.S.A
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17
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Fortuna-Costa A, Granato RA, Meohas W, Lopes ACDS, Caruso AC, Castro E Silva Pinheiro R, d'Eça PDG, Dias RB, Perini JA, Barbosa APF, Moreira de Sá RA, Guimarães JAM, Murray SS, Duarte MEL. An association between successful engraftment of osteosarcoma patient-derived xenografts and clinicopathological findings. Histol Histopathol 2020; 35:1295-1307. [PMID: 32964941 DOI: 10.14670/hh-18-256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Although osteosarcoma is a rare disease, with a global incidence rate estimated at 5.0/million/year, it is the most frequent primary bone sarcoma in children and adolescents. In translational research, the patient-derived xenograft (PDX) model is considered an authentic in vivo model for several types of cancer, as tumorgrafts faithfully retain the biological characteristics of the primary tumors. Our goal was to investigate the association between PDX formation and clinical findings of osteosarcoma patients and the ability of the model to preserve in immunocompromized mice the characteristics of the parental tumor. A fresh sample of the patient tumor obtained from a representative biopsy or from surgical resection was implanted into nude mice. When tumor outgrowths reached ~1,500mm³, fresh PDX fragments were re-transplanted into new hosts. Engraftment in mice was obtained after a latency period of 19-225 days (median 92 days) in 40.54% of the implanted samples. We confirmed the histopathological fidelity between the patient tumor and their respective established PDXs, including the expression of biomarkers. PDX take rate was higher in surgical resection samples, in post-chemotherapy surgical samples and in samples from patients with metastatic disease at presentation. In conclusion, we have shown that the osteosarcoma PDX model reliably recapitulates the morphological aspects of the human disease after serial passage in mice. The observation that more aggressive forms of osteosarcoma, including those with metastatic disease at presentation, have a higher efficiency to generate PDXs provides a promising scenario to address several unanswered issues in clinical oncology.
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Affiliation(s)
- Anneliese Fortuna-Costa
- Research Division, National Institute of Orthopedics and Traumatology (INTO), Rio de Janeiro, RJ, Brazil
| | | | - Walter Meohas
- Center of Orthopedic Oncology, National Institute of Orthopedics and Traumatology (INTO), Rio de Janeiro, RJ, Brazil
| | - Ana Cristina de Sá Lopes
- Center of Orthopedic Oncology, National Institute of Orthopedics and Traumatology (INTO), Rio de Janeiro, RJ, Brazil
| | - Anabela Cunha Caruso
- Research Division, National Institute of Orthopedics and Traumatology (INTO), Rio de Janeiro, RJ, Brazil
| | | | - Pedro da Gama d'Eça
- Center of Orthopedic Oncology, National Institute of Orthopedics and Traumatology (INTO), Rio de Janeiro, RJ, Brazil
| | - Rhayra Braga Dias
- Research Division, National Institute of Orthopedics and Traumatology (INTO), Rio de Janeiro, RJ, Brazil
| | - Jamila Alessandra Perini
- Research Division, National Institute of Orthopedics and Traumatology (INTO), Rio de Janeiro, RJ, Brazil
| | | | | | | | - Samuel S Murray
- Department of Medicine, University of California, Los Angeles and VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Maria Eugenia Leite Duarte
- Research Division, National Institute of Orthopedics and Traumatology (INTO), Rio de Janeiro, RJ, Brazil.
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18
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Wang Y, Wozniak A, Wellens J, Gebreyohannes YK, Guillén MJ, Avilés PM, Debiec-Rychter M, Sciot R, Schöffski P. Plocabulin, a novel tubulin inhibitor, has potent antitumor activity in patient-derived xenograft models of gastrointestinal stromal tumors. Transl Oncol 2020; 13:100832. [PMID: 32711367 PMCID: PMC7381700 DOI: 10.1016/j.tranon.2020.100832] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 06/16/2020] [Indexed: 02/07/2023] Open
Abstract
The majority of patients with gastrointestinal stromal tumors (GIST) eventually become resistant with time due to secondary mutations in the driver receptor tyrosine kinase. Novel treatments that do not target these receptors may therefore be preferable. For the first time, we evaluated a tubulin inhibitor, plocabulin, in patient-derived xenograft (PDX) models of GIST, a disease generally considered to be resistant to cytotoxic agents. Three PDX models of GIST with different KIT genotype were generated by implanting tumor fragments from patients directly into nude mice. We then used these well characterized models with distinct sensitivity to imatinib to evaluate the efficacy of the novel tubulin inhibitor. The efficacy of the drug was assessed by volumetric analysis of the tumors, histopathology, immunohistochemistry and Western blotting. Plocabulin treatment led to extensive necrosis in all three models and significant tumor shrinkage in two models. This histological response can be explained by the drug's vascular-disruptive properties, which resulted in a shutdown of tumor vasculature, reflected by a decreased total vascular area in the tumor tissue. Our results demonstrated the in vivo efficacy of the novel tubulin inhibitor plocabulin in PDX models of GIST and challenge the established view that GIST are resistant to cytotoxic agents in general and to tubulin inhibitors in particular. Our findings provide a convincing rationale for early clinical exploration of plocabulin in GIST and warrant further exploration of this class of drugs in the management of this common sarcoma subtype. First study evaluating a tubulin inhibitor in patient-derived xenograft models of gastro-intestinal stromal tumors Plocabulin, a novel tubulin inhibitor, has efficacy independant of KIT genotype Plocabulin induced extensive, central tumor necrosis, mainly through its antiangiogenic properties. Our results challenge the established view that gastro-intestinal stromal tumors are resistant to cytotoxic agents.
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Affiliation(s)
- Yannick Wang
- Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, Leuven, Belgium.
| | - Agnieszka Wozniak
- Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, Leuven, Belgium
| | - Jasmien Wellens
- Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, Leuven, Belgium
| | | | | | | | - Maria Debiec-Rychter
- Department of Human Genetics, KU Leuven and University Hospitals Leuven, Leuven, Belgium
| | - Raf Sciot
- Department of Pathology, KU Leuven and University Hospitals Leuven, Leuven, Belgium
| | - Patrick Schöffski
- Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, Leuven, Belgium; Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
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Codenotti S, Mansoury W, Pinardi L, Monti E, Marampon F, Fanzani A. Animal models of well-differentiated/dedifferentiated liposarcoma: utility and limitations. Onco Targets Ther 2019; 12:5257-5268. [PMID: 31308696 PMCID: PMC6613351 DOI: 10.2147/ott.s175710] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Accepted: 06/04/2019] [Indexed: 12/31/2022] Open
Abstract
Liposarcoma is a malignant neoplasm of fat tissue. Well-differentiated and dedifferentiated liposarcoma (WDL/DDL) represent the two most clinically observed histotypes occurring in middle-aged to older adults, particularly within the retroperitoneum or extremities. WDL/DDL are thought to represent the broad spectrum of one disease, as they are both associated with the amplification in the chromosomal 12q13-15 region that causes MDM2 and CDK4 overexpression, the most useful predictor for liposarcoma diagnosis. In comparison to WDL, DDL contains additional genetic abnormalities, principally coamplifications of 1p32 and 6q23, that increase recurrence and metastatic rate. In this review, we discuss the xenograft and transgenic animal models generated for studying progression of WDL/DDL, highlighting utilities and pitfalls in such approaches that can facilitate or impede the development of new therapies.
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Affiliation(s)
- Silvia Codenotti
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Walaa Mansoury
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Luca Pinardi
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Eugenio Monti
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Francesco Marampon
- Department of Radiotherapy, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Alessandro Fanzani
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
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Cornillie J, Wozniak A, Li H, Gebreyohannes YK, Wellens J, Hompes D, Debiec-Rychter M, Sciot R, Schöffski P. Anti-tumor activity of the MDM2-TP53 inhibitor BI-907828 in dedifferentiated liposarcoma patient-derived xenograft models harboring MDM2 amplification. Clin Transl Oncol 2020; 22:546-54. [PMID: 31201607 DOI: 10.1007/s12094-019-02158-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 06/06/2019] [Indexed: 12/11/2022]
Abstract
PURPOSE Dedifferentiated liposarcoma (DDLPS) is a soft tissue malignancy characterized by amplification of the mouse double minute 2 homolog (MDM2) gene. MDM2 is a negative regulator of tumor protein 53 (TP53). We tested the in vivo efficacy of BI-907828, a small molecule inhibitor of the MDM2-TP53 interaction, in two DDLPS patient-derived xenografts (PDX). METHODS Partially immunodeficient mice were bilaterally engrafted with UZLX-STS3 (n = 24) and UZLX-STS5 (n = 24) human DDLPS tissue harboring MDM2 amplifications. Mice were grouped as follows: (a) vehicle (0.5% hydroxyethylcellullose) 10 ml/kg daily per os (p.o.); (b) doxorubicin 5 mg/kg weekly intraperitoneally (i.p.); (c) BI-907828 2.5 mg/kg daily p.o. and (d) BI-907828 10 mg/kg daily p.o. The treatment lasted for 15 days, all mice treated with BI-907828 were followed for 37 days post-treatment. Efficacy was assessed by tumor volume and histopathological evaluation. RESULTS The 15-day treatment with 2.5 mg/kg and 10 mg/kg BI-907828 significantly inhibited tumor growth in UZLX-STS5 and -STS3 (p < 0.0001 compared to control for both models). All UZLX-STS5 and -STS3 tumors treated with BI-907828 decreased in size during treatment, and BI-907828-treated UZLX-STS5 tumors even disappeared completely. During the follow-up period, no tumor regrowth was observed in the UZLX-STS5 model and both doses of BI-907828 led to a pathological complete response, whereas a dose-dependent regrowth was seen in the UZLX-STS3 model. CONCLUSION BI-907828 showed significant anti-tumor activity in DDLPS PDX harboring MDM2 amplifications, providing a strong rationale for early clinical testing of BI-907828 in a DDLPS patient population.
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