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Bianconi D, Fabian E, Herac M, Kieler M, Thaler J, Prager G, Unseld M. Expression of CD98hc in Pancreatic Cancer and Its Role in Cancer Cell Behavior. J Cancer 2022; 13:2271-2280. [PMID: 35517419 PMCID: PMC9066202 DOI: 10.7150/jca.70500] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 03/25/2022] [Indexed: 11/27/2022] Open
Abstract
Background: Cluster of differentiation 98 heavy chain (CD98hc) is a transmembrane protein, which functions both as a coreceptor of ß-integrins, enhancing intracellular integrin-dependent downstream signaling, and as a transporter of branched-chain and aromatic amino acids. As such, it is pivotal in cell cycle regulation and protection of oxidative, nutritional and DNA replication stress. Overexpression of CD98hc occurs widely in cancer cells and is associated with poor clinical prognosis. The role of CD98hc in pancreatic cancer remains to be elucidated. The aim of this study was to determine the expression of CD98hc in pancreatic ductal adenocarcinoma and to define its potential functional role in cancer cell biology. Methods: Immunohistochemical staining for CD98hc was performed on 222 tissue samples of patients with pancreatic ductal adenocarcinoma. The pancreatic cancer cell lines PANC-1 and BxPC-3 were used to determine the effect of CD98hc expression on cancer cell behavior using cell adhesion, cell trans-migration and cell spreading assays. Flow cytometry was performed to study the rate of apoptosis after detachment or serum starvation. shRNA-lentiviral constructs were used to knock down or reconstitute full length or mutated CD98hc. Results: Up to 20% of pancreatic ductal adenocarcinomas express CD98hc in the acinar cells (13%) and islet cells (20%) embedded in tumor tissue. Although expression of CD98hc in tumor tissue was not associated with a particular tumor stage or grade, our data show a trend towards longer overall survival of pancreatic cancer patients without CD98hc expression as compared to those with immunohistochemical positivity. In vitro downregulation of CD98hc in the pancreatic cancer cell lines PANC-1 and BxPC-3 significantly inhibits cell proliferation (p<0.05), self-renewal (p<0.05) and anchorage-independent growth (p<0.05). Conclusion: CD98hc is expressed in a remarkable percentage of pancreatic ductal adenocarcinomas. Due to its important role in cell behavior and malignant cell transformation, it may be a promising molecular target for potential new therapeutic approaches in pancreatic cancer in the future.
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Affiliation(s)
- Daniela Bianconi
- Division of Oncology, Comprehensive Cancer Center, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Elisabeth Fabian
- Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Merima Herac
- Department of Pathology, Medical University of Vienna, Austria
| | - Markus Kieler
- Institute for Vascular Biology, Center for Physiology and Pharmacology, Medical University Vienna, Vienna, Austria
| | - Johannes Thaler
- Division of Hematology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Gerald Prager
- Division of Oncology, Comprehensive Cancer Center, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Matthias Unseld
- Division of Palliative Medicine, Department of Medicine I, Medical University of Vienna, Vienna, Austria
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Balendran-Braun S, Kieler M, Liebmann-Reindl S, Unseld M, Bianconi D, W Prager G, Streubel B. Bead-Based Isolation of Circulating Tumor DNA from Pancreatic Cancer Patients Enables High Fidelity Next Generation Sequencing. Cancer Manag Res 2021; 13:6249-6261. [PMID: 34393517 PMCID: PMC8357621 DOI: 10.2147/cmar.s308029] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 06/07/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive cancers and poses a challenge to the treating clinician. With the emergence of genomic profiling technologies, circulating tumor DNA (ctDNA) is increasingly recognized as a versatile biomarker for risk stratification and disease monitoring. We aimed to compare two commercially available NGS panels in a cohort of patients with advanced PDAC undergoing palliative chemotherapy. METHODS CtDNA was isolated with a magnetic bead-based protocol from two consecutive blood samples before and during chemotherapy in 21 patients with PDAC. Mutations were assessed by using a panel covering 15 (GP15) or 50 (GP50) cancer-associated genes. Results were compared to tumor tissue (GP15), if available. RESULTS Isolation of ctDNA resulted in a high mean value of 1.9 ng/µL (total volume of ~40 µL). Although the same number of patients were positive for at least one mutation (76%), the most commonly mutated oncogene in PDAC, KRAS, was detectable in an additional 25% of all patients with the GP15 panel due to a higher coverage. The genomic concordance rate between tissue DNA and ctDNA analyses was 65.22%. DISCUSSION Our study demonstrates the feasibility of an NGS-based approach for ctDNA analysis and underlines the importance of using a disease-specific panel with a sufficiently high coverage.
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Affiliation(s)
| | - Markus Kieler
- Department of Medicine I, Division of Oncology, Comprehensive Cancer Center, Medical University, Vienna, Austria
| | | | - Matthias Unseld
- Department of Medicine I, Division of Oncology, Comprehensive Cancer Center, Medical University, Vienna, Austria
| | - Daniela Bianconi
- Department of Medicine I, Division of Oncology, Comprehensive Cancer Center, Medical University, Vienna, Austria
| | - Gerald W Prager
- Department of Medicine I, Division of Oncology, Comprehensive Cancer Center, Medical University, Vienna, Austria
| | - Berthold Streubel
- Department of Pathology, Medical University of Vienna, Vienna, Austria
- Core Facility Genomics, Medical University of Vienna, Vienna, Austria
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Bianconi D, Herac M, Posch F, Schmeidl M, Unseld M, Kieler M, Brettner R, Müllauer L, Riedl J, Gerger A, Scheithauer W, Prager G. Microvascular density assessed by CD31 predicts clinical benefit upon bevacizumab treatment in metastatic colorectal cancer: results of the PassionATE study, a translational prospective Phase II study of capecitabine and irinotecan plus bevacizumab followed by capecitabine and oxaliplatin plus bevacizumab or the reverse sequence in patients in mCRC. Ther Adv Med Oncol 2020; 12:1758835920928635. [PMID: 32922518 PMCID: PMC7446555 DOI: 10.1177/1758835920928635] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 12/18/2019] [Accepted: 05/01/2020] [Indexed: 12/16/2022] Open
Abstract
Background Targeted therapies offer novel opportunities to explore biomarkers based on their mode of action. Taking this into consideration, we evaluated six angiogenesis-related proteins as potential predictive biomarkers, which expression might predict the benefit of bevacizumab treatment in patients with metastatic colorectal cancer (mCRC). Methods This was a phase II multicenter, two-armed, randomized study, in which patients with mCRC were treated with XELIRI (capecitabine and irinotecan) plus bevacizumab followed by XELOX (capecitabine and oxaliplatin) plus bevacizumab (Arm A) or the reverse sequence (Arm B). Tissue expression level of six prespecified candidates [microvessel density assessed by CD31, PTEN, αV integrin, CD98hc, uPAR and NRP-1] was analyzed via immunohistochemistry. The prognostic impact on survival was quantified using the Cox regression model. The predictive potential for benefit from Arm A versus Arm B treatment was investigated by fitting an interaction between the biomarkers and treatment assignment within a multivariable Cox model. Results In total, 74 out of 126 patients were included in the analysis. The expression of PTEN, αV integrin, uPAR and NRP-1 was not associated with progression-free survival (PFS) or overall survival (OS). For the first time, we identified that patients with tumors expressing CD98hc had a longer PFS than patients without CD98hc-expression (p = 0.032). More importantly, and in accordance with previous studies, low microvessel density was found to be associated with a reduced PFS [adjusted HR per doubling of CD31-expression (p = 0.53, 95% confidence interval: 0.30-0.95, p = 0.034)]. Conclusions These results can contribute to the development of a personalized strategy for the treatment of mCRC with bevacizumab.
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Affiliation(s)
- Daniela Bianconi
- Department of Medicine I, Division of Oncology, Comprehensive Cancer Center, Medical University Vienna, Vienna, Austria
| | - Merima Herac
- Department of Pathology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Florian Posch
- Division of Clinical Oncology, Comprehensive Cancer Center Graz, Medical University of Graz, Graz, Austria
| | - Margit Schmeidl
- Department of Pathology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Matthias Unseld
- Department of Medicine I, Division of Oncology, Comprehensive Cancer Center, Medical University Vienna, Vienna, Austria
| | - Markus Kieler
- Department of Medicine I, Division of Oncology, Comprehensive Cancer Center, Medical University Vienna, Vienna, Austria
| | - Robert Brettner
- Department of Medicine I, Division of Oncology, Comprehensive Cancer Center, Medical University Vienna, Vienna, Austria
| | - Leonhard Müllauer
- Department of Pathology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Jakob Riedl
- Division of Clinical Oncology, Comprehensive Cancer Center Graz, Medical University of Graz, Graz, Austria
| | - Armin Gerger
- Division of Clinical Oncology, Comprehensive Cancer Center Graz, Medical University of Graz, Graz, Austria
| | - Werner Scheithauer
- Department of Medicine I, Division of Oncology, Comprehensive Cancer Center, Medical University Vienna, Vienna, Austria
| | - Gerald Prager
- Department of Medicine I, Division of Oncology, Comprehensive Cancer Center, Medical University Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
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Kieler M, Unseld M, Bianconi D, Schindl M, Kornek GV, Scheithauer W, Prager GW. Impact of New Chemotherapy Regimens on the Treatment Landscape and Survival of Locally Advanced and Metastatic Pancreatic Cancer Patients. J Clin Med 2020; 9:jcm9030648. [PMID: 32121198 PMCID: PMC7141274 DOI: 10.3390/jcm9030648] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [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: 02/19/2020] [Accepted: 02/26/2020] [Indexed: 02/06/2023] Open
Abstract
Background: New chemotherapy regimens for the treatment of metastatic pancreatic cancer have changed the therapy paradigm. We aimed to assess their impact on the treatment landscape and clinical outcome at our academic institution. Methods: In this single institutional posthoc registry analysis, we assessed characteristics and survival rates from all patients with locally advanced and metastatic pancreatic cancer who started a systemic treatment between 01/2011 and 12/2017. Survival analyses were performed by Kaplan-Meier and Cox proportional hazards model. Results: A total of 301 patients started a systemic treatment in the observation period. In the first line treatment, we observed a shift from the four different main regimens (gemcitabine/nab-paclitaxel, modified FOLFIRINOX, gemcitabine/oxaliplatin +/− erlotinib or gemcitabine alone) to gemcitabine/nab-paclitaxel and modified FOLFIRINOX that add up to more than 80% of administered first line treatments in each of the time cohorts (2011–2013 vs. 2014–2017). The rate for first line modified FOLFIRINOX treatment was balanced between the two groups (19% and 15%). Median overall survival differed significantly between the two time cohorts (8.89 versus 11.9 months, p = 0.035). Survival rates for different first to second line treatment sequences (modified FOLFIRINOX to gemcitabine/nab-paclitaxel, gemcitabine/nab-paclitaxel to fluoropyrimidines plus nanoliposomal irinotecan, or gemcitabine/nab-paclitaxel to fluoropyrimidines plus oxaliplatin) were not significantly different and median overall survival ranged from 14.27 to 15.64 months. Conclusion: Our study provides real-world evidence for the effectiveness of the new chemotherapy regimens and underscores the importance of the choice of the front-line regimen when considering different sequencing strategies.
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Affiliation(s)
- Markus Kieler
- Department of Medicine I, Division of Oncology, Comprehensive Cancer Center Vienna, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria; (M.K.); (M.U.); (D.B.); (G.V.K.); (W.S.)
| | - Matthias Unseld
- Department of Medicine I, Division of Oncology, Comprehensive Cancer Center Vienna, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria; (M.K.); (M.U.); (D.B.); (G.V.K.); (W.S.)
| | - Daniela Bianconi
- Department of Medicine I, Division of Oncology, Comprehensive Cancer Center Vienna, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria; (M.K.); (M.U.); (D.B.); (G.V.K.); (W.S.)
| | - Martin Schindl
- Department of Surgery, Division of General Surgery, Pancreatic Cancer Unit, Comprehensive Cancer Center Vienna, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria;
| | - Gabriela V. Kornek
- Department of Medicine I, Division of Oncology, Comprehensive Cancer Center Vienna, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria; (M.K.); (M.U.); (D.B.); (G.V.K.); (W.S.)
| | - Werner Scheithauer
- Department of Medicine I, Division of Oncology, Comprehensive Cancer Center Vienna, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria; (M.K.); (M.U.); (D.B.); (G.V.K.); (W.S.)
| | - Gerald W. Prager
- Department of Medicine I, Division of Oncology, Comprehensive Cancer Center Vienna, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria; (M.K.); (M.U.); (D.B.); (G.V.K.); (W.S.)
- Correspondence: ; Tel.: +43-1-40400-44500
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Kieler M, Unseld M, Bianconi D, Scheithauer W, Prager GW. A real-world analysis of second-line treatment options in pancreatic cancer: liposomal-irinotecan plus 5-fluorouracil and folinic acid. Ther Adv Med Oncol 2019; 11:1758835919853196. [PMID: 31360237 PMCID: PMC6640066 DOI: 10.1177/1758835919853196] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 10/23/2018] [Accepted: 04/12/2019] [Indexed: 12/11/2022] Open
Abstract
Background: Nanoliposomal irinotecan (nal-IRI) plus 5-fluorouracil/leucovorin (5-FU/LV) is a novel treatment option for gemcitabine-pretreated metastatic pancreatic adenocarcinoma (PAC) patients, but real-world evidence is rare. Our aim was to determine the effectiveness and tolerability of this regimen in advanced PAC patients and to compare it with oxaliplatin plus fluoropyrimidines in the second-line setting after failure of gemcitabine. Methods: This is a retrospective single-center analysis of all patients who have been treated with nal-IRI plus 5-FU/LV. To compare its effectiveness with other second-line treatment options, all patients who had received oxaliplatin plus fluoropyrimidines after gemcitabine-based chemotherapy were also eligible for analysis. Results: Fifty-two patients were treated with nal-IRI plus 5-FU/LV between April 2016 and August 2018. The median progression-free survival (PFS) was 3.84 months and the median overall survival (OS) was 6.79 months. Median OS from the beginning of the treatment for advanced disease was 19.9 months. Median PFS in patients that received nal-IRI plus 5-FU/LV as second-line treatment after gemcitabine-based chemotherapy was 4.49 months whereas median PFS in a matched cohort of patients treated with oxaliplatin plus fluoropyrimidines was 3.44 months (p = 0.007). Between these two groups the median OS of patients with CA 19-9 levels above the statistical median (⩾772.8 kU/l) differed significantly (9.33 versus 6.18 months, p = 0.038). Conclusion: Our data confirms the effectiveness of nal-IRI plus 5-FU/LV treatment as a well-tolerated regimen in the treatment of advanced PAC and extends available data on its use as a second-line treatment option when compared with oxaliplatin plus fluoropyrimidines.
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Affiliation(s)
- Markus Kieler
- Department of Medicine I, Division of Oncology, Comprehensive Cancer Center, Medical University Vienna, Austria
| | - Matthias Unseld
- Department of Medicine I, Division of Oncology, Comprehensive Cancer Center, Medical University Vienna, Austria
| | - Daniela Bianconi
- Department of Medicine I, Division of Oncology, Comprehensive Cancer Center, Medical University Vienna, Austria
| | - Werner Scheithauer
- Department of Medicine I, Division of Oncology, Comprehensive Cancer Center, Medical University Vienna, Austria
| | - Gerald W Prager
- Department of Medicine I, Division of Oncology, Comprehensive Cancer Center, Medical University Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
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Kieler M, Unseld M, Bianconi D, Waneck F, Mader R, Wrba F, Fuereder T, Marosi C, Raderer M, Staber P, Berger W, Sibilia M, Polterauer S, Müllauer L, Preusser M, Zielinski CC, Prager GW. Interim analysis of a real-world precision medicine platform for molecular profiling of metastatic or advanced cancers: MONDTI. ESMO Open 2019; 4:e000538. [PMID: 31423337 PMCID: PMC6677998 DOI: 10.1136/esmoopen-2019-000538] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 05/02/2019] [Revised: 06/09/2019] [Accepted: 06/14/2019] [Indexed: 12/25/2022] Open
Abstract
Background High-throughput genomic profiling of tumour specimens facilitates the identification of individual actionable mutations which could be used for individualised targeted therapy. This approach is becoming increasingly more common in the clinic; however, the interpretation of results from molecular profiling tests and efficient guiding of molecular therapies to patients with advanced cancer offer a significant challenge to the oncology community. Experimental design MONDTI is a precision medicine platform for molecular characterisation of metastatic solid tumours to identify actionable genomic alterations. From 2013 to 2016, comprehensive molecular profiles derived from real-time biopsy specimens and archived tumour tissue samples of 295 patients were performed. Results and treatment suggestions were discussed within multidisciplinary tumour board meetings. Results The mutational profile was obtained from 293 (99%) patients and a complete immunohistochemical (IHC) and cytogenetic profile was obtained in 181 (61%) and 188 (64%) patients. The most frequent cancer types were colorectal cancer (12%), non-Hodgkin's lymphomas (9.8%) and head and neck cancers (7.8%). The most commonly detected mutations were TP53 (39%), KRAS (19%) and PIK3CA (9.5%), whereas ≥1 mutation were identified in 217 (74%) samples. Regarding the results for IHC testing, samples were positive for phospho-mammalian target of rapamycin (phospho-mTOR) (71%), epidermal growth factor receptor (EGFR) (68%), mesenchymal epithelial transition (MET) (56%) and/or platelet-derived growth factor alpha (PDGFRα)-expression (48%). Of the 288 tumour samples with one or more genetic alteration detected, 160 (55.6%) targeted therapy recommendations through 67 multidisciplinary tumour board meetings were made; in 69 (24%) cases, an individual treatment concept was initiated. Conclusions The results reveal that the open concept for all solid tumours characterised for molecular profile and immunotherapy could not only match individualised treatment concepts at a high rate but also underscores the challenges encountered when offering molecularly matched therapies to a patient population with an advanced stage cancer.
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Affiliation(s)
- Markus Kieler
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Wien, Austria
| | - Matthias Unseld
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Wien, Austria
| | - Daniela Bianconi
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Wien, Austria
| | - Fredrik Waneck
- Department of Biomedical Imaging and Image-guided Therapy, Division of Cardiovascular and Interventional Radiology, Medical University of Vienna, Wien, Austria
| | - Robert Mader
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Wien, Austria
| | - Fritz Wrba
- Department of Pathology, Medical University of Vienna, Wien, Austria
| | - Thorsten Fuereder
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Wien, Austria
| | - Christine Marosi
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Wien, Austria
| | - Markus Raderer
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Wien, Austria
| | - Philipp Staber
- Department of Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Wien, Austria
| | - Walter Berger
- Institute of Cancer Research, Department of Medicine I, Comprehensive Cancer Center, Medical University of Vienna, Wien, Austria
| | - Maria Sibilia
- Institute of Cancer Research, Department of Medicine I, Comprehensive Cancer Center, Medical University of Vienna, Wien, Austria
| | - Stephan Polterauer
- Department of Obstetrics and Gynecology, Division of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Wien, Austria
| | - Leonhard Müllauer
- Department of Pathology, Medical University of Vienna, Wien, Austria
| | - Matthias Preusser
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Wien, Austria
| | - Christoph C Zielinski
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Wien, Austria
| | - Gerald W Prager
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Wien, Austria
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Unseld M, Filip M, Seirl S, Gleiss A, Bianconi D, Kieler M, Demyanets S, Scheithauer W, Zielinski C, Prager G. Regorafenib therapy in metastatic colorectal cancer patients: markers and outcome in an actual clinical setting. Neoplasma 2019; 65:599-603. [PMID: 29940763 DOI: 10.4149/neo_2018_170727n506] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The oral multikinase inhibitor regorafenib had beneficial effects in randomized clinical phase III trials compared to the placebo in patients with metastatic colorectal cancer (mCRC) who progressed on standard therapies. The factors which influence regorafenib response and therapy sequence during treatment history are still highly discussed, and herein we analyzed the therapy algorithm, outcome and clinical markers following regorafenib application in a single center register study. Clinical data for 48 metastatic colorectal cancer patients were collected from 01.01.2013 to 31.12.2016. Treatment effects according to various patient and tumor characteristics were evaluated using univariate and multivariate Cox proportional hazard regression models. The 48 patients comprised 14 (29%) females and 34 (71%) males, with mean age 64.2±9 and ECOG 0-1. Progression free survival under regorafenib therapy was 2.9 months (quartiles 2.2; 4.4) and the overall response rate was 2 (4%) and disease control rate was 19 (40%). Overall survival (OS) and progression free survival (PFS) were investigated under regorafenib in the chemotherapy regimen given immediately before and afterthis treatment. Variables including tumor localization, Ras status, CEA and CA 19-9 plasma levels were analyzed for their impact on PFS, and the regorafenib-related adverse events were also observed. Our study confirms the efficacy of regorafenib in a real-life setting. We established that response rate and PFS in regorafenib treatment are independent of tumor localization, Ras status or biomarkers such as CEA and CA 19-9. Trifluridin/tripacil application or re-induction of chemotherapy +/- target therapy was effective following regorafenib therapy.
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Affiliation(s)
- M Unseld
- Department of Medicine I, Clin. Div. of Oncology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - M Filip
- Department of Medicine I, Clin. Div. of Oncology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - S Seirl
- Department of Medicine I, Clin. Div. of Oncology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - A Gleiss
- Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - D Bianconi
- Department of Medicine I, Clin. Div. of Oncology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - M Kieler
- Department of Medicine I, Clin. Div. of Oncology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - S Demyanets
- Department of Medicine I, Clin. Div. of Oncology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - W Scheithauer
- Department of Medicine I, Clin. Div. of Oncology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - C Zielinski
- Department of Medicine I, Clin. Div. of Oncology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - G Prager
- Department of Medicine I, Clin. Div. of Oncology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
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Kieler M, Unseld M, Bianconi D, Scheithauer W, Prager GW. Efficacy of liposomal-irinotecan (nal-IRI) plus 5-fluorouracil/folinic acid (5-FU/LV) versus oxaliplatin plus fluoropyrimidines in previous gemcitabine treated pancreatic adenocarcinoma (PAC) patients (pts). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.4_suppl.383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
383 Background: The chemotherapy regimens nal-IRI plus 5-FU/LV as well as oxaliplatin plus fluoropyrimidines are used after previous gemcitabine based chemotherapy in the 2nd line treatment of metastatic PAC. We aimed to compare the clinical efficacy of these two treatment options. Methods: In this single institutional retrospective cohort analysis all pts with advanced PAC that were treated between 01/2012-08/2018 with nal-IRI plus 5-FU/LV or oxaliplatin plus fluoropyrimidines after previous 1st line gemcitabine based chemotherapy were analysed for clinical parameters, median progression free survival (mPFS) and overall survival (mOS). Survival analyses were performed by Kaplan-Meier method. Results: Characteristics of pts were well matched (Table). mPFS in pts (n=30) that received nal-IRI plus 5-FU/LV in the 2nd line treatment after gemcitabine based chemotherapy was 4.49 months while treatment with oxaliplatin plus fluoropyrimidines (n=31) resulted in a mPFS of 3.44 months (p=0.007, HR 0.47, 95% CI 0.27-0.81). Furthermore, pts with a CA 19-9 level >1000 kU/l at the beginning of 2nd line treatment had a significantly improved mPFS and mOS, when treated with nal-IRI plus 5-FU/LV compared to oxaliplatin plus fluoropyrimidines (mPFS 4.94 months versus 3.44 months, p=0.0186, HR 0.42, 95% CI 0.18-0.98; mOS 9.31 months versus 6.16 months, p=0.0386, HR 0.43, 95% CI 0.18-1.02). Conclusions: The efficacy of nal-IRI plus 5-FU/LV in our study is encouraging and outperforms oxaliplatin-based chemotherapy in the 2nd line treatment setting for PAC pts pretreated with gemcitabine. Prospective randomized trials are urged to validate our observation. [Table: see text]
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Kieler M, Unseld M, Bianconi D, Scheithauer W, Prager GW. Impact of new chemotherapy regimens on the treatment landscape and survival of advanced pancreatic cancer (PAC) patients (pts). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.4_suppl.403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
403 Background: The clinical phase III first-line trials MPACT and PRODIGE4/ACCORD11 in metastatic PAC pts have changed the treatment paradigm. We aimed to analyse the impact of these regimens on the treatment landscape and survival of advanced PAC pts. Methods: In this single institutional retrospective cohort analysis patient characteristics and overall survival (OS) from all pts with advanced PAC treated between 01/2011-12/2017 were analysed. Survival analyses were performed by Kaplan-Meier method. Results: A total of 301 pts started a systemic treatment in the observation period. Concerning the first-line treatment, there was a clear shift from four different main regimens (gemcitabine/nab-paclitaxel (G+nab-P), FOLFIRINOX, gemcitabine/oxaliplatin +/- erlotinib, gemcitabine mono) to only two (G+Nab-P, FOLFIRINOX), that made up more than 80% of the administered first-line treatments in each of the groups (2011-2013 vs. 2014-2017). The rate for first-line FOLFIRINOX treatment was balanced between the two groups (19% and 15%). G+nab-P treated pts had a median age of 66 years, 41.3% had an ECOG 1-2, the FOLFIRINOX treated pts were younger and fitter (57 years and 24.5 % ECOG 1, 0% ECOG 2). 60.7% of pts treated with G+nab-P received a second-line and 30.7% pts received a third-line treatment, while for the FOLFIRINOX pts these rates were 69.8% and 41.5%. Median OS of pts that started first-line treatment between 2011 and 2013 was 8.77 months (95% CI 6.98-10.57) and for those that started first-line treatment between 2014 and 2017 median OS was 11.07 months (95% CI 8.94 13.20) (p = 0.038, Log-Rank-Test). Conclusions: There is a clear impact of new chemotherapy regimens on the treatment landscape. Furthermore, we provide real-world evidence that since the introduction of these new treatment options, the survival of pts with advanced PAC has significantly improved.
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10
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Prager GW, Unseld M, Waneck F, Mader R, Wrba F, Raderer M, Fuereder T, Staber P, Jäger U, Kieler M, Bianconi D, Hoda MA, Baumann L, Reinthaller A, Berger W, Grimm C, Kölbl H, Sibilia M, Müllauer L, Zielinski C. Results of the extended analysis for cancer treatment (EXACT) trial: a prospective translational study evaluating individualized treatment regimens in oncology. Oncotarget 2019; 10:942-952. [PMID: 30847023 PMCID: PMC6398177 DOI: 10.18632/oncotarget.26604] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 05/28/2018] [Accepted: 01/02/2019] [Indexed: 01/09/2023] Open
Abstract
Background The concept of personalized medicine defines a promising approach in cancer care. High-throughput genomic profiling of tumor specimens allows the identification of actionable mutations that potentially lead to tailored treatment for individuals' benefit. The aim of this study was to prove efficacy of a personalized treatment option in solid tumor patients after failure of standard treatment concepts. Results Final analysis demonstrates that 34 patients (62%) had a longer PFS upon experimental treatment (PFS1) when compared to previous therapy (PFS0); PFS ratio > 1.0 (p = 0.002). The median PFS under targeted therapy based on molecular profiling (PFS1) was 112 days (quartiles 66/201) and PFS0 = 61 days (quartiles 51/92; p = 0.002). Of the 55 patients, 31 (56%) showed disease control (DCR), consisting of 2 (4%) patients which achieved a complete remission, 14 (25%) patients with a partial remission and 15 (27%) patients who had a stabilization of disease. Median OS from start of experimental therapy was 348 days (quartiles 177/664). Conclusion The prospective trial EXACT suggests that treatment based on real-time molecular tumor profiling leads to superior clinical benefit. Materials and Methods In this prospective clinical phase II trial, 55 cancer patients, after failure of standard treatment options, aimed to achieve a longer progression-free survival on the experimental treatment based on the individual's molecular profile (PFS1) when compared to the last treatment given before (PFS0). The personalized medicine approach was conceived to be clinical beneficial for patients who show a PFS ratio (PFS 1/PFS0) of > 1.0.
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Affiliation(s)
- Gerald W Prager
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria.,Comprehensive Cancer Center of the Medical University of Vienna, Vienna, Austria
| | - Matthias Unseld
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria.,Comprehensive Cancer Center of the Medical University of Vienna, Vienna, Austria
| | - Fredrik Waneck
- Department of Interventional Radiology, Medical University of Vienna, Vienna, Austria.,Comprehensive Cancer Center of the Medical University of Vienna, Vienna, Austria
| | - Robert Mader
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria.,Comprehensive Cancer Center of the Medical University of Vienna, Vienna, Austria
| | - Fritz Wrba
- Clinical Institute of Pathology, Medical University of Vienna, Vienna, Austria.,Comprehensive Cancer Center of the Medical University of Vienna, Vienna, Austria
| | - Markus Raderer
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria.,Comprehensive Cancer Center of the Medical University of Vienna, Vienna, Austria
| | - Thorsten Fuereder
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria.,Comprehensive Cancer Center of the Medical University of Vienna, Vienna, Austria
| | - Phillip Staber
- Department of Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria.,Comprehensive Cancer Center of the Medical University of Vienna, Vienna, Austria
| | - Ulrich Jäger
- Department of Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria.,Comprehensive Cancer Center of the Medical University of Vienna, Vienna, Austria
| | - Markus Kieler
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria.,Comprehensive Cancer Center of the Medical University of Vienna, Vienna, Austria
| | - Daniela Bianconi
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria.,Comprehensive Cancer Center of the Medical University of Vienna, Vienna, Austria
| | - Mir Alireza Hoda
- Department of Surgery, Institute of Cancer Research, Medical University of Vienna, Vienna, Austria.,Comprehensive Cancer Center of the Medical University of Vienna, Vienna, Austria
| | - Lukas Baumann
- Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Alexander Reinthaller
- Department of General Gynecology and Gynecological Oncology, Medical University of Vienna, Vienna, Austria.,Comprehensive Cancer Center of the Medical University of Vienna, Vienna, Austria
| | - Walter Berger
- Department of Medicine I, Institute of Cancer Research, Medical University of Vienna, Vienna, Austria.,Comprehensive Cancer Center of the Medical University of Vienna, Vienna, Austria
| | - Christoph Grimm
- Department of General Gynecology and Gynecological Oncology, Medical University of Vienna, Vienna, Austria.,Comprehensive Cancer Center of the Medical University of Vienna, Vienna, Austria
| | - Heinz Kölbl
- Department of General Gynecology and Gynecological Oncology, Medical University of Vienna, Vienna, Austria.,Comprehensive Cancer Center of the Medical University of Vienna, Vienna, Austria
| | - Maria Sibilia
- Department of Medicine I, Institute of Cancer Research, Medical University of Vienna, Vienna, Austria.,Comprehensive Cancer Center of the Medical University of Vienna, Vienna, Austria
| | - Leonhard Müllauer
- Clinical Institute of Pathology, Medical University of Vienna, Vienna, Austria.,Comprehensive Cancer Center of the Medical University of Vienna, Vienna, Austria
| | - Christoph Zielinski
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria.,Comprehensive Cancer Center of the Medical University of Vienna, Vienna, Austria
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11
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Unseld M, Mader R, Baumann L, Veraar C, Wrba F, Waneck F, Kieler M, Bianconi D, Berger W, Sibilia M, Müllauer L, Zielinski C, Prager GW. Feasibility of personalized treatment concepts in gastrointestinal malignancies: Sub-group results of prospective clinical phase II trial EXACT. Chin J Cancer Res 2018; 30:508-515. [PMID: 30510362 PMCID: PMC6232366 DOI: 10.21147/j.issn.1000-9604.2018.05.04] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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] [Indexed: 12/14/2022] Open
Abstract
Objective Advances in high-throughput genomic profiling and the development of new targeted therapies improve patient’s survival. In gastrointestinal (GI) malignancies, the concept of personalized medicine (PM) was not investigated so far. The aim of this prospective study was to evaluate the efficacy of a personalized treatment in GI patients who failed standard treatment. Methods Out of the original prospective clinical phase II EXACT trial, 21 (38%) GI cancer patients who had no further treatment options were identified. A molecular profile (MP) via a 50 gene next generation sequencing (NGS) panel in combination with immunohistochemistry (IHC) was conducted using real-time biopsy tumor material. Results were discussed by a multidisciplinary team (MDT) to translate the individual MP in an experimental treatment. Results Of the 55 patients originally included in the EXACT trial, 21 (38%) suffered from GI malignancies. The final analysis showed that 15 (71%) patients had experienced a longer progression-free survival (PFS) upon experimental targeted treatment (124 d, quartiles 70/193 d), when compared with the PFS achieved by the previous conventional therapy (62 d, quartiles 55/83 d) (P=0.014). Thirteen (62%) patients receiving targeted treatment experienced a disease control according to Response Evaluation Criteria in Solid Tumors (RECIST). Median overall survival (OS) from the start of experimental therapy to time of censoring or death was 193 d (quartiles 115/374 d). Conclusions PM was not investigated in GI malignancies so far in a prospective trial. This study shows that treatment based on real-time molecular tumor profiling led to a superior clinical benefit, and survival as well as response was significantly improved when compared with previous standard medications.
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Affiliation(s)
- Matthias Unseld
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna 1090, Austria.,Comprehensive Cancer Center, Medical University Vienna - General Hospital, Vienna 1090, Austria
| | - Robert Mader
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna 1090, Austria.,Comprehensive Cancer Center, Medical University Vienna - General Hospital, Vienna 1090, Austria
| | - Lukas Baumann
- Department of Medical Statistics, Medical University of Vienna, Vienna 1090, Austria
| | - Clarence Veraar
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna 1090, Austria.,Comprehensive Cancer Center, Medical University Vienna - General Hospital, Vienna 1090, Austria
| | - Fritz Wrba
- Comprehensive Cancer Center, Medical University Vienna - General Hospital, Vienna 1090, Austria.,Clinical Institute of Pathology, Medical University of Vienna, Vienna 1090, Austria
| | - Fredrik Waneck
- Comprehensive Cancer Center, Medical University Vienna - General Hospital, Vienna 1090, Austria.,Department of Interventional Radiology, Medical University of Vienna, Vienna 1090, Austria
| | - Markus Kieler
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna 1090, Austria.,Comprehensive Cancer Center, Medical University Vienna - General Hospital, Vienna 1090, Austria
| | - Daniela Bianconi
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna 1090, Austria.,Comprehensive Cancer Center, Medical University Vienna - General Hospital, Vienna 1090, Austria
| | - Walter Berger
- Comprehensive Cancer Center, Medical University Vienna - General Hospital, Vienna 1090, Austria.,Department of Medicine I, Institute of Cancer Research, Medical University of Vienna, Vienna 1090, Austria
| | - Maria Sibilia
- Comprehensive Cancer Center, Medical University Vienna - General Hospital, Vienna 1090, Austria.,Department of Medicine I, Institute of Cancer Research, Medical University of Vienna, Vienna 1090, Austria
| | - Leonhard Müllauer
- Comprehensive Cancer Center, Medical University Vienna - General Hospital, Vienna 1090, Austria.,Clinical Institute of Pathology, Medical University of Vienna, Vienna 1090, Austria
| | - Christoph Zielinski
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna 1090, Austria.,Comprehensive Cancer Center, Medical University Vienna - General Hospital, Vienna 1090, Austria
| | - Gerald W Prager
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna 1090, Austria.,Comprehensive Cancer Center, Medical University Vienna - General Hospital, Vienna 1090, Austria
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12
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Kieler M, Unseld M, Wojta J, Kaider A, Bianconi D, Demyanets S, Prager GW. Plasma levels of interleukin-33 and soluble suppression of tumorigenicity 2 in patients with advanced pancreatic ductal adenocarcinoma undergoing systemic chemotherapy. Med Oncol 2018; 36:1. [PMID: 30426271 PMCID: PMC6244890 DOI: 10.1007/s12032-018-1223-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 10/26/2018] [Indexed: 02/07/2023]
Abstract
Interleukin-33 (IL-33) and its "decoy" receptor soluble ST2 (sST2) are involved in the development of chronic inflammation and cancer. We explored IL-33 and sST2 as a potential prognostic marker in patients with metastatic and locally advanced pancreatic ductal adenocarcinoma (PDAC). IL-33 and sST2 plasma levels were assessed in 20 patients with advanced PDAC before start of systemic chemotherapy and were analyzed in relation to clinical outcome. Kaplan Meier and multivariable Cox proportional hazards model analysis revealed a significant association between sST2 plasma levels and survival (HR 2.10, 95% CI 1.33-3.41, p = 0.002) and link high sST2 plasma levels to inferior survival in patients with advanced PDAC undergoing chemotherapy.
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Affiliation(s)
- Markus Kieler
- Division of Oncology, Department of Medicine I, Comprehensive Cancer Center, Medical University Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Matthias Unseld
- Division of Oncology, Department of Medicine I, Comprehensive Cancer Center, Medical University Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Johann Wojta
- Division of Cardiology, Department of Internal Medicine II, Medical University Vienna, Waehringer Guertel 18-20, Vienna, Austria
| | - Alexandra Kaider
- Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, Vienna, Austria
| | - Daniela Bianconi
- Division of Oncology, Department of Medicine I, Comprehensive Cancer Center, Medical University Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Svitlana Demyanets
- Department of Laboratory Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
| | - Gerald W Prager
- Division of Oncology, Department of Medicine I, Comprehensive Cancer Center, Medical University Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
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13
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Bianconi D, Herac M, Spies D, Kieler M, Brettner R, Unseld M, Fürnkranz K, Famler B, Schmeidl M, Minichsdorfer C, Zielinski C, Heller G, Prager GW. SERPINB7 Expression Predicts Poor Pancreatic Cancer Survival Upon Gemcitabine Treatment. Transl Oncol 2018; 12:15-23. [PMID: 30245304 PMCID: PMC6149193 DOI: 10.1016/j.tranon.2018.08.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 06/29/2018] [Revised: 08/23/2018] [Accepted: 08/29/2018] [Indexed: 02/07/2023] Open
Abstract
Stratification of patients with pancreatic ductal adenocarcinoma (PDAC) remains a key challenge in the field of clinical oncology. No predictive biomarkers have yet been found for any available treatment options. Previously, we identified SERPINB7 as a putative biomarker for PDAC and thus, herein, we aimed to validate our previous findings and assessed the predictive value of SERPINB7. Patients who underwent surgery and received gemcitabine (gem) or gemcitabine plus nab-paclitaxel (gem/nab) as adjuvant therapy, between 2011 and 2017, were included in this study (n = 57). Expression level of SERPINB7 was assessed in tumor tissue by immunohistochemistry (IHC) and RNA in situ hybridization (RNA ISH). Its association with disease-free survival (DFS) and overall survival (OS) was investigated. While IHC did not show any correlation between survival and the protein level of SERPINB7, RNA ISH revealed that expression of SERPINB7 was associated with a poor DFS (P = .01) and OS (P = .002) in the gem group but not in the gem/nab. Adjusted Cox-regression analysis confirmed the independent predictive value of SERPINB7 on OS (P = .006, HR: 3.47; 95% CI: 1.49–8.09) in the gem group. In conclusion, SERPINB7 was identified as the first predictive RNA biomarker for PDAC. This study suggests that patients who expressed SERPINB7 might receive another treatment than gem alone.
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Affiliation(s)
- Daniela Bianconi
- Department of Internal Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Merima Herac
- Clinical Institute of Pathology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Daniel Spies
- Swiss Federal Institute of Technology Zurich, Department of Biology, Institute of Molecular Health Sciences, Otto-Stern Weg 7, 8093 Zurich, Switzerland; Life Science Zurich Graduate School, Molecular Life Science Program, University of Zurich, Institute of Molecular Life Sciences, Winterthurerstrasse 190, 8057 Zurich, Switzerland
| | - Markus Kieler
- Department of Internal Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Robert Brettner
- Department of Internal Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Matthias Unseld
- Department of Internal Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Katrin Fürnkranz
- Department of Internal Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Barbara Famler
- Clinical Institute of Pathology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Margit Schmeidl
- Clinical Institute of Pathology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Christoph Minichsdorfer
- Department of Internal Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Christoph Zielinski
- Department of Internal Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Gerwin Heller
- Department of Internal Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Gerald W Prager
- Department of Internal Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
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14
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Unseld M, Drimmel M, Siebenhüner A, Gleiss A, Bianconi D, Kieler M, Scheithauer W, Winder T, Prager GW. Optimizing Treatment Sequence for Late-line Metastatic Colorectal Cancer Patients Using Trifluridine/Tipiracil and Regorafenib. Clin Colorectal Cancer 2018; 17:274-279. [PMID: 30042010 DOI: 10.1016/j.clcc.2018.05.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 03/27/2018] [Revised: 05/08/2018] [Accepted: 05/31/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Treatment sequencing for patients with refractory metastatic colorectal cancer (mCRC) has been highly debated. The thymidine-based nucleoside trifluridine/tipiracil (TAS-102) and the multikinase inhibitor regorafenib have demonstrated clinical benefits in randomized phase III trials compared with placebo. However, limited data are available on the most optimal therapy sequence involving TAS-102 and regorafenib. PATIENTS AND METHODS In the present retrospective, observational, real-life study, clinical data on mCRC patients treated with TAS-102 or an alternative salvage treatment at the Medical University of Vienna and University Hospital Zurich were collected from January 2013 to December 2016. RESULTS A total of 85 patients whose disease had progressed during fluoropyrimidine-based therapy (FBT) with or without an antibody were included. The disease control rate in patients treated with TAS-102 after FBT-based treatment was 24% compared with 35% in patients treated with regorafenib after FBT-based treatment (adjusted odds ratio, 1.75; 95% confidence interval, 0.41-7.47; P = .449). The progression-free survival (PFS) and overall survival (OS) for patients treated with TAS-102 was 2.8 months (quartile, 2.0-4.8 months) and 15.9 months, respectively. When the data were analyzed according to the subgroups of patients with or without an FBT-free period, the TAS-102-treated patients with a previous FBT-free interval had a PFS of 3.1 months and OS of 17.7 months compared with a PFS of 2.2 months and OS of 8.1 months for patients who received TAS-102 immediately after FBT. CONCLUSION Our results have confirmed the efficacy of TAS-102 and regorafenib in the real-life setting. The treatment sequence analysis showed a tendency for longer PFS and OS for TAS-102-treated patients after an FBT-free interval. Prospective randomized data are needed to gain more information about the most beneficial therapy sequence in the salvage treatment of mCRC.
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Affiliation(s)
- Matthias Unseld
- Clinical Division of Oncology, Department of Medicine I, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Magdalena Drimmel
- Clinical Division of Oncology, Department of Medicine I, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | | | - Andreas Gleiss
- Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Daniela Bianconi
- Clinical Division of Oncology, Department of Medicine I, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Markus Kieler
- Clinical Division of Oncology, Department of Medicine I, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Werner Scheithauer
- Clinical Division of Oncology, Department of Medicine I, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Thomas Winder
- Department of Oncology, University Hospital Zurich, Zurich, Switzerland
| | - Gerald W Prager
- Clinical Division of Oncology, Department of Medicine I, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
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15
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Kieler M, Müllauer L, Koperek O, Bianconi D, Unseld M, Raderer M, Prager GW. Analysis of 10 Adrenocortical Carcinoma Patients in the Cohort of the Precision Medicine Platform MONDTI. Oncology 2018; 94:306-310. [PMID: 29444511 DOI: 10.1159/000486678] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 10/04/2017] [Accepted: 12/22/2017] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Adrenocortical carcinoma (ACC) is a rare disease with a dismal prognosis. We aimed to evaluate if a personalized medicine approach may be useful for matching patients with ACC to targeted therapies. METHODS This is an analysis of 10 molecularly profiled ACCs that were progressing under standard of care treatment. The profile consisted of a 50-gene next-generation sequencing panel, immunohistochemistry (IHC), and fluorescence in situ hybridization for several proteins or chromosomal aberrations. RESULTS In 6 (60%) tumor samples, no somatic mutation was detected, while in 3 (30%) tumors 1 mutation was detected and in 1 (10%) tumor 2 mutations were detected. These mutations were CTNNB1 (2 samples), TP53 (1 sample), RB1 (1 sample) and APC (1 sample). Expression of phospho-mTOR and of EGFR was commonly detected by IHC (87.5 and 62.5%). In 4 (50%) samples, IHC revealed a weak expression of progesterone receptor. Less frequent alterations were expression of PDGFR-α, c-KIT, and estrogen receptor, each in 1 case. CONCLUSIONS Based on the molecular profile, no recommendation for targeted therapy was made by the multi-disciplinary team. Currently, ACC might not be suitable for a precision medicine approach according to our tests.
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Affiliation(s)
- Markus Kieler
- Division of Oncology, Department of Medicine I, Comprehensive Cancer Center, Medical University Vienna, Vienna, Austria
| | - Leonhard Müllauer
- Clinical Institute of Pathology, Medical University Vienna, Vienna, Austria
| | - Oskar Koperek
- Clinical Institute of Pathology, Medical University Vienna, Vienna, Austria
| | - Daniela Bianconi
- Division of Oncology, Department of Medicine I, Comprehensive Cancer Center, Medical University Vienna, Vienna, Austria
| | - Matthias Unseld
- Division of Oncology, Department of Medicine I, Comprehensive Cancer Center, Medical University Vienna, Vienna, Austria
| | - Markus Raderer
- Division of Oncology, Department of Medicine I, Comprehensive Cancer Center, Medical University Vienna, Vienna, Austria
| | - Gerald W Prager
- Division of Oncology, Department of Medicine I, Comprehensive Cancer Center, Medical University Vienna, Vienna, Austria
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16
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Kieler M, Unseld M, Demyanets S, Bianconi D, Prager G. Plasma levels of interleukin-33 (IL-33) and soluble suppression of tumorigenicity 2 (sST2) as a potential predictive biomarker in patients (pts) with advanced pancreatic ductal adenocarcinoma (PDAC) undergoing systemic chemotherapy (sCTX). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx711.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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17
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Bianconi D, Heller G, Spies D, Herac M, Gleiss A, Liebmann-Reindl S, Unseld M, Kieler M, Scheithauer W, Streubel B, Zielinski CC, Prager GW. Biochemical and genetic predictors of overall survival in patients with metastatic pancreatic cancer treated with capecitabine and nab-paclitaxel. Sci Rep 2017; 7:4851. [PMID: 28687745 PMCID: PMC5501799 DOI: 10.1038/s41598-017-04743-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 03/29/2017] [Accepted: 05/30/2017] [Indexed: 12/18/2022] Open
Abstract
Pancreatic cancer is a dismal disease with a mortality rate almost similar to its incidence rate. To date, there are neither validated predictive nor prognostic biomarkers for this lethal disease. Thus, the aim of the present study was to retrospectively investigate the capability of biochemical parameters and molecular profiles to predict survival of patients with metastatic pancreatic ductal adenocarcinoma (mPDAC) who participated in a phase II clinical trial to test the safety and efficacy of the combination treatment of capecitabine plus nab-paclitaxel. Herein, we investigated the association of 18 biochemical parameters obtained from routine diagnosis and the clinical outcome of the 30 patients enrolled in the clinical trial. Furthermore, we analysed formalin-fixed paraffin-embedded (FFPE) tumour tissue to identify molecular biomarkers via RNA seq and the Illumina TruSeq Amplicon Cancer panel which covers 48 hotspot genes. Our analysis identified SERPINB7 as a novel transcript and a DNA mutation signature that might predict a poor outcome of disease. Moreover, we identified the bilirubin basal level as an independent predictive factor for overall survival in our study cohort.
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Affiliation(s)
- Daniela Bianconi
- Department of Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria
| | - Gerwin Heller
- Department of Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria
| | - Daniel Spies
- Swiss Federal Institute of Technology Zurich, Department of Biology, Institute of Molecular Health Sciences, Otto-Stern Weg 7, 8093, Zurich, Switzerland.,Life Science Zurich Graduate School, Molecular Life Science Program, Institute of Molecular Life Science, University of Zurich, Winterthurerstrasse 190, Zurich, 8057, Switzerland, Austria
| | - Merima Herac
- Clinical Institute of Pathology, Medical University of Vienna, Vienna, Austria
| | - Andreas Gleiss
- Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | | | - Matthias Unseld
- Department of Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria
| | - Markus Kieler
- Department of Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria
| | - Werner Scheithauer
- Department of Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria
| | - Berthold Streubel
- Clinical Institute of Pathology, Medical University of Vienna, Vienna, Austria
| | - Christoph C Zielinski
- Department of Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria
| | - Gerald W Prager
- Department of Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria.
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Unseld M, Kornek G, Gleiss A, Demyantes S, Schwarzwald J, Bianconi D, Andel J, Tinchon C, Pecherstorfer M, Eisterer W, Jagdt B, Kretschmer A, Gerger A, Greil R, Seebacher A, Krippl P, Laengle F, Zielinski C, Scheithauer W, Prager GW. Soluble CD87 (s-uPAR) predicts bevacizumab-based first line treatment of metastatic colorectal cancer (mCRC): Results from a prospective multi-center study. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.4_suppl.604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
604 Background: Bevacizumab-combined chemotherapy is well established in the induction treatment of metastatic colorectal cancer (mCRC). Despite tremendous efforts, no valid predictive marker for anti-VEGF treatment has so far been defined. CD87, the urokinase plasminogen activator receptor (uPAR), is centrally regulating VEGF-induced angiogenesis via adapting endothelial cell migration and invasion (Unseld et al.; ThrombHaem,2015, Brunner et al.; Blood 2011, Prager et al; Blood 2009; Prager et al; Blood 2004). Preoperative plasma s-uPAR levels were shown to independently predicted survival of patients resectable colorectal cancer. This study aimed to identify any prognostic or predictive value of s-uPAR in front-line bevacizumab-treated mCRC patients. Methods: In this prospective multi-center trial (NCT02119026), patients were either treated with bevacizumab plus FOLFOX or bevacizumab plus FOLFIRI. Baseline s-uPAR levels were assessed in 80 patients (40 ea. group) using respective CE-certified electro-chemiluminescence immunoassay (ECLIA). Biomarkers were explored using Kaplan-Meier curves and were log transformed for survival analysis by Cox proportional hazards models. All P values reported are two-sided. Results: Data from eighty patients were available for analysis. Progression free survival (PFS) and overall survival (OS) were assessed. Data indicate significance for the angiogenic biomarker uPAR to determine prognostic (HR = 3.06, CI 1.45 - 6.53, p = 0.003) and predictive (HR = 3.41, CI 2.03 - 5.74, p < 0.001) value in the treatment of Bevacizumab. Conclusions: This is the first prospective analysis of baseline s-uPAR. High baseline-s-uPAR levels were an independent predictive marker for worse bevacizumab-based first-line treatment response.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Björn Jagdt
- Krankenhaus der Barmherzigen Schwestern Ried im Innkreis, Ried, Austria
| | | | | | - Richard Greil
- Paracelsus Medical University Salzburg, Salzburg, Austria
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Abstract
Integrins are heterodimeric cell surface receptors that bind to different extracellular ligands depending on their composition and regulate all processes which enable multicellular life. In cancer, integrins trigger and play key roles in all the features that were once described as the Hallmarks of Cancer. In this review, we will discuss the contribution of integrins to these hallmarks, including uncontrolled and limitless proliferation, invasion of tumor cells, promotion of tumor angiogenesis and evasion of apoptosis and resistance to growth suppressors, by highlighting the latest findings. Further on, given the paramount role of integrins in cancer, we will present novel strategies for integrin inhibition that are starting to emerge, promising a hopeful future regarding cancer treatment.
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Affiliation(s)
- Daniela Bianconi
- Department of Internal Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, A-1090 Vienna, Austria.
| | - Matthias Unseld
- Department of Internal Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, A-1090 Vienna, Austria.
| | - Gerald W Prager
- Department of Internal Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, A-1090 Vienna, Austria.
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Bianconi D, Herac M, Gleiss A, Unseld M, Weigl R, Schindl M, Scheithauer W, Zielinski C, Prager G. Functional role of 4F2hc in pancreatic ductal adenocarcinoma. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw362.50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Unseld M, Scheithauer W, Weigl R, Kornek G, Stranzl N, Bianconi D, Brunauer G, Steger G, Zielinski CC, Prager GW. Nab-paclitaxel as alternative treatment regimen in advanced cholangiocellular carcinoma. J Gastrointest Oncol 2016; 7:588-94. [PMID: 27563449 DOI: 10.21037/jgo.2016.05.01] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Advanced cholangiocellular carcinoma has a poor prognosis with limited therapeutic options. Nab-paclitaxel has recently been described to be beneficial in metastatic pancreatic cancer improving overall and progression free survival (PFS). The potential antitumor activity of nab-paclitaxel in cholangiocellular carcinoma is hitherto unknown. METHODS We retrospectively analyzed an institutional cholangiocellular carcinoma registry to determine the potential biological activity of nab-paclitaxel in advanced intrahepatic cholangiocellular carcinoma. Disease control rate (DCR), PFS and overall survival (OS) upon nab-paclitaxel based treatment, after failure of platinum-containing first-line combination chemotherapy, was assessed. RESULTS Twelve patients were identified. Five of 12 patients (42%) received nab-paclitaxel as second line, and 7 patients (56%) as third-line treatment. The objective DCR with nab-paclitaxel was 83% (10/12 patients). One patient had a complete remission (CR), two patients had a partial remission (PR) and 7 patients had stable disease (SD). Disease was rated progressive in two patients. In all 12 patients receiving nab-paclitaxel the median time to progression was 6 months (range, 2.1-19.5 months). Median OS after initiation of nab-paclitaxel treatment was 9 months (2.1-28.4 months). The median time of survival after diagnosis of advanced disease was 21.5 months, whereby 3 patients were alive at the date of censoring (04/01/2015). CONCLUSIONS This is the first report suggesting substantial antitumor activity of nab-paclitaxel in advanced cholangiocellular carcinoma. In this small series, nab-paclitaxel based salvage chemotherapy appears to have a biological activity by controlling the disease and positively affecting survival. Randomized trials in this disease entity and subgroup of patients are urged.
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Affiliation(s)
- Matthias Unseld
- Department of Medicine I, Comprehensive Cancer Center, Medical University Vienna, 1090 Vienna, Austria
| | - Werner Scheithauer
- Department of Medicine I, Comprehensive Cancer Center, Medical University Vienna, 1090 Vienna, Austria
| | - Roman Weigl
- Department of Medicine I, Comprehensive Cancer Center, Medical University Vienna, 1090 Vienna, Austria
| | - Gabriela Kornek
- Department of Medicine I, Comprehensive Cancer Center, Medical University Vienna, 1090 Vienna, Austria
| | - Nadja Stranzl
- Department of Medicine I, Comprehensive Cancer Center, Medical University Vienna, 1090 Vienna, Austria
| | - Daniela Bianconi
- Department of Medicine I, Comprehensive Cancer Center, Medical University Vienna, 1090 Vienna, Austria
| | - Georg Brunauer
- Institute for Energy Systems and Thermodynamics, Vienna University of Technology, Vienna, Austria
| | - Guenther Steger
- Department of Medicine I, Comprehensive Cancer Center, Medical University Vienna, 1090 Vienna, Austria
| | - Christoph C Zielinski
- Department of Medicine I, Comprehensive Cancer Center, Medical University Vienna, 1090 Vienna, Austria
| | - Gerald W Prager
- Department of Medicine I, Comprehensive Cancer Center, Medical University Vienna, 1090 Vienna, Austria
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Pietrini F, Bianconi D, Massacci A, Iannelli MA. Combined effects of elevated CO2 and Cd-contaminated water on growth, photosynthetic response, Cd accumulation and thiolic components status in Lemna minor L. J Hazard Mater 2016; 309:77-86. [PMID: 26875143 DOI: 10.1016/j.jhazmat.2016.01.079] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 01/26/2016] [Accepted: 01/29/2016] [Indexed: 06/05/2023]
Abstract
The objective of this study was to investigate the combined effects of elevated CO2 and cadmium (Cd) treatments on growth, photosynthetic efficiency and phytoremediation ability in Lemna minor L. Plants of L. minor were exposed to different Cd concentrations (0, 1.5, 2.5 and 5 mg L(-1) Cd) for periods of 24, 48 and 72 h at ambient (AC) and at elevated (EC) CO2 (350 and 700 ppm, respectively). Cadmium concentration, bioconcentration factor, enzyme activities and thiols content enhanced in plants with the increase of Cd treatments, time of exposure and at both CO2 levels. Glutathione levels increased only at AC. Growth, photosynthetic and chlorophyll fluorescence parameters, and the reduced glutathione to oxidized glutathione ratio declined in plants with increasing exposure time, Cd treatments and at both CO2 levels. Our results suggested that the alleviation of toxicity, at low Cd doses, observed in L. minor grown at EC is dependent on both increased photosynthesis and an enhanced antioxidant capacity.
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Affiliation(s)
- F Pietrini
- Institute of Agro-Environmental and Forest Biology, National Research Council of Italy, Via Salaria Km 29,300, 00015 Monterotondo Scalo, Roma, Italy
| | - D Bianconi
- Institute of Agro-Environmental and Forest Biology, National Research Council of Italy, Via Salaria Km 29,300, 00015 Monterotondo Scalo, Roma, Italy
| | - A Massacci
- Institute of Agro-Environmental and Forest Biology, National Research Council of Italy, Via Salaria Km 29,300, 00015 Monterotondo Scalo, Roma, Italy
| | - M A Iannelli
- Institute of Agricultural Biology and Biotechnology, National Research Council of Italy, Via Salaria Km 29,300, 00015 Monterotondo Scalo, Roma, Italy.
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Bianconi D, Schuler A, Pausz C, Geroldinger A, Kaider A, Lenz HJ, Kornek G, Scheithauer W, Zielinski CC, Pabinger I, Ay C, Prager GW. Integrin beta-3 genetic variants and risk of venous thromboembolism in colorectal cancer patients. Thromb Res 2015; 136:865-9. [PMID: 26440977 PMCID: PMC7496222 DOI: 10.1016/j.thromres.2015.08.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [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: 05/11/2015] [Revised: 08/12/2015] [Accepted: 08/16/2015] [Indexed: 11/16/2022]
Abstract
Background Integrin β3 is involved in tumor and endothelial cell biology as well as in platelet aggregation. Herein, we evaluated the predictive potential of three germline single nucleotide polymorphisms (SNPs) in the integrin β3 gene (rs3809865, rs5918 and rs4642) to predict the risk of venous thromboembolism (VTE) in colorectal cancer (CRC) patients, which is one of the leading causes of death among cancer patients. Methods 112 patients diagnosed with CRC enrolled in the prospective Vienna Cancer and Thrombosis Study (CATS) were assessed with a median follow-up of 46 months. DNA was isolated from venous blood samples and SNPs were analyzed by the PCR-RFLP method. Results VTE occurred in 12% (n = 13) of all patients. The SNPs rs5918 and rs4642 were not associated with VTE risk. For rs3809565, 23% (n = 11) of patients had the A/A genotype, 4% (n = 2) had the A/T genotype, but none (0%) had the T/T genotype. In the univariate analysis, patients with the A/A genotype had a significantly higher risk to develop VTE compared to the other polymorphisms (P = 0.0005 after Fine and Gray). In the multivariable analysis, the predictive value remained significant. Conclusions This study identified the rs3809865 A/A genotype as an independent risk factor for VTE in CRC patients. Our findings would help identify high risk patients and would be essential for tailored anticoagulant prophylaxis.
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Affiliation(s)
- Daniela Bianconi
- Department of Internal Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Austria
| | - Alexandra Schuler
- Department of Internal Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Austria
| | - Clemens Pausz
- Department of Internal Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Austria
| | - Angelika Geroldinger
- Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Austria
| | - Alexandra Kaider
- Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Austria
| | - Heinz-Josef Lenz
- Norris Cancer Center, University of Southern California, Los Angeles, CA, USA
| | - Gabriela Kornek
- Department of Internal Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Austria
| | - Werner Scheithauer
- Department of Internal Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Austria
| | - Christoph C Zielinski
- Department of Internal Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Austria
| | - Ingrid Pabinger
- Department of Internal Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Austria
| | - Cihan Ay
- Department of Internal Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Austria.
| | - Gerald W Prager
- Department of Internal Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Austria.
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Prager G, Bianconi D, Chillà A, Dorda A, Geetha N, Unseld M, Sykoutri D, Poettler M, Redlich K, Zielinski C. Abstract 406: Effects of an RGD peptide in osteoclast maturation and behavior as a therapeutic option for metastatic bone disease. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Metastatic bone disease is a common feature of many types of cancer and has a severe impact on the quality of life of patients. Hence, specific therapeutic strategies inhibiting tumor induced osteolysis are urgently needed. In this study, we aimed to interfere with integrin adhesion receptors, which are central players of the bone resorption process, including osteoclastogenesis as well as osteoclast/bone matrix interaction. For this purpose, we used a cyclic RGD peptide which blocks integrin áVâ3 and áVâ5-ligand binding. Our results revealed that the RGD peptide blocked osteoclast maturation in a dose-dependent manner. In detail, pre-osteoclasts treated with the RGD peptide exhibited reduced cell spreading, migration and adhesion on RGD-containing matrix proteins, such as osteopontin and fibrinogen, which are ligands of integrin áVâ3. The activation of the most upstream signal transduction molecules of the integrin receptor-initiated pathway, such as FAK and c-Src, were consistently blocked by the RGD peptide. First evidence has suggested that the RGD peptide might interfere with metastatic bone disease in vivo and the evidence presented herein describes the underlying mechanisms of the inhibitory effect of the RGD peptide on áV-integrin expressing pre-osteoclasts by blocking integrin ligand binding and interfering with osteoclast maturation and cell behavior. In conclusion, our findings suggest that using an RGD peptide to interfere with áV-integrins on osteoclasts may represent a novel therapeutic strategy in the treatment of malignant bone disease.
Citation Format: Gerald Prager, Daniela Bianconi, Anastasia Chillà, Alexandra Dorda, Nisha Geetha, Matthias Unseld, Despoina Sykoutri, Marina Poettler, Kurt Redlich, Christoph Zielinski. Effects of an RGD peptide in osteoclast maturation and behavior as a therapeutic option for metastatic bone disease. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 406. doi:10.1158/1538-7445.AM2015-406
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Prager G, Schuler A, Pausz C, Bianconi D, Lenz H, Ay C, Pabinger I, Zielinski C. Integrin Beta-3 Genetic Variants Predict the Risk of Thrombo-Embolic Events in Patients with Colorectal Cancer. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu333.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Pasini A, Casali F, Bianconi D, Rossi A, Bontempi M. A new cone-beam computed tomography system for dental applications with innovative 3D software. Int J Comput Assist Radiol Surg 2007. [DOI: 10.1007/s11548-006-0062-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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