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Salguero-Aranda C, Di Blasi E, Galán L, Zaldumbide L, Civantos G, Marcilla D, de Álava E, Díaz-Martín J. Identification of Novel/Rare EWSR1 Fusion Partners in Undifferentiated Mesenchymal Neoplasms. Int J Mol Sci 2024; 25:1735. [PMID: 38339014 PMCID: PMC10855420 DOI: 10.3390/ijms25031735] [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: 12/11/2023] [Revised: 01/23/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024] Open
Abstract
Recurrent gene fusions (GFs) in translocated sarcomas are recognized as major oncogenic drivers of the disease, as well as diagnostic markers whose identification is necessary for differential diagnosis. EWSR1 is a 'promiscuous' gene that can fuse with many different partner genes, defining different entities among a broad range of mesenchymal neoplasms. Molecular testing of EWSR1 translocation traditionally relies on FISH assays with break-apart probes, which are unable to identify the fusion partner. Therefore, other ancillary molecular diagnostic modalities are being increasingly adopted for accurate classification of these neoplasms. Herein, we report three cases with rare GFs involving EWSR1 in undifferentiated mesenchymal neoplasms with uncertain differential diagnoses, using targeted RNA-seq and confirming with RT-PCR and Sanger sequencing. Two GFs involved hormone nuclear receptors as 3' partners, NR4A2 and RORB, which have not been previously reported. NR4A2 may functionally replace NR4A3, the usual 3' partner in extraskeletal myxoid chondrosarcoma. The third GF, EWSR1::BEND2, has previously been reported in a subtype of astroblastoma and other rare entities, including a single case of a soft-tissue tumor that we discuss in this work. In conclusion, our findings indicate that the catalogue of mesenchymal neoplasm-bearing EWSR1 fusions continues to grow, underscoring the value of using molecular ancillary techniques with higher diagnostic abilities in the routine clinical setting.
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Affiliation(s)
- Carmen Salguero-Aranda
- Instituto de Biomedicina de Sevilla, Department of Pathology, Hospital Universitario Virgen del Rocío, CSIC-Universidad de Sevilla, 41013 Seville, Spain; (C.S.-A.)
- Centro de Investigación Biomédica en Red de Cáncer, Instituto de Salud Carlos III (CB16/12/00361; CIBERONC-ISCIII), 28029 Madrid, Spain
- Department of Normal and Pathological Cytology and Histology, School of Medicine, University of Seville, 41004 Seville, Spain
| | - Elena Di Blasi
- Istituto Nazionale dei Tumori, Università degli Studi di Milano, 20133 Milan, Italy
| | - Lourdes Galán
- Instituto de Biomedicina de Sevilla, Department of Pathology, Hospital Universitario Virgen del Rocío, CSIC-Universidad de Sevilla, 41013 Seville, Spain; (C.S.-A.)
| | - Laura Zaldumbide
- Department of Pathology, Hospital Universitario Cruces, 48903 Barakaldo, Spain
| | - Gema Civantos
- Instituto de Biomedicina de Sevilla, Department of Pathology, Hospital Universitario Virgen del Rocío, CSIC-Universidad de Sevilla, 41013 Seville, Spain; (C.S.-A.)
| | - David Marcilla
- Instituto de Biomedicina de Sevilla, Department of Pathology, Hospital Universitario Virgen del Rocío, CSIC-Universidad de Sevilla, 41013 Seville, Spain; (C.S.-A.)
| | - Enrique de Álava
- Instituto de Biomedicina de Sevilla, Department of Pathology, Hospital Universitario Virgen del Rocío, CSIC-Universidad de Sevilla, 41013 Seville, Spain; (C.S.-A.)
- Centro de Investigación Biomédica en Red de Cáncer, Instituto de Salud Carlos III (CB16/12/00361; CIBERONC-ISCIII), 28029 Madrid, Spain
- Department of Normal and Pathological Cytology and Histology, School of Medicine, University of Seville, 41004 Seville, Spain
| | - Juan Díaz-Martín
- Instituto de Biomedicina de Sevilla, Department of Pathology, Hospital Universitario Virgen del Rocío, CSIC-Universidad de Sevilla, 41013 Seville, Spain; (C.S.-A.)
- Centro de Investigación Biomédica en Red de Cáncer, Instituto de Salud Carlos III (CB16/12/00361; CIBERONC-ISCIII), 28029 Madrid, Spain
- Department of Normal and Pathological Cytology and Histology, School of Medicine, University of Seville, 41004 Seville, Spain
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Torrado C, Camaño M, Hindi N, Ortega J, Sevillano AR, Civantos G, Moura DS, Dimino A, Martín-Broto J. Antiangiogenics in Malignant Granular Cell Tumors: Review of the Literature. Cancers (Basel) 2023; 15:5187. [PMID: 37958362 PMCID: PMC10650106 DOI: 10.3390/cancers15215187] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/12/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023] Open
Abstract
Granular cell tumors (GCT) represent 0.5% of all soft tissue sarcomas (STS), and when metastatic, they exhibit aggressive behavior and determine limited survival. Metastatic GCTs are relatively chemo-resistant; however, there is growing evidence of the benefit of using pazopanib and other targeted therapies in this histology. This is a review of the role of pazopanib and other targeted therapies in the treatment of GCTs, along with some insights on pathology and molecular biology described in GCTs. From 256 articles found in our search, 10 case-report articles met the inclusion criteria. Pazopanib was the most employed systemic therapy. The median reported time on therapy with pazopanib was seven months. Eight out of ten patients (80%) experienced disease control with pazopanib, while four out of ten (40%) patients achieved an objective RECIST response. Molecular studies suggested that antitumoral effects of pazopanib in GCT might be due to a loss-of-function of ATP6AP1/2 genes which consequently enhance signaling through several molecular pathways, such as SFKs, STAT5a/b, and PDGFR-β. Other reported targeted therapies for malignant GCTs included pazopanib in combination with crizotinib, which showed disease control for four months in one patient, and a PI3K inhibitor which achieved disease control for nine months in another patient. Dasatinib and megestrol were ineffective in two other different patients. Pazopanib has been demonstrated to be active in advanced GCTs and may be considered as a preferable treatment option.
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Affiliation(s)
- Carlos Torrado
- Medical Oncology Department, University Hospital Virgen del Rocío, 41013 Sevilla, Spain;
| | - Melisa Camaño
- Medical Oncology Department, National Cancer Institute, 11600 Montevideo, Uruguay;
| | - Nadia Hindi
- Instituto de Investigacion Sanitaria Fundacion Jimenez Diaz (IIS/FJD), 28015 Madrid, Spain; (N.H.); (J.O.); (A.R.S.); (D.S.M.)
- Medical Oncology Department, Fundación Jimenez Diaz University Hospital, 28040 Madrid, Spain
- General de Villalba University Hospital, 28400 Madrid, Spain
| | - Justo Ortega
- Instituto de Investigacion Sanitaria Fundacion Jimenez Diaz (IIS/FJD), 28015 Madrid, Spain; (N.H.); (J.O.); (A.R.S.); (D.S.M.)
- Medical Oncology Department, Fundación Jimenez Diaz University Hospital, 28040 Madrid, Spain
- General de Villalba University Hospital, 28400 Madrid, Spain
| | - Alberto R. Sevillano
- Instituto de Investigacion Sanitaria Fundacion Jimenez Diaz (IIS/FJD), 28015 Madrid, Spain; (N.H.); (J.O.); (A.R.S.); (D.S.M.)
- Medical Oncology Department, Fundación Jimenez Diaz University Hospital, 28040 Madrid, Spain
- General de Villalba University Hospital, 28400 Madrid, Spain
| | - Gema Civantos
- Pathology Department, Hospital Virgen del Rocío, 41013 Sevilla, Spain;
| | - David S. Moura
- Instituto de Investigacion Sanitaria Fundacion Jimenez Diaz (IIS/FJD), 28015 Madrid, Spain; (N.H.); (J.O.); (A.R.S.); (D.S.M.)
| | - Alessandra Dimino
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, 90127 Palermo, Italy;
| | - Javier Martín-Broto
- Instituto de Investigacion Sanitaria Fundacion Jimenez Diaz (IIS/FJD), 28015 Madrid, Spain; (N.H.); (J.O.); (A.R.S.); (D.S.M.)
- Medical Oncology Department, Fundación Jimenez Diaz University Hospital, 28040 Madrid, Spain
- General de Villalba University Hospital, 28400 Madrid, Spain
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Díaz-Martín J, Biscuola M, Benoit J, Marcilla D, Civantos G, de Álava E. What's in a name? Molecular subclassification of sarcomas creates fresh challenges. J Pathol 2019; 247:409-412. [PMID: 30474142 DOI: 10.1002/path.5206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 04/05/2018] [Revised: 10/28/2018] [Accepted: 11/20/2018] [Indexed: 12/13/2022]
Abstract
This commentary addresses the issue of the classification of sarcomas in the article written by Watson and colleagues published recently in this journal. The article delves into the molecular characterization and distinct phenotypes of some recently described entities (e.g. BCOR-rearranged sarcomas, CIC-fused sarcomas) and describes new groups with common characteristics. This commentary focuses on several questions raised in the article, such as what makes a group of sarcomas become a clinical entity, which should be the main driver of sarcoma classification, how the classification of small round cell sarcomas is expected to evolve and how high-throughput techniques could be applied to sarcoma diagnosis in the short term. Copyright © 2018 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
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Affiliation(s)
| | | | - Jonatan Benoit
- Department of Pathology, Institute of Biomedicine of Sevilla (IBiS), Virgen del Rocio University Hospital/CSIC/University of Sevilla/CIBERONC, Seville, Spain
| | - David Marcilla
- Department of Pathology, Institute of Biomedicine of Sevilla (IBiS), Virgen del Rocio University Hospital/CSIC/University of Sevilla/CIBERONC, Seville, Spain
| | - Gema Civantos
- Department of Pathology, Institute of Biomedicine of Sevilla (IBiS), Virgen del Rocio University Hospital/CSIC/University of Sevilla/CIBERONC, Seville, Spain
| | - Enrique de Álava
- Department of Pathology, Institute of Biomedicine of Sevilla (IBiS), Virgen del Rocio University Hospital/CSIC/University of Sevilla/CIBERONC, Seville, Spain
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