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Martini G, Belli V, Napolitano S, Ciaramella V, Ciardiello D, Belli A, Izzo F, Avallone A, Selvaggi F, Menegon Tasselli F, Santaniello W, Franco R, Puig I, Ramirez L, Chicote I, Mancuso F, Caratu G, Serres X, Fasani R, Jimenez J, Ros J, Baraibar I, Mulet N, Della Corte CM, Troiani T, Vivancos A, Dienstmann R, Elez E, Palmer HG, Tabernero J, Martinelli E, Ciardiello F, Argilés G. Establishment of patient-derived tumor organoids to functionally inform treatment decisions in metastatic colorectal cancer. ESMO Open 2023; 8:101198. [PMID: 37119788 DOI: 10.1016/j.esmoop.2023.101198] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/16/2023] [Accepted: 02/22/2023] [Indexed: 05/01/2023] Open
Abstract
BACKGROUND Metastatic colorectal cancer (mCRC) patients tend to have modest benefits from molecularly driven therapeutics. Patient-derived tumor organoids (PDTOs) represent an unmatched model to elucidate tumor resistance to therapy, due to their high capacity to resemble tumor characteristics. MATERIALS AND METHODS We used viable tumor tissue from two cohorts of patients with mCRC, naïve or refractory to treatment, respectively, for generating PDTOs. The derived models were subjected to a 6-day drug screening assay (DSA) with a comprehensive pipeline of chemotherapy and targeted drugs against almost all the actionable mCRC molecular drivers. For the second cohort DSA data were matched with those from PDTO genotyping. RESULTS A total of 40 PDTOs included in the two cohorts were derived from mCRC primary tumors or metastases. The first cohort included 31 PDTOs derived from patients treated in front line. For this cohort, DSA results were matched with patient responses. Moreover, RAS/BRAF mutational status was matched with DSA cetuximab response. Ten out of 12 (83.3%) RAS wild-type PDTOs responded to cetuximab, while all the mutant PDTOs, 8 out of 8 (100%), were resistant. For the second cohort (chemorefractory patients), we used part of tumor tissue for genotyping. Four out of nine DSA/genotyping data resulted applicable in the clinic. Two RAS-mutant mCRC patients have been treated with FOLFOX-bevacizumab and mitomycin-capecitabine in third line, respectively, based on DSA results, obtaining disease control. One patient was treated with nivolumab-second mitochondrial-derived activator of caspases mimetic (phase I trial) due to high tumor mutational burden at genotyping, experiencing stable disease. In one case, the presence of BRCA2 mutation correlated with DSA sensitivity to olaparib; however, the patient could not receive the therapy. CONCLUSIONS Using CRC as a model, we have designed and validated a clinically applicable methodology to potentially inform clinical decisions with functional data. Undoubtedly, further larger analyses are needed to improve methodology success rates and propose suitable treatment strategies for mCRC patients.
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Affiliation(s)
- G Martini
- Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples
| | - V Belli
- Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples
| | - S Napolitano
- Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples
| | - V Ciaramella
- Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples
| | - D Ciardiello
- Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples
| | - A Belli
- Hepatobiliary Surgical Oncology Unit, Istituto Nazionale Tumori-Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Fondazione G. Pascale, Napoli
| | - F Izzo
- Hepatobiliary Surgical Oncology Unit, Istituto Nazionale Tumori-Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Fondazione G. Pascale, Napoli
| | - A Avallone
- Experimental Clinical Abdominal Oncology Unit, Istituto Nazionale Tumori-Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Fondazione G. Pascale, Napoli
| | - F Selvaggi
- Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania Luigi Vanvitelli, Naples
| | - F Menegon Tasselli
- Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania Luigi Vanvitelli, Naples
| | - W Santaniello
- Hepatobiliary Surgical Oncology Unit, AORN Cardarelli, Naples
| | - R Franco
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - I Puig
- Translational Program, Stem Cells and Cancer Laboratory, Vall D'Hebron Institute of Oncology (VHIO), Barcelona
| | - L Ramirez
- Translational Program, Stem Cells and Cancer Laboratory, Vall D'Hebron Institute of Oncology (VHIO), Barcelona
| | - I Chicote
- Translational Program, Stem Cells and Cancer Laboratory, Vall D'Hebron Institute of Oncology (VHIO), Barcelona
| | - F Mancuso
- Cancer Genomics Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona
| | - G Caratu
- Cancer Genomics Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona
| | - X Serres
- Department of Interventional Radiology, Hospital Universitari Vall d'Hebron, Barcelona
| | - R Fasani
- Molecular Oncology Lab, Vall d'Hebron Institute of Oncology, Barcelona
| | - J Jimenez
- Molecular Oncology Lab, Vall d'Hebron Institute of Oncology, Barcelona
| | - J Ros
- Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), Barcelona
| | - I Baraibar
- Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), Barcelona
| | - N Mulet
- B-ARGO Badalona Applied Research Group in Oncology, Catalan Institute of Oncology, Badalona
| | - C M Della Corte
- Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples
| | - T Troiani
- Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples
| | - A Vivancos
- Cancer Genomics Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona
| | - R Dienstmann
- Oncology Data Science, Vall d'Hebron Institute of Oncology, Barcelona
| | - E Elez
- Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), Barcelona
| | - H G Palmer
- Translational Program, Stem Cells and Cancer Laboratory, Vall D'Hebron Institute of Oncology (VHIO), Barcelona
| | - J Tabernero
- Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), Barcelona
| | - E Martinelli
- Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples
| | - F Ciardiello
- Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples
| | - G Argilés
- Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), Barcelona; Universitat Autònoma de Barcelona, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York, USA.
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Martinez-Marti A, Felip E, Matito J, Mereu E, Navarro A, Cedrés S, Pardo N, Martinez de Castro A, Remon J, Miquel JM, Guillaumet-Adkins A, Nadal E, Rodriguez-Esteban G, Arqués O, Fasani R, Nuciforo P, Heyn H, Villanueva A, Palmer HG, Vivancos A. Dual MET and ERBB inhibition overcomes intratumor plasticity in osimertinib-resistant-advanced non-small-cell lung cancer (NSCLC). Ann Oncol 2018; 28:2451-2457. [PMID: 28961841 PMCID: PMC5834054 DOI: 10.1093/annonc/mdx396] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background Third-generation epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) such as osimertinib are the last line of targeted treatment of metastatic non-small-cell lung cancer (NSCLC) EGFR-mutant harboring T790M. Different mechanisms of acquired resistance to third-generation EGFR-TKIs have been proposed. It is therefore crucial to identify new and effective strategies to overcome successive acquired mechanisms of resistance. Methods For Amplicon-seq analysis, samples from the index patient (primary and metastasis lesions at different timepoints) as well as the patient-derived orthotopic xenograft tumors corresponding to the different treatment arms were used. All samples were formalin-fixed paraffin-embedded, selected and evaluated by a pathologist. For droplet digital PCR, 20 patients diagnosed with NSCLC at baseline or progression to different lines of TKI therapies were selected. Formalin-fixed paraffin-embedded blocks corresponding to either primary tumor or metastasis specimens were used for analysis. For single-cell analysis, orthotopically grown metastases were dissected from the brain of an athymic nu/nu mouse and cryopreserved at -80°C. Results In a brain metastasis lesion from a NSCLC patient presenting an EGFR T790M mutation, we detected MET gene amplification after prolonged treatment with osimertinib. Importantly, the combination of capmatinib (c-MET inhibitor) and afatinib (ErbB-1/2/4 inhibitor) completely suppressed tumor growth in mice orthotopically injected with cells derived from this brain metastasis. In those mice treated with capmatinib or afatinib as monotherapy, we observed the emergence of KRAS G12C clones. Single-cell gene expression analyses also revealed intratumor heterogeneity, indicating the presence of a KRAS-driven subclone. We also detected low-frequent KRAS G12C alleles in patients treated with various EGFR-TKIs. Conclusion Acquired resistance to subsequent EGFR-TKI treatment lines in EGFR-mutant lung cancer patients may induce genetic plasticity. We assess the biological insights of tumor heterogeneity in an osimertinib-resistant tumor with acquired MET-amplification and propose new treatment strategies in this situation.
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Affiliation(s)
- A Martinez-Marti
- Department of Medical Oncology, Vall d'Hebron University Hospital, Barcelona;; Department of Medical Oncology, Vall d'Hebron Institute of Oncology (VHIO), Barcelona;; Autonomous University of Barcelona (UAB), Barcelona
| | - E Felip
- Department of Medical Oncology, Vall d'Hebron University Hospital, Barcelona;; Department of Medical Oncology, Vall d'Hebron Institute of Oncology (VHIO), Barcelona;; Autonomous University of Barcelona (UAB), Barcelona;.
| | - J Matito
- Cancer Genomics Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona
| | - E Mereu
- Single Cell Genomics Group, Centro Nacional de Análisis Genómico (CNAG) - Center for Genomic Regulation (CRG), Barcelona Institute of Science and Technology (BIST), Barcelona;; Pompeu Fabra University (UPF), Barcelona
| | - A Navarro
- Department of Medical Oncology, Vall d'Hebron University Hospital, Barcelona;; Department of Medical Oncology, Vall d'Hebron Institute of Oncology (VHIO), Barcelona
| | - S Cedrés
- Department of Medical Oncology, Vall d'Hebron University Hospital, Barcelona;; Department of Medical Oncology, Vall d'Hebron Institute of Oncology (VHIO), Barcelona
| | - N Pardo
- Department of Medical Oncology, Vall d'Hebron University Hospital, Barcelona;; Department of Medical Oncology, Vall d'Hebron Institute of Oncology (VHIO), Barcelona;; Autonomous University of Barcelona (UAB), Barcelona
| | - A Martinez de Castro
- Department of Medical Oncology, Vall d'Hebron University Hospital, Barcelona;; Department of Medical Oncology, Vall d'Hebron Institute of Oncology (VHIO), Barcelona
| | - J Remon
- Department of Medical Oncology, Vall d'Hebron University Hospital, Barcelona;; Department of Medical Oncology, Vall d'Hebron Institute of Oncology (VHIO), Barcelona
| | - J M Miquel
- Department of Medical Oncology, Vall d'Hebron Institute of Oncology (VHIO), Barcelona
| | - A Guillaumet-Adkins
- Single Cell Genomics Group, Centro Nacional de Análisis Genómico (CNAG) - Center for Genomic Regulation (CRG), Barcelona Institute of Science and Technology (BIST), Barcelona;; Pompeu Fabra University (UPF), Barcelona
| | - E Nadal
- Chemoresistance and Predictive Factors Group, Program Against Cancer Therapeutic Resistance (ProCURE), Catalan Institute of Oncology (ICO) Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet, Barcelona;; Department of Medical Oncology, ICO, IDIBELL, L'Hospitalet, Barcelona
| | - G Rodriguez-Esteban
- Single Cell Genomics Group, Centro Nacional de Análisis Genómico (CNAG) - Center for Genomic Regulation (CRG), Barcelona Institute of Science and Technology (BIST), Barcelona;; Pompeu Fabra University (UPF), Barcelona
| | | | - R Fasani
- Molecular Oncology Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona
| | - P Nuciforo
- Molecular Oncology Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona
| | - H Heyn
- Single Cell Genomics Group, Centro Nacional de Análisis Genómico (CNAG) - Center for Genomic Regulation (CRG), Barcelona Institute of Science and Technology (BIST), Barcelona;; Pompeu Fabra University (UPF), Barcelona
| | - A Villanueva
- Chemoresistance and Predictive Factors Group, Program Against Cancer Therapeutic Resistance (ProCURE), Catalan Institute of Oncology (ICO) Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet, Barcelona;; Xenopat S.L., Business Bioincubator, Bellvitge Health Science Campus, Barcelona, Spain
| | | | - A Vivancos
- Cancer Genomics Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona;.
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Jubierre L, Soriano A, Planells-Ferrer L, París-Coderch L, Tenbaum SP, Romero OA, Moubarak RS, Almazán-Moga A, Molist C, Roma J, Navarro S, Noguera R, Sánchez-Céspedes M, Comella JX, Palmer HG, Sánchez de Toledo J, Gallego S, Segura MF. BRG1/SMARCA4 is essential for neuroblastoma cell viability through modulation of cell death and survival pathways. Oncogene 2016; 35:5179-90. [PMID: 26996667 DOI: 10.1038/onc.2016.50] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 10/29/2015] [Accepted: 02/01/2016] [Indexed: 12/16/2022]
Abstract
Neuroblastoma (NB) is a neoplasm of the sympathetic nervous system, and is the most common solid tumor of infancy. NBs are very heterogeneous, with a clinical course ranging from spontaneous regression to resistance to all current forms of treatment. High-risk patients need intense chemotherapy, and only 30-40% will be cured. Relapsed or metastatic tumors acquire multi-drug resistance, raising the need for alternative treatments. Owing to the diverse mechanisms that are responsible of NB chemoresistance, we aimed to target epigenetic factors that control multiple pathways to bypass therapy resistance. We found that the SWI/SNF-related, matrix-associated, actin-dependent regulator of chromatin, subfamily a, member 4 (SMARCA4/BRG1) was consistently upregulated in advanced stages of NB, with high BRG1 levels being indicative of poor outcome. Loss-of-function experiments in vitro and in vivo showed that BRG1 is essential for the proliferation of NB cells. Furthermore, whole-genome transcriptome analysis revealed that BRG1 controls the expression of key elements of oncogenic pathways such as PI3K/AKT and BCL2, which offers a promising new combination therapy for high-risk NB.
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Affiliation(s)
- L Jubierre
- Laboratory of Translational Research in Child and Adolescent Cancer. Vall d'Hebron Research Institute (VHIR)-UAB, Barcelona, Spain
| | - A Soriano
- Laboratory of Translational Research in Child and Adolescent Cancer. Vall d'Hebron Research Institute (VHIR)-UAB, Barcelona, Spain
| | | | - L París-Coderch
- Laboratory of Translational Research in Child and Adolescent Cancer. Vall d'Hebron Research Institute (VHIR)-UAB, Barcelona, Spain
| | - S P Tenbaum
- Vall d'Hebron Institut of Oncology (VHIO), Stem Cell and Cancer Laboratory, Barcelona, Spain
| | - O A Romero
- Epigenetic and Cancer Biology Program-PEBC/Bellvitge Biomedical Research Institute-IDIBELL Barcelona, Barcelona, Spain
| | - R S Moubarak
- Cell Signaling and Apoptosis Group, VHIR-UAB, Barcelona, Spain
| | - A Almazán-Moga
- Laboratory of Translational Research in Child and Adolescent Cancer. Vall d'Hebron Research Institute (VHIR)-UAB, Barcelona, Spain
| | - C Molist
- Laboratory of Translational Research in Child and Adolescent Cancer. Vall d'Hebron Research Institute (VHIR)-UAB, Barcelona, Spain
| | - J Roma
- Laboratory of Translational Research in Child and Adolescent Cancer. Vall d'Hebron Research Institute (VHIR)-UAB, Barcelona, Spain
| | - S Navarro
- School of Medicine, University of Valencia, Valencia, Spain
| | - R Noguera
- School of Medicine, University of Valencia, Valencia, Spain
| | | | - J X Comella
- Cell Signaling and Apoptosis Group, VHIR-UAB, Barcelona, Spain
| | - H G Palmer
- Vall d'Hebron Institut of Oncology (VHIO), Stem Cell and Cancer Laboratory, Barcelona, Spain
| | - J Sánchez de Toledo
- Laboratory of Translational Research in Child and Adolescent Cancer. Vall d'Hebron Research Institute (VHIR)-UAB, Barcelona, Spain
| | - S Gallego
- Laboratory of Translational Research in Child and Adolescent Cancer. Vall d'Hebron Research Institute (VHIR)-UAB, Barcelona, Spain
| | - M F Segura
- Laboratory of Translational Research in Child and Adolescent Cancer. Vall d'Hebron Research Institute (VHIR)-UAB, Barcelona, Spain
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