1
|
Holý P, Hlaváč V, Šeborová K, Šůsová S, Tesařová T, Rob L, Hruda M, Bouda J, Bartáková A, Mrhalová M, Kopečková K, Al Obeed Allah M, Špaček J, Sedláková I, Souček P, Václavíková R. Targeted DNA sequencing of high-grade serous ovarian carcinoma reveals association of TP53 mutations with platinum resistance when combined with gene expression. Int J Cancer 2024. [PMID: 38447012 DOI: 10.1002/ijc.34908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 02/09/2024] [Accepted: 02/13/2024] [Indexed: 03/08/2024]
Abstract
High-grade serous ovarian carcinoma (HGSC) is the most common subtype of ovarian cancer and is among the most fatal gynecological malignancies worldwide, due to late diagnosis at advanced stages and frequent therapy resistance. In 47 HGSC patients, we assessed somatic and germline genetic variability of a custom panel of 144 known or suspected HGSC-related genes by high-coverage targeted DNA sequencing to identify the genetic determinants associated with resistance to platinum-based therapy. In the germline, the most mutated genes were DNAH14 (17%), RAD51B (17%), CFTR (13%), BRCA1 (11%), and RAD51 (11%). Somatically, the most mutated gene was TP53 (98%), followed by CSMD1/2/3 (19/19/36%), and CFTR (23%). Results were compared with those from whole exome sequencing of a similar set of 35 HGSC patients. Somatic variants in TP53 were also validated using GENIE data of 1287 HGSC samples. Our approach showed increased prevalence of high impact somatic and germline mutations, especially those affecting splice sites of TP53, compared to validation datasets. Furthermore, nonsense TP53 somatic mutations were negatively associated with patient survival. Elevated TP53 transcript levels were associated with platinum resistance and presence of TP53 missense mutations, while decreased TP53 levels were found in tumors carrying mutations with predicted high impact, which was confirmed in The Cancer Genome Atlas data (n = 260). Targeted DNA sequencing of TP53 combined with transcript quantification may contribute to the concept of precision oncology of HGSC. Future studies should explore targeting the p53 pathway based on specific mutation types and co-analyze the expression and mutational profiles of other key cancer genes.
Collapse
Affiliation(s)
- Petr Holý
- Toxicogenomics Unit, National Institute of Public Health, Prague, Czech Republic
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Viktor Hlaváč
- Toxicogenomics Unit, National Institute of Public Health, Prague, Czech Republic
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Karolína Šeborová
- Toxicogenomics Unit, National Institute of Public Health, Prague, Czech Republic
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Simona Šůsová
- Toxicogenomics Unit, National Institute of Public Health, Prague, Czech Republic
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Tereza Tesařová
- Toxicogenomics Unit, National Institute of Public Health, Prague, Czech Republic
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Lukáš Rob
- Department of Gynecology and Obstetrics, Third Faculty of Medicine and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - Martin Hruda
- Department of Gynecology and Obstetrics, Third Faculty of Medicine and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - Jiří Bouda
- Department of Gynecology and Obstetrics, University Hospital in Pilsen, Charles University, Pilsen, Czech Republic
| | - Alena Bartáková
- Department of Gynecology and Obstetrics, University Hospital in Pilsen, Charles University, Pilsen, Czech Republic
| | - Marcela Mrhalová
- Department of Pathology and Molecular Medicine, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Kateřina Kopečková
- Department of Oncology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Mohammad Al Obeed Allah
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Jiří Špaček
- University Hospital Hradec Králové, Hradec Kralove, Czech Republic
| | - Iva Sedláková
- University Hospital Hradec Králové, Hradec Kralove, Czech Republic
| | - Pavel Souček
- Toxicogenomics Unit, National Institute of Public Health, Prague, Czech Republic
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Radka Václavíková
- Toxicogenomics Unit, National Institute of Public Health, Prague, Czech Republic
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| |
Collapse
|
2
|
Šlegerová L, Kopečková K. The Cost-Effectiveness of Pertuzumab for the Treatment of Metastatic HER2+ Breast Cancer in Czechia: A Semi-Markov Model Using Cost States. Value Health Reg Issues 2023; 38:118-125. [PMID: 37865065 DOI: 10.1016/j.vhri.2023.08.002] [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: 05/23/2022] [Revised: 07/28/2023] [Accepted: 08/02/2023] [Indexed: 10/23/2023]
Abstract
OBJECTIVES This article estimates the cost-effectiveness of adding pertuzumab to the combination of trastuzumab and docetaxel within the first-line treatment for metastatic breast cancer with the amplification of HER2+. METHODS Data from Czech clinical practice recorded in the BREAST register are used. A semi-Markov model with states derived based on the treatment phases (first-line medication, no medication, next-line medication, death) is defined to estimate costs from the healthcare payers' perspective. The benefits are estimated as patient survival until death. The Kaplan-Meier estimates are supplemented by the Cox proportional hazard and the accelerated failure time models to control for patient characteristics. Health-related quality-of-life indicators are derived from relevant literature. RESULTS Based on the used data, adding pertuzumab does not result in statistically significantly longer survival while inducing higher treatment costs (€163 360 compared with €90 112 per patient in 2018 prices). Statistically longer survival was not supported by the log-rank test (P = .97), the Cox proportional hazard model, or the accelerated failure time model using the Gompertz distribution. The incremental cost-effectiveness ratio (€87 200) substantially exceeds the willingness to pay for 1 quality-adjusted life-year (€46 500). CONCLUSIONS This analysis indicates that adding pertuzumab cannot be considered cost-effective in Czechia. However, the observed phenomenon may be attributed to the limited duration of patient follow-up periods at the time of the study's execution (mean of 20-21 months). Importantly, we find that using states connected to specific treatment phases is appropriate for a retrospective analysis of patient-level clinical data.
Collapse
Affiliation(s)
- Lenka Šlegerová
- Institute of Economic Studies, Faculty of Social Sciences, Charles University, Prague, Czechia.
| | - Kateřina Kopečková
- Department of Oncology of the Second Faculty of Medicine of Charles University and University Hospital in Motol, Prague, Czechia
| |
Collapse
|
3
|
Holý P, Brynychová V, Šeborová K, Haničinec V, Koževnikovová R, Trnková M, Vrána D, Gatěk J, Kopečková K, Mrhalová M, Souček P. Integrative analysis of mRNA and miRNA expression profiles and somatic variants in oxysterol signaling in early-stage luminal breast cancer. Mol Oncol 2023; 17:2074-2089. [PMID: 37491786 PMCID: PMC10552891 DOI: 10.1002/1878-0261.13495] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 06/19/2023] [Accepted: 07/24/2023] [Indexed: 07/27/2023] Open
Abstract
Oxysterols, oxidized derivatives of cholesterol, act in breast cancer (BC) as selective estrogen receptor modulators and affect cholesterol homeostasis, drug transport, nuclear and cell receptors, and other signaling proteins. Using data from three highly overlapping sets of patients (N = 162 in total) with early-stage estrogen-receptor-positive luminal BC-high-coverage targeted DNA sequencing (113 genes), mRNA sequencing, and full micro-RNA (miRNA) transcriptome microarrays-we describe complex oxysterol-related interaction (correlation) networks, with validation in public datasets (n = 538) and 11 databases. The ESR1-CH25H-INSIG1-ABCA9 axis was the most prominent, interconnected through miR-125b-5p, miR-99a-5p, miR-100-5p, miR-143-3p, miR-199b-5p, miR-376a-3p, and miR-376c-3p. Mutations in SC5D, CYP46A1, and its functionally linked gene set were associated with multiple differentially expressed oxysterol-related genes. STARD5 was upregulated in patients with positive lymph node status. High expression of hsa-miR-19b-3p was weakly associated with poor survival. This is the first study of oxysterol-related genes in BC that combines DNA, mRNA, and miRNA multiomics with detailed clinical data. Future studies should provide links between intratumoral oxysterol signaling depicted here, circulating oxysterol levels, and therapy outcomes, enabling eventual clinical exploitation of present findings.
Collapse
Affiliation(s)
- Petr Holý
- Third Faculty of MedicineCharles UniversityPragueCzech Republic
- Biomedical Center, Faculty of Medicine in PilsenCharles UniversityPilsenCzech Republic
- Toxicogenomics UnitNational Institute of Public HealthPragueCzech Republic
| | - Veronika Brynychová
- Biomedical Center, Faculty of Medicine in PilsenCharles UniversityPilsenCzech Republic
- Toxicogenomics UnitNational Institute of Public HealthPragueCzech Republic
| | - Karolína Šeborová
- Biomedical Center, Faculty of Medicine in PilsenCharles UniversityPilsenCzech Republic
- Toxicogenomics UnitNational Institute of Public HealthPragueCzech Republic
| | - Vojtěch Haničinec
- Biomedical Center, Faculty of Medicine in PilsenCharles UniversityPilsenCzech Republic
| | | | | | - David Vrána
- Comprehensive Cancer Center Novy JicinHospital Novy JicinCzech Republic
| | - Jiří Gatěk
- Department of SurgeryEUC Hospital Zlin and Tomas Bata University in ZlinCzech Republic
| | - Kateřina Kopečková
- Department of Oncology, Second Faculty of MedicineCharles University and Motol University HospitalPragueCzech Republic
| | - Marcela Mrhalová
- Department of Pathology, Second Faculty of MedicineCharles University and Motol University HospitalPragueCzech Republic
| | - Pavel Souček
- Biomedical Center, Faculty of Medicine in PilsenCharles UniversityPilsenCzech Republic
- Toxicogenomics UnitNational Institute of Public HealthPragueCzech Republic
| |
Collapse
|
4
|
Kubeš J, Vondráček V, Andrlik M, Navrátil M, Sláviková S, Klika D, Haas A, Dědečková K, Kopečková K, Ondrová B, Rotnáglová E, Vinakurau Š, Grebenyuk A, Rosina J. Pencil-beam scanning proton therapy for the treatment of glomus jugulare tumours. J Med Radiat Sci 2022; 69:456-462. [PMID: 35973945 DOI: 10.1002/jmrs.612] [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: 10/06/2021] [Accepted: 07/21/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Glomus jugulare tumours (GJT) are benign tumours that arise locally and destructively in the base of the skull and can be successfully treated with radiotherapy. Patients have a long-life expectancy and the late effects of radiotherapy can be serious. Proton radiotherapy reduces doses to critical organs and can reduce late side effects of radiotherapy. The aim of this study was to report feasibility and early clinical results of 12 patients treated using proton therapy. METHODS Between December 2013 and June 2019, 12 patients (pts) with GJT (median volume 20.4 cm3 ; range 8.5-41 cm3 ) were treated with intensity modulated proton therapy (IMPT). Median dose was 54 GyE (Gray Equivalents) (50-60 GyE) with daily fractions of 2 GyE. Twelve patients were analysed with a median follow-up time of 42.2 months (11.3-86.7). Feasibility, dosimetric parameters, acute and late toxicity and local effect on tumour were evaluated in this retrospective study. RESULTS All patients finished treatment without interruption, with excellent dosimetric parameters and mild acute toxicity. Stabilisation of tumour size was detected on MRI in all patients. No changes in symptoms were observed in comparison with pre-treatment conditions. No late effects of radiotherapy were observed. CONCLUSION Pencil-beam scanning proton radiotherapy is highly feasible in the treatment of large GJT with mild acute toxicity and promising short-term results. Longer follow-up and larger patient cohorts are required to further identify the role of pencil-beam scanning (PBS) for this indication.
Collapse
Affiliation(s)
- Jiří Kubeš
- Proton Therapy Centre Czech, Prague, Czech Republic.,Department of Oncology, 2nd Faculty of Medicine, Charles University Prague and Motol University Hospital, Prague, Czech Republic.,Department of Health Care Disciplines and Population Protection, Faculty of Biomedical Engineering, Czech Technical University Prague, Kladno, Czech Republic
| | - Vladimír Vondráček
- Proton Therapy Centre Czech, Prague, Czech Republic.,Department of Health Care Disciplines and Population Protection, Faculty of Biomedical Engineering, Czech Technical University Prague, Kladno, Czech Republic
| | - Michal Andrlik
- Proton Therapy Centre Czech, Prague, Czech Republic.,Department of Health Care Disciplines and Population Protection, Faculty of Biomedical Engineering, Czech Technical University Prague, Kladno, Czech Republic
| | - Matěj Navrátil
- Proton Therapy Centre Czech, Prague, Czech Republic.,Department of Health Care Disciplines and Population Protection, Faculty of Biomedical Engineering, Czech Technical University Prague, Kladno, Czech Republic
| | - Silvia Sláviková
- Proton Therapy Centre Czech, Prague, Czech Republic.,Department of Oncology, 2nd Faculty of Medicine, Charles University Prague and Motol University Hospital, Prague, Czech Republic
| | - Daniel Klika
- Proton Therapy Centre Czech, Prague, Czech Republic
| | - Alexandra Haas
- Proton Therapy Centre Czech, Prague, Czech Republic.,Department of Oncology, 2nd Faculty of Medicine, Charles University Prague and Motol University Hospital, Prague, Czech Republic
| | - Kateřina Dědečková
- Proton Therapy Centre Czech, Prague, Czech Republic.,Department of Oncology, 2nd Faculty of Medicine, Charles University Prague and Motol University Hospital, Prague, Czech Republic
| | - Kateřina Kopečková
- Department of Oncology, 2nd Faculty of Medicine, Charles University Prague and Motol University Hospital, Prague, Czech Republic
| | - Barbora Ondrová
- Proton Therapy Centre Czech, Prague, Czech Republic.,Department of Oncology, 2nd Faculty of Medicine, Charles University Prague and Motol University Hospital, Prague, Czech Republic
| | - Eliška Rotnáglová
- Proton Therapy Centre Czech, Prague, Czech Republic.,Department of Oncology, 2nd Faculty of Medicine, Charles University Prague and Motol University Hospital, Prague, Czech Republic
| | - Štěpán Vinakurau
- Proton Therapy Centre Czech, Prague, Czech Republic.,Department of Oncology, 2nd Faculty of Medicine, Charles University Prague and Motol University Hospital, Prague, Czech Republic
| | - Alexander Grebenyuk
- Department of Health Protection and Disaster Medicine, Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia
| | - Jozef Rosina
- Department of Health Care Disciplines and Population Protection, Faculty of Biomedical Engineering, Czech Technical University Prague, Kladno, Czech Republic.,Department of Medical Biophysics and Informatics, 3rd Faculty of Medicine, Charles University Prague, Prague, Czech Republic
| |
Collapse
|
5
|
Holý P, Hlaváč V, Ostašov P, Brynychová V, Koževnikovová R, Trnková M, Kopečková K, Měšťáková S, Mrhalová M, Souček P. Germline and somatic genetic variability of oxysterol-related genes in breast cancer patients with early disease of the luminal subtype. Biochimie 2022; 199:158-169. [PMID: 35525372 DOI: 10.1016/j.biochi.2022.04.015] [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: 03/07/2022] [Revised: 04/12/2022] [Accepted: 04/29/2022] [Indexed: 11/25/2022]
Abstract
Oxysterols, oxidized derivatives of cholesterol, have been implicated in multiple pathologies, including cancer. In breast cancer, the link is especially strong due to interactions between oxysterols and estrogen receptor activity. Here, we provide the first dedicated study of 113 oxysterol-related genes in breast cancer patients of the luminal subtype, in terms of both their somatic and germline variability, using targeted high-throughput DNA sequencing of 100 normal-tumor pairs with very high coverage. In the full cohort, or subsets of patients stratified by therapy, we found 12 germline variants in ABCA1, ABCA8, ABCC1, GPR183, LDLR, MBTPS1, NR1I2, OSBPL2, OSBPL3, and OSBPL5 to associate with poor survival of patients and variants in ABCA8, ABCG2, and HSD3B7 (three in total) associated with better survival. However, no associations remained significant after correction for multiple tests. Analysis of somatic variants revealed significantly (after FDR correction) poorer survival in patients mutated in CYP46A1 and 9 interacting (according to STRING analysis) genes, as well as in OSBPL3 and a set of 20 genes that collectively associated with the progesterone receptor status of patients. We propose further exploration of these genes in an integrative manner together with gene expression and epigenomic data.
Collapse
Affiliation(s)
- Petr Holý
- Toxicogenomics Unit, National Institute of Public Health, Prague, Czech Republic; Third Faculty of Medicine, Charles University, Prague, Czech Republic; Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Viktor Hlaváč
- Toxicogenomics Unit, National Institute of Public Health, Prague, Czech Republic; Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Pavel Ostašov
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Veronika Brynychová
- Toxicogenomics Unit, National Institute of Public Health, Prague, Czech Republic; Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | | | | | - Kateřina Kopečková
- Department of Oncology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Soňa Měšťáková
- Department of Surgery, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Marcela Mrhalová
- Department of Pathology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Pavel Souček
- Toxicogenomics Unit, National Institute of Public Health, Prague, Czech Republic; Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.
| |
Collapse
|
6
|
Dundr P, Cibula D, Foretová L, Macek M, Kopečková K, Petruželka L, Němejcová K, Bártů M, Hojný J, Hájková N, Jakša R, Janega P, Stružinská I. Gynecological lesions in hereditary cancer predisposition syndromes. Cesk Patol 2021; 57:96-104. [PMID: 34275319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Hereditary tumor syndromes with a possible manifestation in the female internal genital tract represent a heterogeneous group of diseases. The two most common entities are the hereditary breast and ovarian cancer syndrome, and the Lynch syndrome. The less common syndromes include the rhabdoid tumor predisposition syndrome, Cowden syndrome, tuberous sclerosis complex, DICER1 syndrome, nevoid basal cell carcinoma syndrome, Peutz-Jeghers syndrome, von Hippel-Lindau disease, and hereditary leiomyomatosis and renal cell cancer syndrome. The goal of this manuscript is to provide a comprehensive overview of those hereditary tumor syndromes which can manifest in the area of the female genital system, with an emphasis on their summary, the characteristics of the tumors which can develop in association with these syndromes, and the approach to the processing of prophylactically removed tissues and organs. The issue of Lynch syndrome screening is also discussed.
Collapse
|
7
|
Procházka V, Belada D, Janíková A, Benešová K, Mociková H, Ďuraš J, Pirnos J, Kopečková K, Campr V, Fürst T, Pytlík R, Sýkorová A, Michalka J, Dlouhá J, Papajík T, Trněný M. Rituximab maintenance significantly reduces early follicular lymphoma progressions in patients treated with frontline R-CHOP. EJHaem 2020; 1:170-180. [PMID: 35847728 PMCID: PMC9175682 DOI: 10.1002/jha2.60] [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] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 06/30/2020] [Accepted: 07/02/2020] [Indexed: 12/03/2022]
Abstract
Twenty percent of patients with high-tumor-burden (HTB) follicular lymphoma (FL) develop progression/relapse of disease (POD) within 24 months of frontline immunochemotherapy. Unfortunately, about 50% of these patients die within 5 years since POD event. Rituximab maintenance was proven to reduce relapse rate in responding FL, but its role on preventing POD was not defined. We analyzed 1360 HTB-FL patients from the Czech Lymphoma Study Group registry treated with frontline rituximab-containing regimen. Of those, 950 cases received rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) and achieved complete or partial remission: 712 patients received rituximab maintenance (MAINT) and 238 were a historical observational cohort (OBS). We have proposed a modified POD24 (mPOD24) endpoint for the chemosensitive patients calculated from the end-of-induction (EOI). Survival rates since EOI were as follows: 5-year overall survival (OS) 86.2% versus 94.5% in the OBS and MAINT groups, respectively (P < .001) and 5-year progression-free survival 58.5% (OBS) and 75.4% (MAINT) (P < .001). The Cox proportional hazards model showed a decrease in mPOD24 incidence in the MAINT group with the overall hazard rate reduced by 56% (hazard ratio = 0.44; P < .001). The cumulative incidence of mPOD24 was reduced from 24.1% in OBS to 10.1% in MAINT (P < .001). Comparison of non-mPOD24 cases showed OS similar to that in the general population. Rituximab maintenance given after R-CHOP resulted in a 2.4-fold reduction in mPOD24 incidence. Once the non-POD24 status is achieved, FL does not shorten the patients' life expectancy.
Collapse
Affiliation(s)
- Vít Procházka
- Department of Hemato‐Oncology, Faculty of Medicine and DentistryUniversity Hospital in OlomoucOlomoucCzech Republic
| | - David Belada
- Fourth Department of Internal Medicine – HematologyUniversity HospitalHradec KrálovéCzech Republic
| | - Andrea Janíková
- Department of Hematology and OncologyMasaryk University Hospital BrnoBrnoCzech Republic
| | - Kateřina Benešová
- First Department of Internal Medicine – HematologyFirst Faculty of Medicine and General Teaching HospitalPragueCzech Republic
| | - Heidi Mociková
- Department of Internal Medicine and Hematology, Faculty Hospital Kralovske Vinohrady and Third Faculty of MedicineCharles UniversityPragueCzech Republic
| | - Juraj Ďuraš
- Department of Hemato‐OncologyUniversity Hospital OstravaOstravaCzech Republic
| | - Jan Pirnos
- Department of OncologyHospital České BudějoviceČeské BudějoviceCzech Republic
| | | | - Vít Campr
- Department of Pathology and Molecular MedicineUniversity Hospital in MotolPragueCzech Republic
- Second Faculty of MedicineCharles UniversityPragueCzech Republic
| | - Tomáš Fürst
- Department of Mathematical Analysis and Applications of Mathematics, Faculty of SciencePalacký UniversityOlomoucCzech Republic
| | - Robert Pytlík
- First Department of Internal Medicine – HematologyFirst Faculty of Medicine and General Teaching HospitalPragueCzech Republic
| | - Alice Sýkorová
- Fourth Department of Internal Medicine – HematologyUniversity HospitalHradec KrálovéCzech Republic
| | - Jozef Michalka
- Department of Hematology and OncologyMasaryk University Hospital BrnoBrnoCzech Republic
| | - Jitka Dlouhá
- First Department of Internal Medicine – HematologyFirst Faculty of Medicine and General Teaching HospitalPragueCzech Republic
| | - Tomáš Papajík
- Department of Hemato‐Oncology, Faculty of Medicine and DentistryUniversity Hospital in OlomoucOlomoucCzech Republic
| | - Marek Trněný
- First Department of Internal Medicine – HematologyFirst Faculty of Medicine and General Teaching HospitalPragueCzech Republic
| |
Collapse
|
8
|
Indra R, Pompach P, Vavrová K, Jáklová K, Heger Z, Adam V, Eckschlager T, Kopečková K, Arlt VM, Stiborová M. Cytochrome P450 and flavin-containing monooxygenase enzymes are responsible for differential oxidation of the anti-thyroid-cancer drug vandetanib by human and rat hepatic microsomal systems. Environ Toxicol Pharmacol 2020; 74:103310. [PMID: 31837525 DOI: 10.1016/j.etap.2019.103310] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 08/02/2019] [Revised: 11/24/2019] [Accepted: 12/02/2019] [Indexed: 06/10/2023]
Abstract
We studied the in vitro metabolism of the anti-thyroid-cancer drug vandetanib in a rat animal model and demonstrated that N-desmethylvandetanib and vandetanib N-oxide are formed by NADPH- or NADH-mediated reactions catalyzed by rat hepatic microsomes and pure biotransformation enzymes. In addition to the structural characterization of vandetanib metabolites, individual rat enzymes [cytochrome P450 (CYP) and flavin-containing monooxygenase (FMO)] capable of oxidizing vandetanib were identified. Generation of N-desmethylvandetanib, but not that of vandetanib N-oxide, was attenuated by CYP3A and 2C inhibitors while inhibition of FMO decreased formation of vandetanib N-oxide. These results indicate that liver microsomal CYP2C/3A and FMO1 are major enzymes participating in the formation of N-desmethylvandetanib and vandetanib N-oxide, respectively. Rat recombinant CYP2C11 > >3A1 > 3A2 > 1A1 > 1A2 > 2D1 > 2D2 were effective in catalyzing the formation of N-desmethylvandetanib. Results of the present study explain differences between the CYP- and FMO-catalyzed vandetanib oxidation in rat and human liver reported previously and the enzymatic mechanisms underlying this phenomenon.
Collapse
Affiliation(s)
- Radek Indra
- Department of Biochemistry, Faculty of Science, Charles University, Albertov, 2030, 128 40 Prague 2, Czech Republic
| | - Petr Pompach
- Department of Biochemistry, Faculty of Science, Charles University, Albertov, 2030, 128 40 Prague 2, Czech Republic
| | - Katarína Vavrová
- Department of Biochemistry, Faculty of Science, Charles University, Albertov, 2030, 128 40 Prague 2, Czech Republic
| | - Kateřina Jáklová
- Department of Biochemistry, Faculty of Science, Charles University, Albertov, 2030, 128 40 Prague 2, Czech Republic
| | - Zbyněk Heger
- Department of Chemistry and Biochemistry, Mendel University in Brno, Zemedelska 1, 61300 Brno, Czech Republic
| | - Vojtěch Adam
- Department of Chemistry and Biochemistry, Mendel University in Brno, Zemedelska 1, 61300 Brno, Czech Republic
| | - Tomáš Eckschlager
- Department of Pediatric Hematology and Oncology, 2nd Medical Faculty, Charles University and University Hospital Motol, 150 06 Prague, Czech Republic
| | - Kateřina Kopečková
- Department of Oncology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, 150 06 Prague 5, Czech Republic
| | - Volker Manfred Arlt
- Department of Analytical, Environmental and Forensic Sciences, MRC-PHE Centre for Environment and Health, King's College London, 150 Stamford Street, London SE1 9NH, United Kingdom
| | - Marie Stiborová
- Department of Biochemistry, Faculty of Science, Charles University, Albertov, 2030, 128 40 Prague 2, Czech Republic.
| |
Collapse
|
9
|
Indra R, Pompach P, Martínek V, Takácsová P, Vavrová K, Heger Z, Adam V, Eckschlager T, Kopečková K, Arlt VM, Stiborová M. Identification of Human Enzymes Oxidizing the Anti-Thyroid-Cancer Drug Vandetanib and Explanation of the High Efficiency of Cytochrome P450 3A4 in its Oxidation. Int J Mol Sci 2019; 20:ijms20143392. [PMID: 31295928 PMCID: PMC6679423 DOI: 10.3390/ijms20143392] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 07/07/2019] [Accepted: 07/08/2019] [Indexed: 12/15/2022] Open
Abstract
The metabolism of vandetanib, a tyrosine kinase inhibitor used for treatment of symptomatic/progressive medullary thyroid cancer, was studied using human hepatic microsomes, recombinant cytochromes P450 (CYPs) and flavin-containing monooxygenases (FMOs). The role of CYPs and FMOs in the microsomal metabolism of vandetanib to N-desmethylvandetanib and vandetanib-N-oxide was investigated by examining the effects of CYP/FMO inhibitors and by correlating CYP-/FMO-catalytic activities in each microsomal sample with the amounts of N-desmethylvandetanib/vandetanib-N-oxide formed by these samples. CYP3A4/FMO-activities significantly correlated with the formation of N-desmethylvandetanib/ vandetanib-N-oxide. Based on these studies, most of the vandetanib metabolism was attributed to N-desmethylvandetanib/vandetanib-N-oxide to CYP3A4/FMO3. Recombinant CYP3A4 was most efficient to form N-desmethylvandetanib, while FMO1/FMO3 generated N-oxide. Cytochrome b5 stimulated the CYP3A4-catalyzed formation of N-desmethylvandetanib, which is of great importance because CYP3A4 is not only most efficient in generating N-desmethylvandetanib, but also most significant due to its high expression in human liver. Molecular modeling indicated that binding of more than one molecule of vandetanib into the CYP3A4-active center can be responsible for the high efficiency of CYP3A4 N-demethylating vandetanib. Indeed, the CYP3A4-mediated reaction exhibits kinetics of positive cooperativity and this corresponded to the in silico model, where two vandetanib molecules were found in CYP3A4-active center.
Collapse
Affiliation(s)
- Radek Indra
- Department of Biochemistry, Faculty of Science, Charles University, Albertov 2030, CZ-12843 Prague 2, Czech Republic
| | - Petr Pompach
- Department of Biochemistry, Faculty of Science, Charles University, Albertov 2030, CZ-12843 Prague 2, Czech Republic
| | - Václav Martínek
- Department of Biochemistry, Faculty of Science, Charles University, Albertov 2030, CZ-12843 Prague 2, Czech Republic
| | - Paulína Takácsová
- Department of Biochemistry, Faculty of Science, Charles University, Albertov 2030, CZ-12843 Prague 2, Czech Republic
| | - Katarína Vavrová
- Department of Biochemistry, Faculty of Science, Charles University, Albertov 2030, CZ-12843 Prague 2, Czech Republic
| | - Zbyněk Heger
- Department of Chemistry and Biochemistry, Mendel University in Brno, Zemedelska 1, CZ-61300 Brno, Czech Republic
| | - Vojtěch Adam
- Department of Chemistry and Biochemistry, Mendel University in Brno, Zemedelska 1, CZ-61300 Brno, Czech Republic
| | - Tomáš Eckschlager
- Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, V Uvalu 84/1, CZ-150 06 Prague 5, Czech Republic
| | - Kateřina Kopečková
- Department of Oncology, 2nd Medical Faculty, Charles University and University Hospital Motol, V Uvalu 84/1, CZ-150 06 Prague 5, Czech Republic
| | - Volker Manfred Arlt
- Department of Analytical, Environmental and Forensic Sciences, MRC-PHE Centre for Environment and Health, King's College London, 150 Stamford Street, London SE1 9NH, UK
- NIHR Health Protection Research Unit in Health Impact of Environmental Hazards at King's College London in partnership with Public Health England and Imperial College London, 150 Stamford Street, London SE1 9NH, UK
| | - Marie Stiborová
- Department of Biochemistry, Faculty of Science, Charles University, Albertov 2030, CZ-12843 Prague 2, Czech Republic.
| |
Collapse
|
10
|
Ďuraš J, Procházka V, Belada D, Janíková A, Móciková H, Kopečková K, Hájek R, Trněný M. PREDICTIVE VALUE OF PRIMA-PROGNOSTIC INDEX (PRIMA-PI) IN FIRST RELAPSE OF FOLLICULAR LYMPHOMA. Hematol Oncol 2019. [DOI: 10.1002/hon.68_2631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- J. Ďuraš
- Department of Haematooncology; University Hospital Ostrava and Faculty of Medicine, University of Ostrava; Ostrava Czech Republic
| | - V. Procházka
- Department of Hemato-Oncology; Faculty of Medicine and Dentistry, Palacky University; Olomouc Czech Republic
| | - D. Belada
- Department of Internal Medicine - Hematology; University Hospital Hradec Kralove and Charles University in Prague; Hradec Kralove Czech Republic
| | - A. Janíková
- Department of Hematology and Oncology; University Hospital Brno; Brno Czech Republic
| | - H. Móciková
- Department of Internal Medicine and Haematology; University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University in Prague; Prague Czech Republic
| | - K. Kopečková
- Department on Oncology; University Hospital Motol; Prague Czech Republic
| | - R. Hájek
- Department of Haematooncology; University Hospital Ostrava and Faculty of Medicine, University of Ostrava; Ostrava Czech Republic
| | - M. Trněný
- First Dept. of Medicine - Hematology; Charles University General Hospital and First Faculty of Medicine; Prague Czech Republic
| |
Collapse
|
11
|
Stiborová M, Indra R, Frei E, Kopečková K, Schmeiser HH, Eckschlager T, Adam V, Heger Z, Arlt VM, Martínek V. Cytochrome b5 plays a dual role in the reaction cycle of cytochrome P450 3A4 during oxidation of the anticancer drug ellipticine. Monatsh Chem 2017; 148:1983-1991. [PMID: 29104319 PMCID: PMC5653753 DOI: 10.1007/s00706-017-1986-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 04/13/2017] [Indexed: 12/18/2022]
Abstract
Abstract Ellipticine is an anticancer agent that forms covalent DNA adducts after enzymatic activation by cytochrome P450 (CYP) enzymes, mainly by CYP3A4. This process is one of the most important ellipticine DNA-damaging mechanisms for its antitumor action. Here, we investigated the efficiencies of human hepatic microsomes and human recombinant CYP3A4 expressed with its reductase, NADPH:CYP oxidoreductase (POR), NADH:cytochrome b5 reductase and/or cytochrome b5 in Supersomes™ to oxidize this drug. We also evaluated the effectiveness of coenzymes of two of the microsomal reductases, NADPH as a coenzyme of POR, and NADH as a coenzyme of NADH:cytochrome b5 reductase, to mediate ellipticine oxidation in these enzyme systems. Using HPLC analysis we detected up to five ellipticine metabolites, which were formed by human hepatic microsomes and human CYP3A4 in the presence of NADPH or NADH. Among ellipticine metabolites, 9-hydroxy-, 12-hydroxy-, and 13-hydroxyellipticine were formed by hepatic microsomes as the major metabolites, while 7-hydroxyellipticine and the ellipticine N2-oxide were the minor ones. Human CYP3A4 in Supersomes™ generated only three metabolic products, 9-hydroxy-, 12-hydroxy-, and 13-hydroxyellipticine. Using the 32P-postlabeling method two ellipticine-derived DNA adducts were generated by microsomes and the CYP3A4-Supersome system, both in the presence of NADPH and NADH. These adducts were derived from the reaction of 13-hydroxy- and 12-hydroxyellipticine with deoxyguanosine in DNA. In the presence of NADPH or NADH, cytochrome b5 stimulated the CYP3A4-mediated oxidation of ellipticine, but the stimulation effect differed for individual ellipticine metabolites. This heme protein also stimulated the formation of both ellipticine-DNA adducts. The results demonstrate that cytochrome b5 plays a dual role in the CYP3A4-catalyzed oxidation of ellipticine: (1) cytochrome b5 mediates CYP3A4 catalytic activities by donating the first and second electron to this enzyme in its catalytic cycle, indicating that NADH:cytochrome b5 reductase can substitute NADPH-dependent POR in this enzymatic reaction and (2) cytochrome b5 can act as an allosteric modifier of the CYP3A4 oxygenase. Graphical abstract ![]()
Collapse
Affiliation(s)
- Marie Stiborová
- Department of Biochemistry, Faculty of Science, Charles University, Albertov 2030, 128 40 Prague 2, Czech Republic
| | - Radek Indra
- Department of Biochemistry, Faculty of Science, Charles University, Albertov 2030, 128 40 Prague 2, Czech Republic
| | - Eva Frei
- Department of Biochemistry, Faculty of Science, Charles University, Albertov 2030, 128 40 Prague 2, Czech Republic
| | - Kateřina Kopečková
- Department of Oncology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, V Uvalu 84, 150 06 Prague 5, Czech Republic
| | - Heinz H Schmeiser
- Division of Radiopharmaceutical Chemistry, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Tomáš Eckschlager
- Department of Pediatric Hematology and Oncology, 2nd Medical Faculty, Charles University and University Hospital Motol, V Uvalu 84, 150 06 Prague 5, Czech Republic
| | - Vojtěch Adam
- Laboratory of Metallomics and Nanotechnology, Department of Chemistry and Biochemistry, Mendel University in Brno, Zemedelska 1, 61300 Brno, Czech Republic
| | - Zbyněk Heger
- Laboratory of Metallomics and Nanotechnology, Department of Chemistry and Biochemistry, Mendel University in Brno, Zemedelska 1, 61300 Brno, Czech Republic
| | - Volker M Arlt
- Analytical and Environmental Sciences Division, MRC-PHE Centre for Environment and Health, King's College London, London, SE1 9NH UK
| | - Václav Martínek
- Department of Biochemistry, Faculty of Science, Charles University, Albertov 2030, 128 40 Prague 2, Czech Republic
| |
Collapse
|