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Johansson H, Guerrieri-Gonzaga A, Gandini S, Bertelsen BE, Macis D, Serrano D, Mellgren G, Lazzeroni M, Thomas PS, Crew KD, Kumar NB, Briata IM, Galimberti V, Viale G, Vornik LA, Aristarco V, Buttiron Webber T, Spinaci S, Brown PH, Heckman-Stoddard BM, Szabo E, Bonanni B, DeCensi A. Alternative dosing regimen of exemestane in a randomized presurgical trial: the role of obesity in biomarker modulation. NPJ Breast Cancer 2024; 10:7. [PMID: 38238336 PMCID: PMC10796398 DOI: 10.1038/s41523-024-00616-8] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 01/04/2024] [Indexed: 01/22/2024] Open
Abstract
In a 3-arm presurgical trial, four-six weeks exemestane 25 mg three times/week (TIW) was non-inferior to 25 mg/day (QD) in suppressing circulating estradiol in postmenopausal women with ER-positive breast cancer. Since obesity may decrease exemestane efficacy, we analyzed changes in sex steroids, adipokines, Ki-67, and drug levels in relation to obesity. Postmenopausal women with early-stage ER-positive breast cancer were randomized to either exemestane 25 mg QD (n = 57), 25 mg TIW (n = 57), or 25 mg/week (QW, n = 62) for 4-6 weeks before breast surgery. Serum and tissue pre- and post-treatment biomarkers were stratified by body mass index (BMI)< or ≥30 kg/m2. Post-treatment median exemestane and 17-OH exemestane levels were 5-6 times higher in the QD arm compared to the TIW arm. For obese women, TIW maintained comparable reductions to QD in systemic estradiol levels, although the reduction in estrone was less with the TIW regimen. There was less suppression of SHBG with the TIW versus the QD dose schedule in obese women which should result in less systemic bioavailable estrogens. Metabolically, the effect of the TIW regimen was similar to the QD regimen for obese women in terms of leptin suppression and increase in the adiponectin-leptin ratio. Reduction in tissue Ki-67 was less for obese women on the TIW regimen than QD, although changes were similar for non-obese women. Our findings suggest that TIW exemestane should be explored further for primary cancer prevention in both normal weight and obese cohorts.
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Affiliation(s)
| | | | - Sara Gandini
- IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Bjørn-Erik Bertelsen
- Hormone Laboratory, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
| | - Debora Macis
- IEO, European Institute of Oncology IRCCS, Milan, Italy
| | | | - Gunnar Mellgren
- Hormone Laboratory, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | | | | | | | - Nagi B Kumar
- Moffitt Cancer Center, University of South Florida, Tampa, FL, USA
| | | | | | | | - Lana A Vornik
- University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | | | | | | | - Powel H Brown
- University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | | | - Eva Szabo
- Division of Cancer Prevention, NCI Bethesda, MD, USA
| | | | - Andrea DeCensi
- E.O. Galliera Hospital, Genoa, Italy
- Wolfson Institute of Population Health, Queen Mary University of London, London, UK
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2
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Serrano D, Gandini S, Thomas P, Crew KD, Kumar NB, Vornik LA, Lee JJ, Veronesi P, Viale G, Guerrieri-Gonzaga A, Lazzeroni M, Johansson H, D’Amico M, Guasone F, Spinaci S, Bertelsen BE, Mellgren G, Bedrosian I, Weber D, Castile T, Dimond E, Heckman-Stoddard BM, Szabo E, Brown PH, DeCensi A, Bonanni B. Efficacy of Alternative Dose Regimens of Exemestane in Postmenopausal Women With Stage 0 to II Estrogen Receptor-Positive Breast Cancer: A Randomized Clinical Trial. JAMA Oncol 2023; 9:664-672. [PMID: 36951827 PMCID: PMC10037202 DOI: 10.1001/jamaoncol.2023.0089] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 12/06/2022] [Indexed: 03/24/2023]
Abstract
Importance Successful therapeutic cancer prevention requires definition of the minimal effective dose. Aromatase inhibitors decrease breast cancer incidence in high-risk women, but use in prevention and compliance in adjuvant settings are hampered by adverse events. Objective To compare the noninferiority percentage change of estradiol in postmenopausal women with estrogen receptor-positive breast cancer given exemestane, 25 mg, 3 times weekly or once weekly vs a standard daily dose with a noninferiority margin of -6%. Design, Setting, and Participants This multicenter, presurgical, double-blind phase 2b randomized clinical trial evaluated 2 alternative dosing schedules of exemestane. Postmenopausal women with estrogen receptor-positive breast cancer who were candidates for breast surgery were screened from February 1, 2017, to August 31, 2019. Blood samples were collected at baseline and final visit; tissue biomarker changes were assessed from diagnostic biopsy and surgical specimen. Biomarkers were measured in different laboratories between April 2020 and December 2021. Interventions Exemestane, 25 mg, once daily, 3 times weekly, or once weekly for 4 to 6 weeks before surgery. Main Outcomes and Measures Serum estradiol concentrations were measured by solid-phase extraction followed by liquid chromatography-tandem mass spectrometry detection. Toxic effects were evaluated using the National Cancer Institute terminology criteria, and Ki-67 was assessed by immunohistochemistry. Results A total of 180 women were randomized into 1 of the 3 arms; median (IQR) age was 66 (60-71) years, 63 (60-69) years, and 65 (61-70) years in the once-daily, 3-times-weekly, and once-weekly arms, respectively. In the intention-to-treat population (n = 171), the least square mean percentage change of serum estradiol was -89%, -85%, and -60% for exemestane once daily (n = 55), 3 times weekly (n = 56), and once weekly (n = 60), respectively. The difference in estradiol percentage change between the once-daily and 3-times-weekly arms was -3.6% (P for noninferiority = .37), whereas in compliant participants (n = 153), it was 2.0% (97.5% lower confidence limit, -5.6%; P for noninferiority = .02). Among secondary end points, Ki-67 and progesterone receptor were reduced in all arms, with median absolute percentage changes of -7.5%, -5.0%, and -4.0% for Ki-67 in the once-daily, 3-times-weekly, and once-weekly arms, respectively (once daily vs 3 times weekly, P = .31; once daily vs once weekly, P = .06), and -17.0%, -9.0%, and -7.0% for progesterone receptor, respectively. Sex hormone-binding globulin and high-density lipoprotein cholesterol had a better profile among participants in the 3-times-weekly arm compared with once-daily arm. Adverse events were similar in all arms. Conclusions and Relevance In this randomized clinical trial, exemestane, 25 mg, given 3 times weekly in compliant patients was noninferior to the once-daily dosage in decreasing serum estradiol. This new schedule should be further studied in prevention studies and in women who do not tolerate the daily dose in the adjuvant setting. Trial Registration ClinicalTrials.gov Identifier: NCT02598557; EudraCT: 2015-005063-16.
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Affiliation(s)
| | - Sara Gandini
- European Institute of Oncology IRCCS, Milan, Italy
| | | | | | - Nagi B. Kumar
- Moffitt Cancer Center, University of South Florida, Tampa
| | - Lana A. Vornik
- The University of Texas MD Anderson Cancer Center, Houston
| | - J. Jack Lee
- The University of Texas MD Anderson Cancer Center, Houston
| | | | | | | | | | | | | | | | | | - Bjørn-Erik Bertelsen
- Hormone Laboratory, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
| | - Gunnar Mellgren
- Hormone Laboratory, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | | | - Diane Weber
- The University of Texas MD Anderson Cancer Center, Houston
| | - Tawana Castile
- The University of Texas MD Anderson Cancer Center, Houston
| | - Eileen Dimond
- Division of Cancer Prevention, National Cancer Institute, Bethesda, Maryland
| | | | - Eva Szabo
- Division of Cancer Prevention, National Cancer Institute, Bethesda, Maryland
| | - Powel H. Brown
- The University of Texas MD Anderson Cancer Center, Houston
| | - Andrea DeCensi
- Ospedali Galliera, Genoa, Italy
- Wolfson Institute of Population Health, Queen Mary University of London, London, England, United Kingdom
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Rose KM, Vosoughi A, Borjas G, Huelster HL, Spiess PE, Berglund AE, Sexton WJ, Joshi A, Kumar NB, Li R. Complimentary genomic, pathologic, and artificial intelligence analysis on low-grade noninvasive bladder cancer to predict downstream recurrence. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.6_suppl.553] [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: 03/15/2023] Open
Abstract
553 Background: Low-grade noninvasive (LGTa) bladder cancer is a relatively quiescent but heterogenous malignancy, characterized by downstream recurrences requiring repeated transurethral resections and frequent surveillance. Investigations to elucidate drivers of recurrence have been sparse, but will help risk-stratify patients with LGTa and allow augmentation of follow up protocols. Methods: Patients with LGTa index tumors were stratified by those with no downstream recurrences (nonrecurrent) vs. those with later recurrences (recurrent). RNA sequencing identified differentially expressed genes (DEGs), deconvoluted for cell-type using xCell. Pathologic analysis was performed by a genitourinary pathologist, then a deep-learning artificial intelligence (AI) platform was leveraged to correlate recurrence risk and recurrence-free survival (RFS) based on deep-learning algorithm of segmented nuclei. Results: Thirty index bladder tumors/patients were identified, 18 (60%) of which had later recurrence (Table). There were 238 DEGs recognized, with recurrent tumors expressing signatures for epithelial mesenchymal transition, myogenesis, TNFα signaling via NFκB, and angiogenesis. Recurrent tumors also demonstrated a higher tissue micoenvironment, stroma, and cancer-associated fibroblast score. Pathologic TME analysis validated these findings, with recurrent tumors demonstrating a higher frequency of inverted growth pattern and a higher median stroma percentage. Finally, the AI-derived signature was predictive of recurrence and risk-stratified the cohort (HR= 5.43 [95% CI 1.1-26.76]) for predicting high vs. low risk of recurrence. Patients in the high risk group had a 87.5% recurrence rate while those in the low risk group had a 28.5% recurrence rate (p<0.01). Conclusions: Using a multi-disciplinary approach, we identified key signatures in recurrent LGTa bladder cancer. Characterization of these factors is a critical first step in the risk-stratification of LGTa tumors, and may allow risk-stratification of surveillance protocols and identification of possible targets for chemoprevention trials. [Table: see text]
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Affiliation(s)
- Kyle M. Rose
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | | | | | | | | | | | - Wade J. Sexton
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | | | - Nagi B. Kumar
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Roger Li
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
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De Censi A, Serrano D, Gandini S, Thomas PS, Crew KD, Kumar NB, Lee JJ, Veronesi P, Guerrieri-Gonzaga A, Johansson H, D'Amico M, Guasone F, Ertelsen BE, Mellgren G, Bedrosian I, Dimond E, Heckman-Stoddard BM, Szabo E, Brown P, Bonanni B. A randomized presurgical trial of alternative dosing of exemestane in postmenopausal women with early-stage ER-positive breast cancer. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.519] [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
519 Background: Successful therapeutic cancer prevention requires definition of the minimal effective dose of the proposed agent. Aromatase inhibitors substantially decreased breast cancer incidence in high risk postmenopausal women in phase III trials but their clinical use in prevention and adherence in adjuvant setting is limited by adverse events. We conducted a randomized presurgical phase IIb trial to evaluate two alternative doses of exemestane. Methods: We conducted a multi-center, pre-surgical, double-blind, 3-arm, non-inferiority phase IIb study in postmenopausal women with histologically confirmed estrogen receptor (ER)-positive breast cancer. Patients were randomized to receive either exemestane 25 mg/day (QD), or 25 mg/three times/week (TIW), or 25 mg once a week (QW) for 4-6 weeks before surgery. Blood and tissue biomarkers were collected at baseline and final visit. The primary aim was a non-inferiority percent change of circulating estradiol relative to the standard dose. Secondary endpoints were the change in Ki-67 and PgR expression in cancer tissue, blood sex hormones, lipid profile, toxicity and menopausal symptoms. For the power calculation we assumed a non-inferiority difference of 6% in the percentage change of estradiol among arms, using a one-sided, two-sample t-test. Assuming a 10% drop-out rate, a total sample size of 180 participants (60 per arm) had 80% power to detect a 6% margin of equivalence. The significance level for the main endpoint was 0.025 to account for multiple comparisons and 0.05 for secondary endpoints. Results: A total of 230 women were screened, 180 agreed to participate and 173 were evaluable for response. The median percent change of estradiol was -98%, -98%, and -70% for exemestane QD (n = 56), TIW (n = 57), and QW (n = 60), respectively, showing no significant difference between QD and TIW arms (p = 0.9). Similarly, no differences were observed for estrone, total estrone and estrone sulfate between QD and TIW arms. The QW arm showed some modulation in all hormones, even though less significantly so. Among the secondary endpoints, Ki-67 and PgR were reduced in all arms, with a median change of -5% vs -7.5% for Ki-67(p = 0.124), and -9 vs -17 for PgR (p = 0.246) in the TIW vs QD arms, respectively. SHBG and HDL-cholesterol had a more favorable profile with the TIW dose compared to the daily dose. Adverse events, measured according to the CTCAE (v4), and menopausal symptoms according to MENQOL were similar in all arms, but the short treatment time may not be representative. Conclusions: Exemestane 25 mg TIW retains a comparable activity than 25 mg QD. This activity was similar in both arms throughout the primary and the main secondary endpoints. This new schedule should be further assessed in prevention studies and in women on adjuvant treatment who do not tolerate the daily dose. Clinical trial information: NCT02598557.
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Affiliation(s)
| | | | - Sara Gandini
- IEO, European Institute of Oncology IRCCS, Milan, Italy
| | | | | | - Nagi B. Kumar
- H. Lee Moffitt Cancer Center University of South Florida, Tampa, FL
| | - J. Jack Lee
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | | | | | | | | | | | | | - Eileen Dimond
- National Cancer Institute at the National Institutes of Health, Bethesda, MD
| | | | - Eva Szabo
- National Cancer Institute at the National Institutes of Health, Potomac, MD
| | - Powel Brown
- The University of Texas MD Anderson Cancer Center, Houston, TX
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5
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Zachariah NN, Basu A, Gautam N, Ramamoorthi G, Kodumudi KN, Kumar NB, Loftus L, Czerniecki BJ. Intercepting Premalignant, Preinvasive Breast Lesions Through Vaccination. Front Immunol 2021; 12:786286. [PMID: 34899753 PMCID: PMC8652247 DOI: 10.3389/fimmu.2021.786286] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 09/30/2021] [Accepted: 11/01/2021] [Indexed: 12/24/2022] Open
Abstract
Breast cancer (BC) prevention remains the ultimate cost-effective method to reduce the global burden of invasive breast cancer (IBC). To date, surgery and chemoprevention remain the main risk-reducing modalities for those with hereditary cancer syndromes, as well as high-risk non-hereditary breast lesions such as ADH, ALH, or LCIS. Ductal carcinoma in situ (DCIS) is a preinvasive malignant lesion of the breast that closely mirrors IBC and, if left untreated, develops into IBC in up to 50% of lesions. Certain high-risk patients with DCIS may have a 25% risk of developing recurrent DCIS or IBC, even after surgical resection. The development of breast cancer elicits a strong immune response, which brings to prominence the numerous advantages associated with immune-based cancer prevention over drug-based chemoprevention, supported by the success of dendritic cell vaccines targeting HER2-expressing BC. Vaccination against BC to prevent or interrupt the process of BC development remains elusive but is a viable option. Vaccination to intercept preinvasive or premalignant breast conditions may be possible by interrupting the expression pattern of various oncodrivers. Growth factors may also function as potential immune targets to prevent breast cancer progression. Furthermore, neoantigens also serve as effective targets for interception by virtue of strong immunogenicity. It is noteworthy that the immune response also needs to be strong enough to result in target lesion elimination to avoid immunoediting as it may occur in IBC arising from DCIS. Overall, if the issue of vaccine targets can be solved by interrupting premalignant lesions, there is a potential to prevent the development of IBC.
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Affiliation(s)
| | - Amrita Basu
- Clinical Science Division, H. Lee Moffitt Cancer Center, Tampa, FL, United States
| | - Namrata Gautam
- Clinical Science Division, H. Lee Moffitt Cancer Center, Tampa, FL, United States
| | - Ganesan Ramamoorthi
- Clinical Science Division, H. Lee Moffitt Cancer Center, Tampa, FL, United States
| | - Krithika N Kodumudi
- Clinical Science Division, H. Lee Moffitt Cancer Center, Tampa, FL, United States
| | - Nagi B Kumar
- Clinical Science Division, H. Lee Moffitt Cancer Center, Tampa, FL, United States
| | - Loretta Loftus
- Department of Breast Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, United States
| | - Brian J Czerniecki
- Department of Breast Surgery, H. Lee Moffitt Cancer Center, Tampa, FL, United States
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6
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Guerrieri-Gonzaga A, Serrano D, Thomas P, Crew KD, Kumar NB, Gandini S, Vornik LA, Lee J, Cagnacci S, Vicini E, Accornero CA, D'Amico M, Guasone F, Spinaci S, Webber TB, Brown PH, Szabo E, Heckman-Stoddard B, Bonanni B. Alternative dosing of exemestane in postmenopausal women with ER-positive breast cancer. Design and methods of a randomized presurgical trial. Contemp Clin Trials 2021; 107:106498. [PMID: 34216815 PMCID: PMC8429140 DOI: 10.1016/j.cct.2021.106498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 04/23/2021] [Revised: 06/16/2021] [Accepted: 06/28/2021] [Indexed: 11/18/2022]
Abstract
Introduction: Aromatase inhibitors are effective in lowering breast cancer incidence among postmenopausal women, but adverse events represent a barrier to their acceptability and adherence as a preventive treatment. This study aims to assess whether lowering exemestane schedule may retain biological activity while improving tolerability in breast cancer patients. Methods/design: We are conducting a, pre-surgical, non-inferiority phase IIb study in postmenopausal women with newly diagnosed estrogen receptor-positive breast cancer. Participants are randomized to receive either exemestane 25 mg/day or 25 mg/three times-week or once a week for 4 to 6 weeks prior to surgery. The primary endpoint is the percentage change of serum estradiol concentration between baseline and surgery comparing the three arms. Sample size of 180 women was calculated assuming a 6% non-inferiority of the percent change of estradiol in the lower dose arms compared with the 80% decrease predicted in the full dose arm, with 80% power and using a one-sided 5% significance level and a two-sample t-test. Main secondary outcomes are: safety; change in Ki-67 in cancer and adjacent pre-cancer tissue, circulating sex hormones, adipokines, lipid profile, insulin and glucose changes, in correlation with drug and metabolites concentrations. Results and discussion: The present paper is focused on methodology and operational aspects of the study. A total of 180 participants have ben enrolled. The trial is still blinded, and the analyses are ongoing. Despite the short term duration, results may have relevant implications for clinical management of women at increased risk of developing a ER positive breast cancer.
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Affiliation(s)
| | | | | | | | - Nagi B Kumar
- Moffitt Cancer Center, University of South Florida, Tampa, FL, USA
| | - Sara Gandini
- European Institute of Oncology IRCCS, Milan, Italy
| | - Lana A Vornik
- University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Jack Lee
- University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | | | - Elisa Vicini
- European Institute of Oncology IRCCS, Milan, Italy
| | | | | | | | | | | | - Powel H Brown
- University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Eva Szabo
- Division of Cancer Prevention, NCI, Bethesda, MD, USA
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Kumar NB. The Promise of Nutrient-Derived Bioactive Compounds and Dietary Components to Ameliorate Symptoms of Chemotherapy-Related Cognitive Impairment in Breast Cancer Survivors. Curr Treat Options Oncol 2021; 22:67. [PMID: 34110516 DOI: 10.1007/s11864-021-00865-w] [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] [Accepted: 04/30/2021] [Indexed: 11/30/2022]
Abstract
OPINION STATEMENT One of the most burdensome symptoms reported by breast cancer patients is chemotherapy-related neurocognitive impairment. It is estimated that of the 11 million cancer survivors in the USA, 22% of them are breast cancer patients. The National Cancer Institute classified chemotherapy-related cognitive impairment (CRCI) as one of the most debilitating sequelae of cancer therapy, limiting this patient population from recommencing their lives prior to the diagnosis of breast cancer. Currently, there are no strategies that are established to prevent, mitigate, or treat CRCI. In addition to surviving cancer, quality of life is critical to cancer survivors. Based on the multiple and complex biological and psychosocial etiology, the varying manifestation and extent of cognitive decline documented in breast cancer survivors, possibly attributed to varying combinations of chemotherapy and dose and duration of therapy, multimodal interventions combining promising nutrient-derived bioactive compounds with antioxidant and anti-inflammatory properties, in addition to structured cognitive training and exercise regimens, can work synergistically to reduce inflammation and oxidative stress with significant improvement in cognitive function resulting in improvements in quality of life of breast cancer survivors.
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Affiliation(s)
- Nagi B Kumar
- Cancer Epidemiology Program, Breast & Genitourinary Oncology Departments, H. Lee Moffitt Cancer Center & Research Institute, Inc., 12902 Magnolia Drive, MRC/CANCONT, Tampa, FL, 336129497, USA. .,Oncologic Sciences, University of South Florida College of Medicine, 12902 Magnolia Drive, Tampa, FL, 33612, USA.
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8
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Kumar NB. Does COVID-19-related cachexia mimic cancer-related cachexia? Examining mechanisms, clinical biomarkers, and potential targets for clinical management. J Cachexia Sarcopenia Muscle 2021; 12:519-522. [PMID: 33554483 PMCID: PMC8013485 DOI: 10.1002/jcsm.12681] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Nagi B. Kumar
- Division of Population Sciences and Genitourinary and Breast Oncology DepartmentsH. Lee Moffitt Cancer Center & Research Institute, Inc12902 Magnolia Drive, MRC/CANCONTTampaFL33612USA
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9
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Permuth JB, Dezsi KB, Vyas S, Ali KN, Basinski TL, Utuama OA, Denbo JW, Klapman J, Dam A, Carballido E, Kim DW, Pimiento JM, Powers BD, Otto AK, Choi JW, Chen DT, Teer JK, Beato F, Ward A, Cortizas EM, Whisner SY, Williams IE, Riner AN, Tardif K, Velanovich V, Karachristos A, Douglas WG, Legaspi A, Allan BJ, Meredith K, Molina-Vega MA, Bao P, St. Julien J, Huguet KL, Green L, Odedina FT, Kumar NB, Simmons VN, George TJ, Vadaparampil ST, Hodul PJ, Arnoletti JP, Awad ZT, Bose D, Jiang K, Centeno BA, Gwede CK, Malafa M, Judge SM, Judge AR, Jeong D, Bloomston M, Merchant NB, Fleming JB, Trevino JG. The Florida Pancreas Collaborative Next-Generation Biobank: Infrastructure to Reduce Disparities and Improve Survival for a Diverse Cohort of Patients with Pancreatic Cancer. Cancers (Basel) 2021; 13:809. [PMID: 33671939 PMCID: PMC7919015 DOI: 10.3390/cancers13040809] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 01/08/2021] [Revised: 02/02/2021] [Accepted: 02/05/2021] [Indexed: 12/15/2022] Open
Abstract
Background: Well-annotated, high-quality biorepositories provide a valuable platform to support translational research. However, most biorepositories have poor representation of minority groups, limiting the ability to address health disparities. Methods: We describe the establishment of the Florida Pancreas Collaborative (FPC), the first state-wide prospective cohort study and biorepository designed to address the higher burden of pancreatic cancer (PaCa) in African Americans (AA) compared to Non-Hispanic Whites (NHW) and Hispanic/Latinx (H/L). We provide an overview of stakeholders; study eligibility and design; recruitment strategies; standard operating procedures to collect, process, store, and transfer biospecimens, medical images, and data; our cloud-based data management platform; and progress regarding recruitment and biobanking. Results: The FPC consists of multidisciplinary teams from fifteen Florida medical institutions. From March 2019 through August 2020, 350 patients were assessed for eligibility, 323 met inclusion/exclusion criteria, and 305 (94%) enrolled, including 228 NHW, 30 AA, and 47 H/L, with 94%, 100%, and 94% participation rates, respectively. A high percentage of participants have donated blood (87%), pancreatic tumor tissue (41%), computed tomography scans (76%), and questionnaires (62%). Conclusions: This biorepository addresses a critical gap in PaCa research and has potential to advance translational studies intended to minimize disparities and reduce PaCa-related morbidity and mortality.
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Affiliation(s)
- Jennifer B. Permuth
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (K.B.D.); (S.V.); (K.N.A.); (T.L.B.); (O.A.U.); (N.B.K.)
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - Kaleena B. Dezsi
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (K.B.D.); (S.V.); (K.N.A.); (T.L.B.); (O.A.U.); (N.B.K.)
| | - Shraddha Vyas
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (K.B.D.); (S.V.); (K.N.A.); (T.L.B.); (O.A.U.); (N.B.K.)
| | - Karla N. Ali
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (K.B.D.); (S.V.); (K.N.A.); (T.L.B.); (O.A.U.); (N.B.K.)
| | - Toni L. Basinski
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (K.B.D.); (S.V.); (K.N.A.); (T.L.B.); (O.A.U.); (N.B.K.)
| | - Ovie A. Utuama
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (K.B.D.); (S.V.); (K.N.A.); (T.L.B.); (O.A.U.); (N.B.K.)
| | - Jason W. Denbo
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - Jason Klapman
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - Aamir Dam
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - Estrella Carballido
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - Dae Won Kim
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - Jose M. Pimiento
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - Benjamin D. Powers
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - Amy K. Otto
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33612, USA;
| | - Jung W. Choi
- Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.C.); (D.J.)
| | - Dung-Tsa Chen
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (D.-T.C.); (J.K.T.)
| | - Jamie K. Teer
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (D.-T.C.); (J.K.T.)
| | - Francisca Beato
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - Alina Ward
- Lee Health Regional Cancer Center, Fort Myers, FL 33905, USA; (A.W.); (B.J.A.); (M.B.)
| | - Elena M. Cortizas
- Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL 33136, USA;
| | | | - Iverson E. Williams
- College of Medicine, University of Florida, Gainesville, FL 32610, USA; (I.E.W.); (A.N.R.); (J.G.T.)
| | - Andrea N. Riner
- College of Medicine, University of Florida, Gainesville, FL 32610, USA; (I.E.W.); (A.N.R.); (J.G.T.)
| | - Kenneth Tardif
- Department of Surgery, St. Anthony’s Hospital, St. Petersburg, FL 33705, USA; (K.T.); (J.S.J.); (K.L.H.)
| | - Vic Velanovich
- Tampa General Hospital, University of South Florida, Tampa, FL 33606, USA; (V.V.); (A.K.)
| | - Andreas Karachristos
- Tampa General Hospital, University of South Florida, Tampa, FL 33606, USA; (V.V.); (A.K.)
| | - Wade G. Douglas
- Division of Surgery, Tallahassee Memorial Healthcare, Department of Clinical Sciences, College of Medicine, Florida State University, Tallahassee, FL 32308, USA;
| | - Adrian Legaspi
- Center for Advanced Surgical Oncology at Palmetto General Hospital, Tenet Healthcare Palmetto General, Hialeah, FL 33016, USA;
| | - Bassan J. Allan
- Lee Health Regional Cancer Center, Fort Myers, FL 33905, USA; (A.W.); (B.J.A.); (M.B.)
| | - Kenneth Meredith
- Department of Gastrointestinal Oncology, Brian Jellison Cancer Institute, Sarasota Memorial Hospital, Sarasota, FL 34239, USA;
| | | | - Philip Bao
- Department of Surgical Oncology, Mount Sinai Medical Center, Miami Beach, FL 33140, USA;
| | - Jamii St. Julien
- Department of Surgery, St. Anthony’s Hospital, St. Petersburg, FL 33705, USA; (K.T.); (J.S.J.); (K.L.H.)
| | - Kevin L. Huguet
- Department of Surgery, St. Anthony’s Hospital, St. Petersburg, FL 33705, USA; (K.T.); (J.S.J.); (K.L.H.)
| | - Lee Green
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (L.G.); (V.N.S.); (S.T.V.); (C.K.G.)
| | - Folakemi T. Odedina
- Department of Pharmacotherapy and Translational Research, University of Florida, Gainesville, FL 32610, USA;
| | - Nagi B. Kumar
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (K.B.D.); (S.V.); (K.N.A.); (T.L.B.); (O.A.U.); (N.B.K.)
| | - Vani N. Simmons
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (L.G.); (V.N.S.); (S.T.V.); (C.K.G.)
| | - Thomas J. George
- Division of Oncology, Department of Medicine, University of Florida, Gainesville, FL 32610, USA;
| | - Susan T. Vadaparampil
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (L.G.); (V.N.S.); (S.T.V.); (C.K.G.)
- Office of Community Outreach, Engagement, and Equity, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA
| | - Pamela J. Hodul
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - J. Pablo Arnoletti
- Center for Surgical Oncology, Advent Health Orlando, Orlando, FL 32804, USA;
| | - Ziad T. Awad
- Surgery, University of Florida-Jacksonville, Jacksonville, FL 32209, USA;
| | - Debashish Bose
- Surgical Oncology, University of Florida-Orlando, Orlando, FL 32806, USA;
| | - Kun Jiang
- Department of Pathology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (K.J.); (B.A.C.)
| | - Barbara A. Centeno
- Department of Pathology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (K.J.); (B.A.C.)
| | - Clement K. Gwede
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (L.G.); (V.N.S.); (S.T.V.); (C.K.G.)
| | - Mokenge Malafa
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - Sarah M. Judge
- Department of Physical Therapy, University of Florida, Gainesville, FL 32610, USA; (S.M.J.); (A.R.J.)
| | - Andrew R. Judge
- Department of Physical Therapy, University of Florida, Gainesville, FL 32610, USA; (S.M.J.); (A.R.J.)
| | - Daniel Jeong
- Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.C.); (D.J.)
| | - Mark Bloomston
- Lee Health Regional Cancer Center, Fort Myers, FL 33905, USA; (A.W.); (B.J.A.); (M.B.)
| | - Nipun B. Merchant
- Department of Surgical Oncology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA;
| | - Jason B. Fleming
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA; (J.W.D.); (J.K.); (A.D.); (E.C.); (D.W.K.); (J.M.P.); (B.D.P.); (F.B.); (P.J.H.); (M.M.); (J.B.F.)
| | - Jose G. Trevino
- College of Medicine, University of Florida, Gainesville, FL 32610, USA; (I.E.W.); (A.N.R.); (J.G.T.)
- Division of Surgical Oncology, Department of Surgery, School of Medicine, Virginia Commonwealth University, Richmond, VA 23219, USA
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10
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Kumar NB, Pow-Sang J, Spiess P, Dickinson S, Schell MJ. A phase II randomized clinical trial using aglycone isoflavones to treat patients with localized prostate cancer in the pre-surgical period prior to radical prostatectomy. Oncotarget 2020; 11:1218-1234. [PMID: 32292572 PMCID: PMC7147089 DOI: 10.18632/oncotarget.27529] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 09/24/2019] [Accepted: 03/03/2020] [Indexed: 01/11/2023] Open
Abstract
Prostate cancer (PCa) is the most common cancer in American men. Additionally, African American Men (AAM) are 60% more likely to be diagnosed with PCa and 2.4 times more likely to die from this disease compared to Caucasian men (CM). To date, there are few strategies effective for chemoprevention for men with localized PCa. There is thus a need to continue to evaluate agents and strategies for chemoprevention of prostate cancer. Epidemiological, laboratory and early phase clinical trials have shown that the isoflavones modulates several biomarkers implicated in prostate carcinogenesis. The goal of this phase II randomized clinical trial was to explore the comparative effectiveness and safety of 40 mgs of aglycone isoflavones in AAM and CM with localized PCa in the pre-surgical period prior to radical prostatectomy. Thirty six participants (25 CM, 6AAM) were randomized to the isoflavone arm and 34 (25 CM, 7AAM) to the placebo arm, with 62 completing the intervention. Results indicated that isoflavones at a dose of 20 mgs BID for 3-6 weeks was well tolerated but did not reduce tissue markers of proliferation. A significant reduction in serum PSA was observed with isoflavone supplementation in CM compared to the placebo arm, but not observed in AAM. We observed no changes in serum steroid hormones with isoflavone supplementation. In AAM, a reduction in serum IGF-1 concentrations and IGF1: IGFBP-3 ratios were observed with isoflavone supplementation. Well-powered studies for longer duration of intervention may inform future trials with isoflavones, for chemoprevention of PCa.
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Affiliation(s)
- Nagi B Kumar
- Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Inc., Tampa, FL, USA
| | - Julio Pow-Sang
- Department of Urology, H. Lee Moffitt Cancer Center and Research Institute, Inc., Tampa, FL, USA
| | - Philippe Spiess
- Department of Urology, H. Lee Moffitt Cancer Center and Research Institute, Inc., Tampa, FL, USA
| | - Shohreh Dickinson
- Department of Pathology, H. Lee Moffitt Cancer Center and Research Institute, Inc., Tampa, FL, USA
| | - Michael J Schell
- Department of Biostatistics, H. Lee Moffitt Cancer Center and Research Institute, Inc., Tampa, FL, USA
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11
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Arun BK, Gierach G, Scoggins ME, Khan S, Rao SS, Garber J, Raza S, Kumar NB, Han HH, Heine J, Niell B, Chalasani P, Fitzpatrick K, Wilke LG, Fowler A, Beckwith HC, Mays C, Abutaseh S, Vornik L, Lee O, Dimond E, Perloff M, Liu D, Lee JJ, Brown P, Heckman-Stoddard B. Abstract OT3-15-02: A randomized, double-blind, placebo-controlled study of 4-hydroxytamoxifen topical gel in women with mammographically dense breasts. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-ot3-15-02] [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
Background: Tamoxifen uptake for risk reduction has remained low due to concerns about toxicity despite the efficacy and effectiveness data available. Studies of tamoxifen in the adjuvant and preventive setting have demonstrated that a decline in mammographic density (MD) of approximately 10% is consistently associated with better outcomes. Additionally, MD is one of the strongest independent predictors of breast cancer risk, apart from older age and BRCA1/2 mutation, among women. 4-hydroxytamoxifen topical gel (4-OHT) is a transdermal agent, shown in preliminary studies to be well-tolerated with similar decreases in Ki-67 to oral tamoxifen in presurgical DCIS studies and significant drug concentration in breast parenchyma but very low levels in the systemic circulation. This study examines changes in MD, a potential surrogate biomarker of prevention activity, as the primary endpoint for this one-year early-phase prevention trial using 4-OHT gel in high risk women.
Trial design: Multicenter, randomized, placebo-controlled study of 4-OHT gel (2mg per breast) versus placebo in 152 women with heterogeneously or extremely dense breast tissue for 12 months using standard of care imaging, stratified by enrollment site and baseline breast density category. The primary objective of this study is to evaluate the change in percent MD (using Cumulus software) from baseline to the week 52 in women applying 4 mg (2mg per breast) 4-OHT gel versus placebo. The secondary objectives are to compare the Cumulus vs Volpara breast density measurement methods; evaluate the percentage of women with lowering of BIRADS density; estimate percentage of women with ≥ 10% absolute decrease in quantitative MD percentage; explore patient reported experience assessed by BESS questionnaire; laboratory toxicity assessment (F VIII, vWB factor, SHBG, lipid profile); compare the 2D vs. 3D breast density measurement methods to estimate percent change in mammographic breast density; evaluate serum measurements of parent drug and related metabolite levels and factors related to 4-OHT exposures, such as IGF pathway members, CRP, estradiol, and 4-OHT; collect tissue for biomarkers (among women undergoing optional pre- and post-treatment biopsies); examine the persistence in change of mammographic density one year after 4-OHT vs. placebo gel application has stopped.
Eligibility criteria: Inclusion: Women age 40-69 years, or less than 40 years if 5-year breast cancer Gail risk is greater than/equal to 1.66%; heterogeneously or extremely dense breast tissue based on mammography. Exclusion: abnormal uterine bleeding, or prior diagnosis of endometrial hyperplasia, endometrial polyps, or endometrial cancer; prior use of SERMS and AIs, except for a maximum of 3 months and at least 12 months prior.
Statistical methods: Considering an attrition rate of 15%, 128 evaluable women are expected to have both baseline and 52-week measurements of percent MD. With 64 women in each group, there is 80% power to detect a decrease of 6% in the 4-OHT group versus 2% in the placebo group with a common standard deviation of 8% using a two-sided t-test with a significance level of 0.05. Study accrual: Activated January 2018, as of July 1, 2019, 92 patients have been recruited and 79 were randomized.
Citation Format: Banu K. Arun, Gretchen Gierach, Marion E Scoggins, Seema Khan, Sandra S Rao, Judy Garber, Sughra Raza, Nagi B. Kumar, Heather H Han, John Heine, Bethany Niell, Pavani Chalasani, Kimberly Fitzpatrick, Lee G Wilke, Amy Fowler, Heather C Beckwith, Carrie Mays, Saba Abutaseh, Lana Vornik, Oukseub Lee, Eileen Dimond, Marjorie Perloff, Diane Liu, J. Jack Lee, Powell Brown, Brandy Heckman-Stoddard. A randomized, double-blind, placebo-controlled study of 4-hydroxytamoxifen topical gel in women with mammographically dense breasts [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr OT3-15-02.
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Affiliation(s)
- Banu K. Arun
- 1University of Texas - MD Anderson Cancer Center, Houston, TX
| | | | | | | | | | | | | | - Nagi B. Kumar
- 5Moffitt Cancer Center, University of South Florida, Tampa, FL
| | - Heather H Han
- 5Moffitt Cancer Center, University of South Florida, Tampa, FL
| | - John Heine
- 5Moffitt Cancer Center, University of South Florida, Tampa, FL
| | - Bethany Niell
- 5Moffitt Cancer Center, University of South Florida, Tampa, FL
| | | | | | | | | | | | - Carrie Mays
- 1University of Texas - MD Anderson Cancer Center, Houston, TX
| | - Saba Abutaseh
- 1University of Texas - MD Anderson Cancer Center, Houston, TX
| | - Lana Vornik
- 1University of Texas - MD Anderson Cancer Center, Houston, TX
| | | | | | | | - Diane Liu
- 1University of Texas - MD Anderson Cancer Center, Houston, TX
| | - J. Jack Lee
- 1University of Texas - MD Anderson Cancer Center, Houston, TX
| | - Powell Brown
- 1University of Texas - MD Anderson Cancer Center, Houston, TX
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12
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Kumar S, Kashyap P, Kumar NB, Kashyap B, Garg IB, Saigal SR. 2612. Molecular Evidence of Ureaplasma urealyticum and Ureaplasma parvum Colonization in Preterm Infants with Respiratory Distress. Open Forum Infect Dis 2019. [PMCID: PMC6810791 DOI: 10.1093/ofid/ofz360.2290] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Ureaplasma urealyticum and Ureaplasma parvum have been associated with respiratory diseases in premature newborns, but their role in the pathogenesis of the respiratory distress syndrome (RDS) is unclear. The present study was conducted to investigate preterm newborns with respiratory distress for colonization of U. urealyticum and U. parvum in endotracheal fluid (TF)/nasopharyngeal aspirates (NPA) specimens employing culture and polymerase chain reaction (PCR).
Methods
Sixty preterm infants, presenting with respiratory distress persisting for more than 24 hours were investigated. Endotracheal fluid or nasopharyngeal aspirates specimens were inoculated in 2mL Ureaplasma broth and Ureaplasma agar for culture identification assay and PCR. DNA extracts were processed for a genus specific PCR (429 base pair region) on urease gene of U. urealyticum/U. parvum and species specific PCR (1305 base pair region) on 16S rRNA gene in U. parvum.
Results
Ureaplasma species colonization was positive in 11 (61.11%) male patients and7 (38.89%) females but there was no statistical association between sex and Ureaplasmaspecies colonization (P = 0.771). Ureaplasma spp. culture identification assay was positive in 7 (11.67%).Ureaplasma genus specific PCR was positive in 14 (23.33%) cases; species specific PCR in 9 (64.28%) infants were identified as U. parvum. Considering culture as diagnostic standard, sensitivity of PCR was 42.86%; specificity 79.24%; positive predictive value 21.43% and negative predictive value 91.30 %; with overall percentage agreement at 75%. Septicemia was positive in 12 (66.67%) infants colonized with Ureaplasmaspecies than in 5 (11.9%) of non colonized infants which was found to be significant (P = 0.00). Twelve (66.67%) patients with Ureaplasmaspecies colonization had lethargy with statistically significant association(P = 0.04).
Conclusion
This study confirms that Ureaplasma species and particularly U. parvum colonization in preterm infants was related to respiratory distress.
Disclosures
All authors: No reported disclosures.
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Affiliation(s)
| | | | - N B Kumar
- Maulana Azad Mrdical College, New Delhi, India
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13
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Kumar NB, Dickinson SI, Schell MJ, Manley BJ, Poch MA, Pow-Sang J. Green tea extract for prevention of prostate cancer progression in patients on active surveillance. Oncotarget 2018; 9:37798-37806. [PMID: 30701033 PMCID: PMC6340872 DOI: 10.18632/oncotarget.26519] [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] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 12/10/2018] [Indexed: 01/01/2023] Open
Abstract
Background Active surveillance (AS) has evolved as a management strategy for men with low grade prostate cancer (PCa). However, these patients report anxiety, doubts about the possible progression of the disease as well as higher decisional conflict regarding selection of active surveillance, and have been reported to ultimately opt for treatment without any major change in tumor characteristics. Currently, there is a paucity of research that systematically examines alternate strategies for this target population. Methods We conducted a review the evidence from epidemiological, in vitro, preclinical and early phase trials that have evaluated green tea catechins (GTC) for secondary chemoprevention of prostate cancer, focused on men opting for active surveillanceof low grade PCa. Results Results of our review of the in vitro, preclinical and phase I-II trials, demonstrates that green tea catechins (GTC) can modulate several relevant intermediate biological intermediate endpoint biomarkers implicated in prostate carcinogenesis as well as clinical progression of PCa, without major side effects. Discussion Although clinical trials using GTC have been evaluated in early phase trials in men diagnosed with High-Grade Prostatic Intraepithelial Neoplasia, Atypical Small Acinar Proliferation and in men with localized disease before prostatectomy, the effect of GTC on biological and clinical biomarkers implicated in prostate cancer progression have not been evaluated in this patient population. Conclusion Results of these studies promise to provide a strategy for secondary chemoprevention, reduce morbidities due to overtreatment and improve quality of life in men diagnosed with low-grade PCa.
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Affiliation(s)
- Nagi B Kumar
- H. Lee Moffitt Cancer Center & Research Institute, Inc., Cancer Epidemiology, MRC/CANCONT, Tampa, FL 33612-9497, USA
| | - Shohreh I Dickinson
- H. Lee Moffitt Cancer Center & Research Institute, Inc., Pathology Anatomic MMG, WCB-GU PROG, Tampa, FL 33612-9497, USA
| | - Michael J Schell
- H. Lee Moffitt Cancer Center & Research Institute, Inc., Biostatics and Bioinformatics, MRC-BIOSTAT, Tampa, FL 33612-9497, USA
| | - Brandon J Manley
- H. Lee Moffitt Cancer Center & Research Institute, GU Oncology MMG, Tampa, FL 33612-9497, USA
| | - Michael A Poch
- H. Lee Moffitt Cancer Center & Research Institute, GU Oncology MMG, Tampa, FL 33612-9497, USA
| | - Julio Pow-Sang
- H. Lee Moffitt Cancer Center & Research Institute, GU Oncology MMG, Tampa, FL 33612-9497, USA
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14
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White JD, O'Keefe BR, Sharma J, Javed G, Nukala V, Ganguly A, Khan IA, Kumar NB, Mukhtar H, Pauli GF, Walker L, Sivaram S, Rajaraman P, Trimble EL. India-United States Dialogue on Traditional Medicine: Toward Collaborative Research and Generation of an Evidence Base. J Glob Oncol 2018; 4:1-10. [PMID: 30241135 PMCID: PMC6180779 DOI: 10.1200/jgo.17.00099] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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] [Indexed: 11/20/2022] Open
Abstract
Therapies originating from traditional medical systems are widely used by
patients in both India and the United States. The first India-US Workshop on
Traditional Medicine was held in New Delhi, India, on March 3 and 4, 2016, as a
collaboration between the Ministry of Ayurveda, Yoga and Naturopathy, Unani,
Siddha, and Homoeopathy (AYUSH) of the Government of India, the US National
Cancer Institute (NCI), National Institutes of Health, and the Office of Global
Affairs, US Department of Health and Human Services. It was attended by Indian
and US policymakers, scientists, academics, and medical practitioners from
various disciplines. The workshop provided an opportunity to open a dialogue
between AYUSH and NCI to identify promising research results and potential
topics for Indo-US collaboration. Recommendations that emerged from the workshop
underlined the importance of applying rational and scientific approaches for
drug development; standardizing traditional medicine products and procedures to
ensure reliability and reproducibility; promotion of collaboration between
Indian traditional medicine practitioners and researchers and US researchers;
greater integration of evidence-based traditional medicine practices with
mainstream medical practices in India; and development of training programs
between AYUSH and NCI to facilitate crosstraining. Several positive developments
took place after the thought-provoking deliberations.
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Affiliation(s)
- Jeffrey D White
- Jeffrey D. White, Barry R. O'Keefe, Aniruddha Ganguly, Sudha Sivaram, Preetha Rajaraman, and Edward L. Trimble, National Cancer Institute, Bethesda, MD; Jitendra Sharmaand Ghazala Javed, Government of India; Vid Nukala, US Embassy, New Delhi, India; Ikhlas A. Khanand Larry Walker, University of Mississippi, Oxford, MS; Nagi B. Kumar, Moffitt Cancer Center, Tampa, FL; Hasan Mukhtar, University of Wisconsin-Madison, Madison, WI; and Guido F. Pauli, University of Illinois at Chicago, Chicago, IL
| | - Barry R O'Keefe
- Jeffrey D. White, Barry R. O'Keefe, Aniruddha Ganguly, Sudha Sivaram, Preetha Rajaraman, and Edward L. Trimble, National Cancer Institute, Bethesda, MD; Jitendra Sharmaand Ghazala Javed, Government of India; Vid Nukala, US Embassy, New Delhi, India; Ikhlas A. Khanand Larry Walker, University of Mississippi, Oxford, MS; Nagi B. Kumar, Moffitt Cancer Center, Tampa, FL; Hasan Mukhtar, University of Wisconsin-Madison, Madison, WI; and Guido F. Pauli, University of Illinois at Chicago, Chicago, IL
| | - Jitendra Sharma
- Jeffrey D. White, Barry R. O'Keefe, Aniruddha Ganguly, Sudha Sivaram, Preetha Rajaraman, and Edward L. Trimble, National Cancer Institute, Bethesda, MD; Jitendra Sharmaand Ghazala Javed, Government of India; Vid Nukala, US Embassy, New Delhi, India; Ikhlas A. Khanand Larry Walker, University of Mississippi, Oxford, MS; Nagi B. Kumar, Moffitt Cancer Center, Tampa, FL; Hasan Mukhtar, University of Wisconsin-Madison, Madison, WI; and Guido F. Pauli, University of Illinois at Chicago, Chicago, IL
| | - Ghazala Javed
- Jeffrey D. White, Barry R. O'Keefe, Aniruddha Ganguly, Sudha Sivaram, Preetha Rajaraman, and Edward L. Trimble, National Cancer Institute, Bethesda, MD; Jitendra Sharmaand Ghazala Javed, Government of India; Vid Nukala, US Embassy, New Delhi, India; Ikhlas A. Khanand Larry Walker, University of Mississippi, Oxford, MS; Nagi B. Kumar, Moffitt Cancer Center, Tampa, FL; Hasan Mukhtar, University of Wisconsin-Madison, Madison, WI; and Guido F. Pauli, University of Illinois at Chicago, Chicago, IL
| | - Vid Nukala
- Jeffrey D. White, Barry R. O'Keefe, Aniruddha Ganguly, Sudha Sivaram, Preetha Rajaraman, and Edward L. Trimble, National Cancer Institute, Bethesda, MD; Jitendra Sharmaand Ghazala Javed, Government of India; Vid Nukala, US Embassy, New Delhi, India; Ikhlas A. Khanand Larry Walker, University of Mississippi, Oxford, MS; Nagi B. Kumar, Moffitt Cancer Center, Tampa, FL; Hasan Mukhtar, University of Wisconsin-Madison, Madison, WI; and Guido F. Pauli, University of Illinois at Chicago, Chicago, IL
| | - Aniruddha Ganguly
- Jeffrey D. White, Barry R. O'Keefe, Aniruddha Ganguly, Sudha Sivaram, Preetha Rajaraman, and Edward L. Trimble, National Cancer Institute, Bethesda, MD; Jitendra Sharmaand Ghazala Javed, Government of India; Vid Nukala, US Embassy, New Delhi, India; Ikhlas A. Khanand Larry Walker, University of Mississippi, Oxford, MS; Nagi B. Kumar, Moffitt Cancer Center, Tampa, FL; Hasan Mukhtar, University of Wisconsin-Madison, Madison, WI; and Guido F. Pauli, University of Illinois at Chicago, Chicago, IL
| | - Ikhlas A Khan
- Jeffrey D. White, Barry R. O'Keefe, Aniruddha Ganguly, Sudha Sivaram, Preetha Rajaraman, and Edward L. Trimble, National Cancer Institute, Bethesda, MD; Jitendra Sharmaand Ghazala Javed, Government of India; Vid Nukala, US Embassy, New Delhi, India; Ikhlas A. Khanand Larry Walker, University of Mississippi, Oxford, MS; Nagi B. Kumar, Moffitt Cancer Center, Tampa, FL; Hasan Mukhtar, University of Wisconsin-Madison, Madison, WI; and Guido F. Pauli, University of Illinois at Chicago, Chicago, IL
| | - Nagi B Kumar
- Jeffrey D. White, Barry R. O'Keefe, Aniruddha Ganguly, Sudha Sivaram, Preetha Rajaraman, and Edward L. Trimble, National Cancer Institute, Bethesda, MD; Jitendra Sharmaand Ghazala Javed, Government of India; Vid Nukala, US Embassy, New Delhi, India; Ikhlas A. Khanand Larry Walker, University of Mississippi, Oxford, MS; Nagi B. Kumar, Moffitt Cancer Center, Tampa, FL; Hasan Mukhtar, University of Wisconsin-Madison, Madison, WI; and Guido F. Pauli, University of Illinois at Chicago, Chicago, IL
| | - Hasan Mukhtar
- Jeffrey D. White, Barry R. O'Keefe, Aniruddha Ganguly, Sudha Sivaram, Preetha Rajaraman, and Edward L. Trimble, National Cancer Institute, Bethesda, MD; Jitendra Sharmaand Ghazala Javed, Government of India; Vid Nukala, US Embassy, New Delhi, India; Ikhlas A. Khanand Larry Walker, University of Mississippi, Oxford, MS; Nagi B. Kumar, Moffitt Cancer Center, Tampa, FL; Hasan Mukhtar, University of Wisconsin-Madison, Madison, WI; and Guido F. Pauli, University of Illinois at Chicago, Chicago, IL
| | - Guido F Pauli
- Jeffrey D. White, Barry R. O'Keefe, Aniruddha Ganguly, Sudha Sivaram, Preetha Rajaraman, and Edward L. Trimble, National Cancer Institute, Bethesda, MD; Jitendra Sharmaand Ghazala Javed, Government of India; Vid Nukala, US Embassy, New Delhi, India; Ikhlas A. Khanand Larry Walker, University of Mississippi, Oxford, MS; Nagi B. Kumar, Moffitt Cancer Center, Tampa, FL; Hasan Mukhtar, University of Wisconsin-Madison, Madison, WI; and Guido F. Pauli, University of Illinois at Chicago, Chicago, IL
| | - Larry Walker
- Jeffrey D. White, Barry R. O'Keefe, Aniruddha Ganguly, Sudha Sivaram, Preetha Rajaraman, and Edward L. Trimble, National Cancer Institute, Bethesda, MD; Jitendra Sharmaand Ghazala Javed, Government of India; Vid Nukala, US Embassy, New Delhi, India; Ikhlas A. Khanand Larry Walker, University of Mississippi, Oxford, MS; Nagi B. Kumar, Moffitt Cancer Center, Tampa, FL; Hasan Mukhtar, University of Wisconsin-Madison, Madison, WI; and Guido F. Pauli, University of Illinois at Chicago, Chicago, IL
| | - Sudha Sivaram
- Jeffrey D. White, Barry R. O'Keefe, Aniruddha Ganguly, Sudha Sivaram, Preetha Rajaraman, and Edward L. Trimble, National Cancer Institute, Bethesda, MD; Jitendra Sharmaand Ghazala Javed, Government of India; Vid Nukala, US Embassy, New Delhi, India; Ikhlas A. Khanand Larry Walker, University of Mississippi, Oxford, MS; Nagi B. Kumar, Moffitt Cancer Center, Tampa, FL; Hasan Mukhtar, University of Wisconsin-Madison, Madison, WI; and Guido F. Pauli, University of Illinois at Chicago, Chicago, IL
| | - Preetha Rajaraman
- Jeffrey D. White, Barry R. O'Keefe, Aniruddha Ganguly, Sudha Sivaram, Preetha Rajaraman, and Edward L. Trimble, National Cancer Institute, Bethesda, MD; Jitendra Sharmaand Ghazala Javed, Government of India; Vid Nukala, US Embassy, New Delhi, India; Ikhlas A. Khanand Larry Walker, University of Mississippi, Oxford, MS; Nagi B. Kumar, Moffitt Cancer Center, Tampa, FL; Hasan Mukhtar, University of Wisconsin-Madison, Madison, WI; and Guido F. Pauli, University of Illinois at Chicago, Chicago, IL
| | - Edward L Trimble
- Jeffrey D. White, Barry R. O'Keefe, Aniruddha Ganguly, Sudha Sivaram, Preetha Rajaraman, and Edward L. Trimble, National Cancer Institute, Bethesda, MD; Jitendra Sharmaand Ghazala Javed, Government of India; Vid Nukala, US Embassy, New Delhi, India; Ikhlas A. Khanand Larry Walker, University of Mississippi, Oxford, MS; Nagi B. Kumar, Moffitt Cancer Center, Tampa, FL; Hasan Mukhtar, University of Wisconsin-Madison, Madison, WI; and Guido F. Pauli, University of Illinois at Chicago, Chicago, IL
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15
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Kumar NB, Fink A, Levis S, Xu P, Tamura R, Krischer J. Thyroid function in the etiology of fatigue in breast cancer. Oncotarget 2018; 9:25723-25737. [PMID: 29876020 PMCID: PMC5986636 DOI: 10.18632/oncotarget.25438] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 04/27/2018] [Indexed: 12/14/2022] Open
Abstract
Background Cancer related fatigue (CRF), reported in about 90% of breast cancer patients receiving chemotherapy, and has a profound impact on physical function, psychological distress and quality of life. Although several etiological factors such as anemia, depression, chronic inflammation, neurological pathology and alterations in metabolism have been proposed, the mechanisms of CRF are largely unknown. Methods We conducted a pilot, prospective, case-control study to estimate the magnitude of change in thyroid function in breast cancer patients from baseline to 24 months, compared to cancer-free, age-matched controls. Secondary objectives were to correlate changes in thyroid function and obesity over time with fatigue symptoms scores in this patient population. Results The proportion of women with breast cancer who developed subclinical or overt hypothyroidism (TSH >4.0 mIU/L) from baseline to year 1 was significantly greater compared to controls (9.6% vs. 5%; p=0.02). Subjects with breast cancer reported significantly worse fatigue symptoms than age-matched controls, as indicated by higher disruption indices (p<0.001 at baseline, p=0.02 at year 1, p=0.09 at year 2). Additionally, a significant interaction effect on disruption index score (p=0.019), general level of activity over time (p=0.006) and normal work activity (p= 0.002) was observed in the subgroup of women with BMI>30. Conclusion Screening breast cancer patients for thyroid function status at baseline and serially post-treatment to evaluate the need for thyroid hormone replacement may provide for a novel strategy for treating chemotherapy-induced fatigue.
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Affiliation(s)
- Nagi B Kumar
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA
| | - Angelina Fink
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA
| | - Silvina Levis
- Pediatrics Epidemiology Center at University of South Florida, Health Informatics Institute, Tampa, FL 33612, USA
| | - Ping Xu
- Geriatric Research, Education and Clinical Center, Miami Veterans Affairs Medical Center, Miami, FL 33125, USA
| | - Roy Tamura
- Geriatric Research, Education and Clinical Center, Miami Veterans Affairs Medical Center, Miami, FL 33125, USA
| | - Jeffrey Krischer
- Geriatric Research, Education and Clinical Center, Miami Veterans Affairs Medical Center, Miami, FL 33125, USA
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16
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Leone A, Diorio G, Sexton W, Schell M, Alexandrow M, Fahey JW, Kumar NB. Sulforaphane for the chemoprevention of bladder cancer: molecular mechanism targeted approach. Oncotarget 2018; 8:35412-35424. [PMID: 28423681 PMCID: PMC5471065 DOI: 10.18632/oncotarget.16015] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [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: 10/21/2016] [Accepted: 02/22/2017] [Indexed: 12/11/2022] Open
Abstract
The clinical course for both early and late stage Bladder Cancer (BC) continues to be characterized by significant patient burden due to numerous occurrences and recurrences requiring frequent surveillance strategies, intravesical drug therapies, and even more aggressive treatments in patients with locally advanced or metastatic disease. For these reasons, BC is also the most expensive cancer to treat. Fortunately, BC offers an excellent platform for chemoprevention interventions with potential to optimize the systemic and local exposure of promising agents to the bladder mucosa. However, other than smoking cessation, there is a paucity of research that systematically examines agents for chemoprevention of bladder cancers. Adopting a systematic, molecular-mechanism based approach, the goal of this review is to summarize epidemiological, in vitro, and preclinical studies, including data regarding the safety, bioavailability, and efficacy of agents evaluated for bladder cancer chemoprevention. Based on the available studies, phytochemicals, specifically isothiocyanates such as sulforaphane, present in Brassicaceae or “cruciferous” vegetables in the precursor form of glucoraphanin are: (a) available in standardized formulations; (b) bioavailable- both systemically and in the bladder; (c) observed to be potent inhibitors of BC carcinogenesis through multiple mechanisms; and (d) without toxicities at these doses. Based on available evidence from epidemiological, in vitro, preclinical, and early phase trials, phytochemicals, specifically isothiocyanates (ITCs) such as sulforaphane (SFN) represent a promising potential chemopreventitive agent in bladder cancer.
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Affiliation(s)
- Andrew Leone
- Genitourinary Oncology, H. Lee Moffitt Cancer Center & Research Institute, Inc., Tampa, FL, USA
| | - Gregory Diorio
- Genitourinary Oncology, H. Lee Moffitt Cancer Center & Research Institute, Inc., Tampa, FL, USA
| | - Wade Sexton
- Genitourinary Oncology, H. Lee Moffitt Cancer Center & Research Institute, Inc., Tampa, FL, USA
| | - Michael Schell
- Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center & Research Institute, Inc., Tampa, FL, USA
| | - Mark Alexandrow
- Cancer Biology and Evolution, H. Lee Moffitt Cancer Center & Research Institute, Inc., Tampa, FL, USA
| | - Jed W Fahey
- Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Nagi B Kumar
- Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Inc., Tampa, FL, USA
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17
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Poff A, Koutnik AP, Egan KM, Sahebjam S, D'Agostino D, Kumar NB. Targeting the Warburg effect for cancer treatment: Ketogenic diets for management of glioma. Semin Cancer Biol 2017; 56:135-148. [PMID: 29294371 DOI: 10.1016/j.semcancer.2017.12.011] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [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: 06/01/2017] [Revised: 12/07/2017] [Accepted: 12/29/2017] [Indexed: 12/29/2022]
Abstract
Gliomas are a highly heterogeneous tumor, refractory to treatment and the most frequently diagnosed primary brain tumor. Although the current WHO grading system (2016) demonstrates promise towards identifying novel treatment modalities and better prediction of prognosis over time, to date, existing targeted and mono therapy approaches have failed to elicit a robust impact on disease progression and patient survival. It is possible that tumor heterogeneity as well as specifically targeted agents fail because redundant molecular pathways in the tumor make it refractory to such approaches. Additionally, the underlying metabolic pathology, which is significantly altered during neoplastic transformation and tumor progression, is unaccounted for. With several molecular and metabolic pathways implicated in the carcinogenesis of CNS tumors, including glioma, we postulate that a systemic, broad spectrum approach to produce robust targeting of relevant and multiple molecular and metabolic regulation of growth and survival pathways, critical to the modulation of hallmarks of carcinogenesis, without clinically limiting toxicity, may provide a more sustained impact on clinical outcomes compared to the modalities of treatment evaluated to date. The objective of this review is to examine the emerging hallmark of reprogramming energy metabolism of the tumor cells and the tumor microenvironment during carcinogenesis, and to provide a rationale for exploiting this hallmark and its biological capabilities as a target for secondary chemoprevention and treatment of glioma. This review will primarily focus on interventions to induce ketosis to target the glycolytic phenotype of many cancers, with specific application to secondary chemoprevention of low grade glioma- to halt the progression of lower grade tumors to more aggressive subtypes, as evidenced by reduction in validated intermediate endpoints of disease progression including clinical symptoms.
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Affiliation(s)
- Angela Poff
- The University of South Florida, Department of Molecular Pharmacology and Physiology, 12901 Bruce B. Downs Blvd, MDC 8, Tampa, FL 33612, United States.
| | - Andrew P Koutnik
- The University of South Florida, Department of Molecular Pharmacology and Physiology, 12901 Bruce B. Downs Blvd, MDC 8, Tampa, FL 33612, United States.
| | - Kathleen M Egan
- Moffitt Cancer Center, H. Lee Moffitt Cancer Center and Research Institute, Department of Cancer Epidemiology, 12902 Magnolia Drive, MRC/CANCONT, Tampa, FL 22612-9497, United States.
| | - Solmaz Sahebjam
- Department of Neuro-Oncology, H. Lee Moffitt Cancer Center and Research Institute, Department of Cancer Epidemiology, 12902 Magnolia Drive, Tampa, FL 22612-9497, United States.
| | - Dominic D'Agostino
- The University of South Florida, Department of Molecular Pharmacology and Physiology, 12901 Bruce B. Downs Blvd, MDC 8, Tampa, FL 33612, United States.
| | - Nagi B Kumar
- Moffitt Cancer Center, H. Lee Moffitt Cancer Center and Research Institute, Department of Cancer Epidemiology, 12902 Magnolia Drive, MRC/CANCONT, Tampa, FL 22612-9497, United States.
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18
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Kumar NB, Allen K, Bell H. Perioperative Herbal Supplement Use in Cancer Patients: Potential Implications and Recommendations for Presurgical Screening. Cancer Control 2017; 12:149-57. [PMID: 16062162 DOI: 10.1177/107327480501200302] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Products made from botanicals that are used to maintain or improve health are known as herbal supplements, botanicals, or phytomedicines. Many herbs have a long history of use and claimed health benefits. However, many herbal supplements and botanicals have potent pharmacologic activity that can contribute to adverse effects and drug interactions. The use of herbal supplements by cancer patients in the perioperative period is common and consistent with the substantial increase in the use of alternative medical therapies. METHODS We reviewed the literature to examine the constituents, safety, pharmacokinetics, and pharmacodynamics of those herbal supplements that are predominantly used by cancer patients. RESULTS Different supplements possess antiplatelet activity, adversely interact with corticosteroids and central nervous system depressant drugs, have gastrointestinal manifestations, produce hepatotoxicity and nephrotoxicity, and produce additive effects when used with opioid analgesics. CONCLUSIONS With the increasing use of herbal supplements by cancer patients, surgical staff need to screen patients pre-surgically for use of these supplements. Clinical practice guidelines are needed for screening and prevention of herbal supplement usage to prevent potential adverse events that may arise from herbal medications taken alone or combined with conventional therapies during the perioperative period.
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Affiliation(s)
- Nagi B Kumar
- Department of Nutrition, H. Lee Moffitt Cancer Center & Research Institute, University of South Florida College of Medicine, Tampa, Florida 33612, USA.
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19
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Kumar NB, Patel R, Pow-Sang J, Spiess PE, Salup R, Williams CR, Schell MJ. Long-term supplementation of decaffeinated green tea extract does not modify body weight or abdominal obesity in a randomized trial of men at high risk for prostate cancer. Oncotarget 2017; 8:99093-99103. [PMID: 29228755 PMCID: PMC5716795 DOI: 10.18632/oncotarget.18858] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 06/03/2017] [Indexed: 01/28/2023] Open
Abstract
Background Evidence continues to demonstrate the role of obesity in prostate carcinogenesis and prognosis, underscoring the need to identify and continue to evaluate the effective interventions to reduce obesity in populations at high risk. The aim of the study was to determine the effect of daily consumption of decaffeinated green tea catechins (GTC) formulation (Polyphenon E® (PolyE)) for 1 year on biomarkers of obesity in men who are at high risk for prostate cancer. Materials and Methods A randomized, double-blinded trial was conducted targeting 97 men diagnosed with HGPIN or ASAP. Subjects were randomized to receive GTC (PolyE) (n = 49) or placebo (n = 48) for 1 year. Anthropometric data were collected at baseline, 6 and 12 months and data analyzed to observe change in weight, body mass index (indicator of obesity) and waist: hip ratio (indicator of abdominal obesity). Results Decaffeinated GTC containing 400 mgs of the bioactive catechin, EGCG administered for 1 year to men diagnosed with ASAP and HGPIN appears to be bioavailable, well tolerated but not effective in reducing biomarkers of obesity including body weight, body mass index and waist: hip ratio. Conclusions The results of our trial demonstrates that men who are obese and at high risk for prostate cancer should resort to effective weight management strategies to reduce obesity and not resort to ineffective measures such as taking supplements of green tea to reduce biomarkers of obesity. Changes in body mass index and abdominal obesity seen in other studies were potentially due to caffeine and not GTC.
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Affiliation(s)
- Nagi B Kumar
- H. Lee Moffitt Cancer Center and Research Institute, Inc., MRC/CANCONT, Tampa, FL 33612, USA
| | - Roshni Patel
- H. Lee Moffitt Cancer Center and Research Institute, Inc., MRC/CANCONT, Tampa, FL 33612, USA
| | - Julio Pow-Sang
- H. Lee Moffitt Cancer Center and Research Institute, Inc., WCB-GU PROG, Tampa, FL 33612, USA
| | - Philippe E Spiess
- H. Lee Moffitt Cancer Center and Research Institute, Inc., WCB-GU PROG, Tampa, FL 33612, USA
| | - Raoul Salup
- James A Haley Veterans Hospital, Tampa, FL 33612, USA
| | - Christopher R Williams
- Urologic Oncology, Research, and Robotic Surgery, University of Florida and Shands Medical Center, Jacksonville, FL 32209, USA
| | - Michael J Schell
- H. Lee Moffitt Cancer Center and Research Institute, Inc., MRC/BIOSTAT, Tampa, FL 33612, USA
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20
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Kumar NB, Pow-Sang JM, Spiess PE, Park JY, Chornokur G, Leone AR, Phelan CM. Chemoprevention in African American Men With Prostate Cancer. Cancer Control 2017; 23:415-423. [PMID: 27842331 DOI: 10.1177/107327481602300413] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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] Open
Abstract
BACKGROUND Recommendations for cancer screening are uncertain for the early detection or prevention of prostate cancer in African American men. Thus, chemoprevention strategies are needed to specifically target African American men. METHODS The evidence was examined on the biological etiology of disparities in African Americans related to prostate cancer. Possible chemopreventive agents and biomarkers critical to prostate cancer in African American men were also studied. RESULTS High-grade prostatic intraepithelial neoplasia may be more prevalent in African American men, even after controlling for age, prostate-specific antigen (PSA) level, abnormal results on digital rectal examination, and prostate volume. Prostate cancer in African American men can lead to the overexpression of signaling receptors that may mediate increased proliferation, angiogenesis, and decreased apoptosis. Use of chemopreventive agents may be useful for select populations of men. CONCLUSIONS Green tea catechins are able to target multiple pathways to address the underlying biology of prostate carcinogenesis in African American men, so they may be ideal as a chemoprevention agent in these men diagnosed with high-grade prostatic intraepithelial neoplasia.
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Affiliation(s)
- Nagi B Kumar
- Department of Epidemiology, Moffitt Cancer Center, Tampa, FL, USA.
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21
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Kumar NB, Pow-Sang J, Spiess PE, Park J, Salup R, Williams CR, Parnes H, Schell MJ. Randomized, placebo-controlled trial evaluating the safety of one-year administration of green tea catechins. Oncotarget 2016; 7:70794-70802. [PMID: 28053292 PMCID: PMC5340117 DOI: 10.18632/oncotarget.12222] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 09/13/2016] [Indexed: 01/24/2023] Open
Abstract
PURPOSE Although preclinical, epidemiological and prior clinical trial data suggest that green tea catechins (GTCs) may reduce prostate cancer (PCa) risk, several preclinical studies and case reports have reported liver toxicities and acute gastrointestinal bleeding. Based on these observations, regulatory bodies have required stringent inclusion criteria with frequent, excessive toxicity monitoring and early stopping rules in clinical trials. These requirements have impeded recruitment and retention of subjects in chemoprevention trials and subsequent progress in agent development efforts. EXPERIMENTAL DESIGN We conducted a placebo-controlled, randomized clinical trial of Polyphenon E® (PolyE®), a proprietary mixture of decaffeinated GTCs, containing 400 mg (-)-epigallocatechin-3-gallate (EGCG) per day, in 97 men with high-grade prostatic intraepithelial neoplasia (HGPIN) and/or atypical small acinar proliferation (ASAP). PolyE® containing 200 mg EGCG was administered with food, BID. A secondary study endpoint in this trial was a comparison of the overall one-year treatment related adverse events and grade 3 or higher adverse event on the two study arms. Monthly assessments of toxicity (CTCAE 4.0), concomitant medications and organ function, including hepatic panel, PT/PTT and LDH, were performed. RESULTS Daily intake of a standardized, decaffeinated, catechin mixture containing 200 mg EGCG BID taken with food for 1 year accumulated in plasma and was well tolerated and did not produce treatment related adverse effects in men with baseline HGPIN or ASAP. CONCLUSION The current data provides evidence of safety of decaffeinated, catechin mixture containing 200 mg EGCG BID to be further tested for prostate cancer prevention or other indications.
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Affiliation(s)
- Nagi B. Kumar
- H. Lee Moffitt Cancer Center & Research Institute, Inc., Cancer Epidemiology, Tampa, FL 33612-9497, USA
- H. Lee Moffitt Cancer Center & Research Institute, Inc., Genitourinary Oncology, Tampa, FL 33612-9497, USA
| | - Julio Pow-Sang
- H. Lee Moffitt Cancer Center & Research Institute, Inc., Genitourinary Oncology, Tampa, FL 33612-9497, USA
| | - Philippe E. Spiess
- H. Lee Moffitt Cancer Center & Research Institute, Inc., Genitourinary Oncology, Tampa, FL 33612-9497, USA
| | - Jong Park
- H. Lee Moffitt Cancer Center & Research Institute, Inc., Cancer Epidemiology, Tampa, FL 33612-9497, USA
| | - Raoul Salup
- University of South Florida College of Medicine, Urology, Tampa, FL 33612, USA
| | - Christopher R. Williams
- University of Florida – Jacksonville, UF Health Jacksonville, Urologic Oncology, Jacksonville, FL 32209, USA
| | - Howard Parnes
- National Cancer Institute, Division of Cancer Prevention, Bethesda, MD 20892, USA
| | - Michael J. Schell
- Moffitt Cancer Center & Research Institute, Inc., Biostatistics and Bioinformatics, Tampa, FL 33612-9497, USA
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Block KI, Gyllenhaal C, Lowe L, Amedei A, Amin ARMR, Amin A, Aquilano K, Arbiser J, Arreola A, Arzumanyan A, Ashraf SS, Azmi AS, Benencia F, Bhakta D, Bilsland A, Bishayee A, Blain SW, Block PB, Boosani CS, Carey TE, Carnero A, Carotenuto M, Casey SC, Chakrabarti M, Chaturvedi R, Chen GZ, Chen H, Chen S, Chen YC, Choi BK, Ciriolo MR, Coley HM, Collins AR, Connell M, Crawford S, Curran CS, Dabrosin C, Damia G, Dasgupta S, DeBerardinis RJ, Decker WK, Dhawan P, Diehl AME, Dong JT, Dou QP, Drew JE, Elkord E, El-Rayes B, Feitelson MA, Felsher DW, Ferguson LR, Fimognari C, Firestone GL, Frezza C, Fujii H, Fuster MM, Generali D, Georgakilas AG, Gieseler F, Gilbertson M, Green MF, Grue B, Guha G, Halicka D, Helferich WG, Heneberg P, Hentosh P, Hirschey MD, Hofseth LJ, Holcombe RF, Honoki K, Hsu HY, Huang GS, Jensen LD, Jiang WG, Jones LW, Karpowicz PA, Keith WN, Kerkar SP, Khan GN, Khatami M, Ko YH, Kucuk O, Kulathinal RJ, Kumar NB, Kwon BS, Le A, Lea MA, Lee HY, Lichtor T, Lin LT, Locasale JW, Lokeshwar BL, Longo VD, Lyssiotis CA, MacKenzie KL, Malhotra M, Marino M, Martinez-Chantar ML, Matheu A, Maxwell C, McDonnell E, Meeker AK, Mehrmohamadi M, Mehta K, Michelotti GA, Mohammad RM, Mohammed SI, Morre DJ, Muralidhar V, Muqbil I, Murphy MP, Nagaraju GP, Nahta R, Niccolai E, Nowsheen S, Panis C, Pantano F, Parslow VR, Pawelec G, Pedersen PL, Poore B, Poudyal D, Prakash S, Prince M, Raffaghello L, Rathmell JC, Rathmell WK, Ray SK, Reichrath J, Rezazadeh S, Ribatti D, Ricciardiello L, Robey RB, Rodier F, Rupasinghe HPV, Russo GL, Ryan EP, Samadi AK, Sanchez-Garcia I, Sanders AJ, Santini D, Sarkar M, Sasada T, Saxena NK, Shackelford RE, Shantha Kumara HMC, Sharma D, Shin DM, Sidransky D, Siegelin MD, Signori E, Singh N, Sivanand S, Sliva D, Smythe C, Spagnuolo C, Stafforini DM, Stagg J, Subbarayan PR, Sundin T, Talib WH, Thompson SK, Tran PT, Ungefroren H, Vander Heiden MG, Venkateswaran V, Vinay DS, Vlachostergios PJ, Wang Z, Wellen KE, Whelan RL, Yang ES, Yang H, Yang X, Yaswen P, Yedjou C, Yin X, Zhu J, Zollo M. Designing a broad-spectrum integrative approach for cancer prevention and treatment. Semin Cancer Biol 2016; 35 Suppl:S276-S304. [PMID: 26590477 DOI: 10.1016/j.semcancer.2015.09.007] [Citation(s) in RCA: 190] [Impact Index Per Article: 23.8] [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: 11/19/2014] [Revised: 08/12/2015] [Accepted: 09/14/2015] [Indexed: 12/14/2022]
Abstract
Targeted therapies and the consequent adoption of "personalized" oncology have achieved notable successes in some cancers; however, significant problems remain with this approach. Many targeted therapies are highly toxic, costs are extremely high, and most patients experience relapse after a few disease-free months. Relapses arise from genetic heterogeneity in tumors, which harbor therapy-resistant immortalized cells that have adopted alternate and compensatory pathways (i.e., pathways that are not reliant upon the same mechanisms as those which have been targeted). To address these limitations, an international task force of 180 scientists was assembled to explore the concept of a low-toxicity "broad-spectrum" therapeutic approach that could simultaneously target many key pathways and mechanisms. Using cancer hallmark phenotypes and the tumor microenvironment to account for the various aspects of relevant cancer biology, interdisciplinary teams reviewed each hallmark area and nominated a wide range of high-priority targets (74 in total) that could be modified to improve patient outcomes. For these targets, corresponding low-toxicity therapeutic approaches were then suggested, many of which were phytochemicals. Proposed actions on each target and all of the approaches were further reviewed for known effects on other hallmark areas and the tumor microenvironment. Potential contrary or procarcinogenic effects were found for 3.9% of the relationships between targets and hallmarks, and mixed evidence of complementary and contrary relationships was found for 7.1%. Approximately 67% of the relationships revealed potentially complementary effects, and the remainder had no known relationship. Among the approaches, 1.1% had contrary, 2.8% had mixed and 62.1% had complementary relationships. These results suggest that a broad-spectrum approach should be feasible from a safety standpoint. This novel approach has potential to be relatively inexpensive, it should help us address stages and types of cancer that lack conventional treatment, and it may reduce relapse risks. A proposed agenda for future research is offered.
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Affiliation(s)
- Keith I Block
- Block Center for Integrative Cancer Treatment, Skokie, IL, United States.
| | | | - Leroy Lowe
- Getting to Know Cancer, Truro, Nova Scotia, Canada; Lancaster Environment Centre, Lancaster University, Bailrigg, Lancaster, United Kingdom.
| | - Amedeo Amedei
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - A R M Ruhul Amin
- Winship Cancer Institute of Emory University, Atlanta, GA, United States
| | - Amr Amin
- Department of Biology, College of Science, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Katia Aquilano
- Department of Biology, University of Rome "Tor Vergata", Rome, Italy
| | - Jack Arbiser
- Winship Cancer Institute of Emory University, Atlanta, GA, United States; Atlanta Veterans Administration Medical Center, Atlanta, GA, United States; Department of Dermatology, Emory University School of Medicine, Emory University, Atlanta, GA, United States
| | - Alexandra Arreola
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, United States
| | - Alla Arzumanyan
- Department of Biology, Temple University, Philadelphia, PA, United States
| | - S Salman Ashraf
- Department of Chemistry, College of Science, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Asfar S Azmi
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, United States
| | - Fabian Benencia
- Department of Biomedical Sciences, Ohio University, Athens, OH, United States
| | - Dipita Bhakta
- School of Chemical and Bio Technology, SASTRA University, Thanjavur, Tamil Nadu, India
| | | | - Anupam Bishayee
- Department of Pharmaceutical Sciences, College of Pharmacy, Larkin Health Sciences Institute, Miami, FL, United States
| | - Stacy W Blain
- Department of Pediatrics, State University of New York, Downstate Medical Center, Brooklyn, NY, United States
| | - Penny B Block
- Block Center for Integrative Cancer Treatment, Skokie, IL, United States
| | - Chandra S Boosani
- Department of BioMedical Sciences, School of Medicine, Creighton University, Omaha, NE, United States
| | - Thomas E Carey
- Head and Neck Cancer Biology Laboratory, University of Michigan, Ann Arbor, MI, United States
| | - Amancio Carnero
- Instituto de Biomedicina de Sevilla, Consejo Superior de Investigaciones Cientificas, Seville, Spain
| | - Marianeve Carotenuto
- Centro di Ingegneria Genetica e Biotecnologia Avanzate, Naples, Italy; Department of Molecular Medicine and Medical Biotechnology, Federico II, Via Pansini 5, 80131 Naples, Italy
| | - Stephanie C Casey
- Stanford University, Division of Oncology, Department of Medicine and Pathology, Stanford, CA, United States
| | - Mrinmay Chakrabarti
- Department of Pathology, Microbiology, and Immunology, University of South Carolina, School of Medicine, Columbia, SC, United States
| | - Rupesh Chaturvedi
- School of Biotechnology, Jawaharlal Nehru University, New Delhi, India
| | - Georgia Zhuo Chen
- Winship Cancer Institute of Emory University, Atlanta, GA, United States
| | - Helen Chen
- Department of Pediatrics, University of British Columbia, Michael Cuccione Childhood Cancer Research Program, Child and Family Research Institute, Vancouver, British Columbia, Canada
| | - Sophie Chen
- Ovarian and Prostate Cancer Research Laboratory, Guildford, Surrey, United Kingdom
| | - Yi Charlie Chen
- Department of Biology, Alderson Broaddus University, Philippi, WV, United States
| | - Beom K Choi
- Cancer Immunology Branch, Division of Cancer Biology, National Cancer Center, Goyang, Gyeonggi, Republic of Korea
| | | | - Helen M Coley
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, United Kingdom
| | - Andrew R Collins
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Marisa Connell
- Department of Pediatrics, University of British Columbia, Michael Cuccione Childhood Cancer Research Program, Child and Family Research Institute, Vancouver, British Columbia, Canada
| | - Sarah Crawford
- Cancer Biology Research Laboratory, Southern Connecticut State University, New Haven, CT, United States
| | - Colleen S Curran
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Charlotta Dabrosin
- Department of Oncology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Giovanna Damia
- Department of Oncology, Istituto Di Ricovero e Cura a Carattere Scientifico - Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Santanu Dasgupta
- Department of Cellular and Molecular Biology, the University of Texas Health Science Center at Tyler, Tyler, TX, United States
| | - Ralph J DeBerardinis
- Children's Medical Center Research Institute, University of Texas - Southwestern Medical Center, Dallas, TX, United States
| | - William K Decker
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX, United States
| | - Punita Dhawan
- Department of Surgery and Cancer Biology, Division of Surgical Oncology, Vanderbilt University School of Medicine, Nashville, TN, United States
| | - Anna Mae E Diehl
- Department of Medicine, Duke University Medical Center, Durham, NC, United States
| | - Jin-Tang Dong
- Winship Cancer Institute of Emory University, Atlanta, GA, United States
| | - Q Ping Dou
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, United States
| | - Janice E Drew
- Rowett Institute of Nutrition and Health, University of Aberdeen, Aberdeen, Scotland, United Kingdom
| | - Eyad Elkord
- College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Bassel El-Rayes
- Department of Hematology and Medical Oncology, Emory University, Atlanta, GA, United States
| | - Mark A Feitelson
- Department of Biology, Temple University, Philadelphia, PA, United States
| | - Dean W Felsher
- Stanford University, Division of Oncology, Department of Medicine and Pathology, Stanford, CA, United States
| | - Lynnette R Ferguson
- Discipline of Nutrition and Auckland Cancer Society Research Centre, University of Auckland, Auckland, New Zealand
| | - Carmela Fimognari
- Dipartimento di Scienze per la Qualità della Vita Alma Mater Studiorum-Università di Bologna, Rimini, Italy
| | - Gary L Firestone
- Department of Molecular & Cell Biology, University of California Berkeley, Berkeley, CA, United States
| | - Christian Frezza
- Medical Research Council Cancer Unit, University of Cambridge, Hutchison/MRC Research Centre, Cambridge, United Kingdom
| | - Hiromasa Fujii
- Department of Orthopedic Surgery, Nara Medical University, Kashihara, Nara, Japan
| | - Mark M Fuster
- Medicine and Research Services, Veterans Affairs San Diego Healthcare System & University of California, San Diego, CA, United States
| | - Daniele Generali
- Department of Medical, Surgery and Health Sciences, University of Trieste, Trieste, Italy; Molecular Therapy and Pharmacogenomics Unit, Azienda Ospedaliera Istituti Ospitalieri di Cremona, Cremona, Italy
| | - Alexandros G Georgakilas
- Physics Department, School of Applied Mathematics and Physical Sciences, National Technical University of Athens, Athens, Greece
| | - Frank Gieseler
- First Department of Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | | | - Michelle F Green
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, United States
| | - Brendan Grue
- Departments of Environmental Science, Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Gunjan Guha
- School of Chemical and Bio Technology, SASTRA University, Thanjavur, Tamil Nadu, India
| | - Dorota Halicka
- Department of Pathology, New York Medical College, Valhalla, NY, United States
| | | | - Petr Heneberg
- Charles University in Prague, Third Faculty of Medicine, Prague, Czech Republic
| | - Patricia Hentosh
- School of Medical Laboratory and Radiation Sciences, Old Dominion University, Norfolk, VA, United States
| | - Matthew D Hirschey
- Department of Medicine, Duke University Medical Center, Durham, NC, United States; Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, United States
| | - Lorne J Hofseth
- College of Pharmacy, University of South Carolina, Columbia, SC, United States
| | - Randall F Holcombe
- Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY, United States
| | - Kanya Honoki
- Department of Orthopedic Surgery, Nara Medical University, Kashihara, Nara, Japan
| | - Hsue-Yin Hsu
- Department of Life Sciences, Tzu-Chi University, Hualien, Taiwan
| | - Gloria S Huang
- Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, United States
| | - Lasse D Jensen
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden; Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Wen G Jiang
- Cardiff University School of Medicine, Heath Park, Cardiff, United Kingdom
| | - Lee W Jones
- Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, United States
| | | | | | - Sid P Kerkar
- Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
| | | | - Mahin Khatami
- Inflammation and Cancer Research, National Cancer Institute (Retired), National Institutes of Health, Bethesda, MD, United States
| | - Young H Ko
- University of Maryland BioPark, Innovation Center, KoDiscovery, Baltimore, MD, United States
| | - Omer Kucuk
- Winship Cancer Institute of Emory University, Atlanta, GA, United States
| | - Rob J Kulathinal
- Department of Biology, Temple University, Philadelphia, PA, United States
| | - Nagi B Kumar
- Moffitt Cancer Center, University of South Florida College of Medicine, Tampa, FL, United States
| | - Byoung S Kwon
- Cancer Immunology Branch, Division of Cancer Biology, National Cancer Center, Goyang, Gyeonggi, Republic of Korea; Department of Medicine, Tulane University Health Sciences Center, New Orleans, LA, United States
| | - Anne Le
- The Sol Goldman Pancreatic Cancer Research Center, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Michael A Lea
- New Jersey Medical School, Rutgers University, Newark, NJ, United States
| | - Ho-Young Lee
- College of Pharmacy, Seoul National University, South Korea
| | - Terry Lichtor
- Department of Neurosurgery, Rush University Medical Center, Chicago, IL, United States
| | - Liang-Tzung Lin
- Department of Microbiology and Immunology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Jason W Locasale
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States
| | - Bal L Lokeshwar
- Department of Medicine, Georgia Regents University Cancer Center, Augusta, GA, United States
| | - Valter D Longo
- Andrus Gerontology Center, Division of Biogerontology, University of Southern California, Los Angeles, CA, United States
| | - Costas A Lyssiotis
- Department of Molecular and Integrative Physiology and Department of Internal Medicine, Division of Gastroenterology, University of Michigan, Ann Arbor, MI, United States
| | - Karen L MacKenzie
- Children's Cancer Institute Australia, Kensington, New South Wales, Australia
| | - Meenakshi Malhotra
- Department of Biomedical Engineering, McGill University, Montréal, Canada
| | - Maria Marino
- Department of Science, University Roma Tre, Rome, Italy
| | - Maria L Martinez-Chantar
- Metabolomic Unit, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Technology Park of Bizkaia, Bizkaia, Spain
| | | | - Christopher Maxwell
- Department of Pediatrics, University of British Columbia, Michael Cuccione Childhood Cancer Research Program, Child and Family Research Institute, Vancouver, British Columbia, Canada
| | - Eoin McDonnell
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, United States
| | - Alan K Meeker
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Mahya Mehrmohamadi
- Field of Genetics, Genomics, and Development, Department of Molecular Biology and Genetics, Cornell University, Ithaca, NY, United States
| | - Kapil Mehta
- Department of Experimental Therapeutics, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Gregory A Michelotti
- Department of Medicine, Duke University Medical Center, Durham, NC, United States
| | - Ramzi M Mohammad
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, United States
| | - Sulma I Mohammed
- Department of Comparative Pathobiology, Purdue University Center for Cancer Research, West Lafayette, IN, United States
| | - D James Morre
- Mor-NuCo, Inc, Purdue Research Park, West Lafayette, IN, United States
| | - Vinayak Muralidhar
- Harvard-MIT Division of Health Sciences and Technology, Harvard Medical School, Boston, MA, United States; Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Irfana Muqbil
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, United States
| | - Michael P Murphy
- MRC Mitochondrial Biology Unit, Wellcome Trust-MRC Building, Hills Road, Cambridge, United Kingdom
| | | | - Rita Nahta
- Winship Cancer Institute of Emory University, Atlanta, GA, United States
| | | | - Somaira Nowsheen
- Medical Scientist Training Program, Mayo Graduate School, Mayo Medical School, Mayo Clinic, Rochester, MN, United States
| | - Carolina Panis
- Laboratory of Inflammatory Mediators, State University of West Paraná, UNIOESTE, Paraná, Brazil
| | - Francesco Pantano
- Medical Oncology Department, University Campus Bio-Medico, Rome, Italy
| | - Virginia R Parslow
- Discipline of Nutrition and Auckland Cancer Society Research Centre, University of Auckland, Auckland, New Zealand
| | - Graham Pawelec
- Center for Medical Research, University of Tübingen, Tübingen, Germany
| | - Peter L Pedersen
- Departments of Biological Chemistry and Oncology, Member at Large, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, School of Medicine, Baltimore, MD, United States
| | - Brad Poore
- The Sol Goldman Pancreatic Cancer Research Center, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Deepak Poudyal
- College of Pharmacy, University of South Carolina, Columbia, SC, United States
| | - Satya Prakash
- Department of Biomedical Engineering, McGill University, Montréal, Canada
| | - Mark Prince
- Department of Otolaryngology-Head and Neck, Medical School, University of Michigan, Ann Arbor, MI, United States
| | | | - Jeffrey C Rathmell
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, United States
| | - W Kimryn Rathmell
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, United States
| | - Swapan K Ray
- Department of Pathology, Microbiology, and Immunology, University of South Carolina, School of Medicine, Columbia, SC, United States
| | - Jörg Reichrath
- Center for Clinical and Experimental Photodermatology, Clinic for Dermatology, Venerology and Allergology, The Saarland University Hospital, Homburg, Germany
| | - Sarallah Rezazadeh
- Department of Biology, University of Rochester, Rochester, NY, United States
| | - Domenico Ribatti
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari Medical School, Bari, Italy & National Cancer Institute Giovanni Paolo II, Bari, Italy
| | - Luigi Ricciardiello
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - R Brooks Robey
- White River Junction Veterans Affairs Medical Center, White River Junction, VT, United States; Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - Francis Rodier
- Centre de Rechercher du Centre Hospitalier de l'Université de Montréal and Institut du Cancer de Montréal, Montréal, Quebec, Canada; Université de Montréal, Département de Radiologie, Radio-Oncologie et Médicine Nucléaire, Montréal, Quebec, Canada
| | - H P Vasantha Rupasinghe
- Department of Environmental Sciences, Faculty of Agriculture and Department of Pathology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Gian Luigi Russo
- Institute of Food Sciences National Research Council, Avellino, Italy
| | - Elizabeth P Ryan
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, United States
| | | | - Isidro Sanchez-Garcia
- Experimental Therapeutics and Translational Oncology Program, Instituto de Biología Molecular y Celular del Cáncer, CSIC-Universidad de Salamanca, Salamanca, Spain
| | - Andrew J Sanders
- Cardiff University School of Medicine, Heath Park, Cardiff, United Kingdom
| | - Daniele Santini
- Medical Oncology Department, University Campus Bio-Medico, Rome, Italy
| | - Malancha Sarkar
- Department of Biology, University of Miami, Miami, FL, United States
| | - Tetsuro Sasada
- Department of Immunology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Neeraj K Saxena
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Rodney E Shackelford
- Department of Pathology, Louisiana State University, Health Shreveport, Shreveport, LA, United States
| | - H M C Shantha Kumara
- Department of Surgery, St. Luke's Roosevelt Hospital, New York, NY, United States
| | - Dipali Sharma
- Department of Oncology, Johns Hopkins University School of Medicine and the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, United States
| | - Dong M Shin
- Winship Cancer Institute of Emory University, Atlanta, GA, United States
| | - David Sidransky
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Markus David Siegelin
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, United States
| | - Emanuela Signori
- National Research Council, Institute of Translational Pharmacology, Rome, Italy
| | - Neetu Singh
- Advanced Molecular Science Research Centre (Centre for Advanced Research), King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sharanya Sivanand
- Department of Cancer Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Daniel Sliva
- DSTest Laboratories, Purdue Research Park, Indianapolis, IN, United States
| | - Carl Smythe
- Department of Biomedical Science, Sheffield Cancer Research Centre, University of Sheffield, Sheffield, United Kingdom
| | - Carmela Spagnuolo
- Institute of Food Sciences National Research Council, Avellino, Italy
| | - Diana M Stafforini
- Huntsman Cancer Institute and Department of Internal Medicine, University of Utah, Salt Lake City, UT, United States
| | - John Stagg
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Faculté de Pharmacie et Institut du Cancer de Montréal, Montréal, Quebec, Canada
| | - Pochi R Subbarayan
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Tabetha Sundin
- Department of Molecular Diagnostics, Sentara Healthcare, Norfolk, VA, United States
| | - Wamidh H Talib
- Department of Clinical Pharmacy and Therapeutics, Applied Science University, Amman, Jordan
| | - Sarah K Thompson
- Department of Surgery, Royal Adelaide Hospital, Adelaide, Australia
| | - Phuoc T Tran
- Departments of Radiation Oncology & Molecular Radiation Sciences, Oncology and Urology, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Hendrik Ungefroren
- First Department of Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Matthew G Vander Heiden
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Vasundara Venkateswaran
- Department of Surgery, University of Toronto, Division of Urology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Dass S Vinay
- Section of Clinical Immunology, Allergy, and Rheumatology, Department of Medicine, Tulane University Health Sciences Center, New Orleans, LA, United States
| | - Panagiotis J Vlachostergios
- Department of Internal Medicine, New York University Lutheran Medical Center, Brooklyn, New York, NY, United States
| | - Zongwei Wang
- Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Kathryn E Wellen
- Department of Cancer Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Richard L Whelan
- Department of Surgery, St. Luke's Roosevelt Hospital, New York, NY, United States
| | - Eddy S Yang
- Department of Radiation Oncology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, United States
| | - Huanjie Yang
- The School of Life Science and Technology, Harbin Institute of Technology, Harbin, Heilongjiang, China
| | - Xujuan Yang
- University of Illinois at Urbana Champaign, Champaign, IL, United States
| | - Paul Yaswen
- Life Sciences Division, Lawrence Berkeley National Lab, Berkeley, CA, United States
| | - Clement Yedjou
- Department of Biology, Jackson State University, Jackson, MS, United States
| | - Xin Yin
- Medicine and Research Services, Veterans Affairs San Diego Healthcare System & University of California, San Diego, CA, United States
| | - Jiyue Zhu
- Washington State University College of Pharmacy, Spokane, WA, United States
| | - Massimo Zollo
- Centro di Ingegneria Genetica e Biotecnologia Avanzate, Naples, Italy; Department of Molecular Medicine and Medical Biotechnology, Federico II, Via Pansini 5, 80131 Naples, Italy
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23
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Mohammad RM, Muqbil I, Lowe L, Yedjou C, Hsu HY, Lin LT, Siegelin MD, Fimognari C, Kumar NB, Dou QP, Yang H, Samadi AK, Russo GL, Spagnuolo C, Ray SK, Chakrabarti M, Morre JD, Coley HM, Honoki K, Fujii H, Georgakilas AG, Amedei A, Niccolai E, Amin A, Ashraf SS, Helferich WG, Yang X, Boosani CS, Guha G, Bhakta D, Ciriolo MR, Aquilano K, Chen S, Mohammed SI, Keith WN, Bilsland A, Halicka D, Nowsheen S, Azmi AS. Broad targeting of resistance to apoptosis in cancer. Semin Cancer Biol 2015; 35 Suppl:S78-S103. [PMID: 25936818 PMCID: PMC4720504 DOI: 10.1016/j.semcancer.2015.03.001] [Citation(s) in RCA: 481] [Impact Index Per Article: 53.4] [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: 03/31/2014] [Revised: 03/04/2015] [Accepted: 03/04/2015] [Indexed: 12/15/2022]
Abstract
Apoptosis or programmed cell death is natural way of removing aged cells from the body. Most of the anti-cancer therapies trigger apoptosis induction and related cell death networks to eliminate malignant cells. However, in cancer, de-regulated apoptotic signaling, particularly the activation of an anti-apoptotic systems, allows cancer cells to escape this program leading to uncontrolled proliferation resulting in tumor survival, therapeutic resistance and recurrence of cancer. This resistance is a complicated phenomenon that emanates from the interactions of various molecules and signaling pathways. In this comprehensive review we discuss the various factors contributing to apoptosis resistance in cancers. The key resistance targets that are discussed include (1) Bcl-2 and Mcl-1 proteins; (2) autophagy processes; (3) necrosis and necroptosis; (4) heat shock protein signaling; (5) the proteasome pathway; (6) epigenetic mechanisms; and (7) aberrant nuclear export signaling. The shortcomings of current therapeutic modalities are highlighted and a broad spectrum strategy using approaches including (a) gossypol; (b) epigallocatechin-3-gallate; (c) UMI-77 (d) triptolide and (e) selinexor that can be used to overcome cell death resistance is presented. This review provides a roadmap for the design of successful anti-cancer strategies that overcome resistance to apoptosis for better therapeutic outcome in patients with cancer.
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Affiliation(s)
- Ramzi M Mohammad
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, United States; Interim translational Research Institute, Hamad Medical Corporation, Doha, Qatar.
| | - Irfana Muqbil
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, United States
| | - Leroy Lowe
- Getting to Know Cancer, Truro, Nova Scotia, Canada
| | - Clement Yedjou
- C-SET, [Jackson, #229] State University, Jackson, MS, United States
| | - Hsue-Yin Hsu
- Department of Life Sciences, Tzu-Chi University, Hualien, Taiwan
| | - Liang-Tzung Lin
- Department of Microbiology and Immunology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Markus David Siegelin
- Department of Pathology and Cell Biology, Columbia University, New York City, NY, United States
| | - Carmela Fimognari
- Dipartimento di Scienze per la Qualità della Vita Alma Mater Studiorum-Università di Bologna, Italy
| | - Nagi B Kumar
- Moffit Cancer Center, University of South Florida College of Medicine, Tampa, FL, United States
| | - Q Ping Dou
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, United States; Departments of Pharmacology and Pathology, Karmanos Cancer Institute, Detroit MI, United States
| | - Huanjie Yang
- The School of Life Science and Technology, Harbin Institute of Technology, Harbin, Heilongjiang, China
| | | | - Gian Luigi Russo
- Institute of Food Sciences National Research Council, Avellino, Italy
| | - Carmela Spagnuolo
- Institute of Food Sciences National Research Council, Avellino, Italy
| | - Swapan K Ray
- Department of Pathology, Microbiology, and Immunology, University of South Carolina School of Medicine, Columbia, SC, United States
| | - Mrinmay Chakrabarti
- Department of Pathology, Microbiology, and Immunology, University of South Carolina School of Medicine, Columbia, SC, United States
| | - James D Morre
- Mor-NuCo, Inc, Purdue Research Park, West Lafayette, IN, United States
| | - Helen M Coley
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, United Kingdom
| | - Kanya Honoki
- Department of Orthopedic Surgery, Nara Medical University, Kashihara, Japan
| | - Hiromasa Fujii
- Department of Orthopedic Surgery, Nara Medical University, Kashihara, Japan
| | - Alexandros G Georgakilas
- Department of Physics, School of Applied Mathematical and Physical Sciences, National Technical University of Athens, Zografou 15780, Athens, Greece
| | - Amedeo Amedei
- Department of Experimental and Clinical Medicine, university of florence, Italy
| | - Elena Niccolai
- Department of Experimental and Clinical Medicine, university of florence, Italy
| | - Amr Amin
- Department of Biology, College of Science, UAE University, United Arab Emirates; Faculty of Science, Cairo University, Egypt
| | - S Salman Ashraf
- Department of Chemistry, College of Science, UAE University, United Arab Emirates
| | - William G Helferich
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Xujuan Yang
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Chandra S Boosani
- Department of BioMedical Sciences, School of Medicine Creighton University, Omaha NE, United States
| | - Gunjan Guha
- School of Chemical and Bio Technology, SASTRA University, Thanjavur, India
| | - Dipita Bhakta
- School of Chemical and Bio Technology, SASTRA University, Thanjavur, India
| | | | - Katia Aquilano
- Department of Biology, University of Rome "Tor Vergata", Italy
| | - Sophie Chen
- Ovarian and Prostate Cancer Research Trust Laboratory, Guildford, Surrey, United Kingdom
| | - Sulma I Mohammed
- Department of Comparative Pathobiology and Purdue University Center for Cancer Research, Purdue, West Lafayette, IN, United States
| | - W Nicol Keith
- Institute of Cancer Sciences, University of Glasgow, Glasgow, Ireland
| | - Alan Bilsland
- Institute of Cancer Sciences, University of Glasgow, Glasgow, Ireland
| | - Dorota Halicka
- Department of Pathology, New York Medical College, Valhalla, NY, United States
| | - Somaira Nowsheen
- Mayo Graduate School, Mayo Medical School, Mayo Clinic Medical Scientist Training Program, Rochester, MN, United States
| | - Asfar S Azmi
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, United States
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Kumar NB, Pow-Sang J, Egan KM, Spiess PE, Dickinson S, Salup R, Helal M, McLarty J, Williams CR, Schreiber F, Parnes HL, Sebti S, Kazi A, Kang L, Quinn G, Smith T, Yue B, Diaz K, Chornokur G, Crocker T, Schell MJ. Randomized, Placebo-Controlled Trial of Green Tea Catechins for Prostate Cancer Prevention. Cancer Prev Res (Phila) 2015; 8:879-87. [PMID: 25873370 PMCID: PMC4596745 DOI: 10.1158/1940-6207.capr-14-0324] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 04/02/2015] [Indexed: 01/11/2023]
Abstract
Preclinical, epidemiologic, and prior clinical trial data suggest that green tea catechins (GTC) may reduce prostate cancer risk. We conducted a placebo-controlled, randomized clinical trial of Polyphenon E (PolyE), a proprietary mixture of GTCs, containing 400 mg (-)-epigallocatechin-3-gallate (EGCG) per day, in 97 men with high-grade prostatic intraepithelial neoplasia (HGPIN) and/or atypical small acinar proliferation (ASAP). The primary study endpoint was a comparison of the cumulative one-year prostate cancer rates on the two study arms. No differences in the number of prostate cancer cases were observed: 5 of 49 (PolyE) versus 9 of 48 (placebo), P = 0.25. A secondary endpoint comparing the cumulative rate of prostate cancer plus ASAP among men with HGPIN without ASAP at baseline, revealed a decrease in this composite endpoint: 3 of 26 (PolyE) versus 10 of 25 (placebo), P < 0.024. This finding was driven by a decrease in ASAP diagnoses on the Poly E (0/26) compared with the placebo arm (5/25). A decrease in serum prostate-specific antigen (PSA) was observed on the PolyE arm [-0.87 ng/mL; 95% confidence intervals (CI), -1.66 to -0.09]. Adverse events related to the study agent did not significantly differ between the two study groups. Daily intake of a standardized, decaffeinated catechin mixture containing 400 mg EGCG per day for 1 year accumulated in plasma and was well tolerated but did not reduce the likelihood of prostate cancer in men with baseline HGPIN or ASAP.
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Affiliation(s)
- Nagi B Kumar
- H. Lee Moffitt Cancer Center and Research Institute Cancer Epidemiology, Tampa, Florida.
| | - Julio Pow-Sang
- Department of Urology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Kathleen M Egan
- H. Lee Moffitt Cancer Center and Research Institute Cancer Epidemiology, Tampa, Florida
| | - Philippe E Spiess
- H. Lee Moffitt Cancer Center and Research Institute Cancer Epidemiology, Tampa, Florida
| | - Shohreh Dickinson
- Department of Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Raoul Salup
- Department of Surgery, University of South Florida College of Medicine, Tampa, Florida
| | - Mohamed Helal
- Department of Urology, Tampa Urology, Tampa, Florida
| | - Jerry McLarty
- Department of MedicineLSU Health Sciences Center, Medicine, Tampa, Florida
| | | | - Fred Schreiber
- Watson Clinic-Center for Cancer Care and Research, Lakeland, Florida
| | | | - Said Sebti
- Department of Drug Discovery, H. Lee Moffitt Cancer Center and Research Institute, Inc., Tampa, Florida
| | - Aslam Kazi
- Department of Drug Discovery, H. Lee Moffitt Cancer Center and Research Institute, Inc., Tampa, Florida
| | - Loveleen Kang
- James A. Haley VA Medical Center, Department of Pathology and Laboratory Medicine, Tampa, Florida
| | - Gwen Quinn
- Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida
| | - Tiffany Smith
- H. Lee Moffitt Cancer Center and Research Institute Cancer Epidemiology, Tampa, Florida
| | - Binglin Yue
- Department of Biostatistics Core, H. Lee Moffitt Cancer Center and Research Institute, Inc., Tampa, Florida
| | - Karen Diaz
- H. Lee Moffitt Cancer Center and Research Institute Cancer Epidemiology, Tampa, Florida
| | - Ganna Chornokur
- H. Lee Moffitt Cancer Center and Research Institute Cancer Epidemiology, Tampa, Florida
| | - Theresa Crocker
- Center for Innovation in Disability and Rehabilitation Research, James A. Haley Veterans Administration Hospital, Tampa, Florida
| | - Michael J Schell
- Department of Biostatistics, Moffitt Cancer Center, Tampa, Florida
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25
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Kumar NB, Pow-Sang J, Egan K, Spiess PE, Dickinson SI, Salup R, Helal M, McLarty J, Williams CR, Schreiber FJ, Parnes H, Sebti S, Kazi A, Kang L, Quinn GP, Smith T, Yue B, Chornokur G, Crocker T, Schell MJ. Effect of green tea catechins in prostate cancer chemoprevention. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.1572] [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: 11/20/2022] Open
Affiliation(s)
- Nagi B. Kumar
- H Lee Moffitt Cancer Ctr At Univ of S Florida Coll of Medcn, Tampa, FL
| | - Julio Pow-Sang
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL
| | - Kathleen Egan
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | | | | | - Raoul Salup
- James A. Haley Veterans Administration Hospital, Tampa, FL, US Virgin Islands
| | | | - Jerry McLarty
- Louisiana State University Health Sciences Center, Shreveport, LA
| | | | | | | | - Said Sebti
- H. Lee Moffitt Cancer Center and Research Institute, Inc., Tampa, FL
| | - Aslam Kazi
- H. Lee Moffitt Cancer Center and Research Institute, Inc., Tampa, FL
| | | | | | - Tiffany Smith
- H. Lee Moffitt Cancer Center and Research Institute, Inc., Tampa, FL
| | - Binglin Yue
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | - Ganna Chornokur
- H. Lee Moffitt Cancer Center and Research Institute, Inc., Tampa, FL
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Chornokur G, Amankwah EK, Park JY, Phelan CM, Powsang J, Kumar NB. Abstract B49: Androgen receptor CAG repeat length association with prostate cancer risk in obese and non-obese African American men. Cancer Epidemiol Biomarkers Prev 2014. [DOI: 10.1158/1538-7755.disp13-b49] [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] Open
Abstract
Abstract
Background. Prostate cancer (PCa) racial disparity is likely to be multifactorial, involving the individual's genotype, the environment and their interaction. The trinucleotide (CAG)(n) repeat polymorphism in exon 1 of the androgen receptor (AR) gene regulates AR activity, with longer alleles conferring reduced activity. Significant interethnic variations in the allele frequencies of the AR (CAG)(n) polymorphism have been reported. We investigated the association between the AR CAG(n) repeat length and PCa risk in African American (AA) and Non-Hispanic White (NHW) men. We further explored if this association varied by body mass index (BMI) in the two races.
Methods. We tested DNA samples from 259 (136 cases and 123 controls) AA and 269 (147 cases and 142 controls) NHW men, matched by age, Gleason score and PSA. The CAG repeat region was PCR amplified, and the PCR fragments were analyzed using the Beckman Coulter CEQ8000 DNA sequencer to establish the repeat length. Associations between repeats and PCa risk were evaluated using unconditional logistic regression to estimate odds ratios (OR) and 95% confidence intervals (95%CI) for each race. Repeats were categorized using the median (22 repeats) as a cutpoint.
Results. AA men with longer AR CAG repeats (≥22) had a statistically significantly increased PCa risk, compared to AA men with shorter (<22) repeats (OR=1.81; 95%CI=1.05-3.13; P=0.034). The association was further evident among obese AA men (BMI≥30) (OR=3.12; 95%CI=1.12-8.73; P=0.03), but not in non-obese AA men (BMI<30) (OR=1.43; 95%CI=0.73-2.77; P=0.30). No associations were observed between short or long AR CAG repeats and PCa risk among NHW men, regardless of BMI status.
Conclusions. Our results suggest that PCa risk may be increased among AA men with longer AR CAG repeats (≥22), especially obese (BMI≥30) AA men. The data provide evidence for ethnic differences in androgenic pathway activity and androgen sensitivity which may contribute to PCa disparity.
Citation Format: Ganna Chornokur, Ernest K. Amankwah, Jong Y. Park, Catherine M. Phelan, Julio Powsang, Nagi B. Kumar. Androgen receptor CAG repeat length association with prostate cancer risk in obese and non-obese African American men. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr B49. doi:10.1158/1538-7755.DISP13-B49
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Affiliation(s)
- Ganna Chornokur
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | | | - Jong Y. Park
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | | | - Julio Powsang
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Nagi B. Kumar
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
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B. Kumar N, Dhurandhar M, Aggarwal B, Anant S, Daniel K, Deng G, Djeu J, Dou J, Hawk E, Jayaram B, Jia L, Joshi R, Kararala M, Karunagaran D, Kucuk O, Kumar L, Malafa M, Samathanam GJ, Sarkar F, Siddiqi M, Singh RP, Srivastava A, White JD. Proceedings of the Indo-U.S. bilateral workshop on accelerating botanicals/biologics agent development research for cancer chemoprevention, treatment, and survival. Cancer Med 2014; 2:108-15. [PMID: 24279005 PMCID: PMC3797562 DOI: 10.1002/cam4.42] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
With the evolving evidence of the promise of botanicals/biologics for cancer chemoprevention and treatment, an Indo-U.S. collaborative Workshop focusing on “Accelerating Botanicals Agent Development Research for Cancer Chemoprevention and Treatment” was conducted at the Moffitt Cancer Center, 29–31 May 2012. Funded by the Indo-U.S. Science and Technology Forum, a joint initiative of Governments of India and the United States of America and the Moffitt Cancer Center, the overall goals of this workshop were to enhance the knowledge (agents, molecular targets, biomarkers, approaches, target populations, regulatory standards, priorities, resources) of a multinational, multidisciplinary team of researcher's to systematically accelerate the design, to conduct a successful clinical trials to evaluate botanicals/biologics for cancer chemoprevention and treatment, and to achieve efficient translation of these discoveries into the standards for clinical practice that will ultimately impact cancer morbidity and mortality. Expert panelists were drawn from a diverse group of stakeholders, representing the leadership from the National Cancer Institute's Office of Cancer Complementary and Alternative Medicine (OCCAM), NCI Experimental Therapeutics (NExT), Food and Drug Administration, national scientific leadership from India, and a distinguished group of population, basic and clinical scientists from the two countries, including leaders in bioinformatics, social sciences, and biostatisticians. At the end of the workshop, we established four Indo-U.S. working research collaborative teams focused on identifying and prioritizing agents targeting four cancers that are of priority to both countries. Presented are some of the key proceedings and future goals discussed in the proceedings of this workshop.
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Affiliation(s)
| | - Medha Dhurandhar
- Centre for Development of Advanced Computing, Pune UniversityPune, 411007, India
| | - Bharat Aggarwal
- The University of Texas, M.D. Anderson Cancer CenterHouston, Texas, 77054
| | - Shrikant Anant
- The University of Kansas Medical CenterKansas City, Kansas, 66160
| | | | - Gary Deng
- Memorial Sloan-Kettering Cancer CenterNew York, New York, 10021
| | - Julie Djeu
- Moffitt Cancer Center, Tampa, Florida, 33612-9497
| | - Jinhui Dou
- Food and Drug AdministrationSilver Springs, Maryland, 20993
| | - Ernest Hawk
- The University of Texas, M.D. Anderson Cancer CenterHouston, Texas, 77054
| | - B. Jayaram
- India Institute of Technology-DelhiNew Delhi, 110016, India
| | - Libin Jia
- National Cancer Institute, NIHBethesda, Maryland, 20892
| | - Rajendra Joshi
- Bioinformatics Scientific and Engineering Computing, Pune UniversityPune, 411007, India
| | | | - Devarajan Karunagaran
- Department of Biotechnology, India Institute of Technology – MadrasChennai, 600036, India
| | - Omer Kucuk
- Emory Healthcare, The Emory Clinic Winship Cancer InstituteNE Atlanta, Georgia, 30322
| | - Lalit Kumar
- Institute Rotary Cancer Hospital (IRCH), All India Institute of Medical SciencesNew Delhi, 110029, India
| | | | - G. J. Samathanam
- Department and Transfer DivisionDepartment of Science and Technology, Government of IndiaIndia
| | - Fazlul Sarkar
- Barbara Ann Karmanos Cancer InstituteDetroit, Michigan, 48201
| | | | - Rana P. Singh
- School of Life Sciences, Central University of GujaratGujarat, 382030, India
| | - Anil Srivastava
- Open Health Systems Laboratory at Johns Hopkins Montgomery County CampusRockville, Maryland, 20850
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Kumar NB, Quinn GP, Alexandrow MG, Gray J, Schell M, Sutton S, Haura EB. Chemoprevention Trial Feasibility Using Botanicals in Exceptionally High Risk Populations for Lung Cancer. ACTA ACUST UNITED AC 2014; 4. [PMID: 26101725 DOI: 10.4172/2167-0870.1000180] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
While chemoprevention with botanicals shows promise in reducing cancer risk, recruitment and retention of participants for trials continues to be costly and presents unique challenges. Knowledge of interest, willingness of target populations and evaluation of design challenges are critical to improve accrual in these chemoprevention trials. OBJECTIVE The study assessed interest and willingness of former smokers to participate in a chemoprevention trial using a botanical agent. METHODS An introductory letter and survey instrument were mailed to 609 consecutive, former heavy smokers, with no cancer, from a database of 826 subjects at the Moffitt Cancer Center. RESULTS 202 (40.4%) subjects returned completed surveys. 92-96% reported interest in receiving free lung exams and knowing their lung cancer risk. 88% were interested in participating in a trial evaluating a botanical agent for lung cancer prevention. Over 92% of subjects reported willingness to comply with study requirements; multiple blood draws and trips to the Center, spiral CTs and chest x-rays. Subjects were relatively less enthusiastic (73-79%) about bronchoscopy, taking multiple study agents and assignment to placebo arm. CONCLUSIONS Our study strongly suggests feasibility, highlights potential challenges and the significant interest and willingness of this exceptionally high risk population to participate in chemoprevention trials.
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Affiliation(s)
- Nagi B Kumar
- Departments of Epidemiology, University of South Florida College of Medicine, Tampa, Florida, USA
| | - Gwendolyn P Quinn
- Health Outcomes and Behavior, University of South Florida College of Medicine, Tampa, Florida, USA
| | - Mark G Alexandrow
- Molecular Oncology Thoracic Oncology, University of South Florida College of Medicine, Tampa, Florida, USA
| | - Jhanelle Gray
- Biostatistics, University of South Florida College of Medicine, Tampa, Florida, USA
| | - Michael Schell
- H Lee Moffitt Cancer Center & Research Institute, the University of South Florida College of Medicine, Tampa, Florida, USA
| | - Steve Sutton
- H Lee Moffitt Cancer Center & Research Institute, the University of South Florida College of Medicine, Tampa, Florida, USA
| | - Eric B Haura
- Biostatistics, University of South Florida College of Medicine, Tampa, Florida, USA
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Deng GE, Rausch SM, Jones LW, Gulati A, Kumar NB, Greenlee H, Pietanza MC, Cassileth BR. Complementary therapies and integrative medicine in lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2013; 143:e420S-e436S. [PMID: 23649450 DOI: 10.1378/chest.12-2364] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Physicians are often asked about complementary therapies by patients with cancer, and data show that the interest in and use of these therapies among patients with cancer is common. Therefore, it is important to assess the current evidence base on the benefits and risks of complementary therapies (modalities not historically used in modern Western medicine). METHODS A systematic literature review was carried out and recommendations were made according to the American College of Chest Physicians Evidence-Based Clinical Practice Guidelines development methodology. RESULTS A large number of randomized controlled trials, systematic reviews, and meta-analyses, as well as a number of prospective cohort studies, met the predetermined inclusion criteria. These trials addressed many different issues pertaining to patients with lung cancer, such as symptoms of anxiety, mood disturbance, pain, quality of life, and treatment-related side effects. The available data cover a variety of interventions, including acupuncture, nutrition, mind-body therapies, exercise, and massage. The body of evidence supports a series of recommendations. An evidenced-based approach to modern cancer care should integrate complementary therapies with standard cancer therapies such as surgery, radiation, chemotherapy, and best supportive care measures. CONCLUSIONS Several complementary therapy modalities can be helpful in improving the overall care of patients with lung cancer.
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Affiliation(s)
- Gary E Deng
- Memorial Sloan-Kettering Cancer Center, New York, NY.
| | - Sarah M Rausch
- University of Florida College of Medicine, Jacksonville, FL
| | | | | | - Nagi B Kumar
- Moffitt Cancer Center and Research Institute, Tampa, FL
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Ribeiro MDLC, Silva AS, Bailey KM, Kumar NB, Sellers TA, Gatenby RA, Ibrahim-Hashim A, Gillies RJ. Buffer Therapy for Cancer. J Nutr Food Sci 2012; 2:6. [PMID: 24371544 PMCID: PMC3872072] [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] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Oral administration of pH buffers can reduce the development of spontaneous and experimental metastases in mice, and has been proposed in clinical trials. Effectiveness of buffer therapy is likely to be affected by diet, which could contribute or interfere with the therapeutic alkalinizing effect. Little data on food pH buffering capacity was available. This study evaluated the pH and buffering capacity of different foods to guide prospective trials and test the effect of the same buffer (lysine) at two different ionization states. Food groups were derived from the Harvard Food Frequency Questionnaire. Foods were blended and pH titrated with acid from initial pH values until 4.0 to determine "buffering score", in mmol H+/pH unit. A "buffering score" was derived as the mEq H+ consumed per serving size to lower from initial to a pH 4.0, the postprandial pH of the distal duodenum. To differentiate buffering effect from any metabolic byproduct effects, we compared the effects of oral lysine buffers prepared at either pH 10.0 or 8.4, which contain 2 and 1 free base amines, respectively. The effect of these on experimental metastases formation in mice following tail vein injection of PC-3M prostate cancer cells were monitored with in vivo bioluminescence. Carbohydrates and dairy products' buffering score varied between 0.5 and 19. Fruits and vegetables showed a low to zero buffering score. The score of meats varied between 6 and 22. Wine and juices had negative scores. Among supplements, sodium bicarbonate and Tums® had the highest buffering capacities, with scores of 11 and 20 per serving size, respectively. The "de-buffered" lysine had a less pronounced effect of prevention of metastases compared to lysine at pH 10. This study has demonstrated the anti-cancer effects of buffer therapy and suggests foods that can contribute to or compete with this approach to manage cancer.
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Affiliation(s)
- Maria de Lourdes C Ribeiro
- Department of Cancer Imaging and Metabolism, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612
- Department of Molecular Medicine, Biotechnology M.S. Program, University of South Florida, Tampa, FL 33612
| | - Ariosto S. Silva
- Department of Cancer Imaging and Metabolism, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612
| | - Kate M. Bailey
- Department of Cancer Imaging and Metabolism, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612
- Department of Cell Biology, Microbiology, and Molecular Biology, Cancer Biology Ph.D. Program, University of South Florida, Tampa, FL 33612
| | - Nagi B. Kumar
- Department of Epidemiology and Population Sciences Division, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612
| | - Thomas A. Sellers
- Department of Epidemiology and Population Sciences Division, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612
| | - Robert A. Gatenby
- Departent of Radiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612
| | - Arig Ibrahim-Hashim
- Department of Cancer Imaging and Metabolism, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612
| | - Robert J. Gillies
- Department of Cancer Imaging and Metabolism, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612
- Departent of Radiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612
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Kumar NB, Quinn GP, Crocker T, Alexandrow M, Gray JE, Estrella T, Schell MJ, Sutton S, Haura EB. Assessment of feasibility and willingness of former heavy smokers to participate in chemoprevention trials to prevent lung cancer. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.e21155] [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
e21155 Background: Over 50% of new lung cancers occur in former smokers, who often are seeking strategies to reduce their lung cancer risk. However, recruitment and retention of participants in chemoprevention trials continues to be costly and presents unique challenges. Evaluation of feasibility and knowledge of challenges are critical to inform design and ensure accrual in chemoprevention trials.The study assessed interest and willingness of former heavy smokers to participate in a chemoprevention clinical trial using a botanical agent to prevent lung cancer. Methods: An introductory letter and survey instrument that included the goal of the survey, epidemiological and smoking history, acceptability of trial procedures, perception of lung cancer risk and interest in participating in this trial were mailed to 500 consecutive, former heavy smokers with no cancer from a database of 826 subjects at the Moffitt Cancer Center. Results: 202 (40.4%) men and women returned completed surveys. 98% of respondents were over age 60 and 56% had an undergraduate education or higher. The average years smoked was 40.7 (SD 11.9) pack years. 76% believed there was a 50% chance or greater of developing lung cancer. In response to interest and motivation to participate, 92-96% reported interest in receiving free lung exams, health status monitoring and knowing their lung cancer risk. 88% were interested in being a part of a trial to evaluate a botanical agent for lung cancer prevention. Over 92% of subjects reported a willingness to comply with study requirements, multiple blood draws and trips to the Center, spiral CTs and chest x-rays. Subjects were relatively less enthusiastic (73-79%) about undergoing bronchoscopy, taking multiple study agents and possible assignment to a placebo arm. Conclusions: Our study strongly suggests feasibility, highlights potential challenges and the significant interest and willingness of former smokers to participate in chemoprevention trials.
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Affiliation(s)
- Nagi B. Kumar
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
| | | | - Theresa Crocker
- H. Lee Moffitt Cancer Canter & Research Institute, Tampa, FL
| | - Mark Alexandrow
- H. Lee Moffitt Cancer Canter & Research Institute, Tampa, FL
| | | | | | | | - Steve Sutton
- H. Lee Moffitt Cancer Canter & Research Institute, Tampa, FL
| | - Eric B. Haura
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
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Chornokur G, Han G, Tanner RE, Lin HY, Gwede C, Kumar NB, Pow-Sang J, Phelan CM. Abstract 3592: Risk factors of prostate cancer in African American men. Cancer Res 2012. [DOI: 10.1158/1538-7445.am2012-3592] [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
Background. African American men have 1.6 times the incidence and 2.4 times the mortality rate of prostate cancer, compared to Caucasian men. Thus, prostate cancer constitutes one of the most striking racial health disparities, the causation of which is not well understood. Main hypothesis. We hypothesized that select clinical and/or bio-behavioral risk factors are associated with prostate cancer in African American men. Participants and Methods. 105 African American men aged 34-80 (35 cases and 70 controls) were recruited. Univariable and multivariable logistic regression models were built to test the marginal and joint effects of the variables when predicting the cancer status. Results. In the univariable regression models, PSA (ng/ml; p<.001), smoking (cigarettes/day; p=0.011), diagnosis of benign prostatic hyperplasia (BPH, yes/no; p<.001), diagnosis of prostatitis (yes/no; p<.001) and prostatic intraepithelial neoplasia (PIN, yes/no; p=<.001) were independently associated with the prostate cancer diagnosis. However, only PSA (4.340; (1.484, 12.689)) and diagnosis of BPH (14.248; (1.132, 179.310)) remained significant in the age-adjusted multivariable logistic regression model. Conclusions. Our results suggest that, as expected, PSA levels are associated with prostate cancer in African American men. Interestingly, a history of BPH is also associated with prostate cancer in African American men. Despite the limitation of a small sample size, our data is in agreement to a recent report (Pettaway et al, 2011) in which African Americans with BPH were observed to have a much greater risk of developing prostate cancer than similar Caucasian men, highlighting differences in the biology of prostate cancer between populations. References Curtis A. Pettaway, Lois E. Lamerato, Michael T. Eaddy et al. Benign prostatic hyperplasia: racial differences in treatment patterns and prostate cancer prevalence. BJU International (1 0 8) 1 3 0 2 - 8, 2011
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 3592. doi:1538-7445.AM2012-3592
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Affiliation(s)
| | - Gang Han
- 1H. Lee Moffitt Cancer Ctr. & Res. Inst., Tampa, FL
| | | | - Hui-Yi Lin
- 1H. Lee Moffitt Cancer Ctr. & Res. Inst., Tampa, FL
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Connors SK, Kumar NB. Abstract 616: A cumulative molecular model for the mechanisms of green tea catechins in the chemoprevention of prostate cancer. Cancer Res 2012. [DOI: 10.1158/1538-7445.am2012-616] [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
Background: Prostate cancer (CaP) is the most commonly diagnosed cancer in men. It's long latency, slow progression, and high incidence rates make it ideal for targeting chemoprevention therapies. Studies suggest that green tea may be suitable candidate for CaP chemoprevention. The green tea catechin (GTC) chemopreventive mechanisms against CaP cells, however, are not completely clear. Understanding and refining models of the fundamental molecular pathways by which GTCs modulate prostate carcinogenesis is essential to most appropriately utilize green tea for CaP prevention in clinical settings. Objective: The objective of the study was to review the current literature and develop a model that attempts to recreate the molecular mechanisms and pathways by which GTCs modulate prostate carcinogenesis. Methods: Laboratory studies, clinical studies, and clinical trials focused on GTC chemoprevention of CaP were critically analyzed and reviewed for mechanisms of GTC chemoprevention. The most prevalent mechanisms were combined into a multi-mechanistic model that attempts to recreate the cumulative events that occur as GTCs exert anti-cancer activity on prostate cancer cells and tissues. Results: GTCs exert anti-cancer actions on CaP cells and tissue through six major mechanisms: proteasome inhibition, cell cycle arrest, inhibition of cell proliferation, induction of apoptosis, suppression of carcinogenesis/progression, and inhibition of metastasis. We have proposed a novel model in which GTCs exert chemopreventive effects on CaP though these six major mechanisms that work simultaneously and dependently, largely driven by proteasome inhibition-induced regulation of the NFκB pathway. The cumulative effect of these mechanisms ultimately leads to the inhibition of CaP cell growth, progression, and metastasis. Conclusions: Several mechanisms of GTC chemopreventive activity on CaP cells and tissues have been identified in laboratory and clinical studies. Although GTCs act through distinct cell cycle regulative pathways, the cumulative chemopreventative effect appears to be attributed to their well-coordinated ensemble, rather than a single pathway. Additionally, transitioning to the use of standardized GTC preparations may more accurately reflect human tea consumption, deliver the maximum amount of GTCs, and allow for more generalizable results in epidemiological, laboratory, and clinical studies. We are currently testing and refining our novel cumulative model to fully elucidate the complex mechanism of GTC chemoprevention of prostate cancer in its entirety.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 616. doi:1538-7445.AM2012-616
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Kumar NB, Vadaparampil ST, Mahajan N, Lilienfeld HS, Lee JH, Laronga C, Hakam A, Hein JJ, Egan KM, Arun B, Pal T. Metformin- A Promising Agent for Chemoprevention in BRCA1 Carriers. ACTA ACUST UNITED AC 2012; 1. [PMID: 26097796 PMCID: PMC4474476 DOI: 10.4172/2161-1041.1000104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Nagi B Kumar
- Departments of Cancer Epidemiology The University of Texas MD Anderson Cancer Center, Houston, Texas ; Oncological Sciences University of South Florida College of Medicine, Tampa Florida
| | - Susan T Vadaparampil
- Health Outcomes and Behavior, The University of Texas MD Anderson Cancer Center, Houston, Texas ; Oncological Sciences University of South Florida College of Medicine, Tampa Florida
| | - Nupam Mahajan
- Molecular Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas ; Oncological Sciences University of South Florida College of Medicine, Tampa Florida
| | - Howard S Lilienfeld
- Breast Cancer, The University of Texas MD Anderson Cancer Center, Houston, Texas ; Oncological Sciences University of South Florida College of Medicine, Tampa Florida
| | - Ji-Hyun Lee
- Departments of Cancer Epidemiology The University of Texas MD Anderson Cancer Center, Houston, Texas ; Breast Cancer, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Christine Laronga
- Breast Cancer, The University of Texas MD Anderson Cancer Center, Houston, Texas ; Oncological Sciences University of South Florida College of Medicine, Tampa Florida
| | - Ardeshir Hakam
- Pathology, at the H. Lee Moffitt Cancer Center & Research Institute ; Oncological Sciences University of South Florida College of Medicine, Tampa Florida
| | - John J Hein
- Departments of Cancer Epidemiology The University of Texas MD Anderson Cancer Center, Houston, Texas ; Oncological Sciences University of South Florida College of Medicine, Tampa Florida
| | - Kathleen M Egan
- Departments of Cancer Epidemiology The University of Texas MD Anderson Cancer Center, Houston, Texas ; Oncological Sciences University of South Florida College of Medicine, Tampa Florida
| | - Banu Arun
- Breast Medical Oncology and Clinical Cancer Prevention, and Co-Director of Clinical Cancer Genetics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Tuya Pal
- Genetics, The University of Texas MD Anderson Cancer Center, Houston, Texas ; Oncological Sciences University of South Florida College of Medicine, Tampa Florida
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Abstract
Prostate cancer is the most commonly diagnosed cancer and second most common cause of cancer deaths in American men. Its long latency, slow progression, and high incidence rate make prostate cancer ideal for targeted chemopreventative therapies. Therefore, chemoprevention studies and clinical trials are essential for reducing the burden of prostate cancer on society. Epidemiological studies suggest that tea consumption has protective effects against a variety of human cancers, including that of the prostate. Laboratory and clinical studies have demonstrated that green tea components, specifically the green tea catechin (GTC) epigallocatechin gallate, can induce apoptosis, suppress progression, and inhibit invasion and metastasis of prostate cancer. Multiple mechanisms are involved in the chemoprevention of prostate cancer with GTCs; understanding and refining models of fundamental molecular pathways by which GTCs modulate prostate carcinogenesis is essential to apply the utilization of green tea for the chemoprevention of prostate cancer in clinical settings. The objective of this article is to review and summarize the most current literature focusing on the major mechanisms of GTC chemopreventative action on prostate cancer from laboratory, in vitro, and in vivo studies, and clinical chemoprevention trials.
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Affiliation(s)
- Shahnjayla K Connors
- Department of Cancer Epidemiology, Division of Population Sciences, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida 33612, USA.
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Abstract
Although the benefits of current treatment strategies are well established, many cancer survivors are at risk for developing physiologic and psychological late effects of cancer treatment that might lead to premature mortality and morbidity and compromise their quality of life. Psychological symptoms include anxiety, depression, fatigue, difficulty sleeping, and loss of self-esteem. Physiologic symptoms include pain, numbness, cognitive impairment, weight gain, loss of sexual interest, spontaneous menopause, and peripheral neuropathy. Both length and quality of survival are important end points. The goal of this review is to summarize the psychological and physiologic symptoms related to breast cancer treatment; the prevalence, contributing therapies, and inter-relatedness of these symptoms; current interventions to prevent, ameliorate, or treat these symptoms; and effectiveness and safety of these interventions. The results of this review will identify the gaps in knowledge and assist in the design of assessments and approaches to improve mortality and quality of life and provide the foundation for the development of evidence-based guidelines to standardize palliative care in cancer survivors.
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Affiliation(s)
- Sabrina Brem
- Department of Interdisciplinary Oncology, College of Medicine, Moffitt Cancer Center and Research Institute, University of South Florida, Tampa, USA
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Borysova ME, Ensley DT, Kumar NB. Abstract A75: Ten-year retrospective cross racial and ethnic prostate cancer incidence and mortality in the Florida Department of Corrections. Cancer Epidemiol Biomarkers Prev 2010. [DOI: 10.1158/1055-9965.disp-10-a75] [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] Open
Abstract
Abstract
To establish a novel environment for elucidating the relative socioenvironmental and biological etiologies of racial and ethnic disparities in prostate cancer, we are conducting a 10-year retrospective cross-racial and ethnic analysis of prostate cancer incidence and mortality within the Florida Department of Corrections (FDOC). Prostate Cancer is the most common cancer in men and exhibits the most profound racial and ethnic disparity of all cancers, with a 60% higher incidence rate and an astonishing 140% higher mortality rate in African Americans than in Caucasians. Successful efforts to thwart prostate cancer health disparities depend understanding the relative contributions of biological and socio-behavioral factors on prostate cancer disparities; however, the inherent heterogeneity of a of unlinked factors within and among racial and ethnic groups precludes the effectual determination of the relative contributions of prostate cancer health disparities. We propose that the etiologies of health disparities can be defined within the context of large, racially and ethnically diverse settings in which several variables thought to contribute to prostate cancer health disparities are normalized across racial and ethnic groups. Correctional facilities are vast congregate settings, inherently unique due to the remarkably similar socio-behavioral environments between and within racial and ethnic groups relative to non-incarcerated communities. Prisons are home to over 1.6 million people, primarily African American, Caucasian, and Hispanic men. The FDOC offices of Health Care, Food Services, and Wellness and Recreation provide services that may circuitously reduce racial and ethnic cancer disparities. Prisoners of all races and ethnicities have equal access to free and identical health care services including prostate cancer education, routine prostate cancer screening, and prostate cancer treatment. Inmates are all provided the same nutritionally balanced diets, meeting or exceeding the National Academy of Sciences’ standards, including nutritional supplements, soy-rich products, and nearly 3 million pounds of fresh produce cultivated on FDOC farms; reflecting diets thought to decrease prostate cancer risk. Physical activity in the form of exercise is a regular component of approximately 95% of prisoner's lifestyles. Cigarette smoking is common across racial and ethnic groups in the FDOC; however, alcohol consumption and drug use are prohibited. The FDOC's wellness efforts, and similar efforts by the majority of United States correctional facilities, inadvertently address several conjectural bases of health disparities, thereby providing an environment ripe for distinguishing the factors that contribute to prostate cancer and it vast racial and ethnic disparities. With support and approval by the FDOC, we have begun to elucidate the complex etiologies of racial and ethnic disparities in prostate cancer incidence and mortality by conducting a 10-year, cross-racial and ethnic retrospective analysis of prostate cancer incidence and mortality within the FDOC. The data from this study will provide the foundation for further studies to better understand the socio-environmental and biological factors that contribute to racial and ethnic disparities in prostate cancer incidence and mortality.
Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A75.
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Affiliation(s)
| | | | - Nagi B. Kumar
- 1H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
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Chornokur G, Lin HY, Kumar NB. Abstract A53: Comprehensive population-specific biobehavioral marker panel for early prostate cancer diagnostics and risk assessment: A DETECT study. Cancer Epidemiol Biomarkers Prev 2010. [DOI: 10.1158/1055-9965.disp-10-a53] [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] Open
Abstract
Abstract
Prostate cancer remains the most common cancerous malignancy and the second leading cause of cancer death among men of all races in the United States. However, the men of African descent are 1.4 times more likely to be diagnosed, and two to three times more likely to die of prostate cancer, compared to their counterparts of European descent. Even though the multifaceted nature of the striking racial disparity has been recognized, the majority of research efforts geared towards its resolution is focusing on exploring a discrete contribution of a single factor or a small group of similar factors. This approach has failed to comprehensively elucidate the etiology or the mechanism(s) responsible for the disparity, neither it has been utilized for an efficient prostate cancer screening and early detection in the high risk group of African American men.
Therefore, we hypothesize, that a combination panel (DETECT) of biobehavioral population-specific biomarkers and factors, associated with prostate cancer in African Americans, will provide a valuable screening and risk assessment tool. The purpose of this study is to expound a prostate cancer screening tool that is based on a collective, rather than individual, assessment of prostate cancer bio-behavioral diagnostic markers and risk factors. The bio-behavioral markers are grouped into four general categories: genetic, biochemical, lifestyle and socio-cultural. The category “genetic markers” refer to factors associated with any bodily molecules containing genetic information. We include the measure of family history in this category since it gives an indication of the underlying genetic factors. Age is also included in this section, as the mechanism of aging has genetic background. The group “biochemical markers” refers to biomolecules of any nature (other than nucleic acids, which are classified as genetic markers) found anywhere in the body. The category “lifestyle markers” references the personal habits which heavily dependent upon individual choice. Finally, “sociocultural factors” reflect societal-and cultural-level influence on an individual's risk of prostate cancer.
The choice of biobehavioral markers, together with the descriptive statistics, used to summarize distribution of each marker, is based on the review of current relevant literature. Two approaches are applied to evaluate the potential combined markers. The markers which are marginally significantly associated (p<0.1) are selected and evaluated using a logistic regression model. With this approach, pure interactions with no or weak main effects may be overlooked. Thus, we use Classification and Regression Trees (CART) as the second approach. Finally, logistic regression model is used to suggest a prototype prediction model of prostate cancer risk, based on the data, specified above.
This study contributes into effort to eliminate the prostate cancer racial disparity by offering a prototype of comprehensive prostate cancer screening tool. This may result in higher levels of compliance, lower cost and higher effectiveness of screening, and decreased overall burden of prostate cancer in the high risk African American population.
Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A53.
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Affiliation(s)
- Ganna Chornokur
- 1H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Hui-Yi Lin
- 1H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Nagi B. Kumar
- 1H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
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Kumar NB, Kang L, Pow-Sang J, Xu P, Allen K, Riccardi D, Besterman-Dahan K, Krischer JP. Results of a randomized phase I dose-finding trial of several doses of isoflavones in men with localized prostate cancer: administration prior to radical prostatectomy. J Soc Integr Oncol 2010; 8:3-13. [PMID: 20205984 PMCID: PMC3277948] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The purpose of this phase I dose-finding randomized controlled trial was to evaluate the safe and effective dose of isoflavones to be used in future clinical trials for prostate cancer prevention. Forty-five eligible men were supplemented with 40, 60, and 80 mg of purified isoflavones or no supplement from biopsy to prostatectomy. Compliance with the study agent, toxicity, and changes in plasma isoflavones, serum steroid hormones, prostate-specific antigen (PSA), and tissue Ki-67 were analyzed from baseline to completion of the study. Forty-four subjects completed the study with a duration of intervention of 30 (+/- 3) days. We observed significant increases in plasma isoflavones with treatment for all doses compared with controls without producing any toxicity. Significant increases in serum total estradiol were observed in the 40 and 60 mg isoflavone-treated arms. However, a significant increase in serum free testosterone was observed in the 60 mg isoflavone-treated arm. Changes in serum sex hormone-binding globulin, PSA, and percentage of tissue Ki-67 were not statistically significant with treatment for this sample size and duration of intervention. Our results identify a safe dose of purified isoflavones for future clinical trials and establish the need for further definitive, well-powered trials to examine the role of isoflavones in prostate carcinogenesis.
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Kumar NB, Yu D, Akinremi TO, Odedina FT. Comparing Dietary and Other Lifestyle Factors Among Immigrant Nigerian Men Living in the US and Indigenous Men from Nigeria: Potential Implications for Prostate Cancer Risk Reduction. J Immigr Minor Health 2009; 11:391-9. [DOI: 10.1007/s10903-009-9231-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2008] [Accepted: 01/27/2009] [Indexed: 10/21/2022]
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Kumar NB, Besterman-Dahan K, Kang L, Pow-Sang J, Xu P, Allen K, Riccardi D, Krischer JP. Results of a Randomized Clinical Trial of the Action of Several Doses of Lycopene in Localized Prostate Cancer: Administration Prior to Radical Prostatectomy. ACTA ACUST UNITED AC 2008; 1:1-14. [PMID: 20354574 DOI: 10.4137/cmu.s718] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
PURPOSE: The purpose of this Phase II randomized-controlled trial was to evaluate the safety and effect of administering several doses of lycopene to men with clinically localized prostate cancer, on intermediate endpoint biomarkers implicated in prostate carcinogenesis. METHODS: Forty-five eligible men with clinically localized prostate cancer were supplemented with 15, 30 or 45 mg of lycopene or no supplement from biopsy to prostatectomy. Compliance to study agent, toxicity, changes in plasma lycopene, serum steroid hormones, PSA and tissue Ki-67 were analyzed from baseline to completion of intervention. RESULTS: Forty-two of forty-five five subjects completed the intervention for approximately 30 days from the time of biopsy until prostatectomy. Plasma lycopene increased from baseline to post treatment in all treatment groups with greatest increase observed in the 45 mg lycopene-supplemented arm compared to the control arm without producing any toxicity. Overall, subjects with prostate cancer had lower baseline levels of plasma lycopene similar to those observed in previous studies in men with prostate cancer. Serum free testosterone decreased with 30 mg lycopene supplementation and total estradiol increased significantly with 30 mg and 45 mg supplementation from baseline to end of treatment, with no significant increases in serum PSA or tissue Ki-67. These changes were not significant compared to the control arm for this sample size and duration of intervention. CONCLUSIONS: Although antioxidant properties of lycopene have been hypothesized to be primarily responsible for its beneficial effects, our study suggests that other mechanisms mediated by steroid hormones may also be involved.
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Affiliation(s)
- Nagi B Kumar
- Department of Interdisciplinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida College of Medicine, Tampa Florida
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Kumar NB, Krischer JP, Allen K, Riccardi D, Besterman-Dahan K, Salup R, Kang L, Xu P, Pow-Sang J. Safety of purified isoflavones in men with clinically localized prostate cancer. Nutr Cancer 2008; 59:169-75. [PMID: 18001211 DOI: 10.1080/01635580701432660] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Our purpose was to evaluate the safety of 80 mg of purified isoflavones administered to men with early stage prostate cancer. A total of 53 men with clinically localized prostate cancer, Gleason score of 6 or below, were supplemented with 80 mg purified isoflavones or placebo for 12 wk administered in 2 divided doses of 40 mg to provide a continuous dose of isoflavones. Compliance, changes in plasma isoflavones, and clinical toxicity were analyzed at baseline, 4, and 12 wk. A total of 50 subjects completed the 12-wk intervention. A continuous, divided-dose administration of 80 mg/day of purified isoflavones at amounts that exceeded normal American dietary intakes significantly increased (P < 0.001) plasma isoflavones in the isoflavone-treated group compared to placebo and produced no clinical toxicity. With the current evidence on the cancer preventive properties of isoflavones, these results are significant and offer promise for these phytochemicals to be developed as potent agents to prevent cancer progression.
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Affiliation(s)
- Nagi B Kumar
- Department of Interdisciplinary Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA.
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Kumar NB, Krischer JP, Allen K, Riccardi D, Besterman-Dahan K, Salup R, Kang L, Xu P, Pow-Sang J. A Phase II randomized, placebo-controlled clinical trial of purified isoflavones in modulating steroid hormones in men diagnosed with localized prostate cancer. Nutr Cancer 2008; 59:163-8. [PMID: 18001210 DOI: 10.1080/01635580701432678] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Our purpose was to evaluate the safety and effectiveness of purified isoflavones in producing an increase in plasma isoflavones and a corresponding change in serum sex hormone binding globulin (SHBG) and steroid hormone levels in men diagnosed with early stage prostate cancer. In this Phase II randomized, double-blinded, placebo-controlled trial, 53 prostate cancer patients with a Gleason score of 6 or below were supplemented with 80 mg purified isoflavones or placebo for 12 weeks. Changes in plasma isoflavones, serum steroid hormones, and safety markers were analyzed from baseline to 12 wk. A total of 50 subjects completed the study. Although significant increases in plasma isoflavones (P < 0.001) was observed with no clinical toxicity, the corresponding modulation of serum SHBG, total estradiol, and testosterone in the isoflavone-treated group compared to men receiving placebo was nonsignificant. Increasing plasma isoflavones failed to produce a corresponding modulation of serum steroid hormone levels in men with localized prostate cancer. The study establishes the need to explore other potential mechanisms by which prolonged and consistent purified isoflavone consumption may modulate prostate cancer risk.
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Affiliation(s)
- Nagi B Kumar
- Department of Interdisciplinary Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA.
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Dahan K, Fennal M, Kumar NB. Lycopene in the prevention of prostate cancer. J Soc Integr Oncol 2008; 6:29-36. [PMID: 18302908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Based on the evidence from epidemiologic, animal, and in vitro data and human clinical trials, it is evident that lycopene, a non-provitamin A carotenoid, is a promising agent for prostate cancer chemoprevention. It is also clear that the form of lycopene used (purified versus food sources), dose of lycopene and concomitant use with other carotenoids and antioxidants, duration of exposure, specific target populations, and stage of disease appear to play a major role in determining agonistic or antagonistic effects. Based on our review, there is enough evidence to warrant use of lycopene in phase I and II clinical trials to examine its safety and efficacy as a potential chemopreventive agent for prostate cancer. The objective of this article is to review this evidence from epidemiologic, animal, in vitro, and clinical trials and provide the need and rationale to examine further the role of lycopene for prostate cancer prevention.
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Affiliation(s)
- Karen Dahan
- Department of Interdisciplinary Oncology, University of South Florida College of Medicine, Tampa, FL 33612-9416, USA
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Kumar NB, Riccardi D, Cantor A, Dalton K, Allen K. A case-control study evaluating the association of purposeful physical activity, body fat distribution, and steroid hormones on premenopausal breast cancer risk. Breast J 2005; 11:266-72. [PMID: 15982394 DOI: 10.1111/j.1075-122x.2005.21693.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The objective of this case-control study was to investigate the relationship between purposeful physical activity, body fat distribution, body mass index, and steroid hormones. These factors are known to be implicated in modulating breast cancer risk in premenopausal women. A total of 112 newly diagnosed, premenopausal breast cancer patients and 106 age-matched premenopausal disease-free controls were admitted to the study. Information regarding personal, medical, hormonal, and reproductive history, smoking and alcohol use, physical activity history, and anthropometric measurements was obtained. Serum samples for steroid hormone assays were collected and analyzed. Disease-free premenopausal controls had a significantly higher physical activity index (PAI) (p</=0.05), however, significantly higher weight (p</=0.05), body mass index (BMI) (p=0.01), waist (p</=0.005) and hip (p</=0.05) circumferences, waist:hip ratios (p</=0.05), and serum total estradiol levels (p<0.0005) were observed in cancer cases. The final model using stepwise logistic regression analysis indicates that the variables that significantly predicted breast cancer risk were waist:hip ratio (odds ratio [OR]=1.11, p</=0.005) and serum total estradiol levels (OR=1.03, p</=0.0001). Our study provides some evidence that purposeful physical activity may reduce upper body fat distribution associated with adult weight gain. This may be a result of alterations in the steroid hormone pathway, such as reduced estradiol levels. This demonstrates the potential mechanism through which increased physical activity can reduce the risk for breast cancer in premenopausal women.
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Affiliation(s)
- Nagi B Kumar
- Department of Nutrition, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, Tampa, Florida 33612-9497, USA.
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Kumar NB. Green Tea Polyphenols. ACTA ACUST UNITED AC 2005. [DOI: 10.2165/01197065-200502010-00004] [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: 11/02/2022]
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Abstract
Among the numerous polyphenols isolated from green tea, the catechin EGCG predominates and is the target of anticancer research. But studies suggest that EGCG and other catechins are poorly absorbed and undergo substantial biotransformation to species that include glucuronides, sulfates, and methylated compounds. Numerous studies relate the antioxidant properties of the catechins with anticancer effects, but recent research proposes other mechanisms of action, including those involving methyl transfers that are subject to allelic variability in the enzyme catechol O-methyl transferase. However, preclinical research is promising and EGCG appears to be ready for further study in phase II and III trials.
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Affiliation(s)
- Susan B Moyers
- Department of Cancer Control and Nutrition, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
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Kumar NB, Cantor A, Allen K, Riccardi D, Besterman-Dahan K, Seigne J, Helal M, Salup R, Pow-Sang J. The specific role of isoflavones in reducing prostate cancer risk. Prostate 2004; 59:141-7. [PMID: 15042614 DOI: 10.1002/pros.10362] [Citation(s) in RCA: 114] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
AIMS To evaluate the effectiveness of supplementing a group of early stage prostate cancer patients, with 60 mg of soy isoflavones in producing a change in hormonal and proliferative risk parameters that are implicated in prostate cancer promotion. METHODS Seventy six eligible prostate cancer patients with a Gleason score of 6 or below, between ages 50 and 80 were admitted and supplemented with soy isoflavones or placebo for a 12 week period and changes in PSA and steroid hormones were analyzed at baseline and post intervention. RESULTS Fifty-nine patients completed the 12-week intervention. Serum free testosterone was reduced or showed no change in 61% of subjects in the isoflavone group compared to 33% in the placebo group. Serum total PSA decreased or was unchanged in 69% of the subjects in the isoflavone treated group compared to 55% in the placebo group. However, we did not see an increase in SHBG levels. Nineteen percent of subjects receiving soy isoflavones reduced total PSA by two points or more during the intervention period. CONCLUSIONS These data suggest that supplementing early stage prostate cancer patients with soy isoflavones, even in a study of short duration, altered surrogate markers of proliferation such as serum PSA and free testosterone in a larger number of subjects in the isoflavone supplemented group than the group receiving placebo. The study establishes the need to explore further the effects of prolonged and consistent soy consumption, which could potentially delay onset of histologic disease in this patient population.
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Affiliation(s)
- Nagi B Kumar
- Department of Nutrition, H. Lee Moffitt Cancer Center & Research Institute, University of South Florida, Tampa, Florida, USA.
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Kazi A, Urbizu DA, Kuhn DJ, Acebo AL, Jackson ER, Greenfelder GP, Kumar NB, Dou QP. A natural musaceas plant extract inhibits proteasome activity and induces apoptosis selectively in human tumor and transformed, but not normal and non-transformed, cells. Int J Mol Med 2003; 12:879-87. [PMID: 14612961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
Animal studies have demonstrated that a dietary polyphenol known as tannic acid (TA) exhibits anticarcinogenic activity in chemically induced cancers. Most recently, we have reported that TA and ester-bond containing green tea polyphenols are potent proteasome inhibitors in vitro and in vivo. We hypothesize that CellQuest, a patented formula which contains high level of TA obtained from a musaceas (plantain) plant extract, will inhibit the tumor cell proteasome activity. Here, we report that a partially purified CellQuest fraction, S3, potently inhibits the proteasomal chymotrypsin-like activity of Jurkat T cell extracts in a concentration-dependent manner. Inhibition of the proteasome by S3 in leukemia Jurkat T, simian virus 40-transformed and prostate cancer LNCaP cells results in accumulation of ubiquitinated proteins and the natural proteasome substrate p27Kip1, followed by induction of apoptosis. In contrast, non-transformed, immortalized human natural killer cells and normal human fibroblasts are resistant to S3-mediated proteasome inhibition and apoptosis induction. Our present study suggests that CellQuest targets and inhibits the proteasome selectively in tumor cells, which may contribute to the claimed anticancer activity.
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Affiliation(s)
- Aslamuzzaman Kazi
- Drug Discovery Program, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, 12902 Magnolia Drive, Tampa, FL 33612, USA
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Kazi A, Daniel KG, Smith DM, Kumar NB, Dou QP. Inhibition of the proteasome activity, a novel mechanism associated with the tumor cell apoptosis-inducing ability of genistein. Biochem Pharmacol 2003; 66:965-76. [PMID: 12963483 DOI: 10.1016/s0006-2952(03)00414-3] [Citation(s) in RCA: 107] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Epidemiological studies have suggested that increased soy consumption is associated with reduced cancer occurrence. Genistein, a soy isoflavone, has been reported to inhibit the growth of human tumor cells although the involved molecular mechanisms are not clearly defined. Here we report that genistein inhibits the proteasomal chymotrypsin-like activity in vitro and in vivo. Computational docking studies suggest that the interaction of genistein with the proteasomal beta 5 subunit is responsible for inhibition of the chymotrypsin-like activity. Inhibition of the proteasome by genistein in prostate cancer LNCaP and breast cancer MCF-7 cells is associated with accumulation of ubiquitinated proteins and three known proteasome target proteins, the cyclin-dependent kinase inhibitor p27(Kip1), inhibitor of nuclear factor-kappa B (I kappa B-alpha), and the pro-apoptotic protein Bax. Genistein-mediated proteasome inhibition was accompanied by induction of apoptosis in these solid tumor cells. Finally, genistein induced proteasome inhibition and apoptosis selectively in simian virus 40-transformed human fibroblasts, but not in their parental normal counterpart. Our results suggest that the proteasome is a potential target of genistein in human tumor cells and that inhibition of the proteasome activity by genistein might contribute to its cancer-preventive properties.
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Affiliation(s)
- Aslamuzzaman Kazi
- Drug Discovery Program, H. Lee Moffitt Cancer Center & Research Institute, Department of Interdisciplinary Oncology, College of Medicine, University of South Florida, Tampa, FL 33612, USA
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