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Hopff SM, Onambele LA, Brandenburg M, Berkessel A, Prokop A. Sensitizing multidrug-resistant leukemia cells to common cytostatics by an aluminium-salen complex that has high-apoptotic effects in leukemia, lymphoma and mamma carcinoma cells. Biometals 2021; 34:211-220. [PMID: 33560473 DOI: 10.1007/s10534-020-00273-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 11/18/2020] [Indexed: 11/25/2022]
Abstract
We investigated the aluminium-salen complex MBR-8 as a potential anti-cancer agent. To see apoptotic effects induced by MBR-8, alone and in combination with common cytostatic drugs, DNA-fragmentations were studied using the flow cytometric analysis. Western blot analysis and measurement of the mitochondrial membrane potential with a JC-1 dye were employed to identify the pathway of apoptosis. An impressive overcoming of multidrug-resistance in leukemia (Nalm6) cells was observed. Additionally, solid tumor cells including Burkitt-like lymphoma (BJAB) and mamma carcinoma cells (MCF-7) are affected by MBR-8 in the same way. Western blot analysis revealed activation of caspase-3. MBR-8 showed very pronounced selectivity with regard to tumor cells and high synergistic effects in Nalm6 and daunorubicin-resistant Nalm6 cells when administered in combination with vincristine, daunorubicin and doxorubicin. The aluminium-salen complex MBR-8 showed very promising anti-cancer properties which warrant further development towards a cytostatic agent for future chemotherapy. Studies on aluminium compounds for cancer therapy are rare, and our report adds to this important body of knowledge.
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Affiliation(s)
- Sina M Hopff
- Department of Pediatric Hematology/Oncology, Children's Hospital Cologne, Amsterdamer Straße 59, 50735, Cologne, Germany.
| | - Liliane A Onambele
- Department of Pediatric Hematology/Oncology, Children's Hospital Cologne, Amsterdamer Straße 59, 50735, Cologne, Germany
| | - Marc Brandenburg
- Department of Chemistry, Organic Chemistry, University of Cologne, Greinstraße 4, 50939, Cologne, Germany
| | - Albrecht Berkessel
- Department of Chemistry, Organic Chemistry, University of Cologne, Greinstraße 4, 50939, Cologne, Germany
| | - Aram Prokop
- Department of Pediatric Hematology/Oncology, Children's Hospital Cologne, Amsterdamer Straße 59, 50735, Cologne, Germany
- Department of Pediatric Hematology/Oncology, Helios Clinic Schwerin, Wismarsche Straße 393-397, 19055, Schwerin, Germany
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Völkel V, Hueting TA, Draeger T, van Maaren MC, de Munck L, Strobbe LJA, Sonke GS, Schmidt MK, van Hezewijk M, Groothuis-Oudshoorn CGM, Siesling S. Improved risk estimation of locoregional recurrence, secondary contralateral tumors and distant metastases in early breast cancer: the INFLUENCE 2.0 model. Breast Cancer Res Treat 2021; 189:817-826. [PMID: 34338943 PMCID: PMC8505302 DOI: 10.1007/s10549-021-06335-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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: 03/22/2021] [Accepted: 07/14/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To extend the functionality of the existing INFLUENCE nomogram for locoregional recurrence (LRR) of breast cancer toward the prediction of secondary primary tumors (SP) and distant metastases (DM) using updated follow-up data and the best suitable statistical approaches. METHODS Data on women diagnosed with non-metastatic invasive breast cancer were derived from the Netherlands Cancer Registry (n = 13,494). To provide flexible time-dependent individual risk predictions for LRR, SP, and DM, three statistical approaches were assessed; a Cox proportional hazard approach (COX), a parametric spline approach (PAR), and a random survival forest (RSF). These approaches were evaluated on their discrimination using the Area Under the Curve (AUC) statistic and on calibration using the Integrated Calibration Index (ICI). To correct for optimism, the performance measures were assessed by drawing 200 bootstrap samples. RESULTS Age, tumor grade, pT, pN, multifocality, type of surgery, hormonal receptor status, HER2-status, and adjuvant therapy were included as predictors. While all three approaches showed adequate calibration, the RSF approach offers the best optimism-corrected 5-year AUC for LRR (0.75, 95%CI: 0.74-0.76) and SP (0.67, 95%CI: 0.65-0.68). For the prediction of DM, all three approaches showed equivalent discrimination (5-year AUC: 0.77-0.78), while COX seems to have an advantage concerning calibration (ICI < 0.01). Finally, an online calculator of INFLUENCE 2.0 was created. CONCLUSIONS INFLUENCE 2.0 is a flexible model to predict time-dependent individual risks of LRR, SP and DM at a 5-year scale; it can support clinical decision-making regarding personalized follow-up strategies for curatively treated non-metastatic breast cancer patients.
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Affiliation(s)
- Vinzenz Völkel
- Tumor Center Regensburg/University of Regensburg, Institute for Quality Control and Health Services Research, Regensburg, Germany
| | - Tom A Hueting
- Evidencio, medical Decision Support, Haaksbergen, The Netherlands
- Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, POBox 217, Enschede, 7500 AE, The Netherlands
| | - Teresa Draeger
- Tumor Center Regensburg/University of Regensburg, Institute for Quality Control and Health Services Research, Regensburg, Germany
| | - Marissa C van Maaren
- Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, POBox 217, Enschede, 7500 AE, The Netherlands
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), POBox 19079, Utrecht, 3501 DB, The Netherlands
| | - Linda de Munck
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), POBox 19079, Utrecht, 3501 DB, The Netherlands
| | - Luc J A Strobbe
- Department of Surgical Oncology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Gabe S Sonke
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Marjanka K Schmidt
- Division of Molecular Pathology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | | | - Catharina G M Groothuis-Oudshoorn
- Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, POBox 217, Enschede, 7500 AE, The Netherlands
| | - Sabine Siesling
- Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, POBox 217, Enschede, 7500 AE, The Netherlands.
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), POBox 19079, Utrecht, 3501 DB, The Netherlands.
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Voelkel V, Draeger T, Groothuis-Oudshoorn CGM, de Munck L, Hueting T, Gerken M, Klinkhammer-Schalke M, Lavric M, Siesling S. Predicting the risk of locoregional recurrence after early breast cancer: an external validation of the Dutch INFLUENCE-nomogram with clinical cancer registry data from Germany. J Cancer Res Clin Oncol 2019; 145:1823-33. [PMID: 30927074 DOI: 10.1007/s00432-019-02904-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 03/22/2019] [Indexed: 12/13/2022]
Abstract
Purpose Follow-up after breast cancer treatment aims for an early detection of locoregional breast cancer recurrences (LRR) to improve the patients’ outcome. By estimating individual’s 5-year recurrence-risks, the Dutch INFLUENCE-nomogram can assist health professionals and patients in developing personalized risk-based follow-up pathways. The objective of this study is to validate the prediction tool on non-Dutch patients. Material and methods Data for this external validation derive from a large clinical cancer registry in southern Germany, covering a population of 1.1 million. Patients with curative resection of early-stage breast cancer, diagnosed between 2000 and 2012, were included in the analysis (n = 6520). For each of them, an individual LRR-risk was estimated by the INFLUENCE-nomogram. Its predictive ability was tested by comparing estimated and observed LRR-probabilities using the Hosmer–Lemeshow goodness-of-fit test and C-statistics. Results In the German validation-cohort, 2.8% of the patients developed an LRR within 5 years after primary surgery (n = 184). While the INFLUENCE-nomogram generally underestimates the actual LRR-risk of the German patients (p < 0.001), its discriminative ability is comparable to the one observed in the original Dutch modeling-cohort (C-statistic German validation-cohort: 0.73, CI 0.69–0.77 vs. C-statistic Dutch modeling-cohort: 0.71, CI 0.69–0.73). Similar results were obtained in most of the subgroup analyses stratified by age, type of surgery and intrinsic biological subtypes. Conclusion The outcomes of this external validation underline the generalizability of the INFLUENCE-nomogram beyond the Dutch population. The model performance could be enhanced in future by incorporating additional risk factors for LRR.
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