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Chen Y, Jiang B, He Y, Zhang C, Zhou W, Fang C, Gu D, Zhang M, Ji M, Shi J, Yang X. A lung adenocarcinoma patient with co-mutations of MET and EGFR exon20 insertion responded to crizotinib. BMC Med Genomics 2022; 15:141. [PMID: 35739536 PMCID: PMC9229853 DOI: 10.1186/s12920-022-01291-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 08/05/2021] [Accepted: 06/15/2022] [Indexed: 11/26/2022] Open
Abstract
Background Targeted therapy has revolutionized the treatment of patients with malignancies harboring mutations in driver genes and has brought a favorable survival benefit to the population with actionable oncogenic mutations. In recent years, the MET exon14 skipping mutation has been recognized as a potentially promising therapeutic target in non-small cell lung cancer (NSCLC). These changes are mutually exclusive with molecular drivers such as EGFR, KRAS, HER-2, BRAF, ALK and ROS1. The prevalence rate of coexisting MET exon 14 mutations and EGFR sensitive mutations (L858R, exon 19 deletions) in Chinese population was reported to be 0.2% (3/1590). However, the coexistence of MET exon 14 mutations with EGFR exon 20 insertion mutations has never been reported and the management of this subtype is not identified. Case presentation A 69-year-old male with a right lung adenocarcinoma (T4N2M0, IIIB) was confirmed to be positive for MET exon 14 skipping (c.3028_3028+1delGGinsTT, 44.4%), MET amplification (copy number 4.4), and EGFR exon 20 insertion (p. N771_H773dup, 22.1%) mutations. After the progression of one cycle of chemotherapy (Pemetrexed 0.8 g d1), the patient was subsequently accepted treatment with Crizotinib (250 mg twice a day) and achieved an important clinical remission for six months until the development of brain metastases. Then, he was submitted to a cycle of anti-programmed cell death-1 (PD-1) therapy after failure of Crizotinib and eventually acquired resistance despite of the high expression of programmed death ligand-1 (PD-L1) and tumor mutational burden (TMB) status. Conclusion This case report provides treatment strategies for epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs)-untreated lung adenocarcinoma patients simultaneously carrying MET alterations and EGFR exon 20 insertion mutations. In addition, the signatures of PD-L1 or TMB expression were not the candidate for predicting the efficacy of immunotherapy in this context.
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Affiliation(s)
- Yan Chen
- Department of Oncology, The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, No 185 Juqian Road, Tianning District, Changzhou, 213000, China
| | - Bo Jiang
- Department of Thoracic Surgery, The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, No 185 Juqian Road, Tianning District, Changzhou, 213000, China
| | - Yuange He
- Geneplus-Beijing, 9th Floor, No.6 Building, Peking University Medical Industrial Park, Zhongguancun Life Science Park, Beijing, 102206, China
| | - Chu Zhang
- Department of Oncology, The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, No 185 Juqian Road, Tianning District, Changzhou, 213000, China
| | - Wenjie Zhou
- Department of Oncology, The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, No 185 Juqian Road, Tianning District, Changzhou, 213000, China
| | - Cheng Fang
- Department of Oncology, The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, No 185 Juqian Road, Tianning District, Changzhou, 213000, China
| | - Dejian Gu
- Geneplus-Beijing, 9th Floor, No.6 Building, Peking University Medical Industrial Park, Zhongguancun Life Science Park, Beijing, 102206, China
| | - Minxia Zhang
- Geneplus-Beijing, 9th Floor, No.6 Building, Peking University Medical Industrial Park, Zhongguancun Life Science Park, Beijing, 102206, China
| | - Mei Ji
- Department of Oncology, The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, No 185 Juqian Road, Tianning District, Changzhou, 213000, China
| | - Juntao Shi
- Department of Cardiothoracic Surgery, The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, No 185 Juqian Road, Tianning District, Changzhou, 213000, China.
| | - Xin Yang
- Department of Oncology, The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, No 185 Juqian Road, Tianning District, Changzhou, 213000, China.
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Danesi R, Lo YMD, Oellerich M, Beck J, Galbiati S, Re MD, Lianidou E, Neumaier M, van Schaik RHN. What do we need to obtain high quality circulating tumor DNA (ctDNA) for routine diagnostic test in oncology? - Considerations on pre-analytical aspects by the IFCC workgroup cfDNA. Clin Chim Acta 2021; 520:168-171. [PMID: 34081934 DOI: 10.1016/j.cca.2021.05.033] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 05/28/2021] [Accepted: 05/28/2021] [Indexed: 12/17/2022]
Abstract
The analysis of circulating cell free DNA is an important tool for the analysis of tumor resistance, tumor heterogeneity, detection of minimal residual disease and detection of allograft rejection in kidney or heart transplant patients. The proper use of this technique is important, and starts with considering pre-analytic aspects. The current paper addresses some important technical considerations to ensure the proper and harmonized use of cfDNA techniques.
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Affiliation(s)
- R Danesi
- Clinical Pharmacology and Pharmacogenetics Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Y M D Lo
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - M Oellerich
- Dept. Clinical Pharmacology, George-August University, University Medical Center Goettingen, Goettingen, Germany
| | - J Beck
- Chronix BioMedical GmbH, Goettingen, Germany
| | - S Galbiati
- Unit of Genomic for the Diagnosis of Human Pathologies, Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - M Del Re
- Clinical Pharmacology and Pharmacogenetics Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - E Lianidou
- Dept. Chemistry, University of Athens, Athens, Greece
| | - M Neumaier
- Institute for Clinical Chemistry, Mannheim, Germany
| | - R H N van Schaik
- Dept. Clinical Chemistry, Erasmus University Medical Center, Rotterdam, The Netherlands.
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Wahi D, Soni D, Grover A. A Double-Edged Sword: The Anti-Cancer Effects of Emodin by Inhibiting the Redox-Protective Protein MTH1 and Augmenting ROS in NSCLC. J Cancer 2021; 12:652-681. [PMID: 33403025 PMCID: PMC7778552 DOI: 10.7150/jca.41160] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 04/01/2020] [Indexed: 12/23/2022] Open
Abstract
Background: Reactive oxygen species (ROS), playing a two-fold role in tumorigenesis, are responsible for tumor formation and progression through the induction of genome instability and pro-oncogenic signaling. The same ROS is toxic to cancer cells at higher levels, oxidizing free nucleotide precursors (dNTPs) as well as damaging DNA leading to cell senescence. Research has highlighted the tumor cell-specific expression of a redox-protective phosphatase, MutT homolog 1 (MTH1), that performs the enzymatic conversion of oxidized nucleotides (like 8-oxo-dGTP) to their corresponding monophosphates, up-regulated in numerous cancers, circumventing their misincorporation into the genomic DNA and preventing damage and cell death. Methods: To identify novel natural small molecular inhibitors of MTH1 to be used as cancer therapeutic agents, molecular screening for MTH1 active site binders was performed from natural small molecular libraries. Emodin was identified as a lead compound for MTH1 active site functional inhibition and its action on MTH1 inhibition was validated on non-small cell lung cancer cellular models (NSCLC). Results: Our study provides strong evidence that emodin mediated MTH1 inhibition impaired NSCLC cell growth, inducing senescence. Emodin treatment enhanced the cellular ROS burdens, on one hand, damaged dNTP pools and inhibited MTH1 function on the other. Our work on emodin indicates that ROS is the key driver of cancer cell-specific increased DNA damage and apoptosis upon MTH1 inhibition. Consequently, we observed a time-dependent increase in NSCL cancer cell susceptibility to oxidative stress with emodin treatment. Conclusions: Based on our data, the anti-cancer effects of emodin as an MTH1 inhibitor have clinical potential as a single agent capable of functioning as a ROS inducer and simultaneous blocker of dNTP pool sanitation in the treatment of NSCL cancers. Collectively, our results have identified for the first time that the potential molecular mechanism of emodin function, increasing DNA damage and apoptosis in cancer cells, is via MTH1 inhibition.
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Affiliation(s)
- Divya Wahi
- School of Biotechnology, Jawaharlal Nehru University, New Delhi, India - 110067
| | - Deepika Soni
- School of Biotechnology, Jawaharlal Nehru University, New Delhi, India - 110067
| | - Abhinav Grover
- School of Biotechnology, Jawaharlal Nehru University, New Delhi, India - 110067
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Addeo A, Banna GL, Metro G, Di Maio M. Chemotherapy in Combination With Immune Checkpoint Inhibitors for the First-Line Treatment of Patients With Advanced Non-small Cell Lung Cancer: A Systematic Review and Literature-Based Meta-Analysis. Front Oncol 2019; 9:264. [PMID: 31058078 PMCID: PMC6478036 DOI: 10.3389/fonc.2019.00264] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [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: 02/05/2019] [Accepted: 03/22/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Checkpoint inhibitors plus platinum-based chemotherapy have shown superiority compared to chemotherapy alone as first-line therapy in advanced non–small cell lung carcinoma (NSCLC). To evaluate the relative benefit in term of Overall Survival (OS) and Progression-free Survival (PFS) of checkpoint inhibitors plus chemotherapy vs. chemotherapy alone, overall and in subgroups defined by PDL1 expression we have performed a meta-analysis. Data Sources: This meta-analysis searched PubMed and checked references of the selected English language articles to identify further eligible trials. Data collection for this study took place from October 1 to October 24, 2018. Results: In total, 8 trials involving 4,646 patients with advanced NSCLC, 3.314 (71%) and 1.332 (29%) with a non-squamous and squamous histology, respectively, were included in this meta-analysis. Four trials used atezolizumab, 3 pembrolizumab, and 1 nivolumab, accounting for 2.985 (64%), 1.298 (28%), and 363 (8%) of patients, respectively. The patients were randomized to receive first-line chemotherapy plus a checkpoint inhibitor vs. first-line chemotherapy, 2,978 patients for the OS endpoint and first-line chemotherapy plus a checkpoint inhibitor vs. first-line chemotherapy, 1,740 patients in the PFS endpoint. Checkpoint inhibitors plus chemotherapy were associated with prolonged OS, compared with chemotherapy in the ITT population (HR, 0.74; 95% CI, 0.64–0.87; p = 0.0002, with significant heterogeneity among trials). Notably within the PDL1 low group (1–49) there was a significant heterogeneity (p = 0.06) between type of drug and efficacy: the combination of chemotherapy plus pembrolizumab showed an OS benefit (HR, 0.56; 95% CI, 0.40–0.78; P < 0.00007) unlike the atezolizumab backbone trials (HR, 0.92; 95% CI, 0.62–1.37; P < 0.69). However, checkpoint inhibitors plus chemotherapy were associated with prolonged PFS in the ITT (HR, 0.61; 95% CI, 0.56–0.66; P < 0.00001) and across PDL1 subgroups. Conclusion and Relevance: Checkpoint inhibitors plus chemotherapy compared with chemotherapy, are associated with significantly prolonged OS and PFS in first-line therapy in NSCLC. In the low PDL1 subgroups the benefit was statistically significant only in the pembrolizumab backbone trials. The findings of this meta-analysis could assist in the design and interpretation of future trials and in economic analyses.
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Affiliation(s)
- Alfredo Addeo
- Department of Oncology, University Hospital of Geneva, Geneva, Switzerland
| | | | - Giulio Metro
- Medical Oncology, Santa Maria della Misericordia Hospital, Azienda Ospedaliera di Perugia, Perugia, Italy
| | - Massimo Di Maio
- Department of Oncology, Ordine Mauriziano Hospital, University of Turin, Turin, Italy
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Li X, Qi H, Qing G, Song Z, Xie L, Cao F, Chen X, Fan W. Microwave ablation with continued EGFR tyrosine kinase inhibitor therapy prolongs disease control in non-small-cell lung cancers with acquired resistance to EGFR tyrosine kinase inhibitors. Thorac Cancer 2018; 9:1012-1017. [PMID: 29924498 PMCID: PMC6068442 DOI: 10.1111/1759-7714.12779] [Citation(s) in RCA: 11] [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: 03/14/2018] [Revised: 05/08/2018] [Accepted: 05/08/2018] [Indexed: 11/28/2022] Open
Abstract
Background Although patients with EGFR‐mutant non‐small‐cell lung cancer (NSCLC) benefit from treatment with EGFR‐tyrosine kinase inhibitors (TKIs), outcomes are limited by the eventual development of acquired resistance. We conducted a retrospective study to evaluate the efficacy and feasibility of EGFR‐TKI therapy beyond focal progression, associated with microwave ablation. Methods Patients with metastatic EGFR‐mutant NSCLC treated with EGFR‐TKIs at our institutions from May 2012 to December 2017 were identified. Patients with single lesion progression, treated with MWA, and continually administered EGFR‐TKI therapy until further progression, were included in the study. Initial response to target therapy, median progression‐free survival (PFS1), and first progression site were recorded. The median time to progression after local therapy (PFS2) was also assessed. Overall survival was calculated from the initiation of EGFR‐TKIs to the date of final follow‐up or death. Results Fifteen out of 205 patients (10%) satisfied the inclusion criteria. Local therapy was well tolerated, and complete ablation was performed in 11 (73.3%) patients. The median PFS1 was 9.5 months (range 6–41), and the median PFS2 was 8 months (range 3–24). The corresponding 6 and 12 month PFS rates were 73.3% and 26.7%, respectively. Median overall survival was 23 months (range 15–64). Conclusion The longer disease control observed in our patients suggests that continuation of EGFR‐TKI beyond focal progression associated to microwave ablation is an efficacious therapeutic strategy.
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Affiliation(s)
- Xin Li
- Department of Medical Oncology, Affiliated Xiaolan Hospital, Southern Medical University, Guangzhou, China
| | - Han Qi
- Minimally Invasive Interventional Division, Medical Imaging Center, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Gou Qing
- Department of Imaging and Interventional Radiology, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ze Song
- Minimally Invasive Interventional Division, Medical Imaging Center, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Lin Xie
- Minimally Invasive Interventional Division, Medical Imaging Center, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Fei Cao
- Minimally Invasive Interventional Division, Medical Imaging Center, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Xiaoming Chen
- Department of Imaging and Interventional Radiology, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Weijun Fan
- Minimally Invasive Interventional Division, Medical Imaging Center, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
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Zhu Q, Lv T, Wu Y, Shi X, Liu H, Song Y. Long non-coding RNA 00312 regulated by HOXA5 inhibits tumour proliferation and promotes apoptosis in Non-small cell lung cancer. J Cell Mol Med 2017; 21:2184-2198. [PMID: 28338293 PMCID: PMC5571553 DOI: 10.1111/jcmm.13142] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [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: 09/29/2016] [Accepted: 01/10/2017] [Indexed: 02/07/2023] Open
Abstract
Non‐small cell lung cancer (NSCLC) is the most prevalent type of lung cancer. The abnormal expression of many long non‐coding RNAs (lncRNAs) has been reported involved in the progression of various tumours, which can be used as diagnostic indicators or antitumour targets. Here, we found that the long non‐coding RNA 00312 was down‐regulated in paired NSCLC tissues and correlated with poor clinical outcome; decreased linc00312 expression in NSCLC was associated with larger and later stage tumours. Functional experiments showed that linc00312 could inhibit cell proliferation and promote apoptosis in vitro and in vivo. Furthermore, we found that HOXA5 could bind in the promoter of linc00312 and up‐regulated the expression of it. Moreover, linc00312 was down‐regulated in the plasma of NSCLC patients compared with that of healthy volunteers or other pulmonary diseases patients. Taken together, our findings indicated that linc00312 could be a novel diagnosis biomarker and a promising therapeutic target for NSCLC.
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Affiliation(s)
- Qingqing Zhu
- Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.,Nanjing University Institute of Respiratory Medicine, Nanjing, China
| | - Tangfeng Lv
- Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.,Nanjing University Institute of Respiratory Medicine, Nanjing, China
| | - Ying Wu
- Department of Respiratory Medicine, Zhongda Hospital, Southeast University School of Medicine, Nanjing, China
| | - Xuefei Shi
- Department of Respiratory Medicine, Huzhou Central Hospital, Huzhou, China
| | - Hongbing Liu
- Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.,Nanjing University Institute of Respiratory Medicine, Nanjing, China
| | - Yong Song
- Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.,Nanjing University Institute of Respiratory Medicine, Nanjing, China
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