1
|
Sabe H, Takenaka S, Kakunaga S, Tamiya H, Wakamatsu T, Nakai S, Takami H, Yamada Y, Okada S. Prognostic nutrition index as a predictive factor for overall survival in trabectedin-treated advanced soft tissue sarcoma. J Orthop Sci 2024:S0949-2658(24)00016-2. [PMID: 38467532 DOI: 10.1016/j.jos.2024.02.004] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/31/2024] [Accepted: 02/18/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND Trabectedin binds covalently to the DNA minor groove and causes DNA to bend toward the main groove, then trabectedin regulates the transcription of the involved genes in cell proliferation or acts on the mononuclear phagocyte system in tumors, which contributes to its antitumor effects. Several clinical trials confirmed the efficacy of trabectedin for patients with advanced soft tissue sarcoma (STS) although clinically useful biomarkers remained unidentified. This study aimed to identify prognostic factors of trabectedin treatment, especially focusing on the systemic inflammatory, immune response, and nutritional status. METHODS This study included 44 patients with advanced STS treated with trabectedin from January 2018 to August 2022. We evaluated the associations of clinical factors that influence the efficacy of trabectedin treatment with progression-free survival (PFS) and overall survival (OS), focusing on systemic inflammatory, immune response, and nutritional status represented by the absolute lymphocyte count (ALC), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic inflammation response index (SIRI), prognostic nutrition index (PNI), and C-reactive protein (CRP) using the Kaplan-Meier method and the log-rank test. RESULTS ALC, LMR, PNI, NLR, PLR, and SIRI demonstrated no association with PFS. Patients with CRP of ≥0.3 had a significantly shorter PFS than those with CRP of <0.3 (median PFS: 863 vs. 105 days, P = 0.045). PNI of ≥44 (median: 757 days vs. 232 days, P = 0.021) and CRP of <0.3 (median: 877 days vs. 297 days, P = 0.043) were significantly good prognostic factors in terms of OS. CONCLUSIONS The study results indicate pretreatment PNI and CRP levels as prognostic factors for trabectedin treatment in advanced STS.
Collapse
Affiliation(s)
- Hideaki Sabe
- Department of Orthopaedic Surgery, Osaka International Cancer Institute, Osaka, Japan; Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Satoshi Takenaka
- Department of Orthopaedic Surgery, Osaka International Cancer Institute, Osaka, Japan.
| | - Shigeki Kakunaga
- Department of Orthopaedic Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Hironari Tamiya
- Department of Orthopaedic Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Toru Wakamatsu
- Department of Orthopaedic Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Sho Nakai
- Department of Orthopaedic Surgery, Osaka International Cancer Institute, Osaka, Japan; Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Haruna Takami
- Department of Orthopaedic Surgery, Osaka International Cancer Institute, Osaka, Japan; Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yoshiki Yamada
- Department of Orthopaedic Surgery, Osaka International Cancer Institute, Osaka, Japan; Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Seiji Okada
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| |
Collapse
|
2
|
Zweifler LE, Sinder BP, Stephan C, Koh AJ, Do J, Ulrich E, Grewal J, Woo C, Batoon L, Kozloff K, Roca H, Mishina Y, McCauley LK. Parathyroid hormone and trabectedin have differing effects on macrophages and stress fracture repair. Bone 2024; 179:116983. [PMID: 38013019 DOI: 10.1016/j.bone.2023.116983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 10/25/2023] [Accepted: 11/23/2023] [Indexed: 11/29/2023]
Abstract
Stress fractures occur as a result of repeated mechanical stress on bone and are commonly found in the load-bearing lower extremities. Macrophages are key players in the immune system and play an important role in bone remodeling and fracture healing. However, the role of macrophages in stress fractures has not been adequately addressed. We hypothesize that macrophage infiltration into a stress fracture callus site promotes bone healing. To test this, a unilateral stress fracture induction model was employed in which the murine ulna of four-month-old, C57BL/6 J male mice was repeatedly loaded with a pre-determined force until the bone was displaced a distance below the threshold for complete fracture. Mice were treated daily with parathyroid hormone (PTH, 50 μg/kg/day) starting two days before injury and continued until 24 h before euthanasia either four or six days after injury, or treated with trabectedin (0.15 mg/kg) on the day of stress fracture and euthanized three or seven days after injury. These treatments were used due to their established effects on macrophages. While macrophages have been implicated in the anabolic effects of PTH, trabectedin, an FDA approved chemotherapeutic, compromises macrophage function and reduces bone mass. At three- and four-days post injury, callus macrophage numbers were analyzed histologically. There was a significant increase in macrophages with PTH treatment compared to vehicle in the callus site. By one week of healing, treatments differentially affected the bony callus as analyzed by microcomputed tomography. PTH enhanced callus bone volume. Conversely, callus bone volume was decreased with trabectedin treatment. Interestingly, concurrent treatment with PTH and trabectedin rescued the reduction observed in the callus with trabectedin treatment alone. This study reports on the key involvement of macrophages during stress fracture healing. Given these observed outcomes on macrophage physiology and bone healing, these findings may be important for patients actively receiving either of these FDA-approved therapeutics.
Collapse
Affiliation(s)
- Laura E Zweifler
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, United States of America
| | - Benjamin P Sinder
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, United States of America
| | - Chris Stephan
- Department of Orthopedic Surgery, University of Michigan, Ann Arbor, MI, United States of America
| | - Amy J Koh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, United States of America
| | - Justin Do
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, United States of America
| | - Emily Ulrich
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, United States of America
| | - Jobanpreet Grewal
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, United States of America
| | - Cecilia Woo
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, United States of America
| | - Lena Batoon
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, United States of America
| | - Kenneth Kozloff
- Department of Orthopedic Surgery, University of Michigan, Ann Arbor, MI, United States of America
| | - Hernan Roca
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, United States of America.
| | - Yuji Mishina
- Department of Biologic and Materials Science, University of Michigan School of Dentistry, Ann Arbor, MI, United States of America
| | - Laurie K McCauley
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, United States of America; Department of Pathology, University of Michigan, Medical School, Ann Arbor, MI, United States of America
| |
Collapse
|
3
|
Khoury R, Assi T, Ibrahim R, Ibrahim T, Verret B, Henon C, Bahleda R, Le Cesne A. A Comprehensive Review on the Role of Lurbinectedin in Soft Tissue Sarcomas. Curr Treat Options Oncol 2024; 25:176-190. [PMID: 38324075 DOI: 10.1007/s11864-024-01178-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2024] [Indexed: 02/08/2024]
Abstract
OPINION STATEMENT Soft tissue sarcoma (STS), a substantial group of aggressive and rare tumors with tissue heterogeneity, is infrequently represented in clinical trials with an urgent necessity for newer treatment options. Lurbinectedin, an analog of trabectedin, is currently approved, in various countries, as a single agent, for the treatment of patients with relapsed small cell lung cancer (SCLC). However, preclinical and phase I and phase II trials have demonstrated the efficacy of lurbinectedin in different tumor types, including STS. The better understanding of the pathophysiology and evolution of STS as well as the mechanism of action of lurbinectedin in addition to the available data regarding the activity of this drug in this subset of patients will pave the way to newer therapeutic options and strategies.
Collapse
Affiliation(s)
- Rita Khoury
- Division of International Patients Care, Gustave Roussy Cancer Campus, 114, Rue Edouard Vaillant, Villejuif, France
| | - Tarek Assi
- Division of International Patients Care, Gustave Roussy Cancer Campus, 114, Rue Edouard Vaillant, Villejuif, France.
- Sarcoma Unit, Gustave Roussy Cancer Campus, 114, Rue Edouard Vaillant, Villejuif, France.
| | - Rebecca Ibrahim
- Division of International Patients Care, Gustave Roussy Cancer Campus, 114, Rue Edouard Vaillant, Villejuif, France
| | - Tony Ibrahim
- Division of International Patients Care, Gustave Roussy Cancer Campus, 114, Rue Edouard Vaillant, Villejuif, France
| | - Benjamin Verret
- Sarcoma Unit, Gustave Roussy Cancer Campus, 114, Rue Edouard Vaillant, Villejuif, France
| | - Clemence Henon
- Sarcoma Unit, Gustave Roussy Cancer Campus, 114, Rue Edouard Vaillant, Villejuif, France
| | - Ratislav Bahleda
- Sarcoma Unit, Gustave Roussy Cancer Campus, 114, Rue Edouard Vaillant, Villejuif, France
| | - Axel Le Cesne
- Division of International Patients Care, Gustave Roussy Cancer Campus, 114, Rue Edouard Vaillant, Villejuif, France
- Sarcoma Unit, Gustave Roussy Cancer Campus, 114, Rue Edouard Vaillant, Villejuif, France
| |
Collapse
|
4
|
Miao X, Shen S, Koch G, Wang X, Li J, Shen X, Qu J, Straubinger RM, Jusko WJ. Systems pharmacodynamic model of combined gemcitabine and trabectedin in pancreatic cancer cells. Part I.Çô Effects on signal transduction pathways related to tumor growth. J Pharm Sci 2024; 113:214-227. [PMID: 38498417 PMCID: PMC11017371 DOI: 10.1016/j.xphs.2023.10.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/22/2023] [Accepted: 10/22/2023] [Indexed: 03/20/2024]
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is often chemotherapy-resistant, and novel drug combinations would fill an unmet clinical need. Previously we reported synergistic cytotoxic effects of gemcitabine and trabectedin on pancreatic cancer cells, but underlying protein-level interaction mechanisms remained unclear. We employed a reliable, sensitive, comprehensive, quantitative, high-throughput IonStar proteomic workflow to investigate the time course of gemcitabine and trabectedin effects, alone and combined, upon pancreatic cancer cells. MiaPaCa-2 cells were incubated with vehicle (controls), gemcitabine, trabectedin, and their combinations over 72 hours. Samples were collected at intervals and analyzed using the label-free IonStar liquid chromatography-mass spectrometry (LC-MS/MS) workflow to provide temporal quantification of protein expression for 4,829 proteins in four experimental groups. To characterize diverse signal transduction pathways, a comprehensive systems pharmacodynamic (SPD) model was developed. The analysis is presented in two parts. Here, Part I describes drug responses in cancer cell growth and migration pathways included in the full model: receptor tyrosine kinase- (RTK), integrin-, G-protein coupled receptor- (GPCR), and calcium-signaling pathways. The developed model revealed multiple underlying mechanisms of drug actions, provides insight into the basis of drug interaction synergism, and offers a scientific rationale for potential drug combination strategies.
Collapse
Affiliation(s)
- Xin Miao
- Department of Pharmaceutical Sciences, University at Buffalo, SUNY, Buffalo, NY, United States
| | - Shichen Shen
- Department of Biochemistry, School of Medicine and Biomedical Sciences, University at Buffalo, SUNY, Buffalo, NY, United States; New York State Center of Excellence in Bioinformatics & Life Sciences, Buffalo, NY, United States
| | - Gilbert Koch
- Pediatric Pharmacology and Pharmacometrics Research Center, University of Basel, Children's Hospital, Basel, Switzerland
| | - Xue Wang
- New York State Center of Excellence in Bioinformatics & Life Sciences, Buffalo, NY, United States; Department of Cell Stress Biology, Roswell Park Cancer Institute, Buffalo, NY, United States
| | - Jun Li
- New York State Center of Excellence in Bioinformatics & Life Sciences, Buffalo, NY, United States
| | - Xiaomeng Shen
- Department of Biochemistry, School of Medicine and Biomedical Sciences, University at Buffalo, SUNY, Buffalo, NY, United States; New York State Center of Excellence in Bioinformatics & Life Sciences, Buffalo, NY, United States
| | - Jun Qu
- Department of Pharmaceutical Sciences, University at Buffalo, SUNY, Buffalo, NY, United States; New York State Center of Excellence in Bioinformatics & Life Sciences, Buffalo, NY, United States
| | - Robert M Straubinger
- Department of Pharmaceutical Sciences, University at Buffalo, SUNY, Buffalo, NY, United States; New York State Center of Excellence in Bioinformatics & Life Sciences, Buffalo, NY, United States; Department of Cell Stress Biology, Roswell Park Cancer Institute, Buffalo, NY, United States
| | - William J Jusko
- Department of Pharmaceutical Sciences, University at Buffalo, SUNY, Buffalo, NY, United States.
| |
Collapse
|
5
|
Carrasco García I, Benedetti Pedroza J, Miras Rodriguez I, Rincón I. Trabectedin and Radiotherapy in Endometrial Stromal Sarcoma: A Case Report. Case Rep Oncol 2024; 17:82-90. [PMID: 38213958 PMCID: PMC10783890 DOI: 10.1159/000535747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/29/2023] [Indexed: 01/13/2024] Open
Abstract
Introduction Endometrial stromal sarcoma (ESS) is a rare tumor that remains a diagnostic and therapeutic challenge to physicians worldwide. The metastatic setting implies a poor prognosis, with a 5-year survival rate below 40%. Patients with advanced-stage high-grade ESS (HG-ESS) have limited therapeutic options, often involving various chemotherapy regimens. Case Presentation This report depicts the case of a 47-year-old female diagnosed with HG-ESS. She underwent several lines of treatment starting with radiotherapy and brachytherapy, followed by multiple lines of treatment including trabectedin over several months. After retreatment with trabectedin and achieving disease stabilization for 10 months, treatment was optimized by trabectedin combined with radiotherapy, leading to stable disease that is still ongoing and lasts for over 17 months. Conclusion Our case underscores the challenging nature of treating patients with HG-ESS and highlights the safety of long-term retrial with trabectedin, coupled with radiotherapy administration. This approach maintained a durable stable disease response in the metastatic setting.
Collapse
Affiliation(s)
| | | | | | - Inmaculada Rincón
- Radiotherapy Oncology Department, Virgen del Rocio University Hospital, Seville, Spain
| |
Collapse
|
6
|
Miao X, Koch G, Shen S, Wang X, Li J, Shen X, Qu J, Straubinger RM, Jusko WJ. Systems Pharmacodynamic Model of Combined Gemcitabine and Trabectedin in Pancreatic Cancer Cells. Part II: Cell Cycle, DNA Damage Response, and Apoptosis Pathways. J Pharm Sci 2024; 113:235-245. [PMID: 37918792 PMCID: PMC10902796 DOI: 10.1016/j.xphs.2023.10.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 11/04/2023]
Abstract
Despite decades of research efforts, pancreatic adenocarcinoma (PDAC) continues to present a formidable clinical challenge, demanding innovative therapeutic approaches. In a prior study, we reported the synergistic cytotoxic effects of gemcitabine and trabectedin on pancreatic cancer cells. To investigate potential mechanisms underlying this synergistic pharmacodynamic interaction, liquid chromatography-mass spectrometry-based proteomic analysis was performed, and a systems pharmacodynamics model (SPD) was developed to capture pancreatic cancer cell responses to gemcitabine and trabectedin, alone and combined, at the proteome level. Companion report Part I describes the proteomic workflow and drug effects on the upstream portion of the SPD model related to cell growth and migration, specifically the RTK-, integrin-, GPCR-, and calcium-signaling pathways. This report presents Part II of the SPD model. Here we describe drug effects on pathways associated with cell cycle, DNA damage response (DDR), and apoptosis, and provide insights into underlying mechanisms. Drug combination effects on protein changes in the cell cycle- and apoptosis pathways contribute to the synergistic effects observed between gemcitabine and trabectedin. The SPD model was subsequently incorporated into our previously-established cell cycle model, forming a comprehensive, multi-scale quantification platform for evaluating drug effects across multiple scales, spanning the proteomic-, cellular-, and subcellular levels. This approach provides a quantitative mechanistic framework for evaluating drug-drug interactions in combination chemotherapy, and could potentially serve as a tool to predict combinatorial efficacy and assist in target selection.
Collapse
Affiliation(s)
- Xin Miao
- Department of Pharmaceutical Sciences, University at Buffalo, SUNY, Buffalo, NY, USA
| | - Gilbert Koch
- Pediatric Pharmacology and Pharmacometrics Research Center, University of Basel, Children's Hospital, Basel, Switzerland
| | - Shichen Shen
- Department of Biochemistry, School of Medicine and Biomedical Sciences, University at Buffalo, SUNY, Buffalo, NY, USA; New York State Center of Excellence in Bioinformatics & Life Sciences, Buffalo, NY, USA
| | - Xue Wang
- New York State Center of Excellence in Bioinformatics & Life Sciences, Buffalo, NY, USA; Department of Cell Stress Biology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Jun Li
- New York State Center of Excellence in Bioinformatics & Life Sciences, Buffalo, NY, USA
| | - Xiaomeng Shen
- Department of Biochemistry, School of Medicine and Biomedical Sciences, University at Buffalo, SUNY, Buffalo, NY, USA; New York State Center of Excellence in Bioinformatics & Life Sciences, Buffalo, NY, USA
| | - Jun Qu
- Department of Pharmaceutical Sciences, University at Buffalo, SUNY, Buffalo, NY, USA; New York State Center of Excellence in Bioinformatics & Life Sciences, Buffalo, NY, USA
| | - Robert M Straubinger
- Department of Pharmaceutical Sciences, University at Buffalo, SUNY, Buffalo, NY, USA; New York State Center of Excellence in Bioinformatics & Life Sciences, Buffalo, NY, USA; Department of Cell Stress Biology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - William J Jusko
- Department of Pharmaceutical Sciences, University at Buffalo, SUNY, Buffalo, NY, USA.
| |
Collapse
|
7
|
Li C, Qiao S, Kang M, Gao X, Li Z. Combinational use of trabectedin and pegylated liposomal doxorubicin for recurrent ovarian cancer: a meta-analysis of phase III randomized controlled trials. Am J Transl Res 2023; 15:6675-6689. [PMID: 38186978 PMCID: PMC10767539] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 11/28/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND In recent years, pegylated liposomal doxorubicin (PLD) has been widely used to improve the survival of patients with ovarian cancer; however, it is unclear whether the combinational use of PLD with other drugs is more effective. Therefore, this meta-analysis aimed to confirm the efficacy and safety of trabectedin, combined with PLD, in the treatment of recurrent ovarian cancer. METHODS Data corresponding to all eligible clinical trials as of May 15, 2022, was retrieved using several electronic retrieval databases including PubMed, Medical Literature Analysis and Retrieval System Online (MEDLINE), ClinicalTrials.gov, Excerpta Medica Database (EMBASE) and Cochrane Library clinical controlled trials (CENTRAL). Comprehensive hazard ratios (HRs), risk ratios (RRs), and 95% confidence intervals (CIs) were calculated using the Review Manager software 5.4 (RevMan 5.4). RESULTS From two phase III randomized controlled trials, 1248 patients with recurrent ovarian cancer were included in this meta-analysis. Results of meta-analysis revealed that trabectedin, combined with PLD chemotherapy, significantly improved overall survival (OS) in patients with BReast CAncer gene (BRCA)-associated recurrence (HR, 0.49; 95% CI, [0.33-0.73]; P = 0.0004) and platinum-sensitive recurrence whose platinum-free interval (PFI) was 6-12 months (HR, 0.66; 95% CI, [0.52-0.84]; P = 0.0005). In addition, compared with PLD alone, combination therapy significantly improved the progression-free survival (PFS) in patients with recurrent ovarian cancer (HR, 0.86; 95% CI, [0.74-0.99]; P = 0.03). Combination therapy also significantly improved PFS in patients with BRCA-associated recurrence (HR, 0.58; 95% CI, [0.40-0.58]; P = 0.004), and platinum-sensitive recurrence (HR, 0.73; 95% CI, [0.56-0.95]; P = 0.02). Trabectedin combined with PLD was more prone to grade 3-4 toxic side effects than PLD alone (P < 0.05); however, fatal adverse events related to non-toxic side effects occurred. CONCLUSION Trabectedin combined with PLD significantly improves OS and PFS in patients with BRCA-associated and platinum-sensitive recurrent ovarian cancers. The potential use of trabectedin combined with PLD should be selected according to the PFI and BRCA mutation status of patients.
Collapse
Affiliation(s)
- Chao Li
- Department of Obstetrics and Gynecology, Sichuan Provincial People’s Hospital·Qionglai Medical Center HospitalChengdu, Sichuan, The People’s Republic of China
| | - Siyi Qiao
- He UniversityShenyang, Liaoning, The People’s Republic of China
| | - Min Kang
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical UniversityNanning, Guangxi, The People’s Republic of China
| | - Xiaofeng Gao
- Department of Obstetrics and Gynecology, Sichuan Provincial People’s Hospital·Qionglai Medical Center HospitalChengdu, Sichuan, The People’s Republic of China
| | - Zhiru Li
- Department of Oncology, Sichuan Provincial People’s Hospital·Qionglai Medical Center HospitalChengdu, Sichuan, The People’s Republic of China
| |
Collapse
|
8
|
De Martino M, Pellecchia S, Decaussin-Petrucci M, Testa D, Meireles Da Costa N, Pallante P, Chieffi P, Fusco A, Esposito F. Drug-induced inhibition of HMGA and EZH2 activity as a possible therapy for anaplastic thyroid carcinoma. Cell Cycle 2023; 22:2552-2565. [PMID: 38165007 PMCID: PMC10936675 DOI: 10.1080/15384101.2023.2298027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 12/14/2023] [Indexed: 01/03/2024] Open
Abstract
Anaplastic thyroid carcinoma (ATC) is one of the most aggressive and lethal neoplasms in humans, and just limited progresses have been made to extend patient survival and decrease ATC-associated mortality. Thus, the identification of novel therapeutic strategies for treating ATC is needed. Recently, our group has identified two proteins with oncogenic activity, namely HMGA1 and EZH2, with pivotal roles in ATC cancer progression. Therefore, we tested the ability of trabectedin, a HMGA1-targeting drug, and GSK126, an inhibitor of EZH2 enzymatic activity, to impair cell viability of four ATC-derived cell lines. In the present study, we first confirmed the overexpression of HMGA1 and EZH2 in all ATC-derived cell lines and tissues compared to the normal primary thyroid cells and tissues. Then, treatment of the ATC cell lines with trabectedin and GSK126 resulted in a drastic induction of apoptotic cell death, which increased when the ATC cell lines were treated with a combination of both drugs. Conversely, normal primary human thyroid cells did not show any significant reduction in their viability when exposed to the same drugs. Noteworthy, both drugs induced the deregulation of EZH2- and HMGA1-controlled genes. Altogether, these findings propose the combination of trabectedin and GSK126 as possible novel strategy for ATC therapy.
Collapse
Affiliation(s)
- Marco De Martino
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche (DMMBM), Istituto per l’Endocrinologia e l’Oncologia Sperimentale (IEOS) “G. Salvatore”, Consiglio Nazionale delle Ricerche (CNR) c/o, Università degli Studi di Napoli “Federico II”, Naples, Italy
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Simona Pellecchia
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche (DMMBM), Istituto per l’Endocrinologia e l’Oncologia Sperimentale (IEOS) “G. Salvatore”, Consiglio Nazionale delle Ricerche (CNR) c/o, Università degli Studi di Napoli “Federico II”, Naples, Italy
| | | | - Domenico Testa
- Clinic of Otorhinolaryngology, Head and Neck Surgery Unit, Department of Anesthesiology, Surgical and Emergency Science, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Nathalia Meireles Da Costa
- Programa de Carcinogênese Molecular, Instituto Nacional de Câncer - INCA, Rua André Cavalcanti, Rio de Janeiro, Brazil
| | - Pierlorenzo Pallante
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche (DMMBM), Istituto per l’Endocrinologia e l’Oncologia Sperimentale (IEOS) “G. Salvatore”, Consiglio Nazionale delle Ricerche (CNR) c/o, Università degli Studi di Napoli “Federico II”, Naples, Italy
| | - Paolo Chieffi
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Alfredo Fusco
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche (DMMBM), Istituto per l’Endocrinologia e l’Oncologia Sperimentale (IEOS) “G. Salvatore”, Consiglio Nazionale delle Ricerche (CNR) c/o, Università degli Studi di Napoli “Federico II”, Naples, Italy
- Programa de Carcinogênese Molecular, Instituto Nacional de Câncer - INCA, Rua André Cavalcanti, Rio de Janeiro, Brazil
| | - Francesco Esposito
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche (DMMBM), Istituto per l’Endocrinologia e l’Oncologia Sperimentale (IEOS) “G. Salvatore”, Consiglio Nazionale delle Ricerche (CNR) c/o, Università degli Studi di Napoli “Federico II”, Naples, Italy
| |
Collapse
|
9
|
Marquina G, Manzano A, Benavente C, Macias NP, Rivas A, Diaz-Rubio E, Casado A. Results of a Phase II Trial Testing the Resensitization With Trabectedin in Platinum-resistant Ovarian Cancer. Cancer Diagn Progn 2023; 3:302-310. [PMID: 37168968 PMCID: PMC10165368 DOI: 10.21873/cdp.10216] [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] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 04/04/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND/AIM In patients with advanced platinum-resistant ovarian cancer we prospectively evaluated whether trabectedin could resensitize the tumor cells to platinum rechallenge. PATIENTS AND METHODS Upon progression to platinum-based chemotherapy, trabectedin was administered as a 3-hour infusion every three weeks and subsequently crossed over to carboplatin/carboplatin-based combinations. The primary endpoints comprised objective response rate (ORR) and time to progression after trabectedin (TTP Trab). Secondary endpoints included ORR following platinum post-trabectedin, the growth modulation index (GMI) assessed as the ratio of successive TTP to platinum, given after (TTP2) and before (TTP1) trabectedin, quality of life (QoL), and ancillary translational studies. RESULTS Ten patients with platinum-resistant ovarian cancer from a single institution were treated with trabectedin, one of whom achieved a partial response (PR) reaching the ORR of 10% and six had stable disease (SD) for a disease control rate (DCR) of 70%. After the treatment with platinum post-trabectedin, one patient achieved a PR and two had SD, attaining a rate of resensitization to platinum of 37.5%. The median TTP with trabectedin treatment was 15.0 weeks, while eight patients who received platinum post-trabectedin had the median TTP2 of 19.9 weeks. One patient reached the threshold of GMI >1 (12.5%) as indicator of clinical benefit. QoL of patients was not deteriorated with trabectedin. Predictive biomarkers of response to trabectedin and/or re-exposure to platinum could not be identified. CONCLUSION Although trabectedin did not achieve a wide resensitization to platinum in this heavily pretreated platinum-resistant population, a significant number of patients attained disease control.
Collapse
Affiliation(s)
- Gloria Marquina
- Department of Medical Oncology, Hospital Clínico San Carlos, School of Medicine, Complutense University (UCM), IdISSC, Madrid, Spain
| | - Aranzazu Manzano
- Department of Medical Oncology, Hospital Clínico San Carlos, School of Medicine, Complutense University (UCM), IdISSC, Madrid, Spain
| | - Celina Benavente
- Department of Haemathology, Hospital Clínico San Carlos, School of Medicine, Complutense University (UCM), IdISSC, Madrid, Spain
| | | | - Ana Rivas
- Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | - Eduardo Diaz-Rubio
- Department of Medical Oncology, Hospital Clínico San Carlos, School of Medicine, Complutense University (UCM), IdISSC, Madrid, Spain
| | - Antonio Casado
- Department of Medical Oncology, Hospital Clínico San Carlos, School of Medicine, Complutense University (UCM), IdISSC, Madrid, Spain
| |
Collapse
|
10
|
Yoshizawa K, Ohno Y, Kurata T, Takagi Y, Kasai T, Takizawa M, Soejima Y. Primary leiomyosarcoma of the inferior vena cava in a pediatric case: a case report and literature review. Surg Case Rep 2023; 9:52. [PMID: 37022631 PMCID: PMC10079787 DOI: 10.1186/s40792-023-01630-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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 03/22/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND Leiomyosarcoma is classified as a soft tissue sarcoma. In adults, leiomyosarcoma is the most common malignancy affecting the vascular system; however, vascular leiomyosarcoma in children is extremely rare as most pediatric soft tissue tumors are rhabdomyosarcomas. The survival rate is very low, and incomplete resection is a poor prognostic factor. There is also a high rate of distant recurrence, with the lungs and liver being the most common sites of metastasis. There is no established effective chemotherapy, and complete surgical resection is the only potentially curative treatment for leiomyosarcoma. CASE PRESENTATION A 15-year-old female patient with no significant medical history presented with severe upper abdominal pain and was admitted. Abdominal contrast-enhanced computed tomography and magnetic resonance imaging showed a large retroperitoneal tumor protruding into the lumen of the inferior vena cava behind the liver and multiple small nodules, and metastasis to the liver was suspected. The tumor was 6 × 4 × 5 cm in diameter, located just behind the hepatic hilar structures, and was suspected to infiltrate into the right portal vein. The tumor was diagnosed as a leiomyosarcoma through an open tumor biopsy. As the multiple liver metastases were located only in the right lobe of the liver on imaging, we performed tumor resection with right hepatectomy and replacement of the inferior vena cava (IVC). The postoperative course was uneventful; however, on postoperative day 51, distant metastatic recurrences were found in the remaining liver and right lung. The patient was immediately started on chemotherapy and trabectedin proved to be the most effective drug in the treatment regimen; however, severe side effects, such as hepatotoxicity, prevented timely administration, and the patient passed away 19 months after surgery. CONCLUSIONS IVC resection and reconstruction combined with right hepatectomy were able to be safely performed even in a pediatric case. To improve the prognosis of leiomyosarcoma with multiple metastases, an effective treatment strategy combining surgical treatment and chemotherapy, including molecularly targeted drugs, should be established as early as possible.
Collapse
Affiliation(s)
- Kazuki Yoshizawa
- Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, Japan.
| | - Yasunari Ohno
- Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, Japan
| | - Takashi Kurata
- Department of Hematology/Oncology, Nagano Children's Hospital, 3100 Toyoshina, Azumino, Nagano, Japan
| | - Yuki Takagi
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, Japan
| | - Tomoko Kasai
- Department of Surgery, Nagano Children's Hospital, 3100 Toyoshina, Azumino, Nagano, Japan
| | - Momoko Takizawa
- Department of Laboratory Medicine, Shinshu University Hospital, 3-1-1 Asahi, Matsumoto, Nagano, Japan
| | - Yuji Soejima
- Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, Japan
| |
Collapse
|
11
|
Peraza DA, Povo-Retana A, Mojena M, García-Redondo AB, Avilés P, Boscá L, Valenzuela C. Trabectedin modulates macrophage polarization in the tumor-microenvironment. Role of K V1.3 and K V1.5 channels. Biomed Pharmacother 2023; 161:114548. [PMID: 36940615 DOI: 10.1016/j.biopha.2023.114548] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 03/03/2023] [Accepted: 03/14/2023] [Indexed: 03/23/2023] Open
Abstract
Immune cells have an important role in the tumor-microenvironment. Macrophages may tune the immune response toward inflammatory or tolerance pathways. Tumor-associated macrophages (TAM) have a string of immunosuppressive functions and they are considered a therapeutic target in cancer. This study aimed to analyze the effects of trabectedin, an antitumor agent, on the tumor-microenvironment through the characterization of the electrophysiological and molecular phenotype of macrophages. Experiments were performed using the whole-cell configuration of the patch-clamp technique in resident peritoneal mouse macrophages. Trabectedin does not directly interact with KV1.5 and KV1.3 channels, but their treatment (16 h) with sub-cytotoxic concentrations of trabectedin increased their KV current due to an upregulation of KV1.3 channels. In vitro generated TAM (TAMiv) exhibited an M2-like phenotype. TAMiv generated a small KV current and express high levels of M2 markers. K+ current from TAMs isolated from tumors generated in mice is a mixture of KV and KCa, and in TAM isolated from tumors generated in trabectedin-treated mice, the current is mostly driven by KCa. We conclude that the antitumor capacity of trabectedin is not only due to its effects on tumor cells, but also to the modulation of the tumor microenvironment, due, at least in part, to the modulation of the expression of different macrophage ion channels.
Collapse
Affiliation(s)
- Diego A Peraza
- Instituto de Investigaciones Biomédicas Alberto Sols (CSIC-UAM), 28029 Madrid, Spain.
| | - Adrián Povo-Retana
- Instituto de Investigaciones Biomédicas Alberto Sols (CSIC-UAM), 28029 Madrid, Spain
| | - Marina Mojena
- Instituto de Investigaciones Biomédicas Alberto Sols (CSIC-UAM), 28029 Madrid, Spain
| | - Ana B García-Redondo
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain; Hospital La Paz Institute for Health Research (IdiPAZ), 28046 Madrid, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain
| | - Pablo Avilés
- Departamento de Toxicología y Farmacología Preclínica, PharmaMar S.A., 28770 Colmenar Viejo, Madrid, Spain
| | - Lisardo Boscá
- Instituto de Investigaciones Biomédicas Alberto Sols (CSIC-UAM), 28029 Madrid, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain
| | - Carmen Valenzuela
- Instituto de Investigaciones Biomédicas Alberto Sols (CSIC-UAM), 28029 Madrid, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain.
| |
Collapse
|
12
|
Endo M, Kataoka T, Fujiwara T, Tsukushi S, Takahashi M, Kobayashi E, Yamada Y, Tanaka T, Nezu Y, Hiraga H, Wasa J, Nagano A, Nakano K, Nakayama R, Hamada T, Kawano M, Torigoe T, Sakamoto A, Asanuma K, Morii T, Machida R, Sekino Y, Fukuda H, Oda Y, Ozaki T, Tanaka K. Protocol for the 2ND-STEP study, Japan Clinical Oncology Group study JCOG1802: a randomized phase II trial of second-line treatment for advanced soft tissue sarcoma comparing trabectedin, eribulin and pazopanib. BMC Cancer 2023; 23:219. [PMID: 36890471 PMCID: PMC9996999 DOI: 10.1186/s12885-023-10693-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] [Received: 12/29/2022] [Accepted: 02/28/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Soft tissue sarcomas (STS) are a rare type of malignancy comprising a variety of histological diagnoses. Chemotherapy constitutes the standard treatment for advanced STS. Doxorubicin-based regimens, which include the administration of doxorubicin alone or in combination with ifosfamide or dacarbazine, are widely accepted as first-line chemotherapy for advanced STS. Trabectedin, eribulin, pazopanib, and gemcitabine plus docetaxel (GD), which is the empirical standard therapy in Japan, are major candidates for second-line chemotherapy for advanced STS, although clear evidence of the superiority of any one regimen is lacking. The Bone and Soft Tissue Tumor Study Group of the Japan Clinical Oncology Group (JCOG) conducts this trial to select the most promising regimen among trabectedin, eribulin, and pazopanib for comparison with GD as the test arm regimen in a future phase III trial of second-line treatment for patients with advanced STS. METHODS The JCOG1802 study is a multicenter, selection design, randomized phase II trial comparing trabectedin (1.2 mg/m2 intravenously, every 3 weeks), eribulin (1.4 mg/m2 intravenously, days 1 and 8, every 3 weeks), and pazopanib (800 mg orally, every day) in patients with unresectable or metastatic STS refractory to doxorubicin-based first-line chemotherapy. The principal eligibility criteria are patients aged 16 years or above; unresectable and/or metastatic STS; exacerbation within 6 months prior to registration; histopathological diagnosis of STS other than Ewing sarcoma, embryonal/alveolar rhabdomyosarcoma, well-differentiated liposarcoma and myxoid liposarcoma; prior doxorubicin-based chemotherapy for STS, and Eastern Cooperative Oncology Group performance status 0 to 2. The primary endpoint is progression-free survival, and the secondary endpoints include overall survival, disease-control rate, response rate, and adverse events. The total planned sample size to correctly select the most promising regimen with a probability of > 80% is 120. Thirty-seven institutions in Japan will participate at the start of this trial. DISCUSSION This is the first randomized trial to evaluate trabectedin, eribulin, and pazopanib as second-line therapies for advanced STS. We endeavor to perform a subsequent phase III trial comparing the best regimen selected by this study (JCOG1802) with GD. TRIAL REGISTRATION This study was registered with the Japan Registry of Clinical Trials ( jRCTs031190152 ) on December 5, 2019.
Collapse
Affiliation(s)
- Makoto Endo
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomoko Kataoka
- JCOG Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan
| | - Toshifumi Fujiwara
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Satoshi Tsukushi
- Department of Orthopaedic Surgery, Aichi Cancer Center, Nagoya, Japan
| | - Masanobu Takahashi
- Department of Clinical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Eisuke Kobayashi
- Department of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yoko Yamada
- Department of Breast and Medical Oncology, Saitama Cancer Center, Saitama, Japan
| | - Takaaki Tanaka
- Department of Orthopaedic Surgery, Fukui University School of Medicine, Fukui, Japan
| | - Yutaka Nezu
- Department of Musculoskeletal Tumor Surgery, Kanagawa Cancer Center, Yokohama, Japan
| | - Hiroaki Hiraga
- Department of Musculoskeletal Oncology, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan
| | - Junji Wasa
- Division of Orthopaedic Oncology, Shizuoka Cancer Center, Nagaizumi, Japan
| | - Akihito Nagano
- Department of Orthopaedic Surgery, Gifu University School of Medicine, Gifu, Japan
| | - Kenji Nakano
- Department of Medical Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Robert Nakayama
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Tetsuya Hamada
- Department of Orthopaedic Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Masanori Kawano
- Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Yufu City Oita, Hasama, 879-5593, Japan
| | - Tomoaki Torigoe
- Department of Orthopaedic Oncology and Surgery, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Akio Sakamoto
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kunihiro Asanuma
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Japan
| | - Takeshi Morii
- Department of Orthopaedic Surgery, Faculty of Medicine, Kyorin University, Mitaka, Japan
| | - Ryunosuke Machida
- JCOG Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan
| | - Yuta Sekino
- JCOG Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan
| | - Haruhiko Fukuda
- JCOG Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshinao Oda
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshifumi Ozaki
- Department of Orthopaedic Surgery, Science of Functional Recovery and Reconstruction, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Kazuhiro Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Yufu City Oita, Hasama, 879-5593, Japan. .,Department of Advanced Medical Sciences, Oita University, 1-1 Idaigaoka, Yufu City Oita, Hasama, 879-5593, Japan.
| |
Collapse
|
13
|
Abstract
OPINION STATEMENT Myxoid/round-cell liposarcoma (MRCL) account for 30% of liposarcomas and are the most chemo-sensitive subtype of liposarcoma. The 5-year local relapse and distant metastasis rates are 10% and 20%, respectively. In the advanced setting, the first-line median progression-free survival and overall survival is 9 and 30 months, respectively. The overall response rate (ORR) by RECIST with anthracycline-based chemotherapy is around 40% and with trabectedin is 20%, although response is higher when captured by CHOI criteria. Anthracycline-based combination chemotherapy regimens remain the standard of care first-line treatment option. However, trabectedin is also effective and may be considered in the first-line setting when anthracyclines cannot be prescribed. Beyond chemotherapy, new therapeutic classes are being developed, including autologous adoptive modified T cell receptor cellular therapies which have shown promising results thus far. These new therapies utilize the immunogenic potential of cancer testis antigens, NY-ESO-1 and MAGE-A4, which are expressed in the vast majority of MRCL. Early phase trials have shown encouraging results with up to 40% ORR and a median progression-free survival up to 8.7 months. Other innovative strategies are being developed, tailored to the molecular biology of MRCL. This review summarizes current evidence for the use of standard chemotherapy and the new biomarker-selected treatments under development.
Collapse
|
14
|
Cai S, Ding Z, Liu X, Zeng J. Trabectedin induces ferroptosis via regulation of HIF-1α/IRP1/TFR1 and Keap1/Nrf2/GPX4 axis in non-small cell lung cancer cells. Chem Biol Interact 2023; 369:110262. [PMID: 36396105 DOI: 10.1016/j.cbi.2022.110262] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/24/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND OBJECTIVES Non-small cell lung cancer (NSCLC) is a global health concern. NSCLC treatment outcomes are generally poor due to treatment resistance or toxicity. Ferroptosis is a novel cell death triggered by iron accumulation, reactive oxygen species (ROS), and lipid peroxidation. Ferroptosis may kill cancer cells, particularly those resistant to apoptosis. MATERIALS AND METHODS The Cell Counting Kit-8 assay assessed NSCLC cell viability after trabectedin treatment. Flow cytometry with Annexin V-FITC staining evaluated cell death. ROS, iron, lipid peroxidation, and GSH levels were measured using commercial kits. qRT-PCR and western blots evaluated messenger RNA and protein levels. Proteins were inhibited using short interfering RNA transfection and specific inhibitors. RESULTS Trabectedin was cytotoxic to NSCLC cells regardless of p53 status. Trabectedin upregulated iron, ROS, and lipid peroxidation in NSCLC cells, causing ferroptosis. Trabectedin increases iron and ROS levels by upregulating transferrin receptor 1 and the HIF-1/IRP1 axis. In NSCLC cells, trabectedin suppresses glutathione peroxidase 4, followed by the Keap1/Nrf2 axis. CONCLUSIONS Our findings imply that trabectedin may treat NSCLC effectively.
Collapse
Affiliation(s)
- Shunv Cai
- Department of Anesthesiology, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, Zhejiang, People's Republic of China
| | - Zewu Ding
- Department of Anesthesiology, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, Zhejiang, People's Republic of China
| | - Xinyi Liu
- Department of Anesthesiology, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, Zhejiang, People's Republic of China
| | - Jian Zeng
- Department of Thoracic Surgery, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital). Zhejiang Key Laboratory of Diagnosis and Treatment Technology on Thoracic Oncology (Lung and Esophagus), The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, People's Republic of China.
| |
Collapse
|
15
|
Reichinger A. Long-Time Progression-Free Survival with Trabectedin in Chemorefractory Metastatic Leiomyosarcoma of the Retroperitoneum: A Case Report. Case Rep Oncol 2023; 16:1013-1019. [PMID: 37900801 PMCID: PMC10601826 DOI: 10.1159/000533827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 08/24/2023] [Indexed: 10/31/2023] Open
Abstract
We present the case of a 46-year-old mother of a young child who was diagnosed with metastatic leiomyosarcoma. At diagnosis, the tumor had already infiltrated the vena cava, infiltration of the pancreas was suspected, and pulmonary metastases had been histologically confirmed. The goal of treatment was to prolong survival and gain quality time for the family. When the patient had not responded to 4 cycles of doxorubicin, trabectedin was initiated. After an initial partial remission with a reduction in the size of the primary leiomyosarcoma as well as some pulmonary metastases, the disease remained stable for a total of 10 months. Upon progression, the patient did not further respond to subsequent treatment lines. The presented case shows that second-line trabectedin may represent a promising option for patients with chemotherapy-resistant leiomyosarcoma to prolong survival while preserving quality of life.
Collapse
Affiliation(s)
- Andreas Reichinger
- First department of Internal Medicine, Medical Oncology and Hematology, Ordensklinikum Linz, Barmherzige Schwestern, Linz, Austria
| |
Collapse
|
16
|
Lorusso D, Pignata S, Tamberi S, Mangili G, Bologna A, Nicoloso MS, Giolitto S, Salutari V, Mantero M, Pisano C, Bergamini A, Musacchio L, Ronzulli D, Raspagliesi F, Scambia G. Efficacy and safety of trabectedin for the treatment of advanced uterine or ovarian carcinosarcoma: Results of a phase II multicenter clinical trial (MITO-26). Gynecol Oncol 2022; 167:436-443. [PMID: 36220670 DOI: 10.1016/j.ygyno.2022.09.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 07/08/2022] [Revised: 09/09/2022] [Accepted: 09/27/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE This open-label phase II clinical trial evaluated the antitumor activity and safety of trabectedin in patients with advanced ovarian (OC) or uterine carcinosarcomas (UC). METHODS Eligible patients were adults (≥18 years) with histologically proven recurrent OC/UC not amenable to surgery or radiotherapy who received up to two prior chemotherapy lines. Trabectedin 1.3 mg/m2 was administered as a 3-h infusion every three weeks. The primary endpoint was objective response rate (ORR) as per RECIST v.1.1. If at least 8 of 43 patients (18.6%) achieve an objective response, trabectedin would be declared worthy for further investigations. RESULTS Forty-five patients with either OC (n = 32) or UC (n = 13) from seven MITO centers across Italy were enrolled. The ORR was 11.9% (90% CI: 6-23) and included two patients with a complete response and three with a partial response. Eight patients (19.0%) had disease stabilization for a disease control rate of 31.0% (90% CI: 20-44). Median progression-free survival was 2.01 months (95% CI: 1.78-2.30) and median overall survival was 4.64 months (95% CI: 3.19-8.29). Neutrophil count decreases (n = 8, 18.2%) and transaminase increases (n = 6, 13.6%) were the most common grade 3-5 adverse events related with trabectedin. Two patients died due to trabectedin-related grade 5 hematological toxicity. CONCLUSION Although trabectedin did not meet the prespecified activity criteria, it confers modest but clinically meaningful benefit to patients with advanced OC/UC as being as effective as any other available treatment for this indication. The toxicity profile appears in line with that previously reported for the drug.
Collapse
Affiliation(s)
- Domenica Lorusso
- Fondazione Policlinico Universitario A. Gemelli IRCCS and Catholic University of Sacred Heart, Rome, Italy.
| | - Sandro Pignata
- Department of Urology and Gynecology, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS)-Fondazione G. Pascale Napoli, Naples, Italy
| | | | - Giorgia Mangili
- Department of Obstetrics and Gynecology, San Raffaele Hospital, University of Milan, Italy
| | | | | | - Serena Giolitto
- Gynecologic Oncology Unit, Department of Woman, Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Vanda Salutari
- Fondazione Policlinico Universitario A. Gemelli IRCCS and Catholic University of Sacred Heart, Rome, Italy
| | - Mara Mantero
- Fondazione IRCCS National Cancer Institute Milan, Italy
| | - Carmela Pisano
- Department of Urology and Gynecology, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS)-Fondazione G. Pascale Napoli, Naples, Italy
| | - Alice Bergamini
- Department of Obstetrics and Gynecology, San Raffaele Hospital, University of Milan, Italy
| | - Lucia Musacchio
- Fondazione Policlinico Universitario A. Gemelli IRCCS and Catholic University of Sacred Heart, Rome, Italy
| | | | | | - Giovanni Scambia
- Fondazione Policlinico Universitario A. Gemelli IRCCS and Catholic University of Sacred Heart, Rome, Italy
| |
Collapse
|
17
|
Gent DG, Ali N, Olsson-Brown A, Lip GY, Wright DJ, Dobson R. Trabectedin Cardiotoxicity in Soft Tissue Sarcoma: A Case Series and Clinical Insights. Case Rep Oncol 2022; 15:950-959. [PMID: 36636681 PMCID: PMC9830299 DOI: 10.1159/000526256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 07/18/2022] [Indexed: 11/09/2022] Open
Abstract
Trabectedin is a chemotherapeutic used to treat advanced soft tissue sarcoma and relapsed platinum-sensitive ovarian cancer. Although it is associated with a low incidence of cardiotoxicity, when this occurs it can be fatal or significantly compromise the quality of life in patients with advanced cancer. Here, we present a series of 4 cases where trabectedin-treated sarcoma patients developed cardiovascular complications. Similar to previous literature describing this association, all patients had prior treatment with anthracyclines and presented at different time points following treatment initiation. Each patient presented with exertional breathlessness and was found to have severely impaired left ventricular systolic function (ejection fraction ≤35%), and 1 patient had concurrent atrial fibrillation with a fast ventricular rate. All of the patients were treated with neurohormonal blockade, and a multi-disciplinary decision was made to stop trabectedin in 3 patients and continue in 1 patient. Two of the 4 patients had an improvement in their left ventricular systolic function. It is unclear what effect preceeding anthracycline or tyrosine kinase inhibitor treatment has in priming patients to develop cardiotoxicity in this setting. Our case series adds to the evidence surrounding this association and highlights that trabectedin-associated cardiotoxicity can present in an insidious fashion.
Collapse
Affiliation(s)
- David G. Gent
- Liverpool Centre for Cardiovascular Science, University of Liverpool & Liverpool Heart and Chest Hospital, Liverpool, UK,*David G. Gent,
| | - Nasim Ali
- The Clatterbridge Cancer Centre, Wirral, Liverpool, UK
| | | | - Gregory Y.H. Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool & Liverpool Heart and Chest Hospital, Liverpool, UK,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - David J. Wright
- Liverpool Centre for Cardiovascular Science, University of Liverpool & Liverpool Heart and Chest Hospital, Liverpool, UK
| | - Rebecca Dobson
- Liverpool Centre for Cardiovascular Science, University of Liverpool & Liverpool Heart and Chest Hospital, Liverpool, UK
| |
Collapse
|
18
|
Pacifico F, Mellone S, D'Incalci M, Stornaiuolo M, Leonardi A, Crescenzi E. Trabectedin suppresses escape from therapy-induced senescence in tumor cells by interfering with glutamine metabolism. Biochem Pharmacol 2022; 202:115159. [PMID: 35780827 DOI: 10.1016/j.bcp.2022.115159] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/16/2022] [Accepted: 06/27/2022] [Indexed: 01/10/2023]
Abstract
Conventional and targeted cancer therapies may induce a cellular senescence program termed therapy-induced senescence. However, unlike normal cells, cancer cells are able to evade the senescence cell cycle arrest and to resume proliferation, driving tumor recurrence after treatments. Cells that escape from therapy-induced senescence are characterized by a plastic, cancer stem cell-like phenotype, and recent studies are beginning to define their unique metabolic features, such as glutamine dependence. Here, we show that the antineoplastic drug trabectedin suppresses escape from therapy-induced senescence in all cell lines studied, and reduces breast cancer stem-like cells, at concentrations that do not affect the viability of senescent tumor cells. We demonstrate that trabectedin downregulates both the glutamine transporter SLC1A5 and glutamine synthetase, thereby interfering with glutamine metabolism. On the whole, our results indicate that trabectedin targets a glutamine-dependent cancer stem-like cell population involved in evasion from therapy-induced senescence and suggest a therapeutic potential for trabectedin combined with pro-senescence chemotherapy in tumor treatment.
Collapse
Affiliation(s)
- Francesco Pacifico
- Istituto di Endocrinologia ed Oncologia Sperimentale, CNR, 80131 Naples, Italy
| | - Stefano Mellone
- Istituto di Endocrinologia ed Oncologia Sperimentale, CNR, 80131 Naples, Italy
| | - Maurizio D'Incalci
- Department of Biomedical Sciences, Humanitas University, IRCCS Humanitas Research Hospital, 20072 Pieve Emanuele, Milan, Italy
| | - Mariano Stornaiuolo
- Department of Pharmacy, University of Naples Federico II, 80149 Naples, Italy
| | - Antonio Leonardi
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, University of Naples Federico II, 80131 Naples, Italy.
| | - Elvira Crescenzi
- Istituto di Endocrinologia ed Oncologia Sperimentale, CNR, 80131 Naples, Italy.
| |
Collapse
|
19
|
Wang J, Wang P, Zeng Z, Lin C, Lin Y, Cao D, Ma W, Xu W, Xiang Q, Luo L, Wang W, Shi Y, Gao Z, Zhao Y, Liu H, Liu SL. Trabectedin in Cancers: Mechanisms and Clinical Applications. Curr Pharm Des 2022; 28:1949-1965. [PMID: 35619256 DOI: 10.2174/1381612828666220526125806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 04/04/2022] [Indexed: 12/09/2022]
Abstract
Trabectedin, a tetrahydroisoquinoline alkaloid, is the first marine antineoplastic agent approved with special anticancer mechanisms involving DNA binding, DNA repair pathways, transcription regulation and regulation of the tumor microenvironment. It has favorable clinical applications, especially for the treatment of patients with advanced soft tissue sarcoma, who failed in anthracyclines and ifosfamide therapy or could not receive these agents. Currently, trabectedin monotherapy regimen and regimens of combined therapy with other agents are both widely used for the treatment of malignancies, including soft tissue sarcomas, ovarian cancer, breast cancer, and non-small-cell lung cancer. In this review, we summarized the basic information and some updated knowledge on trabectedin, including its molecular structure, metabolism in various cancers, pharmaceutical mechanisms, clinical applications, drug combination, and adverse reactions, along with prospections on its possibly more optimal use in cancer treatment.
Collapse
Affiliation(s)
- Jiali Wang
- Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Heilongjiang, China.,Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Heilongjiang, China
| | - Pengfei Wang
- Genomics Research Center (State-Province Key Laboratories of Biomedicine Pharmaceutics of China), College of Pharmacy, and, Harbin Medical University, Harbin, China.,Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Heilongjiang, China
| | - Zheng Zeng
- Genomics Research Center (State-Province Key Laboratories of Biomedicine Pharmaceutics of China), College of Pharmacy, and, Harbin Medical University, Harbin, China.,Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Heilongjiang, China
| | - Caiji Lin
- Genomics Research Center (State-Province Key Laboratories of Biomedicine Pharmaceutics of China), College of Pharmacy, and, Harbin Medical University, Harbin, China.,Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Heilongjiang, China
| | - Yiru Lin
- Genomics Research Center (State-Province Key Laboratories of Biomedicine Pharmaceutics of China), College of Pharmacy, and, Harbin Medical University, Harbin, China.,Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Heilongjiang, China
| | - Danli Cao
- Genomics Research Center (State-Province Key Laboratories of Biomedicine Pharmaceutics of China), College of Pharmacy, and, Harbin Medical University, Harbin, China.,Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Heilongjiang, China
| | - Wenqing Ma
- Genomics Research Center (State-Province Key Laboratories of Biomedicine Pharmaceutics of China), College of Pharmacy, and, Harbin Medical University, Harbin, China.,Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Heilongjiang, China
| | - Wenwen Xu
- Genomics Research Center (State-Province Key Laboratories of Biomedicine Pharmaceutics of China), College of Pharmacy, and, Harbin Medical University, Harbin, China.,Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Heilongjiang, China
| | - Qian Xiang
- Genomics Research Center (State-Province Key Laboratories of Biomedicine Pharmaceutics of China), College of Pharmacy, and, Harbin Medical University, Harbin, China.,Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Heilongjiang, China
| | - Lingjie Luo
- Genomics Research Center (State-Province Key Laboratories of Biomedicine Pharmaceutics of China), College of Pharmacy, and, Harbin Medical University, Harbin, China.,Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Heilongjiang, China
| | - Wenxue Wang
- Genomics Research Center (State-Province Key Laboratories of Biomedicine Pharmaceutics of China), College of Pharmacy, and, Harbin Medical University, Harbin, China.,Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Heilongjiang, China
| | - Yongwei Shi
- Genomics Research Center (State-Province Key Laboratories of Biomedicine Pharmaceutics of China), College of Pharmacy, and, Harbin Medical University, Harbin, China.,Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Heilongjiang, China
| | - Zixiang Gao
- Genomics Research Center (State-Province Key Laboratories of Biomedicine Pharmaceutics of China), College of Pharmacy, and, Harbin Medical University, Harbin, China.,Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Heilongjiang, China
| | - Yufan Zhao
- Genomics Research Center (State-Province Key Laboratories of Biomedicine Pharmaceutics of China), College of Pharmacy, and, Harbin Medical University, Harbin, China.,Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Heilongjiang, China
| | - Huidi Liu
- Genomics Research Center (State-Province Key Laboratories of Biomedicine Pharmaceutics of China), College of Pharmacy, and, Harbin Medical University, Harbin, China.,Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, T2N 4N1, Canada
| | - Shu-Lin Liu
- Genomics Research Center (State-Province Key Laboratories of Biomedicine Pharmaceutics of China), College of Pharmacy, and, Harbin Medical University, Harbin, China.,Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Heilongjiang, China.,Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, T2N 4N1, Canada
| |
Collapse
|
20
|
Cerdà Serdà P, Terés R, Sebio A, Bagué S, Orellana R, Moreno ME, Riba M, López-Pousa A. Single-Center Experience with Trabectedin for the Treatment of Non-L-sarcomas. Adv Ther 2022; 39:1596-610. [PMID: 35129790 DOI: 10.1007/s12325-022-02051-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 01/17/2022] [Indexed: 11/01/2022]
Abstract
INTRODUCTION The effectiveness of trabectedin for the treatment of leiomyosarcoma and liposarcoma (commonly referred to as L-sarcomas) has been widely evidenced in clinical trials and real-world studies. Nevertheless, available literature on non-L-sarcomas is less abundant. The objective of the present study is to evaluate the effectiveness and safety of trabectedin in a cohort of patients with non-L-sarcomas in the real-world setting. METHODS This retrospective, observational study included 34 patients who received trabectedin in the Hospital de la Santa Creu i Sant Pau (Barcelona, Spain) between October 2013 and July 2020. RESULTS The most frequent histologic subtypes were undifferentiated spindle cell/pleomorphic sarcoma (n = 11, 32.4%), synovial sarcoma (n = 6, 17.7%), myxofibrosarcoma (n = 5, 14.7%), and malignant peripheral nerve sheath tumor (n = 4, 11.8%). The mean number of cycles with trabectedin was 5.5 (range 2-28). Three patients achieved partial response (8.8%) and eight patients showed stable disease (23.5%). The objective response rate and disease control rate were 8.8% (95% confidence interval (CI), 95% CI 1.9-23.7) and 32.4% (95% CI 17.4-50.5), respectively. Overall, progression-free survival was 2.9 months (95% CI 2.1-3.4). The overall survival was 7.3 months (95% CI 4.7-12.8). The most common trabectedin-related grade 3 adverse events were observed in 10 patients (26.5%), mostly being neutropenia (14.7%) and elevated transaminases (5.9%), whereas one patient (2.9%) reported grade 4 febrile neutropenia that required hospitalization. CONCLUSIONS The findings of this real-life study consistently support that trabectedin is an effective and safe option for the treatment of patients with non-L-sarcoma after failure of anthracyclines and ifosfamide, or in patients who are unsuited to receive these agents.
Collapse
|
21
|
Zhou DDX, King D, Thomson K, Grimison P. Trabectedin for metastatic liposarcoma and leiomyosarcoma: Comparison of real-world experience in an Australian sarcoma specialist center to pivotal clinical trial results. Asia Pac J Clin Oncol 2022; 18:e526-e528. [PMID: 35297193 DOI: 10.1111/ajco.13764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 01/27/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Deborah Di-Xin Zhou
- Medical Oncology Department, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Daniel King
- Medical Oncology Department, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Katie Thomson
- Medical Oncology Department, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Peter Grimison
- Medical Oncology Department, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| |
Collapse
|
22
|
Reuben DY. A Prolonged Response and Characteristics of Trabectedin Treatment of Metastatic Soft Tissue Sarcoma. J Med Cases 2021; 12:160-163. [PMID: 34434451 PMCID: PMC8383654 DOI: 10.14740/jmc3655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 01/18/2021] [Accepted: 01/25/2021] [Indexed: 11/26/2022] Open
Abstract
Unique features and treatment effects of trabectedin are presented in consideration of soft tissue sarcoma management. A prolonged time on trabectedin through 59 cycles is shown. This is one of the longer reported uses of trabectedin successfully to control disease. Adjunctive cytoreduction options with surgery, radiation or ablation are presented. Future studies would be helpful to investigate treatment holidays, the impact of multi-modality care and assessment of genetics of clonal metastases. This may assist in guiding and selecting patients for priority treatment with trabectedin.
Collapse
Affiliation(s)
- Daniel Y Reuben
- Division of Hematology and Oncology, Hollings Cancer Center, Medical University of South Carolina, MSC# 635, 39 Sabin Street, Charleston, SC 29425, USA.
| |
Collapse
|
23
|
Mannarino L, Craparotta I, Ballabio S, Frapolli R, Meroni M, Bello E, Panini N, Callari M, Sanfilippo R, Casali PG, Barisella M, Fabbroni C, Marchini S, D'Incalci M. Mechanisms of responsiveness to and resistance against trabectedin in murine models of human myxoid liposarcoma. Genomics 2021; 113:3439-3448. [PMID: 34339817 DOI: 10.1016/j.ygeno.2021.07.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 05/03/2021] [Revised: 06/18/2021] [Accepted: 07/29/2021] [Indexed: 10/20/2022]
Abstract
Myxoid liposarcoma (MLPS) is a rare soft-tissue sarcoma characterised by the expression of FUS-DDIT3 chimera. Trabectedin has shown significant clinical anti-tumour activity against MLPS. To characterise the molecular mechanism of trabectedin sensitivity and of resistance against it, we integrated genomic and transcriptomic data from treated mice bearing ML017 or ML017/ET, two patient-derived MLPS xenograft models, sensitive to and resistant against trabectedin, respectively. Longitudinal RNA-Seq analysis of ML017 showed that trabectedin acts mainly as a transcriptional regulator: 15 days after the third dose trabectedin modulates the transcription of 4883 genes involved in processes that sustain adipocyte differentiation. No such differences were observed in ML017/ET. Genomic analysis showed that prolonged treatment causes losses in 4p15.2, 4p16.3 and 17q21.3 cytobands leading to acquired-resistance against the drug. The results dissect the complex mechanism of action of trabectedin and provide the basis for novel combinatorial approaches for the treatment of MLPS that could overcome drug-resistance.
Collapse
Affiliation(s)
- Laura Mannarino
- Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, 20072 Pieve Emanuele - Milan, Italy.; Laboratory of Cancer Pharmacology, IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano - Milan, Italy
| | - Ilaria Craparotta
- Department of Oncology, Istituto di Ricerche Farmacologiche "Mario Negri" IRCCS, via Mario Negri 2, 20156 Milan, Italy
| | - Sara Ballabio
- Department of Oncology, Istituto di Ricerche Farmacologiche "Mario Negri" IRCCS, via Mario Negri 2, 20156 Milan, Italy
| | - Roberta Frapolli
- Department of Oncology, Istituto di Ricerche Farmacologiche "Mario Negri" IRCCS, via Mario Negri 2, 20156 Milan, Italy
| | - Marina Meroni
- Department of Oncology, Istituto di Ricerche Farmacologiche "Mario Negri" IRCCS, via Mario Negri 2, 20156 Milan, Italy
| | - Ezia Bello
- Department of Oncology, Istituto di Ricerche Farmacologiche "Mario Negri" IRCCS, via Mario Negri 2, 20156 Milan, Italy
| | - Nicolò Panini
- Department of Oncology, Istituto di Ricerche Farmacologiche "Mario Negri" IRCCS, via Mario Negri 2, 20156 Milan, Italy
| | - Maurizio Callari
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, UK
| | - Roberta Sanfilippo
- Adult Mesenchymal Tumour Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy
| | - Paolo G Casali
- Adult Mesenchymal Tumour Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy
| | - Marta Barisella
- Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Chiara Fabbroni
- Adult Mesenchymal Tumour Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy
| | - Sergio Marchini
- Laboratory of Cancer Pharmacology, IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano - Milan, Italy
| | - Maurizio D'Incalci
- Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, 20072 Pieve Emanuele - Milan, Italy.; Laboratory of Cancer Pharmacology, IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano - Milan, Italy..
| |
Collapse
|
24
|
Souid S, Aissaoui D, Srairi-Abid N, Essafi-Benkhadir K. Trabectedin (Yondelis®) as a Therapeutic Option in Gynecological Cancers: A Focus on its Mechanisms of Action, Clinical Activity and Genomic Predictors of Drug Response. Curr Drug Targets 2021; 21:996-1007. [PMID: 31994460 DOI: 10.2174/1389450121666200128161733] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 10/25/2019] [Accepted: 11/20/2019] [Indexed: 02/07/2023]
Abstract
The use of predictive biomarkers provides potential individualized cancer therapeutic options to prevent therapy failure as well as serious toxicities. Several recent studies showed that predictive and prognostic biomarkers are a notable personalized strategy to improve patients' care in several cancers. Trabectedin (Yondelis®) is a cytotoxic agent, derived from a marine organism, harbouring a significant antitumor activity against several cancers such as soft tissue sarcoma, ovarian, and breast cancers. Recently and with the advent of molecular genetic testing, BRCA mutational status was found as an important predictor of response to this anticancer drug, especially in gynecological cancers. The aim of this updated review is to discuss the mechanisms of action of trabectedin against the wellknown cancer hallmarks described until today. The current advances were also examined related to genomic biomarkers that can be used in the future to predict the efficacy of this potent anticancer natural molecule in various gynecological cancers.
Collapse
Affiliation(s)
- Soumaya Souid
- Universite de Tunis El Manar, Institut Pasteur de Tunis, LR16IPT04 Epidemiologie Moleculaire et Pathologie Experimentale appliquee aux Maladies infectieuses, 1002, Tunis, Tunisia
| | - Dorra Aissaoui
- Universite de Tunis El Manar, Institut Pasteur de Tunis, LR16IPT08 Venins et biomolecules therapeutiques, 1002, Tunis, Tunisia
| | - Najet Srairi-Abid
- Universite de Tunis El Manar, Institut Pasteur de Tunis, LR16IPT08 Venins et biomolecules therapeutiques, 1002, Tunis, Tunisia
| | - Khadija Essafi-Benkhadir
- Universite de Tunis El Manar, Institut Pasteur de Tunis, LR16IPT04 Epidemiologie Moleculaire et Pathologie Experimentale appliquee aux Maladies infectieuses, 1002, Tunis, Tunisia
| |
Collapse
|
25
|
Takahashi S, Takekuma M, Tamura K, Takehara K, Nomura H, Ono M, Yunokawa M, Aoki D. A phase I study of combined trabectedin and pegylated liposomal doxorubicin therapy for advanced relapsed ovarian cancer. Int J Clin Oncol 2021; 26:1977-1985. [PMID: 34189636 PMCID: PMC8449774 DOI: 10.1007/s10147-021-01973-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 06/16/2021] [Indexed: 10/26/2022]
Abstract
BACKGROUND Advanced relapsed ovarian cancer has a poor prognosis, and treatment options are limited. METHODS This phase I trial investigated the dosage, safety, pharmacokinetics and efficacy of trabectedin plus pegylated liposomal doxorubicin (PLD) in Japanese patients with advanced relapsed ovarian, fallopian tube, or primary peritoneal cancer. Patients received trabectedin 0.9 or 1.1 mg/m2 immediately after PLD 30 mg/m2; both drugs were given by intravenous infusion. Treatment was repeated every 21 days until disease progression or unacceptable toxicity. The maximum tolerated dose (MTD) was determined in an initial dose escalation phase, and this was used in a subsequent safety assessment phase. Safety and tumor response were monitored throughout the trial, and drug concentrations for pharmacokinetic analysis were measured during cycle 1. RESULTS Eighteen patients were included. The MTD of trabectedin was determined as 1.1 mg/m2. Gastrointestinal adverse events were experienced by all patients, but were mostly grade 1 or 2 in intensity. Most patients had grade ≥ 3 elevations in transaminase levels or grade ≥ 3 reductions in neutrophil count, but these events were generally manageable through dose reduction and/or supportive therapies, as appropriate. There were no deaths during the trial. Trabectedin exposure increased in a dose-dependent manner. The overall response rate was 27.8%. CONCLUSIONS Trabectedin, in combination with PLD, may have clinical benefits in Japanese patients with relapsed advanced ovarian cancer. The recommended dosage of trabectedin for further study in this population is 1.1 mg/m2 once every 21 days. CLINICAL TRIAL REGISTRATION NUMBER JapicCTI-163164.
Collapse
Affiliation(s)
- Shunji Takahashi
- Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-0063, Japan
| | - Munetaka Takekuma
- Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan
| | - Kenji Tamura
- National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.,Shimane University Hospital, 89-1 Enya-cho, Izumo-shi, Shimane, 693-8501, Japan
| | - Kazuhiro Takehara
- National Hospital Organization Shikoku Cancer Center, 160 Kou, Minamiumemotomachi, Matsuyama-shi, Ehime, 791-0245, Japan
| | - Hiroyuki Nomura
- Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.,Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - Makiko Ono
- Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-0063, Japan
| | - Mayu Yunokawa
- Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-0063, Japan
| | - Daisuke Aoki
- Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| |
Collapse
|
26
|
Romero I, López-Guerrero JA, Pignata S. Real-world experience with trabectedin for the treatment of recurrent ovarian cancer. Expert Rev Anticancer Ther 2021; 21:1089-1095. [PMID: 34128757 DOI: 10.1080/14737140.2021.1941890] [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] [Indexed: 10/21/2022]
Abstract
Introduction: The efficacy and safety of trabectedin/pegylated liposomal doxorubicin (trabectedin/PLD) in patients with recurrent ovarian cancer have been demonstrated in randomized clinical studies. Real-world evidence is a subsequent necessary step for completing information from clinical practice. In the case of trabectedin/PLD, this evidence derives from prospective studies, retrospective analyses, and case series.Areas covered: The present narrative review provides the most relevant data about efficacy and safety of trabectedin/PLD in real-world studies, and the interpretation of the experience with trabectedin/PLD in clinical practice for patients with recurrent ovarian cancer.Expert opinion: Trabectedin/PLD has a proven antitumor activity that is maintained when administered in advanced lines. Trabectedin/PLD in patients who have relapsed between 6 and 12 months have showed comparable survival outcomes than platinum-based regimens. Moreover, the administration of trabectedin/PLD was associated with a positive survival trend after two previous platinum lines and a significantly superior PFS after subsequent platinum-based therapy. Additionally, the activity of trabectedin seems to be increased in patients with BRCA-mutated ovarian cancer. Overall, real-word evidence has confirmed that trabectedin/PLD is an effective and safe non-platinum combination for advanced lines of chemotherapy in patients with platinum-sensitive recurrent ovarian cancer.
Collapse
Affiliation(s)
- Ignacio Romero
- outpatient services, Fundación Instituto Valenciano De Oncología, Valencia, Spain
| | | | - Sandro Pignata
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Napoli, Italy
| |
Collapse
|
27
|
De Vita A, Recine F, Miserocchi G, Pieri F, Spadazzi C, Cocchi C, Vanni S, Liverani C, Farnedi A, Fabbri F, Fausti V, Casadei R, Brandolini F, Ercolani G, Cavaliere D, Bongiovanni A, Riva N, Gurrieri L, Di Menna G, Calpona S, Debonis SA, Mercatali L, Ibrahim T. The potential role of the extracellular matrix in the activity of trabectedin in UPS and L-sarcoma: evidences from a patient-derived primary culture case series in tridimensional and zebrafish models. J Exp Clin Cancer Res 2021; 40:165. [PMID: 33975637 DOI: 10.1186/s13046-021-01963-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 04/26/2021] [Indexed: 12/26/2022]
Abstract
Background Soft tissue sarcomas (STS) are a rare group of solid neoplasm including among others liposarcoma, leiomyosarcoma (L-sarcoma) and undifferentiated pleomorphic sarcoma (UPS) entities. The current first-line treatment is represented by anthracycline based- regimens, second-line may include trabectedin. Currently the activity of trabectedin and its mechanism of action is not completely elucidated. Methods Taking the advantages of our 3D patient-derived primary culture translational model we performed genomic-, chemobiogram, proteomic- and in vivo analysis in a UPS culture (S1). Furthermore pharmacological profiling of a UPS and L-sarcoma patient-derived case series and in silico analysis were carried out. Results Trabectedin exhibited an increased activity in 3D respect to 2D cultures suggesting an extracellular matrix (ECM) and timp1 involvement in its mechanism of action. Moreover 3D S1 xenotranspanted zebrafish model showed an increased sensitivity to trabectedin. Finally the results were further validated in a UPS and L-sarcoma case series. Conclusions Taken together these results confirmed the activity of trabectedin in these STS histotypes. Moreover the data underline the ECM involvement in the cytotoxic effect mediated by trabectedin and could open the door for researches aimed to focus on the patient setting that could benefit from this agent. Supplementary Information The online version contains supplementary material available at 10.1186/s13046-021-01963-1.
Collapse
|
28
|
Chukwueke UN, Wen PY. Medical management of meningiomas. Handb Clin Neurol 2021; 170:291-302. [PMID: 32586501 DOI: 10.1016/b978-0-12-822198-3.00048-3] [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] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Meningiomas are the most frequently occurring primary brain tumors in adults, representing almost one-third of all primary central nervous system tumors. Several factors have been suggested as an underlying cause in the development of meningiomas, such as ionizing radiation (therapeutic or other incidental exposure), hormonal factors, and genetic predisposition syndromes. Other established factors associated with meningiomas include age, female gender, and those from non-Hispanic Black backgrounds. Though the 2016 World Health Organization Classification of Brain Tumors largely preserves the existing grading scheme for organization of meningioma, there is increasing understanding of the molecular factors underlying the development of meningioma, some of which now form the basis for active clinical investigation. The mainstay of treatment has been the combination of radiation therapy and surgery, with a limited role for systemic therapy due to low efficacy, short duration of treatment response, and lack of uniform response criteria. Similar to other primary and metastatic brain tumors, immune-based therapies hold promise and are still under investigation.
Collapse
Affiliation(s)
- Ugonma N Chukwueke
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, MA, United States; Division of Neuro-Oncology, Department of Neurology, Brigham and Women's Hospital, Boston, MA, United States
| | - Patrick Y Wen
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, MA, United States; Division of Neuro-Oncology, Department of Neurology, Brigham and Women's Hospital, Boston, MA, United States.
| |
Collapse
|
29
|
Broto JM, Jones RL. Current Reality of Treating Advanced Soft Tissue Sarcoma as Illustrated by Case Studies. Oncology 2021; 99 Suppl 1:8-16. [PMID: 33849013 DOI: 10.1159/000515366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 02/12/2021] [Indexed: 11/19/2022]
Abstract
In the first-line setting of advanced soft tissue sarcomas (STS), the treatment aim generally drives decision-making. Anthracycline combinations with ifosfamide or dacarbazine are more appropriate when the aim is tumour shrinkage, and doxorubicin monotherapy is suitable for tumour control. In patients who progress on anthracycline-based regimens, scope exists for tumour shrinkage with trabectedin and concurrent low-dose radiotherapy. Selecting systemic treatment for patients with advanced STS unsuited to receive standard anthracycline-based therapy often involves complex decision-making as clinical trial evidence comparing alternative options is lacking. Key factors to consider are patient characteristics (e.g., age, medical history, performance status), disease characteristics (e.g., stage, histology), and treatment requirements such as the drug's safety profile, evidence of efficacy by subtype, and approved indication as an alternative first-line treatment option. Real-world data for elderly STS patients derived from retrospective studies and post hoc analyses of clinical trials have particular value in guiding treatment selection and improving the management of this populous but undertreated segment of the STS population.
Collapse
Affiliation(s)
- Javier Martín Broto
- Biomedicine Institute of Seville (IBIS), Medical Oncology Department, Virgen del Rocio University Hospital, Sevilla, Spain
| | - Robin L Jones
- Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom
| |
Collapse
|
30
|
Pignata S, Scambia G, Villanucci A, Naglieri E, Ibarbia MA, Brusa F, Bourgeois H, Sorio R, Casado A, Reichert D, Dopchie C, De Rivas B, de Sande LM. A European, Observational, Prospective Trial of Trabectedin Plus Pegylated Liposomal Doxorubicin in Patients with Platinum-Sensitive Ovarian Cancer. Oncologist 2021; 26:e658-e668. [PMID: 33289956 PMCID: PMC8018301 DOI: 10.1002/onco.13630] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 11/25/2020] [Indexed: 12/31/2022] Open
Abstract
PURPOSE The noninterventional, prospective NIMES-ROC phase IV study (NCT02825420) evaluated trabectedin plus pegylated liposomal doxorubicin (PLD) in real-life clinical practice. PATIENTS AND METHODS Eligible participants included adults with platinum-sensitive recurrent ovarian cancer (PS-ROC) who had received one or more cycles of trabectedin/PLD before inclusion according to the marketing authorization. The primary endpoint was progression-free survival (PFS) according to investigator criteria. RESULTS Two hundred eighteen patients from five European countries were evaluated, 72.5% of whom were pretreated with at least two prior chemotherapy lines and received a median of six cycles of trabectedin/PLD (range: 1-24). Median PFS was 9.46 months (95% confidence interval [CI], 7.9-10.9), and median overall survival (OS) was 23.56 months (95% CI, 18.1-34.1). Patients not pretreated with an antiangiogenic drug obtained larger median PFS (p < .007) and OS (p < .048), largely owning to differences between the two populations. Twenty-four patients (11.0%) had a complete response, and 57 patients (26.1%) achieved a partial response for an objective response rate (ORR) of 37.2%. Fifty-nine patients (27.1%) had disease stabilization for a disease control rate of 64.2%. No statistically significant difference in PFS, OS, or ORR was observed by BRCA1/2 status and platinum sensitivity. Most common grade 3/4 adverse events (AEs) were neutropenia (30.3%), anemia (6.4%), thrombocytopenia (5.5%), and asthenia (5.0%). No deaths attributed to treatment-related AEs or unexpected AEs occurred. CONCLUSION The combination of trabectedin/PLD represents a clinically meaningful and safe option for patients with PS-ROC regardless of prior treatment with an antiangiogenic drug, being comparable with previously observed outcomes in selected and less pretreated patients from clinical trials. IMPLICATIONS FOR PRACTICE This noninterventional, prospective study, conducted in 57 reference sites across Europe, consistently confirmed that trabectedin plus pegylated liposomal doxorubicin (PLD) in routine clinical practice represents a clinically meaningful and safe option for women with platinum-sensitive recurrent ovarian cancer. Although the study population represented a heterogeneous, older, and more pretreated population than those in prospective clinical trials, the combination of trabectedin plus PLD induced comparable clinical benefits, with a similar and manageable safety profile. Overall, these findings show that trabectedin in combination with PLD maintains antitumor activity when administered to heavily pretreated patients in real-life clinical practice.
Collapse
Affiliation(s)
- Sandro Pignata
- Department of Urology and Gynecology, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS)–Fondazione G. Pascale NapoliNaplesItaly
| | | | - Alessandro Villanucci
- Unità Ospedaliera (UO) Translational Oncology, Department of Oncology, Azienda Ospedaliero Universitaria Careggi FirenzeFlorenceItaly
| | | | | | | | | | - Roberto Sorio
- Centro di Riferimento Oncologico di Aviano–IRCCSAvianoItaly
| | | | - Dietmar Reichert
- Onkologie Westerstede, Medizinische Studiengesellschaft Nord‐West GmbHWesterstedeGermany
| | - Catherine Dopchie
- Centre Hospitalier Wallonie Picarde site Institut Médico‐Chirurgical, Centre Hospitalier Wallonie PicardeTournaiBelgium
| | | | | |
Collapse
|
31
|
Casagrande N, Borghese C, Favero A, Vicenzetto C, Aldinucci D. Trabectedin overcomes doxorubicin-resistance, counteracts tumor-immunosuppressive reprogramming of monocytes and decreases xenograft growth in Hodgkin lymphoma. Cancer Lett 2020; 500:182-193. [PMID: 33326840 DOI: 10.1016/j.canlet.2020.12.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [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: 03/06/2020] [Revised: 09/25/2020] [Accepted: 12/09/2020] [Indexed: 12/14/2022]
Abstract
Classical Hodgkin lymphoma (cHL) tumor cells are surrounded by a protective tumor microenvironment (TME). Trabectedin, an anticancer drug targeting both tumor cells and TME, demonstrated a potent antitumor activity against Hodgkin Reed Sternberg (HRS) cells. It was cytotoxic against cHL cell lines, including the doxorubicin-resistant clones, with subnanomolar IC50 values, and inhibited clonogenic growth and heterospheroid cell viability. It induced necroptosis, caused DNA damage, G2/M cell cycle arrest, and increased reactive oxygen species production. It reduced HRS cell secretion of CCL5, M-CSF, IL-6, IL-13 and TARC, and inhibited migration. Conditioned medium from trabectedin-treated HRS cells was less chemoattractive toward monocytes, mesenchymal stromal cells and lymphocytes, and less effective in educating monocytes to become immunosuppressive macrophages. These monocytes expressed lower levels of indoleamine 2,3-dioxygenase-1, CD206 and PD-L1, secreted lower amounts of IL-10, TARC, and TGF-β, and were less able to inhibit the growth of activated lymphocytes. In vivo, trabectedin inhibited by >75% the growth of cHL murine xenografts with minimal weight loss; tumors of trabectedin-treated mice had fewer TAMs and less angiogenesis. Altogether, this study offers a preclinical rationale for trabectedin use as a new drug candidate in relapsed/refractory cHL patients.
Collapse
Affiliation(s)
- Naike Casagrande
- Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, PN, Italy
| | - Cinzia Borghese
- Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, PN, Italy
| | - Andrea Favero
- Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, PN, Italy
| | - Cristina Vicenzetto
- Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, PN, Italy
| | - Donatella Aldinucci
- Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, PN, Italy.
| |
Collapse
|
32
|
Evangelisti G, Barra F, D'Alessandro G, Tantari M, Stigliani S, Della Corte L, Bifulco G, Ferrero S. Trabectedin for the therapy of ovarian cancer. Drugs Today (Barc) 2020; 56:669-688. [PMID: 33185631 DOI: 10.1358/dot.2020.56.10.3187001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Trabectedin is a marine-derivate antitumor drug with a relevant cytotoxic activity and good safety profile. It has been investigated for the treatment of solid diseases, including ovarian cancer (OC), breast cancer, and soft-tissue sarcoma. In 2009, results from the pivotal trial OVA-301 led the European Medicines Agency (EMA) to the approval of trabectedin in combination with PEGylated liposomal doxorubicin for the treatment of platinum-sensitive recurrent OC; further studies revealed an additional benefit also in the subgroup of patients with partially platinum-sensitive disease and in those with a BRCA-mutated status. Additionally, trabectedin demonstrated to prolong the time interval to the subsequent chemotherapy line. Recently, the improved understanding of the antitumor action exerted by trabectedin paved the way to new investigational trials exploring its combination with targeted therapies.
Collapse
Affiliation(s)
- G Evangelisti
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
| | - F Barra
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy.
| | - G D'Alessandro
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
| | - M Tantari
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
| | - S Stigliani
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
| | - L Della Corte
- Department of Neurosciences and Reproductive Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - G Bifulco
- Department of Neurosciences and Reproductive Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - S Ferrero
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
| |
Collapse
|
33
|
de Sande González LM, Martin-Broto J, Kasper B, Blay JY, Le Cesne A. Real-world evidence of the efficacy and tolerability of trabectedin in patients with advanced soft-tissue sarcoma. Expert Rev Anticancer Ther 2020; 20:957-963. [PMID: 32930637 DOI: 10.1080/14737140.2020.1822744] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 02/07/2023]
Abstract
INTRODUCTION The efficacy and tolerability of trabectedin in patients with soft tissue sarcoma (STS) have been confirmed by various clinical studies involving lipo- and leiomyosarcomas as well as many other subtypes including translocation-related sarcomas. These data have been obtained from randomized phase II and III clinical trials. Studies in real-world clinical practice are necessary to bridge the efficacy-effectiveness gap and complete the body of evidence. Furthermore, reinforcing clinical experience with data from routine clinical practice allows drug management to be optimized and clinical benefits to be maximized. AREAS COVERED The present review provides the most significant data on the efficacy of trabectedin in real-world studies, and the interpretation of real-world experience with trabectedin, in patients with advanced STS. EXPERT OPINION Trabectedin has demonstrated durable disease control and an adequate safety profile, indicating it to be a suitable long-term treatment drug associated with a good quality of life. Personalized strategies and individualized objectives are the way forward in the management of STS.
Collapse
Affiliation(s)
| | - Javier Martin-Broto
- MUsculoSkeletal Tumor Board of Excellence Sevilla (MUSTBE SEVILLA), Virgen del Rocío University Hospital , Sevilla, Spain
| | - Bernd Kasper
- Sarcoma Unit, Interdisciplinary Tumor Center Mannheim, University Medical Center, University of Heidelberg, Theodor‑Kutzer‑Ufer , Mannheim, Germany
| | - Jean-Yves Blay
- Medical Oncology Department, Centre Léon Bérard , Lyon, France.,Medical Oncology Department, Université Claude Bernard Lyon I , Lyon, France
| | - Axel Le Cesne
- Medical Oncology Department, Gustave Roussy , Villejuif, France
| |
Collapse
|
34
|
Tansir G, Rastogi S, Barwad A, Dhamija E. Long lasting response with trabectedin monotherapy in relapsed metastatic mesenchymal chondrosarcoma. Clin Sarcoma Res 2020; 10:16. [PMID: 32864096 PMCID: PMC7453529 DOI: 10.1186/s13569-020-00138-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 05/19/2020] [Accepted: 08/14/2020] [Indexed: 11/10/2022] Open
Abstract
Background Mesenchymal chondrosarcoma is an exceedingly rare malignancy, accounting for around 5% of all patients with chondrosarcoma. It is a translocation-related sarcoma that tends to have both local and distant recurrences. Surgery is the mainstay of treatment in localised cases however treatment of advanced cases remains a challenge. The rarity of the disease precludes dedicated clinical trials and hence guidelines for its management are not well defined. The dearth in literature makes it pertinent that the cases treated with newer therapies must be reported to contribute to existing knowledge. Case presentation We hereby report a case of a 39-year old male without any comorbidity presenting with pelvic pain and was diagnosed as mesenchymal chondrosarcoma of the pelvis. He underwent an initial curative resection followed by a disease-free interval of 7 months. Subsequently, he was treated with pulmonary metastatectomy and local debulking surgery at time of initial relapse. He was then exposed to multiple lines of palliative chemotherapy, which limited our treatment options upon subsequent disease progression. Based on recent data, the patient was given trabectedin monotherapy as fourth line chemotherapy. He tolerated the therapy well and attained a progression-free survival of 12 months, which is an impactful figure in relapsed setting in this patient population. Conclusion This report aims to present a comprehensive review into available and newer treatment choices for mesenchymal chondrosarcoma, and to highlight trabectedin monotherapy as a possible therapeutic option for mesenchymal chondrosarcoma in the relapsed setting.
Collapse
Affiliation(s)
- Ghazal Tansir
- Sarcoma Medical Oncology Clinic, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Sameer Rastogi
- Sarcoma Medical Oncology Clinic, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Adarsh Barwad
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Ekta Dhamija
- Department of Radiodiagnosis, Dr. B.R.A Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
35
|
Abstract
PURPOSE OF REVIEW Our understanding of the genetic and epigenetic alterations in meningioma and the underlying tumor biology of meningioma has significantly changed over the past decade and resulted in revision of prognostically relevant meningioma subclasses within and beyond the WHO classification of CNS tumors. RECENT FINDINGS The 2016 WHO classification of CNS tumors recognizes WHO grade I, II, and III based on histopathological features. Recent work has identified genetic alterations with prognostic implications, including mutations of the TERT promoter, loss of function of the DMD gene, and inactivation of the tumor suppressor BAP-1. Studies of DNA methylation patterns in meningiomas have resulted in a novel and prognostically relevant meningioma subclassification schema. There have been major advances in our understanding of prognostically relevant genetic and epigenetic changes in meningioma which will hopefully allow for improvement in clinical trial design and the development of more effective therapies for meningioma.
Collapse
Affiliation(s)
- Christine Cordova
- Perlmutter Cancer Center, Brain and Spine Tumor Center, NYU Langone Health, 240 E. 38th Street, 19th floor, New York, NY, 10016, USA
| | - Sylvia C Kurz
- Perlmutter Cancer Center, Brain and Spine Tumor Center, NYU Langone Health, 240 E. 38th Street, 19th floor, New York, NY, 10016, USA.
| |
Collapse
|
36
|
Cortinovis D, Grosso F, Carlucci L, Zucali PA, Pasello G, Tiseo M, Sperandi F, Hollander L, Galli F, Torri V, Rulli E, Canova S, Maconi A, Bidoli P, Ceresoli GL, D'Incalci M. Trabectedin in Malignant Pleural Mesothelioma: Results From the Multicentre, Single Arm, Phase II ATREUS Study. Clin Lung Cancer 2020; 22:361-370.e3. [PMID: 32732073 DOI: 10.1016/j.cllc.2020.06.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 06/15/2020] [Accepted: 06/29/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION New therapeutic approaches in unresectable malignant pleural mesothelioma (MPM) are eagerly awaited. Trabectedin is an antitumor agent with an effect on cancer cell proliferation and a modulating action on tumor microenvironment. The ATREUS study explored the activity and safety of trabectedin in patients with unresectable MPM. METHODS Epithelioid patients with MPM received trabectedin as second-line while biphasic/sarcomatoid patients with MPM as first- or second-line therapy. Treatment was given intravenously at an initially planned dose of 1.3 mg/m2 every 3 weeks, until progression or unacceptable toxicity. The primary endpoint was progression-free survival rate at 12 weeks (PFS12wks). RESULTS Overall, 78 patients (54%) had epithelioid and 67 (46%) nonepithelioid MPM. PFS12wks in 62 evaluable patients with epithelioid MPM was 43.5% (80% confidence interval 34.9%-52.5%); median progression-free and overall survival were 2.4 and 9.0 months, respectively. PFS12wks in 52 evaluable patients with nonepithelioid MPM was 30.8% (90% confidence interval 20.3%-42.9%); median progression-free and overall survival were 1.7 and 5.4 months. Trabectedin starting dose was amended due to excess of liver toxicity. Eighty-four (64%) and 48 (36%) patients received 1.3 mg/m2 and 1.1. mg/m2, respectively. The most common grade 3-4 toxicities were hepatotoxicity, leukopenia/neutropenia, and fatigue. Grade 3-4 hepatotoxicity was reported in 59 (70%) patients treated at 1.3 mg/m2, and in 19 (40%) treated at 1.1 mg/m2. CONCLUSIONS Trabectedin showed modest clinical activity, at the expense of relevant liver toxicity. Further development of this drug in MPM at full doses is not warranted.
Collapse
Affiliation(s)
| | - Federica Grosso
- Mesothelioma Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Luciano Carlucci
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Paolo Andrea Zucali
- Department of Medical Oncology and Hematology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Giulia Pasello
- Department of Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy
| | - Marcello Tiseo
- Department of Medicine and Surgery, University of Parma and Medical Oncology Unit, Azienda Ospedaliero-Universitaria, Parma, Italy
| | | | - Lital Hollander
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Francesca Galli
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Valter Torri
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Eliana Rulli
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.
| | - Stefania Canova
- Medical Oncology Unit, ASST Ospedale San Gerardo, Monza, Italy
| | - Antonio Maconi
- Scientific Research and Development Department, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Paolo Bidoli
- Medical Oncology Unit, ASST Ospedale San Gerardo, Monza, Italy
| | | | - Maurizio D'Incalci
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | | |
Collapse
|
37
|
Di Gregorio E, Miolo G, Steffan A, Corona G. Novel method for fast trabectedin quantification using hydrophilic interaction liquid chromatography and tandem mass spectrometry for human pharmacokinetic studies. J Pharm Biomed Anal 2020; 185:113261. [PMID: 32229403 DOI: 10.1016/j.jpba.2020.113261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 03/12/2020] [Accepted: 03/14/2020] [Indexed: 11/24/2022]
Abstract
Few time-consuming bioanalytical methods are currently available for trabectedin quantification in clinical investigations. Here we present a novel, fast and sensitive method for trabectedin determination in human plasma based on hydrophilic interaction liquid chromatography and tandem mass spectrometry (HILIC-MS/MS). Plasma samples are treated with acetonitrile-0.1 % formic acid and the solvent extract is directly injected into an Acquity BEH Amide column (2.1 × 100 mm, 1.7 μm) operating in HILIC mode at 0.2 mL/min with 80:20 acetonitrile-0.1 % formic acid in water. The analyte is separated by an organic solvent gradient and quantified by an Agilent Ultivo triple quadrupole mass spectrometer operating in multiple reaction monitoring (MRM) mode. The quantitative MRM transitions were m/z 762→234 and m/z 765→234 for trabectedin and its d3-labeled derivative, respectively. The lower limit of quantification (LLOQ) was 0.01 ng/mL and the assay was linear up to 2.5 ng/mL. The intra- and inter-day relative error ranged from 1.19 % to 8.52 %, while the relative standard deviation was less than 12.35 %. The method was used to determine the pharmacokinetic profiles of trabectedin in 26 patients with soft tissue sarcoma, showing that this new HILIC-MS/MS method is suitable for use in clinical research.
Collapse
Affiliation(s)
- Emanuela Di Gregorio
- Immunopathology and Cancer Biomarkers Unit, IRCCS CRO Centro di Riferimento Oncologico Aviano, 33081, Aviano (PN), Italy; Department of Molecular Sciences and Nanosystems, University of Venice, 30170, Mestre (VE), Italy
| | - Gianmaria Miolo
- Medical Oncology and Cancer Prevention Unit, IRCCS CRO Centro di Riferimento Oncologico Aviano, 33081, Aviano (PN), Italy
| | - Agostino Steffan
- Immunopathology and Cancer Biomarkers Unit, IRCCS CRO Centro di Riferimento Oncologico Aviano, 33081, Aviano (PN), Italy
| | - Giuseppe Corona
- Immunopathology and Cancer Biomarkers Unit, IRCCS CRO Centro di Riferimento Oncologico Aviano, 33081, Aviano (PN), Italy.
| |
Collapse
|
38
|
Rubio MJ, Lecumberri MJ, Varela S, Alarcón J, Ortega ME, Gaba L, Espinós J, Calzas J, Barretina P, Ruiz I, Marquina G, Santaballa A. Efficacy and safety of trabectedin in metastatic uterine leiomyosarcoma: A retrospective multicenter study of the Spanish ovarian cancer research group (GEICO). Gynecol Oncol Rep 2020; 33:100594. [PMID: 32566719 PMCID: PMC7296187 DOI: 10.1016/j.gore.2020.100594] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 05/26/2020] [Accepted: 05/31/2020] [Indexed: 02/06/2023] Open
Abstract
Trabectedin confers clinical benefit in patients with recurrent/metastatic uterine leiomyosarcoma. Our data are similar to those previously reported in clinical studies. Trabectedin is especially effective when administered in earlier lines. Trabectedin has a manageable safety profile.
Objective We assessed trabectedin in patients with advanced uterine leiomyosarcoma (uLMS) in real-life clinical practice given according to the marketing authorization. Methods Thirty-six women from 11 tertiary hospitals across Spain who received trabectedin after anthracycline-containing regimen/s were retrospectively analyzed. The primary endpoint was progression-free survival (PFS). Results Median PFS and overall survival (OS) since starting trabectedin treatment were 5.4 (95%CI: 3.5–7.3) and 18.5 months (95%CI: 11.5–25.6), respectively. Median OS was significantly higher (P = 0.028) in patients receiving trabectedin in ≤ 2nd line (25.3 months) than in ≥ 3rd (15.1 months) and with ECOG performance status ≤ 1 at trabectedin start (19.8 months) than ECOG 2–3 (6.0 months, P = 0.013). When calculating OS since diagnosis, patients had longer OS with localized disease at diagnosis (87.4 months) vs. locally advanced (30.0 months) or metastatic (44.0 months, P = 0.041); and patients who received adjuvant therapy (87.4 months) compared with those who did not (30.0 months, P = 0.003), especially when receiving radiochemotherapy (106.7 months, P = 0.027). One patient (2.8%) had a complete response (CR) and nine patients (25.0%) achieved a partial response (PR) for an objective response rate of 27.8% with median response duration of 11 months (range: 4–93). Eighteen patients (50.0%) had disease stabilization for a disease control rate (DCR) of 77.8%. More patients receiving trabectedin in 1st-line of advanced disease achieved CR (16.7%) and PR (50.0%) than those in ≥ 2nd line/s (0.0% and 20.0%), whereas the DCR was similar across treatment lines. Reversible neutropenia was the most common grade 3/4 laboratory abnormality (19.4%). Conclusions Trabectedin confers clinical benefit in patients with recurrent/metastatic uLMS, given after failure to an anthracycline-based regimen being comparable to those reported in clinical trials and with a manageable safety profile.
Collapse
Affiliation(s)
- María Jesús Rubio
- Hospital Universitario Reina Sofía, Córdoba, Spain
- Corresponding author at: Hospital Universitario Reina Sofía, Córdoba, Spain.
| | | | | | - Jesús Alarcón
- Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | | | - Lydia Gaba
- Hospital Clínic de Barcelona, Barcelona, Spain
| | | | - Julia Calzas
- Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | - Isabel Ruiz
- Hospital Universitario Sant Joan de Reus, Reus, Spain
| | | | - Ana Santaballa
- Hospital Universitari i Politècnic La Fe, Valencia, Spain
| |
Collapse
|
39
|
Monk BJ, Herzog TJ, Wang G, Triantos S, Maul S, Knoblauch R, McGowan T, Shalaby WSW, Coleman RL. Data on prior pegylated liposomal doxorubicin (PLD) treatment in recurrent ovarian cancer: Post-hoc data analysis from the phase 3 randomized, open-label study comparing trabectedin and PLD versus PLD alone in patients with recurrent ovarian cancer. Data Brief 2020; 30:105465. [PMID: 32346557 PMCID: PMC7178483 DOI: 10.1016/j.dib.2020.105465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 02/21/2020] [Revised: 03/13/2020] [Accepted: 03/16/2020] [Indexed: 11/13/2022] Open
Abstract
The data presented herein are supplementary to our published primary article “A phase 3 randomized, open-label, multicenter trial for safety and efficacy of combined trabectedin and pegylated liposomal doxorubicin therapy for recurrent ovarian cancer”[1]. The exploratory analysis evaluated the impact of prior pegylated liposomal doxorubicin (PLD) therapy in patients who participated in a randomized, open-label study comparing combination therapy of trabectedin and PLD vs PLD alone in third-line recurrent ovarian cancer (ROC). These exploratory analyses showed that prior treatment with PLD in ROC does not impact the response and survival rates nor does it increase toxicities or negatively influence survival and response rates in both treatment groups.
Collapse
Affiliation(s)
- Bradley J Monk
- Arizona Oncology (US Oncology Network), University of Arizona, Creighton University, Phoenix, AZ, United States
| | - Thomas J Herzog
- University of Cincinnati Cancer Center, University of Cincinnati, Cincinnati, OH, United States
| | - George Wang
- Janssen Research & Development, Spring House, PA, United States
| | - Spyros Triantos
- Janssen Research & Development, Spring House, PA, United States
| | - Scott Maul
- Janssen Research & Development, Los Angeles, CA, United States
| | | | - Tracy McGowan
- Janssen Scientific Affairs, LLC, Horsham, PA, United States
| | | | - Robert L Coleman
- The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| |
Collapse
|
40
|
Cordeiro M, Casanova JM, Rodrigues J, Freitas J, Fonseca R, Caetano de Oliveira R, Tavares PF. Long-Term Response after 94 Cycles of Trabectedin in a Patient with Metastatic Leiomyosarcoma of the Lower Extremity. Case Rep Oncol 2020; 13:113-119. [PMID: 32231532 DOI: 10.1159/000505393] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 12/10/2019] [Indexed: 02/01/2023] Open
Abstract
Leiomyosarcomas of the lower extremity are extremely rare disorders and account for 10-15% of limb soft tissue sarcomas. These tumours have poor prognosis and even in early stages, patients persist at high risk for local and distant relapse; consequently, the treatment of advanced leiomyosarcoma of the lower extremity embodies a substantial defy. We present the case of a 73-year-old man diagnosed with metastatic lower extremity leiomyosarcoma of the hallux soft tissue, and with bone, lung and lymph node metastasis. After core needle biopsy confirmation of high-grade fusocellular sarcoma, the patient underwent surgery of the primary tumour and received anthracycline-based chemotherapy. However, after a 7-month progression-free survival period, a CT revealed lung disease progression. Sequentially, the patient was treated with trabectedin (Yondelis®) at a dose of 1.5 mg/m<sup>2</sup> resulting in complete remission of the lung metastasis and stable disease of the remaining lesions after 26 months of treatment. Afterwards, the patient started on maintenance therapy with trabectedin, resulting in long-lasting stable disease, as he was able to receive 94 cycles with very acceptable quality of life. Finally, in March 2019, the patient died of community-acquired pneumonia without objective progression disease. This clinical case reports the first patient ever treated with 94 cycles of trabectedin. Our results additionally confirm that trabectedin wields relevant oncostatic benefits with a manageable safety profile and without cumulative toxicities. Trabectedin properties enable a maintenance long-term therapy (until disease progression or unbearable toxicity), with a high impact on survival and with a preserved quality of life.
Collapse
Affiliation(s)
- Magda Cordeiro
- Department of Oncology, University Hospital Algarve, Faro Hospital, Faro, Portugal
| | | | - Joana Rodrigues
- Bone and Soft Tissue Tumor Unit, Coimbra University Hospital, Coimbra, Portugal
| | - João Freitas
- Bone and Soft Tissue Tumor Unit, Coimbra University Hospital, Coimbra, Portugal
| | - Ruben Fonseca
- Bone and Soft Tissue Tumor Unit, Coimbra University Hospital, Coimbra, Portugal
| | | | | |
Collapse
|
41
|
Manda K, Präkelt T, Schröder T, Kriesen S, Hildebrandt G. Radiosensitizing effects of trabectedin on human A549 lung cancer cells and HT-29 colon cancer cells. Invest New Drugs 2019; 38:967-976. [PMID: 31482373 DOI: 10.1007/s10637-019-00852-x] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 08/30/2019] [Indexed: 01/31/2023]
Abstract
Background and Purpose Trabectedin is a unique alkylating agent with promising effects against a range of solid tumors. In this study, we aimed to examine the cytotoxic and radiosensitizing effects of trabectedin on two human epithelial tumor cell lines in vitro, and its effects on DNA repair capacity. Methods Cancer cells (A549: human lung cancer cells, HT-29: colon cancer cells) were treated with either trabectedin alone for the determination of their growth, or in combination with radiation for the determination of their metabolic activity, proliferation, and clonogenic survival. Besides, the γH2AX foci assay was performed for the assessment of ionizing radiation-induced DNA damage and to evaluate the influence of trabectedin on DNA damage repair. Results Treatment with trabectedin resulted in a growth-inhibiting effect on both cell lines, with the IC50 values remaining within a low nanomolar range. Analyses of metabolic activity confirmed a cytotoxic influence of trabectedin and a BrdU assay demonstrated an antiproliferative effect. When combined with radiation, incubation with trabectedin was found to enhance the radiosensitivity of the tumor cells. The γH2AX foci assay resulted in an increased number of DNA double-strand breaks (DSBs) in cells treated with trabectedin. Conclusion The results of this study underline the antitumor activity of trabectedin at low nanomolar concentrations. We demonstrated that trabectedin enhanced radiation response in human lung (A549) cancer cells and colon (HT-29) cancer cells. Further studies are necessary to examine trabectedin as a potential candidate for future applications in radiotherapy.
Collapse
Affiliation(s)
- Katrin Manda
- Department of Radiotherapy and Radiation Oncology, University Medical Center Rostock, 18059 Rostock, Südring 75, 18059, Rostock, Germany.
| | - Tina Präkelt
- Department of Radiotherapy and Radiation Oncology, University Medical Center Rostock, 18059 Rostock, Südring 75, 18059, Rostock, Germany
| | - Tonja Schröder
- Department of Radiotherapy and Radiation Oncology, University Medical Center Rostock, 18059 Rostock, Südring 75, 18059, Rostock, Germany
| | - Stephan Kriesen
- Department of Radiotherapy and Radiation Oncology, University Medical Center Rostock, 18059 Rostock, Südring 75, 18059, Rostock, Germany
| | - Guido Hildebrandt
- Department of Radiotherapy and Radiation Oncology, University Medical Center Rostock, 18059 Rostock, Südring 75, 18059, Rostock, Germany
| |
Collapse
|
42
|
Poggesi I, Valenzuela B, Ouellet D, Gonzalez M, Hillewaert V, Baruchel S, Fox E, Perez-Ruixo JJ. Population pharmacokinetics of trabectedin in adolescent patients with cancer. Cancer Chemother Pharmacol 2019; 84:707-717. [PMID: 31286189 DOI: 10.1007/s00280-019-03899-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 06/18/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE To characterize the trabectedin population pharmacokinetics in children and adolescent patients with cancer and compare it with the trabectedin pharmacokinetics in adults. METHODS Plasma concentrations from ten adolescent and three children with cancer (age range 4.0-17.0 years) treated with trabectedin at doses ranging from 1.1 to 1.7 mg/m2, administered as a 24-h continuous intravenous infusion every 3 weeks, were available for the analysis. An external model evaluation was performed to verify whether a previously developed adult population pharmacokinetic model was predictive of the pediatric plasma concentrations of trabectedin. The maximum a posteriori estimation of the individual pharmacokinetic parameters for pediatric patients was conducted, after successful completion of the external evaluation step. The relationships between pharmacokinetic parameters and body size were evaluated. RESULTS External evaluation methods showed no major differences between the adult population and children and adolescent patients of this study. The mean ± standard deviation (SD) of the individual estimated clearance and central volume of distribution in these children/adolescent patients was 36.4 ± 16.1 L/h and 13.2 ± 6.54 L, respectively. These values were similar to the typical values reported for adult patients-37.6 L/h and 13.9 L (for females) and 16.1 L (for males). The median area under the plasma concentration versus time curve (AUC) in children/adolescent patients was 55.1 µg h/L, while in the adult population the median AUC was 61.3 µg h/L, both administered a 1.5 mg/m2 dose regimen with mean (range) BSA for adults = 1.86 (0.90-2.80) vs children/adolescent patients = 1.49 (0.66-2.54). CONCLUSIONS The adult population pharmacokinetic model adequately described the trabectedin plasma concentrations and its variability in the pediatric population of patients involved in this assessment that mostly comprised adolescents. The trabectedin systemic exposure achieved in this population was comparable (within 12%) to the exposure obtained in adult population when the same dose, expressed in mg/m2, was administered.
Collapse
Affiliation(s)
- Italo Poggesi
- Janssen-Cilag, Via M. Buonarroti, 23, Cologno Monzese, MI, 20093, Italy.
| | - Belén Valenzuela
- SGS Exprimo, NV, Mechelen, Belgium.,Janssen Research and Development, Beerse, Belgium
| | | | | | | | - Sylvain Baruchel
- The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Elizabeth Fox
- The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | | |
Collapse
|
43
|
Pierantoni F, Maruzzo M, Brunello A, Chiusole B, Pusole G, Bezzon E, Basso U, Zagonel V. Trabectedin Drug Holiday and Rechallenge in Soft Tissue Sarcomas: Report of 4 Cases and Literature Review. Front Oncol 2019; 9:553. [PMID: 31338321 PMCID: PMC6629888 DOI: 10.3389/fonc.2019.00553] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 03/14/2019] [Accepted: 06/06/2019] [Indexed: 01/08/2023] Open
Abstract
Soft tissue sarcomas are rare neoplasms, with a high mortality rate. Few drugs are available for the treatment of patients affected by metastatic sarcomas, who still have a 5-years survival rate lower than 20%. However, some of the more recent therapies can obtain long lasting responses in a portion of patients, such as Trabectedin. We analyzed four such cases treated at our Institute after progression to an anthracycline based regimen. In each case a therapeutic pause was proposed after at least 6 months of therapy with Trabectedin and in three out of four patients a re-challenge was proposed at progression, achieving again disease control or response. In two cases oligo-progressive sites were treated with localized therapies as stereotactic radiotherapy, delaying the systemic treatment re-start. In this article the reports of the patients involved are presented with a concise review of the relevant literature. Our findings support the favorable safety profile of Trabectedin and the feasibility of drug holidays, which should be at least discussed with the patient.
Collapse
Affiliation(s)
- Francesco Pierantoni
- Medical Oncology 1 Unit, Department of Oncology, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy
| | - Marco Maruzzo
- Medical Oncology 1 Unit, Department of Oncology, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy
| | - Antonella Brunello
- Medical Oncology 1 Unit, Department of Oncology, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy
| | - Benedetta Chiusole
- Medical Oncology 1 Unit, Department of Oncology, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy
| | - Grazia Pusole
- Medical Oncology 1 Unit, Department of Oncology, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy
| | - Elisabetta Bezzon
- Radiology Unit, Department of Imaging and Medical Physics, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy
| | - Umberto Basso
- Medical Oncology 1 Unit, Department of Oncology, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy
| | - Vittorina Zagonel
- Medical Oncology 1 Unit, Department of Oncology, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy
| |
Collapse
|
44
|
Guerra Alía EM, Sempere Ortega C, Cortés Salgado A, Sanchez Martínez C, Galindo Álvarez J, Pérez Miez B. Maintenance with Trabectedin in the Treatment of Platinum-Sensitive Recurrent Ovarian Cancer. Case Rep Oncol 2019; 12:447-455. [PMID: 31275136 PMCID: PMC6600046 DOI: 10.1159/000500411] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 04/11/2019] [Accepted: 04/12/2019] [Indexed: 11/29/2022] Open
Abstract
Ovarian cancer is the seventh most common type of cancer and the fifth leading cause of cancer death among women worldwide. The current usual therapeutic approach in this disease includes optimal cytoreductive therapy followed by platinum-based adjuvant chemotherapy, along with neoadjuvant chemotherapy prior to surgery in selected cases. The platinum-free interval (PFI) continues to be the most useful tool to assist in the selection of the subsequent therapy and to predict response to treatment. The combination of trabectedin and pegylated liposomal doxorubicin (PLD) is useful in patients with partially platinum-sensitive recurrent ovarian cancer, in patients who have previously received two or more platinum-based chemotherapy regimens, in patients who have already experienced a platinum-induced hypersensitivity reaction and in patients who have previously failed to respond to a platinum-based treatment.
Collapse
Affiliation(s)
| | | | | | | | - Julio Galindo Álvarez
- Digestive and General Surgery Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Belén Pérez Miez
- Pathological Anatomy, Hospital Universitario Ramón y Cajal, Madrid, Spain
| |
Collapse
|
45
|
Abstract
Soft tissue sarcomas are rare malignancies of mesenchymal origin comprising about 1% of all adult cancers. Systemic therapies for locally advanced and metastatic disease have been restricted for decades to very few effective and approved agents such as doxorubicin and ifosfamide. However, new therapeutic avenues including new drug developments and registrations such as trabectedin, pazopanib and eribulin as well as numerous clinical trial options have recently enriched the therapeutic armamentarium in the treatment of patients with advanced soft tissue sarcomas. The challenges and pitfalls of finding such new therapeutic avenues in recent years for the treatment benefit of patients with soft tissue sarcomas will be presented in this chapter within the thematic series on "Challenges in Sarcoma".
Collapse
Affiliation(s)
- Bernd Kasper
- Sarcoma Unit, Interdisciplinary Tumor Center Mannheim, Mannheim University Medical Center, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| |
Collapse
|
46
|
Higuchi T, Miyake K, Oshiro H, Sugisawa N, Yamamoto N, Hayashi K, Kimura H, Miwa S, Igarashi K, Chawla SP, Bouvet M, Singh SR, Tsuchiya H, Hoffman RM. Trabectedin and irinotecan combination regresses a cisplatinum-resistant osteosarcoma in a patient-derived orthotopic xenograft nude-mouse model. Biochem Biophys Res Commun 2019; 513:326-31. [PMID: 30955860 DOI: 10.1016/j.bbrc.2019.03.191] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 03/28/2019] [Indexed: 12/14/2022]
Abstract
Recurrent osteosarcoma is a chemotherapy-resistant disease. Individualized precision therapy is needed for this disease. Toward this goal, we have developed the patient-derived othotopic xenograft (PDOX) mouse model of all major cancer types including osteosarcoma. Synergistic efficacy of trabectedin (TRAB) and irinotecan (IRT) has been reported in Ewing's sarcoma, soft-tissue sarcoma, and ovarian cancer. However, the efficacy of this combination on osteosarcoma is not known. The goal of present study was to determine the efficacy of the TRAB and IRT combination on cisplatinum (CDDP)-resistant osteosarcoma PDOX. The osteosarcoma PDOX models were randomized into five treatment groups of six mice: Untreated control; CDDP alone; TRAB alone; IRT alone; and TRAB and the IRT combination. Tumor size and body weight were measured during the 14 days of treatment. Tumor growth was regressed only by the TRAB-IRT combination. Tumors treated with the TRAB-IRT combination had the most tumor necrosis with degenerative change. The present study demonstrates the power of the PDOX model to identify a novel effective treatment strategy of the TRAB and IRT combination for chemotherapy-resistant osteosarcoma.
Collapse
|
47
|
Cucè M, Gallo Cantafio ME, Siciliano MA, Riillo C, Caracciolo D, Scionti F, Staropoli N, Zuccalà V, Maltese L, Di Vito A, Grillone K, Barbieri V, Arbitrio M, Di Martino MT, Rossi M, Amodio N, Tagliaferri P, Tassone P, Botta C. Trabectedin triggers direct and NK-mediated cytotoxicity in multiple myeloma. J Hematol Oncol 2019; 12:32. [PMID: 30898137 PMCID: PMC6429746 DOI: 10.1186/s13045-019-0714-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [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: 10/08/2018] [Accepted: 02/26/2019] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Genomic instability is a feature of multiple myeloma (MM), and impairment in DNA damaging response (DDR) has an established role in disease pathobiology. Indeed, a deregulation of DNA repair pathways may contribute to genomic instability, to the establishment of drug resistance to genotoxic agents, and to the escape from immune surveillance. On these bases, we evaluated the role of different DDR pathways in MM and investigated, for the first time, the direct and immune-mediated anti-MM activity of the nucleotide excision repair (NER)-dependent agent trabectedin. METHODS Gene-expression profiling (GEP) was carried out with HTA2.0 Affymetrix array. Evaluation of apoptosis, cell cycle, and changes in cytokine production and release have been performed in 2D and 3D Matrigel-spheroid models through flow cytometry on MM cell lines and patients-derived primary MM cells exposed to increasing nanomolar concentrations of trabectedin. DNA-damage response has been evaluated through Western blot, immunofluorescence, and DNA fragmentation assay. Trabectedin-induced activation of NK has been assessed by CD107a degranulation. miRNAs quantification has been done through RT-PCR. RESULTS By comparing GEP meta-analysis of normal and MM plasma cells (PCs), we observed an enrichment in DNA NER genes in poor prognosis MM. Trabectedin triggered apoptosis in primary MM cells and MM cell lines in both 2D and 3D in vitro assays. Moreover, trabectedin induced DDR activation, cellular stress with ROS production, and cell cycle arrest. Additionally, a significant reduction of MCP1 cytokine and VEGF-A in U266-monocytes co-cultures was observed, confirming the impairment of MM-promoting milieu. Drug-induced cell stress in MM cells led to upregulation of NK activating receptors ligands (i.e., NKG2D), which translated into increased NK activation and degranulation. Mechanistically, this effect was linked to trabectedin-induced inhibition of NKG2D-ligands negative regulators IRF4 and IKZF1, as well as to miR-17 family downregulation in MM cells. CONCLUSIONS Taken together, our findings indicate a pleiotropic activity of NER-targeting agent trabectedin, which appears a promising candidate for novel anti-MM therapeutic strategies.
Collapse
Affiliation(s)
- Maria Cucè
- Department of Experimental and Clinical Medicine, Magna Graecia University, Salvatore Venuta University Campus, Viale Europa, 88100, Catanzaro, Italy
| | - Maria Eugenia Gallo Cantafio
- Department of Experimental and Clinical Medicine, Magna Graecia University, Salvatore Venuta University Campus, Viale Europa, 88100, Catanzaro, Italy
| | - Maria Anna Siciliano
- Department of Experimental and Clinical Medicine, Magna Graecia University, Salvatore Venuta University Campus, Viale Europa, 88100, Catanzaro, Italy
| | - Caterina Riillo
- Department of Experimental and Clinical Medicine, Magna Graecia University, Salvatore Venuta University Campus, Viale Europa, 88100, Catanzaro, Italy
| | - Daniele Caracciolo
- Department of Experimental and Clinical Medicine, Magna Graecia University, Salvatore Venuta University Campus, Viale Europa, 88100, Catanzaro, Italy
| | - Francesca Scionti
- Department of Experimental and Clinical Medicine, Magna Graecia University, Salvatore Venuta University Campus, Viale Europa, 88100, Catanzaro, Italy
| | - Nicoletta Staropoli
- Medical and Translational Oncology Units, AOU Mater Domini, Catanzaro, Italy
| | | | | | - Anna Di Vito
- Department of Experimental and Clinical Medicine, Magna Graecia University, Salvatore Venuta University Campus, Viale Europa, 88100, Catanzaro, Italy
| | - Katia Grillone
- Department of Experimental and Clinical Medicine, Magna Graecia University, Salvatore Venuta University Campus, Viale Europa, 88100, Catanzaro, Italy
| | - Vito Barbieri
- Medical and Translational Oncology Units, AOU Mater Domini, Catanzaro, Italy
| | - Mariamena Arbitrio
- Institute of Neurological Sciences, UOS of Pharmacology, Catanzaro, Italy
| | - Maria Teresa Di Martino
- Department of Experimental and Clinical Medicine, Magna Graecia University, Salvatore Venuta University Campus, Viale Europa, 88100, Catanzaro, Italy.,Medical and Translational Oncology Units, AOU Mater Domini, Catanzaro, Italy
| | - Marco Rossi
- Department of Experimental and Clinical Medicine, Magna Graecia University, Salvatore Venuta University Campus, Viale Europa, 88100, Catanzaro, Italy.,Medical and Translational Oncology Units, AOU Mater Domini, Catanzaro, Italy
| | - Nicola Amodio
- Department of Experimental and Clinical Medicine, Magna Graecia University, Salvatore Venuta University Campus, Viale Europa, 88100, Catanzaro, Italy
| | - Pierosandro Tagliaferri
- Department of Experimental and Clinical Medicine, Magna Graecia University, Salvatore Venuta University Campus, Viale Europa, 88100, Catanzaro, Italy.,Medical and Translational Oncology Units, AOU Mater Domini, Catanzaro, Italy
| | - Pierfrancesco Tassone
- Department of Experimental and Clinical Medicine, Magna Graecia University, Salvatore Venuta University Campus, Viale Europa, 88100, Catanzaro, Italy. .,Medical and Translational Oncology Units, AOU Mater Domini, Catanzaro, Italy. .,Sbarro Institute for Cancer Research and Molecular Medicine, Center for Biotechnology, College of Science and Technology, Temple University, Philadelphia, PA, USA.
| | - Cirino Botta
- Department of Experimental and Clinical Medicine, Magna Graecia University, Salvatore Venuta University Campus, Viale Europa, 88100, Catanzaro, Italy
| |
Collapse
|
48
|
Henry T, Fabre E, Baccar LS, Lamuraglia M. Longer survival in patients with metastatic uterine leiomyosarcoma treated with trabectedin: A case report. Mol Clin Oncol 2019; 10:387-390. [PMID: 30847179 DOI: 10.3892/mco.2019.1797] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 12/17/2018] [Indexed: 11/05/2022] Open
Abstract
Trabectedin (ET-743) is a marine alkaloid isolated from the Caribbean tunicate Ecteinascidia turbinata, with a chemical structure characterized by three fused tetrahydroisoquinoline rings. In the present case report, two patients with advanced and metastatic uterine leiomyosarcomas (ULMS) with significant progression-free survival (PFS) and overall survival (OS) administered Trabectedin as second and third line treatment are reported. The first case received third line Trabectedin with a PFS of 24 months and an OS of 35 months. The second case received second line Trabectedin with a PFS of 24 months and an OS of 30 months. In addition, a good safety record was obtained in the long-term administration of Trabectedin (more so in case 1 than case 2), with a good quality of life.
Collapse
Affiliation(s)
- Théophraste Henry
- Assistance Publique-Hôpitaux de Paris, Louis Mourier Hospital, Medical Oncology Unit, Department of Medicine, 92700 Colombes, France
| | - Elizabeth Fabre
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen George Pompidou, Department of Medical Oncology, 75908 Paris, France
| | - Laurent S Baccar
- Assistance Publique-Hôpitaux de Paris, Louis Mourier Hospital, Department of Radiology, 92700 Colombes, France
| | - Michele Lamuraglia
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale (LIB), Assistance Publique-Hôpitaux de Paris, Hôpital Beaujon, 75006 Paris, France.,Assistance Publique-Hôpitaux de Paris, Medical Oncology Unit, Hôpital Beaujon, 92110 Clichy, France
| |
Collapse
|
49
|
Gronchi A, Hindi N, Cruz J, Blay JY, Lopez-Pousa A, Italiano A, Alvarez R, Gutierrez A, Rincón I, Sangalli C, Pérez Aguiar JL, Romero J, Morosi C, Sunyach MP, Sanfilippo R, Romagosa C, Ranchere-Vince D, Dei Tos AP, Casali PG, Martin-Broto J. Trabectedin and RAdiotherapy in Soft Tissue Sarcoma (TRASTS): Results of a Phase I Study in Myxoid Liposarcoma from Spanish (GEIS), Italian (ISG), French (FSG) Sarcoma Groups. EClinicalMedicine 2019; 9:35-43. [PMID: 31143880 PMCID: PMC6510725 DOI: 10.1016/j.eclinm.2019.03.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 03/01/2019] [Accepted: 03/05/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Myxoid liposarcoma (ML) exhibits a special sensitivity to trabectedin (T) and radiation therapy (RT). Preclinical data suggest a synergistic effect. We aimed to study safety, feasibility and activity of the administration of pre-operative concurrent T and RT in patients affected by localized resectable ML. METHODS Patients received 3 cycles (C) of T in combination with RT (45 Gy) in 25 fractions (1.8 Gy/fraction). Dose Levels for T were: - 1 (1.1 mg/m2), 0 (1.3 mg/m2) and 1 (1.5 mg/m2). Primary endpoint was safety; antitumor activity was assessed by RECIST and Choi criteria. This study is registered at ClinicalTrials.gov, number NCT02275286. The phase 1 part of the study is complete and phase 2 is ongoing. FINDINGS From February 2015 to May 2016, 14 patients (M/F 7/7), median age 36 years (range 24-70) and median tumor size 12.5 cm (range 7-17 cm), were enrolled. One dose limiting toxicity (G3 transaminitis) occurred at Level 0 and one (sepsis due to catheter infection) at Level 1. All patients completed RT. Five patients achieved PR (36%), 8 SD (57%), 1 distant PD (7%) by RECIST, while 12 achieved PR (86%), 1 SD (7%) and 1 distant PD (7%) by Choi criteria. Twelve patients underwent surgery. Median viable residual tumor was 5% (0-60). INTERPRETATION T in combination with RT showed a favorable safety profile and antitumor activity in localized ML. T dose of 1.5 mg/m2 is the recommended dose for the phase 2 study, which is ongoing. FUNDING This study was partially supported by Pharmamar.
Collapse
Affiliation(s)
- Alessandro Gronchi
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Corresponding author at: Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy.
| | - Nadia Hindi
- Biomedicine Institute of Seville (IBIS), Spain
- University Hospital Virgen del Rocio, Seville, Spain
| | | | | | | | | | - Rosa Alvarez
- University Hospital Gregorio Marañon, Madrid, Spain
| | - Antonio Gutierrez
- Son Espases University Hospital/IdISBa, Palma, Illes Baleares, Spain
| | | | | | | | - Jesús Romero
- Puerta de Hierro University Hospital, Madrid, Spain
| | - Carlo Morosi
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | | | | | | | - Angelo P. Dei Tos
- Treviso General Hospital, Treviso, Italy
- Department of Medicine, University of Padova, Padova, Italy
| | - Paolo G. Casali
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Biomedicine Institute of Seville (IBIS), Spain
- University Hospital Virgen del Rocio, Seville, Spain
- University Hospital Canarias, Tenerife, Spain
- Center Leon Berard, Lyon, France
- Hospital Sant Pau, Barcelona, Spain
- Institute Bergonie – Bourdeaux, France
- University Hospital Gregorio Marañon, Madrid, Spain
- Son Espases University Hospital/IdISBa, Palma, Illes Baleares, Spain
- Puerta de Hierro University Hospital, Madrid, Spain
- Vall d'Hebron University Hospital, Barcelona, Spain
- Treviso General Hospital, Treviso, Italy
- Department of Medicine, University of Padova, Padova, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milano, Italy
| | - Javier Martin-Broto
- Biomedicine Institute of Seville (IBIS), Spain
- University Hospital Virgen del Rocio, Seville, Spain
| |
Collapse
|
50
|
Esser M, Kloth C, Thaiss WM, Reinert CP, Fritz J, Kopp HG, Horger M. CT-response patterns and the role of CT-textural features in inoperable abdominal/retroperitoneal soft tissue sarcomas treated with trabectedin. Eur J Radiol 2018; 107:175-182. [PMID: 30292263 DOI: 10.1016/j.ejrad.2018.09.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 05/23/2018] [Revised: 08/06/2018] [Accepted: 09/05/2018] [Indexed: 01/18/2023]
Abstract
PURPOSE To evaluate CT patterns and textural features of soft tissue sarcomas following trabectedin therapy as well as their suitability for predicting therapeutic response. MATERIAL AND METHODS A total of 31 patients (18 female, 13 male; mean age, 58.0years; range, 38-79years) with sarcoma under trabectedin as a third-line therapy between October 2008 and July 2017 underwent baseline and follow-up contrast-enhanced CT. Response evaluation was based on modifiedCHOI-criteria and RECIST1.1, classified as partial response(PR), stable disease(SD), progressive disease(PD). For CT-texture analysis (CTTA), mean, entropy and uniformity of intensity/skewness/entropy of co-occurrence matrix (COM) and contrast of neighboring-grey-level-dependence-matrix (NGLDM) were calculated. RESULTS Following CHOI-criteria, 9 patients achieved PR, 10 SD and 12 PD. RECIST1.1. classified patients into 5 PR, 15 SD and 11 PD. A frequent (n = 6/31; 19.3%) pattern of response was tumor liquefaction. In responders differences in entropy of entropy-NGLDM(p = 0.028) and uniformity-NGLDM(p = 0.021), in non-responders entropy of average(p = 0.039), deviation(p = 0.04) and uniformity of deviation(p = 0.013) occured between baseline and follow-up. Mean intensity and average were higher when liquefication occured(p = 0.03; p = 0.02), whereas mean deviation was lower(p = 0.02) at baseline compared to other response patterns. Differences in mean(p = 0.023), entropy(p = 0.049) and uniformity(p = 0.023) of entropy-NGLDM were found between responders and non-responders at follow-up. For the mean of heterogeneity a cut-off value was calculated for prediction of response in baseline CTTA (0.12; sensitivity 89%; specificity 77%). CONCLUSION A frequent pattern of response to trabectedin was tumor liquefication being responsible for pseudoprogression, therefore modifiedCHOI should be preferred. Single CT-textural features can be used complementarily for prediction and monitoring response to trabectedin.
Collapse
Affiliation(s)
- Michael Esser
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls- University, Hoppe-Seyler-Str.3, 72076, Tübingen, Germany.
| | - Cristopher Kloth
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls- University, Hoppe-Seyler-Str.3, 72076, Tübingen, Germany.
| | - Wolfgang Maximilian Thaiss
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls- University, Hoppe-Seyler-Str.3, 72076, Tübingen, Germany.
| | - Christian Philipp Reinert
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls- University, Hoppe-Seyler-Str.3, 72076, Tübingen, Germany.
| | - Jan Fritz
- Johns Hopkins University School of Medicine, Russell H. Morgan Department of Radiology and Radiological Science, 601 N. Caroline Street, JHOC 3140A, Baltimore, MD, 21287, United States.
| | - Hans-Georg Kopp
- Department of Internal Medicine II, Eberhard-Karls- University, Otfried-Müller-Str. 10, 72076, Tübingen, Germany; Department of Molecular Oncology, Robert-Bosch-Hospital, Auerbacherstr. 110, Stuttgart, 70736, Germany.
| | - Marius Horger
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls- University, Hoppe-Seyler-Str.3, 72076, Tübingen, Germany.
| |
Collapse
|