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Barlier A, Romanet P, Pellegata NS. Editorial: New insights into multiple endocrine neoplasia type 1. Front Endocrinol (Lausanne) 2023; 14:1266148. [PMID: 37635979 PMCID: PMC10457125 DOI: 10.3389/fendo.2023.1266148] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 07/27/2023] [Indexed: 08/29/2023] Open
Affiliation(s)
- Anne Barlier
- Aix Marseille Univ, APHM, INSERM, MMG, Laboratory of Molecular Biology Hospital La Conception, MarMaRa Institute, Marseille, France
| | - Pauline Romanet
- Aix Marseille Univ, APHM, INSERM, MMG, Laboratory of Molecular Biology Hospital La Conception, MarMaRa Institute, Marseille, France
| | - Natalia S. Pellegata
- Institute for Diabetes and Cancer, Helmholtz Zentrum München, Neuherberg, Germany
- Joint Heidelberg-IDC Translational Diabetes Program, Heidelberg University Hospital, Heidelberg, Germany
- Department of Biology and Biotechnology “L. Spallanzani”, University of Pavia, Pavia, Italy
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Melikyan M, Gubaeva D, Shadrina A, Bolmasova A, Kareva M, Tiulpakov A, Efremenkov A, Sokolov Y, Brusgaard K, Christesen HT, Andersen K, Stepanov A, Averyanova J, Makarov S, Gurevich L. Insulinoma in childhood: a retrospective review of 22 patients from one referral centre. Front Endocrinol (Lausanne) 2023; 14:1127173. [PMID: 37152923 PMCID: PMC10155867 DOI: 10.3389/fendo.2023.1127173] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 03/27/2023] [Indexed: 05/09/2023] Open
Abstract
Background Insulinomas are very rare in childhood with sparse knowledge on the clinical aspects and the presence of Multiple Endocrine Neoplasia type 1 (MEN1). Methods We conducted a retrospective review of patients diagnosed with insulinoma between 1995 and 2021, presenting to one referral centre in Russia. Clinical, biochemical, genetic, imaging and histological data were collected. In addition, follow-up and family data were obtained. Results A total of twenty-two children aged 5 to 16 years were identified. The median (range) gap between the first hypoglycaemia symptoms and diagnosis was 10 (1-46) months. Twelve children (55%) were misdiagnosed to have epilepsy and were treated with anticonvulsants before hypoglycemia was revealed. Contrast enhanced MRI and/or CT were accurate to localize the lesion in 82% (n=18). Five patients (23%) had multiple pancreatic lesions. All children underwent surgical treatment. The median (range) diameter of removed tumors was 1.5 (0.3-6) cm. Histopathological studies confirmed the presence of insulinoma in all cases. Immunohistochemical studies revealed G2 differentiation grade in 10 out of 17 cases. Two patients were diagnosed with metastatic insulinoma. One of them had metastases at the time of insulinoma diagnosis, while the other was diagnosed with liver metastases eight years after the surgery. Eight children (36%) were found to carry MEN1 mutations, inherited n=5, de novo n=1, no data, n=2. Children with MEN1 had significantly higher number of pancreatic tumors compared to sporadic cases. All of them developed additional MEN1 symptoms during the following 2-13 years. In the five patients with inherited MEN1, seven family members had hitherto undiscovered MEN1 manifestations. Conclusions In this large cohort of children with rare pediatric insulinomas, MEN1 syndrome and G2 tumors were frequent, as well as hitherto undiscovered MEN1 manifestations in family members. Our data emphasize the need of genetic testing in all children with insulinoma and their relatives, even in the absence of any other features, as well as the importance of a prolonged follow-up observation.
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Affiliation(s)
- Maria Melikyan
- Department of Pediatric Endocrinology, Endocrinology Research Center, Moscow, Russia
- Department of Endocrinology, Yerevan State Medical University, Yerevan, Armenia
- Department of pediatrics, Center of Medical Genetics and Primary Health Care, Yerevan, Armenia
- *Correspondence: Maria Melikyan,
| | - Diliara Gubaeva
- Department of Pediatric Endocrinology, Endocrinology Research Center, Moscow, Russia
- Department of Pediatric Endocrinology, Alder Hey Children’s Hospital, Liverpool, United Kingdom
| | - Anna Shadrina
- Department of Pediatric Endocrinology, Endocrinology Research Center, Moscow, Russia
| | - Anna Bolmasova
- Department of Pediatric Endocrinology, Endocrinology Research Center, Moscow, Russia
| | - Maria Kareva
- Department of Pediatric Endocrinology, Endocrinology Research Center, Moscow, Russia
| | - Anatoly Tiulpakov
- Department of Pediatric Endocrinology, Endocrinology Research Center, Moscow, Russia
- Department of Endocrinology, Federal State Budgetary Scientific Institution Research Centre for Medical Genetics (RCMG), Moscow, Russia
| | - Artem Efremenkov
- Department of Pediatric Surgery, Central Clinical Hospital, Moscow, Russia
| | - Yuri Sokolov
- Department of Pediatric Surgery, Endocrinology Research Center, Moscow, Russia
| | - Klaus Brusgaard
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
- Odense Pancreas Center OPAC and Steno Diabetes Center Odense, Odense, Denmark
- Department of Endocrinology, Hans Christian Andersen Children’s Hospital, Odense University Hospital, Odense, Denmark
| | - Henrik T. Christesen
- Odense Pancreas Center OPAC and Steno Diabetes Center Odense, Odense, Denmark
- Department of Endocrinology, Hans Christian Andersen Children’s Hospital, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Kirstine Andersen
- Odense Pancreas Center OPAC and Steno Diabetes Center Odense, Odense, Denmark
- Department of Endocrinology, Hans Christian Andersen Children’s Hospital, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Alexey Stepanov
- Department of Abdominal Surgery, Russian Children's Clinical Hospital, Moscow, Russia
| | - Julia Averyanova
- Department of Abdominal Surgery, Russian Children's Clinical Hospital, Moscow, Russia
| | - Sergey Makarov
- Department of Abdominal Surgery, Russian Children's Clinical Hospital, Moscow, Russia
| | - Larisa Gurevich
- Morphological Department of Oncology, State Budget Health Agency Moscow Region Moscow Regional Research Clinical Institute, Moscow, Russia
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Gulde S, Foscarini A, April-Monn SL, Genio E, Marangelo A, Satam S, Helbling D, Falconi M, Toledo RA, Schrader J, Perren A, Marinoni I, Pellegata NS. Combined Targeting of Pathogenetic Mechanisms in Pancreatic Neuroendocrine Tumors Elicits Synergistic Antitumor Effects. Cancers (Basel) 2022; 14:cancers14225481. [PMID: 36428573 PMCID: PMC9688197 DOI: 10.3390/cancers14225481] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/01/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022] Open
Abstract
Pancreatic neuroendocrine neoplasms (PanNENs) are the second most common malignancy of the pancreas. Surgery remains the only curative treatment for localized disease. For patients with inoperable advanced or metastatic disease, few targeted therapies are available, but their efficacy is unpredictable and variable. Exploiting prior knowledge on pathogenetic processes involved in PanNEN tumorigenesis, we tested buparlisib (PI3K inhibitor) and ribociclib (CDK4/6 inhibitor), as single agents or in combination, in different preclinical models. First, we used cell lines representative of well-differentiated (INS-1E, NT-3) and poorly differentiated (BON-1) PanNENs. The combination of buparlisib with ribociclib reduced the proliferation of 2D and 3D spheroid cultures more potently than the individual drugs. Buparlisib, but not ribociclib, induced apoptosis. The anti-proliferative activity of the drugs correlated with downstream target inhibition at mRNA and protein levels. We then tested the drugs on primary islet microtissues from a genetic PanNET animal model (Men1-defective mice) and from wild-type mice: the drug combination was effective against the former without altering islet cell physiology. Finally, we treated PanNET patient-derived islet-like 3D tumoroids: the combination of buparlisib with ribociclib was effective in three out of four samples. Combined targeting of PI3K and CDK4/6 is a promising strategy for PanNENs spanning various molecular and histo-pathological features.
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Affiliation(s)
- Sebastian Gulde
- Institute for Diabetes and Cancer, Helmholtz Zentrum München, Ingolstaedter Landstrasse 1, 85764 Neuherberg, Germany
- Joint Heidelberg-IDC Translational Diabetes Program, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Alessia Foscarini
- Institute for Diabetes and Cancer, Helmholtz Zentrum München, Ingolstaedter Landstrasse 1, 85764 Neuherberg, Germany
- Joint Heidelberg-IDC Translational Diabetes Program, Heidelberg University Hospital, 69120 Heidelberg, Germany
- Department of Biology and Biotechnology “L. Spallanzani”, University of Pavia, 27100 Pavia, Italy
| | | | - Edoardo Genio
- Institute for Diabetes and Cancer, Helmholtz Zentrum München, Ingolstaedter Landstrasse 1, 85764 Neuherberg, Germany
- Joint Heidelberg-IDC Translational Diabetes Program, Heidelberg University Hospital, 69120 Heidelberg, Germany
- Department of Biology and Biotechnology “L. Spallanzani”, University of Pavia, 27100 Pavia, Italy
| | - Alessandro Marangelo
- Institute for Diabetes and Cancer, Helmholtz Zentrum München, Ingolstaedter Landstrasse 1, 85764 Neuherberg, Germany
- Joint Heidelberg-IDC Translational Diabetes Program, Heidelberg University Hospital, 69120 Heidelberg, Germany
- Department of Biology and Biotechnology “L. Spallanzani”, University of Pavia, 27100 Pavia, Italy
| | - Swapna Satam
- Institute for Diabetes and Cancer, Helmholtz Zentrum München, Ingolstaedter Landstrasse 1, 85764 Neuherberg, Germany
- Joint Heidelberg-IDC Translational Diabetes Program, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | | | - Massimo Falconi
- Pancreatic Surgery Unit, Pancreas Translational and Clinical Research Centre, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Rodrigo A. Toledo
- CIBERONC, Gastrointestinal and Endocrine Tumors, VHIO, 08035 Barcelona, Spain
| | - Jörg Schrader
- Department of Medicine, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
- Department of Medicine, Klinikum Nordfriesland, 25813 Husum, Germany
| | - Aurel Perren
- Institute of Pathology, University of Bern, 3012 Bern, Switzerland
| | - Ilaria Marinoni
- Institute of Pathology, University of Bern, 3012 Bern, Switzerland
| | - Natalia S. Pellegata
- Institute for Diabetes and Cancer, Helmholtz Zentrum München, Ingolstaedter Landstrasse 1, 85764 Neuherberg, Germany
- Joint Heidelberg-IDC Translational Diabetes Program, Heidelberg University Hospital, 69120 Heidelberg, Germany
- Department of Biology and Biotechnology “L. Spallanzani”, University of Pavia, 27100 Pavia, Italy
- Correspondence: ; Tel.: +49-089-31872633; Fax: +49-089-31873360
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Lakiza O, Lutze J, Vogle A, Williams J, Abukdheir A, Miller P, Liao CY'A, Pitroda SP, Martinez C, Olivas A, Setia N, Kron SJ, Weichselbaum RR, Keutgen XM. Loss of MEN1 function impairs DNA repair capability of pancreatic neuroendocrine tumors. Endocr Relat Cancer 2022; 29:225-239. [PMID: 35171113 PMCID: PMC9045673 DOI: 10.1530/erc-21-0247] [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: 02/14/2022] [Accepted: 02/16/2022] [Indexed: 11/08/2022]
Abstract
Somatic MEN1 mutations occur in up to 50% of pancreatic neuroendocrine tumors (PanNETs). Clinical studies have shown that radiation therapy (IR) is effective in a subset of PanNETs, but it remains unclear why some patients respond better to IR than others. Herein, we study whether MEN1 loss of function increases radiosensitivity of PanNETs and determine its effect on DNA double-strand break (DSB) repair. After creating a MEN1 knockout PanNET cell line, we confirmed reduced DSB repair capacity in MEN1-deficient cells and linked these findings to a defect in homologous recombination, as well as reduced BRCA2 expression levels. Consistent with this model, we found that MEN1 mutant cells displayed increased sensitivity to the highly trapping poly (ADP-ribose) polymerase (PARP) 1 inhibitor talazoparib in vitro. Our results suggest that combining IR with PARP inhibition may be beneficial in patients with PanNETs and MEN1 loss of function.
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Affiliation(s)
- Olga Lakiza
- Endocrine and Neuroendocrine Surgery Research Program, Division of General Surgery and Surgical Oncology, Department of Surgery, University of Chicago Medicine, Chicago, Illinois, USA
| | - Julian Lutze
- Committee on Cancer Biology, University of Chicago, Chicago, Illinois, USA
| | - Alyx Vogle
- Endocrine and Neuroendocrine Surgery Research Program, Division of General Surgery and Surgical Oncology, Department of Surgery, University of Chicago Medicine, Chicago, Illinois, USA
| | - Jelani Williams
- Endocrine and Neuroendocrine Surgery Research Program, Division of General Surgery and Surgical Oncology, Department of Surgery, University of Chicago Medicine, Chicago, Illinois, USA
| | - Abde Abukdheir
- Division of Hematology, Oncology, and Cell Therapy, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Paul Miller
- Endocrine and Neuroendocrine Surgery Research Program, Division of General Surgery and Surgical Oncology, Department of Surgery, University of Chicago Medicine, Chicago, Illinois, USA
| | - Chih-Yi 'Andy' Liao
- Division of Hematology and Oncology, Department of Internal Medicine, University of Chicago, Chicago, Illinois, USA
| | - Sean P Pitroda
- Department of Radiation Oncology and Cellular Biology, University of Chicago, Chicago, Illinois, USA
| | - Carlos Martinez
- Department of Radiation Oncology and Cellular Biology, University of Chicago, Chicago, Illinois, USA
| | - Andrea Olivas
- Department of Pathology, University of Chicago, Chicago, Illinois, USA
| | - Namrata Setia
- Department of Pathology, University of Chicago, Chicago, Illinois, USA
| | - Stephen J Kron
- Committee on Cancer Biology, University of Chicago, Chicago, Illinois, USA
- Department of Molecular Genetics and Cell Biology, University of Chicago, Chicago, Illinois, USA
| | - Ralph R Weichselbaum
- Department of Radiation Oncology and Cellular Biology, University of Chicago, Chicago, Illinois, USA
- Ludwig Center for Metastasis Research, University of Chicago, Chicago, Illinois, USA
| | - Xavier M Keutgen
- Endocrine and Neuroendocrine Surgery Research Program, Division of General Surgery and Surgical Oncology, Department of Surgery, University of Chicago Medicine, Chicago, Illinois, USA
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Abstract
It is now understood that specific somatic and germline mutations may lead to the development of the neuroendocrine tumours (NETs). NETs usually occur as sporadic isolated tumours, although they also may present as part of complex familial endocrine cancer syndromes, such as multiple endocrine neoplasia type 1 (MEN1) and type 2 (MEN2), Von Hippel-Lindau (VHL) and neurofibromatosis syndromes, tuberous sclerosis, Carney triad and dyad, Reed syndrome and polycythaemia-paraganglioma syndromes. Only in MEN2 syndrome is there a specific genotype-phenotype correlation, although in both sporadic and syndromic NETs some gene mutations are associated with specific clinico-pathological features and prognosis. There have been several advances in our understanding of the NETs leading to earlier detection and targeted therapeutic treatment, but given the poor prognosis associated with metastatic NETs, it will be necessary to find new biomarkers for the prediction of malignant potential and to find novel therapeutic targets for NETs.
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Affiliation(s)
- Marianna Minnetti
- Dept. of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Dept. of Medicine, University of Oxford, UK
| | - Ashley Grossman
- Dept. of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Dept. of Medicine, University of Oxford, UK.
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Abstract
Neuroendocrine tumors (NETs) are a rare and heterogeneous group of tumors with widely varying morphologies and behaviors. Due to their rarity and heterogeneity, progress in improving their treatment has been slow. However, in recent years there have been advances both in their characterization and in the available treatment options. This review will attempt to address these, with particular reference to pancreatic NETs. Pancreatic NETs are a subset of NETs, previously known as islet cell tumors, which appear to be a distinct biological entity, responding differently to systemic treatments compared with NETs arising elsewhere in the GI tract.
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Affiliation(s)
- Kate Young
- The Gastrointestinal Unit, The Royal Marsden Hospital NHS Foundation Trust, Fulham Road, London, SW3 6JJ, UK
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