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Fang Q, Mao G, Wang L, Gu Y, Song R, Gu X, Lu S, Li X. Synergetic approaches of fucoidan and trabectedin complex coated PLGA nanoparticles effectively suppresses proliferation and induce apoptosis for the treatment on non-small cell lung cancer. J Biomater Sci Polym Ed 2024:1-20. [PMID: 38530922 DOI: 10.1080/09205063.2024.2328421] [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: 12/28/2023] [Accepted: 03/05/2024] [Indexed: 03/28/2024]
Abstract
Traditional methods of treating lung cancer have not been very effective, contributing to the disease's high incidence and death rate. As a result, Fn/Tn-PLGA NPs, a novel directed fucoidan and trabectedin complex loaded PLGA nanoparticle, were produced to investigate the role of developing therapeutic strategies for NSCLC and A549 cell lines. Quantitative real-time polymerase chain reaction was used to examine protein expression and mRNA expression, respectively. Protein activity was knocked down using specific inhibitors and short disrupting RNA transfection. Lastly, cancer cell lines H1299 and A549 were subjected to an in vitro cytotoxicity experiment. Commercial assays were used to assess the levels of cell viability, ROS and proliferation found that Fn/Tn-PLGA NPs effectively killed lung cancer cells. To examine cell death, annexin flow cytometry was employed. In addition, a scratch-wound assay was conducted to assess the migration effects of Fn/Tn-PLGA NPs in a laboratory setting. Finally, PLGA NPs covered with a mix of fucoidan and trabectedin could be a good vehicle for targeting cancerous tissues with chemotherapeutic drugs.
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Affiliation(s)
- Qingliang Fang
- Department of Radiation Oncology, LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Guangmin Mao
- Department of Radiation Oncology, LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lei Wang
- Department of Radiation Oncology, LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yukai Gu
- Department of Radiation Oncology, LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Renjie Song
- Department of Radiation Oncology, LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xianglian Gu
- Department of Radiation Oncology, LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Song Lu
- Department of Radiation Oncology, LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiaoli Li
- Department of Radiation Oncology, LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Mannarino L, Ravasio N, D’Incalci M, Marchini S, Masseroli M. In-Silico Identification of Novel Pharmacological Synergisms: The Trabectedin Case. Int J Mol Sci 2024; 25:2059. [PMID: 38396735 PMCID: PMC10888651 DOI: 10.3390/ijms25042059] [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: 01/11/2024] [Revised: 02/06/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
The in-silico strategy of identifying novel uses for already existing drugs, known as drug repositioning, has enhanced drug discovery. Previous studies have shown a positive correlation between expression changes induced by the anticancer agent trabectedin and those caused by irinotecan, a topoisomerase I inhibitor. Leveraging the availability of transcriptional datasets, we developed a general in-silico drug-repositioning approach that we applied to investigate novel trabectedin synergisms. We set a workflow allowing the identification of genes selectively modulated by a drug and possible novel drug interactions. To show its effectiveness, we selected trabectedin as a case-study drug. We retrieved eight transcriptional cancer datasets including controls and samples treated with trabectedin or its analog lurbinectedin. We compared gene signature associated with each dataset to the 476,251 signatures from the Connectivity Map database. The most significant connections referred to mitomycin-c, topoisomerase II inhibitors, a PKC inhibitor, a Chk1 inhibitor, an antifungal agent, and an antagonist of the glutamate receptor. Genes coherently modulated by the drugs were involved in cell cycle, PPARalpha, and Rho GTPases pathways. Our in-silico approach for drug synergism identification showed that trabectedin modulates specific pathways that are shared with other drugs, suggesting possible synergisms.
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Affiliation(s)
- Laura Mannarino
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy;
- Laboratory of Cancer Pharmacology, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy;
| | - Nicholas Ravasio
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, 20133 Milan, Italy; (N.R.); (M.M.)
| | - Maurizio D’Incalci
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy;
- Laboratory of Cancer Pharmacology, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy;
| | - Sergio Marchini
- Laboratory of Cancer Pharmacology, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy;
| | - Marco Masseroli
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, 20133 Milan, Italy; (N.R.); (M.M.)
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Mochizuki T, Ikegami M, Akiyama T. Factors predictive of second-line chemotherapy in soft tissue sarcoma: An analysis of the National Genomic Profiling Database. Cancer Sci 2024; 115:575-588. [PMID: 38115234 PMCID: PMC10859616 DOI: 10.1111/cas.16050] [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: 10/17/2023] [Revised: 11/28/2023] [Accepted: 12/06/2023] [Indexed: 12/21/2023] Open
Abstract
Of the drugs used in second-line chemotherapy for soft tissue sarcoma (STS), trabectedin is effective for liposarcoma and leiomyosarcoma (L-sarcoma), eribulin for liposarcoma, and pazopanib for non-liposarcoma. The indications for these drugs in STS other than L-sarcoma have not been established. Here we explored the prognosis, mutation profiles, and drug-response factors in STS using real-world big data. Clinicogenomic data on 1761 patients with sarcoma who underwent FoundationOne CDx were obtained from a national database in Japan. Patients with TP53 and KDM2D mutations had a significantly shorter survival period of 253 (95% CI, 99-404) and 330 (95% CI, 20-552) days, respectively, than those without mutations. Non-supervised clustering based on mutation profiles generated 13 tumor clusters. The response rate (RR) to trabectedin was highest in an MDM2-amplification cluster (odds ratio [OR]: 2.2; p = 0.2). The RR was lowest for eribulin in an MDM2-amplification cluster (OR: 0.4; p = 0.03) and highest in a TERT-mutation cluster (OR: 3.0; p = 0.03). The RR was highest for pazopanib in a PIK3CA/PTEN-wild type cluster (OR: 2.1; p = 0.03). In particular, patients harboring mutations in genes regulating the PI3K/Akt/mTOR pathway had a lower RR than patients without mutations (OR: 0.3; p = 0.04). In STS, mutation profiles were more useful in predicting the drug response than histology. The present study demonstrated the potential of tailored therapy guided by mutation profiles established by comprehensive genomic profiling testing in optimizing second-line chemotherapy for STS. The findings of this study will hopefully contribute some valuable insights into enhancing STS treatment strategies and outcomes.
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Affiliation(s)
- Takao Mochizuki
- Department of Orthopaedic Surgery, Saitama Medical CenterJichi Medical UniversitySaitamaJapan
- Department of Musculoskeletal OncologyTokyo Metropolitan Cancer and Infectious Diseases Center, Komagome HospitalTokyoJapan
| | - Masachika Ikegami
- Department of Musculoskeletal OncologyTokyo Metropolitan Cancer and Infectious Diseases Center, Komagome HospitalTokyoJapan
- Division of Cellular SignalingNational Cancer Center Research InstituteTokyoJapan
| | - Toru Akiyama
- Department of Orthopaedic Surgery, Saitama Medical CenterJichi Medical UniversitySaitamaJapan
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Kasper B, Pink D, Rothermundt C, Richter S, Augustin M, Kollar A, Kunitz A, Eisterer W, Gaidzik V, Brodowicz T, Egerer G, Reichardt P, Hohenberger P, Schuler MK. Geriatric Assessment of Older Patients Receiving Trabectedin in First-Line Treatment for Advanced Soft Tissue Sarcomas: The E-TRAB Study from The German Interdisciplinary Sarcoma Group (GISG-13). Cancers (Basel) 2024; 16:558. [PMID: 38339308 PMCID: PMC10854510 DOI: 10.3390/cancers16030558] [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: 12/29/2023] [Revised: 01/25/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Abstract
E-TRAB was a non-interventional, prospective trial investigating the feasibility and predictive value of geriatric assessments (GA) in older STS patients treated with trabectedin as first-line therapy. Primary endpoints were overall survival (OS), quality of life and individual clinical benefit assessed by the patient-reported outcome measures QLQ-C30 and PRO-CTCAE. Further, several GA tools were applied and correlated with clinical outcomes and treatment-related toxicities. The final analyses included 69 patients from 12 German-speaking sites. The median age of patients was 78 years (range: 55 to 88). Baseline data on PROs and GA identified a diverse population of older patients with respect to their global health status, although a large proportion of them suffered from limitations, required geriatric help and had a high risk of morbidity. The Cancer and Age Research Group (CARG) score classified 38%, 29% and 23% of the patients with low, intermediate and high risks for therapy-related side effects, respectively. Median OS was 11.2 months [95%CI: 5.6; 19.4]. The study confirmed that trabectedin as first-line treatment in older patients with STS has an acceptable and manageable safety profile. Potential prognostic factors for clinical outcome and therapy-related toxicity were identified among the GA tools. Long Timed Up and Go (TUG) showed a significant correlation to OS and early death, whereas a high CARG score (>9) was associated with an increase in unplanned hospitalizations and the incidence of toxicities grade ≥ 3.
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Affiliation(s)
- Bernd Kasper
- Sarcoma Unit, Mannheim Cancer Center (MCC), Mannheim University Medical Center, University of Heidelberg, 68167 Mannheim, Germany
| | - Daniel Pink
- Department of Oncology and Palliative Care, HELIOS Klinikum Bad Saarow, 15526 Bad Saarow, Germany;
- Department of Internal Medicine C, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Christian Rothermundt
- Department of Medical Oncology and Hematology, Kantonsspital St. Gallen, 9007 St. Gallen, Switzerland;
| | - Stephan Richter
- Medical Department I, University Hospital Carl Gustav Carus, Dresden University of Technology, 01307 Dresden, Germany
| | - Marinela Augustin
- Department of Hematology and Oncology, Paracelsus Medical University, 90419 Nuremberg, Germany;
| | - Attila Kollar
- Department of Medical Oncology, Bern University Hospital, University of Bern, 3010 Bern, Switzerland;
| | - Annegret Kunitz
- Department of Hematology, Oncology and Palliative Medicine, Vivantes Klinikum Spandau, 13585 Berlin, Germany;
| | - Wolfgang Eisterer
- Clinical Division of Oncology, Department of Internal Medicine, Medical University Graz, 8036 Graz, Austria;
| | - Verena Gaidzik
- Clinic for Internal Medicine III, University Hospital Ulm, 89081 Ulm, Germany;
| | - Thomas Brodowicz
- Vienna General Hospital (AKH), Medizinische Universität Wien, 1090 Vienna, Austria;
| | - Gerlinde Egerer
- Department of Internal Medicine V, Heidelberg University Hospital, 69120 Heidelberg, Germany;
| | - Peter Reichardt
- Department of Oncology, Helios Klinikum Berlin-Buch, 13125 Berlin, Germany;
| | - Peter Hohenberger
- Division of Surgical Oncology and Thoracic Surgery, University Medical Center Mannheim, Mannheim Medical Faculty, University of Heidelberg, 68167 Mannheim, Germany
| | - Markus K. Schuler
- Medical Department I, University Hospital Carl Gustav Carus, Dresden University of Technology, 01307 Dresden, Germany
- Onkologischer Schwerpunkt am Oskar-Helene Heim, 14195 Berlin, Germany
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Martin-Broto J, Olarte-García A, Fernandéz-Rodríguez R, Ferreira MR, Carrasco-García I, Galvez-Montosa F, Rincon-Perez I, Peinado-Serrano J, Azinovic I, Guzman-Gomez L, Salgado L, Sevillano A, Ortega J, Alvarez C, Gutierrez A, Moura DS, Hindi N. Trabectedin and low-dose radiation therapy in patients with advanced leiomyosarcoma. Ther Adv Med Oncol 2024; 16:17588359231225044. [PMID: 38288156 PMCID: PMC10823838 DOI: 10.1177/17588359231225044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 12/05/2023] [Indexed: 01/31/2024] Open
Abstract
Background and objectives Dimensional response is an unmet need in second lines of advanced soft tissue sarcomas (STS). Indeed, the three approved drugs, pazopanib, trabectedin, and eribulin, achieved an overall response rate (ORR) of less than 10%. This fact potentially hinders the options for fast symptomatic relief or surgical rescue. The combination of trabectedin plus low-dose radiation therapy (T-XRT) demonstrated a response rate of 60% in phase I/II trial, while real-life data achieved 32.5% ORR, probably due to a more relaxed timing between treatments. These results were obtained in progressing and advanced STS. In this study, the merged databases (trial plus real life) have been analyzed, with a special focus on leiomyosarcoma patients. Design and methods As responses were seen in a wide range of sarcoma histologies (11), this study planned to analyze whether leiomyosarcoma, the largest subtype with 26 cases (30.6%) in this series, exhibited a better clinical outcome with this therapeutic strategy. In addition, four advanced and progressing leiomyosarcoma patients, all with extraordinarily long progression-free survival of over 18 months, were collected. Results A total of 847 cycles of trabectedin were administered to 85 patients, with the median number of cycles per patient being 7 (1-45+). A trend toward a longer progression-free survival (PFS) was observed in leiomyosarcoma patients with median PFS (mPFS) of 9.9 months [95% confidence interval (CI): 1.1-18.7] versus 5.6 months (95% CI: 3.2-7.9) for the remaining histologies, p = 0.25. When leiomyosarcoma and liposarcoma were grouped, this difference reached statistical significance, probably due to the special sensitivity of myxoid liposarcoma. The mPFS for L-sarcomas was 12.7 months (95% CI: 7-18.5) versus 4.3 months (95% CI: 3.3-5.3) for the remaining histologies, p = 0.001. Cases with long-lasting disease control are detected among leiomyosarcoma patients. Conclusion Even when extraordinarily long-lasting responses do exist among leiomyosarcoma patients treated with T-XR, we were unable to demonstrate a significant difference favoring leiomyosarcoma patients in clinical outcomes.
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Affiliation(s)
- Javier Martin-Broto
- Medical Oncology Department, Fundación Jimenez Diaz University Hospital, Av. de los Reyes Católicos, 2, Madrid 28040, Spain
- University Hospital General de Villalba, Madrid, Spain
- Instituto de Investigación Sanitaria Fundación Jimenez Diaz, La Universidad Autónoma de Madrid, Madrid, Spain
| | - Alicia Olarte-García
- Radiation Oncology Service, Instituto Oncológico, Clínica IMQ Zorrotzaurre, Bilbao, Spain
| | | | - Marta Ribeiro Ferreira
- Medical Oncology Department, Instituto Português de Oncologia do Porto FG, Porto, Portugal
| | | | | | | | - Javier Peinado-Serrano
- Department of Radiation Oncology, University Hospital Virgen del Rocío, Sevilla, Spain
- Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío, Consejo Superior de Investigaciones Científicas, Universidad de Sevilla, Seville, Spain
- CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
| | - Ignacio Azinovic
- Department of Radiation Oncology, Fundación Jimenez Diaz University Hospital, Madrid, Spain
| | - Laura Guzman-Gomez
- Department of Radiation Oncology, Fundación Jimenez Diaz University Hospital, Madrid, Spain
| | - Lurdes Salgado
- Radiotherapy Department, Instituto Português de Oncologia do Porto FG, Porto, Portugal
| | - Alberto Sevillano
- Medical Oncology Department, Fundación Jimenez Diaz University Hospital, Madrid, Spain
- University Hospital General de Villalba, Madrid, Spain
- Instituto de Investigación Sanitaria Fundación Jimenez Diaz, La Universidad Autónoma de Madrid, Madrid, Spain
| | - Justo Ortega
- Medical Oncology Department, Fundación Jimenez Diaz University Hospital, Madrid, Spain
- University Hospital General de Villalba, Madrid, Spain
- Instituto de Investigación Sanitaria Fundación Jimenez Diaz, La Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Antonio Gutierrez
- Medical Hematology Department, Son Espases University Hospital, Mallorca, Spain
| | - David S. Moura
- Instituto de Investigación Sanitaria Fundación Jimenez Diaz, La Universidad Autónoma de Madrid, Madrid, Spain
| | - Nadia Hindi
- Medical Oncology Department, Fundación Jimenez Diaz University Hospital, Madrid, Spain
- University Hospital General de Villalba, Madrid, Spain
- Instituto de Investigación Sanitaria Fundación Jimenez Diaz, La Universidad Autónoma de Madrid, Madrid, Spain
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Povo-Retana A, Landauro-Vera R, Alvarez-Lucena C, Cascante M, Boscá L. Trabectedin and Lurbinectedin Modulate the Interplay between Cells in the Tumour Microenvironment-Progresses in Their Use in Combined Cancer Therapy. Molecules 2024; 29:331. [PMID: 38257245 PMCID: PMC10820391 DOI: 10.3390/molecules29020331] [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: 12/11/2023] [Revised: 12/30/2023] [Accepted: 01/05/2024] [Indexed: 01/24/2024] Open
Abstract
Trabectedin (TRB) and Lurbinectedin (LUR) are alkaloid compounds originally isolated from Ecteinascidia turbinata with proven antitumoral activity. Both molecules are structural analogues that differ on the tetrahydroisoquinoline moiety of the C subunit in TRB, which is replaced by a tetrahydro-β-carboline in LUR. TRB is indicated for patients with relapsed ovarian cancer in combination with pegylated liposomal doxorubicin, as well as for advanced soft tissue sarcoma in adults in monotherapy. LUR was approved by the FDA in 2020 to treat metastatic small cell lung cancer. Herein, we systematically summarise the origin and structure of TRB and LUR, as well as the molecular mechanisms that they trigger to induce cell death in tumoral cells and supporting stroma cells of the tumoral microenvironment, and how these compounds regulate immune cell function and fate. Finally, the novel therapeutic venues that are currently under exploration, in combination with a plethora of different immunotherapeutic strategies or specific molecular-targeted inhibitors, are reviewed, with particular emphasis on the usage of immune checkpoint inhibitors, or other bioactive molecules that have shown synergistic effects in terms of tumour regression and ablation. These approaches intend to tackle the complexity of managing cancer patients in the context of precision medicine and the application of tailor-made strategies aiming at the reduction of undesired side effects.
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Affiliation(s)
- Adrián Povo-Retana
- Instituto de Investigaciones Biomédicas Alberto Sols-Morreale (CSIC-UAM), Arturo Duperier 4, 28029 Madrid, Spain; (R.L.-V.); (C.A.-L.)
| | - Rodrigo Landauro-Vera
- Instituto de Investigaciones Biomédicas Alberto Sols-Morreale (CSIC-UAM), Arturo Duperier 4, 28029 Madrid, Spain; (R.L.-V.); (C.A.-L.)
| | - Carlota Alvarez-Lucena
- Instituto de Investigaciones Biomédicas Alberto Sols-Morreale (CSIC-UAM), Arturo Duperier 4, 28029 Madrid, Spain; (R.L.-V.); (C.A.-L.)
| | - Marta Cascante
- Department of Biochemistry and Molecular Biomedicine-Institute of Biomedicine (IBUB), Faculty of Biology, Universitat de Barcelona, 08028 Barcelona, Spain;
- Department of Material Science and Physical Chemistry, Research Institute of Theoretical and Computational Chemistry (IQTCUB), University of Barcelona, 08028 Barcelona, Spain
| | - Lisardo Boscá
- Instituto de Investigaciones Biomédicas Alberto Sols-Morreale (CSIC-UAM), Arturo Duperier 4, 28029 Madrid, Spain; (R.L.-V.); (C.A.-L.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain
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Saito Y, Shimoi T, Iwata S, Maejima A, Abe K, Udagawa R, Yonemori K, Furukawa T, Wakao F. Impact of relative dose intensity of trabectedin with pegfilgrastim support: a single-centre retrospective study. J Chemother 2023; 35:737-744. [PMID: 36633925 DOI: 10.1080/1120009x.2022.2164116] [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: 09/06/2022] [Revised: 11/29/2022] [Accepted: 12/27/2022] [Indexed: 01/13/2023]
Abstract
Relative dose intensity (RDI) has been associated with improved survival in patients with advanced solid tumours. However, there is no evidence regarding RDI in patients under long-term treatment with trabectedin for adult advanced soft tissue sarcoma (STS). Pegfilgrastim use was associated with chemotherapy dose intensity maintenance in patients with various cancers. We retrospectively evaluated the RDI in patients with STS receiving trabectedin. The patients were grouped based on whether trabectedin administration was supported by pegfilgrastim. RDI was obtained for 114 of the 140 included patients. Chemotherapy cycles that included filgrastim were excluded. Patients treated with and without pegfilgrastim had similar RDI rates (77.1% ± 17.6% vs 78.8% ± 16.4%; P = 0.485). Moreover, we found no association between patients receiving ≥4 trabectedin cycles and the use of pegfilgrastim. These results suggested that trabectedin dose delays or reductions should be considered before administering prophylactic pegfilgrastim.
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Affiliation(s)
- Yoshimasa Saito
- Division of Quality Assurance Programs, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
- Department of Pharmacy, National Cancer Center Hospital, Tokyo, Japan
| | - Tatsunori Shimoi
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Shintaro Iwata
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| | - Aiko Maejima
- Department of Urology, National Cancer Center Hospital, Tokyo, Japan
| | - Kentaro Abe
- Department of Pharmacy, National Cancer Center Hospital, Tokyo, Japan
| | - Ryoko Udagawa
- Department of Pharmacy, National Cancer Center Hospital, Tokyo, Japan
| | - Kan Yonemori
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Tetsuya Furukawa
- Department of Pharmacy, National Cancer Center Hospital, Tokyo, Japan
| | - Fumihiko Wakao
- Institute for Cancer Control, National Cancer Center, Tokyo, Japan
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Iwai T, Hoshi M, Oebisu N, Takada N, Ban Y, Yao H, Nakamura H. Optimal Prognostic Factors for Metastatic and Inoperable Sarcomas Treated With Pazopanib, Eribulin, and Trabectedin. In Vivo 2023; 37:2634-2641. [PMID: 37905627 PMCID: PMC10621442 DOI: 10.21873/invivo.13371] [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: 07/12/2023] [Revised: 08/23/2023] [Accepted: 09/01/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND/AIM The prognosis of metastatic and inoperable sarcomas is extremely poor, and intensive chemotherapy-based treatment is typically administered to prolong survival. Currently, pazopanib, eribulin, and trabectedin are key drugs used in patients with these sarcomas. The aim of the study was to identify prognostic factors for metastatic and inoperable bone and soft tissue sarcomas. PATIENTS AND METHODS Clinicopathological data of 46 patients with metastatic and inoperable sarcomas treated with pazopanib, eribulin, and trabectedin between January 2013 and February 2022 at our institution were retrospectively analyzed. Age, sex, primary tumor location, adverse effects, history of doxorubicin and radiation therapy, performance status scores, maximum tumor response, and survival duration were evaluated. The significant prognostic factors were identified using Cox proportional hazards models. Moreover, the 5-year survival rate was evaluated using the Kaplan-Meier method. RESULTS The median survival duration after treatment was 13.3 months, where the 5-year overall survival rate was estimated to be 9.85%. Both univariate and multivariate analyses revealed significant relationships among patient prognosis, performance status, and tumor response. CONCLUSION Performance status scores and tumor response were significantly associated with patient prognosis. Therefore, regardless of age, sex, primary tumor location, adverse effects, and history of doxorubicin and radiation therapy, use of cutting-edge drugs, such as pazopanib, eribulin, and trabectedin, may be advantageous in patients with advanced sarcomas, if their drug response and performance status scores are good.
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Affiliation(s)
- Tadashi Iwai
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Manabu Hoshi
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Naoto Oebisu
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Naoki Takada
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Yoshitaka Ban
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Hana Yao
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Hiroaki Nakamura
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
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9
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Zeng Z, Lin C, Zhang MC, Kossinna P, Wang P, Cao D, Wang J, Xu M, Wang X, Li Q, Xu X, Yang H, Zhu S, Liu GR, Xie K, Yang J, Luo Y, Wang Y, Zhang XH, Lin J, Chen H, Liu SL, Liu H. Enterolactone and trabectedin suppress epithelial ovarian cancer synergistically via upregulating THBS1. Phytother Res 2023; 37:4722-4739. [PMID: 37443453 DOI: 10.1002/ptr.7942] [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: 04/15/2023] [Revised: 06/13/2023] [Accepted: 06/25/2023] [Indexed: 07/15/2023]
Abstract
Epithelial ovarian cancer (EOC) is the most common and fatal subtype of ovarian malignancies, with no effective therapeutics available. Our previous studies have demonstrated extraordinary suppressive efficacy of enterolactone (ENL) on EOC. A chemotherapeutic agent, trabectedin (Trabe), is shown to be effective on ovarian cancer, especially when combined with other therapeutics, such as pegylated liposomal doxorubicin or oxaliplatin. Thrombospondin 1 (THBS1), a kind of matrix glycoprotein, plays important roles against cancer development through inhibiting angiogenesis but whether it is involved in the suppression of EOC by ENL or Trabe remains unknown. To test combined suppressive effects of ENL and Trabe on EOC and possible involvement of THBS1 in the anticancer activities of ENL and Trabe. The EOC cell line ES-2 was transfected with overexpressed THBS1 by lentivirus vector. We employed tube formation assay to evaluate the anti-angiogenesis activity of ENL and of its combined use with Trabe after THBS1 overexpression and established drug intervention and xenograft nude mouse cancer models to assess the in vivo effects of the hypothesized synergistic suppression between the agents and the involvement of THBS1. Mouse fecal samples were collected for 16S rDNA sequencing and microbiota analysis. We detected strong inhibitory activities of ENL and Trabe against the proliferation and migration of cancer cells and observed synergistic effects between ENL and Trabe in suppressing EOC. ENL and Trabe, given either separately or in combination, could suppress the tube formation capability of human microvascular endothelial cells, and this inhibitory effect became even stronger with THBS1 overexpression. In the ENL plus Trabe combination group, the expression of tissue inhibitor of metalloproteinases 3 and cluster of differentiation 36 was both upregulated, whereas matrix metalloproteinase 9, vascular endothelial growth factor, and cluster of differentiation 47 were all decreased. With the overexpression of THBS1, the results became even more pronounced. In animal experiments, combined use of ENL and Trabe showed superior inhibitory effects to either single agent and significantly suppressed tumor growth, and the overexpression of THBS1 further enhanced the anti-cancer activities of the drug combination group. ENL and Trabe synergistically suppress EOC and THBS1 could remarkably facilitate the synergistic anticancer effects of ENL and Trabe.
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Affiliation(s)
- Zheng Zeng
- Genomics Research Center, Key Laboratory of Gut Microbiota and Pharmacogenomics of Heilongjiang Province, State-Province Key Laboratory of Biomedicine-Pharmaceutics of China, College of Pharmacy, Harbin Medical University, Harbin, China
- Harbin Medical University-University of Calgary Cumming School of Medicine Centre for Infection and Genomics, Harbin Medical University, Harbin, China
- Department of Biochemistry and Molecular Biology, University of Calgary, Calgary, Canada
- School of Biomedical Science, The University of Hong Kong, Hong Kong
| | - Caiji Lin
- Genomics Research Center, Key Laboratory of Gut Microbiota and Pharmacogenomics of Heilongjiang Province, State-Province Key Laboratory of Biomedicine-Pharmaceutics of China, College of Pharmacy, Harbin Medical University, Harbin, China
- Harbin Medical University-University of Calgary Cumming School of Medicine Centre for Infection and Genomics, Harbin Medical University, Harbin, China
| | - Meng-Chun Zhang
- Genomics Research Center, Key Laboratory of Gut Microbiota and Pharmacogenomics of Heilongjiang Province, State-Province Key Laboratory of Biomedicine-Pharmaceutics of China, College of Pharmacy, Harbin Medical University, Harbin, China
- Harbin Medical University-University of Calgary Cumming School of Medicine Centre for Infection and Genomics, Harbin Medical University, Harbin, China
| | - Pathum Kossinna
- Department of Biochemistry and Molecular Biology, University of Calgary, Calgary, Canada
| | - Pengfei Wang
- Genomics Research Center, Key Laboratory of Gut Microbiota and Pharmacogenomics of Heilongjiang Province, State-Province Key Laboratory of Biomedicine-Pharmaceutics of China, College of Pharmacy, Harbin Medical University, Harbin, China
- Harbin Medical University-University of Calgary Cumming School of Medicine Centre for Infection and Genomics, Harbin Medical University, Harbin, China
| | - Danli Cao
- Genomics Research Center, Key Laboratory of Gut Microbiota and Pharmacogenomics of Heilongjiang Province, State-Province Key Laboratory of Biomedicine-Pharmaceutics of China, College of Pharmacy, Harbin Medical University, Harbin, China
- Harbin Medical University-University of Calgary Cumming School of Medicine Centre for Infection and Genomics, Harbin Medical University, Harbin, China
| | - Jiaxing Wang
- Genomics Research Center, Key Laboratory of Gut Microbiota and Pharmacogenomics of Heilongjiang Province, State-Province Key Laboratory of Biomedicine-Pharmaceutics of China, College of Pharmacy, Harbin Medical University, Harbin, China
- Harbin Medical University-University of Calgary Cumming School of Medicine Centre for Infection and Genomics, Harbin Medical University, Harbin, China
| | - Mengzhi Xu
- Genomics Research Center, Key Laboratory of Gut Microbiota and Pharmacogenomics of Heilongjiang Province, State-Province Key Laboratory of Biomedicine-Pharmaceutics of China, College of Pharmacy, Harbin Medical University, Harbin, China
- Harbin Medical University-University of Calgary Cumming School of Medicine Centre for Infection and Genomics, Harbin Medical University, Harbin, China
| | - Xiaoyu Wang
- Genomics Research Center, Key Laboratory of Gut Microbiota and Pharmacogenomics of Heilongjiang Province, State-Province Key Laboratory of Biomedicine-Pharmaceutics of China, College of Pharmacy, Harbin Medical University, Harbin, China
- Harbin Medical University-University of Calgary Cumming School of Medicine Centre for Infection and Genomics, Harbin Medical University, Harbin, China
| | - Qing Li
- Department of Biochemistry and Molecular Biology, University of Calgary, Calgary, Canada
| | - Xiaohui Xu
- School of Basic Medicine, Harbin Medical University, Harbin, China
| | - Hao Yang
- Department of Pathology, Harbin Chest Hospital, Harbin, China
| | - Songling Zhu
- Genomics Research Center, Key Laboratory of Gut Microbiota and Pharmacogenomics of Heilongjiang Province, State-Province Key Laboratory of Biomedicine-Pharmaceutics of China, College of Pharmacy, Harbin Medical University, Harbin, China
- Harbin Medical University-University of Calgary Cumming School of Medicine Centre for Infection and Genomics, Harbin Medical University, Harbin, China
| | - Gui-Rong Liu
- Genomics Research Center, Key Laboratory of Gut Microbiota and Pharmacogenomics of Heilongjiang Province, State-Province Key Laboratory of Biomedicine-Pharmaceutics of China, College of Pharmacy, Harbin Medical University, Harbin, China
- Harbin Medical University-University of Calgary Cumming School of Medicine Centre for Infection and Genomics, Harbin Medical University, Harbin, China
| | - Kaihong Xie
- Genomics Research Center, Key Laboratory of Gut Microbiota and Pharmacogenomics of Heilongjiang Province, State-Province Key Laboratory of Biomedicine-Pharmaceutics of China, College of Pharmacy, Harbin Medical University, Harbin, China
- Harbin Medical University-University of Calgary Cumming School of Medicine Centre for Infection and Genomics, Harbin Medical University, Harbin, China
| | - Jiaming Yang
- Genomics Research Center, Key Laboratory of Gut Microbiota and Pharmacogenomics of Heilongjiang Province, State-Province Key Laboratory of Biomedicine-Pharmaceutics of China, College of Pharmacy, Harbin Medical University, Harbin, China
- Harbin Medical University-University of Calgary Cumming School of Medicine Centre for Infection and Genomics, Harbin Medical University, Harbin, China
| | - Yao Luo
- Genomics Research Center, Key Laboratory of Gut Microbiota and Pharmacogenomics of Heilongjiang Province, State-Province Key Laboratory of Biomedicine-Pharmaceutics of China, College of Pharmacy, Harbin Medical University, Harbin, China
- Harbin Medical University-University of Calgary Cumming School of Medicine Centre for Infection and Genomics, Harbin Medical University, Harbin, China
| | - Yao Wang
- Genomics Research Center, Key Laboratory of Gut Microbiota and Pharmacogenomics of Heilongjiang Province, State-Province Key Laboratory of Biomedicine-Pharmaceutics of China, College of Pharmacy, Harbin Medical University, Harbin, China
- Harbin Medical University-University of Calgary Cumming School of Medicine Centre for Infection and Genomics, Harbin Medical University, Harbin, China
| | - Xing-Hua Zhang
- Genomics Research Center, Key Laboratory of Gut Microbiota and Pharmacogenomics of Heilongjiang Province, State-Province Key Laboratory of Biomedicine-Pharmaceutics of China, College of Pharmacy, Harbin Medical University, Harbin, China
- Harbin Medical University-University of Calgary Cumming School of Medicine Centre for Infection and Genomics, Harbin Medical University, Harbin, China
| | - Jingwen Lin
- Genomics Research Center, Key Laboratory of Gut Microbiota and Pharmacogenomics of Heilongjiang Province, State-Province Key Laboratory of Biomedicine-Pharmaceutics of China, College of Pharmacy, Harbin Medical University, Harbin, China
- Harbin Medical University-University of Calgary Cumming School of Medicine Centre for Infection and Genomics, Harbin Medical University, Harbin, China
| | - Hang Chen
- Genomics Research Center, Key Laboratory of Gut Microbiota and Pharmacogenomics of Heilongjiang Province, State-Province Key Laboratory of Biomedicine-Pharmaceutics of China, College of Pharmacy, Harbin Medical University, Harbin, China
- Harbin Medical University-University of Calgary Cumming School of Medicine Centre for Infection and Genomics, Harbin Medical University, Harbin, China
| | - Shu-Lin Liu
- Genomics Research Center, Key Laboratory of Gut Microbiota and Pharmacogenomics of Heilongjiang Province, State-Province Key Laboratory of Biomedicine-Pharmaceutics of China, College of Pharmacy, Harbin Medical University, Harbin, China
- Harbin Medical University-University of Calgary Cumming School of Medicine Centre for Infection and Genomics, Harbin Medical University, Harbin, China
- National Key Laboratory of Frigid Zone Cardiovascular Diseases (NKLFZCD) College of Pharmacy, Harbin Medical University, Harbin, China
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Canada
| | - Huidi Liu
- Genomics Research Center, Key Laboratory of Gut Microbiota and Pharmacogenomics of Heilongjiang Province, State-Province Key Laboratory of Biomedicine-Pharmaceutics of China, College of Pharmacy, Harbin Medical University, Harbin, China
- Harbin Medical University-University of Calgary Cumming School of Medicine Centre for Infection and Genomics, Harbin Medical University, Harbin, China
- Department of Biochemistry and Molecular Biology, University of Calgary, Calgary, Canada
- National Key Laboratory of Frigid Zone Cardiovascular Diseases (NKLFZCD) College of Pharmacy, Harbin Medical University, Harbin, China
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Miolo G, Buonadonna A, Scalone S, Lombardi D, Della Puppa L, Steffan A, Corona G. Metabolic Clues to Bile Acid Patterns and Prolonged Survival in Patients with Metastatic Soft-Tissue Sarcoma Treated with Trabectedin. Metabolites 2023; 13:1035. [PMID: 37887360 PMCID: PMC10608628 DOI: 10.3390/metabo13101035] [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: 09/11/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/28/2023] Open
Abstract
Metastatic soft-tissue sarcomas (mSTS) encompass a highly heterogeneous group of rare tumours characterized by different clinical behaviours and outcomes. Currently, prognostic factors for mSTS are very limited, posing significant challenges in predicting patient survival. Within a cohort of 39 mSTS patients undergoing trabectedin treatment, it was remarkable to find one patient who underwent 73 cycles of trabectedin achieving an unforeseen clinical outcome. To identify contributing factors to her exceptional long-term survival, we have explored circulation metabolomics and biohumoral biomarkers to uncover a potential distinct host biochemical phenotype. The long-term survival patient compared with the other mSTS patients exhibited a distinctive metabolic profile characterized by remarkably higher levels of ursodeoxycholic acid (UDCA) derivatives and vitamin D and lower levels of lithocholic acid (LCA) derivatives, as well as reduced levels of inflammatory C-Reactive Protein 4 (C-RP4) biomarker. Despite its exploratory nature, this study reveals a potential association between specific bile acid metabolic profiles and mSTS patients' prognosis. Enhanced clinical understanding of the interplay between bile acid metabolism and disease progression could pave the way for new targeted therapeutic interventions which may improve the overall survival of mSTS patients.
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Affiliation(s)
- Gianmaria Miolo
- Department of Medical Oncology, Unit of Medical Oncology and Cancer Prevention, Centro di Riferimento Oncologico (CRO), IRCCS Aviano, 33081 Aviano, Italy; (G.M.); (A.B.); (S.S.); (D.L.)
| | - Angela Buonadonna
- Department of Medical Oncology, Unit of Medical Oncology and Cancer Prevention, Centro di Riferimento Oncologico (CRO), IRCCS Aviano, 33081 Aviano, Italy; (G.M.); (A.B.); (S.S.); (D.L.)
| | - Simona Scalone
- Department of Medical Oncology, Unit of Medical Oncology and Cancer Prevention, Centro di Riferimento Oncologico (CRO), IRCCS Aviano, 33081 Aviano, Italy; (G.M.); (A.B.); (S.S.); (D.L.)
| | - Davide Lombardi
- Department of Medical Oncology, Unit of Medical Oncology and Cancer Prevention, Centro di Riferimento Oncologico (CRO), IRCCS Aviano, 33081 Aviano, Italy; (G.M.); (A.B.); (S.S.); (D.L.)
| | - Lara Della Puppa
- Unit of Oncogenetics and Functional Oncogenomics, Centro di Riferimento Oncologico (CRO), IRCCS Aviano, 33081 Aviano, Italy;
| | - Agostino Steffan
- Immunopathology and Cancer Biomarkers, Centro di Riferimento Oncologico (CRO), IRCCS Aviano, 33081 Aviano, Italy, 33081 Aviano, Italy;
| | - Giuseppe Corona
- Immunopathology and Cancer Biomarkers, Centro di Riferimento Oncologico (CRO), IRCCS Aviano, 33081 Aviano, Italy, 33081 Aviano, Italy;
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11
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Assi T, Cesne AL. Trabectedin and radiotherapy in soft tissue sarcomas: friends or foes? Future Oncol 2023; 19:1893-1896. [PMID: 37781755 DOI: 10.2217/fon-2023-0542] [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] [Subscribe] [Scholar Register] [Indexed: 10/03/2023] Open
Affiliation(s)
- Tarek Assi
- Division of International Patients Care, Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, 94805, Villejuif, France
| | - Axel Le Cesne
- Division of International Patients Care, Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, 94805, Villejuif, France
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12
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Povo-Retana A, Fariñas M, Landauro-Vera R, Mojena M, Alvarez-Lucena C, Fernández-Moreno MA, Castrillo A, de la Rosa Medina JV, Sánchez-García S, Foguet C, Mas F, Marin S, Cascante M, Boscá L. Immunometabolic actions of trabectedin and lurbinectedin on human macrophages: relevance for their anti-tumor activity. Front Immunol 2023; 14:1211068. [PMID: 37675104 PMCID: PMC10479946 DOI: 10.3389/fimmu.2023.1211068] [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: 04/24/2023] [Accepted: 08/03/2023] [Indexed: 09/08/2023] Open
Abstract
In recent years, the central role of cell bioenergetics in regulating immune cell function and fate has been recognized, giving rise to the interest in immunometabolism, an area of research focused on the interaction between metabolic regulation and immune function. Thus, early metabolic changes associated with the polarization of macrophages into pro-inflammatory or pro-resolving cells under different stimuli have been characterized. Tumor-associated macrophages are among the most abundant cells in the tumor microenvironment; however, it exists an unmet need to study the effect of chemotherapeutics on macrophage immunometabolism. Here, we use a systems biology approach that integrates transcriptomics and metabolomics to unveil the immunometabolic effects of trabectedin (TRB) and lurbinectedin (LUR), two DNA-binding agents with proven antitumor activity. Our results show that TRB and LUR activate human macrophages toward a pro-inflammatory phenotype by inducing a specific metabolic rewiring program that includes ROS production, changes in the mitochondrial inner membrane potential, increased pentose phosphate pathway, lactate release, tricarboxylic acids (TCA) cycle, serine and methylglyoxal pathways in human macrophages. Glutamine, aspartate, histidine, and proline intracellular levels are also decreased, whereas oxygen consumption is reduced. The observed immunometabolic changes explain additional antitumor activities of these compounds and open new avenues to design therapeutic interventions that specifically target the immunometabolic landscape in the treatment of cancer.
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Affiliation(s)
- Adrián Povo-Retana
- Instituto de Investigaciones Biomédicas Alberto Sols, CSIC-UAM, Madrid, Spain
| | - Marco Fariñas
- Department of Biochemistry and Molecular Biomedicine-Institute of Biomedicine (IBUB), Faculty of Biology, Universitat de Barcelona, Barcelona, Spain
| | | | - Marina Mojena
- Instituto de Investigaciones Biomédicas Alberto Sols, CSIC-UAM, Madrid, Spain
| | | | - Miguel A. Fernández-Moreno
- Instituto de Investigaciones Biomédicas Alberto Sols, CSIC-UAM, Madrid, Spain
- Departamento de Bioquímica, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain
| | - Antonio Castrillo
- Instituto de Investigaciones Biomédicas Alberto Sols, CSIC-UAM, Madrid, Spain
- Unidad de Biomedicina (Unidad Asociada al CSIC) de la Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Juan Vladimir de la Rosa Medina
- Unidad de Biomedicina (Unidad Asociada al CSIC) de la Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain
- Unidad Instituto Universitario de Investigaciones Biomédicas y Sanitarias (IUIBS) de la Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain
| | | | - Carles Foguet
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Francesc Mas
- Department of Material Science and Physical Chemistry & Research Institute of Theoretical and Computational Chemistry (IQTCUB), University of Barcelona, Barcelona, Spain
| | - Silvia Marin
- Department of Biochemistry and Molecular Biomedicine-Institute of Biomedicine (IBUB), Faculty of Biology, Universitat de Barcelona, Barcelona, Spain
- CIBER of Hepatic and Digestive Diseases (CIBEREHD), Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Marta Cascante
- Department of Biochemistry and Molecular Biomedicine-Institute of Biomedicine (IBUB), Faculty of Biology, Universitat de Barcelona, Barcelona, Spain
- CIBER of Hepatic and Digestive Diseases (CIBEREHD), Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Lisardo Boscá
- Instituto de Investigaciones Biomédicas Alberto Sols, CSIC-UAM, Madrid, Spain
- Unidad de Biomedicina (Unidad Asociada al CSIC) de la Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Av. Monforte de Lemos, Madrid, Spain
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Corona G, Di Gregorio E, Buonadonna A, Lombardi D, Scalone S, Steffan A, Miolo G. Pharmacometabolomics of trabectedin in metastatic soft tissue sarcoma patients. Front Pharmacol 2023; 14:1212634. [PMID: 37637412 PMCID: PMC10450632 DOI: 10.3389/fphar.2023.1212634] [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: 04/26/2023] [Accepted: 07/20/2023] [Indexed: 08/29/2023] Open
Abstract
Objective: Trabectedin is an anti-cancer drug commonly used for the treatment of patients with metastatic soft tissue sarcoma (mSTS). Despite its recognized efficacy, significant variability in pharmacological response has been observed among mSTS patients. To address this issue, this pharmacometabolomics study aimed to identify pre-dose plasma metabolomics signatures that can explain individual variations in trabectedin pharmacokinetics and overall clinical response to treatment. Methods: In this study, 40 mSTS patients treated with trabectedin administered by 24 h-intravenous infusion at a dose of 1.5 mg/m2 were enrolled. The patients' baseline plasma metabolomics profiles, which included derivatives of amino acids and bile acids, were analyzed using multiple reaction monitoring LC-MS/MS together with their pharmacokinetics profile of trabectedin. Multivariate Partial least squares regression and univariate statistical analyses were utilized to identify correlations between baseline metabolite concentrations and trabectedin pharmacokinetics, while Partial Least Squares-Discriminant Analysis was employed to evaluate associations with clinical response. Results: The multiple regression model, derived from the correlation between the AUC of trabectedin and pre-dose metabolomics, exhibited the best performance by incorporating cystathionine, hemoglobin, taurocholic acid, citrulline, and the phenylalanine/tyrosine ratio. This model demonstrated a bias of 4.6% and a precision of 17.4% in predicting drug AUC, effectively accounting for up to 70% of the inter-individual pharmacokinetic variability. Through the use of Partial least squares-Discriminant Analysis, cystathionine and hemoglobin were identified as specific metabolic signatures that effectively distinguish patients with stable disease from those with progressive disease. Conclusions: The findings from this study provide compelling evidence to support the utilization of pre-dose metabolomics in uncovering the underlying causes of pharmacokinetic variability of trabectedin, as well as facilitating the identification of patients who are most likely to benefit from this treatment.
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Affiliation(s)
- Giuseppe Corona
- Immunopathology and Cancer Biomarkers Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Emanuela Di Gregorio
- Immunopathology and Cancer Biomarkers Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Angela Buonadonna
- Medical Oncology and Cancer Prevention Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Davide Lombardi
- Medical Oncology and Cancer Prevention Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Simona Scalone
- Medical Oncology and Cancer Prevention Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Agostino Steffan
- Immunopathology and Cancer Biomarkers Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Gianmaria Miolo
- Medical Oncology and Cancer Prevention Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
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Landuzzi L, Manara MC, Pazzaglia L, Lollini PL, Scotlandi K. Innovative Breakthroughs for the Treatment of Advanced and Metastatic Synovial Sarcoma. Cancers (Basel) 2023; 15:3887. [PMID: 37568703 PMCID: PMC10416854 DOI: 10.3390/cancers15153887] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/25/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
Synovial sarcoma (SyS) is a rare aggressive soft tissue sarcoma carrying the chromosomal translocation t(X;18), encoding the fusion transcript SS18::SSX. The fusion oncoprotein interacts with both BAF enhancer complexes and polycomb repressor complexes, resulting in genome-wide epigenetic perturbations and a unique altered genetic signature. Over 80% of the patients are initially diagnosed with localized disease and have a 5-year survival rate of 70-80%, but metastatic relapse occurs in 50% of the cases. Advanced, unresectable, or metastatic disease has a 5-year survival rate below 10%, representing a critical issue. This review summarizes the molecular mechanisms behind SyS and illustrates current treatments in front line, second line, and beyond settings. We analyze the use of immune check point inhibitors (ICI) in SyS that do not behave as an ICI-sensitive tumor, claiming the need for predictive genetic signatures and tumor immune microenvironment biomarkers. We highlight the clinical translation of innovative technologies, such as proteolysis targeting chimera (PROTAC) protein degraders or adoptive transfer of engineered immune cells. Adoptive cell transfer of engineered T-cell receptor cells targeting selected cancer/testis antigens has shown promising results against metastatic SyS in early clinical trials and further improvements are awaited from refinements involving immune cell engineering and tumor immune microenvironment enhancement.
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Affiliation(s)
- Lorena Landuzzi
- Experimental Oncology Laboratory, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (M.C.M.); (L.P.)
| | - Maria Cristina Manara
- Experimental Oncology Laboratory, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (M.C.M.); (L.P.)
| | - Laura Pazzaglia
- Experimental Oncology Laboratory, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (M.C.M.); (L.P.)
| | - Pier-Luigi Lollini
- Laboratory of Immunology and Biology of Metastasis, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40126 Bologna, Italy;
| | - Katia Scotlandi
- Experimental Oncology Laboratory, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (M.C.M.); (L.P.)
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15
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Di Fonte R, Strippoli S, Garofoli M, Cormio G, Serratì S, Loizzi V, Fasano R, Arezzo F, Volpicella M, Derakhshani A, Guida M, Porcelli L, Azzariti A. Cervical cancer benefits from trabectedin combination with the β-blocker propranolol: in vitro and ex vivo evaluations in patient-derived organoids. Front Cell Dev Biol 2023; 11:1178316. [PMID: 37384250 PMCID: PMC10294430 DOI: 10.3389/fcell.2023.1178316] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 05/30/2023] [Indexed: 06/30/2023] Open
Abstract
Background: Cervical cancer (CC) is characterized by genomic alterations in DNA repair genes, which could favor treatment with agents causing DNA double-strand breaks (DSBs), such as trabectedin. Hence, we evaluated the capability of trabectedin to inhibit CC viability and used ovarian cancer (OC) models as a reference. Since chronic stress may promote gynecological cancer and may hinder the efficacy of therapy, we investigated the potential of targeting β-adrenergic receptors with propranolol to enhance trabectedin efficacy and change tumor immunogenicity. Methods: OC cell lines, Caov-3 and SK-OV-3, CC cell lines, HeLa and OV2008, and patient-derived organoids were used as study models. MTT and 3D cell viability assays were used for drug(s) IC50 determination. The analysis of apoptosis, JC-1 mitochondrial membrane depolarization, cell cycle, and protein expression was performed by flow cytometry. Cell target modulation analyses were carried out by gene expression, Western blotting, immunofluorescence, and immunocytochemistry. Results: Trabectedin reduced the proliferation of both CC and OC cell lines and notably of CC patient-derived organoids. Mechanistically, trabectedin caused DNA DSBs and S-phase cell cycle arrest. Despite DNA DSBs, cells failed the formation of nuclear RAD51 foci and underwent apoptosis. Under norepinephrine stimulation, propranolol enhanced trabectedin efficacy, further inducing apoptosis through the involvement of mitochondria, Erk1/2 activation, and the increase of inducible COX-2. Notably, trabectedin and propranolol affected the expression of PD1 in both CC and OC cell lines. Conclusion: Overall, our results show that CC is responsive to trabectedin and provide translational evidence that could benefit CC treatment options. Our study pointed out that combined treatment offset trabectedin resistance caused by β-adrenergic receptor activation in both ovarian and cervical cancer models.
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Affiliation(s)
| | | | | | | | | | - Vera Loizzi
- IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | | | - Francesca Arezzo
- Unit of Obstetrics and Gynecology, Department of Interdisciplinary Medicine, Policlinico Hospital, “Aldo Moro” University of Bari, Bari, Italy
| | - Mariateresa Volpicella
- Department of Biosciences, Biotechnologies and Environment, University of Bari, Bari, Italy
| | - Afshin Derakhshani
- Department of Microbiology, Immunology and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Michele Guida
- IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy
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Chawla SP, Tellez WA, Chomoyan H, Valencia C, Ahari A, Omelchenko N, Makrievski S, Brigham DA, Chua-Alcala V, Quon D, Moradkhani A, Gordon EM. Activity of TNT: a phase 2 study using talimogene laherparepvec, nivolumab and trabectedin for previously treated patients with advanced sarcomas (NCT# 03886311). Front Oncol 2023; 13:1116937. [PMID: 37234994 PMCID: PMC10206273 DOI: 10.3389/fonc.2023.1116937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/31/2023] [Indexed: 05/28/2023] Open
Abstract
Background Intratumoral injection of talimogene laherparepvec evokes a cytotoxic immune response. Therefore, the combination of talimogene laherparepvec with trabectedin and nivolumab may have synergistic effects in advanced sarcomas. Patients and methods This phase 2 trial was conducted from May 30, 2019 to January 31, 2022. Endpoints: Primary: Progression free survival rate at month 12. Secondary: Best overall response, progression free survival rate at 6 and 9 months, overall survival rate at 6, 9, and 12 months, incidence of conversion of an unresectable tumor to a resectable tumor, and incidence of adverse events. Eligible patients had to be ≥ 18 years of age, have advanced histologically proven sarcoma, at least 1 previous chemotherapy regimen, and at least one accessible tumor for intratumoral injection. Treatment: Trabectedin intravenously (1.2 mg/m2 q3 weeks), nivolumab intravenously (3 mg/kg q2 weeks), and intratumoral talimogene laherparepvec (1x108 plaque forming units/ml q2 weeks). Results Median time of follow-up: 15.2 months. Efficacy analysis: Thirty-nine patients who had completed at least one treatment cycle and had a follow-up computerized tomography were evaluable for efficacy analysis. Median number of prior therapies: 4 (range 1-11). Progression free survival rate at month 12, 36.7%. Confirmed Best Overall Response by Response Evaluation Criteria in Solid Tumors v1.1 = 3 partial responses, 30 stable disease, 6 progressive disease. Best Overall Response Rate, 7.7%, Disease Control Rate, 84.6%; median progression free survival, 7.8 (95% Confidence Intervals: 4.1-13.1) months; 6-, 9-, 12-month progression free survival rates, 54.5%/45.9%/36.7%; median overall survival 19.3 (95% Confidence Intervals: 12.8 -.) months; 6-, 9- and 12-month overall survival rate, 86.9%/73.3%/73.3%. One patient had a complete surgical resection. Fifty percent of patients had a ≥ grade 3 treatment related adverse events which included anemia (6%), thrombocytopenia (6%), neutropenia (4%), increased alanine transaminase (4%), decreased left ventricular ejection fraction (4%), dehydration (4%), hyponatremia (4%). Conclusions Taken together these data suggest that the TNT regimen is effective and safe for advanced previously treated sarcomas, and is worth being further studied in a randomized phase 3 trial as first- or second- line treatment for patients with advanced sarcomas.
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Affiliation(s)
- Sant P. Chawla
- Medical Oncology, Sarcoma Oncology Research Center, Santa Monica, CA, United States
| | - Walter Andree Tellez
- Medical Oncology, Sarcoma Oncology Research Center, Santa Monica, CA, United States
| | - Hripsime Chomoyan
- Medical Oncology, Sarcoma Oncology Research Center, Santa Monica, CA, United States
| | - Chrysler Valencia
- Medical Oncology, Sarcoma Oncology Research Center, Santa Monica, CA, United States
| | - Amir Ahari
- Medical Oncology, Sarcoma Oncology Research Center, Santa Monica, CA, United States
| | - Nadezhda Omelchenko
- Medical Oncology, Sarcoma Oncology Research Center, Santa Monica, CA, United States
| | - Stefan Makrievski
- Medical Oncology, Sarcoma Oncology Research Center, Santa Monica, CA, United States
| | - Don A. Brigham
- Medical Oncology, Sarcoma Oncology Research Center, Santa Monica, CA, United States
- Gene and Cell Therapy, Aveni Foundation, Santa Monica, CA, United States
| | - Victoria Chua-Alcala
- Medical Oncology, Sarcoma Oncology Research Center, Santa Monica, CA, United States
| | - Doris Quon
- Medical Oncology, Sarcoma Oncology Research Center, Santa Monica, CA, United States
| | - Ania Moradkhani
- Medical Oncology, Sarcoma Oncology Research Center, Santa Monica, CA, United States
| | - Erlinda M. Gordon
- Medical Oncology, Sarcoma Oncology Research Center, Santa Monica, CA, United States
- Gene and Cell Therapy, Aveni Foundation, Santa Monica, CA, United States
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17
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Vincenzi B, Napolitano A, Comandone A, Sanfilippo R, Celant S, Olimpieri PP, Di Segni S, Russo P, Casali PG. Trabectedin use in soft-tissue sarcoma patients in a real-world setting: Data from an Italian national drug-access registry. Int J Cancer 2023; 152:761-768. [PMID: 36196483 PMCID: PMC10092104 DOI: 10.1002/ijc.34309] [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: 04/19/2022] [Revised: 08/24/2022] [Accepted: 09/15/2022] [Indexed: 02/01/2023]
Abstract
Trabectedin is a marine-derived anticancer drug approved for the treatment of patients with advanced soft-tissue sarcomas (STS). Here, we aimed to analyze its use in a large cohort of STS patients treated in Italy in a real-world setting. Data on STS patients treated with trabectedin in Italy were prospectively collected from January 2013 to December 2019 by the national drug regulator, the Italian Medicines Agency (AIFA). Time-to-off-treatment (TToT) was defined as the time between the initial prescription of trabectedin and the date of treatment discontinuation for any cause. The impact of the different baseline covariates, including the initial prescribed dose of trabectedin, on TToT was evaluated using an accelerated failure time (AFT) models with log-logistic distribution. In total, we analyzed data from 2633 sarcoma patients and 14 950 individual cycles of trabectedin. The median number of cycles of trabectedin received per patient was 3 (interquartile range 2-7). The labeled 1.5 mg/sqm dose was used in 27.3% of all first prescriptions. Overall, the median TToT was 93 days. In the final AFT model, the variables significantly associated to longer TToT were female gender (+13% increase in TToT); ECOG performance status 0 (+50%); histological diagnosis of leiomyosarcoma (+22%), well-differentiated/dedifferentiated liposarcoma (+72%) or myxoid liposarcoma (+61%); receiving treatment in a high-volume center (+23%). In this large real-world cohort of STS patients treated with trabectedin, our findings support the use of trabectedin in STS patients, in particular in leiomyosarcoma and liposarcoma patients, and highlight the role of treatment center volume in their management.
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Affiliation(s)
| | - Andrea Napolitano
- University Campus Bio-Medico, Rome, Italy.,Royal Marsden NHS Foundation Trust, London, UK
| | | | | | | | | | | | | | - Paolo G Casali
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,University of Milan, Milan, Italy
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18
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Zambelli A, D’Incalci M. Editorial: Trabectedin, lurbinectedin, and other marine-derived anticancer alkaloids on solid cancer: Mechanisms of action, clinical impact, and future perspectives. Front Oncol 2023; 12:1115342. [PMID: 36761431 PMCID: PMC9905818 DOI: 10.3389/fonc.2022.1115342] [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: 12/03/2022] [Accepted: 12/16/2022] [Indexed: 01/26/2023] Open
Affiliation(s)
- Alberto Zambelli
- Department of Biomedical Sciences, Humanitas University, Milan, Italy,Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Milan, Italy,*Correspondence: Alberto Zambelli,
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19
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Assi T, Cesne AL. Trabectedin and immune checkpoint inhibitors: a blissful combination or another failure in soft tissue sarcomas? Immunotherapy 2023; 15:5-8. [PMID: 36628569 DOI: 10.2217/imt-2022-0157] [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] [Indexed: 01/12/2023] Open
Affiliation(s)
- Tarek Assi
- Division of International Patients Care, Gustave Roussy Cancer Campus, Villejuif, France
| | - Axel Le Cesne
- Division of International Patients Care, Gustave Roussy Cancer Campus, Villejuif, France
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20
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Glinkina K, Nemati F, Teunisse AFAS, Gelmi MC, Etienne V, Kuipers MJ, Alsafadi S, Jager MJ, Decaudin D, Jochemsen AG. Preclinical Evaluation of Trabectedin in Combination With Targeted Inhibitors for Treatment of Metastatic Uveal Melanoma. Invest Ophthalmol Vis Sci 2022; 63:14. [PMID: 36515935 PMCID: PMC9756579 DOI: 10.1167/iovs.63.13.14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Purpose Uveal melanoma (UM) is considered a rare disease; yet, it is the most common intraocular malignancy in adults. Although the primary tumor may be efficiently managed, more than 50% of patients with UM develop distant metastases. The mortality at the first year after diagnosis of metastatic UM has been estimated at 81%, and the poor prognosis has not improved in the past years due to the lack of effective therapies. Methods In order to search for novel therapeutic possibilities for metastatic UM, we performed a small-scale screen of targeted drug combinations. We verified the targets of the tested compounds by western blotting and PCR and clarified the mechanism of action of the selected combinations by caspase 3 and 7 activity assay and flow cytometry. The best two combinations were tested in a mouse patient-derived xenograft (PDX) UM model as putative therapeutics for metastatic UM. Results Combinations of the multitarget drug trabectedin with either the CK2/CLK double-inhibitor CX-4945 (silmitasertib) or the c-MET/TAM (TYRO3, Axl, MERTK) receptor inhibitors foretinib and cabozantinib demonstrated synergistic effects and induced apoptosis (relative caspase 3 and 7 activity increased up to 20.5-fold in UM cell lines). In the case of the combination of foretinib and cabozantinib, inhibition of the TAM receptors, but not c-Met, was essential to inhibit the growth of UM cells. Monotreatment with trabectedin inhibited tumor growth by 42%, 49%, and 35% in the MM26, MM309, and MM339 PDX mouse models, respectively. Conclusions Trabectedin alone or in combination with cabozantinib inhibited tumor growth in PDX UM mouse models. Blocking of MERTK, rather than TYRO3, activity inhibited UM cell growth and synergized with trabectedin.
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Affiliation(s)
- Kseniya Glinkina
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, The Netherlands
| | - Fariba Nemati
- Laboratory of Preclinical Investigation, Department of Translational Research, Institut Curie, PSL University, Paris, France
| | - Amina F. A. S. Teunisse
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, The Netherlands
| | - Maria Chiara Gelmi
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Vesnie Etienne
- Laboratory of Preclinical Investigation, Department of Translational Research, Institut Curie, PSL University, Paris, France
| | - Muriel J. Kuipers
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, The Netherlands
| | - Samar Alsafadi
- Uveal Melanoma Translational Group, Department of Translational Research, Institut Curie, PSL University, Paris, France
| | - Martine J. Jager
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Didier Decaudin
- Laboratory of Preclinical Investigation, Department of Translational Research, Institut Curie, PSL University, Paris, France,Department of Medical Oncology, Institut Curie, PSL University, Paris, France
| | - Aart G. Jochemsen
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, The Netherlands
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21
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Loi M, Salvatore G, Aquilano M, Greto D, Talamonti C, Salvestrini V, Melica ME, Valzano M, Francolini G, Sottili M, Santini C, Becherini C, Campanacci DA, Mangoni M, Livi L. Radiosensitizing Effect of Trabectedin on Human Soft Tissue Sarcoma Cells. Int J Mol Sci 2022; 23:ijms232214305. [PMID: 36430780 PMCID: PMC9698158 DOI: 10.3390/ijms232214305] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/11/2022] [Accepted: 11/15/2022] [Indexed: 11/19/2022] Open
Abstract
Trabectedin is used for the treatment of advanced soft tissue sarcomas (STSs). In this study, we evaluated if trabectedin could enhance the efficacy of irradiation (IR) by increasing the intrinsic cell radiosensitivity and modulating tumor micro-environment in fibrosarcoma (HS 93.T), leiomyosarcoma (HS5.T), liposarcoma (SW872), and rhabdomyosarcoma (RD) cell lines. A significant reduction in cell surviving fraction (SF) following trabectedin + IR compared to IR alone was observed in liposarcoma and leiomyosarcoma (enhancement ratio at 50%, ER50: 1.45 and 2.35, respectively), whereas an additive effect was shown in rhabdomyosarcoma and fibrosarcoma. Invasive cells' fraction significantly decreased following trabectedin ± IR compared to IR alone. Differences in cell cycle distribution were observed in leiomyosarcoma and rhabdomyosarcoma treated with trabectedin + IR. In all STS lines, trabectedin + IR resulted in a significantly higher number of γ-H2AX (histone H2AX) foci 30 min compared to the control, trabectedin, or IR alone. Expression of ATM, RAD50, Ang-2, VEGF, and PD-L1 was not significantly altered following trabectedin + IR. In conclusion, trabectedin radiosensitizes STS cells by affecting SF (particularly in leiomyosarcoma and liposarcoma), invasiveness, cell cycle distribution, and γ-H2AX foci formation. Conversely, no synergistic effect was observed on DNA damage repair, neoangiogenesis, and immune system.
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Affiliation(s)
- Mauro Loi
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Careggi, 50134 Florence, Italy
| | - Giulia Salvatore
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50121 Florence, Italy
| | - Michele Aquilano
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50121 Florence, Italy
| | - Daniela Greto
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Careggi, 50134 Florence, Italy
| | - Cinzia Talamonti
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Careggi, 50134 Florence, Italy
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50121 Florence, Italy
| | - Viola Salvestrini
- CyberKnife Center, Istituto Fiorentino di Cura e Assistenza (IFCA), 50139 Florence, Italy
| | - Maria Elena Melica
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50121 Florence, Italy
| | - Marianna Valzano
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50121 Florence, Italy
| | - Giulio Francolini
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Careggi, 50134 Florence, Italy
| | - Mariangela Sottili
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50121 Florence, Italy
| | - Costanza Santini
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50121 Florence, Italy
| | - Carlotta Becherini
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Careggi, 50134 Florence, Italy
| | | | - Monica Mangoni
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Careggi, 50134 Florence, Italy
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50121 Florence, Italy
- Correspondence: ; Tel.: +39-055-2751830
| | - Lorenzo Livi
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Careggi, 50134 Florence, Italy
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50121 Florence, Italy
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22
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Ghanim B, Baier D, Pirker C, Müllauer L, Sinn K, Lang G, Hoetzenecker K, Berger W. Trabectedin Is Active against Two Novel, Patient-Derived Solitary Fibrous Pleural Tumor Cell Lines and Synergizes with Ponatinib. Cancers (Basel) 2022; 14:cancers14225602. [PMID: 36428694 PMCID: PMC9688590 DOI: 10.3390/cancers14225602] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 11/05/2022] [Accepted: 11/10/2022] [Indexed: 11/17/2022] Open
Abstract
Solitary fibrous tumor of the pleura (SFT) is a rare disease. Besides surgery combined with radiotherapy in nondisseminated stages, curative options are currently absent. Out of fourteen primo-cell cultures, established from surgical SFT specimens, two showed stable in vitro growth. Both cell models harbored the characteristic NAB2-STAT6 fusion and were further investigated by different preclinical methods assessing cell viability, clone formation, and protein regulation upon single-drug treatment or in response to selected treatment combinations. Both fusion-positive cell models showed-in line with the clinical experience and the literature-a low to moderate response to most of the tested cytotoxic and targeted agents. However, the multi-tyrosine kinase inhibitors ponatinib and dasatinib, as well as the anti-sarcoma compound trabectedin, revealed promising activity against SFT growth. Furthermore, both cell models spontaneously presented strong FGFR downstream signaling targetable by ponatinib. Most interestingly, the combination of either ponatinib or dasatinib with trabectedin showed synergistic effects. In conclusion, this study identified novel trabectedin-based treatment combinations with clinically approved tyrosine kinase inhibitors, using two newly established NAB2-STAT6 fusion-positive cell models. These findings can be the basis for anti-SFT drug repurposing approaches in this rare and therapy-refractory disease.
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Affiliation(s)
- Bahil Ghanim
- Department of Thoracic Surgery, Medical University of Vienna, 1090 Vienna, Austria
- Center for Cancer Research and Comprehensive Cancer Center, Medical University of Vienna, 1090 Vienna, Austria
- Department of General and Thoracic Surgery, Karl Landsteiner University of Health Sciences, University Hospital Krems, 3500 Krems, Austria
| | - Dina Baier
- Center for Cancer Research and Comprehensive Cancer Center, Medical University of Vienna, 1090 Vienna, Austria
- Institute of Inorganic Chemistry, University of Vienna, 1090 Vienna, Austria
- Research Cluster “Translational Cancer Therapy Research”, 1090 Vienna, Austria
- Correspondence:
| | - Christine Pirker
- Center for Cancer Research and Comprehensive Cancer Center, Medical University of Vienna, 1090 Vienna, Austria
| | - Leonhard Müllauer
- Department of Pathology, Medical University of Vienna, 1090 Vienna, Austria
| | - Katharina Sinn
- Department of Thoracic Surgery, Medical University of Vienna, 1090 Vienna, Austria
| | - Gyoergy Lang
- Department of Thoracic Surgery, Medical University of Vienna, 1090 Vienna, Austria
| | - Konrad Hoetzenecker
- Department of Thoracic Surgery, Medical University of Vienna, 1090 Vienna, Austria
| | - Walter Berger
- Center for Cancer Research and Comprehensive Cancer Center, Medical University of Vienna, 1090 Vienna, Austria
- Research Cluster “Translational Cancer Therapy Research”, 1090 Vienna, Austria
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23
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Grignani G, Le Cesne A, Martín-Broto J. Trabectedin as second-line treatment in advanced soft tissue sarcoma: quality of life and safety outcomes. Future Oncol 2022; 18:13-22. [PMID: 36200954 DOI: 10.2217/fon-2022-0518] [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] [Indexed: 11/21/2022] Open
Abstract
The choice of second- and later-line options for advanced soft tissue sarcoma (aSTS) should always be considered from the patient's perspective, taking into account the potential impact of treatment on daily activities and quality of life. This review examines data on the safety of trabectedin in the management of patients with aSTS as reported in clinical trials and real-world studies. Evidence indicates that trabectedin exhibits an acceptable and manageable safety profile and is compatible with daily activities. Trabectedin is associated with low rates of toxicity-related discontinuations, few potentially life-threatening toxicities, a lack of apparent cumulative toxicities and low rates of grade 3/4 nausea, vomiting and fatigue. Trabectedin represents a valuable second-line option for aSTS, including in elderly patients.
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Affiliation(s)
- Giovanni Grignani
- Candiolo Cancer Institute, FPO-IRCCS, SP 142 Km 3.95, 10060 Candiolo, Italy
| | - Axel Le Cesne
- International Department of Medical Oncology, Gustave Roussy, 114 Rue Edouard Vaillant, 94805 Villejuif, France
| | - Javier Martín-Broto
- Department of Medical Oncology, University Hospital Fundación Jimenez Diaz, 28040 Madrid, Spain.,University Hospital General de Villalba, 28400 Collado Villalba, Madrid, Spain.,Instituto de Investigacion Sanitaria Fundacion Jimenez Diaz (IIS/FJD; UAM), 28015 Madrid, Spain
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24
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Le Cesne A, Martín-Broto J, Grignani G. A review of the efficacy of trabectedin as second-line treatment of advanced soft tissue sarcoma. Future Oncol 2022; 18:5-11. [PMID: 36200935 DOI: 10.2217/fon-2022-0517] [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: 11/21/2022] Open
Abstract
The goal of second-line therapy for most patients with advanced soft tissue sarcoma is long-term tumor control without detriment to quality of life. Clinical practice guidelines recommend trabectedin as a second-line option for advanced soft tissue sarcoma as it can provide the necessary balance between these interwoven goals. Cumulative experience with trabectedin in clinical trials and clinical practice has informed its usage such that greater benefit can be derived. In particular, use in earlier lines allows more patients to achieve prolonged tumor control (six or more cycles). Efficacy outcomes are superior when trabectedin is administered as second- versus later-line therapy and when it is used continuously until disease progression.
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Affiliation(s)
- Axel Le Cesne
- International Department of Medical Oncology, Gustave Roussy, 114 Rue Edouard Vaillant, 94805 Villejuif, France
| | - Javier Martín-Broto
- Medical Oncology Department, University Hospital Fundación Jimenez Diaz, 28040 Madrid, Spain.,University Hospital General de Villalba, 28400 Collado Villalba, Madrid, Spain.,Instituto de Investigacion Sanitaria Fundacion Jimenez Diaz (IIS/FJD; UAM), 28015 Madrid, Spain
| | - Giovanni Grignani
- Candiolo Cancer Institute, FPO-IRCCS, SP 142 Km 3.95, 10060 Candiolo, Italy
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25
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Le Cesne A. The role of trabectedin as second-line treatment of advanced soft tissue sarcoma: update of key efficacy and safety data. Future Oncol 2022; 18:1-3. [PMID: 36200943 DOI: 10.2217/fon-2022-0516] [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] [Indexed: 11/21/2022] Open
Affiliation(s)
- Axel Le Cesne
- International Department of Medical Oncology, Gustave Roussy, 114 Rue Edouard Vaillant, 94805, Villejuif, France
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26
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Martín-Broto J, Hindi N, Grignani G, Merlini A, Ibrahim T, Le Cesne A. Experience with second-line trabectedin in daily clinical practice: case studies. Future Oncol 2022; 18:23-32. [PMID: 36200932 DOI: 10.2217/fon-2022-0519] [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: 11/21/2022] Open
Abstract
As a recommended second-line option for advanced soft tissue sarcoma, trabectedin can provide the necessary balance between long-term tumor control and preserved quality of life. Three case studies illustrate the long-lasting responses that patients can achieve with second-line trabectedin. A female patient with metastatic leiomyosarcoma maintained disease control for 2 years with trabectedin (× 41 cycles) with excellent tolerability and no relevant adverse events. At the time of writing, a male patient with a metastatic solitary fibrous tumor was asymptomatic after 30 cycles of trabectedin and treatment was ongoing. A young male patient with a recurrent, nonresectable, retroperitoneal myxoid/round cell liposarcoma was able to continue his sporting activities (triathlons) over 2 years with trabectedin (× 14 cycles) plus watchful waiting.
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Affiliation(s)
- Javier Martín-Broto
- Medical Oncology Department, University Hospital Fundación Jimenez Diaz, 28040 Madrid, Spain.,University Hospital General de Villalba, 28400 Collado Villalba, Madrid, Spain.,Instituto de Investigacion Sanitaria Fundacion Jimenez Diaz (IIS/FJD; UAM), 28015 Madrid, Spain
| | - Nadia Hindi
- Medical Oncology Department, University Hospital Fundación Jimenez Diaz, 28040 Madrid, Spain.,University Hospital General de Villalba, 28400 Collado Villalba, Madrid, Spain.,Instituto de Investigacion Sanitaria Fundacion Jimenez Diaz (IIS/FJD; UAM), 28015 Madrid, Spain
| | - Giovanni Grignani
- Candiolo Cancer Institute, FPO-IRCCS, SP 142 Km 3.95, 10060 Candiolo, Italy
| | - Alessandra Merlini
- Candiolo Cancer Institute, FPO-IRCCS, SP 142 Km 3.95, 10060 Candiolo, Italy.,Department of Oncology, University of Turin, 10124 Turin, Italy
| | - Tony Ibrahim
- International Department of Medical Oncology, Gustave Roussy, 114 Rue Edouard Vaillant, 94805 Villejuif, France
| | - Axel Le Cesne
- International Department of Medical Oncology, Gustave Roussy, 114 Rue Edouard Vaillant, 94805 Villejuif, France
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27
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Grignani G, Merlini A, Aliberti S. Being the ultimate travel companion of a patient with uterine leiomyosarcoma. Future Oncol 2022; 18:17-23. [PMID: 36169665 DOI: 10.2217/fon-2022-0637] [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: 11/21/2022] Open
Abstract
Uterine fibroids are difficult to distinguish from malignant masses using standard ultrasonography; and morcellation carries the risk of disseminating occult cancer in a small but relevant group of women with an undetected uterine malignancy. In this context, we follow the progress of a woman diagnosed with uterine leiomyosarcoma after suboptimal initial surgery for an assumed fibroid. Evidence is reviewed that guided multidisciplinary tumor board decisions about optimal management approaches after local seeding and development of distant metastases, and informed treatment selection at each line of therapy. As the case study illustrates, choice of treatment for advanced soft tissue sarcomas frequently involves finding an appropriate balance between the efficacy and toxicity of available options, aiming to allow patients to maintain their normal lives.
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Affiliation(s)
- Giovanni Grignani
- Division of Medical Oncology, Candiolo Cancer Institute - FPO, IRCCS, Str. Prov. 142, km 3.95, I-10060, Candiolo (TO), Italy
| | - Alessandra Merlini
- Division of Medical Oncology, Candiolo Cancer Institute - FPO, IRCCS, Str. Prov. 142, km 3.95, I-10060, Candiolo (TO), Italy.,Department of Oncology, University of Turin, 10124 Turin, Italy
| | - Sandra Aliberti
- Division of Medical Oncology, Candiolo Cancer Institute - FPO, IRCCS, Str. Prov. 142, km 3.95, I-10060, Candiolo (TO), Italy
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Atmaca H, Oğuz F, Ilhan S. Trabectedin (ET-743) in prostate cancer: Endoplasmic reticulum stress-induced apoptotic effect. Andrologia 2022; 54:e14599. [PMID: 36168116 DOI: 10.1111/and.14599] [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: 10/31/2021] [Revised: 05/26/2022] [Accepted: 09/07/2022] [Indexed: 11/28/2022] Open
Abstract
Trabectedin is a chemotherapy agent originating from a tunicate, Ecteinascidia turbinata. In this study, DNA-independent action mechanisms of trabectedin are investigated in prostate cancer (PCa) cells. Cell viability was assessed via XTT assay. Apoptosis was evaluated via flow cytometry. Tetramethylrodamine ethyl ester (TMRE) dye was utilized to determine mitochondrial membrane potential (MMP). Cell cycle distribution was investigated via flow cytometric analysis. Reactive oxygen species (ROS) were monitored using fluorescence CM-H2DCFDA dye. Changes in CHOP, p-eIF2α, GRP78 and p-PERK which are endoplasmic reticulum (ER) stress-involved proteins were investigated via western blot. Trabectedin induced cytotoxicity and cell cycle arrest at the G2/M phase. Trabectedin decreased MMP via ROS generation in PCa cells. ER stress-related proteins CHOP, p-eIF2α, GRP78 and p-PERK were also elevated by trabectedin treatment indicating the induction of ER stress-induced apoptosis. The results of this study show that trabectedin may be an effective chemotherapeutic for PCa.
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Affiliation(s)
- Harika Atmaca
- Department of Biology, Faculty of Science and Letters, Manisa Celal Bayar University, Manisa, Turkey
| | - Ferdi Oğuz
- Section of Molecular Biology, Department of Biology, Institute of Natural and Applied Sciences, Manisa Celal Bayar University, Manisa, Turkey
| | - Suleyman Ilhan
- Department of Biology, Faculty of Science and Letters, Manisa Celal Bayar University, Manisa, Turkey
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Szkandera J. Keeping up the 'race pace' in a patient with nonuterine leiomyosarcoma. Future Oncol 2022; 18:12-16. [PMID: 36154278 DOI: 10.2217/fon-2022-0636] [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: 11/21/2022] Open
Abstract
The most common site of involvement of leiomyosarcoma is the retroperitoneum, accounting for approximately 50% of all cases. The case study presented herein describes the journey of a man with a grade 2 retroperitoneal leiomyosarcoma at the time of diagnosis. The patient received first-line doxorubicin (six cycles) and evofosfamide (11 cycles) during participation in the phase III, randomized, double-blind SARC021 trial and achieved stable disease. Upon progression, he received 24 cycles of second-line trabectedin with stable disease, then third-line pazopanib for 14 months with stable disease. Finally, he received fourth-line gemcitabine monotherapy for 5 months until disease progression, which was followed by death. Notably, trabectedin provided long-term disease control and maintained the patient's functional performance throughout treatment.
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Affiliation(s)
- Joanna Szkandera
- Division of Clinical Oncology, Department of Medicine, Comprehensive Cancer Centre Graz, Medical University of Graz, Auenbruggerpl. 15, Graz, 8036, Austria
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30
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de Lima MF, Freitas MO, Hamedani MK, Rangel-Pozzo A, Zhu XD, Mai S. Consecutive Inhibition of Telomerase and Alternative Lengthening Pathway Promotes Hodgkin's Lymphoma Cell Death. Biomedicines 2022; 10:2299. [PMID: 36140400 PMCID: PMC9496562 DOI: 10.3390/biomedicines10092299] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/19/2022] [Accepted: 09/12/2022] [Indexed: 11/16/2022] Open
Abstract
Telomere maintenance is key during cancer development. Malignant cells can either use telomerase or an alternative lengthening of telomere (ALT) pathway to maintain their telomere length. In Hodgkin's Lymphoma (HL), the presence of telomerase activation is established. The activation of ALT has been reported recently. Our data confirm this notion describing co-localization of the phosphorylated form of telomeric repeat-binding factor 1 (pT371-TRF1) with ALT-associated promyelocytic leukemia bodies. Surprisingly, to our knowledge, there are no published studies targeting both telomere maintenance pathways in HL. Consequently, we investigated, for the first time, the effects of both telomerase and ALT inhibition on HL cell viability: We inhibited telomerase and/or ALT, given either individually, simultaneously, or consecutively. We report that the inhibition of telomerase using BIBR1532 followed by ALT inhibition, using trabectedin, caused a decrease of greater than 90% in cell viability in three patient-derived HL cell lines. Our results suggest that HL cells are most vulnerable to the consecutive inhibition of telomerase followed by ALT inhibition.
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Affiliation(s)
- Matheus Fabiao de Lima
- Department of Physiology and Pathophysiology, CancerCare Manitoba Research Institute, University of Manitoba, Winnipeg, MB R3E 0V9, Canada
| | - Monique Oliveira Freitas
- Genetic Service, Institute of Paediatrics and Puericulture Martagão Gesteira (IPPMG), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-912, Brazil
| | - Mohammad K. Hamedani
- Department of Physiology and Pathophysiology, CancerCare Manitoba Research Institute, University of Manitoba, Winnipeg, MB R3E 0V9, Canada
| | - Aline Rangel-Pozzo
- Department of Physiology and Pathophysiology, CancerCare Manitoba Research Institute, University of Manitoba, Winnipeg, MB R3E 0V9, Canada
| | - Xu-Dong Zhu
- Department of Biology, Faculty of Science, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Sabine Mai
- Department of Physiology and Pathophysiology, CancerCare Manitoba Research Institute, University of Manitoba, Winnipeg, MB R3E 0V9, Canada
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Jang HJ, Lee HS, Yu W, Ramineni M, Truong CY, Ramos D, Splawn T, Choi JM, Jung SY, Lee JS, Wang DY, Sederstrom JM, Pietropaolo M, Kheradmand F, Amos CI, Wheeler TM, Ripley RT, Burt BM. Therapeutic Targeting of Macrophage Plasticity Remodels the Tumor-Immune Microenvironment. Cancer Res 2022; 82:2593-2609. [PMID: 35709756 PMCID: PMC9296613 DOI: 10.1158/0008-5472.can-21-3506] [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: 10/20/2021] [Revised: 03/31/2022] [Accepted: 05/04/2022] [Indexed: 01/21/2023]
Abstract
SIGNIFICANCE Comprehensive single-cell proteomics analyses of lung adenocarcinoma progression reveal the role of tumor-associated macrophages in resistance to PD-1 blockade therapy. See related commentary by Lee et al., p. 2515.
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Affiliation(s)
- Hee-Jin Jang
- Systems Onco-Immunology Laboratory, Division of Thoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA.,Hee-Jin Jang and Hyun-Sung Lee have equally contributed as first authors
| | - Hyun-Sung Lee
- Systems Onco-Immunology Laboratory, Division of Thoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA.,Hee-Jin Jang and Hyun-Sung Lee have equally contributed as first authors.,Hyun-Sung Lee and Bryan M. Burt have equally contributed as corresponding authors
| | - Wendong Yu
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Maheshwari Ramineni
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Cynthia Y. Truong
- Systems Onco-Immunology Laboratory, Division of Thoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA
| | - Daniela Ramos
- Systems Onco-Immunology Laboratory, Division of Thoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA
| | - Taylor Splawn
- Systems Onco-Immunology Laboratory, Division of Thoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA
| | - Jong Min Choi
- Systems Onco-Immunology Laboratory, Division of Thoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA
| | - Sung Yun Jung
- Department of Biochemistry and Molecular Biology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Ju-Seog Lee
- Department of Systems Biology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Daniel Y. Wang
- Division of Hemato-Oncology, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Joel M. Sederstrom
- Advanced Technology Cores, Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas, USA
| | - Massimo Pietropaolo
- Division of Endocrinology, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Farrah Kheradmand
- Division of Pulmonology, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA.,Center for Translational Research on Inflammatory Diseases (CTRID), Michael E. DeBakey Department of Veterans Affairs, Houston, TX, United States
| | - Christopher I. Amos
- Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, TX
| | - Thomas M. Wheeler
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX 77030, USA
| | - R. Taylor Ripley
- Systems Onco-Immunology Laboratory, Division of Thoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA
| | - Bryan M. Burt
- Systems Onco-Immunology Laboratory, Division of Thoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA.,Hyun-Sung Lee and Bryan M. Burt have equally contributed as corresponding authors
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Keritam O, Juhasz V, Schöfer C, Thallinger C, Aretin MB, Schabbauer G, Breuss J, Unseld M, Uhrin P. Determination of Extravasation Effects of Nal-Iri and Trabectedin and Evaluation of Treatment Options for Trabectedin Extravasation in a Preclinical Animal Model. Front Pharmacol 2022; 13:875695. [PMID: 35721106 PMCID: PMC9204062 DOI: 10.3389/fphar.2022.875695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 05/09/2022] [Indexed: 11/18/2022] Open
Abstract
Background: Extravasation during chemotherapy administration can lead to dangerous adverse effects ranging from pain to tissue necrosis. Evidence-based data about prevention and treatment of extravasation injuries of some clinically used compounds still remains elusive. This work aimed to investigate, in a preclinical mouse model, the effects of extravasation of two chemotherapeutic agents, nanoliposomal irinotecan (nal-Iri) and trabectedin. In addition, we aimed to study treatment options for injuries induced by extravasation of these substances. Methods: Mice were subcutaneously injected with nal-Iri or trabectedin applied in clinically used concentration. Doxorubicin was used as a positive control. In subsequently performed experiments, hyaluronidase, DMSO and tacrolimus were tested as potential treatments against extravasation-induced injuries by trabectedin. Systemic effects were analyzed by observation and documentation of the health status of mice and local reactions were measured and graded. In addition, hematoxylin-eosin stained histological sections of the treated skin areas were analyzed. Results: Of the two tested substances, only trabectedin showed vesicant effects. Subcutaneous injection of trabectedin caused erythema formation in mice by day two that was progressing to skin ulcerations by day five. Furthermore, we found that topical treatment of mice with tacrolimus or DMSO reduced the vesicant effects of trabectedin. The results observed in vivo were supported microscopically by the analysis of histological sections. Conclusions: We recommend classifying trabectedin as a vesicant agent and nal-Iri as a non-vesicant agent. Furthermore, our results obtained in a preclinical model suggest that tacrolimus and DMSO might be suitable treatment options of trabectedin extravasations, a finding that might be further utilized in clinical studies.
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Affiliation(s)
- Omar Keritam
- Institute of Vascular Biology and Thrombosis Research, Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Viktoria Juhasz
- Institute of Vascular Biology and Thrombosis Research, Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Christian Schöfer
- Department for Cell and Developmental Biology, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - Christiane Thallinger
- Clinical Division of Infectious Disease, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | | | - Gernot Schabbauer
- Institute of Vascular Biology and Thrombosis Research, Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Johannes Breuss
- Institute of Vascular Biology and Thrombosis Research, Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Matthias Unseld
- Clinical Division of Palliative Care, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - Pavel Uhrin
- Institute of Vascular Biology and Thrombosis Research, Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
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Tortorelli I, Navarria F, Maggio AD, Banzato A, Lestuzzi C, Nicosia L, Chiusole B, Galiano A, Sbaraglia M, Zagonel V, Brunello A. Trabectedin and Radiation Therapy for Cardiac Metastasis From Leiomyosarcoma: A Case Report and Review of the Literature. Front Oncol 2022; 12:838114. [PMID: 35574369 PMCID: PMC9097915 DOI: 10.3389/fonc.2022.838114] [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: 12/17/2021] [Accepted: 03/18/2022] [Indexed: 11/13/2022] Open
Abstract
Leiomyosarcoma (LMS) is one of the most frequent subtypes of soft-tissue sarcomas (STSs). Metastatic spread to the heart in cancer patients carries a poor prognosis and there is no known effective treatment. Cardiac metastases of STSs are very rare. Here we present the case of a 55-year-old patient who underwent surgical resection of a retroperitoneal leiomyosarcoma and then developed widespread metastatic disease, treated with a combination of local treatment and systemic therapy. Three years after surgical resection she presented with a cardiac intraventricular mass, which was treated with radiation therapy, while receiving systemic therapy with trabectedin. Such combination therapy was well-tolerated and effective, allowing a substantial dimensional reduction which is perduring to date, 18 months after diagnosis of cardiac metastasis. Available literature and data point to the feasibility and good tolerability of radiation therapy and trabectedin in metastatic sarcoma, yet this is the first report on the effectiveness of the combination for the treatment of cardiac disease. The extended survival since a metastatic relapse (more than 3 years) is likely the result of integrated systemic and loco-regional treatment, which should be always discussed within the framework of a multiprofessional and multidisciplinary setting.
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Affiliation(s)
- Ilaria Tortorelli
- Oncology 1 Unit, Department of Oncology, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Federico Navarria
- Radiation Oncology Department, National Cancer Institute (CRO)- IRCCS, Aviano, Italy
| | - Antonio Di Maggio
- Oncologic Radiology Unit, Department of Radiology and Medical Physics, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Alberto Banzato
- Cardiology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Chiara Lestuzzi
- Cardiology and Cardio-Oncology Rehabilitation S.D.S, Department of Cardio-Cerebro-Vascular Physiopathology, Azienda Sanitaria Friuli Occidentale (AS FO), Aviano, Italy
| | - Luca Nicosia
- Advanced Radiation Oncology Department, Sacro Cuore Don Calabria Hospital IRCCS, Negrar, Italy
| | - Benedetta Chiusole
- Oncology 1 Unit, Department of Oncology, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Antonella Galiano
- Oncology 1 Unit, Department of Oncology, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Marta Sbaraglia
- Department of Pathology, Azienda Ospedale Università Padova, Padua, Italy
| | - Vittorina Zagonel
- Oncology 1 Unit, Department of Oncology, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Antonella Brunello
- Oncology 1 Unit, Department of Oncology, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
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34
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Ferrari A, Chiaravalli S, Bergamaschi L, Nigro O, Livellara V, Sironi G, Gasparini P, Pasquali S, Zaffaroni N, Stacchiotti S, Morosi C, Massimino M, Casanova M. Trabectedin-irinotecan, a potentially promising combination in relapsed desmoplastic small round cell tumor: report of two cases. J Chemother 2022; 35:163-167. [PMID: 35470779 DOI: 10.1080/1120009x.2022.2067706] [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: 10/18/2022]
Abstract
Effective new drugs are urgently needed for desmoplastic small round cell tumor (DSRCT), an extremely rare and aggressive disease with a generally poor prognosis. We describe two heavily-pretreated young patients with advanced-stage DSRCT given third-line treatment with a combination of trabectedin and irinotecan, based on our preclinical data demonstrating its effect on patient-derived xenografts. This trabectedin-irinotecan treatment showed a limited toxicity. One patient had a mixed response (overall stable disease), the other a complete tumor remission. This is the first report of preliminary findings to suggest that combining trabectedin and irinotecan is worth further investigating as a potentially valuable chemotherapy for DSRCT.
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Affiliation(s)
- Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Stefano Chiaravalli
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Luca Bergamaschi
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Olga Nigro
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Virginia Livellara
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Giovanna Sironi
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Patrizia Gasparini
- Tumor Genomics Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Sandro Pasquali
- Molecular Pharmacology Unit, Department of Applied Research and Technological Development, Molecular Pharmacology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,Sarcoma Service, Department of Surgery, Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Nadia Zaffaroni
- Molecular Pharmacology Unit, Department of Applied Research and Technological Development, Molecular Pharmacology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Silvia Stacchiotti
- Department of Cancer Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Carlo Morosi
- Radiology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Maura Massimino
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Michela Casanova
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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35
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Kokkali S, Boukovinas I, Samantas E, Papakotoulas P, Athanasiadis I, Andreadis C, Makrantonakis P, Samelis G, Timotheadou E, Vassilopoulos G, Papadimitriou C, Tzanninis D, Ardavanis A, Kotsantis I, Karvounis-Marolachakis K, Theodoropoulou T, Psyrri A. A Multicenter, Prospective, Observational Study to Assess the Clinical Activity and Impact on Symptom Burden and Patients' Quality of Life in Patients with Advanced Soft Tissue Sarcomas Treated with Trabectedin in a Real-World Setting in Greece. Cancers (Basel) 2022; 14:1879. [PMID: 35454787 PMCID: PMC9031293 DOI: 10.3390/cancers14081879] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/28/2022] [Accepted: 04/04/2022] [Indexed: 11/16/2022] Open
Abstract
This non-interventional, multicenter, prospective study aimed to evaluate the real-world activity of trabectedin, and its impact on symptom burden and quality of life in patients with advanced soft tissue sarcoma (aSTS) treated in routine clinical settings in Greece. Patients with histologically confirmed aSTS newly initiated on trabectedin were enrolled. The primary endpoint was progression-free survival (PFS) rate at 6 months. Secondary endpoints included PFS rate at 3 months, median PFS, objective response rate (ORR), disease control rate (DCR), overall survival (OS), and an assessment of the impact of treatment on health-related quality of life (HRQoL), cancer-related symptom burden and symptom interference with function, as well as all-cause treatment discontinuation rate. A total of 64 eligible patients from 13 Greek centers were evaluated. Patients received a median of three trabectedin cycles per patient (interquartile range [IQR]: 2.0-6.0). Median PFS was 6.6 months with 67.9% and 51.2% of patients free from progression at 3 and 6 months, respectively. ORR was 7.8% and DCR 21.9%. Median OS was 13.1 months. No significant changes from enrolment were noted in HRQoL scores. In total, 30 patients (46.9%) had at least one trabectedin-related adverse drug reaction (ADR) and 9 (14.1%) at least one serious ADR. The treatment discontinuation rate due to toxicity was 9.4%. These results suggest that trabectedin is an active treatment with clinically meaningful benefits in patients with aSTS with no new safety signals.
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Affiliation(s)
- Stefania Kokkali
- First Department of Medical Oncology, Agios Savvas Athens General Hospital, 11522 Athens, Greece;
| | - Ioannis Boukovinas
- Medical Oncology, Bioclinic of Thessaloniki, 54622 Thessaloniki, Greece;
| | - Epaminondas Samantas
- Third Oncology Clinic, Agioi Anargiroi Athens General Hospital, 14564 Athens, Greece;
| | - Pavlos Papakotoulas
- First Chemotherapeutic Oncology Department, Theagenion Anti-Cancer Hospital of Thessaloniki, 54639 Thessaloniki, Greece;
| | - Ilias Athanasiadis
- Oncology Department, Hygeia Athens Private Hospital, 15123 Maroussi, Greece;
| | - Charalampos Andreadis
- Third Department of Clinical Oncology and Chemotherapy, Theagenion Anti-Cancer Hospital of Thessaloniki, 54639 Thessaloniki, Greece;
| | - Parisis Makrantonakis
- Second Department of Clinical Oncology and Chemotherapy, Theagenion Anti-Cancer Hospital of Thessaloniki, 54639 Thessaloniki, Greece;
| | - Georgios Samelis
- Oncology Department, Hippocration General Hospital of Athens, 11527 Athens, Greece;
| | - Eleni Timotheadou
- Department of Medical Oncology, Papageorgiou Hospital, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, 54629 Thessaloniki, Greece;
| | | | - Christos Papadimitriou
- Oncology Unit, Aretaieion University Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece;
| | | | - Alexandros Ardavanis
- First Department of Medical Oncology, Agios Savvas Athens General Hospital, 11522 Athens, Greece;
| | - Ioannis Kotsantis
- Division Medical Oncology, Attikon University General Hospital of Athens, 12462 Haidari, Greece; (I.K.); (A.P.)
| | | | | | - Amanda Psyrri
- Division Medical Oncology, Attikon University General Hospital of Athens, 12462 Haidari, Greece; (I.K.); (A.P.)
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36
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Inoue M, Horiuchi K, Susa M, Taguchi E, Ishizaka T, Rikitake H, Matsuhashi Y, Chiba K. Trabectedin suppresses osteosarcoma pulmonary metastasis in a mouse tumor xenograft model. J Orthop Res 2022; 40:945-953. [PMID: 34057747 DOI: 10.1002/jor.25105] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 04/27/2021] [Accepted: 05/25/2021] [Indexed: 02/04/2023]
Abstract
Osteosarcoma (OS) is the most common primary bone tumor that mainly affects adolescents and young adults. Although standard treatment modality can achieve up to 60%-70% 5-year survival rate, there has not been any substantial improvement over the past four decades. Furthermore, those presenting with pulmonary metastatic lesions often undergo a highly unfavorable clinical course. Therefore, there is a severely unmet clinical need to provide a more effective treatment for patients with OS. In this study, we show that trabectedin (TBD), a chemotherapeutic agent approved for soft tissue sarcomas, significantly suppresses pulmonary metastasis in a mouse OS xenograft model. In vitro experiments revealed that TBD suppresses cell migration potentially by downregulating the activity of ERK1/2, intracellular molecules that are critically involved in the regulation of cell motility. Collectively, our data may provide a basis for further investigation of TBD on the potential use for OS patients who are at great risk of pulmonary metastasis.
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Affiliation(s)
- Masahiro Inoue
- Department of Orthopedic Surgery, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Keisuke Horiuchi
- Department of Orthopedic Surgery, National Defense Medical College, Tokorozawa, Saitama, Japan
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Michiro Susa
- Department of Orthopedic Surgery, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Eiko Taguchi
- Department of Orthopedic Surgery, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Takahiro Ishizaka
- Department of Orthopedic Surgery, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Hajime Rikitake
- Department of Orthopedic Surgery, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Yusuke Matsuhashi
- Department of Orthopedic Surgery, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Kazuhiro Chiba
- Department of Orthopedic Surgery, National Defense Medical College, Tokorozawa, Saitama, Japan
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37
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Allavena P, Belgiovine C, Digifico E, Frapolli R, D'Incalci M. Effects of the Anti-Tumor Agents Trabectedin and Lurbinectedin on Immune Cells of the Tumor Microenvironment. Front Oncol 2022; 12:851790. [PMID: 35299737 PMCID: PMC8921639 DOI: 10.3389/fonc.2022.851790] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 01/10/2022] [Accepted: 02/08/2022] [Indexed: 12/12/2022] Open
Abstract
Immune cells in the tumor micro-environment (TME) establish a complex relationship with cancer cells and may strongly influence disease progression and response to therapy. It is well established that myeloid cells infiltrating tumor tissues favor cancer progression. Tumor-Associated Macrophages (TAMs) are abundantly present at the TME and actively promote cancer cell proliferation and distant spreading, as well as contribute to an immune-suppressive milieu. Active research of the last decade has provided novel therapeutic approaches aimed at depleting TAMs and/or at reprogramming their functional activities. We reported some years ago that the registered anti-tumor agent trabectedin and its analogue lurbinectedin have numerous mechanisms of action that also involve direct effects on immune cells, opening up new interesting points of view. Trabectedin and lurbinectedin share the unique feature of being able to simultaneously kill cancer cells and to affect several features of the TME, most notably by inducing the rapid and selective apoptosis of monocytes and macrophages, and by inhibiting the transcription of several inflammatory mediators. Furthermore, depletion of TAMs alleviates the immunosuppressive milieu and rescues T cell functional activities, thus enhancing the anti-tumor response to immunotherapy with checkpoint inhibitors. In view of the growing interest in tumor-infiltrating immune cells, the availability of antineoplastic compounds showing immunomodulatory effects on innate and adaptive immunity deserves particular attention in the oncology field.
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Affiliation(s)
- Paola Allavena
- Department Immunology, IRCCS Humanitas Clinical and Research Center, Milan, Italy
| | - Cristina Belgiovine
- Department Immunology, IRCCS Humanitas Clinical and Research Center, Milan, Italy
| | - Elisabeth Digifico
- Department Immunology, IRCCS Humanitas Clinical and Research Center, Milan, Italy
| | - Roberta Frapolli
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Maurizio D'Incalci
- Department Immunology, IRCCS Humanitas Clinical and Research Center, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Italy
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Nakamura T, Sudo A. The Role of Trabectedin in Soft Tissue Sarcoma. Front Pharmacol 2022; 13:777872. [PMID: 35281940 PMCID: PMC8904719 DOI: 10.3389/fphar.2022.777872] [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: 09/16/2021] [Accepted: 02/08/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Systemic chemotherapy for advanced disease is another therapeutic option in the management of metastases in soft tissue sarcoma (STS). Doxorubicin either alone or in combination with ifosfamide has been used as first-line chemotherapy. Furthermore, in the past decade, new drugs have been shown to be effective in the treatment of advanced STS after the failure of first-line anthracycline-based chemotherapy: trabectedin, pazopanib and eribulin. However, the appropriate usage of these agents has not been established. Methods: We summarized clinical trials of trabectedin focusing on the efficacy and toxicity of trabectedin in the treatment of STS. Results: Trabectedin can be administered safely and effectively to the patients with advanced STS at second line setting or later. Although trabectedin may be effective as first-line treatment in selected patients, anthracycline-based chemotherapy should be recommended because no regimen in addition to trabectedin has proved to be unequivocally superior to doxorubicin as the first-line treatment for locally advanced or metastatic STS. Nucleotide excision repair (NER) and homologous recombination (HRe) repair may be of particular importance as efficacy of trabectedin. Conclusion: Trabectedin has shown a favorable toxicity profile and is an alternative therapeutic option in patients with advanced STS.
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Affiliation(s)
- Tomoki Nakamura
- Departmemt of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Japan
| | - Akihiro Sudo
- Departmemt of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Japan
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Schroeder BA, Zhang Y, Smythe KS, Desai P, Thomas A, Viveiros P, Alexiev BA, Obeidin F, Chen EY, Cranmer LD, Wagner MJ, Jones RL, Campbell JS, Pierce RH, He Q, Pollack SM. Immunologic Gene Signature Analysis Correlates Myeloid Cells and M2 Macrophages with Time to Trabectedin Failure in Sarcoma Patients. Cancers (Basel) 2022; 14:1290. [PMID: 35267598 DOI: 10.3390/cancers14051290] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/21/2022] [Accepted: 02/26/2022] [Indexed: 01/29/2023] Open
Abstract
Patients with metastatic soft tissue sarcoma (STS) have a poor prognosis and few available systemic treatment options. Trabectedin is currently being investigated as a potential adjunct to immunotherapy as it has been previously shown to kill tumor-associated macrophages. In this retrospective study, we sought to identify biomarkers that would be relevant to trials combining trabectedin with immunotherapy. We performed a single-center retrospective study of sarcoma patients treated with trabectedin with long-term follow-up. Multiplex gene expression analysis using the NanoString platform was assessed, and an exploratory analysis using the lasso-penalized Cox regression and kernel association test for survival (MiRKAT-S) methods investigated tumor-associated immune cells and correlated their gene signatures to patient survival. In total, 147 sarcoma patients treated with trabectedin were analyzed, with a mean follow-up time of 5 years. Patients with fewer prior chemotherapy regimens were more likely to stay on trabectedin longer (pairwise correlation = -0.17, p = 0.04). At 5 years, increased PD-L1 expression corresponded to worse outcomes (HR = 1.87, p = 0.04, q = 0.199). Additionally, six immunologic gene signatures were associated with up to 7-year survival by MiRKAT-S, notably myeloid-derived suppressor cells (p = 0.023, q = 0.058) and M2 macrophages (p = 0.03, q = 0.058). We found that the number of chemotherapy regimens prior to trabectedin negatively correlated with the number of trabectedin cycles received, suggesting that patients may benefit from receiving trabectedin earlier in their therapy course. The correlation of trabectedin outcomes with immune cell infiltrates supports the hypothesis that trabectedin may function as an immune modulator and supports ongoing efforts to study trabectedin in combination with immunotherapy. Furthermore, tumors with an immunosuppressive microenvironment characterized by macrophage infiltration and high PD-L1 expression were less likely to benefit from trabectedin, which could guide clinicians in future treatment decisions.
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Pignochino Y, Crisafulli G, Giordano G, Merlini A, Berrino E, Centomo ML, Chiabotto G, Brusco S, Basiricò M, Maldi E, Pisacane A, Leuci V, Sangiolo D, D’Ambrosio L, Aglietta M, Kasper B, Bardelli A, Grignani G. PARP1 Inhibitor and Trabectedin Combination Does Not Increase Tumor Mutational Burden in Advanced Sarcomas-A Preclinical and Translational Study. Cancers (Basel) 2021; 13:cancers13246295. [PMID: 34944915 PMCID: PMC8699802 DOI: 10.3390/cancers13246295] [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: 11/22/2021] [Revised: 12/09/2021] [Accepted: 12/13/2021] [Indexed: 11/25/2022] Open
Abstract
Simple Summary Immunotherapy has revolutionized cancer treatment, but not for all tumor types. Indeed, sarcomas are considered “immune-cold” tumors, which are relatively unresponsive to immunotherapy. One strategy to potentiate immunotherapy efficacy is to increase tumor immunogenicity, for instance by boosting the number of candidate targets (neoantigens) to be recognized by the immune system. Tumor mutational burden indicates the number of somatic mutations identified in the tumor and normalized per megabase. Tumor mutational burden is considered as an acceptable, measurable surrogate of tumor neoantigens. Here, we explored whether the combination of two DNA-damaging agents, trabectedin and olaparib, could increase tumor mutational burden in sarcomas, to prime subsequent immunotherapy. We found no variation in tumor mutational burden after trabectedin + olaparib in preclinical and clinical samples. Therefore, other aspects should be considered to increase sarcoma immunogenicity, by exploiting different pathways such as the potential modulation of the tumor microenvironment induced by trabectedin + olaparib. Abstract Drug-induced tumor mutational burden (TMB) may contribute to unleashing the immune response in relatively “immune-cold” tumors, such as sarcomas. We previously showed that PARP1 inhibition perpetuates the DNA damage induced by the chemotherapeutic agent trabectedin in both preclinical models and sarcoma patients. In the present work, we explored acquired genetic changes in DNA repair genes, mutational signatures, and TMB in a translational platform composed of cell lines, xenografts, and tumor samples from patients treated with trabectedin and olaparib combination, compared to cells treated with temozolomide, an alkylating agent that induces hypermutation. Whole-exome and targeted panel sequencing data analyses revealed that three cycles of trabectedin and olaparib combination neither affected the mutational profiles, DNA repair gene status, or copy number alterations, nor increased TMB both in homologous recombinant-defective and proficient cells or in xenografts. Moreover, TMB was not increased in tumor specimens derived from trabectedin- and olaparib-treated patients (5–6 cycles) when compared to pre-treatment biopsies. Conversely, repeated treatments with temozolomide induced a massive TMB increase in the SJSA-1 osteosarcoma model. In conclusion, a trabectedin and olaparib combination did not show mutagenic effects and is unlikely to prime subsequent immune-therapeutic interventions based on TMB increase. On the other hand, these findings are reassuring in the increasing warning of treatment-induced hematologic malignancies correlated to PARP1 inhibitor use.
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Affiliation(s)
- Ymera Pignochino
- Department of Clinical and Biological Sciences, University of Torino, 10100 Torino, Italy;
- Candiolo Cancer Institute, FPO-IRCCS, 10060 Candiolo, Italy; (G.C.); (G.G.); (E.B.); (M.L.C.); (S.B.); (M.B.); (E.M.); (A.P.); (V.L.); (D.S.); (L.D.); (M.A.); (A.B.); (G.G.)
| | - Giovanni Crisafulli
- Candiolo Cancer Institute, FPO-IRCCS, 10060 Candiolo, Italy; (G.C.); (G.G.); (E.B.); (M.L.C.); (S.B.); (M.B.); (E.M.); (A.P.); (V.L.); (D.S.); (L.D.); (M.A.); (A.B.); (G.G.)
- Department of Oncology, University of Torino, 10100 Torino, Italy
| | - Giorgia Giordano
- Candiolo Cancer Institute, FPO-IRCCS, 10060 Candiolo, Italy; (G.C.); (G.G.); (E.B.); (M.L.C.); (S.B.); (M.B.); (E.M.); (A.P.); (V.L.); (D.S.); (L.D.); (M.A.); (A.B.); (G.G.)
- Department of Oncology, University of Torino, 10100 Torino, Italy
| | - Alessandra Merlini
- Candiolo Cancer Institute, FPO-IRCCS, 10060 Candiolo, Italy; (G.C.); (G.G.); (E.B.); (M.L.C.); (S.B.); (M.B.); (E.M.); (A.P.); (V.L.); (D.S.); (L.D.); (M.A.); (A.B.); (G.G.)
- Department of Oncology, University of Torino, 10100 Torino, Italy
- Correspondence: ; Tel.: +39-0119933623
| | - Enrico Berrino
- Candiolo Cancer Institute, FPO-IRCCS, 10060 Candiolo, Italy; (G.C.); (G.G.); (E.B.); (M.L.C.); (S.B.); (M.B.); (E.M.); (A.P.); (V.L.); (D.S.); (L.D.); (M.A.); (A.B.); (G.G.)
- Department of Medical Sciences, University of Torino, 10100 Torino, Italy;
| | - Maria Laura Centomo
- Candiolo Cancer Institute, FPO-IRCCS, 10060 Candiolo, Italy; (G.C.); (G.G.); (E.B.); (M.L.C.); (S.B.); (M.B.); (E.M.); (A.P.); (V.L.); (D.S.); (L.D.); (M.A.); (A.B.); (G.G.)
- Department of Oncology, University of Torino, 10100 Torino, Italy
| | - Giulia Chiabotto
- Department of Medical Sciences, University of Torino, 10100 Torino, Italy;
| | - Silvia Brusco
- Candiolo Cancer Institute, FPO-IRCCS, 10060 Candiolo, Italy; (G.C.); (G.G.); (E.B.); (M.L.C.); (S.B.); (M.B.); (E.M.); (A.P.); (V.L.); (D.S.); (L.D.); (M.A.); (A.B.); (G.G.)
- Department of Oncology, University of Torino, 10100 Torino, Italy
| | - Marco Basiricò
- Candiolo Cancer Institute, FPO-IRCCS, 10060 Candiolo, Italy; (G.C.); (G.G.); (E.B.); (M.L.C.); (S.B.); (M.B.); (E.M.); (A.P.); (V.L.); (D.S.); (L.D.); (M.A.); (A.B.); (G.G.)
| | - Elena Maldi
- Candiolo Cancer Institute, FPO-IRCCS, 10060 Candiolo, Italy; (G.C.); (G.G.); (E.B.); (M.L.C.); (S.B.); (M.B.); (E.M.); (A.P.); (V.L.); (D.S.); (L.D.); (M.A.); (A.B.); (G.G.)
| | - Alberto Pisacane
- Candiolo Cancer Institute, FPO-IRCCS, 10060 Candiolo, Italy; (G.C.); (G.G.); (E.B.); (M.L.C.); (S.B.); (M.B.); (E.M.); (A.P.); (V.L.); (D.S.); (L.D.); (M.A.); (A.B.); (G.G.)
| | - Valeria Leuci
- Candiolo Cancer Institute, FPO-IRCCS, 10060 Candiolo, Italy; (G.C.); (G.G.); (E.B.); (M.L.C.); (S.B.); (M.B.); (E.M.); (A.P.); (V.L.); (D.S.); (L.D.); (M.A.); (A.B.); (G.G.)
| | - Dario Sangiolo
- Candiolo Cancer Institute, FPO-IRCCS, 10060 Candiolo, Italy; (G.C.); (G.G.); (E.B.); (M.L.C.); (S.B.); (M.B.); (E.M.); (A.P.); (V.L.); (D.S.); (L.D.); (M.A.); (A.B.); (G.G.)
- Department of Oncology, University of Torino, 10100 Torino, Italy
| | - Lorenzo D’Ambrosio
- Candiolo Cancer Institute, FPO-IRCCS, 10060 Candiolo, Italy; (G.C.); (G.G.); (E.B.); (M.L.C.); (S.B.); (M.B.); (E.M.); (A.P.); (V.L.); (D.S.); (L.D.); (M.A.); (A.B.); (G.G.)
- Cardinal Massaia Hospital, 14100 Asti, Italy
| | - Massimo Aglietta
- Candiolo Cancer Institute, FPO-IRCCS, 10060 Candiolo, Italy; (G.C.); (G.G.); (E.B.); (M.L.C.); (S.B.); (M.B.); (E.M.); (A.P.); (V.L.); (D.S.); (L.D.); (M.A.); (A.B.); (G.G.)
- Department of Oncology, University of Torino, 10100 Torino, Italy
| | - Bernd Kasper
- Sarcoma Unit, Mannheim University Medical Center, University of Heidelberg, 68167 Mannheim, Germany;
| | - Alberto Bardelli
- Candiolo Cancer Institute, FPO-IRCCS, 10060 Candiolo, Italy; (G.C.); (G.G.); (E.B.); (M.L.C.); (S.B.); (M.B.); (E.M.); (A.P.); (V.L.); (D.S.); (L.D.); (M.A.); (A.B.); (G.G.)
- Department of Oncology, University of Torino, 10100 Torino, Italy
| | - Giovanni Grignani
- Candiolo Cancer Institute, FPO-IRCCS, 10060 Candiolo, Italy; (G.C.); (G.G.); (E.B.); (M.L.C.); (S.B.); (M.B.); (E.M.); (A.P.); (V.L.); (D.S.); (L.D.); (M.A.); (A.B.); (G.G.)
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Catherine J, Jungels C, Durieux V, Deliens C, Grigoriu B. Trabectedin-Related Heart Failure: Case Report and a Systematic Review of the Literature. Front Oncol 2021; 11:694620. [PMID: 34868910 PMCID: PMC8636328 DOI: 10.3389/fonc.2021.694620] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 10/28/2021] [Indexed: 01/28/2023] Open
Abstract
New drugs come not only with benefits but also with unexpected toxicities which need to be promptly recognized and managed. Starting from a scholar case of acute heart failure with preserved ejection fraction following the administration of trabectedin (ET-743, Yondelis®) in a patient with a metastatic solitary fibrous tumor, we performed a systematic review of the literature encompassing the results of previous cardiac safety analysis published ten years ago, a review of clinical trials published during the last 10 years as well as single-case descriptions related to trabectedin cardiotoxicity. The estimated incidence of cardiac toxicity was 3,4% among patients receiving trabectedin, with recent data suggesting a higher rate of heart failure than previously recognized. Previous or concomitant anthracyclines exposure may represent a risk factor. Assaying for NT-pro-BNP may be useful for the early detection of individuals with trabectedin-induced heart failure.
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Affiliation(s)
- Julien Catherine
- Unité de Soins Intensifs et Urgences Oncologiques, Service de Médecine Interne, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Bruxelles, Belgium
| | - Christiane Jungels
- Département de Médecine Oncologique, Institut Jules Bordet, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Valerie Durieux
- Bibliothèque des Sciences de la Santé, Université Libre de Bruxelles (ULB), Bruxelles, Belgium.,Laboratoire de Médecine Factuelle, Faculté de Médecine, Université Libre de Bruxelles (ULB), Bruxelles, Belgium
| | - Coralie Deliens
- Pharmacie Hospitalière, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Bruxelles, Belgium
| | - Bogdan Grigoriu
- Unité de Soins Intensifs et Urgences Oncologiques, Service de Médecine Interne, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Bruxelles, Belgium
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42
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Shimada E, Endo M, Matsumoto Y, Tsuchihashi K, Ito M, Kusaba H, Nabeshima A, Nawata T, Maekawa A, Matsunobu T, Setsu N, Fujiwara T, Iida K, Nakagawa M, Hirose T, Kanahori M, Oyama R, Isobe T, Ariyama H, Kohashi K, Yamamoto H, Oda Y, Iwamoto Y, Akashi K, Baba E, Nakashima Y. Does the Use of Peripheral Immune-Related Markers Indicate Whether to Administer Pazopanib, Trabectedin, or Eribulin to Advanced Soft Tissue Sarcoma Patients? J Clin Med 2021; 10:jcm10214972. [PMID: 34768491 PMCID: PMC8584915 DOI: 10.3390/jcm10214972] [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: 10/04/2021] [Revised: 10/23/2021] [Accepted: 10/25/2021] [Indexed: 11/16/2022] Open
Abstract
Pazopanib, trabectedin, and eribulin are administered for the treatment of soft tissue sarcomas (STSs); however, there is little consensus on which agent should be preferentially used in a clinical setting. This study assessed whether peripheral immune-related markers served as a useful reference when selecting pazopanib, trabectedin, or eribulin. This study included 63 patients who were administered pazopanib, trabectedin, or eribulin for advanced STSs between March 2015 and December 2020. Patients were divided into three groups based on the first drug administered among these three drugs. Differences in overall survival (OS) or progression-free survival (PFS) among the three groups were analyzed. OS showed no significant differences among the drugs administered first. For patients with low neutrophil-to-lymphocyte ratio (NLR), the OS of patients administered pazopanib as the first choice was shorter than the others (hazard ratio [HR] = 9.53, 95% confidence interval [CI] = 1.94–18.13, p = 0.0018). In the low platelet-to-lymphocyte ratio (PLR) subgroup, the OS of the patients administered eribulin for the first choice was longer than that of the others (HR = 0.32, 95%CI = 0.10–0.98, p = 0.046). Therefore, NLR and PLR might be used as prognostic indicators to dictate whether STS patients receive pazopanib, trabectedin, or eribulin.
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Affiliation(s)
- Eijiro Shimada
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (E.S.); (Y.M.); (A.N.); (N.S.); (T.F.); (K.I.); (M.N.); (T.H.); (M.K.); (R.O.); (Y.N.)
| | - Makoto Endo
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (E.S.); (Y.M.); (A.N.); (N.S.); (T.F.); (K.I.); (M.N.); (T.H.); (M.K.); (R.O.); (Y.N.)
- Correspondence: ; Tel.: +81-92-642-5488
| | - Yoshihiro Matsumoto
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (E.S.); (Y.M.); (A.N.); (N.S.); (T.F.); (K.I.); (M.N.); (T.H.); (M.K.); (R.O.); (Y.N.)
| | - Kenji Tsuchihashi
- Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (K.T.); (M.I.); (H.K.); (H.A.); (K.A.)
| | - Mamoru Ito
- Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (K.T.); (M.I.); (H.K.); (H.A.); (K.A.)
| | - Hitoshi Kusaba
- Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (K.T.); (M.I.); (H.K.); (H.A.); (K.A.)
| | - Akira Nabeshima
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (E.S.); (Y.M.); (A.N.); (N.S.); (T.F.); (K.I.); (M.N.); (T.H.); (M.K.); (R.O.); (Y.N.)
| | - Tomoya Nawata
- Department of Orthopaedic Surgery, Kyushu Rosai Hospital, 1-1, Sonekita, Kokuraminami-ku, Kitakyushu, Fukuoka 800-0296, Japan; (T.N.); (A.M.); (T.M.); (Y.I.)
| | - Akira Maekawa
- Department of Orthopaedic Surgery, Kyushu Rosai Hospital, 1-1, Sonekita, Kokuraminami-ku, Kitakyushu, Fukuoka 800-0296, Japan; (T.N.); (A.M.); (T.M.); (Y.I.)
| | - Tomoya Matsunobu
- Department of Orthopaedic Surgery, Kyushu Rosai Hospital, 1-1, Sonekita, Kokuraminami-ku, Kitakyushu, Fukuoka 800-0296, Japan; (T.N.); (A.M.); (T.M.); (Y.I.)
| | - Nokitaka Setsu
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (E.S.); (Y.M.); (A.N.); (N.S.); (T.F.); (K.I.); (M.N.); (T.H.); (M.K.); (R.O.); (Y.N.)
| | - Toshifumi Fujiwara
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (E.S.); (Y.M.); (A.N.); (N.S.); (T.F.); (K.I.); (M.N.); (T.H.); (M.K.); (R.O.); (Y.N.)
| | - Keiichiro Iida
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (E.S.); (Y.M.); (A.N.); (N.S.); (T.F.); (K.I.); (M.N.); (T.H.); (M.K.); (R.O.); (Y.N.)
| | - Makoto Nakagawa
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (E.S.); (Y.M.); (A.N.); (N.S.); (T.F.); (K.I.); (M.N.); (T.H.); (M.K.); (R.O.); (Y.N.)
| | - Takeshi Hirose
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (E.S.); (Y.M.); (A.N.); (N.S.); (T.F.); (K.I.); (M.N.); (T.H.); (M.K.); (R.O.); (Y.N.)
| | - Masaya Kanahori
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (E.S.); (Y.M.); (A.N.); (N.S.); (T.F.); (K.I.); (M.N.); (T.H.); (M.K.); (R.O.); (Y.N.)
| | - Ryunosuke Oyama
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (E.S.); (Y.M.); (A.N.); (N.S.); (T.F.); (K.I.); (M.N.); (T.H.); (M.K.); (R.O.); (Y.N.)
| | - Taichi Isobe
- Department of Oncology and Social Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (T.I.); (E.B.)
| | - Hiroshi Ariyama
- Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (K.T.); (M.I.); (H.K.); (H.A.); (K.A.)
| | - Kenichi Kohashi
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (K.K.); (H.Y.); (Y.O.)
| | - Hidetaka Yamamoto
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (K.K.); (H.Y.); (Y.O.)
| | - Yoshinao Oda
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (K.K.); (H.Y.); (Y.O.)
| | - Yukihide Iwamoto
- Department of Orthopaedic Surgery, Kyushu Rosai Hospital, 1-1, Sonekita, Kokuraminami-ku, Kitakyushu, Fukuoka 800-0296, Japan; (T.N.); (A.M.); (T.M.); (Y.I.)
| | - Koichi Akashi
- Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (K.T.); (M.I.); (H.K.); (H.A.); (K.A.)
| | - Eishi Baba
- Department of Oncology and Social Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (T.I.); (E.B.)
| | - Yasuharu Nakashima
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; (E.S.); (Y.M.); (A.N.); (N.S.); (T.F.); (K.I.); (M.N.); (T.H.); (M.K.); (R.O.); (Y.N.)
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Preusser M, Silvani A, Le Rhun E, Soffietti R, Lombardi G, Sepulveda JM, Brandal P, Brazil L, Bonneville-Levard A, Lorgis V, Vauleon E, Bromberg J, Erridge S, Cameron A, Lefranc F, Clement PM, Dumont S, Sanson M, Bronnimann C, Balaná C, Thon N, Lewis J, Mair MJ, Sievers P, Furtner J, Pichler J, Bruna J, Ducray F, Reijneveld JC, Mawrin C, Bendszus M, Marosi C, Golfinopoulos V, Coens C, Gorlia T, Weller M, Sahm F, Wick W. Trabectedin for recurrent WHO grade 2 or 3 meningioma: a randomized phase 2 study of the EORTC Brain Tumor Group (EORTC-1320-BTG). Neuro Oncol 2021; 24:755-767. [PMID: 34672349 DOI: 10.1093/neuonc/noab243] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND No systemic treatment has been established for meningioma progressing after local therapies. METHODS This randomized, multicenter, open-label, phase 2 study included adult patients with recurrent WHO grade 2 or 3 meningioma. Patients were 2:1 randomly assigned to intravenous trabectedin (1.5 mg/m 2 every three weeks) or local standard of care (LOC). The primary endpoint was progression-free survival (PFS). Secondary endpoints comprised overall survival (OS), objective radiological response, safety, quality of life (QoL) assessment using the QLQ-C30 and QLQ-BN20 questionnaires, and we performed tissue-based exploratory molecular analyses. RESULTS Ninety patients were randomized (n=29 in LOC, n=61 in trabectedin arm). With 71 events, median PFS was 4.17 months in the LOC and 2.43 months in the trabectedin arm (hazard ratio [HR]=1.42; 80% CI, 1.00-2.03; p=0.294) with a PFS-6 rate of 29.1% (95% CI, 11.9%-48.8%) and 21.1% (95% CI, 11.3%-32.9%), respectively. Median OS was 10.61 months in the LOC and 11.37 months in the trabectedin arm (HR=0.98; 95% CI, 0.54-1.76; p=0.94). Grade ≥3 adverse events occurred in 44.4% patients in the LOC and 59% of patients in the trabectedin arm. Enrolled patients had impeded global QoL and overall functionality and high fatigue before initiation of systemic therapy. DNA methylation class, performance status, presence of a relevant co-morbidity, steroid use, and right hemisphere involvement at baseline were independently associated with OS. CONCLUSIONS Trabectedin did not improve PFS and OS and was associated with higher toxicity than LOC treatment in patients with non-benign meningioma. Tumour DNA methylation class is an independent prognostic factor for OS.
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Affiliation(s)
- Matthias Preusser
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Antonio Silvani
- Department of Neuro-oncology, IRCCS Fondazione Istituto Neurologico Carlo Besta, Via Giovanni Celoria 11, 20133 Milan, Italy
| | - Emilie Le Rhun
- University of Lille, U-1192, F-59000 Lille, France; Inserm, U-1192, F-59000 Lille, France; CHU Lille, General and Stereotaxic Neurosurgery service, F-59000 Lille, France; Oscar Lambret Center, Medical Oncology Department, F-59000 Lille
| | - Riccardo Soffietti
- Dept. Neuro-Oncology, University and City of Health and Science Hospital, Via Cherasco 15, 10126 Turin, Italy
| | - Giuseppe Lombardi
- Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV- IRCCS, Via Gattamelata 64, 35128 Padua, Italy
| | - Juan Manuel Sepulveda
- Neurooncology Unit, Hospital Universitario 12 de Octubre, Av. de Córdoba s/n, 28041 Madrid, Spain
| | - Petter Brandal
- Department of Oncology, Division of Cancer Medicine, Oslo University Hospital, P.O.Box 4950 Nydalen, 0424 Oslo, Norway
| | - Lucy Brazil
- St Thomas' Hospital, Westminster Bridge Rd, London SE1 7EH, United Kingdom
| | | | - Veronique Lorgis
- Department of Medical Oncology, Centre Georges François Leclerc, 1 Rue du Professeur Marion, 21000 Dijon, France
| | - Elodie Vauleon
- Department of Medical Oncology, Centre Eugene Marquis, Avenue de la Bataille Flandres Dunkerque, 25042 Rennes, France
| | - Jacoline Bromberg
- Department of Neuro-Oncology, Erasmus MC University Medical Center Cancer Center, Doctor Molewaterplein 40, 3015 Rotterdam, The Netherlands
| | - Sara Erridge
- Edinburgh Cancer Centre, Western General Hospital, Crewe Rd S, Edinburgh EH4 2XU, United Kingdom
| | - Alison Cameron
- Bristol Cancer Institute, University Hospitals Bristol, Marlborough St, Bristol BS1 3NU, United Kingdom
| | - Florence Lefranc
- Department of Neurosurgery, Hôpital Erasme; Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium
| | - Paul M Clement
- Department of Oncology, KU Leuven and Department of General Medical Oncology, UZ Leuven, Leuven Cancer Institute, Herestraat 49, 3000 Leuven, Belgium
| | - Sarah Dumont
- Institut Gustave-Roussy, Université Paris-Saclay, Medical Oncology Department, 114 Rue Edouard Vaillant, 94805 Villejuif, France
| | - Marc Sanson
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie 2-Mazarin, 47-83 Boulevard del l'Hôpital, 75013, Paris, France
| | - Charlotte Bronnimann
- Department of Medical Oncology, Bordeaux University Hospital-CHU, Bordeaux, France, University of Bordeaux, Place Amélie Raba Léon, 33000 Bordeaux, France
| | - Carmen Balaná
- Department of Medical Oncology, Catalan Institute of Oncology, Carretera Canyet sn, 08916 Badalona , Barcelona, Spain
| | - Niklas Thon
- Department of Neurosurgery, Faculty of Medicine and University Hospital, University of Munich LMU), Marchioninistraße 15, 81377 Munich, Germany
| | - Joanne Lewis
- Freeman Hospital, Freeman Rd, High Heaton, Newcastle NE7 7DN, United Kingdom
| | - Maximilian J Mair
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Philipp Sievers
- Department of Neuropathology, Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany, Clinical Cooperation Unit Neuropathology, German Consortium for Translational Cancer Research DKTK), German Cancer Research Center DKFZ), Im Neuenheimer Feld 224, 69120 Heidelberg, Germany
| | - Julia Furtner
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Josef Pichler
- Department of Internal Medicine and Neurooncology, Neuromed Campus, Kepler University Hospital, Johannes Kepler University of Linz, Wagner-Jauregg-Weg 15, 4020 Linz, Austria
| | - Jordi Bruna
- Unit of Neuro-Oncology, Hospital Universitari de Bellvitge-Institut Català D'Oncologia L'Hospitalet, Avinguda de la Granvia de l'Hospitalet, 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Francois Ducray
- Unit of Neuro-Oncology, Hospices Civils de Lyon and Department of Cancer Cell Plasticity, Cancer Research Center of Lyon, Claude Bernard University, 28 Rue Laennec, 69008 Lyon, France
| | - Jaap C Reijneveld
- Brain Tumor Center, Cancer Center Amsterdam, Amsterdam UMC, De Boelelaan 1118, 1081 HV Amsterdam, Netherlands and Stichting Epilepsie Instellingen Nederland, Achterweg 3, 2103 SW Heemstede, Netherlands
| | - Christian Mawrin
- Department of Neuropathology, Otto-von-Guericke-University, Leipziger Straße 44, 39120 Magdeburg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - Christine Marosi
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Vassilis Golfinopoulos
- European Organisation for Research and Treatment of Cancer EORTCHeadquarter, Avenue E. Mounier 83/11, 1200 Brussels, Belgium
| | - Corneel Coens
- European Organisation for Research and Treatment of Cancer EORTCHeadquarter, Avenue E. Mounier 83/11, 1200 Brussels, Belgium
| | - Thierry Gorlia
- European Organisation for Research and Treatment of Cancer EORTCHeadquarter, Avenue E. Mounier 83/11, 1200 Brussels, Belgium
| | - Michael Weller
- Department of Neurology, University Hospital and University of Zurich, Frauenklinikstrasse 26, 8091 Zurich, Switzerland
| | - Felix Sahm
- Department of Neuropathology, Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany, Clinical Cooperation Unit Neuropathology, German Consortium for Translational Cancer Research DKTK), German Cancer Research Center DKFZ), Im Neuenheimer Feld 224, 69120 Heidelberg, Germany
| | - Wolfgang Wick
- Neurology Clinic, Heidelberg University Medical Center, Clinical Cooperation Unit, Neurooncology, German Cancer Research Center, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
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Verma S, Kalra K, Rastogi S, Dhamija E, Upadhyay A, Mittal A, Aggarwal A, Shamim SA. Trabectedin in Advanced Sarcomas-Experience at a Tertiary Care Center and Review of Literature. South Asian J Cancer 2021; 10:53-57. [PMID: 34568214 PMCID: PMC8460345 DOI: 10.1055/s-0041-1734336] [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] [Indexed: 11/30/2022] Open
Abstract
Background
There is sparse literature on trabectedin in advanced soft-tissue sarcomas from developing world. It would be interesting to know about use and outcomes of trabectedin in Indian patients.
Method
In a retrospective study, consecutive patients treated with trabectedin from 2016 to 2019 were analyzed. Patients with L-sarcomas were treated at a dose of 1.5 mg/m
2
, while those with translocation-related sarcomas were treated at a dose of 1.2 mg/m
2
as a 24-hour infusion through peripherally inserted central catheter line. From July 2019, infusions were administered through an ambulatory elastomeric pump, while before that patients were admitted for 24 hours. We used SPSS version 23.0 for statistical calculation.
Result
A total of 20 patients received trabectedin with a total of 116 infusions. The median age was 46 years (range: 22–73 years). The male (
n
= 11, 55%) and female patients were almost equal (
n
= 9, 45%). Thirteen patients (65%) had Eastern Cooperative Oncology Group Performance Status 1. Majority of the patients had leiomyosarcoma (
n
= 8, 40%); remaining comprised of liposarcoma (3, 15%), translocation-related sarcomas excluding myxoid liposarcoma (
n
= 8, 40%) and others (
n
= 1,5%). Most common site was extremity (
n
= 11, 55%) followed by retroperitoneal (
n
= 3, 15%), visceral (
n
= 3, 15%), and others (
n
= 3,15%). Median number of previous lines received was 2 (range: 0–4). Median number of trabectedin cycles received was 4 (range: 1–17). Best response assessed was stable disease (
n
= 10, 50%), progressive disease (
n
= 6, 30%), partial response (
n
= 1, 5%), and not assessed in 3 patients. After a median follow-up of 19 months, median progression-free survival was 4 months.
Conclusion
In this heavily treated population (composed of L-sarcomas and translocation-related sarcomas) with many patients with poor performance status, the outcome with trabectedin is in synchrony with literature. However, the need of 24-hour admission might deter quality of life. Elastomeric pump seems to be a reasonable alternative to admission and can be a breakthrough in administering trabectedin, especially in developing countries.
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Affiliation(s)
- Saurav Verma
- Department of Medical Oncology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Kaushal Kalra
- Department of Medical Oncology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Sameer Rastogi
- Department of Medical Oncology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Ekta Dhamija
- Department of Radiology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Avinash Upadhyay
- Department of Medical Oncology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Abhenil Mittal
- Department of Medical Oncology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Aditi Aggarwal
- Department of Radiotherapy, National Cancer Institute, Haryana, Jhajjar, India
| | - Shamim Ahmed Shamim
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
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Belgiovine C, Frapolli R, Liguori M, Digifico E, Colombo FS, Meroni M, Allavena P, D'Incalci M. Inhibition of tumor-associated macrophages by trabectedin improves the antitumor adaptive immunity in response to anti-PD-1 therapy. Eur J Immunol 2021; 51:2677-2686. [PMID: 34570376 PMCID: PMC9293411 DOI: 10.1002/eji.202149379] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/24/2021] [Accepted: 09/09/2021] [Indexed: 12/15/2022]
Abstract
A considerable proportion of cancer patients are resistant or only partially responsive to immune checkpoint blockade immunotherapy. Tumor‐Associated Macrophages (TAMs) infiltrating the tumor stroma suppress the adaptive immune responses and, hence, promote tumor immune evasion. Depletion of TAMs or modulation of their protumoral functions is actively pursued, with the purpose of relieving this state of immunesuppression. We previously reported that trabectedin, a registered antitumor compound, selectively reduces monocytes and TAMs in treated tumors. However, its putative effects on the adaptive immunity are still unclear. In this study, we investigated whether treatment of tumor‐bearing mice with trabectedin modulates the presence and functional activity of T‐lymphocytes. In treated tumors, there was a significant upregulation of T cell‐associated genes, including CD3, CD8, perforin, granzyme B, and IFN‐responsive genes (MX1, CXCL10, and PD‐1), indicating that T lymphocytes were activated after treatment. Notably, the mRNA levels of the Pdcd1 gene, coding for PD‐1, were strongly increased. Using a fibrosarcoma model poorly responsive to PD‐1‐immunotherapy, treatment with trabectedin prior to anti‐PD‐1 resulted in improved antitumor efficacy. In conclusion, pretreatment with trabectedin enhances the therapeutic response to checkpoint inhibitor‐based immunotherapy. These findings provide a good rational for the combination of trabectedin with immunotherapy regimens.
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Affiliation(s)
- Cristina Belgiovine
- Humanitas Clinical and Research Center - IRCCS, via Manzoni 56, Rozzano, Milan, 20089, Italy
| | - Roberta Frapolli
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Manuela Liguori
- Humanitas Clinical and Research Center - IRCCS, via Manzoni 56, Rozzano, Milan, 20089, Italy
| | - Elisabeth Digifico
- Humanitas Clinical and Research Center - IRCCS, via Manzoni 56, Rozzano, Milan, 20089, Italy
| | - Federico Simone Colombo
- Humanitas Clinical and Research Center - IRCCS, via Manzoni 56, Rozzano, Milan, 20089, Italy
| | - Marina Meroni
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Paola Allavena
- Humanitas Clinical and Research Center - IRCCS, via Manzoni 56, Rozzano, Milan, 20089, Italy
| | - Maurizio D'Incalci
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
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46
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Sato Y, Nakano K, Kawaguchi K, Fukuda N, Wang X, Urasaki T, Ohmoto A, Hayashi N, Yunokawa M, Ono M, Tomomatsu J, Hayakawa K, Funauchi Y, Tanizawa T, Ae K, Matsumoto S, Takahashi S. Changes in Neutrophil-to-lymphocyte Ratio Predict Efficacy of Trabectedin for Soft-tissue Sarcoma. Cancer Diagn Progn 2021; 1:303-308. [PMID: 35403143 PMCID: PMC8988956 DOI: 10.21873/cdp.10040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 06/11/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND/AIM Trabectedin and eribulin are widely used for the treatment of soft-tissue sarcoma (STS). Previously it was shown that the baseline neutrophil-to-lymphocyte ratio (NLR) predicts the efficacy of eribulin for STS. However, prognostic factors for trabectedin on STS have not been identified to date. PATIENTS AND METHODS We conducted a retrospective study of data collected prospectively from 39 patients treated with trabectedin for recurrent or metastatic STS between October 2012 and December 2019. To determine the predictive factors of overall survival (OS) and progression-free survival (PFS), univariate and multivariate analyses were performed. RESULTS Age ≥40 (HR=0.33, 95% CI=0.15-0.71; p=0.0050) and changes in NLR (ΔNLR) <0.5 (HR=2.40, 95% CI-1.01-5.72; p=0.048) were independent factors predictive of longer OS. In addition, age ≥40 (HR=0.23, 95% CI=0.10-0.52; p<0.001) was an independent predictor of longer PFS. CONCLUSION Changes in NLR and age ≥40 years were able to predict the efficacy of trabectedin for STS.
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Affiliation(s)
- Yasuyoshi Sato
- Department of Medical Oncology,The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kenji Nakano
- Department of Medical Oncology,The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kuniki Kawaguchi
- Department of Medical Oncology,The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Naoki Fukuda
- Department of Medical Oncology,The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Xiaofei Wang
- Department of Medical Oncology,The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Tetsuya Urasaki
- Department of Medical Oncology,The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Akihiro Ohmoto
- Department of Medical Oncology,The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Naomi Hayashi
- Department of Medical Oncology,The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Mayu Yunokawa
- Department of Medical Oncology,The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Makiko Ono
- Department of Medical Oncology,The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Junichi Tomomatsu
- Department of Medical Oncology,The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Keiko Hayakawa
- Department of Orthopedic Oncology,The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yuki Funauchi
- Department of Orthopedic Oncology,The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Taisuke Tanizawa
- Department of Orthopedic Oncology,The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Keisuke Ae
- Department of Orthopedic Oncology,The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Seiichi Matsumoto
- Department of Orthopedic Oncology,The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Shunji Takahashi
- Department of Medical Oncology,The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
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47
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Ozaniak A, Vachtenheim J, Lischke R, Bartunkova J, Strizova Z. Novel Insights into the Immunotherapy of Soft Tissue Sarcomas: Do We Need a Change of Perspective? Biomedicines 2021; 9:biomedicines9080935. [PMID: 34440139 PMCID: PMC8393686 DOI: 10.3390/biomedicines9080935] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/19/2021] [Accepted: 07/27/2021] [Indexed: 12/19/2022] Open
Abstract
Soft tissue sarcomas (STSs) are rare mesenchymal tumors. With more than 80 histological subtypes of STSs, data regarding novel biomarkers of strong prognostic and therapeutic value are very limited. To date, the most important prognostic factor is the tumor grade, and approximately 50% of patients that are diagnosed with high-grade STSs die of metastatic disease within five years. Systemic chemotherapy represents the mainstay of metastatic STSs treatment for decades but induces response in only 15–35% of the patients, irrespective of the histological subtype. In the era of immunotherapy, deciphering the immune cell signatures within the STSs tumors may discriminate immunotherapy responders from non-responders and different immunotherapeutic approaches could be combined based on the predominant cell subpopulations infiltrating the STS tumors. Furthermore, understanding the immune diversity of the STS tumor microenvironment (TME) in different histological subtypes may provide a rationale for stratifying patients according to the TME immune parameters. In this review, we introduce the most important immune cell types infiltrating the STSs tumors and discuss different immunotherapies, as well as promising clinical trials, that would target these immune cells to enhance the antitumor immune responses and improve the prognosis of metastatic STSs patients.
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Affiliation(s)
- Andrej Ozaniak
- Third Department of Surgery, First Faculty of Medicine, Charles University and University Hospital Motol, 150 06 Prague, Czech Republic; (A.O.); (J.V.J.); (R.L.)
| | - Jiri Vachtenheim
- Third Department of Surgery, First Faculty of Medicine, Charles University and University Hospital Motol, 150 06 Prague, Czech Republic; (A.O.); (J.V.J.); (R.L.)
| | - Robert Lischke
- Third Department of Surgery, First Faculty of Medicine, Charles University and University Hospital Motol, 150 06 Prague, Czech Republic; (A.O.); (J.V.J.); (R.L.)
| | - Jirina Bartunkova
- Department of Immunology, Second Faculty of Medicine, Charles University and University Hospital Motol, 150 06 Prague, Czech Republic;
| | - Zuzana Strizova
- Department of Immunology, Second Faculty of Medicine, Charles University and University Hospital Motol, 150 06 Prague, Czech Republic;
- Correspondence: ; Tel.: +420-604712471
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48
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Reichardt P. Uncertainties that threaten the benefit/risk balance in early treatment lines for advanced or metastatic soft tissue sarcoma. Future Oncol 2021; 17:7-10. [PMID: 34107768 DOI: 10.2217/fon-2021-0450] [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: 11/21/2022] Open
Abstract
Sarcoma oncologists face many uncertainties which can threaten the benefit/risk balance during early management of patients with advanced or metastatic soft tissue sarcoma. This point is illustrated by a clinical case involving an elderly patient with comorbidities and a diagnosis of metastatic leiomyosarcoma. The patient was not a candidate for doxorubicin-based chemotherapy because of his cardiac history and was hesitant about systemic chemotherapy, ultimately expressing a preference for a well-tolerated regimen. After evaluating the treatment alternatives, trabectedin was chosen based on its indication for use in persons unsuited to receive anthracyclines and evidence supporting its efficacy and safety in elderly patients. The patient received 17 cycles of trabectedin for a best response of stable disease with good quality of life.
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Affiliation(s)
- Peter Reichardt
- Department of Oncology & Palliative Care, Helios Klinikum Berlin-Buch, Berlin, Berlin, 13125, Germany
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49
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Moura DS, Peña‐Chilet M, Cordero Varela JA, Alvarez‐Alegret R, Agra‐Pujol C, Izquierdo F, Ramos R, Ortega‐Medina L, Martin‐Davila F, Castilla‐Ramirez C, Hernandez‐Leon CN, Romagosa C, Vaz Salgado MA, Lavernia J, Bagué S, Mayodormo‐Aranda E, Vicioso L, Hernández Barceló JE, Rubio‐Casadevall J, de Juan A, Fiaño‐Valverde MC, Hindi N, Lopez‐Alvarez M, Lacerenza S, Dopazo J, Gutierrez A, Alvarez R, Valverde C, Martinez‐Trufero J, Martín‐Broto J. A DNA damage repair gene-associated signature predicts responses of patients with advanced soft-tissue sarcoma to treatment with trabectedin. Mol Oncol 2021; 15:3691-3705. [PMID: 33983674 PMCID: PMC8637557 DOI: 10.1002/1878-0261.12996] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 04/13/2021] [Accepted: 05/10/2021] [Indexed: 11/29/2022] Open
Abstract
Predictive biomarkers of trabectedin represent an unmet need in advanced soft‐tissue sarcomas (STS). DNA damage repair (DDR) genes, involved in homologous recombination or nucleotide excision repair, had been previously described as biomarkers of trabectedin resistance or sensitivity, respectively. The majority of these studies only focused on specific factors (ERCC1, ERCC5, and BRCA1) and did not evaluate several other DDR‐related genes that could have a relevant role for trabectedin efficacy. In this retrospective translational study, 118 genes involved in DDR were evaluated to determine, by transcriptomics, a predictive gene signature of trabectedin efficacy. A six‐gene predictive signature of trabectedin efficacy was built in a series of 139 tumor samples from patients with advanced STS. Patients in the high‐risk gene signature group showed a significantly worse progression‐free survival compared with patients in the low‐risk group (2.1 vs 6.0 months, respectively). Differential gene expression analysis defined new potential predictive biomarkers of trabectedin sensitivity (PARP3 and CCNH) or resistance (DNAJB11 and PARP1). Our study identified a new gene signature that significantly predicts patients with higher probability to respond to treatment with trabectedin. Targeting some genes of this signature emerges as a potential strategy to enhance trabectedin efficacy.
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Affiliation(s)
- David S. Moura
- Institute of Biomedicine of Seville (IBIS, HUVR, CSIC, Universidad de Sevilla)Spain
| | - Maria Peña‐Chilet
- Institute of Biomedicine of Seville (IBIS, HUVR, CSIC, Universidad de Sevilla)Spain
- Clinical Bioinformatics AreaFundación Progreso y Salud (FPS)CDCAHospital Virgen del RocioSevilleSpain
- Bioinformatics in Rare Diseases (BiER)Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER)FPSHospital Virgen del RocioSevilleSpain
| | | | | | | | | | - Rafael Ramos
- Pathology DepartmentSon Espases University HospitalMallorcaSpain
| | | | | | | | | | - Cleofe Romagosa
- Pathology DepartmentVall d'Hebron University HospitalBarcelonaSpain
| | | | - Javier Lavernia
- Medical Oncology DepartmentInstituto Valenciano de OncologiaValenciaSpain
| | - Silvia Bagué
- Pathology ServiceHospital de la Santa Creu i Sant PauBarcelonaSpain
| | | | - Luis Vicioso
- Pathology DepartmentVirgen de la Victoria University HospitalMalagaSpain
| | | | - Jordi Rubio‐Casadevall
- Medical Oncology DepartmentHospital Josep TruetaCatalan Institute of OncologyGironaSpain
| | - Ana de Juan
- Medical Oncology DepartmentMarqués de Valdecilla University HospitalSantanderSpain
| | | | - Nadia Hindi
- Institute of Biomedicine of Seville (IBIS, HUVR, CSIC, Universidad de Sevilla)Spain
- Medical Oncology DepartmentUniversity Hospital Fundación Jimenez DiazMadridSpain
- University Hospital General de VillalbaMadridSpain
- Instituto de Investigacion Sanitaria Fundacion Jimenez Diaz (IIS/FJD)MadridSpain
| | - Maria Lopez‐Alvarez
- Institute of Biomedicine of Seville (IBIS, HUVR, CSIC, Universidad de Sevilla)Spain
| | - Serena Lacerenza
- Institute of Biomedicine of Seville (IBIS, HUVR, CSIC, Universidad de Sevilla)Spain
| | - Joaquin Dopazo
- Institute of Biomedicine of Seville (IBIS, HUVR, CSIC, Universidad de Sevilla)Spain
- Clinical Bioinformatics AreaFundación Progreso y Salud (FPS)CDCAHospital Virgen del RocioSevilleSpain
- Bioinformatics in Rare Diseases (BiER)Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER)FPSHospital Virgen del RocioSevilleSpain
- INB‐ELIXIR‐esFPSHospital Virgen del RocíoSevilleSpain
| | | | - Rosa Alvarez
- Medical Oncology DepartmentGregorio Marañon University HospitalMadridSpain
| | - Claudia Valverde
- Medical Oncology DepartmentVall d'Hebron University HospitalBarcelonaSpain
| | | | - Javier Martín‐Broto
- Institute of Biomedicine of Seville (IBIS, HUVR, CSIC, Universidad de Sevilla)Spain
- Medical Oncology DepartmentUniversity Hospital Fundación Jimenez DiazMadridSpain
- University Hospital General de VillalbaMadridSpain
- Instituto de Investigacion Sanitaria Fundacion Jimenez Diaz (IIS/FJD)MadridSpain
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Le Cesne A, Blay JY, Cupissol D, Italiano A, Delcambre C, Penel N, Isambert N, Chevreau C, Bompas E, Bertucci F, Chaigneau L, Piperno-Neumann S, Salas S, Rios M, Guillemet C, Bay JO, Ray-Coquard I, Haddag L, Bonastre J, Kapso R, Fraslin A, Bouvet N, Mir O, Foulon S. A randomized phase III trial comparing trabectedin to best supportive care in patients with pre-treated soft tissue sarcoma: T-SAR, a French Sarcoma Group trial. Ann Oncol 2021; 32:1034-1044. [PMID: 33932507 DOI: 10.1016/j.annonc.2021.04.014] [Citation(s) in RCA: 16] [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: 02/16/2021] [Revised: 04/20/2021] [Accepted: 04/22/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The French Sarcoma Group assessed the efficacy, safety, and quality of life (QoL) of trabectedin versus best supportive care (BSC) in patients with advanced soft tissue sarcoma (STS). PATIENTS AND METHODS This randomized, multicenter, open-label, phase III study included adults with STS who progressed after 1-3 prior treatment lines. Patients were randomized (1 : 1) to receive trabectedin 1.5 mg/m2 every 3 weeks or BSC, stratified into L-STS (liposarcoma/leiomyosarcoma) and non-L-STS groups (other histotypes). Patients from the BSC arm were allowed to cross over to trabectedin at progression. The primary efficacy endpoint was progression-free survival (PFS) confirmed by blinded central review and analyzed in the intention-to-treat population. RESULTS Between 26 January 2015 and 5 November 2015, 103 heavily pre-treated patients (60.2% with L-STS) from 16 French centers were allocated to receive trabectedin (n = 52) or BSC (n = 51). Median PFS was 3.1 months [95% confidence interval (CI) 1.8-5.9 months] in the trabectedin arm versus 1.5 months (0.9-2.6 months) in the BSC arm (hazard ratio = 0.39, 95% CI 0.24-0.64, P < 0.001) with benefits observed across almost all analyzed subgroups, but particularly in patients with L-STS (5.1 versus 1.4 months, P = 0.0001). Seven patients (13.7%) in the trabectedin arm (all with L-STS) achieved a partial response, while no objective responses were observed in the BSC arm (P = 0.004). The most common grade 3/4 adverse events were neutropenia (44.2% of patients), leukopenia (34.6%), and transaminase increase (32.7%). Health-related 30-item core European Organization for the Research and Treatment of Cancer Quality-of-Life Questionnaire evidenced no statistical differences between the arms for any domain and at any time point. After progression, 91.8% of patients crossed over from BSC to trabectedin. CONCLUSION Trabectedin demonstrates superior disease control to BSC without impairing QoL in patients with recurrent STS of multiple histologies, with greater impact in patients with L-STS.
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Affiliation(s)
- A Le Cesne
- Medical Oncology Department, Gustave Roussy, Villejuif, France.
| | - J-Y Blay
- Medical Oncology Department, Centre Léon Bérard and Claude Bernard University, Lyon, France
| | - D Cupissol
- Medical Oncology Department, Centre Val d'Aurelle, Montpellier, France
| | - A Italiano
- Medical Oncology Department, Institut Bergonié, Bordeaux, France
| | - C Delcambre
- Medical Oncology Department, Centre François Baclesse, Caen, France
| | - N Penel
- Medical Oncology Department, Centre Oscar Lambret and Lille University, Lille, France
| | - N Isambert
- Medical Oncology Department, Centre Georges-François Leclerc, Dijon, France
| | - C Chevreau
- Medical Oncology Department, Institut Claudius Regaud, Toulouse, France
| | - E Bompas
- Medical Oncology Department, Centre René Gauduchau, Nantes, France
| | - F Bertucci
- Medical Oncology Department, Institut Paoli-Calmettes, Marseille, France
| | - L Chaigneau
- Medical Oncology Department, Hôpital Jean Minjoz, Besancon, France
| | | | - S Salas
- Medical Oncology Department, Hôpital La Timone, Marseille, France
| | - M Rios
- Medical Oncology Department, Institut de Cancerologie de Lorraine, Nancy, France
| | - C Guillemet
- Medical Oncology Department, Centre Henri Becquerel, Rouen, France
| | - J-O Bay
- Medical Oncology Department, Centre Jean Perrin, Clermont Ferrand, France
| | - I Ray-Coquard
- Medical Oncology Department, Centre Léon Bérard and Claude Bernard University, Lyon, France
| | - L Haddag
- Department of Radiology, Gustave Roussy, Villejuif, France
| | - J Bonastre
- Department of Biostatistics and Epidemiology, Gustave Roussy, Villejuif, France; Oncostat U1018, Inserm, University Paris-Saclay, Labeled Ligue Contre le Cancer, Villejuif, France
| | - R Kapso
- Department of Biostatistics and Epidemiology, Gustave Roussy, Villejuif, France; Oncostat U1018, Inserm, University Paris-Saclay, Labeled Ligue Contre le Cancer, Villejuif, France
| | - A Fraslin
- Department of Biostatistics and Epidemiology, Gustave Roussy, Villejuif, France; Oncostat U1018, Inserm, University Paris-Saclay, Labeled Ligue Contre le Cancer, Villejuif, France
| | - N Bouvet
- Department of Biostatistics and Epidemiology, Gustave Roussy, Villejuif, France
| | - O Mir
- Medical Oncology Department, Gustave Roussy, Villejuif, France
| | - S Foulon
- Department of Biostatistics and Epidemiology, Gustave Roussy, Villejuif, France; Oncostat U1018, Inserm, University Paris-Saclay, Labeled Ligue Contre le Cancer, Villejuif, France
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