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Lam M, Olivier T, Haslam A, Tuia J, Prasad V. Cisplatin shortage results in substitution of more expensive treatments: Drug cost analysis. Eur J Cancer 2024; 202:114019. [PMID: 38522156 DOI: 10.1016/j.ejca.2024.114019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 03/09/2024] [Indexed: 03/26/2024]
Affiliation(s)
- Michael Lam
- University of California, 9500 Gilman Dr, La Jolla, San Diego, CA 92093, USA
| | - Timothée Olivier
- Department of Oncology, Geneva University Hospital, 4 Gabrielle-Perret-Gentil St, 1205, Geneva, Switzerland; University of California San Francisco, 550 16th St, 2nd Fl, San Francisco, CA, USA 94158
| | - Alyson Haslam
- University of California San Francisco, 550 16th St, 2nd Fl, San Francisco, CA, USA 94158
| | - Jordan Tuia
- University of California San Francisco, 550 16th St, 2nd Fl, San Francisco, CA, USA 94158
| | - Vinay Prasad
- University of California San Francisco, 550 16th St, 2nd Fl, San Francisco, CA, USA 94158.
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Freyer G, Martinez-Jañez N, Kukielka-Budny B, Ulanska M, Bourgeois H, Muñoz M, Morales S, Calero JB, Cortesi L, Pintér T, Palácová M, Cherciu N, Petru E, Ettl J, de Almeida C, Villanova G, Raymond R, Minh CTT, Rodrigues A, Cazzaniga ME. Single-agent metronomic versus weekly oral vinorelbine as first-line chemotherapy in patients with HR-positive/HER2-negative advanced breast cancer: The randomized Tempo Breast study. Breast 2024; 74:103681. [PMID: 38377732 PMCID: PMC10891320 DOI: 10.1016/j.breast.2024.103681] [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: 10/27/2023] [Revised: 01/23/2024] [Accepted: 02/08/2024] [Indexed: 02/22/2024] Open
Abstract
INTRODUCTION Single-agent oral vinorelbine is a standard of care for hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer (ABC) that has progressed on endocrine therapy. Metronomic administration may offer a better balance of efficacy and safety than standard regimens, but data from previous trials are scarce. METHODS In this open-label, multicenter, phase II trial, patients were randomized to oral vinorelbine administered on a metronomic (50 mg three times weekly) or weekly (60 mg/m2 in cycle 1, increasing to 80 mg/m2 if well tolerated) schedule. Treatment was continued until disease progression or intolerance. The primary endpoint was disease control rate (DCR, the proportion of patients with a best overall confirmed response of CR, PR, or stable disease lasting 6 months or more). RESULTS One-hundred sixty-three patients were randomized and treated. The DCR was 63.4% (95% confidence interval [CI]: 52.0-73.8) with metronomic vinorelbine and 72.8% (95% CI: 61.8-82.1) with weekly vinorelbine. Weekly vinorelbine was also associated with longer progression-free survival (5.6 vs 4.0 months) and overall survival (26.7 vs 22.3 months) than metronomic vinorelbine, but was associated with more adverse events. CONCLUSIONS In this randomized phase II trial, single-agent metronomic oral vinorelbine was effective and well tolerated as first-line chemotherapy for patients with HR-positive/HER2-negative ABC. Formal comparisons are not done in this phase II study and one can simply observe that confidence intervals of all endpoints overlap. When deciding for a chemotherapy after failure of endocrine therapy and CDK 4/6 inhibitors, oral vinorelbine might be an option to be given with either schedule. CLINICAL TRIAL REGISTRATION NUMBER EudraCT 2014-003860-19.
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Affiliation(s)
- Gilles Freyer
- Medical Oncology Department, Institut de Cancérologie des HCL, 165 chemin du Grand Revoyet, 69495 Pierre-Bénite & Université de Lyon, Lyon, France.
| | - Noelia Martinez-Jañez
- Oncology Department, Hospital Universitario Ramón y Cajal, Carretera De Colmenar Viejo km. 9,1, 28034 Madrid, Spain.
| | - Bożena Kukielka-Budny
- Oncology Department, Centrum Onkologii Ziemi Lubelskiej, Ul. Jaczewskiego 7, 20-090 Lublin, Poland.
| | - Malgorzata Ulanska
- Oncology Department, Centrum Terapii Wspolczesnej, Ul. Kopcinskiego 21, 90-242 Łódź, Poland.
| | - Hugues Bourgeois
- Oncology Department, Centre Jean-Bernard, 9 rue Beauverger, 72015 Le Mans, France.
| | - Montserrat Muñoz
- Oncology Department, Hospital Clinic i Provincial de Barcelona, 170 Esc.2, pl. 5(a), 08036 Barcelona, Spain.
| | - Serafin Morales
- Oncology Department, Hospital Universitario Arnau De Vilanova, Avenida Alcalde Rovira Roure, 80, 25198 Lleida, Spain.
| | - Juan Bayo Calero
- Oncology Department, Hospital Juan Ramón Jiménez, C/ Ronda Norte, s/n, 21005 Huelva, Spain.
| | - Laura Cortesi
- Hematology and Oncology Department, AOU Policlinico di Modena, Via del Pozzo, 71, 41125 Modena, Italy.
| | - Tamás Pintér
- Oncology Department, Petz Aladár County Hospital, Vasvári Pál u. 2-4, 9024 Győr, Hungary.
| | - Markéta Palácová
- Oncology Department, Masakikuv Oncologicky Ustav, Zluty Kopek 7, 656 53 Brno, Czech Republic.
| | - Nelli Cherciu
- Oncology Department, SC Oncolab SRL, Str. Bujorului, Nr. 7, 200385 Craiova, Romania.
| | - Edgar Petru
- Department of Obstetrics and Gynecology, Medical University of Graz, Auenbruggerplatz, 15, 8036 Graz, Austria.
| | - Johannes Ettl
- Department of Obstetrics and Gynecology, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675 Munich, Germany.
| | - Cécilia de Almeida
- Pierre Fabre Medicament, Medical & Patient/Consumer Department, 33 Av. Emile Zola, 92100 Boulogne Billancourt, France.
| | - Gustavo Villanova
- Pierre Fabre Medicament, Medical & Patient/Consumer Department, 33 Av. Emile Zola, 92100 Boulogne Billancourt, France.
| | - Romain Raymond
- Pierre Fabre Medicament, Medical & Patient/Consumer Department, 33 Av. Emile Zola, 92100 Boulogne Billancourt, France.
| | - Christine Ta Thanh Minh
- Pierre Fabre Medicament, Medical & Patient/Consumer Department, 33 Av. Emile Zola, 92100 Boulogne Billancourt, France.
| | - Ana Rodrigues
- Oncology Department, Instituto Portugues de Oncologia do Porto Francisco Gentil, EPE, Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal.
| | - Marina E Cazzaniga
- Phase 1 Clinical Research Unit, ASST Monza, via Pergolesi 33, 20052 Monza, Italy; Medical Oncology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo, 1, 20126, Milan, Italy.
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Molin D. Aging Kairos: treating older Hodgkin patients. Blood 2024; 143:943-945. [PMID: 38483406 DOI: 10.1182/blood.2023023125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2024] Open
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Sun P, Yang H, Wang Y, Zhao B, Nie M, Huang K, Li Z. Tislelizumab monotherapy in patients with previously untreated early-stage classical Hodgkin lymphoma: a real-world study. Ann Hematol 2024; 103:793-801. [PMID: 37953379 DOI: 10.1007/s00277-023-05541-7] [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: 10/07/2023] [Accepted: 11/05/2023] [Indexed: 11/14/2023]
Abstract
The anti-PD-1 antibodies have been reported to show a striking effect in relapsed and refractory(R/R) classical Hodgkin lymphoma (cHL), however, there is still limited real-world data assessing the role of anti-PD-1 antibody monotherapy in early-stage cHL. In this retrospective analysis, we reported the effectiveness and safety of tislelizumab monotherapy in the first-line therapy of early-stage cHL. Twenty-three consecutive patients (10 males and 13 females) with previously untreated stage I A-II B cHL were included. At interim evaluation after 2 doses of tislelizumab monotherapy, 11 of 23 patients (47.8%) achieved complete response (CR). At the end of tislelizumab monotherapy (EOTM), objective response was observed in 22 of 23 patients (95.7%), with CR in 16 patients (69.6%). Among six patients with PR-EOTM, two patients underwent 4 cycles of ABVD chemotherapy and one patient underwent 4 cycles of tislelizumab plus AVD. One patient who developed progressive disease (PD) after 4 doses of tislelizumab subsequently underwent 4 cycles of ABVD chemotherapy. Except for four patients with CR-EOTM, consolidative radiotherapy was given to 19 patients. All patients obtained CR at the end of all treatments. With a median follow-up time of 21.3 months (range, 6.9-32.7 months), the estimated 2-year PFS rate and 2-year OS rate were 95.65% and 100%, respectively. Except for grade 3 lymphocyte count decreased, no other grade 3/4 TRAE was observed. In addition, no serious AE was reported. Our preliminary data observed that tislelizumab monotherapy was safe and highly effective in previously untreated early-stage cHL.
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Affiliation(s)
- Peng Sun
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, China
| | - Hang Yang
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, China
| | - Yu Wang
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, China
| | - Baitian Zhao
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, China
- Department of Clinical Trials Center, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China
| | - Man Nie
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, China
| | - Kangming Huang
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, China
| | - Zhiming Li
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China.
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, China.
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Guo J, Gao D, Lian J, Qu Y. De novo biosynthesis of antiarrhythmic alkaloid ajmaline. Nat Commun 2024; 15:457. [PMID: 38212296 PMCID: PMC10784492 DOI: 10.1038/s41467-024-44797-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 01/05/2024] [Indexed: 01/13/2024] Open
Abstract
The antiarrhythmic drug ajmaline is a monoterpenoid indole alkaloid (MIA) isolated from the Ayurvedic plant Rauvolfia serpentina (Indian Snakeroot). Research into the biosynthesis of ajmaline and another renowned MIA chemotherapeutic drug vinblastine has yielded pivotal advancements in the fields of plant specialized metabolism and engineering over recent decades. While the majority of vinblastine biosynthesis has been recently elucidated, the quest for comprehending ajmaline biosynthesis remains incomplete, marked by the absence of two critical enzymes. Here, we show the discovery and characterization of these two elusive reductases, alongside the identification of two physiologically relevant esterases that complete the biosynthesis of ajmaline. We show that ajmaline biosynthesis proceeds with vomilenine 1,2(R)-reduction followed by its 19,20(S)-reduction. This process is further modulated by two root-expressing esterases that deacetylate 17-O-acetylnorajmaline. Expanding upon the successful completion of the ajmaline biosynthetic pathway, we engineer the de novo biosynthesis of ajmaline in Baker's yeast.
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Affiliation(s)
- Jun Guo
- Department of Chemistry, University of New Brunswick, Fredericton, NB, Canada
| | - Di Gao
- Key Laboratory of Biomass Chemical Engineering of Ministry of Education, College of Chemical and Biological Engineering, Zhejiang University, Hangzhou, China
| | - Jiazhang Lian
- Key Laboratory of Biomass Chemical Engineering of Ministry of Education, College of Chemical and Biological Engineering, Zhejiang University, Hangzhou, China.
- ZJU-Hangzhou Global Scientific and Technological Innovation Center, Zhejiang University, Hangzhou, China.
- Zhejiang Key Laboratory of Smart Biomaterials, Zhejiang University, Hangzhou, China.
| | - Yang Qu
- Department of Chemistry, University of New Brunswick, Fredericton, NB, Canada.
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Domínguez-Gómez M, Mora-Simón S, Rodríguez-Sánchez E. [Mortality associated with neurocognitive disorder and dependence in people over 55 years of age. Systematic review]. Rev Esp Geriatr Gerontol 2024; 59:101411. [PMID: 37820397 DOI: 10.1016/j.regg.2023.101411] [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: 05/30/2023] [Revised: 09/11/2023] [Accepted: 09/14/2023] [Indexed: 10/13/2023]
Abstract
INTRODUCTION The increasing aging of the population brings with it an increase in the incidence of neurocognitive disorder (NCD) as well as various situations that generate dependence. OBJECTIVE To analyze by means of a systematic review the relationship between NCD and dependence with the risk of mortality in the elderly. METHODS A bibliographic search of longitudinal studies published in Pubmed and Scopus addressing the relationship between NCI, dependence for basic activities of daily living (ADL) and mortality published between 1995 and 2021 was performed. Of the 1040 articles found, 10 studies were selected. RESULTS It was observed that cohorts of elderly people with NCI presented mortality risk associated with ABVD impairment (Barthel test) and Mini-Mental State Examination scores following a significant linear trend. Other factors associated with mortality risk were low levels of education, living alone, and frailty. CONCLUSIONS The results underline the importance of performing assessments of cognitive and functional status using validated scales, since both areas are associated with mortality. The link between the three terms used in the search for this work is clear, but it is noteworthy that there are few longitudinal studies that analyze them together. The assessment of dependence and cognitive function in older adults should be considered in both research and clinical practice as it would provide information on their possible relationship with mortality.
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Affiliation(s)
- Manuel Domínguez-Gómez
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACyL), Salamanca, España; Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS) (RD21/0016)
| | - Sara Mora-Simón
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACyL), Salamanca, España; Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS) (RD21/0016); Departamento de Psicología Básica, Psicobiología y Metodología de las Ciencias del Comportamiento, Facultad de Psicología, Universidad de Salamanca, Salamanca, España
| | - Emiliano Rodríguez-Sánchez
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACyL), Salamanca, España; Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS) (RD21/0016); Departamento de Medicina, Facultad de Medicina, Universidad de Salamanca, Salamanca, España.
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Santos FM, Marin JFG, Lima MS, Silva-Junior WF, Alves LBO, Moreira FR, Velasques RD, Atanazio MJ, Maia ACA, Buchpiguel CA, Buccheri V, Rocha V. Impact of baseline and interim quantitative PET parameters on outcomes of classical Hodgkin Lymphoma. Ann Hematol 2024; 103:175-183. [PMID: 37796339 DOI: 10.1007/s00277-023-05461-6] [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: 07/21/2023] [Accepted: 09/17/2023] [Indexed: 10/06/2023]
Abstract
Currently, analysis of interim PET (iPET) according to the Deauville score (DS) is the most important predictive factor in Hodgkin lymphoma (HL); however, there is room for improvement in its prognostic power. This study aimed to evaluate the prognostic value of quantitative PET analysis (maximum standard uptake value [SUVmax], total metabolic tumor volume [TMTV] and total lesion glicolysis [TLG]) at baseline (PET0) and iPET in a retrospective cohort of newly diagnosed classical HL. For positive iPET (+ iPET), the reduction of quantitative parameters in relation to PET0 (ΔSUVmax, ΔTMTV and ΔTLG) was calculated. Between 2011 and 2017, 234 patients treated with ABVD were analyzed. Median age was 30 years-old, 59% had advanced stage disease, 57% a bulky mass and 25% a + iPET (DS 4-5). At baseline, high TLG was associated with an increased cumulative incidence of failure (CIF) (p = 0.032) while neither SUVmax, TMTV or TLG were associated with overall survival (OS) or progression-free survival (PFS). In multivariate analysis, only iPET was associated with CIF (p < 0.001). Among ΔSUVmax, ΔTMTV and ΔTLG, only a ΔSUVmax ≥ 68.8 was significant for PFS (HR: 0.31, CI95%: 0.11-0.86, p = 0.024). A subset of patients with improved PFS amongst + iPET was identified by the quantitative (ΔSUVmax ≥ 68.8%) analysis. In this real-world Brazilian cohort, with prevalent high-risk patients, quantitative analysis of PET0 did not demonstrate to be prognostic, while a dynamic approach incorporating the ΔSUVmax to + iPET succeeded in refining a subset with better prognosis. These findings warrant validation in larger series and indicate that not all patients with + iPET might need treatment intensification.
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Affiliation(s)
- Fernanda Maria Santos
- Instituto Do Cancer Do Estado de Sao Paulo (ICESP), Faculdade de Medicina, Universidade de Sao Paulo (FMUSP), Sao Paulo-SP, Brazil.
| | - Jose Flavio Gomes Marin
- Nuclear Medicine Medical Investigation Laboratory LIM43, Hospital das Clinicas, FMUSP (HCFMUSP), Sao Paulo-SP, Brazil
| | - Marcos Santos Lima
- Instituto Do Cancer Do Estado de Sao Paulo (ICESP), Faculdade de Medicina, Universidade de Sao Paulo (FMUSP), Sao Paulo-SP, Brazil
- Nuclear Medicine Medical Investigation Laboratory LIM43, Hospital das Clinicas, FMUSP (HCFMUSP), Sao Paulo-SP, Brazil
| | - Wellington Fernandes Silva-Junior
- Instituto Do Cancer Do Estado de Sao Paulo (ICESP), Faculdade de Medicina, Universidade de Sao Paulo (FMUSP), Sao Paulo-SP, Brazil
- Division of Hematology and Cell Therapy, HCFMUSP, Sao Paulo-SP, Brazil
| | | | | | - Rodrigo Dolphini Velasques
- Instituto Do Cancer Do Estado de Sao Paulo (ICESP), Faculdade de Medicina, Universidade de Sao Paulo (FMUSP), Sao Paulo-SP, Brazil
- Division of Hematology and Cell Therapy, HCFMUSP, Sao Paulo-SP, Brazil
| | - Marcelo Junqueira Atanazio
- Instituto Do Cancer Do Estado de Sao Paulo (ICESP), Faculdade de Medicina, Universidade de Sao Paulo (FMUSP), Sao Paulo-SP, Brazil
- Division of Hematology and Cell Therapy, HCFMUSP, Sao Paulo-SP, Brazil
| | - Ana Carolina Arrais Maia
- Instituto Do Cancer Do Estado de Sao Paulo (ICESP), Faculdade de Medicina, Universidade de Sao Paulo (FMUSP), Sao Paulo-SP, Brazil
- Division of Hematology and Cell Therapy, HCFMUSP, Sao Paulo-SP, Brazil
| | - Carlos A Buchpiguel
- Nuclear Medicine Medical Investigation Laboratory LIM43, Hospital das Clinicas, FMUSP (HCFMUSP), Sao Paulo-SP, Brazil
| | - Valeria Buccheri
- Instituto Do Cancer Do Estado de Sao Paulo (ICESP), Faculdade de Medicina, Universidade de Sao Paulo (FMUSP), Sao Paulo-SP, Brazil
- Division of Hematology and Cell Therapy, HCFMUSP, Sao Paulo-SP, Brazil
- Laboratory of Medical Investigation in Pathogenesis and Targeted Therapy in Onco-Immuno-Hematology (LIM-31), Department of Internal Medicine, Division of Hematology, HCFMUSP, Sao Paulo-SP, Brazil
| | - Vanderson Rocha
- Instituto Do Cancer Do Estado de Sao Paulo (ICESP), Faculdade de Medicina, Universidade de Sao Paulo (FMUSP), Sao Paulo-SP, Brazil
- Division of Hematology and Cell Therapy, HCFMUSP, Sao Paulo-SP, Brazil
- Laboratory of Medical Investigation in Pathogenesis and Targeted Therapy in Onco-Immuno-Hematology (LIM-31), Department of Internal Medicine, Division of Hematology, HCFMUSP, Sao Paulo-SP, Brazil
- Department of Hematology, Churchill Hospital, NHS BT, Oxford University, Oxford, UK
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Federico M, Fortpied C, Stepanishyna Y, Gotti M, van der Maazen R, Cristinelli C, Re A, Plattel W, Lazarovici J, Merli F, Specht L, Schiano de Colella JM, Hutchings M, Versari A, Edeline V, Stamatoulas A, Girinsky T, Ricardi U, Aleman B, Meulemans B, Tonino S, Raemaekers J, André M. Long-Term Follow-Up of the Response-Adapted Intergroup EORTC/LYSA/FIL H10 Trial for Localized Hodgkin Lymphoma. J Clin Oncol 2024; 42:19-25. [PMID: 37967311 PMCID: PMC10730029 DOI: 10.1200/jco.23.01745] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/02/2023] [Accepted: 09/22/2023] [Indexed: 11/17/2023] Open
Abstract
Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported.The primary analysis of the Early positron emission tomography (ePET) Response-Adapted Treatment in localized Hodgkin Lymphoma H10 Trial demonstrated that in ePET-negative patients, the risk of relapse increased when involved-node radiotherapy (INRT) was omitted and that in ePET-positive patients, switching from doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) to bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPPesc) significantly improved 5-year progression-free survival (PFS). Here, we report the final results of a preplanned analysis at a 10-year follow-up. In the favorable (F) ePET-negative group, the 10-year PFS rates were 98.8% versus 85.4% (hazard ratio [HR], 13.2; 95% CI, 3.1 to 55.8; P value for noninferiority = .9735; difference test P < .0001) in favor of ABVD + INRT; in the unfavorable (U) ePET-negative group, the 10-year PFS rates were 91.4% and 86.5% (HR, 1.52; 95% CI, 0.84 to 2.75; P value for noninferiority = .8577; difference test P = .1628). In ePET-positive patients, the difference in terms of PFS between standard ABVD and intensified BEACOPPesc was no longer statistically significant (HR, 0.67; 95% CI, 0.37 to 1.20; P = .1777). In conclusion, the present long-term analysis confirms that in ePET-negative patients, the omission of INRT is associated with lower 10-year PFS. Instead, in ePET-positive patients, no significant difference between standard and experimental arms emerged although intensification with BEACOPPesc was safe, with no increase in late adverse events, namely, second malignancies.
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Affiliation(s)
| | | | | | - Manuel Gotti
- Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | | | | | - Wouter Plattel
- University Medical Center Groningen, Groningen, the Netherlands
| | | | - Francesco Merli
- Azienda Unità Sanitaria Locale- IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | | | | | - Annibale Versari
- Azienda Unità Sanitaria Locale- IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | | | | | | | - Berthe Aleman
- The Netherlands Cancer Institute-Antoni Van Leeuwenhoekziekenhuis, Amsterdam, the Netherlands
| | | | - Sanne Tonino
- Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - John Raemaekers
- Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands
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Geel J, van Zyl A, Plessis JD, Hendricks M, Goga Y, Carr A, Neethling B, Hramyka A, Omar F, Mathew R, Louw L, Naidoo T, Ngcana T, Schickerling T, Netshituni V, Madzhia E, du Plessis L, Kelsey T, Ballot DE, Metzger ML. Improved survival of children and adolescents with classical Hodgkin lymphoma treated on a harmonised protocol in South Africa. Pediatr Blood Cancer 2024; 71:e30712. [PMID: 37814417 DOI: 10.1002/pbc.30712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 09/11/2023] [Accepted: 09/25/2023] [Indexed: 10/11/2023]
Abstract
BACKGROUND Historic South African 5-year overall survival (OS) rates for Hodgkin lymphoma (HL) from 2000 to 2010 were 46% and 84% for human immunodeficiency virus (HIV)-positive and HIV-negative children, respectively. We investigated whether a harmonised treatment protocol using risk stratification and response-adapted therapy could increase the OS of childhood and adolescent HL. METHODS Seventeen units prospectively enrolled patients less than 18 years, newly diagnosed with classical HL onto a risk-stratified, response-adapted treatment protocol from July 2016 to December 2022. Low- and intermediate-risk patients received four and six courses of adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD), respectively. High-risk patients received two courses of ABVD, followed by four courses of cyclophosphamide, vincristine, prednisone, and dacarbazine (COPDac). Those with a slow early response and bulky disease received consolidation radiotherapy. HIV-positive patients could receive granulocyte colony-stimulating factor and less intensive therapy if stratified as high risk, at the treating clinician's discretion. Kaplan-Meier survival analysis was performed to determine 2-year OS and Cox regression to elucidate prognostic factors. RESULTS The cohort comprised 132 patients (19 HIV-positive, 113 HIV-negative), median age of 9.7 years, with a median follow-up of 2.2 years. Risk grouping comprised nine (7%) low risk, 36 (27%) intermediate risk and 87 (66%) high risk, with 71 (54%) rapid early responders and 45 (34%) slow early responders, and 16 (12%) undocumented. Two-year OS was 100% for low-risk, 93% for intermediate-risk, and 91% for high-risk patients. OS for HIV-negative (93%) and HIV-positive (89%) patients were similar (p = .53). Absolute lymphocyte count greater than 0.6 × 109 predicted survival (94% vs. 83%, p = .02). CONCLUSION In the first South African harmonised HL treatment protocol, risk stratification correlated with prognosis. Two-year OS of HIV-positive and HIV-negative patients improved since 2010, partially ascribed to standardised treatment and increased supportive care. This improved survival strengthens the harmonisation movement and gives hope that South Africa will achieve the WHO Global Initiative for Childhood Cancer goals.
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Affiliation(s)
- Jennifer Geel
- Pediatric Haematology-Oncology, University of the Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital, Wits Donald Gordon Medical Centre, Johannesburg, South Africa
| | - Anel van Zyl
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa
| | - Jan du Plessis
- Pediatric Haematology-Oncology, University of the Free State, Universitas Hospital, Bloemfontein, South Africa
| | - Marc Hendricks
- Department of Paediatrics and Child Health, Haematology-Oncology Service, Faculty of Health Sciences, University of Cape Town, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
| | - Yasmin Goga
- Department of Paediatrics and Child Health, Haematology-Oncology Service, Faculty of Health Sciences, University of Cape Town, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
| | - Amy Carr
- Pediatric Haematology-Oncology, University of KwaZulu-Natal Durban, Greys Hospital, Pietermaritzburg, South Africa
| | - Beverley Neethling
- Pediatric Haematology-Oncology, University of KwaZulu-Natal Durban, Inkosi Albert Luthuli Hospital and Greys Hospital, Pietermaritzburg, South Africa
| | - Artsiom Hramyka
- School of Computer Science, University of St Andrews, St Andrews, UK
| | - Fareed Omar
- Pediatric Haematology-Oncology, University of Pretoria, Steve Biko Academic Hospital, Pretoria, South Africa
| | - Rema Mathew
- Pediatric Haematology-Oncology, Walter Sisulu University, Frere Hospital, East London, South Africa
| | - Lizette Louw
- Centre of Molecular Imaging and Theranostics, Johannesburg, South Africa
| | - Thanushree Naidoo
- Department of Radiation Oncology, University of the Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
- Wits Donald Gordon Medical Centre, Johannesburg, South Africa
| | - Thandeka Ngcana
- Pediatric Haematology-Oncology, University of the Witwatersrand, Chris Hani Baragwanath Academic Hospital, Wits Donald Gordon Medical Centre, Johannesburg, South Africa
| | | | - Vutshilo Netshituni
- Pediatric Haematology-Oncology, University of Limpopo, Polokwane-Mankweng Hospital Complex, Polokwane, South Africa
| | - Elelwani Madzhia
- Pediatric Haematology-Oncology, Sefako Makgatho University, Dr George Mukhari Hospital, Garankuwa, South Africa
| | - Liezl du Plessis
- Pediatric Haematology-Oncology, University of the Free State, Kimberley Hospital, Kimberley, South Africa
| | - Tom Kelsey
- School of Computer Science, University of St Andrews, St Andrews, UK
| | - Daynia E Ballot
- School of Clinical Medicine, University of the Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
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Loison R, Abbar B, Drouin L, Bonnet-Bensimon C, Cuvier C, Giacchetti S, Espie M, Teixeira L, De Castelbajac V. Vinorelbine thiotepa in metastatic breast cancer: a large real-life retrospective study. Acta Oncol 2023; 62:1961-1966. [PMID: 37750392 DOI: 10.1080/0284186x.2023.2260943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 09/14/2023] [Indexed: 09/27/2023]
Affiliation(s)
- Rebecca Loison
- Université de Paris Cité, INSERM U976, Assistance Publique-Hôpitaux de Paris (AP-HP), Saint-Louis Hospital, Breast Disease Unit (Sénopole), Paris, France
| | - Baptiste Abbar
- Sorbonne Université, INSERM U1135, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié Salpêtrière Hospital, Department of Medical Oncology, Institut Universitaire de Cancérologie, CLIP² Galilée, Paris, France
| | - Leonor Drouin
- Université de Paris Cité, INSERM U976, Assistance Publique-Hôpitaux de Paris (AP-HP), Saint-Louis Hospital, Breast Disease Unit (Sénopole), Paris, France
| | - Charlotte Bonnet-Bensimon
- Université de Paris Cité, INSERM U976, Assistance Publique-Hôpitaux de Paris (AP-HP), Saint-Louis Hospital, Breast Disease Unit (Sénopole), Paris, France
| | - Caroline Cuvier
- Université de Paris Cité, INSERM U976, Assistance Publique-Hôpitaux de Paris (AP-HP), Saint-Louis Hospital, Breast Disease Unit (Sénopole), Paris, France
| | - Sylvie Giacchetti
- Université de Paris Cité, INSERM U976, Assistance Publique-Hôpitaux de Paris (AP-HP), Saint-Louis Hospital, Breast Disease Unit (Sénopole), Paris, France
| | - Marc Espie
- Université de Paris Cité, INSERM U976, Assistance Publique-Hôpitaux de Paris (AP-HP), Saint-Louis Hospital, Breast Disease Unit (Sénopole), Paris, France
| | - Luis Teixeira
- Université de Paris Cité, INSERM U976, Assistance Publique-Hôpitaux de Paris (AP-HP), Saint-Louis Hospital, Breast Disease Unit (Sénopole), Paris, France
| | - Victoire De Castelbajac
- Université de Paris Cité, INSERM U976, Assistance Publique-Hôpitaux de Paris (AP-HP), Saint-Louis Hospital, Breast Disease Unit (Sénopole), Paris, France
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11
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Ali N, Moussa E, Khorshed E, Zaghloul MS, Elnashar A, Abdalla A. Variant histology of pediatric nodular lymphocyte-predominant Hodgkin lymphoma with IgD and CD30 expression. Pediatr Blood Cancer 2023; 70:e30647. [PMID: 37638819 DOI: 10.1002/pbc.30647] [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: 01/03/2023] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL), recently known as nodular lymphocyte-predominant B-cell lymphoma (NLPBL), accounts for 5%-10% of Hodgkin lymphoma (HL). Different morphologic patterns of NLPBL are identified and categorized as typical patterns (type A and B) and variant histologic patterns (types C, D, E, and F). PATIENTS AND METHOD We investigated different morphologic patterns, CD30 and IgD expression in pediatric patients with NLPBL diagnosed at the Children's Cancer Hospital Egypt. RESULTS Forty-six (53%) of the patients exhibited a typical histologic pattern, whereas the remaining (47%) exhibited variant histologic pattern. Variant histology is associated with unfavorable clinical characteristics, such as advanced stages, B-symptoms, and extranodal involvements, particularly bone marrow and bone infiltration, with p-values of .06, .05, and 0.01%, respectively. Additionally, 39% of patients with variant histology experienced disease progression or relapse, compared to only 15.2% of patients with typical patterns (p = .009). Types C and D are related to decreased event-free survival (EFS), as shown by a p-value of .05. The 5-year EFS for patients with variant histology was 94.4% for the rituximab, cyclophosphamide, vincristine, doxorubicin, and prednisone (RCHOP) versus 33.3% for the adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD). IgD expression in lymphocyte-predominant (LP) cells was detected in 44 (50%) patients, while CD30 expression in LP cells was found in 39 (44%) patients. CONCLUSION Variant histology of NLPBL was associated with advanced disease stages and a poor prognosis, while expression of IgD and CD30 in LP cells was not. The poor outcome of variant histology improved with the RCHOP regimen.
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Affiliation(s)
- Nesreen Ali
- Pediatric Oncology and Hematology Department, National Cancer Institute (NCI), Cairo University and Children Cancer Hospital, Cairo, Egypt
| | - Emad Moussa
- Clinical Oncology Department, Menoufya University and Children Cancer Hospital Egypt, Cairo, Egypt
| | - Eman Khorshed
- Pathology Department, National Cancer Institute (NCI), Cairo University and Children Cancer Hospital Egypt, Cairo, Egypt
| | - Mohamed S Zaghloul
- Radiation Therapy Department, National Cancer Institute (NCI), Cairo University and Children Cancer Hospital Egypt, Cairo, Egypt
| | - Amr Elnashar
- Clinical Research Department, Children Cancer Hospital, Cairo, Egypt
| | - Amr Abdalla
- Pediatric Oncology and Hematology Department, National Cancer Institute (NCI), Cairo University, Egypt and Child Health Department, Sultan Qaboos University, Muscat, Oman
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12
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Vassilakopoulos TP, Liaskas A, Pereyra P, Panayiotidis P, Angelopoulou MK, Gallamini A. Incorporating Monoclonal Antibodies into the First-Line Treatment of Classical Hodgkin Lymphoma. Int J Mol Sci 2023; 24:13187. [PMID: 37685994 PMCID: PMC10487754 DOI: 10.3390/ijms241713187] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/06/2023] [Accepted: 08/09/2023] [Indexed: 09/10/2023] Open
Abstract
The long-term survival of Hodgkin lymphoma (HL) patients treated according to the current standard of care is excellent. Combined-modality schedules (ABVD plus radiotherapy) in early-stage disease, along with treatment intensity adaptation to early metabolic response assessed by PET/CT in advanced stage HL, have been the cornerstones of risk stratification and treatment decision-making, minimizing treatment-related complications while keeping efficacy. Nevertheless, a non-negligible number of patients are primary refractory or relapse after front-line treatment. Novel immunotherapeutic agents, namely Brentuximab Vedotin (BV) and immune checkpoint inhibitors (CPI), have already shown outstanding efficacy in a relapsed/refractory setting in recent landmark studies. Several phase 2 single-arm studies suggest that the addition of these agents in the frontline setting could further improve long-term disease control permitting one to reduce the exposure to cytotoxic drugs. However, a longer follow-up is needed. At the time of this writing, the only randomized phase 3 trial so far published is the ECHELON-1, which compares 1 to 1 BV-AVD (Bleomycin is replaced by BV) with standard ABVD in untreated advanced-stage III and IV HL. The ECHELON-1 trial has proven that BV-AVD is safe and more effective both in terms of long-term disease control and overall survival. Just recently, the results of the S1826 SWOG trial demonstrated that the combination nivolumab-AVD (N-AVD) is better than BV-AVD, while preliminary results of other randomized ongoing phase 3 trials incorporating anti-PD-1 in this setting will be soon available. The aim of this review is to present the recent data regarding these novel agents in first-line treatment of HL and to highlight current and future trends which will hopefully reshape the overall management of this disease.
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Affiliation(s)
- Theodoros P. Vassilakopoulos
- Department of Hematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, 11527 Athens, Greece; (A.L.); (P.P.); (M.K.A.)
| | - Athanasios Liaskas
- Department of Hematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, 11527 Athens, Greece; (A.L.); (P.P.); (M.K.A.)
| | - Patricio Pereyra
- Department of Hematology, National Hospital Alejandro Posadas, Buenos Aires 1684, Argentina;
| | - Panayiotis Panayiotidis
- Department of Hematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, 11527 Athens, Greece; (A.L.); (P.P.); (M.K.A.)
| | - Maria K. Angelopoulou
- Department of Hematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, 11527 Athens, Greece; (A.L.); (P.P.); (M.K.A.)
| | - Andrea Gallamini
- Research and Clinical Innovation Department, Antoine Lacassagne Cancer Center, 06100 Nice, France;
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13
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Eichenauer DA, Bühnen I, Baues C, Kobe C, Kaul H, Greil R, Moccia A, Zijlstra JM, Hertenstein B, Topp MS, Just M, von Tresckow B, Eich HT, Fuchs M, Dietlein M, Hartmann S, Engert A, Borchmann P. Interim PET-guided treatment for early-stage NLPHL: a subgroup analysis of the randomized GHSG HD16 and HD17 studies. Blood 2023; 142:553-560. [PMID: 37257195 DOI: 10.1182/blood.2023019939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/25/2023] [Accepted: 04/25/2023] [Indexed: 06/02/2023] Open
Abstract
The optimal first-line treatment for nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) diagnosed in early stages is largely undefined. We, therefore, analyzed 100 NLPHL patients treated in the randomized HD16 (early-stage favorable; n = 85) and HD17 (early-stage unfavorable; n = 15) studies. These studies investigated the omission of consolidation radiotherapy (RT) in patients with a negative interim positron emission tomography (iPET) (ie, Deauville score <3) after chemotherapy (HD16: 2× doxorubicin, bleomycin, vinblastine, and dacarbazine [ABVD]; HD17: 2× escalated bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone [BEACOPP] plus 2× ABVD). Patients with NLPHL treated in the HD16 and HD17 studies had 5-year progression-free survival (PFS) rates of 90.3% and 92.9%, respectively. Thus, the 5-year PFS did not differ significantly from that of patients with classical Hodgkin lymphoma treated within the same studies (HD16: P = .88; HD17: P = .50). Patients with early-stage favorable NLPHL who had a negative iPET after 2× ABVD and did not undergo consolidation RT tended to have a worse 5-year PFS than patients with a negative iPET who received consolidation RT (83% vs 100%; P = .05). There were 10 cases of NLPHL recurrence. However, no NLPHL patient died during follow-up. Hence, the 5-year overall survival rate was 100%. Taken together, contemporary Hodgkin lymphoma-directed treatment approaches result in excellent outcomes for patients with newly diagnosed early-stage NLPHL and, thus, represent valid treatment options. In early-stage favorable NLPHL, consolidation RT appears necessary after 2× ABVD to achieve the optimal disease control irrespective of the iPET result.
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Affiliation(s)
- Dennis A Eichenauer
- First Department of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, Cologne, Germany
- German Hodgkin Study Group, University Hospital Cologne, Cologne, Germany
| | - Ina Bühnen
- First Department of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, Cologne, Germany
- German Hodgkin Study Group, University Hospital Cologne, Cologne, Germany
| | - Christian Baues
- German Hodgkin Study Group, University Hospital Cologne, Cologne, Germany
- Department of Radiation Oncology, University of Cologne, Cologne, Germany
| | - Carsten Kobe
- German Hodgkin Study Group, University Hospital Cologne, Cologne, Germany
- Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Helen Kaul
- First Department of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, Cologne, Germany
- German Hodgkin Study Group, University Hospital Cologne, Cologne, Germany
| | - Richard Greil
- Salzburg Cancer Research Institute, Center for Clinical Cancer and Immunology Trials, Cancer Cluster Salzburg, Austrian Group for Medical Tumor Therapy, Paracelsus Medical University, Salzburg, Austria
| | - Alden Moccia
- Department of Medical Oncology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
- Swiss Group for Clinical Cancer Research, Bern, Switzerland
| | - Joseé M Zijlstra
- Department of Hematology, Amsterdam UMC, Vrije universiteit, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Bernd Hertenstein
- Department of Internal Medicine I, Klinikum Bremen-Mitte, Bremen, Germany
| | - Max S Topp
- Second Department of Internal Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Marianne Just
- Onkologische Schwerpunktpraxis Bielefeld, Bielefeld, Germany
| | - Bastian von Tresckow
- German Hodgkin Study Group, University Hospital Cologne, Cologne, Germany
- Department of Hematology and Stem Cell Transplantation, University Hospital Essen, University Duisburg-Essen, German Cancer Consortium (DKTK partner site Essen), Essen, Germany
| | - Hans-Theodor Eich
- German Hodgkin Study Group, University Hospital Cologne, Cologne, Germany
- Department of Radiotherapy, University Hospital Münster, Münster, Germany
| | - Michael Fuchs
- First Department of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, Cologne, Germany
- German Hodgkin Study Group, University Hospital Cologne, Cologne, Germany
| | - Markus Dietlein
- German Hodgkin Study Group, University Hospital Cologne, Cologne, Germany
- Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Sylvia Hartmann
- Dr. Senckenberg Institute of Pathology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Andreas Engert
- First Department of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, Cologne, Germany
- German Hodgkin Study Group, University Hospital Cologne, Cologne, Germany
| | - Peter Borchmann
- First Department of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, Cologne, Germany
- German Hodgkin Study Group, University Hospital Cologne, Cologne, Germany
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Assad M, Paracha RN, Siddique AB, Shaheen MA, Ahmad N, Mustaqeem M, Kanwal F, Mustafa MZU, Rehman MFU, Fatima S, Lu C. In Silico and In Vitro Studies of 4-Hydroxycoumarin-Based Heterocyclic Enamines as Potential Anti-Tumor Agents. Molecules 2023; 28:5828. [PMID: 37570800 PMCID: PMC10421012 DOI: 10.3390/molecules28155828] [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: 06/20/2023] [Revised: 07/20/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
The present study reports the one-step synthesis of several 3-formyl-4-hydroxycouramin-derived enamines (4a-4i) in good yields (65-94%). The characterization of the synthesized compounds was carried out via advanced analytical and spectroscopic techniques, such as melting point, electron impact mass spectrometry (EI-MS), 1H-NMR, 13C-NMR, elemental analysis, FTIR, and UV-Visible spectroscopy. The reaction conditions were optimized, and the maximum yield was obtained at 3-4 h of reflux of the reactants, using 2-butanol as a solvent. The potato disc tumor assay was used to assess Agrobacterium tumefaciens-induced tumors to evaluate the anti-tumor activities of compounds (4a-4i), using Vinblastine as a standard drug. The compound 4g showed the lowest IC50 value (1.12 ± 0.2), which is even better than standard Vinblastine (IC50 7.5 ± 0.6). For further insight into their drug actions, an in silico docking of the compounds was also carried out against the CDK-8 protein. The binding energy values of compounds were found to agree with the experimental results. The compounds 4g and 4h showed the best affinities toward protein, with a binding energy value of -6.8 kcal/mol.
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Affiliation(s)
- Mediha Assad
- College of Biological Sciences and Medical Engineering, Donghua University, 2999 North Ren Min Road, Shanghai 201620, China
- Department of Chemistry, Government Graduate Islamia College for Women Cantt Lahore, Lahore 54000, Pakistan
| | | | - Abu Bakar Siddique
- Institute of Chemistry, University of Sargodha, Sargodha 40100, Pakistan; (A.B.S.)
| | | | - Nadeem Ahmad
- Department of Pharmacy, Comsats University Islamabad, Lahore Campus, Lahore 54000, Pakistan
| | - Muhammad Mustaqeem
- Institute of Chemistry, University of Sargodha, Sargodha 40100, Pakistan; (A.B.S.)
| | - Fariha Kanwal
- School of Biomedical Engineering, Shanghai Jiaotong University, Shanghai 200030, China
| | | | | | - Sumaya Fatima
- Research Center, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Changrui Lu
- College of Biological Sciences and Medical Engineering, Donghua University, 2999 North Ren Min Road, Shanghai 201620, China
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15
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Suwanban T, Chamnanchanunt S, Thungthong P, Nakhahes C, Iam‐arunthai K, Akrawikrai T, Bunworasate U. Survival rates of adult patients with Hodgkin lymphoma who underwent ABVD versus escalated BEACOPP in a resource-limited country: An observational study. Cancer Rep (Hoboken) 2023; 6:e1839. [PMID: 37254799 PMCID: PMC10432437 DOI: 10.1002/cnr2.1839] [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: 12/05/2022] [Revised: 05/03/2023] [Accepted: 05/22/2023] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND The survival rate of adult patients with Hodgkin lymphoma (HL) depends on the responses to standard chemotherapy, radiotherapy, or combined therapy. Resource-limited countries face numerous obstacles in supporting patients with HL who undergo chemotherapy, especially in advanced stages. AIM To analyze the survival outcomes of adult patients with HL after combined-modality treatment (CMT) with involved-field or non-involved-field radiotherapy. METHODS AND RESULTS We retrospectively reviewed the medical records of 90 adult patients with HL who received CMT at Rajavithi Hospital, Bangkok between 2007 and 2021. Patients with stage I-IV disease received different therapies depending on their risk group. The risk groups were evaluated according to initial response, bulky disease, and B symptoms. Patients (n = 90) who underwent CMT were followed up for 34.7 months (range, 1-141 months). The median follow-up periods of early and advanced-stage patients were 53.1 months and 23.5 months, respectively. The estimated 5-year overall survival (OS) and progression-free survival (PFS) rates of patients with advanced-stage diseases were 85% and 62%, respectively. There was a difference in the 3-year overall survival among advance-stage patients who underwent ABVD (94%) compared to those administered BEACOPPesc (50%), and the 3-year PFS (84%) among patients who underwent ABVD was higher than that among those administered BEACOPPesc (66%). Radiotherapy increased toxicity but did not improve the survival rate. CONCLUSION Chemotherapy administered to patients with advanced-stage adult HL was more effective than BEACOPPesc when ABVD was administered. Our findings are relevant for hospitals with limited resources.
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Affiliation(s)
- Tawatchai Suwanban
- Division of Hematology, Department of Medicine, Rajavithi HospitalCollege of Medicine, Rangsit UniversityBangkokThailand
| | - Supat Chamnanchanunt
- Division of Hematology, Department of Medicine, Rajavithi HospitalCollege of Medicine, Rangsit UniversityBangkokThailand
- Department of Clinical Tropical Medicine, Faculty of Tropical MedicineMahidol UniversityBangkokThailand
| | - Pravinwan Thungthong
- Division of Hematology, Department of Medicine, Rajavithi HospitalCollege of Medicine, Rangsit UniversityBangkokThailand
| | - Chajchawan Nakhahes
- Division of Hematology, Department of Medicine, Rajavithi HospitalCollege of Medicine, Rangsit UniversityBangkokThailand
| | - Kunapa Iam‐arunthai
- Division of Hematology, Department of Medicine, Rajavithi HospitalCollege of Medicine, Rangsit UniversityBangkokThailand
| | - Tananchai Akrawikrai
- Division of Hematology, Department of Medicine, Rajavithi HospitalCollege of Medicine, Rangsit UniversityBangkokThailand
| | - Udomsak Bunworasate
- Division of Hematology, Department of Medicine, Faculty of MedicineChulalongkorn UniversityBangkokThailand
- Research Unit in Translational Hematology, Faculty of MedicineChulalongkorn UniversityBangkokThailand
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16
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Hu Y, Fan S, Zhu Y, Xie X. A novel circadian cycle-related gene signature for prognosis prediction of patients with breast cancer. Medicine (Baltimore) 2023; 102:e33718. [PMID: 37144994 PMCID: PMC10158864 DOI: 10.1097/md.0000000000033718] [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: 02/06/2023] [Accepted: 04/18/2023] [Indexed: 05/06/2023] Open
Abstract
The extensive and intricate relationships between circadian rhythm and cancer have been reported in numerous studies. However, in breast cancer (BC), the potential role of circadian clock-related genes (CCRGs) in prognosis prediction has not been fully clarified. The transcriptome data and clinical information were downloaded from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus databases. A CCRGs-based risk signature was established by differential expression analysis, univariate, Lasso and multivariate Cox regression analyses. we conducted a gene set enrichment analysis (GSEA) between groups. A nomogram integrating independent clinical factors and risk score was generated and evaluated by calibration curves and decision curve analysis (DCA). Differentially expression analysis revealed 80 differentially expressed CCRGs, and 27 of them were significantly associated with the overall survival (OS) of BC. BC can be classified into 4 molecular subtypes with significant differences in prognosis based on the 27 CCRGs. Three prognostic CCRGs, including desmocollin 1 (DSC1), LEF1, and protocadherin 9 (PCDH9), were identified to be independent risk factors of BC prognosis and were used to construct a risk score model. BC patients were divided into high- and low-risk groups, and there were significant differences in prognosis between the 2 groups both in the training and validation cohorts. It was found that patients in different groups of race, status, or T stage had significant levels of risk score. Furthermore, patients of different risk levels exhibit varying degrees of sensitivity to vinorelbine, lapatinib, metformin, and vinblastine. GSEA showed that in the high-risk group, immune response-related activities were dramatically repressed whereas cilium-related processes were significantly stimulated. Cox regression analysis demonstrated that age, N stage, radiotherapy and the risk score were independent prognostic risk factors of BC, and a nomogram was established based on these variables. The nomogram exerted a favorable concordance index (0.798) as well as calibration performance, which strongly supports the clinical application of the nomogram. Our study indicated the disruption of the expression of CCRGs in BC and built a favorable prognostic risk model based on 3 independent prognostic CCRGs. These genes may be applied as candidate molecular targets for the diagnosis and therapy of BC.
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Affiliation(s)
- Yuanyuan Hu
- Department of Breast Surgery, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China
| | - Shuyao Fan
- Department of Breast Surgery, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China
| | - Yiwan Zhu
- The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Xiaohong Xie
- Department of Breast Surgery, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China
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Knörr F, Schellekens KPJ, Schoot RA, Landman-Parker J, Teltschik HM, Förster J, Riquelme A, Huitema ADR, Van Eijkelenburg NKA, Beishuizen A, Zwaan CM, Woessmann W, Van der Lugt J. Combination therapy with crizotinib and vinblastine for relapsed or refractory pediatric ALK-positive anaplastic large cell lymphoma. Haematologica 2023; 108:1442-1446. [PMID: 36519329 PMCID: PMC10153539 DOI: 10.3324/haematol.2022.281896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022] Open
Affiliation(s)
- Fabian Knörr
- Pediatric Hematology and Oncology, University Medical Center Hospital Hamburg-Eppendorf, Hamburg, Germany; Mildred Scheel Cancer Career Center HaTriCS4, University Medical Center Hamburg-Eppendorf, Hamburg.
| | - Kim P J Schellekens
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands; Erasmus Medical Center, Sophia Children's Hospital, Rotterdam
| | | | - Judith Landman-Parker
- Pediatric Hematology, Immunology, Oncology, Sorbonne université, Hôpital Armand Trousseau, APHP, Paris
| | | | - Jan Förster
- Pediatric Hematology and Oncology, University Medical Center Hospital Hamburg-Eppendorf, Hamburg
| | - Amambay Riquelme
- Pediatric Hematology and Oncology, University Medical Center Hospital Hamburg-Eppendorf, Hamburg
| | - Alwin D R Huitema
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands; Dept. Pharmacy and Pharmacology, Netherlands Cancer Institute, Amsterdam, The Netherlands; Dept. Clinical Pharmacy, University Medical Center Utrecht, Utrecht University, Utrecht
| | | | - Auke Beishuizen
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands; Erasmus Medical Center, Sophia Children's Hospital, Rotterdam
| | - C Michel Zwaan
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands; Erasmus Medical Center, Sophia Children's Hospital, Rotterdam
| | - Wilhelm Woessmann
- Pediatric Hematology and Oncology, University Medical Center Hospital Hamburg-Eppendorf, Hamburg
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Ali N, Selim M, Salah Z, El Nabarawy NM, Hussein H, Sidhom I. Cardiovascular and Thyroid Late Effects in Pediatric Patients With Hodgkin Lymphoma Treated With ABVD Protocol. J Pediatr Hematol Oncol 2023; 45:e455-e463. [PMID: 36898022 DOI: 10.1097/mph.0000000000002638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 01/10/2023] [Indexed: 03/12/2023]
Abstract
BACKGROUND Hodgkin lymphoma (HL) survivors are at risk of developing a range of therapy-related complications. The goal of this study is to investigate therapy-related late-effects in HL survivors. MATERIALS AND METHODS We performed a cross-sectional study on 208 HL survivors who were treated at the National Cancer Institute or at the Children Cancer Hospital Egypt with doxorubicin, bleomycin, vinblastine, and dacarbazine chemotherapy. RESULTS Age at diagnosis ranged from 2.5 to 17.5 with a median of 8.7 years. The cumulative incidence of cardiac toxicity at 5 and 9 years were 18.7%±2.7% and 43.3%±4.4%, respectively. Preexisting cardiac abnormalities, cumulative anthracycline dose, and end of treatment cardiac status are strong predictors of late cardiotoxicity. Hypertension was observed in ~31% of patients. Young age and obesity at the time of treatment are important risk factors for hypertension. Thyroid abnormalities developed with a 5-year cumulative incidence of 2%±1%, whereas at 9 years the cumulative incidence was 27.9%±4.5%. Thyroid dysfunction was observed in 21.2% and thyroid tumors in 1.6% of cases. Subclinical hypothyroidism was the most common thyroid abnormality. CONCLUSIONS Cardiotoxicity, hypertension, and thyroid dysfunction are frequent late effects after doxorubicin, bleomycin, vinblastine, and dacarbazine regimen, especially if combined with radiation therapy.
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Affiliation(s)
- Nesreen Ali
- Department of Pediatric Oncology, National Cancer Institute
| | - Mustafa Selim
- Department of Pediatric Oncology, National Cancer Institute
| | - Zeinab Salah
- Department of Pediatric Cardiology, Faculty of Medicine, Cairo University and Children Cancer Hospital
| | | | - Hany Hussein
- Department of Pediatric Oncology, National Cancer Institute, Cairo University, Egypt
| | - Iman Sidhom
- Department of Pediatric Oncology, National Cancer Institute
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19
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LaCasce AS, Dockter T, Ruppert AS, Kostakoglu L, Schöder H, Hsi E, Bogart J, Cheson B, Wagner-Johnston N, Abramson J, Blum K, Leonard JP, Bartlett NL. Positron Emission Tomography-Adapted Therapy in Bulky Stage I/II Classic Hodgkin Lymphoma: CALGB 50801 (Alliance). J Clin Oncol 2023; 41:1023-1034. [PMID: 36269899 PMCID: PMC9928671 DOI: 10.1200/jco.22.00947] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 08/01/2022] [Accepted: 08/10/2022] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Patients with bulky stage I/II classic Hodgkin lymphoma (cHL) are typically treated with chemotherapy followed by radiation. Late effects associated with radiotherapy include increased risk of second cancer and cardiovascular disease. We tested a positron emission tomography (PET)-adapted approach in patients with bulky, early-stage cHL, omitting radiotherapy in patients with interim PET-negative (PET-) disease and intensifying treatment in patients with PET-positive (PET+) disease. METHODS Eligible patients with bulky disease (mass > 10 cm or 1/3 the maximum intrathoracic diameter on chest x-ray) received two cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) followed by interim fluorodeoxyglucose PET (PET2). Patients with PET2-, defined as 1-3 on the 5-point scale, received four additional cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine. Patients with PET2+ received four cycles of escalated bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone followed by 30.6 Gy involved-field radiation. RESULTS Of 94 evaluable patients, 53% were female with median age 30 years (range, 18-58 years). Eight-five (90%) had stage II disease, including 48 (51%) with stage IIB/IIBE. Seventy-eight (78%) were PET2- and 21 (22%) were PET2+. The predominant toxicity was neutropenia, with 9% of patients developing febrile neutropenia and one developing sepsis. The primary end point of 3-year progression-free survival (PFS) was 93.1% in PET2- and 89.7% in PET2+ patients. Three-year overall survival was 98.6% and 94.4%, respectively. The estimated hazard ratio comparing PFS of patients with PET2+ and patients with PET2- was 1.03 (85% upper bound 2.38) and was significantly less than the null hypothesis of 4.1 (one-sided P = .04). CONCLUSION Our study of PET-adapted therapy in bulky stage I/II cHL met its primary goal and was associated with an excellent 3-year PFS rate of 92.3% in all patients, with the majority being spared radiotherapy and exposure to intensified chemotherapy.
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Affiliation(s)
| | - Travis Dockter
- Alliance Statistics and Data Management Center, Mayo Clinic, Rochester, MN
| | - Amy S. Ruppert
- Alliance Statistics and Data Management Center, The Ohio State University, Columbus, OH
| | | | - Heiko Schöder
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - Eric Hsi
- Wake Forest University Health Sciences, Winston-Salem, NC
| | - Jeffrey Bogart
- State University of New York Upstate Medical University Syracuse-Health Science Center, Syracuse, NY
| | - Bruce Cheson
- Scientific Advisor, Lymphoma Research Foundation, New York, NY
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20
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Li F, Bordeleau S, Kim KH, Turcotte J, Davis B, Liu L, Bayen S, De Luca V, Dastmalchi M. A lesion-mimic mutant of Catharanthus roseus accumulates the opioid agonist, akuammicine. Phytochemistry 2022; 203:113422. [PMID: 36055422 DOI: 10.1016/j.phytochem.2022.113422] [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] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 08/18/2022] [Accepted: 08/26/2022] [Indexed: 06/15/2023]
Abstract
Catharanthus roseus is a medicinal plant that produces an abundance of monoterpenoid indole alkaloids (MIAs), notably including the anticancer compounds vinblastine and vincristine. While the canonical pathway leading to these drugs has been resolved, the regulatory and catalytic mechanisms controlling many lateral branches of MIA biosynthesis remain largely unknown. Here, we describe an ethyl methanesulfonate (EMS) C. roseus mutant (M2-117523) that accumulates high levels of MIAs. The mutant exhibited stunted growth, partially chlorotic leaves, with deficiencies in chlorophyll biosynthesis, and a lesion-mimic phenotype. The lesions were sporadic and spontaneous, appearing after the first true bifoliate and continuing throughout development. The lesions are also the site of high concentrations of akuammicine, a minor constituent of wild type C. roseus leaves. In addition to akuammicine, the lesions were enriched in 25 other MIAs, resulting, in part, from a higher metabolic flux through the pathway. The unique metabolic shift was associated with significant upregulation of biosynthetic and regulatory genes involved in the MIA pathway, including the transcription factors WRKY1, CrMYC2, and ORCA2, and the biosynthetic genes STR, GO, and Redox1. Following the lesion-mimic mutant (LMM) phenotype, the accumulation of akuammicine is jasmonate (JA)-inducible, suggesting a role in plant defence response. Akuammicine is medicinally significant, as a weak opioid agonist, with a preference for the κ-opioid receptor, and a potential anti-diabetic. Further study of akuammicine biosynthesis and regulation can guide plant and heterologous engineering for medicinal uses.
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Affiliation(s)
- Fanfan Li
- Plant Science, McGill University, Sainte-Anne-de-Bellevue, QC, H9X 3V9, Canada
| | - Stephen Bordeleau
- Cell and Systems Biology, University of Toronto, Toronto, ON, M5S 3B2, Canada
| | - Kyung Hee Kim
- Biological Sciences, Brock University, St. Catharines, ON, L2S 3A1, Canada
| | - Jonathan Turcotte
- Plant Science, McGill University, Sainte-Anne-de-Bellevue, QC, H9X 3V9, Canada
| | - Benjamin Davis
- Biological Sciences, Brock University, St. Catharines, ON, L2S 3A1, Canada
| | - Lan Liu
- Food Science and Agricultural Chemistry, McGill University, Sainte-Anne-de-Bellevue, QC, H9X 3V9, Canada
| | - Stéphane Bayen
- Food Science and Agricultural Chemistry, McGill University, Sainte-Anne-de-Bellevue, QC, H9X 3V9, Canada
| | - Vincenzo De Luca
- Biological Sciences, Brock University, St. Catharines, ON, L2S 3A1, Canada
| | - Mehran Dastmalchi
- Plant Science, McGill University, Sainte-Anne-de-Bellevue, QC, H9X 3V9, Canada.
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21
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Al-Hazmy SM, Zouaghi MO, Al-Johani JN, Arfaoui Y, Al-Ashwal R, Hammami B, Alhagri IA, Alhemiary NA, Hamdi N. Chemosensing Properties of Coumarin Derivatives: Promising Agents with Diverse Pharmacological Properties, Docking and DFT Investigation. Molecules 2022; 27:molecules27185921. [PMID: 36144656 PMCID: PMC9503222 DOI: 10.3390/molecules27185921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 09/02/2022] [Accepted: 09/06/2022] [Indexed: 11/26/2022] Open
Abstract
In this work, a three-component reaction of 3-acetyl-4-hydroxycoumarine, malononitrile, or cyanoacetate in the presence of ammonium acetate was used to form coumarin derivatives. The chemical structures of new compounds were identified by 1H, 13C NMR and an elemental analysis. These compounds were examined in vitro for their antimicrobial activity against a panel of bacterial strains. In addition, these compounds were investigated for antioxidant activities by superoxideradical, DPPH (2,2-Diphenyl-1-picrylhydrazyl), and hydroxyl radical scavenging assays, in which most of them displayed significant antioxidant activities. Furthermore, these compounds were evaluated for anti-inflammatory activity by indirect hemolytic and lipoxygenase inhibition assays and revealed good activity. In addition, screening of the selected compounds 2–4 against colon carcinoma cell lines (HCT-116) and hepatocellular carcinoma cell lines (HepG-2) showed that that 2-amino-4-hydroxy-6-(4-hydroxy-2-oxo-2H-chromen-3-yl)nicotinonitrile 4 exhibited good cytotoxic activity against standard Vinblastine, while the other compounds exhibited moderate cytotoxic activity. Docking simulation showed that2-amino-4-hydroxy-6-(4-hydroxy-2-oxo-2H-chromen-3-yl)nicotinonitrile 4 is an effective inhibitor of the tumor protein HCT-116. A large fluorescence enhancement in a highly acidic medium was observed, and large fluorescence quenching by the addition of traces of Cu2+ and Ni2+ was also remarked.
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Affiliation(s)
- Sadeq M. Al-Hazmy
- Department of Chemistry, College of Science, Qassim University, Buraidah 51452, Saudi Arabia
- Department of Chemistry, College of Science, Sana’a University, Sana’a P.O. Box 1247, Yemen
- Correspondence: (S.M.A.-H.); (J.N.A.-J.); (N.H.)
| | - Mohamed Oussama Zouaghi
- Laboratory of Characterizations, Applications & Modeling of Materials (LR18ES08), Department of Chemistry, Faculty of Sciences, University of Tunis El Manar, Tunis 2092, Tunisia
| | - Jamal N. Al-Johani
- Department of Chemistry, College of Science, Qassim University, Buraidah 51452, Saudi Arabia
- Correspondence: (S.M.A.-H.); (J.N.A.-J.); (N.H.)
| | - Youssef Arfaoui
- Laboratory of Characterizations, Applications & Modeling of Materials (LR18ES08), Department of Chemistry, Faculty of Sciences, University of Tunis El Manar, Tunis 2092, Tunisia
| | - Rania Al-Ashwal
- School of Biomedical Engineering and Health Sciences, Faculty of Engineering, Universiti Teknologi Malaysia, Johor Bahru 81310, Malaysia
- Advanced Diagnostic and Progressive Human Care Research Group, School of Biomedical Engineering and Health Science Teknologi Malaysia, Johor Bahru 81310, Malaysia
| | - Bechir Hammami
- Department of Chemistry, College of Science, Qassim University, Buraidah 51452, Saudi Arabia
| | - Ibrahim A. Alhagri
- Department of Chemistry, College of Science, Qassim University, Buraidah 51452, Saudi Arabia
| | - Nabil A. Alhemiary
- Department of Chemistry, College of Science, Ibb University, Ibb P.O. Box 70270, Yemen
- Department of Chemistry, College of Science and Arts at Sharurah, Najran University, P.O. Box 1988, Najran 11001, Saudi Arabia
| | - Naceur Hamdi
- Department of Chemistry, College of Science and Arts at Ar Rass, Qassim University, P.O. Box 53, Ar Rass 51921, Saudi Arabia
- Research Laboratory of Environmental Sciences and Technologies (LR16ES09), Higher Institute of Environmental Sciences and Technology, University of Carthage, Hammam-Lif 1054, Tunisia
- Correspondence: (S.M.A.-H.); (J.N.A.-J.); (N.H.)
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22
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Liu P, Zhu Z, Ma J, Wei L, Han Y, Shen E, Tan X, Chen Y, Cai C, Guo C, Peng Y, Gao Y, Liu Y, Huang Q, Gao L, Li Y, Jiang Z, Wu W, Liu Y, Zeng S, Li W, Feng Z, Shen H. Prognostic stratification based on m5C regulators acts as a novel biomarker for immunotherapy in hepatocellular carcinoma. Front Immunol 2022; 13:951529. [PMID: 36159831 PMCID: PMC9505913 DOI: 10.3389/fimmu.2022.951529] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/22/2022] [Indexed: 12/24/2022] Open
Abstract
Background Immunotherapy is a promising anti-cancer strategy in hepatocellular carcinoma (HCC). However, a limited number of patients can benefit from it. There are currently no reliable biomarkers available to find the potential beneficiaries. Methylcytosine (m5C) is crucial in HCC, but its role in forecasting clinical responses to immunotherapy has not been fully clarified. Methods In this study, we analyzed 371 HCC patients from The Cancer Genome Atlas (TCGA) database and investigated the expression of 18 m5C regulators. We selected 6 differentially expressed genes (DEGs) to construct a prognostic risk model as well as 2 m5C-related diagnostic models. Results The 1-, 3-, and 5-year area under the curve (AUC) of m5C scores for the overall survival (OS) was 0.781/0.762/0.711, indicating the m5C score system had an ideal distinction of prognostic prediction for HCC. The survival analysis showed that patients with high-risk scores present a worse prognosis than the patients with low-risk scores (p< 0.0001). We got consistent results in 6 public cohorts and validated them in Xiangya real-world cohort by quantitative real-time PCR and immunohistochemical (IHC) assays. The high-m5C score group was predicted to be in an immune evasion state and showed low sensitivity to immunotherapy, but high sensitivity to chemotherapy and potential targeted drugs and agents, such as sepantronium bromide (YM-155), axitinib, vinblastine and docetaxel. Meanwhile, we also constructed two diagnostic models to distinguish HCC tumors from normal liver tissues or liver cirrhosis. Conclusion In conclusion, our study helps to early screen HCC patients and select patients who can benefit from immunotherapy. Step forwardly, for the less likely beneficiaries, this study provides them with new potential targeted drugs and agents for choice to improve their prognosis.
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Affiliation(s)
- Ping Liu
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory for Molecular Radiation Oncology of Hunan Province, Xiangya Hospital, Central South University, Changsha, China
| | - Ziqing Zhu
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory for Molecular Radiation Oncology of Hunan Province, Xiangya Hospital, Central South University, Changsha, China
| | - Jiayao Ma
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory for Molecular Radiation Oncology of Hunan Province, Xiangya Hospital, Central South University, Changsha, China
| | - Le Wei
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory for Molecular Radiation Oncology of Hunan Province, Xiangya Hospital, Central South University, Changsha, China
| | - Ying Han
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory for Molecular Radiation Oncology of Hunan Province, Xiangya Hospital, Central South University, Changsha, China
| | - Edward Shen
- Department of Life Science, McMaster University, Hamilton, ON, Canada
| | - Xiao Tan
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, China
| | - Yihong Chen
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory for Molecular Radiation Oncology of Hunan Province, Xiangya Hospital, Central South University, Changsha, China
| | - Changjing Cai
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory for Molecular Radiation Oncology of Hunan Province, Xiangya Hospital, Central South University, Changsha, China
| | - Cao Guo
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory for Molecular Radiation Oncology of Hunan Province, Xiangya Hospital, Central South University, Changsha, China
| | - Yinghui Peng
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory for Molecular Radiation Oncology of Hunan Province, Xiangya Hospital, Central South University, Changsha, China
| | - Yan Gao
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory for Molecular Radiation Oncology of Hunan Province, Xiangya Hospital, Central South University, Changsha, China
| | - Yongting Liu
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory for Molecular Radiation Oncology of Hunan Province, Xiangya Hospital, Central South University, Changsha, China
| | - Qiaoqiao Huang
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory for Molecular Radiation Oncology of Hunan Province, Xiangya Hospital, Central South University, Changsha, China
| | - Le Gao
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory for Molecular Radiation Oncology of Hunan Province, Xiangya Hospital, Central South University, Changsha, China
| | - Yin Li
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory for Molecular Radiation Oncology of Hunan Province, Xiangya Hospital, Central South University, Changsha, China
| | - Zhaohui Jiang
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory for Molecular Radiation Oncology of Hunan Province, Xiangya Hospital, Central South University, Changsha, China
| | - Wantao Wu
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory for Molecular Radiation Oncology of Hunan Province, Xiangya Hospital, Central South University, Changsha, China
| | - Yihan Liu
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory for Molecular Radiation Oncology of Hunan Province, Xiangya Hospital, Central South University, Changsha, China
| | - Shan Zeng
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory for Molecular Radiation Oncology of Hunan Province, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Wei Li
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory for Molecular Radiation Oncology of Hunan Province, Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Wei Li, ; Ziyang Feng, ; Hong Shen,
| | - Ziyang Feng
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory for Molecular Radiation Oncology of Hunan Province, Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Wei Li, ; Ziyang Feng, ; Hong Shen,
| | - Hong Shen
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory for Molecular Radiation Oncology of Hunan Province, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Wei Li, ; Ziyang Feng, ; Hong Shen,
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23
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Husi K, Pinczés LI, Fejes Z, Nagy B, Illés Á, Miltényi Z. Combined prognostic role of TARC and interim 18F-FDG PET/CT in patients with Hodgkin lymphoma-real world observational study. Hell J Nucl Med 2022; 25:125-131. [PMID: 35913858 DOI: 10.1967/s002449912471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 06/30/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Although the majority of patients with Hodgkin lymphoma (HL) has recently become long-term survivors, 20%-30% of HL patients have primary refractory disease or relapse. It is essential to identify patients at risk of treatment failure during first-line therapy. To objective of the present study was to investigate the combined prognostic role of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) imaging and thymus and activation-regulated chemokine (TARC) levels in Hodgkin lymphoma. SUBJECTS AND METHODS Between 01/01/2013 and 01/03/2019 77 HL patients were enrolled in this study where serum TARC levels were measured by an immunoassay and 18F-FDG PET/CT scans were performed at baseline, after the second cycle of ABVD treatment (interim) and at the end of first-line therapy. RESULTS Twenty-six patients (34%) had early-stage HL, while 51 patients presented with advanced-stage disease. Fifteen patients had primary refractory HL, while 1 patient relapsed after first-line therapy. Optimal TARC cut-off value for progression-free survival (PFS) was 700pg/mL based on receiver operating characteristic (ROC) curve analysis. With Cox regression analysis, 18F-FDG PET/CT with Deauville scores of 3, 4, or 5 and TARC levels above 700pg/mL predicted treatment failure at interim assessment. Inclusion of HL patients with a Deauville score of 3 to the high-risk population resulted in a 7-fold increase in the estimated risk of relapse compared to patients with Deauville score 4-5 with TARC levels above 700pg/mL. Patients with interim 18F-FDG PET/CT Deauville scores 3-5 had a significant survival benefit if their TARC levels were 700pg/mL. Positive predictive value (PPV) of interim 18F-FDG PET/CT scans with a Deauville score 3-5 was 47.8%, while combined PPV of a similar 18F-FDGPET/CT assessment and elevated TARC levels was 88.8%. CONCLUSION Interim 18F-FDG PET/CT and TARC analyzed together accurately identify HL patients who do not respond sufficiently to treatment and who need an early change of therapy.
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Affiliation(s)
- Kata Husi
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Nagyerdeikrt. 98. 4032, Debrecen, Hungary.
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Abstract
Madagascar periwinkle (Catharanthus roseus, family Apocynaceae) is a reservoir of more than 130 monoterpene indole alkaloids (MIAs) including the famous anti-neoplastic dimeric MIAs vinblastine and vincristine, and anti-hypertensive monomeric MIAs ajmalicine and serpentine. Understanding the biosynthetic steps and regulatory factors leading to the formation of MIAs is crucial for rational engineering to achieve targeted enhancement of different MIAs. Due to its highly recalcitrant nature, C. roseus is considered genetically non-tractable for transformation at the whole-plant level. Though few reports have demonstrated tissue culture-mediated regeneration and transformation of C. roseus at whole-plant level recently, the efficiency and reproducibility of these protocols have been a major challenge. To overcome this, we have developed a tissue-culture-independent Agrobacterium-mediated in planta transformation method in C. roseus. Using this method, we were able to efficiently generate stable transgenic plants without relying on the cumbersome methods of tissue-culture regeneration and transformation. Moreover, the transformed plants obtained through this in planta method exhibited stability in subsequent generations. Our method is useful not only for the elucidation of biosynthetic and regulatory steps involved in MIA formation through transgenic plant approach but also for metabolic engineering at the whole-plant level in C. roseus.
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Affiliation(s)
- Dikki Pedenla Bomzan
- Molecular Plant Biology and Biotechnology Lab, CSIR-Central Institute of Medicinal and Aromatic Plants, Research Centre, Bengaluru, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
| | - H B Shilpashree
- Molecular Plant Biology and Biotechnology Lab, CSIR-Central Institute of Medicinal and Aromatic Plants, Research Centre, Bengaluru, India
| | - Dinesh A Nagegowda
- Molecular Plant Biology and Biotechnology Lab, CSIR-Central Institute of Medicinal and Aromatic Plants, Research Centre, Bengaluru, India.
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India.
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Shahsavarani M, Farzana M, De Luca V, Qu Y. Generating an EMS Mutant Population and Rapid Mutant Screening by Thin-Layer Chromatography Enables the Studies of Monoterpenoid Indole Alkaloids Biosynthesis in Catharanthus Roseus. Methods Mol Biol 2022; 2505:181-190. [PMID: 35732945 DOI: 10.1007/978-1-0716-2349-7_13] [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] [Indexed: 06/15/2023]
Abstract
Decades of research on the medicinal plant Catharanthus roseus have led to the complete elucidation of the 29-step pathway for the biosynthesis of the anticancer drug vinblastine from geraniol and tryptophan precursors. Several approaches have been used to identify the enzymes involved in this iconic and remarkably complex pathway. This chapter describes the use of the classic ethyl methanesulfonate (EMS) mutagenesis to create a selfed M2 mutant population, which can be rapidly screened to select mutants with altered monoterpenoid indole alkaloid (MIA) biosynthesis with a simple, high-throughput thin-layer chromatography (TLC)-based screening strategy. This TLC-based MIA screening has led to the discovery and characterization of three enzymes responsible for vinblastine biosynthesis.
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Affiliation(s)
| | - Maisha Farzana
- Department of Chemistry, University of New Brunswick, Fredericton, NB, Canada
| | - Vincenzo De Luca
- Department of Biological Sciences, Brock University, St. Catharines, ON, Canada
| | - Yang Qu
- Department of Chemical Engineering, University of New Brunswick, Fredericton, NB, Canada.
- Department of Chemistry, University of New Brunswick, Fredericton, NB, Canada.
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Nguyen TAM, McConnachie M, Nguyen TD, Dang TTT. Discovery and Characterization of Oxidative Enzymes Involved in Monoterpenoid Indole Alkaloid Biosynthesis. Methods Mol Biol 2022; 2505:141-164. [PMID: 35732943 DOI: 10.1007/978-1-0716-2349-7_11] [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] [Indexed: 06/15/2023]
Abstract
Monoterpene indole alkaloid (MIA) constitutes a structurally diverse plant natural product group with remarkable pharmacological activities. Many MIAs have been routinely used as potent drugs for several diseases, including leukemia (vinblastine), lung cancer (camptothecin), and malaria (quinine). Nevertheless, MIAs are biosynthesized at extremely low abundance in plants and, in many cases, require additional chemical functionalizations before their therapeutic uses. As oxygenations and oxidative rearrangements are critical throughout MIAs' structural scaffolding and modifications, the discovery and engineering of oxidative enzymes play essential roles in understanding and boosting the supplies of MIAs. Recent advances in omics technologies and synthetic biology have provided unprecedented amount of biochemical data and tools, paving a wide pathway for discovering, characterizing, and engineering enzymes involved in MIA biosynthesis. Here, we discuss the latest progress in understanding the roles of oxidative enzymes in MIA metabolism and describe a bioinformatic and biochemical pipeline to identify, characterize, and make use of these plant biocatalysts.
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Affiliation(s)
- Tuan-Anh Minh Nguyen
- Department of Chemistry, Irving K. Barber Faculty of Science, University of British Columbia, Kelowna, BC, Canada
| | - Matthew McConnachie
- Department of Chemistry, Irving K. Barber Faculty of Science, University of British Columbia, Kelowna, BC, Canada
| | - Trinh-Don Nguyen
- Department of Chemistry, Irving K. Barber Faculty of Science, University of British Columbia, Kelowna, BC, Canada
| | - Thu-Thuy T Dang
- Department of Chemistry, Irving K. Barber Faculty of Science, University of British Columbia, Kelowna, BC, Canada.
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Baues C, Goergen H, Fuchs M, Rosenbrock J, Celik E, Eich H, Kobe C, Voltin CA, Engert A, Borchmann P, Marnitz S. Involved-Field Radiation Therapy Prevents Recurrences in the Early Stages of Hodgkin Lymphoma in PET-Negative Patients After ABVD Chemotherapy: Relapse Analysis of GHSG Phase 3 HD16 Trial. Int J Radiat Oncol Biol Phys 2021; 111:900-906. [PMID: 34389407 DOI: 10.1016/j.ijrobp.2021.07.1697] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/16/2021] [Accepted: 07/20/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE The HD16 trial of the German Hodgkin Study Group (NCT00736320) demonstrated that radiation therapy in early-stage Hodgkin lymphoma without risk factors cannot be safely omitted, and therefore combined modality therapy (CMT) remains the standard treatment. To demonstrate the local effect of consolidating involved-field radiation therapy (IF-RT), we performed an analysis of the recurrence pattern of positron emission tomography (PET)-negative HD16 patients. METHODS AND MATERIALS Between 2009 and 2015, 1150 patients with early-stage Hodgkin lymphoma without risk factors were randomly assigned to PET guided to 20 Gy IF-RT after 2 cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine chemotherapy in the HD16 study of the German Hodgkin Study Group. The study was designed as a prospective randomized controlled trial. We correlated the localization of recurrence with the panel-based IF-RT plan, which was drawn up for all patients prospectively, blinded to treatment allocation. Accordingly, we were able to identify recurrences that occurred at least in part inside or outside of the (potential) radiation field (in-field and out-field, respectively). RESULTS There were 328 and 300 PET-negative patients assigned to CMT and PET-guided treatment (ie, chemotherapy alone), respectively. Within a median 47-month follow-up, disease progression or recurrence was documented for 15 and 29 patients treated with and without IF-RT, respectively. Relapse localization was unknown in 1 CMT patient. Without IF-RT, 5-year incidence of in-field relapses was 10.5% (95% confidence interval, 6.5-14.6) compared with 2.4% (0.5-4.3) with CMT (P = .0008). There were no relevant differences in out-field recurrences (5-year incidence 4.1% [1.7-6.6] vs 6.6% [3.0-10.3], P = .54). There was no grade 4 toxicity observed during IF-RT, and incidence of second primary malignancies was similar in both groups. CONCLUSIONS PET-negative patients of the HD16 study showed no significant toxicity after 20 Gy IF-RT, and we demonstrated that omission of IF-RT resulted in more, particularly local, recurrences. Therefore, consolidation IF-RT should still be considered as standard therapy in this setting.
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Affiliation(s)
- Christian Baues
- Department of Radiooncology, Radiotherapy and Cyberknife Center; German Hodgkin Study Group (GHSG).
| | | | - Michael Fuchs
- German Hodgkin Study Group (GHSG); Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany
| | - Johannes Rosenbrock
- Department of Radiooncology, Radiotherapy and Cyberknife Center; German Hodgkin Study Group (GHSG)
| | - Eren Celik
- Department of Radiooncology, Radiotherapy and Cyberknife Center
| | - Hans Eich
- German Hodgkin Study Group (GHSG); Department of Radiotherapy, University Hospital of Muenster, Muenster, Germany
| | - Carsten Kobe
- German Hodgkin Study Group (GHSG); Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Conrad-Amadeus Voltin
- Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Andreas Engert
- German Hodgkin Study Group (GHSG); Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany
| | - Peter Borchmann
- German Hodgkin Study Group (GHSG); Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany
| | - Simone Marnitz
- Department of Radiooncology, Radiotherapy and Cyberknife Center; German Hodgkin Study Group (GHSG)
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Abstract
PURPOSE OF REVIEW Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare B cell-derived malignancy. This review aims at providing an overview of recent developments in the management of NLPHL. RECENT FINDINGS Patients with stage IA NLPHL without risk factors have excellent outcomes. The 8-year progression-free survival (PFS) is roughly 90% and the 8-year overall survival (OS) close to 100% after limited-field radiotherapy (RT) alone. Individuals presenting with early stages other than stage IA without risk factors and intermediate stages have 10-year PFS rates in excess of 70% and 10-year OS rates exceeding 90% when treated with 2 and 4 cycles of ABVD, respectively, followed by consolidation RT. In advanced NLPHL, different protocols such as BEACOPP, ABVD, and R-CHOP have been evaluated retrospectively. However, the optimal approach is undefined. Patients with relapsed NLPHL mostly receive single-agent anti-CD20 antibody treatment or conventional chemotherapy. High-dose chemotherapy and autologous stem cell transplantation are restricted to high-risk patients. NLPHL recurrence is salvaged successfully in the majority of cases. SUMMARY Patients with NLPHL have a very good prognosis. Treatment differs from classical Hodgkin lymphoma in some situations.
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Affiliation(s)
- Dennis A Eichenauer
- University of Cologne, First Department of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf
- German Hodgkin Study Group (GHSG), First Department of Internal Medicine, University Hospital Cologne, Cologne, Germany
| | - Andreas Engert
- University of Cologne, First Department of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf
- German Hodgkin Study Group (GHSG), First Department of Internal Medicine, University Hospital Cologne, Cologne, Germany
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Shibusawa M, Kidoguchi K, Mori J, Tanimoto T. PET-guided omission of radiotherapy in Hodgkin lymphoma. Lancet Oncol 2021; 22:e181. [PMID: 33932378 DOI: 10.1016/s1470-2045(21)00146-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/04/2021] [Accepted: 03/09/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Motoharu Shibusawa
- IMS group Shinmatsudo Central General Hospital, Department of Hematology, Chiba, 270-0034, Japan.
| | | | - Jinichi Mori
- Jyoban Hospital of Tokiwa Foundation, Fukushima, Japan
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Doo NW, Trotman J. 2 + 2 in the long term: informing a new standard of care in 2021 for early stage, unfavourable Hodgkin lymphoma. Lancet Haematol 2021; 8:e243-e245. [PMID: 33770475 DOI: 10.1016/s2352-3026(21)00063-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 03/05/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Nicole Wong Doo
- Concord Repatriation General Hospital, University of Sydney, Concord, NSW, Australia
| | - Judith Trotman
- Concord Repatriation General Hospital, University of Sydney, Concord, NSW, Australia.
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Le Louet S, Barkaoui MA, Miron J, Galambrun C, Aladjidi N, Chastagner P, Kebaili K, Armari-Alla C, Lambilliotte A, Lejeune J, Moshous D, Della Valle V, Sileo C, Ducou Le Pointe H, Chateil JF, Renolleau S, Piloquet JE, Portefaix A, Epaud R, Chiron R, Bugnet E, Lorillon G, Tazi A, Emile JF, Donadieu J, Héritier S. Childhood Langerhans cell histiocytosis with severe lung involvement: a nationwide cohort study. Orphanet J Rare Dis 2020; 15:241. [PMID: 32907615 PMCID: PMC7487928 DOI: 10.1186/s13023-020-01495-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 08/05/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Lung involvement in childhood Langerhans cell histiocytosis (LCH) is infrequent and rarely life threatening, but occasionally, severe presentations are observed. METHODS Among 1482 children (< 15 years) registered in the French LCH registry (1994-2018), 111 (7.4%) had lung involvement. This retrospective study included data for 17 (1.1%) patients that required one or more intensive care unit (ICU) admissions for respiratory failure. RESULTS The median age was 1.3 years at the first ICU hospitalization. Of the 17 patients, 14 presented with lung involvement at the LCH diagnosis, and 7 patients (41%) had concomitant involvement of risk-organ (hematologic, spleen, or liver). Thirty-five ICU hospitalizations were analysed. Among these, 22 (63%) were secondary to a pneumothorax, 5 (14%) were associated with important cystic lesions without pneumothorax, and 8 (23%) included a diffuse micronodular lung infiltration in the context of multisystem disease. First-line vinblastine-corticosteroid combination therapy was administered to 16 patients; 12 patients required a second-line therapy (cladribine: n = 7; etoposide-aracytine: n = 3; targeted therapy n = 2). A total of 6 children (35%) died (repeated pneumothorax: n = 3; diffuse micronodular lung infiltration in the context of multisystem disease: n = 2; following lung transplantation: n = 1). For survivors, the median follow-up after ICU was 11.2 years. Among these, 9 patients remain asymptomatic despite abnormal chest imaging. CONCLUSIONS Severe lung involvement is unusual in childhood LCH, but it is associated with high mortality. Treatment guidelines should be improved for this group of patients: viral infection prophylaxis and early administration of a new LCH therapy, such as targeted therapy.
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Affiliation(s)
- Solenne Le Louet
- French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital, 26 avenue du Dr Netter, 75012, Paris, France.
| | - Mohamed-Aziz Barkaoui
- French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital, 26 avenue du Dr Netter, 75012, Paris, France
| | - Jean Miron
- French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital, 26 avenue du Dr Netter, 75012, Paris, France
| | - Claire Galambrun
- Department of Pediatric Hematology and Oncology, Hôpital de la Timone, Marseille, France
| | - Nathalie Aladjidi
- Department of Pediatric Hematology and Oncology, Centre Hospitalo-Universitaire de Bordeaux, Bordeaux, France
| | - Pascal Chastagner
- Department of Pediatric Hematology and Oncology, Brabois-Enfants Hospital, Centre Hospitalo-Universitaire de Nancy, Vandœuvre-lès-Nancy, France
| | - Kamila Kebaili
- Department of Paediatric Oncology, Institut d'Hémato-Oncologie Pediatrique, Lyon, France
| | - Corinne Armari-Alla
- Department of Pediatric Hematology and Oncology, Centre Hospitalo-Universitaire de Grenoble, La Tronche, France
| | - Anne Lambilliotte
- Department of Pediatric Hematology and Oncology, Centre Hospitalo-Universitaire de Lille, Lille, France
| | - Julien Lejeune
- Department of Pediatric Hematology and Oncology, Centre Hospitalo-Universitaire de Tours, Tours, France
| | - Despina Moshous
- Department of Pediatric Immunology, Hematology and Rheumatology, Necker Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Institut Imagine, Sorbonne University, Paris, France
| | - Valeria Della Valle
- Department of Radiology, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Chiara Sileo
- Department of Radiology, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Hubert Ducou Le Pointe
- Department of Radiology, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jean-François Chateil
- Department of Radiology, Centre Hospitalo-Universitaire de Bordeaux, Bordeaux, France
| | - Sylvain Renolleau
- Intensive care unit, Necker Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jean-Eudes Piloquet
- Intensive care unit, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | - Ralph Epaud
- Service de Pédiatrie générale, CHIC, Créteil, France
| | - Raphaël Chiron
- Service de Pneumologie, Arnaud de Villeneuve Hospital, Montpellier, France
| | - Emmanuelle Bugnet
- Service de Pneumologie Centre de référence des histiocytoses Hôpital Saint Louis, Paris, France
| | - Gwenaël Lorillon
- Service de Pneumologie Centre de référence des histiocytoses Hôpital Saint Louis, Paris, France
| | - Abdelatif Tazi
- Service de Pneumologie Centre de référence des histiocytoses Hôpital Saint Louis, Paris, France
- Paris University, INSERM U976, Paris, France
| | | | - Jean Donadieu
- French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital, 26 avenue du Dr Netter, 75012, Paris, France
- Départment of Pediatric Hematology and Oncology, Sorbonne University, Paris, France
| | - Sébastien Héritier
- French Reference Center for Langerhans Cell Histiocytosis, Trousseau Hospital, 26 avenue du Dr Netter, 75012, Paris, France
- EA4340, UVSQ, Paris-Saclay University, Boulogne-Billancourt, France
- Départment of Pediatric Hematology and Oncology, Sorbonne University, Paris, France
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Hu YF, Huang YH, Luo W, Chen MX, Zhang J, Gou F. [Clinical characteristics and analysis of prognostic factors of 222 patients diagnosed with Hodgkin's lymphoma]. Zhonghua Yi Xue Za Zhi 2019; 99:3792-3796. [PMID: 31874516 DOI: 10.3760/cma.j.issn.0376-2491.2019.48.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Objective: To analyze the clinical characteristics and prognostic factors of patients with Hodgkin's lymphoma(HL). Methods: The clinical data of HL patients who were newly treated in Guizhou Cancer Hospital from August 2007 to March 2019 was retrospectively collected, and the efficacy and prognostic factors were analyzed. Results: The clinical data of a total of 222 patients were analyzed in this study. The 5-year progression-free survival (PFS) and overall survival (OS)rate of them were 82.8% and 81.3%, respectively. The 5-year PFS rate and OS rate of early (stage Ⅰ-Ⅱ) HL were 87.3% and 86.1%, respectively, and the 5-year PFS rate and OS rate of progressive (stage Ⅲ-Ⅳ) HL were 77.9% and 76.3%, respectively. Among the 118 patients with early Hodgkin's lymphoma, the complete remission(CR) rate of chemotherapy alone was 55.6%(15/27), and chemotherapy plus radiotherapy was 86.8% (79/91), the difference between which was statistically significant (P<0.05). Compared with chemotherapy plus radiotherapy in early stage patients, 5-year PFS (93.0%) and 5-year OS (92.0%) rate in patients with chemotherapy plus radiotherapy were better than those with chemotherapy alone which were 63.7% and 62.1%, respectively. Multivariate analysis showed that age, LDH, ABVD cycle number and chemoradiotherapy were independent prognostic factors for 5-year OS and PFS rate in HL patients. The adverse reactions were increased level Ⅰ-Ⅱ aminotransferase with an incidence of 47.7% (106/222), decreased level Ⅰ-Ⅱ neutrophils with an absolute value of 54.1% (120/222), and decreased level Ⅲ-Ⅳ neutrophils with an absolute value of 45.9% (102/222). No adverse cardiac and pulmonary reactions or secondary tumors associated with chemotherapy was found in all patients. Conclusions: HL is a type of malignant tumor with good prognosis, and the short-term and long-term efficacy of chemotherapy combined with radiotherapy in early patients is better than that of chemotherapy alone. Age, LDH, ABVD cycle number and chemoradiotherapy are associated with prognosis in patients with Hodgkin's lymphoma. Adverse reactions can be tolerated.
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Affiliation(s)
- Y F Hu
- Department of Oncology, Affiliated Hospital of Guizhou Medical University/Department of Lymphoma, Guizhou Cancer Hospital,Gui Yang 550001,China
| | - Y H Huang
- Department of Oncology, Affiliated Hospital of Guizhou Medical University/Department of Lymphoma, Guizhou Cancer Hospital,Gui Yang 550001,China
| | - W Luo
- Department of Oncology, Affiliated Hospital of Guizhou Medical University/Department of Lymphoma, Guizhou Cancer Hospital,Gui Yang 550001,China
| | - M X Chen
- Department of Oncology, Affiliated Hospital of Guizhou Medical University/Department of Lymphoma, Guizhou Cancer Hospital,Gui Yang 550001,China
| | - J Zhang
- Department of Oncology, Affiliated Hospital of Guizhou Medical University/Department of Lymphoma, Guizhou Cancer Hospital,Gui Yang 550001,China
| | - F Gou
- Department of Oncology, Affiliated Hospital of Guizhou Medical University/Department of Lymphoma, Guizhou Cancer Hospital,Gui Yang 550001,China
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Frias S. Genomic chaos in peripheral blood lymphocytes of hodgkins lymphoma patients 1 year after ABVD chemotherapy/radiotherapy. Environ Mol Mutagen 2019; 60:387-388. [PMID: 30861193 DOI: 10.1002/em.22279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 02/27/2019] [Indexed: 06/09/2023]
Affiliation(s)
- Sara Frias
- Laboratorio de Citogenética, INP, Insurgentes Sur 3700-C, 6o. piso, Cd. De Mexico, Mexico
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Delea TE, Sharma A, Grossman A, Eichten C, Fenton K, Josephson N, Richhariya A, Moskowitz AJ. Cost-effectiveness of brentuximab vedotin plus chemotherapy as frontline treatment of stage III or IV classical Hodgkin lymphoma. J Med Econ 2019; 22:117-130. [PMID: 30375910 DOI: 10.1080/13696998.2018.1542599] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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] [Indexed: 10/28/2022]
Abstract
OBJECTIVE The ECHELON-1 trial demonstrated efficacy and safety of brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine (A + AVD) vs doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) as frontline therapy for stage III/IV classical Hodgkin lymphoma. This analysis evaluated the cost-effectiveness of A + AVD from a US healthcare payer perspective. METHODS The incremental cost-effectiveness ratio (ICER), defined as the incremental costs per quality-adjusted life year (QALY) gained, was estimated using a non-homogenous semi-Markov cohort model with health states defined on progression following frontline treatment, and for those with progression, receipt of autologous stem-cell transplant (ASCT), and progression after ASCT. Patients undergoing ASCT were classified as refractory or relapsed based on timing of progression. Probabilities of progression/death with frontline therapy were based on parametric survival distributions fit to data on modified progression-free survival (mPFS) from ECHELON-1. Duration of frontline treatment and incidence of adverse events were from ECHELON-1. Utility values for patients in the frontline mPFS state were based on EQ-5D data from ECHELON-1. Other inputs were from published sources. A lifetime time horizon was used. Costs and QALYs were discounted at 3%. Analyses were conducted alternately using data on mPFS for the overall and North American populations of ECHELON-1. RESULTS The ICER for A + AVD vs ABVD was $172,074/QALY gained in the analysis using data on mPFS for the overall population and $69,442/QALY gained in the analysis using data on mPFS for the North American population of ECHELON-1. The ICER is sensitive to estimated costs of ASCT and frontline failure. CONCLUSION The ICER for A + AVD vs ABVD based on ECHELON-1 is within the range of threshold values for cost-effectiveness in the US. A + AVD is, therefore, likely to be a cost-effective frontline therapy for patients with stage III/IV classical Hodgkin lymphoma from a US healthcare payer perspective.
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Affiliation(s)
| | - Arati Sharma
- a Policy Analysis Inc. (PAI) , Brookline , MA , USA
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Silvestri F, Fanin R, Velisig M, Barillari G, Virgolini L, Zaja F, Russo D, Baccarani M. The Role of Granulocyte Colony-Stimulating Factor (Filgrastim) in Maintaining Dose Intensity during Conventional-Dose Chemotherapy with Abvd in Hodgkin's Disease. Tumori 2018; 80:453-8. [PMID: 7534963 DOI: 10.1177/030089169408000609] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background The aim of the study was to evaluate the role and potential benefit of granulocyte colony-stimulating factor (G-CSF, Filgrastim), administered following cytotoxic chemotherapy with the ABVD regimen in Hodgkin's disease, in maintaining cycle schedule and dose intensity and in decreasing neutropenia and number of infections. Patients and Methods Twenty-two patients affected by high-risk Hodgkin's disease (14 localized and 8 diffuse), aged 15 to 69 years (median, 34), were given ABVD chemotherapy for a total of 6 courses (for the purpose of this study, each single course of chemotherapy was considered as two 15-day periods). No patient was given G-CSF after the first cycle. After each cycle, G-CSF was administered only for: 1) absolute neutrophil count < 1 × 109/L between cycles; 2) delay in cycle schedule due to an absolute neutrophil count < 1 × 109/L on the planned day of treatment; or 3) fever or a documented infection, regardless the absolute neutrophil count. Once administered, G-CSF was maintained in the subsequent cycles. Results Seventeen of 22 patients (77%) required the administration of G-CSF (5 μg/kg b.w.; a median of 5 doses/cycle); most of them (13/17) before the 5th dose of chemotherapy. The main reason for introducing G-CSF into therapy was neutropenia during the interval between courses (n = 4) or on the planned day of treatment (n = 11). Comparing 112 courses where G-CSF was not administered with 124 where it was, in the latter group we observed: 1) a significantly lower (P = 0.0002) incidence of cycle delays (0 vs 13), with a median delay of 7 days (5 to 11). The main reason for cycle delay was neutropenia (n = 13); 2) a greater dose intensity delivered to the patients while on G-CSF (100% vs 95.2±8.8%; P = 0.0001); 3) an absolute neutrophil count significantly higher at day 8 (P<0.0001) and day 15 (P< 0.0001); 4) a significantly lower (P = 0.0003) incidence of neutropenia (2 vs. 17). No difference in the incidence of infections was observed between the two groups of cycles (P = 0.5889), but the duration and severity of the same were greater during chemotherapy without G-CSF, requiring antibiotic therapy and causing cycle delay. Conclusions In conclusion, our data suggest the use of Filgrastim in Hodgkin's disease also during conventional-dose chemotherapy with ABVD. It is not required from the first dose of therapy, but as soon as neutropenia appears between cycles or on the planned day of treatment. Then, its use allows maintenance of the chemotherapy schedule and dose intensity. It also decreases frequency, duration and severity of neutropenia and its sequelae.
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Affiliation(s)
- F Silvestri
- Division of Hematology, University Hospital, Udine, Italy
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Cimino G, Anselmo AP, Marzullo A, Maurizi Enrici R, Mauro F, Papa G, Mandelli F. MOPP Treatment of Resistant Hodgkin's Disease following ABVD Failure. Tumori 2018; 69:469-72. [PMID: 6196891 DOI: 10.1177/030089168306900516] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Fourteen patients with Hodgkin's disease resistant to ABVD were treated with MOPP chemotherapy (nitrogen mustard, vincristine, procarbazine, prednisone). Complete remission was obtained in 6 patients (43%). Four of the 6 complete responders are disease free after 5, 20, 23, 35 months. The actuarial median survival after MOPP of all patients is 20 months. These data confirm that there is no «cross-resistance» among the drugs included in the two schedules.
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Abstract
Prolonged follow-up of large series of patients treated for Hodgkin's disease with an intensive therapeutic approach has demonstrated an incidence of second tumors of around 5–10%. Acute leukemia is the most frequent second neoplasia, and treatments including alkylating agents and radiotherapy seem to be correlated with a higher risk of this fatal complication. Bone and soft tissue sarcomas have rarely been observed after treatment of Hodgkin's disease, and only a few cases are described in the literature. Four cases observed at the Istituto Nazionale Tumori of Milano in a large series of nearly 800 patients treated over the last two decades with different modalities are presented. One case of chondrosarcoma and 3 cases of soft tissue sarcomas were diagnosed after a median and mean interval of 50 and 70 months, respectively (range 49–96). Three patients had been treated with radiotherapy plus chemotherapy (MOPP, 2 cases; ABVD, 1 case), and one with radiotherapy alone. The site of the second tumor was always within an irradiated area, which had received a dose ranging from 10 to 43 Gy. Prognosis of secondary bone and soft tissue sarcomas is very poor. Three of our cases died 14, 15 and 19 months after diagnosis; only one patient is alive, 3 months after diagnosis of a chondrosarcoma. The problem of second tumors in patients treated for Hodgkin's disease requires a careful evaluation of aggressive treatment modalities to minimize the risks of this severe complication.
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Tirelli U, Zagonel V, Volpe R, Trovò MG, Carbone A. Non-Hodgkin's Lymphoma in the Elderly: A Retrospective Evaluation of Toxicity Related to Aggressive vs. Conservative Treatments. Tumori 2018; 74:433-8. [PMID: 2460983 DOI: 10.1177/030089168807400410] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The outcome of 70 elderly patients aged 65 years or more (median, 71 years) with non-Hodgkin's lymphoma (NHL) treated between 1973 and 1981 with aggressive (AM) or conservative modalities (CM) was retrospectively evaluated. A significantly higher incidence of lethal and severe toxicity was observed in patients treated with AM than in those treated with CM (32 % vs 3 %, p < 0.01), with 10 % treatment related deaths in the AM group. Only 56 % of the deaths were attributed to NHL; other major causes were treatment-related deaths, infection and cardiac diseases. No significant difference in response and survival was found between AM and CM groups (complete remission rates were 35 % vs 42 %, and 10 year survival rates were 31 % vs 19 %, respectively), but the prevalence of stages III-IV in patients treated with AM makes these results meaningless. Prospective randomized trials with AM vs CM are clearly needed in elderly patients with advanced unfavorable NHL.
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Affiliation(s)
- U Tirelli
- Divisione di Oncologia Medica, Centro di Riferimento Oncologico, Aviano, Italia
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Tao Y, Kang S, Zhou L, Shi Y, Li Y, Sun Y. [A analysis of the outcome and prognostic factors in 415 patients with Hodgkin lymphoma]. Zhonghua Zhong Liu Za Zhi 2015; 37:466-471. [PMID: 26463153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the effectiveness of treatment, survival and prognostic factors in Chinese patients with Hodgkin lymphoma. METHODS A total of previously untreated 415 patients with histologically confirmed Hodgkin lymphoma admitted in the Cancer Hospital, Chinese Academy of Medical Sciences from February 1999 to February 2011 were included in this study. Their short-term and long-term survivals, as well as prognostic factors were analyzed. RESULTS For the whole group, 371 cases (89.4%) had complete remission (CR), 33 cases (8.0%) had partial remission (PR) and 11 cases (2.7%) experienced disease progression. The CR rates for stage I, II, III and IV patients were 96.6% (56/58), 92.0% (219/238), 83.6% (51/61) and 77.6% (45/58), respectively (P < 0.001). The 5-year disease-free survival (DFS), progression-free survival (PFS) and overall survival (OS) were 90.6%, 84.1% and 92.5%. The stage I-II patients were significantly better than stage III-IV patients in terms of 5-year DFS rate (94.5% vs. 79.2%, P < 0.001), 5-year PFS rate (91.2% vs. 66.4%, P < 0.001) and 5-year OS rate (97.0% vs. 81.5%, P < 0.001). For stage I-II patients, combined modality therapy was related to better DFS, PFS and OS as compared with radiotherapy alone, and was associated with a better PFS compared with chemotherapy alone. There was a trend that consolidative radiotherapy could improve the long-term survival for stage III-IV patients who achieved disease remission after chemotherapy. What's more, consolidative radiotherapy could significantly improve PFS for those stage II-IV patients who achieved PR after chemotherapy. Multivariate analysis showed that clinical stage and pathological type were independent prognostic factors for the 5-year DFS rate (both P < 0.05), and the stage, elevated serum β2-microglobulin and none-ABVD/BEACOP chemotherapy regimen were independent prognostic factors for 5-year PFS rate and 5-year overall survival rate (P < 0.05 for all). CONCLUSIONS Patients with HL treated in China have a good prognosis. Combined modality therapy is the preferred treatment for stage I-II patients. Consolidative radiotherapy is recommended to those of stage III-IV patients who experienced PR after chemotherapy. Stage, serum β2-microglobulin and first-line chemotherapy regimen significantly affect the prognosis for patients with Hodgkin lymphoma.
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Affiliation(s)
- Yunxia Tao
- Department of Medical Oncology, Cancer Hospital (Institute), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - Suyi Kang
- Department of Medical Oncology, Cancer Hospital (Institute), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - Liqiang Zhou
- Department of Medical Oncology, Cancer Hospital (Institute), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China;
| | - Yuankai Shi
- Department of Medical Oncology, Cancer Hospital (Institute), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - Yexiong Li
- Department of Medical Oncology, Cancer Hospital (Institute), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - Yan Sun
- Department of Medical Oncology, Cancer Hospital (Institute), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
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Wang WQ, Song WB, Lan XJ, Huang M, Xuan LJ. Merremins A-G, resin glycosides from Merremia hederacea with multidrug resistance reversal activity. J Nat Prod 2014; 77:2234-2240. [PMID: 25310730 DOI: 10.1021/np500483d] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Five new pentasaccharide resin glycosides, named merremins A-E (1-5), two new pentasaccharide resin glycoside methyl esters, named merremins F and G (6, 7), and four known resin glycosides, murucoidin IV, murucoidin V, stoloniferin IV, and murucoidin XVII, were obtained from the aerial parts of Merremia hederacea. This is the first report of resin glycosides obtained from M. hederacea. In addition, the new compounds can be divided into three types: those possessing an 18-membered ring (1-4), compound 5 with a 20-membered ring, and those with an acyclic core (6, 7). Furthermore, the different types of resin glycosides were evaluated for their multidrug resistance reversal activities. Compounds 1, 5, 6, and murucoidin V were noncytotoxic and enhanced the cytotoxicity of vinblastine by 2.3-142.5-fold at 25 μM. Compound 5 and murucoidin V, with 20-membered rings, were more active than compound 1, with an 18-membered ring.
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Affiliation(s)
- Wen-qiong Wang
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences , 555 Zuchongzhi Road, Zhangjiang Hi-Tech Park, Shanghai, 201203, People's Republic of China
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Burger IA, Vargas HA, Goldman DA, Gonen M, Kumar A, Zelenetz AD, Schöder H, Hricak H. The impact of systemic chemotherapy on testicular FDG activity in young men with Hodgkin's lymphoma. Eur J Nucl Med Mol Imaging 2013; 40:701-7. [PMID: 23389428 DOI: 10.1007/s00259-012-2335-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Accepted: 12/25/2012] [Indexed: 11/30/2022]
Abstract
PURPOSE Based on prior reports suggesting a positive correlation between fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET)/CT and total sperm count and concentration, we sought to identify changes in testicular FDG uptake over the course of chemotherapy in young men with Hodgkin's lymphoma. METHODS Fifty-two patients with a mean age of 24.2 years (range 15.5-44.4) at diagnosis monitored with FDG PET/CT to assess treatment response for Hodgkin's lymphoma were selected for this retrospective analysis under an Institutional Review Board waiver. Of the patients, 26 were treated with a chemotherapy regimen known to cause prolonged and sometimes permanent azoospermia (BEACOPP--bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisolone) and 26 with a regimen known to have a much milder effect on gonadal function (ABVD--doxorubicin, bleomycin, vincristine, and dacarbazine). Each patient underwent one FDG PET/CT before treatment and at least one FDG PET/CT after start of chemotherapy. In all examinations, FDG activity was measured in the testes with different quantification metrics: maximum standardized uptake value (SUVmax), SUVmean, functional volume (FV) and total testicular glycolysis (TTG), and blood pool activity determined (SUVmean). RESULTS Testicular FDG uptake (SUVmax) was significantly associated with blood pool activity (p < 0.001). Furthermore, testicular FDG uptake metrics incorporating volume (e.g., FV and TTG) were associated with age. There was no significant change in SUVmax, SUVmean, FV, and TTG from the PET/CT at baseline to the PET/CTs over the course of chemotherapy either for patients treated with BEACOPP or for patients treated with ABVD. CONCLUSION For patients undergoing chemotherapy for Hodgkin's lymphoma, there is a significant association between testicular FDG uptake and blood pool activity, but no significant changes in FDG uptake over the course of chemotherapy. Therefore, FDG uptake may not be a feasible surrogate marker for fertility monitoring in patients with Hodgkin's lymphoma undergoing chemotherapy.
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Affiliation(s)
- Irene A Burger
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065, USA
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da Costa AABA, Flora AC, Stroher M, Soares FA, de Lima VCC. Primary Hodgkin's lymphoma of the rectum: an unusual presentation. J Clin Oncol 2011; 29:e268-70. [PMID: 21220602 DOI: 10.1200/jco.2010.32.2073] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Malhaire C, El Khoury C, Thibault F, Athanasiou A, Petrow P, Ollivier L, Tardivon A. Vacuum-assisted biopsies under MR guidance: results of 72 procedures. Eur Radiol 2010; 20:1554-62. [PMID: 20119729 DOI: 10.1007/s00330-009-1707-9] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2009] [Revised: 10/31/2009] [Accepted: 11/16/2009] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate the clinical accuracy of magnetic resonance imaging-guided breast vacuum-assisted biopsy (MR-VAB). METHODS Of 97 scheduled MR-VAB for single MRI lesions (negative second-look sonography) categorised as BI-RADS 4 or 5, 4 were cancelled (undetected lesion = 2, technical problems = 2). Twenty-one patients lost to follow-up were excluded. RESULTS Twenty-three patients (median age 51 years) were at high risk (BRCA1 = 11, BRCA2 = 7, familial risk = 5), 23 had a suspected local recurrence of breast cancer. Seventy-two imaged lesions (focus = 1, mass enhancement = 32, non-mass-like enhancement = 39) were targeted with a 10-gauge VAB probe using MRI guidance, with a median of 18 specimens per lesion (median procedural time 72 min, range 50-131 min) followed by clip placement. In the case of benignity, MRI follow-up was performed (19 patients, median 389 days, range 33-1,592) or mammography (3 patients, median 420 days, range 372-1,354). According to histopathology results, 29 lesions were benign, 10 were high-risk (papillary = 2, radial scar = 1, atypical epithelial hyperplasia = 7) and 33 malignant (ductal carcinoma in situ = 8, invasive cancers = 25). Three false negative results and 3 complications occurred (1 malaise, 1 skin defect, 1 infection). CONCLUSION MRI-guided VAB represents an accurate tool for the histological diagnosis of lesions visible only at MRI.
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Affiliation(s)
- C Malhaire
- Radiology Department, Institut Curie, Paris, France.
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Inoue T, Obara T, Saito M, Kumazawa T, Narita S, Horikawa Y, Yuasa T, Tsuchiya N, Satoh S, Habuchi T. [Combination therapy consisting of gemcitabine, docetaxel and carboplatin as a second-line chemotherapy for patients with MVAC-treated metastatic urothelial carcinoma]. Hinyokika Kiyo 2008; 54:581-585. [PMID: 18975570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
From 2001 to 2006, 11 patients with MVAC-treated metastatic urothelial carcinoma received as a second-line therapy GDC therapy consisting of gemcitabine (1,000 mg/m2) on day land 8, docetaxel (80 mg/m2) on day 1 and carboplatin (AUC 5) on day 1 in each 21-day cycle. The 11 patients received a total of 42 cycles. The median progression-free survival and the median overall survival were 3 months (range 0-51) and 10 months (range 2-51), respectively. The median overall survival from diagnosis of the metastasis was 13.0 months (range 7-55). Complete response and partial response rates were 1/11 (9%) and 5/11 (45%), respectively. One- and two-year survival rates were 36 and 9%, respectively. Grade 3 or 4 hematologic toxicity included neutropenia (69.0%), thrombocytopenia (47.6%) and anemia (45.2%). Non-hematologic toxicity of grade 3 or 4 consisted mainly of diarrhea (23.8%) and anorexia (21.4%). GDC regimen as a second-line chemotherapy was effective in 54% of patients with MVAC-treated metastatic urothelial carcinoma, although the high incidence of hematologic toxicities and short period of progression-free survival remain to be major problems.
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Affiliation(s)
- Takamitsu Inoue
- Department of Urology, Akita University School of Medicine, Akita, Japan
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Affiliation(s)
- Marco Catani
- Institute of Psychiatry, King's College London, London, SE5 8AF, UK.
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Abstract
Although metastatic transitional cell carcinoma of the bladder and urothelium commonly responds to first-line chemotherapy, eventual progression is nearly universal. Current salvage therapy for progressive disease after first-line chemotherapy is ineffective, and such patients are candidates for clinical trials. Neoadjuvant chemotherapy improves long-term outcome and provides an exciting paradigm for the rapid development of systemic therapy. Neoadjuvant chemotherapy with or without radiation also facilitates bladder conservation in patients who attain pathologic complete remission. Definitive data supporting adjuvant chemotherapy are lacking. With the unraveling of bladder cancer biology and the discovery of novel agents targeting several carcinogenic pathways, the future of therapy for transitional cell carcinoma appears promising.
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Abstract
BACKGROUND Doxorubicin/bleomycin/vinblastine/dacarbazine (ABVD) chemotherapy alone is a viable option for the treatment of stage I/II Hodgkin's lymphoma. Among the main drawbacks for widespread acceptance of this therapy is the absence of available data on the post-salvage therapy course in patients with limited-stage disease who relapse after ABVD. This article focuses on the outcome of 11 limited-stage patients who relapsed after ABVD alone. PATIENTS AND METHODS After a clinical restaging, the patients received mantle-type radiation therapy (only if patients met these criteria: supradiaphragmatic disease in a single-node area, erythrocyte sedimentation rate < 30 mm per hour, and absence of B symptoms) or conventional salvage chemotherapy followed by high-dose chemotherapy and autologous hematopoietic stem cell transplantation. RESULTS After a median follow-up of 64 months, 10 patients showed complete response and are still alive without disease progression. One patient showed refractory disease and died 9 months after relapse. This experiment entails the series with the longest follow-up in patients with limited-stage Hodgkin's lymphoma who relapsed after ABVD alone. CONCLUSION The data seem to indicate that salvage therapy is capable of providing cure in most cases and lend further support for the use of ABVD alone as first-line therapy.
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Affiliation(s)
- Antonio Rueda
- Oncology Department, Hospital Clinico Universitario, Malaga, Spain
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