1
|
Steinlechner M, Strobel L, Leitner K, Pan TL, Feroz B, Marth C, Zeimet AG. Pegylated liposomal doxorubicin combined with trabectedin as a treatment option in uterine sarcomas: a single-institution retrospective analysis. Int J Gynecol Cancer 2024:ijgc-2023-005170. [PMID: 38688662 DOI: 10.1136/ijgc-2023-005170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024] Open
Abstract
OBJECTIVE The use of conventional doxorubicin in combination with trabectedin leads to a considerable prolongation of progression-free survival in the treatment of uterine sarcomas but is associated with dose-limiting toxicities. Significant progression-free survival improvement was recently obtained through treatment prolongation with trabectedin single agent. We hypothesize that the therapeutic index of pegylated liposomal doxorubicin combined with trabectedin could be superior to the combination with conventional doxorubicin due to a more favorable toxicity profile. METHODS In this retrospective cohort study, the clinical outcome was analyzed in patients with advanced or recurrent uterine sarcomas with measurable disease treated with pegylated liposomal doxorubicin 30 mg/m2 plus trabectedin 1.5 mg/m2 given every 3 weeks between January 2011 and April 2023 at the University Hospital in Innsbruck. Response evaluation was done every three cycles. Toxicity was evaluated according to the National Cancer Institute (NCI) Common Terminology Criteria on 107 administered cycles. RESULTS A total of 21 patients were included in the study. In 67% (n=14) of patients, pegylated liposomal doxorubicin plus trabectedin was given as first-line treatment. One patient (5%) achieved a complete response and four (19%) a partial response, resulting in an objective response rate of 24%. Four other patients (19%) had stable disease. The median duration of the response was 14 months (range 3-74). Progression was recorded in 12 patients (57%). Median progression-free survival was 6 months (95% CI 1 to 11 months), while median overall survival was 26 months (95% CI 9 to 43 months). A median of 6 (range 1-11) cycles per patient were administered. Regarding grade ≥3 toxicity, neutropenia was recorded in 29%, thrombocytopenia in 14%, and febrile neutropenia in 19% of patients. Hematologic toxicity was the most frequent reason for dose delays (n=16) and dose reductions (n=5). CONCLUSION Our study found an overall clinical benefit for the combination of pegylated liposomal doxorubicin plus trabectedin in metastatic uterine sarcomas of 43% and appears to exhibit a favorable toxicity profile which allows prolonged administration of this regimen.
Collapse
Affiliation(s)
- Magdalena Steinlechner
- Department of Obstetrics and Gynecology, Medical University Innsbruck, Innsbruck, Austria
| | - Laura Strobel
- Department of Obstetrics and Gynecology, Medical University Innsbruck, Innsbruck, Austria
| | - Katharina Leitner
- Department of Obstetrics and Gynecology, Medical University Innsbruck, Innsbruck, Austria
| | - Teresa L Pan
- Department of Obstetrics and Gynecology, Medical University Innsbruck, Innsbruck, Austria
| | - Barin Feroz
- Department of Obstetrics and Gynecology, Medical University Innsbruck, Innsbruck, Austria
| | - Christian Marth
- Department of Obstetrics and Gynecology, Medical University Innsbruck, Innsbruck, Austria
| | - Alain G Zeimet
- Department of Obstetrics and Gynecology, Medical University Innsbruck, Innsbruck, Austria
| |
Collapse
|
2
|
Schwameis R, Fanfani F, Ebner C, Zimmermann N, Peters I, Nero C, Marth C, Ristl R, Leitner K, Grimm C, Oberndorfer F, Capasso I, Zeimet AG, Polterauer S, Scambia G, Fagotti A, Concin N. Verification of the prognostic precision of the new 2023 FIGO staging system in endometrial cancer patients - An international pooled analysis of three ESGO accredited centres. Eur J Cancer 2023; 193:113317. [PMID: 37748967 DOI: 10.1016/j.ejca.2023.113317] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 08/11/2023] [Accepted: 08/15/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND Recently, the new 2023 International Federation of Gynecology and Obstetrics (FIGO) staging system for endometrial cancer (EC) critically integrating new pathological and molecular features was published. The present study evaluated the clinical impact of the new 2023 FIGO staging system by comparing it to the previous 2009 system. METHODS This is an international, pooled retrospective study of 519 EC patients who underwent primary treatment (and molecular characterisation) at three European Society of Gynaecological Oncology (ESGO) accredited centres in Austria/Italy. Patients were categorised according to the 2009 and the 2023 FIGO staging systems. Stage shifts were analysed and (sub)stage specific 5-year progression-free (PFS) and overall survival (OS) rates were calculated and compared. Different statistical tests were applied to evaluate the prognostic precision of the two FIGO staging systems and to compare them to each other. RESULTS (Sub)stage shifts occurred in 143/519 (27.6%) patients: 123 upshifts (23.7%) and 20 (3.9%) downshifts. 2023 FIGO staging system identified a stage I cohort with a notably higher 5-year PFS rate compared to 2009 (93.0% versus 87.4%, respectively). For stage II disease, the 5-year PFS rate was similar in the 2023 and the 2009 FIGO staging systems (70.2% versus 71.2%, respectively). The two new molecularly defined 2023 FIGO substages IAmPOLEmut and IICmp53abn displayed distinct, particularly favourable and adverse oncologic outcomes within early stage disease, respectively. A remarkably lower 5-year PFS rate for stage III patients was revealed in the 2023 FIGO staging system compared to 2009 (44.4% versus 54.1%, respectively). All applied statistical tests confirmed a more accurate prediction of PFS and OS by the 2023 FIGO staging system compared to 2009. CONCLUSION The new 2023 FIGO stating system led to a substantial stage shift in about one quarter of patients leading to a higher prognostic precision. In early stage disease, the new substages added further prognostic granularity and identified treatment relevant subgroups.
Collapse
Affiliation(s)
- Richard Schwameis
- Department of Obstetrics and Gynecology, Division of General Gynecology and Gynecological Oncology, Gynecologic Cancer Unit, Comprehensive Cancer Center Vienna, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
| | - Francesco Fanfani
- Department of Woman, Children and Public Health Sciences, Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; Institute of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
| | - Christoph Ebner
- Department of Obstetrics and Gynecology, Medical University Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
| | - Naomi Zimmermann
- Department of Obstetrics and Gynecology, Division of General Gynecology and Gynecological Oncology, Gynecologic Cancer Unit, Comprehensive Cancer Center Vienna, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
| | - Inge Peters
- Department of Woman, Children and Public Health Sciences, Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; Institute of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
| | - Camilla Nero
- Department of Woman, Children and Public Health Sciences, Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; Institute of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
| | - Christian Marth
- Department of Obstetrics and Gynecology, Medical University Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
| | - Robin Ristl
- Center for Medical Data Science, Institute of Medical Statistics, Medical University of Vienna, Austria.
| | - Katharina Leitner
- Department of Obstetrics and Gynecology, Medical University Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
| | - Christoph Grimm
- Department of Obstetrics and Gynecology, Division of General Gynecology and Gynecological Oncology, Gynecologic Cancer Unit, Comprehensive Cancer Center Vienna, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
| | - Felicitas Oberndorfer
- Department of Pathology, Gynecologic Cancer Unit, Comprehensive Cancer Center Vienna, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
| | - Ilaria Capasso
- Department of Woman, Children and Public Health Sciences, Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; Institute of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
| | - Alain G Zeimet
- Department of Obstetrics and Gynecology, Medical University Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
| | - Stephan Polterauer
- Department of Obstetrics and Gynecology, Division of General Gynecology and Gynecological Oncology, Gynecologic Cancer Unit, Comprehensive Cancer Center Vienna, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
| | - Giovanni Scambia
- Department of Woman, Children and Public Health Sciences, Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; Institute of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
| | - Anna Fagotti
- Department of Woman, Children and Public Health Sciences, Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; Institute of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
| | - Nicole Concin
- Department of Obstetrics and Gynecology, Medical University Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
| |
Collapse
|
3
|
Zimmer K, Kocher F, Untergasser G, Kircher B, Amann A, Baca Y, Xiu J, Korn WM, Berger MD, Lenz HJ, Puccini A, Fontana E, Shields AF, Marshall JL, Hall M, El-Deiry WS, Hsiehchen D, Macarulla T, Tabernero J, Pichler R, Khushman M, Manne U, Lou E, Wolf D, Sokolova V, Schnaiter S, Zeimet AG, Gulhati P, Widmann G, Seeber A. PBRM1 mutations might render a subtype of biliary tract cancers sensitive to drugs targeting the DNA damage repair system. NPJ Precis Oncol 2023; 7:64. [PMID: 37400502 DOI: 10.1038/s41698-023-00409-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 05/31/2023] [Indexed: 07/05/2023] Open
Abstract
Polybromo-1 (PBRM1) loss of function mutations are present in a fraction of biliary tract cancers (BTCs). PBRM1, a subunit of the PBAF chromatin-remodeling complex, is involved in DNA damage repair. Herein, we aimed to decipher the molecular landscape of PBRM1 mutated (mut) BTCs and to define potential translational aspects. Totally, 1848 BTC samples were analyzed using next-generation DNA-sequencing and immunohistochemistry (Caris Life Sciences, Phoenix, AZ). siRNA-mediated knockdown of PBRM1 was performed in the BTC cell line EGI1 to assess the therapeutic vulnerabilities of ATR and PARP inhibitors in vitro. PBRM1 mutations were identified in 8.1% (n = 150) of BTCs and were more prevalent in intrahepatic BTCs (9.9%) compared to gallbladder cancers (6.0%) or extrahepatic BTCs (4.5%). Higher rates of co-mutations in chromatin-remodeling genes (e.g., ARID1A 31% vs. 16%) and DNA damage repair genes (e.g., ATRX 4.4% vs. 0.3%) were detected in PBRM1-mutated (mut) vs. PBRM1-wildtype (wt) BTCs. No difference in real-world overall survival was observed between PBRM1-mut and PBRM1-wt patients (HR 1.043, 95% CI 0.821-1.325, p = 0.731). In vitro, experiments suggested that PARP ± ATR inhibitors induce synthetic lethality in the PBRM1 knockdown BTC model. Our findings served as the scientific rationale for PARP inhibition in a heavily pretreated PBRM1-mut BTC patient, which induced disease control. This study represents the largest and most extensive molecular profiling study of PBRM1-mut BTCs, which in vitro sensitizes to DNA damage repair inhibiting compounds. Our findings might serve as a rationale for future testing of PARP/ATR inhibitors in PBRM1-mut BTCs.
Collapse
Affiliation(s)
- Kai Zimmer
- Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University Innsbruck (MUI), Innsbruck, Austria
| | - Florian Kocher
- Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University Innsbruck (MUI), Innsbruck, Austria
| | - Gerold Untergasser
- Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University Innsbruck (MUI), Innsbruck, Austria
- Tyrolean Cancer Research Institute, Innsbruck, Austria
| | - Brigitte Kircher
- Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University Innsbruck (MUI), Innsbruck, Austria
- Tyrolean Cancer Research Institute, Innsbruck, Austria
| | - Arno Amann
- Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University Innsbruck (MUI), Innsbruck, Austria
| | | | | | | | - Martin D Berger
- Department of Medical Oncology, Inselspital, University of Bern, Bern, Switzerland
| | - Heinz-Josef Lenz
- Division of Medical Oncology, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Alberto Puccini
- Medical Oncology Unit 1, Ospedale Policlinico San Martino, Genoa, Italy
| | - Elisa Fontana
- Drug Development Unit, Sarah Cannon Research Institute UK, Marylebone, London, UK
| | - Anthony F Shields
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA
| | - John L Marshall
- Ruesch Center for The Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
| | - Michael Hall
- Department of Hematology and Oncology, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA
| | - Wafik S El-Deiry
- Department of Pathology and Laboratory Medicine, Cancer Center at Brown University, Providence, RI, USA
| | - David Hsiehchen
- Division of Hematology and Oncology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Teresa Macarulla
- Medical Oncology Department, Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), IOB-Quiron, Barcelona, Spain
| | - Josep Tabernero
- Medical Oncology Department, Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), IOB-Quiron, Barcelona, Spain
| | - Renate Pichler
- Department of Urology, Comprehensive Cancer Center Innsbruck, Medical University of Innsbruck, Innsbruck, Austria
| | - Moh'd Khushman
- O'Neal Comprehensive Cancer Center, the University of Alabama at Birmingham, Birmingham, Al, USA
| | - Upender Manne
- O'Neal Comprehensive Cancer Center, the University of Alabama at Birmingham, Birmingham, Al, USA
| | - Emil Lou
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Dominik Wolf
- Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University Innsbruck (MUI), Innsbruck, Austria
| | - Viktorija Sokolova
- Department of Nuclear Medicine, Provincial Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University, Bolzano-Bozen, Italy
| | - Simon Schnaiter
- Institute of Human Genetics, Medical University of Innsbruck, Innsbruck, Austria
| | - Alain G Zeimet
- Department of Obstetrics and Gynaecology, Comprehensive Cancer Center Innsbruck, Medical University of Innsbruck, Innsbruck, Austria
| | - Pat Gulhati
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Gerlig Widmann
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Andreas Seeber
- Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University Innsbruck (MUI), Innsbruck, Austria.
| |
Collapse
|
4
|
Roser E, Harter P, Zocholl D, Denschlag D, Chekerov R, Wimberger P, Kurzeder C, Hasenburg A, Muallem MZ, Mustea A, Emons G, Zeimet AG, Beck F, Arndt T, Brucker SY, Kommoss S, Heitz F, Welz J, Egger EK, Kalder M, Buderath P, Klar M, Marth C, Ulrich UA, Weigel M, Traub L, Anthuber C, Strauss H, Hanker L, Link T, Kubiak K, Melekian B, Hornung D, Pölcher M, Lampe B, Krauß T, Keilholz U, Flörcken A, Pietzner K, Sehouli J. Treatment strategies in patients with gynecological sarcoma: Results of the prospective intergroup real-world registry for gynecological sarcoma in Germany (REGSA-NOGGO RU1). Int J Gynecol Cancer 2023; 33:223-230. [PMID: 36631151 DOI: 10.1136/ijgc-2022-003800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE Gynecological sarcomas account for 3% of all gynecological malignancies and are associated with a poor prognosis. Due to the rarity and heterogeneity of gynecological sarcomas there is still no consensus on optimal therapeutic strategies. This study's objective was to describe the treatment strategies used in patients with gynecological sarcomas in the primary course of disease. METHODS The German prospective registry for gynecological sarcoma (REGSA) is the largest registry for gynecological sarcomas in Germany, Austria and Switzerland. Primary inclusion criteria for REGSA are histological diagnosis of sarcoma of the female genital tract, sarcoma of the breast or uterine smooth muscle tumors of uncertain malignant potential (STUMP). We evaluated data of the REGSA registry on therapeutic strategies used for primary treatment from August 2015 to February 2021. RESULTS A total of 723 patients from 120 centers were included. Data on therapeutic strategies for primary treatment were available in 605 cases. Overall, 580 (95.9%) patients underwent primary surgery, 472 (81.4%) of whom underwent only hysterectomy. Morcellation was reported in 11.4% (n=54) of all hysterectomies. A total of 42.8% (n=202) had no further surgical interventions, whereas an additional salpingo-ophorectomy was performed in 54% (n=255) of patients. An additional lymphadenectomy was performed in 12.7% (n=60), an omentectomy in 9.5% (n=45) and intestinal resection in 6.1% (n=29) of all patients. Among 448 patients with available information, 21.4% (n=96) received chemo- or targeted therapies, more commonly as single-agent treatment than as drug combinations. Information about anti-hormonal treatment was available for 423 patients, among which 42 (9.9%) received anti-hormonal treatment, 23 (54.8%) of whom with low-grade endometrial stroma sarcomas. For radiotherapy, data of 437 patients were available, among which 29 (6.6%) patients underwent radiotherapy. CONCLUSION Our study showed that treatment of patients with gynecologic sarcomas is heterogeneous. Further trials are needed along with more information on treatment modalities, therapy response and patient-reported outcomes to implement new treatment strategies.
Collapse
Affiliation(s)
- Eva Roser
- Department of Gynecology with Center for Oncological Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charité Medical University, Berlin, Germany
| | - Philipp Harter
- Department of Gynecology and Gynecological Oncology, Kliniken Essen-Mitte, Essen, Germany
| | - Dario Zocholl
- Institute of Biometry and Clinical Epidemiology, Charité-Universitaetsmedizin Berlin Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Dominik Denschlag
- Department of Gynecology, Hochtaunus-Kliniken gGmbH, Bad Homburg, Germany
| | - Radoslav Chekerov
- Department of Gynecology with Center for Oncological Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charité Medical University, Berlin, Germany
| | - Pauline Wimberger
- Department of Obstetrics and Gynecology, University of Dresden, TU Dresden, Dresden Germany and National Center for Tumor Diseases (NCT/UCC), Dresden, Germany
| | - Christian Kurzeder
- Department of Obstetrics and Gynecology, Universitätsspital Basel, Basel, Switzerland
| | | | - Mustafa-Zelal Muallem
- Department of Gynecology with Center for Oncological Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charité Medical University, Berlin, Germany
| | - Alexander Mustea
- Department of Gynecology and Gynecological Oncology, Bonn University Hospital, Bonn, Germany
| | - Guenter Emons
- Department of Gynecology and Obstetrics, University Medicine Goettingen, Goettingen, Germany
| | - A G Zeimet
- Department of Obstetrics and Gynecology, Innsbruck Medical University, Innsbruck, Innsbruck, Austria
| | - Felix Beck
- Department of Gynecology with Center for Oncological Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charité Medical University, Berlin, Germany
| | - Tjadina Arndt
- Department of Gynecology with Center for Oncological Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charité Medical University, Berlin, Germany
| | - Sara Y Brucker
- Department of Women's Health, Tübingen University Hospital, Tuebingen, Germany
| | - Stefan Kommoss
- Department of Women's Health, Tübingen University Hospital, Tuebingen, Germany
| | - Florian Heitz
- Department of Gynecology and Gynecological Oncology, Kliniken Essen-Mitte, Essen, Germany
| | - Julia Welz
- Department of Gynecology and Gynecological Oncology, Kliniken Essen-Mitte, Essen, Germany
| | - Eva-Katharina Egger
- Department of Gynecology and Gynecological Oncology, Bonn University Hospital, Bonn, Germany
| | - Matthias Kalder
- Department of Gynecology and Obstetrics, University Clinic Gießen and Marburg, Marburg, Germany
| | - Paul Buderath
- Department of Gynecology and Obstetrics, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Maximilian Klar
- Department of Gynecology and Obstetrics, University Medical Center Freiburg, Freiburg, Germany
| | - Christian Marth
- Department of Obstetrics and Gynecology, Innsbruck Medical University, Innsbruck, Innsbruck, Austria
| | - Uwe Andreas Ulrich
- Department of Obstetrics and Gynecology, Martin Luther Hospital Berlin, Berlin, Germany
| | - Michael Weigel
- Department of Obstetrics and Gynecology, Leopoldina Krankenhaus Schweinfurt, Schweinfurt, Germany
| | - Lea Traub
- Department of Obstetrics and Gynecology, Technische Universität Munich, Munich, Germany
| | - Christoph Anthuber
- Department of Obstetrics and Gynecology, Klinikum Starnberg, Starnberg, Germany
| | - Hans Strauss
- Department of Obstetrics and Gynecology, University of Halle (Saale), Halle, Germany
| | - Lars Hanker
- Department of Obstetrics and Gynecology, University of Schleswig-Holstein, Luebeck, Germany
| | - Theresa Link
- Department of Obstetrics and Gynecology, University of Dresden, TU Dresden, Dresden Germany and National Center for Tumor Diseases (NCT/UCC), Dresden, Germany
| | - Karol Kubiak
- Department of Obstetrics and Gynecology, St. Franziskus Hospital Münster, Muenster, Germany
| | - Badrig Melekian
- Department of Obstetrics and Gynecology, Marienkliniken Siegen, Siegen, Germany
| | - Daniela Hornung
- Department of Obstetrics and Gynecology, Vidiakliniken, Standort Diakonissenkrankenhaus, Karlsruhe, Germany
| | - Martin Pölcher
- Department of Gynecologic Oncology, Rotkreuzklinikum Munich, Munich, Germany
| | - Bjoern Lampe
- Department of Obstetrics and Gynecology, Florence-Nightingale-Hospital, Kaiserswerther Diakonie, Duesseldorf, Germany
| | - Thomas Krauß
- Department of Obstetrics and Gynecology, Klinikum Passau, Passau, Germany
| | - Ulrich Keilholz
- Charité Comprehensive Cancer Center and German Cancer Consortium, Berlin, Germany
| | - Anne Flörcken
- Department of Hematology, Oncology, and Tumor Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Klaus Pietzner
- Department of Gynecology with Center for Oncological Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charité Medical University, Berlin, Germany
| | - Jalid Sehouli
- Department of Gynecology with Center for Oncological Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charité Medical University, Berlin, Germany .,Charité Comprehensive Cancer Center and German Cancer Consortium, Berlin, Germany
| |
Collapse
|
5
|
Heinzl N, Koziel K, Maritschnegg E, Berger A, Pechriggl E, Fiegl H, Zeimet AG, Marth C, Zeillinger R, Concin N. A comparison of four technologies for detecting p53 aggregates in ovarian cancer. Front Oncol 2022; 12:976725. [PMID: 36158680 PMCID: PMC9493009 DOI: 10.3389/fonc.2022.976725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022] Open
Abstract
The tumor suppressor protein p53 is mutated in half of all cancers and has been described to form amyloid-like structures, commonly known from key proteins in neurodegenerative diseases. Still, the clinical relevance of p53 aggregates remains largely unknown, which may be due to the lack of sensitive and specific detection methods. The aim of the present study was to compare the suitability of four different methodologies to specifically detect p53 aggregates: co-immunofluorescence (co-IF), proximity ligation assay (PLA), co-immunoprecipitation (co-IP), and the p53-Seprion-ELISA in cancer cell lines and epithelial ovarian cancer tissue samples. In 7 out of 10 (70%) cell lines, all applied techniques showed concordance. For the analysis of the tissue samples co-IF, co-IP, and p53-Seprion-ELISA were compared, resulting in 100% concordance in 23 out of 30 (76.7%) tissue samples. However, Co-IF lacked specificity as there were samples, which did not show p53 staining but abundant staining of amyloid proteins, highlighting that this method demonstrates that proteins share the same subcellular space, but does not specifically detect p53 aggregates. Overall, the PLA and the p53-Seprion-ELISA are the only two methods that allow the quantitative measurement of p53 aggregates. On the one hand, the PLA represents the ideal method for p53 aggregate detection in FFPE tissue, which is the gold-standard preservation method of clinical samples. On the other hand, when fresh-frozen tissue is available the p53-Seprion-ELISA should be preferred because of the shorter turnaround time and the possibility for high-throughput analysis. These methods may add to the understanding of amyloid-like p53 in cancer and could help stratify patients in future clinical trials targeting p53 aggregation.
Collapse
Affiliation(s)
- Nicole Heinzl
- Molecular Oncology Group, Department of Obstetrics and Gynecology, Comprehensive Cancer Center-Gynecologic Cancer Unit, Medical University of Vienna, Vienna, Austria
| | - Katarzyna Koziel
- Department of Gynecology and Obstetrics, Innsbruck Medical University, Innsbruck, Austria
| | - Elisabeth Maritschnegg
- Molecular Oncology Group, Department of Obstetrics and Gynecology, Comprehensive Cancer Center-Gynecologic Cancer Unit, Medical University of Vienna, Vienna, Austria
| | - Astrid Berger
- Department of Gynecology and Obstetrics, Innsbruck Medical University, Innsbruck, Austria
| | - Elisabeth Pechriggl
- Institute for Clinical and Functional Anatomy, Innsbruck Medical University, Innsbruck, Austria
| | - Heidi Fiegl
- Department of Gynecology and Obstetrics, Innsbruck Medical University, Innsbruck, Austria
| | - Alain G. Zeimet
- Department of Gynecology and Obstetrics, Innsbruck Medical University, Innsbruck, Austria
| | - Christian Marth
- Department of Gynecology and Obstetrics, Innsbruck Medical University, Innsbruck, Austria
| | - Robert Zeillinger
- Molecular Oncology Group, Department of Obstetrics and Gynecology, Comprehensive Cancer Center-Gynecologic Cancer Unit, Medical University of Vienna, Vienna, Austria
- *Correspondence: Nicole Concin, ; Robert Zeillinger,
| | - Nicole Concin
- Department of Gynecology and Obstetrics, Innsbruck Medical University, Innsbruck, Austria
- *Correspondence: Nicole Concin, ; Robert Zeillinger,
| |
Collapse
|
6
|
Leitner K, Tsibulak I, Wieser V, Penz M, Fiegl H, Marth C, Zeimet AG. JARID1B beim Ovarialkarzinom. Geburtshilfe Frauenheilkd 2022. [DOI: 10.1055/s-0042-1746162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
7
|
Fiegl H, Hagenbuchner J, Kyvelidou C, Seeber B, Sopper S, Tsibulak I, Wieser V, Reiser E, Roessler J, Huhtinen K, Carpén O, Parson W, Sprung S, Marth C, Ausserlechner MJ, Zeimet AG. Dubious effects of methadone as an "anticancer" drug on ovarian cancer cell-lines and patient-derived tumor-spheroids. Gynecol Oncol 2022; 165:129-136. [PMID: 35033381 DOI: 10.1016/j.ygyno.2022.01.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 12/02/2021] [Accepted: 01/03/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND The opioid agonist D,L-methadone exerts analgesic effects via the mu opioid receptor, encoded by OPRM1 and therefore plays a role in chronic pain management. In preclinical tumor-models D,L-methadone shows apoptotic and chemo-sensitizing effects and was therefore hyped as an off-label "anticancer" drug without substantiation from clinical trials. Its effects in ovarian cancer (OC) are completely unexplored. METHODS We analyzed OPRM1-mRNA expression in six cisplatin-sensitive, two cisplatin-resistant OC cell-lines, 170 OC tissue samples and 12 non-neoplastic control tissues. Pro-angiogenetic, cytotoxic and apoptotic effects of D,L-methadone were evaluated in OC cell-lines and four patient-derived tumor-spheroid models. RESULTS OPRM1 was transcriptionally expressed in 69% of OC-tissues and in three of eight OC cell-lines. D,L-methadone exposure significantly reduced cell-viability in five OC cell-lines irrespective of OPRM1 expression. D,L-methadone, applied alone or combined with cisplatin, showed no significant effects on apoptosis or VEGF secretion in cell-lines. Notably, in two of the four spheroid models, treatment with D,L-methadone significantly enhanced cell growth (by up to 121%), especially after long-term exposure. This is consistent with the observed attenuation of the inhibitory effects of cisplatin in three spheroid models when adding D,L-methadone. The effect of methadone treatment on VEGF secretion in tumor-spheroids was inconclusive. CONCLUSIONS Our study demonstrates that certain OC samples express OPRM1, which, however, is not a prerequisite for D,L-methadone function. As such, D,L-methadone may exert also detrimental effects by stimulating the growth of certain OC-cells and abrogating cisplatin's therapeutic effect.
Collapse
Affiliation(s)
- Heidelinde Fiegl
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Judith Hagenbuchner
- Department of Pediatrics II, Medical University Innsbruck, Innsbruck, Austria
| | - Christiana Kyvelidou
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - Beata Seeber
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - Sieghart Sopper
- Internal Medicine V, Medical University of Innsbruck, Innsbruck, Austria; Tyrolean Cancer Research Institute, Innsbruck, Austria
| | - Irina Tsibulak
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Verena Wieser
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Elisabeth Reiser
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Julia Roessler
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Kaisa Huhtinen
- Cancer Research Program, Institute of Biomedicine and FICAN West Cancer Centre, University of Turku, Turku, Finland
| | - Olli Carpén
- Cancer Research Program, Institute of Biomedicine and FICAN West Cancer Centre, University of Turku, Turku, Finland; Research Programs Unit, Genome-Scale Biology and Medicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Walther Parson
- Institute of Legal Medicine, Medical University of Innsbruck, Innsbruck, Austria; Forensic Science Program, The Pennsylvania State University, University Park, PA, USA
| | - Susanne Sprung
- Department of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Innsbruck, Austria
| | - Christian Marth
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Alain G Zeimet
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria.
| |
Collapse
|
8
|
Fiegl H, Hagenbuchner J, Ausserlechner MJ, Kyvelidou C, Seeber B, Sopper S, Tsibulak I, Wieser V, Roessler J, Reiser E, Huhtinen K, Carpén O, Parson W, Marth C, Zeimet AG. Abstract 947: Effects of methadone on ovarian cancer cell-lines and patient-derived tumor-spheroids. Cancer Res 2021. [DOI: 10.1158/1538-7445.am2021-947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: D,L-Methadone exerts analgesic effects via the mu opioid receptor, encoded by OPRM1 and therefore plays a role in chronic pain management. Although the use of this opioid-receptor agonist as an anti-cancer drug is deemed controversial, this drug is gaining popularity in Europe as an “off-label” therapy despite insufficient research to support its benefits. In preclinical glioblastoma and leukaemia cell culture models D,L-methadone showed apoptotic and chemo-sensitizing effects. Its effects in ovarian cancer (OC) are completely unexplored.
Methods: We analysed the OPRM mRNA expression in six cisplatin-sensitive, two cisplatin-resistant OC cell-lines, 192 OC samples and 12 non-neoplastic control tissues. Pro-angiogenetic, cytotoxic and apoptotic effects of D,L-methadone were evaluated in OC cell-lines and four patient-derived tumor-spheroid models.
Results: OPRM1 was transcriptionally expressed in 69% of OC-tissues and in five of eight OC cell-lines. D,L-methadone exposure significantly reduced cell-viability in five OC cell-lines irrespective of OPRM1 expression. D,L-methadone, applied alone or combined with cisplatin, showed no significant effects on apoptosis or VEGF secretion in cell-lines. Notably, in two of the four spheroid models, treatment with D,L-methadone resulted in significantly enhanced cell growth (by up to 121%), especially after long-term exposure. This is consistent with the observed attenuation of the inhibitory effects of cisplatin in three spheroid models when adding D,L-methadone. The effect of methadone treatment on VEGF secretion in tumor-spheroids was inconclusive.
Conclusions: Our study demonstrates that certain OC samples express OPRM1, which, however, is not a prerequisite for D,L-methadone function. As such, D,L-methadone may exert detrimental effects by stimulating the growth of certain OC-cells and abrogating cisplatin's therapeutic effect.
Citation Format: Heidelinde Fiegl, Judith Hagenbuchner, Michael J. Ausserlechner, Christiana Kyvelidou, Beata Seeber, Sieghart Sopper, Irina Tsibulak, Verena Wieser, Julia Roessler, Elisabeth Reiser, Kaisa Huhtinen, Olli Carpén, Walther Parson, Christian Marth, Alain G. Zeimet. Effects of methadone on ovarian cancer cell-lines and patient-derived tumor-spheroids [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 947.
Collapse
Affiliation(s)
| | | | | | | | - Beata Seeber
- 1Medical University Innsbruck, Innsbruck, Austria
| | | | | | | | | | | | | | - Olli Carpén
- 3University of Turku; University of Helsinki, Turku; Helsinki, Finland
| | | | | | | |
Collapse
|
9
|
Steinkasserer L, Irmgard D, Weiss T, Dirschlmayer W, Mossig M, Zeimet AG, Marth C. Efficacy of an optimal ovarian cancer screening: a best-case scenario study based on real-world data. Arch Gynecol Obstet 2021; 305:159-167. [PMID: 34125280 PMCID: PMC8782802 DOI: 10.1007/s00404-021-06117-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 06/02/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE To date, ovarian cancer screening in asymptomatic women has not shown a mortality benefit. The aim of this simulation study was to outline the impact of different histological subtypes on a potential stage-shift, achieved by screening. METHODS Real-world data were derived in the period of 2000-2017 from the Klinischen Tumorregister Austria. We estimated five-year overall survival (OS) of patients with ovarian cancer regarding different histological subtypes and FIGO stages. A theoretical model was generated predicting the trend of OS mediated by an eventual down-shifting of ovarian cancer from FIGO stage III/IV to FIGO stage I/II by screening, considering the influence of different histological subtypes. RESULTS 3458 ovarian cancer patients were subdivided according to histological subtypes and FIGO classification. Major difference in distribution of histological types was found between FIGO stage I/II and III/IV. A theoretical down-shift of tumors from high to low FIGO stages based on our registry calculations showed that the five-year OS would increase from 50% to nearly 80% by perfect screening. CONCLUSION In our simulation study, we showed that down-shifting ovarian cancers by successful screening might increase OS by 30 percentage point. Our results underscore the importance to recognize ovarian cancer as a heterogenous disease with distinct epidemiologic, molecular and clinical features. The individual characteristic of each histotype is of utmost impact on the definition of screening aims and may influence early detection and stage-shift. Efficacy of screening is mainly dependent on detection of high-risk cancer types and not the slow growing low-grade types.
Collapse
Affiliation(s)
- Lena Steinkasserer
- Department of Obstetrics and Gynecology, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Delmarko Irmgard
- Department of Clinical Epidemiology, Tyrolean Federal Institute for Integrated Care, Tirol Kliniken GmbH, Innsbruck, Austria
| | - Tatjana Weiss
- Department of Obstetrics and Gynecology, Hospital Barmherzige Schwestern, Linz, Austria
| | - Walter Dirschlmayer
- Department of Obstetrics and Gynecology, Hospital Barmherzige Schwestern Ried, Vienna, Austria
| | - Michael Mossig
- Department of Obstetrics and Gynecology, Hospital Hietzing, Vienna, Austria
| | - Alain G Zeimet
- Department of Obstetrics and Gynecology, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Christian Marth
- Department of Obstetrics and Gynecology, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
| |
Collapse
|
10
|
Wieser V, Abdel Azim S, Sprung S, Knoll K, Kögl J, Hackl H, Marth C, Zeimet AG, Fiegl H. TNFα signalling predicts poor prognosis of patients with endometrial cancer. Carcinogenesis 2021; 41:1065-1073. [PMID: 32301486 DOI: 10.1093/carcin/bgaa034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 03/15/2020] [Accepted: 04/03/2020] [Indexed: 02/02/2023] Open
Abstract
Endometrial cancer (EC) is the most common gynaecologic tumour in the Western world. Previous studies have implicated an imbalance of oestrogens and progestogens in the development of most ECs, while the role of low-grade tissue inflammation remains largely unexplored. We investigated the impact of tumour necrosis factor alpha (TNFα), a central mediator of inflammation and spermatogenesis-associated protein 2 (SPATA2), a regulator of TNF receptor signalling, on clinical outcomes in EC. We evaluated TNFA and SPATA2 transcript levels in 239 EC patients and 25 non-malignant control tissues. Findings were validated in a cohort of 332 EC patients from The Cancer Genome Atlas (TCGA). Expression of TNFA and SPATA2 was increased in EC when compared with control tissues (P < 0.001). TNFA expression correlated with SPATA2 expression in non-malignant (P = 0.003, rS = 0.568) and EC tissue (P = 0.005, rS = 0.179). High TNFA and SPATA2 expression were associated with poor recurrence-free survival (RFS; P = 0.049 and P = 0.018) and disease-specific (P = 0.034 and P = 0.002) survival. Increased SPATA2 expression was also associated with decreased overall survival (OS; P = 0.013). In multivariate analysis, both TNFA and SPATA2 were predictors of clinical outcome. The impact of SPATA2 on RFS and OS could be validated in the TCGA cohort. Our study demonstrates that ECs exhibit a TNF signature which predicts clinical outcome. These findings indicate that TNF signalling modulates the course of EC, which could be therapeutically utilized in the future.
Collapse
Affiliation(s)
- Verena Wieser
- Department of Obstetrics and Gynaecology, Medical University of Innsbruck, Innsbruck, Tyrol, Austria
| | - Samira Abdel Azim
- Department of Obstetrics and Gynaecology, Medical University of Innsbruck, Innsbruck, Tyrol, Austria
| | - Susanne Sprung
- Department of Pathology, Medical University of Innsbruck, Innsbruck, Tyrol, Austria
| | - Katharina Knoll
- Department of Obstetrics and Gynaecology, Medical University of Innsbruck, Innsbruck, Tyrol, Austria
| | - Johanna Kögl
- Department of Obstetrics and Gynaecology, Medical University of Innsbruck, Innsbruck, Tyrol, Austria
| | - Hubert Hackl
- Institute of Bioinformatics, Medical University of Innsbruck, Innsbruck, Tyrol, Austria
| | - Christian Marth
- Department of Obstetrics and Gynaecology, Medical University of Innsbruck, Innsbruck, Tyrol, Austria
| | - Alain G Zeimet
- Department of Obstetrics and Gynaecology, Medical University of Innsbruck, Innsbruck, Tyrol, Austria
| | - Heidelinde Fiegl
- Department of Obstetrics and Gynaecology, Medical University of Innsbruck, Innsbruck, Tyrol, Austria
| |
Collapse
|
11
|
Tsibulak I, Wieser V, Welponer H, Leitner K, Hackl H, Marth C, Fiegl H, Zeimet AG. Clinical impact of BRCA2 mRNA expression in high-grade serous ovarian cancer: validation using the TCGA cohort. Acta Oncol 2021; 60:187-190. [PMID: 33147104 DOI: 10.1080/0284186x.2020.1841288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Irina Tsibulak
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Verena Wieser
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Hannah Welponer
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Katharina Leitner
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Hubert Hackl
- Institute of Bioinformatics, Biocenter, Medical University of Innsbruck, Innsbruck, Austria
| | - Christian Marth
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Heidelinde Fiegl
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Alain G. Zeimet
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| |
Collapse
|
12
|
Leitner K, Tsibulak I, Wieser V, Knoll K, Reimer D, Marth C, Fiegl H, Zeimet AG. Clinical impact of EZH2 and its antagonist SMARCA4 in ovarian cancer. Sci Rep 2020; 10:20412. [PMID: 33230143 PMCID: PMC7684284 DOI: 10.1038/s41598-020-77532-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 11/04/2020] [Indexed: 12/13/2022] Open
Abstract
SMARCA4 and EZH2 are two functional key players of their respective antagonizing chromatin remodeling complexes SWI/SNF and PRC2. EZH2 inhibitory drugs may abrogate pro-oncogenic features of PRC2 and turn the balance to cell differentiation via SWI/SNF activity in cancers. SMARCA4 and EZH2 expression was assessed by RT-PCR in 238 epithelial ovarian cancers (OCs) and put in relation to clinico-pathological parameters and patients' outcome. Optimal thresholds for high and low expression of both variables were calculated by the Youden's index based on receiver operating characteristic (ROC) curves. High SMARCA4 mRNA expression was independently associated with favorable progression-free survival (PFS) (P = 0.03) and overall survival (OS) (P = 0.018). As Youden's threshold determination for EZH2 yielded a S-shaped ROC-curve, two cut-off points (29th and 94th percentile) predicting opposite features were defined. Whereas EZH2 mRNA levels beyond the 29th percentile independently predicted poor PFS (P = 0.034), Cox-regression in EZH2 transcripts above the 94th percentile revealed a conversion from unfavorable to favorable PFS and OS (P = 0.009 and P = 0.032, respectively). High SMARCA4 expression associates with improved survival, whereas moderate/high EZH2 expression predicts poor outcome, which converts to favorable survival in ultra-high expressing OCs. This small OC subgroup could be characterized by REV7-abrogated platinum hypersensitivity but concomitant PARP-inhibitor resistance.
Collapse
Affiliation(s)
- Katharina Leitner
- Department of Obstetrics and Gynecology, Innsbruck Medical University, Anichstraße 35, 6020, Innsbruck, Austria
| | - Irina Tsibulak
- Department of Obstetrics and Gynecology, Innsbruck Medical University, Anichstraße 35, 6020, Innsbruck, Austria
| | - Verena Wieser
- Department of Obstetrics and Gynecology, Innsbruck Medical University, Anichstraße 35, 6020, Innsbruck, Austria
| | - Katharina Knoll
- Department of Obstetrics and Gynecology, Innsbruck Medical University, Anichstraße 35, 6020, Innsbruck, Austria
| | - Daniel Reimer
- Department of Obstetrics and Gynecology, Innsbruck Medical University, Anichstraße 35, 6020, Innsbruck, Austria
| | - Christian Marth
- Department of Obstetrics and Gynecology, Innsbruck Medical University, Anichstraße 35, 6020, Innsbruck, Austria
| | - Heidi Fiegl
- Department of Obstetrics and Gynecology, Innsbruck Medical University, Anichstraße 35, 6020, Innsbruck, Austria
| | - Alain G Zeimet
- Department of Obstetrics and Gynecology, Innsbruck Medical University, Anichstraße 35, 6020, Innsbruck, Austria.
| |
Collapse
|
13
|
Pfisterer J, Shannon CM, Baumann K, Rau J, Harter P, Joly F, Sehouli J, Canzler U, Schmalfeldt B, Dean AP, Hein A, Zeimet AG, Hanker LC, Petit T, Marmé F, El-Balat A, Glasspool R, de Gregorio N, Mahner S, Meniawy TM, Park-Simon TW, Mouret-Reynier MA, Costan C, Meier W, Reinthaller A, Goh JC, L'Haridon T, Baron Hay S, Kommoss S, du Bois A, Kurtz JE. Bevacizumab and platinum-based combinations for recurrent ovarian cancer: a randomised, open-label, phase 3 trial. Lancet Oncol 2020; 21:699-709. [PMID: 32305099 DOI: 10.1016/s1470-2045(20)30142-x] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 02/16/2020] [Accepted: 02/17/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND State-of-the art therapy for recurrent ovarian cancer suitable for platinum-based re-treatment includes bevacizumab-containing combinations (eg, bevacizumab combined with carboplatin-paclitaxel or carboplatin-gemcitabine) or the most active non-bevacizumab regimen: carboplatin-pegylated liposomal doxorubicin. The aim of this head-to-head trial was to compare a standard bevacizumab-containing regimen versus carboplatin-pegylated liposomal doxorubicin combined with bevacizumab. METHODS This multicentre, open-label, randomised, phase 3 trial, was done in 159 academic centres in Germany, France, Australia, Austria, and the UK. Eligible patients (aged ≥18 years) had histologically confirmed epithelial ovarian, primary peritoneal, or fallopian tube carcinoma with first disease recurrence more than 6 months after first-line platinum-based chemotherapy, and an Eastern Cooperative Oncology Group performance status of 0-2. Patients were stratified by platinum-free interval, residual tumour, previous antiangiogenic therapy, and study group language, and were centrally randomly assigned 1:1 using randomly permuted blocks of size two, four, or six to receive six intravenous cycles of bevacizumab (15 mg/kg, day 1) plus carboplatin (area under the concentration curve [AUC] 4, day 1) plus gemcitabine (1000 mg/m2, days 1 and 8) every 3 weeks or six cycles of bevacizumab (10 mg/kg, days 1 and 15) plus carboplatin (AUC 5, day 1) plus pegylated liposomal doxorubicin (30 mg/m2, day 1) every 4 weeks, both followed by maintenance bevacizumab (15 mg/kg every 3 weeks in both groups) until disease progression or unacceptable toxicity. There was no masking in this open-label trial. The primary endpoint was investigator-assessed progression-free survival according to Response Evaluation Criteria in Solid Tumors version 1.1. Efficacy data were analysed in the intention-to-treat population. Safety was analysed in all patients who received at least one dose of study drug. This completed study is registered with ClinicalTrials.gov, NCT01837251. FINDINGS Between Aug 1, 2013, and July 31, 2015, 682 eligible patients were enrolled, of whom 345 were randomly assigned to receive carboplatin-pegylated liposomal doxorubicin-bevacizumab (experimental group) and 337 were randomly assigned to receive carboplatin-gemcitabine-bevacizumab (standard group). Median follow-up for progression-free survival at data cutoff (July 10, 2018) was 12·4 months (IQR 8·3-21·7) in the experimental group and 11·3 months (8·0-18·4) in the standard group. Median progression-free survival was 13·3 months (95% CI 11·7-14·2) in the experimental group versus 11·6 months (11·0-12·7) in the standard group (hazard ratio 0·81, 95% CI 0·68-0·96; p=0·012). The most common grade 3 or 4 adverse events were hypertension (88 [27%] of 332 patients in the experimental group vs 67 [20%] of 329 patients in the standard group) and neutropenia (40 [12%] vs 73 [22%]). Serious adverse events occurred in 33 (10%) of 332 patients in the experimental group and 28 (9%) of 329 in the standard group. Treatment-related deaths occurred in one patient in the experimental group (<1%; large intestine perforation) and two patients in the standard group (1%; one case each of osmotic demyelination syndrome and intracranial haemorrhage). INTERPRETATION Carboplatin-pegylated liposomal doxorubicin-bevacizumab is a new standard treatment option for platinum-eligible recurrent ovarian cancer. FUNDING F Hoffmann-La Roche.
Collapse
Affiliation(s)
| | | | - Klaus Baumann
- Gynaecology Department, Klinikum der Stadt Ludwigshafen am Rhein, Ludwigshafen, Germany
| | - Joern Rau
- Coordinating Center for Clinical Trials, Philipps-University, Marburg, Germany
| | - Philipp Harter
- Department of Gynecology and Gynecological Oncology, Kliniken Essen-Mitte, Essen, Germany
| | - Florence Joly
- Gynaecology Department, Centre François Baclesse, Caen, France
| | - Jalid Sehouli
- Department of Gynaecology, and European Competence Center for Ovarian Cancer, Charité - Universitätsmedizin Berlin, Campus Virchow, Berlin, Germany
| | - Ulrich Canzler
- Department of Gynaecology, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Barbara Schmalfeldt
- Technical University of Munich-Klinikum Rechts der Isar, Germany; Department of Gynaecology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Andrew P Dean
- Gynaecological Oncology Department, St John of God Hospital, Subiaco, WA, Australia
| | - Alexander Hein
- Gynaecology Department, Erlangen University Hospital, Erlangen, Germany
| | - Alain G Zeimet
- Department of Obstetrics and Gynaecology, Innsbruck Medical University, Innsbruck, Austria
| | - Lars C Hanker
- Gynaecology Department, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Thierry Petit
- Paul Strauss Cancer Center and Gynaecology Department, University of Strasbourg, Strasbourg, France
| | - Frederik Marmé
- Gynaecology Department, National Center for Tumor Disease, University of Heidelberg, Heidelberg, Germany; Department of Gynaecology and Obstetrics, University Hospital Mannheim, Mannheim, Germany
| | - Ahmed El-Balat
- Department of Gynaecology and Obstetrics, University of Frankfurt/Main, Frankfurt, Germany
| | - Rosalind Glasspool
- National Cancer Research Institute, Beatson West of Scotland Cancer Centre and University of Glasgow, Glasgow, UK
| | | | - Sven Mahner
- Department of Gynaecology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Obstetrics and Gynaecology, University Hospital, Ludwig-Maximilian-University, Munich, Germany
| | - Tarek M Meniawy
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Tjoung-Won Park-Simon
- Department of Gynaecology and Obstetrics, Medical University Hannover, Hannover, Germany
| | | | | | - Werner Meier
- Department of Gynaecology and Obstetrics, Evangelisches Krankenhaus Düsseldorf, Germany; Department of Gynaecology and Obstetrics, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Alexander Reinthaller
- Department of Gynecology and Gynecologic Oncology, Comprehensive Cancer Centre, University Hospital for Gynaecology, Medical University Vienna, Vienna, Austria
| | - Jeffrey C Goh
- Royal Brisbane & Women's Hospital, Brisbane, QLD, Australia
| | - Tifenn L'Haridon
- Centre Hospitalier Départemental les Oudairies, La Roche-Sur-Yon, France
| | - Sally Baron Hay
- Women's Health, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Stefan Kommoss
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - Andreas du Bois
- Department of Gynecology and Gynecological Oncology, Kliniken Essen-Mitte, Essen, Germany
| | - Jean-Emmanuel Kurtz
- Haematology-Oncology Department, Centre Hospitalier Régional et Universitaire de Strasbourg Hôpital Civil, Strasbourg, France
| | | |
Collapse
|
14
|
Steinkasserer L, Zeimet AG, Marth C. Wirksamkeit der Ovarialkarzinom-Früherkennung: Eine Simulationsstudie basierend auf Daten aus dem Klinischen Tumorregister der AGO. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0039-3403399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- L Steinkasserer
- Universitätsklinik für Frauenheilkunde der Medizinischen Universität Innsbruck
| | - A G Zeimet
- Universitätsklinik für Frauenheilkunde der Medizinischen Universität Innsbruck
| | - C Marth
- Universitätsklinik für Frauenheilkunde der Medizinischen Universität Innsbruck
| |
Collapse
|
15
|
Reiser E, Hagenbuchner J, Ausserlechner MJ, Kyvelidou C, Seeber B, Sopper S, Tsibulak I, Wieser V, Roessler J, Marth C, Zeimet AG, Fiegl H. Effekte von D,L-Methadon auf Tumor Sphäroide von Ovarialkarzinompatientinnen. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0039-3403396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- E Reiser
- Universitätsklinik für Gynäkologie und Geburtshilfe der Med. Universität Innsbruck
| | - J Hagenbuchner
- Department für Kinder- und Jugendheilkunde, Pädiatrie II der Med. Universität Innsbruck
| | - M J Ausserlechner
- Department für Kinder- und Jugendheilkunde, Pädiatrie II der Med. Universität Innsbruck
| | - C Kyvelidou
- Universitätsklinik für Gynäkologische Endokrinologie und Reproduktionsmedizin der Med. Universität Innsbruck
| | - B Seeber
- Universitätsklinik für Gynäkologische Endokrinologie und Reproduktionsmedizin der Med. Universität Innsbruck
| | - S Sopper
- Internal Medicine V, der Med. Universität Innsbruck
- Tiroler Krebsforschungsinstitut
| | - I Tsibulak
- Universitätsklinik für Gynäkologie und Geburtshilfe der Med. Universität Innsbruck
| | - V Wieser
- Universitätsklinik für Gynäkologie und Geburtshilfe der Med. Universität Innsbruck
| | - J Roessler
- Universitätsklinik für Gynäkologie und Geburtshilfe der Med. Universität Innsbruck
| | - C Marth
- Universitätsklinik für Gynäkologie und Geburtshilfe der Med. Universität Innsbruck
| | - A G Zeimet
- Universitätsklinik für Gynäkologie und Geburtshilfe der Med. Universität Innsbruck
| | - H Fiegl
- Universitätsklinik für Gynäkologie und Geburtshilfe der Med. Universität Innsbruck
| |
Collapse
|
16
|
Wolf D, Fiegl H, Zeimet AG, Wieser V, Marth C, Sprung S, Sopper S, Hartmann G, Reimer D, Boesch M. High RIG-I expression in ovarian cancer associates with an immune-escape signature and poor clinical outcome. Int J Cancer 2020; 146:2007-2018. [PMID: 31800094 PMCID: PMC7028124 DOI: 10.1002/ijc.32818] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [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: 07/31/2019] [Revised: 10/28/2019] [Accepted: 11/25/2019] [Indexed: 12/25/2022]
Abstract
Ovarian cancer (OC) is the most lethal gynecological malignancy, with platinum-based chemotherapy remaining the mainstay for adjuvant treatment after surgery. The lack of indication for immunotherapy may at least in part result from the lack of suitable biomarkers allowing stratification of potentially responding patients. In this monocentric study of 141 cases with OC, we used real-time quantitative PCR to assess the expression of retinoic acid-inducible gene-I (RIG-I) in primary tumor and healthy ovarian control tissues. RIG-I expression was correlated to various clinicopathological characteristics as well as to a set of molecular and immunological markers. The prognostic significance of RIG-I expression was queried in univariate and multivariate analyses and validated in an independent cohort. RIG-I was overexpressed in the cancerous ovary and correlated with a higher tumor grade. The more aggressive Type-II cancers and cancers with inactivating p53 mutations exhibited higher RIG-I expression. RIG-I levels were also elevated in cancers that recurred after remission or were platinum-refractory. Survival analyses disclosed RIG-I as an independent marker of poor outcome in OC. Continuative analyses revealed the molecular and immunological correlates of RIG-I expression in the tumor microenvironment, including interferon production and a distinct immune-regulatory signature involving checkpoint molecules (PD-L1/PD-1), the RNA-editing enzyme ADAR1 and the regulatory T cell-specific transcription factor FoxP3. We conclude that high RIG-I expression associates with poor outcome in OC, which is explainable by local immunosuppression in the tumor bed. RIG-I expression may inform checkpoint blockade and/or RIG-I agonistic targeting in a subset of high-risk OC patients.
Collapse
Affiliation(s)
- Dominik Wolf
- Internal Medicine VMedical University of InnsbruckInnsbruckAustria
- Medical Clinic III, Oncology, Hematology, Immuno‐Oncology and RheumatologyUniversity Clinic BonnBonnGermany
| | - Heidi Fiegl
- Department of Gynecology and ObstetricsMedical University of InnsbruckInnsbruckAustria
| | - Alain G. Zeimet
- Department of Gynecology and ObstetricsMedical University of InnsbruckInnsbruckAustria
| | - Verena Wieser
- Department of Gynecology and ObstetricsMedical University of InnsbruckInnsbruckAustria
| | - Christian Marth
- Department of Gynecology and ObstetricsMedical University of InnsbruckInnsbruckAustria
| | - Susanne Sprung
- Department of PathologyMedical University of InnsbruckInnsbruckAustria
| | - Sieghart Sopper
- Internal Medicine VMedical University of InnsbruckInnsbruckAustria
- Tyrolean Cancer Research InstituteInnsbruckAustria
| | - Gunther Hartmann
- Institute of Clinical Chemistry and Clinical PharmacologyUniversity Clinic BonnBonnGermany
| | - Daniel Reimer
- Department of Gynecology and ObstetricsMedical University of InnsbruckInnsbruckAustria
| | | |
Collapse
|
17
|
Wieser V, Abdel Azim S, Kögl J, Knoll K, Tsibulak I, Marth C, Fiegl H, Zeimet AG. Tumornekrosefaktor definiert Outcome des Endometriumkarzinoms. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0039-3403404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- V Wieser
- Universitätsklinik für Frauenheilkunde und Geburtshilfe Innsbruck, Medizinische Universität Innsbruck
| | - S Abdel Azim
- Universitätsklinik für Frauenheilkunde und Geburtshilfe Innsbruck, Medizinische Universität Innsbruck
| | - J Kögl
- Universitätsklinik für Frauenheilkunde und Geburtshilfe Innsbruck, Medizinische Universität Innsbruck
| | - K Knoll
- Universitätsklinik für Frauenheilkunde und Geburtshilfe Innsbruck, Medizinische Universität Innsbruck
| | - I Tsibulak
- Universitätsklinik für Frauenheilkunde und Geburtshilfe Innsbruck, Medizinische Universität Innsbruck
| | - C Marth
- Universitätsklinik für Frauenheilkunde und Geburtshilfe Innsbruck, Medizinische Universität Innsbruck
| | - H Fiegl
- Universitätsklinik für Frauenheilkunde und Geburtshilfe Innsbruck, Medizinische Universität Innsbruck
| | - A G Zeimet
- Universitätsklinik für Frauenheilkunde und Geburtshilfe Innsbruck, Medizinische Universität Innsbruck
| |
Collapse
|
18
|
Leitner K, Wieser V, Tsibulak I, Knoll K, Kögl J, Reimer D, Marth C, Fiegl H, Zeimet AG. Die Expression der Histon-Methyltransferase EZH2 beim Ovarialkarziom. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0039-3403392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- K Leitner
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Innsbruck
| | - V Wieser
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Innsbruck
| | - I Tsibulak
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Innsbruck
| | - K Knoll
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Innsbruck
| | - J Kögl
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Innsbruck
| | - D Reimer
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Innsbruck
| | - C Marth
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Innsbruck
| | - H Fiegl
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Innsbruck
| | - A G Zeimet
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Innsbruck
| |
Collapse
|
19
|
Kögl J, Wieser V, Knoll K, Leitner K, Tsibulak I, Fiegl H, Marth C, Zeimet AG. Hochregulation von PDL-1 Expression durch EGF und Zytokine in der Ovarialkarzinom-Zelllinie (HOC-7). Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0039-3403391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- J Kögl
- Universitätsklinik für Gynäkologie und Geburtshilfe, Medizinische Universität Innsbruck
| | - V Wieser
- Universitätsklinik für Gynäkologie und Geburtshilfe, Medizinische Universität Innsbruck
| | - K Knoll
- Universitätsklinik für Gynäkologie und Geburtshilfe, Medizinische Universität Innsbruck
| | - K Leitner
- Universitätsklinik für Gynäkologie und Geburtshilfe, Medizinische Universität Innsbruck
| | - I Tsibulak
- Universitätsklinik für Gynäkologie und Geburtshilfe, Medizinische Universität Innsbruck
| | - H Fiegl
- Universitätsklinik für Gynäkologie und Geburtshilfe, Medizinische Universität Innsbruck
| | - C Marth
- Universitätsklinik für Gynäkologie und Geburtshilfe, Medizinische Universität Innsbruck
| | - A G Zeimet
- Universitätsklinik für Gynäkologie und Geburtshilfe, Medizinische Universität Innsbruck
| |
Collapse
|
20
|
Luger AK, Steinkohl F, Aigner F, Jaschke W, Marth C, Zeimet AG, Reimer D. Enlarged cardiophrenic lymph nodes predict disease involvement of the upper abdomen and the outcome of primary surgical debulking in advanced ovarian cancer. Acta Obstet Gynecol Scand 2020; 99:1092-1099. [PMID: 32112653 PMCID: PMC7496971 DOI: 10.1111/aogs.13835] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 02/21/2020] [Accepted: 02/26/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The outcome of ovarian cancer patients is highly dependent on the success of primary debulking surgery in terms of postoperative residual disease. This study critically evaluates the clinical impact of preoperative radiologic assessment of the cardiophrenic lymph node (CPLN) status in advanced ovarian cancer. MATERIAL AND METHODS Baseline CT scans of 178 stage III and IV ovarian cancer patients were retrospectively reviewed by two independent radiologists. CPLN enlargement defined at a short-axis ≥5 mm was evaluated for its prognostic value and predictive power of upper abdominal tumor involvement and the chance of complete intra-abdominal tumor resection at primary debulking surgery. Only patients without surgically removed CPLN were eligible for this study. RESULTS Enlarged CPLNs were detected in 50% of patients and correlated with radiologically suspicious (P = .028) and histologically confirmed (P = .001) paraaortic lymph node metastases. CPLNs ≥ 5 mm were associated with high CA-125 levels at baseline and revealed independent prognostic relevance for progression-free survival (hazard ratio [HR] 2.14, 95% confidence interval [CI] 1.33-3.42) and overall survival (HR 2.18, 95% CI 1.16-4.08). Noteworthy, patients with enlarged CPLNs nonetheless benefit from complete intra-abdominal tumor debulking in terms of an improvement in progression-free survival (HR 0.60, 95% CI 0.38-0.94) and overall survival (HR 0.59, 95% CI 0.35-0.82). Enlarged CPLNs correctly predicted carcinomatosis of the upper abdomen in 94.6%. A predictive score of complete tumor debulking, termed CD-score, which integrates, beside a CPLN short axis <5 mm, an ascites volume <500 mL, and CA-125 levels <500 U/mL at baseline, correctly predicted complete intra-abdominal debulking in 100% of patients. CONCLUSIONS CPLNs ≥5 mm predict upper abdominal tumor involvement. The application of the CD-score predicted complete macroscopic tumor resection at primary surgery in all of the patients. Although, CPLN pathology suggests extra-abdominal disease, we consistently demonstrated that patients nonetheless benefit from complete intra-abdominal tumor resection.
Collapse
Affiliation(s)
- Anna K Luger
- Department of Radiology, Innsbruck Medical University, Innsbruck, Austria
| | - Fabian Steinkohl
- Department of Radiology, Innsbruck Medical University, Innsbruck, Austria
| | - Friedrich Aigner
- Department of Radiology, Innsbruck Medical University, Innsbruck, Austria
| | - Werner Jaschke
- Department of Radiology, Innsbruck Medical University, Innsbruck, Austria
| | - Christian Marth
- Department of Obstetrics and Gynecology, Innsbruck Medical University, Innsbruck, Austria
| | - Alain G Zeimet
- Department of Obstetrics and Gynecology, Innsbruck Medical University, Innsbruck, Austria
| | - Daniel Reimer
- Department of Obstetrics and Gynecology, Innsbruck Medical University, Innsbruck, Austria
| |
Collapse
|
21
|
Welponer H, Tsibulak I, Wieser V, Degasper C, Shivalingaiah G, Wenzel S, Sprung S, Marth C, Hackl H, Fiegl H, Zeimet AG. The miR-34 family and its clinical significance in ovarian cancer. J Cancer 2020; 11:1446-1456. [PMID: 32047551 PMCID: PMC6995379 DOI: 10.7150/jca.33831] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 11/20/2019] [Indexed: 12/14/2022] Open
Abstract
The tumor suppressor miR-34 family is transcriptionally induced by p53. Clinical significance of the various miR-34 family members has not been studied in ovarian cancer. In 228 ovarian cancers and in 19 non-neoplastic fallopian tube samples we analysed miR-34 a/b/c expression in relation to clinicopathological characteristics and clinical outcome. We found significantly lower levels of miR-34 a/b/c in ovarian cancers as compared to control-tissues (P=0.002, P<0.001, P<0.001, respectively). Expression of miR-34 b/c revealed an inverse correlation with BRCA1/2 mRNA-expression (BRCA1: miR34 b/c P=0.002 each; BRCA2: miR-34 b/c P<0.001 each), the same was true for miR-34a and BRCA2 mRNA-expression (P<0.001). The miR-34 family expression was found to be significantly lower in type 2 in comparison to type 1 cancers (P<0.001) and in TP53-mutated compared with TP53-wild-type ovarian cancers (P<0.001, P=0.002, P=0.004, respectively). When low grade serous ovarian cancers were compared with high grade serous cancers the respective miR-34 a/b/c expression was 2.6-, 40.8- and 32.3-fold higher. The expression of each of the miR-34 family members was revealed to be of independent prognostic relevance regarding progression free survival (PFS); miR-34a: HR 0.6, P=0.033; miR-34b: HR 0.2, P=0.001 and miR-34c: HR 0.3, P=0.002, respectively). For overall survival (OS) independency of the prognostic value was confined to miR-34b (HR 0.4, P=0.016) and miR-34c (HR 0.6, P=0.049). The independency of the prognostic value of our identified thresholds was confirmed for PFS for miR-34c in a publicly available dataset (NCBI Gene Expression Omnibus GSE73582). Our findings suggest that downregulation of miR-34 family is a crucial part in ovarian cancer development. Low miR-34 levels are linked to a worse overall survival and progression free survival and may indicate a more aggressive disease.
Collapse
Affiliation(s)
- Hannah Welponer
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Tyrol, 6020, Austria
| | - Irina Tsibulak
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Tyrol, 6020, Austria
| | - Verena Wieser
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Tyrol, 6020, Austria
| | - Christine Degasper
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Tyrol, 6020, Austria
| | - Giridhar Shivalingaiah
- Division of Human Genetics, Medical University of Innsbruck, Innsbruck, Tyrol, 6020, Austria
| | - Sören Wenzel
- Division of Human Genetics, Medical University of Innsbruck, Innsbruck, Tyrol, 6020, Austria
| | - Susanne Sprung
- Institute of Pathology, Medical University of Innsbruck, Innsbruck, Tyrol, 6020, Austria
| | - Christian Marth
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Tyrol, 6020, Austria
| | - Hubert Hackl
- Biocenter, Division of Bioinformatics, Medical University of Innsbruck, Innsbruck, Tyrol, 6020, Austria
| | - Heidelinde Fiegl
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Tyrol, 6020, Austria
| | - Alain G Zeimet
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Tyrol, 6020, Austria
| |
Collapse
|
22
|
Oskay-Özcelik G, Alavi S, Richter R, Keller M, Chekerov R, Cecere SC, Cormio G, Joly F, Kurtz JE, du Bois A, Maciejewski M, Jedryka M, Vergote I, Van Nieuwenhuysen E, Casado A, Mendiola C, Achimas-Cadariu P, Vlad C, Reimer D, Zeimet AG, Friedlander M, Sehouli J. Expression III: patients' expectations and preferences regarding physician-patient relationship and clinical management-results of the international NOGGO/ENGOT-ov4-GCIG study in 1830 ovarian cancer patients from European countries. Ann Oncol 2019; 29:910-916. [PMID: 29415128 DOI: 10.1093/annonc/mdy037] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Backround The primary aim of this study was to investigate information needs and treatment preferences of patients with ovarian cancer, focusing especially on physician-patient relationship and treatment. Patients and methods A questionnaire was developed based on the experiences of the national German survey 'Expression II', and was provided to patients with ovarian cancer either at initial diagnosis or with recurrent disease via Internet (online-version) or as print-out-version. Results From December 2009 to October 2012, a total of 1830 patients with ovarian cancer from eight European countries (Austria, Belgium, France, Germany, Italy, Poland, Romania, Spain) participated, 902 (49.3%) after initial diagnosis and 731 (39.9%) with recurrent ovarian cancer. The median age was 58 years (range 17-89). Nearly all patients (96.2%) had experienced upfront surgery followed by first-line chemotherapy (91.8%). The majority of patients were satisfied with the completeness and comprehensibility of the explanation about the diagnosis and treatment options. The three most important aspects, identified by patients to improve the treatment for ovarian cancer included: 'the therapy should not induce alopecia' (42%), 'there must be more done to counter fatigue' (34.5%) and 'the therapy should be more effective' (29.7%). Out of 659 (36%) patients, who were offered participation in a clinical trial, 476 (26%) were included. Conclusion This study underlines the high need of patients with ovarian cancer for all details concerning treatment options irrespective of their cultural background, the stage of disease and the patient's age. Increased information requirements regarding potential side effects and treatment alternatives were recorded. Besides the need for more effective therapy, alopecia and fatigue are the most important side effects of concern to patients.
Collapse
Affiliation(s)
- G Oskay-Özcelik
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Department of Gynecology, Charité European Competence Center for Ovarian Cancer, Berlin; North-Eastern German Society of Gynecological Oncology (NOGGO), Berlin, Germany
| | - S Alavi
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Department of Gynecology, Charité European Competence Center for Ovarian Cancer, Berlin; North-Eastern German Society of Gynecological Oncology (NOGGO), Berlin, Germany
| | - R Richter
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Department of Gynecology, Charité European Competence Center for Ovarian Cancer, Berlin
| | - M Keller
- North-Eastern German Society of Gynecological Oncology (NOGGO), Berlin, Germany
| | - R Chekerov
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Department of Gynecology, Charité European Competence Center for Ovarian Cancer, Berlin; North-Eastern German Society of Gynecological Oncology (NOGGO), Berlin, Germany
| | - S C Cecere
- Division of Medical Oncolog, Department of Uro-Gynaecological Oncology, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", Naples, Italy
| | - G Cormio
- Department of Biomedical Science and Human Oncolog, Obstetrics and Gynecology Unit, University of Bari, Bari, Italy
| | - F Joly
- Department of Medical Oncolog, Centre Francois Baclesse, Universite Basse Normandie, Caen, France
| | - J E Kurtz
- Oncology and Hematology, Hôpitaux Universitaires de Strasbourg, Strasbourg
| | - A du Bois
- Deptartment of Gynecology and Gynecologic Oncology, Kliniken Essen Mitte (KEM), Essen, Germany
| | - M Maciejewski
- Dolnoslaskie Centrum onkologii/Oddzial Ginekologii Onkologicznej, Wroclaw, Poland
| | - M Jedryka
- Department of Oncology and Gynaecological Oncology Clinic, Wroclaw Medical University, Wroclaw, Poland
| | - I Vergote
- Division of Gynaecological Oncol, Leuven Cancer Institute, Department of Gynaecology and Obstetrics, Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, Leuven, Belgium
| | - E Van Nieuwenhuysen
- Division of Gynaecological Oncol, Leuven Cancer Institute, Department of Gynaecology and Obstetrics, Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, Leuven, Belgium
| | - A Casado
- Department of Medical Oncology, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - C Mendiola
- University Hospital 12 de Octubre, Madrid, Spain
| | - P Achimas-Cadariu
- Department of Surgery, The Oncology Institute Ion Chiricuţă, Cluj-Napoca, Romania; Department of Surgery and Gynecologic Oncology, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - C Vlad
- Department of Surgery, The Oncology Institute Ion Chiricuţă, Cluj-Napoca, Romania; Department of Surgery and Gynecologic Oncology, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - D Reimer
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - A G Zeimet
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - M Friedlander
- Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - J Sehouli
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Department of Gynecology, Charité European Competence Center for Ovarian Cancer, Berlin; North-Eastern German Society of Gynecological Oncology (NOGGO), Berlin, Germany.
| |
Collapse
|
23
|
Tsibulak I, Zeimet AG, Marth C. Hopes and failures in front-line ovarian cancer therapy. Crit Rev Oncol Hematol 2019; 143:14-19. [PMID: 31449982 DOI: 10.1016/j.critrevonc.2019.08.002] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 08/07/2019] [Accepted: 08/09/2019] [Indexed: 10/26/2022] Open
Abstract
Through the last three decades, the combination of paclitaxel and carboplatin remains the standard of care chemotherapy in newly diagnosed epithelial ovarian cancer (EOC). Based on a single trial, first-line maintenance therapy with angiogenesis inhibitor bevacizumab was approved in Europe and widely applied. In 2018, based on a second trial bevacizumab was approved for first-line maintenance in the United States. Despite complete remission upon chemotherapy, the majority of the patients recur. A large number of randomized trials were conducted to explore the optimal front-line therapy regimen, but neither dose-densing, nor adding of a third chemotherapy agent or intraperitoneal administration could improve overall survival (OS). Also implementation of hyperthermic intraperitoneal chemotherapy (HIPEC) or the neoadjuvant approach failed to improve OS. Recently, maintenance therapy with PARP inhibitors showed encouraging results in patients with BRCA1/2 mutation. Further trials with targeted therapies are ongoing. Here we review the achievements of front-line therapy in primary advanced EOC through the last three decades and discuss future treatment strategies.
Collapse
Affiliation(s)
- Irina Tsibulak
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria.
| | - Alain G Zeimet
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria.
| | - Christian Marth
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria.
| |
Collapse
|
24
|
Concin N, Lorusso D, Braicu I, Ray-Coquard IL, Joly F, Harter P, Wimberger P, Lotz JP, Zeimet AG, Scambia G, Schmalfeldt B, Zamagni C, Raspagliesi F, Mustea A, Ulmer H, Kramer D, Dobbelstein M, Pujade-Lauraine E, Sehouli J, Vergote I. EUDARIO/ENGOTov-48: A European multicenter randomised phase II trial on the combination of the HSP90 inhibitor ganetespib with carboplatin followed by maintenance treatment with niraparib (+/- ganetespib) compared to platinum-based combination-chemotherapy followed by niraparib in relapsed platinum-sensitive ovarian cancer patients. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.tps5605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS5605 Background: Carboplatin (C) mainly acts by forming interstrand crosslinks (ICL) within the DNA double helix, which can only be removed by the Fanconi Anemia (FA) pathway. HSP90 inhibitors destabilise a number of HSP90 client proteins, such as those governing the FA DNA repair pathway and the G2/M checkpoint (e.g. Chk1 and Wee1). Kramer et al. (Cell Death Differ, 2017) showed that the HSP90 inhibitor Ganetespib (G) virtually eliminates a functional FA DNA repair complex, therewith preventing the repair of DNA ICL in vitro and vivo. In parallel, G abrogated Chk1 and Wee1 expression and circumvented a G2/M arrest. Consequently, cells with unrepaired DNA damage rushed into mitosis, which resulted in massive tumour cell death. Furthermore, HSP90 inhibition has been shown to reduce the amount of BRCA1 in the cell therewith broadening sensitivity towards PARPi and preventing acquired PARP resistance. Our trial approach is tested in ovarian carcinomas with a mutant p53 background. EUDARIO (EUDRACT 017-004058-40) is funded by the European Commission (FP7 project GANNET53). Methods: Eligible patients have relapsed platinum-sensitive ovarian cancer, no limits in prior lines, high-grade (but clear cell) histology or carcinosarcoma, disease measurable or evaluable according to RECIST 1.1. Patients are randomised into 3 treatment arms (1:1:1), a) control arm: C+Gemcitabine or C+Paclitaxel (q3w, 6 cycles, investigator`s choice) followed by Niraparib, b+c) 2 experimental arms: C (AUC5, d1) + G (150mg/m2, d1) q3w 6 cycles followed by either Niraparib alone (arm b) or by Niraparib+G (arm c; G at 100mg/m2 weekly, limited to 9 months). Niraparib (200/300mg/day) is given in case of SD, PR or CR after platinum-based treatment until disease progression. The main analysis will combine both experimental arms b+c and jointly compare them against arm a using log-rank test. Primary endpoint is PFS, secondary endpoints are PFS2, TFST, TSST, safety, ORR, PRO, OS. The first patient was dosed in January 2019. Clinical trial information: NCT03783949.
Collapse
Affiliation(s)
| | - Domenica Lorusso
- Fondazione Policlinico Universitario A. Gemelli IRCCS and MITO, Rome, Italy
| | - Ioana Braicu
- Charité University Department of Gynecology, Campus Virchow Clinic, Berlin, Germany
| | | | | | - Philipp Harter
- Kliniken Essen-Mitte, Evangelische Huyssens-Stiftung/Knappschaft GmbH, Essen, Germany
| | - Pauline Wimberger
- Department of Gynecology and Obstetrics, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Jean-Pierre Lotz
- Medical Oncology Department, Hospital Tenon (AP-HP), Paris, France
| | - Alain G Zeimet
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Giovanni Scambia
- Fondazione Policlinico Universitario A Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | | | | | - Alexander Mustea
- University Medicine Greifswald, Department of Gynaecology and Obstetrics, Greifswald, Germany
| | - Hanno Ulmer
- Innsbruck Medical University, Innsbruck, Austria
| | - Daniela Kramer
- Interfaculty Institute for Biochemistry University of Tübingen, Tübingen, Germany
| | - Matthias Dobbelstein
- Institute of Molecular Oncology, Faculty of Medicine, University of Göttingen, Göttingen, Germany
| | | | | | | |
Collapse
|
25
|
Welponer H, Tsibulak I, Wieser V, Degasper C, Shivalingaiah G, Wenzel S, Sprung S, Marth C, Fiegl H, Zeimet AG. Die klinische Relevanz der miR-34 Familie beim Ovarialkarzinom. Geburtshilfe Frauenheilkd 2019. [DOI: 10.1055/s-0039-1682000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- H Welponer
- Universitätsklinik für Gynäkologie und Geburtshilfe, Medizinische Universität Innsbruck
| | - I Tsibulak
- Universitätsklinik für Gynäkologie und Geburtshilfe, Medizinische Universität Innsbruck
| | - V Wieser
- Universitätsklinik für Gynäkologie und Geburtshilfe, Medizinische Universität Innsbruck
| | - C Degasper
- Universitätsklinik für Gynäkologie und Geburtshilfe, Medizinische Universität Innsbruck
| | - G Shivalingaiah
- Division für Humangenetik, Medizinische Universität Innsbruck
| | - S Wenzel
- Division für Humangenetik, Medizinische Universität Innsbruck
| | - S Sprung
- Institut für Pathologie, Medizinische Universität Innsbruck
| | - C Marth
- Universitätsklinik für Gynäkologie und Geburtshilfe, Medizinische Universität Innsbruck
| | - H Fiegl
- Universitätsklinik für Gynäkologie und Geburtshilfe, Medizinische Universität Innsbruck
| | - AG Zeimet
- Universitätsklinik für Gynäkologie und Geburtshilfe, Medizinische Universität Innsbruck
| |
Collapse
|
26
|
Leitner K, Wieser V, Tsibulak I, Degasper C, Welponer H, Reimer D, Wiedemair A, Marth C, Fiegl H, Zeimet AG. Die Expression von SMARCA4 beim Ovarialkarzinom. Geburtshilfe Frauenheilkd 2019. [DOI: 10.1055/s-0039-1681992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- K Leitner
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Innsbruck
| | - V Wieser
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Innsbruck
| | - I Tsibulak
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Innsbruck
| | - C Degasper
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Innsbruck
| | - H Welponer
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Innsbruck
| | - D Reimer
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Innsbruck
| | - A Wiedemair
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Innsbruck
| | - C Marth
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Innsbruck
| | - H Fiegl
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Innsbruck
| | - AG Zeimet
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Innsbruck
| |
Collapse
|
27
|
Knoll K, Berger A, Tsibulak I, Leitner K, Degasper C, Welploner H, Wieser V, Marth C, Fiegl H, Zeimet AG. Locusspezifische TP53-Mutationsanalyse. Geburtshilfe Frauenheilkd 2019. [DOI: 10.1055/s-0039-1681990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- K Knoll
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Innsbruck
| | - A Berger
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Innsbruck
| | - I Tsibulak
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Innsbruck
| | - K Leitner
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Innsbruck
| | - C Degasper
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Innsbruck
| | - H Welploner
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Innsbruck
| | - V Wieser
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Innsbruck
| | - C Marth
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Innsbruck
| | - H Fiegl
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Innsbruck
| | - AG Zeimet
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Innsbruck
| |
Collapse
|
28
|
Wieser V, Tsibulak I, Degasper C, Welponer H, Leitner K, Sprung S, Haybäck J, Fiegl H, Marth C, Zeimet AG. RANKL als unabhängiger Prognoseparameter für Patientinnen mit Ovarialkarzinom. Geburtshilfe Frauenheilkd 2019. [DOI: 10.1055/s-0039-1682001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- V Wieser
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Innsbruck
| | - I Tsibulak
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Innsbruck
| | - C Degasper
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Innsbruck
| | - H Welponer
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Innsbruck
| | - K Leitner
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Innsbruck
| | - S Sprung
- Institute für Pathologie der Med. Universität Innsbruck
| | - J Haybäck
- Institute für Pathologie der Med. Universität Innsbruck
| | - H Fiegl
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Innsbruck
| | - C Marth
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Innsbruck
| | - AG Zeimet
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Innsbruck
| |
Collapse
|
29
|
Tsibulak I, Hackl H, Wieser V, Degasper C, Fiegl H, Marth C, Zeimet AG. BRCA2 mRNA-Expression als prognostisch relevanter Faktor beim Ovarialkarzinom: Validierung an der TCGA-Kohorte. Geburtshilfe Frauenheilkd 2019. [DOI: 10.1055/s-0039-1681998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- I Tsibulak
- Univ. Klinik für Gynäkologie und Geburtshilfe, Medizinische Universität Innsbruck
| | - H Hackl
- Sektion für Bioinformatik, Medizinische Universität Innsbruck
| | - V Wieser
- Univ. Klinik für Gynäkologie und Geburtshilfe, Medizinische Universität Innsbruck
| | - C Degasper
- Univ. Klinik für Gynäkologie und Geburtshilfe, Medizinische Universität Innsbruck
| | - H Fiegl
- Univ. Klinik für Gynäkologie und Geburtshilfe, Medizinische Universität Innsbruck
| | - C Marth
- Univ. Klinik für Gynäkologie und Geburtshilfe, Medizinische Universität Innsbruck
| | - AG Zeimet
- Univ. Klinik für Gynäkologie und Geburtshilfe, Medizinische Universität Innsbruck
| |
Collapse
|
30
|
Degasper C, Brunner A, Sampson N, Tsibulak I, Wieser V, Welponer H, Marth C, Fiegl H, Zeimet AG. NADPH oxidase (NOX4) im normalen Endometrium und im Endometriumkarzinom. Geburtshilfe Frauenheilkd 2019. [DOI: 10.1055/s-0039-1681987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- C Degasper
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Innsbruck
| | - A Brunner
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Innsbruck
| | - N Sampson
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Innsbruck
| | - I Tsibulak
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Innsbruck
| | - V Wieser
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Innsbruck
| | - H Welponer
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Innsbruck
| | - C Marth
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Innsbruck
| | - H Fiegl
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Innsbruck
| | - AG Zeimet
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Innsbruck
| |
Collapse
|
31
|
Wieser V, Tsibulak I, Degasper C, Welponer H, Leitner K, Parson W, Zeimet AG, Marth C, Fiegl H. Tumor necrosis factor receptor modulator spermatogenesis-associated protein 2 is a novel predictor of outcome in ovarian cancer. Cancer Sci 2019; 110:1117-1126. [PMID: 30697874 PMCID: PMC6398874 DOI: 10.1111/cas.13955] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 01/09/2019] [Accepted: 01/15/2019] [Indexed: 01/08/2023] Open
Abstract
Inflammation plays a crucial role in the pathogenesis of cancer with tumor necrosis factor-α (TNF-α) as a key mediator. Recently, spermatogenesis-associated protein 2 (SPATA2) was identified as a TNF receptor modulator which is required for TNF-induced inflammation and apoptosis. The available data on TNF-α in ovarian cancer (OC) are inconsistent, and SPATA2 is completely uncharacterized in tumorigenesis. We analyzed expression of SPATA2 and TNFA by quantitative real-time polymerase chain reaction in tissues of 171 patients with low-grade serous (LGSOC), high-grade serous (HGSOC), endometrioid and clear cell OC compared with 28 non-malignant control tissues. We stimulated OC cells (OVCAR3) with pro-inflammatory (TNF-α, interleukin [IL]-1β) and mitogenic stimuli (IL-6, lysophosphatidic acid) to establish a direct effect between inflammatory signaling and SPATA2. Pro-inflammatory, but not mitogenic stimuli, potently induced SPATA2 expression in OC cells. Expression of TNFA and SPATA2 was higher in OC compared with control tissues (P = 0.010 and P = 0.001, respectively) and correlated with each other (P = 0.034, rs = 0.198). When compared with grade 1 cancers, SPATA2 was expressed higher in grade 2 and 3 tumors (P = 0.011) as well as in HGSOC compared with LGSOC (P = 0.024). Multivariate survival analyses revealed that OC with high SPATA2 expression were associated with reduced progression-free survival (P = 0.048) and overall survival (P < 0.001). In conclusion, SPATA2 expression is regulated by TNF-α and IL-1β and is found to independently affect clinical outcome in OC patients. These data implicate a role of SPATA2 in tumorigenesis which warrants further investigation in gynecological malignancies.
Collapse
Affiliation(s)
- Verena Wieser
- Department of Obstetrics and Gynaecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Irina Tsibulak
- Department of Obstetrics and Gynaecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Christine Degasper
- Department of Obstetrics and Gynaecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Hannah Welponer
- Department of Obstetrics and Gynaecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Katharina Leitner
- Department of Obstetrics and Gynaecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Walther Parson
- Institute of Legal Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - Alain G Zeimet
- Department of Obstetrics and Gynaecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Christian Marth
- Department of Obstetrics and Gynaecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Heidelinde Fiegl
- Department of Obstetrics and Gynaecology, Medical University of Innsbruck, Innsbruck, Austria
| |
Collapse
|
32
|
Marth C, Wieser V, Tsibulak I, Zeimet AG. Immunotherapy in ovarian cancer: fake news or the real deal? Int J Gynecol Cancer 2019; 29:201-211. [DOI: 10.1136/ijgc-2018-000011] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 09/26/2018] [Accepted: 09/28/2018] [Indexed: 01/01/2023] Open
Abstract
Cancer immunotherapy has emerged as one of the most promising approaches in oncology, and comprises the activation of the immune system to induce tumor immune surveillance or to reverse the tumor immune escape. Different therapeutic strategies for ovarian carcinoma have evolved over the years. Already 30 years ago, the first clinical studies focused on modulating the tumor cytokine network with special attention to interferon-mediated immune responses. With the exploration of specific tumor antigens such as NY-ESO-1, which is expressed in ovarian carcinoma and other malignancies, the development of therapeutic cancer vaccines has been pursued initiating the era of personalized anti-cancer medicine. Almost at the same time, the adoptive transfer of genetically modified autologous tumor-reactive T-cells occurred, but response rates in ovarian carcinoma were disappointing. Today, probably the most promising therapeutic approach in this context is the blockade of immune checkpoints, such as programed cell death protein 1 (PD-1) and one of its ligands (PD-L1) or cytotoxic T-cell lymphocyte-associated antigen 4 (CTLA-4), which has demonstrated impressive response rates in malignant melanoma and non-small cell lung cancer. Despite increasing availability of treatment approaches that target tumor immune surveillance in ovarian carcinoma, selecting patient groups that particularly benefit from these treatment modalities is clinically challenging as predictive biomarkers are lacking. Here, we summarize different immunotherapy approaches in ovarian cancer and discuss why immunotherapy in ovarian cancer is still in its infancy.
Collapse
|
33
|
Abstract
Ovarian carcinoma features pronounced clinical, histopathological, and molecular heterogeneity. There is good reason to believe that parts of this heterogeneity can be explained by differences in the respective cell of origin, with a self-renewing fallopian tube secretory cell being likely responsible for initiation of an overwhelming majority of high-grade serous ovarian carcinomas (i.e., type II tumors according to the recent dualistic classification), whereas there are several mutually non-exclusive possibilities for the initiation of type I tumors, including ovarian surface epithelium stem cells, endometrial cells, or even cells of extra-Müllerian origin. Interestingly, both fallopian tube self-renewing secretory cells and ovarian surface epithelium stem cells seem to be characterized by an overlapping array of stemness signaling pathways, especially Wnt/β-catenin. Apart from this variability in the respective cell of origin, the particular clinical behavior of ovarian carcinoma strongly suggests an underlying stem cell component with a crucial impact. This becomes especially evident in high-grade serous ovarian carcinomas treated with classical chemotherapy, which entails a gradual evolution of chemoresistant disease without any apparent selection of clones carrying obvious chemoresistance-associated mutations. Several cell surface markers (e.g., CD24, CD44, CD117, CD133, and ROR1) as well as functional approaches (ALDEFLUOR™ and side population assays) have been used to identify and characterize putative ovarian carcinoma stem cells. We have recently shown that side population cells exhibit marked heterogeneity on their own, which can hamper their straightforward therapeutic targeting. An alternative strategy for stemness-depleting interventions is to target the stem cell niche, i.e., the specific microanatomical structure that secures stem cell maintenance and survival through provision of a set of stem cell-promoting and differentiation-antagonizing factors. Besides identifying direct or indirect therapeutic targets, profiling of side population cells and other ovarian carcinoma stem cell subpopulations can reveal relevant prognostic markers, as exemplified by our recent discovery of the Vav3.1 transcript variant, which filters out a fraction of prognostically unfavorable ovarian carcinoma cases.
Collapse
Affiliation(s)
- Jiri Hatina
- Faculty of Medicine in Pilsen, Institute of Biology, Charles University, Pilsen, Czech Republic
| | | | - Sieghart Sopper
- Internal Medicine V, Medical University of Innsbruck, Innsbruck, Austria.,Tyrolean Cancer Research Institute, Innsbruck, Austria
| | - Michaela Kripnerova
- Faculty of Medicine in Pilsen, Institute of Biology, Charles University, Pilsen, Czech Republic
| | - Dominik Wolf
- Internal Medicine V, Medical University of Innsbruck, Innsbruck, Austria
| | - Daniel Reimer
- Department of Gynecology and Obstetrics, Medical University of Innsbruck, Innsbruck, Austria
| | - Christian Marth
- Department of Gynecology and Obstetrics, Medical University of Innsbruck, Innsbruck, Austria
| | - Alain G Zeimet
- Department of Gynecology and Obstetrics, Medical University of Innsbruck, Innsbruck, Austria.
| |
Collapse
|
34
|
Schirmer U, Fiegl H, Pfeifer M, Zeimet AG, Müller-Holzner E, Bode PK, Tischler V, Altevogt P. Correction to: Epigenetic regulation of L1CAM in endometrial carcinoma: comparison to cancer-testis (CT-X) antigens. BMC Cancer 2018; 18:1047. [PMID: 30373551 PMCID: PMC6205797 DOI: 10.1186/s12885-018-4928-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 10/10/2018] [Indexed: 11/10/2022] Open
Affiliation(s)
- Uwe Schirmer
- Department of Translational Immunology, German Cancer Research Center, D015, D 69120, Heidelberg, Germany
| | - Heidi Fiegl
- Department of Gynecology and Obstetrics, Medical University of Innsbruck, A 6020, Innsbruck, Austria
| | - Marco Pfeifer
- Department of Translational Immunology, German Cancer Research Center, D015, D 69120, Heidelberg, Germany
| | - Alain G Zeimet
- Department of Gynecology and Obstetrics, Medical University of Innsbruck, A 6020, Innsbruck, Austria
| | - Elisabeth Müller-Holzner
- Department of Gynecology and Obstetrics, Medical University of Innsbruck, A 6020, Innsbruck, Austria
| | - Peter K Bode
- Institute of Surgical Pathology, University Hospital Zürich, Zürich, Switzerland
| | - Verena Tischler
- Institute of Surgical Pathology, University Hospital Zürich, Zürich, Switzerland
| | - Peter Altevogt
- Department of Translational Immunology, German Cancer Research Center, D015, D 69120, Heidelberg, Germany.
| |
Collapse
|
35
|
Tsibulak I, Wieser V, Degasper C, Shivalingaiah G, Wenzel S, Sprung S, Lax SF, Marth C, Fiegl H, Zeimet AG. BRCA1 and BRCA2 mRNA-expression prove to be of clinical impact in ovarian cancer. Br J Cancer 2018; 119:683-692. [PMID: 30111871 PMCID: PMC6173779 DOI: 10.1038/s41416-018-0217-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 07/12/2018] [Accepted: 07/16/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Mutations in BRCA1 and BRCA2 are associated with better survival in ovarian cancer (OC) patients due to a better response to platinum-based chemotherapy. However, the impact of the BRCA1/2 mRNA-expression is not well characterized in OC. PATIENTS AND METHODS We investigated BRCA1/2 mRNA-expression in 12 non-neoplastic fallopian tubes and 201 epithelial OCs in relation to their clinical characteristics. RESULTS We found higher BRCA1/2 mRNA-expression in OCs compared to controls (P = 0.011, P < 0.001, respectively). BRCA1 mutated OCs exhibited lower BRCA1 (P = 0.014) but higher BRCA2 mRNA-expression (P = 0.001). Low BRCA1-expression was associated with favorable overall survival (OS) (P = 0.012) and low BRCA2-expression with better progression-free survival (PFS) and OS (P = 0.004, P = 0.001, respectively). A subgroup-analysis showed that this effect was confined only to the BRCA1-wildtype cancers. Cox-regression confirmed the prognostic significance of BRCA1-expression for OS (P = 0.028). Independency of the prognostic value of BRCA2-expression for PFS (P = 0.045) and OS (P = 0.015) was restricted to high-grade serous OCs. Fully platinum-sensitivity was characterized by lower BRCA1/2 mRNA-expression in BRCA1-wildtype cancers in comparison to platinum-refractory OC. CONCLUSION Our findings may reflect higher platinum-sensitivity due to reduced capacity of DNA damage repair in tissues with low BRCA1/2-expression. In this context, especially in BRCA-wildtype cancers both parameters could also be potential predictors for PARP-sensitivity.
Collapse
Affiliation(s)
- Irina Tsibulak
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Verena Wieser
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Christine Degasper
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Giridhar Shivalingaiah
- Division of Human Genetics, Medical University of Innsbruck, Innsbruck, Austria.,Division Biological Chemistry, Biocenter, Innsbruck, Medical University of Innsbruck, Innsbruck, Austria
| | - Sören Wenzel
- Division of Human Genetics, Medical University of Innsbruck, Innsbruck, Austria
| | - Susanne Sprung
- Institute of Pathology, Medical University of Innsbruck, Innsbruck, Austria
| | - Sigurd F Lax
- Department of Pathology, Hospital Graz Süd-West, Academic Teaching Hospital of the Medical University Graz, Graz, Austria
| | - Christian Marth
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Heidelinde Fiegl
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria.
| | - Alain G Zeimet
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria.
| |
Collapse
|
36
|
Boesch M, Sopper S, Marth C, Fiegl H, Wiedemair A, Rössler J, Hatina J, Wolf D, Reimer D, Zeimet AG. Evaluation of Vav3.1 as prognostic marker in endometrial cancer. J Cancer Res Clin Oncol 2018; 144:2067-2076. [PMID: 30083818 PMCID: PMC6153599 DOI: 10.1007/s00432-018-2725-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 07/30/2018] [Indexed: 01/06/2023]
Abstract
PURPOSE Vav3 is a guanine nucleotide exchange factor that regulates the activity of Rho/Rac family GTPases. In a study on ovarian cancer, we recently demonstrated pronounced prognostic and predictive value of Vav3.1, a specific truncation variant of the parental Vav3 gene. Here, we sought to investigate the role of Vav3.1 in the most prevalent gynecological tumor entity, endometrial cancer. METHODS Vav3.1 transcript levels were determined in a large cohort of endometrial cancer patients using variant-specific PCR (n = 239), and non-malignant endometrial tissue served as control (n = 26). Expression levels of Vav3.1 were stratified according to established clinicopathological characteristics and correlated to long-term patient survival (average follow-up of > 7.5 years). Type 1 and type 2 cancers were separately investigated. RESULTS While Vav3.1 was markedly overexpressed in endometrial cancer tissue, we could not detect associations with clinical parameters related to prognosis, such as FIGO stage and tumor grade. Kaplan-Meier estimators of different measures of survival failed to show prognostic significance of Vav3.1 in endometrial cancer. Lack of prognostic value was observed for both type 1 and type 2 cancers. CONCLUSIONS Our study shows that Vav3.1 is not suited as a marker of cancer progression and/or treatment response in endometrial cancer. Feasibility and potential benefit of targeting Vav3.1 in endometrial cancer needs to be evaluated in future studies, proceeding from its clear, roughly ten-fold, induction in the malignant endometrium.
Collapse
Affiliation(s)
- Maximilian Boesch
- Lungenzentrum, Kantonsspital St. Gallen, Rorschacherstrasse 95, 9007, St. Gallen, Switzerland. .,Internal Medicine V, Medical University of Innsbruck (MUI), 6020, Innsbruck, Austria. .,Tyrolean Cancer Research Institute (TKFI), 6020, Innsbruck, Austria. .,Oncotyrol, Center for Personalized Cancer Medicine GmbH, 6020, Innsbruck, Austria.
| | - Sieghart Sopper
- Internal Medicine V, Medical University of Innsbruck (MUI), 6020, Innsbruck, Austria.,Tyrolean Cancer Research Institute (TKFI), 6020, Innsbruck, Austria.,Oncotyrol, Center for Personalized Cancer Medicine GmbH, 6020, Innsbruck, Austria
| | - Christian Marth
- Department of Gynecology and Obstetrics, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Heidi Fiegl
- Department of Gynecology and Obstetrics, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Annemarie Wiedemair
- Department of Gynecology and Obstetrics, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Julia Rössler
- Department of Gynecology and Obstetrics, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Jiri Hatina
- Department of Biology and Biomedical Centre, Faculty of Medicine Pilsen, Charles University Prague, 30100, Pilsen, Czech Republic
| | - Dominik Wolf
- Internal Medicine V, Medical University of Innsbruck (MUI), 6020, Innsbruck, Austria.,Oncotyrol, Center for Personalized Cancer Medicine GmbH, 6020, Innsbruck, Austria.,Medical Clinic III, Oncology, Hematology and Rheumatology, University Clinic Bonn (UKB), 53127, Bonn, Germany
| | - Daniel Reimer
- Oncotyrol, Center for Personalized Cancer Medicine GmbH, 6020, Innsbruck, Austria.,Department of Gynecology and Obstetrics, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Alain G Zeimet
- Oncotyrol, Center for Personalized Cancer Medicine GmbH, 6020, Innsbruck, Austria. .,Department of Gynecology and Obstetrics, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
| |
Collapse
|
37
|
Concin N, Braicu I, Combe P, Ray-Coquard IL, Joly F, Harter P, Wimberger P, Lotz JP, Ignatov A, Schmalfeldt B, van Nieuwenhuysen E, Darb-Esfahani S, Riedmann M, Zeimet AG, Mahner S, Pujade-Lauraine E, Marth C, Berger R, Sehouli J, Vergote I. Phase II results of GANNET53: A European multicenter phase I/randomized II trial of the Hsp90 inhibitor Ganetespib (G) combined with weekly Paclitaxel (P) in women with high-grade serous, high-grade endometrioid, or undifferentiated, platinum-resistant epithelial ovarian, fallopian tube or primary peritoneal cancer. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.5567] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Ioana Braicu
- Charite Medical University, Department of Gynaecology, Campus Virchow Klinikum, Berlin, Germany
| | - Pierre Combe
- Hôpital Européen Georges Pompidou (HEGP), Assistance Publique Hôpitaux de Paris (AP-HP), Paris, France
| | | | - Florence Joly
- GINECO and Regional Centre Control Against Cancer Francois Baclesse, Caen, France
| | | | - Pauline Wimberger
- Department of Gynecology and Obstetrics, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Jean-Pierre Lotz
- Medical Oncology Department, Hospital Tenon (AP-HP), Paris, France
| | | | - Barbara Schmalfeldt
- AGO and Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | | | | | - Alain G Zeimet
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Sven Mahner
- AGO, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Christian Marth
- AGO-A and Department of Obstetrics and Gynecology, Innsbruck Medical University, Innsbruck, Austria
| | - Regina Berger
- Innsbruck Medical University, Department of Obstetrics and Gynecology, Innsbruck, Austria
| | - Jalid Sehouli
- NOGGO and Department of Gynecology, Campus Virchow-Klinikum, Charité Universitätsmedizin Berlin, Berlin, Germany
| | | |
Collapse
|
38
|
Reimer DU, Boesch M, Sopper S, Wolf DGF, Gaber-Wagener A, Hatina J, Marth C, Zeimet AG. Clinical relevance of Vav3.1 expression in ovarian cancer and involvement in mechanisms causing genuine multi-drug resistance. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e17528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Daniel Uwe Reimer
- Department of Obstetrics and Gynecology, Innsbruck Medical University, Innsbruck, Austria
| | - Maximilian Boesch
- Internal Medicine V, Innsbruck Medical University, Innsbruck, Austria
| | - Sieghart Sopper
- Internal Medicine V, Innsbruck Medical University, Innsbruck, Austria
| | | | - Anouk Gaber-Wagener
- Department of Obstetrics and Gynecology, Medical University Innsbruck, Innsbruck, Austria
| | - Jiri Hatina
- Department of Biology and Biomedical Centre, Faculty of Medicine Pilsen, Charles University Prague, Pilsen, Czech Republic
| | - Christian Marth
- AGO-A and Department of Obstetrics and Gynecology, Innsbruck Medical University, Innsbruck, Austria
| | - Alain G Zeimet
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| |
Collapse
|
39
|
Tsibulak I, Shivalingaiah G, Wenzel S, Sprung S, Lax S, Marth C, Fiegl H, Zeimet AG. Clinical impact of BRCA1 and BRCA2 mRNA expression in ovarian cancer. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e17533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Irina Tsibulak
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Giridhar Shivalingaiah
- Division Biological Chemistry, Biocenter, Medical University of Innsbruck, Innsbruck, Austria
| | - Soeren Wenzel
- Division of Human Genetics, Medical University of Innsbruck, Innsbruck, Austria
| | - Susanne Sprung
- Institute of Pathology, Medical University of Innsbruck, Innsbruck, Austria
| | - Sigurd Lax
- Department of Pathology, General Hospital Graz West, Graz, Austria
| | - Christian Marth
- AGO-A and Department of Obstetrics and Gynecology, Innsbruck Medical University, Innsbruck, Austria
| | - Heidi Fiegl
- Department of Gynaecology and Obstetrics, Medical University of Innsbruck, Innsbruck, Austria
| | - Alain G Zeimet
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| |
Collapse
|
40
|
Reimer DU, Luger A, Jaschke W, Aigner F, Gaber-Wagener A, Marth C, Zeimet AG. Prognostic relevance of supradiaphragmatic lymph nodes in advanced stage ovarian cancer. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e17534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Daniel Uwe Reimer
- Department of Obstetrics and Gynecology, Innsbruck Medical University, Innsbruck, Austria
| | - Anna Luger
- Department of Radiology, Innsbruck Medical University, Innsbruck, Austria
| | - Werner Jaschke
- Department for Radiology, Medical University Innsbruck, Innsbruck, Austria
| | - Friedrich Aigner
- Department of Radiology, Innsbruck Medical University, Innsbruck, Austria
| | - Anouk Gaber-Wagener
- Department of Obstetrics and Gynecology, Medical University Innsbruck, Innsbruck, Austria
| | - Christian Marth
- AGO-A and Department of Obstetrics and Gynecology, Innsbruck Medical University, Innsbruck, Austria
| | - Alain G Zeimet
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| |
Collapse
|
41
|
Boesch M, Reimer D, Sopper S, Wolf D, Zeimet AG. (Iso-)form Matters: Differential Implication of Vav3 Variants in Ovarian Cancer. Oncologist 2018; 23:757-759. [PMID: 29674438 DOI: 10.1634/theoncologist.2017-0683] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 02/09/2018] [Indexed: 11/17/2022] Open
Affiliation(s)
- Maximilian Boesch
- Institute of Immunobiology, Kantonsspital St. Gallen, St. Gallen, Switzerland
- Internal Medicine V, Medical University of Innsbruck, Innsbruck, Austria
- Oncotyrol - Center for Personalized Cancer Medicine GmbH, Innsbruck, Austria
- Tyrolean Cancer Research Institute (TKFI), Innsbruck, Austria
| | - Daniel Reimer
- Department of Gynecology and Obstetrics, Medical University of Innsbruck, Innsbruck, Austria
| | - Sieghart Sopper
- Internal Medicine V, Medical University of Innsbruck, Innsbruck, Austria
- Tyrolean Cancer Research Institute (TKFI), Innsbruck, Austria
| | - Dominik Wolf
- Internal Medicine V, Medical University of Innsbruck, Innsbruck, Austria
- Medical Clinic III, University Clinic Bonn (UKB), Bonn, Germany
| | - Alain G Zeimet
- Department of Gynecology and Obstetrics, Medical University of Innsbruck, Innsbruck, Austria
| |
Collapse
|
42
|
Wieser V, Gaugg I, Fleischer M, Shivalingaiah G, Wenzel S, Sprung S, Lax SF, Zeimet AG, Fiegl H, Marth C. BRCA1/2 and TP53 mutation status associates with PD-1 and PD-L1 expression in ovarian cancer. Oncotarget 2018; 9:17501-17511. [PMID: 29707124 PMCID: PMC5915132 DOI: 10.18632/oncotarget.24770] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 02/27/2018] [Indexed: 12/29/2022] Open
Abstract
Checkpoint molecules such as programmed cell death protein-1 (PD-1) and its ligand PD-L1 are critically required for tumor immune escape. The objective of this study was to investigate tumoral PD-1 and PD-L1 mRNA-expression in a cohort of ovarian cancer (OC) patients in relation to tumor mutations. We analyzed mRNA expression of PD-1, PD-L1 and IFNG by quantitative real-time PCR in tissue of 170 patients with low grade-serous (LGSOC), high-grade serous (HGSOC), endometrioid and clear cell OC compared to 28 non-diseased tissues (ovaries and fallopian tubes) in relation to tumor protein 53 (TP53) and breast cancer gene 1/2 (BRCA1/2) mutation status. TP53-mutated OC strongly expressed PD-L1 compared to TP53 wild-type OC (p = 0.028) and BRCA1/2-mutated OC increasingly expressed PD-1 (p = 0.024) and PD-L1 (p = 0.012) compared to BRCA1/2 wild-type OC. For the first time in human, we noted a strong correlation between tumoral IFNG and PD-1 or PD-L1 mRNA-expression, respectively (p < 0.001). OC tissue increasingly expressed PD-1 compared to healthy controls (vs. ovaries: p < 0.001; vs. tubes: p = 0.018). PD-1 and PD-L1 mRNA-expression increased with higher tumor grade (p = 0.008 and p = 0.027, respectively) and younger age (< median age, p = 0.001). Finally, in the major subgroup of our cohort, FIGO stage III/IV HGSOC, high PD-1 and PD-L1 mRNA-expression was associated with reduced progression-free (p = 0.024) and overall survival (p = 0.049) but only in the univariate analysis. Our study suggests that in OC PD-1/PD-L1 mRNA-expression is controlled by IFNγ and affected by TP53 and BRCA1/2 mutations. We suggest that these mutations might serve as potential predictive factors that guide anti-PD1/PD-L1 immunotherapy.
Collapse
Affiliation(s)
- Verena Wieser
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck 6020, Austria
| | - Inge Gaugg
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck 6020, Austria
| | - Martina Fleischer
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck 6020, Austria
| | - Giridhar Shivalingaiah
- Division of Human Genetics, Medical University of Innsbruck, Innsbruck 6020, Austria.,Present address: Division Biological Chemistry, Biocenter, Innsbruck, Medical University of Innsbruck, Innsbruck 6020, Austria
| | - Soeren Wenzel
- Division of Human Genetics, Medical University of Innsbruck, Innsbruck 6020, Austria
| | - Susanne Sprung
- Institute of Pathology, Medical University of Innsbruck, Innsbruck 6020, Austria
| | - Sigurd F Lax
- Department of Pathology, Hospital Graz Süd-West, Academic Teaching Hospital of the Medical University Graz, Graz 8020, Austria
| | - Alain G Zeimet
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck 6020, Austria
| | - Heidelinde Fiegl
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck 6020, Austria
| | - Christian Marth
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck 6020, Austria
| |
Collapse
|
43
|
Wieser V, Gaugg I, Fleischer M, Shivalingaiah G, Wenzel S, Sprung S, Lax SF, Zeimet AG, Fiegl H, Marth C. BRCA1/2 and TP53 mutation status associates with PD-1 and PD-L1 expression in ovarian cancer. Oncotarget 2018. [PMID: 29707124 DOI: 10.18632/oncotarget.24770] [] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Checkpoint molecules such as programmed cell death protein-1 (PD-1) and its ligand PD-L1 are critically required for tumor immune escape. The objective of this study was to investigate tumoral PD-1 and PD-L1 mRNA-expression in a cohort of ovarian cancer (OC) patients in relation to tumor mutations. We analyzed mRNA expression of PD-1, PD-L1 and IFNG by quantitative real-time PCR in tissue of 170 patients with low grade-serous (LGSOC), high-grade serous (HGSOC), endometrioid and clear cell OC compared to 28 non-diseased tissues (ovaries and fallopian tubes) in relation to tumor protein 53 (TP53) and breast cancer gene 1/2 (BRCA1/2) mutation status. TP53-mutated OC strongly expressed PD-L1 compared to TP53 wild-type OC (p = 0.028) and BRCA1/2-mutated OC increasingly expressed PD-1 (p = 0.024) and PD-L1 (p = 0.012) compared to BRCA1/2 wild-type OC. For the first time in human, we noted a strong correlation between tumoral IFNG and PD-1 or PD-L1 mRNA-expression, respectively (p < 0.001). OC tissue increasingly expressed PD-1 compared to healthy controls (vs. ovaries: p < 0.001; vs. tubes: p = 0.018). PD-1 and PD-L1 mRNA-expression increased with higher tumor grade (p = 0.008 and p = 0.027, respectively) and younger age (< median age, p = 0.001). Finally, in the major subgroup of our cohort, FIGO stage III/IV HGSOC, high PD-1 and PD-L1 mRNA-expression was associated with reduced progression-free (p = 0.024) and overall survival (p = 0.049) but only in the univariate analysis. Our study suggests that in OC PD-1/PD-L1 mRNA-expression is controlled by IFNγ and affected by TP53 and BRCA1/2 mutations. We suggest that these mutations might serve as potential predictive factors that guide anti-PD1/PD-L1 immunotherapy.
Collapse
Affiliation(s)
- Verena Wieser
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck 6020, Austria
| | - Inge Gaugg
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck 6020, Austria
| | - Martina Fleischer
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck 6020, Austria
| | - Giridhar Shivalingaiah
- Division of Human Genetics, Medical University of Innsbruck, Innsbruck 6020, Austria.,Present address: Division Biological Chemistry, Biocenter, Innsbruck, Medical University of Innsbruck, Innsbruck 6020, Austria
| | - Soeren Wenzel
- Division of Human Genetics, Medical University of Innsbruck, Innsbruck 6020, Austria
| | - Susanne Sprung
- Institute of Pathology, Medical University of Innsbruck, Innsbruck 6020, Austria
| | - Sigurd F Lax
- Department of Pathology, Hospital Graz Süd-West, Academic Teaching Hospital of the Medical University Graz, Graz 8020, Austria
| | - Alain G Zeimet
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck 6020, Austria
| | - Heidelinde Fiegl
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck 6020, Austria
| | - Christian Marth
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck 6020, Austria
| |
Collapse
|
44
|
Abdel Azim S, Duggan-Peer M, Sprung S, Reimer D, Fiegl H, Soleiman A, Marth C, Zeimet AG. Clinical impact of L1CAM expression measured on the transcriptome level in ovarian cancer. Oncotarget 2018; 7:37205-37214. [PMID: 27174921 PMCID: PMC5095069 DOI: 10.18632/oncotarget.9291] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 04/18/2016] [Indexed: 01/14/2023] Open
Abstract
Background High expression of L1 cell adhesion molecules (L1CAM) has been repeatedly shown to be associated with aggressive disease behavior, which translates in poor clinical outcome in various cancer entities. However, in ovarian cancer results based either on immunohistochemistry or cytosolic protein quantifications remained conflicting regarding clinical behavior. In the present work we assessed L1CAM expression on the transcriptome level with the highly sensitive quantitative real-time PCR (qRT-PCR) to define its relevance in ovarian cancer biology. Results There was a significant difference in L1CAM high and low mRNA expressing cancers with regard to disease-free (p=0.002) and overall survival (p=0.008). L1CAM proofed to be an independent predictor for disease progression (HR 1.8, p=0.01) and overall survival (HR 1.6, p=0.04). Furthermore, a significant positive correlation between the level of L1CAM and the grade of tumor differentiation (p=0.04), the FIGO stage (p=0.025) as well as the histological subtype (p= 0.002) was found. Methods This study included fresh frozen tissue samples of 138 patients with FIGO I-IV stage ovarian cancer. L1CAM mRNA expression was determined using qRT-PCR. In the calculations special attention was put on the various histological subtypes. In survival analysis median L1CAM mRNA expression obtained in the entire cohort of ovarian cancer samples was used as a cut-off to distinguish between high and low L1CAM mRNA expression. Conclusion L1CAM mRNA expression appears to play a substantial role in the pathophysiology of ovarian cancer that is translated into poor clinical outcome. Additionally humanized L1CAM antibodies, which can serve as potential future treatment options are under testing.
Collapse
Affiliation(s)
- Samira Abdel Azim
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Michaela Duggan-Peer
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Susanne Sprung
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Daniel Reimer
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Heidi Fiegl
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, 6020 Innsbruck, Austria.,Department of Obstetrics and Gynecology, Laboratory for Clinical Biochemistry, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Afschin Soleiman
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Christian Marth
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Alain G Zeimet
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, 6020 Innsbruck, Austria
| |
Collapse
|
45
|
Reimer D, Boesch M, Wolf D, Marth C, Sopper S, Hatina J, Altevogt P, Parson W, Hackl H, Zeimet AG. Truncated isoform Vav3.1 is highly expressed in ovarian cancer stem cells and clinically relevant in predicting prognosis and platinum-response. Int J Cancer 2017; 142:1640-1651. [DOI: 10.1002/ijc.31186] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 11/01/2017] [Accepted: 11/16/2017] [Indexed: 01/04/2023]
Affiliation(s)
- Daniel Reimer
- Department of Obstetrics and Gynecology; Medical University Innsbruck; 6020 Innsbruck Austria
| | - Maximilian Boesch
- Institute of Immunobiology, Kantonsspital St. Gallen; 9007 St. Gallen Switzerland
- Internal Medicine V, Innsbruck Medical University; 6020 Innsbruck Austria
- Tyrolean Cancer Research Institute; 6020 Innsbruck Austria
| | - Dominik Wolf
- Internal Medicine V, Innsbruck Medical University; 6020 Innsbruck Austria
- Medical Clinic 3, Oncology, Hematology, Immunology and Rheumatology; University Clinic Bonn (UKB); 53127 Bonn Germany
| | - Christian Marth
- Department of Obstetrics and Gynecology; Medical University Innsbruck; 6020 Innsbruck Austria
| | - Sieghart Sopper
- Internal Medicine V, Innsbruck Medical University; 6020 Innsbruck Austria
- Tyrolean Cancer Research Institute; 6020 Innsbruck Austria
| | - Jiri Hatina
- Department of Biology and Biomedical Centre; Faculty of Medicine Pilsen, Charles University Prague; 30100 Pilsen Czech Republic
| | - Peter Altevogt
- Skin Cancer Unit; German Cancer Research Center (DKFZ); 69120 Heidelberg Germany
- Department of Dermatology, Venereology and Allergology; University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg; 68167 Mannheim Germany
| | - Walther Parson
- Institute of Legal Medicine, Medical University Innsbruck; 6020 Innsbruck Austria
| | - Hubert Hackl
- Division of Bioinformatics; Biocenter, Medical University Innsbruck; 6020 Innsbruck Austria
| | - Alain G. Zeimet
- Department of Obstetrics and Gynecology; Medical University Innsbruck; 6020 Innsbruck Austria
| |
Collapse
|
46
|
Zeimet AG, Mori H, Petru E, Polterauer S, Reinthaller A, Schauer C, Scholl-Firon T, Singer C, Wimmer K, Zschocke J, Marth C. AGO Austria recommendation on screening and diagnosis of Lynch syndrome (LS). Arch Gynecol Obstet 2017; 296:123-127. [PMID: 28510097 PMCID: PMC5486556 DOI: 10.1007/s00404-017-4392-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 05/04/2017] [Indexed: 01/29/2023]
Abstract
Purpose This manuscript reports the consensus recommendations on screening and diagnosis of Lynch syndrome (LS) in patients with endometrial or ovarian cancer as well as on possible preventive measures in effectively LS-diagnosed women. The recommendations are issued by the Austrian Arbeitsgemeinschaft für Gynäkologische Onkologie (AGO) of the Österreichischen Gesellschaft für Gynäkologie und Geburtshilfe (OEGGG) after consultation of the most recent and relevant literature and following deliberation by the Genetic Task-Force convoked May, 2015 by the AGO Council. Results and conclusion The Austrian AGO recommends immunohistochemical tissue screening for type-I and type-II endometrial cancers in all patients below the age of 70 years, and for all endometrioid and clear-cell ovarian cancers independently of the patient’s age. If needed immunohistochemistry should be complemented by tissue MLH1 promotor hypermethylation testing and/or microsatellite instability (MSI) analysis. The diagnosis LS requires confirmation through identification of a germline mutation by a molecular genetic examination in the mismatch repair genes using the patient’s blood. This should be performed without preceding tissue screening when in LS-associated cancer patients the family history fulfills the Amsterdam II or the revised Bethesda criteria. In LS-diagnosed women, the age for prophylactic surgery should be set flexibly based on an informed consent. Regarding the monitoring of these women, chemo-preventive measures as well as screening procedures either to avoid or to early detect LS-related tumors are discussed with a special light on their specific limitations.
Collapse
Affiliation(s)
- Alain G Zeimet
- Department of Obstetrics and Gynecology, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria.
| | - Harald Mori
- MFA-Wiener Medizinische Viktor Frankl Vereinigung, Erdbrustgasse 46, 1010, Vienna, Austria
| | - Edgar Petru
- Department of Obstetrics and Gynecology, Medical University of Graz, Auenbruggerplatz 14, 8036, Graz, Austria
| | - Stephan Polterauer
- Gynecologic Cancer Unit, Department for Gynecology and Gynecologic Oncology, Comprehensive Cancer Centre, Medical University Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Alexander Reinthaller
- Gynecologic Cancer Unit, Department for Gynecology and Gynecologic Oncology, Comprehensive Cancer Centre, Medical University Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Christian Schauer
- Department of Gynecology, Hospital Barmherzige Brüder Graz, Marschallgasse 12, 8020, Graz, Austria
| | - Tonja Scholl-Firon
- Department of Gynecology and Obstetrics, Wilhelminenspital, Montleart Straße 37, 1160, Vienna, Austria
| | - Christian Singer
- Gynecologic Cancer Unit, Department for Gynecology and Gynecologic Oncology, Comprehensive Cancer Centre, Medical University Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Katharina Wimmer
- Division of Human Genetics, Innsbruck Medical University, Peter Mayr-Strasse 1, 6020, Innsbruck, Austria
| | - Johannes Zschocke
- Division of Human Genetics, Innsbruck Medical University, Peter Mayr-Strasse 1, 6020, Innsbruck, Austria
| | - Christian Marth
- Department of Obstetrics and Gynecology, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria
| |
Collapse
|
47
|
Berger A, Abdel Azim S, Tsibulak I, Shivalingaiah G, Wenzel S, Gaugg I, Fleischer M, Zeimet AG, Fiegl H, Zschocke J, Marth C. P53-Mutationsanalysen beim Ovarialkarzinom. Geburtshilfe Frauenheilkd 2017. [DOI: 10.1055/s-0037-1599166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- A Berger
- Univ. Klinik für Gynäkologie und Geburtshilfe
| | | | - I Tsibulak
- Univ. Klinik für Gynäkologie und Geburtshilfe
| | - G Shivalingaiah
- Division für Humangenetik, Medizinische Universität Innsbruck, Innsbruck
| | - S Wenzel
- Division für Humangenetik, Medizinische Universität Innsbruck, Innsbruck
| | - I Gaugg
- Univ. Klinik für Gynäkologie und Geburtshilfe
| | - M Fleischer
- Univ. Klinik für Gynäkologie und Geburtshilfe
| | - AG Zeimet
- Univ. Klinik für Gynäkologie und Geburtshilfe
| | - H Fiegl
- Univ. Klinik für Gynäkologie und Geburtshilfe
| | - J Zschocke
- Division für Humangenetik, Medizinische Universität Innsbruck, Innsbruck
| | - C Marth
- Univ. Klinik für Gynäkologie und Geburtshilfe
| |
Collapse
|
48
|
Abdel Azim S, Tsibulak I, Berger A, Shivalingaiah G, Wenzel S, Gaugg I, Fleischer M, Zeimet AG, Marth C, Fiegl H. Klinische Relevanz der HRAS DNA-Methylierung beim Ovarialkarzinom. Geburtshilfe Frauenheilkd 2017. [DOI: 10.1055/s-0037-1599161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- S Abdel Azim
- Univ. Klinik für Gynäkologie und Geburtshilfe, Medizinische Universität Innsbruck, Innsbruck
| | - I Tsibulak
- Univ. Klinik für Gynäkologie und Geburtshilfe, Medizinische Universität Innsbruck, Innsbruck
| | - A Berger
- Univ. Klinik für Gynäkologie und Geburtshilfe, Medizinische Universität Innsbruck, Innsbruck
| | - G Shivalingaiah
- Division für Humangenetik, Medizinische Universität Innsbruck, Innsbruck
| | - S Wenzel
- Division für Humangenetik, Medizinische Universität Innsbruck, Innsbruck
| | - I Gaugg
- Univ. Klinik für Gynäkologie und Geburtshilfe, Medizinische Universität Innsbruck, Innsbruck
| | - M Fleischer
- Univ. Klinik für Gynäkologie und Geburtshilfe, Medizinische Universität Innsbruck, Innsbruck
| | - AG Zeimet
- Univ. Klinik für Gynäkologie und Geburtshilfe, Medizinische Universität Innsbruck, Innsbruck
| | - C Marth
- Univ. Klinik für Gynäkologie und Geburtshilfe, Medizinische Universität Innsbruck, Innsbruck
| | - H Fiegl
- Univ. Klinik für Gynäkologie und Geburtshilfe, Medizinische Universität Innsbruck, Innsbruck
| |
Collapse
|
49
|
Tsibulak I, Berger A, Abdel Azim S, Shivalingaiah G, Wenzel S, Wiedemair A, Fiegl H, Marth C, Zeimet AG. BRCA2 mRNA-Expression als prognostisch relevanter Faktor beim Ovarialkarzinom. Geburtshilfe Frauenheilkd 2017. [DOI: 10.1055/s-0037-1599181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- I Tsibulak
- Univ. Klinik für Gynäkologie und Geburtshilfe, Innsbruck
| | - A Berger
- Univ. Klinik für Gynäkologie und Geburtshilfe, Innsbruck
| | - S Abdel Azim
- Univ. Klinik für Gynäkologie und Geburtshilfe, Innsbruck
| | - G Shivalingaiah
- Division für Humangenetik, Medizinische Universität Innsbruck
| | - S Wenzel
- Division für Humangenetik, Medizinische Universität Innsbruck
| | - A Wiedemair
- Univ. Klinik für Gynäkologie und Geburtshilfe, Innsbruck
| | - H Fiegl
- Univ. Klinik für Gynäkologie und Geburtshilfe, Innsbruck
| | - C Marth
- Univ. Klinik für Gynäkologie und Geburtshilfe, Innsbruck
| | - AG Zeimet
- Univ. Klinik für Gynäkologie und Geburtshilfe, Innsbruck
| |
Collapse
|
50
|
Wieser V, Gaugg I, Fleischer M, Zeimet AG, Fiegl H, Marth C. Spermatogensis associated 2 (SPATA2) ist ein unabhängiger Prognosemarker für Patientinnen mit Ovarialkarzinom. Geburtshilfe Frauenheilkd 2017. [DOI: 10.1055/s-0037-1599184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- V Wieser
- Medizinische Universität Innsbruck, Universitätsklinik für Gynäkologie und Gebursthilfe, Innsbruck
| | - I Gaugg
- Medizinische Universität Innsbruck, Universitätsklinik für Gynäkologie und Gebursthilfe, Innsbruck
| | - M Fleischer
- Medizinische Universität Innsbruck, Universitätsklinik für Gynäkologie und Gebursthilfe, Innsbruck
| | - AG Zeimet
- Medizinische Universität Innsbruck, Universitätsklinik für Gynäkologie und Gebursthilfe, Innsbruck
| | - H Fiegl
- Medizinische Universität Innsbruck, Universitätsklinik für Gynäkologie und Gebursthilfe, Innsbruck
| | - C Marth
- Medizinische Universität Innsbruck, Universitätsklinik für Gynäkologie und Gebursthilfe, Innsbruck
| |
Collapse
|