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Nilsson K, Klevebro F, Sunde B, Rouvelas I, Lindblad M, Szabo E, Halldestam I, Smedh U, Wallner B, Johansson J, Johnsen G, Aahlin EK, Johannessen HO, Alexandersson von Döbeln G, Hjortland GO, Wang N, Shang Y, Borg D, Quaas A, Bartella I, Bruns C, Schröder W, Nilsson M. Oncological outcomes of standard versus prolonged time to surgery after neoadjuvant chemoradiotherapy for oesophageal cancer in the multicentre, randomised, controlled NeoRes II trial. Ann Oncol 2023; 34:1015-1024. [PMID: 37657554 DOI: 10.1016/j.annonc.2023.08.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/11/2023] [Accepted: 08/14/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND The optimal time to surgery (TTS) after neoadjuvant chemoradiotherapy (nCRT) for oesophageal cancer is unknown and has traditionally been 4-6 weeks in clinical practice. Observational studies have suggested better outcomes, especially in terms of histological response, after prolonged delay of up to 3 months after nCRT. The NeoRes II trial is the first randomised trial to compare standard to prolonged TTS after nCRT for oesophageal cancer. PATIENTS AND METHODS Patients with resectable, locally advanced oesophageal cancer were randomly assigned to standard delay of surgery of 4-6 weeks or prolonged delay of 10-12 weeks after nCRT. The primary endpoint was complete histological response of the primary tumour in patients with adenocarcinoma (AC). Secondary endpoints included histological tumour response, resection margins, overall and progression-free survival in all patients and stratified by histologic type. RESULTS Between February 2015 and March 2019, 249 patients from 10 participating centres in Sweden, Norway and Germany were randomised: 125 to standard and 124 to prolonged TTS. There was no significant difference in complete histological response between AC patients allocated to standard (21%) compared to prolonged (26%) TTS (P = 0.429). Tumour regression, resection margins and number of resected lymph nodes, total and metastatic, did not differ between the allocated interventions. The first quartile overall survival in patients allocated to standard TTS was 26.5 months compared to 14.2 months after prolonged TTS (P = 0.003) and the overall risk of death during follow-up was 35% higher after prolonged delay (hazard ratio 1.35, 95% confidence interval 0.94-1.95, P = 0.107). CONCLUSION Prolonged TTS did not improve histological complete response or other pathological endpoints, while there was a strong trend towards worse survival, suggesting caution in routinely delaying surgery for >6 weeks after nCRT.
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Affiliation(s)
- K Nilsson
- Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm; Division of Surgery and Oncology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm
| | - F Klevebro
- Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm; Division of Surgery and Oncology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm
| | - B Sunde
- Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm; Division of Surgery and Oncology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm
| | - I Rouvelas
- Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm; Division of Surgery and Oncology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm
| | - M Lindblad
- Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm; Division of Surgery and Oncology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm
| | - E Szabo
- Department of Surgery, Faculty of Medicine and Health, Örebro University Hospital, Örebro
| | | | - U Smedh
- Department of Surgery, Sahlgrenska University Hospital, Gothenburg
| | - B Wallner
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå
| | - J Johansson
- Department of Surgery, Skåne University Hospital, Lund, Sweden
| | - G Johnsen
- Department of Gastrointestinal Surgery, St. Olav's Hospital, Trondheim University Hospital, Trondheim
| | - E K Aahlin
- Department of GI and HPB Surgery, University Hospital of Northern Norway, Tromsø
| | - H-O Johannessen
- Department of Gastrointestinal Surgery, Oslo University Hospital, Oslo, Norway
| | - G Alexandersson von Döbeln
- Division of Surgery and Oncology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm; Medical Unit of Head, Neck, Lung and Skin Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - G O Hjortland
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - N Wang
- Department of Clinical Pathology and Cancer Diagnostics, Karolinska University Hospital, Stockholm
| | - Y Shang
- Department of Medicine Huddinge, Karolinska Institutet, Stockholm
| | - D Borg
- Department of Oncology, Skåne University Hospital, Lund, Sweden
| | - A Quaas
- Institute of Pathology, University of Cologne, Cologne
| | - I Bartella
- Department of General, Visceral, Cancer and Transplantation Surgery, University Hospital of Cologne, Cologne, Germany
| | - C Bruns
- Department of General, Visceral, Cancer and Transplantation Surgery, University Hospital of Cologne, Cologne, Germany
| | - W Schröder
- Department of General, Visceral, Cancer and Transplantation Surgery, University Hospital of Cologne, Cologne, Germany
| | - M Nilsson
- Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm; Division of Surgery and Oncology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm.
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Silginer M, Papa E, Szabo E, Vasella F, Pruschy M, Stroh C, Roth P, Weiss T, Weller M. P10.20.A Mechanisms of synergistic glioma growth suppression by radiotherapy and MET inhibition. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.185] [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: 11/14/2022] Open
Abstract
Abstract
Background
Glioblastoma remains to be one of the most lethal solid cancers. Despite multi-modal therapy including surgery as safely feasible, radiotherapy and chemotherapy with the alkylating agent temozolomide, the median survival of affected patients is still limited to approximately one year on a population level. Thus, novel therapies are urgently needed. There is increasing interest in the role of the HGF/MET pathway in the response of glioblastoma to radiotherapy since MET may be involved in radioresistance via proinvasive and DNA damage response pathways.
Material and Methods
Here we assessed the role of the MET pathway in the response to radiotherapy in vitro and in vivo in syngeneic mouse glioma models and explored potential modes of action responsible for the synergistic effects of MET pathway inhibition and irradiation on tumor growth in vivo.
Results
Murine glioma cells express HGF and MET and show increased MET phosphorylation upon exposure to exogenous HGF. In vitro, glioma cell viability and proliferation are not affected by pharmacological MET inhibition using tepotinib or genetic MET inhibition using CRISPR/Cas9-engineered Met gene knockout and sensitization to irradiation by MET inhibition is not seen. In vivo, the combination of MET inhibition with focal radiotherapy mediates prolonged survival of syngeneic orthotopic glioma-bearing mice compared with either treatment alone. Complementary studies demonstrate that synergy is lost when gliomas are established and treated in immunodeficient mice, but also if MET gene expression is disrupted in the tumor of wildtype mice. Combination therapy suppresses a set of pro-inflammatory mediators that are upregulated by radiotherapy alone and which are positively regulated by transforming growth factor (TGF)-β. In line with this data, ex vivo analysis of mouse brains reveal increased TGF-β pathway activity upon irradiation alone that is counteracted by concomitant MET inhibition.
Conclusion
In summary, we demonstrate synergistic suppression of syngeneic glioma growth by irradiation and MET inhibition that requires MET expression in the tumor as well as an intact immune system. Clinical evaluation of this combined treatment approach in newly diagnosed glioblastoma is warranted.
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Affiliation(s)
- M Silginer
- University and University Hospital Zurich , Zürich , Switzerland
| | - E Papa
- University and University Hospital Zurich , Zürich , Switzerland
| | - E Szabo
- University and University Hospital Zurich , Zürich , Switzerland
| | - F Vasella
- University and University Hospital Zurich , Zürich , Switzerland
| | - M Pruschy
- University and University Hospital Zurich , Zürich , Switzerland
| | - C Stroh
- University and University Hospital Zurich , Zürich , Switzerland
| | - P Roth
- University and University Hospital Zurich , Zürich , Switzerland
| | - T Weiss
- University and University Hospital Zurich , Zürich , Switzerland
| | - M Weller
- University and University Hospital Zurich , Zürich , Switzerland
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3
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Atlasz T, Werling D, Song S, Szabo E, Vaczy A, Kovari P, Tamas A, Reglodi D, Yu R. Retinoprotective Effects of TAT-Bound Vasoactive Intestinal Peptide and Pituitary Adenylate Cyclase Activating Polypeptide. J Mol Neurosci 2019. [PMID: 30542799 DOI: 10.1007/s12031-018-1229-5/figures/7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
Vasoactive intestinal peptide (VIP) and pituitary adenylate cyclase activating polypeptide (PACAP) belong to the same peptide family and exert a variety of biological functions. Both PACAP and VIP have protective effects in several tissues. While PACAP is known to be a stronger retinoprotective peptide, VIP has very potent anti-inflammatory effects. The need for a non-invasive therapeutic approach has emerged and PACAP has been shown to be retinoprotective when administered in the form of eye drops as well. The cell penetrating peptide TAT is composed of 11 amino acids and tagging of TAT at the C-terminus of neuropeptides PACAP/VIP can enhance the traversing ability of the peptides through the biological barriers. We hypothesized that TAT-bound PACAP and VIP could be more effective in exerting retinoprotective effects when given in eye drops, by increasing the traversing efficacy and enhancing the activation of the PAC1 receptor. Rats were subjected to bilateral carotid artery occlusion (BCCAO), and retinas were processed for histological analysis 14 days later. The efficiency of the TAT-bound peptides to reach the retina was assessed as well as their cAMP increasing ability. Our present study provides evidence, for the first time, that topically administered PACAP and VIP derivatives (PACAP-TAT and VIP-TAT) attenuate ischemic retinal degeneration via the PAC1 receptor presumably due to a multifactorial protective mechanism.
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Affiliation(s)
- Tamas Atlasz
- Department of Anatomy, Medical School, MTA-PTE PACAP Research Group, University of Pecs, Pecs, Hungary.
- Department of Sportbiology, University of Pecs, Pecs, Hungary.
- Janos Szentagothai Research Center, University of Pecs, Pecs, Hungary.
| | - D Werling
- Department of Anatomy, Medical School, MTA-PTE PACAP Research Group, University of Pecs, Pecs, Hungary
| | - S Song
- Institute of Biomedicine, Jinan University, Guangzhou, China
| | - E Szabo
- Department of Anatomy, Medical School, MTA-PTE PACAP Research Group, University of Pecs, Pecs, Hungary
| | - A Vaczy
- Department of Anatomy, Medical School, MTA-PTE PACAP Research Group, University of Pecs, Pecs, Hungary
| | - P Kovari
- Department of Anatomy, Medical School, MTA-PTE PACAP Research Group, University of Pecs, Pecs, Hungary
| | - A Tamas
- Department of Anatomy, Medical School, MTA-PTE PACAP Research Group, University of Pecs, Pecs, Hungary
| | - D Reglodi
- Department of Anatomy, Medical School, MTA-PTE PACAP Research Group, University of Pecs, Pecs, Hungary
| | - Rongjie Yu
- Institute of Biomedicine, Jinan University, Guangzhou, China.
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4
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Atlasz T, Werling D, Song S, Szabo E, Vaczy A, Kovari P, Tamas A, Reglodi D, Yu R. Retinoprotective Effects of TAT-Bound Vasoactive Intestinal Peptide and Pituitary Adenylate Cyclase Activating Polypeptide. J Mol Neurosci 2018; 68:397-407. [PMID: 30542799 PMCID: PMC6581923 DOI: 10.1007/s12031-018-1229-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 11/21/2018] [Indexed: 12/19/2022]
Abstract
Vasoactive intestinal peptide (VIP) and pituitary adenylate cyclase activating polypeptide (PACAP) belong to the same peptide family and exert a variety of biological functions. Both PACAP and VIP have protective effects in several tissues. While PACAP is known to be a stronger retinoprotective peptide, VIP has very potent anti-inflammatory effects. The need for a non-invasive therapeutic approach has emerged and PACAP has been shown to be retinoprotective when administered in the form of eye drops as well. The cell penetrating peptide TAT is composed of 11 amino acids and tagging of TAT at the C-terminus of neuropeptides PACAP/VIP can enhance the traversing ability of the peptides through the biological barriers. We hypothesized that TAT-bound PACAP and VIP could be more effective in exerting retinoprotective effects when given in eye drops, by increasing the traversing efficacy and enhancing the activation of the PAC1 receptor. Rats were subjected to bilateral carotid artery occlusion (BCCAO), and retinas were processed for histological analysis 14 days later. The efficiency of the TAT-bound peptides to reach the retina was assessed as well as their cAMP increasing ability. Our present study provides evidence, for the first time, that topically administered PACAP and VIP derivatives (PACAP-TAT and VIP-TAT) attenuate ischemic retinal degeneration via the PAC1 receptor presumably due to a multifactorial protective mechanism.
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Affiliation(s)
- Tamas Atlasz
- Department of Anatomy, Medical School, MTA-PTE PACAP Research Group, University of Pecs, Pecs, Hungary. .,Department of Sportbiology, University of Pecs, Pecs, Hungary. .,Janos Szentagothai Research Center, University of Pecs, Pecs, Hungary.
| | - D Werling
- Department of Anatomy, Medical School, MTA-PTE PACAP Research Group, University of Pecs, Pecs, Hungary
| | - S Song
- Institute of Biomedicine, Jinan University, Guangzhou, China
| | - E Szabo
- Department of Anatomy, Medical School, MTA-PTE PACAP Research Group, University of Pecs, Pecs, Hungary
| | - A Vaczy
- Department of Anatomy, Medical School, MTA-PTE PACAP Research Group, University of Pecs, Pecs, Hungary
| | - P Kovari
- Department of Anatomy, Medical School, MTA-PTE PACAP Research Group, University of Pecs, Pecs, Hungary
| | - A Tamas
- Department of Anatomy, Medical School, MTA-PTE PACAP Research Group, University of Pecs, Pecs, Hungary
| | - D Reglodi
- Department of Anatomy, Medical School, MTA-PTE PACAP Research Group, University of Pecs, Pecs, Hungary
| | - Rongjie Yu
- Institute of Biomedicine, Jinan University, Guangzhou, China.
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5
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Mian I, Nichols S, Abernethy A, Carson K, Maignon K, Torres A, Snider J, Frampton G, Li G, Sharon E, Szabo E, Thomas A. P1.12-15 Distinctive Clinical Characteristics of SCLC in Never-Smokers. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.850] [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: 10/28/2022]
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6
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Le Rhun E, von Achenbach C, Lohmann B, Silginer M, Schneider H, Meetze K, Szabo E, Weller M. P04.11 Profound sensitivity of glioblastoma cells to apoptosis induction by TG02, a novel oral multi-cyclin-dependent kinase inhibitor. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.245] [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: 11/13/2022] Open
Affiliation(s)
- E Le Rhun
- University Hospital and University of Zurich, Zurich, Switzerl
| | - C von Achenbach
- University Hospital and University of Zurich, Zurich, Switzerl
| | - B Lohmann
- University Hospital and University of Zurich, Zurich, Switzerl
| | - M Silginer
- University Hospital and University of Zurich, Zurich, Switzerl
| | - H Schneider
- University Hospital and University of Zurich, Zurich, Switzerl
| | - K Meetze
- Tragara Pharmaceuticals, Carlsbad, CA, United States
| | - E Szabo
- University Hospital and University of Zurich, Zurich, Switzerl
| | - M Weller
- University Hospital and University of Zurich, Zurich, Switzerl
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7
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Szabo E, Demuth B, Nagy B, Molnar K, Farkas A, Szabo B, Balogh A, Hirsch E, Nagy B, Marosi G, Nagy ZK. Scaled-up preparation of drug-loaded electrospun polymer fibres and investigation of their continuous processing to tablet form. EXPRESS POLYM LETT 2018. [DOI: 10.3144/expresspolymlett.2018.37] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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8
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Wanjura V, Szabo E, Österberg J, Ottosson J, Enochsson L, Sandblom G. Morbidity of cholecystectomy and gastric bypass in a national database. Br J Surg 2017; 105:121-127. [DOI: 10.1002/bjs.10666] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 07/02/2017] [Accepted: 07/10/2017] [Indexed: 01/23/2023]
Abstract
Abstract
Background
There is a strong association between obesity and gallstones. However, there is no clear evidence regarding the optimal order of Roux-en-Y gastric bypass (RYGB) and cholecystectomy when both procedures are clinically indicated.
Methods
Based on cross-matched data from the Swedish Register for Cholecystectomy and Endoscopic Retrograde Cholangiopancreatography (GallRiks; 79 386 patients) and the Scandinavian Obesity Surgery Registry (SOReg; 36 098 patients) from 2007 to 2013, complication rates, reoperation rates and operation times related to the timing of RYGB and cholecystectomy were explored.
Results
There was a higher aggregate complication risk when cholecystectomy was performed after RYGB rather than before (odds ratio (OR) 1·35, 95 per cent c.i. 1·09 to 1·68; P = 0·006). A complication after the first procedure independently increased the complication risk of the following procedure (OR 2·02, 1·44 to 2·85; P < 0·001). Furthermore, there was an increased complication risk when cholecystectomy was performed at the same time as RYGB (OR 1·72, 1·14 to 2·60; P = 0·010). Simultaneous cholecystectomy added 61·7 (95 per cent c.i. 56·1 to 67·4) min (P < 0·001) to the duration of surgery.
Conclusion
Cholecystectomy should be performed before, not during or after, RYGB.
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Affiliation(s)
- V Wanjura
- Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - E Szabo
- Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - J Österberg
- Department of Surgery, Mora Hospital, Mora, Sweden
| | - J Ottosson
- Department of Surgery, Faculty of Medicine and Health, Örebro University, Lindesberg, Sweden
| | - L Enochsson
- Department of Surgical and Perioperative Sciences, Division of Surgery, Sunderby Hospital, Umeå University, Umeå, Sweden
| | - G Sandblom
- Department of Surgical Gastroenterology, Division of Surgery, CLINTEC, Karolinska Institute, Stockholm, Sweden
- Centre for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden
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Kesarwala A, Kim C, Jones J, Kaushal A, Roper N, Hoang C, Szabo E, Connolly M, Padiernos E, Cultraro C, Waris M, Gao S, Steinberg S, Khan J, Rajan A, Guha U. Radiation As a Local Ablative Therapy Option for Oligoprogressive EGFR-Mutant Non-Small Cell Lung Cancer after Treatment with Osimertinib. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1719] [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: 11/30/2022]
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10
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Erlandson MC, Wong AKO, Szabo E, Vilayphiou N, Zulliger MA, Adachi JD, Cheung AM. Muscle and Myotendinous Tissue Properties at the Distal Tibia as Assessed by High-Resolution Peripheral Quantitative Computed Tomography. J Clin Densitom 2017; 20:226-232. [PMID: 27956336 DOI: 10.1016/j.jocd.2016.10.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 09/13/2016] [Accepted: 10/31/2016] [Indexed: 01/17/2023]
Abstract
High-resolution peripheral quantitative computed tomography (HR-pQCT) quantifies bone microstructure and density at the distal tibia where there is also a sizable amount of myotendinous (muscle and tendon) tissue (MT); however, there is no method for the quantification of MT. This study aimed (1) to assess the feasibility of using HR-pQCT distal tibia scans to estimate MT properties using a custom algorithm, and (2) to determine the relationship between MT properties at the distal tibia and mid-leg muscle density (MD) obtained from pQCT. Postmenopausal women from the Hamilton cohort of the Canadian Multicenter Osteoporosis Study had a single-slice (2.3 ± 0.5 mm) 66% site pQCT scan measuring muscle cross-sectional area (MCSA) and MD. A standard HR-pQCT scan was acquired at the distal tibia. HR-pQCT-derived MT cross-sectional area (MTCSA) and MT density (MTD) were calculated using a custom algorithm in which thresholds (34.22-194.32 mg HA/cm3) identified muscle seed volumes and were iteratively expanded. Pearson and Bland-Altman plots were used to assess correlations and systematic differences between pQCT- and HR-pQCT-derived muscle properties. Among 45 women (mean age: 74.6 ± 8.5 years, body mass index: 25.9 ± 4.3 kg/m2), MTD was moderately correlated with mid-leg MD across the 2 modalities (r = 0.69-0.70, p < 0.01). Bland-Altman analyses revealed no evidence of directional bias for MTD-MD. HR-pQCT and pQCT measures of MTCSA and MCSA were moderately correlated (r = 0.44, p < 0.01). Bland-Altman plots for MTCSA revealed that larger MCSAs related to larger discrepancy between the distal and the mid-leg locations. This is the first study to assess the ability of HR-pQCT to measure MT size, density, and morphometry. HR-pQCT-derived MTD was moderately correlated with mid-leg MD from pQCT. This relationship suggests that distal MT may share common properties with muscle throughout the length of the leg. Future studies will assess the value of HR-pQCT-derived MT properties in the context of falls, mobility, and balance.
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Affiliation(s)
- M C Erlandson
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
| | - A K O Wong
- Department of Medicine and Joint Department of Medical Imaging, University Health Network, Toronto, Ontario, Canada; Department of Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - E Szabo
- Department of Medicine and Joint Department of Medical Imaging, University Health Network, Toronto, Ontario, Canada
| | | | | | - J D Adachi
- Department of Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - A M Cheung
- Department of Medicine and Joint Department of Medical Imaging, University Health Network, Toronto, Ontario, Canada
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11
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Lohmann B, Szabo E. P08.34 Targeting glioma stem cells with interferon-β. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.223] [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: 11/12/2022] Open
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12
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Stenberg E, Szabo E, Ottosson J, Näslund I. Outcomes of laparoscopic gastric bypass in a randomized clinical trial compared with a concurrent national database. Br J Surg 2017; 104:562-569. [PMID: 28239833 DOI: 10.1002/bjs.10448] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 10/24/2016] [Accepted: 10/31/2016] [Indexed: 12/29/2022]
Abstract
BACKGROUND RCTs are the standard for assessing medical interventions, but they may not be feasible and their external validity is sometimes questioned. This study aimed to compare results from an RCT on mesenteric defect closure during laparoscopic gastric bypass with those from a national database containing data on the same procedure, to shed light on the external validity of the RCT. METHODS Patients undergoing laparoscopic gastric bypass surgery within an RCT conducted between 1 May 2010 and 14 November 2011 were compared with those who underwent the same procedure in Sweden outside the RCT over the same time interval. Primary endpoints were severe complications within 30 days and surgery for small bowel obstruction within 4 years. RESULTS Some 2507 patients in the RCT were compared with 8485 patients in the non-RCT group. There were no differences in severe complications within 30 days in the group without closure of the mesenteric defect (odds ratio (OR) for RCT versus non-RCT 0·94, 95 per cent c.i. 0·64 to 1·36; P = 0·728) or in the group with closure of the defect (OR 1·34, 0·96 to 1·86; P = 0·087). There were no differences between the RCT and non-RCT cohorts in reoperation rates for small bowel obstruction in the mesenteric defect non-closure (cumulative incidence 10·9 versus 9·4 per cent respectively; hazard ratio (HR) 1·20, 95 per cent c.i. 0·99 to 1·46; P = 0·065) and closure (cumulative incidence 5·7 versus 7·0 per cent; HR 0·82, 0·62 to 1·07; P = 0·137) groups. The relative risk for small bowel obstruction without mesenteric defect closure compared with closure was 1·91 in the RCT group and 1·39 in the non-RCT group. CONCLUSION The efficacy of mesenteric defect closure was similar in the RCT and national registry, providing evidence for the external validity of the RCT.
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Affiliation(s)
- E Stenberg
- Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - E Szabo
- Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - J Ottosson
- Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - I Näslund
- Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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13
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Szende A, Bussey B, Szabo E, Klastersky J, Tomey O, Mueller U, Gabriel S, Tang B. Budgetary impact of lipegfilgrastim to the Mexican healthcare system. Eur J Cancer 2017. [DOI: 10.1016/s0959-8049(17)30467-7] [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: 11/30/2022]
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14
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Brahme NN, Szabo E. Cancer prevention in the era of precision oncology. Clin Pharmacol Ther 2016; 101:575-577. [PMID: 28032900 DOI: 10.1002/cpt.566] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 11/03/2016] [Accepted: 11/06/2016] [Indexed: 01/11/2023]
Abstract
Cancer is a highly heterogeneous disease, both between and within different target organs. Precision cancer prevention requires understanding the molecular pathways leading to cancer on a "per-person" level, identification of individuals most at risk for developing cancer, and tailoring interventions to accommodate pathogenesis, risk, and individual responses to interventions. This commentary will discuss how an investment in precision prevention research can accelerate cancer prevention agent development-the key to reducing cancer incidence and mortality.
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Affiliation(s)
- N N Brahme
- Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.,Office of Biotechnology Products, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA
| | - E Szabo
- Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
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Vaczy A, Reglodi D, Somoskeoy T, Kovacs K, Lokos E, Szabo E, Tamas A, Atlasz T. The Protective Role of PAC1-Receptor Agonist Maxadilan in BCCAO-Induced Retinal Degeneration. J Mol Neurosci 2016; 60:186-94. [PMID: 27566170 DOI: 10.1007/s12031-016-0818-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 08/10/2016] [Indexed: 12/19/2022]
Abstract
A number of studies have proven that pituitary adenylate cyclase activating polypeptide (PACAP) is protective in neurodegenerative diseases. Permanent bilateral common carotid artery occlusion (BCCAO) causes severe degeneration in the rat retina. In our previous studies, protective effects were observed with PACAP1-38, PACAP1-27, and VIP but not with their related peptides, glucagon, or secretin in BCCAO. All three PACAP receptors (PAC1, VPAC1, VPAC2) appear in the retina. Molecular and immunohistochemical analysis demonstrated that the retinoprotective effects are most probably mainly mediated by the PAC1 receptor. The aim of the present study was to investigate the retinoprotective effects of a selective PAC1-receptor agonist maxadilan in BCCAO-induced retinopathy. Wistar rats were used in the experiment. After performing BCCAO, the right eye was treated with intravitreal maxadilan (0.1 or 1 μM), while the left eye was injected with vehicle. Sham-operated rats received the same treatment. Two weeks after the operation, retinas were processed for standard morphometric and molecular analysis. Intravitreal injection of 0.1 or 1 μM maxadilan caused significant protection in the thickness of most retinal layers and the number of cells in the GCL compared to the BCCAO-operated eyes. In addition, 1 μM maxadilan application was more effective than 0.1 μM maxadilan treatment in the ONL, INL, IPL, and the entire retina (OLM-ILM). Maxadilan treatment significantly decreased cytokine expression (CINC-1, IL-1α, and L-selectin) in ischemia. In summary, our histological and molecular analysis showed that maxadilan, a selective PAC1 receptor agonist, has a protective role in BCCAO-induced retinal degeneration, further supporting the role of PAC1 receptor conveying the retinoprotective effects of PACAP.
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Affiliation(s)
- A Vaczy
- Department of Anatomy, MTA-PTE PACAP Research Team, University of Pecs, Pecs, Hungary
| | - D Reglodi
- Department of Anatomy, MTA-PTE PACAP Research Team, University of Pecs, Pecs, Hungary
| | - T Somoskeoy
- Department of Anatomy, MTA-PTE PACAP Research Team, University of Pecs, Pecs, Hungary
| | - K Kovacs
- Department of Biochemistry and Medical Chemistry, University of Pecs, Pecs, Hungary
| | - E Lokos
- Department of Anatomy, MTA-PTE PACAP Research Team, University of Pecs, Pecs, Hungary
| | - E Szabo
- Department of Anatomy, MTA-PTE PACAP Research Team, University of Pecs, Pecs, Hungary
| | - A Tamas
- Department of Anatomy, MTA-PTE PACAP Research Team, University of Pecs, Pecs, Hungary
| | - T Atlasz
- Department of Anatomy, MTA-PTE PACAP Research Team, University of Pecs, Pecs, Hungary. .,Department of Sportbiology, University of Pecs, Ifjusag Street 6, Pecs, H-7624, Hungary. .,Janos Szentagothai Research Center, University of Pecs, Pecs, Hungary.
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Carter CA, Rajan A, Keen C, Szabo E, Khozin S, Thomas A, Brzezniak C, Guha U, Doyle LA, Steinberg SM, Xi L, Raffeld M, Tomita Y, Lee MJ, Lee S, Trepel JB, Reckamp KL, Koehler S, Gitlitz B, Salgia R, Gandara D, Vokes E, Giaccone G. Selumetinib with and without erlotinib in KRAS mutant and KRAS wild-type advanced nonsmall-cell lung cancer. Ann Oncol 2016; 27:693-9. [PMID: 26802155 DOI: 10.1093/annonc/mdw008] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 12/27/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND KRAS mutations in NSCLC are associated with a lack of response to epidermal growth factor receptor inhibitors. Selumetinib (AZD6244; ARRY-142886) is an oral selective MEK kinase inhibitor of the Ras/Raf/MEK/ERK pathway. PATIENTS AND METHODS Advanced nonsmall-cell lung cancer (NSCLC) patients failing one to two prior regimens underwent KRAS profiling. KRAS wild-type patients were randomized to erlotinib (150 mg daily) or a combination of selumetinib (150 mg daily) with erlotinib (100 mg daily). KRAS mutant patients were randomized to selumetinib (75 mg b.i.d.) or the combination. The primary end points were progression-free survival (PFS) for the KRAS wild-type cohort and objective response rate (ORR) for the KRAS mutant cohort. Biomarker studies of ERK phosphorylation and immune subsets were carried out. RESULTS From March 2010 to May 2013, 89 patients were screened; 41 KRAS mutant and 38 KRAS wild-type patients were enrolled. Median PFS in the KRAS wild-type arm was 2.4 months [95% confidence interval (CI) 1.3-3.7] for erlotinib alone and 2.1 months (95% CI 1.8-5.1) for the combination. The ORR in the KRAS mutant group was 0% (95% CI 0.0% to 33.6%) for selumetinib alone and 10% (95% CI 2.1% to 26.3%) for the combination. Combination therapy resulted in increased toxicities, requiring dose reductions (56%) and discontinuation (8%). Programmed cell death-1 expression on regulatory T cells (Tregs), Tim-3 on CD8+ T cells and Th17 levels were associated with PFS and overall survival in patients receiving selumetinib. CONCLUSIONS This study failed to show improvement in ORR or PFS with combination therapy of selumetinib and erlotinib over monotherapy in KRAS mutant and KRAS wild-type advanced NSCLC. The association of immune subsets and immune checkpoint receptor expression with selumetinib may warrant further studies.
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Affiliation(s)
- C A Carter
- John P. Murtha Cancer Center, Walter Reed National Military Medical Center, Bethesda
| | - A Rajan
- Medical Oncology Branch, Center for Cancer Research
| | - C Keen
- Medical Oncology Branch, Center for Cancer Research
| | - E Szabo
- Lung & Upper Aerodigestive Cancer Research Group Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda
| | - S Khozin
- Medical Oncology Branch, Center for Cancer Research
| | - A Thomas
- Medical Oncology Branch, Center for Cancer Research
| | - C Brzezniak
- John P. Murtha Cancer Center, Walter Reed National Military Medical Center, Bethesda
| | - U Guha
- Medical Oncology Branch, Center for Cancer Research
| | - L A Doyle
- Cancer Therapy Evaluation Program, National Institutes of Health, Bethesda
| | - S M Steinberg
- Biostatistics and Data Management Section, Office of the Clinical Director, Center for Cancer Research
| | - L Xi
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda
| | - M Raffeld
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda
| | - Y Tomita
- Medical Oncology Branch, Center for Cancer Research
| | - M J Lee
- Medical Oncology Branch, Center for Cancer Research
| | - S Lee
- Medical Oncology Branch, Center for Cancer Research
| | - J B Trepel
- Medical Oncology Branch, Center for Cancer Research
| | - K L Reckamp
- Department of Hematology and Medical Oncology, City of Hope Comprehensive Cancer Center, Duarte
| | - S Koehler
- Department of Hematology and Medical Oncology, City of Hope Comprehensive Cancer Center, Duarte
| | - B Gitlitz
- Department of Internal Medicine, University of Southern California, Los Angeles
| | - R Salgia
- Radiation and Cellular Oncology, University of Chicago, Medicine and Biological Sciences, Chicago
| | - D Gandara
- Division of Hematology and Oncology, University of California at Davis Cancer Center, Sacramento
| | - E Vokes
- Radiation and Cellular Oncology, University of Chicago, Medicine and Biological Sciences, Chicago
| | - G Giaccone
- Medical Oncology Branch, Center for Cancer Research Lombardi Comprehensive Cancer Center, Georgetown University, Washington, USA
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Klevebro F, Johnsen G, Johnson E, Viste A, Myrnäs T, Szabo E, Jacobsen AB, Friesland S, Tsai JA, Persson S, Lindblad M, Lundell L, Nilsson M. Morbidity and mortality after surgery for cancer of the oesophagus and gastro-oesophageal junction: A randomized clinical trial of neoadjuvant chemotherapy vs. neoadjuvant chemoradiation. Eur J Surg Oncol 2015; 41:920-6. [PMID: 25908010 DOI: 10.1016/j.ejso.2015.03.226] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Revised: 02/08/2015] [Accepted: 03/05/2015] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To compare the incidence and severity of postoperative complications after oesophagectomy for carcinoma of the oesophagus and gastro-oesophageal junction (GOJ) after randomized accrual to neoadjuvant chemotherapy (nCT) or neoadjuvant chemoradiotherapy (nCRT). BACKGROUND Neoadjuvant therapy improves long-term survival after oesophagectomy. To date, evidence is insufficient to determine whether combined nCT, or nCRT alone, is the most beneficial. METHODS Patients with carcinoma of the oesophagus or GOJ, resectable with a curative intention, were enrolled in this multicenter trial conducted at seven centres in Sweden and Norway. Study participants were randomized to nCT or nCRT followed by surgery with two-field lymphadenectomy. Three cycles of cisplatin/5-fluorouracil was administered in all patients, while 40 Gy of concomitant radiotherapy was administered in the nCRT group. RESULTS Of the randomized 181 patients, 91 were assigned to nCT and 90 to nCRT. One-hundred-and-fifty-five patients, 78 nCT and 77 nCRT, underwent resection. There was no statistically significant difference between the groups in the incidence of surgical or nonsurgical complications (P-value = 0.69 and 0.13, respectively). There was no 30-day mortality, while the 90-day mortality was 3% (2/78) in the nCT group and 6% (5/77) in the nCRT group (P = 0.24). The median Clavien-Dindo complication severity grade was significantly higher in the nCRT group (P = 0.001). CONCLUSION There was no significant difference in the incidence of complications between patients randomized to nCT and nCRT. However, complications were significantly more severe after nCRT. REGISTRATION TRIAL DATABASE The trial was registered in the Clinical Trials Database (registration number NCT01362127).
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Affiliation(s)
- F Klevebro
- Division of Surgery, Department of Clinical Science Intervention and Technology, Karolinska Institutet and Centre for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden.
| | - G Johnsen
- Department of Gastrointestinal Surgery, St Olavs Hospital, Trondheim University Hospital, Norway
| | - E Johnson
- Department of Paediatric and Gastrointestinal Surgery, Ullevål University Hospital, Oslo, Norway
| | - A Viste
- Department of Acute and Gastrointestinal Surgery Haukeland University Hospital, Bergen and Department of Clinical Medicine, University of Bergen, Norway
| | - T Myrnäs
- Department of Surgery, Umeå University Hospital, Umeå, Sweden
| | - E Szabo
- Department of Surgery, Örebro University Hospital, Sweden
| | - A-B Jacobsen
- Department of Oncology, Oslo University Hospital, Norway
| | - S Friesland
- Department of Oncology, Karolinska University Hospital, Stockholm, Sweden
| | - J A Tsai
- Division of Surgery, Department of Clinical Science Intervention and Technology, Karolinska Institutet and Centre for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - S Persson
- Division of Surgery, Department of Clinical Science Intervention and Technology, Karolinska Institutet and Centre for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - M Lindblad
- Division of Surgery, Department of Clinical Science Intervention and Technology, Karolinska Institutet and Centre for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - L Lundell
- Division of Surgery, Department of Clinical Science Intervention and Technology, Karolinska Institutet and Centre for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - M Nilsson
- Division of Surgery, Department of Clinical Science Intervention and Technology, Karolinska Institutet and Centre for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden
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Szabo E, Kovács R, Plangár I, Tokés T, Polanek R, Czifrus S, Bencsik D, Hideghéty K. PO-1074 Vertebrate model to examine the biological effectiveness of different radiation qualities. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)41066-7] [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: 10/23/2022]
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Veronesi G, Lazzeroni M, Szabo E, Brown PH, DeCensi A, Guerrieri-Gonzaga A, Bellomi M, Radice D, Grimaldi MC, Spaggiari L, Bonanni B. Long-term effects of inhaled budesonide on screening-detected lung nodules. Ann Oncol 2015; 26:1025-1030. [PMID: 25672894 DOI: 10.1093/annonc/mdv064] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 01/31/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND A previously carried out randomized phase IIb, placebo-controlled trial of 1 year of inhaled budesonide, which was nested in a lung cancer screening study, showed that non-solid and partially solid lung nodules detected by low-dose computed tomography (LDCT), and not immediately suspicious for lung cancer, tended to regress. Because some of these nodules may be slow-growing adenocarcinoma precursors, we evaluated long-term outcomes (after stopping the 1-year intervention) by annual LDCT. PATIENTS AND METHODS We analyzed the evolution of target and non-target trial nodules detected by LDCT in the budesonide and placebo arms up to 5 years after randomization. The numbers and characteristics of lung cancers diagnosed during follow-up were also analyzed. RESULTS The mean maximum diameter of non-solid nodules reduced significantly (from 5.03 mm at baseline to 2.61 mm after 5 years) in the budesonide arm; there was no significant size change in the placebo arm. The mean diameter of partially solid lesions also decreased significantly, but only by 0.69 mm. The size of solid nodules did not change. Neither the number of new lesions nor the number of lung cancers differed in the two arms. CONCLUSIONS Inhaled budesonide given for 1 year significantly decreased the size of non-solid nodules detected by screening LDCT after 5 years. This is of potential importance since some of these nodules may progress slowly to adenocarcinoma. However, further studies are required to assess clinical implications. CLINICAL TRIAL NUMBER NCT01540552.
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Affiliation(s)
| | - M Lazzeroni
- Cancer Prevention and Genetics, European Institute of Oncology, Milan, Italy
| | - E Szabo
- Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda
| | - P H Brown
- Department of Clinical Cancer Prevention, University of Texas MD Anderson Cancer Center, Houston, USA
| | - A DeCensi
- Cancer Prevention and Genetics, European Institute of Oncology, Milan, Italy; Division of Medical Oncology, Ospedali Galliera, Genoa
| | - A Guerrieri-Gonzaga
- Cancer Prevention and Genetics, European Institute of Oncology, Milan, Italy
| | - M Bellomi
- Division of Radiology, European Institute of Oncology, Milan; University of Milan, Milan
| | - D Radice
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy
| | - M C Grimaldi
- Division of Radiology, European Institute of Oncology, Milan
| | - L Spaggiari
- Divisions of Thoracic Surgery; University of Milan, Milan
| | - B Bonanni
- Cancer Prevention and Genetics, European Institute of Oncology, Milan, Italy
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20
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Szabo E. Oregonator generalization as a minimal model of quorum sensing in Belousov–Zhabotinsky reaction with catalyst confinement in large populations of particles. RSC Adv 2015. [DOI: 10.1039/c5ra12841b] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
The Oregonator demonstrates that quorum sensing in populations of Belousov–Zhabotinsky oscillators arises from modification of the stoichiometry by catalyst confinement.
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Affiliation(s)
- E. Szabo
- Department of Earth and Planetary Sciences
- Harvard University
- Cambridge
- USA
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Tritschler I, Seystahl K, Szabo E, Tabatabai G, Weller M. CS-35 * TGF- INDUCES AND BMP SUPPRESSES VEGF RELEASE DEPENDING ON SMAD2/3 VERSUS SMAD1/5/8 SIGNALING IN GLIOBLASTOMA. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou242.35] [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: 11/14/2022] Open
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Seystahl K, Tritschler I, Szabo E, Tabatabai G, Weller M. P01.21 * DIFFERENTIAL REGULATION OF TGF- -INDUCED, ALK-5-MEDIATED VEGF RELEASE BY SMAD2/3 VERSUS SMAD1/5/8 SIGNALING IN GLIOBLASTOMA. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.114] [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: 11/13/2022] Open
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Codo P, Weller M, Meister G, Szabo E, Steinle A, Wolter M, Reifenberger G, Roth P. P02.04 * MICRORNA-MEDIATED DOWN-REGULATION OF NKG2D LIGAND EXPRESSION REDUCES GLIOMA CELL IMMUNOGENICITY. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.120] [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: 11/12/2022] Open
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Veronesi G, Lazzeroni M, Szabo E, Brown P, De Censi A, Guerrieri-Gonzaga A, Bellomi M, Radice D, Grimaldi M, Spaggiari L, Bonanni B. Long-Term Effects of Inhaled Budesonide on Screening-Detected Lung Nodules. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu351.2] [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: 11/13/2022] Open
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Nigil Haroon N, Cheung A, Szabo E, Raboud J, Anton A, Josse R, Inman R. AB1082 High-Resolution Peripheral Quantitative CT (HRPQCT) in Ankylosing Spondylitis Reveals Diminished Bone Strength and Volumetric Bmd. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4315] [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: 11/03/2022]
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Abuhusain H, Matin A, Qiao Q, Shen H, Daniels B, Laaksonen M, Teo C, Don A, McDonald K, Jahangiri A, De Lay M, Lu K, Park C, Carbonell S, Bergers G, Aghi MK, Anand M, Tucker-Burden C, Kong J, Brat DJ, Bae E, Smith L, Muller-Greven G, Yamada R, Nakano-Okuno M, Feng X, Hambardzumyan D, Nakano I, Gladson CL, Berens M, Jung S, Kim S, Kiefer J, Eschbacher J, Dhruv H, Vuori K, Hauser C, Oshima R, Finlay D, Aza-Blanc P, Bessarabova M, Nikolsky Y, Emig D, Bergers G, Lu K, Rivera L, Chang J, Burrell K, Singh S, Hill R, Zadeh G, Li C, Chen Y, Mei X, Sai K, Chen Z, Wang J, Wu M, Marsden P, Das S, Eskilsson E, Talasila KM, Rosland GV, Leiss L, Saed HS, Brekka N, Sakariassen PO, Lund-Johansen M, Enger PO, Bjerkvig R, Miletic H, Gawrisch V, Ruttgers M, Weigell P, Kerkhoff E, Riemenschneider M, Bogdahn U, Vollmann-Zwerenz A, Hau P, Ichikawa T, Onishi M, Kurozumi K, Maruo T, Fujii K, Ishida J, Shimazu Y, Oka T, Chiocca EA, Date I, Jain R, Griffith B, Khalil K, Scarpace L, Mikkelsen T, Kalkanis S, Schultz L, Jalali S, Chung C, Burrell K, Foltz W, Zadeh G, Jiang C, Wang H, Kijima N, Hosen N, Kagawa N, Hashimoto N, Chiba Y, Kinoshita M, Sugiyama H, Yoshimine T, Klank R, Decker S, Forster C, Price M, SantaCruz K, McCarthy J, Ohlfest J, Odde D, Kurozumi K, Onishi M, Ichikawa T, Fujii K, Ishida J, Shimazu Y, Chiocca EA, Kaur B, Date I, Huang Y, Lin Q, Mao H, Wang Y, Kogiso M, Baxter P, Man C, Wang Z, Zhou Y, Li XN, Liang J, Piao Y, de Groot J, Lu K, Rivera L, Chang J, Bergers G, McDonell S, Liang J, Piao Y, Henry V, Holmes L, de Groot J, Michaelsen SR, Stockhausen MT, Hans, Poulsen S, Rosland GV, Talasila KM, Eskilsson E, Jahedi R, Azuaje F, Stieber D, Foerster S, Varughese J, Ritter C, Niclou SP, Bjerkvig R, Miletic H, Talasila KM, Soentgerath A, Euskirchen P, Rosland GV, Wang J, Huszthy PC, Prestegarden L, Skaftnesmo KO, Sakariassen PO, Eskilsson E, Stieber D, Keunen O, Nigro J, Vintermyr OK, Lund-Johansen M, Niclou SP, Mork S, Enger PO, Bjerkvig R, Miletic H, Mohan-Sobhana N, Hu B, De Jesus J, Hollingsworth B, Viapiano M, Muller-Greven G, Carlin C, Gladson C, Nakada M, Furuta T, Sabit H, Chikano Y, Hayashi Y, Sato H, Minamoto T, Hamada JI, Fack F, Espedal H, Obad N, Keunen O, Gotlieb E, Sakariassen PO, Miletic H, Niclou SP, Bjerkvig R, Bougnaud S, Golebiewska A, Stieber D, Oudin A, Brons NHC, Bjerkvig R, Niclou SP, O'Halloran P, Viel T, Schwegmann K, Wachsmuth L, Wagner S, Kopka K, Dicker P, Faber C, Jarzabek M, Hermann S, Schafers M, O'Brien D, Prehn J, Jacobs A, Byrne A, Oka T, Ichikawa T, Kurozumi K, Inoue S, Fujii K, Ishida J, Shimazu Y, Chiocca EA, Date I, Olsen LS, Stockhausen M, Poulsen HS, Plate KH, Scholz A, Henschler R, Baumgarten P, Harter P, Mittelbronn M, Dumont D, Reiss Y, Rahimpour S, Yang C, Frerich J, Zhuang Z, Renner D, Jin F, Parney I, Johnson A, Rockne R, Hawkins-Daarud A, Jacobs J, Bridge C, Mrugala M, Rockhill J, Swanson K, Schneider H, Szabo E, Seystahl K, Weller M, Takahashi Y, Ichikawa T, Maruo T, Kurozumi K, Onishi M, Ouchida M, Fuji K, Shimazu Y, Oka T, Chiocca EA, Date I, Umakoshi M, Ichikawa T, Kurozumi K, Onishi M, Fujii K, Ishida J, Shimazu Y, Oka T, Chiocca EA, Kaur B, Date I, Sim H, Gruenbacher P, Jakeman L, Viapiano M, Wang H, Jiang C, Wang H, Jiang C, Parker J, Dionne K, Canoll P, DeMasters B, Waziri A. ANGIOGENESIS AND INVASION. Neuro Oncol 2013. [DOI: 10.1093/neuonc/not172] [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: 11/14/2022] Open
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Kelly RJ, Thomas A, Rajan A, Chun G, Lopez-Chavez A, Szabo E, Spencer S, Carter CA, Guha U, Khozin S, Poondru S, Van Sant C, Keating A, Steinberg SM, Figg W, Giaccone G. A phase I/II study of sepantronium bromide (YM155, survivin suppressor) with paclitaxel and carboplatin in patients with advanced non-small-cell lung cancer. Ann Oncol 2013; 24:2601-2606. [PMID: 23857959 DOI: 10.1093/annonc/mdt249] [Citation(s) in RCA: 121] [Impact Index Per Article: 11.0] [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: 12/16/2022] Open
Abstract
BACKGROUND This phase I/II study examined the safety and efficacy of Sepantronium Bromide (S), a small-molecule selective survivin suppressant, administered in combination with carboplatin (C) and paclitaxel (P). PATIENTS AND METHODS Forty-one patients were treated on study. Twenty-two patients received escalating doses of S (3.6-12 mg/m(2)) and 19 with untreated stage IV non-small-cell lung cancer (NSCLC) were treated with the maximum tolerated dose of 10 mg/m(2) in combination with standard doses of C (AUC6) and P (200 mg/m(2)) for six cycles. S was administered as a continuous intravenous infusion (CIVI) over 72 h in 21-day treatment cycles. Study end points included safety and toxic effect, response rate, progression-free and overall survival (PFS and OS), as well as exploratory pharmacodynamic correlates. RESULTS Treatment with S was well tolerated, and toxic effects were mostly hematological in the phase II study. Two (11%) partial responses were observed with a median PFS of 5.7 months and median OS 16.1 months. Pharmacodynamic analysis did not demonstrate an association with response. CONCLUSION The combination of S (10 mg/m(2)/day 72-h CIVI) administered with C and P every 3 weeks exhibited a favorable safety profile but failed to demonstrate an improvement in response rate in advanced NSCLC. CLINICAL TRIAL NUMBER NCT01100931.
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Affiliation(s)
- R J Kelly
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins, Baltimore
| | - A Thomas
- Medical Oncology Branch, Center for Cancer Research
| | - A Rajan
- Medical Oncology Branch, Center for Cancer Research
| | - G Chun
- Medical Oncology Branch, Center for Cancer Research
| | | | - E Szabo
- Lung and Upper Aerodigestive Cancer Research Group, Division of Cancer Prevention, National Cancer Institute, Bethesda
| | - S Spencer
- Medical Oncology Branch, Center for Cancer Research
| | - C A Carter
- Medical Oncology, Walter Reed National Military Medical Center, Bethesda
| | - U Guha
- Medical Oncology Branch, Center for Cancer Research
| | - S Khozin
- Medical Oncology Branch, Center for Cancer Research
| | - S Poondru
- Astellas Pharma Global Development, Northbrook
| | - C Van Sant
- Astellas Pharma Global Development, Northbrook
| | - A Keating
- Astellas Pharma Global Development, Northbrook
| | - S M Steinberg
- Biostatistics and Data Management Section, Office of the Clinical Director, Center for Cancer Research, National Cancer Institute, Bethesda, USA
| | - W Figg
- Medical Oncology Branch, Center for Cancer Research
| | - G Giaccone
- Medical Oncology Branch, Center for Cancer Research.
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Labas A, Szabo E, Mones L, Fuxreiter M. Optimization of reorganization energy drives evolution of the designed Kemp eliminase KE07. Biochim Biophys Acta 2013; 1834:908-17. [PMID: 23380188 DOI: 10.1016/j.bbapap.2013.01.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Revised: 01/06/2013] [Accepted: 01/08/2013] [Indexed: 10/27/2022]
Abstract
Understanding enzymatic evolution is essential to engineer enzymes with improved activities or to generate enzymes with tailor-made activities. The computationally designed Kemp eliminase KE07 carries out an unnatural reaction by converting of 5-nitrobenzisoxazole to cyanophenol, but its catalytic efficiency is significantly lower than those of natural enzymes. Three series of designed Kemp eliminases (KE07, KE70, KE59) were shown to be evolvable with considerable improvement in catalytic efficiency. Here we use the KE07 enzyme as a model system to reveal those forces, which govern enzymatic evolution and elucidate the key factors for improving activity. We applied the Empirical Valence Bond (EVB) method to construct the free energy pathway of the reaction in the original KE07 design and the evolved R7 1/3H variant. We analyzed catalytic effect of residues and demonstrated that not all mutations in evolution are favorable for activity. In contrast to the small decrease in the activation barrier, in vitro evolution significantly reduced the reorganization energy. We developed an algorithm to evaluate group contributions to the reorganization energy and used this approach to screen for KE07 variants with potential for improvement. We aimed to identify those mutations that facilitate enzymatic evolution, but might not directly increase catalytic efficiency. Computational results in accord with experimental data show that all mutations, which appear during in vitro evolution were either neutral or favorable for the reorganization energy. These results underscore that distant mutations can also play role in optimizing efficiency via their contribution to the reorganization energy. Exploiting this principle could be a promising strategy for computer-aided enzyme design. This article is part of a Special Issue entitled: The emerging dynamic view of proteins: Protein plasticity in allostery, evolution and self-assembly.
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Affiliation(s)
- A Labas
- DE OEC-Momentum Laboratory of Protein dynamics, University of Debrecen, Debrecen, Hungary
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Savolt A, Peley G, Toth L, Matrai Z, Polgar C, Horvath Z, Szabo E, Borbely K. 548 FDG-PET/CT Follow-up of Patients with Sentinel Node-Positive Breast Cancer After Axillary Nodal Irradiation Without Completion Axillary Dissection. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)70613-5] [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: 10/28/2022]
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Lubet RA, Bode AM, Szabo E, Grubbs CJ. P3-10-01: Alternative Dosing Regimens with the EGFr Inhibitors (Gefitinib and Lapatinib) in Mammary Cancer Models: Prevention and Therapeutic Efficacy. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p3-10-01] [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
The EGFR inhibitors are effective in treatment of lung and pancreatic cancers (erlotinib, gefitinib) and Neu overexpressing breast cancer (lapatinib) in humans; as well as preventing multiple cancers in animal models. However, the development of toxicities (Iressa, skin rashes; Lapatinib, diarrhea) limit their potential use in prevention; and perhaps even in an adjuvant setting. We examined whether alternative dosing regimens which might reduce toxicity would still achieve preventive and therapeutic efficacy. Female Sprague-Dawley rats were administered a single IV dose of methylnitrosourea (MNU) at 50 days of age. In a prevention study, MNU treated rats administered Gefitinib daily (10 mg/kg BW/day, 7x/week) or Gefitinib (70 mg/kg BW, 1x/week) beginning 5 days after MNU resulted in 94 and 75% reductions, respectively, in cancer multiplicity. Simultaneous measurements of tumor load (number of tumors x tumor weight) showed that both regimens resulted in greater than a 90% decrease. In the therapeutic study (initiating treatment when animals developed a small palpable cancer), both regimens were again highly effective. A prevention study was also performed with Lapatinib (75 mg/kg BW/day, 7x/week or 525 mg/kg BW, 1x/week). While the daily dose reduced cancer multiplicity 90%, the weekly dose caused a 70% reduction. Finally, we examined the effects of daily or weekly dosing with Iressa (100 mg/kg BW/day, 5x/week or 500 or 250 mg/kg BW, 1x/week) in an ER− mouse model (using MMTV-Neu; p53+/− mice). This study showed that while daily dosing with Iressa decreased tumor multiplicity roughly 80%, weekly dosing at either dose caused roughly a 50% decrease. These data show that even a significant alteration in the dosing of Gefitinib (EGFR 1) or Lapatinib (EGFR 2/1) still resulted in a large reduction in mammary cancers. The important clinical question will be whether this altered dosing will diminish the toxicities associated with these agents. We cannot determine this in animal models since, at the effective doses employed, the typical toxicities observed in humans are not observed. Supported by NCI contract number HHSN261200433001C.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P3-10-01.
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Affiliation(s)
- RA Lubet
- 1National Cancer Institute, Bethesda, MD; Hormel Institute, Austin, MN; University of Alabama at Birmingham, Birmingham, AL
| | - AM Bode
- 1National Cancer Institute, Bethesda, MD; Hormel Institute, Austin, MN; University of Alabama at Birmingham, Birmingham, AL
| | - E Szabo
- 1National Cancer Institute, Bethesda, MD; Hormel Institute, Austin, MN; University of Alabama at Birmingham, Birmingham, AL
| | - CJ Grubbs
- 1National Cancer Institute, Bethesda, MD; Hormel Institute, Austin, MN; University of Alabama at Birmingham, Birmingham, AL
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Rajan A, Kelly RJ, Lopez-Chavez A, Carter CA, Szabo E, Scepura B, Manu MJ(, Berman AW, Giaccone G. Management of thymic epithelial tumors (TETs) at the National Cancer Institute (NCI). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e17511] [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: 11/20/2022] Open
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Lubet RA, Iwata K, Szabo E, Grubbs CJ. Abstract P1-08-03: Alternative Dosing Regimens with Tarceva in a Mammary Cancer Model: Effects on Efficacy and Potential Effects on Toxicity. Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-p1-08-03] [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
The EGFR inhibitors (e.g., Tarceva) have been effective in preventing cancer in multiple animal models, including ER positive breast, head and neck, and urinary bladder cancers. Although Tarceva is less toxic than most classical cytotoxic therapies, the development of a skin rash in greater than 35% of patients is a significant impediment to its use in a preventive setting. We, therefore, tested whether alternative dosing regimens would still achieve preventive efficacy. Female Sprague-Dawley rats were administered a single IV dose of methylnitrosourea at 50 days of age. Beginning 5 days later, rats were administered Tarceva (6 mg/kg BW) by gavage. In the first study, three different protocols were employed: (1) dosing with Tarceva daily (7X/week), (2) dosing with Tarceva for one day followed by one day of vehicle treatment, and (3) two days of dosing with Tarceva followed by two days of dosing with vehicle treatment. These treatment regimens resulted in 94, 58, and 77% decreases, respectively, in cancer multiplicity when compared to rats receiving vehicle alone. In a second ongoing study, we are evaluating the following alternative dosing schedules. MNU treated rats are receiving either: (1) daily dosing with 6 mg/kg BW (total of 42 mg/week); (2) dosing 6 mg/kg BW, 2 days on-2 days off (total of 21 mg/week): (3) weekly dosing with a single dose of 42 mg; and (4) daily dosing with the vehicle. The various Tarceva treatment regimens have currently reduced palpable mammary tumor multiplicity by 82, 66, and 71%, respectively. These data imply that by significantly altering the dosing of Tarceva, including a dose of once per week, most of the preventive efficacy is retained. Pharmacokinetic studies from these protocols showed a t½ of <8 hours; implying that sub-effective serum levels were achieved within 48 hours of the last dose. Whether these altered protocols may affect the induced skin rash in women is a significant and practical question. Supported by NCI contract number HHSN261200433001C.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P1-08-03.
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Affiliation(s)
- RA Lubet
- National Cancer Institute, Bethesda, MD; OSI Pharmaceuticals, Farmingdale, NY; University of Alabama at Birmingham
| | - K Iwata
- National Cancer Institute, Bethesda, MD; OSI Pharmaceuticals, Farmingdale, NY; University of Alabama at Birmingham
| | - E Szabo
- National Cancer Institute, Bethesda, MD; OSI Pharmaceuticals, Farmingdale, NY; University of Alabama at Birmingham
| | - CJ. Grubbs
- National Cancer Institute, Bethesda, MD; OSI Pharmaceuticals, Farmingdale, NY; University of Alabama at Birmingham
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Bonanni B, Guerrieri-Gonzaga A, Radice D, Serrano D, Varricchio C, Ferretti S, Johansson H, Szabo E, Decensi A, Veronesi G. Randomized phase II trial of budesonide versus placebo in high-risk population with screening-detected lung nodules: Update on secondary endpoints. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.1518] [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
1518 Background: Lung cancer phase II chemoprevention trials have not focused so far on the peripheral lung. CT discovers small, undetermined peripheral nodules, which may be preinvasive lesions. In a recent phase II trial the glucocorticoid Budesonide reduced peripheral nodules at spiral CT. Methods: We performed a randomized, double-blind, placebo-controlled, phase IIb clinical trial of inhaled budesonide in current (CS) or former smokers (FS) with CT-detected peripheral nodules. Primary endpoint: shrinkage effect on nodules. Secondary endpoints: decrease in size/number of the target lesions, modulation of tumor markers in sputum and plasma, toxicity, effect on pulmonary function. Two hundred and two subjects received 800μg budesonide (B) twice daily or placebo (P) for 1 year. CT scans at 0 and 12 months (mts), and clinical evaluation + serum/plasma collection at 0, 3, 6, and 12 months were performed. Subjects were stratified according to gender, smoking habits (CS vs. FS), and nodule characteristics (solid vs. non-solid). Results: Preliminary data had shown no shrinkage of the nodules in the B treated arm in a per subject analysis (primary objective). We present now results on serum markers (ultrasensitive C-reactive protein, CRP), emphysema and pulmonary function. As compared to baseline, CRP median levels show at 12 months a nonsignificant (p = 0.85) reduction: -0.25 ± 0.63 (B) vs. -1.16 ± 0.97 (P). 12-month values are significantly (p = 0.01) associated with baseline values and smoking status, with higher mean values at 12 months in FS (B 2.1 ± 2.0 vs. P 3.4 ± 1.9). Emphysema values at 12 months are significantly higher (p = 0.0022) in the B (+ 0.29 ± 0.06) versus P arm (+ 0.12 ± 0.07). This difference is not correlated to sex (p = 0.7062) and smoking status (p = 0.8044). As regards spirometry, no significant difference on FEV 1% and DLC/VA appears between arms at 12 months: median FEV 1% values 3.7 ± 1.0 for B versus 2.9 ± 1.0 for P (p = 0.6221); median DLC/VA increase of 0.3 ± 1.9 (B) versus decrease of -3.8 ± 1.6 (P) (p = 0.4191). Conclusions: A significant effect of B on ultrasensitive-CRP and pulmonary function has not been shown. CRP results may indicate the lack of systemic absorption of B. Emphysema appears slightly worse in the B arm, particularly in FS; this is worth further investigation. No significant financial relationships to disclose.
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Affiliation(s)
- B. Bonanni
- European Institute of Oncology, Milan, Italy; National Cancer Institute, NIH, Bethesda, MD; E.O. Ospedali Galliera, Genoa, Italy
| | - A. Guerrieri-Gonzaga
- European Institute of Oncology, Milan, Italy; National Cancer Institute, NIH, Bethesda, MD; E.O. Ospedali Galliera, Genoa, Italy
| | - D. Radice
- European Institute of Oncology, Milan, Italy; National Cancer Institute, NIH, Bethesda, MD; E.O. Ospedali Galliera, Genoa, Italy
| | - D. Serrano
- European Institute of Oncology, Milan, Italy; National Cancer Institute, NIH, Bethesda, MD; E.O. Ospedali Galliera, Genoa, Italy
| | - C. Varricchio
- European Institute of Oncology, Milan, Italy; National Cancer Institute, NIH, Bethesda, MD; E.O. Ospedali Galliera, Genoa, Italy
| | - S. Ferretti
- European Institute of Oncology, Milan, Italy; National Cancer Institute, NIH, Bethesda, MD; E.O. Ospedali Galliera, Genoa, Italy
| | - H. Johansson
- European Institute of Oncology, Milan, Italy; National Cancer Institute, NIH, Bethesda, MD; E.O. Ospedali Galliera, Genoa, Italy
| | - E. Szabo
- European Institute of Oncology, Milan, Italy; National Cancer Institute, NIH, Bethesda, MD; E.O. Ospedali Galliera, Genoa, Italy
| | - A. Decensi
- European Institute of Oncology, Milan, Italy; National Cancer Institute, NIH, Bethesda, MD; E.O. Ospedali Galliera, Genoa, Italy
| | - G. Veronesi
- European Institute of Oncology, Milan, Italy; National Cancer Institute, NIH, Bethesda, MD; E.O. Ospedali Galliera, Genoa, Italy
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Abstract
Epidemiological, pathomorphological, histological and microbiological studies on 272 gosling from 51 flocks showed that disease occurred generally at 3 to 4 weeks of age with morbidity of 15 to 25% and mortality of 3 to 8%. It was characterized by respiratory and nervous symptoms accompanied by serous-fibrinous inflammation of the mucosal membrane of the respiratory tract, pericardium and cerebral membranes. Mycoplasmas of 1220 type were isolated from trachea and airsac walls of 50% of the samples tested, but no adeno or reoviruses could be detected in homogenates of trachea and airsac wall, and no serological response indicative of Derzsy's disease could be demonstrated. E. coli, Ps. aeruginosa, S. typhimurium and Sir. pyogenes were occasionally cultured from the heart and liver of goslings. Cloacal and oviduct swabs and phallus lympha samples from five parent goose flocks also frequently revealed 1220 type mycoplasmas.
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Affiliation(s)
- L Stipkovits
- Veterinary Medical Research Institute of Hungarian Academy of Sciences, Budapest, Hungary
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Horvath Z, Czeglédi F, Ganofszky E, Hitre E, Juhos E, Szabo E, Szabo E, Peter I, Bak M, Lang I. 2078 POSTER Retrospective analysis of routine preoperative chemotherapy on effectivity and survival of 61 inflammatory breast cancer patients. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)70840-6] [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: 10/22/2022] Open
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37
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Grem JL, Wright M, Morrison G, Lin PX, Leonard G, Nguyen D, Guo XD, Szabo E. Phase I pharmacokinetic (PK) & pharmacogenetic study of sequential infusional irinotecan (IR) and fluorouracil (FU). J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.2075] [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)
| | - M. Wright
- National Cancer Institute, Bethesda, MD
| | | | - P.-X. Lin
- National Cancer Institute, Bethesda, MD
| | | | - D. Nguyen
- National Cancer Institute, Bethesda, MD
| | - X.-D. Guo
- National Cancer Institute, Bethesda, MD
| | - E. Szabo
- National Cancer Institute, Bethesda, MD
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38
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Peley G, Matrai Z, Renyi-Vamos F, Farkas E, Sinkovics I, Keresztes S, Bidlek M, Szabo E, Orosz Z, Koves I. Radioguided excision of nonpalpable breast cancer with simultaneous sentinel lymph node biopsy. EJC Suppl 2004. [DOI: 10.1016/s1359-6349(04)90691-x] [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: 11/26/2022] Open
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39
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Vourlekis JS, Szabo E. Major conceptual change required to improve lung cancer: see a respiratory physician. Eur Respir J 2003; 22:866. [PMID: 14621099 DOI: 10.1183/09031936.03.00068403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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40
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Wright MA, Schuler B, Szabo E, Grem JL. Sustained partial response of an intra-abdominal desmoid tumor treated with gemcitabine, 5-fluorouracil and leucovorin. Ann Oncol 2003; 14:659-60. [PMID: 12649120 DOI: 10.1093/annonc/mdg155] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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41
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Szabo E. Chemoprevention of lung cancer: New directions. Eur J Cancer 2002. [DOI: 10.1016/s0959-8049(02)80022-3] [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: 11/26/2022]
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43
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Abstract
Classical midgut carcinoids are rare intestinal neuroendocrine tumors that often present with metastases at diagnosis. In contrast to foregut carcinoids, midgut carcinoids are not related to the multiple endocrine neoplasia type 1 syndrome, and the mechanisms involved in their tumorigenesis are unknown. Eight classical midgut carcinoids were analyzed by genome-wide screening for loss of heterozygosity. Deletions on chromosome 18 were found in 88% of the tumors. DNA sequencing and immunohistochemical staining for Smad4/DPC4, which often is homozygously mutated in pancreatic and colon carcinomas, revealed no aberrations. In 1 tumor, a region telomeric to the Smad4/DPC4/DCC genes at 18q21 was deleted. Other chromosomes were affected in 3 lesions only. The high frequency of chromosome 18 deletions strongly indicates a genetic alteration of importance in classical midgut carcinoid tumorigenesis, apparently not involving the Smad4/DPC4 gene.
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Affiliation(s)
- R M Löllgen
- Department of Surgical Sciences, Endocrine Unit, Uppsala University Hospital, Uppsala, Sweden
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44
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Correa P, Szabo E, Lundgren E, Carling T. [Primary hyperparathyroidism is common among postmenopausal women. Identification of genetic risk factors can contribute to individualized treatment]. Lakartidningen 2001; 98:2198-200. [PMID: 11402599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Primary hyperparathyroidism (pHPT) is commonly seen in postmenopausal women. Along with the clinical characterisation of the disease, studies of molecular genetics have contributed to increased understanding of the etiology of pHPT. Genetic association studies have revealed that certain vitamin D receptor polymorphisms relate to the development of sporadic pHPT. A new type of familial pHPT was recently discovered. Studies of parathyroid adenomas have demonstrated that the tumor suppressor gene MEN1 and the oncogene cyclinD1 are of importance for the tumorigenesis.
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Affiliation(s)
- P Correa
- Burnham Institute, La Jolla, USA.
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Abstract
CC10 is infrequently expressed in human non-small cell lung cancers (NSCLCs), despite being abundantly produced by progenitor cells for normal and neoplastic epithelium. Many abnormalities in the surrounding lung associated with field carcinogenesis, which reflect prolonged exposure to such carcinogens as tobacco smoke, also revealed altered expression of CC10. Exposure of hamsters and mice to the tobacco-specific carcinogen NNK led to reduced CC10 expression, which was partially reversible. Overexpression of CC10 in immortalized bronchial epithelial cells delayed the induction of anchorage-independent growth in response to NNK. The data suggest that downregulation of CC10 contributes to carcinogenesis because CC10 antagonizes the neoplastic phenotype.
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MESH Headings
- Animals
- Antineoplastic Agents/metabolism
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/metabolism
- Disease Models, Animal
- Down-Regulation/genetics
- Gene Expression Regulation, Neoplastic/physiology
- Genes, Tumor Suppressor/drug effects
- Genes, Tumor Suppressor/physiology
- Humans
- Lung/drug effects
- Lung/pathology
- Lung/physiopathology
- Lung Neoplasms/etiology
- Lung Neoplasms/pathology
- Lung Neoplasms/physiopathology
- Mice
- Mice, Transgenic
- Proteins/genetics
- Proteins/metabolism
- Respiratory Mucosa/drug effects
- Respiratory Mucosa/metabolism
- Respiratory Mucosa/pathology
- Signal Transduction/genetics
- Synaptophysin/genetics
- Synaptophysin/metabolism
- Tumor Cells, Cultured/drug effects
- Tumor Cells, Cultured/metabolism
- Tumor Cells, Cultured/pathology
- Uteroglobin
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Affiliation(s)
- R I Linnoila
- Cell and Cancer Biology Department, Medicine Branch, Division of Clinical Sciences, National Cancer Institute, NIH, 9610 Medical Center Drive, Suite 300, Rockville, MD 20850, USA.
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Soejima K, Traber LD, Schmalstieg FC, Hawkins H, Jodoin JM, Szabo C, Szabo E, Virag L, Salzman A, Traber DL, Varig L. Role of nitric oxide in vascular permeability after combined burns and smoke inhalation injury. Am J Respir Crit Care Med 2001; 163:745-52. [PMID: 11254534 DOI: 10.1164/ajrccm.163.3.9912052] [Citation(s) in RCA: 100] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Patients with severe burn and/or smoke inhalation injury suffer both systemic and pulmonary vascular hyperpermeability. We hypothesized that nitric oxide (NO) produced by inducible nitric oxide synthase (iNOS) plays a role in the changes in microvascular permeability seen with this injury. To test the hypothesis, we administered mercaptoethylguanidine (MEG), a selective iNOS inhibitor, to conscious sheep subjected to a combined smoke inhalation and third-degree burn injury to 40% of total body surface area. The sheep were surgically prepared for chronic study with lung and prefemoral lymph fistulas in order to estimate microvascular permeability. Both the groups and a control group of animals showed an increase in iNOS protein and message in their lungs. The control animals showed significant increases in either plasma or lymph NO2-/NO3- (NOx) concentration at 24 h after injury, with associated cardiac depression and hemoconcentration. The airway epithelium stained for nitrotyrosine. In the treatment group, NOx did not increase significantly in plasma or lymph throughout the experiment, there was no nitrotyrosine staining, hemodynamic depression was not observed, and the fluid requirement was significantly less than in the control group. Changes in pulmonary microvascular permeability were significantly suppressed by inhibition of iNOS. However, there was no significant difference between the two study groups in the microvascular permeability of burned tissue. These data suggest that NO produced by iNOS plays an important role in the changes in systemic and pulmonary microvascular permeability in combined smoke inhalation/third-degree burn injury, but does not affect the vascular permeability of third-degree-burned tissue in this type of injury.
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Affiliation(s)
- K Soejima
- Department of Anesthesiology, University of Texas Medical Branch, Galveston, Texas 77555-0591, USA.
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47
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Carling T, Szabo E, Bai M, Ridefelt P, Westin G, Gustavsson P, Trivedi S, Hellman P, Brown EM, Dahl N, Rastad J. Familial hypercalcemia and hypercalciuria caused by a novel mutation in the cytoplasmic tail of the calcium receptor. J Clin Endocrinol Metab 2000; 85:2042-7. [PMID: 10843194 DOI: 10.1210/jcem.85.5.6477] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Familial hyperparathyroidism (HPT), characterized by hypercalcemia and hypercalciuria, and familial benign hypocalciuric hypercalcemia (FHH) are the most common causes of hereditary hypercalcemia. The calcium-sensing receptor (CaR) regulates PTH secretion and renal calcium excretion. Heterozygous inactivating mutations of the gene cause FHH, whereas CaR gene mutations have not been demonstrated in HPT. In a kindred with 20 affected individuals, the hypercalcemic disorder segregated with inappropriately higher serum PTH and magnesium levels and urinary calcium levels than in unaffected members. Subtotal parathyroidectomy revealed parathyroid gland hyperplasia/adenoma and corrected the biochemical signs of the disorder in seven of nine individuals. Linkage analysis mapped the condition to markers flanking the CaR gene on chromosome 3q. Sequence analysis revealed a mutation changing phenylalanine to leucine at codon 881 of the CaR gene, representing the first identified point mutation located within the cytoplasmic tail of the CaR. A construct of the mutant receptor (F881L) was expressed in human embryonic kidney cells (HEK 293), and demonstrated a right-shifted dose-response relationship between the extracellular and intracellular calcium concentrations. The hypercalcemic disorder of the present family is caused by an inactivating point mutation in the cytoplasmic tail of the CaR and displays clinical characteristics atypical of FHH and primary HPT.
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Affiliation(s)
- T Carling
- Department of Surgery, Uppsala University Hospital, Sweden.
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48
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Chang TH, Szabo E. Induction of differentiation and apoptosis by ligands of peroxisome proliferator-activated receptor gamma in non-small cell lung cancer. Cancer Res 2000; 60:1129-38. [PMID: 10706135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
The peroxisome proliferator-activated receptor gamma (PPARgamma) is a ligand-activated transcription factor belonging to the steroid receptor superfamily. It is a key regulator of adipogenic differentiation, the ligands of which have also been demonstrated to induce differentiation in human breast and colon cancer cell lines. This study examined PPARgamma, in non-small cell lung cancer (NSCLC). PPARgamma mRNA and protein were expressed in NSCLC cell lines, with highest levels in adenocarcinomas. PPARgamma protein was also expressed in 50% of primary lung cancers by immunohistochemistry. Treatment of multiple cell lines with two distinct PPARgamma ligands in the presence of serum resulted in growth arrest, irreversible loss of capacity for anchorage-independent growth, decreased activity and expression of matrix metalloproteinase 2, and modulation of multiple markers in a manner consistent with differentiation. Specifically, there was up-regulation of general markers of the differentiated state such as gelsolin, Mad, and p21. Down-regulation of specific markers of progenitor lineages for the peripheral lung, i.e., the type II pneumocyte lineage markers MUC1 and surfactant protein-A and the Clara cell lineage marker CC10, also occurred. In addition, HTI56, a marker of terminally differentiated type I pneumocytes, was also induced. Consistent with a more mature, less malignant phenotype, ligand treatment also inhibited the expression of cyclin D1 and led to hypophosphorylation of the retinoblastoma protein. In contrast, in the absence of serum, ligand treatment rapidly resulted in apoptosis and substantially earlier onset of differentiation. Taken together, these results show that depending on the growth milieu, ligands of PPARgamma induce differentiation and apoptosis in NSCLC, suggesting clinical utility for these agents.
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Affiliation(s)
- T H Chang
- Cell and Cancer Biology Department, Medicine Branch, Division of Clinical Sciences, National Cancer Institute, Rockville, Maryland 20850, USA
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Lee HR, Chang TH, Tebalt MJ, Senderowicz AM, Szabo E. Induction of differentiation accompanies inhibition of Cdk2 in a non-small cell lung cancer cell line. Int J Oncol 1999. [DOI: 10.3892/ijo.15.1.161] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Lee HR, Chang TH, Tebalt MJ, Senderowicz AM, Szabo E. Induction of differentiation accompanies inhibition of Cdk2 in a non-small cell lung cancer cell line. Int J Oncol 1999; 15:161-6. [PMID: 10375610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
Induction of differentiation in a variety of model systems is accompanied by cell cycle exit and inhibition of Cdk2 kinase activity. We asked whether inhibition of Cdk2 activity is sufficient to allow differentiation to occur in a non-small cell lung cancer cell line. Treatment of NCI-H358 with flavopiridol, an inhibitor of multiple Cdk's, resulted in growth arrest and induction of mucinous differentiation. The onset of differentiation coincided temporally with loss of Cdk2 kinase activity. Western analysis revealed that flavopiridol treatment resulted in depletion of both cyclin E and D1, suggesting that loss of the regulatory subunits is at least partially responsible for the loss of Cdk kinase activity. Similarly, roscovitine, an inhibitor of Cdk's 1, 2, and 5, but not Cdk4, also induced differentiation in NCI-H358, although the resulting pattern of expression of cell cycle regulatory genes differed from the pattern obtained with flavopiridol. Furthermore, stable expression of an antisense Cdk2 construct in NCI-H358 also resulted in the appearance of a marker of mucinous differentiation. These results show that the inhibition of activity of cyclin dependent kinases, particularly Cdk2, by multiple different mechanisms is accompanied by differentiation. Thus, induction of differentiation is one potential mechanism of action for agents that down-regulate Cdk activity.
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Affiliation(s)
- H R Lee
- Cell and Cancer Biology Department, Medicine Branch, Division of Clinical Sciences, National Cancer Institute, Rockville, MD 20850, USA
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