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Leu M, Kitz J, Pilavakis Y, Hakroush S, Wolff HA, Canis M, Rieken S, Schirmer MA. Monocarboxylate transporter-1 (MCT1) protein expression in head and neck cancer affects clinical outcome. Sci Rep 2021; 11:4578. [PMID: 33633176 PMCID: PMC7907348 DOI: 10.1038/s41598-021-84019-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 02/04/2021] [Indexed: 01/31/2023] Open
Abstract
Treatment of locally advanced, unresectable head and neck squamous cell carcinoma (HNSCC) often yields only modest results with radiochemotherapy (RCT) as standard of care. Prognostic features related to outcome upon RCT might be highly valuable to improve treatment. Monocarboxylate transporters-1 and -4 (MCT1/MCT4) were evaluated as potential biomarkers. A cohort of HNSCC patients without signs for distant metastases was assessed eliciting 82 individuals eligible whereof 90% were diagnosed with locally advanced stage IV. Tumor specimens were stained for MCT1 and MCT4 in the cell membrane by immunohistochemistry. Obtained data were evaluated with respect to overall (OS) and progression-free survival (PFS). Protein expression of MCT1 and MCT4 in cell membrane was detected in 16% and 85% of the tumors, respectively. Expression of both transporters was not statistically different according to the human papilloma virus (HPV) status. Positive staining for MCT1 (n = 13, negative in n = 69) strongly worsened PFS with a hazard ratio (HR) of 3.1 (95%-confidence interval 1.6-5.7, p < 0.001). OS was likewise affected with a HR of 3.8 (2.0-7.3, p < 0.001). Multivariable Cox regression confirmed these findings. We propose MCT1 as a promising biomarker in HNSCC treated by primary RCT.
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Affiliation(s)
- Martin Leu
- grid.411984.10000 0001 0482 5331Clinic of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Robert-Koch-Strasse 40, 37075 Göttingen, Germany
| | - J. Kitz
- grid.411984.10000 0001 0482 5331Institute of Pathology, University Medical Center Göttingen, Robert-Koch-Strasse 40, 37075 Göttingen, Germany
| | - Y. Pilavakis
- grid.411984.10000 0001 0482 5331Clinic of Otorhinolaryngology, University Medical Center Göttingen, Robert-Koch-Strasse 40, 37075 Göttingen, Germany
| | - S. Hakroush
- grid.411984.10000 0001 0482 5331Institute of Pathology, University Medical Center Göttingen, Robert-Koch-Strasse 40, 37075 Göttingen, Germany
| | - H. A. Wolff
- Department of Radiology, Nuclear Medicine and Radiotherapy, Radiology Munich, Maximiliansplatz 2, 80333 Munich, Germany ,grid.7727.50000 0001 2190 5763Department of Radiation Oncology, Medical Center, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
| | - M. Canis
- grid.5252.00000 0004 1936 973XDepartment of Otorhinolaryngology, Head and Neck Surgery, Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377 Munich, Germany
| | - S. Rieken
- grid.411984.10000 0001 0482 5331Clinic of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Robert-Koch-Strasse 40, 37075 Göttingen, Germany
| | - M. A. Schirmer
- grid.411984.10000 0001 0482 5331Clinic of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Robert-Koch-Strasse 40, 37075 Göttingen, Germany
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Kauffmann P, Troeltzsch M, Cordesmeyer R, Heidekrueger PI, Schliephake H, Canis M, Wolff HA, Rave-Fraenk M, Stroebel P, Kehrer A, Prantl L, Aung T. Presentation of a variation of the chorioallantoic membrane set up as a potential model for individual therapy for squamous cell carcinoma of the oropharynx. Clin Hemorheol Microcirc 2018; 67:453-457. [PMID: 28885213 DOI: 10.3233/ch-179226] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The chorioallantoic membrane of fertilized chicken eggs in an early phase of breeding presents an approved test situation for the growth and treatment of human cancer cells.These models work due to the inoculation of cells into the membrane that stays within the egg shell during the time of investigation. In this study a modification of this model is presented. Samples of native tumors, rather than cell lines, are transplanted into the membrane and the body of the egg is taken out of the shell and placed in a plastic bowl. These modifications lead to an enhanced accessibility to the chorioallantoic membrane and the surrounding vessels thus facilitating intra venous access and application of pharmaceuticals and a focused radiotherapy. With the current modifications the embryo was kept alive and additionally, the vascularized tumor environment was preserved.
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Affiliation(s)
- P Kauffmann
- Department of Maxillofacial Surgery (Head: Prof. Dr. Dr. H. Schliephake), University of Göttingen, Göttingen, Germany
| | - M Troeltzsch
- Department of Maxillofacial Surgery (Head: Prof. Dr. Dr. H. Schliephake), University of Göttingen, Göttingen, Germany
| | - R Cordesmeyer
- Department of Maxillofacial Surgery (Head: Prof. Dr. Dr. H. Schliephake), University of Göttingen, Göttingen, Germany
| | - P I Heidekrueger
- Department of Plastic, Reconstructive, Hand, and Burn Surgery, StKM - Klinikum Bogenhausen, Academic Teaching Hospital, Technical University Munich, Munich, Germany
| | - H Schliephake
- Department of Maxillofacial Surgery (Head: Prof. Dr. Dr. H. Schliephake), University of Göttingen, Göttingen, Germany
| | - M Canis
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Göttingen, Göttingen, Germany
| | - H A Wolff
- University Medical Center Göttingen, Present Address: Department of Radiotherapy and Radiation Oncology, Radiologie München, Munich, Germany
| | - M Rave-Fraenk
- University Medical Center Göttingen, Present Address: Department of Radiotherapy and Radiation Oncology, Radiologie München, Munich, Germany
| | - P Stroebel
- Institute of Pathology, University Medical Centre, Göttingen, Germany
| | - A Kehrer
- Department of Plastic, Hand, and Reconstructive Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - L Prantl
- Department of Plastic, Hand, and Reconstructive Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - T Aung
- Department of Plastic, Hand, and Reconstructive Surgery, University Medical Center Regensburg, Regensburg, Germany
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Hennies S, Hermann RM, Gaedcke J, Grade M, Hess CF, Christiansen H, Wolff HA. Increasing toxicity during neoadjuvant radiochemotherapy as positive prognostic factor for patients with esophageal carcinoma. Dis Esophagus 2013; 27:146-51. [PMID: 23574528 DOI: 10.1111/dote.12067] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The aim of this study was to correlate acute organ toxicity during preoperative radiochemotherapy with overall survival and tumor regression for patients with primarily operable esophageal carcinoma. From 1995 to 2002, 60 patients with primarily operable esophageal carcinoma were treated in a preoperative setting at our department. Thirty-three percent of the patients had International Union against Cancer (UICC)-stage II tumors, 62% had UICC-stage III tumors, and 5% had UICC-stage IVA tumors. All patients received irradiation (40 Gy at 2 Gy/fraction). Chemotherapy for all patients with adenocarcinoma and, from 2001, also for patients with squamous cell carcinoma consisted of two cycles, 5-fluorouracil and cisplatinum; between 1995 and 2001, patients with squamous cell carcinoma received three courses of chemotherapy (folinic acid, etoposide, 5-fluorouracil, and cisplatinum every 3 weeks) before and further cisplatinum and etoposide during radiotherapy. We found a significant correlation between acute organ toxicity and histopathological tumor regression, as well as overall survival. The probability to achieve tumor regression grade 1 after radiochemotherapy was nearly four times higher for patients with worsening of odynophagia than for those without an increase (odds ratio: 3.97). Patients with worsening of odynophagia had a 5-year overall-survival rate of 66% compared with 39% in patients without (P = 0.048). Our data indicate that normal tissue and tumor tissue may behave similar with respect to treatment response, as acute organ toxicity showed to be an independent prognostic marker in our patient population. The hypothesis should be further analyzed on biomolecular and clinical level in future clinical trials.
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Affiliation(s)
- S Hennies
- Department of Radiotherapy, University Medicine Goettingen, Göttingen, Germany
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Conradi L, Bleckmann A, Schirmer M, Sprenger T, Homayounfar K, Wolff HA, Becker H, Ghadimi BM, Beissbarth T, Liersch T. Biomarker study in rectal cancer patients after 5FU-based radiochemotherapy: Evaluation of the prognostic capacity of thymidylate synthase in pretreatment biopsies and resected adenocarcinoma. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.435] [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
435 Background: Fluorouracil (5FU) remains the backbone of neoadjuvant radiochemotherapy (RCT) as well as adjuvant therapeutic strategies in multimodal treatment of rectal cancer patients. Due to its central role as the major target of 5FU thymidylate synthase (TS) is a promising biomarker in rectal cancer. We assessed TS in 208 patients with regard to its predictive/prognostic capacity for disease free DFS and overall cancer specific survival (CSS). Methods: 167 patients cUICC stages II (28%) and III (72%) received preoperative 5FU based RCT followed by total mesorectal excision (TME) A comparison group n = 41 received postoperative RCT after primary TME. All patients were treated after standardized protocols within phase-II/-III trials of the German Rectal Cancer Study Group. TS levels from pretreatment biopsies and corresponding resection specimens were assessed by immunohistochemical staining for their impact on DFS and CSS. Additionally, a TS gene polymorphism (28 bp repeat) was analysed in respect to intracellular protein expression levels and prognostic significance. Results: Patients with low TS expression in pre-treatment biopsies showed a correlation with impaired CSS (p = 0.015). After neoadjuvant RCT there was evidence of lymph node metastases ypUICC stage III in 32.6%. Complete histopathologically confirmed tumor regression TRG 4 was achieved in 16 patients (9.5%). During follow-up (median 57 months) patients with low intratumoral TS expression and positive nodal status were at high risk for local and/or distant metastatic recurrence (p = 0.040). Analysis of the 28bp repeat revealed a correlation of *3/*3 genotype with high TS expression in pretherapeutical biopsies (p = 0.05). Conclusions: TS represents a prognostic biomarker in locally advanced rectal cancer indicating an unfavourable outcome for patients with low TS expression and might help to adapt adjuvant therapy regimens by stratifying patients according to their risk for cancer recurrence. No significant financial relationships to disclose.
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Affiliation(s)
- L. Conradi
- Department of General and Visceral Surgery, University Medical Center, Georg-August University, Göttingen, Germany; Department of Hematology and Oncology, University Medical Center, Göttingen, Germany; Department of Clinical Pharmacology, University Medical Center, Göttingen, Germany; Department of Radiooncology, University Medical Center, Göttingen, Germany; Department of Medical Statistics, University Medical Center, Georg-August-University, Göttingen, GA, Germany
| | - A. Bleckmann
- Department of General and Visceral Surgery, University Medical Center, Georg-August University, Göttingen, Germany; Department of Hematology and Oncology, University Medical Center, Göttingen, Germany; Department of Clinical Pharmacology, University Medical Center, Göttingen, Germany; Department of Radiooncology, University Medical Center, Göttingen, Germany; Department of Medical Statistics, University Medical Center, Georg-August-University, Göttingen, GA, Germany
| | - M. Schirmer
- Department of General and Visceral Surgery, University Medical Center, Georg-August University, Göttingen, Germany; Department of Hematology and Oncology, University Medical Center, Göttingen, Germany; Department of Clinical Pharmacology, University Medical Center, Göttingen, Germany; Department of Radiooncology, University Medical Center, Göttingen, Germany; Department of Medical Statistics, University Medical Center, Georg-August-University, Göttingen, GA, Germany
| | - T. Sprenger
- Department of General and Visceral Surgery, University Medical Center, Georg-August University, Göttingen, Germany; Department of Hematology and Oncology, University Medical Center, Göttingen, Germany; Department of Clinical Pharmacology, University Medical Center, Göttingen, Germany; Department of Radiooncology, University Medical Center, Göttingen, Germany; Department of Medical Statistics, University Medical Center, Georg-August-University, Göttingen, GA, Germany
| | - K. Homayounfar
- Department of General and Visceral Surgery, University Medical Center, Georg-August University, Göttingen, Germany; Department of Hematology and Oncology, University Medical Center, Göttingen, Germany; Department of Clinical Pharmacology, University Medical Center, Göttingen, Germany; Department of Radiooncology, University Medical Center, Göttingen, Germany; Department of Medical Statistics, University Medical Center, Georg-August-University, Göttingen, GA, Germany
| | - H. A. Wolff
- Department of General and Visceral Surgery, University Medical Center, Georg-August University, Göttingen, Germany; Department of Hematology and Oncology, University Medical Center, Göttingen, Germany; Department of Clinical Pharmacology, University Medical Center, Göttingen, Germany; Department of Radiooncology, University Medical Center, Göttingen, Germany; Department of Medical Statistics, University Medical Center, Georg-August-University, Göttingen, GA, Germany
| | - H. Becker
- Department of General and Visceral Surgery, University Medical Center, Georg-August University, Göttingen, Germany; Department of Hematology and Oncology, University Medical Center, Göttingen, Germany; Department of Clinical Pharmacology, University Medical Center, Göttingen, Germany; Department of Radiooncology, University Medical Center, Göttingen, Germany; Department of Medical Statistics, University Medical Center, Georg-August-University, Göttingen, GA, Germany
| | - B. M. Ghadimi
- Department of General and Visceral Surgery, University Medical Center, Georg-August University, Göttingen, Germany; Department of Hematology and Oncology, University Medical Center, Göttingen, Germany; Department of Clinical Pharmacology, University Medical Center, Göttingen, Germany; Department of Radiooncology, University Medical Center, Göttingen, Germany; Department of Medical Statistics, University Medical Center, Georg-August-University, Göttingen, GA, Germany
| | - T. Beissbarth
- Department of General and Visceral Surgery, University Medical Center, Georg-August University, Göttingen, Germany; Department of Hematology and Oncology, University Medical Center, Göttingen, Germany; Department of Clinical Pharmacology, University Medical Center, Göttingen, Germany; Department of Radiooncology, University Medical Center, Göttingen, Germany; Department of Medical Statistics, University Medical Center, Georg-August-University, Göttingen, GA, Germany
| | - T. Liersch
- Department of General and Visceral Surgery, University Medical Center, Georg-August University, Göttingen, Germany; Department of Hematology and Oncology, University Medical Center, Göttingen, Germany; Department of Clinical Pharmacology, University Medical Center, Göttingen, Germany; Department of Radiooncology, University Medical Center, Göttingen, Germany; Department of Medical Statistics, University Medical Center, Georg-August-University, Göttingen, GA, Germany
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