1
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Váradi M, Horváth O, Módos O, Fazekas T, Grunewald CM, Niegisch G, Krafft U, Grünwald V, Hadaschik B, Olah C, Maráz A, Furka A, Szűcs M, Nyirády P, Szarvas T. Efficacy of immune checkpoint inhibitor therapy for advanced urothelial carcinoma in real-life clinical practice: results of a multicentric, retrospective study. Sci Rep 2023; 13:17378. [PMID: 37833455 PMCID: PMC10575904 DOI: 10.1038/s41598-023-44103-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 10/03/2023] [Indexed: 10/15/2023] Open
Abstract
Clinical trials revealed significant antitumor activity for immune checkpoint inhibitors (ICI) in metastatic urothelial carcinoma (mUC). Due to their strict eligibility criteria, clinical trials include selected patient cohorts, and thus do not necessarily represent real-world population outcomes. In this multicentric, retrospective study, we investigated real-world data to assess the effectiveness of pembrolizumab and atezolizumab and to evaluate the prognostic value of routinely available clinicopathological and laboratory parameters. Clinical and follow-up data from mUC patients who received ICIs (01/2017-12/2021) were evaluated. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and duration of response (DOR) were used as endpoints. Patients' (n = 210, n = 76 atezolizumab and 134 pembrolizumab) median OS and PFS were 13.6 and 5.9 months, respectively. Impaired ECOG-PS, the presence of visceral, liver or bone metastases, and hemoglobin levels were independently associated with poor OS and DCR. Furthermore, Bellmunt risk factors and the enhanced Bellmunt-CRP score were shown to be prognostic for OS, PFS and DCR. In conclusion, ICIs are effective treatments for a broad range of mUC patients. Our results confirmed the prognostic value of numerous risk factors and showed that Bellmunt risk scores can further be improved when adding CRP to the model.
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Affiliation(s)
- Melinda Váradi
- Department of Urology, Semmelweis University, Üllői út 78/B, Budapest, 1082, Hungary
| | - Orsolya Horváth
- Department of Genitourinary Medical Oncology and Pharmacology, National Institute of Oncology, Budapest, Hungary
| | - Orsolya Módos
- Department of Urology, Semmelweis University, Üllői út 78/B, Budapest, 1082, Hungary
| | - Tamás Fazekas
- Department of Urology, Semmelweis University, Üllői út 78/B, Budapest, 1082, Hungary
| | - Camilla M Grunewald
- Department of Urology, Medical Faculty and University Hospital Duesseldorf, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
| | - Günter Niegisch
- Department of Urology, Medical Faculty and University Hospital Duesseldorf, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
| | - Ulrich Krafft
- Department of Urology, University of Duisburg-Essen, Hufelandstr 55, 45147, Essen, Germany
| | - Viktor Grünwald
- Department of Urology, University of Duisburg-Essen, Hufelandstr 55, 45147, Essen, Germany
| | - Boris Hadaschik
- Department of Urology, University of Duisburg-Essen, Hufelandstr 55, 45147, Essen, Germany
| | - Csilla Olah
- Department of Urology, University of Duisburg-Essen, Hufelandstr 55, 45147, Essen, Germany
| | - Anikó Maráz
- Department of Oncotherapy, University of Szeged, Szeged, Hungary
| | - Andrea Furka
- Department of Oncology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Department of Clinical Radiology, Institute of Practical Methodology and Diagnostics, Faculty of Health Care, University of Miskolc, Miskolc, Hungary
| | - Miklós Szűcs
- Department of Urology, Semmelweis University, Üllői út 78/B, Budapest, 1082, Hungary
| | - Péter Nyirády
- Department of Urology, Semmelweis University, Üllői út 78/B, Budapest, 1082, Hungary
| | - Tibor Szarvas
- Department of Urology, Semmelweis University, Üllői út 78/B, Budapest, 1082, Hungary.
- Department of Urology, University of Duisburg-Essen, Hufelandstr 55, 45147, Essen, Germany.
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2
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Matusovits D, Murlasits Z, Kupai K, Baráth Z, Kang HL, Osváth P, Szűcs M, Priksz D, Juhász B, Radák Z, Várkonyi T, Pavo I, Pósa A. Paclitaxel Protects against Isoproterenol-Induced Damage in Rat Myocardium: Its Heme-Oxygenase Mediated Role in Cardiovascular Research. Antioxidants (Basel) 2023; 12:antiox12051129. [PMID: 37237995 DOI: 10.3390/antiox12051129] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/04/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023] Open
Abstract
(1) Background: In cardiovascular applications, paclitaxel inhibits smooth muscle cell proliferation and migration and significantly reduces the occurrence of restenosis and target lesion revascularization. However, the cellular effects of paclitaxel in the myocardium are not well understood; (2) Methods: Wistar rats were divided into four groups: control (CTRL), isoproterenol (ISO) treated (1 mg/kg) and two groups treated with paclitaxel (PAC), which was administrated (10 mg/kg/day) for 5 days by gavage/per os alone or in combination (ISO + PAC) 3 weeks after ISO treatment. Ventricular tissue was harvested 24 h later for measurements of heme oxygenase (HO-1), reduced glutathione (GSH), oxidized glutathione (GSSG), superoxide dismutase (SOD), NF-κB, TNF-α and myeloperoxidase (MPO); (3) Results: HO-1 protein concentration, HO-1 activity, SOD protein concentration and total glutathione significantly decreased in response to ISO treatment. When PAC was administered in conjunction with ISO, HO-1, SOD concentration and total glutathione were not different from control levels. MPO activity, NF-κB concentration and TNF-α protein concentration were significantly increased in the ISO-only group, while the levels of these molecules were restored when PAC was co-administered; (4) Conclusions: Oral administration of PAC can maintain the expression of important antioxidants, anti-inflammatory molecules, HO-1, SOD and GSH, and suppress the production of TNF-α, MPO and NF-κB, which are involved in myocardial damage. The principal component of this cellular defense seems to be the expression of HO-1.
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Affiliation(s)
- Danica Matusovits
- Department of Prosthodontics, Faculty of Dentistry, University of Szeged, 6703 Szeged, Hungary
| | - Zsolt Murlasits
- Institute of Sport Science and Physical Education University of Pécs, 7601 Pécs, Hungary
| | - Krisztina Kupai
- Department of Internal Medicine, Albert Szent-Györgyi Medical School, University of Szeged, 6703 Szeged, Hungary
- Department of Oral Biology and Experimental Dental Research, Faculty of Dentistry, University of Szeged, 6703 Szeged, Hungary
| | - Zoltán Baráth
- Department of Oral Biology and Experimental Dental Research, Faculty of Dentistry, University of Szeged, 6703 Szeged, Hungary
| | - Hsu Lin Kang
- Department of Oral Biology and Experimental Dental Research, Faculty of Dentistry, University of Szeged, 6703 Szeged, Hungary
| | - Péter Osváth
- Department of Urology, University of Debrecen, 4006 Debrecen, Hungary
| | - Miklós Szűcs
- Department of Urology, University of Debrecen, 4006 Debrecen, Hungary
| | - Dániel Priksz
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, 4006 Debrecen, Hungary
| | - Béla Juhász
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, 4006 Debrecen, Hungary
| | - Zsolt Radák
- Institute for Sports and Health Sciences, Hungarian University of Sports Science, 1051 Budapest, Hungary
| | - Tamás Várkonyi
- Department of Internal Medicine, Albert Szent-Györgyi Medical School, University of Szeged, 6703 Szeged, Hungary
| | - Imre Pavo
- Department of Internal Medicine, Albert Szent-Györgyi Medical School, University of Szeged, 6703 Szeged, Hungary
| | - Anikó Pósa
- Department of Oral Biology and Experimental Dental Research, Faculty of Dentistry, University of Szeged, 6703 Szeged, Hungary
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3
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Módos O, Váradi M, Dér B, Keszthelyi A, Szűcs M, Reis H, Nyirády P, Szarvas T. [Current diagnostic and treatment strategies for urachal cancer]. Orv Hetil 2023; 164:602-609. [PMID: 37087728 DOI: 10.1556/650.2023.32754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/18/2023] [Indexed: 04/24/2023]
Abstract
Urachal carcinoma is a rare malignancy that is uniquely associated with the field of urology. Urachal carcinoma is mostly diagnosed in urological care centers due to its most frequently presenting symptom that is hematuria. Currently available diagnostic and therapeutic knowledge is solely based on case reports and single center series, while no prospective clinical studies are carried out due to the modest number of patients. These circumstances have made creating professional guidelines challenging, hence the treatment of urachal carcinoma is commonly based on individual clinical decisions. In this review, we summarize the epidemiology, diagnostic modalities, prognosis as well as local and systemic therapeutic approaches of urachal carcinoma. Furthermore, we aim to draw conclusions from this knowledge base that may guide clinical decision-making. Finally, we highlight some of the novel therapeutic strategies that hold the potential to improve urachal carcinoma patients' prognosis and quality of life. Orv Hetil. 2023; 164(16): 602-609.
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Affiliation(s)
- Orsolya Módos
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika és Uroonkológiai Centrum Budapest, Üllői út 78/B, 1082 Magyarország
| | - Melinda Váradi
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika és Uroonkológiai Centrum Budapest, Üllői út 78/B, 1082 Magyarország
| | - Bálint Dér
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika és Uroonkológiai Centrum Budapest, Üllői út 78/B, 1082 Magyarország
| | - Attila Keszthelyi
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika és Uroonkológiai Centrum Budapest, Üllői út 78/B, 1082 Magyarország
| | - Miklós Szűcs
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika és Uroonkológiai Centrum Budapest, Üllői út 78/B, 1082 Magyarország
| | - Henning Reis
- 2 Dr. Senckenberg Patológiai Intézet, Frankfurti Egyetemi Kórház Frankfurt, Németország Magyarország
| | - Péter Nyirády
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika és Uroonkológiai Centrum Budapest, Üllői út 78/B, 1082 Magyarország
| | - Tibor Szarvas
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika és Uroonkológiai Centrum Budapest, Üllői út 78/B, 1082 Magyarország
- 3 Essen-Duisburgi Egyetem, Urológiai Klinika Essen, Németország Magyarország
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4
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Szűcs M, Szalontai J, Nyirády P. [Adjuvant treatment of kidney tumors - a more successful future?]. Magy Onkol 2023; 67:84-89. [PMID: 37086461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 03/29/2023] [Indexed: 04/24/2023]
Abstract
Considering the data of the past years, the number of kidney tumor patients grows constantly. These patients are usually found incidentally with the help of common imaging procedures. The classic triad - lower back pain, bloody urine, and palpable flank terime - occurs rarely. Their presence foresees an advanced disease. In our article, in addition to the mentioning of the epidemiological and etiological data, symptoms, surgical therapy and histological types of the kidney tumors, we present the adjuvant treatment options, their types and effectiveness.
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Affiliation(s)
- Miklós Szűcs
- Urológiai Klinika és Uroonkológiai Centrum, Semmelweis Egyetem, Budapest, Hungary.
| | - János Szalontai
- Urológiai Klinika és Uroonkológiai Centrum, Semmelweis Egyetem, Budapest, Hungary.
| | - Péter Nyirády
- Urológiai Klinika és Uroonkológiai Centrum, Semmelweis Egyetem, Budapest, Hungary.
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5
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Maráz A, Nagyiványi K, Balogh I, Bodoky G, Mangel L, Küronya Z, Géczi L, Torday L, Dudás S, Szűcs M, Nagy Z, Hornyák L, Zolcsák Z, Bassam A, Kocsis J, Keresztes T, Kullmann T, Máhr K, Solymosi T, Papdán T, Szabó I, Varga Z, Biró K. [Multicentric Hungarian results of cabozantinib therapy in patients with metastatic kidney cancer based on real-world data]. Magy Onkol 2023; 67:73-83. [PMID: 37086460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 02/04/2023] [Indexed: 04/24/2023]
Abstract
The aim of our analysis was to evaluate the efficacy of cabozantinib in patients with metastatic renal cell carcinoma. Cabozantinib therapy initiated between 01/01/2019 and 31/12/2022 was evaluated based on a retrospective review of data from 14 renal centers in Hungary. The starting dose was 60 or 40 mg. Physical examinations and laboratory tests were performed every 4 weeks and imaging studies 3-monthly. Tumor response was assessed according to RECIST 1.1, and toxicity according to NCI CTCAE 4.0. A total of 230 patient records were evaluated, 201 (87.4%) of them had clear cell RCC. Cabozantinib was administered as third, second and first-line treatment in 48.7%, 38.3% and <5% of cases, respectively. Dose reductions occurred in 62.6% and treatment interruption in 6.5%. Duration of therapy was 10.03 months, which was independent of dose reduction. Overall tumor response rate was 39.2% and clinical benefit was 82.8%. The duration of first-, second-, third- and fourth-line treatment was 11.47, 8.03, 11.57 and 10.13 months, respectively. Overall survival from the start of therapy was 22.0 months. Cabozantinib therapy in daily practice was more beneficial than according to registry study results. Dose reduction did not affect efficacy.
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Affiliation(s)
- Anikó Maráz
- Onkoterápiás Klinika, Szegedi Tudományegyetem, Szeged, Hungary.
| | - Krisztián Nagyiványi
- Urogenitális Tumorok és Klinikai Farmakológiai Osztály, Országos Onkológiai Intézet, Budapest, Hungary
| | - Ingrid Balogh
- Onkológiai Klinika, Debreceni Egyetem Klinikai Központ, Debrecen, Hungary
| | - György Bodoky
- Onkológiai Centrum, Dél-pesti Centrumkórház, Budapest, Hungary
| | - László Mangel
- Onkoterápiás Intézet, Pécsi Tudományegyetem, Pécs, Hungary
| | - Zsófia Küronya
- Urogenitális Tumorok és Klinikai Farmakológiai Osztály, Országos Onkológiai Intézet, Budapest, Hungary
| | - Lajos Géczi
- Urogenitális Tumorok és Klinikai Farmakológiai Osztály, Országos Onkológiai Intézet, Budapest, Hungary
| | - László Torday
- Onkoterápiás Klinika, Szegedi Tudományegyetem, Szeged, Hungary.
| | - Szilvia Dudás
- Onkológiai Centrum, Dél-pesti Centrumkórház, Budapest, Hungary
| | - Miklós Szűcs
- Urológiai Klinika, Semmelweis Egyetem, Budapest, Hungary
| | - Zsófia Nagy
- Onkológiai Osztály, Észak-pesti Centrumkórház, Budapest, Hungary
| | - Lajos Hornyák
- Közép-dunántúli Regionális Onkológiai Centrum, Veszprém Megyei Csolnoky Ferenc Kórház, Veszprém, Hungary
| | - Zita Zolcsák
- Onkoradiológiai Osztály, Uzsoki Utcai Kórház, Budapest, Hungary
| | - Ali Bassam
- Megyei Onkológiai Központ, Békés Megyei Központi Kórház Pándy Kálmán Tagkórház, Gyula, Hungary
| | - Judit Kocsis
- Onkoradiológia, Bács-Kiskun Megyei Oktatókórház, Kecskemét, Hungary
| | - Tamás Keresztes
- Onkoradiológia, Bács-Kiskun Megyei Oktatókórház, Kecskemét, Hungary
| | - Tamás Kullmann
- Onkoradiológiai Osztály, Petz Aladár Egyetemi Oktató Kórház, Győr, Hungary
| | - Károly Máhr
- Onkológiai Osztály, Zala Megyei Szent Rafael Kórház, Zalaegerszeg, Hungary
| | - Tibor Solymosi
- Klinikai Onkológiai és Sugárterápiás Centrum, Borsod-Abaúj-Zemplén Megyei Központi Kórház, Miskolc, Hungary
| | - Tímea Papdán
- Onkoterápiás Klinika, Szegedi Tudományegyetem, Szeged, Hungary.
| | - Imre Szabó
- Onkoterápiás Intézet, Pécsi Tudományegyetem, Pécs, Hungary
| | - Zoltán Varga
- Onkoterápiás Klinika, Szegedi Tudományegyetem, Szeged, Hungary.
| | - Krisztina Biró
- Urogenitális Tumorok és Klinikai Farmakológiai Osztály, Országos Onkológiai Intézet, Budapest, Hungary
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6
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Maráz A, Nagyiványi K, Balogh I, Bodoky G, Mangel L, Küronya Z, Géczi L, Torday L, Dudás S, Szűcs M, Nagy Z, Hornyák L, Zolcsák Z, Bassam A, Kocsis J, Keresztes T, Kullmann T, Máhr K, Solymosi T, Papdán T, Szabó I, Varga Z, Biró K. [Multicentric Hungarian results of cabozantinib therapy in patients with metastatic kidney cancer based on real-world data]. Magy Onkol 2023; 67:1-10. [PMID: 36989491] [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] [Received: 01/20/2023] [Accepted: 02/04/2023] [Indexed: 03/31/2023]
Abstract
The aim of our analysis was to evaluate the efficacy of cabozantinib in patients with metastatic renal cell carcinoma. Cabozantinib therapy initiated between 01/01/2019 and 31/12/2022 was evaluated based on a retrospective review of data from 14 renal centers in Hungary. The starting dose was 60 or 40 mg. Physical examinations and laboratory tests were performed every 4 weeks and imaging studies 3-monthly. Tumor response was assessed according to RECIST 1.1, and toxicity according to NCI CTCAE 4.0. A total of 230 patient records were evaluated, 201 (87.4%) of them had clear cell RCC. Cabozantinib was administered as third, second and first-line treatment in 48.7%, 38.3% and <5% of cases, respectively. Dose reductions occurred in 62.6% and treatment interruption in 6.5%. Duration of therapy was 10.03 months, which was independent of dose reduction. Overall tumor response rate was 39.2% and clinical benefit was 82.8%. The duration of first-, second-, third- and fourth-line treatment was 11.47, 8.03, 11.57 and 10.13 months, respectively. Overall survival from the start of therapy was 22.0 months. Cabozantinib therapy in daily practice was more beneficial than according to registry study results. Dose reduction did not affect efficacy.
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Affiliation(s)
- Anikó Maráz
- Onkoterápiás Klinika, Szegedi Tudományegyetem, Szeged, Hungary.
| | - Krisztián Nagyiványi
- Urogenitális Tumorok és Klinikai Farmakológiai Osztály, Országos Onkológiai Intézet, Budapest, Hungary
| | - Ingrid Balogh
- Onkológiai Klinika, Debreceni Egyetem Klinikai Központ, Debrecen, Hungary
| | - György Bodoky
- Onkológiai Centrum, Dél-pesti Centrumkórház, Budapest, Hungary
| | - László Mangel
- Onkoterápiás Intézet, Pécsi Tudományegyetem, Pécs, Hungary
| | - Zsófia Küronya
- Urogenitális Tumorok és Klinikai Farmakológiai Osztály, Országos Onkológiai Intézet, Budapest, Hungary
| | - Lajos Géczi
- Urogenitális Tumorok és Klinikai Farmakológiai Osztály, Országos Onkológiai Intézet, Budapest, Hungary
| | - László Torday
- Onkoterápiás Klinika, Szegedi Tudományegyetem, Szeged, Hungary.
| | - Szilvia Dudás
- Onkológiai Centrum, Dél-pesti Centrumkórház, Budapest, Hungary
| | - Miklós Szűcs
- Urológiai Klinika, Semmelweis Egyetem, Budapest, Hungary
| | - Zsófia Nagy
- Onkológiai Osztály, Észak-pesti Centrumkórház, Budapest, Hungary
| | - Lajos Hornyák
- Közép-dunántúli Regionális Onkológiai Centrum, Veszprém Megyei Csolnoky Ferenc Kórház, Veszprém, Hungary
| | - Zita Zolcsák
- Onkoradiológiai Osztály, Uzsoki Utcai Kórház, Budapest, Hungary
| | - Ali Bassam
- Megyei Onkológiai Központ, Békés Megyei Központi Kórház Pándy Kálmán Tagkórház, Gyula, Hungary
| | - Judit Kocsis
- Onkoradiológia, Bács-Kiskun Megyei Oktatókórház, Kecskemét, Hungary
| | - Tamás Keresztes
- Onkoradiológia, Bács-Kiskun Megyei Oktatókórház, Kecskemét, Hungary
| | - Tamás Kullmann
- Onkoradiológiai Osztály, Petz Aladár Egyetemi Oktató Kórház, Győr, Hungary
| | - Károly Máhr
- Onkológiai Osztály, Zala Megyei Szent Rafael Kórház, Zalaegerszeg, Hungary
| | - Tibor Solymosi
- Klinikai Onkológiai és Sugárterápiás Centrum, Borsod-Abaúj-Zemplén Megyei Központi Kórház, Miskolc, Hungary
| | - Tímea Papdán
- Onkoterápiás Klinika, Szegedi Tudományegyetem, Szeged, Hungary.
| | - Imre Szabó
- Onkoterápiás Intézet, Pécsi Tudományegyetem, Pécs, Hungary
| | - Zoltán Varga
- Onkoterápiás Klinika, Szegedi Tudományegyetem, Szeged, Hungary.
| | - Krisztina Biró
- Urogenitális Tumorok és Klinikai Farmakológiai Osztály, Országos Onkológiai Intézet, Budapest, Hungary
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7
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Szalontai J, Horváth A, Szűcs M, Nyirády P. [Prostate cancer screening - past, present, future]. Magy Onkol 2022; 66:219-222. [PMID: 36200502] [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] [Received: 07/27/2022] [Accepted: 08/11/2022] [Indexed: 06/16/2023]
Abstract
Prostate cancer is one of the most significant cancers among men. In addition to epidemiological and etiological data, this summary provides a description of the most important features of prostate specific antigen, used most, and other markers that can make easier to diagnose the disease. It presents the major international and Hungarian studies dealing with prostate cancer screening, including the economic aspects. Genetic tests, DNA- and RNAbased biomarkers are gaining more and more space, they can even help us in screening and avoiding overdiagnosis. The main goal of the future researches should be to develop methods that can be used to detect prostate cancer at an early, curable stage.
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Affiliation(s)
- János Szalontai
- Urológiai Klinika, Semmelweis Egyetem, Uroonkológiai Centrum, Budapest, Hungary.
| | - András Horváth
- Urológiai Klinika, Semmelweis Egyetem, Uroonkológiai Centrum, Budapest, Hungary.
| | - Miklós Szűcs
- Urológiai Klinika, Semmelweis Egyetem, Uroonkológiai Centrum, Budapest, Hungary.
| | - Péter Nyirády
- Urológiai Klinika, Semmelweis Egyetem, Uroonkológiai Centrum, Budapest, Hungary.
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8
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Tóth G, Hécz R, Tóth J, Pencz B, Szabó A, Lukáts O, Szűcs M, Dank M, Nagy ZZ, Csákány B. [Metastatic clear cell renal cell carcinoma: a potential mimicker of choroidal melanoma]. Magy Onkol 2022; 66:157-161. [PMID: 35724394] [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] [Received: 06/04/2021] [Accepted: 07/01/2021] [Indexed: 06/15/2023]
Abstract
While metastases are the most common intraocular malignancies, ocular metastases of renal cell carcinoma are rare. The most frequent primary malignancy of the eye is uveal melanoma. The common ocular localization is the choroid in both cases. The clinical differentiation of choroidal metastasis from renal cell carcinoma and choroidal melanoma malignum is a diagnostic challenge for the ophthalmologist. We present two cases where renal cell carcinoma had metastasized to the choroid. Enucleation was performed in a 61- and a 71-year-old male patient with suspected advanced choroidal malignant melanoma following biomicroscopic and B-scan ultrasonography examination. Histopathological examination confirmed clear-cell renal cell carcinoma in both cases. The clinical and ultrasonographic appearance of clear-cell renal cell carcinoma metastasis may mimic choroidal malignant melanoma, and may only be suspected if a primary renal cell carcinoma is already established.
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Affiliation(s)
- Gábor Tóth
- Szemészeti Klinika, Semmelweis Egyetem, Budapest, Hungary.
| | - Réka Hécz
- I. Sz. Belgyógyászati és Onkológiai Klinika, Semmelweis Egyetem, Budapest, Hungary
| | - Jeannette Tóth
- II. Sz. Patológiai Intézet, Semmelweis Egyetem, Budapest, Hungary
| | - Bianka Pencz
- II. Sz. Patológiai Intézet, Semmelweis Egyetem, Budapest, Hungary
| | - Antal Szabó
- Szemészeti Klinika, Semmelweis Egyetem, Budapest, Hungary.
| | - Olga Lukáts
- Szemészeti Klinika, Semmelweis Egyetem, Budapest, Hungary.
| | - Miklós Szűcs
- Urológiai Klinika, Semmelweis Egyetem, Budapest, Hungary
| | - Magdolna Dank
- I. Sz. Belgyógyászati és Onkológiai Klinika, Semmelweis Egyetem, Budapest, Hungary
| | | | - Béla Csákány
- Szemészeti Klinika, Semmelweis Egyetem, Budapest, Hungary.
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9
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Keresztes D, Csizmarik A, Nagy N, Módos O, Fazekas T, Bracht T, Sitek B, Witzke K, Puhr M, Sevcenco S, Kramer G, Shariat S, Küronya Z, Takács L, Tornyi I, Lázár J, Hadaschik B, Lászik A, Szűcs M, Nyirády P, Szarvas T. Comparative proteome analysis identified CD44 as a possible serum marker for docetaxel resistance in castration-resistant prostate cancer. J Cell Mol Med 2021; 26:1332-1337. [PMID: 34970839 PMCID: PMC8831956 DOI: 10.1111/jcmm.17141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 11/18/2021] [Accepted: 11/23/2021] [Indexed: 12/24/2022] Open
Abstract
Baseline or acquired resistance to docetaxel (DOC) represents a significant risk for patients with metastatic prostate cancer (PC). In the last years, novel therapy regimens have been approved providing reasonable alternatives for DOC‐resistant patients making prediction of DOC resistance of great clinical importance. We aimed to identify serum biomarkers, which are able to select patients who will not benefit from DOC treatment. DOC‐resistant PC3‐DR and DU145‐DR sublines and their sensitive parental cell lines (DU145, PC3) were comparatively analyzed using liquid chromatography‐coupled tandem mass spectrometry (LC‐MS/MS). Results were filtered using bioinformatics approaches to identify promising serum biomarkers. Serum levels of five proteins were determined in serum samples of 66 DOC‐treated metastatic castration‐resistant PC patients (mCRPC) using ELISA. Results were correlated with clinicopathological and survival data. CD44 was subjected to further functional cell culture analyses. We found at least 177 two‐fold significantly overexpressed proteins in DOC‐resistant cell lines. Our bioinformatics method suggested 11/177 proteins to be secreted into the serum. We determined serum levels of five (CD44, MET, GSN, IL13RA2 and LNPEP) proteins in serum samples of DOC‐treated patients and found high CD44 serum levels to be independently associated with poor overall survival (p = 0.001). In accordance, silencing of CD44 in DU145‐DR cells resulted in re‐sensitization to DOC. In conclusion, high serum CD44 levels may help identify DOC‐resistant patients and may thereby help optimize clinical decision‐making regarding type and timing of therapy for mCRPC patients. In addition, our in vitro results imply the possible functional involvement of CD44 in DOC resistance.
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Affiliation(s)
- Dávid Keresztes
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Anita Csizmarik
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Nikolett Nagy
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Orsolya Módos
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Tamás Fazekas
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Thilo Bracht
- Medical Faculty, Medizinisches Proteom-Center, Ruhr-University Bochum, Bochum, Germany.,Department of Anesthesia, Intensive Care Medicine and Pain Therapy, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany.,Center for Protein Diagnostics, Medical Proteome Analysis, Ruhr-University Bochum, Bochum, Germany
| | - Barbara Sitek
- Medical Faculty, Medizinisches Proteom-Center, Ruhr-University Bochum, Bochum, Germany.,Department of Anesthesia, Intensive Care Medicine and Pain Therapy, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany.,Center for Protein Diagnostics, Medical Proteome Analysis, Ruhr-University Bochum, Bochum, Germany
| | - Kathrin Witzke
- Medical Faculty, Medizinisches Proteom-Center, Ruhr-University Bochum, Bochum, Germany.,Center for Protein Diagnostics, Medical Proteome Analysis, Ruhr-University Bochum, Bochum, Germany
| | - Martin Puhr
- Department of Urology, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Gero Kramer
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Shahrokh Shariat
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Zsófia Küronya
- Department of Genitourinary Medical Oncology and Clinical Pharmacology, National Institute of Oncology, Budapest, Hungary
| | - László Takács
- Department of Human Genetics, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Biosystems International Kft., Debrecen, Hungary
| | - Ilona Tornyi
- Department of Human Genetics, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - József Lázár
- Biosystems International Kft., Debrecen, Hungary
| | - Boris Hadaschik
- Department of Urology, University of Duisburg-Essen, Essen, Germany
| | - András Lászik
- Department of Forensic and Insurance Medicine, Semmelweis University, Budapest, Hungary
| | - Miklós Szűcs
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Péter Nyirády
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Tibor Szarvas
- Department of Urology, Semmelweis University, Budapest, Hungary.,Department of Urology, University of Duisburg-Essen, Essen, Germany
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10
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Nagy ND, Fazekas T, Baghy K, Papp G, Csizmarik A, Szűcs M, Nyirády P, Szarvas T. Efficacy of carboplatin chemotherapy in a metastatic, castration-resistant BRCA2 mutation positive prostate cancer patient. Orv Hetil 2021; 162:1004-1008. [PMID: 34148027 DOI: 10.1556/650.2021.32112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 12/12/2020] [Indexed: 11/19/2022]
Abstract
Összefoglaló. A sérült BRCA1/2 gént hordozó prosztatadaganatok klinikai szempontból elkülönülő, agresszív altípust képviselnek. Ugyanakkor a BRCA1/2 gén sérülése a DNS-támadáspontú kemoterápiákkal szemben érzékennyé teszi a daganatot, ami terápiás szempontból kihasználható. A platinaalapú kemoterápia hatékonysága prosztatarákban klinikai vizsgálatokkal nincs alátámasztva, ezért annak alkalmazására igen ritkán kerül sor. Közleményünkben egy előrehaladott stádiumú, agresszív prosztata adenocarcinomával diagnosztizált beteg esetét mutatjuk be, akinél a BRCA2-gén patogén mutációját találtuk, és akinél az előzőleg alkalmazott androgénmegvonásos, valamint docetaxelkezelések sikertelensége miatt karboplatinkezelést alkalmaztunk - ez a beteg állapotának, valamint radiológiai és biokémiai paramétereinek látványos javulásához vezetett. Ez az eset rámutat a DNS-hiba-javító mechanizmusban szerepet játszó gének terápiás szempontból történő felhasználásának potenciális előnyeire prosztatarákban. Orv Hetil. 2021; 162(25): 1004-1008. Summary. BRCA1/2 deficient prostate cancers represent a clinically distinct aggressive subtype. However, the presence of BRCA1/2 alterations enhance the sensitivity to platinum-based chemotherapies. The efficacy of platinum-based chemotherapies in prostate cancer has not been proven in prospective clinical studies and therefore these treatments are rarely used in prostate adenocarcinomas. Here we present a case of BRCA2 mutant prostate cancer, which was diagnosed at a metastatic stage and showed no or only little response to androgen deprivation and docetaxel therapies. Therefore, we started carboplatin chemotherapy which resulted in an exceptional response regarding biochemical, radiographic parameters accompanied by significant improvement of patients' physical condition. This case underlines the potential therapeutic benefits of testing for genes involved in the DNA repair mechanism. Orv Hetil. 2021; 162(25): 1004-1008.
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Affiliation(s)
- Noémi Dalma Nagy
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika és Uroonkológiai Centrum, Budapest, Üllői út 78/B, 1082
| | - Tamás Fazekas
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika és Uroonkológiai Centrum, Budapest, Üllői út 78/B, 1082
| | - Kornélia Baghy
- 2 Semmelweis Egyetem, Általános Orvostudományi Kar, I. Patológiai és Kísérleti Rákkutató Intézet, Budapest
| | - Gergő Papp
- 2 Semmelweis Egyetem, Általános Orvostudományi Kar, I. Patológiai és Kísérleti Rákkutató Intézet, Budapest
| | - Anita Csizmarik
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika és Uroonkológiai Centrum, Budapest, Üllői út 78/B, 1082
| | - Miklós Szűcs
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika és Uroonkológiai Centrum, Budapest, Üllői út 78/B, 1082
| | - Péter Nyirády
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika és Uroonkológiai Centrum, Budapest, Üllői út 78/B, 1082
| | - Tibor Szarvas
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Urológiai Klinika és Uroonkológiai Centrum, Budapest, Üllői út 78/B, 1082.,3 Essen-Duisburgi Egyetem, Urológiai Klinika, Essen, Németország
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11
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Csányi I, Houshmand N, Szűcs M, Ócsai H, Kemény L, Oláh J, Baltás E. Acral lentiginous melanoma: a single-centre retrospective review of four decades in East-Central Europe. J Eur Acad Dermatol Venereol 2020; 34:2004-2010. [PMID: 31989672 DOI: 10.1111/jdv.16227] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 12/17/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Acral lentiginous melanoma (ALM) occurs on the palms, soles and subungual surface and has poor prognosis. It is uncommon in the Caucasian population and has remained unreported in East-Central Europe. OBJECTIVES Our aim was to collect data from East-Central Europe by analysing the demographic and clinicopathologic features of patients with ALM and comparing data with the reports in literature. METHODS We conducted a single-centre, retrospective review between 1976 and 2016 at one of the largest melanoma referral centres in Hungary. RESULTS We identified 176 patients with ALM (3.83%) from 4593 patients with melanoma (mean age: 66.2 years). The tumours were mainly located on the lower extremities (88.63%). The mean Breslow tumour thickness was 3.861 mm, 37.50% of the tumours were thicker than 4.00 mm, and 71.6% exhibited microscopic ulceration. Nearly one-third of the patients underwent sentinel lymph node (SLN) biopsy, and 60.3% of the biopsies were positive for metastasis. The positive SLN status was associated with significantly thick tumours and reduced survival. Patients with ALM had 5- and 10-year overall survival rates of 60.5% and 41.6%, respectively. The mean delay in diagnosis was 18 months after the discovery of skin tumours. In multivariate analyses, age, tumour thickness and distant metastasis were independent risk factors for poor survival (P < 0.001). CONCLUSIONS Our study, which is the first single-centre report in East-Central Europe focusing on ALM, confirms that patient and tumour characteristics and prognostic factors are similar with previous literature data involving Caucasians; however, tumour thickness and survival suggest even worse prognosis.
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Affiliation(s)
- I Csányi
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - N Houshmand
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - M Szűcs
- Department of Medical Physics and Informatics, University of Szeged, Szeged, Hungary
| | - H Ócsai
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary.,Outpatient Department of Dermato-Oncology, Békés County Central Hospital, Kálmán Pándy Subdivision, Gyula, Hungary
| | - L Kemény
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary.,Dermatological Research Group, Hungarian Academy of Sciences, University of Szeged, Szeged, Hungary
| | - J Oláh
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary.,Department of Oncotherapy, University of Szeged, Szeged, Hungary
| | - E Baltás
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
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12
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Szabó B, Szűcs M, Horváth A, Székely E, Pánczél G, Liszkay G, Holló P, Wikonkál N, Nyirády P. [Mucosal melanoma primary and metastatic cases with urogenital localization in our department]. Orv Hetil 2019; 160:378-385. [PMID: 30829059 DOI: 10.1556/650.2019.31303] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Both primary and metastatic cases of mucosal melanoma in urogenital localization are rare tumors. Only 4-5% of all primary melanomas do not arise from the skin. Extracutaneous melanomas have a complex clinical presentation, but these aggressive tumors have a poor prognosis. MATERIALS AND METHOD In our department, we found 7 patients with malignant melanoma of the genitourinary tract in the past few years. The 7 cases were: primary amelanotic melanoma of the female urethra, a primary melanoma of the bladder, two primary melanomas of the penis, a metastatic melanoma of the urethra and another to the testis and a metastatic melanoma of the bladder with melanuria. We retrospectively analyzed the available data to describe the presentation, management, and clinical outcome of the patients. RESULTS In the three inoperative cases, palliative, urologic surgical procedures and systemic antitumor therapy were performed. Two of the four primary urogenital tumors were localized to the penis. In one case, local recurrence developed after surgical treatment, but with a radical, repeated surgery, the patient has been asymptomatic for a year and a half. In the other, neglected case, the penis melanoma spread through the urethra and the inguinal lymph nodes two years after radical surgery and inguinal block dissection. In the female primary urethral melanoma case, the first histological study reported a primary mesenchymal tumor, and the recurrent tumor that occurred one and a half years later showed melanoma diagnosis. Radical surgery performed because of urethral involvement resulted in a 5-year asymptomatic state, followed by local recurrence and distant metastasis. In the fourth case of a primary bladder melanoma, the rapid progression of the disease and the BRAF positivity of the tumor suggested that not the firstly diagnosed bladder melanoma was the primary tumor. CONCLUSION The occurrence of urinary tract melanoma is very rare and its discovery happens often in a disseminated state, so the expected prognosis of the cases is also poor. The most important factors for increasing therapeutic efficacy are early diagnosis and radical surgical intervention. Tumors appearing in different localizations require different urological surgical approaches. The literature recommendations for treatment are not uniform. Their prognosis is worse compared to the cutaneous melanoma, which may be due to clinical and pathological diagnostic difficulties. The latest targeted and immunotherapeutic agents can significantly improve the survival of metastatic patients. Orv Hetil. 2019; 160(10): 378-385.
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Affiliation(s)
- Balázs Szabó
- Urológiai Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Üllői út 78/B, 1082
| | - Miklós Szűcs
- Urológiai Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Üllői út 78/B, 1082
| | - András Horváth
- Urológiai Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Üllői út 78/B, 1082
| | - Eszter Székely
- II. Patológiai Intézet, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest
| | | | | | - Péter Holló
- Bőr-, Nemikórtani és Bőronkológiai Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest
| | - Norbert Wikonkál
- Bőr-, Nemikórtani és Bőronkológiai Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest
| | - Péter Nyirády
- Urológiai Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Üllői út 78/B, 1082
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13
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Uribesalgo I, Hoffmann D, Zhang Y, Kavirayani A, Lazovic J, Berta J, Novatchkova M, Pai TP, Wimmer RA, László V, Schramek D, Karim R, Tortola L, Deswal S, Haas L, Zuber J, Szűcs M, Kuba K, Dome B, Cao Y, Haubner BJ, Penninger JM. Apelin inhibition prevents resistance and metastasis associated with anti-angiogenic therapy. EMBO Mol Med 2019; 11:e9266. [PMID: 31267692 PMCID: PMC6685079 DOI: 10.15252/emmm.201809266] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 05/22/2019] [Accepted: 05/28/2019] [Indexed: 01/03/2023] Open
Abstract
Angiogenesis is a hallmark of cancer, promoting growth and metastasis. Anti-angiogenic treatment has limited efficacy due to therapy-induced blood vessel alterations, often followed by local hypoxia, tumor adaptation, progression, and metastasis. It is therefore paramount to overcome therapy-induced resistance. We show that Apelin inhibition potently remodels the tumor microenvironment, reducing angiogenesis, and effectively blunting tumor growth. Functionally, targeting Apelin improves vessel function and reduces polymorphonuclear myeloid-derived suppressor cell infiltration. Importantly, in mammary and lung cancer, Apelin prevents resistance to anti-angiogenic receptor tyrosine kinase (RTK) inhibitor therapy, reducing growth and angiogenesis in lung and breast cancer models without increased hypoxia in the tumor microenvironment. Apelin blockage also prevents RTK inhibitor-induced metastases, and high Apelin levels correlate with poor prognosis of anti-angiogenic therapy patients. These data identify a druggable anti-angiogenic drug target that reduces tumor blood vessel densities and normalizes the tumor vasculature to decrease metastases.
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Affiliation(s)
- Iris Uribesalgo
- Institute of Molecular Biotechnology of the Austrian Academy of Sciences (IMBA), Vienna BioCenter, Vienna, Austria
| | - David Hoffmann
- Institute of Molecular Biotechnology of the Austrian Academy of Sciences (IMBA), Vienna BioCenter, Vienna, Austria
| | - Yin Zhang
- Department of Microbiology, Tumor and Cell Biology, Biomedicum, Karolinska Institutet, Stockholm, Sweden.,Medicine and Pharmacy Research Center, Binzhou Medical University, Yantai, Shandong Province, China
| | | | - Jelena Lazovic
- VBCF Preclinical Imaging, Vienna BioCenter, Vienna, Austria
| | - Judit Berta
- Department of Tumor Biology, National Koranyi Institute of Pulmonology, Budapest, Hungary
| | - Maria Novatchkova
- Institute of Molecular Biotechnology of the Austrian Academy of Sciences (IMBA), Vienna BioCenter, Vienna, Austria
| | - Tsung-Pin Pai
- Institute of Molecular Biotechnology of the Austrian Academy of Sciences (IMBA), Vienna BioCenter, Vienna, Austria
| | - Reiner A Wimmer
- Institute of Molecular Biotechnology of the Austrian Academy of Sciences (IMBA), Vienna BioCenter, Vienna, Austria
| | - Viktória László
- Division of Thoracic Surgery, Department of Surgery, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Division of Molecular and Gender Imaging, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Daniel Schramek
- Institute of Molecular Biotechnology of the Austrian Academy of Sciences (IMBA), Vienna BioCenter, Vienna, Austria.,Department of Molecular Genetics, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada
| | - Rezaul Karim
- Institute of Molecular Biotechnology of the Austrian Academy of Sciences (IMBA), Vienna BioCenter, Vienna, Austria
| | - Luigi Tortola
- Institute of Molecular Biotechnology of the Austrian Academy of Sciences (IMBA), Vienna BioCenter, Vienna, Austria
| | - Sumit Deswal
- Institute of Molecular Pathology (IMP), Vienna BioCenter, Vienna, Austria
| | - Lisa Haas
- Institute of Molecular Pathology (IMP), Vienna BioCenter, Vienna, Austria
| | - Johannes Zuber
- Institute of Molecular Pathology (IMP), Vienna BioCenter, Vienna, Austria
| | - Miklós Szűcs
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Keiji Kuba
- Institute of Molecular Biotechnology of the Austrian Academy of Sciences (IMBA), Vienna BioCenter, Vienna, Austria.,Department Biochemistry and Metabolic Science, Akita University Graduate School of Medicine, Akita, Japan
| | - Balazs Dome
- Department of Tumor Biology, National Koranyi Institute of Pulmonology, Budapest, Hungary.,Division of Thoracic Surgery, Department of Surgery, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Department of Thoracic Surgery, National Institute of Oncology-Semmelweis University, Budapest, Hungary
| | - Yihai Cao
- Department of Microbiology, Tumor and Cell Biology, Biomedicum, Karolinska Institutet, Stockholm, Sweden
| | - Bernhard J Haubner
- Institute of Molecular Biotechnology of the Austrian Academy of Sciences (IMBA), Vienna BioCenter, Vienna, Austria.,Department of Internal Medicine III (Cardiology and Angiology), Medical University of Innsbruck, Innsbruck, Austria
| | - Josef M Penninger
- Institute of Molecular Biotechnology of the Austrian Academy of Sciences (IMBA), Vienna BioCenter, Vienna, Austria.,Department of Medical Genetics, Life Science Institute, University of British Columbia, Vancouver, BC, Canada
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14
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Abstract
Abstract: In the last few years, the emergence of new high throughput molecular technologies allowed a never-before-seen insight into the genetic, epigenetic, transcriptomic and proteomic background of cancers. These studies have been performed in a large number of patients’ samples and provided a great amount of data. Current efforts to translate these new findings into therapeutic strategies are ongoing, but already provided significant information which may change clinical practice in the near future. As a result of this development, the most frequent molecular alterations and affected pathways responsible for the formation and progression of prostate cancer have been identified. In this review, we provide an overview on the current progress in primary and metastatic prostate cancer research focusing on the molecular subtype classification and the most frequently dysregulated pathways, such as androgen signaling, PI3K pathway, cell cycle and DNA repair regulation. In this context, we highlight therapies already approved or are currently under clinical investigation for prostate cancer. Orv Hetil. 2019; 160(7): 252–263.
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Affiliation(s)
- Tibor Szarvas
- Urológiai Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Üllői út 78/B, 1082
| | - Anita Csizmarik
- Urológiai Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Üllői út 78/B, 1082
| | - Miklós Szűcs
- Urológiai Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Üllői út 78/B, 1082
| | - Péter Nyirády
- Urológiai Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Üllői út 78/B, 1082
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15
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Szendrői A, Szász AM, Kardos M, Tőkés AM, Idan R, Szűcs M, Kulka J, Nyirády P, Szendrői M, Szállási Z, Győrffy B, Tímár J. Opposite prognostic roles of HIF1α and HIF2α expressions in bone metastatic clear cell renal cell cancer. Oncotarget 2018; 7:42086-42098. [PMID: 27244898 PMCID: PMC5173118 DOI: 10.18632/oncotarget.9669] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 04/10/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Prognostic markers of bone metastatic clear cell renal cell cancer (ccRCC) are poorly established. We tested prognostic value of HIF1α/HIF2α and their selected target genes in primary tumors and corresponding bone metastases. RESULTS Expression of HIF2α was lower in mRCC both at mRNA and protein levels (p/mRNA/=0.011, p/protein/=0.001) while HIF1α was similar to nmRCC. At the protein level, CAIX, GAPDH and GLUT1 were increased in mRCC. In all primary RCCs, low HIF2α and high HIF1α as well as CAIX, GAPDH and GLUT1 expressions correlated with adverse prognosis, while VEGFR2 and EPOR gene expressions were associated with favorable prognosis. Multivariate analysis confirmed high HIF2α protein expression as an independent risk factor. Prognostic validation of HIFs, LDH, EPOR and VEGFR2 in RNA-Seq data confirmed higher HIF1α gene expression in primary RCC as an adverse (p=0.07), whereas higher HIF2α and VEGFR2 expressions as favorable prognostic factors. HIF1α/HIF2α-index (HIF-index) proved to be an independent prognostic factor in both the discovery and the TCGA cohort. PATIENTS AND METHODS Expressions of HIF1α and HIF2α as well as their 7 target genes were analysed on the mRNA and protein level in 59 non-metastatic ccRCCs (nmRCC), 40 bone metastatic primary ccRCCs (mRCC) and 55 corresponding bone metastases. Results were validated in 399 ccRCCs from the TCGA project. CONCLUSIONS We identified HIF2α protein as an independent marker of the metastatic potential of ccRCC, however, unlike HIF1α, increased HIF2α expression is a favorable prognostic factor. The HIF-index incorporated these two markers into a strong prognostic biomarker of ccRCC.
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Affiliation(s)
- Attila Szendrői
- Department of Urology, Semmelweis University, Budapest 1082, Hungary
| | - A Marcell Szász
- 2nd Department of Pathology, Semmelweis University, Budapest 1091, Hungary
| | - Magdolna Kardos
- 2nd Department of Pathology, Semmelweis University, Budapest 1091, Hungary
| | - Anna-Mária Tőkés
- 2nd Department of Pathology, Semmelweis University, Budapest 1091, Hungary.,Molecular Oncology Research Group, Hungarian Academy of Sciences and Semmelweis University, Budapest 1091, Hungary
| | - Roni Idan
- 2nd Department of Pathology, Semmelweis University, Budapest 1091, Hungary
| | - Miklós Szűcs
- Department of Urology, Semmelweis University, Budapest 1082, Hungary
| | - Janina Kulka
- 2nd Department of Pathology, Semmelweis University, Budapest 1091, Hungary
| | - Péter Nyirády
- Department of Urology, Semmelweis University, Budapest 1082, Hungary
| | - Miklós Szendrői
- Department of Orthopedics, Semmelweis University, Budapest 1113, Hungary
| | - Zoltán Szállási
- Children's Hospital Informatics Program at the Harvard-MIT Division of Health Sciences and Technology, Harvard Medical School, Boston, MA 02115, USA.,Center for Biological Sequence Analysis, Department of Systems Biology, Technical University of Denmark, Lyngby 2800, Denmark
| | - Balázs Győrffy
- MTA-TTK Lendület Cancer Biomarker Research Group, Budapest 1117, Hungary.,2nd Department of Pediatrics, Semmelweis University, Budapest 1082, Hungary
| | - József Tímár
- 2nd Department of Pathology, Semmelweis University, Budapest 1091, Hungary.,Molecular Oncology Research Group, Hungarian Academy of Sciences and Semmelweis University, Budapest 1091, Hungary
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Maráz A, Bodoky G, Dank M, Géczi L, Kahán Z, Mangel L, Révész J, Szűcs M. [Experience with everolimus therapy for patients with metastatic renal cancer in Hungary]. Magy Onkol 2014; 58:4-9. [PMID: 24712001] [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] [Received: 02/18/2014] [Accepted: 03/04/2014] [Indexed: 06/03/2023]
Abstract
Everolimus is indicated for the therapy of adults with advanced renal cell carcinoma after failure of treatment with vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitor (TKI). The aim of the study was a multicenter evaluation of efficiency and toxicity of everolimus in patients with metastatic renal carcinoma who received one line of VEGFR-TKI therapy. Data of one hundred and one patients were analyzed retrospectively. Patients received everolimus therapy between January 2010 and July 2013. Data were collected in 7 different oncology institutes in Hungary. Starting daily dose of everolimus was 10 mg in 28-day cycles. Physical and laboratory examinations were done monthly. Imaging tests were performed every 3 months. Tumor response and toxicity were evaluated according to RECIST 1.0 and NCI CTCAE 3.0, respectively. Statistical analysis was performed with SPPS version 20.0 for Windows. Currently 26 (27%) patients are being treated, 52 (54.1%) patients are alive. Median progression-free survival (PFS) was 5.7 months (95% CI 4.07-7.33). Partial remission, stable disease and progression occurred in 6 (6%), 71 (74%) and 19 (20%) patients, respectively. Median overall survival (OS) was 14.3 months (95% CI 6.99-19.81). PFS and OS results were more favorable in patients with ECOG 0-1. Survival was poorer in case of anemia, while better if PFS was longer than 12 months. In anemic patients with ECOG 0-1 and ECOG 2-3 OS was 30.9 and 7.7 months, respectively (p=0.031). Dose reduction and treatment delay happened in 8 (7.9%) and 12 (11.9%) cases, respectively. The most common side effects were the following: exanthema, edema, stomatitis, pneumonitis, anemia and abnormal kidney-, liver functions, blood sugar and cholesterol levels. According to the Hungarian experience, everolimus can safely be administered. PFS and OS results representing the centers' everyday practice, are similar to the results of the respective subgroups in the registration study.
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Affiliation(s)
- Anikó Maráz
- Onkoterápiás Klinika, Szegedi Tudományegyetem, Szeged, Hungary.
| | - György Bodoky
- Onkológiai Osztály, Egyesített Szent István és Szent László Kórház, Budapest, Hungary
| | - Magdolna Dank
- I. Sz. Belgyógyászati Klinika, Semmelweis Egyetem, Onkológiai Részleg, Budapest, Hungary
| | - Lajos Géczi
- C Belgyógyászati-Onkológiai és Klinikai Farmakológiai Osztály, Országos Onkológiai Intézet, Budapest, Hungary
| | - Zsuzsanna Kahán
- Onkoterápiás Klinika, Szegedi Tudományegyetem, Szeged, Hungary.
| | - László Mangel
- Onkoterápiás Intézet, Pécsi Tudományegyetem Klinikai Központ, Pécs, Hungary
| | - János Révész
- Borsod-Abaúj-Zemplén Megyei Kórház és Egyetemi Oktató Kórház, Miskolc, Hungary
| | - Miklós Szűcs
- Urológiai Klinika és Uroonkológiai Centrum, Semmelweis Egyetem, Budapest, Hungary
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Molnár T, Földesi I, Farkas K, Lázár G, Tiszlavicz L, Szűcs M, Nagy F, Szepes Z, Bálint A, Bor R, Wittmann T. The diagnostic accuracy of fecal calprotectin in pouchitis. Z Gastroenterol 2013. [DOI: 10.1055/s-0033-1347533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Farkas K, Bálint A, Nagy F, Szepes Z, Szűcs M, Wittmann T, Molnár T. Letter: factors that may predict response to ciclosporin in ulcerative colitis. Aliment Pharmacol Ther 2013; 37:654. [PMID: 23406407 DOI: 10.1111/apt.12190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Accepted: 12/04/2012] [Indexed: 12/08/2022]
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Szűcs M, Keszthelyi A, Szendrői A, Dombóvári P, Majoros A, Mavrogenis S, Riesz P, Keszthelyi L, Asztalos I, Romics I. Investigation of anal sphincter function following Mainz pouch type II urinary diversion after radical cystectomy. Int Urol Nephrol 2012; 44:1013-20. [PMID: 22367172 DOI: 10.1007/s11255-012-0142-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2011] [Accepted: 02/07/2012] [Indexed: 11/28/2022]
Abstract
PURPOSES Our aim was to evaluate the anal sphincter function following cystectomy with urinary diversion of Mainz pouch II. METHODS Seventy-six patients were involved in our survey, and the cohort was for two groups divided. The first group was a retrospective review of 40 patients with examination of the state of continence. Comparative examinations on anal sphincter function and the quality of life survey were carried out. The second group consisting of 15 patients underwent a prospective investigation including rectal manometry in both the pre- and postoperative periods. Measurements of resting anal sphincter pressure (RASP), maximal anal closing pressure (MACP) and the function of the recto anal inhibitions reflex were taken. RESULTS In the first part of our investigation, 80% of the patients were considered as continent. There were no significant differences observed between RASP values in the cases of continent as well as of incontinent patients (79.2 ± 2 vs. 73.6 ± 68.4 mmHg, p = 0-53); however, the MACP values of the continent patients were significantly higher (204.3 ± 22.8 vs. 117.3 ± 14 mmHg, p = 0.001). In the course of the second experiment, both the RASP (86.3 ± 18.7 vs. 76.1 ± 13.9 mmHg p = 0.0049) and the MACP (232.2 ± 53.8 vs. 194.1 ± 74.5 mmHg, p = 0.0054) were detected as decreasing in the case of the incontinent group. CONCLUSIONS A decrease in rectal sphincter function is responsible for incontinence following Mainz pouch type II diversion, and this dysfunction can be correlated with the surgery. Ureterosigmoideostomy is therefore considered as a useful method of urinary diversion only in selected cases with proven good sphincter function.
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Affiliation(s)
- M Szűcs
- Department of Urology and Urooncological Center, Semmelweis University, H1082 Üllői út 78/b, Budapest, Hungary
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Blázovics A, Nyirády P, Bekő G, Székely E, Szilvás Á, Kovács-Nagy E, Horváth A, Szűcs M, Romics I, Sárdi É. Changes in Erythrocyte Transmethylation Ability are Predictive Factors for Tumor Prognosis in Prostate Cancer. CROAT CHEM ACTA 2011. [DOI: 10.5562/cca1748] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Nyirády P, Sárdi É, Bekő G, Szűcs M, Horváth A, Székely E, Szentmihályi K, Romics I, Blázovics A. Effects of bioactive molecules of Beta vulgaris L. ssp. esculenta var. rubra on metastatic prostate cancer. Orv Hetil 2010; 151:1495-503. [DOI: 10.1556/oh.2010.28918] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Számos közlemény beszámol tumoros betegek életminőségének javítására alkalmazott étrend-kiegészítők hatásáról, de mindezek élettani vizsgálata szegényes. A cékla számos, a szervezetben lezajló biokémiai reakcióutat, enzim- és metabolitszintézist befolyásol.Módszer:A szerzők hormonrezisztens és metasztatikus prosztatarák miatt taxán-kemoterápiában részesülő betegek életminőségének javítása érdekében kereskedelmi forgalomból származó természetes céklakészítményt adtak egy hónapon át 2×10 g dózisban 24 (életkor: 68±8 év) betegnek, akik 3,6±2,8 éve jelentkeztek először panaszaikkal. A kezelést követően 18 fő esetében tudták az adatokat kiértékelni. A rutin laboratóriumi vizsgálatok mellett a betegek PSA-, HbA1c-értékeit, 9 citokin- és 3 növekedésifaktor-szintet, a redox-homeosztázis globális paramétereit, fémionháztartásuk néhány elemét, Zn- és szabadprotoporfirin-szintjét, transzmetiláló képességét a kezelés megkezdése előtt és egy hónap múlva határozták meg.Eredmények:Eredményeik azt mutatták, hogy a betegek döntő többségében a cékla kedvező hatása érvényre jutott, és a tumoros betegekre jellemző szignifikánsan magas Zn- és szabadprotoporfirin-szintek csökkentek, valamint a transzmetilezési folyamatok felgyorsultak.Következtetések:Eredményeik alapján úgy tűnik, hogy az általuk alkalmazott céklakészítmény mérsékelt és tartós fogyasztása kedvezően befolyásolja a betegek életminőségét, de több esetben megfigyelhető növekvő EGF-érték miatt szoros orvosi kontroll szükséges kemoterápiában részesülő prosztatarákos betegeknél. Orv. Hetil., 2010, 37, 1495–1503.
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Affiliation(s)
- Péter Nyirády
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar Urológiai Klinika és Uroonkológiai Centrum Budapest Üllői út 78/B 1082
| | - Éva Sárdi
- 4 Corvinus Egyetem, Kertészettudományi Kar Genetika és Növénynemesítési Tanszék Budapest
| | - Gabriella Bekő
- 2 Semmelweis Egyetem, Általános Orvostudományi Kar Központi Laboratórium Pest Budapest
| | - Miklós Szűcs
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar Urológiai Klinika és Uroonkológiai Centrum Budapest Üllői út 78/B 1082
| | - András Horváth
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar Urológiai Klinika és Uroonkológiai Centrum Budapest Üllői út 78/B 1082
| | - Edit Székely
- 5 Semmelweis Egyetem, Gyógyszerésztudományi Kar Farmakognóziai Intézet Budapest
| | - Klára Szentmihályi
- 6 Magyar Tudományos Akadémia Kémiai Kutatóközpont Anyag- és Környezetkémiai Intézet Budapest
| | - Imre Romics
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar Urológiai Klinika és Uroonkológiai Centrum Budapest Üllői út 78/B 1082
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