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Christoph S, Cazzaniga S, Hunger RE, Naldi L, Borradori L, Oberholzer PA. Ultraviolet radiation protection and skin cancer awareness in recreational athletes: a survey among participants in a running event. Swiss Med Wkly 2016; 146:w14297. [DOI: 10.4414/smw.2016.14297] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Houriet C, Klass ND, Beltraminelli H, Borradori L, Oberholzer PA. Localized Epidermal Cysts as a Radiation Recall Phenomenon in a Melanoma Patient Treated with Radiotherapy and the BRAF Inhibitor Vemurafenib. Case Rep Dermatol 2014; 6:213-7. [PMID: 25408648 PMCID: PMC4209266 DOI: 10.1159/000367708] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BRAF inhibitors are broadly used for metastatic melanoma with BRAF mutations. Their use results in various cutaneous side effects, such as the development of keratoacanthomas and squamous cell carcinomas. We report a patient with metastatic melanoma treated with vemurafenib who developed dozens of histologically confirmed epidermal cysts within 2 months after initiation of vemurafenib administration. The cystic lesions were observed only in the localized area where a large exophytic melanoma tumor mass had been previously irradiated. Localized epidermal cysts may constitute an unusual radiation recall reaction in patients treated with BRAF inhibitors.
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Affiliation(s)
- Carine Houriet
- Department of Dermatology, Inselspital, University of Berne, Berne, Switzerland
| | - Natalie D Klass
- Department of Radiotherapy, Inselspital, University of Berne, Berne, Switzerland
| | | | - Luca Borradori
- Department of Dermatology, Inselspital, University of Berne, Berne, Switzerland
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Oberholzer PA, Kee D, Dziunycz P, Sucker A, Kamsukom N, Jones R, Roden C, Chalk CJ, Ardlie K, Palescandolo E, Piris A, MacConaill LE, Robert C, Hofbauer GFL, McArthur GA, Schadendorf D, Garraway LA. RAS mutations are associated with the development of cutaneous squamous cell tumors in patients treated with RAF inhibitors. J Clin Oncol 2011; 30:316-21. [PMID: 22067401 DOI: 10.1200/jco.2011.36.7680] [Citation(s) in RCA: 302] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
PURPOSE RAF inhibitors are effective against melanomas with BRAF V600E mutations but may induce keratoacanthomas (KAs) and cutaneous squamous cell carcinomas (cSCCs). The potential of these agents to promote secondary malignancies is concerning. We analyzed cSCC and KA lesions for genetic mutations in an attempt to identify an underlying mechanism for their formation. METHODS Four international centers contributed 237 KA or cSCC tumor samples from patients receiving an RAF inhibitor (either vemurafenib or sorafenib; n = 19) or immunosuppression therapy (n = 53) or tumors that developed spontaneously (n = 165). Each sample was profiled for 396 known somatic mutations across 33 cancer-related genes by using a mass spectrometric-based genotyping platform. RESULTS Mutations were detected in 16% of tumors (38 of 237), with five tumors harboring two mutations. Mutations in TP53, CDKN2A, HRAS, KRAS, and PIK3CA were previously described in squamous cell tumors. Mutations in MYC, FGFR3, and VHL were identified for the first time. A higher frequency of activating RAS mutations was found in tumors from patients treated with an RAF inhibitor versus populations treated with a non-RAF inhibitor (21.1% v 3.2%; P < .01), although overall mutation rates between treatment groups were similar (RAF inhibitor, 21.1%; immunosuppression, 18.9%; and spontaneous, 17.6%; P = not significant). Tumor histology (KA v cSCC), tumor site (head and neck v other), patient age (≤ 70 v > 70 years), and sex had no significant impact on mutation rate or type. CONCLUSION Squamous cell tumors from patients treated with an RAF inhibitor have a distinct mutational profile that supports a mechanism of therapy-induced tumorigenesis in RAS-primed cells. Conceivably, cotargeting of MEK together with RAF may reduce or prevent formation of these tumors.
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Oberholzer PA, Borradori L, Beltraminelli H. Cetuximab-assozierte Follikulitis mit überwiegendem Befall der unteren Extremitäten. J Dtsch Dermatol Ges 2011. [DOI: 10.1111/j.1610-0387.2011.07716_suppl.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: 10/17/2022]
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Oberholzer PA, Borradori L, Beltraminelli H. Cetuximab-associated folliculitis predominantly affecting the lower limbs. J Dtsch Dermatol Ges 2011; 9:703-4. [PMID: 21627774 DOI: 10.1111/j.1610-0387.2011.07716.x] [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: 11/27/2022]
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Oberholzer PA, Hegyi I, Borradori L, Beltraminelli H. Extra-nodal non-Hodgkin-lymphoma with an acneiform eruption: folliculotropic mycosis fungoides. Eur J Haematol 2011; 87:189-90. [PMID: 21554402 DOI: 10.1111/j.1600-0609.2011.01642.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Patrick A Oberholzer
- Department of Dermatology, Inselspital-University Hospital of Bern, CH-3010 Bern, Switzerland.
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Emery CM, Vijayendran KG, Zipser MC, Sawyer AM, Niu L, Kim JJ, Hatton C, Chopra R, Oberholzer PA, Karpova MB, MacConaill LE, Zhang J, Gray NS, Sellers WR, Dummer R, Garraway LA. MEK1 mutations confer resistance to MEK and B-RAF inhibition. Proc Natl Acad Sci U S A 2009; 106:20411-6. [PMID: 19915144 PMCID: PMC2777185 DOI: 10.1073/pnas.0905833106] [Citation(s) in RCA: 495] [Impact Index Per Article: 33.0] [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: 05/27/2009] [Indexed: 11/18/2022] Open
Abstract
Genetic alterations that activate the mitogen-activated protein kinase (MAP kinase) pathway occur commonly in cancer. For example, the majority of melanomas harbor mutations in the BRAF oncogene, which are predicted to confer enhanced sensitivity to pharmacologic MAP kinase inhibition (e.g., RAF or MEK inhibitors). We investigated the clinical relevance of MEK dependency in melanoma by massively parallel sequencing of resistant clones generated from a MEK1 random mutagenesis screen in vitro, as well as tumors obtained from relapsed patients following treatment with AZD6244, an allosteric MEK inhibitor. Most mutations conferring resistance to MEK inhibition in vitro populated the allosteric drug binding pocket or alpha-helix C and showed robust ( approximately 100-fold) resistance to allosteric MEK inhibition. Other mutations affected MEK1 codons located within or abutting the N-terminal negative regulatory helix (helix A), which also undergo gain-of-function germline mutations in cardio-facio-cutaneous (CFC) syndrome. One such mutation, MEK1(P124L), was identified in a resistant metastatic focus that emerged in a melanoma patient treated with AZD6244. Both MEK1(P124L) and MEK1(Q56P), which disrupts helix A, conferred cross-resistance to PLX4720, a selective B-RAF inhibitor. However, exposing BRAF-mutant melanoma cells to AZD6244 and PLX4720 in combination prevented emergence of resistant clones. These results affirm the importance of MEK dependency in BRAF-mutant melanoma and suggest novel mechanisms of resistance to MEK and B-RAF inhibitors that may have important clinical implications.
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Affiliation(s)
- Caroline M. Emery
- Department of Medical Oncology and
- Center for Cancer Genome Discovery, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115
| | - Krishna G. Vijayendran
- Department of Medical Oncology and
- Center for Cancer Genome Discovery, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115
| | - Marie C. Zipser
- Department of Dermatology, University Hospital of Zurich, Zurich, CH-8091, Switzerland
| | - Allison M. Sawyer
- Department of Medical Oncology and
- Center for Cancer Genome Discovery, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115
| | - Lili Niu
- Department of Medical Oncology and
- Center for Cancer Genome Discovery, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115
| | - Jessica J. Kim
- Department of Medical Oncology and
- Center for Cancer Genome Discovery, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115
| | - Charles Hatton
- Department of Medical Oncology and
- Center for Cancer Genome Discovery, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115
| | - Rajiv Chopra
- Novartis Institute of BioMedical Research, Cambridge, MA 02139
| | - Patrick A. Oberholzer
- Department of Medical Oncology and
- Center for Cancer Genome Discovery, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115
- Department of Dermatology, University Hospital of Zurich, Zurich, CH-8091, Switzerland
- The Broad Institute, Cambridge, MA 02142; and
| | - Maria B. Karpova
- Department of Dermatology, University Hospital of Zurich, Zurich, CH-8091, Switzerland
| | - Laura E. MacConaill
- Department of Medical Oncology and
- Center for Cancer Genome Discovery, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115
| | - Jianming Zhang
- Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA 02115
| | - Nathanael S. Gray
- Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA 02115
| | | | - Reinhard Dummer
- Department of Dermatology, University Hospital of Zurich, Zurich, CH-8091, Switzerland
| | - Levi A. Garraway
- Department of Medical Oncology and
- Center for Cancer Genome Discovery, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115
- The Broad Institute, Cambridge, MA 02142; and
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Oberholzer PA, Nobbe S, Kolm I, Kerl K, Kamarachev J, Trüeb RM. Red scalp disease--a rosacea-like dermatosis of the scalp? Successful therapy with oral tetracycline. Dermatology 2009; 219:179-81. [PMID: 19590169 DOI: 10.1159/000228319] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Oberholzer PA, Cozzio A, Dummer R, French LE, Hofbauer GF. Granulomatous Slack Skin Responds to UVA1 Phototherapy. Dermatology 2009; 219:268-71. [DOI: 10.1159/000226135] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2009] [Accepted: 03/27/2009] [Indexed: 11/19/2022] Open
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Tun-Kyi A, Qin JZ, Oberholzer PA, Navarini AA, Hassel JC, Dummer R, Döbbeling U. Arsenic trioxide down-regulates antiapoptotic genes and induces cell death in mycosis fungoides tumors in a mouse model. Ann Oncol 2008; 19:1488-1494. [PMID: 18349030 DOI: 10.1093/annonc/mdn056] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [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: 11/15/2022] Open
Abstract
BACKGROUND Mycosis fungoides (MF) is the most frequent cutaneous T-cell lymphoma (CTCL). Arsenic trioxide (As(2)O(3)) has recently been shown to be effective against leukemias, so we studied whether As(2)O(3) induces apoptosis of CTCL cells in vitro. We further investigated if As(2)O(3) is effective in a MF mouse model. MATERIAL AND METHODS Annexin V/7-amino-actinomycin-D stainings were carried out to investigate if As(2)O(3) induced apoptosis of CTCL cell lines. To study the underlying mechanisms, the effects of As(2)O(3) on various transcription factors and apoptosis regulating proteins were analyzed by western blots, electrophoretic mobility shift assays and transcription factor enzyme-linked immunosorbent assays. The ability of As(2)O(3) to induce tumor regression was investigated in a MF mouse model. RESULTS As(2)O(3)-induced apoptosis was paralleled by a reduction of the DNA-binding activities of transcription factors of the NFkB and signal transducer and activator of transcription gene families and reduced expression of the antiapoptotic proteins bcl-1, bcl-xL and mcl-1. Local injections of 200 muM As(2)O(3) into tumors caused complete remissions in five of six mice and one partial remission. CONCLUSIONS As(2)O(3) induced apoptosis of CTCL cells by the down-regulation of transcription factors that stimulate the expression of antiapoptotic genes. Local injection of As(2)O(3) into MF tumor-bearing mice resulted in tumor regression.
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Affiliation(s)
- A Tun-Kyi
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland; Harvard Medical School, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Institutes of Medicine, Boston, USA
| | - J-Z Qin
- Skin Disease Research Laboratories, Oncology Institute, Loyola University Medical Center, Maywood, IL, USA
| | - P A Oberholzer
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - A A Navarini
- Institute for Experimental Immunology, University Hospital Zurich, Zurich, Switzerland
| | - J C Hassel
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - R Dummer
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - U Döbbeling
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.
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Oberholzer PA, Urosevic M, Steinert HC, Dummer R. Baseline Staging of Melanoma with Unknown Primary Site: The Value of Serum S100 Protein and Positron Emission Tomography. Dermatology 2008; 217:351-5. [DOI: 10.1159/000155878] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2007] [Accepted: 03/19/2008] [Indexed: 11/19/2022] Open
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Mnich CD, Hoek KS, Oberholzer PA, Seifert B, Hafner J, Dummer R, Mihic D. Reduced pSmad2 immunodetection correlates with increased primary melanoma thickness. Melanoma Res 2007; 17:131-6. [PMID: 17496789 DOI: 10.1097/cmr.0b013e3280dec693] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [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: 01/25/2023]
Abstract
Cutaneous melanoma is the most aggressive of cutaneous neoplasms. Identifying patients with an increased risk for the development of metastases is critical. This study investigates phospho-Smad2, a central factor of the transforming growth factor beta pathway, on formalin-fixed, paraffin-embedded tissues from 60 primary cutaneous melanomas (Breslow >1 mm), for its candidacy for being a prognostic marker in primary cutaneous melanoma. Phospho-Smad2 positivity was assessed for correlation with clinical parameters including Breslow index, melanoma type, survival, development of metastases, sentinel lymph node status and age. Phospho-Smad2 positivity was not associated with survival or development of metastases, suggesting that it would not be a useful prognostic marker. Despite this, we found phospho-Smad2 positivity to be correlated with low tumour thickness, indicating that as the primary tumour grows there is an increased inhibition of transforming growth factor beta signalling resulting in suppressed Smad2 phosphorylation. Additionally, phosphorylation of Smad2 in neighbouring melanoma cells and keratinocytes was interrelated, which is a further indication that Smad2 phosphorylation in primary melanoma is affected by local area microenvironmental factors. We hypothesize that the observed decrease in transforming growth factor beta signalling in thicker primary melanomas is due to the increased production of signalling inhibitors.
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Affiliation(s)
- Christian D Mnich
- Department of Dermatology, University Hospital of Zürich, Zürich, Switzerland
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Künzi V, Oberholzer PA, Heinzerling L, Dummer R, Naim HY. Recombinant Measles Virus Induces Cytolysis of Cutaneous T-Cell Lymphoma In Vitro and In Vivo. J Invest Dermatol 2006; 126:2525-32. [PMID: 16960554 DOI: 10.1038/sj.jid.5700529] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [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: 11/09/2022]
Abstract
Measles virus (MV) has shown promise as an oncolytic virus in the treatment of different tumor models for human B-cell lymphoma, multiple myeloma, ovarian cancer, and glioma. We have shown that, in a phase I clinical trial, MV vaccine induces tumor regression in cutaneous T-cell lymphoma (CTCL) patients. Here, we investigated in detail, the effect of recombinant MV (rMV) vaccine strain in CTCL cell cultures, and in vivo in established CTCL xenografts in nude mice. The susceptibility of three CTCL cell lines, originating from patients, to rMV was tested by determination of cell surface expression of MV receptors. All cell lines expressed the receptors CD150 and CD46 and were easily infected by rMV and induced complete cell lysis. The cytoreductive activity was apparent in cells forming aggregates, indicating a cell-to-cell spread of MV and cytolysis owing to virus infection. Intratumoral (i.t.) injection of rMV, expressing enhanced green fluorescent protein induced complete regression of large established human CTCL tumors in nude mice, whereas tumors with control treatment progressed exponentially. Immunohistochemical analysis of tumor biopsies, after i.t. treatment, for MV-NP protein complex demonstrated replication of MV within the tumors. The data demonstrate the potential of MV as a therapeutic agent against CTCL.
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Mihic-Probst D, Mnich CD, Oberholzer PA, Seifert B, Sasse B, Moch H, Dummer R. p16 expression in primary malignant melanoma is associated with prognosis and lymph node status. Int J Cancer 2006; 118:2262-8. [PMID: 16331607 DOI: 10.1002/ijc.21608] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.3] [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: 11/08/2022]
Abstract
Lymph node (LN) status is an important prognostic factor in melanoma patients. p16 expression and proliferation rate (MIB-1) of primary melanomas have been suggested as a marker of metastatic potential. In this study, the correlation of p16 expression and the proliferation rate (MIB-1) with LN status and tumor-specific survival was investigated in primary melanomas. MIB-1 and p16 expression were analyzed by immunohistochemistry in 64 patients with primary cutaneous melanoma. Thirty four nevi were used as control. All patients underwent sentinel lymph node staging. Three different p16 staining patterns were observed: a combination of nuclear and cytoplasmic staining, only cytoplasmic staining and absence of p16 expression. All 34 nevi displayed a nuclear and cytoplasmic p16 staining, whereas p16 was negative in 14 of 64 (22%) melanomas. The level of p16 expression gradually decreased from benign nevi to melanoma without metastasis to melanoma with metastasis. There was a significant correlation between cytoplasmic p16 expression and absence of metastasis (p < 0.05). Death of disease correlated with absence of p16 immunostaining (p = 0.01). MIB-1 expression was not associated with survival. These results confirm the relevance of p16 expression as a prognostic marker in melanoma patients. In addition, it was shown that cytoplasmic immunostaining for p16 in primary melanoma might serve as a predictor of the LN status. Therefore, immunohistochemical evaluation for p16 expression is of potential value for treatment planning in melanoma surgery.
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Affiliation(s)
- Daniela Mihic-Probst
- Department of Pathology, Institute of Surgical Pathology, University Hospital, Zürich, Switzerland.
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Heinzerling L, Künzi V, Oberholzer PA, Kündig T, Naim H, Dummer R. Oncolytic measles virus in cutaneous T-cell lymphomas mounts antitumor immune responses in vivo and targets interferon-resistant tumor cells. Blood 2005; 106:2287-94. [PMID: 15961518 DOI: 10.1182/blood-2004-11-4558] [Citation(s) in RCA: 129] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Some cutaneous T-cell lymphomas, (CTCLs) clonal T cells are deficient in interferon signaling, making them promising targets for viral oncolysis. We evaluated cytopathic effects of measles virus (MV) in CTCL. CTCL cell lines and infiltrating lymphocytes in CTCL expressed MV receptors CD150 and CD46. In a phase 1 dose escalation trial a total of 16 injections of live MV, Edmonston-Zagreb vaccine strain, were given intratumorally to 5 patients with CTCL. Patients had antimeasles-serum antibodies and were pretreated with interferon-alpha to prevent uncontrolled virus spread. The well-tolerated treatment with MV resulted in clinical responses. Evaluation of biopsies, before and at 11 days after injection, by immunohistochemistry and reverse transcriptase-polymerase chain reaction (RT-PCR) demonstrated local viral activity with positive staining for MV nucleoprotein (NP), an increase of the interferon gamma (IFN-gamma)/CD4 and IFN-gamma/CD8 mRNA ratios and a reduced CD4/CD8 ratio. All patients demonstrated an increased antimeasles antibody titer after therapy. The data demonstrate that CTCLs are promising targets for an MV-based oncolytic therapy.
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Affiliation(s)
- Lucie Heinzerling
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
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Heinzerling L, Burg G, Dummer R, Maier T, Oberholzer PA, Schultz J, Elzaouk L, Pavlovic J, Moelling K. Intratumoral injection of DNA encoding human interleukin 12 into patients with metastatic melanoma: clinical efficacy. Hum Gene Ther 2005; 16:35-48. [PMID: 15703487 DOI: 10.1089/hum.2005.16.35] [Citation(s) in RCA: 103] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Plasmid DNA encoding human interleukin 12 (IL-12) was produced under GMP conditions and injected into lesions of nine patients with malignant melanoma (stage IV) previously treated with both standard and nonstandard therapies. The treatment was based on efficacy in preclinical studies with melanoma in mice and gray horses. The DNA was applied in cycles, three injections per cycle, for up to seven cycles. Three therapy arms comprised low (2 mg), medium (4 mg), and high (10 to 20 mg) amounts of total DNA. The therapy was well tolerated. Three of nine patients experienced a clinical response: two stable disease and one complete remission. One patient receiving a low dose of DNA experienced a long-lasting stabilization of the disease for more than 3 years, whereas the other two responders received high doses of DNA. All patients but one (patient 9) experienced a transient response at the intratumoral injection site. Immunohistochemical staining of responder sections showed local reduction of angiogenesis and lymphocyte infiltrations. All patients, in particular the clinical and local responders (patients 3, 7, and 8), exhibited an antigen-specific immune response against MAGE-1 and MART-1, which in some cases preexisted. Biopsies of responders showed some increase in IL-12, IP-10, and IFN-(). Serum levels revealed fluctuations. The results show that intratumoral injection of DNA produced some beneficial clinical effect. DNA encoding a cytokine may be useful as a therapeutic or adjuvant against various human cancers.
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Affiliation(s)
- Lucie Heinzerling
- Department of Dermatology, University of Zurich, CH-8091 Zurich, Switzerland
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Urosevic M, Oberholzer PA, Maier T, Hafner J, Laine E, Slade H, Benninghoff B, Burg G, Dummer R. Imiquimod treatment induces expression of opioid growth factor receptor: a novel tumor antigen induced by interferon-alpha? Clin Cancer Res 2005; 10:4959-70. [PMID: 15297396 DOI: 10.1158/1078-0432.ccr-04-0193] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Imiquimod represents a synthetic local immune response modifier that has demonstrated efficacy in clearing basal cell carcinoma. Via interaction with Toll-like receptor 7 on immune cells, imiquimod induces local production of cytokines, such as interferon (IFN)-alpha. EXPERIMENTAL DESIGN To more closely define and elucidate mechanisms leading to basal cell carcinoma clearance in vivo, we examined gene expression profiles of skin basal cell carcinoma before and after treatment with 5% imiquimod cream (Aldara) by using high-density oligonucleotide arrays. RESULTS We show that imiquimod predominantly induces genes involved in different aspects of immune response. In addition to effects on immunity, imiquimod treatment modulates the expression of genes involved in the control of apoptosis and oncogenesis. Array data indicated that imiquimod treatment induces expression of opioid growth factor receptor, a molecule recently reported to be a target for antitumor antibody responses. Immunohistochemistry revealed in vivo up-regulation of opioid growth factor receptor protein on tumor and on infiltrating cells after treatment. By using basal cell carcinoma cell lines treated with IFN-alpha or imiquimod, we show that opioid growth factor receptor up-regulation is IFN-alpha-mediated, rather then directly imiquimod-mediated. By using tissue microarray containing 52 basal cell carcinomas, we demonstrate opioid growth factor receptor expression in almost half of the cases. Expression of opioid growth factor receptor correlated with a longer recurrence-free period in basal cell carcinoma that recurred after radiotherapy (Kaplan-Meier analysis, P = 0.041). CONCLUSIONS In addition to its immunomodulatory and antiproliferative activity, opioid growth factor receptor seems to have a prognostic significance in basal cell carcinoma patients. Our data add to the growing list of basal cell carcinoma-associated tumor antigens.
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Affiliation(s)
- Mirjana Urosevic
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
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Abstract
Mycosis fungoides (MF) is the most frequent variant of cutaneous T-cell lymphomas (CTCLs). MF primarily involves the skin initially with patches and plaques. In later stages, cutaneous tumors develop and tumor cells may spread to lymph nodes and finally to visceral sites. Here, we describe an animal model for MF in immune-deficient nude mice, using the CTCL cell line MyLa. Subcutaneous transplantation of MyLa cells leads to the formation of cutaneous tumors in 80% of the mice (50/60 total). Spread of tumor cells to visceral sites was detected by immunohistochemistry and polymerase chain reaction (PCR)-based detection of specific T-cell receptor-gamma rearrangement. MyLa cells were found circulating in the blood, lymph nodes, and in blood vessels of heart, kidney, lung, and liver. In lung and liver tissue, tumor cells presented perivascular invasion, but no large secondary tumors developed. The nude mouse model described here will be a valuable test system for new therapeutic approaches for the treatment of MF and opens the unique opportunity to study the disease in vivo.
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MESH Headings
- Animals
- Cell Line
- Cell Line, Tumor
- Cell Separation
- Disease Models, Animal
- Flow Cytometry
- Gene Rearrangement, T-Lymphocyte
- Immunohistochemistry
- Kinetics
- Lymph Nodes/pathology
- Lymphoma, T-Cell/pathology
- Mice
- Mice, Nude
- Mycosis Fungoides/pathology
- Neoplasm Transplantation
- Neoplastic Cells, Circulating
- Polymerase Chain Reaction
- RNA, Small Interfering/metabolism
- Receptors, Antigen, T-Cell, gamma-delta/immunology
- Skin Neoplasms/pathology
- Time Factors
- Tissue Distribution
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Affiliation(s)
- Sonja Thaler
- Institute for Biomedical Research, Georg-Speyer-Haus, Paul-Ehrlich-Strasse 42-44, D-60596 Frankfurt/Main, Germany
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Oberholzer PA, Heinzerling L, Maier T, Tassis A, Kündig T, Burg G, Dummer R. Masernimpfvirus-Behandlung in CTCL. Akt Dermatol 2003. [DOI: 10.1055/s-2003-822245] [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: 10/19/2022]
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Pfirrmann CW, Oberholzer PA, Zanetti M, Boos N, Trudell DJ, Resnick D, Hodler J. Selective nerve root blocks for the treatment of sciatica: evaluation of injection site and effectiveness--a study with patients and cadavers. Radiology 2001; 221:704-11. [PMID: 11719666 DOI: 10.1148/radiol.2213001635] [Citation(s) in RCA: 102] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To relate different types of radiographic contrast material distributions to anatomic compartments by using cadaveric specimens and to relate the injection site to treatment-induced discomfort and therapeutic effect. MATERIALS AND METHODS The contrast material distributions of selective nerve root blocks (SNRBs) in 36 patients (13 women, 23 men; mean age, 52 years; age range, 22-88 years) were graded by two radiologists in conference as type 1 (tubular appearance), type 2 (nerve root visible as filling defect), or type 3 (nerve root not visible). These patterns were correlated with pain reduction after 15 minutes and 2 weeks (with a visual analogue scale of 100-mm length). In addition, 30 nerve roots were injected with iodine-containing contrast material and blue dye in three cadaveric specimens. Radiographs were compared with anatomic sections. RESULTS After 15 minutes and 2 weeks, 75% and 86% of the patients, respectively, reported pain relief. Mean pain relief length after 15 minutes for type 1 distribution was 60 mm; for type 2, 44 mm; and for type 3, 22 mm; and after 2 weeks, it was 34 mm for type 1, 31 mm for type 2, and 57 mm for type 3. There was no correlation between early and late response. Pain during intervention was less pronounced in type 2 injection, compared with type 1 (P = .002). On the basis of anatomic sections, type 1 injection was intraepineural; type 2, extraepineural; and type 3, paraneural. CONCLUSION Therapeutic SNRB is effective in sciatica, but early response does not predict the effect after 2 weeks. Type 1 injections are more painful than type 2 injections.
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Affiliation(s)
- C W Pfirrmann
- Department of Radiology, University Hospital Balgrist, Forchstrasse 340, CH-8008 Zurich, Switzerland.
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