1
|
Haddad E, Bottet B, Thiebaut PA, Morin S, Dreyfus H, Vannier É, Vincent C, Marguet F, Lamy A, Sobol H, Baste JM, Guisier F, Sabourin JC, Piton N. Squamous Cell Carcinoma of the Lung With Microsatellite Instability in a Patient With Lynch Syndrome: A Case Report. JTO Clin Res Rep 2024; 5:100595. [PMID: 38229768 PMCID: PMC10788277 DOI: 10.1016/j.jtocrr.2023.100595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 10/09/2023] [Accepted: 10/14/2023] [Indexed: 01/18/2024] Open
Abstract
Lynch syndrome is the most common autosomal dominant inherited cancer predisposing syndrome, due to mutations in DNA mismatch repair genes. The key feature of cancers in Lynch syndrome is microsatellite instability and a high risk of developing mainly colorectal and uterine cancers. However, cancers with microsatellite instability outside this spectrum, for example, lung cancer, are extremely rare. Here, we report a case of squamous cell carcinoma of the lung with microsatellite instability in a patient with Lynch syndrome.
Collapse
Affiliation(s)
- Emna Haddad
- University of Rouen Normandy (UNIROUEN), Institut National de la Santé et de la Recherche Médicale (INSERM) U1245, Rouen, France
- Department of Pathology, Hospital Center University De Rouen (CHU Rouen), Rouen, France
| | - Benjamin Bottet
- Department of General and Thoracic Surgery, CHU Rouen, Rouen, France
| | - Pierre-Alain Thiebaut
- University of Rouen Normandy (UNIROUEN), Institut National de la Santé et de la Recherche Médicale (INSERM) U1245, Rouen, France
- Department of Pathology, Hospital Center University De Rouen (CHU Rouen), Rouen, France
| | | | | | | | - Colette Vincent
- Centre Hospitalier Intercommunal (CHI) Elbeuf Louviers Val de Reuil, Saint-Aubin-lès-Elbeuf, France
| | - Florent Marguet
- University of Rouen Normandy (UNIROUEN), Institut National de la Santé et de la Recherche Médicale (INSERM) U1245, Rouen, France
- Department of Pathology, Hospital Center University De Rouen (CHU Rouen), Rouen, France
| | - Aude Lamy
- University of Rouen Normandy (UNIROUEN), Institut National de la Santé et de la Recherche Médicale (INSERM) U1245, Rouen, France
- Department of Pathology, Hospital Center University De Rouen (CHU Rouen), Rouen, France
| | - Hagay Sobol
- Département de Biologie du Cancer, Institut Paloi-Calmettes, Marseille, France
- Faculté des Sciences Médicales et Paramédicales, Aix-Marseille University (AMU), Marseille, France
| | - Jean-Marc Baste
- Department of General and Thoracic Surgery, CHU Rouen, Rouen, France
| | | | - Jean-Christophe Sabourin
- University of Rouen Normandy (UNIROUEN), Institut National de la Santé et de la Recherche Médicale (INSERM) U1245, Rouen, France
- Department of Pathology, Hospital Center University De Rouen (CHU Rouen), Rouen, France
| | - Nicolas Piton
- University of Rouen Normandy (UNIROUEN), Institut National de la Santé et de la Recherche Médicale (INSERM) U1245, Rouen, France
- Department of Pathology, Hospital Center University De Rouen (CHU Rouen), Rouen, France
| |
Collapse
|
2
|
Rivera-Torres N, Bialk P, Kmiec EB. CRISPR-Directed Gene Editing as a Method to Reduce Chemoresistance in Lung Cancer Cells. Methods Mol Biol 2023; 2660:263-271. [PMID: 37191803 DOI: 10.1007/978-1-0716-3163-8_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
We are advancing a novel strategy for the treatment of solid tumors by employing CRISPR-directed gene editing to reduce levels of standard of care required to halt or reverse the progression of tumor growth. We intend to do this by utilizing a combinatorial approach in which CRISPR-directed gene editing is used to eliminate or significantly reduce the acquired resistance emerging from chemotherapy, radiation therapy, or immunotherapy. We will utilize CRISPR/Cas as a biomolecular tool to disable specific genes involved in the sustainability of resistance to cancer therapy. We have also developed a CRISPR/Cas molecule that can distinguish between the genome of a tumor cell in the genome of a normal cell, thereby conferring target selectivity onto this therapeutic approach. We envision delivering these molecules by direct injection into solid tumors for the treatment of squamous cell carcinomas of the lung, esophageal cancer, and head and neck cancer. We provide experimental details and methodology for utilizing CRISPR/Cas as a supplement to chemotherapy to destroy lung cancer cells.
Collapse
Affiliation(s)
| | - Pawel Bialk
- Gene Editing Institute, ChristianaCare Health System, Newark, DE, USA
| | - Eric B Kmiec
- Gene Editing Institute, ChristianaCare Health System, Newark, DE, USA.
| |
Collapse
|
3
|
Parzen JS, Almahariq MF, Quinn TJ, Siddiqui ZA, Thompson AB, Guerrero T, Lee K, Stevens C, Grills IS. Higher biologically effective dose is associated with improved survival in patients with squamous cell carcinoma of the lung treated with stereotactic body radiation therapy. Radiother Oncol 2021; 160:25-31. [PMID: 33892021 DOI: 10.1016/j.radonc.2021.04.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 04/08/2021] [Accepted: 04/12/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Multiple studies have suggested that patients with early-stage SCC of the lung treated with SBRT are more susceptible to local failure compared to other NSCLC histologies. It is unknown if higher BED leads to improved outcomes in this patient population. We evaluated the effect of "high" BED versus "low" BED SBRT on overall survival (OS) in SCC and non-SCC NSCLC patients. METHODS The National Cancer Database was used to identify patients with cT1-2N0M0 NSCLC diagnosed between 2006-2016 treated with 3-5 fraction SBRT. Patients were grouped by BEDhigh (>150 Gy) and BEDlow (≤132 Gy). Univariate and multivariable analysis using Kaplan-Meier and Cox proportional hazards regression modeling were performed. Propensity-score matched analysis with inverse probability of treatment (IPTW) weighting was used to account for selection bias. RESULTS We identified 4,717 eligible SCC patients and 8,807 eligible non-SCC NSCLC patients. In SCC patients, BEDhigh was associated with improved OS in both univariate and multivariate analysis (MVA HR 0.84 95% CI 0.76-0.92, p < 0.001), with estimated IPTW-adjusted 3-year OS of 49% compared to 41% for the BEDlow group. In contrast, BEDhigh was not associated with improved OS compared to BEDlow for non-SCC NSCLC patients (MVA HR 0.94 95% CI 0.86-1.04, p = 0.23), with estimated IPTW-adjusted 3-year OS of 54% and 53%, respectively. CONCLUSIONS Our analysis suggests that in patients with early-stage NSCLC, SBRT regimens with BED > 150 Gy may confer a survival benefit in patients with SCC histology. Histology-based dose modification should be considered, and prospective validation may be warranted.
Collapse
Affiliation(s)
- Jacob S Parzen
- Beaumont Health, Department of Radiation Oncology, Royal Oak, United States
| | - Muayad F Almahariq
- Beaumont Health, Department of Radiation Oncology, Royal Oak, United States.
| | - Thomas J Quinn
- Beaumont Health, Department of Radiation Oncology, Royal Oak, United States
| | - Zaid A Siddiqui
- University of Pittsburgh Medical Center, Pittsburgh, United States
| | - Andrew B Thompson
- Beaumont Health, Department of Radiation Oncology, Royal Oak, United States
| | - Thomas Guerrero
- Beaumont Health, Department of Radiation Oncology, Royal Oak, United States
| | - Kuei Lee
- Beaumont Health, Department of Radiation Oncology, Royal Oak, United States
| | - Craig Stevens
- Beaumont Health, Department of Radiation Oncology, Royal Oak, United States
| | - Inga S Grills
- Beaumont Health, Department of Radiation Oncology, Royal Oak, United States
| |
Collapse
|
4
|
Limberis CL, Nayler S, Rapoport BL. A Rare Case of Synchronous Waldenström's Macroglobulinemia and Cutaneous Squamous Cell Carcinoma with a Lung Mass: A Diagnostic and Management Dilemma. Case Rep Oncol 2021; 13:1474-1482. [PMID: 33442372 PMCID: PMC7772870 DOI: 10.1159/000511460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 09/08/2020] [Indexed: 11/19/2022] Open
Abstract
Cutaneous squamous cell carcinoma has presented an increasing burden globally, with the occurrence of metastatic cutaneous squamous cell carcinoma being a relatively rare event but presenting with significant challenges in management, and a paucity of treatment options. Waldenström's macroglobulinemia is similarly an infrequent diagnosis. We present a rare case of a synchronous diagnosis of cutaneous squamous cell carcinoma and Waldenström's macroglobulinemia with an associated lung mass with squamous differentiation. The considered origin of the lung mass was either metastatic cutaneous squamous cell carcinoma or a primary squamous cell carcinoma of the lung, representing a third primary malignancy. The report highlights complexities in diagnosis and management, particularly in a patient with multiple synchronous malignancies. It further emphasizes the need for expanded global availability of specific therapies, including PD-1 inhibitors.
Collapse
Affiliation(s)
| | - Simon Nayler
- Drs Gritzman and Thatcher Inc. Laboratories, Randburg, Johannesburg, South Africa.,Wits Donald Gordon Medical Centre, Parktown, Johannesburg, South Africa
| | - Bernardo Leon Rapoport
- The Medical Oncology Centre of Rosebank, Saxonwold, Johannesburg, South Africa.,Department of Immunology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| |
Collapse
|
5
|
Asai N, Kubo A, Suzuki S, Murotani K, Numanami H, Yoshikawa K, Ueda R, Yamaguchi E. CCR4 Expression in Tumor-Infiltrating Regulatory T Cells in Patients with Squamous Cell Carcinoma of the Lung: A Prognostic Factor for Relapse and Survival. Cancer Invest 2019; 37:163-173. [PMID: 30907146 DOI: 10.1080/07357907.2019.1582848] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
To clarify the prognostic impact of tumor-infiltrating effector regulatory T cells (eTregs) in non-small cell lung cancer (NSCLC), eTregs were evaluated by immunohistochemical detection of CCR4 and Foxp3 in 108 consecutive surgical NSCLC tumors. Multivariate analysis showed that a high ratio of CCR4+ eTregs to total Tregs (≥40%) was the only independent risk factor for relapse-free survival (odds ratio [OR]: 6.54, 95% confidence interval: 1.67-25.7, p = .007) and overall survival (OR: 3.76, p = .037) in lung squamous cell carcinoma (SqCC). These results highlight the prognostic importance of the balance of tumor-infiltrating Tregs in resected lung SqCC.
Collapse
Affiliation(s)
- Nobuhiro Asai
- a Division of Respiratory Medicine and Allergology, Department of Internal Medicine , Aichi Medical University School of Medicine , Nagakute , Japan
| | - Akihito Kubo
- a Division of Respiratory Medicine and Allergology, Department of Internal Medicine , Aichi Medical University School of Medicine , Nagakute , Japan
| | - Susumu Suzuki
- b Department of Tumor Immunology , Aichi Medical University School of Medicine , Nagakute , Japan
| | - Kenta Murotani
- c Division of Biostatistics, Clinical Research Center , Aichi Medical University School of Medicine , Nagakute , Japan
| | - Hiroki Numanami
- d Division of Chest Surgery, Department of Surgery , Aichi Medical University School of Medicine , Nagakute , Japan
| | - Kazuhiro Yoshikawa
- e Promoting Center for Clinical Research , Aichi Medical University School of Medicine , Nagakute , Japan
| | - Ryuzo Ueda
- b Department of Tumor Immunology , Aichi Medical University School of Medicine , Nagakute , Japan
| | - Etsuro Yamaguchi
- a Division of Respiratory Medicine and Allergology, Department of Internal Medicine , Aichi Medical University School of Medicine , Nagakute , Japan
| |
Collapse
|
6
|
Senoo S, Ninomiya K, Hotta K, Kiura K. Recent treatment strategy for advanced squamous cell carcinoma of the lung in Japan. Int J Clin Oncol 2019; 24:461-7. [PMID: 30847617 DOI: 10.1007/s10147-019-01424-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 03/01/2019] [Indexed: 12/26/2022]
Abstract
Squamous cell carcinoma of the lung is associated with smoking in its development and comprises about 20-30% of all lung cancers. Its treatment strategy had been limited for the past decades, inevitably resulting in the poor outcome. However in the 2010s, it has dramatically changed mainly with the recent clinical introduction of immune checkpoint inhibitors. In this review, we will introduce various clinical studies involving squamous cell carcinoma of the lung.
Collapse
|
7
|
Flockerzi FA, Roggia C, Langer F, Holleczek B, Bohle RM. FGFR1 gene amplification in squamous cell carcinomas of the lung: a potential favorable prognostic marker for women and for patients with advanced cancer. Virchows Arch 2017; 472:759-769. [PMID: 29270870 DOI: 10.1007/s00428-017-2282-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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: 09/27/2017] [Revised: 11/30/2017] [Accepted: 12/11/2017] [Indexed: 12/01/2022]
Abstract
In squamous cell carcinoma (SCC) of the lung, mutations within the genes of fibroblast growth factor receptors (FGFR) such as K660N/K660E in FGFR2 and R248C/S249C in FGFR3 and FGFR1 gene amplification have been described, but their prognostic relevance still remains unclear. In order to detect the mutation frequencies and to define their prognostic value for associated clinicopathologic features and survival of patients, resected ΔNp63/p40-positive SCC of the lung (n = 101) were screened for FGFR1 gene amplification by fluorescence in situ hybridization performed on formalin-fixed paraffin embedded tissues and for the presumed driver mutations in genes of FGFR2 and FGFR3 by PCR and Sanger sequencing. Twenty-two of 101 SCCs (22%) were positive for amplification based on a FGFR1/centromere (chromosome 8) ratio > 2.0 or higher. In advanced tumor stages (III-IV), the overall survival of patients carrying FGFR1 gene amplification was significantly higher (p = 0.006). Among women, FGFR1 gene amplification was significantly associated with longer overall survival (p = 0.023). The presence of FGFR1 gene amplification was associated with patient age (65 versus 69 years, p = 0.046), but not with gender, tumor stage, histologic subtype, tumor grade, or ΔNp63/p40 immunoreactivity. The S249C mutation in the FGFR3 gene was identified in one out of 101 SCCs (1%); the K600N, K660E, or R248C mutations were not identified. These results suggest that FGFR1 gene amplification is a frequent alteration in SCC of the lung and appears not to be a negative but rather a favorable prognostic marker for women and particularly for patients with advanced SCC of the lung (stage III-IV).
Collapse
Affiliation(s)
- Fidelis Andrea Flockerzi
- Department of Pathology, Saarland University Medical Center, Homburg, Building 26, 66421, Homburg, Germany.
| | - Cristiana Roggia
- Department of Pathology, Saarland University Medical Center, Homburg, Building 26, 66421, Homburg, Germany.,Department of Interdisciplinary Division of Neuro-Oncology, University Hospital Tübingen, Tübingen, Germany
| | - Frank Langer
- Department of Thoracic and Cardiovascular Surgery, Saarland University Medical Center, Homburg, Germany
| | | | - Rainer M Bohle
- Department of Pathology, Saarland University Medical Center, Homburg, Building 26, 66421, Homburg, Germany.,Cancer Center Saarland, Saarland University Medical Center, Homburg, Germany
| |
Collapse
|
8
|
Tao H, Soh J, Yamamoto H, Fujiwara T, Ueno T, Hayama M, Okazaki M, Sugimoto R, Yamashita M, Sano Y, Okabe K, Matsuura M, Kataoka K, Moriyama S, Toyooka S, Miyoshi S. Restrictive ventilatory impairment is associated with poor outcome in patients with cT1aN0M0 peripheral squamous cell carcinoma of the lung. J Thorac Dis 2017; 9:4325-4335. [PMID: 29268501 DOI: 10.21037/jtd.2017.10.70] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 11/06/2022]
Abstract
Background Patients with squamous cell carcinoma (SqCC) of the lung sometimes have a comorbid pulmonary disease such as pulmonary emphysema or an interstitial lung disease (ILD), both of which negatively affect patient outcome. The aim of this study was to determine the outcome of patients in a multicenter database who underwent surgery for cT1aN0M0 peripheral SqCC lung cancer. Methods The medical records of a total of 228 eligible patients from seven institutions were reviewed to evaluate the impact of concomitant impaired pulmonary function and other clinicopathological factors on overall survival (OS) and relapse-free survival (RFS). Results Six patients with positive or unclear tumor margins were excluded. Of the 222 remaining study patients, 42 (18.9%) and 97 (43.7%) patients were found to have coexisting restrictive or obstructive ventilatory impairment, respectively. Over a median follow-up period of 30.6 months, the 5-year OS and RFS were 69.0% and 62.6%, respectively. By multivariate analysis, ILDs identified on high-resolution computed tomography (HRCT), pulmonary function test results indicating a restrictive ventilatory impairment, and wedge resection were found to be independent risk factors for poor OS. An increased level of serum squamous cell carcinoma antigen (SCC-Ag) (>1.5 ng/mL) and the same risk factors for poor OS were independent risk factors for recurrence. Among patients who underwent anatomical lung resection (lobectomy and segmentectomy, n=173), a restrictive ventilatory impairment was an independent risk factor for poor OS, and increased serum SCC-Ag level, ILDs on HRCT, and restrictive ventilatory impairment were independent risk factors for poor RFS by multivariate analysis. Factors such as visceral pleural invasion, and lymphatic or vascular invasion were not significantly associated with outcome. Conclusions A restrictive ventilatory impairment negatively affects the outcome of patients with cT1aN0M0 peripheral SqCC lung cancer.
Collapse
Affiliation(s)
- Hiroyuki Tao
- Division of Thoracic Surgery, National Hospital Organization Yamaguchi-Ube Medical Center, Ube, Japan
| | - Junichi Soh
- Department of Thoracic Surgery, Okayama University Hospital, Okayama, Japan
| | - Hiromasa Yamamoto
- Department of Thoracic Surgery, Okayama University Hospital, Okayama, Japan
| | - Toshiya Fujiwara
- Department of Thoracic Surgery, Hiroshima City Hospital, Hiroshima, Japan
| | - Tsuyoshi Ueno
- Department of Thoracic Surgery, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Makio Hayama
- Department of Thoracic Surgery, Okayama Red Cross General Hospital, Okayama, Japan
| | - Mikio Okazaki
- Center of Chest Medicine and Surgery, Ehime University, Toon, Japan
| | - Ryujiro Sugimoto
- Department of Thoracic Surgery, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan.,Department of Thoracic Surgery, National Hospital Organization Iwakuni Clinical Center, Iwakuni, Japan
| | - Motohiro Yamashita
- Department of Thoracic Surgery, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Yoshifumi Sano
- Center of Chest Medicine and Surgery, Ehime University, Toon, Japan
| | - Kazunori Okabe
- Division of Thoracic Surgery, National Hospital Organization Yamaguchi-Ube Medical Center, Ube, Japan
| | - Motoki Matsuura
- Department of Thoracic Surgery, Hiroshima City Hospital, Hiroshima, Japan
| | - Kazuhiko Kataoka
- Department of Thoracic Surgery, National Hospital Organization Iwakuni Clinical Center, Iwakuni, Japan
| | - Shigeharu Moriyama
- Department of Thoracic Surgery, Okayama Red Cross General Hospital, Okayama, Japan
| | - Shinichi Toyooka
- Department of Thoracic Surgery, Okayama University Hospital, Okayama, Japan.,Department of Clinical Genomic Medicine, Okayama University Hospital, Okayama, Japan
| | - Shinichiro Miyoshi
- Department of Thoracic Surgery, Okayama University Hospital, Okayama, Japan
| |
Collapse
|
9
|
Gadgeel S, Goss G, Soria JC, Felip E, Georgoulias V, Lu S, Cobo M, Syrigos K, Lee KH, Göker E, Guclu SZ, Isla D, Morabito A, Dupuis N, Bühnemann C, Krämer N, Solca F, Ehrnrooth E, Ardizzoni A. Evaluation of the VeriStrat ® serum protein test in patients with advanced squamous cell carcinoma of the lung treated with second-line afatinib or erlotinib in the phase III LUX-Lung 8 study. Lung Cancer 2017; 109:101-108. [PMID: 28577938 DOI: 10.1016/j.lungcan.2017.05.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 05/10/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Identification of biomarkers associated with clinical benefit may be crucial in establishing optimal treatment choice for patients with squamous cell carcinoma (SCC) of the lung after first-line chemotherapy. In this study, the ability of the VeriStrat serum protein test to predict differential clinical benefit with afatinib versus erlotinib, and the association of VeriStrat status with clinical outcomes irrespective of EGFR-TKI used, was assessed in a retrospective analysis of the phase III LUX-Lung 8 trial. MATERIALS AND METHODS Pretreatment plasma samples were analyzed using matrix-assisted laser desorption ionization time-of-flight mass spectrometry. Spectra were evaluated to assign a VeriStrat 'Good' (VS-G) or VeriStrat 'Poor' (VS-P) classification. Overall survival (OS), progression-free survival, and other endpoints were assessed with respect to pretreatment VeriStrat status; OS was the primary efficacy variable. Outcomes with other efficacy endpoints were similar. RESULTS Of 795 patients randomized in LUX-Lung 8, 675 were classified (VS-G: 412; VS-P: 263). In the VS-G group, OS was significantly longer with afatinib versus erlotinib (HR 0.79 [95% CI: 0.63-0.98]). In the VS-P group, there was no significant difference in OS between afatinib and erlotinib (HR 0.90 [0.70-1.16]). However, there was no interaction between VeriStrat classification and treatment group for OS (pinteraction=0.5303). OS was significantly longer in VS-G versus VS-P patients, both in the overall VeriStrat-classified population (HR 0.41 [0.35-0.49]) and afatinib-treated patients (HR 0.40 [0.31-0.51]). Multivariate analysis showed that VeriStrat was an independent predictor of OS in afatinib-treated patients, regardless of ECOG PS or best response to first-line chemotherapy. CONCLUSION VS-G classification is strongly associated with favorable survival outcomes with either afatinib or erlotinib compared with VS-P classification. In VS-G patients, survival outcomes with afatinib are superior to those with erlotinib. VeriStrat classification may guide treatment decisions in patients with SCC of the lung. ClinicalTrials.gov registration number: NCT01523587.
Collapse
Affiliation(s)
- Shirish Gadgeel
- Karmanos Cancer Institute/Wayne State University, 4100 John R, Detroit, MI 48201, USA.
| | - Glenwood Goss
- The Ottawa Hospital Research Institute and University of Ottawa, 501 Smyth Rd, Ottawa, Ontario K1H 8L6, Canada.
| | - Jean-Charles Soria
- Gustave Roussy Cancer Campus and University Paris-Sud, 114 Rue Edouard Vaillant, 94800 Villejuif, Paris, France.
| | - Enriqueta Felip
- Vall d'Hebron University Hospital, Passeig Vall d'Hebron, Barcelona, 08035, Spain.
| | | | - Shun Lu
- Shanghai Chest Hospital, China(1).
| | - Manuel Cobo
- Hospital Universitario Málaga Regional y Virgen de la Victoria, IBIMA, 29010 Malaga, Spain.
| | - Konstantinos Syrigos
- Athens School of Medicine, National & Kapodistrian University, Athens 11527, Greece.
| | - Ki Hyeong Lee
- Chungbuk National University College of Medicine, 410 Seongbong-ro, Cheongju 361-711, South Korea.
| | - Erdem Göker
- Ege University Faculty of Medicine, 35040 Bornova, Izmir, Turkey.
| | - Salih Z Guclu
- Izmir Chest Diseases Research Hospital, Dr. Suat Seren Göğüs Hastalıkları ve Cerrahisi Eğitim ve Araştırma Hastanesi, Gaziler Caddesi No:331 P1 Blok 2.kat, Konak, Izmir, Turkey.
| | - Dolores Isla
- University Hospital Lozano Blesa, Avenida San Juan Bosco, 15, 50009 Zaragoza, Spain.
| | - Alessandro Morabito
- Istituto Nazionale Tumori "Fondazione G. Pascale", IRCCS, Via Mariano Semmola, 80131 Naples, Italy.
| | | | - Claudia Bühnemann
- Boehringer Ingelheim Pharma GmbH & Co. KG, Birkendorfer Str. 65, 88400 Biberach, Germany.
| | - Nicole Krämer
- Staburo GmbH, Aschauer Str. 30, 81549 Munich, Germany(2).
| | - Flavio Solca
- Boehringer Ingelheim RCV GmbH & Co KG, Doktor-Boehringer-Gasse 5-11, 1120 Vienna, Austria.
| | - Eva Ehrnrooth
- Boehringer Ingelheim, Danmark A/S, Stroedanvej 52, Copenhagen 2100, Denmark.
| | | |
Collapse
|
10
|
Usul Afsar C, Sahin B, Gunaldi M, Kılıc Bagir E, Gumurdulu D, Burgut R, Erkisi M, Kara IO, Paydas S, Karaca F, Ercolak V. Expression of fibroblast growth factor receptor 1, fibroblast growth factor 2, phosphatidyl inositol 3 phosphate kinase and their clinical and prognostic significance in early and advanced stage of squamous cell carcinoma of the lung. Int J Clin Exp Pathol 2015; 8:9760-9771. [PMID: 26617686 PMCID: PMC4637771] [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] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Accepted: 08/25/2015] [Indexed: 06/05/2023]
Abstract
AIM Non-small cell lung carcinoma is the leading cause of cancer related to death in the world. Squamous cell lung carcinoma (SqCLC) is the second most frequent histological subtype of lung carcinomas. Recently, growth factors, growth factor receptors, and signal transduction system-related gene amplifications and mutations are extensively under investigation to estimate the prognosis and to develop individualized therapies in SqCLC. In this study, besides the signal transduction molecule phosphatidyl inositol-3-phosphate kinase (IP3K) p110α, we explored the expressions of fibroblast growth factor 2 (FGF2) and receptor-1 (FGFR1) in tumor tissue and also their clinical and prognostic significance in patients with early/advanced SqCLC. MATERIALS AND METHODS From 2005 to 2013, 129 patients (23 early, 106 advanced disease) with a histopathological SqCLC diagnosis were selected from the hospital files of Cukurova University Medical Faculty for this study. Two independent pathologists evaluated FGFR1, FGF2, and PI3K (p110α) expressions in both tumor and stromal tissues from 99 of the patients with sufficient tissue samples, using immunohistochemistry. Considering survival analysis separately for patients with both early and advanced stage diseases, the relationship between the clinical features of the patients and expressions were evaluated by univariate and multivariate analyses. RESULTS FGFR1 expression was found to be low in 59 (60%) patients and high in 40 (40%) patients. For FGF2; 12 (12%) patients had high, 87 (88%) patients had low expression and for IP3K; 31 (32%) patients had high and 66 (68%) patients had low expressions. In univariate analysis, overall survival (OS) was significantly associated with stage of the disease and the performance status of the patient (P<0.0001 and P<0.001). There was no significant difference in OS of the patients with either low or high expressions of FGFR1, FGF2, and IP3K. When the patients with early or advanced stage disease were separately taken into consideration, the relationship did not differ, either. Any of FGFR1, FGF2 or IP3K expressions was not found predictive for the treatment of early or advanced staged patients. On the other hand, the expressions of both FGFR1 and FGF2 were significantly different with respect to smoking, scar of tuberculosis and scar of radiotherapy (P=0.002; P=0.06 and P=0.05, respectively). DISCUSSION There has not been identified an effective individualized treatment for SqCLC yet. Therefore, in order to be able to develop such a treatment in the future, it is essential to identify the genetic abnormalities that are responsible for the biological behaviors and carcinogenesis of SqCLC. Although we could not show the prognostic and predictive significance of FGFR1, FGF2 and IP3K expressions in SqCLC, we determined the expression rates of FGFR1, FGF2 and IP3K as a reference for Turkish patients. In conclusion, we want to put some emphasis on the fact that, pulmonary fibrosis which is a late complication of radiotherapy at stage III disease, and the scar of tuberculosis could be associated with FGFR1 and FGF2 expressions.
Collapse
Affiliation(s)
- Cigdem Usul Afsar
- Department of Medical Oncology, Istanbul Training and Research Hospital Istanbul, Turkey
| | - Berksoy Sahin
- Department of Medical Oncology, Cukurova University Medical Faculty Adana, Turkey
| | - Meral Gunaldi
- Department of Medical Oncology, Bakirkoy Sadi Konuk Research and Treatment Hospital Istanbul, Turkey
| | - Emine Kılıc Bagir
- Department of Pathology, Cukurova University Medical Faculty Adana, Turkey
| | - Derya Gumurdulu
- Department of Pathology, Cukurova University Medical Faculty Adana, Turkey
| | - Refik Burgut
- Department of Bioistatistics, Cukurova University Medical Faculty Adana, Turkey
| | - Melek Erkisi
- Department of Medical Oncology, Cukurova University Medical Faculty Adana, Turkey
| | - Ismail Oguz Kara
- Department of Medical Oncology, Cukurova University Medical Faculty Adana, Turkey
| | - Semra Paydas
- Department of Medical Oncology, Cukurova University Medical Faculty Adana, Turkey
| | - Feryal Karaca
- Department of Radiation Oncology, Adana Numune Research and Education Hospital Adana, Turkey
| | - Vehbi Ercolak
- Department of Medical Oncology, Mersin State Hospital Mersin, Turkey
| |
Collapse
|
11
|
Kim MY, Koh J, Kim S, Go H, Jeon YK, Chung DH. Clinicopathological analysis of PD-L1 and PD-L2 expression in pulmonary squamous cell carcinoma: Comparison with tumor-infiltrating T cells and the status of oncogenic drivers. Lung Cancer. 2015;88:24-33. [PMID: 25662388 DOI: 10.1016/j.lungcan.2015.01.016] [Citation(s) in RCA: 159] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 01/09/2015] [Accepted: 01/16/2015] [Indexed: 12/13/2022]
Abstract
PURPOSE Programmed cell death-1 (PD-1)/programmed cell death-ligand-1 (PD-L1) pathway-targeted immunotherapy has beneficial therapeutic effects in pulmonary squamous cell carcinoma (SqCC) patients. However, the expression patterns of PD-1 and PD-1 ligands (PD-Ls) in pulmonary SqCC remain unclear. Moreover, the association between the PD-1/PD-Ls pathway and the status of oncogenic drivers in pulmonary SqCC is unknown. METHODS PD-L1 and PD-L2 expression in tumor cells and the numbers of PD-1(+) and CD8(+) tumor-infiltrating lymphocytes (TILs) were examined in 331 resected SqCC tumors along with matched lymph node metastases from 77 cases using immunohistochemistry. EGFR and FGFR1 and MET expression and genetic status were also examined. RESULTS PD-L1 and PD-L2 expression was detected in 26.9% and 23.9% of the pulmonary SqCC samples, respectively. PD-L1 and PD-L2 expression was maintained or increased in the metastatic lymph node tumors in 81.1% and 93.5% of the 77 cases, respectively. The numbers of PD-1(+) and CD8(+) TILs were significantly positively correlated (P<0.001). Cases displaying high PD-L1 expression exhibited consistently high CD8(+) T cell infiltration (P<0.001), even in subgroup analyses according to age, smoking status, tumor size, lymph node metastasis, stage, and the EGFR, MET and FGFR1 status. Moreover, MET expression in the tumors was significantly correlated with high PD-L2 expression and increased PD-1(+) TILs (P=0.001 for both). Increased numbers of CD8(+) or PD-1(+) TILs were significantly associated with prolonged disease-free survival of these patients, whereas PD-L1 and PD-L2 expression had no significant prognostic implications. CONCLUSION PD-L1 and PD-L2 expression in pulmonary SqCC is associated with an increased number of CD8(+) TILs and increased MET expression, which might provide therapeutic insight into targeting the PD-1/PD-Ls pathway in pulmonary SqCC.
Collapse
|