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Pederzoli F, Riba M, Venegoni C, Marandino L, Bandini M, Alchera E, Locatelli I, Raggi D, Giannatempo P, Provero P, Lazarevic D, Moschini M, Lucianò R, Gallina A, Briganti A, Montorsi F, Salonia A, Necchi A, Alfano M. Stool Microbiome Signature Associated with Response to Neoadjuvant Pembrolizumab in Patients with Muscle-invasive Bladder Cancer. Eur Urol 2024; 85:417-421. [PMID: 38184414 DOI: 10.1016/j.eururo.2023.12.014] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 11/18/2023] [Accepted: 12/22/2023] [Indexed: 01/08/2024]
Abstract
Neoadjuvant pembrolizumab has been shown to be a valid treatment for patients affected by muscle-invasive bladder cancer (MIBC), as demonstrated in the PURE-01 clinical trial (NCT02736266). Among the tumor-extrinsic factors influencing immunotherapy efficacy, extensive data highlighted that the microbiome is a central player in immune-mediated anticancer activity. This report aimed to investigate the composition and role of stool microbiome in patients enrolled in the PURE-01 clinical trial. An orthotopic animal model of bladder cancer (MB49-Luc) was used to support some of the findings from human data. An analysis of stool microbiome before pembrolizumab was conducted for 42 patients, of whom 23 showed a pathologic response. The information in the preclinical model of orthotopic bladder cancer treated with anti-PD-1 antibody or control isotype was validated. Linear discriminant analysis effect size and linear models were used to identify the bacterial taxa enriched in either responders or nonresponders. The identified taxa were also tested for their association with event-free survival (EFS). Survival at 31 d after tumor instillation was used as the study endpoint in the preclinical model. Responders and nonresponders emerged to differ in terms of enrichment for 16 bacterial taxa. Of these, the genus Sutterella was enriched in responders, while the species Ruminococcus bromii was enriched in nonresponders. The negative impact of R. bromii on anti-PD-1 antibody activity was also observed in the preclinical model. EFS and survival of the preclinical model showed a negative role of R. bromii. We found different stool bacterial taxa associated with the response or lack of response to neoadjuvant pembrolizumab. Moreover, we provided experimental data about the negative role of R. bromii on immunotherapy response. Further studies are needed to externally validate our findings and provide mechanistic insights about the host-pathogen interactions in MIBC. PATIENT SUMMARY: Using prepembrolizumab stool samples collected from patients enrolled in the PURE-01 clinical trials, we identified some bacterial taxa that were enriched in patients who either responded or did not respond to immunotherapy. Using an animal model of bladder cancer, we gathered further evidence of the negative impact of the Ruminococcus bromii on immunotherapy efficacy. Further studies are needed to confirm the current findings and test the utility of these bacteria as predictive markers of immunotherapy response.
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Affiliation(s)
- Filippo Pederzoli
- Unit of Urology, Division of Experimental Oncology, URI, IRCCS San Raffaele Hospital, Milan, Italy
| | - Michela Riba
- Center for Omics Sciences, IRCCS San Raffaele Hospital, Milano, Italy
| | - Chiara Venegoni
- Unit of Urology, Division of Experimental Oncology, URI, IRCCS San Raffaele Hospital, Milan, Italy
| | - Laura Marandino
- Department of Medical Oncology, IRCCS San Raffaele Hospital, Milan, Italy
| | - Marco Bandini
- Unit of Urology, Division of Experimental Oncology, URI, IRCCS San Raffaele Hospital, Milan, Italy
| | - Elisa Alchera
- Unit of Urology, Division of Experimental Oncology, URI, IRCCS San Raffaele Hospital, Milan, Italy
| | - Irene Locatelli
- Unit of Urology, Division of Experimental Oncology, URI, IRCCS San Raffaele Hospital, Milan, Italy
| | - Daniele Raggi
- Department of Medical Oncology, IRCCS San Raffaele Hospital, Milan, Italy
| | | | - Paolo Provero
- Center for Omics Sciences, IRCCS San Raffaele Hospital, Milano, Italy; Department of Neurosciences 'Rita Levi Montalcini', University of Turin, Turin, Italy
| | - Dejan Lazarevic
- Center for Omics Sciences, IRCCS San Raffaele Hospital, Milano, Italy
| | - Marco Moschini
- Unit of Urology, Division of Experimental Oncology, URI, IRCCS San Raffaele Hospital, Milan, Italy
| | - Roberta Lucianò
- Department of Anatomic Pathology, IRCCS San Raffaele Hospital, Milan, Italy
| | - Andrea Gallina
- Istituto Oncologico della Svizzera Italiana (IOSI), Bellinzona, Switzerland
| | - Alberto Briganti
- Unit of Urology, Division of Experimental Oncology, URI, IRCCS San Raffaele Hospital, Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy
| | - Francesco Montorsi
- Unit of Urology, Division of Experimental Oncology, URI, IRCCS San Raffaele Hospital, Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy
| | - Andrea Salonia
- Unit of Urology, Division of Experimental Oncology, URI, IRCCS San Raffaele Hospital, Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy
| | - Andrea Necchi
- Department of Medical Oncology, IRCCS San Raffaele Hospital, Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy
| | - Massimo Alfano
- Unit of Urology, Division of Experimental Oncology, URI, IRCCS San Raffaele Hospital, Milan, Italy.
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Yuan H, Wang T, Peng P, Xu Z, Feng F, Cui Y, Ma J, Wu J. Urinary Exosomal miR-17-5p Accelerates Bladder Cancer Invasion by Repressing its Target Gene ARID4B and Regulating the Immune Microenvironment. Clin Genitourin Cancer 2024; 22:569-579.e1. [PMID: 38383173 DOI: 10.1016/j.clgc.2024.01.012] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 01/11/2024] [Accepted: 01/15/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Urothelial bladder cancer (BCa) is a common malignant tumor of the urinary system. It has been identified that exosomal miRNAs contribute to the development of BCa. However, its significance and mechanism in the malignant biological behavior of BCa remain unclear. In this study, the influence of exosomal miRNAs on BCa progression was investigated. METHODS High-throughput sequencing was conducted to analyze the microRNA-expression profile in urinary exosomes to screen out the key miRNA of muscle-invasive bladder cancer (MIBC). Then, candidate miRNA expression was verified and validated in urinary exosomes and tissue samples. To address the potential role of the candidate miRNA, we overexpressed and knocked down the candidate miRNA and explored its activity in BCa cell lines. Furthermore, the target gene of the selected miRNA was predicted and validated. RESULTS The expression profile of miRNAs revealed increased expression of miR-17-5p in MIBC urinary exosomes, and this was later confirmed in urinary exosomes and tissue samples. Cell function studies revealed that exosomal miR-17-5p significantly promoted the growth and invasion of BCa cells. Bioinformatics and luciferase experiments demonstrated that the ARID4B mRNA 3' UTR might be the binding site for miR-17-5p. Low ARID4B levels were linked to high-grade BCa patients and were associated with a better prognosis. CONCLUSION Elevated miR-17-5p contributes to BCa progression by targeting ARID4B and influencing the immune system. Based on these findings, miR-17-5p has the potential to be a new therapeutic target for the treatment of BCa.
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Affiliation(s)
- Hejia Yuan
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Shandong, China
| | - Tianqi Wang
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Shandong, China
| | - Peng Peng
- Department of Pathology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Shandong, China
| | - Zhunan Xu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Fan Feng
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Shandong, China
| | - Yuanshan Cui
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Shandong, China
| | - Jian Ma
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Shandong, China
| | - Jitao Wu
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Shandong, China.
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Klemm J, Shariat SF, Laukhtina E, Rajwa P, Vetterlein MW, Schuettfort VM, von Deimling M, Dahlem R, Fisch M, Rink M. Impact of Preoperative Plasma Potassium Levels on Oncological Outcomes, Major Complications, and 30-Day Mortality in Bladder Cancer Patients Undergoing Radical Cystectomy. Clin Genitourin Cancer 2024:102079. [PMID: 38614853 DOI: 10.1016/j.clgc.2024.102079] [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: 11/23/2023] [Revised: 03/14/2024] [Accepted: 03/15/2024] [Indexed: 04/15/2024]
Abstract
INTRODUCTION AND OBJECTIVES We examined the impact of preoperative plasma potassium levels (PPLs) on outcomes in patients undergoing radical cystectomy (RC) for urothelial carcinoma of the bladder (UCB), hypothesizing that potassium imbalances might influence outcomes. PATIENTS AND METHODS In this retrospective study, 501 UCB patients undergoing RC from 2009 to 2017 at a tertiary center were analyzed. Blood samples collected a week prior to surgery defined normal and abnormal PPL based on institutional standards. We assessed overall survival (OS), cancer-specific survival (CSS), recurrence-free survival (RFS), postoperative complications, 30-day mortality, and non-organ confined disease. Kaplan-Meier estimates, Cox proportional hazards, logistic regression, and decision curve analyses (DCA) were employed. RESULTS 63 (13%) patients had abnormal preoperative PPLs, with 50 (10%) elevated and 13 (2.5%) decreased. In a 59 months median follow-up, 152 (31%) had disease recurrence, 197 (39%) died from any cause, and 119 (24%) from UCB. Multivariable cox regression analyses adjusting for perioperative parameters demonstrated abnormal PPL was associated with worse OS (HR=1.9, P=0.009), CSS (HR=2.8, P<0.001) and RFS (HR=2.1; P=0.007). Elevated preoperative PPLs also demonstrated significant associations with adverse outcomes in OS, CSS, and RFS (all P<0.05). In multivariable logistic regression analyses, abnormal and elevated PPLs were not associated with 30-day mortality, major 30-day postoperative complications, positive nodal disease, pT3/4 stage, and non-organ confined disease (all P>0.05). CONCLUSION Abnormal and elevated preoperative PPLs correlate with adverse oncologic outcomes in UCB patients treated with RC. Pending external validation, preoperative PPLs might be a cost-effective, easily obtainable supplemental biomarker for enriching accuracy of outcome prediction in this highly variable maladie.
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Affiliation(s)
- Jakob Klemm
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan; Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria; Research center for Evidence Medicine, Urology department Tabriz University of Medical Sciences, Tabriz, Iran; Department of Urology, University of Texas Southwestern, Dallas, TX; Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Ekaterina Laukhtina
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Pawel Rajwa
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Medical University of Silesia, Zabrze, Poland
| | - Malte W Vetterlein
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Victor M Schuettfort
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Markus von Deimling
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Roland Dahlem
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Margit Fisch
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Rink
- Department of Urology, Katholisches Marienkrankenhaus, Hamburg, Germany
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Hmaidy O, Roumi Jamal B, Mayo M, Haidar M, Horan M, Alsayed-Ahmad ZA. Non-muscle invasive urothelial bladder cancer in a 17-year-old male: A rare case report. Int J Surg Case Rep 2023; 110:108728. [PMID: 37683512 PMCID: PMC10509874 DOI: 10.1016/j.ijscr.2023.108728] [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: 07/22/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Urothelial carcinoma of the bladder predominantly affects adults with rare cases in young patients. This manuscript presents a rare case of urothelial carcinoma highlighting clinical characteristics, diagnosis, treatment, and prognosis in this age group. Our aim is to raise awareness among healthcare professionals for improved outcomes in children and adolescents with bladder urothelial carcinoma. CASE PRESENTATION A 17-year-old male presented with hematuria and urinary symptoms. No history of smoking, alcohol, surgeries, family conditions, or medications. The patient had environmental chemical exposure near an oil refinery. An initial ultrasound and Cystoscopy showed a sizable bladder tumor. A complete TURBT was done, followed by cauterization and catheter placement. The tumor was diagnosed as low-grade urothelial carcinoma (pT1). Follow-up cystoscopies after 3 and 9 months showed no recurrence. CLINICAL DISCUSSION Urothelial bladder carcinoma (UBC) is linked to occupational exposure and smoking. Limited research exists on UBC in young patients, but genetic factors and environmental exposure may play a role. In young individuals, UBC typically presents as low-grade, non-muscle invasive tumors (NMIBC). Transurethral resection may be sufficient for low-grade tumors, and postoperative follow-up with ultrasound is important. Larger tumors have a higher risk of recurrence and progression. CONCLUSION The present case emphasizes the need to consider urothelial bladder carcinoma as a potential cause of hematuria in young patients and conduct a thorough evaluation of all risk factors. Future research is needed to establish evidence-based guidelines for managing this condition in pediatric and adolescent patients.
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Affiliation(s)
- Osama Hmaidy
- Department of Urologic Surgery, Faculty of Medicine, Damascus University, Damascus, Syria
| | | | - Mohammed Mayo
- Faculty of Medicine, Aleppo University, Aleppo, Syria
| | - Mariam Haidar
- Department of Pathology, Faculty of Medicine, Damascus University, Damascus, Syria
| | - Mohammad Horan
- Department of urology, NMC ROYAL HOSPITAL SHARJAH, NMC healthcare, Sharjah, United Arab Emirates.
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Tabaei S, Haghshenas MR, Ariafar A, Gilany K, Stensballe A, Farjadian S, Ghaderi A. Comparative proteomics analysis in different stages of urothelial bladder cancer for identification of potential biomarkers: highlighted role for antioxidant activity. Clin Proteomics 2023; 20:28. [PMID: 37501157 PMCID: PMC10373361 DOI: 10.1186/s12014-023-09419-8] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 07/10/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Non-muscle-invasive bladder cancer (NMIBC) has a high recurrence rate and muscle-invasive bladder cancer (MIBC) has unfavorable outcomes in urothelial bladder cancer (UBC) patients. Complex UBC-related protein biomarkers for outcome prediction may provide a more efficient management approach with an improved clinical outcome. The aim of this study is to recognize tumor-associated proteins, which are differentially expressed in different stages of UBC patients compared non-cancerous tissues. METHODS The proteome of tissue samples of 42 UBC patients (NMIBC n = 25 and MIBC n = 17) was subjected to two-dimensional electrophoresis (2-DE) combined with Liquid chromatography-mass spectrometry (LC-MS) system to identify differentially expressed proteins. The intensity of protein spots was quantified and compared with Prodigy SameSpots software. Functional, pathway, and interaction analyses of identified proteins were performed using geneontology (GO), PANTHER, Reactome, Gene MANIA, and STRING databases. RESULTS Twelve proteins identified by LC-MS showed differential expression (over 1.5-fold, p < 0.05) by LC-MS, including 9 up-regulated in NMIBC and 3 up-regulated in MIBC patients. Proteins involved in the detoxification of reactive oxygen species and cellular responses to oxidative stress showed the most significant changes in UBC patients. Additionally, the most potential functions related to these detected proteins were associated with peroxidase, oxidoreductase, and antioxidant activity. CONCLUSION We identified several alterations in protein expression involved in canonical pathways which were correlated with the clinical outcomes suggested might be useful as promising biomarkers for early detection, monitoring, and prognosis of UBC.
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Affiliation(s)
- Samira Tabaei
- Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Haghshenas
- Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Ariafar
- Department of Urology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kambiz Gilany
- Integrative Oncology Department, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | - Allan Stensballe
- Department of Health Science and Technology, Aalborg University, Gistrup, 9260, Denmark
- Clinical Cancer Research Center, Aalborg University hospital, Gistrup, 9260, Denmark
| | - Shirin Farjadian
- Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abbas Ghaderi
- Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
- Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
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Wasfie T, Atherton JM, Villegas SJ, Korbitz H, Henke A. Small bowel obstruction secondary to metastatic urothelial bladder cancer. SAGE Open Med Case Rep 2023; 11:2050313X231176356. [PMID: 37483266 PMCID: PMC10357062 DOI: 10.1177/2050313x231176356] [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: 01/03/2023] [Accepted: 05/02/2023] [Indexed: 07/25/2023] Open
Abstract
Small bowel obstruction secondary to primary cancer, such as carcinoid and adenocarcinoma, is not unusual. Less frequently, hematological metastasis from breast, lung, and melanoma can occur. However, metastasis from urothelial bladder carcinoma is extremely rare. In this index case, we describe a 71-year-old Caucasian man with a prior history of urothelial bladder carcinoma. He was treated successfully with chemoradiation and local resection a year prior to his current presentation with small bowel obstruction which required surgical resection of a loop of jejunum, which was found to be caused by obstructive, metastatic urothelial bladder carcinoma on pathology. Therefore, one should consider the possibility of secondary obstructive malignant lesions arising from the urinary bladder in such a patient when presented with bowel obstruction and a history of urothelial bladder carcinoma.
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Affiliation(s)
- Tarik Wasfie
- Department of Surgery, Ascension Genesys Hospital, Grand Blanc, MI, USA
| | - Joshua M Atherton
- Central Michigan University School of Medicine, Mount Pleasant, MI, USA
| | - Sergio J Villegas
- Department of Emergency Medicine, Ascension Genesys Hospital, Grand Blanc, MI, USA
| | - Holland Korbitz
- Department of Surgery, Ascension Genesys Hospital, Grand Blanc, MI, USA
| | - Andrew Henke
- Department of Pathology, Ascension Genesys Hospital, Grand Blanc, MI, USA
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Kerzeli IK, Kostakis A, Türker P, Malmström PU, Hemdan T, Mezheyeuski A, Ward DG, Bryan RT, Segersten U, Lord M, Mangsbo SM. Elevated levels of MMP12 sourced from macrophages are associated with poor prognosis in urothelial bladder cancer. BMC Cancer 2023; 23:605. [PMID: 37391708 DOI: 10.1186/s12885-023-11100-0] [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: 11/14/2022] [Accepted: 06/21/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND Urothelial bladder cancer is most frequently diagnosed at the non-muscle-invasive stage (NMIBC). However, recurrences and interventions for intermediate and high-risk NMIBC patients impact the quality of life. Biomarkers for patient stratification could help to avoid unnecessary interventions whilst indicating aggressive measures when required. METHODS In this study, immuno-oncology focused, multiplexed proximity extension assays were utilised to analyse plasma (n = 90) and urine (n = 40) samples from 90 newly-diagnosed and treatment-naïve bladder cancer patients. Public single-cell RNA-sequencing and microarray data from patient tumour tissues and murine OH-BBN-induced urothelial carcinomas were also explored to further corroborate the proteomic findings. RESULTS Plasma from muscle-invasive, urothelial bladder cancer patients displayed higher levels of MMP7 (p = 0.028) and CCL23 (p = 0.03) compared to NMIBC patients, whereas urine displayed higher levels of CD27 (p = 0.044) and CD40 (p = 0.04) in the NMIBC group by two-sided Wilcoxon rank-sum tests. Random forest survival and multivariable regression analyses identified increased MMP12 plasma levels as an independent marker (p < 0.001) associated with shorter overall survival (HR = 1.8, p < 0.001, 95% CI:1.3-2.5); this finding was validated in an independent patient OLINK cohort, but could not be established using a transcriptomic microarray dataset. Single-cell transcriptomics analyses indicated tumour-infiltrating macrophages as a putative source of MMP12. CONCLUSIONS The measurable levels of tumour-localised, immune-cell-derived MMP12 in blood suggest MMP12 as an important biomarker that could complement histopathology-based risk stratification. As MMP12 stems from infiltrating immune cells rather than the tumor cells themselves, analyses performed on tissue biopsy material risk a biased selection of biomarkers produced by the tumour, while ignoring the surrounding microenvironment.
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Affiliation(s)
- Iliana K Kerzeli
- Department of Pharmacy, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Alexandros Kostakis
- Department of Pharmacy, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Polat Türker
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Per-Uno Malmström
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Tammer Hemdan
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Artur Mezheyeuski
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
- Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Douglas G Ward
- Bladder Cancer Research Centre, Institute of Cancer & Genomic Sciences, College of Medical & Dental Sciences, University of Birmingham, Birmingham, UK
| | - Richard T Bryan
- Bladder Cancer Research Centre, Institute of Cancer & Genomic Sciences, College of Medical & Dental Sciences, University of Birmingham, Birmingham, UK
| | - Ulrika Segersten
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Martin Lord
- Department of Pharmacy, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Sara M Mangsbo
- Department of Pharmacy, Science for Life Laboratory, Uppsala University, Uppsala, Sweden.
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Tabaei S, Haghshenas MR, Webster TJ, Ghaderi A. Proteomics strategies for urothelial bladder cancer diagnosis, prognosis and treatment: Trends for tumor biomarker sources. Anal Biochem 2023; 666:115074. [PMID: 36738874 DOI: 10.1016/j.ab.2023.115074] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/05/2023]
Abstract
Urothelial bladder cancer (UBC) is a heterogeneous multifactorial malignancy with a high recurrence rate. Current procedures for UBC diagnosis suffering from the lack of clinical sensitivity and specificity screening tests. Therefore, biomarkers have promising values to predict pathological conditions and can be considered as effective targets for early diagnosis, prognosis and antitumor immunotherapy. Recently, researchers have been interested for tumor proteins as biomarkers for different diseases. At present, proteomics methods have rapidly progressive that has potential identified biomarkers of UBC. Specifically, there has been several studies on the potential application of proteomics for the identification, quantification, and profiling of proteins for UBC in different sources. Based on these studies, using the panel of biomarkers as proteomic patterns may achieve higher sensitivity and specificity than single proteins in the diagnosis of UBC. In the present review, we evaluate recent literature related to the UBC proteome focusing especially on new proteomics techniques. Moreover, we classify UBC tumor biomarkers as diagnostic, prognostic, and therapeutic targets based on their sources (urine, serum/plasm, cell line, and tumor tissue) and we also discuss the advantages and limitations of each source. In this manner, this review article provides a critical assessment presentation of the advances in proteomics for all aspects of UBC diagnosis, prognosis, and treatment based on sources.
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Affiliation(s)
- Samira Tabaei
- Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Haghshenas
- Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Thomas J Webster
- School of Biomedical Engineering and Health Sciences, Hebei University of Technology, Tianjin, China
| | - Abbas Ghaderi
- Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
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Bolenz C, Kunath F, Zengerling F, Wezel F, Schmidt S, Hartmann A, Eckstein M. Increasing Biomarker Guidance in the Treatment of Urothelial Carcinoma: Systematic Review of International Clinical Trials. Urol Int 2023; 107:480-488. [PMID: 36630942 DOI: 10.1159/000527879] [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: 06/29/2022] [Accepted: 10/28/2022] [Indexed: 01/13/2023]
Abstract
PURPOSE Precision oncology requires biomarker testing from tumor tissue for clinical decision-making and selection of targeted therapies. We systematically evaluated the role of tissue biomarker testing within interventional clinical trials for locally advanced and metastatic urothelial carcinoma (UC). METHODS A systematic search within the publicly available ClinicalTrials.gov database was performed for the period 1995 to January 2020. We searched for all interventional studies on systemic treatments for advanced UC. Two investigators independently screened the records and extracted the data for statistical analyses. RESULTS We included 356 studies out of 827 initial records in the final analysis. The overall number of interventional trials in UC patients significantly increased during the past 25 years. Forty-three studies (12.1%) required specific biomarker testing as a prerequisite for inclusion. Of the remaining 313 trials, explorative biomarkers of interest were studied in 83 studies (23.3%). In trials with obligate biomarker testing as a precondition for study inclusion, only 3 studies (7%) required an actual fresh pretreatment biopsy, while the majority of studies did not state any tissue requirements (55.8%) or accepted archival tissue samples (37.3%). Among studies without biomarker prerequisites, freshly obtained tissue samples were required in 16.3% of studies evaluating immune checkpoint inhibition and 5.7% evaluating targeted therapy. The collection of archival tissue was allowed in 67.4% and 20% of studies evaluating immune checkpoint inhibitors and targeted therapies, respectively. CONCLUSION There has been an increase in the number of studies using biomarker-guided interventions for the treatment of advanced UC over the past 25 years. Studies investigating druggable targets in actual UC biopsies immediately before treatment are still rare. Standardized criteria for tissue-based biomarker testing may further accelerate personalized treatment of patients with advanced UC.
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Affiliation(s)
- Christian Bolenz
- Department of Urology, University of Ulm, Ulm, Germany.,BRIDGE-Consortium e.V, Mannheim, Germany
| | - Frank Kunath
- Department of Urology and Pediatric Urology, University Hospital Erlangen, Friedrich-Alexander Universität, Erlangen, Germany.,UroEvidence@Deutsche Gesellschaft für Urologie, Berlin, Germany.,BRIDGE-Consortium e.V, Mannheim, Germany.,Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | - Friedemann Zengerling
- Department of Urology, University of Ulm, Ulm, Germany.,UroEvidence@Deutsche Gesellschaft für Urologie, Berlin, Germany
| | - Felix Wezel
- Department of Urology, University of Ulm, Ulm, Germany.,BRIDGE-Consortium e.V, Mannheim, Germany
| | | | - Arndt Hartmann
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander Universität, Erlangen, Germany.,BRIDGE-Consortium e.V, Mannheim, Germany.,Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | - Markus Eckstein
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander Universität, Erlangen, Germany.,BRIDGE-Consortium e.V, Mannheim, Germany.,Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
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10
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Chen D, Luo Z, Ye C, Luo Q, Fan W, Chen C, Liu G. Constructing and validating nomograms to predict risk and prognostic factors of distant metastasis in urothelial bladder cancer patients: a population-based retrospective study. BMC Urol 2022; 22:212. [PMID: 36575440 PMCID: PMC9793647 DOI: 10.1186/s12894-022-01166-6] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 12/20/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Urothelial carcinoma is the most common type of bladder cancer worldwide and it has a poor prognosis for patients with distant metastasis. Nomograms are frequently used in clinical research, but no research has evaluated the diagnostic and prognostic factors of distant metastasis in urothelial bladder cancer (UBC). METHODS The Surveillance, Epidemiology, and End Results database was used to analyze all patients diagnosed with UBC between 2000 and 2017. Lasso regression was used to identify the potential risk predictive factors for distant metastasis in UBC. Univariate and multivariate Cox proportional hazard regression analyses were performed to determine independent prognostic factors for distant metastasis urothelial bladder cancer (DMUBC). Subsequently, two nomograms were constructed based on the above models. The receiver operating characteristic (ROC), and calibration curves were performed to evaluate the two nomograms. RESULTS The study included 73,264 patients with UBC, with 2,129 (2.9%) having distant metastasis at the time of diagnosis. In the diagnostic model, tumor size, histologic type, and stage N and T were all important risk predictive factors for distant metastasis of UBC. In the prognostic model, age, tumor size, surgery, and chemotherapy were independent factors affecting the prognosis of DMUBC. DCA, ROC, calibration, and Kaplan-Meier (K-M) survival curves reveal that the two nomograms can effectively predict the diagnosis and prognosis of DMUBC. CONCLUSION The developed nomograms are practical methods for predicting the occurrence risk and prognosis of distant metastasis urothelial bladder cancer patients, which may benefit the clinical decision-making process.
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Affiliation(s)
- Di Chen
- Department of Urology and Reproductive Andrology, The Nanxishan Hospital, Guilin, Guangxi China
| | - Zhihua Luo
- grid.410652.40000 0004 6003 7358Department of Health Management, The People’s Hospital of Guangxi Zhuang Autonomous Region and Research Center of Health Management, Guangxi Academy of Medical Sciences, Nanning, 530021 Guangxi China
| | - Chaoping Ye
- Department of Urology and Reproductive Andrology, The Nanxishan Hospital, Guilin, Guangxi China
| | - Quanhai Luo
- Department of Urology and Reproductive Andrology, The Reproductive Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530021 Guangxi China
| | - Wenji Fan
- Department of Urology andrology, The Nanning Second People’s Hospital, Nanning, 530021 China
| | - Changsheng Chen
- grid.410652.40000 0004 6003 7358Department of Urology, Research Center of Health Management, The People’s Hospital of Guangxi Zhuang Autonomous Region and Guangxi Academy of Medical Sciences, Nanning, 530021 Guangxi China
| | - Gang Liu
- Department of Urology and Reproductive Andrology, The Reproductive Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530021 Guangxi China
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11
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El-Haddad NW, El Kawak M, El Asmar K, Jabbour ME, Moussa MA, Habib RR, Dhaini HR. AhRR methylation contributes to disease progression in urothelial bladder cancer. Cancer Biomark 2022; 35:167-177. [PMID: 36093686 DOI: 10.3233/cbm-220002] [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: 11/15/2022]
Abstract
BACKGROUND Bladder Cancer (BCa) is the tenth most incidental malignancy worldwide. BCa is mostly attributed to environmental exposure and lifestyle, particularly tobacco smoking. The Aryl Hydrocarbon Receptor Repressor (AhRR) participates in the induction of many enzymes involved in metabolizing carcinogens, including tobacco smoke components. Additionally, studies have shown that smoking demethylates the (AhRR) gene in blood, suggesting AhRR demethylation as a specific serum smoking biomarker. OBJECTIVE This study aimed to validate AhRR demethylation as a smoking biomarker in the target tissue and investigate its contribution to bladder carcinogenesis. METHODS AhRR percent methylation was tested for its association with patient smoking status and oncogenic outcome indicators, particularly p53, RB1, and FGFR3 activating mutations, muscle-invasiveness, and tumor grade, in 180 BCa tissue-based DNA. RESULTS Results showed significantly higher AhRR percent methylation in muscle-invasive compared to non-muscle invasive tumors (42.86% vs. 33.98%; p= 0.011), while lower AhRR methylation was significantly associated with FGFR3 Codon 248 mutant genotype compared to wild-type (28.11% ± 9.44 vs. 37.87% ± 22.53; p= 0.036). All other tested associations were non-statistically significant. CONCLUSIONS Although AhRR methylation did not predict smoking status in BCa tumors, it seems to play a role in carcinogenesis and disease progression. Our findings make a basis for further research.
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Affiliation(s)
- Nataly W El-Haddad
- Department of Environmental Health, American University of Beirut, Beirut, Lebanon
| | - Michelle El Kawak
- Department of Environmental Health, American University of Beirut, Beirut, Lebanon
| | - Khalil El Asmar
- Department of Epidemiology and Population Health, American University of Beirut, Beirut, Lebanon
| | - Michel E Jabbour
- Department of Urology, St George Hospital University Medical Center, Beirut, Lebanon.,Faculty of Medicine, University of Balamand, Beirut, Lebanon
| | - Mohamad A Moussa
- Department of Urology, Lebanese University, Beirut, Lebanon.,Department of Surgery, Division of Urology, Al-Zahraa University Hospital, Beirut, Lebanon
| | - Rima R Habib
- Department of Environmental Health, American University of Beirut, Beirut, Lebanon
| | - Hassan R Dhaini
- Department of Environmental Health, American University of Beirut, Beirut, Lebanon
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12
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Bhirud DP, Mittal A, Kumar S, Narain TA, Kishore S, Navriya SC, Ranjan SK, Panwar VK. When to Avoid a Restaging Procedure for Non-muscle Invasive Bladder Cancer? Inferences from a Tertiary Care Center. Indian J Surg Oncol 2022; 13:604-611. [PMID: 36187522 PMCID: PMC9515286 DOI: 10.1007/s13193-022-01516-8] [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: 07/20/2020] [Accepted: 01/31/2022] [Indexed: 11/30/2022] Open
Abstract
The increasing incidence of urinary bladder carcinoma is alarming. Approximately seventy percent of these patients are non-muscle invasive bladder cancer (NMIBC). Restage transurethral resection of bladder tumor (TURBT) is the current recommendation for any T1 and or high-grade non muscle invasive bladder cancers (NMIBC) to accurately stage the malignancy. The question whether a second surgery is always required as a restage procedure is still unanswered. The patient's concern about completeness, morbidity, and financial considerations of a major surgery cannot be overlooked. Moreover, it also puts a strain on the already overburdened healthcare system. To answer this question, whether it is oncologically sound to omit a second resection, the current study evaluated the outcomes of patients undergoing restage TURBT, and analyzed the preoperative factors predicting a change in the staging of this malignancy. The study design was a prospective observational including NMIBC patients from September 2018 to February 2020. A total of 72 patients underwent restage TURBT. Their demographic data, imaging and cystoscopic findings, and histopathological data were recorded. The objective was to study the clinico-pathological correlations and factors predicting recurrence and upstaging of tumor in NMIBC patients undergoing restage TURBT. A total of 101 patients were found eligible for restage TURBT. Eventually, 72 underwent restage TURBT. Twelve (16.7%) patient had recurrence at restage while 3(4.16%) were upstaged to T2. Presence of lower urinary tract symptoms (LUTS) was independently associated with the risk of recurrence of same stage compared to no recurrence (p-0.025, OR-8.793, 95% CI-1.316-98.773). Chemical exposure (p-0.042) was also significantly associated with the same. Presence of lymphadenopathy on CT was independently associated with the risk of upstaging compared to no recurrence (p-0.032, OR-18.25, 95% CI-1.292-257.85). The study concluded that in the presence of a well-performed and adequate initial TURBT, restage TURBT could be skipped for further management. However, in small subgroup of patients with lymphadenopathy on preoperative imaging having a higher risk of tumor recurrence and upstaging, and patients with a history of chemical exposure and previous lower urinary tract symptoms having a high risk of recurrence alone, restage TURBT should still be performed to accurately stage the disease. Further studies with large patient cohort are needed to confirm and reinforce the facts proposed. Supplementary Information The online version contains supplementary material available at 10.1007/s13193-022-01516-8.
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Affiliation(s)
| | - Ankur Mittal
- Department of Urology, AiimsRishikesh, Uttarakhand India 249203
| | - Sunil Kumar
- Department of Urology, AiimsRishikesh, Uttarakhand India 249203
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13
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Wen Z, Huang G, Lai Y, Xiao L, Peng X, Liu K, Zhang C, Chen X, Li R, Li X, Lai Y, Ni L. Diagnostic panel of serum miR-125b-5p, miR-182-5p, and miR-200c-3p as non-invasive biomarkers for urothelial bladder cancer. Clin Transl Oncol 2022; 24:909-918. [PMID: 35028929 DOI: 10.1007/s12094-021-02741-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 09/01/2021] [Accepted: 11/23/2021] [Indexed: 02/05/2023]
Abstract
PURPOSE This study aimed to identify a diagnostic panel of serum microRNAs (miRNAs) for the early detection of bladder cancer (BC). METHODS Serum samples were collected from 112 BC patients and 112 normal controls (NCs). A three-stage selection was conducted to identify differentially expressed miRNAs as candidates to construct the diagnostic panel. Further, to explore their potential roles in urothelial BC, bioinformatics analyses, including target genes prediction and functional annotation, were used. RESULTS Six downregulated miRNAs (miR-1-3p, miR-30a-5p, miR-100-5p, miR-125b-5p, miR-143-3p, and miR-200c-3p) and one upregulated, miR-182-5p, in BC patients' serum were detected compared to NCs and were selected to establish the diagnostic panel. Based on a backward stepwise logistic regression analysis, miR-125b-5p, miR-182-5p, and miR-200c-3p comprehended the diagnostic panel [area under the curve (AUC) = 0.959, sensitivity = 91.67%, specificity = 92.5%]. CONCLUSION The panel of three miRNAs had an excellent diagnostic capability, representing a potential non-invasive method for early BC detection.
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Affiliation(s)
- Z Wen
- Shantou University Medical College, Shantou, Guangdong, 515041, People's Republic of China
- Department of Urology, Guangdong and Shenzhen Key Laboratory of Male Reproductive Medicine and Genetics, Peking University Shenzhen Hospital, Shenzhen, Guangdong, 518036, People's Republic of China
| | - G Huang
- Shantou University Medical College, Shantou, Guangdong, 515041, People's Republic of China
- Department of Urology, Guangdong and Shenzhen Key Laboratory of Male Reproductive Medicine and Genetics, Peking University Shenzhen Hospital, Shenzhen, Guangdong, 518036, People's Republic of China
| | - Y Lai
- Department of Urology, People's Hospital of Longhua, Shenzhen, Guangdong, 518109, People's Republic of China
| | - L Xiao
- Department of Urology, Shenzhen University General Hospital, Shenzhen, Guangdong, 518109, People's Republic of China
| | - X Peng
- Shantou University Medical College, Shantou, Guangdong, 515041, People's Republic of China
- Department of Urology, Guangdong and Shenzhen Key Laboratory of Male Reproductive Medicine and Genetics, Peking University Shenzhen Hospital, Shenzhen, Guangdong, 518036, People's Republic of China
| | - K Liu
- Department of Urology, Guangdong and Shenzhen Key Laboratory of Male Reproductive Medicine and Genetics, Peking University Shenzhen Hospital, Shenzhen, Guangdong, 518036, People's Republic of China
- Anhui Medical University, Hefei, Anhui, 230032, People's Republic of China
| | - C Zhang
- Department of Urology, Guangdong and Shenzhen Key Laboratory of Male Reproductive Medicine and Genetics, Peking University Shenzhen Hospital, Shenzhen, Guangdong, 518036, People's Republic of China
| | - X Chen
- Shantou University Medical College, Shantou, Guangdong, 515041, People's Republic of China
- Department of Urology, Guangdong and Shenzhen Key Laboratory of Male Reproductive Medicine and Genetics, Peking University Shenzhen Hospital, Shenzhen, Guangdong, 518036, People's Republic of China
| | - R Li
- Department of Urology, Guangdong and Shenzhen Key Laboratory of Male Reproductive Medicine and Genetics, Peking University Shenzhen Hospital, Shenzhen, Guangdong, 518036, People's Republic of China
- Anhui Medical University, Hefei, Anhui, 230032, People's Republic of China
| | - X Li
- Shantou University Medical College, Shantou, Guangdong, 515041, People's Republic of China
- Department of Urology, Guangdong and Shenzhen Key Laboratory of Male Reproductive Medicine and Genetics, Peking University Shenzhen Hospital, Shenzhen, Guangdong, 518036, People's Republic of China
| | - Y Lai
- Shantou University Medical College, Shantou, Guangdong, 515041, People's Republic of China
- Department of Urology, Guangdong and Shenzhen Key Laboratory of Male Reproductive Medicine and Genetics, Peking University Shenzhen Hospital, Shenzhen, Guangdong, 518036, People's Republic of China
| | - L Ni
- Shantou University Medical College, Shantou, Guangdong, 515041, People's Republic of China
- Department of Urology, Guangdong and Shenzhen Key Laboratory of Male Reproductive Medicine and Genetics, Peking University Shenzhen Hospital, Shenzhen, Guangdong, 518036, People's Republic of China
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14
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Li Y, Chen X, Li D, Yang Z, Bai Y, Hu S, Liu Z, Gu J, Zhang X. Identification of prognostic and therapeutic value of CC chemokines in Urothelial bladder cancer: evidence from comprehensive bioinformatic analysis. BMC Urol 2021; 21:173. [PMID: 34893045 PMCID: PMC8665633 DOI: 10.1186/s12894-021-00938-w] [Citation(s) in RCA: 6] [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: 08/31/2021] [Accepted: 11/30/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Urothelial bladder cancer (BC) is one of the most prevalent malignancies with high mortality and high recurrence rate. Angiogenesis, tumor growth and metastasis of multiple cancers are partly modulated by CC chemokines. However, we know little about the function of distinct CC chemokines in BC. METHODS ONCOMINE, Gene Expression Profiling Interactive Analysis (GEPIA), Kaplan-Meier plotter, cBioPortal, GeneMANIA, and TIMER were used for analyzing differential expression, prognostic value, protein-protein interaction, genetic alteration and immune cell infiltration of CC chemokines in BC patients based on bioinformatics. RESULTS The results showed that transcriptional levels of CCL2/3/4/5/14/19/21/23 in BC patients were significantly reduced. A significant relation was observed between the expression of CCL2/11/14/18/19/21/23/24/26 and the pathological stage of BC patients. BC patients with high expression levels of CCL1, CCL2, CCL3, CCL4, CCL5, CCL8, CCL13, CCL15, CCL17, CCL18, CCL19, CCL22, CCL25, CCL27 were associated with a significantly better prognosis. Moreover, we found that differentially expressed CC chemokines are primarily correlated with cytokine activity, chemokines receptor binding, chemotaxis, immune cell migration. Further, there were significant correlations among the expression of CC chemokines and the infiltration of several types of immune cells (B cells, CD8+ T cells, CD4+ T cells, macrophages, neutrophils, and dendritic cells). CONCLUSIONS This study is an analysis to the potential role of CC chemokines in the therapeutic targets and prognostic biomarkers of BC, which gives a novel insight into the relationship between CC chemokines and BC.
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Affiliation(s)
- Yuxin Li
- Department of Geriatric Urology, Xiangya International Medical Center, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People's Republic of China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People's Republic of China
| | - Xiong Chen
- Department of Geriatric Urology, Xiangya International Medical Center, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People's Republic of China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People's Republic of China
| | - Dongjie Li
- Department of Geriatric Urology, Xiangya International Medical Center, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People's Republic of China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People's Republic of China
| | - Zhiming Yang
- Department of Geriatric Urology, Xiangya International Medical Center, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People's Republic of China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People's Republic of China
| | - Yao Bai
- Department of Geriatric Urology, Xiangya International Medical Center, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People's Republic of China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People's Republic of China
| | - Sheng Hu
- Department of Geriatric Urology, Xiangya International Medical Center, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People's Republic of China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People's Republic of China
| | - Zhenyu Liu
- Department of Geriatric Urology, Xiangya International Medical Center, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People's Republic of China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People's Republic of China
| | - Jie Gu
- Department of Geriatric Urology, Xiangya International Medical Center, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People's Republic of China. .,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People's Republic of China. .,Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
| | - XiaoBo Zhang
- Department of Geriatric Urology, Xiangya International Medical Center, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People's Republic of China. .,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People's Republic of China. .,Urolithiasis Institute of Central South University, Changsha, Hunan, 410008, People's Republic of China.
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15
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Lin W, Sun J, Sadahira T, Xu N, Wada K, Liu C, Araki M, Xu A, Watanabe M, Nasu Y, Huang P. Discovery and Validation of Nitroxoline as a Novel STAT3 Inhibitor in Drug-resistant Urothelial Bladder Cancer. Int J Biol Sci 2021; 17:3255-3267. [PMID: 34421363 PMCID: PMC8375225 DOI: 10.7150/ijbs.63125] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/06/2021] [Indexed: 01/11/2023] Open
Abstract
Repeated cycles of first-line chemotherapy drugs such as doxorubicin (DOX) and cisplatin (CIS) trigger frequent chemoresistance in recurrent urothelial bladder cancer (UBC). Nitroxoline (NTX), an antibiotic to treat urinary tract infections, has been recently repurposed for cancer treatment. Here we aimed to investigate whether NTX suppresses drug-resistant UBC and its molecular mechanism. The drug-resistant cell lines T24/DOX and T24/CIS were established by continual exposure of parental cell line T24 to DOX and CIS, respectively. T24/DOX and T24/CIS cells were resistant to DOX and CIS, respectively, but they were sensitive to NTX time- and dose-dependently. Overexpressions of STAT3 and P-glycoprotein (P-gp) were identified in T24/DOX and T24/CIS, which could be reversed by NTX. Western blot revealed that NTX downregulated p-STAT3, c-Myc, Cyclin D1, CDK4, CDK6, Bcl-xL, Mcl-1, and Survivin, which were further confirmed by Stattic, a selective STAT3 inhibitor. In vivo, NTX exhibited the significant anti-tumor effect in T24/DOX and T24/CIS tumor-bearing mice. These results suggested that NTX-induced P-gp reversal, G0/G1 arrest, and apoptosis in drug-resistant UBC were mediated by inhibition of STAT3 signaling. Our findings repurpose NTX as a novel STAT3 inhibitor to induce P-gp reversal, G0/G1 arrest, and apoptosis in drug-resistant UBC.
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Affiliation(s)
- Wenfeng Lin
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Jingkai Sun
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.,Department of Urology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Takuya Sadahira
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Naijin Xu
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.,Department of Urology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Koichiro Wada
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Chunxiao Liu
- Department of Urology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Motoo Araki
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Abai Xu
- Department of Urology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Masami Watanabe
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.,Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan
| | - Yasutomo Nasu
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Peng Huang
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.,Department of Urology, Zhujiang Hospital, Southern Medical University, Guangzhou, China.,Okayama Medical Innovation Center, Okayama University, Okayama, Japan
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16
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Nitschke K, Worst TS, von Rhade SM, Thaqi B, Neuberger M, Wessels F, Weis CA, Porubsky S, Gaiser T, Kriegmair M, von Hardenberg J, Weidenbusch M, Erben P, Nuhn P. High IL-22RA1 gene expression is associated with poor outcome in muscle invasive bladder cancer. Urol Oncol 2021; 39:499.e1-499.e8. [PMID: 34134925 DOI: 10.1016/j.urolonc.2021.05.010] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 05/03/2021] [Accepted: 05/05/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND The cell surface interleukin 22 (IL-22) receptor complex is mainly expressed in epithelial and tissue cells like pancreatitis cells. Recent studies described that IL-22R was overexpressed in malignant diseases and was associated with a poor overall survival (OS). The role of IL-22RA1 gene expression in muscle invasive bladder cancer (MIBC) has not been investigated, yet. OBJECTIVES The aim of this study was to analyze the role of IL-22RA1 gene expression in patients with MIBC. METHODS In a cohort of 114 patients with MIBC who underwent radical cystectomy, IL-22RA1 gene expression was analyzed with qRT-PCR and correlated with clinical parameters. Furthermore, Kaplan-Meier and Cox regression analysis were performed. For validation, an in silico dataset (TCGA 2017, n=407) was reanalyzed. RESULTS IL-22RA1 gene expression was independent of clinicopathological parameters like age (P=0.2681), T stage (P=0.2130), nodal status (P=0.3238) and lymph vascular invasion (LVI, P=0.5860) in patients with MIBC. A high expression of IL-22RA1 was associated with a shorter OS (P=0.0040) and disease-specific survival (P=0.0385). Furthermore, a shorter disease-free survival (DFS) was also associated with a high expression of IL-22RA1 (P=0.0102). In the multivariable analysis, IL-22RA1 expression was an independent prognostic predictors regarding OS (P=0.0096, HR=0.48). In the TCGA cohort, IL-22RA1 expression was independent regarding to OS and DFS. CONCLUSION A high IL-22RA1 gene expression was associated with worse outcome. Furthermore, IL-22RA1 represented an independent predictor regarding OS in our cohort and therefore might be used for risk stratification in patients with MIBC.
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Affiliation(s)
- Katja Nitschke
- Klinik für Urologie und Urochirurgie, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany.
| | - Thomas S Worst
- Klinik für Urologie und Urochirurgie, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - Sophie Madeleine von Rhade
- Klinik für Urologie und Urochirurgie, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - Blerta Thaqi
- Klinik für Urologie und Urochirurgie, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - Manuel Neuberger
- Klinik für Urologie und Urochirurgie, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - Frederik Wessels
- Klinik für Urologie und Urochirurgie, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - Cleo-Aron Weis
- Pathologisches Institut, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - Stefan Porubsky
- Institut für Pathologie, Universitätsmedizin, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Timo Gaiser
- Pathologisches Institut, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - Maximilian Kriegmair
- Klinik für Urologie und Urochirurgie, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - Jost von Hardenberg
- Klinik für Urologie und Urochirurgie, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - Marc Weidenbusch
- Nephrologisches Zentrum, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany
| | - Philipp Erben
- Klinik für Urologie und Urochirurgie, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - Philipp Nuhn
- Klinik für Urologie und Urochirurgie, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
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17
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Tellini R, Mari A, Muto G, Cacciamani GE, Ferro M, Stangl-Kremser J, Campi R, Soria F, Rink M, Xylinas E, Minervini A, Briganti A, Montorsi F, Roupret M, Shariat SF, Moschini M. Impact of Smoking Habit on Perioperative Morbidity in Patients Treated with Radical Cystectomy for Urothelial Bladder Cancer: A Systematic Review and Meta-analysis. Eur Urol Oncol 2020; 4:580-593. [PMID: 33160975 DOI: 10.1016/j.euo.2020.10.006] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/23/2020] [Accepted: 10/13/2020] [Indexed: 12/24/2022]
Abstract
CONTEXT Smoking habit at the time of surgery is associated with higher perioperative complications and mortality across different types of surgeries. In recent years, several studies have attempted to explore the influence of smoking on perioperative outcomes following radical cystectomy (RC) for urothelial bladder cancer (UBC) with contradictory results. OBJECTIVE To systematically investigate and meta-analyze the association between smoking habit and perioperative morbidity and mortality in UBC patients treated with RC. EVIDENCE ACQUISITION A systematic review of the literature published between January 2000 and January 2020 investigating the impact of smoking habit on perioperative outcomes of patients treated with RC for UBC was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement and the Cochrane Handbook for Systematic Reviews of Interventions. EVIDENCE SYNTHESIS Overall, 27 articles involving 27 854 patients were included in the systematic review, and of these, 11 studies were included in the meta-analysis. The studies included showed a moderate to high risk of bias. Smoking status (smokers vs nonsmokers) was significantly associated with the onset of major postoperative complications (hazard ratio [HR] 1.87, 95% confidence interval [CI] 1.51-2.32; I2 = 0%), infections (HR 1.34, 95% CI 1.02-1.72; I2 = 66.2%), and mortality (HR 1.84, 95% CI 1.14-2.98; I2 = 4.9%). CONCLUSIONS Smoking status at the time of RC is associated with increased risk for major postoperative complications, infections, and mortality. These results suggest the need for strict postoperative monitoring in smokers due to the increased risk of experiencing adverse events and underline the need for intensive smoking cessation interventions in the preoperative setting. PATIENT SUMMARY In this study, we reviewed the impact of smoking habit on perioperative outcomes following radical cystectomy (RC). Based on the available data, the impact of smoking on morbidity and mortality after RC is significant and relevant; as such, every effort should be made in the preoperative setting to encourage smoking cessation.
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Affiliation(s)
- Riccardo Tellini
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Andrea Mari
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Gianluca Muto
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Giovanni Enrico Cacciamani
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Matteo Ferro
- Division of Urology, European Institute of Oncology-IRCCS, Milan, Italy
| | - Judith Stangl-Kremser
- Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Riccardo Campi
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Francesco Soria
- Division of Urology, Department of Surgical Sciences, University of Studies of Torino, Turin, Italy
| | - Michael Rink
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Evanguelos Xylinas
- Department of Urology, Bichat-Claude Bernard Hospital, APHP, Paris University, Paris, France
| | - Andrea Minervini
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Alberto Briganti
- Department of Urology, Urological Research Institute, San Raffaele Scientific Institute, Milan, Italy
| | - Francesco Montorsi
- Department of Urology, Urological Research Institute, San Raffaele Scientific Institute, Milan, Italy
| | - Morgan Roupret
- Urology, GRC 5 PREDICTIVE ONCO-URO, AP-HP, Sorbonne University, Pitié-Salpêtrière Hospital, Paris, France
| | - Shahrokh F Shariat
- Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Weill Cornell Medical College, New York, NY, USA; Department of Urology, University of Texas Southwestern, Dallas, TX, USA; Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia; Department of Urology, University of Jordan, Amman, Jordan; European Association of Urology research foundation, Arnhem, The Netherlands
| | - Marco Moschini
- Klinik für Urologie, Luzerner Kantonsspital, Lucerne, Switzerland.
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18
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Mari A, Muto G, Di Maida F, Tellini R, Bossa R, Bisegna C, Campi R, Cocci A, Viola L, Grosso A, Scelzi S, Lapini A, Carini M, Minervini A. Oncological impact of inflammatory biomarkers in elderly patients treated with radical cystectomy for urothelial bladder cancer. Arab J Urol 2020; 19:2-8. [PMID: 33763243 PMCID: PMC7954471 DOI: 10.1080/2090598x.2020.1814974] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Objective To evaluate the impact of preoperative markers of systemic inflammation on complications and oncological outcomes in patients aged ≥75 years treated with radical cystectomy (RC) for urothelial bladder cancer (UBC). Patients and methods The clinical data of 694 patients treated with open RC for UBC at our institution between January 2008 and December 2015 were retrospectively reviewed. Patients aged <75 years, with distant metastases, other-than-urothelial histological type, comorbidities that could affect the systemic inflammatory markers, and patients who received neoadjuvant chemotherapy were excluded. Multivariable regression models were built for the prediction of major postoperative surgical complications, disease recurrence, cancer-specific mortality (CSM), and overall mortality (OM). Results The median (interquartile range [IQR]) age at surgery was 79 (75–83) years. Major postoperative surgical complications were registered in 41.9% of the patients. The 5-year overall survival, cancer-specific survival and recurrence-free survival rates were 42.4% (95% confidence interval [CI] 34.7–49.9%), 70.3% (95% CI 62.3–76.9%), and 59.8% (95% CI 52.4–66.5), respectively. At multivariable analysis, higher levels of fibrinogen and a modified Glasgow Prognostic Score (mGPS) of 1 and 2 at baseline were independently associated with higher risk of major postoperative complications and of CSM. The inclusion of mGPS and fibrinogen to a standard multivariable model for recurrence and for CSM increased discrimination from 69.4% to 73.0% and from 71.3% to 73.9%, respectively. Preoperative neutrophil-to-lymphocyte ratio of >3 was independently associated with OM (hazard ratio 1.38, 95% CI 1.01–1.77; P = 0.01). Conclusions In a cohort of elderly patients with UBC treated with RC, fibrinogen and mGPS appeared to be the most relevant prognostic measurements and increased the accuracy of clinicopathological preoperative models to predict major postoperative complications, disease recurrence and mortality. Abbreviations ASA: American Society of Anesthesiologists; CCI: Charlson Comorbidity Index; CIS: carcinoma in situ; CRP: C-reactive protein; CSM: cancer-specific mortality; CSS: cancer-specific survival; ECOG PS: Eastern Cooperative Oncology Group Performance Status; HDL: high-density lipoprotein; (S)HR: (subdistribution) hazard ratio; LND: lymphadenectomy; LVI: lymphovascular invasion; mGPS: modified Glasgow Prognostic Score; NLR: neutrophil-to-lymphocyte ratio; NOC: non-organ-confined; OM: overall mortality; OR: odds ratio; OS: overall survival; RC: radical cystectomy; RNU: radical nephroureterectomy; UBC: urothelial bladder cancer; UTUC: upper urinary tract urothelial carcinoma
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Affiliation(s)
- Andrea Mari
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Gianluca Muto
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Fabrizio Di Maida
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Riccardo Tellini
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Riccardo Bossa
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Claudio Bisegna
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Riccardo Campi
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Andrea Cocci
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Lorenzo Viola
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Antonio Grosso
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Sabino Scelzi
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Alberto Lapini
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Marco Carini
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Andrea Minervini
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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19
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Abstract
PURPOSE OF REVIEW A review of the impact of several key patient characteristics on oncologic outcomes in bladder cancer (BC) summarized and analyzed in a narrative fashion. RECENT FINDINGS The bulk of the published literature suggests that females and blacks have poorer cancer-specific outcomes. Both groups tend to present with worse disease, which may be driven by differences in access to timely and quality care. Attempts to assess the association between smoking status and history and BC outcomes have been hindered by the quality and heterogeneity of the data, although several studies have linked smoking with higher rates of recurrence and poorer survival. Being married, particularly in men, may improve survival after radical cystectomy (RC). Limited data suggests that socioeconomic and education levels may be associated with poorer survival; however, the data is limited. A growing body of investigation suggests that there are significant differences in oncologic outcomes in BC patients based on race, gender, smoking status, socioeconomic status, and others. Further focus and investigation is needed to validate these findings, investigate the root cause of these differences, and offer solutions to mitigate them.
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Affiliation(s)
- Wesley Yip
- USC Institute of Urology, Keck School of Medicine, USC/Norris Comprehensive Cancer Center, 1441 Eastlake Ave, Suite 7416, Los Angeles, CA, 90033, USA
| | - Giovanni Cacciamani
- USC Institute of Urology, Keck School of Medicine, USC/Norris Comprehensive Cancer Center, 1441 Eastlake Ave, Suite 7416, Los Angeles, CA, 90033, USA
| | - Sumeet K Bhanvadia
- USC Institute of Urology, Keck School of Medicine, USC/Norris Comprehensive Cancer Center, 1441 Eastlake Ave, Suite 7416, Los Angeles, CA, 90033, USA.
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20
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Waked R, Choucair J, Chehata N, Haddad E, Saliba G. Intravesical Bacillus Calmette-Guérin (BCG) treatment's severe complications: A single institution review of incidence, presentation and treatment outcome. J Clin Tuberc Other Mycobact Dis 2020; 19:100149. [PMID: 32099909 PMCID: PMC7016447 DOI: 10.1016/j.jctube.2020.100149] [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] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Objectives Intravesical Bacillus Calmette-Guérin (BCG) treatment for superficial bladder cancer is interrupted in approximatively 8% of cases as a result of complications. The objective is to report the severe related complications of Bacillus Calmette-Guérin (BCG) following an intravesical instillation for bladder tumor encountered at our institution for the past 5 years. Methods Medical records of a tertiary teaching hospital, located in Beirut, Lebanon, were retrospectively analyzed from June 2014 to June 2019 searching for severe related complications of BCG. A comprehensive review of articles on this subject was conducted. Results The incidence of severe systemic adverse events related to BCG instillation was 1.5% (5 out of 332 patients). A total of five patients were found to have a severe BCG related complication, with fever, chills, and irritative urinary signs being the most frequent symptoms. All patients received antituberculosis therapy (Isoniazid, Rifampin and Ethambutol). Two were put on add-on corticosteroids. Three patients had a computed tomography scan image in favor of an infection. Two patients had a favorable outcome, three patients died. Conclusion BCG severe adverse events were mostly seen in patients with a traumatic instillation. Treatment used at our institution was similar to most cases reported in the literature. A standardized diagnostic and treatment approach should be implemented to help physicians tackle these life-threatening complications.
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Affiliation(s)
- R. Waked
- Department of Infectious Diseases, Faculty of Medicine, Saint Joseph University, Damascus street, PO BOX 11-5076, Riad El Solh, Beirut 1107 2180, Lebanon
- Corresponding author.
| | - J. Choucair
- Coordinator of the Infectious Diseases department, Saint Joseph University, Beirut, Lebanon
| | - N. Chehata
- Department of Infectious Diseases, Faculty of Medicine, Saint Joseph University, Damascus street, PO BOX 11-5076, Riad El Solh, Beirut 1107 2180, Lebanon
| | - E. Haddad
- Department of Infectious Diseases, Faculty of Medicine, Saint Joseph University, Damascus street, PO BOX 11-5076, Riad El Solh, Beirut 1107 2180, Lebanon
| | - G. Saliba
- Department of Infectious Diseases, Faculty of Medicine, Saint Joseph University, Damascus street, PO BOX 11-5076, Riad El Solh, Beirut 1107 2180, Lebanon
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21
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Schwamborn K, Ammann JU, Knüchel R, Hartmann A, Baretton G, Lasitschka F, Schirmacher P, Braunschweig T, Tauber R, Erlmeier F, Hieke-Schulz S, Weichert W. Multicentric analytical comparability study of programmed death-ligand 1 expression on tumor-infiltrating immune cells and tumor cells in urothelial bladder cancer using four clinically developed immunohistochemistry assays. Virchows Arch 2019; 475:599-608. [PMID: 31267201 PMCID: PMC6861354 DOI: 10.1007/s00428-019-02610-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 06/05/2019] [Accepted: 06/18/2019] [Indexed: 02/06/2023]
Abstract
Programmed death-ligand 1 (PD-L1) expression on tumor cells (TC) or tumor-infiltrating immune cells (IC) correlated in several studies with PD-L1/programmed death-1 (PD-1) checkpoint inhibitor efficacy. Since June 2018, a positive PD-L1 status is required for atezolizumab or pembrolizumab treatment of patients with advanced or metastasized urothelial bladder cancer, who are ineligible for cisplatin-containing therapy. We examined technical comparability and inter-reader agreement of four clinically developed PD-L1 assays in locally advanced disease. Archived, formalin-fixed, paraffin-embedded sections from 30 patients (73.3% cystectomies, 26.7% transurethral resections) were stained by PD-L1 immunohistochemistry using VENTANA SP142, VENTANA SP263, DAKO 22C3, and DAKO 28-8 at two sites per manufacturers’ protocols and scored blinded at five sites for PD-L1 expression on IC (% per tumor area) and TC (%). Small, non-significant inter-assay differences were observed for IC. For TC, SP142 showed significantly lower staining percentages. Pairwise comparisons revealed − 0.3 to 1.6% differences in adjusted means between assays for IC, and for TC, − 10.5 to − 7.8% (SP142 versus others) and − 1.9 to 2.7% (other comparisons). Inter-reader and inter-assay agreement was moderate to high for both IC and TC. Allocation to binary cutoffs (1%, 5%, 10%) showed substantial to high Kappa agreement scores (0.440–0.923) for IC and TC between assays for each reader. This first multicenter study, with five independent readers blinded with respect to the assay used, suggests that all four currently clinically relevant assays are analytically similar for evaluation of PD-L1-stained IC and three (SP263, 22C3, and 28-8) for PD-L1-stained TC. Inter-observer agreement for trained readers in scoring of both IC and TC positivity was generally high.
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Affiliation(s)
- Kristina Schwamborn
- Institute of Pathology, Technische Universität München, Trogerstr. 18, 81675, Munich, Germany.
| | | | - Ruth Knüchel
- Institute of Pathology, Uniklinik RWTH Aachen, Aachen, Germany
| | - Arndt Hartmann
- Institute of Pathology, Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Gustavo Baretton
- Institute of Pathology, Universitätsklinikum Carl Gustav Carus Dresden, Dresden, Germany
| | - Felix Lasitschka
- Institute of Pathology, Universitätsklinikum Heidelberg, Heidelberg, Germany
- Institut für Pathologie, Dres. med., Kaufmann und Wilke, Industriestr 11c, 67063, Ludwigshafen, Germany
| | - Peter Schirmacher
- Institute of Pathology, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | | | - Robert Tauber
- Department of Urology, Technische Universität München, Munich, Germany
| | - Franziska Erlmeier
- Institute of Pathology, Technische Universität München, Trogerstr. 18, 81675, Munich, Germany
| | | | - Wilko Weichert
- Institute of Pathology, Technische Universität München and Member of the German Cancer Consortium (DKTK), Partner site München, Munich, Germany
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22
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Gao BS, Rong CS, Xu HM, Sun T, Hou J, Xu Y. Peptidyl Arginine Deiminase, Type II (PADI2) Is Involved in Urothelial Bladder Cancer. Pathol Oncol Res 2019; 26:1279-1285. [PMID: 31267364 DOI: 10.1007/s12253-019-00687-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 06/16/2019] [Indexed: 12/20/2022]
Abstract
Peptidyl arginine deiminase, type II (PADI2) expression has been shown to potentiate multiple different carcinogenesis pathway including breast carcinoma and spontaneous skin neoplasia. The objective of this study was to examine the role of PADI2 in urothelial bladder cancer which has not been evaluated previously. Analysis of mutation and genome amplification of bladder cancer within The Cancer Genome Atlas (TCGA) showed that PADI2 is both mutated and amplified in a cohort of bladder cancer patients, with the largest number of mutations detected in urothelial bladder cancer. Even though PADI2 expression was not significantly correlated to survival in bladder cancer patients, it was significantly overexpressed at the mRNA and protein levels, as revealed by TCGA data and immunohistochemistry analysis, respectively. PADI2 showed wide expression pattern in bladder cancer tissues but was hardly detected in tumor adjacent normal tissue. RNAi mediated silencing of PADI2 in the bladder cancer cell line T24 did not result in a change of proliferation. Interestingly knockdown of PADI2 expression did not affect Snail1 protein, which is associated with metastatic progression, in these cells. However, PADI2 silencing remarkably attenuated both in vitro migration and invasion- in T24 cells indicating a Snail1-independent effect of PADI2 on invasive potential of urothelial bladder cancer. This was further corroborated by in vivo xenograft assays where PADI2 shRNA harboring T24 cells did not have detectable tumors by week 4 as compared to robust tumors in the control Luciferase shRNA harboring cells. PADI2 silencing did not affect proliferation rates and hence this would suggest that PADI2 knockdown is perhaps causing increased apoptosis as well as transition through the cell cycle, which needs to be confirmed in future studies. Our results reveal a yet undefined role of PADI2 as an oncogene in urothelial bladder cancer.
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Affiliation(s)
- Bao-Shan Gao
- Urology Center, The First Hospital of Jilin University, No.71, Xinmin Street, Changchun, 130021, Jilin, China
| | - Chun-Shu Rong
- Department of Encephalopathy Diseases, The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, 130021, Jilin, China
| | - Hong-Mei Xu
- Obstetric Department, The First Hospital of Jilin University, Changchun, 130021, Jilin, China
| | - Tao Sun
- Urology Center, The First Hospital of Jilin University, No.71, Xinmin Street, Changchun, 130021, Jilin, China
| | - Jie Hou
- Urology Center, The First Hospital of Jilin University, No.71, Xinmin Street, Changchun, 130021, Jilin, China
| | - Ying Xu
- Urology Center, The First Hospital of Jilin University, No.71, Xinmin Street, Changchun, 130021, Jilin, China.
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23
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Turker P, Segersten U, Malmström PU, Hemdan T. Is Bcl-2 a predictive marker of neoadjuvant chemotherapy response in patients with urothelial bladder cancer undergoing radical cystectomy? Scand J Urol 2019; 53:45-50. [PMID: 30806186 DOI: 10.1080/21681805.2019.1575467] [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: 12/23/2022]
Abstract
Background: Response to neoadjuvant cisplatin treatment in bladder cancer has been linked to expression of Bcl-2 protein by cancer cells. The objective of this study was to test Bcl-2 as a predictive marker of neoadjuvant cisplatin chemotherapy response in a patient cohort from randomized cystectomy trials. Methods: Tumor samples were taken from 247 patients with T2-T4 bladder cancer enrolled in two randomized trials comparing cystectomy with or without neoadjuvant chemotherapy. Tissue microarrays from pre-intervention transurethral resection specimens were assessed for Bcl-2 protein status by immunohistochemistry. Extension of staining above 10% was regarded as positive. Downstaging and survival ratios in relation to Bcl-2 immunoreactivity and neoadjuvant chemotherapy utilization were calculated using the log rank test and multivariate Cox proportional hazards regression analyses. Results: Bcl-2 expression was positive in 38% and negative in 62% of the 236 evaluable patients. Bcl-2 negative patients receiving neoadjuvant chemotherapy had a significant increase in survival (p = 0.009), while Bcl-2 positive patients showed no difference (p = 0.4). However, the interaction variable between neoadjuvant chemotherapy and biomarker status was not significant (p = 0.38). When the prognostic value was assessed in the no-chemotherapy group, 5-year overall survival times were significantly better among Bcl-2 positive patients than among Bcl-2 negative patients (42 months vs 33 months, p = 0.04), but again Bcl-2 status did not remain independent when other factors were adjusted. Also, in a multivariate analysis with all patients, Bcl-2 was not significant. Conclusions: Bcl-2 status is not an independent predictor of neoadjuvant cisplatin chemotherapy response and is not prognostic in muscle-invasive bladder cancer.
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Affiliation(s)
- Polat Turker
- a Department of Surgical Sciences , Uppsala University , Uppsala , Sweden
| | - Ulrika Segersten
- a Department of Surgical Sciences , Uppsala University , Uppsala , Sweden
| | - Per-Uno Malmström
- a Department of Surgical Sciences , Uppsala University , Uppsala , Sweden
| | - Tammer Hemdan
- a Department of Surgical Sciences , Uppsala University , Uppsala , Sweden
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24
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Stangl-Kremser J, D'Andrea D, Vartolomei M, Abufaraj M, Goldner G, Baltzer P, Shariat SF, Tamandl D. Prognostic value of nutritional indices and body composition parameters including sarcopenia in patients treated with radiotherapy for urothelial carcinoma of the bladder. Urol Oncol 2018; 37:372-379. [PMID: 30578161 DOI: 10.1016/j.urolonc.2018.11.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 10/31/2018] [Accepted: 11/04/2018] [Indexed: 01/06/2023]
Abstract
PURPOSE To assess the prognostic importance of sarcopenia in survival in patients with high-risk urothelial carcinoma of the bladder (UCB) who were unfit for radical cystectomy or systemic chemotherapy and were, therefore, treated with radiotherapy only. METHODS We evaluated 94 patients treated with transurethral resection of the bladder and radiotherapy for UCB. Sarcopenia, identified from pretreatment computed tomography scans, was defined as a skeletal muscle index of <39 cm2/m2 for women and <55 cm2/m2 for men. Body mass index -adjusted definition of sarcopenia was used to evaluate for sarcopenic obesity. Univariate models were used to assess the association between body composition and nutritional parameters with survival outcomes. RESULTS Overall, 68 patients were eligible for the final analysis, and 49 (72%) patients were sarcopenic. After body mass index adjustment of the definition of sarcopenia, its prevalence changed to 53.8% in women and 52.7% in men. Median age was 82 (interquartile range [IQR] 75-86) years, with a median, age-adjusted comorbidity index of 7.5 (IQR 6-10). The median time of follow-up was 12.5 (IQR 5.1-23.5) months. There were 42 (61.7%) patients who died of any cause and 19 (45.2%) who died because of UCB during the study period. Of all the body composition and nutritional parameters investigated, sarcopenic obesity was associated with cancer-specific survival (hazard ratio 5.0, 95% confidence interval 1.4-16.7, P = 0.01) and a low prognostic nutritional index was associated with overall survival (hazard ratio 0.46, 95% confidence interval 0.2-0.9, P = 0.02). CONCLUSION In patients who are too high risk for the standard treatment of UCB, sarcopenia is highly prevalent, but not prognostic of survival. Nevertheless, sarcopenic obesity and the prognostic nutritional index might act as prognostic markers for patients with UCB undergoing radiotherapy.
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Affiliation(s)
| | - David D'Andrea
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Mihai Vartolomei
- Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Cell and Molecular Biology, University of Medicine and Pharmacy, Tirgu Mures, Romania
| | - Mohammad Abufaraj
- Department of Urology, Medical University of Vienna, Vienna, Austria; Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan
| | - Gregor Goldner
- Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria
| | - Pascal Baltzer
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Shahrokh F Shariat
- Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, University of Texas Southwestern Medical Centre, Dallas, TX; Department of Urology, Weill Cornell Medical College, New York, NY; Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria
| | - Dietmar Tamandl
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria.
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25
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Kaletsch A, Pinkerneil M, Hoffmann MJ, Jaguva Vasudevan AA, Wang C, Hansen FK, Wiek C, Hanenberg H, Gertzen C, Gohlke H, Kassack MU, Kurz T, Schulz WA, Niegisch G. Effects of novel HDAC inhibitors on urothelial carcinoma cells. Clin Epigenetics 2018; 10:100. [PMID: 30064501 PMCID: PMC6069857 DOI: 10.1186/s13148-018-0531-y] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [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: 11/29/2017] [Accepted: 07/09/2018] [Indexed: 11/22/2022] Open
Abstract
Background Histone deacetylase inhibitors (HDACi) are promising anti-cancer drugs that could also be employed for urothelial carcinoma (UC) therapy. It is unclear, however, whether inhibition of all 11 zinc-dependent HDACs or of individual enzymes is more efficacious and specific. Here, we investigated the novel HDACi 19i (LMK235) with presumed preferential activity against class IIA HDAC4/5 in comparison to the pan-HDACi vorinostat (SAHA) and the HDAC4-specific HDACi TMP269 in UC cell lines with basal expression of HDAC4 and characterized two HDAC4-overexpressing UC cell lines. Methods Cytotoxic concentrations 50% (CC50s) for HDACi were determined by MTT assay and high-content analysis-based fluorescent live/dead assay in UC cell lines with different expression of HDAC4 and as well as in normal urothelial cell cultures, HBLAK and HEK-293 cell lines. Effects of HDACis were analyzed by flow cytometry; molecular changes were followed by qRT-PCR and Western blots. UC lines overexpressing HDAC4 were established by lentiviral transduction. Inhibitor activity profiles of HDACi were obtained by current state in vitro assays, and docking analysis was performed using an updated crystal structure of HDAC4. Results In UC cell lines, 19i CC50s ranged around 1 μM; control lines were similarly or less sensitive. Like SAHA, 19i increased the G2/M-fraction, disturbed mitosis, and elicited apoptosis or in some cells senescence. Thymidylate synthase expression was diminished, and p21CIP1 was induced; global histone acetylation and α-tubulin acetylation also increased. In most cell lines, 19i as well as SAHA induced HDAC5 and HDAC4 mRNAs while rather repressing HDAC7. UC cell lines overexpressing HDAC4 were not significantly less sensitive to 19i. Reevaluation of the in vitro HDAC isoenzyme activity inhibition profile of 19i and its docking to HDAC4 using current assays suggested rather low activity against class IIA HDACs. The specific class IIA HDAC inhibitor TMP269 impeded proliferation of UC cell lines only at concentrations > 10 μM. Conclusions Anti-neoplastic effects of 19i on UC cells appear to be exerted by targeting class I HDACs. In fact, HDAC4 may rather impede UC growth. Our results suggest that targeting of class IIA HDACs 4/5 may not be optimal for UC therapy. Moreover, our investigation provides further evidence for cross-regulation of class IIA HDACs by class I HDACs. Electronic supplementary material The online version of this article (10.1186/s13148-018-0531-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Aline Kaletsch
- Department of Urology, Medical Faculty, Heinrich Heine University, Moorenstr. 5, 40225, Duesseldorf, Germany
| | - Maria Pinkerneil
- Department of Urology, Medical Faculty, Heinrich Heine University, Moorenstr. 5, 40225, Duesseldorf, Germany
| | - Michèle J Hoffmann
- Department of Urology, Medical Faculty, Heinrich Heine University, Moorenstr. 5, 40225, Duesseldorf, Germany
| | - Ananda A Jaguva Vasudevan
- Department of Urology, Medical Faculty, Heinrich Heine University, Moorenstr. 5, 40225, Duesseldorf, Germany
| | - Chenyin Wang
- Institute for Pharmaceutical and Medical Chemistry, Heinrich Heine University, Duesseldorf, Germany
| | - Finn K Hansen
- Institute for Pharmaceutical and Medical Chemistry, Heinrich Heine University, Duesseldorf, Germany
| | - Constanze Wiek
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical Faculty, Heinrich Heine University, Duesseldorf, Germany
| | - Helmut Hanenberg
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical Faculty, Heinrich Heine University, Duesseldorf, Germany
| | - Christoph Gertzen
- Institute for Pharmaceutical and Medical Chemistry, Heinrich Heine University, Duesseldorf, Germany
| | - Holger Gohlke
- Institute for Pharmaceutical and Medical Chemistry, Heinrich Heine University, Duesseldorf, Germany
| | - Matthias U Kassack
- Institute for Pharmaceutical and Medical Chemistry, Heinrich Heine University, Duesseldorf, Germany
| | - Thomas Kurz
- Institute for Pharmaceutical and Medical Chemistry, Heinrich Heine University, Duesseldorf, Germany
| | - Wolfgang A Schulz
- Department of Urology, Medical Faculty, Heinrich Heine University, Moorenstr. 5, 40225, Duesseldorf, Germany.
| | - Günter Niegisch
- Department of Urology, Medical Faculty, Heinrich Heine University, Moorenstr. 5, 40225, Duesseldorf, Germany
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Krantz D, Hartana CA, Winerdal ME, Johansson M, Alamdari F, Jakubczyk T, Huge Y, Aljabery F, Palmqvist K, Zirakzadeh AA, Holmström B, Riklund K, Sherif A, Winqvist O. Neoadjuvant Chemotherapy Reinforces Antitumour T cell Response in Urothelial Urinary Bladder Cancer. Eur Urol 2018; 74:688-92. [PMID: 30025882 DOI: 10.1016/j.eururo.2018.06.048] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 06/29/2018] [Indexed: 01/03/2023]
Abstract
Evidence indicates that neoadjuvant chemotherapy (NAC) may promote antitumour immune responses by activating T cells. The tumour-draining sentinel node (SN) is a key site to study tumour-specific T cell activation, being the primary immunological barrier against the tumour. In this prospective study, we set out to elucidate the effects of NAC on T cell subsets in the SNs of patients with muscle-invasive urothelial bladder cancer. We found that CD8+ effector T (Teff) cell exhaustion was reduced after NAC treatment, while cytotoxicity was increased. Additionally, in complete responders (CR patients), these cells were functionally committed effectors, as displayed by epigenetic analysis. In CD4+ Teffs, NAC treatment was associated with increased clonal expansion of tumour-specific SN-derived cells, as demonstrated by a specific cell reactivity assay. In contrast, we observed an attenuating effect of NAC on regulatory T cells (Tregs) with a dose-dependent decrease in Treg frequency and reduced effector molecule expression in the remaining Tregs. In addition, multicolour flow cytometry analysis revealed that CR patients had higher Teff to activated Treg ratio, promoting antitumoural T cell activation. These results suggest that NAC reinforces the antitumour immune response by activating the effector arm of the T cell compartment and diminishing the influence of suppressive Tregs. PATIENT SUMMARY: In this report, we analysed the effect of chemotherapy on immune cell subsets of 40 patients with advanced bladder cancer. We found that chemotherapy has a positive effect on immune effector T cells, whereas an opposite, diminishing effect was observed for immune-suppressive regulatory T cells. We conclude that chemotherapy reinforces the antitumour immune response in bladder cancer patients.
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Marinoni F, Destro F, Selvaggio GGO, Riccipetitoni G. Urothelial carcinoma in children: A case series. Bull Cancer 2018; 105:556-561. [PMID: 29724585 DOI: 10.1016/j.bulcan.2018.03.002] [Citation(s) in RCA: 4] [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: 04/04/2017] [Revised: 10/03/2017] [Accepted: 03/05/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To report a series of 5 patients with urothelial bladder cancer (UBC) three of them with a history of exposure to amines and only two with gross hematuria. MATERIALS AND METHODS After obtaining ethical and legal authorization, we performed a restrospective monocentric study. We collected information of patients with UBC over a period of 10 years. We recorded: age, sex, reason for presentation, familial history and risk factors, preoperative assessment, surgical details, histological type and grade, follow-up. RESULTS 2 children came to our attention for hematuria and 3 for incidental bladder mass finding, at a median age of 11.8 years. We performed microscopically complete transurethral resection of the tumor (TURB). Median tumor size was 1.8cm. No further therapy was required. All cancers belonged to NMIBC (Non-muscle-invasive Bladder Cancer) considering the 2004 WHO classification: 2 urothelial papillomas, 2 papillary tumors with low grade malignancy (PUN-LPM) and 1 papillary urothelial carcinoma of low histological grade (LG-PUC Ta, N0, M0). There was not any complications and no relapse occurred during follow-up (median 30 months). CONCLUSIONS In this study, UBCs presenting at a young age were low-grade and have not recurred in follow-up. This confirms the results of other series reported in Literature. Therefore there might be the space to perform a follow-up dedicated to children.
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Affiliation(s)
- Federica Marinoni
- Ospedale dei Bambini V. Buzzi, Pediatric Surgery Department, Via Castelvetro 32, 20154 Milano, Italy
| | - Francesca Destro
- Ospedale dei Bambini V. Buzzi, Pediatric Surgery Department, Via Castelvetro 32, 20154 Milano, Italy.
| | | | - Giovanna Riccipetitoni
- Ospedale dei Bambini V. Buzzi, Pediatric Surgery Department, Via Castelvetro 32, 20154 Milano, Italy
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Crabb S, Danson SJ, Catto JWF, McDowell C, Lowder JN, Caddy J, Dunkley D, Rajaram J, Ellis D, Hill S, Hathorn D, Whitehead A, Kalevras M, Huddart R, Griffiths G. SPIRE - combining SGI-110 with cisplatin and gemcitabine chemotherapy for solid malignancies including bladder cancer: study protocol for a phase Ib/randomised IIa open label clinical trial. Trials 2018; 19:216. [PMID: 29615077 PMCID: PMC5883402 DOI: 10.1186/s13063-018-2586-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 03/08/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Urothelial bladder cancer (UBC) accounts for 10,000 new diagnoses and 5000 deaths annually in the UK (Cancer Research UK, http://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/bladder-cancer , Cancer Research UK, Accessed 26 Mar 2018). Cisplatin-based chemotherapy is standard of care therapy for UBC for both palliative first-line treatment of advanced/metastatic disease and radical neoadjuvant treatment of localised muscle invasive bladder cancer. However, cisplatin resistance remains a critical cause of treatment failure and a barrier to therapeutic advance in UBC. Based on supportive pre-clinical data, we hypothesised that DNA methyltransferase inhibition would circumvent cisplatin resistance in UBC and potentially other cancers. METHODS The addition of SGI-110 (guadecitabine, a DNA methyltransferase inhibitor) to conventional doublet therapy of gemcitabine and cisplatin (GC) is being tested within the phase Ib/IIa SPIRE clinical trial. SPIRE incorporates an initial, modified rolling six-dose escalation phase Ib design of up to 36 patients with advanced solid tumours followed by a 20-patient open-label randomised controlled dose expansion phase IIa component as neoadjuvant treatment for UBC. Patients are being recruited from UK secondary care sites. The dose escalation phase will determine a recommended phase II dose (RP2D, primary endpoint) of SGI-110, by subcutaneous injection, on days 1-5 for combination with GC at conventional doses (cisplatin 70 mg/m2, IV infusion, day 8; gemcitabine 1000 mg/m2, IV infusion, days 8 and 15) in every 21-day cycle. In the dose expansion phase, patients will be randomised 1:1 to GC with or without SGI-110 at the proposed RP2D. Secondary endpoints will include toxicity profiles, SGI-110 pharmacokinetics and pharmacodynamic biomarkers, and pathological complete response rates in the dose expansion phase. Analyses will not be powered for formal statistical comparisons and descriptive statistics will be used to describe rates of toxicity, efficacy and translational endpoints by treatment arm. DISCUSSION SPIRE will provide evidence for whether SGI-110 in combination with GC chemotherapy is safe and biologically effective prior to future phase II/III trials as a neoadjuvant therapy for UBC and potentially in other cancers treated with GC. TRIAL REGISTRATION EudraCT Number: 2015-004062-29 (entered Dec 7, 2015) ISRCTN registry number: 16332228 (registered on Feb 3, 2016).
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Affiliation(s)
- Simon Crabb
- Southampton Experimental Cancer Medicine Centre, University of Southampton, Southampton, UK
| | - Sarah J. Danson
- Academic Unit of Clinical Oncology, Weston Park Hospital, University of Sheffield, Sheffield, UK
| | - James W. F. Catto
- Academic Urology Unit, The Medical school, University of Sheffield, Sheffield, UK
| | | | | | - Joshua Caddy
- Southampton Clinical Trials Unit, Centre for Cancer Immunology, University of Southampton, Southampton, UK
| | - Denise Dunkley
- Southampton Clinical Trials Unit, Centre for Cancer Immunology, University of Southampton, Southampton, UK
| | - Jessica Rajaram
- Southampton Clinical Trials Unit, Centre for Cancer Immunology, University of Southampton, Southampton, UK
| | - Deborah Ellis
- Southampton Clinical Trials Unit, Centre for Cancer Immunology, University of Southampton, Southampton, UK
| | - Stephanie Hill
- Southampton Clinical Trials Unit, Centre for Cancer Immunology, University of Southampton, Southampton, UK
| | - David Hathorn
- Southampton Clinical Trials Unit, Centre for Cancer Immunology, University of Southampton, Southampton, UK
| | - Amy Whitehead
- Southampton Clinical Trials Unit, Centre for Cancer Immunology, University of Southampton, Southampton, UK
| | - Mihalis Kalevras
- Southampton Clinical Trials Unit, Centre for Cancer Immunology, University of Southampton, Southampton, UK
| | | | - Gareth Griffiths
- Southampton Clinical Trials Unit, Centre for Cancer Immunology, University of Southampton, Southampton, UK
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D Andrea D, Abufaraj M, Susani M, Ristl R, Foerster B, Kimura S, Mari A, Soria F, Briganti A, Karakiewicz PI, Gust KM, Rouprêt M, Shariat SF. Accurate prediction of progression to muscle-invasive disease in patients with pT1G3 bladder cancer: A clinical decision-making tool. Urol Oncol 2018; 36:239.e1-239.e7. [PMID: 29506941 DOI: 10.1016/j.urolonc.2018.01.018] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 01/18/2018] [Accepted: 01/28/2018] [Indexed: 01/07/2023]
Abstract
PURPOSE To improve current prognostic models for the selection of patients with T1G3 urothelial bladder cancer who are more likely to fail intravesical therapy and progress to muscle-invasive bladder cancer (MIBC). MATERIALS AND METHODS We performed a retrospective analysis of 1,289 patients with pT1G3 urothelial bladder cancer who were treated with transurethral resection of the bladder (TURB) and adjuvant intravesical bacillus-Calmette-Guérin (BCG). Random-split sample data and competing-risk regression were used to identify the independent impact of lymphovascular invasion (LVI) and variant histology (VH) on progression to MIBC. We developed a nomogram for predicting patient-specific probability of disease progression at 2 and 5 years after TURB. Decision curve analysis (DCA) was performed to evaluate the clinical benefit associated with the use of our nomogram. RESULTS In the development cohort, within a median follow-up of 51.6 months (IQR: 19.3-92.5), disease progression occurred in 89 patients (13.8%). A total of 84 (13%) patients were found to have VH and 57 (8.8%) with LVI at TURB. Both factors were independently associated with disease progression on multivariable competing-risk analysis (HR: 4.4; 95% CI: 2.8-6.9; P<0.001 and HR: 3.5; 95% CI: 2.1-5.8; P<0.001, respectively). DCA showed superior net benefits for the nomogram within a threshold probability of progression between 5% and 55%. Limitations are inherent to the retrospective design. CONCLUSIONS We demonstrated the clinical value of the integration of LVI and VH in a prognostic model for the prediction of MIBC. Indeed, our tool provides superior individualized risk estimation of progression facilitating decision-making regarding early RC.
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Affiliation(s)
- David D Andrea
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Mohammad Abufaraj
- Department of Urology, Medical University of Vienna, Vienna, Austria; Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan
| | - Martin Susani
- Department of Pathology, Medical University of Vienna, Vienna, Austria
| | - Robin Ristl
- Institute for Medical Statistic, Center for Medical Statistics, Informatics and Intelligent Systems (CEMSIIS), Medical University of Vienna, Vienna, Austria
| | - Beat Foerster
- Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Shoji Kimura
- Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, Jikei University School of Medicine, Tokyo, Japan
| | - Andrea Mari
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Francesco Soria
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Alberto Briganti
- Department of Urology, Urological Research Institute, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy
| | | | - Killian M Gust
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Morgan Rouprêt
- Department of Urology, Pitié-Salpétrière, Assistance-Publique Hôpitaux de Paris and Faculté de Médecine Pierre et Marie Curie, University Paris VI, Paris, France
| | - Shahrokh F Shariat
- Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology and Andrology, Karl Landsteiner Institute, Vienna, Austria; Department of Urology, University of Texas Southwestern Medical Centre, Dallas, TX; Department of Urology, Weill Cornell Medical College, New York, NY.
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Agrawal U, Kumari N, Vasudeva P, Mohanty NK, Saxena S. Overexpression of COX2 indicates poor survival in urothelial bladder cancer. Ann Diagn Pathol 2018; 34:50-55. [PMID: 29661728 DOI: 10.1016/j.anndiagpath.2018.01.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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: 09/15/2015] [Revised: 12/30/2017] [Accepted: 01/13/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND COX2 is a cyclo-oxygenase enzyme expressed in the tumor cells, inflammatory cells, stromal and non-epithelial cells. The study was conducted to evaluate the expression of COX2 in Urothelial carcinoma and find the association with progression and recurrence. METHODS The expression of COX2 was evaluated by real-time PCR and immunohistochemistry. RESULTS Gene expression of COX2 was found to be upregulated >28-fold in urothelial cancer compared to adjacent normal bladder mucosa. Inflammatory cell expression of COX2 was found in 92% cases whereas only 37% cases showed COX2 overexpression in tumor cells. Tumor cell COX2 overexpression was significantly associated with invasion and recurrence. CONCLUSION COX2 expression is a marker of invasion, recurrence and poor survival and may have a role in predicting the cases which will benefit from additional treatment with COX2 inhibitors in urothelial carcinoma.
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Affiliation(s)
- Usha Agrawal
- National Institute of Pathology, Indian Council of Medical Research, New Delhi-110029, India; Faculty of Health and Biomedical Sciences, Symbiosis International University, Lavale, Pune- 412115, India.
| | - Nitu Kumari
- National Institute of Pathology, Indian Council of Medical Research, New Delhi-110029, India; BITS, Pilani, Rajasthan, India
| | - Pawan Vasudeva
- Deptt of Urology, VMMC and Safdarjung Hospital, New Delhi-110029, India
| | | | - Sunita Saxena
- National Institute of Pathology, Indian Council of Medical Research, New Delhi-110029, India.
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Abstract
Members of the APOBEC3 (A3) family of enzymes were shown to act in an oncogenic manner in several cancer types. Immunodetection of APOBEC3A (A3A), APOBEC3B (A3B), and APOBEC3G (A3G) proteins is particularly challenging due to the large sequence homology of these proteins and limited availability of antibodies. Here we combine independent immunoblotting with an in vitro activity assay technique, to detect and categorize specific A3s expressed in urothelial bladder cancer and other cancer cells.
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Affiliation(s)
- Ananda Ayyappan Jaguva Vasudevan
- Clinic for Gastroenterology, Hepatology, and Infectiology, Medical Faculty, Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
- Department of Urology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Wolfgang Goering
- Department of Urology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Institute of Pathology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Dieter Häussinger
- Clinic for Gastroenterology, Hepatology, and Infectiology, Medical Faculty, Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Carsten Münk
- Clinic for Gastroenterology, Hepatology, and Infectiology, Medical Faculty, Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
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Chen CC, Huang CP, Tsai YT, Hseih TF, Shyr CR. The Genomic Alterations of 5α-Reductases and Their Inhibitor Finasteride's Effect in Bladder Cancer. Anticancer Res 2017; 37:6893-6898. [PMID: 29187470 DOI: 10.21873/anticanres.12152] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 09/25/2017] [Accepted: 09/26/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Since androgens affect urothelial bladder cancer (UBC), we examined whether 5α-reductases (5-AR) have genomic alterations in UBC and whether 5α-reductase inhibitors (5-ARI) affect UBC. MATERIALS AND METHODS The cBioPortal was used to analyze genomic alternations of 5-ARs in UBC cancer genomic datasets. Next, we used the Taiwan National Health Insurance Research database to conduct a population-based case-control study to investigate the effect of a 5-ARI, finasteride on UBC incidence. We also performed an XTT assay to examine the direct effect of finasteride on UBC cells. RESULTS We found that 5-AR genomic alternations were observed in 29% of UBC patients and patients with alternations had shorter disease-free survival. Also, the use of finasteride with >180 cDDDs reduced the risk of UBC. Finasteride could directly inhibit UBC cell growth. CONCLUSION Based on our findings, we concluded that 5-AR could be explored as a therapeutic target for UBC with 5-ARIs.
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Affiliation(s)
- Chi-Cheng Chen
- Sex Hormone Research Center, Departments of Medical Laboratory Science and Biotechnology and Urology, Graduate Institute of Clinical Medical Science, China Medical University and Hospital, Taichung, Taiwan, R.O.C.,Department of Urology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan, R.O.C
| | - Chi-Ping Huang
- Sex Hormone Research Center, Departments of Medical Laboratory Science and Biotechnology and Urology, Graduate Institute of Clinical Medical Science, China Medical University and Hospital, Taichung, Taiwan, R.O.C
| | - Yi-Tung Tsai
- Sex Hormone Research Center, Departments of Medical Laboratory Science and Biotechnology and Urology, Graduate Institute of Clinical Medical Science, China Medical University and Hospital, Taichung, Taiwan, R.O.C
| | - Teng-Fu Hseih
- Department of Urology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan, R.O.C.
| | - Chih-Rong Shyr
- Sex Hormone Research Center, Departments of Medical Laboratory Science and Biotechnology and Urology, Graduate Institute of Clinical Medical Science, China Medical University and Hospital, Taichung, Taiwan, R.O.C.
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Zhang Q, Zhuang J, Deng Y, Yang L, Cao W, Chen W, Lin T, Lv X, Yu H, Xue Y, Guo H. miR34a/GOLPH3 Axis abrogates Urothelial Bladder Cancer Chemoresistance via Reduced Cancer Stemness. Am J Cancer Res 2017; 7:4777-4790. [PMID: 29187903 PMCID: PMC5706099 DOI: 10.7150/thno.21713] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 09/12/2017] [Indexed: 11/24/2022] Open
Abstract
Rationale: Chemoresistance and subsequent recurrence of human urothelial bladder cancer (UBC) is partially driven by a subpopulation of tumor initiating cells, namely cancer stem cells (CSCs). However, the underlying molecular mechanism in chemotherapy-induced CSCs enrichment and following chemoresistance and recurrence remains largely unclear. Methods: Gemcitabine and cisplatin (GC) chemoresistant cell lines (T24 GC 3rd and 5637 GC 3rd cells) and the chemo-sensitive UBC cell lines T24 and 5637 were established in vivo for the investigation of acquired resistance mechanisms. The role of miR34a/GOLPH3 axis in regulating UBC chemoresistance and recurrence was evaluated in cell and animal models. The expression levels of miR34a/GOLPH3 axis and CSCs markers were assayed in specimens of UBC. The association of GOLPH3 with clinicopathologic features and prognosis was analysed. Results: RT-PCR and western blotting confirmed that the expression levels of miR34a were decreased and GOLPH3 were increased in GC chemoresistant UBC cell lines. Downregulation of miR34a resulted in the overexpression of GOLPH3, which is a target gene of miR34a confirmed by luciferase experiment. The ectopic expression of miR34a decreased the stem cell properties of chemoresistant UBC cells and re-sensitized these cells to GC treatment in vitro and in vivo. Moreover, miR34a/GOLPH3 axis has obvious clinical relevance with prognosis and recurrence in human UBC patients with standard GC chemotherapy. Conclusion: Our results suggest that miR34a/GOLPH3 axis exert key role in CSCs involved UBC drug resistance and recurrence and warrant further development as a promising therapeutic approach in treating drug-resistant UBC.
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Hussein S, Mosaad H, Rashed HE, Ahmed S, Ragab A, Ismail EI. Molecular factors regulating E-cadherin expression in urothelial bladder cancer and their correlations with the clinicopathological features. Mol Biol Rep 2017; 44:365-377. [PMID: 28808805 DOI: 10.1007/s11033-017-4118-z] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 08/02/2017] [Indexed: 12/18/2022]
Abstract
This study aimed to assess the expression of S100A4, Twist and E-cadherin (mRNA and protein) in urothelial bladder cancer, investigate the correlation between them and evaluate their association with the clinicopathological features of the disease. The study included 54 patients diagnosed as urothelial bladder cancer of different stages and grades. The expression levels of S100A4, Twist and E-cadherin (mRNA and protein) in tissue samples were determined by quantitative RT-PCR and immunohistochemistry. The expression of S100A4 and Twist was significantly upregulated while E- cadherin was significantly downregulated in urothelial bladder cancer tissues compared to the adjacent surrounding normal bladder tissues at both mRNA and protein levels (p < 0.001). Expression levels of S100A4 and Twist were significantly higher in recurrent tumor than in non-recurrent tumors (p < 0.001) while the expression level of E-cadherin was significantly lower in recurrent tumors than in non-recurrent tumors at both mRNA and protein levels (p < 0.001). There was a significant positive correlation between S100A4 and Twist expressions (r = 0.875, p < 0.001) while significant negative correlations were found between E- cadherin and S100A4 expressions(r=- 0.803, p < 0.001) and between E-cadherin and Twist (r = -0.809, p < 0.001). Up-regulation of S100A4 and Twist and down-regulation of E-cadherin in urothelial bladder cancer tissues compared to adjacent normal tissues were observed. There was a significant negative correlation between S100A4 and E- cadherin and between E- cadherin and Twist expression. However, there was a significant positive correlation between S100A4 and Twist expressions. Furthermore, the alterations in the gene expression were associated with disease stage and grade.
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Affiliation(s)
- Samia Hussein
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
| | - Hala Mosaad
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Hayam E Rashed
- Pathology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Shimaa Ahmed
- Pathology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed Ragab
- Urology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Eman I Ismail
- Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Vallo S, Michaelis M, Gust KM, Black PC, Rothweiler F, Kvasnicka HM, Blaheta RA, Brandt MP, Wezel F, Haferkamp A, Cinatl J. Dasatinib enhances tumor growth in gemcitabine-resistant orthotopic bladder cancer xenografts. BMC Res Notes 2016; 9:454. [PMID: 27677700 PMCID: PMC5039786 DOI: 10.1186/s13104-016-2256-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 03/29/2016] [Accepted: 09/20/2016] [Indexed: 01/04/2023] Open
Abstract
Background Systemic chemotherapy with gemcitabine and cisplatin is standard of care for patients with metastatic urothelial bladder cancer. However, resistance formation is common after initial response. The protein Src is known as a proto-oncogene, which is overexpressed in various human cancers. Since there are controversial reports about the role of Src in bladder cancer, we evaluated the efficacy of the Src kinase inhibitor dasatinib in the urothelial bladder cancer cell line RT112 and its gemcitabine-resistant sub-line RT112rGEMCI20 in vitro and in vivo. Methods RT112 urothelial cancer cells were adapted to growth in the presence of 20 ng/ml gemcitabine (RT112rGEMCI20) by continuous cultivation at increasing drug concentrations. Cell viability was determined by MTT assay, cell growth kinetics were determined by cell count, protein levels were measured by western blot, and cell migration was evaluated by scratch assays. In vivo tumor growth was tested in a murine orthotopic xenograft model using bioluminescent imaging. Results Dasatinib exerted similar effects on Src signaling in RT112 and RT112rGEMCI20 cells but RT112rGEMCI20 cells were less sensitive to dasatinib-induced anti-cancer effects (half maximal inhibitory concentration (IC50) of dasatinib in RT112 cells: 349.2 ± 67.2 nM; IC50 of dasatinib in RT112rGEMCI20 cells: 1081.1 ± 239.2 nM). Dasatinib inhibited migration of chemo-naive and gemcitabine-resistant cells. Most strikingly, dasatinib treatment reduced RT112 tumor growth and muscle invasion in orthotopic xenografts, while it was associated with increased size and muscle-invasive growth in RT112rGEMCI20 tumors. Conclusion Dasatinib should be considered with care for the treatment of urothelial cancer, in particular for therapy-refractory cases.
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Affiliation(s)
- Stefan Vallo
- Institute of Medical Virology, Goethe University Frankfurt, Paul-Ehrlich-Str. 40, 60596, Frankfurt am Main, Germany.,Department of Urology, Goethe University Frankfurt, Frankfurt, Germany
| | - Martin Michaelis
- Centre for Molecular Processing and School of Biosciences, University of Kent, Canterbury, UK
| | - Kilian M Gust
- Department of Urology, Goethe University Frankfurt, Frankfurt, Germany.,Department of Urologic Sciences, Vancouver Prostate Centre, University of British Columbia, Vancouver, Canada
| | - Peter C Black
- Department of Urologic Sciences, Vancouver Prostate Centre, University of British Columbia, Vancouver, Canada
| | - Florian Rothweiler
- Institute of Medical Virology, Goethe University Frankfurt, Paul-Ehrlich-Str. 40, 60596, Frankfurt am Main, Germany
| | - Hans-Michael Kvasnicka
- Dr. Senckenberg Institute of Pathology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Roman A Blaheta
- Department of Urology, Goethe University Frankfurt, Frankfurt, Germany
| | | | - Felix Wezel
- Department of Urology, University Hospital Ulm, Ulm, Germany
| | - Axel Haferkamp
- Department of Urology, Goethe University Frankfurt, Frankfurt, Germany
| | - Jindrich Cinatl
- Institute of Medical Virology, Goethe University Frankfurt, Paul-Ehrlich-Str. 40, 60596, Frankfurt am Main, Germany.
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Peng XC, Gong FM, Chen Y, Qiu M, Cheng K, Tang J, Ge J, Chen N, Zeng H, Liu JY. Proteomics identification of PGAM1 as a potential therapeutic target for urothelial bladder cancer. J Proteomics 2016; 132:85-92. [PMID: 26655504 DOI: 10.1016/j.jprot.2015.11.027] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 10/16/2015] [Accepted: 11/03/2015] [Indexed: 02/05/2023]
Abstract
Urothelial bladder cancer (UBC) is a major global health problem. There have been no major advances for the treatment of UBC in the last 30 years. In this study, we attempted to discover novel candidate therapeutic biomarkers for UBC. We utilized a two-dimensional polyacrylamide gel electrophoresis (2-DE) and ESI-Q-TOF MS/MS-based proteomic method to compare and identify differentially expressed proteins in UBC and adjacent normal tissues. Thirty five differentially expressed proteins (over 2-fold, p<0.05) were identified. Further cluster analysis revealed these proteins were mainly involved in metabolism, apoptosis regulation, calcium ion binding and so on. Among them, phosphoglycerate mutase 1 (PGAM1), significantly up-regulated in UBC, was selected for detailed analysis. Immunohistochemical data showed that increased expression of PGAM1 was correlated with the severity of histological grade. Knockdown of PGAM1 expression by RNAi contributed to a marked antitumor activity in vivo. Moreover, we found, upon attenuation of PGAM1, its substrate 3-PG (3-phosphoglycerate) was up-regulated and product 2-PG (2-phosphoglycerate) was down-regulated, which consequently inhibited aerobic glycolysis and oxidative pentose phosphate pathway (PPP) that are essential to cancer cell proliferation. Our finding showed that PGAM1 might serve as a promising therapeutic target for UBC.
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Ben Fradj MK, Kallel A, Gargouri MM, Chehida MAB, Sallemi A, Ouanes Y, Rhouma SB, Riadh J, Feki M, Nouira Y, Kaabachi N. Association of FokI polymorphism of vitamin D receptor with urothelial bladder cancer in Tunisians: role of tobacco smoking and plasma vitamin D concentration. Tumour Biol 2015; 37:6197-203. [PMID: 26615419 DOI: 10.1007/s13277-015-4496-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Accepted: 11/23/2015] [Indexed: 12/14/2022] Open
Abstract
The aim of the study was to test whether the VDR FokI polymorphism is associated with the risk of urothelial bladder cancer (UBC) in Tunisians. The study included 200 unrelated patients with UBC and 200 healthy controls. Genotyping of the VDR FokI polymorphism was determined by PCR-RFLP method. Plasma 25-hydroxyvitamin D concentrations were measured by immunoassay. Binary logistic regression model was applied to test how the association of VDR FokI polymorphism is independent of potential confounding factors. Genotype distribution (FF, 45 vs. 55 %; Ff, 52.1 vs. 47.9 %, and ff, 12 vs. 5.5 %, respectively) and allele frequencies (F, 66.5 vs. 74.8 % and f, 33.5 vs. 25.2 %, respectively) were significantly different between UBC patients and controls. The "ff" genotype [OR (95 % CI), 2.66 (1.24-5.73); p = 0.012] and "f" allele [1.49 (1.09-2.02); p = 0.010] were associated with increased risk of UBC. The association remained significant in multivariate analysis. Stratified analyses showed that VDR FokI polymorphism is only associated with UBC risk in ever-smokers, subjects exposed to chemical carcinogens and those with plasma 25-hydroxyvitamin D over 12 μg/L. The "f" allele of VDR FokI polymorphism is associated with a higher risk of UBC in Tunisians, especially in smokers as well as subjects with occupational exposition and subjects without vitamin D deficiency. These results should be replicated in other ethnic groups and the influence of other genetic factors and environments on this association should be investigated.
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Affiliation(s)
- Mohamed Kacem Ben Fradj
- Faculty of Medicine of Tunis, UR05/08-08, LR99ES11, Department of Biochemistry, Rabta Hospital, University Tunis El Manar, 1007, Jebbari, Tunis, Tunisia. .,Laboratory of Biochemistry, Rabta Hospital, 1007, Jebbari, Tunis, Tunisia. .,Faculty of Sciences of Tunis, University Tunis El Manar, Campus Universitaire, 2092, Tunis, Tunisia.
| | - Amani Kallel
- Faculty of Medicine of Tunis, UR05/08-08, LR99ES11, Department of Biochemistry, Rabta Hospital, University Tunis El Manar, 1007, Jebbari, Tunis, Tunisia
| | - Mohamed Mourad Gargouri
- Faculty of Medicine of Tunis, UR12SP04, Department of Urology, Rabta Hospital, University Tunis El Manar, 1007, Jebbari, Tunis, Tunisia
| | - Mohamed Ali Ben Chehida
- Faculty of Medicine of Tunis, UR12SP04, Department of Urology, Rabta Hospital, University Tunis El Manar, 1007, Jebbari, Tunis, Tunisia
| | - Ahmed Sallemi
- Faculty of Medicine of Tunis, UR12SP04, Department of Urology, Rabta Hospital, University Tunis El Manar, 1007, Jebbari, Tunis, Tunisia
| | - Yassine Ouanes
- Faculty of Medicine of Tunis, UR12SP04, Department of Urology, Rabta Hospital, University Tunis El Manar, 1007, Jebbari, Tunis, Tunisia
| | - Sami Ben Rhouma
- Faculty of Medicine of Tunis, UR12SP04, Department of Urology, Rabta Hospital, University Tunis El Manar, 1007, Jebbari, Tunis, Tunisia
| | - Jemaa Riadh
- Faculty of Medicine of Tunis, UR05/08-08, LR99ES11, Department of Biochemistry, Rabta Hospital, University Tunis El Manar, 1007, Jebbari, Tunis, Tunisia
| | - Moncef Feki
- Faculty of Medicine of Tunis, UR05/08-08, LR99ES11, Department of Biochemistry, Rabta Hospital, University Tunis El Manar, 1007, Jebbari, Tunis, Tunisia
| | - Yassine Nouira
- Faculty of Medicine of Tunis, UR12SP04, Department of Urology, Rabta Hospital, University Tunis El Manar, 1007, Jebbari, Tunis, Tunisia
| | - Naziha Kaabachi
- Faculty of Medicine of Tunis, UR05/08-08, LR99ES11, Department of Biochemistry, Rabta Hospital, University Tunis El Manar, 1007, Jebbari, Tunis, Tunisia
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Wang K, Liu T, Liu C, Meng Y, Yuan X, Liu L, Ge N, Liu J, Wang C, Ren H, Yan K, Hu S, Xu Z, Fan Y, Xu D. TERT promoter mutations and TERT mRNA but not FGFR3 mutations are urinary biomarkers in Han Chinese patients with urothelial bladder cancer. Oncologist 2015; 20:263-9. [PMID: 25657201 DOI: 10.1634/theoncologist.2014-0391] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The TERT promoter and FGFR3 gene mutations are two of the most common genetic events in urothelial bladder cancer (UBC), and these mutation assays in patient urine have been shown to be promising biomarkers for UBC diagnosis and surveillance. These results were obtained mainly from studies of patients with UBC in Western countries, and little is known about such information in Han Chinese patients with UBC. In the present study, we addressed this issue by analyzing tumors from 182 Han Chinese patients with UBC and urine samples from 102 patients for mutations in the TERT promoter and FGFR3 and TERT mRNA expression in tumors and/or urine. TERT promoter and FGFR3 mutations were identified in 87 of 182 (47.8%) and 7 of 102 (6.7%) UBC cases, respectively. In 46 urine samples from patients with TERT promoter mutation-carrying tumors, the mutant promoter was detected in 24 (52%) prior to operation and disappeared in most examined urine samples (80%) taken 1 week after operation. TERT mRNA was detected in urine derived from 46 of 49 patients (94%) that was analyzed before operation independently of the presence of TERT promoter mutations. Collectively, FGFR3 mutations occur at a very low rate in Han Chinese UBC and cannot serve as diagnostic markers for Chinese patients. Han Chinese patients with UBC have relatively low TERT promoter mutation frequency compared with patients in Western countries, and simultaneous detection of both mutant TERT promoter and TERT mRNA improves sensitivity and specificity of urine-based diagnosis.
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MESH Headings
- Adenocarcinoma/genetics
- Adenocarcinoma/pathology
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/urine
- Carcinoma, Transitional Cell/genetics
- Carcinoma, Transitional Cell/pathology
- China/ethnology
- Female
- Humans
- Male
- Mutation
- Neoplasm Recurrence, Local
- Polymerase Chain Reaction
- Promoter Regions, Genetic
- RNA, Messenger/genetics
- Receptor, Fibroblast Growth Factor, Type 3/genetics
- Receptor, Fibroblast Growth Factor, Type 3/urine
- Sensitivity and Specificity
- Sequence Analysis, DNA
- Telomerase/genetics
- Telomerase/urine
- Urinary Bladder Neoplasms/genetics
- Urinary Bladder Neoplasms/pathology
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Affiliation(s)
- Kun Wang
- Departments of Urology and General Surgery, Qilu Hospital, Department of Pathology, School of Medicine, and Department of Urology, Second Hospital, Shandong University, Jinan, People's Republic of China; Department of Medicine, Division of Hematology and Center for Molecular Medicine, Karolinska University Hospital Solna and Karolinska Institutet, Stockholm, Sweden
| | - Tiantian Liu
- Departments of Urology and General Surgery, Qilu Hospital, Department of Pathology, School of Medicine, and Department of Urology, Second Hospital, Shandong University, Jinan, People's Republic of China; Department of Medicine, Division of Hematology and Center for Molecular Medicine, Karolinska University Hospital Solna and Karolinska Institutet, Stockholm, Sweden
| | - Cheng Liu
- Departments of Urology and General Surgery, Qilu Hospital, Department of Pathology, School of Medicine, and Department of Urology, Second Hospital, Shandong University, Jinan, People's Republic of China; Department of Medicine, Division of Hematology and Center for Molecular Medicine, Karolinska University Hospital Solna and Karolinska Institutet, Stockholm, Sweden
| | - Yan Meng
- Departments of Urology and General Surgery, Qilu Hospital, Department of Pathology, School of Medicine, and Department of Urology, Second Hospital, Shandong University, Jinan, People's Republic of China; Department of Medicine, Division of Hematology and Center for Molecular Medicine, Karolinska University Hospital Solna and Karolinska Institutet, Stockholm, Sweden
| | - Xiaotian Yuan
- Departments of Urology and General Surgery, Qilu Hospital, Department of Pathology, School of Medicine, and Department of Urology, Second Hospital, Shandong University, Jinan, People's Republic of China; Department of Medicine, Division of Hematology and Center for Molecular Medicine, Karolinska University Hospital Solna and Karolinska Institutet, Stockholm, Sweden
| | - Li Liu
- Departments of Urology and General Surgery, Qilu Hospital, Department of Pathology, School of Medicine, and Department of Urology, Second Hospital, Shandong University, Jinan, People's Republic of China; Department of Medicine, Division of Hematology and Center for Molecular Medicine, Karolinska University Hospital Solna and Karolinska Institutet, Stockholm, Sweden
| | - Nan Ge
- Departments of Urology and General Surgery, Qilu Hospital, Department of Pathology, School of Medicine, and Department of Urology, Second Hospital, Shandong University, Jinan, People's Republic of China; Department of Medicine, Division of Hematology and Center for Molecular Medicine, Karolinska University Hospital Solna and Karolinska Institutet, Stockholm, Sweden
| | - Jikai Liu
- Departments of Urology and General Surgery, Qilu Hospital, Department of Pathology, School of Medicine, and Department of Urology, Second Hospital, Shandong University, Jinan, People's Republic of China; Department of Medicine, Division of Hematology and Center for Molecular Medicine, Karolinska University Hospital Solna and Karolinska Institutet, Stockholm, Sweden
| | - Chang Wang
- Departments of Urology and General Surgery, Qilu Hospital, Department of Pathology, School of Medicine, and Department of Urology, Second Hospital, Shandong University, Jinan, People's Republic of China; Department of Medicine, Division of Hematology and Center for Molecular Medicine, Karolinska University Hospital Solna and Karolinska Institutet, Stockholm, Sweden
| | - Hongbo Ren
- Departments of Urology and General Surgery, Qilu Hospital, Department of Pathology, School of Medicine, and Department of Urology, Second Hospital, Shandong University, Jinan, People's Republic of China; Department of Medicine, Division of Hematology and Center for Molecular Medicine, Karolinska University Hospital Solna and Karolinska Institutet, Stockholm, Sweden
| | - Keqiang Yan
- Departments of Urology and General Surgery, Qilu Hospital, Department of Pathology, School of Medicine, and Department of Urology, Second Hospital, Shandong University, Jinan, People's Republic of China; Department of Medicine, Division of Hematology and Center for Molecular Medicine, Karolinska University Hospital Solna and Karolinska Institutet, Stockholm, Sweden
| | - Sanyuan Hu
- Departments of Urology and General Surgery, Qilu Hospital, Department of Pathology, School of Medicine, and Department of Urology, Second Hospital, Shandong University, Jinan, People's Republic of China; Department of Medicine, Division of Hematology and Center for Molecular Medicine, Karolinska University Hospital Solna and Karolinska Institutet, Stockholm, Sweden
| | - Zhonghua Xu
- Departments of Urology and General Surgery, Qilu Hospital, Department of Pathology, School of Medicine, and Department of Urology, Second Hospital, Shandong University, Jinan, People's Republic of China; Department of Medicine, Division of Hematology and Center for Molecular Medicine, Karolinska University Hospital Solna and Karolinska Institutet, Stockholm, Sweden
| | - Yidong Fan
- Departments of Urology and General Surgery, Qilu Hospital, Department of Pathology, School of Medicine, and Department of Urology, Second Hospital, Shandong University, Jinan, People's Republic of China; Department of Medicine, Division of Hematology and Center for Molecular Medicine, Karolinska University Hospital Solna and Karolinska Institutet, Stockholm, Sweden
| | - Dawei Xu
- Departments of Urology and General Surgery, Qilu Hospital, Department of Pathology, School of Medicine, and Department of Urology, Second Hospital, Shandong University, Jinan, People's Republic of China; Department of Medicine, Division of Hematology and Center for Molecular Medicine, Karolinska University Hospital Solna and Karolinska Institutet, Stockholm, Sweden
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Sun M, Zhao W, Xie Q, Zhan Y, Wu B. Lentinan reduces tumor progression by enhancing gemcitabine chemotherapy in urothelial bladder cancer. Surg Oncol 2014; 24:28-34. [PMID: 25434982 DOI: 10.1016/j.suronc.2014.11.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 10/30/2014] [Accepted: 11/12/2014] [Indexed: 11/15/2022]
Abstract
It has been shown that chemotherapy has limited antitumor activity against advanced urothelial bladder cancer (UBC). Consequently, there is an urgent need to develop effective therapeutic methods for patients with advanced UBC. In the present study, the inhibitory effects of lentinan alone, gemcitabine alone, or lentinan combined with gemcitabine on the proliferation of the UBC cell line, T24, were investigated. The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide assay, annexin V fluorescein isothiocyanate/propidium iodide staining, and flow cytometry were used to determine the proliferation and apoptosis of T24 cells in each treatment group. Survival-related protein expression was analyzed by western blotting. Increased concentrations of lentinan, or lentinan combined with gemcitabine, positively correlated with decreased T24 cell proliferation. Lentinan combined with gemcitabine chemotherapy significantly inhibited UBC cell proliferation. Gemcitabine has the ability to induce T24 cell apoptosis, and this effect is enhanced when it is combined with lentinan.
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Affiliation(s)
- Ming Sun
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, 110004, Liaoning Province, PR China
| | - Wenyan Zhao
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, 110004, Liaoning Province, PR China
| | - Qingpeng Xie
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, 110004, Liaoning Province, PR China
| | - Yunhong Zhan
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, 110004, Liaoning Province, PR China
| | - Bin Wu
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, 110004, Liaoning Province, PR China.
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Lin R, Shen W, Zhi Y, Zhou Z. Prognostic value of miR-26a and HMGA1 in urothelial bladder cancer. Biomed Pharmacother 2014; 68:929-34. [PMID: 25455159 DOI: 10.1016/j.biopha.2014.10.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 10/01/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND MicroRNA-26a (miR-26a) functions as a tumor suppressor by regulating its direct target gene high mobility group AT-hook 1 (HMGA1). This study was aimed to investigate the associations of differential expression of miR-26a and HMGA1 with tumor progression and prognosis in urothelial bladder cancer (UBC) patients. MATERIALS AND METHODS One hundred and twenty-six UBC patients were selected and quantitative real-time PCR was performed to detect the expression of miR-26a and HMGA1 mRNA in the respective tumors. RESULTS Our data showed the decreased expression of miR-26a and the increased expression of HMGA1 mRNA in UBC tissues compared with corresponding non-cancerous tissues (both P<0.001). Then, the expression levels of miR-26a in UBC tissues were negatively correlated with those of HMGA1 mRNA significantly (r=-0.72, P<0.001). In addition, UBC patients with combined miR-26a downregulation and HMGA1 upregulation (miR-26a-low/HMGA1-high) more frequently had advanced pathological stage (P<0.001) and high tumor grade (P<0.001). Moreover, miR-26a-low/HMGA1-high expression was associated with a significantly shortest disease-free survival (P<0.001) and overall survival (P<0.001) of all miR-26a/HMGA1 combined expression groups. Furthermore, multivariate analysis indicated that miR-26a/HMGA1 expression was an independent prognostic factor for both disease-free survival and overall survival (both P=0.001) in UBC patients. CONCLUSION Interaction between miR-26a and its target gene HMGA1 may contribute to the malignant progression of human UBC. Tumors with miR-26a downregulation in combination with high expression of HMGA1 showed a worse prognosis than the other tumors. Combined detection of their expression might be particularly helpful for surveillance of disease progression and treatment stratification.
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Affiliation(s)
- Rongkai Lin
- Urological Research Institute of PLA, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Wenhao Shen
- Urological Research Institute of PLA, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Yi Zhi
- Urological Research Institute of PLA, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Zhansong Zhou
- Urological Research Institute of PLA, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
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Houédé N, Pourquier P. Targeting the genetic alterations of the PI3K-AKT-mTOR pathway: its potential use in the treatment of bladder cancers. Pharmacol Ther 2014; 145:1-18. [PMID: 24929024 DOI: 10.1016/j.pharmthera.2014.06.004] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 06/06/2014] [Indexed: 02/07/2023]
Abstract
Urothelial carcinoma of the bladder is the most frequent tumor of the urinary tract and represents the fifth cause of death by cancer worldwide. The current first line chemotherapy is a combination of cisplatin and gemcitabine with median survival not exceeding 15months. Vinflunine is the only drug approved by EMEA as second-line treatment and few progresses have been made for the past 20years to increase the survival of metastatic patients, especially those who are not eligible for cisplatin-based regimen. The recent studies characterizing the genetic background of urothelial cancers of the bladder, revealed chromosomal alterations that are not seen at the same level in other types of cancers. This is especially the case for mutations of genes involved in the PI3K/AKT/mTOR signaling pathway that occupies a major place in the etiology of these tumors. Here, we describe the mutations leading to constitutive activation of the PI3K/AKT/mTOR pathway and discuss the potential use of the different classes of PI3K/AKT/mTOR inhibitors in the treatment of urothelial bladder cancers. Despite the recent pivotal study evidencing specific mutations of TSC1 in bladder cancer patients responding to everolimus and the encouraging results obtained with other derivatives than rapalogs, few clinical trials are ongoing in bladder cancers. Because of the genetic complexity of these tumors, the cross-talks of the PI3K/AKT/mTOR pathway with other pathways, and the small number of eligible patients, it will be of utmost importance to carefully choose the drugs or drug combinations to be further tested in the clinic.
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Affiliation(s)
- Nadine Houédé
- Service d'Oncologie Médicale, Centre Hospitalier Universitaire de Nîmes, France; INSERM U896, Institut de Recherche en Cancérologie de Montpellier & Université de Montpellier 1, France.
| | - Philippe Pourquier
- Service d'Oncologie Médicale, Centre Hospitalier Universitaire de Nîmes, France; INSERM U896, Institut de Recherche en Cancérologie de Montpellier & Université de Montpellier 1, France
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Monn MF, Cary KC, Kaimakliotis HZ, Flack CK, Koch MO. National trends in the utilization of robotic-assisted radical cystectomy: an analysis using the Nationwide Inpatient Sample. Urol Oncol 2014; 32:785-90. [PMID: 24863014 DOI: 10.1016/j.urolonc.2014.04.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 04/09/2014] [Accepted: 04/09/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To determine temporal and regional trends in utilization of robotic-assisted radical cystectomy (RARC) in the United States and to explore factors associated with utilization of robotic assistance. MATERIALS AND METHODS Using 2009 to 2011 data from the Nationwide Inpatient Sample, we identified radical cystectomy cases that were performed using either open or robotic assistance and applied Nationwide Inpatient Sample discharge weights to determine national incidence. Univariable and multivariable logistic regressions were performed to assess regional trends and characteristics associated with having RARC. Descriptive analysis was performed using the chi-square test, the Student t test, and the Mann-Whitney U test. RESULTS Of the 29,719 radical cystectomy patients, 3,733 were RARC (12.6%). Although there was no change in the proportion of RARC performed annually (P = 0.702). Length of stay was 1 day longer for open cystectomy than RARC (P<0.001). On multivariate regression, patients whose primary payer was Medicaid were less likely than private insurance patients to undergo RARC (odds ratio = 0.60, P = 0.074). Additionally, patients in the south were at 50% reduced odds of undergoing RARC (odds ratio = 0.49, P = 0.044). Median hospital costs were $5,000 greater for RARC (P<0.001). CONCLUSIONS Regional variation in utilization should be monitored to ensure equal access to new technology and to assess potential overuse of new technology. Although RARC is associated with higher median hospital costs, further studies to assess its benefits are warranted.
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Affiliation(s)
- M Francesca Monn
- Department of Urology, Indiana University School of Medicine, Indianapolis, IN.
| | - K Clint Cary
- Department of Urology, Indiana University School of Medicine, Indianapolis, IN
| | | | - Chandra K Flack
- Department of Urology, Indiana University School of Medicine, Indianapolis, IN
| | - Michael O Koch
- Department of Urology, Indiana University School of Medicine, Indianapolis, IN
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