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Ferrari C, Santo G, Ruta R, Lavelli V, Rubini D, Mammucci P, Sardaro A, Rubini G. Early Predictive Response to Multi-Tyrosine Kinase Inhibitors in Advanced Refractory Radioactive-Iodine Differentiated Thyroid Cancer: A New Challenge for [ 18F]FDG PET/CT. Diagnostics (Basel) 2021; 11:1417. [PMID: 34441351 DOI: 10.3390/diagnostics11081417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 06/18/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 11/22/2022] Open
Abstract
Differentiated thyroid cancer (DTC) represents the most common thyroid cancer histotype. Generally, it exhibits a good prognosis after conventional treatments; nevertheless, about 20% of patients can develop a local recurrence and/or distant metastasis. In one-third of advanced DTC, the metastatic lesions lose the ability to take up iodine and become radioactive iodine-refractory (RAI-R) DTC. In this set of patients, the possibility to perform localized treatments should always be taken into consideration before the initiation of systemic therapy. In the last decade, some multi-tyrosine kinase inhibitor (MKI) drugs were approved for advanced DTC, impacting on patient’s survival rate, but at the same time, these therapies have been associated with several adverse events. In this clinical context, the role of 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography ([18F]FDG PET/CT) in the early treatment response to these innovative therapies was investigated, in order to assess the potentiality of this diagnostic tool in the early recognition of non-responders, avoiding unnecessary therapy. Herein, we aimed to present a critical overview about the reliability of [18F]FDG PET/CT in the early predictive response to MKIs in advanced differentiated thyroid cancer.
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Saeed A, Hildebrand H, Park R, Al-Jumayli M, Abbasi S, Melancon T, Saeed A, Al-Rajabi R, Kasi A, Baranda J, Williamson S, Sun W. Immune Checkpoint Inhibitors versus VEGF Targeted Therapy as Second Line Regimen in Advanced Hepatocellular Carcinoma (HCC): A Retrospective Study. J Clin Med 2020; 9:E2682. [PMID: 32824968 PMCID: PMC7563439 DOI: 10.3390/jcm9092682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 07/28/2020] [Revised: 08/07/2020] [Accepted: 08/14/2020] [Indexed: 12/26/2022] Open
Abstract
Several targeted agents including multi-tyrosine kinase inhibitors (mTKIs) and immunotherapy (IO) agents have been approved for use beyond the frontline setting in patients with advanced hepatocellular carcinoma (HCC). Due to lack of prospective head-to-head comparative trials, there is no standardized way for alternating those agents beyond frontline. Therefore, we performed a retrospective review of the Kansas University (KU) cancer registry to determine whether IO may be superior to non-IO therapy. Patients with advanced HCC were divided into two groups based on the second-line systemic regimen received (IO vs. non-IO). Progression-free survival (PFS) and overall survival (OS) were calculated under the Kaplan-Meier and Cox proportional hazards models. No statistically significant differences in PFS and OS were found, although a non-significant delayed separation in the survival curve favoring IO was identified (median PFS 3.9 months vs. 3 months; median OS 10 months vs. 10 months respectively for IO vs. non-IO). This retrospective analysis is one of the earliest and largest studies comparing second-line IO and non-IO therapies thus far reported. Future studies should aim to define specific biomarkers for response prediction and treatment optimization based on individual patient and tumor characteristics. Furthermore, combinatorial therapeutic strategies is an evolving approach showing early promising signal.
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Affiliation(s)
- Anwaar Saeed
- Department of Medicine, Division of Medical Oncology, Gastrointestinal Oncology Program, Kansas University Cancer Center, Kansas City, KS 66205, USA; (H.H.); (S.A.); (T.M.); (R.A.-R.); (A.K.); (J.B.); (S.W.); (W.S.)
| | - Hannah Hildebrand
- Department of Medicine, Division of Medical Oncology, Gastrointestinal Oncology Program, Kansas University Cancer Center, Kansas City, KS 66205, USA; (H.H.); (S.A.); (T.M.); (R.A.-R.); (A.K.); (J.B.); (S.W.); (W.S.)
| | - Robin Park
- MetroWest Medical Center, Tufts University School of Medicine, Framingham, MA 02111, USA;
| | - Mohammed Al-Jumayli
- Department of Medicine, Division of Medical Oncology, University of South Florida, Moffitt Cancer Center, Tampa, FL 33620, USA;
| | - Saqib Abbasi
- Department of Medicine, Division of Medical Oncology, Gastrointestinal Oncology Program, Kansas University Cancer Center, Kansas City, KS 66205, USA; (H.H.); (S.A.); (T.M.); (R.A.-R.); (A.K.); (J.B.); (S.W.); (W.S.)
| | - Tina Melancon
- Department of Medicine, Division of Medical Oncology, Gastrointestinal Oncology Program, Kansas University Cancer Center, Kansas City, KS 66205, USA; (H.H.); (S.A.); (T.M.); (R.A.-R.); (A.K.); (J.B.); (S.W.); (W.S.)
| | - Azhar Saeed
- Department of Pathology and Laboratory Medicine, Kansas University Medical Center, Kansas City, KS 66160, USA;
| | - Raed Al-Rajabi
- Department of Medicine, Division of Medical Oncology, Gastrointestinal Oncology Program, Kansas University Cancer Center, Kansas City, KS 66205, USA; (H.H.); (S.A.); (T.M.); (R.A.-R.); (A.K.); (J.B.); (S.W.); (W.S.)
| | - Anup Kasi
- Department of Medicine, Division of Medical Oncology, Gastrointestinal Oncology Program, Kansas University Cancer Center, Kansas City, KS 66205, USA; (H.H.); (S.A.); (T.M.); (R.A.-R.); (A.K.); (J.B.); (S.W.); (W.S.)
| | - Joaquina Baranda
- Department of Medicine, Division of Medical Oncology, Gastrointestinal Oncology Program, Kansas University Cancer Center, Kansas City, KS 66205, USA; (H.H.); (S.A.); (T.M.); (R.A.-R.); (A.K.); (J.B.); (S.W.); (W.S.)
| | - Stephen Williamson
- Department of Medicine, Division of Medical Oncology, Gastrointestinal Oncology Program, Kansas University Cancer Center, Kansas City, KS 66205, USA; (H.H.); (S.A.); (T.M.); (R.A.-R.); (A.K.); (J.B.); (S.W.); (W.S.)
| | - Weijing Sun
- Department of Medicine, Division of Medical Oncology, Gastrointestinal Oncology Program, Kansas University Cancer Center, Kansas City, KS 66205, USA; (H.H.); (S.A.); (T.M.); (R.A.-R.); (A.K.); (J.B.); (S.W.); (W.S.)
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Bexelius TS, Wasti A, Chisholm JC. Mini-Review on Targeted Treatment of Desmoplastic Small Round Cell Tumor. Front Oncol 2020; 10:518. [PMID: 32373525 PMCID: PMC7186354 DOI: 10.3389/fonc.2020.00518] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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] [Received: 12/04/2019] [Accepted: 03/23/2020] [Indexed: 12/14/2022] Open
Abstract
Desmoplastic small round cell tumor (DSRCT) is a devastating disease which most commonly affects adolescents, with a male predominance. Despite the best multimodality treatment efforts, most patients will ultimately not survive more than 3-5 years after diagnosis. Some research trials in soft-tissue sarcoma and Ewing sarcoma include DSRCT patients but few studies have been tailored to the specific clinical needs and underlying cytogenetic abnormalities characterizing this disease such as the typical EWSR1-WT1 gene fusion. Downstream activation of EWSR1-WT1 gene fusion includes signaling pathways of platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), and insulin growth factor (IGF)-1. Other biological pathways that are activated and expressed in DSRCT cells include endothelial growth factor receptor (EGFR), androgen receptor pathway, c-KIT, MET, and transforming growth factor (TGF) beta. Investigation of somatic mutations, copy number alterations (CNA), and chromosomes in DSRCT samples suggests that deregulation of mesenchymal-epithelial reverse transition (MErT)/epithelial-mesenchymal transition (EMT) and DNA damage repair (DDR) may be important in DSRCT. This mini review looks at known druggable targets in DSRCT and existing clinical evidence for targeted treatments, particularly multityrosine kinase inhibitors such as pazopanib, imatinib, and sorafenib alone or in combination with other agents such as mTOR (mammalian target of rapamycin) inhibitors. The aim is to increase shared knowledge about current available treatments and identify gaps in research to further efforts toward clinical development of targeted agents.
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Affiliation(s)
- Tomas S. Bexelius
- Children and Young People's Unit, Royal Marsden Hospital NHS Foundation Trust, Sutton, United Kingdom
- Department of Women and Children Health at Karolinska Institutet, Stockholm, Sweden
| | - Ajla Wasti
- Department of Pediatric Oncology, Seattle Children's Hospital, Seattle, WA, United States
- Department of Pediatrics, University of Washington, Seattle, WA, United States
| | - Julia C. Chisholm
- Children and Young People's Unit, Royal Marsden Hospital NHS Foundation Trust, Sutton, United Kingdom
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
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Cirello V, Vaira V, Grassi ES, Vezzoli V, Ricca D, Colombo C, Bosari S, Vicentini L, Persani L, Ferrero S, Fugazzola L. Multicellular spheroids from normal and neoplastic thyroid tissues as a suitable model to test the effects of multikinase inhibitors. Oncotarget 2018; 8:9752-9766. [PMID: 28039458 PMCID: PMC5354768 DOI: 10.18632/oncotarget.14187] [Citation(s) in RCA: 11] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 11/22/2016] [Indexed: 12/12/2022] Open
Abstract
Multicellular three-dimensional (3D) spheroids represent an experimental model that is intermediate in its complexity between monolayer cultures and patients’ tumor. In the present study, we characterize multicellular spheroids from papillary (PTC) and follicular (FTC) thyroid cancers and from the corresponding normal tissues. We show that these 3D structures well recapitulate the features of the original tissues, in either the differentiated and “stem-like” components. As a second step, we were aimed to test the effects of a small multikinase inhibitor, SP600125 (SP), previously shown to efficiently induce cell death in undifferentiated thyroid cancer monolayer cultures. We demonstrate the potent effect of SP on cell growth and survival in our 3D multicellular cultures. SP exerts its main effects through direct and highly significant inhibition of the ROCK pathway, known to be involved in the regulation of cell migration and β-catenin turnover. Consistently, SP treatment resulted in a significant decrease in β-catenin levels with respect to basal conditions in tumor but not in normal spheroids, indicating that the effect is promisingly selective on tumor cells. In conclusion, we provide the morphological and molecular characterization of thyroid normal and tumor spheroids. In this 3D model we tested in vitro the effects of the multikinase inhibitor SP and further characterized its mechanism of action in both normal and tumor spheroids, thus making it an ideal candidate for developing new drugs against thyroid cancer.
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Affiliation(s)
- Valentina Cirello
- Endocrine Unit, Fondazione IRCCS Ca' Granda, 20122 Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Valentina Vaira
- Division of Pathology, Fondazione IRCCS Ca' Granda, 20122 Milan, Italy
| | - Elisa Stellaria Grassi
- Laboratory of Endocrine and Metabolic Research, Istituto Auxologico Italiano IRCCS, 20149 Milan, Italy
| | - Valeria Vezzoli
- Laboratory of Endocrine and Metabolic Research, Istituto Auxologico Italiano IRCCS, 20149 Milan, Italy
| | - Dario Ricca
- Division of Pathology, Fondazione IRCCS Ca' Granda, 20122 Milan, Italy
| | - Carla Colombo
- Endocrine Unit, Fondazione IRCCS Ca' Granda, 20122 Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Silvano Bosari
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy.,Division of Pathology, Fondazione IRCCS Ca' Granda, 20122 Milan, Italy
| | | | - Luca Persani
- Laboratory of Endocrine and Metabolic Research, Istituto Auxologico Italiano IRCCS, 20149 Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Stefano Ferrero
- Division of Pathology, Fondazione IRCCS Ca' Granda, 20122 Milan, Italy.,Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
| | - Laura Fugazzola
- Endocrine Unit, Fondazione IRCCS Ca' Granda, 20122 Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
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