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Harrison DJ, Qumseya A, Xue W, Arnold M, Lautz TB, Hiniker SM, Thomas SM, Venkatramani R, Weiss AR, Mascarenhas L. Adolescents and young adults with rhabdomyosarcoma: A report from the Soft Tissue Sarcoma Committee of the Children's Oncology Group. Pediatr Blood Cancer 2024; 71:e30847. [PMID: 38282125 DOI: 10.1002/pbc.30847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 12/02/2023] [Accepted: 12/21/2023] [Indexed: 01/30/2024]
Abstract
INTRODUCTION The impact of established prognostic factors on survival outcomes for childhood rhabdomyosarcoma (RMS) have not been well described in the adolescent and young adult (AYA) RMS patient population. METHODS This is a retrospective analysis of patients with newly diagnosed RMS enrolled between 1997 and 2016 on seven previously reported Children's Oncology Group (COG) clinical trials. Demographics, clinical features, treatment details, and outcome data were collected. Five-year event-free survival (EFS) and overall survival (OS) were estimated for patients diagnosed at age 15-39 years and those diagnosed under age 15 years using the Kaplan-Meier method. Log-rank test was used to compare prognostic factors for EFS and OS. Factors significant in the univariable analysis were included in a Cox proportional hazards regression model. Nonsignificant covariates were removed from the multiple regression model. RESULTS Total 2151 patients including 402 AYAs were analyzed. AYAs were more likely to present with primary tumors ≥5 cm in size, metastatic disease, alveolar histology, and have FOXO1 fusions compared to children. Five-year EFS for the AYA cohort was 44.2% versus 67% for children (p < .001), and 5-year OS was 52% for the AYA cohort versus 78% for children (p < .001). Multivariable analysis revealed tumor site, size and invasiveness, clinical group, and histology were prognostic in AYAs. CONCLUSION AYAs with RMS have a poorer prognosis compared to younger children due to multiple factors. Further research focused on AYAs to better understand RMS biology and improve treatments is critical to improve survival.
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Affiliation(s)
| | | | - Wei Xue
- University of Florida, Gainesville, Florida, USA
| | - Michael Arnold
- Children's Hospital Colorado, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Timothy B Lautz
- Ann & Robert H Lurie Children's Hospital of Chicago, Northwestern University, Chicago, Illinois, USA
| | | | | | - Rajkumar Venkatramani
- Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center, Houston, Texas, USA
| | | | - Leo Mascarenhas
- Children's Hospital Los Angeles and University of Southern California Keck School of Medicine, Los Angeles, California, USA
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2
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Mohanty SK, Diwaker P, Mishra SK, Jha S, Lobo A, Panda SP, Sharma S, Kumar M, Arora S, Mallik V, Jain D, Jain E, Chakrabarti I, Varshney J, Beg A, Dixit M, Baisakh MR, Naik S, Sahoo SK, Akgul M, Balzer BL, Amin MB, Parwani AV. Diagnostic Utility of GATA3 and ISL1 in Differentiating Neuroblastoma From Other Pediatric Malignant Small Round Blue Cell Tumors. Int J Surg Pathol 2024; 32:294-303. [PMID: 37312579 DOI: 10.1177/10668969231177700] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Accurate diagnosis of neuroblastoma may be challenging, especially with limited or inadequate specimen and at the metastatic sites due to overlapping imaging, histopathologic, and immunohistochemical (immunohistochemistry [IHC]; infidelity among various lineage-associated transcription factors eg FLI1, transducin-like enhancer 1, etc) features. GATA3 and ISL1 have recently been described as markers of neuroblastic differentiation. This study aims at determining the diagnostic utility of GATA3 and ISL1 in differentiating neuroblastoma from other pediatric malignant small round blue cell tumors. We evaluated GATA3 and ISL1 expression in 74 pediatric small round blue cell tumors that included 23 NMYC-amplified neuroblastomas, 11 EWSR1-rearranged round cell sarcomas, 7 SYT::SSX1-rearranged synovial sarcomas, 5 embryonal rhabdomyosarcomas, 10 Wilms tumors (nephroblastomas), 7 lymphoblastic lymphoma, 7 medulloblastoma, and 4 desmoplastic small round cell tumor. All 23 neuroblastomas (moderate to strong staining in >50% of the tumor cells), 5 T-lymphoblastic lymphomas (moderate to strong staining in 40%-90% of the tumor cells), and 2 desmoplastic small round cell tumors (weak to moderate staining in 20%-30% of the tumor cells) expressed GATA3, while other tumors were negative. ISL1 immunoreactivity was observed in 22 (96%) neuroblastomas (strong staining in in >50% of the tumor cells, n = 17; moderate to strong staining in 26%-50% of the tumor cells, n = 5), 3 embryonal rhabdomyosarcoma (moderate to strong staining in 30%-85% of the tumor cells), 1 synovial sarcoma (weak staining in 20% of the tumor cells), and 7 medulloblastoma (strong staining in 60%-90% of the tumor cells). Other tumors were negative. Overall, GATA3 showed 86% specificity, 100% sensitivity, and 90% accuracy for neuroblastoma, with a positive predictive value (PPV) and negative predictive value (NPV) of 77% and 100%, respectively. ISLI showed 72% specificity, 96% sensitivity, and 81% accuracy for neuroblastoma, with a PPV and NPV of 67% and 97%, respectively. After the exclusion of T-lymphoblastic lymphoma and desmoplastic small round cell tumors, GATA3 had 100% specificity, sensitivity, accuracy, and PPV and NPV for neuroblastoma. Similarly, in pediatric small round blue cell tumors, ISL1 had 100% specificity, sensitivity, accuracy, PPV, and NPV for neuroblastoma, after embryonal rhabdomyosarcoma, synovial sarcoma, and medulloblastoma were excluded. CONCLUSIONS GATA3 and ISL1 may be valuable in the diagnostic work-up of neuroblastoma and may reliably be used to support the neuroblastic lineage of pediatric small round blue cell tumors. Furthermore, dual positivity helps in challenging scenarios, when there is equivocal imaging, overlapping IHC features, limited specimen, and the lack of facility for a molecular work up.
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Affiliation(s)
- Sambit K Mohanty
- Department of Pathology and Laboratory Medicine, Advanced Medical Research Institute, Bhubaneswar, Odisha, India
- Department of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, Delhi, India
| | - Preeti Diwaker
- Department of Pathology, University College of Medical Sciences, Delhi, India
| | - Sourav K Mishra
- Department of Medical Oncology, Advanced Medical Research Institute, Bhubaneswar, Odisha, India
| | - Shilpy Jha
- Department of Pathology and Laboratory Medicine, Advanced Medical Research Institute, Bhubaneswar, Odisha, India
| | - Anandi Lobo
- Department of Pathology and Laboratory Medicine, Advanced Medical Research Institute, Bhubaneswar, Odisha, India
| | - Saroj P Panda
- Department of Pediatric Oncology, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, Odisha, India
| | - Shivani Sharma
- Department of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, Delhi, India
| | - Mohit Kumar
- Department of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, Delhi, India
| | - Samriti Arora
- Department of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, Delhi, India
| | - Vipra Mallik
- Department of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, Delhi, India
| | - Deepika Jain
- Department of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, Delhi, India
| | - Ekta Jain
- Department of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, Delhi, India
| | | | - Juhi Varshney
- Department of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, Delhi, India
| | - Arshi Beg
- Department of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, Delhi, India
| | - Mallika Dixit
- Department of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, Delhi, India
| | - Manas R Baisakh
- Department of Pathology, Prolife Diagnostics, Bhubaneswar, Odisha, India
| | - Subhasini Naik
- Department of Pathology, Prolife Diagnostics, Bhubaneswar, Odisha, India
| | - Subrat K Sahoo
- Department of Pediatric Surgery, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, Odisha, India
| | - Mahmut Akgul
- Department of Pathology, Albany Medical Center, Albany, NY, USA
| | - Bonnie L Balzer
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Mahul B Amin
- Department of Pathology and Laboratory, University of Southern California Keck School, Los Angeles, CA, USA
| | - Anil V Parwani
- Department of Pathology and Laboratory, Wexner Medical Center, Pathology, Columbus, OH, USA
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3
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Timothy LD, Healy CM, Quintanilla NM, Montgomery N, Okcu MF. Nocardiosis in an infant with spindle cell rhabdomyosarcoma treated with mild immunosuppressive chemotherapy. Pediatr Blood Cancer 2024; 71:e30873. [PMID: 38259045 DOI: 10.1002/pbc.30873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 01/02/2024] [Accepted: 01/03/2024] [Indexed: 01/24/2024]
Affiliation(s)
- Leander D Timothy
- Cancer and Hematology Center, Texas Children's Hospital, Houston, Texas, USA
| | - C Mary Healy
- Department of Infectious Diseases, Texas Children's Hospital, Houston, Texas, USA
| | - Norma M Quintanilla
- Department of Pathology and Immunology, Texas Children's Hospital, Houston, Texas, USA
| | - Nicole Montgomery
- Department of Orthopedics, Texas Children's Hospital, Houston, Texas, USA
| | - M Fatih Okcu
- Cancer and Hematology Center, Texas Children's Hospital, Houston, Texas, USA
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4
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Zou J, Luo P, Chen T, Qian B. Embryonal rhabdomyosarcoma of the testis in a young male. Asian J Surg 2024; 47:1328-1329. [PMID: 38049349 DOI: 10.1016/j.asjsur.2023.11.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 11/17/2023] [Indexed: 12/06/2023] Open
Affiliation(s)
- Jun Zou
- The First Clinical Medical School of Gannan Medical University, Ganzhou, Jiangxi, China; Key Laboratory of Urology and Andrology of Ganzhou, Ganzhou, Jiangxi, China
| | - Peiyue Luo
- The First Clinical Medical School of Gannan Medical University, Ganzhou, Jiangxi, China; Key Laboratory of Urology and Andrology of Ganzhou, Ganzhou, Jiangxi, China
| | - Tao Chen
- The First Clinical Medical School of Gannan Medical University, Ganzhou, Jiangxi, China; Key Laboratory of Urology and Andrology of Ganzhou, Ganzhou, Jiangxi, China
| | - Biao Qian
- Department of Urology, The First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China; Key Laboratory of Urology and Andrology of Ganzhou, Ganzhou, Jiangxi, China.
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5
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Yoshida KI, Kukita Y, Nakamura H, Wakamatsu T, Honma K, Yagi T. A case of spindle cell rhabdomyosarcoma with a ZFP64::NCOA3 fusion. Genes Chromosomes Cancer 2024; 63:e23212. [PMID: 37905771 DOI: 10.1002/gcc.23212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 10/22/2023] [Indexed: 11/02/2023] Open
Affiliation(s)
- Ken-Ichi Yoshida
- Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Osaka, Japan
| | - Yoji Kukita
- Laboratory of Genomic Pathology, Osaka International Cancer Institute, Osaka, Japan
| | - Harumi Nakamura
- Laboratory of Genomic Pathology, Osaka International Cancer Institute, Osaka, Japan
| | - Toru Wakamatsu
- Department of Orthopedic Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Keiichiro Honma
- Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Osaka, Japan
| | - Toshinari Yagi
- Department of Outpatient Chemotherapy, Osaka International Cancer Institute, Osaka, Japan
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6
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Arceo-Olaiz R, Smith EA, Stokes C, Eaton BR, Garcia-Roig M. Use of Perirectal Hyaluronic Acid Spacer Prior to Radiotherapy in a Pediatric Patient With Bladder Rhabdomyosarcoma: A Case Report. Urology 2023; 181:136-140. [PMID: 37453583 DOI: 10.1016/j.urology.2023.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 06/14/2023] [Accepted: 06/19/2023] [Indexed: 07/18/2023]
Abstract
Rhabdomyosarcoma (RMS) treatment involves surgery, chemotherapy, and radiotherapy. A radioprotective space between the bladder/prostate and rectum reduces postradiation complications, as reported in adult patients. Describe pediatric preradiotherapy perirectal hyaluronic acid (HA) spacer injection for bladder/prostate RMS. We present a case of a 17-month-old male with bladder/prostate RMS. Before radiotherapy, an HA spacer was injected peri-rectally. Under general anesthesia, a transrectal ultrasound was positioned and 1mL of HA spacer was injected into the perirectal space. No complications were reported at 6-month follow-up. This is the first report of pre-radiation therapy spacer injection for pediatric bladder/prostate RMS.
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Affiliation(s)
- Ricardo Arceo-Olaiz
- Pediatric Urology Department, Emory University School of Medicine, Sandy Springs, GA; Pediatric Urology Department, Children's Healthcare of Atlanta, Atlanta, GA
| | - Edwin A Smith
- Pediatric Urology Department, Emory University School of Medicine, Sandy Springs, GA; Pediatric Urology Department, Children's Healthcare of Atlanta, Atlanta, GA
| | - Claire Stokes
- Hematology/Oncology Department, Emory University School of Medicine, Sandy Springs, GA; Hematology/Oncology Department, Children's Healthcare of Atlanta, Atlanta, GA
| | - Bree R Eaton
- Radiation Oncology Department, Emory University School of Medicine, Sandy Springs, GA
| | - Michael Garcia-Roig
- Pediatric Urology Department, Emory University School of Medicine, Sandy Springs, GA; Pediatric Urology Department, Children's Healthcare of Atlanta, Atlanta, GA.
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7
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Zhu S, Gong C, Zheng Y, Huang J. A case of primary embryonal rhabdomyosarcoma of the right breast in a 17-year-old girl. Asian J Surg 2023; 46:4977-4978. [PMID: 37704478 DOI: 10.1016/j.asjsur.2023.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 06/07/2023] [Indexed: 09/15/2023] Open
Affiliation(s)
- Shuo Zhu
- Guizhou Medical University, Department of Clinical Medicine, University Town, Gui'an New District, Guizhou Province, China.
| | - Chulan Gong
- The Affiliated Hospital of Guizhou Medical University, No. 28, Guiyi Street, Guiyang City, Guizhou Province, China.
| | - Yu Zheng
- The Affiliated Hospital of Guizhou Medical University, No. 28, Guiyi Street, Guiyang City, Guizhou Province, China.
| | - Jianjun Huang
- The Affiliated Hospital of Guizhou Medical University, No. 28, Guiyi Street, Guiyang City, Guizhou Province, China.
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8
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Haug L, Doll J, Appenzeller S, Kunzmann V, Rosenwald A, Maurus K, Gerhard-Hartmann E. Epithelioid and spindle cell rhabdomyosarcoma with EWSR1::TFCP2 fusion mimicking metastatic lung cancer: A case report and literature review. Pathol Res Pract 2023; 249:154779. [PMID: 37633005 DOI: 10.1016/j.prp.2023.154779] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 08/20/2023] [Accepted: 08/20/2023] [Indexed: 08/28/2023]
Abstract
Rhabdomyosarcoma (RMS) with EWSR1/FUS::TFCP2 fusion is an emerging, molecularly defined, rare subtype of RMS. It can affect patients in a wide age range and follows an aggressive clinical course according to the reported cases. Due to its unusual clinical and pathohistological features, with a typical intraosseous presentation and common cytokeratin expression, the diagnosis is challenging, and metastatic undifferentiated/sarcomatoid carcinoma can be an important differential diagnosis. We report here a case of a 55-year-old woman with an RMS with EWSR1::TFCP2 fusion mimicking metastatic lung cancer in view of the clinical and microscopic presentation. However, further molecular workup, including RNA sequencing, led to the proper diagnosis. Although these tumors are rare, knowledge of their unique features is essential for correct diagnosis as a basis for clinical management and optimization of therapeutic approaches.
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Affiliation(s)
- Lukas Haug
- Institute of Pathology, University of Würzburg, Würzburg, Germany; Comprehensive Cancer Center Mainfranken, University Hospital of Würzburg, Würzburg, Germany
| | - Julia Doll
- Institute of Pathology, University of Würzburg, Würzburg, Germany; Comprehensive Cancer Center Mainfranken, University Hospital of Würzburg, Würzburg, Germany
| | - Silke Appenzeller
- Comprehensive Cancer Center Mainfranken, University Hospital of Würzburg, Würzburg, Germany
| | - Volker Kunzmann
- Comprehensive Cancer Center Mainfranken, University Hospital of Würzburg, Würzburg, Germany; Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
| | - Andreas Rosenwald
- Institute of Pathology, University of Würzburg, Würzburg, Germany; Comprehensive Cancer Center Mainfranken, University Hospital of Würzburg, Würzburg, Germany
| | - Katja Maurus
- Institute of Pathology, University of Würzburg, Würzburg, Germany; Comprehensive Cancer Center Mainfranken, University Hospital of Würzburg, Würzburg, Germany
| | - Elena Gerhard-Hartmann
- Institute of Pathology, University of Würzburg, Würzburg, Germany; Comprehensive Cancer Center Mainfranken, University Hospital of Würzburg, Würzburg, Germany.
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9
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Hol MLF, Indelicato DJ, Slater O, Kolb F, Hewitt RJ, Ong J, Becking AG, Gains J, Bradley J, Sandler E, Gaze MN, Pieters B, Mandeville H, Fajardo RD, Schoot R, Merks JHM, Hammond P, Smeele LE, Suttie M. Facial deformation following treatment for pediatric head and neck rhabdomyosarcoma; the difference between treatment modalities. Results of a trans-Atlantic, multicenter cross-sectional cohort study. Pediatr Blood Cancer 2023; 70:e30412. [PMID: 37249325 DOI: 10.1002/pbc.30412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/12/2023] [Accepted: 04/24/2023] [Indexed: 05/31/2023]
Abstract
BACKGROUND The four different local therapy strategies used for head and neck rhabdomyosarcoma (HNRMS) include proton therapy (PT), photon therapy (RT), surgery with radiotherapy (Paris-method), and surgery with brachytherapy (AMORE). Local control and survival is comparable; however, the impact of these different treatments on facial deformation is still poorly understood. This study aims to quantify facial deformation and investigates the differences in facial deformation between treatment modalities. METHODS Across four European and North American institutions, HNRMS survivors treated between 1990 and 2017, more than 2 years post treatment, had a 3D photograph taken. Using dense surface modeling, we computed facial signatures for each survivor to show facial deformation relative to 35 age-sex-ethnicity-matched controls. Additionally, we computed individual facial asymmetry. FINDINGS A total of 173 HNRMS survivors were included, survivors showed significantly reduced facial growth (p < .001) compared to healthy controls. Partitioned by tumor site, there was reduced facial growth in survivors with nonparameningeal primaries (p = .002), and parameningeal primaries (p ≤.001), but not for orbital primaries (p = .080) All patients were significantly more asymmetric than healthy controls, independent of treatment modality (p ≤ .001). There was significantly more facial deformation in orbital patients when comparing RT to AMORE (p = .046). In survivors with a parameningeal tumor, there was significantly less facial deformation in PT when compared to RT (p = .009) and Paris-method (p = .007). INTERPRETATION When selecting optimal treatment, musculoskeletal facial outcomes are an expected difference between treatment options. These anticipated differences are currently based on clinicians' bias, expertise, and experience. These data supplement clinician judgment with an objective analysis highlighting the impact of patient age and tumor site between existing treatment options.
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Affiliation(s)
- Marinka L F Hol
- Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Otorhinolaryngology, University of Utrecht, Utrecht, The Netherlands
- Department of Maxillofacial Surgery, Amsterdam UMC, Duivendrecht, The Netherlands
| | - Daniel J Indelicato
- Department of Radiation Oncology, University of Florida Proton Therapy Institute, Jacksonville, Florida, USA
| | - Olga Slater
- Department of Pediatric Oncology, Great Ormond Street Hospital, NHS Foundation Trust, London, UK
| | - Frederic Kolb
- Department of Plastic Surgery, Institute Gustave Roussy, Paris, France
| | - Richard J Hewitt
- Department of Head & Neck and Tracheal Surgery Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Juling Ong
- Department of Craniofacial, Plastic and Reconstructive Surgery, Chelsea and Westminster NHS Hospital Foundation Trust, London, UK
| | - Alfred G Becking
- Department of Maxillofacial Surgery, Amsterdam UMC, Duivendrecht, The Netherlands
| | - Jenny Gains
- Department of Radiation Oncology, NHS Trust, London, UK
| | - Julie Bradley
- Department of Radiation Oncology, University of Florida Proton Therapy Institute, Jacksonville, Florida, USA
| | - Eric Sandler
- Division of Pediatric Oncology, Nemours Children's Specialty Clinic, Jacksonville, Florida, USA
| | - Mark N Gaze
- Department of Radiation Oncology, NHS Trust, London, UK
| | - Bradley Pieters
- Department or Radiation Oncology, Amsterdam UMC, Duivendrecht, The Netherlands
| | - Henry Mandeville
- Department of Radiotherapy, The Royal Marsden NHS Foundation Trust, and Institute of Cancer Research, Sutton, UK
| | | | - Reineke Schoot
- Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | | | | | - Ludwig E Smeele
- Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Maxillofacial Surgery, Amsterdam UMC, Duivendrecht, The Netherlands
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Feng S, Yang Y, Yu Z, Xiong Q, Bi Y. Survival and Analysis of Prognostic Factors for Bladder Malignancies in Children and Adolescents: A Population-based Study. Urology 2023; 177:156-161. [PMID: 37085053 DOI: 10.1016/j.urology.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 04/04/2023] [Accepted: 04/10/2023] [Indexed: 04/23/2023]
Abstract
OBJECTIVE To explore the clinicopathological features and prognosis of pediatric patients with malignant bladder tumors in a population-based cohort. METHODS The database Surveillance, Epidemiology, and End Results was used to evaluate all pediatric patients diagnosed with malignant bladder tumors between 1975 and 2018. The log-rank test was used to compare survival curves. Kaplan-Meier estimations were used to create survival curves based on various parameters. The Cox proportional hazards model was utilized to determine the factors that were independently related to mortality. RESULTS A total of 263 children and adolescents with bladder malignancies were assessed. Papillary urothelial neoplasms of low malignant potential were the most frequent histologic subtype (35.1%), while embryonal rhabdomyosarcoma was more common during the first decade of life. Survival rates varied significantly by age at diagnosis, with older patients showing better outcomes. When compared to other subtypes, papillary urothelial neoplasms of low malignant potential had the highest overall survival rates (3- and 5-year were 99.2% and 98.3%, respectively). Multivariate analysis of the entire cohort showed that Surveillance, Epidemiology, and End Results stage and surgery were significant independent predictors of progression to disease-specific death in this model. CONCLUSION Bladder malignancies are rare in children and adolescents. The prognosis for them varies. The localized stage was independently associated with superior survival and surgery could extend survival time.
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Affiliation(s)
- Shaoguang Feng
- Department of Urology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China; Department of Pediatric Surgery, Hangzhou Children's Hospital, Hangzhou, Zhejiang, China
| | - Yicheng Yang
- Department of Urology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Zhechen Yu
- Department of Urology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Qianwei Xiong
- Department of Urology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Yunli Bi
- Department of Urology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China.
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11
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Vasquez JC, Luo LY, Hiniker SM, Rhee DS, Dasgupta R, Chen S, Weigel BJ, Xue W, Venkatramani R, Arndt CA. Rhabdomyosarcoma with isolated lung metastases: A report from the Soft Tissue Sarcoma Committee of the Children's Oncology Group. Pediatr Blood Cancer 2023; 70:e30293. [PMID: 36916768 PMCID: PMC10424503 DOI: 10.1002/pbc.30293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 01/30/2023] [Accepted: 02/20/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND To determine outcomes of children with rhabdomyosarcoma (RMS) with isolated lung metastases. METHODS Data were analyzed for 428 patients with metastatic RMS treated on COG protocols. Categorical variables were compared using Chi-square or Fisher's exact tests. Event-free survival (EFS) and overall survival (OS) were estimated using Kaplan-Meier method and compared using the log-rank test. RESULTS Compared with patients with other metastatic sites (n = 373), patients with lung-only metastases (n = 55) were more likely to be <10 years of age, have embryonal histology (embryonal rhabdomyosarcoma), have N0 disease, and less likely to have primary extremity tumors. Lung-only patients had significantly better survival outcomes than patients with all other sites of metastatic disease (p < .0001) with 5-year EFS of 48.1 versus 18.8% and 5-year OS of 64.1 versus 26.9%. Patients with lung-only metastases, and those with a single extrapulmonary site of metastasis, had better survival compared with patients with two or more sites of metastatic disease (p < .0001). In patients with ERMS and lung-only metastases, there was no significant difference in survival between patients ≥10 years and 1-9 years (5-year EFS: 58.3 vs. 68.2%, 5-year OS: 66.7 vs. 67.7%). CONCLUSIONS With aggressive treatment, patients with ERMS and lung-only metastatic disease have superior EFS and OS compared with patients with other sites of metastatic disease, even when older than 10 years of age. Consideration should be given to including patients ≥10 years with ERMS and lung-only metastases in the same group as those <10 years in future risk stratification algorithms.
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Affiliation(s)
- Juan C. Vasquez
- Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA
| | - Leo Y. Luo
- Department of Radiation Oncology, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Susan M. Hiniker
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA, USA
| | - Daniel S. Rhee
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Roshni Dasgupta
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Sonja Chen
- Department of Pathology and Laboratory Medicine, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Brenda J. Weigel
- Division of Pediatric Hematology/Oncology, University of Minnesota, Minneapolis, MN, USA
| | - Wei Xue
- Department of Biostatistics, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
| | - Rajkumar Venkatramani
- Department of Pediatrics, Baylor College of Medicine, Texas Children’s Cancer Center, Houston, TX, USA
| | - Carola A. Arndt
- Department of Pediatric and Adolescent Medicine, Mayo Clinic and Foundation, Rochester, MN, USA
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12
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Dehner CA, Geiersbach K, Rowsey R, Murugan P, Broski SM, Meis JM, Rosenberg AE, Folpe AL. Rhabdomyosarcoma Arising in Inflammatory Rhabdomyoblastic Tumor: A Genetically Distinctive Subtype of Rhabdomyosarcoma. Mod Pathol 2023; 36:100131. [PMID: 36966552 DOI: 10.1016/j.modpat.2023.100131] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 01/09/2023] [Revised: 01/30/2023] [Accepted: 02/05/2023] [Indexed: 03/03/2023]
Abstract
"Inflammatory rhabdomyoblastic tumor" (IRMT) is a recently coined name for a distinctive soft tissue neoplasm characterized by slow growth, a dense histiocytic infiltrate, scattered, bizarre-appearing tumor cells with morphologic and immunohistochemical evidence of skeletal muscle differentiation, a near-haploid karyotype with retained biparental disomy of chromosomes 5 and 22, and usually indolent behavior. There are 2 reports of rhabdomyosarcoma (RMS) arising in IRMT. We studied the clinicopathologic and cytogenomic features of 6 cases of IRMT with progression to RMS. Tumors occurred in the extremities of 5 men and 1 woman (median patient age, 50 years; median tumor size, 6.5 cm). Clinical follow-up (6 patients: median, 11 months; range 4-163 months) documented local recurrence and distant metastases in 1 and 5 of 6 patients, respectively. Therapy included complete surgical resection (4 patients) and adjuvant/neoadjuvant chemo/radiotherapy (6 patients). One patient died of disease, 4 were alive with metastatic disease, and one was without evidence of disease. All primary tumors contained conventional IRMT. Progression to RMS appeared as follows: (1) overgrowth of monomorphic rhabdomyoblasts with diminished histiocytes, (2) monomorphic spindle cell morphology with variably pleomorphic rhabdomyoblasts and low mitotic activity, or (3) morphologically undifferentiated spindle cell and epithelioid sarcoma. All but one were diffusely desmin-positive, with more limited MyoD1/myogenin expression. All RMS arising in IRMT, either primary or metastatic, demonstrated widespread loss of heterozygosity with retained heterozygosity of chromosomes 5 and 20, and all but one displayed additional gains and losses involving loci containing oncogenes/ tumor suppressor genes, most often CDKN2A and CDKN2B. RMS arising in IRMT have unique clinicopathologic and cytogenomic features, warranting classification as a distinct, potentially aggressive RMS subtype. It should be distinguished from other RMSs, particularly fusion-driven spindle cell RMS and pleomorphic RMS.
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Affiliation(s)
- Carina A Dehner
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Katherine Geiersbach
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Ross Rowsey
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Paari Murugan
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota
| | | | - Jeanne M Meis
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Andrew E Rosenberg
- Department of Pathology, Miller School of Medicine, University of Miami, Miami Florida
| | - Andrew L Folpe
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota.
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13
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Allen‐Rhoades W, Lupo PJ, Scheurer ME, Chi Y, Kuttesch JF, Venkatramani R, Meyer WH, Mascarenhas L. Alveolar rhabdomyosarcoma has superior response rates to vinorelbine compared to embryonal rhabdomyosarcoma in patients with relapsed/refractory disease: A meta-analysis. Cancer Med 2023; 12:10222-10229. [PMID: 37016270 PMCID: PMC10225185 DOI: 10.1002/cam4.5749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 01/19/2023] [Accepted: 02/16/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Patients with alveolar rhabdomyosarcoma (ARMS) have inferior outcomes compared to patients with embryonal rhabdomyosarcoma (ERMS) and more effective chemotherapy options are needed for these patients. Vinorelbine is a semisynthetic vinca alkaloid that has clinical activity in relapsed rhabdomyosarcoma (RMS) when used alone or in combination with cyclophosphamide. AIMS The goal of our study was to evaluate whether RMS histology subtype influences response rate to vinorelbine alone or in combination. MATERIALS & METHODS Five Phase 2 trials that enrolled RMS patients were included in the meta-analysis. Two studies evaluated vinorelbine alone, two studies evaluated vinorelbine in combination with low dose oral cyclophosphamide, and one study evaluated vinorelbine and intravenous cyclophosphamide in combination with temsirolimus or bevacizumab. All RMS patients had relapsed or refractory disease and had received at least one prior therapy. Response was reported according to RECIST1.1 and was defined as a complete or partial response. Response data was obtained from published results or from trial principal investigator. RMS NOS patients were grouped with ERMS patients for this analysis. Summary estimates comparing differences between ARMS and ERMS response rates were generated using a random-effects model to account for heterogeneity among the studies. RESULTS One hundred fifty-six enrolled patients evaluable for response were included in the meta-analysis, 85 ARMS, 64 ERMS and 7 RMS-NOS. The combined effect generated from the random-effects model demonstrated a 41% increase (p = 0.001, 95% CI; 0.21-0.60) in response to vinorelbine as a single agent or in combination in patients with ARMS compared to patients with ERMS. There was no significant difference in the rate of progressive disease between patients with ARMS compared to ERMS (p = 0.1, 95%CI; -0.26-0.02). DISCUSSION Vinorelbine is an active agent for the treatment of relapsed or refractory RMS and a meta-analysis of Phase 2 studies shows that radiographic responses in patients with ARMS were significantly higher than ERMS or RMS-NOS. CONCLUSION These data support further investigation of vinorelbine in newly diagnosed patients with RMS particularly those with alveolar histology.
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Affiliation(s)
- Wendy Allen‐Rhoades
- Department of Pediatric and Adolescent MedicineMayo ClinicMinnesotaRochesterUSA
| | - Philip J. Lupo
- Department of PediatricsBaylor College of MedicineTexasHoustonUSA
| | | | - Yueh‐Yun Chi
- Cancer and Blood Disease Institute, Children's Hospital of Los Angeles, Norris Comprehensive Cancer Center and Department of Pediatrics, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - John F. Kuttesch
- Department of PediatricsUniversity of New MexicoAlbuquerqueNew MexicoUSA
| | | | - William H. Meyer
- Department of PediatricsUniversity of Oklahoma Health Sciences CenterOklahoma CityOklahomaUSA
| | - Leo Mascarenhas
- Cancer and Blood Disease Institute, Children's Hospital of Los Angeles, Norris Comprehensive Cancer Center and Department of Pediatrics, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
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14
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Uh J, Jordan JA, Pappo AS, Krasin MJ, Hua C. Adaptive Proton Therapy for Pediatric Parameningeal Rhabdomyosarcoma: On-Treatment Anatomic Changes and Timing to Replanning. Clin Oncol (R Coll Radiol) 2023; 35:245-254. [PMID: 36764878 PMCID: PMC10783810 DOI: 10.1016/j.clon.2023.01.013] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/16/2022] [Accepted: 01/18/2023] [Indexed: 01/26/2023]
Abstract
PURPOSE To characterize on-treatment changes in GTV morphology in children with parameningeal rhabdomyosarcoma receiving upfront proton therapy with concurrent chemotherapy and thereby provide guidance on the timing of on-treatment imaging and adaptive replanning. METHODS AND MATERIALS GTV was delineated on 86 simulation and weekly MR images of 15 prospectively enrolled patients (aged 1-21 years). Temporal changes from baseline in volume and surface (95% Hausdorff distance) were analyzed in relation to the need for plan verification and the resultant doses with hypothetical no treatment adaptation. RESULTS The median time was 6 days from the initiation of chemotherapy to CT+MR simulation and 15 days from the simulation to the start of radiotherapy. All but 1 patient showed a continuous decrease in GTV (0.16-1.52%/day) after simulation. At 3 weeks from simulation, 10 of 15 patients exhibited a significant reduction in volume (median, 20%; range, 6-29%). Without replanning, these changes could lead to a reduction in CTV V95 by 7-14% (n = 2) and/or an increase in D0.01 cc/Dmean of adjacent organs at risk by 6-21% of the prescribed target dose (n = 7). Significant dosimetric consequences occurred in cases with (1) a considerable weight gain, (2) shrinkage of the skin surface, or (3) tumor regression in the oral or nasal cavity and sinus that altered air-tissue components in the beam path. The subsequent GTV and dosimetry after 3 weeks from simulation (4 weeks from chemotherapy initiation) demonstrated a relatively stable trend. CONCLUSIONS On-treatment imaging at 3 weeks after simulation is recommended, if the simulation is performed at 1 week after the initiation of chemotherapy, to detect significant anatomic changes that could result in >5% deviation from planned target coverage and/or organ doses in pediatric patients with parameningeal rhabdomyosarcoma receiving early proton therapy.
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Affiliation(s)
- J Uh
- Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
| | - J A Jordan
- College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA; Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - A S Pappo
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - M J Krasin
- Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - C Hua
- Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
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15
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Rekhi B, Dodd L, Dharavath B, Dutt A. Cytomorphology of spindle cell/sclerosing rhabdomyosarcoma, including MYOD1 (LI22R) mutation result. Diagn Cytopathol 2022; 50:E367-E372. [PMID: 35929754 DOI: 10.1002/dc.25032] [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: 04/29/2022] [Revised: 06/20/2022] [Accepted: 07/26/2022] [Indexed: 11/07/2022]
Abstract
Spindle cell/sclerosing rhabdomyosarcoma (RMS), characterized by MYOD1 (L122R) mutation in a subset of cases is a newly described subtype of RMS. Presently, there is no documentation of cytomorphological features, especially of sclerosing RMS. Case 1: A 24-year-old male presented with pain and swelling in his wrist for a one-year duration. MRI revealed a well-defined soft tissue lesion measuring 5.3 cm, encasing the lower end of the ulna. Fine-needle aspiration cytology (FNAC) smears revealed clusters of tumor cells with round to oval to spindle-shaped nuclei, scant to moderate amount of cytoplasm with the wisps of the metachromatic stroma. Histopathological examination revealed a malignant tumor comprising cells with polygonal to spindle-shaped nuclei, arranged in a sclerotic stroma. Immunohistochemically, the tumor cells were positive for desmin, myogenin, and MYOD1. A diagnosis of sclerosing RMS was offered. Furthermore, the tumor revealed MYOD1 (L122R) mutation. Case 2: A 43-year-old male presented with a 4-month history of "nasal stuffiness" and pressure. Imaging revealed a poorly defined infiltrative lesion in his nasal cavity. FNAC smears revealed loose and tightly cohesive clusters of malignant cells with oval to spindle-shaped nuclei, a moderate amount of ill-defined bluish to finely vacuolated cytoplasm, and focal streak artifact with interspersed stromal fragments. Histopathological examination revealed a malignant tumor composed of oval to spindle-shaped nuclei, embedded in a variably hyalinized stroma. Immunohistochemically, the tumor cells were positive for desmin, and myogenin. Diagnosis of spindle cell/sclerosing RMS was offered. The present study constitutes one of the first documentation of cytomorphological features of two rare cases of spindle cell/sclerosing RMS. The differential diagnoses and treatment-related implications are presented.
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Affiliation(s)
- Bharat Rekhi
- Department of Pathology, Tata Memorial Hospital, Mumbai, India
- Homi Bhabha National Institute (HBNI) University, Mumbai, India
| | - Leslie Dodd
- Department of Pathology and Laboratory Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Bhaskar Dharavath
- Homi Bhabha National Institute (HBNI) University, Mumbai, India
- Integrated Genmomics Laboratory, Advanced Centtre for Treatment, Research and Education in Cancer, Khargar, Navi Mumbai, India
| | - Amit Dutt
- Homi Bhabha National Institute (HBNI) University, Mumbai, India
- Integrated Genmomics Laboratory, Advanced Centtre for Treatment, Research and Education in Cancer, Khargar, Navi Mumbai, India
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16
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Croce S, Devouassoux-Shisheboran M, Pautier P, Ray-Coquard I, Treilleux I, Neuville A, Arnould L, Just PA, Belda MALF, Averous G, Leroux A, Mery E, Loussouarn D, Weinbreck N, Le Guellec S, Mishellany F, Morice P, Guyon F, Genestie C. Uterine sarcomas and rare uterine mesenchymal tumors with malignant potential. Diagnostic guidelines of the French Sarcoma Group and the Rare Gynecological Tumors Group. Gynecol Oncol 2022; 167:373-389. [PMID: 36114030 DOI: 10.1016/j.ygyno.2022.07.031] [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: 05/26/2022] [Revised: 07/26/2022] [Accepted: 07/29/2022] [Indexed: 11/04/2022]
Abstract
The landscape of uterine sarcomas is becoming increasingly complex with the description of new entities associated with recurrent molecular alterations. Uterine sarcomas, as well as soft tissue sarcomas, can be distinguished into complex genomic sarcomas and simple genomic sarcomas. Leiomyosarcoma and pleomorphic type undifferentiated uterine sarcoma belong to the first group. Low-grade and high-grade endometrial stromal sarcomas, NTRK, COL1A1::PDGFB, ALK, RET, ROS1 associated sarcomas, and SMARCA4 deficient uterine sarcoma belong to the second group. Leiomyosarcoma is the most common uterine sarcoma followed by endometrial stromal sarcomas. Three different histologic subtypes of leiomyosarcomas are recognized with distinct diagnostic criteria and different clinical outcomes, the myxoid and epithelioid leiomyosarcomas being even more aggressive than the fusiform type. The distinction between low-grade and high-grade endometrial stromal sarcoma is based first on morphology and immunohistochemistry. The detection of fusion transcripts helps in the diagnosis. Definitely recognized as a separate entity, uterine PEComa is a rare tumor whose diagnostic criteria are being recently defined. Uterine PEComa has a specific algorithm stratifying the tumors into uncertain malignant potential and malignant tumors. Embryonal rhabdomyosarcomas of the uterine cervix are not restricted to children but can also be observed in adult women and are almost always DICER1 mutated, unlike embryonal rhabdomyosarcoma of the vagina which are DICER1wild-type, and adenosarcoma which can be DICER1 mutated but with less frequency. As sarcomas associated with fusion transcripts involving the NTRK, ALK, COL1A1::PDGFB genes can benefit from targeted therapy, systematic detection are now relevant especially for patients with high risk of relapse or in recurrent setting. The integration of molecular data with dedicated expert pathology review for histology and clinical data allows better identification of uterine sarcomas in order to better treat them.
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Affiliation(s)
- Sabrina Croce
- Department of BioPathology, Anticancer Center, Institut Bergonié, Bordeaux, France; Unité INSERM U1218, Bordeaux, France; Gynecological Pathology Group of RRePS (Réseau de Référence en Pathologie des Sarcomes) Network, France.
| | - Mojgan Devouassoux-Shisheboran
- Gynecological Pathology Group of RRePS (Réseau de Référence en Pathologie des Sarcomes) Network, France; Department of Pathology, CHU, Lyon, France
| | - Patricia Pautier
- Department of Medical Oncology, Institut Gustave-Roussy, Villejuif, France
| | - Isabelle Ray-Coquard
- Department of Medical Oncology, Centre Leon Berard, Lyon, France; Laboratoire RESHAPE U1290, University Claude Bernard Lyon I, France
| | - Isabelle Treilleux
- Gynecological Pathology Group of RRePS (Réseau de Référence en Pathologie des Sarcomes) Network, France; Department of Pathology, Centre Leon Berard, Lyon, France
| | - Agnès Neuville
- Gynecological Pathology Group of RRePS (Réseau de Référence en Pathologie des Sarcomes) Network, France; Institut de Pathologie de Haut de France, Amiens, France
| | - Laurent Arnould
- Gynecological Pathology Group of RRePS (Réseau de Référence en Pathologie des Sarcomes) Network, France; Biology and Tumor Pathology Department, Centre G-F Leclerc, Dijon, France
| | - Pierre-Alexandre Just
- Gynecological Pathology Group of RRePS (Réseau de Référence en Pathologie des Sarcomes) Network, France; Department of Pathology, Hopital Cochin, APHP, Paris, France
| | - Marie Aude Le Frere Belda
- Gynecological Pathology Group of RRePS (Réseau de Référence en Pathologie des Sarcomes) Network, France; Department of Pathology, European Georges Pompidou Hospital, APHP, Centre, Paris, France
| | - Gerlinde Averous
- Gynecological Pathology Group of RRePS (Réseau de Référence en Pathologie des Sarcomes) Network, France; Department of Pathology, CHRU, Strasbourg, France
| | - Agnès Leroux
- Gynecological Pathology Group of RRePS (Réseau de Référence en Pathologie des Sarcomes) Network, France; Department of Pathology, Institut de Cancérologie de Lorraine, Nancy, France
| | - Eliane Mery
- Gynecological Pathology Group of RRePS (Réseau de Référence en Pathologie des Sarcomes) Network, France; Department of Pathology, IUCT Oncopole, Toulouse, France
| | - Delphine Loussouarn
- Gynecological Pathology Group of RRePS (Réseau de Référence en Pathologie des Sarcomes) Network, France; Department of Pathology, CHU, Nantes, France
| | - Nicolas Weinbreck
- Gynecological Pathology Group of RRePS (Réseau de Référence en Pathologie des Sarcomes) Network, France; Medipath, Fréjus, France
| | - Sophie Le Guellec
- Gynecological Pathology Group of RRePS (Réseau de Référence en Pathologie des Sarcomes) Network, France; Medipath-Les Feuillants, Toulouse, France
| | - Florence Mishellany
- Gynecological Pathology Group of RRePS (Réseau de Référence en Pathologie des Sarcomes) Network, France; Department of Pathology, Centre de Lutte contre le Cancer Jean Perrin, Clermont-Ferrand, France
| | - Philippe Morice
- Department of Gynecological Surgery, Gustave Roussy, Villejuif, Île-de-France, France
| | - Frédéric Guyon
- Department of Surgery, Institut Bergonié, Bordeaux, France
| | - Catherine Genestie
- Department de Biopathologie, Gustave Roussy, Unité 981, Villejuif, France
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17
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Ruhen O, Lak NS, Stutterheim J, Danielli SG, Chicard M, Iddir Y, Saint-Charles A, Di Paolo V, Tombolan L, Gatz SA, Aladowicz E, Proszek P, Jamal S, Stankunaite R, Hughes D, Carter P, Izquierdo E, Wasti A, Chisholm JC, George SL, Pace E, Chesler L, Aerts I, Pierron G, Zaidi S, Delattre O, Surdez D, Kelsey A, Hubank M, Bonvini P, Bisogno G, Di Giannatale A, Schleiermacher G, Schäfer BW, Tytgat GA, Shipley J. Molecular Characterization of Circulating Tumor DNA in Pediatric Rhabdomyosarcoma: A Feasibility Study. JCO Precis Oncol 2022; 6:e2100534. [PMID: 36265118 PMCID: PMC9616639 DOI: 10.1200/po.21.00534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 05/17/2022] [Accepted: 08/26/2022] [Indexed: 05/24/2023] Open
Abstract
PURPOSE Rhabdomyosarcomas (RMS) are rare neoplasms affecting children and young adults. Efforts to improve patient survival have been undermined by a lack of suitable disease markers. Plasma circulating tumor DNA (ctDNA) has shown promise as a potential minimally invasive biomarker and monitoring tool in other cancers; however, it remains underexplored in RMS. We aimed to determine the feasibility of identifying and quantifying ctDNA in plasma as a marker of disease burden and/or treatment response using blood samples from RMS mouse models and patients. METHODS We established mouse models of RMS and applied quantitative polymerase chain reaction (PCR) and droplet digital PCR (ddPCR) to detect ctDNA within the mouse plasma. Potential driver mutations, copy-number alterations, and DNA breakpoints associated with PAX3/7-FOXO1 gene fusions were identified in the RMS samples collected at diagnosis. Patient-matched plasma samples collected from 28 patients with RMS before, during, and after treatment were analyzed for the presence of ctDNA via ddPCR, panel sequencing, and/or whole-exome sequencing. RESULTS Human tumor-derived DNA was detectable in plasma samples from mouse models of RMS and correlated with tumor burden. In patients, ctDNA was detected in 14/18 pretreatment plasma samples with ddPCR and 7/7 cases assessed by sequencing. Levels of ctDNA at diagnosis were significantly higher in patients with unfavorable tumor sites, positive nodal status, and metastasis. In patients with serial plasma samples (n = 18), fluctuations in ctDNA levels corresponded to treatment response. CONCLUSION Comprehensive ctDNA analysis combining high sensitivity and throughput can identify key molecular drivers in RMS models and patients, suggesting potential as a minimally invasive biomarker. Preclinical assessment of treatments using mouse models and further patient testing through prospective clinical trials are now warranted.
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Affiliation(s)
- Olivia Ruhen
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
| | - Nathalie S.M. Lak
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Experimental Immunohematology, Sanquin, Amsterdam, the Netherlands
| | - Janine Stutterheim
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Experimental Immunohematology, Sanquin, Amsterdam, the Netherlands
| | - Sara G. Danielli
- Department of Oncology and Children's Research Centre, University Children's Hospital, Zurich, Switzerland
| | - Mathieu Chicard
- SiRIC RTOP (Recherche Translationelle en Oncologie Pediatrique), Institut Curie, Paris, France
| | - Yasmine Iddir
- SiRIC RTOP (Recherche Translationelle en Oncologie Pediatrique), Institut Curie, Paris, France
| | - Alexandra Saint-Charles
- SiRIC RTOP (Recherche Translationelle en Oncologie Pediatrique), Institut Curie, Paris, France
| | - Virginia Di Paolo
- Department of Pediatric Haematology/Oncology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Lucia Tombolan
- Institute of Pediatric Research, Fondazione Città della Speranza, Padova, Italy
| | - Susanne A. Gatz
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Ewa Aladowicz
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
| | - Paula Proszek
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
- Molecular Diagnostics, Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Sabri Jamal
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
- Molecular Diagnostics, Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Reda Stankunaite
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
- Molecular Diagnostics, Royal Marsden NHS Foundation Trust, London, United Kingdom
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, United Kingdom
| | - Deborah Hughes
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
- Molecular Diagnostics, Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Paul Carter
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
- Molecular Diagnostics, Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Elisa Izquierdo
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
- Molecular Diagnostics, Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Ajla Wasti
- Children & Young People's Unit, Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Julia C. Chisholm
- Children & Young People's Unit, Royal Marsden NHS Foundation Trust, London, United Kingdom
- Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Sally L. George
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
- Children & Young People's Unit, Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Erika Pace
- Children & Young People's Unit, Royal Marsden NHS Foundation Trust, London, United Kingdom
- Department of Diagnostic Radiology, Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Louis Chesler
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
- Children & Young People's Unit, Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Isabelle Aerts
- SiRIC RTOP (Recherche Translationelle en Oncologie Pediatrique), Institut Curie, Paris, France
| | - Gaelle Pierron
- SiRIC RTOP (Recherche Translationelle en Oncologie Pediatrique), Institut Curie, Paris, France
| | - Sakina Zaidi
- INSERM U830, Équipe Labellisée LNCC, PSL Research University, SIREDO Oncology Centre, Institut Curie, Paris, France
| | - Olivier Delattre
- INSERM U830, Équipe Labellisée LNCC, PSL Research University, SIREDO Oncology Centre, Institut Curie, Paris, France
| | - Didier Surdez
- INSERM U830, Équipe Labellisée LNCC, PSL Research University, SIREDO Oncology Centre, Institut Curie, Paris, France
- Bone Sarcoma Research Laboratory, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Anna Kelsey
- Department of Pediatric Histopathology, Manchester University Foundation Trust, Manchester, United Kingdom
| | - Michael Hubank
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
- Molecular Diagnostics, Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Paolo Bonvini
- Institute of Pediatric Research, Fondazione Città della Speranza, Padova, Italy
| | - Gianni Bisogno
- Department of Woman's and Children's Health, Hematology and Oncology Unit, University of Padova, Padova, Italy
| | - Angela Di Giannatale
- Department of Pediatric Haematology/Oncology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Gudrun Schleiermacher
- SiRIC RTOP (Recherche Translationelle en Oncologie Pediatrique), Institut Curie, Paris, France
- Department of Pediatric Oncology, Hospital Group, Institut Curie, Paris, France
| | - Beat W. Schäfer
- Department of Oncology and Children's Research Centre, University Children's Hospital, Zurich, Switzerland
| | - Godelieve A.M. Tytgat
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Experimental Immunohematology, Sanquin, Amsterdam, the Netherlands
| | - Janet Shipley
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
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18
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刘 斯, 叶 芳, 范 宸, 彭 敏, 董 佳, 邓 文, 张 辉, 俞 燕, 杨 良. [Clinical features and prognosis in 20 children with rhabdomyosarcoma]. Zhongguo Dang Dai Er Ke Za Zhi 2022; 24:1036-1041. [PMID: 36111723 PMCID: PMC9495239 DOI: 10.7499/j.issn.1008-8830.2204033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 07/14/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES To study the clinical features of children with rhabdomyosarcoma (RMS) and the influencing factors for prognosis. METHODS A retrospective analysis was performed on the clinical and follow-up data of 20 children with RMS who were admitted to the Department of Pediatric Hematology, Xiangya Hospital of Central South University, from June 2014 to September 2020. RESULTS The most common clinical symptoms of the 20 children with RMS at the first visit were painless mass (13/20, 65%), exophthalmos (4/20, 20%), and abdominal pain (3/20, 15%). According to the staging criteria of Intergroup Rhabdomyosarcoma Study Group (IRSG), there was 1 child (5%) with stage I RMS, 4 (20%) with stage II RMS, 9 (45%) with stage III RMS, and 6 (30%) with stage IV RMS. The median follow-up time was 19 months for the 20 children (range: 3-93 months), with a 2-year overall survival (OS) rate of 79.5% (95%CI: 20.1-24.3) and a 2-year event-free survival (EFS) rate of 72.0% (95%CI: 19.5-23.9). Pleomorphic RMS was associated with the reduced 2-year OS rate (P<0.05), and distant metastasis, IRSG stage IV RMS, and high-risk RMS were associated with the reduced 2-year EFS rate (P<0.05). CONCLUSIONS RMS has no specific clinical symptoms at the first visit, with painless mass as the most common symptom. Distant metastasis, IRSG stage, and risk degree may be associated with the prognosis of children with RMS.
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19
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Yin CY, Wang YC, Du WC, Liu YF. [Analysis of 18 cases of malignant rhabdoid tumor in children]. Zhonghua Er Ke Za Zhi 2022; 60:908-914. [PMID: 36038300 DOI: 10.3760/cma.j.cn112140-20220323-00241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To investigate the clinical characteristics, treatment and prognosis of malignant rhabdoid tumor (MRT) in children. Methods: Clinical data total of 18 children with MRT treated in the Department of Hematology and Oncology, Children's Hospital, the First Affiliated Hospital of Zhengzhou University between June 2015 to June 2021 were analyzed retrospectively. The patients were grouped according to age, gender, tumor type, clinical stage and other factors.Progression free survival (PFS) and overall survival (OS) were calculated by Kaplan-Meier method, survival differences among different groups were compared by Log-rank test, and prognostic factors were analyzed by Cox regression model. Results: Among the 18 patients, there were 5 males and 13 females. The age of disease onset was 30.5 (12.0, 75.0) months, the tumor diameter was (80±29) mm, and no integrase interactor 1 (INI-1) expression was detected by immunohistochemistry. There were 7 cases of malignant rhabdoid tumor of the kidney (MRTK), 6 cases of atypical teratoid rhabdoid tumor (ATRT) and 5 cases of extrarenal extracranial rhabdoid tumor (EERT). At the time of early diagnosis, 12 patients were clinically stage Ⅲ-Ⅳ, 11 patients had local or distant metastasis, and 4 patients had metastasis during treatment. Surgical excision is the preferred treatment. There were 3 cases with preoperative puncture biopsy, 13 cases with complete resection, 4 cases with partial resection, and 1 case without operation. Thirteen patients were treated with the domestic conventional chemotherapy regimen for Wilms' tumor, medulloblastoma and rhabdomyosarcoma, and 5 patients were treated with the international conventional chemotherapy regimen. Nine patients received radiotherapy, including 1 case of MRTK, 4 cases of ATRT and 4 cases of EERT. By the end of follow-up in January 2022, 7 patients survived and 11 patients died. The 3-year PFS and OS rates were (8±8) % and (14±12) %. Log-rank test showed that the 5-year OS of EERT group was higher than ATRT and MRTK groups (χ²=16.31, P<0.001), the tumor diameter <80 mm group was higher than that of the ≥80 mm group (χ²=4.49, P=0.034), and the radiotherapy group was higher than no radiotherapy group (χ²=3.97, P=0.046). The differences were statistically significant. There was no significant difference in the influence of tumor type, age, tumor diameter, radiotherapy and chemotherapy on OS by Cox regression model (all P>0.05). Log-rank test showed that the 3-year PFS of EERT group was higher than ATRT and MRTK groups (χ²=11.14, P=0.004),>3 years group was higher than ≤3 years group (χ²=10.10, P=0.001), the differences were statistically significant. Tumor type, clinical stage, tumor diameter, age, tumor rupture and radiotherapy were included in the Cox regression model, and the results showed that clinical stage (HR=0.49, 95%CI 0.26-0.94, P=0.031), tumor diameter (HR=8.67, 95%CI 1.84-40.89, P=0.006), age (HR=0.01, 95%CI 0.00-0.15, P=0.001) had statistical significance on PFS. Conclusions: MRT is one of the most aggressive and fatal cancers in early childhood and infancy. There is no standard treatment and the prognosis is extremely poor. Clinical stage, tumor size and age are risk factors for disease progression.
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Affiliation(s)
- C Y Yin
- Department of Hematology and Oncology, Children's Hospital, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Y C Wang
- Department of Hematology and Oncology, Children's Hospital, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - W C Du
- Department of Hematology and Oncology, Children's Hospital, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Y F Liu
- Department of Hematology and Oncology, Children's Hospital, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
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20
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Fetzko S, Fonseca A, Wedekind MF, Gupta AA, Setty BA, Schraw J, Lupo PJ, Guillerman RP, Butala AA, Russell H, Nicholls L, Walterhouse D, Hawkins DS, Okcu MF. Is Detection of Relapse by Surveillance Imaging Associated With Longer Survival in Patients With Rhabdomyosarcoma? J Pediatr Hematol Oncol 2022; 44:305-312. [PMID: 35137727 PMCID: PMC10026693 DOI: 10.1097/mph.0000000000002429] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 01/11/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND We investigated whether surveillance imaging had an impact on post-relapse survival in patients with rhabdomyosarcoma (RMS). We hypothesized that relapse detected by imaging (group IM) would be associated with longer survival compared with relapse detected with a clinical sign or symptom (group SS). MATERIALS AND METHODS We performed an observational multi-institutional study in 127 patients with relapsed RMS comparing overall survival (OS) after relapse using Kaplan-Meier and Cox proportional hazards analyses. RESULTS Relapse was detected in 60 (47%) group IM and 67 (53%) SS patients. Median follow-up in survivors was 4 years (range 1.0 to 16.7 y). Four-year OS rates were similar between group IM (28%, 95% confidence interval [CI]: 14%-40%) and SS (21%, 95% CI: 11%-31%) ( P =0.14). In multivariable analyses accounting for institution, age at diagnosis, time to relapse, risk group at diagnosis, and primary site, not receiving chemotherapy (hazard ratio [HR]: 6.8, 95% CI: 2.8-16.6), radiation (HR: 3, 95% CI: 1.7-5.3), or surgery (HR: 2.8, 95% CI: 1.6-4.8) after relapse were independently associated with poor OS. CONCLUSION These results on whether surveillance imaging provides survival benefit in patients with relapsed RMS are inconclusive. Larger studies are needed to justify current surveillance recommendations. Chemotherapy, radiotherapy and surgery to treat recurrence prolong OS.
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Affiliation(s)
- Stephanie Fetzko
- Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital
| | - Adriana Fonseca
- Division of Haematology/Oncology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Mary Frances Wedekind
- Division of Hematology/Oncology/BMT, Department of Pediatrics, Nationwide Children’s Hospital, Columbus, OH
| | - Abha A. Gupta
- Division of Haematology/Oncology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Bhuvana A. Setty
- Division of Hematology/Oncology/BMT, Department of Pediatrics, Nationwide Children’s Hospital, Columbus, OH
| | - Jeremy Schraw
- Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital
| | - Philip J. Lupo
- Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital
| | - Robert P. Guillerman
- Department of Radiology, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX
| | - Anish A. Butala
- Division of Hematology/Oncology, Department of Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL
| | - Heidi Russell
- Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital
- Center for Medical Ethics and Health Policy, Baylor College of Medicine
| | - Lauren Nicholls
- Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital
| | - David Walterhouse
- Division of Hematology/Oncology, Department of Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL
| | - Douglas S. Hawkins
- Division of Hematology/Oncology, Department of Pediatrics, Seattle Children’s Hospital, Seattle, WA
| | - Mehmet F. Okcu
- Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital
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21
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Wei Y, Qin Q, Yan C, Hayes MN, Garcia SP, Xi H, Do D, Jin AH, Eng TC, McCarthy KM, Adhikari A, Onozato ML, Spentzos D, Neilsen GP, Iafrate AJ, Wexler LH, Pyle AD, Suvà ML, Dela Cruz F, Pinello L, Langenau DM. Single-cell analysis and functional characterization uncover the stem cell hierarchies and developmental origins of rhabdomyosarcoma. Nat Cancer 2022; 3:961-975. [PMID: 35982179 PMCID: PMC10430812 DOI: 10.1038/s43018-022-00414-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 06/24/2022] [Indexed: 04/29/2023]
Abstract
Rhabdomyosarcoma (RMS) is a common childhood cancer that shares features with developing skeletal muscle. Yet, the conservation of cellular hierarchy with human muscle development and the identification of molecularly defined tumor-propagating cells has not been reported. Using single-cell RNA-sequencing, DNA-barcode cell fate mapping and functional stem cell assays, we uncovered shared tumor cell hierarchies in RMS and human muscle development. We also identified common developmental stages at which tumor cells become arrested. Fusion-negative RMS cells resemble early myogenic cells found in embryonic and fetal development, while fusion-positive RMS cells express a highly specific gene program found in muscle cells transiting from embryonic to fetal development at 7-7.75 weeks of age. Fusion-positive RMS cells also have neural pathway-enriched states, suggesting less-rigid adherence to muscle-lineage hierarchies. Finally, we identified a molecularly defined tumor-propagating subpopulation in fusion-negative RMS that shares remarkable similarity to bi-potent, muscle mesenchyme progenitors that can make both muscle and osteogenic cells.
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Affiliation(s)
- Yun Wei
- Molecular Pathology Unit, Massachusetts General Research Institute, Charlestown, MA, USA
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Charlestown, MA, USA
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Stem Cell Institute, Cambridge, MA, USA
| | - Qian Qin
- Molecular Pathology Unit, Massachusetts General Research Institute, Charlestown, MA, USA
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Charlestown, MA, USA
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Stem Cell Institute, Cambridge, MA, USA
| | - Chuan Yan
- Molecular Pathology Unit, Massachusetts General Research Institute, Charlestown, MA, USA
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Charlestown, MA, USA
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Stem Cell Institute, Cambridge, MA, USA
| | - Madeline N Hayes
- Molecular Pathology Unit, Massachusetts General Research Institute, Charlestown, MA, USA
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Charlestown, MA, USA
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Stem Cell Institute, Cambridge, MA, USA
| | - Sara P Garcia
- Molecular Pathology Unit, Massachusetts General Research Institute, Charlestown, MA, USA
| | - Haibin Xi
- Department of Microbiology, Immunology, and Molecular Genetics, University of California Los Angeles, Los Angeles, CA, USA
- Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research, University of California Los Angeles, Los Angeles, CA, USA
| | - Daniel Do
- Molecular Pathology Unit, Massachusetts General Research Institute, Charlestown, MA, USA
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Charlestown, MA, USA
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Stem Cell Institute, Cambridge, MA, USA
| | - Alexander H Jin
- Molecular Pathology Unit, Massachusetts General Research Institute, Charlestown, MA, USA
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Charlestown, MA, USA
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Stem Cell Institute, Cambridge, MA, USA
| | - Tiffany C Eng
- Molecular Pathology Unit, Massachusetts General Research Institute, Charlestown, MA, USA
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Charlestown, MA, USA
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Stem Cell Institute, Cambridge, MA, USA
| | - Karin M McCarthy
- Molecular Pathology Unit, Massachusetts General Research Institute, Charlestown, MA, USA
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Charlestown, MA, USA
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Stem Cell Institute, Cambridge, MA, USA
| | - Abhinav Adhikari
- Molecular Pathology Unit, Massachusetts General Research Institute, Charlestown, MA, USA
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Charlestown, MA, USA
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Stem Cell Institute, Cambridge, MA, USA
| | - Maristela L Onozato
- Molecular Pathology Unit, Massachusetts General Research Institute, Charlestown, MA, USA
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Charlestown, MA, USA
| | - Dimitrios Spentzos
- Center for Sarcoma and Connective Tissue Oncology, Department of Orthopedic Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Gunnlaugur P Neilsen
- Center for Sarcoma and Connective Tissue Oncology, Department of Orthopedic Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - A John Iafrate
- Molecular Pathology Unit, Massachusetts General Research Institute, Charlestown, MA, USA
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Charlestown, MA, USA
| | - Leonard H Wexler
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - April D Pyle
- Department of Microbiology, Immunology, and Molecular Genetics, University of California Los Angeles, Los Angeles, CA, USA
- Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research, University of California Los Angeles, Los Angeles, CA, USA
| | - Mario L Suvà
- Molecular Pathology Unit, Massachusetts General Research Institute, Charlestown, MA, USA
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Charlestown, MA, USA
- Harvard Stem Cell Institute, Cambridge, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Filemon Dela Cruz
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Luca Pinello
- Molecular Pathology Unit, Massachusetts General Research Institute, Charlestown, MA, USA.
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Charlestown, MA, USA.
| | - David M Langenau
- Molecular Pathology Unit, Massachusetts General Research Institute, Charlestown, MA, USA.
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Charlestown, MA, USA.
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, USA.
- Harvard Stem Cell Institute, Cambridge, MA, USA.
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22
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Chen XY, Chen G, Zhu Q, Zhu WF, He C, Huang RF. [Clinicopathological features of rhabdomyosarcoma with TFCP2 fusions]. Zhonghua Bing Li Xue Za Zhi 2022; 51:545-547. [PMID: 35673728 DOI: 10.3760/cma.j.cn112151-20211008-00731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- X Y Chen
- Department of Pathology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou 350014, China
| | - G Chen
- Department of Pathology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou 350014, China
| | - Q Zhu
- Department of Molecular Pathology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou 350014, China
| | - W F Zhu
- Department of Pathology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou 350014, China
| | - C He
- Department of Pathology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou 350014, China
| | - R F Huang
- Department of Pathology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou 350014, China
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23
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Erber R, Preidl R, Stoehr R, Haller F, Hartmann A, Kesting M, Agaimy A. DICER1-Mutated Botryoid Fibroepithelial Polyp of the Parotid Duct: Report of the First Case. Head Neck Pathol 2022; 16:573-580. [PMID: 34282560 PMCID: PMC9187814 DOI: 10.1007/s12105-021-01364-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/07/2021] [Indexed: 11/27/2022]
Abstract
DICER1, a member of the ribonuclease III family, is involved in the biogenesis of microRNAs and, hence, it influences gene expression regulation. DICER1 germline (associated with the inherited DICER1 syndrome) or somatic mutations have been linked to tumorigenesis in histogenetically diverse benign and malignant neoplasms in different organs including pleuropulmonary blastoma, cystic nephroma, embryonal rhabdomyosarcoma, nasal chondromesenchymal hamartoma, poorly differentiated thyroid carcinoma, thyroblastoma, intracranial sarcoma and gonadal Sertoli-Leydig cell tumors in addition to others. Moreover, rare botryoid (giant) fibroepithelial polyps may harbor this mutation. Herein, we describe the first reported case of a DICER1-mutated botryoid fibroepithelial polyp occurring within the parotid duct of a 65-year-old female who has no other features or family history of the DICER1 syndrome. Based on its distinctive morphology, we tested this lesion specifically for DICER1 mutations and confirmed the presence of a pathogenic DICER1 variant with a low allele frequency, consistent with a somatic mutation.
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Affiliation(s)
- Ramona Erber
- Institute of Pathology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), University Hospital Erlangen (UKER), Krankenhausstrasse 8-10, 91054, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | - Raimund Preidl
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), University Hospital Erlangen (UKER), Erlangen, Germany
| | - Robert Stoehr
- Institute of Pathology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), University Hospital Erlangen (UKER), Krankenhausstrasse 8-10, 91054, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | - Florian Haller
- Institute of Pathology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), University Hospital Erlangen (UKER), Krankenhausstrasse 8-10, 91054, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | - Arndt Hartmann
- Institute of Pathology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), University Hospital Erlangen (UKER), Krankenhausstrasse 8-10, 91054, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | - Marco Kesting
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), University Hospital Erlangen (UKER), Erlangen, Germany
| | - Abbas Agaimy
- Institute of Pathology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), University Hospital Erlangen (UKER), Krankenhausstrasse 8-10, 91054, Erlangen, Germany.
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany.
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24
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Odeniyide P, Yohe ME, Pollard K, Vaseva AV, Calizo A, Zhang L, Rodriguez FJ, Gross JM, Allen AN, Wan X, Somwar R, Schreck KC, Kessler L, Wang J, Pratilas CA. Targeting farnesylation as a novel therapeutic approach in HRAS-mutant rhabdomyosarcoma. Oncogene 2022; 41:2973-2983. [PMID: 35459782 PMCID: PMC9122815 DOI: 10.1038/s41388-022-02305-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 02/05/2021] [Revised: 03/25/2022] [Accepted: 03/30/2022] [Indexed: 01/11/2023]
Abstract
Activating RAS mutations are found in a subset of fusion-negative rhabdomyosarcoma (RMS), and therapeutic strategies to directly target RAS in these tumors have been investigated, without clinical success to date. A potential strategy to inhibit oncogenic RAS activity is the disruption of RAS prenylation, an obligate step for RAS membrane localization and effector pathway signaling, through inhibition of farnesyltransferase (FTase). Of the major RAS family members, HRAS is uniquely dependent on FTase for prenylation, whereas NRAS and KRAS can utilize geranylgeranyl transferase as a bypass prenylation mechanism. Tumors driven by oncogenic HRAS may therefore be uniquely sensitive to FTase inhibition. To investigate the mutation-specific effects of FTase inhibition in RMS we utilized tipifarnib, a potent and selective FTase inhibitor, in in vitro and in vivo models of RMS genomically characterized for RAS mutation status. Tipifarnib reduced HRAS processing, and plasma membrane localization leading to decreased GTP-bound HRAS and decreased signaling through RAS effector pathways. In HRAS-mutant cell lines, tipifarnib reduced two-dimensional and three-dimensional cell growth, and in vivo treatment with tipifarnib resulted in tumor growth inhibition exclusively in HRAS-mutant RMS xenografts. Our data suggest that small molecule inhibition of FTase is active in HRAS-driven RMS and may represent an effective therapeutic strategy for a genomically-defined subset of patients with RMS.
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Affiliation(s)
- Patience Odeniyide
- Division of Pediatric Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Marielle E Yohe
- Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Kai Pollard
- Division of Pediatric Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Angelina V Vaseva
- The Greehey Children's Cancer Research Institute, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Ana Calizo
- Division of Pediatric Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Lindy Zhang
- Division of Pediatric Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Fausto J Rodriguez
- Department of Laboratory Medicine and Pathology, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - John M Gross
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Amy N Allen
- Division of Pediatric Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Xiaolin Wan
- Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Romel Somwar
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Karisa C Schreck
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Jiawan Wang
- Division of Pediatric Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Christine A Pratilas
- Division of Pediatric Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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25
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Zhou D, Bhadri V, Luk P, Ch'ng S, Franks D, Hong A. Left cheek sclerosing rhabdomyosarcoma and development of isolated free flap donor site metastasis. BMJ Case Rep 2022; 15:e248390. [PMID: 35393277 PMCID: PMC8990714 DOI: 10.1136/bcr-2021-248390] [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] [Accepted: 03/10/2022] [Indexed: 11/03/2022] Open
Abstract
Rhabdomyosarcoma is a rare mesenchymal malignancy with four different morphological subtypes: alveolar, embryonal, pleomorphic and spindle cell/sclerosing. It is the most common soft tissue sarcoma of children and adolescents but occurs less commonly in adults. We describe a male patient in his 20s with sclerosing rhabdomyosarcoma of the left cheek who developed an isolated free flap donor site metastasis in the first instance but subsequently progressed with bilateral pulmonary metastases. Multidisciplinary team involvement in a sarcoma specialist centre is essential and collaboration between the pathologist, radiologist, head and neck surgeon, orthopaedic surgeon, radiation oncologist and medical oncologist were integral in providing optimal management in this patient. Furthermore, this case report highlights this phenomenon of implantation metastasis in a patient with rhabdomyosarcoma, and emphasises the importance of surgical barriers between the resection and reconstruction teams in an oncological case.
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Affiliation(s)
- Deborah Zhou
- Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Vivek Bhadri
- Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
- The University of Sydney, Sydney, New South Wales, Australia
| | - Peter Luk
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Sydney Ch'ng
- The University of Sydney, Sydney, New South Wales, Australia
- Department of Head and Neck Surgery, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Daniel Franks
- Department of Orthopaedics Surgery, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Angela Hong
- The University of Sydney, Sydney, New South Wales, Australia
- Department of Radiation Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
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Wadhwa R, Raychaudhuri S, Jain M, Sidam D, Garg S. Embryonal rhabdomyosarcoma of the petrous ridge a mimicker of Langerhan cell histiocytosis- A rare presentation. INDIAN J PATHOL MICR 2022; 65:490-492. [PMID: 35435406 DOI: 10.4103/ijpm.ijpm_1143_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Affiliation(s)
- Ruchira Wadhwa
- Department of Pathology, ESIC Medical College, Faridabad, Harayana, India
| | | | - Manjula Jain
- Department of Pathology, ESIC Medical College, Faridabad, Harayana, India
| | - Dipti Sidam
- Department of Pathology, ESIC Medical College, Faridabad, Harayana, India
| | - Sugandha Garg
- Department of Radiology, ESIC Medical College, Faridabad, Harayana, India
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27
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Hsu JY, Danis EP, Nance S, O'Brien JH, Gustafson AL, Wessells VM, Goodspeed AE, Talbot JC, Amacher SL, Jedlicka P, Black JC, Costello JC, Durbin AD, Artinger KB, Ford HL. SIX1 reprograms myogenic transcription factors to maintain the rhabdomyosarcoma undifferentiated state. Cell Rep 2022; 38:110323. [PMID: 35108532 PMCID: PMC8917510 DOI: 10.1016/j.celrep.2022.110323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 06/02/2021] [Revised: 10/21/2021] [Accepted: 01/10/2022] [Indexed: 12/13/2022] Open
Abstract
Rhabdomyosarcoma (RMS) is a pediatric muscle sarcoma characterized by expression of the myogenic lineage transcription factors (TFs) MYOD1 and MYOG. Despite high expression of these TFs, RMS cells fail to terminally differentiate, suggesting the presence of factors that alter their functions. Here, we demonstrate that the developmental TF SIX1 is highly expressed in RMS and critical for maintaining a muscle progenitor-like state. SIX1 loss induces differentiation of RMS cells into myotube-like cells and impedes tumor growth in vivo. We show that SIX1 maintains the RMS undifferentiated state by controlling enhancer activity and MYOD1 occupancy at loci more permissive to tumor growth over muscle differentiation. Finally, we demonstrate that a gene signature derived from SIX1 loss correlates with differentiation status and predicts RMS progression in human disease. Our findings demonstrate a master regulatory role of SIX1 in repression of RMS differentiation via genome-wide alterations in MYOD1 and MYOG-mediated transcription.
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Affiliation(s)
- Jessica Y Hsu
- Department of Pharmacology, University of Colorado Anschutz Medical Campus (UC-AMC), Aurora, CO, USA; Pharmacology Graduate Program, UC-AMC, Aurora, CO, USA
| | - Etienne P Danis
- Department of Pharmacology, University of Colorado Anschutz Medical Campus (UC-AMC), Aurora, CO, USA; University of Colorado Cancer Center, UC-AMC, Aurora, CO, USA
| | - Stephanie Nance
- Division of Molecular Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Jenean H O'Brien
- Department of Biology, College of St. Scholastica, Duluth, MN, USA
| | - Annika L Gustafson
- Department of Pharmacology, University of Colorado Anschutz Medical Campus (UC-AMC), Aurora, CO, USA; Molecular Biology Graduate Program, UC-AMC, Aurora, CO, USA
| | | | - Andrew E Goodspeed
- Department of Pharmacology, University of Colorado Anschutz Medical Campus (UC-AMC), Aurora, CO, USA; University of Colorado Cancer Center, UC-AMC, Aurora, CO, USA
| | - Jared C Talbot
- School of Biology and Ecology, University of Maine, Orono, ME, USA
| | - Sharon L Amacher
- Department of Molecular Genetics, Ohio State University, Columbus, OH, USA
| | | | - Joshua C Black
- Department of Pharmacology, University of Colorado Anschutz Medical Campus (UC-AMC), Aurora, CO, USA; Pharmacology Graduate Program, UC-AMC, Aurora, CO, USA
| | - James C Costello
- Department of Pharmacology, University of Colorado Anschutz Medical Campus (UC-AMC), Aurora, CO, USA; Pharmacology Graduate Program, UC-AMC, Aurora, CO, USA; University of Colorado Cancer Center, UC-AMC, Aurora, CO, USA
| | - Adam D Durbin
- Division of Molecular Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Kristin B Artinger
- Department of Craniofacial Biology, UC-AMC, Aurora, CO, USA; University of Colorado Cancer Center, UC-AMC, Aurora, CO, USA.
| | - Heide L Ford
- Department of Pharmacology, University of Colorado Anschutz Medical Campus (UC-AMC), Aurora, CO, USA; Pharmacology Graduate Program, UC-AMC, Aurora, CO, USA; University of Colorado Cancer Center, UC-AMC, Aurora, CO, USA.
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28
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Saadi M, Letaief F, Gabsi A, Mokrani A, Meddeb K, Mezlini A. Clinical and pathological characteristics, treatment outcome and prognostic factors in adult rhabdomyosarcoma: a monocentric retrospective study. Pan Afr Med J 2022; 41:246. [PMID: 35734321 PMCID: PMC9187987 DOI: 10.11604/pamj.2022.41.246.31425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 03/08/2022] [Indexed: 11/14/2022] Open
Abstract
Rhabdomyosarcoma (RMS) is rare in adults. Our study is the first in Tunisia to report outcomes of adult RMS. We retrospectively analyzed clinical data of adult RMS patients. We collected data regarding clinical characteristics, treatment outcome and prognostic factors. Survival was assessed using the Kaplan Meier method. Forty-seven patients were included. Median age was 39. Twenty-five patients were young adults (53%). Sex ratio (M/F) was 1.9. RMS was localized in 33 patients (70%) and metastatic in 14 patients (30%). Extremities were the most frequent tumor site (40%) followed by trunk (23%). Median tumor size was 9 cm. Pleomorphic RMS was the major subtype (36%). Twenty seven of 33 patients with localized RMS underwent surgery (82%). Relapse free survival (RFS) was 38%. Young adults had a significantly worse RFS than adults aged ≥40 (p = 0.045). Surgery was associated with a significantly better RFS (p = 0.023). Five year overall survival (OS) was 35% and 27% in localized and metastatic RMS respectively. RMS localized in the extremities had significantly poorer OS (p = 0.041), same as non-operated patients (p = 0.025). OS for metastatic RMS was significantly worse after surgery of the primary tumor (p = 0.002). In multivariate analysis, surgery (HR = 0.108; 95%CI (0.023-0.519); p = 0.005) and non-extremity localization (HR = 0.238; 95%CI (0.075-0.751); p = 0.014) were independent prognostic factors for OS in localized RMS. Adults with RMS have poor 5 year OS. Surgery and non-extremity localization were independent prognostic factors for OS in localized RMS.
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Affiliation(s)
- Myriam Saadi
- Medical Oncology Department, Institut Salah Azaïz, Tunis, Tunisia
- Corresponding author: Myriam Saadi, Medical Oncology Department, Institut Salah Azaïz, Tunis, Tunisia.
| | - Feryel Letaief
- Medical Oncology Department, Institut Salah Azaïz, Tunis, Tunisia
| | - Azza Gabsi
- Medical Oncology Department, Institut Salah Azaïz, Tunis, Tunisia
| | - Amina Mokrani
- Medical Oncology Department, Institut Salah Azaïz, Tunis, Tunisia
| | - Khedija Meddeb
- Medical Oncology Department, Institut Salah Azaïz, Tunis, Tunisia
| | - Amel Mezlini
- Medical Oncology Department, Institut Salah Azaïz, Tunis, Tunisia
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29
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Xue J, Wang K, Yang XF, Liu XY, Guo W, Li YC, Chen ZH. [Dedifferentiated liposarcoma characterized by spindle cell rhabdomyosarcoma: report of a case]. Zhonghua Bing Li Xue Za Zhi 2021; 50:1376-1378. [PMID: 34865429 DOI: 10.3760/cma.j.cn112151-20210315-00206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- J Xue
- Department of pathology, the First Affiliated Hospital of Hunan Normal University, Hunan Provincial People's Hospital, Changsha 410000, China
| | - K Wang
- Department of pathology, the First Affiliated Hospital of Hunan Normal University, Hunan Provincial People's Hospital, Changsha 410000, China
| | - X F Yang
- Department of pathology, the First Affiliated Hospital of Hunan Normal University, Hunan Provincial People's Hospital, Changsha 410000, China
| | - X Y Liu
- Department of pathology, the First Affiliated Hospital of Hunan Normal University, Hunan Provincial People's Hospital, Changsha 410000, China
| | - W Guo
- Department of pathology, the First Affiliated Hospital of Hunan Normal University, Hunan Provincial People's Hospital, Changsha 410000, China
| | - Y C Li
- Department of pathology, the First Affiliated Hospital of Hunan Normal University, Hunan Provincial People's Hospital, Changsha 410000, China
| | - Z H Chen
- Department of pathology, the First Affiliated Hospital of Hunan Normal University, Hunan Provincial People's Hospital, Changsha 410000, China
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Nodit PG, Bienvenu JM. Rhabdomyosarcoma of the urinary bladder occurring in an adult. Urology 2021; 164:306-307. [PMID: 34736976 DOI: 10.1016/j.urology.2021.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/11/2021] [Accepted: 10/19/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Paul G Nodit
- The University of North Carolina, Chapel Hill, NC.
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Mascarenhas L. A Step Forward in Realizing the Promise of Genomic Medicine for Childhood Rhabdomyosarcoma. J Clin Oncol 2021; 39:2851-2854. [PMID: 34181486 PMCID: PMC8425823 DOI: 10.1200/jco.21.01296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 06/03/2021] [Indexed: 11/20/2022] Open
Affiliation(s)
- Leo Mascarenhas
- Cancer and Blood Disease Institute, Children's Hospital Los Angeles, Los Angeles, CA
- Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
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Pawlik J, Pawlik W, Branecka-Woźniak D, Kotrych K, Cymbaluk-Płoska A. Rhabdomyosarcoma of the Cervix in a Post-Menopausal Woman-An Unparalleled Phenomenon. Int J Environ Res Public Health 2021; 18:ijerph18157851. [PMID: 34360144 PMCID: PMC8345433 DOI: 10.3390/ijerph18157851] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/15/2021] [Accepted: 07/23/2021] [Indexed: 11/20/2022]
Abstract
Rhabdomyosarcoma of the cervix is a soft tissue sarcoma that usually occurs in young women. It is very rare in adulthood. We discuss symptoms, the process of diagnosis of rhabdomyosarcoma embryonale of the cervix in a 61-year-old women and differences in treatment dependent on patient’s age. A 61-year-old woman with symptoms such as palpable mass in the external cervical opening and post-menopausal hemorrhaging was admitted to the oncology ward where excision of the polyp was performed. Embryonal rhabdomyosarcoma (ERMS) was diagnosed by histopathological examination of obtained tissues. The diagnosis was complemented by chest computed tomography and pelvis magnetic resonance imaging to exclude metastases. A Wertheim–Meigs operation and excision of the ovaries, the fallopian tubes and the surrounding tissue was performed in the course of treatment. In the patient’s follow-up of 25 months to date, there have been no signs of recurrence or symptoms connected to ERMS. Based on the therapeutic outcome, the decision to limit the treatment to a surgical resection was adequate for a post-menopausal patient. Because of the rarity of ERMS in the post-menopausal age, we think that the patient should be carefully followed up to further examine this issue and develop diagnostic and treatment guidelines.
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Affiliation(s)
- Jakub Pawlik
- Department of Gynecological Surgery and Oncology of Adults and Adolescents, Pomeranian Medical University, 70-111 Szczecin, Poland; (W.P.); (A.C.-P.)
- Correspondence:
| | - Weronika Pawlik
- Department of Gynecological Surgery and Oncology of Adults and Adolescents, Pomeranian Medical University, 70-111 Szczecin, Poland; (W.P.); (A.C.-P.)
| | - Dorota Branecka-Woźniak
- Department of Gynecology and Reproductive Health, Pomeranian Medical University, 71-210 Szczecin, Poland;
| | - Katarzyna Kotrych
- Department of General and Dental Radiology, Pomeranian Medical University, 70-111 Szczecin, Poland;
| | - Aneta Cymbaluk-Płoska
- Department of Gynecological Surgery and Oncology of Adults and Adolescents, Pomeranian Medical University, 70-111 Szczecin, Poland; (W.P.); (A.C.-P.)
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33
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Darwish C, Shim T, Sparks AD, Chillakuru Y, Strum D, Benito DA, Monfared A. Pediatric head and neck rhabdomyosarcoma: An analysis of treatment and survival in the United States (1975-2016). Int J Pediatr Otorhinolaryngol 2020; 139:110403. [PMID: 33049553 DOI: 10.1016/j.ijporl.2020.110403] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 06/15/2020] [Revised: 09/21/2020] [Accepted: 09/22/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Rhabdomyosarcoma (RMS) is the most common soft tissue head and neck sarcoma in children. Stringent analysis of survival data is imperative to optimize treatment. METHODS The National Cancer Database (NCDB, 2004-2016) and the Surveillance, Epidemiology, and End Results Program (SEER, 1975-2016) were queried for patients ages 0-19 with RMS of the head and neck. Survival trends were analyzed using univariable logistic regression and Chi-square pairwise comparisons. Survival by treatment was analyzed using log-rank tests, Kaplan Meier, and multivariable Cox-proportional hazards regression. RESULTS 1147 (63.3% age <10 years, 54.3% male) and 459 (71.4% age <10 years, 53.6% male) patients were identified in NCDB and SEER, respectively. In NCDB, embryonal (n = 625, 54.5%) and alveolar (n = 300, 26.2%) were the most common histology and nonparameningeal/non-orbital (n = 634, 55.3%), followed by parameningeal (n = 303, 26.4%) and orbital (n = 210, 18.3%) the most common location. Five-year overall survival (OS) was 70.3% with lower mortality risk for embryonal histology (adjusted HR [aHR] = 0.69, p = 0.0038). Orbital tumors had greatest survival (5-year OS = 92.4%) of all sites, and their mortality risk was higher with chemotherapy and radiation compared to surgery and radiation (aHR = 6.27, p = 0.0302). SEER analysis showed average increased survival by 4% per year (p < 0.0001), but no significant 5-year OS difference when comparing 1976-1980 and 2006-2010 (p = 0.0843). CONCLUSIONS Major prognostic factors for survival in childhood RMS of the head and neck were embryonal histology, orbital site, extent of disease, and use of SRT for orbital tumors. Larger population studies are required to demonstrate survival differences between treatment modalities for other sites.
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Affiliation(s)
- Christina Darwish
- Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, DC, USA
| | - Timothy Shim
- Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, DC, USA
| | - Andrew D Sparks
- Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, DC, USA
| | - Yeshwant Chillakuru
- Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, DC, USA
| | - David Strum
- Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, DC, USA
| | - Daniel A Benito
- Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, DC, USA
| | - Ashkan Monfared
- Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, DC, USA.
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Abstract
Researchers have developed an immune-deficient adult zebrafish model that engrafts a variety of human cancers, allowing them to visualize tumor growth at single-cell resolution and track responses to drug therapy. Using the model, they identified a possible treatment for rhabdomyosarcoma.
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35
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Yang GS, Jiang H, Xia D, Fan LX, Liu BC, Zhong RL, Luo YH, Zhou SY. [Paratesticular embryonal rhabdomyosarcoma: report of 5 cases and review of the literature]. Zhonghua Nan Ke Xue 2010; 16:840-843. [PMID: 21171272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To improve the diagnosis and treatment of paratesticular embryonal rhabdomyosarcoma (PER). METHODS We retrospectively studied the clinical data of 5 cases of PER treated from 1997 to 2009 and reviewed the relevant literature, focusing on its clinical manifestations, diagnosis and treatment. RESULTS The 5 cases of PER, 2 involving the spermatic cord, 2 the testis and 1 the tunica vaginalis, were all treated by radical orchiectomy. Pathologically, 2 cases were classified as stage I, 1 as stage II and 2 as stage IV. Postoperatively, 2 of the patients received chemotherapy and the other 3 refused adjunctive therapy. The patients were followed up for 6, 12, 18 and 28 months, respectively. Four of them remained free from relapse and metastasis, and 1 stage IV patient died of multiple metastasis at 6 months. CONCLUSION Early diagnosis, radical orchiectomy and adjunctive chemo- or radio-therapy are effective means to the treatment of PER.
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Affiliation(s)
- Guo-sheng Yang
- Department of Urology, The Second Peoples Hospital of Guangdong Province, Guangzhou, Guangdong 510317, China.
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36
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Rohaizam J, Doris EJYH, Tang PI, Lee SC, Uchang J. Adult embryonal rhabdomyosarcoma of the ethmoid: a rare entity. Med J Malaysia 2010; 65:160-161. [PMID: 23756807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Embryonal rhabdomyosarcoma is an exceedingly rare tumor in adult. We report an embryonal rhabdomyosarcoma of the ethmoid in a 59-year-old Iban lady who presented with proptosis and complete ptosis of her left eye for two months. Imaging investigations showed left ethmoidal and left orbital soft tissue mass with extradura and dura involvement. The patient was planned for chemotherapy. Unfortunately, in such an advanced disease, she succumbed before treatment.
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Affiliation(s)
- J Rohaizam
- Sarawak General Hospital, Department of ENT Head & Neck Surgery, Kuching, Sarawak, Malaysia.
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Lesko E, Gozdzik J, Kijowski J, Jenner B, Wiecha O, Majka M. HSP90 antagonist, geldanamycin, inhibits proliferation, induces apoptosis and blocks migration of rhabdomyosarcoma cells in vitro and seeding into bone marrow in vivo. Anticancer Drugs 2007; 18:1173-81. [PMID: 17893518 DOI: 10.1097/cad.0b013e3282ef532d] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
In this study, geldanamycin (GA) was found to have an antiproliferative effect on both embryonal and alveolar rhabdomyosarcoma (RMS) cell lines. The maximum level of inhibition reached 80% for both embryonal and alveolar RMS. After GA treatment, cells also became apoptotic as judged by Annexin V-positive staining, activation of caspase-3 pathway and poly(ADP ribose) polymerase cleavage. GA was responsible for the arrest of RMS cells in both G1 and G2/M phases of the cell cycle. G1 blockade, however, was transient and was seen only in the first 24 h of GA treatment. RMS often gives distant metastases to various organs including bone marrow. RMS cells express high levels of MET receptor and respond to hepatocyte growth factor with increased motility. In our study, we found that GA decreased the level of MET expression and inhibited the chemotaxis of RMS cells toward the hepatocyte growth factor gradient. GA also blocked the homing of RMS cells into bone marrow of severe combined immune deficient mice. In all our experiments embryonal RMS cell lines were significantly more sensitive, and lower concentrations of GA were sufficient to block embryonal RMS cell proliferation, induce apoptosis and inhibit motility. Our data show that the HSP90 inhibitor GA has the potential to become a new drug in RMS treatment. It blocks RMS proliferation, decreases cell survival and inhibits motility of RMS cells.
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Affiliation(s)
- Ewa Lesko
- Department of Transplantation, Polish-American Institute of Pediatrics, Jagiellonian University School of Medicine, Cracow, Poland
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38
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Kobayashi M, Kagawa T, Takano R, Itagaki S, Hirano T, Iseki K. Effect of medium pH on the cytotoxicity of hydrophilic statins. J Pharm Pharm Sci 2007; 10:332-9. [PMID: 17727796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
PURPOSE The aim of this study was to examine the mechanism of pravastatin- and rosuvastatin-induced cytotoxicity and the relationship between pravastatin- and rosuvastatin-induced cytotoxicity and medium pH using human prototypic embryonal rhabdomyosarcoma cell line (RD) and rat myoblast cell line (L6) as a model of in vitro skeletal muscle. METHODS Statin-induced reduction of cell viability and apoptosis was measured by 3-(4,5-dimethylthiazol-2-yl)2,5 -diphenyl tetrazolium bromide (MTT) assay and caspase assay. Intracellular accumulation of statins was determined using an HPLC system. RESULTS Rosuvastatin cytotoxicity, reduction of cell viability, morphological changes and caspase activation at acidic pH (pH 6.8) were significantly greater than those at neutral pH (pH 7.4). Rosuvastatin accumulation at acidic pH was greater than that at pH 7.4. On the other hand, medium pH had no effect on pravastatin accumulation. CONCLUSIONS Rosuvastatin cytotoxicity at acidic pH is associated with increasing intracellular accumulation of rosuvastatin. On the other hand, medium pH had no effect on cytotoxicity of pravastatin.
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Affiliation(s)
- Masaki Kobayashi
- Laboratory of Clinical Pharmaceutics and Therapeutics, Division of Pharmasciences, Faculty of Pharmaceutical Sciences, Hokkaido University, Kita-12-jo, Nishi-6-chome, Kita-ku, Sapporo 060-0812, Japan
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Wu H, Seki T, Dmitriev I, Uil T, Kashentseva E, Han T, Curiel DT. Double modification of adenovirus fiber with RGD and polylysine motifs improves coxsackievirus-adenovirus receptor-independent gene transfer efficiency. Hum Gene Ther 2002; 13:1647-53. [PMID: 12228019 DOI: 10.1089/10430340260201734] [Citation(s) in RCA: 107] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Adenoviral vectors based on serotype 5 (Ad5) have been widely used to deliver therapeutic genes to different organs and tissues. However, many tissues are poorly infected with Ad5 because of low-level expression of its primary receptor, coxsackievirus-adenovirus receptor (CAR). Two motifs, RGD and polylysine (pK7), have been shown to enhance Ad5 infection via CAR-independent pathways when incorporated into fiber separately. Because the two motifs bind to different cell surface proteins (RGD motif binds to integrins, and pK7 binds to heparan sulfate-containing receptors), we hypothesized that the two motifs function additively to improve gene transfer efficiency. In this study, we sought to improve infectivity of Ad5 by incorporating both RGD and pK7 motifs into fiber. We created an Ad5 vector containing an RGD motif in the HI loop and a pK7 motif at the C terminus of fiber (Ad5.RGD.pK7). Compared with unmodified and singly modified Ad5 vectors Ad5.RGD and Ad5.pK7, the doubly modified Ad5 demonstrated the highest infectivity in both CAR-positive and CAR-negative cells. The enhanced infectivity appeared to be mediated by additive effects of the two motifs. More importantly, Ad5.RGD.pK7 lost the natural CAR-dependent pathway while employing novel targeting mechanisms. This strategy thus may be used to overcome CAR deficiency and to achieve vector retargeting.
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Affiliation(s)
- Hongju Wu
- Division of Human Gene Therapy, Department of Medicine, Gene Therapy Center, University of Alabama at Birmingham, Birmingham, AL 35294-2172, USA
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40
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Paramelle O, Croué A, Dupré F, Rialland X, Saint-André JP. [Pelvic malignant ectomesenchymoma: a case report]. Ann Pathol 2001; 21:344-7. [PMID: 11685134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
We report the case of a 19 month old boy referred to our institution because of a pelvic tumor initially identified as an embryonal rhabdomyosarcoma and treated with surgery and chemotherapy. Eight years after the initial surgery, a local tumor recurrence with bone metastasis was found. Histological examination and immunohistochemistry showed a double differentiation with both muscular and neuronal cells. This double differentiation was retrospectively found in the initial tumor, then allowing the diagnosis of malignant ectomesenchymoma also called gangliorhabdomyosarcoma. This rare tumor, occurring mainly during childhood, is composed of neuroblasts and / or ganglion cells and of malignant mesenchymal cells (usually rhabdomyosarcomatous cells).
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Affiliation(s)
- O Paramelle
- Laboratoire d'Anatomie Pathologique, 49033 Angers Cedex, France
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41
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Blaes F, Beeson D, Plested P, Lang B, Vincent A. IgG from "seronegative" myasthenia gravis patients binds to a muscle cell line, TE671, but not to human acetylcholine receptor. Ann Neurol 2000; 47:504-10. [PMID: 10762162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Antibodies to acetylcholine receptor (AChR) are found in 85% of patients with myasthenia gravis (seropositive MG [SPMG]) and are thought to be pathogenic; but in 15% of MG patients, the standard immunoprecipitation test for anti-AChR is negative (seronegative MG [SNMG]). Here, we used a novel approach, fluorescence-activated cell sorting analysis, to measure binding of SPMG and SNMG IgG antibodies to rhabdomyosarcoma cell lines that express human adult (TE671-epsilon) or fetal (TE671-gamma) AChR, and to human embryonic kidney (HEK) fibroblasts that express adult human AChR (HEK-AChR). We found that whereas most SPMG antibodies bind to all three cell lines, IgG from 8 of 15 SNMG sera/plasmas bind to the surface of both TE671 cell lines but not to HEK-AChR cells. These results indicate that SNMG antibodies bind to a muscle surface antigen that is not the AChR, which strongly supports previous studies that suggest that SNMG should be considered a distinct subtype of MG.
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Affiliation(s)
- F Blaes
- Department of Clinical Neurology, Institute of Molecular Medicine, University of Oxford, UK
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43
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Takimoto Y, Kuramoto A. The potential for bidirectional promoter activity of the human PDGF-A chain gene. Hiroshima J Med Sci 1994; 43:119-122. [PMID: 7883577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Platelet-derived growth factor (PDGF) is a heterodimeric glycoprotein consisting of A and B chains. A functional promoter had been identified in the 5' flanking region of the human PDGF-A chain gene. We found that the PDGF-A chain promoter region possesses the potential for bidirectional activity. This bidirectional promoter activity is influenced by the 5'-untranslated region (5'-UTR) and serum concentration. The 5'-UTR may regulate expression of the PDGF-A chain by transcription in the opposite direction.
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Affiliation(s)
- Y Takimoto
- Department of Internal Medicine, Hiroshima University, Japan
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44
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LEYNS J. [RADIUM TREATED BOTRYOID SARCOMA OF THE VAGINA IN A 10-MONTH OLD GIRL]. Ned Tijdschr Verloskd Gynaecol 1965; 64:319-22. [PMID: 14328101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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45
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EDLAND RW. EMBRYONAL RHABDOMYOSARCOMA. Am J Roentgenol Radium Ther Nucl Med 1965; 93:671-85. [PMID: 14259985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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46
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CARVALHO-PINTO V, MAKSOUD JG, ADDE FC, NOGUEIRA PC. [SARCOMA BOTRYOIDES IN INFANCY; REPORT OF 2 CASES]. Rev Paul Med 1965; 66:87-95. [PMID: 14309270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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47
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SATO H, KATO F, YAMADA S. [SARCOMA BOTRYOIDES OF THE BLADDER IN CHILDREN]. Gan No Rinsho 1965; 11:43-6. [PMID: 14285734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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48
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KIKUCHI K, KODAMA T, KURITA J. [POST MORTEM CASE OF EMBRYONAL RHABDOMYOSARCOMA OF THE EPIPHARYNX]. Gan No Rinsho 1964; 10:813-7. [PMID: 14253639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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49
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TAKEBAYASHI S, HASHIGUCHI T, TANAKA S, ISHIZU S. [ON BOTRYOID SARCOMA (MESODERMAL MIXED TUMOR) IN THE PERINEAL REGION IN INFANT]. Gan No Rinsho 1964; 10:501-9. [PMID: 14171356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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50
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