scholarly journals Expression of the cancer stem cell marker SSEA1 is associated with poor survival in metastatic high-grade serous carcinoma

2020 ◽  
Vol 477 (5) ◽  
pp. 677-685
Author(s):  
Ben Davidson ◽  
Arild Holth ◽  
Hiep Phuc Dong

Abstract The objective of the present study was to perform a quantitative analysis of cancer stem cell (CSC) marker expression in ovarian carcinoma effusions. The clinical role of SSEA1 in metastatic high-grade serous carcinoma (HGSC) was additionally analyzed. CD133, Nanog, SOX2, Oct3/4, SSEA1, and SSEA4 protein expressions were quantitatively analyzed using flow cytometry (FCM) in 24 effusions. SSEA1 expression by immunohistochemistry was analyzed in 384 HGSC effusions. Highly variable expression of CSC markers by FCM was observed, ranging from 0 to 78% of Ber-EP4-positive cells in the case of CD133, with the largest number of negative specimens seen for SSEA4. SSEA1 expression by immunohistochemistry was found in HGSC cells in 336/384 (89%) effusions, most commonly focally (< 5% of cells). SSEA1 was overexpressed in post-chemotherapy disease recurrence specimens compared with chemo-naïve HGSC effusions tapped at diagnosis (p = 0.029). In univariate survival analysis, higher SSEA1 expression was significantly associated with poor overall survival (p = 0.047) and progression-free survival (p = 0.018), though it failed to retain its prognostic role in Cox multivariate survival analysis in which it was analyzed with clinical parameters (p = 0.059 and p = 0.111 for overall and progression-free survival, respectively). In conclusion, CSC markers are variably expressed in ovarian carcinoma effusions. SSEA1 expression is associated with disease progression and poor survival in metastatic HGSC. Silencing this molecule may have therapeutic relevance in this cancer.

2017 ◽  
Vol 38 (1) ◽  
pp. 110-114 ◽  
Author(s):  
Alena Bartakova ◽  
Kveta Michalova ◽  
Jiri Presl ◽  
Pavel Vlasak ◽  
Jan Kostun ◽  
...  

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e17552-e17552
Author(s):  
Rodrigo Sanchez-Bayona ◽  
Pablo Tolosa ◽  
Ana Sanchez de Torre ◽  
Alicia Castelo ◽  
Elsa Bernal-Hertfelder ◽  
...  

e17552 Background: In platinum-resistant ovarian cancer treatment, single-agent paclitaxel can be used alone or in combination with bevacizumab. We aimed to assess the efficacy and safety profile of a weekly paclitaxel (WP) scheme in heavily pretreated platinum-resistant high-grade serous ovarian carcinoma. Methods: We retrospectively analyzed 30 adult patients with platinum-resistant high-grade serous ovarian carcinoma treated with WP at our institution between 2015 and 2020. Patients with platinum-resistant ovarian, fallopian tube or primary carcinoma of the peritoneum who had received at least 3 doses of WP (80 mg/m2) alone or in combination with bevacizumab until disease progression or unacceptable toxicity were included in the analysis. Progression-free survival was assessed according to the Response Evaluation Criteria in Solid Tumors version 1.1. Information about toxicity was gathered from medical reports and lab tests. Kaplan-Meier curves and Log-rank test were performed for survival estimates. Results: In our sample, the median age was 68 years (IQR: 60-75) and the median number of previous lines of systemic treatment was 3 (range 1-5). 40% of patients received WP in combination with bevacizumab. The disease control rate was 60.7% (42.9% partial response and 17.8% stable disease). In the overall analysis, the median progression-free survival (mPFS) was 5.0 months (95% CI: 2.0-7.1 months). The presence of ascites significantly shortened the mPFS compared to patients without it (1.1 vs 5.1 months, p < 0.001). Even though the addition of bevacizumab to WP improved the mPFS, the difference was not statistically significant compared to WP alone (7.1 vs 4.06 months, p=0.30). Peripheral neuropathy was the most common adverse event (78% all grades, 18% grade 3). No grade 3 hematologic toxicity was registered. Treatment was discontinued in 6 patients (20%) – 4 due to peripheral neuropathy and two because of toxicoderma. Conclusions: In our sample, WP was an active and safe regimen in heavily pretreated platinum-resistant ovarian carcinoma. WP was well tolerated in elderly patients. The presence of ascites was associated to a shorter PFS in patients treated with WP compared to ascites-free patients.


1999 ◽  
Vol 17 (5) ◽  
pp. 1551-1551 ◽  
Author(s):  
S. Vincent Rajkumar ◽  
Rafael Fonseca ◽  
Martha Q. Lacy ◽  
Thomas E. Witzig ◽  
Terry M. Therneau ◽  
...  

PURPOSE: To study the prognostic value of plasmablastic morphology after autologous stem-cell transplantation for relapsed or primary refractory myeloma. PATIENTS AND METHODS: Seventy-five patients were studied. Investigators blinded to the clinical details of the individual cases reviewed bone marrow aspirate slides to determine plasmablastic classification. Plasmablasts were defined using strict, well-described criteria. Plasmablastic morphology was considered to be present (plasmablastic myeloma) when 2% or more plasmablasts were present in the plasma-cell population. RESULTS: Patients underwent transplantation 5 to 88 months (median, 20 months) after the initial diagnosis of myeloma. Twenty-eight percent of patients had plasmablastic morphology. A significantly greater proportion of patients with plasmablastic morphology had abnormal cytogenetics compared with those with nonplasmablastic classification (73% v 31%, respectively; P = .003). The overall survival rate measured from the time of transplantation was significantly worse in patients with plasmablastic morphology compared with those without (median survival time, 5 months v 24 months, respectively; P < .001). Progression-free survival time was shortened also, with a median time of 4 months compared with 12 months, respectively (P < .001). In the multivariate analysis, plasmablastic classification was the most powerful prognostic factor after transplantation for both overall (P = .001) and progression-free survival rates (P < .001). We also identified three risk groups based on plasmablastic morphology: plasma-cell labeling index, lactate dehydrogenase, and cytogenetics. The median overall survival time was 38 months when none of these factors was abnormal, 17 months with one abnormal factor, and 8 months with two or more abnormal factors (P < .001). CONCLUSION: Plasmablastic morphology is a powerful independent predictor of poor survival rate after autologous stem-cell transplantation for relapsed or primary refractory myeloma.


Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 326-326 ◽  
Author(s):  
John A. Thompson ◽  
Richard I. Fisher ◽  
Michael L. LeBlanc ◽  
Joseph M. Unger ◽  
Stephen J. Forman ◽  
...  

Abstract Purpose: To determine the effect of post-transplant immunotherapy with Interleukin-2 (IL-2) on the progression-free and overall survival of patients with non-Hodgkin’s lymphoma (NHL) after autologous stem cell transplantation and to assess the toxicity of post-transplant IL-2 therapy. Patients and Methods: Patients with previously treated low, intermediate, or high grade NHL (except Working Formulation Groups A and I) were treated with high-dose cyclophosphamide, etoposide, and total body irradiation (TBI) and an autologous peripheral blood stem cell transplant (PBSCT). Twenty-eight to 80 days after PBSCT, patients were randomized to treatment with IL-2 versus observation. Results: Between January 1995 and July 2004, three hundred ninety-four patients with low-grade (n=61) or intermediate-high grade NHL (n=315) were registered at one of 39 SWOG transplant centers. One hundred ninety patients did not proceed to randomization, because of patient refusal (44), grade V toxicity (30), disease progression (28), toxicity (28), or other reasons. Two hundred four patients were randomized to treatment with continuous infusion intravenous IL-2 (9 ×106 units/m2/day for four days followed five days later by 1.6 ×106 units/m2/day for 10 days) versus observation. The 4-year progression-free survival estimate for all eligible patients is 34%, and the 4-year overall survival estimate is 52%. There was no difference in progression-free survival (hazard ratio (HR) of IL-2 to observation = 0.90; p = 0.56) nor in overall survival (HR of IL-2 to observation = 0.88; p = 0.55). There were no deaths related to IL-2 treatment. Grade IV IL-2-related toxicities included hematologic (n=10), cardiovascular (4), renal/bladder (2), flu-like symptoms (1), lung (1), metabolic (1), and neurologic (1) and were reversible in all cases. Conclusions: These results confirm earlier SWOG findings that a regimen of cylophosphamide, etoposide and TBI followed by PBSCT can be administered to patients with relapsed or refractory NHL with acceptable toxicity and with encouraging progression-free and overall survival. Post-transplant therapy with IL-2 given at this dose and schedule of administration had no significant effect on post-transplant relapse, progression-free survival or overall survival.


2017 ◽  
Vol 27 (9) ◽  
pp. 2006-2013 ◽  
Author(s):  
Nataša Kenda Šuster ◽  
Snježana Frković Grazio ◽  
Irma Virant-Klun ◽  
Ivan Verdenik ◽  
Špela Smrkolj

ObjectiveThe objectives of this study were to assess cancer stem cell–related marker NANOG expression in ovarian serous tumors and to evaluate its prognostic significance in relation to ovarian serous carcinoma.MethodsNANOG protein expression was immunohistochemically evaluated in the ovarian tissue microarrays of 20 patients with benign ovarian serous tumors, 30 patients with borderline ovarian serous tumors, and 109 patients with ovarian serous carcinomas, from which 106 were of high-grade and 3 of low-grade morphology Immunohistochemical reaction was scored according to signal intensity and the percentage of positive cells in tumor samples. Pursuant to our summation of signal intensity and positive cell occurrence, we divided our samples into 4 groups: NANOG-negative, NANOG–slightly positive, NANOG–moderately positive, and NANOG–strongly positive group. Complete clinical data were obtained for the ovarian serous carcinoma group, and correlation between clinical data and NANOG expression was analyzed.ResultsA specific brown nuclear, or cytoplasmic reaction, was considered a positive NANOG staining. In terms of the ovarian serous carcinoma group, 69.7% were NANOG positive, 22.9% slightly positive, 22.9% moderately positive, and 23.9% strongly positive. All NANOG-positive cases were of high-grade morphology. Benign and borderline tumors and low-grade serous carcinomas were NANOG negative. There was no significant correlation between NANOG expression and clinical parameters in terms of the ovarian serous carcinoma group.ConclusionsPositive NANOG expression is significantly associated with high-grade ovarian serous carcinoma and is absent in benign, borderline, and low-grade serous lesions. In our study, there was no correlation between NANOG expression and clinical parameters, including its use in the prognosis of ovarian serous carcinoma.


2018 ◽  
Vol 28 (4) ◽  
pp. 657-665 ◽  
Author(s):  
Shinichi Komiyama ◽  
Yoshihiro Nishijima ◽  
Haruhiro Kondo ◽  
Hiroyuki Nomura ◽  
Satoshi Yamaguchi ◽  
...  

ObjectiveWe conducted a multicenter clinicopathological study to characterize patients with high-grade serous carcinoma presenting as primary peritoneal carcinoma (clinical PPC).MethodsAt 9 sites in Japan, patients with clinical PPC diagnosed according to Gynecologic Oncology Group criteria were enrolled retrospectively. The Gynecologic Oncology Group criteria allow for minor ovarian involvement by high-grade serous carcinoma. There was no systematic detailed histopathological review of the fallopian tubes to determine whether they were involved by serous carcinoma.ResultsThere were 139 patients and 64% were aged 60 years or older. Median pretreatment serum CA-125 was 1653.5 IU/mL. Pretreatment performance status was poor in more than 50%, endometrial cytology was positive in 40.3%, and the preoperative clinical diagnosis was correct in 72.7%. Primary debulking surgery was performed in 36% of patients, whereas 64% underwent neoadjuvant chemotherapy (NAC) with interval debulking surgery (IDS). The main tumor sites were the upper abdomen (greater omentum), extrapelvic peritoneum, mesentery, and diaphragm. Lymph node metastasis was found in 46.8% of patients undergoing systematic retroperitoneal node dissection. The optimal surgery rate was 32.0% with primary debulking surgery versus 53.9% with NAC and IDS (P = 0.0139). The response rate was 82.0% with NAC and 80.6% with postoperative chemotherapy. Median progression-free survival was 19.0 months and median overall survival was 41.0 months. Multivariate analysis showed that prognostic factors for progression-free survival were NAC and residual tumor diameter after debulking surgery, whereas the only prognostic factor for overall survival was the residual tumor diameter.ConclusionsThis study identified various characteristics of clinical PPC. Neoadjuvant chemotherapy with IDS is a reasonable treatment strategy, and complete debulking surgery is optimum.


2019 ◽  
Author(s):  
Λυδία Γιαννοπούλου

Ο καρκίνος των ωοθηκών αποτελεί τον τέταρτο συχνότερα εμφανιζόμενο γυναικολογικό καρκίνο και την πέμπτη αιτία θανάτου σχετιζόμενη με καρκίνο στις γυναίκες. Χαρακτηρίζεται από αξιοσημείωτη ιστολογική και μοριακή ετερογένεια, με κυριότερο υπότυπο τον ορώδη καρκίνο ωοθηκών υψηλού βαθμού κακοήθειας (high grade serous ovarian carcinoma, HGSC), που μελετήθηκε στη διατριβή. Η παρούσα διατριβή έχει σκοπό τη μελέτη της μεθυλίωσης επιλεγμένων γονιδίων στον ορώδη καρκίνο ωοθηκών υψηλού βαθμού κακοήθειας. Τα κλινικά δείγματα που χρησιμοποιήθηκαν είναι δείγματα πρωτοπαθών όγκων, αντίστοιχα δείγματα παρακείμενων ιστών, καθώς και αντίστοιχα δείγματα κυκλοφορούντος καρκινικού DNA (circulating tumor DNA, ctDNA) από τις ίδιες ασθενείς. Οι μεθοδολογίες που εφαρμόστηκαν συνιστούν την real-time MSP για την ανίχνευση της μεθυλίωσης σε δείγματα πρωτοπαθών όγκων, παρακείμενων ιστών και πλάσματος, καθώς και την MS-HRMA για τον ημιποσοτικό προσδιορισμό της μεθυλίωσης σε δείγματα πρωτοπαθών όγκων και παρακείμενων ιστών. Αρχικά εξετάστηκε η μεθυλίωση του ογκοκατασταλτικού γονιδίου RASSF1A, όπου πραγματοποιήθηκε μία συγκριτική μελέτη σε δείγματα πρωτοπαθών όγκων, παρακείμενων ιστών και ctDNA ασθενών με HGSC. Η μεθυλίωση του γονιδίου στα δείγματα πρωτοπαθών όγκων και παρακείμενων ιστών συσχετίστηκε με σημαντικά μειωμένη ολική επιβίωση (overall survival, OS) των ασθενών. Τα συνολικά αποτελέσματα της μελέτης υπέδειξαν για πρώτη φορά την προγνωστική σημασία της μεθυλίωσης του γονιδίου στον HGSC. Στη συνέχεια, ακολούθησε μελέτη μεθυλίωσης του γονιδίου ESR1, όπου πραγματοποιήθηκε μελέτη σε δείγματα πρωτοπαθών όγκων και ctDNA ασθενών με HGSC. Η μεθυλίωση του γονιδίου στα δείγματα πρωτοπαθών όγκων συσχετίστηκε με σημαντικά αυξημένα OS και διάστημα επιβίωσης χωρίς εξέλιξη της νόσου (progression free survival, PFS) των ασθενών. H παρούσα μελέτη αποτέλεσε μία προσπάθεια αποσαφήνισης του ρόλου της μεθυλίωσης του γονιδίου στον HGSC. Ακολούθησαν οι μελέτες μεθυλίωσης γονιδίων που εμπλέκονται σε μοριακά μονοπάτια που διαταράσσονται στον HGSC, όπως τα γονίδια BRCA1 και MGMT που συμμετέχουν σε διαφορετικές πορείες επιδιόρθωσης του DNA, το γονίδιο NR2F1 που συμμετέχει ενεργά στην κυτταρική αδράνεια, τα γονίδιο RASSF10 που εμπλέκεται στην ανάπτυξη χημειοαντίστασης, καθώς και το γονίδιο RKIP που συμμετέχει στην ΕΜΤ διαδικασία. Ύστερα από τη συνολική επεξεργασία των αποτελεσμάτων, παρατηρήθηκε στατιστικά σημαντική συσχέτιση της μεθυλίωσης του γονιδίου NR2F1 στα δείγματα πρωτοπαθών όγκων, με μειωμένο PFS. Επιπλέον, η μεθυλίωση του γονιδίου BRCA1 στο ctDNA συσχετίστηκε με σημαντικά αυξημένο PFS. Τέλος, πραγματοποιήθηκε μελέτη της έκφρασης του γονιδίου PD-L1 σε δείγματα κυκλοφορούντων καρκινικών κυττάρων (circulating tumor cells, CTCs) ασθενών με HGSC, με την εφαρμογή RT-qPCR. Με βάση τα αποτελέσματα της μελέτης, παρατηρήθηκε στατιστικά σημαντική συσχέτιση της έκφρασης του γονιδίου με μειωμένη OS των ασθενών, υποδεικνύοντας μία πιθανή προγνωστική σημασία στον HGSC.


BMC Cancer ◽  
2010 ◽  
Vol 10 (1) ◽  
Author(s):  
Patrick Evers ◽  
Percy P Lee ◽  
John DeMarco ◽  
Nzhde Agazaryan ◽  
James W Sayre ◽  
...  

2020 ◽  
Author(s):  
Mitsutake Yano ◽  
Mariko Miyazawa ◽  
Naoki Ogane ◽  
Aiko Ogasawara ◽  
Kosei Hasegawa ◽  
...  

Abstract Background: Ovarian high-grade serous carcinoma (HGSC) gradually acquires chemoresistance after recurrence. In our previous study on ovarian clear cell carcinoma, histone deacetylase 6 (HDAC6) led to chemoresistance. This study aimed to evaluate HDAC6 as a predictor of chemoresistance and therapeutic target for ovarian HGSC. Methods: We evaluated the clinical significance of HDAC6 as a predictor of prognosis and chemoresistance in HGSC. Immunohistochemical expressions of HDAC6, programmed cell death ligand-1 (PD-L1), and hypoxia inducible factor-1α (HIF-1α) were analyzed using clinical samples from 88 patients with ovarian HGSC. The clinicopathological characteristics were reviewed. Results: Twenty-three patients had high HDAC6 expression; 10, positive PD-L1 expression; and 33, high HIF-1α expression. HDAC6 up-regulation was correlated with not undergoing interval debulking surgery (p < 0.001), incomplete surgical resection (p = 0.002), and frequent occurrence of stable disease/progressive disease according to the RECIST (p = 0.005) criteria. On Kaplan-Meier analysis, high HDAC6 expression was significantly associated with decreased progression-free survival (p = 0.001) and overall survival (p = 0.008). On multivariate analysis, high HDAC6 expression (hazard ratio = 1.65; 95% confidence interval 1.03–2.66, p = 0.039) and surgery status were independent prognostic factors of progression-free survival. PD-L1 and HIF-1α expressions positively correlated with HDAC6. Conclusion: HDAC6 is a potential therapeutic target since HDAC6 up-regulation might cause poor prognosis in patients with ovarian HGSC.


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