细胞周期蛋白依赖性激酶4(CDK4)作为软组织肉瘤预后生物标志物的作用及其抑制在去分化脂肪肉瘤序贯治疗中的协同效应

Role of CDK4 as prognostic biomarker in Soft Tissue Sarcoma and synergistic effect of its inhibition in dedifferentiated liposarcoma sequential treatment.

作者信息

Vanni Silvia, Miserocchi Giacomo, Gallo Graziana, Fausti Valentina, Gabellone Sofia, Liverani Chiara, Spadazzi Chiara, Cocchi Claudia, Calabrese Chiara, De Luca Giovanni, Bassi Massimo, Gessaroli Manlio, Tomasetti Nicola, Campobassi Angelo, Pieri Federica, Ercolani Giorgio, Cavaliere Davide, Gurrieri Lorena, Riva Nada, Recine Federica, Ibrahim Toni, Mercatali Laura, Jones Robin, De Vita Alessandro

机构信息

Preclinic and Osteoncology Unit, Biosciences Laboratory, IRCCS Istituto Romagnolo Per Lo Studio Dei Tumori (IRST) "Dino Amadori", Meldola, FC, Italy.

Pathology Unit, Bufalini Hospital, Cesena, Italy.

出版信息

Exp Hematol Oncol. 2024 Aug 5;13(1):74. doi: 10.1186/s40164-024-00540-4.

Abstract

Soft tissue sarcomas represent an heterogeneous group of rare mesenchymal tumors comprising 1% of all solid malignancies. Among them, liposarcoma is one of the most common histotypes with atypical lipomatous tumor/well differentiated liposarcoma and dedifferentiated liposarcoma (ALT/WDLPS and DDLPS) as the major sub-entities. The unavailability of predictive, prognostic and druggable biomarkers makes the management of these lesions challenging. In recent years CDK4 and its inhibitors have emerged as potential agents for these lesions especially for ALT/WDLPS and DDLPS but the results are not conclusive and need to be elucidated. This study involved 21 ALT/WDLPS and DDLPS patients. Histological analyses of MDM2 and CDK4 were carried out. Moreover, a DDLPS patient-derived cancer model was established in vitro and in vivo assessing the efficacy of palbociclib in combination and sequential treatment. Finally, in silico analyses on CDK4 expression were carried out. The results showed a higher expression of CDK4 and MDM2 in DDLPS compared to ALT/WDLPS. Moreover, no correlation between MDM2 expression and CDK4 was observed. Next, in vitro analysis of CDK4 inhibitor palbociclib showed an antagonistic effect when combined to other chemotherapeutics, while it exhibited a significant synergy when administered in sequential schedule with lenvatinib. Next, in vivo analysis on DDLPS xenotransplanted embryos assessing the efficacy and safety profile of the in vitro tested schedules confirmed the observed data. This proof-of-concept study sheds light on the natural history of ALT/WDLPS and DDLPS and provides the rationale for the clinical applicability of sequential treatment with palbociclib in the management of DDLPS.

摘要

软组织肉瘤是一组异质性的罕见间充质肿瘤,占所有实体恶性肿瘤的1%。其中,脂肪肉瘤是最常见的组织学类型之一,非典型脂肪瘤性肿瘤/高分化脂肪肉瘤和去分化脂肪肉瘤(ALT/WDLPS和DDLPS)是主要的亚实体。缺乏预测性、预后性和可靶向的生物标志物使得这些病变的管理具有挑战性。近年来,CDK4及其抑制剂已成为这些病变的潜在治疗药物,尤其是对于ALT/WDLPS和DDLPS,但结果尚无定论,需要进一步阐明。本研究纳入了21例ALT/WDLPS和DDLPS患者。对MDM2和CDK4进行了组织学分析。此外,建立了一个源自DDLPS患者的癌症模型,在体外和体内评估哌柏西利联合及序贯治疗的疗效。最后,对CDK4表达进行了计算机分析。结果显示,与ALT/WDLPS相比,DDLPS中CDK4和MDM2的表达更高。此外,未观察到MDM2表达与CDK4之间存在相关性。接下来,对CDK4抑制剂哌柏西利的体外分析表明,与其他化疗药物联合使用时具有拮抗作用,而与乐伐替尼序贯给药时则表现出显著的协同作用。接下来,对DDLPS异种移植胚胎进行体内分析,评估体外测试方案的疗效和安全性,证实了观察到的数据。这项概念验证研究揭示了ALT/WDLPS和DDLPS的自然病史,并为哌柏西利序贯治疗在DDLPS管理中的临床应用提供了理论依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e71/11299298/bfecf432ca9b/40164_2024_540_Fig1_HTML.jpg

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