Genomics and Novel Targeted Treatment of Soft-Tissue Sarcoma

A special issue of Cells (ISSN 2073-4409). This special issue belongs to the section "Tissues and Organs".

Deadline for manuscript submissions: closed (30 July 2023) | Viewed by 5059

Special Issue Editor


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Guest Editor
Department of Precision Medicine, School of Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
Interests: sarcoma; organ on chip; immunotherapy; tumor microenvironment immunophenotype

Special Issue Information

Dear Colleagues,

Sarcomas are heterogeneous mesenchymal malignancies arising from bone, cartilage, or connective tissues such as muscle, fat, peripheral nerves, fibrous, or related tissues, and range from indolent to highly invasive and metastatic. From a molecular genetics perspective, few are currently targeted therapeutically. A better understanding of the underlying oncogenic processes and their regulatory mechanisms is essential to improve the patient outcomes of these devastating diseases. Furthermore, the emerging genomic and functional genetic approaches, coupled with novel therapeutic strategies, may have the potential to transform the care of patients with sarcoma.

Dr. Filomena De Nigris
Guest Editor

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Keywords

  • soft sarcoma
  • bone sarcoma
  • Ewing sarcoma
  • chondrosarcoma
  • genomic landscape
  • novel targets
  • tumor microenvironment
  • signaling pathway

Published Papers (3 papers)

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Research

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15 pages, 5202 KiB  
Article
The Impact of O6-Methylguanine-DNA Methyltransferase (MGMT) Promoter Methylation on the Outcomes of Patients with Leiomyosarcoma Treated with Dacarbazine
by Lucia Cannella, Rosa Della Monica, Antonella Lucia Marretta, Domenico Iervolino, Bruno Vincenzi, Anna Rosaria De Chiara, Ottavia Clemente, Michela Buonaiuto, Maria Luisa Barretta, Annabella Di Mauro, Massimiliano Di Marzo, Michele Guida, Giuseppe Badalamenti, Lorenzo Chiariotti and Salvatore Tafuto
Cells 2023, 12(12), 1635; https://doi.org/10.3390/cells12121635 - 15 Jun 2023
Cited by 1 | Viewed by 1290
Abstract
Dacarbazine is an important drug in the therapeutic landscape of leiomyosarcoma (LMS). Alkylating agents are subjected to resistance mechanisms based on anti-apoptotic pathways and repair mechanisms, including the DNA repair enzyme O6-methylguanine-DNA methyltransferase (MGMT). In this retrospective study, the methylation status [...] Read more.
Dacarbazine is an important drug in the therapeutic landscape of leiomyosarcoma (LMS). Alkylating agents are subjected to resistance mechanisms based on anti-apoptotic pathways and repair mechanisms, including the DNA repair enzyme O6-methylguanine-DNA methyltransferase (MGMT). In this retrospective study, the methylation status of the MGMT promoter in histological tumor samples from patients with LMS, dacarbazine-based regimens-treated, was measured and correlated with clinical outcomes aimed at optimizing the use of dacarbazine in soft tissue sarcomas. The patients with unmethylated MGMT had better outcomes than those with methylated MGMT. Patients without MGMT methylation had better Progression Free Survival (PFS) when aged ≥62 years compared to those aged <62 years, while PFS of patients with methylated MGMT was less favorable independently of age (p = 0.0054). The patients without a methylated MGMT gene had higher Disease control rate (DCR). These results are not in agreement with the role of the methylated MGMT gene in other tumors, and with this study, we demonstrated the correlation between methylated MGMT and poor prognosis; despite that, sample smallness, heterogeneity of LMS and of treatment history could be selection bias. Predictive markers of response to chemotherapies in sarcomas remain an unmet need. Full article
(This article belongs to the Special Issue Genomics and Novel Targeted Treatment of Soft-Tissue Sarcoma)
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Review

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15 pages, 724 KiB  
Review
Genomic Profiling and Clinical Outcomes of Targeted Therapies in Adult Patients with Soft Tissue Sarcomas
by Stefania Kokkali, Eleni Georgaki, Georgios Mandrakis, Claudia Valverde and Stamatios Theocharis
Cells 2023, 12(22), 2632; https://doi.org/10.3390/cells12222632 - 15 Nov 2023
Cited by 1 | Viewed by 1654
Abstract
Genomic profiling has improved our understanding of the pathogenesis of different cancers and led to the development of several targeted therapies, especially in epithelial tumors. In this review, we focus on the clinical utility of next-generation sequencing (NGS) to inform therapeutics in soft [...] Read more.
Genomic profiling has improved our understanding of the pathogenesis of different cancers and led to the development of several targeted therapies, especially in epithelial tumors. In this review, we focus on the clinical utility of next-generation sequencing (NGS) to inform therapeutics in soft tissue sarcoma (STS). The role of NGS is still controversial in patients with sarcoma, given the low mutational burden and the lack of recurrent targetable alterations in most of the sarcoma histotypes. The clinical impact of genomic profiling in STS has not been investigated prospectively. A limited number of retrospective, mainly single-institution, studies have addressed this issue using various NGS technologies and platforms and a variety of criteria to define a genomic alteration as actionable. Despite the detailed reports on the different gene mutations, fusions, or amplifications that were detected, data on the use and efficacy of targeted treatment are very scarce at present. With the exception of gastrointestinal stromal tumors (GISTs), these targeted therapies are administered either through off-label prescription of an approved drug or enrollment in a matched clinical trial. Based mainly on anecdotal reports, the outcome of targeted therapies in the different STS histotypes is discussed. Prospective studies are warranted to assess whether genomic profiling improves the management of STS patients. Full article
(This article belongs to the Special Issue Genomics and Novel Targeted Treatment of Soft-Tissue Sarcoma)
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21 pages, 1655 KiB  
Review
Combination of Genomic Landsscape and 3D Culture Functional Assays Bridges Sarcoma Phenotype to Target and Immunotherapy
by Filomena de Nigris, Concetta Meo and Wulf Palinski
Cells 2023, 12(17), 2204; https://doi.org/10.3390/cells12172204 - 4 Sep 2023
Cited by 2 | Viewed by 1695
Abstract
Genomic-based precision medicine has not only improved tumour therapy but has also shown its weaknesses. Genomic profiling and mutation analysis have identified alterations that play a major role in sarcoma pathogenesis and evolution. However, they have not been sufficient in predicting tumour vulnerability [...] Read more.
Genomic-based precision medicine has not only improved tumour therapy but has also shown its weaknesses. Genomic profiling and mutation analysis have identified alterations that play a major role in sarcoma pathogenesis and evolution. However, they have not been sufficient in predicting tumour vulnerability and advancing treatment. The relative rarity of sarcomas and the genetic heterogeneity between subtypes also stand in the way of gaining statistically significant results from clinical trials. Personalized three-dimensional tumour models that reflect the specific histologic subtype are emerging as functional assays to test anticancer drugs, complementing genomic screening. Here, we provide an overview of current target therapy for sarcomas and discuss functional assays based on 3D models that, by recapitulating the molecular pathways and tumour microenvironment, may predict patient response to treatments. This approach opens new avenues to improve precision medicine when genomic and pathway alterations are not sufficient to guide the choice of the most promising treatment. Furthermore, we discuss the aspects of the 3D culture assays that need to be improved, such as the standardisation of growth conditions and the definition of in vitro responses that can be used as a cut-off for clinical implementation. Full article
(This article belongs to the Special Issue Genomics and Novel Targeted Treatment of Soft-Tissue Sarcoma)
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