bims-myxlip 2023-10-29 papers

Issue of 2023–10–29
three papers selected by
Laura Mannarino, Humanitas Research

Metabolites. 2023 Sep 26. pii: 1035. [Epub ahead of print]13(10):

Metabolic Clues to Bile Acid Patterns and Prolonged Survival in Patients with Metastatic Soft-Tissue Sarcoma Treated with Trabectedin.

Gianmaria Miolo, Angela Buonadonna, Simona Scalone, Davide Lombardi, Lara Della Puppa, Agostino Steffan, Giuseppe Corona.

Metastatic soft-tissue sarcomas (mSTS) encompass a highly heterogeneous group of rare tumours characterized by different clinical behaviours and outcomes. Currently, prognostic factors for mSTS are very limited, posing significant challenges in predicting patient survival. Within a cohort of 39 mSTS patients undergoing trabectedin treatment, it was remarkable to find one patient who underwent 73 cycles of trabectedin achieving an unforeseen clinical outcome. To identify contributing factors to her exceptional long-term survival, we have explored circulation metabolomics and biohumoral biomarkers to uncover a potential distinct host biochemical phenotype. The long-term survival patient compared with the other mSTS patients exhibited a distinctive metabolic profile characterized by remarkably higher levels of ursodeoxycholic acid (UDCA) derivatives and vitamin D and lower levels of lithocholic acid (LCA) derivatives, as well as reduced levels of inflammatory C-Reactive Protein 4 (C-RP4) biomarker. Despite its exploratory nature, this study reveals a potential association between specific bile acid metabolic profiles and mSTS patients' prognosis. Enhanced clinical understanding of the interplay between bile acid metabolism and disease progression could pave the way for new targeted therapeutic interventions which may improve the overall survival of mSTS patients.

Keywords: bile acids; glycoursodeoxycholic acid; metabolomics; sarcoma; tauroursodeoxycholic acid; trabectedin; ursodeoxycholic acid

DOI: https://doi.org/10.3390/metabo13101035

Cureus. 2023 Sep;15(9): e45559

Solitary Metastasis to the Breast From Thigh Myxoid Liposarcoma.

Thuy-Linh Tran, Irene Tsai, Hyung Won Choi.

Metastasis to the breast from non-mammary malignancies are rare and suggestive of advanced disease. Accurate and prompt diagnosis of breast metastasis can provide important prognostic information and guide treatment planning. Interestingly, in contrast to primary breast malignancies, non-mammary metastatic breast lesions often have benign-appearing imaging characteristics. Knowing a patient's clinical history and having prior breast imaging studies for comparison is important for making accurate assessments and appropriate recommendations. Imaging-guided biopsy is often indicated for definitive tissue diagnosis. We report a rare case of solitary metastasis to the breast from thigh myxoid liposarcoma.

Keywords: breast mass; breast metastasis; mammography; myxoid liposarcoma; ultrasound

DOI: https://doi.org/10.7759/cureus.45559

Cancers (Basel). 2023 Oct 18. pii: 5036. [Epub ahead of print]15(20):

Prospective, Multicenter Phase II Trial of Non-Pegylated Liposomal Doxorubicin Combined with Ifosfamide in First-Line Treatment of Advanced/Metastatic Soft Tissue Sarcomas.

Angela Buonadonna, Simona Scalone, Davide Lombardi, Arianna Fumagalli, Alessandra Guglielmi, Chiara Lestuzzi, Jerry Polesel, Vincenzo Canzonieri, Stefano Lamon, Petros Giovanis, Sara Gagno, Giuseppe Corona, Maurizio Mascarin, Claudio Belluco, Antonino De Paoli, Gianpiero Fasola, Fabio Puglisi, Gianmaria Miolo.

Doxorubicin is a widely used anticancer agent as a first-line treatment for various tumor types, including sarcomas. Its use is hampered by adverse events, among which is the risk of dose dependence. The potential cardiotoxicity, which increases with higher doses, poses a significant challenge to its safe and effective application. To try to overcome these undesired effects, encapsulation of doxorubicin in liposomes has been proposed. Caelyx and Myocet are different formulations of pegylated (PLD) and non-pegylated liposomal doxorubicin (NPLD), respectively. Both PLD and NPLD have shown similar activity compared with free drugs but with reduced cardiotoxicity. While the hand-foot syndrome exhibits a high occurrence among patients treated with PLD, its frequency is notably reduced in those receiving NPLD. In this prospective, multicenter, one-stage, single-arm phase II trial, we assessed the combination of NPLD and ifosfamide as first-line treatment for advanced/metastatic soft tissue sarcoma (STS). Patients received six cycles of NPLD (50 mg/m2) on day 1 along with ifosfamide (3000 mg/m2 on days 1, 2, and 3 with equidose MESNA) administered every 3 weeks. The overall response rate, yielding 40% (95% CI: 0.29-0.51), resulted in statistical significance; the disease control rate stood at 81% (95% CI: 0.73-0.90), while only 16% (95% CI: 0.08-0.24) of patients experienced a progressive disease. These findings indicate that the combination of NPLD and ifosfamide yields a statistically significant response rate in advanced/metastatic STS with limited toxicity.

Keywords: doxorubicin; ifosfamide; non-pegylated doxorubicin; soft tissue sarcoma

DOI: https://doi.org/10.3390/cancers15205036