Metastasis-directed radiation therapy after radical cystectomy for bladder cancer

Miranda, Andre F.; Howard, Jeffrey; McLaughlin, Mark; Meng, Xiaosong; Clinton, Timothy; Şanlı, Öner; Garant, Aurélie; Bagrodia, Aditya; Margulis, Vitaly; Lotan, Yair; Hannan, Raquibul; Desai, Neil B.; Woldu, Solomon L.

doi:10.1016/j.urolonc.2021.05.005

Cited by 14 publications

(26 citation statements)

References 17 publications

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“…Further assessment of eligibility, based on full-text study of the papers, led to the exclusion of 12 papers. Finally, 6 studies (1 conference abstract and 5 full papers) involving 158 patients were included in the final analysis (Figure 1) [16][17][18][19][20][21].…”

Section: Resultsmentioning

confidence: 99%

“…Traditionally, radiotherapy has been limited to disease palliation. In recent years, MDRT with consolidative intent has emerged as a more-attractive alternative to metastasectomy in oligometastatic patients thanks to its being less invasive [19]. The SABR-COMET and ORIOLE randomized trials demonstrated improved oncologic outcomes with MDRT in patients with several metastatic cancers [33,34].…”

Section: Discussionmentioning

confidence: 99%

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Metastasis-Directed Radiation Therapy with Consolidative Intent for Oligometastatic Urothelial Carcinoma: A Systematic Review and Meta-Analysis

Longo

Celentano

Napolitano

et al. 2022

Cancers

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The management of patients with oligometastatic urothelial carcinoma (UC) represents an evolving field in uro-oncology, and the role of metastasis-directed therapies, including metastasectomy and metastasis-directed radiation therapy (MDRT), is gaining increasing attention. Herein, we summarize available evidence about the role of MDRT with consolidative intent in oligometastatic UC patients. A systematic review was performed in December 2021. Six studies involving 158 patients were identified. Most patients (n = 120, 90.2%) had a history of bladder cancer and the most frequent sites of metastases were lymph nodes (n= 61, 52.1%) followed by the lungs (n = 34, 29%). Overall, 144 metastases were treated with MDRT. Median follow-up ranged from 17.2 to 25 months. Local control rates ranged from 57% to 100%. Median Overall Survival (OS) ranged from 14.9 to 51.0 months and median progression-free survival ranged from 2.9 to 10.1 months. Rates of OS at one and two years ranged from 78.9% to 96% and from 26% to 63%, respectively. Treatment-related toxicity was recorded in few patients and in most cases a low-grade toxicity was evident. MDRT with consolidative intent represents a potential treatment option for selected patients with oligometastatic UC.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Metastasis-Directed Radiation Therapy with Consolidative Intent for Oligometastatic Urothelial Carcinoma: A Systematic Review and Meta-Analysis

Longo

Celentano

Napolitano

et al. 2022

Cancers

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“…For stereotactic body radiation therapy (SBRT), Francolini et al [44] and Leonetti et al [45] report a median OS of 13.8 and 14.5 months, respectively, while Franzese et al [15] observed a median OS of 25.6 months, with no grade at least 3 adverse events; Muilwijk et al [16] retrospectively described 22 metastasectomies in oligorecurrent cancer (59% lung) with an impressive 5-year OS rate of 51.4%; lesion size above 8 mm, multiple lung metastases, hepatic involvement and upper-tract primary tumour were associate with worse outcomes. Miranda et al [46] reported on a cohort of de-novo oligometastatic BCa patients (N ¼ 52; 5 lesions) receiving consolidative or palliative MDT radiotherapy, after cystectomy and concomitant to systemic therapy in 60%. Among patients treated with a consolidative intent, 2-year PFS was 19% and OS was 60%, with no grade 3 (or greater) toxicities were encountered.…”

Section: Role Of Metastasis-directed Therapy For Oligorecurrent/ Olig...mentioning

confidence: 99%

“…Miranda et al . [46] reported on a cohort of de-novo oligometastatic BCa patients ( N = 52; ≤ 5 lesions) receiving consolidative or palliative MDT radiotherapy, after cystectomy and concomitant to systemic therapy in 60%. Among patients treated with a consolidative intent, 2-year PFS was 19% and OS was 60%, with no grade 3 (or greater) toxicities were encountered.…”

Section: Role Of Metastasis-directed Therapy For Oligorecurrent/oligo...mentioning

confidence: 99%

Definitions, outcomes and perspectives for oligometastatic bladder cancer: towards a standardized terminology

Calleris,

von Deimling,

Kesch

et al. 2024

Current Opinion in Urology

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Purpose of review Oligometastatic (om) cancer is considered as a transitional state in between locally confined disease and widespread metastases, accessible to a multimodal treatment, combining systemic and local therapy. In urothelial bladder cancer (BCa), the definitions and the approaches to this condition are poorly standardised and mainly based on retrospective data. We aim to portray the framework for uro-oncologic terminology in omBCa and go through the latest evidence and the future perspectives. Recent findings Retrospective and registry data support the potential benefits of multimodality treatment for carefully selected omBCa patients, especially following a good response to systemic treatment. In 2023, a Delphi consensus has defined omBCa, allowing maximum three metastatic lesions, theoretically amenable to radical local treatment. In de-novo omBCa, surgical treatment of primary tumour might improve overall survival (OS), according to a matched registry analysis; also, consolidative radiotherapy was associated with better OS in two recent cohorts. Furthermore, metastasis-directed therapy (MDT) has shown high local control rates and promising OS (14.9–51 months) in a meta-analysis; benefits might be more pronounced for single-site omBCa and nodal or lung lesions. Summary From a clinical perspective, in de-novo omBCa, the local treatment of primary and metastatic sites might improve disease control and survival, in selected patients; in the oligorecurrent setting, MDT achieves good local symptom control with limited side effects; in selected cases, it could convey a survival benefit, too. From a research perspective, well designed prospective evidence is eagerly awaited, based on recently adopted shared definitions for omBCa.

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“…Currently, more than half of newly diagnosed cancer patients require radiation therapy, which can be combined with surgery, chemotherapy, or molecular targeted therapies ( 4 ). Radiation therapy has played a vital role in the treatment of patients with metastatic disease ( 5 ). It has been proven that the biological basis of radiation therapy is the effect of ionizing radiation on biological cells ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

LncRNA KCNQ1OT1 enhances the radioresistance of lung squamous cell carcinoma by targeting the miR-491-5p/TPX2-RNF2 axis

Liu¹,

Mi²,

Guan³

et al. 2022

J Thorac Dis

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Background: Lung cancer, especially lung squamous cell carcinoma (LUSC), is one of the most common malignant tumors worldwide. Currently, radiosensitization research is a vital direction for the improvement of LUSC therapy. Long non-coding RNAs (lncRNAs) can be novel biomarkers due to their multiple functions in cancers. However, the function and mechanism of lncRNA KCNQ1OT1 in the radioresistance of LUSC remain to be elucidated. Methods:The clonogenic assay was employed to determine the radioresistance of SK-MES-1R and NCI-H226R cells. Real-time quantitative polymerase chain reaction (RT-qPCR) and Western blot were conducted for the detection of gene expression. Cell proliferation was determined by the methyl thiazolyl tetrazolium (MTT) assay, colony formation assay, and 5-ethynyl-2'-deoxyuridine (EdU) staining, and cell apoptosis was assessed by flow cytometry. The relationships between genes were also evaluated by applying the luciferase reporter and radioimmunoprecipitation (RIP) assays.Results: Radioresistant LUSC cells (SK-MES-1R and NCI-H226R) had strong resistance to X-ray irradiation, and lncRNA KCNQ1OT1 was highly expressed in SK-MES-1R and NCI-H226R cells.Moreover, knockdown of lncRNA KCNQ1OT1 prominently suppressed proliferation, attenuated radioresistance, and accelerated the apoptosis of SK-MES-1R and NCI-H226R cells. More importantly, we verified that miR-491-5p was a regulatory target of lncRNA KCNQ1OT1, and Xenopus kinesin-like protein 2 (TPX2) and RING finger protein 2 (RNF2) were the target genes of miR-491-5p. The rescue experiment results also demonstrated that miR-491-5p was involved in the inhibition of cell proliferation and the downregulation of TPX2 and RNF2 expression mediated by lncRNA KCNQ1OT1 knockdown in SK-MES-1R and NCI-H226R cells.Conclusions: LncRNA KCNQ1OT1 was associated with the radioresistance of radioresistant LUSC cells, and the lncRNA KCNQ1OT1/miR-491-5p/TPX2-RNF2 axis might be used as a therapeutic target to enhance the radiosensitivity of radioresistant LUSC cells.

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Metastasis-directed radiation therapy after radical cystectomy for bladder cancer

Cited by 14 publications

References 17 publications

Metastasis-Directed Radiation Therapy with Consolidative Intent for Oligometastatic Urothelial Carcinoma: A Systematic Review and Meta-Analysis

Metastasis-Directed Radiation Therapy with Consolidative Intent for Oligometastatic Urothelial Carcinoma: A Systematic Review and Meta-Analysis

Definitions, outcomes and perspectives for oligometastatic bladder cancer: towards a standardized terminology

LncRNA KCNQ1OT1 enhances the radioresistance of lung squamous cell carcinoma by targeting the miR-491-5p/TPX2-RNF2 axis

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