Tumor Lysis Syndrome in a Patient with Metastatic Colon Cancer after Treatment with 5-Fluorouracil/Leucovorin and Oxaliplatin: Case Report and Literature Review

Kim, Hyung Duk; Ha, Kyung Sun; Woo, In Sook; Jung, Yun Hwa; Han, Chi Wha; Kim, Taejung

doi:10.4143/crt.2014.46.2.204

Cited by 18 publications

(12 citation statements)

References 14 publications

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“…In addition, previous reports have proposed available treatment modalities for colon cancer and have evaluated the accuracy of mini-probe endoscopic ultrasound in assigning clinical stages to colon cancer ( 4 – 6 ). However, appropriate management of diagnosis, treatments and prognosis of colorectal cancer has not been improved and is not clearly understood ( 5 , 6 ). Metastasis and invasion of colon cancer cells causes problems for clinicians attempting to treat the disease and worsens the disease in patients ( 7 , 8 ).…”

Section: Introductionmentioning

confidence: 99%

Tunicamycin inhibits colon carcinoma growth and aggressiveness via modulation of the ERK-JNK-mediated AKT/mTOR signaling pathway

Shang

Guan

2018

Mol Med Report

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Epidemiology and evidence have demonstrated that colon carcinoma is one of the most common gastrointestinal tumors in the clinic. Reports have suggested that Tunicamycin significantly inhibits aggressiveness of colon carcinoma cells by promotion of apoptosis. In the present study, the inhibitory effect of tunicamycin on colon cancer cells and the potential underlying molecular mechanism was investigated. Western blotting, immunohistochemistry, apoptotic assays and immunofluorescence were used to analyze the therapeutic effects of tunicamycin on apoptosis, growth, aggressiveness and cell cycle of colon tumor cells, by downregulation of fibronectin, vimentin and E-cadherin expression levels. In vitro experiments demonstrated that tunicamycin significantly inhibited growth, migration and invasion of colon carcinoma cells. In addition, tunicamycin administration promoted apoptosis of colon carcinoma cells via upregulation of apoptotic protease activating factor 1 and cytochrome c expression levels, which are proteins that have a role in mitochondrial apoptosis signaling. Cell cycle assays revealed that tunicamycin suppressed proliferation and arrested S phase entry of colon carcinoma cells. Mechanistic analysis demonstrated that tunicamycin reduced expression and phosphorylation levels of extracellular signal-regulated kinase (ERK), c-JUN N-terminal kinase (JNK) and protein kinase B (AKT), and inhibited mammalian target of rapamycin (mTOR) expression levels in colon carcinoma cells. Endogenous overexpression of ERK inhibited tunicamycin-mediated downregulation of JNK, AKT and mTOR expression, which further blocked tunicamycin-mediated inhibition of growth and aggressiveness of colon carcinoma. In vivo assays revealed that tunicamycin treatment significantly inhibited tumor growth and promoted apoptosis, which led to long-term survival of tumor-bearing mice compared with the control group. In conclusion, these results suggested that tunicamycin may inhibit growth and aggressiveness of colon cancer via the ERK-JNK-mediated AKT/mTOR signaling pathway, and suggested that tunicamycin may be a potential anti-cancer agent for colon carcinoma therapy.

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Section: Introductionmentioning

confidence: 99%

Tunicamycin inhibits colon carcinoma growth and aggressiveness via modulation of the ERK-JNK-mediated AKT/mTOR signaling pathway

Shang

Guan

2018

Mol Med Report

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“…Nine case reports of TLS in CRC were identified in the literature; one additional case was added from our patient database [2][3][4][5][6][7][8][9]. Patient demographics and disease characteristics such as metastasis, time of onset of TLS from cancer treatment, management, and outcomes of TLS are summarized in the table below ( Table 1).…”

Section: Resultsmentioning

confidence: 99%

A Retrospective Review of Tumor Lysis Syndrome Associated With Colorectal Cancer

Ansari¹,

Findakly²,

Wang³

2020

Cureus

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Tumor lysis syndrome (TLS) is a life-threatening oncologic condition that is most commonly linked with hematologic malignancies and uncommonly seen in solid tumors, including colorectal cancer (CRC). Therefore, a lack of awareness regarding TLS in CRC could lead to significant morbidity and mortality. This study aims to explore the clinical characteristics and outcomes of TLS in patients with CRC. A systematic review of the literature was performed by searching PubMed using the keywords "tumor lysis syndrome" and "colorectal cancer". The English-language case reports and abstracts that the search results yielded were reviewed, and additional articles of interest were identified from reference lists. Information regarding the patients (age at diagnosis, presentation, and comorbidities), the tumors (histology, grade, and stage), radiologic investigations, treatment modalities (surgery, radiation, and systemic therapy), and the outcomes (response, adverse events) were recorded, when available. Descriptive statistics, such as frequency counts, medians, and ranges, were used to characterize the pooled sample. Nine case reports of TLS in CRC were identified in the literature; one additional case was added from our patient database. The median age of these patients was 58.5 years (range: 42-82 years) with 70% of these patients being male. Of note, 100% of these patients had metastatic colon cancer and 80% had metastatic involvement of the liver; 70% of these cases were associated with therapyinduced TLS with the median time-to-event being three days (range: 18 hours-30 days) after receiving chemotherapy. When looking at laboratory parameters, uric acid and lactate dehydrogenase (LDH) were consistently elevated in all the cases, but 50% of the cases had hyperkalemia and 50% had hyperphosphatemia. Treatment of TLS included supportive measures with IV hydration. Five out of 10 patients received urate oxidase and only one underwent hemodialysis. The overall mortality was 60%. TLS can occur with CRCs that demonstrate a high tumor burden. While most cases are associated with therapy, some cases are spontaneous in nature. Keeping in mind the high mortality associated with TLS, physicians should have a high degree of suspicion and should be aware of the fatal complications associated with TLS. Timely implementation of prophylactic and therapeutic measures including IV hydration as well as the use of xanthine oxidase inhibitors such as allopurinol can be life-saving in these cases.

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“…The first reported case of spontaneous tumor lysis in a nonhematologic malignancy was reported in 1977 . There have been 75–100 reported cases of tumor lysis in solid tumors, mostly after treatment, between 1977 and 2011 as described in the literature . STLS is considered rare in all types of malignancy, but according to a study by Tsokos et al, three of 33 patients with non‐Hodgkin lymphoma already had hyperuricemia and kidney injury prior to treatment .…”

Section: Discussionmentioning

confidence: 99%

Spontaneous tumor lysis syndrome in colon cancer: a case report and literature review

Sommerhalder

Takalkar

Shackelford

et al. 2017

Clinical Case Reports

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Tumor Lysis Syndrome in a Patient with Metastatic Colon Cancer after Treatment with 5-Fluorouracil/Leucovorin and Oxaliplatin: Case Report and Literature Review

Cited by 18 publications

References 14 publications

Tunicamycin inhibits colon carcinoma growth and aggressiveness via modulation of the ERK-JNK-mediated AKT/mTOR signaling pathway

Tunicamycin inhibits colon carcinoma growth and aggressiveness via modulation of the ERK-JNK-mediated AKT/mTOR signaling pathway

A Retrospective Review of Tumor Lysis Syndrome Associated With Colorectal Cancer

Spontaneous tumor lysis syndrome in colon cancer: a case report and literature review

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