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Sarcomas are a heterogeneous group of aggressive mesenchymal malignancies. They account for 1% of all tumors in the general population and 15–20% in pediatric age and young adults. Despite differences in histology and pathobiology, the diverse types of sarcomas are traditionally managed with a common multi‐modal approach including surgery, radiotherapy, and aggressive polychemotherapy. Unfortunately, the prognosis for advanced or recurrent disease remains poor. Moreover, the disease rarity and a high cellular, molecular, and genetic/epigenetic heterogeneity make identification of therapeutic targets challenging. Therefore it remains an urgent need to identify effective therapies to improve patients' outcome. Common or peculiar biological motifs including deregulation of growth factor signaling, proangiogenic and promigratory pathways, tumor‐microenviroment interactions, transcriptional and epigenetic machinery, and differentiation program, provide actionable dependencies exploitable for therapeutic intervention. Among these, a deregulated heparan sulfate proteoglycan system due to aberrant expression of key components as well as structural/functional modifications mediated by endosulfatases and the endoβ‐d‐glycosidase heparanase, is emerging as a crucial player in tumor growth and progression and as a valuable therapeutic target across different sarcoma subtypes. In preclinical studies, non‐anticoagulant heparins have been shown to counteract the growth and metastatic dissemination of various sarcoma models according to their heparan sulfate mimetic and anti‐heparanase activities. Heparin derivatives also improved the anti‐sarcoma efficacy of molecularly targeted agents and cytotoxic drugs. In this minireview, we summarize the current knowledge about the interplay between the heparanase/heparan sulfate proteoglycan system and pathways involved in sarcomagenesis and disease progression. We illustrate the current understanding of the mechanisms of action of non‐anticoagulant heparins and the contribution of their anti‐heparanase, anti‐receptor tyrosine kinase, and likely immunomodulatory activities to their anti‐sarcoma effects. Finally, we discuss a few aspects worthy of exploration highlighting how elucidation of mechanisms underpinning antitumor activities of non‐anticoagulant heparin derivatives in the different sarcoma biological contexts may suggest new vulnerabilities and therapeutic approaches.
Sarcomas are a heterogeneous group of aggressive mesenchymal malignancies. They account for 1% of all tumors in the general population and 15–20% in pediatric age and young adults. Despite differences in histology and pathobiology, the diverse types of sarcomas are traditionally managed with a common multi‐modal approach including surgery, radiotherapy, and aggressive polychemotherapy. Unfortunately, the prognosis for advanced or recurrent disease remains poor. Moreover, the disease rarity and a high cellular, molecular, and genetic/epigenetic heterogeneity make identification of therapeutic targets challenging. Therefore it remains an urgent need to identify effective therapies to improve patients' outcome. Common or peculiar biological motifs including deregulation of growth factor signaling, proangiogenic and promigratory pathways, tumor‐microenviroment interactions, transcriptional and epigenetic machinery, and differentiation program, provide actionable dependencies exploitable for therapeutic intervention. Among these, a deregulated heparan sulfate proteoglycan system due to aberrant expression of key components as well as structural/functional modifications mediated by endosulfatases and the endoβ‐d‐glycosidase heparanase, is emerging as a crucial player in tumor growth and progression and as a valuable therapeutic target across different sarcoma subtypes. In preclinical studies, non‐anticoagulant heparins have been shown to counteract the growth and metastatic dissemination of various sarcoma models according to their heparan sulfate mimetic and anti‐heparanase activities. Heparin derivatives also improved the anti‐sarcoma efficacy of molecularly targeted agents and cytotoxic drugs. In this minireview, we summarize the current knowledge about the interplay between the heparanase/heparan sulfate proteoglycan system and pathways involved in sarcomagenesis and disease progression. We illustrate the current understanding of the mechanisms of action of non‐anticoagulant heparins and the contribution of their anti‐heparanase, anti‐receptor tyrosine kinase, and likely immunomodulatory activities to their anti‐sarcoma effects. Finally, we discuss a few aspects worthy of exploration highlighting how elucidation of mechanisms underpinning antitumor activities of non‐anticoagulant heparin derivatives in the different sarcoma biological contexts may suggest new vulnerabilities and therapeutic approaches.
Background Heparan sulfate 2-O-sulfotransferase 1 (HS2ST1) catalyzes the sulfation of glucuronic acid residues in heparan sulfate proteoglycans, enabling these proteoglycans to interact with numerous ligands within tumor microenvironments. However, the prognostic role of HS2ST1 expression in cancer remains unclear. Objective This investigated HS2ST1 expression levels and their prognostic significance in various cancer types, demonstrated the prognostic value of HS2ST1 expression in hepatocellular carcinoma (HCC) patients, and identified molecular signatures associated with HS2ST1 expression. Methods HS2ST1 expression and patient survival data from The Cancer Genome Atlas (TCGA) datasets were analyzed using the Gene Expression Profiling Interactive Analysis (GEPIA) portal. We obtained gene expression and clinicopathological information on HCC patients from the TCGA and the Japan and France International Cancer Genome Consortium (ICGC) databases and performed survival analyses. We also examined relevant protein networks, differentially expressed genes, gene set enrichments, and tumor immune microenvironment features associated with HS2ST1 expression. Results HS2ST1 exhibited higher expression in eight tumor types compared with normal tissues and was associated with poor prognoses in five tumors, including HCC. HS2ST1 status correlated with poor prognosis in two ICGC HCC cohorts. Elevated HS2ST1 expression in HCC tumors was associated with signaling pathways involved in cell cycle progression, protein secretion, and mTORC1 signaling. Moreover, HS2ST1 expression levels were inversely correlated with immune cell infiltration in the tumor microenvironment. Conclusion Our study elucidates the prognostic significance of HS2ST1 expression in HCC patients and provides insights into the potential roles of HS2ST1 in signaling pathways and the tumor microenvironment.
Background Metabolic remodeling and changes in tumor immune microenvironment (TIME) in osteosarcoma are important factors affecting prognosis and treatment. However, the relationship between metabolism and TIME needs to be further explored. Methods RNA-Seq data and clinical information of 84 patients with osteosarcoma from the TARGET database and an independent cohort from the GEO database were included in this study. The activity of seven metabolic super-pathways and immune infiltration levels were inferred in osteosarcoma patients. Metabolism-related genes (MRGs) were identified and different metabolic clusters and MRG-related gene clusters were identified using unsupervised clustering. Then the TIME differences between the different clusters were compared. In addition, an MRGs-based risk model was constructed and the role of a key risk gene, ST3GAL4, in osteosarcoma cells was explored using molecular biological experiments. Results This study revealed four key metabolic pathways in osteosarcoma, with vitamin and cofactor metabolism being the most relevant to prognosis and to TIME. Two metabolic pathway-related clusters (C1 and C2) were identified, with some differences in immune activating cell infiltration between the two clusters, and C2 was more likely to respond to two chemotherapeutic agents than C1. Three MRG-related gene clusters (GC1-3) were also identified, with significant differences in prognosis among the three clusters. GC2 and GC3 had higher immune cell infiltration than GC1. GC3 is most likely to respond to immune checkpoint blockade and to three commonly used clinical drugs. A metabolism-related risk model was developed and validated. The risk model has strong prognostic predictive power and the low-risk group has a higher level of immune infiltration than the high-risk group. Knockdown of ST3GAL4 significantly inhibited proliferation, migration, invasion and glycolysis of osteosarcoma cells and inhibited the M2 polarization of macrophages. Conclusion The metabolism of vitamins and cofactors is an important prognostic regulator of TIME in osteosarcoma, MRG-related gene clusters can well reflect changes in osteosarcoma TIME and predict chemotherapy and immunotherapy response. The metabolism-related risk model may serve as a useful prognostic predictor. ST3GAL4 plays a critical role in the progression, glycolysis, and TIME of osteosarcoma cells.
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