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2010 ; 28
(5
): 835-40
Nephropedia Template TP
gab.com Text
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English Wikipedia
Clinical activity of mTOR inhibition with sirolimus in malignant perivascular
epithelioid cell tumors: targeting the pathogenic activation of mTORC1 in tumors
#MMPMID20048174
Wagner AJ
; Malinowska-Kolodziej I
; Morgan JA
; Qin W
; Fletcher CD
; Vena N
; Ligon AH
; Antonescu CR
; Ramaiya NH
; Demetri GD
; Kwiatkowski DJ
; Maki RG
J Clin Oncol
2010[Feb]; 28
(5
): 835-40
PMID20048174
show ga
PURPOSE Perivascular epithelioid cell tumors (PEComas) represent a family of
mesenchymal neoplasms, mechanistically linked through activation of the mTOR
signaling pathway. There is no known effective therapy for PEComa, and the
molecular pathophysiology of aberrant mTOR signaling provided us with a
scientific rationale to target this pathway therapeutically. On this mechanistic
basis, we treated three consecutive patients with metastatic PEComa with an oral
mTOR inhibitor, sirolimus. PATIENTS AND METHODS Patients with advanced PEComa
were treated with sirolimus and consented to retrospective collection of data
from their medical records and analysis of archival tumor specimens. Tumor
response was determined by computed tomography scans obtained at the clinical
discretion of the treating physicians. Tumors were assessed for
immunohistochemical evidence of mTORC1 activation and genetic evidence of
alterations in TSC1 and TSC2. Results Radiographic responses to sirolimus were
observed in all patients. PEComas demonstrated loss of TSC2 protein expression
and evidence of baseline mTORC1 activation. Homozygous loss of TSC1 was
identified in one PEComa. CONCLUSION Inhibition of mTORC1, pathologically
activated by loss of the TSC1/TSC2 tumor suppressor complex, is a rational
mechanistic target for therapy in PEComas. The clinical activity of sirolimus in
PEComa additionally strengthens the pathobiologic similarities linking PEComas to
other neoplasms related to the tuberous sclerosis complex.
|Administration, Oral
[MESH]
|Aged
[MESH]
|Antibiotics, Antineoplastic/administration & dosage/adverse effects/*therapeutic
use
[MESH]
|Female
[MESH]
|Humans
[MESH]
|Immunohistochemistry
[MESH]
|In Situ Hybridization, Fluorescence
[MESH]
|Intracellular Signaling Peptides and Proteins/analysis/*antagonists & inhibitors
[MESH]