Abstract
Although the osteosarcoma is considered to be among the most chemosensitive malignancies and preoperative chemotherapy is commonly applied, an appreciable proportion of cases are in fact quite insensitive. Predictive markers for chemosensitivity are therefore desirable in order to develop effective treatment strategies. Thirty‐two cases of conventional osteosarcomas treated at the Cancer Institute Hospital, Tokyo, were analyzed. The sensitivity to preoperative chemotherapy was investigated with reference to loss of heterozygosity (LOH) at the 17p13 (p53) and 13q14 (Rb) loci and expression of the cell‐cycle associated proteins, p53, Rb, p21/Waf‐1, mdm‐2 and Ki‐67, as detected immunohistochemically. LOH was detected by analyzing polymerase chain reaction products at marker microsatellite loci. The efficacy of chemotherapy was evaluated both radiologically and histologically. LOH at p53 or Rb loci was seen in 54% (13/24) and 58% (14/24) of cases, respectively. Only 15% of osteosarcomas with LOH at the p53 locus were sensitive to preoperative chemotherapy, as compared to 64% of tumors without such loss (P<0.05). A similar but much less distinct tendency was observed with LOH at the Rb locus. No relationship was evident between chemosensitivity and immunohistochemical staining patterns for p53, Rb, p21/Waf‐1, mdm‐2 or Ki‐67. The results suggest that p53 gene deletion, but not the other parameters investigated, may be useful for predicting chemoresistance of osteosarcomas.
Keywords: Key words, Osteosarcoma, Chemosensitivity, p53, Rb, Loss of heterozygosity
Full Text
The Full Text of this article is available as a PDF (297.0 KB).
REFERENCES
- 1. ) Yen , A. and Varvayanis , S.RB tumor suppressor gene expression responds to DNA synthesis inhibitors . In Vitro Cell. Dev. Biol. , 28A , 669 – 672 ( 1992. ). [DOI] [PubMed] [Google Scholar]
- 2. ) Lowe , S. W. , Ruley , H. E. , Jacks , T. and Housman , D. E.p53‐dependent apoptosis modulates the cytotoxity of anti‐cancer agents . Cell , 74 , 957 – 967 ( 1993. ). [DOI] [PubMed] [Google Scholar]
- 3. ) Lowe , S. W. , Schmitt , E. S. , Smith , S. W. , Osborne , B. A. and Jacks , T.p53 is required for radiation‐induced apoptosis in mouse thymocytes . Nature , 362 , 847 – 849 ( 1993. ). [DOI] [PubMed] [Google Scholar]
- 4. ) Slichenmyer , W. J. , Nelson , W. G. , Slebos , R. J. and Kastan , M. B.Loss of p53‐associated G1 checkpoint does not decrease cell survival following DNA damage . Cancer Res. , 53 , 4164 – 4168 ( 1993. ). [PubMed] [Google Scholar]
- 5. ) Radinsky , R. , Fiedler , I. J. , Price , J. E. , Esumi , N. , Tsan , R. , Petty , C. M. , Bucana , C. D. and Bar‐Eli , M.Terminal differentiation and apoptosis in experimental lung metastasis of human osteogenic sarcoma cells by wild type p53 . Oncogene , 9 , 1877 – 1883 ( 1994. ). [PubMed] [Google Scholar]
- 6. ) Lowe , S. W. , Bodis , S. , McClatchey , A. , Remington , L. , Ruley , H. E. , Fisher , D. E. , Housman , D. E. and Jacks , T.p53 status and the efficacy of cancer therapy in vivo . Science , 266 , 807 – 810 ( 1994. ). [DOI] [PubMed] [Google Scholar]
- 7. ) Niwa , K. , Itoh , H. , Murase , T. , Morishita , S. , Itoh , H. , Mori , H. and Tamaya , T.Alteration of p53 gene in ovarian carcinoma: clinicopathological correlation and prognostic significance . Br. J. Cancer , 70 , 1191 – 1197 ( 1994. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8. ) Wattel , E. , Preudhomme , C. , Hecquet , B. , Vanrumbeke , M. , Quensnel , B. , Dervite , I. , Morel , P. and Fenaux , P.p53 mutations are associated with resistance to chemotherapy and short survival in hematologic malignancies . Blood , 9 , 3148 – 3157 ( 1994. ). [PubMed] [Google Scholar]
- 9. ) Fan , S. , Smith , M. L. , Rivet , D. J. , Duba , D. , Zhan , Q. , Kohn , K. W. , Fornace , A. J. and O'Connor , P. M.Disruption of p53 function sensitizes breast cancer MCF‐7 cells to cisplatin and pentoxifylline . Cancer Res. , 55 , 1649 – 1654 ( 1995. ). [PubMed] [Google Scholar]
- 10. ) Russel , S. J. , Ye , Y. W. , Waber , P. G. , Shuford , M. , Schold , S. C. , Jr. and Nisen , P. D.p53 mutations, O6‐alkylguanine DNA alkyltransferase activity, and sensitivity to procarbazine in human brain tumors . Cancer , 75 , 1339 – 1342 ( 1995. ). [DOI] [PubMed] [Google Scholar]
- 11. ) Miyakoshi , J. , Yamagishi , N. , Ohtsu , S. and Takebe , H.Changes in radiation sensitivity of human osteosarcoma cells after p53 introduction . Jpn. J. Cancer Res. , 86 , 711 – 713 ( 1995. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
- 12. ) Kornblau , S. M. , Xu , H. J. , Zhang , W. , Hu , S.‐X. , Beran , M. , Smith , T. L. , Hester , J. , Estey , E. , Benedict , W. F. and Deisseroth , A. B.Levels of retinoblastoma protein expression in newly diagnosed acute myelogenous leukemia . Blood , 84 , 256 – 261 ( 1994. ). [PubMed] [Google Scholar]
- 13. ) Perego , P. , Giarola , M. , Righetti , S. C. , Supino , R. , Caserini , C. , Delia , D. , Pierotti , M. A. , Miyashita , T. , Reed , J. C. and Zunino , F.Association between cisplatin resistance and mutation of p53 gene and reduced Bax expression in ovarian carcinoma cell systems . Cancer Res. , 56 , 556 – 562 ( 1996. ). [PubMed] [Google Scholar]
- 14. ) Righetti , S. C. , Torre , G. D. , Pilotti , S. , Menard , S. , Ottone , F. , Colnaghi , M. I. , Pierotti , M. A. , Lavarino , C. , Cornarotti , M. , Oriana , S. , Bohm , S. , Bresciani , G. L. , Spatti , G. and Zunino , F.A comparative study of p53 gene mutations, protein accumulation, and response to cisplatin‐based chemotherapy in advanced ovarian carcinoma . Cancer Res. , 56 , 689 – 693 ( 1996. ). [PubMed] [Google Scholar]
- 15. ) Hawkins , D. S. , Demers , G. W. and Galloway , D. A.Inactivation of p53 enhances sensitivity to multiple chemotherapeutic agents . Cancer Res. , 56 , 892 – 898 ( 1996. ). [PubMed] [Google Scholar]
- 16. ) Friend , S. H. , Bernards , R. , Rogelj , S. , Weinberg , R. A. , Rapaport , J. M. , Albert , D. M. and Dryja , T. P.A human DNA segment with properties of the gene that predisposes to retinoblastoma and osteosarcoma . Nature , 323 , 643 – 646 ( 1986. ). [DOI] [PubMed] [Google Scholar]
- 17. ) Toguchido , J. , Ishizaki , K. , Sasaki , M. S. , Ikenaga , M. , Sugimoto , M. , Kotoura , Y. and Yamamoto , T.Chromosomal reorganization for the expression of recessive mutation of retinoblastoma susceptibility gene in the development of osteosarcoma . Cancer Res. , 48 , 3939 – 3943 ( 1988. ). [PubMed] [Google Scholar]
- 18. ) Toguchida , J. , Yamaguchi , T. , Ritchie , B. , Beauchamp , R. L. , Dayton , S. H. , Herrera , G. E. , Yamamuro , T. , Kotoura , Y. , Sasaki , M. S. , Little , J. B. , Weichselbaum , R. R. , Ishizaki , K. and Yandell , D. W.Mutation spectrum of p53 gene in bone and soft tissue sarcomas . Cancer Res. , 52 , 6194 – 6199 ( 1992. ). [PubMed] [Google Scholar]
- 19. ) Yamaguchi , T. , Toguchida , J. , Yamamuro , T. , Kotoura , Y. , Takada , N. , Kawaguchi , N. , Kaneko , Y. , Nakamura , Y. , Sasaki , M. S. and Ishizaki , K.Allelotype analysis in osteosarcomas: frequent allele loss on 3q, 13q, 17p, and 18q . Cancer Res. , 52 , 2419 – 2423 ( 1992. ). [PubMed] [Google Scholar]
- 20. ) Wadayama , B. , Toguchida , J. , Shimizu , T. , Ishizaki , K. , Sasaki , M. S. , Kotoura , Y. and Yamamuro , T.Mutation spectrum of retinoblastoma gene in osteosarcomas . Cancer Res. , 54 , 3042 – 3048 ( 1994. ). [PubMed] [Google Scholar]
- 21. ) Feugeas , O. , Guriec , N. , Babin‐Boilletet , A. , Marcellin , L. , Simon , P. , Babin , S. , Thyss , A. , Hofman , P. , Terrier , P. , Kalifa , C. , Brunat‐Mentigny , M. , Patricot , L. M. and Oberling , F.Loss of heterozygosity of the RB gene is a poor prognostic factor in patients with osteosarcoma . J. Clin. Oncol. , 14 , 467 – 472 ( 1995. ). [DOI] [PubMed] [Google Scholar]
- 22. ) Enneking , W. F.“Musculoskeletal Tumor Surgery,” Vol. 1 , pp. 69 – 88 ( 1983. ). Churchill‐Livingstone; , New York , NY . [Google Scholar]
- 23. ) Dahlin , D.C.Grading of bone tumors . In“Bone Tumors,” ed. Unni K. K. , pp. 35 – 45 ( 1988. ). Churchill‐Livingstone; , Dallas , TX . [Google Scholar]
- 24. ) Kawaguchi , N.Surgical treatment combined with preoperative chemotherapy for mucoskeletal sarcoma . In“Cancer Chemotherapy: Challenges for the Future,” ed. Kimura K. , Ota K. , Yamada K. , Saito H. and Ogawa M. , Vol. 10 , pp. 248 – 256 ( 1995. ). Excerpta Medica; , Tokyo . [Google Scholar]
- 25. ) Smith , J. , Heelan , R. T. , Huvos , A. G. , Caparros , B. , Rosen , G. , Urmacher , C. and Caravelli , J. F.Radiographic changes in primary osteogenic sarcoma following intensive chemotherapy (radiological‐pathological correlation in 63 patients) . Radiology , 143 , 355 – 360 ( 1982. ). [DOI] [PubMed] [Google Scholar]
- 26. ) Chuang , V. P. , Benjamin , R. , Jaffe , N. , Wallace , S. , Ayala , A. G. , Murray , J. , Charnsangavej , C. and Soo , C.‐S.Radiologic and angiographic changes in osteosarcomas after intraarterial chemotherapy . Am. J. Roentgenol. , 139 , 1065 – 1069 ( 1982. ). [DOI] [PubMed] [Google Scholar]
- 27. ) Hiruta , N. , Kameda , N. , Kawaguchi , N. , Matsumoto , S. , Manabe , J. , Kuroda , K. , Tsuchiya , K. , Akima , M. , Nonaka , H. , Machinami , R. and Kitagawa , T.Histological grading of the preoperative chemotherapeutic effect and correlation of the prognosis in osteosarcoma . Rinsho-Seikei-Geka (Clin. Orthoped. Surg.) , 29 , 1221 – 1229 ( 1994. ) ( in Japanese ). [Google Scholar]
- 28. ) Picci , P. , Bacci , G. , Campanacci , M. , Gasparini , M. , Pilotti , S. , Cerasoli , S. , Bertoni , F. , Guerra , A. , Capanna , R. , Albissini , U. , Galletti , S. , Gherlinzoni , F. , Calderoni , P. , Sudanese , A. , Baldini , N. , Bernini , M. and Jaffe , N.Histologic evaluation of necrosis in osteosarcoma induced by chemotherapy . Cancer , 56 , 1515 – 1521 ( 1985. ). [DOI] [PubMed] [Google Scholar]
- 29. ) Baldini , N. , Scotlandi , K. , Barbanti‐Bròdano , G. , Manara , M. C. , Maurici , D. , Bacci , G. , Bertoni , F. , Picci , P. , Sottili , S. , Campanacci , M. and Serra , M.Expression of P‐glyco‐protein in high‐grade osteosarcomas in relation to clinical outcome . N. Engl. J. Med. , 333 , 1380 – 1385 ( 1995. ). [DOI] [PubMed] [Google Scholar]
- 30. ) Goeltz , S. E. , Hamilton , S. R. and Vogelstein , B.Purification of DNA from formaldehyde fixed and paraffin embedded human tissue . Biochem. Biophys. Res. Commun. , 130 , 118 – 126 ( 1985. ). [DOI] [PubMed] [Google Scholar]
- 31. ) Jones , M. H. , Sato , T. , Saito , H. , Tanigami , H. and Nakamura , Y.Six microsatellite polymorphisms at candidate and confirmed tumour supressor gene loci . Hum. Mol. Genet. , 3 , 1911 ( 1994. ). [DOI] [PubMed] [Google Scholar]
- 32. ) Gyapay , G. , Morissette , J. , Vignal , A. , Dib , C. , Fizames , C. , Millasseau , P. , Marc , S. , Bernardi , G. , Lathrop , M. and Weissenbach , J.The 1993–94 Genethon human linkage map . Nat. Genet. , 7 , 246 – 339 ( 1994. ). [DOI] [PubMed] [Google Scholar]
- 33. ) Shi , S. R. , Key , M. E. and Kalra , K. L.Antigen retrieval in formalin‐fixed, paraffin‐embedded tissues: an enhancement method for immunohistochemical staining based on microwave oven heating of tissue sections . J. Histochem. Cytochem. , 39 , 741 – 748 ( 1991. ). [DOI] [PubMed] [Google Scholar]
- 34. ) Feinberg , S. E.“The Analysis of Cross‐classified Categorical Data,” pp. 8 – 23 ( 1977. ). MIT Press; , Cambridge , MA . [Google Scholar]
- 35. ) Kaplan , E.L. and Meier , P.Nonparametric estimation from incomplete observations . J. Am. Stat. Assoc. , 53 , 457 – 481 ( 1958. ). [Google Scholar]
- 36. ) Miller , R. G. , Jr.“Survival Analysis,” pp. 44 – 102 ( 1981. ). John Wiley; , New York , NY . [Google Scholar]
- 37. ) Hamada , M. , Fujiwara , T. , Hizuta , A. , Gochi , A. , Naomoto , Y. , Takakura , N. , Takahashi , K. , Roth , J. A. , Tanaka , N. , Orita , K.The p53 gene is a potent determinant of chemosensitivity in gastric and colorectal cancers . J. Cancer Res. Clin. Oncol. , 122 , 360 – 365 ( 1996. ). [DOI] [PubMed] [Google Scholar]
- 38. ) Berg , J. , Norberg , T. , Sjogren , S. , Lindgren , A. and Holmberg , L.Complete sequencing of the p53 gene provides prognostic information in breast cancer patients, particularly in relation to adjuvant systemic therapy and radiotherapy . Nat. Med. , 1 , 1029 – 1034 ( 1995. ). [DOI] [PubMed] [Google Scholar]
- 39. ) Fearon , E. R. and Vogelstein , B.A genetic model for colorectal tumorigenesis . Cell , 67 , 759 – 767 ( 1990. ). [DOI] [PubMed] [Google Scholar]
- 40. ) Baker , S. J. , Preisinger , A. C. , Jessup , J. M. , Paraskeva , C. , Markowitz , S. , Willson , J. K. V. , Hamilton , S. and Vogelstein , B . p53 gene mutations occur in combination with 17p allelic deletions as late events in colorectal tumorigenesis . Cancer Res. , 50 , 7717 – 7722 ( 1990. ). [PubMed] [Google Scholar]
- 41. ) Fearon , E. R.A genetic basis for the multi‐step pathway of colorectal tumorigenesis . In“Multistage Carcinogenesis,” ed. Harris C. C. , Hirohashi S. , Ito N. , Pitot H. C. , Sugimura T. , Terada M. and Yokota J. , pp. 37 – 48 ( 1991. ). CRC Press; , Tokyo . [PubMed] [Google Scholar]
- 42. ) Ziegler , A. , Jonason , A. S. , Leffell , D. J. , Simon , J. A. , Sharma , H. W. , Kimmelman , J. , Remington , L. , Jacks , T. and Brash , D. E.Sunburn and p53 in the onset of skin cancer . Nature , 372 , 773 – 776 ( 1994. ). [DOI] [PubMed] [Google Scholar]
- 43. ) Ueda , Y. , Dockhorn‐Dworniczak , B. , Blasius , S. , Mellin , W. , Wuisman , P. , Bocker , W. and Roessner , A.Analysis of mutant p53 protein in osteosarcomas and other malignant and benign lesions of bone . J. Cancer Res. Clin. Oncol. , 119 , 172 – 178 ( 1993. ). [DOI] [PubMed] [Google Scholar]
- 44. ) Nishikawa , T. , Yamamoto , T. , Mizuno , K. , Fujimori , T. , Maeda , S. and Ugai , K.Expression of the p53 protein in human osteosarcoma . J. Jpn. Orthop. Assoc. , 68 , 400 – 406 ( 1994. ). [PubMed] [Google Scholar]
- 45. ) Logothetis , C. J. , Xu , H. J. , Ro , J. Y. , Hu , S. X. , Sahin , A. , Ordonez , N. and Benedict , W. F.Altered expression of retinoblastoma protein and known prognostic variables in locally advanced bladder cancer . J. Natl. Cancer. Inst. , 84 , 1256 – 1261 ( 1992. ). [DOI] [PubMed] [Google Scholar]
- 46. ) Tang , J. L. , Yeh , S. H. , Chen , P. J. , Lin , M. T. , Tien , H. F. and Chen , Y. C.Inactivation of the retinoblastoma gene in acute myelogenous leukemia . Br. J. Haematol. , 82 , 502 – 507 ( 1992. ). [DOI] [PubMed] [Google Scholar]