Update of Diagnosis and Targeted Therapy for ALK+ Inflammation Myofibroblastic Tumor

Wang, Qi-An; Chen, Huan-Wu; Wu, Ren-Chin; Wu, Chiao-En

doi:10.1007/s11864-023-01144-6

Cited by 7 publications

(4 citation statements)

References 106 publications

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“…It is indicated in unresectable, recurrent, or refractory tumors. [ 40 ] In our review, ALK-TKI has been used to down-size the tumor before the surgery in three cases and for metastatic disease in one case. Although the use of an ALK-TKI inhibitor is rational in bladder IMTs positive for ALK, the long-term efficacy and toxicity of such a therapy remain unknown in this setting and should be reserved for refractory cases.…”

Section: Discussionmentioning

confidence: 99%

Inflammatory myofibroblastic tumor of the urinary bladder: A systematic review of the literature and report of a case

Hage,

O’Donnell,

Abou Chakra

et al. 2024

Indian Journal of Urology

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Introduction: Inflammatory myofibroblastic tumors (IMTs) are intermediate-grade lesions that frequently recur and rarely metastasize. There are currently no guidelines on the management of bladder IMTs. This systematic review aims to describe the clinical presentation and compare the management options for bladder IMTs. Methods: A PubMed/Medline search was conducted, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, using the following Mesh terms: (“inflammatory myofibroblastic”) AND (“tumor”) OR (“tumor”) AND (“bladder”) AND (“case report”). A total of 75 case reports were included in the analysis. Results: The mean age of the patients was 36 years. 65% of the cases initially presented with hematuria. 68% of the tumors stained positive for anaplastic lymphoma kinase, and 20% invaded the muscularis. Patients underwent either transurethral resection of the bladder tumor (TURBT) only (34%), TURBT followed by complementary partial cystectomy (16%), or TURBT followed by radical cystectomy (4%). 36% and 9% of the cases underwent partial and radical cystectomy after the initial diagnosis, respectively. Cystectomies were performed using an open (74%), laparoscopic (14%), robotic-assisted (10%), or unknown (2%) approach. At a mean follow-up of 14 months, the recurrence and metastasis rates were about 9% and 4%, respectively. In addition, we present the case of a 49-year-old woman with a bladder IMT who underwent TURBT followed by laparoscopic partial cystectomy. The patient remains tumor free postoperatively (follow-up period of 12 months). Conclusion: A complete surgical excision of the bladder IMT is crucial for the optimal management of these cases. Proper differentiation of this tumor from sarcoma or leiomyosarcoma leads to the best outcomes.

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Section: Discussionmentioning

confidence: 99%

Inflammatory myofibroblastic tumor of the urinary bladder: A systematic review of the literature and report of a case

Hage,

O’Donnell,

Abou Chakra

et al. 2024

Indian Journal of Urology

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“…Patients receiving only second-generation ALK inhibitors showed Progression-free survival surpasses that of individuals treated with both crizotinib and second-generation ALK inhibitors. [183][184][185][186] Pralsetinib is a kinase inhibitor that primarily targets wild-type RET (IC50s between 0. 14 and 0.…”

Section: -110mentioning

confidence: 99%

A graphSAGE discovers synergistic combinations of Gefitinib, paclitaxel, and Icotinib for Lung adenocarcinoma management by targeting human genes and proteins: the RAIN protocol

Sadeghi,

Kiaei,

Boush

et al. 2024

Preprint

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Background: Adenocarcinoma of the lung is the most common type of lung cancer, and it is characterized by distinct cellular and molecular features. It occurs when abnormal lung cells multiply out of control and form a tumor in the outer region of the lungs. Adenocarcinoma of the lung is a serious and life-threatening condition that requires effective and timely management to improve the survival and quality of life of the patients. One of the challenges in this cancer treatment is finding the optimal combination of drugs that can target the genes or proteins that are involved in the disease process. Method: In this article, we propose a novel method to recommend combinations of trending drugs to target its associated proteins/genes, using a Graph Neural Network (GNN) under the RAIN protocol. The RAIN protocol is a three-step framework that consists of: 1) Applying graph neural networks to recommend drug combinations by passing messages between trending drugs for managing disease and genes that act as potential targets for disease; 2) Retrieving relevant articles with clinical trials that include those proposed drugs in previous step using Natural Language Processing (NLP); 3) Analyzing the network meta-analysis to measure the comparative efficacy of the drug combinations. Result: We applied our method to a dataset of nodes and edges that represent the network, where each node is a drug or a gene, and each edge is a p-value between them. We found that the graph neural network recommends combining Gefitinib, Paclitaxel, and Icotinib as the most effective drug combination to target this cancer associated proteins/genes. We reviewed the clinical trials and expert opinions on these medications and found that they support our claim. The network meta-analysis also confirmed the effectiveness of these drugs on associated genes. Conclusion: Our method is a novel and promising approach to recommend trending drugs combination to target cancer associated proteins/genes, using graph neural networks under the RAIN protocol. It can help clinicians and researchers to find the best treatment options for patients, and also provide insights into the underlying mechanisms of the disease.

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“…IMT is frequently discovered incidentally during routine examinations or when investigating other medical conditions. In routine clinical practice, computed tomography (CT) and magnetic resonance imaging (MRI) constitute the fundamental diagnostic modalities [ 66 ]. However, specific imaging characteristics for IMT are lacking, and radiological findings typically reveal solid, regular, well-defined masses, contingent upon the primary tumor’s location [ 67 ].…”

Section: Diagnosismentioning

confidence: 99%

“…This resistance, whether primary or acquired during treatment was reported [ 219 ]. Sequential therapy, similar to that employed in NSCLC, may also confer benefits in patients with IMT [ 66 ]. Consequently, successive generations of inhibitors are undergoing investigation.…”

Section: Systematic Treatmentmentioning

confidence: 99%

Inflammatory myofibroblastic tumor from molecular diagnostics to current treatment

CHMIEL,

SłOWIKOWSKA,

BANASZEK

et al. 2024

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Inflammatory myofibroblastic tumor (IMT) is a rare neoplasm with intermediate malignancy characterized by a propensity for recurrence but a low metastatic rate. Diagnostic challenges arise from the diverse pathological presentation, variable symptomatology, and lack of different imaging features. However, IMT is identified by the fusion of the anaplastic lymphoma kinase (ALK) gene, which is present in approximately 70% of cases, with various fusion partners, including ran-binding protein 2 (RANBP2), which allows confirmation of the diagnosis. While surgery is the preferred approach for localized tumors, the optimal long-term treatment for advanced or metastatic disease is difficult to define. Targeted therapies are crucial for achieving sustained response to treatment within the context of genetic alteration in IMT. Crizotinib, an ALK tyrosine kinase inhibitor (TKI), was officially approved by the US Food and Drug Administration (FDA) in 2020 to treat IMT with ALK rearrangement. However, most patients face resistance and disease progression, requiring consideration of sequential treatments. Combining radiotherapy with targeted therapy appears to be beneficial in this indication. Early promising results have also been achieved with immunotherapy, indicating potential for combined therapy approaches. However, defined recommendations are still lacking. This review analyzes the available research on IMT, including genetic disorders and their impact on the course of the disease, data on the latest targeted therapy regimens and the possibility of developing immunotherapy in this indication, as well as summarizing general knowledge about prognostic and predictive factors, also in terms of resistance to systemic therapy.

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Update of Diagnosis and Targeted Therapy for ALK+ Inflammation Myofibroblastic Tumor

Cited by 7 publications

References 106 publications

Inflammatory myofibroblastic tumor of the urinary bladder: A systematic review of the literature and report of a case

Inflammatory myofibroblastic tumor of the urinary bladder: A systematic review of the literature and report of a case

A graphSAGE discovers synergistic combinations of Gefitinib, paclitaxel, and Icotinib for Lung adenocarcinoma management by targeting human genes and proteins: the RAIN protocol

Inflammatory myofibroblastic tumor from molecular diagnostics to current treatment

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