Upper tract urothelial carcinoma(UTUC)is rare but can occur sporadically outside the context of Lynch syndrome.In these cases,knowing whether non-mismatch repair(MMR),DNA damage response and repair(DDR),and cell cycle...Upper tract urothelial carcinoma(UTUC)is rare but can occur sporadically outside the context of Lynch syndrome.In these cases,knowing whether non-mismatch repair(MMR),DNA damage response and repair(DDR),and cell cycle gene alterationsmay predict responses to chemotherapy orimmunotherapy and survival is of clinical importance.This study examined the germline and somatic mutational landscape of two UTUC patients with differential responses to programmed death 1(PD-1)/PD-ligand 1(PD-L1)immune checkpoint inhibitors and queried three independent UTUC cohort studies for co-occurrence of key cell cycle and DDR genes,as well as for their associations with overall survival(OS).TP53 and RB1 emerged as potential determinants of shorter OS in UTUC cohort patients,regardless of concurrent DDR alterations,and if prospectively assessed in larger studies they might also explain resistance to PD-1/PD-L1 blockade despite PD-L1 expression.展开更多
Nuclear factor E2-related factor 2(NRF2),a transcription factor,is a master regulator of an array of genes related to oxidative and electrophilic stress that promote and maintain redox homeostasis.NRF2 function is wel...Nuclear factor E2-related factor 2(NRF2),a transcription factor,is a master regulator of an array of genes related to oxidative and electrophilic stress that promote and maintain redox homeostasis.NRF2 function is well studied in in vitro,animal and general physiology models.However,emerging data has uncovered novel functionality of this transcription factor in human diseases such as cancer,autism,anxiety disorders and diabetes.A key finding in these emerging roles has been its constitutive upregulation in multiple cancers promoting pro-survival phenotypes.The survivability pathways in these studies were mostly explained by classical NRF2 activation involving KEAP-1 relief and transcriptional induction of reactive oxygen species(ROS)neutralizing and cytoprotective drug-metabolizing enzymes(phase I,II,III and 0).Further,NRF2 status and activation is associated with lowered cancer therapeutic efficacy and the eventual emergence of therapeutic resistance.Interestingly,we and others have provided further evidence of direct NRF2 regulation of anticancer drug targets like receptor tyrosine kinases and DNA damage and repair proteins and kinases with implications for therapy outcome.This novel finding demonstrates a renewed role of NRF2 as a key modulatory factor informing anticancer therapeutic outcomes,which extends beyond its described classical role as a ROS regulator.This review will provide a knowledge base for these emerging roles of NRF2 in anticancer therapies involving feedback and feed forward models and will consolidate and present such findings in a systematic manner.This places NRF2 as a key determinant of action,effectiveness and resistance to anticancer therapy.展开更多
文摘Upper tract urothelial carcinoma(UTUC)is rare but can occur sporadically outside the context of Lynch syndrome.In these cases,knowing whether non-mismatch repair(MMR),DNA damage response and repair(DDR),and cell cycle gene alterationsmay predict responses to chemotherapy orimmunotherapy and survival is of clinical importance.This study examined the germline and somatic mutational landscape of two UTUC patients with differential responses to programmed death 1(PD-1)/PD-ligand 1(PD-L1)immune checkpoint inhibitors and queried three independent UTUC cohort studies for co-occurrence of key cell cycle and DDR genes,as well as for their associations with overall survival(OS).TP53 and RB1 emerged as potential determinants of shorter OS in UTUC cohort patients,regardless of concurrent DDR alterations,and if prospectively assessed in larger studies they might also explain resistance to PD-1/PD-L1 blockade despite PD-L1 expression.
文摘Nuclear factor E2-related factor 2(NRF2),a transcription factor,is a master regulator of an array of genes related to oxidative and electrophilic stress that promote and maintain redox homeostasis.NRF2 function is well studied in in vitro,animal and general physiology models.However,emerging data has uncovered novel functionality of this transcription factor in human diseases such as cancer,autism,anxiety disorders and diabetes.A key finding in these emerging roles has been its constitutive upregulation in multiple cancers promoting pro-survival phenotypes.The survivability pathways in these studies were mostly explained by classical NRF2 activation involving KEAP-1 relief and transcriptional induction of reactive oxygen species(ROS)neutralizing and cytoprotective drug-metabolizing enzymes(phase I,II,III and 0).Further,NRF2 status and activation is associated with lowered cancer therapeutic efficacy and the eventual emergence of therapeutic resistance.Interestingly,we and others have provided further evidence of direct NRF2 regulation of anticancer drug targets like receptor tyrosine kinases and DNA damage and repair proteins and kinases with implications for therapy outcome.This novel finding demonstrates a renewed role of NRF2 as a key modulatory factor informing anticancer therapeutic outcomes,which extends beyond its described classical role as a ROS regulator.This review will provide a knowledge base for these emerging roles of NRF2 in anticancer therapies involving feedback and feed forward models and will consolidate and present such findings in a systematic manner.This places NRF2 as a key determinant of action,effectiveness and resistance to anticancer therapy.