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Overexpression of the drug resistance-associated protein metallothionein does not correlate with response of sarcomas to isolated limb perfusion treatment

✍ Scribed by Florian Grabellus; Sien-Yi Sheu; Martin Tötsch; Nils Lehmann; Gernot M. Kaiser; Bharat Jasani; Georg Taeger; Kurt W. Schmid


Book ID
102440157
Publisher
John Wiley and Sons
Year
2010
Tongue
English
Weight
238 KB
Volume
101
Category
Article
ISSN
0022-4790

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✦ Synopsis


Abstract

Background and Objectives

Hyperthermic isolated limb perfusion with TNF‐α and melphalan (HILP‐TM) achieves high response rates in sarcomas. Melphalan resistance was previously reported to be associated with overexpression of metallothioneins (MTs). Objective of this study was to investigate the influence of MT expression on tumor responses in HILP‐TM‐treated soft tissue (STSs) and bone sarcomas (BS).

Methods

In primary biopsies of 41 HILP‐TM‐treated sarcomas (37 STSs and 4 BS), MT expression was assessed by an immunoreactive score. The pathologic response to HILP‐TM was quantified in the corresponding tumor resection specimens. We studied the association of MT‐IRS between histological regression (responder >90%, or non‐responder ≤90% regression), tumor proliferation, and other clinico‐pathological parameters.

Results

MT expression was found in 70.7% (N = 29) of tumors (high 12.2%, moderate 19.5%, and low 39.0%). After HILP‐TM, 20 cases (48.8%) were categorized as “responders” and 21 (51.2%) as “non‐responders.” Six “responders” (14.6%) presented with complete regression. MT expression positively correlated with tumor proliferation but not with HILP‐TM.

Conclusions

HILP‐TM showed a favorable response in a high rate of sarcomas. Although MT overexpression was observed in this cohort of sarcomas, the immunohistochemical MT status was not predictive of the tumor response after HILP‐TM treatment. J. Surg. Oncol. 2010; 101:465–470. © 2010 Wiley‐Liss, Inc.