Publications by authors named "Alexander J Lazar"

this study aims to evaluate the survival outcomes of patients suffering from head and neck synovial sarcoma (HNSS), especially in relation to patients with a localized disease at diagnosis. this retrospective chart review includes 57 patients diagnosed with primary HNSS between 1981 and 2020 who presented with a localized disease at diagnosis. Overall survival (OS) from diagnosis, local recurrence-free survival (LRFS), and metastasis-free survival (MFS) from the end of the primary tumor treatment are estimated.

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Dysregulated FGF23 production is a demonstrated cause of hypophosphatemia and osteomalacia. Diseases associated with these conditions include phosphaturic mesenchymal tumor (PMT) causing tumor induced osteomalacia, various forms of rickets, and fibrous dysplasia (FD). Coexistence of 2 conditions that can increase FGF23 concentrations is rare.

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Purpose: FHD-609, a potent, selective, heterobifunctional degrader of bromodomain-containing protein 9 (BRD9), was evaluated for treatment of patients with advanced synovial sarcoma (SS) or SMARCB1-deficient tumors.

Patients And Methods: In this multinational, open-label, phase 1 study (NCT04965753), patients received FHD609 intravenously at escalating doses either twice weekly (BIW) (5 to 80 mg; n=40) or once weekly (QW) (40 to 120 mg; n=15).

Results: Fifty-five patients received FHD-609 for a median of 43 days.

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Malignant peripheral nerve sheath tumor (MPNST) development is characterized by an altered DNA methylation landscape, which presents a promising area for developing MPNST-specific biomarkers for screening patients with NF1. Genome-wide DNA methylation profiling of a cohort of 13 patients with MPNST (29 samples of tumor and adjacent neurofibroma tissues) and of NF1-MPNST cell lines was performed to identify and validate candidate MPNST-specific CpG sites (CpGs). A logistic regression prediction model was constructed to select MPNST-specific CpGs distinct from adjacent neurofibromas and normal tissues.

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Consensus recommendation published in 2017 histologically defining atypical neurofibromatous neoplasm of uncertain biologic potential (ANNUBP) and malignant peripheral nerve sheath tumor (MPNST) were codified in the 2021 WHO Classification of Tumors of the Central Nervous System and the 2022 WHO Classification of Tumors of Soft Tissue and Bone. However, given the shift in diagnostic pathology toward the use of integrated histopathologic and genomic approaches, the incorporation of additional molecular strata in the classification of Neurofibromatosis Type 1 (NF1)-associated peripheral nerve sheath tumors should be formalized to aid in accurate diagnosis and early identification of malignant transformation to enable appropriate intervention for affected patients. To this end, we assembled a multi-institutional expert pathology working group as part of a "Symposium on Atypical Neurofibroma: State of the Science".

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The aim of the study was to report the outcome of primary localized low-grade fibromyxoid sarcoma (LGFMS), sclerosing epithelioid fibrosarcoma (SEF), and hybrid LGFMS/SEF (H-LGFMS/SEF). Patients with primary localized LGFMS, SEF, or H-LGFMS/SEF, surgically treated with curative intent from January 2000 to September 2022, were enrolled from 14 countries and 27 institutions. Pathologic inclusion criteria were predefined by expert pathologists.

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Article Synopsis
  • Solitary fibrous tumor (SFT) is a rare type of tumor that can occur in various body parts and is often linked to specific genetic fusions, with 10-30% of cases becoming metastatic.
  • A study involving DNA methylation analysis of 79 SFTs revealed distinct epigenetic changes linked to their primary sites, identifying key genes such as EGFR and TBX15 that showed differing levels of expression based on the tumor's location and genetic fusion type.
  • TBX15 emerged as a significant marker, with changes in its methylation and expression strongly correlating to the tumor's tissue of origin, suggesting it could help differentiate between new tumors and metastases without needing extensive genomic analysis.
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  • A new subset of macrophages called iron-rich tumor-associated macrophages (iTAMs) was identified, marked by high levels of intracellular iron and involvement in angiogenesis and immunosuppression in tumors.
  • Two types of iTAMs were characterized based on their location and gene expression: perivascular (pviTAM) and stromal (stiTAM).
  • The endothelin receptor type B (Ednrb) was identified as a specific marker for iTAMs, and its deletion reduced tumor growth, while the transcription factor Bach1 was found to regulate iTAM functions by inhibiting Ednrb expression.
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  • The study examines gene regulatory changes associated with cancer by analyzing chromatin accessibility across eight different tumor types, revealing the influence of copy number alterations on tumor characteristics.
  • Researchers found specific chromatin signatures in cancer that are closely related to healthy cell types, particularly noting similarities between basal-like breast cancer and secretory-type luminal epithelial cells.
  • Advanced neural network models highlighted the significance of noncoding mutations near cancer-associated genes, suggesting that widely dispersed mutations in cancer have important functional roles in gene regulation.
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Background: The course of subclinical gastrointestinal stromal tumors (GISTs) is variable. The management of small GISTs is not well-defined.

Methods: Records of patients presenting with small GISTs with documented follow-up appointment at our institution between 2016 and 2022 were identified and reviewed.

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Objective: We evaluated survival outcomes by primary tumor site in synovial sarcoma (SS) patients with localized and metastatic disease at diagnosis.

Methods: We conducted a retrospective review of 504 SS patients diagnosed from 1974 to 2020. Kaplan-Meier method, log-rank test, and Cox-proportional hazards regression were used.

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  • Atypical intradermal smooth muscle neoplasm, or cutaneous leiomyosarcoma, is a rare skin tumor that grows slowly and usually isn't very aggressive.
  • A study looked at 95 patients with this tumor from 2002 to 2021, mostly men around 58 years old, with most tumors appearing as painless lumps on the legs or arms.
  • After treatment, the majority of patients (96%) stayed free of the disease for five years, showing that the outcomes were mostly good.
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Rhabdomyosarcomas are the most common soft tissue sarcoma in children, and pediatric alveolar rhabdomyosarcoma (ARMS) prognosis has improved based on cooperative studies. However, in adults, ARMS is significantly rarer, has poorer outcomes, and currently lacks optimal treatment strategies. This study aimed to evaluate the clinical outcome of an adult ARMS population with different front-line systemic chemotherapies and determine if any chemotherapy regimen is associated with improved survival.

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Initially described as a highly specific immunohistochemical marker for carcinomas of mammary origin, trichorhinophalangeal syndrome type 1 (TRPS1) has subsequently been detected in a variety of other non-mammary tumors. In this study, we examined the immunohistochemical expression of TRPS1 in 114 peripheral nerve sheath tumors, including 43 malignant peripheral nerve sheath tumors (MPNSTs), 58 schwannomas, including 9 cellular neurofibromas, and 13 neurofibromas, including 1 atypical neurofibroma. Notably, TRPS1 was expressed in 49% of MPNSTs and was absent in all schwannomas and neurofibromas.

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  • Nonsurgical treatments like the levonorgestrel intrauterine device (LIUD) are being explored for managing endometrial atypical hyperplasia (AH) and endometrioid endometrial cancer (EEC), highlighting a need for long-term efficacy data.
  • In a study of 43 patients initially responding to LIUD, 39% relapsed, with significant factors for shorter duration of response including younger age and lack of response at the 6-month mark.
  • Molecular analysis during the study revealed changes in immune cell populations and pathways involved in relapse, suggesting immune mechanisms play a crucial role in the treatment's effectiveness.
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Background: Undifferentiated pleomorphic sarcomas (UPSs) are amongst the most common subtypes of soft-tissue sarcomas. Few real-world data on the use of immune checkpoint blockade (ICB) in UPS patients and other high-grade pleomorphic STS patients are available.

Purpose: The purpose of our study is to describe the efficacy and toxicity of ICB in patients with advanced UPSs and other high-grade pleomorphic sarcomas treated at our institution.

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The vast majority of gastrointestinal stromal tumors (GISTs) are driven by activating mutations in , , or components of the succinate dehydrogenase (SDH) complex (, , , and genes). A small fraction of GISTs lack alterations in , , and . We aimed to further characterize the clinical and genomic characteristics of these so-called "triple-negative" GISTs.

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Most malignant peripheral nerve sheath tumors (MPNSTs) are clinically aggressive high-grade sarcomas, arising in individuals with neurofibromatosis type 1 (NF1) at a significantly elevated estimated lifetime frequency of 8%-13%. In the setting of NF1, MPNSTs arise from malignant transformation of benign plexiform neurofibroma and borderline atypical neurofibromas. Composed of neoplastic cells from the Schwannian lineage, these cancers recur in approximately 50% of individuals, and most patients die within five years of diagnosis, despite surgical resection, radiation, and chemotherapy.

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  • Drivers of Spitz neoplasms are linked to mutations in HRAS and genomic fusions, while some BRAF-mutated melanocytic neoplasms can resemble Spitz tumors, leading to the classification known as BRAF mutated and morphologically spitzoid (BAMS).
  • A study involving 17 pathologists assessed 54 cases, including 40 BAMS and 14 true Spitz tumors, without access to genomic data, and found a split in diagnostic preferences with about 38% identifying BAMS and 32% identifying ST among BAMS cases.
  • The study highlighted significant difficulty in distinguishing BAMS from true Spitz tumors, with poor agreement among experts on precise diagnosis (kappa = 0.16), although there was
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Gene disruption from double-strand DNA breaks within introns is a mechanism of inactivating the tumor suppressor TP53. This occurs more frequently in osteosarcoma and biliary adenocarcinoma compared with other cancer types. The patterns of intron breakpoints within TP53 do not correlate with prevalence, intron length, or overall genome-wide levels of rearrangements.

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Purpose: Mutations in the ATM gene are common in multiple cancers, but clinical studies of therapies targeting ATM-aberrant cancers have yielded mixed results. Refinement of ATM loss of function (LOF) as a predictive biomarker of response is urgently needed.

Experimental Design: We present the first disclosure and preclinical development of a novel, selective ATR inhibitor, ART0380, and test its antitumor activity in multiple preclinical cancer models.

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Despite the successes of immunotherapy in cancer treatment over recent decades, less than <10%-20% cancer cases have demonstrated durable responses from immune checkpoint blockade. To enhance the efficacy of immunotherapies, combination therapies suppressing multiple immune evasion mechanisms are increasingly contemplated. To better understand immune cell surveillance and diverse immune evasion responses in tumor tissues, we comprehensively characterized the immune landscape of more than 1,000 tumors across ten different cancers using CPTAC pan-cancer proteogenomic data.

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