Publications by authors named "Peter Kuppen"

Article Synopsis
  • - Oesophageal cancer patients achieving a clinical complete response (CR) after neoadjuvant chemoradiotherapy (nCRT) may benefit from active surveillance; however, identifying true CRs is difficult due to a 40% regrowth rate in these patients.
  • - The study examined pre-treatment and post-treatment tissue samples to analyze the expression of several tumor markers (CEA, EpCAM, VEGF-α, EGFR, c-MET) through immunohistochemistry, aiming to find markers for potential near-infrared fluorescence imaging.
  • - Results showed high expression of EpCAM in adenocarcinomas and EGFR in squamous cell carcinomas, while neoadjuvant therapy did not alter the
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Purpose: Tumor-targeted positron emission tomography (PET) and fluorescence-guided surgery (FGS) could address current challenges in pre- and intraoperative imaging of gastric cancer. Adequate selection of molecular imaging targets remains crucial for successful tumor visualization. This study evaluated the potential of integrin αβ, carcinoembryonic antigen-related cell adhesion molecule 5 (CEACAM5), epidermal growth factor receptor (EGFR), epithelial cell adhesion molecule (EpCAM) and human epidermal growth factor receptor-2 (HER2) for molecular imaging of primary gastric cancer, as well as lymph node and distant metastases.

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  • * A new imaging agent, AKRO-6qcICG, can be applied to the surface of these tumors and helps surgeons see where cancer cells remain during surgery using near-infrared fluorescence.
  • * In studies with patients, AKRO-6qcICG showed excellent sensitivity (100%) in detecting remaining cancer cells, indicating it could be a valuable tool to improve surgical outcomes and minimize additional treatments.
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Surgical intervention for endometriosis is an important treatment modality, yet incomplete resection resulting from poor visibility of affected tissue and consequently recurrence of disease remains a prevalent challenge. Intra-operative visualization of endometriosis, enabling fluorescence-guided surgery (FGS), could help to optimize surgical treatment. A biomarker, upregulated in endometriosis compared to adjacent tissue, is required to use as a target for FGS.

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Purpose: Cysteine cathepsins are proteases that play a role in normal cellular physiology and neoplastic transformation. Elevated expression and enzymatic activity of cathepsins in breast cancer (BCa) indicates their potential as a target for tumor imaging. In particular cathepsin B (CTSB), L (CTSL), and S (CTSS) are used as targets for near-infrared (NIR) fluorescence imaging (FI), a technique that allows real-time intraoperative tumor visualization and resection margin assessment.

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  • The study investigates the use of fluorescence imaging (FLI) to enhance the surgical identification of oral and laryngeal cancers (OSCC and LSCC) and papillary thyroid carcinoma (PTC), aiming to improve excision precision due to challenges in tumor delineation.
  • Six potential tumor-targeting markers were evaluated through immunohistochemical staining in various cancer samples, with integrin αvβ6 and EGFR showing significant overexpression in OSCC and LSCC, indicating their effectiveness as FLI targets.
  • The research suggests that although PTC shows lower expressions of these markers, the notable overexpression of VEGF-α and c-Met could also make them viable for improving
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Despite advances in treatment strategies, colorectal cancer (CRC) continues to cause significant morbidity and mortality, with mounting evidence a close link between immune system dysfunctions issued. Interleukin-2 receptor gamma (IL-2RG) plays a pivotal role as a common subunit receptor in the IL-2 family cytokines and activates the JAK-STAT pathway. This study delves into the role of Interleukin-2 receptor gamma (IL-2RG) within the tumor microenvironment and investigates potential microRNAs (miRNAs) that directly inhibit IL-2RG, aiming to discern their impact on CRC clinical outcomes.

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Background: Colon cancer is a heterogeneous disease and consists of various molecular subtypes. Despite advances in high-throughput expression profiling, limitations remain in predicting clinical outcome and assigning specific treatment to individual cases. Tumor-immune interactions play a critical role, with tumors that activate the immune system having better outcome for the patient.

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  • Near-infrared fluorescence imaging in cancer surgery currently lacks a consistent method to assess the effectiveness of fluorescent dyes, leading to challenges in translating research findings from lab to clinical settings.
  • The goal of this study is to create a semi-automatic method that provides an objective way to measure fluorescent signals in tissue samples post-surgery.
  • The new method was tested and showed better consistency than traditional techniques, indicating it can enhance the reliability and standardization of studies involving fluorescent dyes in clinical applications.
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Novel biomarkers are needed to improve current imperfect risk prediction models for cancer-associated thrombosis (CAT). We recently identified an RNA-sequencing profile that associates with CAT in colorectal cancer (CRC) patients, with REG4, SPINK4, and SERPINA1 as the top-3 upregulated genes at mRNA level. In the current study, we investigated whether protein expression of REG4, SPINK4 and alpha-1 antitrypsin (A1AT, encoded by SERPINA1) in the tumor associated with CAT in an independent cohort of CRC patients.

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Purpose: Fluorescence-guided surgery (FGS) can play a key role in improving radical resection rates by assisting surgeons to gain adequate visualization of malignant tissue intraoperatively. Designed ankyrin repeat proteins (DARPins) possess optimal pharmacokinetic and other properties for in vivo imaging. This study aims to evaluate the preclinical potential of epithelial cell adhesion molecule (EpCAM)-binding DARPins as targeting moieties for near-infrared fluorescence (NIRF) and photoacoustic (PA) imaging of cancer.

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Fluorescence-guided surgery (FGS), based on fluorescent tracers binding to tumor-specific biomarkers, could assist surgeons to achieve complete tumor resections. This study evaluated potential biomarkers for FGS in pediatric Ewing sarcoma (ES). Immunohistochemistry (IHC) was performed to assess CD99, CXCR4, CD117, NPY-R-Y1, and IGF-1R expression in ES biopsies and resection specimens.

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Intra-operative fluorescent imaging of endometriosis could help to optimize surgical treatment. Potential biomarkers to use as target for endometriosis-binding fluorescent probes were identified using a new five-phase transcriptomics-based approach to broaden the search for biomarkers. Using publicly available datasets, a differentially expressed gene (DEG) analysis was performed for endometriosis versus surgically relevant surrounding tissue (peritoneum, bladder, sigmoid, rectum, transverse colon, small intestine, vagina, and fallopian tubes) for which data was available.

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The lack of multi-omics cancer datasets with extensive follow-up information hinders the identification of accurate biomarkers of clinical outcome. In this cohort study, we performed comprehensive genomic analyses on fresh-frozen samples from 348 patients affected by primary colon cancer, encompassing RNA, whole-exome, deep T cell receptor and 16S bacterial rRNA gene sequencing on tumor and matched healthy colon tissue, complemented with tumor whole-genome sequencing for further microbiome characterization. A type 1 helper T cell, cytotoxic, gene expression signature, called Immunologic Constant of Rejection, captured the presence of clonally expanded, tumor-enriched T cell clones and outperformed conventional prognostic molecular biomarkers, such as the consensus molecular subtype and the microsatellite instability classifications.

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Article Synopsis
  • The study focuses on the long-term recurrence risk in women with hormone receptor-positive, HER2-negative breast cancer, using data from the TEAM trial involving nearly 10,000 patients across multiple countries, including 2,754 from the Netherlands.
  • The research specifically evaluates the effectiveness of the CanAssist Breast (CAB) prognostic test in predicting ten-year clinical outcomes for Dutch patients, finding significant associations with risk stratification.
  • Results reveal that CAB identified 67.5% of patients as low-risk and 32.5% as high-risk at ten years, with high-risk patients showing worse distant recurrence-free intervals and being independent prognostic factors compared to other clinical parameters.
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Introduction: Myxofibrosarcoma (MFS) is the most common soft-tissue sarcoma subtype in elderly patients. Local recurrence (LR) remains a major concern as the lack of intraoperative guidance and an infiltrative growth pattern with long, slender tails hamper surgeons' ability to achieve adequate resection margins for MFS. Fluorescence-guided surgery (FGS) could overcome this concern by delineating tumor tissue during surgery.

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Cancer enhances the risk of venous thromboembolism, but a hypercoagulant microenvironment also promotes cancer progression. Although anticoagulants have been suggested as a potential anticancer treatment, clinical studies on the effect of such modalities on cancer progression have not yet been successful for unknown reasons. In normal physiology, complex formation between the subendothelial-expressed tissue factor (TF) and the blood-borne liver-derived factor VII (FVII) results in induction of the extrinsic coagulation cascade and intracellular signaling via protease-activated receptors (PARs).

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Background: Targeted molecular imaging may improve tumor cell identification during diagnosis and resection of pancreatic ductal adenocarcinoma (PDAC). Although many molecular imaging biomarkers are (over)expressed in PDAC, intertumoral heterogeneity of biomarker expression hampers universal tracer administration. Preoperative, patient-specific screening and selection of the most optimal biomarker could therefore improve tumor delineation.

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Purpose: Intraoperative identification of lung tumors can be challenging. Tumor-targeted fluorescence-guided surgery can provide surgeons with a tool for real-time intraoperative tumor detection. This study evaluated cell surface biomarkers, partially selected via data-driven selection software, as potential targets for fluorescence-guided surgery in non-small cell lung cancers: adenocarcinomas (ADC), adenocarcinomas in situ (AIS), and squamous cell carcinomas (SCC).

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The purpose of this study was to evaluate the association between four distinct histopathological features: (1) tumor infiltrating lymphocytes, (2) mucinous differentiation, (3) tumor-stroma ratio, plus (4) tumor budding and two gene expression-based classifiers—(1) consensus molecular subtypes (CMS) plus (2) colorectal cancer intrinsic subtypes (CRIS). All four histopathological features were retrospectively scored on hematoxylin and eosin sections of the most invasive part of the primary tumor in 218 stage II and III colon cancer patients from two independent cohorts (AMC-AJCC-90 and AC-ICAM). RNA-based CMS and CRIS assignments were independently obtained for all patients.

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Tissue Factor (TF) is the initiator of blood coagulation but also functions as a signal transduction receptor. TF expression in breast cancer is associated with higher tumor grade, metastasis and poor survival. The role of TF signaling on the early phases of metastasis has never been addressed.

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The majority of breast cancer patients is treated with breast-conserving surgery (BCS) combined with adjuvant radiation therapy. Up to 40% of patients has a tumor-positive resection margin after BCS, which necessitates re-resection or additional boost radiation. Cathepsin-targeted near-infrared fluorescence imaging during BCS could be used to detect residual cancer in the surgical cavity and guide additional resection, thereby preventing tumor-positive resection margins and associated mutilating treatments.

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Article Synopsis
  • Colorectal cancer patients have a higher risk of developing venous thromboembolism (VTE), leading to more health complications and higher death rates, prompting the need for better risk assessment methods.
  • The study examined tumor-expressed microRNAs (miRNAs) in a group of colorectal cancer patients to find potential biomarkers associated with VTE, involving 17 patients with VTE and 18 without, using advanced sequencing techniques.
  • The researchers identified 19 miRNAs that were significantly regulated in patients with VTE, suggesting potential new biomarkers that could help predict VTE risk in colorectal cancer patients in the future.
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Lung cancer is the most common cancer type worldwide, with non-small cell lung cancer (NSCLC) being the most common subtype. Non-disseminated NSCLC is mainly treated with surgical resection. The intraoperative detection of lung cancer can be challenging, since small and deeply located pulmonary nodules can be invisible under white light.

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