Drug sensitivity testing on patient-derived sarcoma cells predicts patient response to treatment and identifies c-Sarc inhibitors as active drugs for translocation sarcomas

BACKGROUND: Heterogeneity and low incidence comprise the biggest challenge in sarcoma diagnosis and treatment. Chemotherapy, although efficient for some sarcoma subtypes, generally results in poor clinical responses and is mostly recommended for advanced disease. Specific genomic aberrations have been identified in some sarcoma subtypes but few of them can be targeted with approved drugs. METHODS: We cultured and characterised patient-derived sarcoma cells and evaluated their sensitivity to 525 anti-cancer agents including both approved and non-approved drugs. In total, 14 sarcomas and 5 healthy mesenchymal primary cell cultures were studied. The sarcoma biopsies and derived cells were characterised by gene panel sequencing, cancer driver gene expression and by detecting specific fusion oncoproteins in situ in sarcomas with translocations. RESULTS: Soft tissue sarcoma cultures were established from patient biopsies with a success rate of 58%. The genomic profile and drug sensitivity testing on these samples helped to identify targeted inhibitors active on sarcomas. The cSrc inhibitor Dasatinib was identified as an active drug in sarcomas carrying chromosomal translocations. The drug sensitivity of the patient sarcoma cells ex vivo correlated with the response to the former treatment of the patient. CONCLUSIONS: Our results show that patient-derived sarcoma cells cultured in vitro are relevant and practical models for genotypic and phenotypic screens aiming to identify efficient drugs to treat sarcoma patients with poor treatment options.Peer reviewe

HDAC inhibition by quisinostat synergizes with proteasome inhibition to decrease synovial sarcoma cell viability.

<p>(A) In all synovial sarcoma cell lines, but not HEK293T controls, the addition of 0.005 μM of bortezomib results in a downshift of approximately a full log of quisinostat, decreasing the amount of drug required to achieve the same effect as the HDAC inhibitor alone. (B) Isobologram analysis demonstrates synergy of these drug classes in synovial sarcoma cell lines (but not HEK293T controls), as increasing concentration combinations fall below the additive isoboles. (C) Combination index (CI) values calculated for the combination of bortezomib and quisinostat in synovial sarcoma are significantly less than 1, indicating synergy of the compounds is occurring in all six synovial sarcoma cell lines (but not HEK293T controls). Isobolograms and CI values were calculated using the Chou-Talalay-designed program CompuSyn. Statistical significance compared to vehicle treatment controls was determined by Student t test: * denotes <i>p</i> < 0.05; ** denotes <i>p</i> < 0.01; *** denotes <i>p</i> < 0.001. Error bars represent standard error of mean from conditions performed in triplicate. </p