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Published in: Medical Oncology 3/2014

01-03-2014 | Original Paper

Anti-inflammatory macrophages activate invasion in pancreatic adenocarcinoma by increasing the MMP9 and ADAM8 expression

Authors: Pauli Puolakkainen, Aino Koski, Sanna Vainionpää, Zhanlong Shen, Heikki Repo, Esko Kemppainen, Harri Mustonen, Hanna Seppänen

Published in: Medical Oncology | Issue 3/2014

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Abstract

Patients with chronic pancreatitis with local inflammation have high risk for pancreatic cancer. The aim of this study was to examine the role of the inflammatory cells in the invasion of pancreatic cancer cells, focusing on the involvement of a disintegrin and metalloproteinase 8 (ADAM8) and matrix metalloproteinase 9 (MMP9) proteins. ADAM8 expression is associated with worse survival of pancreatic cancer patients. Monocytes from healthy donors were differentiated into macrophages. Pancreatic adenocarcinoma cells were cultured either alone or with differentiated macrophages. The cancer cell migration rate in Matrigel was measured by imaging fluorescently stained cells for 24 h. After invasion, cells were sorted into CD14 positive/negative macrophages and cancer cells with magnetic separation. The expression of ADAM8 and MMP9 was measured by the real-time PCR. Protein-level expression of ADAM8 and MMP9 was analyzed by Western blotting. In two series, siRNA technique was used to reduce either ADAM8 or MMP9 expression in the cancer cells. The coculture with macrophages increased cancer cell migration rate in Matrigel, and increased ADAM8 and MMP9 mRNA expression and protein level in the cancer cells. Reduction of ADAM8 expression with siRNA in the cancer cells decreased macrophage-induced migration rate of the cancer cells from 11.7 ± 0.3 μm/h to 9.0 ± 0.2 μm/h (p < 0.01), and reduction of MMP9 expression decreased the migration rate to 10.1 ± 0.2 μm/h (p < 0.01). Anti-inflammatory macrophages increase pancreatic cancer cell migration rate in basement membrane matrix by inducing ADAM8 and MMP9 expression in cancer cells, thereby possibly enhancing the invasiveness of cancer.
Literature
1.
go back to reference Puolakkainen PA, Brekken RA, Muneer S, Sage EH. Enhanced growth of pancreatic tumors in SPARC-null mice is associated with decreased deposition of extracellular matrix and reduced tumor cell apoptosis. Mol Cancer Res. 2004;2:215–24.PubMed Puolakkainen PA, Brekken RA, Muneer S, Sage EH. Enhanced growth of pancreatic tumors in SPARC-null mice is associated with decreased deposition of extracellular matrix and reduced tumor cell apoptosis. Mol Cancer Res. 2004;2:215–24.PubMed
2.
go back to reference Chong HC, Tan CK, Huang RL, Tan NS. Matricellular proteins: a sticky affair with cancers. J Oncol. (2012);351089. Chong HC, Tan CK, Huang RL, Tan NS. Matricellular proteins: a sticky affair with cancers. J Oncol. (2012);351089.
3.
go back to reference McKay CJ, Glen P, McMillan DC. Chronic inflammation and pancreatic cancer. Best Pract Res Clin Gastroenterol. 2008;22:65–73.PubMedCrossRef McKay CJ, Glen P, McMillan DC. Chronic inflammation and pancreatic cancer. Best Pract Res Clin Gastroenterol. 2008;22:65–73.PubMedCrossRef
4.
go back to reference Arnold S, Rivera LB, Miller AF, Carbon JG, Dineen SP, Xie Y, Castrillon DH, Sage EH, Puolakkainen P, Bradshaw AD, Brekken RA. Lack of host SPARC enhances vascular function and tumor spread in an orthotopic murine model of pancreatic carcinoma. Dis Model Mech. 2010;3:57–72.PubMedCentralPubMedCrossRef Arnold S, Rivera LB, Miller AF, Carbon JG, Dineen SP, Xie Y, Castrillon DH, Sage EH, Puolakkainen P, Bradshaw AD, Brekken RA. Lack of host SPARC enhances vascular function and tumor spread in an orthotopic murine model of pancreatic carcinoma. Dis Model Mech. 2010;3:57–72.PubMedCentralPubMedCrossRef
5.
go back to reference Pelli H, Juuti A, Mustonen H, Nordling S, Sirén J, Haglund C, Kiviluoto T. Results of 546 consecutive pancreatic operations at Helsinki University Hospital, Finland. Pancreatology. 2010;10:NLS33.CrossRef Pelli H, Juuti A, Mustonen H, Nordling S, Sirén J, Haglund C, Kiviluoto T. Results of 546 consecutive pancreatic operations at Helsinki University Hospital, Finland. Pancreatology. 2010;10:NLS33.CrossRef
6.
go back to reference Mielgo A, Schmid MC. Impact of tumour associated macrophages in pancreatic cancer. BMB Rep. 2013;46:31–8.CrossRef Mielgo A, Schmid MC. Impact of tumour associated macrophages in pancreatic cancer. BMB Rep. 2013;46:31–8.CrossRef
7.
go back to reference Giraudo E, Inoue M, Hanahan D. An amino-bisphosphonate targets MMP-9-expressing macrophages and angiogenesis to impair cervical carcinogenesis. J Clin Invest. 2004;114:623–33.PubMedCentralPubMedCrossRef Giraudo E, Inoue M, Hanahan D. An amino-bisphosphonate targets MMP-9-expressing macrophages and angiogenesis to impair cervical carcinogenesis. J Clin Invest. 2004;114:623–33.PubMedCentralPubMedCrossRef
8.
go back to reference Shen Z, Kauttu T, Cao J, Seppänen H, Vainionpää S, Ye Y, Wang S, Mustonen H, Puolakkainen P. Macrophage coculture enhanced invasion of gastric cancer cells via TGF-β and BMP pathways. Scand J Gastroenterol. 2013;48:466–72.PubMedCrossRef Shen Z, Kauttu T, Cao J, Seppänen H, Vainionpää S, Ye Y, Wang S, Mustonen H, Puolakkainen P. Macrophage coculture enhanced invasion of gastric cancer cells via TGF-β and BMP pathways. Scand J Gastroenterol. 2013;48:466–72.PubMedCrossRef
9.
go back to reference Shen Z, Kauttu T, Seppänen H, Vainionpää S, Ye Y, Wang S, Mustonen H, Puolakkainen P. Both macrophages and hypoxia play critical role in regulating invasion and metastasis of gastric cancer. Acta Oncol. 2013;52:852–60.PubMedCrossRef Shen Z, Kauttu T, Seppänen H, Vainionpää S, Ye Y, Wang S, Mustonen H, Puolakkainen P. Both macrophages and hypoxia play critical role in regulating invasion and metastasis of gastric cancer. Acta Oncol. 2013;52:852–60.PubMedCrossRef
10.
go back to reference Lewis CE, Pollard JW. Distinct role of macrophages in different tumor microenvironments. Cancer Res. 2006;66:605–12.PubMedCrossRef Lewis CE, Pollard JW. Distinct role of macrophages in different tumor microenvironments. Cancer Res. 2006;66:605–12.PubMedCrossRef
11.
go back to reference Fukuda K, Kobayashi A, Watabe K. The role of tumor-associated macrophage in tumor progression. Front Biosci (Schol Ed). 2012;4:787–98.CrossRef Fukuda K, Kobayashi A, Watabe K. The role of tumor-associated macrophage in tumor progression. Front Biosci (Schol Ed). 2012;4:787–98.CrossRef
12.
go back to reference Bloomston M, Shafii A, Zervos E, Rosemurgy AS. TIMP-1 antisense gene transfection attenuates the invasive potential of pancreatic cancer cells in vitro and inhibits tumor growth in vivo. Ann Surg Oncol. 2002;9:668–74.PubMedCrossRef Bloomston M, Shafii A, Zervos E, Rosemurgy AS. TIMP-1 antisense gene transfection attenuates the invasive potential of pancreatic cancer cells in vitro and inhibits tumor growth in vivo. Ann Surg Oncol. 2002;9:668–74.PubMedCrossRef
13.
go back to reference Schoppmann SF, Birner P, Stöckl J, Kalt R, Ullrich R, Caucig C, Kriehuber E, Nagy K, Alitalo K, Kerjaschki D. Tumor-associated macrophages express lymphatic endothelial growth factors and are related to peritumoral lymphangiogenesis. Am J Pathol. 2002;161:947–56.PubMedCrossRef Schoppmann SF, Birner P, Stöckl J, Kalt R, Ullrich R, Caucig C, Kriehuber E, Nagy K, Alitalo K, Kerjaschki D. Tumor-associated macrophages express lymphatic endothelial growth factors and are related to peritumoral lymphangiogenesis. Am J Pathol. 2002;161:947–56.PubMedCrossRef
14.
go back to reference Murphy G. The ADAMs: signaling scissors in the tumor microenvironment. Nat Rev Cancer. 2008;8:929–41.PubMedCrossRef Murphy G. The ADAMs: signaling scissors in the tumor microenvironment. Nat Rev Cancer. 2008;8:929–41.PubMedCrossRef
15.
go back to reference Grutzmann R, Luettges J, Sipos B, Dobrowolski F, Ammerpohi O, Alldinger I, Kersting S, Ockert D, Koch R, Kalthoff H, Schackert HK, Saeger HD, Klöppel G, Pilarsky C. ADAM9 expression in pancreatic cancer is associated with tumor type and is a prognostic factor in ductal adenocarcinoma. Br J Cancer. 2004;90:1053–8.PubMedCentralPubMedCrossRef Grutzmann R, Luettges J, Sipos B, Dobrowolski F, Ammerpohi O, Alldinger I, Kersting S, Ockert D, Koch R, Kalthoff H, Schackert HK, Saeger HD, Klöppel G, Pilarsky C. ADAM9 expression in pancreatic cancer is associated with tumor type and is a prognostic factor in ductal adenocarcinoma. Br J Cancer. 2004;90:1053–8.PubMedCentralPubMedCrossRef
16.
go back to reference Ringel J, Jesnowski R, Moniaux N, Luettges J, Ringel J, Choudhury A, Surinder BK, Klöppel G, Löhr M. Aberrant expression of disintegrin and metalloproteinase 17/tumornecrosis factor α converting enzyme increases malignant potential in human pancreatic ductal adenocarcinoma. Cancer Res. 2006;66:9045–53.PubMedCrossRef Ringel J, Jesnowski R, Moniaux N, Luettges J, Ringel J, Choudhury A, Surinder BK, Klöppel G, Löhr M. Aberrant expression of disintegrin and metalloproteinase 17/tumornecrosis factor α converting enzyme increases malignant potential in human pancreatic ductal adenocarcinoma. Cancer Res. 2006;66:9045–53.PubMedCrossRef
17.
go back to reference Valkovskaya N, Kayed H, Felix K, Hartmann D, Giese NA, Osinsky SP, Friess H, Kleeff J. ADAM8 expression is associated with increased invasiveness and reduced patient survival in pancreatic cancer. J Cell Mol Med. 2007;11:1162–74.PubMedCrossRef Valkovskaya N, Kayed H, Felix K, Hartmann D, Giese NA, Osinsky SP, Friess H, Kleeff J. ADAM8 expression is associated with increased invasiveness and reduced patient survival in pancreatic cancer. J Cell Mol Med. 2007;11:1162–74.PubMedCrossRef
19.
go back to reference Mustonen H, Puolakkainen P, Kemppainen E, Kiviluoto T, Kivilaakso E. Taurocholate potentiates ethanol induced NF-kB activation and inhibits Caspase-3 activity in cultured rat gastric mucosal cells. Dic Dis Sci. 2009;54:928–36. Mustonen H, Puolakkainen P, Kemppainen E, Kiviluoto T, Kivilaakso E. Taurocholate potentiates ethanol induced NF-kB activation and inhibits Caspase-3 activity in cultured rat gastric mucosal cells. Dic Dis Sci. 2009;54:928–36.
20.
go back to reference Terzić J, Grivennikov S, Karin E, Karin M. Inflammation and colon cancer. Gastroenterology. 2010;138:2101–14.PubMedCrossRef Terzić J, Grivennikov S, Karin E, Karin M. Inflammation and colon cancer. Gastroenterology. 2010;138:2101–14.PubMedCrossRef
22.
go back to reference Bingle L, Brown NJ, Lewis CE. The role of tumour-associated macrophages in tumour progression: implications for new anticancer therapies. J Pathol. 2002;196:254–65.PubMedCrossRef Bingle L, Brown NJ, Lewis CE. The role of tumour-associated macrophages in tumour progression: implications for new anticancer therapies. J Pathol. 2002;196:254–65.PubMedCrossRef
23.
go back to reference Dirkx AEM, oude Egbrink MGA, Wagstaff J, Griffioen AW. Monocyte/macrophage infiltration in tumors: modulators of angiogenesis. J Leukoc Biol. 2006;80:1183–96.PubMedCrossRef Dirkx AEM, oude Egbrink MGA, Wagstaff J, Griffioen AW. Monocyte/macrophage infiltration in tumors: modulators of angiogenesis. J Leukoc Biol. 2006;80:1183–96.PubMedCrossRef
24.
go back to reference Lee CC, Liu KJ, Huang TS. Tumor-associated macrophage: its role in tumor angiogenesis. J Cancer Mol. 2006;2:135–40. Lee CC, Liu KJ, Huang TS. Tumor-associated macrophage: its role in tumor angiogenesis. J Cancer Mol. 2006;2:135–40.
25.
go back to reference Morishita A, Gow CH, D’Armiento JM. Macrophages-specific matrix metalloproteinase-9 (mmp9) induces lung cancer metastasis in an animal model. Am J Respir Crit Care Med. 2011;183:2440. Morishita A, Gow CH, D’Armiento JM. Macrophages-specific matrix metalloproteinase-9 (mmp9) induces lung cancer metastasis in an animal model. Am J Respir Crit Care Med. 2011;183:2440.
26.
go back to reference van Kempen LCL, Coussens LM. MMP9 potentiates pulmonary metastasis formation. Cancer Cell. 2002;2:251–2.PubMedCrossRef van Kempen LCL, Coussens LM. MMP9 potentiates pulmonary metastasis formation. Cancer Cell. 2002;2:251–2.PubMedCrossRef
27.
go back to reference Sun HW, Li CJ, Chen HQ, Lin HL, Lv HX, Zhang Y, Zhang M. Involvement of integrins, MAPK, and NF-kappaB in regulation of the shear stress-induced MMP-9 expression in endothelial cells. Biochem Biophys Res Commun. 2007;353:52–8. Sun HW, Li CJ, Chen HQ, Lin HL, Lv HX, Zhang Y, Zhang M. Involvement of integrins, MAPK, and NF-kappaB in regulation of the shear stress-induced MMP-9 expression in endothelial cells. Biochem Biophys Res Commun. 2007;353:52–8.
28.
go back to reference Gordon GM, Dolena R, Ledee DR, Feuer W, Fini ME. Cytokines and signaling pathways regulating matrix metalloproteinase-9 (MMP-9) expression in corneal epithelial cells. J Cell Physiol. 2009;221:402–11.PubMedCentralPubMedCrossRef Gordon GM, Dolena R, Ledee DR, Feuer W, Fini ME. Cytokines and signaling pathways regulating matrix metalloproteinase-9 (MMP-9) expression in corneal epithelial cells. J Cell Physiol. 2009;221:402–11.PubMedCentralPubMedCrossRef
29.
go back to reference Okada Y, Eibl G, Duffy JP, Reber HA, Hines OJ. Glial cell-derived neurotrophic factor upregulates the expression and activation of matrix metalloproteinase-9 in human pancreatic cancer. Surgery. 2003;134:293–9.PubMedCrossRef Okada Y, Eibl G, Duffy JP, Reber HA, Hines OJ. Glial cell-derived neurotrophic factor upregulates the expression and activation of matrix metalloproteinase-9 in human pancreatic cancer. Surgery. 2003;134:293–9.PubMedCrossRef
30.
go back to reference Esseghir S, Todd SK, Hunt T, Poulsom R, Plaza-Menacho I, Reis-Filho JS, Isacke CM. A role for glialcell derived neurotrophic factor induced expression by inflammatory cytokines and RET/GFR alpha 1 receptor up-regulation in breast cancer. Cancer Res. 2007;15:11732–41.CrossRef Esseghir S, Todd SK, Hunt T, Poulsom R, Plaza-Menacho I, Reis-Filho JS, Isacke CM. A role for glialcell derived neurotrophic factor induced expression by inflammatory cytokines and RET/GFR alpha 1 receptor up-regulation in breast cancer. Cancer Res. 2007;15:11732–41.CrossRef
31.
go back to reference Koshiba T, Hosotani R, Wada M, Miyamoto Y, Fujimoto K, Lee JU, Doa R, Arii S, Imamura M. Involvement of matrix metalloproteinase-2 activity in invasion and metastasis of pancreatic carcinoma. Cancer. 1998;82:642–50.PubMedCrossRef Koshiba T, Hosotani R, Wada M, Miyamoto Y, Fujimoto K, Lee JU, Doa R, Arii S, Imamura M. Involvement of matrix metalloproteinase-2 activity in invasion and metastasis of pancreatic carcinoma. Cancer. 1998;82:642–50.PubMedCrossRef
32.
go back to reference Graham CH, Connelly I, MacDougall JR, Kerbel RS, Stetler-Stevenson WG, Lala PK. Resistance of malignant trophoblast cells to both the anti-proliferative and anti-invasive effects of transforming growth factor-beta. Exp Cell Res. 1994;214:93–9.PubMedCrossRef Graham CH, Connelly I, MacDougall JR, Kerbel RS, Stetler-Stevenson WG, Lala PK. Resistance of malignant trophoblast cells to both the anti-proliferative and anti-invasive effects of transforming growth factor-beta. Exp Cell Res. 1994;214:93–9.PubMedCrossRef
33.
go back to reference Kuwada Y, Sasaki T, Morinaka K, Kitadai Y, Mukaida N, Chayama K. Potential involvement of IL-8 and its receptors in the invasiveness of pancreatic cancer cells. Int J Oncol. 2003;22:765–71.PubMed Kuwada Y, Sasaki T, Morinaka K, Kitadai Y, Mukaida N, Chayama K. Potential involvement of IL-8 and its receptors in the invasiveness of pancreatic cancer cells. Int J Oncol. 2003;22:765–71.PubMed
34.
go back to reference Bredin CG, Liu Z, Klominek J. Growth factor-enhanced expression and activity of matrix metalloproteases in human non-small cell lung cancer cell lines. Anticancer Res. 2003;23:4877–84.PubMed Bredin CG, Liu Z, Klominek J. Growth factor-enhanced expression and activity of matrix metalloproteases in human non-small cell lung cancer cell lines. Anticancer Res. 2003;23:4877–84.PubMed
35.
go back to reference Zhang D, Bar-Eli M, Meloche S, Brodt P. Dual regulation of MMP-2 expression by the type 1 insulin-like growth factor receptor. J Biol Chem. 2004;279:19683–90.PubMedCrossRef Zhang D, Bar-Eli M, Meloche S, Brodt P. Dual regulation of MMP-2 expression by the type 1 insulin-like growth factor receptor. J Biol Chem. 2004;279:19683–90.PubMedCrossRef
36.
go back to reference Fritzsche FR, Jung M, Xu C, Rabien A, Schicktanz H, Stephan C, Dietel M, Jung K, Kristiansen G. ADAM8 expression in prostate cancer is associated with parameters of unfavorable prognosis. Surgery. 2003;134:293–9.CrossRef Fritzsche FR, Jung M, Xu C, Rabien A, Schicktanz H, Stephan C, Dietel M, Jung K, Kristiansen G. ADAM8 expression in prostate cancer is associated with parameters of unfavorable prognosis. Surgery. 2003;134:293–9.CrossRef
37.
go back to reference Zhang Y, Tan YF, Jiang C, Zhang K, Zha TZ, Zhang M. High ADAM8 Expression is associated with poor prognosis in patients with hepatocellular carcinoma. PatholOncol Res. 2012. [Epub ahead of print]. Zhang Y, Tan YF, Jiang C, Zhang K, Zha TZ, Zhang M. High ADAM8 Expression is associated with poor prognosis in patients with hepatocellular carcinoma. PatholOncol Res. 2012. [Epub ahead of print].
38.
go back to reference Fourie AM, Coles F, Moreno V, Karlsson L. Catalytic activity of ADAM8, ADAM15, and MDC-L (ADAM28) on synthetic peptide substrates and in ectodomain cleavage of CD23. J Biol Chem. 2003;278:30469–77.PubMedCrossRef Fourie AM, Coles F, Moreno V, Karlsson L. Catalytic activity of ADAM8, ADAM15, and MDC-L (ADAM28) on synthetic peptide substrates and in ectodomain cleavage of CD23. J Biol Chem. 2003;278:30469–77.PubMedCrossRef
39.
go back to reference Black RA, Rauch CT, Kozlosky CJ, Peschon JJ, Slack JL, Wolfson MF, Castner BJ, Stocking KL, Reddy P, Srinivasan S, Nelson N, Boiani N, Schooley KA, Gerhart M, Davis R, Fitzner JN, Johnson RS, Paxton RJ, March CJ, Cerretti DP. A metalloproteinase disintegrin that releases tumour-necrosis factor-α from cells. Nature. 1997;385:729–33.PubMedCrossRef Black RA, Rauch CT, Kozlosky CJ, Peschon JJ, Slack JL, Wolfson MF, Castner BJ, Stocking KL, Reddy P, Srinivasan S, Nelson N, Boiani N, Schooley KA, Gerhart M, Davis R, Fitzner JN, Johnson RS, Paxton RJ, March CJ, Cerretti DP. A metalloproteinase disintegrin that releases tumour-necrosis factor-α from cells. Nature. 1997;385:729–33.PubMedCrossRef
40.
go back to reference Blobel CP. ADAMS: key components in EGFR signalling and development. Nat Rev Mol Cell Biol. 2005;6:32–43.PubMedCrossRef Blobel CP. ADAMS: key components in EGFR signalling and development. Nat Rev Mol Cell Biol. 2005;6:32–43.PubMedCrossRef
41.
go back to reference Franovic A, Robert I, Smith K, Kurban G, Pause A, Gunaratnam L, Lee S. Multiple acquired renal carcinoma tumor capabilities abolished upon silencing of ADAM17. Cancer Res. 2006;66:8083–90.PubMedCrossRef Franovic A, Robert I, Smith K, Kurban G, Pause A, Gunaratnam L, Lee S. Multiple acquired renal carcinoma tumor capabilities abolished upon silencing of ADAM17. Cancer Res. 2006;66:8083–90.PubMedCrossRef
42.
go back to reference Infante J, Burris HA, Lewis N, Donehower R, Redman J, Friedman S, Scherle P, Fridman J, Li J, Emm T, Troy S, Eckhardt SG. A multicenter phase Ib study of the safety, pharmacokinetics, biological activity and clinical efficacy of INCB7839, a potent and selective inhibitor of ADAM10 and ADAM17. Breast Cancer Res Treat. 2007;106(Supp 1):S269. Infante J, Burris HA, Lewis N, Donehower R, Redman J, Friedman S, Scherle P, Fridman J, Li J, Emm T, Troy S, Eckhardt SG. A multicenter phase Ib study of the safety, pharmacokinetics, biological activity and clinical efficacy of INCB7839, a potent and selective inhibitor of ADAM10 and ADAM17. Breast Cancer Res Treat. 2007;106(Supp 1):S269.
43.
go back to reference Choi JY, Jang YS, Min SY, Song JY. Overexpression of MMP-9 and HIF-1α in breast cancer cells under hypoxic conditions. Breast Cancer. 2011;14:88–95.CrossRef Choi JY, Jang YS, Min SY, Song JY. Overexpression of MMP-9 and HIF-1α in breast cancer cells under hypoxic conditions. Breast Cancer. 2011;14:88–95.CrossRef
44.
go back to reference Loging TW, Reisman D. Inhibition of the putative tumor suppressor gene TIMP-3 by tumor-derived p53 mutants and wild type p53. Oncogene. 1999;18:7608–15.PubMedCrossRef Loging TW, Reisman D. Inhibition of the putative tumor suppressor gene TIMP-3 by tumor-derived p53 mutants and wild type p53. Oncogene. 1999;18:7608–15.PubMedCrossRef
Metadata
Title
Anti-inflammatory macrophages activate invasion in pancreatic adenocarcinoma by increasing the MMP9 and ADAM8 expression
Authors
Pauli Puolakkainen
Aino Koski
Sanna Vainionpää
Zhanlong Shen
Heikki Repo
Esko Kemppainen
Harri Mustonen
Hanna Seppänen
Publication date
01-03-2014
Publisher
Springer US
Published in
Medical Oncology / Issue 3/2014
Print ISSN: 1357-0560
Electronic ISSN: 1559-131X
DOI
https://doi.org/10.1007/s12032-014-0884-9

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