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Kudo Y, Haymaker C, Zhang J, Reuben A, Duose DY, Fujimoto J, Roy-Chowdhuri S, Solis Soto LM, Dejima H, Parra ER, Mino B, Abraham R, Ikeda N, Vaporcyan A, Gibbons D, Zhang J, Lang FF, Luthra R, Lee JJ, Moran C, Huse JT, Kadara H, Wistuba II. Suppressed immune microenvironment and repertoire in brain metastases from patients with resected non-small-cell lung cancer. Ann Oncol 2019; 30:1521-1530. [PMID: 31282941 PMCID: PMC6771224 DOI: 10.1093/annonc/mdz207] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The tumor immune microenvironment (TIME) of lung cancer brain metastasis is largely unexplored. We carried out immune profiling and sequencing analysis of paired resected primary tumors and brain metastases of non-small-cell lung carcinoma (NSCLC). PATIENTS AND METHODS TIME profiling of archival formalin-fixed and paraffin-embedded specimens of paired primary tumors and brain metastases from 39 patients with surgically resected NSCLCs was carried out using a 770 immune gene expression panel and by T-cell receptor beta repertoire (TCRβ) sequencing. Immunohistochemistry was carried out for validation. Targeted sequencing was carried out to catalog hot spot mutations in cancer genes. RESULTS Somatic hot spot mutations were mostly shared between both tumor sites (28/39 patients; 71%). We identified 161 differentially expressed genes, indicating inhibition of dendritic cell maturation, Th1, and leukocyte extravasation signaling pathways, in brain metastases compared with primary tumors (P < 0.01). The proinflammatory cell adhesion molecule vascular cell adhesion protein 1 was significantly suppressed in brain metastases compared with primary tumors. Brain metastases exhibited lower T cell and elevated macrophage infiltration compared with primary tumors (P < 0.001). T-cell clones were expanded in 64% of brain metastases compared with their corresponding primary tumors. Furthermore, while TCR repertoires were largely shared between paired brain metastases and primary tumors, T-cell densities were sparse in the metastases. CONCLUSION We present findings that suggest that the TIME in brain metastases from NSCLC is immunosuppressed and comprises immune phenotypes (e.g. immunosuppressive tumor-associated macrophages) that may help guide immunotherapeutic strategies for NSCLC brain metastases.
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MESH Headings
- Adult
- Aged
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/immunology
- Brain Neoplasms/immunology
- Brain Neoplasms/pathology
- Brain Neoplasms/secondary
- Carcinoma, Non-Small-Cell Lung/genetics
- Carcinoma, Non-Small-Cell Lung/immunology
- Carcinoma, Non-Small-Cell Lung/pathology
- Carcinoma, Non-Small-Cell Lung/surgery
- Dendritic Cells/immunology
- Female
- Gene Expression Regulation, Neoplastic/immunology
- Humans
- Immunohistochemistry
- Male
- Middle Aged
- Mutation/genetics
- Neoplasm Proteins/genetics
- Neoplasm Proteins/immunology
- Receptors, Antigen, T-Cell, alpha-beta/genetics
- Receptors, Antigen, T-Cell, alpha-beta/immunology
- Tumor Microenvironment/genetics
- Tumor Microenvironment/immunology
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Benade V, Bhyrapuneni G, Abraham R, Medapati RB, Daripelli S, Kamuju V, Gandipudi S, Tirumalasetty C, Bojja K, Manchineella S, Nirogi R, Jasti V. P3-042: SUVN-502: A PURE 5-HT 6
ANTAGONIST POTENTIATES THE EFFECTS OF DONEPEZIL OR MEMANTINE IN ANIMAL MODELS OF COGNITION, NEUROCHEMISTRY AND ELECTROPHYSIOLOGY. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.3068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Grandhi VR, Tadiparthi J, Ganuga N, Medapati RB, Talakanti HR, Abraham R, Jayarajan P, Saraf SK, Nirogi R, Jasti V. P2-083: SUVN-502: A PURE 5-HT 6
RECEPTOR ANTAGONIST AMELIORATES SENILE DEMENTIA IN ANIMAL MODELS. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.2490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abraham R, Medapati RB, Yathavakilla S, Jayarajan P, Narasimhula T, Nirogi R, Jasti V. P3-434: SUVN-502: A PURE 5-HT 6
RECEPTOR ANTAGONIST ATTENUATES MEMORY DEFICITS INDUCED BY DIVERSE CHALLENGES. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.3468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Nirogi R, Bhyrapuneni G, Abraham R, Subramanian R, Goyal VK, Pandey SK, Badange R, Shinde A. 0139 SUVN-G3031, A Potent and Selective Histamine H3 Receptor Inverse Agonist - Phase-2 Investigational New Drug for the Treatment of Narcolepsy - Differentiating Factors with Competitor Clinical Candidates. Sleep 2019. [DOI: 10.1093/sleep/zsz067.138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Bhayrapuneni G, Kamuju V, Gandipudi S, Jayarajan P, Abraham R, Bojja K, Pandey SK, Mekala VR, Nirogi R. 0120 SUVN-G3031, a Novel, Potent and Selective Histamine H3 Receptor Inverse Agonist for the Treatment of Narcolepsy: Preclinical Characterization. Sleep 2019. [DOI: 10.1093/sleep/zsz067.119] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Henry C, Tonkopi E, O’Connell K, Westcott M, Lewandowski R, Liu D, Boyd D, Kehoe S, Gregoire M, Mawko G, Kappadath S, Syme A, Abraham R. Abstract No. 531 Novel radiopaque Yttrium-90 glass microspheres in a porcine model: clinical potential for real-time targeting and dosimetry. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Hamza A, Khan U, Khurram MS, Abraham R, Mazzara P, Hadid T, Kafri Z. Prognostic Utility of Tumor-Infiltrating Lymphocytes in Noncolorectal Gastrointestinal Malignancies. Int J Surg Pathol 2018; 27:263-267. [PMID: 30426804 DOI: 10.1177/1066896918809460] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Tumor-infiltrating lymphocytes (TILs) and mismatch repair gene mutation (MMR) status are emerging biomarkers in immunotherapy. MMR status and TILs have significant clinical implications with regard to treatment with checkpoint inhibitors. We designed a study to determine the frequency and prognostic utility of TILs and MMR in advanced unresectable noncolorectal gastrointestinal (NCGI) malignancies. METHODS This is a retrospective cohort study of patients who were diagnosed with advanced noncolorectal gastrointestinal tumors. Biopsy specimens were tested for MMR status by immunohistochemistry along with evaluation of TILs. Kaplan-Meier analysis was performed to determine the impact of TILS and MMR on survival. RESULTS We analyzed 146 patients; the mean age at diagnosis was 66.4 ± 11.2 years. 65.8% patients were male, and 62.3% patients had stage 4 disease. All cases had proficient MMR status. The percentage of patients with TILs >5 was 50.7%. There was no statistically significant difference in median overall survival (OS) by TILs when stratified by stage of tumor. When stratified by type of tumor, median OS by TILs level was significantly different for hepatocellular cancers (⩽5 TILs, 86 days versus >5 TILs 312 days, P = .031). CONCLUSIONS Our study suggests that MMR-deficient tumors are quite rare in advanced NCGI malignancies. More than 5 TILs per high power field, evaluated simply on a routine hematoxylin and eosin-stained glass slide confer a better prognosis to most noncolorectal gastrointestinal malignancies, especially hepatocellular carcinoma. This has immense clinical utility with regard to eligibility for immunotherapy.
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Algrafi A, Bednarski J, Kitcharoensakkul M, Cooper M, Shinawi M, Abraham R, Smith M. NOVAL COMBINED IMMUNODEFICIENCY, HYPOGAMMAGLOBINEMIA, BONE MARROW FAILURE AND RADIOSENSITIVITY DUE TO PATHOGENIC MUTATION IN MYSM1. Ann Allergy Asthma Immunol 2018. [DOI: 10.1016/j.anai.2018.09.345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Venkata RG, Tadiparthi J, Ganuga N, Medapati RB, Talakanti HR, Abraham R, Jayarajan P, Nirogi R. P2‐094: SUVN‐502: A PURE 5‐HT
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RECEPTOR ANTAGONIST ALLEVIATES POST‐MENOPAUSE ASSOCIATED DEMENTIA IN AGED MENOPAUSE WISTAR RATS. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abraham R, Goura V, Nirogi R. P2‐081: CHARACTERIZATION OF COGNITIVE DISRUPTING PROPERTIES OF PHENYTOIN IN ADULT AND AGED RATS. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Khan U, Hamza A, Abraham R, Khurram MS, Hadid TH, Mazzara P, Kafri Z. Frequency and prognostic role of tumor infiltrating lymphocytes and MMR status in advanced non-colorectal GI malignancies. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.5_suppl.89] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
89 Background: Tumor infiltrating lymphocytes (TILs) and mismatch repair gene mutation (MMR) status are emerging biomarkers in immunotherapy. MMR status and TILs have significant clinical implications with respect to treatment with checkpoint inhibitors. We designed a study to determine the frequency and prognostic utility of TILs and MMR in advanced unresectable non-colorectal GI (NCGI) cancers. Methods: This is a retrospective cohort study of patients who were diagnosed with metastatic or unresectable NCGI cancers between 2009 and 2015 at St. John Hospital and Medical Center. Immunohistochemistry panels were performed on representative tissue sections for MMR testing. TILs were assessed on the hematoxylin and eosin stained slide of the same tissue section. MMR was interpreted as deficient (d) or proficient and TILs were categorized as ≤5 or > 5 per high power field. Descriptive statistics were generated using frequency distributions, medians and means. Kaplan-Meier analysis was performed to determine the impact of TILS and MMR on survival; differences by factor were assessed with the Log_Rank test. Results: We analyzed 132 patients; the mean age at diagnosis was 66.7 years, 62.1% were male. All samples had proficient MMR status. The percentage of patients with TILs ≤ 5 was 46.2. There was no statistically significant difference in median overall survival (OS) by TILs when stratified by stage of tumor. When stratified by type of tumor, median OS by TILs level was significantly different only for hepatocellular cancers (HCC) (≤ 5 TILs, 86 days vs. > 5 TILs 312 days, p = 0.031), table 1. Conclusions: Our study suggests that MMR-d tumors are quite rare in advanced NCGI malignancies. TILs can be present in tumor microenvironment of NCGI malignancies. Though the number of patients in our study was small, there was a statistically significant difference in median OS of patients with HCC when stratified by TILs status.[Table: see text]
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Khan U, Hamza A, Khurram MS, Abraham R, Mazzara P, Hadid TH, Kafri Z. Frequency and prognostic utility of MSI and TILs in advanced noncolorectal GI malignancies. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.4_suppl.313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
313 Background: Mismatch repair gene mutation status not only has a role in pathogenesis but also has significant clinical implications with respect to treatment with checkpoint inhibitors. Additionally tumor infiltrating lymphocytes (TILs) are also emerging prognostic biomarker and are utilized in adoptive T-cell therapy as well. Methods: This is a retrospective cohort study of patients who were diagnosed with advanced unresectable non-colorectal GI (NCGI) cancers. Biopsy specimens of patients diagnosed between 2009 and 2015 at St. John Hospital and Medical Center were analyzed. Immunohistochemistry panels were performed on a representative tissue sections for microsatellite instability (MSI) testing. TILs were assessed on the hematoxylin and Eosin stained slide of the same tissue section. MSI was interpreted as stable or high and TILs were categorized as ≤5 and > 5 per high power field. Descriptive statistics were generated using frequency distributions, medians and means. Kaplan-Meier analysis was performed to determine the impact of TILs and MSI on survival; differences by factor were assessed with the Log_Rank test. Results: We analyzed 114 patients; the mean age at diagnosis was 66.8 ± 10.7 years, 61.4% were male. All samples were MSI stable. The percentage of patients with TILs ≤ 5 was 46.5. When stratified by tumor stage, overall median survival by TILs level did not differ significantly. When stratified by type of tumor, overall median survival by TILs level was significantly different only for hepatocellular cancers (HCC) (≤ 5 TILs, 86 days vs. > 5 TILs 312 days, p = 0.031) only, (see table). Conclusions: Our study shows that MSI-H tumors are very rare in advanced NCGI malignancies. TILs are definitely present in tumor microenvironment of NCGI malignancies. Though the number of patients of our study was small, there was a statistically significant difference in median overall survival of patients with HCC when stratified by TILs status.[Table: see text]
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Goura V, Vuyyuru AB, Yathavakilla S, Abraham R, Jayarajan P, Goyal V, Nirogi R. Comparison of the Sensitivity Between Conventional Neurobehavioral Toxicity Assays and Natural Burrowing Assay in Rats. J Pharmacol Toxicol Methods 2017. [DOI: 10.1016/j.vascn.2017.09.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abraham R, Vuyyuru AB, Fernandes J, Nirogi R. [P3–429]: CHARACTERIZATION OF TOPIRAMATE: AN ANTIEPILEPTIC IN CONDITIONS OF SENILE DEMENTIA. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.1646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Nirogi R, Abraham R, Benade V, Jayarajan P, Bhyrapuneni G, Medapati RB, Kambhampati R, Reedy T, Bhatta VR. [P1–098]: SUVN‐502 (5‐HT
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ANTAGONIST) POTENTIATES THE EFFECTS OF MEMANTINE IN ANIMAL MODELS OF COGNITION. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bhyrapuneni G, Mudigonda K, Chowdary Palacharla VR, Jayarajan P, Abraham R, Subramanian R, Goyal VK, Pandey SK, Boggavarapu RK, Ajjala DR, Rasheed MA, Nirogi R. [P1–460]: SUVN‐D4010: A POTENT AND SELECTIVE 5‐HT
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RECEPTOR PARTIAL AGONIST— ASSESSMENT OF SAFETY, TOLERABILITY AND PHARMACOKINETICS IN HEALTHY HUMAN VOLUNTEERS. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Nirogi R, Mudigonda K, Ravulu J, Bhyrapuneni G, Benade V, Muddana NR, Chowdary Palacharla VR, Ajjala DR, Goyal VK, Pandey SK, Abraham R, Jayarajan P, Kambhampati R, Shinde AK. [P2–033]: SUVN‐502 + DONEPEZIL + MEMANTINE (TRIPLE COMBINATION) REPRESENTS A PROMISING NEW APPROACH FOR SYMPTOMATIC TREATMENT OF ALZHEIMER's DISEASE. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Mulchandani N, Jauregui J, Abraham R, Seger E, Illical E. Post-partum management of severe pubic diastasis. CLIN EXP OBSTET GYN 2017. [DOI: 10.12891/ceog3533.2017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Kehoe S, El-Khazen Dupuis J, Michaud F, Bigot A, Boyd D, Abraham R, Soulez G. Multimodal “imageable” embolic microspheres: A preliminary study on occlusion effectiveness, level of occlusion, and arterial distribution in a swine liver model. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Mulchandani NB, Jauregui JJ, Abraham R, Seger E, Illica E. Post-partum management of severe pubic diastasis. CLIN EXP OBSTET GYN 2017; 44:464-466. [PMID: 29949295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Pubic symphysis diastasis during pregnancy is a rare complication which can present as pain with ambulation, urinary dysfunction, and pelvic instability. A consensus treatment does not currently exist between surgical and conservative management. The authors present a case of severe pubic diastasis which was successfully treated using a conservative pelvic binder. CASE REPORT A 31-year-old female presented with severe lower back pain following the uneventful delivery of her fourth child. On radiograph, a pubic symphysis diastasis of 5.5 cm was noted and she was subsequently fitted with a pelvic binder on post-partum day 3. She experienced a full range of motion and was pain free at six-week follow-up, with a diastasis of 2.1 cm present. At one year and three-month follow-up, the patient presented with a diastasis of 2.4 cm and continued to have full range of motion and mobility. CONCLUSION This case contributes to the literature in showing that conservative treatment of pubic diastasis could be considered in cases where separation has exceeded normal physiologic limits.
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Bhyrapuneni G, Mudigonda K, Penta KK, Chowdary Palacharla VR, Muddana N, Jayarajan P, Abraham R, Subramanian R, Goyal VK, Pandey SK, Boggavarapu RK, Shinde AK, Nirogi R. P2‐026: SUVN‐G3031, a Potent and Selective H3 Receptor Inverse Agonist: Safety, Tolerability and Pharmacokinetics in Humans. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.1230] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Jayarajan P, Bhyrapuneni G, Mudigonda K, Penta KK, Muddana N, Chowdary Palacharla VR, Benade V, Abraham R, Subramanian R, Goyal VK, Pandey SK, Boggavarapu RK, Ajjala DR, Rasheed MA, Nirogi R. P3‐016: SUVN‐D4010, A Potent and Selective 5‐HT
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Receptor Partial Agonist: Safety, Tolerability and Pharmacokinetics in Humans. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.1673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Nirogi R, Mudigonda K, Penta KK, Bhyrapuneni G, Benade V, Muddana N, Chowdary Palacharla VR, Ajjala DR, Goyal VK, Pandey SK, Abraham R, Jayarajan P, Kambhampati R, Shinde AK. P1‐085: SUVN‐502, Potent and Pure 5‐HT
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Receptor Antagonist: Proof‐of‐Concept Study Design in Moderate Alzheimer’s Disease Patients. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abraham R, Shinde AK, Goyal VK, Pandey SK, Medapati RB, Yathavakilla S, Tadiparthi J, Edula S, Subramanian R, Mekala VR, Muddana N, Uthukam V, Daripelli S, Devarapalli B, Eeda R, Nirogi R. P3‐135: SUVN‐I4035 ‐ Preclinical Characterization of Novel Muscarinic M1 Positive Allosteric Modulator. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.1794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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