501
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Abstract
Patients with type 1 diabetes (T1D) suffer excess mortality from cardiovascular disease (CVD) that has persisted despite substantial reductions in microvascular complications. Although T1D and type 2 diabetes (T2D) are etiologically distinct, it has generally been assumed that CVD in T1D is "the same disease" as that found in T2D. Here, we review the most recent epidemiological and clinical studies on heart disease in T1D, highlighting differences between CVD in T1D and T2D. In addition, we discuss experimental and clinical evidence for a post-myocardial infarction (MI) autoimmune heart syndrome in T1D, including the development of diagnostic assays which we believe can, for the first time, differentiate between heart disease in T1D and T2D. We postulate that a clinically unrecognized form of chronic myocardial inflammation ("myocarditis") triggered by MI contributes to the poor CVD outcomes in T1D. These findings provide a conceptual shift in our understanding of CVD in T1D and have important diagnostic and therapeutic implications.
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Affiliation(s)
- Myra A Lipes
- Joslin Diabetes Center, Harvard Medical School, 1 Joslin Place, Rm. 373, Boston, MA, 02215, USA,
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502
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Remark R, Becker C, Gomez JE, Damotte D, Dieu-Nosjean MC, Sautès-Fridman C, Fridman WH, Powell CA, Altorki NK, Merad M, Gnjatic S. The non-small cell lung cancer immune contexture. A major determinant of tumor characteristics and patient outcome. Am J Respir Crit Care Med 2015; 191:377-90. [PMID: 25369536 DOI: 10.1164/rccm.201409-1671pp] [Citation(s) in RCA: 187] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Solid tumors, beyond mere accumulation of cancer cells, form a complex ecosystem consisting of normal epithelial cells, fibroblasts, blood and lymphatic vessels, structural components, and infiltrating hematopoietic cells including myeloid and lymphoid elements that impact tumor growth, tumor spreading, and clinical outcome. The composition of the immune microenvironment is diverse, including various populations of T cells, B cells, dendritic cells, natural killer cells, myeloid-derived suppressor cells, neutrophils, or macrophages. The immune contexture describes the density, location, and organization of these immune cells within solid tumors. In lung cancer, which is the deadliest type of cancer, and particularly in non-small cell lung cancer, its most prevalent form, reports have described some of the interactions between the tumor and the host. These data, in addition to articles on various types of tumors, provide a greater understanding of the tumor-host microenvironment interaction and stimulate the development of prognostic and predictive biomarkers, the identification of novel target antigens for therapeutic intervention, and the implementation of tools for long-term management of patients with cancer.
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503
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Wu TJ, Schriml LM, Chen QR, Colbert M, Crichton DJ, Finney R, Hu Y, Kibbe WA, Kincaid H, Meerzaman D, Mitraka E, Pan Y, Smith KM, Srivastava S, Ward S, Yan C, Mazumder R. Generating a focused view of disease ontology cancer terms for pan-cancer data integration and analysis. DATABASE-THE JOURNAL OF BIOLOGICAL DATABASES AND CURATION 2015; 2015:bav032. [PMID: 25841438 PMCID: PMC4385274 DOI: 10.1093/database/bav032] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 03/13/2015] [Indexed: 01/01/2023]
Abstract
Bio-ontologies provide terminologies for the scientific community to describe biomedical entities in a standardized manner. There are multiple initiatives that are developing biomedical terminologies for the purpose of providing better annotation, data integration and mining capabilities. Terminology resources devised for multiple purposes inherently diverge in content and structure. A major issue of biomedical data integration is the development of overlapping terms, ambiguous classifications and inconsistencies represented across databases and publications. The disease ontology (DO) was developed over the past decade to address data integration, standardization and annotation issues for human disease data. We have established a DO cancer project to be a focused view of cancer terms within the DO. The DO cancer project mapped 386 cancer terms from the Catalogue of Somatic Mutations in Cancer (COSMIC), The Cancer Genome Atlas (TCGA), International Cancer Genome Consortium, Therapeutically Applicable Research to Generate Effective Treatments, Integrative Oncogenomics and the Early Detection Research Network into a cohesive set of 187 DO terms represented by 63 top-level DO cancer terms. For example, the COSMIC term ‘kidney, NS, carcinoma, clear_cell_renal_cell_carcinoma’ and TCGA term ‘Kidney renal clear cell carcinoma’ were both grouped to the term ‘Disease Ontology Identification (DOID):4467 / renal clear cell carcinoma’ which was mapped to the TopNodes_DOcancerslim term ‘DOID:263 / kidney cancer’. Mapping of diverse cancer terms to DO and the use of top level terms (DO slims) will enable pan-cancer analysis across datasets generated from any of the cancer term sources where pan-cancer means including or relating to all or multiple types of cancer. The terms can be browsed from the DO web site (http://www.disease-ontology.org) and downloaded from the DO’s Apache Subversion or GitHub repositories. Database URL:http://www.disease-ontology.org
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Affiliation(s)
- Tsung-Jung Wu
- Department of Biochemistry and Molecular Medicine, George Washington University, Washington, DC 20037, USA, Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA, Center for Bioinformatics and Information Technology, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, NASA Jet Propulsion Laboratory, Pasadena, CA, USA, Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, Wellcome Trust Sanger Institute, Cambridge, UK and McCormick Genomic and Proteomic Center, George Washington University, Washington, DC 20037, USA
| | - Lynn M Schriml
- Department of Biochemistry and Molecular Medicine, George Washington University, Washington, DC 20037, USA, Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA, Center for Bioinformatics and Information Technology, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, NASA Jet Propulsion Laboratory, Pasadena, CA, USA, Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, Wellcome Trust Sanger Institute, Cambridge, UK and McCormick Genomic and Proteomic Center, George Washington University, Washington, DC 20037, USA
| | - Qing-Rong Chen
- Department of Biochemistry and Molecular Medicine, George Washington University, Washington, DC 20037, USA, Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA, Center for Bioinformatics and Information Technology, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, NASA Jet Propulsion Laboratory, Pasadena, CA, USA, Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, Wellcome Trust Sanger Institute, Cambridge, UK and McCormick Genomic and Proteomic Center, George Washington University, Washington, DC 20037, USA
| | - Maureen Colbert
- Department of Biochemistry and Molecular Medicine, George Washington University, Washington, DC 20037, USA, Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA, Center for Bioinformatics and Information Technology, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, NASA Jet Propulsion Laboratory, Pasadena, CA, USA, Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, Wellcome Trust Sanger Institute, Cambridge, UK and McCormick Genomic and Proteomic Center, George Washington University, Washington, DC 20037, USA
| | - Daniel J Crichton
- Department of Biochemistry and Molecular Medicine, George Washington University, Washington, DC 20037, USA, Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA, Center for Bioinformatics and Information Technology, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, NASA Jet Propulsion Laboratory, Pasadena, CA, USA, Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, Wellcome Trust Sanger Institute, Cambridge, UK and McCormick Genomic and Proteomic Center, George Washington University, Washington, DC 20037, USA
| | - Richard Finney
- Department of Biochemistry and Molecular Medicine, George Washington University, Washington, DC 20037, USA, Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA, Center for Bioinformatics and Information Technology, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, NASA Jet Propulsion Laboratory, Pasadena, CA, USA, Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, Wellcome Trust Sanger Institute, Cambridge, UK and McCormick Genomic and Proteomic Center, George Washington University, Washington, DC 20037, USA
| | - Ying Hu
- Department of Biochemistry and Molecular Medicine, George Washington University, Washington, DC 20037, USA, Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA, Center for Bioinformatics and Information Technology, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, NASA Jet Propulsion Laboratory, Pasadena, CA, USA, Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, Wellcome Trust Sanger Institute, Cambridge, UK and McCormick Genomic and Proteomic Center, George Washington University, Washington, DC 20037, USA
| | - Warren A Kibbe
- Department of Biochemistry and Molecular Medicine, George Washington University, Washington, DC 20037, USA, Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA, Center for Bioinformatics and Information Technology, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, NASA Jet Propulsion Laboratory, Pasadena, CA, USA, Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, Wellcome Trust Sanger Institute, Cambridge, UK and McCormick Genomic and Proteomic Center, George Washington University, Washington, DC 20037, USA
| | - Heather Kincaid
- Department of Biochemistry and Molecular Medicine, George Washington University, Washington, DC 20037, USA, Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA, Center for Bioinformatics and Information Technology, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, NASA Jet Propulsion Laboratory, Pasadena, CA, USA, Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, Wellcome Trust Sanger Institute, Cambridge, UK and McCormick Genomic and Proteomic Center, George Washington University, Washington, DC 20037, USA
| | - Daoud Meerzaman
- Department of Biochemistry and Molecular Medicine, George Washington University, Washington, DC 20037, USA, Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA, Center for Bioinformatics and Information Technology, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, NASA Jet Propulsion Laboratory, Pasadena, CA, USA, Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, Wellcome Trust Sanger Institute, Cambridge, UK and McCormick Genomic and Proteomic Center, George Washington University, Washington, DC 20037, USA
| | - Elvira Mitraka
- Department of Biochemistry and Molecular Medicine, George Washington University, Washington, DC 20037, USA, Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA, Center for Bioinformatics and Information Technology, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, NASA Jet Propulsion Laboratory, Pasadena, CA, USA, Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, Wellcome Trust Sanger Institute, Cambridge, UK and McCormick Genomic and Proteomic Center, George Washington University, Washington, DC 20037, USA
| | - Yang Pan
- Department of Biochemistry and Molecular Medicine, George Washington University, Washington, DC 20037, USA, Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA, Center for Bioinformatics and Information Technology, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, NASA Jet Propulsion Laboratory, Pasadena, CA, USA, Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, Wellcome Trust Sanger Institute, Cambridge, UK and McCormick Genomic and Proteomic Center, George Washington University, Washington, DC 20037, USA
| | - Krista M Smith
- Department of Biochemistry and Molecular Medicine, George Washington University, Washington, DC 20037, USA, Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA, Center for Bioinformatics and Information Technology, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, NASA Jet Propulsion Laboratory, Pasadena, CA, USA, Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, Wellcome Trust Sanger Institute, Cambridge, UK and McCormick Genomic and Proteomic Center, George Washington University, Washington, DC 20037, USA
| | - Sudhir Srivastava
- Department of Biochemistry and Molecular Medicine, George Washington University, Washington, DC 20037, USA, Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA, Center for Bioinformatics and Information Technology, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, NASA Jet Propulsion Laboratory, Pasadena, CA, USA, Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, Wellcome Trust Sanger Institute, Cambridge, UK and McCormick Genomic and Proteomic Center, George Washington University, Washington, DC 20037, USA
| | - Sari Ward
- Department of Biochemistry and Molecular Medicine, George Washington University, Washington, DC 20037, USA, Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA, Center for Bioinformatics and Information Technology, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, NASA Jet Propulsion Laboratory, Pasadena, CA, USA, Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, Wellcome Trust Sanger Institute, Cambridge, UK and McCormick Genomic and Proteomic Center, George Washington University, Washington, DC 20037, USA
| | - Cheng Yan
- Department of Biochemistry and Molecular Medicine, George Washington University, Washington, DC 20037, USA, Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA, Center for Bioinformatics and Information Technology, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, NASA Jet Propulsion Laboratory, Pasadena, CA, USA, Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, Wellcome Trust Sanger Institute, Cambridge, UK and McCormick Genomic and Proteomic Center, George Washington University, Washington, DC 20037, USA
| | - Raja Mazumder
- Department of Biochemistry and Molecular Medicine, George Washington University, Washington, DC 20037, USA, Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA, Center for Bioinformatics and Information Technology, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, NASA Jet Propulsion Laboratory, Pasadena, CA, USA, Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, Wellcome Trust Sanger Institute, Cambridge, UK and McCormick Genomic and Proteomic Center, George Washington University, Washington, DC 20037, USA Department of Biochemistry and Molecular Medicine, George Washington University, Washington, DC 20037, USA, Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA, Center for Bioinformatics and Information Technology, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, NASA Jet Propulsion Laboratory, Pasadena, CA, USA, Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20892-9760, USA, Wellcome Trust Sanger Institute, Cambridge, UK and McCormick Genomic and Proteomic Center, George Washington University, Washington, DC 20037, USA
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504
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Lal N, Beggs AD, Willcox BE, Middleton GW. An immunogenomic stratification of colorectal cancer: Implications for development of targeted immunotherapy. Oncoimmunology 2015; 4:e976052. [PMID: 25949894 PMCID: PMC4404815 DOI: 10.4161/2162402x.2014.976052] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 10/09/2014] [Indexed: 12/31/2022] Open
Abstract
Although tumor infiltrating lymphocyte (TIL) density is prognostic and predictive in colorectal cancer (CRC), the impact of tumor genetics upon colorectal immunobiology is unclear. Identification of genetic factors that influence the tumor immunophenotype is essential to improve the effectiveness of stratified immunotherapy approaches. We carried out a bioinformatics analysis of CRC data in The Cancer Genome Atlas (TCGA) involving two-dimensional hierarchical clustering to define an immune signature that we used to characterize the immune response across key patient groups. An immune signature termed The Co-ordinate Immune Response Cluster (CIRC) comprising 28 genes was coordinately regulated across the patient population. Four patient groups were delineated on the basis of cluster expression. Group A, which was heavily enriched for patients with microsatellite instability (MSI-H) and POL mutations, exhibited high CIRC expression, including the presence of several inhibitory molecules: CTLA4, PDL1, PDL2, LAG3, and TIM3. In contrast, RAS mutation was enriched in patient groups with lower CIRC expression. This work links the genetics and immunobiology of colorectal tumorigenesis, with implications for the development of stratified immunotherapeutic approaches. Microsatellite instability and POL mutations are linked with high mutational burden and high immune infiltration, but the coordinate expression of inhibitory pathways observed suggests combination checkpoint blockade therapy may be required to improve efficacy. In contrast, RAS mutant tumors predict for a relatively poor immune infiltration and low inhibitory molecule expression. In this setting, checkpoint blockade may be less efficacious, highlighting a requirement for novel strategies in this patient group.
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Affiliation(s)
- Neeraj Lal
- Cancer Immunology and Immunotherapy Centre; School of Cancer Sciences; University of Birmingham ; Birmingham, UK
| | - Andrew D Beggs
- Cancer Immunology and Immunotherapy Centre; School of Cancer Sciences; University of Birmingham ; Birmingham, UK
| | - Benjamin E Willcox
- Cancer Immunology and Immunotherapy Centre; School of Cancer Sciences; University of Birmingham ; Birmingham, UK
| | - Gary W Middleton
- Cancer Immunology and Immunotherapy Centre; School of Cancer Sciences; University of Birmingham ; Birmingham, UK
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505
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Gaya A, Akle CA, Mudan S, Grange J. The Concept of Hormesis in Cancer Therapy - Is Less More? Cureus 2015; 7:e261. [PMID: 26180685 PMCID: PMC4494563 DOI: 10.7759/cureus.261] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2015] [Indexed: 12/21/2022] Open
Abstract
There has, in recent years, been a paradigm shift in our understanding of the role of the immune system in the development of cancers. Immune dysregulation, manifesting as chronic inflammation, not only facilitates the growth and spread of tumors but prevents the host from mounting effective immune defenses against it. Many attempts are being made to develop novel immunotherapeutic strategies, but there is growing evidence that a radical reevaluation of the mode of action of chemotherapeutic agents and ionizing radiation is required in the light of advances in immunology. Based on the concept of hormesis – defined as the presence of different modes of action of therapeutic modalities at different doses – a ‘repositioning’ of chemotherapy and radiotherapy may be required in all aspects of cancer management. In the case of chemotherapy, this may involve a change from the maximum tolerated dose concept to low dose intermittent (‘metronomic’) therapy, whilst in radiation therapy, highly accurate stereotactic targeting enables ablative, antigen-releasing (immunogenic) doses of radiation to be delivered to the tumor with sparing of surrounding normal tissues. Coupled with emerging immunotherapeutic procedures, the future of cancer treatment may well lie in repositioned chemotherapy, radiotherapy, and more localized debulking surgery.
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Affiliation(s)
- Andy Gaya
- London Oncology Clinic, Guy's and St Thomas' NHS Foundation Trust
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506
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Fritzsching B, Fellenberg J, Moskovszky L, Sápi Z, Krenacs T, Machado I, Poeschl J, Lehner B, Szendrõi M, Bosch AL, Bernd L, Csóka M, Mechtersheimer G, Ewerbeck V, Kinscherf R, Kunz P. CD8 +/FOXP3 +-ratio in osteosarcoma microenvironment separates survivors from non-survivors: a multicenter validated retrospective study. Oncoimmunology 2015; 4:e990800. [PMID: 25949908 DOI: 10.4161/2162402x.2014.990800] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Accepted: 11/18/2014] [Indexed: 11/19/2022] Open
Abstract
Osteosarcoma is the most common primary bone tumor characterized by juvenile onset, tumor heterogeneity, and early pulmonary metastasis. Therapeutic improvement stagnates since more than two decades. Unlike major malignancies, biomarkers as prognostic factors at time of diagnosis are missing. Disease rareness hampers study recruitment of patient numbers sufficient to outweigh tumor heterogeneity. Here, we analyzed in a multicenter cohort the osteosarcoma microenvironment to reduce effects of tumor cell heterogeneity. We hypothesized that quantitative ratios of intratumoral CD8+T-cells to FOXP3+T-cells (CD8+/FOXP3+-ratios) provide strong prognostic information when analyzed by whole-slide imaging in diagnostic biopsies. We followed recommendations-for-tumor-marker-prognostic-studies (REMARK). From 150 included cases, patients with complete treatment were identified and assigned to the discovery (diagnosis before 2004) or the validation cohort (diagnosis 2004-2012). Highly standardized immunohistochemistry of CD8+ and FOXP3+, which was validated by methylation-specific gene analysis, was performed followed by whole-slide analysis and clinical outcome correlations. We observed improved estimated survival in patients with CD8+/FOXP3+-ratios above the median (3.08) compared to patients with lower CD8+/FOXP3+-ratios (p = 0.000001). No patients with a CD8+/FOXP3+-ratio above the third quartile died within the observation period (median follow-up 69 mo). Multivariate analysis demonstrated independence from current prognostic factors including metastasis and response to neoadjuvant chemotherapy. Data from an independent validation cohort confirmed improved survival (p = 0.001) in patients with CD8+/FOXP3+-ratios above 3.08. Multivariate analysis proofed that this observation was also independent from prognostic factors at diagnosis within the validation cohort. Intratumoral CD8+/FOXP3+-ratio in pretreatment biopsies separates patients with prolonged survival from non-survivors in osteosarcoma.
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Key Words
- CD8+ T cells
- CD8/FOXP3-ratio
- CONSORT, consolidated standard of reporting trials
- COSS, Cooperative German–Austrian–Swiss Osteosarcoma Study Group
- EORTC, the European Organization for Research and Treatment of Cancer
- FFPE, formalin-fixed and paraffin embedded
- IDO, Indoleamine 2, 3-dioxygenase
- MAP, methotrexate-cisplatin-doxorubicin
- PD-L1, Programmed-death-Ligand-1
- REMARK, reporting recommendations for tumor marker prognostic studies
- TIL, tumor infiltrating lymphocyte
- TNFα, tumornecrosis factor-α
- TNM-I, tumor, nodes, metastases-immuno
- Treg, regulatory Tcell.
- immunoscore
- osteosarcoma
- regulatory T cells
- tumor microenvironment
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Affiliation(s)
- Benedikt Fritzsching
- Department of Translational Pulmonology; Translational Lung Research Center (TLRC); Member of the German Center for Lung; University of Heidelberg , Heidelberg, Germany ; Divison of Pediatric Pulmonology & Allergy and Cystic Fibrosis Center; Department of Pediatric Oncology, Hematology; Immunology and Pulmonology; University of Heidelberg , Heidelberg, Germany
| | - Joerg Fellenberg
- Department of Orthopedics and Traumatology; University Hospital Heidelberg , Heidelberg, Germany
| | - Linda Moskovszky
- 1st Department of Pathology and Experimental Cancer Research; Faculty of Medicine, Semmelweis University , Budapest, Hungary
| | - Zoltan Sápi
- 1st Department of Pathology and Experimental Cancer Research; Faculty of Medicine, Semmelweis University , Budapest, Hungary
| | - Tibor Krenacs
- 1st Department of Pathology and Experimental Cancer Research; Faculty of Medicine, Semmelweis University , Budapest, Hungary
| | - Isidro Machado
- Pathology Department; Instituto Valenciano de Oncologia , Valencia, Spain
| | - Johannes Poeschl
- Division of Neonatology; Department of Pediatrics; University of Heidelberg , Heidelberg, Germany
| | - Burkhard Lehner
- Department of Orthopedics and Traumatology; University Hospital Heidelberg , Heidelberg, Germany
| | - Miklos Szendrõi
- Department of Orthopedics; Semmelweis University , Budapest, Hungary
| | | | - Ludger Bernd
- Center for Orthopedics and Traumatology; Hospital Bielefeld , Germany
| | - Monika Csóka
- 2nd Department of Pediatrics; Semmelweis University , Budapest, Hungary
| | - Gunhild Mechtersheimer
- Department of General Pathology; Institute of Pathology; University Hospital Heidelberg , Germany
| | - Volker Ewerbeck
- Department of Orthopedics and Traumatology; University Hospital Heidelberg , Heidelberg, Germany
| | - Ralf Kinscherf
- Institute of Anatomy and Cell Biology; Department of Medical Cell Biology; University of Marburg , Marburg, Germany
| | - Pierre Kunz
- Department of Orthopedics and Traumatology; University Hospital Heidelberg , Heidelberg, Germany
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507
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Butterfield LH, Disis ML, Fox BA, Khleif SN, Marincola FM. Preamble to the 2015 SITC immunotherapy biomarkers taskforce. J Immunother Cancer 2015; 3:8. [PMID: 25806107 PMCID: PMC4371796 DOI: 10.1186/s40425-015-0052-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 02/19/2015] [Indexed: 01/31/2023] Open
Abstract
The Society for Immunotherapy of Cancer (SITC) has regularly hosted workshops and working groups focused on immunologic monitoring and immune biomarkers. Due to advances in cancer immunotherapy, including positive results from clinical trials testing new agents and combinations, emerging new technologies for measuring aspects of immunity, and novel candidate biomarkers from early phase trials, the SITC Immune Biomarkers Taskforce has reconvened to review the state of the art, identify current hurdles to further success and to make recommendations to the field. Topics being addressed by individual working groups include: (1) validation of candidate biomarkers, (2) identification of the most promising technologies, (3) testing of high throughput immune signatures and (4) investigation of the pre-treatment tumor microenvironment. Resultant recommendations will be published in JITC.
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Affiliation(s)
- Lisa H Butterfield
- University of Pittsburgh, Pittsburgh, PA USA ; University of Pittsburgh, Hillman Cancer Center, 5117 Centre Avenue, Suite 1.27, Pittsburgh, PA 15213 USA
| | | | - Bernard A Fox
- Oregon Health and Science University, Portland, OR USA
| | - Samir N Khleif
- GRU Cancer Center, Georgia Regents University, Augusta, GA USA
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508
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Reuben A, Godin-Ethier J, Santos MM, Lapointe R. T lymphocyte-derived TNF and IFN-γ repress HFE expression in cancer cells. Mol Immunol 2015; 65:259-66. [PMID: 25700349 DOI: 10.1016/j.molimm.2015.01.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 01/26/2015] [Accepted: 01/30/2015] [Indexed: 01/20/2023]
Abstract
The immune system and tumors are closely intertwined initially upon tumor development. During this period, tumors evolve to promote self-survival through immune escape, including by targeting crucial components involved in the presentation of antigens to the immune system in order to avoid recognition. Accordingly, components involved in MHC I presentation of tumor antigens are often mutated and down-regulated targets in tumors. On the other hand, the immune system has been shown to influence tumors through production of immunosuppressive cytokines, recruitment and polarization of cells favoring or impeding tumor escape or through production of anti-tumor cytokines promoting tumor rejection. We previously discovered that the hemochromatosis protein HFE, a negative regulator of iron absorption, dampens classical MHC I antigen presentation. In this study, we evaluated the impact of activated T lymphocytes purified from peripheral blood mononuclear cells (PBMC) on HFE expression in tumor cell lines. We co-cultured tumor cell lines from melanoma, lung, and kidney cancers with anti-CD3-activated PBMC and established that HFE expression is increased in tumor cell lines compared to healthy tissues, whilst being down-regulated significantly upon exposure to activated PBMC. HFE down-regulation was mediated by both CD4 and CD8 T lymphocytes, through production of soluble mediators, namely TNF and IFN-γ. These results suggest that the immune system may modulate tumor HFE expression in inflammatory conditions in order to regulate MHC I antigen presentation and promote tumor clearance.
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Affiliation(s)
- Alexandre Reuben
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM) and Institut du cancer de Montréal, Montréal, Québec, Canada H2X 0A9; Département de Médecine, Université de Montréal, Montréal, Québec, Canada H3C 3J7
| | - Jessica Godin-Ethier
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM) and Institut du cancer de Montréal, Montréal, Québec, Canada H2X 0A9; Département de Médecine, Université de Montréal, Montréal, Québec, Canada H3C 3J7
| | - Manuela M Santos
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM) and Institut du cancer de Montréal, Montréal, Québec, Canada H2X 0A9; Département de Médecine, Université de Montréal, Montréal, Québec, Canada H3C 3J7.
| | - Réjean Lapointe
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM) and Institut du cancer de Montréal, Montréal, Québec, Canada H2X 0A9; Département de Médecine, Université de Montréal, Montréal, Québec, Canada H3C 3J7.
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509
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Donnem T, Hald SM, Paulsen EE, Richardsen E, Al-Saad S, Kilvaer TK, Brustugun OT, Helland A, Lund-Iversen M, Poehl M, Olsen KE, Ditzel HJ, Hansen O, Al-Shibli K, Kiselev Y, Sandanger TM, Andersen S, Pezzella F, Bremnes RM, Busund LT. Stromal CD8+ T-cell Density—A Promising Supplement to TNM Staging in Non-Small Cell Lung Cancer. Clin Cancer Res 2015; 21:2635-43. [PMID: 25680376 DOI: 10.1158/1078-0432.ccr-14-1905] [Citation(s) in RCA: 233] [Impact Index Per Article: 25.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 02/01/2015] [Indexed: 11/16/2022]
Abstract
PURPOSE Immunoscore is a prognostic tool defined to quantify in situ immune cell infiltrates, which appears to be superior to the tumor-node-metastasis (TNM) classification in colorectal cancer. In non-small cell lung cancer (NSCLC), no immunoscore has been established, but in situ tumor immunology is recognized as highly important. We have previously evaluated the prognostic impact of several immunological markers in NSCLC, yielding the density of stromal CD8(+) tumor-infiltrating lymphocytes (TIL) as the most promising candidate. Hence, we validate the impact of stromal CD8(+) TIL density as an immunoscore in NSCLC. EXPERIMENTAL DESIGN The prognostic impact of stromal CD8(+) TILs was evaluated in four different cohorts from Norway and Denmark consisting of 797 stage I-IIIA NSCLC patients. The Tromso cohort (n = 155) was used as training set, and the results were further validated in the cohorts from Bodo (n = 169), Oslo (n = 295), and Denmark (n = 178). Tissue microarrays and clinical routine CD8 staining were used for all cohorts. RESULTS Stromal CD8(+) TIL density was an independent prognostic factor in the total material (n = 797) regardless of the endpoint: disease-free survival (P < 0.001), disease-specific survival (P < 0.001), or overall survival (P < 0.001). Subgroup analyses revealed significant prognostic impact of stromal CD8(+) TIL density within each pathologic stage (pStage). In multivariate analysis, stromal CD8(+) TIL density and pStage were independent prognostic variables. CONCLUSIONS Stromal CD8(+) TIL density has independent prognostic impact in resected NSCLC, adds prognostic impact within each pStage, and is a good candidate marker for establishing a TNM-Immunoscore.
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Affiliation(s)
- Tom Donnem
- Department of Oncology, University Hospital of North Norway, Tromso, Norway. Institute of Clinical Medicine, The Arctic University of Norway, Tromso, Norway.
| | - Sigurd M Hald
- Institute of Clinical Medicine, The Arctic University of Norway, Tromso, Norway
| | - Erna-Elise Paulsen
- Department of Oncology, University Hospital of North Norway, Tromso, Norway. Institute of Clinical Medicine, The Arctic University of Norway, Tromso, Norway
| | - Elin Richardsen
- Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway. Institute of Medical Biology, The Arctic University of Norway, Tromso, Norway
| | - Samer Al-Saad
- Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway. Institute of Medical Biology, The Arctic University of Norway, Tromso, Norway
| | - Thomas K Kilvaer
- Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - Odd Terje Brustugun
- Department of Oncology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway. Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Aslaug Helland
- Department of Oncology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway. Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - Mette Poehl
- Department of Oncology, Rigshospitalet, Copenhagen, Denmark. Department of Oncology, Odense University Hospital, Odense, Denmark. Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Karen Ege Olsen
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark. Department of Pathology, Odense University Hospital, Odense, Denmark
| | - Henrik J Ditzel
- Department of Oncology, Odense University Hospital, Odense, Denmark. Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Olfred Hansen
- Department of Oncology, Odense University Hospital, Odense, Denmark. Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | - Yury Kiselev
- Institute of Medical Biology, The Arctic University of Norway, Tromso, Norway. Department of Pharmacy, The Arctic University of Tromso, Tromso, Norway
| | - Torkjel M Sandanger
- Department of Community Medicine, The Artic University of Tromso, Tromso, Norway
| | - Sigve Andersen
- Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - Francesco Pezzella
- Nuffield Department of Clinical Laboratory Sciences, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
| | - Roy M Bremnes
- Department of Oncology, University Hospital of North Norway, Tromso, Norway. Institute of Clinical Medicine, The Arctic University of Norway, Tromso, Norway
| | - Lill-Tove Busund
- Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway. Institute of Medical Biology, The Arctic University of Norway, Tromso, Norway
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510
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Translational Considerations on the Outlook of Immunotherapy for Colorectal Cancer. CURRENT COLORECTAL CANCER REPORTS 2015. [DOI: 10.1007/s11888-015-0258-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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511
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Schalper KA, Brown J, Carvajal-Hausdorf D, McLaughlin J, Velcheti V, Syrigos KN, Herbst RS, Rimm DL. Objective measurement and clinical significance of TILs in non-small cell lung cancer. J Natl Cancer Inst 2015; 107:dju435. [PMID: 25650315 DOI: 10.1093/jnci/dju435] [Citation(s) in RCA: 290] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Tumor-infiltrating lymphocytes (TILs) are usually measured using subjective methods. Studies suggest that TIL subtypes have independent roles in cancer and that they could support the use of novel immunostimulatory therapies. We simultaneously measured TIL subtypes in non-small cell lung cancer (NSCLC) samples using objective methods and determined their relationship with clinico-pathologic characteristics and survival. METHODS Using multiplexed quantitative fluorescence (QIF), we measured the levels of CD3, CD8, and CD20 in 552 NSCLC from two independent collections represented in tissue microarrays (YTMA79, n = 202 and YTMA140, n = 350). The level of TILs was obtained in different tumor compartments using cytokeratin stain to define tumor cells and 4',6-Diamidino-2-Phenylindole. Association of TILs with clinical parameters was determined using univariate and multivariable analyses. All statistical tests were two-sided. RESULTS In both NSCLC collections there was a low correlation between the three TIL markers (linear regression coefficients (R(2)) = 0.19-0.22, P < .001 for YTMA79 and R(2) = 0.23-0.32, P < .001 for YTMA140). No consistent association between the level of TIL subtypes and age, sex, smoking history, tumor size, stage, and histology type was found. In univariate analysis, an elevated CD3 or CD8 signal was statistically significantly associated with longer survival in both collections. However, only CD8 was independent from age, tumor size, histology, and stage in multivariable analysis. High CD20 was associated with longer survival in the YTMA79 cohort. CONCLUSIONS Increased levels of CD3 and CD8 + TILs are associated with better outcome in NSCLC, but only CD8 is independent from other prognostic variables. Objective measurement of TIL subpopulations could be useful to predict response or evaluate the local immune effect of anticancer immune checkpoint inhibitors.
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Affiliation(s)
- Kurt A Schalper
- Department of Pathology (KAS, JB, DCH, DLR) and Medical Oncology (JM, RSH), Yale University School of Medicine, New Haven, CT; Solid Tumor Oncology, Cleveland Clinic, Cleveland, OH (VV); Oncology Unit, 3rd Department of Medicine, School of Medicine, University of Athens, Sotiria General Hospital, Athens, Greece (KNS).
| | - Jason Brown
- Department of Pathology (KAS, JB, DCH, DLR) and Medical Oncology (JM, RSH), Yale University School of Medicine, New Haven, CT; Solid Tumor Oncology, Cleveland Clinic, Cleveland, OH (VV); Oncology Unit, 3rd Department of Medicine, School of Medicine, University of Athens, Sotiria General Hospital, Athens, Greece (KNS)
| | - Daniel Carvajal-Hausdorf
- Department of Pathology (KAS, JB, DCH, DLR) and Medical Oncology (JM, RSH), Yale University School of Medicine, New Haven, CT; Solid Tumor Oncology, Cleveland Clinic, Cleveland, OH (VV); Oncology Unit, 3rd Department of Medicine, School of Medicine, University of Athens, Sotiria General Hospital, Athens, Greece (KNS)
| | - Joseph McLaughlin
- Department of Pathology (KAS, JB, DCH, DLR) and Medical Oncology (JM, RSH), Yale University School of Medicine, New Haven, CT; Solid Tumor Oncology, Cleveland Clinic, Cleveland, OH (VV); Oncology Unit, 3rd Department of Medicine, School of Medicine, University of Athens, Sotiria General Hospital, Athens, Greece (KNS)
| | - Vamsidhar Velcheti
- Department of Pathology (KAS, JB, DCH, DLR) and Medical Oncology (JM, RSH), Yale University School of Medicine, New Haven, CT; Solid Tumor Oncology, Cleveland Clinic, Cleveland, OH (VV); Oncology Unit, 3rd Department of Medicine, School of Medicine, University of Athens, Sotiria General Hospital, Athens, Greece (KNS)
| | - Konstantinos N Syrigos
- Department of Pathology (KAS, JB, DCH, DLR) and Medical Oncology (JM, RSH), Yale University School of Medicine, New Haven, CT; Solid Tumor Oncology, Cleveland Clinic, Cleveland, OH (VV); Oncology Unit, 3rd Department of Medicine, School of Medicine, University of Athens, Sotiria General Hospital, Athens, Greece (KNS)
| | - Roy S Herbst
- Department of Pathology (KAS, JB, DCH, DLR) and Medical Oncology (JM, RSH), Yale University School of Medicine, New Haven, CT; Solid Tumor Oncology, Cleveland Clinic, Cleveland, OH (VV); Oncology Unit, 3rd Department of Medicine, School of Medicine, University of Athens, Sotiria General Hospital, Athens, Greece (KNS)
| | - David L Rimm
- Department of Pathology (KAS, JB, DCH, DLR) and Medical Oncology (JM, RSH), Yale University School of Medicine, New Haven, CT; Solid Tumor Oncology, Cleveland Clinic, Cleveland, OH (VV); Oncology Unit, 3rd Department of Medicine, School of Medicine, University of Athens, Sotiria General Hospital, Athens, Greece (KNS)
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512
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Chevolet I, Speeckaert R, Schreuer M, Neyns B, Krysko O, Bachert C, Van Gele M, van Geel N, Brochez L. Clinical significance of plasmacytoid dendritic cells and myeloid-derived suppressor cells in melanoma. J Transl Med 2015; 13:9. [PMID: 25592374 PMCID: PMC4326397 DOI: 10.1186/s12967-014-0376-x] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 12/26/2014] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Immune markers in the peripheral blood of melanoma patients could provide prognostic information. However, there is currently no consensus on which circulating cell types have more clinical impact. We therefore evaluated myeloid-derived suppressor cells (MDSC), dendritic cells (DC), cytotoxic T-cells and regulatory T-cells (Treg) in a series of blood samples of melanoma patients in different stages of disease. METHODS Flow cytometry was performed on peripheral blood mononuclear cells of 69 stage I to IV melanoma patients with a median follow-up of 39 months after diagnosis to measure the percentage of monocytic MDSCs (mMDSCs), polymorphonuclear MDSCs (pmnMDSCs), myeloid DCs (mDCs), plasmacytoid DCs (pDCs), cytotoxic T-cells and Tregs. We also assessed the expression of PD-L1 and CTLA-4 in cytotoxic T-cells and Tregs respectively. The impact of cell frequencies on prognosis was tested with multivariate Cox regression modelling. RESULTS Circulating pDC levels were decreased in patients with advanced (P = 0.001) or active (P = 0.002) disease. Low pDC levels conferred an independent negative impact on overall (P = 0.025) and progression-free survival (P = 0.036). Even before relapse, a decrease in pDC levels was observed (P = 0.002, correlation coefficient 0.898). High levels of circulating MDSCs (>4.13%) have an independent negative prognostic impact on OS (P = 0.012). MDSC levels were associated with decreased CD3+ (P < 0.001) and CD3 + CD8+ (P = 0.017) T-cell levels. Conversely, patients with high MDSC levels had more PD-L1+ T-cells (P = 0.033) and more CTLA-4 expression by Tregs (P = 0.003). pDCs and MDSCs were inversely correlated (P = 0.004). The impact of pDC levels on prognosis and prediction of the presence of systemic disease was stronger than that of MDSC levels. CONCLUSION We demonstrated that circulating pDC and MDSC levels are inversely correlated but have an independent prognostic value in melanoma patients. These cell types represent a single immunologic system and should be evaluated together. Both are key players in the immunological climate in melanoma patients, as they are correlated with circulating cytotoxic and regulatory T-cells. Circulating pDC and MDSC levels should be considered in future immunoprofiling efforts as they could impact disease management.
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Affiliation(s)
- Ines Chevolet
- Department of Dermatology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium.
| | - Reinhart Speeckaert
- Department of Dermatology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium.
| | - Max Schreuer
- Department of Medical Oncology, UZ-Brussel, Brussels, Belgium.
- Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium.
| | - Bart Neyns
- Department of Medical Oncology, UZ-Brussel, Brussels, Belgium.
| | - Olga Krysko
- Upper Airways Research Laboratory, Ghent University Hospital, Ghent, Belgium.
| | - Claus Bachert
- Upper Airways Research Laboratory, Ghent University Hospital, Ghent, Belgium.
| | - Mireille Van Gele
- Department of Dermatology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium.
| | - Nanja van Geel
- Department of Dermatology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium.
| | - Lieve Brochez
- Department of Dermatology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium.
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513
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Lochhead P, Chan AT, Nishihara R, Fuchs CS, Beck AH, Giovannucci E, Ogino S. Etiologic field effect: reappraisal of the field effect concept in cancer predisposition and progression. Mod Pathol 2015; 28:14-29. [PMID: 24925058 PMCID: PMC4265316 DOI: 10.1038/modpathol.2014.81] [Citation(s) in RCA: 145] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 02/12/2014] [Accepted: 04/02/2014] [Indexed: 02/07/2023]
Abstract
The term 'field effect' (also known as field defect, field cancerization, or field carcinogenesis) has been used to describe a field of cellular and molecular alteration, which predisposes to the development of neoplasms within that territory. We explore an expanded, integrative concept, 'etiologic field effect', which asserts that various etiologic factors (the exposome including dietary, lifestyle, environmental, microbial, hormonal, and genetic factors) and their interactions (the interactome) contribute to a tissue microenvironmental milieu that constitutes a 'field of susceptibility' to neoplasia initiation, evolution, and progression. Importantly, etiological fields predate the acquisition of molecular aberrations commonly considered to indicate presence of filed effect. Inspired by molecular pathological epidemiology (MPE) research, which examines the influence of etiologic factors on cellular and molecular alterations during disease course, an etiologically focused approach to field effect can: (1) broaden the horizons of our inquiry into cancer susceptibility and progression at molecular, cellular, and environmental levels, during all stages of tumor evolution; (2) embrace host-environment-tumor interactions (including gene-environment interactions) occurring in the tumor microenvironment; and, (3) help explain intriguing observations, such as shared molecular features between bilateral primary breast carcinomas, and between synchronous colorectal cancers, where similar molecular changes are absent from intervening normal colon. MPE research has identified a number of endogenous and environmental exposures which can influence not only molecular signatures in the genome, epigenome, transcriptome, proteome, metabolome and interactome, but also host immunity and tumor behavior. We anticipate that future technological advances will allow the development of in vivo biosensors capable of detecting and quantifying 'etiologic field effect' as abnormal network pathology patterns of cellular and microenvironmental responses to endogenous and exogenous exposures. Through an 'etiologic field effect' paradigm, and holistic systems pathology (systems biology) approaches to cancer biology, we can improve personalized prevention and treatment strategies for precision medicine.
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Affiliation(s)
- Paul Lochhead
- Gastrointestinal Research Group, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK
| | - Andrew T Chan
- 1] Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA [2] Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Reiko Nishihara
- 1] Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA [2] Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
| | - Charles S Fuchs
- 1] Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA [2] Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Andrew H Beck
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Edward Giovannucci
- 1] Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA [2] Department of Nutrition, Harvard School of Public Health, Boston, MA, USA [3] Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
| | - Shuji Ogino
- 1] Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA [2] Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA [3] Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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514
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Melanoma brain metastasis globally reconfigures chemokine and cytokine profiles in patient cerebrospinal fluid. Melanoma Res 2014; 24:120-30. [PMID: 24463459 PMCID: PMC3943890 DOI: 10.1097/cmr.0000000000000045] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
The aggressiveness of melanoma is believed to be correlated with tumor–stroma-associated immune cells. Cytokines and chemokines act to recruit and then modulate the activities of these cells, ultimately affecting disease progression. Because melanoma frequently metastasizes to the brain, we asked whether global differences in immunokine profiles could be detected in the cerebrospinal fluid (CSF) of melanoma patients and reveal aspects of tumor biology that correlate with patient outcomes. We therefore measured the levels of 12 cytokines and 12 chemokines in melanoma patient CSF and the resulting data were analyzed to develop unsupervised hierarchical clustergrams and heat maps. Unexpectedly, the overall profiles of immunokines found in these samples showed a generalized reconfiguration of their expression in melanoma patient CSF, resulting in the segregation of individuals with melanoma brain metastasis from nondisease controls. Chemokine CCL22 and cytokines IL1α, IL4, and IL5 were reduced in most samples, whereas a subset including CXCL10, CCL4, CCL17, and IL8 showed increased expression. Further, analysis of clusters identified within the melanoma patient set comparing patient outcome suggests that suppression of IL1α, IL4, IL5, and CCL22, with concomitant elevation of CXCL10, CCL4, and CCL17, may correlate with more aggressive development of brain metastasis. These results suggest that global immunokine suppression in the host, together with a selective increase in specific chemokines, constitute a predominant immunomodulatory feature of melanoma brain metastasis. These alterations likely drive the course of this disease in the brain and variations in the immune profiles of individual patients may predict outcomes.
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515
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Zamarin D, Wolchok JD. Potentiation of immunomodulatory antibody therapy with oncolytic viruses for treatment of cancer. MOLECULAR THERAPY-ONCOLYTICS 2014; 1:14004. [PMID: 27119094 PMCID: PMC4782939 DOI: 10.1038/mto.2014.4] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 06/30/2014] [Indexed: 02/07/2023]
Abstract
Identification of the immune suppressive mechanisms active within the tumor microenvironment led to development of immunotherapeutic strategies aiming to reverse the immunosuppression and to enhance the function of tumor-infiltrating lymphocytes. Of those, cancer therapy with antibodies targeting the immune costimulatory and coinhibitory receptors has demonstrated significant promise in the recent years, with multiple antibodies entering clinical testing. The responses to these agents, however, have not been universal and have not been observed in all cancer types, calling for identification of appropriate predictive biomarkers and development of combinatorial strategies. Pre-existing immune infiltration in tumors has been demonstrated to have a strong association with response to immunotherapies, with the type I interferon (IFN) pathway emerging as a key player in tumor innate immune recognition and activation of adaptive immunity. These findings provide a rationale for evaluation of strategies targeting the type I IFN pathway as a means to enhance tumor immune recognition and infiltration, which could potentially make them susceptible to therapeutics targeting the cosignaling receptors. To this end in particular, oncolytic viruses (OVs) have been demonstrated to enhance tumor recognition by the immune system through multiple mechanisms, which include upregulation of major histocompatibility complex and costimulatory molecules on cancer cells, immunogenic cell death and antigen release, and activation of the type I IFN pathway. Evidence is now emerging that combination therapies using OVs and agents targeting immune cosignaling receptors such as 4-1BB, PD-1, and CTLA-4 may work in concert to enhance antitumor immunity and therapeutic efficacy. Our evolving understanding of the interplay between OVs and the immune system demonstrates that the virus-induced antitumor immune responses can be harnessed to drive the efficacy of the agents targeting cosignaling receptors and provides a strong rationale for integration of such therapies in clinic.
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Affiliation(s)
- Dmitriy Zamarin
- Swim Across America Laboratory, Immunology Program, Sloan-Kettering Institute for Cancer Research, New York, New York, USA; Department of Medicine, Gynecologic Medical Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA; Ludwig Center for Cancer Immunotherapy at Memorial Sloan-Kettering Cancer Center, New York, New York, USA; Weill Cornell Medical College and Graduate School of Medical Sciences of Cornell University, New York, New York, USA
| | - Jedd D Wolchok
- Swim Across America Laboratory, Immunology Program, Sloan-Kettering Institute for Cancer Research, New York, New York, USA; Department of Medicine, Melanoma and Immunotherapy Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA; Ludwig Center for Cancer Immunotherapy at Memorial Sloan-Kettering Cancer Center, New York, New York, USA; Weill Cornell Medical College and Graduate School of Medical Sciences of Cornell University, New York, New York, USA
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516
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Rahma OE, Myint ZW, Estfan B. Dendritic Cell Cancer Vaccines for Treatment of Colon Cancer. CURRENT COLORECTAL CANCER REPORTS 2014. [DOI: 10.1007/s11888-014-0243-4] [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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517
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Ingels A, Sanchez Salas RE, Ravery V, Fromont-Hankard G, Validire P, Patard JJ, Pignot G, Prapotnich D, Olivier F, Galiano M, Barret E, Rozet F, Weber N, Cathelineau X. T-helper 1 immunoreaction influences survival in muscle-invasive bladder cancer: proof of concept. Ecancermedicalscience 2014; 8:486. [PMID: 25525464 PMCID: PMC4263522 DOI: 10.3332/ecancer.2014.486] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Indexed: 11/22/2022] Open
Abstract
Objective To define immunoscore in bladder cancer studying T helper 1 (Th1) immunoreaction. To define a cancer-specific survival model based on Th1 cells infiltration. Methods A total of 252 patients underwent primary transurethral resection of bladder tumour at our Institution. A retrospective review of a selected cohort with pT1 and muscle-invasive bladder cancer (MIBC) lesions was performed. Pathology blocks were marked with CD3 and CD8 antibodies. Immune cells density in stromal reaction (SR) was measured on five distinct high-power field (HPF) by two dedicated uro-pathologist blinded for patients’ evolution. Statistics Student test or non-parametric Wilcoxon test as appropriate to compare means between two groups. Receiver operating characteristics (ROC) curve to define markers threshold. Cox model to assess survival’s predictors. Results Ten pT1 and 20 MIBC consecutive cases were analysed. Median follow-up was 33.4 months. Immunohistological analysis for pT1 lesions featured limited SR. For MIBC, the mean density of lymphocytes in the SR was of 105/HPF (CD3) and 86/HPF (CD8). Survivors harboured higher lymphocytes densities versus non survivors (CD3: p = 0.0319; CD8: p = 0.0279). CD3 (p = 0.034) and CD8 (p = 0.034) lymphocytes densities were independently associated with cancer-specific survival on Cox model analyses. The retrospective design and small size of cohorts are the study limitations. Conclusions High CD3 and CD8 lymphocytes SR densities are associated with better cancer-specific survival for MIBC. Th1 reaction against the tumour seems to be protective for bladder cancer. Further evaluation is warranted.
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Affiliation(s)
- Alexandre Ingels
- Institut Montsouris, Department of Urology, 42 Boulevard Jourdan, 75014 Paris, France
| | | | - Vincent Ravery
- Hôpital Bichat, Department of Urology, 46 Rue Henri Huchard, 75018 Paris, France
| | | | - Pierre Validire
- Institut Montsouris, Department of Pathology, 42 Boulevard Jourdan, 75014 Paris, France
| | - Jean-Jacques Patard
- Hôpital Bicêtre, Department of Urology, 78 Rue du Général Leclerc, 94270 le Kremlin-Bicêtre, France
| | - Géraldine Pignot
- Hôpital Bicêtre, Department of Urology, 78 Rue du Général Leclerc, 94270 le Kremlin-Bicêtre, France
| | - Dominique Prapotnich
- Institut Montsouris, Department of Urology, 42 Boulevard Jourdan, 75014 Paris, France
| | - Fabien Olivier
- ALTRAN, Department of Statistics, 2 Rue Paul Dautier, 78140 Véllizy-Villacoublay, France
| | - Marc Galiano
- Institut Montsouris, Department of Urology, 42 Boulevard Jourdan, 75014 Paris, France
| | - Eric Barret
- Institut Montsouris, Department of Urology, 42 Boulevard Jourdan, 75014 Paris, France
| | - Francois Rozet
- Institut Montsouris, Department of Urology, 42 Boulevard Jourdan, 75014 Paris, France
| | - Nina Weber
- Institut Montsouris, Department of Pathology, 42 Boulevard Jourdan, 75014 Paris, France
| | - Xavier Cathelineau
- Institut Montsouris, Department of Urology, 42 Boulevard Jourdan, 75014 Paris, France
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518
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Olsen LR, Campos B, Barnkob MS, Winther O, Brusic V, Andersen MH. Bioinformatics for cancer immunotherapy target discovery. Cancer Immunol Immunother 2014; 63:1235-49. [PMID: 25344903 PMCID: PMC11029190 DOI: 10.1007/s00262-014-1627-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 10/08/2014] [Indexed: 12/13/2022]
Abstract
The mechanisms of immune response to cancer have been studied extensively and great effort has been invested into harnessing the therapeutic potential of the immune system. Immunotherapies have seen significant advances in the past 20 years, but the full potential of protective and therapeutic cancer immunotherapies has yet to be fulfilled. The insufficient efficacy of existing treatments can be attributed to a number of biological and technical issues. In this review, we detail the current limitations of immunotherapy target selection and design, and review computational methods to streamline therapy target discovery in a bioinformatics analysis pipeline. We describe specialized bioinformatics tools and databases for three main bottlenecks in immunotherapy target discovery: the cataloging of potentially antigenic proteins, the identification of potential HLA binders, and the selection epitopes and co-targets for single-epitope and multi-epitope strategies. We provide examples of application to the well-known tumor antigen HER2 and suggest bioinformatics methods to ameliorate therapy resistance and ensure efficient and lasting control of tumors.
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Affiliation(s)
- Lars Rønn Olsen
- Department of Biology, Bioinformatics Centre, University of Copenhagen, Ole Maaløes Vej 5, 2200, Copenhagen, Denmark,
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Brunner SM, Kesselring R, Rubner C, Martin M, Jeiter T, Boerner T, Ruemmele P, Schlitt HJ, Fichtner-Feigl S. Prognosis according to histochemical analysis of liver metastases removed at liver resection. Br J Surg 2014; 101:1681-91. [PMID: 25331841 DOI: 10.1002/bjs.9627] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Revised: 06/26/2014] [Accepted: 07/10/2014] [Indexed: 12/21/2022]
Abstract
BACKGROUND Liver metastases occur in 40-50 per cent of patients with colorectal cancer and determine long-term survival. The aim of this study was to examine the immunological architecture of colorectal liver metastases and its impact on patient survival. METHODS Specimens from patients with colorectal liver metastases were stained with haematoxylin and eosin and Masson trichrome, immunostained for α-smooth muscle actin, CD4, CD45RO and CD8, and analysed by flow cytometry. In addition to histomorphological evaluation, immunohistochemically stained sections were analysed for cell numbers in the tumour area, infiltrative margin and distant liver stroma separately. These findings were correlated with clinical data and patient outcome. RESULTS Tumour containment by a fibrotic capsule around liver metastases was observed in 37·8 per cent of 201 patients and was prognostic for improved survival (median (s.e.) survival 64 (6) and 31 (4) months for patients with capsule and no capsule respectively; P < 0·001) and independently led to higher R0 resection rates (P = 0·040). In multivariable analysis, CD45RO(+) cell infiltration at the peritumoral margin with low CD45RO(+) cell infiltration in the distant liver stroma (P = 0·001) and fibrotic capsule formation (P = 0·008) both independently prolonged patient survival. Using these two factors, a cellular immune score was designed and shown to stratify patient survival in test and validation samples (both P < 0·001). CONCLUSION Fibrotic capsule formation and localized cell infiltration of colorectal liver metastases by CD45RO(+) cells were related to prolonged patient survival. Based on these immunological criteria a cellular immune score was developed to stratify patients according to prognosis.
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Affiliation(s)
- S M Brunner
- Department of Surgery, University Medical Centre Regensburg, Regensburg, Germany
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520
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Cancer colorectal : compte rendu anatomopathologique type en 2014. ONCOLOGIE 2014. [DOI: 10.1007/s10269-014-2462-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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521
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Mlecnik B, Bindea G, Angell HK, Sasso MS, Obenauf AC, Fredriksen T, Lafontaine L, Bilocq AM, Kirilovsky A, Tosolini M, Waldner M, Berger A, Fridman WH, Rafii A, Valge-Archer V, Pagès F, Speicher MR, Galon J. Functional network pipeline reveals genetic determinants associated with in situ lymphocyte proliferation and survival of cancer patients. Sci Transl Med 2014; 6:228ra37. [PMID: 24648340 DOI: 10.1126/scitranslmed.3007240] [Citation(s) in RCA: 162] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The tumor microenvironment is host to a complex network of cytokines that contribute to shaping the intratumoral immune reaction. Chromosomal gains and losses, coupled with expression analysis, of 59 cytokines and receptors and their functional networks were investigated in colorectal cancers. Changes in local expression for 13 cytokines were shown. Metastatic patients exhibited an increased frequency of deletions of cytokines from chromosome 4. Interleukin 15 (IL15) deletion corresponded with decreased IL15 expression, a higher risk of tumor recurrence, and reduced patient survival. Decreased IL15 expression affected the local proliferation of B and T lymphocytes. Patients with proliferating B and T cells at the invasive margin and within the tumor center had significantly prolonged disease-free survival. These results delineate chromosomal instability as a mechanism of modulating local cytokine expression in human tumors and underline the major role of IL15. Our data provide further mechanisms resulting in changes of specific immune cell densities within the tumor, and the importance of local active lymphocyte proliferation for patient survival.
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Affiliation(s)
- Bernhard Mlecnik
- INSERM UMRS1138, Laboratory of Integrative Cancer Immunology, Paris F-75006, France
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522
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Anitei MG, Zeitoun G, Mlecnik B, Marliot F, Haicheur N, Todosi AM, Kirilovsky A, Lagorce C, Bindea G, Ferariu D, Danciu M, Bruneval P, Scripcariu V, Chevallier JM, Zinzindohoué F, Berger A, Galon J, Pagès F. Prognostic and predictive values of the immunoscore in patients with rectal cancer. Clin Cancer Res 2014; 20:1891-9. [PMID: 24691640 DOI: 10.1158/1078-0432.ccr-13-2830] [Citation(s) in RCA: 261] [Impact Index Per Article: 26.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE To determine whether the tumor immune infiltrate, as recently evaluated with the Immunoscore methodology, could be a useful prognostic marker in patients with rectal cancers. EXPERIMENTAL DESIGN The influence of the immune infiltrate on patient's outcome was investigated in patients with or without preoperative chemoradiation therapy (pCRT). The density of total (CD3(+)) and cytotoxic (CD8(+)) T lymphocytes was evaluated by immunohistochemistry and quantified by a dedicated image analysis software in surgical specimens of patients with rectal cancer (n = 111) who did not receive pCRT and in tumor biopsies performed before pCRT from additional 55 patients. The results were correlated with tumor recurrence, patient's survival, and response to pCRT. RESULTS The densities of CD3(+) and CD8(+) lymphocytes and the associated Immunoscore (from I0 to I4) were significantly correlated with differences in disease-free and overall survival (HR, 1.81 and 1.72, respectively; all P < 0.005). Cox multivariate analysis supports the advantage of the Immunoscore compared with the tumor-node-metastasis (TNM) staging in predicting recurrence and survival (all P < 0.001). Lymph node ratio added information in a prognostic model (all P < 0.05). In addition, high infiltration of CD3(+) and CD8(+) lymphocytes in tumor biopsies was associated with downstaging of the tumor after pCRT (CD3(+) cells; Fisher exact test P = 0.01). CONCLUSIONS The Immunoscore could be a useful prognostic marker in patients with rectal cancer treated by primary surgery. The determination of the immune infiltrate in biopsies before treatment could be a valuable information for the prediction of response to pCRT.
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Affiliation(s)
- Maria-Gabriela Anitei
- Authors' Affiliations: Department of Surgery, University of Medicine and Pharmacy "Gr T Popa"; Departments of Pathology and Surgical Oncology, Regional Institute of Oncology; Department of Pathology St. Spiridon Hospital, Iasi, Romania; Department of General and Digestive Surgery of the Georges Pompidou European Hospital and Department of Pathology of the Georges Pompidou European Hospital, Laboratory of Immunology, Immunomonitoring platform of the Georges Pompidou European Hospital, AP-HP; Laboratory of Integrative Cancer Immunology, Institut national de la santé et de la recherche medicale (INSERM) U872, Cordeliers Research Center; Paris-Descartes University; Pierre et Marie Curie-Paris 6 University, Paris; and Department of Pathology, Avicenne Hospital, Bobigny, France
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523
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Di Caro G, Marchesi F, Galdiero MR, Grizzi F. Immune mediators as potential diagnostic tools for colorectal cancer: from experimental rationale to early clinical evidence. Expert Rev Mol Diagn 2014; 14:387-99. [PMID: 24649823 DOI: 10.1586/14737159.2014.900443] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
At the tumor site, solid tumors recruit native and adaptive infiltrating cell subtypes with a unique pattern, varying according to the organ of origin and the stage of the disease, which contributes to the complexity of the cancer microenvironment. The recruitment and activation of immune cells depend on a plethora of soluble immune mediators, including cytokines and chemokines that have a critical role in the process of cancer onset and progression. In colorectal cancer, measurement of soluble immune mediators in the serum seems to reflect the specific inflammatory reaction at the tumor site, and thus they might serve in clinical practice to improve available colorectal cancer detection and screening strategies. Clinical translation of data from experimental models could lead to the earlier detection of colorectal cancer resulting in a decreased burden of metastatic disease. These models and the most promising candidates for immune-based serum screening tests in colorectal cancer are discussed here.
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Affiliation(s)
- Giuseppe Di Caro
- Humanitas Clinical and Research Center, Via Manzoni 56, 20089, Rozzano, Milan, Italy
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524
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Verma M. Molecular profiling and companion diagnostics: where is personalized medicine in cancer heading? Per Med 2014; 11:761-771. [PMID: 29764045 DOI: 10.2217/pme.14.41] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The goal of personalized medicine is to use the right drug at the right dose - with minimal or no toxicity - for the right patient at the right time. Recent advances in understanding cell biology and pathways, and in using molecular 'omics' technologies to diagnose cancer, offer a strategic bridge to personalized medicine in cancer. Modern personalized medicine takes into account an individual's genetic makeup and disease history before developing a treatment regimen. The future of clinical oncology will be based on the use of predictive and prognostic biomarkers in patient management. Once implemented widely, personalized medicine will benefit patients and the healthcare system greatly.
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525
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Maldonado L, Teague JE, Morrow MP, Jotova I, Wu TC, Wang C, Desmarais C, Boyer JD, Tycko B, Robins HS, Clark RA, Trimble CL. Intramuscular therapeutic vaccination targeting HPV16 induces T cell responses that localize in mucosal lesions. Sci Transl Med 2014; 6:221ra13. [PMID: 24477000 DOI: 10.1126/scitranslmed.3007323] [Citation(s) in RCA: 169] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
About 25% of high-grade cervical intraepithelial neoplasias (CIN2/3) caused by human papillomavirus serotype 16 (HPV16) undergo complete spontaneous regression. However, to date, therapeutic vaccination strategies for HPV disease have yielded limited success when measured by their ability to induce robust peripheral blood T cell responses to vaccine antigen. We report marked immunologic changes in the target lesion microenvironment after intramuscular therapeutic vaccination targeting HPV16 E6/E7 antigens, in subjects with CIN2/3 who had modest detectable responses in circulating T lymphocytes. Histologic and molecular changes, including markedly (average threefold) increased intensity of CD8(+) T cell infiltrates in both the stromal and epithelial compartments, suggest an effector response to vaccination. Postvaccination cervical tissue immune infiltrates included organized tertiary lymphoid-like structures in the stroma subjacent to residual intraepithelial lesions and, unlike infiltrates in unvaccinated lesions, showed evidence of proliferation induced by recognition of cognate antigen. At a molecular level, these histologic changes in the stroma were characterized by increased expression of genes associated with immune activation (CXCR3) and effector function (Tbet and IFNβ), and were also associated with an immunologic signature in the overlying dysplastic epithelium. High-throughput T cell receptor sequencing of unmanipulated specimens identified clonal expansions in the tissue that were not readily detectable in peripheral blood. Together, these findings indicate that peripheral therapeutic vaccination to HPV antigens can induce a robust tissue-localized effector immune response, and that analyses of immune responses at sites of antigen are likely to be much more informative than analyses of cells that remain in the circulation.
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Affiliation(s)
- Leonel Maldonado
- Department of Gynecology and Obstetrics, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA
| | - Jessica E Teague
- Harvard Skin Disease Research Center and the Department of Dermatology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Matthew P Morrow
- Inovio Pharmaceuticals Inc., 1787 Sentry Parkway West, Building 18, Suite 400, Blue Bell, PA 19422, USA
| | - Iveta Jotova
- Department of Pathology and Cell Biology and Institute for Cancer Genetics, Columbia University Medical Center, New York, NY 10025, USA
| | - T C Wu
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA
| | - Chenguang Wang
- Oncology Biostatistics, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA
| | - Cindy Desmarais
- Adaptive Biotechnologies, 1551 Eastlake Avenue, Seattle, WA 98102, USA
| | - Jean D Boyer
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Benjamin Tycko
- Department of Pathology and Cell Biology and Institute for Cancer Genetics, Columbia University Medical Center, New York, NY 10025, USA
| | - Harlan S Robins
- Program in Computational Biology, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Rachael A Clark
- Harvard Skin Disease Research Center and the Department of Dermatology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Cornelia L Trimble
- Department of Gynecology and Obstetrics, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA.,Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA.,Department of Oncology, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA
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526
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Dieu-Nosjean MC, Goc J, Giraldo NA, Sautès-Fridman C, Fridman WH. Tertiary lymphoid structures in cancer and beyond. Trends Immunol 2014; 35:571-80. [PMID: 25443495 DOI: 10.1016/j.it.2014.09.006] [Citation(s) in RCA: 370] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 09/21/2014] [Accepted: 09/21/2014] [Indexed: 01/20/2023]
Abstract
Tertiary lymphoid structures (TLS) are ectopic lymphoid formations found in inflamed, infected, or tumoral tissues. They exhibit all the characteristics of structures in the lymph nodes (LN) associated with the generation of an adaptive immune response, including a T cell zone with mature dendritic cells (DC), a germinal center with follicular dendritic cells (FDC) and proliferating B cells, and high endothelial venules (HEV). In this review, we discuss evidence for the roles of TLS in chronic infection, autoimmunity, and cancer, and address the question of whether TLS present beneficial or deleterious effects in these contexts. We examine the relationship between TLS in tumors and patient prognosis, and discuss the potential role of TLS in building and/or maintaining local immune responses and how this understanding may guide therapeutic interventions.
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Affiliation(s)
- Marie-Caroline Dieu-Nosjean
- Laboratory 'Cancer, Immune Control and Escape', INSERM U1138, Cordeliers Research Centre, Paris, France; University Pierre and Marie Curie, UMRS 1138, Paris, France; University Paris Descartes, UMRS 1138, Paris, France
| | - Jérémy Goc
- Laboratory 'Cancer, Immune Control and Escape', INSERM U1138, Cordeliers Research Centre, Paris, France; University Pierre and Marie Curie, UMRS 1138, Paris, France; University Paris Descartes, UMRS 1138, Paris, France
| | - Nicolas A Giraldo
- Laboratory 'Cancer, Immune Control and Escape', INSERM U1138, Cordeliers Research Centre, Paris, France; University Pierre and Marie Curie, UMRS 1138, Paris, France; University Paris Descartes, UMRS 1138, Paris, France
| | - Catherine Sautès-Fridman
- Laboratory 'Cancer, Immune Control and Escape', INSERM U1138, Cordeliers Research Centre, Paris, France; University Pierre and Marie Curie, UMRS 1138, Paris, France; University Paris Descartes, UMRS 1138, Paris, France
| | - Wolf Herman Fridman
- Laboratory 'Cancer, Immune Control and Escape', INSERM U1138, Cordeliers Research Centre, Paris, France; University Pierre and Marie Curie, UMRS 1138, Paris, France; University Paris Descartes, UMRS 1138, Paris, France.
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527
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Lea D, Håland S, Hagland HR, Søreide K. Accuracy of TNM staging in colorectal cancer: a review of current culprits, the modern role of morphology and stepping-stones for improvements in the molecular era. Scand J Gastroenterol 2014; 49:1153-63. [PMID: 25144865 DOI: 10.3109/00365521.2014.950692] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Colorectal cancer (CRC) is the third most common cancer worldwide. Survival is largely stage-dependant, guided by the tumor-node-metastases (TNM) system for TNM assessment. Histopathological evaluation, including assessment of lymph node status, is important for correct TNM staging. However, recent updates in the TNM system have resulted in controversy. A continued debate on definitions resulting in potential up- and downstaging of patients, which may obscure survival data, has led the investigators to investigate other or alternative staging tools. Consequently, additional prognostic factors have been searched for using the regular light microscopy. Among the factors evaluated by histopathology include the evaluation of tumor budding and stromal environment, angiogenesis, as well as involvement of the immune system (including the 'Immunoscore'). We review the current role of histopathology, controversies in TNM-staging and suggested alternatives to better predict outcome for CRC patients in the era of genomic medicine.
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Affiliation(s)
- Dordi Lea
- Department of Pathology, Stavanger University Hospital , Stavanger , Norway
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528
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Becht E, Goc J, Germain C, Giraldo NA, Dieu-Nosjean MC, Sautès-Fridman C, Fridman WH. Shaping of an effective immune microenvironment to and by cancer cells. Cancer Immunol Immunother 2014; 63:991-7. [PMID: 25112529 PMCID: PMC11028419 DOI: 10.1007/s00262-014-1590-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 07/20/2014] [Indexed: 12/21/2022]
Abstract
A high density of intratumoral effector memory CD8+/Th1 T cells is associated with favorable prognosis in most cancers and may be induced or increased by immunotherapy. Efficient adaptive immune reactions are shaped in tumor adjacent tertiary lymphoid structures, which exhibit all characteristics of immunity generating lymphoid formations in reactive lymph nodes. Malignant tumor cells impact favorably or deleteriously their immune microenvironment if they bear genetic mutations that result in neo-antigens or by producing chemokines and cytokines that recruit lymphocytes and myeloid cells or increase inflammation and neo-angiogenesis. This intricate network of interactions results in control or escape of tumors, and its understanding will help define goals to monitor efficiency of immunotherapies.
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Affiliation(s)
- Etienne Becht
- Laboratory Cancer, Immune Control and Escape, UMRS 1138 INSERM, Cordeliers Research Center, 15, rue de l’école de Médecine, 75270 Paris Cedex 06, France
- Université Paris Descartes, Paris, France
- Université Pierre et Marie Curie, Paris, France
| | - Jeremy Goc
- Laboratory Cancer, Immune Control and Escape, UMRS 1138 INSERM, Cordeliers Research Center, 15, rue de l’école de Médecine, 75270 Paris Cedex 06, France
- Université Paris Descartes, Paris, France
- Université Pierre et Marie Curie, Paris, France
| | - Claire Germain
- Laboratory Cancer, Immune Control and Escape, UMRS 1138 INSERM, Cordeliers Research Center, 15, rue de l’école de Médecine, 75270 Paris Cedex 06, France
- Université Paris Descartes, Paris, France
- Université Pierre et Marie Curie, Paris, France
| | - Nicolas A. Giraldo
- Laboratory Cancer, Immune Control and Escape, UMRS 1138 INSERM, Cordeliers Research Center, 15, rue de l’école de Médecine, 75270 Paris Cedex 06, France
- Université Paris Descartes, Paris, France
- Université Pierre et Marie Curie, Paris, France
| | - Marie-Caroline Dieu-Nosjean
- Laboratory Cancer, Immune Control and Escape, UMRS 1138 INSERM, Cordeliers Research Center, 15, rue de l’école de Médecine, 75270 Paris Cedex 06, France
- Université Paris Descartes, Paris, France
- Université Pierre et Marie Curie, Paris, France
| | - Catherine Sautès-Fridman
- Laboratory Cancer, Immune Control and Escape, UMRS 1138 INSERM, Cordeliers Research Center, 15, rue de l’école de Médecine, 75270 Paris Cedex 06, France
- Université Paris Descartes, Paris, France
- Université Pierre et Marie Curie, Paris, France
| | - Wolf-Herman Fridman
- Laboratory Cancer, Immune Control and Escape, UMRS 1138 INSERM, Cordeliers Research Center, 15, rue de l’école de Médecine, 75270 Paris Cedex 06, France
- Université Paris Descartes, Paris, France
- Université Pierre et Marie Curie, Paris, France
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529
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Brown JR, Wimberly H, Lannin DR, Nixon C, Rimm DL, Bossuyt V. Multiplexed quantitative analysis of CD3, CD8, and CD20 predicts response to neoadjuvant chemotherapy in breast cancer. Clin Cancer Res 2014; 20:5995-6005. [PMID: 25255793 DOI: 10.1158/1078-0432.ccr-14-1622] [Citation(s) in RCA: 127] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE Although tumor-infiltrating lymphocytes (TIL) have been associated with response to neoadjuvant therapy, measurement typically is subjective, semiquantitative, and unable to differentiate among subpopulations. Here, we describe a quantitative objective method for analyzing lymphocyte subpopulations and assessing their predictive value. EXPERIMENTAL DESIGN We developed a quantitative immunofluorescence assay to measure stromal expression of CD3, CD8, and CD20 on one slide. We validated this assay by comparison with flow cytometry on tonsil specimens and assessed predictive value in breast cancer on a neoadjuvant cohort (n = 95). Then, each marker was tested for prediction of pathologic complete response (pCR) compared with pathologist estimation of the percentage of lymphocyte infiltrate. RESULTS The lymphocyte percentage and CD3, CD8, and CD20 proportions were similar between flow cytometry and quantitative immunofluorescence on tonsil specimens. Pathologist TIL count predicted pCR [P = 0.043; OR, 4.77; 95% confidence interval (CI), 1.05-21.6] despite fair interobserver reproducibility (κ = 0.393). Stromal AQUA (automated quantitative analysis) scores for CD3 (P = 0.023; OR, 2.51; 95% CI, 1.13-5.57), CD8 (P = 0.029; OR, 2.00; 95% CI, 1.08-3.72), and CD20 (P = 0.005; OR, 1.80; 95% CI, 1.19-2.72) predicted pCR in univariate analysis. CD20 AQUA score predicted pCR (P = 0.019; OR, 5.37; 95% CI, 1.32-21.8) independently of age, size, nuclear grade, nodal status, ER, PR, HER2, and Ki-67, whereas CD3, CD8, and pathologist estimation did not. CONCLUSIONS We have developed and validated an objective, quantitative assay measuring TILs in breast cancer. Although this work provides analytic validity, future larger studies will be required to prove clinical utility.
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Affiliation(s)
- Jason R Brown
- Department of Pathology, Yale University Medical School, New Haven, Connecticut
| | - Hallie Wimberly
- Department of Pathology, Yale University Medical School, New Haven, Connecticut
| | - Donald R Lannin
- Department of Surgery, Yale University Medical School, New Haven, Connecticut
| | - Christian Nixon
- Department of Pathology, Yale University Medical School, New Haven, Connecticut
| | - David L Rimm
- Department of Pathology, Yale University Medical School, New Haven, Connecticut.
| | - Veerle Bossuyt
- Department of Pathology, Yale University Medical School, New Haven, Connecticut
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530
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Fong L, Carroll P, Weinberg V, Chan S, Lewis J, Corman J, Amling CL, Stephenson RA, Simko J, Sheikh NA, Sims RB, Frohlich MW, Small EJ. Activated lymphocyte recruitment into the tumor microenvironment following preoperative sipuleucel-T for localized prostate cancer. J Natl Cancer Inst 2014; 106:dju268. [PMID: 25255802 PMCID: PMC4241888 DOI: 10.1093/jnci/dju268] [Citation(s) in RCA: 138] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background Sipuleucel-T is a US Food and Drug Administration–approved immunotherapy for asymptomatic or minimally symptomatic metastatic castration-resistant prostate cancer (mCRPC). Its mechanism of action is not fully understood. This prospective trial evaluated the direct immune effects of systemically administered sipuleucel-T on prostatic cancer tissue in the preoperative setting. Methods Patients with untreated localized prostate cancer were treated on an open-label Phase II study of sipuleucel-T prior to planned radical prostatectomy (RP). Immune infiltrates in RP specimens (posttreatment) and in paired pretreatment biopsies were evaluated by immunohistochemistry (IHC). Correlations between circulating immune response and IHC were assessed using Spearman rank order. Results Of the 42 enrolled patients, 37 were evaluable. Adverse events were primarily transient, mild-to-moderate and infusion related. Patients developed T cell proliferation and interferon-γ responses detectable in the blood following treatment. Furthermore, a greater-than-three-fold increase in infiltrating CD3+, CD4+ FOXP3-, and CD8+ T cells was observed in the RP tissues compared with the pretreatment biopsy (binomial proportions: all P < .001). This level of T cell infiltration was observed at the tumor interface, and was not seen in a control group consisting of 12 concurrent patients who did not receive any neoadjuvant treatment prior to RP. The majority of infiltrating T cells were PD-1+ and Ki-67+, consistent with activated T cells. Importantly, the magnitude of the circulating immune response did not directly correlate with T cell infiltration within the prostate based upon Spearman’s rank order correlation. Conclusions This study is the first to demonstrate a local immune effect from the administration of sipuleucel-T. Neoadjuvant sipuleucel-T elicits both a systemic antigen-specific T cell response and the recruitment of activated effector T cells into the prostate tumor microenvironment.
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Affiliation(s)
- Lawrence Fong
- University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA (LF, PC, VW, SC, JL, JS, EJS); Virginia Mason Medical Center, Seattle, WA (JC); Oregon Health & Science University, Portland, OR (CLA); University of Utah School of Medicine, Salt Lake City, UT (RAS); Dendreon Corporation, Seattle, WA (NAS, RBS, MWF).
| | - Peter Carroll
- University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA (LF, PC, VW, SC, JL, JS, EJS); Virginia Mason Medical Center, Seattle, WA (JC); Oregon Health & Science University, Portland, OR (CLA); University of Utah School of Medicine, Salt Lake City, UT (RAS); Dendreon Corporation, Seattle, WA (NAS, RBS, MWF)
| | - Vivian Weinberg
- University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA (LF, PC, VW, SC, JL, JS, EJS); Virginia Mason Medical Center, Seattle, WA (JC); Oregon Health & Science University, Portland, OR (CLA); University of Utah School of Medicine, Salt Lake City, UT (RAS); Dendreon Corporation, Seattle, WA (NAS, RBS, MWF)
| | - Stephen Chan
- University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA (LF, PC, VW, SC, JL, JS, EJS); Virginia Mason Medical Center, Seattle, WA (JC); Oregon Health & Science University, Portland, OR (CLA); University of Utah School of Medicine, Salt Lake City, UT (RAS); Dendreon Corporation, Seattle, WA (NAS, RBS, MWF)
| | - Jera Lewis
- University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA (LF, PC, VW, SC, JL, JS, EJS); Virginia Mason Medical Center, Seattle, WA (JC); Oregon Health & Science University, Portland, OR (CLA); University of Utah School of Medicine, Salt Lake City, UT (RAS); Dendreon Corporation, Seattle, WA (NAS, RBS, MWF)
| | - John Corman
- University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA (LF, PC, VW, SC, JL, JS, EJS); Virginia Mason Medical Center, Seattle, WA (JC); Oregon Health & Science University, Portland, OR (CLA); University of Utah School of Medicine, Salt Lake City, UT (RAS); Dendreon Corporation, Seattle, WA (NAS, RBS, MWF)
| | - Christopher L Amling
- University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA (LF, PC, VW, SC, JL, JS, EJS); Virginia Mason Medical Center, Seattle, WA (JC); Oregon Health & Science University, Portland, OR (CLA); University of Utah School of Medicine, Salt Lake City, UT (RAS); Dendreon Corporation, Seattle, WA (NAS, RBS, MWF)
| | - Robert A Stephenson
- University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA (LF, PC, VW, SC, JL, JS, EJS); Virginia Mason Medical Center, Seattle, WA (JC); Oregon Health & Science University, Portland, OR (CLA); University of Utah School of Medicine, Salt Lake City, UT (RAS); Dendreon Corporation, Seattle, WA (NAS, RBS, MWF)
| | - Jeffrey Simko
- University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA (LF, PC, VW, SC, JL, JS, EJS); Virginia Mason Medical Center, Seattle, WA (JC); Oregon Health & Science University, Portland, OR (CLA); University of Utah School of Medicine, Salt Lake City, UT (RAS); Dendreon Corporation, Seattle, WA (NAS, RBS, MWF)
| | - Nadeem A Sheikh
- University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA (LF, PC, VW, SC, JL, JS, EJS); Virginia Mason Medical Center, Seattle, WA (JC); Oregon Health & Science University, Portland, OR (CLA); University of Utah School of Medicine, Salt Lake City, UT (RAS); Dendreon Corporation, Seattle, WA (NAS, RBS, MWF)
| | - Robert B Sims
- University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA (LF, PC, VW, SC, JL, JS, EJS); Virginia Mason Medical Center, Seattle, WA (JC); Oregon Health & Science University, Portland, OR (CLA); University of Utah School of Medicine, Salt Lake City, UT (RAS); Dendreon Corporation, Seattle, WA (NAS, RBS, MWF)
| | - Mark W Frohlich
- University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA (LF, PC, VW, SC, JL, JS, EJS); Virginia Mason Medical Center, Seattle, WA (JC); Oregon Health & Science University, Portland, OR (CLA); University of Utah School of Medicine, Salt Lake City, UT (RAS); Dendreon Corporation, Seattle, WA (NAS, RBS, MWF)
| | - Eric J Small
- University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA (LF, PC, VW, SC, JL, JS, EJS); Virginia Mason Medical Center, Seattle, WA (JC); Oregon Health & Science University, Portland, OR (CLA); University of Utah School of Medicine, Salt Lake City, UT (RAS); Dendreon Corporation, Seattle, WA (NAS, RBS, MWF)
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531
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Masson-Lecomte A, Rava M, Real FX, Hartmann A, Allory Y, Malats N. Inflammatory biomarkers and bladder cancer prognosis: a systematic review. Eur Urol 2014; 66:1078-91. [PMID: 25151017 DOI: 10.1016/j.eururo.2014.07.033] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 07/25/2014] [Indexed: 01/09/2023]
Abstract
CONTEXT Host immune response has an impact on tumour development and progression. There is interest in the use of inflammatory biomarkers (InfBMs) in cancer care. Although several studies assessing the potential prognostic value of InfBMs in cancer have been published in the past decades, they have had no impact on the management of patients with urothelial bladder carcinoma (UBC). OBJECTIVE To review and summarise the scientific literature on the prognostic value of tumour, serum, urine, and germline DNA InfBMs on UBC. EVIDENCE ACQUISITION A systematic review of the literature was performed searching the Medline and Embase databases for original articles published between January 1975 and November 2013. The main inclusion criterion was the provision of a survival analysis (Kaplan-Meier and/or Cox) according to the Reporting Recommendations for Tumor Marker Prognostic Studies guidelines for the assessment of prognostic markers. We focused on markers assessed at least twice in the literature. Findings are reported following Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. EVIDENCE SYNTHESIS Overall, 34 publications, mostly retrospective, fulfilled the main inclusion criterion. Main limitations of these studies were missing relevant information about design or analysis and heterogeneous methodology used. Inflammatory cells, costimulatory molecules in tumour cells, and serum cytokines showed prognostic significance, mainly in univariable analyses. High C-reactive protein values were consistently reported as an independent prognostic factor for mortality in invasive UBC. CONCLUSIONS There is a dearth of studies on InfBMs in UBC compared with other tumour types. Evidence suggests that InfBMs may have an impact on the management of patients with UBC. Currently, methodological drawbacks of the studies limit the translational potential of results. PATIENT SUMMARY In this review, we analysed studies evaluating the impact of inflammatory response on bladder cancer progression. Despite methodological limitations, some inflammatory biomarkers should be further analysed because they hold promise to improve patient care.
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Affiliation(s)
- Alexandra Masson-Lecomte
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain; Urology Department, Henri Mondor Academic Hospital, INSERM U955Eq7, Créteil, France
| | - Marta Rava
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Francisco X Real
- Epithelial Carcinogenesis Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain; Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain
| | - Arndt Hartmann
- Department of Pathology, University Erlangen-Nürnberg, Erlangen, Germany
| | - Yves Allory
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain; Pathology Department, Henri Mondor Academic Hospital, INSERM U955Eq7, Créteil, France
| | - Núria Malats
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain.
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532
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Fridman WH, Remark R, Goc J, Giraldo NA, Becht E, Hammond SA, Damotte D, Dieu-Nosjean MC, Sautès-Fridman C. The immune microenvironment: a major player in human cancers. Int Arch Allergy Immunol 2014; 164:13-26. [PMID: 24852691 DOI: 10.1159/000362332] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Cancer is a major public health issue and figures among the leading causes of death in the world. Cancer development is a long process, involving the mutation, amplification or deletion of genes and chromosomal rearrangements. The transformed cells change morphologically, enlarge, become invasive and finally detach from the primary tumor to metastasize in other organs through the blood and/or lymph. During this process, the tumor cells interact with their microenvironment, which is complex and composed of stromal and immune cells that penetrate the tumor site via blood vessels and lymphoid capillaries. All subsets of immune cells can be found in tumors, but their respective density, functionality and organization vary from one type of tumor to another. Whereas inflammatory cells play a protumoral role, there is a large body of evidence of effector memory T cells controlling tumor invasion and metastasis. Thus, high densities of memory Th1/CD8 cytotoxic T cells in the primary tumors correlate with good prognosis in most tumor types. Tertiary lymphoid structures, which contain mature dendritic cells (DC) in a T cell zone, proliferating B cells and follicular DC, are found in the tumor stroma and they correlate with intratumoral Th1/CD8 T cell and B cell infiltration. Eventually, tumors undergo genetic and epigenetic modifications that allow them to escape being controlled by the immune system. This comprehensive review describes the immune contexture of human primary and metastatic tumors, how it impacts on patient outcomes and how it could be used as a predictive biomarker and guide immunotherapies.
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Affiliation(s)
- W H Fridman
- Cancer, Immune Control and Escape, UMRS1138, Cordeliers Research Center, Paris, France
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533
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Hegmans JPJJ, Aerts JGJV. Immunomodulation in cancer. Curr Opin Pharmacol 2014; 17:17-21. [DOI: 10.1016/j.coph.2014.06.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 06/11/2014] [Accepted: 06/14/2014] [Indexed: 12/12/2022]
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534
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Lochhead P, Chan AT, Giovannucci E, Fuchs CS, Wu K, Nishihara R, O'Brien M, Ogino S. Progress and opportunities in molecular pathological epidemiology of colorectal premalignant lesions. Am J Gastroenterol 2014; 109:1205-14. [PMID: 24935274 PMCID: PMC4125459 DOI: 10.1038/ajg.2014.153] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 04/18/2014] [Indexed: 02/06/2023]
Abstract
Molecular pathological epidemiology (MPE) is an integrative molecular and population health science that addresses the molecular pathogenesis and heterogeneity of disease processes. The MPE of colonic and rectal premalignant lesions (including hyperplastic polyps, tubular adenomas, tubulovillous adenomas, villous adenomas, traditional serrated adenomas, sessile serrated adenomas/sessile serrated polyps, and hamartomatous polyps) can provide unique opportunities for examining the influence of diet, lifestyle, and environmental exposures on specific pathways of carcinogenesis. Colorectal neoplasia can provide a practical model by which both malignant epithelial tumor (carcinoma) and its precursor are subjected to molecular pathological analyses. KRAS, BRAF, and PIK3CA oncogene mutations, microsatellite instability, CpG island methylator phenotype, and LINE-1 methylation are commonly examined tumor biomarkers. Future opportunities include interrogation of comprehensive genomic, epigenomic, or panomic datasets, and the adoption of in vivo pathology techniques. Considering the colorectal continuum hypothesis and emerging roles of gut microbiota and host immunity in tumorigenesis, detailed information on tumor location is important. There are unique strengths and caveats, especially with regard to case ascertainment by colonoscopy. The MPE of colorectal premalignant lesions can identify etiologic exposures associated with neoplastic initiation and progression, help us better understand colorectal carcinogenesis, and facilitate personalized prevention, screening, and therapy.
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Affiliation(s)
- Paul Lochhead
- 1] Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK [2] The first two authors contributed equally to this work
| | - Andrew T Chan
- 1] Division of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts, USA [2] Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, USA [3] The first two authors contributed equally to this work
| | - Edward Giovannucci
- 1] Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, USA [2] Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA [3] Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA
| | - Charles S Fuchs
- 1] Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, USA [2] Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts, USA
| | - Kana Wu
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA
| | - Reiko Nishihara
- 1] Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA [2] Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts, USA
| | - Michael O'Brien
- Department of Pathology, Boston University Medical Center, Boston, Massachusetts, USA
| | - Shuji Ogino
- 1] Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA [2] Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts, USA [3] Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, USA
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535
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Almo SC, Guha C. Considerations for combined immune checkpoint modulation and radiation treatment. Radiat Res 2014; 182:230-8. [PMID: 25003312 DOI: 10.1667/rr13667.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Recent advances indicate that new therapeutic strategies for the treatment of malignancies will be realized from combined radiation treatment and immune checkpoint modulation. Numerous biophysical properties must be considered for effective biologic development, including affinity, selectivity, oligomeric state and valency. High-resolution structural characterization contributes to our understanding of these properties and can lead to the realization of proteins with unique in vitro activities and novel in vivo therapeutic functions. In this article we focus on the importance of these factors for new potential biologics and consider these in the context of combination therapies with physical modalities, including radiation therapy. In particular, we examine the consequences of altered avidities and subset-specific ligand density on the rational modification of biological function in the immunoglobulin and tumor necrosis factor superfamilies and for new optimized combination therapies.
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Affiliation(s)
- Steven C Almo
- a Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York 10461
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536
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Meshcheryakova A, Tamandl D, Bajna E, Stift J, Mittlboeck M, Svoboda M, Heiden D, Stremitzer S, Jensen-Jarolim E, Grünberger T, Bergmann M, Mechtcheriakova D. B cells and ectopic follicular structures: novel players in anti-tumor programming with prognostic power for patients with metastatic colorectal cancer. PLoS One 2014; 9:e99008. [PMID: 24905750 PMCID: PMC4048213 DOI: 10.1371/journal.pone.0099008] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 05/09/2014] [Indexed: 01/01/2023] Open
Abstract
Remarkably limited information is available about biological mechanisms that determine the disease entity of metastatic colorectal cancer in the liver (CRCLM) with no good clinical parameters to estimate prognosis. For the last few years, understanding the relationship between tumor characteristics and local immune response has gained increasing attention. Given the multifaceted roles of B-cell-driven responses, we aimed to elucidate the immunological imprint of B lymphocytes at the metastatic site, the interrelation with macrophages, and their prognostic relevance. Here we present novel algorithm allowing to assess a link between the local patient-specific immunological capacity and clinical outcome. The microscopy-based imaging platform was used for automated scanning of large-scale tissue sections and subsequent qualitative and quantitative analyses of immune cell subtypes using lineage markers and single-cell recognition strategy. Results indicate massive infiltration of CD45-positive leukocytes confined to the metastatic border. We report for the first time the accumulation of CD20-positive B lymphocytes at the tumor – liver interface comprising the major population within the large CD45-positive aggregates. Strikingly, functionally active, activation-induced cytidine deaminase (AID)-positive ectopic lymphoid structures were found to be assembled within the metastatic margin. Furthermore, the CD20-based data set revealed a strong prognostic power: patients with high CD20 content and/or ectopic follicles had significantly lower risk for disease recurrence as revealed by univariate analysis (p<0.001 for both) and in models adjusted for clinicopathological variables (p<0.001 and p = 0.01, respectively), and showed prolonged overall survival. In contrast, CD68 staining-derived data set did not show an association with clinical outcome. Taken together, we nominate the magnitude of B lymphocytes, including those organized in ectopic follicles, as novel prognostic marker which is superior to clinicopathological parameters. Findings emphasize anti-tumoral role of B cell-driven mechanism(s) and thus indicate a new way of thinking about potential treatment strategies for CRCLM patients.
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Affiliation(s)
- Anastasia Meshcheryakova
- Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Dietmar Tamandl
- Department of Surgery, Medical University of Vienna, Vienna, Austria
- * E-mail: (DT); (DM)
| | - Erika Bajna
- Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Judith Stift
- Department of Pathology, Medical University of Vienna, Vienna, Austria
| | - Martina Mittlboeck
- Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Martin Svoboda
- Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Denise Heiden
- Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Stefan Stremitzer
- Department of Surgery, Medical University of Vienna, Vienna, Austria
| | - Erika Jensen-Jarolim
- Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
- Comparative Medicine, Messerli Research Institute of the Medical University of Vienna, Veterinary University of Vienna and University of Vienna, Vienna, Austria
| | - Thomas Grünberger
- Department of Surgery, Medical University of Vienna, Vienna, Austria
| | - Michael Bergmann
- Department of Surgery, Medical University of Vienna, Vienna, Austria
| | - Diana Mechtcheriakova
- Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
- * E-mail: (DT); (DM)
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537
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Ogino S, Lochhead P, Giovannucci E, Meyerhardt JA, Fuchs CS, Chan AT. Discovery of colorectal cancer PIK3CA mutation as potential predictive biomarker: power and promise of molecular pathological epidemiology. Oncogene 2014; 33:2949-55. [PMID: 23792451 PMCID: PMC3818472 DOI: 10.1038/onc.2013.244] [Citation(s) in RCA: 104] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 04/26/2013] [Accepted: 04/27/2013] [Indexed: 12/18/2022]
Abstract
Regular use of aspirin reduces incidence and mortality of various cancers, including colorectal cancer. Anticancer effect of aspirin represents one of the 'Provocative Questions' in cancer research. Experimental and clinical studies support a carcinogenic role for PTGS2 (cyclooxygenase-2), which is an important enzymatic mediator of inflammation, and a target of aspirin. Recent 'molecular pathological epidemiology' (MPE) research has shown that aspirin use is associated with better prognosis and clinical outcome in PIK3CA-mutated colorectal carcinoma, suggesting somatic PIK3CA mutation as a molecular biomarker that predicts response to aspirin therapy. The PI3K (phosphatidylinositol-4,5-bisphosphonate 3-kinase) enzyme has a pivotal role in the PI3K-AKT signaling pathway. Activating PIK3CA oncogene mutations are observed in various malignancies including breast cancer, ovarian cancer, brain tumor, hepatocellular carcinoma, lung cancer and colon cancer. The prevalence of PIK3CA mutations increases continuously from rectal to cecal cancers, supporting the 'colorectal continuum' paradigm, and an important interplay of gut microbiota and host immune/inflammatory reaction. MPE represents an interdisciplinary integrative science, conceptually defined as 'epidemiology of molecular heterogeneity of disease'. As exposome and interactome vary from person to person and influence disease process, each disease process is unique (the unique disease principle). Therefore, MPE concept and paradigm can extend to non-neoplastic diseases including diabetes mellitus, cardiovascular diseases, metabolic diseases, and so on. MPE research opportunities are currently limited by paucity of tumor molecular data in the existing large-scale population-based studies. However, genomic, epigenomic and molecular pathology testings (for example, analyses for microsatellite instability, MLH1 promoter CpG island methylation, and KRAS and BRAF mutations in colorectal tumors) are becoming routine clinical practices. In order for integrative molecular and population science to be routine practice, we must first reform education curricula by integrating both population and molecular biological sciences. As consequences, next-generation hybrid molecular biological and population scientists can advance science, moving closer to personalized precision medicine and health care.
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Affiliation(s)
- S Ogino
- 1] Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA [2] Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA [3] Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
| | - P Lochhead
- Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK
| | - E Giovannucci
- 1] Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA [2] Department of Nutrition, Harvard School of Public Health, Boston, MA, USA [3] Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - J A Meyerhardt
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - C S Fuchs
- 1] Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA [2] Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - A T Chan
- 1] Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA [2] Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA
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538
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Galon J, Bindea G, Mlecnik B, Angell H, Lagorce C, Todosi AM, Berger A, Pagès F. Microenvironnement immunitaire et cancer. Med Sci (Paris) 2014; 30:439-44. [DOI: 10.1051/medsci/20143004020] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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539
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Di Caro G, Marchesi F, Laghi L, Grizzi F. Immune cells: plastic players along colorectal cancer progression. J Cell Mol Med 2014; 17:1088-95. [PMID: 24151976 PMCID: PMC4118167 DOI: 10.1111/jcmm.12117] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 07/24/2013] [Indexed: 12/13/2022] Open
Abstract
Inflammatory cells are involved in tumour initiation and progression. In parallel, the adaptive immune response plays a key role in fighting tumour growth and dissemination. The double-edged role of the immune system in solid tumours is well represented in colorectal cancer (CRC). The development and progression of CRC are affected by the interactions between the tumour and the host's response, occurring in a milieu named tumour microenvironment. The role of immune cells in human CRC is being unravelled and there is a strong interest in understanding their dynamics as to tumour promotion, immunosurveillance and immunoevasion. A better definition of immune infiltration would be important not only with respect to the ‘natural history’ of CRC, but in a clinically relevant perspective in the 21st century, with respect to its post-surgical management, including chemotherapy responsiveness. While it is becoming established that the amount of tumour-infiltrating lymphocytes influences the post-surgical progression of early-stage CRC, the relevance of this immune parameter as to chemotherapy responsiveness remains to be clarified. Despite recent experimental work supporting the notion that infiltrating immune cells may influence chemotherapy-mediated tumour cell death, tumour-infiltrating cells are not employed to identify patients who are more likely to benefit from adjuvant treatment. This review focuses on studies addressing the role of innate and adaptive immune cells along the occurrence and the progression of potentially curable CRC.
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Affiliation(s)
- Giuseppe Di Caro
- Laboratory of Molecular Gastroenterology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
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540
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Sjödahl G, Lövgren K, Lauss M, Chebil G, Patschan O, Gudjonsson S, Månsson W, Fernö M, Leandersson K, Lindgren D, Liedberg F, Höglund M. Infiltration of CD3⁺ and CD68⁺ cells in bladder cancer is subtype specific and affects the outcome of patients with muscle-invasive tumors. Urol Oncol 2014; 32:791-7. [PMID: 24794251 DOI: 10.1016/j.urolonc.2014.02.007] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 01/13/2014] [Accepted: 02/07/2014] [Indexed: 01/29/2023]
Abstract
OBJECTIVES Urothelial carcinoma (UC) aggressiveness is determined by tumor inherent molecular characteristics, such as molecular subtypes, as well as by host reactions directed toward the tumor. Cell types responsible for the host's response include tumor-infiltrating lymphocytes (TILs) and tumor-associated macrophages (TAMs). The aim of the present investigation was to explore the immunological response in relation to UC molecular subtypes and to evaluate the prognostic effect of TIL and TAM counts in tissue sections from muscle-invasive (MI) tumors. METHODS AND MATERIALS Tissue microarrays with 296 tumors spanning all pathological stages and grades were analyzed with antibodies for CD3, CD8, FOXP3, CD68, and CD163. Cases were classified into the following molecular subtypes: urobasal, genomically unstable, and squamous cell carcinoma-like using a combination of immunohistochemistry and histology. The Cox regression and Kaplan-Meier analyses were performed with progression-free survival and disease-specific survival as end points. RESULTS UC molecular subtypes demonstrate different degrees of immunological responses; the urobasal subtype induces a weak response, the genomically unstable subtype induces an intermediate response, and the squamous cell carcinoma-like subtype induces a strong response. These subtype specific responses are independent of tumor stage and include both TILs and TAMs. The presence of infiltrating CD3(+) TILs was significantly associated with good prognosis in the MI cases (P<0.01). This positive association was modulated by the presence of CD68(+) TAMs. The strongest association with poor survival was observed for a high ratio between CD68 and CD3 (P = 7×10(-5)). CONCLUSION UC molecular subtypes induce immunological responses at different levels. A high CD68/CD3 ratio identifies a bad prognosis group among MI UC cases.
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Affiliation(s)
- Gottfrid Sjödahl
- Department of Oncology, Clinical Sciences, Skåne University Hospital, Lund University, Lund, Sweden
| | - Kristina Lövgren
- Department of Oncology, Clinical Sciences, Skåne University Hospital, Lund University, Lund, Sweden
| | - Martin Lauss
- Department of Oncology, Clinical Sciences, Skåne University Hospital, Lund University, Lund, Sweden
| | - Gunilla Chebil
- Department of Oncology, Clinical Sciences, Skåne University Hospital, Lund University, Lund, Sweden
| | - Oliver Patschan
- Department of Urology, Clinical Sciences, Skåne University Hospital, Lund University, Lund, Sweden
| | - Sigurdur Gudjonsson
- Department of Urology, Clinical Sciences, Skåne University Hospital, Lund University, Lund, Sweden
| | - Wiking Månsson
- Department of Urology, Clinical Sciences, Skåne University Hospital, Lund University, Lund, Sweden
| | - Mårten Fernö
- Department of Oncology, Clinical Sciences, Skåne University Hospital, Lund University, Lund, Sweden
| | - Karin Leandersson
- Department of Laboratory Medicine, Center for Molecular Pathology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - David Lindgren
- Department of Laboratory Medicine, Center for Molecular Pathology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Fredrik Liedberg
- Department of Urology, Clinical Sciences, Skåne University Hospital, Lund University, Lund, Sweden
| | - Mattias Höglund
- Department of Oncology, Clinical Sciences, Skåne University Hospital, Lund University, Lund, Sweden.
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541
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Abstract
More than 1·2 million patients are diagnosed with colorectal cancer every year, and more than 600,000 die from the disease. Incidence strongly varies globally and is closely linked to elements of a so-called western lifestyle. Incidence is higher in men than women and strongly increases with age; median age at diagnosis is about 70 years in developed countries. Despite strong hereditary components, most cases of colorectal cancer are sporadic and develop slowly over several years through the adenoma-carcinoma sequence. The cornerstones of therapy are surgery, neoadjuvant radiotherapy (for patients with rectal cancer), and adjuvant chemotherapy (for patients with stage III/IV and high-risk stage II colon cancer). 5-year relative survival ranges from greater than 90% in patients with stage I disease to slightly greater than 10% in patients with stage IV disease. Screening has been shown to reduce colorectal cancer incidence and mortality, but organised screening programmes are still to be implemented in most countries.
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Affiliation(s)
- Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; German Cancer Consortium (DKTK), Heidelberg, Germany.
| | - Matthias Kloor
- Department of Applied Tumor Biology, Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
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542
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Garziera M, Toffoli G. Inhibition of host immune response in colorectal cancer: Human leukocyte antigen-G and beyond. World J Gastroenterol 2014; 20:3778-3794. [PMID: 24744572 PMCID: PMC3983436 DOI: 10.3748/wjg.v20.i14.3778] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 01/22/2014] [Accepted: 02/27/2014] [Indexed: 02/06/2023] Open
Abstract
Colorectal cancer (CRC) is one of the most diffuse cancers worldwide and is still a clinical burden. Increasing evidences associate CRC clinical outcome to immune contexture represented by adaptive immune cells. Their type, density and location are summarized in the Immune Score that has been shown to improve prognostic prediction of CRC patients. The non-classical MHC class I human leukocyte antigen-G (HLA-G), is a crucial tumor-driven immune escape molecule involved in immune tolerance. HLA-G and soluble counterparts are able to exert inhibitory functions by direct interactions with inhibitory receptors present on both innate cells such as natural killer cells, and adaptive immune cells as cytotoxic T and B lymphocytes. HLA-G may play a prominent role in CRC strategies to avoid host immunosurveillance. This review highlights the current knowledge on HLA-G contribution in CRC, in related inflammatory diseases and in other type of cancers and disorders. HLA-G genetic setting (specific haplotypes, genotypes and alleles frequencies) and association with circulating/soluble profiles was highlighted. HLA G prognostic and predictive value in CRC was investigated in order to define a novel prognostic immune biomarker in CRC.
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543
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Giraldo NA, Becht E, Remark R, Damotte D, Sautès-Fridman C, Fridman WH. The immune contexture of primary and metastatic human tumours. Curr Opin Immunol 2014; 27:8-15. [DOI: 10.1016/j.coi.2014.01.001] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 12/18/2013] [Accepted: 01/05/2014] [Indexed: 12/17/2022]
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544
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Koelzer VH, Lugli A, Dawson H, Hädrich M, Berger MD, Borner M, Mallaev M, Galván JA, Amsler J, Schnüriger B, Zlobec I, Inderbitzin D. CD8/CD45RO T-cell infiltration in endoscopic biopsies of colorectal cancer predicts nodal metastasis and survival. J Transl Med 2014; 12:81. [PMID: 24679169 PMCID: PMC4022053 DOI: 10.1186/1479-5876-12-81] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 03/21/2014] [Indexed: 02/08/2023] Open
Abstract
Background and aims Reliable prognostic markers based on biopsy specimens of colorectal cancer (CRC) are currently missing. We hypothesize that assessment of T-cell infiltration in biopsies of CRC may predict patient survival and TNM-stage before surgery. Methods Pre-operative biopsies and matched resection specimens from 130 CRC patients treated from 2002-2011 were included in this study. Whole tissue sections of biopsy material and primary tumors were immunostained for pancytokeratin and CD8 or CD45RO. Stromal (s) and intraepithelial (i) T-cell infiltrates were analyzed for prediction of patient survival as well as clinical and pathological TNM-stage of the primary tumor. Results CD8 T-cell infiltration in the preoperative biopsy was significantly associated with favorable overall survival (CD8i p = 0.0026; CD8s p = 0.0053) in patients with primary CRC independently of TNM-stage and postoperative therapy (HR [CD8i] = 0.55 (95% CI: 0.36-0.82), p = 0.0038; HR [CD8s] = 0.72 (95% CI: 0.57-0.9), p = 0.0049). High numbers of CD8i in the biopsy predicted earlier pT-stage (p < 0.0001) as well as absence of nodal metastasis (p = 0.0015), tumor deposits (p = 0.0117), lymphatic (p = 0.008) and venous invasion (p = 0.0433) in the primary tumor. Infiltration by CD45ROs cells was independently associated with longer survival (HR = 0.76 (95% CI: 0.61-0.96), p = 0.0231) and predicted absence of venous invasion (p = 0.0025). CD8 counts were positively correlated between biopsies and the primary tumor (r = 0.42; p < 0.0001) and were reproducible between observers (ICC [CD8i] = 0.95, ICC [CD8s] = 0.75). For CD45RO, reproducibility was poor to moderate (ICC [CD45i] = 0.16, ICC [CD45s] = 0.49) and correlation with immune infiltration in the primary tumor was fair and non-significant (r[CD45s] = 0.16; p = 0.2864). For both markers, no significant relationship was observed with radiographic T-stage, N-stage or M-stage, indicating that assessment of T-cells in biopsy material can add additional information to clinical staging in the pre-operative setting. Conclusions T-cell infiltration in pre-operative biopsy specimens of CRC is an independent favorable prognostic factor and strongly correlates with absence of nodal metastasis in the resection specimen. Quantification of CD8i is highly reproducible and allows superior prediction of clinicopathological features as compared to CD45RO. The assessment of CD8i infiltration in biopsies is recommended for prospective investigation.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Inti Zlobec
- Translational Research Unit (TRU), Institute of Pathology, University of Bern, Murtenstr, 31, Bern CH-3010, Switzerland.
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545
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Kaufman HL, Wong MK, Daniels GA, McDermott DF, Aung S, Lowder JN, Morse MA. The Use of Registries to Improve Cancer Treatment: A National Database for Patients Treated with Interleukin-2 (IL-2). J Pers Med 2014; 4:52-64. [PMID: 25562142 PMCID: PMC4251407 DOI: 10.3390/jpm4010052] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Revised: 02/15/2014] [Accepted: 02/27/2014] [Indexed: 02/06/2023] Open
Abstract
Registries evaluating un-randomized patients have provided valuable information with respect to a therapy's utility, treatment practices, and evolution over time. While immunotherapy for cancer has been around for more than three decades, data collection in the form of a registry has not been undertaken. The authors believe that establishing a registry to study HD IL-2 immunotherapy, which has been the only systemic therapy producing long term unmaintained remissions for advanced kidney cancer and melanoma for over 20 years, will be an important resource in understanding the impact of immunotherapy with HD IL-2 in a rapidly changing therapeutic environment. Optimizing administration and improving selection of appropriate patients likely to benefit from HD IL-2 immunotherapy are two of many benefits to be derived from this endeavor.
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Affiliation(s)
- Howard L Kaufman
- Department of Surgery, Rutgers Cancer Center Institute of New Jersey, 195 Little Albany Street, Room 2007, New Brunswick, NJ 08901, USA.
| | - Michael K Wong
- Department of Medicine, University of Southern California, 1441 Eastlake Avenue, Suite 3455, Los Angeles, CA 90033, USA.
| | - Gregory A Daniels
- Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive, La Jolla, CA 92093, USA.
| | - David F McDermott
- Beth Israel Hospital Deaconess Medical Center, Masco Building, 375 Longwood Avenue, Boston, MA 02215, USA.
| | - Sandra Aung
- Prometheus Laboratories Inc., 9410 Carroll Park Drive, San Diego, CA 92121, USA.
| | - James N Lowder
- Prometheus Laboratories Inc., 9410 Carroll Park Drive, San Diego, CA 92121, USA.
| | - Michael A Morse
- Duke University Medical Center, 10 Bryan Searle Drive, Mudd Building, Rm 437, Durham, NC 27710, USA.
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546
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Turcotte S, Katz SC, Shia J, Jarnagin WR, Kingham TP, Allen PJ, Fong Y, D'Angelica MI, DeMatteo RP. Tumor MHC class I expression improves the prognostic value of T-cell density in resected colorectal liver metastases. Cancer Immunol Res 2014; 2:530-7. [PMID: 24894090 DOI: 10.1158/2326-6066.cir-13-0180] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Tumor-infiltrating lymphocytes (TIL) in colorectal cancer liver metastases (CLM) have been associated with more favorable patient outcomes, but whether MHC class I (MHC-I) expression on cancer cells affects prognosis is uncertain. Immunohistochemistry was performed on a tissue microarray of 158 patients with CLM, who underwent partial hepatectomy with curative intent. Using the antibody HC-10, which detects HLA-B and HLA-C antigens and a minority of HLA-A antigens, MHC-I expression was correlated with β-2 microglobulin (β2m; r = 0.7; P < 0.001), but not with T-cell density (r < 0.32). The median follow-up for survivors was 9.7 years. High levels of MHC-I expression in tumors concomitant with high T-cell infiltration (CD3, CD4, or CD8) best identified patients with favorable outcomes, compared with patients with one or none of these immune features. The median overall survival (OS) of patients with MHC-I(hi)CD3(hi) tumors (n = 31) was 116 months compared with 40 months for the others (P = 0.001), and the median time to recurrence (TTR) was not reached compared with 17 months (P = 0.008). By multivariate analysis, MHC(hi)CD3(hi) was associated with OS and TTR independent of the standard clinicopathologic variables. An immune score that combines MHC-I expression and TIL density may be a valuable prognostic tool in the treatment of patients with CLM.
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Affiliation(s)
- Simon Turcotte
- Authors' Affiliations: Departments of Surgery and Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York; and Department of Surgery, Boston University School of Medicine, Roger Williams Medical Center, Providence, Rhode Island
| | - Steven C Katz
- Authors' Affiliations: Departments of Surgery and Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York; and Department of Surgery, Boston University School of Medicine, Roger Williams Medical Center, Providence, Rhode Island
| | - Jinru Shia
- Authors' Affiliations: Departments of Surgery and Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York; and Department of Surgery, Boston University School of Medicine, Roger Williams Medical Center, Providence, Rhode Island
| | - William R Jarnagin
- Authors' Affiliations: Departments of Surgery and Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York; and Department of Surgery, Boston University School of Medicine, Roger Williams Medical Center, Providence, Rhode Island
| | - T Peter Kingham
- Authors' Affiliations: Departments of Surgery and Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York; and Department of Surgery, Boston University School of Medicine, Roger Williams Medical Center, Providence, Rhode Island
| | - Peter J Allen
- Authors' Affiliations: Departments of Surgery and Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York; and Department of Surgery, Boston University School of Medicine, Roger Williams Medical Center, Providence, Rhode Island
| | - Yuman Fong
- Authors' Affiliations: Departments of Surgery and Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York; and Department of Surgery, Boston University School of Medicine, Roger Williams Medical Center, Providence, Rhode Island
| | - Michael I D'Angelica
- Authors' Affiliations: Departments of Surgery and Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York; and Department of Surgery, Boston University School of Medicine, Roger Williams Medical Center, Providence, Rhode Island
| | - Ronald P DeMatteo
- Authors' Affiliations: Departments of Surgery and Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York; and Department of Surgery, Boston University School of Medicine, Roger Williams Medical Center, Providence, Rhode Island
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547
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Di Caro G, Bergomas F, Grizzi F, Doni A, Bianchi P, Malesci A, Laghi L, Allavena P, Mantovani A, Marchesi F. Occurrence of tertiary lymphoid tissue is associated with T-cell infiltration and predicts better prognosis in early-stage colorectal cancers. Clin Cancer Res 2014; 20:2147-58. [PMID: 24523438 DOI: 10.1158/1078-0432.ccr-13-2590] [Citation(s) in RCA: 241] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE Tumor-infiltrating T lymphocytes (TIL) play a key role in the clinical outcome of human colorectal cancer; however, the dynamics of their recruitment along colorectal cancer clinical progression have not been fully elucidated. Tertiary lymphoid tissue (TLT) is an ectopic organized lymph node-like structure that typically forms at sites of chronic inflammation and is involved in adaptive immune responses. Its occurrence in cancer is sporadically documented and its role and clinical relevance is largely unknown. EXPERIMENTAL DESIGN The occurrence of TLT, the correlation with TILs, and the clinical relevance were evaluated retrospectively, in a cohort study involving a consecutive series of 351 patients with stage II and III colorectal cancer. The role of TLT in lymphocyte recruitment was assessed in a preclinical model of colorectal cancer. RESULTS In both human colorectal cancer and in a murine model of colorectal cancer, we identified organized TLT, highly vascularized (including high endothelial venules), and correlated with the density of CD3(+) TILs. Intravenous injection in mice of GFP splenocytes resulted in homing of lymphocytes to TLT, suggesting an active role of TLT in the recruitment of lymphocytes to tumor areas. Accordingly, TLT density and TIL infiltration correlated and were coordinated in predicting better patient's outcome among patients with stage II colorectal cancer. CONCLUSIONS We provide evidence that TLT is associated with lymphocyte infiltration in colorectal cancer, providing a pathway of recruitment for TILs. TLT cooperates with TILs in a coordinated antitumor immune response, when identifying patients with low-risk early-stage colorectal cancer, thus, representing a novel prognostic biomarker for colorectal cancer.
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Affiliation(s)
- Giuseppe Di Caro
- Authors' Affiliations: Departments of Immunology and Inflammation; and Gastroenterology; Laboratory of Molecular Gastroenterology, Humanitas Clinical and Research Center, Rozzano; and Department of Biotechnologies and Translational Medicine, University of Milan, Milan, Italy
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548
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Galon J, Mlecnik B, Bindea G, Angell HK, Berger A, Lagorce C, Lugli A, Zlobec I, Hartmann A, Bifulco C, Nagtegaal ID, Palmqvist R, Masucci GV, Botti G, Tatangelo F, Delrio P, Maio M, Laghi L, Grizzi F, Asslaber M, D'Arrigo C, Vidal-Vanaclocha F, Zavadova E, Chouchane L, Ohashi PS, Hafezi-Bakhtiari S, Wouters BG, Roehrl M, Nguyen L, Kawakami Y, Hazama S, Okuno K, Ogino S, Gibbs P, Waring P, Sato N, Torigoe T, Itoh K, Patel PS, Shukla SN, Wang Y, Kopetz S, Sinicrope FA, Scripcariu V, Ascierto PA, Marincola FM, Fox BA, Pagès F. Towards the introduction of the 'Immunoscore' in the classification of malignant tumours. J Pathol 2014; 232:199-209. [PMID: 24122236 PMCID: PMC4255306 DOI: 10.1002/path.4287] [Citation(s) in RCA: 1006] [Impact Index Per Article: 100.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 09/25/2013] [Accepted: 09/26/2013] [Indexed: 02/06/2023]
Abstract
The American Joint Committee on Cancer/Union Internationale Contre le Cancer (AJCC/UICC) TNM staging system provides the most reliable guidelines for the routine prognostication and treatment of colorectal carcinoma. This traditional tumour staging summarizes data on tumour burden (T), the presence of cancer cells in draining and regional lymph nodes (N) and evidence for distant metastases (M). However, it is now recognized that the clinical outcome can vary significantly among patients within the same stage. The current classification provides limited prognostic information and does not predict response to therapy. Multiple ways to classify cancer and to distinguish different subtypes of colorectal cancer have been proposed, including morphology, cell origin, molecular pathways, mutation status and gene expression-based stratification. These parameters rely on tumour-cell characteristics. Extensive literature has investigated the host immune response against cancer and demonstrated the prognostic impact of the in situ immune cell infiltrate in tumours. A methodology named ‘Immunoscore’ has been defined to quantify the in situ immune infiltrate. In colorectal cancer, the Immunoscore may add to the significance of the current AJCC/UICC TNM classification, since it has been demonstrated to be a prognostic factor superior to the AJCC/UICC TNM classification. An international consortium has been initiated to validate and promote the Immunoscore in routine clinical settings. The results of this international consortium may result in the implementation of the Immunoscore as a new component for the classification of cancer, designated TNM-I (TNM-Immune). © 2013 The Authors. Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Jérôme Galon
- INSERM, U872, Laboratory of Integrative Cancer Immunology, Paris, France; Université Paris Descartes, Paris, France; Centre de Recherche des Cordeliers, Université Pierre et Marie Curie Paris 6, France
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549
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Ichimura T, Morikawa T, Kawai T, Nakagawa T, Matsushita H, Kakimi K, Kume H, Ishikawa S, Homma Y, Fukayama M. Prognostic Significance of CD204-Positive Macrophages in Upper Urinary Tract Cancer. Ann Surg Oncol 2014; 21:2105-12. [DOI: 10.1245/s10434-014-3503-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Indexed: 12/22/2022]
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550
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Chang S, Kohrt H, Maecker HT. Monitoring the immune competence of cancer patients to predict outcome. Cancer Immunol Immunother 2014; 63:713-9. [PMID: 24487923 DOI: 10.1007/s00262-014-1521-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 01/15/2014] [Indexed: 12/22/2022]
Abstract
A new era of cancer immunotherapy has brought not only successful cancer vaccines but also immunomodulators, such as those that target checkpoint blockade in order to induce endogenous host immune responses. However, the immune system of cancer patients can be compromised through multiple means, including immune suppression by the tumor and by prior therapies such as chemotherapy and radiation. Therefore, a comprehensive means of assessing patient immunocompetence would seem helpful for determining whether patients are ready to benefit from immunotherapy, and perhaps even which immunotherapy might be most appropriate for them. Unfortunately, there are no standardized tests for immune competence, nor is there agreement on what to measure and what will be predictive of outcome. In this review, we will discuss the technologies and assays that might be most useful for this purpose. We argue for a comprehensive approach that should maximize the chances of developing predictive biomarkers for eventual clinical use.
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Affiliation(s)
- Serena Chang
- Institute for Immunity, Transplantation, and Infection, Stanford University School of Medicine, Fairchild Science Building, 299 Campus Drive, Stanford, CA, 94305-5124, USA
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