151
|
Tarhini AA, Eads JR, Moore KN, Tatard-Leitman V, Wright J, Forde PM, Ferris RL. Neoadjuvant immunotherapy of locoregionally advanced solid tumors. J Immunother Cancer 2022; 10:jitc-2022-005036. [PMID: 35973745 PMCID: PMC9386211 DOI: 10.1136/jitc-2022-005036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2022] [Indexed: 11/25/2022] Open
Abstract
Definitive management of locoregionally advanced solid tumors presents a major challenge and often consists of a combination of surgical, radiotherapeutic and systemic therapy approaches. Upfront surgical treatment with or without adjuvant radiotherapy carries the risks of significant morbidities and potential complications that could be lasting. In addition, these patients continue to have a high risk of local or distant disease relapse despite the use of standard adjuvant therapy. Preoperative neoadjuvant systemic therapy has the potential to significantly improve clinical outcomes, particularly in this era of expanding immunotherapeutic agents that have transformed the care of patients with metastatic/unresectable malignancies. Tremendous progress has been made with neoadjuvant immunotherapy in the treatment of several locoregionally advanced resectable solid tumors leading to ongoing phase 3 trials and change in clinical practice. The promise of neoadjuvant immunotherapy has been supported by the high pathologic tumor response rates in early trials as well as the durability of these responses making cure a more achievable potential outcome compared with other forms of systemic therapy. Furthermore, neoadjuvant studies allow the assessment of radiologic and pathological responses and the access to biospecimens before and during systemic therapy. Pathological responses may guide future treatment decisions, and biospecimens allow the conduct of mechanistic and biomarker studies that may guide future drug development. On behalf of the National Cancer Institute Early Drug Development Neoadjuvant Immunotherapy Working Group, this article summarizes the current state of neoadjuvant immunotherapy of solid tumors focusing primarily on locoregionally advanced melanoma, gynecologic malignancies, gastrointestinal malignancies, non-small cell lung cancer and head and neck cancer including recent advances and our expert recommendations related to future neoadjuvant trial designs and associated clinical and translational research questions.
Collapse
Affiliation(s)
- Ahmad A Tarhini
- Cutaneous Oncology and Immunology, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida Morsani College of Medicine, Tampa, Florida, USA
| | - Jennifer R Eads
- Medicine, University of Pennsylvania Abramson Cancer Center, Philadelphia, Pennsylvania, USA
| | - Kathleen N Moore
- Gynecologic Oncology, The University of Oklahoma Stephenson Cancer Center, Oklahoma City, Oklahoma, USA
| | | | - John Wright
- National Cancer Institute, Bethesda, Maryland, USA
| | - Patrick M Forde
- Oncology, Johns Hopkins University Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
| | - Robert L Ferris
- Otolaryngology and Immunology, University of Pittsburgh & UPMC Hillman Cancer Center, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
152
|
Park S, An J, Ha SY, Nam S, Kim JH. Immune signature as a potential marker for predicting response to immunotherapy in obesity-associated colorectal cancer. J Gastroenterol Hepatol 2022; 37:1579-1587. [PMID: 35680621 DOI: 10.1111/jgh.15909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 05/23/2022] [Accepted: 05/30/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND AIM It remains unclear whether immunotherapy, which is not generally considered for microsatellite stable (MSS) colorectal cancer (CRC), can be used to effectively treat select CRC patients. We investigated the feasibility of obesity-associated MSS CRC patients for immunotherapy based on genomic alterations. METHODS We evaluated differences in genomic alteration types and immune signatures between obese and non-obese patients with MSS CRC. We performed genomic analyses using 434 CRC patients from The Cancer Genome Atlas (TCGA). Patients with MSS CRC were stratified into subgroups based on their BMI and numbers of nonsynonymous single nucleotide variants (nsSNVs) and frameshift insertions and deletions (fs INDELs) using machine learning. RESULTS The obese subgroup showed higher incidences of single nucleotide variants (SNV) and insertions and deletions (INDELs) in comparison with healthy weight patients with MSS CRC. The subgroup, who had higher numbers of nsSNVs and fs INDLEs, exhibited increased immune signatures, increased number of SNV-derived neoantigens, and had up-regulated two immune checkpoint genes in comparison with healthy weight patients with MSS CRC, reflecting interactions between the cancer genome and immune system. CONCLUSIONS This study suggests that immunotherapy may be suitable for some obesity-associated CRC patients.
Collapse
Affiliation(s)
- Sungjin Park
- Department of Genome Medicine and Science, AI Convergence Center for Genome Medicine, Gachon Institute of Genome Medicine and Science, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Jungsuk An
- Department of Pathology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Seung Yeon Ha
- Department of Pathology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Seungyoon Nam
- Department of Genome Medicine and Science, AI Convergence Center for Genome Medicine, Gachon Institute of Genome Medicine and Science, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea.,Department of Health Sciences and Technology, Gachon Advanced Institute for Health Sciences and Technology (GAIHST), Gachon University, Incheon, Republic of Korea
| | - Jung Ho Kim
- Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea.,Gachon Medical Research Institute, Gachon University Gil Medical Center, Incheon, Republic of Korea
| |
Collapse
|
153
|
Kubo S, Nagano H, Tsujie M, Seo S, Gotoh K, Wada H, Nakashima S, Ioka T. Microsatellite instability in patients with hepato-biliary-pancreatic malignancies in clinical practice (KHBO 1903). Int J Clin Oncol 2022; 27:1340-1347. [PMID: 35718824 DOI: 10.1007/s10147-022-02187-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 05/05/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND This study aimed to determine the prevalence of microsatellite instability (MSI)-high status in hepato-biliary-pancreatic malignancies in clinical practice and the clinical characteristics of and therapeutic results of pembrolizumab on patients with MSI-high cancers. METHODS The subjects were 283 patients who had undergone MSI tests for unresectable, metastatic hepato-biliary-pancreatic malignancies at seven hospitals. The tests were polymerase chain reaction fragment analyses using the microsatellite markers consisting of BAT25, BAT26, NR21, NR24, and MONO27. Formalin-fixed, paraffin-embedded blocks, prepared according to the guidelines of the Japan Society of Pathology were used within 4 years after sampling. There were 13 patients with cancers high in MSI, including eight patients receiving pembrolizumab treatment. The clinical characteristics of these patients and therapeutic outcomes of their pembrolizumab treatment were investigated. RESULTS MSI-high was detected in 13 (4.6%) of the 283 patients with hepato-biliary-pancreatic malignancies. None of these 13 patients had been diagnosed with Lynch syndrome. Of the Eight patients receiving pembrolizumab, a complete response was observed in three patients, a partial response in one patient, and stable disease in three patients. The objective response rate was 50% and the disease control rate was 87.5%. CONCLUSION MSI-high was detected in 4.6% of patients with hepato-biliary-pancreatic malignancies. There was a 50% objective response rate to pembrolizumab treatment for MSI-high cancers. The evaluation of MSI status by the current method using appropriately prepared tissue samples was to be a reliable and accurate approach to both the determination of MSI status and estimation of the effectiveness of pembrolizumab.
Collapse
Affiliation(s)
- Shoji Kubo
- Department of Hepato-Biliary-Pancreatic Surgery, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan.
| | - Hiroaki Nagano
- Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1 MinamiKogushi, Ube, Yamaguchi, 755-8505, Japan
| | - Masanori Tsujie
- Department of Surgery, Osaka Rosai Hospital, 1179-3 Nagasonecho, Kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Satoru Seo
- Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawaharacho Shogoin Sakyo-ku, Kyoto, 6068507, Japan
| | - Kunihito Gotoh
- Department of Surgery, National Hospital Organization Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka, 540-0006, Japan
| | - Hiroshi Wada
- Department of Surgery, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Shinsuke Nakashima
- Department of Surgery, Higashiosaka City Medical Center, 3-4-5 Nishiiwata, Higashiosaka, 578-8588, Japan
| | - Tatsuya Ioka
- Department of Oncology Center, Yamaguchi University Hospital, 1-1-1 MinamiKogushi, Ube, Yamaguchi, 755-8505, Japan
| |
Collapse
|
154
|
O'Malley DM, Bariani GM, Cassier PA, Marabelle A, Hansen AR, De Jesus Acosta A, Miller WH, Safra T, Italiano A, Mileshkin L, Amonkar M, Yao L, Jin F, Norwood K, Maio M. Health-related quality of life with pembrolizumab monotherapy in patients with previously treated advanced microsatellite instability high/mismatch repair deficient endometrial cancer in the KEYNOTE-158 study. Gynecol Oncol 2022; 166:245-253. [PMID: 35835611 DOI: 10.1016/j.ygyno.2022.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Pembrolizumab demonstrated a clinically meaningful objective response rate in patients with previously treated, advanced MSI-H/dMMR endometrial cancer in the multicohort phase 2 KEYNOTE-158 study (ClinicalTrials.gov, NCT02628067). We present health-related quality of life (HRQoL) results for these patients. METHODS This analysis included patients from cohorts D (endometrial cancer with any MSI status) and K (any MSI-H/dMMR solid tumor except colorectal) who had previously treated, advanced MSI-H/dMMR endometrial cancer. Patients received pembrolizumab 200 mg Q3W for 35 cycles. EORTC QLQ-C30 and EQ-5D-3L questionnaires were administered at baseline, at regular intervals during treatment, and 30 days after treatment discontinuation. Pre-specified exploratory analyses included changes from baseline to week 9 in QLQ-C30 global health status (GHS)/QoL and EQ-5D-3L visual analog scale (VAS) score for all patients and by best overall response. RESULTS 84 of 90 enrolled patients completed ≥1 HRQoL questionnaire and were included in the analysis. QLQ-C30 and EQ-5D-3L compliance rates were 90% and 94%, respectively, at baseline, and 92% and 93% at week 9. Mean (95% CI) QLQ-C30 GHS/QoL scores improved from baseline to week 9 by 6.08 (0.71-11.46) points in the overall population, with greater improvement in patients who achieved complete or partial response (11.67 [5.33-18.00]-point increase). Mean (95% CI) EQ-5D-3L VAS scores improved by 6.00 (2.25-9.75) points in the overall population and 9.11 (5.24-12.98) points in patients with CR/PR. CONCLUSIONS Pembrolizumab maintained or improved HRQoL in patients with previously treated, advanced MSI-H/dMMR endometrial cancer, further supporting efficacy and safety results from KEYNOTE-158 and pembrolizumab use in this setting.
Collapse
Affiliation(s)
- D M O'Malley
- The Ohio State University Wexner Medical Center and The James Comprehensive Cancer Center, Columbus, OH, USA. David.O'
| | - G M Bariani
- Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, São Paulo, Brazil.
| | | | - A Marabelle
- Gustave Roussy, Institut National de la Santé et de la Recherche Médicale U1015 & CIC1428, Université Paris Saclay, Villejuif, France.
| | - A R Hansen
- Princess Margaret Cancer Centre, Toronto, ON, Canada.
| | - A De Jesus Acosta
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA.
| | - W H Miller
- Segal Cancer Centre, Jewish General Hospital, Rossy Cancer Network, McGill University, Montreal, QC, Canada.
| | - T Safra
- Tel Aviv Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - A Italiano
- Early Phase Trials Unit, Institut Bergonié and Faculty of Medicine, University of Bordeaux, Bordeaux, France.
| | - L Mileshkin
- Peter MacCallum Cancer Centre and the Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia.
| | | | - L Yao
- Merck & Co., Inc., Rahway, NJ, USA.
| | - F Jin
- Merck & Co., Inc., Rahway, NJ, USA.
| | | | - M Maio
- University of Siena and Center for Immuno-Oncology, Department of Oncology, University Hospital, Siena, Italy.
| |
Collapse
|
155
|
Martelli V, Pastorino A, Sobrero AF. Prognostic and predictive molecular biomarkers in advanced colorectal cancer. Pharmacol Ther 2022; 236:108239. [PMID: 35780916 DOI: 10.1016/j.pharmthera.2022.108239] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 06/21/2022] [Accepted: 06/27/2022] [Indexed: 10/17/2022]
Abstract
The revolution of precision medicine has produced unprecedented seismic shifts in the treatment paradigm of advanced cancers. Among the major killers, colorectal cancer (CRC) is far behind the others. In fact, the great successes obtained in breast, NSCLC, melanoma, and genitourinary tract tumors have been observed only in fewer than 5 % metastatic colorectal cancer (mCRC): those with the mismatch repair deficiency (dMMR), a well-known predictive factor for to the outstanding efficacy of checkpoint inhibitors (CPI). The treatment of the remaining vast majority mCRC patients is still based upon only two molecular determinants: the RAS and BRAF mutational status. New promising biomarkers include HER2, tumor mutational burden (TMB) for its possible implications on CPI efficacy, and the extremely rare NTRK fusions. The Consensus Molecular Subtypes classification (CMS) is a good example of the efforts to combine different molecular features of this disease, although its relevance in clinical practice is still under investigation. In this Review, we focus on all these prognostic and predictive biomarkers, analyzing data from the most important clinical trials of the last years. We also try to rank them according to their prognostic and predictive power.
Collapse
Affiliation(s)
- Valentino Martelli
- Medical Oncology Unit 1, Ospedale Policlinico San Martino - IRCCS, Largo Rosanna Benzi 10, 16132 Genoa, Italy
| | - Alessandro Pastorino
- Medical Oncology Unit 1, Ospedale Policlinico San Martino - IRCCS, Largo Rosanna Benzi 10, 16132 Genoa, Italy
| | - Alberto F Sobrero
- Medical Oncology Unit 1, Ospedale Policlinico San Martino - IRCCS, Largo Rosanna Benzi 10, 16132 Genoa, Italy.
| |
Collapse
|
156
|
Tsumura T, Doi K, Marusawa H. Precision Medicine of Hepatobiliary and Pancreatic Cancers: Focusing on Clinical Trial Outcomes. Cancers (Basel) 2022; 14:cancers14153674. [PMID: 35954337 PMCID: PMC9367472 DOI: 10.3390/cancers14153674] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/23/2022] [Accepted: 07/23/2022] [Indexed: 02/04/2023] Open
Abstract
Tumor-agnostic precision medicine employing comprehensive genome profiling (CGP) and using next-generation sequencing (NGS) has been progressing recently. This review focuses on precision medicine for advanced unresectable hepatobiliary and pancreatic cancers. In this paper, for biliary tract cancer (BTC), therapies that target several regulators of cancer cell growth, including isocitrate dehydrogenase 1 (IDH1), fibroblast growth factor receptor 2 (FGFR2) fusion, proto-oncogene B-Raf (BRAF), and human epidermal growth factor receptor 2 (HER2) alterations, are reviewed. For pancreatic ductal adenocarcinoma (PDAC), therapies for Kirsten rat sarcoma virus (KRAS) gene mutation G12C, neuregulin (NRG)1, and breast cancer type 1 and 2 susceptibility (BRCA1/2), gene alterations are summarized. On the other hand, precision medicine targets were not established for hepatocellular carcinoma (HCC), although telomerase reverse transcriptase (TERT), tumor protein P53 (TP53), and Wnt/β catenin signaling alterations have been recognized as HCC driver oncogenes. Tumor-agnostic therapies for microsatellite instability-high (MSI-H) and neurotropic tyrosine receptor kinase (NTRK) fusion cancers effectively treat biliary and pancreatic cancers. Precision medicine methods developed using NGS of circulating tumor DNA (ctDNA) and utilizing a liquid biopsy technique are discussed.
Collapse
Affiliation(s)
- Takehiko Tsumura
- Department of Medical Oncology, Osaka Red Cross Hospital, Osaka 543-8555, Japan;
- Department of Gastroenterology, Osaka Red Cross Hospital, Osaka 543-8555, Japan;
- Correspondence: ; Tel.: +81-6-6774-5111; Fax: +81-6-6774-5131
| | - Keitaro Doi
- Department of Medical Oncology, Osaka Red Cross Hospital, Osaka 543-8555, Japan;
| | - Hiroyuki Marusawa
- Department of Gastroenterology, Osaka Red Cross Hospital, Osaka 543-8555, Japan;
| |
Collapse
|
157
|
Chen K, Liang B, Ma W, Wan G, Chen B, Lu C, Luo Y, Gu X. Immunological and prognostic analysis of PSENEN in low-grade gliomas: An immune infiltration-related prognostic biomarker. Front Mol Neurosci 2022; 15:933855. [PMID: 35966015 PMCID: PMC9366120 DOI: 10.3389/fnmol.2022.933855] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 07/04/2022] [Indexed: 11/27/2022] Open
Abstract
Metformin is widely used in the treatment of type 2 diabetes (T2D) and plays a role in antitumor and antiobesity processes. A recent study identified its direct molecular target, PEN2 (PSENEN). PSENEN is the minimal subunit of the multiprotein complex γ-secretase, which promotes the differentiation of oligodendrocyte progenitors into astrocytes in the central nervous system. This study was mainly based on gene expression data and clinical data from the TCGA and CGGA databases. Analysis of differential expression of PSENEN between tissues from 31 cancers and paracancerous tissues revealed that it had high expression levels in most cancers except 2 cancers. Using univariate Cox regression analysis and Kaplan-Meier survival analysis, a high expression level of PSENEN was shown to be a risk factor in low-grade gliomas (LGG). Gene ontology (GO) and kyoto encyclopedia of genes and genomes (KEGG) analyses indicated that PSENEN is widely involved in immune-related signaling pathways in LGG. PSENEN expression level was significantly associated with TMB, MSI, tumor stemness index, and the expression levels of immunomodulatory genes in LGG. Finally, immune infiltration analysis revealed that PSENEN level was associated with the presence of various immune infiltrating cells, among which PSENEN was strongly associated with the presence of M2 macrophages and played a synergistic pro-cancer role. In conclusion, PSENEN may partially influence prognosis by modulating immune infiltration in patients with LGG, and PSENEN may be a candidate prognostic biomarker for determining prognosis associated with immune infiltration in LGG.
Collapse
Affiliation(s)
- Kaijie Chen
- Shanghai Key Laboratory of Molecular Imaging, Zhoupu Hospital, Shanghai University of Medicine and Health Sciences, Shanghai, China
- School of Health Science and Engineering, The University of Shanghai for Science and Technology, Shanghai, China
| | - Beibei Liang
- Shanghai Key Laboratory of Molecular Imaging, Zhoupu Hospital, Shanghai University of Medicine and Health Sciences, Shanghai, China
- School of Health Science and Engineering, The University of Shanghai for Science and Technology, Shanghai, China
- School of Pharmacy, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Wenhao Ma
- Shanghai Key Laboratory of Molecular Imaging, Zhoupu Hospital, Shanghai University of Medicine and Health Sciences, Shanghai, China
- School of Health Science and Engineering, The University of Shanghai for Science and Technology, Shanghai, China
| | - Guoqing Wan
- Shanghai Key Laboratory of Molecular Imaging, Zhoupu Hospital, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Bing Chen
- Department of Neurosurgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Changlian Lu
- Shanghai Key Laboratory of Molecular Imaging, Zhoupu Hospital, Shanghai University of Medicine and Health Sciences, Shanghai, China
- *Correspondence: Changlian Lu,
| | - Yuzhou Luo
- Business School, Guilin University of Technology, Guilin, China
- Yuzhou Luo,
| | - Xuefeng Gu
- Shanghai Key Laboratory of Molecular Imaging, Zhoupu Hospital, Shanghai University of Medicine and Health Sciences, Shanghai, China
- School of Health Science and Engineering, The University of Shanghai for Science and Technology, Shanghai, China
- School of Pharmacy, Shanghai University of Medicine and Health Sciences, Shanghai, China
- Xuefeng Gu,
| |
Collapse
|
158
|
Clinicopathological Significance and Prognostic Values of Long Noncoding RNA BCYRN1 in Cancer Patients: A Meta-Analysis and Bioinformatics Analysis. JOURNAL OF ONCOLOGY 2022; 2022:8903265. [PMID: 35874631 PMCID: PMC9303157 DOI: 10.1155/2022/8903265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 06/14/2022] [Indexed: 12/24/2022]
Abstract
Background Although combination therapies have substantially improved the clinical outcomes of cancer patients, the prognosis and early diagnosis remain unsatisfactory. As a result, it is critical to look for novel indicators linked to cancer. Despite a number of recent studies indicating that the lncRNA brain cytoplasmic RNA1(BCYRN1) may be a potential predictive biomarker in cancer patients, BCYRN1's prognostic value is still being debated. Methods We utilized PubMed, Embase, Web of Science, and the Cochrane Library to search for studies related to BCYRN1 until October 2021. Valid data were extracted after determining the articles according to the inclusion and exclusion criteria, and forest plots were made using Stata software. We used hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals to evaluate the relationship between abnormal BCYRN1 expression and patient prognosis and clinicopathological characteristics. Results Meta-analysis revealed that increased BCYRN1 expression was associated with both overall tumor survival (OS; HR = 1.84, 95% CI 1.51–2.25, p < 0.0001) and disease-free survival (DFS; HR = 1.65, 95% CI 1.20–2.26, p=0.002). Furthermore, a strong association was discovered between increased BCYRN1 expression and tumor invasion depth (OR = 2.11, 95% CI 1.49–2.99, p=0.000), clinical stage (OR = 2.52, 95% CI 1.18–5.37, p=0.017), and distant tumor metastasis (OR = 4.19, 95% CI 1.45–12.05, p=0.008). Conclusions We found that high BCYRN1 expression was associated with poor survival prognosis and aggressive clinicopathological characteristics in various cancers, indicating that it is a potential prognostic indicator as well as a therapeutic target. Further research is needed on pan-cancer cohorts to determine the clinical relevance of BCYRN1 in distinct cancer types.
Collapse
|
159
|
A 25-gene panel predicting the benefits of immunotherapy in head and neck squamous cell carcinoma. Int Immunopharmacol 2022; 110:108846. [PMID: 35816946 DOI: 10.1016/j.intimp.2022.108846] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 04/17/2022] [Accepted: 05/06/2022] [Indexed: 11/24/2022]
Abstract
Tumor mutation burden high (TMB-H) is widely used in the guidance of immune checkpoint blocking (ICB) therapy for head and neck squamous cell carcinoma (HNSCC) patients. However, a few patients still had a poor response. Therefore, it is necessary to investigate a better model to guide ICB therapy. We constructed a genomic mutation model conducive to ICB therapy using an available HNSCC dataset. Moreover, treatment procedures for patients with HNSCC from our internal cohort confirmed this model. Here, a genomic mutation signature based on a list of 25 candidate genes that are favorable for immunotherapy was established. Patients with combined mutation had a respectable clinical outcome under ICB treatment. Notably, compared with patients who obtained TMB-H (TMB ≥ 10, but did not have combined mutation), those patients with TMB-L (TMB < 10) and combined mutation acquired remarkably beneficial overall survival. Moreover, the combined mutation signature predicting the survival status of patients was superior to TMB, with a Youden index of 0.55. Furthermore, higher immune cell infiltration levels, more active cancer-immunity cycle activities and immune response pathways were observed in patients with combined mutation. Finally, our internal cohort further confirmed that combined mutated patients can benefit from ICB therapy rather than any other patients.
Collapse
|
160
|
Analysis of CFTR gene expression as an immunological and prognostic biomarker in pan-cancers. Comput Biol Med 2022; 146:105614. [DOI: 10.1016/j.compbiomed.2022.105614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 11/23/2022]
|
161
|
Nebot-Bral L, Hollebecque A, Yurchenko AA, de Forceville L, Danjou M, Jouniaux JM, Rosa RCA, Pouvelle C, Aoufouchi S, Vuagnat P, Smolenschi C, Colomba E, Leary A, Marabelle A, Scoazec JY, Cassard L, Nikolaev S, Chaput N, Kannouche P. Overcoming resistance to αPD-1 of MMR-deficient tumors with high tumor-induced neutrophils levels by combination of αCTLA-4 and αPD-1 blockers. J Immunother Cancer 2022; 10:e005059. [PMID: 35896284 PMCID: PMC9335020 DOI: 10.1136/jitc-2022-005059] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Clinical studies have highlighted the efficacy of anti-programmed death 1 (αPD-1) monoclonal antibodies in patients with DNA mismatch repair-deficient (MMRD) tumors. However, the responsiveness of MMRD cancers to αPD-1 therapy is highly heterogeneous, and the origins of this variability remain not fully understood. METHODS 4T1 and CT26 mouse tumor cell lines were inactivated for the MMRD gene Msh2, leading to a massive accumulation of mutations after serial passages of cells. Insertions/deletion events and mutation load were evaluated by whole exome sequencing. Mice bearing highly mutated MMRD tumor or parental tumors were treated with αPD-1 and tumor volume was monitored. Immune cell type abundance was dynamically assessed in the tumor microenvironment and the blood by flow cytometry. Neutrophils were depleted in mice using αLY6G antibody, and regulatory T (Treg) cell population was reduced with αCD25 or anti-cytotoxic T-lymphocytes-associated protein 4 (αCTLA-4) antibodies. Patients with MMRD tumors treated with immune checkpoint blockade-based therapy were retrospectively identified and neutrophil-to-lymphocyte ratio (NLR) was evaluated and examined for correlation with clinical benefit. RESULTS By recapitulating mismatch repair deficiency in different mouse tumor models, we revealed that elevated circulating tumor-induced neutrophils (TIN) in hypermutated MMRD tumors hampered response to αPD-1 monotherapy. Importantly, depletion of TIN using αLy-6G antibody reduced Treg cells and restored αPD-1 response. Conversely, targeting Treg cells by αCD25 or αCTLA-4 antibodies limited peripheral TIN accumulation and elicited response in αPD-1-resistant MMRD tumors, highlighting a crosstalk between TIN and Treg cells. Thus, αPD-1+αCTLA-4 combination overcomes TIN-induced resistance to αPD-1 in mice bearing MMRD tumors. Finally, in a cohort of human (high microsatellite instability)/MMRD tumors we revealed that early on-treatment change in the NLR ratio may predict resistance to αPD-1 therapy. CONCLUSIONS TIN countered αPD-1 efficacy in MMRD tumors. Since αCTLA-4 could restrict TIN accumulation, αPD-1+αCTLA-4 combination overcomes αPD-1 resistance in hosts with hypermutated MMRD tumors displaying abnormal neutrophil accumulation.
Collapse
Affiliation(s)
- Laetitia Nebot-Bral
- CNRS-UMR9019, Equipe labellisée Ligue Contre le Cancer, Gustave Roussy, Université Paris-Saclay, F-94805 Villejuif, France
| | - Antoine Hollebecque
- Département d’Innovation Thérapeutique et d’Essais Précoces, Gustave Roussy, F-94805, Villejuif, France
| | - Andrey A Yurchenko
- INSERM-U981, Gustave Roussy, Université Paris-Saclay, F-94805 Villejuif, France
| | - Louise de Forceville
- CNRS-UMR9019, Equipe labellisée Ligue Contre le Cancer, Gustave Roussy, Université Paris-Saclay, F-94805 Villejuif, France
| | - Mathieu Danjou
- CNRS-UMR9019, Equipe labellisée Ligue Contre le Cancer, Gustave Roussy, Université Paris-Saclay, F-94805 Villejuif, France
| | - Jean-Mehdi Jouniaux
- Laboratoire d'Immunomonitoring en Oncologie, Unité US-23 INSERM, UMS-3655 CNRS, Gustave Roussy, F-94805 Villejuif, France
| | - Reginaldo C A Rosa
- CNRS-UMR9019, Equipe labellisée Ligue Contre le Cancer, Gustave Roussy, Université Paris-Saclay, F-94805 Villejuif, France
| | - Caroline Pouvelle
- CNRS-UMR9019, Equipe labellisée Ligue Contre le Cancer, Gustave Roussy, Université Paris-Saclay, F-94805 Villejuif, France
| | - Said Aoufouchi
- CNRS-UMR9019, Equipe labellisée Ligue Contre le Cancer, Gustave Roussy, Université Paris-Saclay, F-94805 Villejuif, France
| | - Perrine Vuagnat
- Département d’Innovation Thérapeutique et d’Essais Précoces, Gustave Roussy, F-94805, Villejuif, France
| | - Cristina Smolenschi
- Département de médecine oncologique, Gustave Roussy, F-94805 Villejuif, France
| | - Emeline Colomba
- Département de médecine oncologique, Gustave Roussy, F-94805 Villejuif, France
| | - Alexandra Leary
- Département de médecine oncologique, Gustave Roussy, F-94805 Villejuif, France
| | - Aurelien Marabelle
- Département d’Innovation Thérapeutique et d’Essais Précoces, Gustave Roussy, F-94805, Villejuif, France
- Faculté de Médecine, Université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France
| | - Jean-Yves Scoazec
- Faculté de Médecine, Université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France
- Département de Biologie et pathologie médicales, Gustave Roussy, F-94805 Villejuif, France
| | - Lydie Cassard
- Laboratoire d'Immunomonitoring en Oncologie, Unité US-23 INSERM, UMS-3655 CNRS, Gustave Roussy, F-94805 Villejuif, France
| | - Sergey Nikolaev
- INSERM-U981, Gustave Roussy, Université Paris-Saclay, F-94805 Villejuif, France
| | - Nathalie Chaput
- CNRS-UMR9019, Equipe labellisée Ligue Contre le Cancer, Gustave Roussy, Université Paris-Saclay, F-94805 Villejuif, France
- Laboratoire d'Immunomonitoring en Oncologie, Unité US-23 INSERM, UMS-3655 CNRS, Gustave Roussy, F-94805 Villejuif, France
- Faculté de Pharmacie, Université Paris-Saclay, 91400 Orsay, France
| | - Patricia Kannouche
- CNRS-UMR9019, Equipe labellisée Ligue Contre le Cancer, Gustave Roussy, Université Paris-Saclay, F-94805 Villejuif, France
| |
Collapse
|
162
|
Takahashi H, Watanabe H, Hashimura M, Matsumoto T, Yokoi A, Nakagawa M, Ishibashi Y, Ito T, Ohhigata K, Saegusa M. A combination of stromal PD-L1 and tumoral nuclear β-catenin expression as an indicator of colorectal carcinoma progression and resistance to chemoradiotherapy in locally advanced rectal carcinoma. JOURNAL OF PATHOLOGY CLINICAL RESEARCH 2022; 8:458-469. [PMID: 35762092 PMCID: PMC9353658 DOI: 10.1002/cjp2.285] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/18/2022] [Accepted: 06/02/2022] [Indexed: 11/10/2022]
Abstract
Programmed cell death-1 (PD-1) and its ligand (PD-L1) are significant mediators of immune suppression in the tumor microenvironment. We focused on the immunological impact of PD-1/PD-L1 signaling during tumor progression in colorectal carcinoma (CRC) and its association with resistance to neoadjuvant chemoradiotherapy (NCRT) in locally advanced rectal carcinoma (LAd-RC). Histopathological and immunohistochemical analyses of 100 CRC cases (including 34 RC) without NCRT and 109 NCRT-treated LAd-RC cases were performed. Membranous tumoral PD-L1 expression was identified in 9 of 100 (9%) CRC cases, including 1 of 34 (2.9%) RC cases, but PD-L1 immunopositivity was not associated with any clinicopathological factors, with the exception of deficient mismatch repair (dMMR) status. In contrast, stromal PD-L1+ immune cells, which frequently exhibited coexpression of PD-1 and CD8 markers, were significantly correlated with tumor vessel invasion, nuclear β-catenin+ tumor budding cancer stem cell (CSC)-like features, and unfavorable prognosis. In the LAd-RC cases, stromal CD8+ (but not PD-L1+) immune cell infiltration in pretreatment-biopsied samples was significantly and positively associated with therapeutic efficacy. After NCRT, tumoral PD-L1 expression was observed in only 2 of 83 (2.4%) tumors, independent of dMMR status, whereas high stromal PD-L1+ and tumoral nuclear β-catenin positivity were significantly linked to a poor response to NCRT and high tumor budding features. In addition, high stromal PD-L1 immunoreactivity was significantly associated with poorer overall survival. In conclusion, a combination of stromal PD-L1+ immune cells and nuclear β-catenin+ tumor budding may contribute to tumor progression in CRC and resistance to NCRT in LAd-RC, through formation of niche-like lesions that exhibit immune resistance and CSC properties.
Collapse
Affiliation(s)
- Hiroyuki Takahashi
- Department of Pathology, Kitasato University School of Medicine, Sagamihara, Japan.,Department of Pathology, Kitasato University School of Allied Health Science, Sagamihara, Japan
| | - Hirono Watanabe
- Department of Pathology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Miki Hashimura
- Department of Pathology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Toshihide Matsumoto
- Department of Pathology, Kitasato University School of Medicine, Sagamihara, Japan.,Department of Pathology, Kitasato University School of Allied Health Science, Sagamihara, Japan
| | - Ako Yokoi
- Department of Pathology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Mayu Nakagawa
- Department of Pathology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Yu Ishibashi
- Department of Pathology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Takashi Ito
- Department of Pathology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Kensuke Ohhigata
- Department of Pathology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Makoto Saegusa
- Department of Pathology, Kitasato University School of Medicine, Sagamihara, Japan
| |
Collapse
|
163
|
Association of PTPRT Mutations with Cancer Metastasis in Multiple Cancer Types. BIOMED RESEARCH INTERNATIONAL 2022; 2022:9386477. [PMID: 35789644 PMCID: PMC9250438 DOI: 10.1155/2022/9386477] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 05/21/2022] [Accepted: 05/30/2022] [Indexed: 11/18/2022]
Abstract
Metastasis is one of the characteristics of advanced cancer and the primary cause of cancer-related deaths from cancer, but the mechanism underlying metastasis is unclear, and there is a lack of metastasis markers. PTPRT is a protein-coding gene involved in both signal transduction and cellular adhesion. It is also known as a tumor suppressor gene that inhibits cell malignant proliferation by inhibiting the STAT3 pathway. Recent studies have reported that PTPRT is involved in the early metastatic seeding of colorectal cancer; however, the correlation between PTPRT and metastasis in other types of cancer has not been revealed. A combined analysis using a dataset from the genomics evidence neoplasia information exchange (GENIE) and cBioPortal revealed that PTPRT mutation is associated with poor prognosis in pan-cancer and non-small-cell lung cancer. The mutations of PTPRT or “gene modules” containing PTPRT are significantly enriched in patients with metastatic cancer in multiple cancers, suggesting that the PTPRT mutations serve as potential biomarkers of cancer metastasis.
Collapse
|
164
|
Lefler DS, Snook AE, Bashir B. Immune checkpoint inhibitors in luminal gastrointestinal malignancies: going beyond MSI-H/dMMR, TMB and PD-L1. Immunotherapy 2022; 14:885-902. [PMID: 35694998 DOI: 10.2217/imt-2022-0012] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
In luminal gastrointestinal tumors, immune checkpoint inhibitors (ICIs) targeting PD-1, PD-L1 and CTLA-4 have been investigated in multiple settings. The indications for these drugs are primarily dependent on specific biomarkers that imply immunogenicity: overexpression of PD-L1, tumor mutational burden, loss of mismatch repair proteins (dMMR) and/or high microsatellite instability status. Although these markers can be both predictive and prognostic, there is variability in how they are measured and used to guide therapies. Moreover, the use of ICIs can be further refined with a better understanding of the tumor microenvironment and interactions with other available therapies. The purpose of this review is to characterize luminal gastrointestinal tumors' responses to ICIs considering known predictive biomarkers and discuss emerging therapeutic approaches using ICIs.
Collapse
Affiliation(s)
- Daniel S Lefler
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA
| | - Adam E Snook
- Department of Pharmacology & Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA 19107, USA.,Department of Microbiology & Immunology, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Babar Bashir
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.,Department of Pharmacology & Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA 19107, USA
| |
Collapse
|
165
|
Hidaka Y, Arigami T, Osako Y, Desaki R, Hamanoue M, Takao S, Kirishima M, Ohtsuka T. Conversion surgery for microsatellite instability-high gastric cancer with a complete pathological response to pembrolizumab: a case report. World J Surg Oncol 2022; 20:193. [PMID: 35689267 PMCID: PMC9185925 DOI: 10.1186/s12957-022-02661-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 05/28/2022] [Indexed: 12/27/2022] Open
Abstract
Background Immune checkpoint inhibitors are reportedly effective in treating microsatellite instability (MSI)-high gastric cancer. There are a few case reports of conversion surgery (CS) with nivolumab but none with pembrolizumab. Herein, we describe a patient with MSI-high gastric cancer who was successfully treated with pembrolizumab and underwent CS with a pathological complete response. Case presentation A 69-year-old man was diagnosed with stage III gastric cancer (T3N2M0) based on contrast-enhanced computed tomography, which revealed a neoplastic lesion and enlarged perigastric lymph nodes in the gastric lesser curvature. The anterior superior lymph node of the common hepatic artery (CHA) was determined to be unresectable due to invasion of the pancreatic head and CHA. Histopathologically, the biopsied tissue showed moderately differentiated adenocarcinoma, then determined to be MSI-high. After three courses of mFOLFOX6 therapy, the patient was diagnosed with progressive disease. Since one course of paclitaxel plus ramucirumab therapy caused grade 3 fatigue, his second-line therapy was switched to pembrolizumab monotherapy. After three courses, the primary tumor and perigastric lymph nodes had shrunk, and it was determined as a partial response. The anterior superior lymph node of the CHA became resectable based on the improvement of infiltration of the pancreatic head and CHA due to shrinkage of the lymph node. Tumor markers remained low; hence, distal gastrectomy plus D2 lymphadenectomy was performed at the end of six courses. Anterior superior lymph node of the CHA was confirmed by intraoperative ultrasonography, and the resection was completed safely. The gross examination of the resected specimen revealed an ulcer scar at the primary tumor site. The histopathological examination showed no viable tumor cell remnants in the primary tumor, which had a grade 3 histological response, and resection margins were negative. The lymph nodes showed mucus retention only in the anterior superior lymph node of the CHA, indicating the presence of metastasis, but no viable tumor cells remained. The patient commenced 6 months of adjuvant pembrolizumab monotherapy 3 months after surgery. Twenty months after surgery, there was no evidence of recurrence. Conclusions Conversion surgery following pembrolizumab monotherapy has a potential utility for the treatment of MSI-high gastric cancer.
Collapse
Affiliation(s)
- Yoshifumi Hidaka
- Department of Surgery, Tanegashima Medical Center, 7463 Nishinoomote, Nishinoomote, Kagoshima, 891-3198, Japan.
| | - Takaaki Arigami
- Department of Onco-biological Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 9-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Yusaku Osako
- Department of Surgery, Tanegashima Medical Center, 7463 Nishinoomote, Nishinoomote, Kagoshima, 891-3198, Japan
| | - Ryosuke Desaki
- Department of Surgery, Tanegashima Medical Center, 7463 Nishinoomote, Nishinoomote, Kagoshima, 891-3198, Japan
| | - Masahiro Hamanoue
- Department of Surgery, Tanegashima Medical Center, 7463 Nishinoomote, Nishinoomote, Kagoshima, 891-3198, Japan
| | - Sonshin Takao
- Department of Surgery, Tanegashima Medical Center, 7463 Nishinoomote, Nishinoomote, Kagoshima, 891-3198, Japan
| | - Mari Kirishima
- Department of Pathology, Field of Oncology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Takao Ohtsuka
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical and Dental Science, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan
| |
Collapse
|
166
|
Song CH, Kim N, Nam RH, Choi SI, Jang JY, Kim JW, Na HY, Lee HN. Combination treatment with 17β-estradiol and anti-PD-L1 suppresses MC38 tumor growth by reducing PD-L1 expression and enhancing M1 macrophage population in MC38 colon tumor model. Cancer Lett 2022; 543:215780. [PMID: 35690286 DOI: 10.1016/j.canlet.2022.215780] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 05/20/2022] [Accepted: 06/05/2022] [Indexed: 11/28/2022]
Abstract
17β-estradiol (E2) is known to have a protective effect in colorectal cancer (CRC); thus, E2 may be effective for cancer immunotherapy in CRC. The aim of this study is to evaluate the effect of combination therapy with E2 and anti-programmed cell death receptor-1 ligand (PD-L1) antibodies, and the effects of sex and estrogen on colon tumor growth, PD-L1 expression, and tumor-associated cell populations in an MC38 colon tumor model. Male mice showed increased MC38 colon tumor growth and PD-L1 expression in tumor sections as well as higher proportion of cancer-associated fibroblasts (CD45-CD31-CD140a+), PD-L1-expressing tumor cells (CD45-CD274+) and tumor-associated macrophages (TAMs) (CD11b+F4/80+CD274+) compared to female mice. E2 treatment prior to MC38 injection significantly reduced these phenomena in male mice. Furthermore, co-treatment with E2 and anti-PD-L1 antibodies significantly inhibited MC38 tumor growth and reduced PD-L1-expressing cells in male mice compared to treatment with either E2 or anti-PD-L1 antibodies alone. Combination treatment with E2 and anti-PD-L1 decreased TAM population (CD11b+F4/80+) in the tumor mass while increasing M1 TMAs (CD11b+F4/80+CD86+). These results suggest that estrogen inhibits MC38 tumor growth by downregulating PD-L1 expression and regulating tumor-associated cell populations. Furthermore, estrogen boosted the effect of anti-PD-L1 antibody in the MC38 tumor model.
Collapse
Affiliation(s)
- Chin-Hee Song
- Departments of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, South Korea
| | - Nayoung Kim
- Departments of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, South Korea; Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, South Korea.
| | - Ryoung Hee Nam
- Departments of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, South Korea
| | - Soo In Choi
- Departments of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, South Korea
| | - Jae Young Jang
- Departments of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, South Korea
| | - Jin Won Kim
- Departments of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, South Korea
| | - Hee Young Na
- Pathology, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, South Korea
| | - Ha-Na Lee
- Laboratory of Immunology, Division of Biotechnology Review and Research-III, Office of Biotechnology Products, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD, 20993, USA
| |
Collapse
|
167
|
Pembrolizumab in Microsatellite Instability High or Mismatch Repair Deficient Cancers: Updated Analysis from the Phase 2 KEYNOTE-158 Study. Ann Oncol 2022; 33:929-938. [PMID: 35680043 DOI: 10.1016/j.annonc.2022.05.519] [Citation(s) in RCA: 138] [Impact Index Per Article: 69.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 04/21/2022] [Accepted: 05/29/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Pembrolizumab demonstrated durable antitumor activity in 233 patients with previously treated advanced microsatellite instability high (MSI-H) or mismatch repair deficient (dMMR) advanced solid tumors in the phase 2 multicohort KEYNOTE-158 (NCT02628067) study. Herein, we report safety and efficacy outcomes with longer follow-up for more patients with previously treated advanced MSI-H/dMMR noncolorectal cancers who were included in cohort K of the KEYNOTE-158 (NCT02628067) study. PATIENTS AND METHODS Eligible patients with previously treated advanced noncolorectal MSI-H/dMMR solid tumors, measurable disease per RECIST v1.1, and ECOG performance status of 0 or 1 received pembrolizumab 200 mg Q3W for 35 cycles or until disease progression or unacceptable toxicity. The primary endpoint was ORR per RECIST v1.1 by independent central radiologic review. RESULTS Three hundred and fifty-one patients with various tumor types were enrolled in KEYNOTE-158 cohort K. The most common tumor types were endometrial (22.5%), gastric (14.5%), and small intestine (7.4%). Median time from first dose to database cutoff (October 5, 2020) was 37.5 months (range, 0.2‒55.6 months). ORR among 321 patients in the efficacy population (patients who received ≥1 dose of pembrolizumab enrolled ≥6 months before the data cutoff date) was 30.8% (95% CI, 25.8‒36.2). Median duration of response was 47.5 months (range, 2.1+ to 51.1+ months). Median progression-free survival was 3.5 months (95% CI, 2.3‒4.2 months) and median overall survival was 20.1 months (95% CI, 14.1‒27.1 months). Treatment-related AEs occurred in 227 patients (64.7%). Grade 3‒4 treatment-related AEs occurred in 39 patients (11.1%); three had (0.9%) grade 5 treatment-related AEs (myocarditis, pneumonia, and Guillain-Barre syndrome, n=1 each). CONCLUSION Pembrolizumab demonstrated clinically meaningful and durable benefit, with high ORR of 30.8%, long median duration of response of 47.5 months, and manageable safety across a range of heavily pretreated, advanced MSI-H/dMMR noncolorectal cancers, providing support for use of pembrolizumab in this setting.
Collapse
|
168
|
Liu P, Wang X, Pan L, Han B, He Z. Prognostic Significance and Immunological Role of FBXO5 in Human Cancers: A Systematic Pan-Cancer Analysis. Front Immunol 2022; 13:901784. [PMID: 35720327 PMCID: PMC9203914 DOI: 10.3389/fimmu.2022.901784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/11/2022] [Indexed: 11/13/2022] Open
Abstract
F-box protein 5 (FBXO5), an essential subunit of the ubiquitin protein ligase complex, is increasingly recognized to exhibit important biological effects in regulating tumor occurrence and progression. The present research was intended to systematically investigate the latent roles of FBXO5 in prognosis and immunological function across cancers. Pan-cancer analyses of FBXO5 were performed based upon publicly available online databases, mainly including the Cancer Genome Atlas (TCGA), Genotype-Tissue Expression (GTEx), UCSC Xena, cBioPortal, and ImmuCellAI, revealing the possible relationships between FBXO5 and prognosis, DNA methylation, tumor microenvironment (TME), infiltration of immune cells, immune-related genes, immune checkpoints, tumor mutation burden (TMB), and microsatellite instability (MSI). The results suggested that FBXO5 was expressed at a high level in numerous tumor cell lines with significant upregulation in most cancers as opposed to normal tissues. Of note, elevated expression of FBXO5 was significantly related to an unfavorable prognosis in many cancer types. Furthermore, DNA methylation and TME were confirmed to display evident correlation with the expression of FBXO5 in several malignancies. Moreover, FBXO5 expression was remarkably positively correlated with the levels of infiltrating Treg cells and Tcm cells in most tumors, but negatively correlated with tumor-infiltrating CD8+ T cells, NK/NKT cells, and Th2 cells. Meanwhile, FBXO5 was demonstrated to be co-expressed with the genes encoding immune activating and suppressive factors, chemokines, chemokine receptors, and major histocompatibility complex (MHC). Immune checkpoints, TMB, and MSI were also overtly associated with FBXO5 dysregulation among diverse kinds of cancers. Additionally, the enrichment analyses showed close relationships between FBXO5 expression and the processes related to cell cycle and immune inflammatory response. These findings provided a detailed comprehension of the oncogenic function of FBXO5. Because of its crucial roles in cancer immunity and tumorigenesis, FBXO5 may serve as a novel prognostic indicator and immunotherapeutic target for various malignancies.
Collapse
Affiliation(s)
- Peng Liu
- Institute for Regenerative Medicine, Shanghai East Hospital, School of Life Sciences and Technology, Tongji University, Shanghai, China
- Shanghai Engineering Research Center of Stem Cells Translational Medicine, Shanghai, China
- Shanghai Institute of Stem Cell Research and Clinical Translation, Shanghai, China
| | - Xiaojuan Wang
- Department of Pharmacy, Minhang Hospital, Fudan University, Shanghai, China
| | - Lili Pan
- Institute for Regenerative Medicine, Shanghai East Hospital, School of Life Sciences and Technology, Tongji University, Shanghai, China
- Shanghai Engineering Research Center of Stem Cells Translational Medicine, Shanghai, China
- Shanghai Institute of Stem Cell Research and Clinical Translation, Shanghai, China
| | - Bing Han
- Department of Pharmacy, Minhang Hospital, Fudan University, Shanghai, China
- *Correspondence: Zhiying He, ; Bing Han,
| | - Zhiying He
- Institute for Regenerative Medicine, Shanghai East Hospital, School of Life Sciences and Technology, Tongji University, Shanghai, China
- Shanghai Engineering Research Center of Stem Cells Translational Medicine, Shanghai, China
- Shanghai Institute of Stem Cell Research and Clinical Translation, Shanghai, China
- *Correspondence: Zhiying He, ; Bing Han,
| |
Collapse
|
169
|
Chen S, Su X, Mo Z. KCNN4 is a Potential Biomarker for Predicting Cancer Prognosis and an Essential Molecule that Remodels Various Components in the Tumor Microenvironment: A Pan-Cancer Study. Front Mol Biosci 2022; 9:812815. [PMID: 35720112 PMCID: PMC9205469 DOI: 10.3389/fmolb.2022.812815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 05/02/2022] [Indexed: 12/15/2022] Open
Abstract
Objectives: Potassium Calcium-Activated Channel Subfamily N Member 4 (KCNN4) is a member of the KCNN family. Studies have revealed that KCNN4 is implicated in various physiological processes as well as promotes the malignant phenotypes of cancer cells. However, little is known about its associations with survival outcomes across varying cancer types. Methods: Herein, we systematically explored the prognostic value of KCNN4 in the pan-cancer dataset retrieved from multiple databases. Next, we performed correlation analysis of KCNN4 expression with tumor mutational burden (TMB) and microsatellite instability (MSI), and immune checkpoint genes (ICGs) to assess its potential as a predictor of immunotherapy efficacy. Afterwards, patients were divided into increased-risk group and decreased-risk group based on the contrasting survival outcomes in various cancer types. Furthermore, the underlying mechanisms of the distinctive effects were analyzed using ESTIMATE, CIBERSORT algorithms, and Gene Set Enrichment Analysis (GSEA) analysis. Results: KCNN4 expression levels were aberrant in transcriptomic and proteomic levels between cancer and normal control tissues in pan-cancer datasets, further survival analysis elucidated that KCNN4 expression was correlated to multiple survival data, and clinical annotations. Besides, KCNN4 expression was correlated to TMB and MSI levels in 14 types and 12 types of pan-cancers, respectively. Meanwhile, different types of cancer have specific tumor-infiltrating immune cell (TICs) profiles. Conclusions: Our results revealed that KCNN4 could be an essential biomarker for remodeling components in the tumor microenvironment (TME), and a robust indicator for predicting prognosis as well as immunotherapy response in pan-cancer patients.
Collapse
Affiliation(s)
- Shaohua Chen
- Department of Urology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Guangxi Key Laboratory for Genomic and Personalized Medicine, Center for Genomic and Personalized Medicine, Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China
| | - Xiaotao Su
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zengnan Mo
- Department of Urology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Guangxi Key Laboratory for Genomic and Personalized Medicine, Center for Genomic and Personalized Medicine, Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China
- *Correspondence: Zengnan Mo,
| |
Collapse
|
170
|
Chakrabarti S, Bucheit L, Starr JS, Innis-Shelton R, Shergill A, Dada H, Resta R, Wagner S, Fei N, Kasi PM. Detection of microsatellite instability-high (MSI-H) by liquid biopsy predicts robust and durable response to immunotherapy in patients with pancreatic cancer. J Immunother Cancer 2022; 10:e004485. [PMID: 35710297 PMCID: PMC10098262 DOI: 10.1136/jitc-2021-004485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2022] [Indexed: 01/21/2023] Open
Abstract
Clinical trials reporting the robust antitumor activity of immune checkpoint inhibitors (ICIs) in microsatellite instability-high (MSI-H) solid tumors have used tissue-based testing to determine the MSI-H status. This study assessed if MSI-H detected by a plasma-based circulating tumor DNA liquid biopsy test predicts robust response to ICI in patients with pancreatic ductal adenocarcinoma (PDAC). Retrospective analysis of patients with PDAC and MSI-H identified on Guardant360 from October 2018 to April 2021 was performed; clinical outcomes were submitted by treating providers. From 52 patients with PDAC +MSI-H, outcomes were available for 10 (19%) with a median age of 68 years (range: 56-82 years); the majority were male (80%) and had metastatic disease (80%). Nine of 10 patients were treated with ICI. Eight out of nine patients received single-agent pembrolizumab (8/9), while one received ipilimumab plus nivolumab. The overall response rate by Response Evaluation Criteria in Solid Tumors was 77% (7/9). The median progression-free survival and overall survival were not reached in this cohort. The median duration of treatment with ICI was 8 months (range: 1-24), and six out of seven responders continued to show response at the time of data cut-off after a median follow-up of 21 months (range: 11-33). Tissue-based MSI results were concordant with plasma-based G360 results in five of six patients (83%) who had tissue-based test results available, with G360 identifying one more patient with MSI-H than tissue testing. These results suggest that detecting MSI-H by a well-validated liquid biopsy test could predict a robust response to ICI in patients with PDAC. The use of liquid biopsy may expand the identification of PDAC patients with MSI-H tumors and enable treatment with ICI resulting in improved outcomes.
Collapse
Affiliation(s)
- Sakti Chakrabarti
- Hematology-Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | | | - Jason Scott Starr
- Department of Hematology/Oncology, Mayo Clinic Florida, Jacksonville, Florida, USA
| | | | - Ardaman Shergill
- University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA
| | - Hiba Dada
- Guardant Health Inc, Redwood City, California, USA
| | - Regina Resta
- New York Oncology Hematology PC, Albany, New York, USA
| | | | - Naomi Fei
- The University of Iowa Healthcare, Iowa City, Iowa, USA
| | | |
Collapse
|
171
|
Alteration of Gene and miRNA Expression in Cervical Intraepithelial Neoplasia and Cervical Cancer. Int J Mol Sci 2022; 23:ijms23116054. [PMID: 35682732 PMCID: PMC9180969 DOI: 10.3390/ijms23116054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/23/2022] [Accepted: 05/26/2022] [Indexed: 01/27/2023] Open
Abstract
Background: Cervical cancer is one of the most common malignancies in women in terms of prevalence and mortality. Cervical cancer has some particularities that distinguish it from any other oncologic pathology: first, it is completely preventable by prompt detection of its precursor, cervical intraepithelial neoplasia (CIN); second, the Human Papillomavirus (HPV) infection is a known etiological agent; third, the mean age at diagnosis is much lower than in other oncologic conditions, as a consequence of the sexually-transmitted HPV. Methods: We evaluated the expression level of several long noncoding RNAs and a microRNA in samples from 30 patients with CIN, 9 with cervical cancer and 38 normal samples using qRT-PCR technology. Results: We observed higher expression levels for MEG3, DAPK1, MLH1 and MALAT1 in CIN samples than in normal samples, whereas TIMP3 and SOX1 had lower expression levels. For cancer samples, DAPK1, MLH1 and MALAT1 had higher expression, and MEG3, TIMP3 and SOX1 had lower expression when compared to normal samples. In the case of CIN versus cancer samples, only MEG3 gene showed a statistically significant difference. The expression of miR-205-5p was lower in both CIN and cancer samples compared to normal samples. Conclusion: Decreased MEG3 expression could be considered an alarm signal in the transition from a premalignant cervical lesion to invasive cancer, while altered expression levels of TIMP3, SOX1, MLH1, MALAT1 and miR-205-5p could serve as early biomarkers in the diagnosis of premalignant cervical lesions. Future studies, including a larger number of patients with CIN, will be of particular importance in validating these observations.
Collapse
|
172
|
Health-related quality of life in patients treated with pembrolizumab for microsatellite instability-high/mismatch repair-deficient advanced solid tumours: Results from the KEYNOTE-158 study. Eur J Cancer 2022; 169:188-197. [PMID: 35588692 DOI: 10.1016/j.ejca.2022.03.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 03/30/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND In the KEYNOTE-158 study (NCT02628067), pembrolizumab showed a high objective response rate and durable clinical benefit for patients with previously treated, unresectable/metastatic microsatellite instability-high (MSI-H)/mismatch repair‒deficient (dMMR) non-colorectal solid tumours. We present health-related quality of life (HRQoL) results from the MSI-H/dMMR population (cohort K). PATIENTS AND METHODS Eligible patients had previously treated MSI-H/dMMR advanced non-colorectal solid tumours, measurable disease per RECIST v1.1, and ECOG performance status ≤1. Patients received pembrolizumab 200 mg Q3W for 35 cycles (2 years). The EORTC Quality of Life Questionnaire (QLQ-C30) and EQ-5D-3L were administered at baseline, at regular intervals throughout treatment, and 30 days after treatment discontinuation. Prespecified analyses (exploratory endpoints) included the magnitude of change from baseline to post-baseline timepoints in all patients and by the best overall response for QLQ-C30 global health status (GHS)/QoL, QLQ-C30 functional/symptom scales/items, and EQ-5D-3L visual analogue scale (VAS) score. RESULTS At data cutoff (October 5, 2020), 351 patients were enrolled, of whom 311 and 315 completed baseline QLQ-C30 and EQ-5D-3L questionnaires, respectively. QLQ-C30 GHS/QoL scores improved from baseline to week 9 (mean [95% CI] change, 3.07 [0.19-5.94]), then remained stable or improved by week 111, with greater improvements observed in patients with a best response of complete response (CR) or partial response (PR) (10.85 [6.36-15.35]). Patients with CR/PR showed improvements in physical (5.58 [1.91-9.25]), role (9.88 [3.80-15.97]), emotional (5.62 [1.56-9.68]), and social (8.33 [2.70-13.97]) functioning, and stable cognitive functioning (1.74 [-1.45 to 4.94]). CONCLUSIONS Pembrolizumab generally improved or preserved HRQoL in patients with previously treated MSI-H/dMMR advanced non-colorectal solid tumours.
Collapse
|
173
|
Zhou S, Sun X, Jin Z, Yang H, Ye W. The role of autophagy in initiation, progression, TME modification, diagnosis, and treatment of esophageal cancers. Crit Rev Oncol Hematol 2022; 175:103702. [PMID: 35577254 DOI: 10.1016/j.critrevonc.2022.103702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/14/2022] [Accepted: 05/02/2022] [Indexed: 10/18/2022] Open
Abstract
Autophagy is a highly conserved metabolic process with a cytoprotective function. Autophagy is involved in cancer, infection, immunity, and inflammation and may be a potential therapeutic target. Increasing evidence has revealed that autophagy has primary implications for esophageal cancer, including its initiation, progression, tumor microenvironment (TME) modification, diagnosis, and treatment. Notably, autophagy displayed excellent application potential in radiotherapy combined with immunotherapy. Radiotherapy combined with immunotherapy is a new potential therapeutic strategy for cancers, including esophageal cancer. Autophagy modulators can work as adjuvant enhancers in radiotherapy or immunotherapy of cancers. This review highlights the most recent data related to the role of autophagy regulation in esophageal cancer.
Collapse
Affiliation(s)
- Suna Zhou
- Department of Radiation Oncology, Xi'an No.3 Hospital, the Affiliated Hospital of Northwest University, Xi'an, Shaanxi 710018, P.R. China; Laboratory of Cellular and Molecular Radiation Oncology, The Affiliated Taizhou Hospital, Wenzhou Medical University, Taizhou 317000, Zhejiang, P.R. China; Key Laboratory of Minimally Invasive Techniques & Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Taizhou, P.R. China
| | - Xuefeng Sun
- Laboratory of Cellular and Molecular Radiation Oncology, The Affiliated Taizhou Hospital, Wenzhou Medical University, Taizhou 317000, Zhejiang, P.R. China; Department of Radiation Oncology, The Affiliated Taizhou Hospital, Wenzhou Medical University, Taizhou, P.R. China
| | - Zhicheng Jin
- Laboratory of Cellular and Molecular Radiation Oncology, The Affiliated Taizhou Hospital, Wenzhou Medical University, Taizhou 317000, Zhejiang, P.R. China; Department of Radiation Oncology, The Affiliated Taizhou Hospital, Wenzhou Medical University, Taizhou, P.R. China
| | - Haihua Yang
- Laboratory of Cellular and Molecular Radiation Oncology, The Affiliated Taizhou Hospital, Wenzhou Medical University, Taizhou 317000, Zhejiang, P.R. China; Key Laboratory of Minimally Invasive Techniques & Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Taizhou, P.R. China; Department of Radiation Oncology, The Affiliated Taizhou Hospital, Wenzhou Medical University, Taizhou, P.R. China
| | - Wenguang Ye
- Department of Gastroenterology, Affiliated Hangzhou Cancer Hospital, Zhejiang University School of Medicine, Hangzhou, P.R. China.
| |
Collapse
|
174
|
Chang X, Xing P. Identification of a novel lipid metabolism-related gene signature within the tumour immune microenvironment for breast cancer. Lipids Health Dis 2022; 21:43. [PMID: 35562758 PMCID: PMC9103058 DOI: 10.1186/s12944-022-01651-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 12/15/2021] [Indexed: 12/12/2022] Open
Abstract
Background Systemic factors can strongly affect how tumour cells behave, grow, and communicate with other cells in breast cancer. Lipid metabolic reprogramming is a systemic process that tumour cells undergo; however, the formation and dynamics of lipids associated with the tumour immune microenvironment (TIME) remain unclear. The investigation of the sophisticated bidirectional crosstalk of tumour cells with cancer metabolism, gene expression, and TIME could have the potential to identify novel biomarkers for diagnosis, prognosis, and immunotherapy. This study aimed to construct a prognostic signature to detect the bicrosstalk between the lipid metabolic system and the TIME of breast cancer. Methods To detect the expression of LRGs and execute GO/KEGG analysis, the R program was chosen. Considering the clinical information and pathological features, a prognostic gene signature was constructed by LASSO Cox regression analysis. TMB, MSI, and immune infiltration analyses were performed, and consensus cluster analysis of LRGs was also performed. Results These 16 lipid metabolism-related genes (LRGs) were mainly involved in the process of lipid metabolism and fatty acid binding in breast cancer. Prognosis analysis identified the prognostic value of FABP7(Fatty acid binding protein 7) and NDUFAB1(NADH:ubiquinone oxidoreductase subunit AB1) in breast cancer patients. The prognostic gene signature constructed with FABP7 and NDUFAB1 was significantly related to immune cell infiltration and could predict the overall survival rate with above average correctness of breast cancer patients. FABP7 and NDUFAB1 were proven to have relevance in immune cell infiltration and tumour mutation burden (TMB). Consensus cluster analysis identified that the upregulated mRNAs were mostly related to the oncogenesis process, while the downregulated mRNAs were associated with immune-related signalling pathways. Conclusion A comprehensive analysis was performed to evaluate the lipid metabolic system and identified a signature constructed by two prognostic genes for immunotherapies in breast cancer. The results also revealed evidence of vulnerabilities in the interplay between the lipid metabolic system and the TIME in breast cancer. Further data with clinical studies and experiments are warranted. Supplementary Information The online version contains supplementary material available at 10.1186/s12944-022-01651-9.
Collapse
Affiliation(s)
- Xu Chang
- Department of Surgical Oncology, Breast Surgery, General Surgery, First Affiliated Hospital of China Medical University, No.77 PuHe Road, Shenyang North New Area, Shenyang, 110122, China
| | - Peng Xing
- Department of Surgical Oncology, Breast Surgery, General Surgery, First Affiliated Hospital of China Medical University, No.77 PuHe Road, Shenyang North New Area, Shenyang, 110122, China.
| |
Collapse
|
175
|
Li C, Wang H, Jiang Y, Fu W, Liu X, Zhong R, Cheng B, Zhu F, Xiang Y, He J, Liang W. Advances in lung cancer screening and early detection. Cancer Biol Med 2022; 19:j.issn.2095-3941.2021.0690. [PMID: 35535966 PMCID: PMC9196057 DOI: 10.20892/j.issn.2095-3941.2021.0690] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/03/2022] [Indexed: 11/18/2022] Open
Abstract
Lung cancer is associated with a heavy cancer-related burden in terms of patients' physical and mental health worldwide. Two randomized controlled trials, the US-National Lung Screening Trial (NLST) and Nederlands-Leuvens Longkanker Screenings Onderzoek (NELSON), indicated that low-dose CT (LDCT) screening results in a statistically significant decrease in mortality in patients with lung cancer, LDCT has become the standard approach for lung cancer screening. However, many issues in lung cancer screening remain unresolved, such as the screening criteria, high false-positive rate, and radiation exposure. This review first summarizes recent studies on lung cancer screening from the US, Europe, and Asia, and discusses risk-based selection for screening and the related issues. Second, an overview of novel techniques for the differential diagnosis of pulmonary nodules, including artificial intelligence and molecular biomarker-based screening, is presented. Third, current explorations of strategies for suspected malignancy are summarized. Overall, this review aims to help clinicians understand recent progress in lung cancer screening and alleviate the burden of lung cancer.
Collapse
Affiliation(s)
- Caichen Li
- Department of Thoracic Oncology and Surgery, the First Affiliated Hospital of Guangzhou Medical University, China National Center for Respiratory Medicine, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
- Dongguan Affiliated Hospital of Southern Medical University, Dongguan People Hospital, Dongguan 523059, China
| | - Huiting Wang
- Department of Thoracic Oncology and Surgery, the First Affiliated Hospital of Guangzhou Medical University, China National Center for Respiratory Medicine, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
- Dongguan Affiliated Hospital of Southern Medical University, Dongguan People Hospital, Dongguan 523059, China
| | - Yu Jiang
- Dongguan Affiliated Hospital of Southern Medical University, Dongguan People Hospital, Dongguan 523059, China
| | - Wenhai Fu
- Department of Thoracic Oncology and Surgery, the First Affiliated Hospital of Guangzhou Medical University, China National Center for Respiratory Medicine, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
| | - Xiwen Liu
- Dongguan Affiliated Hospital of Southern Medical University, Dongguan People Hospital, Dongguan 523059, China
| | - Ran Zhong
- Department of Thoracic Oncology and Surgery, the First Affiliated Hospital of Guangzhou Medical University, China National Center for Respiratory Medicine, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
- Dongguan Affiliated Hospital of Southern Medical University, Dongguan People Hospital, Dongguan 523059, China
| | - Bo Cheng
- Dongguan Affiliated Hospital of Southern Medical University, Dongguan People Hospital, Dongguan 523059, China
| | - Feng Zhu
- Department of Internal Medicine, Detroit Medical Center Sinai-Grace Hospital, Detroit, Michigan 48235, USA
| | - Yang Xiang
- Department of Thoracic Oncology and Surgery, the First Affiliated Hospital of Guangzhou Medical University, China National Center for Respiratory Medicine, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
| | - Jianxing He
- Dongguan Affiliated Hospital of Southern Medical University, Dongguan People Hospital, Dongguan 523059, China
- Department of Thoracic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou 510515, China
| | - Wenhua Liang
- Department of Thoracic Oncology and Surgery, the First Affiliated Hospital of Guangzhou Medical University, China National Center for Respiratory Medicine, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
- Dongguan Affiliated Hospital of Southern Medical University, Dongguan People Hospital, Dongguan 523059, China
- Department of Oncology, the First People’s Hospital of Zhaoqing, Zhaoqing 526020, China
| |
Collapse
|
176
|
Wang H, Li C, Yang R, Jin J, Liu D, Li W. Prognostic value of the platelet-to-lymphocyte ratio in lung cancer patients receiving immunotherapy: A systematic review and meta-analysis. PLoS One 2022; 17:e0268288. [PMID: 35522679 PMCID: PMC9075650 DOI: 10.1371/journal.pone.0268288] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 04/26/2022] [Indexed: 11/18/2022] Open
Abstract
Background Current studies have revealed that the platelet to lymphocyte ratio (PLR) may lead to a poor prognosis in lung cancer patients receiving immunotherapy. We conducted a meta-analysis to explore the prognostic value of PLR in lung cancer patients receiving immunotherapy. Methods We retrieved potential studies from the PubMed, Web of Science, Embase, and Scopus databases up to June 2021 and merged the hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs) to evaluate the association between PLR and overall survival (OS) or progression-free survival. Results Fourteen studies involving 1761 patients were included in our meta-analysis. The results indicated that an elevated level of pretreatment PLR was associated with poorer OS and PFS in lung cancer patients receiving immunotherapy (OS: HR = 1.88, 95% CI: 1.37–2.58; PFS: HR = HR = 1.40, 95% CI: 1.11–1.76). The association remained consistent after subgroup analysis and was robust even after sensitivity analysis. Conclusions PLR may be a prognostic factor of lung cancer patients receiving immunotherapy, which can lead to worse survival outcomes. However, further studies are necessary for evidence in clinical application.
Collapse
Affiliation(s)
- Haoyu Wang
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Institute of Respiratory Health, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Cui Li
- Institute of Respiratory Health, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ruiyuan Yang
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jing Jin
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Dan Liu
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Weimin Li
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Institute of Respiratory Health, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- * E-mail:
| |
Collapse
|
177
|
Wang Z, Wang K, Yu X, Chen M, Du Y. Comprehensive analysis of expression signature and immune microenvironment signature of biomarker Endothelin Receptor Type A in stomach adenocarcinoma. J Cancer 2022; 13:2086-2104. [PMID: 35517422 PMCID: PMC9066206 DOI: 10.7150/jca.68673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 03/05/2022] [Indexed: 11/08/2022] Open
Abstract
Background: EDNRA (Endothelin Receptor Type A) is closely associated with tumor progression in many tumor types. However, the functional mechanism of EDNRA in stomach adenocarcinoma (STAD) remains to be elucidated. Methods: ENDRA expression levels in STAD were assessed. A Receiver Operating Characteristic (ROC) curve was constructed to measure the diagnostic value of EDNRA. The correlation between ENDRA expression levels and patient clinical-pathological characteristics was analyzed. The survival and prognostic significance were validated using Kaplan-Meier and Cox regression and confirmed by the immunohistochemistry cohorts. Differentially expressed genes of EDNRA in STAD were determined, and EDNRA related functional enrichment and biological pathways involved in STAD were obtained by Gene-Set Enrichment Analysis (GSEA). The correlation between EDNRA expression in STAD and immune cell infiltration was assessed using the CIBERSORT and Spearman correlation analysis, and the correlation between EDNRA and TMB, MSI, IC50, and immune checkpoints was examined. Results: EDNRA expression was significantly higher in STAD than in normal tissues (P < 0.001) and associated with worse overall survival (OS). EDNRA expression was significantly associated with T stage, histological type, histologic grade, and TP53 status. Cox regression analysis revealed that primary therapy outcome, age, tumor status, and EDNRA were independent prognostic factors for OS. Multivariate analysis revealed that EDNRA expression, tumor status, age, and primary therapy outcome influenced patient prognosis. GSEA was significantly enriched in several pathways and biological processes, which include Immunoregulatory, Hedgehog, WNT, PI3K-AKT.NK cells, Tem, macrophages, and mast cells were substantially positively correlated with EDNRA expression in the STAD microenvironment. Notably, high EDNRA expression may promote M2 macrophages to block PD-1-mediated immunotherapy and induce immunosuppression. In addition, patients with high expression of EDNRA might be resistant to the treatment of several anti-tumor drugs. Conclusion: Our results suggest that EDNRA was closely related to clinicopathologic characteristics, poor prognosis, and promoted macrophage differentiation and synergistic role in immunosuppression.
Collapse
Affiliation(s)
- Zhengguang Wang
- Department of Orthopedics, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Kangchun Wang
- Department of Organ transplantation and Hepatobiliary, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Xue Yu
- Department of Paediatrics, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Moye Chen
- Department of Gastroenterology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yaqi Du
- Department of Gastroenterology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| |
Collapse
|
178
|
Wang M, Chen X, Dai Y, Wu D, Liu F, Yang Z, Song B, Xie L, Yang L, Zhao W, Zhang C, Shen W, Fan C, Teng C, Zhao X, Gao N, Shang D, Zhao G, Xin T. Concordance Study of a 520-Gene Next-Generation Sequencing-Based Genomic Profiling Assay of Tissue and Plasma Samples. Mol Diagn Ther 2022; 26:309-322. [PMID: 35305253 DOI: 10.1007/s40291-022-00579-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2022] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Next-generation sequencing (NGS) enables simultaneous detection of actionable somatic variants and estimation of genomic signatures such as tumor mutational burden (TMB) or microsatellite instability (MSI) status, which empowers therapeutic decisions in clinical oncology. OBJECTIVE Our retrospective study investigated the clinical performance of somatic variant detection in paired tissue and blood samples using a large targeted gene panel, the OncoScreen Plus, which interrogates 520 cancer-related genes. METHODS We analyzed sequencing data derived from paired tissue and blood samples of 3005 patients spanning 20 solid tumor types, including lung (n = 1971), gastrointestinal (n = 625), breast (n = 120) and gynecological (n = 110), genitourinary (n = 38), and other cancers (n = 141). RESULTS Across tumor types, the OncoScreen Plus panel achieved a high tissue detection rate, with an average of 97.9%. The average plasma detection rate was 72.2%, with an average tissue concordance rate of 36.6%. Considering all variant types, the plasma assay yielded an average sensitivity/true positive rate of 45.7%, with a positive predictive value of 64.7% relative to tissue assay. Pearson correlation analysis revealed a strong correlation in TMB estimated from blood and tissue samples (correlation coefficient 0.845, R2 = 0.756). MSI-high status was identified in five tumor types, including endometrial cancer (28.6%), colorectal cancer (2.5%), ovarian cancer (2.0%), gastric cancer (1.5%), and lung adenocarcinoma (0.2%). CONCLUSION Paired tumor and blood samples from a large cohort of patients spanning 20 tumor types demonstrated that the OncoScreen Plus is a reliable pan-cancer panel for the accurate detection of somatic variants and genomic signatures that could guide individualized treatment strategies to improve the care of patients with advanced cancer.
Collapse
Affiliation(s)
- Minghui Wang
- Department of Thoracic Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510220, China
| | - Xianshan Chen
- Department of Thoracic Surgery, Hainan General Hospital, Hainan, 570311, China
| | - Yongmei Dai
- Department of Oncology, Shengli Clinical Medical College of Fujian Medical University & Fujian Provincial Hospital, Fuzhou, 350001, China
| | - Duoguang Wu
- Department of Thoracic Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510220, China
| | - Fang Liu
- Department of Pathology, The First People's Hospital of Foshan, Foshan, 528000, China
| | - Zheng Yang
- Department of Pathology, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518107, China
| | - Baozhi Song
- Department of Gynecology, Shengli Clinical Medical College of Fujian Medical University & Fujian Provincial Hospital, Fuzhou, 350001, China
| | - Li Xie
- Department of Oncology, Shengli Clinical Medical College of Fujian Medical University & Fujian Provincial Hospital, Fuzhou, 350001, China
| | - Liangwei Yang
- Department of Cardiothoracic Surgery, Hwa Mei Hospital, University of Chinese Academy of Sciences (Ningbo No. 2 Hospital), No. 41 Xibei Road, Ningbo, 315010, Zhejiang, China
| | - Weidi Zhao
- Department of Cardiothoracic Surgery, Hwa Mei Hospital, University of Chinese Academy of Sciences (Ningbo No. 2 Hospital), No. 41 Xibei Road, Ningbo, 315010, Zhejiang, China
| | - Chenxu Zhang
- Department of Cardiothoracic Surgery, Hwa Mei Hospital, University of Chinese Academy of Sciences (Ningbo No. 2 Hospital), No. 41 Xibei Road, Ningbo, 315010, Zhejiang, China
| | - Weixi Shen
- Department of Oncology, The Second Affiliated Hospital of Harbin Medical University, No. 246 Xuefu Road, Nangang, Harbin, 150081, Heilongjiang, China
| | - Chengjuan Fan
- Department of Oncology, The Second Affiliated Hospital of Harbin Medical University, No. 246 Xuefu Road, Nangang, Harbin, 150081, Heilongjiang, China
| | - Chong Teng
- Department of Oncology, The Second Affiliated Hospital of Harbin Medical University, No. 246 Xuefu Road, Nangang, Harbin, 150081, Heilongjiang, China
| | - Xue Zhao
- Department of Oncology, The Second Affiliated Hospital of Harbin Medical University, No. 246 Xuefu Road, Nangang, Harbin, 150081, Heilongjiang, China
| | - Naisheng Gao
- Department of Oncology, The Second Affiliated Hospital of Harbin Medical University, No. 246 Xuefu Road, Nangang, Harbin, 150081, Heilongjiang, China
| | - Di Shang
- Department of Oncology, The Second Affiliated Hospital of Harbin Medical University, No. 246 Xuefu Road, Nangang, Harbin, 150081, Heilongjiang, China
| | - Guofang Zhao
- Department of Cardiothoracic Surgery, Hwa Mei Hospital, University of Chinese Academy of Sciences (Ningbo No. 2 Hospital), No. 41 Xibei Road, Ningbo, 315010, Zhejiang, China.
| | - Tao Xin
- Department of Oncology, The Second Affiliated Hospital of Harbin Medical University, No. 246 Xuefu Road, Nangang, Harbin, 150081, Heilongjiang, China.
| |
Collapse
|
179
|
Wood LS, Conway D, Lapuente M, Salvador G, Fernandez Gomez S, Carroll Bullock A, Devgan G, Burns KD. Avelumab First-Line Maintenance Treatment in Advanced Bladder Cancer: Practical Implementation Steps for Infusion Nurses. JOURNAL OF INFUSION NURSING 2022; 45:142-153. [PMID: 35537002 PMCID: PMC9071022 DOI: 10.1097/nan.0000000000000465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Immune checkpoint inhibitors, such as programmed cell death ligand 1 inhibitors pembrolizumab, nivolumab, atezolizumab, and avelumab, are used to treat patients with advanced urothelial carcinoma (UC). Based on data from the phase 3 JAVELIN Bladder 100 trial, avelumab first-line (1L) maintenance is now considered the standard-of-care treatment for patients with locally advanced or metastatic UC who responded or experienced disease stabilization after 1L platinum-containing chemotherapy, and it is the only category 1 preferred checkpoint inhibitor maintenance option in the National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology for patients with cisplatin-eligible and cisplatin-ineligible locally advanced or metastatic UC. This article reviews key considerations related to avelumab 1L maintenance therapy that infusion nurses should be familiar with, including dosing, administration, and immune-related adverse event recognition and management, to ensure safe and appropriate use of this important and impactful therapy.
Collapse
Affiliation(s)
- Laura S. Wood
- Corresponding Author: Laura Wood, MSN, RN, OCN®, Cleveland Clinic Taussig Cancer Center, Cleveland, OH ()
| | - Dawn Conway
- Cleveland Clinic Taussig Cancer Center, Cleveland, Ohio (Ms Wood); University of Chicago Medicine, Genitourinary Oncology, Chicago, Illinois (Ms Conway); St Bartholomew's Hospital, London, United Kingdom (Ms Lapuente, Mr Salvador, Ms Fernandez Gomez); St George's Hospital, London, United Kingdom (Ms Fernandez Gomez); EMD Serono, Rockland, Massachusetts (Ms Carroll Bullock); Pfizer Inc, New York, New York (Dr Devgan); City of Hope Medical Center, Genitourinary Medical Oncology, Duarte, California (Ms Burns)
- Laura S. Wood, MSN, RN, OCN, is the renal cancer clinical research coordinator at the Cleveland Clinic Cancer Center in Cleveland, Ohio. She completed both her bachelor's and master's degrees in nursing at Kent State University in Kent, Ohio. She is involved in the care of patients with renal and genitourinary cancers. Ms Wood is a member of the Protocol Review and Monitoring Committee, the Immunotherapy Education Committee, and the Immune-Related Adverse Event Tumor Board. She is also active in the local and national Oncology Nursing Society, the American Society of Clinical Oncology, and the Society for Immunotherapy of Cancer. A national and international lecturer on topics related to oncology nursing, Ms Wood has authored many book chapters and journal articles on therapeutic approaches and nursing care in the management of cancer. She was also the recipient of the 2012 Oncology Nursing Society Clinical Lectureship Award
- Dawn Conway, BSN, RN, OCN, is a registered nurse with 14 years of oncology experience, the first 3 years of which were spent as a bone marrow transplant nurse at Mount Sinai in New York City. For the past 11 years, Ms Conway has been working with the genitourinary oncology group at University of Chicago Medicine, specifically with patients with urothelial cancer, making her an expert in urothelial cancer management
- Maria Lapuente, RN, works as the lead research nurse for the genitourinary team at St Bartholomew's Hospital in London, United Kingdom. She has 10 years of experience in oncology, including more than 4 years of cancer research collaboration with Dr Thomas Powles. She has specialized in immunotherapy treatments, particularly in phase 1 combination trials. Ms Lapuente has recently expanded her area of expertise into radiotherapy and chemotherapy in combination with immunotherapy trials for patients with metastatic nonsmall cell lung cancer. She is also the principal investigator for a questionnaire study exploring the assessment of the Managing Advanced Cancer Pain Together conversation tool to facilitate communication between patients and their health care professionals, involving patients with genitourinary, lung, breast, and myeloma cancer
- George Salvador, RGN, has 9 years of nursing experience and 6 years of experience in a hematology-oncology department. He is also part of the vascular team at St Bartholomew's Hospital that deals with peripheral and central lines, such as Hickman, Portacath, and peripherally inserted central catheters. Currently, Mr Salvador is pursuing his master's degree in advanced cancer care, which includes nurse prescribing
- Sheila Fernandez Gomez, RN, CNS, is a registered nurse with 8 years of experience in oncology, including more than 4 years working as a senior chemotherapy/oncology/hematology nurse at St Bartholomew's Hospital. She has recently been promoted to acute oncology clinical nurse specialist at St George's Hospital in London and has acquired a specialty in systemic anticancer therapy regimens. This experience, along with her qualifications, has given her the confidence to assess and manage acute oncology complications
- Andrea Carroll Bullock, BSN, ISMPP, CMPP, is the director of US medical communications at EMD Serono, where she has directed US medical publications and communications in the oncology, neurology, immunology, fertility, and HIV therapeutic areas for the past 4 years. She has 20 years of experience in the pharmaceutical industry. Prior to joining industry, Ms Carroll Bullock worked as a registered nurse in teaching hospitals, such as the MedStar Washington Hospital Center. Her primary area of focus in the clinical setting was caring for patients in the medical intensive care and oncology units. Additionally, she has experience as a nurse manager for a community-based hematology/oncology practice, where she was responsible for treating patients and managing the infusion center. Ms Carroll Bullock holds a bachelor of science in nursing from Howard University and is a master of business administration candidate at Johns Hopkins Carey Business School
- Geeta Devgan, PhD, is a senior medical director in US medical affairs at Pfizer Oncology. She received her PhD in molecular, cellular, and developmental biology from Yale University and completed her postdoctoral training at Memorial Sloan-Kettering Cancer Center. Dr Devgan has more than 15 years of oncology experience in medical leadership roles within pharmaceutical companies
- Kathleen D. Burns, MSN, RN, AGACNP-BC, OCN, has a postmaster's certificate for nurse practitioners in acute care–gerontology from the University of Connecticut. Her work experience includes 28 years of cancer nursing in patient care, education, and management
| | - Maria Lapuente
- Cleveland Clinic Taussig Cancer Center, Cleveland, Ohio (Ms Wood); University of Chicago Medicine, Genitourinary Oncology, Chicago, Illinois (Ms Conway); St Bartholomew's Hospital, London, United Kingdom (Ms Lapuente, Mr Salvador, Ms Fernandez Gomez); St George's Hospital, London, United Kingdom (Ms Fernandez Gomez); EMD Serono, Rockland, Massachusetts (Ms Carroll Bullock); Pfizer Inc, New York, New York (Dr Devgan); City of Hope Medical Center, Genitourinary Medical Oncology, Duarte, California (Ms Burns)
- Laura S. Wood, MSN, RN, OCN, is the renal cancer clinical research coordinator at the Cleveland Clinic Cancer Center in Cleveland, Ohio. She completed both her bachelor's and master's degrees in nursing at Kent State University in Kent, Ohio. She is involved in the care of patients with renal and genitourinary cancers. Ms Wood is a member of the Protocol Review and Monitoring Committee, the Immunotherapy Education Committee, and the Immune-Related Adverse Event Tumor Board. She is also active in the local and national Oncology Nursing Society, the American Society of Clinical Oncology, and the Society for Immunotherapy of Cancer. A national and international lecturer on topics related to oncology nursing, Ms Wood has authored many book chapters and journal articles on therapeutic approaches and nursing care in the management of cancer. She was also the recipient of the 2012 Oncology Nursing Society Clinical Lectureship Award
- Dawn Conway, BSN, RN, OCN, is a registered nurse with 14 years of oncology experience, the first 3 years of which were spent as a bone marrow transplant nurse at Mount Sinai in New York City. For the past 11 years, Ms Conway has been working with the genitourinary oncology group at University of Chicago Medicine, specifically with patients with urothelial cancer, making her an expert in urothelial cancer management
- Maria Lapuente, RN, works as the lead research nurse for the genitourinary team at St Bartholomew's Hospital in London, United Kingdom. She has 10 years of experience in oncology, including more than 4 years of cancer research collaboration with Dr Thomas Powles. She has specialized in immunotherapy treatments, particularly in phase 1 combination trials. Ms Lapuente has recently expanded her area of expertise into radiotherapy and chemotherapy in combination with immunotherapy trials for patients with metastatic nonsmall cell lung cancer. She is also the principal investigator for a questionnaire study exploring the assessment of the Managing Advanced Cancer Pain Together conversation tool to facilitate communication between patients and their health care professionals, involving patients with genitourinary, lung, breast, and myeloma cancer
- George Salvador, RGN, has 9 years of nursing experience and 6 years of experience in a hematology-oncology department. He is also part of the vascular team at St Bartholomew's Hospital that deals with peripheral and central lines, such as Hickman, Portacath, and peripherally inserted central catheters. Currently, Mr Salvador is pursuing his master's degree in advanced cancer care, which includes nurse prescribing
- Sheila Fernandez Gomez, RN, CNS, is a registered nurse with 8 years of experience in oncology, including more than 4 years working as a senior chemotherapy/oncology/hematology nurse at St Bartholomew's Hospital. She has recently been promoted to acute oncology clinical nurse specialist at St George's Hospital in London and has acquired a specialty in systemic anticancer therapy regimens. This experience, along with her qualifications, has given her the confidence to assess and manage acute oncology complications
- Andrea Carroll Bullock, BSN, ISMPP, CMPP, is the director of US medical communications at EMD Serono, where she has directed US medical publications and communications in the oncology, neurology, immunology, fertility, and HIV therapeutic areas for the past 4 years. She has 20 years of experience in the pharmaceutical industry. Prior to joining industry, Ms Carroll Bullock worked as a registered nurse in teaching hospitals, such as the MedStar Washington Hospital Center. Her primary area of focus in the clinical setting was caring for patients in the medical intensive care and oncology units. Additionally, she has experience as a nurse manager for a community-based hematology/oncology practice, where she was responsible for treating patients and managing the infusion center. Ms Carroll Bullock holds a bachelor of science in nursing from Howard University and is a master of business administration candidate at Johns Hopkins Carey Business School
- Geeta Devgan, PhD, is a senior medical director in US medical affairs at Pfizer Oncology. She received her PhD in molecular, cellular, and developmental biology from Yale University and completed her postdoctoral training at Memorial Sloan-Kettering Cancer Center. Dr Devgan has more than 15 years of oncology experience in medical leadership roles within pharmaceutical companies
- Kathleen D. Burns, MSN, RN, AGACNP-BC, OCN, has a postmaster's certificate for nurse practitioners in acute care–gerontology from the University of Connecticut. Her work experience includes 28 years of cancer nursing in patient care, education, and management
| | - George Salvador
- Cleveland Clinic Taussig Cancer Center, Cleveland, Ohio (Ms Wood); University of Chicago Medicine, Genitourinary Oncology, Chicago, Illinois (Ms Conway); St Bartholomew's Hospital, London, United Kingdom (Ms Lapuente, Mr Salvador, Ms Fernandez Gomez); St George's Hospital, London, United Kingdom (Ms Fernandez Gomez); EMD Serono, Rockland, Massachusetts (Ms Carroll Bullock); Pfizer Inc, New York, New York (Dr Devgan); City of Hope Medical Center, Genitourinary Medical Oncology, Duarte, California (Ms Burns)
- Laura S. Wood, MSN, RN, OCN, is the renal cancer clinical research coordinator at the Cleveland Clinic Cancer Center in Cleveland, Ohio. She completed both her bachelor's and master's degrees in nursing at Kent State University in Kent, Ohio. She is involved in the care of patients with renal and genitourinary cancers. Ms Wood is a member of the Protocol Review and Monitoring Committee, the Immunotherapy Education Committee, and the Immune-Related Adverse Event Tumor Board. She is also active in the local and national Oncology Nursing Society, the American Society of Clinical Oncology, and the Society for Immunotherapy of Cancer. A national and international lecturer on topics related to oncology nursing, Ms Wood has authored many book chapters and journal articles on therapeutic approaches and nursing care in the management of cancer. She was also the recipient of the 2012 Oncology Nursing Society Clinical Lectureship Award
- Dawn Conway, BSN, RN, OCN, is a registered nurse with 14 years of oncology experience, the first 3 years of which were spent as a bone marrow transplant nurse at Mount Sinai in New York City. For the past 11 years, Ms Conway has been working with the genitourinary oncology group at University of Chicago Medicine, specifically with patients with urothelial cancer, making her an expert in urothelial cancer management
- Maria Lapuente, RN, works as the lead research nurse for the genitourinary team at St Bartholomew's Hospital in London, United Kingdom. She has 10 years of experience in oncology, including more than 4 years of cancer research collaboration with Dr Thomas Powles. She has specialized in immunotherapy treatments, particularly in phase 1 combination trials. Ms Lapuente has recently expanded her area of expertise into radiotherapy and chemotherapy in combination with immunotherapy trials for patients with metastatic nonsmall cell lung cancer. She is also the principal investigator for a questionnaire study exploring the assessment of the Managing Advanced Cancer Pain Together conversation tool to facilitate communication between patients and their health care professionals, involving patients with genitourinary, lung, breast, and myeloma cancer
- George Salvador, RGN, has 9 years of nursing experience and 6 years of experience in a hematology-oncology department. He is also part of the vascular team at St Bartholomew's Hospital that deals with peripheral and central lines, such as Hickman, Portacath, and peripherally inserted central catheters. Currently, Mr Salvador is pursuing his master's degree in advanced cancer care, which includes nurse prescribing
- Sheila Fernandez Gomez, RN, CNS, is a registered nurse with 8 years of experience in oncology, including more than 4 years working as a senior chemotherapy/oncology/hematology nurse at St Bartholomew's Hospital. She has recently been promoted to acute oncology clinical nurse specialist at St George's Hospital in London and has acquired a specialty in systemic anticancer therapy regimens. This experience, along with her qualifications, has given her the confidence to assess and manage acute oncology complications
- Andrea Carroll Bullock, BSN, ISMPP, CMPP, is the director of US medical communications at EMD Serono, where she has directed US medical publications and communications in the oncology, neurology, immunology, fertility, and HIV therapeutic areas for the past 4 years. She has 20 years of experience in the pharmaceutical industry. Prior to joining industry, Ms Carroll Bullock worked as a registered nurse in teaching hospitals, such as the MedStar Washington Hospital Center. Her primary area of focus in the clinical setting was caring for patients in the medical intensive care and oncology units. Additionally, she has experience as a nurse manager for a community-based hematology/oncology practice, where she was responsible for treating patients and managing the infusion center. Ms Carroll Bullock holds a bachelor of science in nursing from Howard University and is a master of business administration candidate at Johns Hopkins Carey Business School
- Geeta Devgan, PhD, is a senior medical director in US medical affairs at Pfizer Oncology. She received her PhD in molecular, cellular, and developmental biology from Yale University and completed her postdoctoral training at Memorial Sloan-Kettering Cancer Center. Dr Devgan has more than 15 years of oncology experience in medical leadership roles within pharmaceutical companies
- Kathleen D. Burns, MSN, RN, AGACNP-BC, OCN, has a postmaster's certificate for nurse practitioners in acute care–gerontology from the University of Connecticut. Her work experience includes 28 years of cancer nursing in patient care, education, and management
| | - Sheila Fernandez Gomez
- Cleveland Clinic Taussig Cancer Center, Cleveland, Ohio (Ms Wood); University of Chicago Medicine, Genitourinary Oncology, Chicago, Illinois (Ms Conway); St Bartholomew's Hospital, London, United Kingdom (Ms Lapuente, Mr Salvador, Ms Fernandez Gomez); St George's Hospital, London, United Kingdom (Ms Fernandez Gomez); EMD Serono, Rockland, Massachusetts (Ms Carroll Bullock); Pfizer Inc, New York, New York (Dr Devgan); City of Hope Medical Center, Genitourinary Medical Oncology, Duarte, California (Ms Burns)
- Laura S. Wood, MSN, RN, OCN, is the renal cancer clinical research coordinator at the Cleveland Clinic Cancer Center in Cleveland, Ohio. She completed both her bachelor's and master's degrees in nursing at Kent State University in Kent, Ohio. She is involved in the care of patients with renal and genitourinary cancers. Ms Wood is a member of the Protocol Review and Monitoring Committee, the Immunotherapy Education Committee, and the Immune-Related Adverse Event Tumor Board. She is also active in the local and national Oncology Nursing Society, the American Society of Clinical Oncology, and the Society for Immunotherapy of Cancer. A national and international lecturer on topics related to oncology nursing, Ms Wood has authored many book chapters and journal articles on therapeutic approaches and nursing care in the management of cancer. She was also the recipient of the 2012 Oncology Nursing Society Clinical Lectureship Award
- Dawn Conway, BSN, RN, OCN, is a registered nurse with 14 years of oncology experience, the first 3 years of which were spent as a bone marrow transplant nurse at Mount Sinai in New York City. For the past 11 years, Ms Conway has been working with the genitourinary oncology group at University of Chicago Medicine, specifically with patients with urothelial cancer, making her an expert in urothelial cancer management
- Maria Lapuente, RN, works as the lead research nurse for the genitourinary team at St Bartholomew's Hospital in London, United Kingdom. She has 10 years of experience in oncology, including more than 4 years of cancer research collaboration with Dr Thomas Powles. She has specialized in immunotherapy treatments, particularly in phase 1 combination trials. Ms Lapuente has recently expanded her area of expertise into radiotherapy and chemotherapy in combination with immunotherapy trials for patients with metastatic nonsmall cell lung cancer. She is also the principal investigator for a questionnaire study exploring the assessment of the Managing Advanced Cancer Pain Together conversation tool to facilitate communication between patients and their health care professionals, involving patients with genitourinary, lung, breast, and myeloma cancer
- George Salvador, RGN, has 9 years of nursing experience and 6 years of experience in a hematology-oncology department. He is also part of the vascular team at St Bartholomew's Hospital that deals with peripheral and central lines, such as Hickman, Portacath, and peripherally inserted central catheters. Currently, Mr Salvador is pursuing his master's degree in advanced cancer care, which includes nurse prescribing
- Sheila Fernandez Gomez, RN, CNS, is a registered nurse with 8 years of experience in oncology, including more than 4 years working as a senior chemotherapy/oncology/hematology nurse at St Bartholomew's Hospital. She has recently been promoted to acute oncology clinical nurse specialist at St George's Hospital in London and has acquired a specialty in systemic anticancer therapy regimens. This experience, along with her qualifications, has given her the confidence to assess and manage acute oncology complications
- Andrea Carroll Bullock, BSN, ISMPP, CMPP, is the director of US medical communications at EMD Serono, where she has directed US medical publications and communications in the oncology, neurology, immunology, fertility, and HIV therapeutic areas for the past 4 years. She has 20 years of experience in the pharmaceutical industry. Prior to joining industry, Ms Carroll Bullock worked as a registered nurse in teaching hospitals, such as the MedStar Washington Hospital Center. Her primary area of focus in the clinical setting was caring for patients in the medical intensive care and oncology units. Additionally, she has experience as a nurse manager for a community-based hematology/oncology practice, where she was responsible for treating patients and managing the infusion center. Ms Carroll Bullock holds a bachelor of science in nursing from Howard University and is a master of business administration candidate at Johns Hopkins Carey Business School
- Geeta Devgan, PhD, is a senior medical director in US medical affairs at Pfizer Oncology. She received her PhD in molecular, cellular, and developmental biology from Yale University and completed her postdoctoral training at Memorial Sloan-Kettering Cancer Center. Dr Devgan has more than 15 years of oncology experience in medical leadership roles within pharmaceutical companies
- Kathleen D. Burns, MSN, RN, AGACNP-BC, OCN, has a postmaster's certificate for nurse practitioners in acute care–gerontology from the University of Connecticut. Her work experience includes 28 years of cancer nursing in patient care, education, and management
| | - Andrea Carroll Bullock
- Cleveland Clinic Taussig Cancer Center, Cleveland, Ohio (Ms Wood); University of Chicago Medicine, Genitourinary Oncology, Chicago, Illinois (Ms Conway); St Bartholomew's Hospital, London, United Kingdom (Ms Lapuente, Mr Salvador, Ms Fernandez Gomez); St George's Hospital, London, United Kingdom (Ms Fernandez Gomez); EMD Serono, Rockland, Massachusetts (Ms Carroll Bullock); Pfizer Inc, New York, New York (Dr Devgan); City of Hope Medical Center, Genitourinary Medical Oncology, Duarte, California (Ms Burns)
- Laura S. Wood, MSN, RN, OCN, is the renal cancer clinical research coordinator at the Cleveland Clinic Cancer Center in Cleveland, Ohio. She completed both her bachelor's and master's degrees in nursing at Kent State University in Kent, Ohio. She is involved in the care of patients with renal and genitourinary cancers. Ms Wood is a member of the Protocol Review and Monitoring Committee, the Immunotherapy Education Committee, and the Immune-Related Adverse Event Tumor Board. She is also active in the local and national Oncology Nursing Society, the American Society of Clinical Oncology, and the Society for Immunotherapy of Cancer. A national and international lecturer on topics related to oncology nursing, Ms Wood has authored many book chapters and journal articles on therapeutic approaches and nursing care in the management of cancer. She was also the recipient of the 2012 Oncology Nursing Society Clinical Lectureship Award
- Dawn Conway, BSN, RN, OCN, is a registered nurse with 14 years of oncology experience, the first 3 years of which were spent as a bone marrow transplant nurse at Mount Sinai in New York City. For the past 11 years, Ms Conway has been working with the genitourinary oncology group at University of Chicago Medicine, specifically with patients with urothelial cancer, making her an expert in urothelial cancer management
- Maria Lapuente, RN, works as the lead research nurse for the genitourinary team at St Bartholomew's Hospital in London, United Kingdom. She has 10 years of experience in oncology, including more than 4 years of cancer research collaboration with Dr Thomas Powles. She has specialized in immunotherapy treatments, particularly in phase 1 combination trials. Ms Lapuente has recently expanded her area of expertise into radiotherapy and chemotherapy in combination with immunotherapy trials for patients with metastatic nonsmall cell lung cancer. She is also the principal investigator for a questionnaire study exploring the assessment of the Managing Advanced Cancer Pain Together conversation tool to facilitate communication between patients and their health care professionals, involving patients with genitourinary, lung, breast, and myeloma cancer
- George Salvador, RGN, has 9 years of nursing experience and 6 years of experience in a hematology-oncology department. He is also part of the vascular team at St Bartholomew's Hospital that deals with peripheral and central lines, such as Hickman, Portacath, and peripherally inserted central catheters. Currently, Mr Salvador is pursuing his master's degree in advanced cancer care, which includes nurse prescribing
- Sheila Fernandez Gomez, RN, CNS, is a registered nurse with 8 years of experience in oncology, including more than 4 years working as a senior chemotherapy/oncology/hematology nurse at St Bartholomew's Hospital. She has recently been promoted to acute oncology clinical nurse specialist at St George's Hospital in London and has acquired a specialty in systemic anticancer therapy regimens. This experience, along with her qualifications, has given her the confidence to assess and manage acute oncology complications
- Andrea Carroll Bullock, BSN, ISMPP, CMPP, is the director of US medical communications at EMD Serono, where she has directed US medical publications and communications in the oncology, neurology, immunology, fertility, and HIV therapeutic areas for the past 4 years. She has 20 years of experience in the pharmaceutical industry. Prior to joining industry, Ms Carroll Bullock worked as a registered nurse in teaching hospitals, such as the MedStar Washington Hospital Center. Her primary area of focus in the clinical setting was caring for patients in the medical intensive care and oncology units. Additionally, she has experience as a nurse manager for a community-based hematology/oncology practice, where she was responsible for treating patients and managing the infusion center. Ms Carroll Bullock holds a bachelor of science in nursing from Howard University and is a master of business administration candidate at Johns Hopkins Carey Business School
- Geeta Devgan, PhD, is a senior medical director in US medical affairs at Pfizer Oncology. She received her PhD in molecular, cellular, and developmental biology from Yale University and completed her postdoctoral training at Memorial Sloan-Kettering Cancer Center. Dr Devgan has more than 15 years of oncology experience in medical leadership roles within pharmaceutical companies
- Kathleen D. Burns, MSN, RN, AGACNP-BC, OCN, has a postmaster's certificate for nurse practitioners in acute care–gerontology from the University of Connecticut. Her work experience includes 28 years of cancer nursing in patient care, education, and management
| | - Geeta Devgan
- Cleveland Clinic Taussig Cancer Center, Cleveland, Ohio (Ms Wood); University of Chicago Medicine, Genitourinary Oncology, Chicago, Illinois (Ms Conway); St Bartholomew's Hospital, London, United Kingdom (Ms Lapuente, Mr Salvador, Ms Fernandez Gomez); St George's Hospital, London, United Kingdom (Ms Fernandez Gomez); EMD Serono, Rockland, Massachusetts (Ms Carroll Bullock); Pfizer Inc, New York, New York (Dr Devgan); City of Hope Medical Center, Genitourinary Medical Oncology, Duarte, California (Ms Burns)
- Laura S. Wood, MSN, RN, OCN, is the renal cancer clinical research coordinator at the Cleveland Clinic Cancer Center in Cleveland, Ohio. She completed both her bachelor's and master's degrees in nursing at Kent State University in Kent, Ohio. She is involved in the care of patients with renal and genitourinary cancers. Ms Wood is a member of the Protocol Review and Monitoring Committee, the Immunotherapy Education Committee, and the Immune-Related Adverse Event Tumor Board. She is also active in the local and national Oncology Nursing Society, the American Society of Clinical Oncology, and the Society for Immunotherapy of Cancer. A national and international lecturer on topics related to oncology nursing, Ms Wood has authored many book chapters and journal articles on therapeutic approaches and nursing care in the management of cancer. She was also the recipient of the 2012 Oncology Nursing Society Clinical Lectureship Award
- Dawn Conway, BSN, RN, OCN, is a registered nurse with 14 years of oncology experience, the first 3 years of which were spent as a bone marrow transplant nurse at Mount Sinai in New York City. For the past 11 years, Ms Conway has been working with the genitourinary oncology group at University of Chicago Medicine, specifically with patients with urothelial cancer, making her an expert in urothelial cancer management
- Maria Lapuente, RN, works as the lead research nurse for the genitourinary team at St Bartholomew's Hospital in London, United Kingdom. She has 10 years of experience in oncology, including more than 4 years of cancer research collaboration with Dr Thomas Powles. She has specialized in immunotherapy treatments, particularly in phase 1 combination trials. Ms Lapuente has recently expanded her area of expertise into radiotherapy and chemotherapy in combination with immunotherapy trials for patients with metastatic nonsmall cell lung cancer. She is also the principal investigator for a questionnaire study exploring the assessment of the Managing Advanced Cancer Pain Together conversation tool to facilitate communication between patients and their health care professionals, involving patients with genitourinary, lung, breast, and myeloma cancer
- George Salvador, RGN, has 9 years of nursing experience and 6 years of experience in a hematology-oncology department. He is also part of the vascular team at St Bartholomew's Hospital that deals with peripheral and central lines, such as Hickman, Portacath, and peripherally inserted central catheters. Currently, Mr Salvador is pursuing his master's degree in advanced cancer care, which includes nurse prescribing
- Sheila Fernandez Gomez, RN, CNS, is a registered nurse with 8 years of experience in oncology, including more than 4 years working as a senior chemotherapy/oncology/hematology nurse at St Bartholomew's Hospital. She has recently been promoted to acute oncology clinical nurse specialist at St George's Hospital in London and has acquired a specialty in systemic anticancer therapy regimens. This experience, along with her qualifications, has given her the confidence to assess and manage acute oncology complications
- Andrea Carroll Bullock, BSN, ISMPP, CMPP, is the director of US medical communications at EMD Serono, where she has directed US medical publications and communications in the oncology, neurology, immunology, fertility, and HIV therapeutic areas for the past 4 years. She has 20 years of experience in the pharmaceutical industry. Prior to joining industry, Ms Carroll Bullock worked as a registered nurse in teaching hospitals, such as the MedStar Washington Hospital Center. Her primary area of focus in the clinical setting was caring for patients in the medical intensive care and oncology units. Additionally, she has experience as a nurse manager for a community-based hematology/oncology practice, where she was responsible for treating patients and managing the infusion center. Ms Carroll Bullock holds a bachelor of science in nursing from Howard University and is a master of business administration candidate at Johns Hopkins Carey Business School
- Geeta Devgan, PhD, is a senior medical director in US medical affairs at Pfizer Oncology. She received her PhD in molecular, cellular, and developmental biology from Yale University and completed her postdoctoral training at Memorial Sloan-Kettering Cancer Center. Dr Devgan has more than 15 years of oncology experience in medical leadership roles within pharmaceutical companies
- Kathleen D. Burns, MSN, RN, AGACNP-BC, OCN, has a postmaster's certificate for nurse practitioners in acute care–gerontology from the University of Connecticut. Her work experience includes 28 years of cancer nursing in patient care, education, and management
| | - Kathleen D. Burns
- Cleveland Clinic Taussig Cancer Center, Cleveland, Ohio (Ms Wood); University of Chicago Medicine, Genitourinary Oncology, Chicago, Illinois (Ms Conway); St Bartholomew's Hospital, London, United Kingdom (Ms Lapuente, Mr Salvador, Ms Fernandez Gomez); St George's Hospital, London, United Kingdom (Ms Fernandez Gomez); EMD Serono, Rockland, Massachusetts (Ms Carroll Bullock); Pfizer Inc, New York, New York (Dr Devgan); City of Hope Medical Center, Genitourinary Medical Oncology, Duarte, California (Ms Burns)
- Laura S. Wood, MSN, RN, OCN, is the renal cancer clinical research coordinator at the Cleveland Clinic Cancer Center in Cleveland, Ohio. She completed both her bachelor's and master's degrees in nursing at Kent State University in Kent, Ohio. She is involved in the care of patients with renal and genitourinary cancers. Ms Wood is a member of the Protocol Review and Monitoring Committee, the Immunotherapy Education Committee, and the Immune-Related Adverse Event Tumor Board. She is also active in the local and national Oncology Nursing Society, the American Society of Clinical Oncology, and the Society for Immunotherapy of Cancer. A national and international lecturer on topics related to oncology nursing, Ms Wood has authored many book chapters and journal articles on therapeutic approaches and nursing care in the management of cancer. She was also the recipient of the 2012 Oncology Nursing Society Clinical Lectureship Award
- Dawn Conway, BSN, RN, OCN, is a registered nurse with 14 years of oncology experience, the first 3 years of which were spent as a bone marrow transplant nurse at Mount Sinai in New York City. For the past 11 years, Ms Conway has been working with the genitourinary oncology group at University of Chicago Medicine, specifically with patients with urothelial cancer, making her an expert in urothelial cancer management
- Maria Lapuente, RN, works as the lead research nurse for the genitourinary team at St Bartholomew's Hospital in London, United Kingdom. She has 10 years of experience in oncology, including more than 4 years of cancer research collaboration with Dr Thomas Powles. She has specialized in immunotherapy treatments, particularly in phase 1 combination trials. Ms Lapuente has recently expanded her area of expertise into radiotherapy and chemotherapy in combination with immunotherapy trials for patients with metastatic nonsmall cell lung cancer. She is also the principal investigator for a questionnaire study exploring the assessment of the Managing Advanced Cancer Pain Together conversation tool to facilitate communication between patients and their health care professionals, involving patients with genitourinary, lung, breast, and myeloma cancer
- George Salvador, RGN, has 9 years of nursing experience and 6 years of experience in a hematology-oncology department. He is also part of the vascular team at St Bartholomew's Hospital that deals with peripheral and central lines, such as Hickman, Portacath, and peripherally inserted central catheters. Currently, Mr Salvador is pursuing his master's degree in advanced cancer care, which includes nurse prescribing
- Sheila Fernandez Gomez, RN, CNS, is a registered nurse with 8 years of experience in oncology, including more than 4 years working as a senior chemotherapy/oncology/hematology nurse at St Bartholomew's Hospital. She has recently been promoted to acute oncology clinical nurse specialist at St George's Hospital in London and has acquired a specialty in systemic anticancer therapy regimens. This experience, along with her qualifications, has given her the confidence to assess and manage acute oncology complications
- Andrea Carroll Bullock, BSN, ISMPP, CMPP, is the director of US medical communications at EMD Serono, where she has directed US medical publications and communications in the oncology, neurology, immunology, fertility, and HIV therapeutic areas for the past 4 years. She has 20 years of experience in the pharmaceutical industry. Prior to joining industry, Ms Carroll Bullock worked as a registered nurse in teaching hospitals, such as the MedStar Washington Hospital Center. Her primary area of focus in the clinical setting was caring for patients in the medical intensive care and oncology units. Additionally, she has experience as a nurse manager for a community-based hematology/oncology practice, where she was responsible for treating patients and managing the infusion center. Ms Carroll Bullock holds a bachelor of science in nursing from Howard University and is a master of business administration candidate at Johns Hopkins Carey Business School
- Geeta Devgan, PhD, is a senior medical director in US medical affairs at Pfizer Oncology. She received her PhD in molecular, cellular, and developmental biology from Yale University and completed her postdoctoral training at Memorial Sloan-Kettering Cancer Center. Dr Devgan has more than 15 years of oncology experience in medical leadership roles within pharmaceutical companies
- Kathleen D. Burns, MSN, RN, AGACNP-BC, OCN, has a postmaster's certificate for nurse practitioners in acute care–gerontology from the University of Connecticut. Her work experience includes 28 years of cancer nursing in patient care, education, and management
| |
Collapse
|
180
|
Monk BJ, Enomoto T, Kast WM, McCormack M, Tan DSP, Wu X, González-Martín A. Integration of immunotherapy into treatment of cervical cancer: Recent data and ongoing trials. Cancer Treat Rev 2022; 106:102385. [PMID: 35413489 PMCID: PMC10697630 DOI: 10.1016/j.ctrv.2022.102385] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 12/27/2022]
Abstract
Cervical cancer constitutes a significant health burden for women globally. While most patients with early-stage disease can be cured with radical surgery or chemoradiotherapy, patients with high-risk locally advanced disease or with recurrent/metastatic disease have a poor prognosis with standard treatments. Immunotherapies are a rational treatment for this HPV-driven cancer that commonly expresses programmed cell death ligand-1. Before 2021, pembrolizumab was the only United States Food and Drug Administration-approved immunotherapy in cervical cancer, specifically for the second-line recurrent or metastatic (r/m) setting. In late 2021, the antibody-drug conjugate tisotumab vedotin was approved for second-line r/m cervical cancer and pembrolizumab combined with chemotherapy ± bevacizumab was approved for first-line r/m disease based on results from KEYNOTE-826. Moreover, with at least 2 dozen additional immunotherapy clinical trials in the second-line and first-line r/m setting, as well as in locally advanced disease, the treatment landscape for cervical cancer may eventually encounter a potential paradigm shift. Pivotal trials of immunotherapies for cervical cancer that were recently approved or with the potential for regulatory consideration through 2024 are reviewed. As immunotherapy has the opportunity to establish new standards of care in the treatment of cervical cancers, new biomarkers to identify the ideal patient populations for these therapies may also become important. However, issues with access, affordability, and compliance in low- and middle-income countries are anticipated.
Collapse
Affiliation(s)
- Bradley J Monk
- HonorHealth Research Institute, University of Arizona College of Medicine, Creighton University School, Phoenix, AZ, USA.
| | - Takayuki Enomoto
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Niigata 951-8514, Japan.
| | - W Martin Kast
- Molecular Microbiology & Immunology, Norris Comprehensive Cancer Center, University of Southern California, 1450 Biggy Street, Los Angeles, CA 90033, USA.
| | - Mary McCormack
- Department of Oncology, University College Hospital London, London NW1 2BU, UK.
| | - David S P Tan
- Department of Haematology-Oncology, National University Cancer Institute Singapore, NUHS Tower Block, Level 7, 1E Kent Ridge Road, Singapore 119228, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, Cancer Science Institute of Singapore, National University of Singapore, NUHS Tower Block, Level 7, 1E Kent Ridge Road, Singapore 119228, Singapore.
| | - Xiaohua Wu
- Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, 270 Dong-an Road, Shanghai 200032, China.
| | - Antonio González-Martín
- Medical Oncology Department, University of Navarra Clinic, 28027 Madrid, Spain; Program for Translational Research in Solid Tumors at Center for Applied Medical Research, 31008 Pamplona, Spain.
| |
Collapse
|
181
|
Cui G. Towards a precision immune checkpoint blockade immunotherapy in patients with colorectal cancer: Strategies and perspectives. Biomed Pharmacother 2022; 149:112923. [DOI: 10.1016/j.biopha.2022.112923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/29/2022] [Accepted: 04/04/2022] [Indexed: 11/02/2022] Open
|
182
|
Current Role of Immunotherapy in Gastric, Esophageal and Gastro-Esophageal Junction Cancers—A Report from the Western Canadian Gastrointestinal Cancer Consensus Conference. Curr Oncol 2022; 29:3160-3170. [PMID: 35621647 PMCID: PMC9139288 DOI: 10.3390/curroncol29050257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/20/2022] [Accepted: 04/28/2022] [Indexed: 12/24/2022] Open
Abstract
Gastric, esophageal and gastro-esophageal junction cancers are associated with inferior outcomes. For early-stage disease, perioperative chemotherapy or chemoradiation followed by surgery is the standard treatment. For most patients with advanced upper gastrointestinal tract cancers, platinum-based chemotherapy remains a standard treatment. Recently, several randomized clinical trials have demonstrated the benefit of immunotherapy involving checkpoint inhibitors alone or in combination with chemotherapy in patients with gastro-esophageal cancer and have changed the treatment landscape. The Western Canadian Gastrointestinal Cancer Consensus Conference (WCGCCC), involving experts from four Western Canadian provinces, convened virtually on 16 June 2021 and developed the recommendations on the role of immunotherapy in patients with gastro-esophageal cancer.
Collapse
|
183
|
Wang Z, Bao A, Liu S, Dai F, Gong Y, Cheng Y. A Pyroptosis-Related Gene Signature Predicts Prognosis and Immune Microenvironment for Breast Cancer Based on Computational Biology Techniques. Front Genet 2022; 13:801056. [PMID: 35464869 PMCID: PMC9021921 DOI: 10.3389/fgene.2022.801056] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 02/22/2022] [Indexed: 12/14/2022] Open
Abstract
Breast cancer (BC) is a malignant tumor with high morbidity and mortality, which seriously threatens women's health worldwide. Pyroptosis is closely correlated with immune landscape and the tumorigenesis and development of various cancers. However, studies about pyroptosis and immune microenvironment in BC are limited. Therefore, our study aimed to investigate the potential prognostic value of pyroptosis-related genes (PRGs) and their relationship to immune microenvironment in BC. First, we identified 38 differentially expressed PRGs between BC and normal tissues. Further on, the least absolute shrinkage and selection operator (LASSO) Cox regression and computational biology techniques were applied to construct a four-gene signature based on PRGs and patients in The Cancer Genome Atlas (TCGA) cohort were classified into high- and low-risk groups. Patients in the high-risk group showed significantly lower survival possibilities compared with the low-risk group, which was also verified in an external cohort. Furthermore, the risk model was characterized as an independent factor for predicting the overall survival (OS) of BC patients. What is more important, functional enrichment analyses demonstrated the robust correlation between risk score and immune infiltration, thereby we summarized genetic mutation variation of PRGs, evaluated the relationship between PRGs, different risk group and immune infiltration, tumor mutation burden (TMB), microsatellite instability (MSI), and immune checkpoint blockers (ICB), which indicated that the low-risk group was enriched in higher TMB, more abundant immune cells, and subsequently had a brighter prognosis. Except for that, the lower expression of PRGs such as GZMB, IL18, IRF1, and GZMA represented better survival, which verified the association between pyroptosis and immune landscape. In conclusion, we performed a comprehensive bioinformatics analysis and established a four-PRG signature consisting of GZMB, IL18, IRF1, and GZMA, which could robustly predict the prognosis of BC patients.
Collapse
Affiliation(s)
- Zitao Wang
- Department of Obstetrics and Gynecology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Anyu Bao
- Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, China
| | - Shiyi Liu
- Department of Obstetrics and Gynecology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Fangfang Dai
- Department of Obstetrics and Gynecology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yiping Gong
- Department of Breast Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yanxiang Cheng
- Department of Obstetrics and Gynecology, Renmin Hospital of Wuhan University, Wuhan, China
| |
Collapse
|
184
|
Zhang HC, Deng SH, Pi YN, Guo JN, Xi H, Shi X, Yang XF, Zhang BM, Xue WN, Cui BB, Liu YL. Identification and Validation in a Novel Quantification System of Ferroptosis Patterns for the Prediction of Prognosis and Immunotherapy Response in Left- and Right-Sided Colon Cancer. Front Immunol 2022; 13:855849. [PMID: 35444656 PMCID: PMC9014300 DOI: 10.3389/fimmu.2022.855849] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 03/07/2022] [Indexed: 12/20/2022] Open
Abstract
Background This study aimed to establish a novel quantification system of ferroptosis patterns and comprehensively analyze the relationship between ferroptosis score (FS) and the immune cell infiltration (ICI) characterization, tumor mutation burden (TMB), prognosis, and therapeutic sensitivity in left-sided and right-sided colon cancers (LCCs and RCCs, respectively). Methods We comprehensively evaluated the ferroptosis patterns in 444 LCCs and RCCs based on 59 ferroptosis-related genes (FRGs). The FS was constructed to quantify ferroptosis patterns by using principal component analysis algorithms. Next, the prognostic value and therapeutic sensitivities were evaluated using multiple methods. Finally, we performed weighted gene co-expression network analysis (WGCNA) to identify the key FRGs. The IMvigor210 cohort, TCGA-COAD proteomics cohort, and Immunophenoscores were used to verify the predictive abilities of FS and the key FRGs. Results Two ferroptosis clusters were determined. Ferroptosis cluster B demonstrated a high degree of congenital ICI and stromal-related signal enrichment with a poor prognosis. The prognosis, response of targeted inhibitors, and immunotherapy were significantly different between high and low FS groups (HSG and LSG, respectively). HSG was characterized by high TMB and microsatellite instability-high subtype with poor prognosis. Meanwhile, LSG was more likely to benefit from immunotherapy. ALOX5 was identified as a key FRG based on FS. Patients with high protein levels of ALOX5 had poorer prognoses. Conclusion This work revealed that the evaluation of ferroptosis subtypes will contribute to gaining insight into the heterogeneity in LCCs and RCCs. The quantification for ferroptosis patterns played a non-negligible role in predicting ICI characterization, prognosis, and individualized immunotherapy strategies.
Collapse
Affiliation(s)
- Heng-Chun Zhang
- Department of Colorectal Surgery, Harbin Medical University Cancer Hospital, Harbin, China
| | - Shen-Hui Deng
- Department of Anesthesiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Ya-Nan Pi
- Department of Gynecology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Jun-Nan Guo
- Department of Colorectal Surgery, Harbin Medical University Cancer Hospital, Harbin, China
| | - Hua Xi
- Department of Colorectal Surgery, Harbin Medical University Cancer Hospital, Harbin, China
| | - Xin Shi
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xue-Fei Yang
- The First Department of Oncology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Bo-Miao Zhang
- Department of Colorectal Surgery, Harbin Medical University Cancer Hospital, Harbin, China
| | - Wei-Nan Xue
- Department of Colorectal Surgery, Harbin Medical University Cancer Hospital, Harbin, China
| | - Bin-Bin Cui
- Department of Colorectal Surgery, Harbin Medical University Cancer Hospital, Harbin, China
| | - Yan-Long Liu
- Department of Colorectal Surgery, Harbin Medical University Cancer Hospital, Harbin, China
| |
Collapse
|
185
|
Wang Z, Wang X, Xu Y, Li J, Zhang X, Peng Z, Hu Y, Zhao X, Dong K, Zhang B, Gao C, Zhao X, Chen H, Cai J, Bai Y, Sun Y, Shen L. Mutations of PI3K-AKT-mTOR pathway as predictors for immune cell infiltration and immunotherapy efficacy in dMMR/MSI-H gastric adenocarcinoma. BMC Med 2022; 20:133. [PMID: 35443723 PMCID: PMC9022268 DOI: 10.1186/s12916-022-02327-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 03/09/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND A significant subset of mismatch repair-deficient (dMMR)/microsatellite instability-high (MSI-H) gastric adenocarcinomas (GAC) are resistant to immune checkpoint inhibitors (ICIs), yet the underlying mechanism remains largely unknown. We sought to investigate the genomic correlates of the density of tumor-infiltrating immune cells (DTICs) and primary resistance to ICI treatment. METHODS Four independent cohorts of MSI-H GAC were included: (i) the surgery cohort (n = 175) with genomic and DTIC data, (ii) the 3DMed cohort (n = 32) with genomic and PD-L1 data, (iii) the Cancer Genome Atlas (TCGA) cohort (n = 73) with genomic, transcriptomic, and survival data, and (iv) the ICI treatment cohort (n = 36) with pre-treatment genomic profile and ICI efficacy data. RESULTS In the dMMR/MSI-H GAC, the number of mutated genes in the PI3K-AKT-mTOR pathway (NMP) was positively correlated with tumor mutational burden (P < 0.001) and sensitivity to PI3K-AKT-mTOR inhibitors and negatively correlated with CD3+ (P < 0.001), CD4+ (P = 0.065), CD8+ (P = 0.004), and FOXP3+ cells (P = 0.033) in the central-tumor rather than invasive-margin area, and the transcription of immune-related genes. Compared to the NMP-low (NMP = 0/1) patients, the NMP-high (NMP ≥ 2) patients exhibited a poorer objective response rate (29.4% vs. 85.7%, P < 0.001), progression-free survival (HR = 3.40, P = 0.019), and overall survival (HR = 3.59, P = 0.048) upon ICI treatment. CONCLUSIONS Higher NMP was identified as a potential predictor of lower DTICs and primary resistance to ICIs in the dMMR/MSI-H GAC. Our results highlight the possibility of using mutational data to estimate DTICs and administering the PI3K-AKT-mTOR inhibitor as an immunotherapeutic adjuvant in NMP-high subpopulation to overcome the resistance to ICIs.
Collapse
Affiliation(s)
- Zhenghang Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Oncology, Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Xinyu Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Pathology, Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Yu Xu
- Medical Affairs, 3D Medicines, Inc, Shanghai, China
| | - Jian Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Oncology, Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Xiaotian Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Oncology, Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Zhi Peng
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Oncology, Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Yajie Hu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Pathology, Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Xinya Zhao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Pathology, Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Kun Dong
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Pathology, Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Bei Zhang
- Medical Affairs, 3D Medicines, Inc, Shanghai, China
| | - Chan Gao
- Medical Affairs, 3D Medicines, Inc, Shanghai, China
| | | | - Hui Chen
- Medical Affairs, 3D Medicines, Inc, Shanghai, China
| | - Jinping Cai
- Medical Affairs, 3D Medicines, Inc, Shanghai, China
| | - Yuezong Bai
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Oncology, Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Yu Sun
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Pathology, Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, China.
| | - Lin Shen
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Oncology, Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, China.
| |
Collapse
|
186
|
Yue Q, Zhang Y, Wang F, Cao F, Duan X, Bai J. Classification of colorectal carcinoma subtypes based on ferroptosis-associated molecular markers. World J Surg Oncol 2022; 20:117. [PMID: 35410338 PMCID: PMC9004151 DOI: 10.1186/s12957-022-02575-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 03/18/2022] [Indexed: 01/17/2023] Open
Abstract
Background Ferroptosis is associated with the development of many cancers; the molecular features of colorectal carcinoma (CRC) based on ferroptosis-related genes (FRGs) remain unknown. Herein, we aimed to identify ferroptosis-associated molecular subtypes of CRC based on the expression profiles of FRGs. Methods To explore ferroptosis-associated subtypes of CRC, the gene expression data and clinical information of 682 patients were extracted from The Cancer Genome Atlas and Gene Expression Omnibus databases. We performed consensus clustering to identify robust clusters of patients. Then the distribution of the subtypes in terms of prognosis significance, transcriptome features, immune microenvironment, drug sensitivity, gene mutations, and copy number alternations (CNAs) were evaluated respectively. In addition, we analyzed the correlation of these ferroptosis-associated molecular subtypes with the distribution of conventional clinical indicators in CRC. Results Four subtypes of CRC (C1, C2, C3, and C4) were identified in which the prognosis, immune cell infiltration, immune score, stromal score, and tumor purity were significantly different between the four subtypes. The C3 subtype had a higher infiltration of B cells, M2 macrophages, resting mast cells, monocytes, natural killer cells, plasma cells, and CD8 T cells. The C3 subtype had the highest immune and stromal scores and the lowest tumor purity. In contrast, the C4 subtype demonstrated the lowest immune and stromal scores and the highest tumor purity. Programmed cell death ligand 1 (PD-L1), an immune checkpoint protein, was differentially expressed in the four subtypes (P < 2e–16) and was significantly correlated with the expression of several FRGs in all subtypes. Significant differences in stem cell indices (P < 0.01) and drug sensitivity (P < 0.01) were observed in the four subtypes. Additionally, gene mutations analysis showed that FRGs such as TP53 had a high frequency of mutation in the four subtypes (49%, 62%, 61%, and 71%, respectively), and the CNAs showed significant difference among all subtypes (P < 0.001). Conclusion In summary, the ferroptosis-associated subtypes could serve as an independent biomarker for estimating oncological outcomes in patients with CRC. Our results demonstrated that the high level of heterogeneity in the expression of FRGs might be useful for the stratification of patients with CRC and the implementation of individualized therapeutic strategies. Supplementary Information The online version contains supplementary material available at 10.1186/s12957-022-02575-5.
Collapse
Affiliation(s)
- Qingfang Yue
- Department of Medical Oncology, Shaanxi Provincial People's Hospital, Affiliated Hospital of Northwestern Polytechnical University, Xi'an, Shaanxi, People's Republic of China.,Institute of Medical Research, Northwestern Polytechnic University, Xi'an, Shaanxi, People's Republic of China
| | - Yuan Zhang
- Department of Medical Oncology, Shaanxi Provincial People's Hospital, Affiliated Hospital of Northwestern Polytechnical University, Xi'an, Shaanxi, People's Republic of China
| | - Fei Wang
- Department of Gynecology, Shaanxi Provincial People's Hospital, Affiliated Hospital of Northwestern Polytechnical University, Xi'an, Shaanxi, People's Republic of China
| | - Fei Cao
- Department of Medical Oncology, Shaanxi Provincial People's Hospital, Affiliated Hospital of Northwestern Polytechnical University, Xi'an, Shaanxi, People's Republic of China
| | - Xianglong Duan
- Institute of Medical Research, Northwestern Polytechnic University, Xi'an, Shaanxi, People's Republic of China. .,Second Department of General Surgery, Shaanxi Provincial People's Hospital, Affiliated Hospital of Northwestern Polytechnical University, Xi'an, Shaanxi, People's Republic of China. .,Medical college, Xizang Mingzu University, Xianyang, Shaanxi, People's Republic of China.
| | - Jun Bai
- Department of Medical Oncology, Shaanxi Provincial People's Hospital, Affiliated Hospital of Northwestern Polytechnical University, Xi'an, Shaanxi, People's Republic of China.
| |
Collapse
|
187
|
Gray S, Lamarca A, Edeline J, Klümpen HJ, Hubner RA, McNamara MG, Valle JW. Targeted Therapies for Perihilar Cholangiocarcinoma. Cancers (Basel) 2022; 14:1789. [PMID: 35406560 PMCID: PMC8997784 DOI: 10.3390/cancers14071789] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 11/16/2022] Open
Abstract
Perihilar cholangiocarcinoma (pCCA) is the anatomical sub-group of biliary tract cancer (BTC) arising between the second-order intrahepatic bile ducts and the cystic duct. Together with distal and intrahepatic cholangiocarcinoma (dCCA and iCCA; originating distal to, and proximal to this, respectively), gallbladder cancer (GBC) and ampulla of Vater carcinoma (AVC), these clinicopathologically and molecularly distinct entities comprise biliary tract cancer (BTC). Most pCCAs are unresectable at diagnosis, and for those with resectable disease, surgery is extensive, and recurrence is common. Therefore, the majority of patients with pCCA will require systemic treatment for advanced disease. The prognosis with cytotoxic chemotherapy remains poor, driving interest in therapies targeted to the molecular nature of a given patient's cancer. In recent years, the search for efficacious targeted therapies has been fuelled both by whole-genome and epigenomic studies, looking to uncover the molecular landscape of CCA, and by specifically testing for aberrations where established therapies exist in other indications. This review aims to provide a focus on the current molecular characterisation of pCCA, targeted therapies applicable to pCCA, and future directions in applying personalised medicine to this difficult-to-treat malignancy.
Collapse
Affiliation(s)
- Simon Gray
- Department of Medical Oncology, The Christie NHS Foundation Trust, Wilmslow Rd, Manchester M20 4BX, UK; (S.G.); (A.L.); (R.A.H.); (M.G.M.)
| | - Angela Lamarca
- Department of Medical Oncology, The Christie NHS Foundation Trust, Wilmslow Rd, Manchester M20 4BX, UK; (S.G.); (A.L.); (R.A.H.); (M.G.M.)
- Division of Cancer Sciences, University of Manchester, Oxford Rd, Manchester M13 9PL, UK
| | - Julien Edeline
- Centre Eugène Marquis, Av. de la Bataille Flandres Dunkerque-CS 44229, CEDEX, 35042 Rennes, France;
| | - Heinz-Josef Klümpen
- Department of Medical Oncology, Amsterdam University Medical Center, P.O. Box 7057, 1081 HV Amsterdam, The Netherlands;
| | - Richard A. Hubner
- Department of Medical Oncology, The Christie NHS Foundation Trust, Wilmslow Rd, Manchester M20 4BX, UK; (S.G.); (A.L.); (R.A.H.); (M.G.M.)
- Division of Cancer Sciences, University of Manchester, Oxford Rd, Manchester M13 9PL, UK
| | - Mairéad G. McNamara
- Department of Medical Oncology, The Christie NHS Foundation Trust, Wilmslow Rd, Manchester M20 4BX, UK; (S.G.); (A.L.); (R.A.H.); (M.G.M.)
- Division of Cancer Sciences, University of Manchester, Oxford Rd, Manchester M13 9PL, UK
| | - Juan W. Valle
- Department of Medical Oncology, The Christie NHS Foundation Trust, Wilmslow Rd, Manchester M20 4BX, UK; (S.G.); (A.L.); (R.A.H.); (M.G.M.)
- Division of Cancer Sciences, University of Manchester, Oxford Rd, Manchester M13 9PL, UK
| |
Collapse
|
188
|
Zhang X, Yang Z, An Y, Liu Y, Wei Q, Xu F, Yao H, Zhang Z. Clinical benefits of PD-1/PD-L1 inhibitors in patients with metastatic colorectal cancer: a systematic review and meta-analysis. World J Surg Oncol 2022; 20:93. [PMID: 35331250 PMCID: PMC8944161 DOI: 10.1186/s12957-022-02549-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 03/01/2022] [Indexed: 01/22/2023] Open
Abstract
Background Immunotherapy for colorectal cancer has developed rapidly in the past decade. Many high-quality clinical trials examining the application of PD-1/PD-L1 inhibitors in patients with metastatic colorectal cancer (mCRC) have been conducted in recent years. However, the clinical benefits, including the efficacy and safety of these treatments against mCRC, remain controversial. Hence, we conducted this meta-analysis on the clinical benefits of PD-1/PD-L1 inhibitors in patients with mCRC. Methods We searched online databases including MEDLINE, Embase, Cochrane Library, and Web of Science, from inception to January 4, 2021. The outcomes related to efficacy and safety were extracted and analyzed. Subgroup analyses were conducted according to the categories of dMMR-MSI-H (tumors with mismatch repair deficiency and high levels of microsatellite instability) ≥ 5% vs. dMMR-MSI-H < 5%, monotherapy vs. combination therapy, PD-1 inhibitors vs. PD-L1 inhibitors, and nivolumab vs. pembrolizumab. Results Fourteen studies including 1129 subjects were included in our systematic review. The overall complete response (CR), partial response (PR), stable disease (SD), and progression of disease (PD) rates were 0.01 (95% CI 0.00–0.04), 0.04 (95% CI 0.05–0.26), 0.27 (95% CI 0.22–0.32), and 0.44 (95% CI 0.30–0.58), respectively. The overall objective response rate (ORR) and disease control rate (DCR) were 0.16 (95%CI 0.06–0.31) and 0.50 (95%CI 0.35–0.65), respectively. The overall rate of adverse events (AEs) and severe adverse responses (SAEs) were 0.84 (95% CI 0.72–0.92) and 0.30 (95% CI 0.20–0.41), respectively. The ORRs of the dMMR-MSI-H ≥ 5% and dMMR-MSI-H < 5% subgroups were 0.40 (95% CI 0.30–0.51) and 0.04 (95% CI 0.00–0.09), respectively. Conclusions PD-1/PD-L1 inhibitors produced encouraging clinical benefits including the response rate in the treatment of dMMR-MSI-H mCRC. They actually have been influenced by the present state of mCRC therapy including pMMR-MSI-L mCRC. Nevertheless, additional multi-center prospective studies are still expected. Trial registration We have registered this study in the International Prospective Register of Systematic Reviews (PROSPERO), and the registration number is CRD42021249601. Supplementary Information The online version contains supplementary material available at 10.1186/s12957-022-02549-7.
Collapse
Affiliation(s)
- Xiao Zhang
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, 95 Yong-an Rd, Xi-Cheng District, Beijing, China
| | - Zhengyang Yang
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, 95 Yong-an Rd, Xi-Cheng District, Beijing, China
| | - Yongbo An
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, 95 Yong-an Rd, Xi-Cheng District, Beijing, China
| | - Yishan Liu
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, 95 Yong-an Rd, Xi-Cheng District, Beijing, China
| | - Qi Wei
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, 95 Yong-an Rd, Xi-Cheng District, Beijing, China
| | - Fengming Xu
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, 95 Yong-an Rd, Xi-Cheng District, Beijing, China
| | - Hongwei Yao
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, 95 Yong-an Rd, Xi-Cheng District, Beijing, China.
| | - Zhongtao Zhang
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, 95 Yong-an Rd, Xi-Cheng District, Beijing, China.
| |
Collapse
|
189
|
Cao Y, Wu Q, Lian S, Deng L. Lymphocytes Infiltration and Expression of PD-1 and PD-L1 in Colorectal Cancer Between HIV-Infected and Non-HIV-Infected Patients: A Propensity Score Matched Cohort Study. Front Oncol 2022; 12:827596. [PMID: 35311077 PMCID: PMC8924460 DOI: 10.3389/fonc.2022.827596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 02/09/2022] [Indexed: 11/25/2022] Open
Abstract
Background Tumor-infiltrating lymphocytes (TILs) and expression of programmed cell death 1 (PD-1)/programmed death ligand-1 (PD-L1) are crucial for antitumor immunity. However, the status remains undetermined in HIV-infected colorectal cancer (CRC), limiting the use of immunotherapy in HIV-infected CRC patients. Methods We examined 27 HIV-infected patients and 120 non-HIV-infected patients with CRC from 2015-2020 at Shanghai Public Health Clinical Center. After matching the propensity score, 13 paired patients in the two groups were also compared. The expression of PD-1/PD-L1 as well as tumor-infiltrating CD4, CD8, and CD56 immune cells was examined using multiplex immunofluorescent analysis. The cell density for positive staining was calculated (cells/mm2) and compared between HIV-infected and non-HIV-infected groups. In addition, the co-expression of PD-1 on immune cells and PD-L1 on tumor cells was compared in these two groups. Results The mean densities of tumor-infiltrating CD4, CD8, CD56 immune cells were 620.2, 261.2, and 0.2 cells/mm2, respectively, in HIV-infected colorectal tumors compared with 698.6, 243, and 14 cells/mm2 in non-HIV-infected tumors. PD-1 expression was 227 cells/mm2 in HIV-infected tumors and 365.2 cells/mm2 in non-HIV-infected tumors. Besides, PD-L1 expression was 108.5 cells/mm2 in HIV-infected tumors and 126.8 cells/mm2 in non-HIV-infected tumors, and no significant difference was found between the two groups. Similarly, there were no significant differences in the expression of PD-1 on TILs and PD-L1 on tumor cells. Conclusion HIV-infected CRC patients had similar tumor-infiltrating lymphocytes (CD4 and CD8 T cells) compared to non-HIV-infected controls and substantially similar PD-1 expression on TILs and PD-L1 expression on tumors. These results support the inclusion of HIV-infected CRC patients in future immunotherapy trials.
Collapse
Affiliation(s)
- Ye Cao
- Department of General Surgery, The Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Qian Wu
- Department of General Surgery, The Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Shixian Lian
- Department of General Surgery, The Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Li Deng
- Department of General Surgery, The Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| |
Collapse
|
190
|
Cann C, Ciombor KK. Systemic therapy for gastric cancer: Perioperative strategies and beyond. J Surg Oncol 2022; 125:1151-1160. [PMID: 35230696 DOI: 10.1002/jso.26834] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 02/16/2022] [Indexed: 12/23/2022]
Abstract
Each year, gastric cancer claims the lives of hundreds of thousands of patients worldwide. Despite surgical resection, the risk of residual disease, micrometastatic disease, and disease recurrence remain elevated. Herein, we review systemic therapy strategies in the neoadjuvant, adjuvant, and metastatic settings, including novel uses of immunotherapy, targeted therapies and cytotoxic chemotherapies, for the treatment of gastric cancer.
Collapse
Affiliation(s)
- Christopher Cann
- Division of Hematology/Oncology, Department of Internal Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Kristen K Ciombor
- Division of Hematology/Oncology, Department of Internal Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| |
Collapse
|
191
|
Kawamata A, Sasada S, Emi A, Masumoto N, Kadoya T. Monitoring of Programmed Cell Death Ligand-1 Blockade Using FDG PET/CT for Microsatellite Instability-High Metastatic Breast Cancer. Clin Nucl Med 2022; 47:e252-e253. [PMID: 34593689 DOI: 10.1097/rlu.0000000000003950] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Microsatellite instability-high/mismatch repair deficiency is one of biomarkers predicting the response to pembrolizumab, an immune checkpoint inhibitor for metastatic solid tumors. A 44-year-old woman with stage IIIC right breast cancer was treated with mastectomy and axillary node dissection after primary systemic chemotherapy followed by radiation, chemotherapy, and hormonal therapy. Eighteen months after surgery, recurrent diseases were revealed and refractory to multiple treatments. The recurrent site biopsy showed microsatellite instability-high, and programmed cell death ligand-1 inhibitor pembrolizumab was administrated. FDG PET/CT showed complete metabolic response over 12 months and is useful to monitor the response of active immunotherapy.
Collapse
Affiliation(s)
- Ayumi Kawamata
- From the Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | | | | | | | | |
Collapse
|
192
|
Cardin DB, Gilbert J, Whisenant JG, Ayers GD, Jalikis F, Dahlman KB, O'Neal JF, Revetta F, Shi C, Berlin J. Safety and Efficacy of Avelumab in Small Bowel Adenocarcinoma. Clin Colorectal Cancer 2022; 21:236-243. [DOI: 10.1016/j.clcc.2022.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 03/17/2022] [Indexed: 11/27/2022]
|
193
|
Yuan F, Wang Y, Ma C. Current WHO Guidelines and the Critical Role of Genetic Parameters in the Classification of Glioma: Opportunities for Immunotherapy. Curr Treat Options Oncol 2022; 23:188-198. [PMID: 35182297 DOI: 10.1007/s11864-021-00930-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2021] [Indexed: 12/25/2022]
Abstract
OPINION STATEMENT In the 5 years since the fourth edition of the WHO Classification of Tumors of the Central Nervous System (CNS) (revised) was released, the development of targeted sequencing and omics technology has helped researchers in the field of neuro-oncology to identify some new tumor types in clinical practice, as well as a series of genetic parameters related to tumor occurrence and development, poor prognosis, treatment response, etc. These findings not only provide basic knowledge for the classification of glioma, but also promote the progress of the treatment of gliomas. As a revolution in cancer treatment, immunotherapy has become a promising strategy since the pioneering discovery of lymphatics in the CNS. The advancement and clinical application of immunotherapy have strengthened the demand for accurate classification of glioma. In June 2021, the WHO and the International Agency for Research on Cancer (IARC) published the fifth edition of the WHO Classification of Tumors of the CNS. The fifth edition focuses on advancing the role of genetic parameters in the classification of glioma and divides glioma into more biologically and molecularly defined entities, with better natural history characteristics, and introduced new tumor types and subtypes, especially in the pediatric population. Most importantly, these updated classifications will enable clinicians to better assess the prognosis and formulate the optimal treatment of gliomas.
Collapse
Affiliation(s)
- Feng Yuan
- Department of Neurosurgery, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| | - Yingshuai Wang
- Department of Internal Medicine III, University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany
| | - Chiyuan Ma
- Department of Neurosurgery, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.
| |
Collapse
|
194
|
Xie M, Chen D, Li Y, Liu X, Kuang D, Li X. Genetic mutation profiles and immune microenvironment analysis of pulmonary enteric adenocarcinoma. Diagn Pathol 2022; 17:30. [PMID: 35172862 PMCID: PMC8849039 DOI: 10.1186/s13000-022-01206-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 01/25/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Pulmonary enteric adenocarcinoma (PEAC) has distinctive clinical outcomes, radiographic, pathological and molecular characteristics. The prognosis of patients with PEAC was poor. However, molecular profiles and therapeutic biomarkers of PEAC remain elusive. METHODS In the present study, the hospitalized patients with PEAC admitted to Tongji Hospital in Wuhan from January 1, 2014 to November 20, 2020 were retrospectively enrolled and followed until December 10, 2020. Comprehensive genomic profiling of tumor tissue from the PEAC patients were performed and compared with lung adenocarcinoma, colorectal cancer and metastatic colorectal carcinoma. Tumor immune microenvironment analysis were evaluated. RESULTS There were 10 patients with PEAC enrolled. 70% of patients were male and the median age of onset was 63 years (interquartile range, 55-72). There were six early-stage patients (Stage IA to IIB) and four stage IV patients. Molecular analysis revealed the most common gene mutations included TP53 (57%, 4/7) and KRAS (57%, 4/7) mutations. There were 40% mutations occurred in genes encoding receptor tyrosine kinases (RTKs). 100% of patients (8/8) were microsatellite stability (MSS). The median level of TMB was 6.0 (interquartile range, 4.5-7.0) mutations/Mb. Three of 10 patients showed low PD-L1 expression (tumor proportion score < 10%) and the others were PD-L1 negative. A small subset of CD8+, CD3+, CD68+ T cells were observed and were mainly distributed in the cancer stroma. CONCLUSION This study demonstrated that PEAC was characterized by low-frequency RTK gene mutation, high KRAS mutation, low PD-L1 expression, low TMB, and low CD8+ T cells infiltration.
Collapse
Affiliation(s)
- Min Xie
- Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, China.,Key Laboratory of Respiratory Diseases, National Ministry of Health of the People's Republic of China and National Clinical Research Center for Respiratory Disease, 1095 Jiefang Avenue, Wuhan, 430030, China
| | - Dong Chen
- Department of Pathology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yong Li
- Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, China.,Key Laboratory of Respiratory Diseases, National Ministry of Health of the People's Republic of China and National Clinical Research Center for Respiratory Disease, 1095 Jiefang Avenue, Wuhan, 430030, China
| | - Xiansheng Liu
- Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, China.,Key Laboratory of Respiratory Diseases, National Ministry of Health of the People's Republic of China and National Clinical Research Center for Respiratory Disease, 1095 Jiefang Avenue, Wuhan, 430030, China
| | - Dong Kuang
- Department of Pathology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Xiaochen Li
- Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, China. .,Key Laboratory of Respiratory Diseases, National Ministry of Health of the People's Republic of China and National Clinical Research Center for Respiratory Disease, 1095 Jiefang Avenue, Wuhan, 430030, China.
| |
Collapse
|
195
|
Meshcheryakova MY, Kolesnikov EN, Trifanov VS, Timoshkina NN, Snezhko AV, Gvaldin DY. Microsatellite instability in colorectal neuroendocrine neoplasms. BULLETIN OF RUSSIAN STATE MEDICAL UNIVERSITY 2022. [DOI: 10.24075/brsmu.2022.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Microsatellite instability (MSI) characterizes a special molecular genetic subtype of malignancies and is associated with the deficiency of mismatched DNA repair. There are no reliable data on the frequency of MSI in colorectal neuroendocrine neoplasms due to the relative rarity of this cancer type. The prognostic significance of MSI is debatable. The aim of this study was to investigate the frequency of the MSI phenotype among colorectal neuroendocrine neoplasms (NENs) with different primary location, grade and stage. Twenty-nine patients (15 men and 14 women, mean age: 62.5 years) included in the study underwent surgery for colorectal neuroendocrine tumors between 2015 and 2018. The mean follow-up period was 3.8 years. Colorectal NENs were grouped by primary location and stage. The majority of the patients (52%) had stage III cancer at diagnosis. The microsatellite stability (MSS) phenotype was confirmed in 24 patients (83%), whereas the MSI phenotype was observed in 5 patients (17%). All MSI-positive tumors were stage I well-differentiated grade G1 or G2 neuroendocrine tumors (NETs) of the rectum. Overall survival was 50% for patients with stage II MSS-positive NENs of the colon and rectum, 33% for stage III and 0% for stage IV. For patients with stage I MSI-positive NENs of the rectum, overall survival was 100%. Thus, the frequency of MSI-positive colorectal NENs was estimated.
Collapse
Affiliation(s)
| | - EN Kolesnikov
- National Medical Research Center of Oncology, Rostov-on-Don, Russia
| | - VS Trifanov
- National Medical Research Center of Oncology, Rostov-on-Don, Russia
| | - NN Timoshkina
- National Medical Research Center of Oncology, Rostov-on-Don, Russia
| | - AV Snezhko
- National Medical Research Center of Oncology, Rostov-on-Don, Russia
| | - DYu Gvaldin
- National Medical Research Center of Oncology, Rostov-on-Don, Russia
| |
Collapse
|
196
|
Zhao L, Luo B, Wang L, Chen W, Jiang M, Zhang N. Pan-cancer analysis reveals the roles of XPO1 in predicting prognosis and tumorigenesis. Transl Cancer Res 2022; 10:4664-4679. [PMID: 35116322 PMCID: PMC8797940 DOI: 10.21037/tcr-21-1646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 10/14/2021] [Indexed: 12/13/2022]
Abstract
Background Exportin 1 (XPO1), a nuclear export protein, participates in many biological processes, including mRNA transport, nucleocytoplasmic transport, nuclear protein export, regulation of mRNA stability, and drug response. XPO1 plays key roles in many cancer types and may serve as a potential biomarker. It is significant to systematically elucidate the roles of XPO1 in various cancer types in terms of function, molecular biology, immunology, and clinical relevance. Methods Data from UCSC Xena, CCLE, and CBioPortal were analyzed for the investigation of the differential expression of XPO1 across multiple cancer types. Clinical data were acquired to analyze the influence of XPO1 on the clinical characteristics of patients, such as survival outcome and clinical stage. The roles of XPO1 in the onset and progression of multiple cancers were expounded in terms of genetic changes at the molecular level [including tumor mutational burden (TMB), microsatellite instability (MSI), copy number variation (CNV), methylation, and gene co-expression], biological pathway changes, and the immune microenvironment. Results XPO1 was overexpressed in various tumor types, which may be related to CNV. Clinical data analysis revealed that XPO1 may serve as a risk factor in tumors, such as adrenocortical carcinoma, liver hepatocellular carcinoma, and low-grade glioma, thereby affecting patient prognosis. XPO1 in multiple tumor types was also substantially correlated with clinical stage, patient gender, and patient age. In certain tumors, the expression level of XPO1 exerted a greater influence on TMB and MSI. It was also found that XPO1 inhibited the activity of immune cells in the tumor immune microenvironment, such as CD8+ T cells, and affected biological pathways, such as the cell cycle and oxidative phosphorylation, and drove the expression of cancer driver genes, immune checkpoint genes, and highly mutated genes. Conclusions XPO1 is a potential pan-cancer risk factor as it may jointly promote tumor onset and progression by inhibiting the immune response, influencing relevant biological pathways, and promoting mutations in other genes.
Collapse
Affiliation(s)
- Lei Zhao
- Department of Critical Care Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Baiwei Luo
- The First Clinical Medical School of Guangdong Medical University, Zhanjiang, China
| | - Liang Wang
- Department of Hematology, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Wei Chen
- Department of Critical Care Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Manyu Jiang
- The First Clinical Medical School of Guangdong Medical University, Zhanjiang, China
| | - Nengwei Zhang
- Surgery Centre of Diabetes Mellitus, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
197
|
Lin MT, Zheng G, Rodriguez E, Tseng LH, Parini V, Xian R, Zou Y, Gocke CD, Eshleman JR. Double PIK3CA Alterations and Parallel Evolution in Colorectal Cancers. Am J Clin Pathol 2022; 157:244-251. [PMID: 34519764 DOI: 10.1093/ajcp/aqab119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 06/11/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To demonstrate clinicopathologic features and evaluate the clonality of double PIK3CA alterations in colorectal cancers (CRCs). METHODS Clonality was examined in 13 CRCs with double PIK3CA alterations (1.7% of CRCs or 9.6% of PIK3CA-mutated CRCs). Multiregional analyses were performed to confirm subclonal PIK3CA alterations. RESULTS PIK3CA alterations were detected within exon 9 (51%), exon 20 (23%), exon 1 (15%), and exon 7 (6.0%). CRCs with exon 7 alterations showed a significantly higher incidence of double PIK3CA alterations. Most double PIK3CA alterations consisted of a hotpsot alteration and an uncommon alteration; they were often clonal and present within a single tumor population. Multiregional analyses of CRCs with predicted subclonal double-alterations revealed multiclonal CRCs with divergent PIK3CA variant status originating from a common APC- and KRAS-mutated founder lineage of adenoma. CONCLUSIONS The findings supported multiclonal CRCs resulting from parallel evolution during the progression from adenoma to adenocarcinoma within the mitogen-activated protein kinase pathway, as previously demonstrated, or the mammalian target of rapamycin pathway. Further studies are warranted to elucidate clinical significance and potential targeted therapy for CRC patients with double PIK3CA alterations and impacts on clinical decision-making in patients with multiclonal CRCs harboring divergent PIK3CA mutational status.
Collapse
Affiliation(s)
- Ming-Tseh Lin
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Gang Zheng
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Pathology and Laboratory Medicine, Mayo Clinic, Rochester, MN, USA
| | - Erika Rodriguez
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Li-Hui Tseng
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Graduate Institute of Medical Genomics and Proteomics, National Taiwan University, Taipei, Taiwan
| | - Vamsi Parini
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Rena Xian
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ying Zou
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Christopher D Gocke
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - James R Eshleman
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| |
Collapse
|
198
|
Stadler JC, Belloum Y, Deitert B, Sementsov M, Heidrich I, Gebhardt C, Keller L, Pantel K. Current and Future Clinical Applications of ctDNA in Immuno-Oncology. Cancer Res 2022; 82:349-358. [PMID: 34815256 PMCID: PMC9397642 DOI: 10.1158/0008-5472.can-21-1718] [Citation(s) in RCA: 59] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 10/06/2021] [Accepted: 11/09/2021] [Indexed: 01/07/2023]
Abstract
Testing peripheral blood for circulating tumor DNA (ctDNA) offers a minimally invasive opportunity to diagnose, characterize, and monitor the disease in individual cancer patients. ctDNA can reflect the actual tumor burden and specific genomic state of disease and thus might serve as a prognostic and predictive biomarker for immune checkpoint inhibitor (ICI) therapy. Recent studies in various cancer entities (e.g., melanoma, non-small cell lung cancer, colon cancer, and urothelial cancer) have shown that sequential ctDNA analyses allow for the identification of responders to ICI therapy, with a significant lead time to imaging. ctDNA assessment may also help distinguish pseudoprogression under ICI therapy from real progression. Developing dynamic changes in ctDNA concentrations as a potential surrogate endpoint of clinical efficacy in patients undergoing adjuvant immunotherapy is ongoing. Besides overall ctDNA burden, further ctDNA characterization can help uncover tumor-specific determinants (e.g., tumor mutational burden and microsatellite instability) of responses or resistance to immunotherapy. In future studies, standardized ctDNA assessments need to be included in interventional clinical trials across cancer entities to demonstrate the clinical utility of ctDNA as a biomarker for personalized cancer immunotherapy.
Collapse
Affiliation(s)
- Julia-Christina Stadler
- Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Dermatology and Venereology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Mildred Scheel Cancer Career Center HaTriCS4, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Yassine Belloum
- Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Benjamin Deitert
- Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mark Sementsov
- Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Isabel Heidrich
- Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Dermatology and Venereology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Mildred Scheel Cancer Career Center HaTriCS4, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christoffer Gebhardt
- Department of Dermatology and Venereology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Laura Keller
- Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Corresponding Authors: Klaus Pantel, Institute for Tumor Biologie, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, Hamburg, 20246, Germany. E-mail: ; and Laura Keller, E-mail:
| | - Klaus Pantel
- Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Corresponding Authors: Klaus Pantel, Institute for Tumor Biologie, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, Hamburg, 20246, Germany. E-mail: ; and Laura Keller, E-mail:
| |
Collapse
|
199
|
Systemic Treatment for Metastatic Biliary Tract Cancer: State of the Art and a Glimpse to the Future. Curr Oncol 2022; 29:551-564. [PMID: 35200550 PMCID: PMC8871084 DOI: 10.3390/curroncol29020050] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 12/30/2022] Open
Abstract
Recent years have seen some breakthroughs in the therapeutic landscape of advanced biliary tract cancer (BTC). Firstly, a better understanding of the molecular background of BTC has led to important improvements in the management of these hepatobiliary malignancies, with the advent of targeted agents representing an unprecedented paradigm shift, as witnessed by the FDA approval of pemigatinib and infigratinib for FGFR2-rearranged and ivosidenib in IDH1-mutant cholangiocarcinoma. In addition, several novel treatments are under assessment, including immune checkpoint inhibitors and combination chemotherapies. In the current review, we provide an overview of systemic treatment for metastatic BTC, summarizing recent clinical data on chemotherapy as well as the main results of targeted therapies and immunotherapy.
Collapse
|
200
|
Zhang S, Xiong H, Yang J, Yuan X. Pan-Cancer Analysis Reveals the Multidimensional Expression and Prognostic and Immunologic Roles of VSTM2L in Cancer. Front Mol Biosci 2022; 8:792154. [PMID: 35155565 PMCID: PMC8829123 DOI: 10.3389/fmolb.2021.792154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 12/29/2021] [Indexed: 11/13/2022] Open
Abstract
Immunotherapy can improve survival in a variety of cancers by modulating the interaction between tumors and the tumor immune microenvironment (TIME). V-set and transmembrane domain containing 2 like (VSTM2L) regulates interleukin (IL)-4 signaling pathway—which involves immune-related factors—and has been linked to some cancers. However, the expression profile and prognostic significance of VSTM2L in different cancers as well as its relationship to the TIME are not known. This study investigated the pan-cancer expression profile, prognostic value, and immunologic relevance of VSTM2L. VSTM2L expression in different cancers was analyzed using the Cancer Cell Line Encyclopedia (CCLE), Human Protein Atlas (HPA), Tumor Immune Estimation Resource (TIMER), The Cancer Genome Atlas (TCGA), and Genotype–Tissue Expression (GTEx) portal. We examined the association between VSTM2L expression and clinical outcomes by Kaplan–Meier and Cox regression analyses using TCGA and Kaplan–Meier Plotter, and the results were validated in a Gene Expression Omnibus cohort. The correlations between VSTM2L expression and immune cell infiltration, immunomodulators, tumor mutation burden (TMB), microsatellite instability (MSI), and immune and stromal scores across cancers were analyzed using TCGA, TIMER, and Tumor–Immune System Interactions and Drugbank databases (TISIDB). The results showed that VSTM2L expression varied across cancers and its aberrant expression was associated with clinical outcomes: upregulation of VSTM2L was positively associated with advanced stage and reduced overall survival (OS), disease-specific survival (DSS), progression-free interval (PFI), and disease-free interval (DFI) in stomach adenocarcinoma (STAD); and its upregulation was associated with early-stage disease and improved OS, DSS, PFI, and DFI in kidney renal papillary cell carcinoma (KIRP). VSTM2L expression level was correlated with immune cell infiltration, expression of immunomodulators, TMB, MSI, and immune and stromal scores in multiple cancers. In conclusion, VSTM2L has prognostic value in various cancers and can predict both poor (STAD) and good (KIRP) outcomes. The relationship between VSTM2L expression and immune markers suggests a role in modulating the TIME.
Collapse
Affiliation(s)
- Shuyi Zhang
- Department of Oncology, Huizhou Municipal Central Hospital, Huizhou, China
| | - Hailin Xiong
- Department of Oncology, Huizhou Municipal Central Hospital, Huizhou, China
| | - Jiahui Yang
- Prenatal Diagnosis Center, Huizhou Municipal Central Hospital, Huizhou, China
| | - Xia Yuan
- Department of Oncology, Huizhou Municipal Central Hospital, Huizhou, China
- *Correspondence: Xia Yuan,
| |
Collapse
|