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Asavarut P, Waramit S, Suwan K, Marais GJK, Chongchai A, Benjathummarak S, Al‐Bahrani M, Vila‐Gomez P, Williams M, Kongtawelert P, Yata T, Hajitou A. Systemically targeted cancer immunotherapy and gene delivery using transmorphic particles. EMBO Mol Med 2022; 14:e15418. [PMID: 35758207 PMCID: PMC9358398 DOI: 10.15252/emmm.202115418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 01/21/2023] Open
Abstract
Immunotherapy is a powerful tool for cancer treatment, but the pleiotropic nature of cytokines and immunological agents strongly limits clinical translation and safety. To address this unmet need, we designed and characterised a systemically targeted cytokine gene delivery system through transmorphic encapsidation of human recombinant adeno-associated virus DNA using coat proteins from a tumour-targeted bacteriophage (phage). We show that Transmorphic Phage/AAV (TPA) particles provide superior delivery of transgenes over current phage-derived vectors through greater diffusion across the extracellular space and improved intracellular trafficking. We used TPA to target the delivery of cytokine-encoding transgenes for interleukin-12 (IL12), and novel isoforms of IL15 and tumour necrosis factor alpha (TNF α ) for tumour immunotherapy. Our results demonstrate selective and efficient gene delivery and immunotherapy against solid tumours in vivo, without harming healthy organs. Our transmorphic particle system provides a promising modality for safe and effective gene delivery, and cancer immunotherapies through cross-species complementation of two commonly used viruses.
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Affiliation(s)
- Paladd Asavarut
- Cancer Phagotherapy, Department of Brain SciencesImperial College LondonLondonUK
| | - Sajee Waramit
- Cancer Phagotherapy, Department of Brain SciencesImperial College LondonLondonUK
| | - Keittisak Suwan
- Cancer Phagotherapy, Department of Brain SciencesImperial College LondonLondonUK
| | - Gert J K Marais
- Cancer Phagotherapy, Department of Brain SciencesImperial College LondonLondonUK
| | - Aitthiphon Chongchai
- Cancer Phagotherapy, Department of Brain SciencesImperial College LondonLondonUK
- Thailand Excellence Centre for Tissue Engineering and Stem Cells, Faculty of MedicineChiang Mai UniversityChiang MaiThailand
| | - Surachet Benjathummarak
- Cancer Phagotherapy, Department of Brain SciencesImperial College LondonLondonUK
- Center of Excellence for Antibody Research, Faculty of Tropical MedicineMahidol UniversityBangkokThailand
| | - Mariam Al‐Bahrani
- Cancer Phagotherapy, Department of Brain SciencesImperial College LondonLondonUK
| | - Paula Vila‐Gomez
- Cancer Phagotherapy, Department of Brain SciencesImperial College LondonLondonUK
| | | | - Prachya Kongtawelert
- Thailand Excellence Centre for Tissue Engineering and Stem Cells, Faculty of MedicineChiang Mai UniversityChiang MaiThailand
| | - Teerapong Yata
- Cancer Phagotherapy, Department of Brain SciencesImperial College LondonLondonUK
- Present address:
Department of PhysiologyChulalongkorn UniversityBangkokThailand
| | - Amin Hajitou
- Cancer Phagotherapy, Department of Brain SciencesImperial College LondonLondonUK
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Scott SC, Shao XM, Niknafs N, Balan A, Pereira G, Marrone KA, Lam VK, Murray JC, Feliciano JL, Levy BP, Ettinger DS, Hann CL, Brahmer JR, Forde PM, Karchin R, Naidoo J, Anagnostou V. Sex-specific differences in immunogenomic features of response to immune checkpoint blockade. Front Oncol 2022; 12:945798. [PMID: 35992816 PMCID: PMC9382103 DOI: 10.3389/fonc.2022.945798] [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: 05/16/2022] [Accepted: 07/04/2022] [Indexed: 12/14/2022] Open
Abstract
Introduction The magnitude of response to immune checkpoint inhibitor (ICI) therapy may be sex-dependent, as females have lower response rates and decreased survival after ICI monotherapy. The mechanisms underlying this sex dimorphism in ICI response are unknown, and may be related to sex-driven differences in the immunogenomic landscape of tumors that shape anti-tumor immune responses in the context of therapy. Methods To investigate the association of immunogenic mutations with HLA haplotypes, we leveraged whole exome sequence data and HLA genotypes from 482 non-small cell lung cancer (NSCLC) tumors from The Cancer Genome Atlas (TCGA). To explore sex-specific genomic features linked with ICI response, we analyzed whole exome sequence data from patients with NSCLC treated with ICI. Tumor mutational burden (TMB), HLA class I and II restricted immunogenic missense mutation (IMM) load, and mutational smoking signature were defined for each tumor. IMM load was combined with HLA class I and II haplotypes and correlated with therapeutic response and survival following ICI treatment. We examined rates of durable clinical benefit (DCB) for at least six months from ICI treatment initiation. Findings were validated utilizing whole exome sequence data from an independent cohort of ICI treated NSCLC. Results Analysis of whole exome sequence data from NSCLC tumors of females and males revealed that germline HLA class II diversity (≥9 unique HLA alleles) was associated with higher tumor class II IMM load in females (p=0.01) and not in males (p=0.64). Similarly, in tumors of female patients, somatic HLA class II loss of heterozygosity was associated with increased IMM load (p=0.01) while this association was not observed in tumors in males (p=0.20). In females, TMB (p=0.005), class I IMM load (p=0.005), class II IMM load (p=0.004), and mutational smoking signature (p<0.001) were significantly higher in tumors responding to ICI as compared to non-responding tumors. In contrast, among males, there was no significant association between DCB and any of these features. When IMM was considered in the context of HLA zygosity, high MHC-II restricted IMM load and high HLA class II diversity was significantly associated with overall survival in males (p=0.017). Conclusions Inherent sex-driven differences in immune surveillance affect the immunogenomic determinants of response to ICI and likely mediate the dimorphic outcomes with ICI therapy. Deeper understanding of the selective pressures and mechanisms of immune escape in tumors in males and females can inform patient selection strategies and can be utilized to further hone immunotherapy approaches in cancer.
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Affiliation(s)
- Susan C. Scott
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Xiaoshan M. Shao
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States
- Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Noushin Niknafs
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Archana Balan
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Gavin Pereira
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Kristen A. Marrone
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Vincent K. Lam
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Joseph C. Murray
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Josephine L. Feliciano
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Benjamin P. Levy
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - David S. Ettinger
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Christine L. Hann
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Julie R. Brahmer
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Patrick M. Forde
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Rachel Karchin
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States
- Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Jarushka Naidoo
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Department of Oncology, RCSI University of Medicine and Health Sciences, Dublin, Ireland
- Department of Oncology, Beaumont Hospital, Dublin, Ireland
| | - Valsamo Anagnostou
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- *Correspondence: Valsamo Anagnostou,
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A comprehensive analysis of gasdermin family gene as therapeutic targets in pan-cancer. Sci Rep 2022; 12:13329. [PMID: 35922531 PMCID: PMC9349317 DOI: 10.1038/s41598-022-17100-7] [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: 03/09/2022] [Accepted: 07/20/2022] [Indexed: 12/31/2022] Open
Abstract
Six members of the gasdermin family are involved in various biological functions in malignant tumors. The present study aimed to perform a comprehensive analysis of gasdermin family genes in pan-cancer. Raw data was acquired from the genotype-tissue expression (GTEx) and the Cancer Genome Atlas. High inter-tumor heterogeneity in the expression between paracancerous and tumor tissues was observed across cancers. Survival analysis confirmed that the risk or protective effects of gasdermin family members on prognosis depended on the cancer types. The mutation frequency appeared to be high, and the mutation group had a worse prognosis. Besides, gasdermin family genes were associated with immune infiltrate subtypes, stromal and immune cell infiltration levels, TMB, MSI, immune checkpoint gene expression, and tumor stemness scores. Moreover, gasdermin family gene expressions affected the expressions of MMR genes and methyltransferases and could predict cancer cells sensitivity to chemotherapeutic drugs. Subsequently, the findings were double-checked in LIHC and PAAD. GSEA results indicated the gasdermin family genes mainly involved in tumor metabolism and immune microenvironment remodeling related signaling pathways. In conclusion, our findings confirmed that gasdermin family genes were potential therapeutic cancer targets in pan-cancer.
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204
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Li ZC, Sun YT, Lai MY, Zhou YX, Qiu MZ. Efficacy and safety of PD-1 inhibitors combined with chemotherapy as first-line therapy for advanced esophageal cancer: A systematic review and network meta-analysis. Int Immunopharmacol 2022; 109:108790. [DOI: 10.1016/j.intimp.2022.108790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 04/14/2022] [Accepted: 04/18/2022] [Indexed: 01/22/2023]
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Liu Z, Diao Y, Li X. Body mass index and serum markers associated with progression-free survival in lung cancer patients treated with immune checkpoint inhibitors. BMC Cancer 2022; 22:824. [PMID: 35902908 PMCID: PMC9336031 DOI: 10.1186/s12885-022-09744-5] [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: 10/06/2021] [Accepted: 05/31/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND ICIs have remarkably affected the treatment strategies for numerous malignancies, including lung cancer. However, only a fraction of patients experience durable responses to ICIs; thus, there is an urgent need to identify the parameters related to ICI therapeutic effects. In this study, we investigated nutritional status surrogates and several serum markers to estimate the efficacy of ICIs. MATERIALS AND METHODS The records of 66 patients with stage III/IV lung cancer who received ICIs were retrospectively analyzed. Features of patients' clinical pathology, including age, sex, histology, line of treatment, BMI, serum albumin, serum creatinine, and serum inflammatory markers such as LMR and PLR, were examined. Progression-free survival was the primary endpoint. Relationships among categorical variables were assessed by the chi-squared test. Survival analysis was performed using the Kaplan-Meier method followed by the log-rank test. Cox multivariate analysis was performed to analyze the association between each variable and the survival time of patients. RESULTS The patients with BMI ≥ 25 (kg/m2), serum ALB≥37 (g/dL), serum creatinine ≥61.8 (μmol/L), LMR ≥ 2.12 had a significantly prolonged PFS in comparison with BMI<25 (kg/m2), ALB<37 (g/dL), creatinine<61.8 (μmol/L), LMR<2.12 (p < 0.05). No statistically significant difference was detected between patients with PLR < 135 and PLR ≥ 135 (p = 0.612). Multivariate analysis revealed that ALB≥37 (g/dL) and creatinine ≥ 61.8 (μmol/L) were associated with prolonged PFS, while statistical significance was not achieved in the BMI groups. CONCLUSIONS The current results indicated that high BMI is related to longer PFS in lung cancer patients treated with ICIs, which may be correlated with high levels of serum albumin and creatinine.
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Affiliation(s)
- Zhenzhen Liu
- Department of Thoracic Cancer 1, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Xiaoheyan Road, Dadong District, Shenyang, 110042, Liaoning Province, P. R. China
| | - Yuzhu Diao
- Department of Thoracic Cancer 1, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Xiaoheyan Road, Dadong District, Shenyang, 110042, Liaoning Province, P. R. China
| | - Xiaoling Li
- Department of Thoracic Cancer 1, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Xiaoheyan Road, Dadong District, Shenyang, 110042, Liaoning Province, P. R. China.
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Blood Immune Cell Biomarkers in Lung Cancer Patients Undergoing Treatment with a Combination of Chemotherapy and Immune Checkpoint Blockade. Cancers (Basel) 2022; 14:cancers14153690. [PMID: 35954354 PMCID: PMC9367406 DOI: 10.3390/cancers14153690] [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: 06/24/2022] [Revised: 07/18/2022] [Accepted: 07/25/2022] [Indexed: 01/25/2023] Open
Abstract
Although immune checkpoint inhibitor (ICI) therapies have improved the treatment of patients with advanced non-small cell lung cancer (NSCLC), several patients do not achieve durable clinical responses. Biomarkers for the prediction of therapy responses are urgently needed. To identify blood cell parameters correlating with patients’ survival, immune cells from 90 patients with NSCLC undergoing a combination of ICI and chemotherapy were prospectively monitored. At the time point of the first and third antibody administration, complete leukocyte blood count, the percentage of HLA-DRlow monocytes, the percentage of 6-Sulfo LacNAc (slan)+CD16+ non-classical monocytes, and the number of circulating dendritic cell (DC) subtypes, as well as T-, B-, and NK cells were determined by multi-color flow cytometry in peripheral blood. The prognostic value of the immune cell parameters investigated was evaluated by patients’ survival analysis, with progression-free survival (PFS) as the main criterion. A total of 67 patients (74.4%) showed a partial remission or a stable disease, and 35% of patients even survived 12 months and longer. Patients with a neutrophil-to-lymphocyte ratio (NLR) ≥6.1, a frequency of HLA-DRlow monocytes ≥22%, of slan+ non-classical monocytes <0.25% of leukocytes, and/or a sum of myeloid DC (MDC) and plasmacytoid DC (PDC) ≤0.14% of leukocytes had a poorer prognosis. The hazard ratio for PFS was 2.097 (1.208−3.640) for the NLR, 1.964 (1.046−3.688) for HLA-DRlow monocytes, 3.202 (1.712−5.99) for slan+ non-classical monocytes, and 2.596 (1.478−4.56) for the MDC/PDC sum. Patients without any of the four risk factors showed the best PFS. Furthermore, low NK cell counts correlated with shorter PFS (cutoff 200 cells/µL). Female patients had lower baseline NK cell counts and a shorter PFS. Our study confirms the usefulness of blood immune cells as biomarkers for clinical response and survival in NSCLC patients undergoing a combined ICI/chemotherapy.
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207
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Luo X, Zhou Z, Zeng X, Liu Q. The Cost-Effectiveness of Tislelizumab Plus Chemotherapy for Locally Advanced or Metastatic Nonsquamous Non-Small Cell Lung Cancer. Front Pharmacol 2022; 13:935581. [PMID: 35935852 PMCID: PMC9354466 DOI: 10.3389/fphar.2022.935581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 06/08/2022] [Indexed: 11/13/2022] Open
Abstract
Objective: To investigate the cost-effectiveness of adding Chinese-developed anti-PD-1 antibody tislelizumab to first-line pemetrexed-platinum chemotherapy in (1) a study population of patients with locally advanced or metastatic nonsquamous non-small cell lung cancer (nsqNSCLC) and without known sensitizing EGFR mutations or ALK rearrangements and (2) its subgroups from the perspective of Chinese healthcare system.Material and Methods: Separate Markov models were constructed for the entire study population and its subgroups; 10,000 patients with locally advanced or metastatic nsqNSCLC and without driver gene mutations were simulated in the first-line tislelizumab plus pemetrexed-platinum (TPP) arm and first-line pemetrexed-platinum (PP) arm, respectively. Transition probabilities were extracted from the RATIONALE 304 trial. Public health state utilities and costs were obtained from published literature, public national databases, and local general hospitals. The main outputs were incremental cost-effectiveness ratios (ICERs). The ICERs were compared to a willingness-to-pay threshold of $35,663 per quality-adjusted life-years (QALYs) to determine the cost-effective treatment. Sensitivity analyses were employed to assess the uncertainty in the model.Results: For the entire patient population, first-line TPP versus PP use increased the effectiveness by 0.99 QALYs and healthcare costs by $28,749, resulting in an ICER of $28,749/QALY that was lower than the prespecified WTP threshold. For patient subgroups, first-line TPP conferred the greatest survival benefit in patients with PD-L1 expression ≥50%, followed by patients with liver metastasis and those who are current or former smokers. Overall, the ICERs for the first-line TPP versus PP ranged from $27,018/QALYs to $33,074/QALYs, which were consistently below the WTP threshold.Conclusion: For Chinese patients with locally advanced or metastatic nsqNSCLC who had no known sensitizing EGFR mutations or ALK rearrangements, adding the Chinese-developed anti-PD-1 antibody tislelizumab to the first-line pemetrexed-platinum chemotherapy was cost-effective regardless of their baseline characteristics.
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Affiliation(s)
- Xia Luo
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Zhen Zhou
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Xiaohui Zeng
- Department of Nuclear Medicine/PET Image Center, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Qiao Liu
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, China
- *Correspondence: Qiao Liu,
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Sex-Biased Immune Responses to Antibiotics during Anti-PD-L1 Treatment in Mice with Colon Cancer. J Immunol Res 2022; 2022:9202491. [PMID: 35903754 PMCID: PMC9325566 DOI: 10.1155/2022/9202491] [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: 04/20/2022] [Revised: 06/22/2022] [Accepted: 06/30/2022] [Indexed: 11/17/2022] Open
Abstract
Colitis is a frequently occurred side effect of immune checkpoint inhibitors (ICIs), which are increasingly used in cancer treatment, whereas antibiotics are widely used to treat colitis, their effectiveness in ICI-associated colitis remains controversial. In this study, we firstly assessed the effectiveness of several commonly used antibiotics and antibiotic cocktails in alleviating of dextran sulfate sodium- (DSS-) induced colitis. We observed that two narrow-spectrum antibiotics, neomycin and metronidazole, were more effective in alleviating colitis, as evidenced by the remission of loss of the body weight, enlargement of the spleen, shortening of the colon, secretion of proinflammatory cytokines, and histological score of the colon tissue. Moreover, these two antibiotics resulted in better relief of colitis symptoms in the MC38 tumor-bearing male mice receiving the anti-PD-L1 mAb (αPD-L1) treatment, compared to the females. In the meantime, an enhanced response to αPD-L1 efficiency against mice colon cancer was observed in the male mouse group upon the application of these two antibiotics. In contrast, both neomycin and metronidazole showed destructive effects on the antitumor efficiency of αPD-L1 in female mice, despite relief from colitis. We found that antibiotic treatment attenuated the increased infiltration of granulocytes and myeloid cells in colon tissue induced by DSS in female mice, while reducing the proportion of Th17 cells in male mice. These differences were further associated with the sex-biased differences in the gut microbiota. These findings indicated that sex-dependent alterations in the gut microbiota should be considered when applying antibiotics for the treatment of ICI-associated colitis.
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209
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Tryambake SR, Gawande JP, Wategaonkar RN. Retrospective Study of Clinical Outcomes and Toxicity Profile in Patients Treated with Immune Checkpoint Inhibitors. ASIAN JOURNAL OF ONCOLOGY 2022. [DOI: 10.1055/s-0042-1751116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
Abstract
Introduction Immune checkpoint inhibitors (ICIs) are rapidly being utilized as treatment option either alone or in combination with chemotherapy in most of the solid tumors.
Objectives Our single-center retrospective study aimed to present our experience with the effectiveness and safety of these agents in Indian set of patients with various advanced solid tumors.
Material and Methods Twenty-five adult patients with stage IV solid tumors of varying sites treated with ICIs at Aditya Birla Memorial Hospital, Pune, Maharashtra, India, between October 2017 and September 2020 were included in the study. Overall survival (OS), progression-free survival (PFS), overall response rate (ORR), disease control rate (DCR), and toxicity profiles were evaluated. All statistical calculations were performed using IBM SPSS version 25.
Results Total of 25 patients (median age 61) was evaluated. Histological evaluation revealed adenocarcinoma (48%), squamous cell carcinoma (40%), and one each (4%) of others. Eastern Cooperative Oncology Group performance status score was I in 16 (64%) and II in 9 (36%) patients. Average of 10 cycles ICIs were received by each patient. Majority were males with 11 (44%) having some comorbidities. Lung (48%) was the most common primary followed by head and neck cancers (32%). Most (76%) were treated with nivolumab, followed by pembrolizumab (20%) while only one patient was given atezolizumab. Median follow-up was 18 months. Median OS was 24 months (95% confidence interval [CI]: 9–NA) and 2-year OS rate in the study was 38.4% (95% CI: 18.8–78.3), while median PFS was 9 months (95% CI: 6–NA) and 1-year PFS rate was 22.3% (95% CI: 9.7–51.2). One patient (4%) had complete response, 6 (24%) had partial response while 12 (48%) had stable disease response at first follow-up. Mean and median time to progression were 5.7 and 9 months, respectively. ORR was 28% (95% CI: 12.07–49.4) while the DCR was 76% (95% CI: 54.87–90.64). PS II patients were associated with significantly poor median OS and PFS. There was no significant difference in survival with respect to age, gender, site, histology, and comorbidities; however, 4/25 patients had undergone biomarker assessment and were associated with a trend toward better median PFS (8 vs. 11 months, hazard ratio 0.53, 95% CI: 0.12–2.34, p = 0.38). Two of 25 patients developed autoimmune conditions namely ophthalmoplegia and hypothyroidism each. Fatigue (36%) and nausea (12%) were the most common toxicities.
Conclusion Real-world data from our study depicts our own experience with ICIs to suggest that these agents are well-tolerated and equally effective in Indian set of patients with advanced metastatic solid tumors. ICIs could be safely used even in patients with PS II and biomarker assessment in adjunction needs to be encouraged wherever feasible for better patient selection, prognostication, and clinical outcomes.
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Affiliation(s)
| | - Jayant Pundlik Gawande
- Department of Medical Oncology, Aditya Birla Memorial Hospital, Pune, Maharashtra, India
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Raskin J, Snoeckx A, Janssens A, De Bondt C, Wener R, van de Wiel M, van Meerbeeck JP, Smits E. New Implications of Patients’ Sex in Today’s Lung Cancer Management. Cancers (Basel) 2022; 14:cancers14143399. [PMID: 35884463 PMCID: PMC9316757 DOI: 10.3390/cancers14143399] [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: 05/06/2022] [Revised: 07/04/2022] [Accepted: 07/11/2022] [Indexed: 12/01/2022] Open
Abstract
Simple Summary We aim to raise awareness that sex is an important factor to take into account in modern-day thoracic oncology practice. Summarized, women should be specifically targeted in smoking cessation campaigns and sex-specific barriers should be addressed. Women present more often with adenocarcinoma histology and EGFR/ALK alterations, as lung cancer in never-smokers is more common in women compared to men. Lung cancer in female patients may show a poorer response to immune checkpoint inhibition; therefore, the addition of chemotherapy should be considered. On the other hand, women experience more benefits from targeted therapy against EGFR. In general, prognosis for women is better compared to that in men. Lung cancer screening trials report that women derive more benefit from screening, although they have not been designed for women. Future trial designs should take this into account and encourage participation of women. Abstract This paper describes where and how sex matters in today’s management of lung cancer. We consecutively describe the differences between males and females in lung cancer demographics; sex-based differences in the immune system (including the poorer outcomes in women who are treated with immunotherapy but no chemotherapy); the presence of oncogenic drivers and the response to targeted therapies according to sex; the greater benefit women derive from lung cancer screening and why they get screened less; and finally, the barriers to smoking cessation that women experience. We conclude that sex is an important but often overlooked factor in modern-day thoracic oncology practice.
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Affiliation(s)
- Jo Raskin
- Department of Thoracic Oncology, MOCA, Antwerp University Hospital, University of Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium; (J.R.); (C.D.B.); (R.W.); (M.v.d.W.); (J.P.v.M.)
| | - Annemiek Snoeckx
- Department of Radiology, Antwerp University Hospital, University of Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium;
| | - Annelies Janssens
- Department of Thoracic Oncology, MOCA, Antwerp University Hospital, University of Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium; (J.R.); (C.D.B.); (R.W.); (M.v.d.W.); (J.P.v.M.)
- Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, Universiteitsplein 1, 2610 Antwerpen, Belgium;
- Correspondence:
| | - Charlotte De Bondt
- Department of Thoracic Oncology, MOCA, Antwerp University Hospital, University of Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium; (J.R.); (C.D.B.); (R.W.); (M.v.d.W.); (J.P.v.M.)
| | - Reinier Wener
- Department of Thoracic Oncology, MOCA, Antwerp University Hospital, University of Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium; (J.R.); (C.D.B.); (R.W.); (M.v.d.W.); (J.P.v.M.)
| | - Mick van de Wiel
- Department of Thoracic Oncology, MOCA, Antwerp University Hospital, University of Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium; (J.R.); (C.D.B.); (R.W.); (M.v.d.W.); (J.P.v.M.)
| | - Jan P. van Meerbeeck
- Department of Thoracic Oncology, MOCA, Antwerp University Hospital, University of Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium; (J.R.); (C.D.B.); (R.W.); (M.v.d.W.); (J.P.v.M.)
| | - Evelien Smits
- Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, Universiteitsplein 1, 2610 Antwerpen, Belgium;
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Pala L, De Pas T, Catania C, Giaccone G, Mantovani A, Minucci S, Viale G, Gelber RD, Conforti F. Sex and cancer immunotherapy: Current understanding and challenges. Cancer Cell 2022; 40:695-700. [PMID: 35750053 DOI: 10.1016/j.ccell.2022.06.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Recent evidence highlights patients' sex relevance in antitumor immune response through a complex interaction-among hormones, genes, behaviors, and the microbiome-that affects both innate and adaptive immune functions, as well as immune evasion mechanisms. These complex interactions ultimately influence the efficacy and toxicity of immune checkpoint inhibitors in solid tumors.
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Affiliation(s)
- Laura Pala
- Division of Melanoma, Sarcomas and Rare Tumors, European Institute of Oncology, Milan, Italy
| | - Tommaso De Pas
- Division of Melanoma, Sarcomas and Rare Tumors, European Institute of Oncology, Milan, Italy
| | - Chiara Catania
- Division of Thoracic Oncology, European Institute of Oncology, IRCCS, Milan, Italy
| | | | - Alberto Mantovani
- Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy; Humanitas University, Pieve Emanuele, Italy; William Harvey Research Institute, Queen Mary University, London, UK
| | - Saverio Minucci
- Department of Experimental Oncology, European Institute of Oncology, IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Giuseppe Viale
- Department of Pathology, European Institute of Oncology, Milan, Italy; University of Milan, Milan, Italy
| | - Richard D Gelber
- Department of Data Science, Dana-Farber Cancer Institute, Harvard Medical School, Harvard T.H. Chan School of Public Health, and Frontier Science Foundation, Boston, MA, USA
| | - Fabio Conforti
- Division of Melanoma, Sarcomas and Rare Tumors, European Institute of Oncology, Milan, Italy.
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Schafer JM, Xiao T, Kwon H, Collier K, Chang Y, Abdel-Hafiz H, Bolyard C, Chung D, Yang Y, Sundi D, Ma Q, Theodorescu D, Li X, Li Z. Sex-biased adaptive immune regulation in cancer development and therapy. iScience 2022; 25:104717. [PMID: 35880048 PMCID: PMC9307950 DOI: 10.1016/j.isci.2022.104717] [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] [Indexed: 02/04/2023] Open
Abstract
The cancer research field is finally starting to unravel the mystery behind why males have a higher incidence and mortality rate than females for nearly all cancer types of the non-reproductive systems. Here, we explain how sex - specifically sex chromosomes and sex hormones - drives differential adaptive immunity across immune-related disease states including cancer, and why males are consequently more predisposed to tumor development. We highlight emerging data on the roles of cell-intrinsic androgen receptors in driving CD8+ T cell dysfunction or exhaustion in the tumor microenvironment and summarize ongoing clinical efforts to determine the impact of androgen blockade on cancer immunotherapy. Finally, we outline a framework for future research in cancer biology and immuno-oncology, underscoring the importance of a holistic research approach to understanding the mechanisms of sex dimorphisms in cancer, so sex will be considered as an imperative factor for guiding treatment decisions in the future.
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Affiliation(s)
- Johanna M. Schafer
- Pelotonia Institute for Immuno-Oncology, the Ohio State University Comprehensive Cancer Center – the James, Columbus, OH 43210, USA
| | - Tong Xiao
- Pelotonia Institute for Immuno-Oncology, the Ohio State University Comprehensive Cancer Center – the James, Columbus, OH 43210, USA
| | - Hyunwoo Kwon
- Pelotonia Institute for Immuno-Oncology, the Ohio State University Comprehensive Cancer Center – the James, Columbus, OH 43210, USA,Medical Scientist Training Program, College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Katharine Collier
- Division of Medical Oncology, the Ohio State University Comprehensive Cancer Center – the James, Columbus, OH 43210, USA
| | - Yuzhou Chang
- Pelotonia Institute for Immuno-Oncology, the Ohio State University Comprehensive Cancer Center – the James, Columbus, OH 43210, USA,Department of Biomedical Informatics, the Ohio State University, Columbus, OH 43210, USA
| | - Hany Abdel-Hafiz
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA,Department of Medicine and Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Chelsea Bolyard
- Pelotonia Institute for Immuno-Oncology, the Ohio State University Comprehensive Cancer Center – the James, Columbus, OH 43210, USA
| | - Dongjun Chung
- Department of Biomedical Informatics, the Ohio State University, Columbus, OH 43210, USA
| | - Yuanquan Yang
- Division of Medical Oncology, the Ohio State University Comprehensive Cancer Center – the James, Columbus, OH 43210, USA
| | - Debasish Sundi
- Department of Urology, the Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA
| | - Qin Ma
- Department of Biomedical Informatics, the Ohio State University, Columbus, OH 43210, USA
| | - Dan Theodorescu
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA,Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Xue Li
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA,Department of Medicine and Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Zihai Li
- Pelotonia Institute for Immuno-Oncology, the Ohio State University Comprehensive Cancer Center – the James, Columbus, OH 43210, USA,Corresponding author
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213
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Zamagni F, Bucchi L, Mancini S, Crocetti E, Dal Maso L, Ferretti S, Biggeri A, Villani S, Baldacchini F, Giuliani O, Ravaioli A, Vattiato R, Brustolin A, Candela G, Carone S, Carrozzi G, Cavallo R, Dinaro YM, Ferrante M, Iacovacci S, Mazzoleni G, Musolino A, Rizzello RV, Serraino D, Stracci F, Tumino R, Masini C, Ridolfi L, Palmieri G, Stanganelli I, Falcini F. The relative contribution of the decreasing trend in tumour thickness to the 2010s increase in net survival from cutaneous malignant melanoma in Italy: a population-based investigation. Br J Dermatol 2022; 187:52-63. [PMID: 35253204 PMCID: PMC9542017 DOI: 10.1111/bjd.21051] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 02/03/2022] [Accepted: 02/06/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND The long-term increase in survival from cutaneous malignant melanoma (CMM) is generally attributed to the decreasing trend in tumour thickness, the single most important prognostic factor. OBJECTIVES To determine the relative contribution of decreased tumour thickness to the favourable trend in survival from CMM in Italy. METHODS Eleven local cancer registries covering a population of 8 056 608 (13.4% of the Italian population in 2010) provided records for people with primary CMM registered between 2003 and 2017. Age-standardized 5-year net survival was calculated. Multivariate analysis of 5-year net survival was undertaken by calculating the relative excess risk (RER) of death. The relative contribution of the decrease in tumour thickness to the RER of death was evaluated using a forward stepwise flexible parametric survival model including the available prognostic factors. RESULTS Over the study period, tumour thickness was inversely associated with 5-year net survival and multivariate RER in both sexes. The median thickness was 0.90 mm in 2003-2007, 0.85 mm in 2008-2012 and 0.75 mm in 2013-2017 among male patients, and 0.78 mm, 0.77 mm and 0.68 mm among female patients, respectively. The 5-year net survival was 86.8%, 89.2% and 93.2% in male patients, and 91.4%, 92.0% and 93.4% in female patients, respectively. In 2013-2017, male patients exhibited the same survival as female patients despite having thicker lesions. For them, the increasing survival trend was more pronounced with increasing thickness, and the inclusion of thickness in the forward stepwise model made the RER in 2013-2017 vs. 2003-2007 increase from 0.64 [95% confidence interval (CI) 0.51-0.80] to 0.70 (95% CI 0.57-0.86). This indicates that the thickness trend accounted for less than 20% of the survival increase. For female patients, the results were not significant but, with multiple imputation of missing thickness values, the RER rose from 0.74 (95% CI 0.58-0.93) to 0.82 (95% CI 0.66-1.02) in 2013-2017. CONCLUSIONS For male patients in particular, decrease in tumour thickness accounted for a small part of the improvement in survival observed in 2013-2017. The introduction of targeted therapies and immune checkpoint inhibitors in 2013 is most likely to account for the remaining improvement.
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Affiliation(s)
- Federica Zamagni
- Romagna Cancer RegistryIRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’MeldolaForlìItaly
| | - Lauro Bucchi
- Romagna Cancer RegistryIRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’MeldolaForlìItaly
| | - Silvia Mancini
- Romagna Cancer RegistryIRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’MeldolaForlìItaly
| | - Emanuele Crocetti
- Romagna Cancer RegistryIRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’MeldolaForlìItaly
| | - Luigino Dal Maso
- Cancer Epidemiology UnitCentro di Riferimento Oncologico di Aviano (CRO) IRCCSAvianoItaly
| | - Stefano Ferretti
- Romagna Cancer Registry, Section of FerraraLocal Health Authority and University of FerraraFerraraItaly
| | - Annibale Biggeri
- Department of Statistics, Computer Science, Applications G. ParentiUniversity of FlorenceFlorenceItaly
| | - Simona Villani
- Department of Public Health, Experimental and Forensic Medicine, Unit of Biostatistics and Clinical EpidemiologyUniversity of PaviaPaviaItaly
| | - Flavia Baldacchini
- Romagna Cancer RegistryIRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’MeldolaForlìItaly
| | - Orietta Giuliani
- Romagna Cancer RegistryIRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’MeldolaForlìItaly
| | - Alessandra Ravaioli
- Romagna Cancer RegistryIRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’MeldolaForlìItaly
| | - Rosa Vattiato
- Romagna Cancer RegistryIRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’MeldolaForlìItaly
| | - Angelita Brustolin
- UOSD Epidemiologia e Registro Tumori (Dip. di Prevenzione ASL VT) c/o Cittadella della SaluteViterboItaly
| | - Giuseppa Candela
- Trapani Cancer Registry, Dipartimento di Prevenzione della SaluteServizio Sanitario Regionale Sicilia, Azienda Sanitaria Provinciale (ASP)TrapaniItaly
| | - Simona Carone
- Registro tumori di TarantoUnità operativa complessa di statistica ed epidemiologiaAzienda sanitaria locale TarantoItaly
| | - Giuliano Carrozzi
- Modena Cancer Registry, Public Health DepartmentLocal Health AuthorityModenaItaly
| | | | | | - Margherita Ferrante
- Integrated Cancer Registry of Catania‐Messina‐EnnaAzienda Ospedaliero‐Universitaria Policlinico ‘Rodolico‐San Marco’CataniaItaly
| | | | | | - Antonino Musolino
- Department of Medicine and SurgeryUniversity of Parma; Medical Oncology Unit and Cancer Registry, University Hospital of ParmaParmaItaly
| | - Roberto Vito Rizzello
- Trento Province Cancer Registry, Unit of Clinical EpidemiologyAzienda Provinciale per i Servizi Sanitari (APSS) TrentoItaly
| | - Diego Serraino
- Cancer Epidemiology UnitCentro di Riferimento Oncologico di Aviano (CRO) IRCCSAvianoItaly
| | - Fabrizio Stracci
- Department of Medicine and SurgeryUniversity of PerugiaPerugiaItaly
| | - Rosario Tumino
- Former Director Cancer RegistryProvincial Health Authority (ASP)RagusaItaly
| | - Carla Masini
- Unit of Oncological PharmacyIRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’MeldolaForlìItaly
| | - Laura Ridolfi
- Immunotherapy, Cell Therapy and BiobankIRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’MeldolaForlìItaly
| | - Giuseppe Palmieri
- Institute of Research on Genetics and Biomedicine (IRGB), National Research Council (CNR)SardegnaSassariItaly
| | - Ignazio Stanganelli
- Skin Cancer UnitIRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’MeldolaForlìItaly
- Department of DermatologyUniversity of ParmaParmaItaly
| | - Fabio Falcini
- Romagna Cancer RegistryIRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’MeldolaForlìItaly
- Cancer Prevention UnitLocal Health AuthorityForlìItaly
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214
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Schafer J, Sundi D. EDITORIAL COMMENT. Urology 2022; 165:104-105. [PMID: 35843687 DOI: 10.1016/j.urology.2021.08.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Johanna Schafer
- The Ohio State University Comprehensive Cancer Center and Pelotonia Institute of Immuno-Oncology, Columbus, Ohio, USA
| | - Debasish Sundi
- The Ohio State University Comprehensive Cancer Center and Pelotonia Institute of Immuno-Oncology, Columbus, Ohio, USA; Department of Urology, Columbus, Ohio, USA
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215
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Gunjur A, Manrique‐Rincón AJ, Klein O, Behren A, Lawley TD, Welsh SJ, Adams DJ. 'Know thyself' - host factors influencing cancer response to immune checkpoint inhibitors. J Pathol 2022; 257:513-525. [PMID: 35394069 PMCID: PMC9320825 DOI: 10.1002/path.5907] [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: 02/01/2022] [Revised: 04/01/2022] [Accepted: 04/05/2022] [Indexed: 11/30/2022]
Abstract
Immune checkpoint inhibitors (ICIs) have revolutionised oncology and are now standard-of-care for the treatment of a wide variety of solid neoplasms. However, tumour responses remain unpredictable, experienced by only a minority of ICI recipients across malignancy types. Therefore, there is an urgent need for better predictive biomarkers to identify a priori the patients most likely to benefit from these therapies. Despite considerable efforts, only three such biomarkers are FDA-approved for clinical use, and all rely on the availability of tumour tissue for immunohistochemical staining or genomic assays. There is emerging evidence that host factors - for example, genetic, metabolic, and immune factors, as well as the composition of one's gut microbiota - influence the response of a patient's cancer to ICIs. Tantalisingly, some of these factors are modifiable, paving the way for co-therapies that may enhance the therapeutic index of these treatments. Herein, we review key host factors that are of potential biomarker value for response to ICI therapy, with a particular focus on the proposed mechanisms for these influences. © 2022 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Ashray Gunjur
- Experimental Cancer Genetics, Wellcome Sanger InstituteHinxtonUK,Olivia Newton‐John Cancer Research InstituteLa Trobe University School of Cancer MedicineHeidelbergAustralia
| | - Andrea J Manrique‐Rincón
- Experimental Cancer Genetics, Wellcome Sanger InstituteHinxtonUK,Cambridge Institute of Therapeutic Immunology & Infectious Disease, Department of MedicineUniversity of CambridgeCambridgeUK
| | - Oliver Klein
- Olivia Newton‐John Cancer Research InstituteLa Trobe University School of Cancer MedicineHeidelbergAustralia,Department of Medical OncologyAustin HealthHeidelbergAustralia
| | - Andreas Behren
- Olivia Newton‐John Cancer Research InstituteLa Trobe University School of Cancer MedicineHeidelbergAustralia,Department of MedicineUniversity of MelbourneParkvilleAustralia
| | | | - Sarah J Welsh
- Department of SurgeryUniversity of CambridgeCambridgeUK,Cambridge University Hospitals NHS Foundation TrustCambridgeUK
| | - David J Adams
- Experimental Cancer Genetics, Wellcome Sanger InstituteHinxtonUK
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216
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An integrated pan-cancer analysis of identifying biomarkers about the EGR family genes in human carcinomas. Comput Biol Med 2022; 148:105889. [DOI: 10.1016/j.compbiomed.2022.105889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/25/2022] [Accepted: 07/16/2022] [Indexed: 12/24/2022]
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217
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Tang JJ, Pan YF, Chen C, Cui XL, Yan ZJ, Zhou DX, Guo LN, Cao D, Yu LX, Wang HY. Androgens drive sexual dimorphism in liver metastasis by promoting hepatic accumulation of neutrophils. Cell Rep 2022; 39:110987. [PMID: 35732131 DOI: 10.1016/j.celrep.2022.110987] [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: 10/10/2021] [Revised: 03/22/2022] [Accepted: 05/31/2022] [Indexed: 12/24/2022] Open
Abstract
The liver is one of the most-favored distant metastatic sites for solid tumors, and interactions between cancer cells and components of the hepatic microenvironment are essential for liver metastasis (LM). Although sex is one of the determinants for primary liver cancer, sexual dimorphism in LM (SDLM) and the underlying mechanisms remain unclear. We herein demonstrate a significant male-biased SDLM, which is attributed to host androgen/androgen receptor (Ar) signaling that promotes hepatic seeding of tumor cells and subsequent outgrowth in a neutrophil-dependent manner. Mechanistically, androgen/Ar signaling promotes hepatic accumulation of neutrophils by promoting proliferation and development of neutrophil precursors in the bone marrow, as well as modulating hepatic recruitment of neutrophils and their functions. Antagonizing the androgen/Ar/neutrophil axis significantly mitigates LM in males. Our data thus reveal an important role of androgen in LM and suggest that androgen/Ar modulation represents a promising target for LM therapy in men.
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Affiliation(s)
- Jiao-Jiao Tang
- International Cooperation Laboratory on Signal Transduction, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China; National Center for Liver Cancer, Second Military Medical University, Shanghai 201805, China; Division of Life Sciences and Medicine, Cancer Research Center, the First Affiliated Hospital of University of Science and Technology of China, Hefei, Anhui 230027, China
| | - Yu-Fei Pan
- International Cooperation Laboratory on Signal Transduction, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China; National Center for Liver Cancer, Second Military Medical University, Shanghai 201805, China
| | - Can Chen
- Department of Hepatobiliary Surgery and Fujian Institute of Hepatobiliary Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian 350000, China; Fujian Medical University Cancer Center, Fuzhou, Fujian 350000, China
| | - Xiu-Liang Cui
- International Cooperation Laboratory on Signal Transduction, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China; National Center for Liver Cancer, Second Military Medical University, Shanghai 201805, China
| | - Zi-Jun Yan
- International Cooperation Laboratory on Signal Transduction, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China; National Center for Liver Cancer, Second Military Medical University, Shanghai 201805, China
| | - Dong-Xun Zhou
- Department of Endoscopy, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China
| | - Lin-Na Guo
- International Cooperation Laboratory on Signal Transduction, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China; National Center for Liver Cancer, Second Military Medical University, Shanghai 201805, China
| | - Dan Cao
- International Cooperation Laboratory on Signal Transduction, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China; National Center for Liver Cancer, Second Military Medical University, Shanghai 201805, China
| | - Le-Xing Yu
- International Cooperation Laboratory on Signal Transduction, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China; National Center for Liver Cancer, Second Military Medical University, Shanghai 201805, China.
| | - Hong-Yang Wang
- International Cooperation Laboratory on Signal Transduction, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China; National Center for Liver Cancer, Second Military Medical University, Shanghai 201805, China; Division of Life Sciences and Medicine, Cancer Research Center, the First Affiliated Hospital of University of Science and Technology of China, Hefei, Anhui 230027, China.
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218
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Wang F, Wu X. Cardiovascular toxicities associated with immune checkpoint inhibitors: An updated comprehensive disproportionality analysis of the FDA adverse event reporting system. J Clin Pharm Ther 2022; 47:1576-1584. [PMID: 35726369 DOI: 10.1111/jcpt.13707] [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: 05/11/2022] [Accepted: 05/18/2022] [Indexed: 12/30/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Immune checkpoint inhibitors (ICIs) have significantly improved clinical outcomes for a wide range of cancers but can also lead to cardiovascular toxicities. This study was to scientifically and systematically explore the association between cardiovascular toxicities and immune checkpoint inhibitors (ICIs) and also to characterize the main features of ICI-related cardiovascular toxicities. METHODS From January 2012 to December 2020, data in the Food and Drug Administration Adverse Event Reporting System (FAERS) database were retrieved for disproportionality analysis. The definition of adverse events (AEs) relied on the Medical Dictionary for Regulatory Activities (MedDRA). We used the reporting odds ratio (ROR) with 95% confidence intervals (CIs) to evaluate the association between ICIs and cardiovascular AEs. Clinical characteristics of patients with ICI-associated cardiovascular toxicities were collected, and the time to onset following different ICI regimens was further investigated. RESULTS AND DISCUSSION We identified a total of 13,713 ICI-associated cardiovascular toxicities which appeared to influence more men (56.90%) than women (36.79%), with a median age of 67 (interquartile range [IQR] 58-74) years. ICI-associated cardiovascular AEs were most frequently reported in lung, pleura, thymus and heart cancer patients (34.49%). Compared with the full database, ICI therapies were detected with pharmacovigilance of myocardial disorders (ROR: 2.64; 95% CI: 2.55-2.75) and pericardial disorders (ROR: 4.51; 95% CI: 4.30-4.74). Concerning myocardial and pericardial disorders, a significant increased ROR was found for all anti-PD-1 and anti-PD-L1 monotherapies, with the exception of anti-CTLA-4 monotherapies. Regarding cardiac arrhythmias, only tremelimumab among ICI monotherapies was associated with an increased ROR (1.92, 1.09-4.72; 4 cases). Compared with ICI monotherapy, ICI combination therapy detected an increase in cardiovascular toxicity spectrum, but did not prolong the onset time. WHAT IS NEW AND CONCLUSION We observed that the spectrum and risk of ICI-associated cardiovascular AEs differed between therapeutic regimens. The poor clinical outcome and early onset of these events should attract clinical attention.
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Affiliation(s)
- Feifei Wang
- Department of Pharmacy, Hefei BOE Hospital, Hefei, People's Republic of China
| | - Xinan Wu
- Department of Pharmacy, Hefei BOE Hospital, Hefei, People's Republic of China
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219
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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.
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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
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220
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Saad M, Lee SJ, Tan AC, El Naqa IM, Hodi FS, Butterfield LH, LaFramboise WA, Storkus W, Karunamurthy AD, Conejo-Garcia J, Hwu P, Streicher H, Sondak VK, Kirkwood JM, Tarhini AA. Enhanced immune activation within the tumor microenvironment and circulation of female high-risk melanoma patients and improved survival with adjuvant CTLA4 blockade compared to males. J Transl Med 2022; 20:253. [PMID: 35659704 PMCID: PMC9164320 DOI: 10.1186/s12967-022-03450-3] [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: 03/17/2022] [Accepted: 05/19/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND We hypothesized that a gender difference in clinical response may exist to adjuvant CTLA4 blockade with ipilimumab versus high-dose IFNα (HDI). We investigated differences in candidate immune biomarkers in the circulation and tumor microenvironment (TME). PATIENTS AND METHODS This gender-based analysis was nested within the E1609 trial that tested adjuvant therapy with ipilimumab 3 mg/kg (ipi3) and 10 mg/kg (ipi10) versus HDI in high risk resected melanoma. We investigated gender differences in treatment efficacy with ipi3 and ipi10 versus HDI while adjusting for age, stage, ECOG performance (PS), ulceration, primary tumor status and lymph node number. Forest plots were created to compare overall survival (OS) and relapse free survival (RFS) between ipi and HDI. Gene expression profiling (GEP) was performed on tumors of 718 (454 male, 264 female) patients. Similarly, serum and peripheral blood mononuclear cells (PBMC) samples were tested for soluble and cellular biomarkers (N = 321 patients; 109 female and 212 male). RESULTS The subgroups of female, stage IIIC, PS = 1, ulcerated primary, in-transit metastasis demonstrated significant improvement in RFS and/or OS with ipi3 versus HDI. Female gender was significant for both OS and RFS and was further explored. In the RFS comparison, a multivariate Cox regression model including significant variables indicated a significant interaction between gender and treatment (P = 0.024). In peripheral blood, percentages of CD3+ T cells (P = 0.024) and CD3+ CD4+ helper T cells (P = 0.0001) were higher in females compared to males. Trends toward higher circulating levels of IL1β (P = 0.07) and IL6 (P = 0.06) were also found in females. Males had higher percentages of monocytes (P = 0.03) with trends toward higher percentages of regulatory T cells (T-reg). Tumor GEP analysis supported enhanced infiltration with immune cells including gammadelta T cells (P = 0.005), NK cells (P = 0.01), dendritic cells (P = 0.01), CD4+ T cells (P = 0.03), CD8+ T cells (P = 0.03) and T-reg (P = 0.008) in the tumors of females compared to males and a higher T-effector and IFNγ gene signature score (P = 0.0244). CONCLUSION Female gender was associated with adjuvant CTLA4 blockade clinical benefits and female patients were more likely to have evidence of type1 immune activation within the TME and the circulation. Trial registration ClinicalTrials.gov NCT01274338. Registered 11 January 2011, https://www. CLINICALTRIALS gov/ct2/show/NCT01274338.
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Affiliation(s)
- Mariam Saad
- grid.468198.a0000 0000 9891 5233Departments of Cutaneous Oncology and Immunology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612 USA 10920 McKinley Dr.,
| | - Sandra J. Lee
- grid.65499.370000 0001 2106 9910Dana Farber Cancer Institute and Harvard Medical School, Boston, MA USA
| | - Aik Choon Tan
- grid.468198.a0000 0000 9891 5233Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, USA Florida
| | - Issam M. El Naqa
- grid.468198.a0000 0000 9891 5233Department of Machine Learning, H. Lee Moffitt Cancer Center and Research Institute, Tampa, USA
| | - F. Stephen Hodi
- grid.65499.370000 0001 2106 9910Dana Farber Cancer Institute, Boston, MA USA
| | - Lisa H. Butterfield
- grid.489192.f0000 0004 7782 4884Univ. California San Francisco and The Parker Institute for Cancer Immunotherapy, San Francisco, CA USA
| | - William A. LaFramboise
- grid.417046.00000 0004 0454 5075Allegheny Health Network Cancer Institute, Pathology, Pittsburgh, PA USA
| | - Walter Storkus
- grid.21925.3d0000 0004 1936 9000University of Pittsburgh School of Medicine (UPSOM), Pittsburgh, PA USA
| | | | - Jose Conejo-Garcia
- grid.468198.a0000 0000 9891 5233Department of Immunology, H. Lee Moffitt Cancer Center and Research Institute, Florida Tampa, USA
| | - Patrick Hwu
- grid.468198.a0000 0000 9891 5233Administration, Cutaneous Oncology, Immunology, H. Lee Moffitt Cancer Center and Research Institute, Florida Tampa, USA
| | - Howard Streicher
- grid.48336.3a0000 0004 1936 8075National Cancer Institute, Rockville, MD USA
| | - Vernon K. Sondak
- grid.468198.a0000 0000 9891 5233Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center and Research Institute, Florida Tampa, USA
| | - John M. Kirkwood
- grid.21925.3d0000 0004 1936 9000University of Pittsburgh School of Medicine (UPSOM), Pittsburgh, PA USA ,grid.21925.3d0000 0004 1936 9000UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA USA
| | - Ahmad A. Tarhini
- grid.468198.a0000 0000 9891 5233Departments of Cutaneous Oncology and Immunology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612 USA 10920 McKinley Dr.,
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Rojas F, Parra ER, Wistuba II, Haymaker C, Solis Soto LM. Pathological Response and Immune Biomarker Assessment in Non-Small-Cell Lung Carcinoma Receiving Neoadjuvant Immune Checkpoint Inhibitors. Cancers (Basel) 2022; 14:cancers14112775. [PMID: 35681755 PMCID: PMC9179283 DOI: 10.3390/cancers14112775] [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: 05/03/2022] [Revised: 05/27/2022] [Accepted: 05/28/2022] [Indexed: 02/05/2023] Open
Abstract
Simple Summary Recently, the U.S. Food and Drug Administration (FDA) approved neoadjuvant immunotherapy plus chemotherapy for the treatment of resectable non-small-cell lung carcinoma (NSCLC) due to the clinical benefits reported in several clinical trials. In these settings, the pathological assessment of the tumor bed to quantify a pathological response has been used as a surrogate method of clinical benefit to neoadjuvant therapy. In addition, several clinical trials are including the assessment of tissue-, blood-, or host-based biomarkers to predict therapy response and to monitor the response to neoadjuvant treatment. In this manuscript, we provide an overview of current recommendations for the evaluation of pathological response and describe potential biomarkers used in clinical trials of neoadjuvant immunotherapy in resectable NSCLC. Abstract Lung cancer is the leading cause of cancer incidence and mortality worldwide. Adjuvant and neoadjuvant chemotherapy have been used in the perioperative setting of non-small-cell carcinoma (NSCLC); however, the five-year survival rate only improves by about 5%. Neoadjuvant treatment with immune checkpoint inhibitors (ICIs) has become significant due to improved survival in advanced NSCLC patients treated with immunotherapy agents. The assessment of pathology response has been proposed as a surrogate indicator of the benefits of neaodjuvant therapy. An outline of recommendations has been published by the International Association for the Study of Lung Cancer (IASLC) for the evaluation of pathologic response (PR). However, recent studies indicate that evaluations of immune-related changes are distinct in surgical resected samples from patients treated with immunotherapy. Several clinical trials of neoadjuvant immunotherapy in resectable NSCLC have included the study of biomarkers that can predict the response of therapy and monitor the response to treatment. In this review, we provide relevant information on the current recommendations of the assessment of pathological responses in surgical resected NSCLC tumors treated with neoadjuvant immunotherapy, and we describe current and potential biomarkers to predict the benefits of neoadjuvant immunotherapy in patients with resectable NSCLC.
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Lu Y, Xu M, Guan L, Yang Y, Chen Y, Yang Y, Wang F. PD-1 Inhibitor Plus Chemotherapy Versus Chemotherapy as First-line Treatment for Advanced Esophageal Cancer: A Systematic Review and Meta-Analysis. J Immunother 2022; 45:243-253. [PMID: 35467579 PMCID: PMC9087869 DOI: 10.1097/cji.0000000000000420] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 03/22/2022] [Indexed: 11/25/2022]
Abstract
Immunotherapy combined with chemotherapy has recently changed the first-line treatment of several cancers. We performed a systematic review and meta-analysis to assess the efficacy and safety of programmed cell death 1 (PD-1) inhibitor plus chemotherapy as a first-line treatment for advanced esophageal cancer. Data were collected from eligible studies searched from PubMed, Web of Science, Cochrane Library, Embase, and meeting abstracts. The pooled hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS) and the pooled odds ratios (ORs) for objective response rate and treatment-related adverse events (TRAEs) were estimated to assess the efficacy and safety of PD-1 inhibitor plus chemotherapy versus chemotherapy. We performed several subgroup analyses to explore the variables affecting immunotherapy efficacy in esophageal cancer. The 5-point Jadad scoring system, the bias risk assessment and sensitivity analyses were used to evaluate the quality of the meta-analysis. Compared with the chemotherapy group, the OS (HR=0.70; P<0.01) and PFS (HR=0.62; P<0.01) were significantly longer and the objective response rate (OR=2.07; P<0.01) was significantly higher in the PD-1 inhibitor plus chemotherapy group. An OS benefit was observed in patients regardless of histology or programmed cell death 1 ligand 1 combined positive score. OS and PFS were generally consistent across subgroups by clinical features. In safety analyses, PD-1 inhibitor plus chemotherapy had a significantly higher incidence of TRAEs (OR=1.85; P<0.01), but there was no significant difference in grade 3 or higher TRAEs (OR=1.24; P=0.05). Compared with chemotherapy, PD-1 inhibitor plus chemotherapy improves antitumor activity and controllable adverse events in the first-line treatment of advanced esophageal cancer.
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223
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Guan X, Polesso F, Wang C, Sehrawat A, Hawkins RM, Murray SE, Thomas GV, Caruso B, Thompson RF, Wood MA, Hipfinger C, Hammond SA, Graff JN, Xia Z, Moran AE. Androgen receptor activity in T cells limits checkpoint blockade efficacy. Nature 2022; 606:791-796. [PMID: 35322234 PMCID: PMC10294141 DOI: 10.1038/s41586-022-04522-6] [Citation(s) in RCA: 160] [Impact Index Per Article: 80.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 02/04/2022] [Indexed: 12/16/2022]
Abstract
Immune checkpoint blockade has revolutionized the field of oncology, inducing durable anti-tumour immunity in solid tumours. In patients with advanced prostate cancer, immunotherapy treatments have largely failed1-5. Androgen deprivation therapy is classically administered in these patients to inhibit tumour cell growth, and we postulated that this therapy also affects tumour-associated T cells. Here we demonstrate that androgen receptor (AR) blockade sensitizes tumour-bearing hosts to effective checkpoint blockade by directly enhancing CD8 T cell function. Inhibition of AR activity in CD8 T cells prevented T cell exhaustion and improved responsiveness to PD-1 targeted therapy via increased IFNγ expression. AR bound directly to Ifng and eviction of AR with a small molecule significantly increased cytokine production in CD8 T cells. Together, our findings establish that T cell intrinsic AR activity represses IFNγ expression and represents a novel mechanism of immunotherapy resistance.
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Affiliation(s)
- Xiangnan Guan
- Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR, USA
- Molecular Microbiology and Immunology, Oregon Health and Science University, Portland, OR, USA
- Genentech, Inc., South San Francisco, CA, USA
| | - Fanny Polesso
- Cell, Developmental and Cancer Biology, Oregon Health and Science University, Portland, OR, USA
| | - Chaojie Wang
- Cell, Developmental and Cancer Biology, Oregon Health and Science University, Portland, OR, USA
- Bristol Myers Squibb, New Brunswick, NJ, USA
| | - Archana Sehrawat
- Cell, Developmental and Cancer Biology, Oregon Health and Science University, Portland, OR, USA
| | - Reed M Hawkins
- Cell, Developmental and Cancer Biology, Oregon Health and Science University, Portland, OR, USA
| | - Susan E Murray
- Molecular Microbiology and Immunology, Oregon Health and Science University, Portland, OR, USA
- Department of Biology, University of Portland, Portland, OR, USA
| | - George V Thomas
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
- Department of Pathology and Laboratory Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Breanna Caruso
- Cell, Developmental and Cancer Biology, Oregon Health and Science University, Portland, OR, USA
| | - Reid F Thompson
- Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR, USA
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
- Department of Radiation Medicine, Oregon Health and Science University, Portland, OR, USA
- VA Portland Health Care System, Portland, OR, USA
| | - Mary A Wood
- VA Portland Health Care System, Portland, OR, USA
| | - Christina Hipfinger
- Cell, Developmental and Cancer Biology, Oregon Health and Science University, Portland, OR, USA
| | - Scott A Hammond
- Clinical IO Discovery, Oncology R&D, AstraZeneca, Gaithersburg, MD, USA
| | - Julie N Graff
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
- VA Portland Health Care System, Portland, OR, USA
| | - Zheng Xia
- Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR, USA
- Molecular Microbiology and Immunology, Oregon Health and Science University, Portland, OR, USA
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
| | - Amy E Moran
- Cell, Developmental and Cancer Biology, Oregon Health and Science University, Portland, OR, USA.
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA.
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Chen C, Zhang C, Wu B, Xu T. Immune-related adverse events in older adults: Data mining of the FDA Adverse Event Reporting System. J Geriatr Oncol 2022; 13:1017-1022. [PMID: 35660091 DOI: 10.1016/j.jgo.2022.05.009] [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: 10/19/2021] [Revised: 03/15/2022] [Accepted: 05/23/2022] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Recent studies reveal that there is no difference in the efficacy of immune checkpoint inhibitors (ICIs) between younger adults and older adults. However, it remains unclear whether age is a risk factor for immune-related adverse events (irAEs). MATERIALS AND METHODS To analyze the association between irAEs and age based on data from the Food and Drug Administration Adverse Event Reporting System (FAERS) database between January 2004 and December 2020, we performed a case/noncase study on ICI-related adverse events. Cases were defined as adverse event cases with ICI therapy and irAEs, and noncases were defined as adverse event cases with ICI therapy and without irAEs. One case was matched to a noncase using the sex, reporter, report year, and type of ICI regimen. The reporting odds ratios (RORs) were used to assess the disproportionality of irAEs between older adults (≥65 years) and younger adults (<65 years). RESULTS The study shows that compared with younger adults, the ROR of older adults was 1.12 (95% confidence interval [CI]: 1.08-1.16) and 1.18 (95% CI: 1.14-1.23) before and after matching, respectively. The signal of age-related irAEs was detected in patients treated with ICI monotherapy but not in patients treated with combination therapy. Further analysis revealed a spectrum of age-related toxicities including cardiovascular toxicities, lung toxicities, musculoskeletal toxicities, nervous system toxicities, renal toxicities, and skin toxicities. CONCLUSION In this analysis performed based on the FAERS, irAE cases were more likely to be reported in older adults. Our pharmacovigilance study complements the safety data of clinical trials. Further studies are expected to explore the underlying reasons for irAEs in older adults.
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Affiliation(s)
- Chen Chen
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; West China School of Pharmacy, Sichuan University, Chengdu, Sichuan 610041, China
| | - Chenyu Zhang
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; West China School of Pharmacy, Sichuan University, Chengdu, Sichuan 610041, China
| | - Bin Wu
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; West China School of Pharmacy, Sichuan University, Chengdu, Sichuan 610041, China.
| | - Ting Xu
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; West China School of Pharmacy, Sichuan University, Chengdu, Sichuan 610041, China
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225
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Jang JK, Pyo J, Suh CH, Park HS, Chae YK, Kim KW. Safety and Efficacy of Chimeric Antigen Receptor T-Cell Therapy for Glioblastoma: A Systemic Review and Meta-Analysis. Front Oncol 2022; 12:851877. [PMID: 35692797 PMCID: PMC9178287 DOI: 10.3389/fonc.2022.851877] [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: 01/10/2022] [Accepted: 04/04/2022] [Indexed: 11/29/2022] Open
Abstract
Background Chimeric antigen receptor (CAR) T-cell therapy is a promising treatment option for patients with refractory hematological malignancies. However, its efficacy in glioblastoma remains unclear. Here, we performed a systematic review to summarize the safety and efficacy of CAR T-cell therapy in glioblastoma. Methods The PubMed, EMBASE, and Cochrane databases were searched to identify articles published before June 30, 2021 describing the use of CAR T-cell therapy in glioblastoma. Information on the toxicity of CAR T-cell therapy was summarized. The pooled objective response rate (ORR) and overall survival (OS) of patients who underwent CAR T-cell therapy were estimated using a random-effects model with an inverse-variance weighting model and quantile estimation method, respectively. Results Of 397 articles identified, eight studies including 63 patients with recurrent glioblastoma treated with various CAR T-cell regimens were included in the analysis. Six (9.5%) patients developed cytokine release syndrome (grade ≤2), and 16 (25.4%) experienced non-critical neurological events. The pooled ORR was 5.1% (95% confidence interval [CI], 0.0-10.4; I 2 = 0.05%), and the pooled median OS was 8.1 months (95% CI, 6.7-9.5; I 2 = 0.00%). Conclusion Although CAR T-cell therapy is a relatively safe therapeutic option in patients with glioblastoma, it shows marginal efficacy, suggesting that further research is necessary for its translation into clinical practice for the treatment of recurrent glioblastoma.
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Affiliation(s)
- Jong Keon Jang
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Junhee Pyo
- Asan Medical Center, Department of Biomedical Engineering, College of Medicine, University of Ulsan, Seoul, South Korea
| | - Chong Hyun Suh
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hye Sun Park
- Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, United States
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Young Kwang Chae
- Robert H. Lurie Comprehensive Cancer Center, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Kyung Won Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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Wang X, Chen X, Liu Y, Huang S, Ding J, Wang B, Dong P, Sun Z, Chen L. CSMD1 suppresses cancer progression by inhibiting proliferation, epithelial-mesenchymal transition, chemotherapy-resistance and inducing immunosuppression in esophageal squamous cell carcinoma. Exp Cell Res 2022; 417:113220. [PMID: 35623420 DOI: 10.1016/j.yexcr.2022.113220] [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: 01/22/2022] [Revised: 05/15/2022] [Accepted: 05/19/2022] [Indexed: 11/17/2022]
Abstract
Human CUB and Sushi multiple domains (CSMD1) is considered a crucial role in cancer progression, but the specific function in esophageal squamous cell carcinoma (ESCC) is not clear. Understanding the role of CSMD1 in ESCC progression may lead to a novel strategy for ESCC treatment. Here, we found that both CSMD1 mRNA and protein levels were downregulated in ESCC tissues. Reduced CSMD1 expression was correlated with a poor prognosis in ESCC patients. CSMD1 expression inhibited proliferation, migration and invasion in ESCC cell lines in vitro. CSMD1 deficiency in established xenografted tumors increases tumor size and weight. We further found that CSMD1-overexpression cells are more sensitive to chemotherapy. Moreover, we addressed the role of CSMD1 in the CD8+ T cell immune response. An in vitro killing assay showed that the cytotoxicity of CD8+ T cells was inhibited in CSMD1-overexpression tumor cells. In vivo, in CSMD1 deficiency tumor-bearing mice activation and expansion of CD8+ T cells were increased. Further investigation showed that CSMD1 expression on tumor cells was positively correlated with CD8+ T cells infiltration and cytokines secretion. These findings highlight that CSMD1 is a tumor suppressor gene in ESCC patients and a positive regulator of CD8+ T cells expansion and activation, and could increase cytokines secretion, indicating that tumor cell-associated CSMD1 might be a target for ESCC.
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Affiliation(s)
- Xing Wang
- Translational Medicine Center, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 201620, Shanghai, China
| | - Xinwei Chen
- Department of Otolaryngology: Head and Neck Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, China
| | - Yuanyuan Liu
- Department of Otolaryngology: Head and Neck Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, China
| | - Shan Huang
- National Engineering Research Center for Nanomedicine, Key Laboratory of Molecular Biophysics of Ministry of Education, College of Life Science and Technology, Tongji Hospital, Huazhong University of Science and Technology, 430074, Wuhan, China
| | - Jian Ding
- Department of Otolaryngology: Head and Neck Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, China
| | - Baoxin Wang
- Department of Otolaryngology: Head and Neck Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, China
| | - Pin Dong
- Department of Otolaryngology: Head and Neck Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, China
| | - Zhenfeng Sun
- Department of Otolaryngology: Head and Neck Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, China
| | - Lixiao Chen
- Department of Otolaryngology: Head and Neck Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, China.
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Differential Regulation of NK Cell Receptors in Acute Lymphoblastic Leukemia. J Immunol Res 2022; 2022:7972039. [PMID: 35652109 PMCID: PMC9150999 DOI: 10.1155/2022/7972039] [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: 01/21/2022] [Accepted: 03/22/2022] [Indexed: 11/18/2022] Open
Abstract
Cancer immunotherapies are preferred over conventional treatments which are highly cytotoxic to normal cells. Focus has been on T cells but natural killer (NK) cells have equal potential. Concepts in cancer control and influence of sex require further investigation to improve successful mobilization of immune cells in cancer patients. Acute lymphoblastic leukemia (ALL) is a hematological malignancy mainly of B cell (B-ALL) and T cell (T-ALL) subtypes. Influence of ALL on NK cell is still unclear. Targeted next-generation sequencing was conducted on 62 activating/inhibitory receptors, ligands, effector, and exhaustion molecules on T-ALL (6 males) and normal controls (NC) (4 males and 4 females). Quantitative PCR (q-PCR) further investigated copy number variation (CNV), methylation index (MI), and mRNA expression of significant genes in T-ALL (14 males), NC (12 males and 12 females), and B-ALL samples (N = 12 males and 12 females). Bioinformatics revealed unique variants particularly rs2253849 (T>C) in KLRC1 and rs1141715 (A>G) in KLRC2 only among T-ALL (allele frequency 0.8-1.0). Gene amplification was highest in female B-ALL compared to male B-ALL (KLRC2, KLRC4, and NCR3, p < 0.05) and lowest in male T-ALL cumulating in deletion of KLRD1 and CD69. MI was higher in male ALL of both subtypes compared to normal (KIR2DL1-2 and 4 and KIR2DS2 and 4, p < 0.05) as well as to female B-ALL (KIR3DL2 and KIR2DS2, p < 0.05). mRNA expressions were low. Thus, ALL subtypes potentially regulated NK cell suppression by different mechanisms which should be considered in future immunotherapies for ALL.
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Abushukair H, Abushukair A, Saeed A. Nivolumab in Esophageal Squamous-Cell Carcinoma. N Engl J Med 2022; 386:1959. [PMID: 35584167 DOI: 10.1056/nejmc2202880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
| | | | - Anwaar Saeed
- University of Kansas Cancer Center, Kansas City, KS
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Relationship between Patients’ Baseline Characteristics and Survival Benefits in Immunotherapy-Treated Non-Small-Cell Lung Cancer: A Systematic Review and Meta-Analysis. JOURNAL OF ONCOLOGY 2022; 2022:3601942. [PMID: 35646119 PMCID: PMC9135521 DOI: 10.1155/2022/3601942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 04/21/2022] [Accepted: 04/30/2022] [Indexed: 11/17/2022]
Abstract
Background The difference of patients' baseline characteristics such as sex, age, Eastern Cooperative Oncology Group performance status (ECOG PS), and smoking status may influence the immune response. However, little is known about whether these factors affect the efficacy of immune checkpoint inhibitors (ICIs) in patients with advanced non-small-cell lung cancer (NSCLC). Therefore, we performed this systematic review and meta-analysis to investigate the relationship between patients' baseline characteristics and survival benefits in immunotherapy-treated NSCLC. Materials and Methods We performed a systematic search of PubMed, the Cochrane Library, and Embase for randomized controlled trials (RCTs) of NSCLC immunotherapy. We also searched abstracts and presentations from the proceedings of the American Society of Clinical Oncology and the European Society of Medical Oncology to identify unpublished studies. These studies have available data based on patients' baseline characteristics (such as sex, age, ECOG PS, and smoking status). We take the hazard ratios (HRs) and 95% confidence intervals (CIs) of overall survival (OS) as the effect index and use the random effect model to pool the results. Results We included 18 phase II/III RCTs with a total of 14,189 participants. The benefits of ICIs were found for both male (pooled OS-HR 0.77, 95% CI 0.72-0.82, P < 0.05) and female patients (pooled OS-HR 0.77, 95% CI 0.67-0.87, P < 0.05); for both younger (<65 y: pooled OS-HR 0.74, 95% CI 0.68-0.81, P < 0.05) and older patients (≥65 y: pooled OS-HR 0.80, 95% CI 0.75-0.86, P < 0.05); and for both patients with ECOG PS = 0 (pooled OS-HR 0.77, 95% CI 0.71-0.84, P < 0.05) and ECOG PS ≥ 1 (pooled OS-HR 0.76, 95% CI 0.70-0.82, P < 0.05). Moreover, there was no significant difference in the efficacy of ICIs among different sex (P value for interaction = 0.955), age (P value for interaction = 0.17), or ECOG PS (P value for interaction = 0.765). However, in patients with different smoking status, the application of ICIs significantly prolonged the OS of smokers (pooled OS-HR 0.77, 95% CI 0.71-0.83, P < 0.05) but could not significantly improve the OS of never smokers (pooled OS-HR 0.85, 95% CI 0.70-1.03, P > 0.05). Conclusions ICIs could significantly improve prognosis in patients with advanced NSCLC, regardless of sex, age, or ECOG PS. But among patients with different smoking status, the survival benefits of never smokers treated with ICIs were no better than that of controls. The impact of these factors on immunotherapy should be considered in the future clinical practice and guidelines.
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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.
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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:
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231
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Abstract
Immune checkpoint inhibitors (ICIs) have limited activity in patients with castration-resistant prostate cancer (CRPC). A Nature article demonstrates that androgen receptor (AR) negatively modulates CD8+ T cell-driven antitumor immune response and that androgen-axis blockade is a promising therapeutic strategy to improve ICI activity in CRPC.
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Affiliation(s)
- Laura Pala
- Division of Melanoma, Sarcomas, and Rare Tumors, European Institute of Oncology, IRCCS, Milan, Italy
| | - Tommaso De Pas
- Division of Melanoma, Sarcomas, and Rare Tumors, European Institute of Oncology, IRCCS, Milan, Italy
| | - Fabio Conforti
- Division of Melanoma, Sarcomas, and Rare Tumors, European Institute of Oncology, IRCCS, Milan, Italy.
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CAR T cells as a second-line therapy for large B-cell lymphoma: a paradigm shift? Blood 2022; 139:2737-2746. [PMID: 35240677 DOI: 10.1182/blood.2022015789] [Citation(s) in RCA: 62] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 03/02/2022] [Indexed: 11/20/2022] Open
Abstract
The standard of care treatment strategy for patients with relapsed or refractory large B-cell lymphoma (LBCL) has been high-dose chemotherapy followed by autologous stem cell transplantation (ASCT) if chemotherapy sensitive in suitable patients. Because of treatment intensity, this approach has only been feasible in half of patients and because of chemotherapy resistance has only been successful in a quarter of transplant-eligible patients. Chimeric antigen receptor (CAR) T-cell therapy, using genetically modified autologous T cells targeting CD19, has been approved for third-line therapy of LBCL and has been associated with durable remissions in a proportion of patients. In this review, we interpret the design and results of 3 randomized phase 3 trials comparing CAR T-cell therapy and ASCT and their implications for CAR T-cell therapy as a potential new standard of care for second-line treatment in appropriate patients with refractory or early relapsing LBCL.
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233
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Wang J, Ma X, Ma Z, Ma Y, Wang J, Cao B. Research Progress of Biomarkers for Immune Checkpoint Inhibitors on Digestive System Cancers. Front Immunol 2022; 13:810539. [PMID: 35493526 PMCID: PMC9043345 DOI: 10.3389/fimmu.2022.810539] [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: 11/07/2021] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
Immunotherapy represented by immune checkpoint inhibitors has gradually entered a new era of precision medicine. In view of the limited clinical benefits of immunotherapy in patients with digestive system cancers, as well as the side-effects and high treatment costs, development of biomarkers to predict the efficacy of immune therapy is a key imperative. In this article, we review the available evidence of the value of microsatellite mismatch repair, tumor mutation burden, specific mutated genes or pathways, PD-L1 expression, immune-related adverse reactions, blood biomarkers, and patient-related biomarkers in predicting the efficacy of immunotherapy against digestive system cancers. Establishment of dynamic personalized prediction models based on multiple biomarkers is a promising area for future research.
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Affiliation(s)
- Jingting Wang
- Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xiao Ma
- Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhongjun Ma
- Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yan Ma
- Department of Comprehensive Medicine, Beijing Shijingshan Hospital, Beijing, China
| | - Jing Wang
- Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Bangwei Cao
- Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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234
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Hall M, Krishnanandan VA, Cheung MC, Coburn NG, Haas B, Chan KKW, Raphael MJ. An Evaluation of Sex- and Gender-Based Analyses in Oncology Clinical Trials. J Natl Cancer Inst 2022; 114:1186-1191. [PMID: 35477781 PMCID: PMC9360459 DOI: 10.1093/jnci/djac092] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 02/17/2022] [Accepted: 04/21/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The objective of this study was to evaluate whether sex- and gender-based analyses and proper sex- and gender-terminology were used in oncology trials leading to regulatory drug approval. METHODS The Food and Drug Administration (FDA) Hematology/Oncology Approvals and Safety Notifications page was used to identify all anti-cancer therapies that received FDA approval between 2012 and 2019. The trials used to support FDA-drug approval were collected along with all available supplemental tables and study protocols. Documents were reviewed to determine if there was a plan to analyze results according to sex and gender and to determine if consistent sex and gender terminology were used. RESULTS 128 randomized-controlled trials were identified corresponding to a cancer medicine which received FDA-approval. No study specified how sex and gender were collected or analyzed. No study reported any information on the gender of participants. Sex and gender terminology was used inconsistently at least once in 76% (97/128) of studies. Among the 102 trials for non-sex-specific cancer sites, 89% (91/102) presented disaggregated survival outcome data by sex. No study presented disaggregated toxicity data by sex or gender. CONCLUSION The majority of pivotal clinical trials in oncology fail to account for the important distinction between sex and gender and conflate sex and gender terminology. More rigor in designing clinical trials to include sex and gender based analyses and more care in using sex and gender terms in the cancer literature is needed. These efforts are essential to improve the reproducibility, generalizability, and inclusiveness of cancer research.
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Affiliation(s)
- Mathew Hall
- Department of General Internal Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Vaishali A Krishnanandan
- Division of Hematology/Medical Oncology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Matthew C Cheung
- Division of Hematology/Medical Oncology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Natalie G Coburn
- Department of General Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Barbara Haas
- Department of General Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Kelvin K W Chan
- Division of Hematology/Medical Oncology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Canadian Centre of Applied Research in Cancer Control, Canada
| | - Michael J Raphael
- Division of Hematology/Medical Oncology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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235
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Abstract
Strong epidemiological evidence now exists that sex is an important biologic variable in immunity. Recent studies, for example, have revealed that sex differences are associated with the severity of symptoms and mortality due to coronavirus disease 2019 (COVID-19). Despite this evidence, much remains to be learned about the mechanisms underlying associations between sex differences and immune-mediated conditions. A growing body of experimental data has made significant inroads into understanding sex-influenced immune responses. As physicians seek to provide more targeted patient care, it is critical to understand how sex-defining factors (e.g., chromosomes, gonadal hormones) alter immune responses in health and disease. In this review, we highlight recent insights into sex differences in autoimmunity; virus infection, specifically severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection; and cancer immunotherapy. A deeper understanding of underlying mechanisms will allow the development of a sex-based approach to disease screening and treatment.
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Affiliation(s)
- Nicole M. Wilkinson
- UCLA/Caltech Medical Scientist Training Program, Los Angeles, California, USA
| | - Ho-Chung Chen
- Molecular Biology Institute, University of California, Los Angeles, California, USA
| | - Melissa G. Lechner
- Division of Endocrinology, Diabetes, and Metabolism, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Maureen A. Su
- Department of Microbiology, Immunology, and Molecular Genetics, David Geffen School of Medicine, University of California, Los Angeles, California, USA,Department of Pediatrics, David Geffen School of Medicine, University of Los Angeles, California, USA
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236
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Sex differences in immune-related adverse events with immune checkpoint inhibitors: data mining of the FDA adverse event reporting system. Int J Clin Pharm 2022; 44:689-697. [PMID: 35449347 DOI: 10.1007/s11096-022-01395-7] [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: 10/15/2021] [Revised: 02/27/2022] [Accepted: 03/01/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND Although immune-related adverse events (irAEs) have been reported in patients receiving immune checkpoint inhibitor (ICI) therapy, sex differences in irAEs are not known. AIM The present study described, evaluated and compared differences in irAEs between females and males treated with ICIs. METHOD irAE reports were obtained from the FDA Adverse Event Reporting System (FAERS) from January 2004 to December 2020. Disproportionality analysis and Bayesian analysis were used to explore differences in irAEs between females and males. The onset time and fatality proportion of irAEs in different ICIs between females and males were further evaluated. RESULTS A total of 30,342 irAE cases were obtained, including 11,097 female cases and 19,245 male cases. Consistent disproportionality signals were detected in females and males, including endocrine toxicity, hepatitis, lung toxicity, nervous system toxicity, and ocular toxicity. Renal toxicity was only detected in male patients receiving ICI therapy (PRR 2.37, 95% CI: 2.25-2.51; IC: 1.24, 95% CI: 1.05-1.43). Males had a longer onset time (females 35 days [IQR 14-87] vs. males 39 days [IQR 14-92], P = 0.041) and higher fatality proportion (females 20.5% vs. males 25.6%, P < 0.01). CONCLUSIONS This analysis revealed that males had a higher chance of exhibiting ICI-associated renal toxicity, longer median onset time and worse prognosis of irAEs than females. Greater attention to sex differences in ICI therapy is needed.
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237
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Gedney A, Salah P, Mahoney JA, Krick E, Martins R, Scavello H, Lenz JA, Atherton MJ. Evaluation of the anti-tumor activity of Coriolus versicolor polysaccharopeptide (I'm Yunity®) alone or in combination with doxorubicin for canine splenic hemangiosarcoma. Vet Comp Oncol 2022; 20:688-696. [PMID: 35442554 DOI: 10.1111/vco.12823] [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: 01/14/2022] [Revised: 04/08/2022] [Accepted: 04/15/2022] [Indexed: 11/29/2022]
Abstract
Canine splenic hemangiosarcoma (HSA) is an aggressive tumor of vascular endothelium that carries a grave prognosis following standard of care treatment with surgery and doxorubicin. A previous pilot study revealed potential anti-tumor activity of I'm Yunity® Polysaccharopeptide (PSP) for canine HSA. The aim of this prospective study was to assess patient outcome when treated with PSP alone or in combination with doxorubicin post-splenectomy compared to patients treated with surgery and doxorubicin that received a placebo in place of PSP. Dogs undergoing splenectomy for splenic HSA were eligible. Following splenectomy, owners were offered treatment with PSP alone or adjuvant doxorubicin chemotherapy(unblinded). Patients with owners that selected to proceed with doxorubicin chemotherapy were blindly randomized to receive placebo or PSP. Dogs were evaluated weekly for 15 weeks, then scheduled for monthly visits until death. One hundred and one dogs were included in the final analysis: 51 PSP alone, 25 doxorubicin/placebo, and 25 combination PSP/doxorubicin. On multivariate analysis, dogs treated with single agent PSP, female dogs, decreased hematocrit at diagnosis, and stage III disease were negatively significantly associated with outcome; however, an interaction between treatment group and sex was documented. Gender-specific outcomes revealed no significant difference in survival between treatment groups for male dogs, but female dogs treated with PSP alone had significantly reduced survival compared to females receiving doxorubicin/placebo (HR 0.21; p = 0.004). Anemia (HR 5.28; p < 0.001) and stage III disease (HR 2.9; p = 0.014) remained negatively associated with survival when controlling for sex and treatment group. The addition of PSP to doxorubicin post-splenectomy did not improve survival in dogs with splenic HSA.
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Affiliation(s)
- Allison Gedney
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Pascale Salah
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Jennifer A Mahoney
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Erika Krick
- Mount Laurel Animal Hospital, Mount Laurel, New Jersey, United States
| | - Reenie Martins
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Heather Scavello
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Jennifer A Lenz
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Matthew J Atherton
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States.,Department of Biomedical Sciences, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
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238
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Zhang Y, Liu P, Cai J, Jing H, Zou L, Huang H, Wu Y, Li W, Zhong L, Jin X, Ye X, Feng R, Zhang H, Zhang L, Lin L, Sun X, Tian Y, Xia Z, Li Z, Huang H, Xia Y, Cai Q. Ibrutinib as monotherapy versus combination therapy in Chinese patients with relapsed/refractory mantle cell lymphoma: A multicenter study. Cancer Med 2022; 11:4134-4145. [PMID: 35438258 DOI: 10.1002/cam4.4765] [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: 09/02/2021] [Revised: 02/18/2022] [Accepted: 04/09/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Ibrutinib has revolutionized the treatment of mantle cell lymphoma (MCL). Both ibrutinib monotherapy and ibrutinib-based combination therapy are important salvage options for patients with relapsed/refractory (R/R) MCL. The real-world efficacy and safety profile of the two strategies in Chinese patients with R/R MCL remain unclarified. METHODS In the present study, data of 121 R/R MCL patients who received either ibrutinib monotherapy (N = 68) or ibrutinib combination therapy (N = 53) in 13 medical centers in China were retrospectively reviewed. RESULTS With a median follow-up of 20.5 months, the overall response rate was 60.3% versus 84.9% (p = 0.003), complete remission rate was 16.2% versus 43.4% (p < 0.001), and median progression-free survival (PFS) was 18.5 months (95% confidence interval [CI], 12.1-21.8) vs. 30.8 months (95% CI, 23.5-NR) (hazard ratio, 0.53 [95% CI, 0.30-0.93]; p = 0.025), with ibrutinib monotherapy and ibrutinib-based combination therapy, respectively. Subgroup analysis showed that patients with male gender, no refractory disease, Ki67 <30%, previous line of therapy = 1, non-blastoid subtype, and the number of extranodal sites involved <2 might benefits more from the combination therapy. Treatment-emergent adverse events were similar, except for a higher incidence of all grade neutropenia in the ibrutinib combination group (12.7% vs. 32.0%, p = 0.017). CONCLUSIONS Ibrutinib combination therapy demonstrated potentially superior efficacy and comparable tolerability to ibrutinib monotherapy. Ibrutinib-based combination therapy could be one of the prominent treatment options for R/R MCL patients.
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Affiliation(s)
- Yuchen Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China.,Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Panpan Liu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China.,Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Jun Cai
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China.,Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Hongmei Jing
- Department of Hematology, Peking University Third Hospital, Beijing, P.R. China
| | - Liqun Zou
- Department of Oncology, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Huiqiang Huang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China.,Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Yuanbin Wu
- Department of Hematology, Guangdong Province Traditional Chinese Medical Hospital, Guangzhou, P.R. China
| | - Wenyu Li
- Division of Lymphoma, Department of Clinical Oncology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, P.R. China
| | - Liye Zhong
- Department of Hematology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, P.R. China
| | - Xueli Jin
- Department of Hematology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, P.R. China
| | - Xu Ye
- Department of Hematology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, P.R. China
| | - Ru Feng
- Department of Hematology, Nanfang Hospital of Nanfang Medical University, Guangzhou, P.R. China
| | - Huilai Zhang
- Department of Lymphoma, Tianjin Medical University Cancer Hospital and Institute, Tianjin, P.R. China
| | - Liling Zhang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Lie Lin
- Department of Hematology, Hainan General Hospital, Haikou, P.R. China
| | - Xiuhua Sun
- Myeloma and Lymphoma Research Center, Second Affiliated Hospital of Dalian Medical University, Dalian, P.R. China
| | - Yuyang Tian
- Department of Hematology, Hainan Cancer Hospital, Haikou, P.R. China
| | - Zhongjun Xia
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China.,Department of Hematologic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Zhiming Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China.,Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - He Huang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China.,Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Yi Xia
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China.,Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Qingqing Cai
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China.,Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
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239
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Olingy C, Alimadadi A, Araujo DJ, Barry D, Gutierrez NA, Werbin MH, Arriola E, Patel SP, Ottensmeier CH, Dinh HQ, Hedrick CC. CD33 Expression on Peripheral Blood Monocytes Predicts Efficacy of Anti-PD-1 Immunotherapy Against Non-Small Cell Lung Cancer. Front Immunol 2022; 13:842653. [PMID: 35493454 PMCID: PMC9046782 DOI: 10.3389/fimmu.2022.842653] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 03/02/2022] [Indexed: 12/25/2022] Open
Abstract
Non-small cell lung carcinoma (NSCLC) is the leading cause of cancer-related deaths globally. Immune checkpoint blockade (ICB) has transformed cancer medicine, with anti-programmed cell death protein 1 (anti-PD-1) therapy now well-utilized for treating NSCLC. Still, not all patients with NSCLC respond positively to anti-PD-1 therapy, and some patients acquire resistance to treatment. There remains an urgent need to find markers predictive of anti-PD-1 responsiveness. To this end, we performed mass cytometry on peripheral blood mononuclear cells from 26 patients with NSCLC during anti-PD-1 treatment. Patients who responded to anti-PD-1 ICB displayed significantly higher levels of antigen-presenting myeloid cells, including CD9+ nonclassical monocytes, and CD33hi classical monocytes. Using matched pre-post treatment samples, we found that the baseline pre-treatment frequencies of CD33hi monocytes predicted patient responsiveness to anti-PD-1 therapy. Moreover, some of these classical and nonclassical monocyte subsets were associated with reduced immunosuppression by T regulatory (CD4+FOXP3+CD25+) cells in the same patients. Our use of machine learning corroborated the association of specific monocyte markers with responsiveness to ICB. Our work provides a high-dimensional profile of monocytes in NSCLC and links CD33 expression on monocytes with anti-PD-1 effectiveness in patients with NSCLC.
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Affiliation(s)
- Claire Olingy
- Center for Cancer Immunotherapy, La Jolla Institute for Immunology, La Jolla, CA, United States
| | - Ahmad Alimadadi
- Center for Cancer Immunotherapy, La Jolla Institute for Immunology, La Jolla, CA, United States
| | - Daniel J. Araujo
- Center for Cancer Immunotherapy, La Jolla Institute for Immunology, La Jolla, CA, United States
| | - David Barry
- Center for Cancer Immunotherapy, La Jolla Institute for Immunology, La Jolla, CA, United States
| | - Norma A. Gutierrez
- Center for Cancer Immunotherapy, La Jolla Institute for Immunology, La Jolla, CA, United States
| | - Max Hardy Werbin
- Cancer Research Program, Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
| | - Edurne Arriola
- Cancer Research Program, Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- Medical Oncology Department, Hospital del Mar-Centro de Investigación Biomédica en Red de Oncología (CIBERONC), Barcelona, Spain
| | - Sandip Pravin Patel
- Moores Cancer Center, University of California, San Diego, La Jolla, CA, United States
| | - Christian H. Ottensmeier
- Institute of Translational Medicine, Department of Molecular & Clinical Cancer Medicine, University of Liverpool, Liverpool, United Kingdom
| | - Huy Q. Dinh
- McArdle Laboratory for Cancer Research, University of Wisconsin-Madison, Madison, WI, United States
| | - Catherine C. Hedrick
- Center for Cancer Immunotherapy, La Jolla Institute for Immunology, La Jolla, CA, United States
- *Correspondence: Catherine C. Hedrick,
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240
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Kwon H, Schafer JM, Song NJ, Kaneko S, Li A, Xiao T, Ma A, Allen C, Das K, Zhou L, Riesenberg B, Chang Y, Weltge P, Velegraki M, Oh DY, Fong L, Ma Q, Sundi D, Chung D, Li X, Li Z. Androgen conspires with the CD8 + T cell exhaustion program and contributes to sex bias in cancer. Sci Immunol 2022; 7:eabq2630. [PMID: 35420889 DOI: 10.1126/sciimmunol.abq2630] [Citation(s) in RCA: 74] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Sex bias exists in the development and progression of non-reproductive organ cancers, but the underlying mechanisms are enigmatic. Studies so far have focused largely on sexual dimorphisms in cancer biology and socioeconomic factors. Here, we establish a role for CD8+ T cell-dependent anti-tumor immunity in mediating sex differences in tumor aggressiveness, which is driven by the gonadal androgen but not sex chromosomes. A male bias exists in the frequency of intratumoral antigen-experienced Tcf7/TCF1+ progenitor exhausted CD8+ T cells that are devoid of effector activity as a consequence of intrinsic androgen receptor (AR) function. Mechanistically, we identify a novel sex-specific regulon in progenitor exhausted CD8+ T cells and a pertinent contribution from AR as a direct transcriptional trans-activator of Tcf7/TCF1. The T cell intrinsic function of AR in promoting CD8+ T cell exhaustion in vivo was established using multiple approaches including loss-of-function studies with CD8-specific Ar knockout mice. Moreover, ablation of the androgen-AR axis rewires the tumor microenvironment to favor effector T cell differentiation and potentiates the efficacy of anti-PD-1 immune checkpoint blockade. Collectively, our findings highlight androgen-mediated promotion of CD8+ T cell dysfunction in cancer and imply broader opportunities for therapeutic development from understanding sex disparities in health and disease.
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Affiliation(s)
- Hyunwoo Kwon
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center - The James, Columbus, OH 43210, USA.,Medical Scientist Training Program, College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Johanna M Schafer
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center - The James, Columbus, OH 43210, USA
| | - No-Joon Song
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center - The James, Columbus, OH 43210, USA
| | - Satoshi Kaneko
- Department of Urology, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Anqi Li
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center - The James, Columbus, OH 43210, USA
| | - Tong Xiao
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center - The James, Columbus, OH 43210, USA
| | - Anjun Ma
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center - The James, Columbus, OH 43210, USA.,Department of Biomedical Informatics, The Ohio State University, Columbus, OH 43210, USA
| | - Carter Allen
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center - The James, Columbus, OH 43210, USA.,Department of Biomedical Informatics, The Ohio State University, Columbus, OH 43210, USA
| | - Komal Das
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center - The James, Columbus, OH 43210, USA
| | - Lei Zhou
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center - The James, Columbus, OH 43210, USA
| | - Brian Riesenberg
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center - The James, Columbus, OH 43210, USA
| | - Yuzhou Chang
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center - The James, Columbus, OH 43210, USA.,Department of Biomedical Informatics, The Ohio State University, Columbus, OH 43210, USA
| | - Payton Weltge
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center - The James, Columbus, OH 43210, USA
| | - Maria Velegraki
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center - The James, Columbus, OH 43210, USA
| | - David Y Oh
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Lawrence Fong
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA 94143, USA.,Parker Institute for Cancer Immunotherapy, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Qin Ma
- Department of Biomedical Informatics, The Ohio State University, Columbus, OH 43210, USA
| | - Debasish Sundi
- Department of Urology, The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA
| | - Dongjun Chung
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center - The James, Columbus, OH 43210, USA.,Department of Biomedical Informatics, The Ohio State University, Columbus, OH 43210, USA
| | - Xue Li
- Department of Urology, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA.,Samuel Oschin Comprehensive Cancer Institute, Departments of Medicine and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Zihai Li
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center - The James, Columbus, OH 43210, USA
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241
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Tellez-Garcia E, Valdivia Padilla A, Grosu H. Immunotherapy-Induced Eosinophilic Tracheitis. Cureus 2022; 14:e24130. [PMID: 35573537 PMCID: PMC9106536 DOI: 10.7759/cureus.24130] [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] [Accepted: 04/12/2022] [Indexed: 11/27/2022] Open
Abstract
The present report describes the case of a 27-year-old male with a longstanding diagnosis of melanoma with metastatic disease treated with nivolumab, an immune checkpoint inhibitor. He presented with a chronic cough of unknown etiology, not responsive to standard of care treatment with cough suppressants. In view of this, a bronchoscopy was done, and biopsies were taken. The patient was diagnosed with eosinophilic tracheitis secondary to nivolumab. His symptoms improved with steroids and cessation of the immune checkpoint inhibitor. Prescribing physicians should be aware of these rare and potentially life-threatening toxic effects.
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242
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Ruggiero R, Stelitano B, Fraenza F, di Mauro G, Scavone C, Sportiello L, Rafaniello C, Di Napoli R, Danesi R, Del Re M, Rossi F, Capuano A. Neurological Manifestations Related to Immune Checkpoint Inhibitors: Reverse Translational Research by Using the European Real-World Safety Data. Front Oncol 2022; 12:824511. [PMID: 35372076 PMCID: PMC8964934 DOI: 10.3389/fonc.2022.824511] [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: 11/29/2021] [Accepted: 02/14/2022] [Indexed: 11/24/2022] Open
Abstract
Immune checkpoint inhibitors (ICIs) are widely used improving clinical outcomes in many cancer patients. However, they can induce serious consequences, like neurological immune-related adverse drug reactions (NirADRs). Although these are rare complications, they can be serious with important impact on patients’ quality of life. Our purpose is to describe these adverse events observed in the European clinical practice context. We carried out a descriptive analysis of individual case safety reports (ICSRs) related to ICIs collected until February 7, 2020, in the European spontaneous reporting database, EudraVigilance, and reported nervous disorders as suspect adverse drug reactions (ADRs). NirADRs were classified according to the Medical Dictionary for Regulatory Activities (MedDRA). In order to identify a hypothetical different reporting probability of the NirADR types between the ICI classes, we carried out a disproportionality analysis. The reporting odds ratio (ROR) with 95% CI was computed comparing the different ICI classes to each other based on their pharmacological target [the cytotoxic T-lymphocyte antigen-4 (CTLA-4), the programmed death-1 (PD-1) or its ligand (PD-L1)]. Finally, we researched in the literature the hypothesized mechanisms, which could explain the onset of these ICI-related neurological complications. Overall, we found 4,875 cases describing 6,429 ICI-related suspected NirADRs. ICI-related neurotoxicities include a wide range of central and peripheral events. These were mainly related to anti-PD-1 agents and occurred in male patients (59%). Our analysis confirmed a gender difference of NirADRs. Twenty-three percent of the events (comprising myasthenia gravis, neuropathy peripheral, and cerebral infarction) had unfavorable fallouts, including fatal outcome (7%). Majority of the NirADRs were categorized as “Neurological disorders NEC” HLGTs MedDRA (2,076; 32%). In 1,094 cases (22%), more NirADRs overlapped with other neurologic complications. An interesting overlapping of myasthenia gravis with myositis or myocarditis emerged. From our disproportionality analysis, an increased reporting probability of peripheral neuropathies and headaches emerged with ipilimumab when compared to anti-PD-1 and anti-PD-L1 agents. However, neuromuscular disorders were more probably reported with anti-PD-1. Several pathogenic mechanisms, including neuronal damage by T cells and autoantibodies and/or cytokine-mediated inflammation processes, have been hypothesized. However, the pathogenesis of these ICI-related complications is not completely understood. Considering the recent marketing authorizations of ICIs, further studies are strongly needed to monitor their neurologic safety profile.
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Affiliation(s)
- Rosanna Ruggiero
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Naples, Italy.,Department of Experimental Medicine - Section of Pharmacology "L. Donatelli", University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Barbara Stelitano
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Naples, Italy.,Department of Experimental Medicine - Section of Pharmacology "L. Donatelli", University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Federica Fraenza
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Naples, Italy.,Department of Experimental Medicine - Section of Pharmacology "L. Donatelli", University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Gabriella di Mauro
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Naples, Italy.,Department of Experimental Medicine - Section of Pharmacology "L. Donatelli", University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Cristina Scavone
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Naples, Italy.,Department of Experimental Medicine - Section of Pharmacology "L. Donatelli", University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Liberata Sportiello
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Naples, Italy.,Department of Experimental Medicine - Section of Pharmacology "L. Donatelli", University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Concetta Rafaniello
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Naples, Italy.,Department of Experimental Medicine - Section of Pharmacology "L. Donatelli", University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Raffaella Di Napoli
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Naples, Italy
| | - Romano Danesi
- Unit of Clinical Pharmacology and Pharmacogenetics, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy
| | - Marzia Del Re
- Unit of Clinical Pharmacology and Pharmacogenetics, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy
| | - Francesco Rossi
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Naples, Italy.,Department of Experimental Medicine - Section of Pharmacology "L. Donatelli", University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Annalisa Capuano
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Naples, Italy.,Department of Experimental Medicine - Section of Pharmacology "L. Donatelli", University of Campania "Luigi Vanvitelli", Naples, Italy
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243
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Moldoveanu D, Ramsay L, Lajoie M, Anderson-Trocme L, Lingrand M, Berry D, Perus LJM, Wei Y, Moraes C, Alkallas R, Rajkumar S, Zuo D, Dankner M, Xu EH, Bertos NR, Najafabadi HS, Gravel S, Costantino S, Richer MJ, Lund AW, Del Rincon SV, Spatz A, Miller WH, Jamal R, Lapointe R, Mes-Masson AM, Turcotte S, Petrecca K, Dumitra S, Meguerditchian AN, Richardson K, Tremblay F, Wang B, Chergui M, Guiot MC, Watters K, Stagg J, Quail DF, Mihalcioiu C, Meterissian S, Watson IR. Spatially mapping the immune landscape of melanoma using imaging mass cytometry. Sci Immunol 2022; 7:eabi5072. [PMID: 35363543 DOI: 10.1126/sciimmunol.abi5072] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Melanoma is an immunogenic cancer with a high response rate to immune checkpoint inhibitors (ICIs). It harbors a high mutation burden compared with other cancers and, as a result, has abundant tumor-infiltrating lymphocytes (TILs) within its microenvironment. However, understanding the complex interplay between the stroma, tumor cells, and distinct TIL subsets remains a substantial challenge in immune oncology. To properly study this interplay, quantifying spatial relationships of multiple cell types within the tumor microenvironment is crucial. To address this, we used cytometry time-of-flight (CyTOF) imaging mass cytometry (IMC) to simultaneously quantify the expression of 35 protein markers, characterizing the microenvironment of 5 benign nevi and 67 melanomas. We profiled more than 220,000 individual cells to identify melanoma, lymphocyte subsets, macrophage/monocyte, and stromal cell populations, allowing for in-depth spatial quantification of the melanoma microenvironment. We found that within pretreatment melanomas, the abundance of proliferating antigen-experienced cytotoxic T cells (CD8+CD45RO+Ki67+) and the proximity of antigen-experienced cytotoxic T cells to melanoma cells were associated with positive response to ICIs. Our study highlights the potential of multiplexed single-cell technology to quantify spatial cell-cell interactions within the tumor microenvironment to understand immune therapy responses.
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Affiliation(s)
- Dan Moldoveanu
- Rosalind and Morris Goodman Cancer Institute, McGill University, Montréal, QC, Canada.,McGill University Health Centre, Montréal, QC, Canada.,Department of Surgery, Division of General Surgery, McGill University, Montréal, QC, Canada
| | - LeeAnn Ramsay
- Rosalind and Morris Goodman Cancer Institute, McGill University, Montréal, QC, Canada
| | - Mathieu Lajoie
- Rosalind and Morris Goodman Cancer Institute, McGill University, Montréal, QC, Canada
| | - Luke Anderson-Trocme
- McGill University Genome Centre, Montréal, QC, Canada.,Department of Human Genetics, McGill University, Montréal, QC, Canada
| | - Marine Lingrand
- Rosalind and Morris Goodman Cancer Institute, McGill University, Montréal, QC, Canada.,Department of Biochemistry, McGill University, Montréal, QC, Canada
| | - Diana Berry
- Rosalind and Morris Goodman Cancer Institute, McGill University, Montréal, QC, Canada.,Department of Biochemistry, McGill University, Montréal, QC, Canada
| | - Lucas J M Perus
- Rosalind and Morris Goodman Cancer Institute, McGill University, Montréal, QC, Canada
| | - Yuhong Wei
- Rosalind and Morris Goodman Cancer Institute, McGill University, Montréal, QC, Canada
| | - Cleber Moraes
- Rosalind and Morris Goodman Cancer Institute, McGill University, Montréal, QC, Canada
| | - Rached Alkallas
- Rosalind and Morris Goodman Cancer Institute, McGill University, Montréal, QC, Canada.,McGill University Genome Centre, Montréal, QC, Canada.,Department of Human Genetics, McGill University, Montréal, QC, Canada
| | - Shivshankari Rajkumar
- Rosalind and Morris Goodman Cancer Institute, McGill University, Montréal, QC, Canada.,Department of Biochemistry, McGill University, Montréal, QC, Canada
| | - Dongmei Zuo
- Rosalind and Morris Goodman Cancer Institute, McGill University, Montréal, QC, Canada
| | - Matthew Dankner
- Rosalind and Morris Goodman Cancer Institute, McGill University, Montréal, QC, Canada
| | - Eric Hongbo Xu
- Research Institute of the McGill University Health Centre, Montréal, QC, Canada
| | - Nicholas R Bertos
- Research Institute of the McGill University Health Centre, Montréal, QC, Canada
| | - Hamed S Najafabadi
- McGill University Genome Centre, Montréal, QC, Canada.,Department of Human Genetics, McGill University, Montréal, QC, Canada
| | - Simon Gravel
- McGill University Genome Centre, Montréal, QC, Canada.,Department of Human Genetics, McGill University, Montréal, QC, Canada
| | | | - Martin J Richer
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Amanda W Lund
- Ronald O. Perelman Department of Dermatology and Department of Pathology, NYU Grossman School of Medicine, New York, NY, USA
| | - Sonia V Del Rincon
- Jewish General Hospital, McGill University, Montréal, QC, Canada.,Lady Davis Institute for Medical Research, Montréal, QC, Canada
| | - Alan Spatz
- McGill University Health Centre, Montréal, QC, Canada.,Lady Davis Institute for Medical Research, Montréal, QC, Canada.,McGill University, Montréal, QC, Canada
| | - Wilson H Miller
- Jewish General Hospital, McGill University, Montréal, QC, Canada.,Lady Davis Institute for Medical Research, Montréal, QC, Canada
| | - Rahima Jamal
- Centre de recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM) and Institut du Cancer de Montréal, Montréal, QC, Canada
| | - Réjean Lapointe
- Centre de recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM) and Institut du Cancer de Montréal, Montréal, QC, Canada.,Département de Médecine, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada
| | - Anne-Marie Mes-Masson
- Centre de recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM) and Institut du Cancer de Montréal, Montréal, QC, Canada.,Département de Médecine, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada
| | - Simon Turcotte
- Centre de recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM) and Institut du Cancer de Montréal, Montréal, QC, Canada
| | - Kevin Petrecca
- Montreal Neurological Institute and Hospital, Montréal, QC, Canada
| | - Sinziana Dumitra
- McGill University Health Centre, Montréal, QC, Canada.,Department of Surgery, Division of General Surgery, McGill University, Montréal, QC, Canada.,Research Institute of the McGill University Health Centre, Montréal, QC, Canada
| | - Ari-Nareg Meguerditchian
- McGill University Health Centre, Montréal, QC, Canada.,Department of Surgery, Division of General Surgery, McGill University, Montréal, QC, Canada.,Research Institute of the McGill University Health Centre, Montréal, QC, Canada
| | | | - Francine Tremblay
- McGill University Health Centre, Montréal, QC, Canada.,Department of Surgery, Division of General Surgery, McGill University, Montréal, QC, Canada
| | - Beatrice Wang
- McGill University Health Centre, Montréal, QC, Canada.,Research Institute of the McGill University Health Centre, Montréal, QC, Canada
| | - May Chergui
- McGill University Health Centre, Montréal, QC, Canada
| | - Marie-Christine Guiot
- Rosalind and Morris Goodman Cancer Institute, McGill University, Montréal, QC, Canada.,McGill University Health Centre, Montréal, QC, Canada.,Montreal Neurological Institute and Hospital, Montréal, QC, Canada
| | - Kevin Watters
- McGill University Health Centre, Montréal, QC, Canada
| | - John Stagg
- Centre de recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM) and Institut du Cancer de Montréal, Montréal, QC, Canada
| | - Daniela F Quail
- Rosalind and Morris Goodman Cancer Institute, McGill University, Montréal, QC, Canada.,Department of Physiology, McGill University, Montréal, QC, Canada
| | - Catalin Mihalcioiu
- McGill University Health Centre, Montréal, QC, Canada.,Research Institute of the McGill University Health Centre, Montréal, QC, Canada
| | - Sarkis Meterissian
- McGill University Health Centre, Montréal, QC, Canada.,Department of Surgery, Division of General Surgery, McGill University, Montréal, QC, Canada.,Research Institute of the McGill University Health Centre, Montréal, QC, Canada
| | - Ian R Watson
- Rosalind and Morris Goodman Cancer Institute, McGill University, Montréal, QC, Canada.,Department of Biochemistry, McGill University, Montréal, QC, Canada.,Research Institute of the McGill University Health Centre, Montréal, QC, Canada
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244
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Ning B, Liu Y, Wang M, Li Y, Xu T, Wei Y. The Predictive Value of Tumor Mutation Burden on Clinical Efficacy of Immune Checkpoint Inhibitors in Melanoma: A Systematic Review and Meta-Analysis. Front Pharmacol 2022; 13:748674. [PMID: 35355708 PMCID: PMC8959431 DOI: 10.3389/fphar.2022.748674] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 02/10/2022] [Indexed: 12/12/2022] Open
Abstract
Background: Tumor mutational burden (TMB) is a genomic biomarker that can predict favorable responses to immune checkpoint inhibitors (ICIs). Although we have better understanding of TMB in cancer immunity and cancer immunotherapy, the relationship between TMB and the clinical efficacy of ICIs remains unknown in the treatment of melanoma patients. Here, we conduct a systematic review and meta-analysis to evaluate the predictive value of TMB on the efficacy of ICIs in patients with melanoma. Methods: We systematically collected data from PubMed, Embase, Cochrane Library, CNKI, China Biomedical Database (CBM), and Wanfang Database. The end date was set to 26 June 2021. We included retrospective studies or clinical trials of ICIs that reported hazard ratios (HRs) for overall survival and/or progression-free survival according to TMB. Data for 1,493 patients from 15 studies were included. In addition, pooled effect size, heterogeneity analysis, sensitivity analysis, publication bias detection, and subgroup analysis were performed based on the included data. Results: Patients with high TMB showed significantly improved OS (HR = 0.49, 95% CI: 0.33, 0.73; p = 0.001) and PFS (HR = 0.47, 95% CI: 0.33, 0.68; p < 0.001) compared with patients with low TMB. This association was very good in patients treated with monotherapy, that is, anti-CTLA-4 or anti-PD-(L)-1 inhibitors, but not for the patients treated with a combination of the two drugs. The subgroup analysis results showed that heterogeneity was substantial in the targeted next-generation sequencing (NGS) group. Publication bias was detected, and the results were visualized using the funnel chart. And sensitivity analysis and trim-and-fill method analysis showed that our results were stable and reliable. Conclusion: High TMB is associated with improved OS and PFS in melanoma patients treated with mono-drug ICIs. TMB determined by NGS should be standardized to eliminate heterogeneity. Therefore, the role of TMB in identifying melanoma patients who may benefit from ICI should be further determined in more randomized controlled trials in the future.
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Affiliation(s)
- Biao Ning
- Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China.,Hubei Key Laboratory of Tumor Biological Behaviors Zhongnan Hospital of Wuhan University, Wuhan, China.,Hubei Cancer Clinical Study Center Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yixin Liu
- Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China.,Hubei Key Laboratory of Tumor Biological Behaviors Zhongnan Hospital of Wuhan University, Wuhan, China.,Hubei Cancer Clinical Study Center Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Miao Wang
- Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China.,Hubei Key Laboratory of Tumor Biological Behaviors Zhongnan Hospital of Wuhan University, Wuhan, China.,Hubei Cancer Clinical Study Center Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yi Li
- Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China.,Hubei Key Laboratory of Tumor Biological Behaviors Zhongnan Hospital of Wuhan University, Wuhan, China.,Hubei Cancer Clinical Study Center Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Tianzi Xu
- Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China.,Hubei Key Laboratory of Tumor Biological Behaviors Zhongnan Hospital of Wuhan University, Wuhan, China.,Hubei Cancer Clinical Study Center Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yongchang Wei
- Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China.,Hubei Key Laboratory of Tumor Biological Behaviors Zhongnan Hospital of Wuhan University, Wuhan, China.,Hubei Cancer Clinical Study Center Zhongnan Hospital of Wuhan University, Wuhan, China
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245
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Zhang Y, Fang Y, Wu J, Huang G, Bin J, Liao Y, Shi M, Liao W, Huang N. Pancreatic Adverse Events Associated With Immune Checkpoint Inhibitors: A Large-Scale Pharmacovigilance Analysis. Front Pharmacol 2022; 13:817662. [PMID: 35431928 PMCID: PMC9012537 DOI: 10.3389/fphar.2022.817662] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 03/11/2022] [Indexed: 11/13/2022] Open
Abstract
Backgrounds: Immune checkpoint inhibitors (ICIs) are considered cornerstones of oncology treatment with durable anti-tumor efficacy, but the increasing use of ICIs is associated with the risk of developing immune-related adverse events (irAEs). Although ICI-associated pancreatic adverse events (AEs) have been reported in patients treated with ICIs, the clinical features and spectrum of pancreatic AEs are still not well-defined. Therefore, this study aimed to identify the association between pancreatic AEs and ICIs treatments and to characterize the main features of ICI-related pancreatic injury (ICIPI) based on the Food and Drug Administration Adverse Event Reporting System (FAERS) database. Methods: Data from the first quarter of 2015 to the first quarter of 2021 in the database were extracted to conduct a disproportionality analysis. The selection of AEs related to the pancreas relied on previous studies and preferred terms from the Medical Dictionary for Regulatory Activities. Two main disproportionality analyses—the reporting odds ratio (ROR) and information component (IC)—were used to evaluate potential associations between ICIs and pancreatic AEs. Results: In total, 2,364 cases of pancreatic AEs in response to ICIs were extracted from the FAERS database, of which, 647 were identified as ICI-associated pancreatitis and 1,293 were identified as ICI-associated diabetes mellitus. Generally, significant signals can be detected between pancreatic AEs and all ICIs treatments (ROR025 = 3.30, IC025 = 1.71). For monotherapy, the strongest signal associated with pancreatitis was reported for anti-PD-L1 (ROR025 = 1.75, IC025 = 0.76), whereas that with diabetes mellitus was reported for anti-PD-1 (ROR025 = 6.39, IC025 = 2.66). Compared with monotherapy, combination therapy showed stronger associations with both ICI-associated pancreatitis (ROR025 = 2.35, IC025 = 1.20 vs. ROR025 = 1.52, IC025 = 0.59) and ICI-associated diabetes mellitus (ROR025 = 9.53, IC025 = 3.23 vs. ROR025 = 5.63, IC025 = 2.48), but lower fatality proportion. Conclusions: ICIs were significantly associated with the over-reporting frequency of pancreatic AEs, in which combination therapy posed a higher reporting frequency. Therefore, patients should be informed of these potential toxicities before ICIs medications are administered.
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Affiliation(s)
- Yue Zhang
- Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yisheng Fang
- Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jianhua Wu
- Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Genjie Huang
- Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jianping Bin
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yulin Liao
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Min Shi
- Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Wangjun Liao
- Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, China
- *Correspondence: Wangjun Liao, ; Na Huang,
| | - Na Huang
- Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, China
- *Correspondence: Wangjun Liao, ; Na Huang,
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246
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Improved prediction of immune checkpoint blockade efficacy across multiple cancer types. Nat Biotechnol 2022; 40:499-506. [PMID: 34725502 PMCID: PMC9363980 DOI: 10.1038/s41587-021-01070-8] [Citation(s) in RCA: 102] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 08/23/2021] [Indexed: 02/07/2023]
Abstract
Only a fraction of patients with cancer respond to immune checkpoint blockade (ICB) treatment, but current decision-making procedures have limited accuracy. In this study, we developed a machine learning model to predict ICB response by integrating genomic, molecular, demographic and clinical data from a comprehensively curated cohort (MSK-IMPACT) with 1,479 patients treated with ICB across 16 different cancer types. In a retrospective analysis, the model achieved high sensitivity and specificity in predicting clinical response to immunotherapy and predicted both overall survival and progression-free survival in the test data across different cancer types. Our model significantly outperformed predictions based on tumor mutational burden, which was recently approved by the U.S. Food and Drug Administration for this purpose1. Additionally, the model provides quantitative assessments of the model features that are most salient for the predictions. We anticipate that this approach will substantially improve clinical decision-making in immunotherapy and inform future interventions.
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247
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Mouritzen MT, Junker KF, Carus A, Ladekarl M, Meldgaard P, Nielsen AWM, Livbjerg A, Larsen JW, Skuladottir H, Kristiansen C, Wedervang K, Schytte T, Hansen KH, Østby AC, Frank MS, Lauritsen J, Sørensen JB, Langer SW, Persson GF, Andersen JL, Homann PH, Kristensen EB, Drivsholm LB, Bøgsted M, Christensen HS, Pøhl M, Bjørnhart B. Clinical features affecting efficacy of immune checkpoint inhibitors in pretreated patients with advanced NSCLC: a Danish nationwide real-world study. Acta Oncol 2022; 61:409-416. [PMID: 35012430 DOI: 10.1080/0284186x.2021.2023213] [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] [Indexed: 12/26/2022]
Abstract
BACKGROUND Immune checkpoint inhibitors (ICIs) are implemented as standard treatment for patients with advanced non-small cell lung cancer (NSCLC) in first-line and subsequent-line treatment. However, certain subgroups such as patients with older age, poor performance status (PS), and severe comorbidity are underrepresented in the randomized controlled trials (RCTs). This study aimed to assess overall survival (OS), treatment data, and clinical features affecting second- or subsequent-line ICI efficacy in an unselected, Danish, nationwide NSCLC population. METHODS Patients with advanced NSCLC who started nivolumab or pembrolizumab as second-line or subsequent-line treatment between 1 September 2015, and 1 October 2018, were identified from institutional records of all Danish oncology departments. Clinical and treatment data were retrospectively collected. Descriptive statistics and survival analyses were performed. RESULTS Data were available for 840 patients; 49% females. The median age was 68 years (19% were ≥75 years), 19% had PS ≥2, and 36% had moderate to severe comorbidity. The median OS (mOS) was 12.2 months; 15.1 months and 10.0 months in females and males, respectively. The median time-to-treatment discontinuation (mTTD) and median progression-free survival (mPFS) was 3.2 and 5.2 months, respectively. Patients with PS ≥2 had a mOS of 4.5 months, mTTD of 1.1 month, and mPFS of 2.0 months. In multivariable Cox regression analysis, male sex (HR = 1.35, 95% CI 1.11-1.62), PS >0 (PS 1, HR = 1.88, 95% CI 1.52-2.33; PS ≥2, HR = 4.15, 95% CI 3.13-5.5), liver metastases (HR = 1.72, 95% CI 1.34-2.22), and bone metastases (HR = 1.27, 95% CI 1.03-1.58) were significant poor prognostic OS factors. CONCLUSIONS Danish real-world patients with advanced NSCLC treated with second- or subsequent-line ICI had an OS comparable to results from RCTs. Women, frail and older patients constituted a higher proportion than in previous RCTs. Clinical features associated with poor OS were male sex, PS ≥1 (in particular PS ≥2), bone-, and liver metastases.
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Affiliation(s)
- Mette T. Mouritzen
- Department of Oncology, Aalborg University Hospital, Aalborg, Denmark
- Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | | | - Andreas Carus
- Department of Oncology, Aalborg University Hospital, Aalborg, Denmark
- Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Morten Ladekarl
- Department of Oncology, Aalborg University Hospital, Aalborg, Denmark
- Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Peter Meldgaard
- Department of Oncology, Aarhus University Hospital, Aarhus N, Denmark
| | | | - Anna Livbjerg
- Department of Oncology, Aarhus University Hospital, Aarhus N, Denmark
| | - Jacob W. Larsen
- Department of Oncology, Region Hospital West Jutland, Herning, Denmark
| | - Halla Skuladottir
- Department of Oncology, Region Hospital West Jutland, Herning, Denmark
| | - Charlotte Kristiansen
- Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, Vejle, Denmark
| | - Kim Wedervang
- Department of Oncology, Hospital Sønderjylland, Sønderborg, Denmark
| | - Tine Schytte
- Department of Oncology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Odense Patient data Explorative Network (OPEN), Odense, Denmark
| | - Karin H. Hansen
- Department of Oncology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Odense Patient data Explorative Network (OPEN), Odense, Denmark
| | - Anne-Cathrine Østby
- Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Roskilde, Denmark
| | - Malene S. Frank
- Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Roskilde, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen N, Denmark
| | - Jakob Lauritsen
- Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Roskilde, Denmark
| | - Jens B. Sørensen
- Department of Oncology, Copenhagen E, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen N, Denmark
| | - Seppo W. Langer
- Department of Oncology, Copenhagen E, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen N, Denmark
| | - Gitte F. Persson
- Department of Clinical Medicine, University of Copenhagen, Copenhagen N, Denmark
- Department of Oncology, Copenhagen University Hospital, Herlev, Denmark
| | - Jon L. Andersen
- Department of Oncology, Copenhagen University Hospital, Herlev, Denmark
| | | | | | | | - Martin Bøgsted
- Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Department of Hematology, Aalborg University Hospital, Aalborg, Denmark
| | - Heidi S. Christensen
- Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Department of Hematology, Aalborg University Hospital, Aalborg, Denmark
| | - Mette Pøhl
- Department of Oncology, Copenhagen E, Denmark
| | - Birgitte Bjørnhart
- Department of Oncology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Odense Patient data Explorative Network (OPEN), Odense, Denmark
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248
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Hegedüs L, Livingstone E, Bánkfalvi Á, Viehof J, Enyedi Á, Bilecz Á, Győrffy B, Baranyi M, Tőkés AM, Gil J, Marko-Varga G, Griewank KG, Zimmer L, Váraljai R, Sucker A, Zaremba A, Schadendorf D, Aigner C, Hegedüs B. The Prognostic Relevance of PMCA4 Expression in Melanoma: Gender Specificity and Implications for Immune Checkpoint Inhibition. Int J Mol Sci 2022; 23:3324. [PMID: 35328746 PMCID: PMC8949876 DOI: 10.3390/ijms23063324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 11/30/2022] Open
Abstract
PMCA4 is a critical regulator of Ca2+ homeostasis in mammalian cells. While its biological and prognostic relevance in several cancer types has already been demonstrated, only preclinical investigations suggested a metastasis suppressor function in melanoma. Therefore, we studied the expression pattern of PMCA4 in human skin, nevus, as well as in primary and metastatic melanoma using immunohistochemistry. Furthermore, we analyzed the prognostic power of PMCA4 mRNA levels in cutaneous melanoma both at the non-metastatic stage as well as after PD-1 blockade in advanced disease. PMCA4 localizes to the plasma membrane in a differentiation dependent manner in human skin and mucosa, while nevus cells showed no plasma membrane staining. In contrast, primary cutaneous, choroidal and conjunctival melanoma cells showed specific plasma membrane localization of PMCA4 with a wide range of intensities. Analyzing the TCGA cohort, PMCA4 mRNA levels showed a gender specific prognostic impact in stage I-III melanoma. Female patients with high transcript levels had a significantly longer progression-free survival. Melanoma cell specific PMCA4 protein expression is associated with anaplasticity in melanoma lung metastasis but had no impact on survival after lung metastasectomy. Importantly, high PMCA4 transcript levels derived from RNA-seq of cutaneous melanoma are associated with significantly longer overall survival after PD-1 blockade. In summary, we demonstrated that human melanoma cells express PMCA4 and PMCA4 transcript levels carry prognostic information in a gender specific manner.
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Affiliation(s)
- Luca Hegedüs
- Department of Thoracic Surgery, University Medicine Essen–Ruhrlandklinik, 45239 Essen, Germany; (L.H.); (J.V.); (C.A.)
| | - Elisabeth Livingstone
- Department of Dermatology, University Medicine Essen, 45147 Essen, Germany; (E.L.); (K.G.G.); (L.Z.); (R.V.); (A.S.); (A.Z.); (D.S.)
| | - Ágnes Bánkfalvi
- Department of Pathology, University Medicine Essen, 45147 Essen, Germany;
| | - Jan Viehof
- Department of Thoracic Surgery, University Medicine Essen–Ruhrlandklinik, 45239 Essen, Germany; (L.H.); (J.V.); (C.A.)
| | - Ágnes Enyedi
- Department of Transfusiology, Semmelweis University, 1085 Budapest, Hungary;
| | - Ágnes Bilecz
- 2nd Department of Pathology, Semmelweis University, 1085 Budapest, Hungary; (Á.B.); (M.B.); (A.-M.T.)
| | - Balázs Győrffy
- Department of Bioinformatics, Semmelweis University, 1085 Budapest, Hungary;
| | - Marcell Baranyi
- 2nd Department of Pathology, Semmelweis University, 1085 Budapest, Hungary; (Á.B.); (M.B.); (A.-M.T.)
| | - Anna-Mária Tőkés
- 2nd Department of Pathology, Semmelweis University, 1085 Budapest, Hungary; (Á.B.); (M.B.); (A.-M.T.)
| | - Jeovanis Gil
- Division of Oncology, Department of Clinical Sciences Lund, Lund University, 221 00 Lund, Sweden;
| | - György Marko-Varga
- Clinical Protein Science & Imaging, Biomedical Centre, Department of Biomedical Engineering, Lund University, 221 00 Lund, Sweden;
| | - Klaus G. Griewank
- Department of Dermatology, University Medicine Essen, 45147 Essen, Germany; (E.L.); (K.G.G.); (L.Z.); (R.V.); (A.S.); (A.Z.); (D.S.)
| | - Lisa Zimmer
- Department of Dermatology, University Medicine Essen, 45147 Essen, Germany; (E.L.); (K.G.G.); (L.Z.); (R.V.); (A.S.); (A.Z.); (D.S.)
| | - Renáta Váraljai
- Department of Dermatology, University Medicine Essen, 45147 Essen, Germany; (E.L.); (K.G.G.); (L.Z.); (R.V.); (A.S.); (A.Z.); (D.S.)
| | - Antje Sucker
- Department of Dermatology, University Medicine Essen, 45147 Essen, Germany; (E.L.); (K.G.G.); (L.Z.); (R.V.); (A.S.); (A.Z.); (D.S.)
| | - Anne Zaremba
- Department of Dermatology, University Medicine Essen, 45147 Essen, Germany; (E.L.); (K.G.G.); (L.Z.); (R.V.); (A.S.); (A.Z.); (D.S.)
| | - Dirk Schadendorf
- Department of Dermatology, University Medicine Essen, 45147 Essen, Germany; (E.L.); (K.G.G.); (L.Z.); (R.V.); (A.S.); (A.Z.); (D.S.)
| | - Clemens Aigner
- Department of Thoracic Surgery, University Medicine Essen–Ruhrlandklinik, 45239 Essen, Germany; (L.H.); (J.V.); (C.A.)
| | - Balázs Hegedüs
- Department of Thoracic Surgery, University Medicine Essen–Ruhrlandklinik, 45239 Essen, Germany; (L.H.); (J.V.); (C.A.)
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249
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Zhang K, Kong X, Li Y, Wang Z, Zhang L, Xuan L. PD-1/PD-L1 Inhibitors in Patients With Preexisting Autoimmune Diseases. Front Pharmacol 2022; 13:854967. [PMID: 35370736 PMCID: PMC8971753 DOI: 10.3389/fphar.2022.854967] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 02/17/2022] [Indexed: 02/04/2023] Open
Abstract
Autoimmune diseases and malignant tumors are the two hotspots and difficulties that are currently being studied and concerned by the medical field. The use of PD-1/PD-L1 inhibitors improves the prognosis of advanced tumors, but excessive immune responses can also induce immune-related adverse events (irAEs). Due to this concern, many clinical trials exclude cancer patients with preexisting autoimmune disease (AID). This review outlines the possible mechanisms of irAE, discusses the safety and efficacy of PD-1/PD-L1 inhibitors in cancer patients with preexisting AID, and emphasizes the importance of early recognition, continuous monitoring, and multidisciplinary cooperation in the prevention and management of cancer patients with preexisting AID.
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Affiliation(s)
- Ke Zhang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiangyi Kong
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuan Li
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhongzhao Wang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- *Correspondence: Zhongzhao Wang, ; Lin Zhang, ; Lixue Xuan,
| | - Lin Zhang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Melbourne School of Population and Global Health, the University of Melbourne, Melbourne, VIC, Australia
- Centre of Cancer Research, Victorian Comprehensive Cancer Centre, Melbourne, VIC, Australia
- *Correspondence: Zhongzhao Wang, ; Lin Zhang, ; Lixue Xuan,
| | - Lixue Xuan
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- *Correspondence: Zhongzhao Wang, ; Lin Zhang, ; Lixue Xuan,
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250
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Li M, Zhong X, Du F, Wu X, Li M, Chen Y, Zhao Y, Shen J, Yang Z, Xiao Z. Current Understanding and Future Perspectives on Hyperprogressive Disease Highlight the Tumor Microenvironment. J Clin Pharmacol 2022; 62:1059-1078. [PMID: 35303368 DOI: 10.1002/jcph.2048] [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: 01/25/2022] [Accepted: 03/14/2022] [Indexed: 11/09/2022]
Abstract
Cancer immunotherapy with immune checkpoint inhibitors has revolutionized traditional cancer therapy. Although many patients have achieved long-term survival benefits from immune checkpoint inhibitors treatment, there are still some patients who develop rapid tumor progression after immunotherapy, known as hyperprogressive disease. Here we summarize current knowledge on hyperprogressive disease after immune checkpoint inhibitors treatment to promote more thorough understanding of the disease. This review focuses on multiple aspects of hyperprogressive disease, especially the tumor microenvironment, with the hope that more reliable biomarkers and therapeutics could be established for hyperprogressive disease in the future. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Meiqi Li
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan, 646000, P.R. China.,Cell Therapy & Cell Drugs of Luzhou Key Laboratory, Luzhou, Sichuan, 646000, P.R. China.,South Sichuan Institute of Translational Medicine, Luzhou, Sichuan, 646000, P.R. China
| | - Xianmei Zhong
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan, 646000, P.R. China.,Cell Therapy & Cell Drugs of Luzhou Key Laboratory, Luzhou, Sichuan, 646000, P.R. China.,South Sichuan Institute of Translational Medicine, Luzhou, Sichuan, 646000, P.R. China
| | - Fukuan Du
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan, 646000, P.R. China.,Cell Therapy & Cell Drugs of Luzhou Key Laboratory, Luzhou, Sichuan, 646000, P.R. China.,South Sichuan Institute of Translational Medicine, Luzhou, Sichuan, 646000, P.R. China
| | - Xu Wu
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan, 646000, P.R. China.,Cell Therapy & Cell Drugs of Luzhou Key Laboratory, Luzhou, Sichuan, 646000, P.R. China.,South Sichuan Institute of Translational Medicine, Luzhou, Sichuan, 646000, P.R. China
| | - Mingxing Li
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan, 646000, P.R. China.,Cell Therapy & Cell Drugs of Luzhou Key Laboratory, Luzhou, Sichuan, 646000, P.R. China.,South Sichuan Institute of Translational Medicine, Luzhou, Sichuan, 646000, P.R. China
| | - Yu Chen
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan, 646000, P.R. China.,Cell Therapy & Cell Drugs of Luzhou Key Laboratory, Luzhou, Sichuan, 646000, P.R. China.,South Sichuan Institute of Translational Medicine, Luzhou, Sichuan, 646000, P.R. China
| | - Yueshui Zhao
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan, 646000, P.R. China.,Cell Therapy & Cell Drugs of Luzhou Key Laboratory, Luzhou, Sichuan, 646000, P.R. China.,South Sichuan Institute of Translational Medicine, Luzhou, Sichuan, 646000, P.R. China
| | - Jing Shen
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan, 646000, P.R. China.,Cell Therapy & Cell Drugs of Luzhou Key Laboratory, Luzhou, Sichuan, 646000, P.R. China.,South Sichuan Institute of Translational Medicine, Luzhou, Sichuan, 646000, P.R. China
| | - Zhongming Yang
- Department of Oncology and Hematology, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, China
| | - Zhangang Xiao
- Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan, 646000, P.R. China.,Cell Therapy & Cell Drugs of Luzhou Key Laboratory, Luzhou, Sichuan, 646000, P.R. China.,South Sichuan Institute of Translational Medicine, Luzhou, Sichuan, 646000, P.R. China
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