351
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Cho H, Kim SH, Kim SJ, Chang JH, Yang WI, Suh CO, Kim YR, Jang JE, Cheong JW, Min YH, Kim JS. Programmed cell death 1 expression is associated with inferior survival in patients with primary central nervous system lymphoma. Oncotarget 2017; 8:87317-87328. [PMID: 29152083 PMCID: PMC5675635 DOI: 10.18632/oncotarget.20264] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 07/13/2017] [Indexed: 11/25/2022] Open
Abstract
Programmed cell death 1 (PD-1) and its ligands PD-L1/PD-L2 have been shown to mediate immune evasion in various cancers, but their prognostic implications in patients with primary central nervous system lymphoma (PCNSL) are poorly understood. Therefore, we analyzed 76 PCNSL patients at initial diagnosis who were treated homogenously with high-dose methotrexate-based chemotherapy, and evaluated the prognostic roles of high immunohistochemical PD-1, PD-L1, and PD-L2 expression. The cut-off values for high PD-1 (≥ 70 cells/high power field [HPF]), PD-L1 (≥ 100 cells/HPF), and PD-L2 (≥ 100 cells/HPF) were determined by the area under the receiver operating characteristic curve. Expression of PD-1, PD-L1, and PD-L2 was high in 7.9%, 13.2%, and 42.1% patients, respectively. High PD-1, (P = 0.007) and Memorial Sloan Kettering Cancer Center (MSKCC) prognostic scoring (P = 0.019) were independently associated with inferior overall survival on multivariate analysis. High PD-1 also remained an independent prognostic factor for inferior progression-free survival (P = 0.028), as did MSKCC prognostic scoring (P = 0.041) on multivariate analysis. However, there were no differences in survival according to the expression levels of PD-L1/PD-L2 in PCNSL tumor microenvironment. Our results suggest that PD-1 may be considered a biomarker and potential therapeutic target in PCNSL.
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Affiliation(s)
- Hyunsoo Cho
- Division of Hematology, Department of Internal Medicine, Yonsei University College of Medicine, Severance Hospital, Seoul 03722, Republic of Korea.,Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea
| | - Se Hoon Kim
- Department of Pathology, Yonsei University College of Medicine, Severance Hospital, Seoul 03722, Republic of Korea
| | - Soo-Jeong Kim
- Division of Hematology, Department of Internal Medicine, Yonsei University College of Medicine, Severance Hospital, Seoul 03722, Republic of Korea
| | - Jong Hee Chang
- Department of Neurosurgery, Yonsei University College of Medicine, Severance Hospital, Seoul 03722, Republic of Korea
| | - Woo-Ick Yang
- Department of Pathology, Yonsei University College of Medicine, Severance Hospital, Seoul 03722, Republic of Korea
| | - Chang-Ok Suh
- Department of Radiation Oncology, Yonsei University College of Medicine, Severance Hospital, Seoul 03722, Republic of Korea
| | - Yu Ri Kim
- Division of Hematology, Department of Internal Medicine, Yonsei University College of Medicine, Severance Hospital, Seoul 03722, Republic of Korea
| | - Ji Eun Jang
- Division of Hematology, Department of Internal Medicine, Yonsei University College of Medicine, Severance Hospital, Seoul 03722, Republic of Korea
| | - June-Won Cheong
- Division of Hematology, Department of Internal Medicine, Yonsei University College of Medicine, Severance Hospital, Seoul 03722, Republic of Korea
| | - Yoo Hong Min
- Division of Hematology, Department of Internal Medicine, Yonsei University College of Medicine, Severance Hospital, Seoul 03722, Republic of Korea
| | - Jin Seok Kim
- Division of Hematology, Department of Internal Medicine, Yonsei University College of Medicine, Severance Hospital, Seoul 03722, Republic of Korea
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352
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Marron TU, Kalac M, Brody J. An Update on the Use of Immunotherapy in the Treatment of Lymphoma. Curr Hematol Malig Rep 2017; 12:282-289. [PMID: 28735365 DOI: 10.1007/s11899-017-0396-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
PURPOSE OF REVIEW Throughout the field of oncology, immunotherapy is moving further towards the first-line setting, and there is encouraging data for the use of these novel therapies in the management of lymphomas, utilizing treatments approved for both solid and hematologic malignancies. Herein, we review promising advances in this rapidly moving field from the past year. RECENT FINDINGS In the last year, we have seen promising clinical data on engineered antibody therapies for the treatment of lymphomas, as well as further optimization of engineered antibody fragments fused onto linkers or chimeric T cell receptors, both of the modalities capable of transforming non-specific T cells into tumor-specific, serial killer cells. Here we will review the promising data on these advances in antibody-based therapies, as well as some of the immunomodulators and checkpoint-blocking therapies that shown to have promising results in the treatment of lymphomas within the past year.
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Affiliation(s)
- Thomas U Marron
- Department of Medicine, Division of Hematology and Oncology, Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, Box 1185, New York, NY, 10029, USA
| | - Matko Kalac
- Department of Medicine, Division of Hematology and Oncology, Columbia University Medical Center, New York, NY, USA
| | - Joshua Brody
- Department of Medicine, Division of Hematology and Oncology, Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, Box 1185, New York, NY, 10029, USA.
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353
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Abstract
Primary CNS lymphoma (PCNSL) is a rare form of extranodal non-Hodgkin lymphoma that is typically confined to the brain, eyes, and cerebrospinal fluid without evidence of systemic spread. The prognosis of patients with PCNSL has improved during the last decades with the introduction of high-dose methotrexate. However, despite recent progress, results after treatment are durable in half of patients, and therapy can be associated with late neurotoxicity. PCNSL is an uncommon tumor, and only four randomized trials and one phase III trial have been completed so far, all in the first-line setting. To our knowledge, no randomized trial has been conducted for recurrent/refractory disease, leaving many questions unanswered about optimal first-line and salvage treatments. This review will give an overview of the presentation, evaluation, and treatment of immunocompetent patients with PCNSL.
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Affiliation(s)
| | - Lisa M DeAngelis
- All authors: Memorial Sloan Kettering Cancer Center, New York, NY
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354
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Lionakis MS, Dunleavy K, Roschewski M, Widemann BC, Butman JA, Schmitz R, Yang Y, Cole DE, Melani C, Higham CS, Desai JV, Ceribelli M, Chen L, Thomas CJ, Little RF, Gea-Banacloche J, Bhaumik S, Stetler-Stevenson M, Pittaluga S, Jaffe ES, Heiss J, Lucas N, Steinberg SM, Staudt LM, Wilson WH. Inhibition of B Cell Receptor Signaling by Ibrutinib in Primary CNS Lymphoma. Cancer Cell 2017; 31:833-843.e5. [PMID: 28552327 PMCID: PMC5571650 DOI: 10.1016/j.ccell.2017.04.012] [Citation(s) in RCA: 345] [Impact Index Per Article: 49.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2016] [Revised: 03/09/2017] [Accepted: 04/18/2017] [Indexed: 01/11/2023]
Abstract
Primary CNS lymphoma (PCNSL) harbors mutations that reinforce B cell receptor (BCR) signaling. Ibrutinib, a Bruton's tyrosine kinase (BTK) inhibitor, targets BCR signaling and is particularly active in lymphomas with mutations altering the BCR subunit CD79B and MYD88. We performed a proof-of-concept phase Ib study of ibrutinib monotherapy followed by ibrutinib plus chemotherapy (DA-TEDDi-R). In 18 PCNSL patients, 94% showed tumor reductions with ibrutinib alone, including patients having PCNSL with CD79B and/or MYD88 mutations, and 86% of evaluable patients achieved complete remission with DA-TEDDi-R. Increased aspergillosis was observed with ibrutinib monotherapy and DA-TEDDi-R. Aspergillosis was linked to BTK-dependent fungal immunity in a murine model. PCNSL is highly dependent on BCR signaling, and ibrutinib appears to enhance the efficacy of chemotherapy.
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Affiliation(s)
- Michail S Lionakis
- Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Kieron Dunleavy
- Lymphoid Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Mark Roschewski
- Lymphoid Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Brigitte C Widemann
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - John A Butman
- Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD 20892, USA
| | - Roland Schmitz
- Lymphoid Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Yandan Yang
- Lymphoid Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Diane E Cole
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Christopher Melani
- Lymphoid Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Christine S Higham
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Jigar V Desai
- Lymphoid Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Michele Ceribelli
- Division of Preclinical Innovation, National Center for Advancing Translational Sciences, National Institutes of Health, Gaithersburg, MD 20850, USA
| | - Lu Chen
- Division of Preclinical Innovation, National Center for Advancing Translational Sciences, National Institutes of Health, Gaithersburg, MD 20850, USA
| | - Craig J Thomas
- Lymphoid Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA; Division of Preclinical Innovation, National Center for Advancing Translational Sciences, National Institutes of Health, Gaithersburg, MD 20850, USA
| | - Richard F Little
- Cancer Therapy Evaluation Program, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Juan Gea-Banacloche
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Sucharita Bhaumik
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Maryalice Stetler-Stevenson
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Stefania Pittaluga
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Elaine S Jaffe
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - John Heiss
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Nicole Lucas
- Lymphoid Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Seth M Steinberg
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Louis M Staudt
- Lymphoid Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.
| | - Wyndham H Wilson
- Lymphoid Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.
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355
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Checkpoint inhibition in CNS lymphoma. Blood 2017; 129:3045-3046. [PMID: 28596436 DOI: 10.1182/blood-2017-04-777797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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356
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Kasenda B, Ihorst G, Schroers R, Korfel A, Schmidt-Wolf I, Egerer G, von Baumgarten L, Röth A, Bloehdorn J, Möhle R, Binder M, Keller U, Lamprecht M, Pfreundschuh M, Valk E, Fricker H, Schorb E, Fritsch K, Finke J, Illerhaus G. High-dose chemotherapy with autologous haematopoietic stem cell support for relapsed or refractory primary CNS lymphoma: a prospective multicentre trial by the German Cooperative PCNSL study group. Leukemia 2017; 31:2623-2629. [PMID: 28559537 DOI: 10.1038/leu.2017.170] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 05/08/2017] [Accepted: 05/15/2017] [Indexed: 01/08/2023]
Abstract
To investigate safety and efficacy of high-dose chemotherapy followed by autologous stem cell transplantation (HCT-ASCT) in relapsed/refractory (r/r) primary central nervous system lymphoma (PCNSL), we conducted a single-arm multicentre study for immunocompetent patients (<66 years) with PCNSL failing high-dose methotrexate)-based chemotherapy. Induction consisted of two courses of rituximab (375 mg/m2), high-dose cytarabine (2 × 3 g/m2) and thiotepa (40 mg/m2) with collection of stem cells in between. Conditioning for HCT-ASCT consisted of rituximab 375 mg/m2, carmustine 400 mg/m2 and thiotepa (4 × 5 mg/kg). Patients commenced HCT-ASCT irrespective of response after induction. Patients not achieving complete remission (CR) after HCT-ASCT received whole-brain radiotherapy. Primary end point was CR after HCT-ASCT. We enrolled 39 patients; median age and Karnofsky performance score are 57 years and 90%, respectively. About 28 patients had relapsed and 8 refractory disease. About 22 patients responded to induction and 32 patients commenced HCT-ASCT. About 22 patients (56.4%) achieved CR after HCT-ASCT. Respective 2-year progression-free survival (PFS) and overall survival (OS) rates were 46.0% (median PFS 12.4 months) and 56.4%; median OS not reached. We recorded four treatment-related deaths. Thiotepa-based HCT-ASCT is an effective treatment option in eligible patients with r/r PCNSL. Comparative studies are needed to further scrutinise the role of HCT-ASCT in the salvage setting.
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Affiliation(s)
- B Kasenda
- Department of Haematology/Oncology, Klinikum Stuttgart, Stuttgart, Germany.,Department of Medical Oncology & Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland
| | - G Ihorst
- Clinical Trials Unit, Medical Centre - University of Freiburg, Freiburg, Germany
| | - R Schroers
- Department of Medicine, Hematology and Oncology, Ruhr-University of Bochum, Knappschaftskrankenhaus Bochum-Langendreer, Bochum, Germany
| | - A Korfel
- Department of Hematology, Oncology and Tumor Immunology, Charite University Medicine, Berlin, Germany
| | - I Schmidt-Wolf
- Department of Internal Medicine III, Center for Integrated Oncology (CIO), University Hospital Bonn, Bonn, Germany
| | - G Egerer
- Department of Haematology and Oncology, Heidelberg University, Heidelberg, Germany
| | - L von Baumgarten
- Department of Neurology, University Hospital Munich LMU, Munich, Germany
| | - A Röth
- Medical Faculty, Department of Haematology, University of Duisburg-Essen, Essen, Germany
| | - J Bloehdorn
- Department of Internal Medicine III, University of Ulm, Ulm, Germany
| | - R Möhle
- Department of Haematology and Oncology, University Tübingen, Tübingen, Germany
| | - M Binder
- Department of Oncology and Hematology, University of Hamburg, Hamburg, Germany
| | - U Keller
- III Medical Department, Technische Universität München, Munich, Germany
| | - M Lamprecht
- Department of Internal Medicine II, University Hospital of Schleswig-Holstein, Campus Kiel, Germany
| | - M Pfreundschuh
- Klinik für Innere Medizin I, Universität des Saarlandes, Homburg, Germany
| | - E Valk
- Department of Haematology/Oncology, Klinikum Stuttgart, Stuttgart, Germany
| | - H Fricker
- Department of Haematology, Oncology and Stem Cell Transplantation, University Hospital Freiburg, Freiburg, Germany
| | - E Schorb
- Department of Haematology, Oncology and Stem Cell Transplantation, University Hospital Freiburg, Freiburg, Germany
| | - K Fritsch
- Department of Haematology, Oncology and Stem Cell Transplantation, University Hospital Freiburg, Freiburg, Germany
| | - J Finke
- Department of Haematology, Oncology and Stem Cell Transplantation, University Hospital Freiburg, Freiburg, Germany
| | - G Illerhaus
- Department of Haematology/Oncology, Klinikum Stuttgart, Stuttgart, Germany.,Department of Haematology, Oncology and Stem Cell Transplantation, University Hospital Freiburg, Freiburg, Germany
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357
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Curran EK, Godfrey J, Kline J. Mechanisms of Immune Tolerance in Leukemia and Lymphoma. Trends Immunol 2017; 38:513-525. [PMID: 28511816 DOI: 10.1016/j.it.2017.04.004] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 04/05/2017] [Accepted: 04/18/2017] [Indexed: 12/18/2022]
Abstract
The mechanisms through which immune responses are generated against solid cancers are well characterized and knowledge of the immune evasion pathways exploited by these malignancies has grown considerably. However, for hematological cancers, which develop and disseminate quite differently than solid tumors, the pathways that regulate immune activation or tolerance are less clear. Growing evidence suggests that, while numerous immune escape pathways are shared between hematological and solid malignancies, several unique pathways are exploited by leukemia and lymphoma. Below we discuss immune evasion mechanisms in leukemia and lymphoma, highlighting key differences from solid tumors. A more complete characterization of the mechanisms of immune tolerance in hematological malignancies is critical to inform the development of future immunotherapeutic approaches.
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Affiliation(s)
- Emily K Curran
- Department of Medicine, Section of Hematology, University of Chicago, Chicago, IL, USA; Committee on Clinical Pharmacology and Pharmacogenomics, University of Chicago, Chicago, IL, USA; University of Chicago Comprehensive Cancer Center, University of Chicago, Chicago, IL, USA
| | - James Godfrey
- Department of Medicine, Section of Hematology, University of Chicago, Chicago, IL, USA
| | - Justin Kline
- Department of Medicine, Section of Hematology, University of Chicago, Chicago, IL, USA; University of Chicago Comprehensive Cancer Center, University of Chicago, Chicago, IL, USA; Committee on Immunology, University of Chicago, Chicago, IL, USA.
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358
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Clinicopathologic significance of MYD88 L265P mutation in diffuse large B-cell lymphoma: a meta-analysis. Sci Rep 2017; 7:1785. [PMID: 28496180 PMCID: PMC5431939 DOI: 10.1038/s41598-017-01998-5] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 04/06/2017] [Indexed: 11/08/2022] Open
Abstract
The precise clinicopathologic significance of myeloid differentiation primary response gene (MYD88) L265P mutation in diffuse large B-cell lymphomas (DLBCLs) remains elusive. To investigate the frequency and clinicopathologic significance of the MYD88 L265P mutation in DLBCLs, we conducted a meta-analysis of 40 published studies on 2736 DLBCL patients. We collected relevant published research findings identified using the PubMed and Embase databases. The effect sizes of outcome parameters were calculated using a random-effects model. In this meta-analysis, the MYD88 L265P mutation in DLBCL showed a significant difference according to tumor sites. The overall incidence of the MYD88 L265P mutation in DLBCLs, excluding the central nervous system and testicular DLBCLs, was 16.5%. Notably, the MYD88 L265P mutation rates of CNS and testicular DLBCL patients were 60% and 77%, respectively. Interestingly, the MYD88 L265P mutation was more frequently detected in activated B-cell-like (ABC) or non-germinal center B-cell-like (GCB) than GCB subtype (OR = 3.414, p < 0.001). The MYD88 L265P mutation was significantly associated with old age and poor overall survival, but not with sex and clinical stage. This pooled analysis demonstrates that the MYD88 L265P mutation is significantly associated with the tumor sites and molecular subtypes in DLBCL patients.
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359
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Abstract
Inhibitory molecules such as PD-1, CTLA-4, LAG-3, or TIM-3 play a role to keep a balance in immune function. However, many cancers exploit such molecules to escape immune surveillance. Accumulating data support that their functions are dysregulated in lymphoid neoplasms, including plasma cell myeloma, myelodysplastic syndrome, and acute myeloid leukemia. In lymphoid neoplasms, aberrations in 9p24.1 (PD-L1, PD-L2, and JAK2 locus), latent Epstein-Barr virus infection, PD-L1 3'-untranslated region disruption, and constitutive JAK-STAT pathway are known mechanisms to induce PD-L1 expression in lymphoma cells. Clinical trials demonstrated that PD-1 blockade is an attractive way to restore host's immune function in hematological malignancies, particularly classical Hodgkin lymphoma. Numerous clinical trials exploring PD-1 blockade as a single therapy or in combination with other immune checkpoint inhibitors in patients with hematologic cancers are under way. Although impressive clinical response is observed with immune checkpoint inhibitors in patients with certain cancers, not all patients respond to immune checkpoint inhibitors. Therefore, to identify best candidates who would have excellent response to checkpoint inhibitors is of utmost importance. Several possible biomarkers are available, but consensus has not been made and pursuit to discover the best biomarker is ongoing.
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Affiliation(s)
- Chi Young Ok
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030-4009 USA
| | - Ken H. Young
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030-4009 USA
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360
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Ilcus C, Bagacean C, Tempescul A, Popescu C, Parvu A, Cenariu M, Bocsan C, Zdrenghea M. Immune checkpoint blockade: the role of PD-1-PD-L axis in lymphoid malignancies. Onco Targets Ther 2017; 10:2349-2363. [PMID: 28496333 PMCID: PMC5417656 DOI: 10.2147/ott.s133385] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The co-inhibitory receptor programmed cell death (PD)-1, expressed by immune effector cells, is credited with a protective role for normal tissue during immune responses, by limiting the extent of effector activation. Its presently known ligands, programmed death ligands (PD-Ls) 1 and 2, are expressed by a variety of cells including cancer cells, suggesting a role for these molecules as an immune evasion mechanism. Blocking of the PD-1-PD-L signaling axis has recently been shown to be effective and was clinically approved in relapsed/refractory tumors such as malignant melanoma and lung cancer, but also classical Hodgkin’s lymphoma. A plethora of trials exploring PD-1 blockade in cancer are ongoing. Here, we review the role of PD-1 signaling in lymphoid malignancies, and the latest results of trials investigating PD-1 or PD-L1 blocking agents in this group of diseases. Early phase studies proved very promising, leading to the clinical approval of a PD-1 blocking agent in Hodgkin’s lymphoma, and Phase III clinical studies are either planned or ongoing in most lymphoid malignancies.
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Affiliation(s)
- Cristina Ilcus
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cristina Bagacean
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Laboratory of Immunology and Immunotherapy, Brest University Medical School, CHRU Morvan
| | - Adrian Tempescul
- Department of Clinical Hematology, Institute of Cancerology and Hematology, Brest, France
| | - Cristian Popescu
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Andrada Parvu
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Hematology, Ion Chiricuta Oncology Institute
| | - Mihai Cenariu
- Biotechnology Research Center, University of Agricultural Sciences and Veterinary Medicine
| | - Corina Bocsan
- Department of Clinical Pharmacology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mihnea Zdrenghea
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Hematology, Ion Chiricuta Oncology Institute
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361
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Pianko MJ, Liu Y, Bagchi S, Lesokhin AM. Immune checkpoint blockade for hematologic malignancies: a review. Stem Cell Investig 2017; 4:32. [PMID: 28529947 PMCID: PMC5420526 DOI: 10.21037/sci.2017.03.04] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 03/08/2017] [Indexed: 12/26/2022]
Abstract
Immune checkpoint blockade has revolutionized the treatment of cancer, with impressive responses seen in a broad variety of tumor types. Blockade of immune checkpoints and immune signaling antibodies has shown promise in multiple types of hematologic malignancies (HMs), with dramatic single agent responses for pembrolizumab and nivolumab in Hodgkin lymphoma (HL). In this review, we outline the current state of immune checkpoint blockade drug development in HMs, and discuss mechanisms of activity and resistance, and highlight potential targets in the immune tumor microenvironment (TME). Blockade of T-cell checkpoint molecules PD-1/PD-L1 and CTLA-4 are the most clinically mature of the immune checkpoint strategies. Novel and upcoming strategies for immune checkpoint blockade drug development in HMs using innovative combinations to modulate immunologic targets shows significant promise as a way to expand the number of patients with blood cancers who could benefit from immunotherapy.
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Affiliation(s)
- Matthew J. Pianko
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Yuzhou Liu
- Department of Medicine, Mount Sinai St. Luke’s and Mount Sinai West, New York, NY, USA
| | - Srishti Bagchi
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Alexander M. Lesokhin
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Immunotherapeutics Core, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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362
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PD-1 blockade with nivolumab in relapsed/refractory primary central nervous system and testicular lymphoma. Blood 2017; 129:3071-3073. [PMID: 28356247 DOI: 10.1182/blood-2017-01-764209] [Citation(s) in RCA: 320] [Impact Index Per Article: 45.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 02/25/2017] [Indexed: 12/16/2022] Open
Abstract
Primary central nervous system (CNS) lymphoma (PCNSL) and primary testicular lymphoma (PTL) are rare extranodal large B-cell lymphomas with similar genetic signatures. There are no standard-of-care treatment options for patients with relapsed and refractory PCNSL and PTL, and the overall prognosis is poor. PCNSLs and PTLs exhibit frequent 9p24.1 copy-number alterations and infrequent translocations of 9p24.1 and associated increased expression of the programmed cell death protein 1 (PD-1) ligands, PD-L1 and PD-L2. The activity of PD-1 blockade in other lymphomas with 9p24.1 alterations prompted us to test the efficacy of the anti-PD1 antibody, nivolumab, in 4 patients with relapsed/refractory PCNSL and 1 patient with CNS relapse of PTL. All 5 patients had clinical and radiographic responses to PD-1 blockade, and 3 patients remain progression-free at 13+ to 17+ months. Our data suggest that nivolumab is active in relapsed/refractory PCNSL and PTL and support further investigation of PD-1 blockade in these diseases.
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363
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Primary central nervous system lymphoma: essential points in diagnosis and management. Med Oncol 2017; 34:61. [PMID: 28315229 DOI: 10.1007/s12032-017-0920-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 03/14/2017] [Indexed: 12/19/2022]
Abstract
Primary central nervous system lymphoma (PCNSL) is an extra-nodal non-Hodgkin lymphoma. PCNSL is defined as lymphoma involving the brain, leptomeninges, eyes, or spinal cord without evidence of lymphoma outside the CNS. Treatment includes induction with chemotherapy and consolidation with whole-brain radiotherapy or high-dose chemotherapy supported by autologous stem cell transplantation. High-dose methotrexate is the most important drug in cases with PCNSL, and this drug will be used in combination with small molecules, BTK inhibitors, new monoclonal antibodies, and checkpoint blockers.
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364
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The role of anti-PD-1 and anti-PD-L1 agents in the treatment of diffuse large B-cell lymphoma: The future is now. Crit Rev Oncol Hematol 2017; 113:52-62. [PMID: 28427522 DOI: 10.1016/j.critrevonc.2017.02.027] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 02/07/2017] [Accepted: 02/10/2017] [Indexed: 11/23/2022] Open
Abstract
Immune checkpoints inhibitors have been incorporated into standard treatment protocols for advanced solid tumors. The aim of T-cell-based immune therapy in cancer has been to generate durable clinical benefits for patients, paired with enhanced side effect profiles. The beneficial antitumoral activity of programmed death-1 (PD-1) and programmed death-ligand 1 (PD-L1) has been thoroughly demonstrated in certain metastatic malignancies (e.g. melanoma, non-small cell lung cancer, renal cell carcinoma); however, the therapeutic role in lymphoid cancers is complex. Nonetheless, the striking clinical activity seen in early clinical trials of various subtypes of relapsed lymphoma have paved the way for these exciting innovative therapeutic alternatives in these tumors. In this article we assess the literature on the role of the PD-1/PD-L1 pathway in Diffuse Large B-cell lymphoma (DLBCL), and describe future strategies involving these new anticancer agents in this lymphoid neoplasm.
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365
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Ok CY, Young KH. Targeting the programmed death-1 pathway in lymphoid neoplasms. Cancer Treat Rev 2017; 54:99-109. [PMID: 28242522 PMCID: PMC5815314 DOI: 10.1016/j.ctrv.2017.01.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Revised: 01/23/2017] [Accepted: 01/29/2017] [Indexed: 12/31/2022]
Abstract
Programmed death-1 (PD-1) is a co-inhibitory molecule and is seen in CD4+ and CD8+ T cells. Upon binding to its ligands, programmed death ligand-1 (PD-L1) and -2 (PD-L2), PD-1 negatively regulates interleukin 2 (IL-2) production and T cell proliferation. Activated effector T-cells, which kill cancer cells, can be affected by PD-1 signaling in some lymphoid neoplasm that express PD-L1 or PD-L2. PD-L1 expression in tumor cells can be induced by extrinsic signal (i.e. interferon gamma) or intrinsic signals, such as genetic aberrations involving 9p24.1, latent Epstein-Barr virus infection, PD-L1 3'- untranslated region disruptions, and activated Janus kinase/signal transducer and activator of transcription (JAK/STAT) pathway. Anti-PD-1 therapy improves the overall response rate to treatment in patients with lymphoid neoplasms, particularly relapsed/refractory classical Hodgkin lymphoma. Inspired by their success in treating patients with classical Hodgkin lymphoma, medical practitioners have expanded PD-1 therapy, given as a single therapy or in combination with other drugs, to patients with other types of lymphoma. In this review, current clinical trials with anti-PD-1 or anti-PD-L1 drugs are summarized. The results of numerous clinical trials will broaden our understanding of PD-1 pathway and shall expand the list of patients who will get benefit from these agents including those who suffer from lymphoid neoplasms.
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Affiliation(s)
- Chi Young Ok
- The Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Ken H Young
- The Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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366
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Li X, Huang Y, Bi C, Yuan J, He H, Zhang H, Yu Q, Fu K, Li D. Primary central nervous system diffuse large B-cell lymphoma shows an activated B-cell-like phenotype with co-expression of C-MYC, BCL-2, and BCL-6. Pathol Res Pract 2017; 213:659-665. [PMID: 28552541 DOI: 10.1016/j.prp.2017.02.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Revised: 02/13/2017] [Accepted: 02/17/2017] [Indexed: 11/28/2022]
Abstract
Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma, whose main prognostic factor is closely related to germinal center B-cell-like subtype (GCB- DLBCL) or activated B-cell-like type (non-GCB-DLBCL). The most common type of primary central nervous system lymphoma is diffuse large B-cell type with poor prognosis and the reason is unclear. This study aims to stratify primary central nervous system diffuse large B-cell lymphoma (PCNS-DLBCL) according to the cell-of-origin (COO) and to investigate the multiple proteins expression of C-MYC, BCL-6, BCL-2, TP53, further to elucidate the reason why primary central nervous system diffuse large B-cell lymphoma possesses a poor clinical outcome as well. Nineteen cases of primary central nervous system DLBCL were stratified according to immunostaining algorithms of Hans, Choi and Meyer (Tally) and we investigated the multiple proteins expression of C-MYC, BCL-6, BCL-2, TP53. The Epstein-Barr virus and Borna disease virus infection were also detected. Among nineteen cases, most (15-17 cases) were assigned to the activated B-cell-like subtype, highly expression of C-MYC (15 cases, 78.9%), BCL-2 (10 cases, 52.6%), BCL-6 (15 cases, 78.9%). Unfortunately, two cases were positive for PD-L1 while PD-L2 was not expressed in any case. Two cases infected with BDV but no one infected with EBV. In conclusion, most primary central nervous system DLBCLs show an activated B-cell-like subtype characteristic and have multiple expressions of C-MYC, BCL-2, BCL-6 protein, these features might be significant factor to predict the outcome and guide treatment of PCNS-DLBCLs.
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Affiliation(s)
- Xiaomei Li
- Department of Pathology, The First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China; Institute of Neuroscience, Faculty of Basic Medicine, Chongqing Medical University, Chongqing 400016, China
| | - Ying Huang
- Department of Pathology, The First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China; Institute of Neuroscience, Faculty of Basic Medicine, Chongqing Medical University, Chongqing 400016, China
| | - Chengfeng Bi
- Department of Pathology & Microbiology, University of Nebraska Medical Center, Omaha 68198, USA
| | - Ji Yuan
- Department of Pathology & Microbiology, University of Nebraska Medical Center, Omaha 68198, USA
| | - Hong He
- Department of Internal Medicine, The First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China
| | - Hong Zhang
- Department of Pathology, The First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China; Institute of Neuroscience, Faculty of Basic Medicine, Chongqing Medical University, Chongqing 400016, China
| | - QiuBo Yu
- Molecular Medical Laboratory, Chongqing Medical University, Chongqing 400016, China
| | - Kai Fu
- Department of Pathology & Microbiology, University of Nebraska Medical Center, Omaha 68198, USA
| | - Dan Li
- Department of Pathology, The First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China; Institute of Neuroscience, Faculty of Basic Medicine, Chongqing Medical University, Chongqing 400016, China.
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367
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Burroni B, Broudin C, Damotte D, Laurent C. [Immune-checkpoint and hemopathies]. Ann Pathol 2017; 37:101-110. [PMID: 28161001 DOI: 10.1016/j.annpat.2016.12.005] [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: 10/19/2016] [Accepted: 12/06/2016] [Indexed: 11/26/2022]
Abstract
Immune-checkpoint inhibitors represent potent new therapies for most lymphomas, particularly for refractory diseases. Contrasting with solid tumors the majority of lymphoma are sensitive to conventional therapies and immunotherapies such as anti-CD20 or anti-CD30. But relapsing lymphoma or refractory disease have a very poor prognosis and new drugs are mandatory. Immune-checkpoint inhibitors targeting CTLA4, PD-1 et PD-L1 demonstrated efficiency with prolonged survivals even after bone marrow allograft for aggressive disease. Lymphomas differ from solid tumors as tumor cells belong to the immune compartment and therefore molecules targeting immune cells may act on both immune environment and tumor cells. Furthermore, PD-L1 expression in most lymphomas is related to tumor cell molecular alterations such as PD-L1 gene amplification or mutation. PD-L1 protein expression on tumor cells and immune cells, particularly it frequency and distribution vary according to different lymphoma subtype and it may help to assess diagnosis as it may predict therapeutical response.
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Affiliation(s)
- Barbara Burroni
- Service de pathologie, hôpital Cochin, AP-HP , 75014 Paris, France
| | - Chloé Broudin
- Service de pathologie, hôpital Cochin, AP-HP , 75014 Paris, France
| | - Diane Damotte
- Service de pathologie, hôpital Cochin, AP-HP , 75014 Paris, France; Inserm U1138, centre de recherche des Cordeliers, 15, rue de l'École de Médecine, 75006 Paris, France; Université Paris Descartes, 75006 Paris, France; Université Pierre-et-Marie-Curie, 75005 Paris, France.
| | - Camille Laurent
- Département de pathologie, institut universitaire du cancer-oncopole de Toulouse, 31059 Toulouse, France; Service de pathologie et cytologie, centre hospitalier universitaire, 31300 Toulouse, France; Inserm UMR1037, centre de recherches en cancérologie de Toulouse, 31100 Toulouse, France
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368
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de Jong D, Roemer MGM, Chan JKC, Goodlad J, Gratzinger D, Chadburn A, Jaffe ES, Said J, Natkunam Y. B-Cell and Classical Hodgkin Lymphomas Associated With Immunodeficiency: 2015 SH/EAHP Workshop Report-Part 2. Am J Clin Pathol 2017; 147:153-170. [PMID: 28395108 DOI: 10.1093/ajcp/aqw216] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES The 2015 Workshop of the Society for Hematopathology/European Association for Haematopathology submitted small and large B-cell lymphomas (BCLs), including classical Hodgkin lymphoma (CHL), in the context of immunodeficiency. METHODS Clinicopathologic and molecular features were studied to explore unifying concepts in malignant B-cell proliferations across immunodeficiency settings. RESULTS Cases submitted to the workshop spanned small BCLs presenting as nodal or extranodal marginal zone lymphoma and lymphoplasmacytic lymphoma, Epstein-Barr virus (EBV) positive in 75% of cases. Submitted large BCLs formed a spectrum from diffuse large B-cell lymphoma (DLBCL) to CHL across immunodeficiency settings. Additional studies demonstrated overexpression of PD-L1 and molecular 9p24 alterations in the large BCL spectrum and across different immunodeficiency settings. CONCLUSIONS Small BCLs occur in all immunodeficiency settings, and EBV positivity is essential for their recognition as immunodeficiency related. Large BCLs include a spectrum from DLBCL to CHL across all immunodeficiency settings; immunohistochemical and molecular features are suggestive of shared pathogenetic mechanisms involving PD-L1 immune checkpoints.
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Affiliation(s)
- Daphne de Jong
- From the VU University Medical Center, Amsterdam, the Netherlands
| | - Margaretha G M Roemer
- From the VU University Medical Center, Amsterdam, the Netherlands
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | | | - John Goodlad
- HMDS, St James's University Hospital, Leeds, United Kingdom
| | | | - Amy Chadburn
- Weill Medical College of Cornell University, New York
| | | | - Jonathan Said
- University of California Los Angeles Medical Center, Los Angeles
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369
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Carreras J, Kikuti YY, Beà S, Miyaoka M, Hiraiwa S, Ikoma H, Nagao R, Tomita S, Martin-Garcia D, Salaverria I, Sato A, Ichiki A, Roncador G, Garcia JF, Ando K, Campo E, Nakamura N. Clinicopathological characteristics and genomic profile of primary sinonasal tract diffuse large B cell lymphoma (DLBCL) reveals gain at 1q31 and RGS1 encoding protein; high RGS1 immunohistochemical expression associates with poor overall survival in DLBC. Histopathology 2017; 70:595-621. [DOI: 10.1111/his.13106] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 09/29/2016] [Accepted: 10/21/2016] [Indexed: 12/22/2022]
Affiliation(s)
- Joaquim Carreras
- Department of Pathology; Tokai University; School of Medicine; Kanagawa Japan
| | - Yara Y Kikuti
- Department of Pathology; Tokai University; School of Medicine; Kanagawa Japan
| | - Sílvia Beà
- Hematopathology Unit; Hospital Clínic; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); University of Barcelona; Barcelona Spain
| | - Masashi Miyaoka
- Department of Pathology; Tokai University; School of Medicine; Kanagawa Japan
| | - Shinichiro Hiraiwa
- Department of Pathology; Tokai University; School of Medicine; Kanagawa Japan
| | - Haruka Ikoma
- Department of Pathology; Tokai University; School of Medicine; Kanagawa Japan
| | - Ryoko Nagao
- Department of Pathology; Tokai University; School of Medicine; Kanagawa Japan
| | - Sakura Tomita
- Department of Pathology; Tokai University; School of Medicine; Kanagawa Japan
| | - David Martin-Garcia
- Hematopathology Unit; Hospital Clínic; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); University of Barcelona; Barcelona Spain
| | - Itziar Salaverria
- Hematopathology Unit; Hospital Clínic; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); University of Barcelona; Barcelona Spain
| | - Ai Sato
- Department of Hematology and Oncology; Tokai University; School of Medicine; Kanagawa Japan
| | - Akifumi Ichiki
- Department of Hematology and Oncology; Tokai University; School of Medicine; Kanagawa Japan
| | - Giovanna Roncador
- Monoclonal Antibodies Unit; Spanish National Cancer Research Centre (CNIO); Madrid Spain
| | - Juan F Garcia
- Department of Pathology; MD Anderson Cancer Center Madrid; Madrid Spain
| | - Kiyoshi Ando
- Department of Hematology and Oncology; Tokai University; School of Medicine; Kanagawa Japan
| | - Elias Campo
- Hematopathology Unit; Hospital Clínic; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); University of Barcelona; Barcelona Spain
| | - Naoya Nakamura
- Department of Pathology; Tokai University; School of Medicine; Kanagawa Japan
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370
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Hude I, Sasse S, Engert A, Bröckelmann PJ. The emerging role of immune checkpoint inhibition in malignant lymphoma. Haematologica 2017; 102:30-42. [PMID: 27884973 PMCID: PMC5210230 DOI: 10.3324/haematol.2016.150656] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 08/19/2016] [Indexed: 12/19/2022] Open
Abstract
To evade elimination by the host immune system, tumor cells commonly exploit physiological immune checkpoint pathways, restraining efficient anti-tumor immune cell function. Growing understanding of the complex dialog between tumor cells and their microenvironment contributed to the development of immune checkpoint inhibitors. This innovative strategy has demonstrated paradigm-shifting clinical activity in various malignancies. Antibodies targeting programmed death 1 and cytotoxic T-lymphocyte-associated protein-4 are also being investigated in lymphoid malignancies with varying levels of activity and a favorable toxicity profile. To date, evaluated only in the setting of relapsed or refractory disease, anti-programmed death 1 antibodies such as nivolumab and pembrolizumab show encouraging response rates particularly in classical Hodgkin lymphoma but also in follicular lymphoma and diffuse-large B-cell lymphoma. As the first immune checkpoint inhibitor in lymphoma, nivolumab was approved for the treatment of relapsed or refractory classical Hodgkin lymphoma by the Food and Drug Administration in May 2016. In this review, we assess the role of the pathways involved and potential rationale of checkpoint inhibition in various lymphoid malignancies. In addition to data from current clinical trials, immune-related side effects, potential limitations and future perspectives including promising combinatory approaches with immune checkpoint inhibition are discussed.
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Affiliation(s)
- Ida Hude
- Department of Internal Medicine, Division of Hematology, University Hospital Center Zagreb, Croatia
| | - Stephanie Sasse
- Department I of Internal Medicine and German Hodgkin Study Group (GHSG), University Hospital of Cologne, Germany
| | - Andreas Engert
- Department I of Internal Medicine and German Hodgkin Study Group (GHSG), University Hospital of Cologne, Germany
| | - Paul J Bröckelmann
- Department I of Internal Medicine and German Hodgkin Study Group (GHSG), University Hospital of Cologne, Germany
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371
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Four M, Cacheux V, Tempier A, Platero D, Fabbro M, Marin G, Leventoux N, Rigau V, Costes-Martineau V, Szablewski V. PD1 and PDL1 expression in primary central nervous system diffuse large B-cell lymphoma are frequent and expression of PD1 predicts poor survival. Hematol Oncol 2016; 35:487-496. [PMID: 27966264 DOI: 10.1002/hon.2375] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 10/28/2016] [Accepted: 11/13/2016] [Indexed: 01/02/2023]
Abstract
Primary central nervous system diffuse large B-cell lymphoma (PCNS-DLBCL) is a rare and aggressive type of diffuse large B-cell lymphoma (DLBCL) whit poorly understood pathogenesis. Finding biomarkers associated with patient survival may be important for understanding its physiopathology and to develop new therapeutic approaches. We investigated 32 PCNS-DLBCL from immunocompetent patients for BCL2, CMYC, LMO2, and P53 expression and for cytogenetic aberrations of BCL2, BCL6, and MYC genes, all known for their prognostic value in systemic DLBCL (s-DLBCL). We analyzed PD1 and PDL1 protein expression in both tumor infiltrating lymphocytes (TILs) and tumor cells. Finally, we searched for correlation between biological data and clinical course. The PCNS-DLBCL expressed BCL2, CMYC, LMO2, and P53 at similar frequency than s-DLBCL but without significant prognostic on survival. None cases harbored aberrations involving BCL2 and MYC gene whereas BCL6 abnormalities were present in 20.7% of cases but without value on survival. Expression of PD1 in TILs and PDL1 in tumor cells was observed at higher rates than in s-DLBCL (58% and 37%, respectively). The PD1 expression in TILs correlated with PDL1 expression in tumor cells (P = .001). Presence of PD1 positive TILs was associated with poorer overall survival (P = .011). Patients with PDL1 overexpression tended to better response to chemotherapy (P = .23). In conclusion PCNS-DLBCL pathogenesis differs from s-DLBCL without prognostic value of the phenotypic and cytogenetic parameters known for their pejorative impact in the latter. The PD1/PDL1 pathway plays a strong role in PCNS-DLBCL and represents an attractive target for this aggressive lymphoma.
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Affiliation(s)
- Marion Four
- Département de Biopathologie, Centre Hospitalo-Universitaire de Montpellier, Montpellier, France
| | - Valère Cacheux
- Département d' Hématologie biologique, Centre Hospitalo-Universitaire de Montpellier, Montpellier, France.,Faculté de Médecine, Université Montpellier 1, Montpellier, France
| | - Ariane Tempier
- Département de Biopathologie, Centre Hospitalo-Universitaire de Montpellier, Montpellier, France
| | - Dolorès Platero
- Département d' Hématologie biologique, Centre Hospitalo-Universitaire de Montpellier, Montpellier, France
| | - Michel Fabbro
- Département d' Oncologie Médicale, Institut du Cancer de Montpellier, Montpellier, France
| | - Grégory Marin
- Département d' Information Médicale, Centre Hospitalo-Universitaire de Montpellier, Montpellier, France
| | - Nicolas Leventoux
- Département de Biopathologie, Centre Hospitalo-Universitaire de Montpellier, Montpellier, France
| | - Valérie Rigau
- Département de Biopathologie, Centre Hospitalo-Universitaire de Montpellier, Montpellier, France.,Faculté de Médecine, Université Montpellier 1, Montpellier, France
| | - Valérie Costes-Martineau
- Département de Biopathologie, Centre Hospitalo-Universitaire de Montpellier, Montpellier, France.,Faculté de Médecine, Université Montpellier 1, Montpellier, France
| | - Vanessa Szablewski
- Département de Biopathologie, Centre Hospitalo-Universitaire de Montpellier, Montpellier, France.,Faculté de Médecine, Université Montpellier 1, Montpellier, France
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372
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Dutoit V, Migliorini D, Dietrich PY, Walker PR. Immunotherapy of Malignant Tumors in the Brain: How Different from Other Sites? Front Oncol 2016; 6:256. [PMID: 28003994 PMCID: PMC5141244 DOI: 10.3389/fonc.2016.00256] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 11/24/2016] [Indexed: 12/25/2022] Open
Abstract
Immunotherapy is now advancing at remarkable pace for tumors located in various tissues, including the brain. Strategies launched decades ago, such as tumor antigen-specific therapeutic vaccines and adoptive transfer of tumor-infiltrating lymphocytes are being complemented by molecular engineering approaches allowing the development of tumor-specific TCR transgenic and chimeric antigen receptor T cells. In addition, the spectacular results obtained in the last years with immune checkpoint inhibitors are transfiguring immunotherapy, these agents being used both as single molecules, but also in combination with other immunotherapeutic modalities. Implementation of these various strategies is ongoing for more and more malignancies, including tumors located in the brain, raising the question of the immunological particularities of this site. This may necessitate cautious selection of tumor antigens, minimizing the immunosuppressive environment and promoting efficient T cell trafficking to the tumor. Once these aspects are taken into account, we might efficiently design immunotherapy for patients suffering from tumors located in the brain, with beneficial clinical outcome.
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Affiliation(s)
- Valérie Dutoit
- Laboratory of Tumor Immunology, Center of Oncology, Geneva University Hospitals and University of Geneva , Geneva , Switzerland
| | - Denis Migliorini
- Oncology, Center of Oncology, Geneva University Hospitals and University of Geneva , Geneva , Switzerland
| | - Pierre-Yves Dietrich
- Oncology, Center of Oncology, Geneva University Hospitals and University of Geneva , Geneva , Switzerland
| | - Paul R Walker
- Laboratory of Tumor Immunology, Center of Oncology, Geneva University Hospitals and University of Geneva , Geneva , Switzerland
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373
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Batchelor TT. Primary central nervous system lymphoma. HEMATOLOGY. AMERICAN SOCIETY OF HEMATOLOGY. EDUCATION PROGRAM 2016; 2016:379-385. [PMID: 27913504 PMCID: PMC6142465 DOI: 10.1182/asheducation-2016.1.379] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Primary central nervous system lymphoma (PCNSL) is an extranodal non-Hodgkin lymphoma (NHL) confined to the brain, leptomeninges, eyes, or spinal cord. The majority of PCNSL cases occur in the immunocompetent host, the focus of this review. The prognosis of PCNSL is inferior to that of other NHL subtypes including other organ-specific subtypes of extranodal NHL. The 5- and 10-year survival proportions for PCNSL are 29.3% and 21.6%, respectively. The diagnosis and management of PCNSL differs from that of other primary brain cancers and NHL in other parts of the body.
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Affiliation(s)
- Tracy T Batchelor
- Departments of Neurology and Radiation Oncology, Division of Hematology/Oncology, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, MA
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374
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Goodman A, Patel SP, Kurzrock R. PD-1-PD-L1 immune-checkpoint blockade in B-cell lymphomas. Nat Rev Clin Oncol 2016; 14:203-220. [PMID: 27805626 DOI: 10.1038/nrclinonc.2016.168] [Citation(s) in RCA: 327] [Impact Index Per Article: 40.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Cancer cells can escape T-cell-mediated cellular cytotoxicity by exploiting the inhibitory programmed cell-death protein 1 (PD-1)/programmed cell death 1 ligand 1 (PD-L1) immune checkpoint. Indeed, therapeutic antibodies that block the PD-1-PD-L1 axis induce durable clinical responses against a growing list of solid tumours. B-cell lymphomas also leverage this checkpoint to escape immune recognition, although the outcomes of PD-1-PD-L1 blockade, and the correlations between PD-L1 expression and treatment responses, are less-well elucidated in these diseases than in solid cancers. Nevertheless, in patients with Hodgkin lymphoma, amplification of the gene encoding PD-L1 is commonly associated with increased expression of this protein on Reed-Sternberg cells. Correspondingly, PD-1 blockade with nivolumab has been demonstrated to result in response rates as high as 87% in unselected patients with relapsed and/or refractory Hodgkin lymphoma, leading to the FDA approval of nivolumab for this indication in May 2016. The PD-1/PD-L1 axis is probably also important for immune evasion of B-cell lymphomas with a viral aetiology, including those associated with human immunodeficiency virus (HIV) and Epstein-Barr virus (EBV). This Review is focused on the role of PD-1-PD-L1 blockade in unleashing host antitumour immune responses against various B-cell lymphomas, and summarizes the clinical studies of this approach performed to date.
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Affiliation(s)
- Aaron Goodman
- Center for Personalized Cancer Therapy and Division of Hematology and Oncology, University of California San Diego Moores Cancer Center, 3855 Health Sciences Drive, La Jolla, California 92093, USA
| | - Sandip P Patel
- Center for Personalized Cancer Therapy and Division of Hematology and Oncology, University of California San Diego Moores Cancer Center, 3855 Health Sciences Drive, La Jolla, California 92093, USA
| | - Razelle Kurzrock
- Center for Personalized Cancer Therapy and Division of Hematology and Oncology, University of California San Diego Moores Cancer Center, 3855 Health Sciences Drive, La Jolla, California 92093, USA
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375
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Korfel A, Schlegel U. Identifying targetable genetic features in primary CNS lymphoma. Int J Hematol Oncol 2016; 5:93-96. [DOI: 10.2217/ijh-2016-0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 11/21/2016] [Indexed: 11/21/2022] Open
Affiliation(s)
- Agnieszka Korfel
- Department of Hematology & Oncology, Charite University Medicine Berlin, Berlin, Germany
| | - Uwe Schlegel
- Department of Neurology, Ruhr-University Bochum, Krankenhaus Langendreer, Bochum, Germany
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376
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Savage KJ, Steidl C. Immune checkpoint inhibitors in Hodgkin and non-Hodgkin lymphoma: how they work and when to use them. Expert Rev Hematol 2016; 9:1007-1009. [PMID: 27677541 DOI: 10.1080/17474086.2016.1242404] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Kerry J Savage
- a Centre for Lymphoid Cancer , British Columbia Cancer Agency , British Columbia , Canada.,b Department of Medical Oncology , British Columbia Cancer Agency , British Columbia , Canada
| | - Christian Steidl
- a Centre for Lymphoid Cancer , British Columbia Cancer Agency , British Columbia , Canada.,c Department of Pathology and Laboratory Medicine , University of British Columbia , British Columbia , Canada
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377
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Kridel R, Telio D, Villa D, Sehn LH, Gerrie AS, Shenkier T, Klasa R, Slack GW, Tan K, Gascoyne RD, Connors JM, Savage KJ. Diffuse large B-cell lymphoma with testicular involvement: outcome and risk of CNS relapse in the rituximab era. Br J Haematol 2016; 176:210-221. [DOI: 10.1111/bjh.14392] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 07/31/2016] [Indexed: 02/03/2023]
Affiliation(s)
- Robert Kridel
- Centre for Lymphoid Cancer; British Columbia Cancer Agency; Vancouver BC Canada
| | - David Telio
- Centre for Lymphoid Cancer; British Columbia Cancer Agency; Vancouver BC Canada
- Department of Medical Oncology; University of British Columbia; Vancouver BC Canada
| | - Diego Villa
- Centre for Lymphoid Cancer; British Columbia Cancer Agency; Vancouver BC Canada
- Department of Medical Oncology; University of British Columbia; Vancouver BC Canada
| | - Laurie H. Sehn
- Centre for Lymphoid Cancer; British Columbia Cancer Agency; Vancouver BC Canada
- Department of Medical Oncology; University of British Columbia; Vancouver BC Canada
| | - Alina S. Gerrie
- Centre for Lymphoid Cancer; British Columbia Cancer Agency; Vancouver BC Canada
- Department of Medical Oncology; University of British Columbia; Vancouver BC Canada
| | - Tamara Shenkier
- Department of Medical Oncology; University of British Columbia; Vancouver BC Canada
| | - Richard Klasa
- Centre for Lymphoid Cancer; British Columbia Cancer Agency; Vancouver BC Canada
- Department of Medical Oncology; University of British Columbia; Vancouver BC Canada
| | - Graham W. Slack
- Centre for Lymphoid Cancer; British Columbia Cancer Agency; Vancouver BC Canada
- Department of Pathology; British Columbia Cancer Agency; Vancouver BC Canada
| | - King Tan
- Centre for Lymphoid Cancer; British Columbia Cancer Agency; Vancouver BC Canada
| | - Randy D. Gascoyne
- Centre for Lymphoid Cancer; British Columbia Cancer Agency; Vancouver BC Canada
- Department of Pathology; British Columbia Cancer Agency; Vancouver BC Canada
| | - Joseph M. Connors
- Centre for Lymphoid Cancer; British Columbia Cancer Agency; Vancouver BC Canada
- Department of Medical Oncology; University of British Columbia; Vancouver BC Canada
| | - Kerry J. Savage
- Centre for Lymphoid Cancer; British Columbia Cancer Agency; Vancouver BC Canada
- Department of Medical Oncology; University of British Columbia; Vancouver BC Canada
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378
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Roemer MGM, Advani RH, Redd RA, Pinkus GS, Natkunam Y, Ligon AH, Connelly CF, Pak CJ, Carey CD, Daadi SE, Chapuy B, de Jong D, Hoppe RT, Neuberg DS, Shipp MA, Rodig SJ. Classical Hodgkin Lymphoma with Reduced β2M/MHC Class I Expression Is Associated with Inferior Outcome Independent of 9p24.1 Status. Cancer Immunol Res 2016; 4:910-916. [PMID: 27737878 DOI: 10.1158/2326-6066.cir-16-0201] [Citation(s) in RCA: 131] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 09/19/2016] [Indexed: 12/26/2022]
Abstract
In classical Hodgkin lymphoma (cHL), malignant Hodgkin Reed-Sternberg (HRS) cells evade antitumor immunity by multiple mechanisms, including perturbed antigen presentation and enhanced PD-1 signaling. HRS cell expression of the PD-1 ligands is attributable, in part, to copy number alterations of 9p24.1/CD274(PD-L1)/PDCD1LG2(PD-L2) Amplification of PD-L1/PD-L2 is associated with advanced clinical stage and inferior progression-free survival (PFS) following first-line (induction) therapy. The relationships between altered expression of β2-microglobulin (β2M), MHC class I, and MHC class II by HRS cells, PD-L1/PD-L2 amplification, and clinical outcome in cHL are poorly defined. We assessed these variables in diagnostic biopsy specimens from 108 patients with cHL who received uniform treatment and had long-term follow-up and found decreased/absent expression of β2M/MHC class I in 79% (85/108) and decreased/absent expression of MHC class II in 67% (72/108) of cases. Patients with decreased/absent β2M/MHC class I had shorter PFS, independent of PD-L1/PD-L2 amplification and advanced stage. Decreased or absent MHC class II was unrelated to outcome. These results suggest that MHC class I-mediated antigen presentation by HRS cells is an important component of the biological response to standard chemo/radiotherapy. The paucity of β2M/MHC class I expression on HRS cells also prompts speculation regarding alternative mechanisms of action of PD-1 blockade in cHL. Cancer Immunol Res; 4(11); 910-6. ©2016 AACR.
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Affiliation(s)
- Margaretha G M Roemer
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Pathology, VU University Medical Center, Amsterdam, the Netherlands
| | | | - Robert A Redd
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Geraldine S Pinkus
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
| | | | - Azra H Ligon
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Courtney F Connelly
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Christine J Pak
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Christopher D Carey
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Sarah E Daadi
- Stanford University Medical Center, Stanford, California
| | - Bjoern Chapuy
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Daphne de Jong
- Department of Pathology, VU University Medical Center, Amsterdam, the Netherlands
| | | | - Donna S Neuberg
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Margaret A Shipp
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Scott J Rodig
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts.
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379
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Comprehensive characterization of programmed death ligand structural rearrangements in B-cell non-Hodgkin lymphomas. Blood 2016; 128:1206-13. [DOI: 10.1182/blood-2015-11-683003] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 05/29/2016] [Indexed: 12/11/2022] Open
Abstract
Key Points
Capture sequencing reveals that PDL SRs cluster into 2 discrete breakpoint regions. PDL SRs are significantly associated with increased protein expression and limit T-cell activation.
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380
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Abstract
Diffuse large B-cell lymphoma (DLBCL) is an aggressive disease with considerable heterogeneity reflected in the 2008 World Health Organization classification. In recent years, genome-wide assessment of genetic and epigenetic alterations has shed light upon distinct molecular subsets linked to dysregulation of specific genes or pathways. Besides fostering our knowledge regarding the molecular complexity of DLBCL types, these studies have unraveled previously unappreciated genetic lesions, which may be exploited for prognostic and therapeutic purposes. Following the last World Health Organization classification, we have witnessed the emergence of new variants of specific DLBCL entities, such as CD30 DLBCL, human immunodeficiency virus-related and age-related variants of plasmablastic lymphoma, and EBV DLBCL arising in young patients. In this review, we will present an update on the clinical, pathologic, and molecular features of DLBCL incorporating recently gained information with respect to their pathobiology and prognosis. We will emphasize the distinctive features of newly described or emerging variants and highlight advances in our understanding of entities presenting a diagnostic challenge, such as T-cell/histiocyte-rich large B-cell lmphoma and unclassifiable large B-cell lymphomas. Furthermore, we will discuss recent advances in the genomic characterization of DLBCL, as they may relate to prognostication and tailored therapeutic intervention. The information presented in this review derives from English language publications appearing in PubMed throughout December 2015. For a complete outline of this paper, please visit: http://links.lww.com/PAP/A12.
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381
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Genetic basis of PD-L1 overexpression in diffuse large B-cell lymphomas. Blood 2016; 127:3026-34. [DOI: 10.1182/blood-2015-12-686550] [Citation(s) in RCA: 134] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 03/17/2016] [Indexed: 12/16/2022] Open
Abstract
Key Points
Translocations between PD-L1 and the IGH locus represent a genetic mechanism of PD-L1 overexpression in DLBCL. Genetic alterations in the PD-L1/PDL-2 locus are mainly associated with the non-GCB subtype of DLBCL.
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382
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Emerging therapies provide new opportunities to reshape the multifaceted interactions between the immune system and lymphoma cells. Leukemia 2016; 30:1805-15. [PMID: 27389058 DOI: 10.1038/leu.2016.161] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 05/04/2016] [Accepted: 05/10/2016] [Indexed: 12/21/2022]
Abstract
The acquisition of a complete neoplastic phenotype requires cancer cells to develop escape mechanisms from the host immune system. This phenomenon, commonly referred to as 'immune evasion,' represents a hallmark of cancers and results from a Darwinian selection of the fittest tumor clones. First reported in solid tumors, cancer immunoescape characterizes several hematological malignancies. The biological bases of cancer immunoescape have recently been disclosed and include: (i) impaired human leukocyte antigen-mediated cancer cell recognition (B2M, CD58, CTIIA, CD80/CD86, CD28 and CTLA-4 mutations); (ii) deranged apoptotic mechanisms (reduced pro-apoptotic signals and/or increased expression of anti-apoptotic molecules); and (iii) changes in the tumor microenvironment involving regulatory T cells and tumor-associated macrophages. These immune-escape mechanisms characterize both Hodgkin and non-Hodgkin (B and T cell) lymphomas and represent a promising target for new anti-tumor therapies. In the present review, the principles of cancer immunoescape and their role in human lymphomagenesis are illustrated. Current therapies targeting these pathways and possible applications for lymphoma treatment are also addressed.
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383
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Houot R, Gaulard P, Schreiber R, Mellman I, Lambotte O, Coulie PG, Fest T, Korman A, Levy R, Shipp M, Tarte K, Kohrt H, Marabelle A, Ansell S, Watier H, van Elsas A, Balakumaran A, Arce Vargas F, Quezada SA, Salles G, Olive D. Immunomodulatory antibodies for the treatment of lymphoma: Report on the CALYM Workshop. Oncoimmunology 2016; 5:e1186323. [PMID: 27622041 DOI: 10.1080/2162402x.2016.1186323] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 04/26/2016] [Accepted: 04/30/2016] [Indexed: 01/21/2023] Open
Abstract
In November 2015, the CALYM Carnot Institute held a 2-d workshop to discuss the current and future development of immunomodulatory antibodies for the treatment of lymphoma. Highlights from the workshop are presented in this article.
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Affiliation(s)
- Roch Houot
- Department of Hematology, CHU de Rennes , Rennes, France
| | - Philippe Gaulard
- Department of Pathology, Inserm U955, Université Paris-Est, CHU Henri Mondor , Créteil, France
| | - Robert Schreiber
- Department of Pathology and Immunology, Washington University , St. Louis, MO, USA
| | | | - Olivier Lambotte
- Department of Clinical Immunology and Internal Medicine, Hospital Kremlin Bicêtre, Université Paris-Sud , Orsay, France
| | - Pierre G Coulie
- de Duve Institute, Université Catholique de Louvain , Brussels, Belgium
| | | | | | - Ronald Levy
- Stanford School of Medicine , Stanford, CA, USA
| | | | | | - Holbrook Kohrt
- Department of Medicine, Stanford School of Medicine , Stanford, CA, USA
| | | | - Stephen Ansell
- Division of Hematology , Mayo Clinic, Rochester, MN, USA
| | - Hervé Watier
- CHRU de Tours, Université François-Rabelais and CNRS, UMR7292 , Tours, France
| | | | | | | | | | - Gilles Salles
- Department of Hematology, Université Claude Bernard, Hospices Civils de Lyon , INSERM 1052 , Lyon, France
| | - Daniel Olive
- Inserm UMR 1068, Institut Paoli Calmettes, Aix Marseille Université , Marseille, France
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384
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Roemer MGM, Advani RH, Ligon AH, Natkunam Y, Redd RA, Homer H, Connelly CF, Sun HH, Daadi SE, Freeman GJ, Armand P, Chapuy B, de Jong D, Hoppe RT, Neuberg DS, Rodig SJ, Shipp MA. PD-L1 and PD-L2 Genetic Alterations Define Classical Hodgkin Lymphoma and Predict Outcome. J Clin Oncol 2016; 34:2690-7. [PMID: 27069084 DOI: 10.1200/jco.2016.66.4482] [Citation(s) in RCA: 560] [Impact Index Per Article: 70.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
PURPOSE Classical Hodgkin lymphomas (cHLs) include small numbers of malignant Reed-Sternberg cells within an extensive but ineffective inflammatory/immune cell infiltrate. In cHL, chromosome 9p24.1/PD-L1/PD-L2 alterations increase the abundance of the PD-1 ligands, PD-L1 and PD-L2, and their further induction through Janus kinase 2-signal transducers and activators of transcription signaling. The unique composition of cHL limits its analysis with high-throughput genomic assays. Therefore, the precise incidence, nature, and prognostic significance of PD-L1/PD-L2 alterations in cHL remain undefined. METHODS We used a fluorescent in situ hybridization assay to evaluate CD274/PD-L1 and PDCD1LG2/PD-L2 alterations in 108 biopsy specimens from patients with newly diagnosed cHL who were treated with the Stanford V regimen and had long-term follow-up. In each case, the frequency and magnitude of 9p24.1 alterations-polysomy, copy gain, and amplification-were determined, and the expression of PD-L1 and PD-L2 was evaluated by immunohistochemistry. We also assessed the association of 9p24.1 alterations with clinical parameters, which included stage (early stage I/II favorable risk, early stage unfavorable risk, advanced stage [AS] III/IV) and progression-free survival (PFS). RESULTS Ninety-seven percent of all evaluated cHLs had concordant alterations of the PD-L1 and PD-L2 loci (polysomy, 5% [five of 108]; copy gain, 56% [61 of 108]; amplification, 36% [39 of 108]). There was an association between PD-L1 protein expression and relative genetic alterations in this series. PFS was significantly shorter for patients with 9p24.1 amplification, and the incidence of 9p24.1 amplification was increased in patients with AS cHL. CONCLUSION PD-L1/PD-L2 alterations are a defining feature of cHL. Amplification of 9p24.1 is more common in patients with AS disease and associated with shorter PFS in this series. Further analyses of 9p24.1 alterations in patients treated with standard cHL induction regimens or checkpoint blockade are warranted.
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Affiliation(s)
- Margaretha G M Roemer
- Margaretha G.M. Roemer, Robert A. Redd, Heather Homer, Courtney F. Connelly, Gordon J. Freeman, Philippe Armand, Bjoern Chapuy, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Azra H. Ligon, Heather H. Sun, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer and Daphne de Jong, VU University Medical Center, Amsterdam, the Netherlands; and Ranjana H. Advani, Yasodha Natkunam, Sarah E. Daadi, and Richard T. Hoppe, Stanford University Medical Center, Stanford, CA
| | - Ranjana H Advani
- Margaretha G.M. Roemer, Robert A. Redd, Heather Homer, Courtney F. Connelly, Gordon J. Freeman, Philippe Armand, Bjoern Chapuy, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Azra H. Ligon, Heather H. Sun, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer and Daphne de Jong, VU University Medical Center, Amsterdam, the Netherlands; and Ranjana H. Advani, Yasodha Natkunam, Sarah E. Daadi, and Richard T. Hoppe, Stanford University Medical Center, Stanford, CA
| | - Azra H Ligon
- Margaretha G.M. Roemer, Robert A. Redd, Heather Homer, Courtney F. Connelly, Gordon J. Freeman, Philippe Armand, Bjoern Chapuy, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Azra H. Ligon, Heather H. Sun, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer and Daphne de Jong, VU University Medical Center, Amsterdam, the Netherlands; and Ranjana H. Advani, Yasodha Natkunam, Sarah E. Daadi, and Richard T. Hoppe, Stanford University Medical Center, Stanford, CA
| | - Yasodha Natkunam
- Margaretha G.M. Roemer, Robert A. Redd, Heather Homer, Courtney F. Connelly, Gordon J. Freeman, Philippe Armand, Bjoern Chapuy, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Azra H. Ligon, Heather H. Sun, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer and Daphne de Jong, VU University Medical Center, Amsterdam, the Netherlands; and Ranjana H. Advani, Yasodha Natkunam, Sarah E. Daadi, and Richard T. Hoppe, Stanford University Medical Center, Stanford, CA
| | - Robert A Redd
- Margaretha G.M. Roemer, Robert A. Redd, Heather Homer, Courtney F. Connelly, Gordon J. Freeman, Philippe Armand, Bjoern Chapuy, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Azra H. Ligon, Heather H. Sun, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer and Daphne de Jong, VU University Medical Center, Amsterdam, the Netherlands; and Ranjana H. Advani, Yasodha Natkunam, Sarah E. Daadi, and Richard T. Hoppe, Stanford University Medical Center, Stanford, CA
| | - Heather Homer
- Margaretha G.M. Roemer, Robert A. Redd, Heather Homer, Courtney F. Connelly, Gordon J. Freeman, Philippe Armand, Bjoern Chapuy, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Azra H. Ligon, Heather H. Sun, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer and Daphne de Jong, VU University Medical Center, Amsterdam, the Netherlands; and Ranjana H. Advani, Yasodha Natkunam, Sarah E. Daadi, and Richard T. Hoppe, Stanford University Medical Center, Stanford, CA
| | - Courtney F Connelly
- Margaretha G.M. Roemer, Robert A. Redd, Heather Homer, Courtney F. Connelly, Gordon J. Freeman, Philippe Armand, Bjoern Chapuy, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Azra H. Ligon, Heather H. Sun, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer and Daphne de Jong, VU University Medical Center, Amsterdam, the Netherlands; and Ranjana H. Advani, Yasodha Natkunam, Sarah E. Daadi, and Richard T. Hoppe, Stanford University Medical Center, Stanford, CA
| | - Heather H Sun
- Margaretha G.M. Roemer, Robert A. Redd, Heather Homer, Courtney F. Connelly, Gordon J. Freeman, Philippe Armand, Bjoern Chapuy, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Azra H. Ligon, Heather H. Sun, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer and Daphne de Jong, VU University Medical Center, Amsterdam, the Netherlands; and Ranjana H. Advani, Yasodha Natkunam, Sarah E. Daadi, and Richard T. Hoppe, Stanford University Medical Center, Stanford, CA
| | - Sarah E Daadi
- Margaretha G.M. Roemer, Robert A. Redd, Heather Homer, Courtney F. Connelly, Gordon J. Freeman, Philippe Armand, Bjoern Chapuy, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Azra H. Ligon, Heather H. Sun, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer and Daphne de Jong, VU University Medical Center, Amsterdam, the Netherlands; and Ranjana H. Advani, Yasodha Natkunam, Sarah E. Daadi, and Richard T. Hoppe, Stanford University Medical Center, Stanford, CA
| | - Gordon J Freeman
- Margaretha G.M. Roemer, Robert A. Redd, Heather Homer, Courtney F. Connelly, Gordon J. Freeman, Philippe Armand, Bjoern Chapuy, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Azra H. Ligon, Heather H. Sun, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer and Daphne de Jong, VU University Medical Center, Amsterdam, the Netherlands; and Ranjana H. Advani, Yasodha Natkunam, Sarah E. Daadi, and Richard T. Hoppe, Stanford University Medical Center, Stanford, CA
| | - Philippe Armand
- Margaretha G.M. Roemer, Robert A. Redd, Heather Homer, Courtney F. Connelly, Gordon J. Freeman, Philippe Armand, Bjoern Chapuy, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Azra H. Ligon, Heather H. Sun, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer and Daphne de Jong, VU University Medical Center, Amsterdam, the Netherlands; and Ranjana H. Advani, Yasodha Natkunam, Sarah E. Daadi, and Richard T. Hoppe, Stanford University Medical Center, Stanford, CA
| | - Bjoern Chapuy
- Margaretha G.M. Roemer, Robert A. Redd, Heather Homer, Courtney F. Connelly, Gordon J. Freeman, Philippe Armand, Bjoern Chapuy, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Azra H. Ligon, Heather H. Sun, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer and Daphne de Jong, VU University Medical Center, Amsterdam, the Netherlands; and Ranjana H. Advani, Yasodha Natkunam, Sarah E. Daadi, and Richard T. Hoppe, Stanford University Medical Center, Stanford, CA
| | - Daphne de Jong
- Margaretha G.M. Roemer, Robert A. Redd, Heather Homer, Courtney F. Connelly, Gordon J. Freeman, Philippe Armand, Bjoern Chapuy, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Azra H. Ligon, Heather H. Sun, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer and Daphne de Jong, VU University Medical Center, Amsterdam, the Netherlands; and Ranjana H. Advani, Yasodha Natkunam, Sarah E. Daadi, and Richard T. Hoppe, Stanford University Medical Center, Stanford, CA
| | - Richard T Hoppe
- Margaretha G.M. Roemer, Robert A. Redd, Heather Homer, Courtney F. Connelly, Gordon J. Freeman, Philippe Armand, Bjoern Chapuy, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Azra H. Ligon, Heather H. Sun, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer and Daphne de Jong, VU University Medical Center, Amsterdam, the Netherlands; and Ranjana H. Advani, Yasodha Natkunam, Sarah E. Daadi, and Richard T. Hoppe, Stanford University Medical Center, Stanford, CA
| | - Donna S Neuberg
- Margaretha G.M. Roemer, Robert A. Redd, Heather Homer, Courtney F. Connelly, Gordon J. Freeman, Philippe Armand, Bjoern Chapuy, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Azra H. Ligon, Heather H. Sun, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer and Daphne de Jong, VU University Medical Center, Amsterdam, the Netherlands; and Ranjana H. Advani, Yasodha Natkunam, Sarah E. Daadi, and Richard T. Hoppe, Stanford University Medical Center, Stanford, CA
| | - Scott J Rodig
- Margaretha G.M. Roemer, Robert A. Redd, Heather Homer, Courtney F. Connelly, Gordon J. Freeman, Philippe Armand, Bjoern Chapuy, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Azra H. Ligon, Heather H. Sun, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer and Daphne de Jong, VU University Medical Center, Amsterdam, the Netherlands; and Ranjana H. Advani, Yasodha Natkunam, Sarah E. Daadi, and Richard T. Hoppe, Stanford University Medical Center, Stanford, CA
| | - Margaret A Shipp
- Margaretha G.M. Roemer, Robert A. Redd, Heather Homer, Courtney F. Connelly, Gordon J. Freeman, Philippe Armand, Bjoern Chapuy, Donna S. Neuberg, and Margaret A. Shipp, Dana-Farber Cancer Institute; Azra H. Ligon, Heather H. Sun, and Scott J. Rodig, Brigham and Women's Hospital, Boston, MA; Margaretha G.M. Roemer and Daphne de Jong, VU University Medical Center, Amsterdam, the Netherlands; and Ranjana H. Advani, Yasodha Natkunam, Sarah E. Daadi, and Richard T. Hoppe, Stanford University Medical Center, Stanford, CA.
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