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Boieri M, Malishkevich A, Guennoun R, Marchese E, Kroon S, Trerice KE, Awad M, Park JH, Iyer S, Kreuzer J, Haas W, Rivera MN, Demehri S. CD4+ T helper 2 cells suppress breast cancer by inducing terminal differentiation. J Exp Med 2022; 219:213261. [PMID: 35657353 PMCID: PMC9170526 DOI: 10.1084/jem.20201963] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/18/2021] [Accepted: 04/27/2022] [Indexed: 12/12/2022] Open
Abstract
Cancer immunology research is largely focused on the role of cytotoxic immune responses against advanced cancers. Herein, we demonstrate that CD4+ T helper (Th2) cells directly block spontaneous breast carcinogenesis by inducing the terminal differentiation of the cancer cells. Th2 cell immunity, stimulated by thymic stromal lymphopoietin, caused the epigenetic reprogramming of the tumor cells, activating mammary gland differentiation and suppressing epithelial–mesenchymal transition. Th2 polarization was required for this tumor antigen–specific immunity, which persisted in the absence of CD8+ T and B cells. Th2 cells directly blocked breast carcinogenesis by secreting IL-3, IL-5, and GM-CSF, which signaled to their common receptor expressed on breast tumor cells. Importantly, Th2 cell immunity permanently reverted high-grade breast tumors into low-grade, fibrocystic-like structures. Our findings reveal a critical role for CD4+ Th2 cells in immunity against breast cancer, which is mediated by terminal differentiation as a distinct effector mechanism for cancer immunoprevention and therapy.
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Affiliation(s)
- Margherita Boieri
- Center for Cancer Immunology and Cutaneous Biology Research Center, Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, MA.,Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Anna Malishkevich
- Center for Cancer Immunology and Cutaneous Biology Research Center, Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, MA.,Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Ranya Guennoun
- Center for Cancer Immunology and Cutaneous Biology Research Center, Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, MA.,Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Emanuela Marchese
- Center for Cancer Immunology and Cutaneous Biology Research Center, Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, MA.,Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Sanne Kroon
- Center for Cancer Immunology and Cutaneous Biology Research Center, Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, MA.,Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Kathryn E Trerice
- Center for Cancer Immunology and Cutaneous Biology Research Center, Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, MA.,Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Mary Awad
- Center for Cancer Immunology and Cutaneous Biology Research Center, Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, MA.,Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Jong Ho Park
- Center for Cancer Immunology and Cutaneous Biology Research Center, Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, MA.,Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Sowmya Iyer
- Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School, Boston, MA.,Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Johannes Kreuzer
- Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School, Boston, MA.,Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Wilhelm Haas
- Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School, Boston, MA.,Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Miguel N Rivera
- Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School, Boston, MA.,Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Shadmehr Demehri
- Center for Cancer Immunology and Cutaneous Biology Research Center, Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, MA.,Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School, Boston, MA
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Beyond Genetics: Metastasis as an Adaptive Response in Breast Cancer. Int J Mol Sci 2022; 23:ijms23116271. [PMID: 35682953 PMCID: PMC9181003 DOI: 10.3390/ijms23116271] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/26/2022] [Accepted: 06/01/2022] [Indexed: 01/27/2023] Open
Abstract
Metastatic disease represents the primary cause of breast cancer (BC) mortality, yet it is still one of the most enigmatic processes in the biology of this tumor. Metastatic progression includes distinct phases: invasion, intravasation, hematogenous dissemination, extravasation and seeding at distant sites, micro-metastasis formation and metastatic outgrowth. Whole-genome sequencing analyses of primary BC and metastases revealed that BC metastatization is a non-genetically selected trait, rather the result of transcriptional and metabolic adaptation to the unfavorable microenvironmental conditions which cancer cells are exposed to (e.g., hypoxia, low nutrients, endoplasmic reticulum stress and chemotherapy administration). In this regard, the latest multi-omics analyses unveiled intra-tumor phenotypic heterogeneity, which determines the polyclonal nature of breast tumors and constitutes a challenge for clinicians, correlating with patient poor prognosis. The present work reviews BC classification and epidemiology, focusing on the impact of metastatic disease on patient prognosis and survival, while describing general principles and current in vitro/in vivo models of the BC metastatic cascade. The authors address here both genetic and phenotypic intrinsic heterogeneity of breast tumors, reporting the latest studies that support the role of the latter in metastatic spreading. Finally, the review illustrates the mechanisms underlying adaptive stress responses during BC metastatic progression.
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Yekedüz E, Dizdar Ö, Kertmen N, Aksoy S. Comparison of Clinical and Pathological Factors Affecting Early and Late Recurrences in Patients with Operable Breast Cancer. J Clin Med 2022; 11:jcm11092332. [PMID: 35566457 PMCID: PMC9105518 DOI: 10.3390/jcm11092332] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 04/07/2022] [Accepted: 04/20/2022] [Indexed: 11/16/2022] Open
Abstract
In this study, we aimed to assess clinicopathological factors affecting early and late recurrences in patients with operable breast cancer. Patients with early (≤5 years) and late (>5 years) recurrences were assessed. Prognostic factors for disease-free survival (DFS) were also evaluated in patients with recurrence. A total of 854 patients were included. There were 432 and 205 patients in the early and late recurrence groups, respectively. In multivariate analyses, HER2+ disease, lymph node metastasis, lymphovascular invasion (LVI), and high tumor grade were associated with increased risk of early recurrence, while HER2+ disease and LVI were associated with decreased risk of late recurrence. In multivariate analyses, presence of HER2+ disease and triple-negative breast cancer (TNBC) were poor prognostic factors for DFS in patients with early recurrence. Presence of LVI and perineural invasion (PNI) were poor prognostic factors for DFS in patients with late recurrence. Molecular subtypes and LVI were effective on the early and late recurrences. However, lymph node positivity and grade were only associated with the early recurrence. After 5 years, LVI and PNI were the prognostic factors for DFS.
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Affiliation(s)
- Emre Yekedüz
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara 06230, Turkey
- Correspondence:
| | - Ömer Dizdar
- Department of Medical Oncology, Hacettepe University School of Medicine, Ankara 06230, Turkey; (Ö.D.); (N.K.); (S.A.)
| | - Neyran Kertmen
- Department of Medical Oncology, Hacettepe University School of Medicine, Ankara 06230, Turkey; (Ö.D.); (N.K.); (S.A.)
| | - Sercan Aksoy
- Department of Medical Oncology, Hacettepe University School of Medicine, Ankara 06230, Turkey; (Ö.D.); (N.K.); (S.A.)
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Yun SG, An YY, Kim SH, Kang BJ. Early Recurrence of Breast Cancer after the Primary Treatment: Analysis of Clinicopathological and Radiological Predictive Factors. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2020; 81:395-408. [PMID: 36237380 PMCID: PMC9431821 DOI: 10.3348/jksr.2020.81.2.395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 08/01/2019] [Accepted: 08/12/2019] [Indexed: 12/09/2022]
Abstract
목적 유방암 일차치료 후 조기 재발 예측에 도움이 되는 임상병리학적 인자 및 원발암의 영상 의학적 특징을 알아보고자 하였다. 대상과 방법 본원에서 2010년 1월부터 2014년 12월까지 유방 보존 수술 및 보조요법 치료 후 추적관찰을 받은 480명을 대상으로 하였다. 일차치료 완결 후 3년 이내 재발한 경우를 조기 재발으로 정의하고, 이와 관련된 임상병리학적 및 영상의학적 예측인자를 알아보기 위해 단변량 및 다변량 로지스틱 회귀분석을 시행하였다. 결과 단변량 분석에서 임상병리학적 인자 중 높은 종양 병기(p=0.021), 고등급 조직학적 분화도(p < 0.001), estrogen receptor 수용체 음성(p=0.002), Ki-67 과발현(p=0.017), 삼중음성유방 아형(p=0.019)과, 영상 소견 중 유방암의 다초점성(p < 0.001), 도플러 검사에서 테두리 혈류(p=0.012), 자기공명영상에서 테두리 조영증강(p < 0.001)이 조기 재발과 유의한 연관성을 보였다. 다변량 분석에서 원발암의 높은 종양 병기[odds ratio (이하 OR) = 3.47, 95% confidence interval (이하 CI) 1.12~10.73, p=0.031]와 도플러 검사에서 테두리 혈류 (OR = 3.32, 95% CI 1.38~8.02,p=0.008)가 조기 재발과 관련된 독립적인 예측인자였다. 결론 유방암 치료 전 도플러 검사에서 원발암의 테두리 혈류 소견은 유방암의 일차치료 후 조기 재발의 독립적인 영상의학적 예측인자이다.
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Affiliation(s)
- Sun Geun Yun
- Department of Radiology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Yeong Yi An
- Department of Radiology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Sung Hun Kim
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Bong Joo Kang
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Avanzini S, Antal T. Cancer recurrence times from a branching process model. PLoS Comput Biol 2019; 15:e1007423. [PMID: 31751332 PMCID: PMC6871767 DOI: 10.1371/journal.pcbi.1007423] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 09/19/2019] [Indexed: 02/07/2023] Open
Abstract
As cancer advances, cells often spread from the primary tumor to other parts of the body and form metastases. This is the main cause of cancer related mortality. Here we investigate a conceptually simple model of metastasis formation where metastatic lesions are initiated at a rate which depends on the size of the primary tumor. The evolution of each metastasis is described as an independent branching process. We assume that the primary tumor is resected at a given size and study the earliest time at which any metastasis reaches a minimal detectable size. The parameters of our model are estimated independently for breast, colorectal, headneck, lung and prostate cancers. We use these estimates to compare predictions from our model with values reported in clinical literature. For some cancer types, we find a remarkably wide range of resection sizes such that metastases are very likely to be present, but none of them are detectable. Our model predicts that only very early resections can prevent recurrence, and that small delays in the time of surgery can significantly increase the recurrence probability.
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Affiliation(s)
- Stefano Avanzini
- School of Mathematics, University of Edinburgh, Edinburgh, United Kingdom
| | - Tibor Antal
- School of Mathematics, University of Edinburgh, Edinburgh, United Kingdom
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Rasmussen LA, Jensen H, Virgilsen LF, Falborg AZ, Møller H, Vedsted P. Time from incident primary cancer until recurrence or second primary cancer: Risk factors and impact in general practice. Eur J Cancer Care (Engl) 2019; 28:e13123. [PMID: 31231898 DOI: 10.1111/ecc.13123] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 05/15/2019] [Accepted: 05/24/2019] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Specialised follow-up care after cancer treatment is changing towards increased involvement of general practice. To ensure timely detection of new cancer events, knowledge is warranted on the timing of cancer recurrence (CR) and second primary cancer (SPC), including risk factors for CR. METHODS This population-based register study included 67,092 patients diagnosed with malignant melanoma, bladder, lung, ovarian, endometrial, colorectal and breast cancer in Denmark in 2008-2016. The time from primary cancer to CR or SPC and risk factors for prolonged time to CR were analysed and stratified on sex and primary cancer type. RESULTS Cancer recurrence proportions ranged from 6% to 35%. The risk of CR increased profoundly within the first 3 years and then levelled off, except for breast cancer. A total of 3%-6% of patients had SPC, with monotonously increasing cumulative incidence proportions. Besides primary tumour characteristics, lower educational level, living alone and comorbidity were associated with earlier CR. For example, in female malignant melanoma, HRs and 95% confidence intervals were 0.47 (0.37-0.61) for high educational level, 1.40 (1.16-1.68) for living alone and 2.38 (1.53-3.70) for high comorbidity. CONCLUSION The results may inform stratified risk assessment in decision of frequency, location and duration of post-cancer follow-up care.
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Affiliation(s)
- Linda Aagaard Rasmussen
- Research Centre for Cancer Diagnosis in Primary Care, Research Unit for General Practice, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Henry Jensen
- Research Centre for Cancer Diagnosis in Primary Care, Research Unit for General Practice, Aarhus, Denmark
| | - Line Flytkjaer Virgilsen
- Research Centre for Cancer Diagnosis in Primary Care, Research Unit for General Practice, Aarhus, Denmark
| | - Alina Zalounina Falborg
- Research Centre for Cancer Diagnosis in Primary Care, Research Unit for General Practice, Aarhus, Denmark
| | - Henrik Møller
- Research Centre for Cancer Diagnosis in Primary Care, Research Unit for General Practice, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Danish Clinical Registries (RKKP), Aarhus, Denmark
| | - Peter Vedsted
- Research Centre for Cancer Diagnosis in Primary Care, Research Unit for General Practice, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
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Alabdulkarim B, Hassanain M, Bokhari A, AlSaif A, Alkarji H. Age distribution and outcomes in patients undergoing breast cancer resection in Saudi Arabia. A single-institute study. Saudi Med J 2018; 39:464-469. [PMID: 29738005 PMCID: PMC6118188 DOI: 10.15537/smj.2018.5.21993] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Objectives In response to rising incidence and mortality we aimed to investigate the
demographic characteristics of patients with operative breast cancer in our
region. Methods We performed a retrospective study of 224 patients who underwent surgery for
breast cancer at King Saud University Medical City, Riyadh, Kingdom of Saudi
Arabia between 2005 and 2012. Results We identified a young population overall with a mean age of 48.8±12.2 years
(range: 26-93 years). Survival rate were however similar across all age groups
with a 10-year overall survival of 87%. Conclusion Patients in our study were generally younger than those with breast cancer in
Western nations. However, unlike Western countries, young age was not associated
with worse outcomes.
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Williams KE, Jawale RM, Schneider SS, Otis CN, Pentecost BT, Arcaro KF. DNA methylation in breast cancers: Differences based on estrogen receptor status and recurrence. J Cell Biochem 2018; 120:738-755. [DOI: 10.1002/jcb.27431] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 07/12/2018] [Indexed: 12/29/2022]
Affiliation(s)
- Kristin E. Williams
- Department of Molecular and Cellular Biology University of Massachusetts –Amherst Amherst Massachusetts
| | - Rahul M. Jawale
- Department of Pathology Baystate Medical Center Springfield Massachusetts
| | - Sallie S. Schneider
- Biospecimen Resource and Molecular Analysis Facility Baystate Medical Center Springfield Massachusetts
| | | | - Brian T. Pentecost
- Division of Translational Medicine Wadsworth Center, New York State Department of Health Albany New York
| | - Kathleen F. Arcaro
- Department of Veterinary and Animal Sciences University of Massachusetts – Amherst Amherst Massachusetts
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Shawky MS, Martin H, Hugo HJ, Lloyd T, Britt KL, Redfern A, Thompson EW. Mammographic density: a potential monitoring biomarker for adjuvant and preventative breast cancer endocrine therapies. Oncotarget 2018; 8:5578-5591. [PMID: 27894075 PMCID: PMC5354931 DOI: 10.18632/oncotarget.13484] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 10/08/2016] [Indexed: 11/25/2022] Open
Abstract
Increased mammographic density (MD) has been shown beyond doubt to be a marker for increased breast cancer risk, though the underpinning pathobiology is yet to be fully elucidated. Estrogenic activity exerts a strong influence over MD, which consequently has been observed to change predictably in response to tamoxifen anti-estrogen therapy, although results for other selective estrogen receptor modulators and aromatase inhibitors are less consistent. In both primary and secondary prevention settings, tamoxifen-associated MD changes correlate with successful modulation of risk or outcome, particularly among pre-menopausal women; an observation that supports the potential use of MD change as a surrogate marker where short-term MD changes reflect longer-term anti-estrogen efficacy. Here we summarize endocrine therapy-induced MD changes and attendant outcomes and discuss both the need for outcome surrogates in such therapy, as well as make a case for MD as such a monitoring marker. We then discuss the process and steps required to validate and introduce MD into practice as a predictor or surrogate for endocrine therapy efficacy in preventive and adjuvant breast cancer treatment settings.
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Affiliation(s)
- Michael S Shawky
- Department of Head and Neck and Endocrine Surgery, Faculty of Medicine, University of Alexandria, Egypt.,Department of Surgery, University College Hospital, London, UK
| | - Hilary Martin
- School of Medicine and Pharmacology, University of Western Australia, and Department of Medical Oncology, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Honor J Hugo
- Institute of Health and Biomedical Innovation and School of Biomedical Sciences, Queensland University of Technology, Australia.,Translational Research Institute, Brisbane, Australia
| | - Thomas Lloyd
- Department of Radiology, Princess Alexandra Hospital, Brisbane, Australia
| | - Kara L Britt
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia.,Peter MacCallum Cancer Centre, Melbourne, Australia.,Department of Anatomy and Developmental Biology, Monash University, Melbourne, Australia
| | - Andrew Redfern
- School of Medicine and Pharmacology, University of Western Australia, and Department of Medical Oncology, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Erik W Thompson
- Institute of Health and Biomedical Innovation and School of Biomedical Sciences, Queensland University of Technology, Australia.,Translational Research Institute, Brisbane, Australia.,Department of Surgery, University of Melbourne, St Vincent's Hospital, Melbourne, Australia
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