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Yang WJ, Zhao HP, Yu Y, Wang JH, Guo L, Liu JY, Pu J, Lv J. Updates on global epidemiology, risk and prognostic factors of gastric cancer. World J Gastroenterol 2023; 29:2452-2468. [PMID: 37179585 PMCID: PMC10167900 DOI: 10.3748/wjg.v29.i16.2452] [Citation(s) in RCA: 58] [Impact Index Per Article: 58.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 03/19/2023] [Accepted: 04/07/2023] [Indexed: 04/24/2023] Open
Abstract
Gastric cancer (GC) is defined as the primary epithelial malignancy derived from the stomach, and it is a complicated and heterogeneous disease with multiple risk factors. Despite its overall declining trend of incidence and mortality in various countries over the past few decades, GC remains the fifth most common malignancy and the fourth leading cause of cancer-related death globally. Although the global burden of GC has shown a significant downward trend, it remains severe in certain areas, such as Asia. GC ranks third in incidence and mortality among all cancer types in China, and it accounts for nearly 44.0% and 48.6% of new GC cases and GC-related deaths in the world, respectively. The regional differences in GC incidence and mortality are obvious, and annual new cases and deaths are increasing rapidly in some developing regions. Therefore, early preventive and screening strategies for GC are urgently needed. The clinical efficacies of conventional treatments for GC are limited, and the developing understanding of GC pathogenesis has increased the demand for new therapeutic regimens, including immune checkpoint inhibitors, cell immunotherapy and cancer vaccines. The present review describes the epidemiology of GC worldwide, especially in China, summarizes its risk and prognostic factors, and focuses on novel immunotherapies to develop therapeutic strategies for the management of GC patients.
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Affiliation(s)
- Wen-Juan Yang
- Department of Clinical Laboratory, Honghui Hospital, Xi'an Jiaotong University, Xi'an 710054, Shaanxi Province, China
| | - He-Ping Zhao
- Department of Clinical Laboratory, Honghui Hospital, Xi'an Jiaotong University, Xi'an 710054, Shaanxi Province, China
| | - Yan Yu
- Department of Clinical Laboratory, Honghui Hospital, Xi'an Jiaotong University, Xi'an 710054, Shaanxi Province, China
| | - Ji-Han Wang
- Institute of Medical Research, Northwestern Polytechnical University, Xi'an 710072, Shaanxi Province, China
| | - Lei Guo
- Department of Spinal Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an 710054, Shaanxi Province, China
| | - Jun-Ye Liu
- Department of Clinical Laboratory, Honghui Hospital, Xi'an Jiaotong University, Xi'an 710054, Shaanxi Province, China
| | - Jie Pu
- Department of Cardiology, Shaanxi Provincial People’s Hospital, Xi'an 710068, Shaanxi Province, China
| | - Jing Lv
- Department of Clinical Laboratory, Honghui Hospital, Xi'an Jiaotong University, Xi'an 710054, Shaanxi Province, China
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2
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Russo L, Avesani G, Gui B, Trombadori CML, Salutari V, Perri MT, Di Paola V, Rodolfino E, Scambia G, Manfredi R. Immunotherapy-Related Imaging Findings in Patients with Gynecological Malignancies: What Radiologists Need to Know. Korean J Radiol 2021; 22:1310-1322. [PMID: 34047505 PMCID: PMC8316780 DOI: 10.3348/kjr.2020.1299] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 01/26/2021] [Accepted: 03/05/2021] [Indexed: 01/15/2023] Open
Abstract
Immunotherapy is an effective treatment option for gynecological malignancies. Radiologists dealing with gynecological patients undergoing treatment with immune checkpoint inhibitors should be aware of unconventional immune-related imaging features for the evaluation of tumor response and immune-related adverse events. In this paper, immune checkpoint inhibitors used for gynecological malignancies and their mechanisms of action are briefly presented. In the second part, patterns of pseudoprogression are illustrated, and different forms of immune-related adverse events are discussed.
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Affiliation(s)
- Luca Russo
- UOC Radiologia Generale ed Interventistica Generale, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Area Diagnostica per Immagini, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giacomo Avesani
- UOC Radiologia Generale ed Interventistica Generale, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Area Diagnostica per Immagini, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Benedetta Gui
- UOC Radiologia Generale ed Interventistica Generale, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Area Diagnostica per Immagini, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
| | | | - Vanda Salutari
- UOC Ginecologia Oncologica, Dipartimento per la Salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Maria Teresa Perri
- Istituto di Ginecologia e Ostetricia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Valerio Di Paola
- UOC Radiologia Generale ed Interventistica Generale, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Area Diagnostica per Immagini, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Elena Rodolfino
- UOC Radiologia Generale ed Interventistica Generale, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Area Diagnostica per Immagini, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giovanni Scambia
- UOC Ginecologia Oncologica, Dipartimento per la Salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Istituto di Ginecologia e Ostetricia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Riccardo Manfredi
- UOC Radiologia Generale ed Interventistica Generale, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Area Diagnostica per Immagini, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento Universitario di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
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Batchu RB, Gruzdyn OV, Kolli BK, Dachepalli R, Umar PS, Rai SK, Singh N, Tavva PS, Weaver DW, Gruber SA. IL-10 Signaling in the Tumor Microenvironment of Ovarian Cancer. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1290:51-65. [PMID: 33559854 DOI: 10.1007/978-3-030-55617-4_3] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Unlike other malignancies, ovarian cancer (OC) creates a complex tumor microenvironment with distinctive peritoneal ascites consisting of a mixture of several immunosuppressive cells which impair the ability of the patient's immune system to fight the disease. The poor survival rates observed in advanced stage OC patients and the lack of effective conventional therapeutic options have been attributed in large part to the immature dendritic cells (DCs), IL-10 secreting regulatory T cells, tumor-associated macrophages, myeloid-derived suppressor cells, and cancer stem cells that secrete inhibitory cytokines. This review highlights the critical role played by the intraperitoneal presence of IL-10 in the generation of an immunosuppressive tumor microenvironment. Further, the effect of antibody neutralization of IL-10 on the efficacy of DC and chimeric antigen receptor T-cell vaccines will be discussed. Moreover, we will review the influence of IL-10 in the promotion of cancer stemness in concert with the NF-κB signaling pathway with regard to OC progression. Finally, understanding the role of IL-10 and its crosstalk with various cells in the ascitic fluid may contribute to the development of novel immunotherapeutic approaches with the potential to kill drug-resistant OC cells while minimizing toxic side effects.
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Affiliation(s)
- Ramesh B Batchu
- Wayne State University School of Medicine, Detroit, MI, USA. .,John D. Dingell VA Medical Center, Detroit, MI, USA.
| | - Oksana V Gruzdyn
- Wayne State University School of Medicine, Detroit, MI, USA.,John D. Dingell VA Medical Center, Detroit, MI, USA
| | - Bala K Kolli
- Wayne State University School of Medicine, Detroit, MI, USA.,John D. Dingell VA Medical Center, Detroit, MI, USA.,Med Manor Organics Pvt. Ltd., Hyderabad, India
| | | | - Prem S Umar
- Med Manor Organics Pvt. Ltd., Hyderabad, India
| | | | | | | | | | - Scott A Gruber
- Wayne State University School of Medicine, Detroit, MI, USA.,John D. Dingell VA Medical Center, Detroit, MI, USA
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4
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Pawłowska A, Suszczyk D, Tarkowski R, Paduch R, Kotarski J, Wertel I. Programmed Death-1 Receptor (PD-1) as a Potential Prognosis Biomarker for Ovarian Cancer Patients. Cancer Manag Res 2020; 12:9691-9709. [PMID: 33116828 PMCID: PMC7548235 DOI: 10.2147/cmar.s263010] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 09/03/2020] [Indexed: 12/25/2022] Open
Abstract
Aim Ovarian cancer (OC) is one of the most lethal gynecological malignancies. Recent studies suggest a crucial role of the PD-1/PD-L1 pathway in OC pathogenesis. Therefore, our study aimed at evaluation of the clinical importance of PD-1 expression in ovarian cancer patients. Patients and Methods In this study, we investigated the role of PD-1 in OC patients (n=50) by analyzing its expression on CD4+ and CD8+ T cells in three OC environments: peripheral blood (PB), peritoneal fluid (PF), and tumor (TT) as well as soluble PD-1 (sPD-1) in plasma and PF in terms of their clinical and prognostic significance. T cells with PD-1 expression were analyzed using flow cytometry. The concentration of sPD-1 was determined with the use of ELISA. Our research demonstrated differences in PD-1 expression on CD4+ and CD8+ T cells in the OC environments. Results We found an elevated level of CD4+PD-1+ T cells in tumor and PF, compared to PB. Additionally, we found the highest percentage of CD8+ PD-1+ in tumor, compared to PB and PF. The levels of sPD-1 were higher (p<0.0001) in plasma than in PF. For the first time, we discovered that the higher level of CD4+PD-1+ T cells in the circulation and the higher sPD-1 level in plasma predict poor survival of OC patients. Conclusion We suggest that PD-1 could be a predictive biomarker for OC patients and successful immunotherapy.
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Affiliation(s)
- Anna Pawłowska
- Independent Laboratory of Cancer Diagnostics and Immunology, I Chair and Department of Oncological Gynaecology and Gynaecology, Medical University of Lublin, Lublin 20-081, Poland
| | - Dorota Suszczyk
- Independent Laboratory of Cancer Diagnostics and Immunology, I Chair and Department of Oncological Gynaecology and Gynaecology, Medical University of Lublin, Lublin 20-081, Poland
| | - Rafał Tarkowski
- I Chair and Department of Oncological Gynaecology and Gynaecology, Medical University of Lublin, Lublin 20-081, Poland
| | - Roman Paduch
- Department of Virology and Immunology, Maria Curie-Sklodowska University, Lublin 20-033, Poland
| | - Jan Kotarski
- I Chair and Department of Oncological Gynaecology and Gynaecology, Medical University of Lublin, Lublin 20-081, Poland
| | - Iwona Wertel
- Independent Laboratory of Cancer Diagnostics and Immunology, I Chair and Department of Oncological Gynaecology and Gynaecology, Medical University of Lublin, Lublin 20-081, Poland
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5
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Brunekreeft KL, Paijens ST, Wouters MC, Komdeur FL, Eggink FA, Lubbers JM, Workel HH, Van Der Slikke EC, Pröpper NE, Leffers N, Adam J, Pijper H, Plat A, Kol A, Nijman HW, De Bruyn M. Deep immune profiling of ovarian tumors identifies minimal MHC-I expression after neoadjuvant chemotherapy as negatively associated with T-cell-dependent outcome. Oncoimmunology 2020; 9:1760705. [PMID: 32923120 PMCID: PMC7458665 DOI: 10.1080/2162402x.2020.1760705] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 01/30/2020] [Indexed: 12/12/2022] Open
Abstract
Epithelial Ovarian cancer (EOC) is the most lethal gynecological malignancy and has limited curative therapeutic options. Immunotherapy for EOC is promising, but clinical efficacy remains restricted to a small percentage of patients. Several lines of evidence suggest that the low response rate might be improved by combining immunotherapy with carboplatin and paclitaxel, the standard-of-care chemotherapy for EOC. Here, we assessed the immune contexture of EOC tumors, draining lymph nodes, and peripheral blood mononuclear cells during carboplatin/paclitaxel chemotherapy. We observed that the immune contexture of EOC patients is defined by the tissue of origin, independent of exposure to chemotherapy. Summarized, draining lymph nodes were characterized by a quiescent microenvironment composed of mostly non-proliferating naïve CD4 + T cells. Circulating T cells shared phenotypic features of both lymph nodes and tumor-infiltrating immune cells. Immunologically 'hot' ovarian tumors were characterized by ICOS, GITR, and PD-1 expression on CD4 + and CD8 + cells, independent of chemotherapy. The presence of PD-1 + cells in tumors prior to, but not after, chemotherapy was associated with disease-specific survival (DSS). Accordingly, we observed high MHC-I expression in tumors prior to chemotherapy, but minimal MHC-I expression in tumors after neoadjuvant chemotherapy, even though there were no differences in the number of tumor-infiltrating lymphocytes (TIL) in both groups. We therefore speculate that the TIL influx into the chemotherapy tumor microenvironment may be a consequence of the general inflammatory nature of chemotherapy-experienced tumors. Strategies to upregulate MHC-I during or after neoadjuvant chemotherapy may thus improve treatment outcome in these patients.
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Affiliation(s)
- Kim L. Brunekreeft
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Sterre T. Paijens
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, The Netherlands
| | | | - Fenne L. Komdeur
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Florine A. Eggink
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Joyce M. Lubbers
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Hagma H. Workel
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Elisabeth C. Van Der Slikke
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Noor E.J. Pröpper
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Ninke Leffers
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Julien Adam
- Department of Clinical Biology, Institut De Cancérologie Gustave Roussy, Paris, France
| | - Harry Pijper
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Annechien Plat
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Arjan Kol
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Hans W. Nijman
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Marco De Bruyn
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, The Netherlands
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6
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Abstract
Epithelial ovarian cancer (EOC) is the fifth most common cause of cancer mortality among women. At present, EOC is treated with one or in a combination of treatments, commonly debulking surgery, combining a platinum-based and a taxane-based therapy; however, the patients have a risk of injury to the bowel, bladder, ureter, and vessels during surgery and many of them suffer from severe adverse effects caused by chemotherapy. Pharmaceutical inhibition of cyclooxygenase (COX) might be an important therapeutic tool in cancer treatment, as COX contributes to cancer progression by upregulating the levels of downstream metabolites. In this review article, we have discussed the role of COX in cancer progression and the therapeutic use of COX inhibitors in the treatment of EOC with subsequent clinical studies and future management. Usually, gonadotropins can promote prostaglandin E2 production in EOC cells via COX-1 and -2 upregulations through the PI3K/AKT signaling pathway. Several reports have shown that treatment of EOC cells with COX-1- and COX-2-specific inhibitors exhibits a therapeutic effect on EOC both in vitro and in vivo. However, more clinical investigations are needed to develop therapeutic COX inhibitors for the prevention and treatment of EOC without adverse effects.
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7
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Pawłowska A, Suszczyk D, Okła K, Barczyński B, Kotarski J, Wertel I. Immunotherapies based on PD-1/PD-L1 pathway inhibitors in ovarian cancer treatment. Clin Exp Immunol 2019; 195:334-344. [PMID: 30582756 PMCID: PMC6378380 DOI: 10.1111/cei.13255] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2018] [Indexed: 12/12/2022] Open
Abstract
Immunotherapies based on anti-programmed death 1/programmed death ligand 1 (PD-1/PD-L1) pathway inhibitors may turn out effective in ovarian cancer (OC) treatment. They can be used in combination with standard therapy and are especially promising in recurrent and platinum-resistant OC. There is growing evidence that the mechanism of the PD-1/PD-L1 pathway can be specific for a particular histological cancer type. Interestingly, the data have shown that the PD-1/PD-L1 pathway blockade may be effective, especially in the endometrioid type of OC. It is important to identify the cause of anti-tumor immune response suppression and exclude its other mechanisms in OC patients. It is also necessary to conduct subsequent studies to confirm in which OC cases the treatment is effective and how to select patients and combine drugs to improve patient survival.
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Affiliation(s)
- A. Pawłowska
- Tumor Immunology Laboratory, 1st Chair and Department of Oncological Gynaecology and GynaecologyMedical University of LublinLublinPoland
| | - D. Suszczyk
- Tumor Immunology Laboratory, 1st Chair and Department of Oncological Gynaecology and GynaecologyMedical University of LublinLublinPoland
| | - K. Okła
- Tumor Immunology Laboratory, 1st Chair and Department of Oncological Gynaecology and GynaecologyMedical University of LublinLublinPoland
| | - B. Barczyński
- Tumor Immunology Laboratory, 1st Chair and Department of Oncological Gynaecology and GynaecologyMedical University of LublinLublinPoland
| | - J. Kotarski
- Tumor Immunology Laboratory, 1st Chair and Department of Oncological Gynaecology and GynaecologyMedical University of LublinLublinPoland
| | - I. Wertel
- Tumor Immunology Laboratory, 1st Chair and Department of Oncological Gynaecology and GynaecologyMedical University of LublinLublinPoland
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8
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Yin L, Cai Z, Zhu B, Xu C. Identification of Key Pathways and Genes in the Dynamic Progression of HCC Based on WGCNA. Genes (Basel) 2018; 9:genes9020092. [PMID: 29443924 PMCID: PMC5852588 DOI: 10.3390/genes9020092] [Citation(s) in RCA: 109] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 02/04/2018] [Accepted: 02/08/2018] [Indexed: 02/06/2023] Open
Abstract
Hepatocellular carcinoma (HCC) is a devastating disease worldwide. Though many efforts have been made to elucidate the process of HCC, its molecular mechanisms of development remain elusive due to its complexity. To explore the stepwise carcinogenic process from pre-neoplastic lesions to the end stage of HCC, we employed weighted gene co-expression network analysis (WGCNA) which has been proved to be an effective method in many diseases to detect co-expressed modules and hub genes using eight pathological stages including normal, cirrhosis without HCC, cirrhosis, low-grade dysplastic, high-grade dysplastic, very early and early, advanced HCC and very advanced HCC. Among the eight consecutive pathological stages, five representative modules are selected to perform canonical pathway enrichment and upstream regulator analysis by using ingenuity pathway analysis (IPA) software. We found that cell cycle related biological processes were activated at four neoplastic stages, and the degree of activation of the cell cycle corresponded to the deterioration degree of HCC. The orange and yellow modules enriched in energy metabolism, especially oxidative metabolism, and the expression value of the genes decreased only at four neoplastic stages. The brown module, enriched in protein ubiquitination and ephrin receptor signaling pathways, correlated mainly with the very early stage of HCC. The darkred module, enriched in hepatic fibrosis/hepatic stellate cell activation, correlated with the cirrhotic stage only. The high degree hub genes were identified based on the protein-protein interaction (PPI) network and were verified by Kaplan-Meier survival analysis. The novel five high degree hub genes signature that was identified in our study may shed light on future prognostic and therapeutic approaches. Our study brings a new perspective to the understanding of the key pathways and genes in the dynamic changes of HCC progression. These findings shed light on further investigations.
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Affiliation(s)
- Li Yin
- College of Life Science, Henan Normal University, Xinxiang 453007, Henan, China.
- State Key Laboratory Cultivation Base for Cell Differentiation Regulation and Henan Engineering Laboratory for Bioengineering and Drug Development, Henan Normal University, Xinxiang 453007, Henan, China.
- Luohe Medical College, Luohe 462002, Henan, China.
| | - Zhihui Cai
- Luohe Medical College, Luohe 462002, Henan, China.
| | - Baoan Zhu
- Luohe Medical College, Luohe 462002, Henan, China.
| | - Cunshuan Xu
- College of Life Science, Henan Normal University, Xinxiang 453007, Henan, China.
- State Key Laboratory Cultivation Base for Cell Differentiation Regulation and Henan Engineering Laboratory for Bioengineering and Drug Development, Henan Normal University, Xinxiang 453007, Henan, China.
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9
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Worzfeld T, Finkernagel F, Reinartz S, Konzer A, Adhikary T, Nist A, Stiewe T, Wagner U, Looso M, Graumann J, Müller R. Proteotranscriptomics Reveal Signaling Networks in the Ovarian Cancer Microenvironment. Mol Cell Proteomics 2017; 17:270-289. [PMID: 29141914 PMCID: PMC5795391 DOI: 10.1074/mcp.ra117.000400] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Indexed: 01/17/2023] Open
Abstract
Ovarian cancer is characterized by early transcoelomic metastatic spread via the peritoneal fluid, where tumor cell spheroids (TU), tumor-associated T cells (TAT), and macrophages (TAM) create a unique microenvironment promoting cancer progression, chemoresistance, and immunosuppression. However, the underlying signaling mechanisms remain largely obscure. To chart these signaling networks, we performed comprehensive proteomic and transcriptomic analyses of TU, TAT, and TAM from ascites of ovarian cancer patients. We identify multiple intercellular signaling pathways driven by protein or lipid mediators that are associated with clinical outcome. Beyond cytokines, chemokines and growth factors, these include proteins of the extracellular matrix, immune checkpoint regulators, complement factors, and a prominent network of axon guidance molecules of the ephrin, semaphorin, and slit families. Intriguingly, both TU and TAM from patients with a predicted short survival selectively produce mediators supporting prometastatic events, including matrix remodeling, stemness, invasion, angiogenesis, and immunosuppression, whereas TAM associated with a longer survival express cytokines linked to effector T-cell chemoattraction and activation. In summary, our study uncovers previously unrecognized signaling networks in the ovarian cancer microenvironment that are of potential clinical relevance.
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Affiliation(s)
- Thomas Worzfeld
- From the ‡Institute of Pharmacology, Biochemical-Pharmacological Center (BPC), Philipps University, Marburg, Germany 35043; .,§Department of Pharmacology, Max-Planck-Institute for Heart and Lung Research, Bad Nauheim, Germany 61231
| | - Florian Finkernagel
- ¶Institute of Molecular Biology and Tumor Research (IMT), Center for Tumor Biology and Immunology (ZTI), Philipps University, Marburg, Germany 35043
| | - Silke Reinartz
- ‖Clinic for Gynecology, Gynecological Oncology and Gynecological Endocrinology, Center for Tumor Biology and Immunology (ZTI), Philipps University, Marburg, Germany 35043
| | - Anne Konzer
- **Biomolecular Mass Spectrometry, Max-Planck-Institute for Heart and Lung Research, Bad Nauheim, Germany 61231
| | - Till Adhikary
- ¶Institute of Molecular Biology and Tumor Research (IMT), Center for Tumor Biology and Immunology (ZTI), Philipps University, Marburg, Germany 35043
| | - Andrea Nist
- ‡‡Genomics Core Facility, Center for Tumor Biology and Immunology (ZTI), Philipps University, Marburg, Germany 35043
| | - Thorsten Stiewe
- ‡‡Genomics Core Facility, Center for Tumor Biology and Immunology (ZTI), Philipps University, Marburg, Germany 35043
| | - Uwe Wagner
- §§Clinic for Gynecology, Gynecological Oncology and Gynecological Endocrinology, University Hospital of Giessen and Marburg (UKGM), Marburg, Germany 35043
| | - Mario Looso
- ¶¶Bioinformatics, Max-Planck-Institute for Heart and Lung Research, Bad Nauheim, Germany 61231
| | - Johannes Graumann
- **Biomolecular Mass Spectrometry, Max-Planck-Institute for Heart and Lung Research, Bad Nauheim, Germany 61231
| | - Rolf Müller
- ¶Institute of Molecular Biology and Tumor Research (IMT), Center for Tumor Biology and Immunology (ZTI), Philipps University, Marburg, Germany 35043;
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10
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Zhu X, Lang J. Programmed death-1 pathway blockade produces a synergistic antitumor effect: combined application in ovarian cancer. J Gynecol Oncol 2017; 28:e64. [PMID: 28657225 PMCID: PMC5540723 DOI: 10.3802/jgo.2017.28.e64] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 01/09/2017] [Accepted: 05/18/2017] [Indexed: 02/08/2023] Open
Abstract
Programmed death-1 (PD-1) and its ligand are part of the immune checkpoint pathway that down-regulates effector T cells in immune response, thereby causing immune suppression. The PD-1/programmed death-ligand 1 (PD-L1) pathway can be blocked by antibodies to reverse tumor-mediated immunosuppression. However, advanced cancers such as stage III-IV ovarian cancer (OC) and certain types such as ID8 OC (a clone of C57BL/6 mouse OC) may hijack the PD-1/PD-L1 pathway to escape immune attack. When combined with chemotherapy, radiotherapy, targeted therapy, immunotherapy, or other agents, these PD-1/PD-L1 pathway blockages can produce a synergistic antitumor response in OC. Combined immunotherapy significantly prolongs overall survival by changing the tumor microenvironment through processes such as increasing the number of CD4⁺ or CD8⁺ T cells or cytokines in mice with OC and decreasing the number of regulatory T cells (Tregs) and myeloid-derived suppressor cells (MDSCs). OC patients treated with combined immunotherapy received better prognoses than those treated with monotherapy. This review reflects the move toward novel therapy combinations for OC and discusses these promising immunotherapeutic approaches, which are more cost-effective and effective than other approaches.
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Affiliation(s)
- Xinxin Zhu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jinghe Lang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
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11
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Su M, Huang CX, Dai AP. Immune Checkpoint Inhibitors: Therapeutic Tools for Breast Cancer. Asian Pac J Cancer Prev 2017; 17:905-10. [PMID: 27039716 DOI: 10.7314/apjcp.2016.17.3.905] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Breast cancer is one of the major threats to female health, and its incidence is rapidly increasing in many countries. Currently, breast cancer is treated with surgery, followed by chemotherapy or radiation therapy, or both. However, a substantial proportion of breast cancer patients might have a risk for local relapse that leads to recurrence of their disease and/or metastatic breast cancer. Therefore searching for new and potential strategies for breast cancer treatment remains necessary. Immunotherapy is an attractive and promising approach that can exploit the ability of the immune system to identify and destroy tumors and thus prevent recurrence and metastatic lesions. The most promising and attractive approach of immunotherapeutic research in cancer is the blockade of immune checkpoints. In this review, we discuss the potential of certain inhibitors of immune checkpoints, such as antibodies targeting cytotoxic T-lymphocyte antigen 4 (CTLA-4), programmed death 1 (PD-1) and lymphocyte activation gene-3 (LAG-3), in breast cancer therapeutics. Immune checkpoint inhibitors may represent future standards of care for breast cancer as monotherapy or combined with standard therapies.
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Affiliation(s)
- Min Su
- Department of Human Anatomy, Histology and Embryology, Institute of Neuroscience, Changsha Medical University, Changsha, Hunan, China E-mail :
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Hefner J, Csef H. The Clinical Relevance of Beta Blockers in Ovarian Carcinoma: A Systematic Review. Geburtshilfe Frauenheilkd 2016; 76:1050-1056. [PMID: 27761025 DOI: 10.1055/s-0042-115016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The last ten years have seen hardly any improvement in the prognosis of ovarian carcinoma. There is a great need for new treatment strategies, and a recent retrospective study showing a survival advantage with the use of beta blockers met with a very positive response. This systematic review summarizes the current state of knowledge and research on the topic: A database analysis identified six clinical studies showing inconsistent results with respect to the administration of beta blockers and disease course. The 13 preclinical studies identified showed almost without exception both that catecholamines had detrimental effects on tumour progression, and that these effects could be influenced by pharmacological blockade. Overall the available evidence does not justify the use of beta blockers in clinical practice for ovarian carcinoma at the present time. This article also outlines details of research design required for further studies needed on the subject. Preclinical research findings are however very impressive: They not only form an important basis for the development of future clinical studies but also, through revealing new pathomechanisms, they already make an important contribution towards the development of new treatment strategies for ovarian carcinoma.
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Affiliation(s)
- J Hefner
- Arbeitsbereich Psychosomatische Medizin und Psychotherapie, Medizinische Klinik und Poliklinik II, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - H Csef
- Arbeitsbereich Psychosomatische Medizin und Psychotherapie, Medizinische Klinik und Poliklinik II, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
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Tan H, He Q, Gong G, Wang Y, Li J, Wang J, Zhu D, Wu X. miR-382 inhibits migration and invasion by targeting ROR1 through regulating EMT in ovarian cancer. Int J Oncol 2016; 48:181-90. [PMID: 26575700 DOI: 10.3892/ijo.2015.3241] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 10/06/2015] [Indexed: 12/23/2022] Open
Abstract
Increasing evidence suggests that microRNAs (miRNAs) play a critical role in tumorigenesis. Decreased expression of miR‑382 has been observed in various types of cancers. However, the biological function of miRNA-382 in ovarian cancer is still largely unknown. Here, we found miR‑382 was downregulated in human ovarian cancer tissues and cell lines. miR‑382 inhibited ovarian cancer cell proliferation, migration, invasion and the epithelial-mesenchymal transition (EMT). Furthermore, we identified receptor tyrosine kinase orphan receptor 1 (ROR1) as a target of miR‑382, and miR‑382 rescued the promotion effect of ROR1 on migration, invasion and EMT process in SKOV3 and COV434 cells. Collectively, these findings revealed that miR‑382 inhibits migration and invision by targeting ROR1 through regulating EMT in ovarian cancer, and might serve as a tumor suppressor in ovarian cancer.
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Affiliation(s)
- Hong Tan
- Department of Pathology, School of Basic Medical Science, Central South University, Changsha, Hunan 410013, P.R. China
| | - Qingnan He
- Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China
| | - Guanhui Gong
- Department of Pathology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Yixuan Wang
- Department of Pathology, School of Basic Medical Science, Central South University, Changsha, Hunan 410013, P.R. China
| | - Juanni Li
- Department of Pathology, School of Basic Medical Science, Central South University, Changsha, Hunan 410013, P.R. China
| | - Junpu Wang
- Department of Pathology, School of Basic Medical Science, Central South University, Changsha, Hunan 410013, P.R. China
| | - Ding Zhu
- Department of Pathology, School of Basic Medical Science, Central South University, Changsha, Hunan 410013, P.R. China
| | - Xiaoying Wu
- Department of Pathology, School of Basic Medical Science, Central South University, Changsha, Hunan 410013, P.R. China
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Strategies and Advancements in Harnessing the Immune System for Gastric Cancer Immunotherapy. J Immunol Res 2015; 2015:308574. [PMID: 26579545 PMCID: PMC4633567 DOI: 10.1155/2015/308574] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 10/05/2015] [Indexed: 12/12/2022] Open
Abstract
In cancer biology, cells and molecules that form the fundamental components of the tumor microenvironment play a major role in tumor initiation, and progression as well as responses to therapy. Therapeutic approaches that would enable and harness the immune system to target tumor cells mark the future of anticancer therapy as it could induce an immunological memory specific to the tumor type and further enhance tumor regression and relapse-free survival in cancer patients. Gastric cancer is one of the leading causes of cancer-related mortalities that has a modest survival benefit from existing treatment options. The advent of immunotherapy presents us with new approaches in gastric cancer treatment where adaptive cell therapies, cancer vaccines, and antibody therapies have all been used with promising outcomes. In this paper, we review the current advances and prospects in the gastric cancer immunotherapy. Special focus is laid on new strategies and clinical trials that attempt to enhance the efficacy of various immunotherapeutic modalities in gastric cancer.
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Chen YL, Chou CY, Chang MC, Lin HW, Huang CT, Hsieh SF, Chen CA, Cheng WF. IL17a and IL21 combined with surgical status predict the outcome of ovarian cancer patients. Endocr Relat Cancer 2015; 22:703-11. [PMID: 26150382 DOI: 10.1530/erc-15-0145] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/06/2015] [Indexed: 12/19/2022]
Abstract
Aside from tumor cells, ovarian cancer-related ascites contains the immune components. The aim of this study was to evaluate whether a combination of clinical and immunological parameters can predict survival in patients with ovarian cancer. Ascites specimens and medical records from 144 ovarian cancer patients at our hospital were used as the derivation group to select target clinical and immunological factors to generate a risk-scoring system to predict patient survival. Eighty-two cases from another hospital were used as the validation group to evaluate this system. The surgical status and expression levels of interleukin 17a (IL17a) and IL21 in ascites were selected for the risk-scoring system in the derivation group. The areas under the receiver operating characteristic (AUROC) curves of the overall score for disease-free survival (DFS) of the ovarian cancer patients were 0.84 in the derivation group, 0.85 in the validation group, and 0.84 for all the patients. The AUROC curves of the overall score for overall survival (OS) of cases were 0.78 in the derivation group, 0.76 in the validation group, and 0.76 for all the studied patients. Good correlations between overall risk score and survival of the ovarian cancer patients were demonstrated by sub-grouping all participants into four groups (P for trend <0.001 for DFS and OS). Therefore, acombination of clinical and immunological parameters can provide a practical scoring system to predict the survival of patients with ovarian carcinoma. IL17a and IL21 can potentially be used as prognostic and therapeutic biomarkers.
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MESH Headings
- Adenocarcinoma, Clear Cell/metabolism
- Adenocarcinoma, Clear Cell/mortality
- Adenocarcinoma, Clear Cell/pathology
- Adenocarcinoma, Clear Cell/surgery
- Adenocarcinoma, Mucinous/metabolism
- Adenocarcinoma, Mucinous/mortality
- Adenocarcinoma, Mucinous/pathology
- Adenocarcinoma, Mucinous/surgery
- Biomarkers, Tumor/metabolism
- Cystadenocarcinoma, Serous/metabolism
- Cystadenocarcinoma, Serous/mortality
- Cystadenocarcinoma, Serous/pathology
- Cystadenocarcinoma, Serous/surgery
- Endometrial Neoplasms/metabolism
- Endometrial Neoplasms/mortality
- Endometrial Neoplasms/pathology
- Endometrial Neoplasms/surgery
- Enzyme-Linked Immunosorbent Assay
- Female
- Follow-Up Studies
- Humans
- Interleukin-17/metabolism
- Interleukins/metabolism
- Middle Aged
- Neoplasm Grading
- Neoplasm Recurrence, Local/metabolism
- Neoplasm Recurrence, Local/mortality
- Neoplasm Recurrence, Local/pathology
- Neoplasm Recurrence, Local/surgery
- Neoplasm Staging
- Ovarian Neoplasms/metabolism
- Ovarian Neoplasms/mortality
- Ovarian Neoplasms/pathology
- Ovarian Neoplasms/surgery
- Prognosis
- Prospective Studies
- ROC Curve
- Survival Rate
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Affiliation(s)
- Yu-Li Chen
- College of MedicineGraduate Institute of Anatomy and Cell Biology, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, TaiwanDepartment of Obstetrics and GynecologyGynecologic Cancer Center, Cathay General Hospital, Taipei, TaiwanDepartment of Obstetrics and GynecologyCollege of Medicine, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, TaiwanDepartment of Obstetrics and GynecologyCollege of Medicine and the Hospital, National Cheng Kung University, Tainan, TaiwanCollege of MedicineGraduate Institute of OncologyCollege of MedicineGraduate Institute of Clinical Medicine, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, Taiwan College of MedicineGraduate Institute of Anatomy and Cell Biology, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, TaiwanDepartment of Obstetrics and GynecologyGynecologic Cancer Center, Cathay General Hospital, Taipei, TaiwanDepartment of Obstetrics and GynecologyCollege of Medicine, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, TaiwanDepartment of Obstetrics and GynecologyCollege of Medicine and the Hospital, National Cheng Kung University, Tainan, TaiwanCollege of MedicineGraduate Institute of OncologyCollege of MedicineGraduate Institute of Clinical Medicine, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, Taiwan College of MedicineGraduate Institute of Anatomy and Cell Biology, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, TaiwanDepartment of Obstetrics and GynecologyGynecologic Cancer Center, Cathay General Hospital, Taipei, TaiwanDepartment of Obstetrics and GynecologyCollege of Medicine, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, TaiwanDepartment of Obstetrics and GynecologyCollege of Medicine and the Hospital, National Cheng Kung University, Tainan, TaiwanCollege of MedicineGraduate Institute of OncologyCollege of MedicineGraduate Institute of Clinical Medicine, National Taiwan Univer
| | - Cheng-Yang Chou
- College of MedicineGraduate Institute of Anatomy and Cell Biology, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, TaiwanDepartment of Obstetrics and GynecologyGynecologic Cancer Center, Cathay General Hospital, Taipei, TaiwanDepartment of Obstetrics and GynecologyCollege of Medicine, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, TaiwanDepartment of Obstetrics and GynecologyCollege of Medicine and the Hospital, National Cheng Kung University, Tainan, TaiwanCollege of MedicineGraduate Institute of OncologyCollege of MedicineGraduate Institute of Clinical Medicine, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, Taiwan
| | - Ming-Cheng Chang
- College of MedicineGraduate Institute of Anatomy and Cell Biology, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, TaiwanDepartment of Obstetrics and GynecologyGynecologic Cancer Center, Cathay General Hospital, Taipei, TaiwanDepartment of Obstetrics and GynecologyCollege of Medicine, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, TaiwanDepartment of Obstetrics and GynecologyCollege of Medicine and the Hospital, National Cheng Kung University, Tainan, TaiwanCollege of MedicineGraduate Institute of OncologyCollege of MedicineGraduate Institute of Clinical Medicine, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, Taiwan
| | - Han-Wei Lin
- College of MedicineGraduate Institute of Anatomy and Cell Biology, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, TaiwanDepartment of Obstetrics and GynecologyGynecologic Cancer Center, Cathay General Hospital, Taipei, TaiwanDepartment of Obstetrics and GynecologyCollege of Medicine, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, TaiwanDepartment of Obstetrics and GynecologyCollege of Medicine and the Hospital, National Cheng Kung University, Tainan, TaiwanCollege of MedicineGraduate Institute of OncologyCollege of MedicineGraduate Institute of Clinical Medicine, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, Taiwan
| | - Ching-Ting Huang
- College of MedicineGraduate Institute of Anatomy and Cell Biology, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, TaiwanDepartment of Obstetrics and GynecologyGynecologic Cancer Center, Cathay General Hospital, Taipei, TaiwanDepartment of Obstetrics and GynecologyCollege of Medicine, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, TaiwanDepartment of Obstetrics and GynecologyCollege of Medicine and the Hospital, National Cheng Kung University, Tainan, TaiwanCollege of MedicineGraduate Institute of OncologyCollege of MedicineGraduate Institute of Clinical Medicine, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, Taiwan
| | - Shu-Feng Hsieh
- College of MedicineGraduate Institute of Anatomy and Cell Biology, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, TaiwanDepartment of Obstetrics and GynecologyGynecologic Cancer Center, Cathay General Hospital, Taipei, TaiwanDepartment of Obstetrics and GynecologyCollege of Medicine, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, TaiwanDepartment of Obstetrics and GynecologyCollege of Medicine and the Hospital, National Cheng Kung University, Tainan, TaiwanCollege of MedicineGraduate Institute of OncologyCollege of MedicineGraduate Institute of Clinical Medicine, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, Taiwan
| | - Chi-An Chen
- College of MedicineGraduate Institute of Anatomy and Cell Biology, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, TaiwanDepartment of Obstetrics and GynecologyGynecologic Cancer Center, Cathay General Hospital, Taipei, TaiwanDepartment of Obstetrics and GynecologyCollege of Medicine, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, TaiwanDepartment of Obstetrics and GynecologyCollege of Medicine and the Hospital, National Cheng Kung University, Tainan, TaiwanCollege of MedicineGraduate Institute of OncologyCollege of MedicineGraduate Institute of Clinical Medicine, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, Taiwan
| | - Wen-Fang Cheng
- College of MedicineGraduate Institute of Anatomy and Cell Biology, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, TaiwanDepartment of Obstetrics and GynecologyGynecologic Cancer Center, Cathay General Hospital, Taipei, TaiwanDepartment of Obstetrics and GynecologyCollege of Medicine, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, TaiwanDepartment of Obstetrics and GynecologyCollege of Medicine and the Hospital, National Cheng Kung University, Tainan, TaiwanCollege of MedicineGraduate Institute of OncologyCollege of MedicineGraduate Institute of Clinical Medicine, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, Taiwan College of MedicineGraduate Institute of Anatomy and Cell Biology, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, TaiwanDepartment of Obstetrics and GynecologyGynecologic Cancer Center, Cathay General Hospital, Taipei, TaiwanDepartment of Obstetrics and GynecologyCollege of Medicine, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, TaiwanDepartment of Obstetrics and GynecologyCollege of Medicine and the Hospital, National Cheng Kung University, Tainan, TaiwanCollege of MedicineGraduate Institute of OncologyCollege of MedicineGraduate Institute of Clinical Medicine, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, Taiwan College of MedicineGraduate Institute of Anatomy and Cell Biology, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, TaiwanDepartment of Obstetrics and GynecologyGynecologic Cancer Center, Cathay General Hospital, Taipei, TaiwanDepartment of Obstetrics and GynecologyCollege of Medicine, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, TaiwanDepartment of Obstetrics and GynecologyCollege of Medicine and the Hospital, National Cheng Kung University, Tainan, TaiwanCollege of MedicineGraduate Institute of OncologyCollege of MedicineGraduate Institute of Clinical Medicine, National Taiwan Univer
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Guo Z, Wang H, Meng F, Li J, Zhang S. Combined Trabectedin and anti-PD1 antibody produces a synergistic antitumor effect in a murine model of ovarian cancer. J Transl Med 2015. [PMID: 26219551 PMCID: PMC4517526 DOI: 10.1186/s12967-015-0613-y] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Monoclonal antibodies (mAb) that block programmed death (PD)-1 signaling pathway hold great potential as a novel cancer immunotherapy. Recent evidence suggests that combining with conventional, targeted or other immunotherapies, these mAb can induce synergistic antitumor responses. In this study, we investigated whether Trabectedin (ET-743), a novel anticancer agent currently used for treating relapsed ovarian cancer, can synergize with anti (α)-PD-1 mAb to increase antitumor activity in the murine ID8 ovarian cancer model. METHODS Mice with established peritoneal ID8 tumor were treated with either single or combined Trabectedin and α-PD-1 mAb, their overall survival was recorded; tumor-associated immune cells and immune gene expression in tumors from treated mice were analyzed by flow cytometry and quantitative RT-PCR, respectively, and antigen-specific immunity of effector CD8(+) T cells was evaluated by ELISA and cytotoxicity assay. In addition, the effect of Trabectedin on tumoral PD-L1 expression was analyzed by both flow cytometry and immunofluorescence staining. RESULTS Though single treatment showed a modest antitumor effect in mice bearing 10-day-established ID8 tumor, combined Trabectedin and α-PD-1 mAb treatment induced a strong antitumor immune response, leading to a significant tumor regression with half of mice tumor-free 90 days after tumor inoculation. Mechanistic investigation revealed that combination treatment induces a systemic tumor-specific immunity with an indispensable role of both CD4(+) and CD8(+) T cells, and effector CD8(+) T cells exhibited the antigen-specific cytokine secretion and cytotoxicity upon tumor antigen stimulation; additionally, combination treatment increased the IFN-γ-producing effector T cells and decreased the immunosuppressive cells in peritoneal cavity; accordingly, it enhanced the expression of Th1-associated immune-stimulating genes while reducing the transcription of regulatory/suppressive immune genes, reshaping tumor microenvironment from a immunosuppressive to a stimulatory state. Finally, in vivo Trabectedin treatment has been shown to induce IFN-γ-dependent PD-L1 expression within tumor, possibly constituting a mechanistic basis for its synergistic antitumor effect with α-PD-1 mAb therapy. CONCLUSION This study provides the evidence that α-PD-1 mAb can produce a synergistic antitumor efficacy when combined with Trabectedin, a clinically available anticancer agent, supporting a direct translation of this combination strategy in clinic for the treatment of ovarian cancer.
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Affiliation(s)
- Zhiqiang Guo
- Department of Gynecology and Obstetrics, Shengjing Hospital, China Medical University, Shenyang, 110004, China.
| | - Haolin Wang
- Department of Acute Abdominal Surgery, The First Hospital of Dalian Medical University, Dalian, 116044, China.
| | - Fandong Meng
- Molecular Oncology Department of Cancer Research Institution, The First Hospital of China Medical University, Shenyang, 110004, China.
| | - Jie Li
- Department of Gynecology and Obstetrics, Shengjing Hospital, China Medical University, Shenyang, 110004, China.
| | - Shulan Zhang
- Department of Gynecology and Obstetrics, Shengjing Hospital, China Medical University, Shenyang, 110004, China.
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Immunotherapy of Ovarian Cancer: The Role of Checkpoint Inhibitors. J Immunol Res 2015; 2015:191832. [PMID: 26236750 PMCID: PMC4508475 DOI: 10.1155/2015/191832] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Accepted: 06/23/2015] [Indexed: 01/21/2023] Open
Abstract
Ovarian cancer is the most important cause of gynecological cancer-related mortality, with the majority of women presenting with advanced disease. Although surgery and chemotherapy can improve survival rates, it is necessary to integrate alternative strategies to improve the outcomes. Advances in understanding the role of immune system in the pathogenesis of cancer have led to the rapid evolvement of immunotherapy, which might establish a sustained immune system response against recurring cancer cells. Recently, it has emerged that powerful immunologic effector cells may be blocked by inhibitory regulatory pathways controlled by specific molecules often called “immune checkpoints,” which turn off the immune system. Similarly, cancer cells are able to use these checkpoints to avoid immune control and rejection. Inhibition of these inhibitory pathways represents a potent strategy in the fight against cancer and is currently under investigation with encouraging results in some cancers, such as melanoma. In ovarian cancer researches are still in an early phase, but with promising results. In this review we will explore the rationale of immunotherapy in ovarian cancer with a special focus on these emerging molecules.
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