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NamKung H, Park S, Im J, Lim G, Ryu M, Seo K, Youn H. Evaluation serum soluble interleukin 2 receptor with diagnosis and prognosis in canine solid tumour: 34 cases. Vet Med Sci 2024; 10:e70033. [PMID: 39285779 PMCID: PMC11405926 DOI: 10.1002/vms3.70033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 04/24/2024] [Accepted: 06/10/2024] [Indexed: 09/20/2024] Open
Abstract
BACKGROUND/AIM The soluble interleukin-2 receptor (sIL-2R) serve as a valuable biomarker for tumors in human patients, as its levels increase during the activation of T lymphocytes in clinical states such as inflammation, infection, and tumor. This study aimed to demonstrate that sIL-2R levels can be also elevated in dogs with tumors and evaluate its applicability as a diagnostic and prognostic factor in canine cancer patients. PATIENTS AND METHODS Serum was collected from 6 healthy dogs and 34 dogs with solid tumors. The concentration of sIL-2R was measured using a commercial enzyme-linked immunosorbent assay kit. RESULTS The median sIL-2R concentration was significantly higher in dogs with solid masses than in healthy dogs (117.3 vs 68.33 pg/ml, p = 0.016). The highest median sIL-2R concentration was found in dogs with malignant tumors, followed by those with benign tumors, and healthy dogs (119.6 vs 93.74 vs 68.33 pg/ml, respectively). In dogs with malignant tumors, the mortality rate was significantly higher in the group with high sIL-2R levels than in the group with low sIL-2R levels. Dogs with solid tumors, particularly those with malignant tumors, had higher concentrations of sIL-2R than healthy dogs. Among dogs with malignant tumors, a correlation between sIL-2R concentration and mortality rate was confirmed. CONCLUSION Serum sIL-2R levels may be used to detect malignant tumors and serve as a prognostic factor in dogs with malignant tumors.
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Affiliation(s)
- Hyun NamKung
- Laboratory of Veterinary Internal MedicineDepartment of Veterinary Clinical ScienceCollege of Veterinary MedicineSeoul National UniversitySeoulRepublic of Korea
| | - Su‐Min Park
- Laboratory of Veterinary Internal MedicineDepartment of Veterinary Clinical ScienceCollege of Veterinary MedicineSeoul National UniversitySeoulRepublic of Korea
- Haemaru Small Animal Clinical Research InstituteSeongnamRepublic of Korea
| | - Jae‐Hyeon Im
- Laboratory of Veterinary Internal MedicineDepartment of Veterinary Clinical ScienceCollege of Veterinary MedicineSeoul National UniversitySeoulRepublic of Korea
| | - Ga‐Hyun Lim
- Laboratory of Veterinary Internal MedicineDepartment of Veterinary Clinical ScienceCollege of Veterinary MedicineSeoul National UniversitySeoulRepublic of Korea
| | - Min‐Ok Ryu
- Laboratory of Veterinary Internal MedicineDepartment of Veterinary Clinical ScienceCollege of Veterinary MedicineSeoul National UniversitySeoulRepublic of Korea
| | - Kyoung‐Won Seo
- Laboratory of Veterinary Internal MedicineDepartment of Veterinary Clinical ScienceCollege of Veterinary MedicineSeoul National UniversitySeoulRepublic of Korea
| | - Hwa‐Young Youn
- Laboratory of Veterinary Internal MedicineDepartment of Veterinary Clinical ScienceCollege of Veterinary MedicineSeoul National UniversitySeoulRepublic of Korea
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Tozuka T, Yanagitani N, Yoshida H, Manabe R, Ogusu S, Tsugitomi R, Sakamoto H, Amino Y, Ariyasu R, Uchibori K, Kitazono S, Seike M, Gemma A, Nishio M. Soluble interleukin-2 receptor as a predictive biomarker for poor efficacy of combination treatment with anti-PD-1/PD-L1 antibodies and chemotherapy in non-small cell lung cancer patients. Invest New Drugs 2023:10.1007/s10637-023-01358-3. [PMID: 37058183 DOI: 10.1007/s10637-023-01358-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 03/30/2023] [Indexed: 04/15/2023]
Abstract
Soluble interleukin-2 receptor (sIL-2R) suppresses effector T-cells. Few studies have assessed serum sIL-2R in patients receiving immunotherapy. We evaluated the association between serum sIL-2R levels and the efficacy of anti-programmed cell death 1/ programmed death-ligand 1 (anti-PD-1/PD-L1) antibody combined with chemotherapy in non-small cell lung cancer (NSCLC) patients. We prospectively enrolled NSCLC patients who received anti-PD-1/PD-L1 antibody combined with platinum-based chemotherapy between 8/2019 and 8/2020 and measured their serum sIL-2R. The patients were divided into high and low sIL-2R groups based on the median of sIL-2R levels at pretreatment. Progression-free survival (PFS) and overall survival (OS) of patients in the high and low sIL-2R groups were compared. The Kaplan-Meier curves of PFS and OS were evaluated using the log-rank test. The multivariate analysis of PFS and OS was performed using the Cox proportional hazard models. Among 54 patients (median age 65, range 34-84), 39 were male and 43 had non-squamous cell carcinoma. The sIL-2R cut-off value was 533 U/mL. Median PFS was 5.1 months (95% CI, 1.8-7.5 months) and 10.1 months (95% CI, 8.3-not reached [NR] months) in the high and low sIL-2R groups (P = 0.007), respectively. Median OS was 10.3 months (95% CI, 4.0-NR months) and NR (95% CI, 10.3-NR months) in the high and low sIL-2R groups (P = 0.005), respectively. Multivariate Cox regression analysis showed that high sIL-2R was significantly associated with shorter PFS and OS. SIL-2R may be a biomarker for the poor efficacy of anti-PD-1/PD-L1 antibody combined with chemotherapy.
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Affiliation(s)
- Takehiro Tozuka
- Department of Thoracic Medical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Noriko Yanagitani
- Department of Thoracic Medical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Hiroshi Yoshida
- Department of Thoracic Medical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Ryo Manabe
- Department of Thoracic Medical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Shinsuke Ogusu
- Department of Thoracic Medical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Ryosuke Tsugitomi
- Department of Thoracic Medical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Hiroaki Sakamoto
- Department of Thoracic Medical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Yoshiaki Amino
- Department of Thoracic Medical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Ryo Ariyasu
- Department of Thoracic Medical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Ken Uchibori
- Department of Thoracic Medical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Satoru Kitazono
- Department of Thoracic Medical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Masahiro Seike
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Akihiko Gemma
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Makoto Nishio
- Department of Thoracic Medical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
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Strong EA, Park SH, Ethun CG, Chow B, King D, Bedi M, Charlson J, Mogal H, Tsai S, Christians K, Tran TB, Poultsides G, Grignol V, Howard JH, Tseng J, Roggin KK, Chouliaras K, Votanopoulos K, Cullinan D, Fields RC, Gamblin TC, Cardona K, Clarke CN. High neutrophil-lymphocyte ratio is not independently associated with worse survival or recurrence in patients with extremity soft tissue sarcoma. Surgery 2020; 168:760-767. [PMID: 32736869 DOI: 10.1016/j.surg.2020.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 05/21/2020] [Accepted: 06/10/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Soft tissue sarcomas are a heterogenous group of neoplasms without well-validated biomarkers. Cancer-related inflammation is a known driver of tumor growth and progression. Recent studies have implicated a high circulating neutrophil-lymphocyte ratio as a surrogate marker for the inflammatory tumor microenvironment and a poor prognosticator in multiple solid tumors, including colorectal and pancreatic cancers. The impact of circulating neutrophil-lymphocyte ratio in soft tissue sarcomas has yet to be elucidated. METHODS We performed a retrospective analysis of patients undergoing curative resection for primary or recurrent extremity soft tissue sarcomas at academic centers within the US Sarcoma Collaborative. Neutrophil-lymphocyte ratio was calculated retrospectively in treatment-naïve patients using blood counts at or near diagnosis. RESULTS A high neutrophil-lymphocyte ratio (≥4.5) was associated with worse survival on univariable analysis in patients with extremity soft tissue sarcomas (hazard ratio 2.07; 95% confidence interval, 1.54-2.8; P < .001). On multivariable analysis, increasing age (hazard ratio 1.03; 95% confidence interval, 1.02-1.04; P < .001), American Joint Committee on Cancer T3 (hazard ratio 1.89; 95% confidence interval, 1.16-3.09; P = .011), American Joint Committee on Cancer T4 (hazard ratio 2.36; 95% confidence interval, 1.42-3.92; P = .001), high tumor grade (hazard ratio 4.56; 95% confidence interval, 2.2-9.45; P < .001), and radiotherapy (hazard ratio 0.58; 95% confidence interval, 0.41-0.82; P = .002) were independently predictive of overall survival, but a high neutrophil-lymphocyte ratio was not predictive of survival (hazard ratio 1.26; 95% confidence interval, 0.87-1.82; P = .22). CONCLUSION Tumor inflammation as measured by high pretreatment neutrophil-lymphocyte ratio was not independently associated with overall survival in patients undergoing resection for extremity soft tissue sarcomas.
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Affiliation(s)
- Erin A Strong
- Department of Surgery, Medical College of Wisconsin, Milwaukee, WI
| | | | - Cecilia G Ethun
- Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA
| | - Bonnie Chow
- Department of Surgery, Medical College of Wisconsin, Milwaukee, WI
| | - David King
- Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, WI
| | - Meena Bedi
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - John Charlson
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
| | - Harveshp Mogal
- Department of Surgery, Medical College of Wisconsin, Milwaukee, WI
| | - Susan Tsai
- Department of Surgery, Medical College of Wisconsin, Milwaukee, WI
| | | | - Thuy B Tran
- Department of Surgery, Stanford University, Palo Alto, CA
| | | | - Valerie Grignol
- Department of Surgery, The Ohio State University, Columbus, OH
| | | | - Jennifer Tseng
- Department of Surgery, University of Chicago Medicine, Chicago, IL
| | - Kevin K Roggin
- Department of Surgery, University of Chicago Medicine, Chicago, IL
| | | | | | | | - Ryan C Fields
- Department of Surgery, Washington University, St. Louis, MO
| | - T Clark Gamblin
- Department of Surgery, Medical College of Wisconsin, Milwaukee, WI
| | - Kenneth Cardona
- Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA
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Santos TD, Jammal MP, Silveira TP, Murta EFC, Nomelini RS. Stromal IL2 is related to the neutrophil/lymphocyte ratio in epithelial ovarian cancer. Pathologica 2020; 111:62-66. [PMID: 31388197 PMCID: PMC8186009 DOI: 10.32074/1591-951x-62-18] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 06/16/2019] [Indexed: 12/18/2022] Open
Abstract
Introduction There is a need for the development of new biomarkers for diagnosis and prognosis of ovarian cancer, which can ideally serve as targets for new therapeutic modalities and individualization of treatment. The objectives of this study were to determine the prognostic significance of the neutrophil/lymphocyte ratio in the peripheral blood of patients with ovarian cancer and tumor staging, and to associate this marker with the immune expression of a panel of cytokines. Methods The study included 24 patients with malignant ovarian neoplasia treated at the Pelvic Mass Outpatient Clinic of the Clinical Hospital of the Federal University of Triângulo Mineiro. The neutrophil/lymphocyte ratio was calculated as the absolute number of neutrophils divided by the absolute number of lymphocytes. Expression of the cytokines was evaluated by the immunohistochemistry method (IL2, IL5, IL6, IL8, IL10 and TNF-R1). Fisher’s statistical test was used for the comparisons of immunohistochemical expression with the neutrophil/lymphocyte ratio, and the unpaired T-Test was used in the analysis of the association of this ratio with tumor staging. Results A neutrophil/lymphocyte ratio > 2.6 was significantly higher in the more advanced stages (II-IV) of malignant ovarian neoplasia (p = 0.0098). In addition, this ratio > 2.6 was associated with IL2 stromal immunostaining (1-3) (p = 0.0472). Conclusion Stromal IL-2 is associated with higher a neutrophil/lymphocyte ratio, suggesting a worse prognosis in ovarian cancer and its role in tumor immunology; a neutrophil/lymphocyte ratio > 2.6 is associated with more advanced stages of malignant ovarian neoplasia.
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Affiliation(s)
- T D Santos
- Research Institute of Oncology (IPON)/Discipline of Gynecology and Obstetrics, Uberaba, MG, Brazil
| | - M P Jammal
- Research Institute of Oncology (IPON)/Discipline of Gynecology and Obstetrics, Uberaba, MG, Brazil
| | - T P Silveira
- Discipline of Special Pathology; Federal University of Triângulo Mineiro, Uberaba, MG, Brazil
| | - E F C Murta
- Research Institute of Oncology (IPON)/Discipline of Gynecology and Obstetrics, Uberaba, MG, Brazil
| | - R S Nomelini
- Research Institute of Oncology (IPON)/Discipline of Gynecology and Obstetrics, Uberaba, MG, Brazil
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De Vita F, Turitto G, di Grazia M, Frattolillo A, Catalano G. Analysis of Interleukin-2/Interleukin-2 Receptor System in Advanced Non-Small-Cell Lung Cancer. TUMORI JOURNAL 2018; 84:33-8. [PMID: 9619711 DOI: 10.1177/030089169808400107] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and background The purpose of the study was to investigate the IL-2/IL-2 receptor system in patients with advanced non-small-cell lung cancer (NSCLC). Patients and methods Sera from 40 subjects and 80 patients with stage III and IV NSCLC were assayed for soluble interleukin-2 receptor (sIL-2R) and interleukin-2 (IL-2) by the enzyme-linked immunosorbent assay. Circulating CD25+ cells were analyzed by flow cytoflorimetry. The data were related to clinical status by comparing the levels of slL-2R and IL-2 at diagnosis and during the treatment. Results The mean slL-2R concentrations of the NSCLC patients were significantly higher than the control population (P=0.0001); the patients with metastatic disease had significantly higher levels than those with locally advanced disease (P=0.02). No correlation was seen between circulating CD25+ cells and slL-2R levels. Disease progression was associated with an increase in slL-2R levels and a decline in IL-2; the sIL-2R/IL-2 ratio showed a gradual increase with tumor progression. Conclusions Our study demonstrates in a large series of patients that in advanced NSCLC there is an imbalance of the IL-2/IL-2 receptor system. Furthermore, circulating slL-2R levels and the sIL-2R/IL-2 ratio may be useful as markers of disease activity and treatment response, suggesting a potential prognostic value.
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Affiliation(s)
- F De Vita
- Department of Internal and Experimental Medicine F. Magrassi, II University of Naples, Italy
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da Silva PB, Perini GF, Pereira LDA, Sacconato EM, Penna AMD, Garibaldi J, Cavalcante E, Baiocchi OCG. Imbalance of Pro- and Anti-Inflammatory Cytokines in Patients With cHL Persists Despite Treatment Compared With Control Subjects. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2015; 15 Suppl:S151-7. [PMID: 26297269 DOI: 10.1016/j.clml.2015.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 02/03/2015] [Indexed: 01/12/2023]
Abstract
BACKGROUND Classical Hodgkin lymphoma (cHL) is a malignant lymphoma that most commonly affects young adults. The lymphomagenesis of cHL depends largely on immune alterations that contribute to proliferation and maintenance of the Hodgkin-Reed-Sternberg (HRS) neoplastic cells. A combination of different immune processes is responsible for the escape of HRS cells, the imbalance between pro- and anti-inflammatory cytokines being one of them. In this study, we aimed to measure serum levels of pro- and anti-inflammatory cytokines in cHL patients before and after treatment compared with a healthy controls group, and to investigate associations with clinical and pathologic characteristics. PATIENTS AND METHODS We prospectively studied all cases of cHL diagnosed between March 2009 to March 2013 at the Universidade Federal de São Paulo and Hospital Santa Marcelina, in Sao Paulo, Brazil. Twenty-nine cases with sufficient clinical data were included in this study. Additionally, 18 healthy control subjects were included and recruited from our University Blood Bank. Serum cytokine levels of interleukin (IL)-2, IL-4, IL-5, IL-6, IL-10, IL-17, tumor necrosis factor (TNF)-α, soluble IL-2 receptor (sCD25), vascular endothelial growth factor (VEGF), and interferon (IFN)-γ were determined in serum of patients and controls using a multiplexed immunoassay system. RESULTS Higher International Prognostic Score was positively correlated with increased levels of IL-6 (P = .003); sCD25 levels were higher in patients with low serum albumin (P = .04), and IFN-γ seemed to correlate with B symptoms, although did not reach statistical significance (P = .057). Pretreatment levels of IL-10, IL-6, TNF-α, and sCD25 were increased in cHL patients compared with in healthy control subjects (P < .001), with median values of 7 pg/mL (range, 0.3-230.9), 5.3 pg/mL (range, 0.4-72.7), 14.6 (range, 4.0-60.4), and 575.9 pg/mL (range, 7.5-1813.3), respectively. Treatment significantly reduced levels of IL-10 (7.0 to 0.3; P < .001), IL-6 (5.3 to 0.4; P = .014), and sCD25 (575.9 to 93.5; P < .001), however, levels of IL-4 increased (0.6 to 2.2; P = .002). Compared with normal control subjects, increased levels of IL-6 (0.4 to 0.4; P = .027), sCD25 (93.5 to 7.5; P = .002), and TNF-α (12 to 8.7; P = .003) persisted after treatment. CONCLUSION In this study we showed higher levels of IL-6, IL-10, TNF-α, and sCD25 in cHL patients at diagnosis than in healthy control subjects. After treatment, levels of IL-6, IL-10, and sCD25 decreased gradually but did not normalize. Understanding the cytokine pattern is extremely important in the development of future therapies that target interactions between neoplastic cells and the inflammatory microenvironment.
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Affiliation(s)
- Priscilla Brito da Silva
- Departamento de Oncologia Clínica e Experimental, Universidade Federal de São Paulo, UNIFESP, São Paulo, São Paulo, Brazil
| | - Guilherme Fleury Perini
- Departamento de Oncologia Clínica e Experimental, Universidade Federal de São Paulo, UNIFESP, São Paulo, São Paulo, Brazil
| | - Luciana de Andrade Pereira
- Departamento de Oncologia Clínica e Experimental, Universidade Federal de São Paulo, UNIFESP, São Paulo, São Paulo, Brazil
| | - Elyse Moritz Sacconato
- Departamento de Oncologia Clínica e Experimental, Universidade Federal de São Paulo, UNIFESP, São Paulo, São Paulo, Brazil
| | - Adriana Marques Damasco Penna
- Departamento de Oncologia Clínica e Experimental, Universidade Federal de São Paulo, UNIFESP, São Paulo, São Paulo, Brazil
| | - Joao Garibaldi
- Departamento de Oncologia Clínica e Experimental, Universidade Federal de São Paulo, UNIFESP, São Paulo, São Paulo, Brazil
| | - Egyla Cavalcante
- Departamento de Oncologia Clínica e Experimental, Universidade Federal de São Paulo, UNIFESP, São Paulo, São Paulo, Brazil
| | - Otavio C G Baiocchi
- Departamento de Oncologia Clínica e Experimental, Universidade Federal de São Paulo, UNIFESP, São Paulo, São Paulo, Brazil.
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Tarhini AA, Lin Y, Zahoor H, Shuai Y, Butterfield LH, Ringquist S, Gogas H, Sander C, Lee S, Agarwala SS, Kirwood JM. Pro-Inflammatory Cytokines Predict Relapse-Free Survival after One Month of Interferon-α but Not Observation in Intermediate Risk Melanoma Patients. PLoS One 2015; 10:e0132745. [PMID: 26192408 PMCID: PMC4508028 DOI: 10.1371/journal.pone.0132745] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 06/17/2015] [Indexed: 01/14/2023] Open
Abstract
Background E1697 was a phase III trial of adjuvant interferon (IFN)-α2b for one month (Arm B) versus observation (Arm A) in patients with resected melanoma at intermediate risk. We evaluated the levels of candidate serum cytokines, the HLA genotype, polymorphisms of CTLA4 and FOXP3 genes and the development of autoantibodies for their association with relapse free survival (RFS) in Arm A and Arm B among 268 patients with banked biospecimens. Methods ELISA was used to test 5 autoantibodies. Luminex/One Lambda LABTypeRSSO was used for HLA Genotyping. Selected CTLA4 and FOXP3 Single nucleotide polymorphisms (SNPs) and microsatellites were tested for by polymerase chain reaction (PCR). Sixteen serum cytokines were tested at baseline and one month by Luminex xMAP multiplex technology. Cox Proportional Hazards model was applied and the Wald test was used to test the marginal association of each individual marker and RFS. We used the Lasso approach to select the markers to be included in a multi-marker Cox Proportional Hazards model. The ability of the resulting models to predict one year RFS was evaluated by the time-dependent ROC curve. The leave-one-out method of cross validation (LOOCV) was used to avoid over-fitting of the data. Results In the multi-marker modeling analysis conducted in Arm B, one month serum IL2Rα, IL-12p40 and IFNα levels predicted one year RFS with LOOCV AUC = 82%. Among the three markers selected, IL2Rα and IFNα were the most stable (selected in all the cross validation cycles). The risk score (linear combination of the 3 markers) separated the RFS curves of low and high risk groups well (p = 0.05). This model did not hold for Arm A, indicating a differential marker profile in Arm B linked to the intervention (adjuvant therapy). Conclusions Early on-treatment proinflammatory serum markers (IL2Rα, IL-12p40, IFNα) significantly predict RFS in our cohort of patients treated with adjuvant IFN-α2b and warrant further study.
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Affiliation(s)
- Ahmad A Tarhini
- University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Yan Lin
- University of Pittsburgh Cancer Institute Biostatistics Facility, Pittsburgh, Pennsylvania, United States of America
| | - Haris Zahoor
- University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Yongli Shuai
- University of Pittsburgh Cancer Institute Biostatistics Facility, Pittsburgh, Pennsylvania, United States of America
| | - Lisa H Butterfield
- University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Steven Ringquist
- University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Helen Gogas
- Hellenic Cooperative Oncology Group, Athens, Greece
| | - Cindy Sander
- University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Sandra Lee
- Dana Farber Cancer Institute, Boston, Massachusetts, United States of America
| | - Sanjiv S Agarwala
- St. Luke's Cancer Center, Bethlehem, Pennsylvania, United States of America; Temple University, Philadelphia, Pennsylvania, United States of America
| | - John M Kirwood
- University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
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Chen ZY, Raghav K, Lieu CH, Jiang ZQ, Eng C, Vauthey JN, Chang GJ, Qiao W, Morris J, Hong D, Hoff P, Tran H, Menter DG, Heymach J, Overman M, Kopetz S. Cytokine profile and prognostic significance of high neutrophil-lymphocyte ratio in colorectal cancer. Br J Cancer 2015; 112:1088-97. [PMID: 25688736 PMCID: PMC4366901 DOI: 10.1038/bjc.2015.61] [Citation(s) in RCA: 110] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 12/29/2014] [Accepted: 01/19/2015] [Indexed: 01/05/2023] Open
Abstract
Background: High circulating neutrophil-lymphocyte ratio (NLR) appears to be prognostic in metastatic colorectal cancer (mCRC). We investigated the relationship of NLR with circulating cytokines and molecular alterations. Methods: We performed retrospective analyses on multiple cohorts of CRC patients (metastatic untreated (n=166), refractory metastatic (n=161), hepatectomy (n=198), stage 2/3 (n=274), and molecularly screened (n=342)). High NLR (ratio of absolute neutrophil-to-lymphocyte counts in peripheral blood) was defined as NLR>5. Plasma cytokines were evaluated using multiplex-bead assays. Kaplan–Meier estimates, non-parametric correlation analysis, and hierarchical cluster analyses were used. Results: High NLR was associated with poor prognosis in mCRC (hazard ratio (HR) 1.73; 95% confidence interval (CI):1.03–2.89; P=0.039) independent of known prognostic factors and molecular alterations (KRAS/NRAS/BRAF/PIK3CA/CIMP). High NLR correlated with increased expression of interleukin 6 (IL-6), IL-8, IL-2Rα, hepatocyte growth factor, macrophage-colony stimulating factor, and vascular epidermal growth factor in exploratory (n=39) and validation (n=166) cohorts. Fourteen additional cytokines correlated with high NLR in the validation cohort. All 20 cytokines fell into three major clusters: inflammatory cytokines, angiogenic cytokines, and epidermal growth factor ligands. In mCRC, composite stratification based on NLR-cytokine score provided enhanced prognostic information (HR 2.09; 95% CI: 1.59–2.76; P<0.001) over and above NLR. Conclusions: High NLR is an independent poor prognostic marker in CRC and correlates with a distinct cytokine profile related to key biological processes involved in carcinogenesis. A composite NLR-cytokine stratification has enhanced prognostic value in mCRC.
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Affiliation(s)
- Z-Y Chen
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - K Raghav
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - C H Lieu
- Division of Medical Oncology, University of Colorado, Aurora, Colorado, USA
| | - Z-Q Jiang
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - C Eng
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - J-N Vauthey
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - G J Chang
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - W Qiao
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - J Morris
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - D Hong
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - P Hoff
- Instituto do Cancer do Estado de São Paulo, Faculdade de Medicina da Universidade de São Paulo, Oncologia Clínica, São Paulo, Brazil
| | - H Tran
- Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - D G Menter
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - J Heymach
- Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - M Overman
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - S Kopetz
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Liang W, Yew DT, Hon KL, Wong CK, Kwok TCY, Leung PC. Indispensable value of clinical trials in the modernization of traditional Chinese medicine: 12 years' experience at CUHK and future perspectives. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2014; 42:587-604. [PMID: 24871653 DOI: 10.1142/s0192415x14500384] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The last decade has seen a wealth of information reporting the beneficial effects of Chinese herbal medicines. While a lot more studies were done using in vitro and in vivo research platforms, much fewer investigations were conducted according to evidence-based requirements in clinical settings. The Institute of Chinese Medicine at the Chinese University of Hong Kong (CUHK) has had the opportunity to collaborate with clinicians over the years to initiate and conduct dozens of clinical trials investigating and verifying the therapeutic values of Chinese herbs in selected disease conditions. Of the many disorders, we chose to focus on those that are known for their difficulties achieving perfect results with conventional treatment methods. Examples include non-healing ulcers, allergic conditions, degenerative diseases and cancer. Protective effects of the herbs in such chronic diseases as coronary artery disease and osteoporosis were also part of our focus. Even in healthy individuals and those recovering from chemotherapy, Chinese herbs could help with the immune system and were studied in our clinical trials as well. This paper aims to highlight the important findings from these clinical studies while at the same time, stressing the indispensable value of clinical trials in modernizing the use of Chinese herbs in present-day medicine.
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Affiliation(s)
- Willmann Liang
- Institute of Chinese Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China
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10
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Filho AM, Jammal MP, Côbo EDC, Silveira TP, Adad SJ, Murta EFC, Nomelini RS. Correlation of cytokines and inducible nitric oxide synthase expression with prognostic factors in ovarian cancer. Immunol Lett 2014; 158:195-9. [DOI: 10.1016/j.imlet.2014.01.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Revised: 12/17/2013] [Accepted: 01/10/2014] [Indexed: 01/21/2023]
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Yoshizato T, Nannya Y, Imai Y, Ichikawa M, Kurokawa M. Clinical significance of serum-soluble interleukin-2 receptor in patients with follicular lymphoma. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2013; 13:410-6. [PMID: 23747081 DOI: 10.1016/j.clml.2013.03.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Revised: 03/17/2013] [Accepted: 03/27/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Although sIL-2R level has a prognostic value in patients with diffuse large B-cell lymphoma, its clinical role in patients with follicular lymphoma has not been determined. PATIENTS AND METHODS We reviewed data on 70 patients diagnosed with follicular lymphoma. RESULTS Ann Arbor stage was I, II, III, and IV in 6, 9, 17, and 38 patients, respectively, and grade classification according to the World Health Organization criteria was 1, 2, 3A, 3B, and not available in 28, 15, 11, 4, and 12 patients, respectively. sIL-2R at diagnosis was significantly correlated with Ann Arbor stages (P < .001), number of nodal lesions (≥ 5 or not) (P = .0050), and Follicular Lymphoma International Prognosis Index risk classification (P = .0015). Furthermore, sIL-2R regressed significantly in patients who achieved complete remission, uncertain complete remission, or partial remission (P < .001), and increased when regrowth of lymphoma was shown (P < .001). Finally, a high level of sIL-2R at diagnosis was correlated with shorter progression-free survival (P = .018) and time to next treatment (P < .001). CONCLUSION Serum-soluble interleukin-2 receptor is correlated with tumor burden at diagnosis and during the clinical course of therapies in patients with follicular lymphoma, and our data support its usefulness to function as a surrogate marker of tumor progression.
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Affiliation(s)
- Tetsuichi Yoshizato
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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12
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Abstract
A NUMBER of receptors for growth factors and differentiation antigens have been found to be secreted or released by cells. Following mononuclear cell (MNC) activation and interleukin-2 receptor (IL-2R) expression, a soluble form of the Alpha;-chain of IL-2R (sIL-2R) is released. The sIL-2R has been shown to be present in the culture supernatants of activated MNCs as well as in normal sera and, in higher amounts, in sera from subjects affected by several diseases including neoplastic, infectious and autoimmune ones, and in sera from transplanted patients suffering allograft rejection. The blood sIL-2R levels depend on the number of producing cells and the number of molecules per cell, so that sIL-2R blood values may represent an index of the number and the functional state of producing cells, both normal and neoplastic. Thus, monitoring of the immune system, mostly T-cells and haematological malignancies might be targets for the measurement of sIL-2R. Since many conditions may influence sIL-2R production, little diagnostic use may result from these measurements. However, since blood sIL-2R levels may correlate with disease progression and/or response to therapy, their measurement may be a useful index of activity and extent of disease. The precise biological role of the soluble form of the IL-2R is still a matter of debate. However, we know that increased sIL-2R levels may be observed in association with several immunological abnormalities and that sIL-2R is able to bind IL-2. It is conceivable then that in these conditions the excess sIL-2R released in vivo by activated lymphoid cells or by neoplastic cells may somehow regulate IL-2-dependent processes. On the other hand, it cannot exclude that sIL-2R is a by-product without biological significance. Finally, it is puzzling that in many conditions in which an increase of blood sIL-2R values has been observed, MNCs display a decreased in vitro capacity to produce sIL-2R. These seemingly contrasting findings are discussed in the light of the data showing that sIL-2R production correlates with IL-2 production.
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Gonda K, Shibata M, Shimura T, Machida T, Suzuki S, Nakamura I, Ohki S, Sakurai K, Ohto H, Tomita R, Takenoshita S. Serum Soluble Interleukin-2 Receptor is Increased in Malnourished and Immunosuppressed Patients With Gastric and Colorectal Cancer: Possible Influence of Myeloid-Derived Suppressor Cells. World J Oncol 2012; 3:158-164. [PMID: 29147299 PMCID: PMC5649838 DOI: 10.4021/wjon548e] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2012] [Indexed: 01/13/2023] Open
Abstract
Background Soluble IL-2 receptor (sIL-2R) is the circulating form of a membrane receptor localized on lymphoid and some tumor cells; its biological function is not completely understood. Methods Serum levels of sIL-2R in blood samples taken from 51 cancer patients (21 gastric and 30 colorectal) and 18 healthy volunteers were measured and found to be significantly higher in the patients. Results Concentrations were significantly inversely correlated to nutritional parameters, including total protein and short turnover proteins such as prealbumin, retinol binding protein and transferrin, as well as to the stimulation index, which is a classical parameter of cell-mediated immunity. Concentrations were significantly positively correlated to neutrophil count and inversely to lymphocyte count. Significantly elevated levels of circulating myeloid-derived suppressor cells (MDSCs) were found in patients; this was significantly correlated to sIL-2R levels. Conclusions Increased production of sIL-2R correlated with systemic inflammation, nutritional impairment and inhibition of cell-mediated immunity, and thus may be involved in immunological mechanisms inducing cancer cachexia. The same factors also appear to relate closely to induction of MDSCs.
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Affiliation(s)
- Kenji Gonda
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University, 1Hikarigaoka, Fukushima, Fukushima 960-1295, Japan.,Department of Organ Regulatory Surgery, Fukushima Medical University, 1Hikarigaoka, Fukushima, Fukushima 960-1295, Japan
| | - Masahiko Shibata
- Department of Tumor and Host Bioscience, Fukushima Medical University, 1Hikarigaoka, Fukushima, Fukushima 960-1295, Japan
| | - Tatsuo Shimura
- Department of Tumor and Host Bioscience, Fukushima Medical University, 1Hikarigaoka, Fukushima, Fukushima 960-1295, Japan
| | - Takeshi Machida
- Department of Immunology, Fukushima Medical University, 1Hikarigaoka, Fukushima, Fukushima 960-1295, Japan
| | - Satoshi Suzuki
- Department of Organ Regulatory Surgery, Fukushima Medical University, 1Hikarigaoka, Fukushima, Fukushima 960-1295, Japan
| | - Izumi Nakamura
- Department of Organ Regulatory Surgery, Fukushima Medical University, 1Hikarigaoka, Fukushima, Fukushima 960-1295, Japan
| | - Shinji Ohki
- Department of Organ Regulatory Surgery, Fukushima Medical University, 1Hikarigaoka, Fukushima, Fukushima 960-1295, Japan
| | - Kenichi Sakurai
- Department of Surgery, Nihon University School of Medicine, 30-1 Otaguchi-kamimachi, Itabashi, Tokyo 173-8610, Japan
| | - Hitoshi Ohto
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University, 1Hikarigaoka, Fukushima, Fukushima 960-1295, Japan
| | - Ryouichi Tomita
- Department of Surgery, Nippon Dental University, 2-3-16Fujimi, Chiyoda, Tokyo 102-8158, Japan
| | - Seiichi Takenoshita
- Department of Organ Regulatory Surgery, Fukushima Medical University, 1Hikarigaoka, Fukushima, Fukushima 960-1295, Japan
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Kris MG, Tonato M, Bria E, Ballatori E, Espersen B, Herrstedt J, Rittenberg C, Einhorn LH, Grunberg S, Saito M, Morrow G, Hesketh P. Consensus recommendations for the prevention of vomiting and nausea following high-emetic-risk chemotherapy. Support Care Cancer 2010; 19 Suppl 1:S25-32. [PMID: 20803039 DOI: 10.1007/s00520-010-0976-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2010] [Accepted: 07/30/2010] [Indexed: 11/25/2022]
Abstract
In this update of our 2005 document, we used an evidence-based approach whenever possible to formulate recommendations, emphasizing the results of controlled trials concerning the best use of antiemetic agents for the prevention of emesis and nausea following anticancer chemotherapies of high emetic risk. A three-drug combination of a 5-hydroxytryptamine type 3 receptor (5-HT(3)) receptor antagonist, dexamethasone, and aprepitant beginning before chemotherapy and continuing for up to 4 days remains the standard of care. We address issues of dose, schedule, and route of administration of five selective 5-HT(3) receptor antagonists. We conclude that, for each of these five drugs, there is a plateau in therapeutic efficacy above which further dose escalation does not improve outcome. In trials designed to prove the equivalence of palonosetron to ondansetron and granisetron, palonosetron proved superior in emesis prevention, while adverse effects were comparable. Furthermore, for all classes of antiemetic agents, a single dose is as effective as multiple doses or a continuous infusion. The oral route is as efficacious as the intravenous route of administration.
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Affiliation(s)
- Mark G Kris
- Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
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Hsiao SH, Lee MS, Lin HY, Su YC, Ho HC, Hwang JH, Lee CC, Hung SK. Clinical significance of measuring levels of tumor necrosis factor-alpha and soluble interleukin-2 receptor in nasopharyngeal carcinoma. Acta Otolaryngol 2009; 129:1519-23. [PMID: 19922107 DOI: 10.3109/00016480902849427] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION Changes in tumor necrosis factor-alpha (TNF-alpha) and soluble interleukin-2 (sIL-2R) levels appear to be closely related to tumor progression and prognosis in nasopharyngeal carcinoma (NPC). Further investigation is suggested. OBJECTIVES The study examined whether changes in TNF-alpha and sIL-2R in NPC can be used to predict tumor progression and prognosis. PATIENTS AND METHODS The study was carried out in 58 patients with NPC newly diagnosed from December 2003 to December 2006 at a single institution and 60 control subjects of comparable age. Blood levels of TNF-alpha and sIL-2R were monitored before, during, and 3 months and 1 year after treatment. RESULTS Differences in TNF-alpha level between patients with NPC in all four stages and healthy controls and in sIL-2R level between patients with advanced stage NPC and healthy controls were significant (p <0.05). Furthermore, 1 year after completing radiotherapy, levels of TNF-alpha and sIL-2R in patients with recurrent tumors were significantly different from those in patients without recurrence and healthy control subjects.
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Affiliation(s)
- Shih-Hsuan Hsiao
- Department of Otolaryngology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
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Bien E, Balcerska A. Serum Soluble Interleukin-2 Receptor, Beta2-Microglobulin, Lactate Dehydrogenase and Erythrocyte Sedimentation Rate in Children with Hodgkin’s Lymphoma. Scand J Immunol 2009; 70:490-500. [DOI: 10.1111/j.1365-3083.2009.02313.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bien E, Rapala M, Krawczyk M, Balcerska A. The serum levels of soluble interleukin-2 receptor alpha and lactate dehydrogenase but not of B2-microglobulin correlate with selected clinico-pathological prognostic factors and response to therapy in childhood soft tissue sarcomas. J Cancer Res Clin Oncol 2009; 136:293-305. [PMID: 19693535 DOI: 10.1007/s00432-009-0661-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2009] [Accepted: 08/04/2009] [Indexed: 10/20/2022]
Abstract
PURPOSE To establish the clinical utility of serum soluble IL-2 receptor (sIL-2R alpha), lactate dehydrogenase (LDH) [corrected] and B2-microglobulin [corrected] (B2-M) as markers for diagnosis, prognosis and treatment monitoring in childhood soft tissue sarcomas (STS). METHODS The markers[corrected] were measured prospectively before treatment, in complete remission (CR) during and after therapy and at relapse [corrected] in 35 children with STS and in 50 healthy children [corrected] (once). RESULTS Serum sIL-2R alpha and LDH [corrected] correlated with age thus they were [corrected] presented as multiplications [corrected] of the upper normal ranges [corrected] for age. Pre-treatment levels [corrected] of sIL-2R alpha and LDH [corrected] but not of B2-M exceeded significantly those of controls. [corrected] Elevated [corrected] sIL-2R alpha levels correlated with more [corrected] advanced stages, poor-risk histology and poor response to chemotherapy, higher LDH with incomplete primary tumour [corrected] resection and increased B2-M with poor-risk histology. [corrected] Patients' age >10 years, male gender and unfavourable tumour localisation were not accompanied by the markers' elevation. [corrected] None of the markers predicted EFS and OS. [corrected] Good response to chemotherapy was paralleled by significant decline of sIL-2R alpha and LDH pre-treatment levels while relapse--by sIL-2R alpha and LDH increase to values similar to those at diagnosis. [corrected] Monitoring of B2-M did not reflect the disease course. [corrected] CONCLUSIONS sIL-2R alpha and LDH were [corrected] proven to be promising markers [corrected] for diagnosis and treatment monitoring in children with STS. The markers [corrected] correlated also with some [corrected] important prognostic clinico-pathological factors for childhood [corrected] STS; however, they [corrected] failed to predict EFS and OS. Measurements of serum [corrected] B2-M were shown [corrected] to have no clinical value in the diagnostics, prognostics and treatment monitoring in paediatric STS.
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Affiliation(s)
- Ewa Bien
- Department of Paediatrics, Haematology, Oncology and Endocrinology, Medical University of Gdansk, 7 Debinki Street, 80-211, Gdansk, Poland.
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Du Bois A. [Management of chemotherapy-induced emesis: what is the standard after 20 years of clinical research]. ACTA ACUST UNITED AC 2009; 93 Suppl 1:3-17. [PMID: 19479418 DOI: 10.1007/bf03041988] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND The knowledge of the importance, the physiopathological mechanisms, and the management of the chemotherapy-induced emesis has increased exponentially during the last 20 years. High-dosage metoclopramide (MCP) therapy has been introduced in the eighties and serotonine type-3 receptor antagonists (5-HT(3) antagonists) have been used since the late eighties and early nineties. Due to both classes of substances the results of the antiemetic therapies have improved drastically. After 20 years of intensive clinical research it seems to be appropriate to come to an intermediate conclusion. METHOD With the aid of an overview and a new analysis of the literature published on this topic so far, the current state of research is shown (including the fields in which further improvement will be necessary), and suggestions are made, wherever it seemed possible, to attain the "gold standard" in antiemetic therapy. RESULTS AND CONCLUSIONS In connection with all highly or very highly emetogenic chemotherapies, an antiemetic prophylaxis should be initiated on the day of therapy, especially when using platinum or most of the cyclophosphamide-based regimes for cancer treatment. The recommended prophylaxis consists of a combination of 5-HT(3) antagonists with a corticosteroid. To combat the so-called delayed emesis on the days following therapy, all patients should undergo an oral corticoid therapy, possibly in combination with MCP (especially platinum-therapy patients), less frequently with 5-HT(3) antagonists. With these means of prophylaxis emesis can be prevented/avoided completely in most patients, and nausea can at least be reduced. It is sufficient to administer a single dose of 5-HT(3) antagonists prior to chemotherapy. For ondansetron and granisetron, the best documented substances within this class of drugs, 8 mg (ondansteron) and 3 mg (granisetron) are considered standard dosages. Among the corticoids, most data have been accumulated for dexamethasone. A standard dose of 10 to 20 mg can be administered prior to chemotherapy. Right after and especially on the days following chemotherapy higher dosages seem to be indicated. PROSPECT Further therapy improvements, especially concerning emesis and nausea on the days following chemotherapy, are necessary and are currently object of clinical research.
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Affiliation(s)
- A Du Bois
- Frauenklinik der St. Vincentius Krankenhäuser, Karlsruhe
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Bien E, Balcerska A. Serum soluble interleukin 2 receptor alpha in human cancer of adults and children: a review. Biomarkers 2008; 13:1-26. [PMID: 17906988 DOI: 10.1080/13547500701674063] [Citation(s) in RCA: 101] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Cancer growth and development is associated with the stimulation of the innate immune system, including enhanced interleukin 2 receptor (IL-2R) expression in immune cells and its shedding into the circulation in a soluble form of sIL-2Ralpha. In most haematological malignancies, including different types of leukaemias and lymphomas, sIL-2Ralpha has been found to be released directly from the surface of neoplastic cells thus reflecting the tumour bulk, turnover and activity. Several studies have proved that not only lymphoid cancer cells, but also some non-lymphoid cancer cells, express IL-2R on their surface. They include malignant melanoma and carcinomas of the kidney, head and neck, oesophagus and lung. It is suggested that in most malignant solid tumours, elevated levels of sIL-2Ralpha are likely to be the product of normal peripheral mononuclear cells activated in response to the neoplasm's growth or that they are released from activated lymphoid cells infiltrating neoplastic tissues. This latter hypothesis has been proved by discovering the high expression of CD25 on the cell surface of most of these cells. Although the precise source and biological role of sIL-2Ralpha has not been clarified definitively, pretreatment serum levels of sIL-2Ralpha have been shown to reflect the activity, advancement and biological aggressiveness of many types of cancer in adults and children as well as to correlate with prognosis and overall survival. The possibility of enriching the diagnostic tools of oncologists with a new biochemical marker of activity of neoplasms resulted in numerous studies and reports concerning the clinical usefulness of sIL-2Ralpha measurements in adult and, less frequently, in paediatric malignancies. This article presents the actual knowledge concerning the structure, source and biological function of sIL-2Ralpha in patients with haematological and non-haematological malignancies. The authors review the published data on clinical applicability of soluble IL-2Ralpha determination in terms of diagnostics, prognosis and treatment monitoring of particular types of malignant disorders both in adults and in children. They also provide an insight into the clinical usefulness of sLL-2Ralpha-blocking antibodies in patients with cancer, and in those who reject organ transplants, develop graft-versus-host disease after allogeneic bone marrow transplantation and are affected with autoimmune disorders.
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Affiliation(s)
- E Bien
- Department of Pediatrics, Hematology, Oncology and Endocrinology, Medical University of Gdansk, Poland.
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Effect of Preemptive Epidural Analgesia on Cytokine Response and Postoperative Pain in Laparoscopic Radical Hysterectomy for Cervical Cancer. Reg Anesth Pain Med 2008. [DOI: 10.1097/00115550-200801000-00008] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
A soluble IL-2 receptor (sIL-2R) is a circulating form of a membrane receptor
localized on lymphoid and some cancer cells. The biological function of sIL-2R has
not been completely understood. Substantially, it seems to reflect T-lymphocyte
activation in diseases of different pathology. Moreover, the soluble receptor has been
considered, at least in part, responsible for unsuccessful immunotherapy with IL-2 in
cancers. Several lines of evidence indicate sIL-2R measurements to be useful in
determining disease progress and prognosis. This review summarizes current knowledge
on the sIL-2R behavior in RA and solid cancers of varied etiology.
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Affiliation(s)
- Anna Maria Witkowska
- Department of Food Commodities Science and Technology, Medical University of Bialystok, Poland.
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Wong CK, Bao YX, Wong ELY, Leung PC, Fung KP, Lam CWK. Immunomodulatory activities of Yunzhi and Danshen in post-treatment breast cancer patients. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2005; 33:381-95. [PMID: 16047556 DOI: 10.1142/s0192415x05002990] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Breast cancer is the most common cancer among women worldwide. Discomfort and fatigue are usually arisen from anticancer therapy such as surgery, radiotherapy, chemotherapy, hormonal therapy, or combination therapy, because of the suppressed immunological functions. Yunzhi (Coriolus versicolor) can modulate various immunological functions in vitro, in vivo, and in human clinical trials. Danshen (Salvia miltiorrhiza) has been shown to benefit the circulatory system by its vasodilating and anti-dementia activity. The purpose of this clinical trial was to evaluate the immunomodulatory effects of Yunzhi-Danshen capsules in post-treatment breast cancer patients. Eighty-two patients with breast cancer were recruited to take Yunzhi [50 mg/kg body weight, 100% polysaccharopeptide (PSP)] and Danshen (20 mg/kg body weight) capsules every day for a total of 6 months. EDTA blood samples were collected every 2 months for the investigation of immunological functions. Flow cytometry was used to assess the percentages and absolute counts of human lymphocyte subsets in whole blood. Plasma level of soluble interleukin-2 receptor (sIL-2R) was measured by enzyme-linked immunosorbent assay (ELISA). Results showed that the absolute counts of T-helper lymphocytes (CD4+), the ratio of T-helper (CD4+)/T suppressor and cytotoxic lymphocytes (CD8+), and the percentage and the absolute counts of B-lymphocytes were significantly elevated in patients with breast cancer after taking Yunzhi-Danshen capsules, while plasma slL-2R concentration was significantly decreased (all p < 0.05). Therefore, the regular oral consumption of Yunzhi-Danshen capsules could be beneficial for promoting immunological function in post-treatment of breast cancer patients.
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Affiliation(s)
- Chun-Kwok Wong
- Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, PR. China
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Wang G, Weng Y, Ishiguro Y, Sakamoto H, Morita S. The effect of tramadol on serum cytokine response in patients undergoing pulmonary lobectomy. J Clin Anesth 2005; 17:444-50. [PMID: 16171665 DOI: 10.1016/j.jclinane.2004.10.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2004] [Accepted: 10/05/2004] [Indexed: 11/20/2022]
Abstract
STUDY OBJECTIVE To investigate the effect of tramadol on the production of serum interleukin (IL) 6, IL-10, and IL-2 and soluble (s) IL-2 receptor (R), thereby evaluating its effects on the proinflammatory and anti-inflammatory responses and immune function in cancer patients undergoing conventional pulmonary lobectomy. DESIGN Randomized, double-blinded, placebo-controlled study. SETTING University hospital. PATIENTS Forty ASA physical status I and II adult patients scheduled for conventional pulmonary lobectomy. INTERVENTIONS Patients were randomly divided into 2 groups (n = 20 in each group). Both groups received general anesthesia with enflurane combined with epidural blockade. At 5 minutes before skin incision, patients were given either tramadol 1.5 mg/kg intravenously (IV), followed by a continuous infusion of 0.5 mg/kg per hour until the end of surgery (group I), or IV normal saline (group II). MEASUREMENTS AND MAIN RESULTS Venous blood samples for the measurement of serum cytokine concentrations were taken before anesthesia and at set intervals until 24 hours after operation. Serum levels of IL-6 and IL-10 in both groups were increased significantly during and after operation compared with baseline levels (P < .05). No statistical differences between groups in terms of IL-6 and IL-10 were observed. Levels of IL-2 were elevated significantly at 4 hours after operation in group I as compared with baseline levels (P < .001), whereas they remained low at 4 and 24 hours after operation in group II (P < .01). There were significant increases in levels of sIL-2R at 4 and 24 hours after operation in group II as compared with baseline levels (P < .05) and at 24 hours after operation in group I (P < .01). Levels of IL-2 were higher at 4 and 24 hours after operation in group I than in group II (P < .01). Levels of sIL-2R were lower at 4 hours after operation in group I than in group II (P < .01). CONCLUSIONS IV infusion of tramadol does not seem to alter IL-6/IL-10 cytokine response to pulmonary lobectomy. As tramadol was associated with increased IL-2 and delayed enhancement of sIL-2R in our study, it may attenuate to some extent an impaired immune response in pulmonary lobectomy.
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Affiliation(s)
- Guonian Wang
- Department of Anesthesiology, The Third Clinical Hospital, Harbin Medical University, Harbin, Heilongjiang Province 150040, China.
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Schütt P, Ebeling P, Buttkereit U, Brandhorst D, Opalka B, Poser M, Müller S, Flasshove M, Moritz T, Seeber S, Nowrousian MR. Thalidomide in combination with dexamethasone for pretreated patients with multiple myeloma: serum level of soluble interleukin-2 receptor as a predictive factor for response rate and for survival. Ann Hematol 2005; 84:594-600. [PMID: 15744524 DOI: 10.1007/s00277-005-1007-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2004] [Accepted: 01/11/2005] [Indexed: 10/25/2022]
Abstract
The aim of this study was to assess the side effects and the efficacy of thalidomide alone or in combination with dexamethasone in relapsed multiple myeloma (MM) and to evaluate possible predictive factors for response rate and survival. Twenty-nine pretreated patients were enrolled, including 13 patients with a relapse after high-dose chemotherapy. The median number of relapses was 3 (range: 1-7). Twenty-two patients received thalidomide in combination with dexamethasone and seven patients thalidomide alone. The dosage of thalidomide was 400 mg/day and the dosage of dexamethasone 20 mg/m2 daily for 4 consecutive days every 3 weeks. Cycles of dexamethasone were given until maximal decline of myeloma protein was achieved, whereas therapy with thalidomide was maintained until disease progression. Responses occurred in 62% of patients, including 5 (17%) complete remissions and 13 (45%) partial remissions. The median event-free survival (EFS) was 7.2 months and the median overall survival (OS) 26.1 months. In multivariate analysis, pretreatment serum levels of soluble interleukin-2 receptor (sIL-2R) were a significant prognostic factor for EFS, and those of beta2-microglobulin (beta2M) and sIL-2R for OS. Serum levels of sIL-2R significantly increased after 3 weeks of treatment in 89% of patients, possibly representing lymphocyte activation induced by thalidomide. Two patients died of septic complications within 3 months after starting treatment with thalidomide and dexamethasone and one patient of herpes encephalitis after 26 months of treatment with thalidomide alone. Also, one case of pneumonia and one case of deep venous thrombosis of the lower limb occurred. Other side effects were somnolence, peripheral neuropathy, and bradycardia occurring in 35, 55, 38 and 55% of patients, respectively. The combination of thalidomide and dexamethasone is an effective therapy in heavily pretreated myeloma patients with a high response rate and acceptable toxicities. A powerful predictive factor both for EFS and OS was the pretreatment serum level of sIL-2R.
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Affiliation(s)
- Philipp Schütt
- Department of Internal Medicine (Cancer Research), West German Cancer Center, University of Essen Medical School, Hufelandstrasse 55, 45122, Essen, Germany.
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26
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Kris MG, Hesketh PJ, Herrstedt J, Rittenberg C, Einhorn LH, Grunberg S, Koeller J, Olver I, Borjeson S, Ballatori E. Consensus proposals for the prevention of acute and delayed vomiting and nausea following high-emetic-risk chemotherapy. Support Care Cancer 2004; 13:85-96. [PMID: 15565277 DOI: 10.1007/s00520-004-0699-x] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2004] [Accepted: 08/26/2004] [Indexed: 11/27/2022]
Abstract
This paper uses an evidence-based approach whenever possible to formulate recommendations, emphasizing the results of controlled trials concerning the best use of antiemetic agents. We address issues of dose, schedule, and route of administration of five selective 5-HT(3) antagonists. We conclude that for each of these five drugs, there is a plateau in therapeutic efficacy above which further dose escalation does not improve outcome. Furthermore, for all classes of antiemetic agents, a single dose is as effective as multiple doses or a continuous infusion. The oral route is as efficacious as the intravenous route of administration, even with chemotherapy of high emetic risk. Selective antagonists of the type 3 serotonin receptor (5-HT(3)) in combination with dexamethasone and aprepitant are the standard of care for the prevention of emesis following chemotherapy of high emetic risk.
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Affiliation(s)
- Mark G Kris
- Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
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27
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Kovac AL. Benefits and risks of newer treatments for chemotherapy-induced and postoperative nausea and vomiting. Drug Saf 2003; 26:227-59. [PMID: 12608887 DOI: 10.2165/00002018-200326040-00003] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Nausea and vomiting are common adverse effects of chemotherapy, radiation therapy, anaesthesia and surgery. The incidence of chemotherapy-induced nausea and vomiting (CINV) is estimated to vary from 30 to 90%, depending on the type of chemotherapeutic agent used. Radiation-induced emesis varies with anatomical site radiated but is estimated to have an overall incidence of approximately 40%. The incidence of postoperative nausea and vomiting (PONV) depends on the type of anaesthesia and surgery, but overall is estimated to be 20-30%. Evidence-based medicine and meta-analysis have been used to direct medical therapy to help determine equivalence, optimal dose, timing, safety and efficacy of antiemetic medications. Concepts such as the number needed to treat and number needed to harm are helpful to guide the clinician regarding the benefits and risks of a particular treatment. The serotonin 5-HT(3) receptor antagonists ondansetron, granisetron, tropisetron and dolasetron have been important additions to the antiemetic armamentarium. The 5-HT(3) receptor antagonists are similar in chemical structure, efficacy and adverse effect profile. They appear to have no important differences among themselves in clinical outcomes for CINV and PONV. Headache, dizziness, constipation and diarrhoea are their most common adverse effects, and when they occur they are usually mild and easily managed. Haemodynamic changes and extrapyramidal adverse effects are uncommon. ECG changes such as prolonged corrected QT (QTc) interval are infrequent, dose-related and overall judged to be clinically insignificant. As most studies with the 5-HT(3) antagonists have been conducted on relatively healthy patients, caution should be exercised when these drugs are used in susceptible patients with co-morbidities. The clinician must weigh the benefit of administering an antiemetic for CINV or PONV against the risk of occurrence of an adverse event.
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Affiliation(s)
- Anthony L Kovac
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City 66160-7415, USA.
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28
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Sedlaczek P, Frydecka I, Gabryś M, Van Dalen A, Einarsson R, Harłozińska A. Comparative analysis of CA125, tissue polypeptide specific antigen, and soluble interleukin-2 receptor alpha levels in sera, cyst, and ascitic fluids from patients with ovarian carcinoma. Cancer 2002; 95:1886-93. [PMID: 12404282 DOI: 10.1002/cncr.10917] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND The serum markers CA125, tissue polypeptide specific antigen (TPS), and soluble interleukin-2 receptor alpha (sIL-2Ralpha) concentrations were determined in sera, cyst, and ascitic fluids from patients with malignant and benign ovarian neoplasms. METHODS CA125, TPS, and sIL-2Ralpha concentrations were measured in sera, cyst, and ascitic fluids by immunoassays in 67 patients with carcinoma and in 32 patients with benign ovarian neoplasms. RESULTS CA125, TPS, and sIL-2Ralpha levels were elevated significantly in sera from patients who had ovarian carcinoma compared with patients who had benign neoplasms (P < 0.001). Patients who had International Federation of Gynecology and Obstetrics (FIGO) Stage III-IV disease had significantly higher serum levels for the markers studied compared with patients who had FIGO Stage I-II disease (P < 0.001 for CA125; P = 0.02 for TPS and sIL-2Ralpha). Concurrent measurement of CA125 and sIL-2Ralpha in sera identified 100% of ovarian carcinomas in FIGO Stage I-II. All patients with carcinoma demonstrated markedly higher levels of CA125 and TPS for both cyst and ascites compared with corresponding sera (P < 0.001). The level of sIL-2Ralpha was higher statistically in ascitic fluid compared with the level in serum (P < 0.001); however, its values in sera and cyst fluids were comparable. In ascitic fluid, the CA125 level was significantly higher in patients who had FIGO Stage III-IV disease compared with patients who had FIGO Stage I-II disease (P = 0.002), whereas such correlations were not found for TPS or sIL-2Ralpha. In cyst fluids, the levels of all studied markers were independent of the FIGO stage. In cyst fluids from patients with benign ovarian neoplasms, TPS and sIL-2Ralpha levels were significantly lower compared with the levels in patients with ovarian carcinoma (P < 0.001), whereas the values of CA125 were overlapping. CA125 and TPS concentrations were higher in cyst fluids compared with corresponding sera, whereas sIL-2Ralpha levels were comparable and low in cyst fluids and in the circulation of patients with benign neoplasms. CONCLUSIONS In patients with ovarian carcinoma, TPS and CA125 concentrations were significantly higher in the place of their generation compared with the concentrations in blood circulation. sIL-2Ralpha values were higher in ascites compared with the values in corresponding sera, and its concentrations in sera and cyst fluids were comparable. The assessment of serum sIL-2Ralpha levels showed potential complementary value to CA125 for the detection of ovarian carcinoma in early FIGO stages; however, a 9% false positive rate limited the significance of cumulative value for a combination of these circulating markers.
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Affiliation(s)
- Paweł Sedlaczek
- Department of Clinical Immunology, Wrocław Medical University, Poland
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29
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Rutkowski P, Kaminska J, Kowalska M, Ruka W, Steffen J. Cytokine serum levels in soft tissue sarcoma patients: correlations with clinico-pathological features and prognosis. Int J Cancer 2002; 100:463-71. [PMID: 12115531 DOI: 10.1002/ijc.10496] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
We investigated the correlations between serum levels of selected proinflammatory, hematopoietic and angiogenic cytokines and soluble cytokine receptors with the clinico-pathological features and prognosis in soft tissue sarcoma patients. Serum levels of 9 cytokines (TNFalpha, IL-1ra, IL-6, IL-8, IL-10, M-CSF, G-CSF, VEGF, bFGF) and 4 free cytokine receptors (sIL-2R alpha, sIL-6R, TNFRI, TNFRII) were measured by means of an enzyme-linked immunoadsorbent assay kit in 156 soft tissue sarcoma patients before the treatment and in 50 healthy controls. Serum levels of 10 cytokines and cytokine receptors were also assayed during patients' follow-up after the treatment. Significantly elevated pretreatment serum levels of 11/13 cytokines and cytokine receptors were found in sarcoma patients, as compared to healthy controls. In 40.4% of patients 6 or more cytokines and cytokine receptors (most frequently: TNF RI, IL-6, IL-8) were elevated in parallel. Serum levels of IL-6, sIL-2R, VEGF, M-CSF and TNF RI correlated significantly with tumor size and serum levels of IL-8 and IL-6 were significantly higher in patients with Grade 2/3 vs. Grade 1 tumors. We did not observe any significant differences in cytokine serum levels between patients with primary and recurrent tumors and patients with and without distant metastases. Using univariate analysis, overall survival (OS) in all patients was affected by tumor size (<5 cm vs. 5-10 cm vs. >10 cm), tumor grade (G1 vs. G2/3), presence of metastases, pretreatment serum levels of 8 cytokines (IL-6, IL-8, IL-10, sIL-2R, TNF RI, TNF RII, M-CSF, VEGF) and the number of cytokines increased (0-1 vs. 2-5 vs. < or = 6). Elevated serum levels of IL-6, IL-8, IL-10 and sIL-2R alpha, high tumor grade and larger tumor size strongly correlated with shorter disease-free survival (DFS). Multivariate analysis identified G2/3 tumor grade (p = 0.001), the presence of metastases (p = 0.004), elevated IL-6 serum level (p = 0.02), elevated IL-8 serum level (p = 0.048) and the number of cytokine serum levels above upper cut-off values (p = 0.01) as the independent prognostic factors related to OS, and G2/3 tumor grade (p = 0.005) and increased IL-6 serum level (p = 0.035) as independent prognostic factors related to DFS. In a group of patients without metastases (M0) higher tumor grade, elevated serum level of IL-6 and TNF RII, and the number of elevated cytokine serum levels correlated independently with poor survival. We found a significant decrease of several cytokine serum levels in patients after treatment (IL-1ra, IL-6, IL-8, IL-10, TNF RII, M-CSF) [p < 0.05]. Persistently elevated serum level of IL-6 after the treatment has also shown negative prognostic significance for OS (univariate analysis). Serum levels of some proinflammatory, hematopoietic and angiogenic cytokines and cytokine receptors are elevated, frequently in parallel, in a large percentage of soft tissue sarcoma patients. Significant correlations of serum cytokine levels with tumor size and grade suggest that some of these cytokines may be directly or indirectly involved in the progression of soft tissue sarcomas. Serum assays of IL-6, IL-8 and TNF RII before or after the treatment may be useful in establishing soft tissue sarcoma patients prognosis.
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Affiliation(s)
- Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcomas, M. Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland.
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30
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Abstract
Nausea and vomiting are among the most distressing adverse effects of cancer chemotherapy. They can lead to both physical and psychological complications if uncontrolled. The exact mechanism for chemotherapy-induced nausea and vomiting is not known; it is thought to occur through numerous neuronal pathways acting on different sites. Chemotherapy-induced nausea and vomiting are broken down into 3 phases: acute, delayed, and anticipatory. The incidence of each phase depends largely on the chemotherapy agent used and is primarily treated with different antiemetic agents. Pharmacists can assist in optimizing antiemetic use by selecting appropriate antiemetics based on the emetogenicity of the cancer treatment and helping to individualize therapy to each patient’s specific needs.
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Affiliation(s)
- Robyn H. Rosen
- New York-Presbyterian Hospital, New York Weill Cornell Center, 525 E 68th St, New York, NY 10021,
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31
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Abstract
In 1987 in Dubrovnik, Yugoslavia, N.H. Spector named a new discipline: Neuroimmunomodulation. R. Ader called this new discipline psychoneuroimmunomodulation when the major emphysis was on its behavioral aspects. Neuroimmunomodulation (NIM) is devoted to the study of the interactions at different morphologic and functional levels among the immune, nervous, and endocrine systems. In fact, this science is the modern manifestation of an old science: in the words of B.D. Jankovic (1987), "Neuroimmunomodulation is a modern reflection in neurosciences and immunosciences of the ideas and experience of philosophers and ingenious observers of ancient Egypt, Greece, China, India, and other civilizations that the mind is involved in the defense against diseases." Twelve years ago NIM was regarded by many conventional scientists almost as a form of witchcraft. Today it may be the fastest growing area of biomedical science research in the world. Important clinical applications will not be far behind. NIM research has also progressed in the field of oncology research. Topics such as treatment of hormone-dependent cancer with analogues of hypothalamic hormones, the role of opioids and T cells in cancer, stress-cancer-immune connections, the anticancer role of melatonin and cytokines, immunotherapy of cancer, and the role of psychotherapy in cancer patients represent some lines of research that have been or are being investigated by scientists. Some areas remain to be thoroughly investigated such as the influence of physical exercise (sports), music (classical or modern), and/or relaxation techniques (e.g. yoga) on the development of human cancer. This paper reviews the role of NIM in oncology and provides some perspectives for further research and development of clinical applications.
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Affiliation(s)
- A Conti
- Istituto Cantonale di Patologia, Centre for Experimental Pathology, via in Selva 24, 6601 Locarno 1, Switzerland.
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32
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Ritter HL, Gralla RJ, Hall SW, Wada JK, Friedman C, Hand L, Fitts D. Efficacy of intravenous granisetron to control nausea and vomiting during multiple cycles of cisplatin-based chemotherapy. Cancer Invest 2001; 16:87-93. [PMID: 9512674 DOI: 10.3109/07357909809039762] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The safety and efficacy of granisetron (10 micrograms/kg and 40 micrograms/kg) were evaluated during a second (n = 393) and third (n = 200) cycle of chemotherapy in this multicenter, double-blind, randomized, parallel-group study. Granisetron was administered as a single intravenous dose before the start of cisplatin chemotherapy (> or = 60 mg/m2). Total control (no vomiting, no retching, no nausea, and no use of antiemetic rescue medication) after the first 24 hr following chemotherapy was achieved in 40% and 49% of patients in Cycles 2 and 3, respectively, for the 10 micrograms/kg group, and in 42% and 38% of patients in Cycles 2 and 3, respectively, for the 40 micrograms/kg group. Both dose levels of granisetron were well tolerated. The results demonstrate comparable efficacy between the 10 micrograms/kg and 40 micrograms/kg doses of granisetron in preventing nausea and vomiting during repeat cycles of high-dose cisplatin-based chemotherapy. The results of this study show that granisetron 10 micrograms/kg is safe and well tolerated, and remains effective with repeat cycle use.
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Affiliation(s)
- H L Ritter
- Toledo Clinic, Inc., Hematology-Oncology Department, Ohio 43623, USA
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33
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Kawashima O, Kamiyoshihara M, Sakata S, Endo K, Saito R, Morishita Y. The clinicopathological significance of preoperative serum-soluble interleukin-2 receptor concentrations in operable non-small-cell lung cancer patients. Ann Surg Oncol 2000; 7:239-45. [PMID: 10791856 DOI: 10.1007/bf02523660] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Serum-soluble interleukin-2 receptor (IL-2R) concentrations have been found to be elevated in cancer patients. However, the importance of this finding in patients with non-small-cell lung cancer (NSCLC) has not been previously established. METHODS Preoperative serum-soluble IL-2R concentrations were determined in 65 consecutive patients with operable NSCLC. The correlation of preoperative serum-soluble IL-2R concentrations with various clinicopathological features of this cancer was evaluated to clarify the clinical significance of this parameter. RESULTS Although serum-soluble IL-2R concentrations were not significantly higher in operable NSCLC patients than in normal controls (P = .1180), serum-soluble IL-2R concentrations were significantly higher in patients with stage IIIB or IV disease than in normal controls (P = .0001). The presence of intrapulmonary metastasis was the only clinicopathological feature that was significantly correlated to serum-soluble IL-2R concentration (P = .0004). The sensitivity of serum-soluble IL-2R concentration in identifying the presence of intrapulmonary metastasis was 87.5%; specificity was 75%. CONCLUSIONS Elevated preoperative serum-soluble IL-2R concentrations in patients with operable NSCLC reflect the occurrence of intrapulmonary metastasis. Preoperative examination of serum-soluble IL-2R concentrations may be valuable in the detection of the intrapulmonary metastasis preoperatively.
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Affiliation(s)
- O Kawashima
- Department of Surgery, National Sanatorium Nishigunma Hospital, Shibukawa, Gunma, Japan.
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34
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Hesketh PJ. Comparative review of 5-HT3 receptor antagonists in the treatment of acute chemotherapy-induced nausea and vomiting. Cancer Invest 2000; 18:163-73. [PMID: 10705879 DOI: 10.3109/07357900009038248] [Citation(s) in RCA: 133] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Since their introduction, 5-HT3 receptor antagonists have become the agents of choice in the prevention of acute chemotherapy-induced nausea and vomiting and are generally superior to high-dose metoclopramide regimens. The availability of four different agents (ondansetron, granisetron, dolasetron, and tropisetron) within this class has prompted investigations into potential differences between the drugs, which appear to be few. More importantly, the results of recently conducted randomized comparative trials in patients receiving moderately or highly emetogenic chemotherapy have demonstrated similar efficacy. Although study designs and patient populations differed, seven large comparative trials in patients receiving highly emetogenic chemotherapy reported no significant differences in complete or complete plus major response rates among the agents. Similar results were generally reported in trials evaluating patients receiving moderately emetogenic chemotherapy. The safety and tolerability of these agents also appear to be similar. The most common adverse events include headache, gastrointestinal effects, lightheadedness, and sedation. All agents are available in both intravenous and oral dosage forms and may be administered as a single dose.
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Affiliation(s)
- P J Hesketh
- Division of Hematology/Oncology, St. Elizabeth's Medical Center, Boston, Massachusetts, USA
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35
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Malik I, Moid I, Khan Z, Hussain M. Prospective randomized comparison of tropisetron with and without dexamethasone against high-dose metoclopramide in prophylaxis of acute and delayed cisplatin-induced nausea and vomiting. Am J Clin Oncol 1999; 22:126-30. [PMID: 10199444 DOI: 10.1097/00000421-199904000-00004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Several studies have confirmed the efficacy of high-dose metoclopramide and, more recently, serotonin antagonists, with and without dexamethasone, in the prophylaxis of cisplatin-induced nausea and vomiting. Most of these trials have been reported from Western countries. There is little or no information about the efficacy and tolerability of these agents in ethnic groups in other countries. Furthermore, many patients in the developing countries cannot afford serotonin antagonists. The result is a critical need to evaluate these agents and justify their increasingly common use. The authors performed a prospective randomized trial to compare the efficacy and tolerability of tropisetron with and without dexamethasone against high-dose metoclopramide cocktail in patients receiving a uniform dose of cisplatin (100 mg/m2). Metoclopramide 2 mg/kg was combined with clemastine, dexamethasone, and lorazepam. These drugs were initially repeated at short intervals and subsequently given in the oral form for the next 5 days. Tropisetron 5 mg was administered intravenously 15 minutes immediately before cisplatin therapy and followed up with oral therapy for 5 days. The third group received the same doses of tropisetron along with dexamethasone before cisplatin and twice daily thereafter. The authors randomized 301 episodes. The patient characteristics were well balanced between the three groups. Acute nausea and vomiting were completely prevented in almost two thirds of patients receiving metoclopramide and tropisetron plus dexamethasone. These results are significantly superior to those of tropisetron alone (p < 0.01). Similarly, delayed nausea and vomiting were significantly better controlled with metoclopramdie cocktail and tropisetron plus dexamethasone than with tropisetron alone. Side effects were generally mild; however, they were more frequent with metoclopramide. The authors conclude that metoclopramide-based combination antiemetic therapy continues to be a cheaper alternative to serotonin antagonists and equally effective. Metoclopramide-based therapy, however, is more labor intensive, and issues related to administrative errors, side effects, and compliance gain increasing importance. The identification of persons at a higher risk for metoclopramide-induced side effects may help minimize the unacceptable consequences of therapy.
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Affiliation(s)
- I Malik
- National Cancer Institute, Clifton, Karachi, Pakistan
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36
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Brunetti G, Bossi A, Baiardi P, Jedrychowska I, Pozzi U, Bacchella L, Bernardo G. Soluble interleukin 2 receptor (sIL2R) in monitoring advanced lung cancer during chemotherapy. Lung Cancer 1999; 23:1-9. [PMID: 10100141 DOI: 10.1016/s0169-5002(98)00094-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
STUDY OBJECTIVES To evaluate the usefulness of measuring sIL2R for diagnostic and prognostic purposes and for monitoring disease during a 6-month period of chemotherapy, and to investigate the clinical significance of sIL2R serum concentrations. METHODS The serum concentration of sIL2R, TPA and lymphocyte subsets CD4, CD8, CD25, CD16 were measured at diagnosis and then 1 and 6 months after the start of chemotherapy. PATIENTS There were 39 patients (three females, 36 males; mean age 61.6 years) with lung cancer (LC), treated with chemotherapy and 22 control subjects (six females, 16 males; mean age 50.1 years) with non-neoplastic lung diseases. RESULTS No significant differences in sIL2R serum concentrations were observed at diagnosis between the control and LC group or when comparing the different histotypes, disease stages (IIIa-b vs IV) and survival (survival < or = 12 vs > 12 months). On comparing the sequential variations of the examined parameters a significant increase in sIL2R (P < 0.007) after 1 and 6 months versus basal value was observed only in patients surviving less than 12 months and in those who did not respond to chemotherapy. Moreover a negative correlation was observed between sIL2R serum concentrations and CD25+ and CD16+ lymphocyte subsets. Evaluation of survival curves of patients with basal sIL2R > or < or = 700 U/ml showed a slightly lower survival rate in the former group. CONCLUSIONS The present results, confirming the poor utility of sIL2R in the diagnostic phase of the disease, show its usefulness in prognostic evaluation and in the clinical surveillance of patients with advanced lung cancer submitted to polychemotherapy. In this case any variations in sIL2R serum levels are likely to relate to the spread of the neoplasia rather than to the host immune response.
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MESH Headings
- Adenocarcinoma/blood
- Adenocarcinoma/drug therapy
- Adenocarcinoma/mortality
- Adenocarcinoma/pathology
- Antigens, CD/blood
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/blood
- CD4-CD8 Ratio
- Carcinoma, Small Cell/blood
- Carcinoma, Small Cell/drug therapy
- Carcinoma, Small Cell/mortality
- Carcinoma, Small Cell/pathology
- Carcinoma, Squamous Cell/blood
- Carcinoma, Squamous Cell/drug therapy
- Carcinoma, Squamous Cell/mortality
- Carcinoma, Squamous Cell/pathology
- Female
- Follow-Up Studies
- Humans
- Lung Diseases/blood
- Lung Neoplasms/blood
- Lung Neoplasms/drug therapy
- Lung Neoplasms/mortality
- Lung Neoplasms/pathology
- Male
- Middle Aged
- Neoplasm Staging
- Prognosis
- Receptors, Interleukin-2/blood
- Survival Rate
- T-Lymphocyte Subsets/immunology
- Tissue Polypeptide Antigen/blood
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Affiliation(s)
- G Brunetti
- Department of Internal Medicine, Salvatore Maugeri Foundation, Pavia, Italy.
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37
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Gansauge F, Steinbach G, Gansauge S, König HH, Müller J, Grünert A, Beger HG. Prognostic significance of soluble interleukin-2 receptor-alpha in adenocarcinoma of the pancreas. Cancer Lett 1998; 134:193-9. [PMID: 10025881 DOI: 10.1016/s0304-3835(98)00259-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Soluble interleukin-2-receptor-alpha (sIL-2Ralpha) serum concentrations were examined in chronic pancreatitis patients, patients with cystadenocarcinoma of the pancreas, patients with adenocarcinoma of the pancreas and healthy blood donors. sIL-2Ralpha serum concentrations in pancreatic cancer patients were significantly higher than those of normal control subjects or chronic pancreatitis patients. In patients with adenocarcinoma of the pancreas no significant differences were found between sIL-2Ralpha and tumor size, grading, resectability and lymph node involvement. In Kaplan-Meier regression analysis patients with adenocarcinoma of the pancreas with low sIL-2Ralpha levels (<500 U/ml) lived significantly shorter than patients with sIL-2Ralpha concentrations above 500 U/ml (P < 0.01), suggesting that determination of sIL-2Ralpha serum concentrations could provide additional important information about prognosis.
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Affiliation(s)
- F Gansauge
- Department of General Surgery, University of Ulm, Germany
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38
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Wu LJ, Chen KY, Chi KH, Chen SY, Liang MJ, Shiau CY, Wang LW, Liu YM, Chow KC, Yen SH. The significance of soluble interleukin-2 receptor in monitoring disease relapse in patients with nasopharyngeal cancer. Jpn J Clin Oncol 1998; 28:729-32. [PMID: 9879289 DOI: 10.1093/jjco/28.12.729] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Soluble interleukin-2 receptor alpha (sIL-2R alpha) is a well-known indicator of T-cell activation noted to be increasing in nasopharyngeal cancer. However, the significance of sIL-2R alpha in monitoring disease relapse is unclear. This study was initiated to address this issue. METHODS Serum of 56 patients with NPC, which underwent either primary, salvage, or palliative treatments, from 1992 to 1993 at the Cancer Center, Veterans General Hospital-Taipei, were collected from our serum bank. According to their disease status at the time of study, at least two years after last treatments, the 56 patients were divided into four groups. The remission group represented those in remission at the time of study (n = 24). The metastasis group represented those with distant metastasis present at the time of study (n = 17). The recurrence group represented those with locoregional recurrence present at the time of study (n = 11). The combined group represented those with locoregional recurrence as well as distant metastasis (n = 4). The seral sIL-2R alpha concentrations of the 56 NPC patients were determined with enzyme-linked immunoabsorbent assay. The combined group was excluded in our statistical analysis. We performed statistical analysis on the differences of paired serum sIL-2R alpha concentrations between different periods of the diseases. The first analysis was on the differences of sIL-2R alpha concentrations between diagnosis and post-radiotherapy periods for 13 out of 24 patients in the remission group and 7 out of 11 patients in the recurrence group. The second analysis was on the differences of sIL-2R alpha concentration between follow-up before detection-of-relapse and after detection-of-relapse for 5 out of 17 patients in the metastasis group and six out of 11 patients in the recurrence group. RESULTS The first statistical analysis revealed no significant differences of sIL-2R alpha concentrations for the remission group (P = 0.946) and the recurrence group (P = 0.156) between diagnosis and post-radiotherapy periods. The second statistical analysis revealed no significant differences of sIL-2R alpha concentrations between before and after detection-of-relapse for the recurrence group, neither (P = 0.438). The results for the metastasis group were different. The sIL-2R alpha concentrations were shown to increase after the detection of metastasis for the 5 paired samples from the metastasis group, although the Wilcoxon signed ranks test on the differences only showed borderline significance (P = 0.063). CONCLUSIONS Our findings show that sIL-2R alpha would be of no value in monitoring the development of locoregional recurrence but might be useful in monitoring distant metastasis. Although our current limited data did not provide strong support for the role of sIL-2R alpha in monitoring metastasis, it might be delineated in the future by collecting more data.
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Affiliation(s)
- L J Wu
- Cancer Center, Veterans General Hospital-Taipe, Taiwan
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Nakata B, Chung KH, Kato Y, Yamashita Y, Inui A, Arimoto Y, Maeda K, Onoda N, Sawada T, Sowa M. Serum soluble interleukin-2 receptor level as a prognostic indicator in gastric cancer. Br J Cancer 1998; 77:1820-4. [PMID: 9667652 PMCID: PMC2150317 DOI: 10.1038/bjc.1998.302] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
T lymphocytes, activated by interleukin 2 during an anti-tumour response, release soluble interleukin 2 receptors (sIL-2R) into the bloodstream. We analysed the prognostic value of the serum sIL-2R level in gastric cancer. Serum concentration of sIL-2R in 96 gastric cancer patients and 100 healthy control subjects' was measured by enzyme-linked immunosorbent assay. All survivors were followed for more than 50 months. Serum sIL-2R level was considered with respect to prognosis, clinicopathological factors, other tumour markers and peripheral blood cell count. Stage III and IV patients had significantly higher sIL-2R levels than lower stage patients and control subjects. Stage III and IV gastric cancer patients were divided into 'high' and 'low' slL-2R groups based upon the control subjects' serum sIL-2R mean value plus one standard deviation. The high group had a significantly worse prognosis than the low group, although clinicopathological features and treatments were similar. Multivariate analysis demonstrated that the serum sIL-2R level is an independent indicator. The sIL-2R level did not correlate with carbohydrate antigen 19-9, however it did correlate with carcinoembryonic antigen (r = 0.22) and with numbers of peripheral blood monocytes (r = 0.54). In conclusion, serum sIL-2R may predict the outcome of gastric cancer patients with stage III or IV disease.
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Affiliation(s)
- B Nakata
- First Department of Surgery, Osaka City University Medical School, Osaka, Japan
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Gebauer G, Rieger M, Jäger W, Lang N. Soluble Interleukin-2 Receptors (sIL-2R) in Ovarian Cancer Patients: Changes in sIL-2R after Surgery as a Prognostic Factor? Int J Biol Markers 1998; 13:45-7. [PMID: 9681299 DOI: 10.1177/172460089801300108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Elg SA, Hill RB, Heldman L, Ramakrishnan S. The in vitro effect on T cell function of soluble IL-2Ralpha from advanced ovarian cancer ascites. Gynecol Oncol 1997; 66:133-7. [PMID: 9234933 DOI: 10.1006/gyno.1997.4741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Activated T cells not only secrete interleukin-2 (IL-2) and express cell surface interleukin 2 receptor alpha (IL-2R alpha), but also shed IL-2R alpha. This soluble receptor is a truncated form of the membrane-bound p55 receptor with a similar binding affinity. It has been proposed that soluble IL-2R alpha (sIL-2R alpha) could negatively modulate local immune response. High levels of sIL-2R alpha have been found in the serum and ascites of ovarian cancer patients. The purpose of this investigation is to determine the amount of in vitro T cell inhibition seen in ovarian cancer ascites that is attributable to high levels of sIL-2R alpha. Purified sIL-2R alpha at levels up to 100,000 pg/ml was placed in lymphocyte proliferation assays. Soluble IL-2R alpha was removed from the ascites of three patients with advanced ovarian cancer. Lymphocyte proliferation assays utilizing phytohemaglutin (PHA) stimulation were carried out with this ascites. Untreated ascites from each patient served as control. Addition of purified sIL-2R alpha to lymphocyte proliferation assays failed to demonstrate significant lymphocyte suppression. Addition of ascites to the lymphocyte assays resulted in up to an 80% decrease in lymphocyte proliferation. Neutralization of ascites sIL-2R alpha as well as removal of sIL-2R alpha via a protein G column failed to reverse any of the observed lymphocyte suppression. We conclude that although sIL2R alpha is elevated in ascites of patients with ovarian cancer, it does not account for the profound ascites-induced T cell suppression observed in vitro.
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Affiliation(s)
- S A Elg
- Department of Obstetrics and Gynecology, Walter Reed Army Medical Center, Washington, DC 20307, USA
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Murakami S, Hirayama R, Satomi A, Okubo K, Matsuki M, Sakata H, Tsuji Y. Serum Soluble Interleukin-2 Receptor Levels in Patients with Breast Cancer. Breast Cancer 1997; 4:25-28. [PMID: 11091572 DOI: 10.1007/bf02967051] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Preoperative levels of serum soluble interleukin-2 receptor (1L-2R) were examined in 37 patients with breast cancer. We investigated the correlations of serum soluble IL-2R levels with various factors such as stage grouping, lymph node metastasis, distant metastasis, tumor size, histophthological type, estrogen receptor (ER), progesterone receptor (PgR) and CA 15-3. Serum soluble 1L-2R levels were measured with an enzyme-linked immunosorbent assay. Levels of serum soluble 1L-2R in the patients with stage III and IV breast cancer were significantly higher than those in the normal controls, and patients with stage I and II breast cancer. Preoperative levels of serum soluble IL-2R in patients with T3 and T4 were also significantly higher than those in patients with T1 and T2. Serum levels of IL-2R in patients with distant metastasis were also significantly higher than those in patients without distant metastasis. Moreover, serum levels of soluble IL-2R in patients with higher CA 15-3 were significantly higher than those in patients with normal CA 15-3 levels. We conclude that preoperative serum soluble IL-2R levels in patients with breast cancer may be a valuable parameter, especially in evaluating whether they have distant metastasis or not.
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Affiliation(s)
- S Murakami
- Second Department of Surgery, Saitama Medical School, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-04, Japan
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Yano T, Fukuyama Y, Yokoyama H, Takai E, Tanaka Y, Asoh H, Ichinose Y. Interleukin-2 receptors in pulmonary adenocarcinoma tissue. Lung Cancer 1996; 16:13-9. [PMID: 9017581 DOI: 10.1016/s0169-5002(96)00608-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We previously reported that the serum soluble interleukin-2 receptor (sIL-2R) level increased with the advance of disease stage in non-small cell lung cancer. The present study was thus conducted to investigate the origin of serum sIL-2R in patients with pulmonary adenocarcinoma. Fresh tumor cell suspensions were prepared from surgically resected specimens of pulmonary adenocarcinoma. They were adjusted to a cell density of 5 x 10(5)/ml and then cultured for 24 h at 37 degrees C. The culture supernatants were collected and assayed to determine the sIL-2R levels using an enzyme immunoassay. The resultant cells were thereafter cytocentrifuged onto glass slides and immunochemically stained with anti-human IL-2R alpha (CD25) monoclonal antibody. In three of six cases examined, a substantial level of sIL-2R was identified in the culture supernatants. In four cases, including those three cases with the presence of sIL-2R in the culture supernatants, various proportions of tumor cells were positively stained with the anti-IL-2R alpha antibody. Further examinations revealed that tumor cells expressed IL-2R alpha (CD25) in seven of 16 cases with pulmonary adenocarcinoma. These results thus suggested that the tumor cells did express IL-2R alpha and release sIL-2R in some cases with pulmonary adenocarcinoma.
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Affiliation(s)
- T Yano
- Department of Chest Surgery, National Kyushu Cancer Center, Fukuoka 815, Japan
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Abstract
The interactions between the tumor and its host are complex, and many aspects of the immune system appear to be adversely affected directly or indirectly by the presence of the tumor. Virtually all of the processes involved in immune induction and action have been implicated in the observed deficient response in tumor-bearing patients. Improved understanding and molecular analysis of the mechanisms underlying the escape of tumors from immune surveillance may lead to the development of novel strategies for the prevention of T-cell immunosuppression in cancer patients, the development of novel immunotherapeutic strategies, and potentially prevention of tumor progression or development.
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Affiliation(s)
- D Y Kavanaugh
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, USA
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Yano T, Yoshino I, Yokoyama H, Fukuyama Y, Takai E, Asoh H, Ichinose Y. The clinical significance of serum soluble interleukin-2 receptors in lung cancer. Lung Cancer 1996; 15:79-84. [PMID: 8865125 DOI: 10.1016/0169-5002(96)00572-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
It has been recently reported that the soluble interleukin-2 receptor (IL-2R) levels in the sera of cancer patients were higher than those of normal controls. The present study was conducted in order to clarify the clinical significance of serum soluble IL-2R in patients with lung cancer. Using commercially available EIA kits, we measured the serum levels of soluble IL-2R in 102 lung cancer patients and 18 normal controls. The serum level of IL-2R was higher than 100 pM (mean +3 S.D. in the normal controls) in 14 of 58 patients with adenocarcinoma and in 13 of 32 patients with squamous cell carcinoma. In both adenocarcinoma and squamous cell carcinoma, the mean level of soluble IL-2R was higher in advanced stages (Stages IIIA, IIIB and IV) than in early stages (Stages I and II). In contrast, no patients with small cell carcinoma exhibited a serum level of soluble IL-2R higher than 100 pM, whereas almost all of those patients were in advanced-stage diseases. These results first demonstrated that the serum level of soluble IL-2R increased in association with both the disease stage and the histological type in lung cancer.
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Affiliation(s)
- T Yano
- Department of Chest Surgery, National Kyushu Cancer Center, Fukuoka, Japan
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Ettinger DS, Eisenberg PD, Fitts D, Friedman C, Wilson-Lynch K, Yocom K. A double-blind comparison of the efficacy of two dose regimens of oral granisetron in preventing acute emesis in patients receiving moderately emetogenic chemotherapy. Cancer 1996; 78:144-51. [PMID: 8646710 DOI: 10.1002/(sici)1097-0142(19960701)78:1<144::aid-cncr20>3.0.co;2-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND The purpose of this study was to define an optimal administration schedule of granisetron for patients receiving moderately emetogenic chemotherapy by comparing the antiemetic efficacy and safety of 2 mg of the drug administrated orally. METHODS In this double-blind, randomized, parallel study, 2-dose regimens of oral granisetron were evaluated in 697 adult cancer patients. Patients were stratified by gender and randomized to receive 2 mg oral granisetron, either as a divided dose given 1 hour prior to chemotherapy and 12 hours after the start of chemotherapy, or as a single dose 1 hour prior to chemotherapy at Cycle 1. The primary efficacy endpoints assessed were the percentage of patients with complete response (no nausea, no emesis, and no additional antiemetic medication during the 24-hour post-chemotherapy interval) and the incidence of emesis and nausea. Following completion of Cycle 1, patients were given the opportunity to receive open-label granisetron (2 mg once daily) on the first day of each remaining cycle of chemotherapy. RESULTS No statistically significant differences in any of the endpoints were observed between the two treatment groups. Approximately 50% of patients in both treatment groups achieved complete response. The proportion of patients with no episodes of emesis occurred with similar frequency in the two treatment groups. Approximately 52% of patients in either treatment group were free of nausea during the postchemotherapy period. There was no difference between treatment groups regarding the use of antiemetic rescue medication. Finally, the incidence of adverse experiences was similar for both treatment groups. CONCLUSIONS Both dose regimens of oral granisetron were similarly effective in controlling nausea and vomiting in the 24-hour interval following chemotherapy. Granisetron was well tolerated with few adverse events attributable to the study drug.
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Affiliation(s)
- D S Ettinger
- The Johns Hopkins Oncology Center, Baltimore, Maryland 21287, USA
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Mantovani G, Macciò A, Bianchi A, Curreli L, Ghiani M, Proto E, Santona MC. Comparison of granisetron, ondansetron, and tropisetron in the prophylaxis of acute nausea and vomiting induced by cisplatin for the treatment of head and neck cancer: a randomized controlled trial. Cancer 1996. [PMID: 8608488 DOI: 10.1002/(sici)1097-0142(19960301)77:5<941::aid-cncr21>3.0.co;2-2] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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48
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Fernandez-Botran R, Chilton PM, Ma Y. Soluble cytokine receptors: their roles in immunoregulation, disease, and therapy. Adv Immunol 1996; 63:269-336. [PMID: 8787633 DOI: 10.1016/s0065-2776(08)60858-5] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- R Fernandez-Botran
- Department of Pathology, School of Medicine, University of Louisville, Kentucky 40292, USA
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Gebbia V, Testa A, Valenza R, Cannata G, Tirrito ML, Gebbia N. Oral granisetron with or without methylprednisolone versus metoclopramide plus methylprednisolone in the management of delayed nausea and vomiting induced by cisplatin-based chemotherapy. A prospective randomized trial. Cancer 1995; 76:1821-8. [PMID: 8625054 DOI: 10.1002/1097-0142(19951115)76:10<1821::aid-cncr2820761022>3.0.co;2-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND A single-institution, randomized open trial was prospectively performed to compare orally administered granisetron with or without intramuscularly administered methylprednisolone to metoclopramide plus methylprednisolone in the prevention of delayed nausea and vomiting induced by cisplatin-based chemotherapy. The effects of antiemetic treatments were evaluated from days 2 to 5 of the first cycle after cisplatin administration among patients who had never before received chemotherapy. METHODS All patients were treated with chemotherapeutic regimens containing cisplatin greater than or equal to 80 mg/m2 and received antiemetic therapy with granisetron 3 mg intravenously for the control of acute emesis. Patients who responded to treatment during the first 24 hours were randomized to receive (1) metoclopramide (0.5 mg/kg) intramuscularly three times daily plus methylprednisolone (125 mg) intramuscularly once a day or (2) granisetron (1 mg) orally twice daily or (3) oral granisetron (1 mg) orally plus methylprednisolone (125 mg) intramuscularly from days 2 to 5. RESULTS Of the patients treated with metoclopramide plus methylprednisolone (n = 92), 53% had complete protection from delayed emesis, 16% a major response, 15% a minor response, and 15% no response. Of the patients treated with granisetron alone (n = 84), 33% had a complete response, 21% a major response, 23% a minor response, and 21% no response. In the patients treated with orally administered granisetron plus intramuscularly administered methylprednisolone (n = 86), 47% had a complete response, 17% a major response, 23% a minor response, and 13% no response. These differences reached statistical significance only when the complete response rate achieved in the metoclopramide plus methylprednisolone group was compared with that recorded in the oral granisetron group (P = 0.012). Moreover, the metoclopramide plus methylprednisolone and the orally administered granisetron plus corticosteroid arms were superior to the orally administered granisetron alone arm in preventing nausea (P < 0.038 and P < 0.002, respectively). No extrapyramidal side effects were noted for the granisetron alone and the granisetron plus methylprednisolone arms, whereas 6% of patients treated with metoclopramide had extrapyramidal adverse effects. Headache was recorded in 8% of patients treated with granisetron alone, in 9% treated with granisetron plus methylprednisolone, and in 3% treated with metoclopramide plus methylprednisolone. CONCLUSIONS These data suggest that orally administered granisetron with or without methylprednisolone may be given safely to patients with cancer as prophylactic therapy against delayed emesis after high dose cisplatin therapy. Orally administered granisetron alone was less active than a standard combination of metoclopramide plus methylprednisolone. However, the addition of corticosteroid to orally administered granisetron improved the control of delayed emesis. The efficacy of the combination of metoclopramide plus methylprednisolone and oral granisetron with or without methylprednisolone against delayed emesis still is not entirely satisfactory.
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Affiliation(s)
- V Gebbia
- Service of Chemotherapy, Institute of Pharmacology, University of Palermo, Italy
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Hurteau JA, Woolas RP, Jacobs IJ, Oram DC, Kurman CC, Rubin LA, Nelson DL, Berchuck A, Bast RC, Mills GB. Soluble interleukin-2 receptor alpha is elevated in sera of patients with benign ovarian neoplasms and epithelial ovarian cancer. Cancer 1995; 76:1615-20. [PMID: 8635066 DOI: 10.1002/1097-0142(19951101)76:9<1615::aid-cncr2820760918>3.0.co;2-g] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Previous studies have established that soluble interleukin-2 receptor alpha (sIL-2R alpha) levels are elevated in ascites and sera from individuals with advanced ovarian cancer (International Federation of Gynecology and Obstetrics [FIGO] Stage III/IV). This study was undertaken to evaluate sIL-2R alpha levels in individuals with benign ovarian neoplasms and early stage ovarian cancer (FIGO Stage I/II). Comparison with CA 125 levels was performed to assess screening potential. METHODS Sera from 92 healthy individuals, 61 with benign adnexal masses, 12 patients with FIGO Stage I/II ovarian cancers, and 27 patients with FIGO Stage III/IV ovarian cancers were assayed for sIL-2R alpha by enzyme-linked immunosorbent assay and CA 125 by radioimmunoassay. RESULTS The mean serum sIL-2R alpha levels for benign pelvic masses, and Stage I/II and Stage III/IV epithelial ovarian cancer were 1507 +/- 82, 1631 +/- 274, and 2596 +/- 384 U/ml, respectively. The difference between mean serum sIL-2R alpha levels in individuals with benign adnexal masses and Stage III/IV epithelial ovarian cancer was statistically significant (P < 0.05). In addition, of the four individuals with FIGO Stage I/II ovarian cancer who had CA125 levels below 35 U/ml, the accepted upper limit of normal, three patients had elevated serum sIL-2R alpha levels. Eleven of 12 patients (92%) with potentially curable Stage I/II disease had elevated serum levels of either sIL-2R alpha or CA125 and 8 of 12 (67%) had elevations of both sIL-2R alpha and CA125. Sensitivity and specificity of a combination of CA 125 and soluble IL-2R alpha were 88.5% and 27.1%, respectively. CONCLUSION Soluble interleukin-2 receptor alpha levels do not appear to differentiate between benign adnexal lesions and early malignancy; however, measurement of sIL-2R alpha levels in combination with CA125 warrants further evaluation to determine if together they will identify individuals with Stages I and II ovarian cancer.
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Affiliation(s)
- J A Hurteau
- Division of Oncology Research, Toronto General Hospital, Ontario, Canada
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