1
|
Sobia P, Mahomed S, Sivro A, Paul S, Osman F, Harkoo I, Garrett N, Karim QA, Karim SSA, Archary D. Circulating immunoglobulins and transient lymphocytopenia in a sub-study of CAPRISA 012B, testing HIV monoclonal antibodies in a phase 1 trial. Sci Rep 2024; 14:13499. [PMID: 38866888 PMCID: PMC11169379 DOI: 10.1038/s41598-024-63902-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 06/03/2024] [Indexed: 06/14/2024] Open
Abstract
Acute, transient lymphocytopenia, not clinically significant was observed in the CAPRISA 012B phase 1 clinical trial following administration of broadly neutralizing antibodies (bnAb)-CAP256V2LS alone or with VRC07-523LS. Lymphocytopenia was assigned upon a > 50% decline in absolute lymphocyte counts following bnAb administration. We posited that systemic immunoglobulins (Igs), and cytokine profiles of eight women who developed lymphocytopenia were different to the 12 women without lymphocytopenia. Plasma Ig subclasses (IgG)/isotypes (IgM/IgA), and 27 cytokines were measured at enrolment (prior to bnAbs) and at days 1, 7, 28, 56 post-bnAb administration. IgG subclasses, IgM and total lymphocyte counts were significantly lower prior to bnAbs in women with gradable lymphocytopenia than those without. Gradable lymphocytopenia compared to non-lymphocytopenia women had significantly higher MIP-1β from enrolment up to day 56. TNF-α was significantly lower in gradable lymphocytopenia compared to non-lymphocytopenia women for enrolment, days 7, 28 and 56 except for day 1. Within the gradable and within the non-lymphocytopenia women, from enrolment to day 1, significantly elevated IL-6, IL-8, IP-10, MCP-1, G-CSF and IL-1RA were found. Additionally, within the gradable lymphocytopenia women, 9 additional cytokines (TNF-α, MIP-1α, MIP-1β, RANTES, Basic FGF, eotaxin, IFN-γ, IL-17A and IL-4) were significantly elevated at day 1 post-bnAbs compared to enrolment. This sub study presents preliminary findings to support the monitoring of baseline immunological markers including lymphocyte counts for assessing the development of transient lymphocytopenia. In high-risk settings conducting clinical trials testing bnAbs for HIV prevention, understanding factors that could amplify rates of lymphocytopenia, even if transient, remain undefined.
Collapse
Affiliation(s)
- Parveen Sobia
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, 2nd Floor, Doris Duke Medical Research Institute, 719 Umbilo Road, Durban, 4041, South Africa
| | - Sharana Mahomed
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, 2nd Floor, Doris Duke Medical Research Institute, 719 Umbilo Road, Durban, 4041, South Africa
- Department of Medical Microbiology, University of Kwazulu-Natal, Durban, South Africa
| | - Aida Sivro
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, 2nd Floor, Doris Duke Medical Research Institute, 719 Umbilo Road, Durban, 4041, South Africa
- Department of Medical Microbiology, University of Kwazulu-Natal, Durban, South Africa
- JC Wilt Infectious Disease Research Centre, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada
| | - Stephane Paul
- GIMAP (EA3064), University of Saint-Etienne/University of Lyon, Saint-Étienne, France
| | - Farzana Osman
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, 2nd Floor, Doris Duke Medical Research Institute, 719 Umbilo Road, Durban, 4041, South Africa
| | - Ishana Harkoo
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, 2nd Floor, Doris Duke Medical Research Institute, 719 Umbilo Road, Durban, 4041, South Africa
| | - Nigel Garrett
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, 2nd Floor, Doris Duke Medical Research Institute, 719 Umbilo Road, Durban, 4041, South Africa
| | - Quarraisha Abdool Karim
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, 2nd Floor, Doris Duke Medical Research Institute, 719 Umbilo Road, Durban, 4041, South Africa
- Department of Epidemiology, Columbia University, New York, NY, USA
| | - Salim S Abdool Karim
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, 2nd Floor, Doris Duke Medical Research Institute, 719 Umbilo Road, Durban, 4041, South Africa
- Department of Epidemiology, Columbia University, New York, NY, USA
| | - Derseree Archary
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, 2nd Floor, Doris Duke Medical Research Institute, 719 Umbilo Road, Durban, 4041, South Africa.
- Department of Medical Microbiology, University of Kwazulu-Natal, Durban, South Africa.
| |
Collapse
|
2
|
Zhang H, Li Y, Liu G, Chen X. Expression analysis of lymphocyte subsets and lymphocyte-to-monocyte ratio: reveling immunosuppression and chronic inflammation in breast cancer. J Cancer Res Clin Oncol 2024; 150:28. [PMID: 38263363 PMCID: PMC10805813 DOI: 10.1007/s00432-023-05508-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 11/06/2023] [Indexed: 01/25/2024]
Abstract
OBJECTIVE To explore the immune status and chronic inflammation of breast cancer patients, this study aims to analyze the diagnostic value of peripheral blood lymphocyte subsets (CD3+T, CD4+T, CD8+T, CD3+CD4-CD8-T, CD19+B, and NK cells) and lymphocyte-to-monocyte ratio (LMR) for breast cancer. Furthermore, it seeks to examine the correlation between these subsets and LMR with clinicopathological features. METHODS A total of 100 breast cancer patients were selected as the experimental group, while 55 patients with benign breast diseases were included in the control group. Statistical analysis, including the Wilcoxon test, Kruskal-Wallis test and the receiver operating characteristic curve, was employed to investigate the association between these serum indexes and the clinicopathological characteristics of the patients. RESULTS The levels of CD3+T cells, CD4+T cells, CD8+T cells, CD4+/CD8+ ratio, NK cells, CD3+CD4-CD8-T cells, and LMR were found to be related to the occurrence of breast cancer when analyzing data from patients with benign and malignant breast diseases. Among these biomarkers, CD3+T cells, CD4+T cells, CD4+/CD8+ ratio, CD3+CD4-CD8-T cells, and LMR were identified as independent risk factors for breast cancer development, and the AUCs were 0.760, 0.750, 0.598, 0.697, and 0.761 (P < 0.05), respectively. Furthermore, we observed varying degrees of differences in the expression of CD3+T cells, CD4+T cells, CD8+T cells, CD4+/CD8+ ratio, and LMR in lymph node metastasis, clinical staging, molecular typing, Ki-67 level (P < 0.05). However, statistical differences in histologic grade and pathology type were not found (P ≥ 0.05). CONCLUSION Lymphocyte subsets and LMR reflect the immune status and chronic inflammation of the body, respectively. They have certain value in the diagnosis of benign and malignant breast diseases, and correlate with lymph node metastasis, clinical staging, molecular typing and other clinicopathological features of breast cancer. Therefore, monitoring the expression of lymphocyte subsets and LMR in the body may help the auxiliary diagnosis and condition analysis of breast cancer in the clinic.
Collapse
Affiliation(s)
- Hao Zhang
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yan Li
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Gang Liu
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xin Chen
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
| |
Collapse
|
3
|
Gao H, Ouyang D, Guan X, Xu J, Chen Q, Zeng L, Pang J, Zou Q, Qian K, Yi W. Immune characteristics and clinical significance of peripheral blood lymphocytes in breast cancer. BMC Cancer 2024; 24:50. [PMID: 38195475 PMCID: PMC10775541 DOI: 10.1186/s12885-024-11815-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 01/01/2024] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND In the context of breast cancer (BC), the correlation between lymphocytes and clinical outcomes, along with treatment response, has garnered attention. Despite this, few investigations have delved into the interplay among distinct peripheral blood lymphocyte (PBL) types, immune attributes, and their clinical implications within the BC landscape. METHODS The primary objective of this study was to scrutinize the baseline status of PBL subsets in patients with primary BC, track their dynamic changes throughout treatment, and ascertain their interrelation with prognosis. Flow cytometry was employed to analyse PBLs from a cohort of 74 BC patients. RESULTS Our analysis revealed that baseline levels of Treg and PD-L1 + T cells were lower in BC patients compared to the reference values. Notably, a disparity in baseline PD-L1 + T cell levels surfaced between patients who underwent adjuvant therapy and those subjected to neoadjuvant therapy (NAT). Furthermore, a meticulous evaluation of PBL subsets before and after treatment underscored discernible alterations in 324 + T cells and CD19 + CD32 + B cells over the course of therapy. Strikingly, heightened CD4 + T cell levels at baseline were linked to enhanced event-free survival (EFS) (p = 0.02) and a robust response to chemotherapy. CONCLUSIONS These results indicate that PBLs may serve as a significant marker to assess the immune status of BC patients, and therapy has the potential to modify patient immune profiles. In addition, peripheral blood CD4 + T cell levels may serve as promising biomarkers for diagnosis and prognosis in future studies of BC.
Collapse
Affiliation(s)
- Hongyu Gao
- Department of General Surgery, The Second Xiangya Hospital, Central South University, No.139 People's Road, Changsha, Hunan, 410011, P.R. China
- Clinical Research Center For Breast Disease In Hunan Province, Changsha, 410011, China
| | - Dengjie Ouyang
- Department of General Surgery, The Second Xiangya Hospital, Central South University, No.139 People's Road, Changsha, Hunan, 410011, P.R. China
- Clinical Research Center For Breast Disease In Hunan Province, Changsha, 410011, China
- Department of General Surgery, Xiangya Hospital Central South University, Changsha, China
| | - Xinyu Guan
- Department of General Surgery, The Second Xiangya Hospital, Central South University, No.139 People's Road, Changsha, Hunan, 410011, P.R. China
- Clinical Research Center For Breast Disease In Hunan Province, Changsha, 410011, China
| | - Jiachi Xu
- Department of General Surgery, The Second Xiangya Hospital, Central South University, No.139 People's Road, Changsha, Hunan, 410011, P.R. China
- Clinical Research Center For Breast Disease In Hunan Province, Changsha, 410011, China
| | - Qitong Chen
- Department of General Surgery, The Second Xiangya Hospital, Central South University, No.139 People's Road, Changsha, Hunan, 410011, P.R. China
- Clinical Research Center For Breast Disease In Hunan Province, Changsha, 410011, China
| | - Liyun Zeng
- Department of General Surgery, The Second Xiangya Hospital, Central South University, No.139 People's Road, Changsha, Hunan, 410011, P.R. China
- Clinical Research Center For Breast Disease In Hunan Province, Changsha, 410011, China
| | - Jian Pang
- Department of General Surgery, The Second Xiangya Hospital, Central South University, No.139 People's Road, Changsha, Hunan, 410011, P.R. China
- Clinical Research Center For Breast Disease In Hunan Province, Changsha, 410011, China
| | - Qiongyan Zou
- Department of General Surgery, The Second Xiangya Hospital, Central South University, No.139 People's Road, Changsha, Hunan, 410011, P.R. China
- Clinical Research Center For Breast Disease In Hunan Province, Changsha, 410011, China
| | - Ke Qian
- Department of General Surgery, The Second Xiangya Hospital, Central South University, No.139 People's Road, Changsha, Hunan, 410011, P.R. China.
- Clinical Research Center For Breast Disease In Hunan Province, Changsha, 410011, China.
| | - Wenjun Yi
- Department of General Surgery, The Second Xiangya Hospital, Central South University, No.139 People's Road, Changsha, Hunan, 410011, P.R. China.
- Clinical Research Center For Breast Disease In Hunan Province, Changsha, 410011, China.
| |
Collapse
|
4
|
Kim CG, Kim MH, Kim JH, Kim SG, Kim GM, Kim TY, Ryu WJ, Kim JY, Park HS, Park S, Cho YU, Park BW, Kim SI, Jeong J, Sohn J. On-treatment derived neutrophil-to-lymphocyte ratio and survival with palbociclib and endocrine treatment: analysis of a multicenter retrospective cohort and the PALOMA-2/3 study with immune correlates. Breast Cancer Res 2023; 25:4. [PMID: 36635767 PMCID: PMC9838072 DOI: 10.1186/s13058-022-01601-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 12/26/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors have been established as a standard treatment for hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer (ABC); however, predictive biomarkers with translational relevance have not yet been elucidated. METHODS Data from postmenopausal women who received the CDK4/6 inhibitor palbociclib and letrozole for HR-positive, HER2-negative ABC from tertiary referral centers were analyzed (N = 221; exploratory cohort). Pre- and on-treatment neutrophil-to-lymphocyte ratio (NLR) and derived NLR (dNLR; neutrophil/[leukocyte-neutrophil]) were correlated with survival outcomes. Data from the PALOMA-2 (NCT01740427) and PALOMA-3 studies (NCT01942135) involving patients treated with endocrine treatment with or without palbociclib were also analyzed (validation cohort). Prospectively enrolled patients (N = 20) were subjected to immunophenotyping with circulating immune cells to explore the biological implications of immune cell dynamics. RESULTS In the exploratory cohort, palbociclib administration significantly reduced leukocyte, neutrophil, and lymphocyte counts on day 1 of cycle 2. Although the baseline dNLR was not significantly associated with progression-free survival (PFS), higher on-treatment dNLRs were associated with worse PFS (hazard ratio = 3.337, P < 0.001). In the PALOMA-2 validation cohort, higher on-treatment dNLRs were associated with inferior PFS in patients treated with palbociclib and letrozole (hazard ratio = 1.498, P = 0.009), and reduction in the dNLR after treatment was predictive of a survival benefit (hazard ratio = 1.555, P = 0.026). On-treatment dNLRs were also predictive of PFS following palbociclib and fulvestrant treatment in the PALOMA-3 validation cohort. Using flow cytometry analysis, we found that the CDK4/6 inhibitor prevented T cell exhaustion and diminished myeloid-derived suppressor cell frequency. CONCLUSIONS On-treatment dNLR significantly predicted PFS in patients with HR-positive, HER2-negative ABC receiving palbociclib and endocrine treatment. Additionally, we observed putative systemic immune responses elicited by palbociclib, suggesting immunologic changes upon CDK4/6 inhibitor treatment.
Collapse
Affiliation(s)
- Chang Gon Kim
- grid.15444.300000 0004 0470 5454Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722 Republic of Korea
| | - Min Hwan Kim
- grid.15444.300000 0004 0470 5454Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722 Republic of Korea
| | - Jee Hung Kim
- grid.15444.300000 0004 0470 5454Division of Medical Oncology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea ,grid.15444.300000 0004 0470 5454Institute for Breast Cancer Precision Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seul-Gi Kim
- grid.15444.300000 0004 0470 5454Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722 Republic of Korea
| | - Gun Min Kim
- grid.15444.300000 0004 0470 5454Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722 Republic of Korea
| | - Tae Yeong Kim
- grid.15444.300000 0004 0470 5454Avison Biomedical Research Center, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Won-Ji Ryu
- grid.15444.300000 0004 0470 5454Avison Biomedical Research Center, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jee Ye Kim
- grid.15444.300000 0004 0470 5454Division of Breast Surgery, Department of Surgery, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyung Seok Park
- grid.15444.300000 0004 0470 5454Division of Breast Surgery, Department of Surgery, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seho Park
- grid.15444.300000 0004 0470 5454Division of Breast Surgery, Department of Surgery, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young Up Cho
- grid.15444.300000 0004 0470 5454Division of Breast Surgery, Department of Surgery, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Byeong Woo Park
- grid.15444.300000 0004 0470 5454Division of Breast Surgery, Department of Surgery, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seung Il Kim
- grid.15444.300000 0004 0470 5454Division of Breast Surgery, Department of Surgery, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Joon Jeong
- Institute for Breast Cancer Precision Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. .,Division of Breast Surgery, Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, 712 Eonjuro, Gangnam-Gu, Seoul, 06273, Republic of Korea.
| | - Joohyuk Sohn
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea.
| |
Collapse
|
5
|
Serum protein profiling of lung, pancreatic, and colorectal cancers reveals alcohol consumption-mediated disruptions in early-stage cancer detection. Heliyon 2022; 8:e12359. [PMID: 36590537 PMCID: PMC9794896 DOI: 10.1016/j.heliyon.2022.e12359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 10/20/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
While the link between serum proteins and cancer has been studied in an effort to enable early-stage cancer detection, factors that might perturb this link has been poorly understood. To ask this question, we performed serum protein profiling on a prospective cohort of 601 individuals with or without lung, pancreatic, or colorectal cancers and identified ten distinct serum protein signatures with distinct link to the patient metadata. Importantly, we discovered that a positive history of alcohol consumption is a major factor that diminishes the sensitivity of serum protein-mediated liquid biopsy in early-stage malignancies, resulting in a 44% decline in the sensitivity of detecting American Joint Committee on Cancer (AJCC) stage I malignancies. Our data provide evidence that patient lifestyle can affect the sensitivity of liquid biopsy and suggest the potential need for abstinence from alcohol before measurement during serum protein-based cancer screening.
Collapse
|
6
|
Gianni C, Palleschi M, Schepisi G, Casadei C, Bleve S, Merloni F, Sirico M, Sarti S, Cecconetto L, Di Menna G, Schettini F, De Giorgi U. Circulating inflammatory cells in patients with metastatic breast cancer: Implications for treatment. Front Oncol 2022; 12:882896. [PMID: 36003772 PMCID: PMC9393759 DOI: 10.3389/fonc.2022.882896] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 07/05/2022] [Indexed: 11/20/2022] Open
Abstract
Adaptive and innate immune cells play a crucial role as regulators of cancer development. Inflammatory cells in blood flow seem to be involved in pro-tumor activities and contribute to breast cancer progression. Circulating lymphocyte ratios such as the platelet-lymphocytes ratio (PLR), the monocyte-lymphocyte ratio (MLR) and the neutrophil-lymphocyte ratio (NLR) are new reproducible, routinely feasible and cheap biomarkers of immune response. These indexes have been correlated to prognosis in many solid tumors and there is growing evidence on their clinical applicability as independent prognostic markers also for breast cancer. In this review we give an overview of the possible value of lymphocytic indexes in advanced breast cancer prognosis and prediction of outcome. Furthermore, targeting the immune system appear to be a promising therapeutic strategy for breast cancer, especially macrophage-targeted therapies. Herein we present an overview of the ongoing clinical trials testing systemic inflammatory cells as therapeutic targets in breast cancer.
Collapse
Affiliation(s)
- Caterina Gianni
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
- *Correspondence: Caterina Gianni,
| | - Michela Palleschi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Giuseppe Schepisi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Chiara Casadei
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Sara Bleve
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Filippo Merloni
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Marianna Sirico
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Samanta Sarti
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Lorenzo Cecconetto
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Giandomenico Di Menna
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Francesco Schettini
- Department of Medical Oncology, Hospital Clinic of Barcelona, Barcelona, Spain
- Translational Genomics and Targeted Therapies in Solid Tumors Group, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Ugo De Giorgi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| |
Collapse
|
7
|
COVID-19, Mucormycosis and Cancer: The Triple Threat-Hypothesis or Reality? J Pers Med 2022; 12:jpm12071119. [PMID: 35887616 PMCID: PMC9320339 DOI: 10.3390/jpm12071119] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/04/2022] [Accepted: 07/08/2022] [Indexed: 01/09/2023] Open
Abstract
COVID-19 has been responsible for widespread morbidity and mortality worldwide. Invasive mucormycosis has death rates scaling 80%. India, one of the countries hit worst by the pandemic, is also a hotbed with the highest death rates for mucormycosis. Cancer, a ubiquitously present menace, also contributes to higher case fatality rates. All three entities studied here are individual, massive healthcare threats. The danger of one disease predisposing to the other, the poor performance status of patients with all three diseases, the impact of therapeutics for one disease on the pathology and therapy of the others all warrant physicians having a better understanding of the interplay. This is imperative so as to effectively establish control over the individual patient and population health. It is important to understand the interactions to effectively manage all three entities together to reduce overall morbidity. In this review article, we search for an inter-relationship between the COVID-19 pandemic, emerging mucormycosis, and the global giant, cancer.
Collapse
|
8
|
He X, Su A, Xu Y, Ma D, Yang G, Peng Y, Guo J, Hu M, Ma Y. Prognostic Role of Lymphocyte-C-Reactive Protein Ratio in Colorectal Cancer: A Systematic Review and Meta Analysis. Front Oncol 2022; 12:905144. [PMID: 35875086 PMCID: PMC9296779 DOI: 10.3389/fonc.2022.905144] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 05/31/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction The lymphocyte-C-reactive protein ratio (LCR) is a new immunoinflammatory score and prognostic marker, but the relationship between this index and the prognosis of colorectal cancer patients remains controversial.Therefore, aim of the study was to assess the relationship between LCR and prognosis for colorectal cancer patients through a systematic evaluation and meta-analysis. Methods We systematically searched PubMed, EMBASE, Web of Science, and Cochrane Library databases for randomized controlled studies and observational studies on the relationship between LCR and prognosis of colorectal cancer patients, all searched from the date of database creation to January 6, 2022.Our primary endpoints observed were overall survival (OS) and disease-free survival (DFS) of colorectal cancer patients, and secondary observables were basic characteristics of included studies, such as country, study duration, sample size, LCR threshold, and pathological characteristics of patients in each study, such as degree of differentiation, gender, tumor location, T stage, and lymphatic metastasis. Results A total of 10 case-control studies including 7068 patients were included. Meta-analysis results showed that overall survival (OS) and disease-free survival (DFS) were worse in colorectal cancer patients with lower levels of LCR (HR=0.44, 95% CI=0.38-0.52, P<0.001; HR=0.56, 95% CI=0.41-0.76, P< 0.001).Subgroup analysis based on country, study length, sample size, and LCR threshold showed that lower levels of LCR were all associated with poorer OS (P < 0.05). Regarding pathological characteristics, patients in the low LCR group were generally poorly differentiated (OR=1.79, 95% CI=1.55-2.07, P<0.001), while there was no significant relationship with gender, tumor location, T stage, and lymphatic metastasis (P>0.05). Discussion/Conclusion LCR can be used as a prognostic marker for colorectal cancer patients, and patients with lower levels of LCR may have a poor prognosis. Due to the limitation of the number and quality of the included studies, the above findings need to be validated by more high-quality studies. Systematic Review Registration https://www.crd.york.ac.uk/prospero/, identifier CRD42022296563.
Collapse
Affiliation(s)
- Xinglong He
- The First Clinical School of Gansu University of Chinese Medicine, Lanzhou, China
- General Surgery Clinical Medical Center, Gansu Provincial People’s Hospital, Lanzhou, China
- Gansu Provincial Key Laboratory of Molecular Diagnosis and Precision Therapy of Surgical Tumors, Gansu Provincial People’s Hospital, Lanzhou, China
| | - Ade Su
- The Second Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Yongcheng Xu
- The First Clinical School of Gansu University of Chinese Medicine, Lanzhou, China
- General Surgery Clinical Medical Center, Gansu Provincial People’s Hospital, Lanzhou, China
- Gansu Provincial Key Laboratory of Molecular Diagnosis and Precision Therapy of Surgical Tumors, Gansu Provincial People’s Hospital, Lanzhou, China
| | - Diaolong Ma
- The First Clinical School of Gansu University of Chinese Medicine, Lanzhou, China
- General Surgery Clinical Medical Center, Gansu Provincial People’s Hospital, Lanzhou, China
- Gansu Provincial Key Laboratory of Molecular Diagnosis and Precision Therapy of Surgical Tumors, Gansu Provincial People’s Hospital, Lanzhou, China
| | - Guoyuan Yang
- The First Clinical School of Gansu University of Chinese Medicine, Lanzhou, China
- General Surgery Clinical Medical Center, Gansu Provincial People’s Hospital, Lanzhou, China
- Gansu Provincial Key Laboratory of Molecular Diagnosis and Precision Therapy of Surgical Tumors, Gansu Provincial People’s Hospital, Lanzhou, China
| | - Yiyun Peng
- The First Clinical School of Gansu University of Chinese Medicine, Lanzhou, China
- General Surgery Clinical Medical Center, Gansu Provincial People’s Hospital, Lanzhou, China
- Gansu Provincial Key Laboratory of Molecular Diagnosis and Precision Therapy of Surgical Tumors, Gansu Provincial People’s Hospital, Lanzhou, China
| | - Jin Guo
- The first Department of general surgery, Gansu Provincial People's Hospital, Lanzhou, China
| | - Ming Hu
- The first Department of general surgery, Gansu Provincial People's Hospital, Lanzhou, China
| | - Yuntao Ma
- The First Clinical School of Gansu University of Chinese Medicine, Lanzhou, China
- General Surgery Clinical Medical Center, Gansu Provincial People’s Hospital, Lanzhou, China
- Gansu Provincial Key Laboratory of Molecular Diagnosis and Precision Therapy of Surgical Tumors, Gansu Provincial People’s Hospital, Lanzhou, China
- *Correspondence: Yuntao Ma,
| |
Collapse
|
9
|
Li M, Xu J, Jiang C, Zhang J, Sun T. Predictive and Prognostic Role of Peripheral Blood T-Cell Subsets in Triple-Negative Breast Cancer. Front Oncol 2022; 12:842705. [PMID: 35242718 PMCID: PMC8886691 DOI: 10.3389/fonc.2022.842705] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 01/17/2022] [Indexed: 11/15/2022] Open
Abstract
Background Triple-negative breast cancer (TNBC), as a highly aggressive and metastatic tumor, can still not contain the medical needs. It has become an urgent problem to develop prognostic markers further and realize precision medicine. The predictive and prognostic significance of peripheral blood lymphocytes, as well as the clinicopathological factors affecting them, were explored in the present study. Methods The clinicopathological data of 278 patients with TNBC were collected and analyzed retrospectively. Peripheral blood lymphocytes (pBL) and blood routine indexes before treatment were quantified by flow cytometry analysis. Progression-free survival (PFS) and overall survival (OS) were analyzed by the Kaplan-Meier curve and Cox hazard proportion regression model. The associations between hematologic parameters and treatment response and clinicopathological characteristics were estimated by the Mann-Whitney test and Spearman test. Results Compared with all blood routine indexes, only a significant correlation between better treatment efficacy and higher peripheral CD4 +/CD8 + ratio of TNBC patients was observed (P=0.059), particularly those treated with chemotherapy combined with immune checkpoint inhibitors (P=0.048). Among the pBL subsets, CD4 + T lymphocyte was the only independent factor that could predict the prognosis of metastatic TNBC. Patients presenting higher values of peripheral CD4 + T lymphocytes showed longer PFS (median PFS 9 months vs. 5 months; HR =0.65, 95%CI: 0.440-0.973, P = 0.032) and OS (median OS 31 months vs. 16 months; HR=0 .63, 95%CI: 0.417-0.940, P< 0.01). Especially CD4+ was found predictive for prognosis in TNBC patients who received chemotherapy (P<0.05). Finally, the older age, higher clinical stage, and more advanced treatment lines were related to the lower level of CD4 +. The older age and having received neoadjuvant therapy were related to the lower CD4 +/CD8 + ratio (P<0.05). Conclusion The baseline CD4+/CD8+ cell ratio in peripheral blood is associated with therapeutic response, especially for chemotherapy combined with immunotherapy. Peripheral CD4+ cells can steadily predict all clinical outcomes for patients with mTNBC, and this clinical prognosis prediction is significantly related to chemotherapy. Peripheral CD4+ and CD4+/CD8+ are both closely associated with clinicopathological parameters.
Collapse
Affiliation(s)
- Meng Li
- Department of Medical Oncology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institution, Shenyang, China
| | - Junnan Xu
- Department of Medical Oncology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institution, Shenyang, China
| | - Cui Jiang
- Department of Medical Oncology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institution, Shenyang, China
| | - Jingyan Zhang
- Department of Medical Oncology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institution, Shenyang, China
| | - Tao Sun
- Department of Medical Oncology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institution, Shenyang, China
| |
Collapse
|
10
|
Deibel A, Stocker D, Meyer zu Schwabedissen C, Husmann L, Kronenberg PA, Grimm F, Deplazes P, Reiner CS, Müllhaupt B. Evaluation of a structured treatment discontinuation in patients with inoperable alveolar echinococcosis on long-term benzimidazole therapy: A retrospective cohort study. PLoS Negl Trop Dis 2022; 16:e0010146. [PMID: 35089933 PMCID: PMC8827419 DOI: 10.1371/journal.pntd.0010146] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 02/09/2022] [Accepted: 01/05/2022] [Indexed: 01/02/2023] Open
Abstract
Objectives Alveolar echinococcosis (AE) is an orphan zoonosis of increasing concern in endemic areas, including Europe. It frequently presents in an advanced, inoperable stage, that requires life-long parasitostatic benzimidazole therapy. In some patients, long-term therapy leads to negative anti-Em18 antibody ELISA and PET. It is disputed, whether these patients are truly cured and treatment can be safely discontinued. Our aim was to retrospectively assess long-term outcome of 34 patients with inoperable AE who participated in a previous study to determine feasibility of benzimidazole treatment cessation. Methods Retrospective analysis of medical charts was undertaken in all 34 AE patients who participated in our previous study. Of particular interest were AE recurrence or other reasons for re-treatment in patients who stopped benzimidazole therapy and whether baseline clinical and laboratory parameters help identify of patients that might qualifiy for treatment cessation. Additionally, volumetric measurement of AE lesions on contrast-enhanced cross-sectional imaging was performed at baseline and last follow-up in order to quantify treatment response. Results 12 of 34 patients stopped benzimidazole therapy for a median of 131 months. 11 of these patients showed stable or regressive AE lesions as determined by volumetric measurement. One patient developed progressive lesions with persistently negative anti-Em18 antibody ELISA but slight FDG-uptake in repeated PET imaging. At baseline, patients who met criteria for treatment cessation demonstrated higher lymphocyte count and lower total IgE. Conclusion Treatment cessation is feasible in inoperable AE patients, who demonstrate negative anti-Em18 antibody ELISA and PET on follow-up. Close monitoring including sectional imaging is strongly advised.
Collapse
Affiliation(s)
- Ansgar Deibel
- Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland
- * E-mail:
| | - Daniel Stocker
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | | | - Lars Husmann
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Philipp Andreas Kronenberg
- Institute of Parasitology, Vetsuisse and Medical Faculty, University of Zurich, Zurich, Switzerland
- Graduate School for Cellular and Biomedical Sciences (GCB), University of Bern, Bern, Switzerland
| | - Felix Grimm
- Institute of Parasitology, Vetsuisse and Medical Faculty, University of Zurich, Zurich, Switzerland
| | - Peter Deplazes
- Institute of Parasitology, Vetsuisse and Medical Faculty, University of Zurich, Zurich, Switzerland
| | - Cäcilia S. Reiner
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Beat Müllhaupt
- Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland
| |
Collapse
|
11
|
Shen DS, Yan C, Chen KH, Li L, Qu S, Zhu XD. A Nomogram Based on Circulating CD4 + T Lymphocytes and Lactate Dehydrogenase to Predict Distant Metastasis in Patients with Nasopharyngeal Carcinoma. J Inflamm Res 2021; 14:6707-6718. [PMID: 34916820 PMCID: PMC8668247 DOI: 10.2147/jir.s341897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/24/2021] [Indexed: 12/24/2022] Open
Abstract
Purpose Distant metastasis is the main pattern of treatment failure in nasopharyngeal carcinoma (NPC) in the era of intensity-modulated radiotherapy (IMRT). We aimed to establish and validate a prognostic nomogram to identify patients with a high risk of distant metastasis. Patients and Methods A total of 503 patients with nonmetastatic NPC were included in this retrospective study. We established a prognostic nomogram for distant metastasis-free survival (DMFS) based on the Cox proportional hazards model. The predictive discriminative ability and accuracy of the nomogram were assessed with the concordance index (C-index), receiver operating characteristic (ROC) curve, and calibration curve. The nomogram’s clinical utility was also evaluated using decision curve analysis (DCA) and Kaplan–Meier method. The predictive ability of the nomogram was validated in an independent cohort. Results The multivariate analysis showed that circulating CD4+ T lymphocytes, lactate dehydrogenase (LDH), serum ferritin (SF), and N stage were independent prognostic factors for DMFS. Then, we constructed the nomogram based on these factors. The C-indexes of the nomogram for distant metastasis were 0.763 (95% CI: 0.685–0.841) and 0.760 (95% CI: 0.643–0.877) in the training cohort and validation cohort, respectively, which was higher than the 8th TNM staging system (0.672 and 0.677). The calibration curve showed that the prediction results of the nomogram were in high agreement with the actual observation. The ROC curve indicated that the nomogram had a better predictive ability than TNM staging. The DCA also demonstrated that the nomogram was clinically beneficial. In addition, the patients were classified into two different risk groups (high-risk, low-risk) by the nomogram. Conclusion As a supplement to TNM staging, our nomogram could provide a more effective and accurate prognostic prediction of distant metastasis in NPC patients. It has the potential to guide the individualized treatment of patients to improve their survival.
Collapse
Affiliation(s)
- De-Song Shen
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People's Republic of China
| | - Chang Yan
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People's Republic of China
| | - Kai-Hua Chen
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People's Republic of China
| | - Ling Li
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People's Republic of China
| | - Song Qu
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People's Republic of China
| | - Xiao-Dong Zhu
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People's Republic of China.,Department of Oncology, Wuming Hospital of Guangxi Medical University, Nanning, Guangxi, 530199, People's Republic of China
| |
Collapse
|
12
|
Shen DS, Yan C, Liang Y, Chen KH, Zhu XD. Prognostic Significance of Circulating Lymphocyte Subsets Before Treatment in Patients with Nasopharyngeal Carcinoma. Cancer Manag Res 2021; 13:8109-8120. [PMID: 34737639 PMCID: PMC8558319 DOI: 10.2147/cmar.s334094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 10/16/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose We set out to explore the prognostic value of circulating lymphocyte subsets in patients with nasopharyngeal carcinoma (NPC) before treatment and to investigate changes in lymphocyte subsets resulting from chemoradiotherapy. Patients and Methods This retrospective study included 677 patients with non-metastatic NPC. The cutoff value of lymphocyte subsets was determined by the receiver operating characteristic curve (ROC), and the prognostic significance of lymphocyte subsets was evaluated by the Log rank test and Cox proportional hazards model. The endpoints were overall survival (OS), progression-free survival (PFS), locoregional relapse-free survival (LRFS) and distant metastasis-free survival (DMFS). Differences in lymphocyte subsets before and after chemoradiotherapy were analyzed by Wilcoxon signed rank test. Results NPC patients with high levels of CD19+ B cells (>9.55%) had better 5-year OS (90.4% VS 76.8%, P < 0.001), 5-year PFS (85.3% VS 71.6%, P < 0.001) and 5-year DMFS (94% VS 86.8%, P = 0.002) than patients with low levels of CD19+ B cells. Patients with high levels of CD4+ T cells (> 37.05%) had better 5-year PFS (83% VS 74.2%, P = 0.015) and better 5-year DMFS (95.8% VS 86.7%, P < 0.001) than those with low levels of CD4+ T cells. Multivariate analyses indicated that CD19+ B cell was an independent prognostic factor for OS, PFS and DMFS in NPC. And CD4+ T cell was an independent prognostic factor for PFS and DMFS. Within 1 month after chemoradiotherapy, the percentages of CD4+ T cells, CD19+ B cells, and the CD4/CD8 ratio decreased significantly, while the percentages of CD8+ T cells increased significantly. Conclusion NPC patients with low levels of CD19+ B cells or CD4+ T cells before treatment have a poor prognosis. In addition, chemoradiotherapy may reduce the body’s immune function in NPC patients.
Collapse
Affiliation(s)
- De-Song Shen
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People's Republic of China
| | - Chang Yan
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People's Republic of China
| | - Yu Liang
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People's Republic of China
| | - Kai-Hua Chen
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People's Republic of China
| | - Xiao-Dong Zhu
- Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People's Republic of China.,Department of Oncology, Wuming Hospital of Guangxi Medical University, Nanning, Guangxi, 530199, People's Republic of China
| |
Collapse
|
13
|
Chen F, Ma L, Wang Q, Zhou M, Nong Y, Jing H, Han Y, Liu Y, Hu Y, Yu H, Fu P, Kong F(S. Chemotherapy is a risk factor of lymphopenia before adjuvant radiotherapy in breast cancer. Cancer Rep (Hoboken) 2021; 5:e1525. [PMID: 34390318 PMCID: PMC9327667 DOI: 10.1002/cnr2.1525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/08/2021] [Accepted: 07/27/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Lymphopenia can decrease immune function of the host and is a known risk factor for poor prognosis in malignant tumors. Radiation induced lymphopenia was common in patients with breast cancer and was also reported to have a negative effect on long-term outcome. AIMS Lymphopenia may be associated with baseline immune status before radiotherapy (RT). This study aimed to explore the rate and risk factors of lymphopenia before start of the adjuvant RT in patients with breast cancer. METHODS Patients with invasive breast cancer treated from March 2015 to February 2020 and with peripheral lymphocyte counts (PLC) available within 7 days from the beginning of RT were eligible for this study. Data were presented as mean and 95% confidence interval unless otherwise specified. The risk factors of low PLC before RT were identified using univariate and multivariable linear regressions. RESULTS A total of 1012 consecutive patients met the study criteria. The mean PLC before RT commencement was 1.58*109 /L (95%CI: 1.55-1.62*109 /L) with 15.2% (95%CI: 13.1%-17.6%) CTCAE defined lymphopenia, rendering 12.3%, 2.6%, 0.3%, and 0% for grade 1, 2, 3 and 4 respectively. Univariate and multivariable linear regression showed prior chemotherapy was the most significant risk factor (p < .001) for low PLC, while age, menopausal status and lymph node stage were not (all ps > .05). A total of 912 (90.1%, 95%CI: 88.1%-91.9%) patients had chemotherapy before adjuvant RT in this study. In patients with HR+/HER2- breast cancer, 69.0% (95%CI: 63.0%-74.5%) N0 and 98.1% (95%CI: 95.1%-99.5%) N1 had also received chemotherapy. CONCLUSIONS Patients with breast cancer might have lymphopenia from prior chemotherapy at the start of adjuvant RT which could have negative effect on long-term outcome. It is also noted that most of the patients with HR+/HER2-, early-stage breast cancer were treated with aggressive chemotherapy without knowing the risk of chemotherapy induced lymphopenia. Future study on predictive or prognostic multigene assays is warranted to avoid unnecessary chemotherapy and subsequent lymphopenia in patients with low risk breast cancer.
Collapse
Affiliation(s)
- Fang Chen
- Department of Clinical OncologyThe University of Hong Kong‐Shenzhen HospitalShenzhenChina
| | - Lingyu Ma
- Department of Clinical OncologyThe University of Hong Kong‐Shenzhen HospitalShenzhenChina
| | - Qian Wang
- Department of Clinical OncologyThe University of Hong Kong‐Shenzhen HospitalShenzhenChina
| | - Manling Zhou
- Department of Clinical OncologyThe University of Hong Kong‐Shenzhen HospitalShenzhenChina
| | - Yaqing Nong
- Department of Clinical OncologyThe University of Hong Kong‐Shenzhen HospitalShenzhenChina
| | - Haiman Jing
- Department of Clinical OncologyThe University of Hong Kong‐Shenzhen HospitalShenzhenChina
| | - Ying Han
- Department of Clinical OncologyThe University of Hong Kong‐Shenzhen HospitalShenzhenChina
| | - Yaya Liu
- Department of Clinical OncologyThe University of Hong Kong‐Shenzhen HospitalShenzhenChina
| | - Yulin Hu
- Department of Clinical OncologyThe University of Hong Kong‐Shenzhen HospitalShenzhenChina
| | - Hao Yu
- Biomedical EngineeringShenzhen PolytechnicShenzhenChina
| | - Pingfu Fu
- Department of Population and Quantitative Health SciencesCase Western Reserve UniversityClevelandOhioUSA
| | | |
Collapse
|
14
|
Lusho S, Durando X, Mouret-Reynier MA, Kossai M, Lacrampe N, Molnar I, Penault-Llorca F, Radosevic-Robin N, Abrial C. Platelet-to-Lymphocyte Ratio Is Associated With Favorable Response to Neoadjuvant Chemotherapy in Triple Negative Breast Cancer: A Study on 120 Patients. Front Oncol 2021; 11:678315. [PMID: 34367964 PMCID: PMC8331686 DOI: 10.3389/fonc.2021.678315] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 06/29/2021] [Indexed: 12/31/2022] Open
Abstract
Introduction Triple negative breast cancer (TNBC) is highly heterogeneous, but still most of the patients are treated by the anthracycline/taxane-based neoadjuvant therapy (NACT). Tumor-infiltrating lymphocytes (TILs) are a strong predictive and prognostic biomarker in TNBC, however are not always available. Peripheral blood counts, which reflect the systemic inflammatory/immune status, are easier to obtain than TILs. We investigated whether baseline white cell or platelet counts, as well as, Neutrophil-to-Lymphocyte Ratio (NLR) or Platelet-to-Lymphocyte Ratio (PLR) could replace baseline TILs as predictive or prognostic biomarkers in a series of TNBC treated by standard NACT. Patients and Methods One hundred twenty patients uniformly treated by FEC/taxane NACT in a tertiary cancer care center were retrospectively analyzed. The presence of pathological complete response (pCR: ypT0/Tis, ypN0) or the presence of pCR and/small residual disease (ypT0/Tis/T1ab, ypN0) were considered as good responses in data analysis. Baseline/pre-NACT blood count, NLR, PLR and TILs were evaluated as predictors of response, distant recurrence rate and distant recurrence-free survival (DRFS). Results TILs ≥30% and ≥1.5% were best predictors of pCR and distant recurrence risk, respectively (p = 0.007, p = 0.012). However, in this cohort, pCR status was not significantly associated with recurrence. Only the ensemble of patients with pCR and small residual disease had lower recurrence risk and longer survival DRFS (p = 0.042, p = 0.024, respectively) than the rest of the cohort (larger residual disease). The only parameter which could predict the pCR/small residual disease status was PLR: patients with values lower than 133.25 had significantly higher chance of reaching that status after NACT (p = 0.045). However, no direct correlation could be established between baseline PLR and metastatic recurrence. No correlation either was found between TIL and individual blood counts, or between TILs and NLR or PLR. Conclusion In this cohort, TILs retained their pCR predictive value; however PLR was a better predictor of the ensemble of responses which had good outcome in terms of less distant recurrences or longer DRFS (pCR or small residual disease). Thus, baseline PLR is worth further, prospective investigation together with baseline TILs, as it might indicate a good TNBC response to NACT when TILs are unavailable.
Collapse
Affiliation(s)
- Sejdi Lusho
- Clermont Auvergne University, INSERM U1240 "Molecular Imaging and Theranostic Strategies", Centre Jean Perrin, Clermont-Ferrand, France.,Delegation for Clinical Research and Innovation, Centre Jean Perrin, Clermont-Ferrand, France.,Centre for Clinical Investigation, INSERM U501, Clermont-Ferrand, France
| | - Xavier Durando
- Clermont Auvergne University, INSERM U1240 "Molecular Imaging and Theranostic Strategies", Centre Jean Perrin, Clermont-Ferrand, France.,Delegation for Clinical Research and Innovation, Centre Jean Perrin, Clermont-Ferrand, France.,Centre for Clinical Investigation, INSERM U501, Clermont-Ferrand, France.,Department of Medical Oncology, Centre Jean Perrin, Clermont-Ferrand, France
| | - Marie-Ange Mouret-Reynier
- Clermont Auvergne University, INSERM U1240 "Molecular Imaging and Theranostic Strategies", Centre Jean Perrin, Clermont-Ferrand, France.,Delegation for Clinical Research and Innovation, Centre Jean Perrin, Clermont-Ferrand, France.,Centre for Clinical Investigation, INSERM U501, Clermont-Ferrand, France.,Department of Medical Oncology, Centre Jean Perrin, Clermont-Ferrand, France
| | - Myriam Kossai
- Clermont Auvergne University, INSERM U1240 "Molecular Imaging and Theranostic Strategies", Centre Jean Perrin, Clermont-Ferrand, France.,Department of Pathology, Centre Jean Perrin, Clermont-Ferrand, France
| | - Nathalie Lacrampe
- Clermont Auvergne University, INSERM U1240 "Molecular Imaging and Theranostic Strategies", Centre Jean Perrin, Clermont-Ferrand, France.,Department of Pathology, Centre Jean Perrin, Clermont-Ferrand, France
| | - Ioana Molnar
- Clermont Auvergne University, INSERM U1240 "Molecular Imaging and Theranostic Strategies", Centre Jean Perrin, Clermont-Ferrand, France.,Delegation for Clinical Research and Innovation, Centre Jean Perrin, Clermont-Ferrand, France.,Centre for Clinical Investigation, INSERM U501, Clermont-Ferrand, France
| | - Frederique Penault-Llorca
- Clermont Auvergne University, INSERM U1240 "Molecular Imaging and Theranostic Strategies", Centre Jean Perrin, Clermont-Ferrand, France
| | - Nina Radosevic-Robin
- Clermont Auvergne University, INSERM U1240 "Molecular Imaging and Theranostic Strategies", Centre Jean Perrin, Clermont-Ferrand, France.,Department of Pathology, Centre Jean Perrin, Clermont-Ferrand, France
| | - Catherine Abrial
- Clermont Auvergne University, INSERM U1240 "Molecular Imaging and Theranostic Strategies", Centre Jean Perrin, Clermont-Ferrand, France.,Delegation for Clinical Research and Innovation, Centre Jean Perrin, Clermont-Ferrand, France.,Centre for Clinical Investigation, INSERM U501, Clermont-Ferrand, France
| |
Collapse
|
15
|
Angin YS, Yildirim M, Dasiran F, Okan I. Could lymphocyte to C-reactive protein ratio predict the prognosis in patients with gastric cancer? ANZ J Surg 2021; 91:1521-1527. [PMID: 33956378 DOI: 10.1111/ans.16913] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 04/18/2021] [Accepted: 04/22/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Development or progression of inflammation in neoplastic diseases is known to be part of the disease. Lymphocyte to C-reactive protein ratio (LCR) is a new indicator showing the inflammatory state. The aim of this study is to show the clinical importance of the relationship between the preoperative LCR and the prognosis of patients with gastric cancer. METHODS AND PATIENTS We evaluated gastric cancer patients, who underwent surgery between 2010 and 2015. LCR and neutrophil-to-lymphocyte ratio (NLR) were calculated from pre-treatment of complete blood counts. Both ratios were compared to the perioperative outcomes and median survival times. Association between LCR and postoperative tumour stage was studied by using multivariate analysis with other clinicopathological variables. RESULTS A total of 123 patients were included. The mean age of the patients was 65.36 ± 10.08. Preoperative low LCR value was associated with advanced tumour stage, adjacent organ invasion, lymph node metastasis and postoperative early complications. The receiver operating characteristic analysis results showed that LCR and NLR parameters were significant (CI 0.718-0.886; 95%); P < 0.001, CI 0.534-0.732; 95%). Cut-off value being 193, the mean survival of patients who had LCR values of overcut-off value was found to be significantly higher compared with the patients with lower LCR values (P < 0.001). CONCLUSION LCR, a simple calculated ratio of values obtained from easy and widely available serum indicators could be an effective prognostic marker with gastric cancer.
Collapse
Affiliation(s)
- Yavuz Selim Angin
- Department of General Surgery, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
| | - Murat Yildirim
- Department of General Surgery, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
| | - Fatih Dasiran
- Department of General Surgery, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
| | - Ismail Okan
- Department of General Surgery, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
| |
Collapse
|
16
|
Ray D, Gupta S, De A, Jain P, Bhattacharya N, Biswas P. Tumor infiltrating lymphocytes profile and response in neoadjuvant chemotherapy-treated triple-negative breast carcinoma patients. J Cancer Res Ther 2021; 18:1782-1788. [DOI: 10.4103/jcrt.jcrt_997_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
17
|
Patil VM, Singh GK, Noronha V, Joshi A, Menon N, Lashkar SG, Mathrudev V, Satam KN, Mukadam SA, Prabhash K. Lymphopenia during chemoradiation-foe or friend. Ecancermedicalscience 2020; 14:1109. [PMID: 33144877 PMCID: PMC7581337 DOI: 10.3332/ecancer.2020.1109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Indexed: 12/02/2022] Open
Abstract
Background Severe lymphopenia during treatment is considered to be a poor prognostic factor. The current literature lacks information regarding its impact on various outcomes in locally advanced head-and-neck cancer patients in a prospective setting. Methods We recently published a randomised study comparing cisplatin–radiation with nimotuzumab cisplatin–radiation. The database of this study was used for the present analysis. The impact of severe lymphopenia (grade 4 lymphopenia) on progression-free survival (PFS), locoregional control (LRC) and overall survival (OS) was studied using the Kaplan–Meier method and Cox regression analysis. The binary logistic regression analysis was used to see the effect of various factors on the development of severe lymphopenia. Results We had a total of 536 patients, of which 521 patients (97.7%) developed lymphopenia. Grade 1 lymphopenia was noted in 10 (1.9%) patients, grade 2 in 100 (18.8%), grade 3 in 338 (63.1%) and grade 4 in 73 (13.7%) patients. The median PFS was 20.53 and 60.33 months in severe and non-severe lymphopenia, respectively (hazard ratio, 0.797; p-value = 0.208). The median duration of LRC was 56.3 months in severe lymphopenia, whereas it was not reached in non-severe lymphopenia (hazard ratio, 0.81; p-value = 0.337). The median OS was 28.46 versus 47.13 months in severe and non-severe lymphopenia, respectively (hazard ratio, 0.76; p-value = 0.11). Of various risk factors, gender was significantly associated with severe lymphopenia. Conclusion The occurrence of severe lymphopenia was not significantly associated with the outcomes. Gender is the only risk factor significantly linked to severe lymphopenia.
Collapse
Affiliation(s)
- Vijay M Patil
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai 400012, India.,Co-first author
| | - Gunjesh Kumar Singh
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai 400012, India.,Co-first author
| | - Vanita Noronha
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai 400012, India
| | - Amit Joshi
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai 400012, India
| | - Nandini Menon
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai 400012, India
| | | | | | - Kavita Nawale Satam
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai 400012, India
| | | | - Kumar Prabhash
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai 400012, India
| |
Collapse
|
18
|
The immuno-oncological challenge of COVID-19. ACTA ACUST UNITED AC 2020; 1:946-964. [DOI: 10.1038/s43018-020-00122-3] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 09/02/2020] [Indexed: 02/06/2023]
|
19
|
Delrieu L, Anota A, Trédan O, Freyssenet D, Maire A, Canada B, Fournier B, Febvey-Combes O, Pilleul F, Bouhamama A, Caux C, Joly F, Fervers B, Pialoux V, Pérol D, Pérol O. Design and methods of a national, multicenter, randomized and controlled trial to assess the efficacy of a physical activity program to improve health-related quality of life and reduce fatigue in women with metastatic breast cancer: ABLE02 trial. BMC Cancer 2020; 20:622. [PMID: 32620149 PMCID: PMC7333295 DOI: 10.1186/s12885-020-07093-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 06/19/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Patients with a metastatic breast cancer suffer from a deteriorated health-related quality of life and numerous symptoms such as pain, severe fatigue and a decrease of their physical fitness. As the feasibility of a physical activity program has been demonstrated in this population, ABLE02 aims to assess the efficacy of a 6 month-physical activity program using connected devices to improve health-related quality of life and to reduce fatigue in women with metastatic breast cancer. METHODS ABLE02 is a prospective, national, multicenter, randomized, controlled and open-label study. A total of 244 patients with a metastatic breast cancer, with at least one positive hormone receptor and a first-line chemotherapy planned, will be randomly assigned (1:1 ratio) to: (i) the intervention arm to receive physical activity recommendations, an activity tracker to wear 24 h a day during the whole intervention (6 months) with at least three weekly walking sessions and quizzes each week on physical activity and nutrition (ii) the control arm to receive physical activity recommendations only. Health-related quality of life will be assessed every 6 weeks and main assessments will be conducted at baseline, M3, M6, M12 and M18 to evaluate the clinical, physical, biological and psychological parameters and survival of participants. All questionnaires will be completed on a dedicated application. DISCUSSION An activity program based on a smartphone application linked to an activity tracker may help to improve quality of life and reduce fatigue of patients with a metastatic breast cancer. The growth of e-health offers the opportunity to get real-time data as well as improving patient empowerment in order to change long-term behaviors. TRIAL REGISTRATION NCT number: NCT04354233 .
Collapse
Affiliation(s)
- Lidia Delrieu
- Department of Cancer and Environment, Léon Bérard Cancer Center, 28 rue Laennec, 69008, Lyon, France
- Inter-University Laboratory of Human Movement Biology EA7424, University Claude Bernard Lyon 1, University of Lyon, Villeurbanne, France
| | - Amélie Anota
- Methodology and Quality of Life in Oncology unit (INSERM UMR 1098), University Hospital of Besançon, Besançon, France
- RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, F-25000, Besançon, France
- French National Platform Quality of Life and Cancer, Besançon, France
| | - Olivier Trédan
- Department of Medical Oncology, Léon Bérard Cancer Center, Lyon, France
| | - Damien Freyssenet
- Inter-University Laboratory of Human Movement Biology EA7424, Univ Lyon, University Jean Monnet Saint-Etienne, Saint-Etienne, France
| | - Aurélia Maire
- Department of Cancer and Environment, Léon Bérard Cancer Center, 28 rue Laennec, 69008, Lyon, France
| | - Brice Canada
- Laboratory on Vulnerabilities and Innovations in Sport, University Claude Bernard Lyon 1, University of Lyon, Villeurbanne, France
| | - Baptiste Fournier
- Department of Cancer and Environment, Léon Bérard Cancer Center, 28 rue Laennec, 69008, Lyon, France
| | - Olivia Febvey-Combes
- Department of Clinical Research and Innovation, Léon Bérard Cancer Center, Lyon, France
| | - Frank Pilleul
- Department of Interventional Radiology, Léon Bérard Cancer Center, Lyon, France
| | - Amine Bouhamama
- Department of Interventional Radiology, Léon Bérard Cancer Center, Lyon, France
| | - Christophe Caux
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Cancer Research Center of Lyon (CRCL), Léon Bérard Cancer Center, Lyon, France
| | - Florence Joly
- Medical Oncology Department, Centre François Baclesse, Caen, France
- INSERM, U1086, ANTICIPE, Caen, France
- Cancer & Cognition, Platform, Ligue Contre le Cancer, CHU de Caen, Caen, France
| | - Béatrice Fervers
- Department of Cancer and Environment, Léon Bérard Cancer Center, 28 rue Laennec, 69008, Lyon, France
- INSERM UA8, Léon Bérard Cancer Center, Lyon, France
| | - Vincent Pialoux
- Inter-University Laboratory of Human Movement Biology EA7424, University Claude Bernard Lyon 1, University of Lyon, Villeurbanne, France
| | - David Pérol
- Department of Clinical Research and Innovation, Léon Bérard Cancer Center, Lyon, France
| | - Olivia Pérol
- Department of Cancer and Environment, Léon Bérard Cancer Center, 28 rue Laennec, 69008, Lyon, France.
- INSERM UA8, Léon Bérard Cancer Center, Lyon, France.
| |
Collapse
|
20
|
A maintained absolute lymphocyte count predicts the overall survival benefit from eribulin therapy, including eribulin re-administration, in HER2-negative advanced breast cancer patients: a single-institutional experience. Breast Cancer Res Treat 2020; 181:211-220. [PMID: 32249370 DOI: 10.1007/s10549-020-05626-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 04/01/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE Eribulin methylate (eribulin) improved the overall survival (OS) of HER2-negative advanced breast cancer (HER2-ABC) patients; however, the mechanism underlying the OS improvement has not been clarified. Several reports suggest that eribulin promotes antitumor immunity via tumor micro-environment conditioning. Recently, a maintained baseline lymphocyte count was proposed as predictive marker for eribulin therapy in HER2-ABC patients; however, no associations with the OS have been noted. We retrospectively investigated the neutrophil-to-lymphocyte ratio and absolute lymphocyte count (ALC) in HER2-ABC patients receiving eribulin and assessed the utility of eribulin re-administration for further OS improvement. METHODS HER2-ABC patients who received eribulin therapy at Shizuoka Cancer Center between November 2011 and December 2018 were retrospectively analyzed. RESULTS A total of 144 HER2-ABC (108 estrogen receptor-positive [ER+], 36 ER-) patients were identified, and 32 patients (28 ER+ , 4 ER-) were re-administered with eribulin. In the ER+ subgroup, a multivariate analysis showed that an ALC ≥ 1000/μL and re-administration were significantly associated with the OS (hazard ratio [HR] 0.503; P = 0.034 and HR 0.366; P < 0.0001, respectively), and an ALC ≥ 1000/μL was also identified as the only predictive factor for re-administration (HR 0.329; P = 0.033). In contrast, a multivariate analysis in the ER- subgroup identified no predictive markers. CONCLUSION In HER2-ER + ABC patients, ALC was identified as a predictive marker for eribulin therapy, and the re-administration of eribulin is considered a valid therapeutic option for further improvement of the OS.
Collapse
|
21
|
Ménétrier-Caux C, Ray-Coquard I, Blay JY, Caux C. Lymphopenia in Cancer Patients and its Effects on Response to Immunotherapy: an opportunity for combination with Cytokines? J Immunother Cancer 2019; 7:85. [PMID: 30922400 PMCID: PMC6437964 DOI: 10.1186/s40425-019-0549-5] [Citation(s) in RCA: 167] [Impact Index Per Article: 33.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 02/27/2019] [Indexed: 12/12/2022] Open
Abstract
Quantitative lymphocyte alterations are frequent in patients with cancer, and strongly impact prognosis and survival. The development of cancers in immunosuppressed patients has demonstrated the contribution of different T cell populations, including CD4+ cells, in the control of cancer occurrence.Whereas absolute numbers of neutrophils, platelets and red blood cells are routinely monitored in clinic following treatments, because of possible short-term complications, absolute lymphocyte counts (ALC), their subpopulations or diversity (phenotype, TCR) are rarely analyzed and never used to choose therapy or as prognostic criteria. The recent identification of immune checkpoint inhibitors (ICPi) as powerful therapeutic agents has revitalized immunotherapy of cancer in a broader group of diseases than anticipated. The status of the immune system is now recognized as an important biomarker for response to these novel treatments. Blood ALC values, along with tumor infiltration by CD8+T cells, and ICPi and ICPi-ligand expression, are likely to be a potential marker of sensitivity to anti-ICPi therapy.In this article, we review the current knowledge on the incidence and significance of lymphopenia in cancer patients, and discuss therapeutic strategies to restore lymphocyte numbers.
Collapse
Affiliation(s)
- Christine Ménétrier-Caux
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Cancer Research Center of Lyon (CRCL), Centre Léon Bérard, F-69008, Lyon, France. .,Innovation in Immuno-monitoring and Immunotherapy Platform (PI3), Centre Léon Bérard, F-69008, Lyon, France.
| | | | - Jean-Yves Blay
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Cancer Research Center of Lyon (CRCL), Centre Léon Bérard, F-69008, Lyon, France.,Medical Oncology department, Centre Léon Bérard, F-69008, Lyon, France
| | - Christophe Caux
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Cancer Research Center of Lyon (CRCL), Centre Léon Bérard, F-69008, Lyon, France.,Innovation in Immuno-monitoring and Immunotherapy Platform (PI3), Centre Léon Bérard, F-69008, Lyon, France
| |
Collapse
|
22
|
Yang J, Xu J, E Y, Sun T. Predictive and prognostic value of circulating blood lymphocyte subsets in metastatic breast cancer. Cancer Med 2019; 8:492-500. [PMID: 30632318 PMCID: PMC6382707 DOI: 10.1002/cam4.1891] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 10/10/2018] [Accepted: 11/04/2018] [Indexed: 01/19/2023] Open
Abstract
The treatment of breast cancer (BC) has improved greatly in recent years, however, the limitations of current therapeutic modalities underscore the need to define new prognostic tools and develop highly targeted therapies. The aims of the present study were to explore the effects of circulating blood lymphocyte subsets on the survival of metastatic breast cancer (MBC) patients and to evaluate their predictive and prognostic value. The clinical data of 482 patients with MBC were retrospectively analyzed, and patients were grouped according to molecular types of BC. The distribution of peripheral blood lymphocyte subsets at the time of first metastasis was examined by flow cytometry, and the distribution of lymphocyte subsets in each group was categorized into ''high or low'' subgroups using the upper quartile point as the cutoff. The relationship between the distribution of lymphocyte subsets and progression-free survival (PFS) as well as overall survival (OS) was evaluated in diverse molecular MBCs. In multivariate analysis, CD4+ was a negative independent predictor of PFS (hazard ratio [HR] = 0.538, 95% confidence interval [CI] = 0.313-0.926, P = 0.025) and CD3+ was a poor independent prognostic factor for OS (HR = 0.437, 95% CI = 0.248-0.772, P = 0.004) in the human epidermal growth factor receptor 2 (HER2)-positive group. Neither the CD8+ , CD19+ , and CD56+ lymphocyte subsets nor the CD4+ /CD8+ ratio in peripheral blood was significant predictive or prognostic factors. In conclusion, higher circulating levels of CD4+ and CD3+ at first diagnosis in HER2-overexpressing MBC were significantly associated with worse survival outcomes. Low levels of plasma CD4+ and CD3+ were associated with increased anti-HER2 benefit in HER2-positive MBC. The present results indicate that these factors can be used as predictive and prognostic indicators of the outcome of patients with MBC.
Collapse
Affiliation(s)
- Jian Yang
- Department of Medical Oncology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Junnan Xu
- Department of Medical Oncology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Ying E
- Department of Medical Oncology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Tao Sun
- Department of Medical Oncology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China
| |
Collapse
|
23
|
Wang WH, Xu HY, Zhao ZM, Zhang GM, Lin FW. Dynamic and significant changes of T-cell subgroups in breast cancer patients during surgery and chemotherapy. Int Immunopharmacol 2018; 65:279-283. [DOI: 10.1016/j.intimp.2018.09.039] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 09/25/2018] [Indexed: 01/08/2023]
|
24
|
Bendriss-Vermare N, Gourdin N, Vey N, Faget J, Sisirak V, Labidi-Galy I, Le Mercier I, Goutagny N, Puisieux I, Ménétrier-Caux C, Caux C. Plasmacytoid DC/Regulatory T Cell Interactions at the Center of an Immunosuppressive Network in Breast and Ovarian Tumors. Oncoimmunology 2018. [DOI: 10.1007/978-3-319-62431-0_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
25
|
Zhao W, Wang P, Jia H, Chen M, Gu X, Liu M, Zhang Z, Cheng W, Wu Z. Lymphocyte count or percentage: which can better predict the prognosis of advanced cancer patients following palliative care? BMC Cancer 2017; 17:514. [PMID: 28768490 PMCID: PMC5541405 DOI: 10.1186/s12885-017-3498-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 07/24/2017] [Indexed: 12/14/2022] Open
Abstract
Background The lymphocytes played an important role in the natural history of cancer. The aim of this study was to explore the prognostic value of lymphocyte count and percentage for survival in advanced cancer patients receiving palliative care. Methods A retrospective review of clinicopathological data from 378 consecutive advanced cancer patients and 106 extended follow-up patients treated with palliative care was conducted. Kaplan–Meier curves and multivariate cox regression analyses were used to evaluate the relationships of peripheral lymphocyte count (LC) and lymphocyte to white blood cell ratio (LWR) with overall survival (OS). Results The median values for pretreatment LC and LWR were 1.1 (IQR, 0.8 ~ 1.5 × 109/L) and 0.138 (IQR, 0.086 ~ 0.208). The median survival times across LWR quartiles were 19, 47, 79, and 101 days (P < 0.001). Multivariate analysis indicated that patients in the highest quartiles of LC and LWR had an HR of 1.082 (95% CI 0.777 ~ 1.506, P = 0.642) and 0.466 (95% CI 0.328 ~ 0.661, P < 0.001), respectively, compared with patients in the lowest quartiles. Furthermore, only the dynamic changes of LWR were confirmed as an independent prognostic factor for overall survival during the follow-up (HR = 0.396, 95% CI 0.243 ~ 0.668; P = 0.001), as were primary tumor site and ECOG. No effect was observed for the dynamic changes of LC. Conclusions Our findings demonstrate that measurement of the dynamic changes of LWR prior to treatment and during follow-up may represent a simple and new powerful prognostic factor for patients with advanced cancer, unlike measurement of LC. As a bedside marker of immune status, the prognostic role of LWR should be further evaluated in prospective studies. Electronic supplementary material The online version of this article (doi:10.1186/s12885-017-3498-8) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Weiwei Zhao
- Department of Integrated Therapy, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Peng Wang
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Department of Integrative Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Huixun Jia
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Clinical Statistics Center, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Menglei Chen
- Department of Integrated Therapy, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Xiaoli Gu
- Department of Integrated Therapy, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Minghui Liu
- Department of Integrated Therapy, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Zhe Zhang
- Department of Integrated Therapy, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Wenwu Cheng
- Department of Integrated Therapy, Fudan University Shanghai Cancer Center, Shanghai, China. .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
| | - Zhenyu Wu
- Department of Biostatistics, School of Public Health, Key Laboratory of Public Health Safety and Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China.
| |
Collapse
|
26
|
Králíčková P, Vokurková D, Haviger J, Řezáčová V, Solichová D, Krčmová LK, Melichar B, Havlík R. Peripheral blood leukocyte populations and urinary neopterin during chemotherapy in patients with breast cancer. Pteridines 2016. [DOI: 10.1515/pterid-2016-0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
The aim of the present study was to investigate serial changes in urinary neopterin and the populations of peripheral blood lymphocytes in breast cancer patients treated with primary chemotherapy. Thirty patients with breast cancer, including 20 patients undergoing primary chemotherapy treated with the combination of doxorubicin and cyclophosphamide with sequential administration of paclitaxel-based therapy (cohort A), and 10 patients presenting for first-line therapy of metastatic disease and treated with the combination of bevacizumab, taxane and carboplatin (cohort M) were studied. Healthy female blood donors served as control group. Significant differences were observed in baseline relative and absolute counts of peripheral blood lymphocyte subpopulations between both patient cohorts and controls. Significant changes of peripheral blood lymphocyte subpopulations were also observed during the course of chemotherapy. However, no significant changes of urinary neopterin concentrations and no correlation between urinary neopterin and peripheral blood lymphocyte counts were observed. In conclusion, present data demonstrate the presence of significant differences in peripheral blood leukocyte phenotype in breast cancer patients even before the start of primary chemotherapy. Significant changes were observed during the course of chemotherapy.
Collapse
Affiliation(s)
- Pavlína Králíčková
- Institute of Clinical Immunology and Allergy, Charles University Medical School and Teaching Hospital, Sokolská 581, 500 05 Hradec Králové, Czech Republic
| | - Doris Vokurková
- Institute of Clinical Immunology and Allergy, Charles University Medical School and Teaching Hospital, Sokolská 581, 500 05 Hradec Králové, Czech Republic
| | - Jiří Haviger
- Department of Informatics and Quantitative Methods, Faculty of Informatics and Management, University of Hradec Králové, Rokitanskeho 62, 500 03 Hradec Králové, Czech Republic
| | - Vladimíra Řezáčová
- Institute of Clinical Immunology and Allergy, Charles University Medical School and Teaching Hospital, Sokolská 581, 500 05 Hradec Králové, Czech Republic
| | - Dagmar Solichová
- Third Department of Medicine, Gerontology and Metabolic Care, University Hospital, Sokolská 581, 500 05 Hradec Králové, Czech Republic
| | - Lenka Kujovská Krčmová
- Third Department of Medicine, Gerontology and Metabolic Care, University Hospital, Sokolská 581, 500 05 Hradec Králové, Czech Republic
| | - Bohuslav Melichar
- Fourth Department of Medicine, Hematology, Sokolská 581, 500 05 Hradec Králové, Czech Republic
- Department of Oncology, Palacký University Medical School and Teaching Hospital, I.P. Pavlova 185/6, 779 00 Olomouc, Czech Republic
- Institute of Molecular and Translational Medicine, Palacký University Medical School and Teaching Hospital, I.P. Pavlova 185/6, 779 00 Olomouc, Czech Republic
| | - Roman Havlík
- First Department of Surgery, Palacký University Medical School and Teaching Hospital, I.P. Pavlova 185/6, 779 00 Olomouc, Czech Republic
| |
Collapse
|
27
|
Yu T, Guo P, Wu Y, Zhao J, Wu L, Li C, Liu K, Zhu G, Chen J, Xu C, Cai Y, Liu J, Wang Z. The role of chemotherapy and operation on lymphocytes accumulation in peripheral blood obtained from patients with oral squamous cell carcinoma. SPRINGERPLUS 2015; 4:698. [PMID: 26587366 PMCID: PMC4643067 DOI: 10.1186/s40064-015-1485-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 10/29/2015] [Indexed: 01/21/2023]
Abstract
The "Cancer Immunoediting" concept has provided critical insights suggesting dual functions of immune system during the cancer initiation and development. However, the dynamics and roles of CD4(+) and CD8(+) T cells, CD19(+) B cells, and CD56(+) NK cells in the patients with oral squamous cell carcinoma during treatment remain unclear. A total of 43 patients with OSCC were divided into different groups according to different clinical factors (TNM staging, pathological patterns, age and genders) for assessment of relations with CD3(+)CD4(+) T cells, CD3(+)CD8(+) T cells, CD3(-)CD19(+) B cells and CD3(-)CD16(+)CD56(+) NK cells and different chemotherapy and radical operation. The expression of CD3(+)CD4(+) T cells were significantly increased in advanced tumor stage, large tumor size and positive lymph nodes metastasis, compared to that in early groups. The accumulation of CD3(+)CD4(+) T cells were significantly increased in OSCC patients received 2 cycles CT and radical operation. Moreover, the accumulation of CD3(+)CD8(+) T cells were significantly decreased in OSCC patients received 2 cycles CT and radical operation. The distribution of circulating CD3(-)CD19(+) B cells was related with radical operation in patients with OSCC. This study indicate that CD4(+) T cells have opposing roles in OSCC progression and outcomes, which provides new insights relevant for the development of effective cancer immunotherapeutic approaches. 2 cycles TP regime chemotherapy and radical therapy may contribute to increase the effects of anti-tumor immunity on patients with OSCC.
Collapse
Affiliation(s)
- Tao Yu
- Department of Head and Neck Oncology Surgery, Sichuan Cancer Hospital, No.55, Sec.4, Renminnan Road, Chengdu, 610041 Sichuan People's Republic Ofchina
| | - Ping Guo
- Department of Head and Neck Oncology Surgery, Sichuan Cancer Hospital, No.55, Sec.4, Renminnan Road, Chengdu, 610041 Sichuan People's Republic Ofchina
| | - Yingying Wu
- State Key Laboratory of Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, 610041 Sichuan People's Republic Ofchina
| | - Jiafeng Zhao
- Department of Head and Neck Oncology Surgery, Sichuan Cancer Hospital, No.55, Sec.4, Renminnan Road, Chengdu, 610041 Sichuan People's Republic Ofchina
| | - Lichun Wu
- Department of Clinical Laboratory, Sichuan Cancer Hospital, No.55, Sec.4, Renminnan Road, Chengdu, 610041 Sichuan People's Republic Ofchina
| | - Chunhua Li
- Department of Head and Neck Oncology Surgery, Sichuan Cancer Hospital, No.55, Sec.4, Renminnan Road, Chengdu, 610041 Sichuan People's Republic Ofchina
| | - Kun Liu
- Department of Head and Neck Oncology Surgery, Sichuan Cancer Hospital, No.55, Sec.4, Renminnan Road, Chengdu, 610041 Sichuan People's Republic Ofchina
| | - Guiquan Zhu
- Department of Head and Neck Oncology Surgery, Sichuan Cancer Hospital, No.55, Sec.4, Renminnan Road, Chengdu, 610041 Sichuan People's Republic Ofchina
| | - Jin Chen
- Department of Head and Neck Oncology Surgery, Sichuan Cancer Hospital, No.55, Sec.4, Renminnan Road, Chengdu, 610041 Sichuan People's Republic Ofchina
| | - Chuan Xu
- Department of Head and Neck Oncology Surgery, Sichuan Cancer Hospital, No.55, Sec.4, Renminnan Road, Chengdu, 610041 Sichuan People's Republic Ofchina
| | - Yongcong Cai
- Department of Head and Neck Oncology Surgery, Sichuan Cancer Hospital, No.55, Sec.4, Renminnan Road, Chengdu, 610041 Sichuan People's Republic Ofchina
| | - Jifeng Liu
- Department of Head and Neck Oncology Surgery, Sichuan Cancer Hospital, No.55, Sec.4, Renminnan Road, Chengdu, 610041 Sichuan People's Republic Ofchina
| | - Zhaohui Wang
- Department of Head and Neck Oncology Surgery, Sichuan Cancer Hospital, No.55, Sec.4, Renminnan Road, Chengdu, 610041 Sichuan People's Republic Ofchina
| |
Collapse
|
28
|
Verronèse E, Delgado A, Valladeau-Guilemond J, Garin G, Guillemaut S, Tredan O, Ray-Coquard I, Bachelot T, N'Kodia A, Bardin-Dit-Courageot C, Rigal C, Pérol D, Caux C, Ménétrier-Caux C. Immune cell dysfunctions in breast cancer patients detected through whole blood multi-parametric flow cytometry assay. Oncoimmunology 2015; 5:e1100791. [PMID: 27141361 PMCID: PMC4839376 DOI: 10.1080/2162402x.2015.1100791] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 09/18/2015] [Accepted: 09/22/2015] [Indexed: 01/08/2023] Open
Abstract
Monitoring functional competence of immune cell populations in clinical routine represents a major challenge. We developed a whole-blood assay to monitor functional competence of peripheral innate immune cells including NK cells, dendritic and monocyte cell subsets through their ability to produce specific cytokines after short-term stimulation, detected through intra-cytoplasmic staining and multi-parametric flow-cytometry. A PMA/ionomycin T cell activation assay complemented this analysis. Comparing cohorts of healthy women and breast cancer (BC) patients at different stages, we identified significant functional alteration of circulating immune cells during BC progression prior to initiation of treatment. Of upmost importance, as early as the localized primary tumor (PT) stage, we observed functional alterations in several innate immune populations and T cells i.e. (i) reduced TNFα production by BDCA-1+ DC and non-classical monocytes in response to Type-I IFN, (ii) a strong drop in IFNγ production by NK cells in response to either Type-I IFN or TLR7/8 ligand, and (iii) a coordinated impairment of cytokine (IL-2, IFNγ, IL-21) production by T cell subpopulations. Overall, these alterations are further accentuated according to the stage of the disease in first-line metastatic patients. Finally, whereas we did not detect functional modification of DC subsets in response to TLR7/8 ligand, we highlighted increased IL-12p40 production by monocytes specifically at first relapse (FR). Our results reinforce the importance of monitoring both innate and adaptive immunity to better evaluate dysfunctions in cancer patients and suggest that our whole-blood assay will be useful to monitor response to treatment, particularly for immunotherapeutic strategies.
Collapse
Affiliation(s)
- E Verronèse
- Innovation in Immuno-monitoring and Immunotherapy Platform (PI3), Léon Bérard Cancer Center , Lyon, France
| | - A Delgado
- Innovation in Immuno-monitoring and Immunotherapy Platform (PI3), Léon Bérard Cancer Center , Lyon, France
| | - J Valladeau-Guilemond
- Team 11, INSERM U1052/CNRS UMR5286, Cancer Research Center of Lyon, Lyon, France; Université de Lyon, Lyon, France; Université Lyon 1, ISPB, Lyon, France
| | - G Garin
- DRCI department, Léon Bérard Cancer Center , Lyon, France
| | - S Guillemaut
- DRCI department, Léon Bérard Cancer Center , Lyon, France
| | - O Tredan
- Department of Medical Oncology, Léon Bérard Cancer Center , Lyon, France
| | - I Ray-Coquard
- Department of Medical Oncology, Léon Bérard Cancer Center , Lyon, France
| | - T Bachelot
- Team 11, INSERM U1052/CNRS UMR5286, Cancer Research Center of Lyon, Lyon, France; Université de Lyon, Lyon, France; Université Lyon 1, ISPB, Lyon, France; Department of Medical Oncology, Léon Bérard Cancer Center, Lyon, France
| | - A N'Kodia
- Innovation in Immuno-monitoring and Immunotherapy Platform (PI3), Léon Bérard Cancer Center , Lyon, France
| | - C Bardin-Dit-Courageot
- Innovation in Immuno-monitoring and Immunotherapy Platform (PI3), Léon Bérard Cancer Center , Lyon, France
| | - C Rigal
- Innovation in Immuno-monitoring and Immunotherapy Platform (PI3), Léon Bérard Cancer Center , Lyon, France
| | - D Pérol
- DRCI department, Léon Bérard Cancer Center , Lyon, France
| | - C Caux
- Innovation in Immuno-monitoring and Immunotherapy Platform (PI3), Léon Bérard Cancer Center, Lyon, France; Team 11, INSERM U1052/CNRS UMR5286, Cancer Research Center of Lyon, Lyon, France; Université de Lyon, Lyon, France; Université Lyon 1, ISPB, Lyon, France
| | - C Ménétrier-Caux
- Innovation in Immuno-monitoring and Immunotherapy Platform (PI3), Léon Bérard Cancer Center, Lyon, France; Team 11, INSERM U1052/CNRS UMR5286, Cancer Research Center of Lyon, Lyon, France; Université de Lyon, Lyon, France; Université Lyon 1, ISPB, Lyon, France
| |
Collapse
|
29
|
Zhou M, Bracci PM, McCoy LS, Hsuang G, Wiemels JL, Rice T, Zheng S, Kelsey KT, Wrensch MR, Wiencke JK. Serum macrophage-derived chemokine/CCL22 levels are associated with glioma risk, CD4 T cell lymphopenia and survival time. Int J Cancer 2015; 137:826-36. [PMID: 25604093 PMCID: PMC4478165 DOI: 10.1002/ijc.29441] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Accepted: 01/09/2015] [Indexed: 01/07/2023]
Abstract
Defects in antigen presenting cell function have been implicated in glioma immunosuppression. We measured peripheral CCL22, a dendritic cell/macrophage derived T cell trafficking chemokine, in sera from 1,208 glioma cases and 976 controls to assess whether it might provide a biomarker of glioma risk, survival and immune dysfunction. Cluster models were used to examine the relationship between CCL22 and glioma risk. Patient survival was assessed using Cox regression models. We also examined the relationship between CCL22 levels and CD4 cell counts, as well as allergy history and IgE levels. CCL22 levels were significantly lower among glioma cases compared with controls (Mean ± SEM: 1.23 ± 0.03 ng/mL in cases vs. 1.60 ± 0.03 ng/mL in controls, p < 0.0001) and this difference remained significant even after controlling for other covariates in the cluster models (highest quartile versus lowest Odds Ratio = 0.21, p < 0.0001). CD4 cell counts were positively correlated with CCL22 in glioma cases (Spearman r(2) = 0.51, p < 0.01) and were significantly lower in cases compared with controls. Higher CCL22 levels were associated with longer survival in all cases combined and in GBM cases (hazard ratio(allcases) = 0.81; 95% CI: 0.72-0.91, p = 0.0003). CCL22 levels were not associated with IgE level or self-reported allergies. Circulating CCL22 levels are related to both glioma risk and survival duration independent of age, histology, grade and IDH mutation status. CCL22 should be considered a marker of immune status with potential prognostic value.
Collapse
Affiliation(s)
- Mi Zhou
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
| | - Paige M. Bracci
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
| | - Lucie S. McCoy
- Department of Neurological Surgery, School of Medicine, University of California San Francisco, San Francisco, CA
| | - George Hsuang
- Department of Neurological Surgery, School of Medicine, University of California San Francisco, San Francisco, CA
| | - Joseph L. Wiemels
- Department of Neurological Surgery, School of Medicine, University of California San Francisco, San Francisco, CA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
| | - Terri Rice
- Department of Neurological Surgery, School of Medicine, University of California San Francisco, San Francisco, CA
| | - Shichun Zheng
- Department of Neurological Surgery, School of Medicine, University of California San Francisco, San Francisco, CA
| | - Karl T. Kelsey
- Department of Laboratory Medicine and Pathology, Brown University, Providence, RI
| | - Margaret R. Wrensch
- Department of Neurological Surgery, School of Medicine, University of California San Francisco, San Francisco, CA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
| | - John K. Wiencke
- Department of Neurological Surgery, School of Medicine, University of California San Francisco, San Francisco, CA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
| |
Collapse
|
30
|
Trédan O, Ménétrier-Caux C, Ray-Coquard I, Garin G, Cropet C, Verronèse E, Bachelot T, Rebattu P, Heudel P, Cassier P, Chabaud S, Croughs T, Dupont P, Cadore A, Clapisson G, Delgado A, Bardin-dit-Courageot C, Rigal C, N'Kodia A, Gilles-Afchain L, Morre M, Pérol D, Blay J, Caux C. ELYPSE-7: a randomized placebo-controlled phase IIa trial with CYT107 exploring the restoration of CD4+ lymphocyte count in lymphopenic metastatic breast cancer patients. Ann Oncol 2015; 26:1353-62. [DOI: 10.1093/annonc/mdv173] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 03/24/2015] [Indexed: 12/29/2022] Open
|
31
|
Wiencke JK, Bracci PM, Hsuang G, Zheng S, Hansen H, Wrensch MR, Rice T, Eliot M, Kelsey KT. A comparison of DNA methylation specific droplet digital PCR (ddPCR) and real time qPCR with flow cytometry in characterizing human T cells in peripheral blood. Epigenetics 2015; 9:1360-5. [PMID: 25437051 DOI: 10.4161/15592294.2014.967589] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Quantitating the copy number of demethylated CpG promoter sites of the CD3Z gene can be used to estimate the numbers and proportions of T cells in human blood and tissue. Quantitative methylation specific PCR (qPCR) is useful for studying T cells but requires extensive calibration and is imprecise at low copy numbers. Here we compared the performance of a new digital PCR platform (droplet digital PCR or ddPCR) to qPCR using bisulfite converted DNA from 157 blood specimens obtained from ambulatory care controls and patients with primary glioma. We compared both ddPCR and qPCR with conventional flow cytometry (FACS) evaluation of CD3 positive T cells. Repeated measures on the same blood sample revealed ddPCR to be less variable than qPCR. Both qPCR and ddPCR correlated significantly with FACS evaluation of peripheral blood CD3 counts and CD3/total leukocyte values. However, statistical measures of agreement showed that linear concordance was stronger for ddPCR than for qPCR and the absolute values were closer to FACS for ddPCR. Both qPCR and ddPCR could distinguish clinically significant differences in T cell proportions and performed similarly to FACS. Given the higher precision, greater accuracy, and technical simplicity of ddPCR, this approach appears to be a superior DNA methylation based method than conventional qPCR for the assessment of T cells.
Collapse
Affiliation(s)
- John K Wiencke
- a Department of Neurological Surgery ; University of California, San Francisco ; San Francisco , CA USA
| | | | | | | | | | | | | | | | | |
Collapse
|
32
|
García-Martínez E, Gil GL, Benito AC, González-Billalabeitia E, Conesa MAV, García García T, García-Garre E, Vicente V, Ayala de la Peña F. Tumor-infiltrating immune cell profiles and their change after neoadjuvant chemotherapy predict response and prognosis of breast cancer. Breast Cancer Res 2014; 16:488. [PMID: 25432519 PMCID: PMC4303200 DOI: 10.1186/s13058-014-0488-5] [Citation(s) in RCA: 181] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Accepted: 11/19/2014] [Indexed: 02/07/2023] Open
Abstract
Introduction Tumor microenvironment immunity is associated with breast cancer outcome. A high lymphocytic infiltration has been associated with response to neoadjuvant chemotherapy, but the contribution to response and prognosis of immune cell subpopulations profiles in both pre-treated and post-treatment residual tumor is still unclear. Methods We analyzed pre- and post-treatment tumor-infiltrating immune cells (CD3, CD4, CD8, CD20, CD68, Foxp3) by immunohistochemistry in a series of 121 breast cancer patients homogeneously treated with neoadjuvant chemotherapy. Immune cell profiles were analyzed and correlated with response and survival. Results We identified three tumor-infiltrating immune cell profiles, which were able to predict pathological complete response (pCR) to neoadjuvant chemotherapy (cluster B: 58%, versus clusters A and C: 7%). A higher infiltration by CD4 lymphocytes was the main factor explaining the occurrence of pCR, and this association was validated in six public genomic datasets. A higher chemotherapy effect on lymphocytic infiltration, including an inversion of CD4/CD8 ratio, was associated with pCR and with better prognosis. Analysis of the immune infiltrate in post-chemotherapy residual tumor identified a profile (cluster Y), mainly characterized by high CD3 and CD68 infiltration, with a worse disease free survival. Conclusions Breast cancer immune cell subpopulation profiles, determined by immunohistochemistry-based computerized analysis, identify groups of patients characterized by high response (in the pre-treatment setting) and poor prognosis (in the post-treatment setting). Further understanding of the mechanisms underlying the distribution of immune cells and their changes after chemotherapy may contribute to the development of new immune-targeted therapies for breast cancer. Electronic supplementary material The online version of this article (doi:10.1186/s13058-014-0488-5) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Elena García-Martínez
- Department of Hematology and Medical Oncology, University Hospital Morales Meseguer, Murcia, Spain.
| | - Ginés Luengo Gil
- Department of Hematology and Medical Oncology, University Hospital Morales Meseguer, Murcia, Spain.
| | | | | | | | - Teresa García García
- Department of Hematology and Medical Oncology, University Hospital Morales Meseguer, Murcia, Spain.
| | - Elisa García-Garre
- Department of Hematology and Medical Oncology, University Hospital Morales Meseguer, Murcia, Spain.
| | - Vicente Vicente
- Department of Hematology and Medical Oncology, University Hospital Morales Meseguer, Murcia, Spain. .,Centro Regional de Hemodonación, Murcia, Spain.
| | | |
Collapse
|
33
|
Prognostic significance of circulating CD19+ B lymphocytes in EBV-associated nasopharyngeal carcinoma. Med Oncol 2014; 31:198. [DOI: 10.1007/s12032-014-0198-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2014] [Accepted: 08/22/2014] [Indexed: 10/24/2022]
|
34
|
Mills LD, Zhang L, Marler R, Svingen P, Fernandez-Barrena MG, Dave M, Bamlet W, McWilliams RR, Petersen GM, Faubion W, Fernandez-Zapico ME. Inactivation of the transcription factor GLI1 accelerates pancreatic cancer progression. J Biol Chem 2014; 289:16516-25. [PMID: 24737325 DOI: 10.1074/jbc.m113.539031] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The role of GLI1 in pancreatic tumor initiation promoting the progression of preneoplastic lesions into tumors is well established. However, its function at later stages of pancreatic carcinogenesis remains poorly understood. To address this issue, we crossed the gli1 knock-out (GKO) animal with cre-dependent pancreatic activation of oncogenic kras concomitant with loss of the tumor suppressor tp53 (KPC). Interestingly, in this model, GLI1 played a tumor-protective function, where survival of GKO/KPC mice was reduced compared with KPC littermates. Both cohorts developed pancreatic cancer without significant histopathological differences in survival studies. However, analysis of mice using ultrasound-based imaging at earlier time points showed increased tumor burden in GKO/KPC mice. These animals have larger tumors, decreased body weight, increased lactate dehydrogenase production, and severe leukopenia. In vivo and in vitro expression studies identified FAS and FAS ligand (FASL) as potential mediators of this phenomenon. The FAS/FASL axis, an apoptotic inducer, plays a role in the progression of pancreatic cancer, where its expression is usually lost or significantly reduced in advanced stages of the disease. Chromatin immunoprecipitation and reporter assays identified FAS and FASL as direct targets of GLI1, whereas GKO/KPC mice showed lower levels of this ligand compared with KPC animals. Finally, decreased levels of apoptosis were detected in tumor tissue in the absence of GLI1 by TUNEL staining. Together, these findings define a novel pathway regulated by GLI1 controlling pancreatic tumor progression and provide a new theoretical framework to help with the design and analysis of trials targeting GLI1-related pathways.
Collapse
Affiliation(s)
| | | | - Ronald Marler
- the Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic Scottsdale, Arizona 85259
| | | | | | - Maneesh Dave
- Laboratory of Epigenetics and Chromatin Dynamics
| | | | | | - Gloria M Petersen
- Division of Epidemiology, Mayo Clinic, Rochester, Minnesota 55905 and
| | | | | |
Collapse
|