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Qayoom H, Sofi S, Mir MA. Targeting tumor microenvironment using tumor-infiltrating lymphocytes as therapeutics against tumorigenesis. Immunol Res 2023; 71:588-599. [PMID: 37004645 DOI: 10.1007/s12026-023-09376-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 03/25/2023] [Indexed: 04/04/2023]
Abstract
The immune system plays a vital role in suppressing tumor cell progression. The tumor microenvironment augmented with significant levels of tumor-infiltrating lymphocytes has been widely investigated and it is suggested that tumor-infiltrating lymphocytes have shown a significant role in the prognosis of cancer patients. Compared to ordinary non-infiltrating lymphocytes, tumor-infiltrating lymphocytes (TILs) are a significant population of lymphocytes that infiltrate tumor tissue and have a higher level of specific immunological reactivity against tumor cells. They serve as an effective immunological defense against various malignancies. TILs are a diverse group of immune cells that are divided into immune subsets based on the pathological and physiological impact they have on the immune system. TILs mainly consist of B-cells, T-cells, or natural killer cells with diverse phenotypic and functional properties. TILs are known to be superior to other immune cells in that they can recognize a wide range of heterogeneous tumor antigens by producing many clones of T cell receptors (TCRs), outperforming treatments like TCR-T cell and CAR-T therapy. With the introduction of genetic engineering technologies, tumor-infiltrating lymphocytes (TILs) have become a ground-breaking therapeutic option for malignancies, but because of the hindrances opposed by the immune microenvironment and the mutation of antigens, the development of TILs as therapeutic has been hindered. By giving some insight into the many variables, such as the various barriers inhibiting its usage as a potential therapeutic agent, we have examined various aspects of TILs in this work.
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Affiliation(s)
- Hina Qayoom
- Department of Bioresources, School of Biological Sciences, University of Kashmir, 190006, Jammu and Kashmir, India
| | - Shazia Sofi
- Department of Bioresources, School of Biological Sciences, University of Kashmir, 190006, Jammu and Kashmir, India
| | - Manzoor A Mir
- Department of Bioresources, School of Biological Sciences, University of Kashmir, 190006, Jammu and Kashmir, India.
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Killeen TF, Shanley R, Ramesh V, Giubellino A. Malignant Melanoma in a Retrospective Cohort of Immunocompromised Patients: A Statistical and Pathologic Analysis. Cancers (Basel) 2023; 15:3600. [PMID: 37509262 PMCID: PMC10377403 DOI: 10.3390/cancers15143600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/30/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Malignant melanoma is the leading cause of death due to cutaneous malignancy. Immunocompromised individuals have an elevated risk of developing melanoma. We aimed to provide histopathologic and statistical characterization of melanoma development in immunocompromised patients. METHODS We reviewed our institution's databases to identify all patients with a confirmed history of immunosuppression who subsequently developed melanoma, focusing on diagnoses during the follow-up period of 2011-2019. A total of 93 patients with a combined 111 melanoma lesions were identified. RESULTS Common causes of immunosuppression included transplantation and lymphoproliferative disorders. Superficial spreading and lentigo malignant melanoma were the most common malignant melanoma subtypes. Median Breslow depth was 0.7 mm, and the most common primary tumor stage was T1a. Our transplant sub-cohort had an overall melanoma incidence of 0.9 per 1000 person-years (95% CI 0.66 to 1.20) and a standardized incidence ratio (SIR) of 1.53 (95% CI 1.12 to 2.04) relative to a general population cohort from the Surveillance, Epidemiology, and End Results Program (SEER). CONCLUSIONS We report histopathologic characteristics of immunocompromised patients developing melanoma at a large academic tertiary-care center. Differences in age, sex, time since transplantation, and transplant type may play a significant role in melanoma SIR in this patient demographic.
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Affiliation(s)
- Trevor F Killeen
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Ryan Shanley
- Masonic Cancer Center-Biostatistics Core, University of Minnesota, Minneapolis, MN 55455, USA
| | - Vidhyalakshmi Ramesh
- Masonic Cancer Center-Clinical Informatics Shared Services, University of Minnesota, Minneapolis, MN 55455, USA
| | - Alessio Giubellino
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN 55455, USA
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
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3
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Van Herck Y, Feyaerts A, Alibhai S, Papamichael D, Decoster L, Lambrechts Y, Pinchuk M, Bechter O, Herrera-Caceres J, Bibeau F, Desmedt C, Hatse S, Wildiers H. Is cancer biology different in older patients? THE LANCET HEALTHY LONGEVITY 2021; 2:e663-e677. [DOI: 10.1016/s2666-7568(21)00179-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 07/14/2021] [Accepted: 07/15/2021] [Indexed: 12/13/2022]
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Patras M, Decullier E, Lebbé C, Delyon J, Dantal J, Legendre C, Mazloum M, Du Thanh A, Boukari F, Morelon E, Jullien D, Kanitakis J, Ducroux E. Outcome of pretransplant melanoma after solid organ transplantation: an observational study. Transpl Int 2021; 34:2154-2165. [PMID: 34519106 DOI: 10.1111/tri.14109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/18/2021] [Accepted: 09/03/2021] [Indexed: 11/30/2022]
Abstract
The number of patients with a history of melanoma who are awaiting a solid organ transplantation (SOT) is increasing. Few recommendations exist on the timing to transplantation after melanoma diagnosis. The aim of this study was to assess the melanoma recurrence-free survival after pretransplant melanoma (PTM). We conducted a multicenter ambispective observational study. Organ transplant recipients (OTR) with a history of PTM and complete AJCC staging were included. Thirty-seven patients (predominantly men with a renal allograft) were included. Five melanomas were in situ, 21 stage IA, 4 stage IB, 5 stage II, and 2 stage IIIB. The median post-transplantation follow-up time was 4 years. Sixty-two percent of patients were followed up more than 2 years. Recurrence-free survival since melanoma reached 89.9%, but varied significantly according to AJCC staging (P = 0.0129). Three patients presented a recurrence. Despite the rather limited sample size and a wide range of follow-up, our findings concerning the recurrence-free survival appear reassuring for in situ and stage IA PTM; accordingly, we suggest that a waiting time to transplantation is not mandatory in patients with in situ or stage IA PTM, especially whenever SOT is urgently needed. Caution is, however, needed for patients with higher stage.
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Affiliation(s)
| | - Evelyne Decullier
- Service d'Epidémiologie et Recherches Cliniques, Pôle de Santé Publique, Hospices Civils de Lyon, Lyon, France
| | - Céleste Lebbé
- AP-HP Dermatology, INSERM U976, Saint Louis Hospital, Université de Paris, Paris, France
| | - Julie Delyon
- Service de Dermatologie, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France
| | - Jacques Dantal
- Service de Néphrologie, Hôpital Universitaire de Nantes, Hôtel Dieu, Nantes, France
| | - Christophe Legendre
- Service de Néphrologie et Transplantation, Assistance Publique-Hôpitaux de Paris, Hôpital Necker, Paris, France
| | - Manal Mazloum
- Service de Néphrologie et Transplantation, Assistance Publique-Hôpitaux de Paris, Hôpital Necker, Paris, France
| | - Aurélie Du Thanh
- Service de Dermatologie, Hôpital Universitaire de Montpellier, Montpellier, France
| | - Feriel Boukari
- Service de Dermatologie, Hôpital Universitaire de Nice, Nice, France
| | - Emmanuel Morelon
- Service de Néphrologie, Hôpital Universitaire Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Denis Jullien
- Service de Dermatologie, Hôpital Universitaire Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Jean Kanitakis
- Service de Dermatologie, Hôpital Universitaire Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Emilie Ducroux
- Service de Dermatologie, Hôpital Universitaire Edouard Herriot, Hospices Civils de Lyon, Lyon, France
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6
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Garg M, Couturier DL, Nsengimana J, Fonseca NA, Wongchenko M, Yan Y, Lauss M, Jönsson GB, Newton-Bishop J, Parkinson C, Middleton MR, Bishop DT, McDonald S, Stefanos N, Tadross J, Vergara IA, Lo S, Newell F, Wilmott JS, Thompson JF, Long GV, Scolyer RA, Corrie P, Adams DJ, Brazma A, Rabbie R. Tumour gene expression signature in primary melanoma predicts long-term outcomes. Nat Commun 2021; 12:1137. [PMID: 33602918 PMCID: PMC7893180 DOI: 10.1038/s41467-021-21207-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 01/15/2021] [Indexed: 02/08/2023] Open
Abstract
Adjuvant systemic therapies are now routinely used following resection of stage III melanoma, however accurate prognostic information is needed to better stratify patients. We use differential expression analyses of primary tumours from 204 RNA-sequenced melanomas within a large adjuvant trial, identifying a 121 metastasis-associated gene signature. This signature strongly associated with progression-free (HR = 1.63, p = 5.24 × 10-5) and overall survival (HR = 1.61, p = 1.67 × 10-4), was validated in 175 regional lymph nodes metastasis as well as two externally ascertained datasets. The machine learning classification models trained using the signature genes performed significantly better in predicting metastases than models trained with clinical covariates (pAUROC = 7.03 × 10-4), or published prognostic signatures (pAUROC < 0.05). The signature score negatively correlated with measures of immune cell infiltration (ρ = -0.75, p < 2.2 × 10-16), with a higher score representing reduced lymphocyte infiltration and a higher 5-year risk of death in stage II melanoma. Our expression signature identifies melanoma patients at higher risk of metastases and warrants further evaluation in adjuvant clinical trials.
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Affiliation(s)
- Manik Garg
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Hinxton, Cambridgeshire, UK
| | - Dominique-Laurent Couturier
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, UK
| | - Jérémie Nsengimana
- University of Leeds School of Medicine, Leeds, United Kingdom
- Biostatistics Research Group, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Nuno A Fonseca
- CIBIO/InBIO-Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Rua Padre Armando Quintas, 4485-601, Vairão, Portugal
| | - Matthew Wongchenko
- Oncology Biomarker Development, Genentech Inc., 1 DNA Way, South San Francisco, CA, 94080, USA
| | - Yibing Yan
- Oncology Biomarker Development, Genentech Inc., 1 DNA Way, South San Francisco, CA, 94080, USA
| | - Martin Lauss
- Lund University Cancer Center, Lund University, Lund, Sweden
| | - Göran B Jönsson
- Lund University Cancer Center, Lund University, Lund, Sweden
| | | | - Christine Parkinson
- Cambridge Cancer Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Mark R Middleton
- Oxford NIHR Biomedical Research Centre and Department of Oncology, University of Oxford, Oxford, UK
| | | | - Sarah McDonald
- Department of Pathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Nikki Stefanos
- Department of Pathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - John Tadross
- Department of Pathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Ismael A Vergara
- Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Serigne Lo
- Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Felicity Newell
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - James S Wilmott
- Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - John F Thompson
- Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Discipline of Surgery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Georgina V Long
- Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Royal North Shore and Mater Hospitals, Sydney, Australia
| | - Richard A Scolyer
- Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital and New South Wales Health Pathology, Sydney, NSW, Australia
| | - Pippa Corrie
- Cambridge Cancer Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - David J Adams
- Experimental Cancer Genetics, The Wellcome Sanger Institute, Hinxton, Cambridgeshire, UK
| | - Alvis Brazma
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Hinxton, Cambridgeshire, UK
| | - Roy Rabbie
- Cambridge Cancer Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
- Experimental Cancer Genetics, The Wellcome Sanger Institute, Hinxton, Cambridgeshire, UK.
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Cutaneous Head and Neck Cancers in the High-Risk Immunosuppressed Population. Otolaryngol Clin North Am 2021; 54:397-413. [PMID: 33602516 DOI: 10.1016/j.otc.2020.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The immunosuppressed (IS) population encompasses a diverse cohort of patients to include iatrogenically immunocompromised organ transplant recipients as well as patients with chronic lymphoid malignancies, human immunodeficiency virus/acquired immunodeficiency syndrome, and autoimmune disorders. Cutaneous cancers in this high-risk patient group are clinically distinct from the general immunocompetent population, showing aggressive behavior with associated poor outcomes. This article reviews the pathogenesis, epidemiology, incidence, prognosis, and special considerations required in managing cutaneous cancers in the IS patient population.
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González-Cruz C, Ferrándiz-Pulido C, García-Patos Briones V. Melanoma in Solid Organ Transplant Recipients. ACTAS DERMO-SIFILIOGRAFICAS 2020; 112:216-224. [PMID: 33197437 DOI: 10.1016/j.ad.2020.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 10/20/2020] [Accepted: 11/02/2020] [Indexed: 12/19/2022] Open
Abstract
In this review, we analyze the 3 clinical scenarios related to the development of melanoma in solid organ transplant recipients: melanoma in patients with a history of the tumor prior to a transplant, de novo melanoma following a transplant, and melanoma of donor origin. The main factors to consider in organ-transplant candidates with a history of melanoma are tumor stage, presence or absence of residual disease, and time from diagnosis to transplantation. Solid organ transplant recipients have a greater risk of melanoma than immunocompetent individuals. Mortality is also higher in this population, especially in patients with advanced melanoma, as treatment is especially challenging. Clinical history and physical examination provide the most useful information for preventing donor-to-recipient transmission of melanoma. Donor-derived melanoma has a very poor prognosis.
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Affiliation(s)
- C González-Cruz
- Servicio de Dermatología, Hospital Universitari Vall d'Hebron. Facultad de Medicina, Universitat Autònoma de Barcelona, Barcelona, España.
| | - C Ferrándiz-Pulido
- Servicio de Dermatología, Hospital Universitari Vall d'Hebron. Facultad de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
| | - V García-Patos Briones
- Servicio de Dermatología, Hospital Universitari Vall d'Hebron. Facultad de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
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9
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Xu Y, Xu WH, Shi SN, Yang XL, Ren YR, Zhuang XY, Qu YY, Zhang HL, Zhang XF. Carbonic Anhydrase 4 serves as a Clinicopathological Biomarker for Outcomes and Immune Infiltration in Renal Cell Carcinoma, Lower Grade Glioma, Lung Adenocarcinoma and Uveal Melanoma. J Cancer 2020; 11:6101-6113. [PMID: 32922550 PMCID: PMC7477427 DOI: 10.7150/jca.46902] [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: 04/11/2020] [Accepted: 07/26/2020] [Indexed: 01/21/2023] Open
Abstract
Background: Carbonic anhydrase 4 (CA4) maintains homeostasis of carbon dioxide and bicarbonate. It is suggested to be a potential prognostic biomarker, while the correlations between CA4 and different cancers are indistinct. Methods: Differential mRNA expression of CA4 among different cancers and corresponding normal tissues was compared based on datasets on the Cancer Genome Atlas (TCGA) platforms. Then, survival analysis was performed using Tumor-immune system interactionsplatform and TCGA cohort on the basis of distinct comparison expression of CA4 in five kinds of tumors. In addition, molecular penal analysis and functional annotations of CA4-related genes was elaborated. The correlation between CA4 mRNA expression and tumor immune microenvironment were analyzed in detail. Results: Compared with adjacent normal tissues, CA4 mRNA expressions were found significantly lower in various tumors. Moreover, decreased expression of CA4 was significantly related to worse overall survival (OS) and progression-free survival (PFS) in kidney renal clear cell carcinoma (KIRC), brain lower grade glioma (LGG), lung adenocarcinoma (LUAD) and uveal melanoma (UVM), and worse OS of prostate adenocarcinoma (PRAD) (p<0.05). Cox regression analyses indicated that CA4 was a significant prognostic biomarker in KIRC, LGG, LUAD and UVM. Moreover, CA4 showed markedly relationship with tumor immune environment and diverse immune infiltration signatures in KIRC, LGG, LUAD and UVM. Conclusions: Our study revealed that CA4 was a potential biomarker for aggressive progression and poor prognosis in KIRC, LGG, LUAD, PRAD and UVM, correlated with immune infiltration in various tumor environments. These results suggested that CA4 possibly served as a promising prognostic and immune infiltration biomarker in many cancers.
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Affiliation(s)
- Yue Xu
- Department of Ophthalmology, First Affiliated Hospital of Soochow University, Suzhou, 215000, China
- Medical College, Soochow University, Suzhou, 215000, China
| | - Wen-Hao Xu
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 20032, China
| | - Shen-Nan Shi
- Cancer Institute, Fudan University Shanghai Cancer Center, Shanghai 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 20032, China
| | - Xiao-Long Yang
- Department of Ophthalmology, First Affiliated Hospital of Soochow University, Suzhou, 215000, China
- Medical College, Soochow University, Suzhou, 215000, China
| | - Ya-Ru Ren
- Department of Ophthalmology, First Affiliated Hospital of Soochow University, Suzhou, 215000, China
- Medical College, Soochow University, Suzhou, 215000, China
| | - Xin-Yu Zhuang
- Department of Ophthalmology, First Affiliated Hospital of Soochow University, Suzhou, 215000, China
- Medical College, Soochow University, Suzhou, 215000, China
| | - Yuan-Yuan Qu
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 20032, China
| | - Hai-Liang Zhang
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 20032, China
| | - Xiao-Feng Zhang
- Department of Ophthalmology, First Affiliated Hospital of Soochow University, Suzhou, 215000, China
- Medical College, Soochow University, Suzhou, 215000, China
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Park CK, Dahlke EJ, Fung K, Kitchen J, Austin PC, Rochon PA, Chan AW. Melanoma incidence, stage, and survival after solid organ transplant: A population-based cohort study in Ontario, Canada. J Am Acad Dermatol 2020; 83:754-761. [PMID: 32111554 DOI: 10.1016/j.jaad.2019.09.072] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 09/12/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Risk of melanoma is increased with potentially worse outcomes after solid organ transplant. OBJECTIVE To estimate the incidence, stage, and survival in transplant recipients with melanoma. METHODS Population-based, retrospective, observational study using linked administrative databases. Adults receiving their first solid organ transplant from 1991 through 2012 were followed to December 2013. RESULTS We identified 51 transplant recipients with melanoma, 11 369 recipients without melanoma, and 255 matched patients with melanoma from the nontransplant population. Transplant recipients were at increased risk of melanoma (standardized incidence ratio, 2.29; 95% confidence interval [CI], 2.07-2.49) and more likely to be diagnosed at stages II through IV (adjusted odds ratio, 4.29; 95% CI, 2.04-9.00) compared with the nontransplant population. Melanoma-specific mortality was increased in transplant recipients compared with the nontransplant population (adjusted hazard ratio, 1.93; 95% CI, 1.03-3.63). Among transplant recipients, all-cause mortality was increased after melanoma compared with those without melanoma (stage T1/T2: adjusted hazard ratio, 2.18; 95% CI, 1.13-4.21; T3/T4: adjusted hazard ratio, 4.07; 95% CI, 2.36-7.04; III/IV: adjusted hazard ratio, 7.92; 95% CI, 3.76-16.70). LIMITATIONS The databases did not contain data on immunosuppressive drugs; ascertainment of melanoma metastasis relied on pathology reports. CONCLUSION Melanoma after solid organ transplant is more often diagnosed at a later stage and leads to increased mortality, even for early-stage tumors.
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Affiliation(s)
- Christina K Park
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Erin J Dahlke
- Division of Dermatology, Women's College Hospital, Toronto, Ontario, Canada
| | | | - Jessica Kitchen
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | | | - Paula A Rochon
- ICES, Toronto, Ontario, Canada; Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - An-Wen Chan
- Division of Dermatology, Women's College Hospital, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
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11
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Pruessmann W, Rytlewski J, Wilmott J, Mihm MC, Attrill GH, Dyring-Andersen B, Fields P, Zhan Q, Colebatch AJ, Ferguson PM, Thompson JF, Kallenbach K, Yusko E, Clark RA, Robins H, Scolyer RA, Kupper TS. Molecular analysis of primary melanoma T cells identifies patients at risk for metastatic recurrence. NATURE CANCER 2020; 1:197-209. [PMID: 33305293 PMCID: PMC7725220 DOI: 10.1038/s43018-019-0019-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 12/10/2019] [Indexed: 12/25/2022]
Abstract
Primary melanomas >1 mm thickness are potentially curable by resection, but can recur metastatically. We assessed the prognostic value of T cell fraction (TCFr) and repertoire T cell clonality, measured by high-throughput-sequencing of the T cell receptor beta chain (TRB) in T2-T4 primary melanomas (n=199). TCFr accurately predicted progression-free survival (PFS) and was independent of thickness, ulceration, mitotic rate, or age. TCFr was second only to tumor thickness in its predictive value, using a gradient boosted model. For accurate PFS prediction, adding TCFr to tumor thickness was superior to adding any other histopathological variable. Furthermore, a TCFr >20% was protective regardless of tumor ulceration status, mitotic rate or presence of nodal disease. TCFr is a quantitative molecular assessment that predicts metastatic recurrence in primary melanoma patients whose disease has been resected surgically. This study suggests that a successful T cell-mediated antitumor response can be present in primary melanomas.
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Affiliation(s)
- Wiebke Pruessmann
- Department of Dermatology and Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
- Department of Dermatology, University of Luebeck, Luebeck, Germany
| | | | - James Wilmott
- Melanoma Institute Australia, University of Sydney, Sydney, New South Wales, Australia
| | - Martin C Mihm
- Department of Dermatology and Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Grace H Attrill
- Melanoma Institute Australia, University of Sydney, Sydney, New South Wales, Australia
| | - Beatrice Dyring-Andersen
- Department of Dermatology and Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
- Novo Nordisk Foundation Centre for Protein Research, University of Copenhagen, Copenhagen, Denmark
| | | | - Qian Zhan
- Department of Dermatology and Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Andrew J Colebatch
- Melanoma Institute Australia, University of Sydney, Sydney, New South Wales, Australia
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Peter M Ferguson
- Melanoma Institute Australia, University of Sydney, Sydney, New South Wales, Australia
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - John F Thompson
- Melanoma Institute Australia, University of Sydney, Sydney, New South Wales, Australia
- Department of Melanoma and Surgical Oncology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Klaus Kallenbach
- Department of Surgical Pathology, Zealand University Hospital, Roskilde, Denmark
| | - Erik Yusko
- Adaptive Biotechnologies, Seattle, WA, USA
| | - Rachael A Clark
- Department of Dermatology and Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Harlan Robins
- Adaptive Biotechnologies, Seattle, WA, USA
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Richard A Scolyer
- Melanoma Institute Australia, University of Sydney, Sydney, New South Wales, Australia
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Thomas S Kupper
- Department of Dermatology and Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.
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12
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Porcellato I, Silvestri S, Menchetti L, Recupero F, Mechelli L, Sforna M, Iussich S, Bongiovanni L, Lepri E, Brachelente C. Tumour-infiltrating lymphocytes in canine melanocytic tumours: An investigation on the prognostic role of CD3 + and CD20 + lymphocytic populations. Vet Comp Oncol 2019; 18:370-380. [PMID: 31750993 DOI: 10.1111/vco.12556] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 11/18/2019] [Accepted: 11/20/2019] [Indexed: 12/16/2022]
Abstract
The study of the immune response in several types of tumours has been rapidly increasing in recent years with the dual aim of understanding the interactions between neoplastic and immune cells and their importance in cancer pathogenesis and progression, as well as identifying targets for cancer immunotherapy. Despite being considered one of the most immunogenic tumour types, melanoma can progress in the presence of abundant lymphocytic infiltration, therefore suggesting that the immune response is not able to efficiently control tumour growth. The purpose of this study was to investigate whether the density, distribution and grade of tumour-infiltrating lymphocytes (TILs) in 97 canine melanocytic tumours is associated with histologic indicators of malignancy and can be considered a prognostic factor in the dog. As a further step in the characterization of the immune response in melanocytic tumours, an immunohistochemical investigation was performed to evaluate the two main populations of TILs, T-lymphocytes (CD3+ ) and B-lymphocytes (CD20+ ). The results of our study show that TILs are present in a large proportion of canine melanocytic tumours, especially in oral melanomas, and that the infiltrate is usually mild. The quantity of CD20+ TILs was significantly associated with some histologic prognostic factors, such as the mitotic count, the cellular pleomorphism and the percentage of pigmented cells. Remarkably, a high infiltration of CD20+ TILs was associated with tumour-related death, presence of metastasis/recurrence, shorter overall and disease-free survival, increased hazard of death and of developing recurrence/metastasis, hence representing a potential new negative prognostic factor in canine melanocytic tumours.
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Affiliation(s)
- Ilaria Porcellato
- Department of Veterinary Medicine, Università degli Studi di Perugia, Perugia, Italy
| | - Serenella Silvestri
- Department of Veterinary Medicine, Università degli Studi di Perugia, Perugia, Italy
| | - Laura Menchetti
- Department of Veterinary Medicine, Università degli Studi di Perugia, Perugia, Italy
| | - Francesca Recupero
- Department of Veterinary Medicine, Università degli Studi di Perugia, Perugia, Italy
| | - Luca Mechelli
- Department of Veterinary Medicine, Università degli Studi di Perugia, Perugia, Italy
| | - Monica Sforna
- Department of Veterinary Medicine, Università degli Studi di Perugia, Perugia, Italy
| | - Selina Iussich
- Department of Veterinary Science, Università degli Studi di Torino, Turin, Italy
| | - Laura Bongiovanni
- Faculty of Veterinary Medicine, Università degli Studi di Teramo, Teramo, Italy
| | - Elvio Lepri
- Department of Veterinary Medicine, Università degli Studi di Perugia, Perugia, Italy
| | - Chiara Brachelente
- Department of Veterinary Medicine, Università degli Studi di Perugia, Perugia, Italy
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13
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Maor D, Vajdic CM, Cumming S, Fahey V, Bala HR, Snaidr V, Brennand S, Goh MSY, Chong AH. Melanoma in a cohort of organ transplant recipients: Experience from a dedicated transplant dermatology clinic in Victoria, Australia. J Am Acad Dermatol 2019; 83:773-779. [PMID: 31706934 DOI: 10.1016/j.jaad.2019.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 10/15/2019] [Accepted: 11/03/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND There is limited information on the profile of melanomas diagnosed in a specialist transplant dermatology clinic. OBJECTIVE To describe the incidence and characteristics of incident primary melanomas in a cohort of organ transplant recipients (OTRs) attending a specialized transplant dermatology clinic and determine the number of pigmented lesions needed to excise for every melanoma diagnosed. METHODS A retrospective study of 327 OTRs monitored by an Australian clinic during a 10-year period. RESULTS There were 11 incident melanomas diagnosed during a total follow-up of 1280 patient-years. The mean interval between the first transplant and diagnosis was 5.5 years. Only 2 melanomas were >1 mm in Breslow thickness. Seven melanomas (64%) arose de novo. A contiguous nevus was present in 4 cases. Metastatic disease did not develop in the melanoma patients during the follow-up period, and all remain alive. The needed to excise for every melanoma diagnosed ratio was 16:1. LIMITATIONS The crude incidence rates were age standardized, unlike the comparison rates of melanoma in the general population, and the cohort was small. CONCLUSION Most melanomas diagnosed in OTR patients attending a specialized transplant dermatology service were detected early. Our data suggest early detection may reduce the proportion of OTRs presenting with thick melanomas, thus improving prognosis and patient outcomes. A needed to excise for every melanoma diagnosed ratio of 16:1 is not unreasonable for this cohort of high-risk patients. To our knowledge, this is the first time this ratio has been calculated for a cohort of OTRs.
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Affiliation(s)
- Danit Maor
- Skin and Cancer Foundation Victoria, Carlton, Victoria
| | - Claire M Vajdic
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales
| | - Simon Cumming
- Skin and Cancer Foundation Victoria, Carlton, Victoria
| | | | - Harini R Bala
- Skin and Cancer Foundation Victoria, Carlton, Victoria
| | | | | | - Michelle S Y Goh
- Skin and Cancer Foundation Victoria, Carlton, Victoria; Department of Dermatology, St Vincent's Hospital Melbourne, Melbourne, Victoria
| | - Alvin H Chong
- Skin and Cancer Foundation Victoria, Carlton, Victoria; Department of Dermatology, St Vincent's Hospital Melbourne, Melbourne, Victoria; Department of Medicine (Dermatology), St Vincent's Hospital Clinical School, The University of Melbourne, Melbourne, Victoria.
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14
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Benoni H, Eloranta S, Ekbom A, Wilczek H, Smedby KE. Survival among solid organ transplant recipients diagnosed with cancer compared to nontransplanted cancer patients-A nationwide study. Int J Cancer 2019; 146:682-691. [PMID: 30919451 DOI: 10.1002/ijc.32299] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 03/10/2019] [Accepted: 03/12/2019] [Indexed: 12/11/2022]
Abstract
Solid organ transplant recipients (OTRs) have an increased cancer risk but their survival once diagnosed with cancer has seldom been assessed. We therefore investigated cancer-specific survival among OTRs with a wide range of cancer forms nationally in Sweden. The study included 2,143 OTRs with cancer, and 946,089 nontransplanted cancer patients diagnosed 1992-2013. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox regression models adjusted for age, sex and calendar year. Median follow-up was 3.1 (range 0-22) years. Overall, OTRs diagnosed with any cancer had a 35% higher rate of cancer death compared to nontransplanted cancer patients (HR: 1.35, 95% CI: 1.24-1.47). Specifically, higher rates of cancer-specific death were observed among OTRs diagnosed with Hodgkin lymphoma (HR: 15.0, 95% CI: 5.56-40.6), high-grade non-Hodgkin lymphoma (HR: 2.68, 95% CI: 1.90-3.77), malignant melanoma (HR: 2.80, 95% CI: 1.74-4.52) and urothelial (HR: 2.56, 95% CI: 1.65-3.97), breast (HR: 2.12, 95% CI: 1.38-3.25), head/neck (HR: 1.55, 95% CI: 1.02-2.36) and colorectal (HR: 1.42, 95% CI: 1.07-1.88) cancer. The worse outcomes were not explained by differences in distribution of cancer stage or histologic subtypes. For other common cancer forms such as prostate, lung and kidney cancer, the prognosis was similar to that in nontransplanted cancer patients. In conclusion, several but not all types of posttransplantation cancer diagnoses are associated with worse outcomes than in the general population. Reasons for this should be further explored to optimize posttransplantation cancer management.
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Affiliation(s)
- Henrik Benoni
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.,Department of Surgery, Akademiska University Hospital, Uppsala, Sweden
| | - Sandra Eloranta
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Anders Ekbom
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Henryk Wilczek
- Division of Transplantation Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Karin E Smedby
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.,Center for Hematology, Karolinska University Hospital, Stockholm, Sweden
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15
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Howard MD, Su JC, Chong AH. Skin Cancer Following Solid Organ Transplantation: A Review of Risk Factors and Models of Care. Am J Clin Dermatol 2018; 19:585-597. [PMID: 29691768 DOI: 10.1007/s40257-018-0355-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The number of solid organ transplants has been increasing annually worldwide. Advances in transplantation surgery and community awareness of organ donation have been key contributors. Combined with increased understanding of immunosuppression, there are a growing number of solid organ transplant recipients in the community as a result of improved long-term outcomes. There remains a high incidence of deaths worldwide post-transplant due to non-melanoma skin cancer (NMSC), which has greater morbidity and mortality in this population than in the general community. Many transplant candidates are not screened prior to organ transplantation and not followed up dermatologically after transplant. After a comprehensive review of the MEDLINE database, we present an update of literature on risk factors for melanoma and non-melanoma skin cancer development in transplant recipients. Medications used by transplant recipients, including immunosuppressants and antibiotics, are discussed along with their respective risks of skin cancer development. We conclude with evidence-based recommendations for models of care, including patient education and dermatological review of transplant recipients.
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16
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Ascha M, Ascha MS, Tanenbaum J, Bordeaux JS. Risk Factors for Melanoma in Renal Transplant Recipients. JAMA Dermatol 2017; 153:1130-1136. [PMID: 28746700 DOI: 10.1001/jamadermatol.2017.2291] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Importance Melanoma risk factors and incidence in renal transplant recipients can inform decision making for both patients and clinicians. Objective To determine risk factors and characteristics of renal transplant recipients who develop melanoma. Design, Setting, and Participants This cohort study of a large national data registry used a cohort of renal transplant recipients from the United States Renal Data System (USRDS) database from the years 2004 through 2012. Differences in baseline characteristics between those who did and did not develop melanoma were examined, and a survival analysis was performed. Patients with renal transplants who received a diagnosis of melanoma according to any inpatient or outpatient claim associated with a billing code for melanoma were included. A history of pretransplant melanoma, previous kidney transplantation, or transplantation after 2012 or before 2004 were exclusion criteria. The data analysis was conducted from 2015 to 2016. Exposure Receipt of a renal transplant. Main Outcomes and Measures Incidence and risk factors for melanoma. Results Of 105 174 patients (64 151 [60.7%] male; mean [SD] age, 49.6 [15.3] years) who received kidney transplants between 2004 and 2012, 488 (0.4%) had a record of melanoma after transplantation. Significant risk factors for developing melanoma vs not developing melanoma included older age among recipients (mean [SD] age, 60.5 [10.2] vs 49.7 [15.3] years; P < .001) and donors (42.6 [15.0] vs 39.2 [15.1] years; P < .001), male sex (71.5% vs 60.7%; P < .001), recipient (96.1% vs 66.5%; P < .001) and donor (92.4% vs 82.9%; P < .001) white race, less than 4 HLA mismatches (44.9% vs 37.1%; P = .001), living donors (44.7% vs 33.7%; P < .001), and sirolimus (22.3% vs 13.2%; P < .001) and cyclosporine (4.9% vs 3.2%; P = .04) therapy. Risk factors significant on survival analysis included older recipient age (hazard ratio [HR] per year, 1.06; 95% CI, 1.05-1.06; P < .001), recipient male sex (HR, 1.53; 95% CI, 1.25-1.88; P < .001), recipient white race, living donors (HR, 1.35; 95% CI, 1.11-1.64; P = .002), and sirolimus (HR, 1.54; 95% CI, 1.22-1.94; P < .001) and cyclosporine (HR, 1.93; 95% CI, 1.24-2.99; P = .004) therapy. The age-standardized relative rate of melanoma in USRDS patients compared with Surveillance, Epidemiology, and End Results patients across all years was 4.9. A Kaplan-Meier estimate of the median time to melanoma among those patients who did develop melanoma was 1.45 years (95% CI, 1.31-1.70 years). Conclusions and Relevance Renal transplant recipients had greater risk of developing melanoma than the general population. We believe that the risk factors we identified can guide clinicians in providing adequate care for patients in this vulnerable group.
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Affiliation(s)
- Mona Ascha
- Medical student at Case Western Reserve University School of Medicine, Cleveland, Ohio.,now with Department of Plastic Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Mustafa S Ascha
- Center for Clinical Investigation, Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio
| | - Joseph Tanenbaum
- Medical student at Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Jeremy S Bordeaux
- Department of Dermatology, University Hospitals Case Medical Center, Cleveland, Ohio
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17
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Mittal A, Colegio OR. Skin Cancers in Organ Transplant Recipients. Am J Transplant 2017; 17:2509-2530. [PMID: 28556451 DOI: 10.1111/ajt.14382] [Citation(s) in RCA: 115] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 05/05/2017] [Accepted: 05/19/2017] [Indexed: 02/06/2023]
Abstract
Long-term utilization of immunosuppression in organ transplant recipients (OTRs) leads to decreased immune-mediated tumor surveillance and development of malignant tumors. A delicate balance needs to be maintained in the intensity of immunosuppression to keep the risk of malignancy low without jeopardizing life-saving graft function. OTRs are prone to developing skin cancers that exhibit unique epidemiologic, pathophysiologic, and prognostic characteristics. In this review, we discuss the most commonly reported skin cancers in OTRs: squamous cell carcinoma (SCC), basal cell carcinoma (BCC), Kaposi sarcoma, Merkel cell carcinoma, and malignant melanoma (MM). Tumors in this high-risk population are aggressive and may respond poorly to standard therapies; however, new targeted therapies are promising. Checkpoint inhibitor antibodies have been used for treatment of cutaneous SCC, Merkel cell carcinoma, and MM; epidermal growth factor receptor inhibitors have been used for cutaneous SCC; hedgehog pathway inhibitors have been used for BCC; and BRAF and MEK inhibitors are being used increasingly in the management of MM. Guidelines for dermatologic screening are variable and primarily based on expert opinion. Prospective evidence-based trials by multidisciplinary groups are needed to better define surveillance schedules for pre- and posttransplant cutaneous malignancies.
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Affiliation(s)
- A Mittal
- Departments of Dermatology, Yale University School of Medicine, New Haven, CT
| | - O R Colegio
- Departments of Dermatology, Yale University School of Medicine, New Haven, CT.,Departments of Pathology, Yale University School of Medicine, New Haven, CT.,Departments of Surgery, Yale University School of Medicine, New Haven, CT.,Yale Cancer Center, Yale University School of Medicine, New Haven, CT.,Yale-New Haven Transplantation Center, Yale University School of Medicine, New Haven, CT
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18
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Fattouh K, Ducroux E, Decullier E, Kanitakis J, Morelon E, Boissonnat P, Sebbag L, Jullien D, Euvrard S. Increasing incidence of melanoma after solid organ transplantation: a retrospective epidemiological study. Transpl Int 2017; 30:1172-1180. [PMID: 28700114 DOI: 10.1111/tri.13011] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 02/27/2017] [Accepted: 07/07/2017] [Indexed: 12/20/2022]
Abstract
The risk of melanoma in organ transplant recipients (OTR) is increased compared with the general population. This retrospective study registered all cases of post-transplant melanoma in kidney, heart, lung, and liver transplant recipients followed in our specialized post-transplant Dermatology Clinic since 1991. The yearly prevalence of melanoma and skin carcinoma between 2000 and 2015 was computed and compared in this population. Based on another cohort of kidney transplant recipients grafted since 2005, adjusted age- and sex-standardized incidence ratio (SIR) was calculated using a renal transplantation registry. In our overall OTR cohort, between 1991 and 2000, five melanomas occurred in 1800 OTRs (0.28%), whereas between 1991 and 2015, 53 melanomas were diagnosed in 49 of 4510 OTR (1.09%), representing a 3.9-fold increase in prevalence after 2000. Remarkably, the prevalence of nonmelanoma skin cancers remained unchanged over this period. Two deaths related to melanoma were recorded with an overall follow-up of 62 months. In our cohort of 1102 renal transplant recipients, the SIR of melanoma was 4.52. Our data suggest that contrasting with nonmelanoma skin cancer, the risk of post-transplant melanoma has considerably increased over the last decade.
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Affiliation(s)
- Kinda Fattouh
- Department of Dermatology, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Emilie Ducroux
- Department of Dermatology, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Evelyne Decullier
- Unité de Recherche Clinique, Pôle Information Médicale Evaluation Recherche, Hospices Civils de Lyon, Lyon, France.,EA Santé-Individu-Société, Université Lyon 1, Lyon, France
| | - Jean Kanitakis
- Department of Dermatology, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Emmanuel Morelon
- Department of Transplantation and Nephrology, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Pascale Boissonnat
- Department of Transplant Cardiology, Louis Pradel Hospital, Hospices Civils de Lyon, Bron, France
| | - Laurent Sebbag
- Department of Transplant Cardiology, Louis Pradel Hospital, Hospices Civils de Lyon, Bron, France
| | - Denis Jullien
- Department of Dermatology, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Sylvie Euvrard
- Department of Dermatology, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
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19
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Zito Marino F, Ascierto PA, Rossi G, Staibano S, Montella M, Russo D, Alfano R, Morabito A, Botti G, Franco R. Are tumor-infiltrating lymphocytes protagonists or background actors in patient selection for cancer immunotherapy? Expert Opin Biol Ther 2017; 17:735-746. [PMID: 28318336 DOI: 10.1080/14712598.2017.1309387] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Tumor-infiltrating lymphocytes (TILs) are frequently observed in several tumors, reflecting the dynamic process of '"cancer immunoediting"'. Prognostic and predictive values of TILs have been demonstrated in different cancers, proving their pivotal role in clinical outcome. In recent years, new therapies targeting immune checkpoint inhibitors, especially CTLA-4 and PD-1/PDL-1 pathways, have been introduced into clinical practice. In this context, TILs may even have a possible utility as a predictive biomarker for immunotherapy response. Areas covered: In this review, the authors summarize the most relevant knowledge related to TILs. This includes their prognostic and predictive significance in various types of tumour and the recent findings about their potential role in the cancer immunotherapy. Expert opinion: TILs evaluation could lead to a predictive biomarker for immunotherapy effectiveness in several cancer types. Furthermore, typing of TILs subpopulation could have clinical relevance in patient selection for treatment with immune checkpoint inhibitors. However further studies are still needed.
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Affiliation(s)
- Federica Zito Marino
- a Pathology Unit , Istituto Nazionale Tumori "Fondazione G. Pascale"-IRCCS , Naples , Italy.,b Pathology Unit , Università della campania 'Luigi Vanvitelli' , Naples , Italy
| | | | - Giulio Rossi
- d Unit of Pathologic Anatomy , Azienda USL Valle d'Aosta , Aosta , Italy
| | - Stefania Staibano
- e Departmentof Biomorphological and Functional Sciences , University of Naples 'Federico II' , Naples , Italy
| | - Marco Montella
- b Pathology Unit , Università della campania 'Luigi Vanvitelli' , Naples , Italy
| | - Daniela Russo
- e Departmentof Biomorphological and Functional Sciences , University of Naples 'Federico II' , Naples , Italy
| | - Roberto Alfano
- f Department of Anesthesiology , Surgery and Emergency, Università della Campania 'Luigi Vanvitelli' , Naples , Italy
| | - Alessandro Morabito
- g Medical Oncology Unit, Department of Thoracic Surgical and Medical Oncology , Istituto Nazionale Tumori "Fondazione G. Pascale"-IRCCS , Naples , Italy
| | - Gerardo Botti
- a Pathology Unit , Istituto Nazionale Tumori "Fondazione G. Pascale"-IRCCS , Naples , Italy
| | - Renato Franco
- b Pathology Unit , Università della campania 'Luigi Vanvitelli' , Naples , Italy
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20
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Doycheva I, Amer S, Watt KD. De Novo Malignancies After Transplantation: Risk and Surveillance Strategies. Med Clin North Am 2016; 100:551-67. [PMID: 27095645 DOI: 10.1016/j.mcna.2016.01.006] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
De novo malignancies are one of the leading causes of late mortality after liver and kidney transplantation. Nonmelanoma skin cancer is the most common malignancy, followed by posttransplant lymphoproliferative disorder and solid organ tumors. Immunosuppression is a key factor for cancer development, although many other transplant-related and traditional risk factors also play a role. In this review, the authors summarize risk factors and outcomes of frequently encountered de novo malignancies after liver and kidney transplantation to stratify recipients at highest risk. Future efforts in prospectively validated, cost-effective surveillance strategies that improve survival of these complex patients are greatly needed.
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Affiliation(s)
- Iliana Doycheva
- Division of Gastroenterology and Hepatology, Medical University-Sofia, 1 G. Sofiisky Boulevard, Sofia 1431, Bulgaria
| | - Syed Amer
- Division of Internal Medicine, Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA
| | - Kymberly D Watt
- Division of Gastroenterology and Hepatology, Mayo Clinic and Foundation, CH-10, 200 First Street Southwest, Rochester, MN 55905, USA.
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21
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Tumour-infiltrating lymphocytes in melanoma prognosis and cancer immunotherapy. Pathology 2016; 48:177-87. [PMID: 27020390 DOI: 10.1016/j.pathol.2015.12.006] [Citation(s) in RCA: 172] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Accepted: 11/16/2015] [Indexed: 12/26/2022]
Abstract
The field of systemic cancer therapy for metastatic disease has entered an exciting era with the advent of novel immunomodulatory strategies targeting immune checkpoints. At the heart of these promising efforts are the tumour-infiltrating lymphocytes (TILs). As the reports demonstrating efficacy of modulating TIL effector function in patients with advanced stage cancer continue to accrue, it has become essential to better understand TIL immunobiology in order to further improve clinical outcome. In addition to providing an overview of the current immunotherapies available for metastatic melanoma, this review will briefly introduce the history and classification of TILs. Moreover, we will dissect the multifaceted roles of TILs in tumour-specific immunity and melanoma immune escape. The significance of TILs in melanoma prognosis and cancer immunotherapy will also be discussed, with a particular focus on their potential utility as biomarkers of patient response. The goal of personalised medicine appears to be in realistic sight, as new immunomodulatory techniques and technological innovations continue to advance the field of cancer immunotherapy. In light of recent studies highlighting the possible utility of TILs in determining therapeutic outcome, further characterisation of TIL phenotype and function has the potential to help translate individualised care into current medical practice.
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22
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Melanoma Incidence and Lethality Is Increased Following Solid Organ Transplantation. J Invest Dermatol 2015; 135:2560-2562. [DOI: 10.1038/jid.2015.326] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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