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Pham JP, Dwyer L, Phan K, Menzies AM, Frew JW. Efficacy of topical diphencyprone for melanoma in-transit metastases: a systematic review and meta-analysis. Melanoma Res 2023; 33:434-436. [PMID: 37650727 DOI: 10.1097/cmr.0000000000000914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Affiliation(s)
- James P Pham
- Department of Dermatology, Liverpool Hospital
- School of Clinical Medicine, UNSW Medicine and Health, Sydney
- Laboratory of Translational Cutaneous Medicine, Ingham Institute of Applied Medical Research, Liverpool
| | - Liam Dwyer
- School of Clinical Medicine, UNSW Medicine and Health, Sydney
- Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown
| | - Kevin Phan
- Department of Dermatology, Liverpool Hospital
| | - Alexander M Menzies
- Melanoma Institute Australia, The University of Sydney
- Faculty of Medicine and Health, The University of Sydney
- Department of Medical Oncology, Royal North Shore and Mater Hospitals, Sydney, New South Wales, Australia
| | - John W Frew
- Department of Dermatology, Liverpool Hospital
- School of Clinical Medicine, UNSW Medicine and Health, Sydney
- Laboratory of Translational Cutaneous Medicine, Ingham Institute of Applied Medical Research, Liverpool
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2
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Han J, Correa da Rosa J, Agarwal A, Owji S, Yassky D, Luu Y, Shah A, Estrada Y, Ungar J, Sarin KY, Krueger JG, Gulati N. Modulation of Inflammatory Proteins in Serum May Reflect Cutaneous Immune Responses in Cancer Immunotherapy. JID INNOVATIONS 2023; 3:100179. [PMID: 36876222 PMCID: PMC9982329 DOI: 10.1016/j.xjidi.2022.100179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 11/28/2022] [Accepted: 12/05/2022] [Indexed: 01/30/2023] Open
Abstract
Diphencyprone (DPCP), a topical contact sensitizer, has shown efficacy in treating cutaneous melanoma metastases, including at times beyond the directly treated sites, but biomarkers indicative of treatment response have not been characterized. Thus, we performed a proteomic analysis of the skin and serum of five patients with cutaneous melanoma metastases treated with DPCP on days 0, 63, and 112 of the treatment course. In the serum, we found a significant upregulation (P < 0.05) in 13 of 96 assessed immuno-oncology proteins after DPCP treatment. Upregulated proteins included those of the T helper 1 axis (CXCL9, CXCL10), immune checkpoint proteins (PD-1), and various proteins with roles in promoting tumor immunity such as CD80 and TNFRSF4/9. Given the positive clinical response to topical treatment noted in the five patients studied, these proteins may represent prognostic biomarkers in the serum for evaluating the efficacy of DPCP treatment of cutaneous melanoma metastases. Because DPCP does not lead to nonspecific immune-related adverse events seen with immune checkpoint inhibitors, our study provides evidence for potential tumor-specific systemic immune activation and systemic antitumor effectors elicited by topical DPCP.
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Affiliation(s)
- Joseph Han
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Joel Correa da Rosa
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Aneesh Agarwal
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Shayan Owji
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Daniel Yassky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Yen Luu
- School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Aatman Shah
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Yeriel Estrada
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jonathan Ungar
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Kavita Y. Sarin
- Department of Dermatology, Stanford University School of Medicine, Stanford, California, USA
| | - James G. Krueger
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, New York, USA
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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3
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Han J, Stratman S, Young JN, Poplausky D, Owji S, Luu Y, Estrada Y, Correa da Rosa J, Krueger JG, Gulati N. Unique protein signatures evolve during the course of a delayed-type hypersensitivity reaction in human skin. J Dermatol 2022. [PMID: 36578124 DOI: 10.1111/1346-8138.16688] [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: 08/19/2022] [Revised: 11/18/2022] [Accepted: 12/06/2022] [Indexed: 12/30/2022]
Abstract
Diphencyprone (DPCP) is a hapten that causes a delayed-type hypersensitivity reaction when applied topically. It has clinical uses in the treatment of various conditions such as melanoma metastases, warts, and alopecia areata, but the mechanisms are currently not well understood in humans. To further characterize the immunologic effects of DPCP, the authors performed a proteomic analysis of normal skin of eight healthy volunteers following a single application of DPCP and compared them with placebo-treated skin from the same volunteers. A total of 96 proteins were examined using the Olink immuno-oncology panel at 3 days (peak response), 14 days (partially resolved response), and 120 days (completely resolved response). Our analysis revealed significant upregulation of markers of immune cell activation (interleukin [IL] 8), vascular and tissue remodeling (matrix metallopeptidase 12 [MMP12], nitric oxide synthase 3 [NOS3]), antineoplastic markers (granzyme B [GZMB]), and the Th1 axis (interferon gamma [IFNG], chemokine (C-X-C motif) ligand [CXCL] 9, CXCL10, CXCL11) at days 3 and 14 compared with placebo (p < 0.05). In addition, several negative regulators of immune function such as programmed cell death 1 (PD1), programmed cell death ligand 1 (PDL1) (p < 0.001), and lymphocyte activation gene 3 (LAG3) (p < 0.05) were significantly upregulated at days 3 and 14. This induction of negative regulators may explain the seemingly paradoxical therapeutic benefits of DPCP in autoimmune conditions such as alopecia areata. The current analysis also indicated IL-4 upregulation only at day 3, followed by IL-12 upregulation only at day 14, suggesting a transient Th2 response followed by Th1 polarization. Overall, these data suggest a complex and evolving immunological delayed-type hypersensitivity response to a single application of DPCP over time. Future proteomic studies of samples from patients with melanoma metastases, warts, and alopecia areata treated long term with DPCP are needed to further evaluate its pharmacologic mechanisms.
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Affiliation(s)
- Joseph Han
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Scott Stratman
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jade N Young
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Dina Poplausky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Shayan Owji
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Yen Luu
- School of Medicine, University of Missouri, Kansas City, Missouri, USA
| | - Yeriel Estrada
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Joel Correa da Rosa
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - James G Krueger
- Laboratory for Investigative Dermatology, Rockefeller University, New York, New York, USA
| | - Nicholas Gulati
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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4
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Han J, Agarwal A, Young JN, Owji S, Luu Y, Poplausky D, Yassky D, Estrada Y, Ungar J, Krueger JG, Gulati N. Proteomic profiling of a patient with cutaneous melanoma metastasis regression following topical contact sensitizer diphencyprone and immune checkpoint inhibitor treatment. Sci Rep 2022; 12:22364. [PMID: 36572780 PMCID: PMC9792448 DOI: 10.1038/s41598-022-27020-1] [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: 08/17/2022] [Accepted: 12/23/2022] [Indexed: 12/28/2022] Open
Abstract
Immune checkpoint inhibitors (ICIs) such as pembrolizumab have revolutionized the treatment of advanced melanoma, but many patients do not respond to ICIs alone, and thus there is need for additional treatment options. Topical immunomodulators such as diphencyprone (DPCP) also have clinical use in advanced melanoma, particularly in the treatment of cutaneous metastases. In a previous report, we characterized the enhanced clinical response to dual agent immunotherapy with pembrolizumab and DPCP in a patient with cutaneous melanoma metastases. To improve mechanistic understanding of this response, we analyzed proteomic data using the Olink immuno-oncology panel of 96 biomarkers from tissue and serum samples of this patient throughout his treatment course. Particular attention was paid to programmed death-1 (PD-1), programmed death-ligand 1 (PD-L1), and lymphocyte-activation gene 3 (LAG-3) given they are all targeted by ICIs in clinical practice. These proteins were upregulated during the period of DPCP monotherapy, then downregulated during pembrolizumab monotherapy, and then robustly upregulated again during dual therapy. Although not exclusively, the induction of checkpoint inhibitor proteins in the presence of DPCP suggests potential synergy between this agent and ICIs in the treatment of cutaneous melanoma metastases. Large-scale investigation is warranted to further evaluate this potential novel combination therapeutic approach.
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Affiliation(s)
- Joseph Han
- grid.59734.3c0000 0001 0670 2351Department of Dermatology, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, New York, NY 10029 USA
| | - Aneesh Agarwal
- grid.59734.3c0000 0001 0670 2351Department of Dermatology, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, New York, NY 10029 USA
| | - Jade N. Young
- grid.59734.3c0000 0001 0670 2351Department of Dermatology, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, New York, NY 10029 USA
| | - Shayan Owji
- grid.59734.3c0000 0001 0670 2351Department of Dermatology, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, New York, NY 10029 USA
| | - Yen Luu
- grid.266756.60000 0001 2179 926XSchool of Medicine, University of Missouri-Kansas City, Kansas City, MO USA
| | - Dina Poplausky
- grid.59734.3c0000 0001 0670 2351Department of Dermatology, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, New York, NY 10029 USA
| | - Daniel Yassky
- grid.59734.3c0000 0001 0670 2351Department of Dermatology, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, New York, NY 10029 USA
| | - Yeriel Estrada
- grid.59734.3c0000 0001 0670 2351Department of Dermatology, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, New York, NY 10029 USA
| | - Jonathan Ungar
- grid.59734.3c0000 0001 0670 2351Department of Dermatology, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, New York, NY 10029 USA
| | - James G. Krueger
- grid.134907.80000 0001 2166 1519Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY USA
| | - Nicholas Gulati
- grid.59734.3c0000 0001 0670 2351Department of Dermatology, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, New York, NY 10029 USA
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Han J, Correa da Rosa J, Owji S, Yassky D, Luu Y, Estrada Y, Ungar J, Ji A, Krueger JG, Gulati N. Skin proteomic analysis of immune activation associated with regression of melanoma metastases induced by diphencyprone. JAAD Int 2022; 9:65-68. [PMID: 36147215 PMCID: PMC9486131 DOI: 10.1016/j.jdin.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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6
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Henderson MA. Topical and intralesional therapies for in-transitmelanoma. Melanoma Manag 2019; 6:MMT23. [PMID: 31807274 PMCID: PMC6891934 DOI: 10.2217/mmt-2019-0008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 05/08/2019] [Indexed: 01/03/2023] Open
Abstract
This report surveys the role of topical and intralesional agents in the management of in-transit melanoma. The extent and progression of in-transit disease is highly variable and many patients can have a protracted period of locoregional control. These agents are useful in the management of patients who have progressed beyond local surgical excision in whom more aggressive therapies, such as isolated limb infusion or use of talimogene laherparepvec, are not appropriate or have failed. In general, these agents are modestly effective and associated with frequent but only minor toxicity. As the mechanism of action of many of these agents includes initiation of a local immune response, combinations with immune checkpoint inhibitors are currently being explored.
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Affiliation(s)
- Michael A Henderson
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne, Victoria 3000, Australia
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Racz JM, Block MS, Baum CL, Jakub JW. Management of local or regional non‐nodal disease. J Surg Oncol 2018; 119:187-199. [DOI: 10.1002/jso.25330] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 11/19/2018] [Indexed: 12/31/2022]
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Tsao H, Fukunaga-Kalabis M, Herlyn M. Recent Advances in Melanoma and Melanocyte Biology. J Invest Dermatol 2017; 137:557-560. [PMID: 28089201 DOI: 10.1016/j.jid.2016.11.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 11/03/2016] [Indexed: 01/06/2023]
Affiliation(s)
- Hensin Tsao
- Department of Dermatology, Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
| | - Mizuho Fukunaga-Kalabis
- Molecular and Cellular Oncogenesis Program and Melanoma Research Center, The Wistar Institute, Philadelphia, Pennsylvania, USA
| | - Meenhard Herlyn
- Molecular and Cellular Oncogenesis Program and Melanoma Research Center, The Wistar Institute, Philadelphia, Pennsylvania, USA.
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