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Trivillin VA, Langle YV, Palmieri MA, Pozzi ECC, Thorp SI, Benitez Frydryk DN, Garabalino MA, Monti Hughes A, Curotto PM, Colombo LL, Santa Cruz IS, Ramos PS, Itoiz ME, Argüelles C, Eiján AM, Schwint AE. Evaluation of local, regional and abscopal effects of Boron Neutron Capture Therapy (BNCT) combined with immunotherapy in an ectopic colon cancer model. Br J Radiol 2021; 94:20210593. [PMID: 34520668 DOI: 10.1259/bjr.20210593] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE The aim of the present study was to evaluate the local and regional therapeutic efficacy and abscopal effect of BNCT mediated by boronophenyl-alanine, combined with Bacillus Calmette-Guerin (BCG) as an immunotherapy agent in this model. METHODS The local effect of treatment was evaluated in terms of tumor response in the irradiated tumor-bearing right hind flank. Metastatic spread to tumor-draining lymph nodes was analyzed as an indicator of regional effect. The abscopal effect of treatment was assessed as tumor growth inhibition in the contralateral (non-irradiated) left hind flank inoculated with tumor cells 2 weeks post-irradiation. The experimental groups BNCT, BNCT + BCG, BCG, Beam only (BO), BO +BCG, SHAM (tumor-bearing, no treatment, same manipulation) were studied. RESULTS BNCT and BNCT + BCG induced a highly significant local anti-tumor response, whereas BCG alone induced a weak local effect. BCG and BNCT + BCG induced a significant abscopal effect in the contralateral non-irradiated leg. The BNCT + BCG group showed significantly less metastatic spread to tumor-draining lymph nodes vs SHAM and vs BO. CONCLUSION This study suggests that BNCT + BCG-immunotherapy would induce local, regional and abscopal effects in tumor-bearing animals. BNCT would be the main effector of the local anti-tumor effect whereas BCG would be the main effector of the abscopal effect. ADVANCES IN KNOWLEDGE Although the local effect of BNCT has been widely evidenced, this is the first study to show the local, regional and abscopal effects of BNCT combined with immunotherapy, contributing to comprehensive cancer treatment with combined therapies.
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Affiliation(s)
- Verónica A Trivillin
- Comisión Nacional de Energía Atómica (CNEA), Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Yanina V Langle
- Universidad de Buenos Aires, Instituto de Oncología Ángel H. Roffo, Área Investigación, Buenos Aires, Argentina
| | - Mónica A Palmieri
- Departamento de Biodiversidad y Biología Experimental, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires (UBA), Buenos Aires, Argentina
| | | | - Silvia I Thorp
- Comisión Nacional de Energía Atómica (CNEA), Buenos Aires, Argentina
| | | | | | - Andrea Monti Hughes
- Comisión Nacional de Energía Atómica (CNEA), Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Paula M Curotto
- Comisión Nacional de Energía Atómica (CNEA), Buenos Aires, Argentina
| | - Lucas L Colombo
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina.,Universidad de Buenos Aires, Instituto de Oncología Ángel H. Roffo, Área Investigación, Buenos Aires, Argentina
| | - Iara S Santa Cruz
- Comisión Nacional de Energía Atómica (CNEA), Buenos Aires, Argentina
| | - Paula S Ramos
- Comisión Nacional de Energía Atómica (CNEA), Buenos Aires, Argentina
| | - María E Itoiz
- Comisión Nacional de Energía Atómica (CNEA), Buenos Aires, Argentina.,Facultad de Odontología, Universidad de Buenos Aires (UBA), Buenos Aires, Argentina
| | - Claudia Argüelles
- Instituto Nacional de Producción de Biológicos, ANLIS Dr. Carlos G. Malbrán, Buenos Aires, Argentina
| | - Ana M Eiján
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina.,Universidad de Buenos Aires, Instituto de Oncología Ángel H. Roffo, Área Investigación, Buenos Aires, Argentina
| | - Amanda E Schwint
- Comisión Nacional de Energía Atómica (CNEA), Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
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Wilkins A, Ost P, Sundahl N. Is There a Benefit of Combining Immunotherapy and Radiotherapy in Bladder Cancer? Clin Oncol (R Coll Radiol) 2021; 33:407-414. [PMID: 33726945 DOI: 10.1016/j.clon.2021.02.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/10/2021] [Accepted: 02/25/2021] [Indexed: 01/13/2023]
Abstract
Immune checkpoint inhibitors have transformed the management of patients with metastatic urothelial cancer, by leading to long-term response and prolongation of survival in a subset of patients. Unfortunately, only one in five patients with metastatic urothelial cancer responds to anti-programmed death ligand-1 ([AQ1]anti-PD-1) monotherapy. Preclinical and early clinical evidence indicates that radiotherapy not only acts locally, but also exerts systemic anti-tumour effects by modulating the immune system. It is hypothesised that combining checkpoint inhibitors with radiotherapy might enhance an anti-tumour immune response and increase response rates. So far, a handful of early phase clinical trials have been performed seeking to answer this question in urothelial cancer patients. The current review summarises the available preclinical and clinical evidence on radiotherapy/immunotherapy combinations in locally advanced and metastatic bladder cancer and suggests future avenues worthy of exploration.
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Affiliation(s)
- A Wilkins
- Division of Radiotherapy and Imaging, Institute of Cancer Research, London, UK
| | - P Ost
- Department of Radiation Oncology and Experimental Cancer Research, Ghent University Hospital, Ghent, Belgium
| | - N Sundahl
- Division of Radiotherapy and Imaging, Institute of Cancer Research, London, UK; Department of Radiation Oncology and Experimental Cancer Research, Ghent University Hospital, Ghent, Belgium.
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The Role of Biomimetic Hypoxia on Cancer Cell Behaviour in 3D Models: A Systematic Review. Cancers (Basel) 2021; 13:cancers13061334. [PMID: 33809554 PMCID: PMC7999912 DOI: 10.3390/cancers13061334] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/05/2021] [Accepted: 03/13/2021] [Indexed: 12/18/2022] Open
Abstract
Simple Summary Cancer remains one of the leading causes of death worldwide. The advancements in 3D tumour models provide in vitro test-beds to study cancer growth, metastasis and response to therapy. We conducted this systematic review on existing experimental studies in order to identify and summarize key biomimetic tumour microenvironmental features which affect aspects of cancer biology. The review noted the significance of in vitro hypoxia and 3D tumour models on epithelial to mesenchymal transition, drug resistance, invasion and migration of cancer cells. We highlight the importance of various experimental parameters used in these studies and their subsequent effects on cancer cell behaviour. Abstract The development of biomimetic, human tissue models is recognized as being an important step for transitioning in vitro research findings to the native in vivo response. Oftentimes, 2D models lack the necessary complexity to truly recapitulate cellular responses. The introduction of physiological features into 3D models informs us of how each component feature alters specific cellular response. We conducted a systematic review of research papers where the focus was the introduction of key biomimetic features into in vitro models of cancer, including 3D culture and hypoxia. We analysed outcomes from these and compiled our findings into distinct groupings to ascertain which biomimetic parameters correlated with specific responses. We found a number of biomimetic features which primed cancer cells to respond in a manner which matched in vivo response.
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Review of Experimental Studies to Improve Radiotherapy Response in Bladder Cancer: Comments and Perspectives. Cancers (Basel) 2020; 13:cancers13010087. [PMID: 33396795 PMCID: PMC7795454 DOI: 10.3390/cancers13010087] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/22/2020] [Accepted: 12/22/2020] [Indexed: 01/04/2023] Open
Abstract
Bladder cancer is among the top ten most common cancer types in the world. Around 25% of all cases are muscle-invasive bladder cancer, for which the gold standard treatment in the absence of metastasis is the cystectomy. In recent years, trimodality treatment associating maximal transurethral resection and radiotherapy combined with concurrent chemotherapy is increasingly used as an organ-preserving alternative. However, the use of this treatment is still limited by the lack of biomarkers predicting tumour response and by a lack of targeted radiosensitising drugs that can improve the therapeutic index, especially by limiting side effects such as bladder fibrosis. In order to improve the bladder-preserving treatment, experimental studies addressing these main issues ought to be considered (both in vitro and in vivo studies). Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic reviews, we conducted a literature search in PubMed on experimental studies investigating how to improve bladder cancer radiotherapy with different radiosensitising agents using a comprehensive search string. We made comments on experimental model selection, experimental design and results, formulating the gaps of knowledge still existing: such as the lack of reliable predictive biomarkers of tumour response to chemoradiation according to the molecular tumour subtype and lack of efficient radiosensitising agents specifically targeting bladder tumour cells. We provided guidance to improve forthcoming studies, such as taking into account molecular characteristics of the preclinical models and highlighted the value of using patient-derived xenografts as well as syngeneic models. Finally, this review could be a useful tool to set up new radiation-based combined treatments with an improved therapeutic index that is needed for bladder preservation.
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Prack Mc Cormick B, Langle Y, Belgorosky D, Vanzulli S, Balarino N, Sandes E, Eiján AM. Flavonoid silybin improves the response to radiotherapy in invasive bladder cancer. J Cell Biochem 2018; 119:5402-5412. [PMID: 29363820 DOI: 10.1002/jcb.26693] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 01/22/2018] [Indexed: 11/11/2022]
Abstract
Conservative treatment for invasive bladder cancer (BC) involves a complete transurethral tumor resection combined with chemotherapy (CT) and radiotherapy (RT). The major obstacles of chemo-radiotherapy are the addition of the toxicities of RT and CT, and the recurrence due to RT and CT resistances. The flavonoid Silybin (Sb) inhibits pathways involved in cell survival and resistance mechanisms, therefore the purpose of this paper was to study in vitro and in vivo, the ability of Sb to improve the response to RT, in two murine BC cell lines, with different levels of invasiveness, placing emphasis on radio-sensitivity, and pathways involved in radio-resistance and survival. In vitro, Sb radio-sensitized murine invasive cells through the inhibition of RT-induced NF-κB and PI3K pathways, and the increase of oxidative stress, while non-invasive cells did not show to be sensitized. In vivo, Sb improved RT-response and overall survival in invasive murine tumors. As Sb is already being tested in clinical trials for other urological cancers and it improves RT-response in invasive BC, these results could have translational relevance, supporting further research.
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Affiliation(s)
- Barbara Prack Mc Cormick
- Universidad de Buenos Aires, Instituto de Oncología "Ángel H. Roffo", Área de Investigaciones, Ciudad de Buenos Aires, Argentina.,CONICET, Buenos Aires, Argentina.,Universidad Nacional de Lomas de Zamora, Facultad de Ciencias Agrarias, Laboratorio de Suelos, Buenos Aires, Argentina
| | - Yanina Langle
- Universidad de Buenos Aires, Instituto de Oncología "Ángel H. Roffo", Área de Investigaciones, Ciudad de Buenos Aires, Argentina
| | - Denise Belgorosky
- Universidad de Buenos Aires, Instituto de Oncología "Ángel H. Roffo", Área de Investigaciones, Ciudad de Buenos Aires, Argentina.,CONICET, Buenos Aires, Argentina
| | - Silvia Vanzulli
- Universidad de Buenos Aires, Instituto de Oncología "Ángel H. Roffo", Área de Investigaciones, Ciudad de Buenos Aires, Argentina.,Academia Nacional de Medicina, Ciudad de Buenos Aires, Argentina
| | - Natalia Balarino
- Universidad de Buenos Aires, Instituto de Oncología "Ángel H. Roffo", Área de Investigaciones, Ciudad de Buenos Aires, Argentina.,CONICET, Buenos Aires, Argentina
| | - Eduardo Sandes
- Universidad de Buenos Aires, Instituto de Oncología "Ángel H. Roffo", Área de Investigaciones, Ciudad de Buenos Aires, Argentina
| | - Ana M Eiján
- Universidad de Buenos Aires, Instituto de Oncología "Ángel H. Roffo", Área de Investigaciones, Ciudad de Buenos Aires, Argentina.,CONICET, Buenos Aires, Argentina
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