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Kotsifa E, Machairas N, Angelis A, Nikiteas NI, Dimitroulis D, Sotiropoulos GC. Decoding the Prognostic Significance and Therapeutic Implications of Inflammation-Based Scores in Hepatocellular Carcinoma: A Comprehensive Review. Cancers (Basel) 2024; 16:2549. [PMID: 39061188 PMCID: PMC11274930 DOI: 10.3390/cancers16142549] [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: 05/23/2024] [Revised: 07/11/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
Hepatocellular carcinoma (HCC) is the most common primary liver cancer, posing a significant global health challenge with an increasing incidence. In recent years, multiple staging systems and scores have been proposed, emphasising the necessity for the development of precise prognostic tools. The well-documented etiological relationship between chronic inflammation and carcinogenesis has prompted researchers to explore novel prognostic markers associated with the inflammatory status of HCC patients. This review summarises the current data about inflammation-based scores in the context of HCC. We discuss established scores like the Glasgow Prognostic Score (GPS), modified GPS (mGPS) and the neutrophil-to-lymphocyte ratio (NLR) and others not as extensively studied, examining their utility in predicting survival outcomes and treatment response in HCC patients. Furthermore, we explore emerging scores, including the prognostic nutritional index (PNI) and other lymphocyte-based scores, assessing their potential in refining risk stratification and guiding therapeutic decisions in the era of precision medicine. As research progresses and these scores undergo further refinement and integration into the evolving landscape of HCC management, they carry significant potential for improving patient outcomes.
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Affiliation(s)
- Evgenia Kotsifa
- 2nd Propaedeutic Department of Surgery, General Hospital of Athens “Laiko”, National and Kapodistrian University of Athens, Agiou Thoma 17, 11527 Athens, Greece
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Yasue S, Ozeki M, Nozawa A, Endo S, Ohnishi H. Changes in cell morphology and function induced by the NRAS Q61R mutation in lymphatic endothelial cells. PLoS One 2024; 19:e0289187. [PMID: 38809881 PMCID: PMC11135733 DOI: 10.1371/journal.pone.0289187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 05/06/2024] [Indexed: 05/31/2024] Open
Abstract
Recently, a low-level somatic mutation in the NRAS gene (c.182 A > G, Q61R) was identified in various specimens from patients with kaposiform lymphangiomatosis. However, it is unknown how these low-frequency mutated cells can affect the characterization and surrounding environment of their lesions. To understand the pathogenesis and association of these gene abnormalities, we established NRASQ61R mutated lymphatic endothelial cells transfected with lentivirus vector and undertook morphological and functional characterization, protein expression profiling, and metabolome analysis. NRASQ61R human dermal lymphatic endothelial cells showed poor tube formation, a low proliferation rate, and high migration ability, with an increase in the ratio of mutated cells. An analysis of signaling pathways showed inactivation of the PIK3/AKT/mTOR pathway and hyperactivation of the RAS/MAPK/ERK pathway, which was improved by MAPK kinase (MEK) inhibitor treatment. This study shows the theoretical circumstances induced in vitro by NRASQ61R-mutated cells in the affected lesions of kaposiform lymphangiomatosis patients.
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Affiliation(s)
- Shiho Yasue
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Michio Ozeki
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Akifumi Nozawa
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Saori Endo
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Hidenori Ohnishi
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan
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3
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Park Y, Chung C. Immune Evasion of G-CSF and GM-CSF in Lung Cancer. Tuberc Respir Dis (Seoul) 2024; 87:22-30. [PMID: 37726942 PMCID: PMC10758314 DOI: 10.4046/trd.2023.0037] [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: 03/23/2023] [Revised: 07/20/2023] [Accepted: 09/12/2023] [Indexed: 09/21/2023] Open
Abstract
Tumor immune evasion is a complex process that involves various mechanisms, such as antigen recognition restriction, immune system suppression, and T cell exhaustion. The tumor microenvironment contains various immune cells involved in immune evasion. Recent studies have demonstrated that granulocyte colony-stimulating factor (G-CSF) and granulocyte-macrophage colony-stimulating factor (GM-CSF) induce immune evasion in lung cancer by modulating neutrophils and myeloid-derived suppressor cells. Here we describe the origin and function of G-CSF and GM-CSF, particularly their role in immune evasion in lung cancer. In addition, their effects on programmed death-ligand 1 expression and clinical implications are discussed.
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Affiliation(s)
- Yeonhee Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Republic of Korea
| | - Chaeuk Chung
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Republic of Korea
- Infection Control Convergence Research Center, Chungnam National University College of Medicine, Daejeon, Republic of Korea
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Yanagi M, Suda T, Oishi N, Kobayashi M, Matsushita E. Adenosquamous carcinoma of the gallbladder simultaneously producing granulocyte-colony-stimulating factor and parathyroid hormone-related protein. Clin J Gastroenterol 2023; 16:901-907. [PMID: 37598132 DOI: 10.1007/s12328-023-01841-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 07/31/2023] [Indexed: 08/21/2023]
Abstract
We report a rare case of adenosquamous carcinoma of the gallbladder which simultaneously produces granulocyte-colony-stimulating factor (G-CSF) and parathyroid hormone-related protein (PTHrP), confirmed serologically and histologically. A 71-year-old man was examined for a gallbladder tumor with multiple lymph nodes and liver metastases. Histopathological evaluation by endoscopic ultrasound fine-needle aspiration revealed adenosquamous carcinoma of the gallbladder. Laboratory data showed markedly elevated white blood cell (WBC) count of 34,700 µL and corrected serum calcium level of 14.9 mg/dL. Serum G-CSF (191 pg/mL) and PTHrP (23.1 pmol/L) levels were high. Zoledronic acid and calcitonin were administered to treat hypercalcemia, which normalized serum calcium levels. Gemcitabine-cisplatin chemotherapy was started for cStage IVB gallbladder cancer. After chemotherapy initiation, WBCs showed a rapid downward trend; however, the patient suddenly developed acute respiratory distress syndrome; thus, chemotherapy was discontinued. Subsequently, WBC count increased again, and the patient's overall condition deteriorated. The patient died on day 27. Immunohistochemistry using autopsy specimens demonstrated patchy staining for G-CSF in the squamous cell carcinoma portion and diffuse and weak positive staining for PTHrP in the squamous cell carcinoma and poorly differentiated adenocarcinoma portions of the tumor, suggesting simultaneous G-CSF and PTHrP production by the tumor. This is the first report of a patient with gallbladder cancer with serological and histological evidence for G-CSF and PTHrP production.
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Affiliation(s)
- Masahiro Yanagi
- Department of Gastroenterology, Kanazawa Municipal Hospital, 3-7-3, Heiwamachi, Kanazawa, Ishikawa, 921-8105, Japan
| | - Tsuyoshi Suda
- Department of Gastroenterology, Kanazawa Municipal Hospital, 3-7-3, Heiwamachi, Kanazawa, Ishikawa, 921-8105, Japan.
| | - Naoki Oishi
- Department of Gastroenterology, Kanazawa Municipal Hospital, 3-7-3, Heiwamachi, Kanazawa, Ishikawa, 921-8105, Japan
| | - Masako Kobayashi
- Department of Pathology, Kanazawa Municipal Hospital, Kanazawa, , Ishikawa, Japan
| | - Eiki Matsushita
- Department of Gastroenterology, Kanazawa Municipal Hospital, 3-7-3, Heiwamachi, Kanazawa, Ishikawa, 921-8105, Japan
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Cao Y, Langer R, Ferrara N. Targeting angiogenesis in oncology, ophthalmology and beyond. Nat Rev Drug Discov 2023; 22:476-495. [PMID: 37041221 DOI: 10.1038/s41573-023-00671-z] [Citation(s) in RCA: 52] [Impact Index Per Article: 52.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2023] [Indexed: 04/13/2023]
Abstract
Angiogenesis is an essential process in normal development and in adult physiology, but can be disrupted in numerous diseases. The concept of targeting angiogenesis for treating diseases was proposed more than 50 years ago, and the first two drugs targeting vascular endothelial growth factor (VEGF), bevacizumab and pegaptanib, were approved in 2004 for the treatment of cancer and neovascular ophthalmic diseases, respectively. Since then, nearly 20 years of clinical experience with anti-angiogenic drugs (AADs) have demonstrated the importance of this therapeutic modality for these disorders. However, there is a need to improve clinical outcomes by enhancing therapeutic efficacy, overcoming drug resistance, defining surrogate markers, combining with other drugs and developing the next generation of therapeutics. In this Review, we examine emerging new targets, the development of new drugs and challenging issues such as the mode of action of AADs and elucidating mechanisms underlying clinical benefits; we also discuss possible future directions of the field.
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Affiliation(s)
- Yihai Cao
- Department of Microbiology, Tumour and Cell Biology, Karolinska Institute, Stockholm, Sweden.
| | - Robert Langer
- David H Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Napoleone Ferrara
- Department of Pathology, University of California San Diego, La Jolla, CA, USA.
- Department of Ophthalmology, University of California San Diego, La Jolla, CA, USA.
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA.
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Mao Y, Liu X, He K, Lin C, He B, Gao J. Xuanhusuo powder has an anti-breast cancer effect by inhibiting myeloid-derived suppressor cell differentiation in the spleen of mice through down-regulating granulocyte colony stimulating factor. Zhejiang Da Xue Xue Bao Yi Xue Ban 2023; 52:88-100. [PMID: 37283122 PMCID: PMC10407995 DOI: 10.3724/zdxbyxb-2022-0353] [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: 09/27/2022] [Accepted: 11/30/2022] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To investigate the mechanism of Xuanhusuo powder (XHSP) inhibiting the differentiation of spleen myeloid-derived suppressor cells (MDSCs) in breast cancer mice. METHODS Forty-eight BALB/c female mice aged 4-5 weeks were selected, 6 of them were in normal control group, while others were in tumor-bearing models established by orthotopic injection of 4T1 cells into the subcutaneous fat pad of the second pair of left mammary glands. The tumor-bearing mice were divided into granulocyte colony stimulating factor (G-CSF) control group, G-CSF knock-down group, model control group, XHSP small dose group, XHSP medium dose group, XHSP high dose group, and cyclophosphamide (CTX) group, with 6 mice in each group. G-CSF control group and G-CSF knock-down group were constructed by stably transfecting 4T1 cells established by shRNA lentivirus combined with puromycin selection. 48 h after the model was established, XHSP small, medium, high dose group were given 2, 4, 8 g·kg-1·d-1 intragastric administration once a day, respectively. CTX was given 30 mg/kg by intraperitoneal injection, once every other day. The other groups were given an equal volume of 0.5% hydroxymethylcellulose sodium. The drugs in each group were continuously administered for 25 d. Histological changes in spleen were observed by HE staining, the proportion of MDSCs subsets in the spleen were detected by flow cytometry, the co-expression of CD11b and Ly6G in the spleen was detected by immunofluorescence, and the concentration of G-CSF in peripheral blood was detected by ELISA. The spleen of tumor-bearing mice was co-cultured with 4T1 stably transfected cell lines in vitro, treated with XHSP (30 μg/mL) for 24 h, and the co-expression of CD11b and Ly6G in the spleen was detected by immunofluorescence. 4T1 cells were treated by XHSP (10, 30, 100 μg/mL) for 12 h. The mRNA level of G-CSF was detected by realtime RT-PCR. RESULTS Compared with normal mice, the red pulp of the spleen in tumor-bearing mice was widened with megakaryocyte infiltration. The proportion of spleen polymorphonucleocyte-like MDSCs (PMN-MDSCs) was significantly increased (P<0.01) and the co-expression of CD11b and Ly6G was increased, and the concentration of G-CSF in peripheral blood was significantly increased (P<0.01). However, XHSP could significantly reduce the proportion of PMN-MDSCs (P<0.05) and the co-expression of CD11b and Ly6G in the spleen, down-regulate the mRNA level of G-CSF in 4T1 cells (P<0.01). The concentration of G-CSF in peripheral blood of tumor-bearing mice also decreased (P<0.05) and tumor volume was reduced and splenomegaly was improved (all P<0.05). CONCLUSIONS XHSP may play an anti-breast cancer role by down-regulating G-CSF, negatively regulating the differentiation of MDSCs, and reconstruct the spleen myeloid microenvironment.
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Affiliation(s)
- Youer Mao
- Department of Pharmacy, Ningbo Municipal Hospital of Traditional Chinese Medicine, Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo 315010, Zhejiang Province, China.
| | - Xi Liu
- School of Basic Medicine, Zhejiang Chinese Medical University, Hangzhou 311499, China.
- Department of Traditional Chinese Medicine, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325003, Zhejiang Province, China.
| | - Kai He
- Department of Traditional Chinese Pharmacy, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Chen Lin
- School of Basic Medicine, Zhejiang Chinese Medical University, Hangzhou 311499, China
| | - Bingqian He
- Academy of Chinese Medical Sciences, Zhejiang Chinese Medical University, Hangzhou 311499, China
| | - Jianli Gao
- Department of Pharmacy, Zhejiang Chinese Medical University, Hangzhou 311499, China.
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Wang P, Tao L, Yu Y, Wang Q, Ye P, Sun Y, Zhou J. Oral squamous cell carcinoma cell-derived GM-CSF regulates PD-L1 expression in tumor-associated macrophages through the JAK2/STAT3 signaling pathway. Am J Cancer Res 2023; 13:589-601. [PMID: 36895967 PMCID: PMC9989602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 01/26/2023] [Indexed: 03/11/2023] Open
Abstract
Previous study reported that gastric cancer-derived granulocyte-macrophage colony-stimulating factor (GM-CSF) could mediate neutrophil activation and induce PD-L1 expression through JAK2/STAT3 signaling pathway. Moreover, this pathway in various cancers could also regulate PD-L1 expression of tumor cells. Therefore, our study aimed to investigate whether the JAK2/STAT3 pathway regulates PD-L1 expression in tumor-associated macrophages (TAMs) in oral squamous cell carcinoma (OSCC), which can help us achieve further understanding of immune escape mechanisms in OSCC. We induced human monocytes THP-1 into M0, M1, and M2 macrophages, and applied them to common medium and tumor-conditioned medium, the latter was collected from two types of OSCC cell line. Western blot and RT-PCR were used to detect PD-L1 expression and activation of JAK2/STAT3 pathway in macrophages under various conditions. We found that GM-CSF in tumor-conditioned medium from OSCC cells increased PD-L1 expression in M0 macrophages in a time-dependent manner. Moreover, both GM-CSF neutralizing antibody and JAK2/STAT3 pathway inhibitor AG490 could inhibited its up-regulation. In the meantime, we confirmed that GM-CSF indeed acted through JAK2/STAT3 pathway by measuring phosphorylation of key proteins in this pathway. Therefore, we concluded that OSCC cell-derived GM-CSF was able to up-regulate PD-L1 expression in TAMs through JAK2/STAT3 signaling pathway.
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Affiliation(s)
- Pingping Wang
- Anhui Engineering Research Center for Oral Materials and Application, Wannan Medical College Wuhu 241000, Anhui, People's Republic of China.,Department of Oral Medicine, School of Stomatology, Wannan Medical College Wuhu 241000, Anhui, People's Republic of China
| | - Liqing Tao
- Department of Neurobiology, School of Basic Medical Sciences, Nanjing Medical University Nanjing 211166, Jiangsu, People's Republic of China
| | - Yudu Yu
- Anhui Engineering Research Center for Oral Materials and Application, Wannan Medical College Wuhu 241000, Anhui, People's Republic of China.,Department of Oral Medicine, School of Stomatology, Wannan Medical College Wuhu 241000, Anhui, People's Republic of China
| | - Qiong Wang
- Department of Stomatology, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital of Wannan Medical College) Wuhu 241000, Anhui, People's Republic of China.,Key Laboratory of Non-coding RNA Transformation Research of Anhui Higher Education Institution (Wannan Medical College) Wuhu 241000, Anhui, People's Republic of China
| | - Peihong Ye
- Anhui Engineering Research Center for Oral Materials and Application, Wannan Medical College Wuhu 241000, Anhui, People's Republic of China.,Department of Oral Medicine, School of Stomatology, Wannan Medical College Wuhu 241000, Anhui, People's Republic of China
| | - Yi Sun
- Anhui Engineering Research Center for Oral Materials and Application, Wannan Medical College Wuhu 241000, Anhui, People's Republic of China
| | - Jingping Zhou
- Anhui Engineering Research Center for Oral Materials and Application, Wannan Medical College Wuhu 241000, Anhui, People's Republic of China.,Department of Oral Medicine, School of Stomatology, Wannan Medical College Wuhu 241000, Anhui, People's Republic of China
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Antuamwine BB, Bosnjakovic R, Hofmann-Vega F, Wang X, Theodosiou T, Iliopoulos I, Brandau S. N1 versus N2 and PMN-MDSC: A critical appraisal of current concepts on tumor-associated neutrophils and new directions for human oncology. Immunol Rev 2022; 314:250-279. [PMID: 36504274 DOI: 10.1111/imr.13176] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Research on tumor-associated neutrophils (TAN) currently surges because of the well-documented strong clinical relevance of tumor-infiltrating neutrophils. This relevance is illustrated by strong correlations between high frequencies of intratumoral neutrophils and poor outcome in the majority of human cancers. Recent high-dimensional analysis of murine neutrophils provides evidence for unexpected plasticity of neutrophils in murine models of cancer and other inflammatory non-malignant diseases. New analysis tools enable deeper insight into the process of neutrophil differentiation and maturation. These technological and scientific developments led to the description of an ever-increasing number of distinct transcriptional states and associated phenotypes in murine models of disease and more recently also in humans. At present, functional validation of these different transcriptional states and potential phenotypes in cancer is lacking. Current functional concepts on neutrophils in cancer rely mainly on the myeloid-derived suppressor cell (MDSC) concept and the dichotomous and simple N1-N2 paradigm. In this manuscript, we review the historic development of those concepts, critically evaluate these concepts against the background of our own work and provide suggestions for a refinement of current concepts in order to facilitate the transition of TAN research from experimental insight to clinical translation.
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Affiliation(s)
- Benedict Boateng Antuamwine
- Experimental and Translational Research, Department of Otorhinolaryngology, University Hospital Essen, Essen, Germany
| | - Rebeka Bosnjakovic
- Experimental and Translational Research, Department of Otorhinolaryngology, University Hospital Essen, Essen, Germany
| | - Francisca Hofmann-Vega
- Experimental and Translational Research, Department of Otorhinolaryngology, University Hospital Essen, Essen, Germany
| | - Xi Wang
- Experimental and Translational Research, Department of Otorhinolaryngology, University Hospital Essen, Essen, Germany
| | - Theodosios Theodosiou
- Department of Basic Sciences, School of Medicine, University of Crete, Heraklion, Greece
| | - Ioannis Iliopoulos
- Department of Basic Sciences, School of Medicine, University of Crete, Heraklion, Greece
| | - Sven Brandau
- Experimental and Translational Research, Department of Otorhinolaryngology, University Hospital Essen, Essen, Germany.,German Cancer Consortium, Partner Site Essen-Düsseldorf, Essen, Germany
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Huang HC, Chen YT, Lin HH, Li ZQ, Yang JM, Tzou SC. Inhibition of IRAK1 Is an Effective Therapy for Autoimmune Hypophysitis in Mice. Int J Mol Sci 2022; 23:ijms232314958. [PMID: 36499283 PMCID: PMC9738236 DOI: 10.3390/ijms232314958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/21/2022] [Accepted: 11/23/2022] [Indexed: 12/05/2022] Open
Abstract
Autoimmune hypophysitis (AH) is an autoimmune disease of the pituitary for which the pathogenesis is incompletely known. AH is often treated with corticosteroids; however, steroids may lead to considerable side effects. Using a mouse model of AH (experimental autoimmune hypophysitis, EAH), we show that interleukin-1 receptor-associated kinase 1 (IRAK1) is upregulated in the pituitaries of mice that developed EAH. We identified rosoxacin as a specific inhibitor for IRAK1 and found it could treat EAH. Rosoxacin treatment at an early stage (day 0-13) slightly reduced disease severity, whereas treatment at a later stage (day 14-27) significantly suppressed EAH. Further investigation indicated rosoxacin reduced production of autoantigen-specific antibodies. Rosoxacin downregulated production of cytokines and chemokines that may dampen T cell differentiation or recruitment to the pituitary. Finally, rosoxacin downregulated class II major histocompatibility complex expression on antigen-presenting cells that may lead to impaired activation of autoantigen-specific T cells. These data suggest that IRAK1 may play a pathogenic role in AH and that rosoxacin may be an effective drug for AH and other inflammatory diseases involving IRAK1 dysregulation.
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Affiliation(s)
- Hsiao-Chen Huang
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan
| | - Yun-Ti Chen
- Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan
| | - Han-Huei Lin
- Institute of Molecular Medicine and Bioengineering, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan
| | - Zhi-Qin Li
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan
| | - Jinn-Moon Yang
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan
- Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan
- Center for Intelligent Drug Systems and Smart Bio-Devices, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan
- Correspondence: (J.-M.Y.); (S.-C.T.)
| | - Shey-Cherng Tzou
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan
- Institute of Molecular Medicine and Bioengineering, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan
- Center for Intelligent Drug Systems and Smart Bio-Devices, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan
- Correspondence: (J.-M.Y.); (S.-C.T.)
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Paraneoplastische Hyperleukozytose bei Lungenkarzinom. DIE INNERE MEDIZIN 2022; 63:1312-1315. [PMID: 36149442 PMCID: PMC9510345 DOI: 10.1007/s00108-022-01407-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/02/2022] [Indexed: 11/01/2022]
Abstract
Paraneoplastische Leukozytosen bei soliden Tumoren sind mit einer schlechten Prognose assoziiert. Während milde paraneoplastische Leukozytosen regelhaft auftreten, sind nur wenige Fälle mit Leukozytenzahlen über 100.000/µl beschrieben. Dargestellt ist der Fall eines 73-jährigen Mannes mit Adenokarzinom der Lunge und Leukozytenzahlen bis 178.000/µl. Der Patient verstarb in der Neutropenie nach dem zweiten Zyklus Immunchemotherapie nur etwa 8 Wochen nach initialer Vorstellung. Spezifische Therapieansätze werden erforscht, sind bisher allerdings noch nicht im klinischen Alltag etabliert.
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11
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Fang L, Liu K, Liu C, Wang X, Ma W, Xu W, Wu J, Sun C. Tumor accomplice: T cell exhaustion induced by chronic inflammation. Front Immunol 2022; 13:979116. [PMID: 36119037 PMCID: PMC9479340 DOI: 10.3389/fimmu.2022.979116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 08/22/2022] [Indexed: 11/17/2022] Open
Abstract
The development and response to treatment of tumor are modulated by inflammation, and chronic inflammation promotes tumor progression and therapy resistance. This article summarizes the dynamic evolution of inflammation from acute to chronic in the process of tumor development, and its effect on T cells from activation to the promotion of exhaustion. We review the mechanisms by which inflammatory cells and inflammatory cytokines regulate T cell exhaustion and methods for targeting chronic inflammation to improve the efficacy of immunotherapy. It is great significance to refer to the specific state of inflammation and T cells at different stages of tumor development for accurate clinical decision-making of immunotherapy and improving the efficiency of tumor immunotherapy.
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Affiliation(s)
- Liguang Fang
- College of First Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Kunjing Liu
- College of First Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Cun Liu
- College of Traditional Chinese Medicine, Weifang Medical University, Weifang, China
| | - Xiaomin Wang
- Department of Inspection, The Medical Faculty of Qingdao University, Qingdao, China
| | - Wenzhe Ma
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, Macao SAR, China
| | - Wenhua Xu
- Department of Inspection, The Medical Faculty of Qingdao University, Qingdao, China
| | - Jibiao Wu
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Changgang Sun
- College of Traditional Chinese Medicine, Weifang Medical University, Weifang, China
- Department of Oncology, Weifang Traditional Chinese Hospital, Weifang, China
- *Correspondence: Changgang Sun,
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12
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Huang M, Lin Y, Wang C, Deng L, Chen M, Assaraf YG, Chen ZS, Ye W, Zhang D. New insights into antiangiogenic therapy resistance in cancer: Mechanisms and therapeutic aspects. Drug Resist Updat 2022; 64:100849. [PMID: 35842983 DOI: 10.1016/j.drup.2022.100849] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Angiogenesis is a hallmark of cancer and is required for tumor growth and progression. Antiangiogenic therapy has been revolutionarily developing and was approved for the treatment of various types of cancer for nearly two decades, among which bevacizumab and sorafenib continue to be the two most frequently used antiangiogenic drugs. Although antiangiogenic therapy has brought substantial survival benefits to many cancer patients, resistance to antiangiogenic drugs frequently occurs during clinical treatment, leading to poor outcomes and treatment failure. Cumulative evidence has demonstrated that the intricate interplay among tumor cells, bone marrow-derived cells, and local stromal cells critically allows for tumor escape from antiangiogenic therapy. Currently, drug resistance has become the main challenge that hinders the therapeutic efficacies of antiangiogenic therapy. In this review, we describe and summarize the cellular and molecular mechanisms conferring tumor drug resistance to antiangiogenic therapy, which was predominantly associated with redundancy in angiogenic signaling molecules (e.g., VEGFs, GM-CSF, G-CSF, and IL17), alterations in biological processes of tumor cells (e.g., tumor invasiveness and metastasis, stemness, autophagy, metabolic reprogramming, vessel co-option, and vasculogenic mimicry), increased recruitment of bone marrow-derived cells (e.g., myeloid-derived suppressive cells, tumor-associated macrophages, and tumor-associated neutrophils), and changes in the biological functions and features of local stromal cells (e.g., pericytes, cancer-associated fibroblasts, and endothelial cells). We also review potential biomarkers to predict the response to antiangiogenic therapy in cancer patients, which mainly consist of imaging biomarkers, cellular and extracellular proteins, a certain type of bone marrow-derived cells, local stromal cell content (e.g., pericyte coverage) as well as serum or plasma biomarkers (e.g., non-coding RNAs). Finally, we highlight the recent advances in combination strategies with the aim of enhancing the response to antiangiogenic therapy in cancer patients and mouse models. This review introduces a comprehensive understanding of the mechanisms and biomarkers associated with the evasion of antiangiogenic therapy in cancer, providing an outlook for developing more effective approaches to promote the therapeutic efficacy of antiangiogenic therapy.
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Affiliation(s)
- Maohua Huang
- Guangdong Province Key Laboratory of Pharmacodynamic Constituents of Traditional Chinese Medicine and New Drugs Research, College of Pharmacy, Jinan University, Guangzhou, 510632, China; Integrated Chinese and Western Medicine Postdoctoral Research Station, Jinan University, Guangzhou, 510632, China
| | - Yuning Lin
- Guangdong Province Key Laboratory of Pharmacodynamic Constituents of Traditional Chinese Medicine and New Drugs Research, College of Pharmacy, Jinan University, Guangzhou, 510632, China
| | - Chenran Wang
- Guangdong Province Key Laboratory of Pharmacodynamic Constituents of Traditional Chinese Medicine and New Drugs Research, College of Pharmacy, Jinan University, Guangzhou, 510632, China
| | - Lijuan Deng
- Formula-Pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, 510632, China
| | - Minfeng Chen
- Guangdong Province Key Laboratory of Pharmacodynamic Constituents of Traditional Chinese Medicine and New Drugs Research, College of Pharmacy, Jinan University, Guangzhou, 510632, China
| | - Yehuda G Assaraf
- The Fred Wyszkowski Cancer Research Laboratory, Department of Biology, Technion-Israel Institute of Technology, Haifa, 3200003, Israel
| | - Zhe-Sheng Chen
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, Institute for Biotechnology, St. John's University, NY 11439, USA.
| | - Wencai Ye
- Guangdong Province Key Laboratory of Pharmacodynamic Constituents of Traditional Chinese Medicine and New Drugs Research, College of Pharmacy, Jinan University, Guangzhou, 510632, China.
| | - Dongmei Zhang
- Guangdong Province Key Laboratory of Pharmacodynamic Constituents of Traditional Chinese Medicine and New Drugs Research, College of Pharmacy, Jinan University, Guangzhou, 510632, China.
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13
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Mouchemore KA, Anderson RL. Immunomodulatory effects of G-CSF in cancer: Therapeutic implications. Semin Immunol 2021; 54:101512. [PMID: 34763974 DOI: 10.1016/j.smim.2021.101512] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 10/23/2021] [Indexed: 01/04/2023]
Abstract
Numerous preclinical studies have reported a pro-tumour role for granulocyte colony-stimulating factor (G-CSF) that is predominantly mediated by neutrophils and MDSCs, the major G-CSF receptor expressing populations. In the presence of G-CSF (either tumour-derived or exogenous) these myeloid populations commonly exhibit a T cell suppressive phenotype. However, the direct effects of this cytokine on other immune lineages, such as T and NK cells, are not as well established. Herein we discuss the most recent data relating to the effect of G-CSF on the major immune populations, exclusively in the context of cancer. Recent publications have drawn attention to the other tumour-promoting effects of G-CSF on myeloid cells, including NETosis, promotion of cancer stemness and skewed differentiation of bone marrow progenitors towards myelopoiesis. Although G-CSF is safely and commonly used as a supportive therapy to prevent or treat chemotherapy-associated neutropenia in cancer patients, we also discuss the potential impacts of G-CSF on other anti-cancer treatments. Importantly, considerations for immune checkpoint blockade are highlighted, as many publications report a T cell suppressive effect of G-CSF that may diminish the effectiveness of this immunotherapy.
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Affiliation(s)
- Kellie A Mouchemore
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC 3084, Australia; School of Cancer Medicine, La Trobe University, Bundoora, VIC 3086, Australia
| | - Robin L Anderson
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC 3084, Australia; School of Cancer Medicine, La Trobe University, Bundoora, VIC 3086, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC, Australia.
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14
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Zhou X, Zhao J, Zhang JV, Wu Y, Wang L, Chen X, Ji D, Zhou GG. Enhancing Therapeutic Efficacy of Oncolytic Herpes Simplex Virus with MEK Inhibitor Trametinib in Some BRAF or KRAS-Mutated Colorectal or Lung Carcinoma Models. Viruses 2021; 13:v13091758. [PMID: 34578339 PMCID: PMC8473197 DOI: 10.3390/v13091758] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/03/2021] [Accepted: 08/31/2021] [Indexed: 12/22/2022] Open
Abstract
Oncolytic virus (OV) as a promising therapeutic agent can selectively infect and kill tumor cells with naturally inherited or engineered properties. Considering the limitations of OVs monotherapy, combination therapy has been widely explored. MEK inhibitor (MEKi) Trametinib is an FDA-approved kinase inhibitor indicated for the treatment of tumors with BRAF V600E or V600K mutations. In this study, the oncolytic activity in vitro and anti-tumor therapeutic efficacy in vivo when combined with oHSV and MEKi Trametinib were investigated. We found: (1) Treatment with MEKi Trametinib augmented oHSV oncolytic activity in BRAF V600E-mutated tumor cells. (2) Combination treatment with oHSV and MEKi Trametinib enhanced virus replication mediated by down-regulation of STAT1 and PKR expression or phosphorylation in BRAF V600E-mutated tumor cells as well as BRAF wt/KRAS-mutated tumor cells. (3) A remarkably synergistic therapeutic efficacy was shown in vivo for BRAF wt/KRAS-mutated tumor models, when a combination of oHSV including PD-1 blockade and MEK inhibition. Collectively, these data provide some new insights for clinical development of combination therapy with oncolytic virus, MEK inhibition, and checkpoint blockade for BRAF or KRAS-mutated tumors.
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Affiliation(s)
- XuSha Zhou
- Shenzhen International Institute for Biomedical Research, Shenzhen 518110, China; (X.Z.); (J.Z.); (X.C.)
| | - Jing Zhao
- Shenzhen International Institute for Biomedical Research, Shenzhen 518110, China; (X.Z.); (J.Z.); (X.C.)
| | - Jian V. Zhang
- Center for Energy Metabolism and Reproduction, Institute of Biomedicine and Biotechnology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- Correspondence: (J.V.Z.); (G.G.Z.)
| | - Yinglin Wu
- Department of Immunology, School of Basic Medical Sciences, Guangzhou Medical University, Guangzhou 511436, China; (Y.W.); (L.W.)
| | - Lei Wang
- Department of Immunology, School of Basic Medical Sciences, Guangzhou Medical University, Guangzhou 511436, China; (Y.W.); (L.W.)
| | - Xiaoqing Chen
- Shenzhen International Institute for Biomedical Research, Shenzhen 518110, China; (X.Z.); (J.Z.); (X.C.)
| | - Dongmei Ji
- Department of Medical Oncology, Shanghai Cancer Center and Shanghai Medical College, Fudan University, Shanghai 200032, China;
| | - Grace Guoying Zhou
- Shenzhen International Institute for Biomedical Research, Shenzhen 518110, China; (X.Z.); (J.Z.); (X.C.)
- Correspondence: (J.V.Z.); (G.G.Z.)
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15
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Neutrophil in the Pancreatic Tumor Microenvironment. Biomolecules 2021; 11:biom11081170. [PMID: 34439836 PMCID: PMC8394314 DOI: 10.3390/biom11081170] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 07/30/2021] [Accepted: 08/05/2021] [Indexed: 12/20/2022] Open
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is a malignancy with a poor prognosis and low survival rates. PDAC is characterized by a fibroinflammatory tumor microenvironment enriched by abundant fibroblasts and a variety of immune cells, contributing to its aggressiveness. Neutrophils are essential infiltrating immune cells in the PDAC microenvironment. Recent studies have identified several cellular mechanisms by which neutrophils are recruited to tumor lesion and promote tumorigenesis. This review summarizes the current understanding of the interplay between neutrophils, tumor cells, and other components in the PDAC tumor microenvironment. The prognosis and therapeutic implications of neutrophils in PDAC are also discussed.
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16
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Karagiannidis I, Salataj E, Said Abu Egal E, Beswick EJ. G-CSF in tumors: Aggressiveness, tumor microenvironment and immune cell regulation. Cytokine 2021; 142:155479. [PMID: 33677228 DOI: 10.1016/j.cyto.2021.155479] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 12/14/2022]
Abstract
Granulocyte colony-stimulating factor (G-CSF) is a cytokine most well-known for maturation and mobilization of bone marrow neutrophils. Although it is used therapeutically to treat chemotherapy induced neutropenia, it is also highly expressed in some tumors. Case reports suggest that tumors expressing high levels of G-CSF are aggressive, more difficult to treat, and present with poor prognosis and high mortality rates. Research on this topic suggests that G-CSF has tumor-promoting effects on both tumor cells and the tumor microenvironment. G-CSF has a direct effect on tumor cells to promote tumor stem cell longevity and overall tumor cell proliferation and migration. Additionally, it may promote pro-tumorigenic immune cell phenotypes such as M2 macrophages, myeloid-derived suppressor cells, and regulatory T cells. Overall, the literature suggests a plethora of pro-tumorigenic activity that should be balanced with the therapeutic use. In this review, we present an overview of the multiple complex roles of G-CSF and G-CSFR in tumors and their microenvironment and discuss how clinical advances and strategies may open new therapeutic avenues.
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Affiliation(s)
- Ioannis Karagiannidis
- Division of Gastroenterology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, United States
| | - Eralda Salataj
- Institute of Molecular Biology and Biotechnology-Foundation for Research and Technology Hellas, Heraklion, Crete, Greece
| | - Erika Said Abu Egal
- Division of Gastroenterology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, United States
| | - Ellen J Beswick
- Division of Gastroenterology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, United States.
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17
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Granulocyte Colony Stimulating Factor Expression in Breast Cancer and Its Association with Carbonic Anhydrase IX and Immune Checkpoints. Cancers (Basel) 2021; 13:cancers13051022. [PMID: 33804486 PMCID: PMC7957699 DOI: 10.3390/cancers13051022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/10/2021] [Accepted: 02/23/2021] [Indexed: 01/15/2023] Open
Abstract
Simple Summary Preclinical studies suggest that interactions between granulocyte colony-stimulating factor (G-CSF) and hypoxia-induced carbonic anhydrase IX regulate the trafficking and function of immune cells in the tumour microenvironment. We investigated the clinical significance of this crosstalk by analyzing the protein expression of G-CSF and macrophage markers by immunohistochemistry on a well-characterized tissue microarray series of invasive breast cancers. We report that high expression of G-CSF on breast carcinoma cells is linked with significantly improved survival in an important group of breast cancers that do not respond to hormonal therapy. These tumours were infiltrated by immune cells expressing biomarkers that can be targeted with immune checkpoint inhibitor drugs. In contrast, carbonic anhydrase IX expression was associated with unfavourable outcomes. Abstract Purpose: Granulocyte colony-stimulating factor (G-CSF) and hypoxia modulate the tumour immune microenvironment. In model systems, hypoxia-induced carbonic anhydrase IX (CAIX) has been associated with G-CSF and immune responses, including M2 polarization of macrophages. We investigated whether these associations exist in human breast cancer specimens, their relation to breast cancer subtypes, and clinical outcome. Methods: Using validated protocols and prespecified scoring methodology, G-CSF expression on carcinoma cells and CD163 expression on tumour-associated macrophages were assayed by immunohistochemistry and applied to a tissue microarray series of 2960 primary excision specimens linked to clinicopathologic, biomarker, and outcome data. Results: G-CSFhigh expression showed a significant positive association with ER negativity, HER2 positivity, presence of CD163+ M2 macrophages, and CAIX expression. In univariate analysis, G-CSFhigh phenotype was associated with improved survival in non-luminal cases, although the CAIX+ subset had a significantly adverse prognosis. A significant positive association was observed between immune checkpoint biomarkers on tumour-infiltrating lymphocytes and both G-CSF- and CAIX-expressing carcinoma cells. Immune checkpoint biomarkers correlated significantly with favourable prognosis in G-CSFhigh/non-luminal cases independent of standard clinicopathological features. Conclusions: The prognostic associations linking G-CSF to immune biomarkers and CAIX strongly support their immunomodulatory roles in the tumour microenvironment.
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Gebremeskel S, Nelson A, Walker B, Oliphant T, Lobert L, Mahoney D, Johnston B. Natural killer T cell immunotherapy combined with oncolytic vesicular stomatitis virus or reovirus treatments differentially increases survival in mouse models of ovarian and breast cancer metastasis. J Immunother Cancer 2021; 9:e002096. [PMID: 33722907 PMCID: PMC7970295 DOI: 10.1136/jitc-2020-002096] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Oncolytic viruses reduce tumor burden in animal models and have generated promising results in clinical trials. However, it is likely that oncolytic viruses will be more effective when used in combination with other therapies. Current therapeutic approaches, including chemotherapeutics, come with dose-limiting toxicities. Another option is to combine oncolytic viruses with immunotherapeutic approaches. METHODS Using experimental models of metastatic 4T1 breast cancer and ID8 ovarian peritoneal carcinomatosis, we examined natural killer T (NKT) cell-based immunotherapy in combination with recombinant oncolytic vesicular stomatitis virus (VSV) or reovirus. 4T1 mammary carcinoma cells or ID8 ovarian cancer cells were injected into syngeneic mice. Tumor-bearing mice were treated with VSV or reovirus followed by activation of NKT cells via the intravenous administration of autologous dendritic cells loaded with the glycolipid antigen α-galactosylceramide. The effects of VSV and reovirus on immunogenic cell death (ICD), cell viability and immunogenicity were tested in vitro. RESULTS VSV or reovirus treatments followed by NKT cell activation mediated greater survival in the ID8 model than individual therapies. The regimen was less effective when the treatment order was reversed, delivering virus treatments after NKT cell activation. In the 4T1 model, VSV combined with NKT cell activation increased overall survival and decreased metastatic burden better than individual treatments. In contrast, reovirus was not effective on its own or in combination with NKT cell activation. In vitro, VSV killed a panel of tumor lines better than reovirus. VSV infection also elicited greater increases in mRNA transcripts for proinflammatory cytokines, chemokines, and antigen presentation machinery compared with reovirus. Oncolytic VSV also induced the key hallmarks of ICD (calreticulin mobilization, plus release of ATP and HMGB1), while reovirus only mobilized calreticulin. CONCLUSION Taken together, these results demonstrate that oncolytic VSV and NKT cell immunotherapy can be effectively combined to decrease tumor burden in models of metastatic breast and ovarian cancers. Oncolytic VSV and reovirus induced differential responses in our models which may relate to differences in virus activity or tumor susceptibility.
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Affiliation(s)
- Simon Gebremeskel
- Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Adam Nelson
- Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Brynn Walker
- Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Tora Oliphant
- Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Lynnea Lobert
- Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Douglas Mahoney
- Department of Microbiology, Immunology & Infectious Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Brent Johnston
- Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia, Canada
- Beatrice Hunter Cancer Research Institute, Halifax, Nova Scotia, Canada
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19
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Yuen VWH, Wong CCL. Hypoxia-inducible factors and innate immunity in liver cancer. J Clin Invest 2021; 130:5052-5062. [PMID: 32750043 DOI: 10.1172/jci137553] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The liver has strong innate immunity to counteract pathogens from the gastrointestinal tract. During the development of liver cancer, which is typically driven by chronic inflammation, the composition and biological roles of the innate immune cells are extensively altered. Hypoxia is a common finding in all stages of liver cancer development. Hypoxia drives the stabilization of hypoxia-inducible factors (HIFs), which act as central regulators to dampen the innate immunity of liver cancer. HIF signaling in innate immune cells and liver cancer cells together favors the recruitment and maintenance of pro-tumorigenic immune cells and the inhibition of anti-tumorigenic immune cells, promoting immune evasion. HIFs represent attractive therapeutic targets to inhibit the formation of an immunosuppressive microenvironment and growth of liver cancer.
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Affiliation(s)
| | - Carmen Chak-Lui Wong
- Department of Pathology and.,State Key Laboratory of Liver Research, University of Hong Kong, Hong Kong, China
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20
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Abstract
Ras proteins mediate extracellular and cytoplasmic signaling networks via receptor tyrosine kinase. The Ras pathway induces activation of signaling molecules involved in cell proliferation and growth, cell survival and apoptosis, metabolism, and motility. Although Ras mutations in breast cancer are not frequently reported, hyperactivation of Ras signaling plays an important role in breast cancer growth and progression. Oncogenic Ras activation occurs via loss of Ras GTPase-activating proteins, overexpression of growth factor receptor, and stimulation by various cytokines. Effective control of oncogenic Ras is one of the therapeutic strategies in breast cancer. The mechanisms of intracellular localization, activation, and signaling pathway of Ras in cancer have been used to develop therapeutic candidates. Recent studies have reported an effective therapy for breast cancer by inhibition of enzymes involved in the posttranslational modification of Ras, such as farnesyltransferase and geranylgeranyltransferase 1, and anti-cancer therapies targeting the epidermal growth factor receptor (EGFR). Emerging targets involved in EGF-mediated Ras activity in breast cancer have shed new insight into Ras activation in breast cancer progression. These alternative mechanisms for Ras signaling pathway may suggest novel therapeutic approaches for targeting Ras in breast cancer. In spite of the difficulties in targeting Ras protein, important discoveries highlight the direct inhibition of Ras activity. Further studies may elucidate the effects of targeting Ras protein and the clinical relevance thereof.
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21
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Kalafati L, Mitroulis I, Verginis P, Chavakis T, Kourtzelis I. Neutrophils as Orchestrators in Tumor Development and Metastasis Formation. Front Oncol 2020; 10:581457. [PMID: 33363012 PMCID: PMC7758500 DOI: 10.3389/fonc.2020.581457] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 11/10/2020] [Indexed: 12/16/2022] Open
Abstract
Several lines of clinical and experimental evidence suggest that immune cell plasticity is a central player in tumorigenesis, tumor progression, and metastasis formation. Neutrophils are able to promote or inhibit tumor growth. Through their interaction with tumor cells or their crosstalk with other immune cell subsets in the tumor microenvironment, they modulate tumor cell survival. Here, we summarize current knowledge with regards to the mechanisms that underlie neutrophil–mediated effects on tumor establishment and metastasis development. We also discuss the tumor-mediated effects on granulopoiesis and neutrophil precursors in the bone marrow and the involvement of neutrophils in anti-tumor therapeutic modalities.
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Affiliation(s)
- Lydia Kalafati
- Institute for Clinical Chemistry and Laboratory Medicine, University Hospital and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.,National Center for Tumor Diseases, Partner Site Dresden and German Cancer Research Center, Heidelberg, Germany
| | - Ioannis Mitroulis
- National Center for Tumor Diseases, Partner Site Dresden and German Cancer Research Center, Heidelberg, Germany.,Department of Hematology and Laboratory of Molecular Hematology, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Panayotis Verginis
- University of Crete, School of Medicine, Heraklion, Greece.,Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology-Hellas, Heraklion, Crete, Greece
| | - Triantafyllos Chavakis
- Institute for Clinical Chemistry and Laboratory Medicine, University Hospital and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Ioannis Kourtzelis
- York Biomedical Research Institute, Hull York Medical School, University of York, York, United Kingdom
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22
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Jaillon S, Ponzetta A, Di Mitri D, Santoni A, Bonecchi R, Mantovani A. Neutrophil diversity and plasticity in tumour progression and therapy. Nat Rev Cancer 2020; 20:485-503. [PMID: 32694624 DOI: 10.1038/s41568-020-0281-y] [Citation(s) in RCA: 528] [Impact Index Per Article: 132.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/04/2020] [Indexed: 12/11/2022]
Abstract
Neutrophils play a key role in defence against infection and in the activation and regulation of innate and adaptive immunity. In cancer, tumour-associated neutrophils (TANs) have emerged as an important component of the tumour microenvironment. Here, they can exert dual functions. TANs can be part of tumour-promoting inflammation by driving angiogenesis, extracellular matrix remodelling, metastasis and immunosuppression. Conversely, neutrophils can also mediate antitumour responses by direct killing of tumour cells and by participating in cellular networks that mediate antitumour resistance. Neutrophil diversity and plasticity underlie the dual potential of TANs in the tumour microenvironment. Myeloid checkpoints as well as the tumour and tissue contexture shape neutrophil function in response to conventional therapies and immunotherapy. We surmise that neutrophils can provide tools to tailor current immunotherapy strategies and pave the way to myeloid cell-centred therapeutic strategies, which would be complementary to current approaches.
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Affiliation(s)
- Sebastien Jaillon
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy.
- Humanitas Clinical and Research Center IRCCS, Rozzano (MI), Italy.
| | - Andrea Ponzetta
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Humanitas Clinical and Research Center IRCCS, Rozzano (MI), Italy
| | - Diletta Di Mitri
- Humanitas Clinical and Research Center IRCCS, Rozzano (MI), Italy
| | - Angela Santoni
- Dipartimento di Medicina Molecolare Istituto Pasteur-Fondazione Cenci Bolognetti, Università di Roma 'La Sapienza', Rome, Italy
- IRCCS Neuromed, Pozzilli (IS), Italy
| | - Raffaella Bonecchi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Humanitas Clinical and Research Center IRCCS, Rozzano (MI), Italy
| | - Alberto Mantovani
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy.
- Humanitas Clinical and Research Center IRCCS, Rozzano (MI), Italy.
- The William Harvey Research Institute, Queen Mary University of London, London, UK.
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23
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Wang Z, Xu Q, Zhang N, Du X, Xu G, Yan X. CD146, from a melanoma cell adhesion molecule to a signaling receptor. Signal Transduct Target Ther 2020; 5:148. [PMID: 32782280 PMCID: PMC7421905 DOI: 10.1038/s41392-020-00259-8] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 06/14/2020] [Accepted: 06/18/2020] [Indexed: 12/11/2022] Open
Abstract
CD146 was originally identified as a melanoma cell adhesion molecule (MCAM) and highly expressed in many tumors and endothelial cells. However, the evidence that CD146 acts as an adhesion molecule to mediate a homophilic adhesion through the direct interactions between CD146 and itself is still lacking. Recent evidence revealed that CD146 is not merely an adhesion molecule, but also a cellular surface receptor of miscellaneous ligands, including some growth factors and extracellular matrixes. Through the bidirectional interactions with its ligands, CD146 is actively involved in numerous physiological and pathological processes of cells. Overexpression of CD146 can be observed in most of malignancies and is implicated in nearly every step of the development and progression of cancers, especially vascular and lymphatic metastasis. Thus, immunotherapy against CD146 would provide a promising strategy to inhibit metastasis, which accounts for the majority of cancer-associated deaths. Therefore, to deepen the understanding of CD146, we review the reports describing the newly identified ligands of CD146 and discuss the implications of these findings in establishing novel strategies for cancer therapy.
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Affiliation(s)
- Zhaoqing Wang
- Key Laboratory of Protein and Peptide Pharmaceuticals, Institute of Biophysics, Chinese Academy of Sciences, 100101, Beijing, China.
| | - Qingji Xu
- Key Laboratory of Protein and Peptide Pharmaceuticals, Institute of Biophysics, Chinese Academy of Sciences, 100101, Beijing, China
- College of Life Science, University of Chinese Academy of Sciences, 100049, Beijing, China
| | - Nengwei Zhang
- Department of Gastrointestinal Hepatobiliary Tumor Surgery, Beijing Shijitan Hospital, Capital Medical University, 100038, Beijing, China
| | - Xuemei Du
- Departments of Pathology, Beijing Shijitan Hospital, Capital Medical University, 100038, Beijing, China
| | - Guangzhong Xu
- Department of Gastrointestinal Hepatobiliary Tumor Surgery, Beijing Shijitan Hospital, Capital Medical University, 100038, Beijing, China
| | - Xiyun Yan
- Key Laboratory of Protein and Peptide Pharmaceuticals, Institute of Biophysics, Chinese Academy of Sciences, 100101, Beijing, China.
- College of Life Science, University of Chinese Academy of Sciences, 100049, Beijing, China.
- Nanozyme Medical Center, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, 450001, China.
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24
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Si Y, Merz SF, Jansen P, Wang B, Bruderek K, Altenhoff P, Mattheis S, Lang S, Gunzer M, Klode J, Squire A, Brandau S. Multidimensional imaging provides evidence for down-regulation of T cell effector function by MDSC in human cancer tissue. Sci Immunol 2020; 4:4/40/eaaw9159. [PMID: 31628161 DOI: 10.1126/sciimmunol.aaw9159] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 09/19/2019] [Indexed: 12/29/2022]
Abstract
A high intratumoral frequency of neutrophils is associated with poor clinical outcome in most cancer entities. It is hypothesized that immunosuppressive MDSC (myeloid-derived suppressor cell) activity of neutrophils against tumor-reactive T cells contributes to this effect. However, direct evidence for such activity in situ is lacking. Here, we used whole-mount labeling and clearing, three-dimensional (3D) light sheet microscopy and digital image reconstruction supplemented by 2D multiparameter immunofluorescence, for in situ analyses of potential MDSC-T cell interactions in primary human head and neck cancer tissue. We could identify intratumoral hotspots of high polymorphonuclear (PMN)-MDSC and T cell colocalization. In these areas, the expression of effector molecules Granzyme B and Ki67 in T cells was strongly reduced, in particular for T cells that were in close proximity or physically engaged with PMN-MDSC, which expressed LOX-1 and arginase I. Patients with cancer with evidence for strong down-regulation of T cell function by PMN-MDSC had significantly impaired survival. In summary, our approach identifies areas of clinically relevant functional interaction between MDSC and T cells in human cancer tissue and may help to inform patient selection in future combination immunotherapies.
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Affiliation(s)
- Yu Si
- Department of Otorhinolaryngology, University of Duisburg-Essen, University Hospital Essen, Essen, Germany.,Department of Otolaryngology, Head and Neck Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Simon F Merz
- Institute for Experimental Immunology and Imaging, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.,Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Philipp Jansen
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Baoxiao Wang
- Department of Otorhinolaryngology, University of Duisburg-Essen, University Hospital Essen, Essen, Germany.,Department of Otolaryngology, Head and Neck Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Kirsten Bruderek
- Department of Otorhinolaryngology, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Petra Altenhoff
- Department of Otorhinolaryngology, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Stefan Mattheis
- Department of Otorhinolaryngology, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Stephan Lang
- Department of Otorhinolaryngology, University of Duisburg-Essen, University Hospital Essen, Essen, Germany.,German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Matthias Gunzer
- Institute for Experimental Immunology and Imaging, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Joachim Klode
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Anthony Squire
- Institute for Experimental Immunology and Imaging, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Sven Brandau
- Department of Otorhinolaryngology, University of Duisburg-Essen, University Hospital Essen, Essen, Germany. .,German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
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25
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Zhang X, Yan L, Yuan X, Bai T, Zhang L, Han S. Rapid exacerbation featuring acute leukemoid reaction after retrolaparoscopic nephrectomy: a rare case report of renal cell carcinoma with postoperative comprehensive genomic profiling. World J Surg Oncol 2020; 18:155. [PMID: 32631368 PMCID: PMC7339471 DOI: 10.1186/s12957-020-01926-4] [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: 11/06/2019] [Accepted: 06/18/2020] [Indexed: 11/24/2022] Open
Abstract
Background Rapid lethal exacerbation and recurrence featuring acute leukemoid reaction (ALR) after retrolaparoscopic radical nephrectomy (RN) is a relatively rare clinical incident. Performing the reoperation for the patient and analyzing the tissue-based genetic mutation information postoperatively are a skill-demanding and meaningful task, which have been even more rarely reported. Case presentation We present a case with a large right renal mass (13.0 × 10.0 × 8.0 cm). This 71-year-old male patient underwent the retrolaparoscopic RN in our department. The operation was technically precise and successful with final pathological diagnosis of hybrid (clear cell and papillary type) renal cell carcinoma (RCC). However, 10 days after the patient was discharged, he was readmitted with the chief complaint of high fever with severe right flank pain. CT scanning revealed that right retroperitoneal hematoma and the blood routine showed the dramatic elevation of white blood cell count (WBC). Even though the immediate broad-spectrum antibiotics were administered without delay and subsequent percutaneous puncturing and drainage was performed, the patient’s condition still exacerbated rapidly. In spite of the reoperation of hematoma evacuation, the patient died of multiple organ failure 10 days after the reoperation. The pathological result of reoperation showed the necrotic and hematoma tissue blended with RCC tumor cells (nuclear grading III), and both of the postoperative tissue-originated comprehensive genomic profiling by using the specimens from the RN and reoperation respectively indicated significant mutations of some oncogenes which might have potential relevance with ALR. Besides, both of the immunohistochemical (IHC) staining results from primary surgical renal mass and reoperative resected tissue revealed the positive expressions of granulocyte colony-stimulating factor (G-CSF). Conclusions ALR may be a predictor of poor prognosis in patients with RCC, and comprehensive genomic profiling as well as the alterative expression of G-CSF can help to provide potential valuable genetic etiological information and evidence for guiding the potential effective molecular-targeting therapy.
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Affiliation(s)
- Xuhui Zhang
- Department of Urology, First Hospital of Shanxi Medical University, No. 85, Jiefangnan Road, Taiyuan, 030001, Shanxi, China.
| | - Lijuan Yan
- Shanxi Cancer Institute, Shanxi Cancer Hospital, Taiyuan, 030000, Shanxi, China
| | - Xiaobin Yuan
- Department of Urology, First Hospital of Shanxi Medical University, No. 85, Jiefangnan Road, Taiyuan, 030001, Shanxi, China
| | - Tao Bai
- Department of Pathology, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Lei Zhang
- Department of Urology, First Hospital of Shanxi Medical University, No. 85, Jiefangnan Road, Taiyuan, 030001, Shanxi, China
| | - Shuaihong Han
- Department of Urology, First Hospital of Shanxi Medical University, No. 85, Jiefangnan Road, Taiyuan, 030001, Shanxi, China
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26
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Zhang H, Guo L, Chen J. Rationale for Lung Adenocarcinoma Prevention and Drug Development Based on Molecular Biology During Carcinogenesis. Onco Targets Ther 2020; 13:3085-3091. [PMID: 32341654 PMCID: PMC7166063 DOI: 10.2147/ott.s248436] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 03/14/2020] [Indexed: 12/18/2022] Open
Abstract
Lung adenocarcinoma (LUAD) is the most common and aggressive subtype of lung cancer with the greatest heterogeneity and aggression. Inspite of recent years’ achievements in understanding the pathogenesis of this disease, as well as the development of new therapeutic approaches, our knowledge on crucial early molecular events during its development is still rudimentary. Recent classification and grading of LUAD has postulated that LUAD does not arise spontaneously, but through a stepwise process from lung adenomatous premalignancy atypical adenomatous hyperplasia to adenocarcinoma in situ, minimally invasive adenocarcinoma, and eventually frankly invasive predominant adenocarcinoma. In this review, we discuss the molecular processes that drive the evolutionary process that results in the formation of LUAD. We also describe how to handle lung premalignancy in clinical settings based on the most recent advances in genomic biology and our own understanding of lung cancer prevention.
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Affiliation(s)
- Hongming Zhang
- Department of Respiratory Medicine, Yancheng Third People's Hospital, Affiliated Yancheng Hospital of Southeast University Medical College, Yancheng, Jiangsu Province, People's Republic of China
| | - Liting Guo
- Department of Oncology, Ruijin Hospital,affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Jibei Chen
- Department of Respiratory Medicine, Yancheng Third People's Hospital, Affiliated Yancheng Hospital of Southeast University Medical College, Yancheng, Jiangsu Province, People's Republic of China
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27
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The complexity of neutrophils in health and disease: Focus on cancer. Semin Immunol 2020; 48:101409. [PMID: 32958359 PMCID: PMC7500440 DOI: 10.1016/j.smim.2020.101409] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/21/2020] [Accepted: 09/04/2020] [Indexed: 12/14/2022]
Abstract
Neutrophils are essential soldiers of the immune response and their role have long been restricted to their activities in defence against microbial infections and during the acute phase of the inflammatory response. However, increasing number of investigations showed that neutrophils are endowed with plasticity and can participate in the orchestration of both innate and adaptive immune responses. Neutrophils have an impact on a broad range of disorders, including infections, chronic inflammations, and cancer. Neutrophils are present in the tumour microenvironment and have been reported to mediate both pro-tumour and anti-tumour responses. Neutrophils can contribute to genetic instability, tumour cell proliferation, angiogenesis and suppression of the anti-tumour immune response. In contrast, neutrophils are reported to mediate anti-tumour resistance by direct killing of tumour cells or by engaging cooperative interactions with other immune cells. Here we discuss the current understandings of neutrophils biology and functions in health and diseases, with a specific focus on their role in cancer biology and their prognostic significance in human cancer.
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28
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Jeong J, Suh Y, Jung K. Context Drives Diversification of Monocytes and Neutrophils in Orchestrating the Tumor Microenvironment. Front Immunol 2019; 10:1817. [PMID: 31474975 PMCID: PMC6706790 DOI: 10.3389/fimmu.2019.01817] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 07/18/2019] [Indexed: 12/24/2022] Open
Abstract
Recent preclinical/clinical studies have underscored the significant impact of tumor microenvironment (TME) on tumor progression in diverse scenarios. Highly heterogeneous and complex, the tumor microenvironment is composed of malignant cancer cells and non-malignant cells including endothelial cells, fibroblasts, and diverse immune cells. Since immune compartments play pivotal roles in regulating tumor progression via various mechanisms, understanding of their multifaceted functions is crucial to developing effective cancer therapies. While roles of lymphoid cells in tumors have been systematically studied for a long time, the complex functions of myeloid cells have been relatively underexplored. However, constant findings on tumor-associated myeloid cells are drawing attention, highlighting the primary effects of innate immune cells such as monocytes and neutrophils in disease progression. This review focuses on hitherto identified contextual developments and functions of monocytes and neutrophils with a special interest in solid tumors. Moreover, ongoing clinical applications are discussed at the end of the review.
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Affiliation(s)
- Juhee Jeong
- Lab of Cancer Immunology and In Vivo Imaging, Department of Biomedical Sciences, BK21 Plus Biomedical Science Project, Seoul National University College of Medicine, Seoul, South Korea
| | - Yoorock Suh
- Lab of Cancer Immunology and In Vivo Imaging, Department of Biomedical Sciences, BK21 Plus Biomedical Science Project, Seoul National University College of Medicine, Seoul, South Korea
| | - Keehoon Jung
- Lab of Cancer Immunology and In Vivo Imaging, Department of Biomedical Sciences, BK21 Plus Biomedical Science Project, Seoul National University College of Medicine, Seoul, South Korea
- Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul, South Korea
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, South Korea
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29
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Mollinedo F, Gajate C. Novel therapeutic approaches for pancreatic cancer by combined targeting of RAF→MEK→ERK signaling and autophagy survival response. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:S153. [PMID: 31576360 PMCID: PMC6685885 DOI: 10.21037/atm.2019.06.40] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Faustino Mollinedo
- Department of Molecular Biomedicine, Laboratory of Cell Death and Cancer Therapy, Centro de Investigaciones Biológicas, Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
| | - Consuelo Gajate
- Department of Molecular Biomedicine, Laboratory of Cell Death and Cancer Therapy, Centro de Investigaciones Biológicas, Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
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30
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High baseline neutrophil-to-lymphocyte ratio predicts worse outcome in patients with metastatic BRAF-positive melanoma treated with BRAF and MEK inhibitors. Melanoma Res 2019; 28:435-441. [PMID: 29782381 DOI: 10.1097/cmr.0000000000000461] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Neutrophil-to-lymphocyte ratio (NLR) has been shown to be prognostic in several solid malignancies. There are limited data regarding its value during novel therapies in patients with melanoma. The aim of the study was to assess the practical utility of this ratio in patients with BRAF-mutant melanoma treated with a combination of BRAF and MEK inhibitors (BRAFi/MEKi). We included 215 patients with inoperable or metastatic melanoma who underwent BRAFi/MEKi treatment between October 2015 and June 2017. Baseline NLR and other complete blood count-derived inflammatory markers were tested for association with overall survival and progression-free survival in univariate and multivariate models. On-treatment NLR was also assessed for relationship with these outcomes using the time-dependent Cox's proportional hazard model. Prognostic model based on NLR and lactate dehydrogenase (LDH) levels was also developed. Patients with NLR values more than four had poorer progression-free survival (P<0.001, 1-year rates 51.6 vs. 26.7%) and overall survival (P<0.001, 1-year rates 77.3 vs. 53.1%). In a multivariate model adjusted for LDH levels, metastatic sites and age baseline NLR ratio and delay in starting MEKi were deemed statistically significant (hazard ratio: 1.81; 95% confidence interval: 1.16-2.85; P=0.009 and hazard ratio: 2.06; 95% confidence interval: 1.24-3.44, P=0.005 respectively). In a model based on NLR and LDH, 1-year survival rates were 57, 40 and 23%, respectively if zero, one or both factors were elevated. Our results demonstrate the usefulness of NLR and a predictive model based on combinations of NLR and LDH as a prognostic markers during BRAFi/MEKi treatment. Our real-world data confirm the efficacy of BRAFi/MEKi therapy showed in the clinical trials.
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31
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Long JE, Wongchenko MJ, Nickles D, Chung WJ, Wang BE, Riegler J, Li J, Li Q, Sandoval W, Eastham-Anderson J, Modrusan Z, Junttila T, Carano RAD, Foreman O, Yan Y, Junttila MR. Therapeutic resistance and susceptibility is shaped by cooperative multi-compartment tumor adaptation. Cell Death Differ 2019; 26:2416-2429. [PMID: 30824837 PMCID: PMC6889278 DOI: 10.1038/s41418-019-0310-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 01/30/2019] [Indexed: 02/07/2023] Open
Abstract
Emerging research suggests that multiple tumor compartments can influence treatment responsiveness and relapse, yet the search for therapeutic resistance mechanisms remains largely focused on acquired genomic alterations in cancer cells. Here we show how treatment-induced changes occur in multiple tumor compartments during tumor relapse and can reduce benefit of follow-on therapies. By using serial biopsies, next-generation sequencing, and single-cell transcriptomics, we tracked the evolution of multiple cellular compartments within individual lesions during first-line treatment response, relapse, and second-line therapeutic interventions in an autochthonous model of melanoma. We discovered that although treatment-relapsed tumors remained genetically stable, they converged on a shared resistance phenotype characterized by dramatic changes in tumor cell differentiation state, immune infiltration, and extracellular matrix (ECM) composition. Similar alterations in tumor cell differentiation were also observed in more than half of our treatment-relapsed patient tumors. Tumor cell-state changes were coincident with ECM remodeling and increased tumor stiffness, which alone was sufficient to alter tumor cell fate and reduce treatment responses in melanoma cell lines in vitro. Despite the absence of acquired mutations in the targeted pathway, resistant tumors showed significantly decreased responsiveness to second-line therapy intervention within the same pathway. The ability to preclinically model relapse and refractory settings—while capturing dynamics within and crosstalk between all relevant tumor compartments—provides a unique opportunity to better design and sequence appropriate clinical interventions.
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Affiliation(s)
- Jason E Long
- Department of Translational Oncology, Genentech, Inc., 1 DNA Way, South San Francisco, CA, 94080, USA
| | - Matthew J Wongchenko
- Department of Oncology Biomarker Development, Genentech, Inc., 1 DNA Way, South San Francisco, CA, 94080, USA
| | - Dorothee Nickles
- Department of Bioinformatics and Computational Biology, Genentech, Inc., 1 DNA Way, South San Francisco, CA, 94080, USA
| | - Wei-Jen Chung
- Department of Bioinformatics and Computational Biology, Genentech, Inc., 1 DNA Way, South San Francisco, CA, 94080, USA.,23andMe, 899 W Evelyn Ave, Mountain View, CA, 94041, USA
| | - Bu-Er Wang
- Department of Translational Oncology, Genentech, Inc., 1 DNA Way, South San Francisco, CA, 94080, USA
| | - Johannes Riegler
- Department of Biomedical Imaging, Genentech, Inc., 1 DNA Way, South San Francisco, CA, 94080, USA
| | - Ji Li
- Department of Translational Oncology, Genentech, Inc., 1 DNA Way, South San Francisco, CA, 94080, USA
| | - Qingling Li
- Department of Microchemistry, Proteomics, & Lipidomics, Genentech, Inc., 1 DNA Way, South San Francisco, CA, 94080, USA
| | - Wendy Sandoval
- Department of Microchemistry, Proteomics, & Lipidomics, Genentech, Inc., 1 DNA Way, South San Francisco, CA, 94080, USA
| | - Jeff Eastham-Anderson
- Department of Pathology, Genentech, Inc., 1 DNA Way, South San Francisco, CA, 94080, USA
| | - Zora Modrusan
- Department of Molecular Biology, Genentech, Inc., 1 DNA Way, South San Francisco, CA, 94080, USA
| | - Teemu Junttila
- Department of Translational Oncology, Genentech, Inc., 1 DNA Way, South San Francisco, CA, 94080, USA
| | - Richard A D Carano
- Department of Biomedical Imaging, Genentech, Inc., 1 DNA Way, South San Francisco, CA, 94080, USA
| | - Oded Foreman
- Department of Pathology, Genentech, Inc., 1 DNA Way, South San Francisco, CA, 94080, USA
| | - Yibing Yan
- Department of Oncology Biomarker Development, Genentech, Inc., 1 DNA Way, South San Francisco, CA, 94080, USA
| | - Melissa R Junttila
- Department of Translational Oncology, Genentech, Inc., 1 DNA Way, South San Francisco, CA, 94080, USA.
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32
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Choi D, Spinelli C, Montermini L, Rak J. Oncogenic Regulation of Extracellular Vesicle Proteome and Heterogeneity. Proteomics 2019; 19:e1800169. [PMID: 30561828 DOI: 10.1002/pmic.201800169] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Revised: 09/05/2018] [Indexed: 12/12/2022]
Abstract
Mutational and epigenetic driver events profoundly alter intercellular communication pathways in cancer. This effect includes deregulated release, molecular composition, and biological activity of extracellular vesicles (EVs), membranous cellular fragments ranging from a few microns to less than 100 nm in diameter and filled with bioactive molecular cargo (proteins, lipids, and nucleic acids). While EVs are usually classified on the basis of their physical properties and biogenetic mechanisms, recent analyses of their proteome suggest a larger than expected molecular diversity, a notion that is also supported by multicolour nano-flow cytometry and other emerging technology platforms designed to analyze single EVs. Both protein composition and EV diversity are markedly altered by oncogenic transformation, epithelial to mesenchymal transition, and differentiation of cancer stem cells. Interestingly, only a subset of EVs released from mutant cells may carry oncogenic proteins (e.g., EGFRvIII), hence, these EVs are often referred to as "oncosomes". Indeed, oncogenic transformation alters the repertoire of EV-associated proteins, increases the presence of pro-invasive cargo, and alters the composition of distinct EV populations. Molecular profiling of single EVs may reveal a more intricate effect of transforming events on the architecture of EV populations in cancer and shed new light on their biological role and diagnostic utility.
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Affiliation(s)
- Dongsic Choi
- Research Institute, Health Centre, Glen Site, McGill University, Montreal, Quebec, H4A 3J1, Canada
| | - Cristiana Spinelli
- Research Institute, Health Centre, Glen Site, McGill University, Montreal, Quebec, H4A 3J1, Canada
| | - Laura Montermini
- Research Institute, Health Centre, Glen Site, McGill University, Montreal, Quebec, H4A 3J1, Canada
| | - Janusz Rak
- Research Institute, Health Centre, Glen Site, McGill University, Montreal, Quebec, H4A 3J1, Canada
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33
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Abstract
Thrombosis is a major cause of morbidity and mortality in cancer patients. The pathogenesis of blood coagulation activation in oncological patients is complex and involves both clinical and biological factors. Abnormalities in one or more coagulation test are common in cancer patients, even without thrombotic manifestations, indicating an ongoing hypercoagulable condition. Moreover, venous thromboembolism (VTE) can be the first symptom of an occult malignancy in an otherwise healthy individual. The levels of laboratory markers of activation of blood coagulation parallel the development of malignancy, being the coagulant mechanisms important for both thrombogenesis and tumor progression. Besides general clinical risk factors for VTE, also disease-specific clinical factors, i.e., type and stage of the tumor, and anticancer therapies increase the thrombotic risk in these patients. Furthermore, biological factors, including the cancer cell-specific prothrombotic properties together with the host cell inflammatory response to the tumor, are relevant as well as unique players in the pathogenesis of the cancer-associated hypercoagulability. Cancer cells produce and release procoagulant and fibrinolytic proteins, inflammatory cytokines, and procoagulant microparticles. They also express adhesion molecules binding to the receptors of host vascular cells (i.e., endothelial cells, platelets, and leukocytes), thereby stimulating the prothrombotic properties of these normal cells, including the shed of cell-specific microparticles and neutrophil extracellular traps. Of interest, several genes responsible for the cellular neoplastic transformation drive the programs of hemostatic properties expressed by cancer tissues. A better understanding of such mechanisms will help the development of novel strategies to prevent and treat the Trousseau's syndrome (i.e., cancer-associated thrombosis).
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Affiliation(s)
- Anna Falanga
- Department of Transfusion Medicine and Hematology, Hospital Papa Giovanni XXIII, Bergamo, Italy.
- University of Milan Bicocca, School of Medicine and Surgery, Monza, Italy.
| | - Francesca Schieppati
- Department of Transfusion Medicine and Hematology, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Laura Russo
- Department of Transfusion Medicine and Hematology, Hospital Papa Giovanni XXIII, Bergamo, Italy
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34
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Chua DW, Koh YX, Liew YX, Chan CY, Lee SY, Cheow PC, Chow PK, Chung AY, Ooi LL, Goh BK. Pre-operative predictors of early recurrence/mortality including the role of inflammatory indices in patients undergoing partial hepatectomy for spontaneously ruptured hepatocellular carcinoma. J Surg Oncol 2018; 118:1227-1236. [PMID: 30399204 DOI: 10.1002/jso.25281] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 10/09/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND OBJECTIVES Spontaneous rupture of Hepatocellular Carcinoma (srHCC) is a life-threatening emergency. We sought to identify the pre-operative predictors of early tumor recurrence/mortality including the role of inflammatory indices after partial hepatectomy for srHCC. METHODS Between 2000-2015, 79 patients with srHCC were identified to have undergone upfront partial hepatectomy following srHCC. Clinicopathologic data were retrospectively analyzed to identify pre-operative predictors of early (<1 year) recurrence and mortality. RESULTS Seventy-nine patients were identified to have undergone partial hepatectomy for srHCC. The 1-year mortality and 1-year recurrence rate in our series was 30.3% and 41.8% respectively. On multivariate analyses, free tumor rupture and a tumor size > 10 cm were identified to be independent predictors of early recurrence while an alpha fetoprotein (AFP) > 200 ng/mL was an independent predictor of early mortality. Neutrophil-to-lymphocyte ratio > 3 and prognostic nutritional index < 40 were predictors of early recurrence while PLR > 180 was a predictor of early mortality on univariate analyses but not multivariate analyses. CONCLUSIONS Tumor size > 10 cm, free tumor rupture, and an AFP > 200 ng/mL were useful predictors in avoiding "futile surgery" in patients with srHCC undergoing a partial hepatectomy. Preoperative inflammatory markers appear to be less useful as predictors of early recurrence/mortality in this cohort of patients.
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Affiliation(s)
- Darren W Chua
- Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore
| | - Ye Xin Koh
- Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore
| | - Yi Xin Liew
- Department of Pharmacy, Singapore General Hospital, Singapore
| | - Chung-Yip Chan
- Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore.,Duke-National University of Singapore (NUS) Medical School, Singapore
| | - Ser-Yee Lee
- Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore.,Duke-National University of Singapore (NUS) Medical School, Singapore
| | - Peng-Chung Cheow
- Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore.,Duke-National University of Singapore (NUS) Medical School, Singapore
| | - Pierce K Chow
- Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore.,Duke-National University of Singapore (NUS) Medical School, Singapore
| | - Alexander Y Chung
- Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore.,Duke-National University of Singapore (NUS) Medical School, Singapore
| | - London L Ooi
- Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore.,Duke-National University of Singapore (NUS) Medical School, Singapore
| | - Brian Kp Goh
- Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore.,Duke-National University of Singapore (NUS) Medical School, Singapore
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35
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Negri L, Ferrara N. The Prokineticins: Neuromodulators and Mediators of Inflammation and Myeloid Cell-Dependent Angiogenesis. Physiol Rev 2018. [PMID: 29537336 DOI: 10.1152/physrev.00012.2017] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
The mammalian prokineticins family comprises two conserved proteins, EG-VEGF/PROK1 and Bv8/PROK2, and their two highly related G protein-coupled receptors, PKR1 and PKR2. This signaling system has been linked to several important biological functions, including gastrointestinal tract motility, regulation of circadian rhythms, neurogenesis, angiogenesis and cancer progression, hematopoiesis, and nociception. Mutations in PKR2 or Bv8/PROK2 have been associated with Kallmann syndrome, a developmental disorder characterized by defective olfactory bulb neurogenesis, impaired development of gonadotropin-releasing hormone neurons, and infertility. Also, Bv8/PROK2 is strongly upregulated in neutrophils and other inflammatory cells in response to granulocyte-colony stimulating factor or other myeloid growth factors and functions as a pronociceptive mediator in inflamed tissues as well as a regulator of myeloid cell-dependent tumor angiogenesis. Bv8/PROK2 has been also implicated in neuropathic pain. Anti-Bv8/PROK2 antibodies or small molecule PKR inhibitors ameliorate pain arising from tissue injury and inhibit angiogenesis and inflammation associated with tumors or some autoimmune disorders.
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Affiliation(s)
- Lucia Negri
- Sapienza University of Rome, Rome, Italy ; and University of California, San Diego, La Jolla, California
| | - Napoleone Ferrara
- Sapienza University of Rome, Rome, Italy ; and University of California, San Diego, La Jolla, California
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36
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Biffi G, Oni TE, Spielman B, Hao Y, Elyada E, Park Y, Preall J, Tuveson DA. IL1-Induced JAK/STAT Signaling Is Antagonized by TGFβ to Shape CAF Heterogeneity in Pancreatic Ductal Adenocarcinoma. Cancer Discov 2018; 9:282-301. [PMID: 30366930 DOI: 10.1158/2159-8290.cd-18-0710] [Citation(s) in RCA: 747] [Impact Index Per Article: 124.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 09/20/2018] [Accepted: 10/19/2018] [Indexed: 12/16/2022]
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is poorly responsive to therapies and histologically contains a paucity of neoplastic cells embedded within a dense desmoplastic stroma. Within the stroma, cancer-associated fibroblasts (CAF) secrete tropic factors and extracellular matrix components, and have been implicated in PDAC progression and chemotherapy resistance. We recently identified two distinct CAF subtypes characterized by either myofibroblastic or inflammatory phenotypes; however, the mechanisms underlying their diversity and their roles in PDAC remain unknown. Here, we use organoid and mouse models to identify TGFβ and IL1 as tumor-secreted ligands that promote CAF heterogeneity. We show that IL1 induces LIF expression and downstream JAK/STAT activation to generate inflammatory CAFs and demonstrate that TGFβ antagonizes this process by downregulating IL1R1 expression and promoting differentiation into myofibroblasts. Our results provide a mechanism through which distinct fibroblast niches are established in the PDAC microenvironment and illuminate strategies to selectively target CAFs that support tumor growth. SIGNIFICANCE: Understanding the mechanisms that determine CAF heterogeneity in PDAC is a prerequisite for the rational development of approaches that selectively target tumor-promoting CAFs. Here, we identify an IL1-induced signaling cascade that leads to JAK/STAT activation and promotes an inflammatory CAF state, suggesting multiple strategies to target these cells in vivo. See related commentary by Ling and Chiao, p. 173. This article is highlighted in the In This Issue feature, p. 151.
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Affiliation(s)
- Giulia Biffi
- Cold Spring Harbor Laboratory, Cold Spring Harbor, New York.,Lustgarten Foundation Pancreatic Cancer Research Laboratory, Cold Spring Harbor, New York
| | - Tobiloba E Oni
- Cold Spring Harbor Laboratory, Cold Spring Harbor, New York.,Lustgarten Foundation Pancreatic Cancer Research Laboratory, Cold Spring Harbor, New York
| | - Benjamin Spielman
- Cold Spring Harbor Laboratory, Cold Spring Harbor, New York.,Lustgarten Foundation Pancreatic Cancer Research Laboratory, Cold Spring Harbor, New York
| | - Yuan Hao
- Cold Spring Harbor Laboratory, Cold Spring Harbor, New York
| | - Ela Elyada
- Cold Spring Harbor Laboratory, Cold Spring Harbor, New York.,Lustgarten Foundation Pancreatic Cancer Research Laboratory, Cold Spring Harbor, New York
| | - Youngkyu Park
- Cold Spring Harbor Laboratory, Cold Spring Harbor, New York.,Lustgarten Foundation Pancreatic Cancer Research Laboratory, Cold Spring Harbor, New York
| | | | - David A Tuveson
- Cold Spring Harbor Laboratory, Cold Spring Harbor, New York. .,Lustgarten Foundation Pancreatic Cancer Research Laboratory, Cold Spring Harbor, New York
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37
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Ribatti D, Tamma R. Hematopoietic growth factors and tumor angiogenesis. Cancer Lett 2018; 440-441:47-53. [PMID: 30312730 DOI: 10.1016/j.canlet.2018.10.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 09/26/2018] [Accepted: 10/08/2018] [Indexed: 01/13/2023]
Abstract
Angiogenesis is regulated by numerous "classic" factors such as vascular endothelial growth factor (VEGF) and many other endogenous "non-classic"peptides, including erythropoietin (Epo), and granulocyte-/granulocyte macrophage colony stimulating factor (G-/GM-CSF). The latter play an important regulatory role in angiogenesis, especially under pathological conditions and constitute a crosslink between angiogenesis and hematopoiesis. This article reviews studies on the ability of hematopoietic cytokines to affect several endothelial cell functions in tumor angiogenesis. These findings in all these studies support the hypothesis formulated at the beginning of this century that a common ancestral cell, the hemangioblast, gives rise to cells of both the endothelial and the hematopoietic lineages.
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Affiliation(s)
- Domenico Ribatti
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari Medical School, Bari, Italy.
| | - Roberto Tamma
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari Medical School, Bari, Italy.
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Wang J, Liu L, Bai Q, Ou C, Xiong Y, Qu Y, Wang Z, Xia Y, Guo J, Xu J. Tumor-infiltrating neutrophils predict therapeutic benefit of tyrosine kinase inhibitors in metastatic renal cell carcinoma. Oncoimmunology 2018; 8:e1515611. [PMID: 30546957 DOI: 10.1080/2162402x.2018.1515611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 08/17/2018] [Accepted: 08/21/2018] [Indexed: 01/15/2023] Open
Abstract
Tumor-infiltrating neutrophils (TINs) show diverse predictive effects in the context of different cancer types and therapeutic regimens. In this study we investigated their relevance with therapeutic effect of tyrosine kinase inhibitors (TKIs) in metastatic renal cell carcinoma (mRCC). Two independent datasets including 271 mRCC patients treated by TKIs or IL-2/IFN-α based immunotherapy were retrospective included, and TINs were detected by immunohistochemistry. The presence of TINs was observed in 50 (45.0%) samples of the TKI cohort and in 73 (45.6%) samples of the immunotherapy cohort. TINs were associated with shorter overall survival (HR, 1.776; 95%CI, 1.191-2.650; p = 0.004) in the TKI cohort, but not in the immunotherapy cohort (HR, 1.074; 95%CI, 0.767-1.505; p = 0.672). Multivariate Cox analysis confirmed the independent prognostic value of TINs for TKI-treated patients (HR, 2.078, 95%CI, 1.352-3.195; p = 0.001), apart from other parameters. Moreover, survival benefit of TKI therapy was superior to IL-2/IFN-α immunotherapy only among TINs-absent patients (HR, 1.561; 95%CI, 0.927-2.629; p = 0.094). Data mining in the TCGA cohort of renal cell carcinoma revealed the predominant immunosuppressive function of TINs in renal cell carcinoma. The negative correlation between TINs and intratumoral CD8+ T cells was further confirmed in the TKI cohort (p = 0.019), the immunotherapy cohort (p = 0.001) and the TCGA cohort (p < 0.001). In conclusion, the presence of TINs was an independent, unfavorable prognostic factor in TKI-treated mRCC patients. TINs could also predict therapeutic benefit of TKIs over IL-2/IFN-α immunotherapy. These findings should be further confirmed within datasets of clinical trials or prospective observational studies.
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Affiliation(s)
- Jiajun Wang
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Li Liu
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Qi Bai
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Chenzhang Ou
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Ying Xiong
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yang Qu
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Zewei Wang
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Yu Xia
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jianming Guo
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jiejie Xu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, China
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Miller KD, O’Neill A, Gradishar W, Hobday TJ, Goldstein LJ, Mayer IA, Bloom S, Brufsky AM, Tevaarwerk AJ, Sparano JA, Le-Lindqwister NA, Hendricks CB, Northfelt DW, Dang CT, Sledge GW. Double-Blind Phase III Trial of Adjuvant Chemotherapy With and Without Bevacizumab in Patients With Lymph Node-Positive and High-Risk Lymph Node-Negative Breast Cancer (E5103). J Clin Oncol 2018; 36:2621-2629. [PMID: 30040523 PMCID: PMC6118403 DOI: 10.1200/jco.2018.79.2028] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Purpose Bevacizumab improves progression-free survival but not overall survival in patients with metastatic breast cancer. E5103 tested the effect of bevacizumab in the adjuvant setting in patients with human epidermal growth factor receptor 2-negative disease. Patients and Methods Patients were assigned 1:2:2 to receive placebo with doxorubicin and cyclophosphamide (AC) followed by weekly paclitaxel (arm A), bevacizumab only during AC and paclitaxel (arm B), or bevacizumab during AC and paclitaxel followed by bevacizumab monotherapy for 10 cycles (arm C). Random assignment was stratified and bevacizumab dose adjusted for choice of AC schedule. Radiation and hormonal therapy were administered concurrently with bevacizumab in arm C. The primary end point was invasive disease-free survival (IDFS). Results Four thousand nine hundred ninety-four patients were enrolled. Median age was 52 years; 64% of patients were estrogen receptor positive, 27% were lymph node negative, and 78% received dose-dense AC. Chemotherapy-associated adverse events including myelosuppression and neuropathy were similar across all arms. Grade ≥ 3 hypertension was more common in bevacizumab-treated patients, but thrombosis, proteinuria, and hemorrhage were not. The cumulative incidence of clinical congestive heart failure at 15 months was 1.0%, 1.9%, and 3.0% in arms A, B, and C, respectively. Bevacizumab exposure was less than anticipated, with approximately 24% of patients in arm B and approximately 55% of patients in arm C discontinuing bevacizumab before completing planned therapy. Five-year IDFS was 77% (95% CI, 71% to 81%) in arm A, 76% (95% CI, 72% to 80%) in arm B, and 80% (95% CI, 77% to 83%) in arm C. Conclusion Incorporation of bevacizumab into sequential anthracycline- and taxane-containing adjuvant therapy does not improve IDFS or overall survival in patients with high-risk human epidermal growth factor receptor 2-negative breast cancer. Longer duration bevacizumab therapy is unlikely to be feasible given the high rate of early discontinuation.
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Affiliation(s)
- Kathy D. Miller
- Kathy D. Miller, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Anne O’Neill, Dana-Farber Cancer Institute, Boston, MA; William Gradishar, Northwestern University, Chicago; Nguyet Anh Le-Lindqwister, Heartland Cancer Research National Cancer Institute Community Oncology Research Program, Peoria, IL; Timothy J. Hobday, Mayo Clinic, Rochester; Stuart Bloom, Abbott Northwestern Hospital, Minneapolis, MN; Lori J. Goldstein, Fox Chase Cancer Center, Philadelphia; Adam M. Brufsky, University of Pittsburgh, Pittsburgh, PA; Ingrid A. Mayer, Vanderbilt University, Nashville, TN; Amye J. Tevaarwerk, University of Wisconsin, Madison, WI; Joseph A. Sparano, Montefiore Hospital and Medical Center, Bronx; Chau T. Dang, Memorial Sloan Kettering Cancer Center, New York, NY; Carolyn B. Hendricks, Association Community Clinical Oncology Program, Bethesda, MD; Donald W. Northfelt, Mayo Clinic, Scottsdale, AZ; and George W. Sledge JR, Stanford University, Stanford, CA
| | - Anne O’Neill
- Kathy D. Miller, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Anne O’Neill, Dana-Farber Cancer Institute, Boston, MA; William Gradishar, Northwestern University, Chicago; Nguyet Anh Le-Lindqwister, Heartland Cancer Research National Cancer Institute Community Oncology Research Program, Peoria, IL; Timothy J. Hobday, Mayo Clinic, Rochester; Stuart Bloom, Abbott Northwestern Hospital, Minneapolis, MN; Lori J. Goldstein, Fox Chase Cancer Center, Philadelphia; Adam M. Brufsky, University of Pittsburgh, Pittsburgh, PA; Ingrid A. Mayer, Vanderbilt University, Nashville, TN; Amye J. Tevaarwerk, University of Wisconsin, Madison, WI; Joseph A. Sparano, Montefiore Hospital and Medical Center, Bronx; Chau T. Dang, Memorial Sloan Kettering Cancer Center, New York, NY; Carolyn B. Hendricks, Association Community Clinical Oncology Program, Bethesda, MD; Donald W. Northfelt, Mayo Clinic, Scottsdale, AZ; and George W. Sledge JR, Stanford University, Stanford, CA
| | - William Gradishar
- Kathy D. Miller, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Anne O’Neill, Dana-Farber Cancer Institute, Boston, MA; William Gradishar, Northwestern University, Chicago; Nguyet Anh Le-Lindqwister, Heartland Cancer Research National Cancer Institute Community Oncology Research Program, Peoria, IL; Timothy J. Hobday, Mayo Clinic, Rochester; Stuart Bloom, Abbott Northwestern Hospital, Minneapolis, MN; Lori J. Goldstein, Fox Chase Cancer Center, Philadelphia; Adam M. Brufsky, University of Pittsburgh, Pittsburgh, PA; Ingrid A. Mayer, Vanderbilt University, Nashville, TN; Amye J. Tevaarwerk, University of Wisconsin, Madison, WI; Joseph A. Sparano, Montefiore Hospital and Medical Center, Bronx; Chau T. Dang, Memorial Sloan Kettering Cancer Center, New York, NY; Carolyn B. Hendricks, Association Community Clinical Oncology Program, Bethesda, MD; Donald W. Northfelt, Mayo Clinic, Scottsdale, AZ; and George W. Sledge JR, Stanford University, Stanford, CA
| | - Timothy J. Hobday
- Kathy D. Miller, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Anne O’Neill, Dana-Farber Cancer Institute, Boston, MA; William Gradishar, Northwestern University, Chicago; Nguyet Anh Le-Lindqwister, Heartland Cancer Research National Cancer Institute Community Oncology Research Program, Peoria, IL; Timothy J. Hobday, Mayo Clinic, Rochester; Stuart Bloom, Abbott Northwestern Hospital, Minneapolis, MN; Lori J. Goldstein, Fox Chase Cancer Center, Philadelphia; Adam M. Brufsky, University of Pittsburgh, Pittsburgh, PA; Ingrid A. Mayer, Vanderbilt University, Nashville, TN; Amye J. Tevaarwerk, University of Wisconsin, Madison, WI; Joseph A. Sparano, Montefiore Hospital and Medical Center, Bronx; Chau T. Dang, Memorial Sloan Kettering Cancer Center, New York, NY; Carolyn B. Hendricks, Association Community Clinical Oncology Program, Bethesda, MD; Donald W. Northfelt, Mayo Clinic, Scottsdale, AZ; and George W. Sledge JR, Stanford University, Stanford, CA
| | - Lori J. Goldstein
- Kathy D. Miller, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Anne O’Neill, Dana-Farber Cancer Institute, Boston, MA; William Gradishar, Northwestern University, Chicago; Nguyet Anh Le-Lindqwister, Heartland Cancer Research National Cancer Institute Community Oncology Research Program, Peoria, IL; Timothy J. Hobday, Mayo Clinic, Rochester; Stuart Bloom, Abbott Northwestern Hospital, Minneapolis, MN; Lori J. Goldstein, Fox Chase Cancer Center, Philadelphia; Adam M. Brufsky, University of Pittsburgh, Pittsburgh, PA; Ingrid A. Mayer, Vanderbilt University, Nashville, TN; Amye J. Tevaarwerk, University of Wisconsin, Madison, WI; Joseph A. Sparano, Montefiore Hospital and Medical Center, Bronx; Chau T. Dang, Memorial Sloan Kettering Cancer Center, New York, NY; Carolyn B. Hendricks, Association Community Clinical Oncology Program, Bethesda, MD; Donald W. Northfelt, Mayo Clinic, Scottsdale, AZ; and George W. Sledge JR, Stanford University, Stanford, CA
| | - Ingrid A. Mayer
- Kathy D. Miller, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Anne O’Neill, Dana-Farber Cancer Institute, Boston, MA; William Gradishar, Northwestern University, Chicago; Nguyet Anh Le-Lindqwister, Heartland Cancer Research National Cancer Institute Community Oncology Research Program, Peoria, IL; Timothy J. Hobday, Mayo Clinic, Rochester; Stuart Bloom, Abbott Northwestern Hospital, Minneapolis, MN; Lori J. Goldstein, Fox Chase Cancer Center, Philadelphia; Adam M. Brufsky, University of Pittsburgh, Pittsburgh, PA; Ingrid A. Mayer, Vanderbilt University, Nashville, TN; Amye J. Tevaarwerk, University of Wisconsin, Madison, WI; Joseph A. Sparano, Montefiore Hospital and Medical Center, Bronx; Chau T. Dang, Memorial Sloan Kettering Cancer Center, New York, NY; Carolyn B. Hendricks, Association Community Clinical Oncology Program, Bethesda, MD; Donald W. Northfelt, Mayo Clinic, Scottsdale, AZ; and George W. Sledge JR, Stanford University, Stanford, CA
| | - Stuart Bloom
- Kathy D. Miller, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Anne O’Neill, Dana-Farber Cancer Institute, Boston, MA; William Gradishar, Northwestern University, Chicago; Nguyet Anh Le-Lindqwister, Heartland Cancer Research National Cancer Institute Community Oncology Research Program, Peoria, IL; Timothy J. Hobday, Mayo Clinic, Rochester; Stuart Bloom, Abbott Northwestern Hospital, Minneapolis, MN; Lori J. Goldstein, Fox Chase Cancer Center, Philadelphia; Adam M. Brufsky, University of Pittsburgh, Pittsburgh, PA; Ingrid A. Mayer, Vanderbilt University, Nashville, TN; Amye J. Tevaarwerk, University of Wisconsin, Madison, WI; Joseph A. Sparano, Montefiore Hospital and Medical Center, Bronx; Chau T. Dang, Memorial Sloan Kettering Cancer Center, New York, NY; Carolyn B. Hendricks, Association Community Clinical Oncology Program, Bethesda, MD; Donald W. Northfelt, Mayo Clinic, Scottsdale, AZ; and George W. Sledge JR, Stanford University, Stanford, CA
| | - Adam M. Brufsky
- Kathy D. Miller, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Anne O’Neill, Dana-Farber Cancer Institute, Boston, MA; William Gradishar, Northwestern University, Chicago; Nguyet Anh Le-Lindqwister, Heartland Cancer Research National Cancer Institute Community Oncology Research Program, Peoria, IL; Timothy J. Hobday, Mayo Clinic, Rochester; Stuart Bloom, Abbott Northwestern Hospital, Minneapolis, MN; Lori J. Goldstein, Fox Chase Cancer Center, Philadelphia; Adam M. Brufsky, University of Pittsburgh, Pittsburgh, PA; Ingrid A. Mayer, Vanderbilt University, Nashville, TN; Amye J. Tevaarwerk, University of Wisconsin, Madison, WI; Joseph A. Sparano, Montefiore Hospital and Medical Center, Bronx; Chau T. Dang, Memorial Sloan Kettering Cancer Center, New York, NY; Carolyn B. Hendricks, Association Community Clinical Oncology Program, Bethesda, MD; Donald W. Northfelt, Mayo Clinic, Scottsdale, AZ; and George W. Sledge JR, Stanford University, Stanford, CA
| | - Amye J. Tevaarwerk
- Kathy D. Miller, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Anne O’Neill, Dana-Farber Cancer Institute, Boston, MA; William Gradishar, Northwestern University, Chicago; Nguyet Anh Le-Lindqwister, Heartland Cancer Research National Cancer Institute Community Oncology Research Program, Peoria, IL; Timothy J. Hobday, Mayo Clinic, Rochester; Stuart Bloom, Abbott Northwestern Hospital, Minneapolis, MN; Lori J. Goldstein, Fox Chase Cancer Center, Philadelphia; Adam M. Brufsky, University of Pittsburgh, Pittsburgh, PA; Ingrid A. Mayer, Vanderbilt University, Nashville, TN; Amye J. Tevaarwerk, University of Wisconsin, Madison, WI; Joseph A. Sparano, Montefiore Hospital and Medical Center, Bronx; Chau T. Dang, Memorial Sloan Kettering Cancer Center, New York, NY; Carolyn B. Hendricks, Association Community Clinical Oncology Program, Bethesda, MD; Donald W. Northfelt, Mayo Clinic, Scottsdale, AZ; and George W. Sledge JR, Stanford University, Stanford, CA
| | - Joseph A. Sparano
- Kathy D. Miller, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Anne O’Neill, Dana-Farber Cancer Institute, Boston, MA; William Gradishar, Northwestern University, Chicago; Nguyet Anh Le-Lindqwister, Heartland Cancer Research National Cancer Institute Community Oncology Research Program, Peoria, IL; Timothy J. Hobday, Mayo Clinic, Rochester; Stuart Bloom, Abbott Northwestern Hospital, Minneapolis, MN; Lori J. Goldstein, Fox Chase Cancer Center, Philadelphia; Adam M. Brufsky, University of Pittsburgh, Pittsburgh, PA; Ingrid A. Mayer, Vanderbilt University, Nashville, TN; Amye J. Tevaarwerk, University of Wisconsin, Madison, WI; Joseph A. Sparano, Montefiore Hospital and Medical Center, Bronx; Chau T. Dang, Memorial Sloan Kettering Cancer Center, New York, NY; Carolyn B. Hendricks, Association Community Clinical Oncology Program, Bethesda, MD; Donald W. Northfelt, Mayo Clinic, Scottsdale, AZ; and George W. Sledge JR, Stanford University, Stanford, CA
| | - Nguyet Anh Le-Lindqwister
- Kathy D. Miller, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Anne O’Neill, Dana-Farber Cancer Institute, Boston, MA; William Gradishar, Northwestern University, Chicago; Nguyet Anh Le-Lindqwister, Heartland Cancer Research National Cancer Institute Community Oncology Research Program, Peoria, IL; Timothy J. Hobday, Mayo Clinic, Rochester; Stuart Bloom, Abbott Northwestern Hospital, Minneapolis, MN; Lori J. Goldstein, Fox Chase Cancer Center, Philadelphia; Adam M. Brufsky, University of Pittsburgh, Pittsburgh, PA; Ingrid A. Mayer, Vanderbilt University, Nashville, TN; Amye J. Tevaarwerk, University of Wisconsin, Madison, WI; Joseph A. Sparano, Montefiore Hospital and Medical Center, Bronx; Chau T. Dang, Memorial Sloan Kettering Cancer Center, New York, NY; Carolyn B. Hendricks, Association Community Clinical Oncology Program, Bethesda, MD; Donald W. Northfelt, Mayo Clinic, Scottsdale, AZ; and George W. Sledge JR, Stanford University, Stanford, CA
| | - Carolyn B. Hendricks
- Kathy D. Miller, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Anne O’Neill, Dana-Farber Cancer Institute, Boston, MA; William Gradishar, Northwestern University, Chicago; Nguyet Anh Le-Lindqwister, Heartland Cancer Research National Cancer Institute Community Oncology Research Program, Peoria, IL; Timothy J. Hobday, Mayo Clinic, Rochester; Stuart Bloom, Abbott Northwestern Hospital, Minneapolis, MN; Lori J. Goldstein, Fox Chase Cancer Center, Philadelphia; Adam M. Brufsky, University of Pittsburgh, Pittsburgh, PA; Ingrid A. Mayer, Vanderbilt University, Nashville, TN; Amye J. Tevaarwerk, University of Wisconsin, Madison, WI; Joseph A. Sparano, Montefiore Hospital and Medical Center, Bronx; Chau T. Dang, Memorial Sloan Kettering Cancer Center, New York, NY; Carolyn B. Hendricks, Association Community Clinical Oncology Program, Bethesda, MD; Donald W. Northfelt, Mayo Clinic, Scottsdale, AZ; and George W. Sledge JR, Stanford University, Stanford, CA
| | - Donald W. Northfelt
- Kathy D. Miller, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Anne O’Neill, Dana-Farber Cancer Institute, Boston, MA; William Gradishar, Northwestern University, Chicago; Nguyet Anh Le-Lindqwister, Heartland Cancer Research National Cancer Institute Community Oncology Research Program, Peoria, IL; Timothy J. Hobday, Mayo Clinic, Rochester; Stuart Bloom, Abbott Northwestern Hospital, Minneapolis, MN; Lori J. Goldstein, Fox Chase Cancer Center, Philadelphia; Adam M. Brufsky, University of Pittsburgh, Pittsburgh, PA; Ingrid A. Mayer, Vanderbilt University, Nashville, TN; Amye J. Tevaarwerk, University of Wisconsin, Madison, WI; Joseph A. Sparano, Montefiore Hospital and Medical Center, Bronx; Chau T. Dang, Memorial Sloan Kettering Cancer Center, New York, NY; Carolyn B. Hendricks, Association Community Clinical Oncology Program, Bethesda, MD; Donald W. Northfelt, Mayo Clinic, Scottsdale, AZ; and George W. Sledge JR, Stanford University, Stanford, CA
| | - Chau T. Dang
- Kathy D. Miller, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Anne O’Neill, Dana-Farber Cancer Institute, Boston, MA; William Gradishar, Northwestern University, Chicago; Nguyet Anh Le-Lindqwister, Heartland Cancer Research National Cancer Institute Community Oncology Research Program, Peoria, IL; Timothy J. Hobday, Mayo Clinic, Rochester; Stuart Bloom, Abbott Northwestern Hospital, Minneapolis, MN; Lori J. Goldstein, Fox Chase Cancer Center, Philadelphia; Adam M. Brufsky, University of Pittsburgh, Pittsburgh, PA; Ingrid A. Mayer, Vanderbilt University, Nashville, TN; Amye J. Tevaarwerk, University of Wisconsin, Madison, WI; Joseph A. Sparano, Montefiore Hospital and Medical Center, Bronx; Chau T. Dang, Memorial Sloan Kettering Cancer Center, New York, NY; Carolyn B. Hendricks, Association Community Clinical Oncology Program, Bethesda, MD; Donald W. Northfelt, Mayo Clinic, Scottsdale, AZ; and George W. Sledge JR, Stanford University, Stanford, CA
| | - George W. Sledge
- Kathy D. Miller, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Anne O’Neill, Dana-Farber Cancer Institute, Boston, MA; William Gradishar, Northwestern University, Chicago; Nguyet Anh Le-Lindqwister, Heartland Cancer Research National Cancer Institute Community Oncology Research Program, Peoria, IL; Timothy J. Hobday, Mayo Clinic, Rochester; Stuart Bloom, Abbott Northwestern Hospital, Minneapolis, MN; Lori J. Goldstein, Fox Chase Cancer Center, Philadelphia; Adam M. Brufsky, University of Pittsburgh, Pittsburgh, PA; Ingrid A. Mayer, Vanderbilt University, Nashville, TN; Amye J. Tevaarwerk, University of Wisconsin, Madison, WI; Joseph A. Sparano, Montefiore Hospital and Medical Center, Bronx; Chau T. Dang, Memorial Sloan Kettering Cancer Center, New York, NY; Carolyn B. Hendricks, Association Community Clinical Oncology Program, Bethesda, MD; Donald W. Northfelt, Mayo Clinic, Scottsdale, AZ; and George W. Sledge JR, Stanford University, Stanford, CA
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Zhang L, Tao L, Guo L, Zhan J, Yuan C, Ma Z, Jiang B, Xiu D. G-CSF associates with neurogenesis and predicts prognosis and sensitivity to chemotherapy in pancreatic ductal adenocarcinoma. Cancer Manag Res 2018; 10:2767-2775. [PMID: 30147373 PMCID: PMC6103318 DOI: 10.2147/cmar.s165226] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background Recent studies demonstrated that granulocyte colony-stimulating factor (G-CSF), regularly used for the prevention of neutropenia, is engaged in cancer progression. However, the role of G-CSF in pancreatic ductal adenocarcinoma (PDAC) is not clear. The aim of the present study was to investigate the expression and prognostic value of G-CSF in patients with PDAC. Materials and methods The localization and expression of G-CSF in PDAC were examined by immunohistochemistry (IHC). The analysis of the levels of G-CSF in plasma was evaluated using ELISA kit. The correlation between G-CSF expression and patients’ survival was assessed by Kaplan–Meier analysis. Results In IHC specimens, G-CSF was discovered predominantly in the cell cytoplasm and expressed in most of PDAC, while in plasma, the systemic level of G-CSF is no different between normal patients and pancreatic cancer patients. In 100 PDAC cases with IHC, patients with grades 2 and 3 were defined as the high expression group (41 patients, 41%), and those with grades 0 and 1 as the low expression group (59 patients, 59%). Significant correlation was noted between high G-CSF expression and neural invasion (P = 0.042) or early recurrence (P < 0.001). G-CSF appeared to be an independent adverse prognostic factor (hazard ratio = 1.774, 95% confidence interval 1.150–2.737, P = 0.010) in addition to N stage (P = 0.002). Specifically, adjuvant chemotherapy consisting of gemcitabine prolongs survival of patients with high G-CSF expression (median survival time 14 months vs 7.5 months). Morphologically, high G-CSF expression cells demonstrate the association with neurogenesis. Conclusion High expression of G-CSF is a prognostic marker and an indicator to chemotherapy response in PDAC.
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Affiliation(s)
- Lingfu Zhang
- Department of General Surgery, Peking University Third Hospital, Beijing, People's Republic of China,
| | - Lianyuan Tao
- Department of General Surgery, Peking University Third Hospital, Beijing, People's Republic of China,
| | - Limei Guo
- Department of Pathology, Peking University Third Hospital, Beijing, People's Republic of China
| | - Jun Zhan
- Laboratory of Molecular Cell Biology and Tumor Biology, Department of Anatomy, Histology and Embryology, Peking University Health Science Center, Beijing, People's Republic of China
| | - Chunhui Yuan
- Department of General Surgery, Peking University Third Hospital, Beijing, People's Republic of China,
| | - Zhaolai Ma
- Department of General Surgery, Peking University Third Hospital, Beijing, People's Republic of China,
| | - Bin Jiang
- Department of General Surgery, Peking University Third Hospital, Beijing, People's Republic of China,
| | - Dianrong Xiu
- Department of General Surgery, Peking University Third Hospital, Beijing, People's Republic of China,
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Itatani Y, Kawada K, Yamamoto T, Sakai Y. Resistance to Anti-Angiogenic Therapy in Cancer-Alterations to Anti-VEGF Pathway. Int J Mol Sci 2018; 19:ijms19041232. [PMID: 29670046 PMCID: PMC5979390 DOI: 10.3390/ijms19041232] [Citation(s) in RCA: 200] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 04/12/2018] [Accepted: 04/15/2018] [Indexed: 02/06/2023] Open
Abstract
Anti-angiogenic therapy is one of the promising strategies for many types of solid cancers. Bevacizumab (Avastin), a recombinant humanized monoclonal antibody of vascular endothelial growth factor (VEGF) A, was approved for the first time as an anti-angiogenic drug for the treatment of metastatic colorectal cancer (CRC) by the Food and Drug Administration (FDA) in 2004. In addition, the other VEGF pathway inhibitors including small molecule tyrosine kinase inhibitors (sunitinib, sorafenib, and pazopanib), a soluble VEGF decoy receptor (aflibercept), and a humanized monoclonal antibody of VEGF receptor 2 (VEGFR2) (ramucirumab) have been approved for cancer therapy. Although many types of VEGF pathway inhibitors can improve survival in most cancer patients, some patients have little or no beneficial effect from them. The primary or acquired resistance towards many oncological drugs, including anti-VEGF inhibitors, is a common problem in cancer treatment. This review summarizes the proposed alternative mechanisms of angiogenesis other than the VEGF pathway. These mechanisms are involved in the development of resistance to anti-VEGF therapies in cancer patients.
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Affiliation(s)
- Yoshiro Itatani
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan.
| | - Kenji Kawada
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan.
| | - Takamasa Yamamoto
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan.
- Moores Cancer Center, University of California San Diego, San Diego, CA 92093, USA.
| | - Yoshiharu Sakai
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan.
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Bertaut A, Truntzer C, Madkouri R, Kaderbhai CG, Derangère V, Vincent J, Chauffert B, Aubriot-Lorton MH, Farah W, Mourier KL, Boidot R, Ghiringhelli F. Blood baseline neutrophil count predicts bevacizumab efficacy in glioblastoma. Oncotarget 2018; 7:70948-70958. [PMID: 27487142 PMCID: PMC5342600 DOI: 10.18632/oncotarget.10898] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 07/10/2016] [Indexed: 12/19/2022] Open
Abstract
Bevacizumab is used to treat glioblastoma; however, no current biomarker predicts its efficacy. We used an exploratory cohort of patients treated with the radiochemotherapy then bevacizumab or chemotherapy at recurrence (N = 265). Bevacizumab use increased median overall survival (OS) 18.7 vs 11.3 months, p = 0.0014). In multivariate analysis, age, initial surgery, neutrophil count, Karnofsky status >70% and bevacizumab administration were independent prognostic factors of survival. We found an interaction between bevacizumab use and baseline neutrophil count. The cut-off value for the neutrophil count was set at 6000/mm3. Only patients with a high neutrophil count benefited from the bevacizumab treatment (17.3 vs 8.8 months p < 0.0001). We validated this result using data from the TEMAVIR trial, which tested the efficacy of neoadjuvant bevacizumab plus irinotecan versus radiochemotherapy in the first-line treatment of glioblastoma. Transcriptomic data from TCGA underlined that CSF3 expression, the gene encoding G-CSF, the growth factor for neutrophils, correlated with VEGF-A-dependent angiogenesis. In another independent cohort (BELOB trial), which compared lomustine versus lomustine plus bevacizumab at recurrence, bevacizumab only benefited patients with high CSF3 expression in the tumor. These data suggest that only patients with a high peripheral neutrophil count before bevacizumab treatment benefited from this therapy.
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Affiliation(s)
- Aurélie Bertaut
- Biostatistics unit Georges Francois Leclerc Cancer Center, Dijon, France
| | | | | | | | - Valentin Derangère
- Platform of Transfer in Cancer Biology Genetic and histology, Georges Francois Leclerc Cancer Center, Dijon, France
| | - Julie Vincent
- Department of Medical Oncology, Georges Francois Leclerc Cancer Center, Dijon, France
| | - Bruno Chauffert
- Department of Medical Oncology, University Hospital Amiens, Amiens, France
| | | | | | | | - Romain Boidot
- Platform of Transfer in Cancer Biology Genetic and histology, Georges Francois Leclerc Cancer Center, Dijon, France.,INSERM U866, Dijon, France
| | - Francois Ghiringhelli
- Department of Medical Oncology, Georges Francois Leclerc Cancer Center, Dijon, France.,Platform of Transfer in Cancer Biology Genetic and histology, Georges Francois Leclerc Cancer Center, Dijon, France.,INSERM U866, Dijon, France.,University of Bourgogne Franche-Comté, Dijon, France
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43
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Dissecting neutrophil complexity in cancer. Emerg Top Life Sci 2017; 1:457-470. [PMID: 33525797 DOI: 10.1042/etls20170062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 11/15/2017] [Accepted: 11/15/2017] [Indexed: 01/04/2023]
Abstract
Neutrophils represent the most abundant leukocyte population in human peripheral blood, and their role had long been considered restricted to their phagocytic and antimicrobial activities during the acute phase of inflammation. However, an increasing number of recent investigations had highlighted their possible impact in tumor initiation and development, and the nature of neutrophil contribution in cancer had become a hot topic in immunology. Over the years, neutrophils have been shown to display both pro-tumor and antitumor effects, emphasizing an unexpected cellular heterogeneity in cancer. In this review, we will focus on the several 'shades' of neutrophils in tumor initiation, growth and metastasis. In addition, we will discuss the clinical significance of tumor-associated neutrophils in humans and their potential targeting in cancer therapy.
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44
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Piryani SO, Kam AYF, Kliassov EG, Chen BJ, Spector NL, Chute JP, Hsu DS, Chao NJ, Doan PL. Epidermal Growth Factor and Granulocyte Colony Stimulating Factor Signaling Are Synergistic for Hematopoietic Regeneration. Stem Cells 2017; 36:252-264. [PMID: 29086459 DOI: 10.1002/stem.2731] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Revised: 10/05/2017] [Accepted: 10/24/2017] [Indexed: 12/11/2022]
Abstract
Hematopoietic regeneration following chemotherapy may be distinct from regeneration following radiation. While we have shown that epidermal growth factor (EGF) accelerates regeneration following radiation, its role following chemotherapy is currently unknown. We sought to identify EGF as a hematopoietic growth factor for chemotherapy-induced myelosuppression. Following 5-fluorouracil (5-FU), EGF accelerated hematopoietic stem cell regeneration and prolonged survival compared with saline-treated mice. To mitigate chemotherapy-induced injury to endothelial cells in vivo, we deleted Bax in VEcadherin+ cells (VEcadherinCre;BaxFL/FL mice). Following 5-FU, VEcadherinCre;BaxFL/FL mice displayed preserved hematopoietic stem/progenitor content compared with littermate controls. 5-FU and EGF treatment resulted in increased cellular proliferation, decreased apoptosis, and increased DNA double-strand break repair by non-homologous end-joining recombination compared with saline-treated control mice. When granulocyte colony stimulating factor (G-CSF) is given with EGF, this combination was synergistic for regeneration compared with either G-CSF or EGF alone. EGF increased G-CSF receptor (G-CSFR) expression following 5-FU. Conversely, G-CSF treatment increased both EGF receptor (EGFR) and phosphorylation of EGFR in hematopoietic stem/progenitor cells. In humans, the expression of EGFR is increased in patients with colorectal cancer treated with 5-FU compared with cancer patients not on 5-FU. Similarly, EGFR signaling is responsive to G-CSF in humans in vivo with both increased EGFR and phospho-EGFR in healthy human donors following G-CSF treatment compared with donors who did not receive G-CSF. These data identify EGF as a hematopoietic growth factor following myelosuppressive chemotherapy and that dual therapy with EGF and G-CSF may be an effective method to accelerate hematopoietic regeneration. Stem Cells 2018;36:252-264.
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Affiliation(s)
- Sadhna O Piryani
- Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, North Carolina, USA
| | - Angel Y F Kam
- Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, North Carolina, USA
| | - Evelyna G Kliassov
- Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, North Carolina, USA
| | - Benny J Chen
- Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, North Carolina, USA.,Duke Cancer Institute, Duke University, Durham, North Carolina, USA
| | - Neil L Spector
- Duke Cancer Institute, Duke University, Durham, North Carolina, USA.,Division of Medical Oncology, Duke University, Durham, North Carolina, USA
| | - John P Chute
- Division of Medical Oncology, University of California, Los Angeles, Los Angeles, California, USA.,Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research, University of California, Los Angeles, Los Angeles, California, USA.,Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, California, USA
| | - David S Hsu
- Duke Cancer Institute, Duke University, Durham, North Carolina, USA.,Division of Medical Oncology, Duke University, Durham, North Carolina, USA
| | - Nelson J Chao
- Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, North Carolina, USA.,Duke Cancer Institute, Duke University, Durham, North Carolina, USA
| | - Phuong L Doan
- Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, North Carolina, USA.,Duke Cancer Institute, Duke University, Durham, North Carolina, USA
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45
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Schernberg A, Blanchard P, Chargari C, Deutsch E. Neutrophils, a candidate biomarker and target for radiation therapy? Acta Oncol 2017; 56:1522-1530. [PMID: 28835188 DOI: 10.1080/0284186x.2017.1348623] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Neutrophils are the most abundant blood-circulating white blood cells, continuously generated in the bone marrow. Growing evidence suggests they regulate the innate and adaptive immune system during tumor evolution. This review will first summarize the recent findings on neutrophils as a key player in cancer evolution, then as a potential biomarker, and finally as therapeutic targets, with respective focuses on the interplay with radiation therapy. A complex interplay: Neutrophils have been associated with tumor progression through multiple pathways. Ionizing radiation has cytotoxic effects on cancer cells, but the sensitivity to radiation therapy in vivo differ from isolated cancer cells in vitro, partially due to the tumor microenvironment. Different microenvironmental states, whether baseline or induced, can modulate or even attenuate the effects of radiation, with consequences for therapeutic efficacy. Inflammatory biomarkers: Inflammation-based scores have been widely studied as prognostic biomarkers in cancer patients. We have performed a large retrospective cohort of patients undergoing radiation therapy (1233 patients), with robust relationship between baseline blood neutrophil count and 3-year's patient's overall survival in patients with different cancer histologies. (Pearson's correlation test: p = .001, r = -.93). Therapeutic approaches: Neutrophil-targeting agents are being developed for the treatment of inflammatory and autoimmune diseases. Neutrophils either can exert antitumoral (N1 phenotype) or protumoral (N2 phenotype) activity, depending on the Tumor Micro Environment. Tumor associated N2 neutrophils are characterized by high expression of CXCR4, VEGF, and gelatinase B/MMP9. TGF-β within the tumor microenvironment induces a population of TAN with a protumor N2 phenotype. TGF-β blockade slows tumor growth through activation of CD8 + T cells, macrophages, and tumor associated neutrophils with an antitumor N1 phenotype. CONCLUSIONS This supports the need for prospective neutrophils evaluation in clinical trials, making neutrophils a predictive biomarker with potential specific therapies.
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Affiliation(s)
- Antoine Schernberg
- Radiation Oncology Department, SIRIC SOCRATES, Gustave Roussy Cancer Campus, Villejuif, France
- INSERM U1018, CESP, Université Paris-Sud, Université Paris-Saclay, Villejuif, France
| | - Pierre Blanchard
- Radiation Oncology Department, SIRIC SOCRATES, Gustave Roussy Cancer Campus, Villejuif, France
- INSERM U1018, CESP, Université Paris-Sud, Université Paris-Saclay, Villejuif, France
| | - Cyrus Chargari
- Radiation Oncology Department, SIRIC SOCRATES, Gustave Roussy Cancer Campus, Villejuif, France
- INSERM 1030, Molecular Radiotherapy, Gustave Roussy Cancer Campus, Villejuif, France
- Faculté de Médecine du Kremlin-Bicetre, Université Paris Sud, Université Paris Saclay, Le Kremlin-Bicetre, France
| | - Eric Deutsch
- Radiation Oncology Department, SIRIC SOCRATES, Gustave Roussy Cancer Campus, Villejuif, France
- INSERM 1030, Molecular Radiotherapy, Gustave Roussy Cancer Campus, Villejuif, France
- Faculté de Médecine du Kremlin-Bicetre, Université Paris Sud, Université Paris Saclay, Le Kremlin-Bicetre, France
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46
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Merchant M, Moffat J, Schaefer G, Chan J, Wang X, Orr C, Cheng J, Hunsaker T, Shao L, Wang SJ, Wagle MC, Lin E, Haverty PM, Shahidi-Latham S, Ngu H, Solon M, Eastham-Anderson J, Koeppen H, Huang SMA, Schwarz J, Belvin M, Kirouac D, Junttila MR. Combined MEK and ERK inhibition overcomes therapy-mediated pathway reactivation in RAS mutant tumors. PLoS One 2017; 12:e0185862. [PMID: 28982154 PMCID: PMC5628883 DOI: 10.1371/journal.pone.0185862] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 09/20/2017] [Indexed: 12/19/2022] Open
Abstract
Mitogen-activated protein kinase (MAPK) pathway dysregulation is implicated in >30% of all cancers, rationalizing the development of RAF, MEK and ERK inhibitors. While BRAF and MEK inhibitors improve BRAF mutant melanoma patient outcomes, these inhibitors had limited success in other MAPK dysregulated tumors, with insufficient pathway suppression and likely pathway reactivation. In this study we show that inhibition of either MEK or ERK alone only transiently inhibits the MAPK pathway due to feedback reactivation. Simultaneous targeting of both MEK and ERK nodes results in deeper and more durable suppression of MAPK signaling that is not achievable with any dose of single agent, in tumors where feedback reactivation occurs. Strikingly, combined MEK and ERK inhibition is synergistic in RAS mutant models but only additive in BRAF mutant models where the RAF complex is dissociated from RAS and thus feedback productivity is disabled. We discovered that pathway reactivation in RAS mutant models occurs at the level of CRAF with combination treatment resulting in a markedly more active pool of CRAF. However, distinct from single node targeting, combining MEK and ERK inhibitor treatment effectively blocks the downstream signaling as assessed by transcriptional signatures and phospho-p90RSK. Importantly, these data reveal that MAPK pathway inhibitors whose activity is attenuated due to feedback reactivation can be rescued with sufficient inhibition by using a combination of MEK and ERK inhibitors. The MEK and ERK combination significantly suppresses MAPK pathway output and tumor growth in vivo to a greater extent than the maximum tolerated doses of single agents, and results in improved anti-tumor activity in multiple xenografts as well as in two Kras mutant genetically engineered mouse (GEM) models. Collectively, these data demonstrate that combined MEK and ERK inhibition is functionally unique, yielding greater than additive anti-tumor effects and elucidates a highly effective combination strategy in MAPK-dependent cancer, such as KRAS mutant tumors.
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Affiliation(s)
- Mark Merchant
- Department of Translational Oncology, Genentech, Inc., South San Francisco, California, United States of America
| | - John Moffat
- Department of Biochemical and Cellular Pharmacology, Genentech, Inc., South San Francisco, California, United States of America
| | - Gabriele Schaefer
- Department of Translational Oncology, Genentech, Inc., South San Francisco, California, United States of America
| | - Jocelyn Chan
- Department of Translational Oncology, Genentech, Inc., South San Francisco, California, United States of America
| | - Xi Wang
- Department of Translational Oncology, Genentech, Inc., South San Francisco, California, United States of America
| | - Christine Orr
- Department of Translational Oncology, Genentech, Inc., South San Francisco, California, United States of America
| | - Jason Cheng
- Department of Translational Oncology, Genentech, Inc., South San Francisco, California, United States of America
| | - Thomas Hunsaker
- Department of Translational Oncology, Genentech, Inc., South San Francisco, California, United States of America
| | - Lily Shao
- Department of Translational Oncology, Genentech, Inc., South San Francisco, California, United States of America
| | - Stephanie J. Wang
- Department of Biological Engineering, The Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
| | - Marie-Claire Wagle
- Department of Oncology Biomarker Development, Genentech, Inc., South San Francisco, California, United States of America
| | - Eva Lin
- Department of Discovery Oncology, Genentech, Inc., South San Francisco, California, United States of America
| | - Peter M. Haverty
- Department of Bioinformatics, Genentech, Inc., South San Francisco, California, United States of America
| | - Sheerin Shahidi-Latham
- Department of Drug Metabolism and Pharmacokinetics, Genentech, Inc., South San Francisco, California, United States of America
| | - Hai Ngu
- Department of Pathology, Genentech, Inc., South San Francisco, California, United States of America
| | - Margaret Solon
- Department of Discovery Chemistry, Genentech, Inc., South San Francisco, California, United States of America
| | - Jeffrey Eastham-Anderson
- Department of Pathology, Genentech, Inc., South San Francisco, California, United States of America
| | - Hartmut Koeppen
- Department of Pathology, Genentech, Inc., South San Francisco, California, United States of America
| | - Shih-Min A. Huang
- Department of Oncology Biomarker Development, Genentech, Inc., South San Francisco, California, United States of America
| | - Jacob Schwarz
- Department of Discovery Chemistry, Genentech, Inc., South San Francisco, California, United States of America
| | - Marcia Belvin
- Department of Cancer Immunology, Genentech, Inc., South San Francisco, California, United States of America
| | - Daniel Kirouac
- Department of Pre-clinical & Translational Pharmacokinetics Genentech, Inc., South San Francisco, California, United States of America
| | - Melissa R. Junttila
- Department of Translational Oncology, Genentech, Inc., South San Francisco, California, United States of America
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47
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Mastri M, Rosario S, Tracz A, Frink RE, Brekken RA, Ebos JML. The Challenges of Modeling Drug Resistance to Antiangiogenic Therapy. Curr Drug Targets 2017; 17:1747-1754. [PMID: 26648063 DOI: 10.2174/1389450117666151209123544] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Revised: 11/11/2015] [Accepted: 11/11/2015] [Indexed: 02/08/2023]
Abstract
Drug resistance remains an ongoing challenge for the majority of patients treated with inhibitors of the vascular endothelial growth factor (VEGF) pathway, a key regulator of tumor angiogenesis. Preclinical models have played a significant role in identifying multiple complex mechanisms of antiangiogenic treatment failure. Yet questions remain about the optimal methodology to study resistance that may assist in making clinically relevant choices about alternative or combination treatment strategies. The origins of antiangiogenic treatment failure may stem from the tumor vasculature, the tumor itself, or both together, and preclinical methods that define resistance are diverse and rarely compared. We performed a literature search of the preclinical methodologies used to examine resistance to VEGF pathway inhibitors and identified 109 papers from more than 400 that use treatment failure as the starting point for mechanistic study. We found that definitions of resistance are broad and inconsistent, involve only a small number of reagents, and derive mostly from in vitro and in vivo methodologies that often do not represent clinically relevant disease stages or progression. Together, this literature analysis highlights the challenges of studying inhibitors of the tumor microenvironment in the preclinical setting and the need for improved methodology to assist in qualifying (and quantifying) treatment failure to identify mechanisms that will help predict alternative strategies in patients.
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Affiliation(s)
| | | | | | | | | | - John M L Ebos
- Department of Cancer Genetics and Medicine, Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY 142631, USA
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48
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Abstract
Tumours display considerable variation in the patterning and properties of angiogenic blood vessels, as well as in their responses to anti-angiogenic therapy. Angiogenic programming of neoplastic tissue is a multidimensional process regulated by cancer cells in concert with a variety of tumour-associated stromal cells and their bioactive products, which encompass cytokines and growth factors, the extracellular matrix and secreted microvesicles. In this Review, we discuss the extrinsic regulation of angiogenesis by the tumour microenvironment, highlighting potential vulnerabilities that could be targeted to improve the applicability and reach of anti-angiogenic cancer therapies.
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Affiliation(s)
- Michele De Palma
- The Swiss Institute for Experimental Cancer Research (ISREC), School of Life Sciences, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Daniela Biziato
- The Swiss Institute for Experimental Cancer Research (ISREC), School of Life Sciences, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Tatiana V Petrova
- Department of Fundamental Oncology, Ludwig Institute for Cancer Research and Division of Experimental Pathology, University of Lausanne and University of Lausanne Hospital, 1066 Lausanne, Switzerland
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49
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Subbiah V, Meyer C, Zinner R, Meric-Bernstam F, Zahurak ML, O'Connor A, Roszik J, Shaw K, Ludwig JA, Kurzrock R, Azad NA. Phase Ib/II Study of the Safety and Efficacy of Combination Therapy with Multikinase VEGF Inhibitor Pazopanib and MEK Inhibitor Trametinib In Advanced Soft Tissue Sarcoma. Clin Cancer Res 2017; 23:4027-4034. [PMID: 28377484 PMCID: PMC5754188 DOI: 10.1158/1078-0432.ccr-17-0272] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Revised: 02/14/2017] [Accepted: 03/31/2017] [Indexed: 11/16/2022]
Abstract
Purpose: Pazopanib, a multireceptor tyrosine kinase inhibitor targeting primarily VEGFRs1-3, is approved for advanced soft tissue sarcoma (STS) and renal cell cancer. Downstream of VEGFR, trametinib is an FDA-approved MEK inhibitor used for melanoma. We hypothesized that vertical pathway inhibition using trametinib would synergize with pazopanib in advanced STS.Experimental Design: In an open-label, multicenter, investigator-initiated National Comprehensive Cancer Network (NCCN)-sponsored trial, patients with metastatic or advanced STS received pazopanib 800 mg and 2 mg of trametinib continuously for 28-day cycles. The primary endpoint was 4-month progression-free survival (PFS). Secondary endpoints were overall survival, response rate, and disease control rate.Results: Twenty-five patients were enrolled. The median age was 49 years (range, 22-77 years) and 52% were male. Median PFS was 2.27 months [95% confidence interval (CI), 1.9-3.9], and the 4-month PFS rate was 21.1% (95% CI, 9.7-45.9), which was not an improvement over the hypothesized null 4-month PFS rate of 28.3% (P = 0.79). Median overall survival was 9.0 months (95% CI, 5.7-17.7). A partial response occurred in 2 (8%) of the evaluable patients (95% CI, 1.0-26.0), one with PIK3CA E542K-mutant embryonal rhabdomyosarcoma and another with spindle cell sarcoma. The disease control rate was 14/25 (56%; 95% CI, 34.9-75.6). The most common adverse events were diarrhea (84%), nausea (64%), fatigue (56%), and hypertension (52%).Conclusions: The combination of pazopanib and trametinib was tolerable without indication of added activity of the combination in STS. Further study may be warranted in RAS/RAF aberrant sarcomas. Clin Cancer Res; 23(15); 4027-34. ©2017 AACR.
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Affiliation(s)
- Vivek Subbiah
- The University of Texas MD Anderson Cancer Center, Houston, Texas.
| | - Christian Meyer
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland
| | - Ralph Zinner
- The University of Texas MD Anderson Cancer Center, Houston, Texas
- Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | | | - Marianna L Zahurak
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland
| | - Ashley O'Connor
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland
| | - Jason Roszik
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Kenna Shaw
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Joseph A Ludwig
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Razelle Kurzrock
- The University of Texas MD Anderson Cancer Center, Houston, Texas
- University of California, San Diego, San Diego, California
| | - Nilofer A Azad
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland
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50
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Zhu YJ, Zhang HB, Liu YH, Bai JP, Li Y, Liu LR, Qu YC, Qu X, Chen X. Meta-analysis of the role of bevacizumab in extensive stage small cell lung cancer. Oncol Lett 2017; 14:655-664. [PMID: 28693218 PMCID: PMC5494762 DOI: 10.3892/ol.2017.6249] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 03/10/2017] [Indexed: 11/26/2022] Open
Abstract
Progress in the treatment options for small cell lung cancer (SCLC) remains poor. Concerns exist regarding the efficacy of bevacizumab in SCLC. The present study aimed to evaluate the efficacy of bevacizumab in extensive stage (ES)-SCLC. A meta-analysis on studies conducted and listed on the Medline, Cochrane Trials, ASCO, ESMO and ClinicalTrial databases, and Chinese databases prior to April 2015 was performed. All clinical trials in which patients with ES-SCLC were treated with bevacizumab were considered. Survival rates at specific time points were extracted from the reported survival curves. Hazard ratios (HR) for progression-free survival (PFS) and overall survival (OS), rates for PFS, OS, overall response rate (ORR), and side-effects were synthesized using random-effects or fixed-effects model. Two randomized control trials (RCT) (176 patients) and six single-arm trials (292 patients) were identified. In RCTs, no statistically significant differences were observed in PFS [HR, 0.70; 95% confidence interval (CI), 0.41–1.19; P=0.19] or OS (HR, 1.21; 95% CI, 0.84–1.75; P=0.31). In the first-line trials, pooled 6-month and 1-year PFS rates were 57% (95% CI, 39–76%) and 10% (95% CI, 4–16%), respectively. Synthesized 1-year and 2-year OS rates were 45% (95% CI, 36–54%) and 10% (95% CI, 6–14%), respectively. Reported median PFS and OS times for pretreated patients were 2.7–4.0 months and 6.3–7.4 months, respectively. Pooled ORRs were 71% (95% CI, 59–82%) in the first-line trials and 18% (95% CI, 11–25%) in the second-line trials. The most common types of reported toxicities were chemotherapy-associated, including neutropenia, leukopenia, fatigue and thrombocytopenia. According to the RCTs, bevacizumab did not appear to improve the PFS or OS for patients with ES-SCLC, with low quality of evidence. Due to the disappointing pooled efficacy in the single-arm trials, more clinical studies on bevacizumab in SCLC may not be valuable, although the evidence was with low quality.
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Affiliation(s)
- Yan-Juan Zhu
- Department of Oncology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong 510120, P.R. China
| | - Hai-Bo Zhang
- Department of Oncology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong 510120, P.R. China
| | - Yi-Hong Liu
- Department of Oncology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong 510120, P.R. China
| | - Jian-Ping Bai
- Department of Oncology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong 510120, P.R. China
| | - Yong Li
- Department of Oncology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong 510120, P.R. China
| | - Li-Rong Liu
- Department of Oncology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong 510120, P.R. China
| | - Yan-Chun Qu
- Department of Oncology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong 510120, P.R. China
| | - Xin Qu
- Department of Oncology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong 510120, P.R. China
| | - Xian Chen
- Department of Oncology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong 510120, P.R. China
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