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Mitteldorf C, Kulberg A, Tronnier M, Schön MP, Kempf W. Subcellular expression of CD30 in cutaneous mastocytosis-An important factor for targeted treatment. J Cutan Pathol 2024. [PMID: 39092659 DOI: 10.1111/cup.14695] [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: 02/21/2024] [Revised: 07/04/2024] [Accepted: 07/09/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND The subcellular distribution of CD30 on mast cells and the presence of eosinophils in cutaneous mastocytosis require further investigation, especially as the cell surface expression of CD30 is critical for the therapeutic response of systemic mastocytosis to brentuximab vedotin. OBJECTIVE Investigation of 147 biopsy specimens from 143 patients with cutaneous mastocytosis for mast cell density and distribution, frequency of CD30 expression, CD30 staining patterns, and presence and distribution of eosinophils. Correlation with clinical patterns. METHODS Retrospective multicenter immunohistochemical study of CD30 expression, eosinophils and basic clinical data in cutaneous mastocytosis. RESULTS CD30 expression was found in all samples (cut-off: ≥1%), whereby the staining was predominantly cytoplasmic in 99% of the samples. Additional membrane staining was detected in 62% of the samples. Surface expression of CD30 was more common in biopsy specimens with a high mast cell burden and in biopsy specimens with a higher CD30 expression rate. Eosinophils were admixed in 58% of the samples. Females and older patients showed a trend of a lower mast cell burden. LIMITATIONS Retrospective study on formalin-fixed and paraffin-embedded tissue without functional analysis. CONCLUSION Most cases of cutaneous mastocytosis show cell surface expression of CD30 expression and is, therefore, in principle, accessible for therapy with antibodies against CD30, provided the overall situation of the patient warrants.
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Affiliation(s)
- Christina Mitteldorf
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Aleksandra Kulberg
- Department of Dermatology, Venereology and Allergology, Helios Klinikum Hildesheim, Hildesheim, Germany
| | - Michael Tronnier
- Department of Dermatology, Venereology and Allergology, Helios Klinikum Hildesheim, Hildesheim, Germany
| | - Michael P Schön
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Werner Kempf
- Kempf und Pfaltz Histologische Diagnostik, Zürich, Switzerland
- Department of Dermatology, University Hospital Zürich, Zürich, Switzerland
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2
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D’Alò F, Bellesi S, Maiolo E, Alma E, Bellisario F, Malafronte R, Viscovo M, Campana F, Hohaus S. Novel Targets and Advanced Therapies in Diffuse Large B Cell Lymphomas. Cancers (Basel) 2024; 16:2243. [PMID: 38927948 PMCID: PMC11201587 DOI: 10.3390/cancers16122243] [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: 05/10/2024] [Revised: 06/07/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024] Open
Abstract
Since the introduction of rituximab in the late 1990s, significant progress has been made in advancing targeted therapies for B cell lymphomas, improving patients' chance of being cured and clinicians' therapeutic armamentarium. A better understanding of disease biology and pathogenic pathways, coupled with refinements in immunophenotypic and molecular diagnostics, have been instrumental in these achievements. While traditional chemotherapy remains fundamental in most cases, concerns surrounding chemorefractoriness and cumulative toxicities, particularly the depletion of the hemopoietic reserve, underscore the imperative for personalized treatment approaches. Integrating targeted agents, notably monoclonal antibodies, alongside chemotherapy has yielded heightened response rates and prolonged survival. A notable paradigm shift is underway with innovative-targeted therapies replacing cytotoxic drugs, challenging conventional salvage strategies like stem cell transplantation. This review examines the landscape of emerging targets for lymphoma cells and explores innovative therapies for diffuse large B cell lymphoma (DLBCL). From Chimeric Antigen Receptor-T cells to more potent monoclonal antibodies, antibody-drug conjugates, bispecific antibodies, checkpoint inhibitors, and small molecules targeting intracellular pathways, each modality offers promising avenues for therapeutic advancement. This review aims to furnish insights into their potential implications for the future of DLBCL treatment strategies.
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Affiliation(s)
- Francesco D’Alò
- Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (F.B.); (R.M.); (M.V.); (F.C.); (S.H.)
- UOSD Malattie Linfoproliferative Extramidollari, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy;
| | - Silvia Bellesi
- UOC Servizio e DH di Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (S.B.); (E.M.)
| | - Elena Maiolo
- UOC Servizio e DH di Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (S.B.); (E.M.)
| | - Eleonora Alma
- UOSD Malattie Linfoproliferative Extramidollari, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy;
| | - Flaminia Bellisario
- Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (F.B.); (R.M.); (M.V.); (F.C.); (S.H.)
- UOSD Malattie Linfoproliferative Extramidollari, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy;
| | - Rosalia Malafronte
- Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (F.B.); (R.M.); (M.V.); (F.C.); (S.H.)
- UOSD Malattie Linfoproliferative Extramidollari, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy;
| | - Marcello Viscovo
- Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (F.B.); (R.M.); (M.V.); (F.C.); (S.H.)
- UOSD Malattie Linfoproliferative Extramidollari, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy;
| | - Fabrizia Campana
- Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (F.B.); (R.M.); (M.V.); (F.C.); (S.H.)
- UOSD Malattie Linfoproliferative Extramidollari, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy;
| | - Stefan Hohaus
- Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (F.B.); (R.M.); (M.V.); (F.C.); (S.H.)
- UOSD Malattie Linfoproliferative Extramidollari, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy;
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Visweshwar N, Rico JF, Killeen R, Manoharan A. Harnessing the Immune System: An Effective Way to Manage Diffuse Large B-Cell Lymphoma. J Hematol 2023; 12:145-160. [PMID: 37692863 PMCID: PMC10482611 DOI: 10.14740/jh1112] [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: 03/15/2023] [Accepted: 05/01/2023] [Indexed: 09/12/2023] Open
Abstract
Diffuse large B-cell lymphoma (DLBCL) is a heterogenous hematological disorder with malignant potential controlled by immunological characteristics of the tumor microenvironment. Rapid breakthrough in the molecular pathways has made immunological approaches the main anchor in the management of DLBCL, with or without chemotherapeutic agents. Rituximab was the first monoclonal antibody approved for the treatment of DLBCL. Following rituximab that transformed the therapeutic landscape, other novel immunological agents including chimeric antigen T-cell therapy have reshaped the management of relapsed/refractory DLBCL. However, resistance and refractory state remain a challenge in the management of DLBCL. For this literature review, we screened articles from Medline, Embase, Cochrane databases and the European/North American guidelines from March 2010 through October 2022 for DLBCL. Here we discuss immunological agents that will significantly affect future treatment of this aggressive type of lymphoma.
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Affiliation(s)
- Nathan Visweshwar
- Department of Hematology, University of South Florida, Tampa, FL, USA
| | - Juan Felipe Rico
- Department of Pediatrics, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - Robert Killeen
- Department of Hematology, Moffitt Cancer Center, Tampa, FL, USA
| | - Arumugam Manoharan
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
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4
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Zana A, Puig-Moreno C, Bocci M, Gilardoni E, Di Nitto C, Principi L, Ravazza D, Rotta G, Prodi E, De Luca R, Neri D, Cazzamalli S. A Comparative Analysis of Fibroblast Activation Protein-Targeted Small Molecule-Drug, Antibody-Drug, and Peptide-Drug Conjugates. Bioconjug Chem 2023. [PMID: 37399501 DOI: 10.1021/acs.bioconjchem.3c00244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
We present the first in vivo comparative evaluation of chemically defined antibody-drug conjugates (ADCs), small molecule-drug conjugates (SMDCs), and peptide-drug conjugates (PDCs) targeting and activated by fibroblast activation protein (FAP) in solid tumors. Both the SMDC (OncoFAP-Gly-Pro-MMAE) and the ADC (7NP2-Gly-Pro-MMAE) candidates delivered high amounts of active payload (i.e., MMAE) selectively at the tumor site, thus producing a potent antitumor activity in a preclinical cancer model.
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Affiliation(s)
- Aureliano Zana
- Philochem AG, R&D Department, Libernstrasse 3, CH-8112 Otelfingen, Zürich, Switzerland
| | - Claudia Puig-Moreno
- Philochem AG, R&D Department, Libernstrasse 3, CH-8112 Otelfingen, Zürich, Switzerland
- Swiss Federal Institute of Technology, Department of Chemistry and Applied Biosciences, CH-8093 Zürich, Switzerland
| | - Matilde Bocci
- Philochem AG, R&D Department, Libernstrasse 3, CH-8112 Otelfingen, Zürich, Switzerland
| | - Ettore Gilardoni
- Philochem AG, R&D Department, Libernstrasse 3, CH-8112 Otelfingen, Zürich, Switzerland
| | - Cesare Di Nitto
- Philochem AG, R&D Department, Libernstrasse 3, CH-8112 Otelfingen, Zürich, Switzerland
| | - Lucrezia Principi
- Philochem AG, R&D Department, Libernstrasse 3, CH-8112 Otelfingen, Zürich, Switzerland
| | - Domenico Ravazza
- Philochem AG, R&D Department, Libernstrasse 3, CH-8112 Otelfingen, Zürich, Switzerland
| | - Giulia Rotta
- Philochem AG, R&D Department, Libernstrasse 3, CH-8112 Otelfingen, Zürich, Switzerland
| | - Eleonora Prodi
- Philochem AG, R&D Department, Libernstrasse 3, CH-8112 Otelfingen, Zürich, Switzerland
| | - Roberto De Luca
- Philochem AG, R&D Department, Libernstrasse 3, CH-8112 Otelfingen, Zürich, Switzerland
| | - Dario Neri
- Philochem AG, R&D Department, Libernstrasse 3, CH-8112 Otelfingen, Zürich, Switzerland
- Swiss Federal Institute of Technology, Department of Chemistry and Applied Biosciences, CH-8093 Zürich, Switzerland
- Philogen S.p.A., 53100 Siena, Italy
| | - Samuele Cazzamalli
- Philochem AG, R&D Department, Libernstrasse 3, CH-8112 Otelfingen, Zürich, Switzerland
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5
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El Hussein S, Medeiros LJ, Gruschkus SK, Wei P, Schlette E, Fang H, Jelloul FZ, Wang W, Fiskus W, Kanagal-Shamanna R, Loghavi S, Yang H, Li S, Xu J, Tang Z, Thakral B, Jain N, Wierda WG, Patel K, Bhalla KN, Khoury JD. Immune evasion phenotype is common in Richter transformation diffuse large B-cell lymphoma variant. Virchows Arch 2023; 482:1011-1019. [PMID: 36864257 DOI: 10.1007/s00428-023-03520-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 02/14/2023] [Accepted: 02/16/2023] [Indexed: 03/04/2023]
Abstract
Immune checkpoint inhibitors (PD-1 inhibitors) have shown clinical activity in Richter transformation-diffuse large B-cell lymphoma variant (RT-DLBCL), thus providing for a novel therapeutic approach. The study group consists of 64 patients with RT-DLBCL. Expression of PD-1, PD-L1, CD30, and microsatellite instability (MSI) status (hMLH1, hMSH2, hMSH6, PMS1) was assessed using immunohistochemistry. EBV-encoded RNA (EBER) was evaluated using colorimetric in situ hybridization. PD-1 and PD-L1 expression levels were categorized on the basis of tumor cell expression as follows: negative (< 5%), positive to low-positive (5-50%), or high-positive (> 50%). An "immune evasion phenotype" (IEP) was defined as RT-DLBCL cases having high-positive expression of PD-1 and/or PD-L1 on tumor cells. The level of PD1-positive tumor-infiltrating lymphocytes (TILs) was estimated as a fraction of total lymphocytes and categorized as negative/low vs. brisk (> 20%). 28/64 (43.7%) patients were characterized as IEP+ RT-DLBCL. A brisk level of PD1+ TILs was significantly more common in IEP1+ compared with IEP- tumors (17/28, 60.7% vs. 5/34, 14.7%; p = 0.001). In addition, CD30 expression was significantly more common in IEP+ compared with IEP- RT-DLBCL (6/20, 30% vs. 1/27, 3.7%; p = 0.0320). Two (2/36; 5.5%) cases were positive for EBER, both IEP+. There was no significant difference between the two groups in terms of age, sex, or time to transformation. Assessment of mismatch repair proteins demonstrated absence of microsatellite instability (MSI) in all cases (18/18; 100%). Notably, patients with brisk PD1+ TILs had a significantly better OS compared to those with a negative/low infiltrate (p = 0.0285).
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Affiliation(s)
- Siba El Hussein
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
- Department of Pathology, The University of Rochester Medical Center, Rochester, NY, USA.
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Stephen K Gruschkus
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Peng Wei
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ellen Schlette
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Hong Fang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Fatima Zahra Jelloul
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Wei Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Warren Fiskus
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Rashmi Kanagal-Shamanna
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sanam Loghavi
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Hong Yang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Shaoying Li
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jie Xu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Zhenya Tang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Beenu Thakral
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Nitin Jain
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - William G Wierda
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Keyur Patel
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Kapil N Bhalla
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Joseph D Khoury
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
- Department of Pathology & Microbiology, The University of Nebraska Medical Center, Omaha, NE, USA.
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Varma G, Goldstein J, Advani RH. Novel agents in relapsed/refractory diffuse large B-cell lymphoma. Hematol Oncol 2023; 41 Suppl 1:92-106. [PMID: 37294966 DOI: 10.1002/hon.3143] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 03/28/2023] [Indexed: 06/11/2023]
Abstract
Patients with relapsed or refractory (R/R) diffuse large B-cell lymphoma (DLBCL), ineligible for or relapsing after autologous stem-cell transplant or chimeric antigen-receptor T-cell therapies have poor outcomes. Several novel agents, polatuzumab vedotin, tafasitamab, loncastuximab tesirine, and selinexor, have been approved and offer new opportunities for this difficult to treat population. Studies are evaluating combination of these agents with chemotherapy and other emerging therapies. Additionally, advances in our understanding of DLBCL biology, genetics, and immune microenvironment have allowed for the identification of new therapeutic targets like Ikaros and Aiolos, IRAK4, MALT1, and CD47 with several agents in ongoing clinical trials. In this chapter we review updated data supporting the use of the approved agents and discuss other emerging novel therapies for patients with R/R DLBCL.
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Affiliation(s)
- Gaurav Varma
- Division of Hematology and Medical Oncology, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
| | - Jordan Goldstein
- Department of Medicine, Division of Oncology, Stanford University, Stanford, California, USA
| | - Ranjana H Advani
- Department of Medicine, Division of Oncology, Stanford University, Stanford, California, USA
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Gru AA, Lim MS, Dogan A, Horwitz SM, Delabie J, Fu K, Peker D, Reddy VVB, Xu ML, Vij K, Slack GW, Miranda RN, Jagadeesh D, Lisano JM, Hsi ED, Torlakovic E. Best Practices in CD30 Immunohistochemistry Testing, Interpretation, and Reporting: An Expert Panel Consensus. Arch Pathol Lab Med 2023; 147:79-86. [PMID: 35472771 DOI: 10.5858/arpa.2021-0270-oa] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2021] [Indexed: 12/31/2022]
Abstract
CONTEXT.— Although CD30 testing is an established tool in the diagnostic workup of lymphomas, it is also emerging as a predictive biomarker that informs treatment. The current definition of CD30 positivity by immunohistochemistry is descriptive and based on reactivity in lymphomas that are defined by their universal strong expression of CD30, rather than any established threshold. Challenges include inconsistencies with preanalytic variables, tissue processing, pathologist readout, and with the pathologist and oncologist interpretation of reported results. OBJECTIVE.— To develop and propose general best practice recommendations for reporting CD30 expression by immunohistochemistry in lymphoma biopsies to harmonize practices across institutions and facilitate assessment of its significance in clinical decision-making. DESIGN.— Following literature review and group discussion, the panel of 14 academic hematopathologists and 2 clinical/academic hematologists/oncologists divided into 3 working groups. Each working group was tasked with assessing CD30 testing by immunohistochemistry, CD30 expression readout, or CD30 expression interpretation. RESULTS.— Panel recommendations were reviewed and discussed. An online survey was conducted to confirm the consensus recommendations. CONCLUSIONS.— CD30 immunohistochemistry is required for all patients in whom classic Hodgkin lymphoma and any lymphoma within the spectrum of peripheral T-cell lymphoma are differential diagnostic considerations. The panel reinforced and summarized that immunohistochemistry is the preferred methodology and any degree of CD30 expression should be reported. For diagnostic purposes, the interpretation of CD30 expression should follow published guidelines. To inform therapeutic decisions, report estimated percent positive expression in tumor cells (or total cells where applicable) and record descriptively if nontumor cells are positive.
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Affiliation(s)
- Alejandro A Gru
- From the Department of Pathology, E. Couric Clinical Cancer Center, University of Virginia, Charlottesville (Gru)
| | - Megan S Lim
- The Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia (Lim)
| | - Ahmet Dogan
- The Department of Pathology and Laboratory Medicine (Dogan), Memorial Sloan Kettering Cancer Center, New York, New York
| | - Steven M Horwitz
- The Department of Medical Oncology (Horwitz), Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jan Delabie
- The Department of Laboratory Medicine & Pathobiology, University Health Network, Toronto, Ontario, Canada (Delabie)
| | - Kai Fu
- The Department of Pathology, Roswell Park Cancer Institution, Buffalo, New York (Fu)
| | - Deniz Peker
- The Department of Pathology & Laboratory Medicine, Emory University, Atlanta, Georgia (Peker)
| | - Vishnu V B Reddy
- The Department of Pathology, University of Alabama Medical Center, Birmingham (Reddy)
| | - Mina L Xu
- The Department of Pathology, Yale School of Medicine, Yale University, New Haven, Connecticut (Xu)
| | - Kiran Vij
- The Departments of Internal Medicine and Pathology & Immunology, Washington University School of Medicine, St Louis, Missouri (Vij)
| | - Graham W Slack
- The Department of Pathology and Laboratory Medicine, British Columbia Cancer, Vancouver, British Columbia, Canada (Slack)
| | - Roberto N Miranda
- The Department of Hematopathology, University of Texas MD Anderson Cancer Center, Houston (Miranda)
| | - Deepa Jagadeesh
- The Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland, Ohio (Jagadeesh)
| | - Julie M Lisano
- Medical Affairs, Seagen Inc, Bothell, Washington (Lisano)
| | - Eric D Hsi
- The Department of Pathology, Wake Forest School of Medicine, Winston-Salem, North Carolina (Hsi)
| | - Emina Torlakovic
- The Department of Pathology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada (Torlakovic)
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8
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Zibara V, Sen F, Scordo M, Falchi L. Successful brentuximab vedotin and nivolumab therapy of multiply refractory diffuse large B-cell lymphoma with Hodgkin features. Leuk Lymphoma 2022; 63:3241-3244. [PMID: 36120859 DOI: 10.1080/10428194.2022.2113528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Victor Zibara
- Department of Medicine, Mount Sinai Morningside West, New York, NY, USA.,Lymphoma, Hematopathology, and Bone Marrow Transplantation Services, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Filiz Sen
- Lymphoma, Hematopathology, and Bone Marrow Transplantation Services, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Michael Scordo
- Lymphoma, Hematopathology, and Bone Marrow Transplantation Services, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Lorenzo Falchi
- Lymphoma, Hematopathology, and Bone Marrow Transplantation Services, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
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9
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Evolving Landscape of Antibody Drug Conjugates in Lymphoma. Cancer J 2022; 28:479-487. [DOI: 10.1097/ppo.0000000000000631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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10
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Jagadeesh D, Horwitz S, Bartlett NL, Kim Y, Jacobsen E, Duvic M, Little M, Trepicchio W, Fenton K, Onsum M, Lisano J, Advani R. Response to Brentuximab Vedotin by CD30 Expression in Non-Hodgkin Lymphoma. Oncologist 2022; 27:864-873. [PMID: 35948003 PMCID: PMC9526494 DOI: 10.1093/oncolo/oyac137] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 06/01/2022] [Indexed: 11/26/2022] Open
Abstract
Background The safety and efficacy of brentuximab vedotin (BV), an antibody-drug conjugate directed to the CD30 antigen, has been assessed in several trials in patients with peripheral T-cell lymphoma (PTCL), cutaneous T-cell lymphoma (CTCL), or B-cell non-Hodgkin lymphoma (NHL). The objective of this research was to examine the relationship between CD30 expression level and clinical response to BV. Patients and Methods We analyzed response in patients treated with BV monotherapy in 5 prospective clinical studies in relapsed or refractory PTCL, CTCL, or B-cell NHL. CD30 expression was assessed by immunohistochemistry (IHC) using the Ber H2 antibody for 275 patients. Results Across all 5 studies, 140 (50.9%) patients had tumors with CD30 expression <10%, including 60 (21.8%) with undetectable CD30 by IHC. No significant differences were observed for any study in overall response rates between patients with CD30 expression ≥10% or <10%. Median duration of response was also similar in the CD30 ≥10% and <10% groups for all studies. Conclusions In this analysis of studies across a range of CD30-expressing lymphomas, CD30 expression alone, as measured by standard IHC, does not predict clinical benefit from BV, making the determination of a threshold level of expression uncertain.
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Affiliation(s)
| | - Steve Horwitz
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Nancy L Bartlett
- Washington University School of Medicine, Siteman Cancer Center, St. Louis, MO, USA
| | - Youn Kim
- Department of Dermatology, Stanford University School of Medicine, Stanford, CA, USA; Stanford Cancer Institute, Stanford, CA, USA
| | | | - Madeleine Duvic
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Meredith Little
- Millennium Pharmaceuticals, Inc., Cambridge, MA, USA (a wholly owned subsidiary of Takeda Pharmaceuticals Limited)
| | - William Trepicchio
- Millennium Pharmaceuticals, Inc., Cambridge, MA, USA (a wholly owned subsidiary of Takeda Pharmaceuticals Limited)
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11
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Caballero AC, Escribà-Garcia L, Alvarez-Fernández C, Briones J. CAR T-Cell Therapy Predictive Response Markers in Diffuse Large B-Cell Lymphoma and Therapeutic Options After CART19 Failure. Front Immunol 2022; 13:904497. [PMID: 35874685 PMCID: PMC9299440 DOI: 10.3389/fimmu.2022.904497] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 06/07/2022] [Indexed: 12/02/2022] Open
Abstract
Immunotherapy with T cells genetically modified with chimeric antigen receptors (CARs) has shown significant clinical efficacy in patients with relapsed/refractory B-cell lymphoma. Nevertheless, more than 50% of treated patients do not benefit from such therapy due to either absence of response or further relapse. Elucidation of clinical and biological features that would predict clinical response to CART19 therapy is of paramount importance and eventually may allow for selection of those patients with greater chances of response. In the last 5 years, significant clinical experience has been obtained in the treatment of diffuse large B-cell lymphoma (DLBCL) patients with CAR19 T cells, and major advances have been made on the understanding of CART19 efficacy mechanisms. In this review, we discuss clinical and tumor features associated with response to CART19 in DLBCL patients as well as the impact of biological features of the infusion CART19 product on the clinical response. Prognosis of DLBCL patients that fail CART19 is poor and therapeutic approaches with new drugs are also discussed.
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Affiliation(s)
- Ana Carolina Caballero
- Hematology Service, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Laboratory of Experimental Hematology-IIB, Institut Recerca Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Campus Sant Pau, Josep Carreras Leukemia Research Institute, Barcelona, Spain.,Autonomous University of Barcelona, Barcelona, Spain
| | - Laura Escribà-Garcia
- Hematology Service, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Laboratory of Experimental Hematology-IIB, Institut Recerca Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Campus Sant Pau, Josep Carreras Leukemia Research Institute, Barcelona, Spain
| | - Carmen Alvarez-Fernández
- Hematology Service, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Laboratory of Experimental Hematology-IIB, Institut Recerca Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Campus Sant Pau, Josep Carreras Leukemia Research Institute, Barcelona, Spain
| | - Javier Briones
- Hematology Service, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Laboratory of Experimental Hematology-IIB, Institut Recerca Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Campus Sant Pau, Josep Carreras Leukemia Research Institute, Barcelona, Spain.,Autonomous University of Barcelona, Barcelona, Spain
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12
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Mitteldorf C, Kampa F, Ströbel P, Schön MP, Kempf W. Intraindividual variability of
CD30
expression in mycosis fungoides –implications for diagnostic evaluation and therapy. Histopathology 2022; 81:55-64. [DOI: 10.1111/his.14660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/24/2022] [Accepted: 04/04/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Christina Mitteldorf
- Department of Dermatology, Venereology and Allergology University Medical Center Göttingen Germany
| | - Franziska Kampa
- Department of Dermatology, Venereology and Allergology University Medical Center Göttingen Germany
| | | | - Michael P. Schön
- Department of Dermatology, Venereology and Allergology University Medical Center Göttingen Germany
- Lower Saxony Institute of Occupational Dermatology
| | - Werner Kempf
- Kempf und Pfaltz Histologische Diagnostik, Affolternstrasse 56, CH‐8050 Zürich Switzerland
- Department of Dermatology University Hospital Zurich CH‐8091 Zurich Switzerland
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13
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Papageorgiou SG, Thomopoulos TP, Liaskas A, Vassilakopoulos TP. Monoclonal Antibodies in the Treatment of Diffuse Large B-Cell Lymphoma: Moving beyond Rituximab. Cancers (Basel) 2022; 14:1917. [PMID: 35454825 PMCID: PMC9026383 DOI: 10.3390/cancers14081917] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/01/2022] [Accepted: 04/07/2022] [Indexed: 11/23/2022] Open
Abstract
Although rituximab has revolutionized the treatment of diffuse large B-cell lymphoma (DLBCL), a significant proportion of patients experience refractory disease or relapse early after the end of treatment. The lack of effective treatment options in the relapsed/refractory (R/R) setting had made the prognosis of these patients dismal. The initial enthusiasm for novel anti-CD20 antibodies had been short-lived as they failed to prove their superiority to rituximab. Therefore, research has focused on developing novel agents with a unique mechanism of action. Among them, two antibody-drug conjugates, namely polatuzumab vedotin (PolaV) and loncastuximab tesirine, along with tafasitamab, an anti-CD19 bioengineered antibody, have been approved for the treatment of R/R DLBCL. Whereas PolaV has been FDA and EMA approved, EMA has not approved loncastuximab tesirine and tafasitamab yet. Results from randomized trials, as well as real-life data for PolaV have been promising. Novel agents as bispecific antibodies bridging CD3 on T-cells to CD20 have shown very promising results in clinical trials and are expected to gain approval for treatment of R/R DLBCL soon. As the therapeutic armamentarium against DLBCL is expanding, an improvement in survival of patients with R/R and higher cure rates might soon become evident.
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Affiliation(s)
- Sotirios G. Papageorgiou
- Hematology Unit, Second Propaedeutic Department of Internal Medicine and Research Institute, School of Medicine, National and Kapodistrian University of Athens, University General Hospital “Attikon”, 18120 Athens, Greece; (S.G.P.); (T.P.T.)
| | - Thomas P. Thomopoulos
- Hematology Unit, Second Propaedeutic Department of Internal Medicine and Research Institute, School of Medicine, National and Kapodistrian University of Athens, University General Hospital “Attikon”, 18120 Athens, Greece; (S.G.P.); (T.P.T.)
| | - Athanasios Liaskas
- Department of Haematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, 11527 Athens, Greece;
| | - Theodoros P. Vassilakopoulos
- Department of Haematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, 11527 Athens, Greece;
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14
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Ward JP, Berrien-Elliott MM, Gomez F, Luo J, Becker-Hapak M, Cashen AF, Wagner-Johnston ND, Maddocks K, Mosior M, Foster M, Krysiak K, Schmidt A, Skidmore ZL, Desai S, Watkins MP, Fischer A, Griffith M, Griffith OL, Fehniger TA, Bartlett NL. Phase 1/dose expansion trial of brentuximab vedotin and lenalidomide in relapsed or refractory diffuse large B-cell lymphoma. Blood 2022; 139:1999-2010. [PMID: 34780623 PMCID: PMC8972094 DOI: 10.1182/blood.2021011894] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 11/02/2021] [Indexed: 11/20/2022] Open
Abstract
New therapies are needed for patients with relapsed/refractory (rel/ref) diffuse large B-cell lymphoma (DLBCL) who do not benefit from or are ineligible for stem cell transplant and chimeric antigen receptor therapy. The CD30-targeted, antibody-drug conjugate brentuximab vedotin (BV) and the immunomodulator lenalidomide (Len) have demonstrated promising activity as single agents in this population. We report the results of a phase 1/dose expansion trial evaluating the combination of BV/Len in rel/ref DLBCL. Thirty-seven patients received BV every 21 days, with Len administered continuously for a maximum of 16 cycles. The maximum tolerated dose of the combination was 1.2 mg/kg BV with 20 mg/d Len. BV/Len was well tolerated with a toxicity profile consistent with their use as single agents. Most patients required granulocyte colony-stimulating factor support because of neutropenia. The overall response rate was 57% (95% CI, 39.6-72.5), complete response rate, 35% (95% CI, 20.7-52.6); median duration of response, 13.1 months; median progression-free survival, 10.2 months (95% CI, 5.5-13.7); and median overall survival, 14.3 months (95% CI, 10.2-35.6). Response rates were highest in patients with CD30+ DLBCL (73%), but they did not differ according to cell of origin (P = .96). NK cell expansion and phenotypic changes in CD8+ T-cell subsets in nonresponders were identified by mass cytometry. BV/Len represents a potential treatment option for patients with rel/ref DLBCL. This combination is being further explored in a phase 3 study (registered on https://clinicaltrials.org as NCT04404283). This trial was registered on https://clinicaltrials.gov as NCT02086604.
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Affiliation(s)
- Jeffrey P Ward
- Division of Oncology and Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO
| | - Melissa M Berrien-Elliott
- Division of Oncology and Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO
| | - Felicia Gomez
- Division of Oncology and Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO
- McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
| | - Jingqin Luo
- Division of Public Health Sciences, Washington University School of Medicine, St. Louis, MO
| | - Michelle Becker-Hapak
- Division of Oncology and Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO
| | - Amanda F Cashen
- Division of Oncology and Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO
| | - Nina D Wagner-Johnston
- Division of Oncology and Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO
| | - Kami Maddocks
- Division of Hematology, The Ohio State University, Columbus, OH; and
| | - Matthew Mosior
- Division of Oncology and Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO
- McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
| | - Mark Foster
- Division of Oncology and Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO
| | - Kilannin Krysiak
- Division of Oncology and Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO
- McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO
| | - Alina Schmidt
- Division of Oncology and Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO
- McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
| | - Zachary L Skidmore
- Division of Oncology and Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO
- McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
| | - Sweta Desai
- Division of Oncology and Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO
| | - Marcus P Watkins
- Division of Oncology and Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO
| | - Anne Fischer
- Division of Oncology and Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO
| | - Malachi Griffith
- Division of Oncology and Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO
- McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
| | - Obi L Griffith
- Division of Oncology and Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO
- McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
| | - Todd A Fehniger
- Division of Oncology and Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO
| | - Nancy L Bartlett
- Division of Oncology and Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO
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15
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Jin Y, Schladetsch MA, Huang X, Balunas MJ, Wiemer AJ. Stepping forward in antibody-drug conjugate development. Pharmacol Ther 2022; 229:107917. [PMID: 34171334 PMCID: PMC8702582 DOI: 10.1016/j.pharmthera.2021.107917] [Citation(s) in RCA: 72] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/26/2021] [Accepted: 05/27/2021] [Indexed: 01/03/2023]
Abstract
Antibody-drug conjugates (ADCs) are cancer therapeutic agents comprised of an antibody, a linker and a small-molecule payload. ADCs use the specificity of the antibody to target the toxic payload to tumor cells. After intravenous administration, ADCs enter circulation, distribute to tumor tissues and bind to the tumor surface antigen. The antigen then undergoes endocytosis to internalize the ADC into tumor cells, where it is transported to lysosomes to release the payload. The released toxic payloads can induce apoptosis through DNA damage or microtubule inhibition and can kill surrounding cancer cells through the bystander effect. The first ADC drug was approved by the United States Food and Drug Administration (FDA) in 2000, but the following decade saw no new approved ADC drugs. From 2011 to 2018, four ADC drugs were approved, while in 2019 and 2020 five more ADCs entered the market. This demonstrates an increasing trend for the clinical development of ADCs. This review summarizes the recent clinical research, with a specific focus on how the in vivo processing of ADCs influences their design. We aim to provide comprehensive information about current ADCs to facilitate future development.
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Affiliation(s)
- Yiming Jin
- Division of Medicinal Chemistry, Department of Pharmaceutical Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Megan A Schladetsch
- Division of Medicinal Chemistry, Department of Pharmaceutical Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Xueting Huang
- Division of Medicinal Chemistry, Department of Pharmaceutical Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Marcy J Balunas
- Division of Medicinal Chemistry, Department of Pharmaceutical Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Andrew J Wiemer
- Division of Medicinal Chemistry, Department of Pharmaceutical Sciences, University of Connecticut, Storrs, CT 06269, USA; Institute for Systems Genomics, University of Connecticut, Storrs, CT 06269, USA.
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16
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Horwitz S, O'Connor OA, Pro B, Trümper L, Iyer S, Advani R, Bartlett NL, Christensen JH, Morschhauser F, Domingo-Domenech E, Rossi G, Kim WS, Feldman T, Menne T, Belada D, Illés Á, Tobinai K, Tsukasaki K, Yeh SP, Shustov A, Hüttmann A, Savage KJ, Yuen S, Zinzani PL, Miao H, Bunn V, Fenton K, Fanale M, Puhlmann M, Illidge T. The ECHELON-2 Trial: 5-year results of a randomized, phase 3 study of brentuximab vedotin with chemotherapy for CD30-positive peripheral T-cell lymphoma. Ann Oncol 2021; 33:288-298. [PMID: 34921960 PMCID: PMC9447792 DOI: 10.1016/j.annonc.2021.12.002] [Citation(s) in RCA: 97] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 11/12/2021] [Accepted: 12/07/2021] [Indexed: 01/18/2023] Open
Abstract
Background: For patients with peripheral T-cell lymphoma (PTCL), outcomes using frontline treatment with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or CHOP-like therapy are typically poor. The ECHELON-2 study demonstrated that brentuximab vedotin plus cyclophosphamide, doxorubicin, and prednisone (A+CHP) exhibited statistically superior progression-free survival (PFS) per independent central review and improvements in overall survival versus CHOP for the frontline treatment of patients with systemic anaplastic large cell lymphoma or other CD30-positive PTCL. Patients and methods: ECHELON-2 is a double-blind, double-dummy, randomized, placebo-controlled, active-comparator phase III study. We present an exploratory update of the ECHELON-2 study, including an analysis of 5-year PFS per investigator in the intent-to-treat analysis group. Results: A total of 452 patients were randomized (1 : 1) to six or eight cycles of A+CHP (N = 226) or CHOP (N = 226). At median follow-up of 47.6 months, 5-year PFS rates were 51.4% [95% confidence interval (CI): 42.8% to 59.4%] with A+CHP versus 43.0% (95% CI: 35.8% to 50.0%) with CHOP (hazard ratio = 0.70; 95% CI: 0.53–0.91), and 5-year overall survival (OS) rates were 70.1% (95% CI: 63.3% to 75.9%) with A+CHP versus 61.0% (95% CI: 54.0% to 67.3%) with CHOP (hazard ratio = 0.72; 95% CI: 0.53–0.99). Both PFS and OS were generally consistent across key subgroups. Peripheral neuropathy was resolved or improved in 72% (84/117) of patients in the A+CHP arm and 78% (97/124) in the CHOP arm. Among patients who relapsed and subsequently received brentuximab vedotin, the objective response rate was 59% with brentuximab vedotin retreatment after A+CHP and 50% with subsequent brentuximab vedotin after CHOP. Conclusions: In this 5-year update of ECHELON-2, frontline treatment of patients with PTCL with A+CHP continues to provide clinically meaningful improvement in PFS and OS versus CHOP, with a manageable safety profile, including continued resolution or improvement of peripheral neuropathy.
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Affiliation(s)
- S Horwitz
- Memorial Sloan Kettering Cancer Center, New York, New York, USA.
| | - O A O'Connor
- University of Virginia Cancer Center, University of Virginia, Charlottesville, Virginia, USA
| | - B Pro
- Division of Hematology and Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - L Trümper
- Universitätsmedizin Göttingen, Göttingen, Germany
| | - S Iyer
- MD Anderson Cancer Center/University of Texas, Houston, Texas, USA
| | - R Advani
- Stanford Cancer Center, Blood and Marrow Transplant Program, Stanford, California, USA
| | - N L Bartlett
- Washington University School of Medicine, St. Louis, Missouri, USA
| | | | | | - E Domingo-Domenech
- Institut Catala D'oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| | - G Rossi
- Azienda Ospedaliera Spedali Civili di Brescia, Brescia, Italy
| | - W S Kim
- Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - T Feldman
- John Theurer Cancer Center, Hackensack Meridian Health School of Medicine, Hackensack NJ
| | - T Menne
- Freeman Hospital, Newcastle upon Tyne, England
| | - D Belada
- 4th Department of Internal Medicine - Hematology, University Hospital Hradec Králové, Czech Republic and Charles University in Prague, Faculty of Medicine in Hradec Kralove, Czech Republic
| | - Á Illés
- Debreceni Egyetem, Debrecen, Hajdu-Bihar, Hungary
| | - K Tobinai
- National Cancer Center Hospital, Tokyo, Japan
| | - K Tsukasaki
- Saitama Medical University International Medical Center, Saitama, Japan
| | - S-P Yeh
- China Medical University Hospital, Taichung, Taiwan
| | - A Shustov
- University of Washington Medical Center, Seattle, Washington, USA
| | - A Hüttmann
- Universitatsklinikum Essen, Essen, Nordrhein-Westfalen, Germany
| | - K J Savage
- Department of Medical Oncology and University of British Columbia, BC Cancer, Vancouver, British Columbia, Canada
| | - S Yuen
- Calvary Mater Newcastle Hospital, Australia
| | - P L Zinzani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli"; Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italia
| | - H Miao
- Millennium Pharmaceuticals, Inc., Cambridge, Massachusetts, USA, a wholly owned subsidiary of Takeda Pharmaceuticals Limited
| | - V Bunn
- Millennium Pharmaceuticals, Inc., Cambridge, Massachusetts, USA, a wholly owned subsidiary of Takeda Pharmaceuticals Limited
| | - K Fenton
- Seagen Inc., Bothell, Washington, USA
| | - M Fanale
- Seagen Inc., Bothell, Washington, USA
| | | | - T Illidge
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, NIHR Biomedical Research Centre, Manchester Academic Health Sciences Centre, Christie Hospital NHS Foundation Trust, Manchester, UK
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17
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Morais-Perdigão AL, Rodrigues-Fernandes CI, Araújo GR, Soares CD, de Andrade BAB, Martins MD, Vargas PA, Pontes HAR, Pires FR, Burbano RMR, Fonseca FP. CD30 Expression in Oral and Oropharyngeal Diffuse Large B Cell Lymphoma, not Otherwise Specified. Head Neck Pathol 2021; 16:476-485. [PMID: 34655411 PMCID: PMC9187795 DOI: 10.1007/s12105-021-01387-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 10/06/2021] [Indexed: 12/24/2022]
Abstract
Diffuse large B cell lymphoma, not otherwise specified (DLBCL, NOS) is the most frequent non-Hodgkin lymphoma subtype. This aggressive neoplasm may variably express the CD30 protein, which may be used as a therapeutic target for this tumor. However, CD30 expression in DLBCL NOS arising from the oral cavity and the oropharynx has not been investigated. Therefore, this study aims to determine the frequency of CD30 expression and its prognostic significance for patients affected by oral/oropharyngeal DLBCL NOS. Fifty cases were retrieved from pathology files and submitted to immunohistochemistry against CD30. Reactivity was accessed by two oral pathologists using two cut-off values (> 0% and > 20% of tumor cells) to determine positivity in each case. Clinical data were obtained from the patients' medical files to investigate the prognostic potential of the protein. Seven high-grade B cell lymphomas and two EBV-positive DLBCL NOS were identified. We found one CD30-positive case in each of these two groups of lymphomas. Among the remaining 41 DLBCL NOS, other four cases (three in the oral cavity and one in the oropharynx) were positive for CD30, but only two expressed the protein in > 20% of tumor cells, both in the oral cavity. Survival analysis demonstrated that CD30-positive cases had a higher five-year overall survival rate (75%) than CD30-negative cases (32.3%), although a statistically significant result was not achieved (p = 0.19). Only a minor subset of oral and oropharyngeal DLBCL NOS express CD30 and these patients seems to have a higher survival rate.
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Affiliation(s)
- Ana Luísa Morais-Perdigão
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, 31270-901, Pampulha, Belo Horizonte, Brazil
| | | | - Gabriela Ribeiro Araújo
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, 31270-901, Pampulha, Belo Horizonte, Brazil
| | | | | | - Manoela Domingues Martins
- Department of Pathology, School of Dentistry, Federal University of Rio Grande Do Sul, Porto Alegre, Brazil
| | - Pablo Agustin Vargas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil ,Department of Oral Biology and Oral Pathology, University of Pretoria, Pretoria, South Africa
| | - Hélder Antônio Rebelo Pontes
- Service of Oral Pathology, João de Barros, Barreto University Hospital, Federal University of Pará, Belem, Brazil
| | - Fábio Ramôa Pires
- Oral Pathology, Dental School, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | | | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, 31270-901, Pampulha, Belo Horizonte, Brazil ,Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil ,Department of Oral Biology and Oral Pathology, University of Pretoria, Pretoria, South Africa
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18
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Immune targeted therapy for diffuse large B cell lymphoma. BLOOD SCIENCE 2021; 3:136-148. [PMID: 35402846 PMCID: PMC8975004 DOI: 10.1097/bs9.0000000000000095] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 10/06/2021] [Indexed: 11/25/2022] Open
Abstract
Diffuse large B-cell lymphoma (DLBCL), the most common subtype of non-Hodgkin lymphoma, is highly heterogeneous and invasive. Although the majority of DLBCL patients show a good response to rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone treatment, approximately one-third of patients still have a poor prognosis. Many immune-targeted drugs, such as bispecific T-cell engagers and CAR T-cell therapy, have been proven effective for refractory and relapsed patients. This article reviews the progress of immune targeted therapy for DLBCL.
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19
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Lobastova L, Lettau M, Babatz F, de Oliveira TD, Nguyen PH, Pauletti BA, Schauss AC, Dürkop H, Janssen O, Paes Leme AF, Hallek M, Hansen HP. CD30-Positive Extracellular Vesicles Enable the Targeting of CD30-Negative DLBCL Cells by the CD30 Antibody-Drug Conjugate Brentuximab Vedotin. Front Cell Dev Biol 2021; 9:698503. [PMID: 34395429 PMCID: PMC8362802 DOI: 10.3389/fcell.2021.698503] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 07/07/2021] [Indexed: 11/29/2022] Open
Abstract
CD30, a member of the TNF receptor superfamily, is selectively expressed on a subset of activated lymphocytes and on malignant cells of certain lymphomas, such as classical Hodgkin Lymphoma (cHL), where it activates critical bystander cells in the tumor microenvironment. Therefore, it is not surprising that the CD30 antibody-drug conjugate Brentuximab Vedotin (BV) represents a powerful, FDA-approved treatment option for CD30+ hematological malignancies. However, BV also exerts a strong anti-cancer efficacy in many cases of diffuse large B cell lymphoma (DLBCL) with poor CD30 expression, even when lacking detectable CD30+ tumor cells. The mechanism remains enigmatic. Because CD30 is released on extracellular vesicles (EVs) from both, malignant and activated lymphocytes, we studied whether EV-associated CD30 might end up in CD30– tumor cells to provide binding sites for BV. Notably, CD30+ EVs bind to various DLBCL cell lines as well as to the FITC-labeled variant of the antibody-drug conjugate BV, thus potentially conferring the BV binding also to CD30– cells. Confocal microscopy and imaging cytometry studies revealed that BV binding and uptake depend on CD30+ EVs. Since BV is only toxic toward CD30– DLBCL cells when CD30+ EVs support its uptake, we conclude that EVs not only communicate within the tumor microenvironment but also influence cancer treatment. Ultimately, the CD30-based BV not only targets CD30+ tumor cell but also CD30– DLBCL cells in the presence of CD30+ EVs. Our study thus provides a feasible explanation for the clinical impact of BV in CD30– DLBCL and warrants confirming studies in animal models.
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Affiliation(s)
- Liudmila Lobastova
- Department I of Internal Medicine, University of Cologne, Cologne, Germany.,Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Cologne, Germany.,Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany.,CECAD Center of Excellence on Cellular Stress Responses in Aging-Associated Diseases, Cologne, Germany
| | - Marcus Lettau
- Institute of Immunology, Christian-Albrechts-University of Kiel and University Hospital Schleswig-Holstein, Kiel, Germany.,Department of Hematology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Felix Babatz
- CECAD Center of Excellence on Cellular Stress Responses in Aging-Associated Diseases, Imaging Facility, Cologne, Germany
| | - Thais Dolzany de Oliveira
- Department I of Internal Medicine, University of Cologne, Cologne, Germany.,Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Cologne, Germany.,Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany.,CECAD Center of Excellence on Cellular Stress Responses in Aging-Associated Diseases, Cologne, Germany
| | - Phuong-Hien Nguyen
- Department I of Internal Medicine, University of Cologne, Cologne, Germany.,Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Cologne, Germany.,Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany.,CECAD Center of Excellence on Cellular Stress Responses in Aging-Associated Diseases, Cologne, Germany
| | - Bianca Alves Pauletti
- Laboratório de Espectrometria de Massas, Laboratório Nacional de Biociências, Centro Nacional de Pesquisa em Energia e Materiais, Campinas, Brazil
| | - Astrid C Schauss
- CECAD Center of Excellence on Cellular Stress Responses in Aging-Associated Diseases, Imaging Facility, Cologne, Germany
| | - Horst Dürkop
- Pathodiagnostik Berlin MVZ GmbH Berlin, Berlin, Germany
| | - Ottmar Janssen
- Institute of Immunology, Christian-Albrechts-University of Kiel and University Hospital Schleswig-Holstein, Kiel, Germany
| | - Adriana F Paes Leme
- Laboratório de Espectrometria de Massas, Laboratório Nacional de Biociências, Centro Nacional de Pesquisa em Energia e Materiais, Campinas, Brazil
| | - Michael Hallek
- Department I of Internal Medicine, University of Cologne, Cologne, Germany.,Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Cologne, Germany.,Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany.,CECAD Center of Excellence on Cellular Stress Responses in Aging-Associated Diseases, Cologne, Germany
| | - Hinrich P Hansen
- Department I of Internal Medicine, University of Cologne, Cologne, Germany.,Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Cologne, Germany.,Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany.,CECAD Center of Excellence on Cellular Stress Responses in Aging-Associated Diseases, Cologne, Germany
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20
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Karube K, Kakimoto Y, Tonozuka Y, Ohshima K. The expression of CD30 and its clinico-pathologic significance in peripheral T-cell lymphomas. Expert Rev Hematol 2021; 14:777-787. [PMID: 34263699 DOI: 10.1080/17474086.2021.1955344] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Recent studies have shown that CD30 expression can be an important feature of peripheral and cutaneous T-cell lymphomas (PTCLs and CTCLs) and CD30 testing has increased in importance with the emergence of CD30-directed therapy. AREAS COVERED This article reviews the literature on CD30-related biology, prevalence, and therapy in patients with PTCL or CTCL. We searched the PubMed database from 1 January 2010 to 28 April 2020, using terms 'CD30' ('peripheral T-cell lymphomas' or 'cutaneous T-cell lymphoma') and 'immunohistochemistry' or 'flow cytometry' or 'pathology,' and synonyms including terms for T-cell lymphoma subtypes. EXPERT OPINION CD30 is expressed at relatively high rates of prevalence across a broad range of PTCLs and CTCLs. CD30 expression may be critical to the development of a subset of PTCLs and also a biomarker for treatment choice in some subtypes. Large-scale randomized, controlled studies have shown that CD30-directed treatment with brentuximab vedotin is significantly more effective against CD30-expressing PTCL and CTCL than current standard-of-care regimens. However, accurate CD30 evaluation is limited by inconsistencies in detection methodology and expression cutoffs defining CD30-expressing disease. Greater understanding of CD30 testing and reporting will enable more patients with CD30-expressing PTCL and CTCL to be identified and treated appropriately.
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Affiliation(s)
- Kennosuke Karube
- Department of Pathology and Cell Biology, University of the Ryukyus, Okinawa, Japan
| | - Yoshihide Kakimoto
- Medical Affairs, Japan Oncology Business Unit, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | - Yukio Tonozuka
- Medical Affairs, Japan Oncology Business Unit, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | - Koichi Ohshima
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
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21
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Rodrigues-Fernandes CI, Abreu LG, Radhakrishnan R, Perez DEDC, Amaral-Silva GK, Gondak RDO, Rahimi S, Brennan PA, Fonseca FP, Vargas PA. Prognostic significance of CD30 expression in diffuse large B-cell lymphoma: A systematic review with meta-analysis. J Oral Pathol Med 2021; 50:587-593. [PMID: 34101913 DOI: 10.1111/jop.13208] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 06/02/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND CD30 is variably expressed in diffuse large B-cell lymphoma (DLBCL), but its prognostic potential for the affected patients remains debatable and unclear. Therefore, we aimed to determine the frequency of CD30 expression in DLBCL and its potential for prognostic determination. METHODS An electronic systematic review was performed using multiple databases, followed by a quantitative meta-analysis to assess the frequency of CD30 expression with positivity cut-off values of >0% and >20%, and to determine its association with clinicopathological features and patients' survival. RESULTS Using a cut-off value >0%, we observed that 3.5%-59.1% of the cases were considered positive for CD30. There was a significant association of the protein expression with a lower number of extra-nodal sites affected by the neoplasm, with Ann Arbor advanced stage, the absence of B-symptoms, the lack of MYC and BCL2 translocations, and a lower ECOG performance. Using a cut-off value >20%, we observed that 2.5%-36.7% of the cases were considered positive for CD30, being significantly associated with a lower number of extra-nodal sites affected by the neoplasm, Ann Arbor stages III/IV, non-GCB tumours, the lack of MYC and BCL2 translocations, and a lower ECOG value. CD30 expression was significantly associated with a better survival rate, regardless of what cut-off parameter was used. CONCLUSION Despite variations in the cut-off values used to determine CD30 positivity in DLBCL, the expression of this protein seems to be associated with a higher survival rate and better prognosis.
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Affiliation(s)
| | - Lucas Guimarães Abreu
- Department of Child's and Adolescent's Oral Health, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Raghu Radhakrishnan
- Department of Oral Pathology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Danyel Elias da Cruz Perez
- Department of Clinical and Preventive Dentistry, School of Dentistry, Universidade Federal de Pernambuco, Recife, Brazil
| | | | | | - Siavash Rahimi
- Department of Pathology, Queen Alexandra Hospital, Portsmouth, UK
| | - Peter A Brennan
- Department of Oral and Maxillofacial Surgery, Queen Alexandra Hospital, Portsmouth, UK
| | - Felipe Paiva Fonseca
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil.,Department of Oral Biology and Oral Pathology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.,Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Pablo Agustin Vargas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil.,Department of Oral Biology and Oral Pathology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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22
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Wang L, Li LR, Young KH. New agents and regimens for diffuse large B cell lymphoma. J Hematol Oncol 2020; 13:175. [PMID: 33317571 PMCID: PMC7734862 DOI: 10.1186/s13045-020-01011-z] [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: 08/26/2020] [Accepted: 11/24/2020] [Indexed: 12/14/2022] Open
Abstract
As a widely recognized standard regimen, R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone) is able to cure two-thirds patients with diffuse large B cell lymphoma (DLBCL), and the remaining patients suffer from refractory or relapsed disease due to resistance to R-CHOP and fare poorly. Unsatisfied outcomes for those relapsed/refractory patients prompted efforts to discover new treatment approaches for DLBCL, including chimeric antigen receptor T cells, bispecific T cell engagers, immunomodulatory drugs, immune checkpoint inhibitors, monoclonal antibodies, antibody-drug conjugates, molecular pathway inhibitors, and epigenetic-modifying drugs. Herein, up-to-date data about the most promising treatment approaches for DLBCL are recapitulated, and novel genetic classification systems are introduced to guide individualized treatment for DLBCL.
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MESH Headings
- Animals
- Antineoplastic Agents/pharmacology
- Antineoplastic Agents/therapeutic use
- Antineoplastic Agents, Immunological/pharmacology
- Antineoplastic Agents, Immunological/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/pharmacology
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Drug Development
- Epigenesis, Genetic/drug effects
- Humans
- Immune Checkpoint Inhibitors/pharmacology
- Immune Checkpoint Inhibitors/therapeutic use
- Immunoconjugates/pharmacology
- Immunoconjugates/therapeutic use
- Immunologic Factors/pharmacology
- Immunologic Factors/therapeutic use
- Immunotherapy/methods
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/immunology
- Lymphoma, Large B-Cell, Diffuse/metabolism
- Lymphoma, Large B-Cell, Diffuse/therapy
- Signal Transduction
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Affiliation(s)
- Liang Wang
- Department of Hematology, Beijing TongRen Hospital, Capital Medical University, Beijing, 100730, China.
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University & Capital Medical University, Beijing TongRen Hospital, Beijing, 100730, China.
| | - Lin-Rong Li
- Peking Union Medical College Hospital, Beijing, 100560, China
| | - Ken H Young
- Division of Hematopathology, Department of Pathology, Duke University Medical Center and Cancer Institute, Durham, NC, 27710, USA.
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Thuresson PO, Vander Velde N, Gupta P, Talbot J. A Systematic Review of the Clinical Efficacy of Treatments in Relapsed or Refractory Diffuse Large B Cell Lymphoma. Adv Ther 2020; 37:4877-4893. [PMID: 33001384 PMCID: PMC7595978 DOI: 10.1007/s12325-020-01507-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 09/14/2020] [Indexed: 02/07/2023]
Abstract
Introduction Novel treatment options are needed to improve outcomes in transplant-ineligible relapsed/refractory (R/R) diffuse large B cell lymphoma (DLBCL). This systematic literature review evaluated clinical evidence on treatments for patients with R/R DLBCL ineligible for, or relapsed following, stem cell transplantation. Methods We assessed the feasibility of conducting an indirect treatment comparison (ITC) or network meta-analysis (NMA) to evaluate the relative efficacy and safety of polatuzumab vedotin in combination with bendamustine + rituximab versus other relevant treatments. Results Thirty-seven studies were identified, of which 20 were eligible [seven randomized, controlled trials (RCTs); 13 observational/single-arm trials]. Due to a lack of RCTs, an ITC/NMA summary of the relative efficacy and safety of the treatment options was not possible. Only two of the seven RCTs had positive outcomes. Conclusions These findings highlight the paucity of published RCTs to establish the comparative efficacy of treatments for transplant-ineligible R/R DLBCL and lack of standard of care in this setting. Electronic Supplementary Material The online version of this article (10.1007/s12325-020-01507-7) contains supplementary material, which is available to authorized users.
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24
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Makawita S, Meric-Bernstam F. Antibody-Drug Conjugates: Patient and Treatment Selection. Am Soc Clin Oncol Educ Book 2020; 40:1-10. [PMID: 32213087 DOI: 10.1200/edbk_280775] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Antibody-drug conjugates (ADCs) are a promising drug platform designed to enhance the therapeutic index and minimize the toxicity of anticancer agents. ADCs have experienced substantial progress and technological growth over the past decades; however, several challenges to patient selection and treatment remain. Methods to optimally capture all patients who may benefit from a particular ADC are still largely unknown. Although target antigen expression remains a biomarker for patient selection, the impact of intratumor heterogeneity on antigen expression, as well as the dynamic changes in expression with treatment and disease progression, are important considerations in patient selection. Better understanding of these factors, as well as minimum levels of target antigen expression required to achieve therapeutic efficacy, will enable further optimization of selection strategies. Other important considerations include understanding mechanisms of primary and acquired resistance to ADCs. Ongoing efforts in the design of its constituent parts to possess the intrinsic ability to overcome these mechanisms, including use of the "bystander effect" to enhance efficacy in heterogeneous or low target antigen-expressing tumors, as well as modulation of the chemical and immunophenotypic properties of antibodies and linker molecules to improve payload sensitivity and therapeutic efficacy, are under way. These strategies may also lead to improved safety profiles. Similarly, combination strategies using ADCs with other cytotoxic or immunomodulatory agents are also under development. Great strides have been made in ADC technology. With further refinements, this therapeutic modality has the potential to make an important clinical impact on a wider range of tumor types.
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Affiliation(s)
- Shalini Makawita
- Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Funda Meric-Bernstam
- Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, TX.,Department of Investigational Cancer Therapeutics, University of Texas MD Anderson Cancer Center, Houston, TX
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25
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Kampa F, Mitteldorf C. A review of CD30 expression in cutaneous neoplasms. J Cutan Pathol 2020; 48:495-510. [PMID: 33047376 DOI: 10.1111/cup.13894] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 08/26/2020] [Accepted: 10/05/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND The surface protein CD30 is a therapeutic target of monoclonal antibody therapy. Knowledge of the frequency of CD30 expression and its prognostic relevance is therefore interesting, not only in lymphoproliferative disorders (LPD) but also in solid tumors of the skin. METHODS A review was completed in PubMed for all published reports of CD30 expression in cutaneous lymphomas, mastocytosis, epithelial tumors and sarcomas from 1982 to April 2019. Only accessible articles in English and German were considered. Entities with an expected CD30 expression, such as CD30-positive LPD, were not evaluated. RESULTS The electronic research identified 1091 articles and a further 34 articles were obtained from manual bibliographic reference. Overall 91 articles were included that examined CD30 expression in various entities of cutaneous neoplasms and matched the inclusion criteria. CONCLUSION Apart from cutaneous CD30-positive LPD, the best-studied group for CD30 expression was mycosis fungoides (MF). CD30 positivity was found in 32% of classical (patch and plaque stage) and in 59.4% cases of transformed MF. CD30 was also frequently expressed in cutaneous mastocytosis (96.5%). In solid tumors, some single reports describe CD30 expression by tumor cells, but CD30-reactive lymphocytes were frequently observed in the tumor microenvironment (TME), especially in keratoacanthoma (KA).
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Affiliation(s)
- Franziska Kampa
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Christina Mitteldorf
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
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26
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Debliquis A, Baseggio L, Bouyer S, Guy J, Garnache-Ottou F, Genevieve F, Mayeur-Rousse C, Letestu R, Chapuis N, Harrivel V, Bennani H, Lachot S, Loosveld M, Nicolino-Brunet C, Pérès M, Roussel M, Veyrat-Masson R, Jacob MC, Drenou B. Multicentric MFI30 study: Standardization of flow cytometry analysis of CD30 expression in non-Hodgkin lymphoma. CYTOMETRY PART B-CLINICAL CYTOMETRY 2020; 100:488-496. [PMID: 32803917 DOI: 10.1002/cyto.b.21940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 06/15/2020] [Accepted: 07/15/2020] [Indexed: 02/03/2023]
Abstract
CD30 transmembrane receptor, a member of the tumor necrosis factor receptor family, is expressed in different lymphomas. Brentuximab vedotin (BV), a CD30 monoclonal antibody (Ab)-drug conjugate, is effective in CD30-positive lymphomas. However, the response to BV is not always correlated to CD30 expression detected by immunohistochemistry (IHC). The objectives of this study were to standardize and evaluate CD30 intensity by flow cytometry (FCM) in non-Hodgkin's lymphomas. Twelve centers analyzed 161 cases on standardized cytometers using normalized median fluorescence intensity (nMFI30) of three different Abs, of which one clone can recognize the same epitope as BV. FCM distinguished four groups of cases: negative group (n = 110) which showed no expression with the three clones; high positive group (n = 13) which gave nMFI30 > 5% with all tested clones; dim positive group (n = 17) which showed nMFI30 > 1% with all tested clones and <5% for at least one; discordant group (n = 21) with positive and negative expression of the different clones. In consistency with the literature, CD30 was positive in all anaplastic large cell lymphomas, in some diffuse large B-cell lymphomas (DLBCL), and in other rare lymphomas. FCM results were concordant with those of IHC in 77% of cases. Discrepancies could be explained by clones-related differences, microenvironment, or intracytoplasmic staining. Interestingly, FCM was more sensitive than IHC in 11% of cases, especially in DLBCL. Multicenter standardized FCM of specific CD30 could improve case detection and extend the treatment of BV to various CD30-positive lymphomas.
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Affiliation(s)
- Agathe Debliquis
- Laboratoire d'Hématologie, Groupe Hospitalier de la région Mulhouse Sud Alsace, Mulhouse, France
| | - Lucile Baseggio
- Laboratoire d'Hématologie Cellulaire, Groupement Hospitalier Sud/Hospices Civils de Lyon, Lyon, France
| | - Sabrina Bouyer
- Service d'Hématologie Biologique, Center Hospitalier Universitaire de Poitiers, Poitiers, France
| | - Julien Guy
- Service d'Hématologie biologique, Center Hospitalier Universitaire de Dijon, Dijon, France
| | | | - Franck Genevieve
- Laboratoire d'Hématologie, Center Hospitalier Universitaire d'Angers, Fédération Hospitalo-Universitaire "Grand Ouest Against Leukemia" (FHU GOAL), Angers, France
| | - Caroline Mayeur-Rousse
- Laboratoire d'Hématologie, Center Hospitalier Universitaire de Strasbourg, Strasbourg, France
| | - Remi Letestu
- Service d'Hématologie Biologique, Hôpital Avicenne HUPSSD, AP-HP, Bobigny, France
| | - Nicolas Chapuis
- Service d'Hématologie Biologique, Hopital Cochin APHP, Paris, France
| | | | - Hind Bennani
- Laboratoire de biologie, Hopital Foch, Suresnes, France
| | - Sebastien Lachot
- Service d'Hématologie Biologie, Center Hospitalier Universitaire de Tours, Tours, France
| | - Marie Loosveld
- Laboratoire d'Hématologie, Center Hospitalier Universitaire de Marseille, CNRS, INSERM, CIML, Aix Marseille Université, Marseille, France
| | - Corinne Nicolino-Brunet
- Laboratoire d'Hématologie et Biologie Vasculaire du Pr Françoise Dignat George, Center Hospitalier Universitaire La Conception, Marseille, France
| | - Michaël Pérès
- Laboratoire d'Hématologie, IUCT-Oncopole, CHU de Toulouse, Toulouse, France
| | - Mikael Roussel
- Pôle Biologie, Center Hospitalier Universitaire de Rennes, Rennes, France
| | - Richard Veyrat-Masson
- Service d'Hématologie Biologique, Hôpital Estaing, Center Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Marie-Christine Jacob
- Laboratoire d'Immunologie, Center Hospitalier Universitaire de Grenoble-Alpes, La Tronche, France
| | - Bernard Drenou
- Laboratoire d'Hématologie, Groupe Hospitalier de la région Mulhouse Sud Alsace, Mulhouse, France
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27
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Harker-Murray PD, Pommert L, Barth MJ. Novel Therapies Potentially Available for Pediatric B-Cell Non-Hodgkin Lymphoma. J Natl Compr Canc Netw 2020; 18:1125-1134. [PMID: 32755987 DOI: 10.6004/jnccn.2020.7608] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 06/22/2020] [Indexed: 11/17/2022]
Abstract
Burkitt lymphoma, diffuse large B-cell lymphoma (DLBCL), and primary mediastinal B-cell lymphoma are the most common aggressive pediatric mature B-cell non-Hodgkin lymphomas (B-NHLs). Despite excellent survival with current chemotherapy regimens, therapy for Burkitt lymphoma and DLBCL has a high incidence of short- and long-term toxicities. Patients who experience relapse generally have a very poor prognosis. Therefore, novel approaches using targeted therapies to reduce toxicities and improve outcomes in the relapse setting are needed. The addition of rituximab, a monoclonal antibody against CD20, to upfront therapy has improved survival outcomes for high-risk patients and may allow decreased total chemotherapy in those with low-risk disease. Antibody-drug conjugates have been combined with chemotherapy in relapsed/refractory (R/R) NHL, and multiple antibody-drug conjugates are in development. Additionally, bispecific T-cell-engaging antibody constructs and autologous CAR T-cells have been successful in the treatment of R/R acute leukemias and are now being applied to R/R B-NHL with some successes. PD-L1 and PD-L2 on tumor cells can be targeted with checkpoint inhibitors, which restore T-cell-mediated immunity and antitumor responses and can be added to conventional chemotherapy and immune-directed therapies to augment responses. Lastly, trials of small molecule inhibitors targeting cell signaling pathways in NHL subtypes are underway. This article reviews many of the targeted therapies under development that could be considered for future trials in R/R pediatric mature B-NHL.
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Affiliation(s)
| | - Lauren Pommert
- Pediatric Oncology, Midwest Children's Cancer Center, Milwaukee, Wisconsin; and
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28
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Ednersson SB, Stern M, Fagman H, Nilsson-Ehle H, Hasselblom S, Andersson PO. TBLR1 and CREBBP as potential novel prognostic immunohistochemical biomarkers in diffuse large B-cell lymphoma. Leuk Lymphoma 2020; 61:2595-2604. [PMID: 32546039 DOI: 10.1080/10428194.2020.1775216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Recent studies have identified prognostic mutational clusters for diffuse large B-cell lymphoma (DLBCL) patients, both within and outside the original cell-of-origin (COO) classification. For many of these mutations, there is limited information regarding the corresponding protein expression. With the aim to determine the relationship of protein expression and intensity to COO and prognosis, we used digital image analysis to quantitate immunohistochemical staining of CREBBP, IRF8, EZH2, and TBLR1 in 209 DLBCL patients. We found that patients with strong nuclear expression of TBLR1 had inferior progression-free survival (PFS) and overall survival (OS) in univariable analysis and inferior PFS in multivariable analysis. Patients with higher proportion of intermediate to strong nuclear CREBBP expression had a worse PFS and OS in univariable analysis. CREBBP was expressed with stronger intensity in non-GCB patients and the prognostic impact was restricted to this subgroup. These findings suggest that high nuclear protein expression of TBLR1 and CREBBP is negatively associated with prognosis in DLBCL.
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Affiliation(s)
- Susanne Bram Ednersson
- Department of Pathology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Institute of Biomedicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Mimmie Stern
- Department of Medicine, Section of Hematology, South Älvsborg Hospital, Borås, Sweden.,Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Henrik Fagman
- Department of Pathology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Institute of Biomedicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Herman Nilsson-Ehle
- Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,Section of Hematology and Coagulation, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Sverker Hasselblom
- Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,Department of Research, Development & Education, Region Halland, Halmstad, Sweden
| | - Per-Ola Andersson
- Department of Medicine, Section of Hematology, South Älvsborg Hospital, Borås, Sweden.,Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
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29
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Malecek MK, Watkins MP, Bartlett NL. Polatuzumab vedotin for the treatment of adults with relapsed or refractory diffuse large B-cell lymphoma. Expert Opin Biol Ther 2020; 21:831-839. [PMID: 32500753 DOI: 10.1080/14712598.2020.1777979] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Polatuzumab vedotin is an antibody-drug conjugate comprised of an anti-CD79b monoclonal antibody conjugated to monomethyl auristatin (MMAE), a microtubule-disrupting cytotoxin. CD79b is almost exclusively expressed on normal and malignant B-cells, making it an appealing target for novel therapeutics. AREAS COVERED This article reviews the current literature on polatuzumab vedotin, including its pharmacology, as well as summarizing the results of clinical trials in relapsed/refractory diffuse large B-cell lymphoma (DLBCL) as a single agent and in combination with other chemotherapies and chemoimmunotherapies. The current landscape of approved therapies for relapsed and refractory DLBCL, as well as other promising novel approaches, is discussed. EXPERT OPINION The recent approval of polatuzumab vedotin in combination with bendamustine and rituximab (BR) offers another option to patients with DLBCL who are not eligible for autologous hematopoietic cell transplant or chimeric antigen receptors (CAR)-T cell therapy. In younger patients and those without serious comorbidities, polatuzumab vedotin-BR may serve as bridging therapy to more intensive therapies with reasonable efficacy and tolerability. Polatuzumab vedotin is currently being studied in a randomized trial in the front line setting in combination with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP).
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Affiliation(s)
- Mary-Kate Malecek
- Division of Oncology, Washington University School of Medicine, St. Louis, MO, USA
| | - Marcus P Watkins
- Division of Oncology, Washington University School of Medicine, St. Louis, MO, USA
| | - Nancy L Bartlett
- Division of Oncology, Washington University School of Medicine, St. Louis, MO, USA
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30
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Kinch A, Amini RM, Hollander P, Molin D, Sundström C, Enblad G. CD30 expression and survival in posttransplant lymphoproliferative disorders. Acta Oncol 2020; 59:673-680. [PMID: 32102582 DOI: 10.1080/0284186x.2020.1731924] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Post-transplant lymphoproliferative disorder (PTLD) is a rare but life-threatening complication of transplantation. For refractory and relapsed PTLD new therapies are needed, such as the antibody-drug conjugate brentuximab vedotin that targets CD30. There is limited knowledge of CD30 expression in various subtypes of PTLD and its correlation to clinicopathological features. Therefore, we studied the expression of CD30 in PTLD following solid organ transplantation and correlated CD30 expression to PTLD subtype, Epstein-Barr virus (EBV)-status, intratumoral regulatory T-cells (Tregs), clinical features, and outcome.Methods: We included 50 cases of PTLD from a nation-wide study of PTLDs following solid organ transplantation in Sweden. The tumor biopsies were reevaluated, and clinical data were collected. CD30 expression on tumor cells was analyzed by immunohistochemistry with the clone Ber-H2. Thirty-one cases were stained with clone 236 A/E7 for detection of forkhead box protein 3 (FoxP3, a Treg biomarker).Results: The case series consisted of 6% polymorphic, 88% monomorphic, and 6% Hodgkin lymphoma-like PTLDs and 53% of the cases were EBV+. Overall, 70% (35/50) of the PTLDs were CD30+ (≥1% CD30+ tumor cells) and 30% (15/50) were CD30-. All polymorphic PTLDs (n = 3) and Hodgkin lymphomas (n = 3), 88% (14/16) of non-germinal center type of diffuse large B-cell lymphoma (DLBCL), and 75% (9/12) of T-cell PTLDs were CD30+ whereas all germinal center-type of DLBCL (n = 5) and Burkitt type PTLD (n = 2) were CD30-. CD30+ PTLD tended to be EBV+ more frequently (p = .07) and occurred earlier posttransplant (2.1 vs. 8.2 years, p = .01) than CD30- PTLD. Type of transplant and localization of the tumor did not differ between the groups except that CNS engagement was more common in CD30- PTLD (p = .02). CD30-status was not associated with presence of intratumoral Tregs or overall survival.Conclusion: Expression of CD30 varied with PTLD subtype. There was no association between CD30 and survival, regardless of subtype.
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Affiliation(s)
- Amelie Kinch
- Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, Uppsala, Sweden
| | - Rose-Marie Amini
- Clinical and Experimental Pathology, Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Peter Hollander
- Clinical and Experimental Pathology, Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Daniel Molin
- Experimental and Clinical Oncology, Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Christer Sundström
- Clinical and Experimental Pathology, Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Gunilla Enblad
- Experimental and Clinical Oncology, Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
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31
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Abstract
Non-Hodgkin lymphomas (NHL) are a diverse group of diseases, encompassing mature B-cell, T-cell, and natural killer cell malignancies and ranging in behavior from indolent to highly aggressive. For many years, the traditional treatment of NHL centered on chemotherapy. However, the introduction of rituximab ushered in the era of immunotherapy for NHLs. This article reviews novel immune therapies that have been used for the treatment of NHL. The data supporting the use of rituximab have been reviewed extensively; this article focuses on novel immunotherapies other than rituximab that remain in use or are actively being studied in clinical trials.
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32
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Barth MJ, Minard-Colin V. Novel targeted therapeutic agents for the treatment of childhood, adolescent and young adult non-Hodgkin lymphoma. Br J Haematol 2019; 185:1111-1124. [PMID: 30701541 DOI: 10.1111/bjh.15783] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 12/29/2018] [Indexed: 02/06/2023]
Abstract
Non-Hodgkin lymphomas (NHLs) are a heterogeneous group of malignancies. Most NHLs in children, adolescent and young adult patients are aggressive lymphomas that are generally treated with multi-agent chemotherapy or immunochemotherapy regimens. While overall survival is high, the treatment can lead to a high rate of acute and long-term toxicity. However, in the rarer instance of relapsed or refractory disease, outcomes are dismal. Novel therapeutic approaches to the treatment of both T-cell and B-cell NHLs are critical to improve outcomes while also minimising the associated toxicity of current treatment regimes. Potential therapeutic approaches in development include humoral and cellular immunotherapies, small molecule inhibitors of relevant signalling pathways and epigenetic modifying agents. In this review, we will highlight the current state of development of agents of interest with a focus on agents relevant to childhood, adolescent and young adult NHL.
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Affiliation(s)
- Matthew J Barth
- Department of Pediatric Hematology/Oncology, University at Buffalo, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
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33
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Egan G, Goldman S, Alexander S. Mature B-NHL in children, adolescents and young adults: current therapeutic approach and emerging treatment strategies. Br J Haematol 2019; 185:1071-1085. [PMID: 30613948 DOI: 10.1111/bjh.15734] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Mature B cell lymphomas account for approximately 60% of all cases of non-Hodgkin lymphoma (NHL) in children and adolescents and includes Burkitt lymphoma (BL), diffuse large B cell lymphoma (DLBCL) and other less common histologies. The outcome for patients treated with modern regimens in resource-intensive settings is excellent. Improvements in care have been accomplished through enhanced supportive therapy, including tumour lysis management and incremental refinement of chemotherapy backbones via cooperative group clinical trials in which patients receive risk group-specific intensive chemotherapy. More recent trials have established the safety and efficacy of immunotherapy. Ongoing work is required to address the substantial burden of acute therapy-related toxicity, as well as the identification of effective therapies for those patients with relapsed and refractory disease, for whom outcomes remain very poor. In this review we will summarize the results from recent therapeutic clinical trials, describe the evidence to support the inclusion of rituximab and review the rationale for the investigation of several new categories of novel agents for mature B cell lymphomas in children and adolescents.
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Affiliation(s)
- Grace Egan
- Division of Hematology/Oncology, The Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Stan Goldman
- Department of Pediatrics, Medical City Children's Hospital and Texas Oncology, Dallas, TX, USA
| | - Sarah Alexander
- Division of Hematology/Oncology, The Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
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34
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Bauzon M, Drake PM, Barfield RM, Cornali BM, Rupniewski I, Rabuka D. Maytansine-bearing antibody-drug conjugates induce in vitro hallmarks of immunogenic cell death selectively in antigen-positive target cells. Oncoimmunology 2019; 8:e1565859. [PMID: 30906660 PMCID: PMC6422391 DOI: 10.1080/2162402x.2019.1565859] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 11/15/2018] [Accepted: 12/12/2018] [Indexed: 12/22/2022] Open
Abstract
Oncology treatment has been revolutionized by the introduction of immune checkpoint inhibitor drugs, which enable 20-40% of patients to generate anti-tumor immune responses. Combination treatment approaches with chemotherapeutic drugs may enable responses in the remaining patient cohorts. In this regard, a handful of drugs are promising due to their ability to induce immunogenic cell death in target cells. However, these agents are systemically delivered and indiscriminately cytotoxic to proliferating cells. By contrast, antibody-drug conjugates can selectively deliver a cytotoxic payload to a tumor, sparing most healthy cells. The ability of antibody-drug conjugates to induce immunogenic cell death in target cells has not yet been determined, although preclinical in vivo studies suggest this possibility. Here, we describe for the first time production of the in vitro hallmarks of immunogenic cell death - ecto-calreticulin and secreted ATP and HMGB1 protein - by cells in response to treatment with antibody-drug conjugates bearing a maytansine payload.
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Affiliation(s)
| | | | | | | | | | - David Rabuka
- Catalent Biologics, Emeryville, CA, USA
- CONTACT David Rabuka Catalent Biologics, 5703 Hollis Street, Emeryville, CA 94608
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35
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Faulk KE, Sopfe JM, Campbell K, Liptzin DR, Liu AK, Franklin ARK, Cost CR. Pulmonary toxicity in paediatric patients with relapsed or refractory Hodgkin lymphoma receiving brentuximab vedotin. Br J Haematol 2018; 183:251-256. [PMID: 30198571 DOI: 10.1111/bjh.15586] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Brentuximab vedotin (Bv) is becoming increasingly important in the treatment of Hodgkin lymphoma (HL), with improved outcomes and an overall favourable toxicity profile. However, Bv is associated with severe pulmonary toxicity when combined with bleomycin, suggesting that additive toxicity may be an important consideration. Furthermore, little has been published on tolerability in paediatric patients. We retrospectively evaluated the occurrence of pulmonary toxicity of Bv in 19 paediatric and young adult patients with relapsed or refractory HL. Patient characteristics, baseline health status, treatment regimens including cumulative doses of Bv, bleomycin, gemcitabine, radiation and carmustine, and the occurrence of pulmonary toxicity were collected. Seven (36·8%) of the 19 patients were treated with Bv. The odds of pulmonary toxicity were 4·0-fold higher (95% confidence interval 0·55-29·18) in patients exposed to Bv compared to unexposed patients in univariate analysis (P = 0·17). Similar results were found in multivariable analysis. Pulmonary toxicity occurred frequently in our cohort and was more common in patients who received Bv than in patients who did not receive Bv, although this was not statistically significant. Because patients with HL are exposed to a myriad of therapies with potential for pulmonary toxicity, continuing to evaluate the risk associated with Bv is critical.
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Affiliation(s)
- Kelly E Faulk
- Center for Cancer and Blood Disorders, Department of Paediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Jenna M Sopfe
- Center for Cancer and Blood Disorders, Department of Paediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Kristen Campbell
- Department of Paediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Deborah R Liptzin
- Paediatric Respiratory Center, Department of Paediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Arthur K Liu
- Center for Cancer and Blood Disorders, Department of Paediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Anna R K Franklin
- Center for Cancer and Blood Disorders, Department of Paediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Carrye R Cost
- Center for Cancer and Blood Disorders, Department of Paediatrics, University of Colorado School of Medicine, Aurora, CO, USA
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36
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Investigational Antibody–Drug Conjugates for Treatment of B-lineage Malignancies. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2018; 18:452-468.e4. [DOI: 10.1016/j.clml.2018.05.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 05/02/2018] [Accepted: 05/04/2018] [Indexed: 02/01/2023]
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37
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Wight JC, Chong G, Grigg AP, Hawkes EA. Prognostication of diffuse large B-cell lymphoma in the molecular era: moving beyond the IPI. Blood Rev 2018; 32:400-415. [PMID: 29605154 DOI: 10.1016/j.blre.2018.03.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 03/21/2018] [Accepted: 03/22/2018] [Indexed: 12/21/2022]
Abstract
Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous disease with variable outcomes. Despite the majority of patients being cured with combination chemoimmunotherapy, up to 30% eventually succumb to the disease. Until recently, baseline prognostic assessment has centred on the International Prognostic Index (IPI), although this index is yet to impact strongly on treatment choice. Molecular features such as cell of origin, MYC and BCL-2 genetic alterations and protein overexpression were identified over a decade ago, yet their prognostic value is still not fully elucidated. Adding complexity are the plethora of new clinical, biological and molecular prognostic markers described in the recent literature, most of which lack independent validation, likely act as surrogate markers for those already in common use and have yet to substantially impact on therapeutic decision making. This review comprehensively assesses the value of individual prognostic markers in the clinical setting and their potential to predict response to novel agents, and ways to optimise their use in future research.
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Affiliation(s)
- Joel C Wight
- Olivia Newton John Cancer Research and Wellness Centre, Austin Health, Heidelberg, Australia.
| | - Geoffrey Chong
- Olivia Newton John Cancer Research and Wellness Centre, Austin Health, Heidelberg, Australia.
| | - Andrew P Grigg
- Olivia Newton John Cancer Research and Wellness Centre, Austin Health, Heidelberg, Australia; University of Melbourne, Melbourne, Australia.
| | - Eliza A Hawkes
- Olivia Newton John Cancer Research and Wellness Centre, Austin Health, Heidelberg, Australia; University of Melbourne, Melbourne, Australia; Eastern Health, Box Hill, Australia.
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38
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Staudacher AH, Brown MP. Antibody drug conjugates and bystander killing: is antigen-dependent internalisation required? Br J Cancer 2017; 117:1736-1742. [PMID: 29065110 PMCID: PMC5729478 DOI: 10.1038/bjc.2017.367] [Citation(s) in RCA: 263] [Impact Index Per Article: 37.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 08/15/2017] [Accepted: 08/24/2017] [Indexed: 12/14/2022] Open
Abstract
Antibody drug conjugates (ADCs) employ the exquisite specificity of tumour-specific monoclonal antibodies (mAb) for the targeted delivery of highly potent cytotoxic drugs to the tumour site. The chemistry of the linker, which connects the drug to the mAb, determines how and when the drug is released from the mAb. This, as well as the chemistry of the drug, can dictate whether the drug can diffuse into surrounding cells, resulting in 'bystander killing'. Initially, any bystander killing mechanism of action of an ADC was understood to involve an essential sequence of steps beginning with surface antigen targeting, internalisation, intracellular linker cleavage, drug release, and diffusion of drug away from the targeted cell. However, recent studies indicate that, depending on the linker and drug combination, this mechanism may not be essential and ADCs can be cleaved extracellularly or via other mechanisms. In this minireview, we will examine the role of bystander killing by ADCs and explore the emerging evidence of how this can occur independently of internalisation.
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Affiliation(s)
- Alexander H Staudacher
- Translational Oncology Laboratory, Centre for Cancer Biology, SA Pathology and University of South Australia, Adelaide, SA 5000, Australia
- School of Medicine, University of Adelaide, Adelaide, SA 5000, Australia
| | - Michael P Brown
- Translational Oncology Laboratory, Centre for Cancer Biology, SA Pathology and University of South Australia, Adelaide, SA 5000, Australia
- School of Medicine, University of Adelaide, Adelaide, SA 5000, Australia
- Cancer Clinical Trials Unit, Royal Adelaide Hospital, Adelaide, SA 5000, Australia
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39
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Abstract
The antibody-drug conjugate (ADC) field is in a transitional period. Older approaches to conjugate composition and dosing regimens still dominate the ADC clinical pipeline, but preclinical work is driving a rapid evolution in how we strategize to improve efficacy and reduce toxicity towards better therapeutic outcomes. These advances are largely based upon a body of investigational studies that together offer a deeper understanding of the absorption, distribution, metabolism, and excretion (ADME) and drug metabolism and pharmacokinetics (DMPK) fates of both the intact conjugate and its small-molecule component. Knowing where the drug goes and how it is processed allows mechanistic connections to be drawn with commonly observed clinical toxicities. The field is also starting to consider ADC interactions with the immune system and potential synergistic therapeutic opportunities therein. In an indication of future directions for the field, antibody conjugates bearing non-cytotoxic small-molecule payloads are being developed to reduce side effects associated with treatment of chronic diseases. ADCs are not a magic bullet to cure disease. However, they will increasingly become valuable therapeutic tools to improve patient outcomes across a variety of indications.
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Affiliation(s)
- Penelope M Drake
- Catalent Biologics, 5703 Hollis Street, Emeryville, CA, 94608, USA
| | - David Rabuka
- Catalent Biologics, 5703 Hollis Street, Emeryville, CA, 94608, USA.
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40
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Hartley C, Vaughan JW, Jarzembowski J, Kroft SH, Hosking P, Harrington AM, Olteanu H. CD30 Expression in Monomorphic Posttransplant Lymphoproliferative Disorder, Diffuse Large B-Cell Lymphoma Correlates With Greater Regulatory T-Cell Infiltration. Am J Clin Pathol 2017; 148:485-493. [PMID: 29126177 DOI: 10.1093/ajcp/aqx097] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES CD30 is a protein thought to promote cell proliferation/survival and downregulate the immune response. Twenty percent to 40% of de novo diffuse large B-cell lymphomas (DLBCLs) express CD30, and some patients have been treated with the anti-CD30 agent brentuximab. In the solid organ transplant setting, allograft regulatory T cells (Tregs) have been shown to be modulated via CD30 signaling. METHODS Posttransplant lymphoproliferative disorders (PTLDs) constitute a heterogeneous group of lymphomas, and since CD30 expression has been rarely formally assessed in PTLDs, we analyzed a cohort of PTLDs. RESULTS We found that 26 (79%) of 33 PTLDs were CD30+. Of these, 17 (77%) of 22 DLBCL monomorphic PTLDs were CD30+ compared with 56 (38%) of 148 de novo DLBCLs (P = .009). The median FoxP3+ Treg count was higher in CD30+ than in CD30- PTLDs, 3.0 vs 0 (P = .012). CONCLUSIONS These findings suggest a pathophysiologic link between CD30 activity and Tregs and may indicate differential expression of CD30 in B-cell lymphomas arising in the setting of immune dysregulation.
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MESH Headings
- Adult
- Aged
- Epstein-Barr Virus Infections/pathology
- Female
- Humans
- Ki-1 Antigen/metabolism
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/therapy
- Lymphoproliferative Disorders/metabolism
- Lymphoproliferative Disorders/therapy
- Male
- Middle Aged
- Neoplasms, Second Primary/metabolism
- Neoplasms, Second Primary/pathology
- T-Lymphocytes, Regulatory/metabolism
- T-Lymphocytes, Regulatory/pathology
- Young Adult
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Affiliation(s)
| | - James W Vaughan
- Department of Pathology, Medical College of Wisconsin, Milwaukee
| | | | - Steven H Kroft
- Department of Pathology, Medical College of Wisconsin, Milwaukee
| | - Paul Hosking
- Department of Pathology, Medical College of Wisconsin, Milwaukee
| | | | - Horatiu Olteanu
- Department of Pathology, Medical College of Wisconsin, Milwaukee
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41
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Cazzamalli S, Corso AD, Neri D. Targeted Delivery of Cytotoxic Drugs: Challenges, Opportunities and New Developments. Chimia (Aarau) 2017; 71:712-715. [PMID: 29070415 PMCID: PMC5844459 DOI: 10.2533/chimia.2017.712] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Cytotoxic drugs, which are commonly used for the pharmacotherapy of many forms of cancer, often cause substantial toxicity to the patient without being able to induce long-lasting remissions. Ligands specific to accessible tumor-associated targets, capable of selective localization at the neoplastic site, may facilitate the preferential delivery of anti-cancer drugs, boosting activity and helping spare normal organs. In this article, we present a critical analysis of the limitation of conventional anti-cancer drugs and we contrast monoclonal antibodies and small organic ligands, as vehicles for pharmacodelivery applications.
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Affiliation(s)
- Samuele Cazzamalli
- Department of Chemistry and Applied Biosciences Swiss Federal Institute of Technology (ETH Zurich) Vladimir-Prelog-Weg 4, CH-8093 Zurich
| | - Alberto Dal Corso
- Department of Chemistry and Applied Biosciences Swiss Federal Institute of Technology (ETH Zurich) Vladimir-Prelog-Weg 4, CH-8093 Zurich
| | - Dario Neri
- Department of Chemistry and Applied Biosciences Swiss Federal Institute of Technology (ETH Zurich) Vladimir-Prelog-Weg 4, CH-8093 Zurich;,
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42
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Schönberger S, van Beekum C, Götz B, Nettersheim D, Schorle H, Schneider DT, Casati A, Craveiro RB, Calaminus G, Dilloo D. Brentuximab vedotin exerts profound antiproliferative and pro-apoptotic efficacy in CD30-positive as well as cocultured CD30-negative germ cell tumour cell lines. J Cell Mol Med 2017; 22:568-575. [PMID: 28941150 PMCID: PMC5742680 DOI: 10.1111/jcmm.13344] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 07/14/2017] [Indexed: 01/06/2023] Open
Abstract
Prognosis in patients suffering from high‐risk, refractory and relapsed germ cell tumours (GCT) often comprising of CD30‐positive embryonal carcinoma (EC) components remains poor. Thus, novel treatment strategies are warranted. The antibody‐drug conjugate (ADC) brentuximab vedotin delivers the potent antimitotic drug monomethyl auristatin E (MMAE) to CD30‐expressing tumour cells. After CD30 binding, internalization and intracellular linker cleavage cytotoxic MMAE can efflux and eradicate neighbouring CD30‐negative cells. To analyse cytotoxicity and a potential bystander effect of brentuximab vedotin in GCT, we established an in vitro coculture model mimicking GCT of heterogeneous CD30 positivity and measured cell viability, proliferation and apoptosis after exposure to brentuximab vedotin and unbound MMAE by MTS‐ and flow cytometry‐based CFSE/Hoechst assay. CD30 expression being assessed by quantitative RT‐PCR and immunohistochemistry was apparent in all EC cell lines with different intensity. Brentuximab vedotin abrogates cell viability of CD30‐positive GCT27 EC line exerting marked time‐dependent antiproliferative and pro‐apoptotic activity. CD30‐negative JAR cultured alone barely responds to brentuximab vedotin, while in coculture with GCT27 brentuximab vedotin induces clear dose‐dependent cytotoxicity. Cellular proliferation and cell death are significantly enhanced in CD30‐negative JAR cocultured with CD30‐positive GCT27 compared to JAR cultured alone in proof of substantial bystander activity of brentuximab vedotin in CD30‐negative GCT. We present first evidence that in an in vitro model mimicking GCT of heterogeneous histology, brentuximab vedotin exerts potent antiproliferative and pro‐apoptotic activity against both CD30‐positive as well as CD30‐negative GCT subsets. Our results strongly support translational efforts to evaluate clinical efficacy of brentuximab vedotin in high‐risk GCT of heterogeneous CD30 positivity.
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Affiliation(s)
- Stefan Schönberger
- Department of Paediatric Haematology and Oncology, University Children's Hospital Bonn, University of Bonn Medical School, Bonn, Germany
| | - Cornelius van Beekum
- Department of Paediatric Haematology and Oncology, University Children's Hospital Bonn, University of Bonn Medical School, Bonn, Germany
| | - Barbara Götz
- Department of Paediatric Haematology and Oncology, University Children's Hospital Bonn, University of Bonn Medical School, Bonn, Germany
| | - Daniel Nettersheim
- Department of Developmental Pathology, Institute of Pathology, University of Bonn Medical School, Bonn, Germany
| | - Hubert Schorle
- Department of Developmental Pathology, Institute of Pathology, University of Bonn Medical School, Bonn, Germany
| | | | - Anna Casati
- Department of Paediatric Haematology and Oncology, University Children's Hospital Bonn, University of Bonn Medical School, Bonn, Germany
| | - Rogerio B Craveiro
- Department of Paediatric Haematology and Oncology, University Children's Hospital Bonn, University of Bonn Medical School, Bonn, Germany
| | - Gabriele Calaminus
- Department of Paediatric Haematology and Oncology, University Children's Hospital Bonn, University of Bonn Medical School, Bonn, Germany
| | - Dagmar Dilloo
- Department of Paediatric Haematology and Oncology, University Children's Hospital Bonn, University of Bonn Medical School, Bonn, Germany
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43
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van der Weyden CA, Pileri SA, Feldman AL, Whisstock J, Prince HM. Understanding CD30 biology and therapeutic targeting: a historical perspective providing insight into future directions. Blood Cancer J 2017; 7:e603. [PMID: 28885612 PMCID: PMC5709754 DOI: 10.1038/bcj.2017.85] [Citation(s) in RCA: 149] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 07/17/2017] [Accepted: 07/20/2017] [Indexed: 12/12/2022] Open
Abstract
CD30 is a member of the tumor necrosis factor receptor superfamily. It is characteristically expressed in certain hematopoietic malignancies, including anaplastic large cell lymphoma and Hodgkin lymphoma, among others. The variable expression of CD30 on both normal and malignant lymphoid cells has focused research efforts on understanding the pathogenesis of CD30 upregulation, its contribution to lymphomagenesis through anti-apoptotic mechanisms, and its effect on cell survival. Given the restriction of CD30 to certain tumor types, the logical extension of this has been to attempt to exploit it as a therapeutic target. The efficacy of naked anti-CD30 antibodies in practice was, however, modest. Moreover, combinations with bacterial toxins and radioimmunoconjugates have also had limited success. The development of the antibody-drug compound brentuximab vedotin (BV), however, has rejuvenated interest in CD30 as a tumor target. Phase I and II clinical trials in Hodgkin lymphoma, peripheral T-cell lymphoma, cutaneous T cell lymphoma, and even CD30-expressing B-cell lymphomas, have shown the compound is well tolerated, but more importantly, able to deliver meaningful disease control even in patients with multiply relapsed or refractory disease. FDA approval has been granted for its use in relapsed Hodgkin lymphoma and systemic anaplastic large cell lymphoma. A recent phase III trial of BV in cutaneous T-cell lymphoma has confirmed its superiority to standard of care therapies. In this manuscript, we explore the history of CD30 as a tumor marker and as a therapeutic target, both in the laboratory and in the clinic, with a view to understanding future avenues for further study.
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Affiliation(s)
- C A van der Weyden
- Department of Haematology, Peter McCallum Cancer Centre, Melbourne, Victoria, Australia
| | - S A Pileri
- Haematopathology Unit, European Institute of Oncology, Milan, Italy
- Bologna University School of Medicine, Bologna, Italy
| | - A L Feldman
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - J Whisstock
- ARC Centre of Excellence in Advanced Molecular Imaging, Monash University, Clayton, Victoria, Australia
| | - H M Prince
- Department of Haematology, Peter McCallum Cancer Centre, Melbourne, Victoria, Australia
- Epworth Healthcare, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
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44
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Dal Corso A, Gébleux R, Murer P, Soltermann A, Neri D. A non-internalizing antibody-drug conjugate based on an anthracycline payload displays potent therapeutic activity in vivo. J Control Release 2017; 264:211-218. [PMID: 28867376 DOI: 10.1016/j.jconrel.2017.08.040] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 08/25/2017] [Accepted: 08/30/2017] [Indexed: 12/29/2022]
Abstract
Antibody-drug conjugates are generally believed to crucially rely on internalization into cancer cells for therapeutic activity. Here, we show that a non-internalizing antibody-drug conjugate, based on the F16 antibody specific to the alternatively spliced A1 domain of tenascin-C, mediates a potent therapeutic activity when equipped with the anthracycline PNU159682. The peptide linker, connecting the F16 antibody in IgG format at a specific cysteine residue to the drug, was stable in serum but could be efficiently cleaved in the subendothelial extracellular matrix by proteases released by the dying tumor cells. The results indicate that there may be a broader potential applicability of non-internalizing antibody-drug conjugates for cancer therapy than what had previously been assumed.
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Affiliation(s)
- Alberto Dal Corso
- Department of Chemistry and Applied Biosciences, Swiss Federal Institute of Technology (ETH Zürich), Vladimir-Prelog-Weg 4, CH-8093 Zürich, Switzerland
| | - Rémy Gébleux
- Department of Chemistry and Applied Biosciences, Swiss Federal Institute of Technology (ETH Zürich), Vladimir-Prelog-Weg 4, CH-8093 Zürich, Switzerland
| | - Patrizia Murer
- Department of Chemistry and Applied Biosciences, Swiss Federal Institute of Technology (ETH Zürich), Vladimir-Prelog-Weg 4, CH-8093 Zürich, Switzerland
| | - Alex Soltermann
- Institute of Pathology, University Hospital Zurich, Schmelzbergstrasse 12, CH-8091 Zurich, Switzerland
| | - Dario Neri
- Department of Chemistry and Applied Biosciences, Swiss Federal Institute of Technology (ETH Zürich), Vladimir-Prelog-Weg 4, CH-8093 Zürich, Switzerland.
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45
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Absalon MJ, Khoury RA, Phillips CL. Post-transplant lymphoproliferative disorder after solid-organ transplant in children. Semin Pediatr Surg 2017; 26:257-266. [PMID: 28964482 DOI: 10.1053/j.sempedsurg.2017.07.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The post-transplant lymphoproliferative disorders (PTLD) are a diverse group of potentially life-threatening conditions affecting organ transplant recipients. PTLD arises in the setting of an attenuated host immunologic system that is manipulated to allow a foreign graft but then fails to provide adequate immune surveillance of transformed malignant or premalignant lymphocytes. The diversity of biological behavior and clinical presentation makes for a challenging clinical situation for those involved in the care of children with PTLD occurring after solid-organ transplantation. This review details a large transplant center's multidisciplinary approach to monitoring for PTLD and systematic approach to intervention, which has been essential for early recognition and successful treatment.
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Affiliation(s)
- Michael J Absalon
- Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 7018, Cincinnati, Ohio 45229.
| | - Ruby A Khoury
- Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 7018, Cincinnati, Ohio 45229
| | - Christine L Phillips
- Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 7018, Cincinnati, Ohio 45229
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46
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Chen R. Is CD30 a predictive biomarker for brentuximab vedotin? Leuk Lymphoma 2017; 58:1524-1525. [DOI: 10.1080/10428194.2017.1283687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Robert Chen
- Department of Hematology/HCT, City of Hope Medical Center, Duarte, CA, USA
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