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Bansal G, Ghanem M, Sears KT, Galen JE, Tennant SM. Genetic engineering of Salmonella spp. for novel vaccine strategies and therapeutics. EcoSal Plus 2024:eesp00042023. [PMID: 39023252 DOI: 10.1128/ecosalplus.esp-0004-2023] [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: 02/16/2024] [Accepted: 06/24/2024] [Indexed: 07/20/2024]
Abstract
Salmonella enterica is a diverse species that infects both humans and animals. S. enterica subspecies enterica consists of more than 1,500 serovars. Unlike typhoidal Salmonella serovars which are human host-restricted, non-typhoidal Salmonella (NTS) serovars are associated with foodborne illnesses worldwide and are transmitted via the food chain. Additionally, NTS serovars can cause disease in livestock animals causing significant economic losses. Salmonella is a well-studied model organism that is easy to manipulate and evaluate in animal models of infection. Advances in genetic engineering approaches in recent years have led to the development of Salmonella vaccines for both humans and animals. In this review, we focus on current progress of recombinant live-attenuated Salmonella vaccines, their use as a source of antigens for parenteral vaccines, their use as live-vector vaccines to deliver foreign antigens, and their use as therapeutic cancer vaccines in humans. We also describe development of live-attenuated Salmonella vaccines and live-vector vaccines for use in animals.
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Affiliation(s)
- Garima Bansal
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Mostafa Ghanem
- Department of Veterinary Medicine, Virginia-Maryland College of Veterinary Medicine, University of Maryland, College Park, Maryland, USA
| | - Khandra T Sears
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - James E Galen
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Sharon M Tennant
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
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Schneider AK, Domingos-Pereira S, Cesson V, Polak L, Fallon PG, Zhu J, Roth B, Nardelli-Haefliger D, Derré L. Type 2 innate lymphoid cells are not involved in mouse bladder tumor development. Front Immunol 2024; 14:1335326. [PMID: 38283350 PMCID: PMC10820705 DOI: 10.3389/fimmu.2023.1335326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 12/20/2023] [Indexed: 01/30/2024] Open
Abstract
Therapies for bladder cancer patients are limited by side effects and failures, highlighting the need for novel targets to improve disease management. Given the emerging evidence highlighting the key role of innate lymphoid cell subsets, especially type 2 innate lymphoid cells (ILC2s), in shaping the tumor microenvironment and immune responses, we investigated the contribution of ILC2s in bladder tumor development. Using the orthotopic murine MB49 bladder tumor model, we found a strong enrichment of ILC2s in the bladder under steady-state conditions, comparable to that in the lung. However, as tumors grew, we observed an increase in ILC1s but no changes in ILC2s. Targeting ILC2s by blocking IL-4/IL-13 signaling pathways, IL-5, or IL-33 receptor, or using IL-33-deficient or ILC2-deficient mice, did not affect mice survival following bladder tumor implantation. Overall, these results suggest that ILC2s do not contribute significantly to bladder tumor development, yet further investigations are required to confirm these results in bladder cancer patients.
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Affiliation(s)
- Anna K Schneider
- Urology Research Unit and Urology Biobank, Department of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Sonia Domingos-Pereira
- Urology Research Unit and Urology Biobank, Department of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Valérie Cesson
- Urology Research Unit and Urology Biobank, Department of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Lenka Polak
- Urology Research Unit and Urology Biobank, Department of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Padraic G Fallon
- School of Medicine, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Jinfang Zhu
- Molecular and Cellular Immunoregulation Section, Laboratory of Immune System Biology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States
| | - Beat Roth
- Urology Research Unit and Urology Biobank, Department of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Denise Nardelli-Haefliger
- Urology Research Unit and Urology Biobank, Department of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Laurent Derré
- Urology Research Unit and Urology Biobank, Department of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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3
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Derré L, Lucca I, Cesson V, Bohner P, Crettenand F, Rodrigues-Dias SC, Dartiguenave F, Masnada A, Teixeira-Pereira C, Benmerzoug S, Chevalier MF, Domingos-Pereira S, Nguyen S, Polak L, Schneider AK, Jichlinski P, Roth B, Nardelli-Haefliger D. Intravesical Ty21a treatment of non-muscle invasive bladder cancer induces immune responses that correlate with safety and may be associated to therapy potential. J Immunother Cancer 2023; 11:e008020. [PMID: 38101861 PMCID: PMC10729085 DOI: 10.1136/jitc-2023-008020] [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] [Accepted: 11/30/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Standard of care treatment of non-muscle invasive bladder cancer (NMIBC) with intravesical Bacillus Calmette Guérin (BCG) is associated with side effects, disease recurrence/progression and supply shortages. We recently showed in a phase I trial (NCT03421236) that intravesical instillation in patients with NMIBC with the maximal tolerated dose of Ty21a/Vivotif, the oral vaccine against typhoid fever, might have a better safety profile. In the present report, we assessed the immunogenicity of intravesical Ty21a in patients of the clinical trial that had received the maximal tolerated dose and compared it with data obtained in patients that had received standard BCG. METHODS Urinary cytokines and immune cells of patients with NMIBC treated with intravesical instillations of Ty21a (n=13, groups A and F in NCT03421236) or with standard BCG in a concomitant observational study (n=12, UROV1) were determined by Luminex and flow cytometry, respectively. Serum anti-lipopolysaccharide Typhi antibodies and circulating Ty21a-specific T-cell responses were also determined in the Ty21a patients. Multiple comparisons of different paired variables were performed with a mixed-effect analysis, followed by Sidak post-test. Single comparisons were performed with a paired or an unpaired Student's t-test. RESULTS As compared with BCG, Ty21a induced lower levels of inflammatory urinary cytokines, which correlated to the milder adverse events (AEs) observed in Ty21a patients. However, both Ty21a and BCG induced a Th1 tumor environment. Peripheral Ty21a-specific T-cell responses and/or antibodies were observed in most Ty21a patients, pointing the bladder as an efficient local immune inductive site. Besides, Ty21a-mediated stimulation of unconventional Vδ2 T cells was also observed, which turned out more efficient than BCG. Finally, few Ty21a instillations were sufficient for increasing urinary infiltration of dendritic cells and T cells, which were previously associated with therapeutic efficacy in the orthotopic mouse model of NMIBC. CONCLUSIONS Ty21a immunotherapy of patient with NMIBC is promising with fewer inflammatory cytokines and mild AE, but induction of immune responses with possible antitumor potentials. Future phase II clinical trials are necessary to explore possible efficacy of intravesical Ty21a.
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Affiliation(s)
- Laurent Derré
- Urology Research Unit and Urology Biobank, Deptment of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Vaud, Switzerland
| | - Ilaria Lucca
- Urology Research Unit and Urology Biobank, Deptment of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Vaud, Switzerland
| | - Valérie Cesson
- Urology Research Unit and Urology Biobank, Deptment of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Vaud, Switzerland
| | - Perrine Bohner
- Urology Research Unit and Urology Biobank, Deptment of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Vaud, Switzerland
| | - Francois Crettenand
- Urology Research Unit and Urology Biobank, Deptment of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Vaud, Switzerland
| | - Sonia-Cristina Rodrigues-Dias
- Urology Research Unit and Urology Biobank, Deptment of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Vaud, Switzerland
| | - Florence Dartiguenave
- Urology Research Unit and Urology Biobank, Deptment of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Vaud, Switzerland
| | - Audrey Masnada
- Urology Research Unit and Urology Biobank, Deptment of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Vaud, Switzerland
| | - Carla Teixeira-Pereira
- Urology Research Unit and Urology Biobank, Deptment of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Vaud, Switzerland
| | - Sulayman Benmerzoug
- Urology Research Unit and Urology Biobank, Deptment of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Vaud, Switzerland
| | - Mathieu F Chevalier
- Urology Research Unit and Urology Biobank, Deptment of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Vaud, Switzerland
| | - Sonia Domingos-Pereira
- Urology Research Unit and Urology Biobank, Deptment of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Vaud, Switzerland
| | - Sylvain Nguyen
- Urology Research Unit and Urology Biobank, Deptment of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Vaud, Switzerland
| | - Lenka Polak
- Urology Research Unit and Urology Biobank, Deptment of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Vaud, Switzerland
| | - Anna K Schneider
- Urology Research Unit and Urology Biobank, Deptment of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Vaud, Switzerland
| | - Patrice Jichlinski
- Urology Research Unit and Urology Biobank, Deptment of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Vaud, Switzerland
| | - Beat Roth
- Urology Research Unit and Urology Biobank, Deptment of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Vaud, Switzerland
| | - Denise Nardelli-Haefliger
- Urology Research Unit and Urology Biobank, Deptment of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Vaud, Switzerland
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Tumor-Microenvironment Characterization of the MB49 Non-Muscle-Invasive Bladder-Cancer Orthotopic Model towards New Therapeutic Strategies. Int J Mol Sci 2022; 24:ijms24010123. [PMID: 36613562 PMCID: PMC9820528 DOI: 10.3390/ijms24010123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/15/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Bacillus Calmette-Guérin (BCG) instillations for the treatment of non-muscle-invasive bladder cancer patients can result in significant side effects and treatment failure. Immune checkpoint blockade and/or decreasing tumor-infiltrating myeloid suppressor cells may be alternative or complementary treatments. Here, we have characterized immune cell infiltration and chemoattractant molecules in mouse orthotopic MB49 bladder tumors. Our data show a 100-fold increase in CD45+ immune cells from day 5 to day 9 tumors including T cells and mainly myeloid cells. Both monocytic myeloid-derived suppressor-cells (M-MDSC) and polymorphonuclear (PMN)-MDSC were strongly increased in day 9 tumors, with PMN-MDSC representing ca. 70% of the myeloid cells in day 12 tumors, while tumor associated macrophages (TAM) were only modestly increased. The kinetic of PD-L1 tumor expression correlated with published data from patients with PD-L1 expressing bladder tumors and with efficacy of anti-PD-1 treatment, further validating the orthotopic MB49 bladder-tumor model as suitable for designing novel therapeutic strategies. Comparison of chemoattractants expression during MB49 bladder tumors grow highlighted CCL8 and CCL12 (CCR2-ligands), CCL9 and CCL6 (CCR-1-ligands), CXCL2 and CXCL5 (CXCR2-ligands), CXCL12 (CXCR4-ligand) and antagonist of C5/C5a as potential targets to decrease myeloid suppressive cells. Data obtained with a single CCR2 inhibitor however showed that the complex chemokine crosstalk would require targeting multiple chemokines for anti-tumor efficacy.
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Lucca I, Derré L, Cesson V, Bohner P, Crettenand F, Rodrigues-Dias S, Dartiguenave F, Masnada A, Texeira-Pereira C, Benmerzoug S, Chevalier M, Domingos-Pereira S, Nguyen S, Polak L, Schneider A, Roth B, Jichlinski P, Nardelli-Haefliger D. Intravesical Ty21a Treatment of Non-muscle-invasive Bladder Cancer Shows a Good Safety Profile. EUR UROL SUPPL 2022; 45:55-58. [PMID: 36212980 PMCID: PMC9539774 DOI: 10.1016/j.euros.2022.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2022] [Indexed: 11/05/2022] Open
Abstract
Standard-of-care immunotherapy for non–muscle-invasive bladder cancer (NMIBC) with intravesical Bacillus Calmettte-Guérin (BCG) is associated with adverse events (AEs), disease recurrence/progression, and supply shortages. Preclinical data have shown that intravesical instillation of Ty21a/Vivotif, the oral vaccine against typhoid fever, may be an effective and safer alternative to BCG. We assessed the safety of intravesical Ty21a in NMIBC. For ethical reasons, patients with low- or intermediate-risk NMIBC not requiring BCG immunotherapy were enrolled. To determine the maximum tolerated dose, escalating doses of Ty21a/Vivotif were intravesically instilled in three patients once a week for 4 wk in phase 1a. In phase 1b, ten patients received the selected dose (1 × 108 CFU) once a week for 6 wk, as for standard BCG therapy. At this dose, all patients completed their treatment. Most patients experienced minor systemic AEs, while half reported mild local bladder AEs. AEs only occurred after one or two instillations for 40% of the patients. Ty21a bacteria were only recovered in three out of 72 urinary samples at 1 wk after instillation. Intravesical Ty21a might be well tolerated with no cumulative side effects, no fever >39 °C, and lower risk of bacterial persistence than with BCG. Ty21a treatment thus warrants clinical trials to explore its safety and antitumor efficacy in high-risk NMIBC. This trial is registered on ClinicalTrials.gov as NCT03421236. Patient summary We examined the safety of a new intra-bladder immunotherapy for non–muscle-invasive bladder cancer as an alternative to the standard BCG treatment. Our data show that the Ty21a vaccine might be well tolerated. Further studies are needed to determine the safety and antitumor efficacy of this treatment.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Denise Nardelli-Haefliger
- Corresponding author. Department of Urology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Bugnon 48, 1011 Lausanne, Switzerland. Tel. 021 3144081; Fax: 021 3144060.
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Lu Y, Yuan X, Wang M, He Z, Li H, Wang J, Li Q. Gut microbiota influence immunotherapy responses: mechanisms and therapeutic strategies. J Hematol Oncol 2022; 15:47. [PMID: 35488243 PMCID: PMC9052532 DOI: 10.1186/s13045-022-01273-9] [Citation(s) in RCA: 143] [Impact Index Per Article: 71.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 04/20/2022] [Indexed: 12/12/2022] Open
Abstract
The gut microbiota have long been recognized to play a key role in human health and disease. Currently, several lines of evidence from preclinical to clinical research have gradually established that the gut microbiota can modulate antitumor immunity and affect the efficacy of cancer immunotherapies, especially immune checkpoint inhibitors (ICIs). Deciphering the underlying mechanisms reveals that the gut microbiota reprogram the immunity of the tumor microenvironment (TME) by engaging innate and/or adaptive immune cells. Notably, one of the primary modes by which the gut microbiota modulate antitumor immunity is by means of metabolites, which are small molecules that could spread from their initial location of the gut and impact local and systemic antitumor immune response to promote ICI efficiency. Mechanistic exploration provides novel insights for developing rational microbiota-based therapeutic strategies by manipulating gut microbiota, such as fecal microbiota transplantation (FMT), probiotics, engineered microbiomes, and specific microbial metabolites, to augment the efficacy of ICI and advance the age utilization of microbiota precision medicine.
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Affiliation(s)
- Yuting Lu
- Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Xiangliang Yuan
- Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Miao Wang
- Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Zhihao He
- Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Hongzhong Li
- Chongqing Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Ji Wang
- National Institute of TCM Constitution and Preventive Medicine, Beijing University of Chinese Medicine, Beijing, 100029, China.
| | - Qin Li
- Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.
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Targeting Endothelial Connexin37 Reduces Angiogenesis and Decreases Tumor Growth. Int J Mol Sci 2022; 23:ijms23062930. [PMID: 35328350 PMCID: PMC8948817 DOI: 10.3390/ijms23062930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 02/28/2022] [Accepted: 03/03/2022] [Indexed: 12/13/2022] Open
Abstract
Connexin37 (Cx37) and Cx40 form intercellular channels between endothelial cells (EC), which contribute to the regulation of the functions of vessels. We previously documented the participation of both Cx in developmental angiogenesis and have further shown that loss of Cx40 decreases the growth of different tumors. Here, we report that loss of Cx37 reduces (1) the in vitro proliferation of primary human EC; (2) the vascularization of subcutaneously implanted matrigel plugs in Cx37−/− mice or in WT using matrigel plugs supplemented with a peptide targeting Cx37 channels; (3) tumor angiogenesis; and (4) the growth of TC-1 and B16 tumors, resulting in a longer mice survival. We further document that Cx37 and Cx40 function in a collaborative manner to promote tumor growth, inasmuch as the injection of a peptide targeting Cx40 into Cx37−/− mice decreased the growth of TC-1 tumors to a larger extent than after loss of Cx37. This loss did not alter vessel perfusion, mural cells coverage and tumor hypoxia compared to tumors grown in WT mice. The data show that Cx37 is relevant for the control of EC proliferation and growth in different tumor models, suggesting that it may be a target, alone or in combination with Cx40, in the development of anti-tumoral treatments.
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Lobo N, Martini A, Kamat AM. Evolution of immunotherapy in the treatment of non-muscle-invasive bladder cancer. Expert Rev Anticancer Ther 2022; 22:361-370. [PMID: 35212590 DOI: 10.1080/14737140.2022.2046466] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Immunotherapy with intravesical bacillus Calmette-Guérin (BCG) has been the gold standard treatment for intermediate- and high-risk non-muscle-invasive bladder cancer (NMIBC) for nearly half a century. Yet, many patients with high-risk disease will experience recurrence, including those who progress and eventually become unresponsive to BCG. For decades, apart from radical cystectomy, few therapeutic options existed for this at-risk population. However, the advent of novel immunotherapeutic agents has transformed treatment in a range of tumour types, including urothelial carcinoma. These immunotherapies have yielded promising results in the treatment of metastatic urothelial carcinoma and, as such, are also being investigated for use in NIMIBC. AREAS COVERED This article provides an overview of the evolution of immunotherapy for NMIBC, beginning from the original immunotherapy- BCG - to current agents including checkpoint inhibitors, IL-15 agonists, viral gene therapies and therapeutic cancer vaccines. EXPERT OPINION The KEYNOTE-057 trial represented a pivotal moment for immunotherapy in NMIBC, but patient selection and the development of biomarkers to guide the identification of patients who will benefit most from a particular immunotherapy remains critical. As research efforts come to fruition, novel immunotherapies may become integrated into the standard treatment paradigm for intermediate- and high-risk NMBIC.
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Affiliation(s)
- Niyati Lobo
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Alberto Martini
- Department of Urology, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Ashish M Kamat
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Non-muscle-invasive bladder cancer: An overview of potential new treatment options. Urol Oncol 2021; 39:642-663. [PMID: 34167873 DOI: 10.1016/j.urolonc.2021.05.015] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/29/2021] [Accepted: 05/09/2021] [Indexed: 01/22/2023]
Abstract
AIM This review article summarizes the current clinical practice guidelines around disease definitions and risk stratifications, and the treatment of non-muscle-invasive bladder cancer (NMIBC). Recently completed and ongoing clinical trials of novel and investigational therapies in Bacillus Calmette-Guérin (BCG)-naïve, BCG-recurrent, and BCG-unresponsive patient populations are also described, e.g., those involving immune checkpoint inhibitors, targeted therapies, other chemotherapy regimens, vaccines, and viral- or bacterial-based treatments. Finally, a brief overview of enhanced cystoscopy and drug delivery systems for the diagnosis and treatment of NMIBC is provided. BACKGROUND A global shortage of access to BCG is affecting the management of BCG-naïve and BCG-recurrent/unresponsive NMIBC; hence, there is an urgent need to assist patients and urologists to enhance the treatment of this disease. METHODS Searches of ClinicalTrials.gov, PubMed, and Google Scholar were conducted. Published guidance and conference proceedings from major congresses were reviewed. CONCLUSION Treatment strategies for NMIBC are generally consistent across guidelines. Several novel therapies have demonstrated promising antitumor activity in clinical trials, including in high-risk or BCG-unresponsive disease. The detection, diagnosis, surveillance, and treatment of NMIBC have also been improved through enhanced disease detection.
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Vandeborne L, Pantziarka P, Van Nuffel AMT, Bouche G. Repurposing Infectious Diseases Vaccines Against Cancer. Front Oncol 2021; 11:688755. [PMID: 34055652 PMCID: PMC8155725 DOI: 10.3389/fonc.2021.688755] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 04/27/2021] [Indexed: 11/30/2022] Open
Abstract
Vaccines used to prevent infections have long been known to stimulate immune responses to cancer as illustrated by the approval of the Bacillus Calmette-Guérin (BCG) vaccine to treat bladder cancer since the 1970s. The recent approval of immunotherapies has rejuvenated this research area with reports of anti-tumor responses with existing infectious diseases vaccines used as such, either alone or in combination with immune checkpoint inhibitors. Here, we have reviewed and summarized research activities using approved vaccines to treat cancer. Data supporting a cancer therapeutic use was found for 16 vaccines. For 10 (BCG, diphtheria, tetanus, human papillomavirus, influenza, measles, pneumococcus, smallpox, typhoid and varicella-zoster), clinical trials have been conducted or are ongoing. Within the remaining 6, preclinical evidence supports further evaluation of the rotavirus, yellow fever and pertussis vaccine in carefully designed clinical trials. The mechanistic evidence for the cholera vaccine, combined with the observational data in colorectal cancer, is also supportive of clinical translation. There is limited data for the hepatitis B and mumps vaccine (without measles vaccine). Four findings are worth highlighting: the superiority of intravesical typhoid vaccine instillations over BCG in a preclinical bladder cancer model, which is now the subject of a phase I trial; the perioperative use of the influenza vaccine to limit and prevent the natural killer cell dysfunction induced by cancer surgery; objective responses following intratumoral injections of measles vaccine in cutaneous T-cell lymphoma; objective responses induced by human papillomavirus vaccine in cutaneous squamous cell carcinoma. All vaccines are intended to induce or improve an anti-tumor (immune) response. In addition to the biological and immunological mechanisms that vary between vaccines, the mode of administration and sequence with other (immuno-)therapies warrant more attention in future research.
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11
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Kines RC, Thompson CD, Spring S, Li Z, de Los Pinos E, Monks S, Schiller JT. Virus-Like Particle-Drug Conjugates Induce Protective, Long-lasting Adaptive Antitumor Immunity in the Absence of Specifically Targeted Tumor Antigens. Cancer Immunol Res 2021; 9:693-706. [PMID: 33853825 DOI: 10.1158/2326-6066.cir-19-0974] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 12/24/2020] [Accepted: 04/07/2021] [Indexed: 12/30/2022]
Abstract
This study examined the ability of a papillomavirus-like particle drug conjugate, belzupacap sarotalocan (AU-011), to eradicate subcutaneous tumors after intravenous injection and to subsequently elicit long-term antitumor immunity in the TC-1 syngeneic murine tumor model. Upon in vitro activation with near-infrared light (NIR), AU-011-mediated cell killing was proimmunogenic in nature, resulting in the release of damage-associated molecular patterns such as DNA, ATP, and HMGB-1, activation of caspase-1, and surface relocalization of calreticulin and HSP70 on killed tumor cells. A single in vivo administration of AU-011 followed by NIR caused rapid cell death, leading to long-term tumor regression in ∼50% of all animals. Within hours of treatment, calreticulin surface expression, caspase-1 activation, and depletion of immunosuppressive leukocytes were observed in tumors. Combination of AU-011 with immune-checkpoint inhibitor antibodies, anti-CTLA-4 or anti-PD-1, improved therapeutic efficacy, resulting in 70% to 100% complete response rate that was durable 100 days after treatment, with 50% to 80% of those animals displaying protection from secondary tumor rechallenge. Depletion of CD4+ or CD8+ T cells, either at the time of AU-011 treatment or secondary tumor rechallenge of tumor-free mice, indicated that both cell populations are vital to AU-011's ability to eradicate primary tumors and induce long-lasting antitumor protection. Tumor-specific CD8+ T-cell responses could be observed in circulating peripheral blood mononuclear cells within 3 weeks of AU-011 treatment. These data, taken together, support the conclusion that AU-011 has a direct cytotoxic effect on tumor cells and induces long-term antitumor immunity, and this activity is enhanced when combined with checkpoint inhibitor antibodies.
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Affiliation(s)
| | - Cynthia D Thompson
- Laboratory of Cellular Oncology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | | | - Zhenyu Li
- Aura Biosciences, Cambridge, Massachusetts
| | | | | | - John T Schiller
- Laboratory of Cellular Oncology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
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Burggraaf MJ, Waanders L, Verlaan M, Maaskant J, Houben D, Luirink J, Bitter W, Kuijl C, Molthoff CF. Surface Labeling with Adhesion Protein FimH Improves Binding of Immunotherapeutic Agent Salmonella Ty21a to the Bladder Epithelium. Bladder Cancer 2021; 7:79-90. [PMID: 38993217 PMCID: PMC11181684 DOI: 10.3233/blc-200382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 11/16/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND Bladder cancer is the ninth most common cancer in men. 70% of these tumors are classified as non-muscle invasive bladder cancer and those patients receive 6 intravesical instillations with Mycobacterium bovis BCG after transurethral resection. However, 30% of patients show recurrences after treatment and experience severe side effects that often lead to therapy discontinuation. Recently, another vaccine strain, Salmonella enterica typhi Ty21a, demonstrated promising antitumor activity in vivo. Here we focus on increasing bacterial retention in the bladder in order to reduce the number of instillations required and improve antitumor activity. OBJECTIVE To increase the binding of Ty21a to the bladder wall by surface labeling of the bacteria with adhesion protein FimH and to study its effect in a bladder cancer mouse model. METHODS Binding of Ty21a with surface-labeled FimH to the bladder wall was analyzed in vitro and in vivo. The antitumor effect of a single instillation of Ty21a+FimH in treatment was determined in a survival experiment. RESULTS FimH-labeled Ty21a showed significant (p < 0.0001) improved binding to mouse and human cell lines in vitro. Furthermore, FimH labeled bacteria showed ∼5x more binding to the bladder than controls in vivo. Enhanced binding to the bladder via FimH labeling induced a modest improvement in median but not in overall mice survival. CONCLUSIONS FimH labeling of Ty21a significantly improved binding to bladder tumor cells in vitro and the bladder wall in vivo. The improved binding leads to a modest increase in median survival in a single bladder cancer mouse study.
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Affiliation(s)
- Maroeska J. Burggraaf
- Department of Medical Microbiology and Infection Control, Amsterdam University Medical Center (AUMC), Location VU Medical Center (VUMC), Amsterdam, The Netherlands
| | - Lisette Waanders
- Department of Medical Microbiology and Infection Control, Amsterdam University Medical Center (AUMC), Location VU Medical Center (VUMC), Amsterdam, The Netherlands
| | - Mariska Verlaan
- Department of Radiology & Nuclear Medicine, Amsterdam University Medical Center (AUMC), Location VU Medical Center (VUMC), Amsterdam, The Netherlands
| | - Janneke Maaskant
- Department of Medical Microbiology and Infection Control, Amsterdam University Medical Center (AUMC), Location VU Medical Center (VUMC), Amsterdam, The Netherlands
| | - Diane Houben
- Section Molecular Microbiology, AIMMS, Vrije Universiteit, Amsterdam, The Netherlands
| | | | - Wilbert Bitter
- Department of Medical Microbiology and Infection Control, Amsterdam University Medical Center (AUMC), Location VU Medical Center (VUMC), Amsterdam, The Netherlands
- Section Molecular Microbiology, AIMMS, Vrije Universiteit, Amsterdam, The Netherlands
| | - Coen Kuijl
- Department of Medical Microbiology and Infection Control, Amsterdam University Medical Center (AUMC), Location VU Medical Center (VUMC), Amsterdam, The Netherlands
| | - Carla F.M. Molthoff
- Department of Radiology & Nuclear Medicine, Amsterdam University Medical Center (AUMC), Location VU Medical Center (VUMC), Amsterdam, The Netherlands
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13
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Wang S, Jin S, Shu Q, Wu S. Strategies to Get Drugs across Bladder Penetrating Barriers for Improving Bladder Cancer Therapy. Pharmaceutics 2021; 13:166. [PMID: 33513793 PMCID: PMC7912621 DOI: 10.3390/pharmaceutics13020166] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 01/21/2021] [Accepted: 01/21/2021] [Indexed: 12/20/2022] Open
Abstract
Bladder cancer is a significant public health concern and social burden due to its high recurrence risk. Intravesical drug instillation is the primary therapy for bladder cancer to prevent recurrence. However, the intravesical drug therapeutic effect is limited by bladder penetrating barriers. The inadequate intravesical treatment might cause the low drug concentration in lesions, resulting in a high recurrence/progression rate of bladder cancer. Many strategies to get drugs across bladder penetrating barriers have been developed to improve intravesical treatment, including physical and chemical methods. This review summarizes the classical and updated literature and presents insights into great therapeutic potential strategies to overcome bladder penetrating barriers for improving the intravesical treatment of bladder cancer.
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Affiliation(s)
- Shupeng Wang
- School of Material Science and Engineering, Beijing Institute of Technology, Beijing 100081, China; (S.W.); (S.J.)
| | - Shaohua Jin
- School of Material Science and Engineering, Beijing Institute of Technology, Beijing 100081, China; (S.W.); (S.J.)
| | - Qinghai Shu
- School of Material Science and Engineering, Beijing Institute of Technology, Beijing 100081, China; (S.W.); (S.J.)
| | - Song Wu
- School of Medicine, Shenzhen University, Shenzhen 518000, China
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14
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Moussa M, Papatsoris AG, Dellis A, Abou Chakra M, Saad W. Novel anticancer therapy in BCG unresponsive non-muscle-invasive bladder cancer. Expert Rev Anticancer Ther 2020; 20:965-983. [PMID: 32915676 DOI: 10.1080/14737140.2020.1822743] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Many patients with non-muscle-invasive bladder cancer (NMIBC) failed intravesical BCG therapy. Currently, radical cystectomy is the recommended standard of care for those patients. There is unfortunately no effective other second-line therapy recommended. AREAS COVERED In this review, we present the topics of BCG unresponsive NMIBC; definition, prognosis, and further treatment options: immunotherapy, intravesical chemotherapy, gene therapy, and targeted individualized therapy. EXPERT OPINION There are major challenges of the management of NMIBC who failed BCG therapy as many patients refuse or are unfit for radical cystectomy. Multiple new modalities currently under investigation in ongoing clinical trials to better treat this category of patients. Immunotherapy, especially PD-1/PD-L1 inhibitors, offers exciting and potentially effective strategies for the treatment of BCG unresponsive NMIBC. As the data expands, it is sure that soon there will be established new guidelines for NMIBC.
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Affiliation(s)
- Mohamad Moussa
- Head of Urology Department, Zahraa Hospital, University Medical Center, Lebanese University , Beirut, Lebanon
| | - Athanasios G Papatsoris
- 2nd Department of Urology, School of Medicine, Sismanoglio Hospital, National and Kapodistrian University of Athens , Athens, Greece
| | - Athanasios Dellis
- Department of Surgery, School of Medicine, Aretaieion Hospital, National and Kapodistrian University of Athens , Athens, Greece
| | - Mohamed Abou Chakra
- Faculty of Medical Sciences, Department of Urology, Lebanese University , Beirut,Lebanon
| | - Wajih Saad
- Head of Oncology Department, Zahraa Hospital, University Medical Center, Lebanese University , Beirut, Lebanon
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15
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Bach-Griera M, Campo-Pérez V, Barbosa S, Traserra S, Guallar-Garrido S, Moya-Andérico L, Herrero-Abadía P, Luquin M, Rabanal RM, Torrents E, Julián E. Mycolicibacterium brumae Is a Safe and Non-Toxic Immunomodulatory Agent for Cancer Treatment. Vaccines (Basel) 2020; 8:E198. [PMID: 32344808 PMCID: PMC7349652 DOI: 10.3390/vaccines8020198] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 04/17/2020] [Accepted: 04/22/2020] [Indexed: 12/11/2022] Open
Abstract
Intravesical Mycobacterium bovis Bacillus Calmette-Guérin (BCG) immunotherapy remains the gold-standard treatment for non-muscle-invasive bladder cancer patients, even though half of the patients develop adverse events to this therapy. On exploring BCG-alternative therapies, Mycolicibacterium brumae, a nontuberculous mycobacterium, has shown outstanding anti-tumor and immunomodulatory capabilities. As no infections due to M. brumae in humans, animals, or plants have been described, the safety and/or toxicity of this mycobacterium have not been previously addressed. In the present study, an analysis was made of M. brumae- and BCG-intravenously-infected severe combined immunodeficient (SCID) mice, M. brumae-intravesically-treated BALB/c mice, and intrahemacoelic-infected-Galleria mellonella larvae. Organs from infected mice and the hemolymph from larvae were processed to count bacterial burden. Blood samples from mice were also taken, and a wide range of hematological and biochemical parameters were analyzed. Finally, histopathological alterations in mouse tissues were evaluated. Our results demonstrate the safety and non-toxic profile of M. brumae. Differences were observed in the biochemical, hematological and histopathological analysis between M. brumae and BCG-infected mice, as well as survival curves rates and colony forming units (CFU) counts in both animal models. M. brumae constitutes a safe therapeutic biological agent, overcoming the safety and toxicity disadvantages presented by BCG in both mice and G. mellonella animal models.
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Affiliation(s)
- Marc Bach-Griera
- Departament de Genètica i de Microbiologia, Facultat de Biociències, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain; (M.B.-G.); (V.C.-P.); (S.G.-G.); (P.H.-A.); (M.L.)
| | - Víctor Campo-Pérez
- Departament de Genètica i de Microbiologia, Facultat de Biociències, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain; (M.B.-G.); (V.C.-P.); (S.G.-G.); (P.H.-A.); (M.L.)
- Bacterial Infections and Antimicrobial Therapies group, Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology (BIST), 08028 Barcelona, Spain; (L.M.-A.); (E.T.)
| | - Sandra Barbosa
- Department of Cell Biology, Physiology and Immunology, Facultat de Veterinària, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain; (S.B.); (S.T.)
- Integrated Services of Laboratory Animals, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - Sara Traserra
- Department of Cell Biology, Physiology and Immunology, Facultat de Veterinària, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain; (S.B.); (S.T.)
- Integrated Services of Laboratory Animals, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - Sandra Guallar-Garrido
- Departament de Genètica i de Microbiologia, Facultat de Biociències, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain; (M.B.-G.); (V.C.-P.); (S.G.-G.); (P.H.-A.); (M.L.)
| | - Laura Moya-Andérico
- Bacterial Infections and Antimicrobial Therapies group, Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology (BIST), 08028 Barcelona, Spain; (L.M.-A.); (E.T.)
| | - Paula Herrero-Abadía
- Departament de Genètica i de Microbiologia, Facultat de Biociències, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain; (M.B.-G.); (V.C.-P.); (S.G.-G.); (P.H.-A.); (M.L.)
| | - Marina Luquin
- Departament de Genètica i de Microbiologia, Facultat de Biociències, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain; (M.B.-G.); (V.C.-P.); (S.G.-G.); (P.H.-A.); (M.L.)
| | - Rosa Maria Rabanal
- Unitat de Patologia Murina i Comparada, Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain;
| | - Eduard Torrents
- Bacterial Infections and Antimicrobial Therapies group, Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology (BIST), 08028 Barcelona, Spain; (L.M.-A.); (E.T.)
- Microbiology Section, Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, 643 Diagonal Ave., 08028 Barcelona, Spain
| | - Esther Julián
- Departament de Genètica i de Microbiologia, Facultat de Biociències, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain; (M.B.-G.); (V.C.-P.); (S.G.-G.); (P.H.-A.); (M.L.)
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16
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Annels NE, Simpson GR, Pandha H. Modifying the Non-muscle Invasive Bladder Cancer Immune Microenvironment for Optimal Therapeutic Response. Front Oncol 2020; 10:175. [PMID: 32133299 PMCID: PMC7040074 DOI: 10.3389/fonc.2020.00175] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 01/31/2020] [Indexed: 12/31/2022] Open
Abstract
It is now well-recognized that the tumor microenvironment (TME) is not only a key regulator of cancer progression but also plays a crucial role in cancer treatment responses. Recently, several high-profile publications have demonstrated the importance of particular immune parameters and cell types that dictate responsiveness to immunotherapies. With this increased understanding of TME-mediated therapy, approaches that increase therapeutic efficacy by remodeling the TME are actively being pursued. A classic example of this, in practice by urologists for over 40 years, is the manipulation of the bladder microenvironment for the treatment of non-muscle invasive bladder cancer (NMIBC) by instillation of intravesical bacillus Calmette-Guerin (BCG). The success of BCG treatment is thought to be due to its ability to induce a massive influx of Th1-polarized inflammatory cells, production of Th1 inflammatory cytokines and the generation of tumor-targeted Th1-mediated cytotoxic responses. Whilst BCG immunotherapy is currently the best treatment for NMIBC, ~30% of patients show no response to this treatment. Here we present a review highlighting a variety of promising alternative immunotherapies being developed that remodel the bladder tumor microenvironment. These include (1) the use of oncolytic viruses which selectively replicate within cancer cells whilst also modifying the immunological components of the TME, (2) manipulation of the bladder microbiome to augment the response to BCG or other immunotherapies (3) utilizing Toll-like Receptor agonists as anti-tumor agents due to their potent stimulation of innate and adaptive immunity and (4) the growing recognition that immunotherapeutic strategies that will have the largest impact on patients may require multiple therapeutic approaches combined together. The accumulating knowledge on TME remodeling holds promise for providing an alternative therapy for patients with BCG-unresponsive NMIBC.
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Affiliation(s)
- Nicola E Annels
- Department of Clinical and Experimental Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Guy R Simpson
- Department of Clinical and Experimental Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Hardev Pandha
- Department of Clinical and Experimental Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
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17
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Domingos-Pereira S, Sathiyanadan K, La Rosa S, Polák L, Chevalier MF, Martel P, Hojeij R, Derré L, Haefliger JA, Jichlinski P, Nardelli-Haefliger D. Intravesical Ty21a Vaccine Promotes Dendritic Cells and T Cell-Mediated Tumor Regression in the MB49 Bladder Cancer Model. Cancer Immunol Res 2019; 7:621-629. [PMID: 30696629 DOI: 10.1158/2326-6066.cir-18-0671] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 11/28/2018] [Accepted: 01/25/2019] [Indexed: 11/16/2022]
Abstract
Preclinical data show that intravesical instillation of Ty21a/Vivotif, a commercial vaccine against typhoid fever, is an effective alternative option to standard Bacillus Calmette-Guérin (BCG) immunotherapy for non-muscle-invasive bladder cancer (NMIBC). Here, we characterized the inflammatory effects of Ty21a on the bladder and investigated the immune mechanisms underlying tumor regression toward the use of this bacterial vaccine in NMIBC patients. MB49 bladder tumor-bearing mice had significantly improved survival after intravesical instillations of Ty21a doses of 106 to 108 colony-forming units. By IHC and morphology, both BCG and Ty21a instillations were associated with bladder inflammation, which was decreased with the use of low, but effective doses of Ty21a. Flow-cytometry analysis showed a significant infiltration of T cells, natural killer (NK) cells, and myeloid cells, compared with controls, after a single dose of Ty21a, whereas this was only observed after multiple doses of BCG. The induced myeloid cells were predominantly neutrophils and Ly6C+CD103+ dendritic cells (DC), the latter being significantly more numerous after instillation of Ty21a than BCG. Ex vivo infection of human leukocytes with Ty21a, but not BCG, similarly significantly increased DC frequency. CD4+ and CD8+ T cells, but not NK cells nor neutrophils, were required for effective bladder tumor regression upon Ty21a treatment. Thus, the generation of antitumor adaptive immunity was identified as a key process underlying Ty21a-mediated treatment efficacy. Altogether, these results demonstrate mechanisms behind intravesical Ty21a therapy and suggest its potential as a safe and effective treatment for NMIBC patients.
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Affiliation(s)
| | - Karthik Sathiyanadan
- Department of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Stefano La Rosa
- Service of Clinical Pathology, Institute of Pathology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Lenka Polák
- Department of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Mathieu F Chevalier
- Department of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Paul Martel
- Department of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Rim Hojeij
- Department of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Laurent Derré
- Department of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | | | - Patrice Jichlinski
- Department of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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18
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Alvarez-Arguedas S, Uranga S, Martín M, Elizalde J, Gomez AB, Julián E, Nardelli-Haefliger D, Martín C, Aguilo N. Therapeutic efficacy of the live-attenuated Mycobacterium tuberculosis vaccine, MTBVAC, in a preclinical model of bladder cancer. Transl Res 2018; 197:32-42. [PMID: 29702078 DOI: 10.1016/j.trsl.2018.03.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 03/28/2018] [Accepted: 03/29/2018] [Indexed: 12/17/2022]
Abstract
Intravesical instillation of bacillus Calmette-Guérin (BCG) has been a first-line therapy for non-muscle-invasive bladder cancer for the last 4 decades. However, this treatment causes serious adverse events in a significant number of patients and a substantial percentage of recurrence episodes. MTBVAC is a live-attenuated vaccine derived from a Mycobacterium tuberculosis clinical isolate and is currently under evaluation in clinical trials to replace BCG as a tuberculosis vaccine. Here, we describe for the first time the potential of MTBVAC as a bladder cancer therapy in vitro and in vivo in a preclinical model. MTBVAC colonized human bladder tumor cells to a much greater extent than BCG via a mechanism mediated by macropinocytosis and induced cell growth inhibition after internalization. In vivo testing in an orthotopic murine model of bladder cancer demonstrated a higher antitumor effect of MTBVAC in experimental conditions in which BCG did not work. Our data encourage further studies to support the possible application of MTBVAC as a new immunotherapeutic agent for bladder cancer.
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Affiliation(s)
- Samuel Alvarez-Arguedas
- Grupo de Genética de Micobacterias, Departamento de Microbiología, Medicina Preventiva y Salud Pública, Universidad de Zaragoza, Zaragoza, Spain; CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - Santiago Uranga
- Grupo de Genética de Micobacterias, Departamento de Microbiología, Medicina Preventiva y Salud Pública, Universidad de Zaragoza, Zaragoza, Spain; CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - Manuel Martín
- Servicio de Urología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Javier Elizalde
- Servicio de Urología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Ana Belen Gomez
- Grupo de Genética de Micobacterias, Departamento de Microbiología, Medicina Preventiva y Salud Pública, Universidad de Zaragoza, Zaragoza, Spain; CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - Esther Julián
- Departament de Genètica i de Microbiologia, Facultat de Biociències, UAB, Bellaterra, Barcelona, Spain
| | | | - Carlos Martín
- Grupo de Genética de Micobacterias, Departamento de Microbiología, Medicina Preventiva y Salud Pública, Universidad de Zaragoza, Zaragoza, Spain; CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain; Servicio de Microbiología, Hospital Universitario Miguel Servet, ISS Aragón, Zaragoza, Spain
| | - Nacho Aguilo
- Grupo de Genética de Micobacterias, Departamento de Microbiología, Medicina Preventiva y Salud Pública, Universidad de Zaragoza, Zaragoza, Spain; CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain.
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19
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Ringuette-Goulet C, Bolduc S, Pouliot F. Modeling human bladder cancer. World J Urol 2018; 36:1759-1766. [PMID: 29948049 DOI: 10.1007/s00345-018-2369-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 05/25/2018] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Bladder cancer is a major public health concern and the treatment options available are unable to significantly prevent disease recurrence and progression. The need for experimental tumor models to efficiently reproduce the pathology of human cancers has prompted researchers to attempt various approaches. METHODS A PubMed search combining the MeSH bladder cancer and models was executed in March 2017. RESULTS We review the advantages and limitations of currently available in vitro 2D and 3D bladder cancer models as well as in vivo rodent models. To date, despite the description of a variety of animal models (including transplantable, carcinogen-induced and genetically engineered models), the establishment of reliable, simple, practicable and reproducible animal models remains an ongoing challenge. Recently, sophisticated 3D culture systems have been designed to better recapitulate the phenotypic and cellular heterogeneity as well as microenvironmental aspects of in vivo tumor growth, while being more flexible to conduct repeated experiments. CONCLUSION Selecting the most appropriate model for a specific application will maximize the conversion of potential therapies from the laboratory to clinical practice and requires an understanding of the various models available.
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Affiliation(s)
- Cassandra Ringuette-Goulet
- Centre de recherche en organogénèse expérimentale/LOEX, Regenerative Medicine Division, CHU de Québec Research Center, Quebec, QC, Canada
- Department of Surgery, Faculty of Medicine, Université Laval, Quebec, QC, Canada
- Oncology Division, CHU de Québec Research Center, Quebec, QC, Canada
| | - Stéphane Bolduc
- Centre de recherche en organogénèse expérimentale/LOEX, Regenerative Medicine Division, CHU de Québec Research Center, Quebec, QC, Canada
- Department of Surgery, Faculty of Medicine, Université Laval, Quebec, QC, Canada
| | - Frédéric Pouliot
- Department of Surgery, Faculty of Medicine, Université Laval, Quebec, QC, Canada.
- Oncology Division, CHU de Québec Research Center, Quebec, QC, Canada.
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20
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Chevalier MF, Trabanelli S, Racle J, Salomé B, Cesson V, Gharbi D, Bohner P, Domingos-Pereira S, Dartiguenave F, Fritschi AS, Speiser DE, Rentsch CA, Gfeller D, Jichlinski P, Nardelli-Haefliger D, Jandus C, Derré L. ILC2-modulated T cell-to-MDSC balance is associated with bladder cancer recurrence. J Clin Invest 2017. [PMID: 28650339 DOI: 10.1172/jci89717] [Citation(s) in RCA: 160] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Non-muscle-invasive bladder cancer (NMIBC) is a highly recurrent tumor despite intravesical immunotherapy instillation with the bacillus Calmette-Guérin (BCG) vaccine. In a prospective longitudinal study, we took advantage of BCG instillations, which increase local immune infiltration, to characterize immune cell populations in the urine of patients with NMIBC as a surrogate for the bladder tumor microenvironment. We observed an infiltration of neutrophils, T cells, monocytic myeloid-derived suppressor cells (M-MDSCs), and group 2 innate lymphoid cells (ILC2). Notably, patients with a T cell-to-MDSC ratio of less than 1 showed dramatically lower recurrence-free survival than did patients with a ratio of greater than 1. Analysis of early and later time points indicated that this patient dichotomy existed prior to BCG treatment. ILC2 frequency was associated with detectable IL-13 in the urine and correlated with the level of recruited M-MDSCs, which highly expressed IL-13 receptor α1. In vitro, ILC2 were increased and potently expressed IL-13 in the presence of BCG or tumor cells. IL-13 induced the preferential recruitment and suppressive function of monocytes. Thus, the T cell-to-MDSC balance, associated with a skewing toward type 2 immunity, may predict bladder tumor recurrence and influence the mortality of patients with muscle-invasive cancer. Moreover, these results underline the ILC2/IL-13 axis as a targetable pathway to curtail the M-MDSC compartment and improve bladder cancer treatment.
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Affiliation(s)
- Mathieu F Chevalier
- Urology Research Unit, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
| | - Sara Trabanelli
- Translational Tumor Immunology, Ludwig Center for Cancer Research at the University of Lausanne, Department of Fundamental Oncology, Epalinges, Switzerland
| | - Julien Racle
- Computational Cancer Biology, Ludwig Center for Cancer Research at the University of Lausanne, Epalinges, Switzerland.,Swiss Institute of Bioinformatics (SIB), Lausanne, Switzerland
| | - Bérengère Salomé
- Translational Tumor Immunology, Ludwig Center for Cancer Research at the University of Lausanne, Department of Fundamental Oncology, Epalinges, Switzerland
| | - Valérie Cesson
- Urology Research Unit, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
| | - Dalila Gharbi
- Urology Research Unit, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
| | - Perrine Bohner
- Urology Research Unit, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
| | | | - Florence Dartiguenave
- Urology Research Unit, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
| | - Anne-Sophie Fritschi
- Urology Research Unit, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
| | - Daniel E Speiser
- Department of Oncology and Ludwig Center for Cancer Research, University of Lausanne, Epalinges, Switzerland
| | - Cyrill A Rentsch
- Department of Urology, University Hospital of Basel, Basel, Switzerland
| | - David Gfeller
- Computational Cancer Biology, Ludwig Center for Cancer Research at the University of Lausanne, Epalinges, Switzerland.,Swiss Institute of Bioinformatics (SIB), Lausanne, Switzerland
| | - Patrice Jichlinski
- Urology Research Unit, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
| | | | - Camilla Jandus
- Translational Tumor Immunology, Ludwig Center for Cancer Research at the University of Lausanne, Department of Fundamental Oncology, Epalinges, Switzerland
| | - Laurent Derré
- Urology Research Unit, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
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