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Ocular Inflammation Induced by Immune Checkpoint Inhibitors. J Clin Med 2022; 11:jcm11174993. [PMID: 36078923 PMCID: PMC9456546 DOI: 10.3390/jcm11174993] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 11/16/2022] Open
Abstract
Ocular immunotherapy-related adverse events (IRAEs), although rare, can be sight-threatening. Our objective was to analyze ocular IRAEs diagnosed in France from the marketing of immune checkpoint inhibitors (ICPIs) until June 2021 and to review the literature. We collected the cases of 28 patients (36 ocular IRAEs), occurring after an average of 17 weeks (±19). Forty-six percent of patients were treated for metastatic melanoma. Anti-PD1 agents were responsible for 57% of the IRAEs. Anterior uveitis was the most common (44%), followed by panuveitis (28%). Of 25 uveitis cases, 80% were bilateral and 60% were granulomatous. We found one case with complete Vogt-Koyanagi–Harada syndrome and one case of birdshot retinochoroidopathy. The other IRAEs were eight ocular surface disorders, one optic neuropathy, and one inflammatory orbitopathy. Seventy percent of the IRAEs were grade 3 according to the common terminology of AEs. ICPIs were discontinued in 60% of patients and 50% received local corticosteroids alone. The literature review included 230 uveitis cases, of which 7% were granulomatous. The distributions of ICPIs, cancer, and type of uveitis were similar to our cohort. Ocular IRAEs appeared to be easily controlled by local or systemic corticosteroids and did not require routine discontinuation of ICPIs. Further work is still warranted to define the optimal management of ocular IRAEs.
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Abstract
The discovery of immune checkpoints (ICs) and the development of specific blockers to relieve immune effector cells from this inhibiting mechanism has changed the view of anti-cancer therapy. In addition to cytotoxic T lymphocyte antigen 4 (CTLA4) and programmed death 1 (PD1), classical ICs of T lymphocytes and recently described also on a fraction of natural killer (NK) cells, several NK cell receptors, including killer immunoglobulin-like inhibitory receptors (KIRs) and NGK2A, have been recognized as checkpoint members typical of the NK cell population. This offers the opportunity of a dual-checkpoint inhibition approach, targeting classical and non-classical ICs and leading to a synergistic therapeutic effect. In this review, we will overview and discuss this new perspective, focusing on the most relevant candidates for this role among the variety of potential NK ICs. Beside listing and defining classical ICs expressed also by NK cells, or non-classical ICs either on T or on NK cells, we will address their role in NK cell survival, chronic stimulation or functional exhaustion, and the potential relevance of this phenomenon on anti-tumor immune response. Furthermore, NK ICs will be proposed as possible new targets for the development of efficient combined immunotherapy, not forgetting the relevant concerns that may be raised on NK IC blockade. Finally, the impact of epigenetic drugs in such a complex therapeutic picture will be briefly addressed.
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Mehdizadeh S, Bayatipoor H, Pashangzadeh S, Jafarpour R, Shojaei Z, Motallebnezhad M. Immune checkpoints and cancer development: Therapeutic implications and future directions. Pathol Res Pract 2021; 223:153485. [PMID: 34022684 DOI: 10.1016/j.prp.2021.153485] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/10/2021] [Accepted: 05/13/2021] [Indexed: 02/08/2023]
Abstract
Over the past few decades, different inhibitory receptors have been identified, which have played prominent roles in reducing anti-tumor immune responses. The role of immune checkpoint inhibitors in cancer was revealed by critical blockade of the cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) and programmed cell death protein-1 (PD-1) checkpoints. Immune checkpoint inhibitors, including anti-PD-1 (nivolumab and pembrolizumab), anti-PD-L1 (Atezolizumab, avelumab, and duravulumab), and anti-CTLA-4 (ipilimumab, tremelimumab), are currently FDA-approved treatment options for a broad range of cancer types. However, regarding immunotherapy advances in recent years, most studies have been focused on finding the antibodies against other inhibitory immune checkpoints in the tumor microenvironment such as lymphocyte activation gene-3 (LAG-3), T cell immunoglobulin, and mucin domain 3 (TIM-3), B7-homolog 3 (B7-H3), V-domain immunoglobulin-containing suppressor of T-cell activation (VISTA), diacylglycerol kinase-α (DGK-α), T cell immunoglobulin and ITIM domain (TIGIT), and B and T lymphocyte attenuator (BTLA). This immune checkpoint exerts differential inhibitory impacts on various types of lymphocytes. The suppression of immune responses demonstrates a surprising synergy with PD-1. Therefore, most antibodies against these immune checkpoints are undertaking clinical trials for cancer immunotherapy of advanced solid tumors and hematologic malignancies. In this review, we will summarize recent findings of immune checkpoint and the role of monoclonal antibodies in cancer immunotherapy targeting these receptors.
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Affiliation(s)
- Saber Mehdizadeh
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; Immunology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hashem Bayatipoor
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; Immunology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Salar Pashangzadeh
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; Immunology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Roghayeh Jafarpour
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; Immunology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Zeinab Shojaei
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; Immunology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Morteza Motallebnezhad
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; Immunology Research Center, Iran University of Medical Sciences, Tehran, Iran.
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Tian CY, Ou YH, Chang SL, Lin CM. Pembrolizumab-induced myasthenia gravis-like disorder, ocular myositis, and hepatitis: a case report. J Med Case Rep 2021; 15:244. [PMID: 33926558 PMCID: PMC8086081 DOI: 10.1186/s13256-021-02722-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 02/08/2021] [Indexed: 01/02/2023] Open
Abstract
Introduction Pembrolizumab and other immune checkpoint inhibitors are the emerging treatment for selected, high-grade malignancies. However, a small number of patients are unable to tolerate its adverse effects, leading to discontinuation of this potentially life-changing therapy. In this study, we present a case of high-grade urothelial carcinoma patient, who experienced neurocomplications during the first pembrolizumab administration. However, we were able to limit the adverse effect by concomitant use of low-dose oral steroids. Case presentation A 75-year-old Taiwanese female with high-grade urothelial carcinoma of the left ureter came to the neurology clinic with complaints of acute onset of bilateral ptosis 16 days after her first infusion of pembrolizumab. It was found that she developed complete bilateral ptosis and limited extraocular muscle movements. Myasthenia gravis-related antibodies and repetitive stimulation test were negative. We diagnosed her with pembrolizumab-induced myasthenia gravis-like disorder and myositis based on clinical symptoms and elevation of muscle enzymes. We commenced methylprednisolone pulse therapy followed by oral steroid therapy with gradual resolution of the symptoms. Three months later, the patient received a second cycle of pembrolizumab with low-dose oral steroids without any complications. Conclusion Pembrolizumab exerts its antitumor activity by interfering with the binding of programmed death 1 and its ligand, programmed death ligand 1. As a result, enhanced cytotoxic T cells can recognize tumor cells and induce cellular death. However, neurological complications may be severe and require prompt recognition and treatment. Our case demonstrated that concomitant use of low-dose steroids and pembrolizumab might prevent such complications.
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Affiliation(s)
- Chia-Yi Tian
- Department of Neurology, Changhua Christian Hospital, No. 135, Nanxiao Street, Changhua, 500, Taiwan
| | - Yang-Hao Ou
- Department of Neurology, Changhua Christian Hospital, No. 135, Nanxiao Street, Changhua, 500, Taiwan
| | - Shih-Liang Chang
- Department of Medicinal Botanicals and Health Applications, Da-Yeh University, No.168, University Road, Changhua, Taiwan. .,School of Chinese Medicine, China Medical University, Taichung, Taiwan.
| | - Chih-Ming Lin
- Department of Neurology, Changhua Christian Hospital, No. 135, Nanxiao Street, Changhua, 500, Taiwan. .,Department of Social Work and Child Welfare, Providence University, Taichung, Taiwan. .,Department of Medicinal Botanicals and Health Applications, Da-Yeh University, No.168, University Road, Changhua, Taiwan.
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Merino M, Lozano T, Casares N, Lana H, Troconiz IF, Ten Hagen TLM, Kochan G, Berraondo P, Zalba S, Garrido MJ. Dual activity of PD-L1 targeted Doxorubicin immunoliposomes promoted an enhanced efficacy of the antitumor immune response in melanoma murine model. J Nanobiotechnology 2021; 19:102. [PMID: 33849551 PMCID: PMC8042980 DOI: 10.1186/s12951-021-00846-z] [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: 12/01/2020] [Accepted: 03/27/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The immunomodulation of the antitumor response driven by immunocheckpoint inhibitors (ICIs) such as PD-L1 (Programmed Death Ligand-1) monoclonal antibody (α-PD-L1) have shown relevant clinical outcomes in a subset of patients. This fact has led to the search for rational combinations with other therapeutic agents such as Doxorubicin (Dox), which cytotoxicity involves an immune activation that may enhance ICI response. Therefore, this study aims to evaluate the combination of chemotherapy and ICI by developing Dox Immunoliposomes functionalized with monovalent-variable fragments (Fab') of α-PD-L1. RESULTS Immunoliposomes were assayed in vitro and in vivo in a B16 OVA melanoma murine cell line over-expressing PD-L1. Here, immune system activation in tumor, spleen and lymph nodes, together with the antitumor efficacy were evaluated. Results showed that immunoliposomes bound specifically to PD-L1+ cells, yielding higher cell interaction and Dox internalization, and decreasing up to 30-fold the IC50, compared to conventional liposomes. This mechanism supported a higher in vivo response. Indeed, immunoliposomes promoted full tumor regression in 20% of mice and increased in 1 month the survival rate. This formulation was the only treatment able to induce significant (p < 0.01) increase of activated tumor specific cytotoxic T lymphocytes at the tumor site. CONCLUSION PD-L1 targeted liposomes encapsulating Dox have proved to be a rational combination able to enhance the modulation of the immune system by blocking PD-L1 and selectively internalizing Dox, thus successfully providing a dual activity offered by both, chemo and immune therapeutic strategies.
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Affiliation(s)
- María Merino
- Department of Pharmaceutical Technology and Chemistry, School of Pharmacy, University of Navarra, 31008, Pamplona, Navarra, Spain
| | - Teresa Lozano
- Program of Immunology and Immunotherapy, CIMA-Universidad de Navarra, Pamplona, Spain.,Navarra Institute for Health Research (IdisNA), Pamplona, Spain
| | - Noelia Casares
- Program of Immunology and Immunotherapy, CIMA-Universidad de Navarra, Pamplona, Spain.,Navarra Institute for Health Research (IdisNA), Pamplona, Spain
| | - Hugo Lana
- Department of Pharmaceutical Technology and Chemistry, School of Pharmacy, University of Navarra, 31008, Pamplona, Navarra, Spain
| | - Iñaki F Troconiz
- Department of Pharmaceutical Technology and Chemistry, School of Pharmacy, University of Navarra, 31008, Pamplona, Navarra, Spain.,Navarra Institute for Health Research (IdisNA), Pamplona, Spain
| | - Timo L M Ten Hagen
- Laboratory of Experimental Oncology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Grazyna Kochan
- Navarra Institute for Health Research (IdisNA), Pamplona, Spain.,Department of Oncology, Navarrabiomed-Biomedical Research Centre, Pamplona, Spain
| | - Pedro Berraondo
- Program of Immunology and Immunotherapy, CIMA-Universidad de Navarra, Pamplona, Spain.,Navarra Institute for Health Research (IdisNA), Pamplona, Spain
| | - Sara Zalba
- Department of Pharmaceutical Technology and Chemistry, School of Pharmacy, University of Navarra, 31008, Pamplona, Navarra, Spain. .,Navarra Institute for Health Research (IdisNA), Pamplona, Spain.
| | - María J Garrido
- Department of Pharmaceutical Technology and Chemistry, School of Pharmacy, University of Navarra, 31008, Pamplona, Navarra, Spain. .,Navarra Institute for Health Research (IdisNA), Pamplona, Spain.
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Li M, Wang L, Yu C, Wang J. Development of a robust reporter gene assay for measuring the bioactivity of OX40-targeted therapeutic antibodies. LUMINESCENCE 2021; 36:885-893. [PMID: 33382183 DOI: 10.1002/bio.4004] [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: 09/02/2020] [Revised: 11/12/2020] [Accepted: 12/27/2020] [Indexed: 11/12/2022]
Abstract
OX40 plays a prominent role in the onset and development of solid tumors, and OX40-targeted monoclonal antibodies (mAbs) have entered clinical trials for various tumors. Bioactivity determination of therapeutic mAbs is of great significance in product quality, however, mechanism of action-based bioassays to determine the bioactivity of anti-OX40 mAbs is still lacking. Here, we established a reporter gene assay system based on two cell lines, namely Jurkat-OX40-NFκB-Luc which stably expresses NFκB-controlled luciferase, and Raji cells which inherently express FcγRs. In the model, FcγRs on Raji cells could crosslink the Fc of anti-OX40 mAbs, which leads to the further crosslinking between Fab of anti-OX40 mAbs and OX40 on Jurkat-OX40-NFκB-Luc cells. OX40 crosslinking could activate Jurkat-OX40-NFκB-Luc cells, and induce the expression of NFκB-controlled luciferase, the extent of which could reflect the bioactivity of anti-OX40 mAbs in a dose-dependent manner. After the optimization of various assay conditions, the validation of the cell-based bioassay showed good assay performance characteristics, including specificity, accuracy, precision, linearity, and stability. This innovative assay that is based on the OX40-NFκB pathway can be a powerful pool to measure the bioactivity of OX40-targeted mAbs.
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Affiliation(s)
- Meng Li
- Key Laboratory of the Ministry of Health for Research on Quality and Standardization of Biotech Products, National Institutes for Food and Drug Control, Beijing, China
| | - Lan Wang
- Key Laboratory of the Ministry of Health for Research on Quality and Standardization of Biotech Products, National Institutes for Food and Drug Control, Beijing, China
| | - Chuanfei Yu
- Key Laboratory of the Ministry of Health for Research on Quality and Standardization of Biotech Products, National Institutes for Food and Drug Control, Beijing, China
| | - Junzhi Wang
- Key Laboratory of the Ministry of Health for Research on Quality and Standardization of Biotech Products, National Institutes for Food and Drug Control, Beijing, China
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Wehrhan F, Weber M, Baran C, Agaimy A, Büttner-Herold M, Kesting M, Ries J. PD1 expression and correlation with its ligands in oral cancer specimens and peripheral blood. J Craniomaxillofac Surg 2020; 49:118-125. [PMID: 33358116 DOI: 10.1016/j.jcms.2020.12.007] [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] [Received: 06/07/2020] [Revised: 09/27/2020] [Accepted: 12/11/2020] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVES This study analyzed the expression of the PD1 receptor in tumor tissue and peripheral blood of oral squamous cell carcinoma (OSCC) patients, and correlated it with the PD1 ligands PD-L1 and PD-L2. The currently low response rates of checkpoint inhibitor treatment in OSCC could be increased by a better understanding of immune checkpoint biology. Despite evidence in the literature for upregulation of PD1 checkpoint ligands in OSCC tissue, there has been no correlation analysis of the PD1 receptor with its ligands in tissue specimens and peripheral blood of OSCC patients. MATERIALS AND METHODS An RT-qPCR analysis of PD1 mRNA expression was performed in oral cancer specimens, healthy mucosa, and corresponding blood samples. A cut-off point (COP) was determined and a chi-square (χ2) test was carried out. PD1 expression was correlated with previously reported PD-L1 and PD-L2 expression values using the Spearman test. RESULTS Tissue and blood specimens of 48 OSCC patients and 26 healthy individuals were analyzed. PD1 expression in OSCC specimens was significantly increased (p = 0.006) compared with healthy oral mucosa. PD1 overexpression in tissue samples showed a significant association with the presence of malignancy (p = 0.006). PD1 expression in tissue samples showed a significant positive correlation (p < 0.001) with the ligands PD-L1 and PD-L2. In contrast, there was no correlation between PD1 and its ligands in blood samples. However, there was a significant positive correlation (p < 0.001) between the ligands PD-L1 and PD-L2, both in tissue and blood samples. CONCLUSIONS Increased PD1 expression might be a manifestation of T-cell exhaustion in OSCC specimens, leading to immune tolerance. PD-L1/PD-L2-PD1 interaction may be a major mediator of local immunosuppression in OSCC, requiring advanced multimodal treatment protocols.
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Affiliation(s)
- Falk Wehrhan
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
| | - Manuel Weber
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany.
| | - Christoph Baran
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
| | - Abbas Agaimy
- Institute of Pathology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
| | - Maike Büttner-Herold
- Institute of Pathology, Department of Nephropathology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
| | - Marco Kesting
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
| | - Jutta Ries
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
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Chen W, Yuan Y, Jiang X. Antibody and antibody fragments for cancer immunotherapy. J Control Release 2020; 328:395-406. [PMID: 32853733 DOI: 10.1016/j.jconrel.2020.08.021] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 08/13/2020] [Accepted: 08/14/2020] [Indexed: 02/07/2023]
Abstract
Antibody has become the most rapidly expanding class of pharmaceuticals for treating a wide variety of human diseases including cancers. Especially, with the fast development of cancer immunotherapy, antibody drugs have become the most promising therapeutic for curing cancers. Immune-mediated cell killing by antibodies including antibody-dependent cellular cytotoxicity (ADCC), antibody-dependent cell phagocytosis (ADCP) and complement-dependent cytotoxicity (CDC) as well as regulation of T cell function through immune checkpoint blockade. Due to the absence of Fc fragment, antibody fragments including single-chain variable fragments (scFvs) and single-domain antibodies (sdAds) are mainly applied in chimeric antigen receptors (CAR) T cell therapy for redirecting T cells to tumors and T cell activation by immune checkpoint blockade. In this review, the cancer immunity is first discussed. Then the principal mechanisms of antibody-based immunotherapy will be reviewed. Next, the antibody and antibody fragments applied for cancer immunotherapy will be summarized. Bispecific and multispecific antibodies and a combination of cancer immunotherapy with other tumor treatments will also be mentioned. Finally, an outlook and perspective of antibody-based cancer immunotherapy will be given. This review would provide a comprehensive guidance for the researchers who are interested in and intended to involve in the antibodies- or antibody fragments-based tumor immunity.
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Affiliation(s)
- Weizhi Chen
- MOE Key Laboratory of High Performance Polymer Materials and Technology, Department of Polymer Science & Engineering, College of Chemistry & Chemical Engineering, Jiangsu Key Laboratory for Nanotechnology, Nanjing University, Nanjing 210093, PR China
| | - Yang Yuan
- MOE Key Laboratory of High Performance Polymer Materials and Technology, Department of Polymer Science & Engineering, College of Chemistry & Chemical Engineering, Jiangsu Key Laboratory for Nanotechnology, Nanjing University, Nanjing 210093, PR China
| | - Xiqun Jiang
- MOE Key Laboratory of High Performance Polymer Materials and Technology, Department of Polymer Science & Engineering, College of Chemistry & Chemical Engineering, Jiangsu Key Laboratory for Nanotechnology, Nanjing University, Nanjing 210093, PR China.
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Silence of Hippo Pathway Associates with Pro-Tumoral Immunosuppression: Potential Therapeutic Target of Glioblastomas. Cells 2020; 9:cells9081761. [PMID: 32717825 PMCID: PMC7464204 DOI: 10.3390/cells9081761] [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: 06/02/2020] [Revised: 07/12/2020] [Accepted: 07/21/2020] [Indexed: 12/15/2022] Open
Abstract
The critical role of the Hippo pathway has been recently investigated in various cancers, but little is known about its role in glioblastoma (GBM). In order to evaluate the clinical relevance of the Hippo pathway in GBM, we generated a core gene expression signature from four different previously-established silence of Hippo pathway (SOH) signatures. Based on a newly generated core SOH signature, a SOH and active Hippo pathway (AH) was predicted in GBM samples from The Cancer Genome Atlas (TCGA) and validated in a separate cohort. A comparative analysis was performed on multi-panel genomic datasets from TCGA and the possible association of SOH with immune activity and epithelial mesenchymal transition was also evaluated. The SOH signature was associated with poor prognosis in GBM in both cohorts. Expression levels of CTGF and CYR61, the most reliable and well-known downstream targets of YAP1, were markedly increased in the SOH subgroup of GBM patients. SOH signature was strongly associated with a high immune signature score and mesenchymal features. Genes differentially expressed between SOH and AH groups revealed many markers for inhibitory immune checkpoints and M2-polarized macrophages were upregulated in the SOH subgroup, suggesting that SOH may induce the resistance of cancer cells to host immune response in GBM. In summary, SOH is significantly associated with the poor prognosis of GBM patients and is possibly mediated by pro-tumoral immunosuppression.
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Danbaran GR, Aslani S, Sharafkandi N, Hemmatzadeh M, Hosseinzadeh R, Azizi G, Jadidi-Niaragh F, Babaie F, Mohammadi H. How microRNAs affect the PD-L1 and its synthetic pathway in cancer. Int Immunopharmacol 2020; 84:106594. [PMID: 32416456 DOI: 10.1016/j.intimp.2020.106594] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 04/27/2020] [Accepted: 05/08/2020] [Indexed: 12/17/2022]
Abstract
Programmed cell death-ligand 1 (PD-L1) is a glycoprotein that is expressed on the cell surface of both hematopoietic and nonhematopoietic cells. PD-L1 play a role in the immune tolerance and protect self-tissues from immune system attack. Dysfunction of this molecule has been highlighted in the pathogenesis of tumors, autoimmunity, and infectious disorders. MicroRNAs (miRNAs) are endogenous molecules that are classified as small non-coding RNA with approximately 20-22 nucleotides (nt) length. The function of miRNAs is based on complementary interactions with target mRNA via matching completely or incompletely. The result of this function is decay of the target mRNA or preventing mRNA translation. In the past decades, several miRNAs have been discovered which play an important role in the regulation of PD-L1 in various malignancies. In this review, we discuss the effect of miRNAs on PD-L1 expression and consider the effect of miRNAs on the synthetic pathway of PD-L1, especially during cancers.
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Affiliation(s)
| | - Saeed Aslani
- Department of Medical Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Nadia Sharafkandi
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Maryam Hemmatzadeh
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ramin Hosseinzadeh
- Department of Medical Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Azizi
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Farhad Jadidi-Niaragh
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Immunology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farhad Babaie
- Cellular and Molecular Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Hamed Mohammadi
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran; Department of Immunology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
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Bitton K, Michot JM, Barreau E, Lambotte O, Haigh O, Marabelle A, Voisin AL, Mateus C, Rémond AL, Couret C, Champiat S, Labetoulle M, Rousseau A. Prevalence and Clinical Patterns of Ocular Complications Associated With Anti-PD-1/PD-L1 Anticancer Immunotherapy. Am J Ophthalmol 2019; 202:109-117. [PMID: 30772350 DOI: 10.1016/j.ajo.2019.02.012] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 02/01/2019] [Accepted: 02/06/2019] [Indexed: 12/29/2022]
Abstract
PURPOSE Immune checkpoint inhibitors (ICI) targeting the programmed cell death protein 1 (PD-1), or its ligand PD-L1, are the mainstay of metastatic cancer treatment. Patients receiving these treatments may develop immune-related adverse events (irAEs). This study aimed to estimate the prevalence and describe the clinical patterns of moderate-to-severe ocular irAEs-associated with anti-PD-(L)1 treatment. DESIGN Prospective case series. METHODS This study included patients recruited via (1) a single-center prospective cohort and (2) a national pharmacovigilance registry between June 2014 and March 2018, and focused on patients with moderate-to-severe ocular irAEs following anti-PD-(L)1. All patients underwent a comprehensive ophthalmologic assessment. The main outcome measure was the prevalence of moderate-to-severe ocular irAEs. RESULTS Of a total of 745 patients included in the prospective cohort, 3 developed moderate-to-severe ocular irAEs, providing a prevalence of 0.4% and an incidence of 0.7 per 1000 patient-months of treatment. An additional 5 cases of moderate-to-severe ocular irAEs were reported through the national registry. From these 8 patients, 5 presented with intraocular inflammation, 2 with ocular surface disease, and 1 with orbital myopathy. Five patients (62.5%) experienced additional extraophthalmologic irAEs. Ocular irAEs led to permanent discontinuation of anti-PD-(L)1 in 4 patients. Treatment by local and/or systemic corticosteroids allowed resolution or control of the ocular symptoms in 7 of 8 patients. CONCLUSION Although uncommon, anti-PD-(L)1-associated ocular complications may be sight-threatening and lead to discontinuation of anti-PD-(L)1 treatments. Patients complaining of eye problems while receiving ICI treatment should immediately be seen by an ophthalmologist.
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Affiliation(s)
- Karen Bitton
- Service d'Ophtalmologie, DHU Vision & Handicaps, Centre de référence pour les maladies rares en ophtalmologie (OPHTARA), Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, Le Kremlin-Bicêtre, France; Université Paris-Sud, Le Kremlin-Bicêtre, France
| | - Jean-Marie Michot
- Département d'Innovation Thérapeutique et d'Essais Précoces, Université Paris-Saclay, Gustave Roussy, Villejuif, France
| | - Emmanuel Barreau
- Service d'Ophtalmologie, DHU Vision & Handicaps, Centre de référence pour les maladies rares en ophtalmologie (OPHTARA), Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | - Olivier Lambotte
- Service de Médecine Interne et Immunologie Clinique, Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, Le Kremlin-Bicêtre, France; Université Paris-Sud, Le Kremlin-Bicêtre, France; Immunology of Viral Infections and Autoimmune Diseases, INSERM U1184, Le Kremlin-Bicêtre, France; Department of Immunology of Viral and Auto-immune Disease, UMR1184, CEA, CEA, DSV/iMETI, IDMIT, Fontenay-aux-Roses, France
| | - Oscar Haigh
- Department of Immunology of Viral and Auto-immune Disease, UMR1184, CEA, CEA, DSV/iMETI, IDMIT, Fontenay-aux-Roses, France
| | - Aurélien Marabelle
- Département d'Innovation Thérapeutique et d'Essais Précoces, Université Paris-Saclay, Gustave Roussy, Villejuif, France; INSERM U1015, Gustave Roussy, Villejuif, France
| | - Anne-Laure Voisin
- Unité Fonctionnelle de Pharmacovigilance, Université Paris-Saclay, Gustave Roussy, Villejuif, France
| | - Christine Mateus
- Department of Supportive Care, Université Paris-Saclay, Gustave Roussy, Villejuif, France
| | - Anne-Laure Rémond
- Service d'Ophtalmologie, DHU Vision & Handicaps, Centre de référence pour les maladies rares en ophtalmologie (OPHTARA), Hôpital Pitié-Salpétrière, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Chloé Couret
- Service d'Ophtalmologie, CHU de Nantes, Nantes, France
| | - Stéphane Champiat
- Département d'Innovation Thérapeutique et d'Essais Précoces, Université Paris-Saclay, Gustave Roussy, Villejuif, France
| | - Marc Labetoulle
- Service d'Ophtalmologie, DHU Vision & Handicaps, Centre de référence pour les maladies rares en ophtalmologie (OPHTARA), Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, Le Kremlin-Bicêtre, France; Université Paris-Sud, Le Kremlin-Bicêtre, France; Immunology of Viral Infections and Autoimmune Diseases, INSERM U1184, Le Kremlin-Bicêtre, France; Department of Immunology of Viral and Auto-immune Disease, UMR1184, CEA, CEA, DSV/iMETI, IDMIT, Fontenay-aux-Roses, France
| | - Antoine Rousseau
- Service d'Ophtalmologie, DHU Vision & Handicaps, Centre de référence pour les maladies rares en ophtalmologie (OPHTARA), Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, Le Kremlin-Bicêtre, France; Université Paris-Sud, Le Kremlin-Bicêtre, France; Immunology of Viral Infections and Autoimmune Diseases, INSERM U1184, Le Kremlin-Bicêtre, France; Department of Immunology of Viral and Auto-immune Disease, UMR1184, CEA, CEA, DSV/iMETI, IDMIT, Fontenay-aux-Roses, France.
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12
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Merino M, Contreras A, Casares N, Troconiz IF, Ten Hagen TL, Berraondo P, Zalba S, Garrido MJ. A new immune-nanoplatform for promoting adaptive antitumor immune response. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2019; 17:13-25. [PMID: 30654186 DOI: 10.1016/j.nano.2018.12.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 12/21/2018] [Accepted: 12/28/2018] [Indexed: 01/02/2023]
Abstract
Immunoliposomes (ILs), obtained with monoclonal antibodies (mAbs) decorating the liposome surface, are used for cancer treatment. These mAbs provide the recognition of molecules upregulated in cancer cells, like Programmed Death-Ligand 1 (PD-L1), an immune-checkpoint involved in tumor resistance, forming a complex that blocks this molecule and thereby, induces antitumor immune response. This mechanism introduces a new concept for ILs. ILs coupled to anti-PD-L1 or its Fab' fragment have been developed and in vitro/in vivo characterized. Factors such as coupling methods, PEG density and ligand size were optimized. In vitro data showed that Fab'-ILs displayed the highest PD-L1 cell interaction, correlating with a higher in vivo tumor accumulation and an increase of effector cytotoxic CD8+ T cells, providing tumor shrinkage and total regression in 20% of mice. Therefore, a novel immune-nanoplatform able to modulate the immune system has been developed, allowing the encapsulation of several agents for combinatorial therapies.
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Affiliation(s)
- María Merino
- Department of Pharmacy and Pharmaceutical Technology, School of Pharmacy, University of Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdisNA)
| | - Ana Contreras
- Department of Pharmacy and Pharmaceutical Technology, School of Pharmacy, University of Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdisNA)
| | - Noelia Casares
- Program of Immunology and Immunotherapy, CIMA, Pamplona, Spain; Navarra Institute for Health Research (IdisNA)
| | - Iñaki F Troconiz
- Department of Pharmacy and Pharmaceutical Technology, School of Pharmacy, University of Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdisNA)
| | - Timo Lm Ten Hagen
- Laboratory of Experimental Oncology, Erasmus MC, Rotterdam, The Netherlands
| | - Pedro Berraondo
- Program of Immunology and Immunotherapy, CIMA, Pamplona, Spain; Navarra Institute for Health Research (IdisNA)
| | - Sara Zalba
- Department of Pharmacy and Pharmaceutical Technology, School of Pharmacy, University of Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdisNA)
| | - María J Garrido
- Department of Pharmacy and Pharmaceutical Technology, School of Pharmacy, University of Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdisNA).
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13
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Kim M, Shin SW, Lim CW, Kim J, Um SH, Kim D. Polyaspartamide-based graft copolymers encapsulating iron oxide nanoparticles for imaging and fluorescence labelling of immune cells. Biomater Sci 2018; 5:305-312. [PMID: 27999834 DOI: 10.1039/c6bm00763e] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Iron oxide nanoparticles (NPs) were encapsulated with polyaspartamide-based graft copolymers to bind and track the immune cells as imaging probes. Mono-disperse iron oxide NPs with a mean diameter of 10.7 nm were synthesized by the thermal decomposition method, and their shape and distribution were measured by electrophoretic light scattering and transmission electron microscopy. To enhance their biocompatibility, interfacial and hydrodynamic stability, and fluorescence detection, biodegradable polysuccinimide (PSI) grafted with several functional groups of octadecylamine (C18), ethanolamine (EA), ethylenediamine (EDA), 4-(N-maleimidomethyl) cyclohexane carboxylic acid N-hydroxysuccinimide ester (SMCC), and fluorescein isothiocyanate (FITC) was coated on the iron oxide NPs. The structure of the C18/EA/SMCC/FITC-g-PSI copolymer was confirmed using 1H-NMR and FTIR spectroscopy, and its cell binding ability was investigated by flow cytometry and confocal laser scanning microscopy. The synthesized C18/EA/SMCC/FITC-g-PSI copolymer showed an excellent binding affinity to CD4+ T cells, and was highly biocompatible as the cell viability at the highest polymer concentration of 0.4 mg mL-1 was greater than 85 and 75% after 24 and 48 h, respectively, from MTT assay.
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Affiliation(s)
- Minsun Kim
- School of Chemical Engineering, Sungkyunkwan University, Suwon, Kyunggi 440-746, Republic of Korea.
| | - Seung Won Shin
- School of Chemical Engineering, Sungkyunkwan University, Suwon, Kyunggi 440-746, Republic of Korea.
| | - Cheol Won Lim
- School of Chemical Engineering, Sungkyunkwan University, Suwon, Kyunggi 440-746, Republic of Korea.
| | - Jaeyun Kim
- School of Chemical Engineering, Sungkyunkwan University, Suwon, Kyunggi 440-746, Republic of Korea.
| | - Soong Ho Um
- School of Chemical Engineering, Sungkyunkwan University, Suwon, Kyunggi 440-746, Republic of Korea.
| | - Dukjoon Kim
- School of Chemical Engineering, Sungkyunkwan University, Suwon, Kyunggi 440-746, Republic of Korea.
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14
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Abstract
Systemic sclerosis (SSc) is an autoimmune disease of unknown aetiology characterized by vascular lesions, immunological alterations and diffuse fibrosis of the skin and internal organs. Since recent evidence suggests that there is a link between metabolomics and immune mediated disease, serum metabolic profile of SSc patients and healthy controls was investigated by 1H-NMR and GC-MS techniques. The results indicated a lower level of aspartate, alanine, choline, glutamate, and glutarate in SSc patients compared with healthy controls. Moreover, comparing patients affected by limited SSc (lcSSc) and diffuse SSc (dcSSc), 6 discriminant metabolites were identified. The multivariate analysis performed using all the metabolites significantly different revealed glycolysis, gluconeogenesis, energetic pathways, glutamate metabolism, degradation of ketone bodies and pyruvate metabolism as the most important networks. Aspartate, alanine and citrate yielded a high area under receiver-operating characteristic (ROC) curves (AUC of 0.81; CI 0.726–0.93) for discriminating SSc patients from controls, whereas ROC curve generated with acetate, fructose, glutamate, glutamine, glycerol and glutarate (AUC of 0.84; CI 0.7–0.98) discriminated between lcSSc and dcSSc. These results indicated that serum NMR-based metabolomics profiling method is sensitive and specific enough to distinguish SSc from healthy controls and provided a feasible diagnostic tool for the diagnosis and classification of the disease.
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15
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Marconcini R, Spagnolo F, Stucci LS, Ribero S, Marra E, Rosa FD, Picasso V, Di Guardo L, Cimminiello C, Cavalieri S, Orgiano L, Tanda E, Spano L, Falcone A, Queirolo P. Current status and perspectives in immunotherapy for metastatic melanoma. Oncotarget 2018; 9:12452-12470. [PMID: 29552325 PMCID: PMC5844761 DOI: 10.18632/oncotarget.23746] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Accepted: 11/03/2017] [Indexed: 12/31/2022] Open
Abstract
Metastatic melanoma was the first malignancy in which immune checkpoint inhibitors demonstrated their successful efficacy. Currently, the knowledge on the interaction between the immune system and malignant disease is steadily increasing and new drugs and therapeutic strategies are overlooking in the clinical scenario. To provide a comprehensive overview of immune modulating drugs currently available in the treatment of melanoma as well as to discuss of possible future strategies in the metastatic melanoma setting, the present review aims at analyzing controversial aspects about the optimal immunomodulating treatment sequences, the search for biomarkers of efficacy of immunocheckpoint inhibitors, and innovative combinations of drugs currently under investigation.
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Affiliation(s)
- Riccardo Marconcini
- Unit of Medical Oncology 2, Azienda Ospedaliera-Universitaria
Pisana, Department of Translational Research and New Technologies in Medicine and
Surgery, University of Pisa, Italy
| | - Francesco Spagnolo
- Department of Medical Oncology, IRCCS AOU San Martino-Istituto
Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - Luigia Stefania Stucci
- Medical Oncology Unit, Department of Biomedical Sciences and
Clinical Oncology, University of Bari, Bari, Italy
| | - Simone Ribero
- Dermatologic Clinic, Department of Medical Sciences,
University of Turin, Turin, Italy
| | - Elena Marra
- Dermatologic Clinic, Department of Medical Sciences,
University of Turin, Turin, Italy
| | - Francesco De Rosa
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei
Tumori, IRST IRCCS, Meldola, Italy
| | - Virginia Picasso
- Department of Medical Oncology, IRCCS AOU San Martino-Istituto
Nazionale per la Ricerca sul Cancro, Genova, Italy
| | | | | | | | - Laura Orgiano
- AOU Cagliari, Department of Medical Oncology, University of
Cagliari, Cagliari, Italy
| | - Enrica Tanda
- Department of Medical Oncology, IRCCS AOU San Martino-Istituto
Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - Laura Spano
- Department of Medical Oncology, IRCCS AOU San Martino-Istituto
Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - Alfredo Falcone
- Unit of Medical Oncology 2, Azienda Ospedaliera-Universitaria
Pisana, Department of Translational Research and New Technologies in Medicine and
Surgery, University of Pisa, Italy
| | - Paola Queirolo
- Department of Medical Oncology, IRCCS AOU San Martino-Istituto
Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - for the Italian Melanoma Intergroup (IMI)
- Unit of Medical Oncology 2, Azienda Ospedaliera-Universitaria
Pisana, Department of Translational Research and New Technologies in Medicine and
Surgery, University of Pisa, Italy
- Department of Medical Oncology, IRCCS AOU San Martino-Istituto
Nazionale per la Ricerca sul Cancro, Genova, Italy
- Medical Oncology Unit, Department of Biomedical Sciences and
Clinical Oncology, University of Bari, Bari, Italy
- Dermatologic Clinic, Department of Medical Sciences,
University of Turin, Turin, Italy
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei
Tumori, IRST IRCCS, Meldola, Italy
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan,
Italy
- AOU Cagliari, Department of Medical Oncology, University of
Cagliari, Cagliari, Italy
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16
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Checkpoint inhibitors in breast cancer – Current status. Cancer Treat Rev 2018; 63:122-134. [DOI: 10.1016/j.ctrv.2017.12.008] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 12/11/2017] [Accepted: 12/12/2017] [Indexed: 12/13/2022]
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17
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Garant A, Guilbault C, Ekmekjian T, Greenwald Z, Murgoi P, Vuong T. Concomitant use of corticosteroids and immune checkpoint inhibitors in patients with hematologic or solid neoplasms: A systematic review. Crit Rev Oncol Hematol 2017; 120:86-92. [DOI: 10.1016/j.critrevonc.2017.10.009] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 10/22/2017] [Indexed: 12/17/2022] Open
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18
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Le Goux C, Vacher S, Pignot G, Sibony M, Barry Delongchamps N, Terris B, Piaggio E, Zerbib M, Damotte D, Bieche I. mRNA Expression levels of genes involved in antitumor immunity: Identification of a 3-gene signature associated with prognosis of muscle-invasive bladder cancer. Oncoimmunology 2017; 6:e1358330. [PMID: 29147616 DOI: 10.1080/2162402x.2017.1358330] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 07/18/2017] [Indexed: 12/24/2022] Open
Abstract
Immunotherapy for bladder cancer has given promising results. Here we aimed to evaluate the possible involvement and prognostic value of 33 genes involved in the immune response during bladder carcinogenesis. Expression levels were assessed by quantitative real-time RT-PCR in normal and tumor human bladder samples. Immunohistochemistry was performed to evaluate the protein expression of 2 genes and relation of the mRNA and protein levels was analyzed. Tumors were obtained from 154 patients (83 with muscle-invasive bladder cancer [MIBC] and 71 non-MIBC [NMIBC]) who underwent transurethral bladder resection or radical cystectomy between 2002 and 2006. All patients signed an informed consent. Results of molecular analyses were coupled with survival analyses. Overall, 25 genes (75.8%) were significantly overexpressed in MIBC and 15 (45.5%) were deregulated in NMIBC as compared with normal tissue. On multivariate analysis, risk of NMIBC recurrence was increased with high FOXP3/CD8 ratio and overexpression of OX40L (p = 0.016 and p = 0.0039, respectively). In MIBC, a molecular signature of 3 genes (OX40L, CD8 and TIGIT) was significantly associated with prognosis in terms of recurrence-free and overall survival (p = 0.0007 and p = 0.007). RT-PCR findings were confirmed by immunohistochemistry for CD8 and FOXP3, with high association between mRNA and protein levels. Finally, risk of recurrence of non-muscle-invasive bladder cancer was increased with high FOXP3/CD8 ratio and OX40L overexpression. We identified a 3 gene molecular signature associated with prognosis of muscle-invasive bladder cancer. These results confirm the useful role of immune checkpoints in bladder carcinogenesis and suggest targets for therapy.
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Affiliation(s)
- Constance Le Goux
- Department of Genetic, Institut curie, Unité de pharmacogénomique, Service de génétique, Paris, France
| | - Sophie Vacher
- Department of Genetic, Institut curie, Unité de pharmacogénomique, Service de génétique, Paris, France
| | - Géraldine Pignot
- Department of Urology, Institut Paoli-Calmettes, Service d'Urologie, Marseille, France
| | - Mathilde Sibony
- Department of Pathology, Université Paris Descartes; Hôpital Cochin, Service d'Anatomopathologie, Paris, France
| | | | - Benoit Terris
- Department of Pathology, Université Paris Descartes; Hôpital Cochin, Service d'Anatomopathologie, Paris, France
| | - Eliane Piaggio
- Department of Translational Immunotherapy, Institut Curie, PSL Research University, INSERM U932, Translational Immunotherapy Siric Team, Centre d'Investigation Clinique Biothérapie CICBT , Paris, France
| | - Marc Zerbib
- Department of Urology, Université Paris Descartes, Hôpital Cochin, Service d'Urologie, Paris, France
| | - Diane Damotte
- Department of Pathology, Université Paris Descartes; Hôpital Cochin, Service d'Anatomopathologie, Paris, France.,Centre de Recherche des Cordeliers, Cancer et Immunité anti tumorale, INSERM U1138, Paris, France
| | - Ivan Bieche
- Department of Genetic, Institut curie, Unité de pharmacogénomique, Service de génétique, Paris, France.,Université Paris Descartes, Paris, France
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19
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de la Torre AN, Contractor S, Castaneda I, Cathcart CS, Razdan D, Klyde D, Kisza P, Gonzales SF, Salazar AM. A Phase I trial using local regional treatment, nonlethal irradiation, intratumoral and systemic polyinosinic-polycytidylic acid polylysine carboxymethylcellulose to treat liver cancer: in search of the abscopal effect. J Hepatocell Carcinoma 2017; 4:111-121. [PMID: 28848723 PMCID: PMC5557908 DOI: 10.2147/jhc.s136652] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose To determine the safety of an approach to immunologically enhance local treatment of hepatocellular cancer (HCC) by combining nonlethal radiation, local regional therapy with intratumoral injection, and systemic administration of a potent Toll-like receptor (TLR) immune adjuvant. Methods Patients with HCC not eligible for liver transplant or surgery were subject to: 1) 3 fractions of 2-Gy focal nonlethal radiation to increase tumor antigen expression, 2) intra-/peri-tumoral (IT) injection of the TLR3 agonist, polyinosinic-polycytidylic acid polylysine carboxymethylcellulose (poly-ICLC), to induce an immunologic “danger” response in the tumor microenvironment with local regional therapy, and 3) systemic boosting of immunity with intramuscular poly-ICLC. Primary end points were safety and tolerability; secondary end points were progression-free survival (PFS) and overall survival (OS) at 6 months, 1 year, and 2 years. Results Eighteen patients with HCC not eligible for surgery or liver transplant were treated. Aside from 1 embolization-related severe adverse event, all events were ≤grade II. PFS was 66% at 6 months, 39% at 12 months, and 28% at 24 months. Overall 1-year survival was 69%, and 2-year survival 38%. In patients <60 years old, 2-year survival was 62.5% vs. 11.1% in patients aged >60 years (P<0.05). Several patients had prolonged PFS and OS. Conclusion Intra-tumoral injection of the TLR3 agonist poly-ICLC in patients with HCC is safe and tolerable when combined with local nonlethal radiation and local regional treatment. Further work is in progress to evaluate if this approach improves survival compared to local regional treatment alone and characterize changes in anticancer immunity.
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Affiliation(s)
- Andrew N de la Torre
- Department of Surgery, St Joseph's Regional Medical Center, Paterson.,Department of Surgery, Rutgers New Jersey Medical School-University Hospital
| | - Sohail Contractor
- Department of Interventional Radiology, Rutgers New Jersey Medical School-University Hospital
| | - Ismael Castaneda
- Department of Surgery, St Joseph's Regional Medical Center, Paterson
| | | | - Dolly Razdan
- Department of Radiation Oncology, Clara Maas Hospital, Belleville, NJ
| | - David Klyde
- Department of Interventional Radiology, Rutgers New Jersey Medical School-University Hospital
| | - Piotr Kisza
- Department of Interventional Radiology, Rutgers New Jersey Medical School-University Hospital
| | - Sharon F Gonzales
- Department of Interventional Radiology, Rutgers New Jersey Medical School-University Hospital
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20
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Correale P, Botta C, Ciliberto D, Pastina P, Ingargiola R, Zappavigna S, Tassone P, Pirtoli L, Caraglia M, Tagliaferri P. Immunotherapy of colorectal cancer: new perspectives after a long path. Immunotherapy 2017; 8:1281-1292. [PMID: 27993089 DOI: 10.2217/imt-2016-0089] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Although significant therapeutic improvement has been achieved in the last 10 years, the survival of metastatic colorectal cancer patients remains in a range of 28 to 30 months. Presently, systemic treatment includes combination chemotherapy with oxaliplatin and/or irinotecan together with a backbone of 5-fluorouracil/levofolinate, alone or in combination with monoclonal antibodies to VEGFA (bevacizumab) or EGF receptor (cetuximab and panitumumab). The recent rise of immune checkpoint inhibitors in the therapeutic scenario has renewed scientific interest in the investigation of immunotherapy in metastatic colorectal cancer patients. According to our experience and view, here, we review the immunological strategies investigated for the treatment of this disease, including the use of tumor target-specific cancer vaccines, chemo-immunotherapy and immune checkpoint inhibitors.
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Affiliation(s)
- Pierpaolo Correale
- Unit of Radiotherapy, Department of Medicine, Surgery & Neuroscience, Siena University School of Medicine, Viale Bracci 11, 53100 Siena, Italy
| | - Cirino Botta
- Medical Oncology Unit & Medical Oncology Unit, AUO 'Materdomini', Magna Grecia University, Catanzaro, Italy
| | - Domenico Ciliberto
- Medical Oncology Unit & Medical Oncology Unit, AUO 'Materdomini', Magna Grecia University, Catanzaro, Italy
| | - Pierpaolo Pastina
- Unit of Radiotherapy, Department of Medicine, Surgery & Neuroscience, Siena University School of Medicine, Viale Bracci 11, 53100 Siena, Italy
| | - Rossana Ingargiola
- Medical Oncology Unit & Medical Oncology Unit, AUO 'Materdomini', Magna Grecia University, Catanzaro, Italy
| | - Silvia Zappavigna
- Department of Biochemistry, Biophysics & General Pathology, Second Naples University, Naples, Italy
| | - Pierfrancesco Tassone
- Medical Oncology Unit & Medical Oncology Unit, AUO 'Materdomini', Magna Grecia University, Catanzaro, Italy
| | - Luigi Pirtoli
- Unit of Radiotherapy, Department of Medicine, Surgery & Neuroscience, Siena University School of Medicine, Viale Bracci 11, 53100 Siena, Italy
| | - Michele Caraglia
- Department of Biochemistry, Biophysics & General Pathology, Second Naples University, Naples, Italy
| | - Pierosandro Tagliaferri
- Medical Oncology Unit & Medical Oncology Unit, AUO 'Materdomini', Magna Grecia University, Catanzaro, Italy
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Dal Bello MG, Alama A, Coco S, Vanni I, Grossi F. Understanding the checkpoint blockade in lung cancer immunotherapy. Drug Discov Today 2017; 22:1266-1273. [PMID: 28600190 DOI: 10.1016/j.drudis.2017.05.016] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 05/15/2017] [Accepted: 05/30/2017] [Indexed: 01/30/2023]
Abstract
Immunotherapies have changed the treatment strategy of some types of tumor including melanoma and, more recently, non-small-cell lung cancer (NSCLC). Immune checkpoints are crucial for the maintenance of self-tolerance and it is known that some tumors use checkpoint systems to evade antitumor immune response. The treatment of advanced NSCLC by immune-checkpoint blockade targeting the programmed cell death protein-1 (PD1/PDL1) and cytotoxic T-lymphocyte antigen 4 (CTLA4) pathways has led to significant clinical benefit either as monotherapy or in combination therapy. Moreover, checkpoint receptors such as lymphocyte activation gene 3 protein (LAG3), T-cell immunoglobulin mucin domain 3 (TIM3) and killer immunoglobulin-like receptors (KIRs) are also being investigated as potential immunotherapeutic targets. This review focuses on the mechanisms of action of the main checkpoint inhibitors in lung cancer and presents the most relevant results from preclinical and clinical studies on immune-based treatments.
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Affiliation(s)
- Maria Giovanna Dal Bello
- Lung Cancer Unit, Ospedale Policlinico San Martino, Istituto di Ricovero e Cura a Carattere Scientifico per l'Oncologia, Largo R. Benzi, 10-16132 Genoa, Italy
| | - Angela Alama
- Lung Cancer Unit, Ospedale Policlinico San Martino, Istituto di Ricovero e Cura a Carattere Scientifico per l'Oncologia, Largo R. Benzi, 10-16132 Genoa, Italy.
| | - Simona Coco
- Lung Cancer Unit, Ospedale Policlinico San Martino, Istituto di Ricovero e Cura a Carattere Scientifico per l'Oncologia, Largo R. Benzi, 10-16132 Genoa, Italy
| | - Irene Vanni
- Lung Cancer Unit, Ospedale Policlinico San Martino, Istituto di Ricovero e Cura a Carattere Scientifico per l'Oncologia, Largo R. Benzi, 10-16132 Genoa, Italy
| | - Francesco Grossi
- Lung Cancer Unit, Ospedale Policlinico San Martino, Istituto di Ricovero e Cura a Carattere Scientifico per l'Oncologia, Largo R. Benzi, 10-16132 Genoa, Italy
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22
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New developments in the biology and the treatment of metastatic Merkel cell carcinoma. Curr Opin Oncol 2017; 29:221-226. [PMID: 28282342 DOI: 10.1097/cco.0000000000000363] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Patients with stage IIIB und IV metastatic Merkel cell carcinoma (mMCC), who are not suitable candidates for surgery or radiotherapy, are unlikely to achieve lasting remission or tumor control by chemo or targeted therapy. In the majority of cases, the tumor arises from viral carcinogenesis associated with the Merkel cell polyomavirus (MCPyV). In MCPyV-negative tumors with a presumable ultraviolet carcinogenesis, a high mutational burden resulting in neoantigens was discovered. In two phase II clinical trials in either the first or second-line setting, a high response rate was observed for immunotherapies with antibodies blocking the programmed death-1 (PD-1) and programmed death ligand-1 (PD-L1) immune checkpoints. RECENT FINDINGS The response rate was 56% with the anti-PD-1 inhibitor pembrolizumab as a first-line and 32% with the anti-PD-L1 antibody avelumab used as second-line therapy. Both treatments were well tolerated. Treatment response was rapid and in most cases maintained during follow-up, which, however, is still rather short. Whether the MCPyV or the PD-L1 status is predictive for treatment response and progression-free survival is still ambiguous. Additionally, clinical criteria for patient selection for immunotherapy of mMCC have not yet been defined. SUMMARY PD-1/PD-L1 inhibition can be regarded as new first-line therapy for patients with mMCC not amendable by surgery and/or radiation.
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Meerveld-Eggink A, Rozeman E, Lalezari F, van Thienen J, Haanen J, Blank C. Short-term CTLA-4 blockade directly followed by PD-1 blockade in advanced melanoma patients: a single-center experience. Ann Oncol 2017; 28:862-867. [DOI: 10.1093/annonc/mdw692] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Indexed: 01/23/2023] Open
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Rubin KM. Understanding Immune Checkpoint Inhibitors for Effective Patient Care. Clin J Oncol Nurs 2017; 19:709-17. [PMID: 26583635 DOI: 10.1188/15.cjon.709-717] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Immune checkpoint inhibitors represent a paradigm change in the treatment of melanoma and other advanced cancers. These agents manipulate key immune-regulating pathways to restore immune responses against tumors. The success of this approach is demonstrated by ipilimumab (Yervoy®) for the treatment of advanced melanoma, with improvement in three-year survival rates of about 20%. Newer checkpoint inhibitors targeting the programmed death-1 (PD-1) pathway have been approved and may have higher response rates and improved tolerability. OBJECTIVES This article aims to educate nurses and increase their comfort level with these new therapies. METHODS The mechanism of action of immune checkpoint inhibitors is reviewed, and insight is provided on how nurses can use this knowledge to more effectively care for patients receiving these therapies. FINDINGS The use of immuno-oncology agents is increasing. Oncology nurses must understand the basic immune mechanism of action responsible for the novel toxicity profile characterized by immune-related adverse events (irAEs) and clinical response patterns. Managing irAEs with immune checkpoint inhibitors is not necessarily more difficult than with conventional agents, but a difference does exist. Nurses and other healthcare providers must consider the underlying cause of toxicity with immune checkpoint inhibitors when making management decisions.
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Affiliation(s)
- Krista M Rubin
- Melanoma Disease Center, Massachusetts General Hospital Cancer Center in Boston
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Su M, Huang CX, Dai AP. Immune Checkpoint Inhibitors: Therapeutic Tools for Breast Cancer. Asian Pac J Cancer Prev 2017; 17:905-10. [PMID: 27039716 DOI: 10.7314/apjcp.2016.17.3.905] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Breast cancer is one of the major threats to female health, and its incidence is rapidly increasing in many countries. Currently, breast cancer is treated with surgery, followed by chemotherapy or radiation therapy, or both. However, a substantial proportion of breast cancer patients might have a risk for local relapse that leads to recurrence of their disease and/or metastatic breast cancer. Therefore searching for new and potential strategies for breast cancer treatment remains necessary. Immunotherapy is an attractive and promising approach that can exploit the ability of the immune system to identify and destroy tumors and thus prevent recurrence and metastatic lesions. The most promising and attractive approach of immunotherapeutic research in cancer is the blockade of immune checkpoints. In this review, we discuss the potential of certain inhibitors of immune checkpoints, such as antibodies targeting cytotoxic T-lymphocyte antigen 4 (CTLA-4), programmed death 1 (PD-1) and lymphocyte activation gene-3 (LAG-3), in breast cancer therapeutics. Immune checkpoint inhibitors may represent future standards of care for breast cancer as monotherapy or combined with standard therapies.
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Affiliation(s)
- Min Su
- Department of Human Anatomy, Histology and Embryology, Institute of Neuroscience, Changsha Medical University, Changsha, Hunan, China E-mail :
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Lyu M, Huang XJ. [Advances of therapeutic strategies in hematological malignancies]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2016; 37:1008-1011. [PMID: 27995892 PMCID: PMC7348503 DOI: 10.3760/cma.j.issn.0253-2727.2016.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Indexed: 11/28/2022]
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Carlsten M, Korde N, Kotecha R, Reger R, Bor S, Kazandjian D, Landgren O, Childs RW. Checkpoint Inhibition of KIR2D with the Monoclonal Antibody IPH2101 Induces Contraction and Hyporesponsiveness of NK Cells in Patients with Myeloma. Clin Cancer Res 2016; 22:5211-5222. [PMID: 27307594 DOI: 10.1158/1078-0432.ccr-16-1108] [Citation(s) in RCA: 124] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 05/28/2016] [Indexed: 12/29/2022]
Abstract
PURPOSE Immune checkpoint inhibitors have recently revolutionized cancer immunotherapy. On the basis of data showing KIR-ligand mismatched natural killer (NK) cells reduce the risk of leukemia and multiple myeloma relapse following allogeneic hematopoietic stem cell transplantation, investigators have developed a checkpoint inhibition antibody that blocks KIR on NK cells. Although in vitro studies suggest the KIR2D-specific antibody IPH2101 induces KIR-ligand mismatched tumor killing by NK cells, our single-arm phase II clinical trial in patients with smoldering multiple myeloma was prematurely terminated due to lack of clinical efficacy. This study aimed at unveiling the underlying mechanisms behind the lack of clinical efficacy. EXPERIMENTAL DESIGN Treatment-naïve patients received an intravenous infusion of 1 mg/kg IPH2101 every other month for up to a year. Peripheral blood was collected at baseline and 24 hours after first infusion, followed by weekly samples for the first month and monthly samples thereafter. NK cell phenotype and function was analyzed using high-resolution flow cytometry. RESULTS Unexpectedly, infusion of IPH2101 resulted in rapid reduction in both NK cell responsiveness and KIR2D expression on the NK cell surface. In vitro assays revealed KIR2D molecules are removed from the surface of IPH2101-treated NK cells by trogocytosis, with reductions in NK cell function directly correlating with loss of free KIR2D surface molecules. Although IPH2101 marginally augmented the antimyeloma cytotoxicity of remaining KIR2Ddull patient NK cells, the overall response was diminished by significant contraction and reduced function of KIR2D-expressing NK cells. CONCLUSIONS These data raise concerns that the unexpected biological events reported in this study could compromise antibody-based strategies designed at augmenting NK cell tumor killing via checkpoint inhibition. Clin Cancer Res; 22(21); 5211-22. ©2016 AACRSee related commentary by Felices and Miller, p. 5161.
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Affiliation(s)
- Mattias Carlsten
- Hematology Branch, National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland
| | - Neha Korde
- Metabolism Branch, NCI, NIH, Bethesda, Maryland
| | - Ritesh Kotecha
- Hematology Branch, National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland
| | - Robert Reger
- Hematology Branch, National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland
| | - Simona Bor
- Hematology Branch, National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland
| | | | | | - Richard W Childs
- Hematology Branch, National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland.
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Müller P, Kreuzaler M, Khan T, Thommen DS, Martin K, Glatz K, Savic S, Harbeck N, Nitz U, Gluz O, von Bergwelt-Baildon M, Kreipe H, Reddy S, Christgen M, Zippelius A. Trastuzumab emtansine (T-DM1) renders HER2+ breast cancer highly susceptible to CTLA-4/PD-1 blockade. Sci Transl Med 2016; 7:315ra188. [PMID: 26606967 DOI: 10.1126/scitranslmed.aac4925] [Citation(s) in RCA: 241] [Impact Index Per Article: 30.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Targeted drug delivery with antibody-drug conjugates such as the HER2-directed ado-trastuzumab emtansine (T-DM1) has emerged as a powerful strategy for cancer therapy. We show that T-DM1 is particularly effective in eliciting antitumor immunity in patients with early breast cancer (WSG-ADAPT trial) and in a HER2-expressing orthotopic tumor model. In the latter, despite primary resistance to immunotherapy, combined treatment with T-DM1 and anti-CTLA-4/PD-1 (cytotoxic T lymphocyte-associated protein-4/programmed cell death protein-1) was curative because it triggered innate and adaptive immunity. Tumor rejection was accompanied by massive T cell infiltration, TH1 (T helper 1) cell polarization, and, notably, a substantial increase in regulatory T cells. Depletion of regulatory T cells resulted in inflammation and tissue damage, implying their essential role in protecting the host during therapy. This study provides insights into the mechanisms of T-DM1's therapeutic activity and a rationale for potential therapeutic combination strategies with immunotherapy.
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Affiliation(s)
- Philipp Müller
- Department of Biomedicine, University Hospital and University of Basel, CH-4031 Basel, Switzerland.
| | - Matthias Kreuzaler
- Department of Biomedicine, University Hospital and University of Basel, CH-4031 Basel, Switzerland
| | - Tarik Khan
- Department of Biosystems Science and Engineering, ETH Zürich, CH-4058 Basel, Switzerland
| | - Daniela S Thommen
- Department of Biomedicine, University Hospital and University of Basel, CH-4031 Basel, Switzerland. Department of Medical Oncology, University Hospital Basel, CH-4031 Basel, Switzerland
| | - Kea Martin
- Department of Biomedicine, University Hospital and University of Basel, CH-4031 Basel, Switzerland
| | - Katharina Glatz
- Institute of Pathology, University Hospital Basel, CH-4031 Basel, Switzerland
| | - Spasenija Savic
- Institute of Pathology, University Hospital Basel, CH-4031 Basel, Switzerland
| | - Nadia Harbeck
- Breast Center, Department of Obstetrics and Gynecology, University of Munich, D-81377 Munich, Germany. West German Study Group, D-41061 Mönchengladbach, Germany
| | - Ulrike Nitz
- West German Study Group, D-41061 Mönchengladbach, Germany. Women's Clinic, Heinrich Heine University Düsseldorf, D-40225 Düsseldorf, Germany. Breast Center Niederrhein, Ev. Bethesda Hospital, D-41061 Mönchengladbach, Germany
| | - Oleg Gluz
- West German Study Group, D-41061 Mönchengladbach, Germany. Breast Center Niederrhein, Ev. Bethesda Hospital, D-41061 Mönchengladbach, Germany
| | | | - Hans Kreipe
- West German Study Group, D-41061 Mönchengladbach, Germany. Institute of Pathology, Hannover Medical School, D-30625 Hannover, Germany
| | - Sai Reddy
- Department of Biosystems Science and Engineering, ETH Zürich, CH-4058 Basel, Switzerland
| | - Matthias Christgen
- West German Study Group, D-41061 Mönchengladbach, Germany. Institute of Pathology, Hannover Medical School, D-30625 Hannover, Germany
| | - Alfred Zippelius
- Department of Biomedicine, University Hospital and University of Basel, CH-4031 Basel, Switzerland. Department of Medical Oncology, University Hospital Basel, CH-4031 Basel, Switzerland.
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Liang J, Liu X, Xie Q, Chen G, Li X, Jia Y, Yin B, Qu X, Li Y. Endostatin enhances antitumor effect of tumor antigen-pulsed dendritic cell therapy in mouse xenograft model of lung carcinoma. Chin J Cancer Res 2016; 28:452-60. [PMID: 27647974 PMCID: PMC5018541 DOI: 10.21147/j.issn.1000-9604.2016.04.09] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Objective To investigate the antitumor effect of endostatin combined with tumor antigen-pulsed dendritic cell (DC)-T cell therapy on lung cancer. Methods Transplanted Lewis lung cancer (LLC) models of C57BL/6 mice were established by subcutaneous injection of LLC cells in left extremity axillary. Tumor antigen-pulsed DC-T cells from spleen cells and bone of mice were cultured in vitro. Tumor-bearing mice were randomly divided into three groups, including DC-T+endostatin group, DC-T group, and phosphate-buffered saline (PBS) control group. Microvessel density (MVD) of tumor tissue in tumor-bearing mice was determined by immunohistochemistry (IHC). The expressions of vascular endothelial growth factor (VEGF) and hypoxia-inducible factor-1α (HIF-1α) were determined by Western blotting and IHC staining. The proportions of CD8+ T cells, mature dendritic cells (mDC), tumor-associated macrophages [TAM (M1/M2)], and myeloid-derived suppressor cells (MDSC) in suspended cells of tumor tissue were determined by flow cytometry. The expressions of interleukin (IL)-6, IL-10, IL-17, transforming growth factor-β (TGF-β) and interferon-γ (IFN-γ) in suspended cells of tumor tissue were detected by enzyme-linked immune sorbent assay (ELISA). Results DC-T cells combined with endostatin remarkably suppressed tumor growth. MVD of mice in DC-T+endostatin group was significantly lower than that of the control group and DC-T monotherapy group. The expressions of VEGF, IL-6 and IL-17 in tumors were markedly decreased, but IFN-γ and HIF-1α increased after treating with DC-T cells combined with endostatin, compared to control group and DC-T group. In the DC-T+endostatin group, the proportions of MDSC and TAM (M2 type) were significantly decreased, mDC and TAM (M1 type) were up-regulated, and CD8+ T cells were recruited to infiltrate tumors, in contrast to PBS control and DC-T monotherapy. DC-T cells combined with endostatin potently reduced the expressions of IL-6, IL-10, TGF-β and IL-17 in tumor tissue, and enhanced the expression of IFN-γ. Conclusions The study indicated the synergic antitumor effects between endostatin and tumor antigen-pulsed DC-T cells, which may be a prospective therapy strategy to achieve potent antitumor effects on lung cancer.
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Affiliation(s)
| | | | - Qi Xie
- Central Laboratory, Qianfoshan Hospital, Shandong University, Jinan 250014, China
| | - Guoling Chen
- Islet Cell Lab, MedStar Georgetown University Hospital, Washington DC 20007, USA
| | | | | | - Beibei Yin
- Central Laboratory, Qianfoshan Hospital, Shandong University, Jinan 250014, China
| | - Xun Qu
- Institute of Basic Medical Sciences and Key Laboratory of Cardiovascular Proteomics of Shandong Province, Qilu Hospital, Shandong University, Jinan 250012, China
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Habets THPM, Oth T, Houben AW, Huijskens MJAJ, Senden-Gijsbers BLMG, Schnijderberg MCA, Brans B, Dubois LJ, Lambin P, De Saint-Hubert M, Germeraad WTV, Tilanus MGJ, Mottaghy FM, Bos GMJ, Vanderlocht J. Fractionated Radiotherapy with 3 x 8 Gy Induces Systemic Anti-Tumour Responses and Abscopal Tumour Inhibition without Modulating the Humoral Anti-Tumour Response. PLoS One 2016; 11:e0159515. [PMID: 27427766 PMCID: PMC4948777 DOI: 10.1371/journal.pone.0159515] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 07/05/2016] [Indexed: 11/18/2022] Open
Abstract
Accumulating evidence indicates that fractionated radiotherapy (RT) can result in distant non-irradiated (abscopal) tumour regression. Although preclinical studies indicate the importance of T cells in this infrequent phenomenon, these studies do not preclude that other immune mechanisms exhibit an addition role in the abscopal effect. We therefore addressed the question whether in addition to T cell mediated responses also humoral anti-tumour responses are modulated after fractionated RT and whether systemic dendritic cell (DC) stimulation can enhance tumour-specific antibody production. We selected the 67NR mammary carcinoma model since this tumour showed spontaneous antibody production in all tumour-bearing mice. Fractionated RT to the primary tumour was associated with a survival benefit and a delayed growth of a non-irradiated (contralateral) secondary tumour. Notably, fractionated RT did not affect anti-tumour antibody titers and the composition of the immunoglobulin (Ig) isotypes. Likewise, we demonstrated that treatment of tumour-bearing Balb/C mice with DC stimulating growth factor Flt3-L did neither modulate the magnitude nor the composition of the humoral immune response. Finally, we evaluated the immune infiltrate and Ig isotype content of the tumour tissue using flow cytometry and found no differences between treatment groups that were indicative for local antibody production. In conclusion, we demonstrate that the 67NR mammary carcinoma in Balb/C mice is associated with a pre-existing antibody response. And, we show that in tumour-bearing Balb/C mice with abscopal tumour regression such pre-existing antibody responses are not altered upon fractionated RT and/or DC stimulation with Flt3-L. Our research indicates that evaluating the humoral immune response in the setting of abscopal tumour regression is not invariably associated with therapeutic effects.
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Affiliation(s)
- Thomas H P M Habets
- Division of Hematology, Department of Internal Medicine, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center +, Maastricht, The Netherlands.,Tissue Typing Laboratory, Department of Transplantation Immunology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - Tammy Oth
- Division of Hematology, Department of Internal Medicine, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - Ans W Houben
- Division of Hematology, Department of Internal Medicine, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center +, Maastricht, The Netherlands.,Division of Nuclear Medicine, Department of Internal Medicine, School of NUTRIM, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - Mirelle J A J Huijskens
- Division of Hematology, Department of Internal Medicine, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - Birgit L M G Senden-Gijsbers
- Division of Hematology, Department of Internal Medicine, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - Melanie C A Schnijderberg
- Division of Hematology, Department of Internal Medicine, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - Boudewijn Brans
- Division of Nuclear Medicine, Department of Internal Medicine, School of NUTRIM, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - Ludwig J Dubois
- MaastRO Laboratory, Department of Radiation Oncology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - Philippe Lambin
- MaastRO Laboratory, Department of Radiation Oncology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - Marijke De Saint-Hubert
- Division of Nuclear Medicine, Department of Internal Medicine, School of NUTRIM, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - Wilfred T V Germeraad
- Division of Hematology, Department of Internal Medicine, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center +, Maastricht, The Netherlands.,CiMaas BV, Maastricht, The Netherlands
| | - Marcel G J Tilanus
- Tissue Typing Laboratory, Department of Transplantation Immunology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - Felix M Mottaghy
- Division of Nuclear Medicine, Department of Internal Medicine, School of NUTRIM, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - Gerard M J Bos
- Division of Hematology, Department of Internal Medicine, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center +, Maastricht, The Netherlands.,CiMaas BV, Maastricht, The Netherlands
| | - Joris Vanderlocht
- Tissue Typing Laboratory, Department of Transplantation Immunology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center +, Maastricht, The Netherlands
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Kroon P, Gadiot J, Peeters M, Gasparini A, Deken MA, Yagita H, Verheij M, Borst J, Blank CU, Verbrugge I. Concomitant targeting of programmed death-1 (PD-1) and CD137 improves the efficacy of radiotherapy in a mouse model of human BRAFV600-mutant melanoma. Cancer Immunol Immunother 2016; 65:753-63. [PMID: 27160390 PMCID: PMC4880641 DOI: 10.1007/s00262-016-1843-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 04/28/2016] [Indexed: 01/18/2023]
Abstract
T cell checkpoint blockade with antibodies targeting programmed cell death (ligand)-1 (PD-1/PD-L1) and/or cytotoxic T lymphocyte-antigen 4 (CTLA-4) has improved therapy outcome in melanoma patients. However, a considerable proportion of patients does not benefit even from combined α-CTLA-4 and α-PD-1 therapy. We therefore examined to which extent T cell (co)stimulation and/or stereotactic body radiation therapy (SBRT) could further enhance the therapeutic efficacy of T cell checkpoint blockade in a genetically engineered mouse melanoma model that is driven by PTEN-deficiency, and BRAFV600 mutation, as in human, but lacks the sporadic UV-induced mutations. Tumor-bearing mice were treated with different combinations of immunomodulatory antibodies (α-CTLA-4, α-PD-1, α-CD137) or interleukin-2 (IL-2) alone or in combination with SBRT. None of our immunotherapeutic approaches (alone or in combination) had any anti-tumor efficacy, while SBRT alone delayed melanoma outgrowth. However, α-CD137 combined with α-PD-1 antibodies significantly enhanced the anti-tumor effect of SBRT, while the anti-tumor effect of SBRT was not enhanced by interleukin-2, or the combination of α-CTLA-4 and α-PD-1. We conclude that α-CD137 and α-PD-1 antibodies were most effective in enhancing SBRT-induced tumor growth delay in this mouse melanoma model, outperforming the ability of IL-2, or the combination of α-CTLA-4 and α-PD-1 to synergize with SBRT. Given the high mutational load and increased immunogenicity of human melanoma with the same genotype, our findings encourage testing α-CD137 and α-PD-1 alone or in combination with SBRT clinically, particularly in patients refractory to α-CTLA-4 and/or α-PD-1 therapy.
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Affiliation(s)
- Paula Kroon
- Divisions of Immunology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Jules Gadiot
- Divisions of Immunology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Marlies Peeters
- Divisions of Immunology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Alessia Gasparini
- Divisions of Radiotherapy, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Marcel A Deken
- Divisions of Immunology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Hideo Yagita
- Department of Immunology, Juntendo University School of Medicine, Tokyo, Japan
| | - Marcel Verheij
- Divisions of Radiotherapy, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Jannie Borst
- Divisions of Immunology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Christian U Blank
- Divisions of Immunology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
- Divisions of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
| | - Inge Verbrugge
- Divisions of Immunology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
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Halpert MM, Konduri V, Liang D, Chen Y, Wing JB, Paust S, Levitt JM, Decker WK. Dendritic Cell-Secreted Cytotoxic T-Lymphocyte-Associated Protein-4 Regulates the T-cell Response by Downmodulating Bystander Surface B7. Stem Cells Dev 2016; 25:774-87. [PMID: 26979751 DOI: 10.1089/scd.2016.0009] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The remarkable functional plasticity of professional antigen-presenting cells (APCs) allows the adaptive immune system to respond specifically to an incredibly diverse array of potential pathogenic insults; nonetheless, the specific molecular effectors and mechanisms that underpin this plasticity remain poorly characterized. Cytotoxic T-lymphocyte-associated protein-4 (CTLA-4), the target of the blockbuster cancer immunotherapeutic ipilimumab, is one of the most well-known and well-studied members of the B7 superfamily and negatively regulates T cell responses by a variety of known mechanisms. Although CTLA-4 is thought to be expressed almost exclusively among lymphoid lineage hematopoietic cells, a few reports have indicated that nonlymphoid APCs can also express the CTLA-4 mRNA transcript and that transcript levels can be regulated by external stimuli. In this study, we substantially build upon these critical observations, definitively demonstrating that mature myeloid lineage dendritic cells (DC) express significant levels of intracellular CTLA-4 that they constitutively secrete in microvesicular structures. CTLA-4(+) microvesicles can competitively bind B7 costimulatory molecules on bystander DC, resulting in downregulation of B7 surface expression with significant functional consequences for downstream CD8(+) T-cell responses. Hence, the data indicate a previously unknown role for DC-derived CTLA-4 in immune cell functional plasticity and have significant implication for the design and implementation of immunomodulatory strategies intended to treat cancer and infectious disease.
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Affiliation(s)
- Matthew M Halpert
- 1 Department of Pathology & Immunology, Baylor College of Medicine , Houston, Texas
| | - Vanaja Konduri
- 1 Department of Pathology & Immunology, Baylor College of Medicine , Houston, Texas
| | - Dan Liang
- 1 Department of Pathology & Immunology, Baylor College of Medicine , Houston, Texas
| | - Yunyu Chen
- 1 Department of Pathology & Immunology, Baylor College of Medicine , Houston, Texas
| | - James B Wing
- 2 Immunology Frontier Research Center, Osaka University , Osaka, Japan
| | - Silke Paust
- 3 Department of Pediatrics, Baylor College of Medicine , Houston, Texas
- 4 Center for Human Immunobiology, Baylor College of Medicine , Houston, Texas
| | - Jonathan M Levitt
- 1 Department of Pathology & Immunology, Baylor College of Medicine , Houston, Texas
- 5 Department of Urology, Baylor College of Medicine , Houston, Texas
| | - William K Decker
- 1 Department of Pathology & Immunology, Baylor College of Medicine , Houston, Texas
- 6 Center for Cell and Gene Therapy, Baylor College of Medicine , Houston, Texas
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Menderes G, Hicks C, Black JD, Schwab CL, Santin AD. Immune checkpoint inhibitors in gynecologic cancers with lessons learned from non-gynecologic cancers. Expert Opin Biol Ther 2016; 16:989-1004. [DOI: 10.1080/14712598.2016.1177018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Hamanishi J, Mandai M, Konishi I. Immune checkpoint inhibition in ovarian cancer. Int Immunol 2016; 28:339-48. [PMID: 27055470 DOI: 10.1093/intimm/dxw020] [Citation(s) in RCA: 108] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 04/05/2016] [Indexed: 12/13/2022] Open
Abstract
Recent studies have shown that tumor cells acquire escape mechanisms to evade host immunity in the tumor microenvironment. Two key immune checkpoint pathways mediated by immunosuppressive co-signaling, the first via programmed cell death 1 (PD-1) and PD-1 ligand 1 (PD-1/PD-L1) and the second via CTLA-4 and B7 (CTLA-4/B7), have been previously described. Several clinical trials have revealed an outstanding anti-tumor efficacy of immune checkpoint inhibitors (anti-CTLA-4 antibody, anti-PD-1 antibody and/or anti-PD-L1 antibody) in patients with various types of solid malignancies, including non-small cell lung cancer, melanoma, renal cell cancer and ovarian cancer. In this review, we examine pre-clinical studies that described the local immune status and immune checkpoint signals in ovarian cancer, highlight recent clinical trials that evaluated immune checkpoint inhibitors against ovarian cancer and discuss the clinical issues regarding immune checkpoint inhibitors.
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Affiliation(s)
- Junzo Hamanishi
- Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, 54 Shogoinkawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Masaki Mandai
- Department of Obstetrics and Gynecology, Kinki University, Higashiosaka, Osaka, 577-8502, Japan
| | - Ikuo Konishi
- Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, 54 Shogoinkawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
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35
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Fairchild PJ, Leishman A, Sachamitr P, Telfer C, Hackett S, Davies TJ. Dendritic cells and pluripotency: unlikely allies in the pursuit of immunotherapy. Regen Med 2016; 10:275-86. [PMID: 25933237 DOI: 10.2217/rme.15.6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
As the fulcrum on which the balance between the opposing forces of tolerance and immunity has been shown to pivot, dendritic cells (DC) hold significant promise for immune intervention in a variety of disease states. Here we discuss how the directed differentiation of human pluripotent stem cells may address many of the current obstacles to the use of monocyte-derived DC in immunotherapy, providing a novel source of previously inaccessible DC subsets and opportunities for their scale-up, quality control and genetic modification. Indeed, given that it is the immunological legacy DC leave behind that is of therapeutic value, rather than their persistence per se, we propose that immunotherapy should serve as an early target for the clinical application of pluripotent stem cells.
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Affiliation(s)
- Paul J Fairchild
- Sir William Dunn School of Pathology, University of Oxford, South Parks Road, Oxford, OX1 3RE, UK
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Brunn ND, Mauze S, Gu D, Wiswell D, Ueda R, Hodges D, Beebe AM, Zhang S, Escandon E. The Role of Anti-Drug Antibodies in the Pharmacokinetics, Disposition, Target Engagement, and Efficacy of a GITR Agonist Monoclonal Antibody in Mice. ACTA ACUST UNITED AC 2015; 356:574-86. [DOI: 10.1124/jpet.115.229864] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 12/14/2015] [Indexed: 12/17/2022]
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Aoun F, Kourie HR, Sideris S, Roumeguère T, Velthoven RV, Gil T. Checkpoint inhibitors in bladder and renal cancers: results and perspectives. Immunotherapy 2015; 7:1259-71. [DOI: 10.2217/imt.15.91] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The field of immunotherapy in urinary malignancy is expanding in several directions and checkpoint inhibitors are leading the way. The aim of this report is to highlight the efficacy and safety profile of the two classes of molecules, anti-cytotoxic T-lymphocyte antigen-4 and anti-programmed death receptor-1/programmed death ligand type 1, that are under investigation and represent potential candidates to be used in the near future for the management of bladder and renal cell cancer. The preliminary results as well as the future perspectives of this novel immunotherapy are analyzed. Novel immune checkpoint targets are reviewed as well.
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Affiliation(s)
- Fouad Aoun
- Department of Urology, Jules Bordet Institute, 1 Héger Bordet Street, 1000 Brussels, Belgium
| | - Hampig R Kourie
- Department of Oncology, Jules Bordet Institute, 1 Héger Bordet Street, 1000 Brussels, Belgium
| | - Spyridon Sideris
- Department of Oncology, Jules Bordet Institute, 1 Héger Bordet Street, 1000 Brussels, Belgium
| | - Thierry Roumeguère
- Department of Urology, Erasme Hospital, Route de Lennik 808, 1070 Brussels, Belgium
| | - Roland van Velthoven
- Department of Urology, Jules Bordet Institute, 1 Héger Bordet Street, 1000 Brussels, Belgium
| | - Thierry Gil
- Department of Oncology, Jules Bordet Institute, 1 Héger Bordet Street, 1000 Brussels, Belgium
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Guislain A, Gadiot J, Kaiser A, Jordanova ES, Broeks A, Sanders J, van Boven H, de Gruijl TD, Haanen JBAG, Bex A, Blank CU. Sunitinib pretreatment improves tumor-infiltrating lymphocyte expansion by reduction in intratumoral content of myeloid-derived suppressor cells in human renal cell carcinoma. Cancer Immunol Immunother 2015; 64:1241-50. [PMID: 26105626 PMCID: PMC11028512 DOI: 10.1007/s00262-015-1735-z] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 06/09/2015] [Indexed: 12/16/2022]
Abstract
Targeted therapy with sunitinib, pazopanib or everolimus has improved treatment outcome for patients with metastatic renal cell carcinoma patients (RCC). However, despite considerable efforts in sequential or combined modalities, durable remissions are rare. Immunotherapy like cytokine therapy with interleukin-2, T cell checkpoint blockade or adoptive T cell therapies can achieve long-term benefit and even cure. This raises the question of whether combining targeted therapy with immunotherapy could also be an effective treatment option for RCC patients. Sunitinib, one of the most frequently administered therapeutics in RCC patients has been implicated in impairing T cell activation and proliferation in vitro. In this work, we addressed whether this notion holds true for expansion of tumor-infiltrating lymphocytes (TILs) in sunitinib-treated patients. We compared resected primary RCC tumor material of patients pretreated with sunitinib with resection specimen from sunitinib-naïve patients. We found improved TIL expansion from sunitinib-pretreated tumor digests. These TIL products contained more PD-1 expressing TIL, while the regulatory T cell infiltration was not altered. The improved TIL expansion was associated with reduced intratumoral myeloid-derived suppressor cell (MDSC) content. Depletion of MDSCs from sunitinib-naïve RCC tissue-digest improved TIL expansion, proving the functional relevance of the MDSC alteration by sunitinib. Our in vivo results do not support previous in vitro observations of sunitinib inhibiting T cell function, but do provide a possible rationale for the combination of sunitinib with immunotherapy.
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Affiliation(s)
- Aurelie Guislain
- Division of Immunology, The Netherlands Cancer Institute (NKI), Amsterdam, The Netherlands
- Sanquin Blood Supply Foundation, Amsterdam, The Netherlands
| | - Jules Gadiot
- Division of Immunology, The Netherlands Cancer Institute (NKI), Amsterdam, The Netherlands
| | - Andrew Kaiser
- Division of Immunology, The Netherlands Cancer Institute (NKI), Amsterdam, The Netherlands
- Miltenyi Biotec, Bergisch Gladbach, Germany
| | - Ekaterina S. Jordanova
- Division of Immunology, The Netherlands Cancer Institute (NKI), Amsterdam, The Netherlands
- Center for Gynecological Oncology Amsterdam (CGOA), Free University Medical Center (VUMC), Amsterdam, The Netherlands
- Core Facility Molecular Pathology and Biobanking, The Netherlands Cancer Institute (NKI), Amsterdam, The Netherlands
| | - Annegien Broeks
- Core Facility Molecular Pathology and Biobanking, The Netherlands Cancer Institute (NKI), Amsterdam, The Netherlands
| | - Joyce Sanders
- Department of Pathology, The Netherlands Cancer Institute (NKI), Amsterdam, The Netherlands
| | - Hester van Boven
- Department of Pathology, The Netherlands Cancer Institute (NKI), Amsterdam, The Netherlands
| | - Tanja D. de Gruijl
- Department of Medical Oncology, Free University Medical Center (VUMC), Amsterdam, The Netherlands
| | - John B. A. G. Haanen
- Division of Immunology, The Netherlands Cancer Institute (NKI), Amsterdam, The Netherlands
- Department of Medical Oncology, The Netherlands Cancer Institute (NKI), Plesmanlaan 121, 1066CX Amsterdam, The Netherlands
| | - Axel Bex
- Division of Surgical Oncology, Department of Urology, The Netherlands Cancer Institute (NKI), Amsterdam, The Netherlands
| | - Christian U. Blank
- Division of Immunology, The Netherlands Cancer Institute (NKI), Amsterdam, The Netherlands
- Department of Medical Oncology, The Netherlands Cancer Institute (NKI), Plesmanlaan 121, 1066CX Amsterdam, The Netherlands
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Abstract
PURPOSE OF REVIEW To outline the most urgent challenges in the management of advanced melanoma. RECENT FINDINGS Considerable progress in targeted and immunotherapy of advanced melanoma has opened a perspective for a cure if all molecular and medical information is integrated in a rational precision treatment algorithm. SUMMARY Bioinformatics and system biology approaches will be needed to deal with omics databases. The support of patient advocacy groups may help to increase the acceptance of large scale, routine biobanking.
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Michielin O, Hoeller C. Gaining momentum: New options and opportunities for the treatment of advanced melanoma. Cancer Treat Rev 2015; 41:660-70. [DOI: 10.1016/j.ctrv.2015.05.012] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 05/26/2015] [Accepted: 05/27/2015] [Indexed: 12/31/2022]
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Xu C, Ricciuti A, Caturegli P, Keene CD, Kargi AY. Autoimmune lymphocytic hypophysitis in association with autoimmune eye disease and sequential treatment with infliximab and rituximab. Pituitary 2015; 18:441-7. [PMID: 25224140 DOI: 10.1007/s11102-014-0592-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Autoimmune lymphocytic hypophysitis associates predominantly with other autoimmune endocrinopathies and is most commonly treated with glucocorticoids and/or decompressive pituitary surgery. Here we report a new association and treatment modality for lymphocytic hypophysitis. METHODS A 52-year-old woman presented with scleritis, uveitis, facial palsy, and central diabetes insipidus, accompanied by thickened pituitary stalk and enlarged pituitary on cranial MRI. Neurosarcoidosis was suspected and treatment with glucocorticoids and methotrexate initiated. Since symptoms persisted, infliximab (a monoclonal antibody that antagonizes tumor necrosis factor alpha) was added to her regimen. The patient initially improved but after 6 months developed recurrent pituitary enlargement, bilateral optic neuritis, and panhypopituitarism. To ascertain the nature of the pituitary lesion, she underwent transsphenoidal biopsy, which revealed lymphocytic hypophysitis with numerous CD20 positive B lymphocytes. The pathological finding suggested to us that administration of rituximab (a monoclonal antibody that lyzes B cells expressing CD20) could be useful. Following two courses of rituximab, the pituitary mass resolved and the corticotroph axis partially recovered. The patient has remained in remission during 3 years of follow up. CONCLUSION This is the first report of hypophysitis occurring with the triad of scleritis, uveitis, and optic neuritis, as well as the first immunotherapy based on the sequential use of infliximab and rituximab.
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Affiliation(s)
- Chengyu Xu
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA,
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Chakrabarti L, Morgan C, Sandler AD. Combination of Id2 Knockdown Whole Tumor Cells and Checkpoint Blockade: A Potent Vaccine Strategy in a Mouse Neuroblastoma Model. PLoS One 2015; 10:e0129237. [PMID: 26079374 PMCID: PMC4469424 DOI: 10.1371/journal.pone.0129237] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Accepted: 05/06/2015] [Indexed: 12/14/2022] Open
Abstract
Tumor vaccines have held much promise, but to date have demonstrated little clinical success. This lack of success is conceivably due to poor tumor antigen presentation combined with immuno-suppressive mechanisms exploited by the tumor itself. Knock down of Inhibitor of differentiation protein 2 (Id2-kd) in mouse neuroblastoma whole tumor cells rendered these cells immunogenic. Id2-kd neuroblastoma (Neuro2a) cells (Id2-kd N2a) failed to grow in most immune competent mice and these mice subsequently developed immunity against further wild-type Neuro2a tumor cell challenge. Id2-kd N2a cells grew aggressively in immune-compromised hosts, thereby establishing the immunogenicity of these cells. Therapeutic vaccination with Id2-kd N2a cells alone suppressed tumor growth even in established neuroblastoma tumors and when used in combination with immune checkpoint blockade eradicated large established tumors. Mechanistically, immune cell depletion studies demonstrated that while CD8+ T cells are critical for antitumor immunity, CD4+ T cells are also required to induce a sustained long-lasting helper effect. An increase in number of CD8+ T-cells and enhanced production of interferon gamma (IFNγ) was observed in tumor antigen stimulated splenocytes of vaccinated mice. More importantly, a massive influx of cytotoxic CD8+ T-cells infiltrated the shrinking tumor following combined immunotherapy. These findings show that down regulation of Id2 induced tumor cell immunity and in combination with checkpoint blockade produced a novel, potent, T-cell mediated tumor vaccine strategy.
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Affiliation(s)
- Lina Chakrabarti
- The Joseph E. Robert Jr. Center for Surgical Care and The Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National Medical Center, George Washington University, Washington, District of Columbia, United States of America
| | - Clifford Morgan
- The Joseph E. Robert Jr. Center for Surgical Care and The Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National Medical Center, George Washington University, Washington, District of Columbia, United States of America
| | - Anthony D. Sandler
- The Joseph E. Robert Jr. Center for Surgical Care and The Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National Medical Center, George Washington University, Washington, District of Columbia, United States of America
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Trends of Systemic Therapy Use for Renal Cell Carcinoma in the United States. Urology 2015; 85:1399-403. [DOI: 10.1016/j.urology.2015.03.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 02/20/2015] [Accepted: 03/09/2015] [Indexed: 01/12/2023]
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Hekim N, Cetin Z, Nikitaki Z, Cort A, Saygili EI. Radiation triggering immune response and inflammation. Cancer Lett 2015; 368:156-63. [PMID: 25911239 DOI: 10.1016/j.canlet.2015.04.016] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 04/13/2015] [Accepted: 04/15/2015] [Indexed: 12/23/2022]
Abstract
Radiation therapy (RT) is a well-established but still under optimization branch of Cancer Therapy (CT). RT uses electromagnetic waves or charged particles in order to kill malignant cells, by accumulating the energy onto these cells. The issue at stake for RT, as well as for any other Cancer Therapy technique, is always to kill only cancer cells, without affecting the surrounding healthy ones. This perspective of CT is usually described under the terms "specificity" and "selectivity". Specificity and selectivity are the ideal goal, but the ideal is never entirely achieved. Thus, in addition to killing healthy cells, changes and effects are observed in the immune system after irradiation. In this review, we mainly focus on the effects of ionizing radiation on the immune system and its components like bone marrow. Additionally, we are interested in the effects and benefits of low-dose ionizing radiation on the hematopoiesis and immune response. Low dose radiation has been shown to induce biological responses like inflammatory responses, innate immune system activation and DNA repair (adaptive response). This review reveals the fact that there are many unanswered questions regarding the role of radiation as either an immune-activating (low dose) or immunosuppressive (high dose) agent.
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Affiliation(s)
- Nezih Hekim
- Department of Medical Biochemistry, School of Medicine, SANKO University, Gaziantep, Turkey
| | - Zafer Cetin
- Department of Medical Biology & Genetics, School of Medicine, SANKO University, Gaziantep, Turkey
| | - Zacharenia Nikitaki
- Department of Physics, School of Applied Mathematical and Physical Sciences, National Technical University of Athens, Zografou 15780, Athens, Greece
| | - Aysegul Cort
- Department of Medical Biochemistry, School of Medicine, SANKO University, Gaziantep, Turkey; Department of Nutrition and Dietetics, Faculty of Health Sciences, SANKO University, Gaziantep, Turkey
| | - Eyup Ilker Saygili
- Department of Medical Biochemistry, School of Medicine, SANKO University, Gaziantep, Turkey.
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Laurent C, Charmpi K, Gravelle P, Tosolini M, Franchet C, Ysebaert L, Brousset P, Bidaut A, Ycart B, Fournié JJ. Several immune escape patterns in non-Hodgkin's lymphomas. Oncoimmunology 2015; 4:e1026530. [PMID: 26405585 PMCID: PMC4570141 DOI: 10.1080/2162402x.2015.1026530] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 02/27/2015] [Accepted: 02/27/2015] [Indexed: 12/31/2022] Open
Abstract
Follicular Lymphomas (FL) and diffuse large B cell lymphomas (DLBCL) must evolve some immune escape strategy to develop from lymphoid organs, but their immune evasion pathways remain poorly characterized. We investigated this issue by transcriptome data mining and immunohistochemistry (IHC) of FL and DLBCL lymphoma biopsies. A set of genes involved in cancer immune-evasion pathways (Immune Escape Gene Set, IEGS) was defined and the distribution of the expression levels of these genes was compared in FL, DLBCL and normal B cell transcriptomes downloaded from the GEO database. The whole IEGS was significantly upregulated in all the lymphoma samples but not in B cells or other control tissues, as shown by the overexpression of the PD-1, PD-L1, PD-L2 and LAG3 genes. Tissue microarray immunostainings for PD-1, PD-L1, PD-L2 and LAG3 proteins on additional biopsies from 27 FL and 27 DLBCL patients confirmed the expression of these proteins. The immune infiltrates were more abundant in FL than DLBCL samples, and the microenvironment of FL comprised higher rates of PD-1+ lymphocytes. Further, DLBCL tumor cells comprised a higher proportion of PD-1+, PD-L1+, PD-L2+ and LAG3+ lymphoma cells than the FL tumor cells, confirming that DLBCL mount immune escape strategies distinct from FL. In addition, some cases of DLBCL had tumor cells co-expressing both PD-1, PD-L1 and PD-L2. Among the DLBCLs, the activated B cell (ABC) subtype comprised more PD-L1+ and PD-L2+ lymphoma cells than the GC subtype. Thus, we infer that FL and DLBCL evolved several pathways of immune escape.
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Affiliation(s)
- Camille Laurent
- Institut Universitaire du Cancer-Oncopole de Toulouse ; Toulouse, France ; Centre de Recherches en Cancérologie de Toulouse; INSERM UMR1037 ; Toulouse, France ; Université Toulouse III Paul-Sabatier ; Toulouse, France ; ERL 5294 CNRS ; Toulouse, France ; Programme Hospitalo-Universitaire en Cancérologie CAPTOR ; Toulouse, France ; Institut Carnot Lymphome CALYM ; Toulouse, France ; Laboratoire d'Excellence 'TOUCAN' ; Toulouse, France
| | - Konstantina Charmpi
- Laboratoire d'Excellence 'TOUCAN' ; Toulouse, France ; Laboratoire Jean Kuntzmann; CNRS UMR5224 ; Grenoble, France
| | - Pauline Gravelle
- Institut Universitaire du Cancer-Oncopole de Toulouse ; Toulouse, France ; Centre de Recherches en Cancérologie de Toulouse; INSERM UMR1037 ; Toulouse, France ; Université Toulouse III Paul-Sabatier ; Toulouse, France ; ERL 5294 CNRS ; Toulouse, France ; Programme Hospitalo-Universitaire en Cancérologie CAPTOR ; Toulouse, France ; Institut Carnot Lymphome CALYM ; Toulouse, France ; Laboratoire d'Excellence 'TOUCAN' ; Toulouse, France
| | - Marie Tosolini
- Centre de Recherches en Cancérologie de Toulouse; INSERM UMR1037 ; Toulouse, France ; Université Toulouse III Paul-Sabatier ; Toulouse, France ; ERL 5294 CNRS ; Toulouse, France ; Programme Hospitalo-Universitaire en Cancérologie CAPTOR ; Toulouse, France ; Institut Carnot Lymphome CALYM ; Toulouse, France ; Laboratoire d'Excellence 'TOUCAN' ; Toulouse, France
| | - Camille Franchet
- Institut Universitaire du Cancer-Oncopole de Toulouse ; Toulouse, France
| | - Loïc Ysebaert
- Institut Universitaire du Cancer-Oncopole de Toulouse ; Toulouse, France ; Centre de Recherches en Cancérologie de Toulouse; INSERM UMR1037 ; Toulouse, France ; Université Toulouse III Paul-Sabatier ; Toulouse, France ; ERL 5294 CNRS ; Toulouse, France ; Programme Hospitalo-Universitaire en Cancérologie CAPTOR ; Toulouse, France ; Institut Carnot Lymphome CALYM ; Toulouse, France ; Laboratoire d'Excellence 'TOUCAN' ; Toulouse, France
| | - Pierre Brousset
- Institut Universitaire du Cancer-Oncopole de Toulouse ; Toulouse, France ; Centre de Recherches en Cancérologie de Toulouse; INSERM UMR1037 ; Toulouse, France ; Université Toulouse III Paul-Sabatier ; Toulouse, France ; ERL 5294 CNRS ; Toulouse, France ; Programme Hospitalo-Universitaire en Cancérologie CAPTOR ; Toulouse, France ; Institut Carnot Lymphome CALYM ; Toulouse, France ; Laboratoire d'Excellence 'TOUCAN' ; Toulouse, France
| | | | - Bernard Ycart
- Laboratoire d'Excellence 'TOUCAN' ; Toulouse, France ; Laboratoire Jean Kuntzmann; CNRS UMR5224 ; Grenoble, France
| | - Jean-Jacques Fournié
- Centre de Recherches en Cancérologie de Toulouse; INSERM UMR1037 ; Toulouse, France ; Université Toulouse III Paul-Sabatier ; Toulouse, France ; ERL 5294 CNRS ; Toulouse, France ; Programme Hospitalo-Universitaire en Cancérologie CAPTOR ; Toulouse, France ; Institut Carnot Lymphome CALYM ; Toulouse, France ; Laboratoire d'Excellence 'TOUCAN' ; Toulouse, France
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Hojjat-Farsangi M. Novel and emerging targeted-based cancer therapy agents and methods. Tumour Biol 2015; 36:543-56. [PMID: 25663495 DOI: 10.1007/s13277-015-3184-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 01/27/2015] [Indexed: 02/06/2023] Open
Abstract
After several decades of uncovering the cancer features and following the improvement of therapeutic agents, however cancer remains as one of the major reasons of mortality. Chemotherapy is one of the main treatment options and has significantly improved the overall survival of cancer patients, but chemotherapeutic agents are highly toxic for normal cells. Therefore, there is a great unmet medical need to develop new therapeutic principles and agents. Targeted-based cancer therapy (TBCT) agents and methods have revolutionized the cancer treatment efficacy. Monoclonal antibodies (mAbs) and small molecule inhibitors (SMIs) are among the most effective agents of TBCT. These drugs have improved the prognosis and survival of cancer patients; however, the therapeutic resistance has subdued the effects. Several mechanisms lead to drug resistance such as mutations in the drug targets, activation of compensatory pathways, and intrinsic or acquired resistance of cancer stem cells. Therefore, new modalities, improving current generation of inhibitors and mAbs, and optimizing the combinational therapy regimens are necessary to decrease the current obstacles in front of TBCT. Moreover, the success of new TBCT agents such as mAbs, SMIs, and immunomodulatory agents has sparked further therapeutic modalities with novel targets to inhibit. Due to the lack of cumulative information describing different agents and methods of TBCT, this review focuses on the most important agents and methods of TBCT that are currently under investigation.
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Affiliation(s)
- Mohammad Hojjat-Farsangi
- Department of Oncology-Pathology, Immune and Gene therapy Lab, Cancer Center Karolinska (CCK), Karolinska University Hospital Solna and Karolinska Institute, SE-171 76, Stockholm, Sweden,
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Deyev SM, Lebedenko EN, Petrovskaya LE, Dolgikh DA, Gabibov AG, Kirpichnikov MP. Man-made antibodies and immunoconjugates with desired properties: function optimization using structural engineering. RUSSIAN CHEMICAL REVIEWS 2015. [DOI: 10.1070/rcr4459] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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48
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Vela M, Aris M, Llorente M, Garcia-Sanz JA, Kremer L. Chemokine receptor-specific antibodies in cancer immunotherapy: achievements and challenges. Front Immunol 2015; 6:12. [PMID: 25688243 PMCID: PMC4311683 DOI: 10.3389/fimmu.2015.00012] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 01/07/2015] [Indexed: 12/22/2022] Open
Abstract
The 1990s brought a burst of information regarding the structure, expression pattern, and role in leukocyte migration and adhesion of chemokines and their receptors. At that time, the FDA approved the first therapeutic antibodies for cancer treatment. A few years later, it was reported that the chemokine receptors CXCR4 and CCR7 were involved on directing metastases to liver, lung, bone marrow, or lymph nodes, and the over-expression of CCR4, CCR6, and CCR9 by certain tumors. The possibility of inhibiting the interaction of chemokine receptors present on the surface of tumor cells with their ligands emerged as a new therapeutic approach. Therefore, many research groups and companies began to develop small molecule antagonists and specific antibodies, aiming to neutralize signaling from these receptors. Despite great expectations, so far, only one anti-chemokine receptor antibody has been approved for its clinical use, mogamulizumab, an anti-CCR4 antibody, granted in Japan to treat refractory adult T-cell leukemia and lymphoma. Here, we review the main achievements obtained with anti-chemokine receptor antibodies for cancer immunotherapy, including discovery and clinical studies, proposed mechanisms of action, and therapeutic applications.
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Affiliation(s)
- Maria Vela
- Department of Immunology and Oncology, Centro Nacional de Biotecnología, Consejo Superior de Investigaciones Científicas (CNB/CSIC), Madrid, Spain
| | - Mariana Aris
- Centro de Investigaciones Oncológicas, Fundación Cáncer, Buenos Aires, Argentina
| | - Mercedes Llorente
- Protein Tools Unit, Centro Nacional de Biotecnología, Consejo Superior de Investigaciones Científicas (CNB/CSIC), Madrid, Spain
| | - Jose A. Garcia-Sanz
- Department of Cellular and Molecular Medicine, Centro de Investigaciones Biológicas, Consejo Superior de Investigaciones Científicas (CIB/CSIC), Madrid, Spain
| | - Leonor Kremer
- Department of Immunology and Oncology, Centro Nacional de Biotecnología, Consejo Superior de Investigaciones Científicas (CNB/CSIC), Madrid, Spain
- Protein Tools Unit, Centro Nacional de Biotecnología, Consejo Superior de Investigaciones Científicas (CNB/CSIC), Madrid, Spain
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49
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Romagnoli GG, Zelante BB, Toniolo PA, Migliori IK, Barbuto JAM. Dendritic Cell-Derived Exosomes may be a Tool for Cancer Immunotherapy by Converting Tumor Cells into Immunogenic Targets. Front Immunol 2015; 5:692. [PMID: 25646096 PMCID: PMC4298225 DOI: 10.3389/fimmu.2014.00692] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 12/31/2014] [Indexed: 01/17/2023] Open
Abstract
Dendritic cells (DCs) have been attracting attention in cancer immunotherapy because of their role in inducing and modulating effective immune responses. Besides the direct contact with other cell types and the secretion of cytokines, it is becoming clear that nanovesicles, such as exosomes (Exo), secreted by DCs also have a role in their function. Conversely, tumor-derived Exo carry antigens and have been used as a source of specific stimulus for the immune response against tumors. At the same time, several works have shown that different cells types incorporate DC-derived Exo (DC-Exo), resulting in modifications of their phenotype and function. Since DC-Exo carry many of the immune function-associated molecules of DCs, their incorporation by tumor cells could turn tumor cells into immunogenic targets. We have, therefore, treated human breast adenocarcinoma cells (SK-BR-3) with DCs-Exo and used these to stimulate previously SK-BR-3-primed CD3+ T-cells. Sensitized T-cells cultured with DC-Exo-treated tumor cells showed a significantly higher percentage of IFN-γ-secreting cells (as measured by ELISPOT), when compared to the frequency of cells responding to non-DC-Exo-treated cells. These data show that the incorporation of DC-Exo by the tumor cells increased their ability to activate T-cells for a possibly more effective response, thus showing that DC-Exo may become another tool in cancer immunotherapy.
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Affiliation(s)
- Graziela Gorete Romagnoli
- Laboratory of Tumor Immunology, Department of Immunology, Institute of Biomedical Sciences, University of São Paulo , São Paulo , Brazil
| | - Bruna Barbosa Zelante
- Laboratory of Tumor Immunology, Department of Immunology, Institute of Biomedical Sciences, University of São Paulo , São Paulo , Brazil
| | - Patrícia Argenta Toniolo
- Laboratory of Tumor Immunology, Department of Immunology, Institute of Biomedical Sciences, University of São Paulo , São Paulo , Brazil
| | - Isabella Katz Migliori
- Laboratory of Tumor Immunology, Department of Immunology, Institute of Biomedical Sciences, University of São Paulo , São Paulo , Brazil
| | - José Alexandre M Barbuto
- Laboratory of Tumor Immunology, Department of Immunology, Institute of Biomedical Sciences, University of São Paulo , São Paulo , Brazil ; Center for Cellular and Molecular Studies and Therapy (NETCEM), University of São Paulo , São Paulo , Brazil
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50
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Brauns T, Leblanc P, Gelfand JA, Poznanski M. Could mycobacterial Hsp70-containing fusion protein lead the way to an affordable therapeutic cancer vaccine? Expert Rev Vaccines 2014; 14:435-46. [PMID: 25496347 DOI: 10.1586/14760584.2015.979797] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Cancer vaccine development efforts have recently gained momentum, but most vaccines showing clinical impact in human trials tend to be based on technology approaches that are very costly and difficult to produce at scale. With the projected doubling of the incidence of cancer and its related cost of care in the U.S. over the next two decades, the widespread clinical use of such vaccines will prove difficult to justify. Heat shock protein-based vaccines have shown the potential to elicit clinically meaningful immunologic responses in cancer, but the predominant development approach - heat shock protein-peptide complexes derived from a patient's own tumor - face similar challenges of cost and scalability. New innovative modalities for deploying heat shock proteins in cancer vaccines may open the door to vaccines that can generate potent cytotoxic responses against multiple tumor targets and can be made in a cost-effective and scalable manner.
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Affiliation(s)
- Timothy Brauns
- Vaccine and Immunotherapy Center, Massachusetts General Hospital - Medicine/Infectious Diseases, 149 13th Street, Mailstop 149-5-5246, Charlestown, MA 02129, USA
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