1
|
Garrone O, Paccagnella M, Abbona A, Ruatta F, Vanella P, Denaro N, Tomasello G, Croce N, Barbin F, Rossino MG, La Porta CAM, Sapino A, Torri V, Albini A, Merlano MC. Moderate physical activity during neoadjuvant chemotherapy in breast cancer patients: effect on cancer-related inflammation and pathological complete response-the Neo-Runner study. ESMO Open 2024; 9:103665. [PMID: 39121813 DOI: 10.1016/j.esmoop.2024.103665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Revised: 07/06/2024] [Accepted: 07/15/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Physical activity (PA) reduces the risk of developing breast cancer (BC) and mortality rate in BC patients starting PA after diagnosis. Immunomodulation is considered responsible for these effects. However, limited data exist on the immunomodulation induced by moderate PA (mPA) during neoadjuvant chemotherapy (NACT). We have investigated the longitudinal change of cytokines during NACT alone or combined with mPA. MATERIALS AND METHODS Twenty-three cytokines were analyzed in BC patients at consecutive timepoints: at baseline (T0), before starting mPA (T1), before surgery (T2), and after surgery (T3). mPA consisted of 3-weekly brisk-walking sessions for 9-10 consecutive weeks. RESULTS Ninety-two patients were assessed: 21 patients refused mPA (untrained) and 71 agreed (trained). At T1, NACT induced significant up-regulation of interleukin (IL)-5, IL-6, IL-15, chemokine ligand (CCL)-2, interferon-γ, and C-X-C motif ligand (CXCL)-10 and reduction of expression of IL-13 and CCL-22. At T2, NACT and mPA induced up-regulation of IL-21, CCL-2, and tumor necrosis factor-α and reduction of expression of IL-8, IL-15, vascular endothelial growth factor, and soluble interleukin 6 receptor. Only CXCL-10 increased in untrained patients. A cytokine score (CS) was created to analyze, all together, the changes between T1 and T2. At T2 the CS decreased in trained and increased in untrained patients. We clustered the patients using cytokines and predictive factors and identified two clusters. The cluster A, encompassing 90% of trained patients, showed more pathological complete response (pCR) compared to the cluster B: 78% versus 22%, respectively. CONCLUSIONS mPA interacts with NACT inducing CS reduction in trained patients not observed in untrained patients, suggesting a reduction of inflammation, notwithstanding chemotherapy. This effect may contribute to the higher rate of pCR observed in the cluster A, including most trained patients.
Collapse
Affiliation(s)
- O Garrone
- Department of Medical Oncology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan.
| | - M Paccagnella
- Translational Oncology ARCO Foundation, Cuneo. https://twitter.com/matteo_babeuf
| | - A Abbona
- Translational Oncology ARCO Foundation, Cuneo. https://twitter.com/AbbonaAndr36863
| | - F Ruatta
- Department of Medical Oncology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan. https://twitter.com/fiorella_ruatta
| | - P Vanella
- Department of Medical Oncology, S. Croce e Carle Teaching Hospital, Cuneo
| | - N Denaro
- Department of Medical Oncology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan
| | - G Tomasello
- Medical Oncology, ASST Ospedale Maggiore Crema, Crema. https://twitter.com/glucatom
| | - N Croce
- Department of Medical Oncology, S. Croce e Carle Teaching Hospital, Cuneo
| | - F Barbin
- Department of Medical Oncology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan
| | - M G Rossino
- Department of Medical Oncology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan
| | - C A M La Porta
- Center for Complexity and Biosystems, University of Milan, Milan; Department of Environmental Science and Policy, University of Milan, Milan. https://twitter.com/CAMLaPorta
| | - A Sapino
- Scientific Direction, Candiolo Cancer Institute, FPO-IRCCS Candiolo, Turin; Department of Medical Science, University of Turin, Turin. https://twitter.com/sapino58
| | - V Torri
- Mario Negri Institute for Pharmacological Research, Milan. https://twitter.com/ValterTorri
| | - A Albini
- European Institute of Oncology, Milan, Italy. https://twitter.com/adrianaalbini1
| | - M C Merlano
- Scientific Direction, Candiolo Cancer Institute, FPO-IRCCS Candiolo, Turin
| |
Collapse
|
2
|
Saldajeno DP, Kawaoka S, Masuda N, Tanaka S, Bando H, Nishimura T, Kadoya T, Yamanaka T, Imoto S, Velaga RM, Tamura N, Aruga T, Ikeda K, Fukui Y, Maeshima Y, Takada M, Suzuki E, Ueno T, Ogawa S, Haga H, Ohno S, Morita S, Kawaguchi K, Toi M. Time-series blood cytokine profiles correlate with treatment responses in triple-negative breast cancer patients. Br J Cancer 2024; 130:1023-1035. [PMID: 38238427 PMCID: PMC10951271 DOI: 10.1038/s41416-023-02527-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 10/12/2023] [Accepted: 11/27/2023] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Triple-negative breast cancer (TNBC) is the most heterogeneous breast cancer subtype. Partly due to its heterogeneity, it is currently challenging to stratify TNBC patients and predict treatment outcomes. METHODS In this study, we examined blood cytokine profiles of TNBC patients throughout treatments (pre-treatment, during chemotherapy, pre-surgery, and 1 year after the surgery in a total of 294 samples). We analyzed the obtained cytokine datasets using weighted correlation network analyses, protein-protein interaction analyses, and logistic regression analyses. RESULTS We identified five cytokines that correlate with good clinical outcomes: interleukin (IL)-1α, TNF-related apoptosis-inducing ligand (TRAIL), Stem Cell Factor (SCF), Chemokine ligand 5 (CCL5 also known as RANTES), and IL-16. The expression of these cytokines was decreased during chemotherapy and then restored after the treatment. Importantly, patients with good clinical outcomes had constitutively high expression of these cytokines during treatments. Protein-protein interaction analyses implicated that these five cytokines promote an immune response. Logistic regression analyses revealed that IL-1α and TRAIL expression levels at pre-treatment could predict treatment outcomes in our cohort. CONCLUSION We concluded that time-series cytokine profiles in breast cancer patients may be useful for understanding immune cell activity during treatment and for predicting treatment outcomes, supporting precision medicine. TRIAL REGISTRATION The study has been registered with the University Hospital Medical Information Network Clinical Trials Registry ( http://www.umin.ac.jp/ctr/index-j.htm ) with the unique trial number UMIN000023162. The association Japan Breast Cancer Research Group trial number is JBCRG-22. The clinical outcome of the JBCRG-22 study was published in Breast Cancer Research and Treatment on 25 March 2021. https://doi.org/10.1007/s10549-021-06184-w .
Collapse
Affiliation(s)
- Don Pietro Saldajeno
- Inter-Organ Communication Research Team, Institute for Life and Medical Sciences, Kyoto University, 54 Kawahara-cho, Shogoin Sakyo-ku, Kyoto, 606-8507, Japan
- Mathematical Informatics Laboratory, Division of Information Science, Nara Institute of Science and Technology, 8916-5 Takayama-cho, Ikoma, Nara, 630-0192, Japan
| | - Shinpei Kawaoka
- Inter-Organ Communication Research Team, Institute for Life and Medical Sciences, Kyoto University, 54 Kawahara-cho, Shogoin Sakyo-ku, Kyoto, 606-8507, Japan
- Department of Integrative Bioanalytics, Institute of Development, Aging and Cancer, Tohoku University, Sendai, 980-8575, Japan
| | - Norikazu Masuda
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Sunao Tanaka
- Department of Breast Surgery, Kyoto University Hospital, Graduate School of Medicine, 54 Kawahara-cho, Shogoin Sakyo-ku, Kyoto, 606-8507, Japan
| | - Hiroko Bando
- Breast and Endocrine Surgery, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Tomomi Nishimura
- Department of Breast Surgery, Kyoto University Hospital, Graduate School of Medicine, 54 Kawahara-cho, Shogoin Sakyo-ku, Kyoto, 606-8507, Japan
- Department of Next-generation Clinical Genomic Medicine, Kyoto University Graduate School of Medicine, Yoshida-Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan
- Department of Pathology and Tumor Biology, Kyoto University Graduate School of Medicine, Yoshida-Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan
| | - Takayuki Kadoya
- Department of Breast Surgery, Shimane University Hospital, Enyacho 89-1, Izumo, Shimane, 693-0021, Japan
| | - Takashi Yamanaka
- Department of Breast Surgery and Oncology, Kanagawa Cancer Center, 2-3-2 Nakano, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Shigeru Imoto
- Department of Breast Surgery, Kyorin University Hospital, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan
| | - Ravindranath M Velaga
- Department of Breast Surgery, Kyoto University Hospital, Graduate School of Medicine, 54 Kawahara-cho, Shogoin Sakyo-ku, Kyoto, 606-8507, Japan
| | - Nobuko Tamura
- Department of Breast and Endocrine Surgery, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan
| | - Tomoyuki Aruga
- Department of Breast Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan
| | - Kazushi Ikeda
- Mathematical Informatics Laboratory, Division of Information Science, Nara Institute of Science and Technology, 8916-5 Takayama-cho, Ikoma, Nara, 630-0192, Japan
| | - Yukiko Fukui
- Department of Breast Surgery, Kyoto University Hospital, Graduate School of Medicine, 54 Kawahara-cho, Shogoin Sakyo-ku, Kyoto, 606-8507, Japan
| | - Yurina Maeshima
- Department of Breast Surgery, Kyoto University Hospital, Graduate School of Medicine, 54 Kawahara-cho, Shogoin Sakyo-ku, Kyoto, 606-8507, Japan
| | - Masahiro Takada
- Department of Breast Surgery, Kyoto University Hospital, Graduate School of Medicine, 54 Kawahara-cho, Shogoin Sakyo-ku, Kyoto, 606-8507, Japan
| | - Eiji Suzuki
- Department of Breast Surgery, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminamimachi Chuo-ku, Kobe-shi, Hyogo, 650-0047, Japan
| | - Takayuki Ueno
- Breast Surgical Oncology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Seishi Ogawa
- Department of Pathology and Tumor Biology, Kyoto University Graduate School of Medicine, Yoshida-Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan
- Department of Pathology and Tumor Biology, Institute for the Advanced Study of Human Biology (WPI-ASHBi), Kyoto University Graduate School of Medicine, Yoshida-Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan
| | - Hironori Haga
- Department of Diagnostic Pathology, Kyoto University Hospital, 54 Kawahara-cho, Shogoin Sakyo-ku, Kyoto, 606-8507, Japan
| | - Shinji Ohno
- Breast Oncology Center, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Satoshi Morita
- Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin Sakyo-ku, Kyoto, 606-8507, Japan
| | - Kosuke Kawaguchi
- Department of Breast Surgery, Kyoto University Hospital, Graduate School of Medicine, 54 Kawahara-cho, Shogoin Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Masakazu Toi
- Department of Breast Surgery, Kyoto University Hospital, Graduate School of Medicine, 54 Kawahara-cho, Shogoin Sakyo-ku, Kyoto, 606-8507, Japan.
- Tokyo Metropolitan Cancer and Infectious Disease Center, Komagome Hospital, 3-18-22, Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan.
| |
Collapse
|
3
|
Bun A, Nagahashi M, Kuroiwa M, Komatsu M, Miyoshi Y. Baseline interleukin-6 is a prognostic factor for patients with metastatic breast cancer treated with eribulin. Breast Cancer Res Treat 2023; 202:575-583. [PMID: 37733188 PMCID: PMC10564839 DOI: 10.1007/s10549-023-07086-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/10/2023] [Indexed: 09/22/2023]
Abstract
PURPOSE Eribulin is a unique anti-cancer drug which can improve overall survival (OS) of patients with metastatic breast cancer (MBC), probably by modulating the tumor immune microenvironment. The aim of this study was to investigate the clinical significance of serum levels of immune-related and inflammatory cytokines in patients treated with eribulin. Furthermore, we investigated the association between cytokines and immune cells, such as myeloid-derived suppressor cells (MDSCs) and cytotoxic and regulatory T cells, to explore how these cytokines might affect the immune microenvironment. METHODS Sixty-eight patients with MBC treated with eribulin were recruited for this retrospective study. The relationship of cytokines, including interleukin (IL)-6, to progression-free survival and OS was examined. CD4+ and CD8+ lymphocyte, MDSCs and regulatory T cell levels were determined in the blood by flow cytometry analysis. RESULTS In our cohort, patients with high IL-6 at baseline had shorter progression-free survival and OS compared with those with low IL-6 (p = 0.0017 and p = 0.0012, respectively). Univariable and multivariable analyses revealed that baseline IL-6 was an independent prognostic factor for OS (p = 0.0058). Importantly, CD8+ lymphocytes were significantly lower and MDSCs were significantly higher in patients with high IL-6, compared to those with low IL-6. CONCLUSION Baseline IL-6 is an important prognostic factor in patients with MBC treated with eribulin. Our results show that high IL-6 is associated with higher levels of MDSCs which suppress anti-tumor immunity, such as CD8+ cells. It appears that eribulin is not particularly effective in patients with high IL-6 due to a poor tumor immune microenvironment.
Collapse
Affiliation(s)
- Ayako Bun
- Department of Surgery, Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Masayuki Nagahashi
- Department of Surgery, Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Mamiko Kuroiwa
- Department of Surgery, Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Miki Komatsu
- Department of Surgery, Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Yasuo Miyoshi
- Department of Surgery, Division of Breast and Endocrine Surgery, School of Medicine, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.
| |
Collapse
|
4
|
Merlano MC, Paccagnella M, Denaro N, Abbona A, Galizia D, Sangiolo D, Gammaitoni L, Fiorino E, Minei S, Bossi P, Licitra L, Garrone O. Baseline Values of Circulating IL-6 and TGF-β Might Identify Patients with HNSCC Who Do Not Benefit from Nivolumab Treatment. Cancers (Basel) 2023; 15:5257. [PMID: 37958430 PMCID: PMC10649732 DOI: 10.3390/cancers15215257] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 10/20/2023] [Accepted: 10/31/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND The immunotherapy of head and neck cancer induces a limited rate of long-term survivors at the cost of treating many patients exposed to toxicity without benefit, regardless of PD-L1 expression. The identification of better biomarkers is warranted. We analyzed a panel of cytokines, chemokines and growth factors, hereinafter all referred to as 'cytokines', as potential biomarkers in patients with head and neck cancer treated with nivolumab. MATERIALS AND METHODS A total of 18 circulating cytokines were analyzed. Samples were gathered at baseline (T0) and after 3 courses of nivolumab (T1) in patients with relapsed/metastatic disease. The data extracted at T0 were linked to survival; the comparison of T0-T1 explored the effect of immunotherapy. RESULTS A total of 22 patients were accrued: 64% current heavy smokers, 36% female and 14% had PS = 2. At T0, ROC analysis showed that IL-6, IL-8, IL-10 and TGF-β were higher in patients with poor survival. Cox analysis demonstrated that only patients with the IL-6 and TGF-β discriminate had good or poor survival, respectively. Longitudinal increments of CCL-4, IL-15, IL-2 and CXCL-10 were observed in all patients during nivolumab treatment. CONCLUSION In this small population with poor clinical characteristics, this study highlights the prognostic role of IL-6 and TGF-β. Nivolumab treatment is associated with a positive modulation of some Th1 cytokines, but it does not correlate with the outcome.
Collapse
Affiliation(s)
- Marco Carlo Merlano
- Candiolo Cancer Institute, FPO-IRCCS Candiolo, 10060 Torino, Italy; (M.C.M.); (D.G.); (L.G.)
| | | | - Nerina Denaro
- Medical Oncology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy; (N.D.); (O.G.)
| | - Andrea Abbona
- Translational Oncology ARCO Foundation, 12100 Cuneo, Italy;
| | - Danilo Galizia
- Candiolo Cancer Institute, FPO-IRCCS Candiolo, 10060 Torino, Italy; (M.C.M.); (D.G.); (L.G.)
| | - Dario Sangiolo
- Department of Oncology, University of Turin, 10060 Torino, Italy; (D.S.); (E.F.)
| | - Loretta Gammaitoni
- Candiolo Cancer Institute, FPO-IRCCS Candiolo, 10060 Torino, Italy; (M.C.M.); (D.G.); (L.G.)
| | - Erika Fiorino
- Department of Oncology, University of Turin, 10060 Torino, Italy; (D.S.); (E.F.)
| | - Silvia Minei
- Post-Graduate School of Specialization Medical Oncology, University of Bari “A. Moro”, 70120 Bari, Italy;
- Medical Oncology, A.U.O. Consorziale Policlinico di Bari, 70120 Bari, Italy
| | - Paolo Bossi
- Medical Oncology, Department of Medical and Surgical Specialties, Radiological Sciences, Public Health, University of Brescia, 25123 Brescia, Italy;
| | - Lisa Licitra
- Fondazione IRCCS Istituto Nazionale dei Tumori, University of Milan, 20133 Milan, Italy;
| | - Ornella Garrone
- Medical Oncology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy; (N.D.); (O.G.)
| |
Collapse
|
5
|
Hayashi T, Kobayashi N, Ushida K, Asai N, Nakano S, Fujii K, Ando T, Utsumi T. Effect of eribulin on epithelial-mesenchymal transition plasticity in metastatic breast cancer: An exploratory, prospective study. Genes Cells 2023; 28:364-373. [PMID: 36849792 DOI: 10.1111/gtc.13019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 02/01/2023] [Accepted: 02/20/2023] [Indexed: 03/01/2023]
Abstract
Epithelial-mesenchymal transition (EMT) plays a pivotal role in cancer metastasis and treatment resistance, which worsens prognosis. In phase III trials, eribulin improved overall survival in metastatic breast cancer (MBC) patients. In preclinical studies, eribulin suppressed EMT. However, clinical data on the use of eribulin for MBC patients are limited. In this exploratory, prospective study, we examined the effect of eribulin on EMT in MBC patients. Twenty-two patients aged 44-82 years with recurrent breast cancer or MBC were treated with eribulin. Breast cancer tissue samples were obtained before treatment and on Day 15 ± 5 of the first cycle of eribulin treatment. EMT markers (E-cadherin, claudin-3, vimentin, and N-cadherin) were analyzed using western blotting. EMT changes were evaluated based on the ratio of epithelial to mesenchymal markers before and after treatment in individual tumors. E-cadherin/vimentin, claudin-3/vimentin, E-cadherin/N-cadherin, and claudin-3/N-cadherin ratios were significantly higher after treatment (p = .007, p = .005, p = .006, and p = .011, respectively). Based on E-cadherin/vimentin, 65.0% of tumors shifted to an epithelial phenotype, as compared to 66.7% based on claudin-3/vimentin, 84.6% based on E-cadherin/N-cadherin, and 71.4% based on claudin-3/N-cadherin ratios. Thus, our results showed that eribulin suppressed EMT in breast cancer tissues.
Collapse
Affiliation(s)
- Takanori Hayashi
- Department of Biochemistry, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Naomi Kobayashi
- Department of Breast Surgery, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Aichi, Japan
| | - Kaori Ushida
- Department of Pathology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Naoya Asai
- Department of Pathology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Shogo Nakano
- Division of Breast and Endocrine Surgery, Department of Surgery, Aichi Medical University, Nagakute, Aichi, Japan
| | - Kimihito Fujii
- Division of Breast and Endocrine Surgery, Department of Surgery, Aichi Medical University, Nagakute, Aichi, Japan
| | - Takahito Ando
- Division of Breast and Endocrine Surgery, Department of Surgery, Aichi Medical University, Nagakute, Aichi, Japan
| | - Toshiaki Utsumi
- Department of Surgery, Fujita Health University School of Medicine, Nagoya, Aichi, Japan
| |
Collapse
|
6
|
The Role of Cytokinome in the HNSCC Tumor Microenvironment: A Narrative Review and Our Experience. Diagnostics (Basel) 2022; 12:diagnostics12112880. [PMID: 36428939 PMCID: PMC9689412 DOI: 10.3390/diagnostics12112880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/31/2022] [Accepted: 11/14/2022] [Indexed: 11/22/2022] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer. In locally advanced (LA) HNSCC, a multidisciplinary approach consisting of surgery followed by chemoradiation (CRT) or definitive CRT is the mainstay of treatment. In recurrent metastatic (R/M), HNSCC immune checkpoint inhibitors (ICIs) with or without chemotherapy represent the new first-line option. However, cancer will recur in about two out of five patients with LA HNSCC. If progression occurs within six months from platin-radiotherapy treatment, anti-programmed cell death-1 (PD-1) may be prescribed. Otherwise, immunotherapy with or without chemotherapy might be considered if PD-L1 is expressed. Despite several improvements in the outcome of patients with R/M HNSCC, overall survival (OS) remains dismal, equaling a median of 14 months. In-depth knowledge of the tumor microenvironment (TME) would be required to change the course of this complex disease. In recent years, many predictive and prognostic biomarkers have been studied in the HNSCC TME, but none of them alone can select the best candidates for response to ICIs or targeted therapy (e.g., Cetuximab). The presence of cytokines indicates an immune response that might occur, among other things, after tumor antigen recognition, viral and bacterial infection, and physic damage. An immune response against HNSCC results in the production of some cytokines that induce a pro-inflammatory response and attract cells, such as neutrophils, macrophages, and T cell effectors, to enhance the innate and adaptive anti-tumor response. We revised the role of a group of cytokines as biomarkers for treatment response in HNSCC.
Collapse
|
7
|
Paccagnella M, Abbona A, Michelotti A, Geuna E, Ruatta F, Landucci E, Denaro N, Vanella P, Lo Nigro C, Galizia D, Merlano M, Garrone O. Circulating Cytokines in Metastatic Breast Cancer Patients Select Different Prognostic Groups and Patients Who Might Benefit from Treatment beyond Progression. Vaccines (Basel) 2022; 10:78. [PMID: 35062739 PMCID: PMC8781714 DOI: 10.3390/vaccines10010078] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 12/28/2021] [Accepted: 01/03/2022] [Indexed: 12/28/2022] Open
Abstract
Cancer induces immune suppression to overcome its recognition and eradication by the immune system. Cytokines are messengers able to modulate immune response or suppression. There is great interest in the evaluation of their changes during treatment in order to identify their relationship with clinical outcome. We evaluated 18 cytokines in breast cancer patients treated with eribulin before starting treatment (T0) and after four courses of therapy (T1). Longitudinal modifications were considered and cytokine clusters through PCA and HCPC correlated to patients' outcomes were identified. Forty-one metastatic breast cancer patients and fifteen healthy volunteers were included. After clustering, we identified at T0 six patient clusters with different risk of relapse and death. At T1, only four clusters were identified, and three of them accounted for thirty-eight of forty-one patients, suggesting a possible role of treatment in reducing heterogeneity. The cluster with the best survival at T1 was characterized by low levels of IL-4, IL-6, IL-8, IL-10, CCL-2, CCL-4, and TGF-β. The cluster showing the worst survival encompassed high levels of IL-4, IL-6, IL-8, IL-10, CCL-2, and IFN-γ. A subgroup of patients with short progression-free survival (PFS) and long overall survival (OS) was comprised in the cluster characterized by low levels of CCL-2, IL-6, IL-8, IL-10, and IL-12 at T0. Our data support the prognostic significance of longitudinal serum cytokine analysis. This approach may help identify patients for whom early treatment stop avoids needless toxicity or might justify treatment beyond early progression. Further investigations are required to validate this hypothesis.
Collapse
Affiliation(s)
| | - Andrea Abbona
- Translational Oncology ARCO Foundation, 12100 Cuneo, Italy;
| | - Andrea Michelotti
- Department of Medical Oncology, Azienda Ospedaliero Universitaria Pisana, 56126 Pisa, Italy; (A.M.); (E.L.)
| | - Elena Geuna
- Multidisciplinary Oncology Outpatient Clinic, Candiolo Cancer Institute FPO-IRCCS, 10060 Candiolo, Italy; (E.G.); (D.G.)
| | - Fiorella Ruatta
- Department of Medical Oncology, S. Croce e Carle Teaching Hospital, 12100 Cuneo, Italy; (F.R.); (N.D.); (P.V.)
| | - Elisabetta Landucci
- Department of Medical Oncology, Azienda Ospedaliero Universitaria Pisana, 56126 Pisa, Italy; (A.M.); (E.L.)
| | - Nerina Denaro
- Department of Medical Oncology, S. Croce e Carle Teaching Hospital, 12100 Cuneo, Italy; (F.R.); (N.D.); (P.V.)
| | - Paola Vanella
- Department of Medical Oncology, S. Croce e Carle Teaching Hospital, 12100 Cuneo, Italy; (F.R.); (N.D.); (P.V.)
| | | | - Danilo Galizia
- Multidisciplinary Oncology Outpatient Clinic, Candiolo Cancer Institute FPO-IRCCS, 10060 Candiolo, Italy; (E.G.); (D.G.)
| | - Marco Merlano
- Experimental Cell Therapy Lab, Candiolo Cancer Institute, FPO-IRCCS Candiolo, 10060 Torino, Italy;
| | - Ornella Garrone
- Department of Medical Oncology, Fondazione IRCCS Ca’ Granda Ospedale Policlinico Maggiore, 20122 Milano, Italy;
| |
Collapse
|
8
|
Kobayashi H, Okuma T, Okajima K, Ishibashi Y, Zhang L, Hirai T, Ohki T, Ikegami M, Sawada R, Shinoda Y, Akiyama T, Goto T, Tanaka S. Systemic inflammation response index (SIRI) as a predictive factor for overall survival in advanced soft tissue sarcoma treated with eribulin. J Orthop Sci 2022; 27:222-228. [PMID: 33384219 DOI: 10.1016/j.jos.2020.11.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 11/10/2020] [Accepted: 11/23/2020] [Indexed: 01/21/2023]
Abstract
BACKGROUND Eribulin is a tubulin and microtubule-targeting drug that has clinical benefit in overall survival (OS) for patients with advanced soft tissue sarcoma. Eribulin's efficacy has been confirmed in several clinical trials, although no clinically useful biomarkers have been identified. We therefore sought to clarify the predictive factor of eribulin treatment, while focusing on systemic inflammation and immune response values. METHODS This study included 33 advanced STS patients treated with eribulin between March 2016 and September 2019. We evaluated the associations of clinical factors influencing the efficacy of eribulin treatment and systemic inflammatory and immune response, including the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), the lymphocyte-to-monocyte ratio (LMR), the systemic inflammation response index (SIRI), and the prognostic nutrition index (PNI), with progression-free survival (PFS) and OS using the Kaplan-Meier method and log-rank test. RESULTS NLR, LMR, PLR, SIRI, and PNI were unassociated with PFS. Compared with patients with SIRI <1.5, those with an SIRI ≥1.5 had a significantly shorter OS [median OS 15 months (95% confidence interval [CI] 8-not reached) vs. 7 months (95% CI 3-14), P = 0.04]. Moreover, the PFS tended to be shorter for patients with SIRI ≥1.5 who received chemotherapy after eribulin treatment than in those with SIRI >1.5 [median PFS 92.5 days (95% CI 27-204) vs. 133 days (95% CI 36-507), P = 0.08]. CONCLUSIONS High SIRI values may predict poorer overall survival and the efficacy of subsequent drugs after eribulin treatment among patients with advanced soft tissue sarcoma.
Collapse
Affiliation(s)
- Hiroshi Kobayashi
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Tomotake Okuma
- Department of Musculoskeletal Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan
| | - Koichi Okajima
- Department of Musculoskeletal Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan
| | - Yuki Ishibashi
- Department of Musculoskeletal Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan
| | - Liuzhe Zhang
- Department of Orthopaedic Surgery, Saitama Medical Center, Jichi Medical University
| | - Toshihide Hirai
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Takahiro Ohki
- Department of Musculoskeletal Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan
| | - Masachika Ikegami
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Ryoko Sawada
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yusuke Shinoda
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Toru Akiyama
- Department of Orthopaedic Surgery, Saitama Medical Center, Jichi Medical University
| | - Takahiro Goto
- Department of Musculoskeletal Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| |
Collapse
|
9
|
Eribulin and Paclitaxel Differentially Alter Extracellular Vesicles and Their Cargo from Triple-Negative Breast Cancer Cells. Cancers (Basel) 2021; 13:cancers13112783. [PMID: 34205051 PMCID: PMC8199867 DOI: 10.3390/cancers13112783] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/22/2021] [Accepted: 05/31/2021] [Indexed: 12/15/2022] Open
Abstract
Extracellular vesicles play a central role in intercellular communication and contribute to cancer progression, including the epithelial-to-mesenchymal transition (EMT). Microtubule targeting agents (MTAs) including eribulin and paclitaxel continue to provide significant value in cancer therapy and their abilities to inhibit oncogenic signaling pathways, including eribulin's capacity to reverse EMT are being revealed. Because microtubules are involved in the intracellular trafficking required for the formation and cargo loading of small extracellular vesicles (sEVs), we investigated whether MTA-mediated disruption of microtubule-dependent transport would impact sEV release and their cargo. Eribulin and paclitaxel caused an intracellular accumulation of CD63, a tetraspanin component of sEVs, in late/multivesicular endosomes of triple-negative breast cancer cells, consistent with the disruption of endosomal sorting and exosome cargo loading in these cells. While the concentrations of sEVs released from MTA-treated cells were not significantly altered, levels of CD63 and the CD63-associated cargos, ILK and β-integrin, were reduced in sEVs isolated from eribulin-treated HCC1937 cells as compared to vehicle or paclitaxel-treated cells. These results show that eribulin can reduce specific sEV cargos, including ILK, a major transducer of EMT in the tumor microenvironment, which may contribute to eribulin's ability to reverse EMT to promote anticancer efficacy.
Collapse
|
10
|
Merlano MC, Abbona A, Paccagnella M, Falletta A, Granetto C, Ricci V, Fea E, Denaro N, Ruatta F, Merlotti A, Bertetto O, Crosetto N, Galizia D, Basiricò M, Gammaitoni L, Sangiolo D, Aglietta M, Garrone O. Cytokine Profiling of End Stage Cancer Patients Treated with Immunotherapy. Vaccines (Basel) 2021; 9:vaccines9030235. [PMID: 33800511 PMCID: PMC7999072 DOI: 10.3390/vaccines9030235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/04/2021] [Accepted: 03/06/2021] [Indexed: 01/22/2023] Open
Abstract
Published data suggest that immunotherapy plays a role even in patients with very advanced tumours. We investigated the immune profile of end-stage cancer patients treated with immunotherapy to identify changes induced by treatment. Breast, colon, renal and prostate cancer patients were eligible. Treatment consisted of metronomic cyclophosphamide, low-dose interleukin-2 (IL-2) and a single radiation shot. A panel of 16 cytokines was assessed using automated ELISA before treatment (T0), after radiation (RT; T1), at cycle 2 (T2) and at disease progression (TPD). Receiving operating characteristic (ROC) analysis was used to identify cytokine cut-off related to overall survival (OS). Principal component analysis (PCA) was used to identify the immune profile correlating better with OS and progression-free survival. Twenty-three patients were enrolled. High IL-2, low IL-8 and CCL-2 correlated with OS. The PCA identified a cluster of patients, with high IL-2, IL-12 and IFN-γ levels at T0 having longer PFS and OS. In all cohorts, IL-2 and IL-5 increased from T0 to T2; a higher CCL-4 level compared to T2 and a higher IL-8 level compared to T0 were found at TPD. The progressive increase of the IL-10 level during treatment negatively correlated with OS. Our data suggested that baseline cytokine levels may predict patients’ outcome and that the treatment may affect their kinetic even in end-stage patients. Cytokine profiling of end-stage patients might offer a tool for medical decisions (EUDRACT: 2016-000578-39).
Collapse
Affiliation(s)
- Marco Carlo Merlano
- Experimental Cell Therapy Lab, Department of Medical Oncology, Candiolo Cancer Institute, FPO-IRCCS, 10060 Turin, Italy; (L.G.); (D.S.); (M.A.)
- Correspondence: or ; Tel.: +39-0171-616342
| | - Andrea Abbona
- Translational Oncology, ARCO Foundation, 12100 Cuneo, Italy; (A.A.); (M.P.); (A.F.); (O.G.)
| | - Matteo Paccagnella
- Translational Oncology, ARCO Foundation, 12100 Cuneo, Italy; (A.A.); (M.P.); (A.F.); (O.G.)
| | - Antonella Falletta
- Translational Oncology, ARCO Foundation, 12100 Cuneo, Italy; (A.A.); (M.P.); (A.F.); (O.G.)
| | - Cristina Granetto
- Department of Medical Oncology, S. Croce e Carle Teaching Hospital, 12100 Cuneo, Italy; (C.G.); (V.R.); (E.F.); (N.D.); (F.R.)
| | - Vincenzo Ricci
- Department of Medical Oncology, S. Croce e Carle Teaching Hospital, 12100 Cuneo, Italy; (C.G.); (V.R.); (E.F.); (N.D.); (F.R.)
| | - Elena Fea
- Department of Medical Oncology, S. Croce e Carle Teaching Hospital, 12100 Cuneo, Italy; (C.G.); (V.R.); (E.F.); (N.D.); (F.R.)
| | - Nerina Denaro
- Department of Medical Oncology, S. Croce e Carle Teaching Hospital, 12100 Cuneo, Italy; (C.G.); (V.R.); (E.F.); (N.D.); (F.R.)
| | - Fiorella Ruatta
- Department of Medical Oncology, S. Croce e Carle Teaching Hospital, 12100 Cuneo, Italy; (C.G.); (V.R.); (E.F.); (N.D.); (F.R.)
| | - Anna Merlotti
- Department of Radiotherapy, S. Croce e Carle Teaching Hospital, 12100 Cuneo, Italy;
| | - Oscar Bertetto
- Rete Oncologica del Piemonte e Della Valle d’Aosta, 10125 Turin, Italy;
| | - Nicola Crosetto
- Department of Medical Biochemistry and Biophysiscs, Karolinska Institute, 17177 Stockholm, Sweden;
| | - Danilo Galizia
- Multidisciplinary Oncology Outpatient Clinic, Candiolo Cancer Institute, FPO-IRCCS, 10060 Turin, Italy;
| | - Marco Basiricò
- Department of Oncology, University of Turin, 10043 Turin, Italy;
| | - Loretta Gammaitoni
- Experimental Cell Therapy Lab, Department of Medical Oncology, Candiolo Cancer Institute, FPO-IRCCS, 10060 Turin, Italy; (L.G.); (D.S.); (M.A.)
| | - Dario Sangiolo
- Experimental Cell Therapy Lab, Department of Medical Oncology, Candiolo Cancer Institute, FPO-IRCCS, 10060 Turin, Italy; (L.G.); (D.S.); (M.A.)
- Department of Oncology, University of Turin, 10043 Turin, Italy;
| | - Massimo Aglietta
- Experimental Cell Therapy Lab, Department of Medical Oncology, Candiolo Cancer Institute, FPO-IRCCS, 10060 Turin, Italy; (L.G.); (D.S.); (M.A.)
- Department of Oncology, University of Turin, 10043 Turin, Italy;
| | - Ornella Garrone
- Translational Oncology, ARCO Foundation, 12100 Cuneo, Italy; (A.A.); (M.P.); (A.F.); (O.G.)
- Breast Unit, S. Croce e Carle Teaching Hospital, 12100 Cuneo, Italy
| |
Collapse
|