1
|
Ferreira CS, Babitzki G, Klaman I, Krieter O, Lechner K, Bendell J, Vega Harring S, Heil F. Predictive potential of angiopoietin-2 in a mCRC subpopulation treated with vanucizumab in the McCAVE trial. Front Oncol 2023; 13:1157596. [PMID: 37207143 PMCID: PMC10190963 DOI: 10.3389/fonc.2023.1157596] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 03/31/2023] [Indexed: 05/21/2023] Open
Abstract
Introduction Angiopoetin-2 (Ang-2) is a key mediator of tumour angiogenesis. When upregulated it is associated with tumour progression and poor prognosis. Anti-vascular endothelial growth factor (VEGF) therapy has been widely used in the treatment of metastatic colorectal cancer (mCRC). The potential benefit of combined inhibition of Ang-2 and VEGF-A in previously untreated patients with mCRC was evaluated in the phase II McCAVE study (NCT02141295), assessing vanucizumab versus bevacizumab (VEGF-A inhibitor), both in combination with mFOLFOX-6 (modified folinic acid [leucovorin], fluorouracil and oxaliplatin) chemotherapy. To date, there are no known predictors of outcome of anti-angiogenic treatment in patients with mCRC. In this exploratory analysis, we investigate potential predictive biomarkers in baseline samples from McCAVE participants. Methods Tumour tissue samples underwent immunohistochemistry staining for different biomarkers, including Ang-2. Biomarker densities were scored on the tissue images using dedicated machine learning algorithms. Ang-2 levels were additionally assessed in plasma. Patients were stratified by KRAS mutation status determined using next generation sequencing. Median progression-free survival (PFS) for each treatment group by biomarker and KRAS mutation was estimated using Kaplan-Meier plots. PFS hazard ratios (and 95% confidence intervals) were compared using Cox regression. Results Overall low tissue baseline levels of Ang-2 were associated with longer PFS, especially in patients with wild-type KRAS status. In addition, our analysis identified a new subgroup of patients with KRAS wild-type mCRC and high levels of Ang-2 in whom vanucizumab/mFOLFOX-6 prolonged PFS significantly (log-rank p=0.01) by ~5.5 months versus bevacizumab/mFOLFOX-6. Similar findings were seen in plasma samples. Discussion This analysis demonstrates that additional Ang-2 inhibition provided by vanucizumab shows a greater effect than single VEGF-A inhibition in this subpopulation. These data suggest that Ang-2 may be both a prognostic biomarker in mCRC and a predictive biomarker for vanucizumab in KRAS wild-type mCRC. Thus, this evidence can potentially support the establishment of more tailored treatment approaches for patients with mCRC.
Collapse
Affiliation(s)
- Cláudia S. Ferreira
- Roche Pharma Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany
- *Correspondence: Cláudia S. Ferreira, ; Galina Babitzki,
| | - Galina Babitzki
- PHCS Biostatistics & Data Management, Roche Innovation Center Munich, Penzberg, Germany
- *Correspondence: Cláudia S. Ferreira, ; Galina Babitzki,
| | - Irina Klaman
- Roche Pharma Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany
| | - Oliver Krieter
- Roche Pharma Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany
| | - Katharina Lechner
- Roche Pharma Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany
| | - Johanna Bendell
- Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN, United States
| | - Suzana Vega Harring
- Roche Pharma Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany
| | - Florian Heil
- Roche Pharma Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany
| |
Collapse
|
2
|
Spehner L, Boustani J, Cabel L, Doyen J, Vienot A, Borg C, Kim S. Present and Future Research on Anal Squamous Cell Carcinoma. Cancers (Basel) 2021; 13:3895. [PMID: 34359795 PMCID: PMC8345786 DOI: 10.3390/cancers13153895] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/14/2021] [Accepted: 07/30/2021] [Indexed: 12/24/2022] Open
Abstract
Squamous cell carcinoma of the anus is an orphan disease, and after more than three decades of no substantial advances in disease knowledge and treatment, it is finally gaining momentum with the arrival of a taxane-based chemotherapy and immunotherapy. Currently, about 20 combination clinical trials with an anti-PD1/L1 are ongoing in localized and advanced stages, in association with radiotherapy, chemotherapy, tumor vaccines, anti-CTLA4, anti-EGFR, or antiangiogenic molecules. Moreover, a new biomarker with high sensitivity and specificity such as HPV circulating tumor DNA (HPV ctDNA) by liquid biopsy, is improving not only the prognostic measurement but also the treatment strategy guidance for this disease. Finally, better understanding of potential targets is reshaping the present and future clinical research in this unique, HPV genotype-16-related disease in the great majority of patients.
Collapse
Affiliation(s)
- Laurie Spehner
- Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique Research Unit INSERM UMR1098, University of Bourgogne Franche-Comté, 25020 Besançon, France; (L.S.); (A.V.); (C.B.)
- Department of Medical Oncology, University Hospital of Besançon, 25030 Besançon, France
| | - Jihane Boustani
- Department of Radiotherapy, University Hospital of Besançon, 25030 Besançon, France;
| | - Luc Cabel
- Department of Medical Oncology, Curie Institute, 75005 Paris, France;
| | - Jérôme Doyen
- Department of Medical Oncology, Centre Antoine-Lacassagne, 06189 Nice, France;
| | - Angélique Vienot
- Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique Research Unit INSERM UMR1098, University of Bourgogne Franche-Comté, 25020 Besançon, France; (L.S.); (A.V.); (C.B.)
- Department of Medical Oncology, University Hospital of Besançon, 25030 Besançon, France
- Clinical Investigational Center, INSERM CIC-1431, Centre Hospitalier Universitaire de Besançon, 25030 Besançon, France
| | - Christophe Borg
- Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique Research Unit INSERM UMR1098, University of Bourgogne Franche-Comté, 25020 Besançon, France; (L.S.); (A.V.); (C.B.)
- Department of Medical Oncology, University Hospital of Besançon, 25030 Besançon, France
- Clinical Investigational Center, INSERM CIC-1431, Centre Hospitalier Universitaire de Besançon, 25030 Besançon, France
| | - Stefano Kim
- Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique Research Unit INSERM UMR1098, University of Bourgogne Franche-Comté, 25020 Besançon, France; (L.S.); (A.V.); (C.B.)
- Department of Medical Oncology, University Hospital of Besançon, 25030 Besançon, France
- Clinical Investigational Center, INSERM CIC-1431, Centre Hospitalier Universitaire de Besançon, 25030 Besançon, France
- Department of Oncology and Radiotherapy, Nord Franche Comté Hospital, 25209 Montbéliard, France
| |
Collapse
|
3
|
Diao H, Xu X, Zhao B, Yang G. miR‑135a‑5p inhibits tumor invasion by targeting ANGPT2 in gallbladder cancer. Mol Med Rep 2021; 24:528. [PMID: 34036386 PMCID: PMC8170269 DOI: 10.3892/mmr.2021.12167] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 03/25/2021] [Indexed: 12/28/2022] Open
Abstract
Gallbladder cancer (GBC) is the most aggressive cancer type in the biliary tract, and our previous studies observed that microRNA (miR)-135a-5p expression was downregulated in GBC tissues. However, few studies have focused on the mechanism of action of the miR-135a-5p target genes in GBC. The present study aimed to investigate the regulatory role of miR-135a-5p signaling in GBC. The present study found that miR-135a-5p expression was downregulated in GBC tissue, as detected by immunohistochemistry and reverse transcription-quantitative PCR. In addition, overexpression of miR-135a-5p significantly inhibited the proliferation and migration of GBC-SD cells. Using a luciferase activity assay, it was identified that angiopoietin-2 (ANGPT2) was a potential target gene of miR-135a-5p in GBC. Knockdown of ANGPT2 expression significantly inhibited the proliferation and invasion of GBC-SD cells. In conclusion, the present results suggested that miR-135a-5p affected GBC cell proliferation and invasion by targeting ANGPT2. Moreover, miR-135a-5p may be a potential biomarker for GBC progression and a potential target for GBC therapeutic intervention.
Collapse
Affiliation(s)
- Haiyan Diao
- Department of General Surgery, The Seventh People's Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200137, P.R. China
| | - Xing Xu
- Department of General Surgery, The Seventh People's Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200137, P.R. China
| | - Bin Zhao
- Department of General Surgery, The Seventh People's Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200137, P.R. China
| | - Guanghua Yang
- Department of General Surgery, The Seventh People's Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200137, P.R. China
| |
Collapse
|
4
|
Piao HY, Guo S, Jin H, Wang Y, Zhang J. LINC00184 involved in the regulatory network of ANGPT2 via ceRNA mediated miR-145 inhibition in gastric cancer. J Cancer 2021; 12:2336-2350. [PMID: 33758610 PMCID: PMC7974899 DOI: 10.7150/jca.49138] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 12/26/2020] [Indexed: 12/11/2022] Open
Abstract
Background: Disrupted gene levels are intimately correlated with the occurrence and prognosis of gastric cancer (GC). As genes do not function in isolation, we set out to investigate the possible relationship among mRNA and non-coding RNAs (ncRNAs). Materials and methods: RNA sequencing from 406 cases of GC was acquired through the TCGA database. R packages were utilized to assess differential RNA expression. The competing endogenous RNA (ceRNA) network was predicted using miRcode, miRDB, mirTarBase, Target Scan and constructed by Cytoscape 3.6.1. GO enrichment analysis, KEGG pathway analysis, GSEA, and WGCNA were applied for pathway analysis. The expression of select candidate molecules was confirmed using western blot and RT-PCR in GC cells and tissues. CCK-8, EdU staining, and Transwell assays were conducted to assess the influence of candidate molecules on proliferation and invasion. The gain and loss-of-function were achieved by co-culture with sh-lncRNA, mimics and sh-mRNA. Luciferase reporters were created using the psiCHECK2 vector, and the relative luciferase activity was calculated. Results: Using data from TCGA, we determined differentially expressed RNAs and created a ceRNA regulatory network. Interestingly, we identified a regulatory complex surrounding ANGPT2. We detected that ANGPT2 was highly expressed in GC, which correlated with a worse prognosis. Our findings indicated that ANGPT2 encourages growth, invasion, and epithelial-mesenchymal transition (EMT) in GC. Importantly, miR-145 inhibits ANGPT2 and abrogates its effects. Furthermore, LINC00184, a ceRNA, blocks miR-145, thereby improving ANGPT2-mediated carcinogenesis. Conclusions: Our findings indicate that the LINC00184/miR-145/ANGPT2 pathway has a crucial function in the development of GC and can act as a possible biomarker and targets for GC therapy.
Collapse
Affiliation(s)
- Hai-Yan Piao
- Medical Oncology Department of Gastrointestinal cancer, Liaoning Province Cancer Hospital & Institute (Cancer Hospital of China Medical University), No. 44 Xiaoheyan Road, Dadong District, Shenyang City, Liaoning Province, China 110042
| | - Shuai Guo
- Gastric Cancer Department, Liaoning Province Cancer Hospital & Institute (Cancer Hospital of China Medical University), No. 44 Xiaoheyan Road, Dadong District, Shenyang City, Liaoning Province, China 110042
| | - Haoyi Jin
- Pancreatic and Thyroid Surgery Department, Sheng Jing Hospital of China Medical University, 36 Sanhao St, Heping District, Shenyang City, Liaoning Province, China 110003
| | - Yue Wang
- Gastric Cancer Department, Liaoning Province Cancer Hospital & Institute (Cancer Hospital of China Medical University), No. 44 Xiaoheyan Road, Dadong District, Shenyang City, Liaoning Province, China 110042
| | - Jun Zhang
- Gastric Cancer Department, Liaoning Province Cancer Hospital & Institute (Cancer Hospital of China Medical University), No. 44 Xiaoheyan Road, Dadong District, Shenyang City, Liaoning Province, China 110042
| |
Collapse
|
5
|
Jary M, Hasanova R, Vienot A, Asgarov K, Loyon R, Tirole C, Bouard A, Orillard E, Klajer E, Kim S, Viot J, Colle E, Adotevi O, Bouché O, Lecomte T, Borg C, Feugeas JP. Molecular description of ANGPT2 associated colorectal carcinoma. Int J Cancer 2020; 147:2007-2018. [PMID: 32222972 DOI: 10.1002/ijc.32993] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 02/01/2020] [Accepted: 02/26/2020] [Indexed: 12/20/2022]
Abstract
Angiopoietin-2 (ANGPT2) is a prognostic factor in metastatic colorectal cancer (CRC). Nevertheless, it remains to be elucidated which molecular characteristics make up the ANGPT2-related poor-prognosis CRC subset. Public transcriptomic datasets were collected from Gene Expression Omnibus GEO and with the TCGAbiolinks R-package for the TCGA. After appropriate normalization, differential expression analysis was performed using Benjamini and Hochberg method for false discovery rate. Plasma from two prospective clinical trials were used to investigate the clinical impact of ANGPT2-related biomarkers. In the 935 samples included in four annotated platforms (GPL) and derived from localized CRC, ANGPT2hi expression conferred a worst overall survival (HR = 1.20; p = 0.02). CRC stage, ANGPT2hi expression but not Consortium Molecular Subtype (CMS) predict overall survival in multivariate analysis. ANGPT2 expression was not correlated with a specific CMS nor to RAS, RAF, MSI, p53, CIN, CIMP genomic alterations. Gene expression analysis revealed that ANGPT2hi CRC subset is characterized by angiogenesis-related gene expression, presence of myeloid cells, stromal organization and resistance to chemotherapy. A prognostic model was proposed using seric levels of ANGPT2, STC1 and CD138 in 97 mCRC patients. Our results provide evidence that ANGPT2 is a prognostic factor in localized CRC and defined a specific CRC subset with potential clinical implementation.
Collapse
Affiliation(s)
- Marine Jary
- INSERM, EFS BFC, UMR1098, RIGHT, University of Bourgogne Franche-Comté, Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaireet Génique, Besançon, France.,Department of Medical Oncology, University Hospital of Besançon, Besançon, France.,Clinical Investigation Center in Biotherapy, INSERM CIC-BT1431, University Hospital of Besançon, Besançon, France
| | - Reyhan Hasanova
- INSERM, EFS BFC, UMR1098, RIGHT, University of Bourgogne Franche-Comté, Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaireet Génique, Besançon, France
| | - Angélique Vienot
- INSERM, EFS BFC, UMR1098, RIGHT, University of Bourgogne Franche-Comté, Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaireet Génique, Besançon, France.,Department of Medical Oncology, University Hospital of Besançon, Besançon, France
| | - Kamal Asgarov
- INSERM, EFS BFC, UMR1098, RIGHT, University of Bourgogne Franche-Comté, Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaireet Génique, Besançon, France
| | - Romain Loyon
- INSERM, EFS BFC, UMR1098, RIGHT, University of Bourgogne Franche-Comté, Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaireet Génique, Besançon, France.,Department of Medical Oncology, University Hospital of Besançon, Besançon, France
| | - Charline Tirole
- Department of Medical Oncology, University Hospital of Besançon, Besançon, France
| | - Adeline Bouard
- INSERM, EFS BFC, UMR1098, RIGHT, University of Bourgogne Franche-Comté, Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaireet Génique, Besançon, France
| | - Emeline Orillard
- INSERM, EFS BFC, UMR1098, RIGHT, University of Bourgogne Franche-Comté, Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaireet Génique, Besançon, France.,Department of Medical Oncology, University Hospital of Besançon, Besançon, France
| | - Elodie Klajer
- Department of Medical Oncology, University Hospital of Besançon, Besançon, France
| | - Stefano Kim
- Department of Medical Oncology, University Hospital of Besançon, Besançon, France.,Clinical Investigation Center in Biotherapy, INSERM CIC-BT1431, University Hospital of Besançon, Besançon, France
| | - Julien Viot
- INSERM, EFS BFC, UMR1098, RIGHT, University of Bourgogne Franche-Comté, Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaireet Génique, Besançon, France.,Department of Medical Oncology, University Hospital of Besançon, Besançon, France
| | - Elise Colle
- University Hospital St-Antoine, Paris, France
| | - Olivier Adotevi
- INSERM, EFS BFC, UMR1098, RIGHT, University of Bourgogne Franche-Comté, Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaireet Génique, Besançon, France.,Department of Medical Oncology, University Hospital of Besançon, Besançon, France
| | - Olivier Bouché
- Department of Hepato-Gastroenterology and Digestive Oncology, University Hospital Robert Debré, Reims, France
| | - Thierry Lecomte
- Department of Hepato-Gastroenterology and Digestive Oncology, CHRU de Tours, Tours Cedex 09, France.,University of Tours, Tours Cedex 01, France
| | - Christophe Borg
- INSERM, EFS BFC, UMR1098, RIGHT, University of Bourgogne Franche-Comté, Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaireet Génique, Besançon, France.,Department of Medical Oncology, University Hospital of Besançon, Besançon, France.,Clinical Investigation Center in Biotherapy, INSERM CIC-BT1431, University Hospital of Besançon, Besançon, France
| | - Jean P Feugeas
- INSERM, EFS BFC, UMR1098, RIGHT, University of Bourgogne Franche-Comté, Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaireet Génique, Besançon, France
| |
Collapse
|
6
|
Lauret Marie Joseph E, Laheurte C, Jary M, Boullerot L, Asgarov K, Gravelin E, Bouard A, Rangan L, Dosset M, Borg C, Adotévi O. Immunoregulation and Clinical Implications of ANGPT2/TIE2 + M-MDSC Signature in Non-Small Cell Lung Cancer. Cancer Immunol Res 2019; 8:268-279. [PMID: 31871121 DOI: 10.1158/2326-6066.cir-19-0326] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 10/04/2019] [Accepted: 12/18/2019] [Indexed: 11/16/2022]
Abstract
Myeloid-derived suppressor cells (MDSC) promote immunosuppression and are a target in the field of immuno-oncology. Accumulation of MDSCs is associated with poor prognosis and resistance to immunotherapy for several cancers. Here, we describe an accumulation of a subset of circulating monocytic MDSCs (M-MDSC) overexpressing TIE2, the receptor for angiopoietin-2 (ANGPT2), in patients with non-small cell lung cancer (NSCLC). Greater numbers of circulating TIE2+ M-MDSCs were detected in patients with NSCLC compared with healthy subjects, and this accumulation correlated with ANGPT2 concentration in blood. The presence of an ANGPT2-rich environment was associated with impairment of preexisting T-cell responses against tumor-associated antigens (TAA) in patients with NSCLC. We demonstrated that ANGPT2 sensitizes TIE2+ M-MDSCs such that these cells suppress TAA-specific T cells. In patients with NSCLC, upregulation of the ANGPT2/TIE2+ M-MDSC signature in blood was associated with a poor prognosis. Our results identify the ANGPT2/TIE2+ M-MDSC axis as a participant in tumor immune evasion that should be taken into account in future cancer immunotherapy.
Collapse
Affiliation(s)
| | - Caroline Laheurte
- Université Bourgogne Franche-Comté, INSERM, EFS, BFC, UMR1098, RIGHT, Besançon, France.,Etablissement Français du Sang Bourgogne Franche-Comté, Plateforme de Biomonitoring, Besançon, France.,INSERM CIC-1431, CHU Besançon, Besançon, France
| | - Marine Jary
- Université Bourgogne Franche-Comté, INSERM, EFS, BFC, UMR1098, RIGHT, Besançon, France.,Service d'Oncologie médicale, CHU Besançon, Besançon, France
| | - Laura Boullerot
- Université Bourgogne Franche-Comté, INSERM, EFS, BFC, UMR1098, RIGHT, Besançon, France.,INSERM CIC-1431, CHU Besançon, Besançon, France
| | - Kamal Asgarov
- Université Bourgogne Franche-Comté, INSERM, EFS, BFC, UMR1098, RIGHT, Besançon, France
| | - Eléonore Gravelin
- Université Bourgogne Franche-Comté, INSERM, EFS, BFC, UMR1098, RIGHT, Besançon, France.,INSERM CIC-1431, CHU Besançon, Besançon, France
| | - Adeline Bouard
- Université Bourgogne Franche-Comté, INSERM, EFS, BFC, UMR1098, RIGHT, Besançon, France
| | - Laurie Rangan
- Université Bourgogne Franche-Comté, INSERM, EFS, BFC, UMR1098, RIGHT, Besançon, France
| | - Magalie Dosset
- Université Bourgogne Franche-Comté, INSERM, EFS, BFC, UMR1098, RIGHT, Besançon, France
| | - Christophe Borg
- Université Bourgogne Franche-Comté, INSERM, EFS, BFC, UMR1098, RIGHT, Besançon, France.,INSERM CIC-1431, CHU Besançon, Besançon, France.,Service d'Oncologie médicale, CHU Besançon, Besançon, France
| | - Olivier Adotévi
- Université Bourgogne Franche-Comté, INSERM, EFS, BFC, UMR1098, RIGHT, Besançon, France. .,Etablissement Français du Sang Bourgogne Franche-Comté, Plateforme de Biomonitoring, Besançon, France.,INSERM CIC-1431, CHU Besançon, Besançon, France.,Service d'Oncologie médicale, CHU Besançon, Besançon, France
| |
Collapse
|
7
|
Bendell JC, Sauri T, Gracián AC, Alvarez R, López‐López C, García‐Alfonso P, Hussein M, Miron ML, Cervantes A, Montagut C, Vivas CS, Bessudo A, Plezia P, Moons V, Andel J, Bennouna J, van der Westhuizen A, Samuel L, Rossomanno S, Boetsch C, Lahr A, Franjkovic I, Heil F, Lechner K, Krieter O, Hurwitz H. The McCAVE Trial: Vanucizumab plus mFOLFOX-6 Versus Bevacizumab plus mFOLFOX-6 in Patients with Previously Untreated Metastatic Colorectal Carcinoma (mCRC). Oncologist 2019; 25:e451-e459. [PMID: 32162804 PMCID: PMC7066709 DOI: 10.1634/theoncologist.2019-0291] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 08/07/2019] [Indexed: 01/12/2023] Open
Abstract
Background Bevacizumab, a VEGF‐A inhibitor, in combination with chemotherapy, has proven to increase progression‐free survival (PFS) and overall survival in multiple lines of therapy of metastatic colorectal cancer (mCRC). The angiogenic factor angiopoetin‐2 (Ang‐2) is associated with poor prognosis in many cancers, including mCRC. Preclinical models demonstrate improved activity when inhibiting both VEGF‐A and Ang‐2, suggesting that the dual VEGF‐A and Ang‐2 blocker vanucizumab (RO5520985 or RG‐7221) may improve clinical outcomes. This phase II trial evaluated the efficacy of vanucizumab plus modified (m)FOLFOX‐6 (folinic acid (leucovorin), fluorouracil (5‐FU) and oxaliplatin) versus bevacizumab/mFOLFOX‐6 for first‐line mCRC. Patients and Methods All patients received mFOLFOX‐6 and were randomized 1:1 to also receive vanucizumab 2,000 mg or bevacizumab 5 mg/kg every other week. Oxaliplatin was given for eight cycles; other agents were continued until disease progression or unacceptable toxicity for a maximum of 24 months. The primary endpoint was investigator‐assessed PFS. Results One hundred eighty‐nine patients were randomized (vanucizumab, n = 94; bevacizumab, n = 95). The number of PFS events was comparable (vanucizumab, n = 39; bevacizumab, n = 43). The hazard ratio was 1.00 (95% confidence interval, 0.64–1.58; p = .98) in a stratified analysis based on number of metastatic sites and region. Objective response rate was 52.1% and 57.9% in the vanucizumab and bevacizumab arm, respectively. Baseline plasma Ang‐2 levels were prognostic in both arms but not predictive for treatment effects on PFS of vanucizumab. The incidence of adverse events of grade ≥3 was similar between treatment arms (83.9% vs. 82.1%); gastrointestinal perforations (10.8% vs. 8.4%) exceeded previously reported rates in this setting. Hypertension and peripheral edema were more frequent in the vanucizumab arm. Conclusion Vanucizumab/mFOLFOX‐6 did not improve PFS and was associated with increased rates of antiangiogenic toxicity compared with bevacizumab/mFOLFOX‐6. Our results suggest that Ang‐2 is not a relevant therapeutic target in first‐line mCRC. Implications for Practice This randomized phase II study demonstrates that additional angiopoietin‐2 (Ang‐2) inhibition does not result in superior benefit over anti–VEGF‐A blockade alone when each added to standard chemotherapy. Moreover, the performed pharmacokinetic and pharmacodynamic analysis revealed that vanucizumab was bioavailable and affected its intended target, thereby strongly suggesting that Ang‐2 is not a relevant therapeutic target in the clinical setting of treatment‐naïve metastatic colorectal cancer. As a result, the further clinical development of the dual VEGF‐A and Ang‐2 inhibitor vanucizumab was discontinued. This phase II trial evaluated the efficacy of vanucizumab plus mFOLFOX‐6 versus bevacizumab/mFOLFOX‐6 in the first‐line setting of metastatic colorectal cancer.
Collapse
Affiliation(s)
- Johanna C. Bendell
- Sarah Cannon Research Institute and Tennessee OncologyNashvilleTennesseeUSA
| | | | | | - Rafael Alvarez
- Centro Integral Oncológico Clara Campal, Hospital Madrid Norte SanchinarroMadridSpain
| | | | | | | | | | - Andrés Cervantes
- Department of Medical Oncology, Biomedical Research Institute, INCLIVA, University of ValenciaValenciaSpain
| | | | - Cristina Santos Vivas
- Institut Català d'Oncologia and L'Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de LlobregatSpain
| | - Alberto Bessudo
- California Cancer Associates for Research and ExcellenceSan DiegoCaliforniaUSA
| | | | | | | | | | | | - Leslie Samuel
- Aberdeen Royal Infirmary, University of AberdeenAberdeenUnited Kingdom
| | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
González-Vacarezza N, Alonso I, Arroyo G, Martínez J, De Andrés F, LLerena A, Estévez-Carrizo F. Predictive biomarkers candidates for patients with metastatic colorectal cancer treated with bevacizumab-containing regimen. Drug Metab Pers Ther 2017; 31:83-90. [PMID: 26974145 DOI: 10.1515/dmpt-2015-0027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 01/12/2016] [Indexed: 01/28/2023]
Abstract
Bevacizumab was the first molecular-targeted antiangiogenic therapy approved for the treatment of metastatic colorectal cancer. Until now, there are no predictive biomarkers available to decide the prescription of bevacizumab in patients with colorectal cancer. The purposes of this review were to provide a critical appraisal of the evidence and to identify possible predictive genetic biomarkers. A literature search was performed to identify studies that determine different levels of treatment response between patients stratified according to defined biomarkers. Interesting findings were reported between patients stratified according to rs3025039 and rs833061 polymorphisms of the gene VEGFA, with statistically and clinically significant differences for progression-free survival and overall survival. However, another study conducted in a larger sample does not confirm these previous findings, suggesting that well-designed prospective studies are still needed to achieve conclusive results. FLT1 (or VEGFR1) rs9513070 seems to be an interesting candidate as a predictive biomarker, with differences of more than 10 months in OS between different patients groups. In our opinion, possible interesting biomarker candidates for future research could be the polymorphisms rs833061 and rs3025039 of VEGF-A, rs9513070 or haplotype analysis of FLT1, rs2661280 of RGS5, rs444903 and rs6220 of EGF and Ang-2 or LDH plasma levels.
Collapse
|
9
|
Saharinen P, Eklund L, Alitalo K. Therapeutic targeting of the angiopoietin-TIE pathway. Nat Rev Drug Discov 2017; 16:635-661. [PMID: 28529319 DOI: 10.1038/nrd.2016.278] [Citation(s) in RCA: 325] [Impact Index Per Article: 46.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The endothelial angiopoietin (ANG)-TIE growth factor receptor pathway regulates vascular permeability and pathological vascular remodelling during inflammation, tumour angiogenesis and metastasis. Drugs that target the ANG-TIE pathway are in clinical development for oncological and ophthalmological applications. The aim is to complement current vascular endothelial growth factor (VEGF)-based anti-angiogenic therapies in cancer, wet age-related macular degeneration and macular oedema. The unique function of the ANG-TIE pathway in vascular stabilization also renders this pathway an attractive target in sepsis, organ transplantation, atherosclerosis and vascular complications of diabetes. This Review covers key aspects of the function of the ANG-TIE pathway in vascular disease and describes the recent development of novel therapeutics that target this pathway.
Collapse
Affiliation(s)
- Pipsa Saharinen
- Wihuri Research Institute and Translational Cancer Biology Program, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, P.O. Box 63, FI-00014 Helsinki, Finland
| | - Lauri Eklund
- Oulu Center for Cell-Matrix Research, Faculty of Biochemistry and Molecular Medicine, Biocenter Oulu, Aapistie 5A, University of Oulu, 90220 Oulu, Finland
| | - Kari Alitalo
- Wihuri Research Institute and Translational Cancer Biology Program, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, P.O. Box 63, FI-00014 Helsinki, Finland
| |
Collapse
|
10
|
From Humoral Theory to Performant Risk Stratification in Kidney Transplantation. J Immunol Res 2017; 2017:5201098. [PMID: 28133619 PMCID: PMC5241462 DOI: 10.1155/2017/5201098] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 12/15/2016] [Indexed: 12/17/2022] Open
Abstract
The purpose of the present review is to describe how we improve the model for risk stratification of transplant outcomes in kidney transplantation by incorporating the novel insights of donor-specific anti-HLA antibody (DSA) characteristics. The detection of anti-HLA DSA is widely used for the assessment of pre- and posttransplant risks of rejection and allograft loss; however, not all anti-HLA DSA carry the same risk for transplant outcomes. These antibodies have been shown to cause a wide spectrum of effects on allografts, ranging from the absence of injury to indolent or full-blown acute antibody-mediated rejection. Consequently, the presence of circulating anti-HLA DSA does not provide a sufficient level of accuracy for the risk stratification of allograft outcomes. Enhancing the predictive performance of anti-HLA DSA is currently one of the most pressing unmet needs for facilitating individualized treatment choices that may improve outcomes. Recent advancements in the assessment of anti-HLA DSA properties, including their strength, complement-binding capacity, and IgG subclass composition, significantly improved the risk stratification model to predict allograft injury and failure. Although risk stratification based on anti-HLA DSA properties appears promising, further specific studies that address immunological risk stratification in large and unselected populations are required to define the benefits and cost-effectiveness of such comprehensive assessment prior to clinical implementation.
Collapse
|
11
|
Wu X, Giobbie-Hurder A, Liao X, Connelly C, Connolly EM, Li J, Manos MP, Lawrence D, McDermott D, Severgnini M, Zhou J, Gjini E, Lako A, Lipschitz M, Pak CJ, Abdelrahman S, Rodig S, Hodi FS. Angiopoietin-2 as a Biomarker and Target for Immune Checkpoint Therapy. Cancer Immunol Res 2016; 5:17-28. [PMID: 28003187 DOI: 10.1158/2326-6066.cir-16-0206] [Citation(s) in RCA: 113] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 11/07/2016] [Accepted: 11/09/2016] [Indexed: 01/07/2023]
Abstract
Immune checkpoint therapies targeting CTLA-4 and PD-1 have proven effective in cancer treatment. However, the identification of biomarkers for predicting clinical outcomes and mechanisms to overcome resistance remain as critical needs. Angiogenesis is increasingly appreciated as an immune modulator with potential for combinatorial use with checkpoint blockade. Angiopoietin-2 (ANGPT2) is an immune target in patients and is involved in resistance to anti-VEGF treatment with the monoclonal antibody bevacizumab. We investigated the predictive and prognostic value of circulating ANGPT2 in metastatic melanoma patients receiving immune checkpoint therapy. High pretreatment serum ANGPT2 was associated with reduced overall survival in CTLA-4 and PD-1 blockade-treated patients. These treatments also increased serum ANGPT2 in many patients early after treatment initiation, whereas ipilimumab plus bevacizumab treatment decreased serum concentrations. ANGPT2 increases were associated with reduced response and/or overall survival. Ipilimumab increased, and ipilimumab plus bevacizumab decreased, tumor vascular ANGPT2 expression in a subset of patients, which was associated with increased and decreased tumor infiltration by CD68+ and CD163+ macrophages, respectively. In vitro, bevacizumab blocked VEGF-induced ANGPT2 expression in tumor-associated endothelial cells, whereas ANGPT2 increased PD-L1 expression on M2-polarized macrophages. Treatments elicited long-lasting and functional antibody responses to ANGPT2 in a subset of patients receiving clinical benefit. Our findings suggest that serum ANGPT2 may be considered as a predictive and prognostic biomarker for immune checkpoint therapy and may contribute to treatment resistance via increasing proangiogenic and immunosuppressive activities in the tumor microenvironment. Targeting ANGPT2 provides a rational combinatorial approach to improve the efficacy of immune therapy. Cancer Immunol Res; 5(1); 17-28. ©2016 AACR.
Collapse
Affiliation(s)
- Xinqi Wu
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Anita Giobbie-Hurder
- Center for Immuno-oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Xiaoyun Liao
- Center for Immuno-oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Courtney Connelly
- Center for Immuno-oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Erin M Connolly
- Center for Immuno-oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
- Melanoma Disease Center, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Jingjing Li
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Michael P Manos
- Center for Immuno-oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Donald Lawrence
- Massachusetts General Hospital Cancer Center, Boston, Massachusetts
| | | | - Mariano Severgnini
- Center for Immuno-oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Jun Zhou
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Evisa Gjini
- Center for Immuno-oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Ana Lako
- Center for Immuno-oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Mikel Lipschitz
- Center for Immuno-oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Christine J Pak
- Center for Immuno-oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Sara Abdelrahman
- Center for Immuno-oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Scott Rodig
- Center for Immuno-oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
| | - F Stephen Hodi
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts.
- Center for Immuno-oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
- Melanoma Disease Center, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
12
|
Jary M, Lecomte T, Bouché O, Kim S, Dobi E, Queiroz L, Ghiringhelli F, Etienne H, Léger J, Godet Y, Balland J, Lakkis Z, Adotevi O, Bonnetain F, Borg C, Vernerey D. Prognostic value of baseline seric Syndecan-1 in initially unresectable metastatic colorectal cancer patients: a simple biological score. Int J Cancer 2016; 139:2325-35. [PMID: 27472156 DOI: 10.1002/ijc.30367] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 06/24/2016] [Accepted: 07/01/2016] [Indexed: 01/17/2023]
Abstract
In first-line metastatic colorectal cancer (mCRC), baseline prognostic factors allowing death risk and treatment strategy stratification are lacking. Syndecan-1 (CD138) soluble form was never described as a prognostic biomarker in mCRC. We investigated its additional prognostic value for overall survival (OS). mCRC patients with unresectable disease at diagnosis were treated with bevacizumab-based chemotherapy in two independent prospective clinical trials (development set: n = 126, validation set: n = 51, study NCT00489697 and study NCT00544011, respectively). Serums were collected at baseline for CD138 measurement. OS determinants were assessed and, based on the final multivariate model, a prognostic score was proposed. Two independent OS prognostic factors were identified: Lactate Dehydrogenase (LDH) high level (p = 0.0066) and log-CD138 high level (p = 0.0190). The determination of CD138 binary information (cutoff: 75 ng/mL) allowed the assessment of a biological prognostic score with CD138 and LDH values, identifying three risk groups for death (median OS= 38.9, 30.1 and 19.8 months for the low, intermediate and high risk groups, respectively; p < 0.0001). This score had a good discrimination ability (C-index = 0.63). These results were externally confirmed in the validation set. Our study provides robust evidence in favor of the additional baseline soluble CD138 prognostic value for OS, in mCRC patients. A simple biological scoring system is proposed including LDH and CD138 binary status values.
Collapse
Affiliation(s)
- Marine Jary
- Department of Medical Oncology, University Hospital, Besançon, France. .,INSERM, Unit 1098, University of Bourgogne- Franche Comté, Besançon, France. .,Clinical Investigation Center 1431, EFS Bourgogne-Franche Comté, Besançon, France.
| | - Thierry Lecomte
- CNRS, Unit 7292, University François-Rabelais, Tours, France.,Department of HepatoGastroenterology and Digestive Oncology, University Hospital, Tours, France
| | - Olivier Bouché
- Department of HepatoGastroenterology and Digestive Oncology, University Hospital Robert Debré, Reims, France
| | - Stefano Kim
- Department of Medical Oncology, University Hospital, Besançon, France.,Clinical Investigation Center 1431, EFS Bourgogne-Franche Comté, Besançon, France
| | - Erion Dobi
- Department of Medical Oncology, University Hospital, Besançon, France
| | - Lise Queiroz
- INSERM, Unit 1098, University of Bourgogne- Franche Comté, Besançon, France
| | | | - Hélène Etienne
- Department of Medical Oncology, University Hospital, Besançon, France.,Department of Gastroenterology, University Hospital, Besançon, France
| | - Julie Léger
- INSERM, Clinical Investigational Center CIC 1415, Tours, France
| | - Yann Godet
- INSERM, Unit 1098, University of Bourgogne- Franche Comté, Besançon, France
| | - Jérémy Balland
- INSERM, Unit 1098, University of Bourgogne- Franche Comté, Besançon, France
| | - Zaher Lakkis
- Department of Digestive Surgery and Liver Transplantation, University Hospital, Besançon, France
| | - Olivier Adotevi
- Department of Medical Oncology, University Hospital, Besançon, France.,INSERM, Unit 1098, University of Bourgogne- Franche Comté, Besançon, France
| | - Franck Bonnetain
- INSERM, Unit 1098, University of Bourgogne- Franche Comté, Besançon, France.,Clinical Investigation Center 1431, EFS Bourgogne-Franche Comté, Besançon, France.,Methodological and Quality of Life in Oncology Unit, EA 3181, University Hospital, Besançon, France
| | - Christophe Borg
- Department of Medical Oncology, University Hospital, Besançon, France.,INSERM, Unit 1098, University of Bourgogne- Franche Comté, Besançon, France.,Clinical Investigation Center 1431, EFS Bourgogne-Franche Comté, Besançon, France
| | - Dewi Vernerey
- INSERM, Unit 1098, University of Bourgogne- Franche Comté, Besançon, France.,Clinical Investigation Center 1431, EFS Bourgogne-Franche Comté, Besançon, France.,Methodological and Quality of Life in Oncology Unit, EA 3181, University Hospital, Besançon, France
| |
Collapse
|