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Nair R, Lannagan TRM, Jackstadt R, Andrusaite A, Cole J, Boyne C, Nibbs RJB, Sansom OJ, Milling S. Co-inhibition of TGF-β and PD-L1 pathways in a metastatic colorectal cancer mouse model triggers interferon responses, innate cells and T cells, alongside metabolic changes and tumor resistance. Oncoimmunology 2024; 13:2330194. [PMID: 38516270 PMCID: PMC10956632 DOI: 10.1080/2162402x.2024.2330194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 03/11/2024] [Indexed: 03/23/2024] Open
Abstract
Colorectal cancer (CRC) is the third most prevalent cancer worldwide with a high mortality rate (20-30%), especially due to metastasis to adjacent organs. Clinical responses to chemotherapy, radiation, targeted and immunotherapies are limited to a subset of patients making metastatic CRC (mCRC) difficult to treat. To understand the therapeutic modulation of immune response in mCRC, we have used a genetically engineered mouse model (GEMM), "KPN", which resembles the human 'CMS4'-like subtype. We show here that transforming growth factor (TGF-β1), secreted by KPN organoids, increases cancer cell proliferation, and inhibits splenocyte activation in vitro. TGF-β1 also inhibits activation of naive but not pre-activated T cells, suggesting differential effects on specific immune cells. In vivo, the inhibition of TGF-β inflames the KPN tumors, causing infiltration of T cells, monocytes and monocytic intermediates, while reducing neutrophils and epithelial cells. Co-inhibition of TGF-β and PD-L1 signaling further enhances cytotoxic CD8+T cells and upregulates innate immune response and interferon gene signatures. However, simultaneous upregulation of cancer-related metabolic genes correlated with limited control of tumor burden and/or progression despite combination treatment. Our study illustrates the importance of using GEMMs to predict better immunotherapies for mCRC.
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Affiliation(s)
- Reshmi Nair
- School of infection and immunity, University of Glasgow, Glasgow, UK
| | | | | | - Anna Andrusaite
- School of infection and immunity, University of Glasgow, Glasgow, UK
| | - John Cole
- School of infection and immunity, University of Glasgow, Glasgow, UK
| | - Caitlin Boyne
- School of infection and immunity, University of Glasgow, Glasgow, UK
| | | | - Owen J. Sansom
- Cancer Research UK Scotland Institute, Glasgow, UK
- School of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Simon Milling
- School of infection and immunity, University of Glasgow, Glasgow, UK
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2
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Wangmo D, Gates TJ, Zhao X, Sun R, Subramanian S. Centrosomal Protein 55 (CEP55) Drives Immune Exclusion and Resistance to Immune Checkpoint Inhibitors in Colorectal Cancer. Vaccines (Basel) 2024; 12:63. [PMID: 38250876 PMCID: PMC10820828 DOI: 10.3390/vaccines12010063] [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: 11/14/2023] [Revised: 01/02/2024] [Accepted: 01/05/2024] [Indexed: 01/23/2024] Open
Abstract
Colorectal cancer (CRC) currently ranks as the third most common cancer in the United States, and its incidence is on the rise, especially among younger individuals. Despite the remarkable success of immune checkpoint inhibitors (ICIs) in various cancers, most CRC patients fail to respond due to intrinsic resistance mechanisms. While microsatellite instability-high phenotypes serve as a reliable positive predictive biomarker for ICI treatment, the majority of CRC patients with microsatellite-stable (MSS) tumors remain ineligible for this therapeutic approach. In this study, we investigated the role of centrosomal protein 55 (CEP55) in shaping the tumor immune microenvironment in CRC. CEP55 is overexpressed in multiple cancer types and was shown to promote tumorigenesis by upregulating the PI3K/AKT pathway. Our data revealed that elevated CEP55 expression in CRC was associated with reduced T cell infiltration, contributing to immune exclusion. As CRC tumors progressed, CEP55 expression increased alongside sequential mutations in crucial driver genes (APC, KRAS, TP53, and SMAD4), indicating its involvement in tumor progression. CEP55 knockout significantly impaired tumor growth in vitro and in vivo, suggesting that CEP55 plays a crucial role in tumorigenesis. Furthermore, the CEP55 knockout increased CD8+ T cell infiltration and granzyme B production, indicating improved anti-tumor immunity. Additionally, we observed reduced regulatory T cell infiltration in CEP55 knockout tumors, suggesting diminished immune suppression. Most significantly, CEP55 knockout tumors demonstrated enhanced responsiveness to immune checkpoint inhibition in a clinically relevant orthotopic CRC model. Treatment with anti-PD1 significantly reduced tumor growth in CEP55 knockout tumors compared to control tumors, suggesting that inhibiting CEP55 could improve the efficacy of ICIs. Collectively, our study underscores the crucial role of CEP55 in driving immune exclusion and resistance to ICIs in CRC. Targeting CEP55 emerges as a promising therapeutic strategy to sensitize CRC to immune checkpoint inhibition, thereby improving survival outcomes for CRC patients.
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Affiliation(s)
- Dechen Wangmo
- Department of Surgery, University of Minnesota Medical School, Minneapolis, MN 55455, USA; (D.W.); (T.J.G.); (X.Z.)
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN 55455, USA
| | - Travis J. Gates
- Department of Surgery, University of Minnesota Medical School, Minneapolis, MN 55455, USA; (D.W.); (T.J.G.); (X.Z.)
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN 55455, USA
| | - Xianda Zhao
- Department of Surgery, University of Minnesota Medical School, Minneapolis, MN 55455, USA; (D.W.); (T.J.G.); (X.Z.)
| | - Ruping Sun
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA;
- Department of Laboratory Medicine & Pathology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Subbaya Subramanian
- Department of Surgery, University of Minnesota Medical School, Minneapolis, MN 55455, USA; (D.W.); (T.J.G.); (X.Z.)
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA;
- Center for Immunology, University of Minnesota, Minneapolis, MN 55455, USA
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3
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Zhao C, Zhang Z, Zhou Y, Wang J, Liu C, Wang X, Liu H. Potential role of lnc-METRNL-1 in the occurrence and prognosis of oral squamous cell carcinoma. 3 Biotech 2023; 13:256. [PMID: 37396471 PMCID: PMC10313615 DOI: 10.1007/s13205-023-03674-0] [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: 03/27/2023] [Accepted: 06/13/2023] [Indexed: 07/04/2023] Open
Abstract
Oral squamous cell carcinoma (OSCC) is one of the most common malignant tumors of the head and neck with poor prognosis. This study aimed to explore the role of lnc-METRNL-1 in occurrence and prognosis of OSCC patients. Expression of lnc-METRNL-1 was compared between OSCC samples and paracancerous samples from The Cancer Genome Atlas (TCGA) database. Additionally, the lnc-METRNL-1 expression in cell lines was detected by using qRT-PCR. The overall survival (OS) was estimated based on the Kaplan-Meier and the immune cell infiltration was evaluated using CIBERSORT. Significantly enriched biological pathways were identified by Gene-set enrichment analysis (GSEA). Differential expression analysis was done in edgeR package. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways of differential expression genes were conducted using DAVID version 6.8. The lnc-METRNL-1 expression in OSCC was significantly lower than that in paracancerous samples, and patients with low lnc-METRNL-1 expression had poorer OS. Additionally, lnc-METRNL-1 was significantly down-regulated in OSCC cell lines compared with normal cell line. High expression of lnc-METRNL-1 was closely associated with the activation of several tumor metabolic and metabolism-related pathways. Besides, aberrant lnc-METRNL-1 expression was found to be related to the differential infiltration of immune cells in tumor tissue, such as regulatory T cells, and Macrophages. Low lnc-METRNL-1 expression was probably a poor prognostic biomarker for OSCC patients. Moreover, the potential role of lnc-METRNL-1 in the onset of OSCC was partly revealed. Supplementary Information The online version contains supplementary material available at 10.1007/s13205-023-03674-0.
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Affiliation(s)
- Chenguang Zhao
- Department of Emergency and General Dentistry, Tianjin Stomatology Hospital, Hospital of Stomatology, NanKai University·Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, No. 75 Dagubei Road, Heping District, Tianjin, 300041 China
| | - Zhiling Zhang
- Department of Oral and Maxillofacial Surgery, Tianjin Stomatology Hospital, Hospital of Stomatology, NanKai University·Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, No. 75 Dagubei Road, Heping District, Tianjin, 300041 China
| | - Yingrui Zhou
- Department of Emergency and General Dentistry, Tianjin Stomatology Hospital, Hospital of Stomatology, NanKai University·Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, No. 75 Dagubei Road, Heping District, Tianjin, 300041 China
| | - Jinhui Wang
- Department of Emergency and General Dentistry, Tianjin Stomatology Hospital, Hospital of Stomatology, NanKai University·Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, No. 75 Dagubei Road, Heping District, Tianjin, 300041 China
| | - Chunlin Liu
- Department of Emergency and General Dentistry, Tianjin Stomatology Hospital, Hospital of Stomatology, NanKai University·Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, No. 75 Dagubei Road, Heping District, Tianjin, 300041 China
| | - Xi Wang
- Department of Emergency and General Dentistry, Tianjin Stomatology Hospital, Hospital of Stomatology, NanKai University·Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, No. 75 Dagubei Road, Heping District, Tianjin, 300041 China
| | - Hao Liu
- Department of Oral and Maxillofacial Surgery, Tianjin Stomatology Hospital, Hospital of Stomatology, NanKai University·Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, No. 75 Dagubei Road, Heping District, Tianjin, 300041 China
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Cheng RYS, Ridnour LA, Wink AL, Gonzalez AL, Femino EL, Rittscher H, Somasundaram V, Heinz WF, Coutinho L, Rangel MC, Edmondson EF, Butcher D, Kinders RJ, Li X, Wong STC, McVicar DW, Anderson SK, Pore M, Hewitt SM, Billiar TR, Glynn SA, Chang JC, Lockett SJ, Ambs S, Wink DA. Interferon-gamma is quintessential for NOS2 and COX2 expression in ER - breast tumors that lead to poor outcome. Cell Death Dis 2023; 14:319. [PMID: 37169743 PMCID: PMC10175544 DOI: 10.1038/s41419-023-05834-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 04/20/2023] [Accepted: 04/24/2023] [Indexed: 05/13/2023]
Abstract
A strong correlation between NOS2 and COX2 tumor expression and poor clinical outcomes in ER breast cancer has been established. However, the mechanisms of tumor induction of these enzymes are unclear. Analysis of The Cancer Genome Atlas (TCGA) revealed correlations between NOS2 and COX2 expression and Th1 cytokines. Herein, single-cell RNAseq analysis of TNBC cells shows potent NOS2 and COX2 induction by IFNγ combined with IL1β or TNFα. Given that IFNγ is secreted by cytolytic lymphocytes, which improve clinical outcomes, this role of IFNγ presents a dichotomy. To explore this conundrum, tumor NOS2, COX2, and CD8+ T cells were spatially analyzed in aggressive ER-, TNBC, and HER2 + breast tumors. High expression and clustering of NOS2-expressing tumor cells occurred at the tumor/stroma interface in the presence of stroma-restricted CD8+ T cells. High expression and clustering of COX2-expressing tumor cells extended into immune desert regions in the tumor core where CD8+ T cell penetration was limited or absent. Moreover, high NOS2-expressing tumor cells were proximal to areas with increased satellitosis, suggestive of cell clusters with a higher metastatic potential. Further in vitro experiments revealed that IFNγ + IL1β/TNFα increased the elongation and migration of treated tumor cells. This spatial analysis of the tumor microenvironment provides important insight into distinct neighborhoods where stroma-restricted CD8+ T cells exist proximal to NOS2-expressing tumor niches that could have increased metastatic potential.
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Affiliation(s)
- Robert Y S Cheng
- Cancer Innovation Laboratory, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Frederick, MD, USA
| | - Lisa A Ridnour
- Cancer Innovation Laboratory, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Frederick, MD, USA
| | - Adelaide L Wink
- Optical Microscopy and Analysis Laboratory, Frederick National Laboratory for Cancer Research, Leidos Biomedical Research Inc. for the National Cancer Institute, Frederick, MD, USA
| | - Ana L Gonzalez
- Cancer Innovation Laboratory, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Frederick, MD, USA
| | - Elise L Femino
- Cancer Innovation Laboratory, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Frederick, MD, USA
| | - Helene Rittscher
- Cancer Innovation Laboratory, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Frederick, MD, USA
| | - Veena Somasundaram
- Cancer Innovation Laboratory, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Frederick, MD, USA
| | - William F Heinz
- Optical Microscopy and Analysis Laboratory, Frederick National Laboratory for Cancer Research, Leidos Biomedical Research Inc. for the National Cancer Institute, Frederick, MD, USA
| | - Leandro Coutinho
- Center for Translational Research in Oncology, ICESP/HC, Faculdade de Medicina da Universidade de São Paulo; and Comprehensive Center for Precision Oncology, Universidade de São Paulo, São Paulo, SP, Brazil
| | - M Cristina Rangel
- Center for Translational Research in Oncology, ICESP/HC, Faculdade de Medicina da Universidade de São Paulo; and Comprehensive Center for Precision Oncology, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Elijah F Edmondson
- Molecular Histopathology Laboratories, Leidos Biomedical Research Inc. for NCI, Frederick, MD, USA
| | - Donna Butcher
- Molecular Histopathology Laboratories, Leidos Biomedical Research Inc. for NCI, Frederick, MD, USA
| | - Robert J Kinders
- Office of the Director, Division of Cancer Treatment and Diagnosis, NCI, Frederick, MD, USA
| | - Xiaoxian Li
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA
| | - Stephen T C Wong
- Systems Medicine and Bioengineering Department, Houston Methodist Neal Cancer Center, Houston Methodist Hospital and Weill Cornell Medicine, Houston, TX, USA
| | - Daniel W McVicar
- Cancer Innovation Laboratory, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Frederick, MD, USA
| | - Stephen K Anderson
- Cancer Innovation Laboratory, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Frederick, MD, USA
| | - Milind Pore
- Imaging Mass Cytometry Laboratory, Cancer Research Technology Program, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | | | - Timothy R Billiar
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, 15213, USA
| | - Sharon A Glynn
- Discipline of Pathology, Lambe Institute for Translational Research, School of Medicine, University of Galway, Galway, Ireland
| | - Jenny C Chang
- Mary and Ron Neal Cancer Center, Houston Methodist Hospital and Weill Cornell Medicine, Houston, TX, USA
| | - Stephen J Lockett
- Optical Microscopy and Analysis Laboratory, Frederick National Laboratory for Cancer Research, Leidos Biomedical Research Inc. for the National Cancer Institute, Frederick, MD, USA
| | - Stefan Ambs
- Laboratory of Human Carcinogenesis, CCR, NCI, NIH, Bethesda, MD, USA
| | - David A Wink
- Cancer Innovation Laboratory, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Frederick, MD, USA.
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5
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Cheng RY, Ridnour LA, Wink AL, Gonzalez AL, Femino EL, Rittscher H, Somasundarum V, Heinz WF, Coutinho L, Cristina Rangel M, Edmondson EF, Butcher D, Kinders RJ, Li X, Wong STC, McVicar DW, Anderson SK, Pore M, Hewitt SM, Billiar TR, Glynn S, Chang JC, Lockett SJ, Ambs S, Wink DA. Interferon-gamma is Quintessential for NOS2 and COX2 Expression in ER - Breast Tumors that Lead to Poor Outcome. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.04.06.535916. [PMID: 37066331 PMCID: PMC10104135 DOI: 10.1101/2023.04.06.535916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
A strong correlation between NOS2 and COX2 tumor expression and poor clinical outcomes in ER-breast cancer has been established. However, mechanisms of tumor induction of these enzymes are unclear. Analysis of The Cancer Genome Atlas (TCGA) revealed correlations between NOS2 and COX2 expression and Th1 cytokines. Herein, single cell RNAseq analysis of TNBC cells shows potent NOS2 and COX2 induction by IFNγ combined with IL1β or TNFα. Given that IFNγ is secreted by cytolytic lymphocytes, which improve clinical outcomes, this role of IFNγpresents a dichotomy. To explore this conundrum, tumor NOS2, COX2, and CD8 + T cells were spatially analyzed in aggressive ER-, TNBC, and HER2+ breast tumors. High expression and clustering of NOS2-expressing tumor cells occurred at the tumor/stroma interface in the presence of stroma-restricted CD8 + T cells. High expression and clustering of COX2-expressing tumor cells extended into immune desert regions in the tumor core where CD8 + T cell penetration was limited or absent. Moreover, high NOS2-expressing tumor cells were proximal to areas with increased satellitosis suggestive of cell clusters with a higher metastatic potential. Further in vitro experiments revealed that IFNγ+IL1β/TNFα increased elongation and migration of treated tumor cells. This spatial analysis of the tumor microenvironment provides important insight of distinct neighborhoods where stroma-restricted CD8 + T cells exist proximal to NOS2-expressing tumor niches that could have increased metastatic potential.
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6
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The Association of CD8+ Cytotoxic T Cells and Granzyme B+ Lymphocytes with Immunosuppressive Factors, Tumor Stage and Prognosis in Cutaneous Melanoma. Biomedicines 2022; 10:biomedicines10123209. [PMID: 36551965 PMCID: PMC9775436 DOI: 10.3390/biomedicines10123209] [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: 10/29/2022] [Revised: 11/30/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022] Open
Abstract
The immunosuppressive tumor microenvironment (TME) consists of suppressive cells producing a variety of immunomodulatory proteins, such as programmed death ligand 1 (PD-L1) and indoleamine-2,3-dioxygenase (IDO). Although granzyme B (GrB) is known to convey the cytolytic activities of CD8+ cytotoxic lymphocytes, it is also expressed by other cells, such as regulatory T and B cells, for immunosuppressive purposes. The role of GrB+ lymphocytes in melanoma has not been examined extensively. In this study, benign, premalignant, and malignant melanocytic tumors were stained immunohistochemically for CD8 and GrB. PD-L1 was also stained from malignant samples that had accompanying clinicopathological data. The association of CD8+ and GrB+ lymphocytes with PD-L1 expression, tumor stage, prognosis, and previously analyzed immunosuppressive factors were evaluated. Our aim was to obtain a more comprehensive perception of the immunosuppressive TME in melanoma. The results show that both CD8+ and GrB+ lymphocytes were more abundant in pT4 compared to pT1 melanomas, and in lymph node metastases compared to primary melanomas. Surprisingly, a low GrB/CD8 ratio was associated with better recurrence-free survival in primary melanomas, which indicates that GrB+ lymphocytes might represent activated immunosuppressive lymphocytes rather than cytotoxic T cells. In the present study, CD8+ lymphocytes associated positively with both tumor and stromal immune cell PD-L1 and IDO expression. In addition, PD-L1+ tumor and stromal immune cells associated positively with IDO+ stromal immune and melanoma cells. The data suggest that IDO and PD-L1 seem to be key immunosuppressive factors in CD8+ lymphocyte-predominant tumors in CM.
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He F, Furones AR, Landegren N, Fuxe J, Sarhan D. Sex dimorphism in the tumor microenvironment - From bench to bedside and back. Semin Cancer Biol 2022; 86:166-179. [PMID: 35278635 DOI: 10.1016/j.semcancer.2022.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 02/20/2022] [Accepted: 03/06/2022] [Indexed: 01/27/2023]
Abstract
Cancer represents a significant cause of death and suffering in both the developed and developing countries. Key underlying issues in the mortality of cancer are delayed diagnosis and resistance to treatments. However, improvements in biomarkers represent one important step that can be taken for alleviating the suffering caused by malignancy. Precision-based medicine is promising for revolutionizing diagnostic and treatment strategies for cancer patients worldwide. Contemporary methods, including various omics and systems biology approaches, as well as advanced digital imaging and artificial intelligence, allow more accurate assessment of tumor characteristics at the patient level. As a result, treatment strategies can be specifically tailored and adapted for individual and/or groups of patients that carry certain tumor characteristics. This includes immunotherapy, which is based on characterization of the immunosuppressive tumor microenvironment (TME) and, more specifically, the presence and activity of immune cell subsets. Unfortunately, while it is increasingly clear that gender strongly affects immune regulation and response, there is a knowledge gap concerning differences in sex-specific immune responses and how these contribute to the immunosuppressive TME and the response to immunotherapy. In fact, sex dimorphism is poorly understood in cancer progression and is typically ignored in current clinical practice. In this review, we aim to survey the available literature and highlight the existing knowledge gap in order to encourage further studies that would contribute to understanding both gender-biased immunosuppression in the TME and the driver of tumor progression towards invasive and metastatic disease. The review highlights the need to include sex optimized/genderized medicine as a new concept in future medicine cancer diagnostics and treatments.
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Affiliation(s)
- Fei He
- Department of Laboratory Medicine, Division of Pathology, Karolinska Institute, SE-141 86 Stockholm, Sweden; Department of Urology, First affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Andrea Rodgers Furones
- Department of Laboratory Medicine, Division of Pathology, Karolinska Institute, SE-141 86 Stockholm, Sweden; Tumor Immunology Department, Radboud Institute for Molecular Life Sciences, Nijmegen, Netherlands
| | - Nils Landegren
- Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala 751 23, Sweden; Center for Molecular Medicine, Department of Medicine (Solna), Karolinska Institutet, Stockholm 171 76, Sweden
| | - Jonas Fuxe
- Department of Laboratory Medicine, Division of Pathology, Karolinska Institute, SE-141 86 Stockholm, Sweden
| | - Dhifaf Sarhan
- Department of Laboratory Medicine, Division of Pathology, Karolinska Institute, SE-141 86 Stockholm, Sweden.
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8
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Noti L, Galván JA, Dawson H, Lugli A, Kirsch R, Assarzadegan N, Messenger D, Krebs P, Berger MD, Zlobec I. A combined spatial score of granzyme B and CD68 surpasses CD8 as an independent prognostic factor in TNM stage II colorectal cancer. BMC Cancer 2022; 22:987. [PMID: 36114487 PMCID: PMC9482175 DOI: 10.1186/s12885-022-10048-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 08/31/2022] [Indexed: 12/24/2022] Open
Abstract
Background Previous assessments of peritumoral inflammatory infiltrate in colorectal cancer (CRC) have focused on the role of CD8+ T lymphocytes. We sought to compare the prognostic value of CD8 with downstream indicators of active immune cell function, specifically granzyme B (GZMB) and CD68 in the tumour microenvironment. Methods Immunohistochemical (IHC) staining was performed for CD8, GZMB, CD68 and CD163 on next-generation tissue microarrays (ngTMAs) in a primary cohort (n = 107) and a TNM stage II validation cohort (n = 151). Using digital image analysis, frequency of distinct immune cell types was calculated for tumour proximity (TP) zones with varying radii (10 μm-100 μm) around tumour cells. Results Associations notably of advanced TNM stage were observed for low density of CD8 (p = 0.002), GZMB (p < 0.001), CD68 (p = 0.034) and CD163 (p = 0.011) in the primary cohort. In the validation cohort only low GZMB (p = 0.036) was associated with pT4 stage. Survival analysis showed strongest prognostic effects in the TP25μm zone at the tumour centre for CD8, GZMB and CD68 (all p < 0.001) in the primary cohort and for CD8 (p = 0.072), GZMB (p = 0.035) and CD68 (p = 0.004) in the validation cohort with inferior prognostic effects observed at the tumour invasive margin. In a multivariate survival analysis, joint analysis of GZMB and CD68 was similarly prognostic to CD8 in the primary cohort (p = 0.007 vs. p = 0.002) and superior to CD8 in the validation cohort (p = 0.005 vs. p = 0.142). Conclusion Combined high expression of GZMB and CD68 within 25 μm to tumour cells is an independent prognostic factor in CRC and of superior prognostic value to the well-established CD8 in TNM stage II cancers. Thus, assessment of antitumoral effect should consider the quality of immune activation in peritumoral inflammatory cells and their actual proximity to tumour cells. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-10048-x.
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Hu D, Zhang T, Yan Z, Wang L, Wang Y, Meng N, Tu B, Teng Y, Li Z, Lou X, Lei Y, Ren X, Zou Y, Wang F. Multimolecular characteristics of cell-death related hub genes in human cancers: a comprehensive pan-cancer analysis. Cell Cycle 2022; 21:2444-2454. [PMID: 35848940 DOI: 10.1080/15384101.2022.2101337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Failure of the normal process of cell death pathways contributes to the defection of immune systems and the occurrence of cancers. The key genes, the multimolecular mechanisms, and the immune functions of these genes in pan-cancers remain unclear. Using online databases of The Cancer Genome Atlas, GEPIA2, TISIDB, HPA, Kaplan-Meier Plotter, PrognoScan, cBioPortal, GSCALite, TIMER, and Sangerbox, we identified the key genes from the six primary cell death-related pathways and performed a comprehensive analysis to investigate the multimolecular characteristics and immunological functions of the hub genes in 33 human cancers. We identified five hub genes in the six primary cell death-related pathways (JUN, NFKB1, CASP3, PARP1, and TP53). We found that CASP3, PARP1, and TP53 were overexpressed in 28, 23, and 27 cancers. The expression of the five genes was associated with the development and prognosis of many cancers. Particularly, JUN, NFKB1, CASP3, and TP53 have prognostic values in Brain Lower Grade Glioma (LGG), while PARP1 and CASP3 could predict the survival outcomes in Adrenocortical carcinoma (ACC). In addition, an extensive association between five genes' expression, DNA methylation, and tumor-immune system interactions was noticed. The five cell death-related hub genes could function as potential biomarkers for various cancers, particularly LGG and ACC. The immunological function analysis of the five genes also proposes new targets for developing immunosuppressants and improving the immunotherapy efficacy of cancers. However, further extensive clinical and experimental research are required to validate their clinical values.
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Affiliation(s)
- Dingtao Hu
- Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Anhui, China.,Clinical Cancer Institute, Center for Translational Medicine, Second Military Medical University, Shanghai, China
| | - Tingyu Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Anhui, China
| | - Ziye Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Anhui, China
| | - Linlin Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Anhui, China
| | - Yuhua Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Anhui, China
| | - Nana Meng
- Department of Quality Management Office, The Second Affiliated Hospital of Anhui Medical University, Anhui, China
| | - Bizhi Tu
- Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, Anhui, China
| | - Ying Teng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Anhui, China
| | - Zhen Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Anhui, China
| | - Xiaoqi Lou
- Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Anhui, China
| | - Yu Lei
- Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Anhui, China
| | - Xiaoshuang Ren
- Department of Social Management, Ritsumeikan University, Osaka, Japan
| | - Yanfeng Zou
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Anhui, China
| | - Fang Wang
- Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Anhui, China
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Huertas-Caro CA, Ramirez MA, Gonzalez-Torres HJ, Sanabria-Salas MC, Serrano-Gómez SJ. Immune Lymphocyte Infiltrate and its Prognostic Value in Triple-Negative Breast Cancer. Front Oncol 2022; 12:910976. [PMID: 35924147 PMCID: PMC9342669 DOI: 10.3389/fonc.2022.910976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/20/2022] [Indexed: 11/16/2022] Open
Abstract
Triple-negative breast cancer (TNBC) occurs more frequently in young (<50 years) non-Hispanic black and Hispanic/Latina women. It is considered the most aggressive subtype of breast cancer, although, recently, immune infiltrate has been associated with long-term survival, lower risk of death and recurrence, and response to neoadjuvant chemotherapy. The aim of this review was to evaluate the clinical impact of the immune infiltrate in TNBC by discussing whether its prognostic value varies across different populations. A comprehensive systematic search in databases such as PubMed and Web of Science was conducted to include papers focused on tumor-infiltrating lymphocytes (TILs) in TNBC in different population groups and that were published before January 2021. TNBC patients with higher levels of TILs had longer overall survival and disease-free survival times compared with TNBC patients with low TIL levels. Similar results were observed for CD4+, CD8+ TIL populations. On the other hand, patients with high TIL levels showed a higher rate of pathological complete response regardless of the population group (Asian, European, and American). These results altogether suggest that TIL subpopulations might have a prognostic role in TNBC, but the underlying mechanism needs to be elucidated. Although the prognosis value of TILs was not found different between the population groups analyzed in the revised literature, further studies including underrepresented populations with different genetic ancestries are still necessary to conclude in this regard.
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Affiliation(s)
| | - Mayra Alejandra Ramirez
- Grupo de investigación en biología del cáncer, Instituto Nacional de Cancerología, Bogotá, Colombia
| | - Henry J. Gonzalez-Torres
- Doctorado en Ciencias Biomédicas, Universidad del Valle, Cali, Colombia
- Facultad de Ciencias de la Salud, Universidad Simón Bolívar, Barranquilla, Colombia
| | | | - Silvia J. Serrano-Gómez
- Grupo de apoyo y seguimiento para la investigación, Instituto Nacional de Cancerología, Bogotá, Colombia
- *Correspondence: Silvia J. Serrano-Gómez,
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11
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Zhang X, Liang H, Tang Q, Chen H, Guo F. Pyroptosis-Related Gene to Construct Prognostic Signature and Explore Immune Microenvironment and Immunotherapy Biomarkers in Bladder Cancer. Front Genet 2022; 13:801665. [PMID: 35846123 PMCID: PMC9283834 DOI: 10.3389/fgene.2022.801665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 05/19/2022] [Indexed: 11/22/2022] Open
Abstract
Bladder cancer is known to be the most common malignant tumor in the urinary system and has a poor prognosis; thus, new targets for drug treatment are urgently needed. Pyroptosis is defined as programmed cell death in the inflammatory form mediated by the gasdermin protein. It has therapeutic potential due to the synergistic effect of radiotherapy and chemotherapy, can reverse chemotherapy resistance, is able to regulate the body environment to alter tumor metabolism, and may enhance the response rate of the immune checkpoint inhibitor. Accordingly, this study attempted to explore the role of pyroptosis in bladder cancer. A prognostic model based on five pyroptosis-related genes was constructed by conducting univariate Cox survival and LASSO regression analyses using The Cancer Genome Atlas (TCGA) cohort. Patients were divided into high- and low-risk groups according to the median risk score, with all five PRGs having downregulated expression in the high-risk group. The high-risk group was shown to have a worse prognosis than the low-risk group, and survival differences between the two groups were then validated in the Gene Expression Omnibus (GEO) cohort. Moreover, the ROC curves demonstrated the model’s moderate predictive ability. The univariate and multivariate Cox regression analyses indicated that risk scores were found to serve as an independent prognosis factor for OS in bladder cancer patients. In addition, the high-risk group was observed to be associated with advanced N and TNM stages. A nomogram combining risk scores and clinical features was then established, with the ROC curve indicating that the AUC of TCGA training cohort in 3 and 5 years was 0.789 and 0.775, respectively. The calibration curve exhibited a high consistency between the actual survival rate and the predicted rate. Furthermore, the GO and KEGG analyses found that antigen processing and presentation of exogenous antigen, exogenous peptide antigen, and peptide antigen were enriched in the low-risk group. A higher abundance of tumor-infiltrating immune cells and additional active immune pathways were also noted in the low-risk group. In addition, immunotherapy biomarkers, including TMB, PD1, PD-L1, CTLA4, and LAG3, were shown to have higher levels in the low-risk group. Therefore, patients in the low-risk group may be potential responders to immune checkpoint inhibitors.
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12
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CD40 monoclonal antibody and OK432 synergistically promote the activation of dendritic cells in immunotherapy. Cancer Cell Int 2022; 22:216. [PMID: 35715855 PMCID: PMC9206283 DOI: 10.1186/s12935-022-02630-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 06/08/2022] [Indexed: 12/05/2022] Open
Abstract
Background Colorectal cancer (CRC) with pulmonary metastasis usually indicates a poor prognosis, whereas patients may benefit from adoptive cell therapy. Tumor-specific cytotoxic T lymphocytes (CTLs) have been reported as a promising treatment for CRC. However, the antitumor effect of CTLs remains limited partially due to insufficient production of effector cells via the activation by antigen-presenting dendritic cells (DCs). Method This study showed that a combination of CD40 mAb and Picibanil (OK-432) could significantly enhance the activation of CTLs by DCs, both in vitro and in vivo. Flow cytometry, colon cancer mouse model, and pathological staining were employed to demonstrate the specific functions. Results This approach promoted the maturation of DCs, augmented the production of stimulatory cytokines, and suppressed the secretion of inhibitory cytokines. Additionally, it facilitated the killing efficiency of CTLs via stimulating their proliferation while restraining the number of Tregs, concomitantly with the positive regulation of corresponding cytokines. Furthermore, the combined unit could hurdle the expansion of tumor cells on metastatic lungs in the colon cancer mouse model. Conclusion Collectively, the combination of CD40-mAb and OK-432 facilitated the maturation of DCs and enhanced the cytotoxicity of T cells, promising therapeutic approach against CRC. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s12935-022-02630-x.
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13
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Lin Y, Kong DX, Zhang YN. Does the Microbiota Composition Influence the Efficacy of Colorectal Cancer Immunotherapy? Front Oncol 2022; 12:852194. [PMID: 35463305 PMCID: PMC9023803 DOI: 10.3389/fonc.2022.852194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 03/07/2022] [Indexed: 12/12/2022] Open
Abstract
Colorectal cancer (CRC) is the second most common malignancy globally, and many people with CRC suffer the fate of death. Due to the importance of CRC and its negative impact on communities, treatment strategies to control it or increase patient survival are being studied. Traditional therapies, including surgery and chemotherapy, have treated CRC patients. However, with the advancement of science, we are witnessing the emergence of novel therapeutic approaches such as immunotherapy for CRC treatment, which have had relatively satisfactory clinical outcomes. Evidence shows that gastrointestinal (GI) microbiota, including various bacterial species, viruses, and fungi, can affect various biological events, regulate the immune system, and even treat diseases like human malignancies. CRC has recently shown that the gut microorganism pattern can alter both antitumor and pro-tumor responses, as well as cancer immunotherapy. Of course, this is also true of traditional therapies because it has been revealed that gut microbiota can also reduce the side effects of chemotherapy. Therefore, this review summarized the effects of gut microbiota on CRC immunotherapy.
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Affiliation(s)
- Yan Lin
- Health Management Center, Department of General Practice, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, China
- *Correspondence: Yan Lin, ; You-Ni Zhang,
| | - De-Xia Kong
- Health Management Center, Department of General Practice, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, China
| | - You-Ni Zhang
- Department of Laboratory Medicine, Tiantai People’s Hospital, Taizhou, China
- *Correspondence: Yan Lin, ; You-Ni Zhang,
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14
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Zhou W, He X, Wang J, He S, Xie C, Fan Q, Pu K. Semiconducting Polymer Nanoparticles for Photoactivatable Cancer Immunotherapy and Imaging of Immunoactivation. Biomacromolecules 2022; 23:1490-1504. [PMID: 35286085 DOI: 10.1021/acs.biomac.2c00065] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Immunotherapy that stimulates the body's own immune system to kill cancer cells has emerged as a promising cancer therapeutic method. However, some types of cancer exhibited a low response rate to immunotherapy, and the high risk of immune-related side effects has been aroused during immunotherapy, which greatly restrict its broad applications in cancer therapy. Phototherapy that uses external light to trigger the therapeutic process holds advantages including high selectivity and efficiency, and low side effects. Recently, it has been proven to be able to stimulate immune response in the tumor region by inducing immunogenic cell death (ICD), the process of which was termed photo-immunotherapy, dramatically improving therapeutic specificity over conventional immunotherapy in several aspects. Among numerous optical materials for photo-immunotherapy, semiconducting polymer nanoparticles (SPNs) have gained more and more attention owing to their excellent optical properties and good biocompatibility. In this review, we summarize recent developments of SPNs for immunotherapy and imaging of immunoactivation. Different therapeutic modalities triggered by SPNs including photo-immunotherapy and photo-immunometabolic therapy are first introduced. Then, applications of SPNs for real-time monitoring immunoactivation are discussed. Finally, the conclusion and future perspectives of this research field are given.
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Affiliation(s)
- Wen Zhou
- Key Laboratory for Organic Electronics and Information Displays, Institute of Advanced Materials (IAM), Jiangsu National Synergetic Innovation Center for Advanced Materials (SICAM), Nanjing University of Posts & Telecommunications, Nanjing 210023, China
| | - Xiaowen He
- Key Laboratory for Organic Electronics and Information Displays, Institute of Advanced Materials (IAM), Jiangsu National Synergetic Innovation Center for Advanced Materials (SICAM), Nanjing University of Posts & Telecommunications, Nanjing 210023, China
| | - Jinghui Wang
- Key Laboratory for Organic Electronics and Information Displays, Institute of Advanced Materials (IAM), Jiangsu National Synergetic Innovation Center for Advanced Materials (SICAM), Nanjing University of Posts & Telecommunications, Nanjing 210023, China
| | - Shasha He
- School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore 636921, Singapore
| | - Chen Xie
- Key Laboratory for Organic Electronics and Information Displays, Institute of Advanced Materials (IAM), Jiangsu National Synergetic Innovation Center for Advanced Materials (SICAM), Nanjing University of Posts & Telecommunications, Nanjing 210023, China
| | - Quli Fan
- Key Laboratory for Organic Electronics and Information Displays, Institute of Advanced Materials (IAM), Jiangsu National Synergetic Innovation Center for Advanced Materials (SICAM), Nanjing University of Posts & Telecommunications, Nanjing 210023, China
| | - Kanyi Pu
- School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore 636921, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 636921, Singapore
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15
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Vance K, Alitinok A, Winfree S, Jensen-Smith H, Swanson BJ, Grandgenet PM, Klute KA, Crichton DJ, Hollingsworth MA. Machine learning analyses of highly-multiplexed immunofluorescence identifies distinct tumor and stromal cell populations in primary pancreatic tumors. Cancer Biomark 2022; 33:219-235. [PMID: 35213363 PMCID: PMC9278645 DOI: 10.3233/cbm-210308] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Pancreatic ductal adenocarcinoma (PDAC) is a formidable challenge for patients and clinicians. OBJECTIVE To analyze the distribution of 31 different markers in tumor and stromal portions of the tumor microenvironment (TME) and identify immune cell populations to better understand how neoplastic, non-malignant structural, and immune cells, diversify the TME and influence PDAC progression. METHODS Whole slide imaging (WSI) and cyclic multiplexed-immunofluorescence (MxIF) was used to collect 31 different markers over the course of nine distinctive imaging series of human PDAC samples. Image registration and machine learning algorithms were developed to largely automate an imaging analysis pipeline identifying distinct cell types in the TME. RESULTS A random forest algorithm accurately predicted tumor and stromal-rich areas with 87% accuracy using 31 markers and 77% accuracy using only five markers. Top tumor-predictive markers guided downstream analyses to identify immune populations effectively invading into the tumor, including dendritic cells, CD4+ T cells, and multiple immunoregulatory subtypes. CONCLUSIONS Immunoprofiling of PDAC to identify differential distribution of immune cells in the TME is critical for understanding disease progression, response and/or resistance to treatment, and the development of new treatment strategies.
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Affiliation(s)
- Krysten Vance
- Eppley Institute for Research in Cancer and Allied Diseases, Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA
| | - Alphan Alitinok
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA, USA
| | - Seth Winfree
- Eppley Institute for Research in Cancer and Allied Diseases, Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Heather Jensen-Smith
- Eppley Institute for Research in Cancer and Allied Diseases, Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA
| | - Benjamin J. Swanson
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Paul M. Grandgenet
- Eppley Institute for Research in Cancer and Allied Diseases, Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA
| | - Kelsey A. Klute
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Daniel J. Crichton
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA, USA
| | - Michael A. Hollingsworth
- Eppley Institute for Research in Cancer and Allied Diseases, Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA
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16
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Sparger EE, Chang H, Chin N, Rebhun RB, Withers SS, Kieu H, Canter RJ, Monjazeb AM, Kent MS. T Cell Immune Profiles of Blood and Tumor in Dogs Diagnosed With Malignant Melanoma. Front Vet Sci 2021; 8:772932. [PMID: 34926643 PMCID: PMC8674490 DOI: 10.3389/fvets.2021.772932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 11/05/2021] [Indexed: 11/29/2022] Open
Abstract
Investigation of canine T cell immunophenotypes in canine melanomas as prognostic biomarkers for disease progression or predictive biomarkers for targeted immunotherapeutics remains in preliminary stages. We aimed to examine T cell phenotypes and function in peripheral blood mononuclear cells (PBMC) and baseline tumor samples by flow cytometry, and to compare patient (n = 11–20) T cell phenotypes with healthy controls dogs (n = 10–20). CD3, CD4, CD8, CD25, FoxP3, Ki67, granzyme B, and interferon-γ (IFN-γ) were used to classify T cell subsets in resting and mitogen stimulated PBMCs. In a separate patient cohort (n = 11), T cells were classified using CD3, CD4, CD8, FoxP3, and granzyme B in paired PBMC and single cell suspensions of tumor samples. Analysis of flow cytometric data of individual T cell phenotypes in PBMC revealed specific T cell phenotypes including FoxP3+ and CD25+FoxP3- populations that distinguished patients from healthy controls. Frequencies of IFN-γ+ cells after ConA stimulation identified two different patient phenotypic responses, including a normal/exaggerated IFN-γ response and a lower response suggesting dysfunction. Principle component analysis of selected T cell immunophenotypes also distinguished patients and controls for T cell phenotype and revealed a clustering of patients based on metastasis detected at diagnosis. Findings supported the overall hypothesis that canine melanoma patients display a T cell immunophenotype profile that is unique from healthy pet dogs and will guide future studies designed with larger patient cohorts necessary to further characterize prognostic T cell immunophenotypes.
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Affiliation(s)
- Ellen E Sparger
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Hong Chang
- Center for Companion Animal Health, Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Ning Chin
- California National Primate Research Center, Department of Medical Microbiology and Immunology, University of California, Davis, Davis, CA, United States
| | - Robert B Rebhun
- Center for Companion Animal Health, Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Sita S Withers
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, United States
| | - Hung Kieu
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Robert J Canter
- Surgical Oncology, School of Medicine, University of California, Davis, Sacramento, CA, United States
| | - Arta M Monjazeb
- Radiation Oncology, School of Medicine, University of California, Davis, Sacramento, CA, United States
| | - Michael S Kent
- Center for Companion Animal Health, Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
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17
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Renman D, Gylling B, Vidman L, Bodén S, Strigård K, Palmqvist R, Harlid S, Gunnarsson U, van Guelpen B. Density of CD3 + and CD8 + Cells in the Microenvironment of Colorectal Cancer according to Prediagnostic Physical Activity. Cancer Epidemiol Biomarkers Prev 2021; 30:2317-2326. [PMID: 34607838 PMCID: PMC9398178 DOI: 10.1158/1055-9965.epi-21-0508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/19/2021] [Accepted: 09/27/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Physical activity is associated not only with a decreased risk of developing colorectal cancer but also with improved survival. One putative mechanism is the infiltration of immune cells in the tumor microenvironment. Experimental findings suggest that physical activity may mobilize immune cells to the tumor. We hypothesized that higher levels of physical activity prior to colorectal cancer diagnosis are associated with higher densities of tumor-infiltrating T-lymphocytes in colorectal cancer patients. METHODS The study setting was a northern Swedish population-based cohort, including 109,792 participants with prospectively collected health- and lifestyle-related data. For 592 participants who later developed colorectal cancer, archival tumor tissue samples were used to assess the density of CD3+ and CD8+ cytotoxic T cells by IHC. Odds ratios for associations between self-reported, prediagnostic recreational physical activity and immune cell infiltration were estimated by ordinal logistic regression. RESULTS Recreational physical activity >3 times per week was associated with a higher density of CD8+ T cells in the tumor front and center compared with participants reporting no recreational physical activity. Odds ratios were 2.77 (95% CI, 1.21-6.35) and 2.85 (95% CI, 1.28-6.33) for the tumor front and center, respectively, after adjustment for sex, age at diagnosis, and tumor stage. The risk estimates were consistent after additional adjustment for several potential confounders. For CD3, no clear associations were found. CONCLUSIONS Physical activity may promote the infiltration of CD8+ immune cells in the tumor microenvironment of colorectal cancer. IMPACT The study provides some evidence on how physical activity may alter the prognosis in colorectal cancer.
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Affiliation(s)
- David Renman
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden.,Corresponding Author: David Renman, Department of Surgical and Perioperative Sciences, Umeå University, SE-90185 Umeå, Sweden. Phone: 46-61184149; E-mail:
| | - Björn Gylling
- Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden
| | - Linda Vidman
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Stina Bodén
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Karin Strigård
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden
| | - Richard Palmqvist
- Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden
| | - Sophia Harlid
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Ulf Gunnarsson
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden
| | - Bethany van Guelpen
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden.,Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden
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18
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Wang JJ, Siu MKY, Jiang YX, Leung THY, Chan DW, Wang HG, Ngan HYS, Chan KKL. A Combination of Glutaminase Inhibitor 968 and PD-L1 Blockade Boosts the Immune Response against Ovarian Cancer. Biomolecules 2021; 11:biom11121749. [PMID: 34944392 PMCID: PMC8698585 DOI: 10.3390/biom11121749] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 11/10/2021] [Accepted: 11/17/2021] [Indexed: 12/24/2022] Open
Abstract
Programmed cell death 1 ligand (PD-L1) blockade has been used therapeutically in the treatment of ovarian cancer, and potential combination treatment approaches are under investigation to improve the treatment response rate. The increased dependence on glutamine is widely observed in various type of tumors, including ovarian cancer. Kidney-type glutaminase (GLS), as one of the isotypes of glutaminase, is found to promote tumorigenesis. Here, we have demonstrated that the combined treatment with GLS inhibitor 968 and PD-L1 blockade enhances the immune response against ovarian cancer. Survival analysis using the Kaplan–Meier plotter dataset from ovarian cancer patients revealed that the expression level of GLS predicts poor survival and correlates with the immunosuppressive microenvironment of ovarian cancer. 968 inhibits the proliferation of ovarian cancer cells and enhances granzyme B secretion by CD8+ T cells as detected by XTT assay and flow cytometry, respectively. Furthermore, 968 enhances the apoptosis-inducing ability of CD8+ T cells toward cancer cells and improves the treatment effect of anti-PD-L1 in treating ovarian cancer as assessed by Annexin V apoptosis assay. In vivo studies demonstrated the prolonged overall survival upon combined treatment of 968 with anti-PD-L1 accompanied by increased granzyme B secretion by CD4+ and CD8+ T cells isolated from ovarian tumor xenografts. Additionally, 968 increases the infiltration of CD3+ T cells into tumors, possibly through enhancing the secretion of CXCL10 and CXCL11 by tumor cells. In conclusion, our findings provide a novel insight into ovarian cancer cells influence the immune system in the tumor microenvironment and highlight the potential clinical implication of combination of immune checkpoints with GLS inhibitor 968 in treating ovarian cancer.
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19
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Fu X, He Y, Li M, Huang Z, Najafi M. Targeting of the tumor microenvironment by curcumin. Biofactors 2021; 47:914-932. [PMID: 34375483 DOI: 10.1002/biof.1776] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 07/26/2021] [Indexed: 02/06/2023]
Abstract
The tumor microenvironment (TME) is made up of several cells and molecules that affect the survival of cancer cells. Indeed, certain (immunosuppressive) cells which promote tumors can promote the growth of tumors by stimulating the proliferation of cancer cells and promoting angiogenesis. During tumor growth, antitumoral immunity includes natural killer cells and CD8+ T cells cannot overcome immunosuppressive responses and cancer cell proliferation. In order to achieve the appropriate therapeutic response, we must kill cancer cells and suppress the release of immunosuppressive molecules. The balance between anti-tumor immunity and immunosuppressive cells, such as regulatory T cells (Tregs), cancer-associated fibroblasts, tumor-associated macrophages, and myeloid-derived suppressor cells plays a key role in the suppression or promotion of cancer cells. Curcumin is a plant-derived agent that has shown interesting properties for cancer therapy. It has shown that not only directly inhibit the growth of cancer cells, but can also modulate the growth and activity of immunosuppressant and tumor-promoting cells. In this review, we explain how curcumin modulates interactions within TME in favor of tumor treatment. The potential modulating effects of curcumin on the responses of cancer cells to treatment modalities such as immunotherapy will also be discussed.
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Affiliation(s)
- Xiao Fu
- College of Basic Medicine, Shaoyang University, Shaoyang, China
| | - Yingni He
- College of Basic Medicine, Shaoyang University, Shaoyang, China
| | - Mu Li
- College of Basic Medicine, Shaoyang University, Shaoyang, China
| | - Zezhi Huang
- Shaoyang Key Laboratory of Molecular Biology Diagnosis, Shaoyang, China
| | - Masoud Najafi
- Medical Technology Research Center, Institute of Health Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
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20
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Ravindran Menon D, Li Y, Yamauchi T, Osborne DG, Vaddi PK, Wempe MF, Zhai Z, Fujita M. EGCG Inhibits Tumor Growth in Melanoma by Targeting JAK-STAT Signaling and Its Downstream PD-L1/PD-L2-PD1 Axis in Tumors and Enhancing Cytotoxic T-Cell Responses. Pharmaceuticals (Basel) 2021; 14:1081. [PMID: 34832863 PMCID: PMC8618268 DOI: 10.3390/ph14111081] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/19/2021] [Accepted: 10/21/2021] [Indexed: 12/13/2022] Open
Abstract
Over the last decade, therapies targeting immune checkpoints, such as programmed death-1 (PD-1), have revolutionized the field of cancer immunotherapy. However, low response rates and immune-related adverse events remain a major concern. Here, we report that epigallocatechin gallate (EGCG), the most abundant catechin in green tea, inhibits melanoma growth by modulating an immune response against tumors. In vitro experiments revealed that EGCG treatment inhibited interferon-gamma (IFN-γ)-induced PD-L1 and PD-L2 expression and JAK-STAT signaling. We confirmed that this effect was driven by inhibiting STAT1 gene expression and STAT1 phosphorylation, thereby downregulating the PD-L1/PD-L2 transcriptional regulator IRF1 in both human and mouse melanoma cells. Animal studies revealed that the in vivo tumor-inhibitory effect of EGCG was through CD8+ T cells and that the inhibitory effect of EGCG was comparable to anti-PD-1 therapy. However, their mechanisms of action were different. Dissimilar to anti-PD-1 treatment that blocks PD-1/PD-L1 interaction, EGCG inhibited JAK/STAT signaling and PD-L1 expression in tumor cells, leading to the re-activation of T cells. In summary, we demonstrate that EGCG enhances anti-tumor immune responses by inhibiting JAK-STAT signaling in melanoma. EGCG could be used as an alternative treatment strategy to target the PD-L1/PD-L2-PD-1 axis in cancers.
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Affiliation(s)
- Dinoop Ravindran Menon
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; (D.R.M.); (Y.L.); (T.Y.); (D.G.O.); (P.K.V.); (Z.Z.)
| | - Yang Li
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; (D.R.M.); (Y.L.); (T.Y.); (D.G.O.); (P.K.V.); (Z.Z.)
| | - Takeshi Yamauchi
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; (D.R.M.); (Y.L.); (T.Y.); (D.G.O.); (P.K.V.); (Z.Z.)
| | - Douglas Grant Osborne
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; (D.R.M.); (Y.L.); (T.Y.); (D.G.O.); (P.K.V.); (Z.Z.)
| | - Prasanna Kumar Vaddi
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; (D.R.M.); (Y.L.); (T.Y.); (D.G.O.); (P.K.V.); (Z.Z.)
| | - Michael F Wempe
- Department of Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA;
| | - Zili Zhai
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; (D.R.M.); (Y.L.); (T.Y.); (D.G.O.); (P.K.V.); (Z.Z.)
| | - Mayumi Fujita
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; (D.R.M.); (Y.L.); (T.Y.); (D.G.O.); (P.K.V.); (Z.Z.)
- Department of Veterans Affairs Medical Center, VA Eastern Colorado Health Care System, Aurora, CO 80045, USA
- Department of Immunology & Microbiology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
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21
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Ferreira CA, Heidari P, Ataeinia B, Sinevici N, Sise ME, Colvin RB, Wehrenberg-Klee E, Mahmood U. Non-invasive Detection of Immunotherapy-Induced Adverse Events. Clin Cancer Res 2021; 27:5353-5364. [PMID: 34253581 DOI: 10.1158/1078-0432.ccr-20-4641] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/27/2021] [Accepted: 07/08/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE Cancer immunotherapy has markedly improved the prognosis of patients with a broad variety of malignancies. However, benefits are weighed against unique toxicities, with immune-related adverse events (irAE) that are frequent and potentially life-threatening. The diagnosis and management of these events are challenging due to heterogeneity of timing onset, multiplicity of affected organs, and lack of non-invasive monitoring techniques. We demonstrate the use of a granzyme B-targeted PET imaging agent (GZP) for irAE identification in a murine model. EXPERIMENTAL DESIGN We generated a model of immunotherapy-induced adverse events in Foxp3-DTR-GFP mice bearing MC38 tumors. GZP PET imaging was performed to evaluate organs non-invasively. We validated imaging with ex vivo analysis, correlating the establishment of these events with the presence of immune infiltrates and granzyme B upregulation in tissue. To demonstrate the clinical relevance of our findings, the presence of granzyme B was identified through immunofluorescence staining in tissue samples of patients with confirmed checkpoint inhibitor-associated adverse events. RESULTS GZP PET imaging revealed differential uptake in organs affected by irAEs, such as colon, spleen, and kidney, which significantly diminished after administration of the immunosuppressor dexamethasone. The presence of granzyme B and immune infiltrates were confirmed histologically and correlated with significantly higher uptake in PET imaging. The presence of granzyme B was also confirmed in samples from patients that presented with clinical irAEs. CONCLUSIONS We demonstrate an interconnection between the establishment of irAEs and granzyme B presence and, for the first time, the visualization of those events through PET imaging.
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Affiliation(s)
- Carolina A Ferreira
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
| | - Pedram Heidari
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
| | - Bahar Ataeinia
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
| | - Nicoleta Sinevici
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
| | - Meghan E Sise
- Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Robert B Colvin
- Department of Pathology and Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | | | - Umar Mahmood
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts.
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22
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Affiliation(s)
- Huiling Wang
- Guangxi Key Laboratory of Bio‐targeting Theranostics National Center for International Research of Bio‐targeting Theranostics Collaborative Innovation Center for Targeting Tumor Diagnosis and Therapy Guangxi Medical University Nanning China
| | - Yong Huang
- Guangxi Key Laboratory of Bio‐targeting Theranostics National Center for International Research of Bio‐targeting Theranostics Collaborative Innovation Center for Targeting Tumor Diagnosis and Therapy Guangxi Medical University Nanning China
| | - Jian He
- Guangxi Key Laboratory of Bio‐targeting Theranostics National Center for International Research of Bio‐targeting Theranostics Collaborative Innovation Center for Targeting Tumor Diagnosis and Therapy Guangxi Medical University Nanning China
| | - Liping Zhong
- Guangxi Key Laboratory of Bio‐targeting Theranostics National Center for International Research of Bio‐targeting Theranostics Collaborative Innovation Center for Targeting Tumor Diagnosis and Therapy Guangxi Medical University Nanning China
| | - Yongxiang Zhao
- Guangxi Key Laboratory of Bio‐targeting Theranostics National Center for International Research of Bio‐targeting Theranostics Collaborative Innovation Center for Targeting Tumor Diagnosis and Therapy Guangxi Medical University Nanning China
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23
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Hsu FT, Liu YC, Tsai CL, Yueh PF, Chang CH, Lan KL. Preclinical Evaluation of Recombinant Human IL15 Protein Fused with Albumin Binding Domain on Anti-PD-L1 Immunotherapy Efficiency and Anti-Tumor Immunity in Colon Cancer and Melanoma. Cancers (Basel) 2021; 13:cancers13081789. [PMID: 33918641 PMCID: PMC8070266 DOI: 10.3390/cancers13081789] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 04/02/2021] [Accepted: 04/07/2021] [Indexed: 11/30/2022] Open
Abstract
Simple Summary In this manuscript, we reported that a newly developed recombinant human IL15 fused with albumin binding domain (hIL15-ABD) showed superior biological half-life, pharmacokinetic and anti-tumor immunity than wild-type (WT) hIL15. Our hIL-15-ABD can effectively enhance anti-tumor efficacy of anti-PD-L1 on colon cancer and melanoma animal models. The anti-tumor potential of hIL-15-ABD was associated with tumor microenvironment (TME) regulation, including the activation of NK cells and CD8+ T cells, the reduction of immunosuppressive cells (MDSCs and Tregs) and the suppression of immunosuppressive factors (IDO, FOXP3 and VEGF). In conclusion, our new hIL15-ABD combined with anti-PD-L1 antibody increased the activity of anti-tumor effector cells involved in both innate and adaptive immunities, decreased the TME’s immunosuppressive cells, and showed greater anti-tumor effect than that of either monotherapy. We suggested hIL15-ABD as the potential complementary agent may effectively augment the therapeutic efficacy of anti-PD-L1 antibody in colon cancer and melanoma model. Abstract Anti-PD-L1 antibody monotherapy shows limited efficacy in a significant proportion of the patients. A common explanation for the inefficacy is a lack of anti-tumor effector cells in the tumor microenvironment (TME). Recombinant human interleukin-15 (hIL15), a potent immune stimulant, has been investigated in clinical trial with encouraging results. However, hIL15 is constrained by the short half-life of hIL15 and a relatively unfavorable pharmacokinetics profile. We developed a recombinant fusion IL15 protein composed of human IL15 (hIL15) and albumin binding domain (hIL15-ABD) and explored the therapeutic efficacy and immune regulation of hIL-15, hIL15-ABD and/or combination with anti-PD-L1 on CT26 murine colon cancer (CC) and B16-F10 murine melanoma models. We demonstrated that hIL15-ABD has significant inhibitory effect on the CT26 and B16-F10 tumor growths as compared to hIL-15. hIL-15-ABD not only showed superior half-life and pharmacokinetics data than hIL-15, but also enhance anti-tumor efficacy of antibody against PD-L1 via suppressive effect on accumulation of Tregs and MDSCs and activation of NK and CD8+T cells. Immune suppressive factors including VEGF and IDO were also decreased by combination treatment. hIL15-ABD combined with anti-PD-L1 antibody increased the activity of anti-tumor effector cells involved in both innate and adaptive immunities, decreased the TME’s immunosuppressive cells, and showed greater anti-tumor effect than that of either monotherapy.
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Affiliation(s)
- Fei-Ting Hsu
- Department of Biological Science and Technology, China Medical University, Taichung 406, Taiwan; (F.-T.H.); (P.-F.Y.)
| | - Yu-Chang Liu
- Department of Radiation Oncology, Chang Bing Show Chwan Memorial Hospital, Lukang, Changhua 505, Taiwan;
- Department of Radiation Oncology, Show Chwan Memorial Hospital, Changhua 500, Taiwan
- Department of Medical Imaging and Radiological Sciences, Central Taiwan University of Science and Technology, Taichung 406, Taiwan
| | - Chang-Liang Tsai
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei 112, Taiwan; (C.-L.T.); (C.-H.C.)
| | - Po-Fu Yueh
- Department of Biological Science and Technology, China Medical University, Taichung 406, Taiwan; (F.-T.H.); (P.-F.Y.)
- Institute of Traditional Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Chih-Hsien Chang
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei 112, Taiwan; (C.-L.T.); (C.-H.C.)
- Isotope Application Division, Institute of Nuclear Energy Research, Taoyuan 325, Taiwan
| | - Keng-Li Lan
- Institute of Traditional Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Department of Oncology, Taipei Veterans General Hospital, Taipei 112, Taiwan
- Correspondence: or ; Tel.: +886-2-2826-7000 (ext. 7121)
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24
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Kamal Y, Dwan D, Hoehn HJ, Sanz-Pamplona R, Alonso MH, Moreno V, Cheng C, Schell MJ, Kim Y, Felder SI, Rennert HS, Melas M, Lazaris C, Bonner JD, Siegel EM, Shibata D, Rennert G, Gruber SB, Frost HR, Amos CI, Schmit SL. Tumor immune infiltration estimated from gene expression profiles predicts colorectal cancer relapse. Oncoimmunology 2021; 10:1862529. [PMID: 33763292 PMCID: PMC7951964 DOI: 10.1080/2162402x.2020.1862529] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 12/01/2020] [Indexed: 01/10/2023] Open
Abstract
A substantial fraction of patients with stage I-III colorectal adenocarcinoma (CRC) experience disease relapse after surgery with curative intent. However, biomarkers for predicting the likelihood of CRC relapse have not been fully explored. Therefore, we assessed the association between tumor infiltration by a broad array of innate and adaptive immune cell types and CRC relapse risk. We implemented a discovery-validation design including a discovery dataset from Moffitt Cancer Center (MCC; Tampa, FL) and three independent validation datasets: (1) GSE41258 (2) the Molecular Epidemiology of Colorectal Cancer (MECC) study, and (3) GSE39582. Infiltration by 22 immune cell types was inferred from tumor gene expression data, and the association between immune infiltration by each cell type and relapse-free survival was assessed using Cox proportional hazards regression. Within each of the four independent cohorts, CD4+ memory activated T cell (HR: 0.93, 95% CI: 0.90-0.96; FDR = 0.0001) infiltration was associated with longer time to disease relapse, independent of stage, microsatellite instability, and adjuvant therapy. Based on our meta-analysis across the four datasets, 10 innate and adaptive immune cell types associated with disease relapse of which 2 were internally validated using multiplex immunofluorescence. Moreover, immune cell type infiltration was a better predictors of disease relapse than Consensus Molecular Subtype (CMS) and other expression-based biomarkers (Immune-AICMCC:238.1-238.9; CMS-AICMCC: 241.0). These data suggest that transcriptome-derived immune profiles are prognostic indicators of CRC relapse and quantification of both innate and adaptive immune cell types may serve as candidate biomarkers for predicting prognosis and guiding frequency and modality of disease surveillance.
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Affiliation(s)
- Yasmin Kamal
- Department of Biomedical Data Sciences, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Dennis Dwan
- Department of Biomedical Data Sciences, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Hannah J. Hoehn
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Rebeca Sanz-Pamplona
- Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology (ICO), ONCOBELL Program, Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - M. Henar Alonso
- Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology (ICO), ONCOBELL Program, Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Victor Moreno
- Oncology Data Analytics Program (ODAP), Catalan Institute of Oncology (ICO), ONCOBELL Program, Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Chao Cheng
- Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
- Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, TX, USA
| | - Michael J. Schell
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Columbus, OH, USA
| | - Youngchul Kim
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Columbus, OH, USA
| | - Seth I. Felder
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute
| | - Hedy S. Rennert
- Department of Community Medicine & Epidemiology, Lady Davis Carmel Medical Center, Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology
- Steve and Cindy Rasmussen Institute for Genomic Medicine, Lady Davis Carmel Medical Center and Technion Faculty of Medicine, Clalit National Cancer Control Center, Haifa, Israel
| | - Marilena Melas
- Department of Medical Oncology and Therapeutics Research, Center for Precision Medicine, City of Hope National Medical Center, Duarte, CA, USA
- Nationwide Children’s Hospital, Columbus, OH, USA
| | - Charalampos Lazaris
- Department of Medical Oncology and Therapeutics Research, Center for Precision Medicine, City of Hope National Medical Center, Duarte, CA, USA
- Whitehead Institute for Biomedical Research, Cambridge, MA, USA
- Klarman Cell Observatory, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Joseph D. Bonner
- Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, CA, USA
| | - Erin M. Siegel
- Cancer Epidemiology Program, H. Lee Moffitt Cancer Center and Research Institute
| | - David Shibata
- Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Gad Rennert
- Department of Community Medicine & Epidemiology, Lady Davis Carmel Medical Center, Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology
- Steve and Cindy Rasmussen Institute for Genomic Medicine, Lady Davis Carmel Medical Center and Technion Faculty of Medicine, Clalit National Cancer Control Center, Haifa, Israel
| | - Stephen B. Gruber
- Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, CA, USA
| | - H. Robert Frost
- Department of Biomedical Data Sciences, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Christopher I. Amos
- Department of Biomedical Data Sciences, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
- Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, TX, USA
| | - Stephanie L. Schmit
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute
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25
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Yang W, Zhang W, Wang X, Tan L, Li H, Wu J, Wu Q, Sun W, Chen J, Yin Y. HCA587 Protein Vaccine Induces Specific Antitumor Immunity Mediated by CD4 + T-cells Expressing Granzyme B in a Mouse Model of Melanoma. Anticancer Agents Med Chem 2021; 21:738-746. [PMID: 32723258 DOI: 10.2174/1871520620666200728131951] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 05/21/2020] [Accepted: 05/23/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND The antigen HCA587 (also known as MAGE-C2), which is considered a cancer-testis antigen, exhibits upregulated expression in a wide range of malignant tumors with unique immunological properties, and may thus serve as a promising target for tumor immunotherapy. OBJECTIVE The study aimed to explore the antitumor effect of the HCA587 protein vaccine and the response of humoral and cell-mediated immunity. METHODS The HCA587 protein vaccine was formulated with adjuvants CpG and ISCOM. B16 melanoma cells were subcutaneously inoculated to C57BL/6 mice, followed by treatment with HCA587 protein vaccine subcutaneously. Mouse survival was monitored daily, and tumor volume was measured every 2 to 3 days. The tumor sizes, survival time and immune cells in tumor tissues were detected. And the vital immune cell subset and effector molecules were explored. RESULTS After treatment with HCA587 protein vaccine, the vaccination elicited significant immune responses, which delayed tumor growth and improved animal survival. The vaccination increased the proportion of CD4+ T cells expressing IFN-γ and granzyme B in tumor tissues. The depletion of CD4+T cells resulted in an almost complete abrogation of the antitumor effect of the vaccination, suggesting that the antitumor efficacy was mediated by CD4+ T cells. In addition, knockout of IFN-γ resulted in a decrease in granzyme B levels, which were secreted by CD4+ T cells, and the antitumor effect was also significantly attenuated. CONCLUSION The HCA587 protein vaccine may increase the levels of granzyme B expressed by CD4+ T cells, and this increase is dependent on IFN-γ, and the vaccine resulted in a specific tumor immune response and subsequent eradication of the tumor.
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Affiliation(s)
- Weiming Yang
- Department of Clinical Laboratory, The Second Affiliated Hospital of Nanchang University, Jiangxi Province Key Laboratory of Laboratory Medicine, Nanchang 330006, China
| | - Weiheng Zhang
- Department of Oncology, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - Xiaozhong Wang
- Department of Clinical Laboratory, The Second Affiliated Hospital of Nanchang University, Jiangxi Province Key Laboratory of Laboratory Medicine, Nanchang 330006, China
| | - Liming Tan
- Department of Clinical Laboratory, The Second Affiliated Hospital of Nanchang University, Jiangxi Province Key Laboratory of Laboratory Medicine, Nanchang 330006, China
| | - Hua Li
- Department of Clinical Laboratory, The Second Affiliated Hospital of Nanchang University, Jiangxi Province Key Laboratory of Laboratory Medicine, Nanchang 330006, China
| | - Jiemin Wu
- Department of Clinical Laboratory, Wuyuan County People's Hospital, Wuyuan 333200, Jiangxi Province, China
| | - Qiong Wu
- Department of Clinical Laboratory, The Second Affiliated Hospital of Nanchang University, Jiangxi Province Key Laboratory of Laboratory Medicine, Nanchang 330006, China
| | - Wanlei Sun
- Department of Clinical Laboratory, The Second Affiliated Hospital of Nanchang University, Jiangxi Province Key Laboratory of Laboratory Medicine, Nanchang 330006, China
| | - Juanjuan Chen
- Department of Clinical Laboratory, The Second Affiliated Hospital of Nanchang University, Jiangxi Province Key Laboratory of Laboratory Medicine, Nanchang 330006, China
| | - Yanhui Yin
- Department of Immunology, School of Basic Medical Sciences, and Key Laboratory of Medical Immunology of Ministry of Health, Peking University Health Science Center, Beijing 100191, China
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26
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Syed Najmuddin SUF, Amin ZM, Tan SW, Yeap SK, Kalyanasundram J, Veerakumarasivam A, Chan SC, Chia SL, Yusoff K, Alitheen NB. Oncolytic effects of the recombinant Newcastle disease virus, rAF-IL12, against colon cancer cells in vitro and in tumor-challenged NCr-Foxn1nu nude mice. PeerJ 2020; 8:e9761. [PMID: 33354412 PMCID: PMC7731658 DOI: 10.7717/peerj.9761] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 07/28/2020] [Indexed: 12/13/2022] Open
Abstract
Colon cancer remains one of the main cancers causing death in men and women worldwide as certain colon cancer subtypes are resistant to conventional treatments and the development of new cancer therapies remains elusive. Alternative modalities such as the use of viral-based therapeutic cancer vaccine is still limited, with only the herpes simplex virus (HSV) expressing granulocyte-macrophage colony- stimulating factor (GM-CSF) or talimogene laherparepvec (T-Vec) being approved in the USA and Europe so far. Therefore, it is imperative to continue the search for a new treatment modality. This current study evaluates a combinatorial therapy between the oncolytic Newcastle disease virus (NDV) and interleukin-12 (IL-12) cytokine as a potential therapeutic vaccine to the current anti-cancer drugs. Several in vitro analyses such as MTT assay, Annexin V/FITC flow cytometry, and cell cycle assay were performed to evaluate the cytotoxicity effect of recombinant NDV, rAF-IL12. Meanwhile, serum cytokine, serum biochemical, histopathology of organs and TUNEL assay were carried out to assess the anti-tumoral effects of rAF-IL12 in HT29 tumor-challenged nude mice. The apoptosis mechanism underlying the effect of rAF-IL12 treatment was also investigated using NanoString Gene expression analysis. The recombinant NDV, rAF-IL12 replicated in HT29 colon cancer cells as did its parental virus, AF2240-i. The rAF-IL12 treatment had slightly better cytotoxicity effects towards HT29 cancer cells when compared to the AF2240-i as revealed by the MTT, Annexin V FITC and cell cycle assay. Meanwhile, the 28-day treatment with rAF-IL12 had significantly (p < 0.05) perturbed the growth and progression of HT29 tumor in NCr-Foxn1nu nude mice when compared to the untreated and parental wild-type NDV strain AF2240-i. The rAF-IL12 also modulated the immune system in nude mice by significantly (p < 0.05) increased the level of IL-2, IL-12, and IFN-γ cytokines. Treatment with rAF-IL12 had also significantly (p < 0.05) increased the expression level of apoptosis-related genes such as Fas, caspase-8, BID, BAX, Smad3 and granzyme B in vitro and in vivo. Besides, rAF-IL12 intra-tumoral delivery was considered safe and was not hazardous to the host as evidenced in pathophysiology of the normal tissues and organs of the mice as well as from the serum biochemistry profile of liver and kidney. Therefore, this study proves that rAF-IL12 had better cytotoxicity effects than its parental AF2240-i and could potentially be an ideal treatment for colon cancer in the near future.
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Affiliation(s)
| | - Zahiah Mohamed Amin
- Universiti Putra Malaysia, Serdang, Malaysia.,Institute of Bioscience, Universiti Putra Malaysia, Serdang, Malaysia
| | - Sheau Wei Tan
- Universiti Putra Malaysia, Serdang, Malaysia.,Institute of Bioscience, Universiti Putra Malaysia, Serdang, Malaysia
| | | | | | | | | | - Suet Lin Chia
- Universiti Putra Malaysia, Serdang, Malaysia.,Institute of Bioscience, Universiti Putra Malaysia, Serdang, Malaysia
| | - Khatijah Yusoff
- Universiti Putra Malaysia, Serdang, Malaysia.,Malaysian Genome Institute, National Institute of Biotechnology Malaysia, Kajang, Malaysia
| | - Noorjahan Banu Alitheen
- Universiti Putra Malaysia, Serdang, Malaysia.,Institute of Bioscience, Universiti Putra Malaysia, Serdang, Malaysia
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27
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Tremble LF, Heffron CCBB, Forde PF. The effect of calcium electroporation on viability, phenotype and function of melanoma conditioned macrophages. Sci Rep 2020; 10:20645. [PMID: 33244152 PMCID: PMC7691332 DOI: 10.1038/s41598-020-77743-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 09/01/2020] [Indexed: 02/06/2023] Open
Abstract
Electroporation in combination with chemotherapy is an established treatment used on solid malignancies that results in enhanced chemotherapeutic uptake. Recent advances have begun to transition to the use of non-toxic compounds, such as calcium, in lieu of chemotherapy, which can also induce tumour cell death. While the effect of treatment on tumour cell death has been well characterized and has been shown to induce an immunogenic form of cell death, the effect of treatment on intratumoural immune cells has not been investigated. Here we present data showing the effect of calcium electroporation on immune cells, using melanoma-conditioned bone marrow-derived macrophages. Similar to tumour cells, macrophage cell membranes are susceptible to poration following treatment and subsequently reseal. Macrophages are less susceptible to calcium electroporation induced cell death in comparison to B16F10 melanoma cells. However treatment with electroporation with or without bleomycin or calcium was shown to affect macrophage phenotype and function. Coculture of calcium electroporated macrophages revealed that both the capacity of macrophages to stimulate and direct T cell responses are affected following exposure to treatment. We conclude that calcium electroporation has the potential to boost the immunogenic capacity of exposed tumour associated macrophages, and further research is warranted to determine if calcium electroporation can be optimised to generate systemic anti-cancer immune responses.
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Affiliation(s)
- Liam Friel Tremble
- CancerResearch@UCC, University College Cork, Fourth floor, Western Gateway Building, Western Road, Cork, Ireland
| | | | - Patrick F Forde
- CancerResearch@UCC, University College Cork, Fourth floor, Western Gateway Building, Western Road, Cork, Ireland.
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28
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Oyenuga M, Vierkant RA, Lynch CF, Pengo T, Tillmans LS, Cerhan JR, Church TR, Lazovich D, Anderson KE, Limburg PJ, Prizment AE. Associations between tissue-based CD3+ T-lymphocyte count and colorectal cancer survival in a prospective cohort of older women. Mol Carcinog 2020; 60:15-24. [PMID: 33200476 DOI: 10.1002/mc.23267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 10/18/2020] [Accepted: 10/28/2020] [Indexed: 12/11/2022]
Abstract
Tumor-infiltrating lymphocytes in colorectal cancer (CRC) predict better survival. However, associations between T-lymphocyte count in histologically normal tissues from patients with CRC and survival remain uncertain. We examined associations of CD3+ T-cells in colorectal tumor and histologically normal tissues with CRC-specific and all-cause mortality in the prospective Iowa Women's Health Study. Tissue microarrays were constructed using paraffin-embedded colorectal tissue samples from 464 women with tumor tissues and 314 women with histologically normal tissues (55-69 years at baseline) diagnosed with incident CRC from 1986 to 2002 and followed through 2014 (median follow-up 20.5 years). Three tumor and two histologically normal tissue cores for each patient were immunostained using CD3+ antibody and quantified, and the counts were averaged across the cores in each tissue. Cox proportional hazards regression estimated hazard ratios (HR) and 95% confidence interval (CI) for CRC-specific and all-cause mortality. After adjustment for age at diagnosis, body mass index, smoking status, tumor grade, and stage, HRs (95% CI) for the highest versus lowest tertile of tumor CD3+ score were 0.59 (0.38-0.89) for CRC-specific mortality and 0.82 (0.63-1.05) for all-cause mortality; for histologically normal CD3+ score, the corresponding HRs (95% CI) were 0.47 (0.19-1.17) and 0.50 (0.27-0.90), respectively. The CD3+ score combining the tumor and histologically normal scores was inversely associated with CRC-specific and all-cause mortality. Although the association between tumor CD3+ score and all-cause mortality was not significant, both higher CD3+ T-lymphocyte counts in tumor and histologically normal scores tended to be associated with lower CRC-specific and all-cause mortality.
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Affiliation(s)
- Mosunmoluwa Oyenuga
- Department of Internal Medicine, SSM St Mary's Hospital, St. Louis, Missouri, USA.,Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Robert A Vierkant
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA
| | - Charles F Lynch
- Department of Epidemiology, University of Iowa, Iowa City, Iowa, USA
| | - Thomas Pengo
- University of Minnesota Informatics Institute, University of Minnesota, Minneapolis, Minnesota, USA
| | - Lori S Tillmans
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - James R Cerhan
- Division of Epidemiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Timothy R Church
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - DeAnn Lazovich
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.,Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Kristin E Anderson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.,Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Paul J Limburg
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Anna E Prizment
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.,Division of Hematology, Oncology, and Transplantation, University of Minnesota Medical School, Minneapolis, Minnesota, USA.,Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
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29
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Wu Y, Wan X, Jia G, Xu Z, Tao Y, Song Z, Du T. Aberrantly Methylated and Expressed Genes as Prognostic Epigenetic Biomarkers for Colon Cancer. DNA Cell Biol 2020; 39:1961-1969. [PMID: 33085517 DOI: 10.1089/dna.2020.5591] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
This study aimed to identify prognostic epigenetic biomarkers for colon cancer (CC). Methylation and mRNA expression in CC samples with clinical characteristics that corresponded to those in The Cancer Genome Atlas were analyzed. Differentially methylated genes (DMGs) and differentially expressed genes (DEGs) were screened between matched tumor and nontumor tissues. Among the 415 DEGs and DMGs that significantly correlated between cytosine-phosphate-guanine (CpG) methylation and gene expression, unc-5 netrin receptor C (UNC5C), solute carrier family 35 member F (SLC35F)1, Ly6/Neurotoxin (LYNX)1, stathmin (STMN)2, slit guidance ligand (SLIT)3, cell adhesion molecule L1 like (CHL1), CAP-Gly domain containing linker protein family member 4 (CLIP4), transmembrane protein (TMEM) 255A, granzyme B (GZMB), and brain expressed X-Linked (BEX)1 were promising epigenetic biomarkers. Prediction was more accurate when models were based on the expression and/or methylation of GZMB rather than clinical stage. Comparisons of tissues with high or low GZMB expression significantly associated the DEGs with natural killer-mediated cytotoxicity, cytokine-cytokine receptor interactions, and chemokine signaling pathways. From among the 10 epigenetic biomarkers, GZMB might serve as a tumor suppressor and function in several immune-related pathways in CC. Prognostic models based on GZMB expression and/or methylation would be significant for patients with CC.
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Affiliation(s)
- Yuanyu Wu
- Department of Gastrointestinal and Colorectal Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Xiaoyu Wan
- Department of Breast Surgery and The Second Clinical Hospital of Jilin University, Changchun, China
| | - Guoliang Jia
- Department of Orthopedics, The Second Clinical Hospital of Jilin University, Changchun, China
| | - Zhonghang Xu
- Department of Gastrointestinal and Colorectal Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Youmao Tao
- Department of Gastrointestinal and Colorectal Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Zheyu Song
- Department of Gastrointestinal and Colorectal Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Tonghua Du
- Department of Breast Surgery and The Second Clinical Hospital of Jilin University, Changchun, China
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Zhang J, Wang L, Xu X, Li X, Guan W, Meng T, Xu G. Transcriptome-Based Network Analysis Unveils Eight Immune-Related Genes as Molecular Signatures in the Immunomodulatory Subtype of Triple-Negative Breast Cancer. Front Oncol 2020; 10:1787. [PMID: 33042828 PMCID: PMC7530237 DOI: 10.3389/fonc.2020.01787] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 08/11/2020] [Indexed: 12/21/2022] Open
Abstract
Objective: Triple-negative breast cancer (TNBC) is a high heterogeneity cancer. The identification of genomic aberrations that drive each of the TNBC subtypes may predict the prognosis of patients with TNBC and provide novel therapeutic strategies in clinical practice. This study focuses on the transcriptome-based gene expression of TNBC and aims to generate comprehensive gene co-expression networks correlated with the immune-related subtype of TNBC. Methods: The transcriptome profiles of 107 female patients with TNBC were analyzed. Weighted gene co-expression network analysis (WGCNA) was applied to construct related networks and to sort hub-genes associated with the survival of TNBC patients. The data of the transcriptional expression, genomic alteration, survival status, and tumor immune microenvironment, which associated with hub-genes, were extracted, retrieved, and analyzed from Oncomine, UALCAN, TCGA, starBase, Kaplan–Meier Plotter, cBioPortal, and TIMER databases. Results: Immune-related hub-genes, including BIRC3, BTN3A1, CSF2RB, GIMAP7, GZMB, HCLS1, LCP2, and SELL, were found to be associated with clinical features of TNBC evaluated by WGCNA. These hub-genes belonged to the immunomodulatory subtype of TNBC and were upregulated in the TNBC cells. The protein expression of eight immune-related hub-genes was further confirmed to be upregulated in TNBC/CD8+ tissues detected by immunohistochemical staining. Survival analysis revealed that overexpression of eight immune-related hub-genes was in favor of the survival of patients with TNBC. Moreover, a positive correlation between eight immune-related hub-genes and immune cell infiltration was observed in TNBC patients. Furthermore, checkpoint inhibitor genes such as PD-L1, PD-1, and CTLA4 were more enrichment in the immunomodulatory subtype of TNBC and the expression of PD-L1, PD-1, and CTLA4 was positively correlated with eight immune-related hub-genes in the breast cancer dataset of TCGA. Conclusions: Eight immune-related hub-genes were identified to be molecular signatures in the immunomodulatory subtype of TNBC, which may provide therapeutic targets for the treatment of patients with breast cancer.
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Affiliation(s)
- Jinguo Zhang
- Research Center for Clinical Medicine, Jinshan Hospital, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Li Wang
- Department of Pathology, Jinshan Hospital, Fudan University, Shanghai, China
| | - Xiaolin Xu
- Research Center for Clinical Medicine, Jinshan Hospital, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xin Li
- Research Center for Clinical Medicine, Jinshan Hospital, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Wencai Guan
- Research Center for Clinical Medicine, Jinshan Hospital, Fudan University, Shanghai, China
| | - Ting Meng
- Research Center for Clinical Medicine, Jinshan Hospital, Fudan University, Shanghai, China
| | - Guoxiong Xu
- Research Center for Clinical Medicine, Jinshan Hospital, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Center for Tumor Diagnosis and Therapy, Jinshan Hospital, Fudan University, Shanghai, China
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31
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Paredes J, Zabaleta J, Garai J, Ji P, Imtiaz S, Spagnardi M, Alvarado J, Li L, Akadri M, Barrera K, Munoz-Sagastibelza M, Gupta R, Alshal M, Agaronov M, Talus H, Wang X, Carethers JM, Williams JL, Martello LA. Immune-Related Gene Expression and Cytokine Secretion Is Reduced Among African American Colon Cancer Patients. Front Oncol 2020; 10:1498. [PMID: 32983990 PMCID: PMC7492388 DOI: 10.3389/fonc.2020.01498] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 07/13/2020] [Indexed: 12/11/2022] Open
Abstract
Background: Colorectal cancer is the third most deadly cancer among African Americans (AA). When compared to Caucasian Americans (CA), AA present with more advanced disease and lower survival rates. Here, we investigated if differences in tumor immunology could be contributive to disparities observed between these populations. Methods: We examined gene expression of tumor and non-tumor adjacent tissues from AA and CA by whole transcriptome sequencing, and generated scores for immune cell populations by NanoString. In addition, we utilized “The Cancer Genome Atlas” (TCGA) database from AA and CA as a validation cohort. Finally, we measured the secretion of cytokines characteristic of effector T helper cell (Th) subsets by ELISA using plasma from each AA and CA participant. Results: Colon tumors from AA patients showed significant fold-change increase in gene expression when compared to CA for FOXP3 (6.22 vs. 3.22), IL1B (103 vs. 11.4) and IL8 (220 vs. 28.9) (p < 0.05). In contrast, among CA we observed statistically higher gene expression of markers associated with antitumor activity such as GZMB (Granzyme B), IFNG and the immunotherapy targets PDL1 (CD274) and CTLA4 (p < 0.05). TCGA data validated our observed higher gene expression of GZMB and PDL1 in CA patients when compared to AA. Notably, our observations on immune cell populations show that AA tumors have significantly higher number of exhausted CD8+ cells (p < 0.01), mast cells (p < 0.02) and increased T regulatory cells when compared to CA. AA colon cancer patients differed from CA in cytokine production patterns in plasma (i.e., reduced IL-12). Conclusions: Our study demonstrates significant differences of the immunological profiles of colon tumors from AA compared to CA that suggest a deficiency of appropriate immune defense mechanisms in terms of gene expression, recruitment of immune cells and systemic secretion of cytokines. As such, these immune differences could be mitigated through population-specific therapeutic approaches.
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Affiliation(s)
- Jenny Paredes
- Division of Gastroenterology and Hepatology, Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY, United States
| | - Jovanny Zabaleta
- Department of Pediatrics, Louisiana State University Health Sciences Center, New Orleans, LA, United States.,Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center, New Orleans, LA, United States
| | - Jone Garai
- Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center, New Orleans, LA, United States
| | - Ping Ji
- Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, NY, United States
| | - Sayed Imtiaz
- Department of Surgery, SUNY Downstate Medical Center, Brooklyn, NY, United States
| | - Marzia Spagnardi
- Division of Gastroenterology and Hepatology, Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY, United States
| | - Joussette Alvarado
- Department of Genetics, Louisiana State University Health Sciences Center, Loyola University New Orleans, New Orleans, LA, United States
| | - Li Li
- Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center, New Orleans, LA, United States
| | - Mubarak Akadri
- Division of Gastroenterology and Hepatology, Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY, United States
| | - Kaylene Barrera
- Department of Surgery, SUNY Downstate Medical Center, Brooklyn, NY, United States
| | - Maria Munoz-Sagastibelza
- Division of Gastroenterology and Hepatology, Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY, United States
| | - Raavi Gupta
- Department of Pathology, SUNY Downstate Medical Center, Brooklyn, NY, United States
| | - Mohamed Alshal
- Department of Pathology, SUNY Downstate Medical Center, Brooklyn, NY, United States
| | - Maksim Agaronov
- Department of Pathology, Kings County Hospital, Brooklyn, NY, United States
| | - Henry Talus
- Department of Surgery, Kings County Hospital, Brooklyn, NY, United States
| | - Xuefeng Wang
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, United States
| | - John M Carethers
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Jennie L Williams
- Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, NY, United States
| | - Laura A Martello
- Division of Gastroenterology and Hepatology, Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY, United States
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Kamal Y, Schmit SL, Frost HR, Amos CI. The tumor microenvironment of colorectal cancer metastases: opportunities in cancer immunotherapy. Immunotherapy 2020; 12:1083-1100. [PMID: 32787587 DOI: 10.2217/imt-2020-0026] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
About a fifth of individuals with colorectal cancer (CRC) present with disease metastasis at the time of diagnosis. While the role of the tumor microenvironment (TME) in governing CRC progression is undeniable, the role of the TME in either establishing or suppressing the formation of distant metastases of CRC is less well established. Despite advances in immunotherapy, many individuals with metastatic CRC do not respond to standard-of-care therapy. Therefore, understanding the role of the TME in establishing distant metastases is essential for developing new immunological agents. Here, we summarize our current understanding of the TME of CRC metastases, describe differences between the TME of primary tumors and their distant metastases, and discuss advances in the design and combinations of immunotherapeutic agents.
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Affiliation(s)
- Yasmin Kamal
- Department of Biomedical Data Sciences, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA.,Quantitative Biomedical Sciences, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA
| | - Stephanie L Schmit
- Department of Cancer Epidemiology, H Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA
| | - Hildreth Robert Frost
- Department of Biomedical Data Sciences, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA.,Quantitative Biomedical Sciences, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA
| | - Christopher I Amos
- Department of Biomedical Data Sciences, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA.,Quantitative Biomedical Sciences, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA.,Dan L Duncan Comprehensive Cancer Center at Baylor College of Medicine, Houston, TX 77030, USA
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Bosch DJ, Meurs MV, Jongman RM, Heeringa P, Abdulahad WH, Struys MMRF. Effects of propofol and dexmedetomidine with and without remifentanil on serum cytokine concentrations in healthy volunteers: a post hoc analysis. Br J Anaesth 2020; 125:267-274. [PMID: 32660717 DOI: 10.1016/j.bja.2020.05.039] [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: 11/27/2019] [Revised: 05/19/2020] [Accepted: 05/19/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Anaesthetic agents are likely to alter circulating cytokine concentrations. Because preceding studies have not been able to exclude the contribution of surgical trauma, perioperative stress, or both to circulating cytokine concentrations, the effects of anaesthesia remain unclear. The aim of this study was to quantify serum cytokines in healthy volunteers administered i.v. anaesthetic agents in the absence of surgical trauma and perioperative stress. METHODS Serum samples obtained during previous standardised studies from healthy volunteers were compared before and 6-8 h after induction of anaesthesia with propofol (n=31), propofol/remifentanil (n=30), dexmedetomidine (n=17) or dexmedetomidine/remifentanil (n=15). Anaesthetic regimens were standardised and volunteers did not undergo any surgical intervention. Serum concentrations of interleukin (IL)2, IL4, IL6, IL10, IL17, IL18, IL21, IL22, IL23, C-X-C motif ligand 8, interferon gamma, E-selectin, L-selectin, major histocompatibility complex class I chain-polypeptide-related sequence (MIC)A, MICB, Granzyme A, and Granzyme B were quantified using a multiplexed antibody-based assay (Luminex). RESULTS Samples were obtained from volunteers of either sex aged 18-70 yr. After anaesthesia with propofol alone, concentrations of IL4 (P=0.012), IL6 (P=0.027), IL21 (P=0.035), IL22 (P=0.002), C-X-C motif ligand 8 (P=0.004), MICB (P=0.046), and Granzyme A (P=0.045) increased. After anaesthesia with propofol and remifentanil, IL17 (P=0.013), interferon gamma (P=0.003), and MICA (P=0.001) decreased, but IL6 (P=0.006) and L-selectin (P=0.001) increased. After dexmedetomidine alone, IL18 (P=0.002), L-selectin (P=0.017), E-selectin (P=0.002), and Granzyme B (P=0.023) decreased. After dexmedetomidine with remifentanil no changes were observed. CONCLUSIONS In healthy volunteers not undergoing surgery, different i.v. anaesthesia regimens were associated with differential effects on circulating cytokines.
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Affiliation(s)
- Dirk J Bosch
- Department of Anesthesiology, University of Groningen, University Medical Centre Groningen (UMCG), Groningen, the Netherlands.
| | - Matijs V Meurs
- Department of Critical Care, University of Groningen, University Medical Centre Groningen (UMCG), Groningen, the Netherlands; Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Centre Groningen (UMCG), Groningen, the Netherlands
| | - Rianne M Jongman
- Department of Anesthesiology, University of Groningen, University Medical Centre Groningen (UMCG), Groningen, the Netherlands; Department of Pathology and Medical Biology, University of Groningen, University Medical Centre Groningen (UMCG), Groningen, the Netherlands
| | - Peter Heeringa
- Department of Pathology and Medical Biology, University of Groningen, University Medical Centre Groningen (UMCG), Groningen, the Netherlands
| | - Wayel H Abdulahad
- Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Centre Groningen (UMCG), Groningen, the Netherlands; Department of Pathology and Medical Biology, University of Groningen, University Medical Centre Groningen (UMCG), Groningen, the Netherlands
| | - Michel M R F Struys
- Department of Anesthesiology, University of Groningen, University Medical Centre Groningen (UMCG), Groningen, the Netherlands; Department of Basic and Applied Medical Sciences, Ghent University, Ghent, Belgium
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The role of sex in the innate and adaptive immune environment of metastatic colorectal cancer. Br J Cancer 2020; 123:624-632. [PMID: 32451467 PMCID: PMC7435180 DOI: 10.1038/s41416-020-0913-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 04/17/2020] [Accepted: 05/06/2020] [Indexed: 12/14/2022] Open
Abstract
Background Women with colorectal cancer (CRC) have a significant survival advantage over men. Sex influences on the tumour microenvironment (TME) are not well characterised, despite the importance of immune response in CRC. We hypothesised that sex-divergent immune responses could contribute to survival. Methods Using a murine model of metastatic CRC, we examined T cells, macrophages, and cytokines locally and systemically. TME and serum cytokines were measured by multiplex bead-based arrays, while FCA was used to identify cells and phenotypes. IHC provided spatial confirmation of T cell infiltration. Results Females had increased survival and T cell infiltration. CD8, CD4 and Th2 populations correlated with longer survival. Males had increased serum levels of chemokines and inflammation-associated cytokines. Within the TME, males had lower cytokine levels than females, and a shallower cytokine gradient to the periphery. Female tumours had elevated IL-10+ macrophages, which correlated with survival. Conclusions These data demonstrate survival-associated differences in the immune response of males and females to metastatic CRC. Females showed changes in cytokine production accompanied by increased immune cell populations, biased toward Th2-axis phenotypes. Key differences in the immune response to CRC correlated with survival in this model. These differences support a multi-faceted shift across the TME.
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Zhang H, Qin C, Gan H, Guo X, Zhang L. Construction of an Immunogenomic Risk Score for Prognostication in Colon Cancer. Front Genet 2020; 11:499. [PMID: 32508884 PMCID: PMC7253627 DOI: 10.3389/fgene.2020.00499] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 04/22/2020] [Indexed: 01/18/2023] Open
Abstract
Immune-related genes (IRGs) play regulatory roles in the immune system and are involved in the initiation and progression of colon cancer. This study aimed to develop an immunogenomic risk score for predicting survival outcomes among colon cancer patients. We analyzed the expressions of IRGs in colon specimens and discovered 484 differentially expressed IRGs when we compared specimens from colon cancer and adjacent normal tissue. Univariate Cox regression analyses were performed to identify 26 IRGs that were associated with survival. A Cox proportional hazards model with a lasso penalty identified five optimal IRGs for constructing the immunogenomic risk score (CD1B, XCL1, PLCG2, NGF, and OXTR). The risk score had good performance in predicting overall survival among patients with colon cancer and was correlated with the amount of tumor-infiltrating immune cells. Our findings suggest that the immunogenomic risk score may be useful for prognostication in colon cancer cases. Furthermore, the five IRGs included in the risk score might be useful targets for investigating the initiation of colon cancer and designing personalized treatments.
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Affiliation(s)
- Han Zhang
- First Clinical Medical College, Chongqing Medical University, Chongqing, China.,Department of Digestive Oncology, Three Gorges Hospital, Chongqing University, Chongqing, China
| | - Chuan Qin
- Department of Gastrointestinal Surgery, Three Gorges Hospital, Chongqing University, Chongqing, China
| | - Hua Gan
- First Clinical Medical College, Chongqing Medical University, Chongqing, China
| | - Xiong Guo
- First Clinical Medical College, Chongqing Medical University, Chongqing, China
| | - Li Zhang
- Department of Digestive Oncology, Three Gorges Hospital, Chongqing University, Chongqing, China
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Alexander PG, McMillan DC, Park JH. The local inflammatory response in colorectal cancer - Type, location or density? A systematic review and meta-analysis. Cancer Treat Rev 2019; 83:101949. [PMID: 31869737 DOI: 10.1016/j.ctrv.2019.101949] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 12/04/2019] [Accepted: 12/05/2019] [Indexed: 02/06/2023]
Abstract
INTRODUCTION The host anti-tumour inflammatory response is a strong prognostic indicator, and tumour infiltrating lymphocytes (TILs) are believed to have a complimentary role alongside TNM assessment in dictating future management. However, there is wide disagreement regarding the most efficacious and cost-effective method of assessment. METHODS A comprehensive literature search was performed of EMBASE, MedLine and PubMed as well as an assessment of references to identify all relevant studies relating to the assessment of the peri-tumoural inflammatory response or TILs and prognosis in colorectal cancer (CRC). A meta-analysis was performed of 67 studies meeting the REMARK criteria using RevMan software. RESULTS Intratumoural assessment of both CD3 and CD8 in CRC were significant for disease-free survival (DFS) (combined HRs 0.46; 95%CI: 0.39-0.54 and 0.54; 95%CI: 0.45-0.65), as well as overall survival (OS) and disease-specific survival (DSS). The same was true for assessment of CD3 and CD8 at the invasive margin (DFS: combined HRs 0.45; 95%CI: 0.33-0.61 and 0.51; 95%CI: 0.41-0.62). However, similar fixed effects summaries were also observed for H&E-based methods, like Klintrup-Makinen grade (DFS: HR 0.62; 95%CI: 0.43-0.88). Furthermore, inflammatory assessments were independent of MSI status. CONCLUSION The evidence suggests that it is the density of a co-ordinated local inflammatory infiltrate that confers survival benefit, rather than any individual immune cell subtype. Furthermore, the location of individual cells within the tumour microenvironment does not appear to influence survival. The authors advocate a standardised assessment of the local inflammatory response, but caution against emphasizing the importance of any individual immune cell subtype.
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Affiliation(s)
| | | | - James H Park
- School of Medicine, University of Glasgow, Glasgow, United Kingdom
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Song J, Deng Z, Su J, Yuan D, Liu J, Zhu J. Patterns of Immune Infiltration in HNC and Their Clinical Implications: A Gene Expression-Based Study. Front Oncol 2019; 9:1285. [PMID: 31867268 PMCID: PMC6904960 DOI: 10.3389/fonc.2019.01285] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 11/05/2019] [Indexed: 12/26/2022] Open
Abstract
Background: Immune infiltration of head and neck cancer (HNC) highly correlated with the patient's prognosis. However, previous studies failed to explain the diversity of different cell types that make up the function of the immune response system. The aim of the study was to uncover the differences in immune phenotypes of the tumor microenvironment (TME) between HNC adjacent tumor tissues and tumor tissues using CIBERSORT method and explore their therapeutic implications. Method: In current work, we employed the CIBERSORT method to evaluate the relative proportions of immune cell profiling in 11 paired HNC and adjacent samples, and analyzed the correlation between immune cell infiltration and clinical information. The tumor-infiltrating immune cells of TCGA HNC cohort was analyzed for the first time. The fractions of LM22 immune cells were imputed to determine the correlation between each immune cell subpopulation and survival and response to chemotherapy. Three types of molecular classification were identified via “CancerSubtypes” R-package. The functional enrichment was analyzed in each subtype. Results: The profiles of immune infiltration in TCGA HNC cohort significantly vary between paired cancer and para-cancerous tissue and the variation could reflect the individual difference. Total Macrophage, Macrophages M0 and NK cells resting were elevated in HNC tissues, while total T cells, total B cells, T cells CD8, B cell navie, T cell follicular helper, NK cells activated, Monocyte and Mast cells resting were decreased when compared to paracancerous tissues. Among each cell immune subtype, T cells regulatory Tregs, B cells naïve, T cells follicular helper, and T cells CD4 memory activated was significantly associated with HNC survival. Three clusters were observed via Cancer Subtypes R-package. Each cancer subtype has a specific molecular classification and subtype-specific immune cell characterization. Conclusions: Our data suggest a difference in immune response may be an important driver of HNC progression and response to treatment. The deconvolution algorithm of gene expression microarray data by CIBERSOFT provides useful information about the immune cell composition of HNC patients.
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Affiliation(s)
- Jukun Song
- Department of Oral and Maxillofacial Surgery, Guizhou Provincial People's Hospital, Guiyang, China.,School of Medicine, Guizhou University, Guiyang, China
| | - Zhenghao Deng
- Department of Pathology, School of Basic Medicine, Central South University, Guangzhou, China
| | - Jiaming Su
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Dongbo Yuan
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Jianguo Liu
- Department of Oral Medicine, School of Stomatology, Zunyi Medical University, Zunyi, China
| | - Jianguo Zhu
- School of Medicine, Guizhou University, Guiyang, China.,Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China
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Albonici L, Giganti MG, Modesti A, Manzari V, Bei R. Multifaceted Role of the Placental Growth Factor (PlGF) in the Antitumor Immune Response and Cancer Progression. Int J Mol Sci 2019; 20:ijms20122970. [PMID: 31216652 PMCID: PMC6627047 DOI: 10.3390/ijms20122970] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 06/10/2019] [Accepted: 06/14/2019] [Indexed: 12/22/2022] Open
Abstract
The sharing of molecules function that affects both tumor growth and neoangiogenesis with cells of the immune system creates a mutual interplay that impairs the host’s immune response against tumor progression. Increasing evidence shows that tumors are able to create an immunosuppressive microenvironment by recruiting specific immune cells. Moreover, molecules produced by tumor and inflammatory cells in the tumor microenvironment create an immunosuppressive milieu able to inhibit the development of an efficient immune response against cancer cells and thus fostering tumor growth and progression. In addition, the immunoediting could select cancer cells that are less immunogenic or more resistant to lysis. In this review, we summarize recent findings regarding the immunomodulatory effects and cancer progression of the angiogenic growth factor namely placental growth factor (PlGF) and address the biological complex effects of this cytokine. Different pathways of the innate and adaptive immune response in which, directly or indirectly, PlGF is involved in promoting tumor immune escape and metastasis will be described. PlGF is important for building up vascular structures and functions. Although PlGF effects on vascular and tumor growth have been widely summarized, its functions in modulating the immune intra-tumoral microenvironment have been less highlighted. In agreement with PlGF functions, different antitumor strategies can be envisioned.
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Affiliation(s)
- Loredana Albonici
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Via Montpellier 1, 00133 Rome, Italy.
| | - Maria Gabriella Giganti
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Via Montpellier 1, 00133 Rome, Italy.
| | - Andrea Modesti
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Via Montpellier 1, 00133 Rome, Italy.
| | - Vittorio Manzari
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Via Montpellier 1, 00133 Rome, Italy.
| | - Roberto Bei
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Via Montpellier 1, 00133 Rome, Italy.
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Ogino S, Nowak JA, Hamada T, Milner DA, Nishihara R. Insights into Pathogenic Interactions Among Environment, Host, and Tumor at the Crossroads of Molecular Pathology and Epidemiology. ANNUAL REVIEW OF PATHOLOGY 2019; 14:83-103. [PMID: 30125150 PMCID: PMC6345592 DOI: 10.1146/annurev-pathmechdis-012418-012818] [Citation(s) in RCA: 156] [Impact Index Per Article: 31.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Evidence indicates that diet, nutrition, lifestyle, the environment, the microbiome, and other exogenous factors have pathogenic roles and also influence the genome, epigenome, transcriptome, proteome, and metabolome of tumor and nonneoplastic cells, including immune cells. With the need for big-data research, pathology must transform to integrate data science fields, including epidemiology, biostatistics, and bioinformatics. The research framework of molecular pathological epidemiology (MPE) demonstrates the strengths of such an interdisciplinary integration, having been used to study breast, lung, prostate, and colorectal cancers. The MPE research paradigm not only can provide novel insights into interactions among environment, tumor, and host but also opens new research frontiers. New developments-such as computational digital pathology, systems biology, artificial intelligence, and in vivo pathology technologies-will further transform pathology and MPE. Although it is necessary to address the rarity of transdisciplinary education and training programs, MPE provides an exemplary model of integrative scientific approaches and contributes to advancements in precision medicine, therapy, and prevention.
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Affiliation(s)
- Shuji Ogino
- Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts 02215, USA; , ,
- Department of Oncologic Pathology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, Massachusetts 02215, USA;
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, USA
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts 02142, USA
| | - Jonathan A Nowak
- Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts 02215, USA; , ,
| | - Tsuyoshi Hamada
- Department of Oncologic Pathology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, Massachusetts 02215, USA;
| | - Danny A Milner
- American Society for Clinical Pathology, Chicago, Illinois 60603, USA;
| | - Reiko Nishihara
- Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts 02215, USA; , ,
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, USA
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts 02142, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, USA
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Koh H, Hamada T, Song M, Liu L, Cao Y, Nowak JA, da Silva A, Twombly T, Morikawa T, Kim SA, Masugi Y, Kosumi K, Shi Y, Gu M, Li W, Du C, Chen Y, Li W, Liu H, Li C, Wu K, Nosho K, Inamura K, Hanyuda A, Zhang X, Giannakis M, Chan AT, Fuchs CS, Nishihara R, Meyerhardt JA, Ogino S. Physical Activity and Colorectal Cancer Prognosis According to Tumor-Infiltrating T Cells. JNCI Cancer Spectr 2019; 2:pky058. [PMID: 31276098 PMCID: PMC6591576 DOI: 10.1093/jncics/pky058] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 09/15/2018] [Accepted: 09/27/2018] [Indexed: 12/11/2022] Open
Abstract
Background Evidence suggests that high-level physical activity may potentially reduce cancer mortality through its immune enhancement effect. We therefore hypothesized that survival benefits associated with physical activity might be stronger in colorectal carcinomas with lower immune reaction at diagnosis. Methods Using molecular pathological epidemiology databases of 470 colon and rectal carcinoma cases in the Nurses’ Health Study and the Health Professionals Follow-up Study, we assessed the prognostic association of postdiagnosis physical activity in strata of densities of CD3+ cells, CD8+ cells, CD45RO (PTPRC)+ cells, or FOXP3+ cells in tumor tissue. Cox proportional hazards regression model was used to adjust for potential confounders, including microsatellite instability, CpG island methylator phenotype, long interspersed nucleotide element-1 methylation, KRAS, BRAF, and PIK3CA mutations, and expression of CTNNB1 (beta-catenin), PTGS2 (cyclooxygenase-2), and IRS1. Results The association of postdiagnosis physical activity with colorectal cancer-specific mortality differed by CD3+ cell density (Pinteraction < .001). Multivariable-adjusted colorectal cancer-specific mortality hazard ratios for a quartile-unit increase in physical activity were 0.56 (95% confidence interval = 0.38 to 0.83) among cases with the lowest quartile of CD3+ cell density compared with 1.14 (95% confidence interval = 0.79 to 1.65) in cases with the highest quartile. We observed no differential survival association of physical activity by densities of CD8+ cells, CD45RO+ cells, or FOXP3+ cells. Conclusions The association between postdiagnosis physical activity and colorectal cancer survival appeared stronger for carcinomas with lower T cell infiltrates, suggesting an interactive effect of exercise and immunity on colorectal cancer progression.
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Affiliation(s)
- Hideo Koh
- Department of Oncologic Pathology.,Department of Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | | | - Mingyang Song
- Department of Nutrition.,Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA.,Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Li Liu
- Department of Oncologic Pathology.,Department of Nutrition.,Department of Epidemiology and Biostatistics, and the Ministry of Education Key Lab of Environment and Health, School of Public Health, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Yin Cao
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, MO
| | - Jonathan A Nowak
- Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | | | | | - Teppei Morikawa
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Sun A Kim
- Laboratory of Human Carcinogenesis, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | | | | | - Yan Shi
- Department of Oncologic Pathology.,Department of Medical Oncology, Chinese PLA General Hospital, Beijing, P.R. China
| | - Mancang Gu
- Department of Oncologic Pathology.,College of Pharmacy, Zhejiang Chinese Medical University, Zhejiang, P.R. China
| | | | | | | | | | | | | | - Kana Wu
- Department of Nutrition.,Department of Epidemiology.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Katsuhiko Nosho
- Department of Gastroenterology, Rheumatology, and Clinical Immunology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Kentaro Inamura
- Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Akiko Hanyuda
- Department of Nutrition.,Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Xuehong Zhang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Marios Giannakis
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.,Broad Institute of MIT and Harvard, Cambridge, MA.,Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Andrew T Chan
- Department of Immunology and Infectious Diseases.,Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA.,Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Broad Institute of MIT and Harvard, Cambridge, MA
| | - Charles S Fuchs
- Yale Cancer Center, New Haven, CT.,Department of Medicine, Yale School of Medicine, New Haven, CT.,Smilow Cancer Hospital, New Haven, CT
| | - Reiko Nishihara
- Department of Oncologic Pathology.,Department of Nutrition.,Department of Epidemiology.,Department of Immunology and Infectious Diseases.,Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, MA.,Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Jeffrey A Meyerhardt
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Shuji Ogino
- Department of Oncologic Pathology.,Department of Epidemiology.,Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Broad Institute of MIT and Harvard, Cambridge, MA
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Hamada T, Nowak JA, Masugi Y, Drew DA, Song M, Cao Y, Kosumi K, Mima K, Twombly TS, Liu L, Shi Y, da Silva A, Gu M, Li W, Nosho K, Keum N, Giannakis M, Meyerhardt JA, Wu K, Wang M, Chan AT, Giovannucci EL, Fuchs CS, Nishihara R, Zhang X, Ogino S. Smoking and Risk of Colorectal Cancer Sub-Classified by Tumor-Infiltrating T Cells. J Natl Cancer Inst 2019; 111:42-51. [PMID: 30312431 PMCID: PMC6335108 DOI: 10.1093/jnci/djy137] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 07/10/2018] [Indexed: 02/06/2023] Open
Abstract
Background Evidence indicates not only carcinogenic effect of cigarette smoking but also its immunosuppressive effect. We hypothesized that the association of smoking with colorectal cancer risk might be stronger for tumors with lower anti-tumor adaptive immune response. Methods During follow-up of 134 981 participants (3 490 851 person-years) in the Nurses' Health Study and Health Professionals Follow-up Study, we documented 729 rectal and colon cancer cases with available data on T-cell densities in tumor microenvironment. Using the duplication-method Cox regression model, we examined a differential association of smoking status with risk of colorectal carcinoma subclassified by densities of CD3+ cells, CD8+ cells, CD45RO (PTPRC)+ cells, or FOXP3+ cells. All statistical tests were two-sided. Results The association of smoking status with colorectal cancer risk differed by CD3+ cell density (Pheterogeneity = .007). Compared with never smokers, multivariable-adjusted hazard ratios for CD3+ cell-low colorectal cancer were 1.38 (95% confidence interval = 1.09 to 1.75) in former smokers and 1.59 (95% confidence interval = 1.14 to 2.23) in current smokers (Ptrend = .002, across smoking status categories). In contrast, smoking status was not associated with CD3+ cell-high cancer risk (Ptrend = .52). This differential association appeared consistent in strata of microsatellite instability, CpG island methylator phenotype, or BRAF mutation status. There was no statistically significant differential association according to densities of CD8+ cells, CD45RO+ cells, or FOXP3+ cells (Pheterogeneity > .04, with adjusted α of 0.01). Conclusions Colorectal cancer risk increased by smoking was stronger for tumors with lower T-lymphocyte response, suggesting an interplay of smoking and immunity in colorectal carcinogenesis.
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Affiliation(s)
| | - Jonathan A Nowak
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA
- Program in Molecular Pathological Epidemiology, Department of Pathology
| | | | - David A Drew
- Clinical and Translational Epidemiology Unit, and Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Mingyang Song
- Clinical and Translational Epidemiology Unit, and Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
- Department of Nutrition
| | - Yin Cao
- Clinical and Translational Epidemiology Unit, and Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
- Department of Nutrition
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO
| | | | - Kosuke Mima
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA
| | | | - Li Liu
- Department of Oncologic Pathology
- Department of Nutrition
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO
- Department of Epidemiology and Biostatistics, and the Ministry of Education Key Lab of Environment and Health, School of Public Health, Huazhong University of Science and Technology, Hubei, P.R. China
| | - Yan Shi
- Department of Oncologic Pathology
- Department of Medical Oncology, Chinese PLA General Hospital, Beijing, P.R. China
| | | | - Mancang Gu
- Department of Oncologic Pathology
- College of Pharmacy, Zhejiang Chinese Medical University, Zhejiang, P.R. China
| | | | - Katsuhiko Nosho
- Department of Gastroenterology, Rheumatology, and Clinical Immunology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - NaNa Keum
- Department of Nutrition
- Department of Food Science and Biotechnology, Dongguk University, Goyang, the Republic of Korea
| | - Marios Giannakis
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA
- Department of Medicine, and Channing Division of Network Medicine
- Broad Institute of MIT and Harvard, Cambridge, MA
| | | | - Kana Wu
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
- Department of Nutrition
- Department of Epidemiology
| | - Molin Wang
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
- Department of Epidemiology
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Andrew T Chan
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
- Clinical and Translational Epidemiology Unit, and Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Edward L Giovannucci
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
- Department of Nutrition
- Department of Epidemiology
| | - Charles S Fuchs
- Yale Cancer Center, New Haven, CT
- Department of Medicine, Yale School of Medicine, New Haven, CT
- Smilow Cancer Hospital, New Haven, CT
| | - Reiko Nishihara
- Department of Oncologic Pathology
- Program in Molecular Pathological Epidemiology, Department of Pathology
- Department of Nutrition
- Department of Epidemiology
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Xuehong Zhang
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Shuji Ogino
- Department of Oncologic Pathology
- Program in Molecular Pathological Epidemiology, Department of Pathology
- Department of Epidemiology
- Broad Institute of MIT and Harvard, Cambridge, MA
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Shergalis A, Bankhead A, Luesakul U, Muangsin N, Neamati N. Current Challenges and Opportunities in Treating Glioblastoma. Pharmacol Rev 2018; 70:412-445. [PMID: 29669750 PMCID: PMC5907910 DOI: 10.1124/pr.117.014944] [Citation(s) in RCA: 469] [Impact Index Per Article: 78.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Glioblastoma multiforme (GBM), the most common and aggressive primary brain tumor, has a high mortality rate despite extensive efforts to develop new treatments. GBM exhibits both intra- and intertumor heterogeneity, lending to resistance and eventual tumor recurrence. Large-scale genomic and proteomic analysis of GBM tumors has uncovered potential drug targets. Effective and “druggable” targets must be validated to embark on a robust medicinal chemistry campaign culminating in the discovery of clinical candidates. Here, we review recent developments in GBM drug discovery and delivery. To identify GBM drug targets, we performed extensive bioinformatics analysis using data from The Cancer Genome Atlas project. We discovered 20 genes, BOC, CLEC4GP1, ELOVL6, EREG, ESR2, FDCSP, FURIN, FUT8-AS1, GZMB, IRX3, LITAF, NDEL1, NKX3-1, PODNL1, PTPRN, QSOX1, SEMA4F, TH, VEGFC, and C20orf166AS1 that are overexpressed in a subpopulation of GBM patients and correlate with poor survival outcomes. Importantly, nine of these genes exhibit higher expression in GBM versus low-grade glioma and may be involved in disease progression. In this review, we discuss these proteins in the context of GBM disease progression. We also conducted computational multi-parameter optimization to assess the blood-brain barrier (BBB) permeability of small molecules in clinical trials for GBM treatment. Drug delivery in the context of GBM is particularly challenging because the BBB hinders small molecule transport. Therefore, we discuss novel drug delivery methods, including nanoparticles and prodrugs. Given the aggressive nature of GBM and the complexity of targeting the central nervous system, effective treatment options are a major unmet medical need. Identification and validation of biomarkers and drug targets associated with GBM disease progression present an exciting opportunity to improve treatment of this devastating disease.
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Affiliation(s)
- Andrea Shergalis
- Department of Medicinal Chemistry, College of Pharmacy, North Campus Research Complex, Ann Arbor, Michigan (A.S., U.L., N.N.); Biostatistics Department and School of Public Health, University of Michigan, Ann Arbor, Michigan (A.B.); and Department of Chemistry, Faculty of Science, Chulalongkorn University, Bangkok, Thailand (U.L., N.M.)
| | - Armand Bankhead
- Department of Medicinal Chemistry, College of Pharmacy, North Campus Research Complex, Ann Arbor, Michigan (A.S., U.L., N.N.); Biostatistics Department and School of Public Health, University of Michigan, Ann Arbor, Michigan (A.B.); and Department of Chemistry, Faculty of Science, Chulalongkorn University, Bangkok, Thailand (U.L., N.M.)
| | - Urarika Luesakul
- Department of Medicinal Chemistry, College of Pharmacy, North Campus Research Complex, Ann Arbor, Michigan (A.S., U.L., N.N.); Biostatistics Department and School of Public Health, University of Michigan, Ann Arbor, Michigan (A.B.); and Department of Chemistry, Faculty of Science, Chulalongkorn University, Bangkok, Thailand (U.L., N.M.)
| | - Nongnuj Muangsin
- Department of Medicinal Chemistry, College of Pharmacy, North Campus Research Complex, Ann Arbor, Michigan (A.S., U.L., N.N.); Biostatistics Department and School of Public Health, University of Michigan, Ann Arbor, Michigan (A.B.); and Department of Chemistry, Faculty of Science, Chulalongkorn University, Bangkok, Thailand (U.L., N.M.)
| | - Nouri Neamati
- Department of Medicinal Chemistry, College of Pharmacy, North Campus Research Complex, Ann Arbor, Michigan (A.S., U.L., N.N.); Biostatistics Department and School of Public Health, University of Michigan, Ann Arbor, Michigan (A.B.); and Department of Chemistry, Faculty of Science, Chulalongkorn University, Bangkok, Thailand (U.L., N.M.)
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O'Malley G, Treacy O, Lynch K, Naicker SD, Leonard NA, Lohan P, Dunne PD, Ritter T, Egan LJ, Ryan AE. Stromal Cell PD-L1 Inhibits CD8 + T-cell Antitumor Immune Responses and Promotes Colon Cancer. Cancer Immunol Res 2018; 6:1426-1441. [PMID: 30228206 DOI: 10.1158/2326-6066.cir-17-0443] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 06/14/2018] [Accepted: 09/11/2018] [Indexed: 11/16/2022]
Abstract
Stromal cells of mesenchymal origin reside below the epithelial compartment and provide structural support in the intestine. These intestinal stromal cells interact with both the epithelial cell compartments, as well as infiltrating hematopoietic immune cells. The importance of these cells in regulating immune homeostasis during inflammation is well recognized. However, little is known about their function and phenotype in the inflammatory tumor microenvironment. Using a syngeneic, immunogenic model of colorectal cancer, we showed that TNFα-initiated inflammatory signaling in CT26 colorectal cancer cells selectively induced PD-L1 expression in stromal cells. Using CD274 shRNA and antibody-mediated approaches, we showed that stromal cell PD-L1 potentiated enhanced immunosuppression, characterized by inhibition of activated CD8+ granzyme B-secreting T cells in vitro, and the inhibition of CD8+ effector cells was associated with enhanced tumor progression. Stromal cell immunosuppressive and tumor-promoting effects could be reversed with administration of anti-PD-1 in vivo We validated our findings of stromal cell CD274 expression in two cohorts of clinical samples and also observed PD-L1 induction on human stromal cells in response to exposure to the inflammatory secretome from human colon cancer cells, irrespective of microsatellite instability. Collectively, our data showed that tumor-associated stromal cells support T-cell suppression by PD-L1 induction, which is dependent on colon cancer inflammatory signaling. Our findings reveal a key role of mesenchymal stromal cells PD-L1 in suppression of CD8+ antitumor immune responses and potentiation of colorectal cancer progression. Cancer Immunol Res; 6(11); 1426-41. ©2018 AACR.
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Affiliation(s)
- Grace O'Malley
- Discipline of Pharmacology and Therapeutics, School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Republic of Ireland.,Regenerative Medicine Institute (REMEDI), School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Republic of Ireland
| | - Oliver Treacy
- Discipline of Pharmacology and Therapeutics, School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Republic of Ireland.,Regenerative Medicine Institute (REMEDI), School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Republic of Ireland
| | - Kevin Lynch
- Regenerative Medicine Institute (REMEDI), School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Republic of Ireland
| | - Serika D Naicker
- Regenerative Medicine Institute (REMEDI), School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Republic of Ireland
| | - Niamh A Leonard
- Discipline of Pharmacology and Therapeutics, School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Republic of Ireland.,Regenerative Medicine Institute (REMEDI), School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Republic of Ireland
| | - Paul Lohan
- Regenerative Medicine Institute (REMEDI), School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Republic of Ireland
| | - Philip D Dunne
- Centre for Cancer Research and Cell Biology, Queens University Belfast, Belfast, United Kingdom
| | - Thomas Ritter
- Regenerative Medicine Institute (REMEDI), School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Republic of Ireland
| | - Laurence J Egan
- Discipline of Pharmacology and Therapeutics, School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Republic of Ireland
| | - Aideen E Ryan
- Discipline of Pharmacology and Therapeutics, School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Republic of Ireland. .,Regenerative Medicine Institute (REMEDI), School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Republic of Ireland
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Wallace K, Lewin DN, Sun S, Spiceland CM, Rockey DC, Alekseyenko AV, Wu JD, Baron JA, Alberg AJ, Hill EG. Tumor-Infiltrating Lymphocytes and Colorectal Cancer Survival in African American and Caucasian Patients. Cancer Epidemiol Biomarkers Prev 2018; 27:755-761. [PMID: 29769214 PMCID: PMC6449046 DOI: 10.1158/1055-9965.epi-17-0870] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 12/08/2017] [Accepted: 05/08/2018] [Indexed: 12/11/2022] Open
Abstract
Background: Compared with Caucasian Americans (CAs), African Americans (AAs) with colorectal cancer have poorer survival, especially younger-age patients. A robust lymphocytic reaction within colorectal cancers is strongly associated with better survival, but whether immune response impacts the disparity in colorectal cancer survival is unknown.Methods: The study population was comprised of 211 histologically confirmed colorectal cancers at the Medical University of South Carolina (Charleston, SC; 159 CAs and 52 AAs) diagnosed between Jan 01, 2000, and June 30, 2013. We constructed a lymphocyte score based on blinded pathologic assessment of the four different types of lymphocytic reactions. Cox proportional hazards regression was used to evaluate the association between the lymphocyte score and risk of death by race.Results: Colorectal cancers in AAs (vs. CAs) had a stronger lymphocytic reaction at diagnosis. A high lymphocyte score (vs. the lowest) was associated with better survival in AAs [HR 0.19; 95% confidence interval (CI), 0.04-0.99] and CAs (HR 0.47; 95% CI, 0.15-1.45). AAs with no lymphocytic reaction (vs. other categories) had poor survival HR 4.48 (1.58-12.7) whereas no difference was observed in CAs. The risk of death in AAs (vs. CA) was more pronounced in younger patients (HR 2.92; 95% CI, 1.18-7.22) compared with older (HR 1.20; 95% CI, 0.54-2.67), especially those with lymphocytic poor colorectal cancers.Conclusions: The lymphocytic reaction in tumor impacted the racial disparity in survival.Impact: Our results confirm the importance of the lymphocytic score on survival and highlight the need to fully characterize the immune environment of colorectal cancers by race. Cancer Epidemiol Biomarkers Prev; 27(7); 755-61. ©2018 AACR.
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Affiliation(s)
- Kristin Wallace
- Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina.
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - David N Lewin
- Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Shaoli Sun
- Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Clayton M Spiceland
- Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Don C Rockey
- Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Alexander V Alekseyenko
- Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Jennifer D Wu
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - John A Baron
- Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Anthony J Alberg
- Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Elizabeth G Hill
- Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina
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Ogino S, Nowak JA, Hamada T, Phipps AI, Peters U, Milner DA, Giovannucci EL, Nishihara R, Giannakis M, Garrett WS, Song M. Integrative analysis of exogenous, endogenous, tumour and immune factors for precision medicine. Gut 2018; 67:1168-1180. [PMID: 29437869 PMCID: PMC5943183 DOI: 10.1136/gutjnl-2017-315537] [Citation(s) in RCA: 128] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 01/02/2018] [Accepted: 01/05/2018] [Indexed: 12/14/2022]
Abstract
Immunotherapy strategies targeting immune checkpoints such as the CTLA4 and CD274 (programmed cell death 1 ligand 1, PD-L1)/PDCD1 (programmed cell death 1, PD-1) T-cell coreceptor pathways are revolutionising oncology. The approval of pembrolizumab use for solid tumours with high-level microsatellite instability or mismatch repair deficiency by the US Food and Drug Administration highlights promise of precision immuno-oncology. However, despite evidence indicating influences of exogenous and endogenous factors such as diet, nutrients, alcohol, smoking, obesity, lifestyle, environmental exposures and microbiome on tumour-immune interactions, integrative analyses of those factors and immunity lag behind. Immune cell analyses in the tumour microenvironment have not adequately been integrated into large-scale studies. Addressing this gap, the transdisciplinary field of molecular pathological epidemiology (MPE) offers research frameworks to integrate tumour immunology into population health sciences, and link the exposures and germline genetics (eg, HLA genotypes) to tumour and immune characteristics. Multilevel research using bioinformatics, in vivo pathology and omics (genomics, epigenomics, transcriptomics, proteomics and metabolomics) technologies is possible with use of tissue, peripheral blood circulating cells, cell-free plasma, stool, sputum, urine and other body fluids. This immunology-MPE model can synergise with experimental immunology, microbiology and systems biology. GI neoplasms represent exemplary diseases for the immunology-MPE model, given rich microbiota and immune tissues of intestines, and the well-established carcinogenic role of intestinal inflammation. Proof-of-principle studies on colorectal cancer provided insights into immunomodulating effects of aspirin, vitamin D, inflammatory diets and omega-3 polyunsaturated fatty acids. The integrated immunology-MPE model can contribute to better understanding of environment-tumour-immune interactions, and effective immunoprevention and immunotherapy strategies for precision medicine.
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Affiliation(s)
- Shuji Ogino
- Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA,Department of Oncologic Pathology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA,Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts, USA
| | - Jonathan A Nowak
- Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Tsuyoshi Hamada
- Department of Oncologic Pathology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA
| | - Amanda I Phipps
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA,Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Ulrike Peters
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA,Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Danny A Milner
- American Society for Clinical Pathology, Chicago, Illinois, USA
| | - Edward L Giovannucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA,Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Reiko Nishihara
- Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA,Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts, USA,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA,Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Marios Giannakis
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts, USA,Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA,Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Wendy S Garrett
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts, USA,Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA,Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Mingyang Song
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA,Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusetts, USA,Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Noguti J, Chan AA, Bandera B, Brislawn CJ, Protic M, Sim MS, Jansson JK, Bilchik AJ, Lee DJ. Both the intratumoral immune and microbial microenvironment are linked to recurrence in human colon cancer: results from a prospective, multicenter nodal ultrastaging trial. Oncotarget 2018; 9:23564-23576. [PMID: 29805756 PMCID: PMC5955112 DOI: 10.18632/oncotarget.25276] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 04/08/2018] [Indexed: 12/15/2022] Open
Abstract
Colon cancer (CC) is the third most common cancer diagnosed in the United States and the incidence has been rising among young adults. We and others have shown a relationship between the immune infiltrate and prognosis, with improved disease-free survival (DFS) being associated with a higher expression of CD8+ T cells. We hypothesized that a microbial signature might be associated with intratumoral immune cells as well as DFS. We found that the relative abundance of one Operational Taxonomic Unit (OTU), OTU_104, was significantly associated with recurrence even after applying false discovery correction (HR 1.21, CI 1.08 to 1.36). The final multivariable model showed that DFS was influenced by three parameters: N-stage, CD8+ labeling, as well as this OTU_104 belonging to the order Clostridiales. Not only were CD8+ labeling and OTU_104 significant contributors in the final DFS model, but they were also inversely correlated to each other (p=0.022). Interestingly, CD8+ was also significantly associated with the microbiota composition in the tumor: CD8+ T cells was inversely correlated with alpha diversity (p=0.027) and significantly associated with the beta diversity. This study is the first to demonstrate an association among the intratumoral microbiome, CD8+ T cells, and recurrence in CC. An increased relative abundance of a specific OTU_104 was inversely associated with CD8+ T cells and directly associated with CC recurrence. The link between this microbe, CD8+ T cells, and DFS has not been previously shown.
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Affiliation(s)
- Juliana Noguti
- Dirks/Dougherty Laboratory for Cancer Research, Department of Translational Immunology, John Wayne Cancer Institute, Providence Saint John's Health Center, Santa Monica, CA, USA.,Los Angeles Biomedical Research Institute, Harbor - UCLA Medical Center, Torrance, CA, USA
| | - Alfred A Chan
- Dirks/Dougherty Laboratory for Cancer Research, Department of Translational Immunology, John Wayne Cancer Institute, Providence Saint John's Health Center, Santa Monica, CA, USA.,Los Angeles Biomedical Research Institute, Harbor - UCLA Medical Center, Torrance, CA, USA
| | - Bradley Bandera
- Department of Surgical Oncology. The John Wayne Cancer Institute at Providence St. John's Health Center, Santa Monica, CA, USA
| | - Colin J Brislawn
- Earth and Biological Sciences Directorate, Pacific Northwest National Laboratory, Richland, Washington, USA
| | - Mladjan Protic
- University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia.,Oncology Institute of Vojvodina, Sremska Kamenica, Serbia
| | - Myung S Sim
- UCLA Department of Medicine, Statistics Core, Los Angeles, CA, USA
| | - Janet K Jansson
- Earth and Biological Sciences Directorate, Pacific Northwest National Laboratory, Richland, Washington, USA
| | - Anton J Bilchik
- Department of Surgical Oncology. The John Wayne Cancer Institute at Providence St. John's Health Center, Santa Monica, CA, USA
| | - Delphine J Lee
- Dirks/Dougherty Laboratory for Cancer Research, Department of Translational Immunology, John Wayne Cancer Institute, Providence Saint John's Health Center, Santa Monica, CA, USA.,Los Angeles Biomedical Research Institute, Harbor - UCLA Medical Center, Torrance, CA, USA.,Division of Dermatology, Department of Medicine, Harbor - UCLA Medical Center, Torrance, CA, USA.,David Geffen School of Medicine, University of California - Los Angeles, Los Angeles, CA, USA
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47
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Hamada T, Cao Y, Qian ZR, Masugi Y, Nowak JA, Yang J, Song M, Mima K, Kosumi K, Liu L, Shi Y, da Silva A, Gu M, Li W, Keum N, Zhang X, Wu K, Meyerhardt JA, Giovannucci EL, Giannakis M, Rodig SJ, Freeman GJ, Nevo D, Wang M, Chan AT, Fuchs CS, Nishihara R, Ogino S. Aspirin Use and Colorectal Cancer Survival According to Tumor CD274 (Programmed Cell Death 1 Ligand 1) Expression Status. J Clin Oncol 2017; 35:1836-1844. [PMID: 28406723 DOI: 10.1200/jco.2016.70.7547] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose Blockade of the programmed cell death 1 (PDCD1, PD-1) immune checkpoint pathway can improve clinical outcomes in various malignancies. Evidence suggests that aspirin (a widely used nonsteroidal anti-inflammatory drug) not only prolongs colorectal cancer survival, but can also activate T cell-mediated antitumor immunity and synergize with immunotherapy through inhibition of prostaglandin E2 production. We hypothesized that the survival benefit associated with aspirin might be stronger in colorectal carcinoma with a lower CD274 (PDCD1 ligand 1, PD-L1) expression level that resulted in lower signaling of the immune checkpoint pathway. Patients and Methods Using data from 617 patients with rectal and colon cancer in the Nurses' Health Study and the Health Professionals Follow-Up Study, we examined the association of postdiagnosis aspirin use with patient survival in strata of tumor CD274 expression status measured by immunohistochemistry. We used multivariable Cox proportional hazards regression models to control for potential confounders, including disease stage, microsatellite instability status, CpG island methylator phenotype, long interspersed nucleotide element-1 methylation, cyclooxygenase-2 (PTGS2), and CDX2 expression, and KRAS, BRAF, and PIK3CA mutations. Results The association of postdiagnosis aspirin use with colorectal cancer-specific survival differed by CD274 expression status ( Pinteraction < .001); compared with aspirin nonusers; multivariable-adjusted hazard ratios for regular aspirin users were 0.16 (95% CI, 0.06 to 0.41) in patients with low CD274 and 1.01 (95% CI, 0.61 to 1.67) in patients with high CD274. This differential association seemed consistent in patients with microsatellite-stable or PIK3CA wild-type disease and in strata of PTGS2 expression, CDX2 expression, tumor-infiltrating lymphocytes, or prediagnosis aspirin use status. Conclusion The association of aspirin use with colorectal cancer survival is stronger in patients with CD274-low tumors than CD274-high tumors. Our findings suggest a differential antitumor effect of aspirin according to immune checkpoint status.
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Affiliation(s)
- Tsuyoshi Hamada
- Tsuyoshi Hamada, Zhi Rong Qian, Yohei Masugi, Juhong Yang, Kosuke Mima, Keisuke Kosumi, Li Liu, Yan Shi, Annacarolina da Silva, Mancang Gu, Wanwan Li, Jeffrey A. Meyerhardt, Marios Giannakis, Scott J. Rodig, Gordon J. Freeman, Charles S. Fuchs, Reiko Nishihara, and Shuji Ogino, Dana-Farber Cancer Institute and Harvard Medical School; Yin Cao, Mingyang Song, and Andrew T. Chan, Massachusetts General Hospital and Harvard Medical School; Yin Cao, Mingyang Song, Li Liu, NaNa Keum, Kana Wu, Edward L. Giovannucci, Daniel Nevo, Molin Wang, Reiko Nishihara, and Shuji Ogino, Harvard T.H. Chan School of Public Health; Jonathan A. Nowak, Xuehong Zhang, Edward L. Giovannucci, Marios Giannakis, Gordon J. Freeman, Molin Wang, Andrew T. Chan, Charles S. Fuchs, and Shuji Ogino, Brigham and Women's Hospital and Harvard Medical School, Boston; Marios Giannakis and Andrew T. Chan, Broad Institute of MIT and Harvard University, Cambridge, MA; Li Liu, Huazhong University of Science and Technology, Wuhan; Yan Shi, Chinese People's Liberation Army General Hospital, Beijing; and Mancang Gu, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Yin Cao
- Tsuyoshi Hamada, Zhi Rong Qian, Yohei Masugi, Juhong Yang, Kosuke Mima, Keisuke Kosumi, Li Liu, Yan Shi, Annacarolina da Silva, Mancang Gu, Wanwan Li, Jeffrey A. Meyerhardt, Marios Giannakis, Scott J. Rodig, Gordon J. Freeman, Charles S. Fuchs, Reiko Nishihara, and Shuji Ogino, Dana-Farber Cancer Institute and Harvard Medical School; Yin Cao, Mingyang Song, and Andrew T. Chan, Massachusetts General Hospital and Harvard Medical School; Yin Cao, Mingyang Song, Li Liu, NaNa Keum, Kana Wu, Edward L. Giovannucci, Daniel Nevo, Molin Wang, Reiko Nishihara, and Shuji Ogino, Harvard T.H. Chan School of Public Health; Jonathan A. Nowak, Xuehong Zhang, Edward L. Giovannucci, Marios Giannakis, Gordon J. Freeman, Molin Wang, Andrew T. Chan, Charles S. Fuchs, and Shuji Ogino, Brigham and Women's Hospital and Harvard Medical School, Boston; Marios Giannakis and Andrew T. Chan, Broad Institute of MIT and Harvard University, Cambridge, MA; Li Liu, Huazhong University of Science and Technology, Wuhan; Yan Shi, Chinese People's Liberation Army General Hospital, Beijing; and Mancang Gu, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Zhi Rong Qian
- Tsuyoshi Hamada, Zhi Rong Qian, Yohei Masugi, Juhong Yang, Kosuke Mima, Keisuke Kosumi, Li Liu, Yan Shi, Annacarolina da Silva, Mancang Gu, Wanwan Li, Jeffrey A. Meyerhardt, Marios Giannakis, Scott J. Rodig, Gordon J. Freeman, Charles S. Fuchs, Reiko Nishihara, and Shuji Ogino, Dana-Farber Cancer Institute and Harvard Medical School; Yin Cao, Mingyang Song, and Andrew T. Chan, Massachusetts General Hospital and Harvard Medical School; Yin Cao, Mingyang Song, Li Liu, NaNa Keum, Kana Wu, Edward L. Giovannucci, Daniel Nevo, Molin Wang, Reiko Nishihara, and Shuji Ogino, Harvard T.H. Chan School of Public Health; Jonathan A. Nowak, Xuehong Zhang, Edward L. Giovannucci, Marios Giannakis, Gordon J. Freeman, Molin Wang, Andrew T. Chan, Charles S. Fuchs, and Shuji Ogino, Brigham and Women's Hospital and Harvard Medical School, Boston; Marios Giannakis and Andrew T. Chan, Broad Institute of MIT and Harvard University, Cambridge, MA; Li Liu, Huazhong University of Science and Technology, Wuhan; Yan Shi, Chinese People's Liberation Army General Hospital, Beijing; and Mancang Gu, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Yohei Masugi
- Tsuyoshi Hamada, Zhi Rong Qian, Yohei Masugi, Juhong Yang, Kosuke Mima, Keisuke Kosumi, Li Liu, Yan Shi, Annacarolina da Silva, Mancang Gu, Wanwan Li, Jeffrey A. Meyerhardt, Marios Giannakis, Scott J. Rodig, Gordon J. Freeman, Charles S. Fuchs, Reiko Nishihara, and Shuji Ogino, Dana-Farber Cancer Institute and Harvard Medical School; Yin Cao, Mingyang Song, and Andrew T. Chan, Massachusetts General Hospital and Harvard Medical School; Yin Cao, Mingyang Song, Li Liu, NaNa Keum, Kana Wu, Edward L. Giovannucci, Daniel Nevo, Molin Wang, Reiko Nishihara, and Shuji Ogino, Harvard T.H. Chan School of Public Health; Jonathan A. Nowak, Xuehong Zhang, Edward L. Giovannucci, Marios Giannakis, Gordon J. Freeman, Molin Wang, Andrew T. Chan, Charles S. Fuchs, and Shuji Ogino, Brigham and Women's Hospital and Harvard Medical School, Boston; Marios Giannakis and Andrew T. Chan, Broad Institute of MIT and Harvard University, Cambridge, MA; Li Liu, Huazhong University of Science and Technology, Wuhan; Yan Shi, Chinese People's Liberation Army General Hospital, Beijing; and Mancang Gu, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Jonathan A Nowak
- Tsuyoshi Hamada, Zhi Rong Qian, Yohei Masugi, Juhong Yang, Kosuke Mima, Keisuke Kosumi, Li Liu, Yan Shi, Annacarolina da Silva, Mancang Gu, Wanwan Li, Jeffrey A. Meyerhardt, Marios Giannakis, Scott J. Rodig, Gordon J. Freeman, Charles S. Fuchs, Reiko Nishihara, and Shuji Ogino, Dana-Farber Cancer Institute and Harvard Medical School; Yin Cao, Mingyang Song, and Andrew T. Chan, Massachusetts General Hospital and Harvard Medical School; Yin Cao, Mingyang Song, Li Liu, NaNa Keum, Kana Wu, Edward L. Giovannucci, Daniel Nevo, Molin Wang, Reiko Nishihara, and Shuji Ogino, Harvard T.H. Chan School of Public Health; Jonathan A. Nowak, Xuehong Zhang, Edward L. Giovannucci, Marios Giannakis, Gordon J. Freeman, Molin Wang, Andrew T. Chan, Charles S. Fuchs, and Shuji Ogino, Brigham and Women's Hospital and Harvard Medical School, Boston; Marios Giannakis and Andrew T. Chan, Broad Institute of MIT and Harvard University, Cambridge, MA; Li Liu, Huazhong University of Science and Technology, Wuhan; Yan Shi, Chinese People's Liberation Army General Hospital, Beijing; and Mancang Gu, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Juhong Yang
- Tsuyoshi Hamada, Zhi Rong Qian, Yohei Masugi, Juhong Yang, Kosuke Mima, Keisuke Kosumi, Li Liu, Yan Shi, Annacarolina da Silva, Mancang Gu, Wanwan Li, Jeffrey A. Meyerhardt, Marios Giannakis, Scott J. Rodig, Gordon J. Freeman, Charles S. Fuchs, Reiko Nishihara, and Shuji Ogino, Dana-Farber Cancer Institute and Harvard Medical School; Yin Cao, Mingyang Song, and Andrew T. Chan, Massachusetts General Hospital and Harvard Medical School; Yin Cao, Mingyang Song, Li Liu, NaNa Keum, Kana Wu, Edward L. Giovannucci, Daniel Nevo, Molin Wang, Reiko Nishihara, and Shuji Ogino, Harvard T.H. Chan School of Public Health; Jonathan A. Nowak, Xuehong Zhang, Edward L. Giovannucci, Marios Giannakis, Gordon J. Freeman, Molin Wang, Andrew T. Chan, Charles S. Fuchs, and Shuji Ogino, Brigham and Women's Hospital and Harvard Medical School, Boston; Marios Giannakis and Andrew T. Chan, Broad Institute of MIT and Harvard University, Cambridge, MA; Li Liu, Huazhong University of Science and Technology, Wuhan; Yan Shi, Chinese People's Liberation Army General Hospital, Beijing; and Mancang Gu, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Mingyang Song
- Tsuyoshi Hamada, Zhi Rong Qian, Yohei Masugi, Juhong Yang, Kosuke Mima, Keisuke Kosumi, Li Liu, Yan Shi, Annacarolina da Silva, Mancang Gu, Wanwan Li, Jeffrey A. Meyerhardt, Marios Giannakis, Scott J. Rodig, Gordon J. Freeman, Charles S. Fuchs, Reiko Nishihara, and Shuji Ogino, Dana-Farber Cancer Institute and Harvard Medical School; Yin Cao, Mingyang Song, and Andrew T. Chan, Massachusetts General Hospital and Harvard Medical School; Yin Cao, Mingyang Song, Li Liu, NaNa Keum, Kana Wu, Edward L. Giovannucci, Daniel Nevo, Molin Wang, Reiko Nishihara, and Shuji Ogino, Harvard T.H. Chan School of Public Health; Jonathan A. Nowak, Xuehong Zhang, Edward L. Giovannucci, Marios Giannakis, Gordon J. Freeman, Molin Wang, Andrew T. Chan, Charles S. Fuchs, and Shuji Ogino, Brigham and Women's Hospital and Harvard Medical School, Boston; Marios Giannakis and Andrew T. Chan, Broad Institute of MIT and Harvard University, Cambridge, MA; Li Liu, Huazhong University of Science and Technology, Wuhan; Yan Shi, Chinese People's Liberation Army General Hospital, Beijing; and Mancang Gu, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Kosuke Mima
- Tsuyoshi Hamada, Zhi Rong Qian, Yohei Masugi, Juhong Yang, Kosuke Mima, Keisuke Kosumi, Li Liu, Yan Shi, Annacarolina da Silva, Mancang Gu, Wanwan Li, Jeffrey A. Meyerhardt, Marios Giannakis, Scott J. Rodig, Gordon J. Freeman, Charles S. Fuchs, Reiko Nishihara, and Shuji Ogino, Dana-Farber Cancer Institute and Harvard Medical School; Yin Cao, Mingyang Song, and Andrew T. Chan, Massachusetts General Hospital and Harvard Medical School; Yin Cao, Mingyang Song, Li Liu, NaNa Keum, Kana Wu, Edward L. Giovannucci, Daniel Nevo, Molin Wang, Reiko Nishihara, and Shuji Ogino, Harvard T.H. Chan School of Public Health; Jonathan A. Nowak, Xuehong Zhang, Edward L. Giovannucci, Marios Giannakis, Gordon J. Freeman, Molin Wang, Andrew T. Chan, Charles S. Fuchs, and Shuji Ogino, Brigham and Women's Hospital and Harvard Medical School, Boston; Marios Giannakis and Andrew T. Chan, Broad Institute of MIT and Harvard University, Cambridge, MA; Li Liu, Huazhong University of Science and Technology, Wuhan; Yan Shi, Chinese People's Liberation Army General Hospital, Beijing; and Mancang Gu, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Keisuke Kosumi
- Tsuyoshi Hamada, Zhi Rong Qian, Yohei Masugi, Juhong Yang, Kosuke Mima, Keisuke Kosumi, Li Liu, Yan Shi, Annacarolina da Silva, Mancang Gu, Wanwan Li, Jeffrey A. Meyerhardt, Marios Giannakis, Scott J. Rodig, Gordon J. Freeman, Charles S. Fuchs, Reiko Nishihara, and Shuji Ogino, Dana-Farber Cancer Institute and Harvard Medical School; Yin Cao, Mingyang Song, and Andrew T. Chan, Massachusetts General Hospital and Harvard Medical School; Yin Cao, Mingyang Song, Li Liu, NaNa Keum, Kana Wu, Edward L. Giovannucci, Daniel Nevo, Molin Wang, Reiko Nishihara, and Shuji Ogino, Harvard T.H. Chan School of Public Health; Jonathan A. Nowak, Xuehong Zhang, Edward L. Giovannucci, Marios Giannakis, Gordon J. Freeman, Molin Wang, Andrew T. Chan, Charles S. Fuchs, and Shuji Ogino, Brigham and Women's Hospital and Harvard Medical School, Boston; Marios Giannakis and Andrew T. Chan, Broad Institute of MIT and Harvard University, Cambridge, MA; Li Liu, Huazhong University of Science and Technology, Wuhan; Yan Shi, Chinese People's Liberation Army General Hospital, Beijing; and Mancang Gu, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Li Liu
- Tsuyoshi Hamada, Zhi Rong Qian, Yohei Masugi, Juhong Yang, Kosuke Mima, Keisuke Kosumi, Li Liu, Yan Shi, Annacarolina da Silva, Mancang Gu, Wanwan Li, Jeffrey A. Meyerhardt, Marios Giannakis, Scott J. Rodig, Gordon J. Freeman, Charles S. Fuchs, Reiko Nishihara, and Shuji Ogino, Dana-Farber Cancer Institute and Harvard Medical School; Yin Cao, Mingyang Song, and Andrew T. Chan, Massachusetts General Hospital and Harvard Medical School; Yin Cao, Mingyang Song, Li Liu, NaNa Keum, Kana Wu, Edward L. Giovannucci, Daniel Nevo, Molin Wang, Reiko Nishihara, and Shuji Ogino, Harvard T.H. Chan School of Public Health; Jonathan A. Nowak, Xuehong Zhang, Edward L. Giovannucci, Marios Giannakis, Gordon J. Freeman, Molin Wang, Andrew T. Chan, Charles S. Fuchs, and Shuji Ogino, Brigham and Women's Hospital and Harvard Medical School, Boston; Marios Giannakis and Andrew T. Chan, Broad Institute of MIT and Harvard University, Cambridge, MA; Li Liu, Huazhong University of Science and Technology, Wuhan; Yan Shi, Chinese People's Liberation Army General Hospital, Beijing; and Mancang Gu, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Yan Shi
- Tsuyoshi Hamada, Zhi Rong Qian, Yohei Masugi, Juhong Yang, Kosuke Mima, Keisuke Kosumi, Li Liu, Yan Shi, Annacarolina da Silva, Mancang Gu, Wanwan Li, Jeffrey A. Meyerhardt, Marios Giannakis, Scott J. Rodig, Gordon J. Freeman, Charles S. Fuchs, Reiko Nishihara, and Shuji Ogino, Dana-Farber Cancer Institute and Harvard Medical School; Yin Cao, Mingyang Song, and Andrew T. Chan, Massachusetts General Hospital and Harvard Medical School; Yin Cao, Mingyang Song, Li Liu, NaNa Keum, Kana Wu, Edward L. Giovannucci, Daniel Nevo, Molin Wang, Reiko Nishihara, and Shuji Ogino, Harvard T.H. Chan School of Public Health; Jonathan A. Nowak, Xuehong Zhang, Edward L. Giovannucci, Marios Giannakis, Gordon J. Freeman, Molin Wang, Andrew T. Chan, Charles S. Fuchs, and Shuji Ogino, Brigham and Women's Hospital and Harvard Medical School, Boston; Marios Giannakis and Andrew T. Chan, Broad Institute of MIT and Harvard University, Cambridge, MA; Li Liu, Huazhong University of Science and Technology, Wuhan; Yan Shi, Chinese People's Liberation Army General Hospital, Beijing; and Mancang Gu, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Annacarolina da Silva
- Tsuyoshi Hamada, Zhi Rong Qian, Yohei Masugi, Juhong Yang, Kosuke Mima, Keisuke Kosumi, Li Liu, Yan Shi, Annacarolina da Silva, Mancang Gu, Wanwan Li, Jeffrey A. Meyerhardt, Marios Giannakis, Scott J. Rodig, Gordon J. Freeman, Charles S. Fuchs, Reiko Nishihara, and Shuji Ogino, Dana-Farber Cancer Institute and Harvard Medical School; Yin Cao, Mingyang Song, and Andrew T. Chan, Massachusetts General Hospital and Harvard Medical School; Yin Cao, Mingyang Song, Li Liu, NaNa Keum, Kana Wu, Edward L. Giovannucci, Daniel Nevo, Molin Wang, Reiko Nishihara, and Shuji Ogino, Harvard T.H. Chan School of Public Health; Jonathan A. Nowak, Xuehong Zhang, Edward L. Giovannucci, Marios Giannakis, Gordon J. Freeman, Molin Wang, Andrew T. Chan, Charles S. Fuchs, and Shuji Ogino, Brigham and Women's Hospital and Harvard Medical School, Boston; Marios Giannakis and Andrew T. Chan, Broad Institute of MIT and Harvard University, Cambridge, MA; Li Liu, Huazhong University of Science and Technology, Wuhan; Yan Shi, Chinese People's Liberation Army General Hospital, Beijing; and Mancang Gu, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Mancang Gu
- Tsuyoshi Hamada, Zhi Rong Qian, Yohei Masugi, Juhong Yang, Kosuke Mima, Keisuke Kosumi, Li Liu, Yan Shi, Annacarolina da Silva, Mancang Gu, Wanwan Li, Jeffrey A. Meyerhardt, Marios Giannakis, Scott J. Rodig, Gordon J. Freeman, Charles S. Fuchs, Reiko Nishihara, and Shuji Ogino, Dana-Farber Cancer Institute and Harvard Medical School; Yin Cao, Mingyang Song, and Andrew T. Chan, Massachusetts General Hospital and Harvard Medical School; Yin Cao, Mingyang Song, Li Liu, NaNa Keum, Kana Wu, Edward L. Giovannucci, Daniel Nevo, Molin Wang, Reiko Nishihara, and Shuji Ogino, Harvard T.H. Chan School of Public Health; Jonathan A. Nowak, Xuehong Zhang, Edward L. Giovannucci, Marios Giannakis, Gordon J. Freeman, Molin Wang, Andrew T. Chan, Charles S. Fuchs, and Shuji Ogino, Brigham and Women's Hospital and Harvard Medical School, Boston; Marios Giannakis and Andrew T. Chan, Broad Institute of MIT and Harvard University, Cambridge, MA; Li Liu, Huazhong University of Science and Technology, Wuhan; Yan Shi, Chinese People's Liberation Army General Hospital, Beijing; and Mancang Gu, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Wanwan Li
- Tsuyoshi Hamada, Zhi Rong Qian, Yohei Masugi, Juhong Yang, Kosuke Mima, Keisuke Kosumi, Li Liu, Yan Shi, Annacarolina da Silva, Mancang Gu, Wanwan Li, Jeffrey A. Meyerhardt, Marios Giannakis, Scott J. Rodig, Gordon J. Freeman, Charles S. Fuchs, Reiko Nishihara, and Shuji Ogino, Dana-Farber Cancer Institute and Harvard Medical School; Yin Cao, Mingyang Song, and Andrew T. Chan, Massachusetts General Hospital and Harvard Medical School; Yin Cao, Mingyang Song, Li Liu, NaNa Keum, Kana Wu, Edward L. Giovannucci, Daniel Nevo, Molin Wang, Reiko Nishihara, and Shuji Ogino, Harvard T.H. Chan School of Public Health; Jonathan A. Nowak, Xuehong Zhang, Edward L. Giovannucci, Marios Giannakis, Gordon J. Freeman, Molin Wang, Andrew T. Chan, Charles S. Fuchs, and Shuji Ogino, Brigham and Women's Hospital and Harvard Medical School, Boston; Marios Giannakis and Andrew T. Chan, Broad Institute of MIT and Harvard University, Cambridge, MA; Li Liu, Huazhong University of Science and Technology, Wuhan; Yan Shi, Chinese People's Liberation Army General Hospital, Beijing; and Mancang Gu, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - NaNa Keum
- Tsuyoshi Hamada, Zhi Rong Qian, Yohei Masugi, Juhong Yang, Kosuke Mima, Keisuke Kosumi, Li Liu, Yan Shi, Annacarolina da Silva, Mancang Gu, Wanwan Li, Jeffrey A. Meyerhardt, Marios Giannakis, Scott J. Rodig, Gordon J. Freeman, Charles S. Fuchs, Reiko Nishihara, and Shuji Ogino, Dana-Farber Cancer Institute and Harvard Medical School; Yin Cao, Mingyang Song, and Andrew T. Chan, Massachusetts General Hospital and Harvard Medical School; Yin Cao, Mingyang Song, Li Liu, NaNa Keum, Kana Wu, Edward L. Giovannucci, Daniel Nevo, Molin Wang, Reiko Nishihara, and Shuji Ogino, Harvard T.H. Chan School of Public Health; Jonathan A. Nowak, Xuehong Zhang, Edward L. Giovannucci, Marios Giannakis, Gordon J. Freeman, Molin Wang, Andrew T. Chan, Charles S. Fuchs, and Shuji Ogino, Brigham and Women's Hospital and Harvard Medical School, Boston; Marios Giannakis and Andrew T. Chan, Broad Institute of MIT and Harvard University, Cambridge, MA; Li Liu, Huazhong University of Science and Technology, Wuhan; Yan Shi, Chinese People's Liberation Army General Hospital, Beijing; and Mancang Gu, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Xuehong Zhang
- Tsuyoshi Hamada, Zhi Rong Qian, Yohei Masugi, Juhong Yang, Kosuke Mima, Keisuke Kosumi, Li Liu, Yan Shi, Annacarolina da Silva, Mancang Gu, Wanwan Li, Jeffrey A. Meyerhardt, Marios Giannakis, Scott J. Rodig, Gordon J. Freeman, Charles S. Fuchs, Reiko Nishihara, and Shuji Ogino, Dana-Farber Cancer Institute and Harvard Medical School; Yin Cao, Mingyang Song, and Andrew T. Chan, Massachusetts General Hospital and Harvard Medical School; Yin Cao, Mingyang Song, Li Liu, NaNa Keum, Kana Wu, Edward L. Giovannucci, Daniel Nevo, Molin Wang, Reiko Nishihara, and Shuji Ogino, Harvard T.H. Chan School of Public Health; Jonathan A. Nowak, Xuehong Zhang, Edward L. Giovannucci, Marios Giannakis, Gordon J. Freeman, Molin Wang, Andrew T. Chan, Charles S. Fuchs, and Shuji Ogino, Brigham and Women's Hospital and Harvard Medical School, Boston; Marios Giannakis and Andrew T. Chan, Broad Institute of MIT and Harvard University, Cambridge, MA; Li Liu, Huazhong University of Science and Technology, Wuhan; Yan Shi, Chinese People's Liberation Army General Hospital, Beijing; and Mancang Gu, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Kana Wu
- Tsuyoshi Hamada, Zhi Rong Qian, Yohei Masugi, Juhong Yang, Kosuke Mima, Keisuke Kosumi, Li Liu, Yan Shi, Annacarolina da Silva, Mancang Gu, Wanwan Li, Jeffrey A. Meyerhardt, Marios Giannakis, Scott J. Rodig, Gordon J. Freeman, Charles S. Fuchs, Reiko Nishihara, and Shuji Ogino, Dana-Farber Cancer Institute and Harvard Medical School; Yin Cao, Mingyang Song, and Andrew T. Chan, Massachusetts General Hospital and Harvard Medical School; Yin Cao, Mingyang Song, Li Liu, NaNa Keum, Kana Wu, Edward L. Giovannucci, Daniel Nevo, Molin Wang, Reiko Nishihara, and Shuji Ogino, Harvard T.H. Chan School of Public Health; Jonathan A. Nowak, Xuehong Zhang, Edward L. Giovannucci, Marios Giannakis, Gordon J. Freeman, Molin Wang, Andrew T. Chan, Charles S. Fuchs, and Shuji Ogino, Brigham and Women's Hospital and Harvard Medical School, Boston; Marios Giannakis and Andrew T. Chan, Broad Institute of MIT and Harvard University, Cambridge, MA; Li Liu, Huazhong University of Science and Technology, Wuhan; Yan Shi, Chinese People's Liberation Army General Hospital, Beijing; and Mancang Gu, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Jeffrey A Meyerhardt
- Tsuyoshi Hamada, Zhi Rong Qian, Yohei Masugi, Juhong Yang, Kosuke Mima, Keisuke Kosumi, Li Liu, Yan Shi, Annacarolina da Silva, Mancang Gu, Wanwan Li, Jeffrey A. Meyerhardt, Marios Giannakis, Scott J. Rodig, Gordon J. Freeman, Charles S. Fuchs, Reiko Nishihara, and Shuji Ogino, Dana-Farber Cancer Institute and Harvard Medical School; Yin Cao, Mingyang Song, and Andrew T. Chan, Massachusetts General Hospital and Harvard Medical School; Yin Cao, Mingyang Song, Li Liu, NaNa Keum, Kana Wu, Edward L. Giovannucci, Daniel Nevo, Molin Wang, Reiko Nishihara, and Shuji Ogino, Harvard T.H. Chan School of Public Health; Jonathan A. Nowak, Xuehong Zhang, Edward L. Giovannucci, Marios Giannakis, Gordon J. Freeman, Molin Wang, Andrew T. Chan, Charles S. Fuchs, and Shuji Ogino, Brigham and Women's Hospital and Harvard Medical School, Boston; Marios Giannakis and Andrew T. Chan, Broad Institute of MIT and Harvard University, Cambridge, MA; Li Liu, Huazhong University of Science and Technology, Wuhan; Yan Shi, Chinese People's Liberation Army General Hospital, Beijing; and Mancang Gu, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Edward L Giovannucci
- Tsuyoshi Hamada, Zhi Rong Qian, Yohei Masugi, Juhong Yang, Kosuke Mima, Keisuke Kosumi, Li Liu, Yan Shi, Annacarolina da Silva, Mancang Gu, Wanwan Li, Jeffrey A. Meyerhardt, Marios Giannakis, Scott J. Rodig, Gordon J. Freeman, Charles S. Fuchs, Reiko Nishihara, and Shuji Ogino, Dana-Farber Cancer Institute and Harvard Medical School; Yin Cao, Mingyang Song, and Andrew T. Chan, Massachusetts General Hospital and Harvard Medical School; Yin Cao, Mingyang Song, Li Liu, NaNa Keum, Kana Wu, Edward L. Giovannucci, Daniel Nevo, Molin Wang, Reiko Nishihara, and Shuji Ogino, Harvard T.H. Chan School of Public Health; Jonathan A. Nowak, Xuehong Zhang, Edward L. Giovannucci, Marios Giannakis, Gordon J. Freeman, Molin Wang, Andrew T. Chan, Charles S. Fuchs, and Shuji Ogino, Brigham and Women's Hospital and Harvard Medical School, Boston; Marios Giannakis and Andrew T. Chan, Broad Institute of MIT and Harvard University, Cambridge, MA; Li Liu, Huazhong University of Science and Technology, Wuhan; Yan Shi, Chinese People's Liberation Army General Hospital, Beijing; and Mancang Gu, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Marios Giannakis
- Tsuyoshi Hamada, Zhi Rong Qian, Yohei Masugi, Juhong Yang, Kosuke Mima, Keisuke Kosumi, Li Liu, Yan Shi, Annacarolina da Silva, Mancang Gu, Wanwan Li, Jeffrey A. Meyerhardt, Marios Giannakis, Scott J. Rodig, Gordon J. Freeman, Charles S. Fuchs, Reiko Nishihara, and Shuji Ogino, Dana-Farber Cancer Institute and Harvard Medical School; Yin Cao, Mingyang Song, and Andrew T. Chan, Massachusetts General Hospital and Harvard Medical School; Yin Cao, Mingyang Song, Li Liu, NaNa Keum, Kana Wu, Edward L. Giovannucci, Daniel Nevo, Molin Wang, Reiko Nishihara, and Shuji Ogino, Harvard T.H. Chan School of Public Health; Jonathan A. Nowak, Xuehong Zhang, Edward L. Giovannucci, Marios Giannakis, Gordon J. Freeman, Molin Wang, Andrew T. Chan, Charles S. Fuchs, and Shuji Ogino, Brigham and Women's Hospital and Harvard Medical School, Boston; Marios Giannakis and Andrew T. Chan, Broad Institute of MIT and Harvard University, Cambridge, MA; Li Liu, Huazhong University of Science and Technology, Wuhan; Yan Shi, Chinese People's Liberation Army General Hospital, Beijing; and Mancang Gu, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Scott J Rodig
- Tsuyoshi Hamada, Zhi Rong Qian, Yohei Masugi, Juhong Yang, Kosuke Mima, Keisuke Kosumi, Li Liu, Yan Shi, Annacarolina da Silva, Mancang Gu, Wanwan Li, Jeffrey A. Meyerhardt, Marios Giannakis, Scott J. Rodig, Gordon J. Freeman, Charles S. Fuchs, Reiko Nishihara, and Shuji Ogino, Dana-Farber Cancer Institute and Harvard Medical School; Yin Cao, Mingyang Song, and Andrew T. Chan, Massachusetts General Hospital and Harvard Medical School; Yin Cao, Mingyang Song, Li Liu, NaNa Keum, Kana Wu, Edward L. Giovannucci, Daniel Nevo, Molin Wang, Reiko Nishihara, and Shuji Ogino, Harvard T.H. Chan School of Public Health; Jonathan A. Nowak, Xuehong Zhang, Edward L. Giovannucci, Marios Giannakis, Gordon J. Freeman, Molin Wang, Andrew T. Chan, Charles S. Fuchs, and Shuji Ogino, Brigham and Women's Hospital and Harvard Medical School, Boston; Marios Giannakis and Andrew T. Chan, Broad Institute of MIT and Harvard University, Cambridge, MA; Li Liu, Huazhong University of Science and Technology, Wuhan; Yan Shi, Chinese People's Liberation Army General Hospital, Beijing; and Mancang Gu, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Gordon J Freeman
- Tsuyoshi Hamada, Zhi Rong Qian, Yohei Masugi, Juhong Yang, Kosuke Mima, Keisuke Kosumi, Li Liu, Yan Shi, Annacarolina da Silva, Mancang Gu, Wanwan Li, Jeffrey A. Meyerhardt, Marios Giannakis, Scott J. Rodig, Gordon J. Freeman, Charles S. Fuchs, Reiko Nishihara, and Shuji Ogino, Dana-Farber Cancer Institute and Harvard Medical School; Yin Cao, Mingyang Song, and Andrew T. Chan, Massachusetts General Hospital and Harvard Medical School; Yin Cao, Mingyang Song, Li Liu, NaNa Keum, Kana Wu, Edward L. Giovannucci, Daniel Nevo, Molin Wang, Reiko Nishihara, and Shuji Ogino, Harvard T.H. Chan School of Public Health; Jonathan A. Nowak, Xuehong Zhang, Edward L. Giovannucci, Marios Giannakis, Gordon J. Freeman, Molin Wang, Andrew T. Chan, Charles S. Fuchs, and Shuji Ogino, Brigham and Women's Hospital and Harvard Medical School, Boston; Marios Giannakis and Andrew T. Chan, Broad Institute of MIT and Harvard University, Cambridge, MA; Li Liu, Huazhong University of Science and Technology, Wuhan; Yan Shi, Chinese People's Liberation Army General Hospital, Beijing; and Mancang Gu, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Daniel Nevo
- Tsuyoshi Hamada, Zhi Rong Qian, Yohei Masugi, Juhong Yang, Kosuke Mima, Keisuke Kosumi, Li Liu, Yan Shi, Annacarolina da Silva, Mancang Gu, Wanwan Li, Jeffrey A. Meyerhardt, Marios Giannakis, Scott J. Rodig, Gordon J. Freeman, Charles S. Fuchs, Reiko Nishihara, and Shuji Ogino, Dana-Farber Cancer Institute and Harvard Medical School; Yin Cao, Mingyang Song, and Andrew T. Chan, Massachusetts General Hospital and Harvard Medical School; Yin Cao, Mingyang Song, Li Liu, NaNa Keum, Kana Wu, Edward L. Giovannucci, Daniel Nevo, Molin Wang, Reiko Nishihara, and Shuji Ogino, Harvard T.H. Chan School of Public Health; Jonathan A. Nowak, Xuehong Zhang, Edward L. Giovannucci, Marios Giannakis, Gordon J. Freeman, Molin Wang, Andrew T. Chan, Charles S. Fuchs, and Shuji Ogino, Brigham and Women's Hospital and Harvard Medical School, Boston; Marios Giannakis and Andrew T. Chan, Broad Institute of MIT and Harvard University, Cambridge, MA; Li Liu, Huazhong University of Science and Technology, Wuhan; Yan Shi, Chinese People's Liberation Army General Hospital, Beijing; and Mancang Gu, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Molin Wang
- Tsuyoshi Hamada, Zhi Rong Qian, Yohei Masugi, Juhong Yang, Kosuke Mima, Keisuke Kosumi, Li Liu, Yan Shi, Annacarolina da Silva, Mancang Gu, Wanwan Li, Jeffrey A. Meyerhardt, Marios Giannakis, Scott J. Rodig, Gordon J. Freeman, Charles S. Fuchs, Reiko Nishihara, and Shuji Ogino, Dana-Farber Cancer Institute and Harvard Medical School; Yin Cao, Mingyang Song, and Andrew T. Chan, Massachusetts General Hospital and Harvard Medical School; Yin Cao, Mingyang Song, Li Liu, NaNa Keum, Kana Wu, Edward L. Giovannucci, Daniel Nevo, Molin Wang, Reiko Nishihara, and Shuji Ogino, Harvard T.H. Chan School of Public Health; Jonathan A. Nowak, Xuehong Zhang, Edward L. Giovannucci, Marios Giannakis, Gordon J. Freeman, Molin Wang, Andrew T. Chan, Charles S. Fuchs, and Shuji Ogino, Brigham and Women's Hospital and Harvard Medical School, Boston; Marios Giannakis and Andrew T. Chan, Broad Institute of MIT and Harvard University, Cambridge, MA; Li Liu, Huazhong University of Science and Technology, Wuhan; Yan Shi, Chinese People's Liberation Army General Hospital, Beijing; and Mancang Gu, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Andrew T Chan
- Tsuyoshi Hamada, Zhi Rong Qian, Yohei Masugi, Juhong Yang, Kosuke Mima, Keisuke Kosumi, Li Liu, Yan Shi, Annacarolina da Silva, Mancang Gu, Wanwan Li, Jeffrey A. Meyerhardt, Marios Giannakis, Scott J. Rodig, Gordon J. Freeman, Charles S. Fuchs, Reiko Nishihara, and Shuji Ogino, Dana-Farber Cancer Institute and Harvard Medical School; Yin Cao, Mingyang Song, and Andrew T. Chan, Massachusetts General Hospital and Harvard Medical School; Yin Cao, Mingyang Song, Li Liu, NaNa Keum, Kana Wu, Edward L. Giovannucci, Daniel Nevo, Molin Wang, Reiko Nishihara, and Shuji Ogino, Harvard T.H. Chan School of Public Health; Jonathan A. Nowak, Xuehong Zhang, Edward L. Giovannucci, Marios Giannakis, Gordon J. Freeman, Molin Wang, Andrew T. Chan, Charles S. Fuchs, and Shuji Ogino, Brigham and Women's Hospital and Harvard Medical School, Boston; Marios Giannakis and Andrew T. Chan, Broad Institute of MIT and Harvard University, Cambridge, MA; Li Liu, Huazhong University of Science and Technology, Wuhan; Yan Shi, Chinese People's Liberation Army General Hospital, Beijing; and Mancang Gu, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Charles S Fuchs
- Tsuyoshi Hamada, Zhi Rong Qian, Yohei Masugi, Juhong Yang, Kosuke Mima, Keisuke Kosumi, Li Liu, Yan Shi, Annacarolina da Silva, Mancang Gu, Wanwan Li, Jeffrey A. Meyerhardt, Marios Giannakis, Scott J. Rodig, Gordon J. Freeman, Charles S. Fuchs, Reiko Nishihara, and Shuji Ogino, Dana-Farber Cancer Institute and Harvard Medical School; Yin Cao, Mingyang Song, and Andrew T. Chan, Massachusetts General Hospital and Harvard Medical School; Yin Cao, Mingyang Song, Li Liu, NaNa Keum, Kana Wu, Edward L. Giovannucci, Daniel Nevo, Molin Wang, Reiko Nishihara, and Shuji Ogino, Harvard T.H. Chan School of Public Health; Jonathan A. Nowak, Xuehong Zhang, Edward L. Giovannucci, Marios Giannakis, Gordon J. Freeman, Molin Wang, Andrew T. Chan, Charles S. Fuchs, and Shuji Ogino, Brigham and Women's Hospital and Harvard Medical School, Boston; Marios Giannakis and Andrew T. Chan, Broad Institute of MIT and Harvard University, Cambridge, MA; Li Liu, Huazhong University of Science and Technology, Wuhan; Yan Shi, Chinese People's Liberation Army General Hospital, Beijing; and Mancang Gu, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Reiko Nishihara
- Tsuyoshi Hamada, Zhi Rong Qian, Yohei Masugi, Juhong Yang, Kosuke Mima, Keisuke Kosumi, Li Liu, Yan Shi, Annacarolina da Silva, Mancang Gu, Wanwan Li, Jeffrey A. Meyerhardt, Marios Giannakis, Scott J. Rodig, Gordon J. Freeman, Charles S. Fuchs, Reiko Nishihara, and Shuji Ogino, Dana-Farber Cancer Institute and Harvard Medical School; Yin Cao, Mingyang Song, and Andrew T. Chan, Massachusetts General Hospital and Harvard Medical School; Yin Cao, Mingyang Song, Li Liu, NaNa Keum, Kana Wu, Edward L. Giovannucci, Daniel Nevo, Molin Wang, Reiko Nishihara, and Shuji Ogino, Harvard T.H. Chan School of Public Health; Jonathan A. Nowak, Xuehong Zhang, Edward L. Giovannucci, Marios Giannakis, Gordon J. Freeman, Molin Wang, Andrew T. Chan, Charles S. Fuchs, and Shuji Ogino, Brigham and Women's Hospital and Harvard Medical School, Boston; Marios Giannakis and Andrew T. Chan, Broad Institute of MIT and Harvard University, Cambridge, MA; Li Liu, Huazhong University of Science and Technology, Wuhan; Yan Shi, Chinese People's Liberation Army General Hospital, Beijing; and Mancang Gu, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Shuji Ogino
- Tsuyoshi Hamada, Zhi Rong Qian, Yohei Masugi, Juhong Yang, Kosuke Mima, Keisuke Kosumi, Li Liu, Yan Shi, Annacarolina da Silva, Mancang Gu, Wanwan Li, Jeffrey A. Meyerhardt, Marios Giannakis, Scott J. Rodig, Gordon J. Freeman, Charles S. Fuchs, Reiko Nishihara, and Shuji Ogino, Dana-Farber Cancer Institute and Harvard Medical School; Yin Cao, Mingyang Song, and Andrew T. Chan, Massachusetts General Hospital and Harvard Medical School; Yin Cao, Mingyang Song, Li Liu, NaNa Keum, Kana Wu, Edward L. Giovannucci, Daniel Nevo, Molin Wang, Reiko Nishihara, and Shuji Ogino, Harvard T.H. Chan School of Public Health; Jonathan A. Nowak, Xuehong Zhang, Edward L. Giovannucci, Marios Giannakis, Gordon J. Freeman, Molin Wang, Andrew T. Chan, Charles S. Fuchs, and Shuji Ogino, Brigham and Women's Hospital and Harvard Medical School, Boston; Marios Giannakis and Andrew T. Chan, Broad Institute of MIT and Harvard University, Cambridge, MA; Li Liu, Huazhong University of Science and Technology, Wuhan; Yan Shi, Chinese People's Liberation Army General Hospital, Beijing; and Mancang Gu, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
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