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Vinayak S, Cecil DL, Disis ML. Vaccines for breast cancer prevention: Are we there yet? Mol Aspects Med 2024; 98:101292. [PMID: 38991631 DOI: 10.1016/j.mam.2024.101292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 06/10/2024] [Accepted: 06/30/2024] [Indexed: 07/13/2024]
Affiliation(s)
- Shaveta Vinayak
- University of Washington, Division of Oncology, Seattle, WA, USA; Fred Hutchinson Cancer Center, Seattle, WA, USA.
| | - Denise L Cecil
- University of Washington, Division of Oncology, Seattle, WA, USA
| | - Mary L Disis
- University of Washington, Division of Oncology, Seattle, WA, USA; Fred Hutchinson Cancer Center, Seattle, WA, USA
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2
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Stanton SE, Castle PE, Finn OJ, Sei S, Emens LA. Advances and challenges in cancer immunoprevention and immune interception. J Immunother Cancer 2024; 12:e007815. [PMID: 38519057 PMCID: PMC10961508 DOI: 10.1136/jitc-2023-007815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/29/2024] [Indexed: 03/24/2024] Open
Abstract
Invasive cancers typically evade immune surveillance through profound local and systemic immunosuppression, preventing their elimination or control. Targeting immune interventions to prevent or intercept premalignant lesions, before significant immune dysregulation has occurred, may be a more successful strategy. The field of cancer immune interception and prevention is nascent, and the scientific community has been slow to embrace this potentially most rational approach to reducing the global burden of cancer. This may change due to recent promising advances in cancer immunoprevention including the use of vaccines for the prevention of viral cancers, the use of cancer-associated antigen vaccines in the setting of precancers, and the development of cancer-preventative vaccines for high-risk individuals who are healthy but carry cancer-associated heritable genetic mutations. Furthermore, there is increasing recognition of the importance of cancer prevention and interception by national cancer organizations. The National Cancer Institute (NCI) recently released the National Cancer Plan, which includes cancer prevention among the top priorities of the institute. The NCI's Division of Cancer Prevention has been introducing new funding opportunities for scientists with an interest in the field of cancer prevention: The Cancer Prevention-Interception Targeted Agent Discovery Program and The Cancer Immunoprevention Network. Moreover, the Human Tumor Atlas Network is spearheading the development of a precancer atlas to better understand the biology of pre-invasive changes, including the tissue microenvironment and the underlying genetics that drive carcinogenesis. These data will inform the development of novel immunoprevention/immuno-interception strategies. International cancer foundations have also started recognizing immunoprevention and immune interception with the American Association for Cancer Research, Cancer Research UK and the Society for Immunotherapy of Cancer each implementing programming focused on this area. This review will present recent advances, opportunities, and challenges in the emerging field of cancer immune prevention and immune interception.
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Affiliation(s)
- Sasha E Stanton
- Cancer Immunoprevention Laboratory, Earle A Chiles Research Institute, Providence Cancer Institute, Portland, Oregon, USA
| | - Philip E Castle
- Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - Olivera J Finn
- Department of Immunology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Shizuko Sei
- Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
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3
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To KKW, Cho WC. Drug Repurposing to Circumvent Immune Checkpoint Inhibitor Resistance in Cancer Immunotherapy. Pharmaceutics 2023; 15:2166. [PMID: 37631380 PMCID: PMC10459070 DOI: 10.3390/pharmaceutics15082166] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/07/2023] [Accepted: 08/18/2023] [Indexed: 08/27/2023] Open
Abstract
Immune checkpoint inhibitors (ICI) have achieved unprecedented clinical success in cancer treatment. However, drug resistance to ICI therapy is a major hurdle that prevents cancer patients from responding to the treatment or having durable disease control. Drug repurposing refers to the application of clinically approved drugs, with characterized pharmacological properties and known adverse effect profiles, to new indications. It has also emerged as a promising strategy to overcome drug resistance. In this review, we summarized the latest research about drug repurposing to overcome ICI resistance. Repurposed drugs work by either exerting immunostimulatory activities or abolishing the immunosuppressive tumor microenvironment (TME). Compared to the de novo drug design strategy, they provide novel and affordable treatment options to enhance cancer immunotherapy that can be readily evaluated in the clinic. Biomarkers are exploited to identify the right patient population to benefit from the repurposed drugs and drug combinations. Phenotypic screening of chemical libraries has been conducted to search for T-cell-modifying drugs. Genomics and integrated bioinformatics analysis, artificial intelligence, machine and deep learning approaches are employed to identify novel modulators of the immunosuppressive TME.
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Affiliation(s)
- Kenneth K. W. To
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - William C. Cho
- Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong SAR, China
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4
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Kupfer SS. Broadening our Understanding of the Immune Landscape in Lynch Syndrome. Gastroenterology 2022; 162:1024-1025. [PMID: 34999096 DOI: 10.1053/j.gastro.2022.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 01/04/2022] [Indexed: 12/02/2022]
Affiliation(s)
- Sonia S Kupfer
- Section of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Chicago, Chicago, Illinois.
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5
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Pantziarka P, Blagden S. Inhibiting the Priming for Cancer in Li-Fraumeni Syndrome. Cancers (Basel) 2022; 14:cancers14071621. [PMID: 35406393 PMCID: PMC8997074 DOI: 10.3390/cancers14071621] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/08/2022] [Accepted: 03/20/2022] [Indexed: 12/12/2022] Open
Abstract
Simple Summary Li-Fraumeni Syndrome (LFS) is a rare cancer pre-disposition syndrome associated with a germline mutation in the TP53 tumour suppressor gene. People with LFS have a 90% chance of suffering one or more cancers in their lifetime. No treatments exist to reduce this cancer risk. This paper reviews the evidence for how cancers start in people with LFS and proposes that a series of commonly used non-cancer drugs, including metformin and aspirin, can help reduce that lifetime risk of cancer. Abstract The concept of the pre-cancerous niche applies the ‘seed and soil’ theory of metastasis to the initial process of carcinogenesis. TP53 is at the nexus of this process and, in the context of Li-Fraumeni Syndrome (LFS), is a key determinant of the conditions in which cancers are formed and progress. Important factors in the creation of the pre-cancerous niche include disrupted tissue homeostasis, cellular metabolism and chronic inflammation. While druggability of TP53 remains a challenge, there is evidence that drug re-purposing may be able to address aspects of pre-cancerous niche formation and thereby reduce the risk of cancer in individuals with LFS.
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Affiliation(s)
- Pan Pantziarka
- The George Pantziarka TP53 Trust, London KT1 2JP, UK
- The Anti-Cancer Fund, Brusselsesteenweg 11, 1860 Meise, Belgium
- Correspondence:
| | - Sarah Blagden
- Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK;
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6
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Mohammed A, Dashwood RH, Dickinson S, Disis ML, Jaffee EM, Johnson BD, Khleif SN, Pollak MN, Schlom J, Shoemaker RH, Stanton SE, Wondrak GT, You M, Zhu H, Miller MS. Translational Advances in Cancer Prevention Agent Development (TACPAD) Virtual Workshop on Immunomodulatory Agents: Report. J Cancer Prev 2021; 26:309-317. [PMID: 35047458 PMCID: PMC8749317 DOI: 10.15430/jcp.2021.26.4.309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 12/14/2021] [Indexed: 11/03/2022] Open
Abstract
The National Cancer Institute (NCI) Division of Cancer Prevention (DCP) convened the "Translational Advances in Cancer Prevention Agent Development (TACPAD) Workshop on Immunomodulatory Agents" as a virtual 2-day workshop on September 13 to 14, 2021. The main goals of this workshop were to foster the exchange of ideas and potentially new collaborative interactions among leading cancer immunoprevention researchers from basic and clinical research and highlight new and emerging trends in immunoprevention. The workshop included an overview of the mechanistic classes of immunomodulatory agents and three sessions covering the gamut from preclinical to clinical studies. The workshop convened individuals working in immunology and cancer prevention to discuss trends in discovery and development of immunomodulatory agents individually and in combination with other chemopreventive agents or vaccines.
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Affiliation(s)
- Altaf Mohammed
- Chemopreventive Agent Development Research Group, Division of Cancer Prevention, National Cancer Institute, Rockville, MD, USA
| | - Roderick H. Dashwood
- Center for Epigenetics & Disease Prevention, Texas A&M Health, College of Medicine, Houston, TX, USA
| | | | - Mary L. Disis
- UW Medicine Cancer Vaccine Institute, University of Washington, Seattle, WA, USA
| | - Elizabeth M. Jaffee
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Bryon D. Johnson
- Department of Microbiology & Immunology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Samir N. Khleif
- The Loop Immuno-Oncology Laboratory, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
| | - Michael N. Pollak
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Departments of Medicine and Oncology, McGill University, Montreal, QC, Canada
| | - Jeffrey Schlom
- Laboratory of Tumor Immunology and Biology, National Cancer Institute, Bethesda, MD, USA
| | - Robert H. Shoemaker
- Chemopreventive Agent Development Research Group, Division of Cancer Prevention, National Cancer Institute, Rockville, MD, USA
| | | | - Georg T. Wondrak
- Department of Pharmacology and Toxicology, College of Pharmacy and UA Cancer Center, University of Arizona, Tucson, AZ, USA
| | - Ming You
- Center for Cancer Prevention, Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, TX, USA
| | - Hao Zhu
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Mark Steven Miller
- Chemopreventive Agent Development Research Group, Division of Cancer Prevention, National Cancer Institute, Rockville, MD, USA
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7
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Fletcher R, Tong J, Risnik D, Leibowitz BJ, Wang YJ, Concha-Benavente F, DeLiberty JM, Stolz DB, Pai RK, Ferris RL, Schoen RE, Yu J, Zhang L. Non-steroidal anti-inflammatory drugs induce immunogenic cell death in suppressing colorectal tumorigenesis. Oncogene 2021; 40:2035-2050. [PMID: 33603166 PMCID: PMC7981263 DOI: 10.1038/s41388-021-01687-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 01/19/2021] [Accepted: 01/27/2021] [Indexed: 01/30/2023]
Abstract
Use of non-steroidal anti-inflammatory drugs (NSAIDs) is associated with reduced risk of colorectal cancer (CRC). However, the mechanism by which NSAIDs suppress colorectal tumorigenesis remains unclear. We previously showed that NSAIDs selectively kill emerging tumor cells via death receptor (DR) signaling and a synthetic lethal interaction mediated by the proapoptotic Bcl-2 family protein BID. In this study, we found NSAIDs induce endoplasmic reticulum (ER) stress to activate DR signaling and BID in tumor suppression. Importantly, our results unveiled an ER stress- and BID-dependent immunogenic effect of NSAIDs, which may be critical for tumor suppression. NSAID treatment induced hallmarks of immunogenic cell death (ICD) in CRC cells and colonic epithelial cells upon loss of APC tumor suppressor, and elevated tumor-infiltrating lymphocytes (TILs) in the polyps of APCMin/+ mice. ER stress inhibition or BID deletion abrogated the antitumor and immunogenic effects of NSAIDs. Furthermore, increased ER stress and TILs were detected in human advanced adenomas from NSAID-treated patients. Together, our results suggest that NSAIDs induce ER stress- and BID-mediated ICD to restore immunosurveillance and suppress colorectal tumor formation.
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Affiliation(s)
- Rochelle Fletcher
- UPMC Hillman Cancer Center, Pittsburgh, PA, USA
- Department of Pharmacology and Chemical Biology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jingshan Tong
- UPMC Hillman Cancer Center, Pittsburgh, PA, USA
- Department of Pharmacology and Chemical Biology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Denise Risnik
- UPMC Hillman Cancer Center, Pittsburgh, PA, USA
- Department of Pharmacology and Chemical Biology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Brian J Leibowitz
- UPMC Hillman Cancer Center, Pittsburgh, PA, USA
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Yi-Jun Wang
- UPMC Hillman Cancer Center, Pittsburgh, PA, USA
- Department of Pharmacology and Chemical Biology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Fernando Concha-Benavente
- UPMC Hillman Cancer Center, Pittsburgh, PA, USA
- Departments of Otolaryngology and Immunology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jonathan M DeLiberty
- Department of Pharmacology and Chemical Biology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Donna B Stolz
- UPMC Hillman Cancer Center, Pittsburgh, PA, USA
- Department of Cell Biology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Reet K Pai
- UPMC Hillman Cancer Center, Pittsburgh, PA, USA
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Robert L Ferris
- UPMC Hillman Cancer Center, Pittsburgh, PA, USA
- Departments of Otolaryngology and Immunology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Robert E Schoen
- UPMC Hillman Cancer Center, Pittsburgh, PA, USA
- Departments of Medicine and Epidemiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jian Yu
- UPMC Hillman Cancer Center, Pittsburgh, PA, USA
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Lin Zhang
- UPMC Hillman Cancer Center, Pittsburgh, PA, USA.
- Department of Pharmacology and Chemical Biology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
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8
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Murray NP. Immune dysfunction, minimal residual disease and patient outcome in nonmetastatic cancer: could modulation of immune function improve outcome? Future Oncol 2021; 17:1571-1575. [PMID: 33626930 DOI: 10.2217/fon-2020-1259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Nigel P Murray
- Head Circulating Tumour Cell Laboratory & Professor Haematology Faculty of Medicine, University Finis Terrae, Santiago, 7501015, Chile
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9
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Molehin D, Rasha F, Rahman RL, Pruitt K. Regulation of aromatase in cancer. Mol Cell Biochem 2021; 476:2449-2464. [PMID: 33599895 DOI: 10.1007/s11010-021-04099-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 02/04/2021] [Indexed: 12/21/2022]
Abstract
The regulation of aromatase, an enzyme involved in the biosynthesis of estrogen in normal and cancer cells, has been associated with growth factor signaling and immune response modulation. The tissue-specific regulatory roles of these factors are of particular importance as local aromatase expression is strongly linked to cancer development/progression and disease outcomes in patients. Therefore, aromatase has become a chemotherapeutic target and aromatase inhibitors (AIs) are used in the clinic for treating hormone-dependent cancers. Although AIs have shown promising results in the treatment of cancers, the emerging increase in AI-resistance necessitates the development of new and improved targeted therapies. This review discusses the role of tumor and stromal-derived growth factors and immune cell modulators in regulating aromatase. Current single-agent and combination therapies with or without AIs targeting growth factors and immune checkpoints are also discussed. This review highlights recent studies that show new connections between growth factors, mediators of immune response, and aromatase regulation.
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Affiliation(s)
- Deborah Molehin
- Department of Immunology & Molecular Microbiology, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Fahmida Rasha
- Department of Immunology & Molecular Microbiology, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | | | - Kevin Pruitt
- Department of Immunology & Molecular Microbiology, Texas Tech University Health Sciences Center, Lubbock, TX, USA. .,Department of Immunology & Molecular Microbiology, Texas Tech University Health Sciences Center, 3601 4th Street, Lubbock, TX, 79430-6591, USA.
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10
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Grigolato R, Bizzoca ME, Calabrese L, Leuci S, Mignogna MD, Lo Muzio L. Leukoplakia and Immunology: New Chemoprevention Landscapes? Int J Mol Sci 2020; 21:ijms21186874. [PMID: 32961682 PMCID: PMC7555729 DOI: 10.3390/ijms21186874] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/04/2020] [Accepted: 09/17/2020] [Indexed: 12/23/2022] Open
Abstract
Oral potentially malignant disorders (OPMDs) comprise a range of clinical-pathological alterations frequently characterized by an architectural and cytological derangements upon histological analysis. Among them, oral leukoplakia is the most common type of these disorders. This work aims to analyze the possible use of drugs such as immunochemopreventive agents for OPMDs. Chemoprevention is the use of synthetic or natural compounds for the reversal, suppression, or prevention of a premalignant lesion conversion to malignant form. Experimental and in vivo data offer us the promise of molecular prevention through immunomodulation; however, currently, there is no evidence for the efficacy of these drugs in the chemoprevention action. Alternative ways to deliver drugs, combined use of molecules with complementary antitumor activities, diet influence, and better definition of individual risk factors must also be considered to reduce toxicity, improve compliance to the protocol treatment and offer a better individualized prevention. In addition, we must carefully reconsider the mode of action of many traditional cancer chemoprevention agents on the immune system, such as enhancing immunosurveillance and reversing the immune evasion. Several studies emphasize the concept of green chemoprevention as an alternative approach to accent healthy lifestyle changes in order to decrease the incidence of HNSCC.
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Affiliation(s)
- Roberto Grigolato
- Division of Prevention, San Maurizio Hospital, 39100 Bolzano, Italy;
| | - Maria Eleonora Bizzoca
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy;
| | - Luca Calabrese
- Division of Otorhinolaryngology, “San Maurizio” Hospital, 39100 Bolzano, Italy;
| | - Stefania Leuci
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Oral Medicine Unit, Federico II University of Naples, 80138 Naples, Italy; (S.L.); (M.D.M.)
| | - Michele Davide Mignogna
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Oral Medicine Unit, Federico II University of Naples, 80138 Naples, Italy; (S.L.); (M.D.M.)
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy;
- C.I.N.B.O. (Consorzio Interuniversitario Nazionale per la Bio-Oncologia), 66100 Chieti, Italy
- Correspondence: ; Tel.: +39-0881-588-090
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11
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Burn J, Sheth H, Elliott F, Reed L, Macrae F, Mecklin JP, Möslein G, McRonald FE, Bertario L, Evans DG, Gerdes AM, Ho JWC, Lindblom A, Morrison PJ, Rashbass J, Ramesar R, Seppälä T, Thomas HJW, Pylvänäinen K, Borthwick GM, Mathers JC, Bishop DT. Cancer prevention with aspirin in hereditary colorectal cancer (Lynch syndrome), 10-year follow-up and registry-based 20-year data in the CAPP2 study: a double-blind, randomised, placebo-controlled trial. Lancet 2020; 395:1855-1863. [PMID: 32534647 PMCID: PMC7294238 DOI: 10.1016/s0140-6736(20)30366-4] [Citation(s) in RCA: 200] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 01/31/2020] [Accepted: 02/06/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Lynch syndrome is associated with an increased risk of colorectal cancer and with a broader spectrum of cancers, especially endometrial cancer. In 2011, our group reported long-term cancer outcomes (mean follow-up 55·7 months [SD 31·4]) for participants with Lynch syndrome enrolled into a randomised trial of daily aspirin versus placebo. This report completes the planned 10-year follow-up to allow a longer-term assessment of the effect of taking regular aspirin in this high-risk population. METHODS In the double-blind, randomised CAPP2 trial, 861 patients from 43 international centres worldwide (707 [82%] from Europe, 112 [13%] from Australasia, 38 [4%] from Africa, and four [<1%] from The Americas) with Lynch syndrome were randomly assigned to receive 600 mg aspirin daily or placebo. Cancer outcomes were monitored for at least 10 years from recruitment with English, Finnish, and Welsh participants being monitored for up to 20 years. The primary endpoint was development of colorectal cancer. Analysis was by intention to treat and per protocol. The trial is registered with the ISRCTN registry, number ISRCTN59521990. FINDINGS Between January, 1999, and March, 2005, 937 eligible patients with Lynch syndrome, mean age 45 years, commenced treatment, of whom 861 agreed to be randomly assigned to the aspirin group or placebo; 427 (50%) participants received aspirin and 434 (50%) placebo. Participants were followed for a mean of 10 years approximating 8500 person-years. 40 (9%) of 427 participants who received aspirin developed colorectal cancer compared with 58 (13%) of 434 who received placebo. Intention-to-treat Cox proportional hazards analysis revealed a significantly reduced hazard ratio (HR) of 0·65 (95% CI 0·43-0·97; p=0·035) for aspirin versus placebo. Negative binomial regression to account for multiple primary events gave an incidence rate ratio of 0·58 (0·39-0·87; p=0·0085). Per-protocol analyses restricted to 509 who achieved 2 years' intervention gave an HR of 0·56 (0·34-0·91; p=0·019) and an incidence rate ratio of 0·50 (0·31-0·82; p=0·0057). Non-colorectal Lynch syndrome cancers were reported in 36 participants who received aspirin and 36 participants who received placebo. Intention-to-treat and per-protocol analyses showed no effect. For all Lynch syndrome cancers combined, the intention-to-treat analysis did not reach significance but per-protocol analysis showed significantly reduced overall risk for the aspirin group (HR=0·63, 0·43-0·92; p=0·018). Adverse events during the intervention phase between aspirin and placebo groups were similar, and no significant difference in compliance between intervention groups was observed for participants with complete intervention phase data; details reported previously. INTERPRETATION The case for prevention of colorectal cancer with aspirin in Lynch syndrome is supported by our results. FUNDING Cancer Research UK, European Union, MRC, NIHR, Bayer Pharma AG, Barbour Foundation.
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Affiliation(s)
- John Burn
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
| | - Harsh Sheth
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Faye Elliott
- Division of Haematology and Immunology, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - Lynn Reed
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Finlay Macrae
- Colorectal Medicine and Genetics, Royal Melbourne Hospital, Melbourne, Australia
| | - Jukka-Pekka Mecklin
- Department of Education & Research, Jyväskylä Central Hospital, Jyväskylä, Finland; Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | | | - Fiona E McRonald
- National Cancer Registration and Analysis Service, Public Health England, London, UK
| | - Lucio Bertario
- Instituto Nazionale per lo Studio e, la Cura dei Tumori, Milan, Italy
| | - D Gareth Evans
- Division of Evolution and Genomic Medicine, University of Manchester, Manchester, UK; St Mary's Hospital, Manchester Universities Foundation Trust, Manchester, UK
| | | | - Judy W C Ho
- Hereditary GI Cancer Registry, Department of Surgery, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - Annika Lindblom
- Department of Molecular Medicine & Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Patrick J Morrison
- Department of Medical Genetics, Queens University Belfast, Belfast City Hospital HSC Trust, Belfast, UK
| | - Jem Rashbass
- National Cancer Registration and Analysis Service, Public Health England, London, UK
| | - Raj Ramesar
- Genomic and Precision Medicine Research Unit, Division of Human Genetics, Institute of Infectious Diseases and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, South Africa
| | - Toni Seppälä
- Department of Gastrointestinal Surgery, Helsinki University Hospital, Helsinki, Finland
| | - Huw J W Thomas
- St Mark's Hospital, London, UK; Faculty of Medicine, Imperial College London, London, UK
| | - Kirsi Pylvänäinen
- Department of Education & Research, Jyväskylä Central Hospital, Jyväskylä, Finland
| | - Gillian M Borthwick
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - John C Mathers
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - D Timothy Bishop
- Division of Haematology and Immunology, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
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12
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Bauer D, Mazzio E, Soliman KFA. Whole Transcriptomic Analysis of Apigenin on TNFα Immuno-activated MDA-MB-231 Breast Cancer Cells. Cancer Genomics Proteomics 2020; 16:421-431. [PMID: 31659097 DOI: 10.21873/cgp.20146] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 09/30/2019] [Accepted: 10/08/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Triple-negative breast cancer is categorized by a lack of hormone receptors, inefficacy of anti-estrogen or aromatase inhibitor chemotherapies and greater mortality rates in African American populations. Advanced-stage breast tumors have a high concentration of tumor necrosis factor-α (TNFα) throughout the tumor/stroma milieu, prompting sustained release of diverse chemokines (i.e. C-C motif chemokine ligand 2 (CCL2)/CCL5). These potent chemokines can subsequently direct mass infiltration of leukocyte sub-populations to lodge within the tumor, triggering a loss of tumor immune surveillance and subsequent rapid tumor growth. Previously, we demonstrated that in the MDA-MB-231 TNBC cell line, TNFα evoked a rise in immune signaling proteins: CCL2, granulocyte macrophage colony-stimulating factor, interleukin (IL)1α, IL6 and inhibitor of nuclear factor kappa-B kinase subunit epsilon (IKBKε) all of which were attenuated by apigenin, a dietary flavonoid found in chamomile and parsley. MATERIALS AND METHODS The present work elucidates changes evoked by TNFα in the presence or absence of apigenin by examining the entire transcriptome for mRNA and long intergenic non-coding RNA with Affymetrix Hugene-2.1_ST human microarrays. Differential gene-expression analysis was conducted on 48,226 genes. RESULTS TNFα caused up-regulation of 75 genes and down-regulation of 10. Of these, apigenin effectively down-regulated 35 of the 75 genes which were up-regulated by TNFα. These findings confirm our previous work, specifically for the TNFα-evoked spike in IL1A vs. untreated controls [+21-fold change (FC), p<0.0001] being attenuated by apigenin in the presence of TNFa (-15 FC vs. TNFα, p<0.0001). Similar trends were seen for apigenin-mediated down-regulation of TNFα-up-regulated transcripts: IKBKE (TNFα: 4.55 FC vs. control, p<0.001; and TNFα plus apigenin: -4.92 FC, p<0.001), CCL2 (2.19 FC, p<0.002; and -2.12 FC, p<0.003), IL6 (3.25 FC, p<0.020; and -2.85 FC, p<0.043) and CSF2 (TNFα +6.04 FC, p<0.001; and -2.36 FC, p<0.007). In addition, these data further establish more than a 65% reduction by apigenin for the following transcripts which were also up-regulated by TNFα: cathepsin S (CTSS), complement C3 (C3), laminin subunit gamma 2 (LAMC2), (TLR2), toll-like receptor 2 G protein-coupled receptor class C group 5 member B (GPRC5B), contactin-associated protein 1 (CNTNAP1), claudin 1 (CLDN1), nuclear factor of activated T-cells 2 (NFATC2), C-X-C motif chemokine ligand 10 (CXCL10), CXCL11, interleukin 1 receptor-associated kinase 3 (IRAK3), nuclear receptor subfamily 3 group C member 2 (NR3C2), interleukin 32 (IL32), IL24, slit guidance ligand 2 (SLIT2), transmembrane protein 132A (TMEM132A), TMEM171, signal transducing adaptor family member 2 (STAP2), mixed lineage kinase domain-like pseudokinase (MLKL), kinase insert domain receptor (KDR), BMP-binding endothelial regulator (BMPER), and kelch-like family member 36 (KLHL36). CONCLUSION There is a possible therapeutic role for apigenin in down-regulating diverse genes associated with tumorigenic leukocyte sub-population infiltration by triple-negative breast cancer. The data have been deposited into the Gene Expression Omnibus for public analysis at https://www.ncbi.nlm.nih.gov/geo/query/acc.cgi?acc=GSE120550.
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Affiliation(s)
- David Bauer
- College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, Tallahassee, FL, U.S.A
| | - Elizabeth Mazzio
- College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, Tallahassee, FL, U.S.A
| | - Karam F A Soliman
- College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, Tallahassee, FL, U.S.A.
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Le Cornet C, Schildknecht K, Rossello Chornet A, Fortner RT, González Maldonado S, Katzke VA, Kühn T, Johnson T, Olek S, Kaaks R. Circulating Immune Cell Composition and Cancer Risk: A Prospective Study Using Epigenetic Cell Count Measures. Cancer Res 2020; 80:1885-1892. [PMID: 32075798 DOI: 10.1158/0008-5472.can-19-3178] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 12/31/2019] [Accepted: 02/12/2020] [Indexed: 11/16/2022]
Abstract
Although ample evidence indicates that immune cell homeostasis is an important prognostic outcome determinant in patients with cancer, few studies have examined whether it also determines cancer risk among initially healthy individuals. We performed a case-cohort study including incident cases of breast (n = 207), colorectal (n = 111), lung (n = 70), and prostate (n = 201) cancer as well as a subcohort (n = 465) within the European Prospective Investigation into Cancer and Nutrition-Heidelberg cohort. Relative counts of neutrophils, monocytes, and lymphocyte sublineages were measured by qRT-PCR. HRs and 95% confidence intervals were used to measure the associations between relative counts of immune cell and cancer risks. When relative counts of immune cell types were taken individually, a significant positive association was observed between relative counts of FOXP3+ regulatory T cells (Tregs) and lung cancer risk, and significant inverse associations were observed between relative CD8+ counts and risks of lung and breast cancer (overall and ER+ subtype). Multivariable models with mutual adjustments across immune markers showed further significant positive associations between higher relative FOXP3+ T-cell counts and increased risks of colorectal and breast cancer (overall and ER- subtype). No associations were found between immune cell composition and prostate cancer risk. These results affirm the relevance of elevated FOXP3+ Tregs and lower levels of cytotoxic (CD8+) T cells as risk factors for tumor development. SIGNIFICANCE: This epidemiologic study supports a role for both regulatory and cytotoxic T cells in determining cancer risk among healthy individuals.See related commentary by Song and Tworoger, p. 1801.
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Affiliation(s)
- Charlotte Le Cornet
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Konstantin Schildknecht
- Ivana Türbachova Laboratory for Epigenetics, Precision for Medicine Group, Epiontis GmbH, Berlin, Germany
| | - Araceli Rossello Chornet
- Ivana Türbachova Laboratory for Epigenetics, Precision for Medicine Group, Epiontis GmbH, Berlin, Germany
| | - Renée T Fortner
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Verena A Katzke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Tilman Kühn
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Theron Johnson
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Sven Olek
- Ivana Türbachova Laboratory for Epigenetics, Precision for Medicine Group, Epiontis GmbH, Berlin, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany. .,Translational Lung Research Center (TLRC) Heidelberg, Member of the German Center for Lung Research (DZL), Heidelberg, Germany
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14
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Fong W, To KKW. Drug repurposing to overcome resistance to various therapies for colorectal cancer. Cell Mol Life Sci 2019; 76:3383-3406. [PMID: 31087119 PMCID: PMC11105507 DOI: 10.1007/s00018-019-03134-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 04/06/2019] [Accepted: 05/06/2019] [Indexed: 02/06/2023]
Abstract
Emergence of novel treatment modalities provides effective therapeutic options, apart from conventional cytotoxic chemotherapy, to fight against colorectal cancer. Unfortunately, drug resistance remains a huge challenge in clinics, leading to invariable occurrence of disease progression after treatment initiation. While novel drug development is unfavorable in terms of time frame and costs, drug repurposing is one of the promising strategies to combat resistance. This approach refers to the application of clinically available drugs to treat a different disease. With the well-established safety profile and optimal dosing of these approved drugs, their combination with current cancer therapy is suggested to provide an economical, safe and efficacious approach to overcome drug resistance and prolong patient survival. Here, we review both preclinical and clinical efficacy, as well as cellular mechanisms, of some extensively studied repurposed drugs, including non-steroidal anti-inflammatory drugs, statins, metformin, chloroquine, disulfiram, niclosamide, zoledronic acid and angiotensin receptor blockers. The three major treatment modalities in the management of colorectal cancer, namely classical cytotoxic chemotherapy, molecular targeted therapy and immunotherapy, are covered in this review.
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Affiliation(s)
- Winnie Fong
- Faculty of Medicine, School of Pharmacy, Room 801N, Lo Kwee-Seong Integrated Biomedical Sciences Building, The Chinese University of Hong Kong, Area 39, Shatin, New Territories, Hong Kong SAR, China
| | - Kenneth K W To
- Faculty of Medicine, School of Pharmacy, Room 801N, Lo Kwee-Seong Integrated Biomedical Sciences Building, The Chinese University of Hong Kong, Area 39, Shatin, New Territories, Hong Kong SAR, China.
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15
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Patente TA, Pinho MP, Oliveira AA, Evangelista GCM, Bergami-Santos PC, Barbuto JAM. Human Dendritic Cells: Their Heterogeneity and Clinical Application Potential in Cancer Immunotherapy. Front Immunol 2019; 9:3176. [PMID: 30719026 PMCID: PMC6348254 DOI: 10.3389/fimmu.2018.03176] [Citation(s) in RCA: 226] [Impact Index Per Article: 45.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 12/24/2018] [Indexed: 12/13/2022] Open
Abstract
Dendritic cells (DC) are professional antigen presenting cells, uniquely able to induce naïve T cell activation and effector differentiation. They are, likewise, involved in the induction and maintenance of immune tolerance in homeostatic conditions. Their phenotypic and functional heterogeneity points to their great plasticity and ability to modulate, according to their microenvironment, the acquired immune response and, at the same time, makes their precise classification complex and frequently subject to reviews and improvement. This review will present general aspects of the DC physiology and classification and will address their potential and actual uses in the management of human disease, more specifically cancer, as therapeutic and monitoring tools. New combination treatments with the participation of DC will be also discussed.
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Affiliation(s)
- Thiago A Patente
- Laboratory of Tumor Immunology, Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Mariana P Pinho
- Laboratory of Tumor Immunology, Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Aline A Oliveira
- Laboratory of Tumor Immunology, Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Gabriela C M Evangelista
- Laboratory of Tumor Immunology, Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Patrícia C Bergami-Santos
- Laboratory of Tumor Immunology, Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - José A M Barbuto
- Laboratory of Tumor Immunology, Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.,Discipline of Molecular Medicine, Department of Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
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16
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Prevention of carcinogenesis and metastasis by Artemisinin-type drugs. Cancer Lett 2018; 429:11-18. [DOI: 10.1016/j.canlet.2018.05.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 05/02/2018] [Accepted: 05/03/2018] [Indexed: 12/20/2022]
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17
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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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18
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Shen D, Yu X, Wu Y, Chen Y, Li G, Cheng F, Xia L. Emerging roles of bexarotene in the prevention, treatment and anti-drug resistance of cancers. Expert Rev Anticancer Ther 2018. [PMID: 29521139 DOI: 10.1080/14737140.2018.1449648] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Danyang Shen
- Department of Urology and Chawnshang Chang Liver Cancer Center, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaoming Yu
- Department of Urology and Chawnshang Chang Liver Cancer Center, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yan Wu
- Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yuanlei Chen
- Department of Urology and Chawnshang Chang Liver Cancer Center, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Gonghui Li
- Department of Urology and Chawnshang Chang Liver Cancer Center, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Feng Cheng
- College of Biotechnology and Bioengineering, Zhejiang University of Technology, Hangzhou, China
| | - Liqun Xia
- Department of Urology and Chawnshang Chang Liver Cancer Center, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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19
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Emambux S, Tachon G, Junca A, Tougeron D. Results and challenges of immune checkpoint inhibitors in colorectal cancer. Expert Opin Biol Ther 2018; 18:561-573. [DOI: 10.1080/14712598.2018.1445222] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Sheik Emambux
- Department of Medical Oncology, Poitiers University Hospital, Poitiers, France
| | - Gaelle Tachon
- Department of Cancer biology, Poitiers University Hospital, Poitiers, France
- INSERM U-1084, Experimental and Clinical Neurosciences Laboratory, Cellular Therapies in Brain Diseases group, University of Poitiers, Poitiers, France
- University of Poitiers, Faculty of medicine, Poitiers France
| | - Audelaure Junca
- University of Poitiers, Faculty of medicine, Poitiers France
- Department of Pathology, Poitiers University Hospital, Poitiers, France
| | - David Tougeron
- Department of Medical Oncology, Poitiers University Hospital, Poitiers, France
- University of Poitiers, Faculty of medicine, Poitiers France
- Department of Gastroenterology, Poitiers University Hospital, Poitiers, France
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20
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Fletcher R, Wang YJ, Schoen RE, Finn OJ, Yu J, Zhang L. Colorectal cancer prevention: Immune modulation taking the stage. Biochim Biophys Acta Rev Cancer 2018; 1869:138-148. [PMID: 29391185 DOI: 10.1016/j.bbcan.2017.12.002] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 12/12/2017] [Accepted: 12/13/2017] [Indexed: 02/07/2023]
Abstract
Prevention or early detection is one of the most promising strategies against colorectal cancer (CRC), the second leading cause of cancer death in the US. Recent studies indicate that antitumor immunity plays a key role in CRC prevention. Accumulating evidence suggests that immunosurveillance represents a critical barrier that emerging tumor cells have to overcome in order to sustain the course of tumor development. Virtually all of the agents with cancer preventive activity have been shown to have an immune modulating effect. A number of immunoprevention studies aimed at triggering antitumor immune response against early lesions have been performed, some of which have shown promising results. Furthermore, the recent success of immune checkpoint blockade therapy reinforces the notion that cancers including CRC can be effectively intervened via immune modulation including immune normalization, and has stimulated various immune-based combination prevention studies. This review summarizes recent advances to help better harness the immune system in CRC prevention.
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Affiliation(s)
- Rochelle Fletcher
- Department of Pharmacology and Chemical Biology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; UPMC Hillman Cancer Center, Pittsburgh, PA 15213, USA
| | - Yi-Jun Wang
- Department of Pharmacology and Chemical Biology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; UPMC Hillman Cancer Center, Pittsburgh, PA 15213, USA
| | - Robert E Schoen
- UPMC Hillman Cancer Center, Pittsburgh, PA 15213, USA; Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Olivera J Finn
- UPMC Hillman Cancer Center, Pittsburgh, PA 15213, USA; Department of Immunology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Jian Yu
- UPMC Hillman Cancer Center, Pittsburgh, PA 15213, USA; Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Lin Zhang
- Department of Pharmacology and Chemical Biology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; UPMC Hillman Cancer Center, Pittsburgh, PA 15213, USA.
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21
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Liu L, Nishihara R, Qian ZR, Tabung FK, Nevo D, Zhang X, Song M, Cao Y, Mima K, Masugi Y, Shi Y, da Silva A, Twombly T, Gu M, Li W, Hamada T, Kosumi K, Inamura K, Nowak JA, Drew DA, Lochhead P, Nosho K, Wu K, Wang M, Garrett WS, Chan AT, Fuchs CS, Giovannucci EL, Ogino S. Association Between Inflammatory Diet Pattern and Risk of Colorectal Carcinoma Subtypes Classified by Immune Responses to Tumor. Gastroenterology 2017; 153:1517-1530.e14. [PMID: 28865736 PMCID: PMC5705461 DOI: 10.1053/j.gastro.2017.08.045] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 08/02/2017] [Accepted: 08/23/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Dietary patterns affect systemic and local intestinal inflammation, which have been linked to colorectal carcinogenesis. Chronic inflammation can interfere with the adaptive immune response. We investigated whether the association of a diet that promotes intestinal inflammation with risk of colorectal carcinoma was stronger for tumors with lower lymphocytic reactions than tumors with higher lymphocytic reactions. METHODS We collected data from the molecular pathological epidemiology databases of 2 prospective cohort studies: the Nurses' Health Study (since 1976) and the Health Professionals Follow-Up Study (since 1986). We used duplication-method time-varying Cox proportional cause-specific hazards regression to assess the association of empirical dietary inflammatory pattern (EDIP) score (derived from food frequency questionnaire data) with colorectal carcinoma subtype. Foods that contribute to high EDIP scores include red and processed meats, refined grains, carbonated beverages, and some vegetables; foods that contribute to low EDIP scores include beer, wine, coffee, tea, yellow and leafy vegetables, and fruit juice. Colorectal tissue samples were analyzed histologically for patterns of lymphocytic reactions (Crohn's-like lymphoid reaction, peritumoral lymphocytic reaction, intratumoral periglandular reaction, and tumor-infiltrating lymphocytes). RESULTS During follow-up of 124,433 participants, we documented 1311 incident colon and rectal cancer cases with available tissue data. The association between the EDIP and colorectal cancer risk was significant (Ptrend = .02), and varied with degree of peritumoral lymphocytic reaction (Pheterogeneity < .001). Higher EDIP scores were associated with increased risk of colorectal cancer with an absent or low peritumoral lymphocytic reaction (highest vs lowest EDIP score quintile hazard ratio, 2.60; 95% confidence interval, 1.60-4.23; Ptrend < .001), but not risk of tumors with intermediate or high peritumoral lymphocytic reaction (Ptrend > .80). CONCLUSIONS In 2 prospective cohort studies, we associated inflammatory diets with a higher risk of colorectal cancer subtype that contains little or no peritumoral lymphocytic reaction. These findings suggest that diet-related inflammation might contribute to development of colorectal cancer, by suppressing the adaptive anti-tumor immune response.
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Affiliation(s)
- Li Liu
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; 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, People's Republic of China
| | - Reiko Nishihara
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Zhi Rong Qian
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Fred K Tabung
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Daniel Nevo
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Xuehong Zhang
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Mingyang Song
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Yin Cao
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Kosuke Mima
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Yohei Masugi
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Yan Shi
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts; Medical Oncology Department 2, Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Annacarolina da Silva
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Tyler Twombly
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Mancang Gu
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts; College of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
| | - Wanwan Li
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Tsuyoshi Hamada
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Keisuke Kosumi
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Kentaro Inamura
- Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Jonathan A Nowak
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - David A Drew
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Paul Lochhead
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Katsuhiko Nosho
- Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Kana Wu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Molin Wang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Wendy S Garrett
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Boston, Massachusetts
| | - Andrew T Chan
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Charles S Fuchs
- Yale Cancer Center, New Haven, Connecticut; Department of Medicine, Yale School of Medicine, New Haven, Connecticut; Smilow Cancer Hospital, New Haven, Connecticut
| | - Edward L Giovannucci
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Shuji Ogino
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Oncologic Pathology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts.
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22
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Ye J, Talaiti A, Ma Y, Zhang Q, Ma L, Zheng H. Allergies and risk of colorectal cancer: a systematic review and meta-analysis of observational studies. Oncotarget 2017; 8:14646-14654. [PMID: 28086228 PMCID: PMC5362432 DOI: 10.18632/oncotarget.14599] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 12/13/2016] [Indexed: 12/17/2022] Open
Abstract
A history of allergy or allergic condition has been reported to be associated with reduced risk of some types of malignancies. However, the understanding of this association for colorectal cancer (CRC) is controversial. We conducted a meta-analysis of CRC risk in individuals who had history of allergy compared to those without the history of allergic condition. Pumbed and Embase databases were searched for relevant studies. The adjusted relative risk (RR) and 95% confidence interval (CI) were pooled using the random-effects model. Nine studies, including 775, 178 individuals, were eligible for inclusion. The pooled estimate showed no significant association between history of allergy and CRC risk (adjusted RR 1.01, 95 % CI 0.88–1.17). Subgroup analyses confirmed the neutral association stratified by tumor location (colon: n = 6 studies; adjusted RR 1.01, 95 % CI 0.81–1.25; rectum: n = 6 studies; adjusted RR 0.94, 95% CI 0.77–1.15; colorectum: n = 3 studies; adjusted RR 0.92, 95 % CI 0.70 to 1.21), sex (male: n = 4 studies; adjusted RR 0.93, 95 % CI 0.81–1.07; female: n = 6 studies; adjusted RR 0.94, 95 % CI 0.80–1.09) or by allery type (asthma: n = 5 studies; adjusted RR 1.16, 95 % CI 0.96–1.42; hay fever: n = 4 studies; adjusted RR 0.93, 95 % CI 0.86–1.03). Meta-analysis of existing evidence provides a neutral association between allergies and CRC risk. Future well-designed prospective cohort studies should be conducted to better understand this association.
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Affiliation(s)
- Jianrong Ye
- Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Ailaiti Talaiti
- Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Yan Ma
- Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Qin Zhang
- Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Long Ma
- Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Hong Zheng
- Department of Anesthesiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
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23
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Chen J, Stark LA. Aspirin Prevention of Colorectal Cancer: Focus on NF-κB Signalling and the Nucleolus. Biomedicines 2017; 5:biomedicines5030043. [PMID: 28718829 PMCID: PMC5618301 DOI: 10.3390/biomedicines5030043] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 07/07/2017] [Accepted: 07/13/2017] [Indexed: 02/06/2023] Open
Abstract
Overwhelming evidence indicates that aspirin and related non-steroidal anti-inflammatory drugs (NSAIDs) have anti-tumour activity and the potential to prevent cancer, particularly colorectal cancer. However, the mechanisms underlying this effect remain hypothetical. Dysregulation of the nuclear factor-kappaB (NF-κB) transcription factor is a common event in many cancer types which contributes to tumour initiation and progression by driving expression of pro-proliferative/anti-apoptotic genes. In this review, we will focus on the current knowledge regarding NSAID effects on the NF-κB signalling pathway in pre-cancerous and cancerous lesions, and the evidence that these effects contribute to the anti-tumour activity of the agents. The nuclear organelle, the nucleolus, is emerging as a central regulator of transcription factor activity and cell growth and death. Nucleolar function is dysregulated in the majority of cancers which promotes cancer growth through direct and indirect mechanisms. Hence, this organelle is emerging as a promising target for novel therapeutic agents. Here, we will also discuss evidence for crosstalk between the NF-κB pathway and nucleoli, the role that this cross-talk has in the anti-tumour effects of NSAIDs and ways forward to exploit this crosstalk for therapeutic purpose.
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Affiliation(s)
- Jingyu Chen
- Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Crewe Rd., Edinburgh, Scotland EH4 2XU, UK.
| | - Lesley A Stark
- Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Crewe Rd., Edinburgh, Scotland EH4 2XU, UK.
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24
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Singh SK, Dorak MT. Cancer Immunoprevention and Public Health. Front Public Health 2017; 5:101. [PMID: 28534024 PMCID: PMC5421153 DOI: 10.3389/fpubh.2017.00101] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 04/18/2017] [Indexed: 12/17/2022] Open
Abstract
The power of cancer immune surveillance has been documented beyond doubt, and the successful exploitation of immune response to cancer has started a new era in the war against cancer. Cancer biologists have recognized immunoevasion as an emerging hallmark in addition to the six hallmarks of cancer. Besides the natural connection between the immune system and cancer development, most established environmental risk factors are now known to interfere with immune surveillance mechanisms. Genetic variations regulating immunity may also modulate cancer susceptibility, but evidence for this is currently limited. Molecular cross talk linking “immune” and “genomic” surveillance pathways has been characterized. It appears that immune mechanisms may contribute to the effects of common cancer risk factors. We provide an updated overview of evidence for cancer immune surveillance, cancer risk factors interfering with it, and interventions to enhance cancer immune surveillance as tools to complement ongoing vaccine development efforts for cancer immunoprevention. Although there is a lot of support for cancer immunoprevention with simple lifestyle modifications from observational studies, there is an urgent need for clinical trials to establish the effectiveness of this approach for public health benefits.
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Affiliation(s)
- Sandeep K Singh
- Department of Biological Sciences, Florida International University, Miami, FL, USA
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25
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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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Khammanivong A, Anandharaj A, Qian X, Song JM, Upadhyaya P, Balbo S, Bandyopadhyay D, Dickerson EB, Hecht SS, Kassie F. Transcriptome profiling in oral cavity and esophagus tissues from (S)-N'-nitrosonornicotine-treated rats reveals candidate genes involved in human oral cavity and esophageal carcinogenesis. Mol Carcinog 2016; 55:2168-2182. [PMID: 26785143 PMCID: PMC5142294 DOI: 10.1002/mc.22459] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 12/10/2015] [Accepted: 01/04/2016] [Indexed: 01/11/2023]
Abstract
Recently, we have shown that (S)-N'-Nitrosonornicotine [(S)-NNN], the major form of NNN in tobacco products, is a potent oral cavity and esophageal carcinogen in rats. To determine the early molecular alterations induced by (S)-NNN in the oral and esophageal mucosa, we administered the carcinogen to rats in the drinking water for 10 wk and global gene expression alterations were analyzed by RNA sequencing. At a false discovery rate P-value < 0.05 and fold-change ≥2, we found alterations in the level of 39 genes in the oral cavity and 69 genes in the esophagus. Validation of RNA sequencing results by qRT-PCR assays revealed a high cross-platform concordance. The most significant impact of exposure to (S)-NNN was alteration of genes involved in immune regulation (Aire, Ctla4, and CD80), inflammation (Ephx2 and Inpp5d) and cancer (Cdkn2a, Dhh, Fetub B, Inpp5d, Ly6E, Nr1d1, and Wnt6). Consistent with the findings in rat tissues, most of the genes were deregulated, albeit to different degrees, in immortalized oral keratinocytes treated with (S)-NNN and in non-treated premalignant oral cells and malignant oral and head and neck squamous cells. Furthermore, interrogation of TCGA data sets showed that genes deregulated by (S)-NNN in rat tissues (Fetub, Ly6e, Nr1d1, Cacna1c, Cd80, and Dgkg) are also altered in esophageal and head and neck tumors. Overall, our findings provide novel insights into early molecular changes induced by (S)-NNN and, therefore, could contribute to the development of biomarkers for the early detection and prevention of (S)-NNN-associated oral and esophageal cancers. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Ali Khammanivong
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, Minnesota
| | | | - Xuemin Qian
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Jung Min Song
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Pramod Upadhyaya
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Silvia Balbo
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
- Environmental Health Sciences Division, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | | | - Erin B. Dickerson
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, Minnesota
| | - Stephen S Hecht
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Fekadu Kassie
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, Minnesota
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27
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Cao Y, Nishihara R, Qian ZR, Song M, Mima K, Inamura K, Nowak JA, Drew DA, Lochhead P, Nosho K, Morikawa T, Zhang X, Wu K, Wang M, Garrett WS, Giovannucci EL, Fuchs CS, Chan AT, Ogino S. Regular Aspirin Use Associates With Lower Risk of Colorectal Cancers With Low Numbers of Tumor-Infiltrating Lymphocytes. Gastroenterology 2016; 151:879-892.e4. [PMID: 27475305 PMCID: PMC5159194 DOI: 10.1053/j.gastro.2016.07.030] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Revised: 06/26/2016] [Accepted: 07/19/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND & AIMS Aspirin use reduces colorectal cancer risk. Aspirin, a nonsteroidal anti-inflammatory drug, inhibits prostaglandin-endoperoxide synthase 2 (PTGS2 or cyclooxygenase-2); PTGS2 promotes inflammation and suppresses T-cell-mediated adaptive immunity. We investigated whether the inverse association of aspirin use with colorectal carcinoma risk was stronger for tumors with lower degrees of lymphocytic infiltrates than for tumors with higher degrees of lymphocytic infiltrates. METHODS We collected aspirin use data biennially from participants in the Nurses' Health Study and Health Professionals Follow-up Study. Participants were asked whether they took aspirin in most weeks, the number of tablets taken per week, and years of aspirin use. We collected available tumor specimens (n = 1458) from pathology laboratories in the United States. A pathologist confirmed the diagnosis of colorectal adenocarcinoma (excluding anal squamous cell carcinoma), and evaluated histopathology features, including patterns and degrees of lymphocytic infiltrates within and around tumor areas. Person-years of follow-up evaluation were accrued from the date of return of questionnaires until dates of colorectal cancer diagnosis, death, or the end of follow-up evaluation (June 2010). Duplication-method Cox proportional hazards regression was used to assess the association of aspirin with the incidence of colorectal carcinoma subgroups according to the degree of tumor-infiltrating lymphocytes (TILs), intratumoral periglandular reaction, peritumoral reaction, or Crohn's-like reaction. RESULTS We documented 1458 rectal and colon cancers. The inverse association between regular aspirin use and colorectal cancer risk significantly differed by concentrations of TILs (Pheterogeneity = .007). Compared with nonregular use, regular aspirin use was associated with a lower risk of tumors that had low levels of TILs (relative risk, 0.72; 95% confidence interval, 0.63-0.81), and strength of the association depended on aspirin dose and duration (both Ptrend < .001). In contrast, aspirin use was not associated with a risk of tumors having intermediate or high levels of TILs. This differential association was consistent regardless of the status of tumor microsatellite instability, mutations in BRAF, or expression of PTGS2. Regular aspirin use was associated with a lower risk of tumors that contained low levels of CD3+ T cells, CD8+ T cells, or CD45RO (PTPRC)+ T cells (measured by immunohistochemistry and computer-assisted image analysis). CONCLUSIONS Based on data from the prospective cohort studies, regular use of aspirin is associated with a lower risk of colorectal carcinomas with low concentrations of TILs. These findings indicate that the immune response in the tumor microenvironment could be involved in the chemopreventive effects of aspirin.
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Affiliation(s)
- Yin Cao
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA,Division of Gastroenterology, Massachusetts General Hospital, Boston, MA,Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Reiko Nishihara
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA,Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA,Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Zhi Rong Qian
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA
| | - Mingyang Song
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA,Division of Gastroenterology, Massachusetts General Hospital, Boston, MA,Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Kosuke Mima
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA
| | | | - Jonathan A. Nowak
- Division of MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - David A. Drew
- Division of Gastroenterology, Massachusetts General Hospital, Boston, MA,Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Paul Lochhead
- Division of Gastroenterology, Massachusetts General Hospital, Boston, MA,Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Katsuhiko Nosho
- Department of Gastroenterology, Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Teppei Morikawa
- Department of Pathology, University of Tokyo Hospital, Tokyo, Japan
| | - Xuehong Zhang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Kana Wu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Molin Wang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA,Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Wendy S. Garrett
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA,Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Edward L. Giovannucci
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA,Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Charles S. Fuchs
- Department of Medical Oncology, Dana-Farber Cancer Institute 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
| | - Andrew T. Chan
- Division of Gastroenterology, Massachusetts General Hospital, Boston, MA,Clinical and Translational Epidemiology Unit, 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
| | - Shuji Ogino
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Division of MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
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28
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Kensler TW, Spira A, Garber JE, Szabo E, Lee JJ, Dong Z, Dannenberg AJ, Hait WN, Blackburn E, Davidson NE, Foti M, Lippman SM. Transforming Cancer Prevention through Precision Medicine and Immune-oncology. Cancer Prev Res (Phila) 2016; 9:2-10. [PMID: 26744449 DOI: 10.1158/1940-6207.capr-15-0406] [Citation(s) in RCA: 112] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
We have entered a transformative period in cancer prevention (including early detection). Remarkable progress in precision medicine and immune-oncology, driven by extraordinary recent advances in genome-wide sequencing, big-data analytics, blood-based technologies, and deep understanding of the tumor immune microenvironment (TME), has provided unprecedented possibilities to study the biology of premalignancy. The pace of research and discovery in precision medicine and immunoprevention has been astonishing and includes the following clinical firsts reported in 2015: driver mutations detected in circulating cell-free DNA in patients with premalignant lesions (lung); clonal hematopoiesis shown to be a premalignant state; molecular selection in chemoprevention randomized controlled trial (RCT; oral); striking efficacy in RCT of combination chemoprevention targeting signaling pathway alterations mechanistically linked to germline mutation (duodenum); molecular markers for early detection validated for lung cancer and showing promise for pancreatic, liver, and ovarian cancer. Identification of HPV as the essential cause of a major global cancer burden, including HPV16 as the single driver of an epidemic of oropharyngeal cancer in men, provides unique opportunities for the dissemination and implementation of public health interventions. Important to immunoprevention beyond viral vaccines, genetic drivers of premalignant progression were associated with increasing immunosuppressive TME; and Kras vaccine efficacy in pancreas genetically engineered mouse (GEM) model required an inhibitory adjuvant (Treg depletion). In addition to developing new (e.g., epigenetic) TME regulators, recent mechanistic studies of repurposed drugs (aspirin, metformin, and tamoxifen) have identified potent immune activity. Just as precision medicine and immune-oncology are revolutionizing cancer therapy, these approaches are transforming cancer prevention. Here, we set out a brief agenda for the immediate future of cancer prevention research (including a "Pre-Cancer Genome Atlas" or "PCGA"), which will involve the inter-related fields of precision medicine and immunoprevention - pivotal elements of a broader domain of personalized public health.
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Affiliation(s)
- Thomas W Kensler
- University of Pittsburgh, Pittsburgh, Pennsylvania and Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | | | - Eva Szabo
- Division of Cancer Prevention, National Cancer Institute, Rockville, Maryland
| | - J Jack Lee
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Zigang Dong
- The Hormel Institute, University of Minnesota, Minneapolis, Minnesota
| | | | - William N Hait
- Janssen Research & Development, LLC, Raritan, New Jersey
| | | | - Nancy E Davidson
- University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
| | - Margaret Foti
- American Association for Cancer Research, Philadelphia, Pennsylvania
| | - Scott M Lippman
- Moores Cancer Center, University of California San Diego, La Jolla, California.
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Song M, Nishihara R, Wang M, Chan AT, Qian ZR, Inamura K, Zhang X, Ng K, Kim SA, Mima K, Sukawa Y, Nosho K, Fuchs CS, Giovannucci EL, Wu K, Ogino S. Plasma 25-hydroxyvitamin D and colorectal cancer risk according to tumour immunity status. Gut 2016; 65:296-304. [PMID: 25591978 PMCID: PMC4503524 DOI: 10.1136/gutjnl-2014-308852] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 12/16/2014] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Evidence suggests protective effects of vitamin D and antitumour immunity on colorectal cancer risk. Immune cells in tumour microenvironment can convert 25-hydroxyvitamin D [25(OH)D] to bioactive 1α,25-dihydroxyvitamin D3, which influences neoplastic and immune cells as an autocrine and paracrine factor. Thus, we hypothesised that the inverse association between vitamin D and colorectal cancer risk might be stronger for cancers with high-level immune response than those with low-level immune response. DESIGN We designed a nested case-control study (318 rectal and colon carcinoma cases and 624 matched controls) within the Nurses' Health Study and Health Professionals Follow-up Study using molecular pathological epidemiology database. Multivariable conditional logistic regression was used to assess the association of plasma 25(OH)D with tumour subtypes according to the degree of lymphocytic reaction, tumour-infiltrating T cells (CD3+, CD8+, CD45RO+ (PTPRC) and FOXP3+ cells), microsatellite instability or CpG island methylator phenotype. RESULTS The association of plasma 25(OH)D with colorectal carcinoma differed by the degree of intratumoural periglandular reaction (p for heterogeneity=0.001); high 25(OH)D was associated with lower risk of tumour with high-level reaction (comparing the highest versus lowest tertile: OR 0.10; 95% CI 0.03 to 0.35; p for trend<0.001), but not risk of tumour with lower-level reaction (p for trend>0.50). A statistically non-significant difference was observed for the associations of 25(OH)D with tumour subtypes according to CD3+ T cell density (p for heterogeneity=0.03; adjusted statistical significance level of α=0.006). CONCLUSIONS High plasma 25(OH)D level is associated with lower risk of colorectal cancer with intense immune reaction, supporting a role of vitamin D in cancer immunoprevention through tumour-host interaction.
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Affiliation(s)
- Mingyang Song
- Department of Nutrition, Harvard School of Public Health, Boston, MA, United States
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, United States
| | - Reiko Nishihara
- Department of Nutrition, Harvard School of Public Health, Boston, MA, United States
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, United States
| | - Molin Wang
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, United States
| | - Andrew T. Chan
- Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, United States
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, United States
| | - Zhi Rong Qian
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, United States
| | - Kentaro Inamura
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, United States
- Laboratory of Human Carcinogenesis, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
| | - Xuehong Zhang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, United States
| | - Kimmie Ng
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, United States
| | - Sun A Kim
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, United States
| | - Kosuke Mima
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, United States
| | - Yasutaka Sukawa
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, United States
| | - Katsuhiko Nosho
- Department of Gastroenterology, Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Charles S. Fuchs
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, United States
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, United States
| | - Edward L. Giovannucci
- Department of Nutrition, Harvard School of Public Health, Boston, MA, United States
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, United States
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, United States
| | - Kana Wu
- Department of Nutrition, Harvard School of Public Health, Boston, MA, United States
| | - Shuji Ogino
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, United States
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, United States
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, United States
- Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, United States
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Aspirin and atenolol enhance metformin activity against breast cancer by targeting both neoplastic and microenvironment cells. Sci Rep 2016; 6:18673. [PMID: 26728433 PMCID: PMC4700497 DOI: 10.1038/srep18673] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 11/23/2015] [Indexed: 01/10/2023] Open
Abstract
Metformin can induce breast cancer (BC) cell apoptosis and reduce BC local and metastatic growth in preclinical models. Since Metformin is frequently used along with Aspirin or beta-blockers, we investigated the effect of Metformin, Aspirin and the beta-blocker Atenolol in several BC models. In vitro, Aspirin synergized with Metformin in inducing apoptosis of triple negative and endocrine-sensitive BC cells, and in activating AMPK in BC and in white adipose tissue (WAT) progenitors known to cooperate to BC progression. Both Aspirin and Atenolol added to the inhibitory effect of Metformin against complex I of the respiratory chain. In both immune-deficient and immune-competent preclinical models, Atenolol increased Metformin activity against angiogenesis, local and metastatic growth of HER2+ and triple negative BC. Aspirin increased the activity of Metformin only in immune-competent HER2+ BC models. Both Aspirin and Atenolol, when added to Metformin, significantly reduced the endothelial cell component of tumor vessels, whereas pericytes were reduced by the addition of Atenolol but not by the addition of Aspirin. Our data indicate that the addition of Aspirin or of Atenolol to Metformin might be beneficial for BC control, and that this activity is likely due to effects on both BC and microenvironment cells.
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Wojtowicz ME, Dunn BK, Umar A. Immunologic approaches to cancer prevention-current status, challenges, and future perspectives. Semin Oncol 2015; 43:161-172. [PMID: 26970135 DOI: 10.1053/j.seminoncol.2015.11.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The potential of the immune system to recognize and reject tumors has been investigated for more than a century. However, only recently impressive breakthroughs in cancer immunotherapy have been seen with the use of checkpoint inhibitors. The experience with various immune-based strategies in the treatment of late cancer highlighted the importance of negative impact advanced disease has on immunity. Consequently, use of immune modulation for cancer prevention rather than therapy has gained considerable attention, with many promising results seen already in preclinical and early clinical studies. Although not without challenges, these results provide much excitement and optimism that successful cancer immunoprevention could be within our reach. In this review we will discuss the current state of predominantly primary and secondary cancer immunoprevention, relevant research, potential barriers, and future directions.
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Affiliation(s)
- Malgorzata E Wojtowicz
- Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
| | - Barbara K Dunn
- Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Asad Umar
- Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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Chu NJ, Armstrong TD, Jaffee EM. Nonviral oncogenic antigens and the inflammatory signals driving early cancer development as targets for cancer immunoprevention. Clin Cancer Res 2015; 21:1549-57. [PMID: 25623216 DOI: 10.1158/1078-0432.ccr-14-1186] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 12/18/2014] [Indexed: 12/13/2022]
Abstract
Cancer immunoprevention is an emerging field that holds much promise. Within the past 20 years, prophylactic vaccines have been implemented on the population level for the immunoprevention of carcinomas induced by viruses, specifically hepatitis B virus (HBV) and human papillomavirus (HPV) infection. Armed with the success of prophylactic vaccines that prevent viral-induced tumors, the field must overcome its next hurdle: to develop robust prophylactic vaccines that prevent the remaining >80% of human cancers not induced by viral infection. In this review, we discuss some of the most promising non-virus-associated prophylactic vaccines that target endogenous neoantigens, including the earliest oncogene products, altered mucin 1 (MUC1) and α-enolase (ENO1), all of which produce new targets in the earliest stages of nonviral-induced tumorigenesis. We also highlight a novel attenuated Listeria monocytogenes-based vaccine expressing mutant oncogene Kras(G12D) (LM-Kras) effective in a pancreatic cancer model. A novel chimeric human/rat HER-2 plasmid vaccine (HuRT-DNA vaccine) effective in a breast cancer model is also discussed. In addition to prophylactic vaccine developments, this review highlights the potential use of classic drugs, such as aspirin and metformin, as chemopreventive agents that can potentially be used as adjuvants to enhance the anticancer immunogenicity and efficacy of noninfectious prophylactic vaccines by modulating the inflammatory pathways within the early tumor microenvironment (TME) that propels tumorigenesis. Finally, timing of prophylactic vaccine administration is critical to its immunopreventive efficacy, providing a necessary role of current and emerging biomarkers for cancer screening and early cancer detection.
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Affiliation(s)
- Nina J Chu
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland. Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Todd D Armstrong
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Elizabeth M Jaffee
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland. Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
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Lu L, Yan H, Shyam-Sundar V, Janowitz T. Cross-sectional and longitudinal analysis of cancer vaccination trials registered on the US Clinical Trials Database demonstrates paucity of immunological trial endpoints and decline in registration since 2008. DRUG DESIGN DEVELOPMENT AND THERAPY 2014; 8:1539-53. [PMID: 25302014 PMCID: PMC4189706 DOI: 10.2147/dddt.s65963] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Introduction Cancer vaccination has been researched as a means of treating and preventing cancer, but successful translational efforts yielding clinical therapeutics have been limited. Numerous reasons have been offered in explanation, pertaining both to the vaccine formulation, and the clinical trial methodology used. This study aims to characterize the tumor vaccine clinical trial landscape quantitatively, and explore the possible validity of the offered explanations including the translational obstacles posed by the current common endpoints. Methods We performed a detailed cross-sectional and longitudinal analysis of tumor vaccine trials (n=955) registered in the US Clinical Trials database. Results The number of tumor vaccine trials initiated per annum has declined 30% since a peak in 2008. In terms of vaccine formulation, 25% of trials use tumor cell/lysate preparations; whereas, 73% of trials vaccinate subjects against defined protein/peptide antigens. Also, 68% of trials do not use vectors for antigen delivery. Both these characteristics of tumor vaccines have remained unchanged since 1996. The top five types of cancer studied are: melanoma (22.6%); cervical cancer (13.0%); breast cancer (11.3%); lung cancer (9.5%); and prostate cancer (9.4%). In addition, 86% of the trials are performed where there is established disease rather than prophylactically, of which 67% are performed exclusively in the adjuvant setting. Also, 42% of Phase II trials do not measure any survival-related endpoint, and only 23% of Phase III trials assess the immune response to vaccination. Conclusion The clinical trial effort in tumor vaccination is declining, necessitating a greater urgency in identifying and removing the obstacles to clinical translation. These obstacles may include: 1) vaccination against a small range of antigens; 2) naked delivery of antigen; 3) investigation of less immunogenic cancer types; and 4) investigation in the setting of established disease. In addition, the prevalence of late phase failure may be due to inadequate assessment of survival-related endpoints in Phase II trials. The clinical trial development of tumor vaccines should include mechanism-based translational endpoints, as well as the discovery of immune biomarkers with which to stratify, monitor, and prognosticate patients.
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Affiliation(s)
- Liangjian Lu
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Haixi Yan
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | | | - Tobias Janowitz
- Cancer Research UK, Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, UK
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Disis ML, Stanton SE. Can immunity to breast cancer eliminate residual micrometastases? Clin Cancer Res 2014; 19:6398-403. [PMID: 24298070 DOI: 10.1158/1078-0432.ccr-13-0734] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
An effective immune response has the potential for breast cancer sterilization with marked reduction in the potential for disease relapse. Adaptive type I immune cells uniquely have the capability of (i) cytotoxic T-cell activation and proliferation until all antigen expressing cells are eradicated, (ii) traversing endothelial barriers to penetrate tumor deposits wherever they occur, and (iii) immunologic memory, which allows the persistence of destructive immunity over the years it may take for breast cancer micrometastases to become clinically evident. Numerous recent investigations suggest that some breast cancers stimulate the type of immunity that results in a decreased risk of relapse. Moreover, the endogenous type I tumor microenvironment or type I immunity induced by drugs or biologic agents may improve response to standard therapies, further lowering the probability of disease recurrence.
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Affiliation(s)
- Mary L Disis
- Authors' Affiliation: Tumor Vaccine Group, Center for Translational Medicine in Women's Health, University of Washington, Seattle, Washington
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Lippman SM. Letter from the Editor. Cancer Prev Res (Phila) 2014; 7:179-81. [PMID: 24464731 DOI: 10.1158/1940-6207.capr-13-0443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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