1
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Jaiswal AR, Liu AJ, Pudakalakatti S, Dutta P, Jayaprakash P, Bartkowiak T, Ager CR, Wang ZQ, Reuben A, Cooper ZA, Ivan C, Ju Z, Nwajei F, Wang J, Davies MA, Davis RE, Wargo JA, Bhattacharya PK, Hong DS, Curran MA. Melanoma Evolves Complete Immunotherapy Resistance through the Acquisition of a Hypermetabolic Phenotype. Cancer Immunol Res 2020; 8:1365-1380. [PMID: 32917656 DOI: 10.1158/2326-6066.cir-19-0005] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 06/24/2020] [Accepted: 09/03/2020] [Indexed: 12/31/2022]
Abstract
Despite the clinical success of T-cell checkpoint blockade, most patients with cancer still fail to have durable responses to immunotherapy. The molecular mechanisms driving checkpoint blockade resistance, whether preexisting or evolved, remain unclear. To address this critical knowledge gap, we treated B16 melanoma with the combination of CTLA-4, PD-1, and PD-L1 blockade and a Flt3 ligand vaccine (≥75% curative), isolated tumors resistant to therapy, and serially passaged them in vivo with the same treatment regimen until they developed complete resistance. Using gene expression analysis and immunogenomics, we determined the adaptations associated with this resistance phenotype. Checkpoint resistance coincided with acquisition of a "hypermetabolic" phenotype characterized by coordinated upregulation of the glycolytic, oxidoreductase, and mitochondrial oxidative phosphorylation pathways. These resistant tumors flourished under hypoxic conditions, whereas metabolically starved T cells lost glycolytic potential, effector function, and the ability to expand in response to immunotherapy. Furthermore, we found that checkpoint-resistant versus -sensitive tumors could be separated by noninvasive MRI imaging based solely on their metabolic state. In a cohort of patients with melanoma resistant to both CTLA-4 and PD-1 blockade, we observed upregulation of pathways indicative of a similar hypermetabolic state. Together, these data indicated that melanoma can evade T-cell checkpoint blockade immunotherapy by adapting a hypermetabolic phenotype.
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Affiliation(s)
- Ashvin R Jaiswal
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, Texas
| | - Arthur J Liu
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, Texas
| | - Shivanand Pudakalakatti
- Department of Cancer Systems Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Prasanta Dutta
- Department of Cancer Systems Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Priyamvada Jayaprakash
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Todd Bartkowiak
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, Texas
| | - Casey R Ager
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, Texas
| | - Zhi-Qiang Wang
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Alexandre Reuben
- Departments of Genomic Medicine and Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Zachary A Cooper
- Departments of Genomic Medicine and Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Cristina Ivan
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Zhenlin Ju
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Felix Nwajei
- Department of Symptom Research, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jing Wang
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Michael A Davies
- MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, Texas.,Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - R Eric Davis
- MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, Texas.,Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jennifer A Wargo
- MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, Texas.,Departments of Genomic Medicine and Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Pratip K Bhattacharya
- MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, Texas.,Department of Cancer Systems Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - David S Hong
- MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, Texas.,Department of Investigational Cancer Therapeutics, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Michael A Curran
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, Texas. .,MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, Texas
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2
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Aresta A, Milani G, Clodoveo ML, Franchini C, Cotugno P, Radojcic Redovnikovic I, Quinto M, Corbo F, Zambonin C. Development, Optimization, and Comparison of Different Sample Pre-Treatments for Simultaneous Determination of Vitamin E and Vitamin K in Vegetables. Molecules 2020; 25:molecules25112509. [PMID: 32481534 PMCID: PMC7321086 DOI: 10.3390/molecules25112509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 05/25/2020] [Accepted: 05/26/2020] [Indexed: 11/16/2022] Open
Abstract
The absence of vitamin E from the diet can lead to cardiovascular disease, cancer, cataracts, and premature aging. Vitamin K deficiency can lead to bleeding disorders. These fat-soluble vitamins are important nutritional factors that can be determined in different methods in vegetables. In this work, the simultaneous determination of α-tocopherol, α-tocopheryl acetate, phylloquinone, and menaquinone-4 by gas chromatography–mass spectrometry (GC–MS) has been optimized using both direct injection and solid phase microextraction (SPME). Three different sample pre-treatment approaches based on: (A) solid–liquid–liquid–liquid extraction (SLE–LLE), (B) SLE, and (C) SPME were then applied to extract the target analytes from vegetables samples using menaquinone as internal standard. All the procedures allowed the determination of the target analytes in onion, carrot, celery, and curly kale samples. Similar results were obtained with the three different approaches, even if the one based on SPME offers the best performance, together with a reduced use of solvent, time consumption, and experimental complexity, which makes it the preferable option for industrial applications.
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Affiliation(s)
- Antonella Aresta
- Department of Chemistry, University “Aldo Moro”, Bari Via E. Orabona, 4, I-70125 Bari, Italy; (A.A.); (P.C.); (C.Z.)
| | - Gualtiero Milani
- Department of Pharmacy-Pharmaceutical Sciences, University “Aldo Moro”, Bari Via E. Orabona, 4, I-70125 Bari, Italy; (G.M.); (C.F.)
| | - Maria Lisa Clodoveo
- Interdisciplinary Department of Medicine, University “Aldo Moro”, Bari Pz G. Cesare 11, Policlinico di Bari, 70124 Bari, Italy;
| | - Carlo Franchini
- Department of Pharmacy-Pharmaceutical Sciences, University “Aldo Moro”, Bari Via E. Orabona, 4, I-70125 Bari, Italy; (G.M.); (C.F.)
| | - Pietro Cotugno
- Department of Chemistry, University “Aldo Moro”, Bari Via E. Orabona, 4, I-70125 Bari, Italy; (A.A.); (P.C.); (C.Z.)
| | | | - Maurizio Quinto
- Department of Agricultural Food and Environmental Sciences, University of Foggia, Via A.Gramsci 89/91, 71122 Foggia, Italy;
| | - Filomena Corbo
- Department of Pharmacy-Pharmaceutical Sciences, University “Aldo Moro”, Bari Via E. Orabona, 4, I-70125 Bari, Italy; (G.M.); (C.F.)
- Correspondence: ; Tel.: +39-0805442746
| | - Carlo Zambonin
- Department of Chemistry, University “Aldo Moro”, Bari Via E. Orabona, 4, I-70125 Bari, Italy; (A.A.); (P.C.); (C.Z.)
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3
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Kudo M. Scientific Rationale for Combination Immunotherapy of Hepatocellular Carcinoma with Anti-PD-1/PD-L1 and Anti-CTLA-4 Antibodies. Liver Cancer 2019; 8:413-426. [PMID: 32479569 PMCID: PMC6883444 DOI: 10.1159/000503254] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 09/09/2019] [Indexed: 02/04/2023] Open
Affiliation(s)
- Masatoshi Kudo
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
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4
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Kudo M. Pembrolizumab for the Treatment of Hepatocellular Carcinoma. Liver Cancer 2019; 8:143-154. [PMID: 31192152 PMCID: PMC6547263 DOI: 10.1159/000500143] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 04/04/2019] [Indexed: 02/04/2023] Open
Affiliation(s)
- Masatoshi Kudo
- *Prof. Masatoshi Kudo, Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osaka-Sayama 589-8511 (Japan), E-Mail
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5
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Kudo M. Immune Checkpoint Inhibition in Hepatocellular Carcinoma: Basics and Ongoing Clinical Trials. Oncology 2017; 92 Suppl 1:50-62. [PMID: 28147363 DOI: 10.1159/000451016] [Citation(s) in RCA: 125] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Clinical trials of antibodies targeting the immune checkpoint inhibitors programmed cell death 1 (PD-1), programmed cell death ligand 1 (PD-L1), or cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) for the treatment of advanced hepatocellular carcinoma (HCC) are ongoing. Expansion cohorts of a phase I/II trial of the anti-PD-1 antibody nivolumab in advanced HCC showed favorable results. Two phase III studies are currently ongoing: a comparison of nivolumab and sorafenib in the first-line setting for advanced HCC, and a comparison of the anti-PD-1 antibody pembrolizumab and a placebo in the second-line setting for patients with advanced HCC who progressed on sorafenib therapy. The combination of anti-PD-1/PD-L1 and anti-CTLA-4 antibodies is being evaluated in other phase I/II trials, and the results suggest that an anti-PD-1 antibody combined with locoregional therapy or other molecular targeted agents is an effective treatment strategy for HCC. Immune checkpoint inhibitors may therefore open new doors to the treatment of HCC.
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Affiliation(s)
- Masatoshi Kudo
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
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6
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Wahid B, Ali A, Idrees M, Rafique S. Immunotherapeutic strategies for sexually transmitted viral infections: HIV, HSV and HPV. Cell Immunol 2016; 310:1-13. [PMID: 27514252 PMCID: PMC7124316 DOI: 10.1016/j.cellimm.2016.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 07/22/2016] [Accepted: 08/02/2016] [Indexed: 12/24/2022]
Abstract
More than 1 million sexually transmitted infections (STIs) are acquired each day globally. Etiotropic drugs cannot effectively control infectious diseases therefore, there is a dire need to explore alternative strategies especially those based on the regulation of immune system. The review discusses all rational approaches to develop better understanding towards immunotherapeutic strategies based on modulation of immune system in an attempt to curb the elevating risk of infectious diseases such as HIV, HPV and HSV because of their high prevalence. Development of monoclonal antibodies, vaccines and several other immune based treatments are promising alternative strategies that are offering new opportunities to eradicate pathogens.
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Affiliation(s)
- Braira Wahid
- Centre for Applied Molecular Biology, 87-West Canal Bank Road, Thokar Niaz Baig, University of the Punjab, Lahore, Pakistan.
| | - Amjad Ali
- Centre for Applied Molecular Biology, 87-West Canal Bank Road, Thokar Niaz Baig, University of the Punjab, Lahore, Pakistan.
| | - Muhammad Idrees
- Centre for Applied Molecular Biology, 87-West Canal Bank Road, Thokar Niaz Baig, University of the Punjab, Lahore, Pakistan; Vice Chancellor Hazara University Mansehra, Pakistan.
| | - Shazia Rafique
- Centre for Applied Molecular Biology, 87-West Canal Bank Road, Thokar Niaz Baig, University of the Punjab, Lahore, Pakistan.
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7
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8
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Kudo M. Recent Trends in the Management of Hepatocellular Carcinoma with Special Emphasis on Treatment with Regorafenib and Immune Checkpoint Inhibitors. Dig Dis 2016; 34:714-730. [PMID: 27750243 DOI: 10.1159/000448864] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Hepatocellular carcinoma (HCC) is the fifth most common cancer and the third leading cause of cancer deaths worldwide. Sonazoid-enhanced ultrasound and gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced MRI are the most important imaging modalities in diagnosing HCC. There are 2 non-contradictory HCC treatment algorithms in Japan. Hepatic arterial infusion chemotherapy plays an important role in the treatment of advanced HCC with main or branch portal vein invasion. Regorafenib, as a second-line systemic treatment, prolongs survival in patients with intermediate and advanced HCC who progressed on sorafenib. In recent clinical trials, immune check point inhibitors show promising results for the treatment of HCC. This review describes recent trends in the management of HCC.
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Abstract
PURPOSE OF REVIEW We review recent data on immunotherapies for bladder cancer and discuss strategies to maximize the antitumor effect of immunotherapy in solid tumors. RECENT FINDINGS Anti-programmed death ligand 1 has shown promise in advanced bladder cancer. Clinical trials of immune checkpoint inhibitors as monotherapy or in combination are underway. Here we review strategies for enhancing antitumor immunity using immunomodulating agents or combination treatments that may increase tumor response. SUMMARY Combining immune checkpoint inhibitors with other treatment modalities may lead to the development of new treatment strategies in advanced bladder cancer; however, identifying predictive biomarkers is essential for appropriate patient selection.
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10
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Fukuda T, Kamai T, Masuda A, Nukui A, Abe H, Arai K, Yoshida KI. Higher preoperative serum levels of PD-L1 and B7-H4 are associated with invasive and metastatic potential and predictable for poor response to VEGF-targeted therapy and unfavorable prognosis of renal cell carcinoma. Cancer Med 2016; 5:1810-20. [PMID: 27292320 PMCID: PMC4971909 DOI: 10.1002/cam4.754] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 02/29/2016] [Accepted: 04/05/2016] [Indexed: 12/19/2022] Open
Abstract
Renal cell carcinoma (RCC) is an immunogenic and proangiogenic cancer. Although antivascular endothelial growth factor (VEGF) therapies achieve impressive responses in some patients, many tumors eventually develop resistance to such therapy. The B7 family molecules such as CTLA‐4, PD‐1, and PD‐L1 are pivotal players in immune checkpoints that positively or negatively regulate various immune responses. Recently, immunotherapy based on blocking immune checkpoints with anti‐CTLA4, anti‐PD‐1, or anti‐PD‐L1 antibodies has been proposed as a potential new approach to the treatment of metastatic RCC. Higher expression of PD‐L1 and B7‐H4 in the tumors is associated with a poor prognosis in RCCs, however, the clinical impact of serum levels of B7 family molecules has not been elucidated in patients with metastatic RCCs receiving VEGF‐targeted agents. We assessed the preoperative serum levels of B7 family molecules, including CD80, CD86, PD‐1, PD‐L1, B7‐H3, B7‐H4, and CTLA‐4, and CD28 in RCC patients, and determined their relations with various clinicopathological characteristics. Elevated preoperative serum levels of PD‐L1 and B7‐H4 were correlated with less differentiated tumors, higher invasive and metastatic potential, a worse response to anti‐VEGF therapy, and shorter overall survival. These findings suggested that investigating preoperative serum levels of PD‐L1 and B7‐H4 might not only be useful to assess the biological aggressiveness of RCCs, but also to predict the efficacy of anti‐VEGF therapy and the eventual prognosis, indicating the future design of clinical trials of therapies targeting immune checkpoint in advanced RCCs.
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Affiliation(s)
- Takehiko Fukuda
- Department of Urology, Dokkyo Medical University, Tochigi, Japan
| | - Takao Kamai
- Department of Urology, Dokkyo Medical University, Tochigi, Japan
| | - Akinori Masuda
- Dialysis center, Dokkyo Medical University Koshigaya Hospital, Saitama, Japan
| | - Akinori Nukui
- Department of Urology, Nasu Red Cross Hospital, Tochigi, Japan
| | - Hideyuki Abe
- Department of Urology, Dokkyo Medical University, Tochigi, Japan
| | - Kyoko Arai
- Department of Urology, Dokkyo Medical University, Tochigi, Japan
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11
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12
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Chen YJ, Chen HT, Hsu HC. Preoperative palsy score has no significant association with survival in non-small-cell lung cancer patients with spinal metastases who undergo spinal surgery. J Orthop Surg Res 2015; 10:149. [PMID: 26381378 PMCID: PMC4573298 DOI: 10.1186/s13018-015-0291-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Accepted: 09/07/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Survival is a key factor physicians consider when selecting a treatment modality for the treatment of spinal metastases. Various assessment systems can predict length of survival and facilitate selection of the most appropriate treatment. Spinal palsy is a prognostic parameter in the Tokuhashi scoring system but not in the Tomita scoring system. A limitation of these scoring systems is that studies of them have included different tumor types. The aim of this study was to evaluate the usefulness of preoperative neurological status as a prognostic factor in non-small-cell lung cancer patients with spinal metastases who underwent surgical treatment. METHODS From November 2000 to March 2010, 50 patients with symptomatic metastatic spinal cord compression secondary to non-small-cell lung cancer underwent palliative surgery. Data collected included patient age and sex, tumor histology, date of surgery, death or last follow-up, preoperative and postoperative ambulatory status according to the Frankel grading system, body mass index (BMI), number of vertebra involved, number of other bone metastasis, visceral metastasis, and preoperative Karnofsky performance status. Log-rank test and multivariate Cox proportional hazard regressions were used to evaluate possible prognostic factors. RESULTS The mean patient age was 61.6 years (range, 20-87 years), and 34 were male and 16 were female. The median postoperative survival time was 7.5 months. The median survival was 2.5 months (95% confidence interval (CI): 1.22-16.3 months) in the Frankel A + B group and 8.0 months (95% CI: 5.52-9.89 months) in the Frankel C + D group (p = 0.87). Multivariate Cox proportional hazard regressions showed that preoperative performance status was significantly associated with survival. Preoperative palsy score had no statistically significant association with survival. CONCLUSIONS Preoperative palsy score had no statistically significant association with survival in non-small-cell lung cancer patients with spinal metastases who underwent spinal surgery in this study.
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Affiliation(s)
- Yen-Jen Chen
- Department of Orthopedic Surgery, China Medical University Hospital Taichung, Taiwan, No. 2, Yuh-Der Road, Taichung, 404, Taiwan. .,Department of Orthopedic Surgery, School of Medicine, China Medical University, Taichung, Taiwan. .,Department of Public Health and Department of Health Services Administration, China Medical University, Taiwan, No. 91, Hsueh-Shuh Road, Taichung, 404, Taiwan.
| | - Hsien-Te Chen
- Department of Orthopedic Surgery, China Medical University Hospital Taichung, Taiwan, No. 2, Yuh-Der Road, Taichung, 404, Taiwan.
| | - Horng-Chaung Hsu
- Department of Orthopedic Surgery, China Medical University Hospital Taichung, Taiwan, No. 2, Yuh-Der Road, Taichung, 404, Taiwan. .,Department of Orthopedic Surgery, School of Medicine, China Medical University, Taichung, Taiwan.
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13
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Kohlhapp FJ, Broucek JR, Hughes T, Huelsmann EJ, Lusciks J, Zayas JP, Dolubizno H, Fleetwood VA, Grin A, Hill GE, Poshepny JL, Nabatiyan A, Ruby CE, Snook JD, Rudra JS, Schenkel JM, Masopust D, Zloza A, Kaufman HL. NK cells and CD8+ T cells cooperate to improve therapeutic responses in melanoma treated with interleukin-2 (IL-2) and CTLA-4 blockade. J Immunother Cancer 2015; 3:18. [PMID: 25992289 PMCID: PMC4437746 DOI: 10.1186/s40425-015-0063-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 04/17/2015] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Melanoma is one of the few types of cancer with an increasing annual incidence. While a number of immunotherapies for melanoma have been associated with significant clinical benefit, including high-dose IL-2 and cytotoxic T lymphocyte antigen 4 (CTLA-4) blockade, clinical response to either of these single agents has been limited to 11-20% of treated patients. Therefore, in this study, we sought to test the hypothesis that the combination of IL-2 and CTLA-4 blockade could mediate a more profound therapeutic response. METHODS Here, B6 mice were challenged with poorly immunogenic B16 melanoma on day 0, and treated with CTLA-4 blocking antibody (100 μg/mouse) on days 3, 6, and 9, and IL-2 (100,000 units) twice daily on days 4-8, or both. RESULTS A highly significant synergistic effect that delayed tumor growth and prolonged survival was demonstrated with the combination immunotherapy compared to either monotherapy alone. The therapeutic effect of combination immunotherapy was dependent on both CD8+ T and NK cells and co-depletion of these subsets (but not either one alone) abrogated the therapeutic effect. CTLA-4 blockade increased immune cell infiltration (including CD8+ T cells and NK cells) in the tumor and IL-2 reduced the proportion of highly differentiated/exhausted tumor-infiltrating NK cells. CONCLUSIONS These results have implications for the design of clinical trials in patients with metastatic melanoma and provide new insights into how the immune system may be mediating anti-tumor activity with combination IL-2 and CTLA-4 blockade in melanoma.
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Affiliation(s)
- Frederick J Kohlhapp
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street Room 2007, New Brunswick, NJ 08901 USA.,Department of Immunology/Microbiology, Rush University Medical Center, Chicago, IL 60612 USA
| | - Joseph R Broucek
- Department of General Surgery, Rush University Medical Center, Chicago, IL 60612 USA
| | - Tasha Hughes
- Department of General Surgery, Rush University Medical Center, Chicago, IL 60612 USA
| | - Erica J Huelsmann
- Department of Immunology/Microbiology, Rush University Medical Center, Chicago, IL 60612 USA
| | - Jevgenijs Lusciks
- Department of Immunology/Microbiology, Rush University Medical Center, Chicago, IL 60612 USA
| | - Janet P Zayas
- Department of Immunology/Microbiology, Rush University Medical Center, Chicago, IL 60612 USA
| | - Hubert Dolubizno
- Department of Immunology/Microbiology, Rush University Medical Center, Chicago, IL 60612 USA
| | | | - Alisa Grin
- Department of Immunology/Microbiology, Rush University Medical Center, Chicago, IL 60612 USA
| | - Graham E Hill
- Department of Immunology/Microbiology, Rush University Medical Center, Chicago, IL 60612 USA
| | - Joseph L Poshepny
- Department of Immunology/Microbiology, Rush University Medical Center, Chicago, IL 60612 USA
| | - Arman Nabatiyan
- Department of Immunology/Microbiology, Rush University Medical Center, Chicago, IL 60612 USA.,Department of Internal Medicine, Rush University Medical Center, Chicago, IL 60612 USA
| | - Carl E Ruby
- Department of Immunology/Microbiology, Rush University Medical Center, Chicago, IL 60612 USA.,Department of General Surgery, Rush University Medical Center, Chicago, IL 60612 USA
| | - Joshua D Snook
- Department of Pharmacology & Toxicology and Sealy Center for Vaccine Development, University of Texas Medical Branch, Galveston, TX 77555 USA
| | - Jai S Rudra
- Department of Pharmacology & Toxicology and Sealy Center for Vaccine Development, University of Texas Medical Branch, Galveston, TX 77555 USA
| | - Jason M Schenkel
- Department of Microbiology and Center for Immunology, University of Minnesota Medical School, Minneapolis, MN 55455 USA
| | - David Masopust
- Department of Microbiology and Center for Immunology, University of Minnesota Medical School, Minneapolis, MN 55455 USA
| | - Andrew Zloza
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street Room 2007, New Brunswick, NJ 08901 USA.,Department of Immunology/Microbiology, Rush University Medical Center, Chicago, IL 60612 USA.,Department of Internal Medicine, Rush University Medical Center, Chicago, IL 60612 USA.,Department of Surgery, Rutgers Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, NJ 08903 USA
| | - Howard L Kaufman
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street Room 2007, New Brunswick, NJ 08901 USA.,Department of Surgery, Rutgers Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, NJ 08903 USA
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14
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Abstract
PURPOSE OF REVIEW Inhibition of immune escape mechanisms, such as the programed death-ligand 1 pathway, has demonstrated rapid, durable responses in multiple tumor types, including advanced urothelial carcinoma. This review discusses emerging immunotherapies for urothelial carcinoma in various stages of clinical development. RECENT FINDINGS Urothelial carcinoma has a high mutational burden, which may increase the number of tumor antigens and potentially enhance the ability of the immune system to recognize tumor cells as foreign. However, urothelial carcinoma can evade the immune system by downregulating tumor-antigen presentation, upregulating various immune checkpoints, and inactivating cytotoxic T cells. Immunotherapies for urothelial carcinoma target each of these steps to restore immune-mediated cytotoxicity. Many of these agents are in clinical trials for urothelial carcinoma. SUMMARY Immunotherapies are active in urothelial carcinoma, but only in a fraction of patients, implying the presence of persistent immune escape. Identifying the mechanisms of immune escape and developing rational combinatorial regimens may make the benefit of immunotherapy accessible to a broader population.
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Affiliation(s)
- Joseph W. Kim
- Prostate and Urologic Cancers Program, Yale Cancer Center, Yale University School of Medicine, New Haven, Connecticut
| | - Yusuke Tomita
- Developmental Therapeutics Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Jane Trepel
- Developmental Therapeutics Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Andrea B. Apolo
- Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
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15
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Sfakianos JP, Galsky MD. Neoadjuvant chemotherapy in the management of muscle-invasive bladder cancer: bridging the gap between evidence and practice. Urol Clin North Am 2015; 42:181-7, viii. [PMID: 25882560 DOI: 10.1016/j.ucl.2015.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Although cisplatin-based chemotherapy followed by radical cystectomy is the standard treatment of muscle-invasive bladder cancer, population-based studies reveal that only a small fraction of patients actually receive such treatment. A comprehensive understanding of the reasons for this gap between efficacy and effectiveness is necessary to increase the likelihood of cure of all patients with muscle-invasive bladder cancer. These reasons include systems-, provider-, and patient-level barriers that are not amenable to a single solution. Tackling each barrier will ultimately be necessary to bridge the disconnect between what is achievable and what is actually achieved.
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Affiliation(s)
- John P Sfakianos
- Departments of Urology and Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY 10029, USA
| | - Matthew D Galsky
- Departments of Urology and Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY 10029, USA.
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Evans EE, Jonason AS, Bussler H, Torno S, Veeraraghavan J, Reilly C, Doherty MA, Seils J, Winter LA, Mallow C, Kirk R, Howell A, Giralico S, Scrivens M, Klimatcheva K, Fisher TL, Bowers WJ, Paris M, Smith ES, Zauderer M. Antibody Blockade of Semaphorin 4D Promotes Immune Infiltration into Tumor and Enhances Response to Other Immunomodulatory Therapies. Cancer Immunol Res 2015; 3:689-701. [PMID: 25614511 DOI: 10.1158/2326-6066.cir-14-0171] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 01/12/2015] [Indexed: 11/16/2022]
Abstract
Semaphorin 4D (SEMA4D, CD100) and its receptor plexin-B1 (PLXNB1) are broadly expressed in murine and human tumors, and their expression has been shown to correlate with invasive disease in several human tumors. SEMA4D normally functions to regulate the motility and differentiation of multiple cell types, including those of the immune, vascular, and nervous systems. In the setting of cancer, SEMA4D-PLXNB1 interactions have been reported to affect vascular stabilization and transactivation of ERBB2, but effects on immune-cell trafficking in the tumor microenvironment (TME) have not been investigated. We describe a novel immunomodulatory function of SEMA4D, whereby strong expression of SEMA4D at the invasive margins of actively growing tumors influences the infiltration and distribution of leukocytes in the TME. Antibody neutralization of SEMA4D disrupts this gradient of expression, enhances recruitment of activated monocytes and lymphocytes into the tumor, and shifts the balance of cells and cytokines toward a proinflammatory and antitumor milieu within the TME. This orchestrated change in the tumor architecture was associated with durable tumor rejection in murine Colon26 and ERBB2(+) mammary carcinoma models. The immunomodulatory activity of anti-SEMA4D antibody can be enhanced by combination with other immunotherapies, including immune checkpoint inhibition and chemotherapy. Strikingly, the combination of anti-SEMA4D antibody with antibody to CTLA-4 acts synergistically to promote complete tumor rejection and survival. Inhibition of SEMA4D represents a novel mechanism and therapeutic strategy to promote functional immune infiltration into the TME and inhibit tumor progression.
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Makkouk A, Weiner GJ. Cancer immunotherapy and breaking immune tolerance: new approaches to an old challenge. Cancer Res 2014; 75:5-10. [PMID: 25524899 DOI: 10.1158/0008-5472.can-14-2538] [Citation(s) in RCA: 209] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Cancer immunotherapy has proven to be challenging as it depends on overcoming multiple mechanisms that mediate immune tolerance to self-antigens. A growing understanding of immune tolerance has been the foundation for new approaches to cancer immunotherapy. Adoptive transfer of immune effectors such as antitumor mAb and chimeric antigen receptor T cells bypasses many of the mechanisms involved in immune tolerance by allowing for expansion of tumor-specific effectors ex vivo. Vaccination with whole tumor cells, protein, peptide, or dendritic cells has proven challenging, yet may be more useful when combined with other cancer immunotherapeutic strategies. Immunomodulatory approaches to cancer immunotherapy include treatment with agents that enhance and maintain T-cell activation. Recent advances in the use of checkpoint blockade to block negative signals and to maintain the antitumor response are particularly exciting. With our growing knowledge of immune tolerance and ways to overcome it, combination treatments are being developed, tested, and have particular promise. One example is in situ immunization that is designed to break tolerance within the tumor microenvironment. Progress in all these areas is continuing based on clear evidence that cancer immunotherapy designed to overcome immune tolerance can be useful for a growing number of patients with cancer.
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Affiliation(s)
- Amani Makkouk
- Interdisciplinary Graduate Program in Immunology, University of Iowa, Iowa City, Iowa
| | - George J Weiner
- Interdisciplinary Graduate Program in Immunology, University of Iowa, Iowa City, Iowa. Holden Comprehensive Cancer Center and Department of Internal Medicine, University of Iowa, Iowa City, Iowa.
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