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Chee SJ, Lopez M, Mellows T, Gankande S, Moutasim KA, Harris S, Clarke J, Vijayanand P, Thomas GJ, Ottensmeier CH. Evaluating the effect of immune cells on the outcome of patients with mesothelioma. Br J Cancer 2017; 117:1341-1348. [PMID: 28817839 PMCID: PMC5672927 DOI: 10.1038/bjc.2017.269] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 07/18/2017] [Accepted: 07/20/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND We systematically assessed the prognostic and predictive value of infiltrating adaptive and innate immune cells in a large cohort of patients with advanced mesothelioma. METHODS A tissue microarray from 302 samples was constructed. Markers of adaptive immune response in T-cells (CD8+, FOXP3+, CD4+, CD45RO+, CD3+) and B-cells (CD20+), and of innate immune response; neutrophils (NP57+), natural killer cells (CD56+) and macrophages (CD68+) were evaluated. RESULTS We found that in the epithelioid tumours, high CD4+ and CD20+ counts, and low FOXP3+, CD68+ and NP57+ counts linked to better outcome. In the non-epithelioid group low CD8+ and low FOXP3+ counts were beneficial.On multivariate analysis low FOXP3+ remained independently associated with survival in both groups. In the epithelioid group additionally high CD4+, high CD20+, and low NP57+ counts were prognostic. CONCLUSIONS Our data demonstrate for the first time, in predominately advanced disease, the association of key markers of adaptive and innate immunity with survival and the differential effect of histology. A better understanding of the immunological drivers of the different subtypes of mesothelioma will assist prognostication and disease-specific clinical decision-making.
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Affiliation(s)
- Serena J Chee
- Cancer Sciences Unit, Faculty of Medicine, University of Southampton, Tremona Road, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, Tremona Road Southampton General Hospital Southampton SO16 6YD, UK
| | - Maria Lopez
- Cancer Sciences Unit, Faculty of Medicine, University of Southampton, Tremona Road, Southampton SO16 6YD, UK
- Department of Cellular Pathology, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK
| | - Toby Mellows
- Department of Cellular Pathology, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK
- Clinical and Experimental Sciences, Southampton National Institute for Health Research Respiratory Biomedical Research Unit, University of Southampton, Faculty of Medicine, Southampton SO16 6YD, UK
| | - Sharmali Gankande
- Department of Cellular Pathology, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK
| | - Karwan A Moutasim
- Cancer Sciences Unit, Faculty of Medicine, University of Southampton, Tremona Road, Southampton SO16 6YD, UK
- Department of Cellular Pathology, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK
| | - Scott Harris
- Public Health Sciences and Medical Statistics, University of Southampton, Tremona Road, Southampton SO16 6YD, UK
| | - James Clarke
- Cancer Sciences Unit, Faculty of Medicine, University of Southampton, Tremona Road, Southampton SO16 6YD, UK
| | - Pandurangan Vijayanand
- Clinical and Experimental Sciences, Southampton National Institute for Health Research Respiratory Biomedical Research Unit, University of Southampton, Faculty of Medicine, Southampton SO16 6YD, UK
| | - Gareth J Thomas
- Cancer Sciences Unit, Faculty of Medicine, University of Southampton, Tremona Road, Southampton SO16 6YD, UK
- NIHR CRUK Experimental Cancer Medicine Centre Southampton, Tremona Road, Southampton SO16 7YD, UK
| | - Christian H Ottensmeier
- Cancer Sciences Unit, Faculty of Medicine, University of Southampton, Tremona Road, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, Tremona Road Southampton General Hospital Southampton SO16 6YD, UK
- NIHR CRUK Experimental Cancer Medicine Centre Southampton, Tremona Road, Southampton SO16 7YD, UK
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Hassan R, Thomas A, Alewine C, Le DT, Jaffee EM, Pastan I. Mesothelin Immunotherapy for Cancer: Ready for Prime Time? J Clin Oncol 2016; 34:4171-4179. [PMID: 27863199 DOI: 10.1200/jco.2016.68.3672] [Citation(s) in RCA: 223] [Impact Index Per Article: 27.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Mesothelin is a tumor antigen that is highly expressed in many human cancers, including malignant mesothelioma and pancreatic, ovarian, and lung adenocarcinomas. It is an attractive target for cancer immunotherapy because its normal expression is limited to mesothelial cells, which are dispensable. Several antibody-based therapeutic agents as well as vaccine and T-cell therapies directed at mesothelin are undergoing clinical evaluation. These include antimesothelin immunotoxins (SS1P, RG7787/LMB-100), chimeric antimesothelin antibody (amatuximab), mesothelin-directed antibody drug conjugates (anetumab ravtansine, DMOT4039A, BMS-986148), live attenuated Listeria monocytogenes-expressing mesothelin (CRS-207, JNJ-64041757), and chimeric antigen receptor T-cell therapies. Two antimesothelin agents are currently in multicenter clinical registration trials for malignant mesothelioma: amatuximab in the first-line setting and anetumab ravtansine as second-line therapy. Phase II randomized clinical trials of CRS-207 as a boosting agent and in combination with immune checkpoint inhibition for pancreatic cancer are nearing completion. These ongoing studies will define the utility of mesothelin immunotherapy for treating cancer.
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Affiliation(s)
- Raffit Hassan
- Raffit Hassan, Anish Thomas, Christine Alewine, and Ira Pastan, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda; and Dung T. Le and Elizabeth M. Jaffee, Sidney Kimmel Cancer Center, Johns Hopkins University, Baltimore, MD
| | - Anish Thomas
- Raffit Hassan, Anish Thomas, Christine Alewine, and Ira Pastan, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda; and Dung T. Le and Elizabeth M. Jaffee, Sidney Kimmel Cancer Center, Johns Hopkins University, Baltimore, MD
| | - Christine Alewine
- Raffit Hassan, Anish Thomas, Christine Alewine, and Ira Pastan, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda; and Dung T. Le and Elizabeth M. Jaffee, Sidney Kimmel Cancer Center, Johns Hopkins University, Baltimore, MD
| | - Dung T Le
- Raffit Hassan, Anish Thomas, Christine Alewine, and Ira Pastan, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda; and Dung T. Le and Elizabeth M. Jaffee, Sidney Kimmel Cancer Center, Johns Hopkins University, Baltimore, MD
| | - Elizabeth M Jaffee
- Raffit Hassan, Anish Thomas, Christine Alewine, and Ira Pastan, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda; and Dung T. Le and Elizabeth M. Jaffee, Sidney Kimmel Cancer Center, Johns Hopkins University, Baltimore, MD
| | - Ira Pastan
- Raffit Hassan, Anish Thomas, Christine Alewine, and Ira Pastan, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda; and Dung T. Le and Elizabeth M. Jaffee, Sidney Kimmel Cancer Center, Johns Hopkins University, Baltimore, MD
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