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Shao C, Yan X, Pang S, Nian D, Ren L, Li H, Sun J. Bifunctional molecular probe targeting tumor PD-L1 enhances anti-tumor efficacy by promoting ferroptosis in lung cancer mouse model. Int Immunopharmacol 2024; 130:111781. [PMID: 38442580 DOI: 10.1016/j.intimp.2024.111781] [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] [Received: 12/27/2023] [Revised: 02/19/2024] [Accepted: 02/27/2024] [Indexed: 03/07/2024]
Abstract
PURPOSE Immune checkpoint inhibitors (ICIs) targeting tumor-specific PD-1/PD-L1 significantly improve the overall survival rate of patients with advanced cancer by reactivating the immune system to attack cancer cells. To explore their tumor killing effect, we used the radionuclide iodine-131 (131I) to label the anti-PD-L1 antibody Atezolizumab (131I-PD-L1 mAb). METHOD We prepared the radioimmunoassay molecular probe 131I-PD-L1 mAb by the chloramine-T method and evaluated its affinity using Lewis lung cancer (LLC) cells. The uptake of 131I-PD-L1 mAb by transplanted tumors was examined through SPECT and its in vivo distribution. We then compared the in vitro and in vivo anti-tumor efficacy of groups treated with control, PD-L1 mAb, 131I-PD-L1 mAb, and 131I-PD-L1 mAb + PD-L1 mAb combined treatment. We performed H&E staining to examine the changes in tumor, as well as the damage in major tissues and organs caused by potential side effects. The anti-tumor mechanism of 131I-PD-L1 mAb was analyzed by Western blot, RT-qPCR and immunohistochemistry (IHC). RESULT 131I-PD-L1 mAb was highly stable and specific, and easily penetrated into tumor. 131I-PD-L1 mAb suppressed cancer cell proliferation in vitro, and inhibited tumor growth in vivo by inducing ferroptosis, thus prolonging the survival of experimental animals while demonstrating biological safety. CONCLUSION Therefore, our study suggested that 131I-PD-L1 mAb affected the expression of tumor-related factors through β-rays and thus promoted ferroptosis in tumor. Combined treatment showed better anti-tumor effect compared to single ICI treatment.
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Affiliation(s)
- Chenxu Shao
- Department of Nuclear Medicine, School of Laboratory Medicine, Bengbu Medical University, Anhui Province, Bengbu 233000, PR China
| | - Xiaoping Yan
- Department of Radiology, The People's Hospital of Jiangyou, Jiangyou 621700, PR China
| | - Shangjie Pang
- Department of Nuclear Medicine, School of Laboratory Medicine, Bengbu Medical University, Anhui Province, Bengbu 233000, PR China
| | - Di Nian
- Department of Nuclear Medicine, School of Laboratory Medicine, Bengbu Medical University, Anhui Province, Bengbu 233000, PR China
| | - Li Ren
- Department of Nuclear Medicine, School of Laboratory Medicine, Bengbu Medical University, Anhui Province, Bengbu 233000, PR China
| | - Hui Li
- Department of Nuclear Medicine, First Affiliated Hospital of Bengbu Medical University, Bengbu 233000, PR China
| | - Junjie Sun
- Department of Nuclear Medicine, School of Laboratory Medicine, Bengbu Medical University, Anhui Province, Bengbu 233000, PR China.
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Hohloch K, Windemuth-Kieselbach C, Kolz J, Zinzani PL, Cacchione R, Jurczak W, Bischof Delaloye A, Trümper L, Scholz CW. Radioimmunotherapy (RIT) for Follicular Lymphoma achieves long term lymphoma control in first line and at relapse: 8-year follow-up data of 281 patients from the international RIT-registry. Br J Haematol 2018; 184:949-956. [PMID: 30515751 DOI: 10.1111/bjh.15712] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 11/05/2018] [Indexed: 11/28/2022]
Abstract
To assess efficacy of radioimmunotherapy (RIT) in follicular lymphoma, data from 281 patients collected in the RIT Network, with a median follow-up of 8·2 years after RIT were analysed. RIT was given at first line in 18·5% and at relapse in 81·5%. Following first line therapy, 76·9% achieved complete remission (CR), 9·6% partial remission (PR), 1·9% stable disease (SD) and 1·9% had progressive disease (PD); response was not documented in 9·7%. At relapse, the rate of CR was 48·5% and that of PR was 16·6%, SD 2·6% and PD 10·5%; response was not documented in 21·8%. After median follow-up of 8·2 years, median progression-free survival (PFS) for all was 2·54 years, median overall survival (OS) was not reached. Median PFS and OS (both not reached) were significantly better in first line, compared to RIT at relapse (PFS, 2·11 years; OS, 10·8 years; P = 0·0037 and P = 0·0021, respectively). Overall 8-year PFS was 33·9%, 53·6% for first line and 29·6% for relapsed individuals. Overall 8-year OS was 58·8%, 78·1% for first line and 54·5% for relapsed patients. Thirty-five patients (12·5%) developed secondary malignancy and 16 patients (5·7%) experienced transformation into aggressive lymphoma. RIT is a safe and effective treatment option for follicular lymphoma, both at front line and relapse with an 8-year PFS of 53·6% and 29·6%, respectively.
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Affiliation(s)
- Karin Hohloch
- Kantonsspital Graubünden, Department of Haematology and Oncology, Chur, Switzerland.,Department of Haematology and Oncology, Georg August University, Goettingen, Germany
| | | | - Julia Kolz
- Department of Haematology and Oncology, Georg August University, Goettingen, Germany
| | - Pier Luigi Zinzani
- Istituto di Ematologia e Oncologia Medica, Università di Bologna, Bologna, Italy
| | - Roberto Cacchione
- CEMIC, Centro de Educación, Médica e Investigaciones Clínical, "Norberto Quirno", Buenos Aires, Argentina
| | | | | | - Lorenz Trümper
- Istituto di Ematologia e Oncologia Medica, Università di Bologna, Bologna, Italy
| | - Christian W Scholz
- Department of Haematology and Oncology, Vivantes Klinikum Am Urban, Berlin, Germany
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Puvvada SD, Guillén-Rodríguez JM, Yan J, Inclán L, Heard K, Rivera XI, Anwer F, Mahadevan D, Schatz JH, Persky DO. Yttrium-90-Ibritumomab Tiuxetan (Zevalin®) Radioimmunotherapy after Cytoreduction with ESHAP Chemotherapy in Patients with Relapsed Follicular Non-Hodgkin Lymphoma: Final Results of a Phase II Study. Oncology 2018; 94:274-280. [PMID: 29471300 PMCID: PMC6050637 DOI: 10.1159/000486788] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 01/10/2018] [Accepted: 01/10/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Radioimmunotherapy (RIT) is effective in treating relapsed/refractory follicular lymphoma (FL), with durable remissions in first-line consolidation. We hypothesized that RIT with ibritumomab tiuxetan (Zevalin®) would result in durable remissions by eliminating minimal residual disease after cytoreduction. METHODS Patients with FL received 2 cycles of ESHAP (etoposide, methylprednisolone, cytarabine, cisplatin) every 28 days, followed by Zevalin 4-6 weeks later if there was no disease progression and bone marrow biopsy showed < 25% involvement. RESULTS Twenty-eight patients were treated, with a median age of 61 years, median of 3 prior therapies, 49% high-risk disease (Follicular Lymphoma International Prognostic Index, FLIPI), and 39% progressive disease. Three patients did not receive Zevalin due to residual bone marrow involvement. The main toxicities were cytopenias, with 11% febrile neutropenia. The overall response rate (ORR) was 72%, with 45% achieving complete response. With a median follow-up of 73 months, 1-year progression-free survival (PFS) was 38%, and median PFS was 10 months, but median overall survival (OS) was not reached. CONCLUSION The study did not reach its primary endpoint of a 1-year PFS of 67.3%. Reasons for this could include low accrual, high-risk disease, and inadequate debulking provided by 2 cycles of ESHAP. However, this protocol was associated with tolerable toxicity, high ORR, and high OS. Further studies would optimize debulking and focus on high-risk FL patients.
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Affiliation(s)
- Soham D. Puvvada
- Division of Hematology-Oncology, Department of Medicine, University of Arizona Cancer Center, Tucson, Arizona, USA
| | - José M. Guillén-Rodríguez
- Division of Hematology-Oncology, Department of Medicine, University of Arizona Cancer Center, Tucson, Arizona, USA
| | - Jessica Yan
- Internal Medicine Residency Program, Department of Medicine, University of Arizona, Tucson, Arizona, USA
| | - Lora Inclán
- University of Arizona Cancer Center, Tucson, Arizona, USA
| | - Kara Heard
- University of Arizona Cancer Center, Tucson, Arizona, USA
| | | | - Faiz Anwer
- Division of Hematology-Oncology, Department of Medicine, University of Arizona Cancer Center, Tucson, Arizona, USA
| | - Daruka Mahadevan
- Division of Hematology-Oncology, Department of Medicine, University of Arizona Cancer Center, Tucson, Arizona, USA
| | - Jonathan H. Schatz
- Division of Hematology, Department of Medicine, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Daniel O. Persky
- Division of Hematology-Oncology, Department of Medicine, University of Arizona Cancer Center, Tucson, Arizona, USA
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Chen XZ, Cao ZY, Zhang YQ, Li JN, Liao LM, Du J. Fuzheng Qingjie granules potentiate the anticancer effect of cyclophosphamide by regulating cellular immune function and inducing apoptosis in Hepatoma 22 tumor-bearing mice. Oncol Lett 2017; 13:3261-3268. [PMID: 28529567 DOI: 10.3892/ol.2017.5849] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 01/06/2017] [Indexed: 01/02/2023] Open
Abstract
Fuzheng Qingjie (FZQJ) is a polyherbal Chinese medicine that has previously been implemented as an adjuvant therapy for gastrointestinal cancer. The present study investigated whether FZQJ is able to potentiate the anticancer effect of cyclophosphamide (CTX). Hepatoma 22 tumor-bearing mice were randomly divided into a vehicle group, CTX group, FZQJ group and combination (CTX+FZQJ) group. In addition, untreated mice without H22 cells served as blank controls. Seven days post-treatment, the mice were sacrificed and the tumors were weighed. Blood cells were evaluated using an automatic hemocytometer analyzer and flow cytometer. The expression levels of interleukin (IL)-2 and tumor necrosis factor (TNF)-α were evaluated using a radioimmunoassay. Apoptotic cells were observed using a terminal deoxynucleotidyl transferase dUTP nick-end labeling assay. Alanine transaminase, aspartate aminotransferase, blood urea nitrogen and creatinine were examined using an automatic biochemical analyzer. The results demonstrated that the tumor inhibitory rate and apoptosis index were higher in the combination group, compared with those in the CTX group. Notably, FZQJ was able to alleviate CTX-induced decreases in the numbers of white blood cells and platelets, CD3+ and CD4+ T lymphocyte subsets, and the concentration of hemoglobin, body weight and thymus index, and increase serum TNF-α and IL-2 levels without overt hepatorenal toxicity. These results suggest that FZQJ granules may enhance the anticancer effect of CTX, in addition to alleviating the side effects.
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Affiliation(s)
- Xu-Zheng Chen
- Center of Oncology, Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Zhi-Yun Cao
- Center of Oncology, Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - You-Quan Zhang
- Department of Clinical Laboratory, The Second Affiliated Hospital, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350003, P.R. China
| | - Jin-Nong Li
- Department of Pharmacognosy, College of Pharmacy, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Lian-Ming Liao
- Center of Oncology, Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Jian Du
- Center of Oncology, Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
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Castellino A, Santambrogio E, Nicolosi M, Botto B, Boccomini C, Vitolo U. Follicular Lymphoma: The Management of Elderly Patient. Mediterr J Hematol Infect Dis 2017; 9:e2017009. [PMID: 28105297 PMCID: PMC5224805 DOI: 10.4084/mjhid.2017.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 12/01/2016] [Indexed: 11/17/2022] Open
Abstract
Follicular lymphoma (FL) is the most common indolent non-Hodgkin lymphoma, which typically affects mature adults and elderly, whose median age at diagnosis is 65 years. The natural history of FL appears to have been favorably impacted by the introduction of Rituximab. Randomized clinical trials demonstrated that the addition of rituximab to standard chemotherapy induction has improved the overall survival and new strategies of chemo-immunotherapy, such as Bendamustine combined with Rituximab, showed optimal results on response and reduced hematological toxicity, becoming one of the standard treatments, particularly in elderly patients. Moreover, maintenance therapy with Rituximab demonstrated improvement of progression-free survival. Despite these exciting results, FL is still an incurable disease. It remains a critical unmet clinical need finding new prognostic factors to identify poor outcome patients better, to reduce the risk of transformation and to explore new treatment strategies, especially for patients not candidate to intensive chemotherapy regimens, such as elderly patients. Some progress were already reached with novel agents, but larger and more validated studies are needed. Elderly patients are the largest portion of patients with FL and represent a subgroup with higher treatment difficulties, because of comorbidities and smaller spectrum for treatment choice. Further studies, focused on elderly follicular lymphoma patients, with their peculiar characteristics, are needed to define the best-tailored treatment at diagnosis and at the time of relapse in this setting.
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Affiliation(s)
- Alessia Castellino
- Città della Salute e della Scienza University and Hospital, Hematology Unit, Turin, Italy
| | - Elisa Santambrogio
- Città della Salute e della Scienza University and Hospital, Hematology Unit, Turin, Italy
| | - Maura Nicolosi
- Città della Salute e della Scienza University and Hospital, Hematology Unit, Turin, Italy
| | - Barbara Botto
- Città della Salute e della Scienza University and Hospital, Hematology Unit, Turin, Italy
| | - Carola Boccomini
- Città della Salute e della Scienza University and Hospital, Hematology Unit, Turin, Italy
| | - Umberto Vitolo
- Città della Salute e della Scienza University and Hospital, Hematology Unit, Turin, Italy
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Andrade-Campos MM, Liévano P, Espinosa-Lara N, Soro-Alcubierre G, Grasa-Ulrich JM, López-Gómez L, Baringo T, Giraldo P. Long-term complication in follicular lymphoma: assessing the risk of secondary neoplasm in 242 patients treated or not with 90-yttrium-ibritumomab-tiuxetan. Eur J Haematol 2016; 97:576-582. [PMID: 27157440 DOI: 10.1111/ejh.12775] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2016] [Indexed: 01/09/2023]
Abstract
BACKGROUND Non-Hodgkin lymphoma patients have a 25% increased risk of secondary primary neoplasms (SPNs). Regarding the controversy about the increased risk of SPN in patients exposed to radioimmunotherapy (RIT), we have analyzed this issue in a cohort of follicular lymphoma (FL) patients treated with/without RIT. PATIENTS AND METHODS A retrospective study including all consecutive FL patients diagnosed since 2001 was performed. Demographic, clinical data including the incidence of any kind of neoplasm (excluding basocellular skin carcinoma) were recorded. RESULTS A total of 242 patients were registered, male/female: 103/139, mean age: 59.9 yr (15-86), stage IV (57.8%), and Follicular Lymphoma Prognostic Index (FLIPI) low-risk (62.15%) predominance. Ninety-six patients (39.7%) were treated with 90Y-IT. The median follow-up for patients treated or not with 90Y-IT was 61 (8-273) and 38 (1-171) months. With respect to SPN incidence, 38 (15.6%) patients have at least two cancers, in 17 (44.7%), FL was the SPN; for the rest (226), the global incidence of SPNs was 9.3% (21), but there were no differences related to the exposition or not to 90Y-IT (P = 0.26). In seven patients, more than two (2-6) different therapies were registered; four were exposed to fludarabine-based therapy, three to radiotherapy and two to autologous stem-cell transplantation, and in the RIT cohort, two patients developed myelodysplastic syndrome. CONCLUSION This is one of the largest single institution reports assessing the risk of SPN in FL patients treated (96) or not (146) with 90Y-IT. It seems that 90Y-IT does not increase significantly the risk of SPN but avoiding its use after fludarabine and other intense cytotoxic schemes is recommended.
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Affiliation(s)
- Marcio Miguel Andrade-Campos
- Translational Research Unit, Aragon Health Research Institute (IIS-A), Zaragoza, Spain
- CIBER de Enfermedades Raras, CIBERER, Instituto Aragonés de Ciencias de la Salud (I+CS), Zaragoza, Spain
- Department of Hematology, Miguel Servet University Hospital, Zaragoza, Spain
| | - Paola Liévano
- Department of Nuclear Medicine, Miguel Servet University Hospital, Zaragoza, Spain
| | | | | | | | - Luis López-Gómez
- Department of Hematology, Royo Villanova Hospital, Zaragoza, Spain
| | - Teresa Baringo
- Department of Nuclear Medicine, Miguel Servet University Hospital, Zaragoza, Spain
| | - Pilar Giraldo
- Translational Research Unit, Aragon Health Research Institute (IIS-A), Zaragoza, Spain
- CIBER de Enfermedades Raras, CIBERER, Instituto Aragonés de Ciencias de la Salud (I+CS), Zaragoza, Spain
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