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Chen WJ, Pan XW, Song X, Liu ZC, Xu D, Chen JX, Dong KQ, Di SC, Ye JQ, Gan SS, Wang LH, Zhou W, Cui XG. Preoperative neoadjuvant targeted therapy remodels intra-tumoral heterogeneity of clear-cell renal cell carcinoma and ferroptosis inhibition induces resistance progression. Cancer Lett 2024; 593:216963. [PMID: 38768682 DOI: 10.1016/j.canlet.2024.216963] [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: 01/06/2024] [Revised: 04/15/2024] [Accepted: 05/14/2024] [Indexed: 05/22/2024]
Abstract
Neoadjuvant tyrosine kinase inhibitor (TKI) therapy is an important treatment option for advanced renal cell carcinoma (RCC). Many RCC patients may fail to respond or be resistant to TKI therapy. We aimed to explore the key mechanisms of neoadjuvant therapy résistance. We obtained tumor samples from matched pre-treatment biopsy and post-treatment surgical samples and performed single-cell RNA sequencing. Sunitinib-resistant ccRCC cell lines were established. Ferroptosis was detected by ferrous ion and lipid peroxidation levels. Tumor growth and resistance to Sunitinib was validated in vitro and vivo. Immunohistochemistry was used to validate the levels key genes and lipid peroxidation. Multi-center cohorts were included, including TCGA, ICGC, Checkmate-025 and IMmotion151 clinical trial. Survival analysis was performed to identify the associated clinical and genomic variables. Intratumoral heterogeneity was first described in the whole neoadjuvant management. The signature of endothelial cells was correlated with drug sensitivity and progression-free survival. Ferroptosis was shown to be the key biological program in malignant cell resistance. We observed tissue lipid peroxidation was negatively correlated with IL6 and tumor response. TKI-resistant cell line was established. SLC7A11 knockdown promoted cell growth and lipid peroxidation, increased the ferroptosis level, and suppressed the growth of tumor xenografts significantly (P < 0.01). IL6 could reverse the ferroptosis and malignant behavior caused by SLC7A11 (-) via JAK2/STAT3 pathway, which was rescued by the ferroptosis inducer Erastin. Our data indicate that ferroptosis is a novel strategy for advanced RCC treatment, which activated by IL6, providing a new idea for resistance to TKIs.
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Affiliation(s)
- Wen-Jin Chen
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai, 200092, China; Depanrtment of Urology, Third Affiliated Hospital of the Naval Medical University, Shanghai, 201805, China.
| | - Xiu-Wu Pan
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai, 200092, China.
| | - Xu Song
- Department of Urology, Shanghai Seventh People's Hospital, Shanghai, 200137, China.
| | - Zi-Chang Liu
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai, 200092, China.
| | - Da Xu
- Depanrtment of Urology, Third Affiliated Hospital of the Naval Medical University, Shanghai, 201805, China.
| | - Jia-Xin Chen
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai, 200092, China.
| | - Ke-Qin Dong
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai, 200092, China.
| | - Si-Chen Di
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai, 200092, China.
| | - Jian-Qing Ye
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai, 200092, China.
| | - Si-Shun Gan
- Depanrtment of Urology, Third Affiliated Hospital of the Naval Medical University, Shanghai, 201805, China.
| | - Lin-Hui Wang
- Department of Urology, Changhai Hospital of Naval Medical University, 168 Changhai Road, Shanghai, 200433, China.
| | - Wang Zhou
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai, 200092, China.
| | - Xin-Gang Cui
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai, 200092, China; Depanrtment of Urology, Third Affiliated Hospital of the Naval Medical University, Shanghai, 201805, China.
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Vargová D, Dargaj J, Dohál M, Fraňová S, Ľupták J, Škorňová I, Švihra J, Briš L, Slávik P, Šutovská M. Immune analysis of urine and plasma samples from patients with clear cell renal cell carcinoma. Oncol Lett 2024; 27:281. [PMID: 38736737 PMCID: PMC11082642 DOI: 10.3892/ol.2024.14414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 03/25/2024] [Indexed: 05/14/2024] Open
Abstract
Clear cell renal cell carcinoma (ccRCC) is the third most common type of urological malignancy worldwide, and it is associated with a silent progression and late manifestation. Patients with a metastatic form of ccRCC have a poor prognosis; however, when the disease is diagnosed early, it is largely curable. Currently, there are no biomarkers available in clinical practice for ccRCC. Thus, the aim of the present study was to measure 27 biologically relevant cytokines in preoperative and postoperative urine samples, and in preoperative plasma samples from 34 patients with ccRCC, and to evaluate their diagnostic significance. The concentrations of cytokines were assessed by multiplex immune assay. The results showed significantly higher levels of IL-1 receptor antagonist, IL-6, IL-15, chemokine (C-C motif) ligand (CCL)2, CCL3, CCL4, C-X-C motif ligand (CXCL)10, granulocyte-macrophage colony stimulating factor (GM-CSF) and platelet-derived growth factor-BB (PDGF-BB), and lower levels of granulocyte colony stimulating factor (G-CSF) in urine samples from patients prior to surgery compared with those in the controls. Notably, the urine levels of G-CSF, IL-5 and vascular endothelial growth factor differed following tumor removal compared with the preoperative urine levels. In addition, urinary G-CSF, GM-CSF, IL-6, CXCL10, CCL5 and PDGF-BB appeared to be potential markers of tumor grade. Plasma from patients with ccRCC contained significantly higher levels of IL-6 and lower levels of CCL2 than control plasma. In conclusion, the present findings indicated that urinary and circulating cytokines may represent a promising novel tool for the early diagnosis of ccRCC and/or prediction of tumor grade.
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Affiliation(s)
- Daniela Vargová
- Department of Pharmacology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 036 01 Martin, Slovakia
| | - Ján Dargaj
- Department of Urology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava and University Hospital Martin, 036 01 Martin, Slovakia
| | - Matúš Dohál
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 036 01 Martin, Slovakia
| | - Soňa Fraňová
- Department of Pharmacology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 036 01 Martin, Slovakia
| | - Ján Ľupták
- Department of Urology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava and University Hospital Martin, 036 01 Martin, Slovakia
| | - Ingrid Škorňová
- Department of Hematology and Transfusiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava and University Hospital Martin, 036 01 Martin, Slovakia
| | - Ján Švihra
- Department of Urology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava and University Hospital Martin, 036 01 Martin, Slovakia
| | - Lukáš Briš
- Department of Urology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava and University Hospital Martin, 036 01 Martin, Slovakia
| | - Pavol Slávik
- Department of Pathological Anatomy, Jessenius Faculty of Medicine in Martin, Comenius University, 036 01 Martin, Slovakia
| | - Martina Šutovská
- Department of Pharmacology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 036 01 Martin, Slovakia
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Ren Y, Guo W, Qiao B. Abnormal expression of CEBPB promotes the progression of renal cell carcinoma through regulating the generation of IL-6. Heliyon 2023; 9:e20175. [PMID: 37767481 PMCID: PMC10520310 DOI: 10.1016/j.heliyon.2023.e20175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 09/03/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
Background The CCAAT/enhancer-binding protein beta (CEBPB), a transcription factor regulating immune and inflammatory responses, has been implicated in the pathogenesis of various malignancies. However, its specific regulatory mechanism in renal cell carcinoma (RCC) remains poorly understood. Methods The expression of CEBPB was detected in RCC cells and tissues using qRT-PCR, western blotting and immunohistochemistry. ELISA assay was used to detect the immune factors regulated by CEBPB in supernatants. Additionally, western blotting was employed to measure the phosphorylation level of STAT3 and the expression levels of its downstream target genes. Results CEBPB was found to be overexpressed in both RCC tissues and cell lines, and its higher expression was associated with a lower survival rate. In RCC cells, CEBPB enhances the expression of IL6, consequently promoting the phosphorylation of STAT3 and the expression of its downstream target genes. This mechanism ultimately facilitates tumor progression. Conclusions The dysregulated expression of CEBPB facilitates RCC progression through the IL6/STAT3 pathway. CEBPB is a potential diagnostic markers and a novel effective therapeutic target for RCC patients.
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Affiliation(s)
- Yaoqiang Ren
- Departments of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Wenke Guo
- Department of Thyroid Surgery, Fenyang Hospital of Shanxi Province, Lüliang, Shanxi, China
| | - Baoping Qiao
- Departments of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Kruk L, Mamtimin M, Braun A, Anders HJ, Andrassy J, Gudermann T, Mammadova-Bach E. Inflammatory Networks in Renal Cell Carcinoma. Cancers (Basel) 2023; 15:cancers15082212. [PMID: 37190141 DOI: 10.3390/cancers15082212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/23/2023] [Accepted: 04/04/2023] [Indexed: 05/17/2023] Open
Abstract
Cancer-associated inflammation has been established as a hallmark feature of almost all solid cancers. Tumor-extrinsic and intrinsic signaling pathways regulate the process of cancer-associated inflammation. Tumor-extrinsic inflammation is triggered by many factors, including infection, obesity, autoimmune disorders, and exposure to toxic and radioactive substances. Intrinsic inflammation can be induced by genomic mutation, genome instability and epigenetic remodeling in cancer cells that promote immunosuppressive traits, inducing the recruitment and activation of inflammatory immune cells. In RCC, many cancer cell-intrinsic alterations are assembled, upregulating inflammatory pathways, which enhance chemokine release and neoantigen expression. Furthermore, immune cells activate the endothelium and induce metabolic shifts, thereby amplifying both the paracrine and autocrine inflammatory loops to promote RCC tumor growth and progression. Together with tumor-extrinsic inflammatory factors, tumor-intrinsic signaling pathways trigger a Janus-faced tumor microenvironment, thereby simultaneously promoting or inhibiting tumor growth. For therapeutic success, it is important to understand the pathomechanisms of cancer-associated inflammation, which promote cancer progression. In this review, we describe the molecular mechanisms of cancer-associated inflammation that influence cancer and immune cell functions, thereby increasing tumor malignancy and anti-cancer resistance. We also discuss the potential of anti-inflammatory treatments, which may provide clinical benefits in RCCs and possible avenues for therapy and future research.
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Affiliation(s)
- Linus Kruk
- Walther-Straub-Institute for Pharmacology and Toxicology, Ludwig-Maximilian-University, 80336 Munich, Germany
- Division of Nephrology, Department of Medicine IV, Hospital of the Ludwig-Maximilian-University, 80336 Munich, Germany
| | - Medina Mamtimin
- Walther-Straub-Institute for Pharmacology and Toxicology, Ludwig-Maximilian-University, 80336 Munich, Germany
- Division of Nephrology, Department of Medicine IV, Hospital of the Ludwig-Maximilian-University, 80336 Munich, Germany
| | - Attila Braun
- Walther-Straub-Institute for Pharmacology and Toxicology, Ludwig-Maximilian-University, 80336 Munich, Germany
| | - Hans-Joachim Anders
- Division of Nephrology, Department of Medicine IV, Hospital of the Ludwig-Maximilian-University, 80336 Munich, Germany
| | - Joachim Andrassy
- Division of General, Visceral, Vascular and Transplant Surgery, Hospital of LMU, 81377 Munich, Germany
| | - Thomas Gudermann
- Walther-Straub-Institute for Pharmacology and Toxicology, Ludwig-Maximilian-University, 80336 Munich, Germany
- German Center for Lung Research (DZL), 80336 Munich, Germany
| | - Elmina Mammadova-Bach
- Walther-Straub-Institute for Pharmacology and Toxicology, Ludwig-Maximilian-University, 80336 Munich, Germany
- Division of Nephrology, Department of Medicine IV, Hospital of the Ludwig-Maximilian-University, 80336 Munich, Germany
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Yang BY, Zhao FZ, Li XH, Zhao MS, Lv JC, Shi MJ, Li J, Zhou ZY, Wang JJ, Song J. Alteration of pro-carcinogenic gut microbiota is associated with clear cell renal cell carcinoma tumorigenesis. Front Microbiol 2023; 14:1133782. [PMID: 37089532 PMCID: PMC10113506 DOI: 10.3389/fmicb.2023.1133782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/21/2023] [Indexed: 04/08/2023] Open
Abstract
ObjectiveIncreasing evidence suggests that gut microbiota is involved in the occurrence and progression of urinary system diseases such as clear cell renal cell carcinoma (ccRCC). However, the mechanism of how alteration of gut metagenome promotes ccRCC remains unclear. Here we aim to elucidate the association of specific gut bacteria and their metabolites with ccRCC.MethodsIn a pilot case-control study among 30 ccRCC patients (RCC group) and 30 healthy controls (Control group), 16S ribosomal RNA (rRNA) gene sequencing were analyzed from fecal samples collected prior to surgery or hospitalization. Alpha diversity and beta diversity analysis of the gut microbiota were performed, and differential taxa were identified by multivariate statistics. Meanwhile, serum metabolism was measured by UHPLC-MS, and differential genes were identified based on the TCGA database.ResultsAlpha diversity found there were no significant microbial diversity differences of gut microbiota between the RCC group and the Control group. However, beta diversity analysis showed that the overall structures of the two groups were significantly separated (p = 0.008). Random Forests revealed the relative abundances of 20 species differed significantly between the RCC group and the Control group, among which nine species were enriched in the RCC group such as Desulfovibrionaceae, and 11 species were less abundant such as four kinds of Lactobacillus. Concomitantly, serum level of taurine, which was considered to be consumed by Desulfovibrionaceae and released by Lactobacillus, has decreased in the RCC group. In addition, macrophage-related genes such as Gabbr1 was upregulated in ccRCC patients.ConclusionReduction of protective bacteria, proliferation of sulfide-degrading bacteria Desulfovibrionaceae, reduction of taurine, and enrichment of macrophage related genes might be the risk predictors of ccRCC.
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Affiliation(s)
- Bo-Yu Yang
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Fang-Zhou Zhao
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xuan-Hao Li
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Mei-Shan Zhao
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jing-Cheng Lv
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Ming-Jun Shi
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jun Li
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhi-Yuan Zhou
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- Shanghai Pudong New Area Gongli Hospital, Shanghai, China
- *Correspondence: Zhi-Yuan Zhou,
| | - Jing-Jing Wang
- Shanghai Key Laboratory of Pancreatic Diseases, Institute of Translational Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Jing-Jing Wang,
| | - Jian Song
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- Jian Song,
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High Serum Levels of IL-6 Predict Poor Responses in Patients Treated with Pembrolizumab plus Axitinib for Advanced Renal Cell Carcinoma. Cancers (Basel) 2022; 14:cancers14235985. [PMID: 36497467 PMCID: PMC9738341 DOI: 10.3390/cancers14235985] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/21/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
Renal cell carcinoma (RCC) is the most common type of kidney malignancy worldwide with Pembrolizumab and axitinib treatment (Pembro/Axi) amongst the most effective first-line immunotherapies for advanced RCC. However, it remains difficult to predict treatment response and early resistance. Therefore, we evaluated whether baseline serum interleukin-6 (IL-6) could be a predictive biomarker. Between November 2019 and December 2021, 58 patients with advanced RCC were enrolled, administered first-line Pembro/Axi, and baseline blood samples were analyzed using flow cytometry. The mean baseline serum IL-6 concentration was 8.6 pg/mL in responders and 84.1 pg/mL in patients with progressive disease. The IL-6 cut-off value was set at 6.5 pg/mL using time-dependent receiver operating characteristic curves, with 37.9% of patients having high baseline serum IL-6 levels and 62.1% having low levels. Objective response rates were 58.3% and 36.4% in low and high IL-6 groups, respectively. Overall survival and progression-free survival were longer in patients with low IL-6 levels than in those with high levels. High IL-6 levels were related to reduced interferon-γ and tumor necrosis factor-α production from CD8+ T cells. Overall, high baseline serum IL-6 levels were associated with worse survival outcomes and reduced T-cell responses in Pembro/Axi-treated advanced RCC patients.
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Patient-Specific Mathematical Model of the Clear Cell Renal Cell Carcinoma Microenvironment. J Pers Med 2022; 12:jpm12101681. [PMID: 36294824 PMCID: PMC9605269 DOI: 10.3390/jpm12101681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/21/2022] [Accepted: 09/30/2022] [Indexed: 11/04/2022] Open
Abstract
The interactions between cells and molecules in the tumor microenvironment can give insight into the initiation and progression of tumors and their optimal treatment options. In this paper, we developed an ordinary differential equation (ODE) mathematical model of the interaction network of key players in the clear cell renal cell carcinoma (ccRCC) microenvironment. We then performed a global gradient-based sensitivity analysis to investigate the effects of the most sensitive parameters of the model on the number of cancer cells. The results indicate that parameters related to IL-6 have high a impact on cancer cell growth, such that decreasing the level of IL-6 can remarkably slow the tumor's growth.
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Ultra-Sensitive and Semi-Quantitative Vertical Flow Assay for the Rapid Detection of Interleukin-6 in Inflammatory Diseases. BIOSENSORS 2022; 12:bios12090756. [PMID: 36140141 PMCID: PMC9496834 DOI: 10.3390/bios12090756] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 09/07/2022] [Accepted: 09/08/2022] [Indexed: 11/16/2022]
Abstract
The inflammation biomarker Interleukin 6 (IL-6) exhibits a concentration of less than 7 pg/mL in healthy serum but increases 10–100-fold when inflammation occurs. Increased serum IL-6 has been reported in chronic diseases such as rheumatoid arthritis (RA), as well as in life-threatening acute illnesses such as sepsis and cytokine release syndrome (CRS). This work seeks to meet the demand for rapid detection of serum IL-6 both for rapid monitoring of chronic diseases and for triaging patients with acute illnesses. Following the optimization of several types of gold nanoparticles, membrane pore sizes, and buffer systems, an ultra-sensitive vertical flow assay (VFA) was engineered, allowing the detection of recombinant IL-6 in spiked buffer with a limit of detection (LoD) of 10 pg/mL and a reportable range of 10–10,000 pg/mL with a 15-min assay time. The detection of IL-6 in spiked pooled healthy serum exhibited an LoD of 3.2 pg/mL and a reportable range of 10–10,000 pg/mL. The VFA’s stability was demonstrated over 1-day, two-week, four-week, and six-week storage durations at room temperature. The inter-operator CV and intra-operator CV were determined to be 14.3% and 15.2%, respectively. Three reference zones, high, low, and blank, were introduced into the cartridge to facilitate on-site semi-quantitative measurements across a 6-point semi-quantitative range. Finally, the performance of the IL-6 VFA was validated using 20 RA and 20 healthy control (HC) clinical serum samples, using ELISA as the gold standard platform. The ultra-sensitive, rapid IL-6 VFA could potentially be used to triage patients for intensive care, treatment adjustments, or for monitoring disease activity in inflammatory conditions.
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9
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Nixon AB, Halabi S, Liu Y, Starr MD, Brady JC, Shterev I, Luo B, Hurwitz HI, Febbo PG, Rini BI, Beltran H, Small EJ, Morris MJ, George DJ. Predictive Biomarkers of Overall Survival in Patients with Metastatic Renal Cell Carcinoma Treated with IFNα ± Bevacizumab: Results from CALGB 90206 (Alliance). Clin Cancer Res 2022; 28:2771-2778. [PMID: 34965953 PMCID: PMC9240110 DOI: 10.1158/1078-0432.ccr-21-2386] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 10/25/2021] [Accepted: 12/21/2021] [Indexed: 01/03/2023]
Abstract
PURPOSE CALGB 90206 was a phase III trial of 732 patients with metastatic renal cell carcinoma (mRCC) comparing bevacizumab plus IFNα (BEV + IFN) with IFNα alone (IFN). No difference in overall survival (OS) was observed. Baseline samples were analyzed to identify predictive biomarkers for survival benefit. PATIENTS AND METHODS A total of 32 biomarkers were assessed in 498 consenting patients randomly assigned into training (n = 279) and testing (n = 219) sets. The proportional hazards model was used to test for treatment arm and biomarker interactions of OS. The estimated coefficients from the training set were used to compute a risk score for each patient and to classify patients by risk in the testing set. The resulting model was assessed for predictive accuracy using the time-dependent area under the ROC curve (tAUROC). RESULTS A statistically significant three-way interaction between IL6, hepatocyte growth factor (HGF), and bevacizumab treatment was observed in the training set and confirmed in the testing set (P < 0.0001). The model based on IL6, HGF, and bevacizumab treatment was predictive of OS (P < 0.001), with the high- and low-risk groups having a median OS of 10.2 [95% confidence interval (CI), 8.0-13.8] and 34.3 (95% CI, 28.5-40.5) months, respectively. The average tAUROC for the final model of OS based on 100 randomly split testing sets was 0.78 (first, third quartiles = 0.77, 0.79). CONCLUSIONS IL6 and HGF are potential predictive biomarkers of OS benefit from BEV + IFN in patients with mRCC. The model based on key biological and clinical factors demonstrated predictive efficacy for OS. These markers warrant further validation in future anti-VEGF and immunotherapy in mRCC trials. See related commentaries by Mishkin and Kohn, p. 2722 and George and Bertagnolli, p. 2725.
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Affiliation(s)
- Andrew B. Nixon
- Department of Medical Oncology, Duke Cancer Institute, Duke University Medical Center; Durham, NC
| | - Susan Halabi
- Department of Biostatistics and Bioinformatics and Alliance Statistics and Data Center, Duke University Medical Center; Durham, NC
| | - Yingmiao Liu
- Department of Medical Oncology, Duke Cancer Institute, Duke University Medical Center; Durham, NC
| | - Mark D. Starr
- Department of Medical Oncology, Duke Cancer Institute, Duke University Medical Center; Durham, NC
| | - John C. Brady
- Department of Medical Oncology, Duke Cancer Institute, Duke University Medical Center; Durham, NC
| | - Ivo Shterev
- Department of Biostatistics and Bioinformatics and Alliance Statistics and Data Center, Duke University Medical Center; Durham, NC
- Current address: Illumina, Redwood City, CA
| | - Bin Luo
- Department of Biostatistics and Bioinformatics and Alliance Statistics and Data Center, Duke University Medical Center; Durham, NC
| | | | | | - Brian I. Rini
- Department of Medicine, Cleveland Clinic Taussig Cancer Institute, Lerner College of Medicine, Case Western Reserve University, Cleveland, OH
| | - Himisha Beltran
- Department of Medicine, Dana-Farber/Partners Cancer Care, Harvard Cancer Center; Boston, MA
| | - Eric J. Small
- Department of Medicine, University of California, San Francisco; San Francisco, CA
| | - Michael J. Morris
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Daniel J. George
- Department of Medical Oncology, Duke Cancer Institute, Duke University Medical Center; Durham, NC
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Park KY, Hefti HO, Liu P, Lugo-Cintrón KM, Kerr SC, Beebe DJ. Immune cell mediated cabozantinib resistance for patients with renal cell carcinoma. Integr Biol (Camb) 2021; 13:259-268. [PMID: 34931665 PMCID: PMC8730366 DOI: 10.1093/intbio/zyab018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/15/2021] [Accepted: 10/29/2021] [Indexed: 01/05/2023]
Abstract
Renal cell carcinoma (RCC) is the third most common genitourinary cancer in the USA. Despite recent advances in the treatment for advanced and metastatic clear cell RCC (ccRCC), the 5-year relative survival rate for the distant disease remains at 12%. Cabozantinib, a tyrosine kinase inhibitor (TKI), which is one of the first-line therapies approved to treat advanced ccRCC as a single agent, is now being investigated as a combination therapy with newer immunotherapeutic agents. However, not much is known about how cabozantinib modulates the immune system. Here, we present a high throughput tri-culture model that incorporates cancer cells, endothelial cells, and patient-derived immune cells to study the effect of immune cells from patients with ccRCC on angiogenesis and cabozantinib resistance. We show that circulating immune cells from patients with ccRCC induce cabozantinib resistance via increased secretion of a set of pro-angiogenic factors. Using multivariate partial least square regression modeling, we identified CD4+ T cell subsets that are correlated with cabozantinib resistance and report the changes in the frequency of these populations in ccRCC patients who are undergoing cabozantinib therapy. These findings provide a potential set of biomarkers that should be further investigated in the current TKI-immunotherapy combination clinical trials to improve personalized treatments for patients with ccRCC.
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Affiliation(s)
- Keon Young Park
- Department of Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Hunter O Hefti
- Department of Biomedical Engineering, University of Wisconsin, Madison, WI, USA
| | - Peng Liu
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Carbone Cancer Center, University of Wisconsin, Madison, WI, USA
| | | | - Sheena C Kerr
- Carbone Cancer Center, University of Wisconsin, Madison, WI, USA
- Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - David J Beebe
- Department of Biomedical Engineering, University of Wisconsin, Madison, WI, USA
- Carbone Cancer Center, University of Wisconsin, Madison, WI, USA
- Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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Chen D, Su H, Li Y, Wu X, Li Y, Wei C, Shi D, Gao Y, Zhou Q, Wang Q, Jin X, Xie C. miR-20b and miR-125a promote tumorigenesis in radioresistant esophageal carcinoma cells. Aging (Albany NY) 2021; 13:9566-9581. [PMID: 33714953 PMCID: PMC8064182 DOI: 10.18632/aging.202690] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 11/20/2020] [Indexed: 12/12/2022]
Abstract
Radiation therapy is an effective method in the management of esophageal cancer. MicroRNAs (miRNAs) have been reported to play an important role in tumorigenesis. However, the roles of specific miRNAs in radioresistant esophageal cancer remain to be investigated. In present study, the relative expression level of miR-20b-5p and miR-125a-5p were evaluated by quantitative Real-time polymerase chain reaction. Cell counting Kit-8 assay, wound-healing assay, transwell assay were used to assess cell proliferation, cell migration and cell invasion. TUNEL and Annexin V-FITC assays were applied to evaluate cell apoptosis. Dual-luciferase reporter gene assay was conducted to identify direct targets of miRNAs. The protein expression level was assessed by Western blot. The results indicated that miR-20b-5p was increased in radioresistant KYSE-150R cells compared with KYSE-150 cells, whereas miR-125a-5p was downregulated. MiR-20b-5p upregulation promoted cell proliferation, migration, invasion, and the EMT process, and decreased apoptosis by negatively regulating PTEN. MiR-125a-5p inhibited cell proliferation, migration, invasion, the EMT process and it induced apoptosis by negatively regulating IL6R. These data indicate that miR-20b-5p and miR-125a-5p promote tumorigenesis in radioresistant KYSE-150R cells and have the potential to be used as novel therapeutic targets for the treatment of esophageal cancer.
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Affiliation(s)
- Didi Chen
- Department of Radiation and Medical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Huafang Su
- Department of Radiation and Medical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yunhao Li
- Department of Radiation and Medical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xinyi Wu
- Department of Radiation and Medical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yifei Li
- Department of Radiation and Medical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Chaoyi Wei
- Department of Radiation and Medical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Deli Shi
- Department of Radiation and Medical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ya Gao
- Department of Radiation and Medical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Qingyu Zhou
- Department of Radiation and Medical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Qiongqiong Wang
- Department of Radiation and Medical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiance Jin
- Department of Radiation and Medical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Congying Xie
- Department of Radiation and Medical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
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Chehrazi-Raffle A, Meza L, Alcantara M, Dizman N, Bergerot P, Salgia N, Hsu J, Ruel N, Salgia S, Malhotra J, Karczewska E, Kortylewski M, Pal S. Circulating cytokines associated with clinical response to systemic therapy in metastatic renal cell carcinoma. J Immunother Cancer 2021; 9:jitc-2020-002009. [PMID: 33688021 PMCID: PMC7944971 DOI: 10.1136/jitc-2020-002009] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2020] [Indexed: 12/22/2022] Open
Abstract
Background Circulating cytokines and angiogenic factors have been associated with clinical outcomes in patients with metastatic renal cell carcinoma (RCC) receiving systemic therapy. However, none have yet examined cytokine concentrations in parallel cohorts receiving either immunotherapy or targeted therapy. Methods In this prospective correlative study, we enrolled 56 patients who were planned for treatment with either a vascular endothelial growth factor-tyrosine kinase inhibitor (VEGF-TKI) or immune checkpoint inhibitor (ICI). Eligibility requirements permitted any RCC histologic subtype, International Metastatic Renal Cell Carcinoma risk classification, and line of therapy. Immunologic profile was assessed at baseline and after 1 month on treatment using a Human Cytokine 30-plex protein assay (Invitrogen). Clinical benefit was defined as complete response, partial response, or stable disease ≥6 months per RECIST (Response Evaluation Criteria in Solid Tumors) V.1.1 criteria. Results Clinical benefit was similar between VEGF-TKI and ICI arms (65% vs 54%). Patients with clinical benefit from VEGF-TKIs had lower pretreatment levels of interleukin-6 (IL-6) (p=0.02), IL-1RA (p=0.03), and granulocyte colony-stimulating factor (CSF) (p=0.02). At 1 month, patients with clinical benefit from ICIs had higher levels of interferon-γ (IFN-γ) (p=0.04) and IL-12 (p=0.03). Among patients on VEGF-TKIs, those with clinical benefit had lower 1 month IL-13 (p=0.02) and granulocyte macrophage CSF (p=0.01) as well as higher 1 month VEGF (p=0.04) compared with patients with no clinical benefit. Conclusion For patients receiving VEGF-TKI or ICI therapy, distinct plasma cytokines were associated with clinical benefit. Our findings support additional investigation into plasma cytokines as biomarkers in metastatic RCC.
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Affiliation(s)
- Alexander Chehrazi-Raffle
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Luis Meza
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Marice Alcantara
- Department of Immuno-Oncology, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Nazli Dizman
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Paulo Bergerot
- Department of Medical Oncology, Cettro Cancer Center, Brasilia, Brazil
| | - Nicholas Salgia
- Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, Brazil
| | - JoAnn Hsu
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Nora Ruel
- Department of Computational and Quantitative Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Sabrina Salgia
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Jasnoor Malhotra
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Ewa Karczewska
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Marcin Kortylewski
- Department of Immuno-Oncology, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Sumanta Pal
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, California, USA
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13
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Sepe P, Martinetti A, Mennitto A, Verzoni E, Claps M, Raimondi A, Sottotetti E, Grassi P, Guadalupi V, Stellato M, Zattarin E, Di Maio M, Procopio G. Prospective Translational Study Investigating Molecular PrEdictors of Resistance to First-Line PazopanIb in Metastatic reNal CEll Carcinoma (PIPELINE Study). Am J Clin Oncol 2020; 43:621-627. [PMID: 32889831 DOI: 10.1097/coc.0000000000000719] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Despite the initial clinical benefit, resistance to antiangiogenic therapies develops through the activation of alternative pathways. We measured plasma levels of circulating angiogenic factors to explore their predictive role in metastatic renal cell carcinoma (mRCC) patients treated with pazopanib. MATERIALS AND METHODS mRCC patients receiving first-line pazopanib were prospectively enrolled. The levels of circulating interleuchine (IL)-6, IL-8, stromal derived factor-1, vascular endothelial growth factor-A, hepatocyte growth factor (HGF), osteopontin, and E-selectin were quantified at baseline and every 4 weeks until disease progression (PD). Patients were dichotomized into "low" and "high" subgroups by a cutoff point defined by the respective median circulating angiogenic factor (CAF) value at baseline. Then, association with the objective response was determined. Changes in CAF levels between baseline and PD were also compared. RESULTS Among 25 patients included in the final data set, 6 patients were still on treatment. As best response, 12 patients presented a partial response (48%), 9 showed stable disease, and 4 showed PD. The median follow-up was 31.9 months. The median progression-free survival was 14.8 months. Low baseline levels of IL-6, IL-8, HGF, and osteopontin were found to be significantly associated with objective response. In addition, patients with low baseline levels of HGF showed longer progression-free survival and overall survival, whereas patients with low baseline levels of IL-8 showed longer overall survival. Among patients experiencing PD, the median plasma levels of stromal derived factor-1 and vascular endothelial growth factor-A were significantly higher compared with the baseline (P=0.01; P=0.011). Conversely, the median levels of E-selectin were significantly lower compared with the baseline (P=0.017). CONCLUSION Changes in levels of selected CAFs were associated with response/resistance to pazopanib in mRCC patients.
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Affiliation(s)
- Pierangela Sepe
- Department of Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan
| | - Antonia Martinetti
- Department of Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan
| | - Alessia Mennitto
- Department of Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan
| | - Elena Verzoni
- Department of Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan
| | - Melanie Claps
- Department of Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan
| | - Alessandra Raimondi
- Department of Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan
| | - Elisa Sottotetti
- Department of Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan
| | - Paolo Grassi
- Department of Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan
| | - Valentina Guadalupi
- Department of Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan
| | - Marco Stellato
- Department of Medical Oncology, Campus Bio-Medico University of Rome, Rome
| | - Emma Zattarin
- Department of Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan
| | - Massimo Di Maio
- Department of Oncology, Ordine Mauriziano Hospital, University of Turin, Turin, Italy
| | - Giuseppe Procopio
- Department of Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan
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14
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Nader Marta G, Isaacsson Velho P, Bonadio RRC, Nardo M, Faraj SF, de Azevedo Souza MCL, Muniz DQB, Bastos DA, Dzik C. Prognostic Value of Systemic Inflammatory Biomarkers in Patients with Metastatic Renal Cell Carcinoma. Pathol Oncol Res 2020; 26:2489-2497. [DOI: 10.1007/s12253-020-00840-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 06/10/2020] [Indexed: 12/20/2022]
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15
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Assaad S, Avrillon V, Fournier ML, Mastroianni B, Russias B, Swalduz A, Cassier P, Eberst L, Steineur MP, Kazes M, Perol M, Michallet AS, Rey P, Erena-Penet AS, Morel A, Brahmi M, Dufresne A, Tredan O, Chvetzoff G, Fayette J, de la Fouchardiere C, Ray-Coquard I, Bachelot T, Saintigny P, Tabutin M, Dupré A, Nicolas-Virelizier E, Belhabri A, Roux PE, Fuhrmann C, Pilleul F, Basle A, Bouhamama A, Galvez C, Herr AL, Gautier J, Chabaud S, Zrounba P, Perol D, Blay JY. High mortality rate in cancer patients with symptoms of COVID-19 with or without detectable SARS-COV-2 on RT-PCR. Eur J Cancer 2020; 135:251-259. [PMID: 32540204 PMCID: PMC7275994 DOI: 10.1016/j.ejca.2020.05.028] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/22/2020] [Accepted: 05/31/2020] [Indexed: 02/06/2023]
Abstract
Background Cancer patients presenting with COVID-19 have a high risk of death. In this work, predictive factors for survival in cancer patients with suspected SARS-COV-2 infection were investigated. Methods PRE-COVID-19 is a retrospective study of all 302 cancer patients presenting to this institute with a suspicion of COVID-19 from March 1st to April 25th 2020. Data were collected using a web-based tool within electronic patient record approved by the Institutional Review Board. Patient characteristics symptoms and survival were collected and compared in SARS-COV-2 real-time or reverse-transcriptase PCR (RT-PCR)–positive and RT-PCR–negative patients. Results Fifty-five of the 302 (18.2%) patients with suspected COVID-19 had detectable SARS-COV-2 with RT-PCR in nasopharyngeal samples. RT-PCR–positive patients were older, had more frequently haematological malignancies, respiratory symptoms and suspected COVID-19 pneumonia of computed tomography (CT) scan. However, respectively, 38% and 20% of SARS-COV-2 RT-PCR–negative patients presented similar respiratory symptoms and CT scan images. Thirty of the 302 (9.9%) patients died during the observation period, including 24 (80%) with advanced disease. At the median follow-up of 25 days after the first symptoms, the death rate in RT-PCR–positive and RT-PCR–negative patients were 21% and 10%, respectively. In both groups, independent risk factors for death were male gender, Karnofsky performance status <60, cancer in relapse and respiratory symptoms. Detection of SARS-COV-2 on RT-PCR was not associated with an increased death rate (p = 0.10). None of the treatment given in the previous month (including cytotoxics, PD1 Ab, anti-CD20, VEGFR2…) correlated with survival. The survival of RT-PCR–positive and –negative patients with respiratory symptoms and/or COVID-19 type pneumonia on CT scan was similar with a 18.4% and 19.7% death rate at day 25. Most (22/30, 73%) cancer patients dying during this period were RT-PCR negative. Conclusion The 30-day death rate of cancer patients with or without documented SARS-COV-2 infection is poor, but the majority of deaths occur in RT-PCR–negative patients.
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Affiliation(s)
- Souad Assaad
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Virginie Avrillon
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Marie-Line Fournier
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Benedicte Mastroianni
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Bruno Russias
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Aurélie Swalduz
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Philippe Cassier
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Lauriane Eberst
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Marie-Pierre Steineur
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Marianne Kazes
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Maurice Perol
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Anne-Sophie Michallet
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Philippe Rey
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Anne-Sophie Erena-Penet
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Astrid Morel
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Mehdi Brahmi
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Armelle Dufresne
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Olivier Tredan
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Gisèle Chvetzoff
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Jérome Fayette
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Christelle de la Fouchardiere
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Isabelle Ray-Coquard
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Thomas Bachelot
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Pierre Saintigny
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Mayeul Tabutin
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Aurélien Dupré
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Emmanuelle Nicolas-Virelizier
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Amine Belhabri
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Pierre-Eric Roux
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Christine Fuhrmann
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Franck Pilleul
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Alexandre Basle
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Amine Bouhamama
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Christelle Galvez
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Andrée-Laure Herr
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Julien Gautier
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Sylvie Chabaud
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Philippe Zrounba
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - David Perol
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France
| | - Jean-Yves Blay
- Centre Léon Bérard, 28 Rue Laënnec, 69373, Lyon Cedex 08, France; Université Claude Bernard Lyon I, France; Unicancer, Paris, France.
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Tjokrowidjaja A, Goldstein D, Hudson HM, Lord SJ, Gebski V, Clarke S, de Souza P, Motzer RJ, Lee CK. The impact of neutrophil-lymphocyte ratio on risk reclassification of patients with advanced renal cell cancer to guide risk-directed therapy. Acta Oncol 2020; 59:20-27. [PMID: 31462137 DOI: 10.1080/0284186x.2019.1656342] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background: An elevated neutrophil-lymphocyte ratio (NLR) is associated with poor prognosis in advanced renal cell carcinoma (RCC). We examined whether the addition of NLR improves the risk reclassification of advanced RCC using current prognostic tools from the Memorial Sloan Kettering Cancer Center (MSKCC) and International Metastatic Renal Cell Carcinoma Database Consortium (IMDC).Methods: Using randomised data from the COMPARZ trial of first-line pazopanib vs. sunitinib in advanced RCC, we constructed multivariable models containing MSKCC and IMDC predictor variables with and without NLR. We evaluated model discrimination using the concordance index (C-index). We computed net reclassification improvement to quantify patient reclassification into low/intermediate/poor risk groups with the addition of NLR.Results: Of 1102 patients, NLR ≥ 5 (16%) was associated with shorter survival adjusting for MSKCC variables (adjusted HR 1.89, p < .001). Adding NLR to MSKCC variables increased the C-index by 0.01. Among patients who died before 24 months (N = 415), adding NLR reclassified 8% and 2% to a higher and lower risk category, respectively. Among those alive at 24 months (N = 636), adding NLR reclassified 4% and 1% to a higher and lower risk category, respectively. This finding translates to a net benefit of eight additional patients who die within 24 months correctly identified as poor risk per 1000 patients tested. We obtained similar results when evaluating NLR with IMDC variables.Conclusions: NLR does not substantially improve risk reclassification over pre-existing prognostic tools. MSKCC and IMDC classifications remain the standard for guiding risk-directed therapy and trial stratification of patients with advanced RCC.
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Affiliation(s)
- Angelina Tjokrowidjaja
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, Australia
- Cancer Care Centre, St George Hospital, Kogarah, Australia
| | - David Goldstein
- Translational Cancer Research Network, University of New South Wales, Sydney, Australia
- Nelune Cancer Centre, Prince of Wales Hospital, Randwick, Australia
| | - H. Malcolm Hudson
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, Australia
- Department of Statistics, Macquarie University, Macquarie Park, Australia
| | - Sarah J. Lord
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, Australia
- School of Medicine, The University of Notre Dame, Sydney, Australia
| | - Val Gebski
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, Australia
| | - Stephen Clarke
- Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Paul de Souza
- Department of Medical Oncology, Liverpool Hospital, Liverpool, Australia
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Robert J. Motzer
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Chee Khoon Lee
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, Australia
- Cancer Care Centre, St George Hospital, Kogarah, Australia
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17
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Cao DL, Dai WX, Huang YQ, Yu LJ, Wu JL, Shi GH, Zhang HL, Zhu Y, Dai B, Ye DW. Development and validation of a robust multigene signature as an aid to predict early relapse in stage I-III clear cell and papillary renal cell cancer. J Cancer 2020; 11:997-1007. [PMID: 31956346 PMCID: PMC6959077 DOI: 10.7150/jca.38274] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 11/14/2019] [Indexed: 01/07/2023] Open
Abstract
Background and objectives: Multi-gene signature can be used as prognostic indicator in many types of cancer, but the association with early-relapse in patients with stage I-III clear cell and papillary renal cell cancer (RCC) is unknown. We aim to establish a mRNAs signature for improving prediction of early-relapse in patients with stage I-III clear cell and papillary RCC. Methods: The data of 610 patients with stage I-III RCC from The Cancer Genome Atlas (TCGA) and 270 patients from Fudan University Shanghai Cancer Center (FUSCC) were extracted. Propensity score matching analysis, linear models for microarray data VOOM method, least absolute shrinkage and selection operation Cox regression modeling analysis was conducted in turn for selecting multi-mRNA signature. Survival differences were assessed by Kaplan-Meier estimate and compared using log-rank test. Multivariable Cox regression and time-dependent receiver operating characteristic curves were used to evaluate the association of mRNAs signature with relapse-free survival (RFS). Results: Seventeen mRNAs were identified to constitute the early-relapse signature. Among patients with stage I-III RCC, those with high-risk score calculated from 17 mRNAs signature showed shorter RFS than those with low-risk score, both in TCGA discovery and internal validation sets, and in FUSCC discovery and internal validation sets (all p < 0.05). In multivariable Cox regression analysis, the 17 mRNAs signature remained an independent prognostic factor both in TCGA discovery (HR 2.43, 95%CI 1.98-2.96) and internal validation sets (HR 1.66, 95%CI 1.19-2.30), and FUSCC discovery (HR 1.28, 95%CI 1.13-1.43) and internal validation sets (HR 1.65, 95%CI 1.11-2.48). Additionally, the 17 mRNAs signature achieved a higher accuracy for RFS estimation beyond clinical indicator. Conclusion: The 17 mRNAs signature could classify stage I-III RCC patients into low- or high-risk of early-relapse, and will help to guide interventions to optimize survival outcomes.
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Affiliation(s)
- Da-Long Cao
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Wei-Xing Dai
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Yong-Qiang Huang
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Lei-Jun Yu
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Jun-Long Wu
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Guo-Hai Shi
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Hai-Liang Zhang
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Yao Zhu
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Bo Dai
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Ding-Wei Ye
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
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18
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Song J, Xu S, Zhang ZH, Chen YH, Gao L, Xie DD, Sun GP, Yu DX, Xu DX. The correlation between low vitamin D status and renal interleukin-6/STAT3 hyper-activation in patients with clear cell renal cell carcinoma. Steroids 2019; 150:108445. [PMID: 31295461 DOI: 10.1016/j.steroids.2019.108445] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 04/18/2019] [Accepted: 04/29/2019] [Indexed: 10/26/2022]
Abstract
Low vitamin D status has been associated with increased risks of renal cell carcinoma (RCC). This study aimed to analyze the link between low vitamin D status and interleukin (IL)-6/STAT3 hyper-activation in clear cell RCC (ccRCC) patients. Forty-three newly diagnosed ccRCC patients and 86 age- and sex-matched controls were recruited. The association between low vitamin D status and IL-6/STAT3 hyper-activation was analyzed. Proliferation makersand STAT3 signal were evaluated. As expected, serum IL-6 level was higher in ccRCC patients than in controls. Moreover, serum IL-6 level was reversely correlated with serum 25(OH)D in ccRCC patients but not in controls. In addition, STAT3 signaling was hyper-activated in cancerous tissue. CcRCC patients were divided into three groups according to serum 25(OH)D level: vitamin D sufficiency (VitD-S, ≥30 ng/ml), vitamin D insufficiency (VitD-I, ≥20 and <30 ng/ml) or vitamin D deficiency (VitD-D, <20 ng/ml). Serum IL-6 was higher in ccRCC patients with VitD-D than those with VitD-S/VitD-I. Cancerous pSTAT3 level was higher in ccRCC patients with VitD-D than those with VitD-S/VitD-I. The number of pSTAT3+ nuclei in cancerous tissue was more in ccRCC patients with VitD-D than those with VitD-S/VitD-I. The expressions of cancerous PCNA, cyclin D1 and Ki-67, three markers of proliferation, were higher in ccRCC patients with VitD-D than those with VitD-S/VitD-I. The in vitro experiments showed that active vitamin D3 inhibited LPS-induced STAT3 phosphorylation in ACHN cells. Our results provide evidence that low vitamin D status is correlated with hyper-activation of cancerous IL-6/STAT3 and proliferation in ccRCC patients.
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Affiliation(s)
- Jin Song
- Department of Urology, Second Affiliated Hospital, Anhui Medical University, Hefei 230022, China
| | - Shen Xu
- Department of Oncology, First Affiliated Hospital, Anhui Medical University, Hefei 230022, China
| | - Zhi-Hui Zhang
- Department of Urology, Second Affiliated Hospital, Anhui Medical University, Hefei 230022, China
| | - Yuan-Hua Chen
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Lan Gao
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Dong-Dong Xie
- Department of Urology, Second Affiliated Hospital, Anhui Medical University, Hefei 230022, China
| | - Guo-Ping Sun
- Department of Oncology, First Affiliated Hospital, Anhui Medical University, Hefei 230022, China
| | - De-Xin Yu
- Department of Urology, Second Affiliated Hospital, Anhui Medical University, Hefei 230022, China.
| | - De-Xiang Xu
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei 230032, China.
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19
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Wang Y, Zhang Y. Prognostic role of interleukin-6 in renal cell carcinoma: a meta-analysis. Clin Transl Oncol 2019; 22:835-843. [DOI: 10.1007/s12094-019-02192-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 07/25/2019] [Indexed: 12/18/2022]
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20
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Kleczko EK, Kwak JW, Schenk EL, Nemenoff RA. Targeting the Complement Pathway as a Therapeutic Strategy in Lung Cancer. Front Immunol 2019; 10:954. [PMID: 31134065 PMCID: PMC6522855 DOI: 10.3389/fimmu.2019.00954] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 04/15/2019] [Indexed: 12/20/2022] Open
Abstract
Lung cancer is the leading cause of cancer death in men and women. Lung adenocarcinoma (LUAD), represents approximately 40% of all lung cancer cases. Advances in recent years, such as the identification of oncogenes and the use of immunotherapies, have changed the treatment of LUAD. Yet survival rates still remain low. Additionally, there is still a gap in understanding the molecular and cellular interactions between cancer cells and the immune tumor microenvironment (TME). Defining how cancer cells with distinct oncogenic drivers interact with the TME and new strategies for enhancing anti-tumor immunity are greatly needed. The complement cascade, a central part of the innate immune system, plays an important role in regulation of adaptive immunity. Initially it was proposed that complement activation on the surface of cancer cells would inhibit cancer progression via membrane attack complex (MAC)-dependent killing. However, data from several groups have shown that complement activation promotes cancer progression, probably through the actions of anaphylatoxins (C3a and C5a) on the TME and engagement of immunoevasive pathways. While originally shown to be produced in the liver, recent studies show localized complement production in numerous cell types including immune cells and tumor cells. These results suggest that complement inhibitory drugs may represent a powerful new approach for treatment of NSCLC, and numerous new anti-complement drugs are in clinical development. However, the mechanisms by which complement is activated and affects tumor progression are not well understood. Furthermore, the role of local complement production vs. systemic activation has not been carefully examined. This review will focus on our current understanding of complement action in LUAD, and describe gaps in our knowledge critical for advancing complement therapy into the clinic.
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Affiliation(s)
- Emily K Kleczko
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Jeff W Kwak
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Erin L Schenk
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Raphael A Nemenoff
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
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21
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Elevated plasma interleukin 6 predicts poor response in patients treated with sunitinib for metastatic clear cell renal cell carcinoma. Cancer Treat Res Commun 2019; 19:100127. [PMID: 30913495 DOI: 10.1016/j.ctarc.2019.100127] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 03/05/2019] [Accepted: 03/13/2019] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Clear cell renal cell carcinoma (ccRCC) is the most common type among renal cell carcinomas, and anti-angiogenic treatment is currently first line therapy in metastatic ccRCC (mccRCC). Response rates and duration of response show considerable variation, and adverse events have major influence on patient's quality of life. The need for predictive biomarkers to select those patients most likely to respond to receptor tyrosine kinase inhibitors (rTKI) upfront is urgent. We investigated the predictive value of plasma interleukin-6 (pIL6), interleukin-6 receptor α (pIL6Rα) and interleukin 6 signal transducer (pIL6ST) in mccRCC patients treated with sunitinib. MATERIAL AND METHODS Forty-six patients with metastatic or non-resectable ccRCC treated with sunitinib were included. Full blood samples were collected at baseline before start of sunitinib and after every second cycle of treatment during the study time. pIL6, pIL6R and pIL6ST at baseline and week 12 samples were analysed by ELISA. The predictive potential of the candidate markers was assessed by correlation with response rates (RECIST). In addition, progression free survival (PFS) and overall survival (OS) were analysed. RESULTS Low pIL6 at baseline was significantly associated with improved response to sunitinib (Fisher's exact test, p < 0.01). Furthermore, low pIL6 at baseline was significantly associated with improved PFS (log rank, p = 0.04). In addition, patients with a decrease in concentration of pIL6R between baseline and week 12 showed significantly improved PFS (log rank, p = 0.04) and patients with high pIL6ST at baseline showed significantly improved OS (log rank, p = 0.03). CONCLUSION Low pIL6 at baseline in mccRCC patients treated with sunitinib predicts improved treatment response, and might represent a candidate predictive marker.
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22
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Yang L, Yu X, Yang Y. Autotaxin upregulated by STAT3 activation contributes to invasion in pancreatic neuroendocrine neoplasms. Endocr Connect 2018; 7:1299-1307. [PMID: 30352421 PMCID: PMC6240148 DOI: 10.1530/ec-18-0356] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Accepted: 10/10/2018] [Indexed: 12/14/2022]
Abstract
Although the upregulation of autotaxin (ATX) is associated with many solid tumours, its role in pancreatic neuroendocrine neoplasms (pNEN) has not been well elucidated. The expression of ATX in pNEN tissues and pNEN cell line BON1 was analysed by Western blot, PCR and immunocytochemistry upon exposure to interleukin-6 (IL-6). Additionally, pNEN cell line BON1 was transfected with siRNAs against ATX or signal transducer and activator of transcription 3 (STAT3) and assessed by in vitro invasion assays. The following results were obtained. The expression of ATX in pNEN tissues was significantly increased compared with that in normal pancreatic tissues. High ATX expression was strongly correlated with tumour grade, lymph node metastasis and tumour-node-metastasis stage. Furthermore, ATX downregulation notably inhibited the metastatic capacity of pNEN cells, whereas STAT3 knockdown was found to downregulate the expression of ATX. ATX expression was upregulated in BON1 cells upon stimulation with IL-6, and this was accompanied by activation/phosphorylation of STAT3. Western blot analysis of human pNEN tissue extracts confirmed increased ATX expression and STAT3 phosphorylation with elevated expression levels of IL-6. In conclusion, ATX is upregulated in pNEN and is correlated with the metastatic capacity of pNEN cells, potentially via interaction with STAT3 activation.
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Affiliation(s)
- Linfei Yang
- Center for Medical Experiments, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Xiao Yu
- Department of General Surgery, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Yongchao Yang
- Department of Burns and Plastic Surgery, The Third Xiangya Hospital, Central South University, Changsha, China
- European Pancreas Center, Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
- Correspondence should be addressed to Y Yang:
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23
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Ishibashi K, Koguchi T, Matsuoka K, Onagi A, Tanji R, Takinami-Honda R, Hoshi S, Onoda M, Kurimura Y, Hata J, Sato Y, Kataoka M, Ogawsa S, Haga N, Kojima Y. Interleukin-6 induces drug resistance in renal cell carcinoma. Fukushima J Med Sci 2018; 64:103-110. [PMID: 30369518 DOI: 10.5387/fms.2018-15] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Metastatic renal cell carcinoma (mRCC) is a tumor entity with poor prognosis due to limited therapy options. Tyrosine kinase inhibitors (TKIs), the novel targeted agents have been used for the treatment of mRCC and have shown efficacy. Interferon (IFN)-α is also one of the most frequently used agents in immunotherapy. However, drug resistance needs to be overcome to achieve a sufficiently positive effect. Interleukin-6 (IL-6), which induce suppressor of cytokine signaling-3 (SOCS3) expression, is one of the factors associated with poor prognosis of patients with renal cell carcinoma (RCC). To analyze the influence of IL-6 in drug resistance of RCC, anti-IL-6 receptor antibody was used in combination with IFN or TKIs. The SOCS3 mRNA expression level was significantly increased by IFN-α stimulation in 786-O RCC cells which were resistant to IFN, but not in ACHN cells that were sensitive to IFN. The overexpression of SOCS3 by gene transfection in ACHN significantly inhibited the growth-inhibitory effect of IFN-α. An in vivo study demonstrated that co-administration of SOCS3-targeted siRNA promoted INF-α-induced cell death and growth suppression in 786-O cell xenograft. SOCS3 could be a key component in the resistance to interferon treatment of renal cell carcinoma. Because SOCS3 is rapidly up-regulated by IL-6 and a negative regulator of cytokine signaling, IL-6 expression on RCC cells was also analyzed and the 786-O cells showed the high level of IL-6 mRNA expression under the condition of interferon stimulation. IL-6R antibody, tocilizumab, significantly suppressed cell proliferation in 786-O cells by interferon stimulation accompanied with phosphorylation of STAT1 and inhibited SOCS3 expression. The in vivo effects of combination therapy with tocilizumab and interferon showed significant suppression of 786-O tumor growth in a xenograft model. We also hypothesized that TKI resistance and IL-6 secretion are causally connected. And we found that 786-O RCC cells secrete high IL-6 levels after low dose stimulation with the TKIs sorafenib, sunitinib and pazopanib, inducing activation of AKT-mTOR pathway, NFκB, HIF-2α and VEGF expression. Tocilizumab neutralizes the AKT-mTOR pathway activation and results in reduced proliferation. A combination therapy with tocilizumab and TKI suppresses 786-O tumor growth and inhibits angiogenesis in vivo more efficient than TKI alone. Our findings suggest that IL-6 could induce drug resistance on RCC, and combination therapy of IL-6R inhibitors and IFN/TKIs may represent a novel therapeutic approach for RCC treatment.
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Affiliation(s)
- Kei Ishibashi
- Department of Urology, Fukushima Medical University School of Medicine
| | - Tomoyuki Koguchi
- Department of Urology, Fukushima Medical University School of Medicine
| | - Kanako Matsuoka
- Department of Urology, Fukushima Medical University School of Medicine
| | - Akifumi Onagi
- Department of Urology, Fukushima Medical University School of Medicine
| | - Ryo Tanji
- Department of Urology, Fukushima Medical University School of Medicine
| | | | - Seiji Hoshi
- Department of Urology, Fukushima Medical University School of Medicine
| | - Mitsutaka Onoda
- Department of Urology, Fukushima Medical University School of Medicine
| | | | - Junya Hata
- Department of Urology, Fukushima Medical University School of Medicine
| | - Yuichi Sato
- Department of Urology, Fukushima Medical University School of Medicine
| | - Masao Kataoka
- Department of Urology, Fukushima Medical University School of Medicine
| | - Soichiro Ogawsa
- Department of Urology, Fukushima Medical University School of Medicine
| | - Nobuhiro Haga
- Department of Urology, Fukushima Medical University School of Medicine
| | - Yoshiyuki Kojima
- Department of Urology, Fukushima Medical University School of Medicine
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24
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Yabe M, Ishibashi K, Onagi A, Tanji R, Honda-Takinami R, Koguchi T, Matsuoka K, Hoshi S, Hata J, Kataoka M, Ogawa S, Hiraki H, Haga N, Kojima Y. Suppression of SOCS3 enhances TRAIL-induced cell growth inhibition through the upregulation of DR4 expression in renal cell carcinoma cells. Oncotarget 2018; 9:31697-31708. [PMID: 30167088 PMCID: PMC6114968 DOI: 10.18632/oncotarget.25851] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 07/13/2018] [Indexed: 12/13/2022] Open
Abstract
Background Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) is a tumor-selective apoptosis inducer that is expressed in natural killer cells, whose cytotoxicity is activated by interferon (IFN). We investigated the effect of suppressor of cytokine signaling (SOCS) 3 on the expression of TRAIL receptors (DR4) and on TRAIL sensitivity in renal cell carcinoma (RCC) cells. Methods Vector expression, RNA interference and IL-6 receptor antibody tocilizumab were used to investigate the functional role of SOCS3 in DR4 expression. Immunoprecipitation was employed to detect the biochemical interaction between SOCS3 and DR4. The expression of DR4 induced by combination with IFN-α and tocilizumab was also examined by immunohistochemical staining using mice xenograft model. Results DR4 expression was up-regulated by IFN stimulation in RCC cells. 786-O cells were resistant to TRAIL and showed higher SOCS3 expression. ACHN cells showed higher DR4 expression and lower SOCS3 expression. Suppression of SOCS3 up-regulated DR4 expression and enhanced the TRAIL sensitivity in 786-O cells. In ACHN cells, DR4 expression was down-regulated by transfection with pCI-SOCS3, and the cells became resistant to TRAIL. Immunoprecipitation revealed the biochemical interaction between SOCS3 and DR4. A marked increase in IFN-induced DR4 protein expression after tocilizumab treatment was observed by immunohistochemical staining in the tumor from the mice xenograft model. Conclusions Our results indicate that IFN and SOCS3 regulate DR4 expression in RCC cells. Combination therapy with IFN-α, tocilizumab and an anti-DR4 agonistic ligand appears to effectively inhibit advanced RCC cell growth.
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Affiliation(s)
- Michihiro Yabe
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kei Ishibashi
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Akifumi Onagi
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Ryo Tanji
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Ruriko Honda-Takinami
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tomoyuki Koguchi
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kanako Matsuoka
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Seiji Hoshi
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Junya Hata
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Masao Kataoka
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Soichiro Ogawa
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hiroyuki Hiraki
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Nobuhiro Haga
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yoshiyuki Kojima
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
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25
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Yang Y, Yang L, Li Y. Neuropilin-1 (NRP-1) upregulated by IL-6/STAT3 signaling contributes to invasion in pancreatic neuroendocrine neoplasms. Hum Pathol 2018; 81:192-200. [PMID: 30420046 DOI: 10.1016/j.humpath.2018.06.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 06/19/2018] [Accepted: 06/22/2018] [Indexed: 12/18/2022]
Abstract
Although the upregulation of Neuropilin-1 (NRP-1) is associated with many solid tumors, its role in pancreatic neuroendocrine neoplasms (pNEN) has not been well elucidated. The aim of this study was to investigate the role of NRP-1 in improving treatment and determining the prognosis of pNEN. In this study, the expression of NRP-1 in pNEN tissue samples and pNEN cell line BON1 was analyzed by Western blot, polymerase chain reaction (PCR) and immunocytochemistry upon exposure to interleukin-6 (IL-6). Additionally, pNEN cell line BON1 was transfected with small interfering RNAs against NRP-1 or signal transducer and activator of transcription 3 (STAT3) and assessed by in vitro invasion assays. The expression of NRP-1 in pNEN tissues was markedly increased compared with adjacent normal pancreatic tissues. High NRP-1 expression was strongly correlated with tumor grades (P = .026), lymph node metastasis (P = .025), and tumor-node-metastasis stages (P = .012). Furthermore, NRP-1 downregulation notably inhibited the metastatic capacity of pNEN cells, and STAT3 knockdown was found to downregulate the expression of NRP-1. BON1 cells upregulated NRP-1 expression upon stimulation with IL-6. This was accompanied by activation/phosphorylation of the AKT and STAT3 signaling pathways. Western blot of extracts of human pNENs confirmed increased NRP-1 expression, as well as AKT/STAT3 phosphorylation in tissue of pNENs with elevated expression levels of IL-6. In conclusion, our findings suggest that NRP-1 is upregulated in pNEN and is correlated with the metastatic capacity of pNEN cells, potentially via interaction with the IL-6/STAT3 signaling pathway.
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Affiliation(s)
- Yongchao Yang
- Department of General Surgery, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Linfei Yang
- Center for Medical Experiments, Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - Yixiong Li
- Department of General Surgery, Xiangya Hospital, Central South University, Changsha 410008, China.
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26
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Abstract
Metastatic renal cell carcinoma (mRCC) is an incurable malignancy, characterized by its resistance to traditional chemotherapy, radiation, and hormonal therapy. Treatment perspectives and prognosis of patients with mRCC have been significantly improved by advances in the understanding of its molecular pathogenesis, which have led to the development of targeted therapeutics. Different molecular factors derived from the tumor or the host detected in both tissue or serum could be predictive of therapeutic benefit. Some of them suggest a rational selection of patients to be treated with certain therapies, though none have been validated for routine use. This article provides an overview of both clinical and molecular factors associated with predictive or prognostic value in mRCC and emphasizes that both should be considered in parallel to provide the most appropriate, individualized treatment and achieve the best outcomes in clinical practice.
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27
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Setrerrahmane S, Xu H. Tumor-related interleukins: old validated targets for new anti-cancer drug development. Mol Cancer 2017; 16:153. [PMID: 28927416 PMCID: PMC5606116 DOI: 10.1186/s12943-017-0721-9] [Citation(s) in RCA: 149] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 09/05/2017] [Indexed: 02/07/2023] Open
Abstract
In-depth knowledge of cancer molecular and cellular mechanisms have revealed a strong regulation of cancer development and progression by the inflammation which orchestrates the tumor microenvironment. Immune cells, residents or recruited, in the inflammation milieu can have rather contrasting effects during cancer development. Accumulated clinical and experimental data support the notion that acute inflammation could exert an immunoprotective effect leading to tumor eradication. However, chronic immune response promotes tumor growth and invasion. These reactions are mediated by soluble mediators or cytokines produced by either host immune cells or tumor cells themselves. Herein, we provide an overview of the current understanding of the role of the best-validated cytokines involved in tumor progression, IL-1, IL-4 and IL-6; in addition to IL-2 cytokines family, which is known to promote tumor eradication by immune cells. Furthermore, we summarize the clinical attempts to block or bolster the effect of these tumor-related interleukins in anti-cancer therapy development.
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Affiliation(s)
- Sarra Setrerrahmane
- The Engineering Research Center of Peptide Drug Discovery and Development, China Pharmaceutical University, Nanjing, Jiangsu, 210009, People's Republic of China
| | - Hanmei Xu
- The Engineering Research Center of Peptide Drug Discovery and Development, China Pharmaceutical University, Nanjing, Jiangsu, 210009, People's Republic of China. .,State Key Laboratory of Natural Medicines, Ministry of Education, China Pharmaceutical University, Nanjing, Jiangsu, 210009, People's Republic of China.
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28
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Cai W, Chen QY, Dang LH, Luesch H. Apratoxin S10, a Dual Inhibitor of Angiogenesis and Cancer Cell Growth To Treat Highly Vascularized Tumors. ACS Med Chem Lett 2017; 8:1007-1012. [PMID: 29057042 DOI: 10.1021/acsmedchemlett.7b00192] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 09/06/2017] [Indexed: 11/30/2022] Open
Abstract
Renal, hepatocellular, and neuroendocrine carcinomas are known as highly vascularized tumors. Although vascular endothelial growth factor A (VEGF-A)-targeted therapies have shown efficacy in the treatment of these cancers, drug resistance is a major concern and might be mediated by interleukin 6 (IL-6). Furthermore, upon antiangiogenic drug exposure, tumor cells may adapt to survive in a vascular-independent manner. Apratoxins are potent marine-derived cytotoxic in vivo-active agents, preventing cotranslational translocation in the secretory pathway, and show promise to overcome resistance by targeting angiogenesis and tumor growth simultaneously. We designed and synthesized a novel apratoxin analogue, apratoxin S10, with a balanced potency and stability as well as synthetic accessibility and scalability. We showed that apratoxin S10 potently inhibits both angiogenesis in vitro and growth of cancer cells from vascularized tumors. Apratoxin S10 down-regulated vascular endothelial growth factor receptor 2 (VEGFR2) on endothelial cells and blocked the secretion of VEGF-A and IL-6 from cancer cells. It inhibited cancer cell growth through down-regulation of multiple receptor tyrosine kinases (RTKs) and compares favorably to currently approved RTK inhibitors in both angiogenesis and cancer cell growth.
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Affiliation(s)
- Weijing Cai
- Department
of Medicinal Chemistry, ‡Center for Natural Products, Drug Discovery
and Development (CNPD3), and ∥Department of Medicine, University of Florida, Gainesville, Florida 32610, United States
| | - Qi-Yin Chen
- Department
of Medicinal Chemistry, ‡Center for Natural Products, Drug Discovery
and Development (CNPD3), and ∥Department of Medicine, University of Florida, Gainesville, Florida 32610, United States
| | - Long H. Dang
- Department
of Medicinal Chemistry, ‡Center for Natural Products, Drug Discovery
and Development (CNPD3), and ∥Department of Medicine, University of Florida, Gainesville, Florida 32610, United States
| | - Hendrik Luesch
- Department
of Medicinal Chemistry, ‡Center for Natural Products, Drug Discovery
and Development (CNPD3), and ∥Department of Medicine, University of Florida, Gainesville, Florida 32610, United States
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29
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Négrier S, Pérol D, Bahleda R, Hollebecque A, Chatelut E, Boyle H, Cassier P, Metzger S, Blanc E, Soria JC, Escudier B. Phase I dose-escalation study of pazopanib combined with bevacizumab in patients with metastatic renal cell carcinoma or other advanced tumors. BMC Cancer 2017; 17:547. [PMID: 28810837 PMCID: PMC5558713 DOI: 10.1186/s12885-017-3527-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 08/01/2017] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Vascular endothelial growth factor (VEGF) directed therapies are being used in a large number of advanced tumors. Metastatic renal cell carcinoma (mRCC) is highly dependent on the VEGF pathway; VEGF receptor (VEGFR) tyrosine kinase inhibitors (TKI) and humanized VEGF monoclonal antibody have been registered for clinical use in advanced renal cell carcinoma. The VEGFR TKI, pazopanib, with a rather manageable toxicity profile, was preferred to sunitinib by mRCC patients. We investigate the combination of pazopanib and bevacizumab to determine the maximum tolerated dose (MTD) in mRCC and other advanced solid tumors. METHODS In this bicentric phase I trial with a 3 + 3 + 3 dose-escalation design, patients received oral pazopanib once daily plus intravenous infusion of bevacizumab every 2 weeks from D15, at one of the four dose levels (DL) planned according to the occurrence of dose limiting toxicities (DLT). 400 and 600 mg pazopanib were respectively combined with 7.5 mg/kg bevacizumab in DL1 and DL2, and 600 and 800 mg pazopanib with 10 mg/kg bevacizumab in DL3 and DL4. Tumor response was evaluated every 8 weeks. Blood samples were assayed to investigate pazopanib pharmacokinetics. RESULTS Twenty five patients including seven mRCC were enrolled. Nine patients received the DL1, ten received the DL2. No DLT were observed at DL1, five DLT at DL2, and 3 DLT in the six additional patients who received the DL1. A grade 3 microangiopathic hemolytic anemia syndrome was observed in four (16%) patients. Five (22%) patients achieved a partial response. The mean (range) plasmatic concentrations of 400 and 600 pazopanib were respectively 283 (139-427) and 494 (227-761) μg.h/mL at Day 1, and 738 (487-989) and 1071 (678-1464) μg.h/mL at Day 15 i.e. higher than those previously reported with pazopanib, and were not directly influenced by bevacizumab infusion. CONCLUSIONS The combination of pazopanib and bevacizumab induces angiogenic toxicity in patients without any pre-existing renal or vascular damage. Even if a marginal efficacy was reported with five (22%) patients in partial response in different tumor types, the toxicity profile compromises the development of this combination. TRIAL REGISTRATION The study was retrospectively registered on ClinicalTrials.gov (number NCT01202032 ) on 2010, Sept 14th.
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Affiliation(s)
- Sylvie Négrier
- University Lyon, Université Claude Bernard Lyon 1, Centre Léon Bérard, Lyon, France.
| | - David Pérol
- Clinical Research and Innovation Department, Centre Léon Bérard, F-69373, Lyon, Cedex 08, France
| | - Rastislav Bahleda
- DITEP -Département d'Innovation Thérapeutiques et Essais Précoces, Institut Gustave Roussy, 94805, Villejuif Cedex, France
| | - Antoine Hollebecque
- DITEP -Département d'Innovation Thérapeutiques et Essais Précoces, Institut Gustave Roussy, 94805, Villejuif Cedex, France
| | - Etienne Chatelut
- Institut Claudius Regaud, Inserm UMR1037 CRCT, Université Paul-Sabatier, 20/24 rue du Pont Saint-Pierre, 31052, Toulouse, France
| | - Helen Boyle
- Medical Oncology Department, Centre Léon Bérard, F-69373, Lyon, Cedex 08, France
| | - Philippe Cassier
- Medical Oncology Department, Centre Léon Bérard, F-69373, Lyon, Cedex 08, France
| | - Séverine Metzger
- Medical Oncology Department, Centre Léon Bérard, F-69373, Lyon, Cedex 08, France
| | - Ellen Blanc
- Medical Oncology Department, Centre Léon Bérard, F-69373, Lyon, Cedex 08, France
| | - Jean-Charles Soria
- University of Paris Sud, Orsay, Institut Gustave Roussy, 94805, Villejuif Cedex, France
| | - Bernard Escudier
- Department of Medical Oncology, Institut Gustave Roussy, 114, rue Edouard-Vaillant, 94805, Villejuif Cedex, France
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Zurita AJ, Gagnon RC, Liu Y, Tran HT, Figlin RA, Hutson TE, D'Amelio AM, Sternberg CN, Pandite LN, Heymach JV. Integrating cytokines and angiogenic factors and tumour bulk with selected clinical criteria improves determination of prognosis in advanced renal cell carcinoma. Br J Cancer 2017; 117:478-484. [PMID: 28683470 PMCID: PMC5558688 DOI: 10.1038/bjc.2017.206] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 04/28/2017] [Accepted: 06/07/2017] [Indexed: 12/26/2022] Open
Abstract
Background: In two clinical trials of the vascular endothelial growth factor (VEGF) receptor inhibitor pazopanib in advanced renal cell carcinoma (mRCC), we found interleukin-6 as predictive of pazopanib benefit. We evaluated the prognostic significance of candidate cytokines and angiogenic factors (CAFs) identified in that work relative to accepted clinical parameters. Methods: Seven preselected plasma CAFs (interleukin-6, interleukin-8, osteopontin, VEGF, hepatocyte growth factor, tissue inhibitor of metalloproteinases (TIMP-1), and E-selectin) were measured using multiplex ELISA in plasma collected pretreatment from 343 mRCC patients participating in the phase 3 registration trial of pazopanib vs placebo (NCT00334282). Tumour burden (per sum of longest diameters (SLD)) and 10 other clinical factors were also analysed for association with overall survival (OS; based on initial treatment assignment). Results: Osteopontin, interleukin-6, and TIMP-1 were independently associated with OS in multivariable analysis. A model combining the three CAFs and five clinical variables (including SLD) had higher prognostic accuracy than the International Metastatic Renal Cell Carcinoma Database Consortium criteria (concordance-index 0.75 vs 0.67, respectively), and distinguished two groups of patients within the original intermediate risk category. Conclusions: A prognostic model incorporating osteopontin, interleukin-6, TIMP-1, tumour burden, and selected clinical criteria increased prognostic accuracy for OS determination in mRCC patients.
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Affiliation(s)
- A J Zurita
- MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA
| | - R C Gagnon
- Bristol-Myers Squibb Company, PO Box 5400, J42-05, Princeton, NJ 08543, USA
| | - Y Liu
- Pfizer Translational Oncology, 10646 Science Center Dr, San Diego, CA 92121, USA
| | - H T Tran
- MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA
| | - R A Figlin
- Cedars-Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA 90048, USA
| | - T E Hutson
- US Oncology/McKesson Specialty Health, The Woodlands, TX, USA.,Texas Oncology, Dallas, TX, USA.,Baylor Sammons Cancer Center, Dallas, TX 75246, USA
| | - A M D'Amelio
- Novartis Pharmaceuticals Corporation, East Hanover, NJ 07936, USA
| | - C N Sternberg
- Department of Medical Oncology, San Camillo and Forlanini Hospitals, Rome 00152, Italy
| | - L N Pandite
- Adaptimmune LLC, Philadelphia, PA 19112, USA
| | - J V Heymach
- MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA
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Dlouhy I, Filella X, Rovira J, Magnano L, Rivas-Delgado A, Baumann T, Martínez-Trillos A, Balagué O, Martínez A, González-Farre B, Karube K, Gine E, Delgado J, Campo E, López-Guillermo A. High serum levels of soluble interleukin-2 receptor (sIL2-R), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF) are associated with adverse clinical features and predict poor outcome in diffuse large B-cell lymphoma. Leuk Res 2017; 59:20-25. [PMID: 28544905 DOI: 10.1016/j.leukres.2017.05.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 05/11/2017] [Accepted: 05/12/2017] [Indexed: 10/19/2022]
Abstract
Diffuse large B-cell lymphoma (DLBCL) is an aggressive lymphoma with heterogeneous outcomes. To improve accuracy of the international prognostic index score, new biological variables are being investigated. The aim of this study was to determine the prognostic significance of serum levels of different cytokines, namely soluble interleukin-2 receptor (sIL2-R), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF). We analyzed 197 de novo DLBCL patients (91 M/106 F; median age 66 years) treated with immunochemotherapy in a single institution. Serum cytokine determination was performed with ELISA, using the upper normal values as cut-offs. sIL-2R, IL-6 and TNF were elevated in 133, 130 and 144 cases, respectively. Elevation of each of these cytokines correlated with worse performance status, presence of B symptoms, advanced stage, elevated LDH and β2-microglobulin (P<0.03) and lower complete remission rate (P<0.001). Elevated levels of serum sIL-2R and TNF were significantly associated with shorter progression-free (PFS) and overall survival (OS), while elevated IL-6 only with shorter PFS. Early death (<4months from diagnosis) strongly correlated with elevated cytokines. Determination of serum cytokines levels is simple and adds information regarding risk of early death, response to therapy, and outcome.
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Affiliation(s)
- Ivan Dlouhy
- Department of Hematology, Hospital Clinic, Villarroel St. 170, 08036 Barcelona, Spain.
| | - Xavier Filella
- Department of Biochemistry and Molecular Genetics, Hospital Clinic, Villarroel St. 170, 08036 Barcelona, Spain
| | - Jordina Rovira
- Department of Hematology, Hospital Clinic, Villarroel St. 170, 08036 Barcelona, Spain
| | - Laura Magnano
- Department of Hematology, Hospital Clinic, Villarroel St. 170, 08036 Barcelona, Spain
| | - Alfredo Rivas-Delgado
- Department of Hematology, Hospital Clinic, Villarroel St. 170, 08036 Barcelona, Spain
| | - Tycho Baumann
- Department of Hematology, Hospital Clinic, Villarroel St. 170, 08036 Barcelona, Spain
| | | | - Olga Balagué
- Hematopathology Unit, Hospital Clínic, August Pi and Sunyer Biomedical Investigation Center (IDIBAPS), Villarroel St. 170, 08036 Barcelona, Spain
| | - Antonio Martínez
- Hematopathology Unit, Hospital Clínic, August Pi and Sunyer Biomedical Investigation Center (IDIBAPS), Villarroel St. 170, 08036 Barcelona, Spain
| | - Blanca González-Farre
- Hematopathology Unit, Hospital Clínic, August Pi and Sunyer Biomedical Investigation Center (IDIBAPS), Villarroel St. 170, 08036 Barcelona, Spain
| | - Kennosuke Karube
- Cell Biology & Pathology Department, University of the Ryukyus Graduate School of Medicine, 207 Uehara, Nishihara, Okinawa, Japan
| | - Eva Gine
- Department of Hematology, Hospital Clinic, Villarroel St. 170, 08036 Barcelona, Spain
| | - Julio Delgado
- Department of Hematology, Hospital Clinic, Villarroel St. 170, 08036 Barcelona, Spain
| | - Elías Campo
- Hematopathology Unit, Hospital Clínic, August Pi and Sunyer Biomedical Investigation Center (IDIBAPS), Villarroel St. 170, 08036 Barcelona, Spain
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Ishihara H, Kondo T, Yoshida K, Omae K, Takagi T, Iizuka J, Tanabe K. Preoperative controlling nutritional status (CONUT) score as a novel predictive biomarker of survival in patients with localized urothelial carcinoma of the upper urinary tract treated with radical nephroureterectomy. Urol Oncol 2017; 35:539.e9-539.e16. [PMID: 28499734 DOI: 10.1016/j.urolonc.2017.04.012] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 04/04/2017] [Accepted: 04/15/2017] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The purpose of this study was to investigate the correlation between the controlling nutritional status (CONUT) score and survival of patients with localized urothelial carcinoma of the upper urinary tract treated with radical nephroureterectomy (RNU). METHODS AND MATERIALS We retrospectively enrolled 107 patients. CONUT score was calculated based on the serum albumin concentration, lymphocyte count, and total cholesterol concentration. Patients were classified into 2 groups based on CONUT score. Relapse-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS) after RNU were compared between the 2 groups, and predictors of survival were analyzed using Cox proportional hazards regression models. RESULTS For CONUT score, the area under the curve was 0.588 and the optimal cutoff value was 3. Twenty-four patients (22.4%) had high CONUT scores. The patients with high CONUT scores had significantly shorter 5-year RFS, CSS, and OS than did those with low CONUT scores (RFS: 50.1% vs. 66.0%; CSS: 28.1% vs. 71.7%; OS: 26.4% vs. 66.8%; all P<0.05). Results of the multivariable analysis, after adjustment for factors such as pT stage, pN stage, tumor grade, presence of lymphovascular invasion, and C-reactive protein level, revealed that CONUT score was an independent predictor of CSS (hazard ratio [HR] = 5.44, P = 0.0016) and OS (HR = 2.90, P = 0.0214) and showed marginal significance for predicting RFS (HR = 2.26, P = 0.0581). CONCLUSIONS Preoperative CONUT score helps predict survival in patients with localized urothelial carcinoma of the upper urinary tract treated with RNU.
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Affiliation(s)
- Hiroki Ishihara
- Department of Urology, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan
| | - Tsunenori Kondo
- Department of Urology, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan; Department of Urology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
| | - Kazuhiko Yoshida
- Department of Urology, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan
| | - Kenji Omae
- Department of Urology, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan; Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Yoshida Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan; Center for Innovative Research for Communities and Clinical Excellence, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, Fukushima 960-1295, Japan
| | - Toshio Takagi
- Department of Urology, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan
| | - Junpei Iizuka
- Department of Urology, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan
| | - Kazunari Tanabe
- Department of Urology, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan
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Lorente D, Trilla E, Meseguer A, Planas J, Placer J, Celma A, Salvador C, Regis L, Morote J. Systematic review of renal carcinoma prognostic factors. Actas Urol Esp 2017; 41:215-225. [PMID: 27659130 DOI: 10.1016/j.acuro.2016.08.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 08/04/2016] [Accepted: 08/05/2016] [Indexed: 11/16/2022]
Abstract
CONTEXT AND OBJECTIVES The natural history of renal cell carcinoma is heterogeneous. Some scenarios can be found in terms of clinical presentation, clinical evolution or type of recurrence (local/metastatic). The aim of this publication is to analyze the most important prognostic factors published in the literature. EVIDENCE ACQUISITION A literature review ob published papers was performed using the Pubmed, from first Motzer's classification published in 1999 to 2015, according to PRISMA declaration. Search was done using the following keywords: kidney neoplasm, kidney cancer, renal cell carcinoma, prognostic factors, mortality, survival and disease progression. Papers were classified according to level of evidence, the number of patients included and the type of study performed. EVIDENCE SYNTHESIS The evolution in the knowledge of molecular pathways related to renal oncogenesis and the new targeted therapies has left to remain obsolete the old prognostic models. It's necessary to perform a continuous review to actualize nomograms and to adapt them to the new scenarios. CONCLUSIONS Is necessary to perform a proper external validation of existing prognostic factors using prospective and multicentric studies to add them into the daily urologist clinical practice.
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Affiliation(s)
- D Lorente
- Servicio de Urología, Hospital de la Vall d'Hebron, Universidad Autonoma de Barcelona, Barcelona, España
| | - E Trilla
- Servicio de Urología, Hospital de la Vall d'Hebron, Universidad Autonoma de Barcelona, Barcelona, España.
| | - A Meseguer
- Unidad de fisiología y fisiopatología renal (VHIR), Barcelona, España
| | - J Planas
- Servicio de Urología, Hospital de la Vall d'Hebron, Universidad Autonoma de Barcelona, Barcelona, España
| | - J Placer
- Servicio de Urología, Hospital de la Vall d'Hebron, Universidad Autonoma de Barcelona, Barcelona, España
| | - A Celma
- Servicio de Urología, Hospital de la Vall d'Hebron, Universidad Autonoma de Barcelona, Barcelona, España
| | - C Salvador
- Servicio de Urología, Hospital de la Vall d'Hebron, Universidad Autonoma de Barcelona, Barcelona, España
| | - L Regis
- Servicio de Urología, Hospital de la Vall d'Hebron, Universidad Autonoma de Barcelona, Barcelona, España
| | - J Morote
- Servicio de Urología, Hospital de la Vall d'Hebron, Universidad Autonoma de Barcelona, Barcelona, España
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Ishihara H, Kondo T, Yoshida K, Omae K, Takagi T, Iizuka J, Tanabe K. Effect of Systemic Inflammation on Survival in Patients With Metastatic Renal Cell Carcinoma Receiving Second-line Molecular-targeted Therapy. Clin Genitourin Cancer 2017; 15:495-501. [PMID: 28363437 DOI: 10.1016/j.clgc.2017.01.018] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 01/05/2017] [Accepted: 01/23/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND The role of systemic inflammatory markers, including C-reactive protein (CRP), the neutrophil/lymphocyte ratio (NLR), and the platelet/lymphocyte ratio (PLR), in predicting survival for patients with metastatic renal cell carcinoma receiving second-line molecular-targeted therapy (mTT) after first-line tyrosine kinase inhibitor failure remains unclear. Thus, we investigated the relationship between systemic inflammation and survival in such patients. PATIENTS AND METHODS Sixty-three patients were evaluated. Progression-free survival (PFS) and overall survival (OS) after second-line mTT initiation were evaluated according to the inflammatory marker levels. In addition, the prognostic factors for survival were examined. RESULTS The receiver operating characteristic curves for CRP, NLR, and PLR had areas under the curve of 0.779, 0.619, and 0.655, respectively; no significant differences were noted. The corresponding cutoff values were 0.48, 2.53, and 183. Patients with higher CRP (n = 40), NLR (n = 32), and PLR (n = 22) levels had significantly lower PFS and OS than those with lower CRP, NLR, and PLR levels. Multivariate analyses showed that CRP was the sole independent predictor for PFS and OS. CONCLUSION Systemic inflammation is associated with survival after second-line mTT. In particular, CRP was a strong independent predictive biomarker of prognosis.
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Affiliation(s)
- Hiroki Ishihara
- Department of Urology, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan
| | - Tsunenori Kondo
- Department of Urology, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan.
| | - Kazuhiko Yoshida
- Department of Urology, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan
| | - Kenji Omae
- Department of Urology, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan
| | - Toshio Takagi
- Department of Urology, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan
| | - Junpei Iizuka
- Department of Urology, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan
| | - Kazunari Tanabe
- Department of Urology, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan
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Serum Cytokinome Profile Evaluation: A Tool to Define New Diagnostic and Prognostic Markers of Cancer Using Multiplexed Bead-Based Immunoassays. Mediators Inflamm 2016; 2016:3064643. [PMID: 28050120 PMCID: PMC5168457 DOI: 10.1155/2016/3064643] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Revised: 09/19/2016] [Accepted: 10/27/2016] [Indexed: 12/15/2022] Open
Abstract
In recent years, many researchers are focusing their attention on the link between inflammation and cancer. The inflammation is involved in the tumor development and suppression, by stimulating the immune response. In particular, the transition from chronic inflammation to cancer produces angiogenic and growth factors able to repair the tissue and to promote cancer cell survival, implantation, and growth. In this contest, the cytokines contribute to the development of these processes becoming active before and during the inflammatory process and playing an important function at the various disease levels. Thus, these proteins can represent specific markers of tumor development and progression. Therefore the "cytokinome" term is used to indicate the evaluation of cytokine pattern by using an "omics" approach. Newly, specific protein chips of considerable and improved sensitivity are being developed to determine simultaneously several and different cytokines. This can be achieved by a multiplex technology that, through the use of small amounts of serum or other fluids, is used to determine the presence and the levels of underrepresented cytokines. Since this method is an accurate, sensitive, and reproducible cytokine assay, it is already used in many different studies. Thus, this review focuses on the more latest aspects related to cytokinome profile evaluation in different cancers.
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36
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Gatto F, Maruzzo M, Magro C, Basso U, Nielsen J. Prognostic Value of Plasma and Urine Glycosaminoglycan Scores in Clear Cell Renal Cell Carcinoma. Front Oncol 2016; 6:253. [PMID: 27933273 PMCID: PMC5121125 DOI: 10.3389/fonc.2016.00253] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 11/14/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The prognosis of metastatic clear cell renal cell carcinoma (ccRCC) vastly improved since the introduction of antiangiogenic-targeted therapy. However, it is still unclear which biological processes underlie ccRCC aggressiveness and affect prognosis. Here, we checked whether a recently discovered systems biomarker based on plasmatic or urinary measurements of glycosaminoglycans (GAGs) aggregated into diagnostic scores correlated with ccRCC prognosis. METHODS Thirty-one patients with a diagnosis of ccRCC (23 metastatic) were prospectively enrolled, and their urine and plasma biomarker scores were correlated to progression-free survival (PFS) and overall survival (OS) as either a dichotomous ("Low" vs. "High") or a continuous variable in a multivariate survival analysis. RESULTS The survival difference between "High"- vs. "Low"-scored patients was significant in the case of urine scores (2-year PFS rate = 53.3 vs. 100%, p = 3 × 10-4 and 2-year OS rate = 73.3 vs. 100%, p = 0.0078) and in the case of OS for plasma scores (2-year PFS rate = 60 vs. 84%, p = 0.0591 and 2-year OS rate = 66.7 vs. 90%, p = 0.0206). In multivariate analysis, the urine biomarker score as a continuous variable was an independent predictor of PFS [hazard ratio (HR): 4.62, 95% CI: 1.66-12.83, p = 0.003] and OS (HR: 10.13, 95% CI: 1.80-57.04, p = 0.009). CONCLUSION This is the first report on an association between plasma or urine GAG scores and the prognosis of ccRCC patients. Prospective trials validating the prognostic and predictive role of this novel systems biomarker are warranted.
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Affiliation(s)
- Francesco Gatto
- Department of Biology and Biological Engineering, Chalmers University of Technology, Göteborg, Sweden
| | - Marco Maruzzo
- Medical Oncology Unit 1, IOV Istituto Oncologico Veneto (IRCSS), Padova, Italy
| | - Cristina Magro
- Medical Oncology Unit 1, IOV Istituto Oncologico Veneto (IRCSS), Padova, Italy
| | - Umberto Basso
- Medical Oncology Unit 1, IOV Istituto Oncologico Veneto (IRCSS), Padova, Italy
| | - Jens Nielsen
- Department of Biology and Biological Engineering, Chalmers University of Technology, Göteborg, Sweden
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Guðbrandsdottir G, Hjelle KM, Frugård J, Bostad L, Aarstad HJ, Beisland C. Preoperative high levels of serum vascular endothelial growth factor are a prognostic marker for poor outcome after surgical treatment of renal cell carcinoma. Scand J Urol 2016; 49:388-94. [PMID: 25773545 DOI: 10.3109/21681805.2015.1021833] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The aim of this study was to determine whether concentrations of vascular endothelial growth factor (VEGF) in blood taken preoperatively can predict subtype, survival and recurrence in patients with renal cell carcinoma (RCC). MATERIALS AND METHODS The patient group consisted of 124 patients with an RCC that was surgically removed with nephrectomy or nephron-sparing surgery at Haukeland University Hospital from 2007 to 2010. All subtypes and stages were included. Preoperative blood samples were taken on the day of surgery, and the samples were prepared and frozen at -80 °C. The level of VEGF in serum was analysed using Luminex® immunobead technology. The patients were followed until death or to 31 October 2014 (>4.5 years). RESULTS Patients with higher levels of VEGF were more likely to have clear cell RCC [odds ratio (OR) 2.43, p = 0.046], as were older patients (OR 1.04, p = 0.024). In a multivariate analysis, high VEGF, stage and nuclear grade all had a significant predictive value for cancer-specific survival (OR 4.56, p = 0.017; OR 11.54, p < 0.001; and OR 7.85, p = 0.015, respectively). VEGF, stage and nuclear grade predicted recurrence in patients presumed to have been radically treated (OR 4.37, p = 0.03; OR 5.02, p = 0.011; and OR 6.57, p = 0.008, respectively). CONCLUSIONS Tumour stage and a high level of serum VEGF were predictors for an increased risk of recurrence and cancer-specific death. Furthermore, the study showed that serum VEGF may be used to determine the subtype of RCC preoperatively.
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Affiliation(s)
| | - Karin M Hjelle
- a Departments of 1Urology, Haukeland University Hospital.,b 2 Department of Clinical Medicine, University of Bergen , Bergen, Norway
| | | | - Leif Bostad
- b 2 Department of Clinical Medicine, University of Bergen , Bergen, Norway.,c 3 Department of Pathology
| | - Hans J Aarstad
- b 2 Department of Clinical Medicine, University of Bergen , Bergen, Norway.,d 4 Otolaryngology/Head and Neck Surgery, Haukeland University Hospital , Bergen, Norway
| | - Christian Beisland
- a Departments of 1Urology, Haukeland University Hospital.,b 2 Department of Clinical Medicine, University of Bergen , Bergen, Norway
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Cardillo MR, Ippoliti F. Interleukin-6, Interleukin-10 and Heat Shock Protein-90 Expression in Renal Epithelial Neoplasias and Surrounding Normal-Appearing Renal Parenchyma. Int J Immunopathol Pharmacol 2016; 20:37-46. [PMID: 17346426 DOI: 10.1177/039463200702000105] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Cytokines, notably the interleukins IL-6 and IL-10, have an important role in the development and progression of renal-cell carcinomas, acting in the host-tumor interaction and in tumor bulk. Heat shock proteins (HSP), in particular HSP-90, may have a regulatory role in cytokine biosynthesis and prognostic implication in some tumors. To define the roles of the cytokines IL-6 and IL-10 and HSP-90 in the progression of renal-cell carcinoma we analyzed immunohistochemical expression of these proteins in human renal-cell carcinomas from 95 total nephrectomies. IL-6, IL-10 and HSP-90 proteins were more strongly expressed in epithelium and stroma of the renal tumoral compartment than in adjacent normal peritumoral tissue. But the difference reached significance only for HSP-90 protein. The percentage of cells expressing IL-6, IL-10 and HSP-90 immunoreactivity was higher in benign epithelial tumors, than in normal peritumoral tissue, but lower than in renal-cell carcinomas. Whereas HSP-90 immunoreactivity seemed higher in more aggressive histological phenotypes (collecting-duct carcinoma) of renal-cell carcinomas, IL-10 protein levels were higher in more advanced TNM stage (pT3) tumors. Our observation suggests that IL-6 and IL-10 and HSP-90 may be useful markers associated with the development and progression of renal-cell carcinomas and have independent functional roles in this malignant condition.
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Affiliation(s)
- M R Cardillo
- Department of Experimental Medicine and Pathology, Section of Pathologic Anatomy-Uropathology Unit, University of Rome La Sapienza, Rome, Italy.
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Lippitz BE, Harris RA. Cytokine patterns in cancer patients: A review of the correlation between interleukin 6 and prognosis. Oncoimmunology 2016; 5:e1093722. [PMID: 27467926 PMCID: PMC4910721 DOI: 10.1080/2162402x.2015.1093722] [Citation(s) in RCA: 153] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 09/08/2015] [Indexed: 02/09/2023] Open
Abstract
OBJECTIVE In tumor patients, IL-6 appears to be one component of a consistent cancer-associated cytokine network resulting in both a systemic immune stimulation and a microenvironment of cancer-induced immune suppression that ultimately protects the cancer cells. IL-6 has been associated with prognosis in cancer patients, but so far a systemical analysis has not been carried out. METHODS The present meta-analysis studies the relation between IL-6 serum levels and the prognosis of cancer patients in the available clinical literature of 100 articles published between 1993 and 2013 comprising 11,583 patients. RESULTS The IL-6 serum level was described as significantly correlating with survival in 82/101 series comprising 85.6% of patients (9917/11,583) with 23 different cancer types. A total of 64 studies dichotomized patient cohorts according to various cut-off IL-6 serum levels: in 59/64 of these series corresponding to 94.5% of the reported patients (7694/8142) significant correlations between IL-6 serum level and survival were seen. The median survival of cancer patients had been determined above various cut-off levels of serum IL-6 in 24 dichotomized studies (26 cohorts). There was a highly significant inverse correlation between median survival of the cohorts with IL-6 serum level above cut-off (1272 patients) and their corresponding IL-6 cut-off values (Spearman R -0,48 p= < 0.001) following a linear regression when both parameters were log-transformed (p < 0.001). A significant correlation between increasing serum IL-6 and tumor stage or metastases was described in 39/44 studies and 91% of published patients (4221/4636) where clinical parameters had been specified. CONCLUSIONS Closely associated with the patient's clinical condition and independent of the cancer histology, the increased IL-6 serum level uniformly appears to correlate with survival as paraneoplastic condition in later cancer stages independent of the cancer type. Modifications of this paraneoplastic immune reaction may offer new therapeutic options in cancer.
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Affiliation(s)
- Bodo E Lippitz
- Department of Clinical Neuroscience, Center for Molecular Medicine, Karolinska Sjukhuset, Karolinska Institutet , Stockholm, Sweden
| | - Robert A Harris
- Department of Clinical Neuroscience, Center for Molecular Medicine, Karolinska Sjukhuset, Karolinska Institutet , Stockholm, Sweden
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Mehrazin R, Tsao CK, Sfakianos J, Galsky MD. Systemic adjuvant therapy for renal cell carcinoma: Any hope for future clinical trials? Urol Oncol 2016; 34:221-4. [DOI: 10.1016/j.urolonc.2016.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 12/14/2015] [Accepted: 01/23/2016] [Indexed: 12/22/2022]
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Viers BR, Thompson RH, Lohse CM, Cheville JC, Leibovich BC, Boorjian SA, Tollefson MK. Pre-treatment neutrophil-to-lymphocyte ratio predicts tumor pathology in newly diagnosed renal tumors. World J Urol 2016; 34:1693-1699. [PMID: 27052014 DOI: 10.1007/s00345-016-1821-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 03/29/2016] [Indexed: 01/04/2023] Open
Abstract
PURPOSE The neutrophil-to-lymphocyte ratio (NLR) predicts adverse outcomes after surgical treatment for clear cell renal cell carcinoma (ccRCC). However, its ability to distinguish aggressive from indolent renal tumors remains unknown. We therefore evaluated the association between NLR and pathologic outcomes at nephrectomy. METHODS From 1995 to 2008, 2402 patients underwent radical or partial nephrectomy for localized renal tumors. Of these, 2039 had an NLR within 90 days prior to surgery. Comparisons of NLR by tumor size, histologic subtype, and nuclear grade were evaluated. RESULTS Benign renal masses had a significantly lower NLR than malignant tumors (median 2.92 vs. 3.12; p = 0.037) with the greatest difference noted among renal lesions >7 cm (median 2.79 vs. 3.87; p < 0.001). There was a significant difference in NLR among RCC subtypes (p = 0.002), with cystic ccRCC demonstrating the lowest (median 2.48) and collecting duct RCC the highest NLR (median 5.99). Moreover, there was a significant increase in NLR with larger tumor size and greater nuclear grade (p < 0.001). Specifically, in patients with ccRCC, an incremental increase in tumor size (≤4 cm = 2.80, >4 but ≤7 cm = 3.09 and >7 cm = 3.95) and nuclear grade (G1 = 2.68, G2 = 2.87, G3 = 3.48, and G4 = 5.18) was associated with greater NLR (p < 0.001). CONCLUSIONS An elevated NLR is associated with RCC pathology, higher-grade tumors, and more aggressive histologic subtypes at the time of nephrectomy. Therefore, NLR appears to be a preoperative marker of biologically aggressive RCC and may be useful in predicting malignancy and guiding management among patients with suspicious renal tumors.
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Affiliation(s)
- Boyd R Viers
- Department of Urology, Mayo Clinic, 200 First Street Southwest, Rochester, MN, 55905, USA
| | - R Houston Thompson
- Department of Urology, Mayo Clinic, 200 First Street Southwest, Rochester, MN, 55905, USA
| | - Christine M Lohse
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - John C Cheville
- Department of Anatomic Pathology, Mayo Clinic, Rochester, MN, USA
| | - Bradley C Leibovich
- Department of Urology, Mayo Clinic, 200 First Street Southwest, Rochester, MN, 55905, USA
| | - Stephen A Boorjian
- Department of Urology, Mayo Clinic, 200 First Street Southwest, Rochester, MN, 55905, USA
| | - Matthew K Tollefson
- Department of Urology, Mayo Clinic, 200 First Street Southwest, Rochester, MN, 55905, USA.
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Eichten A, Su J, Adler AP, Zhang L, Ioffe E, Parveen AA, Yancopoulos GD, Rudge J, Lowy I, Lin HC, MacDonald D, Daly C, Duan X, Thurston G. Resistance to Anti-VEGF Therapy Mediated by Autocrine IL6/STAT3 Signaling and Overcome by IL6 Blockade. Cancer Res 2016; 76:2327-39. [PMID: 26921327 DOI: 10.1158/0008-5472.can-15-1443] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 12/29/2015] [Indexed: 11/16/2022]
Abstract
Anti-VEGF therapies benefit several cancer types, but drug resistance that limits therapeutic response can emerge. We generated cell lines from anti-VEGF-resistant tumor xenografts to investigate the mechanisms by which resistance develops. Of all tumor cells tested, only A431 (A431-V) epidermoid carcinoma cells developed partial resistance to the VEGF inhibitor aflibercept. Compared with the parental tumors, A431-V tumors secreted greater amounts of IL6 and exhibited higher levels of phospho-STAT3. Notably, combined blockade of IL6 receptor (IL6R) and VEGF resulted in enhanced activity against A431-V tumors. Similarly, inhibition of IL6R enhanced the antitumor effects of aflibercept in DU145 prostate tumor cells that displays high endogenous IL6R activity. In addition, post hoc stratification of data obtained from a clinical trial investigating aflibercept efficacy in ovarian cancer showed poorer survival in patients with high levels of circulating IL6. These results suggest that the activation of the IL6/STAT3 pathway in tumor cells may provide a survival advantage during anti-VEGF treatment, suggesting its utility as a source of response biomarkers and as a therapeutic target to heighten efficacious results. Cancer Res; 76(8); 2327-39. ©2016 AACR.
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Affiliation(s)
| | - Jia Su
- Regeneron Pharmaceuticals, Tarrytown, New York
| | | | - Li Zhang
- Regeneron Pharmaceuticals, Tarrytown, New York
| | - Ella Ioffe
- Regeneron Pharmaceuticals, Tarrytown, New York
| | | | | | - John Rudge
- Regeneron Pharmaceuticals, Tarrytown, New York
| | - Israel Lowy
- Regeneron Pharmaceuticals, Tarrytown, New York
| | | | | | | | - Xunbao Duan
- Regeneron Pharmaceuticals, Tarrytown, New York
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Hawkins RE, Gore M, Shparyk Y, Bondar V, Gladkov O, Ganev T, Harza M, Polenkov S, Bondarenko I, Karlov P, Karyakin O, Khasanov R, Hedlund G, Forsberg G, Nordle Ö, Eisen T. A Randomized Phase II/III Study of Naptumomab Estafenatox + IFNα versus IFNα in Renal Cell Carcinoma: Final Analysis with Baseline Biomarker Subgroup and Trend Analysis. Clin Cancer Res 2016; 22:3172-81. [PMID: 26851187 DOI: 10.1158/1078-0432.ccr-15-0580] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 11/03/2015] [Indexed: 11/16/2022]
Abstract
PURPOSE To prospectively determine the efficacy of naptumomab estafenatox (Nap) + IFNα versus IFN in metastatic renal cell carcinoma (RCC). EXPERIMENTAL DESIGN In a randomized, open-label, multicenter, phase II/III study, 513 patients with RCC received Nap (15 μg/kg i. v. in three cycles of four once-daily injections) + IFN (9 MU s.c. three times weekly), or the same regimen of IFN monotherapy. The primary endpoint was overall survival (OS). RESULTS This phase II/III study did not meet its primary endpoint. Median OS/PFS for Nap + IFN patients was 17.1/5.8 months versus 17.5/5.8 months for the patients receiving IFN alone (P = 0.56; HR, 1.08/P = 0.41; HR, 0.92). Post hoc exploratory subgroup and trend analysis revealed that the baseline plasma concentrations of anti-SEA/E-120 (anti-Nap antibodies) for drug exposure and IL6 for immune status could be used as predictive biomarkers. A subgroup of patients (SG; n = 130) having concentrations below median of anti-SEA/E-120 and IL6 benefitted greatly from the addition of Nap. In SG, median OS/PFS for the patients treated with Nap + IFN was 63.3/13.7 months versus 31.1/5.8 months for the patients receiving IFN alone (P = 0.02; HR, 0.59/P = 0.02; HR, 0.62). Addition of Nap to IFN showed predicted and transient immune related AEs and the treatment had an acceptable safety profile. CONCLUSIONS The study did not meet its primary endpoint. Nap + IFN has an acceptable safety profile, and results from post hoc subgroup analyses showed that the treatment might improve OS/PFS in a baseline biomarker-defined RCC patient subgroup. The results warrant further studies with Nap in this subgroup. Clin Cancer Res; 22(13); 3172-81. ©2016 AACR.
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Affiliation(s)
| | - Martin Gore
- Royal Marsden Hospital NHS Trust, London, United Kingdom
| | - Yaroslav Shparyk
- State Regional Treatment and Diagnostics Oncology Center, Lviv, Ukraine
| | - Vladimir Bondar
- Public Clinical Treatment and Prophylaxis Institution, Donetsk, Ukraine
| | - Oleg Gladkov
- Chelyabinsk Regional Clinical Oncology Dispensary, Chelyabinsk, Russia
| | - Tosho Ganev
- Urology Clinic General Hospital for Active Treatment "St. Anna", Varna, Bulgaria
| | - Mihai Harza
- Fundeni Clinical Institute, Bucharest, Romania
| | - Serhii Polenkov
- Public Treatment and Prophylaxis Institution, Chernihiv Regional Oncology Center, Chernihiv, Ukraine
| | | | - Petr Karlov
- City Clinical Oncology Dispensary, St. Petersburg, Russia
| | - Oleg Karyakin
- Medical Radiological Research Center, Obninsk, Russia
| | | | | | | | | | - Timothy Eisen
- Cambridge University Health Partners, Addenbrooke's Hospital, Cambridge, United Kingdom
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Dielmann A, Letsch A, Nonnenmacher A, Miller K, Keilholz U, Busse A. Favorable prognostic influence of T-box transcription factor Eomesodermin in metastatic renal cell cancer patients. Cancer Immunol Immunother 2016; 65:181-92. [PMID: 26753694 PMCID: PMC11029520 DOI: 10.1007/s00262-015-1786-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 12/21/2015] [Indexed: 10/22/2022]
Abstract
T-box transcription factors, T-box expressed in T cells (T-bet) encoded by Tbx21 and Eomesodermin (Eomes), drive the differentiation of effector/memory T cell lineages and NK cells. The aim of the study was to determine the prognostic influence of the expression of these transcription factors in peripheral blood (pB) in a cohort of 41 metastatic (m) RCC patients before receiving sorafenib treatment and to analyze their association with the immunophenotype in pB. In contrast to Tbx21, in the multivariate analysis including clinical features, Eomes mRNA expression was identified as an independent good prognostic factor for progression-free survival (PFS, p = 0.042) and overall survival (OS, p = 0.001) in addition to a favorable ECOG performance status (p = 0.01 and p = 0.008, respectively). Eomes expression correlated positively not only with expression of Tbx21 and TGFβ1 mRNA, but also with mRNA expression of the activation marker ICOS, and with in vivo activated HLA-DR(+) T cells. Eomes expression was negatively associated with TNFα-producing T cells. On protein level, Eomes was mainly expressed by CD56(+)CD3(-) NK cells in pB. In conclusion, we identified a higher Eomes mRNA expression as an independent good prognostic factor for OS and PFS in mRCC patients treated with sorafenib.
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MESH Headings
- Adult
- Aged
- Carcinoma, Renal Cell/drug therapy
- Carcinoma, Renal Cell/genetics
- Carcinoma, Renal Cell/immunology
- Carcinoma, Renal Cell/mortality
- Carcinoma, Renal Cell/pathology
- Female
- Gene Expression Regulation, Neoplastic
- Humans
- Immunophenotyping
- Kidney Neoplasms/drug therapy
- Kidney Neoplasms/genetics
- Kidney Neoplasms/immunology
- Kidney Neoplasms/mortality
- Kidney Neoplasms/pathology
- Killer Cells, Natural/immunology
- Killer Cells, Natural/metabolism
- Male
- Middle Aged
- Neoplasm Metastasis
- Neoplasm Staging
- Prognosis
- RNA, Messenger/genetics
- RNA, Messenger/metabolism
- T-Box Domain Proteins/genetics
- T-Box Domain Proteins/metabolism
- T-Lymphocyte Subsets/immunology
- T-Lymphocyte Subsets/metabolism
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Affiliation(s)
- Anastasia Dielmann
- Department of Medicine III (Hematology, Oncology and Tumor Immunology), Charité, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany
| | - Anne Letsch
- Department of Medicine III (Hematology, Oncology and Tumor Immunology), Charité, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany
| | - Anika Nonnenmacher
- Department of Medicine III (Hematology, Oncology and Tumor Immunology), Charité, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany
| | - Kurt Miller
- Department of Urology, Charité, Campus Benjamin Franklin, Berlin, Germany
| | - Ulrich Keilholz
- Department of Medicine III (Hematology, Oncology and Tumor Immunology), Charité, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany
| | - Antonia Busse
- Department of Medicine III (Hematology, Oncology and Tumor Immunology), Charité, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany.
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Zhong H, Davis A, Ouzounova M, Carrasco RA, Chen C, Breen S, Chang YS, Huang J, Liu Z, Yao Y, Hurt E, Moisan J, Fung M, Tice DA, Clouthier SG, Xiao Z, Wicha MS, Korkaya H, Hollingsworth RE. A Novel IL6 Antibody Sensitizes Multiple Tumor Types to Chemotherapy Including Trastuzumab-Resistant Tumors. Cancer Res 2016; 76:480-90. [PMID: 26744529 DOI: 10.1158/0008-5472.can-15-0883] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 10/02/2015] [Indexed: 11/16/2022]
Abstract
Elevated levels of the proinflammatory cytokine IL6 are associated with poor survival outcomes in many cancers. Antibodies targeting IL6 and its receptor have been developed for chronic inflammatory disease, but they have not yet been shown to clearly benefit cancer patients, possibly due to antibody potency or the settings in which they have been tested. In this study, we describe the development of a novel high-affinity anti-IL6 antibody, MEDI5117, which features an extended half-life and potent inhibitory effects on IL6 biologic activity. MEDI5117 inhibited IL6-mediated activation of STAT3, suppressing the growth of several tumor types driven by IL6 autocrine signaling. In the same models, MEDI5117 displayed superior preclinical activity relative to a previously developed anti-IL6 antibody. Consistent with roles for IL6 in promoting tumor angiogenesis, we found that MEDI5117 inhibited the growth of endothelial cells, which can produce IL6 and support tumorigenesis. Notably, in tumor xenograft assays in mice, we documented the ability of MEDI5117 to enhance the antitumor activities of chemotherapy or gefitinib in combination treatment regimens. MEDI5117 also displayed robust activity on its own against trastuzumab-resistant HER2(+) tumor cells by targeting the CD44(+)CD24(-) cancer stem cell population. Collectively, our findings extend the evidence of important pleiotropic roles of IL6 in tumorigenesis and drug resistance, and offer a preclinical proof of concept for the use of IL6 antibodies in combination regimens to heighten therapeutic responses and overcome drug resistance.
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Affiliation(s)
- Haihong Zhong
- Oncology Research, MedImmune, Gaithersburg, Maryland
| | - April Davis
- Translational Science, MedImmune, Gaithersburg, Maryland
| | | | | | - Cui Chen
- Oncology Research, MedImmune, Gaithersburg, Maryland
| | - Shannon Breen
- Oncology Research, MedImmune, Gaithersburg, Maryland
| | - Yong S Chang
- University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan
| | - Jiaqi Huang
- Department of Biochemistry and Molecular Biology, Georgia Regents University, Augusta, Georgia
| | - Zheng Liu
- Department of Biochemistry and Molecular Biology, Georgia Regents University, Augusta, Georgia
| | - Yihong Yao
- Department of Biochemistry and Molecular Biology, Georgia Regents University, Augusta, Georgia
| | - Elaine Hurt
- Oncology Research, MedImmune, Gaithersburg, Maryland
| | | | - Michael Fung
- Department of Biochemistry and Molecular Biology, Georgia Regents University, Augusta, Georgia
| | - David A Tice
- Oncology Research, MedImmune, Gaithersburg, Maryland
| | | | - Zhan Xiao
- Oncology Research, MedImmune, Gaithersburg, Maryland
| | - Max S Wicha
- Translational Science, MedImmune, Gaithersburg, Maryland
| | - Hasan Korkaya
- Aileron Therapeutics, Inc., Cambridge, Massachusetts.
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Validation of the diagnostic and prognostic relevance of serum MMP-7 levels in renal cell cancer by using a novel automated fluorescent immunoassay method. Int Urol Nephrol 2016; 48:355-61. [DOI: 10.1007/s11255-015-1185-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 12/07/2015] [Indexed: 10/22/2022]
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Becht E, Giraldo NA, Germain C, de Reyniès A, Laurent-Puig P, Zucman-Rossi J, Dieu-Nosjean MC, Sautès-Fridman C, Fridman WH. Immune Contexture, Immunoscore, and Malignant Cell Molecular Subgroups for Prognostic and Theranostic Classifications of Cancers. Adv Immunol 2016; 130:95-190. [DOI: 10.1016/bs.ai.2015.12.002] [Citation(s) in RCA: 126] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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48
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Coppin C, Porzsolt F, Autenrieth M, Kumpf J, Coldman A, Wilt TJ. WITHDRAWN: Immunotherapy for advanced renal cell cancer. Cochrane Database Syst Rev 2015; 2015:CD001425. [PMID: 26713838 PMCID: PMC10759780 DOI: 10.1002/14651858.cd001425.pub3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This review is being updated and replaced following the publication of a new protocol (Unverzagt S, Moldenhauer I, Coppin C, Greco F, Seliger B. Immunotherapy for metastatic renal cell carcinoma [Protocol]. Cochrane Database of Systematic Reviews 2015, Issue 4. Art. No.: CD011673. DOI: 10.1002/14651858.CD011673). It will remain withdrawn when the new review is published. The editorial group responsible for this previously published document have withdrawn it from publication.
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Affiliation(s)
- Chris Coppin
- BC Cancer Agency Vancouver Island CentreMedical Oncology2410 Lee AvenueVictoriaBCCanadaV8R 6V5
| | - Franz Porzsolt
- University of UlmClinical Economics, Institute of History, Philosophy and Ethics in MedicineFrauensteige 6UlmGermany89075
| | | | | | | | - Timothy J Wilt
- Minneapolis VA Medical CenterGeneral Internal Medicine (111‐0)One Veterans DriveMinneapolisMinnesotaUSA55417
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Elkord E, Burt DJ, Sundstedt A, Nordle Ö, Hedlund G, Hawkins RE. Immunological response and overall survival in a subset of advanced renal cell carcinoma patients from a randomized phase 2/3 study of naptumomab estafenatox plus IFN-α versus IFN-α. Oncotarget 2015; 6:4428-39. [PMID: 25669986 PMCID: PMC4414201 DOI: 10.18632/oncotarget.2922] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 12/11/2014] [Indexed: 01/05/2023] Open
Abstract
Naptumomab estafenatox/ABR-217620/ANYARA (Nap) has been evaluated in clinical phase 1 and 2/3 studies. RCC patients in the phase 2/3 trial were randomized 1:1 in an open label study to receive Nap+IFN-α or IFN-α. In this study, we analyzed the UK patients for their immunological response in relation to prolonged overall survival (OS). We found that Nap-specific T cells were reduced after 3 treatment days in patients' peripheral blood. Levels of both Nap-specific CD4+ and CD8+ T cells were significantly higher 8 days after the first treatment. Patients with such pattern of reduction and expansion of Nap-binding T cells also showed increased levels of IL-2 and IFN-γ in plasma 3 hours after the first Nap treatment. In addition, Nap caused an increase of IL-6, IL-10 and TNF-α. The patients in the UK subset showed a tendency of OS benefit after Nap treatment. Most Nap treated patients with long OS had low baseline IL-6 and normal levels of anti-SEA/E-120 antibodies. Furthermore, patients with pronounced Nap induced IL-2 and T cell expansion had long OS. In conclusion, patients with low baseline IL-6 and normal anti-SEA/E-120 may respond well to Nap by T cell activation and expansion paving the way for anti-tumour effects.
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Affiliation(s)
- Eyad Elkord
- Department of Medical Oncology, Institute of Cancer Sciences, The University of Manchester, Manchester, UK.,Department of Medical Microbiology & Immunology, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, UAE.,Biomedical Research Centre, School of Environment & Life Sciences, University of Salford, Salford, UK
| | - Deborah J Burt
- Department of Medical Oncology, Institute of Cancer Sciences, The University of Manchester, Manchester, UK
| | | | | | | | - Robert E Hawkins
- Department of Medical Oncology, Institute of Cancer Sciences, The University of Manchester, Manchester, UK
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50
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Fu Q, Chang Y, An H, Fu H, Zhu Y, Xu L, Zhang W, Xu J. Prognostic value of interleukin-6 and interleukin-6 receptor in organ-confined clear-cell renal cell carcinoma: a 5-year conditional cancer-specific survival analysis. Br J Cancer 2015; 113:1581-9. [PMID: 26554658 PMCID: PMC4705889 DOI: 10.1038/bjc.2015.379] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 08/11/2015] [Accepted: 10/07/2015] [Indexed: 11/25/2022] Open
Abstract
Background: Interleukin-6 (IL-6) is the major cytokine that induces transcriptional acute and chronic inflammation responses, and was recently incorporated as a recurrence prognostication signature for localised clear-cell renal cell carcinoma (ccRCC). As the prognostic efficacy of initial risk factors may ebb during long-term practice, we aim to report conditional cancer-specific survival (CCSS) of RCC patients and evaluate the impact of IL-6 as well as its receptor (IL-6R) to offer more relevant prognostic information accounting for elapsing time. Methods: We enrolled 180 histologically proven localised ccRCC patients who underwent nephrectomy between 2001 and 2004 with available pathologic information. Five-year CCSS was determined and stratified by future prognostic factors. Constant Cox regression analysis and Harrell's concordance index were used to indicate the predictive accuracy of established models. Results: The 5-year CCSS of organ-confined ccRCC patients with both IL-6- and IL-6R-positive expression was 52% at year 2 after surgery, which was close to locally advanced patients (48%, P=0.564) and was significantly poorer than organ-confined patients with IL-6- or IL-6R-negative expression (89%, P<0.001). Multivariate analyses proved IL-6 and IL-6R as independent predictors after adjusting for demographic factors. Concordance index of pT-IL-6-IL-6R risk stratification was markedly higher compared with the stage, size, grade and necrosis prognostic model (0.724 vs 0.669, P=0.002) or UCLA Integrated Staging System (0.724 vs 0.642, P=0.007) in organ-confined ccRCC population during the first 5 years. Conclusions: Combined IL-6 and IL-6R coexpression emerges as an independent early-stage immunologic prognostic factor for organ-confined ccRCC patients.
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Affiliation(s)
- Qiang Fu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, 200032, China
| | - Yuan Chang
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Huimin An
- Department of Urology, Shanghai Cancer Center, Shanghai Medical College, Fudan University, Mailbox 226, 138 Yixueyuan Road, Shanghai 200032, China
| | - Hangcheng Fu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, 200032, China
| | - Yu Zhu
- Department of Urology, Shanghai Cancer Center, Shanghai Medical College, Fudan University, Mailbox 226, 138 Yixueyuan Road, Shanghai 200032, China
| | - Le Xu
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Weijuan Zhang
- Department of Immunology, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China
| | - Jiejie Xu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, 200032, China
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