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Walle T, Kraske JA, Liao B, Lenoir B, Timke C, von Bohlen und Halbach E, Tran F, Griebel P, Albrecht D, Ahmed A, Suarez-Carmona M, Jiménez-Sánchez A, Beikert T, Tietz-Dahlfuß A, Menevse AN, Schmidt G, Brom M, Pahl JHW, Antonopoulos W, Miller M, Perez RL, Bestvater F, Giese NA, Beckhove P, Rosenstiel P, Jäger D, Strobel O, Pe’er D, Halama N, Debus J, Cerwenka A, Huber PE. Radiotherapy orchestrates natural killer cell dependent antitumor immune responses through CXCL8. SCIENCE ADVANCES 2022; 8:eabh4050. [PMID: 35319989 PMCID: PMC8942354 DOI: 10.1126/sciadv.abh4050] [Citation(s) in RCA: 63] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 01/31/2022] [Indexed: 05/17/2023]
Abstract
Radiotherapy is a mainstay cancer therapy whose antitumor effects partially depend on T cell responses. However, the role of Natural Killer (NK) cells in radiotherapy remains unclear. Here, using a reverse translational approach, we show a central role of NK cells in the radiation-induced immune response involving a CXCL8/IL-8-dependent mechanism. In a randomized controlled pancreatic cancer trial, CXCL8 increased under radiotherapy, and NK cell positively correlated with prolonged overall survival. Accordingly, NK cells preferentially infiltrated irradiated pancreatic tumors and exhibited CD56dim-like cytotoxic transcriptomic states. In experimental models, NF-κB and mTOR orchestrated radiation-induced CXCL8 secretion from tumor cells with senescence features causing directional migration of CD56dim NK cells, thus linking senescence-associated CXCL8 release to innate immune surveillance of human tumors. Moreover, combined high-dose radiotherapy and adoptive NK cell transfer improved tumor control over monotherapies in xenografted mice, suggesting NK cells combined with radiotherapy as a rational cancer treatment strategy.
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Affiliation(s)
- Thomas Walle
- Department of Molecular and Radiooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg, Germany
- Department of Medical Oncology, University Hospital Heidelberg, Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
- Department of Immunobiochemistry and MI3, Mannheim Institute for Innate Immunoscience, Heidelberg University, Medical Faculty Mannheim, Mannheim, Germany
- Corresponding author. (T.W.); (P.E.H.)
| | - Joscha A. Kraske
- Department of Molecular and Radiooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Radiooncology and Radiotherapy, University Hospital Heidelberg, Heidelberg, Germany
| | - Boyu Liao
- Department of Molecular and Radiooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Radiooncology and Radiotherapy, University Hospital Heidelberg, Heidelberg, Germany
| | - Bénédicte Lenoir
- Clinical Cooperation Unit Applied Tumor Immunity, German Cancer Research Center, Heidelberg, Germany
- Department of Translational Immunotherapy, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Carmen Timke
- Department of Molecular and Radiooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Radiation Oncology, St. Franziskus Hospital, Flensburg, Germany
| | - Emilia von Bohlen und Halbach
- Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg, Germany
- Department of Medical Oncology, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Applied Tumor Immunity, German Cancer Research Center, Heidelberg, Germany
- Department of Translational Immunotherapy, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Florian Tran
- Institute of Clinical Molecular Biology, Kiel University and University Medical Center Schleswig-Holstein, Kiel, Germany
- Department of Internal Medicine I, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Paul Griebel
- Institute of Clinical Molecular Biology, Kiel University and University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Dorothee Albrecht
- Department of Molecular and Radiooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Azaz Ahmed
- Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg, Germany
- Clinical Cooperation Unit Applied Tumor Immunity, German Cancer Research Center, Heidelberg, Germany
- Department of Translational Immunotherapy, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Meggy Suarez-Carmona
- Clinical Cooperation Unit Applied Tumor Immunity, German Cancer Research Center, Heidelberg, Germany
- Department of Translational Immunotherapy, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Alejandro Jiménez-Sánchez
- Program for Computational and Systems Biology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Tizian Beikert
- Department of Molecular and Radiooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Radiooncology and Radiotherapy, University Hospital Heidelberg, Heidelberg, Germany
| | - Alexandra Tietz-Dahlfuß
- Department of Molecular and Radiooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Ayse Nur Menevse
- Leibniz Institute for Immunotherapy, Division of Interventional Immunology, Regensburg, Germany
| | - Gabriele Schmidt
- Core Facility Light Microscopy, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Manuela Brom
- Core Facility Light Microscopy, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jens H. W. Pahl
- Department of Immunobiochemistry and MI3, Mannheim Institute for Innate Immunoscience, Heidelberg University, Medical Faculty Mannheim, Mannheim, Germany
| | | | - Matthias Miller
- Department of Immunobiochemistry and MI3, Mannheim Institute for Innate Immunoscience, Heidelberg University, Medical Faculty Mannheim, Mannheim, Germany
| | - Ramon Lopez Perez
- Department of Molecular and Radiooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Radiooncology and Radiotherapy, University Hospital Heidelberg, Heidelberg, Germany
| | - Felix Bestvater
- Core Facility Light Microscopy, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Nathalia A. Giese
- Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Philipp Beckhove
- Leibniz Institute for Immunotherapy, Division of Interventional Immunology, Regensburg, Germany
| | - Philip Rosenstiel
- Institute of Clinical Molecular Biology, Kiel University and University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Dirk Jäger
- Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg, Germany
- Department of Medical Oncology, University Hospital Heidelberg, Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
- Clinical Cooperation Unit Applied Tumor Immunity, German Cancer Research Center, Heidelberg, Germany
| | - Oliver Strobel
- Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Dana Pe’er
- Parker Institute for Cancer Immunotherapy, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Program for Computational and Systems Biology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Niels Halama
- Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg, Germany
- Department of Medical Oncology, University Hospital Heidelberg, Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
- Department of Translational Immunotherapy, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Helmholtz Center for Translational Oncology (HITRON), Mainz, Germany
- Institute of Immunology, Heidelberg University Hospital, Heidelberg, Germany
| | - Jürgen Debus
- Department of Radiooncology and Radiotherapy, University Hospital Heidelberg, Heidelberg, Germany
- Heidelberg Ion Therapy Center (HIT), Heidelberg, Germany
- Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany
| | - Adelheid Cerwenka
- Department of Immunobiochemistry and MI3, Mannheim Institute for Innate Immunoscience, Heidelberg University, Medical Faculty Mannheim, Mannheim, Germany
| | - Peter E. Huber
- Department of Molecular and Radiooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Radiooncology and Radiotherapy, University Hospital Heidelberg, Heidelberg, Germany
- Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany
- Corresponding author. (T.W.); (P.E.H.)
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Seshacharyulu P, Baine MJ, Souchek JJ, Menning M, Kaur S, Yan Y, Ouellette MM, Jain M, Lin C, Batra SK. Biological determinants of radioresistance and their remediation in pancreatic cancer. Biochim Biophys Acta Rev Cancer 2017; 1868:69-92. [PMID: 28249796 PMCID: PMC5548591 DOI: 10.1016/j.bbcan.2017.02.003] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 02/16/2017] [Accepted: 02/17/2017] [Indexed: 12/17/2022]
Abstract
Despite recent advances in radiotherapy, a majority of patients diagnosed with pancreatic cancer (PC) do not achieve objective responses due to the existence of intrinsic and acquired radioresistance. Identification of molecular mechanisms that compromise the efficacy of radiation therapy and targeting these pathways is paramount for improving radiation response in PC patients. In this review, we have summarized molecular mechanisms associated with the radio-resistant phenotype of PC. Briefly, we discuss the reversible and irreversible biological consequences of radiotherapy, such as DNA damage and DNA repair, mechanisms of cancer cell survival and radiation-induced apoptosis following radiotherapy. We further describe various small molecule inhibitors and molecular targeting agents currently being tested in preclinical and clinical studies as potential radiosensitizers for PC. Notably, we draw attention towards the confounding effects of cancer stem cells, immune system, and the tumor microenvironment in the context of PC radioresistance and radiosensitization. Finally, we discuss the need for examining selective radioprotectors in light of the emerging evidence on radiation toxicity to non-target tissue associated with PC radiotherapy.
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Affiliation(s)
- Parthasarathy Seshacharyulu
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, Nebraska, United States of America
| | - Michael J Baine
- Fred & Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, Nebraska, United States of America
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska, United States of America
| | - Joshua J Souchek
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, Nebraska, United States of America
| | - Melanie Menning
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, Nebraska, United States of America
| | - Sukhwinder Kaur
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, Nebraska, United States of America
| | - Ying Yan
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska, United States of America
| | - Michel M. Ouellette
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, Nebraska, United States of America
| | - Maneesh Jain
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, Nebraska, United States of America
| | - Chi Lin
- Fred & Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, Nebraska, United States of America
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska, United States of America
| | - Surinder K. Batra
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, Nebraska, United States of America
- Eppley Institute for Research in Cancer and Allied Diseases, University of Nebraska Medical Center, Omaha, Nebraska, United States of America
- Fred & Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, Nebraska, United States of America
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Faloppi L, Andrikou K, Cascinu S. Cetuximab: still an option in the treatment of pancreatic cancer? Expert Opin Biol Ther 2013; 13:791-801. [PMID: 23560505 DOI: 10.1517/14712598.2013.786697] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION In this review, we analyzed the current literature about cetuximab to clarify its role in the treatment of pancreatic cancer. Using single-agent gemcitabine has been the standard treatment for more than 15 years for advanced pancreatic cancer. The attempts at improving the results by combining it with several other drugs, such as fluorouracil, cisplatin, irinotecan, oxaliplatin, or pemetrexed produced no clear survival benefit. Recently, however, new combination chemotherapy regimens (e.g., FOLFIRINOX, nab-paclitaxel plus gemcitabine) achieved a significant survival benefit compared to gemcitabine alone. AREAS COVERED Epidermal growth factor receptor (EGFR) transmembrane glycoprotein has been demonstrated to be overexpressed in pancreatic cancer, and it correlates with more advanced disease, poor survival, and the presence of metastases. Therefore, inhibition of the EGFR signaling pathway could be an attractive therapeutic target in this tumor. Although several combinations of EGFR inhibitors with chemotherapy demonstrate inhibition of tumor-induced angiogenesis, tumor cell apoptosis, and regression in xenograft models, these benefits remain to be confirmed. EXPERT OPINION The encouraging results from preclinical and early clinical studies with cetuximab in pancreatic cancer were not confirmed in a Phase III trial. Cetuximab failed to demonstrate improved patient outcome when paired with various chemotherapeutic regimens and/or other biological agents.
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Affiliation(s)
- Luca Faloppi
- University Hospital, Università Politecnica delle Marche, Department of Medical Oncology, via Conca 71, 60126 Ancona, Italy
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Rudra S, Narang AK, Pawlik TM, Wang H, Jaffee EM, Zheng L, Le DT, Cosgrove D, Hruban RH, Fishman EK, Tuli R, Laheru DA, Wolfgang CL, Diaz LA, Herman JM. Evaluation of predictive variables in locally advanced pancreatic adenocarcinoma patients receiving definitive chemoradiation. Pract Radiat Oncol 2012; 2:77-85. [PMID: 23585823 DOI: 10.1016/j.prro.2011.06.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE To analyze a single-center experience with locally advanced pancreatic cancer (LAPC) patients treated with chemoradiation (CRT) and to evaluate predictive variables of outcome. METHODS AND MATERIALS LAPC patients at our institution between 1997 and 2009 were identified (n = 109). Progression-free survival (PFS) and overall survival (OS) were assessed using Kaplan-Meier analysis. Cox proportional hazard models were used to evaluate predictive factors for survival. Patterns of failure were characterized, and associations between local progression and distant metastasis were explored. RESULTS Median OS was 12.1 months (2.5-34.7 months) and median PFS was 6.7 months (1.1-34.7 months). Poor prognostic factors for OS include Karnofsky performance status ≤80 (P = .0062), treatment interruption (P = .0474), and locally progressive disease at time of first post-therapy imaging (P = .0078). Karnofsky performance status ≤80 (P = .0128), pretreatment CA19-9 >1000 U/mL (P = .0224), and treatment interruption (P = .0009) were poor prognostic factors for PFS. Both local progression (36%) and distant failure (62%) were common. Local progression was associated with a higher incidence of metastasis (P < .0001) and decreased time to metastasis (P < .0001). CONCLUSIONS LAPC patients who suffer local progression following definitive CRT may experience inferior OS and increased risk of metastasis, warranting efforts to improve control of local disease. However, patients with poor pretreatment performance status, elevated CA19-9 levels, and treatment interruptions may experience poor outcomes despite aggressive management with CRT, and may optimally be treated with induction chemotherapy or supportive care. Novel therapies aimed at controlling both local and systemic progression are needed for patients with LAPC.
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Affiliation(s)
- Sonali Rudra
- Department of Radiation and Cellular Oncology University of Chicago, Chicago, Illinois
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