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Garcia-Mouronte E, Berna-Rico E, de Nicolas-Ruanes B, Azcarraga-Llobet C, Alonso-Martinez de Salinas L, Bea-Ardebol S. Imiquimod as Local Immunotherapy in the Management of Premalignant Cutaneous Conditions and Skin Cancer. Int J Mol Sci 2023; 24:10835. [PMID: 37446011 DOI: 10.3390/ijms241310835] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 06/24/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
Cutaneous cancers are, by far, the most common malignant neoplasms of the human being. Due to the great array of clinical conditions, their worldwide increasing incidence and the steady ageing of the population, non-invasive treatments modalities that show a good clinical response, a proper benefit-risk ratio and cosmetic results are becoming increasingly important in the clinical setting. Imiquimod is a topically applied immunomodulator which is often used in the management of several premalignant and malignant cutaneous disorders. This article is a review of the current literature on its mechanism of action, pharmacokinetics, and therapeutical effects.
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Affiliation(s)
| | - Emilio Berna-Rico
- Dermatology Department, Hospital Universitario Ramon y Cajal, 28034 Madrid, Spain
| | | | | | | | - Sonia Bea-Ardebol
- Dermatology Department, Hospital Universitario Ramon y Cajal, 28034 Madrid, Spain
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2
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Conlin A, Chun B, Borges V, Moxon N, Parris H, Walker L, Murthy R. Cutaneous responses in HER2+ metastatic breast cancer: A retrospective case series of a Phase 1b study of Tucatinib, an Oral HER2-specific inhibitor in combination with Capecitabine and/or Trastuzumab in third-line or later treatment. CURRENT PROBLEMS IN CANCER: CASE REPORTS 2022. [DOI: 10.1016/j.cpccr.2022.100170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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3
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Drohan A, Vidovic D, Barnes PJ, Giacomantonio CA, Helyer LK. Cutaneous Breast Cancer Metastasis Is Effectively Treated With Intralesional Interleukin-2 and Imiquimod: A Case Report and Brief Literature Review. Front Oncol 2022; 12:877014. [PMID: 35712509 PMCID: PMC9192334 DOI: 10.3389/fonc.2022.877014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 04/28/2022] [Indexed: 12/11/2022] Open
Abstract
Breast cancer is the most common non-cutaneous cancer affecting women worldwide and is a major cause of cancer-related morbidity and mortality in females. While many women are diagnosed with early-stage disease, a subset of women may present with isolated cutaneous metastases or recurrent locoregional cutaneous metastatic disease. There is a paucity of evidence for effective treatments for cutaneous breast cancer metastases. Herein, we present a case of hormone receptor negative, HER2 positive cutaneous breast cancer metastasis treated with intralesional IL-2 and topical imiquimod, which was well tolerated with only minor low grade side effects. We also present a brief literature review of immunotherapy for cutaneous breast cancer metastasis to frame the discussion around using minimally invasive local therapies for this disease. Together, this limited data suggests that intralesional IL-2 and imiquimod may be considered as a safe option when treating a patient with cutaneous breast cancer metastases.
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Affiliation(s)
- Ashley Drohan
- Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Dejan Vidovic
- Department of Surgery, Dalhousie University, Halifax, NS, Canada
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4
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Huang S, Parekh V, Waisman J, Jones V, Yuan Y, Vora N, Li R, Jung J, Kruper L, Abdulla F, Fong Y, Li WY. Cutaneous metastasectomy: Is there a role in breast cancer? A systematic review and overview of current treatment modalities. J Surg Oncol 2022; 126:217-238. [PMID: 35389520 PMCID: PMC9545220 DOI: 10.1002/jso.26870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 03/03/2022] [Accepted: 03/13/2022] [Indexed: 12/21/2022]
Abstract
Cutaneous metastases (CM) are neoplastic lesions involving the dermis or subcutaneous tissues, originating from another primary tumor. Breast cancer is commonest primary solid tumor, representing 24%–50% of CM patients. There is no “standard of care” on management. In particular, the role of surgery in the treatment of cutaneous metastases from breast carcinoma (CMBC) remains controversial. This systematic review evaluates the role of cutaneous metastasectomy in breast cancer and provides an overview of existing treatment types.
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Affiliation(s)
- Samantha Huang
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Vishwas Parekh
- Department of Pathology, City of Hope, Duarte, California, USA
| | - James Waisman
- Department of Medical Oncology & Therapeutics Research, City of Hope, Duarte, California, USA
| | - Veronica Jones
- Division of Breast Surgery, City of Hope, Duarte, California, USA
| | - Yuan Yuan
- Department of Medical Oncology & Therapeutics Research, City of Hope, Duarte, California, USA
| | - Nayana Vora
- Department of Radiation Oncology, City of Hope, Duarte, California, USA
| | - Richard Li
- Department of Radiation Oncology, City of Hope, Duarte, California, USA
| | - Jae Jung
- Division of Derm-oncology, Norton Cancer Institute, Louisville, Kentucky, USA
| | - Laura Kruper
- Division of Breast Surgery, City of Hope, Duarte, California, USA
| | - Farah Abdulla
- Division of Dermatology, City of Hope, Duarte, California, USA
| | - Yuman Fong
- Department of Surgery, City of Hope, Duarte, California, USA
| | - Wai-Yee Li
- Division of Plastic Surgery, City of Hope, Duarte, California, USA
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5
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Nguyen AL, Chong EG, Lee J, Mirshahidi S, Mirshahidi H. A case report of imiquimod topical therapy as treatment for cutaneous metastasis of breast cancer. Rare Tumors 2021; 13:2036361320975748. [PMID: 34249290 PMCID: PMC8239964 DOI: 10.1177/2036361320975748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 11/02/2020] [Indexed: 11/23/2022] Open
Abstract
Cutaneous metastasis of breast cancer carries a poor prognosis, invokes a poor quality of life, and increases mortality by raising one’s risk of bleeding and infection. Currently, options for treatment are systemic chemotherapy, surgical resection and radiation. These treatments are invasive and can have toxic side effects. A 50-year-old African-American woman with stage IV breast cancer with cutaneous metastasis to the left anterior chest and left supraclavicular area was successfully treated with topical imiquimod. She experienced improvement in appearance and symptoms within several months of starting treatment, resulting in near resolution of her cutaneous metastasis. Imiquimod is currently approved for several cutaneous conditions and has the potential to treat cutaneous metastasis of breast cancer.
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Affiliation(s)
- Anthony L Nguyen
- Division of Medical Oncology and Hematology, Department of Medicine, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Esther G Chong
- Department of Medicine, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Joanne Lee
- Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Saied Mirshahidi
- Loma Linda University Cancer Center Biospecimen Laboratory, Department of Microbiology, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Hamid Mirshahidi
- Division of Medical Oncology and Hematology, Department of Medicine, Loma Linda University Medical Center, Loma Linda, CA, USA
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6
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Zheng H, Zou Z, Wu X, Xu Y, Zhu J, Zhou Q, Han R, Song Y, Cheng H. HPV11E7 inhibits IMQ-induced chemokine and colony-stimulating factor production in keratinocytes. Gene 2020; 760:145003. [PMID: 32739587 DOI: 10.1016/j.gene.2020.145003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/05/2020] [Accepted: 07/25/2020] [Indexed: 10/23/2022]
Abstract
Imiquimod (IMQ) is approved as a first-line treatment for genital warts caused by human papillomavirus (HPV) infection. However, the recurrence rate is very high. HPV E7 protein plays a critical role in HPV immune escape. However, the role of HPV11 E7 protein in genital warts recurrence during IMQ treatment is not clear. Here, we found that the expression profile of NHEK cells was obviously changed after IMQ treatment, and a large number of genes encoding cytokines and genes involved in cytokine-mediated signaling pathways and cellular metabolic signaling pathways were up- or downregulated. HPV11E7 overexpression inhibited the IMQ-induced production of of multiple chemokines and colony-stimulating factors in NHEK cells. Furthermore, we found that HPV11E7 could impair the activation of mitogen-activated protein kinase (MAPK) signaling pathway. Therefore, our results suggested that HPV11 E7 diminishes the production of chemokines, colony-stimulating factors and other cytokines via inhibition of the MAPK signaling pathway, which suppresses the therapeutic effect of IMQ and promotes the recurrence of diseases, such as condyloma acuminatum.
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Affiliation(s)
- Huimin Zheng
- Department of Dermatology and Venereology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang, PR China; Department of Dermatology, Lin Hai First People's Hospital, Taizhou 317000, Zhejiang, PR China
| | - Ziqi Zou
- Institute of Immunology, Zhejiang University School of Medicine, Hangzhou 310058, PR China
| | - Xia Wu
- Department of Dermatology and Venereology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang, PR China
| | - Yaohan Xu
- Department of Dermatology and Venereology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang, PR China
| | - Jiang Zhu
- Department of Dermatology and Venereology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang, PR China
| | - Qiang Zhou
- Department of Dermatology and Venereology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang, PR China
| | - Rui Han
- Department of Dermatology and Venereology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang, PR China
| | - Yinjing Song
- Department of Dermatology and Venereology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang, PR China.
| | - Hao Cheng
- Department of Dermatology and Venereology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang, PR China.
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7
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Jouret G, Gonne E, Quatresooz P, Reginster MA, Collins P, Lebas E, Jerusalem G, Nikkels AF. Cutaneous Breast Cancer Metastases Successfully Treated Using an Oxygen Flow Assisted Topical Administration of Methotrexate (OFAMTX). Dermatol Ther (Heidelb) 2020; 10:855-861. [PMID: 32415574 PMCID: PMC7367989 DOI: 10.1007/s13555-020-00393-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Indexed: 12/14/2022] Open
Abstract
Introduction Cutaneous metastases of breast cancer remain a therapeutic challenge. Oxygen flow-assisted topical administration of methotrexate 5% (OFAMTX, 5% methotrexate in a carrier solution) has recently been proven to be an efficacious alternative treatment for extramammary Paget’s disease, which is considered to be an in situ mammary adenocarcinoma of the epidermis. Case Report A 51-year-old patient with triple negative breast cancer presenting with biopsy-proven skin metastases on the chest agreed to a treatment with OFAMTX5%. The treatment duration was 2 weeks and consisted of twice-weekly sessions with OFAMTX5% applied to an area of skin of approximately 40 cm2. Skin biopsies were performed before and 2 months after procedure. The tolerance to the treatment was excellent, and no pain sensations were experienced. Two months post-procedure the treated area presented a post-inflammatory hyperpigmentation. No residual metastatic lesions were detectable on the control skin biopsy. Six months post-procedure the patient is still in clinical remission. Discussion OFAMTX5% represents an alternative skin-directed, painless, patient-friendly and efficacious adjuvant treatment for superficial metastatic lesions of breast cancer. Larger series are required to evaluate the potential of OFAMTX5% for the treatment of superficial metastatic lesions of breast cancer.
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Affiliation(s)
- Gaëlle Jouret
- Department of Dermatology (Skin Cancer Center), Centre Hospitalier Universitaire (CHU) du Sart Tilman, University of Liège, Liège, Belgium
| | - Elodie Gonne
- Department of Medical Oncology, CHU du Sart Tilman, University of Liège, Liège, Belgium
| | - Pascale Quatresooz
- Department of Dermatopathology, CHU du Sart Tilman, University of Liège, Liège, Belgium
| | | | - Patrick Collins
- Department of Dermatopathology, CHU du Sart Tilman, University of Liège, Liège, Belgium
| | - Eve Lebas
- Department of Dermatology (Skin Cancer Center), Centre Hospitalier Universitaire (CHU) du Sart Tilman, University of Liège, Liège, Belgium
| | - Guy Jerusalem
- Department of Medical Oncology, CHU du Sart Tilman, University of Liège, Liège, Belgium
| | - Arjen F Nikkels
- Department of Dermatology (Skin Cancer Center), Centre Hospitalier Universitaire (CHU) du Sart Tilman, University of Liège, Liège, Belgium.
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8
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Cutaneous Metastases in Ovarian Cancer. Cancers (Basel) 2019; 11:cancers11091292. [PMID: 31480743 PMCID: PMC6788186 DOI: 10.3390/cancers11091292] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 08/20/2019] [Accepted: 08/28/2019] [Indexed: 12/12/2022] Open
Abstract
Skin metastases in ovarian cancer are uncommon, but their incidence may be increasing due to improved survival rates. Skin metastases can be divided into umbilical metastases, which are known as Sister Joseph nodules (SJNs) and are associated with peritoneal metastasis, and non-SJN skin metastases, which usually develop within surgical scars and in the vicinity of superficial lymphadenopathy. As most skin metastases develop after specific conditions, recognition of preceding metastatic diseases and prior treatments is necessary for early diagnosis of skin lesions. The prognosis of skin metastases in ovarian cancer varies widely since they are heterogeneous in the site of lesion and the time of appearance. Patients with SJNs at initial diagnosis and patients with surgical scar recurrences without concomitant metastases may have prolonged survival with a combination of surgery and chemotherapy. In patients who developed skin recurrences as a late manifestation, symptoms should be treated with external beam radiotherapy and immune response modifiers. Immune checkpoint blockade can enhance anti-tumor immunity and induce durable clinical responses in multiple tumor types, including advanced chemoresistant ovarian cancer. With the use of radiation therapy, which enhances the systemic anti-tumor immune response, immune checkpoint blockade may be a promising therapeutic strategy for distant metastasis, including skin metastasis.
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Abstract
Cutaneous metastasis portends a poor prognosis. Therefore, a high clinical index of suspicion is necessary so that a clinician knows how to recognize the presentation of a cutaneous metastasis, while the pathologist must know the appropriate stains to order. In this review, the authors summarize the common and uncommon ways that these tumors will present. Frequently a metastatic cancer will present as a firm red nodule or as a plaque, ulcer, or papule. Less commonly they will present with a clinical clue that can alert a clinician to a likely diagnosis; these manifestations include alopecic, vesicular, blue color, sclerodermoid, acrochordon-, or pellagra-like.
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Affiliation(s)
- Evan Alexander Choate
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Alexander Nobori
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA
| | - Scott Worswick
- Department of Dermatology, Keck School of Medicine, University of Southern California, 1441 Eastlake Avenue, Ezralow Tower, Suite 5301, Los Angeles, CA 90033-9174, USA.
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10
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Locy H, de Mey S, de Mey W, De Ridder M, Thielemans K, Maenhout SK. Immunomodulation of the Tumor Microenvironment: Turn Foe Into Friend. Front Immunol 2018; 9:2909. [PMID: 30619273 PMCID: PMC6297829 DOI: 10.3389/fimmu.2018.02909] [Citation(s) in RCA: 166] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 11/27/2018] [Indexed: 12/23/2022] Open
Abstract
Immunotherapy, where the patient's own immune system is exploited to eliminate tumor cells, has become one of the most prominent new cancer treatment options in the last decade. The main hurdle for classical cancer vaccines is the need to identify tumor- and patient specific antigens to include in the vaccine. Therefore, in situ vaccination represents an alternative and promising approach. This type of immunotherapy involves the direct intratumoral administration of different immunomodulatory agents and uses the tumor itself as the source of antigen. The ultimate aim is to convert an immunodormant tumor microenvironment into an immunostimulatory one, enabling the immune system to eradicate all tumor lesions in the body. In this review we will give an overview of different strategies, which can be exploited for the immunomodulation of the tumor microenvironment and their emerging role in the treatment of cancer patients.
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Affiliation(s)
- Hanne Locy
- Laboratory of Molecular and Cellular Therapy (LMCT), Vrije Universiteit Brussel, Brussels, Belgium
| | - Sven de Mey
- Department of Radiotherapy, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Wout de Mey
- Laboratory of Molecular and Cellular Therapy (LMCT), Vrije Universiteit Brussel, Brussels, Belgium
| | - Mark De Ridder
- Department of Radiotherapy, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Kris Thielemans
- Laboratory of Molecular and Cellular Therapy (LMCT), Vrije Universiteit Brussel, Brussels, Belgium
| | - Sarah K. Maenhout
- Laboratory of Molecular and Cellular Therapy (LMCT), Vrije Universiteit Brussel, Brussels, Belgium
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11
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Krishnasamy SR, Almazan TH, Suero-Abreu GA, Jung JY. Successful treatment of cutaneous metastatic breast cancer with topical treatments that potentially synergize with systemic therapy: A case series. JAAD Case Rep 2018; 4:711-715. [PMID: 30128345 PMCID: PMC6098206 DOI: 10.1016/j.jdcr.2018.04.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Shalini R Krishnasamy
- Department of Internal Medicine, Rutgers New Jersey Medical School, New Brunswick, New Jersey.,Department of Dermatology, City of Hope National Comprehensive Cancer Center, Los Angeles, California
| | - Timothy H Almazan
- Department of Dermatology, Stanford University School of Medicine Stanford, Los Angeles.,Department of Dermatology, City of Hope National Comprehensive Cancer Center, Los Angeles, California
| | - Giselle A Suero-Abreu
- Department of Internal Medicine, Rutgers New Jersey Medical School, New Brunswick, New Jersey
| | - Jae Y Jung
- Department of Dermatology, City of Hope National Comprehensive Cancer Center, Los Angeles, California.,Department of Dermatology, University of Louisville, Louisville, Kentucky
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12
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Marron TU, Hammerich L, Brody J. Local Immunotherapies of Cancer. Oncoimmunology 2018. [DOI: 10.1007/978-3-319-62431-0_28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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13
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Hanna E, Abadi R, Abbas O. Imiquimod in dermatology: an overview. Int J Dermatol 2017; 55:831-44. [PMID: 27387373 DOI: 10.1111/ijd.13235] [Citation(s) in RCA: 112] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 07/28/2015] [Accepted: 11/04/2015] [Indexed: 11/28/2022]
Abstract
Imiquimod is an immune response modifier commercially available as a 3.75 and 5% cream. Topical imiquimod stimulates the innate and adaptive immune responses and induces cytokine production. This allows its use for the treatment of a wide variety of benign and malignant skin conditions due to its potential antiviral, antitumor, and immunoregulatory effects. Currently, topical imiquimod is US Food and Drug Administration (FDA)-approved for the treatment of anogenital warts, actinic keratosis, and superficial basal cell carcinomas. However, it has also shown a beneficial effect in the treatment of many other skin disorders. In this review, we describe existing evidence on the mechanism of action of topical imiquimod, its FDA-approved indications, off-label uses, and side effects.
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Affiliation(s)
- Edith Hanna
- American University of Beirut-Medical Center, Beirut, Lebanon
| | - Rami Abadi
- American University of Beirut-Medical Center, Beirut, Lebanon
| | - Ossama Abbas
- American University of Beirut-Medical Center, Beirut, Lebanon
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Abstract
Cancer immunotherapy has long offered the promise of producing cancer treatments that are more effective and less toxic than traditional chemotherapy and radiotherapy. That potential has only begun to be realized in the last 5 years with the first US FDA-approved cancer vaccine (sipuleucel-T), checkpoint inhibitors and adoptive cell therapy. While these therapies have been remarkably more effective than previous cancer immunotherapeutics, they are often limited by their inherently personalized nature. Indeed, each patient’s immune system and cancer are unique, limiting the scalability and generalizability of new approaches. However, emerging solutions may overcome these limitations, producing ‘off-the-shelf’ cancer immunotherapies that transform patient outcomes.
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Affiliation(s)
- Tara S Abraham
- Department of Pharmacology & Experimental Therapeutics, Thomas Jefferson University, 1020 Locust Street Philadelphia, PA 19107, USA
| | - Adam E Snook
- Department of Pharmacology & Experimental Therapeutics, Thomas Jefferson University, 1020 Locust Street Philadelphia, PA 19107, USA
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15
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Damaskos C, Dimitroulis D, Pergialiotis V, Doula C, Koulermou G, Antoniou EA, Frangoulis M, Stergios K, Kontzoglou K. An unexpected metastasis of breast cancer mimicking wheal rush. G Chir 2017; 37:136-138. [PMID: 27734799 DOI: 10.11138/gchir/2016.37.3.136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Breast cancer is the most common cancer among women and ranks second in cancer deaths worldwide. Breast cancer can metastasize to the skin but rarely, cutaneous metastases may be the first indication of the cancer. Skin metastases of breast cancer are usually found on the chest and close to the point of the mastectomy. We present the rare clinical entity of a breast cancer which was first diagnosed due to the skin metastasis away from the breast tumor. This is a rare case because the skin lesions usually appear simultaneously or secondary. Also, while the existing metastasis; the only symptom was the wheal rash.
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16
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Tumor Associated Macrophages as Therapeutic Targets for Breast Cancer. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 1026:331-370. [PMID: 29282692 DOI: 10.1007/978-981-10-6020-5_16] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Tumor-associated macrophages (TAMs) are the most abundant inflammatory infiltrates in the tumor stroma. TAMs promote tumor growth by suppressing immunocompetent cells, including neovascularization and supporting cancer stem cells. In the chapter, we discuss recent efforts in reprogramming or inhibiting tumor-protecting properties of TAMs, and developing potential strategies to increase the efficacy of breast cancer treatment.
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17
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Graziano V, Scognamiglio MT, Zilli M, Giampietro J, Vici P, Natoli C, Grassadonia A. Is the skin a sanctuary for breast cancer cells during treatment with anti-HER2 antibodies? Cancer Biol Ther 2016; 16:1704-9. [PMID: 26552483 PMCID: PMC4847805 DOI: 10.1080/15384047.2015.1108490] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
The occurrence of skin metastases is a common event in patients affected by advanced breast cancer, usually associated with systemic disease progression. Here we describe 2 cases of diffuse cutaneous metastases from HER2-overexpressing breast cancer occurring despite a dramatic response in liver and bone, respectively, during treatment with anti-HER2 antibodies Trastuzumab and Pertuzumab. We discuss the reasons for this discrepancy and suggest a possible implication of impaired immune response in the skin. Future research should provide strategies to overcome the induction of immune privilege in the skin in order to avoid discontinuation of effective treatments.
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Affiliation(s)
- Vincenzo Graziano
- a Department of Medical ; Oral and Biotechnological Sciences; University "G. D'Annunzio" ; Chieti , Italy
| | | | - Marinella Zilli
- c Medical Oncology Unit; "SS. Annunziata" Hospital ; Chieti , Italy
| | | | - Patrizia Vici
- d Division of Medical Oncology B; Regina Elena National Cancer Institute ; Rome , Italy
| | - Clara Natoli
- a Department of Medical ; Oral and Biotechnological Sciences; University "G. D'Annunzio" ; Chieti , Italy
| | - Antonino Grassadonia
- a Department of Medical ; Oral and Biotechnological Sciences; University "G. D'Annunzio" ; Chieti , Italy
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18
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Vacchelli E, Bloy N, Aranda F, Buqué A, Cremer I, Demaria S, Eggermont A, Formenti SC, Fridman WH, Fucikova J, Galon J, Spisek R, Tartour E, Zitvogel L, Kroemer G, Galluzzi L. Trial Watch: Immunotherapy plus radiation therapy for oncological indications. Oncoimmunology 2016; 5:e1214790. [PMID: 27757313 DOI: 10.1080/2162402x.2016.1214790] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 07/15/2016] [Indexed: 02/08/2023] Open
Abstract
Malignant cells succumbing to some forms of radiation therapy are particularly immunogenic and hence can initiate a therapeutically relevant adaptive immune response. This reflects the intrinsic antigenicity of malignant cells (which often synthesize a high number of potentially reactive neo-antigens) coupled with the ability of radiation therapy to boost the adjuvanticity of cell death as it stimulates the release of endogenous adjuvants from dying cells. Thus, radiation therapy has been intensively investigated for its capacity to improve the therapeutic profile of several anticancer immunotherapies, including (but not limited to) checkpoint blockers, anticancer vaccines, oncolytic viruses, Toll-like receptor (TLR) agonists, cytokines, and several small molecules with immunostimulatory effects. Here, we summarize recent preclinical and clinical advances in this field of investigation.
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Affiliation(s)
- Erika Vacchelli
- INSERM, U1138, Paris, France; Université Paris Descartes/Paris V, Sorbonne Paris Cité, Paris, France; Université Pierre et Marie Curie/Paris VI, Paris, France; Equipe 11 labellisée par la Ligue Nationale contre le Cancer, Center de Recherche des Cordeliers, Paris, France; Gustave Roussy Cancer Campus, Villejuif, France
| | - Norma Bloy
- INSERM, U1138, Paris, France; Université Paris Descartes/Paris V, Sorbonne Paris Cité, Paris, France; Université Pierre et Marie Curie/Paris VI, Paris, France; Equipe 11 labellisée par la Ligue Nationale contre le Cancer, Center de Recherche des Cordeliers, Paris, France; Gustave Roussy Cancer Campus, Villejuif, France
| | - Fernando Aranda
- Group of Immune receptors of the Innate and Adaptive System, Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS) , Barcelona, Spain
| | - Aitziber Buqué
- INSERM, U1138, Paris, France; Université Paris Descartes/Paris V, Sorbonne Paris Cité, Paris, France; Université Pierre et Marie Curie/Paris VI, Paris, France; Equipe 11 labellisée par la Ligue Nationale contre le Cancer, Center de Recherche des Cordeliers, Paris, France; Gustave Roussy Cancer Campus, Villejuif, France
| | - Isabelle Cremer
- INSERM, U1138, Paris, France; Université Paris Descartes/Paris V, Sorbonne Paris Cité, Paris, France; Université Pierre et Marie Curie/Paris VI, Paris, France; Equipe 13, Center de Recherche des Cordeliers, Paris, France
| | - Sandra Demaria
- Department of Radiation Oncology, Weill Cornell Medical College , New York, NY, USA
| | | | | | - Wolf Hervé Fridman
- INSERM, U1138, Paris, France; Université Paris Descartes/Paris V, Sorbonne Paris Cité, Paris, France; Université Pierre et Marie Curie/Paris VI, Paris, France; Equipe 13, Center de Recherche des Cordeliers, Paris, France
| | - Jitka Fucikova
- Sotio, Prague, Czech Republic; Department of Immunology, 2nd Faculty of Medicine and University Hospital Motol, Charles University, Prague, Czech Republic
| | - Jérôme Galon
- INSERM, U1138, Paris, France; Université Paris Descartes/Paris V, Sorbonne Paris Cité, Paris, France; Université Pierre et Marie Curie/Paris VI, Paris, France; Laboratory of Integrative Cancer Immunology, Center de Recherche des Cordeliers, Paris, France
| | - Radek Spisek
- Sotio, Prague, Czech Republic; Department of Immunology, 2nd Faculty of Medicine and University Hospital Motol, Charles University, Prague, Czech Republic
| | - Eric Tartour
- Université Paris Descartes/Paris V, Sorbonne Paris Cité, Paris, France; INSERM, U970, Paris, France; Paris-Cardiovascular Research Center (PARCC), Paris, France; Service d'Immunologie Biologique, Hôpital Européen Georges Pompidou (HEGP), AP-HP, Paris, France
| | - Laurence Zitvogel
- Gustave Roussy Cancer Campus, Villejuif, France; INSERM, U1015, CICBT1428, Villejuif, France
| | - Guido Kroemer
- INSERM, U1138, Paris, France; Université Paris Descartes/Paris V, Sorbonne Paris Cité, Paris, France; Université Pierre et Marie Curie/Paris VI, Paris, France; Equipe 11 labellisée par la Ligue Nationale contre le Cancer, Center de Recherche des Cordeliers, Paris, France; Pôle de Biologie, Hôpital Européen Georges Pompidou, AP-HP, Paris, France; Metabolomics and Cell Biology Platforms, Gustave Roussy Cancer Campus, Villejuif, France; Department of Women's and Children's Health, Karolinska University Hospital, Stockholm, Sweden
| | - Lorenzo Galluzzi
- INSERM, U1138, Paris, France; Université Paris Descartes/Paris V, Sorbonne Paris Cité, Paris, France; Université Pierre et Marie Curie/Paris VI, Paris, France; Equipe 11 labellisée par la Ligue Nationale contre le Cancer, Center de Recherche des Cordeliers, Paris, France; Gustave Roussy Cancer Campus, Villejuif, France; Department of Radiation Oncology, Weill Cornell Medical College, New York, NY, USA
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19
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Bubna AK. Imiquimod - Its role in the treatment of cutaneous malignancies. Indian J Pharmacol 2016; 47:354-9. [PMID: 26288465 PMCID: PMC4527053 DOI: 10.4103/0253-7613.161249] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 03/26/2015] [Accepted: 06/20/2015] [Indexed: 01/12/2023] Open
Abstract
Imiquimod is a synthetic imidazoquinolone amine, which has potent immune response modifier activity, when topically used. This characteristic property of imiquimod has led to its use in a number of applications in dermatology, particularly in cutaneous malignancies, where it has been found to be effective and safe. Currently, additional mechanisms for its activity in actinic keratosis, basal cell carcinoma, and invasive squamous cell carcinoma have been elucidated. Its usage for cutaneous metastasis in breast cancer has been a further addition to its therapeutic armamentarium recently.
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Affiliation(s)
- Aditya Kumar Bubna
- Assistant Professor, Department of Dermatology, Sri Ramachandra University, Porur, Chennai, Tamil Nadu, India
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20
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Hammerich L, Bhardwaj N, Kohrt HE, Brody JD. In situ vaccination for the treatment of cancer. Immunotherapy 2016; 8:315-30. [DOI: 10.2217/imt.15.120] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Vaccination has had a tremendous impact on human health by harnessing the immune system to prevent and eradicate infectious diseases and this same approach might be used in cancer therapy. Cancer vaccine development has been slowed hindered by the paucity of universal tumor-associated antigens and the difficulty in isolating and preparing individualized vaccines ex vivo. Another approach has been to initiate or stimulate an immune response in situ (at the tumor site) and thus exploit the potentially numerous tumor-associated antigens there. Here, we review the many approaches that have attempted to accomplish effective in situ vaccination, using intratumoral administration of immunomodulators to increase the numbers or activation state of either antigen present cells or T cells within the tumor.
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Affiliation(s)
- Linda Hammerich
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Nina Bhardwaj
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Holbrook E Kohrt
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Joshua D Brody
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
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21
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Liu R, Luo F, Liu X, Wang L, Yang J, Deng Y, Huang E, Qian J, Lu Z, Jiang X, Zhang D, Chu Y. Biological Response Modifier in Cancer Immunotherapy. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 909:69-138. [PMID: 27240457 DOI: 10.1007/978-94-017-7555-7_2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Biological response modifiers (BRMs) emerge as a lay of new compounds or approaches used in improving cancer immunotherapy. Evidences highlight that cytokines, Toll-like receptor (TLR) signaling, and noncoding RNAs are of crucial roles in modulating antitumor immune response and cancer-related chronic inflammation, and BRMs based on them have been explored. In particular, besides some cytokines like IFN-α and IL-2, several Toll-like receptor (TLR) agonists like BCG, MPL, and imiquimod are also licensed to be used in patients with several malignancies nowadays, and the first artificial small noncoding RNA (microRNA) mimic, MXR34, has entered phase I clinical study against liver cancer, implying their potential application in cancer therapy. According to amounts of original data, this chapter will review the regulatory roles of TLR signaling, some noncoding RNAs, and several key cytokines in cancer and cancer-related immune response, as well as the clinical cases in cancer therapy based on them.
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Affiliation(s)
- Ronghua Liu
- Department of Immunology, Key Laboratory of Medical Molecular Virology of MOE/MOH, School of Basic Medical Sciences, Fudan University, No.138, Yi Xue Yuan Rd., mail box 226, Shanghai, 200032, People's Republic of China.,Biotherapy Research Center, Fudan University, Shanghai, 200032, China
| | - Feifei Luo
- Biotherapy Research Center, Fudan University, Shanghai, 200032, China.,Department of Digestive Diseases of Huashan Hospital, Fudan University, Shanghai, China
| | - Xiaoming Liu
- Department of Immunology, Key Laboratory of Medical Molecular Virology of MOE/MOH, School of Basic Medical Sciences, Fudan University, No.138, Yi Xue Yuan Rd., mail box 226, Shanghai, 200032, People's Republic of China.,Department of Dermatology, Shenzhen Hospital, Peking University, Shenzhen, Guangdong, 518036, China
| | - Luman Wang
- Department of Immunology, Key Laboratory of Medical Molecular Virology of MOE/MOH, School of Basic Medical Sciences, Fudan University, No.138, Yi Xue Yuan Rd., mail box 226, Shanghai, 200032, People's Republic of China.,Biotherapy Research Center, Fudan University, Shanghai, 200032, China
| | - Jiao Yang
- Department of Immunology, Key Laboratory of Medical Molecular Virology of MOE/MOH, School of Basic Medical Sciences, Fudan University, No.138, Yi Xue Yuan Rd., mail box 226, Shanghai, 200032, People's Republic of China.,Biotherapy Research Center, Fudan University, Shanghai, 200032, China
| | - Yuting Deng
- Department of Immunology, Key Laboratory of Medical Molecular Virology of MOE/MOH, School of Basic Medical Sciences, Fudan University, No.138, Yi Xue Yuan Rd., mail box 226, Shanghai, 200032, People's Republic of China.,Biotherapy Research Center, Fudan University, Shanghai, 200032, China
| | - Enyu Huang
- Department of Immunology, Key Laboratory of Medical Molecular Virology of MOE/MOH, School of Basic Medical Sciences, Fudan University, No.138, Yi Xue Yuan Rd., mail box 226, Shanghai, 200032, People's Republic of China.,Biotherapy Research Center, Fudan University, Shanghai, 200032, China
| | - Jiawen Qian
- Department of Immunology, Key Laboratory of Medical Molecular Virology of MOE/MOH, School of Basic Medical Sciences, Fudan University, No.138, Yi Xue Yuan Rd., mail box 226, Shanghai, 200032, People's Republic of China.,Biotherapy Research Center, Fudan University, Shanghai, 200032, China
| | - Zhou Lu
- Department of Immunology, Key Laboratory of Medical Molecular Virology of MOE/MOH, School of Basic Medical Sciences, Fudan University, No.138, Yi Xue Yuan Rd., mail box 226, Shanghai, 200032, People's Republic of China.,Biotherapy Research Center, Fudan University, Shanghai, 200032, China
| | - Xuechao Jiang
- Department of Immunology, Key Laboratory of Medical Molecular Virology of MOE/MOH, School of Basic Medical Sciences, Fudan University, No.138, Yi Xue Yuan Rd., mail box 226, Shanghai, 200032, People's Republic of China.,Biotherapy Research Center, Fudan University, Shanghai, 200032, China
| | - Dan Zhang
- Department of Immunology, Key Laboratory of Medical Molecular Virology of MOE/MOH, School of Basic Medical Sciences, Fudan University, No.138, Yi Xue Yuan Rd., mail box 226, Shanghai, 200032, People's Republic of China.,Biotherapy Research Center, Fudan University, Shanghai, 200032, China
| | - Yiwei Chu
- Department of Immunology, Key Laboratory of Medical Molecular Virology of MOE/MOH, School of Basic Medical Sciences, Fudan University, No.138, Yi Xue Yuan Rd., mail box 226, Shanghai, 200032, People's Republic of China. .,Biotherapy Research Center, Fudan University, Shanghai, 200032, China.
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22
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Hammerich L, Binder A, Brody JD. In situ vaccination: Cancer immunotherapy both personalized and off-the-shelf. Mol Oncol 2015; 9:1966-81. [PMID: 26632446 PMCID: PMC5528727 DOI: 10.1016/j.molonc.2015.10.016] [Citation(s) in RCA: 127] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 10/20/2015] [Accepted: 10/20/2015] [Indexed: 01/15/2023] Open
Abstract
As cancer immunotherapy continues to benefit from novel approaches which cut immune 'brake pedals' (e.g. anti-PD1 and anti-CTLA4 antibodies) and push immune cell gas pedals (e.g. IL2, and IFNα) there will be increasing need to develop immune 'steering wheels' such as vaccines to guide the immune system specifically toward tumor associated antigens. Two primary hurdles in cancer vaccines have been: identification of universal antigens to be used in 'off-the-shelf' vaccines for common cancers, and 2) logistical hurdles of ex vivo production of individualized whole tumor cell vaccines. Here we summarize approaches using 'in situ vaccination' in which intratumoral administration of off-the-shelf immunomodulators have been developed to specifically induce (or amplify) T cell responses to each patient's individual tumor. Clinical studies have confirmed the induction of systemic immune and clinical responses to such approaches and preclinical models have suggested ways to further potentiate the translation of in situ vaccine trials for our patients.
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Affiliation(s)
- Linda Hammerich
- Icahn School of Medicine at Mount Sinai Hess Center for Science and Medicine, United States
| | - Adam Binder
- Icahn School of Medicine at Mount Sinai Hess Center for Science and Medicine, United States
| | - Joshua D Brody
- Icahn School of Medicine at Mount Sinai Hess Center for Science and Medicine, United States.
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23
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Gentile F, Deriu MA, Licandro G, Prunotto A, Danani A, Tuszynski JA. Structure Based Modeling of Small Molecules Binding to the TLR7 by Atomistic Level Simulations. Molecules 2015; 20:8316-40. [PMID: 26007168 PMCID: PMC6272798 DOI: 10.3390/molecules20058316] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Revised: 04/17/2015] [Accepted: 04/30/2015] [Indexed: 12/15/2022] Open
Abstract
Toll-Like Receptors (TLR) are a large family of proteins involved in the immune system response. Both the activation and the inhibition of these receptors can have positive effects on several diseases, including viral pathologies and cancer, therefore prompting the development of new compounds. In order to provide new indications for the design of Toll-Like Receptor 7 (TLR7)-targeting drugs, the mechanism of interaction between the TLR7 and two important classes of agonists (imidazoquinoline and adenine derivatives) was investigated through docking and Molecular Dynamics simulations. To perform the computational analysis, a new model for the dimeric form of the receptors was necessary and therefore created. Qualitative and quantitative differences between agonists and inactive compounds were determined. The in silico results were compared with previous experimental observations and employed to define the ligand binding mechanism of TLR7.
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Affiliation(s)
- Francesco Gentile
- Department of Physics, University of Alberta, Edmonton, AB T6G 2E1, Canada.
| | - Marco A Deriu
- Institute of Computer Integrated Manufacturing for Sustainable Innovation, Department of Innovative Technologies, University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Manno CH-6928, Switzerland.
| | - Ginevra Licandro
- Institute of Computer Integrated Manufacturing for Sustainable Innovation, Department of Innovative Technologies, University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Manno CH-6928, Switzerland.
| | - Alessio Prunotto
- Institute of Computer Integrated Manufacturing for Sustainable Innovation, Department of Innovative Technologies, University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Manno CH-6928, Switzerland.
| | - Andrea Danani
- Institute of Computer Integrated Manufacturing for Sustainable Innovation, Department of Innovative Technologies, University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Manno CH-6928, Switzerland.
| | - Jack A Tuszynski
- Department of Physics, University of Alberta, Edmonton, AB T6G 2E1, Canada.
- Cross Cancer Institute, Department of Oncology, University of Alberta, Edmonton, AB T6G 1Z2, Canada.
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24
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Adams S, Novik Y, Oratz R, Axelrod D, Speyer J, Tiersten A, Goldberg JD, Bhardwaj N, Unutmaz D, Demaria S, Formenti S. Clinical trial evidence of the antitumor activity of topical imiquimod for breast cancer skin metastases. J Clin Oncol 2014; 32:3204-5. [PMID: 25092780 DOI: 10.1200/jco.2014.56.1282] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Sylvia Adams
- New York University School of Medicine, New York, NY
| | - Yelena Novik
- New York University School of Medicine, New York, NY
| | - Ruth Oratz
- New York University School of Medicine, New York, NY
| | | | - James Speyer
- New York University School of Medicine, New York, NY
| | | | | | | | - Derya Unutmaz
- New York University School of Medicine, New York, NY
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