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Daei Sorkhabi A, Fazlollahi A, Sarkesh A, Aletaha R, Feizi H, Mousavi SE, Nejadghaderi SA, Sullman MJM, Kolahi AA, Safiri S. Efficacy and safety of veliparib plus chemotherapy for the treatment of lung cancer: A systematic review of clinical trials. PLoS One 2023; 18:e0291044. [PMID: 37682974 PMCID: PMC10490931 DOI: 10.1371/journal.pone.0291044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND As a poly-ADP ribose polymerase (PARP) inhibitor, veliparib has been identified as a potential therapeutic agent for lung cancer. The present study aimed to conduct a systematic review of clinical trials investigating the efficacy and safety of veliparib for treating lung cancer. METHODS PubMed, Scopus, the Web of Science, and Google Scholar were systematically searched up to October 30, 2022. Only randomized controlled trials (RCTs) evaluating the efficacy or safety of veliparib in the treatment of lung cancer patients were included. Studies were excluded if they were not RCTs, enrolled healthy participants or patients with conditions other than lung cancer, or investigated therapeutic approaches other than veliparib. The Cochrane risk-of-bias tool was used for quality assessment. RESULTS The seven RCTs (n = 2188) showed that patients treated with a combination of veliparib and chemotherapy had a significantly higher risk of adverse events, when compared to the control arm. There was no statistically significant difference in overall survival (OS) between those treated with veliparib plus chemotherapy and those receiving the standard therapies. Only two trials demonstrated an improvement in progression-free survival (PFS), and only one study found an increase in objective response rate (ORR). Furthermore, adding veliparib to standard chemotherapy showed no benefit in extending the duration of response (DoR) in any of the studies. CONCLUSIONS Only a small number of studies have found veliparib to be effective, in terms of improved OS, PFS, and ORR, while the majority of studies found no benefit for veliparib over standard treatment.
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Affiliation(s)
- Amin Daei Sorkhabi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Asra Fazlollahi
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Aila Sarkesh
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Aletaha
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamidreza Feizi
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyed Ehsan Mousavi
- Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyed Aria Nejadghaderi
- Tuberculosis and Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Mark J. M. Sullman
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
- Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
| | - Ali-Asghar Kolahi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeid Safiri
- Clinical Research Development Unit of Tabriz Valiasr Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
- Social Determinants of Health Research Center, Department of Community Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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Kang K, Wu Y, Yao Z, Lu Y. Tackling the current dilemma of immunotherapy in extensive-stage small cell lung cancer: A promising strategy of combining with radiotherapy. Cancer Lett 2023; 565:216239. [PMID: 37211066 DOI: 10.1016/j.canlet.2023.216239] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/05/2023] [Accepted: 05/17/2023] [Indexed: 05/23/2023]
Abstract
Progress in the treatment of small cell lung cancer (SCLC) has been modest over the past decades until the advent of immune checkpoint inhibitors, which have redefined the standard first-line treatment for extensive-stage SCLC (ES-SCLC). However, despite the positive results of several clinical trials, the limited survival benefit achieved suggests that the priming and sustaining of immunotherapeutic efficacy are poor and further investigation is urgently needed. In this review, we aim to summarize the potential mechanisms underlying the limited efficacy of immunotherapy and intrinsic resistance in ES-SCLC, including impaired antigen presentation and limited T cell infiltration. Moreover, to tackle the current dilemma, given the synergistic effects of radiotherapy on immunotherapy, especially the unique advantages of low-dose radiotherapy (LDRT), such as less immunosuppression and lower radiation toxicity, we propose radiotherapy as a booster to enhance the immunotherapeutic efficacy by overcoming the poor priming effect. Recent clinical trials, including ours, have also focused on adding radiotherapy, including LDRT, to first-line treatment of ES-SCLC. Additionally, we also suggest combination strategies to sustain the immunostimulatory effect of radiotherapy, as well as the cancer-immunity cycle, and further improve survival outcomes.
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Affiliation(s)
- Kai Kang
- Division of Thoracic Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yijun Wu
- Division of Thoracic Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Zhuoran Yao
- Division of Thoracic Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - You Lu
- Division of Thoracic Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
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Zhu Y, Liu K, Yang Q, Zeng M, Peng L. First-line Immuno-chemotherapy for extensive-stage small-cell lung cancer: A network meta-analysis and cost-effectiveness analysis. Front Public Health 2023; 11:1028202. [PMID: 37006537 PMCID: PMC10061061 DOI: 10.3389/fpubh.2023.1028202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 03/03/2023] [Indexed: 03/18/2023] Open
Abstract
IntroductionMany randomized controlled trials have indicated that immuno-chemotherapy could generate clinical benefits, though the cost of immuno-chemotherapy was so prohibitive and the options were varied. This investigation aimed at evaluating effectiveness, safety, and cost-effectiveness for immuno-chemotherapy as a first-line therapeutic option for ES-SCLC patients.MethodsMultiple scientific literature repositories were searched for clinical studies where immuno-chemotherapy was regarded as the first-line treatment for ES-SCLC, which were published in English between Jan 1, 2000, and Nov 30, 2021. This study conducted a network meta-analysis (NMA) and cost-effectiveness analysis (CEA) based upon US-resident payer perspectives. Overall survival (OS), progression-free survival (PFS), and adverse events (AEs) were evaluated through NMA. In addition, costings, life-years (LYs), quality-adjusted life-years (QALYs), and incremental cost–benefit ratio (ICER) were estimated by CEA.ResultsWe identified 200 relevant search records, of which four randomized controlled trials (RCTs) (2,793 patients) were included. NMA demonstrated that the effect of atezolizumab plus chemotherapy was ranked at a more elevated position in comparison to other immuno-chemotherapy options and chemotherapy alone, within the general population. The influence of atezolizumab plus chemotherapy and durvalumab plus chemotherapy was ranked higher within populations experiencing non-brain metastases (NBMs) andbrain metastases (BMs), respectively. The CEA revealed that the ICERs of immuno-chemotherapy over chemotherapyalone were higher than the willingness-to-pay (WTP) threshold of $150,000/QALY in any population. However, treatment with atezolizumab plus chemotherapy and durvalumab plus chemotherapy were more favorable health advantages than other immuno-chemotherapy regimens and chemotherapy alone, and the results were 1.02 QALYs and 0.89 QALYs within overall populations and populations with BMs, respectively.ConclusionThe NMA and cost-effectiveness investigation demonstrated that atezolizumab plus chemotherapy could be an optimal first-line therapeutic option for ES-SCLC when compared with other immuno-chemotherapy regimens. Durvalumab plus chemotherapy is likely to be the most favorable first-line therapeutic option for ES-SCLC with BMs.
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Affiliation(s)
- Youwen Zhu
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Kun Liu
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Qiuping Yang
- Department of Pathology, Tangshan Cancer Hospital, Tangshan, Hebei, China
| | - Manting Zeng
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- *Correspondence: Manting Zeng,
| | - Libo Peng
- Department of Oncology, Loudi Central Hospital, Loudi, Hunan, China
- Libo Peng,
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van der Merwe L, Svitina H, Willers C, Wrzesinski K, Gouws C. A novel NCI-H69V small cell lung cancer functional mini-tumor model for future treatment screening applications. Biotechnol Prog 2022; 38:e3253. [PMID: 35362670 PMCID: PMC10909478 DOI: 10.1002/btpr.3253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/24/2022] [Accepted: 03/29/2022] [Indexed: 12/09/2022]
Abstract
Small cell lung cancer (SCLC) is aggressive and despite multiple clinical trials, its standard of care is unchanged for the past three decades. In vitro cancer models are crucial in chemotherapy development, and three-dimensional (3D) models aim to bridge the gap between two-dimensional (2D) flat cultures and in vivo testing. Functional 3D spheroids can better represent the in vivo situation and tumor characteristics than 2D models. An NCI-H69V SCLC mini-tumor model was developed in a clinostat-based rotating bioreactor system. Spheroid growth and viability were characterized for 30 days, and the ideal experimental window with mature and metabolically stable spheroids was determined. Application of the model for anticancer treatment screening was validated with the standard chemotherapeutic drug irinotecan, for an exposure period of 72 h. The following parameters were measured: soluble protein content, planar surface area measurements, intracellular adenosine triphosphate and extracellular adenylate kinase levels, and glucose consumption. Histological morphology of the spheroids was observed. The established model proved viable and stable, while treatment with irinotecan caused a decrease in cell growth, viability, and glucose consumption demonstrating reactivity of the model to chemotherapy. Therefore, this NCI-H69V SCLC functional spheroid model could be used for future anticancer compound screening.
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Affiliation(s)
- Liezaan van der Merwe
- Centre of Excellence for Pharmaceutical Sciences (Pharmacen™)North‐West UniversityPotchefstroomSouth Africa
| | - Hanna Svitina
- Centre of Excellence for Pharmaceutical Sciences (Pharmacen™)North‐West UniversityPotchefstroomSouth Africa
- Laboratory of Biosynthesis of Nucleic Acids, Department of Functional GenomicsInstitute of Molecular Biology and Genetics of NASUKyivUkraine
| | - Clarissa Willers
- Centre of Excellence for Pharmaceutical Sciences (Pharmacen™)North‐West UniversityPotchefstroomSouth Africa
| | - Krzysztof Wrzesinski
- Centre of Excellence for Pharmaceutical Sciences (Pharmacen™)North‐West UniversityPotchefstroomSouth Africa
- CelVivo ApSBlommenslystDenmark
| | - Chrisna Gouws
- Centre of Excellence for Pharmaceutical Sciences (Pharmacen™)North‐West UniversityPotchefstroomSouth Africa
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Validation of Pretreatment Prognostic Factors and Prognostic Staging Systems for Small Cell Lung Cancer in a Real-World Data Set. Cancers (Basel) 2022; 14:cancers14112625. [PMID: 35681605 PMCID: PMC9179878 DOI: 10.3390/cancers14112625] [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: 04/11/2022] [Revised: 05/09/2022] [Accepted: 05/17/2022] [Indexed: 02/05/2023] Open
Abstract
Simple Summary We present an analysis of a real-world cohort of patients with small cell lung cancer (SCLC) and examine the value of prognostic factors and scores that have been published in recent decades. In our analysis, only a few clinical (age, tumor stage) and a single laboratory parameter (alkaline phosphatase) are associated with the prognosis of patients with SCLC. We could not confirm the prognostic role of most of the published complex prognostic scores. Abstract Treatment decisions in patients with small cell lung cancer (SCLC) are made based on the extent of the disease. However, the outcome varies among patients at the same stage. A simple tool to predict outcomes in SCLC patients would be helpful for clinical decision-making. In recent years, several prognostic scores have been proposed. In this study, we evaluated the different prognostic factors in an unselected real-world cohort of patients. We retrospectively collected clinical, radiological and laboratory data from 92 patients diagnosed with SCLC. Univariate and multivariate cox regression analyses of survival were performed to assess the prognostic value of relevant clinical and laboratory factors for SCLC. Furthermore, we examined the association between eight published prognostic scores for SCLC and overall survival (OS). In the overall cohort, the median OS was 10.3 months (20.9 months and 9.2 months for limited disease (LD) SCLC and extensive disease (ED) SCLC, respectively). In univariate analysis, initial staging, number of metastatic sites and presence of liver, bone and adrenal gland metastases were significantly associated with worse OS. Of the established laboratory markers, albumin, alkaline phosphatase and hyponatremia but not lactate dehydrogenase (LDH) significantly predicted OS. All published prognostic scores, with the exception of the Glasgow Prognostic Score, did not significantly predict OS. In multivariate analysis, age, staging and alkaline phosphatase serum levels showed significant association with OS. We could not confirm the prognostic significance of most of the published complex prognostic scores. We therefore recommend using simple clinical and laboratory factors instead of complex scores to estimate the prognosis of SCLC patients in clinical practice.
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Wang WZ, Shulman A, Amann JM, Carbone DP, Tsichlis PN. Small cell lung cancer: Subtypes and therapeutic implications. Semin Cancer Biol 2022; 86:543-554. [DOI: 10.1016/j.semcancer.2022.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/23/2022] [Accepted: 04/04/2022] [Indexed: 12/20/2022]
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Hung SY, Lin SC, Wang S, Chang TJ, Tung YT, Lin CC, Ho CT, Li S. Bavachinin Induces G2/M Cell Cycle Arrest and Apoptosis via the ATM/ATR Signaling Pathway in Human Small Cell Lung Cancer and Shows an Antitumor Effect in the Xenograft Model. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2021; 69:6260-6270. [PMID: 34043345 DOI: 10.1021/acs.jafc.1c01657] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Lung cancer is grouped into small cell lung cancer (SCLC) and non-SCLC (NSCLC). SCLC exhibits a poor prognosis, and the current anticancer treatment remains unsatisfactory. Bavachinin, present in the seed of Psoralea corylifolia, shows anti-inflammatory effects, immune modulation, and anticancer potency. This study aims to investigate the antitumor effect of bavachinin on SCLC and its underlying mechanism. The SCLC cell line H1688 was treated with different concentrations of bavachinin and showed decreased viability with arrested G2/M and sub-G1 phase cell accumulation at a concentration as low as 25 μM. Expression levels of caspase-3, -8, and -9, as well as Fas, FasL, and Bax, increased with the concentration of bavachinin. The accumulated sub-G1 cells and annexin V confirmed increasing apoptotic cancer cells after treatment. The accumulated G2/M phase cells with increasing levels of phosphorylated CDC25C, CDC2, ATM/ATR, and CHK2/CHK1 confirmed the arrested cell cycle caused by bavachinin via a dose-dependent manner. This phenomenon can be reversed by an ATM/ATR inhibitor, caffeine. Following the administration of bavachinin to xenograft mice with SCLC, the tumor burden decreased without impairing hematologic or hepatorenal functions. Bavachinin induces SCLC apoptosis via intrinsic and extrinsic pathways and causes cancer cell cycle arrest via the ATM/ATR signaling pathway.
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Affiliation(s)
- Shih-Ya Hung
- Division of Colorectal Surgery, China Medical University Hospital, Taichung 404, Taiwan
- Graduate Institute of Acupuncture Science, China Medical University, Taichung 404, Taiwan
| | - Shih-Chao Lin
- Bachelor Degree Program in Marine Biotechnology, College of Life Sciences, National Taiwan Ocean University, Keelung 202, Taiwan
| | - Shuzhen Wang
- Hubei Key Laboratory of Economic Forest Germplasm Improvement and Resources Comprehensive Utilization, Huanggang Normal University, Huanggang 438000, Hubei Province, China
| | - Tzu-Jung Chang
- Institute of Biomedical Science, the iEGG and Animal Biotechnology Center, National Chung-Hsing University, Taichung 402, Taiwan
| | - Yu-Tang Tung
- Graduate Institute of Biotechnology, National Chung Hsing University, Taichung 402, Taiwan
| | - Chi-Chien Lin
- Institute of Biomedical Science, the iEGG and Animal Biotechnology Center, National Chung-Hsing University, Taichung 402, Taiwan
- Department of Medical Research, China Medical University Hospital, Taichung 404, Taiwan
- Department of Pharmacology, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Chi-Tang Ho
- Department of Food Science, Rutgers University, New Brunswick, New Jersey 08901, USA
| | - Shiming Li
- Hubei Key Laboratory of Economic Forest Germplasm Improvement and Resources Comprehensive Utilization, Huanggang Normal University, Huanggang 438000, Hubei Province, China
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Zou DJ, Zhao YB, Yang JH, Xu HT, Li QC, Wu GP. Expression and Significance of HPV16 E6/E7 mRNAs in the Bronchial Brush and TBNA Cells of Patients With Small Cell Lung Cancer. Technol Cancer Res Treat 2021; 20:15330338211019505. [PMID: 34032147 PMCID: PMC8155753 DOI: 10.1177/15330338211019505] [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] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Small cell lung cancer (SCLC) is characterized by rapid growth, strong invasion, and early metastasis. However, the cause of its occurrence remains unclear. High-risk HPV infection is closely related to the occurrence of non-small cell lung cancer and cervical small cell neuroendocrine carcinoma. METHODS The expression levels of E6 mRNA and E7 mRNA in HPV16 were detected by qRT-PCR in the bronchial brushing and transbronchial needle aspiration (TBNA) of 310 patients with lung cancer and with benign lung diseases. To make the design of this experiment scientific and reasonable, the expression levels in lung squamous cell carcinoma were taken as positive controls, while those in benign cells were taken as negative controls. RESULTS The expression levels of E6 mRNA and E7 mRNA in SCLC group were significantly higher than those in benign cell group and slight higher than those in squamous cell carcinoma group. The expression levels of E6 mRNA and E7 mRNA in the central type of SCLC were significantly higher than those in the peripheral type of SCLC. CONCLUSIONS We speculate that the occurrence of some small cell carcinoma is the same as that of some squamous cell carcinoma, which is closely related to HPV16 infection. The overexpression of E6 mRNA and E7 mRNA is in some benign lesion cells, which may be related to HPV transient infection.
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Affiliation(s)
- Di-Jia Zou
- Department of Pathology, The First Affiliated Hospital and College of Basic Medical Sciences, China Medical University, Shenyang, China.,Department of Radiology, The First Hospital of China Medical University, Shenyang, China
| | - Ya-Bin Zhao
- Institute of Respiratory Disease, The First Hospital of China Medical University, Shenyang, China
| | - Jing-Hua Yang
- Department of Pathology, The First Affiliated Hospital and College of Basic Medical Sciences, China Medical University, Shenyang, China
| | - Hong-Tao Xu
- Department of Pathology, The First Affiliated Hospital and College of Basic Medical Sciences, China Medical University, Shenyang, China
| | - Qing-Chang Li
- Department of Pathology, The First Affiliated Hospital and College of Basic Medical Sciences, China Medical University, Shenyang, China
| | - Guang-Ping Wu
- Department of Pathology, The First Affiliated Hospital and College of Basic Medical Sciences, China Medical University, Shenyang, China
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Wang B, Feng N, Shi X, Qi Q, Chi X, Song T, Li H. [Analysis of Correlation between TTF-1 and Sensitivity to First-line Chemotherapy and Prognosis in Patients with Small Cell Lung Cancer]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2021; 23:547-553. [PMID: 32702788 PMCID: PMC7406437 DOI: 10.3779/j.issn.1009-3419.2020.101.27] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
背景与目的 甲状腺转录因子-1(thyroid transcription factor-1, TTF-1)在非小细胞肺癌中被广泛研究,被认为是非小细胞肺癌的独立预后因子,但TTF-1在小细胞肺癌(small cell lung cancer, SCLC)中的预后价值研究较少。本研究旨在探讨TTF-1的表达状态与SCLC患者一线化疗敏感性及预后的关系。 方法 回顾性分析2017年1月1日-2019年1月1日在青岛大学附属医院确诊并治疗的、一线应用以铂类为基础的化疗的SCLC患者234例,随访患者临床特征及治疗、生存情况,采用χ2检验及Logistic回归模型分析TTF-1的表达状况与化疗反应率的关系,Kaplan-Meier法和Cox比例风险回归模型分析TTF-1的表达对患者生存期的影响。 结果 234例患者中,TTF-1阳性表达188例(80.3%, 188/234),TTF-1阴性表达46例(19.7%, 46/234),TTF-1阳性患者一线化疗客观反应率(objective response rate, ORR)高于阴性患者(70.7% vs 47.8%)(χ2=8.681, P=0.003)。Logistic回归多因素分析显示,TTF-1的表达是一线化疗ORR的独立预测因素(OR=0.216, 95%CI: 0.076-0.615, P=0.004),但此差异仅体现在局限期SCLC(limited-stage SCLC, LS-SCLC)中。TTF-1阴性表达患者中位无进展生存期(progression free survival, PFS)6.9个月短于TTF-1阳性表达患者的9.0个月(χ2=9.357, P=0.002)。TTF-1阴性组患者中位总生存期(overall survival, OS)13.3个月短于TTF-1阳性组患者的20.1个月(χ2=12.082, P=0.001)。 结论 TTF-1表达状态为SCLC患者一线化疗反应率及生存的独立预测因素,可能成为预测SCLC治疗疗效及预后的生物标志物。
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Affiliation(s)
- Bingrui Wang
- Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - Nuan Feng
- Department of Nutriology, Qingdao Women and Children's Hospital, Qingdao 266000, China
| | - Xinyan Shi
- Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - Qi Qi
- Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - Xiaorui Chi
- Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - Tingting Song
- Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - Hongmei Li
- Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao 266003, China
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Wong SK, Iams WT. Front Line Applications and Future Directions of Immunotherapy in Small-Cell Lung Cancer. Cancers (Basel) 2021; 13:506. [PMID: 33572705 PMCID: PMC7865814 DOI: 10.3390/cancers13030506] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/20/2021] [Accepted: 01/26/2021] [Indexed: 12/25/2022] Open
Abstract
After being stagnant for decades, there has finally been a paradigm shift in the treatment of small-cell lung cancer (SCLC) with the emergence and application of immune checkpoint inhibitors (ICIs). Multiple trials of first-line ICI-chemotherapy combinations have demonstrated survival benefit compared to chemotherapy alone in patients with extensive-stage SCLC, establishing this as the new standard of care. ICIs are now being applied in the potentially curative limited-stage setting, actively being investigated as concurrent treatment with chemoradiation and as adjuvant treatment following completion of chemoradiation. This review highlights the evidence behind the practice-changing addition of ICIs in the first-line setting of extensive-stage SCLC, the potentially practice-changing immunotherapy trials that are currently underway in the limited-stage setting, and alternate immunotherapeutic strategies being studied in the treatment of SCLC.
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Affiliation(s)
- Selina K. Wong
- Department of Medicine, Division of Hematology and Oncology, Nashville, TN 37232, USA;
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Wade T. Iams
- Department of Medicine, Division of Hematology and Oncology, Nashville, TN 37232, USA;
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN 37232, USA
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Zhou T, Zhang L, Liu T, Yang Y, Luo F, Zhang Z, Huang Y, Zhao H, Zhang L, Zhao Y. Myeloid cell leukemia-1 is an important predictor of survival and progression of small cell lung cancer. ANNALS OF TRANSLATIONAL MEDICINE 2021; 8:1589. [PMID: 33437788 PMCID: PMC7791257 DOI: 10.21037/atm-20-2305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Small cell lung cancer (SCLC) is the most fatal malignancy for which more effective therapies are urgently needed. Overexpression of myeloid cell leukemia-1 (Mcl-1) has been demonstrated to be one of the most common genetic alterations among different types of tumor/cancer, which induces resistance against various anti-cancer therapies including cisplatin. The study aimed to explore the role of Mcl-1 in the prognosis and resistance to anti-cancer therapy in patients with SCLC. Methods Patients with SCLC were recruited from those enrolled/treated in Sun Yat-sen University Cancer Center. Their specimens were collected for immunohistochemical evaluation. We compared the baseline characteristics, response to chemotherapy and overall survival (OS) of the patients with different expression levels of Mcl-1. Results The expression level of Mcl-1 was significantly lower in patients with limited stage SCLC than in those with extensive stage SCLC (P=0.014). Based on the median value of Mcl-1 expression level, the patients were divided into high and low Mcl-1 groups, respectively. Univariate analysis revealed that low Mcl-1 expression was associated with a significant improvement in OS, with a hazard ratio (HR) of 0.538. Multivariate analysis confirmed the independent prognostic value of Mcl-1 expression level (P=0.014). Moreover, we found a significantly close relationship between higher Mcl-1 expression level and shorter time to progression (TTP) of the patients received chemotherapy (P=0.040). Conclusions Our findings demonstrated that Mcl-1 expression level was a prognostic biomarker for survival outcomes and cancer progression in the patients with SCLC. Thus, it could be used as a valuable biomarker in identifying those patients with high risk of treatment failure.
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Affiliation(s)
- Ting Zhou
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Lin Zhang
- Department of Clinical Laboratory, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Tingting Liu
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Yunpeng Yang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Fan Luo
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Zhonghan Zhang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Yan Huang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Hongyun Zhao
- Department of Clinical Research, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Li Zhang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Yuanyuan Zhao
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
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12
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Real World Analysis of Small Cell Lung Cancer Patients: Prognostic Factors and Treatment Outcomes. ACTA ACUST UNITED AC 2021; 28:317-331. [PMID: 33435584 PMCID: PMC7903279 DOI: 10.3390/curroncol28010036] [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] [Received: 11/17/2020] [Revised: 12/02/2020] [Accepted: 12/03/2020] [Indexed: 01/22/2023]
Abstract
In this observational study, we assessed treatment patterns and prognostic factors in patients with small cell lung cancer (SCLC) in a large state-mandated healthcare organization in Israel. Methods: All incident cases with histologically confirmed SCLC who initiated systemic anti-cancer treatment between 2011 and 2017 were identified. Treatment patterns and overall survival (OS) were evaluated for each line of therapy. Results: A total of 235 patients were identified (61% male, median age 64 years, 95% ever smokers, 64% had extensive stage). The first-line treatment was platinum-etoposide regimen for 98.7% of the cohort. The second and third-line regimen were given to 43% and 12% of patients, respectively. Mean OS for extensive and limited stage patients was 9.1 and 23.5 months respectively. In a multivariable model, increased risk for mortality was observed among patients with an ECOG performance status (PS) of 2 compared to a PS of 0-1 for the extensive stage patients (Hazard ratio (HR) = 1.63, 95% confidence ratios (CI): 1.00-2.65); and for males compared to females for the limited stage patients (HR = 2.17; 95% CI: 1.12-4.20). Regarding all 2nd line patients in a multivariable model incorporating relevant confounding factors, demonstrated a significantly better outcome with platinum-based regimens compared to topotecan. Median survival after initiation of 2nd line in platinum-sensitive patients was longer (p = 0.056) for those re-challenged with platinum-based regimen (n = 7): 6.8mo (6.1-not reported (NR)), compared with those switched to a different treatment (n = 27): 4.5 mo (2.6-6.6) for extensive stage patients, and a non-significant difference was also observed for limited stage patients. Conclusion: To our knowledge, this is one of the largest real-world studies of SCLC patients. OS for SCLC patients was similar to that reported in clinical trials. PS for extensive stage patients and sex for limited stage patients were significant correlates of prognosis. Re-challenge of the platinum-based doublet was associated with longer OS compared to switching treatment in extensive stage patients.
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13
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Chen HL, Tu YK, Chang HM, Lee TH, Wu KL, Tsai YC, Lee MH, Yang CJ, Hung JY, Chong IW. Systematic Review and Network Meta-Analysis of Immune Checkpoint Inhibitors in Combination with Chemotherapy as a First-Line Therapy for Extensive-Stage Small Cell Carcinoma. Cancers (Basel) 2020; 12:E3629. [PMID: 33287455 PMCID: PMC7761843 DOI: 10.3390/cancers12123629] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 11/26/2020] [Accepted: 12/01/2020] [Indexed: 12/19/2022] Open
Abstract
Patients with extensive-stage small cell lung cancer (ED-SCLC) have a very short survival time even if they receive standard cytotoxic chemotherapy with etoposide and platinum (EP). Several randomized controlled trials have shown that patients with ED-SCLC who received a combination of EP plus immune checkpoint inhibitors (ICIs) had superior survival compared with those who received EP alone. We conducted a systematic review and network meta-analysis to provide a ranking of ICIs for our primary endpoints in terms of overall survival (OS), progression free survival (PFS), and objective response rate (ORR), as well as our secondary endpoint in terms of adverse events. The fractional polynomial model was used to evaluate the adjusted hazard ratios for the survival indicators (OS and PFS). Treatment rank was estimated using the surface under the cumulative ranking curve (SUCRA), as well as the probability of being best (Prbest) reference. EP plus nivolumab, atezolizumab or durvalumab had significant benefits compared with EP alone in terms of OS (Hazard Ratio HR = 0.67, 95% Confidence Interval CI = 0.46-0.98 for nivolumab, HR = 0.70, 95% CI = 0.54-0.91 for atezolizumab, HR = 0.73, 95% CI = 0.59-0.90 for durvalumab) but no significant differences were observed for pembrolizumab or ipilimumab. The probability of nivolumab being ranked first among all treatment arms was highest (SCURA = 78.7%, Prbest = 46.7%). All EP plus ICI combinations had a longer PFS compared with EP alone (HR = 0.65, 95% CI = 0.46-0.92 for nivolumab, HR = 0.77, 95% CI = 0.61-0.96 for atezolizumab, HR = 0.78, 95% CI = 0.65-0.94 for durvalumab, HR = 0.75, 95% CI = 0.61-0.92 for pembrolizumab), and nivolumab was ranked first in terms of PFS (SCURA = 85.0%, Prbest = 66.8%). In addition, nivolumab had the highest probability of grade 3-4 adverse events (SUCRA = 84.8%) in our study. We found that nivolumab had the best PFS and OS in all combinations of ICIs and EP, but nivolumab also had the highest probability of grade 3-4 adverse events in our network meta-analysis. Further head-to head large-scale phase III randomized controlled studies are needed to verify our conclusions.
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Affiliation(s)
- Hsiao-Ling Chen
- Department of Pharmacy, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80145, Taiwan; (H.-L.C.); (H.-M.C.)
| | - Yu-Kang Tu
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei 100225, Taiwan;
- Department of Medical Research, National Taiwan University Hospital, Taipei 100225, Taiwan
| | - Hsiu-Mei Chang
- Department of Pharmacy, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80145, Taiwan; (H.-L.C.); (H.-M.C.)
| | - Tai-Huang Lee
- Department of Internal Medicine Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung 88145, Taiwan; (T.-H.L.); (J.-Y.H.)
| | - Kuan-Li Wu
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 88708, Taiwan; (K.-L.W.); (Y.-C.T.)
| | - Yu-Chen Tsai
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 88708, Taiwan; (K.-L.W.); (Y.-C.T.)
| | - Mei-Hsuan Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 88708, Taiwan; (K.-L.W.); (Y.-C.T.)
| | - Chih-Jen Yang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 88708, Taiwan; (K.-L.W.); (Y.-C.T.)
- Department of General Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 88708, Taiwan;
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 88708, Taiwan
- Respiratory Therapy, College of Medicine, Kaohsiung Medical University, Kaohsiung 88708, Taiwan
| | - Jen-Yu Hung
- Department of Internal Medicine Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung 88145, Taiwan; (T.-H.L.); (J.-Y.H.)
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 88708, Taiwan; (K.-L.W.); (Y.-C.T.)
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 88708, Taiwan
| | - Inn-Wen Chong
- Department of General Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 88708, Taiwan;
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 88708, Taiwan
- Respiratory Therapy, College of Medicine, Kaohsiung Medical University, Kaohsiung 88708, Taiwan
- Department of Biological Science & Technology, National Chiao Tung University, Hsinchu 300, Taiwan
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14
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Russo A, McCusker MG, Scilla KA, Arensmeyer KE, Mehra R, Adamo V, Rolfo C. Immunotherapy in Lung Cancer: From a Minor God to the Olympus. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1244:69-92. [PMID: 32301011 DOI: 10.1007/978-3-030-41008-7_4] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Over the last decade, we have witnessed a paradigm shift in cancer treatment, with the advent of novel therapeutic approaches that target or manipulate the immune system, also known as immunotherapy. Blocking immune checkpoints has emerged as an effective strategy with unprecedented results in several solid tumors, including lung cancer. Since 2012 when PD(L)-1 inhibitors showed first clinical signals of activity in lung cancer, immune checkpoint blockade (ICB) has emerged as a novel effective therapeutic strategy in different settings, determining a dramatic change in the therapeutic landscape of both non-small cell lung cancer (NSCLC) and, more recently, small cell lung cancer (SCLC). Although the benefit from this novel therapeutic approach is undeniable, several open questions still remain unanswered. Herein, we summarize the major breakthroughs in the immunotherapy journey in lung cancer and how it is changing our clinical practice.
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Affiliation(s)
- Alessandro Russo
- University of Maryland Medical Center, Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA.,Medical Oncology Unit A.O. Papardo & Department of Human Pathology, University of Messina, Messina, Italy
| | - Michael G McCusker
- University of Maryland Medical Center, Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA
| | - Katherine A Scilla
- University of Maryland Medical Center, Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA
| | - Katherine E Arensmeyer
- University of Maryland Medical Center, Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA
| | - Ranee Mehra
- University of Maryland Medical Center, Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA
| | - Vincenzo Adamo
- Medical Oncology Unit A.O. Papardo & Department of Human Pathology, University of Messina, Messina, Italy
| | - Christian Rolfo
- University of Maryland Medical Center, Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA.
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15
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MET Inhibitors in Small Cell Lung Cancer: From the Bench to the Bedside. Cancers (Basel) 2019; 11:cancers11101404. [PMID: 31547040 PMCID: PMC6827355 DOI: 10.3390/cancers11101404] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 09/14/2019] [Accepted: 09/18/2019] [Indexed: 02/06/2023] Open
Abstract
Small cell lung cancer (SCLC) is the most aggressive type of lung cancer. The different systemic treatment approaches attempted in the last 35 years have not improved overall survival in the advanced stage. Targeted therapies assessed in clinical trials have failed to show efficacy against SCLC. Within the potentially interesting targets, the hepatocyte growth factor (HGF)/mesenchymal-epithelial transition (MET) pathway activation is associated with worse survival and chemoresistance in SCLC. Preclinical data suggest that the inhibition of the MET pathway can revert chemoresistance and prevent tumor growth. Recently, immunotherapy has shown modest but relevant activity in SCLC. Interestingly, MET modulation seems to be involved in increasing the efficacy of standard checkpoint inhibitors. Here, we review the preclinical and clinical data of MET inhibition in SCLC, and the role of this pathway in the immune response.
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16
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Immune checkpoint blockade in small cell lung cancer. Lung Cancer 2019; 137:31-37. [PMID: 31525648 DOI: 10.1016/j.lungcan.2019.08.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 08/14/2019] [Accepted: 08/21/2019] [Indexed: 02/07/2023]
Abstract
Despite the highly immunogenic potential of small cell lung cancer (SCLC), progress in evaluating the therapeutic value of immune checkpoint agents has lagged behind that of non-small cell lung cancer. Results from a number of phase I-III clinical trials that specifically address the use of anti-PD-1, anti-PD-L1 and anti-CTLA-4 agents in SCLC have now been reported. This review will focus on the available evidence for immune checkpoint blockade in SCLC and review current biomarker strategies with the aim of providing perspective and interpretation of this data for clinical practice.
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17
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Morgensztern D, Rose M, Waqar SN, Morris J, Ma PC, Reid T, Brzezniak CE, Zeman KG, Padmanabhan A, Hirth J, I Spira A, Trepel JB, Padda SK. RRx-001 followed by platinum plus etoposide in patients with previously treated small-cell lung cancer. Br J Cancer 2019; 121:211-217. [PMID: 31231122 PMCID: PMC6738071 DOI: 10.1038/s41416-019-0504-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 05/15/2019] [Accepted: 05/29/2019] [Indexed: 01/22/2023] Open
Abstract
Background This exploratory single-arm phase II study evaluated the efficacy and safety of RRx-001 followed by reintroduction of platinum plus etoposide in patients with previously treated small-cell lung cancer (SCLC). Methods Patients were treated with RRx-001 4 mg IV on day 1 of each week of a 21-day cycle followed at progression by re-challenge with etoposide 80–100 IV mg/m2 on days 1, 2 and 3 and cisplatin 60–80 mg/m2 IV on day 1 or carboplatin AUC 5–6 IV on day 1, every 21 days. The primary end points were overall survival (OS) and overall response rate to platinum regimen. Results Twenty-six patients were enroled and received at least one dose of RRx-001. The median number of prior lines of therapy was 2 (range 1–9) and 19 (73.1%) patients had platinum-resistant disease. In the intention-to-treat population, one patient (3.8%) had complete response and six (23.1%) had partial response on platinum plus etoposide. The estimated median and 12-month OS from enrolment were 8.6 months and 44.1%, respectively. The most common treatment-emergent adverse event from RRx-001 was mild discomfort at the infusion site (23%). Conclusions RRx-001 followed by re-challenge with platinum plus etoposide chemotherapy is feasible and associated with promising results. Clinical trial registration NCT02489903.
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Affiliation(s)
| | | | - Saiama N Waqar
- Washington University School of Medicine, St. Louis, MO, USA
| | - John Morris
- University of Cincinnati Cancer Institute, Cincinnati, OH, USA
| | | | | | | | - Karen G Zeman
- Walter Reed National Military Medical Center, Bethesda, MD, USA
| | | | - JoAnn Hirth
- Henry Ford Allegiance Health, Jackson, MI, USA
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18
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Hardy-Werbin M, Rocha P, Arpi O, Taus Á, Nonell L, Durán X, Villanueva X, Joseph-Pietras D, Nolan L, Danson S, Griffiths R, Lopez-Botet M, Rovira A, Albanell J, Ottensmeier C, Arriola E. Serum cytokine levels as predictive biomarkers of benefit from ipilimumab in small cell lung cancer. Oncoimmunology 2019; 8:e1593810. [PMID: 31069160 DOI: 10.1080/2162402x.2019.1593810] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 02/22/2019] [Accepted: 02/28/2019] [Indexed: 01/22/2023] Open
Abstract
Background. Immunotherapy has shown efficacy in small cell lung cancer (SCLC), but only a subset of patients benefits. Surrogate biomarkers are urgently needed. Our aim was to evaluate serum Th1, Th2, and proinflammatory cytokines in two cohorts of SCLC patients before and during treatment with chemotherapy with or without ipilimumab and to correlate them with survival. Patients and methods. Two cohorts of SCLC patients were studied: patients treated with chemotherapy (n = 47), and patients treated with chemotherapy plus ipilimumab (n = 37). Baseline, on-treatment and after-treatment serum samples were evaluated for the presence of IL-1beta, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IFN-gamma, TNF-alpha, GM-CSF, and Mip-1alpha using a Luminex assay. Differential changes in cytokines between cohorts were analyzed. Associations between cytokine levels and their changes with overall survival were evaluated. Results. Patients treated with ipilimumab showed a global increase of all cytokines after treatment initiation. A high level of IL-8 at baseline was associated with worse prognosis regardless of treatment. Baseline increased IL-2 levels predicted sensitivity to ipilimumab, while high IL-6 and TNF-alpha predicted resistance. An on-treatment increase in IL-4 levels in patients treated with immune-chemotherapy was associated with a better overall survival. Conclusions. The addition of ipilimumab to standard chemotherapy in SCLC modulates the serum levels of cytokines. Baseline levels and their change over time relate to overall survival. Blood-based biomarkers are convenient for patients, and our results support prospective validation of cytokines as predictive biomarkers for ipilimumab in SCLC.
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Affiliation(s)
- Max Hardy-Werbin
- Cancer Research Program, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain.,Universitat de Barcelona, Barcelona, Spain
| | - Pedro Rocha
- Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain
| | - Oriol Arpi
- Cancer Research Program, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain
| | - Álvaro Taus
- Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain
| | - Lara Nonell
- Microarrays analysis service, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain
| | - Xavier Durán
- Statistics department, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain
| | - Xavier Villanueva
- Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain
| | | | - Luke Nolan
- Medical Oncology Department, University Hospital Southampton, Southampton, UK
| | - Sarah Danson
- Sheffield Experimental Cancer Medicine Centre, Weston Park Hospital, Sheffield, UK
| | | | - Miguel Lopez-Botet
- Immunology unit, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
| | - Ana Rovira
- Cancer Research Program, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain.,Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain
| | - Joan Albanell
- Cancer Research Program, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain.,Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
| | - Christian Ottensmeier
- NIHR Experimental Cancer Medicine Centre, Southampton, UK.,Cancer Science Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Edurne Arriola
- Cancer Research Program, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain.,Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain
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19
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Ochi N, Kawahara T, Nagasaki Y, Nakagawa N, Yamagishi T, Umemura S, Honda Y, Nakanishi H, Yamane H, Takigawa N. Publication of lung cancer clinical trials in the Japanese Clinical Trial Registry. Jpn J Clin Oncol 2018; 48:995-1000. [PMID: 30256970 DOI: 10.1093/jjco/hyy131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 09/05/2018] [Indexed: 12/17/2022] Open
Abstract
Introduction Since June 2005, the University Hospital Medical Information Network-Clinical Trial Registry (UMIN-CTR) has been an International Committee of Medical Journal Editors (ICMJE)-approved clinical trial registry in Japan. The number of clinical trials registered in the UMIN-CTR has increased annually. To date, no report exists regarding the publishing of clinical trials registered in the UMIN-CTR. Therefore, we evaluated the publication frequency of clinical trials registered in the UMIN-CTR in Japan. Methods We targeted trials that assessed the treatment effect of chemotherapy or molecular targeting drugs for lung cancer. We included trials registered between June 2005 and January 2010, and identified published trials through a computer-based search of MEDLINE and Google Scholar. The cumulative publication rate of the trials was calculated using Kaplan-Meier analysis. Results In our study, 179 trials met the inclusion criteria. Of these, 46.4% (83/179) trials were published by the end of the cut-off period. With regard to publication, differences existed between the information recorded in the UMIN-CTR database and the actual searched results. The publication rate between groups was insignificantly different; however, whether a clinical study group did or did not conduct a trial differed significantly (53.3% vs. 36.1%; P = 0.024). Phase II studies with positive results were more likely to be published (84.4%); however, the overall publication rate was low (41.8%), which may reflect publication bias. Conclusions The UMIN-CTR fundamentally functions as the unique ICMJE-approved clinical trial registry in Japan. However, it seems insufficient to require it as the official clinical database.
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Affiliation(s)
- Nobuaki Ochi
- Department of General Internal Medicine 4, Kawasaki Medical School, Okayama, Japan
| | - Tatsuyuki Kawahara
- Department of General Internal Medicine 4, Kawasaki Medical School, Okayama, Japan
| | - Yasunari Nagasaki
- Department of General Internal Medicine 4, Kawasaki Medical School, Okayama, Japan
| | - Nozomu Nakagawa
- Department of General Internal Medicine 4, Kawasaki Medical School, Okayama, Japan
| | - Tomoko Yamagishi
- Department of General Internal Medicine 4, Kawasaki Medical School, Okayama, Japan
| | - Shigeki Umemura
- Department of Thoracic Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - Yoshihiro Honda
- Department of General Internal Medicine 4, Kawasaki Medical School, Okayama, Japan
| | - Hidekazu Nakanishi
- Department of General Internal Medicine 4, Kawasaki Medical School, Okayama, Japan
| | - Hiromichi Yamane
- Department of General Internal Medicine 4, Kawasaki Medical School, Okayama, Japan
| | - Nagio Takigawa
- Department of General Internal Medicine 4, Kawasaki Medical School, Okayama, Japan
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20
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Lamichhane P, Amin NP, Agarwal M, Lamichhane N. Checkpoint Inhibition: Will Combination with Radiotherapy and Nanoparticle-Mediated Delivery Improve Efficacy? MEDICINES (BASEL, SWITZERLAND) 2018; 5:E114. [PMID: 30360504 PMCID: PMC6313567 DOI: 10.3390/medicines5040114] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 10/17/2018] [Accepted: 10/18/2018] [Indexed: 02/07/2023]
Abstract
Checkpoint inhibition (CPI) has been a rare success story in the field of cancer immunotherapy. Knowledge gleaned from preclinical studies and patients that do not respond to these therapies suggest that the presence of tumor-infiltrating lymphocytes and establishment of immunostimulatory conditions, prior to CPI treatment, are required for efficacy of CPI. To this end, radiation therapy (RT) has been shown to promote immunogenic cell-death-mediated tumor-antigen release, increase infiltration and cross-priming of T cells, and decreasing immunosuppressive milieu in the tumor microenvironment, hence allowing CPI to take effect. Preclinical and clinical studies evaluating the combination of RT with CPI have been shown to overcome the resistance to either therapy alone. Additionally, nanoparticle and liposome-mediated delivery of checkpoint inhibitors has been shown to overcome toxicities and improve therapeutic efficacy, providing a rationale for clinical investigations of nanoparticle, microparticle, and liposomal delivery of checkpoint inhibitors. In this review, we summarize the preclinical and clinical studies of combined RT and CPI therapies in various cancers, and review findings from studies that evaluated nanoparticle and liposomal delivery of checkpoint inhibitors for cancer treatments.
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Affiliation(s)
| | - Neha P Amin
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
| | - Manuj Agarwal
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
| | - Narottam Lamichhane
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
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21
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Abstract
BACKGROUND Small cell lung cancer (SCLC) accounts for approximately 13% of all lung cancer diagnoses each year. SCLC is characterized by a rapid doubling time, early metastatic spread, and an unfavorable prognosis overall. AREAS OF UNCERTAINTY Most patients with SCLC will respond to initial treatment; however, the majority will experience a disease recurrence and response to second-line therapies is poor. Immune checkpoint inhibitors may be an option given the success in other diseases. DATA SOURCES A literature search was conducted using Medline (1946-July week 1, 2017) and Embase (1996-2017 week 28) with the search terms small cell lung cancer combined with nivolumab or ipilimumab or pembrolizumab or atezolizumab or tremelimumab or durvalumab. Five clinical trials, including extended follow-up for 2, that evaluated immune checkpoint inhibitors in limited stage or extensive stage SCLC were included. RESULTS In 2 phase 2 trials, ipilimumab was added to upfront chemotherapy. In both trials, an improvement in progression-free survival was seen. Toxicity, when combined with a platinum and etoposide, was significant. In a confirmatory phase 3 trial, ipilimumab did not prolong overall survival when added to first-line chemotherapy. Overall, response rates were similar between the placebo and ipilimumab groups. A phase 1/2 trial evaluated nivolumab alone or in combination with ipilimumab in recurrent SCLC. Results revealed that nivolumab monotherapy and the combination of nivolumab and ipilimumab were relatively safe and had antitumor activity. Pembrolizumab has been evaluated in a multicohort, phase 1b trial. Preliminary data showed a durable response in the second-line setting. CONCLUSION Given the lack of overall survival data and significant toxicity associated with the combination of ipilimumab with first-line chemotherapy, this treatment is not a reasonable option at this time. Nivolumab alone or in combination with ipilimumab is a valid option for recurrent SCLC.
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22
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Abstract
Despite high response rates to initial therapy, relapses are common in patients with small-cell lung cancer (SCLC). Systemic therapy after first-line failure remains important in the treatment paradigm of SCLC. Reinitiation of a previously administered first-line chemotherapy regimen is recommended for relapse > 6 months from completion of initial therapy. For relapse ≤ 6 months of initial therapy, sequential therapy with single agents is recommended. Clinical trial enrollment should be considered at all stages of treatment of SCLC. This review highlights the available treatment options in relapsed SCLC. In particular, we focus on prospective clinical trials demonstrating activity for the most commonly used agents in this setting. We end with a discussion on future directions and emerging targets with potential to improve outcomes in relapsed SCLC.
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Affiliation(s)
- Jun Gong
- City of Hope National Medical Center, Duarte, CA
| | - Ravi Salgia
- City of Hope National Medical Center, Duarte, CA
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23
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Iida Y, Masuda S, Nakanishi Y, Shimizu T, Nishimaki H, Takahashi M, Hikichi M, Maruoka S, Gon Y, Takahashi N, Hashimoto S. Clinicopathological characteristics of thyroid transcription factor 1-negative small cell lung cancers. Hum Pathol 2018; 79:127-134. [PMID: 29787820 DOI: 10.1016/j.humpath.2018.05.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 04/29/2018] [Accepted: 05/11/2018] [Indexed: 02/06/2023]
Abstract
Limitations in obtaining surgically resected or biopsy samples of small cell lung cancer (SCLC) tumors make comprehensive biological analyses difficult. The loss of thyroid transcription factor 1 (TTF-1) has been associated with the aggressive behavior of non-small cell lung cancer; however, clinicopathological features of TTF-1-negative SCLC remain unclear. This study aimed to elucidate the characteristics of TTF-1-negative SCLC. We studied the associations between the expression of TTF-1 and the clinicopathological factors associated with SCLC, including survival and expression of neuroendocrine markers (synaptophysin, chromogranin A, and CD56), neuroendocrine cell-specific transcription factors (ASCL1, BRN2), a proliferation marker (Ki-67 labeling index), and an oncogene (NF1B). Formalin-fixed and paraffin-embedded sections of SCLC tumors were subjected to immunohistochemistry and quantitative reverse-transcription polymerase chain reaction analyses. In a case-control cohort matched for basic clinical factors, expression of ProGRP, synaptophysin, chromogranin A, and ASCL1 was significantly decreased in TTF-1-negative SCLC samples. In contrast, there was no significant correlation between Ki-67 labeling index and TTF-1. In a larger serial case cohort, TTF-1-negative SCLC cases were older at diagnosis, but there was no significant difference in the overall survival of patients with TTF-1-negative and TTF-1-positive SCLC. In conclusion, TTF-1-negative SCLC showed decreased neuroendocrine differentiation, and significantly worse clinical outcomes were not observed.
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Affiliation(s)
- Yuko Iida
- Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan
| | - Shinobu Masuda
- Division of Oncologic Pathology, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo 173-8610, Japan.
| | - Yoko Nakanishi
- Division of Oncologic Pathology, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo 173-8610, Japan
| | - Tetsuo Shimizu
- Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan
| | - Haruna Nishimaki
- Division of Oncologic Pathology, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo 173-8610, Japan
| | - Mai Takahashi
- Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan
| | - Mari Hikichi
- Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan
| | - Shuichiro Maruoka
- Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan
| | - Yasuhiro Gon
- Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan
| | - Noriaki Takahashi
- Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan
| | - Shu Hashimoto
- Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan
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Reck M, Luft A, Szczesna A, Havel L, Kim SW, Akerley W, Pietanza MC, Wu YL, Zielinski C, Thomas M, Felip E, Gold K, Horn L, Aerts J, Nakagawa K, Lorigan P, Pieters A, Kong Sanchez T, Fairchild J, Spigel D. Phase III Randomized Trial of Ipilimumab Plus Etoposide and Platinum Versus Placebo Plus Etoposide and Platinum in Extensive-Stage Small-Cell Lung Cancer. J Clin Oncol 2017; 34:3740-3748. [PMID: 27458307 DOI: 10.1200/jco.2016.67.6601] [Citation(s) in RCA: 365] [Impact Index Per Article: 52.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Purpose Patients with extensive-stage disease small-cell lung cancer (SCLC) have poor survival outcomes despite first-line chemotherapy with etoposide and platinum. This randomized, double-blind phase III study evaluated the efficacy and safety of ipilimumab or placebo plus etoposide and platinum in patients with newly diagnosed extensive-stage disease SCLC. Patients and Methods Patients were randomly assigned at a ratio of one to one to receive chemotherapy with etoposide and platinum (cisplatin or carboplatin) plus ipilimumab 10 mg/kg or placebo every 3 weeks for a total of four doses each in a phased induction schedule (chemotherapy in cycles one to four; ipilimumab or placebo beginning in cycle three up to cycle six), followed by ipilimumab or placebo maintenance every 12 weeks. Primary end point was overall survival (OS) among patients receiving at least one dose of blinded study therapy. Results Of 1,132 patients randomly assigned, 954 received at least one dose of study therapy (chemotherapy plus ipilimumab, n = 478; chemotherapy plus placebo, n = 476). Median OS was 11.0 months for chemotherapy plus ipilimumab versus 10.9 months for chemotherapy plus placebo (hazard ratio, 0.94; 95% CI, 0.81 to 1.09; P = .3775). Median progression-free survival was 4.6 months for chemotherapy plus ipilimumab versus 4.4 months for chemotherapy plus placebo (hazard ratio, 0.85; 95% CI, 0.75 to 0.97). Rates and severity of treatment-related adverse events were similar between arms, except for diarrhea, rash, and colitis, which were more frequent with chemotherapy plus ipilimumab. Rate of treatment-related discontinuation was higher with chemotherapy plus ipilimumab (18% v 2% with chemotherapy plus placebo). Five treatment-related deaths occurred with chemotherapy plus ipilimumab and two with chemotherapy plus placebo. Conclusion Addition of ipilimumab to chemotherapy did not prolong OS versus chemotherapy alone in patients with newly diagnosed extensive-stage disease SCLC. No new or unexpected adverse events were observed with chemotherapy plus ipilimumab. Several ongoing studies are evaluating ipilimumab in combination with programmed death-1 inhibitors in SCLC.
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Affiliation(s)
- Martin Reck
- Martin Reck, LungenClinic Grosshansdorf, Airway Research Center North, Grosshansdorf; Michael Thomas, Translational Lung Research Center Heidelberg, Thoraxklinik im Universitätsklinikum Heidelberg, Heidelberg, Germany; Alexander Luft, Leningrad Regional Clinical Hospital, Leningrad, Russia; Aleksandra Szczesna, Mazowieckie Centrum Leczenia Chorob Pluc i Gruzlicy w Otwocku, Otwocku, Poland; Libor Havel, Hospital Na Bulovce, Prague, Czech Republic; Sang-We Kim, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea; Wallace Akerley, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Maria Catherine Pietanza, Memorial Sloan Kettering Cancer Center, New York, NY; Kathryn Gold, University of Texas MD Anderson Cancer Center, Houston, TX; Leora Horn, Vanderbilt-Ingram Cancer Center; David Spigel, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Anne Pieters, Teresa Kong Sanchez, and Justin Fairchild, Bristol-Myers Squibb, Princeton, NJ; Yi-long Wu, Guangdong Lung Cancer Institute, Guangdong General Hospital, Guangdong, People's Republic of China; Christoph Zielinski, Medical University of Vienna, Vienna, Austria; Enriqueta Felip, Vall d'Hebron University Hospital, Barcelona, Spain; Joachim Aerts, Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Kazuhiko Nakagawa, Kinki University Hospital, Osaka, Japan; and Paul Lorigan, the Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Alexander Luft
- Martin Reck, LungenClinic Grosshansdorf, Airway Research Center North, Grosshansdorf; Michael Thomas, Translational Lung Research Center Heidelberg, Thoraxklinik im Universitätsklinikum Heidelberg, Heidelberg, Germany; Alexander Luft, Leningrad Regional Clinical Hospital, Leningrad, Russia; Aleksandra Szczesna, Mazowieckie Centrum Leczenia Chorob Pluc i Gruzlicy w Otwocku, Otwocku, Poland; Libor Havel, Hospital Na Bulovce, Prague, Czech Republic; Sang-We Kim, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea; Wallace Akerley, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Maria Catherine Pietanza, Memorial Sloan Kettering Cancer Center, New York, NY; Kathryn Gold, University of Texas MD Anderson Cancer Center, Houston, TX; Leora Horn, Vanderbilt-Ingram Cancer Center; David Spigel, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Anne Pieters, Teresa Kong Sanchez, and Justin Fairchild, Bristol-Myers Squibb, Princeton, NJ; Yi-long Wu, Guangdong Lung Cancer Institute, Guangdong General Hospital, Guangdong, People's Republic of China; Christoph Zielinski, Medical University of Vienna, Vienna, Austria; Enriqueta Felip, Vall d'Hebron University Hospital, Barcelona, Spain; Joachim Aerts, Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Kazuhiko Nakagawa, Kinki University Hospital, Osaka, Japan; and Paul Lorigan, the Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Aleksandra Szczesna
- Martin Reck, LungenClinic Grosshansdorf, Airway Research Center North, Grosshansdorf; Michael Thomas, Translational Lung Research Center Heidelberg, Thoraxklinik im Universitätsklinikum Heidelberg, Heidelberg, Germany; Alexander Luft, Leningrad Regional Clinical Hospital, Leningrad, Russia; Aleksandra Szczesna, Mazowieckie Centrum Leczenia Chorob Pluc i Gruzlicy w Otwocku, Otwocku, Poland; Libor Havel, Hospital Na Bulovce, Prague, Czech Republic; Sang-We Kim, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea; Wallace Akerley, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Maria Catherine Pietanza, Memorial Sloan Kettering Cancer Center, New York, NY; Kathryn Gold, University of Texas MD Anderson Cancer Center, Houston, TX; Leora Horn, Vanderbilt-Ingram Cancer Center; David Spigel, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Anne Pieters, Teresa Kong Sanchez, and Justin Fairchild, Bristol-Myers Squibb, Princeton, NJ; Yi-long Wu, Guangdong Lung Cancer Institute, Guangdong General Hospital, Guangdong, People's Republic of China; Christoph Zielinski, Medical University of Vienna, Vienna, Austria; Enriqueta Felip, Vall d'Hebron University Hospital, Barcelona, Spain; Joachim Aerts, Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Kazuhiko Nakagawa, Kinki University Hospital, Osaka, Japan; and Paul Lorigan, the Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Libor Havel
- Martin Reck, LungenClinic Grosshansdorf, Airway Research Center North, Grosshansdorf; Michael Thomas, Translational Lung Research Center Heidelberg, Thoraxklinik im Universitätsklinikum Heidelberg, Heidelberg, Germany; Alexander Luft, Leningrad Regional Clinical Hospital, Leningrad, Russia; Aleksandra Szczesna, Mazowieckie Centrum Leczenia Chorob Pluc i Gruzlicy w Otwocku, Otwocku, Poland; Libor Havel, Hospital Na Bulovce, Prague, Czech Republic; Sang-We Kim, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea; Wallace Akerley, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Maria Catherine Pietanza, Memorial Sloan Kettering Cancer Center, New York, NY; Kathryn Gold, University of Texas MD Anderson Cancer Center, Houston, TX; Leora Horn, Vanderbilt-Ingram Cancer Center; David Spigel, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Anne Pieters, Teresa Kong Sanchez, and Justin Fairchild, Bristol-Myers Squibb, Princeton, NJ; Yi-long Wu, Guangdong Lung Cancer Institute, Guangdong General Hospital, Guangdong, People's Republic of China; Christoph Zielinski, Medical University of Vienna, Vienna, Austria; Enriqueta Felip, Vall d'Hebron University Hospital, Barcelona, Spain; Joachim Aerts, Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Kazuhiko Nakagawa, Kinki University Hospital, Osaka, Japan; and Paul Lorigan, the Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Sang-We Kim
- Martin Reck, LungenClinic Grosshansdorf, Airway Research Center North, Grosshansdorf; Michael Thomas, Translational Lung Research Center Heidelberg, Thoraxklinik im Universitätsklinikum Heidelberg, Heidelberg, Germany; Alexander Luft, Leningrad Regional Clinical Hospital, Leningrad, Russia; Aleksandra Szczesna, Mazowieckie Centrum Leczenia Chorob Pluc i Gruzlicy w Otwocku, Otwocku, Poland; Libor Havel, Hospital Na Bulovce, Prague, Czech Republic; Sang-We Kim, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea; Wallace Akerley, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Maria Catherine Pietanza, Memorial Sloan Kettering Cancer Center, New York, NY; Kathryn Gold, University of Texas MD Anderson Cancer Center, Houston, TX; Leora Horn, Vanderbilt-Ingram Cancer Center; David Spigel, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Anne Pieters, Teresa Kong Sanchez, and Justin Fairchild, Bristol-Myers Squibb, Princeton, NJ; Yi-long Wu, Guangdong Lung Cancer Institute, Guangdong General Hospital, Guangdong, People's Republic of China; Christoph Zielinski, Medical University of Vienna, Vienna, Austria; Enriqueta Felip, Vall d'Hebron University Hospital, Barcelona, Spain; Joachim Aerts, Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Kazuhiko Nakagawa, Kinki University Hospital, Osaka, Japan; and Paul Lorigan, the Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Wallace Akerley
- Martin Reck, LungenClinic Grosshansdorf, Airway Research Center North, Grosshansdorf; Michael Thomas, Translational Lung Research Center Heidelberg, Thoraxklinik im Universitätsklinikum Heidelberg, Heidelberg, Germany; Alexander Luft, Leningrad Regional Clinical Hospital, Leningrad, Russia; Aleksandra Szczesna, Mazowieckie Centrum Leczenia Chorob Pluc i Gruzlicy w Otwocku, Otwocku, Poland; Libor Havel, Hospital Na Bulovce, Prague, Czech Republic; Sang-We Kim, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea; Wallace Akerley, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Maria Catherine Pietanza, Memorial Sloan Kettering Cancer Center, New York, NY; Kathryn Gold, University of Texas MD Anderson Cancer Center, Houston, TX; Leora Horn, Vanderbilt-Ingram Cancer Center; David Spigel, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Anne Pieters, Teresa Kong Sanchez, and Justin Fairchild, Bristol-Myers Squibb, Princeton, NJ; Yi-long Wu, Guangdong Lung Cancer Institute, Guangdong General Hospital, Guangdong, People's Republic of China; Christoph Zielinski, Medical University of Vienna, Vienna, Austria; Enriqueta Felip, Vall d'Hebron University Hospital, Barcelona, Spain; Joachim Aerts, Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Kazuhiko Nakagawa, Kinki University Hospital, Osaka, Japan; and Paul Lorigan, the Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Maria Catherine Pietanza
- Martin Reck, LungenClinic Grosshansdorf, Airway Research Center North, Grosshansdorf; Michael Thomas, Translational Lung Research Center Heidelberg, Thoraxklinik im Universitätsklinikum Heidelberg, Heidelberg, Germany; Alexander Luft, Leningrad Regional Clinical Hospital, Leningrad, Russia; Aleksandra Szczesna, Mazowieckie Centrum Leczenia Chorob Pluc i Gruzlicy w Otwocku, Otwocku, Poland; Libor Havel, Hospital Na Bulovce, Prague, Czech Republic; Sang-We Kim, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea; Wallace Akerley, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Maria Catherine Pietanza, Memorial Sloan Kettering Cancer Center, New York, NY; Kathryn Gold, University of Texas MD Anderson Cancer Center, Houston, TX; Leora Horn, Vanderbilt-Ingram Cancer Center; David Spigel, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Anne Pieters, Teresa Kong Sanchez, and Justin Fairchild, Bristol-Myers Squibb, Princeton, NJ; Yi-long Wu, Guangdong Lung Cancer Institute, Guangdong General Hospital, Guangdong, People's Republic of China; Christoph Zielinski, Medical University of Vienna, Vienna, Austria; Enriqueta Felip, Vall d'Hebron University Hospital, Barcelona, Spain; Joachim Aerts, Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Kazuhiko Nakagawa, Kinki University Hospital, Osaka, Japan; and Paul Lorigan, the Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Yi-Long Wu
- Martin Reck, LungenClinic Grosshansdorf, Airway Research Center North, Grosshansdorf; Michael Thomas, Translational Lung Research Center Heidelberg, Thoraxklinik im Universitätsklinikum Heidelberg, Heidelberg, Germany; Alexander Luft, Leningrad Regional Clinical Hospital, Leningrad, Russia; Aleksandra Szczesna, Mazowieckie Centrum Leczenia Chorob Pluc i Gruzlicy w Otwocku, Otwocku, Poland; Libor Havel, Hospital Na Bulovce, Prague, Czech Republic; Sang-We Kim, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea; Wallace Akerley, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Maria Catherine Pietanza, Memorial Sloan Kettering Cancer Center, New York, NY; Kathryn Gold, University of Texas MD Anderson Cancer Center, Houston, TX; Leora Horn, Vanderbilt-Ingram Cancer Center; David Spigel, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Anne Pieters, Teresa Kong Sanchez, and Justin Fairchild, Bristol-Myers Squibb, Princeton, NJ; Yi-long Wu, Guangdong Lung Cancer Institute, Guangdong General Hospital, Guangdong, People's Republic of China; Christoph Zielinski, Medical University of Vienna, Vienna, Austria; Enriqueta Felip, Vall d'Hebron University Hospital, Barcelona, Spain; Joachim Aerts, Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Kazuhiko Nakagawa, Kinki University Hospital, Osaka, Japan; and Paul Lorigan, the Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Christoph Zielinski
- Martin Reck, LungenClinic Grosshansdorf, Airway Research Center North, Grosshansdorf; Michael Thomas, Translational Lung Research Center Heidelberg, Thoraxklinik im Universitätsklinikum Heidelberg, Heidelberg, Germany; Alexander Luft, Leningrad Regional Clinical Hospital, Leningrad, Russia; Aleksandra Szczesna, Mazowieckie Centrum Leczenia Chorob Pluc i Gruzlicy w Otwocku, Otwocku, Poland; Libor Havel, Hospital Na Bulovce, Prague, Czech Republic; Sang-We Kim, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea; Wallace Akerley, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Maria Catherine Pietanza, Memorial Sloan Kettering Cancer Center, New York, NY; Kathryn Gold, University of Texas MD Anderson Cancer Center, Houston, TX; Leora Horn, Vanderbilt-Ingram Cancer Center; David Spigel, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Anne Pieters, Teresa Kong Sanchez, and Justin Fairchild, Bristol-Myers Squibb, Princeton, NJ; Yi-long Wu, Guangdong Lung Cancer Institute, Guangdong General Hospital, Guangdong, People's Republic of China; Christoph Zielinski, Medical University of Vienna, Vienna, Austria; Enriqueta Felip, Vall d'Hebron University Hospital, Barcelona, Spain; Joachim Aerts, Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Kazuhiko Nakagawa, Kinki University Hospital, Osaka, Japan; and Paul Lorigan, the Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Michael Thomas
- Martin Reck, LungenClinic Grosshansdorf, Airway Research Center North, Grosshansdorf; Michael Thomas, Translational Lung Research Center Heidelberg, Thoraxklinik im Universitätsklinikum Heidelberg, Heidelberg, Germany; Alexander Luft, Leningrad Regional Clinical Hospital, Leningrad, Russia; Aleksandra Szczesna, Mazowieckie Centrum Leczenia Chorob Pluc i Gruzlicy w Otwocku, Otwocku, Poland; Libor Havel, Hospital Na Bulovce, Prague, Czech Republic; Sang-We Kim, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea; Wallace Akerley, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Maria Catherine Pietanza, Memorial Sloan Kettering Cancer Center, New York, NY; Kathryn Gold, University of Texas MD Anderson Cancer Center, Houston, TX; Leora Horn, Vanderbilt-Ingram Cancer Center; David Spigel, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Anne Pieters, Teresa Kong Sanchez, and Justin Fairchild, Bristol-Myers Squibb, Princeton, NJ; Yi-long Wu, Guangdong Lung Cancer Institute, Guangdong General Hospital, Guangdong, People's Republic of China; Christoph Zielinski, Medical University of Vienna, Vienna, Austria; Enriqueta Felip, Vall d'Hebron University Hospital, Barcelona, Spain; Joachim Aerts, Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Kazuhiko Nakagawa, Kinki University Hospital, Osaka, Japan; and Paul Lorigan, the Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Enriqueta Felip
- Martin Reck, LungenClinic Grosshansdorf, Airway Research Center North, Grosshansdorf; Michael Thomas, Translational Lung Research Center Heidelberg, Thoraxklinik im Universitätsklinikum Heidelberg, Heidelberg, Germany; Alexander Luft, Leningrad Regional Clinical Hospital, Leningrad, Russia; Aleksandra Szczesna, Mazowieckie Centrum Leczenia Chorob Pluc i Gruzlicy w Otwocku, Otwocku, Poland; Libor Havel, Hospital Na Bulovce, Prague, Czech Republic; Sang-We Kim, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea; Wallace Akerley, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Maria Catherine Pietanza, Memorial Sloan Kettering Cancer Center, New York, NY; Kathryn Gold, University of Texas MD Anderson Cancer Center, Houston, TX; Leora Horn, Vanderbilt-Ingram Cancer Center; David Spigel, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Anne Pieters, Teresa Kong Sanchez, and Justin Fairchild, Bristol-Myers Squibb, Princeton, NJ; Yi-long Wu, Guangdong Lung Cancer Institute, Guangdong General Hospital, Guangdong, People's Republic of China; Christoph Zielinski, Medical University of Vienna, Vienna, Austria; Enriqueta Felip, Vall d'Hebron University Hospital, Barcelona, Spain; Joachim Aerts, Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Kazuhiko Nakagawa, Kinki University Hospital, Osaka, Japan; and Paul Lorigan, the Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Kathryn Gold
- Martin Reck, LungenClinic Grosshansdorf, Airway Research Center North, Grosshansdorf; Michael Thomas, Translational Lung Research Center Heidelberg, Thoraxklinik im Universitätsklinikum Heidelberg, Heidelberg, Germany; Alexander Luft, Leningrad Regional Clinical Hospital, Leningrad, Russia; Aleksandra Szczesna, Mazowieckie Centrum Leczenia Chorob Pluc i Gruzlicy w Otwocku, Otwocku, Poland; Libor Havel, Hospital Na Bulovce, Prague, Czech Republic; Sang-We Kim, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea; Wallace Akerley, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Maria Catherine Pietanza, Memorial Sloan Kettering Cancer Center, New York, NY; Kathryn Gold, University of Texas MD Anderson Cancer Center, Houston, TX; Leora Horn, Vanderbilt-Ingram Cancer Center; David Spigel, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Anne Pieters, Teresa Kong Sanchez, and Justin Fairchild, Bristol-Myers Squibb, Princeton, NJ; Yi-long Wu, Guangdong Lung Cancer Institute, Guangdong General Hospital, Guangdong, People's Republic of China; Christoph Zielinski, Medical University of Vienna, Vienna, Austria; Enriqueta Felip, Vall d'Hebron University Hospital, Barcelona, Spain; Joachim Aerts, Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Kazuhiko Nakagawa, Kinki University Hospital, Osaka, Japan; and Paul Lorigan, the Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Leora Horn
- Martin Reck, LungenClinic Grosshansdorf, Airway Research Center North, Grosshansdorf; Michael Thomas, Translational Lung Research Center Heidelberg, Thoraxklinik im Universitätsklinikum Heidelberg, Heidelberg, Germany; Alexander Luft, Leningrad Regional Clinical Hospital, Leningrad, Russia; Aleksandra Szczesna, Mazowieckie Centrum Leczenia Chorob Pluc i Gruzlicy w Otwocku, Otwocku, Poland; Libor Havel, Hospital Na Bulovce, Prague, Czech Republic; Sang-We Kim, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea; Wallace Akerley, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Maria Catherine Pietanza, Memorial Sloan Kettering Cancer Center, New York, NY; Kathryn Gold, University of Texas MD Anderson Cancer Center, Houston, TX; Leora Horn, Vanderbilt-Ingram Cancer Center; David Spigel, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Anne Pieters, Teresa Kong Sanchez, and Justin Fairchild, Bristol-Myers Squibb, Princeton, NJ; Yi-long Wu, Guangdong Lung Cancer Institute, Guangdong General Hospital, Guangdong, People's Republic of China; Christoph Zielinski, Medical University of Vienna, Vienna, Austria; Enriqueta Felip, Vall d'Hebron University Hospital, Barcelona, Spain; Joachim Aerts, Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Kazuhiko Nakagawa, Kinki University Hospital, Osaka, Japan; and Paul Lorigan, the Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Joachim Aerts
- Martin Reck, LungenClinic Grosshansdorf, Airway Research Center North, Grosshansdorf; Michael Thomas, Translational Lung Research Center Heidelberg, Thoraxklinik im Universitätsklinikum Heidelberg, Heidelberg, Germany; Alexander Luft, Leningrad Regional Clinical Hospital, Leningrad, Russia; Aleksandra Szczesna, Mazowieckie Centrum Leczenia Chorob Pluc i Gruzlicy w Otwocku, Otwocku, Poland; Libor Havel, Hospital Na Bulovce, Prague, Czech Republic; Sang-We Kim, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea; Wallace Akerley, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Maria Catherine Pietanza, Memorial Sloan Kettering Cancer Center, New York, NY; Kathryn Gold, University of Texas MD Anderson Cancer Center, Houston, TX; Leora Horn, Vanderbilt-Ingram Cancer Center; David Spigel, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Anne Pieters, Teresa Kong Sanchez, and Justin Fairchild, Bristol-Myers Squibb, Princeton, NJ; Yi-long Wu, Guangdong Lung Cancer Institute, Guangdong General Hospital, Guangdong, People's Republic of China; Christoph Zielinski, Medical University of Vienna, Vienna, Austria; Enriqueta Felip, Vall d'Hebron University Hospital, Barcelona, Spain; Joachim Aerts, Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Kazuhiko Nakagawa, Kinki University Hospital, Osaka, Japan; and Paul Lorigan, the Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Kazuhiko Nakagawa
- Martin Reck, LungenClinic Grosshansdorf, Airway Research Center North, Grosshansdorf; Michael Thomas, Translational Lung Research Center Heidelberg, Thoraxklinik im Universitätsklinikum Heidelberg, Heidelberg, Germany; Alexander Luft, Leningrad Regional Clinical Hospital, Leningrad, Russia; Aleksandra Szczesna, Mazowieckie Centrum Leczenia Chorob Pluc i Gruzlicy w Otwocku, Otwocku, Poland; Libor Havel, Hospital Na Bulovce, Prague, Czech Republic; Sang-We Kim, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea; Wallace Akerley, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Maria Catherine Pietanza, Memorial Sloan Kettering Cancer Center, New York, NY; Kathryn Gold, University of Texas MD Anderson Cancer Center, Houston, TX; Leora Horn, Vanderbilt-Ingram Cancer Center; David Spigel, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Anne Pieters, Teresa Kong Sanchez, and Justin Fairchild, Bristol-Myers Squibb, Princeton, NJ; Yi-long Wu, Guangdong Lung Cancer Institute, Guangdong General Hospital, Guangdong, People's Republic of China; Christoph Zielinski, Medical University of Vienna, Vienna, Austria; Enriqueta Felip, Vall d'Hebron University Hospital, Barcelona, Spain; Joachim Aerts, Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Kazuhiko Nakagawa, Kinki University Hospital, Osaka, Japan; and Paul Lorigan, the Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Paul Lorigan
- Martin Reck, LungenClinic Grosshansdorf, Airway Research Center North, Grosshansdorf; Michael Thomas, Translational Lung Research Center Heidelberg, Thoraxklinik im Universitätsklinikum Heidelberg, Heidelberg, Germany; Alexander Luft, Leningrad Regional Clinical Hospital, Leningrad, Russia; Aleksandra Szczesna, Mazowieckie Centrum Leczenia Chorob Pluc i Gruzlicy w Otwocku, Otwocku, Poland; Libor Havel, Hospital Na Bulovce, Prague, Czech Republic; Sang-We Kim, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea; Wallace Akerley, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Maria Catherine Pietanza, Memorial Sloan Kettering Cancer Center, New York, NY; Kathryn Gold, University of Texas MD Anderson Cancer Center, Houston, TX; Leora Horn, Vanderbilt-Ingram Cancer Center; David Spigel, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Anne Pieters, Teresa Kong Sanchez, and Justin Fairchild, Bristol-Myers Squibb, Princeton, NJ; Yi-long Wu, Guangdong Lung Cancer Institute, Guangdong General Hospital, Guangdong, People's Republic of China; Christoph Zielinski, Medical University of Vienna, Vienna, Austria; Enriqueta Felip, Vall d'Hebron University Hospital, Barcelona, Spain; Joachim Aerts, Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Kazuhiko Nakagawa, Kinki University Hospital, Osaka, Japan; and Paul Lorigan, the Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Anne Pieters
- Martin Reck, LungenClinic Grosshansdorf, Airway Research Center North, Grosshansdorf; Michael Thomas, Translational Lung Research Center Heidelberg, Thoraxklinik im Universitätsklinikum Heidelberg, Heidelberg, Germany; Alexander Luft, Leningrad Regional Clinical Hospital, Leningrad, Russia; Aleksandra Szczesna, Mazowieckie Centrum Leczenia Chorob Pluc i Gruzlicy w Otwocku, Otwocku, Poland; Libor Havel, Hospital Na Bulovce, Prague, Czech Republic; Sang-We Kim, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea; Wallace Akerley, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Maria Catherine Pietanza, Memorial Sloan Kettering Cancer Center, New York, NY; Kathryn Gold, University of Texas MD Anderson Cancer Center, Houston, TX; Leora Horn, Vanderbilt-Ingram Cancer Center; David Spigel, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Anne Pieters, Teresa Kong Sanchez, and Justin Fairchild, Bristol-Myers Squibb, Princeton, NJ; Yi-long Wu, Guangdong Lung Cancer Institute, Guangdong General Hospital, Guangdong, People's Republic of China; Christoph Zielinski, Medical University of Vienna, Vienna, Austria; Enriqueta Felip, Vall d'Hebron University Hospital, Barcelona, Spain; Joachim Aerts, Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Kazuhiko Nakagawa, Kinki University Hospital, Osaka, Japan; and Paul Lorigan, the Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Teresa Kong Sanchez
- Martin Reck, LungenClinic Grosshansdorf, Airway Research Center North, Grosshansdorf; Michael Thomas, Translational Lung Research Center Heidelberg, Thoraxklinik im Universitätsklinikum Heidelberg, Heidelberg, Germany; Alexander Luft, Leningrad Regional Clinical Hospital, Leningrad, Russia; Aleksandra Szczesna, Mazowieckie Centrum Leczenia Chorob Pluc i Gruzlicy w Otwocku, Otwocku, Poland; Libor Havel, Hospital Na Bulovce, Prague, Czech Republic; Sang-We Kim, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea; Wallace Akerley, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Maria Catherine Pietanza, Memorial Sloan Kettering Cancer Center, New York, NY; Kathryn Gold, University of Texas MD Anderson Cancer Center, Houston, TX; Leora Horn, Vanderbilt-Ingram Cancer Center; David Spigel, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Anne Pieters, Teresa Kong Sanchez, and Justin Fairchild, Bristol-Myers Squibb, Princeton, NJ; Yi-long Wu, Guangdong Lung Cancer Institute, Guangdong General Hospital, Guangdong, People's Republic of China; Christoph Zielinski, Medical University of Vienna, Vienna, Austria; Enriqueta Felip, Vall d'Hebron University Hospital, Barcelona, Spain; Joachim Aerts, Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Kazuhiko Nakagawa, Kinki University Hospital, Osaka, Japan; and Paul Lorigan, the Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Justin Fairchild
- Martin Reck, LungenClinic Grosshansdorf, Airway Research Center North, Grosshansdorf; Michael Thomas, Translational Lung Research Center Heidelberg, Thoraxklinik im Universitätsklinikum Heidelberg, Heidelberg, Germany; Alexander Luft, Leningrad Regional Clinical Hospital, Leningrad, Russia; Aleksandra Szczesna, Mazowieckie Centrum Leczenia Chorob Pluc i Gruzlicy w Otwocku, Otwocku, Poland; Libor Havel, Hospital Na Bulovce, Prague, Czech Republic; Sang-We Kim, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea; Wallace Akerley, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Maria Catherine Pietanza, Memorial Sloan Kettering Cancer Center, New York, NY; Kathryn Gold, University of Texas MD Anderson Cancer Center, Houston, TX; Leora Horn, Vanderbilt-Ingram Cancer Center; David Spigel, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Anne Pieters, Teresa Kong Sanchez, and Justin Fairchild, Bristol-Myers Squibb, Princeton, NJ; Yi-long Wu, Guangdong Lung Cancer Institute, Guangdong General Hospital, Guangdong, People's Republic of China; Christoph Zielinski, Medical University of Vienna, Vienna, Austria; Enriqueta Felip, Vall d'Hebron University Hospital, Barcelona, Spain; Joachim Aerts, Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Kazuhiko Nakagawa, Kinki University Hospital, Osaka, Japan; and Paul Lorigan, the Christie NHS Foundation Trust, Manchester, United Kingdom
| | - David Spigel
- Martin Reck, LungenClinic Grosshansdorf, Airway Research Center North, Grosshansdorf; Michael Thomas, Translational Lung Research Center Heidelberg, Thoraxklinik im Universitätsklinikum Heidelberg, Heidelberg, Germany; Alexander Luft, Leningrad Regional Clinical Hospital, Leningrad, Russia; Aleksandra Szczesna, Mazowieckie Centrum Leczenia Chorob Pluc i Gruzlicy w Otwocku, Otwocku, Poland; Libor Havel, Hospital Na Bulovce, Prague, Czech Republic; Sang-We Kim, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea; Wallace Akerley, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Maria Catherine Pietanza, Memorial Sloan Kettering Cancer Center, New York, NY; Kathryn Gold, University of Texas MD Anderson Cancer Center, Houston, TX; Leora Horn, Vanderbilt-Ingram Cancer Center; David Spigel, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Anne Pieters, Teresa Kong Sanchez, and Justin Fairchild, Bristol-Myers Squibb, Princeton, NJ; Yi-long Wu, Guangdong Lung Cancer Institute, Guangdong General Hospital, Guangdong, People's Republic of China; Christoph Zielinski, Medical University of Vienna, Vienna, Austria; Enriqueta Felip, Vall d'Hebron University Hospital, Barcelona, Spain; Joachim Aerts, Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Kazuhiko Nakagawa, Kinki University Hospital, Osaka, Japan; and Paul Lorigan, the Christie NHS Foundation Trust, Manchester, United Kingdom
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26
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Inoue H, Kato T, Olugbile S, Tamura K, Chung S, Miyamoto T, Matsuo Y, Salgia R, Nakamura Y, Park JH. Effective growth-suppressive activity of maternal embryonic leucine-zipper kinase (MELK) inhibitor against small cell lung cancer. Oncotarget 2017; 7:13621-33. [PMID: 26871945 PMCID: PMC4924666 DOI: 10.18632/oncotarget.7297] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 01/29/2016] [Indexed: 12/20/2022] Open
Abstract
Maternal embryonic leucine zipper kinase (MELK), that plays a critical role in maintenance of cancer stem cells (CSCs), is predominantly expressed in various types of human cancer including small cell lung cancer (SCLC). SCLC usually acquires resistance to anti-cancer drugs and portends dismal prognosis. We have delineated roles of MELK in development/progression of SCLC and examined anti-tumor efficacy of OTS167, a highly potent MELK inhibitor, against SCLC. MELK expression was highly upregulated in both SCLC cell lines and primary tumors. siRNA-mediated MELK knockdown induced significant growth inhibition in SCLC cell lines. Concordantly, treatment with OTS167 exhibited strong cytotoxicity against eleven SCLC cell lines with IC50 of < 10 nM. As similar to siRNA knockdown, OTS167 treatment induced cytokinetic defects with intercellular bridges, and in some cell lines we observed formation of neuronal protrusions accompanied with increase of a neuronal differentiation marker (CD56), indicating that the compound induced differentiation of cancer cells to neuron-like cells. Furthermore, the MELK inhibition decreased its downstream FOXM1 activity and Akt expression in SCLC cells, and led to apoptotic cell death. OTS167 appeared to be more effective to CSCs as measured by the sphere formation assay, thus MELK inhibition might become a promising treatment modality for SCLC.
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Affiliation(s)
- Hiroyuki Inoue
- Department of Medicine, The University of Chicago, Chicago, IL 60637, USA
| | - Taigo Kato
- Department of Medicine, The University of Chicago, Chicago, IL 60637, USA
| | - Sope Olugbile
- Department of Medicine, The University of Chicago, Chicago, IL 60637, USA
| | - Kenji Tamura
- Department of Medicine, The University of Chicago, Chicago, IL 60637, USA
| | - Suyoun Chung
- OncoTherapy Science, Inc., Kawasaki, 213-0012, Japan
| | | | - Yo Matsuo
- OncoTherapy Science, Inc., Kawasaki, 213-0012, Japan
| | - Ravi Salgia
- Department of Medicine, The University of Chicago, Chicago, IL 60637, USA
| | - Yusuke Nakamura
- Department of Medicine, The University of Chicago, Chicago, IL 60637, USA
| | - Jae-Hyun Park
- Department of Medicine, The University of Chicago, Chicago, IL 60637, USA
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27
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Hardy-Werbin M, Arpí O, Taus A, Rocha P, Joseph-Pietras D, Nolan L, Danson S, Griffiths R, Lopez-Botet M, Rovira A, Albanell J, Ottensmeier CH, Arriola E. Assessment of neuronal autoantibodies in patients with small cell lung cancer treated with chemotherapy with or without ipilimumab. Oncoimmunology 2017; 7:e1395125. [PMID: 29308329 PMCID: PMC5749672 DOI: 10.1080/2162402x.2017.1395125] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 10/17/2017] [Indexed: 12/17/2022] Open
Abstract
Small-cell lung cancer (SCLC) is often associated with paraneoplastic syndromes. To assess the role of anti-neuronal autoantibodies (NAAs) as biomarkers of treatment outcome, we assessed NAAs in serial samples from SCLC patients treated with chemoimmunotherapy compared to chemotherapy alone. We evaluated 2 cohorts: in cohort 1 (C1), 47 patients received standard platinum/etoposide, and in cohort 2 (C2), 38 patients received ipilimumab, carboplatin and etoposide. Serum samples at baseline and subsequent time points were analyzed for the presence of NAAs. NAAs were detected at baseline in 25 patients (53.2%) in C1 and in 20 patients (52.6%) in C2 (most frequently anti-Sox1). NAA at baseline was associated with limited disease (75% vs 50%; p: 0.096) and better overall survival (15.1 m vs 11.7 m; p: 0.032) in C1. Thirteen patients (28.9%) showed 2 or more reactivities before treatment; this was associated with worse PFS (5.5 m vs 7.3 m; p: 0.005) in patients treated with chemoimmunotherapy. NAA titers decreased after therapy in 68.9% patients, with no differential patterns of change between cohorts. Patients whose NAA titer decreased after treatment, showed longer OS [18.5 m (95% CI: 15.8 - 21.2)] compared with those whose NAA increased [12.3 m (95% CI: 8.1 - 16.5; p 0.049)], suggesting that antibody levels correlate to tumor load. Our findings reinforce the role of NAAs as prognostic markers and tumor activity/burden in SCLC, warrant further investigation in their predictive role for immunotherapy and raise concern over the use of immunotherapy in patients with more than one anti-NAA reactivity.
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Affiliation(s)
- M. Hardy-Werbin
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
| | - O. Arpí
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - A. Taus
- Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain
| | - P. Rocha
- Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain
| | - D. Joseph-Pietras
- NIHR Experimental Cancer Medicine Centre, Southampton, United Kingdom
| | - L. Nolan
- Medical Oncology Department, University Hospital Southampton, Southampton, United Kingdom
| | - S. Danson
- Sheffield Experimental Cancer Medicine Centre, Weston Park Hospital, Sheffield, United Kingdom
| | - R. Griffiths
- Medical Oncology Department, The Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, United Kingdom
| | - M. Lopez-Botet
- Immunology unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - A. Rovira
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - J. Albanell
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain
| | - C. H. Ottensmeier
- Cancer Science Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- NIHR Experimental Cancer Medicine Centre, Southampton, United Kingdom
| | - E. Arriola
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Medical Oncology Department, Hospital del Mar-CIBERONC, Barcelona, Spain
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28
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Miles LA, Burga LN, Gardner EE, Bostina M, Poirier JT, Rudin CM. Anthrax toxin receptor 1 is the cellular receptor for Seneca Valley virus. J Clin Invest 2017. [PMID: 28650343 DOI: 10.1172/jci93472] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Seneca Valley virus (SVV) is an oncolytic picornavirus with selective tropism for neuroendocrine cancers. It has shown promise as a cancer therapeutic in preclinical studies and early-phase clinical trials. Here, we have identified anthrax toxin receptor 1 (ANTXR1) as the receptor for SVV using genome-wide loss-of-function screens. ANTXR1 is necessary for permissivity in vitro and in vivo. However, robust SVV replication requires an additional innate immune defect. We found that SVV interacts directly and specifically with ANTXR1, that this interaction is required for SVV binding to permissive cells, and that ANTXR1 expression is necessary and sufficient for infection in cell lines with decreased expression of antiviral IFN genes at baseline. Finally, we identified the region of the SVV capsid that is responsible for receptor recognition using cryoelectron microscopy of the SVV-ANTXR1-Fc complex. These studies identify ANTXR1, a class of receptor that is shared by a mammalian virus and a bacterial toxin, as the cellular receptor for SVV.
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Affiliation(s)
- Linde A Miles
- Molecular Pharmacology Program and Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | | | - Eric E Gardner
- Molecular Pharmacology Program and Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Mihnea Bostina
- Department of Microbiology and Immunology and.,Otago Centre for Electron Microscopy, University of Otago, Dunedin, New Zealand
| | - John T Poirier
- Molecular Pharmacology Program and Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Charles M Rudin
- Molecular Pharmacology Program and Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Medicine, Weill Cornell Medical College, New York, New York, USA
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29
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Sharma SK, Pourat J, Abdel-Atti D, Carlin SD, Piersigilli A, Bankovich AJ, Gardner EE, Hamdy O, Isse K, Bheddah S, Sandoval J, Cunanan KM, Johansen EB, Allaj V, Sisodiya V, Liu D, Zeglis BM, Rudin CM, Dylla SJ, Poirier JT, Lewis JS. Noninvasive Interrogation of DLL3 Expression in Metastatic Small Cell Lung Cancer. Cancer Res 2017; 77:3931-3941. [PMID: 28487384 DOI: 10.1158/0008-5472.can-17-0299] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 03/31/2017] [Accepted: 04/27/2017] [Indexed: 11/16/2022]
Abstract
The Notch ligand DLL3 has emerged as a novel therapeutic target expressed in small cell lung cancer (SCLC) and high-grade neuroendocrine carcinomas. Rovalpituzumab teserine (Rova-T; SC16LD6.5) is a first-in-class DLL3-targeted antibody-drug conjugate with encouraging initial safety and efficacy profiles in SCLC in the clinic. Here we demonstrate that tumor expression of DLL3, although orders of magnitude lower in surface protein expression than typical oncology targets of immunoPET, can serve as an imaging biomarker for SCLC. We developed 89Zr-labeled SC16 antibody as a companion diagnostic agent to facilitate selection of patients for treatment with Rova-T based on a noninvasive interrogation of the in vivo status of DLL3 expression using PET imaging. Despite low cell-surface abundance of DLL3, immunoPET imaging with 89Zr-labeled SC16 antibody enabled delineation of subcutaneous and orthotopic SCLC tumor xenografts as well as distant organ metastases with high sensitivity. Uptake of the radiotracer in tumors was concordant with levels of DLL3 expression and, most notably, DLL3 immunoPET yielded rank-order correlation for response to SC16LD6.5 therapy in SCLC patient-derived xenograft models. Cancer Res; 77(14); 3931-41. ©2017 AACR.
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Affiliation(s)
- Sai Kiran Sharma
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.,Program in Molecular Pharmacology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jacob Pourat
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.,Program in Molecular Pharmacology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Dalya Abdel-Atti
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.,Program in Molecular Pharmacology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sean D Carlin
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.,Program in Molecular Pharmacology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Alessandra Piersigilli
- Tri-Institutional Laboratory of Comparative Pathology, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College and The Rockefeller University, New York
| | | | - Eric E Gardner
- Program in Molecular Pharmacology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Omar Hamdy
- Stemcentrx, Inc., South San Francisco, California
| | - Kumiko Isse
- Stemcentrx, Inc., South San Francisco, California
| | | | | | - Kristen M Cunanan
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - Viola Allaj
- Program in Molecular Pharmacology, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - David Liu
- Stemcentrx, Inc., South San Francisco, California
| | - Brian M Zeglis
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York.,Department of Chemistry, Hunter College and the Graduate Center of the City University of New York, New York, New York.,Ph.D. Program in Chemistry, the Graduate Center of the City University of New York, New York, New York
| | - Charles M Rudin
- Program in Molecular Pharmacology, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York
| | | | - John T Poirier
- Program in Molecular Pharmacology, Memorial Sloan Kettering Cancer Center, New York, New York. .,Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jason S Lewis
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York. .,Program in Molecular Pharmacology, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York
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30
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Park JH, Inoue H, Kato T, Zewde M, Miyamoto T, Matsuo Y, Salgia R, Nakamura Y. TOPK (T-LAK cell-originated protein kinase) inhibitor exhibits growth suppressive effect on small cell lung cancer. Cancer Sci 2017; 108:488-496. [PMID: 28075524 PMCID: PMC5378278 DOI: 10.1111/cas.13160] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 12/15/2016] [Accepted: 12/17/2016] [Indexed: 02/06/2023] Open
Abstract
T-lymphokine-activated killer cell-originated protein kinase (TOPK) plays critical roles in cancer cell proliferation as well as maintenance of cancer stem cells (CSC). Small cell lung cancer (SCLC) has highly aggressive phenotype, reveals early spread to distant sites, and results in dismal prognosis with little effective treatment. In this study, we demonstrate that TOPK expression was highly upregulated in both SCLC cell lines and primary tumors. Similar to siRNA-mediated TOPK knockdown effects, treatment with a potent TOPK inhibitor, OTS514, effectively suppressed growth of SCLC cell lines (IC50 ; 0.4-42.6 nM) and led to their apoptotic cell death. TOPK inhibition caused cell morphologic changes in SCLC cells, elongation of intercellular bridges caused by cytokinesis defects or neuronal protrusions induced by neuronal differentiation in a subset of CSC-like SCLC cells. Treatment with OTS514 suppressed forkhead box protein M1 (FOXM1) activity, which was involved in stemness of CSC. Furthermore, OTS514 treatment reduced CD90-positive SCLC cells and showed higher cytotoxic effect against lung sphere-derived CSC-like SCLC cells. Collectively, our results suggest that targeting TOPK is a promising approach for SCLC therapy.
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Affiliation(s)
- Jae-Hyun Park
- Department of Medicine, The University of Chicago, Chicago, IL, USA
| | - Hiroyuki Inoue
- Department of Medicine, The University of Chicago, Chicago, IL, USA
| | - Taigo Kato
- Department of Medicine, The University of Chicago, Chicago, IL, USA
| | - Makda Zewde
- Department of Medicine, The University of Chicago, Chicago, IL, USA
| | | | - Yo Matsuo
- OncoTherapy Science Inc., Kawasaki, Japan
| | - Ravi Salgia
- Department of Medicine, The University of Chicago, Chicago, IL, USA
| | - Yusuke Nakamura
- Department of Medicine, The University of Chicago, Chicago, IL, USA
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31
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Pan CH, Chang YF, Lee MS, Wen BC, Ko JC, Liang SK, Liang MC. Vorinostat enhances the cisplatin-mediated anticancer effects in small cell lung cancer cells. BMC Cancer 2016; 16:857. [PMID: 27821078 PMCID: PMC5100277 DOI: 10.1186/s12885-016-2888-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 10/25/2016] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Vorinostat, a histone deacetylase (HDAC) inhibitor, is a promising agent for cancer therapy. Combining vorinostat with cisplatin may relax the chromatin structure and facilitate the accessibility of cisplatin, thus enhancing its cytotoxicity. Studies have not yet investigated the effects of the combination of vorinostat and cisplatin on small cell lung cancer (SCLC). METHODS We first assessed the efficacy of vorinostat with etoposide/cisplatin (EP; triple combination) and then investigated the effects of cotreatment with vorinostat and cisplatin on H209 and H146 SCLC cell lines. The anticancer effects of various combinations were determined in terms of cell viability, apoptosis, cell cycle distribution, and vorinostat-regulated proteins. We also evaluated the efficacy of vorinostat/cisplatin combination in H209 xenograft nude mice. RESULTS Our data revealed that the triple combination engendered a significant reduction of cell viability and high apoptotic cell death. In addition, vorinostat combined with cisplatin enhanced cell growth inhibition, induced apoptosis, and promoted cell cycle arrest. We observed that the acetylation levels of histone H3 and α-tubulin were higher in combination treatments than in vorinostat treatment alone. Moreover, vorinostat reduced the expression of thymidylate synthase (TS), and TS remained inhibited after cotreament with cisplatin. Furthermore, an in vivo study revealed that the combination of vorinostat and cisplatin significantly inhibited tumor growth in xenograft nude mice (tumor growth inhibition T/C% = 20.5 %). CONCLUSIONS Combined treatments with vorinostat promote the cytotoxicity of cisplatin and induce the expression of vorinostat-regulated acetyl proteins, eventually enhancing antitumor effects in SCLC cell lines. Triple combinations with a low dosage of cisplatin demonstrate similar therapeutic effects. Such triple combinations, if applied clinically, may reduce the undesired adverse effects of cisplatin. The effects of the combination of vorinostat and cisplatin should be evaluated further before conducting clinical trials for SCLC treatment.
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Affiliation(s)
- Chun-Hao Pan
- Institute of Molecular Medicine and Bioengineering, National Chiao Tung University, 75 Po-Ai Street, Hsinchu, 300 Taiwan
| | - Ying-Fang Chang
- Department of Biological Science and Technology, National Chiao Tung University, 75 Po-Ai Street, Hsinchu, 300 Taiwan
| | - Ming-Shuo Lee
- Institute of Molecular Medicine and Bioengineering, National Chiao Tung University, 75 Po-Ai Street, Hsinchu, 300 Taiwan
| | - B-Chen Wen
- Department of Biological Science and Technology, National Chiao Tung University, 75 Po-Ai Street, Hsinchu, 300 Taiwan
| | - Jen-Chung Ko
- Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, No. 25, Lane 442, Section 1, Jingguo Road, Hsinchu, 300 Taiwan
| | - Sheng-Kai Liang
- Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, No. 25, Lane 442, Section 1, Jingguo Road, Hsinchu, 300 Taiwan
| | - Mei-Chih Liang
- Institute of Molecular Medicine and Bioengineering, National Chiao Tung University, 75 Po-Ai Street, Hsinchu, 300 Taiwan
- Department of Biological Science and Technology, National Chiao Tung University, 75 Po-Ai Street, Hsinchu, 300 Taiwan
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32
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Arriola E, Wheater M, Galea I, Cross N, Maishman T, Hamid D, Stanton L, Cave J, Geldart T, Mulatero C, Potter V, Danson S, Woll PJ, Griffiths R, Nolan L, Ottensmeier C. Outcome and Biomarker Analysis from a Multicenter Phase 2 Study of Ipilimumab in Combination with Carboplatin and Etoposide as First-Line Therapy for Extensive-Stage SCLC. J Thorac Oncol 2016; 11:1511-21. [PMID: 27296105 PMCID: PMC5063510 DOI: 10.1016/j.jtho.2016.05.028] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 05/23/2016] [Accepted: 05/23/2016] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Our aim was to evaluate the safety and efficacy of ipilimumab combined with standard first-line chemotherapy for patients with extensive-stage SCLC. METHODS Patients with chemotherapy-naive extensive-stage SCLC were treated with carboplatin and etoposide for up to six cycles. Ipilimumab, 10 mg/kg, was given on day 1 of cycles 3 to 6 and every 12 weeks. Response was assessed by the Response Evaluation Criteria in Solid Tumors (RECIST), version 1.0, and immune-related response criteria. The primary end point was 1-year progression-free survival (PFS) according to RECIST. Secondary end points included PFS according to immune-related PFS and overall survival. Autoantibody serum levels were evaluated and correlated with clinical outcomes. RESULTS A total of 42 patients were enrolled between September 2011 and April 2014; 39 were evaluable for safety and 38 for efficacy. Six of 38 patients (15.8% [95% confidence interval (CI): 7.4-30.4]) were alive and progression-free at 1-year by RECIST. Median PFS was 6.9 months (95% CI: 5.5-7.9). Median immune-related PFS was 7.3 months (95% CI: 5.5-8.8). Median overall survival was 17.0 months (95% CI: 7.9-24.3). Of the patients evaluable for response, 21 of 29 (72.4%) achieved an objective response by RECIST and 28 of 33 (84.8%) achieved an objective response by the immune-related response criteria. All patients experienced at least one adverse event; at least one grade 3 or higher toxicity developed in 35 of 39 patients (89.7%); in 27 patients (69.2%) this was related to ipilimumab. Five deaths were reported to be related to ipilimumab. Positivity of an autoimmune profile at baseline was associated with improved outcomes and severe neurological toxicity. CONCLUSIONS Ipilimumab in combination with carboplatin and etoposide might benefit a subgroup of patients with advanced SCLC. Autoantibody analysis correlates with treatment benefit and toxicity and warrants further investigation.
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Affiliation(s)
| | - Matthew Wheater
- University Hospital Southampton, Southampton, United Kingdom
| | - Ian Galea
- Clinical Neurosciences, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Nadia Cross
- Southampton Clinical Trials Unit, University of Southampton, United Kingdom
| | - Tom Maishman
- Southampton Clinical Trials Unit, University of Southampton, United Kingdom
| | - Debbie Hamid
- Southampton Clinical Trials Unit, University of Southampton, United Kingdom
| | - Louise Stanton
- Southampton Clinical Trials Unit, University of Southampton, United Kingdom
| | - Judith Cave
- University Hospital Southampton, Southampton, United Kingdom
| | - Tom Geldart
- Royal Bournemouth and Christchurch Hospitals National Health Service Trust, Bournemouth, United Kingdom
| | | | - Vannessa Potter
- Nottingham University Hospitals National Health Service Trust, Nottingham, United Kingdom
| | - Sarah Danson
- Sheffield Experimental Cancer Medicine Centre, Weston Park Hospital, Sheffield, United Kingdom
| | - Pennella J Woll
- Sheffield Experimental Cancer Medicine Centre, Weston Park Hospital, Sheffield, United Kingdom
| | - Richard Griffiths
- The Clatterbridge Cancer Centre National Health Service Foundation Trust, Wirral, United Kingdom
| | - Luke Nolan
- University Hospital Southampton, Southampton, United Kingdom
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Mahmoud O, Kwon D, Greenfield B, Wright JL, Samuels MA. Intrathoracic extensive-stage small cell lung cancer: assessment of the benefit of thoracic and brain radiotherapy using the SEER database. Int J Clin Oncol 2016; 21:1062-1070. [PMID: 27380168 DOI: 10.1007/s10147-016-1011-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 06/20/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Extensive-stage small cell lung cancer (ESCLC) includes metastatic disease and locally advanced disease confined to the thorax that cannot be encompassed in a typical radiation portal. We assessed and then compared the benefits of thoracic radiotherapy (TRT) and/or brain radiotherapy (BRT) on overall survival (OS) between the intrathoracic (T-ESCLC) and metastatic (M-ESCLC) groups using the Surveillance Epidemiology and End Results database. METHODS TRT and BRT data were available for 10150 patients treated from 1988-1997. The T-ESCLC group included 1774 patients. The Kaplan-Meier method was used to estimate OS and the proportional hazards model was used to estimate OS hazard ratios for prognostic factors including age, gender, race, tumor size, T/N stage, TRT, and BRT. RESULTS The 2-year OS for T-ESCLC was 7.8 % compared to 3 % in the M-ESCLC group (p < 0.001). In the T-ESCLC group, TRT and BRT were delivered to 750 and 102 patients, respectively. The 2-year OS was 13 % in the TRT group compared to 4.1 % in the no-TRT group (p ≤ 0.001) and 22.5 % in the BRT group compared to 7 % in the no-BRT group (p < 0.001). In the M-ESCLC group, TRT and BRT were delivered to 3093 and 1887 patients, respectively. The 2-year OS was 4.4 % in the TRT group compared to 2.8 % in the no-TRT group (p < 0.001) and 4.3 % in the BRT compared to 2.6 % in the no-BRT group (p < 0.001). Age, gender, TRT and BRT were significant OS prognostic factors in both groups. CONCLUSIONS Our study suggests that T-ESCLC is a disease entity distinct from M-ESCLC. Prospective studies to determine whether TRT should be recommended for the thoracic-only subgroup are warranted.
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Affiliation(s)
- Omar Mahmoud
- Department of Radiation Oncology, Robert Wood Johnson Medical School, Rutgers Cancer Institue of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08903, USA.
| | - Deukwoo Kwon
- Biostatistics Core, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Brad Greenfield
- Department of Radiation Oncology, Baylor College of Medicine, Houston, TX, USA
| | - Jean L Wright
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Michael A Samuels
- Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, FL, USA
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Moving Immune Checkpoint Blockade in Thoracic Tumors beyond NSCLC. J Thorac Oncol 2016; 11:1819-1836. [PMID: 27288978 DOI: 10.1016/j.jtho.2016.05.027] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 05/24/2016] [Accepted: 05/28/2016] [Indexed: 02/07/2023]
Abstract
SCLC and malignant pleural mesothelioma (MPM) are historically characterized by a disappointing lack of significant therapeutic breakthroughs for novel agents, and both malignancies represent true unmet medical needs. Given the promising results of anti-cytotoxic T-lymphocyte associated protein-4 and anti-programmed cell death-1/programmed death ligand-1 antibodies in the treatment of advanced NSCLCs, these immune checkpoint inhibitors are now also under investigation in SCLC and MPM, as well as in thymic epithelial tumors (TETs). Here, we review the biological and clinical rationale for immune checkpoint inhibition in SCLC, MPM, and TETs and present preliminary clinical results with available antibodies. Immunotherapeutic perspectives for these malignancies in terms of novel agents currently under evaluation or anticipated in the near future are also discussed. Current immune checkpoint blockers targeting cytotoxic T-lymphocyte associated protein-4 and the programmed cell death-1/programmed death ligand-1 axis, administered alone or in combination and as multimodality treatment, are likely to be a valuable addition to the therapeutic array for managing SCLC and MPM; studies in TETs, which are currently in their infancy, are merited. Close attention to potential toxicities will be important to the success of such strategies in these settings.
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Prognostic factors affecting the risk of thoracic progression in extensive-stage small cell lung cancer. BMC Cancer 2016; 16:197. [PMID: 26955807 PMCID: PMC4782389 DOI: 10.1186/s12885-016-2222-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 02/28/2016] [Indexed: 12/21/2022] Open
Abstract
Background The efficacy of combined modality therapy is evaluated for patients with extensive-stage (ES) small cell lung cancer (SCLC). This study evaluated prognostic factors affecting the risk of thoracic progression in ES-SCLC patients likely to undergo thoracic radiotherapy combined chemotherapy. Methods A retrospective review of ES-SCLC patients who had received systemic chemotherapy at our hospital was performed. Tumor size, metastatic sites, and laboratory data at diagnosis were evaluated as potential prognostic factors. In ES-SCLC patients without pleural dissemination, the rate of thoracic progression after initial chemotherapy was assessed. Results Eighty-three of 96 consecutive ES-SCLC patients were analyzed. The overall response rate was 55 %, median progression free survival was 5.0 months (mo), and overall survival (OS) was 9.2 mo. Tumor size (19.4 mo for ≤3 cm vs. 8.5 mo for >3 cm, p = 0.017) and the number of metastatic sites (12.9 mo for single sites vs. 7.1 mo for multiple sites, p = 0.015) were prognostic factors, in addition to known prognostic factors such as performance status and the levels of LDH and sodium. Cox proportional hazard model showed that the OS was significantly worse in patients with large (>3 cm) primary tumor size {HR 2.44 [95 % confidential interval (CI) 1.05–5.68], p = 0.038} and multiple metastatic sites [HR 1.81 (95 % CI 1.08–3.04), p = 0.026]. In 51 cases without pleural dissemination, the number of metastatic sites was associated with thoracic progression after initial chemotherapy (65 % for single sites vs. 36 % for multiple sites, p = 0.036). Conclusion Large tumor size and multiple metastatic sites at diagnosis significantly predicted poor survival in ES-SCLC patients. Based on the high rate of thoracic progression in ES-SCLC patients with single site of distant metastasis, we should consider thoracic radiotherapy combined with chemotherapy for this population. Electronic supplementary material The online version of this article (doi:10.1186/s12885-016-2222-4) contains supplementary material, which is available to authorized users.
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Cyclophosphamide and tucotuzumab (huKS-IL2) following first-line chemotherapy in responding patients with extensive-disease small-cell lung cancer. Anticancer Drugs 2015; 26:1061-8. [DOI: 10.1097/cad.0000000000000281] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hubaux R, Vandermeers F, Cosse JP, Crisanti C, Kapoor V, Albelda SM, Mascaux C, Delvenne P, Hubert P, Willems L. Valproic acid improves second-line regimen of small cell lung carcinoma in preclinical models. ERJ Open Res 2015; 1:00028-2015. [PMID: 27730151 PMCID: PMC5005116 DOI: 10.1183/23120541.00028-2015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 08/24/2015] [Indexed: 11/21/2022] Open
Abstract
With 5-year survival rates below 5%, small cell lung carcinoma (SCLC) has very poor prognosis and requires improved therapies. Despite an excellent overall response to first-line therapy, relapses are frequent and further treatments are disappointing. The goal of the study was to improve second-line therapy of SCLC. The effect of chemotherapeutic agents was evaluated in cell lines (apoptosis, reactive oxygen species, and RNA and protein expression) and in mouse models (tumour development). We demonstrate here that valproic acid, a histone deacetylase inhibitor, improves the efficacy of a second-line regimen (vindesine, doxorubicin and cyclophosphamide) in SCLC cells and in mouse models. Transcriptomic profiling integrating microRNA and mRNA data identifies key signalling pathways in the response of SCLC cells to valproic acid, opening new prospects for improved therapies. Valproic acid improves second-line regimen of SCLC response in preclinical modelshttp://ow.ly/Rsyd8
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Affiliation(s)
- Roland Hubaux
- Molecular Biology (GxABT), University of Liege (ULg), Gembloux, Belgium; Molecular and Cellular Epigenetics (GIGA), ULg, Liege, Belgium; Interdisciplinary Cluster for Applied Genoproteomics (GIGA), ULg, Liege, Belgium; Pulmonary, Allergy and Critical Care Division, University of Pennsylvania, School of Medicine, Philadelphia, PA, USA
| | - Fabian Vandermeers
- Molecular Biology (GxABT), University of Liege (ULg), Gembloux, Belgium; Molecular and Cellular Epigenetics (GIGA), ULg, Liege, Belgium; Interdisciplinary Cluster for Applied Genoproteomics (GIGA), ULg, Liege, Belgium; Pulmonary, Allergy and Critical Care Division, University of Pennsylvania, School of Medicine, Philadelphia, PA, USA
| | - Jean-Philippe Cosse
- Molecular Biology (GxABT), University of Liege (ULg), Gembloux, Belgium; Molecular and Cellular Epigenetics (GIGA), ULg, Liege, Belgium
| | - Cecilia Crisanti
- Pulmonary, Allergy and Critical Care Division, University of Pennsylvania, School of Medicine, Philadelphia, PA, USA
| | - Veena Kapoor
- Pulmonary, Allergy and Critical Care Division, University of Pennsylvania, School of Medicine, Philadelphia, PA, USA
| | - Steven M Albelda
- Pulmonary, Allergy and Critical Care Division, University of Pennsylvania, School of Medicine, Philadelphia, PA, USA
| | - Céline Mascaux
- Department of Multidisciplinary Oncology and Therapeutic Innovations, Aix Marseille University, Marseille, France
| | | | - Pascale Hubert
- Experimental Pathology, GIGA-Cancer, ULg, Liège, Belgium
| | - Luc Willems
- Molecular Biology (GxABT), University of Liege (ULg), Gembloux, Belgium; Molecular and Cellular Epigenetics (GIGA), ULg, Liege, Belgium; Interdisciplinary Cluster for Applied Genoproteomics (GIGA), ULg, Liege, Belgium
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Murray N, Noonan KL. Can we expect progress from targeted therapy of SCLC? Lung Cancer 2015. [DOI: 10.1183/2312508x.10010914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Small Cell Lung Cancer Patient with Profound Hyponatremia and Acute Neurological Symptoms: An Effective Treatment with Fludrocortisone. Case Rep Oncol Med 2015; 2015:286029. [PMID: 26240768 PMCID: PMC4512576 DOI: 10.1155/2015/286029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 07/01/2015] [Indexed: 11/29/2022] Open
Abstract
Hyponatremia is a frequent electrolyte abnormality in patients with small cell lung cancer (SCLC). Being usually asymptomatic, hyponatremia may cause symptoms like nausea, fatigue, disorientation, headache, muscle cramps, or even seizures, particularly if severe and rapid decrease of serum sodium levels occurs. Here we report a case of SCLC patient with severe hyponatremia and acute neurological symptoms that developed 2 days after the first course of second-line chemotherapy, most probably due to the release of antidiuretic hormone (ADH, also known as arginine vasopressin) during lysis of the tumour cells. Initial treatment consisted of continuous administration of hypertonic saline that resulted in improvement of patient's neurological status. However, to obtain a persistent increase in serum sodium level, pharmacological intervention with oral fludrocortisone 0.1 mg twice daily was needed. We can therefore conclude that mineralocorticoids may be used to correct hyponatremia in SCLC patients when appropriate.
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Cho SH, Kim HK, Jang HJ, Park MJ. Modified one-day etoposide and cisplatin combination for previously untreated extensive-disease small-cell lung cancer: A retrospective evaluation of 36 cases. Mol Clin Oncol 2015; 3:914-918. [PMID: 26171206 DOI: 10.3892/mco.2015.556] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 03/27/2015] [Indexed: 11/06/2022] Open
Abstract
The combination of etoposide and cisplatin (EP) remains one of the standard first-line treatments for extensive-disease small-cell lung cancer (ED-SCLC) We devised a one-day modified EP regimen for better tolerance and convenience by modifying the dose and schedule of conventional EP with administration over 3-5 consecutive days. The modified EP consists of two infusions of etoposide (120 mg/m2 each) and 60 mg/m2 of cisplatin on day 1 of a 21-day cycle and a maximum of 6 cycles of treatment. A total of 36 consecutive ED-SCLC patients were treated with the modified EP as first-line therapy and retrospectively reviewed to assess the efficacy and safety of this regimen. Of the 36 patients, 24 exhibited confirmed objective tumor response (overall response rate of 66%, with a complete response rate of 3% and a partial response rate of 63%). The median overall survival (OS) was 11.8 months [95% confidence interval (CI): 7.9-15.3] and the progression-free survival (PFS) was 7.3 months (95% CI: 5.2-9.7). The survival estimates at 1 year were 35 and 17% for OS and PFS, respectively. The chemotherapy treatment was well tolerated, with only one case of grade 4 non-hematological adverse events, no grade 4 hematological toxicities and no treatment-related deaths. The mean relative dose intensity of etoposide and cisplatin was measured to be 94.7 and 98.5% of the planned dose, respectively. Therefore, the modified EP warrants further clinical research regarding its effectiveness, toxicity profile and convenience of administration. Prospective randomized clinical trials are required to determine the therapeutic role of the modified EP as first-line treatment in patients with ED-SCLC.
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Affiliation(s)
- Su-Hee Cho
- Division of Hematology-Oncology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Hyun Kuk Kim
- Division of Pulmonology, Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Hang Jea Jang
- Division of Pulmonology, Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Min Jae Park
- Division of Hematology-Oncology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea
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Poirier JT, Gardner EE, Connis N, Moreira AL, de Stanchina E, Hann CL, Rudin CM. DNA methylation in small cell lung cancer defines distinct disease subtypes and correlates with high expression of EZH2. Oncogene 2015; 34:5869-78. [PMID: 25746006 PMCID: PMC4564363 DOI: 10.1038/onc.2015.38] [Citation(s) in RCA: 165] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 01/16/2014] [Accepted: 01/27/2015] [Indexed: 12/13/2022]
Abstract
Small cell lung cancer (SCLC) is an aggressive malignancy characterized by early metastasis, rapid development of resistance to chemotherapy, and genetic instability. This study profiles DNA methylation in SCLC, patient-derived xenografts (PDXs) and cell lines at single nucleotide resolution. DNA methylation patterns of primary samples are distinct from those of cell lines, while PDXs maintain a pattern closely consistent with primary samples. Clustering of DNA methylation and gene expression of primary SCLC revealed distinct disease subtypes among histologically indistinguishable primary patient samples with similar genetic alterations. SCLC is notable for dense clustering of high-level methylation in discrete promoter CpG islands, in a pattern clearly distinct from other lung cancers and strongly correlated with high expression of the E2F target and histone methyltransferase gene EZH2. Pharmacologic inhibition of EZH2 in a SCLC PDX markedly inhibited tumor growth.
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Affiliation(s)
- J T Poirier
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - E E Gardner
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Pharmacology and Molecular Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - N Connis
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD, USA
| | - A L Moreira
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - E de Stanchina
- Molecular Pharmacology & Chemistry Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - C L Hann
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD, USA
| | - C M Rudin
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Pharmacology and Molecular Sciences, Johns Hopkins University, Baltimore, MD, USA
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Byers LA, Rudin CM. Small cell lung cancer: where do we go from here? Cancer 2015; 121:664-72. [PMID: 25336398 PMCID: PMC5497465 DOI: 10.1002/cncr.29098] [Citation(s) in RCA: 415] [Impact Index Per Article: 46.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 08/29/2014] [Accepted: 09/10/2014] [Indexed: 12/23/2022]
Abstract
Small cell lung cancer (SCLC) is an aggressive disease that accounts for approximately 14% of all lung cancers. In the United States, approximately 31,000 patients are diagnosed annually with SCLC. Despite numerous clinical trials, including at least 40 phase 3 trials since the 1970s, systemic treatment for patients with SCLC has not changed significantly in the past several decades. Consequently, the 5-year survival rate remains low at <7% overall, and most patients survive for only 1 year or less after diagnosis. Unlike nonsmall cell lung cancer (NSCLC), in which major advances have been made using targeted therapies, there are still no approved targeted drugs for SCLC. Significant barriers to progress in SCLC include 1) a lack of early detection modalities, 2) limited tumor tissue for translational research (eg, molecular profiling of DNA, RNA, and/or protein alterations) because of small diagnostic biopsies and the rare use of surgical resection in standard treatment, and 3) rapid disease progression with poor understanding of the mechanisms contributing to therapeutic resistance. In this report, the authors review the current state of SCLC treatment, recent advances in current understanding of the underlying disease biology, and opportunities to advance translational research and therapeutic approaches for patients with SCLC.
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Affiliation(s)
- Lauren Averett Byers
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Charles M. Rudin
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland
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Abstract
INTRODUCTION There remains a significant therapeutic need for small-cell lung cancer (SCLC). We and others have reported high frequency of copy number gains in cytogenetic bands encoding fibroblast growth factor receptor 1 (FGFR1) in SCLC tumors and cell lines. METHODS Thirteen SCLC cell lines and 68 SCLC patient tumor samples were studied for FGFR1 amplification. Growth inhibition assays were performed using PD173074, a pan-FGFR inhibitor to determine the correlation between FGFR1 expression and drug sensitivity. RESULTS We did not detect FGFR1 mutations in SCLC cell lines. Focal amplification of FGFR1 gene was found in five tumor samples (7%), with high-level focal amplification in only one tumor sample (1%). Amplification owing to polysomy of chromosome 8, where FGFR1 locates, was observed in 22 tumor samples (32%). There was no correlation between FGFR1 gene copy number and messenger RNA expression or protein expression in SCLC cells. FGFR inhibitor sensitivity correlated with FGFR1 copy number determined by real-time polymerase chain reaction assay (r= -0.79; p = 0.01). CONCLUSION FGFR1 gene mutations and focal amplification are rare in SCLC, but polysomy of chromosome 8 is relatively common. FGFR1 copy number gain predicts sensitivity to FGFR inhibition, and FGFR expression correlates inversely with chemosensitivity.
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Yomo S, Hayashi M. Upfront stereotactic radiosurgery in patients with brain metastases from small cell lung cancer: retrospective analysis of 41 patients. Radiat Oncol 2014; 9:152. [PMID: 25005424 PMCID: PMC4099016 DOI: 10.1186/1748-717x-9-152] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 06/30/2014] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Although the efficacy of prophylactic or therapeutic whole brain radiotherapy (WBRT) for brain metastases (BM) from small cell lung cancer (SCLC) is well established, the role of stereotactic radiosurgery (SRS) has yet to be determined. In the present retrospective analysis, we investigated whether upfront SRS might be an effective treatment option for patients with BM from SCLC. METHODS We analyzed 41 consecutive patients with a limited number of BM (≤ 10) from SCLC who received SRS as the initial treatment. No prophylactic and therapeutic WBRT was given prior to SRS. The median patient age was 69 years and the median Karnofsky performance status (KPS) score was 90. Repeat SRS was given for new distant lesions detected on follow-up neuroradiological imaging, as necessary. Overall survival, neurological death, and local and distant BM recurrence rates were analyzed. The survival results were tested with three prognostic scoring systems validated for SCLC: Diagnosis-specific graded prognostic assessment (DS-GPA), Radiation therapy oncology group -recursive partitioning analysis and Rades's survival score. RESULTS One- and 2-year overall survival rates were 44% and 17%, respectively. The median survival time was 8.1 months. Survival results replicated the DS-GPA (P = 0.022) and Rades's survival score (P = 0.034). On multivariate analysis, patients with high KPS (hazard ratio (HR): 0.308, P = 0.009) and post-SRS chemotherapy (HR: 0.324, P = 0.016) had better overall survival. In total, 95/121 tumors (79%) in 34 patients (83%) with sufficient radiological follow-up data were evaluated. Six- and 12-month rates of local control failure were 0% and 14%, respectively. Six- and 12-month distant BM rates were 22% and 44%, respectively. Repeat SRS, salvage WBRT and microsurgery were subsequently required in 18, 7 and one patient, respectively. Symptomatic radiation injury developed in two patients and both were treated conservatively. CONCLUSIONS Our survival analyses with the validated prognostic grading systems suggested upfront SRS for limited BM from SCLC to be a potential treatment option, with patient survival being slightly more than eight months after SRS. Although SRS provided durable local tumor control, repeat treatment was needed in nearly half of patients to achieve control of distant BM.
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Affiliation(s)
- Shoji Yomo
- Division of Radiation Oncology, Aizawa Comprehensive Cancer Center, Aizawa Hospital, Matsumoto, Japan.
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Lu Y, Liu Y, Jiang J, Xi Z, Zhong N, Shi S, Wang J, Wei X. Knocking down the expression of Aurora-A gene inhibits cell proliferation and induces G2/M phase arrest in human small cell lung cancer cells. Oncol Rep 2014; 32:243-9. [PMID: 24841948 DOI: 10.3892/or.2014.3194] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Accepted: 03/10/2014] [Indexed: 11/06/2022] Open
Abstract
A hallmark of small cell lung cancer (SCLC) is frequent relapse characterized by newfound resistance to formerly efficacious chemotherapies. The prognosis for SCLC patients is particularly unfavorable. Aurora kinase A (AURKA), a member of the serine/threonine kinase family, is overexpressed across many types of human tumors. Recent studies have identified AURKA as an important factor in tumorigenesis, but little is known regarding its specific roles in SCLC. The aim of the present study was to establish the roles of AURKA in the molecular pathogenesis of human SCLC. In the present study, we constructed a lentiviral vector to express siRNA against AURKA (LV-AURKA siRNA). As we expected, the viral construct effectively suppressed the expression of the AURKA gene and protein in H446 and H1688 cell lines. Additionally, RNA interference of AURKA inhibited the colony formation and subsequent growth of H446 and H1688 cell lines by increasing the incidence of cell cycle arrest in the G2/M phase. Furthermore, suppression of AURKA by LV-AURKA siRNA also increased apoptosis of SCLC cells. A potential mechanism for the increase of apoptosis is the downregulation of Bcl-2 and upregulation of Bax. AURKA gene suppression may provide a novel, effective therapy for SCLC patients by inhibiting cell division and increasing the rate of apoptosis of SCLC cells.
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Affiliation(s)
- Yimin Lu
- Department of Emergency, Jiangsu Province Hospital of TCM, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210029, P.R. China
| | - Yuanhua Liu
- Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing, Jiangsu 210009, P.R. China
| | - Jianzhong Jiang
- Department of Geriatrics, People's Hospital of Yixing City, Yixing, Jiangsu 214200, P.R. China
| | - Zhaoqing Xi
- Department of Emergency, Jiangsu Province Hospital of TCM, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210029, P.R. China
| | - Ning Zhong
- Department of Surgery, Kunshan First People's Hospital Affiliated to Jiangsu University, Kunshan, Jiangsu 215300, P.R. China
| | - Shunbin Shi
- Department of Thoracic Surgery, Affiliated Wujiang Hospital of Nantong University, Suzhou, Jiangsu 215200, P.R. China
| | - Jinzhi Wang
- Department of Cell Biology, School of Medicine, Soochow University, Suzhou, Jiangsu 215123, P.R. China
| | - Xiaodong Wei
- Department of Thoracic Surgery, No. 101 Hospital of PLA, Wuxi, Jiangsu 214044, P.R. China
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Small steps of improvement in small-cell lung cancer (SCLC) within two decades: A comprehensive analysis of 484 patients. Lung Cancer 2014; 84:168-74. [DOI: 10.1016/j.lungcan.2014.02.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 01/18/2014] [Accepted: 02/10/2014] [Indexed: 11/21/2022]
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Gardner EE, Connis N, Poirier JT, Cope L, Dobromilskaya I, Gallia GL, Rudin CM, Hann CL. Rapamycin rescues ABT-737 efficacy in small cell lung cancer. Cancer Res 2014; 74:2846-56. [PMID: 24614082 DOI: 10.1158/0008-5472.can-13-3460] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Overexpression of the antiapoptotic protein Bcl-2 is observed in the majority of small cell lung cancer (SCLC) cases and is associated with resistance to chemotherapy. While targeting Bcl-2 in hematologic malignancies continues to show signs of promise, translating the BH3 mimetic ABT-737 (or ABT-263; navitoclax) to the clinic for solid tumors has remained problematic, with limited single-agent activity in early-phase clinical trials. Here, we used patient-derived xenograft (PDX) models of SCLC to study ABT-737 resistance and demonstrated that responses to ABT-737 are short lived and coincide with decreases in HIF-1α-regulated transcripts. Combining the mTOR inhibitor rapamycin with ABT-737 rescued this resistance mechanism, was highly synergistic in vitro, and provided durable tumor regressions in vivo without notable hematologic suppression. In comparison, tumor regressions did not occur when ABT-737 was combined with etoposide, a gold-standard cytotoxic for SCLC therapy. Rapamycin exposure was consistently associated with an increase in the proapoptotic protein BAX, whereas ABT-737 caused dose-dependent decreases in BAX. As ABT-737 triggers programmed cell death in a BAX/BAK-dependent manner, we provide preclinical evidence that the efficacy of ABT-737 as a single agent is self-limiting in SCLC, but the addition of rapamycin can maintain or increase levels of BAX protein and markedly enhance the anticancer efficacy of ABT-737. These data have direct translational implications for SCLC clinical trials.
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Affiliation(s)
- Eric E Gardner
- Authors' Affiliations: Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine; Departments of Oncology and Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New YorkAuthors' Affiliations: Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine; Departments of Oncology and Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Nick Connis
- Authors' Affiliations: Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine; Departments of Oncology and Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - John T Poirier
- Authors' Affiliations: Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine; Departments of Oncology and Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Leslie Cope
- Authors' Affiliations: Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine; Departments of Oncology and Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Irina Dobromilskaya
- Authors' Affiliations: Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine; Departments of Oncology and Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Gary L Gallia
- Authors' Affiliations: Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine; Departments of Oncology and Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New YorkAuthors' Affiliations: Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine; Departments of Oncology and Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Charles M Rudin
- Authors' Affiliations: Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine; Departments of Oncology and Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New YorkAuthors' Affiliations: Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine; Departments of Oncology and Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New YorkAuthors' Affiliations: Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine; Departments of Oncology and Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Christine L Hann
- Authors' Affiliations: Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine; Departments of Oncology and Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York
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Gao Y, Geng J, Hong X, Qi J, Teng Y, Yang Y, Qu D, Chen G. Expression of p300 and CBP is associated with poor prognosis in small cell lung cancer. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2014; 7:760-767. [PMID: 24551300 PMCID: PMC3925924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 01/03/2014] [Indexed: 06/03/2023]
Abstract
PURPOSE To investigate the correlation among p300, CBP and MLL expression and the clinicopathological characteristics in resected SCLC patients. METHODS Two hundred and twenty-two resected SCLC patients were included in this study. We evaluated p300, CBP and MLL expression by immunohistochemistry. RESULTS Patients with high p300 expression had shorter OS and DFS than those with low p300 expression (p = 0.01; p = 0.009, respectively). The patients with CBP-positive tumors had significantly lower OS and DFS than those with CBP-negative tumors (p = 0.005 and p = 0.007, respectively). Moreover, the p300- and CBP-positive (+) group had a significantly poor OS and DFS. The multivariate Cox regression analysis showed that high p300 and CBP expression are independent markers of poor overall survival (p = 0.006; p = 0.017, respectively) in operable SCLC patients. CONCLUSIONS High p300 and CBP expression are independent prognostic markers of poor overall survival for resected SCLC patients. The combination of p300 and CBP expression may be useful in identifying patients with increased risks of cancer recurrence of SCLC.
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Affiliation(s)
- Yina Gao
- Department of Pulmonary Medicine, The Third Affiliated Hospital of Harbin Medical University150 Hapin Avenue, Nangang, Harbin, China
| | - Jingshu Geng
- Department of Pathology, The Third Affiliated Hospital of Harbin Medical University150 Hapin Avenue, Nangang, Harbin, China
| | - Xuan Hong
- Department of Pulmonary Medicine, The Third Affiliated Hospital of Harbin Medical University150 Hapin Avenue, Nangang, Harbin, China
| | - Jiping Qi
- Department of Pathology, The First Affiliated Hospital of Harbin Medincal UniversityHarbin, China
| | - Yang Teng
- Department of Pulmonary Medicine, The Third Affiliated Hospital of Harbin Medical University150 Hapin Avenue, Nangang, Harbin, China
| | - Yang Yang
- Department of Pulmonary Medicine, The Third Affiliated Hospital of Harbin Medical University150 Hapin Avenue, Nangang, Harbin, China
| | - Di Qu
- Department of Pulmonary Medicine, The Second Affiliated Hospital of Harbin Medical University150 Hapin Avenue, Nangang, Harbin, China
| | - Gongyan Chen
- Department of Pulmonary Medicine, The Third Affiliated Hospital of Harbin Medical University150 Hapin Avenue, Nangang, Harbin, China
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马 满, 王 孟, 徐 燕, 胡 克, 刘 慧, 李 龙, 钟 巍, 张 力, 赵 静, 王 华. [First-line chemotherapy and its survival analysis of 394 patients with extensive-stage small cell lung cancer in a single institute]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2014; 17:8-14. [PMID: 24398308 PMCID: PMC6000203 DOI: 10.3779/j.issn.1009-3419.2014.01.02] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Revised: 08/29/2013] [Indexed: 11/05/2022]
Abstract
BACKGROUND AND OBJECTIVE Small cell lung cancer (SCLC) is the most malignant neuroendocrine tumor but highly sensitive to chemotherapy and radiotherapy. At present, the standard first-line chemotherapy regimen of extensive-stage SCLC is platinum combined etoposide regimen. However, most patients who receive first-line chemotherapy will relapse within one to two years. Once recurrent, it indicates poor prognosis. In this study, we analyzed the survival among all extensive-stage SCLC and patients who received first-line chemotherapy and determined prognostic factors. METHODS Total of 394 patients who were diagnosed as extensive-stage small cell lung cancer from February 2001 to December 2011 hospitalized in Peking Union Medical College Hospital were collected. Kaplan-Meier method was used to calculate the overall survival (OS) and progression-free survival (PFS). Univariate analysis and Cox regression analysis were used to detect the influence factors of survival. RESULTS The median OS of all extensive-stage small cell lung cancer was 14.8 months; 1-year, 2-year and 5-year survival rates were 58.9%, 27.2% and 7.8%, respectively. According to the results of univariate and Cox multivariate analysis, OS of extensive-stage SCLC was closely associated with age (P=0.006), ECOG PS (P=0.021), liver metastasis (P<0.001), bone metastasis (P<0.001) and chemotherapy (P<0.001). The mortality risk of patients who didn't receive chemotherapy was 4.919 times higher than that who received; the mortality risk of patients without liver, bone metastasis was reduced by approximately 50 percent. The first-line chemotherapy was mainly EP (DDP+VP-16) or CE (CBP+VP-16) regimens (accounting for 82.8%) with 4-6 cycles. The median OS and PFS in first-line chemotherapy were 15.1 months and 7.5 months, respectively. The result of Cox regression analysis indicated that OS in first-line chemotherapy was remarkably related to smoking history (P=0.041), liver metastasis (P<0.001), bone metastasis (P<0.001), chemotherapy cycle number (P<0.001); PFS was relevant with smoking history (P=0.003), liver metastasis (P=0.001), bone metastasis (P<0.001), chemotherapy cycle number (P<0.001). Thoracic radiotherapy was not an independent influence factor of OS and PFS in extensive-stage small cell lung cancer. CONCLUSIONS The patients who were younger than 60-year old, with good KPS, absence of liver and bone metastasis had better prognosis. Patients should receive chemotherapy with first-line standard regimen (CE/EP regimen). It was beneficial to survival if the effect of first-line chemotherapy was SD or PR-CR and the proper chemotherapy cycle number was 4-6 cycles. The role of thoracic radiotherapy in extensive-stage small cell lung cancer needed to be investigated further.
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Affiliation(s)
- 满姣 马
- 100730 北京,中国医学科学院北京协和医院呼吸内科Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - 孟昭 王
- 100730 北京,中国医学科学院北京协和医院呼吸内科Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - 燕 徐
- 100730 北京,中国医学科学院北京协和医院呼吸内科Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - 克 胡
- 100730 北京,中国医学科学院北京协和医院肿瘤放疗科Department of Oncological Radiotherapy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - 慧慧 刘
- 100730 北京,中国医学科学院北京协和医院呼吸内科Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - 龙芸 李
- 100730 北京,中国医学科学院北京协和医院呼吸内科Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - 巍 钟
- 100730 北京,中国医学科学院北京协和医院呼吸内科Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - 力 张
- 100730 北京,中国医学科学院北京协和医院呼吸内科Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - 静 赵
- 100730 北京,中国医学科学院北京协和医院呼吸内科Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - 华竹 王
- 100730 北京,中国医学科学院北京协和医院呼吸内科Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
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50
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Lee JH, Park KS, Alberobello AT, Kallakury B, Weng MT, Wang Y, Giaccone G. The Janus kinases inhibitor AZD1480 attenuates growth of small cell lung cancers in vitro and in vivo. Clin Cancer Res 2013; 19:6777-86. [PMID: 24158701 PMCID: PMC3872034 DOI: 10.1158/1078-0432.ccr-13-1110] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE The prognosis of small cell lung cancer (SCLC) is poor, and there has been very little progress in the medical treatment of SCLC in the past two decades. We investigated the potential of Janus-activated kinases (JAK) inhibitor, AZD1480, for treatment of SCLC in vitro and in vivo. EXPERIMENTAL DESIGN JAK1 and JAK2 were inhibited by AZD1480 or siRNAs, and the effect of inhibition of JAK gene family on SCLC cell viability was evaluated. The effect of AZD1480 on cell-cycle distribution and apoptosis induction was studied. Antitumor effects of AZD1480 in tumor xenografts were assessed. RESULTS AZD1480 significantly inhibited growth of six out of 13 SCLC cells with IC50s ranging from 0.73 to 3.08 μmol/L. Knocking down of JAK2 and JAK1 inhibited proliferation of Jak2-positive/Jak1-negative H82 cells and Jak1-positive/Jak2-negative GLC4 cells, respectively. Treatment of SCLC cells with AZD1480 for 24 hours resulted in an increase of 4N DNA content and histone 3 serine 10 phosphorylation, indicative of G2-M phase arrest. Moreover, SCLCs underwent apoptosis after AZD1480 treatment as exemplified by the downregulation of MCL1, the accumulation of cleaved caspase 3, cleaved PARP, and increase of annexin-V-positive cells. Finally, xenograft experiments showed that AZD1480 attenuated the growth of H82 and GLC4 tumors in mice, and we observed stronger apoptosis as well as decreased CD31-positive endothelial cells in H82 and GLC4 xenografts upon AZD1480 treatment. CONCLUSIONS JAK inhibitor AZD1480 attenuated growth of SCLC cells in vitro and in vivo. Clinical development of anti-JAKs therapies in SCLC warrants further investigation.
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Affiliation(s)
- Jih-Hsiang Lee
- Medical Oncology Branch, National Cancer Institute, National Institutes of Health, USA
| | - Kang-Seo Park
- Medical Oncology Branch, National Cancer Institute, National Institutes of Health, USA
- Lombardi Comprehensive Cancer Center, Georgetown University, USA
| | | | | | - Meng-Tzu Weng
- Medical Oncology Branch, National Cancer Institute, National Institutes of Health, USA
- Lombardi Comprehensive Cancer Center, Georgetown University, USA
| | - Yisong Wang
- Medical Oncology Branch, National Cancer Institute, National Institutes of Health, USA
| | - Giuseppe Giaccone
- Medical Oncology Branch, National Cancer Institute, National Institutes of Health, USA
- Lombardi Comprehensive Cancer Center, Georgetown University, USA
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