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Torres‐Martínez S, Calabuig‐Fariñas S, Moreno‐Manuel A, Bertolini G, Herreros‐Pomares A, Escorihuela E, Duréndez‐Saéz E, Guijarro R, Blasco A, Roz L, Camps C, Jantus‐Lewintre E. Soluble galectin-3 as a microenvironment-relevant immunoregulator with prognostic and predictive value in lung adenocarcinoma. Mol Oncol 2024; 18:190-215. [PMID: 37567864 PMCID: PMC10766205 DOI: 10.1002/1878-0261.13505] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/12/2023] [Accepted: 08/08/2023] [Indexed: 08/13/2023] Open
Abstract
Despite the success of therapies in lung cancer, more studies of new biomarkers for patient selection are urgently needed. The present study aims to analyze the role of galectin-3 (GAL-3) in the lung tumor microenvironment (TME) using tumorspheres as a model and explore its potential role as a predictive and prognostic biomarker in non-small cell lung cancer patients. For in vitro studies, lung adenocarcinoma (LUAD) and lung squamous carcinoma (LUSC) primary cultures from early-stage patients and commercial cell lines were cultured, using tumorsphere-forming assays and adherent conditions for the control counterparts. We analyzed the pattern of secretion and expression of GAL-3 using reverse transcription-quantitative real-time PCR (RTqPCR), immunoblot, immunofluorescence, flow cytometry, and immunoassay analysis. Our results using three-dimensional (3D) models of lung tumor cells revealed that soluble GAL-3 (sGAL-3) is highly expressed and secreted. To more accurately mimic the TME, a co-culture of tumorspheres and fibroblasts was used, revealing that GAL-3 could be important as an immunomodulatory molecule expressed and secreted in the TME, modulating immunosuppression through regulatory T cells (TREGS ). In the translational phase, we confirmed that patients with high expression levels of GAL-3 had more TREGS , which suggests that tumors may be recruiting this population through GAL-3. Next, we evaluated levels of sGAL-3 before surgery in LUAD and LUSC patients, hypothesizing that sGAL-3 could be used as an independent prognostic biomarker for overall survival and relapse-free survival in early-stage LUAD patients. Additionally, levels of sGAL-3 at pretreatment and first response assessment from plasma to predict clinical outcomes in advanced LUAD and LUSC patients treated with first-line pembrolizumab were evaluated, further supporting that sGAL-3 has a high efficiency in predicting durable clinical response to pembrolizumab with an area under curve of 0.801 (P = 0.011). Moreover, high levels might predict decreased progression-free survival and OS to anti-PD-1 therapy, with sGAL-3 being a prognosis-independent biomarker for advanced LUAD.
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Affiliation(s)
- Susana Torres‐Martínez
- Molecular Oncology LaboratoryFundación Investigación Hospital General Universitario de ValenciaSpain
- TRIAL Mixed UnitCentro Investigación Príncipe Felipe—Fundación Investigación Hospital General Universitario de ValenciaSpain
- Centro de Investigación Biomédica en Red CáncerCIBERONCMadridSpain
| | - Silvia Calabuig‐Fariñas
- Molecular Oncology LaboratoryFundación Investigación Hospital General Universitario de ValenciaSpain
- TRIAL Mixed UnitCentro Investigación Príncipe Felipe—Fundación Investigación Hospital General Universitario de ValenciaSpain
- Centro de Investigación Biomédica en Red CáncerCIBERONCMadridSpain
- Department of PathologyUniversitat de ValènciaSpain
| | - Andrea Moreno‐Manuel
- Molecular Oncology LaboratoryFundación Investigación Hospital General Universitario de ValenciaSpain
| | - Giulia Bertolini
- Tumor Genomics UnitFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Alejandro Herreros‐Pomares
- Centro de Investigación Biomédica en Red CáncerCIBERONCMadridSpain
- Department of BiotechnologyUniversitat Politècnica de ValènciaSpain
| | - Eva Escorihuela
- Molecular Oncology LaboratoryFundación Investigación Hospital General Universitario de ValenciaSpain
- TRIAL Mixed UnitCentro Investigación Príncipe Felipe—Fundación Investigación Hospital General Universitario de ValenciaSpain
| | - Elena Duréndez‐Saéz
- Molecular Oncology LaboratoryFundación Investigación Hospital General Universitario de ValenciaSpain
- TRIAL Mixed UnitCentro Investigación Príncipe Felipe—Fundación Investigación Hospital General Universitario de ValenciaSpain
| | - Ricardo Guijarro
- Centro de Investigación Biomédica en Red CáncerCIBERONCMadridSpain
- Department of SurgeryUniversitat de ValènciaSpain
- Department of Thoracic SurgeryHospital General Universitario de ValenciaSpain
| | - Ana Blasco
- TRIAL Mixed UnitCentro Investigación Príncipe Felipe—Fundación Investigación Hospital General Universitario de ValenciaSpain
- Centro de Investigación Biomédica en Red CáncerCIBERONCMadridSpain
- Department of Medical OncologyHospital General Universitario de ValenciaSpain
| | - Luca Roz
- Tumor Genomics UnitFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Carlos Camps
- Molecular Oncology LaboratoryFundación Investigación Hospital General Universitario de ValenciaSpain
- TRIAL Mixed UnitCentro Investigación Príncipe Felipe—Fundación Investigación Hospital General Universitario de ValenciaSpain
- Centro de Investigación Biomédica en Red CáncerCIBERONCMadridSpain
- Department of Medical OncologyHospital General Universitario de ValenciaSpain
- Department of MedicineUniversitat de ValènciaSpain
| | - Eloisa Jantus‐Lewintre
- Molecular Oncology LaboratoryFundación Investigación Hospital General Universitario de ValenciaSpain
- TRIAL Mixed UnitCentro Investigación Príncipe Felipe—Fundación Investigación Hospital General Universitario de ValenciaSpain
- Centro de Investigación Biomédica en Red CáncerCIBERONCMadridSpain
- Department of BiotechnologyUniversitat Politècnica de ValènciaSpain
- Joint Unit: NanomedicineCentro Investigación Príncipe Felipe—Universitat Politècnica de ValenciaSpain
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Wei D, Sun D, Sirera R, Afzal MZ, Leong TL, Li X, Wang Y. Overexpression of MRPL19 in predicting poor prognosis and promoting the development of lung adenocarcinoma. Transl Lung Cancer Res 2023; 12:1517-1538. [PMID: 37577299 PMCID: PMC10413030 DOI: 10.21037/tlcr-23-306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 07/07/2023] [Indexed: 08/15/2023]
Abstract
Background Mitochondrial ribosomal protein L19 (MRPL19) is a member of the mitochondrial ribosomal protein (MRP) family. MRPs have a role in the progression of many cancers. However, the role of MRPL19 in lung adenocarcinoma (LUAD) is yet unknown. Methods The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) datasets, real-time polymerase chain reaction, and immunohistochemistry (IHC) were used to assess MRPL19 expression and clinical relevance. Gene Expression Profiling Interactive Analysis (GEPIA) and the online Kaplan-Meier (KM) Plotter database were used to determine the prognostic significance. Through use of LinkedOmics, genes that were coexpressed with MRPL19 and its regulators were identified. The biological roles of MRPL19 were investigated through R-implemented packages and RNA interference. The Tumor Immune Estimation Resource (TIMER) was employed to assess the connection between MRPL19 expression and infiltrated immune cells in LUAD. Results MRPL19 expression in LUAD was upregulated and was correlated with lymph node metastasis, differentiation level, and tumor status. MRPL19 was prognostic and associated with poor prognosis. Functional network analysis revealed that MRPL19 may be associated with the cell cycle, cell adhesion molecules, spliceosome, and T-helper cell differentiation and was regulated by several microRNA and the E2F family. The gene set enrichment analysis (GSEA) and protein-protein interaction (PPI) network indicated that MRPL19 was correlated with cancer proliferation signaling pathways. The immune infiltration analysis revealed a correlation between MRPL19 expression and the extent of B cells, CD4+ T cells, and dendritic cells' infiltration in LUAD. Additionally, MRPL19 knockdown in LUAD cells substantially reduced cell growth, migration, and invasion of malignant cells. Conclusions The poor prognosis and immunological infiltration in LUAD were significantly associated with MRPL19, which may have pro-oncogenic effects on the disease.
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Affiliation(s)
- Dong Wei
- Graduate School, Tianjin Medical University, Tianjin, China
- Department of Thoracic Surgery, the First Affiliated Hospital of Hebei North University, Zhangjiakou, China
| | - Daqiang Sun
- Department of Thoracic Surgery, Tianjin Chest Hospital of Nankai University, Tianjin, China
| | - Rafael Sirera
- Department of Biotechnology, Universitat Politècnica de València, València, Spain
| | - Muhammad Zubair Afzal
- Hematology-Oncology, Dartmouth-Hitchcock Medical Center, Medical Center Dr., Lebanon, NH, USA
| | - Tracy L. Leong
- Department of Respiratory Medicine, Austin Hospital, Heidelberg, Victoria, Australia
| | - Xin Li
- Department of Thoracic Surgery, Tianjin Chest Hospital of Nankai University, Tianjin, China
| | - Yuhang Wang
- Graduate School, Tianjin Medical University, Tianjin, China
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Comprehensive Analysis of a Novel Immune-Related Gene Signature in Lung Adenocarcinoma. J Clin Med 2022; 11:jcm11206154. [PMID: 36294477 PMCID: PMC9605017 DOI: 10.3390/jcm11206154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/08/2022] [Accepted: 10/11/2022] [Indexed: 11/17/2022] Open
Abstract
Lung cancer is the major cause of cancer-related deaths around the world. Lung adenocarcinoma (LUAD), the most common subtype of lung cancer, contributed to the majority of mortalities and showed different clinical outcomes in prognosis. Tumor-infiltrated immune cells at the tumor site are associated with better survival and immunotherapy response. Thus, it is essential to further investigate the molecular mechanisms and new prognostic biomarkers of lung adenocarcinoma development and progression. In this study, a six-gene signature (CR2, FGF5, INSL4, RAET1L, AGER, and TNFRSF13C) was established to predict the prognosis of LUAD patients, as well as predictive value. The prognostic risk model was also significantly associated with the infiltration of immune cells in LUAD microenvironments. To sum up, a novel immune-related six-gene signature (CR2, FGF5, INSL4, RAET1L, AGER, and TNFRSF13C) was identified that could predict LUAD survival and is highly related to B cells and dendritic cells, which may provide a theoretical basis of personalized treatment for targeted immunotherapy.
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Chuang IC, Jang CS. Appraisal of clinicopathological prognosticators in advanced acral lentiginous melanoma with characterization of PD-L1 and CD8/CD4 immunoprofiles. Jpn J Clin Oncol 2022; 52:975-981. [PMID: 35662346 DOI: 10.1093/jjco/hyac093] [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: 03/01/2022] [Accepted: 05/18/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Acral lentiginous melanoma is the most common subtype of cutaneous melanoma in Asian countries. This study aims to clarify the associations between certain histologic and immunohistochemical parameters, and identify their prognostic values. METHODS We assessed several histologic features and conducted immunohistochemical study of programmed cell death ligand 1 (clone 22C3) and CD8/CD4 in 61 Taiwanese patients with Stage III/IV, non-BRAF acral lentiginous melanomas. RESULTS A total of 41 males and 20 females were included, with a median age of 74 years. The majority of tumors occurred at nonungual locations (86.9%), with 'foot' being the most frequently affected site (85.2%). Positive programmed cell death ligand 1 staining (combined positive score ≥ 10) was significantly associated with the status of tumor-infiltrating lymphocytes (P = 0.036). Lack of skin ulceration was linked to the immunoexpression of CD8/CD4-high (P = 0.004). A superior clinical outcome was found in the tumor-infiltrating lymphocytes-present group (P = 0.011), and among which, CD8/CD4-high was significantly correlated with better survival (P < 0.001). Combined survival analysis revealed that the PD-L1(-) TIL(+) CD8/CD4-high subgroup was associated with favorable prognosis, and cases with PD-L1(+) TIL(-) showed the worst disease specific survival (P < 0.001). In the univariate analysis, lymphovascular invasion (P = 0.002), skin ulceration (P = 0.002), tumor-infiltrating lymphocytes (P = 0.015) and CD8/CD4 status (P < 0.001) were significant prognostic factors. At the multivariate level, the statuses of CD8/CD4-low (P < 0.001) and lymphovascular invasion (P = 0.014) represented the independent poor prognosticators. CONCLUSION For advanced, non-BRAF acral lentiginous melanomas, comprehensive assessments of these microscopic traits, along with CD8/CD4 and PD-L1 immunoprofiles, may help guide the clinicians and patients through treatment decisions.
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Affiliation(s)
- I-Chieh Chuang
- Department of Anatomic Pathology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chiau-Sheng Jang
- Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
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Neoadjuvant Chemotherapy Improves the Immunosuppressive Microenvironment of Bladder Cancer and Increases the Sensitivity to Immune Checkpoint Blockade. J Immunol Res 2022; 2022:9962397. [PMID: 35915657 PMCID: PMC9338739 DOI: 10.1155/2022/9962397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/20/2022] [Accepted: 06/23/2022] [Indexed: 12/24/2022] Open
Abstract
Although tumor immune microenvironment plays an important role in antitumor therapy, few studies explored the gene signatures associated with the tumor immune microenvironment of bladder cancer after neoadjuvant chemotherapy. We examined and analyzed differentially expressed genes from 9 patients with stage I-III bladder cancer by RNA immune-oncology profiling platform. After neoadjuvant chemotherapy, the expressions of 43 genes in 19 pathways and 10 genes in 5 pathways were upregulated and downregulated, respectively. Neoadjuvant chemotherapy also promoted the expression of genes related to the activation of antitumor immune responses and decreased the expression of genes related to tumor proliferation pathways. In addition, neoadjuvant chemotherapy improved tumor response to immune checkpoint blockade. Furthermore, this study also identified several genes that can be used to predict the efficacy of neoadjuvant chemotherapy and their possible molecular mechanisms. In conclusion, neoadjuvant chemotherapy may promote the activation of antitumor effects, improve the suppressive tumor immune microenvironment, and increase the sensitivity of bladder cancer to immune checkpoint blockade.
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Duréndez-Sáez E, Calabuig-Fariñas S, Torres-Martínez S, Moreno-Manuel A, Herreros-Pomares A, Escorihuela E, Mosqueda M, Gallach S, Guijarro R, Serna E, Suárez-Cabrera C, Paramio JM, Blasco A, Camps C, Jantus-Lewintre E. Analysis of Exosomal Cargo Provides Accurate Clinical, Histologic and Mutational Information in Non-Small Cell Lung Cancer. Cancers (Basel) 2022; 14:cancers14133216. [PMID: 35804987 PMCID: PMC9264915 DOI: 10.3390/cancers14133216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 12/10/2022] Open
Abstract
Simple Summary Non-small cell lung cancer (NSCLC) is the second most commonly diagnosed cancer and the leading cause of cancer-related death worldwide. Clinical decision-making depends on the histological classification; however, tissue biopsy is frequently not technically feasible due to tumor location or limited tissue samples. Therefore, we propose to find clinical, molecular and histological biomarkers using a minimally invasive approach based on the analysis of the cargo of the blood extracellular vesicles. Exosomes are membranous vesicles present in several biological fluids, which carry biological information to distant tissues, regulating several tumor processes. This study aims to analyze NSCLC exosome cargo for search biomarkers that could improve clinical management. This report demonstrates the possibility of implementing exosomes to detect molecular alterations and as a source of biomarkers to differentiate NSCLC histology, allowing for a new approach in precision oncology. Abstract Lung cancer is a malignant disease with high mortality and poor prognosis, frequently diagnosed at advanced stages. Nowadays, immense progress in treatment has been achieved. However, the present scenario continues to be critical, and a full comprehension of tumor progression mechanisms is required, with exosomes being potentially relevant players. Exosomes are membranous vesicles that contain biological information, which can be transported cell-to-cell and modulate relevant processes in the hallmarks of cancer. The present research aims to characterize the exosomes’ cargo and study their role in NSCLC to identify biomarkers. We analyzed exosomes secreted by primary cultures and cell lines, grown in monolayer and tumorsphere formations. Exosomal DNA content showed molecular alterations, whereas RNA high-throughput analysis resulted in a pattern of differentially expressed genes depending on histology. The most significant differences were found in XAGE1B, CABYR, NKX2-1, SEPP1, CAPRIN1, and RIOK3 genes when samples from two independent cohorts of resected NSCLC patients were analyzed. We identified and validated biomarkers for adenocarcinoma and squamous cell carcinoma. Our results could represent a relevant contribution concerning exosomes in clinical practice, allowing for the identification of biomarkers that provide information regarding tumor features, prognosis and clinical behavior of the disease.
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Affiliation(s)
- Elena Duréndez-Sáez
- Molecular Oncology Laboratory, Fundación Investigación Hospital General Universitario de Valencia, 46014 Valencia, Spain; (E.D.-S.); (S.C.-F.); (S.T.-M.); (A.M.-M.); (A.H.-P.); (E.E.); (M.M.); (S.G.)
- TRIAL Mixed Unit, Centro Investigación Príncipe Felipe—Fundación Investigación Hospital General Universitario de Valencia, 46014 Valencia, Spain;
- Centro de Investigación Biomédica en Red Cáncer, CIBERONC, 28029 Madrid, Spain; (R.G.); (C.S.-C.); (J.M.P.)
| | - Silvia Calabuig-Fariñas
- Molecular Oncology Laboratory, Fundación Investigación Hospital General Universitario de Valencia, 46014 Valencia, Spain; (E.D.-S.); (S.C.-F.); (S.T.-M.); (A.M.-M.); (A.H.-P.); (E.E.); (M.M.); (S.G.)
- TRIAL Mixed Unit, Centro Investigación Príncipe Felipe—Fundación Investigación Hospital General Universitario de Valencia, 46014 Valencia, Spain;
- Centro de Investigación Biomédica en Red Cáncer, CIBERONC, 28029 Madrid, Spain; (R.G.); (C.S.-C.); (J.M.P.)
- Department of Pathology, Universitat de València, 46010 Valencia, Spain
| | - Susana Torres-Martínez
- Molecular Oncology Laboratory, Fundación Investigación Hospital General Universitario de Valencia, 46014 Valencia, Spain; (E.D.-S.); (S.C.-F.); (S.T.-M.); (A.M.-M.); (A.H.-P.); (E.E.); (M.M.); (S.G.)
- TRIAL Mixed Unit, Centro Investigación Príncipe Felipe—Fundación Investigación Hospital General Universitario de Valencia, 46014 Valencia, Spain;
- Centro de Investigación Biomédica en Red Cáncer, CIBERONC, 28029 Madrid, Spain; (R.G.); (C.S.-C.); (J.M.P.)
| | - Andrea Moreno-Manuel
- Molecular Oncology Laboratory, Fundación Investigación Hospital General Universitario de Valencia, 46014 Valencia, Spain; (E.D.-S.); (S.C.-F.); (S.T.-M.); (A.M.-M.); (A.H.-P.); (E.E.); (M.M.); (S.G.)
- TRIAL Mixed Unit, Centro Investigación Príncipe Felipe—Fundación Investigación Hospital General Universitario de Valencia, 46014 Valencia, Spain;
- Centro de Investigación Biomédica en Red Cáncer, CIBERONC, 28029 Madrid, Spain; (R.G.); (C.S.-C.); (J.M.P.)
| | - Alejandro Herreros-Pomares
- Molecular Oncology Laboratory, Fundación Investigación Hospital General Universitario de Valencia, 46014 Valencia, Spain; (E.D.-S.); (S.C.-F.); (S.T.-M.); (A.M.-M.); (A.H.-P.); (E.E.); (M.M.); (S.G.)
- Centro de Investigación Biomédica en Red Cáncer, CIBERONC, 28029 Madrid, Spain; (R.G.); (C.S.-C.); (J.M.P.)
- Department of Biotechnology, Universitat Politècnica de València, 46022 Valencia, Spain
| | - Eva Escorihuela
- Molecular Oncology Laboratory, Fundación Investigación Hospital General Universitario de Valencia, 46014 Valencia, Spain; (E.D.-S.); (S.C.-F.); (S.T.-M.); (A.M.-M.); (A.H.-P.); (E.E.); (M.M.); (S.G.)
- TRIAL Mixed Unit, Centro Investigación Príncipe Felipe—Fundación Investigación Hospital General Universitario de Valencia, 46014 Valencia, Spain;
- Centro de Investigación Biomédica en Red Cáncer, CIBERONC, 28029 Madrid, Spain; (R.G.); (C.S.-C.); (J.M.P.)
| | - Marais Mosqueda
- Molecular Oncology Laboratory, Fundación Investigación Hospital General Universitario de Valencia, 46014 Valencia, Spain; (E.D.-S.); (S.C.-F.); (S.T.-M.); (A.M.-M.); (A.H.-P.); (E.E.); (M.M.); (S.G.)
- TRIAL Mixed Unit, Centro Investigación Príncipe Felipe—Fundación Investigación Hospital General Universitario de Valencia, 46014 Valencia, Spain;
| | - Sandra Gallach
- Molecular Oncology Laboratory, Fundación Investigación Hospital General Universitario de Valencia, 46014 Valencia, Spain; (E.D.-S.); (S.C.-F.); (S.T.-M.); (A.M.-M.); (A.H.-P.); (E.E.); (M.M.); (S.G.)
- TRIAL Mixed Unit, Centro Investigación Príncipe Felipe—Fundación Investigación Hospital General Universitario de Valencia, 46014 Valencia, Spain;
- Centro de Investigación Biomédica en Red Cáncer, CIBERONC, 28029 Madrid, Spain; (R.G.); (C.S.-C.); (J.M.P.)
| | - Ricardo Guijarro
- Centro de Investigación Biomédica en Red Cáncer, CIBERONC, 28029 Madrid, Spain; (R.G.); (C.S.-C.); (J.M.P.)
- Department of Surgery, Universitat de València, 46010 Valencia, Spain
- Department of Thoracic Surgery, Hospital General Universitario de Valencia, 46014 Valencia, Spain
| | - Eva Serna
- Freshage Research Group, Department of Physiology, Universitat de València, 46010 Valencia, Spain;
- Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable CIBERFES, Fundación Investigación Hospital Clínico Universitario/INCLIVA, 46010 Valencia, Spain
| | - Cristian Suárez-Cabrera
- Centro de Investigación Biomédica en Red Cáncer, CIBERONC, 28029 Madrid, Spain; (R.G.); (C.S.-C.); (J.M.P.)
- Biomedical Research Institute i+12, Hospital Universitario “12 de Octubre”, 28040 Madrid, Spain
- Molecular Oncology Unit, CIEMAT, 28045 Madrid, Spain
| | - Jesús M. Paramio
- Centro de Investigación Biomédica en Red Cáncer, CIBERONC, 28029 Madrid, Spain; (R.G.); (C.S.-C.); (J.M.P.)
- Biomedical Research Institute i+12, Hospital Universitario “12 de Octubre”, 28040 Madrid, Spain
- Molecular Oncology Unit, CIEMAT, 28045 Madrid, Spain
| | - Ana Blasco
- TRIAL Mixed Unit, Centro Investigación Príncipe Felipe—Fundación Investigación Hospital General Universitario de Valencia, 46014 Valencia, Spain;
- Centro de Investigación Biomédica en Red Cáncer, CIBERONC, 28029 Madrid, Spain; (R.G.); (C.S.-C.); (J.M.P.)
- Department of Medical Oncology, Hospital General Universitario de Valencia, 46014 Valencia, Spain
| | - Carlos Camps
- Molecular Oncology Laboratory, Fundación Investigación Hospital General Universitario de Valencia, 46014 Valencia, Spain; (E.D.-S.); (S.C.-F.); (S.T.-M.); (A.M.-M.); (A.H.-P.); (E.E.); (M.M.); (S.G.)
- TRIAL Mixed Unit, Centro Investigación Príncipe Felipe—Fundación Investigación Hospital General Universitario de Valencia, 46014 Valencia, Spain;
- Centro de Investigación Biomédica en Red Cáncer, CIBERONC, 28029 Madrid, Spain; (R.G.); (C.S.-C.); (J.M.P.)
- Department of Medical Oncology, Hospital General Universitario de Valencia, 46014 Valencia, Spain
- Department of Medicine, Universitat de València, 46010 Valencia, Spain
- Correspondence: (C.C.); (E.J.-L.)
| | - Eloisa Jantus-Lewintre
- Molecular Oncology Laboratory, Fundación Investigación Hospital General Universitario de Valencia, 46014 Valencia, Spain; (E.D.-S.); (S.C.-F.); (S.T.-M.); (A.M.-M.); (A.H.-P.); (E.E.); (M.M.); (S.G.)
- TRIAL Mixed Unit, Centro Investigación Príncipe Felipe—Fundación Investigación Hospital General Universitario de Valencia, 46014 Valencia, Spain;
- Centro de Investigación Biomédica en Red Cáncer, CIBERONC, 28029 Madrid, Spain; (R.G.); (C.S.-C.); (J.M.P.)
- Department of Biotechnology, Universitat Politècnica de València, 46022 Valencia, Spain
- Joint Unit: Nanomedicine, Centro Investigación Príncipe Felipe—Universitat Politècnica de Valencia, 46022 Valencia, Spain
- Correspondence: (C.C.); (E.J.-L.)
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Chen Z, Jiang W, Li Z, Zong Y, Deng G. Immune-and Metabolism-Associated Molecular Classification of Ovarian Cancer. Front Oncol 2022; 12:877369. [PMID: 35646692 PMCID: PMC9133421 DOI: 10.3389/fonc.2022.877369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 04/19/2022] [Indexed: 01/25/2023] Open
Abstract
Ovarian cancer (OV) is a complex gynecological disease, and its molecular characteristics are not clear. In this study, the molecular characteristics of OV subtypes based on metabolic genes were explored through the comprehensive analysis of genomic data. A set of transcriptome data of 2752 known metabolic genes was used as a seed for performing non negative matrix factorization (NMF) clustering. Three subtypes of OV (C1, C2 and C3) were found in analysis. The proportion of various immune cells in C1 was higher than that in C2 and C3 subtypes. The expression level of immune checkpoint genes TNFRSF9 in C1 was higher than that of other subtypes. The activation scores of cell cycle, RTK-RAS, Wnt and angiogenesis pathway and ESTIMATE immune scores in C1 group were higher than those in C2 and C3 groups. In the validation set, grade was significantly correlated with OV subtype C1. Functional analysis showed that the extracellular matrix related items in C1 subtype were significantly different from other subtypes. Drug sensitivity analysis showed that C2 subtype was more sensitive to immunotherapy. Survival analysis of differential genes showed that the expression of PXDN and CXCL11 was significantly correlated with survival. The results of tissue microarray immunohistochemistry showed that the expression of PXDN was significantly correlated with tumor size and pathological grade. Based on the genomics of metabolic genes, a new OV typing method was developed, which improved our understanding of the molecular characteristics of human OV.
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Affiliation(s)
- Zhenyue Chen
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Weiyi Jiang
- College of First Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Zhen Li
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yun Zong
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Gaopi Deng
- Department Obstetrics and Gynecology, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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8
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Tsunokake J, Fujishima F, Watanabe H, Sato I, Miura K, Sakamoto K, Suzuki H, Sawai T, Itakura Y, Hoshi T, Kunimitsu A, Yamauchi T, Akaishi R, Ozawa Y, Fukutomi T, Okamoto H, Sato C, Taniyama Y, Kamei T, Sasano H. Tumor Microenvironment in Mixed Neuroendocrine Non-Neuroendocrine Neoplasms: Interaction between Tumors and Immune Cells, and Potential Effects of Neuroendocrine Differentiation on the Tumor Microenvironment. Cancers (Basel) 2022; 14:2152. [DOI: doi.org/10.3390/cancers14092152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/03/2023] Open
Abstract
The tumor microenvironment is considered to play a pivotal role in various human malignancies. Neuroendocrine and non-neuroendocrine neoplasms are considered to have different tumor microenvironments. However, owing to differences in the systemic and/or local immune statuses, tumor microenvironments in different patients may be difficult to compare. Mixed neuroendocrine non-neuroendocrine neoplasms (MiNENs), although rare, could be useful for exploring the effects of neuroendocrine differentiation on the tumor microenvironment, because both neuroendocrine and non-neuroendocrine components are present in the same tumor. Here, we examined 33 cases of histologically confirmed MiNENs and evaluated the influence of neuroendocrine differentiation on the tumor microenvironment by comparing tumor-infiltrating lymphocytes, tumor-associated macrophages, and other relevant factors in the two components the same tumor. The immunoreactivity of those examined above was evaluated quantitatively. The values of vasohibin-1-positive density (p < 0.0001) and immunoreactivity (p < 0.0001) (representing the neoangiogenesis status) were significantly higher in neuroendocrine as compared to non-neuroendocrine areas of the same tumors. In addition, the Foxp3/CD8 (p = 0.0717) and the PD-1/CD8 ratios (p = 0.0176) (representing tumor immunity suppression) tend to increase in neuroendocrine carcinomas. Immunoreactivity of CD163, a marker of M2-like macrophages, was also higher in the neuroendocrine areas. Our findings indicate that neuroendocrine and non-neuroendocrine tumors differ from each other with respect to the characteristics of both tumor cells and the tumor microenvironment.
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9
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Tsunokake J, Fujishima F, Watanabe H, Sato I, Miura K, Sakamoto K, Suzuki H, Sawai T, Itakura Y, Hoshi T, Kunimitsu A, Yamauchi T, Akaishi R, Ozawa Y, Fukutomi T, Okamoto H, Sato C, Taniyama Y, Kamei T, Sasano H. Tumor Microenvironment in Mixed Neuroendocrine Non-Neuroendocrine Neoplasms: Interaction between Tumors and Immune Cells, and Potential Effects of Neuroendocrine Differentiation on the Tumor Microenvironment. Cancers (Basel) 2022; 14:cancers14092152. [PMID: 35565281 PMCID: PMC9100554 DOI: 10.3390/cancers14092152] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 04/16/2022] [Accepted: 04/23/2022] [Indexed: 11/16/2022] Open
Abstract
The tumor microenvironment is considered to play a pivotal role in various human malignancies. Neuroendocrine and non-neuroendocrine neoplasms are considered to have different tumor microenvironments. However, owing to differences in the systemic and/or local immune statuses, tumor microenvironments in different patients may be difficult to compare. Mixed neuroendocrine non-neuroendocrine neoplasms (MiNENs), although rare, could be useful for exploring the effects of neuroendocrine differentiation on the tumor microenvironment, because both neuroendocrine and non-neuroendocrine components are present in the same tumor. Here, we examined 33 cases of histologically confirmed MiNENs and evaluated the influence of neuroendocrine differentiation on the tumor microenvironment by comparing tumor-infiltrating lymphocytes, tumor-associated macrophages, and other relevant factors in the two components the same tumor. The immunoreactivity of those examined above was evaluated quantitatively. The values of vasohibin-1-positive density (p < 0.0001) and immunoreactivity (p < 0.0001) (representing the neoangiogenesis status) were significantly higher in neuroendocrine as compared to non-neuroendocrine areas of the same tumors. In addition, the Foxp3/CD8 (p = 0.0717) and the PD-1/CD8 ratios (p = 0.0176) (representing tumor immunity suppression) tend to increase in neuroendocrine carcinomas. Immunoreactivity of CD163, a marker of M2-like macrophages, was also higher in the neuroendocrine areas. Our findings indicate that neuroendocrine and non-neuroendocrine tumors differ from each other with respect to the characteristics of both tumor cells and the tumor microenvironment.
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Affiliation(s)
- Junichi Tsunokake
- Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; (A.K.); (T.Y.); (R.A.); (Y.O.); (T.F.); (H.O.); (C.S.); (Y.T.); (T.K.)
- Department of Pathology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; (F.F.); (H.W.); (H.S.)
- Correspondence: ; Tel.: +81-22-717-7440
| | - Fumiyoshi Fujishima
- Department of Pathology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; (F.F.); (H.W.); (H.S.)
| | - Hirofumi Watanabe
- Department of Pathology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; (F.F.); (H.W.); (H.S.)
| | - Ikuro Sato
- Department of Pathology, Miyagi Cancer Center, Natori 981-1293, Japan;
| | - Koh Miura
- Department of Surgery, Miyagi Cancer Center, Natori 981-1293, Japan;
| | - Kazuhiro Sakamoto
- Department of Pathology, Osaki Citizen Hospital, Osaki 989-6183, Japan;
| | - Hiroyoshi Suzuki
- Department of Pathology, Sendai Medical Center, Sendai 983-8520, Japan;
| | - Takashi Sawai
- Department of Pathology, Sendai Open Hospital, Sendai 983-0824, Japan;
| | - Yuko Itakura
- Department of Pathology, Japanese Red Cross Ishinomaki Hospital, Ishinomaki 986-8522, Japan;
| | - Tatsuya Hoshi
- Department of Internal Medicine, Kesennuma Citizen Hospital, Kesennuma 988-0181, Japan;
| | - Atsushi Kunimitsu
- Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; (A.K.); (T.Y.); (R.A.); (Y.O.); (T.F.); (H.O.); (C.S.); (Y.T.); (T.K.)
- Department of Pathology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; (F.F.); (H.W.); (H.S.)
| | - Takuro Yamauchi
- Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; (A.K.); (T.Y.); (R.A.); (Y.O.); (T.F.); (H.O.); (C.S.); (Y.T.); (T.K.)
| | - Ryujiro Akaishi
- Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; (A.K.); (T.Y.); (R.A.); (Y.O.); (T.F.); (H.O.); (C.S.); (Y.T.); (T.K.)
| | - Yohei Ozawa
- Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; (A.K.); (T.Y.); (R.A.); (Y.O.); (T.F.); (H.O.); (C.S.); (Y.T.); (T.K.)
| | - Toshiaki Fukutomi
- Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; (A.K.); (T.Y.); (R.A.); (Y.O.); (T.F.); (H.O.); (C.S.); (Y.T.); (T.K.)
| | - Hiroshi Okamoto
- Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; (A.K.); (T.Y.); (R.A.); (Y.O.); (T.F.); (H.O.); (C.S.); (Y.T.); (T.K.)
| | - Chiaki Sato
- Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; (A.K.); (T.Y.); (R.A.); (Y.O.); (T.F.); (H.O.); (C.S.); (Y.T.); (T.K.)
| | - Yusuke Taniyama
- Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; (A.K.); (T.Y.); (R.A.); (Y.O.); (T.F.); (H.O.); (C.S.); (Y.T.); (T.K.)
| | - Takashi Kamei
- Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; (A.K.); (T.Y.); (R.A.); (Y.O.); (T.F.); (H.O.); (C.S.); (Y.T.); (T.K.)
| | - Hironobu Sasano
- Department of Pathology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; (F.F.); (H.W.); (H.S.)
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10
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Tavares DF, Chaves Ribeiro V, Andrade MAV, Moreira Cardoso-Júnior L, Rhangel Gomes Teixeira T, Ramos Varrone G, Lopes Britto R. Immunotherapy using PD-1/PDL-1 inhibitors in metastatic triple-negative breast cancer: A systematic review. Oncol Rev 2021; 15:497. [PMID: 35003528 PMCID: PMC8678626 DOI: 10.4081/oncol.2021.497] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 10/09/2020] [Indexed: 12/12/2022] Open
Abstract
Breast cancer is the most commonly diagnosed cancer in women and is one of the leading causes of death from cancer in women worldwide. Despite the significant benefits of using conventional chemotherapy in the treatment of breast cancer, one of its subtypes, the triple-negative breast cancer, is still a challenge in clinical practice. Recent studies have been investigating the role of the immune system in breast cancer and the development of immunotherapy. Although recently the use of atezolizumab, an anti-PD-L1 monoclonal antibody, combined with chemotherapy was approved, an important step in the treatment of patients with triple-negative metastatic breast cancer, the use of immunotherapy to treat breast tumors remains a major challenge. In this systematic literature review, following PRISMA guidelines, we searched for clinical trials using immunotherapy in the treatment of metastatic triple-negative breast cancer published until March 2020 in the databases EMBASE, PubMed and Cochrane Central Register of Controlled Trials (CENTRAL), with no language restrictions. We did not contact the authors of the clinical trials to obtain additional information. Two researchers independently collected the data and assessed the quality of this study. The literature shows that immunotherapy with anti-PD-1/PD-L1 agents is emerging as a new treatment option in breast cancer. On the other hand, when compared to other types of cancer in which several agents have already been approved, the research is still in its infancy. The use of anti-PD-1/PD-L1 agents as monotherapy revealed encouraging results in the metastatic setting, especially when administered in the early course of the disease, although combination strategies with chemotherapy appear to increase its efficacy. The main limitation of this study is the approach of cancer only in advanced stages.
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Affiliation(s)
- Dione Fernandes Tavares
- Graduate program in Medicine and Health, Medicine Faculty of Bahia, Federal University of Bahia, Salvador
| | | | | | | | | | | | - Renata Lopes Britto
- Graduate program in Medicine and Health, Medicine Faculty of Bahia, Federal University of Bahia, Salvador
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11
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Blessin NC, Abu-Hashem R, Mandelkow T, Li W, Simon R, Hube-Magg C, Möller-Koop C, Witt M, Schmidt A, Büscheck F, Fraune C, Luebke AM, Möller K, Jacobsen F, Lutz F, Lennartz M, Steurer S, Sauter G, Höflmayer D, Tsourlakis MC, Hinsch A, Burandt E, Wilczak W, Minner S, Clauditz TS. Prevalence of proliferating CD8 + cells in normal lymphatic tissues, inflammation and cancer. Aging (Albany NY) 2021; 13:14590-14603. [PMID: 34083496 PMCID: PMC8221353 DOI: 10.18632/aging.203113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 05/11/2021] [Indexed: 12/13/2022]
Abstract
CD8+ cytotoxic T-lymphocytes are essential components of the anti-tumor immunity. To better understand the expansion of CD8+ T-cells we used multiplex fluorescence immunohistochemistry to study Ki67+CD8+ cells in normal lymphoid tissues, selected inflammatory diseases and cancers in 41 large sections/ microenvironment tissue microarrays (TMAs) as well as 765 samples in a conventional TMA format. The evaluation of more than 20 different compartments of normal lymphoid tissues revealed that the percentage of proliferating (ki67+) CD8+ cells did commonly not exceed 3%. In inflammations, the percentage of Ki67+CD8+ cells was more variable and higher compared to normal tissues. In cancers, the percentage of Ki67+CD8+ cells was higher in the tumor center than at the invasive margin. In the tumor center of 765 colorectal cancers, the density of Ki67+CD8+ cells and the percentage of proliferating CD8+ cytotoxic T-cells was significantly associated with microsatellite instability (p<0.0001), pT (p<0.0002) and pN category (p<0.0098). In summary, these data show that the percentage of Ki67+CD8+ cells is usually at a baseline proliferation rate below 3% in healthy secondary lymphoid organs. This rate is often markedly higher in inflammatory and neoplastic diseases compared to normal tissues. The striking link with unfavorable tumor features in colorectal cancer suggest a potential clinical utility of assessing the percentage of Ki67+CD8+ cells to predict patients outcome.
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Affiliation(s)
- Niclas C Blessin
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Hamburg D-20246, Germany
| | - Raed Abu-Hashem
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Hamburg D-20246, Germany
| | - Tim Mandelkow
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Hamburg D-20246, Germany
| | - Wenchao Li
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Hamburg D-20246, Germany
| | - Ronald Simon
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Hamburg D-20246, Germany
| | - Claudia Hube-Magg
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Hamburg D-20246, Germany
| | - Christina Möller-Koop
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Hamburg D-20246, Germany
| | - Melanie Witt
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Hamburg D-20246, Germany
| | - Alice Schmidt
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Hamburg D-20246, Germany
| | - Franziska Büscheck
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Hamburg D-20246, Germany
| | - Christoph Fraune
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Hamburg D-20246, Germany
| | - Andreas M Luebke
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Hamburg D-20246, Germany
| | - Katharina Möller
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Hamburg D-20246, Germany
| | - Frank Jacobsen
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Hamburg D-20246, Germany
| | - Florian Lutz
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Hamburg D-20246, Germany
| | - Maximilian Lennartz
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Hamburg D-20246, Germany
| | - Stefan Steurer
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Hamburg D-20246, Germany
| | - Guido Sauter
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Hamburg D-20246, Germany
| | - Doris Höflmayer
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Hamburg D-20246, Germany
| | | | - Andrea Hinsch
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Hamburg D-20246, Germany
| | - Eike Burandt
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Hamburg D-20246, Germany
| | - Waldemar Wilczak
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Hamburg D-20246, Germany
| | - Sarah Minner
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Hamburg D-20246, Germany
| | - Till S Clauditz
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Hamburg D-20246, Germany
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12
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Wang H, Chen S, Meng D, Wu C, Zhu J, Jiang M, Ning J, Wu S, Wu L, Li J, Chen B, Zhao S, Li W, Yu J, Fang Q, Zhu J, Zhao W, He Y, Zhou C. Tumor Mutation Burden and Differentially Mutated Genes Among Immune Phenotypes in Patients with Lung Adenocarcinoma. Onco Targets Ther 2021; 14:2953-2965. [PMID: 33976553 PMCID: PMC8106479 DOI: 10.2147/ott.s294993] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/25/2021] [Indexed: 12/26/2022] Open
Abstract
Introduction Nowadays, immune checkpoint blockades (ICBs) have been extensively applied in non-small cell lung cancer (NSCLC) treatment. However, the outcome of anti-program death-1/program death ligand-1 (anti-PD-1/PD-L1) therapy is not satisfying in EGFR-mutant lung adenocarcinoma (LUAD) patients and its exact mechanisms have not been fully understood. Since tumor mutation burden (TMB) and tumor immune phenotype had been thought as potential predictors for efficacy of ICBs, we further studied the TMB and immune phenotype in LUAD patients to explore potential mechanisms for poor efficacy of ICBs in EGFR positive mutated patients and to find possible factors that could impact the tumor immune phenotype which might uncover some new therapeutic strategies or combination therapies. Methods We enrolled 223 LUAD patients who underwent surgery in our hospital. We evaluated TMB through targeted panel sequencing. The tumor immune phenotype, which could be divided into non-inflamed, intermediate and inflamed, was determined through immunohistochemistry using formalin-fixed paraffin-embedded samples. Enumeration data were analyzed by Chi-square test or Fisher exact test and shown as number (proportion). Logistic regression model was employed for univariate and multivariate analysis of the association between TMB levels and clinical characteristics. Results The median TMB level was 4.0445 mutations/Mb. Multivariate analysis showed the TMB level was significantly associated with age (P=0.026), gender (P=0.041) and EGFR mutation status (P=0.015), and in EGFR-mutant patients we found a lower proportion of patients with mutated KRAS and BRCA2. Furthermore, we found patients with or without metastatic lesions would have different immune phenotype (P=0.007). And the mutational frequencies of ALK, CDKN2A, MAP2K1, IDH2 and PTEN were significantly different among three immune phenotypes. Conclusion Low TMB level could be the reason for the poor efficacy of ICBs in patients having EGFR mutation. And mutational frequencies of KRAS and BRCA2 were lower in EGFR-mutant patients. Furthermore, ALK, CDKN2A, MAP2K1, IDH2 and PTEN might involve in the formation of immune phenotypes.
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Affiliation(s)
- Hao Wang
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Shanghai, 200433, People's Republic of China.,Medical School, Tongji University, Shanghai, 200433, People's Republic of China
| | - Shanhao Chen
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Shanghai, 200433, People's Republic of China
| | - Die Meng
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Shanghai, 200433, People's Republic of China.,Medical School, Tongji University, Shanghai, 200433, People's Republic of China
| | - Chunyan Wu
- Pathology Department, Shanghai Pulmonary Hospital, Shanghai, 200433, People's Republic of China
| | - Junjie Zhu
- Surgery Department, Shanghai Pulmonary Hospital, Shanghai, 200433, People's Republic of China
| | - Minlin Jiang
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Shanghai, 200433, People's Republic of China.,Medical School, Tongji University, Shanghai, 200433, People's Republic of China
| | - Jing Ning
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Shanghai, 200433, People's Republic of China.,Medical School, Tongji University, Shanghai, 200433, People's Republic of China
| | - Shengyu Wu
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Shanghai, 200433, People's Republic of China.,Medical School, Tongji University, Shanghai, 200433, People's Republic of China
| | - Lijia Wu
- Genecast Biotechnology Co., Ltd, Wuxi City, Jiangsu, 214104, People's Republic of China
| | - Jingjie Li
- Genecast Biotechnology Co., Ltd, Wuxi City, Jiangsu, 214104, People's Republic of China
| | - Bin Chen
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Shanghai, 200433, People's Republic of China
| | - Sha Zhao
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Shanghai, 200433, People's Republic of China
| | - Wei Li
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Shanghai, 200433, People's Republic of China
| | - Jia Yu
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Shanghai, 200433, People's Republic of China.,Medical School, Tongji University, Shanghai, 200433, People's Republic of China
| | - Qiyu Fang
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Shanghai, 200433, People's Republic of China.,Medical School, Tongji University, Shanghai, 200433, People's Republic of China
| | - Jun Zhu
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Shanghai, 200433, People's Republic of China.,Medical School, Tongji University, Shanghai, 200433, People's Republic of China
| | - Wencheng Zhao
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Shanghai, 200433, People's Republic of China.,Medical School, Tongji University, Shanghai, 200433, People's Republic of China
| | - Yayi He
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Shanghai, 200433, People's Republic of China
| | - Caicun Zhou
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Shanghai, 200433, People's Republic of China
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13
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Blessin NC, Li W, Mandelkow T, Jansen HL, Yang C, Raedler JB, Simon R, Büscheck F, Dum D, Luebke AM, Hinsch A, Möller K, Menz A, Bernreuther C, Lebok P, Clauditz T, Sauter G, Marx A, Uhlig R, Wilczak W, Minner S, Krech T, Fraune C, Höflmayer D, Burandt E, Steurer S. Prognostic role of proliferating CD8 + cytotoxic Tcells in human cancers. Cell Oncol (Dordr) 2021; 44:793-803. [PMID: 33864611 PMCID: PMC8338812 DOI: 10.1007/s13402-021-00601-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2021] [Indexed: 02/07/2023] Open
Abstract
PURPOSE Expansion of CD8+ cytotoxic Tlymphocytes is a prerequisite for anti-cancer immune activity and has gained interest in the era of immune checkpoint therapy. METHODS To understand the CD8+ T cell dynamics in the tumor microenvironment, we used multiplex fluorescence immunohistochemistry to quantitate CD8+ proliferation (Ki67 co-expression) in tissue microarrays from 1107 colorectal, 642 renal cell, 1066 breast, 375 ovarian, 451 pancreatic and 347 gastric cancer samples. RESULTS The density and the percentage of proliferating (Ki67+) CD8+ T cells were both highly variable between tumor types as well as between patients with the same tumor type. Elevated density and percentage of proliferating CD8+ cytotoxic T cells were significantly associated with favorable tumor parameters such as low tumor stage, negative nodal stage (p ≤ 0.0041 each), prolonged overall survival (p ≤ 0.0028 each) and an inflamed immune phenotype (p = 0.0025) in colorectal cancer and, in contrast, linked to high tumor stage, advanced ISUP/Fuhrman/Thoenes grading (each p ≤ 0.003), shorter overall survival (p ≤ 0.0330 each) and an immune inflamed phenotype (p = 0.0094) in renal cell cancer. In breast, ovarian, pancreatic and gastric cancer the role of (Ki67+)CD8+ Tcells was not linked to clinicopathological data. CONCLUSION Our data demonstrate a tumor type dependent prognostic impact of proliferating (Ki67+)CD8+ Tcells and an inverse impact in colorectal and renal cell cancer.
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Affiliation(s)
- Niclas C Blessin
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, D-20246, Hamburg, Germany
| | - Wenchao Li
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, D-20246, Hamburg, Germany
| | - Tim Mandelkow
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, D-20246, Hamburg, Germany
| | - Hannah L Jansen
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, D-20246, Hamburg, Germany
| | - Cheng Yang
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, D-20246, Hamburg, Germany
| | - Jonas B Raedler
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, D-20246, Hamburg, Germany.,College of Arts and Sciences, Boston University, Boston, MA, USA
| | - Ronald Simon
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, D-20246, Hamburg, Germany.
| | - Franziska Büscheck
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, D-20246, Hamburg, Germany
| | - David Dum
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, D-20246, Hamburg, Germany
| | - Andreas M Luebke
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, D-20246, Hamburg, Germany
| | - Andrea Hinsch
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, D-20246, Hamburg, Germany
| | - Katharina Möller
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, D-20246, Hamburg, Germany
| | - Anne Menz
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, D-20246, Hamburg, Germany
| | - Christian Bernreuther
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, D-20246, Hamburg, Germany
| | - Patrick Lebok
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, D-20246, Hamburg, Germany
| | - Till Clauditz
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, D-20246, Hamburg, Germany
| | - Guido Sauter
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, D-20246, Hamburg, Germany
| | - Andreas Marx
- Institute of Pathology, Medical Centre Fürth, D-90766, Fürth, Germany
| | - Ria Uhlig
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, D-20246, Hamburg, Germany
| | - Waldemar Wilczak
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, D-20246, Hamburg, Germany
| | - Sarah Minner
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, D-20246, Hamburg, Germany
| | - Till Krech
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, D-20246, Hamburg, Germany
| | - Christoph Fraune
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, D-20246, Hamburg, Germany
| | - Doris Höflmayer
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, D-20246, Hamburg, Germany
| | - Eike Burandt
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, D-20246, Hamburg, Germany
| | - Stefan Steurer
- Institute of Pathology, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, D-20246, Hamburg, Germany
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14
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Tan HNC, Catedral LIG, San Juan MD. Prognostic Significance of Tumor-infiltrating Lymphocytes on Survival Outcomes of Patients With Resected Pancreatic Ductal Adenocarcinoma: A Systematic Review and Meta-Analysis. J Immunother 2021; 44:29-40. [PMID: 32909965 DOI: 10.1097/cji.0000000000000331] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Tumor-infiltrating lymphocytes (TILs) play an important role in mediating treatment response in pancreatic cancer. This meta-analysis investigated the prognostic significance of TIL subsets on overall survival (OS) and disease-free survival (DFS) of patients with pancreatic cancer. Studies were gathered via search of PubMed, Google Scholar, and Cochrane Library databases up to August 1, 2019. Using Review Manager version 5.3.5, pooled hazard ratios and 95% confidence intervals (CIs) were calculated using random or fixed-effects models, depending on the heterogeneity of studies. A total of 11 studies comprising 1760 patients were included in the meta-analysis. Pooled analysis revealed that high CD8 TILs were associated with improved OS [hazard ratio (HR)=0.59, 95% CI=0.51-0.69, P<0.00001] and DFS (HR=0.60, 95% CI=0.50-0.73, P<0.00001). Similarly, high CD3 TILs correlated with better OS (HR=0.64, 95% CI=0.54-0.75, P<0.00001) and DFS (HR=0.53, 95% CI=0.31-0.92, P<0.0001). In contrast, high FoxP3 TILs were associated with worse OS (HR=1.39, 95% CI=1.03-1.88, P=0.03). Finally, high CD4 TILs showed significant improvement in OS (HR=0.74, 95% CI=0.63-0.86, P=0.0001). TILs are a promising prognostic biomarker in pancreatic cancer. Prospective studies evaluating TILs are recommended as well as the establishment of standards in the assessment of TILs.
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Affiliation(s)
- Harold N C Tan
- Division of Medical Oncology, Department of Medicine, University of the Philippines-Philippine General Hospital, Manila, Philippines
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15
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Chen B, Li H, Liu C, Xiang X, Wang S, Wu A, Shen Y, Li G. Prognostic value of the common tumour-infiltrating lymphocyte subtypes for patients with non-small cell lung cancer: A meta-analysis. PLoS One 2020; 15:e0242173. [PMID: 33170901 PMCID: PMC7654825 DOI: 10.1371/journal.pone.0242173] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 10/27/2020] [Indexed: 12/25/2022] Open
Abstract
Background Many previous studies have revealed that tumour-infiltrating lymphocytes (TILs) are significantly associated with prognosis in various tumours. However, this finding remains controversial in non-small cell lung cancer (NSCLC). We performed this meta-analysis systematically to evaluate the prognostic value of TILs in NSCLC. Methods The references were collected by searching the PubMed, EMBASE and Web of Science databases. The pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were summarized using random or fixed effects models to evaluate the association between TILs and NSCLC survival outcomes. Results A total of 45 interrelated studies were eligible that included 11,448 patients. Pooled analysis showed that a high density of TILs indicated a better overall survival (HR = 0.80, 0.70–0.89) and progression-free survival (HR = 0.73, 0.61–0.85) for patients with NSCLC; a high density of CD3+ TILs in the tumour nest indicated a better overall survival (HR = 0.84, 0.69–0.99) and disease-specific survival (HR = 0.57, 0.34–0.80); a high density of CD4+ TILs in the tumor nest indicated a favourable overall survival (HR = 0.86, 0.76–0.96); a high density of CD8+ TILs indicated a favourable overall survival (HR = 0.995, 0.99–1.0), progression-free survival (HR = 0.52, 0.34–0.71), disease-free survival (HR = 0.64, 0.43–0.85), relapse/recurrence-free survival (HR = 0.42, 0.18–0.67) and disease-specific survival (HR = 0.56, 0.35–0.78); and a high density of CD20+ TILs in the tumour nest indicated a favourable overall survival (HR = 0.65, 0.36–0.94). However, a high density of Foxp3+ TILs in the tumour stroma indicated a worse relapse/recurrence-free survival (HR = 1.90, 1.05–2.76) in NSCLC. Conclusions Our meta-analysis confirmed that high densities of TILs, CD3+TILs, CD4+TILs, CD8+TILs and CD20+TILs in the tumour nest are favourable prognostic biomarkers for patients with NSCLC, and Foxp3+TILs in the tumour stroma are a poor prognostic biomarker.
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Affiliation(s)
- Benchao Chen
- Department of Thoracic Surgery, The Third Affiliated Hospital of Kunming Medical University (Tumor Hospital of Yunnan Province), Kunming, Yunnan, China
| | - Heng Li
- Department of Thoracic Surgery, The Third Affiliated Hospital of Kunming Medical University (Tumor Hospital of Yunnan Province), Kunming, Yunnan, China
| | - Chao Liu
- Department of Thoracic Surgery, The Third Affiliated Hospital of Kunming Medical University (Tumor Hospital of Yunnan Province), Kunming, Yunnan, China
| | - Xudong Xiang
- Department of Thoracic Surgery, The Third Affiliated Hospital of Kunming Medical University (Tumor Hospital of Yunnan Province), Kunming, Yunnan, China
| | - Shuting Wang
- Department of Thoracic Surgery, The Third Affiliated Hospital of Kunming Medical University (Tumor Hospital of Yunnan Province), Kunming, Yunnan, China
| | - Anhao Wu
- Department of Thoracic Surgery, The Third Affiliated Hospital of Kunming Medical University (Tumor Hospital of Yunnan Province), Kunming, Yunnan, China
| | - Yan Shen
- Department of Thoracic Surgery, The Third Affiliated Hospital of Kunming Medical University (Tumor Hospital of Yunnan Province), Kunming, Yunnan, China
| | - Gaofeng Li
- Department of Thoracic Surgery, The Third Affiliated Hospital of Kunming Medical University (Tumor Hospital of Yunnan Province), Kunming, Yunnan, China
- * E-mail:
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16
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Moreno-Manuel A, Jantus-Lewintre E, Simões I, Aranda F, Calabuig-Fariñas S, Carreras E, Zúñiga S, Saenger Y, Rosell R, Camps C, Lozano F, Sirera R. CD5 and CD6 as immunoregulatory biomarkers in non-small cell lung cancer. Transl Lung Cancer Res 2020; 9:1074-1083. [PMID: 32953486 PMCID: PMC7481598 DOI: 10.21037/tlcr-19-445] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 02/28/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND The study of immune surveillance in the tumour microenvironment is leading to the development of new biomarkers and therapies. The present research focuses on the expression of CD5 and CD6-two lymphocyte surface markers involved in the fine tuning of TCR signaling-as potential prognostic biomarkers in resectable stages of non-small cell lung cancer (NSCLC). METHODS CD5 and CD6 gene expression was analysed by reverse transcription quantitative polymerase chain reaction (RTqPCR) in 186 paired fresh frozen tumour and normal tissue samples of resected NSCLC. RESULTS Patients with higher CD5 expression had significantly increased overall survival (OS, 49.63 vs. 99.90 months, P=0.013). CD5 expression levels were correlated to CD4 infiltration and expression levels, and survival analysis showed that patients with a higher CD5/CD4 + ratio had significantly improved prognosis. Multivariate analysis established CD5 expression as an independent prognostic biomarker for OS in early stages of NSCLC (HR=0.554; 95% CI, 0.360-0.853; P=0.007). Further survival analysis of NSCLC cases (n=97) from The Cancer Genome Atlas (TCGA) database, confirmed the prognostic value of both CD5 and CD6 expression¸ although CD6 expression alone did not reach significant prognostic value in our NSCLC training cohort. CONCLUSIONS Our data support further studies on CD5 and CD6 as novel prognostic markers in resectable NSCLC and other cancer types (i.e., melanoma), as well as a role for these receptors in immune surveillance.
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Affiliation(s)
- Andrea Moreno-Manuel
- Molecular Oncology Laboratory, Fundación para la Investigación del Hospital General Universitario de Valencia, Valencia, Spain
- TRIAL Mixed Unit, Centro de Investigación Príncipe Felipe-Fundación para la Investigación del Hospital General Universitario de Valencia, Valencia, Spain
| | - Eloisa Jantus-Lewintre
- Molecular Oncology Laboratory, Fundación para la Investigación del Hospital General Universitario de Valencia, Valencia, Spain
- TRIAL Mixed Unit, Centro de Investigación Príncipe Felipe-Fundación para la Investigación del Hospital General Universitario de Valencia, Valencia, Spain
- Department of Biotechnology, Universitat Politècnica de València, Valencia, Spain
- CIBERONC, Valencia, Spain
| | - Ines Simões
- Immunoreceptors of the Innate and Adaptative System, Institut d’Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Fernando Aranda
- Immunoreceptors of the Innate and Adaptative System, Institut d’Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Silvia Calabuig-Fariñas
- TRIAL Mixed Unit, Centro de Investigación Príncipe Felipe-Fundación para la Investigación del Hospital General Universitario de Valencia, Valencia, Spain
- CIBERONC, Valencia, Spain
- Department of Pathology, Universitat de València, Valencia, Spain
| | - Esther Carreras
- Immunoreceptors of the Innate and Adaptative System, Institut d’Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Sheila Zúñiga
- Unidad de Medicina de Precisión en Oncología Traslacional, INCLIVA, Valencia, Spain
| | - Yvonne Saenger
- Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Rafael Rosell
- Catalan Institute of Oncology, Germans Trias i Pujol Health Sciences Institute and Hospital, Badalona, Spain
| | - Carlos Camps
- Molecular Oncology Laboratory, Fundación para la Investigación del Hospital General Universitario de Valencia, Valencia, Spain
- TRIAL Mixed Unit, Centro de Investigación Príncipe Felipe-Fundación para la Investigación del Hospital General Universitario de Valencia, Valencia, Spain
- CIBERONC, Valencia, Spain
- Department of Medicine, Universitat de València, Valencia, Spain
- Servicio de Oncología Médica, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - Francisco Lozano
- Immunoreceptors of the Innate and Adaptative System, Institut d’Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Servei d’Immunologia, Centre de Diagnòstic Biomèdic, Hospital Clínic de Barcelona, Barcelona, Spain
- Departament de Biomedicina, Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
| | - Rafael Sirera
- Molecular Oncology Laboratory, Fundación para la Investigación del Hospital General Universitario de Valencia, Valencia, Spain
- TRIAL Mixed Unit, Centro de Investigación Príncipe Felipe-Fundación para la Investigación del Hospital General Universitario de Valencia, Valencia, Spain
- Department of Biotechnology, Universitat Politècnica de València, Valencia, Spain
- CIBERONC, Valencia, Spain
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17
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Hao J, Wang H, Song L, Li S, Che N, Zhang S, Zhang H, Wang J. Infiltration of CD8 + FOXP3 + T cells, CD8 + T cells, and FOXP3 + T cells in non-small cell lung cancer microenvironment. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2020; 13:880-888. [PMID: 32509058 PMCID: PMC7270696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 03/27/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Studies about CD8+ FOXP3+ T cells as a subtype of regulatory T cells (Treg cells) in non-small cell lung cancer (NSCLC) are few. Associations among the clinicopathologic factors of NSCLC and tumor-infiltrating lymphocytes (TILs) such as CD8+ FOXP3+ T cells, CD8+ T cells, FOXP3+ T cells and tumor PD-L1 expression are unclear. METHODS We retrospectively enrolled 192 patients who underwent resections for NSCLC. We used tissue microarrays (TMA) with multiplex immunofluorescence and immunohistochemistry staining to evaluate the expression of CD8, FOXP3, cytokeratin, DAPI and PD-L1. We then used Wilcoxon test, Kaplan-Meier method, and Cox hazard proportion model to analyze their relationships with clinicopathologic factors and prognosis. RESULTS Density of tumor CD8+ FOXP3+ T cells was significant by univariate analysis, and positively associated with tumor CD8+ T cells and FOXP3+ T cells. Density of tumor CD8+ T cells was higher in lung adenocarcinoma (LUAD) than squamous cell carcinoma (LUSC), and was an independent prognostic factor for NSCLC. The density of tumor FOXP3+ T cells decreased with tumor size. Tumor PD-L1 expression was higher in LUSC than LUAD. Cox hazard proportion model analysis correlated being younger than 65 years, early TNM stage, early T stage, high tumor CD8+ T cell density, and adjuvant chemotherapy with longer overall survival. CONCLUSION Infiltration of CD8+ FOXP3+ T cells, CD8+ T cells, and FOXP3+ T cells is important in non-small cell lung cancer microenvironment, and needs to be investigated more.
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Affiliation(s)
- Jianqing Hao
- Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research InstituteBeijing, China
| | - Helin Wang
- Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research InstituteBeijing, China
- Department of Oncology, First Affiliated Hospital of Xinxiang Medical UniversityXinxiang, Henan, China
| | - Lai Song
- Beijing DCTY Bioinformation Technology Co.Beijing, China
| | - Shuping Li
- Department of Central Laboratory, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research InstituteBeijing, China
| | - Nanying Che
- Department of Pathology, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research InstituteBeijing, China
| | - Shucai Zhang
- Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research InstituteBeijing, China
| | - Hongtao Zhang
- Department of Central Laboratory, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research InstituteBeijing, China
| | - Jinghui Wang
- Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research InstituteBeijing, China
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18
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Giatromanolaki A, Harris AL, Banham AH, Contrafouris CA, Koukourakis MI. Carbonic anhydrase 9 (CA9) expression in non-small-cell lung cancer: correlation with regulatory FOXP3+T-cell tumour stroma infiltration. Br J Cancer 2020; 122:1205-1210. [PMID: 32066909 PMCID: PMC7156529 DOI: 10.1038/s41416-020-0756-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 01/13/2020] [Accepted: 01/30/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Low pH suppresses the proliferation and cytotoxic activity of CD8+ cytotoxic and natural killer lymphocytes. The hypoxia-regulated transmembrane protein, carbonic anhydrase CA9, converts carbon dioxide produced by the Krebs cycle to bicarbonate and protons that acidify the extracellular milieu. We examined whether CA9 is also involved in intratumoural immunosuppression pathways. METHODS A series of 98 tissue samples of primary non-small-cell lung carcinomas (NSCLC) from patients treated with surgery were analysed for the expression of CA9 and programmed-death ligand PD-L1 by cancer cells, and of FOXP3 by tumour-infiltrating lymphocytes (TILs). RESULTS There was no direct association of CA9 with PD-L1 expression or the density of TILs in the tumour stroma, but CA9 was directly related to the extent of FOXP3+ TIL density (p = 0.008). Double-stratification survival analysis showed that patients with high CA9 expression and low TIL score had significantly poorer survival compared with all other groups (p < 0.04). In a multivariate analysis stage (p < 0.0001, HR 1.95, 95% CI: 1.3-2.7), TIL score (p = 0.05, HR 0.55, 95% CI: 0.2-1.0) was an independent prognostic variable of death events. CA9 expression by cancer cells is associated significantly with FOXP3+ regulatory T-cell abundance in the tumour stroma of NSCLC. CONCLUSION The study provides a basis for testing CA9 as a marker of resistance to immune-checkpoint inhibitors and as a therapeutic target to enhance the efficacy of immunotherapy.
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Affiliation(s)
- Alexandra Giatromanolaki
- Department of Pathology, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Adrian L Harris
- Cancer Research UK, Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Alison H Banham
- Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine, John Radcliffe Hospital, Oxford, OX3 9DU, UK
| | | | - Michael I Koukourakis
- Department of Radiotherapy/Oncology, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece.
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Handa Y, Tsutani Y, Shiroma N, Kai Y, Mimae T, Miyata Y, Takeshima Y, Arihiro K, Okada M. Prognostic Impact of Programmed Death-ligand 1 and Surrounding Immune Status on Stage I Lung Cancer. Clin Lung Cancer 2020; 21:e302-e314. [PMID: 32102750 DOI: 10.1016/j.cllc.2020.01.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 12/16/2019] [Accepted: 01/20/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND The programmed death 1/programmed death-ligand 1 (PD-L1) pathway reportedly is as an important factor determining effects of immunotherapy; however, its prognostic impact is controversial, and its association with the surrounding immune microenvironment has not yet been elucidated. PATIENTS AND METHODS We retrospectively analyzed 126 patients with pathologic stage I non-small-cell lung cancer. Patients with lepidic-dominant adenocarcinoma were excluded. PD-L1 expression was evaluated with immunohistochemistry correlated with clinicopathologic features and surrounding immune microenvironment status, including CD4, CD8, regulatory T cells, and human leukocyte antigen class I. Factors affecting prognosis were assessed by Kaplan-Meier and Cox regression analyses. RESULTS Twenty-three (18.3%) patients were positive for PD-L1 expression. No significant correlation was observed between PD-L1 expression and the surrounding immune microenvironment status. The PD-L1-positive group had a worse prognosis than the PD-L1-negative group (5-year recurrence-free survival rates, 63.4% vs. 81.0%; P = .061). Among surrounding immune cells, intratumoral CD8 status had the strongest impact on prognosis (P = .12). In the intratumoral CD8-high group, PD-L1 expression demonstrated no significant prognostic impact, whereas in the intratumoral CD8-low group, patients positive for PD-L1 demonstrated a significantly worse prognosis than those negative for PD-L1 (5-year recurrence-free survival rates, 41.7% vs. 78.6%; P = .034). Multivariable Cox regression analysis revealed that 'PD-L1-positive and intratumoral CD8-low' status was an independent prognostic factor (hazard ratio, 3.80; 95% confidence interval, 1.22-10.5; P = .023). CONCLUSIONS The prognostic impact of the PD-1/PD-L1 pathway may be distinct according to concurrent intratumoral CD8 status.
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Affiliation(s)
- Yoshinori Handa
- Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan; Department of Anatomical Pathology, Hiroshima University, Hiroshima, Japan
| | - Yasuhiro Tsutani
- Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan
| | - Noriyuki Shiroma
- Department of Anatomical Pathology, Hiroshima University, Hiroshima, Japan
| | - Yuichiro Kai
- Department of Pathology, Hiroshima University, Hiroshima, Japan
| | - Takahiro Mimae
- Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan
| | - Yoshihiro Miyata
- Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan
| | - Yukio Takeshima
- Department of Pathology, Hiroshima University, Hiroshima, Japan
| | - Koji Arihiro
- Department of Anatomical Pathology, Hiroshima University, Hiroshima, Japan
| | - Morihito Okada
- Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan.
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20
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Tuminello S, Veluswamy R, Lieberman-Cribbin W, Gnjatic S, Petralia F, Wang P, Flores R, Taioli E. Prognostic value of immune cells in the tumor microenvironment of early-stage lung cancer: a meta-analysis. Oncotarget 2019; 10:7142-7155. [PMID: 31903172 PMCID: PMC6935257 DOI: 10.18632/oncotarget.27392] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 12/05/2019] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Early-stage non-small cell lung cancer (NSCLC) patients carry significant risk of recurrence post-surgery. In-depth characterization of the immune tumor microenvironment (TME) can have prognostic value. This study aimed to evaluate the association of individual immune cell types in the TME with clinical outcomes in surgically resected, early-stage NSCLC. METHODS We performed a systematic literature search of the National Library of Medicine database through November 2019, investigating predefined biomarkers (CD3+ T cells, CD4+ T helper cells, CD8+ cytotoxic T cells, CD20+ B cells, CD56+ & CD57+ Natural Killer (NK) cells, CD68+ Tissue Associated Macrophages (TAMS), FoxP3+ T regulatory cells, and Mast Cells (MC)), and their association with survival following PRISMA guidelines. RESULTS Studies that adjusted for important clinical covariates (such as stage and age) showed that higher levels of CD8+ cytotoxic T cells were associated with improved OS (HR = 0.68; 95% CI, 0.50-0.93) and DFS (HR = 0.60; 95% CI, 0.41-0.87), while increased CD20+ B cells (HR = 0.16; 95% CI, 0.04-0.64) and CD 56/57+ NK cells (HR = 0.50; 95% CI, 0.26-0.95) were associated with improved OS; lung cancers with increased FoxP3+ T regulatory cells (HR = 2.22; 95% CI, 1.47-3.34) had worse OS. CONCLUSIONS Immune cell components of the TME have prognostic value in early-stage, surgically resected NSCLC, and may reveal which patients are more likely to need additional systemic treatment, including immunotherapy. Clinical covariates need to be considered when evaluating the prognostic value of immune cells in the TME.
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Affiliation(s)
- Stephanie Tuminello
- Institute for Translational Epidemiology and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rajwanth Veluswamy
- Institute for Translational Epidemiology and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Medicine, Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Wil Lieberman-Cribbin
- Institute for Translational Epidemiology and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sacha Gnjatic
- Department of Medicine, Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Francesca Petralia
- Department of Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Pei Wang
- Department of Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Raja Flores
- Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Emanuela Taioli
- Institute for Translational Epidemiology and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Giatromanolaki A, Banham AH, Harris AL, Koukourakis MI. FOXP3 infiltrating lymphocyte density and PD-L1 expression in operable non-small cell lung carcinoma. Exp Lung Res 2019; 45:76-83. [PMID: 31134811 DOI: 10.1080/01902148.2019.1617371] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Purpose/Aim: Regulatory FOXP3+ T-cells control the cytotoxic activity of effector cells and may have an essential role in the development of immune tolerance in cancer patients. Programed death ligand 1 PD-L1, expressed on cancer cell membranes also blocks the cytotoxic activity of PD1+ cytotoxic lymphocytes. Materials and Methods: We assessed the immunohistochemical detection of these immune-tolerance related markers in a series of 98 non-small cell lung carcinomas (NSCLC) treated with surgery. The Tumor Infiltration Lymphocyte TIL density (mean number per x400 optical field) and the percentage of FOXP3+ TILs were assessed. Results: PD-L1 expression was directly linked with the TIL density (p = 0.01) and with the extent of infiltration with FOXP3+ TILs, named as the FIL-score (p = 0.01). FIL-score was significantly higher in stage I disease (p = 0.04). IL6 expression was linked with high TIL-score. A low TIL-score, characterizing immune deficient tumors defined a significantly poorer prognosis subgroup of patients (p = 0.03). Stratification of these tumors according to the FIL-score showed that FOXP3 expression by TILs correlated with an even a poorer prognosis in univariate (p = 0.007; median survival 14 vs. 44 months, respectively) and in multivariate analysis (p = 0.01, hazard ratio 4.3). Conclusion: Tumor stroma infiltration by FOXP3+ Tregs is an early event in the progression of NSCLC. Low lymphocytic infiltration defines poor prognosis, which becomes worse when the small numbers of infiltrating lymphocytes characterizing these tumors contain FOXP3 + Tregs. Furthermore, the direct association of FOXP3+ Treg infiltration density with PD-L1 expression by cancer cells implies a co-ordinated immune-suppressive activity in NSCLC.
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Affiliation(s)
- Alexandra Giatromanolaki
- a Department of Pathology , University Hospital of Alexandroupolis, Democritus University of Thrace , Alexandroupolis , Greece
| | - Alison H Banham
- b Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine , John Radcliffe Hospital , Oxford , UK
| | - Adrian L Harris
- c Cancer Research UK, Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine , University of Oxford , Oxford , UK
| | - Michael I Koukourakis
- d Department of Radiotherapy/Oncology , University Hospital of Alexandroupolis, Democritus University of Thrace , Alexandroupolis , Greece
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The Interplay between MicroRNAs and Cellular Components of Tumour Microenvironment (TME) on Non-Small-Cell Lung Cancer (NSCLC) Progression. J Immunol Res 2019; 2019:3046379. [PMID: 30944831 PMCID: PMC6421779 DOI: 10.1155/2019/3046379] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 12/26/2018] [Accepted: 01/06/2019] [Indexed: 12/30/2022] Open
Abstract
Cellular components of the tumour microenvironment (TME) are recognized to regulate the hallmarks of cancers including tumour proliferation, angiogenesis, invasion, and metastasis, as well as chemotherapeutic resistance. The linkage between miRNA, TME, and the development of the hallmarks of cancer makes miRNA-mediated regulation of TME a potential therapeutic strategy to complement current cancer therapies. Despite significant advances in cancer therapy, lung cancer remains the deadliest form of cancer among males in the world and has overtaken breast cancer as the most fatal cancer among females in more developed countries. Therefore, there is an urgent need to develop more effective treatments for NSCLC, which is the most common type of lung cancer. Hence, this review will focus on current literature pertaining to antitumour or protumourigenic effects elicited by nonmalignant stromal cells of TME in NSCLC through miRNA regulation as well as current status and future prospects of miRNAs as therapeutic agents or targets to regulate TME in NSCLC.
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FUT4 is involved in PD-1-related immunosuppression and leads to worse survival in patients with operable lung adenocarcinoma. J Cancer Res Clin Oncol 2018; 145:65-76. [PMID: 30357521 DOI: 10.1007/s00432-018-2761-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 09/26/2018] [Indexed: 12/22/2022]
Abstract
PURPOSE As an important glycosyltransferase, fucosyltransferase IV (FUT4) is abnormally upregulated in different types of cancers, but its clinical role remains inexplicit. This work aimed to determine the predictive ability of FUT4 in lung adenocarcinoma (LUAD) after curative resection, as well as to explore the role of a possible FUT4 molecular mechanism on LUAD malignant behavior. METHODS A total of 273 LUAD patients after curative resection with complete clinicopathological and RNAseq data from The Cancer Genome Atlas (TCGA) cohort were collected. Correlation of FUT4 with overall survival (OS) was analyzed based on TCGA and further validated by online "Kaplan-Meier Plotter" database and IHC in 70 LUAD patients recruited in the First Hospital of China Medical University cohort. Multivariate Cox regression analysis and 1000 bootstrapping were performed to verify the predictive value of FUT4. Gene set enrichment assay (GSEA) was performed to investigate the biological characteristics. Correlation between PD-1 and FUT4 was analyzed based on TCGA cohort and validated by IHC on cohort from our hospital. RESULTS Increased FUT4 expression led to reduced overall survival (OS) of LUAD patients based on TCGA (p = 0.006 and 0.001 for dichotomous and trichotomous modeling, respectively) and externally validated in KMPLOTTER (p = 0.01) and by IHC based on cohort from our hospital (p = 0.005 and p = 0.019 for dichotomous and trichotomous modeling, respectively). FUT4 overexpression was an independent high risk factor for OS along with advanced pT stage and pTNM stage (p = 0.001, p = 0.037, and p < 0.001, respectively). GSEA revealed that FUT4 overexpression might correlate with shortened survival of LUAD patients by promoting cell proliferation via ERBB signaling, and suppressing immune response-related pathways. FUT4 expression positively correlated with PD-1 in TCGA (p = 0.026) and validated by IHC on cohort from our hospital (p = 0.029). CONCLUSIONS Increased FUT4 expression led to reduced OS in operable LUAD. FUT4 showed significant correlation with immune response and PD-1 expression.
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Chen J, He Q, Liu J, Xiao Y, Xiao C, Chen K, Xie D, Zhang X. CD8+ tumor-infiltrating lymphocytes as a novel prognostic biomarker in lung sarcomatoid carcinoma, a rare subtype of lung cancer. Cancer Manag Res 2018; 10:3505-3511. [PMID: 30271199 PMCID: PMC6145683 DOI: 10.2147/cmar.s169074] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose The aim of this study was to investigate the degree of infiltration of CD8+ tumor-infiltrating lymphocytes (TILs) including high and low density in lung sarcomatoid carcinoma (LSC) and their clinicopathological significance. Patients and methods The density of CD8+ TILs in paraffin-embedded tissue sections from 100 LSC patients was detected by immunohistochemical staining, and the relationship of CD8+ TILs with clinicopathological features and prognosis was analyzed. Results The chi-squared test showed that the degree of infiltration of CD8+ TILs was significantly correlated with the clinicopathological stage and T stage of LSC (P<0.05). The univariate analysis demonstrated that tumor size, clinicopathological stage, T stage, N stage, M stage, and CD8+ TILs are risk factors that affect prognosis of the patients (P<0.05). The mean overall survival (OS) of LSC patients with a high density of CD8+ TILs was 92.3 months, which was significantly higher than 31.2 months in patients with a low density of CD8+ TILs (P<0.05). Cox regression multivariate analysis confirmed that the density of CD8+ TILs was an independent prognostic factor for OS time of LSC patients (hazard ratio=0.455, P<0.05). Conclusion CD8+ TILs could be used as an effective prognostic index for LSC patients, and a high density of CD8+ TILs in tumor tissue may predict a better outcome.
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Affiliation(s)
- Jiewei Chen
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China, ; .,Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People's Republic of China, ;
| | - Qingmei He
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People's Republic of China, ;
| | - Jun Liu
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China, ; .,Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People's Republic of China, ;
| | - Yongbo Xiao
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China, ;
| | - Canhua Xiao
- Department of Pathology, Qingyuan People's Hospital, Qingyuan, 511581, People's Republic of China
| | - Keming Chen
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China, ;
| | - Dan Xie
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China, ; .,Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People's Republic of China, ;
| | - Xinke Zhang
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China, ; .,Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, People's Republic of China, ;
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Chang B, Shen L, Wang K, Jin J, Huang T, Chen Q, Li W, Wu P. High number of PD-1 positive intratumoural lymphocytes predicts survival benefit of cytokine-induced killer cells for hepatocellular carcinoma patients. Liver Int 2018; 38:1449-1458. [PMID: 29356308 PMCID: PMC6099434 DOI: 10.1111/liv.13697] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 01/12/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND & AIMS Adjuvant cytokine-induced killer (CIK) cells treatment has shown potential in reducing the recurrence rate and prolonging the survival of patients with hepatocellular carcinoma (HCC). We aimed to identify the best predictive biomarker for adjuvant CIK cells treatment in patients with HCC after curative resection. METHODS This study retrospectively included 145 pairs of HCC patients by one-to-one propensity score matching. One group received CIK cells transfusion after surgery (surgery-CIK group); the other one group underwent surgery only (surgery-only group). Immunohistochemistry (IHC) was used to measure PD-1, PD-L1, CD4, CD8 and Foxp3 expression in tumour tissues of surgery-CIK group; IHC of PD-1 and PD-L1 was conducted in the surgery-only group. RESULTS The surgery-CIK group had a significantly higher disease-free survival (DFS) and overall survival (OS) rates compared to the surgery-only group. Of all the intratumoural biomarkers, in the surgery-CIK group, multivariate analysis showed that a high number of PD-1+ tumour infiltrative lymphocytes (TILs) was the only factor that independently predicted favourable OS and DFS. By contrast, in the surgery-only group, no significant correlations between PD-1/PD-L1 expression and survival of patients were identified. Further correlation analysis showed a high number of PD-1+ TILs associated with a high number of both CD4+ and CD8+ TILs in surgery-CIK group. CONCLUSIONS A high number of PD-1+ TILs can serve as a potent biomarker for adopting CIK cells therapy in HCC patients after curative resection.
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Affiliation(s)
- Boyang Chang
- State Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineSun Yat‐sen University Cancer CenterGuangzhouChina,Department of Medical Imaging and Interventional RadiologySun Yat‐sen University Cancer CenterGuangzhouChina
| | - Lujun Shen
- State Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineSun Yat‐sen University Cancer CenterGuangzhouChina,Department of Medical Imaging and Interventional RadiologySun Yat‐sen University Cancer CenterGuangzhouChina
| | - Kefeng Wang
- Department of Thoracic SurgeryThe Sun Yat‐sen Memorial Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Jietian Jin
- State Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineSun Yat‐sen University Cancer CenterGuangzhouChina,Department of PathologySun Yat‐sen University Cancer CenterGuangzhouChina
| | - Tao Huang
- State Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineSun Yat‐sen University Cancer CenterGuangzhouChina,Department of Medical Imaging and Interventional RadiologySun Yat‐sen University Cancer CenterGuangzhouChina
| | - Qifeng Chen
- State Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineSun Yat‐sen University Cancer CenterGuangzhouChina,Department of Medical Imaging and Interventional RadiologySun Yat‐sen University Cancer CenterGuangzhouChina
| | - Wang Li
- State Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineSun Yat‐sen University Cancer CenterGuangzhouChina,Department of Medical Imaging and Interventional RadiologySun Yat‐sen University Cancer CenterGuangzhouChina
| | - Peihong Wu
- State Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineSun Yat‐sen University Cancer CenterGuangzhouChina,Department of Medical Imaging and Interventional RadiologySun Yat‐sen University Cancer CenterGuangzhouChina
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Christofides A, Karantanos T, Bardhan K, Boussiotis VA. Epigenetic regulation of cancer biology and anti-tumor immunity by EZH2. Oncotarget 2018; 7:85624-85640. [PMID: 27793053 PMCID: PMC5356764 DOI: 10.18632/oncotarget.12928] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 10/13/2016] [Indexed: 12/22/2022] Open
Abstract
Polycomb group proteins regulate chromatin structure and have an important regulatory role on gene expression in various cell types. Two polycomb group complexes (Polycomb repressive complex 1 (PRC1) and 2 (PRC2)) have been identified in mammalian cells. Both PRC1 and PRC2 compact chromatin, and also catalyze histone modifications. PRC1 mediates monoubiquitination of histone H2A, whereas PRC2 catalyzes methylation of histone H3 on lysine 27. These alterations of histones can lead to altered gene expression patterns by regulating chromatin structure. Numerous studies have highlighted the role of the PRC2 catalytic component enhancer of zeste homolog 2 (EZH2) in neoplastic development and progression, and EZH2 mutations have been identified in various malignancies. Through modulating the expression of critical genes, EZH2 is actively involved in fundamental cellular processes such as cell cycle progression, cell proliferation, differentiation and apoptosis. In addition to cancer cells, EZH2 also has a decisive role in the differentiation and function of T effector and T regulatory cells. In this review we summarize the recent progress regarding the role of EZH2 in human malignancies, highlight the molecular mechanisms by which EZH2 aberrations promote the pathogenesis of cancer, and discuss the anti-tumor effects of EZH2 targeting via activating direct anti-cancer mechanisms and anti-tumor immunity.
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Affiliation(s)
- Anthos Christofides
- Division of Hematology-Oncology, Beth Israel Deaconess Medical Center, Boston, MA, USA.,Department of Medicine Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Theodoros Karantanos
- Division of Hematology-Oncology, Beth Israel Deaconess Medical Center, Boston, MA, USA.,Department of Medicine Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.,General Internal Medicine Section, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Kankana Bardhan
- Division of Hematology-Oncology, Beth Israel Deaconess Medical Center, Boston, MA, USA.,Department of Medicine Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Vassiliki A Boussiotis
- Division of Hematology-Oncology, Beth Israel Deaconess Medical Center, Boston, MA, USA.,Department of Medicine Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Guo W, Liu S, Zhang X, Chen Y, Qian R, Zou Z, Chen X, Luo P. The coexpression of multi-immune inhibitory receptors on T lymphocytes in primary non-small-cell lung cancer. DRUG DESIGN DEVELOPMENT AND THERAPY 2017; 11:3367-3376. [PMID: 29238163 PMCID: PMC5713689 DOI: 10.2147/dddt.s148443] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Non-small-cell lung cancer (NSCLC) is a common disease threatening the health of humankind. It has a low survival rate and a poor prognosis. Under normal circumstances, tumor infiltrating lymphocytes (TILs) play the main role in the antitumor process, but studies in recent years have found that NSCLC is capable of releasing various immunosuppressive factors, inducing the TILs to exhibit high expression of immune inhibitory receptors and relevant immunosuppressive factors. They can not only activate their own signal pathways but also block those of TILs, which causes inefficiency of tumor destruction. Researchers have now developed targeted drugs that specifically bind to immunosuppression receptors. By blocking signal transmission of immune inhibitory receptors, restraint on T lymphocytes can be released to recover antitumor role. Further research and understanding of the immunosuppression signal pathways of NSCLC are of significant importance to promote the development of immune-targeted drugs and the formulation of new treatment plans. This paper summarizes the immunosuppressive mechanisms of multiple important and newly discovered immune inhibitory receptors on T lymphocytes and immunosuppressive factors released by NSCLC cells, and their influence on patients' survival rate and prognosis. Further laboratory and clinical studies on immune-targeted drugs for primary NSCLC are needed to provide more evidence.
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Affiliation(s)
- Wenjie Guo
- Department of Respiratory Medicine, Zhujiang Hospital
| | - Sihan Liu
- Department of Respiratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, People's Republic of China
| | - Xiaoli Zhang
- Department of Respiratory Medicine, Zhujiang Hospital
| | - Yating Chen
- Department of Respiratory Medicine, Zhujiang Hospital
| | - Ruolan Qian
- Department of Respiratory Medicine, Zhujiang Hospital
| | - Ziyuan Zou
- Department of Respiratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, People's Republic of China
| | - Xin Chen
- Department of Respiratory Medicine, Zhujiang Hospital
| | - Peng Luo
- Department of Respiratory Medicine, Zhujiang Hospital
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28
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Zhang Q, Peng C. Cancer-associated fibroblasts regulate the biological behavior of cancer cells and stroma in gastric cancer. Oncol Lett 2017; 15:691-698. [PMID: 29399141 DOI: 10.3892/ol.2017.7385] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Accepted: 09/28/2017] [Indexed: 12/21/2022] Open
Abstract
Gastric cancer (GC) is a frequently diagnosed type of cancer in China, and is associated with a high mortality rate. The biological behavior of GC requires investigation in order to provide an evidence base for the development of strategies to prevent and treat GC. For this purpose, the present review outlines the process of tumor microenvironment (TME) evolution, including the dynamic biological behavior of different types of cancer cell and stroma. Cancer-associated fibroblasts (CAFs) serve as prominent stromal cellular components in the GC TME, and exhibit an essential function in GC progression. In the present study, the function of CAFs in cancer cell proliferation, cell migration, invasion, extracellular matrix remodeling, pathological angiogenesis and immune cell infiltration were investigated. The studies discussed in the present review demonstrate that the cross-talk between CAF, cancer cells and tumor stroma promotes GC progression.
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Affiliation(s)
- Qian Zhang
- Department of The Second Clinical College, Wuhan University, Wuchang, Wuhan 430071, P.R. China
| | - Chunwei Peng
- Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Key Laboratory of Tumor Biological Behaviors and Hubei Cancer Clinical Study Center, Wuchang, Wuhan 430071, P.R. China
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Conde E, Caminoa A, Dominguez C, Calles A, Walter S, Angulo B, Sánchez E, Alonso M, Jimenez L, Madrigal L, Hernando F, Sanz-Ortega J, Jimenez B, Garrido P, Paz-Ares L, de Castro J, Hernandez S, Lopez-Rios F. Aligning digital CD8+scoring and targeted next-generation sequencing with programmed death ligand 1 expression: a pragmatic approach in early-stage squamous cell lung carcinoma. Histopathology 2017; 72:270-284. [DOI: 10.1111/his.13346] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 08/16/2017] [Indexed: 12/21/2022]
Affiliation(s)
- Esther Conde
- Pathology-Laboratorio de Dianas Terapeuticas; Hospital Universitario HM Sanchinarro; Universidad CEU San Pablo; Madrid Spain
- Centro de Investigación Biomedica en Red de Cancer (CIBERONC); Madrid Spain
| | - Alejandra Caminoa
- Pathology-Laboratorio de Dianas Terapeuticas; Hospital Universitario HM Sanchinarro; Universidad CEU San Pablo; Madrid Spain
| | - Carolina Dominguez
- Pathology-Laboratorio de Dianas Terapeuticas; Hospital Universitario HM Sanchinarro; Universidad CEU San Pablo; Madrid Spain
| | - Antonio Calles
- Medical Oncology; Hospital Universitario Gregorio Marañón; Madrid Spain
| | - Stefan Walter
- Fundación de Investigación Sanitaria de Getafe; Madrid Spain
- University of California San Francisco; San Francisco CA USA
| | - Barbara Angulo
- Pathology-Laboratorio de Dianas Terapeuticas; Hospital Universitario HM Sanchinarro; Universidad CEU San Pablo; Madrid Spain
- Centro de Investigación Biomedica en Red de Cancer (CIBERONC); Madrid Spain
| | - Elena Sánchez
- Pathology-Laboratorio de Dianas Terapeuticas; Hospital Universitario HM Sanchinarro; Universidad CEU San Pablo; Madrid Spain
| | - Marta Alonso
- Pathology-Laboratorio de Dianas Terapeuticas; Hospital Universitario HM Sanchinarro; Universidad CEU San Pablo; Madrid Spain
| | - Luis Jimenez
- Thoracic Surgery; Hospital Universitario HM Sanchinarro; Madrid Spain
| | - Luis Madrigal
- Thoracic Surgery; Hospital Universitario HM Sanchinarro; Madrid Spain
| | - Florentino Hernando
- Thoracic Surgery; Hospital Clínico San Carlos; Universidad Complutense; Madrid Spain
| | - Julian Sanz-Ortega
- Centro de Investigación Biomedica en Red de Cancer (CIBERONC); Madrid Spain
- Pathology; Hospital Clínico San Carlos; Universidad Complutense; Madrid Spain
| | - Beatriz Jimenez
- Medical Oncology; Hospital Universitario HM Sanchinarro; Madrid Spain
| | - Pilar Garrido
- Centro de Investigación Biomedica en Red de Cancer (CIBERONC); Madrid Spain
- Medical Oncology, IRYCIS; Hospital Universitario Ramón y Cajal; Universidad de Alcalá; Madrid Spain
| | - Luis Paz-Ares
- Centro de Investigación Biomedica en Red de Cancer (CIBERONC); Madrid Spain
- Medical Oncology; Hospital Universitario 12 de Octubre; CNIO and Universidad Complutense; Madrid Spain
| | - Javier de Castro
- Centro de Investigación Biomedica en Red de Cancer (CIBERONC); Madrid Spain
- Medical Oncology; Hospital Universitario HM Sanchinarro; Madrid Spain
| | - Susana Hernandez
- Pathology-Laboratorio de Dianas Terapeuticas; Hospital Universitario HM Sanchinarro; Universidad CEU San Pablo; Madrid Spain
| | - Fernando Lopez-Rios
- Pathology-Laboratorio de Dianas Terapeuticas; Hospital Universitario HM Sanchinarro; Universidad CEU San Pablo; Madrid Spain
- Centro de Investigación Biomedica en Red de Cancer (CIBERONC); Madrid Spain
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Wang Z, Zhao J, Zhao H, A S, Liu Z, Zhang Y, Liu X, Wang F. Infiltrating CD4/CD8 high T cells shows good prognostic impact in pancreatic cancer. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2017; 10:8820-8828. [PMID: 31966748 PMCID: PMC6965435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 04/11/2017] [Indexed: 06/10/2023]
Abstract
Tumor infiltrating lymphocytes in a certain tumor microenvironment are associated with the prognosis of cancer patients. The function of CD4+ and CD8+ T cells in the microenvironment of pancreatic cancer remains largely unknown. This study aimed to investigate the prognostic value of both CD4+ and CD8+ TIL subsets and their combined role in pancreatic cancer. In this study, pancreatic cancer tissues and corresponding adjacent normal tissues were collected from 90 patients. The expression levels of CD4 and CD8+ T cells in pancreatic cancer tissues were detected by immunohistochemistry method. The results showed that CD4+ iTIL expression was significantly correlated with tumor stage. CD8+ iTILs were significantly correlated with lymphatic vessel invasion and tumor stage; CD8+ sTILs not only showed correlation with lymphatic vessel invasion and tumor stage, but also had correlation with pathologic differentiation; the survival time of high CD4 expression group was longer compared to the low CD4 expression group. CD4+ T cells were capable of killing tumor cells and prolonging the survival time of patients either directly or indirectly. According to Cox regression analysis, it was indicated that pathological differentiation, lymphatic vessel invasion, tumor stage, CD4+ and CD8+ TILs were the principle risk factors of pancreatic cancer prognosis. Especially multivariate analysis showed that pathological differentiation and the combination of CD4+ and CD8+ TILs expression were independent predictors of pancreatic cancer survival. Expression levels of CD4+ and CD8+ TILs in pancreatic cancer may provide promising and useful markers for prognosis of pancreatic cancer.
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Affiliation(s)
- Zhenxia Wang
- Department of General Surgery, Inner Mongolia Medical College Affiliated Hospital Hohhot, China
| | - Jianguo Zhao
- Department of General Surgery, Inner Mongolia Medical College Affiliated Hospital Hohhot, China
| | - Haiping Zhao
- Department of General Surgery, Inner Mongolia Medical College Affiliated Hospital Hohhot, China
| | - Sileng A
- Department of General Surgery, Inner Mongolia Medical College Affiliated Hospital Hohhot, China
| | - Zhonghua Liu
- Department of General Surgery, Inner Mongolia Medical College Affiliated Hospital Hohhot, China
| | - Yanfei Zhang
- Department of General Surgery, Inner Mongolia Medical College Affiliated Hospital Hohhot, China
| | - Xitao Liu
- Department of General Surgery, Inner Mongolia Medical College Affiliated Hospital Hohhot, China
| | - Fei Wang
- Department of General Surgery, Inner Mongolia Medical College Affiliated Hospital Hohhot, China
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Ghanem S, El Bitar S, Hossri S, Weerasinghe C, Atallah JP. What we know about surgical therapy in early-stage non-small-cell lung cancer: a guide for the medical oncologist. Cancer Manag Res 2017; 9:267-278. [PMID: 28740431 PMCID: PMC5505543 DOI: 10.2147/cmar.s139253] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Lung cancer remains the leading cause of death in cancer patients. The gold standard for the treatment of early-stage non-small-cell lung cancer is lobectomy with mediastinal lymph-node dissection or systematic lymph-node sampling. The evidence behind this recommendation is based on the sole randomized controlled trial conducted to date, done by the Lung Cancer Study Group and published in 1995, which found a superiority for lobectomy over sublobar resection with regard to local recurrence rate and improved survival. The population studied at that time were medically fit patients at low risk for surgery with a stage IA non-small-cell lung carcinoma, ie, a solitary tumor less than 3 cm in size. In practice, however, thoracic surgeons have continued to push the limit of a more conservative surgical resection in this patient population. Since then, several retrospective studies have attempted to identify the ideal population to benefit from sublobar resection without it affecting survival or local recurrence. Several variables have been studied, including tumor size, patient age, surgical approach, histological and radiological properties, and optimal surgical resection margin, as well as promising prognostic biomarkers. In this review, we summarize the data available in the literature regarding the surgical approach to patients with stage IA non-small-cell lung cancer studying all the aforementioned variables.
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Affiliation(s)
| | | | | | - Chanudi Weerasinghe
- Department of Hematology and Oncology, Staten Island University Hospital - Northwell Health, New York, NY, USA
| | - Jean Paul Atallah
- Department of Hematology and Oncology, Staten Island University Hospital - Northwell Health, New York, NY, USA
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Gallach S, Jantus-Lewintre E, Calabuig-Fariñas S, Montaner D, Alonso S, Sirera R, Blasco A, Usó M, Guijarro R, Martorell M, Camps C. MicroRNA profiling associated with non-small cell lung cancer: next generation sequencing detection, experimental validation, and prognostic value. Oncotarget 2017; 8:56143-56157. [PMID: 28915579 PMCID: PMC5593550 DOI: 10.18632/oncotarget.18603] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 06/09/2017] [Indexed: 02/06/2023] Open
Abstract
Background The average five-year survival for non-small cell lung cancer (NSCLC) patients is approximately 15%. Emerging evidence indicates that microRNAs (miRNAs) constitute a new class of gene regulators in humans that may play an important role in tumorigenesis. Hence, there is growing interest in studying their role as possible new biomarkers whose expression is aberrant in cancer. Therefore, in this study we identified dysregulated miRNAs by next generation sequencing (NGS) and analyzed their prognostic value. Methods Sequencing by oligo ligation detection technology was used to identify dysregulated miRNAs in a training cohort comprising paired tumor/normal tissue samples (N = 32). We validated 22 randomly selected differentially-expressed miRNAs by quantitative real time PCR in tumor and adjacent normal tissue samples (N = 178). Kaplan-Meier survival analysis and Cox regression were used in multivariate analysis to identify independent prognostic biomarkers. Results NGS analysis revealed that 39 miRNAs were dysregulated in NSCLC: 28 were upregulated and 11 were downregulated. Twenty-two miRNAs were validated in an independent cohort. Interestingly, the group of patients with high expression of both miRNAs (miR-21high and miR-188high) showed shorter relapse-free survival (RFS) and overall survival (OS) times. Multivariate analysis confirmed that this combined signature is an independent prognostic marker for RFS and OS (p = 0.001 and p < 0.0001, respectively). Conclusions NGS technology can specifically identify dysregulated miRNA profiles in resectable NSCLC samples. MiR-21 or miR-188 overexpression correlated with a negative prognosis, and their combined signature may represent a new independent prognostic biomarker for RFS and OS.
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Affiliation(s)
- Sandra Gallach
- Molecular Oncology Laboratory, Fundación Investigación, Hospital General Universitario de Valencia, Valencia, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBEROnc), Madrid, Spain
| | - Eloisa Jantus-Lewintre
- Molecular Oncology Laboratory, Fundación Investigación, Hospital General Universitario de Valencia, Valencia, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBEROnc), Madrid, Spain.,Department of Biotechnology, Universitat Politècnica de València, Valencia, Spain
| | - Silvia Calabuig-Fariñas
- Molecular Oncology Laboratory, Fundación Investigación, Hospital General Universitario de Valencia, Valencia, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBEROnc), Madrid, Spain.,Department of Pathology, Universitat de València, Valencia, Spain
| | - David Montaner
- Department of Computational Genomics, Centro de Investigación Príncipe Felipe, Valencia, Spain
| | - Sergio Alonso
- Program of Predictive and Personalized Medicine of Cancer, Institut de Reserca Germans Trias i Pujol (PMPPC-IGTP), Badalona, Spain
| | - Rafael Sirera
- Centro de Investigación Biomédica en Red de Cáncer (CIBEROnc), Madrid, Spain.,Department of Biotechnology, Universitat Politècnica de València, Valencia, Spain
| | - Ana Blasco
- Centro de Investigación Biomédica en Red de Cáncer (CIBEROnc), Madrid, Spain.,Department of Medical Oncology, Hospital General Universitario de Valencia, Valencia, Spain
| | - Marta Usó
- Molecular Oncology Laboratory, Fundación Investigación, Hospital General Universitario de Valencia, Valencia, Spain
| | - Ricardo Guijarro
- Department of Surgery, Universitat de València, Valencia, Spain.,Department of Thoracic Surgery, Hospital General Universitario de Valencia, Valencia, Spain
| | - Miguel Martorell
- Department of Pathology, Universitat de València, Valencia, Spain.,Department of Pathology, Hospital General Universitario de Valencia, Valencia, Spain
| | - Carlos Camps
- Molecular Oncology Laboratory, Fundación Investigación, Hospital General Universitario de Valencia, Valencia, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBEROnc), Madrid, Spain.,Department of Medical Oncology, Hospital General Universitario de Valencia, Valencia, Spain.,Department of Medicine, Universitat de València, Valencia, Spain
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Usó M, Jantus-Lewintre E, Calabuig-Fariñas S, Blasco A, García Del Olmo E, Guijarro R, Martorell M, Camps C, Sirera R. Analysis of the prognostic role of an immune checkpoint score in resected non-small cell lung cancer patients. Oncoimmunology 2016; 6:e1260214. [PMID: 28197383 DOI: 10.1080/2162402x.2016.1260214] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 10/28/2016] [Accepted: 11/08/2016] [Indexed: 01/01/2023] Open
Abstract
Tumors develop mechanisms to recruit tolerogenic immune cells and to induce the expression of molecules that act as immune checkpoints. This regulation of the immune microenvironment favors immune tolerance to the neoplastic cells. In this study, we have investigated the prognostic role of immune-checkpoint expression markers in a cohort of resectable non-small cell lung cancer (NSCLC) patients. RNA was isolated from fresh-frozen lung specimens (tumor and normal lung) (n = 178). RTqPCR was performed to analyze the relative expression of 20 immune-related genes that were normalized by the use of endogenous genes selected by GeNorm algorithm. Patients with higher expression levels of IL23A and LGALS2 presented better outcomes. In the clustering expression patterns, we observed that patients with higher expression of immunoregulatory genes had better survival rates. Additionally, these data were used to develop a gene expression score. Since CTLA4 and PD1 were associated with prognosis based on Cox regression analysis (Z-score > 1.5), a multivariate model including these two genes was created. Absolute regression coefficients from this analysis were used in order to calculate the immune-checkpoint score: (PD1×0.116) + (CTLA4×0.059) for each case. Kaplan-Meier survival analysis showed that patients with high immune-checkpoint score have longer overall survival (OS) [NR vs. 40.4 mo, p = 0.008] and longer relapse-free survival (RFS) [82.6 vs. 23 mo, p = 0.009]. Multivariate analysis in the entire cohort indicated that the immune-checkpoint score was an independent biomarker of prognosis for OS [HR: 0.308; 95% CI, 0.156-0.609; p = 0.001] and RFS [HR: 0.527; 95% CI, 0.298-0.933; p = 0.028] in early-stage NSCLC patients. In conclusion, this score provides relevant prognostic information for a better characterization of early stage NSCLS patients with strikingly different outcomes and who may be candidates for immune-based therapies.
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Affiliation(s)
- Marta Usó
- Department of Medicine, Universitat de València, Valencia, Spain; Molecular Oncology Laboratory, Fundación Investigación, Hospital General Universitario de Valencia, Valencia, Spain
| | - Eloísa Jantus-Lewintre
- Molecular Oncology Laboratory, Fundación Investigación, Hospital General Universitario de Valencia, Valencia, Spain; Department of Biotechnology, Universitat Politècnica de València, Valencia, Spain; Medical Oncology Department, Hospital General Universitario de Valencia, Valencia, Spain
| | - Silvia Calabuig-Fariñas
- Molecular Oncology Laboratory, Fundación Investigación, Hospital General Universitario de Valencia, Valencia, Spain; Medical Oncology Department, Hospital General Universitario de Valencia, Valencia, Spain; Department of Pathology, Universitat de Valencia, Valencia, Spain
| | - Ana Blasco
- Medical Oncology Department, Hospital General Universitario de Valencia , Valencia, Spain
| | - Eva García Del Olmo
- Department of Thoracic Surgery, Hospital General Universitario de Valencia , Valencia, Spain
| | - Ricardo Guijarro
- Department of Thoracic Surgery, Hospital General Universitario de Valencia , Valencia, Spain
| | - Miguel Martorell
- Centro de Investigación Médica Aplicada (CIMA), Universidad de Navarra, Pamplona, Spain; Department of Pathology, Hospital General Universitario de Valencia, Valencia, Spain
| | - Carlos Camps
- Department of Medicine, Universitat de València, Valencia, Spain; Molecular Oncology Laboratory, Fundación Investigación, Hospital General Universitario de Valencia, Valencia, Spain; Medical Oncology Department, Hospital General Universitario de Valencia, Valencia, Spain
| | - Rafael Sirera
- Molecular Oncology Laboratory, Fundación Investigación, Hospital General Universitario de Valencia, Valencia, Spain; Department of Biotechnology, Universitat Politècnica de València, Valencia, Spain; Medical Oncology Department, Hospital General Universitario de Valencia, Valencia, Spain
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