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Tada A, Minami T, Kitai H, Higashiguchi Y, Tokuda M, Higashiyama T, Negi Y, Horio D, Nakajima Y, Otsuki T, Mikami K, Takahashi R, Nakamura A, Kitajima K, Ohmuraya M, Kuribayashi K, Kijima T. Combination therapy with anti-programmed cell death 1 antibody plus angiokinase inhibitor exerts synergistic antitumor effect against malignant mesothelioma via tumor microenvironment modulation. Lung Cancer 2023; 180:107219. [PMID: 37146474 DOI: 10.1016/j.lungcan.2023.107219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/21/2023] [Accepted: 04/24/2023] [Indexed: 05/07/2023]
Abstract
Malignant pleural mesothelioma (MPM) is an asbestos-related fatal malignant neoplasm. Although there has been no reliable chemotherapeutic regimen other than combination therapy of cisplatin and pemetrexed for two decades, combination of ipilimumab plus nivolumab brought about a better outcome in patients with MPM. Thus, cancer immunotherapy using immune checkpoint inhibitor (ICI) is expected to play a central role in the treatment of MPM. To maximize the antitumor effect of ICI, we evaluated whether nintedanib, an antiangiogenic agent, could augment the antitumor effect of anti-programmed cell death 1 (PD-1) antibody (Ab). Although nintedanib could not inhibit the proliferation of mesothelioma cells in vitro, it significantly suppressed the growth of mesothelioma allografts in mice. Moreover, combination therapy with anti-PD-1 Ab plus nintedanib reduced tumor burden more dramatically compared with nintedanib monotherapy via inducing remarkable necrosis in MPM allografts. Nintedanib did not promote the infiltration of CD8+ T cells within the tumor when used alone or in combination with anti-PD-1 Ab but it independently decreased the infiltration of tumor-associated macrophages (TAMs). Moreover, immunohistochemical analysis and ex vivo study using bone marrow-derived macrophages (BMDMs) showed that nintedanib could polarize TAMs from M2 to M1 phenotype. These results indicated that nintedanib had a potential to suppress protumor activity of TAMs both numerically and functionally. On the other hand, ex vivo study revealed that nintedanib upregulated the expression of PD-1 and PD-ligand 1 (PD-L1) in BMDMs and mesothelioma cells, respectively, and exhibited the impairment of phagocytic activity of BMDMs against mesothelioma cells. Co-administration of anti-PD-1 Ab may reactivate phagocytic activity of BMDMs by disrupting nintedanib-induced immunosuppressive signal via binding between PD-1 on BMDMs and PD-L1 on mesothelioma cells. Collectively, combination therapy of anti-PD-1 Ab plus nintedanib enhances the antitumor activity compared with respective monotherapy and can become a novel therapeutic option for patients with MPM.
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Affiliation(s)
- Akio Tada
- Department of Respiratory Medicine and Hematology, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Toshiyuki Minami
- Department of Respiratory Medicine and Hematology, Hyogo Medical University, Nishinomiya, Hyogo, Japan; Department of Thoracic Oncology, Hyogo Medical University, Nishinomiya, Hyogo, Japan.
| | - Hidemi Kitai
- Department of Thoracic Oncology, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Yoko Higashiguchi
- Department of Respiratory Medicine and Hematology, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Mayuko Tokuda
- Department of Respiratory Medicine and Hematology, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Tomoki Higashiyama
- Department of Respiratory Medicine and Hematology, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Yoshiki Negi
- Department of Respiratory Medicine and Hematology, Hyogo Medical University, Nishinomiya, Hyogo, Japan; Department of Thoracic Oncology, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Daisuke Horio
- Department of Respiratory Medicine and Hematology, Hyogo Medical University, Nishinomiya, Hyogo, Japan; Department of Thoracic Oncology, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Yasuhiro Nakajima
- Department of Respiratory Medicine and Hematology, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Taiichiro Otsuki
- Department of Respiratory Medicine and Hematology, Hyogo Medical University, Nishinomiya, Hyogo, Japan; Department of Thoracic Oncology, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Koji Mikami
- Department of Respiratory Medicine and Hematology, Hyogo Medical University, Nishinomiya, Hyogo, Japan; Department of Thoracic Oncology, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Ryo Takahashi
- Department of Respiratory Medicine and Hematology, Hyogo Medical University, Nishinomiya, Hyogo, Japan; Department of Thoracic Oncology, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Akifumi Nakamura
- Department of Thoracic Surgery, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Kazuhiro Kitajima
- Department of Radiology, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Masaki Ohmuraya
- Department of Genetics, Hyogo Medical University, Nishinomiya, Japan
| | - Kozo Kuribayashi
- Department of Respiratory Medicine and Hematology, Hyogo Medical University, Nishinomiya, Hyogo, Japan; Department of Thoracic Oncology, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Takashi Kijima
- Department of Respiratory Medicine and Hematology, Hyogo Medical University, Nishinomiya, Hyogo, Japan; Department of Thoracic Oncology, Hyogo Medical University, Nishinomiya, Hyogo, Japan
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Principe N, Aston WJ, Hope DE, Tilsed CM, Fisher SA, Boon L, Dick IM, Chin WL, McDonnell AM, Nowak AK, Lake RA, Chee J, Lesterhuis WJ. Comprehensive Testing of Chemotherapy and Immune Checkpoint Blockade in Preclinical Cancer Models Identifies Additive Combinations. Front Immunol 2022; 13:872295. [PMID: 35634282 PMCID: PMC9132586 DOI: 10.3389/fimmu.2022.872295] [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: 02/09/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
Antibodies that target immune checkpoints such as cytotoxic T lymphocyte antigen 4 (CTLA‐4) and the programmed cell death protein 1/ligand 1 (PD-1/PD-L1) are now a treatment option for multiple cancer types. However, as a monotherapy, objective responses only occur in a minority of patients. Chemotherapy is widely used in combination with immune checkpoint blockade (ICB). Although a variety of isolated immunostimulatory effects have been reported for several classes of chemotherapeutics, it is unclear which chemotherapeutics provide the most benefit when combined with ICB. We investigated 10 chemotherapies from the main canonical classes dosed at the clinically relevant maximum tolerated dose in combination with anti‐CTLA-4/anti-PD-L1 ICB. We screened these chemo-immunotherapy combinations in two murine mesothelioma models from two different genetic backgrounds, and identified chemotherapies that produced additive, neutral or antagonistic effects when combined with ICB. Using flow cytometry and bulk RNAseq, we characterized the tumor immune milieu in additive chemo-immunotherapy combinations. 5-fluorouracil (5-FU) or cisplatin were additive when combined with ICB while vinorelbine and etoposide provided no additional benefit when combined with ICB. The combination of 5-FU with ICB augmented an inflammatory tumor microenvironment with markedly increased CD8+ T cell activation and upregulation of IFNγ, TNFα and IL-1β signaling. The effective anti‐tumor immune response of 5-FU chemo-immunotherapy was dependent on CD8+ T cells but was unaffected when TNFα or IL-1β cytokine signaling pathways were blocked. Our study identified additive and non-additive chemotherapy/ICB combinations and suggests a possible role for increased inflammation in the tumor microenvironment as a basis for effective combination therapy.
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Affiliation(s)
- Nicola Principe
- National Centre for Asbestos Related Diseases, University of Western Australia, Perth, WA, Australia.,School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia.,Institute for Respiratory Health, Perth, WA, Australia
| | - Wayne J Aston
- National Centre for Asbestos Related Diseases, University of Western Australia, Perth, WA, Australia
| | - Danika E Hope
- National Centre for Asbestos Related Diseases, University of Western Australia, Perth, WA, Australia
| | - Caitlin M Tilsed
- National Centre for Asbestos Related Diseases, University of Western Australia, Perth, WA, Australia.,School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia.,Institute for Respiratory Health, Perth, WA, Australia
| | - Scott A Fisher
- National Centre for Asbestos Related Diseases, University of Western Australia, Perth, WA, Australia.,School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia.,Institute for Respiratory Health, Perth, WA, Australia
| | | | - Ian M Dick
- National Centre for Asbestos Related Diseases, University of Western Australia, Perth, WA, Australia.,Institute for Respiratory Health, Perth, WA, Australia
| | - Wee Loong Chin
- National Centre for Asbestos Related Diseases, University of Western Australia, Perth, WA, Australia.,Telethon Kids Institute, Perth, WA, Australia.,Medical School, University of Western Australia, Crawley, WA, Australia
| | | | - Anna K Nowak
- National Centre for Asbestos Related Diseases, University of Western Australia, Perth, WA, Australia.,Institute for Respiratory Health, Perth, WA, Australia.,Medical School, University of Western Australia, Crawley, WA, Australia
| | - Richard A Lake
- National Centre for Asbestos Related Diseases, University of Western Australia, Perth, WA, Australia.,School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia.,Institute for Respiratory Health, Perth, WA, Australia
| | - Jonathan Chee
- National Centre for Asbestos Related Diseases, University of Western Australia, Perth, WA, Australia.,School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia.,Institute for Respiratory Health, Perth, WA, Australia
| | - Willem Joost Lesterhuis
- National Centre for Asbestos Related Diseases, University of Western Australia, Perth, WA, Australia.,School of Biomedical Sciences, University of Western Australia, Crawley, WA, Australia.,Institute for Respiratory Health, Perth, WA, Australia.,Telethon Kids Institute, Perth, WA, Australia
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Interleukin-6 as an enhancer of anti-angiogenic therapy for ovarian clear cell carcinoma. Sci Rep 2021; 11:7689. [PMID: 33833265 PMCID: PMC8032732 DOI: 10.1038/s41598-021-86913-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 03/16/2021] [Indexed: 11/08/2022] Open
Abstract
Ovarian clear cell carcinoma (OCCC) is a subtype of epithelial ovarian cancer (EOC) that is associated with elevated interleukin-6 (IL-6) expression, resistance to chemotherapy, and increased mortality. Although bevacizumab (Bev) is a widely used anti-angiogenic agent for EOC, the efficacy of Bev and the role of IL-6 in modulating angiogenesis in OCCC are unknown. We performed tube formation assays using human umbilical vein endothelial cells (HUVEC) cultured in OCCC cell-conditioned medium and using cells directly co-cultured with OCCC cells. We observed that IL-6 inhibition significantly mitigated the ability of Bev to impede tube formation in both cases. Furthermore, IL-6 blockade disrupted the anti-angiogenic efficacy of Bev and its concomitant anti-tumor activity. In addition, IL-6 inhibition resulted in a significant increase in angiopoietin-1 (Ang1) secretion and decreased vascular endothelial growth factor (VEGF) expression. Clinical specimens also exhibited this reciprocal relationship between IL-6 and Ang1 expression. Finally, depletion of Ang1 abrogated the effects of IL-6 inhibition on Bev activity, demonstrating that IL-6 supports the anti-angiogenic activity of Bev by suppressing Ang1 expression and promoting dependence on VEGF for angiogenesis. Altogether, our data suggest that OCCC tumors with high IL-6 levels are candidates for Bev therapy.
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Chu GJ, van Zandwijk N, Rasko JEJ. The Immune Microenvironment in Mesothelioma: Mechanisms of Resistance to Immunotherapy. Front Oncol 2019; 9:1366. [PMID: 31867277 PMCID: PMC6908501 DOI: 10.3389/fonc.2019.01366] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 11/19/2019] [Indexed: 12/18/2022] Open
Abstract
Although mesothelioma is the consequence of a protracted immune response to asbestos fibers and characterized by a clear immune infiltrate, novel immunotherapy approaches show less convincing results as compared to those seen in melanoma and non-small cell lung cancer. The immune suppressive microenvironment in mesothelioma is likely contributing to this therapy resistance. Therefore, it is important to explore the characteristics of the tumor microenvironment for explanations for this recalcitrant behavior. This review describes the stromal, cytokine, metabolic, and cellular milieu of mesothelioma, and attempts to make connection with the outcome of immunotherapy trials.
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Affiliation(s)
- Gerard J. Chu
- Gene and Stem Cell Therapy Program Centenary Institute, University of Sydney, Department of Immunology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Nico van Zandwijk
- Sydney Medical School, Sydney Local Health District (Concord Repatriation General Hospital), University of Sydney, Sydney, NSW, Australia
| | - John E. J. Rasko
- Gene and Stem Cell Therapy Program Centenary Institute, University of Sydney, Cell & Molecular Therapies, Royal Prince Alfred Hospital, Sydney, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
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Alcala N, Mangiante L, Le-Stang N, Gustafson CE, Boyault S, Damiola F, Alcala K, Brevet M, Thivolet-Bejui F, Blanc-Fournier C, Le Rochais JP, Planchard G, Rousseau N, Damotte D, Pairon JC, Copin MC, Scherpereel A, Wasielewski E, Wicquart L, Lacomme S, Vignaud JM, Ancelin G, Girard C, Sagan C, Bonnetaud C, Hofman V, Hofman P, Mouroux J, Thomas de Montpreville V, Clermont-Taranchon E, Mazieres J, Rouquette I, Begueret H, Blay JY, Lantuejoul S, Bueno R, Caux C, Girard N, McKay JD, Foll M, Galateau-Salle F, Fernandez-Cuesta L. Redefining malignant pleural mesothelioma types as a continuum uncovers immune-vascular interactions. EBioMedicine 2019; 48:191-202. [PMID: 31648983 PMCID: PMC6838392 DOI: 10.1016/j.ebiom.2019.09.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 08/27/2019] [Accepted: 09/03/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Malignant Pleural Mesothelioma (MPM) is an aggressive disease related to asbestos exposure, with no effective therapeutic options. METHODS We undertook unsupervised analyses of RNA-sequencing data of 284 MPMs, with no assumption of discreteness. Using immunohistochemistry, we performed an orthogonal validation on a subset of 103 samples and a biological replication in an independent series of 77 samples. FINDINGS A continuum of molecular profiles explained the prognosis of the disease better than any discrete model. The immune and vascular pathways were the major sources of molecular variation, with strong differences in the expression of immune checkpoints and pro-angiogenic genes; the extrema of this continuum had specific molecular profiles: a "hot" bad-prognosis profile, with high lymphocyte infiltration and high expression of immune checkpoints and pro-angiogenic genes; a "cold" bad-prognosis profile, with low lymphocyte infiltration and high expression of pro-angiogenic genes; and a "VEGFR2+/VISTA+" better-prognosis profile, with high expression of immune checkpoint VISTA and pro-angiogenic gene VEGFR2. We validated the gene expression levels at the protein level for a subset of five selected genes belonging to the immune and vascular pathways (CD8A, PDL1, VEGFR3, VEGFR2, and VISTA), in the validation series, and replicated the molecular profiles as well as their prognostic value in the replication series. INTERPRETATION The prognosis of MPM is best explained by a continuous model, which extremes show specific expression patterns of genes involved in angiogenesis and immune response.
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Affiliation(s)
- Nicolas Alcala
- Section of Genetics, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Lise Mangiante
- Section of Genetics, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | | | - Corinne E Gustafson
- Division of Thoracic Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Sandrine Boyault
- Translational Research and Innovation Platform, Cancer Research Centre of Lyon (CRCL), Lyon, France
| | | | - Karine Alcala
- Section of Genetics, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Marie Brevet
- Pathology Institute, Hospices Civils de Lyon, University Claude Bernard Lyon 1, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jean-Yves Blay
- Department of Medical Oncology, Centre Léon Bérard (CLB), Lyon, France; European Reference Network (ENR-EURACAN), France
| | - Sylvie Lantuejoul
- Department of Pathology, Centre Léon Bérard (CLB), Lyon, France; University Grenoble Alpes, Grenoble, France
| | - Raphael Bueno
- Division of Thoracic Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Christophe Caux
- Department of Immunity, Virus, and Inflammation, Cancer Research Centre of Lyon (CRCL), Lyon, France
| | - Nicolas Girard
- European Reference Network (ENR-EURACAN), France; University Lyon 1, Lyon, France; INSERM U932, Paris, France; Institut Curie, Paris, France
| | - James D McKay
- Section of Genetics, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Matthieu Foll
- Section of Genetics, International Agency for Research on Cancer (IARC-WHO), Lyon, France
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Magkouta S, Kollintza A, Moschos C, Spella M, Skianis I, Pappas A, Vazakidou ME, Stathopoulos G, Kalomenidis I. Role of angiopoietins in mesothelioma progression. Cytokine 2018; 118:99-106. [PMID: 30201261 DOI: 10.1016/j.cyto.2018.08.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 08/03/2018] [Accepted: 08/08/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND OBJECTIVE Anti-angiogenic treatment has been recently shown to be clinically beneficial for mesothelioma patients. Angiopoietins-1 and -2 are key regulators of tumor angiogenesis. Ang-1 is mainly known to promote angiogenesis and vessel stability, while Ang-2 could serve as an antagonist of Ang-1 causing vessel regression and destabilization or enhance angiogenesis in a context-dependent manner. We hypothesized that Ang-1 would promote and Ang2 would halt experimental mesothelioma by affecting tumor angiogenesis. METHODS To examine the effects of angiopoietins in mesothelioma angiogenesis and in vivo growth we constructed Ang-1 or Ang-2 overexpressing AE17 and AB1 mesothelioma cells and implanted them in the respective syngeneic animals. We also explored the clinical relevance of our observations using the human tumoral mRNAseq data available in the TCGA database. RESULTS AND CONCLUSIONS Ang-1 promotes mesothelioma angiogenesis and growth while the effect of Ang-2 is context-dependent. Low Ang-1 levels in human mesotheliomas are associated with the epitheloid subtype. Tumors of high Ang-1, or concurrent high Ang-2 and VEGF expression present high PECAM-1 and CDH5 expression, markers of vascularity and vascular stability, respectively. Our results highlight the importance of angiopoietins in mesothelioma pathophysiology and pave the way for the clinical development of novel anti-angiogenic strategies.
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Affiliation(s)
- Sophia Magkouta
- "Marianthi Simou Laboratory", 1st Department of Critical Care and Pulmonary Medicine, National and Kapodistrian University of Athens, School of Medicine, Evangelismos Hospital, 10675 Athens, Greece.
| | - Androniki Kollintza
- "Marianthi Simou Laboratory", 1st Department of Critical Care and Pulmonary Medicine, National and Kapodistrian University of Athens, School of Medicine, Evangelismos Hospital, 10675 Athens, Greece
| | - Charalampos Moschos
- "Marianthi Simou Laboratory", 1st Department of Critical Care and Pulmonary Medicine, National and Kapodistrian University of Athens, School of Medicine, Evangelismos Hospital, 10675 Athens, Greece
| | - Magdalini Spella
- Laboratory for Molecular Respiratory Carcinogenesis, Department of Physiology, Faculty of Medicine, University of Patras, 26504 Rio, Greece
| | - Ioannis Skianis
- Applied Econometrics & Data Analysis, Department of Statistics, Athens University of Economic & Business, Athens, Greece
| | - Apostolos Pappas
- "Marianthi Simou Laboratory", 1st Department of Critical Care and Pulmonary Medicine, National and Kapodistrian University of Athens, School of Medicine, Evangelismos Hospital, 10675 Athens, Greece
| | - Maria-Eleni Vazakidou
- "Marianthi Simou Laboratory", 1st Department of Critical Care and Pulmonary Medicine, National and Kapodistrian University of Athens, School of Medicine, Evangelismos Hospital, 10675 Athens, Greece
| | - Georgios Stathopoulos
- Laboratory for Molecular Respiratory Carcinogenesis, Department of Physiology, Faculty of Medicine, University of Patras, 26504 Rio, Greece; Comprehensive Pneumology Center (CPC) and Institute for Lung Biology and Disease (iLBD), University Hospital, Ludwig-Maximilians University and Helmholtz Center Munich, Member of the German Center for Lung Research (DZL), 81377 Munich, Germany
| | - Ioannis Kalomenidis
- "Marianthi Simou Laboratory", 1st Department of Critical Care and Pulmonary Medicine, National and Kapodistrian University of Athens, School of Medicine, Evangelismos Hospital, 10675 Athens, Greece
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