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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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Johnson BW, Takahashi K, Cheng YY. Preclinical Models and Resources to Facilitate Basic Science Research on Malignant Mesothelioma - A Review. Front Oncol 2021; 11:748444. [PMID: 34900693 PMCID: PMC8660093 DOI: 10.3389/fonc.2021.748444] [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: 07/28/2021] [Accepted: 10/25/2021] [Indexed: 12/29/2022] Open
Abstract
Malignant mesothelioma is an aggressive cancer with poor prognosis, predominantly caused by human occupational exposure to asbestos. The global incidence of mesothelioma is predicted to increase as a consequence of continued exposure to asbestos from a variety of sources, including construction material produced in the past in developed countries, as well as those currently being produced in developing countries. Mesothelioma typically develops after a long latency period and consequently it is often diagnosed in the clinic at an advanced stage, at which point standard care of treatment, such as chemo- and radio-therapy, are largely ineffective. Much of our current understanding of mesothelioma biology, particularly in relation to disease pathogenesis, diagnosis and treatment, can be attributed to decades of preclinical basic science research. Given the postulated rising incidence in mesothelioma cases and the limitations of current diagnostic and treatment options, continued preclinical research into mesothelioma is urgently needed. The ever-evolving landscape of preclinical models and laboratory technology available to researchers have made it possible to study human disease with greater precision and at an accelerated rate. In this review article we provide an overview of the various resources that can be exploited to facilitate an enhanced understanding of mesothelioma biology and their applications to research aimed to improve the diagnosis and treatment of mesothelioma. These resources include cell lines, animal models, mesothelioma-specific biobanks and modern laboratory techniques/technologies. Given that different preclinical models and laboratory technologies have varying limitations and applications, they must be selected carefully with respect to the intended objectives of the experiments. This review therefore aims to provide a comprehensive overview of the various preclinical models and technologies with respect to their advantages and limitations. Finally, we will detail about a highly valuable preclinical laboratory resource to curate high quality mesothelioma biospecimens for research; the biobank. Collectively, these resources are essential to the continued advancement of precision medicine to curtail the increasing health burden caused by malignant mesothelioma.
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Affiliation(s)
| | - Ken Takahashi
- Asbestos Diseases Research Institute, Sydney, NSW, Australia
| | - Yuen Yee Cheng
- Asbestos Diseases Research Institute, Sydney, NSW, Australia
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Behrouzfar K, Burton K, Mutsaers SE, Morahan G, Lake RA, Fisher SA. How to Better Understand the Influence of Host Genetics on Developing an Effective Immune Response to Thoracic Cancers. Front Oncol 2021; 11:679609. [PMID: 34235080 PMCID: PMC8256168 DOI: 10.3389/fonc.2021.679609] [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: 03/12/2021] [Accepted: 05/31/2021] [Indexed: 01/02/2023] Open
Abstract
Thoracic cancers pose a significant global health burden. Immune checkpoint blockade therapies have improved treatment outcomes, but durable responses remain limited. Understanding how the host immune system interacts with a developing tumor is essential for the rational development of improved treatments for thoracic malignancies. Recent technical advances have improved our understanding of the mutational burden of cancer cells and changes in cancer-specific gene expression, providing a detailed understanding of the complex biology underpinning tumor-host interactions. While there has been much focus on the genetic alterations associated with cancer cells and how they may impact treatment outcomes, how host genetics affects cancer development is also critical and will greatly determine treatment response. Genome-wide association studies (GWAS) have identified genetic variants associated with cancer predisposition. This approach has successfully identified host genetic risk factors associated with common thoracic cancers like lung cancer, but is less effective for rare cancers like malignant mesothelioma. To assess how host genetics impacts rare thoracic cancers, we used the Collaborative Cross (CC); a powerful murine genetic resource designed to maximize genetic diversity and rapidly identify genes associated with any biological trait. We are using the CC in conjunction with our asbestos-induced MexTAg mouse model, to identify host genes associated with mesothelioma development. Once genes that moderate tumor development and progression are known, human homologues can be identified and human datasets interrogated to validate their association with disease outcome. Furthermore, our CC-MexTAg animal model enables in-depth study of the tumor microenvironment, allowing the correlation of immune cell infiltration and gene expression signatures with disease development. This strategy provides a detailed picture of the underlying biological pathways associated with mesothelioma susceptibility and progression; knowledge that is crucial for the rational development of new diagnostic and therapeutic strategies. Here we discuss the influence of host genetics on developing an effective immune response to thoracic cancers. We highlight current knowledge gaps, and with a focus on mesothelioma, describe the development and application of the CC-MexTAg to overcome limitations and illustrate how the knowledge gained from this unique study will inform the rational design of future treatments of mesothelioma.
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Affiliation(s)
- Kiarash Behrouzfar
- National Centre for Asbestos Related Diseases (NCARD), University of Western Australia, Nedlands, WA, Australia
- School of Biomedical Sciences, University of Western Australia, Nedlands, WA, Australia
| | - Kimberley Burton
- National Centre for Asbestos Related Diseases (NCARD), University of Western Australia, Nedlands, WA, Australia
- School of Biomedical Sciences, University of Western Australia, Nedlands, WA, Australia
| | - Steve E. Mutsaers
- School of Biomedical Sciences, University of Western Australia, Nedlands, WA, Australia
- Institute for Respiratory Health, University of Western Australia, Nedlands, WA, Australia
| | - Grant Morahan
- Centre for Diabetes Research, Harry Perkins Institute of Medical Research, Nedlands, WA, Australia
| | - Richard A. Lake
- National Centre for Asbestos Related Diseases (NCARD), University of Western Australia, Nedlands, WA, Australia
| | - Scott A. Fisher
- National Centre for Asbestos Related Diseases (NCARD), University of Western Australia, Nedlands, WA, Australia
- School of Biomedical Sciences, University of Western Australia, Nedlands, WA, Australia
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The Future of Mesothelioma Research: Basic Science Research. CARING FOR PATIENTS WITH MESOTHELIOMA: PRINCIPLES AND GUIDELINES 2019. [PMCID: PMC7119960 DOI: 10.1007/978-3-319-96244-3_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Our current understanding of mesothelioma in terms of disease induction, development, and treatment is underpinned by decades of basic laboratory science. In this chapter, we discuss the tools that have been developed to aid our understanding of mesothelioma such as cell lines and animal models. We then go on to detail the current use and understanding of conventional therapies for mesothelioma, e.g. chemotherapy, surgery, and radiotherapy, plus their mechanisms of action, and why they may be ineffective. Finally, we discuss a range of newer treatments that are either undergoing clinical trials or are still in the earlier stages of preclinical investigation. These include a growing number of immunotherapies (e.g. checkpoint inhibitors), plus targeted therapies, the search for clinical biomarkers to predict whether patients with mesothelioma might respond to particular treatments, and combined therapies where conventional treatments may be added to newer drugs. The strategy of repositioning existing drugs, approved for other diseases, to treat mesothelioma is also discussed.
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Sneddon S, Patch AM, Dick IM, Kazakoff S, Pearson JV, Waddell N, Allcock RJN, Holt RA, Robinson BWS, Creaney J. Whole exome sequencing of an asbestos-induced wild-type murine model of malignant mesothelioma. BMC Cancer 2017; 17:396. [PMID: 28577549 PMCID: PMC5455120 DOI: 10.1186/s12885-017-3382-6] [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: 11/03/2016] [Accepted: 05/23/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malignant mesothelioma (MM) is an aggressive cancer of the pleural and peritoneal cavities caused by exposure to asbestos. Asbestos-induced mesotheliomas in wild-type mice have been used extensively as a preclinical model because they are phenotypically identical to their human counterpart. However, it is not known if the genetic lesions in these mice tumours are similar to in the human disease, a prerequisite for any new preclinical studies that target genetic abnormalities. METHODS We performed whole exome sequencing of fifteen asbestos-induced murine MM tumour cell lines from BALB/c, CBA and C57BL/6 mouse strains and compared the somatic mutations and copy number variations with those recurrently reported in human MM. We then catalogued and characterised the mutational landscape of the wild-type murine MM tumours. Quantitative RT-PCR was used to interrogate the expression of key MM genes of interest in the mRNA. RESULTS Consistent with human MM tumours, we identified homozygous loss of the tumour suppressor Cdkn2a in 14/15 tumours. One tumour retained the first exon of both of the p16INK4a and p19ARF isoforms though this tumour also contained genetic amplification of Myc resulting in increased expression of the c-Myc proto-oncogene in the mRNA. There were no chromosomal losses in either the Bap1 or Nf2 regions. One tumour harbored homozygous loss of Trp53 in the DNA. Mutation rates were similar in tumours generated in the CBA and C57BL/6 strains when compared to human MM. Interestingly, all BALB/c tumour lines displayed high mutational loads, consistent with the known mutator phenotype of the host strain. The Wnt, MAPK and Jak-STAT signaling pathways were found to be the most commonly affected biological pathways. Mutations and copy number deletions also occurred in the Hedgehog and Hippo pathways. CONCLUSIONS These data suggest that in the wild-type murine model asbestos causes mesotheliomas in a similar way to in human MM. This further supports the notion that the murine model of MM represents a genuine homologue of the human disease, something uncommon in cancer, and is thus a valuable tool to provide insight into MM tumour development and to aide the search for novel therapeutic strategies.
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Affiliation(s)
- Sophie Sneddon
- National Centre for Asbestos Related Disease, School of Medicine and Pharmacology, QEII Medical Centre, University of Western Australia, QQ Block, 6 Verdun Street, Nedlands, WA, 6009, Australia
| | - Ann-Marie Patch
- QIMR Berghofer Medical Research Institute, Brisbane, Brisbane, QLD, 4006, Australia
| | - Ian M Dick
- National Centre for Asbestos Related Disease, School of Medicine and Pharmacology, QEII Medical Centre, University of Western Australia, QQ Block, 6 Verdun Street, Nedlands, WA, 6009, Australia
| | - Stephen Kazakoff
- QIMR Berghofer Medical Research Institute, Brisbane, Brisbane, QLD, 4006, Australia
| | - John V Pearson
- QIMR Berghofer Medical Research Institute, Brisbane, Brisbane, QLD, 4006, Australia
| | - Nicola Waddell
- QIMR Berghofer Medical Research Institute, Brisbane, Brisbane, QLD, 4006, Australia
| | - Richard J N Allcock
- School of Pathology and Laboratory Medicine, University of Western Australia, Nedlands, WA, 6009, Australia.,Pathwest Laboratory Medicine, Western Australia, QEII Medical Centre, Nedlands, WA, 6009, Australia
| | - Robert A Holt
- Michael Smith Genome Sciences Centre, BC Cancer Agency, Vancouver, BC, Canada
| | - Bruce W S Robinson
- National Centre for Asbestos Related Disease, School of Medicine and Pharmacology, QEII Medical Centre, University of Western Australia, QQ Block, 6 Verdun Street, Nedlands, WA, 6009, Australia.,Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, WA, 6009, Australia
| | - Jenette Creaney
- National Centre for Asbestos Related Disease, School of Medicine and Pharmacology, QEII Medical Centre, University of Western Australia, QQ Block, 6 Verdun Street, Nedlands, WA, 6009, Australia.
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Robinson C, Dick IM, Wise MJ, Holloway A, Diyagama D, Robinson BWS, Creaney J, Lake RA. Consistent gene expression profiles in MexTAg transgenic mouse and wild type mouse asbestos-induced mesothelioma. BMC Cancer 2015; 15:983. [PMID: 26680231 PMCID: PMC4683914 DOI: 10.1186/s12885-015-1953-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Accepted: 11/23/2015] [Indexed: 02/08/2023] Open
Abstract
Background The MexTAg transgenic mouse model of mesothelioma replicates many aspects of human mesothelioma, including induction by asbestos, pathogenicity and response to cytotoxic chemotherapy, despite high levels of the SV40 large T Antigen (TAg) in the mesothelial compartment. This model enables analysis of the molecular events associated with asbestos induced mesothelioma and is utilised here to investigate the molecular dynamics of tumours induced in these mice, using gene expression patterns as a read out. Methods Gene expression of MexTAg mesothelioma cell lines bearing a high or low number of copies of the TAg transgene were compared to wild type mouse mesotheliomas and normal mouse mesothelial cells using Affymetrix microarray. These data were then compared to a similar published human microarray study using the same platform. Results The main expression differences between transgenic mouse and wild type mouse mesotheliomas occurred for genes involved in cell cycle regulation and DNA replication, as would be expected from overexpression of the TAg oncogene. Quantitative PCR confirmed that E2F and E2F regulated genes were significantly more upregulated in MexTAg mesotheliomas and MexTAg mesothelial cells compared to wild type mesotheliomas. Like human mesothelioma, both MexTAg and wild type mesotheliomas had more genes underexpressed than overexpressed compared to normal mouse mesothelial cells. Most notably, the cdkn2 locus was deleted in the wild type mouse mesotheliomas, consistent with 80 % human mesotheliomas, however, this region was not deleted in MexTAg mesotheliomas. Regardless of the presence of TAg, all mouse mesotheliomas had a highly concordant set of deregulated genes compared to normal mesothelial cells that overlapped with the deregulated genes between human mesotheliomas and mesothelial cells. Conclusions This investigation demonstrates that the MexTAg mesotheliomas are comparable with wild type mouse mesotheliomas in their representation of human mesothelioma at the molecular level, with some key gene expression differences that are attributable to the TAg transgene expression. Of particular note, MexTAg mesothelioma development was not dependent on cdkn2 deletion. Electronic supplementary material The online version of this article (doi:10.1186/s12885-015-1953-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Cleo Robinson
- National Centre for Asbestos Related Diseases, School of Medicine and Pharmacology, University of Western Australia, M503, Harry Perkins Institute for Medical Research, QQ Block, QEII Medical Centre, Nedlands, Perth, 6009, Western Australia, Australia. .,Anatomical Pathology, PathWest Laboratory Medicine, J Block, QEII Medical Centre, Hospital Ave, Nedlands, Perth, 6009, Western Australia, Australia. .,Present address: Anatomical Pathology, PathWest Laboratory Medicine, J Block, QEII Medical Centre, Hospital Ave, Nedlands, Perth, 6009, Western Australia, Australia.
| | - Ian M Dick
- National Centre for Asbestos Related Diseases, School of Medicine and Pharmacology, University of Western Australia, M503, Harry Perkins Institute for Medical Research, QQ Block, QEII Medical Centre, Nedlands, Perth, 6009, Western Australia, Australia.
| | - Michael J Wise
- School of Chemistry and Biochemistry, University of Western Australia, Crawley, Perth, 6008, Western Australia, Australia.
| | - Andrew Holloway
- Peter MacCallum Institute for Cancer Research, St. Andrew's Place, Melbourne, 3002, Victoria, Australia.
| | - Dileepa Diyagama
- Peter MacCallum Institute for Cancer Research, St. Andrew's Place, Melbourne, 3002, Victoria, Australia.
| | - Bruce W S Robinson
- National Centre for Asbestos Related Diseases, School of Medicine and Pharmacology, University of Western Australia, M503, Harry Perkins Institute for Medical Research, QQ Block, QEII Medical Centre, Nedlands, Perth, 6009, Western Australia, Australia.
| | - Jenette Creaney
- National Centre for Asbestos Related Diseases, School of Medicine and Pharmacology, University of Western Australia, M503, Harry Perkins Institute for Medical Research, QQ Block, QEII Medical Centre, Nedlands, Perth, 6009, Western Australia, Australia.
| | - Richard A Lake
- National Centre for Asbestos Related Diseases, School of Medicine and Pharmacology, University of Western Australia, M503, Harry Perkins Institute for Medical Research, QQ Block, QEII Medical Centre, Nedlands, Perth, 6009, Western Australia, Australia.
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Aston WJ, Fisher SA, Khong A, Mok C, Nowak AK, Lake RA, Lesterhuis WJ. Combining chemotherapy and checkpoint blockade in thoracic cancer: how to proceed? Lung Cancer Manag 2014. [DOI: 10.2217/lmt.14.37] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
SUMMARY Given the impressive efficacy of immune checkpoint blockade in thoracic malignancies, and the recently discovered immune-stimulating properties of many cytotoxic drugs, a logical next step would be to combine these treatments. However, the rational design of clinical trials investigating these combinations is hampered by a lack of knowledge regarding the overall immunogenic effects of the different chemotherapeutics. Here, we give an overview of the field with regard to checkpoint blockade and the immunological effects of cytotoxic chemotherapeutics, with particular focus on preclinical and clinical studies investigating the combination of these two treatment modalities. We discuss the hurdles that need to be overcome in order to optimally exploit chemotherapy and immune checkpoint blockade combinations in thoracic cancers.
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Affiliation(s)
- Wayne J Aston
- National Centre for Asbestos Related Diseases, School of Medicine & Pharmacology, The University of Western Australia, The Harry Perkins Institute of Medical Research, 5th Floor, QQ Block, 6 Verdun Street, Nedlands, WA 6009, Australia
- School of Medicine & Pharmacology, The University of Western Australia, Nedlands, WA 6009, Australia
| | - Scott A Fisher
- National Centre for Asbestos Related Diseases, School of Medicine & Pharmacology, The University of Western Australia, The Harry Perkins Institute of Medical Research, 5th Floor, QQ Block, 6 Verdun Street, Nedlands, WA 6009, Australia
- School of Medicine & Pharmacology, The University of Western Australia, Nedlands, WA 6009, Australia
| | - Andrea Khong
- National Centre for Asbestos Related Diseases, School of Medicine & Pharmacology, The University of Western Australia, The Harry Perkins Institute of Medical Research, 5th Floor, QQ Block, 6 Verdun Street, Nedlands, WA 6009, Australia
- School of Medicine & Pharmacology, The University of Western Australia, Nedlands, WA 6009, Australia
| | - Clara Mok
- National Centre for Asbestos Related Diseases, School of Medicine & Pharmacology, The University of Western Australia, The Harry Perkins Institute of Medical Research, 5th Floor, QQ Block, 6 Verdun Street, Nedlands, WA 6009, Australia
- School of Medicine & Pharmacology, The University of Western Australia, Nedlands, WA 6009, Australia
| | - Anna K Nowak
- National Centre for Asbestos Related Diseases, School of Medicine & Pharmacology, The University of Western Australia, The Harry Perkins Institute of Medical Research, 5th Floor, QQ Block, 6 Verdun Street, Nedlands, WA 6009, Australia
- School of Medicine & Pharmacology, The University of Western Australia, Nedlands, WA 6009, Australia
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia
| | - Richard A Lake
- National Centre for Asbestos Related Diseases, School of Medicine & Pharmacology, The University of Western Australia, The Harry Perkins Institute of Medical Research, 5th Floor, QQ Block, 6 Verdun Street, Nedlands, WA 6009, Australia
- School of Medicine & Pharmacology, The University of Western Australia, Nedlands, WA 6009, Australia
| | - W Joost Lesterhuis
- National Centre for Asbestos Related Diseases, School of Medicine & Pharmacology, The University of Western Australia, The Harry Perkins Institute of Medical Research, 5th Floor, QQ Block, 6 Verdun Street, Nedlands, WA 6009, Australia
- School of Medicine & Pharmacology, The University of Western Australia, Nedlands, WA 6009, Australia
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