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Laborda-Illanes A, Sanchez-Alcoholado L, Dominguez-Recio ME, Jimenez-Rodriguez B, Lavado R, Comino-Méndez I, Alba E, Queipo-Ortuño MI. Breast and Gut Microbiota Action Mechanisms in Breast Cancer Pathogenesis and Treatment. Cancers (Basel) 2020; 12:E2465. [PMID: 32878124 PMCID: PMC7565530 DOI: 10.3390/cancers12092465] [Citation(s) in RCA: 90] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 08/25/2020] [Accepted: 08/27/2020] [Indexed: 12/11/2022] Open
Abstract
In breast cancer (BC) the employment of sequencing technologies for metagenomic analyses has allowed not only the description of the overall metagenomic landscape but also the specific microbial changes and their functional implications. Most of the available data suggest that BC is related to bacterial dysbiosis in both the gut microenvironment and breast tissue. It is hypothesized that changes in the composition and functions of several breast and gut bacterial taxa may contribute to BC development and progression through several pathways. One of the most prominent roles of gut microbiota is the regulation of steroid-hormone metabolism, such as estrogens, a component playing an important role as risk factor in BC development, especially in postmenopausal women. On the other hand, breast and gut resident microbiota are the link in the reciprocal interactions between cancer cells and their local environment, since microbiota are capable of modulating mucosal and systemic immune responses. Several in vivo and in vitro studies show remarkable evidence that diet, probiotics and prebiotics could exert important anticarcinogenic effects in BC. Moreover, gut microbiota have an important role in the metabolism of chemotherapeutic drugs and in the activity of immunogenic chemotherapies since they are a potential dominant mediator in the response to cancer therapy. Then, the microbiome impact in BC is multi-factorial, and the gut and breast tissue bacteria population could be important in regulating the local immune system, in tumor formation and progression and in therapy response and/or resistance.
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Affiliation(s)
- Aurora Laborda-Illanes
- Unidad de Gestión Clínica Intercentros de Oncología Médica, Hospitales Universitarios Regional y Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA)-CIMES-UMA, 29010 Málaga, Spain; (A.L.-I.); (L.S.-A.); (M.E.D.-R.); (B.J.-R.); (R.L.); (I.C.-M.)
- Facultad de Medicina, Universidad de Málaga, 29071 Málaga, Spain
| | - Lidia Sanchez-Alcoholado
- Unidad de Gestión Clínica Intercentros de Oncología Médica, Hospitales Universitarios Regional y Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA)-CIMES-UMA, 29010 Málaga, Spain; (A.L.-I.); (L.S.-A.); (M.E.D.-R.); (B.J.-R.); (R.L.); (I.C.-M.)
- Facultad de Medicina, Universidad de Málaga, 29071 Málaga, Spain
| | - María Emilia Dominguez-Recio
- Unidad de Gestión Clínica Intercentros de Oncología Médica, Hospitales Universitarios Regional y Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA)-CIMES-UMA, 29010 Málaga, Spain; (A.L.-I.); (L.S.-A.); (M.E.D.-R.); (B.J.-R.); (R.L.); (I.C.-M.)
| | - Begoña Jimenez-Rodriguez
- Unidad de Gestión Clínica Intercentros de Oncología Médica, Hospitales Universitarios Regional y Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA)-CIMES-UMA, 29010 Málaga, Spain; (A.L.-I.); (L.S.-A.); (M.E.D.-R.); (B.J.-R.); (R.L.); (I.C.-M.)
| | - Rocío Lavado
- Unidad de Gestión Clínica Intercentros de Oncología Médica, Hospitales Universitarios Regional y Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA)-CIMES-UMA, 29010 Málaga, Spain; (A.L.-I.); (L.S.-A.); (M.E.D.-R.); (B.J.-R.); (R.L.); (I.C.-M.)
| | - Iñaki Comino-Méndez
- Unidad de Gestión Clínica Intercentros de Oncología Médica, Hospitales Universitarios Regional y Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA)-CIMES-UMA, 29010 Málaga, Spain; (A.L.-I.); (L.S.-A.); (M.E.D.-R.); (B.J.-R.); (R.L.); (I.C.-M.)
| | - Emilio Alba
- Unidad de Gestión Clínica Intercentros de Oncología Médica, Hospitales Universitarios Regional y Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA)-CIMES-UMA, 29010 Málaga, Spain; (A.L.-I.); (L.S.-A.); (M.E.D.-R.); (B.J.-R.); (R.L.); (I.C.-M.)
| | - María Isabel Queipo-Ortuño
- Unidad de Gestión Clínica Intercentros de Oncología Médica, Hospitales Universitarios Regional y Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA)-CIMES-UMA, 29010 Málaga, Spain; (A.L.-I.); (L.S.-A.); (M.E.D.-R.); (B.J.-R.); (R.L.); (I.C.-M.)
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Núñez NG, Tosello Boari J, Ramos RN, Richer W, Cagnard N, Anderfuhren CD, Niborski LL, Bigot J, Meseure D, De La Rochere P, Milder M, Viel S, Loirat D, Pérol L, Vincent-Salomon A, Sastre-Garau X, Burkhard B, Sedlik C, Lantz O, Amigorena S, Piaggio E. Tumor invasion in draining lymph nodes is associated with Treg accumulation in breast cancer patients. Nat Commun 2020; 11:3272. [PMID: 32601304 PMCID: PMC7324591 DOI: 10.1038/s41467-020-17046-2] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 06/04/2020] [Indexed: 02/06/2023] Open
Abstract
Tumor-draining lymph node (TDLN) invasion by metastatic cells in breast cancer correlates with poor prognosis and is associated with local immunosuppression, which can be partly mediated by regulatory T cells (Tregs). Here, we study Tregs from matched tumor-invaded and non-invaded TDLNs, and breast tumors. We observe that Treg frequencies increase with nodal invasion, and that Tregs express higher levels of co-inhibitory/stimulatory receptors than effector cells. Also, while Tregs show conserved suppressive function in TDLN and tumor, conventional T cells (Tconvs) in TDLNs proliferate and produce Th1-inflammatory cytokines, but are dysfunctional in the tumor. We describe a common transcriptomic signature shared by Tregs from tumors and nodes, including CD80, which is significantly associated with poor patient survival. TCR RNA-sequencing analysis indicates trafficking between TDLNs and tumors and ongoing Tconv/Treg conversion. Overall, TDLN Tregs are functional and express a distinct pattern of druggable co-receptors, highlighting their potential as targets for cancer immunotherapy.
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Affiliation(s)
- Nicolas Gonzalo Núñez
- Institut Curie, PSL Research University, INSERM U932, F-75005, Paris, France
- Institute of Experimental Immunology, University of Zurich, Winterthurerstr. 190, CH-8057, Zurich, Switzerland
| | | | - Rodrigo Nalio Ramos
- Institut Curie, PSL Research University, INSERM U932, F-75005, Paris, France
| | - Wilfrid Richer
- Institut Curie, PSL Research University, INSERM U932, F-75005, Paris, France
| | - Nicolas Cagnard
- Paris-Descartes Bioinformatics Platform, 75015, Paris, France
| | - Cyrill Dimitri Anderfuhren
- Institute of Experimental Immunology, University of Zurich, Winterthurerstr. 190, CH-8057, Zurich, Switzerland
| | | | - Jeremy Bigot
- Institut Curie, PSL Research University, INSERM U932, F-75005, Paris, France
| | - Didier Meseure
- Institut Curie, PSL Research University, Departement de Biologie des Tumeurs, F-75005, Paris, France
- Centre d'Investigation Clinique Biotherapie CICBT 1428, Institut Curie, Paris, F-75005, France
| | | | - Maud Milder
- Institut Curie, PSL Research University, Departement de Biologie des Tumeurs, F-75005, Paris, France
- Centre d'Investigation Clinique Biotherapie CICBT 1428, Institut Curie, Paris, F-75005, France
| | - Sophie Viel
- Institut Curie, PSL Research University, INSERM U932, F-75005, Paris, France
| | - Delphine Loirat
- Institut Curie, PSL Research University, INSERM U932, F-75005, Paris, France
- Centre d'Investigation Clinique Biotherapie CICBT 1428, Institut Curie, Paris, F-75005, France
- Institut Curie, PSL Research University, Departement d'Oncologie Medicale, F-75005, Paris, France
| | - Louis Pérol
- Institut Curie, PSL Research University, INSERM U932, F-75005, Paris, France
| | - Anne Vincent-Salomon
- Institut Curie, PSL Research University, Departement de Biologie des Tumeurs, F-75005, Paris, France
- Centre d'Investigation Clinique Biotherapie CICBT 1428, Institut Curie, Paris, F-75005, France
| | - Xavier Sastre-Garau
- Institut Curie, PSL Research University, Departement de Biologie des Tumeurs, F-75005, Paris, France
- Institut de Cancerologie de Lorraine Department of Biopathology, 6, avenue de Bourgogne CS 30519, 54519, Vandoeuvre-lès-Nancy cedex, France
| | - Becher Burkhard
- Institute of Experimental Immunology, University of Zurich, Winterthurerstr. 190, CH-8057, Zurich, Switzerland
| | - Christine Sedlik
- Institut Curie, PSL Research University, INSERM U932, F-75005, Paris, France
- Centre d'Investigation Clinique Biotherapie CICBT 1428, Institut Curie, Paris, F-75005, France
| | - Olivier Lantz
- Institut Curie, PSL Research University, INSERM U932, F-75005, Paris, France
- Institut Curie, PSL Research University, Departement de Biologie des Tumeurs, F-75005, Paris, France
- Centre d'Investigation Clinique Biotherapie CICBT 1428, Institut Curie, Paris, F-75005, France
| | - Sebastian Amigorena
- Institut Curie, PSL Research University, INSERM U932, F-75005, Paris, France
- Centre d'Investigation Clinique Biotherapie CICBT 1428, Institut Curie, Paris, F-75005, France
| | - Eliane Piaggio
- Institut Curie, PSL Research University, INSERM U932, F-75005, Paris, France.
- Centre d'Investigation Clinique Biotherapie CICBT 1428, Institut Curie, Paris, F-75005, France.
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Gibert-Ramos A, López C, Bosch R, Fontoura L, Bueno G, García-Rojo M, Berenguer M, Lejeune M. Immune response profile of primary tumour, sentinel and non-sentinel axillary lymph nodes related to metastasis in breast cancer: an immunohistochemical point of view. Histochem Cell Biol 2019; 152:177-193. [DOI: 10.1007/s00418-019-01802-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2019] [Indexed: 12/24/2022]
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4
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Henke G, Knauer M, Ribi K, Hayoz S, Gérard MA, Ruhstaller T, Zwahlen DR, Muenst S, Ackerknecht M, Hawle H, Fitzal F, Gnant M, Mátrai Z, Ballardini B, Gyr A, Kurzeder C, Weber WP. Tailored axillary surgery with or without axillary lymph node dissection followed by radiotherapy in patients with clinically node-positive breast cancer (TAXIS): study protocol for a multicenter, randomized phase-III trial. Trials 2018; 19:667. [PMID: 30514362 PMCID: PMC6278139 DOI: 10.1186/s13063-018-3021-9] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 10/25/2018] [Indexed: 12/25/2022] Open
Abstract
Background Complete lymph node removal through conventional axillary dissection (ALND) has been standard treatment for breast cancer patients for almost a century. In the 1990s, however, and in parallel with the advent of the sentinel lymph node (SLN) procedure, ALND came under increasing scrutiny due to its association with significant patient morbidity. Several studies have since provided evidence to suggest omission of ALND, often in favor of axillary radiation, in selected clinically node-negative, SLN-positive patients, thus supporting the current trend in clinical practice. Clinically node-positive patients, by contrast, continue to undergo ALND in many cases, if only for the lack of studies re-assessing the indication for ALND in these patients. Hence, there is a need for a clinical trial to evaluate the optimal treatment for clinically node-positive breast cancer patients in terms of surgery and radiotherapy. The TAXIS trial is designed to fill this gap by examining in particular the value of tailored axillary surgery (TAS), a new technique for selectively removing positive lymph nodes. Methods In this international, multicenter, phase-III, non-inferiority, randomized controlled trial (RCT), including 34 study sites from four different countries, we plan to randomize 1500 patients to either receive TAS followed by ALND and regional nodal irradiation excluding the dissected axilla, or receive TAS followed by regional nodal irradiation including the full axilla. All patients undergo adjuvant whole-breast irradiation after breast-conserving surgery and chest-wall irradiation after mastectomy. The main objective of the trial is to test the hypothesis that treatment with TAS and axillary radiotherapy is non-inferior to ALND in terms of disease-free survival of clinically node-positive breast cancer patients in the era of effective systemic therapy and extended regional nodal irradiation. The trial was activated on 31 July 2018 and the first patient was randomized on 7 August 2018. Discussion Designed to test the hypothesis that TAS is non-inferior to ALND in terms of curing patients and preventing recurrences, yet is significantly superior in reducing patient morbidity, this trial may establish a new worldwide treatment standard in breast cancer surgery. If found to be non-inferior to standard treatment, TAS may significantly contribute to reduce morbidity in breast cancer patients by avoiding surgical overtreatment. Trial registration ClinicalTrials.gov, ID: NCT03513614. Registered on 1 May 2018. www.kofam.ch, ID: NCT03513614. Registered on 17 June 2018. EudraCT No.: 2018–000372-14. Electronic supplementary material The online version of this article (10.1186/s13063-018-3021-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Guido Henke
- Department of Radiation Oncology, St. Gallen Cantonal Hospital, Rorschacher Strasse 95, 9007, St.Gallen, Switzerland
| | - Michael Knauer
- Breast Center, St. Gallen Cantonal Hospital, Rorschacherstrasse 95, 9007, St. Gallen, Switzerland
| | - Karin Ribi
- SAKK Coordinating Center, Effingerstrasse 33, 3008, Bern, Switzerland.,IBCSG Coordinating Center, Effingerstrasse 40, 3008, Bern, Switzerland
| | - Stefanie Hayoz
- SAKK Coordinating Center, Effingerstrasse 33, 3008, Bern, Switzerland
| | | | - Thomas Ruhstaller
- Breast Center, St. Gallen Cantonal Hospital, Rorschacherstrasse 95, 9007, St. Gallen, Switzerland
| | - Daniel R Zwahlen
- Department of Radiation Oncology, Graubünden Cantonal Hospital, Loestrasse 170, 7000, Chur, Switzerland
| | - Simone Muenst
- Institute of Pathology, University Hospital Basel, Schönbeinstrasse 40, 4031, Basel, Switzerland.,Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056, Basel, Switzerland
| | - Markus Ackerknecht
- Department of Biomedicine, University Hospital Basel, Hebelstrasse 20, 4031, Basel, Switzerland.,Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056, Basel, Switzerland
| | - Hanne Hawle
- SAKK Coordinating Center, Effingerstrasse 33, 3008, Bern, Switzerland
| | - Florian Fitzal
- Department of Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,Breast Health Center, Comprehensive Cancer Center Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Michael Gnant
- Department of Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,Breast Health Center, Comprehensive Cancer Center Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Zoltan Mátrai
- Department of Breast and Sarcoma Surgery, National Institute of Oncology, Ráth György u. 7-9, 1122, Budapest, Hungary
| | | | - Andreas Gyr
- Breast Center, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland.,Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056, Basel, Switzerland
| | - Christian Kurzeder
- Breast Center, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland.,Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056, Basel, Switzerland
| | - Walter P Weber
- Breast Center, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland. .,Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056, Basel, Switzerland.
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5
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Characterization of sentinel node-derived antibodies from breast cancer patients. J Immunol Methods 2018; 455:14-23. [DOI: 10.1016/j.jim.2018.01.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 01/22/2018] [Accepted: 01/24/2018] [Indexed: 12/22/2022]
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Banin-Hirata BK, de Oliveira CEC, Losi-Guembarovski R, Ozawa PMM, Vitiello GAF, de Almeida FC, Derossi DR, André ND, Watanabe MAE. The prognostic value of regulatory T cells infiltration in HER2-enriched breast cancer microenvironment. Int Rev Immunol 2017; 37:144-150. [PMID: 29257906 DOI: 10.1080/08830185.2017.1401620] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Breast cancer represents a complex and heterogeneous disease that comprises distinct disease conditions, histological features, and clinical outcome. Since many years, it has been demonstrated as an association between HER2 amplification and poor prognosis, because its overexpression is associated with an aggressive phenotype of breast tumor cells. A significant proportion of cases have developed resistance to the current therapies available. Consequently, new prognostic markers are urgently needed to identify patients who are at the highest risk for developing metastases. During the past decade, new insights provided valuable knowledge regarding mechanisms underlying the dynamic interplayed between immune cells and tumor progression. It has been shown that the presence of a lymphocytic infiltrate, particularly of regulatory T cells, in cancer tissue, is associated with clinical outcome promoting rather than inhibiting cancer development and progression. It has been also verified that the clinical value of lymphocytic infiltration in breast cancers could be subtype-dependent, including the HER2-enriched subtype. In this context, this work summarizes proposed to discuss the prognostic value of regulatory T cell infiltration in microenvironment of HER2-enriched breast cancer.
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Affiliation(s)
- Bruna K Banin-Hirata
- a Laboratory of Study and Application of DNA Polymorphisms and Immunology, Department of Pathological Sciences , Biological Sciences Center, State University of Londrina, Pr 445 Km 380 Celso Garcia Cid Highway , Londrina , Paraná , Brazil
| | - Carlos E C de Oliveira
- a Laboratory of Study and Application of DNA Polymorphisms and Immunology, Department of Pathological Sciences , Biological Sciences Center, State University of Londrina, Pr 445 Km 380 Celso Garcia Cid Highway , Londrina , Paraná , Brazil
| | - Roberta Losi-Guembarovski
- a Laboratory of Study and Application of DNA Polymorphisms and Immunology, Department of Pathological Sciences , Biological Sciences Center, State University of Londrina, Pr 445 Km 380 Celso Garcia Cid Highway , Londrina , Paraná , Brazil
| | - Patricia M M Ozawa
- a Laboratory of Study and Application of DNA Polymorphisms and Immunology, Department of Pathological Sciences , Biological Sciences Center, State University of Londrina, Pr 445 Km 380 Celso Garcia Cid Highway , Londrina , Paraná , Brazil
| | - Glauco A F Vitiello
- a Laboratory of Study and Application of DNA Polymorphisms and Immunology, Department of Pathological Sciences , Biological Sciences Center, State University of Londrina, Pr 445 Km 380 Celso Garcia Cid Highway , Londrina , Paraná , Brazil
| | - Felipe C de Almeida
- a Laboratory of Study and Application of DNA Polymorphisms and Immunology, Department of Pathological Sciences , Biological Sciences Center, State University of Londrina, Pr 445 Km 380 Celso Garcia Cid Highway , Londrina , Paraná , Brazil
| | - Daniela R Derossi
- b Cancer Hospital of Londrina, Department of Human Pathology , Clinical Analysis and Toxicology, Health Sciences Center, State University of Londrina , Londrina , Parana , Brazil
| | - Nayara D André
- c Department of Biochemistry , Federal University of São João del-Rei , Divinópolis , Minas Gerais , Brazil
| | - Maria A E Watanabe
- a Laboratory of Study and Application of DNA Polymorphisms and Immunology, Department of Pathological Sciences , Biological Sciences Center, State University of Londrina, Pr 445 Km 380 Celso Garcia Cid Highway , Londrina , Paraná , Brazil
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7
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Miyan M, Schmidt-Mende J, Kiessling R, Poschke I, de Boniface J. Differential tumor infiltration by T-cells characterizes intrinsic molecular subtypes in breast cancer. J Transl Med 2016; 14:227. [PMID: 27473163 PMCID: PMC4966793 DOI: 10.1186/s12967-016-0983-9] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 07/18/2016] [Indexed: 12/31/2022] Open
Abstract
Background Molecular subtypes of breast cancer and presence of tumor-infiltrating immune cells have both been implicated as important predictive and prognostic factors for improved risk stratification and treatment individualization of breast cancer patients. Their association, however, has not been studied in detail. The aim of this study was to evaluate the expression of the T cell markers CD8, FoxP3, CD3 and ζ-chain in molecular subtypes of the invasive margin and tumor center of breast cancer and corresponding sentinel nodes and to deduct prognostic information from these findings. Methods Tumor and sentinel node sections from 177 patients with primary, invasive, unilateral early-stage breast cancer were stained by immunohistochemistry and T-cell phenotypes quantified manually. Clinical data were collected from medical records. Results The degree of T-cell infiltration and expression of all markers differed significantly among the molecular subtypes, being highest in non-luminal, more aggressive tumors: more T-cell infiltration and higher expression of all markers were associated with hormone receptor negativity, higher proliferation and higher histological grades, but also with larger tumor size. Basal-like tumors, and most remarkably their tumor centers, hosted the highest number of FoxP3+ T-cells with an unfavorable ratio to cytotoxic CD8+ T-cells. T-cell infiltration was generally higher in the invasive margin than the tumor center. A scoring system based on densities of CD3 and CD8 could significantly separate molecular subtypes (p < 0.001). Conclusions Thus, immunological patterns with functional implications within each subtype are associated with prognostic factors. These findings should be further validated in studies using larger patient populations and longer follow-up. Electronic supplementary material The online version of this article (doi:10.1186/s12967-016-0983-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- M Miyan
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - J Schmidt-Mende
- Department of Oncology and Pathology, Cancer Center Karolinska, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.,Department of Pathology, Karolinska University Hospital, Stockholm, Sweden
| | - R Kiessling
- Department of Oncology and Pathology, Cancer Center Karolinska, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - I Poschke
- Division of Molecular Oncology of Gastrointestinal Tumors, German Cancer Research Center, Heidelberg, Germany
| | - J de Boniface
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. .,Department of Breast and Endocrine Surgery, P9:03, Karolinska University Hospital, 17176, Stockholm, Sweden.
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8
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Kwa M, Adams S. Prognostic and Predictive Value of Tumor-Infiltrating Lymphocytes in Breast Cancer. CURRENT BREAST CANCER REPORTS 2016. [DOI: 10.1007/s12609-016-0198-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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9
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van der Sluis TC, van Duikeren S, Huppelschoten S, Jordanova ES, Beyranvand Nejad E, Sloots A, Boon L, Smit VTHBM, Welters MJP, Ossendorp F, van de Water B, Arens R, van der Burg SH, Melief CJM. Vaccine-induced tumor necrosis factor-producing T cells synergize with cisplatin to promote tumor cell death. Clin Cancer Res 2014; 21:781-94. [PMID: 25501579 DOI: 10.1158/1078-0432.ccr-14-2142] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Cancer immunotherapy, such as vaccination, is an increasingly successful treatment modality, but its interaction with chemotherapy remains largely undefined. Therefore, we explored the mechanism of synergy between vaccination with synthetic long peptides (SLP) of human papillomavirus type 16 (HPV16) and cisplatin in a preclinical tumor model for HPV16. EXPERIMENTAL DESIGN SLP vaccination in this preclinical tumor model allowed the elucidation of novel mechanisms of synergy between chemo- and immunotherapy. By analyzing the tumor immune infiltrate, we focused on the local intratumoral effects of chemotherapy, vaccination, or the combination. RESULTS Of several chemotherapeutic agents, cisplatin synergized best with SLP vaccination in tumor eradication, without requirement for the maximum-tolerated dose (MTD). Upon SLP vaccination, tumors were highly infiltrated with HPV-specific, tumor necrosis factor-α (TNFα)- and interferon-γ (IFNγ)-producing T cells. Upon combined treatment, tumor cell proliferation was significantly decreased compared with single treated and untreated tumors. Furthermore, we showed that TNFα strongly enhanced cisplatin-induced apoptotic tumor cell death in a JNK-dependent manner. This is consistent with upregulation of proapoptotic molecules and with enhanced cell death in vivo upon combined SLP vaccination and cisplatin treatment. In vivo neutralization of TNFα significantly reduced the antitumor responses induced by the combined treatment. CONCLUSION Taken together, our data show that peptide vaccination with cisplatin treatment leads to decreased tumor cell proliferation and TNFα-induced enhanced cisplatin-mediated killing of tumor cells, together resulting in superior tumor eradication.
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Affiliation(s)
- Tetje C van der Sluis
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | - Suzanne van Duikeren
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | - Suzanna Huppelschoten
- Division of Toxicology, Leiden Academic Centre for Drug Research, Leiden University, the Netherlands
| | - Ekaterina S Jordanova
- Center for Gynaecological Oncology Amsterdam, Free University Amsterdam, the Netherlands
| | - Elham Beyranvand Nejad
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | - Arjen Sloots
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | - Louis Boon
- Department of Cell Biology, Bioceros, Utrecht, the Netherlands
| | | | - Marij J P Welters
- Clinical Oncology, Leiden University Medical Center, Leiden, the Netherlands
| | - Ferry Ossendorp
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | - Bob van de Water
- Division of Toxicology, Leiden Academic Centre for Drug Research, Leiden University, the Netherlands
| | - Ramon Arens
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | | | - Cornelis J M Melief
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Center (LUMC), Leiden, the Netherlands. ISA Pharmaceuticals, Leiden, the Netherlands.
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Faghih Z, Erfani N, Haghshenas MR, Safaei A, Talei AR, Ghaderi A. Immune profiles of CD4+ lymphocyte subsets in breast cancer tumor draining lymph nodes. Immunol Lett 2014; 158:57-65. [DOI: 10.1016/j.imlet.2013.11.021] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 11/30/2013] [Accepted: 11/30/2013] [Indexed: 01/07/2023]
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Adams S, Kozhaya L, Martiniuk F, Meng TC, Chiriboga L, Liebes L, Hochman T, Shuman N, Axelrod D, Speyer J, Novik Y, Tiersten A, Goldberg JD, Formenti SC, Bhardwaj N, Unutmaz D, Demaria S. Topical TLR7 agonist imiquimod can induce immune-mediated rejection of skin metastases in patients with breast cancer. Clin Cancer Res 2012; 18:6748-57. [PMID: 22767669 DOI: 10.1158/1078-0432.ccr-12-1149] [Citation(s) in RCA: 167] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE Skin metastases of breast cancer remain a therapeutic challenge. Toll-like receptor 7 agonist imiquimod is an immune response modifier and can induce immune-mediated rejection of primary skin malignancies when topically applied. Here we tested the hypothesis that topical imiquimod stimulates local antitumor immunity and induces the regression of breast cancer skin metastases. EXPERIMENTAL DESIGN A prospective clinical trial was designed to evaluate the local tumor response rate of breast cancer skin metastases treated with topical imiquimod, applied 5 d/wk for 8 weeks. Safety and immunologic correlates were secondary objectives. RESULTS Ten patients were enrolled and completed the study. Imiquimod treatment was well tolerated, with only grade 1 to 2 transient local and systemic side effects consistent with imiquimod's immunomodulatory effects. Two patients achieved a partial response [20%; 95% confidence interval (CI), 3%-56%]. Responders showed histologic tumor regression with evidence of an immune-mediated response, showed by changes in the tumor lymphocytic infiltrate and locally produced cytokines. CONCLUSION Topical imiquimod is a beneficial treatment modality for breast cancer metastatic to skin/chest wall and is well tolerated. Importantly, imiquimod can promote a proimmunogenic tumor microenvironment in breast cancer. Preclinical data generated by our group suggest superior results with a combination of imiquimod and ionizing radiation and we are currently testing in patients whether the combination can further improve antitumor immune and clinical responses.
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Affiliation(s)
- Sylvia Adams
- Departments of Medicine, New York University School of Medicine, New York, New York 10016, USA.
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Krausz LT, Fischer-Fodor E, Major ZZ, Fetica B. GITR-expressing regulatory T-cell subsets are increased in tumor-positive lymph nodes from advanced breast cancer patients as compared to tumor-negative lymph nodes. Int J Immunopathol Pharmacol 2012; 25:59-66. [PMID: 22507318 DOI: 10.1177/039463201202500108] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Lymph node (LN) infiltration by neoplastic process involves important changes in lymph node immune microenvironment. In particular, regulatory T cells (Treg) seem to have a key role in altering the immunoediting function of the immune system which leads to the elusion of the tumor from immune surveillance. In this study, we evaluated the expression of T-cell markers in CD4+ and CD8+ subsets from tumor-positive and tumor-negative lymph nodes from the same, advanced stage breast cancer patient. The study was carried out on 3 patients and similar results were obtained. Flow cytometric analysis of CD8+ cells demonstrated a significant difference in the expression of CD25, CD45RA, CD45RO, and GITRL (Glucocorticoid-Induced TNF receptor-Related ligand). Flowcytometric analysis of CD4+ cells demonstrated a significant difference in the expression of GITR (Glucocorticoid-Induced TNF receptor-Related), CD25, FoxP3 (Forkhead box P3), CD28, and CD45RA. Multiple staining allowed the identification of two Treg subpopulations, CD4+ CD25 highGITR+ CD127-/low and CD4+ CD25 low GITR+ CD127+ cells, proving that both are increased in the positive nodes in comparison with the negative nodes from the same patient. We identified for the first time the CD4+ CD25 low GITR+ CD127+ Treg subpopulation in cancer, and the 2.6 fold increase in positive LN suggests that this Treg subpopulation could be a key player in metastasis. We also found GITRL expression in the CD8 lymphocytes, which may also contribute to the changes of metastatic lymph node microenvironment. These findings make both GITR and GITRL good possible co-candidates for future therapeutical intervention against metastasis and perhaps also as disease evolution biomarkers.
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Affiliation(s)
- L T Krausz
- Iuliu Hatieganu University of Medicine and Pharmacy, Pharmacology Department, Cluj- Napoca, Romania.
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[Expression of Foxp3 and RORgamma t in peripheral blood mononuclear cells in patients with laryngeal carcinoma as indicators of tumor stage--preliminary study]. Otolaryngol Pol 2011; 65:109-16. [PMID: 22000260 DOI: 10.1016/s0030-6657(11)70718-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2011] [Accepted: 08/16/2011] [Indexed: 11/22/2022]
Abstract
INTRODUCTION The degree of activation of cells involved in cellular immune response against tumor antigens (cytotoxic lymphocytes Tc) as well as efficiency of the mechanisms which promote immunosuppression (Treg - regulatory cells CD4(+)CD25(+)Foxp3(+)) may determine the course of the neoplastic disease. The aim of this study was to assess the function of autologous peripheral blood mononuclear cells (PBMCs) involved in the immunological processes on the basis of expression of Foxp3 and RORgamma t molecules as well as analysis of the relationships with clinical and morphological features of the tumor (pT and pN stage, G feature, degree of invasiveness according to the TFG classification) in laryngeal carcinoma. MATERIAL AND METHODS The analysis included a group of 59 patients with verified squamous cell carcinoma of the larynx. In the pathologic evaluation pTNM classification criteria, depth of invasion and degree of histological differentiation were used. Expression levels of mRNA for Foxp3 and RORgamma t in peripheral blood mononuclear cells by quantitative analysis of the amplified product in real time (real-time RT(2)-PCR) were evaluated. The level of Foxp3 and RORgamma t protein expression by Western blot analysis was determined. RESULTS In squamous cell carcinomas of the larynx, with the highest tumor aggressiveness the significantly highest level of mRNA and protein expression for Foxp3 molecule were observed. The severity of Foxp3 expression at both gene and protein level were positively linearly correlated with the degree of local extent of the tumor (pT3-4), depth of invasion (invasion of cartilage) and the degree of histological differentiation (low-differentiated tumors G3). In the study group of laryngeal cancers significantly lower level of RORgamma t expression in carcinomas with less invasive changes (pT1-2, high-differentiated tumors G1, carcinomas with microinvasion without evidence of invasion beyond the lamina propria) was also noted. CONCLUSIONS The study results indicate the important role of immune cell activity as indicators of advancement of clinical and morphological changes in squamous cell carcinoma of the larynx.
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