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Hu X, Yu L, Bian Y, Zeng X, Luo S, Wen Q, Chen P. Paclitaxel-loaded tumor cell-derived microparticles improve radiotherapy efficacy in triple-negative breast cancer by enhancing cell killing and stimulating immunity. Int J Pharm 2023; 632:122560. [PMID: 36586632 DOI: 10.1016/j.ijpharm.2022.122560] [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: 08/10/2022] [Revised: 12/03/2022] [Accepted: 12/25/2022] [Indexed: 12/29/2022]
Abstract
Triple-negative breast cancer (TNBC) is a highly heterogeneous tumor characterized by high recurrence and metastasis, with a very poor prognosis, and there are still great challenges in its clinical treatment. Here, we describe the development of a novel modality for the treatment of TNBC with tumor cell-derived microparticles loaded with paclitaxel (MP-PTX) in combination with radiotherapy. We show that MP can deliver agents to tumor cells by homologous targeting, thereby increasing the absorption rate of the chemotherapeutic agent and enhancing its killing effects on tumor cells. We further demonstrate that MP-PTX combined with radiotherapy shows a synergistic antitumor effect by enhancing the inhibition of tumor cell proliferation, promoting tumor cell apoptosis, reducing the immunosuppressive microenvironment at the tumor site, and activating the antitumor immune response. Altogether, this study provides a referable and optional method for the clinical treatment of refractory tumors such as TNBC based on the combination of T-MP-delivered chemotherapeutic drugs and radiotherapy. Chemical compounds: paclitaxel (PTX), paclitaxel-loaded tumor cell-derived microparticles (MP-PTX).
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Affiliation(s)
- Xiao Hu
- Department of Oncology, the Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
| | - Li Yu
- Department of Oncology, the Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
| | - Yuan Bian
- Department of Oncology, the Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
| | - Xiaonan Zeng
- Department of Oncology, the Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
| | - Shan Luo
- Chengdu Institute of Biological Products Co., Ltd, Chengdu 610023, China
| | - Qinglian Wen
- Department of Oncology, the Affiliated Hospital of Southwest Medical University, Luzhou 646000, China; Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou 646000, China.
| | - Ping Chen
- Department of Oncology, the Affiliated Hospital of Southwest Medical University, Luzhou 646000, China; Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou 646000, China.
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2
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Marcq G, Souhami L, Cury FL, Salimi A, Aprikian A, Tanguay S, Vanhuyse M, Rajan R, Brimo F, Mansure JJ, Kassouf W. Phase 1 Trial of Atezolizumab Plus Trimodal Therapy in Patients With Localized Muscle-Invasive Bladder Cancer. Int J Radiat Oncol Biol Phys 2021; 110:738-741. [PMID: 33421558 DOI: 10.1016/j.ijrobp.2020.12.033] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/27/2020] [Accepted: 12/22/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE Immune checkpoint programmed death-ligand 1 inhibitor therapy has shown response in metastatic muscle invasive bladder cancer (MIBC). We evaluated the safety and tolerability of atezolizumab (anti-programmed death-ligand 1) in combination with trimodal therapy in patients with localized MIBC. METHODS AND MATERIALS A prospective nonrandomized phase 1 study using a 3 + 3 design was conducted in patients with localized MIBC (T2-T4a N0M0) treated on a bladder preservation program. After transurethral resection of bladder tumor, patients received concurrent radiation therapy at a fixed dose of 50 Gy in 20 fractions, gemcitabine (100 mg/m2, intravenously once weekly for 4 weeks) and atezolizumab (1200 mg intravenously every 3 weeks for 16 cycles). The primary endpoint was safety/toxicity profile. RESULTS Between May 2018 and March 2019, 8 patients (6 male and 2 female) were enrolled. The first 5 patients received atezolizumab at 1200 mg, 3 of whom developed grade 3 side effects (2 of them dose-limiting toxicity). Atezolizumab dose was reduced to 840 mg for 3 additional patients. The study was terminated due to the presence of 3 grade 3 adverse events (2 of which were dose-limiting toxicity) despite the reduced atezolizumab dose. Gastrointestinal events were the main toxicity. No grade 4 to 5 adverse effects were observed. CONCLUSIONS Concurrent administration of atezolizumab with concomitant hypofractionated radiation therapy and gemcitabine appears to be associated with unacceptable gastrointestinal toxicity. Although the numbers studied are small, our results suggest considerable caution with its concurrent use with trimodal therapy for MIBC.
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Affiliation(s)
- Gautier Marcq
- Division of Urology, University Health Centre, McGill University, Montreal, Canada
| | - Luis Souhami
- Division of Radiation Oncology, University Health Centre, McGill University, Montreal, Canada
| | - Fabio L Cury
- Division of Radiation Oncology, University Health Centre, McGill University, Montreal, Canada
| | - Afsar Salimi
- Center of Innovation, University Health Centre, McGill University, Montreal, Canada
| | - Armen Aprikian
- Division of Urology, University Health Centre, McGill University, Montreal, Canada
| | - Simon Tanguay
- Division of Urology, University Health Centre, McGill University, Montreal, Canada
| | - Marie Vanhuyse
- Department of Medical Oncology, University Health Centre, McGill University, Montreal, Canada
| | - Raghu Rajan
- Department of Medical Oncology, University Health Centre, McGill University, Montreal, Canada
| | - Fadi Brimo
- Department of Pathology, University Health Centre, McGill University, Montreal, Canada
| | - José João Mansure
- Division of Urology, University Health Centre, McGill University, Montreal, Canada
| | - Wassim Kassouf
- Division of Urology, University Health Centre, McGill University, Montreal, Canada.
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Hui C, Chau B, Gan G, Stokes W, Karam SD, Amini A. Overcoming Resistance to Immunotherapy in Head and Neck Cancer Using Radiation: A Review. Front Oncol 2021; 11:592319. [PMID: 34277390 PMCID: PMC8280353 DOI: 10.3389/fonc.2021.592319] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 06/21/2021] [Indexed: 12/19/2022] Open
Abstract
Radiation therapy remains at the center of head and neck cancer treatment. With improvements in treatment delivery, radiation therapy has become an affective ablative modality for head and neck cancers. Immune checkpoint inhibitors are now also playing a more active role both in the locally advanced and metastatic setting. With improved systemic options, local noninvasive modalities including radiation therapy are playing a critical role in overcoming resistance in head and neck cancer. The aim of this review is to describe the role of radiation therapy in modulating the tumor microenvironment and how radiation dose, fractionation and treatment field can impact the immune system and potentially effect outcomes when combined with immunotherapy. The review will encompass several common scenarios where radiation is used to improve outcomes and overcome potential resistance that may develop with immunotherapy in head and neck squamous cell carcinoma (HNSCC), including upfront locally advanced disease receiving definitive radiation and recurrent disease undergoing re-irradiation. Lastly, we will review the potential toxicities of combined therapy and future directions of their role in the management of HNSCC.
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Affiliation(s)
- Caressa Hui
- Department of Radiation Oncology, Stanford University, Palo Alto, CA, United States
| | - Brittney Chau
- School of Medicine, New York Medical College, Valhalla, NY, United States
| | - Greg Gan
- Department of Radiation Oncology, University of Kansas, Kansas City, KA, United States
| | - William Stokes
- Department of Radiation Oncology, Emory University, Atlanta, GA, United States
| | - Sana D. Karam
- Department of Radiation Oncology, University of Colorado, Aurora, CO, United States
| | - Arya Amini
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA, United States
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4
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Tumor Microenvironment as A "Game Changer" in Cancer Radiotherapy. Int J Mol Sci 2019; 20:ijms20133212. [PMID: 31261963 PMCID: PMC6650939 DOI: 10.3390/ijms20133212] [Citation(s) in RCA: 276] [Impact Index Per Article: 55.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 06/19/2019] [Accepted: 06/25/2019] [Indexed: 12/24/2022] Open
Abstract
Radiotherapy (RT), besides cancer cells, also affects the tumor microenvironment (TME): tumor blood vessels and cells of the immune system. It damages endothelial cells and causes radiation-induced inflammation. Damaged vessels inhibit the infiltration of CD8+ T lymphocytes into tumors, and immunosuppressive pathways are activated. They lead to the accumulation of radioresistant suppressor cells, including tumor-associated macrophages (TAMs) with the M2 phenotype, myeloid-derived suppressor cells (MDSCs), and regulatory T cells (Tregs). The area of tumor hypoxia increases. Hypoxia reduces oxygen-dependent DNA damage and weakens the anti-cancer RT effect. It activates the formation of new blood vessels and leads to cancer relapse after irradiation. Irradiation may also activate the immune response through immunogenic cell death induction. This leads to the "in situ" vaccination effect. In this article, we review how changes in the TME affect radiation-induced anticancer efficacy. There is a very delicate balance between the activation of the immune system and the immunosuppression induced by RT. The effects of RT doses on immune system reactions and also on tumor vascularization remain unclear. A better understanding of these interactions will contribute to the optimization of RT treatment, which may prevent the recurrence of cancer.
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SONGKAITIWONG KITTIPHOT, LOCHAROENRAT KITSAKORN. COMPUTATIONAL ALGORITHM OF TWO PARALLEL ULTRASOUND BEAMS OF 1D CANCER TISSUE MODEL FOR SAFE AND EFFECTIVE HYPERTHERMIA TREATMENT. J MECH MED BIOL 2019. [DOI: 10.1142/s021951941950012x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The mathematical algorithm of two parallel ultrasound beams on a one-dimensional (1D) cancer tissue model for hyperthermia treatment was created using Matlab software. Physically, the model incorporated two beams; the first beam was permanently placed at the center of the tumor, whereas the other was set between the first beam and the tumor. The computational implementation of this technique relies on the Crank–Nicolson method. This technique is a finite different method that offers an exact heat transfer calculation based on the heat analysis of the heat node structure from a 1D biological tissue model. The Matlab software implementation was composed of two stages: tissue temperature profile calculation and optimization computation. To obtain the tissue temperature profile, the beam heat was varied from 45∘C to 75∘C (seven different levels of heat from the same source), while the second beam was allowed to move between the first beam and the tumor to locations at distances of 1 to 9[Formula: see text]mm (nine positions). The obtained tissue temperature profiles were subsequently analyzed to achieve the optimal time, beam position, and beam heat of the treatment. As a result of the optimization, the best position for the second beam was determined to be 5[Formula: see text]mm from the center of the tumor. Further, all tumor cells were observed to have died, whereas all normal tissues were safe. The optimal time, beam position, and beam heat of the treatment were finally collected to create and fit a mathematical function for further hyperthermia treatment.
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Affiliation(s)
- KITTIPHOT SONGKAITIWONG
- Biomedical Physics Research Unit, Department of Physics, Faculty of Science, King Mongkut’s Institute of Technology Ladkrabang, Bangkok 10520, Thailand
| | - KITSAKORN LOCHAROENRAT
- Biomedical Physics Research Unit, Department of Physics, Faculty of Science, King Mongkut’s Institute of Technology Ladkrabang, Bangkok 10520, Thailand
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Liu J, Zhou J, Wu M, Hu C, Yang J, Li D, Wu P, Chen Y, Chen P, Lin S, Cui Y, Fu S, Wu J. Low-Dose Total Body Irradiation Can Enhance Systemic Immune Related Response Induced by Hypo-Fractionated Radiation. Front Immunol 2019; 10:317. [PMID: 30873170 PMCID: PMC6401363 DOI: 10.3389/fimmu.2019.00317] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 02/06/2019] [Indexed: 12/20/2022] Open
Abstract
A systemic immune related response (SIME) of radiotherapy has been occasionally observed on metastatic tumors, but the clinical outcomes remain poor. Novel treatment approaches are therefore needed to improve SIME ratio. We used a combination of hypo-fractionated radiation therapy (H-RT) with low-dose total body irradiation (L-TBI) in a syngeneic mouse model of breast and colon carcinoma. The combination therapy of H-RT and L-TBI potentially enhanced SIME by infiltration of CD8+ T cell and altering the immunosuppressive microenvironment in non-irradiated subcutaneous tumor lesions. The frequency of IFN-γ, as a tumor-specific CD8+ T cells producing, significantly inhibited the secondary tumor growth of breast and colon. Our findings suggest that L-TBI could serve as a potential therapeutic agent for metastatic breast and colon cancer and, together with H-RT, their therapeutic potential is enhanced significantly.
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Affiliation(s)
- Jing Liu
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Jie Zhou
- Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Min Wu
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - ChuanFei Hu
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Juan Yang
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Dong Li
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Peng Wu
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Yue Chen
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Ping Chen
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Sheng Lin
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - YongXia Cui
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - ShaoZhi Fu
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - JingBo Wu
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
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Rodríguez-Fernández IA, Rodríguez-Romo L, Hernandez-Barajas D, Gonzalez-Conchas GA, Verdines-Perez A, Templeton AJ, Ocana A, Seruga B, Tannock IF, Amir E, Vera-Badillo FE. Adjuvant Radiation Therapy After Radical Nephrectomy in Patients with Localized Renal Cell Carcinoma: A Systematic Review and Meta-analysis. Eur Urol Oncol 2018; 2:448-455. [PMID: 31277782 DOI: 10.1016/j.euo.2018.10.003] [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: 05/04/2018] [Revised: 09/08/2018] [Accepted: 10/06/2018] [Indexed: 01/03/2023]
Abstract
CONTEXT Adjuvant radiation therapy has been recommended for patients at higher risk of relapse from renal cell carcinoma (RCC) to improve disease-free survival (DFS) and overall survival (OS) after radical nephrectomy. OBJECTIVE To quantify the benefit of adjuvant radiation therapy. EVIDENCE ACQUISITION A systematic review of electronic databases identified publications exploring the association between adjuvant radiation therapy and locoregional recurrence (LRR), DFS, and OS among patients after radical nephrectomy for early-stage RCC. Hazard ratios for DFS were weighted and pooled using the generic inverse variance and random effects model. Odds ratios for LRR, DFS, and OS at 5yr were weighted and pooled in a meta-analysis using Mantel-Haenszel random-effects modeling. EVIDENCE SYNTHESIS Twelve studies comprising 1624 patients were included in the analysis. Ten studies were retrospective and two were randomized controlled trials. Adjuvant radiation therapy was delivered to 37% of patients. The median follow-up was 49mo. Adjuvant radiation therapy was not associated with better DFS or OS at 5yr, but was associated with less LRR. CONCLUSIONS With the caveat that confounding by indication may result from pooling data from predominantly nonrandomized studies, adjuvant radiation after radical nephrectomy was not associated with improved DFS or OS but was associated with less LRR. PATIENT SUMMARY Radiation therapy after resection of renal cell carcinoma with a high risk of relapse may reduce the risk of local recurrence but not the risk of disease recurrence or death after 5yr.
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Affiliation(s)
- Iván A Rodríguez-Fernández
- Centro Universitario Contra el Cáncer, Hospital Universitario, Universidad Autónoma de Nuevo León, Monterrey, Mexico; Department of Radiation Oncology, Klinikum rechts der Isar, TU München, Munich, Germany
| | - Laura Rodríguez-Romo
- Centro Universitario Contra el Cáncer, Hospital Universitario, Universidad Autónoma de Nuevo León, Monterrey, Mexico; Department of Medical Oncology, Faculty of Medicine, Queen's University, Kingston, ON, Canada
| | - David Hernandez-Barajas
- Centro Universitario Contra el Cáncer, Hospital Universitario, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Galileo A Gonzalez-Conchas
- Centro Universitario Contra el Cáncer, Hospital Universitario, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Adrian Verdines-Perez
- Centro Universitario Contra el Cáncer, Hospital Universitario, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Arnoud J Templeton
- Department of Medical Oncology, St. Claraspital, Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Alberto Ocana
- Medical Oncology Department and Translational Research Unit, Albacete University Hospital, Castilla La Mancha University, Albacete, Spain
| | - Bostjan Seruga
- Division of Medical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Ian F Tannock
- Division of Medical Oncology & Hematology, Princess Margaret Cancer Centre, Department of Medicine, University of Toronto, Toronto, Canada
| | - Eitan Amir
- Division of Medical Oncology & Hematology, Princess Margaret Cancer Centre, Department of Medicine, University of Toronto, Toronto, Canada
| | - Francisco E Vera-Badillo
- Centro Universitario Contra el Cáncer, Hospital Universitario, Universidad Autónoma de Nuevo León, Monterrey, Mexico; Department of Medical Oncology, Faculty of Medicine, Queen's University, Kingston, ON, Canada.
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Meiers C, Taylor A, Geller B, Toskich B. Safety and initial efficacy of radiation segmentectomy for the treatment of hepatic metastases. J Gastrointest Oncol 2018; 9:311-315. [PMID: 29755770 DOI: 10.21037/jgo.2017.11.02] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background Hepatic metastatectomy and ablation are associated with prolonged survival, but not all lesions are anatomically amenable to these therapies. We evaluated safety and initial efficacy of segmental ablative transarterial radioembolization, or radiation segmentectomy (RS), as a treatment for hepatic metastases. Methods A single institution retrospective analysis was performed of patients with hepatic metastases, determined unamenable to resection by a multidisciplinary tumor board, treated with RS from 2015-2017. Safety parameters evaluated were pre and post procedure liver chemistry, MELD score, ALBI grade, platelet count, and adverse events using both Common Terminology Criteria for Adverse Events (CTCAE) v 4.0 and Clavien Dindo (CD) classifications. Initial efficacy was evaluated using RECIST, mRECIST, and PERCIST criteria. Results Ten patients underwent between 1-3 RS treatments. There was no clinical treatment toxicity or significant post-treatment change in liver chemistry, MELD, or ALBI score. One patient had a CTCAE Grade 1/CD Grade 1 adverse event. All patients showed partial or complete imaging response at initial assessment (1-3 months). Seven patients demonstrated disease control at a mean of 7.1 months post treatment. Three patients developed out of field disease progression. One RS was technically unsuccessful. Conclusions Early evaluation of segmental radioembolization suggests a safe treatment option for select patients with hepatic metastases. Initial efficacy as definitive radiotherapy with minimal toxicity is promising in anatomic locations unamenable to resection or alternative means of ablation.
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Affiliation(s)
- Craig Meiers
- Department of Radiology, University of Florida, College of Medicine, Gainesville, FL, USA
| | - Amy Taylor
- Department of Radiology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Brian Geller
- Department of Radiology, University of Florida, College of Medicine, Gainesville, FL, USA
| | - Beau Toskich
- Department of Radiology, Mayo Clinic, Jacksonville, FL, USA
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Beg MS, Meyer J. Developing rational combinations of immune checkpoint inhibitors and radiation therapy for gastrointestinal cancers. J Gastrointest Oncol 2018; 9:225-230. [PMID: 29564188 DOI: 10.21037/jgo.2017.06.17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Evidence supporting the synergistic antitumor activity of radiation therapy combined with immune checkpoint inhibitors is rapidly growing. Investigators should consider the characteristics and challenges of gastrointestinal (GI) cancers to evaluate the safety and clinical effectiveness of this combination. In this paper, we present the rationale for exploring this strategy and the opportunities it possesses to challenge our standard of care. We also discuss unique considerations to systematically develop this combination in GI cancers.
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Affiliation(s)
- Muhammad Shaalan Beg
- Division of Hematology and Medical Oncology, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, USA.,Harold Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX, USA
| | - Jeffrey Meyer
- Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, TX, USA
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Du J, Su S, Li H, Shao J, Meng F, Yang M, Qian H, Zou Z, Qian X, Liu B. Low dose irradiation increases adoptive cytotoxic T lymphocyte migration in gastric cancer. Exp Ther Med 2017; 14:5711-5716. [PMID: 29285113 PMCID: PMC5740708 DOI: 10.3892/etm.2017.5305] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 02/03/2017] [Indexed: 01/09/2023] Open
Abstract
Adoptive cellular immunotherapy (ACI) has been demonstrated to be a promising cancer therapeutic; however, the inefficient migration of adoptive immune cells to tumors is one of the rate-limiting factors of ACI. The present study investigated whether 2 Gy low dose irradiation (LDI) was able to increase the migration of adoptive lymphocytes to gastric cancer cells. Treatment with 2 Gy LDI resulted in marked chemokine (C-X-C motif) ligand 9 (CXCL9) and CXCL10 production from gastric cancer cell lines. A Transwell chamber migration assay demonstrated enhanced transmigration of cytotoxic T lymphocytes to gastric cancer cells following LDI treatment. After 2 Gy LDI application to established gastric carcinoma in nude mice, labeled immune cells were infused by intravenous injection and concentrated fluorescence signals were observed at the tumor sites within the mice, with a peak signal at 8-h LDI. Increased numbers of adoptive T cells at the tumor sites were also observed using flow cytometry. Furthermore, a case study of a patient with metastatic gastric cancer who had received ACI treatment combined with 2 Gy LDI provided further evidence that 2 Gy LDI is able to recruit antitumor effector T cells to tumor sites. Therefore, the ability of 2 Gy LDI to convert tumors into inflamed peripheral tissues may be exploited to overcome obstacles at the effector phase of the antitumor immune response and improve the therapeutic efficacy of immunotherapy.
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Affiliation(s)
- Juan Du
- The Comprehensive Cancer Center of Drum Tower Hospital, The Affiliated Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing, Jiangsu 210008, P.R. China
| | - Shu Su
- The Comprehensive Cancer Center of Drum Tower Hospital, The Affiliated Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing, Jiangsu 210008, P.R. China
| | - Hongyan Li
- The Comprehensive Cancer Center of Drum Tower Hospital, The Affiliated Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing, Jiangsu 210008, P.R. China
| | - Jie Shao
- The Comprehensive Cancer Center of Drum Tower Hospital, The Affiliated Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing, Jiangsu 210008, P.R. China
| | - Fanyan Meng
- The Comprehensive Cancer Center of Drum Tower Hospital, The Affiliated Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing, Jiangsu 210008, P.R. China
| | - Mi Yang
- The Comprehensive Cancer Center of Drum Tower Hospital, The Affiliated Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing, Jiangsu 210008, P.R. China
| | - Hanqing Qian
- The Comprehensive Cancer Center of Drum Tower Hospital, The Affiliated Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing, Jiangsu 210008, P.R. China
| | - Zhengyun Zou
- The Comprehensive Cancer Center of Drum Tower Hospital, The Affiliated Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing, Jiangsu 210008, P.R. China
| | - Xiaoping Qian
- The Comprehensive Cancer Center of Drum Tower Hospital, The Affiliated Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing, Jiangsu 210008, P.R. China
| | - Baorui Liu
- The Comprehensive Cancer Center of Drum Tower Hospital, The Affiliated Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing, Jiangsu 210008, P.R. China
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11
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Prieto I, Montemuiño S, Luna J, de Torres MV, Amaya E. The role of immunonutritional support in cancer treatment: Current evidence. Clin Nutr 2016; 36:1457-1464. [PMID: 27931879 DOI: 10.1016/j.clnu.2016.11.015] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 11/12/2016] [Accepted: 11/14/2016] [Indexed: 01/01/2023]
Abstract
The significant role of the immune system in cancer treatment has given rise to an emerging field of study within oncology, and one that is attracting increasing attention from researchers. Immunotherapy has demonstrated that the immune system is crucial in the fight against cancer. This challenge has led researchers to analyze whether the immune influencing capacity of immunonutrition may aid in improving immune status, modulate the acquired immune response, decrease the treatment toxicity and improve patient outcomes. Immunonutrition, new developed formulas has been demonstrated to improve outcome in surgical patients. This improvement is related to the modulation of the inflammatory response in the peri-operative period. The aim of this review is to analyze current evidence on the benefit of immunonutrition in patients undergoing pro-inflammatory processes in cancer, such as receiving chemotherapy or radiation treatment. With this aim, authors have analyzed the problem studying different aspects: the role of the immune system in cancer treatment, current evidence regarding immunonutrition in perioperative period, current evidence regarding immunonutrition in cancer patients and the relation between immunity and radiotherapy. The conclusions of this review confirm that immunonutrition formulas could modulate inflammatory and immune response in cancer patients. This effect decreases acute toxicity, although the pathways and the measure of this immune response are unclear. Immunonutrition is an emerging field in oncology, and further research is needed.
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Affiliation(s)
- Isabel Prieto
- Radiation Oncology Department, Fundacion Jimenez Diaz, Oncohealth Institute, Avda. Reyes Católicos 2, 28040 Madrid, Spain.
| | - Sara Montemuiño
- Radiation Oncology Department, Hospital Universitario de Fuenlabrada, Calle Camino del Molino, 2, 28942 Fuenlabrada, Madrid, Spain.
| | - Javier Luna
- Radiation Oncology Department, Fundacion Jimenez Diaz, Oncohealth Institute, Avda. Reyes Católicos 2, 28040 Madrid, Spain.
| | - Maria Victoria de Torres
- Radiation Oncology Department, Hospital Universitario de Fuenlabrada, Calle Camino del Molino, 2, 28942 Fuenlabrada, Madrid, Spain.
| | - Enrique Amaya
- Radiation Oncology Department, Hospital Universitario Rey Juan Carlos I, C/ Gladiolo, s/n, 28933 Móstoles, Madrid, Spain.
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The role of immune system exhaustion on cancer cell escape and anti-tumor immune induction after irradiation. Biochim Biophys Acta Rev Cancer 2016; 1865:168-75. [PMID: 26868867 DOI: 10.1016/j.bbcan.2016.02.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 02/05/2016] [Accepted: 02/06/2016] [Indexed: 12/14/2022]
Abstract
Immune surveillance seems to represent an effective tumor suppressor mechanism. However, some cancer cells survive and become variants, being poorly immunogenic and able to enter a steady-state phase. These cells become functionally dormant or remain hidden clinically throughout. Neoplastic cells seem to be able to instruct immune cells to undergo changes promoting malignancy. Radiotherapy may act as a trigger of the immune response. After radiotherapy a sequence of reactions occurs, starting in the damage of oncogenic cells by multiple mechanisms, leading to the immune system positive feedback against the tumor. The link between radiotherapy and the immune system is evident. T cells, macrophages, Natural Killer cells and other immune cells seem to have a key role in controlling the tumor. T cells may be dysfunctional and remain in a state of T cell exhaustion, nonetheless, they often retain a high potential for successful defense against cancer, being able to be mobilized to become highly functional. The lack of clinical trials on a large scale makes data a little robust, in spite of promising information, there are still many variables in the studies relating to radiation and immune system. The clarification of the mechanisms underlying immune response to radiation exposure may contribute to treatment improvement, gain of life quality and span of patients.
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Smilowitz HM, Micca PL, Sasso D, Wu Q, Dyment N, Xue C, Kuo L. Increasing radiation dose improves immunotherapy outcome and prolongation of tumor dormancy in a subgroup of mice treated for advanced intracerebral melanoma. Cancer Immunol Immunother 2016; 65:127-39. [PMID: 26660339 PMCID: PMC11028885 DOI: 10.1007/s00262-015-1772-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 11/06/2015] [Indexed: 12/14/2022]
Abstract
Previously, we developed a clinically relevant therapy model for advanced intracerebral B16 melanomas in syngeneic mice combining radiation and immunotherapies. Here, 7 days after B16-F10-luc2 melanoma cells were implanted intracerebrally (D7), syngeneic mice with bioluminescent tumors that had formed (1E10(5) to 7E10(6) photons per minute (>1E10(6), large; <1E10(6), small) were segregated into large-/small-balanced subgroups. Then, mice received either radiation therapy alone (RT) or radiation therapy plus immunotherapy (RT plus IT) (single injection of mAbPC61 to deplete regulatory T cells followed by multiple injections of irradiated granulocyte macrophage colony stimulating factor transfected B16-F10 cells) (RT plus IT). Radiation dose was varied (15, 18.75 or 22.5 Gy, given on D8), while immunotherapy was provided similarly to all mice. The data support the hypothesis that increasing radiation dose improves the outcome of immunotherapy in a subgroup of mice. The tumors that were greatly delayed in beginning their progressive growth were bioluminescent in vivo-some for many months, indicating prolonged tumor "dormancy," in some cases presaging long-term cures. Mice bearing such tumors had far more likely received radiation plus immunotherapy, rather than RT alone. Radiotherapy is a very important adjunct to immunotherapy; the greater the tumor debulking by RT, the greater should be the benefit to tumor immunotherapy.
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Affiliation(s)
- Henry M Smilowitz
- Department of Cell Biology, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT, 06030, USA.
| | - Peggy L Micca
- Department of Biology, Brookhaven National Laboratory, Upton, NY, 11973, USA
| | - Daniel Sasso
- Department of Cell Biology, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT, 06030, USA
| | - Qian Wu
- Department of Anatomic Pathology and Laboratory Medicine, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT, 06030, USA
| | - Nathanial Dyment
- Department of Reconstructive Sciences, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT, 06030, USA
| | - Crystal Xue
- Department of Cell Biology, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT, 06030, USA
| | - Lynn Kuo
- Department of Statistics, University of Connecticut, 215 Glenbrook Road, Storrs, CT, 06269-4120, USA
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Hietanen T, Pitkänen M, Kapanen M, Kellokumpu-Lehtinen PL. Post-irradiation viability and cytotoxicity of natural killer cells isolated from human peripheral blood using different methods. Int J Radiat Biol 2015; 92:71-9. [PMID: 26634866 DOI: 10.3109/09553002.2016.1115136] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Purpose We compared the pre- and post-irradiation viability and cytotoxicity of human peripheral natural killer cell (NK) populations obtained using different isolation methods. Material and methods Three methods were used to enrich total NK cells from buffy coats: (I) a Ficoll-Paque gradient, plastic adherence and a nylon wool column; (II) a discontinuous Percoll gradient; or (III) the Dynal NK cell isolation kit. Subsequently, CD16(+) and CD56(+) NK cell subsets were collected using (IV) flow cytometry or (V) magnetic-activated cell sorting (MACS) NK cell isolation kits. The yield, viability, purity and cytotoxicity of the NK cell populations were measured using trypan blue exclusion, flow cytometry using propidium iodide and (51)Cr release assays after enrichments as well as viability and cytotoxicity after a single radiation dose. Results The purity of the preparations, as measured by the CD16(+) and CD56(+) cell content, was equally good between methods I-III (p = 0.323), but the content of CD16(+) and CD56(+) cells using these methods was significantly lower than that using methods IV and V (p = 0.005). The viability of the cell population enriched via flow cytometry (85.5%) was significantly lower than that enriched via other methods (99.4-98.0%, p = 0.003). The cytotoxicity of NK cells enriched using methods I-III was significantly higher than that of NK cells enriched using methods IV and V (p = 0.000). In vitro the NK cells did not recover cytotoxic activity following irradiation. In addition, we detected considerable inter-individual variation in yield, cytotoxicity and radiation sensitivity between the NK cells collected from different human donors. Conclusions The selection of the appropriate NK cell enrichment method is very important for NK cell irradiation studies. According to our results, the Dynal and MACS NK isolation kits best retained the killing capacity and the viability of irradiated NK cells.
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Affiliation(s)
- Tenho Hietanen
- a Department of Oncology , School of Medicine, University of Tampere , Tampere
| | - Maunu Pitkänen
- b Department of Oncology , Tampere University Hospital , Tampere , Finland ;,c Department of Medical Physics , Tampere University Hospital , Tampere , Finland
| | - Mika Kapanen
- b Department of Oncology , Tampere University Hospital , Tampere , Finland ;,c Department of Medical Physics , Tampere University Hospital , Tampere , Finland
| | - Pirkko-Liisa Kellokumpu-Lehtinen
- a Department of Oncology , School of Medicine, University of Tampere , Tampere ;,b Department of Oncology , Tampere University Hospital , Tampere , Finland
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