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Neoadjuvant Chemotherapy Improves the Immunosuppressive Microenvironment of Bladder Cancer and Increases the Sensitivity to Immune Checkpoint Blockade. J Immunol Res 2022; 2022:9962397. [PMID: 35915657 PMCID: PMC9338739 DOI: 10.1155/2022/9962397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/20/2022] [Accepted: 06/23/2022] [Indexed: 12/24/2022] Open
Abstract
Although tumor immune microenvironment plays an important role in antitumor therapy, few studies explored the gene signatures associated with the tumor immune microenvironment of bladder cancer after neoadjuvant chemotherapy. We examined and analyzed differentially expressed genes from 9 patients with stage I-III bladder cancer by RNA immune-oncology profiling platform. After neoadjuvant chemotherapy, the expressions of 43 genes in 19 pathways and 10 genes in 5 pathways were upregulated and downregulated, respectively. Neoadjuvant chemotherapy also promoted the expression of genes related to the activation of antitumor immune responses and decreased the expression of genes related to tumor proliferation pathways. In addition, neoadjuvant chemotherapy improved tumor response to immune checkpoint blockade. Furthermore, this study also identified several genes that can be used to predict the efficacy of neoadjuvant chemotherapy and their possible molecular mechanisms. In conclusion, neoadjuvant chemotherapy may promote the activation of antitumor effects, improve the suppressive tumor immune microenvironment, and increase the sensitivity of bladder cancer to immune checkpoint blockade.
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Modified Immunoscore Improves Prediction of Survival Outcomes in Patients Undergoing Radical Cystectomy for Bladder Cancer—A Retrospective Digital Pathology Study. Diagnostics (Basel) 2022; 12:diagnostics12061360. [PMID: 35741170 PMCID: PMC9222135 DOI: 10.3390/diagnostics12061360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/20/2022] [Accepted: 05/29/2022] [Indexed: 12/30/2022] Open
Abstract
To evaluate the prognostic value of a modified Immunoscore (mIS) in a cohort of bladder cancer (BC) patients undergoing radical cystectomy (RC), two tissue microarrays of 159 BC patients were immunohistochemically stained for CD3/CD8/FOXP3 and CD45RO to detect Tumor-Infiltrating Lymphocytes (TIL). To predict progression free survival (PFS) and cancer specific survival (CSS), a predictive model cumulatively incorporating all four components was constructed and labeled as mIS. Patients were stratified into two risk groups; “high mIS/favorable risk” and “low mIS/unfavorable risk”. Kaplan–Meier analysis was used to test mIS within each American Joint Committee on Cancer (AJCC) stage group for BC. In a univariable cox regression analysis all single components used for mIS, showed a significant association with CSS. Patients with high mIS (all components) in the AJCC stage IIIa group additionally showed a significantly longer PFS (Hazard Ratio (HR): 2.7; p = 0.008) and CSS (HR: 3.5; p = 0.006) as compared to patients with low mIS. mIS is of prognostic value in BC patients undergoing RC and was able to stratify patients within AJCC stage IIIa and might thus serve as a prognostic marker to guide risk-adapted treatment or follow-up strategies after RC.
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A novel 6-gene signature derived from tumor-infiltrating T cells and neutrophils predicts survival of bladder urothelial carcinoma. Aging (Albany NY) 2021; 13:25496-25517. [PMID: 34905506 PMCID: PMC8714163 DOI: 10.18632/aging.203770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 12/03/2021] [Indexed: 12/25/2022]
Abstract
Intratumoral immune cells were reported to be associated with prognosis of bladder urothelial carcinoma (BUC). However, the role of immune cells related genes in BUC prognosis is less well defined. In the study, we analyzed data retrieved from the Cancer Genome Atlas database and found higher neutrophils and lower T cells infiltration in BUC tumor tissues were significantly correlated with patients’ worse prognosis. Additionally, the expression levels of 164 genes were significantly correlated with T cells and neutrophils proportions. A Cox proportional-hazards model integrating 6 genes expression (EMP1, RASGRP4, HSPA1L, AHNAK, SLC1A6, and PRSS8) was identified. The 6-gene signature outperformed other clinical factors in risk prediction and was an independent prognostic factor for BUC. The findings were further conformed in three Gene Expression Omnibus datasets (n=331) and Jiangsu Province Hospital cohort (n = 46). Gene set enrichment analysis revealed that the model was highly involved in some immune-related pathways. A comprehensive nomogram combining the model and other clinical parameters was finally constructed to facilitate clinical application. In conclusion, a T cell and neutrophil-associated 6-gene prognostic model was identified for the survival prediction of BUC patients.
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Links between Infections, Lung Cancer, and the Immune System. Int J Mol Sci 2021; 22:ijms22179394. [PMID: 34502312 PMCID: PMC8431665 DOI: 10.3390/ijms22179394] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 08/25/2021] [Accepted: 08/25/2021] [Indexed: 12/25/2022] Open
Abstract
Lung cancer is the leading disease of cancer-related deaths worldwide. Since the beginning of the 20th century, various infectious agents associated with lung cancer have been identified. The mechanisms that include systemic inflammatory pathways as effect of microbial persistence in the lung can secondarily promote the development of lung carcinogenesis. Chronic inflammation associated with lung-cancer infections is known to precede tumor development, and it has a strong effect on the response(s) to therapy. In fact, both viral and bacterial infections can activate inflammatory cells and inflammatory signaling pathways. In this review, an overview of critical findings of recent studies investigating associations between each of viral and bacterial pathogens and lung carcinoma is provided, with particular emphasis on how infectious organisms can interfere with oncogenic processes and all the way through immunity. Moreover, a discussion of the direct crosstalk between lung tumor development and inflammatory processes is also presented.
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Hülsen S, Lippolis E, Ferrazzi F, Otto W, Distel L, Fietkau R, Denzinger S, Breyer J, Burger M, Bertz S, Eckstein M, Ebner A, Hartmann A, Geppert CI. High Stroma T-Cell Infiltration is Associated with Better Survival in Stage pT1 Bladder Cancer. Int J Mol Sci 2020; 21:E8407. [PMID: 33182484 PMCID: PMC7665154 DOI: 10.3390/ijms21218407] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 10/30/2020] [Accepted: 11/04/2020] [Indexed: 12/24/2022] Open
Abstract
Stage pT1 bladder cancer (BC) shows highly diverse outcomes. Predictive markers are required to stratify patients for personalized treatment. The present study aimed to validate immune response quantification as a prognostic marker. Patients with pT1 BC (n = 167) treated by transurethral resection of the bladder (TURB) were enrolled. Formaldehyde-fixed paraffin-embedded material was stained for CD3 and CD8. Corresponding T cells were counted in three regions with the highest immune response. Numbers of tertiary lymphoid structures (TLS) and lymphocyte aggregates (LA) were quantified. High CD3+ stroma T-cell infiltration was associated with improved survival (p = 0.045), especially in the G3 subgroup (p = 0.01). Cluster with higher immune response showed less recurrence (p = 0.034) and favorable overall survival (OS) (p = 0.019). In contrast, higher CD3+ and CD8+ tumor T-cell infiltration seemed to have a negative impact on prognosis. TLS and LA were more frequently observed in G3 tumors, indicating an increased anti-tumoral immune response. We proved the role of immune cell infiltration and showed that higher infiltration numbers of CD3+ (not CD8+) lymphocytes in the stroma are associated with favorable outcome. Immune cell quantification could be used as a marker to help stratify patients' risk and therefore, to optimize patients' management and follow-up examination as well as possible therapies.
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Affiliation(s)
- Sabine Hülsen
- Institute of Pathology, Friedrich-Alexander-University, Erlangen-Nürnberg, 91054 Erlangen, Germany; (S.H.); (F.F.); (S.B.); (M.E.); (A.E.); (A.H.)
| | - Eleonora Lippolis
- Institute of Human Genetics, Friedrich-Alexander-University, Erlangen-Nürnberg, 91054 Erlangen, Germany;
| | - Fulvia Ferrazzi
- Institute of Pathology, Friedrich-Alexander-University, Erlangen-Nürnberg, 91054 Erlangen, Germany; (S.H.); (F.F.); (S.B.); (M.E.); (A.E.); (A.H.)
- Institute of Human Genetics, Friedrich-Alexander-University, Erlangen-Nürnberg, 91054 Erlangen, Germany;
- Department of Nephropathology, Institute of Pathology, Friedrich-Alexander-University, Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Wolfgang Otto
- Caritas St. Josef Medical Center, Department of Urology, Regensburg University, 93053 Regensburg, Germany; (W.O.); (S.D.); (J.B.); (M.B.)
| | - Luitpold Distel
- Department of Radiation Therapy, Friedrich-Alexander-University, Erlangen-Nürnberg, 91054 Erlangen, Germany; (L.D.); (R.F.)
| | - Rainer Fietkau
- Department of Radiation Therapy, Friedrich-Alexander-University, Erlangen-Nürnberg, 91054 Erlangen, Germany; (L.D.); (R.F.)
| | - Stefan Denzinger
- Caritas St. Josef Medical Center, Department of Urology, Regensburg University, 93053 Regensburg, Germany; (W.O.); (S.D.); (J.B.); (M.B.)
| | - Johannes Breyer
- Caritas St. Josef Medical Center, Department of Urology, Regensburg University, 93053 Regensburg, Germany; (W.O.); (S.D.); (J.B.); (M.B.)
| | - Maximilian Burger
- Caritas St. Josef Medical Center, Department of Urology, Regensburg University, 93053 Regensburg, Germany; (W.O.); (S.D.); (J.B.); (M.B.)
| | - Simone Bertz
- Institute of Pathology, Friedrich-Alexander-University, Erlangen-Nürnberg, 91054 Erlangen, Germany; (S.H.); (F.F.); (S.B.); (M.E.); (A.E.); (A.H.)
| | - Markus Eckstein
- Institute of Pathology, Friedrich-Alexander-University, Erlangen-Nürnberg, 91054 Erlangen, Germany; (S.H.); (F.F.); (S.B.); (M.E.); (A.E.); (A.H.)
| | - Annette Ebner
- Institute of Pathology, Friedrich-Alexander-University, Erlangen-Nürnberg, 91054 Erlangen, Germany; (S.H.); (F.F.); (S.B.); (M.E.); (A.E.); (A.H.)
| | - Arndt Hartmann
- Institute of Pathology, Friedrich-Alexander-University, Erlangen-Nürnberg, 91054 Erlangen, Germany; (S.H.); (F.F.); (S.B.); (M.E.); (A.E.); (A.H.)
| | - Carol-I. Geppert
- Institute of Pathology, Friedrich-Alexander-University, Erlangen-Nürnberg, 91054 Erlangen, Germany; (S.H.); (F.F.); (S.B.); (M.E.); (A.E.); (A.H.)
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6
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Peng YL, Wu ZS, Lu HM, Wei WS, Xiong LB, Yu CP, Liu ZF, Li XD, Jiang LJ, Li YH, Liu ZW, Zhang ZL, Zhou FJ. Prognostic significance of tumor-infiltrating immune cells in muscle-invasive bladder cancer. Am J Transl Res 2020; 12:6524-6536. [PMID: 33194049 PMCID: PMC7653560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 09/17/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Muscle-invasive bladder cancer (MIBC) is a lethal disease with poor treatment response and a high death rate. Immune cells infiltrating the tumor tissues have been shown to play a vital role in tumorigenesis and tumor progression, but their prognostic significance in MIBC remains unclear. OBJECTIVES To explore the landscape and prognostic significance of tumor-infiltrating immune cells (TIICs) in MIBC, and to develop a model to improve the prognostic predictions of MIBC. METHODS AND MATERIALS The gene expression profile and clinical data of MIBC patients were downloaded from the Gene Expression Omnibus and The Cancer Genome Atlas portal. The fractions of 22 TIIC subtypes were calculated using the Cell Type Identification by Estimating Relative Subsets of RNA Transcripts (CIBERSORT) algorithm. A TIICs-based model was constructed using least absolute shrinkage and selection operator (LASSO) Cox regression in a training cohort and validated in the validation cohort. RESULTS Ten types of TIICs demonstrated different infiltration abundance between MIBC and normal tissue. We also found 11 types of TIICs that were significantly associated with overall survival (OS). A TIICs-based model was established, consisting of 15 types of immune cells, and an immunoscore was calculated. Significant differences in OS were found between the high and low immunoscore groups, in both training (n = 343) and validation (n = 146) cohorts. The model could identify patients who would have worse OS despite having similar clinical characteristics. Furthermore, multivariate analysis identified the immunoscore as an independent risk factor (hazard ratio, 3.23; 95% confidence interval; 2.22-4.70) for OS in MIBC patients. CONCLUSION The landscape of immune infiltration is different between MIBC and normal tissue. The TIICs-based model could provide promising predictive value to complement the existing staging system for predicting the OS of MIBC patients.
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Affiliation(s)
- Yu-Lu Peng
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterGuangzhou, P. R. China
- Department of Urology, Sun Yat-sen University Cancer CenterGuangzhou, P. R. China
| | - Ze-Shen Wu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterGuangzhou, P. R. China
- Department of Urology, Sun Yat-sen University Cancer CenterGuangzhou, P. R. China
| | - Hui-Ming Lu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterGuangzhou, P. R. China
- Department of Urology, Sun Yat-sen University Cancer CenterGuangzhou, P. R. China
| | - Wen-Su Wei
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterGuangzhou, P. R. China
- Department of Urology, Sun Yat-sen University Cancer CenterGuangzhou, P. R. China
| | - Long-Bin Xiong
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterGuangzhou, P. R. China
- Department of Urology, Sun Yat-sen University Cancer CenterGuangzhou, P. R. China
| | - Chun-Ping Yu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterGuangzhou, P. R. China
- Department of Urology, Sun Yat-sen University Cancer CenterGuangzhou, P. R. China
| | - Ze-Fu Liu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterGuangzhou, P. R. China
- Department of Urology, Sun Yat-sen University Cancer CenterGuangzhou, P. R. China
| | - Xiang-Dong Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterGuangzhou, P. R. China
- Department of Urology, Sun Yat-sen University Cancer CenterGuangzhou, P. R. China
| | - Li-Juan Jiang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterGuangzhou, P. R. China
- Department of Urology, Sun Yat-sen University Cancer CenterGuangzhou, P. R. China
| | - Yong-Hong Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterGuangzhou, P. R. China
- Department of Urology, Sun Yat-sen University Cancer CenterGuangzhou, P. R. China
| | - Zhuo-Wei Liu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterGuangzhou, P. R. China
- Department of Urology, Sun Yat-sen University Cancer CenterGuangzhou, P. R. China
| | - Zhi-Ling Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterGuangzhou, P. R. China
- Department of Urology, Sun Yat-sen University Cancer CenterGuangzhou, P. R. China
| | - Fang-Jian Zhou
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterGuangzhou, P. R. China
- Department of Urology, Sun Yat-sen University Cancer CenterGuangzhou, P. R. China
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7
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Blessin NC, Spriestersbach P, Li W, Mandelkow T, Dum D, Simon R, Hube-Magg C, Lutz F, Viehweger F, Lennartz M, Fraune C, Nickelsen V, Fehrle W, Göbel C, Weidemann S, Clauditz T, Lebok P, Möller K, Steurer S, Izbicki JR, Sauter G, Minner S, Jacobsen F, Luebke AM, Büscheck F, Höflmayer D, Wilczak W, Burandt E, Hinsch A. Prevalence of CD8 + cytotoxic lymphocytes in human neoplasms. Cell Oncol (Dordr) 2020; 43:421-430. [PMID: 32141029 PMCID: PMC7214387 DOI: 10.1007/s13402-020-00496-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2020] [Indexed: 12/17/2022] Open
Abstract
PURPOSE Immune checkpoint inhibitors have recently been approved by the US FDA as first and/or second line therapy in a subset of cancer types. Recent evidence suggests that the quantity of tumor infiltrating lymphocytes (TILs) influences the likelihood of response to immune checkpoint inhibitors. Here, we set out to assess the density of CD8+ lymphocytes in a wide range of different cancer types and subtypes. METHODS The density of CD8+ lymphocytes was compared across different cancer types using tissue microarrays (TMAs) composed of up to 50 tumor samples each from 84 different cancer types and subtypes. In total 2652 cancers and 608 normal tissues were successfully analyzed by CD8 immunohistochemistry followed by automated image analysis of digitized slides. RESULTS We found that the median CD8+ lymphocyte counts ranged from 6 cells/mm2 in pleomorphic adenoma up to 1573 cells/mm2 in Hodgkin's lymphoma. The CD8 counts were generally lower in normal tissues compared to cancer tissues. Blood vessels of the spleen were the only non-lymphatic tissue staining positive for CD8. Tumor types approved for checkpoint inhibitor therapy, including malignant melanoma (81), muscle invasive urothelial carcinoma (119), small cell lung cancer (120), clear cell renal cell cancer (153), squamous cell carcinoma (189) and adenocarcinoma of the lung (328) as well as Hodgkin's lymphoma (1573) were all ranking among the upper half of our list. Comparably high CD8 densities (median cells/mm2) were also found in several rare and aggressive cancer types including Merkel cell carcinoma (70), angiosarcoma (95), anaplastic thyroid cancer (156) and embryonal carcinoma of the testis (186). In 73 of the 84 analyzed cancer types, the highly variable CD8 counts occasionally exceeded the average CD8 count of tumors for which checkpoint inhibitors have been approved. CONCLUSION These data support the concept that among most tumor types at least some individual cancers may benefit from treatment with immune checkpoint inhibitors.
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Affiliation(s)
- Niclas C Blessin
- Institute of Pathology, Martinistraße 52, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany
| | - Patrick Spriestersbach
- Institute of Pathology, Martinistraße 52, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany
| | - Wenchao Li
- Institute of Pathology, Martinistraße 52, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany
| | - Tim Mandelkow
- Institute of Pathology, Martinistraße 52, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany
| | - David Dum
- Institute of Pathology, Martinistraße 52, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany
| | - Ronald Simon
- Institute of Pathology, Martinistraße 52, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany.
| | - Claudia Hube-Magg
- Institute of Pathology, Martinistraße 52, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany
| | - Florian Lutz
- Institute of Pathology, Martinistraße 52, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany
| | - Florian Viehweger
- Institute of Pathology, Martinistraße 52, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany
| | - Maximillian Lennartz
- Institute of Pathology, Martinistraße 52, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany
| | - Christoph Fraune
- Institute of Pathology, Martinistraße 52, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany
| | - Vera Nickelsen
- Institute of Pathology, Martinistraße 52, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany
| | - Wilfried Fehrle
- Institute of Pathology, Martinistraße 52, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany
| | - Cosima Göbel
- Institute of Pathology, Martinistraße 52, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany
| | - Sören Weidemann
- Institute of Pathology, Martinistraße 52, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany
| | - Till Clauditz
- Institute of Pathology, Martinistraße 52, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany
| | - Patrick Lebok
- Institute of Pathology, Martinistraße 52, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany
| | - Katharina Möller
- Institute of Pathology, Martinistraße 52, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany
| | - Stefan Steurer
- Institute of Pathology, Martinistraße 52, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany
| | - Jacob R Izbicki
- Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Guido Sauter
- Institute of Pathology, Martinistraße 52, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany
| | - Sarah Minner
- Institute of Pathology, Martinistraße 52, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany
| | - Frank Jacobsen
- Institute of Pathology, Martinistraße 52, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany
| | - Andreas M Luebke
- Institute of Pathology, Martinistraße 52, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany
| | - Franziska Büscheck
- Institute of Pathology, Martinistraße 52, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany
| | - Doris Höflmayer
- Institute of Pathology, Martinistraße 52, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany
| | - Waldemar Wilczak
- Institute of Pathology, Martinistraße 52, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany
| | - Eike Burandt
- Institute of Pathology, Martinistraße 52, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany
| | - Andrea Hinsch
- Institute of Pathology, Martinistraße 52, University Medical Center Hamburg-Eppendorf, D-20246, Hamburg, Germany
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8
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Competitive glucose metabolism as a target to boost bladder cancer immunotherapy. Nat Rev Urol 2020; 17:77-106. [PMID: 31953517 DOI: 10.1038/s41585-019-0263-6] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2019] [Indexed: 12/24/2022]
Abstract
Bladder cancer - the tenth most frequent cancer worldwide - has a heterogeneous natural history and clinical behaviour. The predominant histological subtype, urothelial bladder carcinoma, is characterized by high recurrence rates, progression and both primary and acquired resistance to platinum-based therapy, which impose a considerable economic burden on health-care systems and have substantial effects on the quality of life and the overall outcomes of patients with bladder cancer. The incidence of urothelial tumours is increasing owing to population growth and ageing, so novel therapeutic options are vital. Based on work by The Cancer Genome Atlas project, which has identified targetable vulnerabilities in bladder cancer, immune checkpoint inhibitors (ICIs) have arisen as an effective alternative for managing advanced disease. However, although ICIs have shown durable responses in a subset of patients with bladder cancer, the overall response rate is only ~15-25%, which increases the demand for biomarkers of response and therapeutic strategies that can overcome resistance to ICIs. In ICI non-responders, cancer cells use effective mechanisms to evade immune cell antitumour activity; the overlapping Warburg effect machinery of cancer and immune cells is a putative determinant of the immunosuppressive phenotype in bladder cancer. This energetic interplay between tumour and immune cells leads to metabolic competition in the tumour ecosystem, limiting nutrient availability and leading to microenvironmental acidosis, which hinders immune cell function. Thus, molecular hallmarks of cancer cell metabolism are potential therapeutic targets, not only to eliminate malignant cells but also to boost the efficacy of immunotherapy. In this sense, integrating the targeting of tumour metabolism into immunotherapy design seems a rational approach to improve the therapeutic efficacy of ICIs.
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9
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Approaches to treat immune hot, altered and cold tumours with combination immunotherapies. Nat Rev Drug Discov 2019; 18:197-218. [PMID: 30610226 DOI: 10.1038/s41573-018-0007-y] [Citation(s) in RCA: 1927] [Impact Index Per Article: 385.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Immunotherapies are the most rapidly growing drug class and have a major impact in oncology and on human health. It is increasingly clear that the effectiveness of immunomodulatory strategies depends on the presence of a baseline immune response and on unleashing of pre-existing immunity. Therefore, a general consensus emerged on the central part played by effector T cells in the antitumour responses. Recent technological, analytical and mechanistic advances in immunology have enabled the identification of patients who are more likely to respond to immunotherapy. In this Review, we focus on defining hot, altered and cold tumours, the complexity of the tumour microenvironment, the Immunoscore and immune contexture of tumours, and we describe approaches to treat such tumours with combination immunotherapies, including checkpoint inhibitors. In the upcoming era of combination immunotherapy, it is becoming critical to understand the mechanisms responsible for hot, altered or cold immune tumours in order to boost a weak antitumour immunity. The impact of combination therapy on the immune response to convert an immune cold into a hot tumour will be discussed.
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10
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Selvi I, Demirci U, Bozdogan N, Basar H. The prognostic effect of immunoscore in patients with clear cell renal cell carcinoma: preliminary results. Int Urol Nephrol 2019; 52:21-34. [PMID: 31541404 DOI: 10.1007/s11255-019-02285-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 09/14/2019] [Indexed: 12/21/2022]
Abstract
PURPOSE This study aimed to evaluate the density of CD8+ and CD3+ tumor-infiltrating lymphocytes (TILs) and determine whether the immunoscore has any prognostic effect on the oncological outcomes in patients with clear cell renal cell carcinoma (RCC). MATERIALS AND METHODS A total of 129 patients diagnosed with clear cell RCC following radical or partial nephrectomy between 2009 and 2014 were retrospectively analyzed. Both tumor core (CT) and the invasive margin of nephrectomy specimens were assessed. The specimens were immunostained for anti-CD8+ and anti-CD3+ TILs. The patients were divided into three groups (favorable, intermediate, and poor risk) according to immunoscore levels. RESULTS In the multivariate analysis, a favorable immunoscore (I3-4) was associated with prolonged disease-free survival (DFS), progression-free survival (PFS), and overall survival (OS) (HR 2.652, 2.848, and 2.933, respectively; all p < 0.001). The lower Fuhrman grade and pathological tumor-node-metastasis (TNM) stage had better DFS, PFS, and OS, whereas prolonged PFS was associated with a higher density of CD8+ CT (HR 1.602, 95% CI 0.934-3.470; p = 0.014). The shorter DFS, PFS, and OS were observed in the group with poor immunoscore (I0-1) at the early TNM stage of RCC (p < 0.001). In the metastatic subgroup analysis, the immunoscore showed better estimation than the International Metastatic RCC Database Consortium model and the Memorial Sloan-Kettering Cancer Center risk model for progression and OS (p < 0.001). CONCLUSION The additional contributions of immunoscore to TNM stage, Fuhrman grade, and the WHO/ISUP 2016 grade for estimating oncological outcomes were found in ROC analysis. According to our preliminary results, immunoscore can be a promising prediction tool in clear cell RCC for postoperative oncological outcomes following nephrectomy.
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Affiliation(s)
- Ismail Selvi
- Department of Urology, Karabük University Training and Research Hospital, 78200, Karabük, Turkey.
| | - Umut Demirci
- Department of Medical Oncology, Health Science University Dr, Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Nazan Bozdogan
- Department of Pathology, Health Science University Dr, Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Halil Basar
- Department of Urology, Health Science University Dr, Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
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Li XD, Huang CW, Liu ZF, Jiang LJ, Chen JW, Xie D, Zhou FJ, Lu HM, Liu ZW. Prognostic Role of the Immunoscore for Patients with Urothelial Carcinoma of the Bladder Who Underwent Radical Cystectomy. Ann Surg Oncol 2019; 26:4148-4156. [DOI: 10.1245/s10434-019-07529-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Indexed: 01/19/2023]
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12
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Presence of lymphocytic infiltrate cytotoxic T lymphocyte CD3+, CD8+, and immunoscore as prognostic marker in patients after radical cystectomy. PLoS One 2018; 13:e0205746. [PMID: 30308033 PMCID: PMC6181418 DOI: 10.1371/journal.pone.0205746] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 09/17/2018] [Indexed: 12/30/2022] Open
Abstract
Tumor-Infiltrating Lymphocytes (TILs) has been shown to be essential to predict disease outcome in several types of cancers. Moreover, the distribution of cytotoxic T lymphocytes (CD8+) and T cells in general (CD3+) have been used to establish an Immunoscore, as a new cancer prognosticator for survival in colon and lung cancer. In bladder cancer, immune activation has been shown to be associated with genomic subtypes of muscle invasive bladder cancer (MIBC). We sought to evaluate the prognostic impact of these immune cell types in MIBC patients treated with radical cystectomy. For this purpose, cystectomy sections (n = 67) with identifiable invasive margin were selected and stained for CD8+ and CD3+ tumour infiltrating lymphocytes (TILs); both tumor core (CT) and invasive margin (IM) were assessed. Immunoscore was calculated based on previously defined criteria and used to illustrate differences in survival. High density of CD8IM TILs was associated with better disease-free (DFS) (P = 0.01) and overall survival (OS) (P = 0.02) whereas CD3IM TILs were associated with better OS (P = 0.05). Immunoscore was associated with improved DFS (P = 0.02) and OS (P = 0.05). The expression of cytotoxic T cells (CD8+ T cells) in TCGA bladder cancer was also investigated from RNA-Seq profiles of 344 cases. T cell cytotoxicity associated genes (n = 113) were derived from MSig GSEA database. Luminal (n = 121) and basal (n = 68) samples were used to evaluate expression differences. Differential expression (P<0.05) of cytotoxic T cell genes was noted across different molecular subsets of bladder cancer within TCGA analysis. Our data suggests host immune system appears to play a valuable prognostic role in MIBC.
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Jacqueline C, Tasiemski A, Sorci G, Ujvari B, Maachi F, Missé D, Renaud F, Ewald P, Thomas F, Roche B. Infections and cancer: the "fifty shades of immunity" hypothesis. BMC Cancer 2017; 17:257. [PMID: 28403812 PMCID: PMC5389015 DOI: 10.1186/s12885-017-3234-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 03/24/2017] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Since the beginning of the twentieth century, infection has emerged as a fundamental aspect of cancer causation with a growing number of pathogens recognized as oncogenic. Meanwhile, oncolytic viruses have also attracted considerable interest as possible agents of tumor destruction. DISCUSSION Lost in the dichotomy between oncogenic and oncolytic agents, the indirect influence of infectious organisms on carcinogenesis has been largely unexplored. We describe the various ways - from functional aspects to evolutionary considerations such as modernity mismatches - by which infectious organisms could interfere with oncogenic processes through immunity. Finally, we discuss how acknowledging these interactions might impact public health approaches and suggest new guidelines for therapeutic and preventive strategies both at individual and population levels. Infectious organisms, that are not oncogenic neither oncolytic, may play a significant role in carcinogenesis, suggesting the need to increase our knowledge about immune interactions between infections and cancer.
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Affiliation(s)
- Camille Jacqueline
- CREEC, 911 Avenue Agropolis, BP 64501, 34394 Montpellier Cedex 5, France
- MIVEGEC, UMR IRD/CNRS/UM 5290, 911 Avenue Agropolis, BP 64501, 34394 Montpellier Cedex 5, France
| | - Aurélie Tasiemski
- Unité d’Evolution, Ecologie et Paléontologie (EEP) Université de Lille 1 CNRS UMR 8198, groupe d’Ecoimmunologie des Annélides, 59655 Villeneuve-d’Ascqd’Ascq, France
| | - Gabriele Sorci
- BiogéoSciences, CNRS UMR 6282, Université de Bourgogne Franche-Comté, 6 Boulevard Gabriel, 21000 Dijon, France
| | - Beata Ujvari
- Centre for Integrative Ecology, School of Life and Environmental Sciences, Deakin University, Waurn Ponds, Vic Australia
| | - Fatima Maachi
- Laboratoire de Pathologie Oncologie Digestive, Institut Pasteur 1, Place Abou Kacem Ez-Zahraoui- B.P, 120, Casablanca, Morocco
| | - Dorothée Missé
- CREEC, 911 Avenue Agropolis, BP 64501, 34394 Montpellier Cedex 5, France
- MIVEGEC, UMR IRD/CNRS/UM 5290, 911 Avenue Agropolis, BP 64501, 34394 Montpellier Cedex 5, France
| | - François Renaud
- CREEC, 911 Avenue Agropolis, BP 64501, 34394 Montpellier Cedex 5, France
- MIVEGEC, UMR IRD/CNRS/UM 5290, 911 Avenue Agropolis, BP 64501, 34394 Montpellier Cedex 5, France
| | - Paul Ewald
- Department of Biology, University of Louisville, Louisville, KY 40292 USA
| | - Frédéric Thomas
- CREEC, 911 Avenue Agropolis, BP 64501, 34394 Montpellier Cedex 5, France
- MIVEGEC, UMR IRD/CNRS/UM 5290, 911 Avenue Agropolis, BP 64501, 34394 Montpellier Cedex 5, France
| | - Benjamin Roche
- CREEC, 911 Avenue Agropolis, BP 64501, 34394 Montpellier Cedex 5, France
- International Center for Mathematical and Computational Modeling of Complex Systems (UMI IRD/UPMC UMMISCO), 32 Avenue Henri Varagnat, 93143 Bondy Cedex, France
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Jacqueline C, Biro PA, Beckmann C, Moller AP, Renaud F, Sorci G, Tasiemski A, Ujvari B, Thomas F. Cancer: A disease at the crossroads of trade-offs. Evol Appl 2017; 10:215-225. [PMID: 28250806 PMCID: PMC5322410 DOI: 10.1111/eva.12444] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 11/01/2016] [Indexed: 12/14/2022] Open
Abstract
Central to evolutionary theory is the idea that living organisms face phenotypic and/or genetic trade-offs when allocating resources to competing life-history demands, such as growth, survival, and reproduction. These trade-offs are increasingly considered to be crucial to further our understanding of cancer. First, evidences suggest that neoplastic cells, as any living entities subject to natural selection, are governed by trade-offs such as between survival and proliferation. Second, selection might also have shaped trade-offs at the organismal level, especially regarding protective mechanisms against cancer. Cancer can also emerge as a consequence of additional trade-offs in organisms (e.g., eco-immunological trade-offs). Here, we review the wide range of trade-offs that occur at different scales and their relevance for understanding cancer dynamics. We also discuss how acknowledging these phenomena, in light of human evolutionary history, may suggest new guidelines for preventive and therapeutic strategies.
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Affiliation(s)
- Camille Jacqueline
- CREECMontpellier Cedex 5France
- MIVEGECUMR IRD/CNRS/UM 5290Montpellier Cedex 5France
| | - Peter A. Biro
- Centre for Integrative EcologySchool of Life and Environmental SciencesDeakin UniversityWaurn PondsVICAustralia
| | - Christa Beckmann
- Centre for Integrative EcologySchool of Life and Environmental SciencesDeakin UniversityWaurn PondsVICAustralia
| | - Anders Pape Moller
- Ecologie Systématique EvolutionUniversité Paris‐SudCNRSAgroParisTechUniversité Paris‐Saclay, F‐91405 Orsay CedexFrance
| | - François Renaud
- CREECMontpellier Cedex 5France
- MIVEGECUMR IRD/CNRS/UM 5290Montpellier Cedex 5France
| | - Gabriele Sorci
- BiogéoSciencesCNRS UMR 6282Université de BourgogneDijonFrance
| | - Aurélie Tasiemski
- Unité d'EvolutionEcologie et Paléontologie (EEP) Université de Lille 1 CNRS UMR 8198groupe d'Ecoimmunologie des AnnélidesVilleneuve‐d'AscqFrance
| | - Beata Ujvari
- Centre for Integrative EcologySchool of Life and Environmental SciencesDeakin UniversityWaurn PondsVICAustralia
| | - Frédéric Thomas
- CREECMontpellier Cedex 5France
- MIVEGECUMR IRD/CNRS/UM 5290Montpellier Cedex 5France
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15
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Jacqueline C, Bourfia Y, Hbid H, Sorci G, Thomas F, Roche B. Interactions between immune challenges and cancer cells proliferation: timing does matter! EVOLUTION MEDICINE AND PUBLIC HEALTH 2016; 2016:299-311. [PMID: 27535084 PMCID: PMC5046994 DOI: 10.1093/emph/eow025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Indexed: 12/17/2022]
Abstract
The immune system is a key component of malignant cell control and it is also involved in the elimination of pathogens that threaten the host. Despite our body is permanently exposed to a myriad of pathogens, the interference of such infections with the immune responses against cancer has been poorly investigated. Through a mathematical model, we show that the frequency, the duration and the action (positive or negative) of immune challenges may significantly impact tumor proliferation. First, we observe that a long immunosuppressive challenge increases accumulation of cancerous cells only if it occurs 14 years after the beginning of immunosenescence. However, short immune challenges result in an even greater accumulation of cancerous cells for the same total duration of immunosuppression. Finally, we show that short challenges of immune activation could lead to a slightly decrease in cancerous cell accumulation compared to a long one. Our results predict that frequent and acute immune challenges could have a different and in some extent higher impact on cancer risk than persistent ones even they have been much less studied in cancer epidemiology. These results are discussed regarding the existing empirical evidences and we suggest potential novel indirect role of infectious diseases on cancer incidence which should be investigated to improve prevention strategies against cancer.
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Affiliation(s)
- Camille Jacqueline
- CREEC, 911 Avenue Agropolis, BP 64501, Montpellier, Cedex 5 34394, France MIVEGEC, UMR IRD/CNRS/UM 5290, 911 Avenue Agropolis, BP 64501, Montpellier, Cedex 5 34394, France
| | - Youssef Bourfia
- Laboratoire Jacques-Louis Lions (LJLL), UMR 7598 Université Pierre et Marie Curie (UPMC), Paris 6, Boîte courrier 187, ;Paris, Cedex 05 75252, France Université Cadi Ayyad Laboratoire de Mathématiques et Dynamique de Populations, Cadi Ayyad University, Marrakech, Morocco
| | - Hassan Hbid
- Université Cadi Ayyad Laboratoire de Mathématiques et Dynamique de Populations, Cadi Ayyad University, Marrakech, Morocco International Center for Mathematical and Computational Modeling of Complex Systems (UMI IRD/UPMC UMMISCO), 32 Avenue Henri Varagnat, Bondy Cedex 93143, France
| | - Gabriele Sorci
- BiogéoSciences, CNRS UMR 6282, Université de Bourgogne, 6 Boulevard Gabriel, Dijon 21000, France
| | - Frédéric Thomas
- CREEC, 911 Avenue Agropolis, BP 64501, Montpellier, Cedex 5 34394, France MIVEGEC, UMR IRD/CNRS/UM 5290, 911 Avenue Agropolis, BP 64501, Montpellier, Cedex 5 34394, France
| | - Benjamin Roche
- CREEC, 911 Avenue Agropolis, BP 64501, Montpellier, Cedex 5 34394, France International Center for Mathematical and Computational Modeling of Complex Systems (UMI IRD/UPMC UMMISCO), 32 Avenue Henri Varagnat, Bondy Cedex 93143, France
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Becht E, Giraldo NA, Germain C, de Reyniès A, Laurent-Puig P, Zucman-Rossi J, Dieu-Nosjean MC, Sautès-Fridman C, Fridman WH. Immune Contexture, Immunoscore, and Malignant Cell Molecular Subgroups for Prognostic and Theranostic Classifications of Cancers. Adv Immunol 2016; 130:95-190. [DOI: 10.1016/bs.ai.2015.12.002] [Citation(s) in RCA: 126] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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