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Incorvaia L, Monteiro FSM, Massari F, Park SH, Roviello G, Fiala O, Myint ZW, Kucharz J, Molina-Cerrillo J, Santini D, Buttner T, Poprach A, Kopecky J, Zeppellini A, Pichler M, Buchler T, Pichler R, Facchini G, Fay AP, Soares A, Manneh R, Iezzi L, Kuronya Z, Russo A, Bourlon MT, Bhuva D, Ansari J, Kanesvaran R, Grande E, Buti S, Santoni M. Sex and survival outcomes in patients with renal cell carcinoma receiving first-line immune-based combinations. Cancer Immunol Immunother 2024; 73:142. [PMID: 38832989 PMCID: PMC11150359 DOI: 10.1007/s00262-024-03719-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 04/29/2024] [Indexed: 06/06/2024]
Abstract
BACKGROUND There is an ongoing debate as to whether sex could be associated with immune checkpoint inhibitor (ICI) benefit. Existing literature data reveal contradictory results, and data on first-line immune combinations are lacking. METHOD This was a real-world, multicenter, international, observational study to determine the sex effects on the clinical outcomes in metastatic renal cell carcinoma (mRCC) patients treated with immuno-oncology combinations as first-line therapy. RESULTS A total of 1827 mRCC patients from 71 cancer centers in 21 countries were included. The median OS was 38.7 months (95% CI 32.7-44.2) in the overall study population: 40.0 months (95% CI 32.7-51.6) in males and 38.7 months (95% CI 26.4-41.0) in females (p = 0.202). The median OS was higher in males vs. females in patients aged 18-49y (36.9 months, 95% CI 29.0-51.6, vs. 24.8 months, 95% CI 16.8-40.4, p = 0.426, with + 19% of 2y-OS rate, 72% vs. 53%, p = 0.006), in the clear cell histology subgroup (44.2 months, 95% CI 35.8-55.7, vs. 38.7 months, 95% CI 26.0-41.0, p = 0.047), and in patients with sarcomatoid differentiation (34.4 months, 95% CI 26.4-59.0, vs. 15.3 months, 95% CI 8.9-41.0, p < 0.001). Sex female was an independent negative prognostic factor in the sarcomatoid population (HR 1.72, 95% CI 1.15 - 2.57, p = 0.008). CONCLUSIONS Although the female's innate and adaptive immunity has been observed to be more active than the male's, women in the subgroup of clear cell histology, sarcomatoid differentiation, and those under 50 years of age showed shorter OS than males.
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Affiliation(s)
- Lorena Incorvaia
- Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), Section of Medical Oncology, University of Palermo, 90127, Palermo, Italy.
| | - Fernando Sabino Marques Monteiro
- Latin American Cooperative Oncology Group - LACOG, Porto Alegre, RS, Brazil.
- Oncology and Hematology Department, Hospital Sírio-Libanês, Brasilia, DF, Brazil.
| | - Francesco Massari
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Se Hoon Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Republic of Korea
| | | | - Ondřej Fiala
- Department of Oncology and Radiotherapeutics, Faculty of Medicine and University Hospital in Pilsen, Charles University, Alej Svobody 80, Pilsen, 304 60, Czech Republic
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Alej Svobody 76, Pilsen, Czech Republic
| | - Zin W Myint
- Markey Cancer Center, University of Kentucky, Lexington, KY, 40536-0293, USA
| | - Jakub Kucharz
- Department of Uro-Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | | | - Daniele Santini
- Department of Medical-Surgical Sciences and Biotechnology, La Sapienza University, Polo Pontino, Rome, Italy
| | - Thomas Buttner
- Department of Urology, University Hospital Bonn (UKB), 53127, Bonn, Germany
| | - Alexandr Poprach
- Department of Comprehensive Cancer Care and Faculty of Medicine, Masaryk Memorial Cancer Institute and Masaryk University, Brno, Czech Republic
| | - Jindrich Kopecky
- Department of Clinical Oncology and Radiotherapy, University Hospital Hradec Kralove, Hradec Kralove, Czechia
| | - Annalisa Zeppellini
- Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Martin Pichler
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, 8036, Graz, Austria
| | - Tomas Buchler
- Department of Oncology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Renate Pichler
- Department of Urology, Medical University of Innsbruck, Innsbruck, Austria
| | - Gaetano Facchini
- Oncology Unit, "S. Maria Delle Grazie" Hospital, ASL NA2 NORD, 80078, Pozzuoli, Naples, Italy
| | | | - Andrey Soares
- Latin American Cooperative Oncology Group - LACOG, Porto Alegre, Brazil
- Oncology and Hematology Center of Hospital Albert Einstein, Hospital Albert Einstein, Sao Paulo, Brazil
| | - Ray Manneh
- Clinical Oncology, Sociedad de Oncología Y Hematología del Cesar, Valledupar, Colombia
| | - Laura Iezzi
- Oncology Division, Hospital 'Maria SS. Dello Splendore' ASL 4, Giulianova, Italy
| | - Zsofia Kuronya
- Department of Genitourinary Medical Oncology and Clinical Pharmacology, National Institute of Oncology, Budapest, Hungary
| | - Antonio Russo
- Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), Section of Medical Oncology, University of Palermo, 90127, Palermo, Italy
| | - Maria T Bourlon
- Hematology and Oncology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Dipen Bhuva
- Department of Medical Oncology, Army Hospital Research and Referral, New Delhi, India
| | - Jawaher Ansari
- Medical Oncology, Tawam Hospital, Al Ain, United Arab Emirates
| | | | - Enrique Grande
- Department of Medical Oncology, MD Anderson Cancer Center Madrid, Madrid, Spain
| | - Sebastiano Buti
- Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43126, Parma, Italy
- Oncology Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
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Dakal TC, Dhabhai B, Pant A, Moar K, Chaudhary K, Yadav V, Ranga V, Sharma NK, Kumar A, Maurya PK, Maciaczyk J, Schmidt‐Wolf IGH, Sharma A. Oncogenes and tumor suppressor genes: functions and roles in cancers. MedComm (Beijing) 2024; 5:e582. [PMID: 38827026 PMCID: PMC11141506 DOI: 10.1002/mco2.582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 04/21/2024] [Accepted: 04/26/2024] [Indexed: 06/04/2024] Open
Abstract
Cancer, being the most formidable ailment, has had a profound impact on the human health. The disease is primarily associated with genetic mutations that impact oncogenes and tumor suppressor genes (TSGs). Recently, growing evidence have shown that X-linked TSGs have specific role in cancer progression and metastasis as well. Interestingly, our genome harbors around substantial portion of genes that function as tumor suppressors, and the X chromosome alone harbors a considerable number of TSGs. The scenario becomes even more compelling as X-linked TSGs are adaptive to key epigenetic processes such as X chromosome inactivation. Therefore, delineating the new paradigm related to X-linked TSGs, for instance, their crosstalk with autosome and involvement in cancer initiation, progression, and metastasis becomes utmost importance. Considering this, herein, we present a comprehensive discussion of X-linked TSG dysregulation in various cancers as a consequence of genetic variations and epigenetic alterations. In addition, the dynamic role of X-linked TSGs in sex chromosome-autosome crosstalk in cancer genome remodeling is being explored thoroughly. Besides, the functional roles of ncRNAs, role of X-linked TSG in immunomodulation and in gender-based cancer disparities has also been highlighted. Overall, the focal idea of the present article is to recapitulate the findings on X-linked TSG regulation in the cancer landscape and to redefine their role toward improving cancer treatment strategies.
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Affiliation(s)
- Tikam Chand Dakal
- Department of BiotechnologyGenome and Computational Biology LabMohanlal Sukhadia UniversityUdaipurRajasthanIndia
| | - Bhanupriya Dhabhai
- Department of BiotechnologyGenome and Computational Biology LabMohanlal Sukhadia UniversityUdaipurRajasthanIndia
| | - Anuja Pant
- Department of BiochemistryCentral University of HaryanaMahendergarhHaryanaIndia
| | - Kareena Moar
- Department of BiochemistryCentral University of HaryanaMahendergarhHaryanaIndia
| | - Kanika Chaudhary
- School of Life Sciences. Jawaharlal Nehru UniversityNew DelhiIndia
| | - Vikas Yadav
- School of Life Sciences. Jawaharlal Nehru UniversityNew DelhiIndia
| | - Vipin Ranga
- Dearptment of Agricultural BiotechnologyDBT‐NECAB, Assam Agricultural UniversityJorhatAssamIndia
| | | | - Abhishek Kumar
- Manipal Academy of Higher EducationManipalKarnatakaIndia
- Institute of Bioinformatics, International Technology ParkBangaloreIndia
| | - Pawan Kumar Maurya
- Department of BiochemistryCentral University of HaryanaMahendergarhHaryanaIndia
| | - Jarek Maciaczyk
- Department of Stereotactic and Functional NeurosurgeryUniversity Hospital of BonnBonnGermany
| | - Ingo G. H. Schmidt‐Wolf
- Department of Integrated OncologyCenter for Integrated Oncology (CIO)University Hospital BonnBonnGermany
| | - Amit Sharma
- Department of Stereotactic and Functional NeurosurgeryUniversity Hospital of BonnBonnGermany
- Department of Integrated OncologyCenter for Integrated Oncology (CIO)University Hospital BonnBonnGermany
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3
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Lucas-Domínguez R, Aragonés González M, Sixto-Costoya A, Ruiz-Martínez E, Alonso-Arroyo A, Valderrama-Zurián JC. The inclusion of the gender perspective in oncology research with Spanish participation. Heliyon 2024; 10:e30043. [PMID: 38756605 PMCID: PMC11096823 DOI: 10.1016/j.heliyon.2024.e30043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 04/18/2024] [Accepted: 04/18/2024] [Indexed: 05/18/2024] Open
Abstract
The gender perspective is important for a better diagnosis and treatment of diseases, especially in the field of oncology. This study aimed to analyse the gender approach in scientific articles in the field of oncology by studying the gender composition of the authorship of papers and the gender inclusion in the research carried out. A bibliographic search of articles and reviews signed by at least one Spanish institution published between 2010 and 2019 was carried out using the Science Citation Index Expanded database in the Oncology category. A total of 7523 studies were classified according to the gender composition determined by the author's name and a randomised sample was used to evaluate the inclusion of gender perspectives using a checklist. This study revealed a lack of gender parity in the authorship of oncology publications involving Spanish participation. Papers without author gender parity were eight times higher than papers with parity and showed a greater presence of male than female authorship (58 % versus 31 %). Regarding the introduction of the gender perspective, a negative response of 68 % referring to compliance with the entire checklist was obtained, and only a fifth of the articles presented gender balance in the study sample. Moreover, there is a positive correlation between gender parity in authorship and gender perspective integration in published research. In conclusion, there is a great need to advance the inclusion of gender perspectives in cancer research to overcome gender bias and promote better prevention, detection, and intervention for cancer.
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Affiliation(s)
- Rut Lucas-Domínguez
- Grupo UISYS. Departamento de Historia de la Ciencia y Documentación, Facultad de Medicina y Odontología, Universitat de Valencia, Spain
- Unidad asociada al Instituto Interuniversitario de Investigación Avanzada sobre Evaluación de la Ciencia y la Universidad (INAECU), UC3M-UAM3, Spain
- CIBERONC, Valencia, Spain
| | - María Aragonés González
- Universitat d'Alacant, Grupo de Investigación sobre Trabajo Social y Servicios Sociales (GITSS), Spain
| | - Andrea Sixto-Costoya
- Grupo UISYS. Departamento de Historia de la Ciencia y Documentación, Facultad de Medicina y Odontología, Universitat de Valencia, Spain
- Unidad asociada al Instituto Interuniversitario de Investigación Avanzada sobre Evaluación de la Ciencia y la Universidad (INAECU), UC3M-UAM3, Spain
- Departamento de Trabajo Social y Servicios Sociales, Facultad de Ciencias Sociales, Universitat de València, Spain
| | - Emmanuel Ruiz-Martínez
- Grupo UISYS. Departamento de Historia de la Ciencia y Documentación, Facultad de Medicina y Odontología, Universitat de Valencia, Spain
| | - Alonso Alonso-Arroyo
- Grupo UISYS. Departamento de Historia de la Ciencia y Documentación, Facultad de Medicina y Odontología, Universitat de Valencia, Spain
- Unidad asociada al Instituto Interuniversitario de Investigación Avanzada sobre Evaluación de la Ciencia y la Universidad (INAECU), UC3M-UAM3, Spain
| | - Juan Carlos Valderrama-Zurián
- Grupo UISYS. Departamento de Historia de la Ciencia y Documentación, Facultad de Medicina y Odontología, Universitat de Valencia, Spain
- Unidad asociada al Instituto Interuniversitario de Investigación Avanzada sobre Evaluación de la Ciencia y la Universidad (INAECU), UC3M-UAM3, Spain
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Chen J, Wang X, Ye W. Prognostic analysis of sex and age in hepatocellular carcinoma: a SEER study. Eur J Gastroenterol Hepatol 2024; 36:646-651. [PMID: 38555602 PMCID: PMC10965129 DOI: 10.1097/meg.0000000000002745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 02/12/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVES This study aimed to explore the impact of sex on clinical features and survival among hepatocellular carcinoma (HCC) patients. METHODS HCC case data from the Surveillance, Epidemiology, and End Results (SEER) database for the period 2010 to 2015 were selected for analysis. Kaplan-Meier curves displayed overall survival. Univariate cox regression examined the prognostic characteristics of individual features, and multivariate Cox regression assessed hazard ratios. RESULTS This study comprised 3486 HCC patients, with 2682 males and 804 females. Across all age groups, there was a higher prevalence of males compared to females. Survival curves among female patients showed no significant differences across various age groups. However, among male patients, those under 60 demonstrated notably higher survival rates compared to those aged 60 and above. Regarding various ethnicities, TNM staging systems, tumor sizes, the presence of lung/bone/brain metastases, location in Purchased/Referred Care Delivery Areas, SEER historic stages, tumor grades, and individuals receiving chemotherapy, the proportion of male patients consistently exceeded that of female patients. Within the female patient group, individuals receiving chemotherapy exhibited significantly higher survival rates compared to those who did not. However, the administration of chemotherapy showed no significant impact on the survival rate of male patients. Multivariate Cox regression analysis revealed age, gender, and the administration of chemotherapy key factors influencing the overall survival prognosis. CONCLUSION Age, gender, and the administration of chemotherapy are influential factors in the prognosis of both male and female HCC patients.
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Affiliation(s)
- Jun Chen
- Department of Geriatrics, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)
| | - Xiao Wang
- Department of Geriatrics, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)
| | - Wenyi Ye
- Department of Traditional Chinese Internal Medicine, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
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5
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Cerrato C, Crocerossa F, Marchioni M, Giannarini G, Gupta S, Albiges L, Brouwer O, Albersen M, Fankhauser C, Grimm MO, Gandaglia G, Roupret M, Mir MC. Effect of Sex on the Oncological Outcomes in Response to Immunotherapy and Antibody-drug Conjugates in Patients with Urothelial and Kidney Cancer: A Systematic Review and a Network Meta-analysis. Eur Urol Oncol 2024:S2588-9311(24)00096-8. [PMID: 38644155 DOI: 10.1016/j.euo.2024.03.014] [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: 01/28/2024] [Revised: 03/03/2024] [Accepted: 03/26/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND AND OBJECTIVE Immune checkpoint inhibitors (ICIs) and antibody-drug conjugates (ADCs) herald a transformative era in metastatic renal cell carcinoma (RCC) and transitional cell carcinoma (TCC) treatment, amid acknowledged sex-based disparities in these cancers. We conducted a systematic review and network meta-analysis (NMA) to identify sex-specific differences in the efficacy of ICI/ADC monotherapy or combination therapies for RCC and TCC survival, in metastatic and adjuvant settings. METHODS A systematic search was conducted up to October 2023 for English articles on ICIs and ADCs as systemic therapies (ICIs in first-line and adjuvant treatment for RCC, ICIs and ADCs in first- and second-line treatment for TCC). Randomised clinical trials were considered. The primary objective was overall survival (OS) of ICIs and ADCs between males and females. The secondary outcomes included progression-free survival, overall response rate, disease-free survival, and recurrence-free survival. Treatment efficacy was evaluated by sex via odds ratios (ORs) and confidence intervals compared with controls. Log ORs were used for creating a frequentist NMA. This meta-analysis was registered on PROSPERO (CRD42023468632). KEY FINDINGS AND LIMITATIONS Eighteen articles met the inclusion criteria. Females had an advantage for RCC-adjuvant treatment for atezolizumab (log OR [SE] = -0.57 ± 0.25, p = 0.024) in OS. Males showed a survival advantage in TCC second-line treatment for ADC-Nectin 4 (log OR [SE] = 0.65 ± 0.28, p = 0.02). No other significant results were shown. CONCLUSIONS AND CLINICAL IMPLICATIONS The NMA revealed gender-specific variations in ICI and ADC responses for RCC and TCC, offering insights for personalised cancer care and addressing disparities in cancer care and outcomes. PATIENT SUMMARY In this systematic review, we looked at the sex differences for metastatic renal cell carcinoma (RCC) and transitional cell carcinoma (TCC) for antibody-drug conjugates and immune checkpoint inhibitors. In our analysis, female and male sex has better overall survival for adjuvant and second-line therapies for RCC and TCC, respectively. Urgent research on gender-specific cancer therapies is imperative.
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Affiliation(s)
- Clara Cerrato
- University Hospital Southampton NHS Trust, Southampton, UK
| | - Fabio Crocerossa
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | | | - Gianluca Giannarini
- Urology Unit, "Santa Maria della Misericordia" University Hospital, Udine, Italy
| | - Shilpa Gupta
- Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA
| | - Laurence Albiges
- Department of Cancer Medicine, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Oscar Brouwer
- The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Maarten Albersen
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Christian Fankhauser
- Department of Urology, Luzerner Kantonsspital, Luzern, Switzerland; University of Lucerne, Lucerne, Switzerland; University of Zurich, Zurich, Switzerland
| | | | - Giorgio Gandaglia
- Department of Urology, Division of Experimental Oncology, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Morgan Roupret
- GRC 5 Predictive Onco-Uro, Department of Urology, AP-HP, Pitié Salpétrière Hospital, Sorbonne University, Paris, France
| | - Maria Carmen Mir
- Department of Urology, Hospital Universitario La Ribera, Valencia, Spain.
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Kammula AV, Schäffer AA, Rajagopal PS, Kurzrock R, Ruppin E. Outcome differences by sex in oncology clinical trials. Nat Commun 2024; 15:2608. [PMID: 38521835 PMCID: PMC10960820 DOI: 10.1038/s41467-024-46945-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 03/15/2024] [Indexed: 03/25/2024] Open
Abstract
Identifying sex differences in outcomes and toxicity between males and females in oncology clinical trials is important and has also been mandated by National Institutes of Health policies. Here we analyze the Trialtrove database, finding that, strikingly, only 472/89,221 oncology clinical trials (0.5%) had curated post-treatment sex comparisons. Among 288 trials with comparisons of survival, outcome, or response, 16% report males having statistically significant better survival outcome or response, while 42% reported significantly better survival outcome or response for females. The strongest differences are in trials of EGFR inhibitors in lung cancer and rituximab in non-Hodgkin's lymphoma (both favoring females). Among 44 trials with side effect comparisons, more trials report significantly lesser side effects in males (N = 22) than in females (N = 13). Thus, while statistical comparisons between sexes in oncology trials are rarely reported, important differences in outcome and toxicity exist. These considerable outcome and toxicity differences highlight the need for reporting sex differences more thoroughly going forward.
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Affiliation(s)
- Ashwin V Kammula
- Cancer Data Science Laboratory, Center for Cancer Research, National Cancer Institute, Bethesda, MD, 20892, USA
| | - Alejandro A Schäffer
- Cancer Data Science Laboratory, Center for Cancer Research, National Cancer Institute, Bethesda, MD, 20892, USA.
| | - Padma Sheila Rajagopal
- Cancer Data Science Laboratory, Center for Cancer Research, National Cancer Institute, Bethesda, MD, 20892, USA
- Women's Malignancies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, 20892, USA
| | - Razelle Kurzrock
- WIN Consortium and Medical College of Wisconsin, Milwaukee, WI 53226 and University of Nebraska, Omaha, NE, 68198, USA
| | - Eytan Ruppin
- Cancer Data Science Laboratory, Center for Cancer Research, National Cancer Institute, Bethesda, MD, 20892, USA.
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Cappelletto E, Fasiolo LT, Salizzato V, Piccin L, Fabozzi A, Contato A, Bianco PD, Pasello G, Chiarion-Sileni V, Gion M, Fabricio ASC. Cytokine and soluble programmed death-ligand 1 levels in serum and plasma of cancer patients treated with immunotherapy: Preanalytical and analytical considerations. Int J Biol Markers 2024; 39:9-22. [PMID: 38407953 DOI: 10.1177/03936155231226234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
AIM To evaluate cytokine and soluble programmed death ligand-1 (sPD-L1) levels in the serum and plasma of cancer patients treated with immunotherapy, and to test different assays. METHODS Three Luminex xMAP assays and two ELLA microfluidic cartridges were used to screen 28 immune-related biomarkers in 38 paired serum and citrate-theophylline-adenosine-dipyridamole (CTAD) plasma samples collected from 10 advanced melanoma or non-small cell lung cancer (NSCLC) patients at different time points during immunotherapy. RESULTS Twenty-three of 28 biomarkers were detected both in serum and plasma by at least one of the assays, including IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, GM-CSF, IFN-γ, TNF-α, VEGF, IP-10, MCP-1, eotaxin, fractalkine, G-CSF, IFN-α, IL-1RA, IL-13, IL-17A, MIP-1β and sPD-L1. Conversely, FGF-2 and IL-1α were not detected in both matrices; GRO-α factor and EGF were detected only in serum and MIP-1α only in plasma. sPD-L1, MCP-1, IFN-γ, IL-8, MIP-1β and VEGF were, respectively, 1.15-, 1.44-, 1.83-, 2.43-, 2.82-, 6.72-fold higher in serum, whereas IL-10, IL-4, IL-2 and IL-5 were 1.05-, 1.19-, 1.92- and 2.17-fold higher, respectively, in plasma. IP-10 levels were higher in plasma but, as well as for VEGF, the bias serum versus plasma varied depending on the assay used (IP-10: -5.7% to -145%; VEGF: 115% to 165%). No significant differences were found for the remaining nine analyzed cytokines. CONCLUSION The cytokine and sPD-L1 levels may differ between serum and plasma samples collected from cancer patients treated with immunotherapy, and the results obtained can be influenced by the different characteristics of the tested assays. The standardization of pre-analytical and analytical procedures is therefore needed for the future implementation of these circulating biomarkers in clinical practice.
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Affiliation(s)
- Elia Cappelletto
- Regional Center for Biomarkers, Department of Clinical Pathology, AULSS3 Serenissima, Venice, Italy
| | | | | | - Luisa Piccin
- Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Alessio Fabozzi
- Medical Oncology 3, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Anna Contato
- Regional Center for Biomarkers, Department of Clinical Pathology, AULSS3 Serenissima, Venice, Italy
| | - Paola Del Bianco
- Clinical Research Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Giulia Pasello
- Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | | | - Massimo Gion
- Regional Center for Biomarkers, Department of Clinical Pathology, AULSS3 Serenissima, Venice, Italy
| | - Aline S C Fabricio
- Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
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8
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Berardi R, Rossi F, Papa R, Appetecchia M, Baggio G, Bianchini M, Mazzei T, Maria Moretti A, Ortona E, Pietrantonio F, Tarantino V, Vavalà T, Cinieri S. Gender oncology: recommendations and consensus of the Italian Association of Medical Oncology (AIOM). ESMO Open 2024; 9:102243. [PMID: 38394984 PMCID: PMC10937209 DOI: 10.1016/j.esmoop.2024.102243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/29/2023] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Following the development of gender medicine in the past 20 years, more recently in the field of oncology an increasing amount of evidence suggests gender differences in the epidemiology of cancers, as well as in the response and toxicity associated with therapies. In a gender approach, critical issues related to sexual and gender minority (SGM) populations must also be considered. MATERIALS AND METHODS A working group of opinion leaders approved by the Italian Association of Medical Oncology (AIOM) has been set up with the aim of drafting a shared document on gender oncology. Through the 'consensus conference' method of the RAND/University of California Los Angeles (UCLA) variant, the members of the group evaluated statements partly from the scientific literature and partly produced by the experts themselves [good practice points (GPPs)], on the following topics: (i) Healthcare organisation, (ii) Therapy, (iii) Host factors, (iv) Cancer biology, and (v) Communication and social interventions. Finally, in support of each specific topic, they considered it appropriate to present some successful case studies. RESULTS A total of 42 articles met the inclusion criteria, from which 50 recommendations were extracted. Panel participants were given the opportunity to propose additional evidence from studies not included in the research results, from which 32 statements were extracted, and to make recommendations not derived from literature such as GPPs, four of which have been developed. After an evaluation of relevance by the panel, it was found that 81 recommendations scored >7, while 3 scored between 4 and 6.9, and 2 scored below 4. CONCLUSIONS This consensus and the document compiled thereafter represent an attempt to evaluate the available scientific evidence on the theme of gender oncology and to suggest standard criteria both for scientific research and for the care of patients in clinical practice that should take gender into account.
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Affiliation(s)
- R Berardi
- Medical Oncology, Polytechnic University of Marche Region, Ancona; Medical Oncology, AOU Marche, Ancona, Italy - National Councilor AIOM (Italian Association of Medical Oncology); Treasurer AIOM (Italian Association of Medical Oncology).
| | - F Rossi
- Medical Oncology, Polytechnic University of Marche Region, Ancona
| | - R Papa
- Quality, Risk Management and Health Technology Innovation Unit, Department of Staff, AOU Marche, Ancona
| | - M Appetecchia
- Oncological Endocrinology Unit, IRCCS Regina Elena National Cancer Institute, Rome
| | - G Baggio
- President of the Italian Research Center for Gender Health and Medicine, Chair of Gender Medicine 2012-2017, University of Padua, Padua
| | - M Bianchini
- Oncological Endocrinology Unit, IRCCS Regina Elena National Cancer Institute, Rome
| | - T Mazzei
- Department of Pharmacology, University of Florence, Florence
| | - A Maria Moretti
- National President of the Scientific Society GISeG (Italian Group Health and Gender); President of the International Society IGM (International Gender Medicine)
| | - E Ortona
- Head - Center for Gender-specific Medicine, Italian National Institute of Health, Rome
| | - F Pietrantonio
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - V Tarantino
- Medical Oncology, Polytechnic University of Marche Region, Ancona
| | - T Vavalà
- SC of Oncology 1U, Department of Oncology, AOU Città della Salute e della Scienza, Torino; AIOM (Italian Association of Medical Oncology); GISeG (Italian Group Health and Gender)
| | - S Cinieri
- Medical Oncology and Breast Unit, Perrino Hospital, Brindisi; President of AIOM Foundation (Italian Association of Medical Oncology), Italy
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9
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Bakhshi P, Ho JQ, Zanganeh S. Sex-specific outcomes in cancer therapy: the central role of hormones. FRONTIERS IN MEDICAL TECHNOLOGY 2024; 6:1320690. [PMID: 38362126 PMCID: PMC10867131 DOI: 10.3389/fmedt.2024.1320690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 01/08/2024] [Indexed: 02/17/2024] Open
Abstract
Sex hormones play a pivotal role in modulating various physiological processes, with emerging evidence underscoring their influence on cancer progression and treatment outcomes. This review delves into the intricate relationship between sex hormones and cancer, elucidating the underlying biological mechanisms and their clinical implications. We explore the multifaceted roles of estrogen, androgens, and progesterone, highlighting their respective influence on specific cancers such as breast, ovarian, endometrial, and prostate. Special attention is given to estrogen receptor-positive (ER+) and estrogen receptor-negative (ER-) tumors, androgen receptor signaling, and the dual role of progesterone in both promoting and inhibiting cancer progression. Clinical observations reveal varied treatment responses contingent upon hormonal levels, with certain therapies like tamoxifen, aromatase inhibitors, and anti-androgens demonstrating notable success. However, disparities in treatment outcomes between males and females in hormone-sensitive cancers necessitate further exploration. Therapeutically, the utilization of hormone replacement therapy (HRT) during cancer treatments presents both potential risks and benefits. The promise of personalized therapies, tailored to an individual's hormonal profile, offers a novel approach to optimizing therapeutic outcomes. Concurrently, the burgeoning exploration of new drugs and interventions targeting hormonal pathways heralds a future of more effective and precise treatments for hormone-sensitive cancers. This review underscores the pressing need for a deeper understanding of sex hormones in cancer therapy and the ensuing implications for future therapeutic innovations.
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Affiliation(s)
- Parisa Bakhshi
- Research and Development, MetasFree Biopharmaceutical Company, Mansfield, MA, United States
| | - Jim Q. Ho
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States
| | - Steven Zanganeh
- Research and Development, MetasFree Biopharmaceutical Company, Mansfield, MA, United States
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10
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Chua KJ, Kronstedt S, Kaldany A, Srivastava A, Doppalapudi SK, Liu H, Tarhini AA, Gatti‐Mays M, Gaughan E, Hu‐Lieskovan S, Aljumaily R, Nepple K, Schneider B, Sterling J, Singer EA. Comparing the rate of immunotherapy treatment change due to toxicity by sex. Cancer Rep (Hoboken) 2024; 7:e1932. [PMID: 38189893 PMCID: PMC10849926 DOI: 10.1002/cnr2.1932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 10/07/2023] [Accepted: 11/06/2023] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND Immuno-oncology therapy (IO) is associated with a variety of treatment-related toxicities. However, the impact of toxicity on the treatment discontinuation rate between males and females is unknown. We hypothesized that immune-related adverse events would lead to more frequent treatment changes in females since autoimmune diseases occur more frequently in females. AIMS Our aim was to determine if there was a difference in the rate of immunotherapy treatment change due to toxicity between males and females. METHODS AND RESULTS The Oncology Research Information Exchange Network Avatar Database collected clinical data from 10 United States cancer centers. Of 1035 patients receiving IO, 447 were analyzed, excluding those who did not have documentation noting if a patient changed treatment (n = 573). Fifteen patients with unknown or gender-specific cancer were excluded. All cancer types and stages were included. The primary endpoint was documented treatment change due to toxicity. Four hundred and forty-seven patients (281 males and 166 females) received IO treatment. The most common cancers treated were kidney, skin, and lung for 99, 84, and 54 patients, respectively. Females had a shorter IO course than males (median 3.7 vs. 5.1 months, respectively, p = .02). Fifty-four patients changed treatment due to toxicity. There was no significant difference between females and males on chi-square test (11.4% vs. 12.5%, respectively, p = 0.75) and multivariable logistic regression (OR 0.924, 95% CI 0.453-1.885, p = .827). Significantly more patients with chronic obstructive pulmonary disease (COPD) changed therapy due to toxicity (OR 2.491, 95% CI 1.025-6.054, p = .044). CONCLUSION Females received a shorter course of IO than males. However, there was no significant difference in the treatment discontinuation rate due to toxicity between males and females receiving IO. Toxicity-related treatment change was associated with COPD.
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Affiliation(s)
- Kevin J. Chua
- Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical SchoolSection of Urologic OncologyNew BrunswickNew JerseyUSA
- Rutgers Robert Wood Johnson Medical SchoolPiscatawayNew JerseyUSA
| | - Shane Kronstedt
- Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical SchoolSection of Urologic OncologyNew BrunswickNew JerseyUSA
- Rutgers Robert Wood Johnson Medical SchoolPiscatawayNew JerseyUSA
| | - Alain Kaldany
- Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical SchoolSection of Urologic OncologyNew BrunswickNew JerseyUSA
- Rutgers Robert Wood Johnson Medical SchoolPiscatawayNew JerseyUSA
| | - Arnav Srivastava
- Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical SchoolSection of Urologic OncologyNew BrunswickNew JerseyUSA
- Rutgers Robert Wood Johnson Medical SchoolPiscatawayNew JerseyUSA
| | - Sai Krishnaraya Doppalapudi
- Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical SchoolSection of Urologic OncologyNew BrunswickNew JerseyUSA
- Rutgers Robert Wood Johnson Medical SchoolPiscatawayNew JerseyUSA
| | - Hao Liu
- Department of Biostatistics and EpidemiologyRutgers School of Public HealthPiscatawayNew JerseyUSA
| | - Ahmad A. Tarhini
- Departments of Cutaneous Oncology and ImmunologyMoffitt Cancer CenterTampaFloridaUSA
| | - Margaret Gatti‐Mays
- Division of Medical OncologyThe Ohio State University Comprehensive Cancer CenterColumbusOhioUSA
| | - Elizabeth Gaughan
- Division of Hematology/OncologyThe University of Virginia Health SystemCharlottesvilleVirginiaUSA
| | - Siwen Hu‐Lieskovan
- Department of Internal Medicine Division of OncologyUniversity of Utah School of Medicine and Huntsman Cancer InstituteSalt Lake CityUtahUSA
| | - Raid Aljumaily
- Department of Hematology/Oncology Stephenson Cancer CenterUniversity of Oklahoma Health Sciences CenterOklahoma CityOklahomaUSA
| | - Kenneth Nepple
- Department of UrologyUniversity of Iowa Holden Comprehensive Cancer CenterIowa CityIowaUSA
| | - Bryan Schneider
- Indiana University Melvin and Bren Simon Comprehensive Cancer CenterIndianapolisIndianaUSA
| | - Joshua Sterling
- Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical SchoolSection of Urologic OncologyNew BrunswickNew JerseyUSA
- Rutgers Robert Wood Johnson Medical SchoolPiscatawayNew JerseyUSA
| | - Eric A. Singer
- Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical SchoolSection of Urologic OncologyNew BrunswickNew JerseyUSA
- Division of Urologic OncologyThe Ohio State University Comprehensive Cancer CenterColumbusOhioUSA
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11
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Arakawa H, Komatsu S, Kamiya H, Nishibeppu K, Ohashi T, Konishi H, Shiozaki A, Kubota T, Fujiwara H, Otsuji E. Differences of clinical features and outcomes between male and female elderly patients in gastric cancer. Sci Rep 2023; 13:17192. [PMID: 37821583 PMCID: PMC10567739 DOI: 10.1038/s41598-023-44465-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 10/09/2023] [Indexed: 10/13/2023] Open
Abstract
Although the average life span differs between males and females, little is known about differences in clinical features and short and long-term outcomes between elderly male and female gastric cancer patients. This study was designed to clarify these issues to identify the possibility for sex-based treatment strategies in elderly gastric cancer patients. This study included 295 consecutive elderly gastric cancer patients (75 years or older) who underwent curative gastrectomy between 1997 and 2016. We defined postoperative complications as Clavien-Dindo classification grade II or higher. Comorbidities were present in 67% of all patients. Males tended to have more comorbidities than females (P = 0.077). Male patients had significantly more upper gastric cancers (P = 0.001), a higher incidence of postoperative complications (P = 0.045), and poorer prognoses than females (P = 0.003). Multivariate analysis revealed that being male was an independent risk factor for postoperative complications (Odds ratio 2.5, P = 0.045) and a poor prognostic factor (Hazard ratio 1.81, P = 0.008). Patients who underwent limited surgery without postoperative complications tended to have a better prognosis than patients receiving standard surgery with postoperative complications (3-year overall survival: 78% vs. 55%, P = 0.156). Male was an independent risk factor for postoperative complications and an independent poor prognostic factor in elderly gastric cancer patients. To avoid postoperative complications, the limited surgery might be justified for high-risk elderly male patients.
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Affiliation(s)
- Hiroshi Arakawa
- Division of Digestive Surgery (Gastric Surgery Division), Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Shuhei Komatsu
- Division of Digestive Surgery (Gastric Surgery Division), Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
| | - Hajime Kamiya
- Division of Digestive Surgery (Gastric Surgery Division), Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Keiji Nishibeppu
- Division of Digestive Surgery (Gastric Surgery Division), Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Takuma Ohashi
- Division of Digestive Surgery (Gastric Surgery Division), Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Hirotaka Konishi
- Division of Digestive Surgery (Gastric Surgery Division), Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Atsushi Shiozaki
- Division of Digestive Surgery (Gastric Surgery Division), Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Takeshi Kubota
- Division of Digestive Surgery (Gastric Surgery Division), Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Hitoshi Fujiwara
- Division of Digestive Surgery (Gastric Surgery Division), Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Eigo Otsuji
- Division of Digestive Surgery (Gastric Surgery Division), Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
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12
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Valencia K, Montuenga LM, Calvo A. Estrogen Receptor and Immune Checkpoint Inhibitors: New Partners in Lung Cancer? Clin Cancer Res 2023; 29:3832-3834. [PMID: 37548629 DOI: 10.1158/1078-0432.ccr-23-1736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/18/2023] [Accepted: 07/31/2023] [Indexed: 08/08/2023]
Abstract
The influence of sex on immunotherapy response in patients with non-small cell lung cancer (NSCLC) had been studied with no clear conclusions. An article in this issue reports that a key determinant of response is not sex but the existence of a 17β-estradiol/ERα/PDL1 signaling loop in NSCLC. This intriguing result opens new therapeutic options. See related article by Anobile et al., p. 3958.
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Affiliation(s)
- Karmele Valencia
- Program in Solid Tumors, CIMA-University of Navarra, Pamplona, Spain
- Consorcio de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Navarra Health Research Institute (IDISNA), Pamplona, Spain
- Department of Biochemistry and Genetics, School of Sciences, University of Navarra, Pamplona, Spain
- Cancer Center Clínica Universidad de Navarra (CCUN), Pamplona, Spain
| | - Luis M Montuenga
- Program in Solid Tumors, CIMA-University of Navarra, Pamplona, Spain
- Consorcio de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Navarra Health Research Institute (IDISNA), Pamplona, Spain
- Cancer Center Clínica Universidad de Navarra (CCUN), Pamplona, Spain
- Department of Pathology, Anatomy and Physiology, School of Medicine, University of Navarra, Pamplona, Spain
| | - Alfonso Calvo
- Program in Solid Tumors, CIMA-University of Navarra, Pamplona, Spain
- Consorcio de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Navarra Health Research Institute (IDISNA), Pamplona, Spain
- Cancer Center Clínica Universidad de Navarra (CCUN), Pamplona, Spain
- Department of Pathology, Anatomy and Physiology, School of Medicine, University of Navarra, Pamplona, Spain
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13
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Suay G, Garcia-Cañaveras JC, Aparisi F, Lahoz A, Juan-Vidal O. Sex Differences in the Efficacy of Immune Checkpoint Inhibitors in Neoadjuvant Therapy of Non-Small Cell Lung Cancer: A Meta-Analysis. Cancers (Basel) 2023; 15:4433. [PMID: 37760403 PMCID: PMC10526439 DOI: 10.3390/cancers15184433] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 08/30/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
Non-small cell lung cancer (NSCLC) is one of the world's leading causes of morbidity and mortality. ICIs alone or combined with chemotherapy have become the standard first-line treatment of metastatic NSCLC. The impressive results obtained have stimulated our interest in applying these therapies in early disease stage treatments, as neoadjuvant immunotherapy has shown promising results. Among many of the factors that may influence responses, the role played by sex is attracting increased interest and needs to be addressed. Here, we aim to first review the state of the art regarding neoadjuvant ICIs, whether they are administered in monotherapy or in combination with chemotherapy at stages IB-IIIA, particularly at stage IIIA, before analyzing whether sex may influence responses. To this end, a meta-analysis of publicly available data comparing male and female major pathological responses (MPR) and pathological complete responses (pCR) was performed. In our meta-analysis, MPR was found to be significantly higher in females than in males, with an odds ratio (OR) of 1.82 (95% CI 1.13-2.93; p = 0.01), while pCR showed a trend to be more favorable in females than in males, but the OR of 1.62 was not statistically significant (95% CI 0.97-2.75; p = 0.08). Overall, our results showed that sex should be systematically considered in future clinical trials settings in order to establish the optimal treatment sequence.
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Affiliation(s)
- Guillermo Suay
- Biomarkers and Precision Medicine Unit, Health Research Institute La Fe, Av. Fernando Abril Martorell, 106, 46026 Valencia, Spain; (G.S.); (J.-C.G.-C.); (F.A.)
| | - Juan-Carlos Garcia-Cañaveras
- Biomarkers and Precision Medicine Unit, Health Research Institute La Fe, Av. Fernando Abril Martorell, 106, 46026 Valencia, Spain; (G.S.); (J.-C.G.-C.); (F.A.)
| | - Francisco Aparisi
- Biomarkers and Precision Medicine Unit, Health Research Institute La Fe, Av. Fernando Abril Martorell, 106, 46026 Valencia, Spain; (G.S.); (J.-C.G.-C.); (F.A.)
| | - Agustin Lahoz
- Biomarkers and Precision Medicine Unit, Health Research Institute La Fe, Av. Fernando Abril Martorell, 106, 46026 Valencia, Spain; (G.S.); (J.-C.G.-C.); (F.A.)
| | - Oscar Juan-Vidal
- Medical Oncology Department, La Fe University and Polytechnic Hospital, Av. Fernando Abril Martorell, 106, 46026 Valencia, Spain
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14
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Pandya Shesh B, Walter V, Palsa K, Slagle-Webb B, Neely E, Schell T, Connor JR. Sexually dimorphic effect of H-ferritin genetic manipulation on survival and tumor microenvironment in a mouse model of glioblastoma. J Neurooncol 2023; 164:569-586. [PMID: 37812288 DOI: 10.1007/s11060-023-04415-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 08/03/2023] [Indexed: 10/10/2023]
Abstract
PURPOSE Iron plays a crucial role in various biological mechanisms and has been found to promote tumor growth. Recent research has shown that the H-ferritin (FTH1) protein, traditionally recognized as an essential iron storage protein, can transport iron to GBM cancer stem cells, reducing their invasion activity. Moreover, the binding of extracellular FTH1 to human GBM tissues, and brain iron delivery in general, has been found to have a sex bias. These observations raise questions, addressed in this study, about whether H-ferritin levels extrinsic to the tumor can affect tumor cell pathways and if this impact is sex-specific. METHODS To interrogate the role of systemic H-ferritin in GBM we introduce a mouse model in which H-ferritin levels are genetically manipulated. Mice that were genetically manipulated to be heterozygous for H-ferritin (Fth1+/-) gene expression were orthotopically implanted with a mouse GBM cell line (GL261). Littermate Fth1 +/+ mice were used as controls. The animals were evaluated for survival and the tumors were subjected to RNA sequencing protocols. We analyzed the resulting data utilizing the murine Microenvironment Cell Population (mMCP) method for in silico immune deconvolution. mMCP analysis estimates the abundance of tissue infiltrating immune and stromal populations based on cell-specific gene expression signatures. RESULTS There was a clear sex bias in survival. Female Fth1+/- mice had significantly poorer survival than control females (Fth1+/+). The Fth1 genetic status did not affect survival in males. The mMCP analysis revealed a significant reduction in T cells and CD8 + T cell infiltration in the tumors of females with Fth1+/- background as compared to the Fth1+/+. Mast and fibroblast cell infiltration was increased in females and males with Fth1+/- background, respectively, compared to Fth1+/+ mice. CONCLUSION Genetic manipulation of Fth1 which leads to reduced systemic levels of FTH1 protein had a sexually dimorphic impact on survival. Fth1 heterozygosity significantly worsened survival in females but did not affect survival in male GBMs. Furthermore, the genetic manipulation of Fth1 significantly affected tumor infiltration of T-cells, CD8 + T cells, fibroblasts, and mast cells in a sexually dimorphic manner. These results demonstrate a role for FTH1 and presumably iron status in establishing the tumor cellular landscape that ultimately impacts survival and further reveals a sex bias that may inform the population studies showing a sex effect on the prevalence of brain tumors.
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Affiliation(s)
| | - Vonn Walter
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Kondaiah Palsa
- Department of Neurosurgery, Penn State College of Medicine, Hershey, PA, USA
| | - Becky Slagle-Webb
- Department of Neurosurgery, Penn State College of Medicine, Hershey, PA, USA
| | - Elizabeth Neely
- Department of Neurosurgery, Penn State College of Medicine, Hershey, PA, USA
| | - Todd Schell
- Department of Microbiology and Immunology, Penn State College of Medicine, Hershey, PA, USA
| | - James R Connor
- Department of Neurosurgery, Penn State College of Medicine, Hershey, PA, USA.
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15
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Cecchin E, Posocco B, Mezzalira S, Appetecchia M, Toffoli G. The Role of Gender Pharmacogenetics in the Personalization of Drug Treatment. J Pharmacol Exp Ther 2023; 386:190-197. [PMID: 37001987 DOI: 10.1124/jpet.122.001416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 03/21/2023] [Indexed: 07/20/2023] Open
Abstract
The use of pharmacogenetic guidelines in personalizing treatments has shown the potential to reduce interindividual variability in drug response by enabling genotype-matched dosing and drug selection. However, other important factors, such as patient gender, may interact strongly with pharmacogenetics in determining the individual profile of toxicity and efficacy but are still rarely considered when planning pharmacological treatment. The literature indicates that males and females respond differently to drugs, with women being at higher risk for toxicity and having different plasma exposure to drugs at standard doses. Recent studies have shown that pharmacogenetic variants may have different predictive value in different sexes, as in the case of treatment with opioids, angiotensin-converting enzyme inhibitors, or proton pump inhibitors. Of particular interest is the case of treatment with fluoropyrimidines for cancer. A significant increase in toxicity has been described in female patients, with a more pronounced effect of specific DPYD and TYMS polymorphisms also noted. This manuscript reviews the major findings in the field of sex-specific pharmacogenomics. SIGNIFICANCE STATEMENT: Interindividual variability in drug response is an emerging issue in pharmacology. The genetic profile of patients, as well as their gender, may play a role in the identification of patients more exposed to the risk of adverse drug reactions or poor efficacy. This article reviews the current state of research on the interaction between gender and pharmacogenetics in addressing interindividual variability.
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Affiliation(s)
- Erika Cecchin
- Experimental and Clinical Pharmacology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano PN, Italy (E.C., B.P., S.M., G.T.); and Oncological Endocrinology Unit, IRCCS Regina Elena National Cancer Institute-IFO, Rome, Italy (M.A.)
| | - Bianca Posocco
- Experimental and Clinical Pharmacology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano PN, Italy (E.C., B.P., S.M., G.T.); and Oncological Endocrinology Unit, IRCCS Regina Elena National Cancer Institute-IFO, Rome, Italy (M.A.)
| | - Silvia Mezzalira
- Experimental and Clinical Pharmacology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano PN, Italy (E.C., B.P., S.M., G.T.); and Oncological Endocrinology Unit, IRCCS Regina Elena National Cancer Institute-IFO, Rome, Italy (M.A.)
| | - Marialuisa Appetecchia
- Experimental and Clinical Pharmacology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano PN, Italy (E.C., B.P., S.M., G.T.); and Oncological Endocrinology Unit, IRCCS Regina Elena National Cancer Institute-IFO, Rome, Italy (M.A.)
| | - Giuseppe Toffoli
- Experimental and Clinical Pharmacology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano PN, Italy (E.C., B.P., S.M., G.T.); and Oncological Endocrinology Unit, IRCCS Regina Elena National Cancer Institute-IFO, Rome, Italy (M.A.)
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16
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Stanciu AE, Hurduc A, Stanciu MM, Gherghe M, Gheorghe DC, Prunoiu VM, Zamfir-Chiru-Anton A. Portrait of the Inflammatory Response to Radioiodine Therapy in Female Patients with Differentiated Thyroid Cancer with/without Type 2 Diabetes Mellitus. Cancers (Basel) 2023; 15:3793. [PMID: 37568611 PMCID: PMC10417100 DOI: 10.3390/cancers15153793] [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: 06/22/2023] [Revised: 07/12/2023] [Accepted: 07/21/2023] [Indexed: 08/13/2023] Open
Abstract
No clinical studies have investigated the effect of radioiodine (131I)-targeted therapy on the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as inflammatory response markers in patients with differentiated thyroid cancer (DTC) associated with type 2 diabetes mellitus (T2DM) and obesity. This study aimed to assess the relationship between blood radioactivity, body mass index (BMI), and peripheral blood cells three days after 131I intake in 56 female patients without T2DM (DTC/-T2DM) vs. 24 female patients with T2DM (DTC/+T2DM). Blood radioactivity, measured three days after 131I intake, was significantly lower in the DTC/+T2DM than in the DTC/-T2DM patients (0.7 mCi vs. 1.5 mCi, p < 0.001). The relationship between blood radioactivity and BMI (r = 0.83, p < 0.001), blood radioactivity and NLR (r = 0.53, p = 0.008), and BMI and NLR (r = 0.58, p = 0.003) indicates a possible connection between the bloodstream 131I uptake and T2DM-specific chronic inflammation. In patients without T2DM, 131I therapy has immunosuppressive effects, leading to increased NLR (19.6%, p = 0.009) and PLR (39.1%, p = 0.002). On the contrary, in the chronic inflammation context of T2DM, 131I therapy amplifies immune metabolism, leading to a drop in NLR (10%, p = 0.032) and PLR (13.4%, p = 0.021). Our results show that, in DTC/+T2DM, the bidirectional crosstalk between neutrophils and obesity may limit 131I uptake in the bloodstream. Considering the immune response to 131I therapy, the two groups of patients can be seen as a synchronous portrait of two sides. The explanation could lie in the different radiosensitivity of T and B lymphocytes, with T lymphocytes being predominant in patients with DTC/-T2DM and, most likely, B lymphocytes being predominant in T2DM.
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Affiliation(s)
- Adina Elena Stanciu
- Department of Carcinogenesis and Molecular Biology, Institute of Oncology Bucharest, 022328 Bucharest, Romania
| | - Anca Hurduc
- Department of Radionuclide Therapy, Institute of Oncology Bucharest, 022328 Bucharest, Romania;
| | - Marcel Marian Stanciu
- Electrical Engineering Faculty, University Politehnica of Bucharest, 060042 Bucharest, Romania;
| | - Mirela Gherghe
- Nuclear Medicine Department, Institute of Oncology Bucharest, 022328 Bucharest, Romania
- Nuclear Medicine Department, University of Medicine and Pharmacy “Carol Davila” Bucharest, 050474 Bucharest, Romania
| | - Dan Cristian Gheorghe
- ENT Department, “Maria Sklodowska Curie” Children’s Emergency Hospital, 077120 Bucharest, Romania;
- ENT Department, University of Medicine and Pharmacy “Carol Davila” Bucharest, 050474 Bucharest, Romania
| | - Virgiliu Mihail Prunoiu
- Oncological Surgery Department, Institute of Oncology Bucharest, 022328 Bucharest, Romania;
- Oncological Surgery Department, University of Medicine and Pharmacy “Carol Davila” Bucharest, 050474 Bucharest, Romania
| | - Adina Zamfir-Chiru-Anton
- ENT Department, “Grigore Alexandrescu” Children’s Emergency Hospital, 011743 Bucharest, Romania;
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Bukasa-Kakamba J, Bangolo AI, Bayauli P, Mbunga B, Iyese F, Nkodila A, Atoot A, Anand G, Lee SH, Chaudhary M, Fernandes PQ, Mannam HPSS, Polavarapu A, Merajunnissa M, Azhar A, Alichetty MN, Singh G, Arana Jr GV, Sekhon I, Singh M, Rodriguez-Castro JD, Atoot A, Weissman S, M’buyamba JR. Proportion of thyroid cancer and other cancers in the democratic republic of Congo. World J Exp Med 2023; 13:17-27. [PMID: 37396884 PMCID: PMC10308319 DOI: 10.5493/wjem.v13.i3.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 05/15/2023] [Accepted: 05/22/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Cancer diagnosis is increasing around the world and in the Democratic Republic of the Congo (DRC). The proportion of thyroid cancer has increased over the past three decades. There are very few studies on cancer epidemiology, and in particular on thyroid cancer in the DRC.
AIM To establish the most recent proportion of thyroid cancer in the DRC compared to other cancers.
METHODS This is a retrospective and descriptive study of 6106 consecutive cancer cases listed in the pathological registers of 4 Laboratories in the city of Kinshasa. This study included all cancer cases recorded in the registers between 2005 and 2019.
RESULTS From a sample of 6106 patients, including all cancer types, 68.3% cases were female and 31.7% were male. Breast and cervical cancer were the most common types of cancer in women and, prostate and skin cancer were the most common types in men. Thyroid cancer was sixth in proportion in women and eleventh in men compared to all cancers. Papillary carcinoma was the most common of thyroid cancers. Rare cancers such as anaplastic and medullary thyroid carcinomas had a proportion of 7% and 2%, respectively.
CONCLUSION Newer diagnostic tools led to a surge in cancer diagnoses in the DRC. Thyroid cancer has more than doubled its proportion over the last several decades in the country.
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Affiliation(s)
- John Bukasa-Kakamba
- Endocrine and Metabolic Disorders Department, University of Kinshasa, Kinshasa Kinshasa, Congo
| | - Ayrton I Bangolo
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Pascal Bayauli
- Endocrine and Metabolic Disorders Department, University of Kinshasa, Kinshasa Kinshasa, Congo
| | - Branly Mbunga
- School of Public Health, University of Kinshasa, Kinshasa Kinshasa, Congo
| | - Francis Iyese
- Endocrine and Metabolic Disorders Department, University of Kinshasa, Kinshasa Kinshasa, Congo
| | - Aliocha Nkodila
- Family Medicine, Protestant University of Congo, Kinshasa Kinshasa, Congo
| | - Ali Atoot
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Gaurav Anand
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Stacy H Lee
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Maimona Chaudhary
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Pamela Q Fernandes
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Hari PSS Mannam
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Adithya Polavarapu
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Merajunissa Merajunnissa
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Abdullah Azhar
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Mohan N Alichetty
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Gauravdeep Singh
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Georgemar V Arana Jr
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Imranjot Sekhon
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Manbir Singh
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - José D Rodriguez-Castro
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Adam Atoot
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
- Department of Medicine, Hackensack University-Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Simcha Weissman
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Jean Rene M’buyamba
- Endocrine and Metabolic Disorders Department, University of Kinshasa, Kinshasa Kinshasa, Congo
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18
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Fan Q, Chen H, Hu Y, Zhao B. Evaluation of uveitis events in real-world patients receiving immune checkpoint inhibitors based on the FAERS database. Cutan Ocul Toxicol 2023; 42:68-73. [PMID: 37130046 DOI: 10.1080/15569527.2023.2208661] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
PURPOSE Immune checkpoint inhibitors (ICIs) have emerged as a novel class of drugs carrying a potential risk of uveitis. Due to the rarity, current knowledge on this safety issue is still incomplete. This study employed the post-marketing surveillance data to comprehensively describe and assess the uveitis events after the use of ICIs. METHODS Data between 2004 and 2021 were downloaded from the Food and Drug Administration Adverse Event Reporting System (FAERS), and the uveitis events reported for ICIs were identified and included in this study. Clinical details of these reports were collected and analyzed. Four data mining methods were utilized to investigate the potential associations between uveitis and different ICI regimens. RESULTS Overall, 461 uveitis cases after exposure to ICI therapies were reported. Melanoma (58.79%) was revealed as the most common indication for receiving ICIs. The median onset time of uveitis was 41 (interquartile range 18-91) days after ICI initiation. 9.54% of these cases resulted in disability. Data mining results showed 5 ICIs generated positive uveitis signals when used alone. Ipilimumab yielded the most noticeable uveitis signal with the highest reporting odds ratio (ROR = 6.73, 95% two-sided CI = 5.26, 8.60), proportional reporting ratio (PRR = 6.69, χ2=308.52), information component (IC = 2.74, IC025 = 2.14) and empirical Bayes geometric mean (EBGM = 6.66, EBGM05 = 5.42), followed by pembrolizumab, cemiplimab, nivolumab and atezolizumab. When nivolumab, pembrolizumab or atezolizumab was administrated together with ipilimumab, obviously stronger uveitis signal was detected than that for either of them. CONCLUSIONS This study provided an overview of the clinical features of ICI-related uveitis cases in the FAERS. Data mining results revealed that positive uveitis signals commonly existed within this drug class, but signal strength varied among ICIs. When ICIs were used in a combined way, uveitis signals became obviously stronger. Therefore, early ophthalmic monitoring is important when applying ICIs to patients, especially those with a tendency for uveitis, such as melanoma patients.
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Affiliation(s)
- Qianqian Fan
- Department of Pharmacy, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Huan Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yang Hu
- Department of Pharmacy, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Bin Zhao
- Department of Pharmacy, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
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19
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Zhang R, Clark SD, Guo B, Zhang T, Jeansonne D, Jeyaseelan SJ, Francis J, Huang W. Challenges in the combination of radiotherapy and immunotherapy for breast cancer. Expert Rev Anticancer Ther 2023; 23:375-383. [PMID: 37039098 PMCID: PMC10929662 DOI: 10.1080/14737140.2023.2188196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 03/03/2023] [Indexed: 04/12/2023]
Abstract
INTRODUCTION Immunotherapy (IT) is showing promise in the treatment of breast cancer, but IT alone only benefits a minority of patients. Radiotherapy (RT) is usually included in the standard of care for breast cancer patients and is traditionally considered as a local form of treatment. The emerging knowledge of RT-induced systemic immune response, and the observation that the rare abscopal effect of RT on distant cancer metastases can be augmented by IT, have increased the enthusiasm for combinatorial immunoradiotherapy (IRT) for breast cancer patients. However, IRT largely follows the traditional sole RT and IT protocols and does not consider patient specificity, although patients' responses to treatment remain heterogeneous. AREAS COVERED This review discusses the rationale of IRT for breast cancer, the current knowledge, challenges, and future directions. EXPERT OPINION The synergy between RT and the immune system has been observed but not well understood at the basic level. The optimal dosages, timing, target, and impact of biomarkers are largely unknown. There is an urgent need to design efficacious pre-clinical and clinical trials to optimize IRT for cancer patients, maximize the synergy of radiation and immune response, and explore the abscopal effect in depth, taking into account patients' personal features.
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Affiliation(s)
- Rui Zhang
- Medical Physics Program, Department of Physics and Astronomy, Louisiana State University, Baton Rouge, LA, USA
- Department of Radiation Oncology, Mary Bird Perkins Cancer Center, Baton Rouge, LA, USA
| | - Samantha D Clark
- Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA
| | - Beibei Guo
- Department of Experimental Statistics, Louisiana State University, Baton Rouge, LA, USA
| | - Tianyi Zhang
- Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA
| | - Duane Jeansonne
- Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA
| | - Samithamby J Jeyaseelan
- Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA
| | - Joseph Francis
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA
| | - Weishan Huang
- Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA
- Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
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20
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Nikoloudi M, Tsilika E, Kostopoulou S, Mystakidou K. Hope and Distress Symptoms of Oncology Patients in a Palliative Care Setting. Cureus 2023; 15:e38041. [PMID: 37228555 PMCID: PMC10206604 DOI: 10.7759/cureus.38041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2023] [Indexed: 05/27/2023] Open
Abstract
Background Hope has a positive impact on health, playing a significant role in managing illness and its associated losses. In oncology patients, hope is crucial for effective adaptation to the disease, as well as a strategy for coping with physical and mental distress. It enhances disease management, psychological adaptation, and overall quality of life. However, due to the complexity of the effect of hope on patients, particularly those under palliative care, identifying its relationship with anxiety and depression remains a challenge. Methodology In this study, 130 cancer patients completed the Greek version of the Herth Hope Index (HHI-G) and the Hospital Anxiety and Depression Scale (HADS-GR). Results The HHI-G hope total score was strongly negatively correlated with HADS-anxiety (r = -0.491, p < 0.001) and HADS-depression (r = -0.626, p < 0.001). Patients with performance status, as defined by the Eastern Cooperative Oncology Group (ECOG), of 0-1 without radiotherapy had higher HHI-G hope total scores compared to those with ECOG status 2-3 (p = 0.002) and radiotherapy (p = 0.009). Multivariate regression analysis showed that patients who received radiotherapy had 2.49 points higher HHI-G hope scores compared to those who did not (explaining 3.6% of hope). An increase of 1 point in depression led to a 0.65-point decrease in the HHI-G hope score (explaining 40% of hope). Conclusions A deeper understanding of common psychological concerns and hope in patients with serious illnesses can improve their clinical care. Mental health care should focus on managing depression and anxiety, as well as other psychological symptoms, to enhance and maintain patients' hope.
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Affiliation(s)
- Maria Nikoloudi
- Pain Relief and Palliative Care Unit, Department of Radiology, Areteion Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, GRC
| | - Eleni Tsilika
- Pain Relief and Palliative Care Unit, Department of Radiology, Areteion Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, GRC
| | - Sotiria Kostopoulou
- Pain Relief and Palliative Care Unit, Department of Radiology, Areteion Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, GRC
| | - Kyriaki Mystakidou
- Pain Relief and Palliative Care Unit, Department of Radiology, Areteion Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, GRC
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21
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Wang S, Pan W, Mi WX, Wang SH. Sex-specific gene expression patterns in head and neck squamous cell carcinomas. Heliyon 2023; 9:e14890. [PMID: 37064442 PMCID: PMC10102211 DOI: 10.1016/j.heliyon.2023.e14890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 03/15/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Abstract
Objective The head and neck squamous cell carcinomas (HNSCCs) have higher incidence rates in men, but the reasons are still obscure. This study aimed to investigate the sex-specific gene expression patterns and predict the regulatory mechanisms. Design Data including clinical, survival, RNA-seq, miRNA, and methylation information were derived from The Cancer Genome Atlas (TCGA). A total of 131 paired male and female cases were included based on propensity score matching. We concentrated on the prognostic values of the sex-specific pathways enriched by differentially expressed genes (DEGs) and predicted the potential regulatory mechanisms from immune cell infiltration, ceRNA regulatory network, methylation, and differential coexpression analysis. Results Compared with females, males exhibited a lower activity of immune-related functions and higher activities of mitochondrial and ubiquitination functions. The pathway activities were associated with the prognosis of males but less relevant to females. We extracted eight pathways with sex-biased survival patterns, of which five were about down-regulated immune functions, and three were up-regulated pathways (GTP biosynthetic, DNA polymerase, and spliceosomal complex assembly). The five immune pathways were moderately or strongly correlated with the proportion of macrophages. We identified six over-expressed lncRNAs that might be involved in the regulation of the three up-regulated pathways. These lncRNAs exhibited a lower methylation density in males, which might account for their over-expression. Conclusions For HNSCCs, males were characterized by immunosuppression. It was a sign of unfavorable prognosis and might be associated the proportion of macrophages. LncRNAs and methylation might be involved in the regulation of these pathways.
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Affiliation(s)
- Shuo Wang
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Germany
| | - Wei Pan
- Institute for Macromolecular Chemistry, University of Freiburg, Stefan-Meier-Str. 31, 79104 Freiburg, Germany
| | - Wen-xiang Mi
- Department of Stomatology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China
| | - Shao-hai Wang
- Department of Stomatology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China
- Corresponding author. Department of Stomatology, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai 200120, China.
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22
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Shaaban S, Ji Y. Pharmacogenomics and health disparities, are we helping? Front Genet 2023; 14:1099541. [PMID: 36755573 PMCID: PMC9900000 DOI: 10.3389/fgene.2023.1099541] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/10/2023] [Indexed: 01/24/2023] Open
Abstract
Pharmacogenomics has been at the forefront of precision medicine during the last few decades. Precision medicine carries the potential of improving health outcomes at both the individual as well as population levels. To harness the benefits of its initiatives, careful dissection of existing health disparities as they relate to precision medicine is of paramount importance. Attempting to address the existing disparities at the early stages of design and implementation of these efforts is the only guarantee of a successful just outcome. In this review, we glance at a few determinants of existing health disparities as they intersect with pharmacogenomics research and implementation. In our opinion, highlighting these disparities is imperative for the purpose of researching meaningful solutions. Failing to identify, and hence address, these disparities in the context of the current and future precision medicine initiatives would leave an already strained health system, even more inundated with inequality.
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Affiliation(s)
- Sherin Shaaban
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah, United States,ARUP Laboratories, Salt Lake City, Utah, United States,*Correspondence: Sherin Shaaban,
| | - Yuan Ji
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah, United States,ARUP Laboratories, Salt Lake City, Utah, United States
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23
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Cosci I, Grande G, Di Nisio A, Rocca MS, Del Fiore P, Benna C, Mocellin S, Ferlin A. Cutaneous Melanoma and Hormones: Focus on Sex Differences and the Testis. Int J Mol Sci 2022; 24:ijms24010599. [PMID: 36614041 PMCID: PMC9820190 DOI: 10.3390/ijms24010599] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/24/2022] [Accepted: 12/25/2022] [Indexed: 12/31/2022] Open
Abstract
Cutaneous melanoma, the most aggressive type of skin cancer, remains one the most represented forms of cancer in the United States and European countries, representing, in Australia, the primary cause of cancer-related deaths. Recently, many studies have shown that sex disparities previously observed in most cancers are particularly accentuated in melanoma, where male sex is consistently associated with an increased risk of disease progression and a higher mortality rate. The causes of these sex differences rely on biological mechanisms related to sex hormones, immune homeostasis and oxidative processes. The development of newer therapies, such as immune checkpoint inhibitors (ICIs) (i.e., anti-PD-1 and anti-CTLA-4 monoclonal antibodies) has dramatically changed the treatment landscape of metastatic melanoma patients, though ICIs can interfere with the immune response and lead to inflammatory immune-related adverse events (irAEs). Recently, some studies have shown a potential adverse influence of this immunotherapy treatment also on male fertility and testicular function. However, while many anticancer drugs are known to cause defects in spermatogenesis, the effects of ICIs therapy remain largely unknown. Notwithstanding the scarce and conflicting information available on this topic, the American Society of Clinical Oncology guidelines recommend sperm cryopreservation in males undergoing ICIs. As investigations regarding the long-term outcomes of anticancer immunotherapy on the male reproductive system are still in their infancy, this review aims to support and spur future research in order to understand a potential gonadotoxic effect of ICIs on testicular function, spermatogenesis and male fertility.
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Affiliation(s)
- Ilaria Cosci
- Veneto Institute of Oncology IOV-IRCCS, 35128 Padova, Italy
| | - Giuseppe Grande
- Unit of Andrology and Reproductive Medicine, University Hospital of Padova, 35128 Padova, Italy
| | - Andrea Di Nisio
- Department of Medicine, University of Padova, 35128 Padova, Italy
| | - Maria Santa Rocca
- Unit of Andrology and Reproductive Medicine, University Hospital of Padova, 35128 Padova, Italy
| | - Paolo Del Fiore
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy
| | - Clara Benna
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy
- Department of Surgical, Oncological and Gastroenterological Sciences (DISCOG), University of Padua, 35128 Padova, Italy
| | - Simone Mocellin
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy
- Department of Surgical, Oncological and Gastroenterological Sciences (DISCOG), University of Padua, 35128 Padova, Italy
| | - Alberto Ferlin
- Unit of Andrology and Reproductive Medicine, University Hospital of Padova, 35128 Padova, Italy
- Department of Medicine, University of Padova, 35128 Padova, Italy
- Correspondence: ; Tel.: +39-049-8212723
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24
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Stukan AI, Murashko RA, Tsygan NA, Goryainova AY, Nefedov ON, Porkhanov VA. Adaptive immune response in pathogenesis and treatment of head and neck squamous cell carcinoma: the influence of immunosuppression factors and gender. HEAD AND NECK TUMORS (HNT) 2022. [DOI: 10.17650/2222-1468-2022-12-3-114-126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
An obvious trend of the last decade in head and neck squamous cell carcinoma pathogenesis evaluation is awareness of the impact of immune response disorders on disease manifestation. The review presents an analysis of the differences in the type and degree of immunosuppression, as well as treatment response in head and neck squamous cell carcinoma patients in accordance with influencing carcinogenic factor, gender, age of the patient and concomitant diseases. An increase in CD8+ T-lymphocytes and a decrease of memory T-cells has been evaluated in smoking and alcohol abusing patients with head and neck squamous cell carcinoma, and a smaller number of CD8+ T-lymphocytes were detected in the tumor microenvironment compared to non-smoking and non-drinking patients. Studies have shown that the improved prognosis of patients with human papillomavirus (Hpv) – associated head and neck squamous cell carcinoma is largely due to the presence of antibodies against Hpv E6 and E7, E7-specific CD8+T lymphocytes in periphe ral blood and a high level of tumor-infiltrating T lymphocytes. The issue of gender differences in the type of immune response is widely discussed. It has been shown that the use of immune response checkpoint inhibitors is more effective in improving survival rates in men, and the use of these drugs in combination with chemotherapy is more effective in women. In addition, in elderly cancer patients, numerous age-associated T-lymphocyte’s function changes were revealed, including a decrease in the number of naive T-lymphocytes due to age-related involution of the thymus and an in crease in the relative number of memory cells and effector cells. Thus, it is clear that immunosuppression type, as well as treatment response, differ depending on the influencing factor, gender, age of the patient, as well as comorbidities.
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Affiliation(s)
- A. I. Stukan
- Clinical Oncological Dispensary No. 1, Ministry of Health of Krasnodar Territory; Kuban State Medical University, Ministry of Health of Russia
| | - R. A. Murashko
- Clinical Oncological Dispensary No. 1, Ministry of Health of Krasnodar Territory; Kuban State Medical University, Ministry of Health of Russia
| | - N. A. Tsygan
- Clinical Oncological Dispensary No. 1, Ministry of Health of Krasnodar Territory
| | - A. Yu. Goryainova
- Clinical Oncological Dispensary No. 1, Ministry of Health of Krasnodar Territory; Kuban State Medical University, Ministry of Health of Russia
| | - O. N. Nefedov
- Clinical Oncological Dispensary No. 1, Ministry of Health of Krasnodar Territory; Kuban State Medical University, Ministry of Health of Russia
| | - V. A. Porkhanov
- Clinical Oncological Dispensary No. 1, Ministry of Health of Krasnodar Territory; Kuban State Medical University, Ministry of Health of Russia; S.V. Ochapovsky Research Institute – Regional Clinical Hospital No. 1, Ministry of Health of Krasnodar Territory
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25
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Bibi K, Shah MH. Elemental Analysis of Laryngeal Cancer Patients in Comparison with Controls Using Scalp Hair as an Analytical Tool. Biol Trace Elem Res 2022:10.1007/s12011-022-03468-0. [PMID: 36355263 DOI: 10.1007/s12011-022-03468-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 10/30/2022] [Indexed: 11/11/2022]
Abstract
Laryngeal cancer, a rare form of head and neck cancer, is more common in men, and various factors play important roles in its etiology. In the current study, trace elemental contents in the scalp hair of laryngeal cancer patients and healthy subjects were evaluated. Selected essential and toxic elements were measured using flame atomic absorption spectrophotometry after the hair samples were digested with HNO3-HClO4. The mean/median levels of Pb in the scalp hair of patients were significantly higher than the healthy donors, but Sr, Zn, and Co exhibited comparatively lower levels in the laryngeal cancer patients. In comparison to healthy donors, the correlation pattern among the elements in the hair of the patients exhibited diverse mutual relationships. The multivariate apportionment of the elemental levels in the scalp hair of both donor groups was significantly divergent. The average elemental levels varied significantly among the cancer types (glottic, supraglottic, transglottic, and subglottic) as well as the cancer stages (I, II, III, IV). The average levels of the elements also exhibited considerable variations depending on the donors' habitat, gender, food, and smoking habits. Overall, the study revealed significantly divergent disparities among the elemental contents in the scalp hair of the laryngeal cancer patients in comparison with counterpart controls.
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Affiliation(s)
- Kalsoom Bibi
- Department of Chemistry, Quaid-I-Azam University, Islamabad, 45320, Pakistan
| | - Munir H Shah
- Department of Chemistry, Quaid-I-Azam University, Islamabad, 45320, Pakistan.
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26
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Geddes AE, Ray AL, Nofchissey RA, Esmaeili A, Saunders A, Bender DE, Khan M, Aravindan S, Ahrendsen JT, Li M, Fung KM, Jayaraman M, Yang J, Booth KK, Dunn GD, Carter SN, Morris KT. An analysis of sexual dimorphism in the tumor microenvironment of colorectal cancer. Front Oncol 2022; 12:986103. [PMID: 36387163 PMCID: PMC9651089 DOI: 10.3389/fonc.2022.986103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 09/29/2022] [Indexed: 12/24/2022] Open
Abstract
Women with colorectal cancer (CRC) have survival advantages over men, yet the underlying mechanisms are unclear. T cell infiltration within the CRC tumor microenvironment (TME) correlates strongly with survival. We hypothesized that women with CRC have increased T cell infiltration and differential gene expression in the TME compared to men. Tissue microarrays comprising primary tumor, tumor infiltrated lymph nodes, and uninvolved colon were created from CRC patients. Proportions of CD4 positive (CD4+) and CD8 positive (CD8+) T cells were identified using immunohistochemistry. TME immune- and cancer-related genetic expression from primary and metastatic CRC tumor were also evaluated via the NanoStringIO360 panel and The Cancer Genome Atlas Project database. CD4+ was higher in tumor samples from women compared to men (22.04% vs. 10.26%, p=0.002) and also in lymph node samples (39.54% vs. 8.56%, p=0.001). CD8+ was increased in uninvolved colon from women compared to men (59.40% vs. 43.61%, p=0.015), and in stage I/II tumors compared to III/IV in all patients (37.01% vs. 23.91%, p=0.009). Top CD8+ tertile patients survived longer compared to the bottom (43.9 months vs. 25.3 months, p=0.007). Differential gene expression was observed in pathways related to Treg function, T cell activity, and T cell exhaustion, amongst several others, in women compared to men. Thus, significant sexual dimorphism exists in the TME that could contribute to survival advantages observed in female patients with CRC.
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Affiliation(s)
- Andrea E. Geddes
- Department of Surgery, University of Oklahoma Health Science Center, Oklahoma City, OK, United States
| | - Anita L. Ray
- Department of Surgery, University of Oklahoma Health Science Center, Oklahoma City, OK, United States
| | - Robert A. Nofchissey
- Department of Surgery, University of Oklahoma Health Science Center, Oklahoma City, OK, United States
| | - Azadeh Esmaeili
- Department of Pathology, University of Oklahoma Health Science Center, Oklahoma City, OK, United States
| | - Apryl Saunders
- Department of Surgery, University of Oklahoma Health Science Center, Oklahoma City, OK, United States
| | - Dawn E. Bender
- Department of Surgery, University of Oklahoma Health Science Center, Oklahoma City, OK, United States
| | - Maaz Khan
- Department of Pathology, University of Oklahoma Health Science Center, Oklahoma City, OK, United States
| | - Sheeja Aravindan
- University of Oklahoma Health Science Center, Stephenson Cancer Center, Oklahoma City, OK, United States
| | - Jared T. Ahrendsen
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Min Li
- Department of Surgery, University of Oklahoma Health Science Center, Oklahoma City, OK, United States,Department of Cell Biology, University of Oklahoma Health Science Center, Oklahoma City, OK, United States
| | - Kar-Ming Fung
- Department of Pathology, University of Oklahoma Health Science Center, Oklahoma City, OK, United States,University of Oklahoma Health Science Center, Stephenson Cancer Center, Oklahoma City, OK, United States
| | - Muralidharan Jayaraman
- University of Oklahoma Health Science Center, Stephenson Cancer Center, Oklahoma City, OK, United States,Department of Medicine, University of Oklahoma Health Science Center, Oklahoma City, OK, United States
| | - Jingxuan Yang
- Department of Cell Biology, University of Oklahoma Health Science Center, Oklahoma City, OK, United States
| | - Kristina K. Booth
- Department of Surgery, University of Oklahoma Health Science Center, Oklahoma City, OK, United States
| | - Gary D. Dunn
- Department of Surgery, University of Oklahoma Health Science Center, Oklahoma City, OK, United States
| | - Steven N. Carter
- Department of Surgery, University of Oklahoma Health Science Center, Oklahoma City, OK, United States
| | - Katherine T. Morris
- Department of Surgery, University of Oklahoma Health Science Center, Oklahoma City, OK, United States,*Correspondence: Katherine T. Morris,
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Sirufo MM, Magnanimi LM, Ginaldi L, De Martinis M. Anorexia nervosa and autoimmune comorbidities: A bidirectional route? CNS Neurosci Ther 2022; 28:1921-1929. [PMID: 36114699 PMCID: PMC9627382 DOI: 10.1111/cns.13953] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/30/2022] [Accepted: 08/03/2022] [Indexed: 02/06/2023] Open
Abstract
Immunological dysfunctions in eating disorders have recently gained increasing scientific attention. Furthermore, the reciprocal association between anorexia and autoimmune diseases is of particular interest and suggests a role of autoimmunity in the pathogenesis of eating disorders. Anorexia nervosa (AN) and autoimmune diseases are linked by a bidirectional relationship based on common immunopathological mechanisms. In this review, in addition to reporting the numerous cases described in which autoimmune disorders are associated with anorexia or vice versa, we summarize the many aspects of this relationship between the immune system (IS) and AN. We describe how the microbiota affects the IS, disrupts gut-brain communication, and possibly triggers eating disorders. We also describe the shared immunological pathways of autoimmune and eating disorders and in particular the occurrence of disrupted T cell tolerance and autoantibodies in AN. The described observations represent the starting point for possible, future research directions.
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Affiliation(s)
- Maria M. Sirufo
- Department of Life, Health and Environmental SciencesUniversity of L'AquilaL'AquilaItaly,Allergy and Clinical Immunology UnitCenter for the Diagnosis and Treatment of OsteoporosisTeramoItaly
| | - Lina M. Magnanimi
- Department of Life, Health and Environmental SciencesUniversity of L'AquilaL'AquilaItaly
| | - Lia Ginaldi
- Department of Life, Health and Environmental SciencesUniversity of L'AquilaL'AquilaItaly,Allergy and Clinical Immunology UnitCenter for the Diagnosis and Treatment of OsteoporosisTeramoItaly
| | - Massimo De Martinis
- Department of Life, Health and Environmental SciencesUniversity of L'AquilaL'AquilaItaly,Allergy and Clinical Immunology UnitCenter for the Diagnosis and Treatment of OsteoporosisTeramoItaly
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28
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Raskin J, Snoeckx A, Janssens A, De Bondt C, Wener R, van de Wiel M, van Meerbeeck JP, Smits E. New Implications of Patients’ Sex in Today’s Lung Cancer Management. Cancers (Basel) 2022; 14:cancers14143399. [PMID: 35884463 PMCID: PMC9316757 DOI: 10.3390/cancers14143399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/04/2022] [Accepted: 07/11/2022] [Indexed: 12/01/2022] Open
Abstract
Simple Summary We aim to raise awareness that sex is an important factor to take into account in modern-day thoracic oncology practice. Summarized, women should be specifically targeted in smoking cessation campaigns and sex-specific barriers should be addressed. Women present more often with adenocarcinoma histology and EGFR/ALK alterations, as lung cancer in never-smokers is more common in women compared to men. Lung cancer in female patients may show a poorer response to immune checkpoint inhibition; therefore, the addition of chemotherapy should be considered. On the other hand, women experience more benefits from targeted therapy against EGFR. In general, prognosis for women is better compared to that in men. Lung cancer screening trials report that women derive more benefit from screening, although they have not been designed for women. Future trial designs should take this into account and encourage participation of women. Abstract This paper describes where and how sex matters in today’s management of lung cancer. We consecutively describe the differences between males and females in lung cancer demographics; sex-based differences in the immune system (including the poorer outcomes in women who are treated with immunotherapy but no chemotherapy); the presence of oncogenic drivers and the response to targeted therapies according to sex; the greater benefit women derive from lung cancer screening and why they get screened less; and finally, the barriers to smoking cessation that women experience. We conclude that sex is an important but often overlooked factor in modern-day thoracic oncology practice.
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Affiliation(s)
- Jo Raskin
- Department of Thoracic Oncology, MOCA, Antwerp University Hospital, University of Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium; (J.R.); (C.D.B.); (R.W.); (M.v.d.W.); (J.P.v.M.)
| | - Annemiek Snoeckx
- Department of Radiology, Antwerp University Hospital, University of Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium;
| | - Annelies Janssens
- Department of Thoracic Oncology, MOCA, Antwerp University Hospital, University of Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium; (J.R.); (C.D.B.); (R.W.); (M.v.d.W.); (J.P.v.M.)
- Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, Universiteitsplein 1, 2610 Antwerpen, Belgium;
- Correspondence:
| | - Charlotte De Bondt
- Department of Thoracic Oncology, MOCA, Antwerp University Hospital, University of Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium; (J.R.); (C.D.B.); (R.W.); (M.v.d.W.); (J.P.v.M.)
| | - Reinier Wener
- Department of Thoracic Oncology, MOCA, Antwerp University Hospital, University of Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium; (J.R.); (C.D.B.); (R.W.); (M.v.d.W.); (J.P.v.M.)
| | - Mick van de Wiel
- Department of Thoracic Oncology, MOCA, Antwerp University Hospital, University of Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium; (J.R.); (C.D.B.); (R.W.); (M.v.d.W.); (J.P.v.M.)
| | - Jan P. van Meerbeeck
- Department of Thoracic Oncology, MOCA, Antwerp University Hospital, University of Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium; (J.R.); (C.D.B.); (R.W.); (M.v.d.W.); (J.P.v.M.)
| | - Evelien Smits
- Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, Universiteitsplein 1, 2610 Antwerpen, Belgium;
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29
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Schafer JM, Xiao T, Kwon H, Collier K, Chang Y, Abdel-Hafiz H, Bolyard C, Chung D, Yang Y, Sundi D, Ma Q, Theodorescu D, Li X, Li Z. Sex-biased adaptive immune regulation in cancer development and therapy. iScience 2022; 25:104717. [PMID: 35880048 PMCID: PMC9307950 DOI: 10.1016/j.isci.2022.104717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The cancer research field is finally starting to unravel the mystery behind why males have a higher incidence and mortality rate than females for nearly all cancer types of the non-reproductive systems. Here, we explain how sex - specifically sex chromosomes and sex hormones - drives differential adaptive immunity across immune-related disease states including cancer, and why males are consequently more predisposed to tumor development. We highlight emerging data on the roles of cell-intrinsic androgen receptors in driving CD8+ T cell dysfunction or exhaustion in the tumor microenvironment and summarize ongoing clinical efforts to determine the impact of androgen blockade on cancer immunotherapy. Finally, we outline a framework for future research in cancer biology and immuno-oncology, underscoring the importance of a holistic research approach to understanding the mechanisms of sex dimorphisms in cancer, so sex will be considered as an imperative factor for guiding treatment decisions in the future.
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Affiliation(s)
- Johanna M. Schafer
- Pelotonia Institute for Immuno-Oncology, the Ohio State University Comprehensive Cancer Center – the James, Columbus, OH 43210, USA
| | - Tong Xiao
- Pelotonia Institute for Immuno-Oncology, the Ohio State University Comprehensive Cancer Center – the James, Columbus, OH 43210, USA
| | - Hyunwoo Kwon
- Pelotonia Institute for Immuno-Oncology, the Ohio State University Comprehensive Cancer Center – the James, Columbus, OH 43210, USA,Medical Scientist Training Program, College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Katharine Collier
- Division of Medical Oncology, the Ohio State University Comprehensive Cancer Center – the James, Columbus, OH 43210, USA
| | - Yuzhou Chang
- Pelotonia Institute for Immuno-Oncology, the Ohio State University Comprehensive Cancer Center – the James, Columbus, OH 43210, USA,Department of Biomedical Informatics, the Ohio State University, Columbus, OH 43210, USA
| | - Hany Abdel-Hafiz
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA,Department of Medicine and Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Chelsea Bolyard
- Pelotonia Institute for Immuno-Oncology, the Ohio State University Comprehensive Cancer Center – the James, Columbus, OH 43210, USA
| | - Dongjun Chung
- Department of Biomedical Informatics, the Ohio State University, Columbus, OH 43210, USA
| | - Yuanquan Yang
- Division of Medical Oncology, the Ohio State University Comprehensive Cancer Center – the James, Columbus, OH 43210, USA
| | - Debasish Sundi
- Department of Urology, the Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA
| | - Qin Ma
- Department of Biomedical Informatics, the Ohio State University, Columbus, OH 43210, USA
| | - Dan Theodorescu
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA,Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Xue Li
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA,Department of Medicine and Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Zihai Li
- Pelotonia Institute for Immuno-Oncology, the Ohio State University Comprehensive Cancer Center – the James, Columbus, OH 43210, USA,Corresponding author
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30
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Sirufo MM, Magnanimi LM, Ginaldi L, De Martinis M. A sex and gender specific approach to achieve diagnostic excellence for older patients. Arch Gerontol Geriatr 2022; 102:104755. [PMID: 35732107 DOI: 10.1016/j.archger.2022.104755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 11/02/2022]
Affiliation(s)
- Maria Maddalena Sirufo
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy; Allergy and Clinical Immunology Unit, Center for the diagnosis and treatment of Osteoporosis, AUSL 04 Teramo, Italy; Technical group for the coordination of Gender Medicine, AUSL 04, Teramo, Italy
| | - Lina Maria Magnanimi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy
| | - Lia Ginaldi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy; Allergy and Clinical Immunology Unit, Center for the diagnosis and treatment of Osteoporosis, AUSL 04 Teramo, Italy; Technical group for the coordination of Gender Medicine, Regione Abruzzo, Italy
| | - Massimo De Martinis
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy; Allergy and Clinical Immunology Unit, Center for the diagnosis and treatment of Osteoporosis, AUSL 04 Teramo, Italy; Technical group for the coordination of Gender Medicine, Regione Abruzzo, Italy.
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31
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Immunometabolic Markers in a Small Patient Cohort Undergoing Immunotherapy. Biomolecules 2022; 12:biom12050716. [PMID: 35625643 PMCID: PMC9139165 DOI: 10.3390/biom12050716] [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: 04/08/2022] [Revised: 05/15/2022] [Accepted: 05/16/2022] [Indexed: 11/16/2022] Open
Abstract
Although the discovery of immune checkpoints was hailed as a major breakthrough in cancer therapy, generating a sufficient response to immunotherapy is still limited. Thus, the objective of this exploratory, hypothesis-generating study was to identify potentially novel peripheral biomarkers and discuss the possible predictive relevance of combining scarcely investigated metabolic and hormonal markers with immune subsets. Sixteen markers that differed significantly between responders and non-responders were identified. In a further step, the correlation with progression-free survival (PFS) and false discovery correction (Benjamini and Hochberg) revealed potential predictive roles for the immune subset absolute lymphocyte count (rs = 0.51; p = 0.0224 *), absolute basophil count (rs = 0.43; p = 0.04 *), PD-1+ monocytes (rs = −0.49; p = 0.04 *), hemoglobin (rs = 0.44; p = 0.04 *), metabolic markers LDL (rs = 0.53; p = 0.0224 *), free androgen index (rs = 0.57; p = 0.0224 *) and CRP (rs = −0.46; p = 0.0352 *). The absolute lymphocyte count, LDL and free androgen index were the most significant individual markers, and combining the immune subsets with the metabolic markers into a biomarker ratio enhanced correlation with PFS (rs = −0.74; p ≤ 0.0001 ****). In summary, in addition to well-established markers, we identified PD-1+ monocytes and the free androgen index as potentially novel peripheral markers in the context of immunotherapy. Furthermore, the combination of immune subsets with metabolic and hormonal markers may have the potential to enhance the power of future predictive scores and should, therefore, be investigated further in larger trials.
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32
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Neoadjuvant Chemo-Immunotherapy for Locally Advanced Non-Small-Cell Lung Cancer: A Review of the Literature. J Clin Med 2022; 11:jcm11092629. [PMID: 35566754 PMCID: PMC9099888 DOI: 10.3390/jcm11092629] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/29/2022] [Accepted: 04/30/2022] [Indexed: 02/06/2023] Open
Abstract
Non-small cell lung cancer accounts for approximately 80–85% of all lung cancers and at present represents the main cause of cancer death among both men and women. To date, surgery represents the cornerstone; nevertheless, around 40% of completely resected patients develop disease recurrence. Therefore, combining neoadjuvant chemo-immunotherapy and surgery might lead to improved survival. Immunotherapy is normally well tolerated, although significant adverse reactions have been reported in certain patients treated with inhibitors of immune checkpoints. In this review, we explore the current literature on the use of neoadjuvant chemo-immunotherapy followed by surgery for treatment of locally advanced non-small-cell lung cancer, with particular attention to the histological aspects, ongoing trials, and the most common surgical approaches. In conclusion, neoadjuvant immunotherapy whether combined or not with chemotherapy reveals a promising survival benefit for patients with advanced non-small-cell lung cancer; nevertheless, more data remain necessary to identify the best candidates for neoadjuvant regimens.
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33
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Stanciu AE, Verzia A, Stanciu MM, Zamfirescu A, Gheorghe DC. Analysis of the Correlation between the Radioactive Iodine Activity and Neutrophil-to-Lymphocyte Ratio in Patients with Differentiated Thyroid Cancer. Cancers (Basel) 2022; 14:cancers14081899. [PMID: 35454805 PMCID: PMC9024474 DOI: 10.3390/cancers14081899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/05/2022] [Accepted: 04/07/2022] [Indexed: 11/16/2022] Open
Abstract
Publications investigating the effect of radioactive iodine (131I) therapy on the circulating peripheral blood cells in patients with differentiated thyroid cancer (DTC) are limited to blood samples collected more than 92 h after 131I. Studies conducted on blood samples collected up to 92 h are rare due to the radioactive contamination risk. This research aimed to assess the relationship between the prescribed 131I activity, human whole blood activity, and peripheral blood cells at many time points (6, 22, 46, 69, and 92 h after 131I). The study enrolled 50 female patients with DTC who received a 131I median activity of 90.54 mCi (3.35 GBq). The neutrophil-to-lymphocyte ratio (NLR) was measured as an inflammatory marker. 131I uptake in the residual thyroid tissue peaked after 46 h. Blood activity decreased in the first 46 h and increased 69 h after the 131I intake. Blood activity was associated with the absolute lymphocyte count and the NLR at 69 h (r = −0.49 and r = 0.52, p < 0.001). Our results demonstrate that the time interval between 46 and 69 h should be associated with the release of hematological inflammatory mediators, such as neutrophils and lymphocytes, to eradicate tumor cells in response to 131I therapy.
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Affiliation(s)
- Adina Elena Stanciu
- Department of Carcinogenesis and Molecular Biology, Institute of Oncology Bucharest, 022328 Bucharest, Romania
- Correspondence:
| | - Andreea Verzia
- Cernavoda Nuclear Power Plant Division, Nuclearelectrica, 905200 Cernavoda, Romania;
| | - Marcel Marian Stanciu
- Electrical Engineering Faculty, University Politehnica of Bucharest, 060042 Bucharest, Romania;
| | - Anca Zamfirescu
- Department of Radionuclide Therapy, Institute of Oncology Bucharest, 022328 Bucharest, Romania; or
| | - Dan Cristian Gheorghe
- ENT Department, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 Bucharest, Romania;
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High Risk-Human Papillomavirus in HNSCC: Present and Future Challenges for Epigenetic Therapies. Int J Mol Sci 2022; 23:ijms23073483. [PMID: 35408843 PMCID: PMC8998945 DOI: 10.3390/ijms23073483] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/16/2022] [Accepted: 03/18/2022] [Indexed: 02/01/2023] Open
Abstract
Head and Neck Squamous Cell Carcinoma (HNSCC) is a highly heterogeneous group of tumors characterized by an incidence of 650,000 new cases and 350,000 deaths per year worldwide and a male to female ratio of 3:1. The main risk factors are alcohol and tobacco consumption and Human Papillomavirus (HPV) infections. HNSCC cases are divided into two subgroups, the HPV-negative (HPV−) and the HPV-positive (HPV+) which have different clinicopathological and molecular profiles. However, patients are still treated with the same therapeutic regimens. It is thus of utmost importance to characterize the molecular mechanisms underlying these differences to find new biomarkers and novel therapeutic targets towards personalized therapies. Epigenetic alterations are a hallmark of cancer and can be exploited as both promising biomarkers and potential new targets. E6 and E7 HPV oncoviral proteins besides targeting p53 and pRb, impair the expression and the activity of several epigenetic regulators. While alterations in DNA methylation patterns have been well described in HPV+ and HPV− HNSCC, accurate histone post-translational modifications (hPTMs) characterization is still missing. Herein, we aim to provide an updated overview on the impact of HPV on the hPTMs landscape in HNSCC. Moreover, we will also discuss the sex and gender bias in HNSCC and how the epigenetic machinery could be involved in this process, and the importance of taking into account sex and/or gender also in this field.
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35
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Prescription Patterns, Recurrence, and Toxicity Rates of Adjuvant Treatment for Stage III/IV Melanoma—A Real World Single-Center Analysis. BIOLOGY 2022; 11:biology11030422. [PMID: 35336796 PMCID: PMC8945449 DOI: 10.3390/biology11030422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/03/2022] [Accepted: 03/08/2022] [Indexed: 11/20/2022]
Abstract
Simple Summary Adjuvant treatment with the immune checkpoint inhibitors (ICI) pembrolizumab or nivolumab, or the targeted therapies dabrafenib and trametinib is recommended for patients with completely resected stage III melanoma and significantly decreases recurrence risk. Currently, limited data are available on physicians’ prescription preferences regarding ICI and targeted therapies and patient outcome in clinical practice. This study investigates the real-world situation of 109 patients from the Cancer Center of the University Hospital Bern, Switzerland, with an indication for adjuvant treatment since 2018. We describe treatment patterns, recurrence, and toxicity rates under immune checkpoint inhibitors, and targeted therapies. Abstract Approved adjuvant treatment options for stage III melanoma are the immune checkpoint inhibitors (ICI) pembrolizumab and nivolumab, and in presence of a BRAF V600E/K mutation additionally dabrafenib in combination with trametinib (BRAFi/MEKi). This study aims to describe prescription patterns and recurrence and toxicity rates of adjuvant-treated melanoma patients from the Cancer Center of the University Hospital Bern, Switzerland. One hundred and nine patients with an indication for adjuvant treatment were identified. Five (4.6%) had contraindications and, as such, were not proposed any adjuvant treatment, while 10 patients (9.2%) declined treatment. BRAF status was known for 91 (83.5%) patients. Of 40 (36.7%) patients with BRAF V600E/K melanoma, pembrolizumab was prescribed to 18 (45.0%), nivolumab to 16 (40.0%), and dabrafenib/trametinib to three (7.5%) patients. Grade 3–4 toxicity was reported in 18.9% and 16.7% of all the patients treated with pembrolizumab and nivolumab, respectively. No toxicities were observed for dabrafenib/trametinib. Thirty-eight percent of the patients treated with pembrolizumab and 40.0% of those treated with nivolumab relapsed. No relapses were reported for dabrafenib/trametinib. Prescription patterns indicate a clear preference for adjuvant ICI treatment.
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Tokatli MR, Sisti LG, Marziali E, Nachira L, Rossi MF, Amantea C, Moscato U, Malorni W. Hormones and Sex-Specific Medicine in Human Physiopathology. Biomolecules 2022; 12:413. [PMID: 35327605 PMCID: PMC8946266 DOI: 10.3390/biom12030413] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 03/04/2022] [Indexed: 12/11/2022] Open
Abstract
A prodigious increment of scientific evidence in both preclinical and clinical studies is narrowing a major gap in knowledge regarding sex-specific biological responses observed in numerous branches of clinical practices. Some paradigmatic examples include neurodegenerative and mental disorders, immune-related disorders such as pathogenic infections and autoimmune diseases, oncologic conditions, and cardiovascular morbidities. The male-to-female proportion in a population is expressed as sex ratio and varies eminently with respect to the pathophysiology, natural history, incidence, prevalence, and mortality rates. The factors that determine this scenario incorporate both sex-associated biological differences and gender-dependent sociocultural issues. A broad narrative review focused on the current knowledge about the role of hormone regulation in gender medicine and gender peculiarities across key clinical areas is provided. Sex differences in immune response, cardiovascular diseases, neurological disorders, cancer, and COVID-19 are some of the hints reported. Moreover, gender implications in occupational health and health policy are offered to support the need for more personalized clinical medicine and public health approaches to achieve an ameliorated quality of life of patients and better outcomes in population health.
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Affiliation(s)
| | - Leuconoe Grazia Sisti
- Center for Global Health Research and Studies, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (L.G.S.); (E.M.); (L.N.); (U.M.)
- National Institute for Health, Migration and Poverty, 00153 Rome, Italy
| | - Eleonora Marziali
- Center for Global Health Research and Studies, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (L.G.S.); (E.M.); (L.N.); (U.M.)
| | - Lorenza Nachira
- Center for Global Health Research and Studies, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (L.G.S.); (E.M.); (L.N.); (U.M.)
| | - Maria Francesca Rossi
- Department of Life Sciences and Public Health, Section of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (M.F.R.); (C.A.)
| | - Carlotta Amantea
- Department of Life Sciences and Public Health, Section of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (M.F.R.); (C.A.)
| | - Umberto Moscato
- Center for Global Health Research and Studies, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (L.G.S.); (E.M.); (L.N.); (U.M.)
- Department of Life Sciences and Public Health, Section of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (M.F.R.); (C.A.)
| | - Walter Malorni
- Course in Pharmacy, University of Tor Vergata, 00133 Rome, Italy;
- Center for Global Health Research and Studies, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (L.G.S.); (E.M.); (L.N.); (U.M.)
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Sirufo MM, Bassino EM, De Pietro F, Ginaldi L, De Martinis M. Sex differences in the efficacy of omalizumab in the treatment of chronic spontaneous urticaria. Int J Immunopathol Pharmacol 2022; 35:20587384211065870. [PMID: 35170369 PMCID: PMC8855371 DOI: 10.1177/20587384211065870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background Omalizumab is shown to be effective in the treatment of chronic spontaneous
urticaria (CSU), a disease with high personal and social impact. Sex
differences in CSU are recognized with women more frequently affected.
Scarce is the knowledge about response to omalizumab between sex groups. We
sought to identify any differences based on the sex of patients receiving
omalizumab. Methods We evaluated data of patients diagnosed with CSU refractory to high-dose
second-generation H1 antihistamines and treated with 300 mg omalizumab every
4 weeks for 6 months and then at relapse. Results Discussion: All patients, regardless of sex, age, or any other factor,
achieved the clinical remission of the disease after the first 3 doses with
a reduction of the disease activity indices and impact on the quality of
life. Recurrences predominate in men, two months after the suspension of the
drug. Respect to sex and recurrence we did not find any correlation with
age, body mass index, peripheral eosinophil counts, total IgE levels,
D-dimer, plasma prothrombine level or C-reactive protein. We found no sex
differences in tolerability and safety. CSU in girls may persist longer and
have worse prognosis, but no one has so far noted sex differences in
response to omalizumab. Conclusions Although there are no certainties on the mechanism of action of omalizumab in
CSU, the noticeable difference in response between males and females lead us
to suppose a role of the hormonal balance both on the pathogenesis of the
CSU and on the efficacy of OmAb.
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Affiliation(s)
- Maria Maddalena Sirufo
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.,Allergology and Clinical Immunology Unit, Teramo, Italy
| | - Enrica Maria Bassino
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.,Allergology and Clinical Immunology Unit, Teramo, Italy
| | - Francesca De Pietro
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.,Allergology and Clinical Immunology Unit, Teramo, Italy
| | - Lia Ginaldi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.,Allergology and Clinical Immunology Unit, Teramo, Italy
| | - Massimo De Martinis
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.,Allergology and Clinical Immunology Unit, Teramo, Italy
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Zhao LF, Zhang JG, Qi FY, Hou WY, Li YR, Shen DD, Zhao LJ, Qi L, Liu HM, Zheng YC. SDC: An Integrated Database for Sex Differences in Cancer. Comput Struct Biotechnol J 2022; 20:1068-1076. [PMID: 35284049 PMCID: PMC8897669 DOI: 10.1016/j.csbj.2022.02.023] [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: 11/01/2021] [Revised: 01/29/2022] [Accepted: 02/24/2022] [Indexed: 12/24/2022] Open
Abstract
Sex differences are evident in the incidence and mortality of diverse cancers. With the development of personalized approaches in cancer treatment, the impact of sex differences has not been systematically incorporated into preclinical and clinical cancer research. The molecular mechanisms underlying sex differences in cancer have not been elucidated. Here, we developed the first database of Sex Differences in Cancer (SDC), a web-based public database that integrates resources from multiple databases, including The Cancer Genome Atlas (TCGA), Genotype-Tissue Expression Project (GTEx), UCSC Xena, Broad Institute Cancer Cell Line Encyclopedia (CCLE), Genomics of Drug Sensitivity in Cancer (GDSC). SDC contains 27 types of cancers, 6 types of molecular data, more than 10,000 donors, 977 cancer cell lines were used to analyze sex differences among cancers. It provides five main modules: Survival and phenotype, Molecular differences, Signatures and pathways, Therapy response, Download. Users can download the all the visualized results and raw data after analysis. Collectively, SDC is the first integrated database to analyze sex differences in cancer on the web server, which will strengthen our understanding of the role of sex in cancers. It is implemented in Shiny-server and freely available for public use at http://sdc.anticancer.xyz.
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Affiliation(s)
- Long-Fei Zhao
- Key Lab of Advanced Drug Preparation Technologies, Ministry of Education of China, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- State Key Laboratory of Esophageal Cancer Prevention & Treatment, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- Key Laboratory of Henan Province for Drug Quality and Evaluation, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- Institute of Drug Discovery and Development, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- School of Pharmaceutical Sciences, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
| | - Jin-Ge Zhang
- Key Lab of Advanced Drug Preparation Technologies, Ministry of Education of China, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- State Key Laboratory of Esophageal Cancer Prevention & Treatment, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- Key Laboratory of Henan Province for Drug Quality and Evaluation, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- Institute of Drug Discovery and Development, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- School of Pharmaceutical Sciences, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
| | - Feng-Yu Qi
- Key Lab of Advanced Drug Preparation Technologies, Ministry of Education of China, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- State Key Laboratory of Esophageal Cancer Prevention & Treatment, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- Key Laboratory of Henan Province for Drug Quality and Evaluation, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- Institute of Drug Discovery and Development, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- School of Pharmaceutical Sciences, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
| | - Wei-Yan Hou
- School of Information Engineering, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
| | - Yin-Rui Li
- Key Lab of Advanced Drug Preparation Technologies, Ministry of Education of China, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- State Key Laboratory of Esophageal Cancer Prevention & Treatment, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- Key Laboratory of Henan Province for Drug Quality and Evaluation, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- Institute of Drug Discovery and Development, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- School of Pharmaceutical Sciences, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
| | - Dan-Dan Shen
- Key Lab of Advanced Drug Preparation Technologies, Ministry of Education of China, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- State Key Laboratory of Esophageal Cancer Prevention & Treatment, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- Key Laboratory of Henan Province for Drug Quality and Evaluation, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- Institute of Drug Discovery and Development, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- School of Pharmaceutical Sciences, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
| | - Li-Juan Zhao
- Key Lab of Advanced Drug Preparation Technologies, Ministry of Education of China, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- State Key Laboratory of Esophageal Cancer Prevention & Treatment, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- Key Laboratory of Henan Province for Drug Quality and Evaluation, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- Institute of Drug Discovery and Development, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- School of Pharmaceutical Sciences, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
| | - Lin Qi
- School of Information Engineering, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- Corresponding authors at: Key Lab of Advanced Drug Preparation Technologies, Ministry of Education of China, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China (H.M. Liu and Y.C. Zheng).
| | - Hong-Min Liu
- Key Lab of Advanced Drug Preparation Technologies, Ministry of Education of China, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- State Key Laboratory of Esophageal Cancer Prevention & Treatment, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- Key Laboratory of Henan Province for Drug Quality and Evaluation, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- Institute of Drug Discovery and Development, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- School of Pharmaceutical Sciences, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- Corresponding authors at: Key Lab of Advanced Drug Preparation Technologies, Ministry of Education of China, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China (H.M. Liu and Y.C. Zheng).
| | - Yi-Chao Zheng
- Key Lab of Advanced Drug Preparation Technologies, Ministry of Education of China, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- State Key Laboratory of Esophageal Cancer Prevention & Treatment, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- Key Laboratory of Henan Province for Drug Quality and Evaluation, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- Institute of Drug Discovery and Development, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- School of Pharmaceutical Sciences, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China
- Corresponding authors at: Key Lab of Advanced Drug Preparation Technologies, Ministry of Education of China, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan 450001, China (H.M. Liu and Y.C. Zheng).
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Sex, Allergic Diseases and Omalizumab. Biomedicines 2022; 10:biomedicines10020328. [PMID: 35203537 PMCID: PMC8869622 DOI: 10.3390/biomedicines10020328] [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: 12/10/2021] [Revised: 01/25/2022] [Accepted: 01/26/2022] [Indexed: 11/17/2022] Open
Abstract
Gender differences are increasingly emerging in every area of medicine including drug therapy; however, specific gender-targeted studies are infrequent. Sex is a fundamental variable, which cannot be neglected. When optimizing therapies, gender pharmacology must always be considered in order to improve the effectiveness and safety of the use of drugs. Knowledge of gender differences promotes appropriate use of therapies and greater health protection for both genders. Further development of gender research would make it possible to report on differences in the assimilation and response of the female organism as compared to the male, in order to identify potential risks and benefits that can be found between genders. Furthermore, a better understanding of sex/gender-related influences, with regard to pharmacological activity, would allow the development of personalized “tailor-made” medicines. Here, we summarize the state of knowledge on the role of sex in several allergic diseases and their treatment with omalizumab, the first biologic drug authorized for use in the field of allergology.
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White AA, Lin A, Bickendorf X, Cavve BS, Moore JK, Siafarikas A, Strickland DH, Leffler J. Potential immunological effects of gender-affirming hormone therapy in transgender people - an unexplored area of research. Ther Adv Endocrinol Metab 2022; 13:20420188221139612. [PMID: 36533187 PMCID: PMC9747891 DOI: 10.1177/20420188221139612] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 10/31/2022] [Indexed: 12/14/2022] Open
Abstract
There are well-described sex-based differences in how the immune system operates. In particular, cisgender (cis) females have a more easily activated immune system; associated with an increased prevalence of autoimmune diseases and adverse events following vaccinations. Conversely, cis males have a higher threshold for immune activation, and are more prone to certain infectious diseases, such as coronavirus disease (COVID-19). Oestrogen and testosterone have immune-modulatory properties, and it is likely that these contribute to the sexual dimorphism of the immune system. There are also important immune-related genes located on the X chromosome, such as toll-like receptor (TLR) 7/8; and the mosaic bi-allelic expression of such genes may contribute to the state of immune hyperactivation in cis females. The scientific literature strongly suggests that sex-based differences in the functioning of the immune system are related to both X-linked genes and immune modulation by sex hormones. However, it is currently not clear how this impacts transgender (trans) people receiving gender-affirming hormonal therapy. Moreover, it is estimated that in Australia, at least 2.3% of adolescents identify as trans and/or gender diverse, and referrals to specialist gender-affirming care are increasing each year. Despite the improving social awareness of trans people, they remain chronically underrepresented in the scientific literature. In addition, a small number of case studies describe new onset autoimmune disorders in adult trans females following oestrogen use. However, there is currently minimal long-term research with an immunological focus on trans people. Therefore, to ensure the positive health outcomes of trans people, it is crucial that the role of sex hormones in immune modulation is investigated further.
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Affiliation(s)
- Alice A. White
- Telethon Kids Institute, University of Western Australia, Nedlands, WA, Australia
| | - Ashleigh Lin
- Telethon Kids Institute, University of Western Australia, Nedlands, WA, Australia
| | - Xander Bickendorf
- Telethon Kids Institute, University of Western Australia, WA, Australia
- Gender Diversity Service, Child and Adolescent Health Service, Nedlands, WA, Australia
| | - Blake S. Cavve
- Gender Diversity Service, Child and Adolescent Health Service, Nedlands, WA, Australia
| | - Julia K. Moore
- Gender Diversity Service, Child and Adolescent Health Service, Nedlands, WA, Australia
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Nedlands, WA, Australia
| | - Aris Siafarikas
- Telethon Kids Institute, University of Western Australia, Nedlands, WA, Australia
- Gender Diversity Service, Child and Adolescent Health Service, Nedlands, WA, Australia
- Paediatrics, Medical School, The University of Western Australia, Nedlands, WA, Australia
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The impact of biological sex on diseases of the urinary tract. Mucosal Immunol 2022; 15:857-866. [PMID: 35869147 PMCID: PMC9305688 DOI: 10.1038/s41385-022-00549-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/22/2022] [Accepted: 07/03/2022] [Indexed: 02/04/2023]
Abstract
Biological sex, being female or male, broadly influences diverse immune phenotypes, including immune responses to diseases at mucosal surfaces. Sex hormones, sex chromosomes, sexual dimorphism, and gender differences all contribute to how an organism will respond to diseases of the urinary tract, such as bladder infection or cancer. Although the incidence of urinary tract infection is strongly sex biased, rates of infection change over a lifetime in women and men, suggesting that accompanying changes in the levels of sex hormones may play a role in the response to infection. Bladder cancer is also sex biased in that 75% of newly diagnosed patients are men. Bladder cancer development is shaped by contributions from both sex hormones and sex chromosomes, demonstrating that the influence of sex on disease can be complex. With a better understanding of how sex influences disease and immunity, we can envision sex-specific therapies to better treat diseases of the urinary tract and potentially diseases of other mucosal tissues.
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Patel K, Alpert N, Tuminello S, Taioli E. OUP accepted manuscript. JNCI Cancer Spectr 2022; 6:6528855. [PMID: 35603843 PMCID: PMC8935137 DOI: 10.1093/jncics/pkac015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 12/13/2021] [Accepted: 12/20/2021] [Indexed: 11/23/2022] Open
Abstract
Background Although immunotherapy can increase survival in non-small cell lung cancer (NSCLC), response rates are low. It is unclear which characteristics contribute to variability in immunotherapy efficacy and survival. Research is needed to identify reasons for heterogeneity in response rates to better tailor treatments. Methods Web of Science, Ovid EMBASE, and MEDLINE were queried from 2013 to January 2021, and all studies reporting overall or progression-free survival for patients treated with immunotherapy for NSCLC of at least stage IIIB were screened. Results Included were 18 randomized controlled trials (RCTs; 6534 immunotherapy RCTs; 11 192 nonimmunotherapy RCTs) and 16 observational studies (n = 9073 immunotherapy patients). Among RCTs, there was improved survival with the addition of immunotherapy in patients aged younger than 65 years in 10 of 17 studies; smokers in 8 of 15 studies; and males in 10 of 17 studies and 6 of 17 females. Only 5 studies reported outcomes by race. Among observational studies, younger patients (aged younger than 60, younger than 65, or younger than 70 years in most studies) had better survival than older patients (aged 60 years and older, 65 years and older, or 70 years and older) in 4 of 13 studies, ever-smokers in 7 of 13, and females in 2 of 14. Three studies reported race with mixed results. Conclusion Although evidence is mixed, younger patients, smokers, and males may derive more benefit from immunotherapy. Evidence on racial differences is limited. Physicians should be mindful of personal characteristics when formulating treatment plans. Further research is needed to understand underlying mechanisms and to identify the best immunotherapy candidates and alternative treatments for those unlikely to benefit.
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Affiliation(s)
- Krishna Patel
- Institute for Translational Epidemiology and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Naomi Alpert
- Institute for Translational Epidemiology and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stephanie Tuminello
- Division of Epidemiology, New York University Grossman School of Medicine, New York, NY, USA
| | - Emanuela Taioli
- Institute for Translational Epidemiology and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Institute for Translational Epidemiology and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, Tisch Cancer Institute, New York, NY, USA
- Correspondence to: Emanuela Taioli, MD, PhD, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1133, New York, NY, 10029, USA (e-mail: )
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dNLR-Based Score Predicting Overall Survival Benefit for The Addition of Platinum-Based Chemotherapy to Pembrolizumab in Advanced NSCLC With PD-L1 Tumor Proportion Score ≥50%. Clin Lung Cancer 2021; 23:122-134. [DOI: 10.1016/j.cllc.2021.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 12/11/2021] [Accepted: 12/13/2021] [Indexed: 11/15/2022]
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Neoadjuvant/Perioperative Treatment Affects Spatial Distribution and Densities of Tumor Associated Neutrophils and CD8+ Lymphocytes in Gastric Cancer. J Pers Med 2021; 11:jpm11111184. [PMID: 34834537 PMCID: PMC8622782 DOI: 10.3390/jpm11111184] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/04/2021] [Accepted: 11/10/2021] [Indexed: 12/15/2022] Open
Abstract
Tumor associated neutrophils (TANs) and cytotoxic T cells (CTLs) are part of the tumor microenvironment of gastric cancer (GC). We explored their tumor biological significance in neoadjuvantly/perioperatively treated GC. Immunostaining was performed on whole tissue sections of 173 GCs, using antibodies directed against myeloperoxidase (MPO) and CD8. Stained specimens were digitalized, and the densities of TANs and CTLs were assessed separately in the mucosa, tumor surface, tumor center, invasion front, and tumor scar. The densities were correlated with clinicopathological patient characteristics. Compared with a historical cohort of 449 treatment naive GCs, the TAN density in the invasion front was significantly lower in neoadjuvantly/perioperatively treated GCs. TAN density in the tumor center and invasion front correlated with tumor regression. TAN density also correlated with CTL density in the tumor center and invasion front. A high density of CTL in the tumor center correlated with an improved overall survival and tumor specific survival. We show that neoadjuvant/perioperative (radio-) chemotherapy impacts on the immune microenvironment of GC, while also depending on sex. The density of TANs in neoadjuvantly/perioperatively treated GCs differed from findings made in a treatment naive GC cohort.
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Vichaya EG, Ford BG, Moltenkine JM, Taniguchi CM, Phillip West A, Dantzer R. Sex differences in the behavioral and immune responses of mice to tumor growth and cancer therapy. Brain Behav Immun 2021; 98:161-172. [PMID: 34418499 PMCID: PMC8511067 DOI: 10.1016/j.bbi.2021.08.225] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/29/2021] [Accepted: 08/14/2021] [Indexed: 10/20/2022] Open
Abstract
There is significant variability in the expression of cancer-related fatigue. Understanding the factors that account for this variation provide insight into the underlying mechanisms. One important, but often overlooked, variable is biological sex. While a few clinical studies have indicated that female patients report higher levels of fatigue, these studies are subject to potential socio-culture reporting biases. Only a limited number of preclinical studies have considered sex differences in animal model of fatigue and few have simultaneously considered both disease- and treatment-related factors. The present series of studies was initiated to address the current knowledge gap on the importance of sex differences in cancer-related fatigue. We selected a murine model of human papilloma virus-positive head and neck cancer based on heterotypic injection of the mEERL95 cell line that grows in both male and female mice and responds to a regimen of cisplatin plus irradiation. We also tested the impact of immunotherapy treatment targeting PD1. Voluntary wheel running was used to evaluate fatigue-like behavior. Male mice grew larger tumors than did female mice and showed more severe fatigue-like behavior. We confirmed that the tumor increased the expression of inflammatory cytokines in the liver, but no sex differences were observed. As a trend toward elevated Cd3 mRNA was observed in female mice, we tested the importance of T cells using female Rag2-/- mice. The Rag2-/- female mice had accelerated tumor growth and more severe fatigue-like behavior. In response to cisplatin alone non-tumor-bearing female mice showed a slower recovery of wheel running activity compared to males. However, in response to chemoradiation and anti-PD1 neutralizing antibody, tumor-bearing female mice showed a better tumor response to therapy than male mice, but no significant sex differences were observed for wheel running. These findings point to different mechanisms underlying tumor- and treatment-induced behavioral fatigue and indicate that the sex factor can intervene to modulate the expression of fatigue-like behavior in particular circumstances.
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Affiliation(s)
- Elisabeth G Vichaya
- Department of Psychology & Neuroscience, Baylor University, Waco, TX 76798, United States
| | - Bianca G Ford
- Department of Symptom Research, MD Anderson Cancer Center, Houston, TX 77030, United States
| | - Jessica M Moltenkine
- Department of Experimental Radiation Oncology, MD Anderson Cancer Center, Houston, TX 77030, United States
| | - Cullen M Taniguchi
- Department of Experimental Radiation Oncology, MD Anderson Cancer Center, Houston, TX 77030, United States
| | - A Phillip West
- Department of Microbial Pathogenesis and Immunology, College of Medicine, Texas A&M University, Bryan, TX 77087, United States
| | - Robert Dantzer
- Department of Symptom Research, MD Anderson Cancer Center, Houston, TX 77030, United States.
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Abstract
Cancer is a leading cause of death worldwide. Sex influences cancer in a bewildering variety of ways. In some cancer types, it affects prevalence; in others, genomic profiles, response to treatment, or mortality. In some, sex seems to have little or no influence. How and when sex influences cancer initiation and progression remain a critical gap in our understanding of cancer, with direct relevance to precision medicine. Here, we note several factors that complicate our understanding of sex differences: representativeness of large cohorts, confounding with features such as ancestry, age, obesity, and variability in clinical presentation. We summarize the key resources available to study molecular sex differences and suggest some likely directions for improving our understanding of how patient sex influences cancer behavior.
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Affiliation(s)
- Chenghao Zhu
- Department of Human Genetics, University of California, Los Angeles, CA, USA
- Department of Urology, University of California, Los Angeles, CA, USA
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, USA
- Institute for Precision Health, University of California, Los Angeles, CA, USA
| | - Paul C Boutros
- Department of Human Genetics, University of California, Los Angeles, CA, USA
- Department of Urology, University of California, Los Angeles, CA, USA
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, USA
- Institute for Precision Health, University of California, Los Angeles, CA, USA
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Ng KYY, Tan SH, Tan JJE, Tay DSH, Lee AWX, Ang AJS, Wong LWJ, Choo SP, Tai DWM, Lee JJX. Impact of Immune-Related Adverse Events on Efficacy of Immune Checkpoint Inhibitors in Patients with Advanced Hepatocellular Carcinoma. Liver Cancer 2021; 11:9-21. [PMID: 35222504 PMCID: PMC8820151 DOI: 10.1159/000518619] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 07/20/2021] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Development of immune-related adverse events (irAEs) has been associated with enhanced efficacy with the use of immune checkpoint inhibitors (ICIs). It remains unknown whether such an association exists in advanced hepatocellular carcinoma (aHCC). This study aims to evaluate the association between irAEs and ICI efficacy in patients with aHCC. METHODS We performed a retrospective cohort study on patients with aHCC who received at least one dose of an ICI between May 2015 and November 2019 at the National Cancer Centre Singapore. The primary study objectives were to compare the overall survival (OS) and progression-free survival (PFS) between patients with and without irAEs. Complementary multivariable landmark analyses were performed at the 6-week and 12-week landmarks. Data cutoff was December 31, 2020. RESULTS One hundred and sixty-eight patients were included. Median age was 69 years, 85.7% were male, 57.7% had hepatitis B infection, 60.7% had ECOG 0, and 78.0% had Child-Pugh A liver cirrhosis. 82.7% received ICI monotherapy, while 17.3% received ICI in combination. Development and severity of irAE were correlated with survival. The median PFS for grade ≥3 irAE versus grades 1-2 irAE versus no irAE was 8.5 versus 3.6 versus 1.3 mths (p < 0.001). The median OS for grade ≥3 irAE versus grades 1-2 irAE versus no irAE was 26.9 versus 14.0 versus 4.6 mths (p < 0.001). Patients with ≥2 irAEs had a significantly longer OS on multivariable analysis (adjusted hazard ratio [aHR]0.35, p < 0.001). The presence of grade ≥3 irAEs was associated with a significantly longer OS on the multivariable analysis at the 6-week landmark (aHR0.34, p = 0.030) and 12-week landmark (aHR0.28, p = 0.011). The use of systemic corticosteroids in patients with irAE was associated with a trend toward a longer OS (20.7 vs. 14.3 mths, p = 0.064). CONCLUSION Our study suggests that the presence of all-grade irAEs may be a potential prognostic biomarker in patients with aHCC treated with ICI. Patients with more severe irAEs and multisystem involvement have better prognosis. The prompt use of systemic corticosteroids to treat patients with irAEs is key to ensure the best long-term outcomes for these patients.
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Affiliation(s)
- Kennedy Yao Yi Ng
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Sze Huey Tan
- Division of Clinical Trials and Epidemiological Sciences, National Cancer Centre Singapore, Singapore, Singapore,Oncology Academic Program, Duke-NUS Medical School, Singapore, Singapore
| | - Jack Jie En Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Desiree Shu Hui Tay
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ailica Wan Xin Lee
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Andrea Jing Shi Ang
- Division of Internal Medicine, Singapore General Hospital, Singapore, Singapore
| | | | - Su Pin Choo
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore,Curie Oncology, Singapore, Singapore
| | - David Wai-Meng Tai
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore,Oncology Academic Program, Duke-NUS Medical School, Singapore, Singapore
| | - Joycelyn Jie Xin Lee
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore,Oncology Academic Program, Duke-NUS Medical School, Singapore, Singapore,*Joycelyn Jie Xin Lee,
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Sex-Based Differences in the Tumor Microenvironment. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1329:499-533. [PMID: 34664253 DOI: 10.1007/978-3-030-73119-9_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Cancers are heterogeneous multifactorial diseases consisting of a major public health issue worldwide. Sex disparities are evidenced in cancer incidence, mortality, expression of prognosis factor, response to treatment, and survival. For both sexes, an interplay of intrinsic and environmental factors influences cancer cells and tumor microenvironment (TME) components. The TME cumulates both supportive and communicative functions, contributing to cancer development, progression, and metastasis dissemination. The frontline topics of this chapter are focused on the contribution of sex, via steroid hormones, such as estrogens and androgens, on the following components of the TME: cancer-associated fibroblasts (CAFs), extracellular matrix (ECM), blood and lymphatic endothelial cells, and immunity/inflammatory system.
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Mezzalira S, Toffoli G. The effects of sex on pharmacogenetically guided drug treatment. Pharmacogenomics 2021; 22:959-962. [PMID: 34545749 DOI: 10.2217/pgs-2021-0088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Tweetable abstract Sex-related pharmacogenetics is emerging area of research to better explain sex discrepancies in drug response. Sex pharmacogenetics should be considered an essential step for personalized medicine.
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Affiliation(s)
- Silvia Mezzalira
- Experimental & Clinical Pharmacology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Via Franco Gallini 2, Aviano, 33081, Italy
| | - Giuseppe Toffoli
- Experimental & Clinical Pharmacology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Via Franco Gallini 2, Aviano, 33081, Italy
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Xue C, Zheng S, Dong H, Lu X, Zhang X, Zhang J, Li J, Cui H. Association Between Efficacy of Immune Checkpoint Inhibitors and Sex: An Updated Meta-Analysis on 21 Trials and 12,675 Non-Small Cell Lung Cancer Patients. Front Oncol 2021; 11:627016. [PMID: 34513654 PMCID: PMC8427763 DOI: 10.3389/fonc.2021.627016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 08/10/2021] [Indexed: 12/24/2022] Open
Abstract
Background Mounting randomized clinical trials have proved that immune checkpoint inhibitors (ICIs) achieved better overall survival (OS) and progression-free survival (PFS) than chemotherapy drugs for advanced non-small cell lung cancer (NSCLC) patients. However, some literatures have indicated that different sexes might not have equal immune response. Also, no agreement reached on the issue whether therapeutic benefit of ICIs is related to sex. Objectives To explore the association between efficacy of ICIs for NSCLC patients and their sexes and summarize overall treatment-related adverse events (TRAEs) in an exploratory manner. Methods We performed this systematic review and meta-analysis of all potentially relevant studies retrieved from PubMed, EMBASE, and the Cochrane Library until June 2021, for eligible randomized controlled trials (RCTs) comparing immunotherapy with chemotherapy in advanced NSCLC patients. Literature screening, summary data extraction was performed independently and in duplicate. The pooled hazard ratio (HR) and 95% confidence interval (CI) of OS, PFS and TRAEs were calculated, applying STATA software and random-effects models. This study was registered in international prospective register of systematic reviews (PROSPERO), number CRD42020210797. Results Twenty-one trials involving 12,675 NSCLC patients were included. For patients with advanced NSCLC, ICIs significantly prolonged the OS (males: HR 0.73, 95%CI 0.67-0.79; females: HR 0.73, 95%CI 0.61-0.85) and PFS (males: HR 0.62, 95%CI 0.55-0.70; females: HR 0.68, 95%CI 0.55-0.81) versus chemotherapy. Overall, there was no statistical difference between their sexes (OS: P = 0.97; PFS: P = 0.43), respectively. Owing to insufficient TRAEs data of different sexes, we only found immunotherapy for NSCLC patients had more all-grades (RR 0.88; 95%CI 0.82-0.95) and 3-5 grades (RR 0.60; 95%CI 0.47-0.75) AEs compared with chemotherapy. Conclusion Our findings indicated that the interaction between immunotherapy efficacy and different sexes was equally evident. Overall, patients with NSCLC could obtain more benefits from ICIs than chemotherapy regimen regardless of their sexes. Systematic Review Registration PROSPERO (https://www.crd.york.ac.uk/prospero/), identifier CRD42020210797.
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Affiliation(s)
- Chongxiang Xue
- China-Japan Friendship Clinical Medical College, Beijing University of Chinese Medicine, Beijing, China.,Department of Integrative Oncology, China-Japan Friendship Hospital, Beijing, China
| | - Shuyue Zheng
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong, SAR China
| | - Huijing Dong
- China-Japan Friendship Clinical Medical College, Beijing University of Chinese Medicine, Beijing, China
| | - Xingyu Lu
- China-Japan Friendship Clinical Medical College, Beijing University of Chinese Medicine, Beijing, China
| | - Xu Zhang
- China-Japan Friendship Clinical Medical College, Beijing University of Chinese Medicine, Beijing, China
| | - Jingyi Zhang
- China-Japan Friendship Clinical Medical College, Beijing University of Chinese Medicine, Beijing, China
| | - Jia Li
- China-Japan Friendship Clinical Medical College, Beijing University of Chinese Medicine, Beijing, China
| | - Huijuan Cui
- Department of Integrative Oncology, China-Japan Friendship Hospital, Beijing, China
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