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Zucca LER, Laus AC, Sorroche BP, Paro E, Sussuchi L, Marques RF, Teixeira GR, Berardinelli GN, Arantes LMRB, Reis RM, Cárcano FM. Immune-checkpoint gene expression and BCG response in non-muscle invasive bladder cancer. Transl Oncol 2024; 46:102003. [PMID: 38838438 PMCID: PMC11214516 DOI: 10.1016/j.tranon.2024.102003] [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: 12/22/2023] [Revised: 04/05/2024] [Accepted: 05/19/2024] [Indexed: 06/07/2024] Open
Abstract
METHODS One-hundred-six patients diagnosed with non-muscle invasive bladder cancer and treated with intravesical BCG were included and divided into two groups, BCG-responsive (n = 47) and -unresponsive (n = 59). Immunohistochemistry was used to evaluate PD-L1 expression and MSI was assessed by a commercial multiplex PCR kit. The mRNA expression profile of 15 immune checkpoints was performed using the nCounter technology. For in silico validation, two distinct cohorts sourced from the Gene Expression Omnibus (GEO) database were used. RESULTS Among the 106 patients, only one (<1 %) exhibited MSI instability. PD-L1 expression was present in 9.4 % of cases, and no association was found with BCG-responsive status. We found low gene expression of canonic actionable immune checkpoints PDCD1 (PD-1), CD274 (PD-L1), and CTLA4, while high expression was observed for CD276 (B7-H3), CD47, TNFRSF14, IDO1 and PVR (CD155) genes. High IDO1 expression levels was associated with worst overall survival. The PDCD1, CTLA4 and TNFRSF14 expression levels were associated with BCG responsiveness, whereas TIGIT and CD276 were associated with unresponsiveness. Finally, CD276 was validated in silico cohorts. CONCLUSION In NMIBC, MSI is rare and PD-L1 expression is present in a small subset of cases. Expression levels of PDCD1, CTLA4, TNFRSF14, TIGIT and CD276 could constitute predictive biomarkers of BCG responsiveness.
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Affiliation(s)
- Luis Eduardo Rosa Zucca
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil; Instituto do Câncer Brasil, Taubaté, Brazil
| | - Ana Carolina Laus
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil
| | | | - Eduarda Paro
- Barretos School of Health Sciences Dr. Paulo Prata - FACISB, Barretos, Brazil
| | - Luciane Sussuchi
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil
| | - Rui Ferreira Marques
- Life and Health Sciences Research Institute (ICVS), Medical School, University of Minho, Braga, Portugal
| | | | | | | | - Rui Manuel Reis
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil; Life and Health Sciences Research Institute (ICVS), Medical School, University of Minho, Braga, Portugal; 3ICVS/3B's-PT Government Associate Laboratory, Braga, Portugal
| | - Flavio Mavignier Cárcano
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil; Oncoclinicas & Co - Medica Scientia Innovation Research (MEDSIR), Sao Paulo, Brazil.
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Minato A, Furubayashi N, Tomoda T, Hori Y, Kiyoshima K, Negishi T, Kuroiwa K, Tomisaki I, Harada K, Nakamura M, Fujimoto N. Efficacy of avelumab maintenance therapy for advanced urothelial carcinoma with histologic subtype and divergent differentiation: a multicenter retrospective study conducted by the Uro-Oncology Group in Kyushu. Transl Androl Urol 2024; 13:1118-1126. [PMID: 39100842 PMCID: PMC11291420 DOI: 10.21037/tau-24-53] [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: 01/24/2024] [Accepted: 05/27/2024] [Indexed: 08/06/2024] Open
Abstract
Background The subtype of urothelial carcinoma (SUC) has been known to possess morphological diversity for histologic subtype or divergent differentiation. However, the efficacy of avelumab against SUC remains unclear. Therefore, the effect of the treatment as well as the survival results of avelumab monotherapy were evaluated as a first-line therapeutic maintenance in patients with advanced SUC. Methods A retrospective analysis was conducted on consecutive patients from the Uro-Oncology Group in Kyushu study population with advanced lower and upper urinary tract cancer who underwent avelumab maintenance therapy without progression after first-line platinum-based chemotherapy. Patients with pure urothelial carcinoma (PUC) and SUC were comparatively analyzed based on objective response rate (ORR), disease control rate, progression-free survival (PFS), and overall survival (OS). Results Out of 49 recorded patients, 38 and 11 had PUC and SUC, respectively. The most common subtype element was glandular differentiation (n=5), followed by squamous differentiation (n=3), micropapillary (n=1), and plasmacytoid subtypes (n=1). The SUC and PUC groups had comparable ORR (0% vs. 2.6%, P>0.99) and disease control rates (54.5% vs. 44.7%, P=0.73). These patient groups also showed no significant difference in PFS (median 3.9 vs. 3.1 months, P=0.33) or OS (median 16.7 vs. 22.1 months, P=0.47). Conclusions The response of SUC and PUC to avelumab was comparable in patients with advanced lower and upper urinary tract cancer, indicating that avelumab maintenance therapy is also effective for SUC.
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Affiliation(s)
- Akinori Minato
- Department of Urology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Nobuki Furubayashi
- Department of Urology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | | | - Yoshifumi Hori
- Department of Urology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan
| | - Keijiro Kiyoshima
- Department of Urology, Japanese Red Cross Fukuoka Hospital, Fukuoka, Japan
| | - Takahito Negishi
- Department of Urology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Kentaro Kuroiwa
- Department of Urology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan
| | - Ikko Tomisaki
- Department of Urology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Kenichi Harada
- Department of Urology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Motonobu Nakamura
- Department of Urology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Naohiro Fujimoto
- Department of Urology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
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Ni L, Xu J, Li Q, Ge X, Wang F, Deng X, Miao L. Focusing on the Immune Cells: Recent Advances in Immunotherapy for Biliary Tract Cancer. Cancer Manag Res 2024; 16:941-963. [PMID: 39099760 PMCID: PMC11296367 DOI: 10.2147/cmar.s474348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 07/17/2024] [Indexed: 08/06/2024] Open
Abstract
Biliary tract cancer (BTC) represents a challenging malignancy characterized by aggressive behavior, high relapse rates, and poor prognosis. In recent years, immunotherapy has revolutionized the treatment landscape for various cancers, but its efficacy in BTC remains limited. This article provides a comprehensive overview of the advances in preclinical and clinical studies of immunotherapy for BTC. We explore the potential of immune checkpoint inhibitors in reshaping the management of BTC. Despite disappointing results thus far, ongoing clinical trials are investigating the combination of immunotherapy with other treatment modalities. Furthermore, research on the tumor microenvironment has unveiled novel targets for immunotherapeutic interventions. By understanding the current state of immunotherapy in BTC and highlighting future directions, this article aims to fuel further exploration and ultimately improve patient outcomes in this challenging disease.
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Affiliation(s)
- Luohang Ni
- Medical Center for Digestive Diseases, Second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Jianing Xu
- Medical Center for Digestive Diseases, Second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Quanpeng Li
- Medical Center for Digestive Diseases, Second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Xianxiu Ge
- Medical Center for Digestive Diseases, Second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Fei Wang
- Medical Center for Digestive Diseases, Second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Xueting Deng
- Medical Center for Digestive Diseases, Second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Lin Miao
- Medical Center for Digestive Diseases, Second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
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4
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Lobo A, Collins K, Kaushal S, Acosta AM, Akgul M, Adhya AK, Al-Ahmadie HA, Al-Obaidy KI, Amin A, Amin MB, Aron M, Balzer BL, Biswal R, Mohanty S, Browning L, Chakrabarti I, Cima L, Cimadamore A, Desai S, Dhillon J, Deshwal A, Diego GG, Diwaker P, Galea LA, Magi-Galluzzi C, Giannico GA, Gupta NS, Haider A, Hirsch MS, Iczkowski KA, Arora S, Jain E, Jain D, Jha S, Kandukuri S, Kao CS, Kryvenko ON, Kumar RM, Kumari N, Kunju LP, Kuthi L, Lobo J, Lopez JI, Luthringer DJ, Maclean F, Manini C, Mannan R, Martos MG, Mehra R, Menon S, Mishra P, Moch H, Montironi R, Baisakh MR, Netto GJ, Nigam LK, Osunkoya AO, Pagliuca F, Paner GP, Panizo A, Parwani AV, Picken MM, Prendeville S, Przybycin CG, Purkait S, Queipo FJ, Rao BV, Rao P, Reuter VE, Sancheti S, Sangoi AR, Sardana R, Satturwar S, Shah RB, Sharma S, Dixit M, Verma M, Sirohi D, Smith SC, Soni S, Sundaram S, Swain M, Tretiakova M, Trpkov K, MuñizUnamunzaga G, Zhou M, Williamson SR, Lopez-Beltran A, Cheng L, Mohanty SK. Advances, recognition, and interpretation of molecular heterogeneity among conventional and subtype histology of urothelial carcinoma (UC): a survey among urologic pathologists and comprehensive review of the literature. Histopathology 2024. [PMID: 39075659 DOI: 10.1111/his.15287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 07/08/2024] [Accepted: 07/10/2024] [Indexed: 07/31/2024]
Abstract
AIMS Urothelial carcinoma (UC) demonstrates significant molecular and histologic heterogeneity. The WHO 2022 classification has hinted at adding molecular signatures to the morphologic diagnosis. As morphology and associated molecular repertoire may potentially translate to choices of and response to therapy and relapse rate, broader acceptability of recognizing these key features among uropathologists is needed. This prompted an international survey to ascertain the practice patterns in classical/subtype UC among uropathologists across the globe. METHODS AND RESULTS A survey instrument was shared among 98 uropathologists using SurveyMonkey software. Anonymized respondent data were analysed. The response rate was 85%. A majority were in concordance with the profiles of luminal (93%) and basal (82%) types. Opinion on the FGFR3 testing platform was variable. While 95% concurred that TERT promoter mutation is the key driver in UC, 72% had the opinion that APOBEC mutagenesis is the main signature in muscle invasive bladder cancer (MIBC). Uropathologists have divergent opinions on MIBC and ERCC2 mutations. Among the participants, 94% would quantify aggressive micropapillary and sarcomatoid histology, while 88% would reevaluate another transurethral resection of the bladder tumour specimen in nonmuscle invasive tumour with micropapillary, small cell, or sarcomatoid histology. A leading number agreed to specific molecular signatures of micropapillary (93%), plasmacytoid (97%), and small cell (86%) subtypes. Ninety-six percent of participants agreed that a small-cell component portends a more aggressive course and should be treated with neoadjuvant chemotherapy and 63% would perform HER2/neu testing only on oncologist's request in advanced tumours. Ninety percent agreed that microsatellite instability testing, although not a standard protocol, should be considered in young patients with upper tract UC. Eighty-six percent agreed that UC with high tumour mutational burden would be a better candidate for immunotherapy. CONCLUSION In the era of precision medicine, enhanced understanding of molecular heterogeneity of UC will contribute to better therapeutic options, novel biomarker discovery, innovative management protocols, and outcomes. Our survey provides a broad perspective of pathologists' perceptions and experience regarding incorporation of histomolecular approaches to "personalize" therapy. Due to variable clinical adoption, there is a need for additional data using uniform study criteria. This will drive generation of best practice guidelines in this area for widespread and consistent clinical utility.
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Affiliation(s)
- Anandi Lobo
- Department of Pathology, Kapoor Centre of Urology and Pathology, Raipur, India
| | - Katrina Collins
- Department of Pathology, Indiana University Health, Indiana, USA
| | - Seema Kaushal
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Andres M Acosta
- Department of Pathology, Indiana University Health, Indiana, USA
| | - Mahmut Akgul
- Department of Pathology, Albany Medical Center, Albany, USA
| | - Amit K Adhya
- Department of Pathology, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Hikmat A Al-Ahmadie
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, USA
| | | | - Ali Amin
- Department of Pathology, Alpert Medical School of Brown University, Providence, USA
| | - Mahul B Amin
- Department of Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, USA
| | - Manju Aron
- Department of Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, USA
| | - Bonnie L Balzer
- Department of Pathology, Cedars-Sinai Medical Center, Los Angeles, USA
| | - Rupanita Biswal
- Department of Pathology, Bagchi Sri Shankara Cancer Hospital, Bhubaneswar, India
| | - Subashish Mohanty
- Department of Pathology, SUM Ultimate Medicare Hospital, Bhubaneswar, India
| | - Lisa Browning
- Department of Pathology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Indranil Chakrabarti
- Department of Pathology, All India Institute of Medical Sciences, Kalyani, India
| | - Luca Cima
- Department of Pathology, Santa Chiara Hospital of Trento, Trento, Italy
| | - Alessia Cimadamore
- Department of Pathology, Molecular Medicine and Cell Therapy Foundation, c/o Polytechnic University of the Marche Region, Ancona, Italy
| | - Sangeeta Desai
- Department of Pathology, Tata Memorial Hospital, Mumbai, India
| | | | | | - Guillermo G Diego
- Department of Pathology, University Gregorio Marañon Hospital, Madrid, Spain
| | - Preeti Diwaker
- Department of Pathology, University College of Medical Sciences, New Delhi, India
| | - Laurence A Galea
- Department of Pathology, Melbourne Pathology, Melbourne, Australia
| | | | | | - Nilesh S Gupta
- Department of Pathology, Henry Ford Health System, Detroit, USA
| | - Aiman Haider
- Department of Pathology, University College London Hospitals NHS Foundation Trust, London, UK
| | | | | | - Samriti Arora
- Department of Pathology, CORE Diagnostics, Gurgaon, India
| | - Ekta Jain
- Department of Pathology, CORE Diagnostics, Gurgaon, India
| | - Deepika Jain
- Department of Pathology, CORE Diagnostics, Gurgaon, India
| | - Shilpy Jha
- Department of Pathology, Advanced Medical and Research Institute, Bhubaneswar, India
| | - Shivani Kandukuri
- Department of Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, USA
| | - Chia-Sui Kao
- Department of Pathology, Cleveland Clinic, Cleveland, USA
| | - Oleksandr N Kryvenko
- Department of Pathology, University of Miami Miller School of Medicine, Miami, USA
| | - Ramani M Kumar
- Department of Pathology, Dane Diagnostics, Palakkad, India
| | - Niraj Kumari
- Department of Pathology, All India Institute of Medical Sciences, Raebareli, India
| | - Lakshmi P Kunju
- Department of Pathology, University of Michigan, Ann Arbor, USA
| | - Levente Kuthi
- Department of Pathology, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - João Lobo
- Department of Pathology, Portuguese Oncology Institute - Porto, Porto, Portugal
| | - Jose I Lopez
- Department of Pathology, Cruces University Hospital, Barakaldo, Spain
| | | | - Fiona Maclean
- Department of Pathology, Douglass Hanly Moir Pathology, Sydney, Australia
| | - Claudia Manini
- Department of Pathology, University of Turin, Turin, Italy
| | - Rahul Mannan
- Department of Pathology, University of Michigan, Ann Arbor, USA
| | - María G Martos
- Department of Pathology, University Gregorio Marañon Hospital, Madrid, Spain
| | - Rohit Mehra
- Department of Pathology, University of Michigan, Ann Arbor, USA
| | - Santosh Menon
- Department of Pathology, Tata Memorial Hospital, Mumbai, India
| | - Pritinanda Mishra
- Department of Pathology, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Holger Moch
- Department of Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Rodolfo Montironi
- Department of Pathology, Molecular Medicine and Cell Therapy Foundation, c/o Polytechnic University of the Marche Region, Ancona, Italy
| | - Manas R Baisakh
- Department of Pathology, Prolife Diagnostics, Bhubaneswar, India
| | - George J Netto
- Department of Pathology, University of Pennsylvania, Philadelphia, USA
| | - Lovelesh K Nigam
- Department of Pathology, Institute of Kidney Diseases and Research Center, Ahmedabad, India
| | - Adeboye O Osunkoya
- Department of Pathology, Emory University School of Medicine, Atlanta, USA
| | - Francesca Pagliuca
- Department of Pathology, Università degliStudidella Campania Luigi Vanvitelli, Caserta, Italy
| | - Gladell P Paner
- Department of Pathology, University of Chicago, Chicago, USA
| | - Angel Panizo
- Department of Pathology, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Anil V Parwani
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, USA
| | - Maria M Picken
- Department of Pathology, Loyola University Medical Center, Hines, USA
| | - Susan Prendeville
- Department of Pathology, University Health Network, University of Toronto, Toronto, Canada
| | | | - Suvendu Purkait
- Department of Pathology, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Francisco J Queipo
- Department of Pathology, Hospital Universitario de A Coruna, A Coruna, Spain
| | - B Vishal Rao
- Department of Pathology, Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, India
| | - Priya Rao
- Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, USA
| | - Victor E Reuter
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - Sankalp Sancheti
- Department of Pathology, Homi Bhabha Cancer Hospital, Punjab, India
| | - Ankur R Sangoi
- Department of Pathology, Stanford University, Stanford, USA
| | - Rohan Sardana
- Department of Pathology, Sardana Laboratories, Jalandhar, India
| | - Swati Satturwar
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, USA
| | - Rajal B Shah
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, USA
| | - Shivani Sharma
- Department of Pathology, CORE Diagnostics, Gurgaon, India
| | - Mallika Dixit
- Department of Pathology, CORE Diagnostics, Gurgaon, India
| | - Monica Verma
- Department of Pathology, CORE Diagnostics, Gurgaon, India
| | - Deepika Sirohi
- Department of Pathology, University of California, San Francisco, USA
| | - Steven C Smith
- Department of Pathology, Virginia Commonwealth University School of Medicine, Richmond, USA
| | - Shailesh Soni
- Department of Pathology, Muljibhai Patel Urological Hospital, Nadiad, India
| | - Sandhya Sundaram
- Department of Pathology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | | | | | - Kiril Trpkov
- Department of Pathology, University of Calgary, Calgary, Canada
| | | | - Ming Zhou
- Department of Pathology, Tufts University School of Medicine, Boston, Massachusetts, USA
| | | | - Antonio Lopez-Beltran
- Department of Pathology, Unit of Anatomical Pathology, Faculty of Medicine, Cordoba University, Cordoba, Spain
| | - Liang Cheng
- Department of Pathology, Alpert Medical School of Brown University, Providence, USA
| | - Sambit K Mohanty
- Department of Pathology, CORE Diagnostics, Gurgaon, India
- Department of Pathology, Advanced Medical and Research Institute, Bhubaneswar, India
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5
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Portugal-Gaspar F, Lopez-Beltran A, Paner GP, Blanca A, Gómez EG, Montironi R, Cimadamore A, Bilé A, Volavšek M, Cheng L. Giant cell carcinoma of the urinary bladder : Clinicopathologic analysis and oncological outcomes. Virchows Arch 2024:10.1007/s00428-024-03858-w. [PMID: 39023556 DOI: 10.1007/s00428-024-03858-w] [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: 04/02/2024] [Revised: 06/18/2024] [Accepted: 06/24/2024] [Indexed: 07/20/2024]
Abstract
We present the clinicopathological features of 23 cases of the giant cell subtype of urothelial carcinoma, a rare subtype of bladder cancer recognized in the current World Health Organization classification of urological tumors. Histologically, the architectural pattern of the tumor varied from infiltrating to the solid expansile pleomorphic tumor with giant, bizarre, anaplastic cells. Typical or atypical mitotic figures were frequently present in all cases. Between 10 and 30% of the tumor had a giant cell component. All cases were associated with conventional high-grade urothelial carcinoma, with areas of squamous cell divergent differentiation and micropapillary carcinoma present in six and two cases, respectively. In one case each had sarcomatoid, nested, small cell, or glandular divergent differentiation. At diagnosis, 35% of patients had advanced disease and 12% had distant metastases. When comparing giant cell urothelial carcinoma with conventional urothelial carcinoma in a matched analysis, differences in overall and cancer-specific survival were observed, particularly in the T1 stage category. Immunohistochemical staining showed a similar profile of urothelial lineage with frequent positive expression of uroplakin II, GATA3, CK20, CK7, and S100P in both giant cell and conventional urothelial carcinomas. High Ki67 proliferation (range, 60-90%; mean, 71%) and nuclear p53 accumulation (mutant profile; range, 50-90%; mean, 64%) were observed. Using the 22C3 assay, the expression of PD-L1 was found to be variable in two cases, and beta-HCG was negative. In conclusion, giant cell carcinoma is a subtype of urothelial carcinoma associated with advanced clinical stage and a trend to lower survival rates.
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Affiliation(s)
| | - Antonio Lopez-Beltran
- Department of Morphological Sciences, Cordoba University Medical School, E-14004, Cordoba, Spain.
| | - Gladell P Paner
- Departments of Pathology and Surgery (Urology), University of Chicago, Chicago, IL, USA
| | - Ana Blanca
- Maimonides Biomedical Research Institute of Cordoba, E-14004, Cordoba, Spain
| | - Enrique Gómez Gómez
- Urology Department, Reina Sofía University Hospital, Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), University of Cordoba (UCO), Cordoba, Spain
| | - Rodolfo Montironi
- Molecular Medicine and Cell Therapy Foundation, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - Alessia Cimadamore
- Institute of Pathological Anatomy, Department of Medicine (DMED), Udine University, 33100, Udine, Italy
| | - Andreia Bilé
- Urology Department, Egas Moniz Hospital, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - Metka Volavšek
- Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Liang Cheng
- Department of Pathology and Laboratory Medicine, Department of Surgery/Urology, Warren Alpert Medical School of Brown University, Lifespan Health, and The Legorreta Cancer Center at Brown University, Providence, RI, USA
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6
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Di Gianfrancesco L, Montagner IM, Tormen D, Crestani A, Amodeo A, Corsi P, De Marchi D, Miglioranza E, Lista G, Simonetti F, Busetto GM, Maggi M, Marino F, Scapinello A, Porreca A. The Feasibility and Diagnostic Adequacy of PD-L1 Expression Analysis Using the Cytoinclusion Technique in Bladder Cancer: A Prospective Single-Center Study. J Clin Med 2024; 13:4072. [PMID: 39064112 PMCID: PMC11277725 DOI: 10.3390/jcm13144072] [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: 05/16/2024] [Revised: 06/29/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024] Open
Abstract
Background: Programmed death-ligand 1 (PD-L1) expression has been recognized as a potential biomarker for various cancers, yet its diagnostic and prognostic significance in urothelial bladder cancer (BCa) requires further investigation. Methods: In this prospective single-center study, we aimed to assess the feasibility and diagnostic adequacy of PD-L1 expression analysis using cytoinclusion in BCa patients. We enrolled consecutive patients undergoing endoscopic transurethral resection of bladder tumor (TURBT), repeat TURBT, or robot-assisted radical cystectomy. Urinary and tissue specimens were collected from these patients for cytoinclusion and histopathological analysis to evaluate PD-L1 expression. Results: Out of 29 patients, PD-L1 expression was detected from cytoinclusion in 42.8% (3 out of 7), 10% (1 out of 10), and 66.8% (8 out of 12) of patients with negative/papilloma, low-grade, and high-grade tumors, respectively. Conversely, histopathological analysis identified PD-L1 expression in 57.2% (4 out of 7), 30% (3 out of 10), and 83.3% (10 out of 12) of patients with negative/papilloma, low-grade, and high-grade tumors, respectively. The diagnostic concordance between cytoinclusion and histopathology was 85.7%, 80%, and 83.3% in patients with negative/papilloma, low-grade, and high-grade tumors, respectively. Conclusions: Our study underscores the promise of cytoinclusion as a minimally invasive method for quantifying urinary PD-L1 percentages. This approach could serve as both a potential prognostic and diagnostic indicator, easily obtainable from urine samples. Standardizing this technique could facilitate its widespread use as a valuable tool.
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Affiliation(s)
- Luca Di Gianfrancesco
- Department of Urology, Veneto Institute of Oncology (IOV)—IRCCS, Headquarter of Castelfranco Veneto, 35128 Padua, Italy; (L.D.G.); (A.A.); (P.C.); (D.D.M.); (E.M.); (G.L.); (F.S.); (A.P.)
| | - Isabella Monia Montagner
- Anatomy and Pathological Histology Unit, Veneto Institute of Oncology IOV—IRCCS, 35128 Padua, Italy; (I.M.M.); (D.T.); (A.S.)
| | - Debora Tormen
- Anatomy and Pathological Histology Unit, Veneto Institute of Oncology IOV—IRCCS, 35128 Padua, Italy; (I.M.M.); (D.T.); (A.S.)
| | - Alessandro Crestani
- Department of Urology, Ospedale Santa Maria Della Misericordia di Udine, 33100 Udine, Italy;
| | - Antonio Amodeo
- Department of Urology, Veneto Institute of Oncology (IOV)—IRCCS, Headquarter of Castelfranco Veneto, 35128 Padua, Italy; (L.D.G.); (A.A.); (P.C.); (D.D.M.); (E.M.); (G.L.); (F.S.); (A.P.)
| | - Paolo Corsi
- Department of Urology, Veneto Institute of Oncology (IOV)—IRCCS, Headquarter of Castelfranco Veneto, 35128 Padua, Italy; (L.D.G.); (A.A.); (P.C.); (D.D.M.); (E.M.); (G.L.); (F.S.); (A.P.)
| | - Davide De Marchi
- Department of Urology, Veneto Institute of Oncology (IOV)—IRCCS, Headquarter of Castelfranco Veneto, 35128 Padua, Italy; (L.D.G.); (A.A.); (P.C.); (D.D.M.); (E.M.); (G.L.); (F.S.); (A.P.)
| | - Eugenio Miglioranza
- Department of Urology, Veneto Institute of Oncology (IOV)—IRCCS, Headquarter of Castelfranco Veneto, 35128 Padua, Italy; (L.D.G.); (A.A.); (P.C.); (D.D.M.); (E.M.); (G.L.); (F.S.); (A.P.)
| | - Giuliana Lista
- Department of Urology, Veneto Institute of Oncology (IOV)—IRCCS, Headquarter of Castelfranco Veneto, 35128 Padua, Italy; (L.D.G.); (A.A.); (P.C.); (D.D.M.); (E.M.); (G.L.); (F.S.); (A.P.)
| | - Francesca Simonetti
- Department of Urology, Veneto Institute of Oncology (IOV)—IRCCS, Headquarter of Castelfranco Veneto, 35128 Padua, Italy; (L.D.G.); (A.A.); (P.C.); (D.D.M.); (E.M.); (G.L.); (F.S.); (A.P.)
| | | | - Martina Maggi
- Department of Urology, Sapienza University, 00185 Rome, Italy;
| | - Filippo Marino
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, University of Sacre Heart, 00168 Rome, Italy
| | - Antonio Scapinello
- Anatomy and Pathological Histology Unit, Veneto Institute of Oncology IOV—IRCCS, 35128 Padua, Italy; (I.M.M.); (D.T.); (A.S.)
| | - Angelo Porreca
- Department of Urology, Veneto Institute of Oncology (IOV)—IRCCS, Headquarter of Castelfranco Veneto, 35128 Padua, Italy; (L.D.G.); (A.A.); (P.C.); (D.D.M.); (E.M.); (G.L.); (F.S.); (A.P.)
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7
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Smith DJ, Lunj S, Adamson AD, Nagarajan S, Smith TAD, Reeves KJ, Hoskin PJ, Choudhury A. CRISPR-Cas9 potential for identifying novel therapeutic targets in muscle-invasive bladder cancer. Nat Rev Urol 2024:10.1038/s41585-024-00901-y. [PMID: 38951705 DOI: 10.1038/s41585-024-00901-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2024] [Indexed: 07/03/2024]
Abstract
Gene editing technologies help identify the genetic perturbations driving tumour initiation, growth, metastasis and resistance to therapeutics. This wealth of information highlights tumour complexity and is driving cancer research towards precision medicine approaches based on an individual's tumour genetics. Bladder cancer is the 11th most common cancer in the UK, with high rates of relapse and low survival rates in patients with muscle-invasive bladder cancer (MIBC). MIBC is highly heterogeneous and encompasses multiple molecular subtypes, each with different responses to therapeutics. This evidence highlights the need to identify innovative therapeutic targets to address the challenges posed by this heterogeneity. CRISPR-Cas9 technologies have been used to advance our understanding of MIBC and determine novel drug targets through the identification of drug resistance mechanisms, targetable cell-cycle regulators, and novel tumour suppressor and oncogenes. However, the use of these technologies in the clinic remains a substantial challenge and will require careful consideration of dosage, safety and ethics. CRISPR-Cas9 offers considerable potential for revolutionizing bladder cancer therapies, but substantial research is required for validation before these technologies can be used in the clinical setting.
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Affiliation(s)
- Danielle J Smith
- Division of Cancer Sciences, University of Manchester, Manchester, UK.
| | - Sapna Lunj
- Division of Cancer Sciences, University of Manchester, Manchester, UK
| | - Antony D Adamson
- Faculty of Biology, Medicine and Health Research and Innovation, University of Manchester, Manchester, UK
| | - Sankari Nagarajan
- Division of Molecular and Cellular Function, University of Manchester, Manchester, UK
| | - Tim A D Smith
- Division of Cancer Sciences, University of Manchester, Manchester, UK
- Nuclear Futures Institute, Bangor University, Bangor, UK
| | | | - Peter J Hoskin
- Division of Cancer Sciences, University of Manchester, Manchester, UK
- The Christie NHS Foundation Trust, Manchester, UK
| | - Ananya Choudhury
- Division of Cancer Sciences, University of Manchester, Manchester, UK
- The Christie NHS Foundation Trust, Manchester, UK
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8
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Ertl I, Shariat SF, Berger W, Englinger B. Preclinical models for bladder cancer therapy research. Curr Opin Urol 2024; 34:244-250. [PMID: 38630912 PMCID: PMC11155278 DOI: 10.1097/mou.0000000000001182] [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: 04/19/2024]
Abstract
PURPOSE OF REVIEW Bladder cancer (BC) is a highly heterogenous disease comprising tumours of various molecular subtypes and histologic variants. This heterogeneity represents a major challenge for the development of novel therapeutics. Preclinical models that closely mimic in vivo tumours and reflect their diverse biology are indispensable for the identification of therapies with specific activity in various BC subtypes. In this review, we summarize efforts and progress made in this context during the last 24 months. RECENT FINDINGS In recent years, one main focus was laid on the development of patient-derived BC models. Patient-derived organoids (PDOs) and patient-derived xenografts (PDXs) were demonstrated to widely recapitulate the molecular and histopathological characteristics, as well as the drug response profiles of the corresponding tumours of origin. These models, thus, represent promising tools for drug development and personalized medicine. Besides PDXs, syngenic in vivo models are of growing importance. Since these models are generated using immunocompetent hosts, they can, amongst others, be used to develop novel immunotherapeutics and to evaluate the impact of the immune system on drug response and resistance. SUMMARY In the past two years, various in vivo and in vitro models closely recapitulating the biology and heterogeneity of human bladder tumours were developed.
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Affiliation(s)
- Iris Ertl
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Shahrokh F. Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
- Department of Urology, Weill Cornell Medical College, New York, New York
- Department of Urology, University of Texas Southwestern, Dallas, Texas, USA
- Department of Urology, Second Faculty of Medicine, Charles University, Prag, Czech Republic
- Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria
- Research Center for Evidence Medicine, Urology Department Tabriz University of Medical Sciences, Tabriz, Iran
- Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan
| | - Walter Berger
- Center for Cancer Research, Medical University of Vienna, Vienna, Austria
| | - Bernard Englinger
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
- Center for Cancer Research, Medical University of Vienna, Vienna, Austria
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9
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Ma Q, Wu F, Liu X, Zhao C, Sun Y, Li Y, Zhang W, Ju H, Wang Y. 20-hydroxyecdysone suppresses bladder cancer progression via inhibiting USP21: A mechanism associated with deubiquitination and degradation of p65. Transl Oncol 2024; 45:101958. [PMID: 38663220 PMCID: PMC11059137 DOI: 10.1016/j.tranon.2024.101958] [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: 12/06/2023] [Revised: 03/22/2024] [Accepted: 04/08/2024] [Indexed: 05/03/2024] Open
Abstract
Bladder cancer is one of the most common malignancies of the urinary tract and a prevalent cancer worldwide, still requiring efficient therapeutic agents and approaches. 20-Hydroxyecdysone (20-HE), a steroid hormone, can be found in insects and few plants and mediate numerous biological events to control the progression of varying diseases; however, its impacts on bladder cancer remain unclear. In the study, we found that 20-HE treatments effectively inhibited the viability and proliferation of bladder cancer cells and induced apoptosis by activating Caspase-3. The migratory and invasive potential of bladder cancer cells was markedly repressed by 20-HE in a dose-dependent manner. The inhibitory effects of 20-HE on bladder cancer were confirmed in an established xenograft mouse model, as indicated by the markedly reduced tumor growth rates and limited lung and lymph node metastasis. High-throughput RNA sequencing was performed to explore dysregulated genes in bladder cancer cells after 20-HE treatment. We identified ubiquitin-specific protease 21 (USP21) as a key deubiquitinating enzyme for bladder cancer progression and a positive correlation between USP21 and nuclear factor-κB (NF-κB)/p65 in patients. Furthermore, 20-HE treatments markedly reduced USP21 expression, NF-κB/p65 mRNA, stability and phosphorylated NF-κB/p65 expression levels in bladder cancer cells, which were validated in animal tumor tissues. Mechanistic studies showed that USP21 directly interacted with and stabilized p65 by deubiquitinating its K48-linked polyubiquitination in bladder cancer cells, which could be abolished by 20-HE treatment, contributing to p65 degradation. Finally, we found that USP21 overexpression could not only facilitate the proliferation, migration, and invasion of bladder cancer cells, but also significantly eliminated the suppressive effects of 20-HE on bladder cancer. Notably, 20-HE could still perform its anti-tumor role in bladder cancer when USP21 was knocked down with decreased NF-κB/p65 expression and activation, revealing that USP21 suppression might not be the only way for 20-HE during bladder cancer treatment. Collectively, all our results clearly demonstrated that 20-HE may function as a promising therapeutic strategy for bladder cancer treatment mainly through reducing USP21/p65 signaling expression.
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Affiliation(s)
- Qiang Ma
- School of Basic and Forensic Medicine, Baotou Medical College, Baotou, China; School of Medicine, Southern University of Science and Technology, Shenzhen, China; Department of Pathology, The First Affiliated Hospital of Baotou Medical College, Baotou, China; Department of Pharmacy, Southern University of Science and Technology Hospital, Shenzhen, China
| | - Fei Wu
- School of Basic and Forensic Medicine, Baotou Medical College, Baotou, China
| | - Xiaohui Liu
- School of Basic and Forensic Medicine, Baotou Medical College, Baotou, China
| | - Cuifang Zhao
- School of Basic and Forensic Medicine, Baotou Medical College, Baotou, China
| | - Yang Sun
- Department of Pathology, The First Affiliated Hospital of Baotou Medical College, Baotou, China
| | - Yuanyuan Li
- Department of Pathology, The First Affiliated Hospital of Baotou Medical College, Baotou, China
| | - Wei Zhang
- School of Basic and Forensic Medicine, Baotou Medical College, Baotou, China; Department of Pathology, The First Affiliated Hospital of Baotou Medical College, Baotou, China
| | - Hongge Ju
- School of Basic and Forensic Medicine, Baotou Medical College, Baotou, China; Department of Pathology, The First Affiliated Hospital of Baotou Medical College, Baotou, China.
| | - Yukun Wang
- School of Medicine, Southern University of Science and Technology, Shenzhen, China; Department of Pharmacy, Southern University of Science and Technology Hospital, Shenzhen, China.
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10
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Coelho JQ, Ramos MJ, Ranchor R, Pichel R, Guerra L, Miranda H, Simões J, Azevedo SX, Febra J, Araújo A. What's new about the tumor microenvironment of urothelial carcinoma? Clin Transl Oncol 2024; 26:1549-1560. [PMID: 38332225 DOI: 10.1007/s12094-024-03384-w] [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: 11/02/2023] [Accepted: 01/04/2024] [Indexed: 02/10/2024]
Abstract
Urothelial carcinoma is a significant global health concern that accounts for a substantial part of cancer diagnoses and deaths worldwide. The tumor microenvironment is a complex ecosystem composed of stromal cells, soluble factors, and altered extracellular matrix, that mutually interact in a highly immunomodulated environment, with a prominent role in tumor development, progression, and treatment resistance. This article reviews the current state of knowledge of the different cell populations that compose the tumor microenvironment of urothelial carcinoma, its main functions, and distinct interactions with other cellular and non-cellular components, molecular alterations and aberrant signaling pathways already identified. It also focuses on the clinical implications of these findings, and its potential to translate into improved quality of life and overall survival. Determining new targets or defining prognostic signatures for urothelial carcinoma is an ongoing challenge that could be accelerated through a deeper understanding of the tumor microenvironment.
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Affiliation(s)
| | | | - Ridhi Ranchor
- Unidade Local de Saúde de Santo António, Porto, Portugal
| | - Rita Pichel
- Unidade Local de Saúde de Santo António, Porto, Portugal
| | - Laura Guerra
- Unidade Local de Saúde de Santo António, Porto, Portugal
| | - Hugo Miranda
- Unidade Local de Saúde de Santo António, Porto, Portugal
| | - Joana Simões
- Unidade Local de Saúde de Santo António, Porto, Portugal
| | | | - Joana Febra
- Unidade Local de Saúde de Santo António, Porto, Portugal
| | - António Araújo
- Unidade Local de Saúde de Santo António, Porto, Portugal
- Oncology Research Unit, UMIB - Unit for Multidisciplinary Research in Biomedicine, ICBAS - School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
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11
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Ishida K, Osakunor DNM, Rossi M, Lamanna OK, Mbanefo EC, Cody JJ, Le L, Hsieh MH. RNA-seq gene expression profiling of the bladder in a mouse model of urogenital schistosomiasis. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.06.29.601185. [PMID: 38979184 PMCID: PMC11230422 DOI: 10.1101/2024.06.29.601185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
Background Parasitic flatworms of the Schistosoma genus cause schistosomiasis, which affects over 230 million people. Schistosoma haematobium causes the urogenital form of schistosomiasis (UGS), which can lead to hematuria, fibrosis, and increased risk of secondary infections by bacteria or viruses. UGS is also linked to bladder cancer. To understand the bladder pathology during S. haematobium infection, our group previously developed a mouse model that involves the injection of S. haematobium eggs into the bladder wall. Using this model, we studied changes in epigenetics profile, as well as changes in gene and protein expression in the host bladder tissues. In the current study, we expand upon this work by examining the expression level of both host and parasite genes using RNA sequencing (RNA-seq) in the mouse bladder wall injection model of S. haematobium infection. Methods We used a mouse model of S. haematobium infection in which parasite eggs or vehicle control were injected into the bladder walls of female BALB/c mice. RNA-seq was performed on the RNA isolated from the bladders four days after bladder wall injection. Results/Conclusions RNA-seq analysis of egg- and vehicle control-injected bladders revealed the differential expression of 1025 mouse genes in the egg-injected bladders, including genes associated with cellular infiltration, immune cell chemotaxis, cytokine signaling, and inflammation We also observed the upregulation of immune checkpoint-related genes, which suggests that while the infection causes an inflammatory response, it also dampens the response to avoid excessive inflammation-related damage to the host. Identifying these changes in host signaling and immune responses improves our understanding of the infection and how it may contribute to the development of bladder cancer. Analysis of the differential gene expression of the parasite eggs between bladder-injected versus uninjected eggs revealed 119 S. haematobium genes associated with transcription, intracellular signaling, and metabolism. The analysis of the parasite genes also revealed fewer transcript reads compared to that found in the analysis of mouse genes, highlighting the challenges of studying parasite egg biology in the mouse model of S. haematobium infection.
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Affiliation(s)
- Kenji Ishida
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Research Institute, Washington, District of Columbia, United States
| | - Derick N M Osakunor
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Research Institute, Washington, District of Columbia, United States
| | - Mario Rossi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Olivia K Lamanna
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Research Institute, Washington, District of Columbia, United States
| | - Evaristus C Mbanefo
- National Eye Institute, National Institutes of Health, Bethesda, Maryland, United States
| | - James J Cody
- Charles River Laboratories, Rockville, Maryland, United States
| | - Loc Le
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States
| | - Michael H Hsieh
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Research Institute, Washington, District of Columbia, United States
- Department of Urology, The George Washington University, Washington, District of Columbia, United States
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12
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AlHariry NS, El Saftawy EA, Aboulhoda BE, Abozamel AH, Alghamdi MA, Hamoud AE, Khalil Ghanam WAE. Comparison of tissue biomarkers between non-schistosoma and schistosoma-associated urothelial carcinoma. Tissue Cell 2024; 88:102416. [PMID: 38796863 DOI: 10.1016/j.tice.2024.102416] [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: 01/03/2024] [Revised: 04/15/2024] [Accepted: 05/20/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND High-grade urothelial carcinoma either non-Schistosoma (NS-UBC) or Schistosoma (S-UBC)-associated is the tenth cause of death worldwide and represents a serious therapeutic problem. AIM Evaluation of the immmunohistochemical expression of tumor necrosis factor-alpha (TNFα), epidermal growth factor receptor (EGFR), programmed cell death protein-1 (PDL1), estrogen receptor-alpha (ERα) and UroplakinIII, in the high-grade in NS-UBC and S-UBC as potential prognostic and therapeutic targets analyzed through estimation of area percentage, optical density and international pathological scoring system for each marker. MATERIAL AND METHODS Sixty high grade urothelial carcinoma cases were enrolled in the study (30 cases of NS-UBC and 30 cases of S-UBC). The cases were immunohistochemically-assessed for TNFα, EGFR, PDL1, ERα and Uroplakin III expression. In S-UBC, parasite load was also evaluated for correlation with the immunohistochemical markers' expression in S-UBC. RESULTS The area percentage of immune-expression of TNFα and EGFR was higher in S-UBC compared to NS-UBC. On the other hand, the NS-UBC displayed statistically-higher expression of PDL1 and uroplakinIII (p-value <0.001). ERα revealed higher, yet, non-significant expressions in S-UBC compared to NS-UBC (p-value =0.459). PDL1 expression showed the most superior record regarding area percentage (64.6± 34.5). Regarding optical density, TNF-α showed the highest transmittance expression (2.4 ± 0.9). EGFR positively correlated with PDL1 in S-UBC (r= 0.578, p-value =0.001) whereas in NS-UBC, TNFα and PDL1 (r=0.382, p-value=0.037) had positive correlation. Schistosoma eggs in tissues oppose uroplakin III expression and trigger immunomodulation via PDL1. CONCLUSION Due to lower UroplakinIII expression, S-UBC is supposed to have a poorer prognosis. Hormonal therapy is not hypothesized due to a very minimal ERα expression in both NS-UBC and S-UBC. Regarding immunotherapy, anti-TNF-α is suggested for S-UBC whilst in NS-UBC, blockading PDL1 might be useful. Targeted EGFR therapy seems to carry emphasized outcomes in S-UBC. Correlations encourage combined immune therapy in NS-UBC; nevertheless, in S-UBC, combined anti-EGFR and PDL1 seem to be of benefit.
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Affiliation(s)
| | - Enas A El Saftawy
- Department of Medical Parasitology, Faculty of Medicine, Cairo University, Egypt; Department of Medical Parasitology, Armed Forces College of Medicine, Cairo, Egypt
| | - Basma Emad Aboulhoda
- Department of Anatomy and Embryology, Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Ahmed H Abozamel
- Department of Urology, Kasr Alainy Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mansour A Alghamdi
- Department of Anatomy, College of Medicine, King Khalid University, Abha 62529, Saudi Arabia; Genomics and Personalized Medicine Unit, The Center for Medical and Health Research, King Khalid University, Abha 62529, Saudi Arabia
| | - Amany E Hamoud
- Department of Anatomy and Embryology, Faculty of Medicine, Cairo University, Cairo, Egypt
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13
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Zhang G, Wang Y, Lu S, Ding F, Wang X, Zhu C, Wang Y, Wang K. Molecular understanding and clinical outcomes of CAR T cell therapy in the treatment of urological tumors. Cell Death Dis 2024; 15:359. [PMID: 38789450 PMCID: PMC11126652 DOI: 10.1038/s41419-024-06734-2] [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: 01/15/2024] [Revised: 05/01/2024] [Accepted: 05/08/2024] [Indexed: 05/26/2024]
Abstract
Chimeric antigen receptor engineered T (CAR T) cell therapy has developed rapidly in recent years, leading to profound developments in oncology, especially for hematologic malignancies. However, given the pressure of immunosuppressive tumor microenvironments, antigen escape, and diverse other factors, its application in solid tumors is less developed. Urinary system tumors are relatively common, accounting for approximately 24% of all new cancers in the United States. CAR T cells have great potential for urinary system tumors. This review summarizes the latest developments of CAR T cell therapy in urinary system tumors, including kidney cancer, bladder cancer, and prostate cancer, and also outlines the various CAR T cell generations and their pathways and targets that have been developed thus far. Finally, the current advantages, problems, and side effects of CAR T cell therapy are discussed in depth, and potential future developments are proposed in view of current shortcomings.
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Affiliation(s)
- Gong Zhang
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Yuan Wang
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Shiyang Lu
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Fengzhu Ding
- Department of Nursing, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Xia Wang
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Chunming Zhu
- Department of Family Medicine, Shengjing Hospital of China Medical University, Shenyang, 110004, China.
| | - Yibing Wang
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, 110004, China.
| | - Kefeng Wang
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, 110004, China.
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14
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Wang N, Wang B, Maswikiti EP, Yu Y, Song K, Ma C, Han X, Ma H, Deng X, Yu R, Chen H. AMPK-a key factor in crosstalk between tumor cell energy metabolism and immune microenvironment? Cell Death Discov 2024; 10:237. [PMID: 38762523 PMCID: PMC11102436 DOI: 10.1038/s41420-024-02011-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 04/30/2024] [Accepted: 05/07/2024] [Indexed: 05/20/2024] Open
Abstract
Immunotherapy has now garnered significant attention as an essential component in cancer therapy during this new era. However, due to immune tolerance, immunosuppressive environment, tumor heterogeneity, immune escape, and other factors, the efficacy of tumor immunotherapy has been limited with its application to very small population size. Energy metabolism not only affects tumor progression but also plays a crucial role in immune escape. Tumor cells are more metabolically active and need more energy and nutrients to maintain their growth, which causes the surrounding immune cells to lack glucose, oxygen, and other nutrients, with the result of decreased immune cell activity and increased immunosuppressive cells. On the other hand, immune cells need to utilize multiple metabolic pathways, for instance, cellular respiration, and oxidative phosphorylation pathways to maintain their activity and normal function. Studies have shown that there is a significant difference in the energy expenditure of immune cells in the resting and activated states. Notably, competitive uptake of glucose is the main cause of impaired T cell function. Conversely, glutamine competition often affects the activation of most immune cells and the transformation of CD4+T cells into inflammatory subtypes. Excessive metabolite lactate often impairs the function of NK cells. Furthermore, the metabolite PGE2 also often inhibits the immune response by inhibiting Th1 differentiation, B cell function, and T cell activation. Additionally, the transformation of tumor-suppressive M1 macrophages into cancer-promoting M2 macrophages is influenced by energy metabolism. Therefore, energy metabolism is a vital factor and component involved in the reconstruction of the tumor immune microenvironment. Noteworthy and vital is that not only does the metabolic program of tumor cells affect the antigen presentation and recognition of immune cells, but also the metabolic program of immune cells affects their own functions, ultimately leading to changes in tumor immune function. Metabolic intervention can not only improve the response of immune cells to tumors, but also increase the immunogenicity of tumors, thereby expanding the population who benefit from immunotherapy. Consequently, identifying metabolic crosstalk molecules that link tumor energy metabolism and immune microenvironment would be a promising anti-tumor immune strategy. AMPK (AMP-activated protein kinase) is a ubiquitous serine/threonine kinase in eukaryotes, serving as the central regulator of metabolic pathways. The sequential activation of AMPK and its associated signaling cascades profoundly impacts the dynamic alterations in tumor cell bioenergetics. By modulating energy metabolism and inflammatory responses, AMPK exerts significant influence on tumor cell development, while also playing a pivotal role in tumor immunotherapy by regulating immune cell activity and function. Furthermore, AMPK-mediated inflammatory response facilitates the recruitment of immune cells to the tumor microenvironment (TIME), thereby impeding tumorigenesis, progression, and metastasis. AMPK, as the link between cell energy homeostasis, tumor bioenergetics, and anti-tumor immunity, will have a significant impact on the treatment and management of oncology patients. That being summarized, the main objective of this review is to pinpoint the efficacy of tumor immunotherapy by regulating the energy metabolism of the tumor immune microenvironment and to provide guidance for the development of new immunotherapy strategies.
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Affiliation(s)
- Na Wang
- The Second Clinical Medical School, Lanzhou University, Lanzhou, Gansu, 730030, China
| | - Bofang Wang
- The Second Clinical Medical School, Lanzhou University, Lanzhou, Gansu, 730030, China
| | - Ewetse Paul Maswikiti
- The Second Clinical Medical School, Lanzhou University, Lanzhou, Gansu, 730030, China
| | - Yang Yu
- The Second Clinical Medical School, Lanzhou University, Lanzhou, Gansu, 730030, China
| | - Kewei Song
- The Second Clinical Medical School, Lanzhou University, Lanzhou, Gansu, 730030, China
| | - Chenhui Ma
- The Second Clinical Medical School, Lanzhou University, Lanzhou, Gansu, 730030, China
| | - Xiaowen Han
- The Second Clinical Medical School, Lanzhou University, Lanzhou, Gansu, 730030, China
| | - Huanhuan Ma
- The Second Clinical Medical School, Lanzhou University, Lanzhou, Gansu, 730030, China
| | - Xiaobo Deng
- The Second Clinical Medical School, Lanzhou University, Lanzhou, Gansu, 730030, China
| | - Rong Yu
- The Second Clinical Medical School, Lanzhou University, Lanzhou, Gansu, 730030, China
| | - Hao Chen
- The Department of Tumor Surgery, The Second Hospital of Lanzhou University, Lanzhou, Gansu, 730030, China.
- Key Laboratory of Environmental Oncology of Gansu Province, Lanzhou, Gansu, 730030, China.
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15
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Qiu J, Cheng Z, Jiang Z, Gan L, Zhang Z, Xie Z. Immunomodulatory Precision: A Narrative Review Exploring the Critical Role of Immune Checkpoint Inhibitors in Cancer Treatment. Int J Mol Sci 2024; 25:5490. [PMID: 38791528 PMCID: PMC11122264 DOI: 10.3390/ijms25105490] [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: 03/24/2024] [Revised: 05/11/2024] [Accepted: 05/14/2024] [Indexed: 05/26/2024] Open
Abstract
An immune checkpoint is a signaling pathway that regulates the recognition of antigens by T-cell receptors (TCRs) during an immune response. These checkpoints play a pivotal role in suppressing excessive immune responses and maintaining immune homeostasis against viral or microbial infections. There are several FDA-approved immune checkpoint inhibitors (ICIs), including ipilimumab, pembrolizumab, and avelumab. These ICIs target cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), programmed cell death protein 1 (PD-1), and programmed death ligand 1 (PD-L1). Furthermore, ongoing efforts are focused on developing new ICIs with emerging potential. In comparison to conventional treatments, ICIs offer the advantages of reduced side effects and durable responses. There is growing interest in the potential of combining different ICIs with chemotherapy, radiation therapy, or targeted therapies. This article comprehensively reviews the classification, mechanism of action, application, and combination strategies of ICIs in various cancers and discusses their current limitations. Our objective is to contribute to the future development of more effective anticancer drugs targeting immune checkpoints.
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Affiliation(s)
- Junyu Qiu
- College of Basic Medical, Nanchang University, Nanchang 330006, China; (J.Q.); (Z.C.); (Z.J.); (L.G.); (Z.Z.)
- Queen Mary School, Medical Department, Nanchang University, Nanchang 330031, China
| | - Zilin Cheng
- College of Basic Medical, Nanchang University, Nanchang 330006, China; (J.Q.); (Z.C.); (Z.J.); (L.G.); (Z.Z.)
- Queen Mary School, Medical Department, Nanchang University, Nanchang 330031, China
| | - Zheng Jiang
- College of Basic Medical, Nanchang University, Nanchang 330006, China; (J.Q.); (Z.C.); (Z.J.); (L.G.); (Z.Z.)
- Queen Mary School, Medical Department, Nanchang University, Nanchang 330031, China
| | - Luhan Gan
- College of Basic Medical, Nanchang University, Nanchang 330006, China; (J.Q.); (Z.C.); (Z.J.); (L.G.); (Z.Z.)
- Huan Kui School, Medical Department, Nanchang University, Nanchang 330031, China
| | - Zixuan Zhang
- College of Basic Medical, Nanchang University, Nanchang 330006, China; (J.Q.); (Z.C.); (Z.J.); (L.G.); (Z.Z.)
- Queen Mary School, Medical Department, Nanchang University, Nanchang 330031, China
| | - Zhenzhen Xie
- College of Basic Medical, Nanchang University, Nanchang 330006, China; (J.Q.); (Z.C.); (Z.J.); (L.G.); (Z.Z.)
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16
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Jones RT, Scholtes M, Goodspeed A, Akbarzadeh M, Mohapatra S, Feldman LE, Vekony H, Jean A, Tilton CB, Orman MV, Romal S, Deiter C, Kan TW, Xander N, Araki SP, Joshi M, Javaid M, Clambey ET, Layer R, Laajala TD, Parker SJ, Mahmoudi T, Zuiverloon TC, Theodorescu D, Costello JC. NPEPPS Is a Druggable Driver of Platinum Resistance. Cancer Res 2024; 84:1699-1718. [PMID: 38535994 PMCID: PMC11094426 DOI: 10.1158/0008-5472.can-23-1976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 12/20/2023] [Accepted: 02/29/2024] [Indexed: 04/05/2024]
Abstract
There is an unmet need to improve the efficacy of platinum-based cancer chemotherapy, which is used in primary and metastatic settings in many cancer types. In bladder cancer, platinum-based chemotherapy leads to better outcomes in a subset of patients when used in the neoadjuvant setting or in combination with immunotherapy for advanced disease. Despite such promising results, extending the benefits of platinum drugs to a greater number of patients is highly desirable. Using the multiomic assessment of cisplatin-responsive and -resistant human bladder cancer cell lines and whole-genome CRISPR screens, we identified puromycin-sensitive aminopeptidase (NPEPPS) as a driver of cisplatin resistance. NPEPPS depletion sensitized resistant bladder cancer cells to cisplatin in vitro and in vivo. Conversely, overexpression of NPEPPS in sensitive cells increased cisplatin resistance. NPEPPS affected treatment response by regulating intracellular cisplatin concentrations. Patient-derived organoids (PDO) generated from bladder cancer samples before and after cisplatin-based treatment, and from patients who did not receive cisplatin, were evaluated for sensitivity to cisplatin, which was concordant with clinical response. In the PDOs, depletion or pharmacologic inhibition of NPEPPS increased cisplatin sensitivity, while NPEPPS overexpression conferred resistance. Our data present NPEPPS as a druggable driver of cisplatin resistance by regulating intracellular cisplatin concentrations. SIGNIFICANCE Targeting NPEPPS, which induces cisplatin resistance by controlling intracellular drug concentrations, is a potential strategy to improve patient responses to platinum-based therapies and lower treatment-associated toxicities.
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Affiliation(s)
- Robert T. Jones
- Department of Pharmacology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Mathijs Scholtes
- Department of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Andrew Goodspeed
- Department of Pharmacology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
- University of Colorado Cancer Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Maryam Akbarzadeh
- Department of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Biochemistry, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Saswat Mohapatra
- Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute, Los Angeles, California
| | - Lily Elizabeth Feldman
- Department of Pharmacology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Hedvig Vekony
- Department of Pharmacology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Annie Jean
- Department of Pharmacology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Charlene B. Tilton
- Department of Pharmacology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Michael V. Orman
- Department of Pharmacology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Shahla Romal
- Department of Biochemistry, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Cailin Deiter
- Department of Pharmacology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Tsung Wai Kan
- Department of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Pathology, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Nathaniel Xander
- Department of Pharmacology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Stephanie P. Araki
- Department of Pharmacology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Molishree Joshi
- Department of Pharmacology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
- Functional Genomics Facility, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Mahmood Javaid
- Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Eric T. Clambey
- Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Ryan Layer
- Computer Science Department, University of Colorado, Boulder, Colorado
- BioFrontiers Institute, University of Colorado, Boulder, Colorado
| | - Teemu D. Laajala
- Department of Pharmacology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
- Department of Mathematics and Statistics, University of Turku, Turku, Finland
| | - Sarah J. Parker
- Smidt Heart Institute and Advanced Clinical Biosystems Research Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Tokameh Mahmoudi
- Department of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Biochemistry, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Pathology, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Tahlita C.M. Zuiverloon
- Department of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Dan Theodorescu
- Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute, Los Angeles, California
- Department of Urology, Cedars-Sinai Medical Center, Los Angeles, California
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California
| | - James C. Costello
- Department of Pharmacology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
- University of Colorado Cancer Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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17
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Qin R, Ma X, Pu S, Shen C, Hu D, Liu C, Wang K, Wang Y. Identification and validation of a signature based on myofibroblastic cancer-associated fibroblast marker genes for predicting prognosis, immune infiltration, and therapeutic response in bladder cancer. Investig Clin Urol 2024; 65:263-278. [PMID: 38714517 PMCID: PMC11076800 DOI: 10.4111/icu.20230300] [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: 09/02/2023] [Revised: 11/08/2023] [Accepted: 01/02/2024] [Indexed: 05/10/2024] Open
Abstract
PURPOSE Myofibroblastic cancer-associated fibroblasts (myCAFs) are important components of the tumor microenvironment closely associated with tumor stromal remodeling and immunosuppression. This study aimed to explore myCAFs marker gene biomarkers for clinical diagnosis and therapy for patients with bladder cancer (BC). MATERIALS AND METHODS BC single-cell RNA sequencing (scRNA-seq) data were obtained from the National Center for Biotechnology Information Sequence Read Archive. Transcriptome and clinical data were downloaded from The Cancer Genome Atlas and the Gene Expression Omnibus databases. Subsequently, univariate Cox and LASSO (Least Absolute Shrinkage and Selection Operator regression) regression analyses were performed to construct a prognostic signature. Immune cell activity was estimated using single-sample gene set enrichment analysis whilst the TIDE (tumor immune dysfunction and exclusion) method was employed to assess patient response to immunotherapy. The chemotherapy response of patients with BC was evaluated using genomics of drug sensitivity in cancer. Furthermore, Immunohistochemistry was used to verify the correlation between MAP1B expression and immunotherapy efficacy. The scRNA-seq data were analyzed to identify myCAFs marker genes. RESULTS Combined with bulk RNA-sequencing data, we constructed a two-gene (COL6A1 and MAP1B) risk signature. In patients with BC, the signature demonstrated outstanding prognostic value, immune infiltration, and immunotherapy response. This signature served as a crucial guide for the selection of anti-tumor chemotherapy medications. Additionally, immunohistochemistry confirmed that MAP1B expression was significantly correlated with immunotherapy efficacy. CONCLUSIONS Our findings revealed a typical prognostic signature based on myCAF marker genes, which offers patients with BC a novel treatment target alongside theoretical justification.
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Affiliation(s)
- Ruize Qin
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiaocheng Ma
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Shi Pu
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Chengquan Shen
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Ding Hu
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Changxue Liu
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Kongjia Wang
- Department of Urology, Qingdao Municipal Hospital, Qingdao, China
| | - Yonghua Wang
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China.
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18
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Meneceur S, De Vos CE, Petzsch P, Köhrer K, Niegisch G, Hoffmann MJ. New synergistic combination therapy approaches with HDAC inhibitor quisinostat, cisplatin or PARP inhibitor talazoparib for urothelial carcinoma. J Cell Mol Med 2024; 28:e18342. [PMID: 38693852 PMCID: PMC11063726 DOI: 10.1111/jcmm.18342] [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: 06/09/2023] [Revised: 02/13/2024] [Accepted: 04/05/2024] [Indexed: 05/03/2024] Open
Abstract
Urothelial carcinoma (UC) urgently requires new therapeutic options. Histone deacetylases (HDAC) are frequently dysregulated in UC and constitute interesting targets for the development of alternative therapy options. Thus, we investigated the effect of the second generation HDAC inhibitor (HDACi) quisinostat in five UC cell lines (UCC) and two normal control cell lines in comparison to romidepsin, a well characterized HDACi which was previously shown to induce cell death and cell cycle arrest. In UCC, quisinostat led to cell cycle alterations, cell death induction and DNA damage, but was well tolerated by normal cells. Combinations of quisinostat with cisplatin or the PARP inhibitor talazoparib led to decrease in cell viability and significant synergistic effect in five UCCs and platinum-resistant sublines allowing dose reduction. Further analyses in UM-UC-3 and J82 at low dose ratio revealed that the mechanisms included cell cycle disturbance, apoptosis induction and DNA damage. These combinations appeared to be well tolerated in normal cells. In conclusion, our results suggest new promising combination regimes for treatment of UC, also in the cisplatin-resistant setting.
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Affiliation(s)
- Sarah Meneceur
- Department of Urology, Medical Faculty and University Hospital DüsseldorfHeinrich Heine University DüsseldorfDüsseldorfGermany
- Center for Integrated Oncology (CIO) DüsseldorfCIO Aachen Bonn Köln DüsseldorfDüsseldorfGermany
| | - Caroline E. De Vos
- Department of Urology, Medical Faculty and University Hospital DüsseldorfHeinrich Heine University DüsseldorfDüsseldorfGermany
- Center for Integrated Oncology (CIO) DüsseldorfCIO Aachen Bonn Köln DüsseldorfDüsseldorfGermany
| | - Patrick Petzsch
- Center for Integrated Oncology (CIO) DüsseldorfCIO Aachen Bonn Köln DüsseldorfDüsseldorfGermany
- Genomics and Transcriptomics Laboratory (GTL), Biological and Medical Research Center (BMFZ)Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University DüsseldorfDüsseldorfGermany
| | - Karl Köhrer
- Center for Integrated Oncology (CIO) DüsseldorfCIO Aachen Bonn Köln DüsseldorfDüsseldorfGermany
- Genomics and Transcriptomics Laboratory (GTL), Biological and Medical Research Center (BMFZ)Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University DüsseldorfDüsseldorfGermany
| | - Günter Niegisch
- Department of Urology, Medical Faculty and University Hospital DüsseldorfHeinrich Heine University DüsseldorfDüsseldorfGermany
- Center for Integrated Oncology (CIO) DüsseldorfCIO Aachen Bonn Köln DüsseldorfDüsseldorfGermany
| | - Michèle J. Hoffmann
- Department of Urology, Medical Faculty and University Hospital DüsseldorfHeinrich Heine University DüsseldorfDüsseldorfGermany
- Center for Integrated Oncology (CIO) DüsseldorfCIO Aachen Bonn Köln DüsseldorfDüsseldorfGermany
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19
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Abbas N, Chehade L, Shamseddine A. Personalized treatment with PARP inhibitors in advanced urothelial carcinoma: a case report and literature review. Ther Adv Med Oncol 2024; 16:17588359241245283. [PMID: 38638285 PMCID: PMC11025443 DOI: 10.1177/17588359241245283] [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: 12/10/2023] [Accepted: 03/19/2024] [Indexed: 04/20/2024] Open
Abstract
Bladder cancer (BC) poses a significant health challenge, particularly in metastatic cases, where the prognosis is unfavorable and therapeutic options are limited. Poly ADP-ribose polymerase (PARP) inhibitors have gained approval for use in various cancer types, but their application in BC remains controversial, despite the notable prevalence of DNA damage response alterations in advanced or metastatic urothelial carcinomas. In this report, we describe a 66-year-old heavy-smoking female diagnosed with muscle-invasive BC. She underwent multiple rounds of chemotherapy and radiation, yet her disease remained poorly controlled, leading to metastasis in the left obturator internus muscle. Comprehensive genomic profiling through FoundationOne® Liquid CDx, examining a 324-gene panel using circulating tumor DNA from blood samples, revealed a pathogenic ATM gene alteration (p.Q654fs*10, c.1960delC), suggesting potential eligibility for PARP inhibitor therapy. Remarkably, the patient achieved a complete response to talazoparib, prompting an optimal investigation into BC candidates for this promising therapy.
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Affiliation(s)
- Noura Abbas
- Naef K. Basile Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Laudy Chehade
- Naef K. Basile Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ali Shamseddine
- Naef K. Basile Cancer Institute, American University of Beirut Medical Center, P.O. Box 11-0236, Riad El-Solh, Beirut 1107 2020, Lebanon
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20
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Mokbel S, Baciarello G, Lavaud P, Omlin A, Calabrò F, Cathomas R, Aeppli S, Parent P, Giannatempo P, Koster KL, Appel N, Gonnet P, Angius G, Tsantoulis P, Arkenau HT, Cattrini C, Messina C, Zeghondy J, Morelli C, Loriot Y, Formica V, Patrikidou A. Development and Validation of an Inflammatory Prognostic Index to Predict Outcomes in Advanced/Metastatic Urothelial Cancer Patients Receiving Immune Checkpoint Inhibitors. Cancers (Basel) 2024; 16:1465. [PMID: 38672547 PMCID: PMC11048042 DOI: 10.3390/cancers16081465] [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: 03/06/2024] [Revised: 04/02/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Immune checkpoint inhibitors (ICIs) improve overall survival (OS) in advanced/metastatic urothelial cancer (a/mUC) patients. Preliminary evidence suggests a prognostic role of inflammatory biomarkers in this setting. We aimed to develop a disease-specific prognostic inflammatory index for a/mUC patients on ICIs. METHODS Fifteen variables were retrospectively correlated with OS and progression-free survival (PFS) in a development (D, n = 264) and a validation (V, n = 132) cohort of platinum-pretreated a/mUC pts receiving ICIs at L2 or further line. A nomogram and inflammatory prognostic index (U-IPI) were developed. The index was also tested in a control cohort of patients treated with chemotherapy only (C, n = 114). RESULTS The strongest predictors of OS were baseline platelet/lymphocyte (PLR) and neutrophil/lymphocyte (NLR) ratios, and lactate dehydrogenase (LDH), NLR, and albumin changes at 4 weeks. These were used to build the U-IPI, which can distinctly classify patients into good or poor response groups. The nomogram scoring is significant for PFS and OS (p < 0.001 in the D, V, and combined cohorts) for the immunotherapy (IO) cohort, but not for the control cohort. CONCLUSIONS The lack of a baseline systemic inflammatory profile and the absence of early serum inflammatory biomarker changes are associated with significantly better outcomes on ICIs in a/mUC pts. The U-IPI is an easily applicable dynamic prognostic tool for PFS and OS, allowing for the early identification of a sub-group with dismal outcomes that would not benefit from ICIs, while distinguishing another that draws an important benefit.
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Affiliation(s)
- Sara Mokbel
- Faculty of Medicine, UCL—University College London, London WC1H 0AP, UK;
| | - Giuilia Baciarello
- Medical Oncology Department, Azienda Ospedaliera San Camillo Forlanini, 00152 Roma, Italy; (G.B.); (G.A.)
| | - Pernelle Lavaud
- Medical Oncology Department, Gustave Roussy Cancer Campus, 94805 Villejuif, France; (P.L.); (J.Z.); (Y.L.)
| | - Aurelius Omlin
- Medical Oncology and Haematology Department, OnkoZentrum Zürich, 8038 Zurich, Switzerland;
| | - Fabio Calabrò
- Medical Oncology 1, IRCCS National Cancer Institute Regina Elena, 00144 Rome, Italy; (F.C.)
| | - Richard Cathomas
- Medical Oncology 1, IRCCS National Cancer Institute Regina Elena, 00144 Rome, Italy; (F.C.)
| | - Stefanie Aeppli
- Department of Medical Oncology and Haematology, Cantonal Hospital St.Gallen, 9000 St. Gallen, Switzerland; (S.A.); (K.-L.K.)
| | - Pauline Parent
- Medical Oncology Departement, CHU Lille—Centre Hospitalier Régional Universitaire de Lille, 59000 Lille, France;
| | - Patrizia Giannatempo
- Medical Oncology Department, Fondazione IRCCS—Istituto Nazionale dei Tumori, 20133 Milan, Italy;
| | - Kira-Lee Koster
- Department of Medical Oncology and Haematology, Cantonal Hospital St.Gallen, 9000 St. Gallen, Switzerland; (S.A.); (K.-L.K.)
| | - Naara Appel
- Medical Oncology Departement, HUG—Hopitaux Universitaires Geneve, 1205 Geneva, Switzerland; (N.A.); (P.G.)
| | - Philippe Gonnet
- Medical Oncology Departement, HUG—Hopitaux Universitaires Geneve, 1205 Geneva, Switzerland; (N.A.); (P.G.)
| | - Gesuino Angius
- Medical Oncology Department, Azienda Ospedaliera San Camillo Forlanini, 00152 Roma, Italy; (G.B.); (G.A.)
| | - Petros Tsantoulis
- Medical Oncology Departement, HUG—Hopitaux Universitaires Geneve, 1205 Geneva, Switzerland; (N.A.); (P.G.)
| | | | - Carlo Cattrini
- Maggiore della Carità University Hospital, 28100 Novara, Italy;
| | | | - Jean Zeghondy
- Medical Oncology Department, Gustave Roussy Cancer Campus, 94805 Villejuif, France; (P.L.); (J.Z.); (Y.L.)
| | - Cristina Morelli
- Medical Oncology Unit, Policlinico Tor Vergata, 00133 Rome, Italy; (C.M.); (V.F.)
| | - Yohann Loriot
- Medical Oncology Department, Gustave Roussy Cancer Campus, 94805 Villejuif, France; (P.L.); (J.Z.); (Y.L.)
| | - Vincenzo Formica
- Medical Oncology Unit, Policlinico Tor Vergata, 00133 Rome, Italy; (C.M.); (V.F.)
| | - Anna Patrikidou
- Medical Oncology Department, Gustave Roussy Cancer Campus, 94805 Villejuif, France; (P.L.); (J.Z.); (Y.L.)
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21
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Russo AE, Memon A, Ahmed S. Bladder Cancer and the Urinary Microbiome-New Insights and Future Directions: A Review. Clin Genitourin Cancer 2024; 22:434-444. [PMID: 38220540 DOI: 10.1016/j.clgc.2023.12.015] [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: 10/10/2023] [Revised: 12/26/2023] [Accepted: 12/28/2023] [Indexed: 01/16/2024]
Abstract
The presence of a microbiome in the urinary system has been established through recent advancements in technology and investigation of microbial communities in the human body. The study of the taxonomic and genomic ecology of microbial communities has been greatly improved by the use of metagenomics. The research in this area has expanded our understanding of microbial ecosystems and shows that the urinary tract contains over 100 species from over 50 genera, with Lactobacillus, Gardnerella, and Streptococcus being the most common. Previous studies have suggested that the microbiota in the urinary tract may play a role in carcinogenesis by causing chronic inflammation and genotoxicity, but more research is needed to reach a definite conclusion. This is a narrative review. We conducted a search for relevant publications by using the databases Medline/PubMed and Google Scholar. The search was based on keywords such as "urinary microbiome," "bladder cancer," "carcinogenesis," "urothelial carcinoma," and "next-generation sequencing." The retrieved publications were then reviewed to study the contribution of the urinary microbiome in the development of bladder cancer. The results have been categorized into four sections to enhance understanding of the urinary microbiome and to highlight its role in the emergence of bladder cancer through alterations in the immune response that involve T-cells and antibodies. The immune system and microbiome play crucial roles in maintaining health and preventing disease. Manipulating the immune system is a key aspect of various cancer treatments, and certain gut bacteria have been linked to positive responses to immunotherapies. However, the impact of these treatments on the urinary microbiome, and how diet and lifestyle affect it, are not well understood. Research in this area could have significant implications for improving bladder cancer treatment and patient outcomes.
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Affiliation(s)
- Angela E Russo
- Larner College of Medicine, University of Vermont, Burlington, VT.
| | - Areeba Memon
- Medical College, Aga Khan University, Karachi, Sindh, Pakistan
| | - Shahid Ahmed
- Department of Hematology and Oncology, University of Vermont, Burlington, VT
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22
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Rüschoff J, Kumar G, Badve S, Jasani B, Krause E, Rioux-Leclercq N, Rojo F, Martini M, Cheng L, Tretiakova M, Mitchell C, Anders RA, Robert ME, Fahy D, Pyle M, Le Q, Yu L, Glass B, Baxi V, Babadjanova Z, Pratt J, Brutus S, Karasarides M, Hartmann A. Scoring PD-L1 Expression in Urothelial Carcinoma: An International Multi-Institutional Study on Comparison of Manual and Artificial Intelligence Measurement Model (AIM-PD-L1) Pathology Assessments. Virchows Arch 2024; 484:597-608. [PMID: 38570364 DOI: 10.1007/s00428-024-03795-8] [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: 01/10/2024] [Revised: 03/20/2024] [Accepted: 03/22/2024] [Indexed: 04/05/2024]
Abstract
Assessing programmed death ligand 1 (PD-L1) expression on tumor cells (TCs) using Food and Drug Administration-approved, validated immunoassays can guide the use of immune checkpoint inhibitor (ICI) therapy in cancer treatment. However, substantial interobserver variability has been reported using these immunoassays. Artificial intelligence (AI) has the potential to accurately measure biomarker expression in tissue samples, but its reliability and comparability to standard manual scoring remain to be evaluated. This multinational study sought to compare the %TC scoring of PD-L1 expression in advanced urothelial carcinoma, assessed by either an AI Measurement Model (AIM-PD-L1) or expert pathologists. The concordance among pathologists and between pathologists and AIM-PD-L1 was determined. The positivity rate of ≥ 1%TC PD-L1 was between 20-30% for 8/10 pathologists, and the degree of agreement and scoring distribution for among pathologists and between pathologists and AIM-PD-L1 was similar both scored as a continuous variable or using the pre-defined cutoff. Numerically higher score variation was observed with the 22C3 assay than with the 28-8 assay. A 2-h training module on the 28-8 assay did not significantly impact manual assessment. Cases exhibiting significantly higher variability in the assessment of PD-L1 expression (mean absolute deviation > 10) were found to have patterns of PD-L1 staining that were more challenging to interpret. An improved understanding of sources of manual scoring variability can be applied to PD-L1 expression analysis in the clinical setting. In the future, the application of AI algorithms could serve as a valuable reference guide for pathologists while scoring PD-L1.
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Affiliation(s)
- Josef Rüschoff
- Discovery Life Sciences and Pathology Nordhessen, Kassel, Germany.
| | | | - Sunil Badve
- Emory University School of Medicine, Atlanta, GA, USA
| | - Bharat Jasani
- Discovery Life Sciences and Pathology Nordhessen, Kassel, Germany
- University of Cardiff, Cardiff, Wales, UK
| | | | | | - Federico Rojo
- IIS-Fundacion Jimenez Diaz CIBERONC (Madrid), Madrid, Spain
| | | | - Liang Cheng
- Brown University Warren Alpert Medical School and the Legorreta Cancer Center at Brown University, Providence, RI, USA
| | | | | | | | | | | | | | | | | | | | - Vipul Baxi
- Bristol Myers Squibb, Princeton, NJ, USA
| | | | | | | | | | - Arndt Hartmann
- Comprehensive Cancer Center EMN, Institute of Pathology, Friedrich-Alexander-University Erlangen-Nürnberg, University Hospital Erlangen, Erlangen, Germany.
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23
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Meagher M, Krause H, Elliott A, Farrell A, Antonarakis ES, Bastos B, Heath EI, Jamieson C, Stewart TF, Bagrodia A, Nabhan C, Oberley M, McKay RR, Salmasi A. Characterization and impact of non-canonical WNT signaling on outcomes of urothelial carcinoma. Cancer Med 2024; 13:e7148. [PMID: 38558536 PMCID: PMC10983807 DOI: 10.1002/cam4.7148] [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: 01/11/2024] [Accepted: 03/08/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Non-canonical WNT family (WNT5A pathway) signaling via WNT5A through ROR1 and its partner, ROR2, or Frizzled2 (FZD2) is linked to processes driving tumorigenesis and therapy resistance. We utilized a large dataset of urothelial carcinoma (UC) tumors to characterize non-canonical WNT signaling through WNT5A, ROR1, ROR2, or FZD2 expression. METHODS NextGen Sequencing of DNA (592 genes or WES)/RNA (WTS) was performed for 4125 UC tumors submitted to Caris Life Sciences. High and low expression of WNT5A, ROR1, ROR2, and FZD2 was defined as ≥ top and RESULTS WNT5A pathway gene expression varied significantly between primary versus metastatic sites: WNT5A (25.2 vs. 16.8 TPM), FZD2 (3.2 vs. 4.05), ROR1 (1.7 vs. 2.1), and ROR2 (2.4 vs. 2.6) p < 0.05 for all. Comparison of high- and low-expression subgroups revealed variation in the prevalence of TP53, FGFR3, and RB1 pathogenic mutations, as well as increasing T cell-inflamed scores as expression of the target gene increased. High gene expression for ROR2 (HR 1.31, 95% CI 1.15-1.50, p < 0.001) and FZD2 (HR 1.16, 95% CI 1.02-1.32, p = 0.024) was associated with worse OS. CONCLUSION Distinct genomic and immune landscapes for the four investigated WNT5A pathway components were observed in patients with UC. External validation studies are needed.
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Affiliation(s)
- Margaret Meagher
- Department of UrologyUC San Diego School of MedicineLa JollaCaliforniaUSA
| | | | | | | | | | - Bruno Bastos
- Miami Cancer InstituteMiamiFloridaUSA
- Karmanos Cancer Institute, Department of OncologyWayne State University School of MedicineDetroitMichiganUSA
| | - Elisabeth I. Heath
- Department of MedicineUC San Diego School of MedicineLa JollaCaliforniaUSA
| | - Christina Jamieson
- Department of UrologyUC San Diego School of MedicineLa JollaCaliforniaUSA
| | - Tyler F. Stewart
- Department of UrologyUC San Diego School of MedicineLa JollaCaliforniaUSA
| | - Aditya Bagrodia
- Department of UrologyUC San Diego School of MedicineLa JollaCaliforniaUSA
| | | | | | - Rana R. McKay
- Department of UrologyUC San Diego School of MedicineLa JollaCaliforniaUSA
- Barbara Ann Karmanos Cancer InstituteDetroitUSA
| | - Amirali Salmasi
- Department of UrologyUC San Diego School of MedicineLa JollaCaliforniaUSA
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24
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Bitam S, Hamadache M, Hanini S. Targeting bladder cancer with Trigonella foenum-graecum: a computational study using network pharmacology and molecular docking. J Biomol Struct Dyn 2024; 42:3286-3293. [PMID: 37232424 DOI: 10.1080/07391102.2023.2217926] [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: 02/23/2023] [Accepted: 04/27/2023] [Indexed: 05/27/2023]
Abstract
Trigonella foenum-graecum (TF-graecum), known as Hulba or Fenugreek, is one of the oldest known medicinal plants. It has been found to have antimicrobial, antifungal, antioxidant, wound-healing, anti-diarrheal, hypoglycemic, anti-diabetic, and anti-inflammatory activities. In our current report, we have collected and screened the active compounds of TF-graecum and their potential targets via different pharmacology platforms. Network construction shows that eight active compounds may act on 223 potential bladder cancer targets. The pathway enrichment analysis for the seven potential targets of the eight compounds selected, based on KEGG pathway analysis, was conducted to clarify the potential pharmacological effects. Finally, molecular docking and molecular dynamics simulation showed the stability of protein-ligand interactions. This study highlights the need for increased research into the potential medical benefits of this plant.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Said Bitam
- Faculté de Technologie, Département du Génie des Procédés et Environnement, Laboratoire des Biomatériaux et Phénomènes de Transport (LBMPT), Université de Médéa, Médéa, Algérie
| | - Mabrouk Hamadache
- Faculté de Technologie, Département du Génie des Procédés et Environnement, Laboratoire des Biomatériaux et Phénomènes de Transport (LBMPT), Université de Médéa, Médéa, Algérie
| | - Salah Hanini
- Faculté de Technologie, Département du Génie des Procédés et Environnement, Laboratoire des Biomatériaux et Phénomènes de Transport (LBMPT), Université de Médéa, Médéa, Algérie
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25
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Cao Y, Zhu H, Li Z, Liu C, Ye J. CT Image-Based Radiomic Analysis for Detecting PD-L1 Expression Status in Bladder Cancer Patients. Acad Radiol 2024:S1076-6332(24)00138-7. [PMID: 38556431 DOI: 10.1016/j.acra.2024.02.047] [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: 11/01/2023] [Revised: 02/26/2024] [Accepted: 02/26/2024] [Indexed: 04/02/2024]
Abstract
RATIONALE AND OBJECTIVES The role of Programmed death-ligand 1 (PD-L1) expression is crucial in guiding immunotherapy selection. This study aims to develop and evaluate a radiomic model, leveraging Computed Tomography (CT) imaging, with the objective of predicting PD-L1 expression status in patients afflicted with bladder cancer. MATERIALS AND METHODS The study encompassed 183 subjects diagnosed with histologically confirmed bladder cancer, among which the PD-L1(+) cohort constituted 60.1% of the total population. Stratified random sampling was utilized at a 7:3 ratio. We employed five diverse machine learning algorithms-Decision Tree, Random Forest, Linear Support Vector Classification, Support Vector Machine, and Logistic Regression-to establish radiomic models on the training dataset. These models endeavored to predict PD-L1 expression status premised on radiomic features derived from region-of-interest segmentation. Subsequent to this, the predictive performance of these models was examined on a validation set employing the receiver operating characteristic (ROC) curve. The DeLong test was utilized to contrast ROC curves, thereby pinpointing the model with superior predictive accuracy. RESULTS 16 features were chosen for the model construction. All five models revealed strong performance in the training set (AUC, 0.920-1) and commendable predictive ability in the validation set (AUC, 0.753-0.766). As per the DeLong test, no statistically significant disparities were observed among any of the models (P > 0.05) in the validation set. Additional verification through the calibration curve and decision curve analysis indicated that the Logistic Regression model exhibited extraordinary precision and practicality. CONCLUSION Our machine learning model, grounded on radiomic features, demonstrated its proficiency in accurately distinguishing bladder cancer patients with high PD-L1 expression. Future research, incorporating more exhaustive datasets, could potentially augment the predictive efficiency of radiomic algorithms, thereby advancing their clinical utility.
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Affiliation(s)
- Ying Cao
- Department of Radiotherapy, Suzhou Kowloon Hospital, Shanghai Jiaotong University School of Medicine, Suzhou 215028, China
| | - Hongyu Zhu
- Department of Radiotherapy, The Affiliated Suzhou Hospital of Nanjing University Medical School, Suzhou 215153, China
| | - Zhenkai Li
- Department of Radiology, Suzhou Kowloon Hospital, Shanghai Jiaotong University School of Medicine, Suzhou 215028, China
| | - Canyu Liu
- Department of Radiotherapy, Dushu Lake Hospital Affiliated to Soochow University, Suzhou 215127, China
| | - Juan Ye
- Department of Radiology, Suzhou Kowloon Hospital, Shanghai Jiaotong University School of Medicine, Suzhou 215028, China.
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26
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Shebbo S, Binothman N, Darwaish M, Niaz HA, Abdulal RH, Borjac J, Hashem AM, Mahmoud AB. Redefining the battle against colorectal cancer: a comprehensive review of emerging immunotherapies and their clinical efficacy. Front Immunol 2024; 15:1350208. [PMID: 38533510 PMCID: PMC10963412 DOI: 10.3389/fimmu.2024.1350208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 02/21/2024] [Indexed: 03/28/2024] Open
Abstract
Colorectal cancer (CRC) is the third most common cancer globally and presents a significant challenge owing to its high mortality rate and the limitations of traditional treatment options such as surgery, radiotherapy, and chemotherapy. While these treatments are foundational, they are often poorly effective owing to tumor resistance. Immunotherapy is a groundbreaking alternative that has recently emerged and offers new hope for success by exploiting the body's own immune system. This article aims to provide an extensive review of clinical trials evaluating the efficacy of various immunotherapies, including CRC vaccines, chimeric antigen receptor T-cell therapies, and immune checkpoint inhibitors. We also discuss combining CRC vaccines with monoclonal antibodies, delve into preclinical studies of novel cancer vaccines, and assess the impact of these treatment methods on patient outcomes. This review seeks to provide a deeper understanding of the current state of CRC treatment by evaluating innovative treatments and their potential to redefine the prognosis of patients with CRC.
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Affiliation(s)
- Salima Shebbo
- Strategic Research and Innovation Laboratories, Taibah University, Madinah, Saudi Arabia
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Biological Sciences, Beirut Arab University, Debbieh, Lebanon
| | - Najat Binothman
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Chemistry, College of Sciences and Arts, King Abdulaziz University, Rabigh, Saudi Arabia
| | - Manar Darwaish
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Immunology Research Program, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Hanan A. Niaz
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk, Saudi Arabia
| | - Rwaa H. Abdulal
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Jamilah Borjac
- Department of Biological Sciences, Beirut Arab University, Debbieh, Lebanon
| | - Anwar M. Hashem
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Clinical Microbiology and Immunology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahmad Bakur Mahmoud
- Strategic Research and Innovation Laboratories, Taibah University, Madinah, Saudi Arabia
- College of Applied Medical Sciences, Taibah University, Almadinah Almunawarah, Saudi Arabia
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27
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Liu J, Gao Y, Song C, Liao W, Meng L, Yang S, Xiong Y. Immunotherapeutic prospects and progress in bladder cancer. J Cell Mol Med 2024; 28:e18101. [PMID: 38165009 PMCID: PMC10902563 DOI: 10.1111/jcmm.18101] [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: 09/26/2023] [Revised: 11/28/2023] [Accepted: 12/10/2023] [Indexed: 01/03/2024] Open
Abstract
Bladder cancer is one of the most common malignant tumours of the urogenital system, with high morbidity and mortality. In most cases, surgery is considered the first choice of treatment, followed by adjuvant chemotherapy. However, the 5-year recurrence rate is still as high as 65% in patients with non-invasive or in situ tumours and up to 73% in patients with slightly more advanced disease at initial diagnosis. Various treatment methods for bladder cancer have been developed, and hundreds of new immunotherapies are being tested. To date, only a small percentage of people have had success with new treatments, though studies have suggested that the combination of immunotherapy with other therapies improves treatment efficiency and positive outcomes for individuals, with great hopes for the future. In this article, we summarize the origins, therapeutic mechanisms and current status of research on immunotherapeutic agents for bladder cancer.
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Affiliation(s)
- Junwei Liu
- Department of UrologyRenmin Hospital of Wuhan UniversityWuhanHubei ProvinceChina
| | - Yue Gao
- Department of Party and AdministrationRenmin Hospital of Wuhan UniversityWuhanHubei ProvinceChina
| | - Chao Song
- Department of UrologyRenmin Hospital of Wuhan UniversityWuhanHubei ProvinceChina
| | - Wenbiao Liao
- Department of UrologyRenmin Hospital of Wuhan UniversityWuhanHubei ProvinceChina
| | - Lingchao Meng
- Department of UrologyRenmin Hospital of Wuhan UniversityWuhanHubei ProvinceChina
| | - Sixing Yang
- Department of UrologyRenmin Hospital of Wuhan UniversityWuhanHubei ProvinceChina
| | - Yunhe Xiong
- Department of UrologyRenmin Hospital of Wuhan UniversityWuhanHubei ProvinceChina
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28
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Du Y, Yang J, He F, Zhao X, Zhou J, Zang P, Liu C, Xie Y, Zhang Y, Yang P. Revealing the Mutually Enhanced Mechanism of Necroptosis and Immunotherapy Induced by Defect Engineering and Piezoelectric Effect. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2024; 36:e2304322. [PMID: 37824104 DOI: 10.1002/adma.202304322] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 09/22/2023] [Indexed: 10/13/2023]
Abstract
Owing to low immunogenicity-induced immune escape and short-term circulating immune responses, the efficiency of immunotherapy is unsatisfactory. Therefore, triggering immunogenic cell death and establishing a long-term, mutually reinforced treatment modality are urgent challenges. In this study, ultrathin CaBi2 Nb2 O9 nanosheets with tunable oxygen vacancies (abbreviated as CBNO-OV1) are prepared for synergistic necroptosis and immunotherapy. The optimized vacancy concentration significantly improves the piezoelectric effect under ultrasound irradiation, thereby considerably improving the generation of reactive oxygen species (ROS). Density functional theory shows that oxygen vacancies can improve the efficiency of electron hole separation by suppressing their recombination, thus resulting in enhanced piezocatalytic activity. Moreover, the piezoelectric effect improves the permeability of tumor cell membranes, thus resulting in Ca2+ influx. Additionally, CBNO-OV1 also releases a portion of Ca2+ , which induces necroptosis assisted by explosive ROS. Ribonucleic acid transcription tests suggest the mechanisms associated with immune response activation and necroptosis. More importantly, necroptosis can trigger a significant immune response in vivo, thus activating macrophage M1 polarization through the NF-kappa B pathway and promoting T-cell differentiation.Tumor Necrosis Factor-α differentiated from macrophages conversely promotes necroptosis, thus realizing a mutually enhanced effect. This study demonstrates the feasibility of mutually reinforced necroptosis and immunotherapy for amplifying tumor efficacy.
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Affiliation(s)
- Yaqian Du
- Key Laboratory of Superlight Materials and Surface Technology, Ministry of Education, College of Material Science and Chemical Engineering, Harbin Engineering University, Harbin, 150001, P. R. China
| | - Jiani Yang
- Department of Gastrointestinal Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, 150001, P. R. China
| | - Fei He
- Key Laboratory of Superlight Materials and Surface Technology, Ministry of Education, College of Material Science and Chemical Engineering, Harbin Engineering University, Harbin, 150001, P. R. China
| | - Xudong Zhao
- Key Laboratory of Superlight Materials and Surface Technology, Ministry of Education, College of Material Science and Chemical Engineering, Harbin Engineering University, Harbin, 150001, P. R. China
| | - Jialing Zhou
- Key Laboratory of Superlight Materials and Surface Technology, Ministry of Education, College of Material Science and Chemical Engineering, Harbin Engineering University, Harbin, 150001, P. R. China
| | - Pengyu Zang
- Key Laboratory of Superlight Materials and Surface Technology, Ministry of Education, College of Material Science and Chemical Engineering, Harbin Engineering University, Harbin, 150001, P. R. China
| | - Changlin Liu
- Key Laboratory of Superlight Materials and Surface Technology, Ministry of Education, College of Material Science and Chemical Engineering, Harbin Engineering University, Harbin, 150001, P. R. China
| | - Ying Xie
- Key Laboratory of Functional Inorganic Material Chemistry, Ministry of Education, School of Chemistry and Materials Science, Heilongjiang University, Harbin, 150001, P. R. China
| | - Yanqiao Zhang
- Department of Gastrointestinal Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, 150001, P. R. China
| | - Piaoping Yang
- Key Laboratory of Superlight Materials and Surface Technology, Ministry of Education, College of Material Science and Chemical Engineering, Harbin Engineering University, Harbin, 150001, P. R. China
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Gill E, Perks CM. Mini-Review: Current Bladder Cancer Treatment-The Need for Improvement. Int J Mol Sci 2024; 25:1557. [PMID: 38338835 PMCID: PMC10855537 DOI: 10.3390/ijms25031557] [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: 12/03/2023] [Revised: 01/18/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
Bladder cancer is the tenth most common cancer and is a significant burden on health care services worldwide, as it is one of the most costly cancers to treat per patient. This expense is due to the extensive treatment and follow-ups that occur with costly and invasive procedures. Improvement in both treatment options and the quality of life these interventions offer has not progressed at the rates of other cancers, and new alternatives are desperately needed to ease the burden. A more modern approach needs to be taken, with urinary biomarkers being a positive step in making treatments more patient-friendly, but there is still a long way to go to make these widely available and of a comparable standard to the current treatment options. New targets to hit the major signalling pathways that are upregulated in bladder cancer, such as the PI3K/AkT/mTOR pathway, are urgently needed, with only one drug approved so far, Erdafitinib. Immune checkpoint inhibitors also hold promise, with both PD-1 and CDLA-4 antibody therapies approved for use. They effectively block ligand/receptor binding to block the immune checkpoint used by tumour cells. Other avenues must be explored, including drug repurposing and novel biomarkers, which have revolutionised this area in other cancers.
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Affiliation(s)
| | - Claire M. Perks
- Cancer Endocrinology Group, Learning & Research Building, Southmead Hospital, Translational Health Sciences, Bristol Medical School, Bristol BS10 5NB, UK;
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30
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Desponds E, Croci D, Wosika V, Hadadi N, Fonseca Costa SS, Ciarloni L, Ongaro M, Zdimerova H, Leblond MM, Hosseinian Ehrensberger S, Romero P, Verdeil G. Immuno-Transcriptomic Profiling of Blood and Tumor Tissue Identifies Gene Signatures Associated with Immunotherapy Response in Metastatic Bladder Cancer. Cancers (Basel) 2024; 16:433. [PMID: 38275874 PMCID: PMC10814931 DOI: 10.3390/cancers16020433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 01/11/2024] [Accepted: 01/15/2024] [Indexed: 01/27/2024] Open
Abstract
Blood-based biomarkers represent ideal candidates for the development of non-invasive immuno-oncology-based assays. However, to date, no blood biomarker has been validated to predict clinical responses to immunotherapy. In this study, we used next-generation sequencing (RNAseq) on bulk RNA extracted from whole blood and tumor samples in a pre-clinical MIBC mouse model. We aimed to identify biomarkers associated with immunotherapy response and assess the potential application of simple non-invasive blood biomarkers as a therapeutic decision-making assay compared to tissue-based biomarkers. We established that circulating immune cells and the tumor microenvironment (TME) display highly organ-specific transcriptional responses to ICIs. Interestingly, in both, a common lymphocytic activation signature can be identified associated with the efficient response to immunotherapy, including a blood-specific CD8+ T cell activation/proliferation signature which predicts the immunotherapy response.
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Affiliation(s)
- Emma Desponds
- Department of Oncology UNIL CHUV, University of Lausanne, 1015 Lausanne, Switzerland; (E.D.); (M.O.); (H.Z.); (M.M.L.)
- Ludwig Institute for Cancer Research, University of Lausanne, 1015 Lausanne, Switzerland
| | - Davide Croci
- Novigenix SA, 1066 Epalinges, Switzerland; (D.C.); (N.H.); (S.S.F.C.); (L.C.); (S.H.E.); (P.R.)
| | - Victoria Wosika
- Novigenix SA, 1066 Epalinges, Switzerland; (D.C.); (N.H.); (S.S.F.C.); (L.C.); (S.H.E.); (P.R.)
| | - Noushin Hadadi
- Novigenix SA, 1066 Epalinges, Switzerland; (D.C.); (N.H.); (S.S.F.C.); (L.C.); (S.H.E.); (P.R.)
| | - Sara S. Fonseca Costa
- Novigenix SA, 1066 Epalinges, Switzerland; (D.C.); (N.H.); (S.S.F.C.); (L.C.); (S.H.E.); (P.R.)
| | - Laura Ciarloni
- Novigenix SA, 1066 Epalinges, Switzerland; (D.C.); (N.H.); (S.S.F.C.); (L.C.); (S.H.E.); (P.R.)
| | - Marco Ongaro
- Department of Oncology UNIL CHUV, University of Lausanne, 1015 Lausanne, Switzerland; (E.D.); (M.O.); (H.Z.); (M.M.L.)
- Ludwig Institute for Cancer Research, University of Lausanne, 1015 Lausanne, Switzerland
| | - Hana Zdimerova
- Department of Oncology UNIL CHUV, University of Lausanne, 1015 Lausanne, Switzerland; (E.D.); (M.O.); (H.Z.); (M.M.L.)
- Ludwig Institute for Cancer Research, University of Lausanne, 1015 Lausanne, Switzerland
| | - Marine M. Leblond
- Department of Oncology UNIL CHUV, University of Lausanne, 1015 Lausanne, Switzerland; (E.D.); (M.O.); (H.Z.); (M.M.L.)
- Ludwig Institute for Cancer Research, University of Lausanne, 1015 Lausanne, Switzerland
| | | | - Pedro Romero
- Novigenix SA, 1066 Epalinges, Switzerland; (D.C.); (N.H.); (S.S.F.C.); (L.C.); (S.H.E.); (P.R.)
| | - Grégory Verdeil
- Department of Oncology UNIL CHUV, University of Lausanne, 1015 Lausanne, Switzerland; (E.D.); (M.O.); (H.Z.); (M.M.L.)
- Ludwig Institute for Cancer Research, University of Lausanne, 1015 Lausanne, Switzerland
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31
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Petrylak DP, Eigl BJ, George S, Heath EI, Hotte SJ, Chism DD, Nabell LM, Picus J, Cheng SY, Appleman LJ, Sonpavde GP, Morgans AK, Pourhosseini P, Wu R, Standley L, Croitoru R, Yu EY. Phase I Dose-Escalation Study of the Safety and Pharmacokinetics of AGS15E Monotherapy in Patients with Metastatic Urothelial Carcinoma. Clin Cancer Res 2024; 30:63-73. [PMID: 37861407 PMCID: PMC10767306 DOI: 10.1158/1078-0432.ccr-22-3627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 07/10/2023] [Accepted: 10/17/2023] [Indexed: 10/21/2023]
Abstract
PURPOSE Effective treatment of locally advanced or metastatic urothelial carcinoma (mUC) remains an unmet need. Antibody-drug conjugates (ADC) providing targeted drug delivery have shown antitumor activity in this setting. AGS15E is an investigational ADC that delivers the cytotoxic drug monomethyl auristatin E to cells expressing SLITRK6, a UC-associated antigen. PATIENTS AND METHODS This was a multicenter, single-arm, phase I dose-escalation and expansion trial of AGS15E in patients with mUC (NCT01963052). During dose escalation, AGS15E was administered intravenously at six levels (0.10, 0.25, 0.50, 0.75, 1.00, 1.25 mg/kg), employing a continual reassessment method to determine dose-limiting toxicities (DLT) and the recommended phase II dose (RP2D) for the dose-expansion cohort. The primary objective was to evaluate the safety and pharmacokinetics of AGS15E in patients with and without prior chemotherapy and with prior checkpoint inhibitor (CPI) therapy. Best overall response was also examined. RESULTS Ninety-three patients were recruited, including 33 patients previously treated with CPI. The most common treatment-emergent adverse events were fatigue (54.8%), nausea (37.6%), and decreased appetite (35.5%). Peripheral neuropathy and ocular toxicities occurred at doses of ≥0.75 mg/kg. AGS15E increased in a dose-proportional manner after single- and multiple-dose administration; accumulation was low. Five DLT occurred from 0.50 to 1.25 mg/kg. The RP2D was assessed at 1.00 mg/kg; the objective response rate (ORR) was 35.7% at this dose level. The ORR in the total population and CPI-exposed subgroup were 18.3% and 27.3%, respectively. CONCLUSIONS DLT with AGS15E were observed at 0.75, 1.00, and 1.25 mg/kg, with an RP2D of 1.00 mg/kg being determined.
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Affiliation(s)
| | | | - Saby George
- Roswell Park Cancer Institute, Buffalo, New York
| | | | | | | | | | - Joel Picus
- Siteman Cancer Center, Washington University School of Medicine, St. Louis, Missouri
| | | | | | - Guru P. Sonpavde
- Advent Health Cancer Institute, Orlando, Florida
- University of Central Florida, Orlando, Florida
| | | | | | - Ruishan Wu
- Astellas Pharma Global Development, Inc., Northbrook, Illinois
| | - Laura Standley
- Astellas Pharma Global Development, Inc., Northbrook, Illinois
| | - Ruslan Croitoru
- Astellas Pharma Global Development, Inc., Northbrook, Illinois
| | - Evan Y. Yu
- Division of Medical Oncology, Seattle Cancer Care Alliance, Seattle, Washington
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32
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Sun Y, Lu Z, Taylor JA, Au JLS. Quantitative image analysis of intracellular protein translocation in 3-dimensional tissues for pharmacodynamic studies of immunogenic cell death. J Control Release 2024; 365:89-100. [PMID: 37981052 PMCID: PMC11078532 DOI: 10.1016/j.jconrel.2023.11.023] [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: 05/22/2023] [Revised: 11/05/2023] [Accepted: 11/12/2023] [Indexed: 11/21/2023]
Abstract
A recent development in cancer chemotherapy is to use cytotoxics to induce tumor-specific immune response through immunogenic cell death (ICD). In ICD, calreticulin is translocated from endoplasmic reticulum to cell membrane (ecto-CRT) which serves as the 'eat-me-signal' to antigen-presenting cells. Ecto-CRT measurements, e.g., by ecto-CRT immunostaining plus flow cytometry, can be used to study the pharmacodynamics of ICD in single cells, whereas ICD studies in intact 3-dimensional tissues such as human tumors require different approaches. The present study described a method that used (a) immunostaining with fluorescent antibodies followed by confocal microscopy to obtain the spatial locations of two molecules-of-interest (CRT and a marker protein WGA), and (b) machine-learning (trainable WEKA segmentation) and additional image processing tools to locate the target molecules, remove the interfering signals in the nucleus, cytosol and extracellular space, enable the distinction of the inner and outer edges of the cell membrane and thereby identify the cells with ecto-CRT. This method, when applied to 3-dimensional human bladder cancer cell spheroids, yielded drug-induced ecto-CRT measurements that were qualitatively comparable to the flow cytometry results obtained with single cells disaggregated from spheroids. This new method was applied to study drug-induced ICD in short-term cultures of surgical specimens of human patient bladder tumors.
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Affiliation(s)
- Yajing Sun
- Department of Pharmaceutical Sciences, University of Oklahoma, Oklahoma City, OK 73117, United States of America
| | - Ze Lu
- Institute of Quantitative Systems Pharmacology, Carlsbad, CA 92008, United States of America; Optimum Therapeutics LLC, Carlsbad, CA 92008, United States of America
| | - John A Taylor
- Department of Urology, University of Kansas Medical Center, Kansas City, KS 66160, United States of America
| | - Jessie L S Au
- Department of Pharmaceutical Sciences, University of Oklahoma, Oklahoma City, OK 73117, United States of America; Institute of Quantitative Systems Pharmacology, Carlsbad, CA 92008, United States of America; Optimum Therapeutics LLC, Carlsbad, CA 92008, United States of America; College of Pharmacy, Taipei Medical University, Taipei, Taiwan.
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33
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Chen JQ, Salas LA, Wiencke JK, Koestler DC, Molinaro AM, Andrew AS, Seigne JD, Karagas MR, Kelsey KT, Christensen BC. Matched analysis of detailed peripheral blood and tumor immune microenvironment profiles in bladder cancer. Epigenomics 2024; 16:41-56. [PMID: 38221889 PMCID: PMC10804212 DOI: 10.2217/epi-2023-0358] [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: 10/13/2023] [Accepted: 12/11/2023] [Indexed: 01/16/2024] Open
Abstract
Background: Bladder cancer and therapy responses hinge on immune profiles in the tumor microenvironment (TME) and blood, yet studies linking tumor-infiltrating immune cells to peripheral immune profiles are limited. Methods: DNA methylation cytometry quantified TME and matched peripheral blood immune cell proportions. With tumor immune profile data as the input, subjects were grouped by immune infiltration status and consensus clustering. Results: Immune hot and cold groups had different immune compositions in the TME but not in circulating blood. Two clusters of patients identified with consensus clustering had different immune compositions not only in the TME but also in blood. Conclusion: Detailed immune profiling via methylation cytometry reveals the significance of understanding tumor and systemic immune relationships in cancer patients.
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Affiliation(s)
- Ji-Qing Chen
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03766, USA
| | - Lucas A Salas
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03766, USA
| | - John K Wiencke
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94143, USA
| | - Devin C Koestler
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Annette M Molinaro
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94143, USA
| | - Angeline S Andrew
- Department of Neurology, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03766, USA
| | - John D Seigne
- Department of Surgery, Section of Urology, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03766, USA
| | - Margaret R Karagas
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03766, USA
| | - Karl T Kelsey
- Departments of Epidemiology & Pathology & Laboratory Medicine, Brown University, Providence, RI 02912, USA
| | - Brock C Christensen
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03766, USA
- Departments of Molecular and Systems Biology, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03766, USA
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Liu Y, Pang Z, Wang J, Wang J, Ji B, Xu Y, He J, Zhang L, Han Y, Shen L, Xu W, Ren M. Multi-omics comprehensive analysis reveals the predictive value of N6-methyladenosine- related genes in prognosis and immune escape of bladder cancer. Cancer Biomark 2024; 40:79-94. [PMID: 38517777 PMCID: PMC11307005 DOI: 10.3233/cbm-230286] [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: 07/03/2023] [Accepted: 12/18/2023] [Indexed: 03/24/2024]
Abstract
BACKGROUND N6-methyladenosine (m6A) is the most frequent RNA modification in mammals, and its role in bladder cancer (BC) remains rarely revealed. OBJECTIVE To predict the value of m6A-related genes in prognosis and immunity in BC. METHODS We performed multiple omics analysis of 618 TCGA and GEO patients and used principal component analysis (PCA) to calculate the m6A score for BC patients. RESULTS We described the multiple omics status of 23 m6A methylation-related genes (MRGs), and four m6A clusters were identified, which showed significant differences in immune infiltration and biological pathways. Next, we intersected the differential genes among m6A clusters, and 11 survival-related genes were identified, which were used to calculate the m6A score for the patients. We found that the high-score (HS) group showed lower tumor mutation burden (TMB) and TP53 mutations and better prognosis than the low-score (LS) group. Lower immune infiltration, higher expression of PD-L1, PD-1, and CTLA4, and higher immune dysfunction and immune exclusion scores were identified in the LS group, suggesting a higher possibility of immune escape. Finally, the experimental verification shows that the m6A related genes, such as IGFBP1, plays an important role in the growth and metastasis of bladder cancer. CONCLUSIONS These findings revealed the important roles of m6A MRGs in predicting prognosis, TMB status, TP53 mutation, immune functions and immunotherapeutic response in BC.
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Affiliation(s)
- Yang Liu
- Department of Urology, The Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, Guangdong, China
- Department of Urology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Zhongqi Pang
- Department of Urology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Jianshe Wang
- Department of Urology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Jinfeng Wang
- Department of Urology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Bo Ji
- Department of Urology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Yidan Xu
- Department of Urology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Jiaxin He
- Department of Urology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Lu Zhang
- Department of Urology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Yansong Han
- Department of Urology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Linkun Shen
- Department of Urology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Wanhai Xu
- Department of Urology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Minghua Ren
- Department of Urology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
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Mollica V, Tassinari E, Santoni M, Marchese PV, Giunchi F, Maloberti T, Tateo V, Ricci C, Rosellini M, Marchetti A, Fiorentino M, Biase DD, Massari F. TERT promoter mutations and the outcome of patients with advanced urothelial carcinoma treated by platinum-based chemotherapy or pembrolizumab. Pathol Res Pract 2024; 253:155008. [PMID: 38103361 DOI: 10.1016/j.prp.2023.155008] [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: 09/28/2023] [Revised: 11/12/2023] [Accepted: 12/01/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND TERT promoter mutation is one of the most common genomic alterations in urothelial carcinoma (UC). Its prognostic role on patients' outcomes is still not clear. METHODS We performed a single-center retrospective analysis on patients with advanced UC treated with platinum-based chemotherapy or immunotherapy to assess the presence of somatic TERT-124[C>T] and TERT-146[C>T] mutations and their association with clinicopathologic factors and survival outcomes. Patients were assessed for Overall Survival (OS), Progression-Free Survival (PFS), and Overall Response Rate (ORR). RESULTS We analyzed 45 UC tumors; 38 of them received first-line chemotherapy and 21 second-line pembrolizumab; 6 patients (13%) harbored -146 C > T TERTp mutation and 25 patients (56%)-124 C > T. The presence of TERT promoter mutations was associated with a higher rate of lower tract UC and a lower rate of synchronous or lymph node metastases. TERT wild-type patients showed higher 12- and 24-months OS-rates in the chemotherapy subgroup and 6-, 12- and 24-months OS rates in the pembrolizumab subgroup. The presence of TERT promoter mutations was also associated with a lower 6 months-PFS rate in patients receiving chemotherapy and in all the three time points in those treated by pembrolizumab. The ORRs of pembrolizumab were 21% and 71% in patients with or without TERT promoter mutations, respectively (p < 0.001). CONCLUSIONS Our analysis suggests that the presence of TERT promoter mutations could negatively affect the outcome of UC patients treated by chemotherapy or pembrolizumab. This hypothesis should be further evaluated in wider cohorts.
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Affiliation(s)
- Veronica Mollica
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni - 15, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy.
| | - Elisa Tassinari
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni - 15, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Matteo Santoni
- Oncology Unit, Macerata Hospital, Via Santa Lucia 2, 62100 Macerata, Italy
| | - Paola Valeria Marchese
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni - 15, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Francesca Giunchi
- Pathology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Thais Maloberti
- Solid Tumor Molecular Pathology Laboratory, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Valentina Tateo
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni - 15, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | | | - Matteo Rosellini
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni - 15, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Andrea Marchetti
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni - 15, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Michelangelo Fiorentino
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy; Pathology Unit, Maggiore Hospital-AUSL Bologna, Bologna, Italy
| | - Dario De Biase
- Pathology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; Department of Pharmacy and Biotechnology, University of Bologna, 40126 Bologna, Italy
| | - Francesco Massari
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni - 15, Bologna, Italy
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Wang M, Zhang C, Ying Y, Hua M, Meng F, Wang Z, Liu A, Zeng S, Zhang Z, Xu C. PKMYT1 induced by YAP/TEAD1 gives rise to the progression and worse prognosis of bladder cancer. Mol Carcinog 2024; 63:160-172. [PMID: 37787394 DOI: 10.1002/mc.23643] [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: 05/26/2023] [Revised: 09/11/2023] [Accepted: 09/21/2023] [Indexed: 10/04/2023]
Abstract
Protein kinase, membrane-associated tyrosine/threonine 1 (PKMYT1), which is associated with progression of tumor, is upregulated in a variety of cancers. However, its expression and the underlying molecular mechanisms in the context of bladder cancer (BLCA) remain elusive. Here we found that PKMYT1 expression was markedly higher expression in BLCA, which was correlated with poorer prognosis compared with low expression. Knockdown of PKMYT1 significantly inhibited the BLCA cells proliferation in vivo and in vitro, and migration and invasion, reduced G2/M phase in cell cycle and induced apoptosis. Mechanically, YAP and TEAD1 knockdown suppressed PKMYT1 expression in BLCA cells, whereas overexpression of YAP upregulated PKMYT1 expression and YAP prompted PKMYT1 transcriptional expression via TEAD1-mediated direct binding to PKMYT1 promotor. Collectively, these findings suggest that PKMYT1, functioning as a direct gene target regulated by YAP/TEAD1, could serve as a potential indicator of progression and prognosis in BLCA. Further, PKMYT1 could serve as a novel therapeutic target for BLCA.
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Affiliation(s)
- Maoyu Wang
- Department of Urology, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China
| | - Chen Zhang
- Department of Urology, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China
| | - Yidie Ying
- Department of Urology, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China
| | - Meimian Hua
- Department of Urology, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China
| | - Fang Meng
- Department of Urology, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China
| | - Ziwei Wang
- Department of Urology, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China
| | - Anwei Liu
- Department of Critical Care Medicine, Hospital of Southern Theatre Command of PLA, Guangzhou, China
| | - Shuxiong Zeng
- Department of Urology, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China
| | - Zhensheng Zhang
- Department of Urology, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China
| | - Chuanliang Xu
- Department of Urology, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China
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Ogbuji V, Paster IC, Recio-Boiles A, Carew JS, Nawrocki ST, Chipollini J. Current Landscape of Immune Checkpoint Inhibitors for Metastatic Urothelial Carcinoma: Is There a Role for Additional T-Cell Blockade? Cancers (Basel) 2023; 16:131. [PMID: 38201559 PMCID: PMC10778285 DOI: 10.3390/cancers16010131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 11/30/2023] [Accepted: 12/23/2023] [Indexed: 01/12/2024] Open
Abstract
Urothelial carcinoma (UC) is the most common form of bladder cancer (BC) and is the variant with the most immunogenic response. This makes urothelial carcinoma an ideal candidate for immunotherapy with immune checkpoint inhibitors. Key immune checkpoint proteins PD-1 and CTLA-4 are frequently expressed on T-cells in urothelial carcinoma. The blockade of this immune checkpoint can lead to the reactivation of lymphocytes and augment the anti-tumor immune response. The only immune checkpoint inhibitors that are FDA-approved for metastatic urothelial carcinoma target the programmed death-1 receptor and its ligand (PD-1/PD-L1) axis. However, the overall response rate and progression-free survival rates of these agents are limited in this patient population. Therefore, there is a need to find further immune-bolstering treatment combinations that may positively impact survival for patients with advanced UC. In this review, the current immune checkpoint inhibition treatment landscape is explored with an emphasis on combination therapy in the form of PD-1/PD-L1 with CTLA-4 blockade. The investigation of the current literature on immune checkpoint inhibition found that preclinical data show a decrease in tumor volumes and size when PD-1/PD-L1 is blocked, and similar results were observed with CTLA-4 blockade. However, there are limited investigations evaluating the combination of CTLA-4 and PD-1/PD-L1 blockade. We anticipate this review to provide a foundation for a deeper experimental investigation into combination immune checkpoint inhibition therapy in metastatic urothelial carcinoma.
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Affiliation(s)
- Vanessa Ogbuji
- College of Medicine, University of Arizona, Tucson, AZ 85724, USA; (V.O.); (I.C.P.); (S.T.N.)
| | - Irasema C. Paster
- College of Medicine, University of Arizona, Tucson, AZ 85724, USA; (V.O.); (I.C.P.); (S.T.N.)
| | - Alejandro Recio-Boiles
- Department of Medicine, The University of Arizona Cancer Center, Tucson, AZ 85724, USA; (A.R.-B.); (J.S.C.)
| | - Jennifer S. Carew
- Department of Medicine, The University of Arizona Cancer Center, Tucson, AZ 85724, USA; (A.R.-B.); (J.S.C.)
| | - Steffan T. Nawrocki
- College of Medicine, University of Arizona, Tucson, AZ 85724, USA; (V.O.); (I.C.P.); (S.T.N.)
- Department of Medicine, The University of Arizona Cancer Center, Tucson, AZ 85724, USA; (A.R.-B.); (J.S.C.)
| | - Juan Chipollini
- College of Medicine, University of Arizona, Tucson, AZ 85724, USA; (V.O.); (I.C.P.); (S.T.N.)
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Bantounou MA, Plascevic J, MacDonald L, Wong MC, O'Connell N, Galley HF. Enfortumab vedotin and pembrolizumab as monotherapies and combination treatment in locally advanced or metastatic urothelial carcinoma: A narrative review. Curr Urol 2023; 17:271-279. [PMID: 37994340 PMCID: PMC10662875 DOI: 10.1097/cu9.0000000000000204] [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: 10/20/2022] [Accepted: 01/25/2023] [Indexed: 11/24/2023] Open
Abstract
Background Bladder cancer is the 10th most common cancer globally. The majority of bladder cancers are urothelial carcinomas (UCs), which, if locally advanced or metastatic, carry poor long-term prognosis. Cancer cells can evade the immune system by expressing the programmed cell death ligand 1 protein (PD-L1). Programmed cell death ligand 1 protein binds to programmed cell death protein 1 (PD-1) on T cells, inhibiting their antitumor action. Bladder tumor cells also overexpress nectin-4, a cell adhesion polypeptide that contributes to metastasis, worsening prognosis. Current platinum-based chemotherapy treatments are suboptimal. This review aimed to assess novel treatments for locally advanced or metastatic UC that specifically target PD-L1 or nectin-4, namely, the PD-1 inhibitor pembrolizumab and the anti-nectin-4 antibody-drug conjugate enfortumab vedotin (EV). Materials and methods Relevant English-language peer-reviewed articles and conference abstracts from the last 5 years were identified through MEDLINE and EMBASE database searches. A narrative review was performed, with key results outlined below. Results Pembrolizumab was demonstrated to be superior to chemotherapy as a second-line treatment for platinum-unresponsive participants in the KEYNOTE-045 trial, resulting in its Food and Drug Administration (FDA) approval. Enfortumab vedotin therapy resulted in superior outcomes compared with chemotherapy in the EV-301 trial, resulting in FDA approval for its use for patients with locally advanced or metastatic UC who had previously undergone treatment with platinum-based chemotherapy and PD-1/PD-L1 inhibitors. Positive preliminary results for pembrolizumab and EV combination therapy have led to FDA approval in patients with locally advanced or metastatic UC who are not eligible for platinum chemotherapy. Conclusions Pembrolizumab and EV represent novel treatment options for patients with locally advanced or metastatic UC with documented superior outcomes and tolerability as compared with standard chemotherapy.
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Affiliation(s)
| | | | | | | | | | - Helen F. Galley
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
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Yue M, Yang Z, Sun J, Liu Z. A candidate prognostic biomarker: TFEB inhibits tumor progression via elevating CDKN1A in bladder cancer. Int Immunopharmacol 2023; 125:111016. [PMID: 37890378 DOI: 10.1016/j.intimp.2023.111016] [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: 04/26/2023] [Revised: 09/12/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023]
Abstract
Bladder cancer(BC) is among the most prevalent malignancies in the world, with 549,393 new cases documented in 2018, and most BC patients have a poor prognosis. Transcription factor EB (TFEB) is considered a crucial controller of lysosomal-associated diseases, but a growing number of research in recent years have reported that TFEB plays other functions in tumors independent of lysosomal autophagy. In this study, we aimed to assess whether TFEB is a biomarker for BC and a molecular target for BC therapy. TFEB was lowly expressed in BC tissues relative to paracancerous tissues, and its elevated expression was strongly associated to a better prognosis for BC patients. TFEB overexpression markedly suppressed cell proliferation, limited cell migration, and accelerated apoptosis. Tumor growth in vivo was also suppressed. Mechanistically, we found that TFEB promoted CDKN1A expression by binding to the upstream progenitor of the CDKN1A promoter, which was also dependent on p53. Finally, Immune cell infiltration in BC tissues, PDL-1 expression, and Single-cell RNA sequencing data revealed immunotherapy may have a positive correlation with TFEB expression. Our study identifies that TFEB regulates CDKN1A in BC and has a positive prognostic value, while its expression is also positively correlated with immune cell infiltration. Therefore, TFEB may represent a recent therapeutic target for BC.
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Affiliation(s)
- Minghao Yue
- Department of Urology, Tianjin First Central Hospital, Tianjin, China.
| | - Zhe Yang
- Department of Urology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China.
| | - Jiabin Sun
- Department of Urology, The First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang Province, China.
| | - Zan Liu
- Department of Urology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China.
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Wang Y, Ni Q. Prognostic and clinicopathological significance of Systemic Immune-Inflammation Index in cancer patients receiving immune checkpoint inhibitors: a meta-analysis. Ann Med 2023; 55:808-819. [PMID: 36892953 PMCID: PMC10795596 DOI: 10.1080/07853890.2023.2181983] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 02/13/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Among malignant neoplasm patients taking immune checkpoint inhibitors (ICIs), it remains unknown how the systemic immune-inflammation index (SII) affects their clinical prognosis. We therefore performed the present meta-analysis by collecting the most recent data, so that SII's prognostic value among ICI-receiving carcinoma patients could be fully clarified. METHODS For the prognostic significance evaluation of SII in ICI-receiving carcinoma patients, the combined hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated. RESULTS The number of studies enrolled in the present meta-analysis totaled 17, where 1,990 patients were involved. Among the ICI-treated carcinoma patients, a high SII was linked significantly to inferior overall survival (OS) (HR = 2.62, 95% CI = 1.76-3.90), as well as progression-free survival (PFS) (HR = 2.09, 95% CI = 1.48-2.95) (p both <.001). Contrastively, SII was linked insignificantly to the age (OR = 1.08, 95% CI = 0.39-2.98, p = .881), gender (OR = 1.01, 95% CI = 0.59-1.73, p = .959), lymph node (LN) metastasis (OR = 1.41, 95% CI = 0.92-2.17, p = .117), or metastatic site quantity (OR = 1.49, 95% CI = 0.90-2.46, p = .119). CONCLUSION There are prominent associations of elevated SII with the poor survival outcomes (both short- and long-terms) among the ICIreceiving carcinoma patients. SII has potential as a reliable and cheap prognostic biomarker in the clinic for carcinoma patients receiving ICIs.
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Affiliation(s)
- Yan Wang
- Clinical Laboratory, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Huzhou, Zhejiang, China
| | - Qunqin Ni
- Clinical Laboratory, Traditional Chinese Medical Hospital of Huzhou Affiliated to Zhejiang Chinese Medical University, Huzhou, Zhejiang, China
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Loriot Y, Matsubara N, Park SH, Huddart RA, Burgess EF, Houede N, Banek S, Guadalupi V, Ku JH, Valderrama BP, Tran B, Triantos S, Kean Y, Akapame S, Deprince K, Mukhopadhyay S, Stone NL, Siefker-Radtke AO. Erdafitinib or Chemotherapy in Advanced or Metastatic Urothelial Carcinoma. N Engl J Med 2023; 389:1961-1971. [PMID: 37870920 DOI: 10.1056/nejmoa2308849] [Citation(s) in RCA: 33] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
BACKGROUND Erdafitinib is a pan-fibroblast growth factor receptor (FGFR) inhibitor approved for the treatment of locally advanced or metastatic urothelial carcinoma in adults with susceptible FGFR3/2 alterations who have progression after platinum-containing chemotherapy. The effects of erdafitinib in patients with FGFR-altered metastatic urothelial carcinoma who have progression during or after treatment with checkpoint inhibitors (anti-programmed cell death protein 1 [PD-1] or anti-programmed death ligand 1 [PD-L1] agents) are unclear. METHODS We conducted a global phase 3 trial of erdafitinib as compared with chemotherapy in patients with metastatic urothelial carcinoma with susceptible FGFR3/2 alterations who had progression after one or two previous treatments that included an anti-PD-1 or anti-PD-L1. Patients were randomly assigned in a 1:1 ratio to receive erdafitinib or the investigator's choice of chemotherapy (docetaxel or vinflunine). The primary end point was overall survival. RESULTS A total of 266 patients underwent randomization: 136 to the erdafitinib group and 130 to the chemotherapy group. The median follow-up was 15.9 months. The median overall survival was significantly longer with erdafitinib than with chemotherapy (12.1 months vs. 7.8 months; hazard ratio for death, 0.64; 95% confidence interval [CI], 0.47 to 0.88; P = 0.005). The median progression-free survival was also longer with erdafitinib than with chemotherapy (5.6 months vs. 2.7 months; hazard ratio for progression or death, 0.58; 95% CI, 0.44 to 0.78; P<0.001). The incidence of grade 3 or 4 treatment-related adverse events was similar in the two groups (45.9% in the erdafitinib group and 46.4% in the chemotherapy group). Treatment-related adverse events that led to death were less common with erdafitinib than with chemotherapy (in 0.7% vs. 5.4% of patients). CONCLUSIONS Erdafitinib therapy resulted in significantly longer overall survival than chemotherapy among patients with metastatic urothelial carcinoma and FGFR alterations after previous anti-PD-1 or anti-PD-L1 treatment. (Funded by Janssen Research and Development; THOR ClinicalTrials.gov number, NCT03390504.).
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Affiliation(s)
- Yohann Loriot
- From the Department of Cancer Medicine, INSERM Unité 981, Gustave Roussy, Université Paris-Saclay, Villejuif (Y.L.), the Department of Medical Oncology, Institut de Cancérologie du Gard, Centre Hospitalier Universitaire Caremeau, Nîmes (N.H.), and Montpellier University, Montpellier (N.H.) - all in France; the Department of Medical Oncology, National Cancer Center Hospital East, Chiba, Japan (N.M.); the Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine (S.H.P.), and Seoul National University Hospital (J.H.K.) - both in Seoul, South Korea; the Section of Radiotherapy and Imaging, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, United Kingdom (R.A.H.); Medical Oncology, Levine Cancer Institute, Atrium Health, Charlotte, NC (E.F.B.); the Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany (S.B.); the Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (V.G.); the Department of Medical Oncology, Hospital Universitario Virgen del Rocío, Seville, Spain (B.P.V.); the Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia (B.T.); Janssen Research and Development, Spring House, PA (S.T., Y.K., S.A., N.L.S.); Janssen Research and Development, Beerse, Belgium (K.D.); Janssen Research and Development, Raritan, NJ (S.M.); and the Department of Genitourinary Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston (A.O.S.-R.)
| | - Nobuaki Matsubara
- From the Department of Cancer Medicine, INSERM Unité 981, Gustave Roussy, Université Paris-Saclay, Villejuif (Y.L.), the Department of Medical Oncology, Institut de Cancérologie du Gard, Centre Hospitalier Universitaire Caremeau, Nîmes (N.H.), and Montpellier University, Montpellier (N.H.) - all in France; the Department of Medical Oncology, National Cancer Center Hospital East, Chiba, Japan (N.M.); the Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine (S.H.P.), and Seoul National University Hospital (J.H.K.) - both in Seoul, South Korea; the Section of Radiotherapy and Imaging, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, United Kingdom (R.A.H.); Medical Oncology, Levine Cancer Institute, Atrium Health, Charlotte, NC (E.F.B.); the Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany (S.B.); the Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (V.G.); the Department of Medical Oncology, Hospital Universitario Virgen del Rocío, Seville, Spain (B.P.V.); the Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia (B.T.); Janssen Research and Development, Spring House, PA (S.T., Y.K., S.A., N.L.S.); Janssen Research and Development, Beerse, Belgium (K.D.); Janssen Research and Development, Raritan, NJ (S.M.); and the Department of Genitourinary Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston (A.O.S.-R.)
| | - Se Hoon Park
- From the Department of Cancer Medicine, INSERM Unité 981, Gustave Roussy, Université Paris-Saclay, Villejuif (Y.L.), the Department of Medical Oncology, Institut de Cancérologie du Gard, Centre Hospitalier Universitaire Caremeau, Nîmes (N.H.), and Montpellier University, Montpellier (N.H.) - all in France; the Department of Medical Oncology, National Cancer Center Hospital East, Chiba, Japan (N.M.); the Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine (S.H.P.), and Seoul National University Hospital (J.H.K.) - both in Seoul, South Korea; the Section of Radiotherapy and Imaging, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, United Kingdom (R.A.H.); Medical Oncology, Levine Cancer Institute, Atrium Health, Charlotte, NC (E.F.B.); the Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany (S.B.); the Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (V.G.); the Department of Medical Oncology, Hospital Universitario Virgen del Rocío, Seville, Spain (B.P.V.); the Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia (B.T.); Janssen Research and Development, Spring House, PA (S.T., Y.K., S.A., N.L.S.); Janssen Research and Development, Beerse, Belgium (K.D.); Janssen Research and Development, Raritan, NJ (S.M.); and the Department of Genitourinary Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston (A.O.S.-R.)
| | - Robert A Huddart
- From the Department of Cancer Medicine, INSERM Unité 981, Gustave Roussy, Université Paris-Saclay, Villejuif (Y.L.), the Department of Medical Oncology, Institut de Cancérologie du Gard, Centre Hospitalier Universitaire Caremeau, Nîmes (N.H.), and Montpellier University, Montpellier (N.H.) - all in France; the Department of Medical Oncology, National Cancer Center Hospital East, Chiba, Japan (N.M.); the Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine (S.H.P.), and Seoul National University Hospital (J.H.K.) - both in Seoul, South Korea; the Section of Radiotherapy and Imaging, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, United Kingdom (R.A.H.); Medical Oncology, Levine Cancer Institute, Atrium Health, Charlotte, NC (E.F.B.); the Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany (S.B.); the Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (V.G.); the Department of Medical Oncology, Hospital Universitario Virgen del Rocío, Seville, Spain (B.P.V.); the Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia (B.T.); Janssen Research and Development, Spring House, PA (S.T., Y.K., S.A., N.L.S.); Janssen Research and Development, Beerse, Belgium (K.D.); Janssen Research and Development, Raritan, NJ (S.M.); and the Department of Genitourinary Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston (A.O.S.-R.)
| | - Earle F Burgess
- From the Department of Cancer Medicine, INSERM Unité 981, Gustave Roussy, Université Paris-Saclay, Villejuif (Y.L.), the Department of Medical Oncology, Institut de Cancérologie du Gard, Centre Hospitalier Universitaire Caremeau, Nîmes (N.H.), and Montpellier University, Montpellier (N.H.) - all in France; the Department of Medical Oncology, National Cancer Center Hospital East, Chiba, Japan (N.M.); the Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine (S.H.P.), and Seoul National University Hospital (J.H.K.) - both in Seoul, South Korea; the Section of Radiotherapy and Imaging, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, United Kingdom (R.A.H.); Medical Oncology, Levine Cancer Institute, Atrium Health, Charlotte, NC (E.F.B.); the Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany (S.B.); the Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (V.G.); the Department of Medical Oncology, Hospital Universitario Virgen del Rocío, Seville, Spain (B.P.V.); the Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia (B.T.); Janssen Research and Development, Spring House, PA (S.T., Y.K., S.A., N.L.S.); Janssen Research and Development, Beerse, Belgium (K.D.); Janssen Research and Development, Raritan, NJ (S.M.); and the Department of Genitourinary Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston (A.O.S.-R.)
| | - Nadine Houede
- From the Department of Cancer Medicine, INSERM Unité 981, Gustave Roussy, Université Paris-Saclay, Villejuif (Y.L.), the Department of Medical Oncology, Institut de Cancérologie du Gard, Centre Hospitalier Universitaire Caremeau, Nîmes (N.H.), and Montpellier University, Montpellier (N.H.) - all in France; the Department of Medical Oncology, National Cancer Center Hospital East, Chiba, Japan (N.M.); the Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine (S.H.P.), and Seoul National University Hospital (J.H.K.) - both in Seoul, South Korea; the Section of Radiotherapy and Imaging, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, United Kingdom (R.A.H.); Medical Oncology, Levine Cancer Institute, Atrium Health, Charlotte, NC (E.F.B.); the Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany (S.B.); the Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (V.G.); the Department of Medical Oncology, Hospital Universitario Virgen del Rocío, Seville, Spain (B.P.V.); the Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia (B.T.); Janssen Research and Development, Spring House, PA (S.T., Y.K., S.A., N.L.S.); Janssen Research and Development, Beerse, Belgium (K.D.); Janssen Research and Development, Raritan, NJ (S.M.); and the Department of Genitourinary Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston (A.O.S.-R.)
| | - Severine Banek
- From the Department of Cancer Medicine, INSERM Unité 981, Gustave Roussy, Université Paris-Saclay, Villejuif (Y.L.), the Department of Medical Oncology, Institut de Cancérologie du Gard, Centre Hospitalier Universitaire Caremeau, Nîmes (N.H.), and Montpellier University, Montpellier (N.H.) - all in France; the Department of Medical Oncology, National Cancer Center Hospital East, Chiba, Japan (N.M.); the Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine (S.H.P.), and Seoul National University Hospital (J.H.K.) - both in Seoul, South Korea; the Section of Radiotherapy and Imaging, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, United Kingdom (R.A.H.); Medical Oncology, Levine Cancer Institute, Atrium Health, Charlotte, NC (E.F.B.); the Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany (S.B.); the Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (V.G.); the Department of Medical Oncology, Hospital Universitario Virgen del Rocío, Seville, Spain (B.P.V.); the Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia (B.T.); Janssen Research and Development, Spring House, PA (S.T., Y.K., S.A., N.L.S.); Janssen Research and Development, Beerse, Belgium (K.D.); Janssen Research and Development, Raritan, NJ (S.M.); and the Department of Genitourinary Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston (A.O.S.-R.)
| | - Valentina Guadalupi
- From the Department of Cancer Medicine, INSERM Unité 981, Gustave Roussy, Université Paris-Saclay, Villejuif (Y.L.), the Department of Medical Oncology, Institut de Cancérologie du Gard, Centre Hospitalier Universitaire Caremeau, Nîmes (N.H.), and Montpellier University, Montpellier (N.H.) - all in France; the Department of Medical Oncology, National Cancer Center Hospital East, Chiba, Japan (N.M.); the Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine (S.H.P.), and Seoul National University Hospital (J.H.K.) - both in Seoul, South Korea; the Section of Radiotherapy and Imaging, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, United Kingdom (R.A.H.); Medical Oncology, Levine Cancer Institute, Atrium Health, Charlotte, NC (E.F.B.); the Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany (S.B.); the Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (V.G.); the Department of Medical Oncology, Hospital Universitario Virgen del Rocío, Seville, Spain (B.P.V.); the Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia (B.T.); Janssen Research and Development, Spring House, PA (S.T., Y.K., S.A., N.L.S.); Janssen Research and Development, Beerse, Belgium (K.D.); Janssen Research and Development, Raritan, NJ (S.M.); and the Department of Genitourinary Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston (A.O.S.-R.)
| | - Ja Hyeon Ku
- From the Department of Cancer Medicine, INSERM Unité 981, Gustave Roussy, Université Paris-Saclay, Villejuif (Y.L.), the Department of Medical Oncology, Institut de Cancérologie du Gard, Centre Hospitalier Universitaire Caremeau, Nîmes (N.H.), and Montpellier University, Montpellier (N.H.) - all in France; the Department of Medical Oncology, National Cancer Center Hospital East, Chiba, Japan (N.M.); the Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine (S.H.P.), and Seoul National University Hospital (J.H.K.) - both in Seoul, South Korea; the Section of Radiotherapy and Imaging, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, United Kingdom (R.A.H.); Medical Oncology, Levine Cancer Institute, Atrium Health, Charlotte, NC (E.F.B.); the Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany (S.B.); the Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (V.G.); the Department of Medical Oncology, Hospital Universitario Virgen del Rocío, Seville, Spain (B.P.V.); the Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia (B.T.); Janssen Research and Development, Spring House, PA (S.T., Y.K., S.A., N.L.S.); Janssen Research and Development, Beerse, Belgium (K.D.); Janssen Research and Development, Raritan, NJ (S.M.); and the Department of Genitourinary Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston (A.O.S.-R.)
| | - Begoña P Valderrama
- From the Department of Cancer Medicine, INSERM Unité 981, Gustave Roussy, Université Paris-Saclay, Villejuif (Y.L.), the Department of Medical Oncology, Institut de Cancérologie du Gard, Centre Hospitalier Universitaire Caremeau, Nîmes (N.H.), and Montpellier University, Montpellier (N.H.) - all in France; the Department of Medical Oncology, National Cancer Center Hospital East, Chiba, Japan (N.M.); the Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine (S.H.P.), and Seoul National University Hospital (J.H.K.) - both in Seoul, South Korea; the Section of Radiotherapy and Imaging, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, United Kingdom (R.A.H.); Medical Oncology, Levine Cancer Institute, Atrium Health, Charlotte, NC (E.F.B.); the Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany (S.B.); the Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (V.G.); the Department of Medical Oncology, Hospital Universitario Virgen del Rocío, Seville, Spain (B.P.V.); the Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia (B.T.); Janssen Research and Development, Spring House, PA (S.T., Y.K., S.A., N.L.S.); Janssen Research and Development, Beerse, Belgium (K.D.); Janssen Research and Development, Raritan, NJ (S.M.); and the Department of Genitourinary Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston (A.O.S.-R.)
| | - Ben Tran
- From the Department of Cancer Medicine, INSERM Unité 981, Gustave Roussy, Université Paris-Saclay, Villejuif (Y.L.), the Department of Medical Oncology, Institut de Cancérologie du Gard, Centre Hospitalier Universitaire Caremeau, Nîmes (N.H.), and Montpellier University, Montpellier (N.H.) - all in France; the Department of Medical Oncology, National Cancer Center Hospital East, Chiba, Japan (N.M.); the Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine (S.H.P.), and Seoul National University Hospital (J.H.K.) - both in Seoul, South Korea; the Section of Radiotherapy and Imaging, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, United Kingdom (R.A.H.); Medical Oncology, Levine Cancer Institute, Atrium Health, Charlotte, NC (E.F.B.); the Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany (S.B.); the Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (V.G.); the Department of Medical Oncology, Hospital Universitario Virgen del Rocío, Seville, Spain (B.P.V.); the Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia (B.T.); Janssen Research and Development, Spring House, PA (S.T., Y.K., S.A., N.L.S.); Janssen Research and Development, Beerse, Belgium (K.D.); Janssen Research and Development, Raritan, NJ (S.M.); and the Department of Genitourinary Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston (A.O.S.-R.)
| | - Spyros Triantos
- From the Department of Cancer Medicine, INSERM Unité 981, Gustave Roussy, Université Paris-Saclay, Villejuif (Y.L.), the Department of Medical Oncology, Institut de Cancérologie du Gard, Centre Hospitalier Universitaire Caremeau, Nîmes (N.H.), and Montpellier University, Montpellier (N.H.) - all in France; the Department of Medical Oncology, National Cancer Center Hospital East, Chiba, Japan (N.M.); the Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine (S.H.P.), and Seoul National University Hospital (J.H.K.) - both in Seoul, South Korea; the Section of Radiotherapy and Imaging, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, United Kingdom (R.A.H.); Medical Oncology, Levine Cancer Institute, Atrium Health, Charlotte, NC (E.F.B.); the Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany (S.B.); the Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (V.G.); the Department of Medical Oncology, Hospital Universitario Virgen del Rocío, Seville, Spain (B.P.V.); the Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia (B.T.); Janssen Research and Development, Spring House, PA (S.T., Y.K., S.A., N.L.S.); Janssen Research and Development, Beerse, Belgium (K.D.); Janssen Research and Development, Raritan, NJ (S.M.); and the Department of Genitourinary Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston (A.O.S.-R.)
| | - Yin Kean
- From the Department of Cancer Medicine, INSERM Unité 981, Gustave Roussy, Université Paris-Saclay, Villejuif (Y.L.), the Department of Medical Oncology, Institut de Cancérologie du Gard, Centre Hospitalier Universitaire Caremeau, Nîmes (N.H.), and Montpellier University, Montpellier (N.H.) - all in France; the Department of Medical Oncology, National Cancer Center Hospital East, Chiba, Japan (N.M.); the Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine (S.H.P.), and Seoul National University Hospital (J.H.K.) - both in Seoul, South Korea; the Section of Radiotherapy and Imaging, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, United Kingdom (R.A.H.); Medical Oncology, Levine Cancer Institute, Atrium Health, Charlotte, NC (E.F.B.); the Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany (S.B.); the Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (V.G.); the Department of Medical Oncology, Hospital Universitario Virgen del Rocío, Seville, Spain (B.P.V.); the Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia (B.T.); Janssen Research and Development, Spring House, PA (S.T., Y.K., S.A., N.L.S.); Janssen Research and Development, Beerse, Belgium (K.D.); Janssen Research and Development, Raritan, NJ (S.M.); and the Department of Genitourinary Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston (A.O.S.-R.)
| | - Sydney Akapame
- From the Department of Cancer Medicine, INSERM Unité 981, Gustave Roussy, Université Paris-Saclay, Villejuif (Y.L.), the Department of Medical Oncology, Institut de Cancérologie du Gard, Centre Hospitalier Universitaire Caremeau, Nîmes (N.H.), and Montpellier University, Montpellier (N.H.) - all in France; the Department of Medical Oncology, National Cancer Center Hospital East, Chiba, Japan (N.M.); the Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine (S.H.P.), and Seoul National University Hospital (J.H.K.) - both in Seoul, South Korea; the Section of Radiotherapy and Imaging, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, United Kingdom (R.A.H.); Medical Oncology, Levine Cancer Institute, Atrium Health, Charlotte, NC (E.F.B.); the Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany (S.B.); the Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (V.G.); the Department of Medical Oncology, Hospital Universitario Virgen del Rocío, Seville, Spain (B.P.V.); the Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia (B.T.); Janssen Research and Development, Spring House, PA (S.T., Y.K., S.A., N.L.S.); Janssen Research and Development, Beerse, Belgium (K.D.); Janssen Research and Development, Raritan, NJ (S.M.); and the Department of Genitourinary Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston (A.O.S.-R.)
| | - Kris Deprince
- From the Department of Cancer Medicine, INSERM Unité 981, Gustave Roussy, Université Paris-Saclay, Villejuif (Y.L.), the Department of Medical Oncology, Institut de Cancérologie du Gard, Centre Hospitalier Universitaire Caremeau, Nîmes (N.H.), and Montpellier University, Montpellier (N.H.) - all in France; the Department of Medical Oncology, National Cancer Center Hospital East, Chiba, Japan (N.M.); the Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine (S.H.P.), and Seoul National University Hospital (J.H.K.) - both in Seoul, South Korea; the Section of Radiotherapy and Imaging, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, United Kingdom (R.A.H.); Medical Oncology, Levine Cancer Institute, Atrium Health, Charlotte, NC (E.F.B.); the Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany (S.B.); the Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (V.G.); the Department of Medical Oncology, Hospital Universitario Virgen del Rocío, Seville, Spain (B.P.V.); the Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia (B.T.); Janssen Research and Development, Spring House, PA (S.T., Y.K., S.A., N.L.S.); Janssen Research and Development, Beerse, Belgium (K.D.); Janssen Research and Development, Raritan, NJ (S.M.); and the Department of Genitourinary Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston (A.O.S.-R.)
| | - Sutapa Mukhopadhyay
- From the Department of Cancer Medicine, INSERM Unité 981, Gustave Roussy, Université Paris-Saclay, Villejuif (Y.L.), the Department of Medical Oncology, Institut de Cancérologie du Gard, Centre Hospitalier Universitaire Caremeau, Nîmes (N.H.), and Montpellier University, Montpellier (N.H.) - all in France; the Department of Medical Oncology, National Cancer Center Hospital East, Chiba, Japan (N.M.); the Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine (S.H.P.), and Seoul National University Hospital (J.H.K.) - both in Seoul, South Korea; the Section of Radiotherapy and Imaging, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, United Kingdom (R.A.H.); Medical Oncology, Levine Cancer Institute, Atrium Health, Charlotte, NC (E.F.B.); the Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany (S.B.); the Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (V.G.); the Department of Medical Oncology, Hospital Universitario Virgen del Rocío, Seville, Spain (B.P.V.); the Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia (B.T.); Janssen Research and Development, Spring House, PA (S.T., Y.K., S.A., N.L.S.); Janssen Research and Development, Beerse, Belgium (K.D.); Janssen Research and Development, Raritan, NJ (S.M.); and the Department of Genitourinary Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston (A.O.S.-R.)
| | - Nicole L Stone
- From the Department of Cancer Medicine, INSERM Unité 981, Gustave Roussy, Université Paris-Saclay, Villejuif (Y.L.), the Department of Medical Oncology, Institut de Cancérologie du Gard, Centre Hospitalier Universitaire Caremeau, Nîmes (N.H.), and Montpellier University, Montpellier (N.H.) - all in France; the Department of Medical Oncology, National Cancer Center Hospital East, Chiba, Japan (N.M.); the Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine (S.H.P.), and Seoul National University Hospital (J.H.K.) - both in Seoul, South Korea; the Section of Radiotherapy and Imaging, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, United Kingdom (R.A.H.); Medical Oncology, Levine Cancer Institute, Atrium Health, Charlotte, NC (E.F.B.); the Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany (S.B.); the Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (V.G.); the Department of Medical Oncology, Hospital Universitario Virgen del Rocío, Seville, Spain (B.P.V.); the Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia (B.T.); Janssen Research and Development, Spring House, PA (S.T., Y.K., S.A., N.L.S.); Janssen Research and Development, Beerse, Belgium (K.D.); Janssen Research and Development, Raritan, NJ (S.M.); and the Department of Genitourinary Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston (A.O.S.-R.)
| | - Arlene O Siefker-Radtke
- From the Department of Cancer Medicine, INSERM Unité 981, Gustave Roussy, Université Paris-Saclay, Villejuif (Y.L.), the Department of Medical Oncology, Institut de Cancérologie du Gard, Centre Hospitalier Universitaire Caremeau, Nîmes (N.H.), and Montpellier University, Montpellier (N.H.) - all in France; the Department of Medical Oncology, National Cancer Center Hospital East, Chiba, Japan (N.M.); the Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine (S.H.P.), and Seoul National University Hospital (J.H.K.) - both in Seoul, South Korea; the Section of Radiotherapy and Imaging, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, United Kingdom (R.A.H.); Medical Oncology, Levine Cancer Institute, Atrium Health, Charlotte, NC (E.F.B.); the Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany (S.B.); the Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan (V.G.); the Department of Medical Oncology, Hospital Universitario Virgen del Rocío, Seville, Spain (B.P.V.); the Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia (B.T.); Janssen Research and Development, Spring House, PA (S.T., Y.K., S.A., N.L.S.); Janssen Research and Development, Beerse, Belgium (K.D.); Janssen Research and Development, Raritan, NJ (S.M.); and the Department of Genitourinary Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston (A.O.S.-R.)
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Freshour SL, Chen THP, Fisk B, Shen H, Mosior M, Skidmore ZL, Fronick C, Bolzenius JK, Griffith OL, Arora VK, Griffith M. Endothelial cells are a key target of IFN-g during response to combined PD-1/CTLA-4 ICB treatment in a mouse model of bladder cancer. iScience 2023; 26:107937. [PMID: 37810214 PMCID: PMC10558731 DOI: 10.1016/j.isci.2023.107937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 08/08/2023] [Accepted: 09/13/2023] [Indexed: 10/10/2023] Open
Abstract
To explore mechanisms of response to combined PD-1/CTLA-4 immune checkpoint blockade (ICB) treatment in individual cell types, we generated scRNA-seq using a mouse model of invasive urothelial carcinoma with three conditions: untreated tumor, treated tumor, and tumor treated after CD4+ T cell depletion. After classifying tumor cells based on detection of somatic variants and assigning non-tumor cell types using SingleR, we performed differential expression analysis, overrepresentation analysis, and gene set enrichment analysis (GSEA) within each cell type. GSEA revealed that endothelial cells were enriched for upregulated IFN-g response genes when comparing treated cells to both untreated cells and cells treated after CD4+ T cell depletion. Functional analysis showed that knocking out IFNgR1 in endothelial cells inhibited treatment response. Together, these results indicated that IFN-g signaling in endothelial cells is a key mediator of ICB induced anti-tumor activity.
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Affiliation(s)
- Sharon L. Freshour
- Department of Medicine, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
| | - Timothy H.-P. Chen
- Department of Medicine, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
| | - Bryan Fisk
- Department of Medicine, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
- McDonnell Genome Institute, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
| | - Haolin Shen
- Department of Medicine, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
| | - Matthew Mosior
- Department of Medicine, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
- McDonnell Genome Institute, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
| | - Zachary L. Skidmore
- Department of Medicine, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
- McDonnell Genome Institute, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
| | - Catrina Fronick
- McDonnell Genome Institute, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
| | - Jennifer K. Bolzenius
- Department of Medicine, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
- Siteman Cancer Center, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
| | - Obi L. Griffith
- Department of Medicine, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
- McDonnell Genome Institute, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
- Siteman Cancer Center, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
- Department of Genetics, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
| | - Vivek K. Arora
- Department of Medicine, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
- Siteman Cancer Center, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
| | - Malachi Griffith
- Department of Medicine, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
- McDonnell Genome Institute, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
- Siteman Cancer Center, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
- Department of Genetics, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
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Juengel E, Rutz J, Meiborg M, Markowitsch SD, Maxeiner S, Grein T, Thomas A, Chun FKH, Haferkamp A, Tsaur I, Vakhrusheva O, Blaheta RA. Mistletoe Extracts from Different Host Trees Disparately Inhibit Bladder Cancer Cell Growth and Proliferation. Cancers (Basel) 2023; 15:4849. [PMID: 37835543 PMCID: PMC10571756 DOI: 10.3390/cancers15194849] [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: 09/14/2023] [Revised: 10/02/2023] [Accepted: 10/02/2023] [Indexed: 10/15/2023] Open
Abstract
Extracts of European mistletoe (Viscum album) are popular as a complementary treatment for patients with many different cancer types. However, whether these extracts actually block bladder cancer progression remains unknown. The influence of different mistletoe extracts on bladder cancer cell growth and proliferation was investigated by exposing RT112, UMUC3, and TCCSup cells to mistletoe from hawthorn (Crataegi), lime trees (Tiliae), willow trees (Salicis), or poplar trees (Populi). The tumor cell growth and proliferation, apoptosis induction, and cell cycle progression were then evaluated. Alterations in integrin α and β subtype expression as well as CD44 standard (CD44s) and CD44 variant (CD44v) expressions were evaluated. Cell cycle-regulating proteins (CDK1 and 2, Cyclin A and B) were also investigated. Blocking and knock-down studies served to correlate protein alterations with cell growth. All extracts significantly down-regulated the growth and proliferation of all bladder cancer cell lines, most strongly in RT112 and UMUC3 cells. Alterations in CD44 expression were not homogeneous but rather depended on the extract and the cell line. Integrin α3 was, likewise, differently modified. Integrin α5 was diminished in RT112 and UMUC3 cells (significantly) and TCCSup (trend) by Populi and Salicis. Populi and Salicis arrested UMUC3 in G0/G1 to a similar extent, whereas apoptosis was induced most efficiently by Salicis. Examination of cell cycle-regulating proteins revealed down-regulation of CDK1 and 2 and Cyclin A by Salicis but down-regulation of CDK2 and Cyclin A by Populi. Blocking and knock-down studies pointed to the influence of integrin α5, CD44, and the Cyclin-CDK axis in regulating bladder cancer growth. Mistletoe extracts do block bladder cancer growth in vitro, with the molecular action differing according to the cell line and the host tree of the mistletoe. Integrating mistletoe into a guideline-based treatment regimen might optimize bladder cancer therapy.
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Affiliation(s)
- Eva Juengel
- Department of Urology and Pediatric Urology, University Medical Center Mainz, 55131 Mainz, Germany; (E.J.); (S.D.M.); (A.T.); (A.H.); (I.T.); (O.V.)
| | - Jochen Rutz
- Department of Urology, Goethe-University, 60590 Frankfurt am Main, Germany; (J.R.); (M.M.); (S.M.); (T.G.); (F.K.-H.C.)
| | - Moritz Meiborg
- Department of Urology, Goethe-University, 60590 Frankfurt am Main, Germany; (J.R.); (M.M.); (S.M.); (T.G.); (F.K.-H.C.)
| | - Sascha D. Markowitsch
- Department of Urology and Pediatric Urology, University Medical Center Mainz, 55131 Mainz, Germany; (E.J.); (S.D.M.); (A.T.); (A.H.); (I.T.); (O.V.)
| | - Sebastian Maxeiner
- Department of Urology, Goethe-University, 60590 Frankfurt am Main, Germany; (J.R.); (M.M.); (S.M.); (T.G.); (F.K.-H.C.)
| | - Timothy Grein
- Department of Urology, Goethe-University, 60590 Frankfurt am Main, Germany; (J.R.); (M.M.); (S.M.); (T.G.); (F.K.-H.C.)
| | - Anita Thomas
- Department of Urology and Pediatric Urology, University Medical Center Mainz, 55131 Mainz, Germany; (E.J.); (S.D.M.); (A.T.); (A.H.); (I.T.); (O.V.)
| | - Felix K.-H. Chun
- Department of Urology, Goethe-University, 60590 Frankfurt am Main, Germany; (J.R.); (M.M.); (S.M.); (T.G.); (F.K.-H.C.)
| | - Axel Haferkamp
- Department of Urology and Pediatric Urology, University Medical Center Mainz, 55131 Mainz, Germany; (E.J.); (S.D.M.); (A.T.); (A.H.); (I.T.); (O.V.)
| | - Igor Tsaur
- Department of Urology and Pediatric Urology, University Medical Center Mainz, 55131 Mainz, Germany; (E.J.); (S.D.M.); (A.T.); (A.H.); (I.T.); (O.V.)
| | - Olesya Vakhrusheva
- Department of Urology and Pediatric Urology, University Medical Center Mainz, 55131 Mainz, Germany; (E.J.); (S.D.M.); (A.T.); (A.H.); (I.T.); (O.V.)
| | - Roman A. Blaheta
- Department of Urology and Pediatric Urology, University Medical Center Mainz, 55131 Mainz, Germany; (E.J.); (S.D.M.); (A.T.); (A.H.); (I.T.); (O.V.)
- Department of Urology, Goethe-University, 60590 Frankfurt am Main, Germany; (J.R.); (M.M.); (S.M.); (T.G.); (F.K.-H.C.)
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Di Gianfrancesco L, Crestani A, Amodeo A, Corsi P, De Marchi D, Miglioranza E, Lista G, Simonetti F, Busetto GM, Maggi M, Pierconti F, Martini M, Montagner IM, Tormen D, Scapinello A, Marino F, Porreca A. The Role of Checkpoint Inhibitor Expression Directly on Exfoliated Cells from Bladder Cancer: A Narrative Review. Diagnostics (Basel) 2023; 13:3119. [PMID: 37835862 PMCID: PMC10572290 DOI: 10.3390/diagnostics13193119] [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: 07/18/2023] [Revised: 09/15/2023] [Accepted: 10/02/2023] [Indexed: 10/15/2023] Open
Abstract
Bladder cancer (BCa) is a common type of cancer that affects the urinary bladder. The early detection and management of BCa is critical for successful treatment and patient outcomes. In recent years, researchers have been exploring the use of biomarkers as a non-invasive and effective tool for the detection and monitoring of BCa. One such biomarker is programmed death-ligand 1 (PD-L1), which is expressed on the surface of cancer cells and plays a crucial role in the evasion of the immune system. Studies have shown that the PD-L1 expression is higher in BCa tumors than in healthy bladder tissue. Additionally, PD-L1 expression might even be detected in urine samples in BCa patients, in addition to the examination of a histological sample. The technique is being standardized and optimized. We reported how BCa patients had higher urinary PD-L1 levels than controls by considering BCa tumors expressing PD-L1 in the tissue specimen. The expression of PD-L1 in urinary BCa cells might represent both a diagnostic and a prognostic tool, with the perspective that the PD-L1 expression of exfoliate urinary cells might reveal and anticipate eventual BCa recurrence or progression. Further prospective and longitudinal studies are needed to assess the expression of PD-L1 as a biomarker for the monitoring of BCa patients. The use of PD-L1 as a biomarker for the detection and monitoring of BCa has the potential to significantly improve patient outcomes by allowing for earlier detection and more effective management of the disease.
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Affiliation(s)
- Luca Di Gianfrancesco
- Department of Urology, Veneto Institute of Oncology (IOV)—IRCCS, Headquarter of Castelfranco Veneto, 35128 Padua, Italy; (A.C.); (A.A.); (P.C.); (D.D.M.); (E.M.); (G.L.); (F.S.); (A.P.)
| | - Alessandro Crestani
- Department of Urology, Veneto Institute of Oncology (IOV)—IRCCS, Headquarter of Castelfranco Veneto, 35128 Padua, Italy; (A.C.); (A.A.); (P.C.); (D.D.M.); (E.M.); (G.L.); (F.S.); (A.P.)
| | - Antonio Amodeo
- Department of Urology, Veneto Institute of Oncology (IOV)—IRCCS, Headquarter of Castelfranco Veneto, 35128 Padua, Italy; (A.C.); (A.A.); (P.C.); (D.D.M.); (E.M.); (G.L.); (F.S.); (A.P.)
| | - Paolo Corsi
- Department of Urology, Veneto Institute of Oncology (IOV)—IRCCS, Headquarter of Castelfranco Veneto, 35128 Padua, Italy; (A.C.); (A.A.); (P.C.); (D.D.M.); (E.M.); (G.L.); (F.S.); (A.P.)
| | - Davide De Marchi
- Department of Urology, Veneto Institute of Oncology (IOV)—IRCCS, Headquarter of Castelfranco Veneto, 35128 Padua, Italy; (A.C.); (A.A.); (P.C.); (D.D.M.); (E.M.); (G.L.); (F.S.); (A.P.)
| | - Eugenio Miglioranza
- Department of Urology, Veneto Institute of Oncology (IOV)—IRCCS, Headquarter of Castelfranco Veneto, 35128 Padua, Italy; (A.C.); (A.A.); (P.C.); (D.D.M.); (E.M.); (G.L.); (F.S.); (A.P.)
| | - Giuliana Lista
- Department of Urology, Veneto Institute of Oncology (IOV)—IRCCS, Headquarter of Castelfranco Veneto, 35128 Padua, Italy; (A.C.); (A.A.); (P.C.); (D.D.M.); (E.M.); (G.L.); (F.S.); (A.P.)
| | - Francesca Simonetti
- Department of Urology, Veneto Institute of Oncology (IOV)—IRCCS, Headquarter of Castelfranco Veneto, 35128 Padua, Italy; (A.C.); (A.A.); (P.C.); (D.D.M.); (E.M.); (G.L.); (F.S.); (A.P.)
| | | | - Martina Maggi
- Department of Urology, Sapienza University, 00185 Rome, Italy;
| | - Francesco Pierconti
- Department of Pathology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, University of Sacred Heart, 00168 Rome, Italy;
| | - Maurizio Martini
- Department of Pathology, University of Messina, 98122 Messina, Italy;
| | - Isabella Monia Montagner
- Anatomy and Pathological Histology Unit, Veneto Institute of Oncology IOV—IRCCS, 35128 Padua, Italy; (I.M.M.); (A.S.)
| | - Debora Tormen
- Anatomy and Pathological Histology Unit, Veneto Institute of Oncology IOV—IRCCS, 35128 Padua, Italy; (I.M.M.); (A.S.)
| | - Antonio Scapinello
- Anatomy and Pathological Histology Unit, Veneto Institute of Oncology IOV—IRCCS, 35128 Padua, Italy; (I.M.M.); (A.S.)
| | - Filippo Marino
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, University of Sacred Heart, 00168 Rome, Italy;
| | - Angelo Porreca
- Department of Urology, Veneto Institute of Oncology (IOV)—IRCCS, Headquarter of Castelfranco Veneto, 35128 Padua, Italy; (A.C.); (A.A.); (P.C.); (D.D.M.); (E.M.); (G.L.); (F.S.); (A.P.)
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Li L, Zhang Y, Hu W, Zou F, Ning J, Rao T, Ruan Y, Yu W, Cheng F. MTHFD2 promotes PD-L1 expression via activation of the JAK/STAT signalling pathway in bladder cancer. J Cell Mol Med 2023; 27:2922-2936. [PMID: 37480214 PMCID: PMC10538262 DOI: 10.1111/jcmm.17863] [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: 03/26/2023] [Revised: 07/09/2023] [Accepted: 07/11/2023] [Indexed: 07/23/2023] Open
Abstract
Although combination chemotherapy is widely used for bladder cancer (BC) treatment, the recurrence and progression rates remain high. Therefore, novel therapeutic targets are required. Methylenetetrahydrofolate dehydrogenase 2 (MTHFD2) contributes to tumourigenesis and immune evasion in several cancers; however, its biological function in BC remains unknown. This study aimed to investigate the expression, prognostic value and protumoural function of MTHFD2 in BC and elucidate the mechanism of programmed death-ligand 1 (PD-L1) upregulation by MTHFD2. An analysis using publicly available databases revealed that a high MTHFD2 expression was correlated with clinical features and a poor prognosis in BC. Furthermore, MTHFD2 promoted the growth, migration, invasion and tumourigenicity and decreased the apoptosis of BC cells in vivo and in vitro. The results obtained from databases showed that MTHFD2 expression was correlated with immune infiltration levels, PD-L1 expression, and the Janus kinase/signal transducer and activator of transcription (JAK/STAT) pathway. The expression of MTHFD2, PD-L1 and JAK/STAT signalling pathway-related proteins increased after interferon gamma treatment and decreased after MTHFD2 knockdown. Moreover, addition of a JAK/STAT pathway activator partially reduced the effect of MTHFD2 knockdown on BC cells. Collectively, our findings suggest that MTHFD2 promotes the expression of PD-L1 through the JAK/STAT signalling pathway in BC.
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Affiliation(s)
- Linzhi Li
- Department of UrologyRenmin Hospital of Wuhan UniversityWuhanChina
| | - Yunlong Zhang
- Department of UrologyRenmin Hospital of Wuhan UniversityWuhanChina
| | - Weimin Hu
- Department of UrologyRenmin Hospital of Wuhan UniversityWuhanChina
| | - Fan Zou
- Department of UrologyRenmin Hospital of Wuhan UniversityWuhanChina
| | - Jinzhuo Ning
- Department of UrologyRenmin Hospital of Wuhan UniversityWuhanChina
| | - Ting Rao
- Department of UrologyRenmin Hospital of Wuhan UniversityWuhanChina
| | - Yuan Ruan
- Department of UrologyRenmin Hospital of Wuhan UniversityWuhanChina
| | - Weimin Yu
- Department of UrologyRenmin Hospital of Wuhan UniversityWuhanChina
| | - Fan Cheng
- Department of UrologyRenmin Hospital of Wuhan UniversityWuhanChina
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Atiq S, Hirshman N, Shariff A, Zhang T. The management of toxicities from immune, targeted and ADCs treatments in patients with urothelial cancer. Urol Oncol 2023; 41:410-419. [PMID: 34973855 DOI: 10.1016/j.urolonc.2021.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 09/08/2021] [Accepted: 10/12/2021] [Indexed: 12/20/2022]
Abstract
Newly approved systemic treatment options for metastatic urothelial cancer (mUC) have diversified treatments and improved responses and survival for chemotherapy refractory disease. These systemic treatments have associated toxicities which need appropriate management for patients to stay on treatment and potentially have longer benefit from treatment. We review the expected toxicities of immune checkpoint inhibitors, FGFR inhibitors such as erdafitinib, and antibody drug conjugates such as enfortumab vedotin and sacituzumab govitecan.
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Affiliation(s)
- Saad Atiq
- Department of Medicine, Duke University, Durham, NC
| | | | - Afreen Shariff
- Department of Medicine, Duke University, Durham, NC; Division of Endocrinology, Department of Medicine, Duke University, Durham, NC
| | - Tian Zhang
- Department of Medicine, Duke University, Durham, NC; Division of Medical Oncology, Department of Medicine, Duke University, Durham, NC; Duke Cancer Institute Center for Prostate and Urologic Cancers, Durham, NC; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX.
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47
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Boll LM, Perera-Bel J, Rodriguez-Vida A, Arpí O, Rovira A, Juanpere N, Vázquez Montes de Oca S, Hernández-Llodrà S, Lloreta J, Albà MM, Bellmunt J. The impact of mutational clonality in predicting the response to immune checkpoint inhibitors in advanced urothelial cancer. Sci Rep 2023; 13:15287. [PMID: 37714872 PMCID: PMC10504302 DOI: 10.1038/s41598-023-42495-2] [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: 04/05/2023] [Accepted: 09/11/2023] [Indexed: 09/17/2023] Open
Abstract
Immune checkpoint inhibitors (ICI) have revolutionized cancer treatment and can result in complete remissions even at advanced stages of the disease. However, only a small fraction of patients respond to the treatment. To better understand which factors drive clinical benefit, we have generated whole exome and RNA sequencing data from 27 advanced urothelial carcinoma patients treated with anti-PD-(L)1 monoclonal antibodies. We assessed the influence on the response of non-synonymous mutations (tumor mutational burden or TMB), clonal and subclonal mutations, neoantigen load and various gene expression markers. We found that although TMB is significantly associated with response, this effect can be mostly explained by clonal mutations, present in all cancer cells. This trend was validated in an additional cohort. Additionally, we found that responders with few clonal mutations had abnormally high levels of T and B cell immune markers, suggesting that a high immune cell infiltration signature could be a better predictive biomarker for this subset of patients. Our results support the idea that highly clonal cancers are more likely to respond to ICI and suggest that non-additive effects of different signatures should be considered for predictive models.
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Affiliation(s)
| | | | - Alejo Rodriguez-Vida
- Hospital del Mar Research Institute, Barcelona, Spain
- Medical Oncology Department, Hospital del Mar, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Oncología (CIBERONC-ISCIII), Barcelona, Spain
| | - Oriol Arpí
- Hospital del Mar Research Institute, Barcelona, Spain
| | - Ana Rovira
- Hospital del Mar Research Institute, Barcelona, Spain
- Medical Oncology Department, Hospital del Mar, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Oncología (CIBERONC-ISCIII), Barcelona, Spain
| | | | | | | | - Josep Lloreta
- Hospital del Mar Research Institute, Barcelona, Spain
- Department of Medicine and Life Science, Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - M Mar Albà
- Hospital del Mar Research Institute, Barcelona, Spain.
- Catalan Institute for Research and Advanced Studies (ICREA), Barcelona, Spain.
| | - Joaquim Bellmunt
- Hospital del Mar Research Institute, Barcelona, Spain.
- Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
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Wang X, Pan J, Guan Q, Ren N, Wang P, Wei M, Li Z. Identification of novel lactate metabolism-related lncRNAs with prognostic value for bladder cancer. Front Pharmacol 2023; 14:1215296. [PMID: 37781694 PMCID: PMC10533998 DOI: 10.3389/fphar.2023.1215296] [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: 05/01/2023] [Accepted: 08/31/2023] [Indexed: 10/03/2023] Open
Abstract
Background: Bladder cancer (BCA) has high recurrence and metastasis rates, and current treatment options show limited efficacy and significant adverse effects. It is crucial to find diagnostic markers and therapeutic targets with clinical value. This study aimed to identify lactate metabolism-related lncRNAs (LM_lncRNAs) to establish a model for evaluating bladder cancer prognosis. Method: A risk model consisting of lactate metabolism-related lncRNAs was developed to forecast bladder cancer patient prognosis using The Cancer Genome Atlas (TCGA) database. Kaplan‒Meier survival analysis, receiver operating characteristic curve (ROC) analysis and decision curve analysis (DCA) were used to evaluate the reliability of risk grouping for predictive analysis of bladder cancer patients. The results were also validated in the validation set. Chemotherapeutic agents sensitive to lactate metabolism were assessed using the Genomics of Drug Sensitivity in Cancer (GDSC) database. Results: As an independent prognostic factor for patients, lactate metabolism-related lncRNAs can be used as a nomogram chart that predicts overall survival time (OS). There were significant differences in survival rates between the high-risk and low-risk groups based on the Kaplan‒Meier survival curve. decision curve analysis and receiver operating characteristic curve analysis confirmed its good predictive capacity. As a result, 22 chemotherapeutic agents were predicted to positively affect the high-risk group. Conclusion: An lactate metabolism-related lncRNA prediction model was proposed to predict the prognosis for patients with bladder cancer and chemotherapeutic drug sensitivity in high-risk groups, which provided a new idea for the prognostic evaluation of the clinical treatment of bladder cancer.
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Affiliation(s)
- Xiushen Wang
- Department of Urology, The Fourth Affiliated Hospital, China Medical University, Shenyang, China
| | - Jing Pan
- College of Pharmacy, China Medical University, Shenyang, China
- School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang, China
| | - Qiutong Guan
- College of Pharmacy, China Medical University, Shenyang, China
| | - Ninghui Ren
- College of Pharmacy, China Medical University, Shenyang, China
| | - Ping Wang
- Department of Urology, The Fourth Affiliated Hospital, China Medical University, Shenyang, China
| | - Minjie Wei
- College of Pharmacy, China Medical University, Shenyang, China
| | - Zhenhua Li
- College of Pharmacy, China Medical University, Shenyang, China
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Andrade DL, Jalalizadeh M, Salustiano ACC, Reis LO. Bladder cancer immunomodulatory effects of intravesical Nitazoxanide, Rapamycin, Thalidomide and Bacillus Calmette-Guérin (BCG). World J Urol 2023; 41:2375-2380. [PMID: 37470811 DOI: 10.1007/s00345-023-04526-5] [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: 03/22/2023] [Accepted: 07/10/2023] [Indexed: 07/21/2023] Open
Abstract
PURPOSE To understand the effect of Nitazoxanide (NTZ), Rapamycin, Thalidomide, alone and in combination with BCG on bladder cancer (BC) histopathology and programmed death-ligand 1 (PD-L1) and anti-cytotoxic T lymphocyte antigen 4 (CTLA4) expression. METHODS Female Fisher-344 rats underwent intravesical N-methyl-N-nitrosourea (MNU) followed by weekly intravesical treatment with saline (controls, n = 10), BCG (n = 10), NTZ (n = 8), BCG plus NTZ (n = 8), Rapamycin (n = 10) BCG plus Rapamycin (n = 10), Thalidomide (n = 10), and BCG plus Thalidomide (n = 10), and euthanized after 8 weeks and their bladders were investigated for BC and PD-L1 and CTLA4 expression. RESULTS Rapamicyn alone and in combination with BCG had the lowest number of bladder neoplasias in the histopathology exam (1/10). Neoplastic lesions were found in 4/10 BCG recipients, 5/10 Thalidomide recipients, 4/10 Thalidomide plus BCG recipients, 5/8 NTZ and 3/8 NTZ plus BCG recipients. Adding NTZ to BCG increased the expression of PD-L1 and adding Rapamycin or Thalidomide decreased PD-L1 and CTLA4 expression compared to BCG alone. Rapamycin alone significantly increased CTLA4 and slightly increased PD-L1 expression but its combination with BCG significantly decreased both markers. Thalidomide had a similar effect; however, it was only slightly different from the control and BCG alone groups. CONCLUSION Intravesical BCG combination treatment seems to effectively prevent BC development in an immunecompetent clinically relevant animal model, introducing Thalidomide, Nitazoxanide, and specially Rapamycin as candidates in the intravesical immunotherapy advancement. Our study contributes in understanding the mechanism of cancer immunotherapy.
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Affiliation(s)
- Danilo L Andrade
- UroScience and Department of Urology, Faculty of Medical Sciences, State University of Campinas-UNICAMP, Campinas, São Paulo, Brazil
| | - Mehrsa Jalalizadeh
- UroScience and Department of Urology, Faculty of Medical Sciences, State University of Campinas-UNICAMP, Campinas, São Paulo, Brazil
| | - Ana Clara C Salustiano
- UroScience and Department of Urology, Faculty of Medical Sciences, State University of Campinas-UNICAMP, Campinas, São Paulo, Brazil
| | - Leonardo O Reis
- UroScience and Department of Urology, Faculty of Medical Sciences, State University of Campinas-UNICAMP, Campinas, São Paulo, Brazil.
- Urologic Oncology Department, School of Life Sciences, Pontifical Catholic University of Campinas, PUC-Campinas, Av. John Boyd Dunlop-Jardim Ipaussurama, Campinas, São Paulo, 13034-685, Brazil.
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50
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Sabaté Ortega J, Fort Culillas R, Escoda Garcia M, Vásquez-Dongo CA, Sala González N. Case Report: A Presentation of Early-Onset Immune-Mediated Bullous Pemphigoid in a Patient with Urothelial Cancer. Curr Oncol 2023; 30:7802-7809. [PMID: 37754481 PMCID: PMC10529691 DOI: 10.3390/curroncol30090566] [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: 07/25/2023] [Revised: 08/18/2023] [Accepted: 08/20/2023] [Indexed: 09/28/2023] Open
Abstract
Cutaneous immune-related adverse events (cirAEs) are the most common side effects of immune checkpoint inhibitor (ICI) therapy (30-50% for all grades). The vast majority of them are low or mild and can be treated without ICI interruption. Autoimmune blistering disorders, such as immune-mediated bullous pemphigoid (IBP), are rare (<1%) but potentially serious conditions that must be early detected. The onset generally occurs within the first months of the treatment, and it appears to be more common with antiprogrammed death-1 or antiprogrammed ligand 1 (anti-PD1/PDL1) than with anticytotoxic T-lymphocyte-associated protein 4 (anti-CTLA4). We present a case of a three-day severe IBP onset after receiving the first cycle of atezolizumab. This exceptional early presentation could suggest the presence of some predisposing condition and demonstrates the need to better understand predictive toxicity-related biomarkers in candidate patients for immunotherapy.
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Affiliation(s)
- Josep Sabaté Ortega
- Oncology Department, Catalan Institute of Oncology, Hospital Universitari Doctor Josep Trueta, 17007 Girona, Spain;
| | - Roser Fort Culillas
- Oncology Department, Catalan Institute of Oncology, Hospital Universitari Doctor Josep Trueta, 17007 Girona, Spain;
| | - Marina Escoda Garcia
- Dermatology Department, Hospital Universitari Doctor Josep Trueta, 17007 Girona, Spain;
| | | | - Núria Sala González
- Oncology Department, Catalan Institute of Oncology, Hospital Universitari Doctor Josep Trueta, 17007 Girona, Spain;
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