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Klausen U, Grauslund JH, Jørgensen NGD, Ahmad SM, Jonassen M, Weis-Banke SE, Martinenaite E, Pedersen LB, Lisle TL, Gang AO, Enggaard L, Hansen M, Holmström MO, Met Ö, Svane IM, Niemann CU, Pedersen LM, Andersen MH. Anti-PD-L1/PD-L2 therapeutic vaccination in untreated chronic lymphocytic leukemia patients with unmutated IgHV. Front Oncol 2022; 12:1023015. [DOI: 10.3389/fonc.2022.1023015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/28/2022] [Indexed: 11/23/2022] Open
Abstract
Chronic lymphocytic leukemia (CLL) patients with unmutated immunoglobulin heavy chain (IgHV) are at risk of early disease progression compared to patients with mutated IgHV. As a preventive strategy, we treated 19 previously untreated CLL patients with unmutated IgHV in a phase 1/2 trial (clinicaltrials.gov, NCT03939234) exploring the efficacy and toxicity of a therapeutic cancer vaccine containing peptides derived from programmed death ligand 1 (PD-L1) and ligand 2 (PD-L2), hoping to restore immunological control of the disease. According to the International Workshop on Chronic lymphocytic Leukemia (iwCLL) response criteria, no patients obtained a response; however, during follow-up, one patient had complete normalization of the peripheral lymphocyte count and remained in biochemical remission after a follow-up time of 15 months. At the end of treatment, one patient had progressed, and 17 patients had stable disease. During follow-up with a median time of 23.5 months since inclusion, seven patients had progressed, and eight patients had stable disease. The median time to first treatment (TTFT) from diagnosis was 90.3 months with a median follow-up time of 50.1 months. This apparent favorable outcome in TTFT needs to be investigated in a randomized setting, as our population may have been biased. More than 80% of patients obtained vaccine-specific immune responses, confirming the immunogenicity of the vaccine. The vaccine was generally well tolerated with only grade I–II adverse events. Although there were some signs of clinical effects, the vaccine seems to be insufficient as monotherapy in CLL, possibly due to a high tumor burden. The efficacy of the vaccine should preferably be tested in combination with novel targeted therapies or as a consolidating treatment.
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Bojko M, Węgrzyn K, Sikorska E, Kocikowski M, Parys M, Battin C, Steinberger P, Kogut MM, Winnicki M, Sieradzan AK, Spodzieja M, Rodziewicz-Motowidło S. Design, synthesis and biological evaluation of PD-1 derived peptides as inhibitors of PD-1/PD-L1 complex formation for cancer therapy. Bioorg Chem 2022; 128:106047. [DOI: 10.1016/j.bioorg.2022.106047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/04/2022] [Accepted: 07/19/2022] [Indexed: 12/11/2022]
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De Giorgi V, Scarfì F, Trane L, Silvestri F, Venturi F, Zuccaro B, Spinelli G, Scoccianti S, De Rosa F, Dika E, Longo C. Treatment of Advanced Basal Cell Carcinoma with Hedgehog Pathway Inhibitors: A Multidisciplinary Expert Meeting. Cancers (Basel) 2021; 13:cancers13225706. [PMID: 34830860 PMCID: PMC8616316 DOI: 10.3390/cancers13225706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/05/2021] [Accepted: 11/09/2021] [Indexed: 11/17/2022] Open
Abstract
Despite recent progress and the publishing of several clinical guidelines on the management of advanced basal cell carcinoma, there is still no comprehensive set of clinical guidelines addressing the complexity inherent to the use of Hedgehog pathway inhibitors in the treatment of advanced basal cell carcinoma in real-world clinical practice. To develop practical and valuable tools that help specialists improve the clinical management of these patients, we sought the opinion of expert physicians with extensive knowledge and experience in the treatment of advanced basal cell carcinoma.
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Affiliation(s)
- Vincenzo De Giorgi
- Section of Dermatology, Department of Health Sciences, University of Florence, 50100 Florence, Italy; (F.S.); (F.S.); (F.V.); (B.Z.)
- Correspondence: ; Tel./Fax: +39-055-6939632
| | - Federica Scarfì
- Section of Dermatology, Department of Health Sciences, University of Florence, 50100 Florence, Italy; (F.S.); (F.S.); (F.V.); (B.Z.)
| | - Luciana Trane
- Cancer Research “AttiliaPofferi” Foundation, 50100 Pistoia, Italy;
| | - Flavia Silvestri
- Section of Dermatology, Department of Health Sciences, University of Florence, 50100 Florence, Italy; (F.S.); (F.S.); (F.V.); (B.Z.)
| | - Federico Venturi
- Section of Dermatology, Department of Health Sciences, University of Florence, 50100 Florence, Italy; (F.S.); (F.S.); (F.V.); (B.Z.)
| | - Biancamaria Zuccaro
- Section of Dermatology, Department of Health Sciences, University of Florence, 50100 Florence, Italy; (F.S.); (F.S.); (F.V.); (B.Z.)
| | - Giuseppe Spinelli
- Maxillofacial Surgery Department, Azienda Ospedaliero-Universitaria Careggi, 50100 Florence, Italy;
| | - Silvia Scoccianti
- Radiation Oncology Unit, Azienda Toscana Centro, 50100 Florence, Italy;
| | - Francesco De Rosa
- Immunotherapy-Cell Therapy and Biobank, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) “Dino Amadori” IRCCS, 47014 Meldola, Italy;
| | - Emi Dika
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy;
- Dermatology, IRCCS Policlinico di Sant’Orsola, Via Massarenti 9, 40138 Bologna, Italy
| | - Caterina Longo
- Department of Dermatology, University of Modena and Reggio Emilia, 42100 Modena, Italy;
- Azienda Unità Sanitaria Locale—IRCCS di Reggio Emilia, Centro Oncologico ad Alta Tecnologia Diagnostica-Dermatologia, 41121 Reggio Emilia, Italy
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Omland SH, Wenande EC, Svane IM, Tam J, Olesen UH, Hædersdal M. Laser Immunotherapy: A Potential Treatment Modality for Keratinocyte Carcinoma. Cancers (Basel) 2021; 13:cancers13215405. [PMID: 34771568 PMCID: PMC8582581 DOI: 10.3390/cancers13215405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 10/25/2021] [Indexed: 12/22/2022] Open
Abstract
Simple Summary In light of expanding incidences of keratinocyte carcinoma (KC) with many patients developing multiple tumors, the demand for new treatment modalities is high. With the approval of cemplimab for locally advanced and metastasizing basal cell carcinoma and squamous cell carcinoma, KC is now included as an indication for systemic immunotherapy. At present, however, systemic KC therapy remains limited by the severe side effects associated with treatment. Immunotherapy might be more broadly applied if locally administered. Localized to the skin, KCs are easily accessible to topical drugs and physical interventions such as laser. There is an increasing appreciation of lasers’ potential to activate an immune response. Further enhancement of the laser-based immune activation might be obtained by combining laser and immunotherapeutic agents, known as laser immunotherapy. In search of new treatment modalities for KC and aiming to broaden the field of KC immunotherapy, this review discusses the current literature on immune activation following both laser monotherapy and laser immunotherapy. Abstract The role of the immune system in cancer growth is well recognized and the development of immunotherapy represents a breakthrough in cancer treatment. Recently, the use of systemic immunotherapy was extended to keratinocyte carcinoma (KC), specifically locally advanced and metastasizing basal and squamous cell carcinoma. However, since most KC lesions are non-aggressive, systemic treatment with associated side effects is rarely justified. Conversely, topical immunotherapy with imiquimod remains restricted to premalignant and superficial lesions. Use of laser in the treatment of KC has evolved from physical tumor destruction and laser-assisted drug delivery to laser-mediated immune modulation. Evidence indicates that laser monotherapy can lead to immune cell infiltration, tumor reduction and resistance to tumor re-inoculation. Combining laser with immunotherapeutic agents, termed laser immunotherapy (LIT), may further potentiate immune activation and tumor response. Studies on LIT show not only direct anti-tumor effects but systemic adaptive immunity, illustrated by the prevention of tumor recurrence and regression in distant untreated tumors. These findings imply a therapeutic potential for both local and metastatic disease. This work provides rationales for immune-based treatment of KC and presents the current status of KC immunotherapy. Aiming to expand the field of KC immunotherapy, the review discusses the literature on immune activation following laser monotherapy and LIT.
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Affiliation(s)
- Silje Haukali Omland
- Department of Dermatology, Copenhagen University Hospital, Bispebjerg, 2700 Copenhagen, Denmark; (E.C.W.); (U.H.O.); (M.H.)
- Correspondence:
| | - Emily Cathrine Wenande
- Department of Dermatology, Copenhagen University Hospital, Bispebjerg, 2700 Copenhagen, Denmark; (E.C.W.); (U.H.O.); (M.H.)
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA;
| | - Inge Marie Svane
- Center for Cancer Immune Therapy, Department of Oncology, Copenhagen University Hospital, 2730 Herlev, Denmark;
- National Center for Cancer Immune Therapy, Department of Oncology, Copenhagen University Hospital, 2730 Herlev, Denmark
| | - Joshua Tam
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA;
| | - Uffe Høgh Olesen
- Department of Dermatology, Copenhagen University Hospital, Bispebjerg, 2700 Copenhagen, Denmark; (E.C.W.); (U.H.O.); (M.H.)
| | - Merete Hædersdal
- Department of Dermatology, Copenhagen University Hospital, Bispebjerg, 2700 Copenhagen, Denmark; (E.C.W.); (U.H.O.); (M.H.)
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA;
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Klausen U, Grønne Dahlager Jørgensen N, Grauslund JH, Munir Ahmad S, Gang AO, Martinenaite E, Weis-Banke SE, Breinholt MF, Novotny GW, Kjeldsen JW, Orebo Holmström M, Pedersen LB, Poulsen CB, Hansen PB, Met Ö, Svane IM, Niemann CU, Pedersen LM, Andersen MH. An immunogenic first-in-human immune modulatory vaccine with PD-L1 and PD-L2 peptides is feasible and shows early signs of efficacy in follicular lymphoma. Oncoimmunology 2021; 10:1975889. [PMID: 38283034 PMCID: PMC10813564 DOI: 10.1080/2162402x.2021.1975889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 08/30/2021] [Indexed: 10/20/2022] Open
Abstract
Cells in the tumor microenvironment of Follicular lymphoma (FL) express checkpoint molecules such as programmed death ligands 1 and 2 (PD-L1 and PD-L2) and are suppressing anti-tumor immune activity. Stimulation of peripheral blood mononuclear cells (PBMC) with PD-L1 (IO103) or PD-L2 (IO120) peptides can activate specific T cells inducing anti-regulatory functions including cytotoxicity against PD-L1/PD-L2-expressing cells. In this study, we vaccinated eight FL patients with PD-L1 and PD-L2 peptides following treatment with standard chemotherapy. Patients experienced grade 1-2 injection site reaction (5/8) and mild flu-like symptoms (6/8). One patient experienced neutropenia and thrombocytopenia during pseudo-progression. Enzyme-linked immunospot detected vaccine-specific immune responses in PBMC from all patients, predominately toward PD-L1. The circulating immune composition was stable during treatment; however, we observed a reduction regulatory T cells, however, not significant. One patient achieved a complete remission during vaccination and two patients had pseudo-progression followed by long-term disease regression. Further examination of these early signs of clinical efficacy of the dual-epitope vaccine in a larger study is warranted.
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Affiliation(s)
- Uffe Klausen
- Dept. Of Hematology, Herlev Hospital, Herlev, Denmark
- Dept. Of Hematology, Rigshospitalet, Copenhagen, Denmark
- National Center for Cancer Immune Therapy (CCIT-DK), Department of Oncology Herlev Hospital, Herlev, Denmark
- Institute for Immunology and Microbiology, Copenhagen University, Copenhagen K, Denmark
| | - Nicolai Grønne Dahlager Jørgensen
- Dept. Of Hematology, Herlev Hospital, Herlev, Denmark
- National Center for Cancer Immune Therapy (CCIT-DK), Department of Oncology Herlev Hospital, Herlev, Denmark
| | - Jacob Handlos Grauslund
- National Center for Cancer Immune Therapy (CCIT-DK), Department of Oncology Herlev Hospital, Herlev, Denmark
- Institute for Immunology and Microbiology, Copenhagen University, Copenhagen K, Denmark
| | - Shamaila Munir Ahmad
- National Center for Cancer Immune Therapy (CCIT-DK), Department of Oncology Herlev Hospital, Herlev, Denmark
| | | | - Evelina Martinenaite
- National Center for Cancer Immune Therapy (CCIT-DK), Department of Oncology Herlev Hospital, Herlev, Denmark
| | - Stine Emilie Weis-Banke
- National Center for Cancer Immune Therapy (CCIT-DK), Department of Oncology Herlev Hospital, Herlev, Denmark
| | | | - Guy Wayne Novotny
- Dept. Of Hematology, Herlev Hospital, Herlev, Denmark
- Dept. Of Pathology, Herlev Hospital, Herlev, Denmark
| | - Julie Westerlin Kjeldsen
- National Center for Cancer Immune Therapy (CCIT-DK), Department of Oncology Herlev Hospital, Herlev, Denmark
- Institute for Immunology and Microbiology, Copenhagen University, Copenhagen K, Denmark
| | - Morten Orebo Holmström
- National Center for Cancer Immune Therapy (CCIT-DK), Department of Oncology Herlev Hospital, Herlev, Denmark
- Institute for Immunology and Microbiology, Copenhagen University, Copenhagen K, Denmark
| | | | | | - Per Boye Hansen
- Dept. Of Hematology, Zealand University Hospital, Roskilde, Rosklide, Denmark
| | - Özcan Met
- National Center for Cancer Immune Therapy (CCIT-DK), Department of Oncology Herlev Hospital, Herlev, Denmark
| | - Inge Marie Svane
- National Center for Cancer Immune Therapy (CCIT-DK), Department of Oncology Herlev Hospital, Herlev, Denmark
- Institute for Immunology and Microbiology, Copenhagen University, Copenhagen K, Denmark
| | - Carsten Utoft Niemann
- Dept. Of Hematology, Rigshospitalet, Copenhagen, Denmark
- Institute for Immunology and Microbiology, Copenhagen University, Copenhagen K, Denmark
| | - Lars Møller Pedersen
- Dept. Of Hematology, Herlev Hospital, Herlev, Denmark
- Dept. Of Hematology, Rigshospitalet, Copenhagen, Denmark
- Dept. Of Hematology, Zealand University Hospital, Roskilde, Rosklide, Denmark
| | - Mads Hald Andersen
- National Center for Cancer Immune Therapy (CCIT-DK), Department of Oncology Herlev Hospital, Herlev, Denmark
- Institute for Immunology and Microbiology, Copenhagen University, Copenhagen K, Denmark
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