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Haake M, Haack B, Schäfer T, Harter PN, Mattavelli G, Eiring P, Vashist N, Wedekink F, Genssler S, Fischer B, Dahlhoff J, Mokhtari F, Kuzkina A, Welters MJP, Benz TM, Sorger L, Thiemann V, Almanzar G, Selle M, Thein K, Späth J, Gonzalez MC, Reitinger C, Ipsen-Escobedo A, Wistuba-Hamprecht K, Eichler K, Filipski K, Zeiner PS, Beschorner R, Goedemans R, Gogolla FH, Hackl H, Rooswinkel RW, Thiem A, Roche PR, Joshi H, Pühringer D, Wöckel A, Diessner JE, Rüdiger M, Leo E, Cheng PF, Levesque MP, Goebeler M, Sauer M, Nimmerjahn F, Schuberth-Wagner C, von Felten S, Mittelbronn M, Mehling M, Beilhack A, van der Burg SH, Riedel A, Weide B, Dummer R, Wischhusen J. Tumor-derived GDF-15 blocks LFA-1 dependent T cell recruitment and suppresses responses to anti-PD-1 treatment. Nat Commun 2023; 14:4253. [PMID: 37474523 PMCID: PMC10359308 DOI: 10.1038/s41467-023-39817-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 06/09/2023] [Indexed: 07/22/2023] Open
Abstract
Immune checkpoint blockade therapy is beneficial and even curative for some cancer patients. However, the majority don't respond to immune therapy. Across different tumor types, pre-existing T cell infiltrates predict response to checkpoint-based immunotherapy. Based on in vitro pharmacological studies, mouse models and analyses of human melanoma patients, we show that the cytokine GDF-15 impairs LFA-1/β2-integrin-mediated adhesion of T cells to activated endothelial cells, which is a pre-requisite of T cell extravasation. In melanoma patients, GDF-15 serum levels strongly correlate with failure of PD-1-based immune checkpoint blockade therapy. Neutralization of GDF-15 improves both T cell trafficking and therapy efficiency in murine tumor models. Thus GDF-15, beside its known role in cancer-related anorexia and cachexia, emerges as a regulator of T cell extravasation into the tumor microenvironment, which provides an even stronger rationale for therapeutic anti-GDF-15 antibody development.
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Affiliation(s)
- Markus Haake
- Department of Gynecology, University Hospital Würzburg, Würzburg, Germany
- CatalYm GmbH, Am Klopferspitz 19, 82152, Munich, Germany
| | - Beatrice Haack
- Department of Gynecology, University Hospital Würzburg, Würzburg, Germany
| | - Tina Schäfer
- Department of Gynecology, University Hospital Würzburg, Würzburg, Germany
| | - Patrick N Harter
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Neurological Institute (Edinger Institute), University Hospital, Goethe University, Frankfurt/Main, Germany
- Frankfurt Cancer Institute (FCI), Frankfurt/Main, Germany
- Center for Neuropathology and Prion Research, Munich, Ludwig-Maximilians-University, Munich, Germany
| | - Greta Mattavelli
- Mildred Scheel Early Career Center, University Hospital of Würzburg, Würzburg, Germany
| | - Patrick Eiring
- Department of Biotechnology and Biophysics, Julius Maximilians University Würzburg, Am Hubland, 97074, Würzburg, Germany
| | - Neha Vashist
- Department of Gynecology, University Hospital Würzburg, Würzburg, Germany
- CatalYm GmbH, Am Klopferspitz 19, 82152, Munich, Germany
| | - Florian Wedekink
- Department of Gynecology, University Hospital Würzburg, Würzburg, Germany
| | | | - Birgitt Fischer
- Department of Gynecology, University Hospital Würzburg, Würzburg, Germany
- CatalYm GmbH, Am Klopferspitz 19, 82152, Munich, Germany
| | - Julia Dahlhoff
- Department of Medicine II, University Hospital of Würzburg, Würzburg, Germany
| | - Fatemeh Mokhtari
- Department of Medicine II, University Hospital of Würzburg, Würzburg, Germany
| | - Anastasia Kuzkina
- Department of Gynecology, University Hospital Würzburg, Würzburg, Germany
| | - Marij J P Welters
- Department of Medical Oncology, Oncode Institute, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333 ZA, The Netherlands
| | - Tamara M Benz
- Department of Gynecology, University Hospital Würzburg, Würzburg, Germany
| | - Lena Sorger
- Department of Gynecology, University Hospital Würzburg, Würzburg, Germany
| | - Vincent Thiemann
- Department of Gynecology, University Hospital Würzburg, Würzburg, Germany
| | - Giovanni Almanzar
- Department of Gynecology, University Hospital Würzburg, Würzburg, Germany
- Department of Pediatrics, University Hospital Würzburg, Würzburg, Germany
| | - Martina Selle
- Department of Gynecology, University Hospital Würzburg, Würzburg, Germany
| | - Klara Thein
- Department of Gynecology, University Hospital Würzburg, Würzburg, Germany
| | - Jacob Späth
- Department of Gynecology, University Hospital Würzburg, Würzburg, Germany
| | | | - Carmen Reitinger
- Division of Genetics, Department of Biology, University of Erlangen, 91058, Erlangen, Germany
| | - Andrea Ipsen-Escobedo
- Division of Genetics, Department of Biology, University of Erlangen, 91058, Erlangen, Germany
| | - Kilian Wistuba-Hamprecht
- Department of Dermatology, University Medical Center Tübingen, Tübingen, Germany
- Department of Immunology, University of Tübingen, Tübingen, Germany
- Section for Clinical Bioinformatics, Department of Internal Medicine I, University Medical Center Tübingen, Tübingen, Germany
| | - Kristin Eichler
- Department of Gynecology, University Hospital Würzburg, Würzburg, Germany
- CatalYm GmbH, Am Klopferspitz 19, 82152, Munich, Germany
| | - Katharina Filipski
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Neurological Institute (Edinger Institute), University Hospital, Goethe University, Frankfurt/Main, Germany
- Frankfurt Cancer Institute (FCI), Frankfurt/Main, Germany
| | - Pia S Zeiner
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Neurological Institute (Edinger Institute), University Hospital, Goethe University, Frankfurt/Main, Germany
- Frankfurt Cancer Institute (FCI), Frankfurt/Main, Germany
- Dr. Senckenberg Institute of Neurooncology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Rudi Beschorner
- Department of Neuropathology, University of Tübingen, Tübingen, Germany
| | - Renske Goedemans
- Department of Medical Oncology, Oncode Institute, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333 ZA, The Netherlands
| | - Falk Hagen Gogolla
- Institute of Bioinformatics, Biocenter, Medical University of Innsbruck, Innrain 80, 6020, Innsbruck, Austria
| | - Hubert Hackl
- Institute of Bioinformatics, Biocenter, Medical University of Innsbruck, Innrain 80, 6020, Innsbruck, Austria
| | | | - Alexander Thiem
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany
- Clinic for Dermatology and Venereology, Rostock University Medical Center, Rostock, Germany
| | - Paula Romer Roche
- Department of Gynecology, University Hospital Würzburg, Würzburg, Germany
- CatalYm GmbH, Am Klopferspitz 19, 82152, Munich, Germany
| | - Hemant Joshi
- Department of Gynecology, University Hospital Würzburg, Würzburg, Germany
- Division of Infectious Diseases, Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, 63130, USA
| | - Dirk Pühringer
- Department of Gynecology, University Hospital Würzburg, Würzburg, Germany
| | - Achim Wöckel
- Department of Gynecology, University Hospital Würzburg, Würzburg, Germany
| | - Joachim E Diessner
- Department of Gynecology, University Hospital Würzburg, Würzburg, Germany
| | | | - Eugen Leo
- CatalYm GmbH, Am Klopferspitz 19, 82152, Munich, Germany
| | - Phil F Cheng
- Department of Dermatology, University of Zurich, University of Zurich Hospital, Wagistrasse 18, 8952, Zürich, Switzerland
| | - Mitchell P Levesque
- Department of Dermatology, University of Zurich, University of Zurich Hospital, Wagistrasse 18, 8952, Zürich, Switzerland
| | - Matthias Goebeler
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany
| | - Markus Sauer
- Department of Biotechnology and Biophysics, Julius Maximilians University Würzburg, Am Hubland, 97074, Würzburg, Germany
| | - Falk Nimmerjahn
- Division of Genetics, Department of Biology, University of Erlangen, 91058, Erlangen, Germany
| | | | - Stefanie von Felten
- oikostat GmbH, Statistical Analyses and Consulting, Lucerne, Switzerland
- Department of Biostatistics, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001, Zürich, Switzerland
| | - Michel Mittelbronn
- Department of Oncology (DONC), Luxembourg Institute of Health (LIH), Luxembourg, Luxembourg
- Luxembourg Centre of Neuropathology (LCNP), Luxembourg, Luxembourg
- National Center of Pathology (NCP), Laboratoire National de Santé (LNS), Dudelange, Luxembourg
- Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg
- Department of Life Sciences and Medicine (DLSM), University of Luxembourg, Luxembourg, Luxembourg
- Faculty of Science, Technology and Medicine (FSTM), University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Matthias Mehling
- Department of Biomedicine and Neurology Department, University Hospital Basel, 4031, Basel, Switzerland
| | - Andreas Beilhack
- Department of Medicine II, University Hospital of Würzburg, Würzburg, Germany
| | - Sjoerd H van der Burg
- Department of Medical Oncology, Oncode Institute, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333 ZA, The Netherlands
| | - Angela Riedel
- Mildred Scheel Early Career Center, University Hospital of Würzburg, Würzburg, Germany
| | - Benjamin Weide
- Department of Dermatology, University Medical Center Tübingen, Tübingen, Germany
| | | | - Jörg Wischhusen
- Department of Gynecology, University Hospital Würzburg, Würzburg, Germany.
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Necchi A, Iacovelli R, Di Maio M, Gontero P, Fettes P, Klar K, Hermann F, Leo E. Neutralizing GDF-15 in muscle-invasive bladder cancer (MIBC): A neoadjuvant immunotherapy trial of visugromab (CTL-002) in combination with the anti-PD1 antibody nivolumab (NEO-GDFATHER). J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.6_suppl.tps595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023] Open
Abstract
TPS595 Background: Neoadjuvant chemotherapy (NACT) is a well-established treatment modality in MIBC but suffers from limited activity and significant toxicity. Recently, neoadjuvant immunotherapy (I/O) has demonstrated clinical safety and efficacy in various solid tumor indications including MIBC, with potentially less toxicity. Results from previous studies of single-agent I/O indicated a proportion of pathologic complete responses (ypT0N0) similar to that reported with NACT. Therefore, improving ypT0N0 responses remains a major task for successful treatment of MIBC in the future. Increasing evidence has emerged that Growth and Differentiation Factor 15 (GDF-15) plays a critical local immunosuppressive. Apart from blocking immune-cell entry into tissues GDF-15 also has major impact on the formation of the immune synapse. Many tumors overexpress GDF-15 and have hijacked this mechanism to block I/O therapy success. Various translational research efforts have indicated that GDF-15 may play a significant role for immunosuppression and T-cell exclusion in urothelial carcinoma (UC). Visugromab (CTL-002) is a GDF-15 neutralizing IgG4 monoclonal antibody that has demonstrated in Phase 1 a favorable safety profile and promising clinical activity with durable and deep responses in PD-1/PD-L1 relapsed/refractory metastatic solid tumors in combination with the anti-PD1 antibody Nivolumab (Nivo)*. This clinical trial is intended to investigate the combination of Visugromab with Nivo vs. Nivo monotherapy as neoadjuvant therapy for MIBC in patients (pts) who are ineligible for or elect not to undergo NACT. Primary endpoints are the complete pathologic response rate and radiologic response. Methods: This is a multi-center, parallel-cohorts and single-blinded Phase 2 study of neoadjuvant therapy in pts planned for radical cystectomy (RC). A total number of 30 subjects with stage T2-T4N0M0 MIBC will be enrolled and assigned 1:1 to receive either Nivo + Visugromab or Nivo + Placebo after stratification for CPS PD-L1 expression and cT-stage. No statistical assumptions have been undertaken at this stage. Treatment consists of three 4-week cycles [i.v., Q4Wk], and RC is planned 4-8 weeks after last dose of study drug. After RC, pts will follow standard recommendations according to EAU guidelines. Primary endpoints are the proportion of ypT0N0 response and radiologic response rate. Secondary endpoints comprise additional efficacy parameter, surgical and medical safety, PK and PD assessments. Translational research includes evaluation of immunologic parameters in the tumor, other immune-correlates and molecular profiles, as well as evaluation of treatment-emergent cytokine and chemokine profiles in peripheral blood. * Melero et al., Annals of Oncology (2022) 33 (suppl_7): S331-S355.
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Affiliation(s)
- Andrea Necchi
- Vita-Salute San Raffaele University and IRCCS San Raffaele Hospital, Milan, Italy
| | - Roberto Iacovelli
- Oncology Unit, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Catholic University of Rome, Rome, Italy
| | - Massimo Di Maio
- Department of Oncology, University of Turin at Ordine Mauriziano Hospital, Torino, Italy, Torino, Italy
| | - Paolo Gontero
- Dipartimento di Discipline Medico Chirurgiche, Clinica Urologica, University of Torino, Torino, Italy
| | | | | | | | - Eugen Leo
- CatalYm GmbH, Planegg-Martinsried, Germany
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Wolf J, Heist R, Kim T, Nishio M, Dooms C, Kanthala R, Leo E, Giorgetti E, Wang Y, Mardjuadi F, Cortot A. 994P Efficacy and safety of capmatinib plus spartalizumab in treatment-naïve patients with advanced NSCLC harboring MET exon 14 skipping mutation. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Melero I, Calvo E, Goebeler ME, Garralda E, Dummer R, Rodríguez-Ruiz M, De Miguel M, Sayehli C, Casal GA, Ramelyte E, Schuler M, Gromke T, Sanmamed M, Moreno I, Bargou R, Lostes M, Maul JT, Richly H, Fettes P, Klar K, Schuberth-Wagner C, Haake M, Wischhusen J, Leo E. Abstract P06-01: A phase I, first-in-human clinical trial of the GDF-15 neutralizing antibody CTL-002 in subjects with advanced stage solid tumors (Acronym: GDFATHER). Mol Cancer Ther 2021. [DOI: 10.1158/1535-7163.targ-21-p06-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Growth and differentiation factor 15 (GDF-15) is a TGF-β superfamily member physiologically expressed mainly in placenta and linked to feto-maternal tolerance. Under pathophysiologic conditions, prevention of excessive immune cell infiltration during tissue damage and cachexia induction have been ascribed to GDF-15. A recent study [Haake et al. AACR2020; Abstract #5597] elucidated a mechanism by which GDF-15 inhibits LFA-1 activation on CD8+ T cells, thus interfering with effector T cell recruitment to tissues. Importantly, several cancer entities secrete high levels of GDF-15, correlating with poor prognosis and reduced overall survival [reviewed in Front Immunol 2020 May 19;11:951]. To block this effect the GDF-15 neutralizing antibody CTL-002 was generated. In preclinical models CTL-002 demonstrated potent effector T cell shifting into tumor tissue by neutralizing GDF-15 and enhancing response to checkpoint inhibitor therapy. Methods: This is a phase 1, first-in-human (FIH), two-part, open-label clinical trial of intravenous (IV) administration of CTL-002 given as monotherapy and in combination with an anti-PD-1 antibody in subjects with advanced-stage, relapsed/refractory solid tumors who relapsed on or were refractory to a prior anti-PD-1/PD-L1 therapy. Eligible subjects have exhausted all available approved standard treatments, including prior anti-PD1/-PD-L1 treatment, and present with a biopsy-accessible tumor for serial biopsy taking. The trial is termed GDFATHER, for “GDF-15 Antibody-mediaTed Effector cell Relocation”. Main endpoints are safety of CTL-002 monotherapy and CTL-002 combination with an anti-PD-1 antibody, pharmacokinetics, pharmacodynamics (e.g., degree of GDF-15 neutralization achieved and change in immune-cell number and composition in the tumor tissue) as well as preliminary clinical efficacy (tumor mass reduction; anticachexia effect). In part A of the trial (dose escalation) up to 24 subjects will receive escalating doses of CTL-002 IV (0.3 – 20 mg/kg) in a „mono-followed-by-combination“-design with CTL-002 given as monotherapy and followed by combination with an anti-PD-1 checkpoint inhibitor. In part B (expansion) up to 5 cohorts with up to 25 subjects per cohort with defined tumor entities expected to be GDF-15 dependent will be treated to determine the recommended phase 2 dose (RP2D) and further evaluate safety and preliminary efficacy of CTL-002 monotherapy and the combination. The study was initiated in December 2020 and enrolled the first patient on Dec 09, 2020. Cohort 4 is ongoing at time of submission (07/2021) and so far no DLT has occurred. Updated safety, biomarker and response assessments will be reported. The ClinicalTrials.gov Identifier is NCT04725474.
Citation Format: Ignacio Melero, Emiliano Calvo, Maria-Elisabeth Goebeler, Elena Garralda, Reinhard Dummer, María Rodríguez-Ruiz, María De Miguel, Cyrus Sayehli, Guzman Alonso Casal, Egle Ramelyte, Martin Schuler, Tanja Gromke, Miguel Sanmamed, Irene Moreno, Ralf Bargou, Maria Lostes, Julia-Tatjana Maul, Heike Richly, Petra Fettes, Kathrin Klar, Christine Schuberth-Wagner, Markus Haake, Joerg Wischhusen, Eugen Leo. A phase I, first-in-human clinical trial of the GDF-15 neutralizing antibody CTL-002 in subjects with advanced stage solid tumors (Acronym: GDFATHER) [abstract]. In: Proceedings of the AACR-NCI-EORTC Virtual International Conference on Molecular Targets and Cancer Therapeutics; 2021 Oct 7-10. Philadelphia (PA): AACR; Mol Cancer Ther 2021;20(12 Suppl):Abstract nr P06-01.
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Affiliation(s)
| | - Emiliano Calvo
- 2Hospital Universitario HM Sanchinarro START, Madrid, Spain,
| | | | | | | | | | - María De Miguel
- 2Hospital Universitario HM Sanchinarro START, Madrid, Spain,
| | | | | | | | | | | | | | - Irene Moreno
- 2Hospital Universitario HM Sanchinarro START, Madrid, Spain,
| | - Ralf Bargou
- 3University Hospital Würzburg, Würzburg, Germany,
| | - Maria Lostes
- 4Hospital Universitari Vall d'Hebron, Barcelona, Spain,
| | | | | | | | | | | | | | | | - Eugen Leo
- 7CatalYm GmbH, Planegg-Martinsried, Germany,
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Haake M, Schäfer T, Haack B, Vashist N, Genßler S, Harter P, Martens A, Wistuba-Hamprecht K, Wedekink F, Fischer B, Mittelbronn M, Levesque M, Cheng P, Dummer R, Weide B, Klar K, Leo E, Nimmerjahn F, Schuberth-Wagner C, Wischhusen J. 568 Tumor-derived GDF-15 prevents therapy success of checkpoint inhibitors by blocking T-lymphocyte recruitment. J Immunother Cancer 2021. [DOI: 10.1136/jitc-2021-sitc2021.568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BackgroundImmune checkpoint blockade (ICB) can achieve durable responses in a subgroup of patients with metastatic cancer, only. Poor immune effector cell infiltration into the tumor microenvironment is a major obstacle to successful therapy. Growth and differentiation factor 15 (GDF-15) is a divergent member of the TGF-β superfamily and has been linked to feto-maternal tolerance, anorexia but recently also to potent local immunosuppression under physiologic and pathophysiologic conditions. GDF-15 is overexpressed in a wide variety of tumors and may be key factor produced by tumors to prevent effective immune cell infiltration into the tumor and to potently block checkpoint inhibitor activity.MethodsEffects of recombinant GDF-15 and a proprietary GDF-15 neutralizing antibody (CTL-002) on immune cell trafficking and activation were analyzed by adhesion and interaction assays and in melanoma-bearing humanized mouse models. The impact of GDF-15 overexpression was tested in subcutaneously implanted, GDF-15-transgenic MC38 cells. Additionally, patient GDF-15 serum levels were correlated with immune infiltration and OS in cutaneous melanoma. Associations between GDF-15 serum levels, response to PD-1-based ICB and corresponding OS were assessed in two independent cohorts of melanoma patients.ResultsGDF-15 impairs adhesion of T and NK cells on activated endothelia. In HV18-MK bearing humanized mice, inhibition of GDF-15 strongly enhances infiltration of activated myeloid and lymphoid cells. In MC38 tumors, GDF-15 overexpression can abrogate tumor rejection upon anti-PD-1 therapy. 50% of the mice with GDF-15 overexpressing tumors were, however, rescued when anti-PD-1 was combined with anti-GDF-15 (CTL-002). Likewise, anti-GDF-15 improved responses to anti-CD40 + poly(I:C) in the same tumor model. Clinically, inverse correlations of GDF-15 levels with CD8+ T cell infiltration were shown for melanoma brain metastases. In two independent melanoma patient cohorts, low baseline serum GDF-15 levels predicted clinical response to anti-PD1 treatment and superior OS. Bivariate analysis including LDH indicates that GDF-15 is an independently predictor for poor survival in anti-PD-1 treated melanoma patients.ConclusionsTumor-derived GDF-15 blocks the infiltration of immune effector cells into tumor tissues. Neutralizing GDF-15 with CTL-002 restores the ability of immune cells to extravasate blood vessels and enter the tumor microenvironment in vivo. GDF-15 thus represents a promising target for cancer immunotherapy. Antibodies against GDF-15 may support treatments with anti-PD-1 and other immunotherapeutic agents. A clinical trial combining anti-GDF-15 (CTL002) with anti-PD-1 (NCT04725474, submitted Abstract ID 15073) is ongoing.Ethics ApprovalUse of patient samples for this study had been approved by the institutional ethics committee Tübingen (ethic vote 125/2015BO2). Use of surplus sera collected in the University of Zurich Hospital (USZ) Biobank during routine blood draws from consenting metastatic melanoma patients was performed according to IRB approval (KEK.Zh- 647/800) and followed the Declaration of Helsinki on Human Rights.ConsentAll patients had given written informed consent to have clinical data recorded by the Central Malignant Melanoma Registry (CMMR) database.
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Oduro J, Simon R, Gorbokon N, Fraune C, Bluhm J, Scheuplein V, Kieback E, Obenaus M, Blankenstein T, Leo E. 95 MAGE-A1 protein expression pattern in > 5,000 tumor and healthy tissue samples: Validation of MAGE-A1 as an ideal target for TCR-based cell therapy. J Immunother Cancer 2021. [DOI: 10.1136/jitc-2021-sitc2021.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BackgroundCancer testis antigens (CTAs) are considered attractive targets for T cell receptor (TCR)-based cellular therapies as their expression in healthy adults is considered restricted to the immune-privileged testis. However, low-level expression of some CTAs in healthy tissue has been observed, resulting in significant on-target/off-cancer toxicity. Melanoma associated antigen 1 (MAGE-A1) is a member of the MAGE-A CTA family, whose members are known to influence cellular signaling pathways through their E3 ubiquitin ligase-binding MAGE homology domain. MAGE-A proteins are frequently expressed in different cancer types, have been linked to oncogenic activity and their expression has been associated with poor prognosis.1 Literature data suggest that in healthy tissues MAGE-A1 is detected in testis, only, with one exception suggesting MAGE-A1 RNA expression in cerebellum and cerebrum.2 Therefore, to evaluate MAGE-A1 as a potential target for cellular immunotherapies, an in-depth analysis of MAGE-A1 expression in > 70 different healthy tissue types and > 5,000 cancer biopsies was conducted, aiming to assess if MAGE-A1 represents a valid and safe target.MethodsA MAGE-A1 antibody with high specificity (TK-AbMA1P) was identified and characterized for immunohistochemistry. A large panel of > 70 different healthy tissue types and > 5,000 tumor biopsies was explored and scored for MAGE-A1 expression by tissue microarray. Identified cancer entities with relevant MAGE-A1 expression were further investigated to assess spatial intratumoral MAGE-A1 expression distribution and expression consistency between primary tumor and lymph node/distant metastases.ResultsCharacterization of TK-AbMA1P demonstrated fully paralog-selective staining for MAGE-A1. Analysis of MAGE-A1 expression in over 70 different healthy tissues confirmed strictly selective expression of MAGE-A1 in testis. An extended analysis of various CNS tissues including cerebellum and cerebrum did not reveal any expression in CNS. The analysis of > 5,000 tumor biopsies showed significant MAGE-A1 expression in distinct subgroups of multiple major tumor types with high unmet medical need. Substantial expression was detected for example in non-small-cell lung cancer, various breast cancer subtypes, gastrointestinal and urogenital cancers, among others. Extended analysis of the MAGE-A1 positive tumors demonstrated highly homogenous and consistent spatial intratumoral distribution of MAGE-A1 expression as well as between primary tumor and metastases.ConclusionsThis analysis confirms that MAGE-A1 is a highly selectively expressed CTA and demonstrates relevant expression in various indications with high unmet medical need, suggesting that MAGE-A1 is an ideal target for highly potent TCR-based adoptive cell therapy.ReferencesWeon JL, Potts PR. The MAGE protein family and cancer. Curr Opin Cell Biol 2015;37:1–8.Morgan RA, Chinnasamy N, Abate-Daga D, Gros A, Robbins PF, Zheng Z, Dudley ME, Feldman SA, Yang JC, Sherry RM, Phan GQ, Hughes MS, Kammula US, Miller AD, Hessman CJ, Stewart AA, Restifo NP, Quezado MM, Alimchandani M, Rosenberg AZ, Nath A, Wang T, Bielekova B, Wuest SC, Akula N, McMahon FJ, Wilde S, Mosetter B, Schendel DJ, Laurencot CM, Rosenberg SA. Cancer regression and neurological toxicity following anti-MAGE-A3 TCR gene therapy. J Immunother 2013;36(2):133–51.Ethics ApprovalThis study was approved by the Ethics Commission of the Ärztekammer Hamburg; approval number WF-049/09. Participants gave informed consent before taking part.
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Thistlethwaite F, Busse A, Calvo E, Goebeler ML, Wermke M, Rottey S, Kotecki N, Obenaus M, Scheuplein V, Wolter R, Perdomo-Ortiz C, Gavvovidis I, Kieback E, Blankenstein T, Leo E. 499 A first-in-human, phase 1/2 clinical trial of TK-8001, a MAGE-A1 directed T cell receptor in patients with advanced-stage solid tumors (The “IMAG1NE”-trial). J Immunother Cancer 2021. [DOI: 10.1136/jitc-2021-sitc2021.499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BackgroundMelanoma-associated antigen 1 (MAGE-A1) is a cancer-testis antigen with highly selective expression in testis (which is an immune privileged site) and in multiple high unmet medical need cancers. Therefore, it represents an attractive target for T cell receptor (TCR)-based therapies. TK-8001 is a MAGE-A1 directed TCR with optimized affinity and specificity, derived from the huTCR mouse platform,1 introduced by retroviral transduction into autologous patient-derived CD8+ T cells. The anticipated mode of action of TK-8001 is to bind to MAGE-A1-epitope presenting tumor cells and eliminate them via CD8+ cytotoxic activity and interferon-γ release. Preclinical exploration of the TK-8001 TCR has demonstrated potent antitumor activity, even in low-expressing MAGE-1 positive tumor cells, and favorable benchmarking vs. existing MAGE-A1 directed TCRs derived from human donors. This abstract describes the currently launched phase 1/2 trial for TK-8001.MethodsThe IMAG1NE trial (Immunotherapeutic MAGE-A1 directed Neoplasm Elimination) is a phase 1/2, first-in-human, open-label, accelerated titration, two-part clinical trial of TK-8001 (MAGE-A1-directed TCR-transduced autologous CD8+ T cells) in subjects with HLA-A*02:01 genotype and advanced-stage/metastatic, MAGE-A1+ solid tumors that either have no approved therapeutic alternative(s) or are in non-curable state and have received a minimum of two lines of systemic therapy. Major endpoints for the IMAG1NE trial will be safety, pharmacokinetics, pharmacodynamics (e.g. cytokine profiles) as well as preliminary clinical efficacy (degree of tumor mass reduction and duration of response).In Part 1 of the trial, three different doses of TK-8001 will be explored for safety and preliminary clinical efficacy in an accelerated titration design. The starting dose is set at 1x10E8 MAGE-A1 TCR transduced CD8+ T cells followed by two escalation steps. Part 2 of the trial will enroll up to 30 subjects with advanced-stage, MAGE-A1 positive cancer to confirm safety and efficacy.The study is expected to open for enrolment in Q4/2021. For further information please contact T-knife GmbH at info@t-knife.com.ReferencesLi, Liang-Ping, J Christoph Lampert, Xiaojing Chen, Catarina Leitao, Jelena Popović, Werner Müller, and Thomas Blankenstein. Transgenic mice with a diverse human T cell antigen receptor repertoire. Nature Medicine 2010;16: 1029–34.Ethics ApprovalIn progress, expected 11/2021
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Melero I, Calvo E, Goebeler ME, Garralda E, Dummer R, Rodríguez-Ruiz M, Miguel MD, Sayehli CM, Casal GA, Ramelyte E, Schuler M, Gromke T, Sanmamed M, Moreno I, Bargou R, Lostes M, Maul JT, Eggenschwiler C, Richly H, Fettes P, Klar K, Schuberth-Wagner C, Haake M, Wischhusen J, Leo E. 504 A phase I, first-in-human clinical trial of the GDF-15 neutralizing antibody CTL-002 in subjects with advanced stage solid tumors (Acronym: GDFATHER). J Immunother Cancer 2021. [DOI: 10.1136/jitc-2021-sitc2021.504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BackgroundGrowth and differentiation factor 15 (GDF-15) is a TGF-β superfamily member physiologically expressed mainly in placenta and linked to feto-maternal tolerance. Under pathophysiologic conditions, prevention of excessive immune cell infiltration during tissue damage and cachexia induction have been ascribed to GDF-15. Recent research has though indicated a prominant role in modulation of the tumor microenvironment and the immune synapse, too1 2 indicating that GDF-15 may be a major tumor-derived immunosuppressant. Importantly, several cancer entities secrete high levels of GDF-15, correlating with poor prognosis and reduced overall survival [Front Immunol 2020 May 19;11:951]. To block this effect the GDF-15 neutralizing antibody CTL-002 was generated. In preclinical models CTL-002 demonstrated potent effector T cell shifting into tumor tissue by neutralizing GDF-15.MethodsThis is a phase 1, first-in-human (FIH), two-part, open-label clinical trial of intravenous (IV) administration of CTL-002 given as monotherapy and in combination with an anti-PD-1 antibody in subjects with advanced-stage, relapsed/refractory solid tumors who relapsed or were refractory to a prior anti-PD-1/PD-L1 therapy. Eligible subjects have exhausted all available approved standard treatments, including prior anti-PD1/-PD-L1 treatment, and present with a biopsy-accessible tumor for serial biopsy taking. The trial is termed GDFATHER, for ”GDF-15 Antibody-mediaTed Effector cell Relocation”.Main endpoints are safety of CTL-002 monotherapy and CTL-002 combination with an anti-PD-1 antibody, pharmacokinetics, pharmacodynamics (e.g. degree of GDF-15 neutralization achieved and change in immune-cell number and composition in the tumor tissue) as well as preliminary clinical efficacy (tumor mass reduction; anticachexia effect)In part A of the trial (dose escalation) up to 24 subjects will receive escalating doses of CTL-002 IV (0.3 – 20 mg/kg) in a ”mono-followed-by-combination”-design with CTL-002 given as monotherapy and followed by combination with an anti-PD-1 checkpoint inhibitor. In part B (expansion) up to 5 cohorts with up to 25 subjects per cohort with defined tumor entities expected to be GDF-15 dependent will be treated to determine the recommended phase 2 dose (RP2D) and further evaluate safety and preliminary efficacy of CTL-002 monotherapy and the combination.The study was initiated in December 2020 and enrolled the first patient on Dec 09, 2020. Cohort 4 is ongoing at time of submission (07/2021) and so far no DLT has occurred. Updated safety, biomarker and response assessments will be reported at the meeting. The ClinicalTrials.gov Identifier is NCT04725474. For more information please contact info@catalym.com.Trial RegistrationNCT04725474ReferencesWischhusen J, Wistuba-Hamprecht K, Harter PN, Cheng P, Martens A, Gogolla F, Nonomura Y, Romer P, Koch SD, Haake M, Schuberth-Wagner C, Rudiger M, Leo E, Mittelbronn M, Levesque MP, Hackl H, Dummer R, Weide B. Identifying GDF-15 as potential novel immunotherapeutic target linked to immune cell exclusion in tumors and resistance to anti-PD-1 treatment [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27–28 and Jun 22–24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl): Abstract nr 2161.Hurt E, Thomas S, Mulgrew K, Blackmore S, Moynihan J, Cusdin F, Dodd R, Cariuk P, Sigurdardottir A, Brannigan E, Dobson C, Kumar R, Cobbold M. AZD8853: A novel antibody targeting GDF15 for immunotherapy refractory tumors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10–15 and May 17–21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl): Abstract nr 1828.Ethics ApprovalAll participants gave informed consent prior to participation. EC approval by Gobierno de Navarra, Departamento de Salud, EC_2020/30, Dated: Oct 13, 2020 in Pamplona, Spain. Respective additional national lead EC approvals for Germany (Ethikkommission der Universität Würzburg, 203–20ff of Oct 26, 2020) and Switzerland (Kantonale Ethikkommission Zürich, 2020–02308 of Nov 24, 2020).
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Melero I, Calvo E, Dummer R, Garralda E, Schuler MH, Goebeler ME, Bargou RC, Gromke T, Tabernero J, Ramelyte E, De Miguel M, Sanmamed MF, Rodriguez-Ruiz ME, Fettes P, Klar K, Ruediger M, Schuberth-Wagner C, Haake M, Wischhusen J, Leo E. A phase I, first-in-human clinical trial of the GDF-15 neutralizing antibody CTL-002 in subjects with advanced-stage solid tumors (ACRONYM: GDFATHER). J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.tps2658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS2658 Background: Growth and differentiation factor 15 (GDF-15) is a TGF-β superfamily member physiologically expressed mainly in placenta and linked to feto-maternal tolerance. Under pathophysiologic conditions, prevention of excessive immune cell infiltration during tissue damage and cachexia induction have been ascribed to GDF-15. A recent study [Haake et al. AACR2020; Abstract #5597] elucidated a mechanism by which GDF-15 inhibits LFA-1 activation on CD8+ T cells, thus interfering with effector T cell recruitment to tissues. Importantly, several cancer entities secrete high levels of GDF-15, correlating with poor prognosis and reduced overall survival [reviewed in Front Immunol 2020 May 19;11:951]. To block this effect the GDF-15 neutralizing antibody CTL-002 was generated. In preclinical models CTL-002 demonstrated potent effector T cell shifting into tumor tissue by neutralizing GDF-15. Methods: This is a phase 1, first-in-human (FIH), two-part, open-label clinical trial of intravenous (IV) administration of CTL-002 given as monotherapy and in combination with an anti-PD-1 antibody in subjects with advanced-stage, relapsed/refractory solid tumors who relapsed post or were refractory to a prior anti-PD-1/PD-L1 therapy. Eligible subjects have exhausted all available approved standard treatments. Further key eligibility criteria include having received at least one prior anti-PD1/-PD-L1 treatment and having relapsed on or after it or having been refractory to it, and presenting with a biopsy-accessible tumor for serial biopsy taking. The trial is termed GDFATHER, for “GDF-15 Antibody-mediaTed Effector cell Relocation”. Main endpoints are safety of CTL-002 monotherapy and CTL-002 combination with an anti-PD-1 antibody, pharmacokinetics, pharmacodynamics (e.g. degree of GDF-15 neutralization achieved and change in immune-cell number and composition in the tumor tissue) as well as preliminary clinical efficacy (tumor mass reduction; anticachexia effect) In part A of the trial (dose escalation) up to 24 subjects will receive escalating doses of CTL-002 IV (0.3 – 20 mg/kg) in a „mono-followed-by-combination“-design with CTL-002 given as monotherapy and followed by combination with an anti-PD-1 checkpoint inhibitor. In part B (expansion) up to 5 cohorts with up to 25 subjects per cohort with defined tumor entities expected to be GDF-15 dependent will be treated to determine the recommended phase 2 dose (RP2D) and further evaluate safety and preliminary efficacy of CTL-002 monotherapy and the combination. The study was initiated in December 2020 and enrolled the first patient on Dec 09, 2020. Cohort 1 has been completed without DLT and enrollment for cohort 2 began in February 2021. Clinical trial information: NCT04725474.
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Affiliation(s)
- Ignacio Melero
- Universidad de Navarra, Center for Applied Medical Research (CIMA), Pamplona, Spain
| | - Emiliano Calvo
- START Madrid-CIOCC, Centro Integral Oncológico Clara Campal, Hospital Madrid Norte Sanchinarro, Madrid, Spain
| | - Reinhard Dummer
- Skin Cancer Center, University Hospital of Zürich, Zürich, Switzerland
| | | | - Martin H. Schuler
- West German Cancer Centre, University Hospital Essen, Essen, Germany
| | - Maria-Elisabeth Goebeler
- Translational Oncology/Early Clinical Trial Unit (ECTU), Medizinische Klinik II, University Hospital Würzburg, Würzburg, Germany
| | - Ralf C. Bargou
- Comprehensive Cancer Center Mainfranken, University Hospital Würzburg, Würzburg, Germany
| | | | - Josep Tabernero
- Vall d’Hebron University Hospital and Vall d’Hebron Institute of Oncology (VHIO), UVic-UCC, Barcelona, Spain
| | | | - Maria De Miguel
- START Madrid-CIOCC, Centro Integral Oncológico Clara Campal, Hospital Universitario HM Sanchinarro, Madrid, Spain
| | - Miguel F. Sanmamed
- Department of Medical Oncology, Clinica Universidad de Navarra, Pamplona, Spain
| | - Maria E. Rodriguez-Ruiz
- Center for Applied Medical Research (CIMA), University of Navarra, Clínica Universidad de Navarra, Madrid, Spain
| | | | | | | | | | | | - Joerg Wischhusen
- University of Wuerzburg, Department of Gynecology and Obstetrics, Würzburg, Germany
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Wischhusen J, Haake M, Vashist N, Genßler S, Wistuba-Hamprecht K, Harter P, Martens A, Mittelbronn M, Levesque MP, Dummer R, Weide B, Welters MJP, van der Burg SH, Ruediger M, Leo E, Nimmerjahn F, Schuberth-Wagner C. Tumor-derived GDF-15 to suppress t-lymphocyte recruitment to the tumor microenvironment resulting in resistance to ANTI-PD-1 treatment. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.e14532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e14532 Background: Growth and differentiation factor 15 (GDF-15) is a divergent member of the TGF-β superfamily with low to absent expression in healthy tissue. GDF-15 has been linked to feto-maternal immune tolerance, to prevention of excessive immune cell infiltration during tissue damage, and to anorexia. Various major tumor types secrete high levels of GDF-15. In cancer patients, elevated GDF-15 serum levels correlate with poor prognosis and reduced overall survival (OS). Methods: Impact of a proprietary GDF-15 neutralizing antibody (CTL-002) regarding T cell trafficking was analyzed by whole blood adhesion assays, a HV18-MK melanoma-bearing humanized mouse model and a GDF-15-transgenic MC38 model. Additionally, patient GDF-15 serum levels were correlated with clinical response and overall survival in oropharyngeal squamous cell carcinoma (OPSCC) and melanoma brain metastases. Results: In whole blood cell adhesion assays GDF-15 impairs adhesion of T and NK cells to activated endothelial cells. Neutralization of GDF-15 by CTL-002 rescued T cell adhesion. In HV18-MK-bearing humanized mice CTL-002 induced a strong increase in TIL numbers. Subset analysis revealed an overproportional enrichment of T cells, in particular CD8+ T cells. As immune cell exclusion is detrimental for checkpoint inhibitor (CPI) therapy, a GDF-15-transgenic MC38 model was tested for anti-PD-1 therapy efficacy. In GDF-15 overexpressing MC38 tumors response to anti PD-1 therapy was reduced by 90% compared to wtMC38 tumors. Combining aPD-1 with CTL-002 resulted in 50% of the mice rejecting their GDF-15 overexpressing tumors. Clinically, inverse correlations of GDF-15 levels with CD8+ T cell infiltration were shown for HPV+ OPSCC and for melanoma brain metastases. GDF-15 serum levels were significantly higher in HPV- than in HPV+ OPSCC patient (p < 0.0001). Low GDF-15 levels corresponded to longer OS in both HPV- and HPV+ OPSCC. In two independent melanoma patient cohorts treated with nivolumab or pembrolizumab low baseline serum GDF-15 levels were predictive for clinical response to anti-PD1 treatment and superior OS. Bivariate analysis including LDH indicates that GDF-15 independently predicts poor survival in aPD-1 treated melanoma patients. Conclusions: Taken together our in vitro and in vivo data show that elevated GDF-15 levels block T-cell infiltration into tumor tissues. Neutralizing GDF-15 with CTL-002 restores the ability of T cells to extravasate blood vessels and enter tumor tissue both in vitro and in vivo. In melanoma, patients with higher GDF-15 levels have significantly shorter survival and are less likely to respond to anti-PD1 therapy. GDF-15 may thus serve as a new predictive biomarker for anti-PD1 response, but most importantly also represents a novel target for cancer immunotherapy to improve tumor immune cell infiltration and response to anti-PD1 therapy.
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Affiliation(s)
- Joerg Wischhusen
- University of Wuerzburg, Department of Gynecology and Obstetrics, Würzburg, Germany
| | | | | | | | | | | | | | | | | | - Reinhard Dummer
- Skin Cancer Center, University Hospital of Zürich, Zürich, Switzerland
| | - Benjamin Weide
- Department of Dermatology, University Hospital Tübingen, Tübingen, Germany
| | - Marij JP Welters
- Department of Medical Oncology, Leiden University Medical Center, Leiden, Netherlands
| | - Sjoerd H van der Burg
- Department of Medical Oncology, Oncode Institute, Leiden University Medical Center, Leiden, Netherlands
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Gavvovidis I, Leisegang M, Oduro J, Obenaus M, Leo E, Blankenstein T, Kieback E. Generation of a HuTCR mouse platform-derived MAGE-A1-directed high-affinity TCR with superior potency versus human-derived TCRs. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.e14515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e14515 Background: As cancer-testis antigens are self-antigens, T cells expressing high-affinity TCRs against such antigens are suppressed via negative thymic selection. Therefore, patient- or donor-derived TCRs are typically of low affinity and result in a reduced antitumor effect. Using our proprietary HuTCR platform, which consists of mouse lines carrying the full human TCR α/β loci in combination with common human HLA alleles, we have isolated high-affinity TCRs specific for the cancer-testis antigen MAGE-A1 and compared them to human-derived MAGE-A1-specific TCRs that are currently reported to be in clinical development. Furthermore, we validated MAGE-A1 as a potential cancer therapy target by using immunohistochemistry to evaluate expression in several major tumor types and healthy tissue. Methods: Using scRNAseq, TCRs were isolated from HuTCR mice. Human-derived MAGE-A1-specific TCR sequences were obtained from publicly available databases. All TCRs were expressed in primary human T cells as verified using peptide-MHC-multimer staining. Functional avidity of the TCRs was analyzed by coculture with T2 target cells loaded with titrated amounts of epitope peptides and measuring cytokine concentration by ELISA. Reactivity of TCRs to endogenously processed MAGE-A1 protein was assessed by co-culture with a panel of tumor cell lines varying in MAGE-A1 and/or MHC-class-I expression. MAGE-A1 expression on protein level was evaluated by immunohistochemistry. Results: Immunization of HuTCR mice with the antigen resulted in robust CD8+ T cell responses and several TCR clonotypes were identified by scRNAseq, with the majority of clonotypes being specific to the MAGE-A1-derived peptide KVLEYVIKV and TCR affinities ranging from 0.3 nM to 3 nM. By comparison, human-derived TCRs exhibited generally lower functional avidity from 3 nM to 60 nM. In addition, HuTCR-mouse-derived TCRs were more sensitive in recognition of tumor cell lines expressing low MAGE-A1 and/or HLA-A2. Immunohistochemical analysis of MAGE-A1 expression in healthy tissues demonstrated highly selective expression of MAGE-A1 in testis, only. Screening for expression confirmed that a significant proportion of several major cancer types expresses MAGE-A1 as reported by various other groups [reviewed in Curr Opin Cell Biol. 2015 December; 37: 1–8]. Conclusions: The HuTCR mouse platform allows for the generation of high-affinity MAGE-A1-specific TCRs with increased anti-tumor efficacy as compared to human-derived TCRs against the same cancer antigen. In addition, it was confirmed that MAGE-A1 has a highly selective expression pattern in healthy tissues (testis, only), but shows distinct expression in several major human tumor types.
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Affiliation(s)
| | | | | | | | | | - Thomas Blankenstein
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
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Zipfel S, Biancari F, Mariscalco G, Dalén M, Settembre N, Welp H, Perrotti A, Wiebe K, Leo E, Loforte A, Chocron S, Pacini D, Juvonen T, Broman LM, Di Perna D, Yusuff H, Harvey C, Mongardon N, Maureira JP, Levy B, Falk L, Ruggieri VG, Kluge S, Reichenspurner H, Folliguet T, Fiore A. Extracorporeal Membrane Oxygenation for Patients with Severe COVID-19-Related ARDS: A European Multicenter Analysis. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Wischhusen J, Wistuba-Hamprecht K, Harter PN, Cheng P, Martens A, Gogolla F, Nonomura Y, Romer P, Koch SD, Haake M, Schuberth-Wagner C, Rudiger M, Leo E, Mittelbronn M, Levesque MP, Hackl H, Dummer R, Weide B. Abstract 2161: Identifying GDF-15 as potential novel immunotherapeutic target linked to immune cell exclusion in tumors and resistance to anti-PD-1 treatment. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-2161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction:
Growth and differentiation factor 15 (GDF-15) is a TGF-β superfamily member mainly expressed in placenta and prostate of healthy individuals. GDF-15 has been linked to feto-maternal tolerance, prevention of excessive immune cell infiltration during tissue damage and to anorexia. In cancer patients, GDF-15 serum levels are frequently elevated and associated with poor prognosis, via so far mostly unknown mechanism(s). A recent study elucidated a mechanism by which GDF-15 inhibits LFA-1 activation on CD8+ T cells, thus interfering with T cell recruitment to tissues [Haake et al. AACR 2020; submitted]. To further delineate the role of GDF-15 in cancer in this study GDF-15 serum and tissue levels were analyzed and correlated with tumoral immune-cell infiltration and clinical anti-PD1 response.
Methods:
In-silico, TCGA-derived mRNA levels of GDF-15 were compared in cancer vs. normal tissue. Two independent melanoma patient cohorts (88 and 34 patients) treated with nivolumab or pembrolizumab were analyzed regarding baseline GDF-15 serum levels, correlation with clinical response and overall survival. Melanoma brain metastases from 80 patients were collected to assess and compare intratumoral GDF-15 levels vs. CD3+, CD8+ and Foxp3+ cell numbers by immunohistochemistry (IHC).
Results:
TCGA-based analyses demonstrated significantly elevated GDF-15 mRNA levels in tumor vs. surrounding normal tissue in various major cancer types such as e.g. colorectal, prostate, head & neck and melanoma. In the two independent, anti-PD1 treated melanoma patient cohorts baseline serum GDF-15 levels were predictive for superior overall survival and clinical response to anti-PD1 treatment (p<0.0001 and p=0.0382, respectively). In melanoma biopsies an inverse correlation of GDF-15 levels (histoscore) with CD3+ (R=-0.26; p=0.016) and CD8+ T cells (R=-0.21; p=0.05), but no correlation with Foxp3+ T cells was shown.
Conclusion:
GDF-15 is elevated in serum and tumor tissue of various major cancer types. In melanoma, patients with higher GDF-15 levels have significantly shorter survival and are less likely to respond to anti-PD1 therapy. In addition, intratumoral GDF-15 levels in melanoma brain metastasis correlate inversely with CD3+ and CD8+ T cell infiltration. Consequently, GDF-15 may serve as a predictive biomarker for anti-PD1 response and potentially represent a novel target in the immunotherapy of cancer to improve tumor immune cell infiltration and anti-PD1 response.
Citation Format: Jorg Wischhusen, Kilian Wistuba-Hamprecht, Patrick N. Harter, Phil Cheng, Alexander Martens, Falk Gogolla, Yumi Nonomura, Paula Romer, Sven D. Koch, Markus Haake, Christine Schuberth-Wagner, Manfred Rudiger, Eugen Leo, Michael Mittelbronn, Mitchell P. Levesque, Hubert Hackl, Reinhard Dummer, Benjamin Weide. Identifying GDF-15 as potential novel immunotherapeutic target linked to immune cell exclusion in tumors and resistance to anti-PD-1 treatment [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 2161.
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Affiliation(s)
- Jorg Wischhusen
- 1University of Wurzburg, Clinics for Gynecology and Obstetrics, Center for Clinical Research, Catalym GmbH, Planegg-Martinsried, Germany; Catalym GmbH, Planegg-Martinsried, Germany, Wurzburg, Germany
| | | | - Patrick N. Harter
- 3German Cancer Research Center (DKFZ), Heidelberg, Germany; Neurological Institute (Edinger Institute) University Hospital Franfurt; Frankfurt Cancer Institute (FCI); German Cancer Konsortium (DKTK), Frankfurt, Germany
| | - Phil Cheng
- 4University of Zurich, University of Zurich Hospital, Zurich, Switzerland
| | - Alexander Martens
- 2University of Tubingen, University Medical Center, Tubingen, Germany
| | - Falk Gogolla
- 5Medical University of Innsbruck, Institute of Bioinformatics, Innsbruck, Austria
| | - Yumi Nonomura
- 4University of Zurich, University of Zurich Hospital, Zurich, Switzerland
| | - Paula Romer
- 6University of Wurzburg, Clinics for Gynecology and Obstetrics, Center for Clinical Research; Catalym GmbH, Planegg-Martinsried, Germany, Wurzburg, Germany
| | | | | | | | | | - Eugen Leo
- 7CatalYm GmbH, Planegg-Martinsried, Germany
| | - Michael Mittelbronn
- 8National Center of Pathology (NCP), Dudelange Luxembourg; Luxembourg Center of Neuropathology (LCNP); Luxembourg Institute of Health (LIH); Luxembourg Centre of Systems Biomedicine (LCSB), Esch-sur-Alzette, Luxembourg
| | | | - Hubert Hackl
- 5Medical University of Innsbruck, Institute of Bioinformatics, Innsbruck, Austria
| | - Reinhard Dummer
- 4University of Zurich, University of Zurich Hospital, Zurich, Switzerland
| | - Benjamin Weide
- 2University of Tubingen, University Medical Center, Tubingen, Germany
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Chaparro M, Garre A, Guerra Veloz MF, Vázquez Morón JM, De Castro ML, Leo E, Rodriguez E, Carbajo AY, Riestra S, Jiménez I, Calvet X, Bujanda L, Rivero M, Gomollón F, Benítez JM, Bermejo F, Alcaide N, Gutiérrez A, Mañosa M, Iborra M, Lorente R, Rojas-Feria M, Barreiro-de Acosta M, Kolle L, Van Domselaar M, Amo V, Argüelles F, Ramírez E, Morell A, Bernardo D, Gisbert JP. Effectiveness and Safety of the Switch from Remicade® to CT-P13 in Patients with Inflammatory Bowel Disease. J Crohns Colitis 2019; 13:1380-1386. [PMID: 30976785 DOI: 10.1093/ecco-jcc/jjz070] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS To evaluate the clinical outcomes in patients with IBD after switching from Remicade® to CT-P13 in comparison with patients who maintain Remicade®. METHODS Patients under Remicade® who were in clinical remission with standard dosage at study entry were included. The 'switch cohort' [SC] comprised patients who made the switch from Remicade® to CT-P13, and the 'non-switch' cohort [NC] patients remained under Remicade®. RESULTS A total of 476 patients were included: 199 [42%] in the SC and 277 [58%] in the NC. The median follow-up was 18 months in the SC and 23 months in the NC [p < 0.01]. Twenty-four out of 277 patients relapsed in the NC; the incidence of relapse was 5% per patient-year. The cumulative incidence of relapse was 2% at 6 months and 10% at 24 months in this group. Thirty-eight out of 199 patients relapsed in the SC; the incidence rate of relapse was 14% per patient-year. The cumulative incidence of relapse was 5% at 6 months and 28% at 24 months. In the multivariate analysis, the switch to CT-P13 was associated with a higher risk of relapse (HR = 3.5, 95% confidence interval [CI] = 2-6). Thirteen percent of patients had adverse events in the NC, compared with 6% in the SC [p < 0.05]. CONCLUSIONS Switching from Remicade® to CT-P13 might be associated with a higher risk of clinical relapse, although this fact was not supported in our study by an increase in objective markers of inflammation. The nocebo effect might have influenced this result. Switching from Remicade® to CT-P13 was safe.
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Affiliation(s)
- M Chaparro
- Gastroenterology Units from Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa [IIS-IP] and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas [CIBERehd], Madrid, Spain
| | - A Garre
- Gastroenterology Units from Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa [IIS-IP] and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas [CIBERehd], Madrid, Spain
| | - M F Guerra Veloz
- Gastroenterology Units from Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - J M Vázquez Morón
- Gastroenterology Units from Hospital Juan Ramón Jiménez, Huelva, Spain
| | - M L De Castro
- Gastroenterology Units from Complejo Hospitalario Universitario de Vigo, Vigo, Spain
| | - E Leo
- Gastroenterology Units from Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - E Rodriguez
- Gastroenterology Units from Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - A Y Carbajo
- Gastroenterology Units from Hospital Universitario Río Hortega, Valladolid, Spain
| | - S Riestra
- Gastroenterology Units from Hospital Universitario Central de Asturias and ISPA, Asturias, Spain
| | - I Jiménez
- Gastroenterology Units from Hospital de Galdakao-Usansolo, Vizcaya, Spain
| | - X Calvet
- Gastroenterology Units from Consorcí Corporació Sanitària Parc Tauli de Sabadell and CIBERehd, Barcelona, Spain
| | - L Bujanda
- Gastroenterology Units from Instituto Biodonostia, Universidad del País Vasco [UPV/EHU] and CIBERehd, San Sebastián, Spain
| | - M Rivero
- Gastroenterology Units from Hospital Universitario Marqués de Valdecilla and IDIVAL, Santander, Spain
| | - F Gomollón
- Gastroenterology Units from Hospital Clínico Universitario Lozano Blesa, IIS Aragón and CIBERehd, Zaragoza, Spain
| | - J M Benítez
- Gastroenterology Units from Hospital Universitario Reina Sofía, Córdoba, Spain
| | - F Bermejo
- Gastroenterology Units from Hospital Universitario de Fuenlabrada and Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - N Alcaide
- Gastroenterology Units from Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - A Gutiérrez
- Gastroenterology Units from Hospital General Universitario de Alicante and CIBERehd, Alicante, Spain
| | - M Mañosa
- Gastroenterology Units from Hospital Germans Trials i Pujol and CIBERehd, Barcelona, Spain
| | - M Iborra
- Gastroenterology Units from Hospital Universitario y Politécnico de La Fe and CIBERehd, Valencia, Spain
| | - R Lorente
- Gastroenterology Units from Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - M Rojas-Feria
- Gastroenterology Units from Hospital Universitario Nuestra Señora de Valme, Sevilla, Spain
| | - M Barreiro-de Acosta
- Gastroenterology Units from Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain
| | - L Kolle
- Gastroenterology Units from Hospital General de La Palma, La Palma, Spain
| | - M Van Domselaar
- Gastroenterology Units from Hospital Universitario de Torrejón, Madrid, Spain
| | - V Amo
- Gastroenterology Units from Hospital Regional Universitario de Málaga, Málaga, Spain
| | - F Argüelles
- Gastroenterology Units from Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - E Ramírez
- Gastroenterology Units from Pharmacy Unit, Hospital Universitario de La Princesa, IIS-IP, Madrid, Spain
| | - A Morell
- Gastroenterology Units from Pharmacy Unit, Hospital Universitario de La Princesa, IIS-IP, Madrid, Spain
| | - D Bernardo
- Gastroenterology Units from Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa [IIS-IP] and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas [CIBERehd], Madrid, Spain
| | - J P Gisbert
- Gastroenterology Units from Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa [IIS-IP] and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas [CIBERehd], Madrid, Spain
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15
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Molinari A, Leo E, Ferraresi M, Ferrari S, Terzi A, Sommaruga S. Distal Extended Endovascular Aortic Repair PETTICOAT: A Modified Technique to Improve False Lumen Remodeling in Acute Type B Aortic Dissection. J Vasc Surg 2019. [DOI: 10.1016/j.jvs.2019.06.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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16
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Cascinelli N, Greco M, Leo E, Agresti R, Andreola S. Monoclonal Antibodies MBr1 and MBr8 as Predictors of Response to Oophorectomy in Advanced Breast Cancer. Tumori 2018; 74:309-12. [PMID: 3400120 DOI: 10.1177/030089168807400311] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The response to oophorectomy in 40 patients with advanced breast cancer was evaluated as a function of the presence or absence of the antigens recognized by the monoclonal antibodies MBrl, MBr8, and MOv2 on the cell surface of the primary tumor. Two groups (20 patients alive 5 years after oophorectomy and 20 patients who died within 5 years) were evaluated. These groups had a) the same distribution of lymph node status, diameter of the primary, and the presence of estrogen receptors at the time of first treatment and b) a comparable extent of the disease at the time of oophorectomy. The frequency of complete response after oophorectomy was significantly higher in patients whose tumors did not express the antigens recognized by antibodies MBrl and MBr8. Fourteen of the 22 patients with tumors not reacting with MBrl and 11 of the 18 negative to MBr8 had a complete response. There was no correlation with response and the monoclonal antibody MOv2. Both MBrl and MBr8 were present in 11 patients and both were absent in another 11. The simultaneous absence of the two antigens was related to the highest complete response rate (9 out of 11 patients).
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Affiliation(s)
- N Cascinelli
- Division of Surgical Oncology B, Istituto Nazionale Tumori, Milano, Italy
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17
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Abstract
The concentrations of serum albumin and the cumulative loss of albumin through the drainage tubes were followed in 14 patients who underwent radical mastectomy for cancer. The concentration of serum albumin declined during the postoperative period, and the nadir was on the 5th day. On the first 5 days a good correlation was observed between hypoalbuminemia and loss of albumin from the wound. After this period, hypoalbuminemia persisted unchanged although small quantities of albumin continued to be lost through the drains. It is concluded that in surgery complicated by abundant serum discharge, the albumin loss may be the main cause of postoperative hypoalbuminemia.
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18
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Gallino G, Belli F, Bonfanti G, Ditto A, Andreola S, Tragni G, Massone PP, Civelli E, Vitellaro M, Leo E, Cascinelli N. Surgical Treatment of Gastric Metastases from Cutaneous Melanoma: Experience of the National Cancer Institute of Milan. Tumori 2018; 87:229-31. [PMID: 11693800 DOI: 10.1177/030089160108700404] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aim To evaluate the role of a surgical approach in patients affected with gastric metastases from cutaneous melanoma. Methods A retrospective review of our local melanoma database of 2100 patients identified 31 cases with gastric metastatic deposits. Nine of them were considered candidates for surgical resection. Results Median overall survival of the 9 patients who underwent surgery was 14.2 months. Six (67%) underwent a local radical resection of disease, and 3 (33%) had a simple exploratory laparotomy. The median survival was 21.6 months (range, 4-32 months) for the subset receiving radical surgery and 3.6 months (range, 2-6 months) for the patients who had no resection. Median follow-up was 14.2 months. No specific correlation of serologic LDH levels and final outcome, as documented elsewhere, was observed. A marked decreased or substantial remission of symptoms with an improvement in quality of life was observed in all radically resected patients. Conclusions Patients with gastric metastases from melanoma may benefit from surgery if all macroscopic disease can be removed. In addition, gastric resection in patients with symptomatic melanoma spread to the stomach provides important symptomatic palliation.
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Affiliation(s)
- G Gallino
- Department of Surgery, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy.
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19
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Civelli EM, Gallino G, Mariani L, Cozzi G, Biganzoli E, Salvetti M, Gallo R, Belli F, Bonfanti G, Bertario L, Andreola S, Leo E. Double-Contrast Barium Enema and Computerised Tomography in the Pre-Operative Evaluation of Rectal Carcinoma: Are they Still Useful Diagnostic Procedures? Tumori 2018; 86:389-92. [PMID: 11130567 DOI: 10.1177/030089160008600504] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose In modern management of rectal carcinoma, the preoperative evaluation of disease parameters is important for selection of therapeutic options. Such parameters are currently defined through endorectal ultrasonography or endoscopic ultrasonography. A retrospective analysis of the parameters obtained with double-contrast barium enema (DCBE) and endorectal balloon computed tomography (CT) was conducted to verify the diagnostic reliability of the radiological techniques and to establish whether there is still an indication for their use. Methods 53 consecutive patients with adenocarcinoma of the distal half of the rectal ampulla underwent double contrast barium enema examination and CT of the pelvis with endorectal balloon. On the basis of the DCBE and CT assessment we evaluated: 1) the distance between the cranial extremity of the anal canal and the distal margin of the neoplasm; 2) the radial diffusion of the tumor; 3) the metastatic involvement of the perirectal and inferior mesenteric lymph nodes. Results 1) CT and DBCE measurements of the distal margin tended to coincide, but both tended to overestimate the measurement when compared to the pathologic examination; 2) in the identification of neoplastic infiltration of perirectal fat (T3) CT had 100% sensitivity, 78.7% specificity and 86.8% accuracy; 3) the CT sensitivity for detecting lymph node metastasis was 52.6%, specificity 85.3% and accuracy 73.6%. Conclusions The diagnostic information provided by the radiological examinations is comparable to that of clinical and instrumental methods currently employed for staging of rectal carcinoma, although the latter are preferred because they are more readily accessible and less costly. DCBE and CT can therefore be usefully employed for staging of cancer of the rectum in those cases in which there are limitations of the current standard methods.
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Affiliation(s)
- E M Civelli
- Department of Radiology, Istituto Nazionale perlo Studio e la Cura dei Tumori, Milan, Italy
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20
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Gallino G, Belli F, Tragni G, Ferro F, Massone PP, Ditto A, Leo E, Cascinelli N. Association between Cutaneous Melanoma and Neurofibromatosis Type 1: Analysis of Three Clinical Cases and Review of the Literature. Tumori 2018; 86:70-4. [PMID: 10778770 DOI: 10.1177/030089160008600113] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The authors report a rare association between cutaneous melanoma and Von Recklinghausen's disease (NF-1) and analyze the possible meaning of this occurrence. Various types of tumors have been associated with NF-1, in particular those of neuroectodermal origin, such as malignant peripheral nerve sheath tumors (MPNST) and phaeochromocytoma. The development of malignant melanoma in NF-1 patients is rare. Data from the literature is enable to demonstrate an increased incidence of cutaneous melanoma in patients with neurofibromatosis but the association of these two disorders seems reasonable in theory, as both are abnormalities of a neural crest origin. The cases described may represent not only a clinical report of two rarely associated disorders, but may also confirm the biological mechanisms responsible for these infrequent diseases.
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Affiliation(s)
- G Gallino
- Division of General Surgery B, National Cancer Institute, Milan, Italy
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21
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Pfeiffer N, Voykov B, Renieri G, Bell K, Richter P, Weigel M, Thieme H, Wilhelm B, Lorenz K, Feindor M, Wosikowski K, Janicot M, Päckert D, Römmich R, Mala C, Fettes P, Leo E. First-in-human phase I study of ISTH0036, an antisense oligonucleotide selectively targeting transforming growth factor beta 2 (TGF-β2), in subjects with open-angle glaucoma undergoing glaucoma filtration surgery. PLoS One 2017; 12:e0188899. [PMID: 29190672 PMCID: PMC5708654 DOI: 10.1371/journal.pone.0188899] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 11/10/2017] [Indexed: 12/12/2022] Open
Abstract
Purpose To evaluate the safety and tolerability of intravitreal ISTH0036, an antisense oligonucleotide selectively targeting transforming growth factor beta 2 (TGF-β2), in patients with primary open angle glaucoma (POAG) undergoing trabeculectomy (TE; glaucoma filtration surgery). Methods In this prospective phase I trial glaucoma patients scheduled for TE with mitomycin C (MMC) received a single intravitreal injection of ISTH0036 at the end of surgery in escalating total doses of 6.75 μg, 22.5 μg, 67.5 μg or 225 μg, resulting in calculated intraocular ISTH0036 concentrations in the vitreous humor of approximately 0.3 μM, 1 μM, 3 μM or 10 μM after injection, respectively. Outcomes assessed included: type and frequency of adverse events (AEs), intraocular pressure (IOP), numbers of interventions post trabeculectomy, bleb survival, visual acuity, visual field, electroretinogram (ERG), slit lamp biomicroscopy and optic disc assessment. Results In total, 12 patients were treated in the 4 dose groups. Main ocular AEs observed were corneal erosion, corneal epithelium defect, or too high or too low IOP, among others. No AE was reported to be related to ISTH0036. All other safety-related analyses did not reveal any toxicities of concern, either. The mean medicated preoperative IOP at decision time-point for surgery was 27.3 mmHg +/- 12.6 mmHg (SD). Mean IOP (±SD) for dose levels 1, 2, 3, and 4 were at Day 43 9.8 mmHg ± 1.0 mmHg, 11.3 mmHg ± 6.7 mmHg, 5.5 mmHg ± 3.0 mmHg and 7.5 mmHg ± 2.3 mmHg SD; and at Day 85 9.7 mmHg ± 3.3 mmHg, 14.2 mmHg ± 6.5 mmHg, 5.8 mmHg ± 1.8 mmHg and 7.8 mmHg ± 0.6 mmHg, respectively. In contrast to IOP values for dose levels 1 and 2, IOP values for dose levels 3 and 4 persistently remained below 10 mmHg throughout the observation period. Conclusion This first-in-human trial demonstrates that intravitreal injection of ISTH0036 at the end of TE is safe. Regarding IOP control, single-dose ISTH0036 administration of 67.5 μg or 225 μg at the time of TE resulted in IOP values persistently < 10 mmHg over the three month postoperative observation period.
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Affiliation(s)
- Norbert Pfeiffer
- Dpt. of Ophthalmology, University Medical Center Mainz, Mainz, Germany
- * E-mail:
| | - Bogomil Voykov
- Dpt. of Ophthalmology, University Hospital Tuebingen, Tuebingen, Germany
| | - Giulia Renieri
- Dpt. of Ophthalmology, Otto-von-Guericke-University, Magdeburg, Germany
| | - Katharina Bell
- Dpt. of Ophthalmology, University Medical Center Mainz, Mainz, Germany
| | - Paul Richter
- Dpt. of Ophthalmology, University Hospital Tuebingen, Tuebingen, Germany
| | - Melanie Weigel
- Dpt. of Ophthalmology, Otto-von-Guericke-University, Magdeburg, Germany
| | - Hagen Thieme
- Dpt. of Ophthalmology, Otto-von-Guericke-University, Magdeburg, Germany
| | - Barbara Wilhelm
- STZ Eyetrial, University Hospital Tuebingen, Tuebingen, Germany
| | - Katrin Lorenz
- Dpt. of Ophthalmology, University Medical Center Mainz, Mainz, Germany
- SynteractHCR Deutschland GmbH, Munich, Germany
| | | | | | | | | | | | | | | | - Eugen Leo
- Isarna Therapeutics GmbH, Munich, Germany
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22
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O'Connor M, Cadogan E, Leo E, Hughes A, Learoyd M, Xu H, Li J, Yates J. Generation of a novel preclinical PK/PD model provides insights into PARP inhibitor clinical monotherapy activity. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx367.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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23
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Riemenschneider MJ, Hirblinger M, Vollmann-Zwerenz A, Hau P, Proescholdt MA, Jaschinski F, Rothhammer-Hampl T, Wosikowski K, Janicot M, Leo E. TGF-ß isoforms in cancer: Immunohistochemical expression and Smad-pathway-activity-analysis in thirteen major tumor types with a critical appraisal of antibody specificity and immunohistochemistry assay validity. Oncotarget 2016; 6:26770-81. [PMID: 26450853 PMCID: PMC4694951 DOI: 10.18632/oncotarget.5780] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 08/31/2015] [Indexed: 11/25/2022] Open
Abstract
The literature on TGF-Δ in cancer including data on the expression or activation of TGF-Δ pathway components in specific tumors types is steadily growing. However, no systematic and uniform analysis exists reporting expression levels of the main TGF-Δ pathway components across the most frequent tumor types. We used a standardized immunohistochemical assay investigating TGF-Δ isoform expression and pathway activation across 13 different tumor types and corresponding non-neoplastic tissues. The study was performed on tissue microarrays allowing for the parallel analysis of a total of 1638 human tumor samples. TGF-Δ1, TGF-Δ2 and p-Smad2/3 were substantially expressed in multiple cancers widening the options for TGF-Δ isoform directed therapies. Of note, TGF-Δ antigens appear to be expressed in an individual manner pointing towards a need for patient preselection for TGF-β isoform specific treatment. Yet, a thorough investigation of antibody specificity and assay validity revealed that immunohistochemistry did not correlate with other detection methods on mRNA or protein level in all instances. As such, with the currently available means (i.e. antibodies tested) a stratification of patients within clinical trials for TGF-Δ directed antisense therapies based upon TGF-β immunohistochemistry alone has to be interpreted with caution and should be carefully evaluated in combination with other parameters.
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Affiliation(s)
- Markus J Riemenschneider
- Department of Neuropathology, Regensburg University Hospital, Regensburg, Germany.,Wilhelm Sander Neuro-Oncology Unit, Regensburg University Hospital, Regensburg, Germany
| | - Maria Hirblinger
- Department of Neuropathology, Regensburg University Hospital, Regensburg, Germany.,Wilhelm Sander Neuro-Oncology Unit, Regensburg University Hospital, Regensburg, Germany
| | - Arabel Vollmann-Zwerenz
- Wilhelm Sander Neuro-Oncology Unit, Regensburg University Hospital, Regensburg, Germany.,Department of Neurology, Regensburg University, Regensburg, Germany
| | - Peter Hau
- Wilhelm Sander Neuro-Oncology Unit, Regensburg University Hospital, Regensburg, Germany.,Department of Neurology, Regensburg University, Regensburg, Germany
| | - Martin A Proescholdt
- Wilhelm Sander Neuro-Oncology Unit, Regensburg University Hospital, Regensburg, Germany.,Department of Neurosurgery, Regensburg University Hospital, Regensburg, Germany
| | | | - Tanja Rothhammer-Hampl
- Department of Neuropathology, Regensburg University Hospital, Regensburg, Germany.,Isarna Therapeutics GmbH, Munich, Germany
| | | | | | - Eugen Leo
- Isarna Therapeutics GmbH, Munich, Germany
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Goebeler ME, Knop S, Viardot A, Kufer P, Topp MS, Einsele H, Noppeney R, Hess G, Kallert S, Mackensen A, Rupertus K, Kanz L, Libicher M, Nagorsen D, Zugmaier G, Klinger M, Wolf A, Dorsch B, Quednau BD, Schmidt M, Scheele J, Baeuerle PA, Leo E, Bargou RC. Bispecific T-Cell Engager (BiTE) Antibody Construct Blinatumomab for the Treatment of Patients With Relapsed/Refractory Non-Hodgkin Lymphoma: Final Results From a Phase I Study. J Clin Oncol 2016; 34:1104-11. [PMID: 26884582 DOI: 10.1200/jco.2014.59.1586] [Citation(s) in RCA: 315] [Impact Index Per Article: 39.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Blinatumomab is a CD19/CD3 BiTE (bispecific T-cell engager) antibody construct for the treatment of Philadelphia chromosome-negative acute B-lymphoblastic leukemia. We evaluated blinatumomab in relapsed/refractory B-cell non-Hodgkin lymphoma (NHL). PATIENTS AND METHODS This 3 + 3 design, phase I dose-escalation study determined adverse events and the maximum tolerated dose (MTD) of continuous intravenous infusion blinatumomab in patients with relapsed/refractory NHL. Blinatumomab was administered over 4 or 8 weeks at seven different dose levels (0.5 to 90 μg/m(2)/day). End points were incidence of adverse events, pharmacokinetics, pharmacodynamics, and overall response rate. RESULTS Between 2004 and 2011, 76 heavily pretreated patients with relapsed/refractory NHL, who included 14 with diffuse large B-cell lymphoma, were enrolled; 42 received treatment in the formal dose-escalation phase. Neurologic events were dose limiting, and 60 μg/m(2)/day was established as the MTD. Thirty-four additional patients were recruited to evaluate antilymphoma activity and strategies for mitigating neurologic events at a prespecified MTD. Stepwise dosing (5 to 60 μg/m(2)/day) plus pentosan polysulfate SP54 (n = 3) resulted in no treatment discontinuations; single-step (n = 5) and double-step (n = 24) dosing entailed two and seven treatment discontinuations due to neurologic events, respectively. Grade 3 neurologic events occurred in 22% of patients (no grade 4/5). Among patients treated at 60 μg/m(2)/day (target dose; n = 35), the overall response rate was 69% across NHL subtypes and 55% for diffuse large B-cell lymphoma (n = 11); median response duration was 404 days (95% CI, 207 to 1,129 days). CONCLUSION In this phase I study of relapsed/refractory NHL, continuous infusion with CD19-targeted immunotherapy blinatumomab at various doses and schedules was feasible, with an MTD of 60 μg/m(2)/day. Single-agent blinatumomab showed antilymphoma activity.
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Affiliation(s)
- Maria-Elisabeth Goebeler
- Maria-Elisabeth Goebeler, Stefan Knop, Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg; Andreas Viardot, University Ulm; Peter Kufer, Gerhard Zugmaier, Matthias Klinger, Andreas Wolf, Margit Schmidt, and Patrick A. Baeuerle, Amgen Research (Munich); Brigitte Dorsch, Metronomia Clinical Research, Munich; Richard Noppeney, University of Essen Medical Center, Essen; Georg Hess, Johannes Gutenberg-University, Mainz; Stefan Kallert and Andreas Mackensen, University of Erlangen Medical Center, Erlangen; Kathrin Rupertus and Lothar Kanz, University of Tübingen Medical Center, Tübingen; Martin Libicher, Diakoniekrankenhaus Schwäbisch-Hall, Schwäbisch-Hall; Jürgen Scheele, University of Freiburg Medical Center; Eugen Leo, LEOConsulting, Freiburg, Germany; and Dirk Nagorsen and Beate D. Quednau, Amgen, Thousand Oaks, CA.
| | - Stefan Knop
- Maria-Elisabeth Goebeler, Stefan Knop, Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg; Andreas Viardot, University Ulm; Peter Kufer, Gerhard Zugmaier, Matthias Klinger, Andreas Wolf, Margit Schmidt, and Patrick A. Baeuerle, Amgen Research (Munich); Brigitte Dorsch, Metronomia Clinical Research, Munich; Richard Noppeney, University of Essen Medical Center, Essen; Georg Hess, Johannes Gutenberg-University, Mainz; Stefan Kallert and Andreas Mackensen, University of Erlangen Medical Center, Erlangen; Kathrin Rupertus and Lothar Kanz, University of Tübingen Medical Center, Tübingen; Martin Libicher, Diakoniekrankenhaus Schwäbisch-Hall, Schwäbisch-Hall; Jürgen Scheele, University of Freiburg Medical Center; Eugen Leo, LEOConsulting, Freiburg, Germany; and Dirk Nagorsen and Beate D. Quednau, Amgen, Thousand Oaks, CA
| | - Andreas Viardot
- Maria-Elisabeth Goebeler, Stefan Knop, Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg; Andreas Viardot, University Ulm; Peter Kufer, Gerhard Zugmaier, Matthias Klinger, Andreas Wolf, Margit Schmidt, and Patrick A. Baeuerle, Amgen Research (Munich); Brigitte Dorsch, Metronomia Clinical Research, Munich; Richard Noppeney, University of Essen Medical Center, Essen; Georg Hess, Johannes Gutenberg-University, Mainz; Stefan Kallert and Andreas Mackensen, University of Erlangen Medical Center, Erlangen; Kathrin Rupertus and Lothar Kanz, University of Tübingen Medical Center, Tübingen; Martin Libicher, Diakoniekrankenhaus Schwäbisch-Hall, Schwäbisch-Hall; Jürgen Scheele, University of Freiburg Medical Center; Eugen Leo, LEOConsulting, Freiburg, Germany; and Dirk Nagorsen and Beate D. Quednau, Amgen, Thousand Oaks, CA
| | - Peter Kufer
- Maria-Elisabeth Goebeler, Stefan Knop, Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg; Andreas Viardot, University Ulm; Peter Kufer, Gerhard Zugmaier, Matthias Klinger, Andreas Wolf, Margit Schmidt, and Patrick A. Baeuerle, Amgen Research (Munich); Brigitte Dorsch, Metronomia Clinical Research, Munich; Richard Noppeney, University of Essen Medical Center, Essen; Georg Hess, Johannes Gutenberg-University, Mainz; Stefan Kallert and Andreas Mackensen, University of Erlangen Medical Center, Erlangen; Kathrin Rupertus and Lothar Kanz, University of Tübingen Medical Center, Tübingen; Martin Libicher, Diakoniekrankenhaus Schwäbisch-Hall, Schwäbisch-Hall; Jürgen Scheele, University of Freiburg Medical Center; Eugen Leo, LEOConsulting, Freiburg, Germany; and Dirk Nagorsen and Beate D. Quednau, Amgen, Thousand Oaks, CA
| | - Max S Topp
- Maria-Elisabeth Goebeler, Stefan Knop, Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg; Andreas Viardot, University Ulm; Peter Kufer, Gerhard Zugmaier, Matthias Klinger, Andreas Wolf, Margit Schmidt, and Patrick A. Baeuerle, Amgen Research (Munich); Brigitte Dorsch, Metronomia Clinical Research, Munich; Richard Noppeney, University of Essen Medical Center, Essen; Georg Hess, Johannes Gutenberg-University, Mainz; Stefan Kallert and Andreas Mackensen, University of Erlangen Medical Center, Erlangen; Kathrin Rupertus and Lothar Kanz, University of Tübingen Medical Center, Tübingen; Martin Libicher, Diakoniekrankenhaus Schwäbisch-Hall, Schwäbisch-Hall; Jürgen Scheele, University of Freiburg Medical Center; Eugen Leo, LEOConsulting, Freiburg, Germany; and Dirk Nagorsen and Beate D. Quednau, Amgen, Thousand Oaks, CA
| | - Hermann Einsele
- Maria-Elisabeth Goebeler, Stefan Knop, Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg; Andreas Viardot, University Ulm; Peter Kufer, Gerhard Zugmaier, Matthias Klinger, Andreas Wolf, Margit Schmidt, and Patrick A. Baeuerle, Amgen Research (Munich); Brigitte Dorsch, Metronomia Clinical Research, Munich; Richard Noppeney, University of Essen Medical Center, Essen; Georg Hess, Johannes Gutenberg-University, Mainz; Stefan Kallert and Andreas Mackensen, University of Erlangen Medical Center, Erlangen; Kathrin Rupertus and Lothar Kanz, University of Tübingen Medical Center, Tübingen; Martin Libicher, Diakoniekrankenhaus Schwäbisch-Hall, Schwäbisch-Hall; Jürgen Scheele, University of Freiburg Medical Center; Eugen Leo, LEOConsulting, Freiburg, Germany; and Dirk Nagorsen and Beate D. Quednau, Amgen, Thousand Oaks, CA
| | - Richard Noppeney
- Maria-Elisabeth Goebeler, Stefan Knop, Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg; Andreas Viardot, University Ulm; Peter Kufer, Gerhard Zugmaier, Matthias Klinger, Andreas Wolf, Margit Schmidt, and Patrick A. Baeuerle, Amgen Research (Munich); Brigitte Dorsch, Metronomia Clinical Research, Munich; Richard Noppeney, University of Essen Medical Center, Essen; Georg Hess, Johannes Gutenberg-University, Mainz; Stefan Kallert and Andreas Mackensen, University of Erlangen Medical Center, Erlangen; Kathrin Rupertus and Lothar Kanz, University of Tübingen Medical Center, Tübingen; Martin Libicher, Diakoniekrankenhaus Schwäbisch-Hall, Schwäbisch-Hall; Jürgen Scheele, University of Freiburg Medical Center; Eugen Leo, LEOConsulting, Freiburg, Germany; and Dirk Nagorsen and Beate D. Quednau, Amgen, Thousand Oaks, CA
| | - Georg Hess
- Maria-Elisabeth Goebeler, Stefan Knop, Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg; Andreas Viardot, University Ulm; Peter Kufer, Gerhard Zugmaier, Matthias Klinger, Andreas Wolf, Margit Schmidt, and Patrick A. Baeuerle, Amgen Research (Munich); Brigitte Dorsch, Metronomia Clinical Research, Munich; Richard Noppeney, University of Essen Medical Center, Essen; Georg Hess, Johannes Gutenberg-University, Mainz; Stefan Kallert and Andreas Mackensen, University of Erlangen Medical Center, Erlangen; Kathrin Rupertus and Lothar Kanz, University of Tübingen Medical Center, Tübingen; Martin Libicher, Diakoniekrankenhaus Schwäbisch-Hall, Schwäbisch-Hall; Jürgen Scheele, University of Freiburg Medical Center; Eugen Leo, LEOConsulting, Freiburg, Germany; and Dirk Nagorsen and Beate D. Quednau, Amgen, Thousand Oaks, CA
| | - Stefan Kallert
- Maria-Elisabeth Goebeler, Stefan Knop, Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg; Andreas Viardot, University Ulm; Peter Kufer, Gerhard Zugmaier, Matthias Klinger, Andreas Wolf, Margit Schmidt, and Patrick A. Baeuerle, Amgen Research (Munich); Brigitte Dorsch, Metronomia Clinical Research, Munich; Richard Noppeney, University of Essen Medical Center, Essen; Georg Hess, Johannes Gutenberg-University, Mainz; Stefan Kallert and Andreas Mackensen, University of Erlangen Medical Center, Erlangen; Kathrin Rupertus and Lothar Kanz, University of Tübingen Medical Center, Tübingen; Martin Libicher, Diakoniekrankenhaus Schwäbisch-Hall, Schwäbisch-Hall; Jürgen Scheele, University of Freiburg Medical Center; Eugen Leo, LEOConsulting, Freiburg, Germany; and Dirk Nagorsen and Beate D. Quednau, Amgen, Thousand Oaks, CA
| | - Andreas Mackensen
- Maria-Elisabeth Goebeler, Stefan Knop, Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg; Andreas Viardot, University Ulm; Peter Kufer, Gerhard Zugmaier, Matthias Klinger, Andreas Wolf, Margit Schmidt, and Patrick A. Baeuerle, Amgen Research (Munich); Brigitte Dorsch, Metronomia Clinical Research, Munich; Richard Noppeney, University of Essen Medical Center, Essen; Georg Hess, Johannes Gutenberg-University, Mainz; Stefan Kallert and Andreas Mackensen, University of Erlangen Medical Center, Erlangen; Kathrin Rupertus and Lothar Kanz, University of Tübingen Medical Center, Tübingen; Martin Libicher, Diakoniekrankenhaus Schwäbisch-Hall, Schwäbisch-Hall; Jürgen Scheele, University of Freiburg Medical Center; Eugen Leo, LEOConsulting, Freiburg, Germany; and Dirk Nagorsen and Beate D. Quednau, Amgen, Thousand Oaks, CA
| | - Kathrin Rupertus
- Maria-Elisabeth Goebeler, Stefan Knop, Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg; Andreas Viardot, University Ulm; Peter Kufer, Gerhard Zugmaier, Matthias Klinger, Andreas Wolf, Margit Schmidt, and Patrick A. Baeuerle, Amgen Research (Munich); Brigitte Dorsch, Metronomia Clinical Research, Munich; Richard Noppeney, University of Essen Medical Center, Essen; Georg Hess, Johannes Gutenberg-University, Mainz; Stefan Kallert and Andreas Mackensen, University of Erlangen Medical Center, Erlangen; Kathrin Rupertus and Lothar Kanz, University of Tübingen Medical Center, Tübingen; Martin Libicher, Diakoniekrankenhaus Schwäbisch-Hall, Schwäbisch-Hall; Jürgen Scheele, University of Freiburg Medical Center; Eugen Leo, LEOConsulting, Freiburg, Germany; and Dirk Nagorsen and Beate D. Quednau, Amgen, Thousand Oaks, CA
| | - Lothar Kanz
- Maria-Elisabeth Goebeler, Stefan Knop, Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg; Andreas Viardot, University Ulm; Peter Kufer, Gerhard Zugmaier, Matthias Klinger, Andreas Wolf, Margit Schmidt, and Patrick A. Baeuerle, Amgen Research (Munich); Brigitte Dorsch, Metronomia Clinical Research, Munich; Richard Noppeney, University of Essen Medical Center, Essen; Georg Hess, Johannes Gutenberg-University, Mainz; Stefan Kallert and Andreas Mackensen, University of Erlangen Medical Center, Erlangen; Kathrin Rupertus and Lothar Kanz, University of Tübingen Medical Center, Tübingen; Martin Libicher, Diakoniekrankenhaus Schwäbisch-Hall, Schwäbisch-Hall; Jürgen Scheele, University of Freiburg Medical Center; Eugen Leo, LEOConsulting, Freiburg, Germany; and Dirk Nagorsen and Beate D. Quednau, Amgen, Thousand Oaks, CA
| | - Martin Libicher
- Maria-Elisabeth Goebeler, Stefan Knop, Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg; Andreas Viardot, University Ulm; Peter Kufer, Gerhard Zugmaier, Matthias Klinger, Andreas Wolf, Margit Schmidt, and Patrick A. Baeuerle, Amgen Research (Munich); Brigitte Dorsch, Metronomia Clinical Research, Munich; Richard Noppeney, University of Essen Medical Center, Essen; Georg Hess, Johannes Gutenberg-University, Mainz; Stefan Kallert and Andreas Mackensen, University of Erlangen Medical Center, Erlangen; Kathrin Rupertus and Lothar Kanz, University of Tübingen Medical Center, Tübingen; Martin Libicher, Diakoniekrankenhaus Schwäbisch-Hall, Schwäbisch-Hall; Jürgen Scheele, University of Freiburg Medical Center; Eugen Leo, LEOConsulting, Freiburg, Germany; and Dirk Nagorsen and Beate D. Quednau, Amgen, Thousand Oaks, CA
| | - Dirk Nagorsen
- Maria-Elisabeth Goebeler, Stefan Knop, Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg; Andreas Viardot, University Ulm; Peter Kufer, Gerhard Zugmaier, Matthias Klinger, Andreas Wolf, Margit Schmidt, and Patrick A. Baeuerle, Amgen Research (Munich); Brigitte Dorsch, Metronomia Clinical Research, Munich; Richard Noppeney, University of Essen Medical Center, Essen; Georg Hess, Johannes Gutenberg-University, Mainz; Stefan Kallert and Andreas Mackensen, University of Erlangen Medical Center, Erlangen; Kathrin Rupertus and Lothar Kanz, University of Tübingen Medical Center, Tübingen; Martin Libicher, Diakoniekrankenhaus Schwäbisch-Hall, Schwäbisch-Hall; Jürgen Scheele, University of Freiburg Medical Center; Eugen Leo, LEOConsulting, Freiburg, Germany; and Dirk Nagorsen and Beate D. Quednau, Amgen, Thousand Oaks, CA
| | - Gerhard Zugmaier
- Maria-Elisabeth Goebeler, Stefan Knop, Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg; Andreas Viardot, University Ulm; Peter Kufer, Gerhard Zugmaier, Matthias Klinger, Andreas Wolf, Margit Schmidt, and Patrick A. Baeuerle, Amgen Research (Munich); Brigitte Dorsch, Metronomia Clinical Research, Munich; Richard Noppeney, University of Essen Medical Center, Essen; Georg Hess, Johannes Gutenberg-University, Mainz; Stefan Kallert and Andreas Mackensen, University of Erlangen Medical Center, Erlangen; Kathrin Rupertus and Lothar Kanz, University of Tübingen Medical Center, Tübingen; Martin Libicher, Diakoniekrankenhaus Schwäbisch-Hall, Schwäbisch-Hall; Jürgen Scheele, University of Freiburg Medical Center; Eugen Leo, LEOConsulting, Freiburg, Germany; and Dirk Nagorsen and Beate D. Quednau, Amgen, Thousand Oaks, CA
| | - Matthias Klinger
- Maria-Elisabeth Goebeler, Stefan Knop, Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg; Andreas Viardot, University Ulm; Peter Kufer, Gerhard Zugmaier, Matthias Klinger, Andreas Wolf, Margit Schmidt, and Patrick A. Baeuerle, Amgen Research (Munich); Brigitte Dorsch, Metronomia Clinical Research, Munich; Richard Noppeney, University of Essen Medical Center, Essen; Georg Hess, Johannes Gutenberg-University, Mainz; Stefan Kallert and Andreas Mackensen, University of Erlangen Medical Center, Erlangen; Kathrin Rupertus and Lothar Kanz, University of Tübingen Medical Center, Tübingen; Martin Libicher, Diakoniekrankenhaus Schwäbisch-Hall, Schwäbisch-Hall; Jürgen Scheele, University of Freiburg Medical Center; Eugen Leo, LEOConsulting, Freiburg, Germany; and Dirk Nagorsen and Beate D. Quednau, Amgen, Thousand Oaks, CA
| | - Andreas Wolf
- Maria-Elisabeth Goebeler, Stefan Knop, Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg; Andreas Viardot, University Ulm; Peter Kufer, Gerhard Zugmaier, Matthias Klinger, Andreas Wolf, Margit Schmidt, and Patrick A. Baeuerle, Amgen Research (Munich); Brigitte Dorsch, Metronomia Clinical Research, Munich; Richard Noppeney, University of Essen Medical Center, Essen; Georg Hess, Johannes Gutenberg-University, Mainz; Stefan Kallert and Andreas Mackensen, University of Erlangen Medical Center, Erlangen; Kathrin Rupertus and Lothar Kanz, University of Tübingen Medical Center, Tübingen; Martin Libicher, Diakoniekrankenhaus Schwäbisch-Hall, Schwäbisch-Hall; Jürgen Scheele, University of Freiburg Medical Center; Eugen Leo, LEOConsulting, Freiburg, Germany; and Dirk Nagorsen and Beate D. Quednau, Amgen, Thousand Oaks, CA
| | - Brigitte Dorsch
- Maria-Elisabeth Goebeler, Stefan Knop, Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg; Andreas Viardot, University Ulm; Peter Kufer, Gerhard Zugmaier, Matthias Klinger, Andreas Wolf, Margit Schmidt, and Patrick A. Baeuerle, Amgen Research (Munich); Brigitte Dorsch, Metronomia Clinical Research, Munich; Richard Noppeney, University of Essen Medical Center, Essen; Georg Hess, Johannes Gutenberg-University, Mainz; Stefan Kallert and Andreas Mackensen, University of Erlangen Medical Center, Erlangen; Kathrin Rupertus and Lothar Kanz, University of Tübingen Medical Center, Tübingen; Martin Libicher, Diakoniekrankenhaus Schwäbisch-Hall, Schwäbisch-Hall; Jürgen Scheele, University of Freiburg Medical Center; Eugen Leo, LEOConsulting, Freiburg, Germany; and Dirk Nagorsen and Beate D. Quednau, Amgen, Thousand Oaks, CA
| | - Beate D Quednau
- Maria-Elisabeth Goebeler, Stefan Knop, Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg; Andreas Viardot, University Ulm; Peter Kufer, Gerhard Zugmaier, Matthias Klinger, Andreas Wolf, Margit Schmidt, and Patrick A. Baeuerle, Amgen Research (Munich); Brigitte Dorsch, Metronomia Clinical Research, Munich; Richard Noppeney, University of Essen Medical Center, Essen; Georg Hess, Johannes Gutenberg-University, Mainz; Stefan Kallert and Andreas Mackensen, University of Erlangen Medical Center, Erlangen; Kathrin Rupertus and Lothar Kanz, University of Tübingen Medical Center, Tübingen; Martin Libicher, Diakoniekrankenhaus Schwäbisch-Hall, Schwäbisch-Hall; Jürgen Scheele, University of Freiburg Medical Center; Eugen Leo, LEOConsulting, Freiburg, Germany; and Dirk Nagorsen and Beate D. Quednau, Amgen, Thousand Oaks, CA
| | - Margit Schmidt
- Maria-Elisabeth Goebeler, Stefan Knop, Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg; Andreas Viardot, University Ulm; Peter Kufer, Gerhard Zugmaier, Matthias Klinger, Andreas Wolf, Margit Schmidt, and Patrick A. Baeuerle, Amgen Research (Munich); Brigitte Dorsch, Metronomia Clinical Research, Munich; Richard Noppeney, University of Essen Medical Center, Essen; Georg Hess, Johannes Gutenberg-University, Mainz; Stefan Kallert and Andreas Mackensen, University of Erlangen Medical Center, Erlangen; Kathrin Rupertus and Lothar Kanz, University of Tübingen Medical Center, Tübingen; Martin Libicher, Diakoniekrankenhaus Schwäbisch-Hall, Schwäbisch-Hall; Jürgen Scheele, University of Freiburg Medical Center; Eugen Leo, LEOConsulting, Freiburg, Germany; and Dirk Nagorsen and Beate D. Quednau, Amgen, Thousand Oaks, CA
| | - Jürgen Scheele
- Maria-Elisabeth Goebeler, Stefan Knop, Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg; Andreas Viardot, University Ulm; Peter Kufer, Gerhard Zugmaier, Matthias Klinger, Andreas Wolf, Margit Schmidt, and Patrick A. Baeuerle, Amgen Research (Munich); Brigitte Dorsch, Metronomia Clinical Research, Munich; Richard Noppeney, University of Essen Medical Center, Essen; Georg Hess, Johannes Gutenberg-University, Mainz; Stefan Kallert and Andreas Mackensen, University of Erlangen Medical Center, Erlangen; Kathrin Rupertus and Lothar Kanz, University of Tübingen Medical Center, Tübingen; Martin Libicher, Diakoniekrankenhaus Schwäbisch-Hall, Schwäbisch-Hall; Jürgen Scheele, University of Freiburg Medical Center; Eugen Leo, LEOConsulting, Freiburg, Germany; and Dirk Nagorsen and Beate D. Quednau, Amgen, Thousand Oaks, CA
| | - Patrick A Baeuerle
- Maria-Elisabeth Goebeler, Stefan Knop, Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg; Andreas Viardot, University Ulm; Peter Kufer, Gerhard Zugmaier, Matthias Klinger, Andreas Wolf, Margit Schmidt, and Patrick A. Baeuerle, Amgen Research (Munich); Brigitte Dorsch, Metronomia Clinical Research, Munich; Richard Noppeney, University of Essen Medical Center, Essen; Georg Hess, Johannes Gutenberg-University, Mainz; Stefan Kallert and Andreas Mackensen, University of Erlangen Medical Center, Erlangen; Kathrin Rupertus and Lothar Kanz, University of Tübingen Medical Center, Tübingen; Martin Libicher, Diakoniekrankenhaus Schwäbisch-Hall, Schwäbisch-Hall; Jürgen Scheele, University of Freiburg Medical Center; Eugen Leo, LEOConsulting, Freiburg, Germany; and Dirk Nagorsen and Beate D. Quednau, Amgen, Thousand Oaks, CA
| | - Eugen Leo
- Maria-Elisabeth Goebeler, Stefan Knop, Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg; Andreas Viardot, University Ulm; Peter Kufer, Gerhard Zugmaier, Matthias Klinger, Andreas Wolf, Margit Schmidt, and Patrick A. Baeuerle, Amgen Research (Munich); Brigitte Dorsch, Metronomia Clinical Research, Munich; Richard Noppeney, University of Essen Medical Center, Essen; Georg Hess, Johannes Gutenberg-University, Mainz; Stefan Kallert and Andreas Mackensen, University of Erlangen Medical Center, Erlangen; Kathrin Rupertus and Lothar Kanz, University of Tübingen Medical Center, Tübingen; Martin Libicher, Diakoniekrankenhaus Schwäbisch-Hall, Schwäbisch-Hall; Jürgen Scheele, University of Freiburg Medical Center; Eugen Leo, LEOConsulting, Freiburg, Germany; and Dirk Nagorsen and Beate D. Quednau, Amgen, Thousand Oaks, CA
| | - Ralf C Bargou
- Maria-Elisabeth Goebeler, Stefan Knop, Max S. Topp, Hermann Einsele, and Ralf C. Bargou, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg; Andreas Viardot, University Ulm; Peter Kufer, Gerhard Zugmaier, Matthias Klinger, Andreas Wolf, Margit Schmidt, and Patrick A. Baeuerle, Amgen Research (Munich); Brigitte Dorsch, Metronomia Clinical Research, Munich; Richard Noppeney, University of Essen Medical Center, Essen; Georg Hess, Johannes Gutenberg-University, Mainz; Stefan Kallert and Andreas Mackensen, University of Erlangen Medical Center, Erlangen; Kathrin Rupertus and Lothar Kanz, University of Tübingen Medical Center, Tübingen; Martin Libicher, Diakoniekrankenhaus Schwäbisch-Hall, Schwäbisch-Hall; Jürgen Scheele, University of Freiburg Medical Center; Eugen Leo, LEOConsulting, Freiburg, Germany; and Dirk Nagorsen and Beate D. Quednau, Amgen, Thousand Oaks, CA
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Niger M, Maggi C, Di Bartolomeo M, Perrone F, Tamborini E, Milione M, Deraco M, Kusamura S, Baratti D, Berenato R, Caporale M, Consonni P, Bossi I, Leo E, Pelosi G, de Braud F, Pietrantonio F. Metronomic capecitabine and bevacizumab is an active combination in patients with relapsed peritoneal pseudomyxoma. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv344.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Baratti D, Kusamura S, Pietrantonio F, Guaglio M, Berenato R, Niger M, Caporale M, Leo E, Deraco M, De Braud F. Adjuvant hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with colorectal cancer at high risk for the development of peritoneal metastases. A matched case-control study. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv340.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Maggi C, De Braud F, Di Bartolomeo M, Perrone F, Tamborini E, Milione M, Deraco M, Kusamura S, Baratti D, Berenato R, Caporale M, Consonni P, Niger M, Bossi I, Leo E, Pelosi G, Pietrantonio F. 2366 Metronomic capecitabine and bevacizumab is an active combination in patients with relapsed peritoneal pseudomyxoma. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31282-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Venditti A, Breems D, Havelange V, Martinelli G, Baldini S, Binaschi M, Crea A, Leo E, Maggi CA, Manzini S, Matera M, Mazzei P, Rossi C, Scartoni S, Scordari A, Tonini G, Wilson K, Capriati A, Simonelli C. "ARMY": First-in-human study of the humanized, defucosylated monoclonal antibody (mAb) MEN1112/OBT357 targeting CD157 antigen, in relapsed or refractory (R/R) acute myeloid leukemia (AML). J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.tps3100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | - Eugen Leo
- Oxford Biotherapeutics, San Josè, CA
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Wosikowski K, Jaschinski F, Kohonen H, Braun S, Leo E, Janicot M. Abstract 716: ASPH_0047: a potent and selective antisense oligonucleotide-targeting transforming growth factor beta 2 (TGF-β2). Cancer Res 2014. [DOI: 10.1158/1538-7445.am2014-716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Transforming growth factor beta (TGF-β) is a key member of a large family of cytokines, including bone morphogenetic protein (BMP), nodals, activins and others, which play critical, pleiotropic roles in the pathophysiology of various human diseases, such as cancer, inflammation, autoimmune disease, and cirrhosis/fibrosis. In particular, the different TGF-β isoforms (TGF-β1, -β2, and -β3, encoded by different genes but sharing high sequence and structure homology) are overexpressed in many human tumors. Correlations between TGF-β expression, cancer stage and clinical parameters have been reported and linked to poor clinical outcome. TGF-β has been associated with a wide range of tumor-promoting processes, including tumor cell invasion and migration, angiogenesis, immunosuppression, as well as tumor stem cell maintenance and protection. Therefore, blocking the TGF-β signaling pathway via inhibition of TGF-β expression appears as an attractive therapeutic intervention in Oncology.
We have previously reported the rational design and preliminary outcome of an extensive discovery program for identification of antisense oligodeoxynucleotides targeting the various TGF-β isoforms. We present here ASPH_0047, a 17-mer LNA-modified gapmer based on the sequence of the human TGF-β2 mRNA, as novel preclinical development candidate. ASPH_0047 shows potent and selective target downregulation (mRNA and protein) in various cell-based assays. Preliminary preclinical biodistribution studies in rodent point at tissue penetration in expected target organs (e.g., liver, kidney, spleen) and accumulation in tumor tissue consistent with observed target downregulation and efficacy in relevant in vivo experimental antitumor models. Key pharmacology properties and preclinical features of ASPH_0047 supporting rapid advancement to clinical development will be presented.
Citation Format: Katja Wosikowski, Frank Jaschinski, Hanna Kohonen, Stephan Braun, Eugen Leo, Michel Janicot. ASPH_0047: a potent and selective antisense oligonucleotide-targeting transforming growth factor beta 2 (TGF-β2). [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 716. doi:10.1158/1538-7445.AM2014-716
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Affiliation(s)
| | | | | | | | - Eugen Leo
- Isarna Therapeutics, Munich, Germany
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Baratti D, Kusamura S, Iusco D, Bonomi S, Grassi A, Virzì S, Leo E, Deraco M. Postoperative complications after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy affect long-term outcome of patients with peritoneal metastases from colorectal cancer: a two-center study of 101 patients. Dis Colon Rectum 2014; 57:858-68. [PMID: 24901687 DOI: 10.1097/dcr.0000000000000149] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy is an effective but potentially morbid treatment for colorectal cancer peritoneal metastases. The impact of treatment-related morbidity on long-term survival has been reported in various malignancies, but it has never been assessed in this clinical setting. OBJECTIVE The aim of this study was to assess the impact of major postoperative complications on oncological outcomes after cytoreduction and hyperthermic intraperitoneal chemotherapy for colorectal peritoneal metastases. DESIGN Two prospective databases were reviewed. Major complications were defined as grade 3 to 5 according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0. The extent of peritoneal involvement was scored by the use of the Peritoneal Cancer Index. SETTINGS This study was conducted in 2 high-volume peritoneal malignancy management centers. PATIENTS One hundred one consecutive patients with peritoneal metastases potentially amenable to macroscopically complete cytoreduction were selected. INTERVENTIONS Peritonectomy procedures and multivisceral resections were used to remove all macroscopic tumor, and mitomycin-C plus cisplatin-based hyperthermic intraperitoneal chemotherapy was used to control microscopic residual disease. MAIN OUTCOME MEASURES The primary outcomes measured were overall and disease-specific survival. RESULTS Mortality and major morbidity were 3.0%, and 23.8%. Median follow-up was 44.9 months (95% CI, 24.1-65.7). Five-year disease-specific survival was 14.3% for patients who experienced major complications and 52.3% for those who did not (p = 0.001). Five-year overall survival was 11.7% for patients who experienced major complications, and 58.8% for those who did not (p = 0.003). At multivariate analysis, major morbidity correlated to both worse overall and disease-specific survival, along with a Peritoneal Cancer Index >19, and suboptimal cytoreduction. Poor performance status correlated only to worse disease-specific survival, and liver metastases correlated to worse overall survival. Longer operative time (OR, 4.1; 95% CI, 1.3-12.6; p = 0.01) and Peritoneal Cancer Index >19 (OR, 2.6; 95% CI, 1.1-6.0; p = 0.02) were independent risk factors for major morbidity. LIMITATIONS This study is limited by its observational design. CONCLUSIONS The prevention of major complications, by refining surgical technique and patient selection, is crucial because it affects oncologic outcome.
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Affiliation(s)
- D Baratti
- 1Peritoneal Surface Malignancy Program,Department of Surgery, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy 2General Surgery Unit, Bentivoglio Hospital, Bentivoglio (BO), Italy 3Colorectal Unit, Department of Surgery, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
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Janicot M, Wosikowski K, Jaschinski F, Korhonen H, Braun S, Hasenbach K, Leo E. Preclinical profile of ASPH_0047, a potent and selective antisense oligonucleotide targeting transforming growth factor beta 2 (TGF-β2). J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.11088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | | | | | - Eugen Leo
- Isarna Therapeutics GmbH, Munich, Germany
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Coronel J, Roper MH, Herrera C, Bonilla C, Jave O, Gianella C, Sabogal I, Huancaré V, Leo E, Tyas A, Mendoza-Ticona A, Caviedes L, Moore DAJ. Validation of microscopic observation drug susceptibility testing for rapid, direct rifampicin and isoniazid drug susceptibility testing in patients receiving tuberculosis treatment. Clin Microbiol Infect 2013; 20:536-41. [PMID: 24107197 PMCID: PMC4302318 DOI: 10.1111/1469-0691.12401] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Revised: 07/22/2013] [Accepted: 09/16/2013] [Indexed: 12/01/2022]
Abstract
Drug susceptibility testing (DST) is often needed in patients clinically failing tuberculosis (TB) therapy. Most studies of phenotypic direct drug susceptibility tests, such as microscopic observation drug susceptibility (MODS) tests, have been performed in patients not receiving TB treatment. The effect of ongoing TB treatment on the performance of MODS direct DST has not been previously explored, but patients failing such therapy constitute an important target group. The aim of this study was to determine the performance of MODS direct rifampicin and isoniazid DST in patients clinically failing first-line TB treatment, and to compare MODS direct DST with indirect proportion method DST. Sputa from 264 TB patients were cultured in parallel in Lowenstein–Jensen (LJ) and MODS assays; strains were tested for rifampicin and isoniazid susceptibility by the proportion method at the national reference laboratory. Ninety-three samples were culture-positive by LJ and MODS (concordance of 96%; kappa 0.92). With conventional MODS plate DST reading (performed on the same day as the sample is classified as culture-positive), the isoniazid DST concordance was 96.8% (kappa 0.89), and the concordance for rifampicin susceptibility testing was 92.6% (kappa 0.80). Reading of MODS DST plates 1 week after cultures had been determined to be culture-positive improved overall performance marginally—the isoniazid DST concordance was 95.7% (kappa 0.85); and the rifampicin DST concordance was 96.8% (kappa 0.91). Sensitivity for detection of multidrug-resistant TB was 95.8%. MODS testing provided reliable rifampicin and isoniazid DST results for samples obtained from patients receiving TB therapy. A modified DST reading schedule for such samples, with a final reading 1 week after a MODS culture turns positive, marginally improves the concordance with reference DST.
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Affiliation(s)
- J Coronel
- Laboratorio de Investigación de Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Peru
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McClanahan F, Hielscher T, Rieger M, Hensel M, Bentz M, Schmidt-Wolf I, Käbisch A, Salwender H, Dürk H, Staiger H, Mandel T, Neben K, Hillengass J, Leo E, Krämer A, Ho AD, Witzens-Harig M. Final results of a randomized trial comparing 1, 3, or 6 infusions of Rituximab plus 6 cycles CHOP provide valuable preliminary data towards a more cost-effective and safer treatment of advanced follicular lymphoma. Am J Hematol 2012; 87:E68-71. [PMID: 22847344 DOI: 10.1002/ajh.23286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
MESH Headings
- Adult
- Aged
- Antibodies, Monoclonal, Murine-Derived/administration & dosage
- Antibodies, Monoclonal, Murine-Derived/adverse effects
- Antibodies, Monoclonal, Murine-Derived/economics
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Antineoplastic Combined Chemotherapy Protocols/economics
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor
- Cost-Benefit Analysis
- Cyclophosphamide/administration & dosage
- Cyclophosphamide/adverse effects
- Cyclophosphamide/economics
- Doxorubicin/administration & dosage
- Doxorubicin/adverse effects
- Doxorubicin/economics
- Humans
- Kaplan-Meier Estimate
- Lymphoma, Follicular/drug therapy
- Lymphoma, Follicular/economics
- Lymphoma, Follicular/genetics
- Middle Aged
- Polymerase Chain Reaction
- Prednisone/administration & dosage
- Prednisone/adverse effects
- Prednisone/economics
- Proportional Hazards Models
- Remission Induction
- Rituximab
- Treatment Outcome
- Vincristine/administration & dosage
- Vincristine/adverse effects
- Vincristine/economics
- Young Adult
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Affiliation(s)
- F McClanahan
- Internal Medicine V, University of Heidelberg, Heidelberg, Germany
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Poiasina E, Battaglia L, Leo E, Muscarà C, Rampa M, Vannelli A. Delayed and occult splenic rupture: a diagnostic puzzle. G Chir 2012; 33:119-122. [PMID: 22668529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Splenic rupture is a common complaint encountered in emergency surgery. Trauma is the most common cause of splenic rupture, while non-traumatic or occult splenic rupture (OSR) is a rare condition. The differential diagnosis weighs on treatment that ranges between close monitoring, splenorrhaphy, splenic conservation and splenectomy. We report a case of an 63-year-old man presenting with acute atraumatic left upper quadrant pain. Preliminary diagnosis was subsequently determined to be a hematoma secondary to OSR. More accurate detailed history revealed a previous trauma, which occurred more than one year before and mimicked an OSR. Delayed and occult splenic rupture are as different diagnosis as different treatment. Even in emergency surgery, the key for a target therapeutic strategy should consider an accurate diagnostic time.
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Affiliation(s)
- E Poiasina
- Division of General Surgery B, Fondazione IRCCS "Istituto Nazionale Tumori", Milan, Italy
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Vannelli A, Lualdi M, Sottotetti E, Morelli D, Colombo A, Battaglia L, Leo E. 1431 POSTER Application of Native Fluorescence of Blood Plasma in Colorectal Cancer Detection: Results of a Prospective Study. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)70924-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abad C, González-Escribano MF, Diaz-Gallo LM, Lucena-Soto JM, Márquez JL, Leo E, Crivell C, Gómez-García M, Martín J, Núñez-Roldán A, García-Lozano JR. Association of Toll-like receptor 10 and susceptibility to Crohn's disease independent of NOD2. Genes Immun 2011; 12:635-42. [PMID: 21716313 DOI: 10.1038/gene.2011.41] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Impaired innate inflammatory response has a key role in the Crohn's disease (CD) pathogenesis. The aim of this study was to investigate the possible role of the TLR10-TLR1-TLR6 gene cluster in CD susceptibility. A total of 508 CD patients (284, cohort 1 and 224, cohort 2) and 576 controls were included. TLR10-TLR1-TLR6 cluster single-nucleotide polymorphisms genotyping, NOD2 mutations and TLR10 mRNA quantification were performed using TaqMan assays. Nucleotide-binding oligomerization domain containing 2 (NOD2) and Toll-like receptor (TLR) loci interaction was analyzed by logistic regression and multifactor-dimensionality reduction (MDR). Entropy-based analysis was used to interpret combination effects. One TLR10 haplotype (TLR10(GGGG)) was found associated with CD susceptibility in both cohorts, individuals with two copies had approximately twofold more risk of CD susceptibility than individuals having no copies (odds ratio=1.89, P-value=0.0002). No differences in the mRNA levels were observed among the genotypes. The strongest model for predicting CD risk according to the MDR analysis was a two-locus model including NOD2 mutations and TLR10(GGGG) haplotype (P(c)<0.0001). The interaction gain attributed to the combination of both genes was negative (IG=-2.36%), indicating redundancy or independent effects. Our results support association of the TLR10 gene with CD susceptibility. The effect of TLR10 would be independent of NOD2, suggesting different signaling pathways for both genes.
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Affiliation(s)
- C Abad
- Servicio de Inmunología, Instituto de Biomedicina, Hospital Universitario Virgen del Rocío, Sevilla, Spain
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Costa S, Venturoli S, Mennini FS, Marcellusi A, Pesaresi M, Leo E, Falasca A, Marra E, Cricca M, Santini D, Zerbini M, Pelusi G. Population-based frequency assessment of HPV-induced lesions in patients with borderline Pap tests in the Emilia-Romagna Region: the PATER study. Curr Med Res Opin 2011; 27:569-78. [PMID: 21222568 DOI: 10.1185/03007995.2010.546730] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND The PATER study assessed the frequency of high-risk (HR) and low-risk (LR) human papillomavirus (HPV) in HPV-induced lesions in patients with borderline cytology. METHODS This retrospective observational cohort study was designed to evaluate ASCUS patients detected through a local cervical cancer screening programme and referred to the Department of Gynaecology and Obstetrics at the S. Orsola-Malpighi University Hospital in Bologna, in the period between January 2000 and December 2007. RESULTS In 1047 patients aged 38.4 ± 9.6 years (range 23-65 years), 34.8% (n = 364) was positive for HR- or LR-HPV DNA. The mean age of women with HPV infection was significantly lower compared with the negative group (36.8 ± 9.4 versus 39.3 ± 9.6 years; p < 0.001). Overall, 357 (34.1%) women had cervical lesions: 279 (26.6%) had CIN1, 18 (1.7%) CIN2, and 60 (5.7%) CIN3+. HR-HPV genotype was detected in 83.3%, and 91.5% of patients with CIN2 and CIN3+ respectively. Among the 124 CIN1 HPV-positive women, 8.9% harboured LR-HPV genotypes, 80.6% HR-HPV and 10.5% a combination of HR- and LR-HPV. HPV-6 and 11 accounted for 19.4% of all HPV-positive CIN1 lesions. CONCLUSION Our study suggest that: in ASCUS patients over 40 years there is a low risk of positivity for HPV infection; the HPV DNA testing in patients with CIN3+ and a mean age close to 40 years is highly sensitive (98.3%) and acceptably specific (75.5%); the frequency of LR-HPV (alone or in combination with HR) in ASCUS cytology is not negligible. A tetravalent-based HPV vaccination alongside the screening programme would provide considerable clinical, organizational, and economic benefits.
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Affiliation(s)
- S Costa
- Department of Gynaecology and Obstetrics, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
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Rampa M, Boati P, Battaglia L, Leo E, Vannelli A. [Elective laparoscopic cholecystectomy: the limit of a dream become true]. G Chir 2011; 32:77-82. [PMID: 21352716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Laparoscopic technique in elective cholecystectomy is the last step in an evolutive time to minimize the abdominal access. From 1st January 2004 to 31th December 2006 we analyzed 5515 cholecystectomy procedures: 4877 laparoscopic cholecystectomy, 635 open cholecystectomy. Complications and supplementary diagnosis have been identified in SDO Lombardia's country database. Morbidity occurred in 82 patients (12.9%) with open technique and 109 patients (2.23%) with laparoscopic technique; mortality occurred in 11 patients (1.73%) with open technique and 1 patient (0.02%) with laparoscopic technique. Mean hospital stay are 14.40 days with open technique and 4.75 with laparoscopic technique. Morbidity in open technique is 6 fold more than laparoscopia technique. The difference between the two technique is present in literature and it's the result of non invasive technique compared with the incision of the laparoscopia technique. This is the critical point in the difference of hospital stay between the two technique all to the good of laparoscopy. The high mortality ratio is due to the selective criteria in laparoscopic technique. First remark is the high quality of our hospital care, compared with hospital teaching in the word. In this hospital the laparoscopic cholecystectomy is the gold standard in cholelitiasis treatment. The second remark is the limit of the open technique in severe cholelitiasis with evidence in high ratio of hospital stay, morbidity and mortality.
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Affiliation(s)
- M Rampa
- Foundation IRCSS Istituto Nazionale dei Tumori, Milano, Italy
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Stühmer T, Arts J, Chatterjee M, Borawski J, Wolff A, King P, Einsele H, Leo E, Bargou RC. Preclinical anti-myeloma activity of the novel HDAC-inhibitor JNJ-26481585. Br J Haematol 2010; 149:529-36. [PMID: 20331455 DOI: 10.1111/j.1365-2141.2010.08126.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Pharmacological inhibitors of histone deacetylases (HDACs) are currently being developed and tested as anti-cancer agents and may be useful to enhance the therapeutic efficiency of established anti-myeloma treatments. This study preclinically evaluated the effects of the 'second generation' pan-HDAC inhibitor JNJ-26481585 on human multiple myeloma (MM) cells from established cell lines and primary MM samples (n=42). Molecular responses in both groups of MM cells included histone acetylation, a shift in Bcl2-family members towards proapoptotic bias, attenuation of growth and survival pathway activity and Hsp72 induction. Mcl-1 depletion and Hsp72 induction were the most reliable features observed in JNJ-26481585-treated primary MM samples. The drug alone effectively induced myeloma cell death at low nanomolar concentrations. In vitro combination of JNJ-26481585 with anti-myeloma therapeutic agents generally resulted In effects close to additivity. In view of the favourable activity of this novel HDAC-inhibitor towards primary myeloma cells further evaluation in a clinical setting is warranted.
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Affiliation(s)
- Thorsten Stühmer
- Department of Internal Medicine II, Division of Haematology, University Hospital of Würzburg, Würzburg, Germany.
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Venturoli S, Leo E, Cricca M, Nocera M, Plazzi M, Musiani M, Zerbini M. PX-8 Comparison of abbott realtime HPV assay and digene HC2 HPV DNA test for the detection of high-risk HPV DNA in a referral population setting. J Clin Virol 2009. [DOI: 10.1016/s1386-6532(09)70230-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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41
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Burch JB, Tom J, Zhai Y, Criswell L, Leo E, Ogoussan K. Shiftwork impacts and adaptation among health care workers. Occup Med (Lond) 2009; 59:159-66. [DOI: 10.1093/occmed/kqp015] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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42
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Garrido A, Giráldez A, Trigo C, Leo E, Guil A, Márquez JL. [Intravenous proton-pump inhibitor for acute peptic ulcer bleeding--is profound acid suppression beneficial to reduce the risk of rebleeding?]. Rev Esp Enferm Dig 2009; 100:466-9. [PMID: 18942898 DOI: 10.4321/s1130-01082008000800004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To compare two regimens of pantoprazole administered intravenously in patients with ulcerative gastrointestinal bleeding (UGB), and a high risk of presenting with persitent or recurrent hemorrhage. MATERIAL AND METHOD Patients were randomized into two groups: group 0--treatment with a 80 mg bolus of pantoprazole administered intravenously, followed by continuous infusion of 8 mg/h for 72 hours; group 1--treatment with 40 mg of pantoprazole administered intravenously on a daily basis. The percentage of hemorrhagic persistence/recurrence in both groups was analyzed, as were transfusion requirements, need for surgery, and mortality resulting from the hemorrhagic episode. RESULTS There were 20 patients in group 0 and 21 in group 1. No differences were found between groups in terms of gender, age, smoking habits, use of NSAIDs, presence of hemodynamic instability or stigmata in ulcer crater (Forrest Ia: 5 vs. 14.3%, p = 0.322; Forrest Ib: 30 vs. 33.3%, p = 0.819; Forrest IIa: 60 vs. 50.1%, p = 0.753). In group 0, 90% of patients received endoscopic treatment, versus 100% in group 1, p = 0.232. In group 0, 50% of patients had a transfusion, as compared to 52.4% in group 1, p = 0.879. In group 0, 2 patients (10.5%) presented with recurrent hemorrhage, versus 3 patients (14.3%) in group 1. Surgery was required by 1 person from each group, and 1 patient in group 0 died. CONCLUSIONS Maximum acid inhibition with a bolus and then a continuous infusion of pantoprazole does not yield better results than treatment with conventional doses in acute hemorrhagic episodes.
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Affiliation(s)
- A Garrido
- Servicio de Aparato Digestivo, Hospital Virgen del Rocío, Seville.
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43
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Bargou R, Leo E, Zugmaier G, Klinger M, Goebeler M, Knop S, Noppeney R, Viardot A, Hess G, Schuler M, Einsele H, Brandl C, Wolf A, Kirchinger P, Klappers P, Schmidt M, Riethmüller G, Reinhardt C, Baeuerle PA, Kufer P. Tumor regression in cancer patients by very low doses of a T cell-engaging antibody. Science 2008; 321:974-7. [PMID: 18703743 DOI: 10.1126/science.1158545] [Citation(s) in RCA: 766] [Impact Index Per Article: 47.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Previous attempts have shown the potential of T cells in immunotherapy of cancer. Here, we report on the clinical activity of a bispecific antibody construct called blinatumomab, which has the potential to engage all cytotoxic T cells in patients for lysis of cancer cells. Doses as low as 0.005 milligrams per square meter per day in non-Hodgkin's lymphoma patients led to an elimination of target cells in blood. Partial and complete tumor regressions were first observed at a dose level of 0.015 milligrams, and all seven patients treated at a dose level of 0.06 milligrams experienced a tumor regression. Blinatumomab also led to clearance of tumor cells from bone marrow and liver. T cell-engaging antibodies appear to have therapeutic potential for the treatment of malignant diseases.
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Affiliation(s)
- Ralf Bargou
- Interdisciplinary Phase I/II Unit of the University of Würzburg, Klinikstrasse 6-8, 97070 Würzburg, Germany
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Perrone F, Lampis A, Orsenigo M, Di Bartolomeo M, Gevorgyan A, Losa M, Frattini M, Riva C, Andreola S, Bajetta E, Bertario L, Leo E, Pierotti MA, Pilotti S. PI3KCA/PTEN deregulation contributes to impaired responses to cetuximab in metastatic colorectal cancer patients. Ann Oncol 2008; 20:84-90. [PMID: 18669866 DOI: 10.1093/annonc/mdn541] [Citation(s) in RCA: 334] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND It has been reported that KRAS mutations (and to a lesser extent KRAS mutations with the BRAF V600E mutation) negatively affect response to anti-epidermal growth factor receptor (EGFR) mAbs in metastatic colorectal cancer (mCRC) patients, while the biological impact of the EGFR pathway represented by PI3K/PTEN/AKT on anti-EGFR treatment is still not clear. PATIENTS AND METHODS We analysed formalin-fixed samples from a cohort of 32 mCRC patients treated with cetuximab by means of EGFR immunohistochemistry, EGFR and PTEN FISH analysis, and KRAS, BRAF, PI3KCA, and PTEN genomic sequencing. RESULTS Ten (31%) of 32 patients showed a partial response to cetuximab and 22 (69%) did not [nonresponder (NR)]. EGFR immunophenotype and FISH-based gene status did not predict an anti-EGFR mAb response, whereas KRAS mutations (24%) and PI3K pathway activation, by means of PI3KCA mutations (13%) or PTEN mutation (10%)/loss (13%), were significantly restricted to, respectively, 41% and 37% of NRs. CONCLUSION These findings suggested that KRAS mutations and PI3KCA/PTEN deregulation significantly correlate with resistance to cetuximab. In line with this, patients carrying KRAS mutations or with activated PI3K profiles can benefit from targeted treatments only by switching off molecules belonging to the downstream signalling of activated EGFR, such as mammalian target of rapamycin.
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Affiliation(s)
- F Perrone
- Experimental Molecular Pathology, Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Kornacker M, Kornacker B, Schmitt C, Leo E, Ho AD, Hensel M. Commercial LightCycler-based quantitative real-time PCR compared to nested PCR for monitoring of Bcl-2/IgH rearrangement in patients with follicular lymphoma. Ann Hematol 2008; 88:43-50. [PMID: 18636259 DOI: 10.1007/s00277-008-0550-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2008] [Accepted: 06/24/2008] [Indexed: 10/21/2022]
Abstract
Translocation of chromosomes 14 and 18 [t(14;18)] for detection of minimal residual disease in follicular lymphoma patients can be analyzed by nested polymerase chain reaction (PCR) or by quantitative PCR like LightCycler-based assays. We have compared both methods in blood and bone marrow samples of 28 patients enrolled in a clinical study on immunochemotherapy. In 42% of samples, the bcl2-IgH rearrangement was detectable by nested PCR, but not by LightCycler PCR. Nested PCR was able to reveal a significant drop in positive bone marrow or peripheral blood samples after therapy. In contrast, with LightCycler PCR, the detected drop in t(14;18)-positive cells did not reach statistical significance. The majority of patients showed positive results with nested PCR of peripheral blood or bone marrow without any associations to presence or absence of histological bone marrow (BM) infiltration by lymphoma cells. With LightCycler PCR, the numbers of positive cells were higher in samples from patients with BM infiltration of lymphoma cells (1.9 x 10(-2)) compared to samples from patients without involvement (4.08 x 10(-5)). A similar trend was seen in samples derived from the peripheral blood. Positivity for t(14;18) after therapy in two patients correlated with clinical relapse 6 months later. The data shown here demonstrate a lower sensitivity of LightCycler vs. nested PCR for detection of t(14;18). The usefulness of nested PCR for t(14;18) for risk stratification after primary therapy has to be validated in larger trials.
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Affiliation(s)
- M Kornacker
- Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
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Belli F, Gallino GF, Lo Vullo S, Mariani L, Poiasina E, Leo E. Melanoma of the anorectal region: the experience of the National Cancer Institute of Milano. Eur J Surg Oncol 2008; 35:757-62. [PMID: 18602790 DOI: 10.1016/j.ejso.2008.05.001] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2008] [Accepted: 05/03/2008] [Indexed: 12/14/2022] Open
Abstract
AIMS This study describes the experience of the National Cancer Institute of Milano in the treatment of anorectal melanoma over the last 32 years. METHODS The influence of different surgical approaches on local care and final outcome was investigated on 40 completely evaluable patients, followed for a median follow-up time of 75 months. The analysis was carried out by calculating and comparing overall survival, disease-free survival and cumulative incidence curves of disease recurrence. RESULTS Thirty-one patients underwent radical surgery: nine abdominoperineal resections, four total rectal resections and coloendoanal anastomosis, and 18 local excisions. The remaining nine patients received palliative treatments. Median overall survival time for patients receiving non-radical treatments was poor: only 6 months. However, even when a radical surgery was undergone, the prognosis of patients with anal melanoma remains dismal. Local relapse incidence was 45.8% for the limited surgery group, but non-existent for the extended-surgery group (p = 0.007). However, the median disease-free survival time was 7 and 9 months for patients receiving limited or major surgery (p = 0.97). Overall survival was 17 months, irrespective of the adopted surgery. CONCLUSION Prognosis of anal melanoma remains poor. Final outcome is not influenced by modality of surgery. A limited but radical excision can be considered whenever possible while a major demolitive surgery should be applied only for therapy of advanced or bulky lesions.
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Affiliation(s)
- F Belli
- Division of Colo-Rectal Surgery, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy.
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Frattini M, Gallino G, Signoroni S, Balestra D, Lusa L, Battaglia L, Sozzi G, Bertario L, Leo E, Pilotti S, Pierotti MA. Quantitative and qualitative characterization of plasma DNA identifies primary and recurrent colorectal cancer. Cancer Lett 2008; 263:170-81. [PMID: 18395974 DOI: 10.1016/j.canlet.2008.03.021] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2008] [Revised: 03/17/2008] [Accepted: 03/19/2008] [Indexed: 02/06/2023]
Abstract
Because plasma DNA may be a useful tool for cancer detection, we screened primary tumors and related multiple plasma samples at the time of surgery and during the follow-up period for plasma DNA level as well as for K-Ras mutations and p16INK4a promoter hypermethylation in colorectal cancer patients. At the time of surgery, DNA levels were higher in tumor patients than in healthy donors, and K-Ras and p16INK4a alterations were detected in 7 and 11 cancers respectively, and in all related plasma samples. During the follow-up, plasma DNA levels decrease progressively but rapidly increased when a relapse occurred, whereas K-Ras and p16INK4a alterations were detected only in relapsed patients. Therefore, combined quantitative and qualitative analyses of plasma DNA confirm the presence of colorectal cancer, define disease-free status and indicate the presence of relapse.
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Affiliation(s)
- M Frattini
- Experimental Molecular Pathology, Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Stühmer T, Arts J, King P, Page M, Bommert K, Leo E, Bargou RC. A first-in-class HDM2-inhibitor (JNJ-26854165) in phase I development shows potent activity against multiple myeloma (MM) cells in vitro and ex vivo. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.14694] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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49
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Cricca M, Venturoli S, Leo E, Musiani M, Zerbini M. ANALISI DI TRASCRITTI VIRALI DI HPV16 COME INDICATORI DI CARCINOMA CERVICALE IN SITU. Microbiol Med 2007. [DOI: 10.4081/mm.2007.2797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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50
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Zugmaier G, Viardot A, Hess G, Noppeney R, Kufer P, Leo E, Reitsma D, Goebeler M, Knop S, Einsele H, Bargou R. P047 The bi-specific T-cell enhancer (BiTE) MT103 (MEDI-538) shows clinical activity in pre-treated NHL: update from the ongoing Phase I study MT103-104. Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70395-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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