1
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Ahmadi AR, Song G, Gao T, Ma J, Han X, Hu MW, Cameron AM, Wesson RN, Philosophe B, Ottmann S, King E, Gurakar A, Qi L, Peiffer B, Burdick J, Anders R, Zhou Z, Lu H, Feng D, Chen CS, Qian J, Gao B, Zhu H, Sun Z. Discovery and characterization of cross-reactive intrahepatic antibodies in severe alcoholic hepatitis. eLife 2023; 12:RP86678. [PMID: 38055614 PMCID: PMC10699809 DOI: 10.7554/elife.86678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023] Open
Abstract
The pathogenesis of antibodies in severe alcoholic hepatitis (SAH) remains unknown. We analyzed immunoglobulins (Ig) in explanted livers from SAH patients (n=45) undergoing liver transplantation and tissues from corresponding healthy donors (HD, n=10) and found massive deposition of IgG and IgA isotype antibodies associated with complement fragment C3d and C4d staining in ballooned hepatocytes in SAH livers. Ig extracted from SAH livers, but not patient serum exhibited hepatocyte killing efficacy. Employing human and Escherichia coli K12 proteome arrays, we profiled the antibodies extracted from explanted SAH, livers with other diseases, and HD livers. Compared with their counterparts extracted from livers with other diseases and HD, antibodies of IgG and IgA isotypes were highly accumulated in SAH and recognized a unique set of human proteins and E. coli antigens. Further, both Ig- and E. coli-captured Ig from SAH livers recognized common autoantigens enriched in several cellular components including cytosol and cytoplasm (IgG and IgA), nucleus, mitochondrion, and focal adhesion (IgG). Except IgM from primary biliary cholangitis livers, no common autoantigen was recognized by Ig- and E. coli-captured Ig from livers with other diseases. These findings demonstrate the presence of cross-reacting anti-bacterial IgG and IgA autoantibodies in SAH livers.
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Affiliation(s)
- Ali Reza Ahmadi
- Department of Surgery, Johns Hopkins University School of MedicineBaltimoreUnited States
| | - Guang Song
- Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of MedicineBaltimoreUnited States
| | - Tianshun Gao
- Department of Ophthalmology, Johns Hopkins University School of MedicineBaltimoreUnited States
| | - Jing Ma
- Laboratory of Liver Diseases, National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institutes of Health (NIH)BaltimoreUnited States
| | - Xiaomei Han
- Department of Ophthalmology, Johns Hopkins University School of MedicineBaltimoreUnited States
| | - Ming-Wen Hu
- Department of Ophthalmology, Johns Hopkins University School of MedicineBaltimoreUnited States
| | - Andrew M Cameron
- Department of Surgery, Johns Hopkins University School of MedicineBaltimoreUnited States
| | - Russell N Wesson
- Department of Surgery, Johns Hopkins University School of MedicineBaltimoreUnited States
| | - Benjamin Philosophe
- Department of Surgery, Johns Hopkins University School of MedicineBaltimoreUnited States
| | - Shane Ottmann
- Department of Surgery, Johns Hopkins University School of MedicineBaltimoreUnited States
| | - Elizabeth King
- Department of Surgery, Johns Hopkins University School of MedicineBaltimoreUnited States
| | - Ahmet Gurakar
- Department of Medicine, Johns Hopkins University School of MedicineBaltimoreUnited States
| | - Le Qi
- Department of Surgery, Johns Hopkins University School of MedicineBaltimoreUnited States
| | - Brandon Peiffer
- Department of Surgery, Johns Hopkins University School of MedicineBaltimoreUnited States
| | - James Burdick
- Department of Surgery, Johns Hopkins University School of MedicineBaltimoreUnited States
| | - Robert Anders
- Department of Pathology, Johns Hopkins University School of MedicineBaltimoreUnited States
| | - Zhanxiang Zhou
- Center for Translational Biomedical Research and Department of Nutrition, University of North Carolina at Greensboro, North Carolina Research CampusKannapolisUnited States
| | - Hongkun Lu
- Laboratory of Liver Diseases, National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institutes of Health (NIH)BaltimoreUnited States
| | - Dechun Feng
- Laboratory of Liver Diseases, National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institutes of Health (NIH)BaltimoreUnited States
| | - Chien-Sheng Chen
- Department of Food Safety/Hygiene and Risk Management, National Cheng Kung UniversityTainanTaiwan
| | - Jiang Qian
- Department of Ophthalmology, Johns Hopkins University School of MedicineBaltimoreUnited States
| | - Bin Gao
- Laboratory of Liver Diseases, National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institutes of Health (NIH)BaltimoreUnited States
| | - Heng Zhu
- Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of MedicineBaltimoreUnited States
| | - Zhaoli Sun
- Department of Surgery, Johns Hopkins University School of MedicineBaltimoreUnited States
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2
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Shu DH, Ho WJ, Kagohara LT, Girgis A, Shin SM, Danilova L, Lee JW, Sidiropoulos DN, Mitchell S, Munjal K, Howe K, Bendinelli KJ, Qi H, Mo G, Montagne J, Leatherman JM, Lopez-Vidal TY, Zhu Q, Huff AL, Yuan X, Hernandez A, Coyne EM, Zaidi N, Zabransky DJ, Engle LL, Ogurtsova A, Baretti M, Laheru D, Durham JN, Wang H, Anders R, Jaffee EM, Fertig EJ, Yarchoan M. Immune landscape of tertiary lymphoid structures in hepatocellular carcinoma (HCC) treated with neoadjuvant immune checkpoint blockade. bioRxiv 2023:2023.10.16.562104. [PMID: 37904980 PMCID: PMC10614819 DOI: 10.1101/2023.10.16.562104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Neoadjuvant immunotherapy is thought to produce long-term remissions through induction of antitumor immune responses before removal of the primary tumor. Tertiary lymphoid structures (TLS), germinal center-like structures that can arise within tumors, may contribute to the establishment of immunological memory in this setting, but understanding of their role remains limited. Here, we investigated the contribution of TLS to antitumor immunity in hepatocellular carcinoma (HCC) treated with neoadjuvant immunotherapy. We found that neoadjuvant immunotherapy induced the formation of TLS, which were associated with superior pathologic response, improved relapse free survival, and expansion of the intratumoral T and B cell repertoire. While TLS in viable tumor displayed a highly active mature morphology, in areas of tumor regression we identified an involuted TLS morphology, which was characterized by dispersion of the B cell follicle and persistence of a T cell zone enriched for ongoing antigen presentation and T cell-mature dendritic cell interactions. Involuted TLS showed increased expression of T cell memory markers and expansion of CD8+ cytotoxic and tissue resident memory clonotypes. Collectively, these data reveal the circumstances of TLS dissolution and suggest a functional role for late-stage TLS as sites of T cell memory formation after elimination of viable tumor.
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Affiliation(s)
- Daniel H. Shu
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Convergence Institute, Johns Hopkins University, Baltimore, Maryland
| | - Won Jin Ho
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Convergence Institute, Johns Hopkins University, Baltimore, Maryland
| | - Luciane T. Kagohara
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Convergence Institute, Johns Hopkins University, Baltimore, Maryland
| | - Alexander Girgis
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Convergence Institute, Johns Hopkins University, Baltimore, Maryland
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Sarah M. Shin
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ludmila Danilova
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jae W. Lee
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Dimitrios N. Sidiropoulos
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Convergence Institute, Johns Hopkins University, Baltimore, Maryland
| | - Sarah Mitchell
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Kabeer Munjal
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Kathryn Howe
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Kayla J. Bendinelli
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Hanfei Qi
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Guanglan Mo
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Janelle Montagne
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Convergence Institute, Johns Hopkins University, Baltimore, Maryland
| | - James M. Leatherman
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Tamara Y. Lopez-Vidal
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Convergence Institute, Johns Hopkins University, Baltimore, Maryland
| | - Qingfeng Zhu
- Convergence Institute, Johns Hopkins University, Baltimore, Maryland
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Amanda L. Huff
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Convergence Institute, Johns Hopkins University, Baltimore, Maryland
| | - Xuan Yuan
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Alexei Hernandez
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Erin M. Coyne
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Neeha Zaidi
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Convergence Institute, Johns Hopkins University, Baltimore, Maryland
| | - Daniel J. Zabransky
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Convergence Institute, Johns Hopkins University, Baltimore, Maryland
| | - Logan L. Engle
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
- The Mark Foundation Center for Advanced Genomics and Imaging, Johns Hopkins University, Baltimore, Maryland
- Bloomberg∼Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland
| | - Aleksandra Ogurtsova
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
- The Mark Foundation Center for Advanced Genomics and Imaging, Johns Hopkins University, Baltimore, Maryland
- Bloomberg∼Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland
| | - Marina Baretti
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Daniel Laheru
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Convergence Institute, Johns Hopkins University, Baltimore, Maryland
| | - Jennifer N. Durham
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Hao Wang
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Robert Anders
- Convergence Institute, Johns Hopkins University, Baltimore, Maryland
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Elizabeth M. Jaffee
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Convergence Institute, Johns Hopkins University, Baltimore, Maryland
- Bloomberg∼Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland
| | - Elana J. Fertig
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Convergence Institute, Johns Hopkins University, Baltimore, Maryland
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Applied Mathematics and Statistics, Johns Hopkins University Whiting School of Engineering, Baltimore, Maryland
| | - Mark Yarchoan
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Convergence Institute, Johns Hopkins University, Baltimore, Maryland
- Bloomberg∼Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland
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3
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Gupta A, Zorzi J, Ho WJ, Baretti M, Azad NS, Griffith P, Dao D, Kim A, Philosophe B, Georgiades C, Kamel I, Burkhart R, Liddell R, Hong K, Shubert C, Lafaro K, Meyer J, Anders R, Burns III W, Yarchoan M. Relationship of Hepatocellular Carcinoma Stage and Hepatic Function to Health-Related Quality of Life: A Single Center Analysis. Healthcare (Basel) 2023; 11:2571. [PMID: 37761768 PMCID: PMC10531156 DOI: 10.3390/healthcare11182571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/14/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
Health-related quality of life (HRQoL) is known to be an important prognostic indicator and clinical endpoint for patients with hepatocellular carcinoma (HCC). However, the correlation of the Barcelona Clinic Liver Cancer (BCLC) stage with HRQoL in HCC has not been previously studied. We examined the relationship between BCLC stage, Child-Pugh (CP) score, and Eastern Cooperative Oncology Group (ECOG) performance status on HRQoL for patients who presented at a multidisciplinary liver cancer clinic. HRQoL was assessed using the Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) questionnaire. Fifty-one patients met our inclusion criteria. The FACT-Hep total and subscales showed no significant association with BCLC stages (p = 0.224). Patients with CP B had significantly more impairment in FACT-Hep than patients with CP A. These data indicate that in patients with HCC, impaired liver function is associated with reduced quality of life, whereas the BCLC stage poorly correlates with quality of life metrics. Impairment of quality of life is common in HCC patients and further studies are warranted to determine the impact of early supportive interventions on HRQoL and survival outcomes.
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Affiliation(s)
- Amol Gupta
- The Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins Hospital, Baltimore, MD 21287, USA; (J.Z.); (W.J.H.); (M.B.); (N.S.A.); (P.G.); (D.D.); (A.K.); (B.P.); (C.G.); (I.K.); (R.B.); (R.L.); (K.H.); (C.S.); (K.L.); (J.M.); (R.A.); (W.B.III); (M.Y.)
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4
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Benson AB, D'Angelica MI, Abrams T, Abbott DE, Ahmed A, Anaya DA, Anders R, Are C, Bachini M, Binder D, Borad M, Bowlus C, Brown D, Burgoyne A, Castellanos J, Chahal P, Cloyd J, Covey AM, Glazer ES, Hawkins WG, Iyer R, Jacob R, Jennings L, Kelley RK, Kim R, Levine M, Palta M, Park JO, Raman S, Reddy S, Ronnekleiv-Kelly S, Sahai V, Singh G, Stein S, Turk A, Vauthey JN, Venook AP, Yopp A, McMillian N, Schonfeld R, Hochstetler C. NCCN Guidelines® Insights: Biliary Tract Cancers, Version 2.2023. J Natl Compr Canc Netw 2023; 21:694-704. [PMID: 37433432 DOI: 10.6004/jnccn.2023.0035] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
In 2023, the NCCN Guidelines for Hepatobiliary Cancers were divided into 2 separate guidelines: Hepatocellular Carcinoma and Biliary Tract Cancers. The NCCN Guidelines for Biliary Tract Cancers provide recommendations for the evaluation and comprehensive care of patients with gallbladder cancer, intrahepatic cholangiocarcinoma, and extrahepatic cholangiocarcinoma. The multidisciplinary panel of experts meets at least on an annual basis to review requests from internal and external entities as well as to evaluate new data on current and emerging therapies. These Guidelines Insights focus on some of the recent updates to the NCCN Guidelines for Biliary Tract Cancers as well as the newly published section on principles of molecular testing.
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Affiliation(s)
- Al B Benson
- 1Robert H. Lurie Comprehensive Cancer Center of Northwestern University
| | | | | | | | | | | | - Robert Anders
- 7The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
| | | | | | | | | | | | | | | | | | - Prabhleen Chahal
- 16Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
| | - Jordan Cloyd
- 17The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | | | | | - William G Hawkins
- 19Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
| | | | | | - Lawrence Jennings
- 1Robert H. Lurie Comprehensive Cancer Center of Northwestern University
| | - R Kate Kelley
- 22UCSF Helen Diller Family Comprehensive Cancer Center
| | - Robin Kim
- 23Huntsman Cancer Institute at the University of Utah
| | - Matthew Levine
- 24Abramson Cancer Center at the University of Pennsylvania
| | | | | | | | | | | | | | | | | | - Anita Turk
- 31Indiana University Melvin and Bren Simon Comprehensive Cancer Center
| | | | - Alan P Venook
- 22UCSF Helen Diller Family Comprehensive Cancer Center
| | - Adam Yopp
- 33UT Southwestern Simmons Comprehensive Cancer Center
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5
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Heumann T, Judkins C, Li K, Lim SJ, Hoare J, Parkinson R, Cao H, Zhang T, Gai J, Celiker B, Zhu Q, McPhaul T, Durham J, Purtell K, Klein R, Laheru D, De Jesus-Acosta A, Le DT, Narang A, Anders R, Burkhart R, Burns W, Soares K, Wolfgang C, Thompson E, Jaffee E, Wang H, He J, Zheng L. A platform trial of neoadjuvant and adjuvant antitumor vaccination alone or in combination with PD-1 antagonist and CD137 agonist antibodies in patients with resectable pancreatic adenocarcinoma. Nat Commun 2023; 14:3650. [PMID: 37339979 PMCID: PMC10281953 DOI: 10.1038/s41467-023-39196-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 06/01/2023] [Indexed: 06/22/2023] Open
Abstract
A neoadjuvant immunotherapy platform clinical trial allows for rapid evaluation of treatment-related changes in tumors and identifying targets to optimize treatment responses. We enrolled patients with resectable pancreatic adenocarcinoma into such a platform trial (NCT02451982) to receive pancreatic cancer GVAX vaccine with low-dose cyclophosphamide alone (Arm A; n = 16), with anti-PD-1 antibody nivolumab (Arm B; n = 14), and with both nivolumab and anti-CD137 agonist antibody urelumab (Arm C; n = 10), respectively. The primary endpoint for Arms A/B - treatment-related change in IL17A expression in vaccine-induced lymphoid aggregates - was previously published. Here, we report the primary endpoint for Arms B/C: treatment-related change in intratumoral CD8+ CD137+ cells and the secondary outcomes including safety, disease-free and overall survivals for all Arms. Treatment with GVAX+nivolumab+urelumab meets the primary endpoint by significantly increasing intratumoral CD8+ CD137+ cells (p = 0.003) compared to GVAX+Nivolumab. All treatments are well-tolerated. Median disease-free and overall survivals, respectively, are 13.90/14.98/33.51 and 23.59/27.01/35.55 months for Arms A/B/C. GVAX+nivolumab+urelumab demonstrates numerically-improved disease-free survival (HR = 0.55, p = 0.242; HR = 0.51, p = 0.173) and overall survival (HR = 0.59, p = 0.377; HR = 0.53, p = 0.279) compared to GVAX and GVAX+nivolumab, respectively, although not statistically significant due to small sample size. Therefore, neoadjuvant and adjuvant GVAX with PD-1 blockade and CD137 agonist antibody therapy is safe, increases intratumoral activated, cytotoxic T cells, and demonstrates a potentially promising efficacy signal in resectable pancreatic adenocarcinoma that warrants further study.
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Affiliation(s)
- Thatcher Heumann
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Department of Oncology, Cancer Convergence Institute and Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Vanderbilt University Medical Center, Department of Hematology-Oncology, Nashville, TN, USA
- The Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins, Baltimore, MD, USA
| | - Carol Judkins
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Department of Oncology, Cancer Convergence Institute and Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins, Baltimore, MD, USA
| | - Keyu Li
- Division of Pancreatic Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Su Jin Lim
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Department of Oncology, Cancer Convergence Institute and Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Division of Quantitative Sciences, Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jessica Hoare
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Department of Oncology, Cancer Convergence Institute and Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins, Baltimore, MD, USA
| | - Rose Parkinson
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Department of Oncology, Cancer Convergence Institute and Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins, Baltimore, MD, USA
| | - Haihui Cao
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Department of Oncology, Cancer Convergence Institute and Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins, Baltimore, MD, USA
| | - Tengyi Zhang
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Department of Oncology, Cancer Convergence Institute and Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins, Baltimore, MD, USA
- The Pancreatic Cancer Precision Medicine Center of Excellence Program at Johns Hopkins, Baltimore, MD, USA
| | - Jessica Gai
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Department of Oncology, Cancer Convergence Institute and Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins, Baltimore, MD, USA
- The Pancreatic Cancer Precision Medicine Center of Excellence Program at Johns Hopkins, Baltimore, MD, USA
| | - Betul Celiker
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Department of Oncology, Cancer Convergence Institute and Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins, Baltimore, MD, USA
| | - Qingfeng Zhu
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Department of Oncology, Cancer Convergence Institute and Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins, Baltimore, MD, USA
- The Pancreatic Cancer Precision Medicine Center of Excellence Program at Johns Hopkins, Baltimore, MD, USA
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Thomas McPhaul
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Department of Oncology, Cancer Convergence Institute and Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The Pancreatic Cancer Precision Medicine Center of Excellence Program at Johns Hopkins, Baltimore, MD, USA
- Department of Radiation Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jennifer Durham
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Department of Oncology, Cancer Convergence Institute and Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins, Baltimore, MD, USA
| | - Katrina Purtell
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Department of Oncology, Cancer Convergence Institute and Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins, Baltimore, MD, USA
| | - Rachel Klein
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Department of Oncology, Cancer Convergence Institute and Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Daniel Laheru
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Department of Oncology, Cancer Convergence Institute and Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins, Baltimore, MD, USA
- The Pancreatic Cancer Precision Medicine Center of Excellence Program at Johns Hopkins, Baltimore, MD, USA
| | - Ana De Jesus-Acosta
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Department of Oncology, Cancer Convergence Institute and Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins, Baltimore, MD, USA
- The Pancreatic Cancer Precision Medicine Center of Excellence Program at Johns Hopkins, Baltimore, MD, USA
| | - Dung T Le
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Department of Oncology, Cancer Convergence Institute and Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins, Baltimore, MD, USA
- The Pancreatic Cancer Precision Medicine Center of Excellence Program at Johns Hopkins, Baltimore, MD, USA
| | - Amol Narang
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Department of Oncology, Cancer Convergence Institute and Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The Pancreatic Cancer Precision Medicine Center of Excellence Program at Johns Hopkins, Baltimore, MD, USA
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Robert Anders
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Department of Oncology, Cancer Convergence Institute and Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins, Baltimore, MD, USA
- The Pancreatic Cancer Precision Medicine Center of Excellence Program at Johns Hopkins, Baltimore, MD, USA
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Richard Burkhart
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Department of Oncology, Cancer Convergence Institute and Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins, Baltimore, MD, USA
- The Pancreatic Cancer Precision Medicine Center of Excellence Program at Johns Hopkins, Baltimore, MD, USA
- Department of Radiation Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - William Burns
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Department of Oncology, Cancer Convergence Institute and Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins, Baltimore, MD, USA
- The Pancreatic Cancer Precision Medicine Center of Excellence Program at Johns Hopkins, Baltimore, MD, USA
- Department of Radiation Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kevin Soares
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Christopher Wolfgang
- Department of Surgery, New York University School of Medicine and NYU-Langone Medical Center, New York, NY, USA
| | - Elizabeth Thompson
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Department of Oncology, Cancer Convergence Institute and Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins, Baltimore, MD, USA
- The Pancreatic Cancer Precision Medicine Center of Excellence Program at Johns Hopkins, Baltimore, MD, USA
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Elizabeth Jaffee
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Department of Oncology, Cancer Convergence Institute and Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins, Baltimore, MD, USA
- The Pancreatic Cancer Precision Medicine Center of Excellence Program at Johns Hopkins, Baltimore, MD, USA
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Hao Wang
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Department of Oncology, Cancer Convergence Institute and Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins, Baltimore, MD, USA
- Division of Quantitative Sciences, Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jin He
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Department of Oncology, Cancer Convergence Institute and Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins, Baltimore, MD, USA
- The Pancreatic Cancer Precision Medicine Center of Excellence Program at Johns Hopkins, Baltimore, MD, USA
- Department of Radiation Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Lei Zheng
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Department of Oncology, Cancer Convergence Institute and Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- The Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins, Baltimore, MD, USA.
- The Pancreatic Cancer Precision Medicine Center of Excellence Program at Johns Hopkins, Baltimore, MD, USA.
- Department of Radiation Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Lyman MR, Mitchell JT, Kagohara LT, Barrett B, Huff A, Shin S, Longway G, Gupta A, Andaloori L, Armstrong TD, Haldar D, Anders R, Thompson E, Azad N, Ho WJ, Jaffee E, Fertig EJ, Zaidi N. Abstract 2873: Evolution of immune cell composition and functionality as pancreatic intraepithelial neoplasia progresses to pancreatic ductal adenocarcinoma. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-2873] [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: 04/07/2023]
Abstract
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is most often diagnosed at an advanced stage. Newly diagnosed patients therefore have a dismal five-year survival rate of 11%. However, PDAC progresses from pre-invasive pancreatic intraepithelial neoplasia (PanIN) over at least a decade. Throughout this transition, the tissue microenvironment becomes increasingly immunosuppressive. Early PanINs may therefore be more amenable to immune-based interception strategies; however, little is known about the pre-malignant lesion immune microenvironment in PDAC. We hypothesized that the identification of the immune landscape of PanINs will elucidate the immuno-dynamic changes that occur during PanIN-to-PDAC progression and identify novel strategies for intercepting PDAC. Here, we use an inducible mouse model to study the evolution of immunosuppression from PanINs to PDAC. We pair spatial molecular profiling of our mouse model with profiling of human tissue in a cohort of patients with normal tissue, chronic pancreatitis, PanIN, and PDAC. To examine the evolution of the immune microenvironment throughout PanIN-to-PDAC progression, we first optimized a tamoxifen-inducible Pdx1-CreERT2 mouse that controls KRASG12D expression and knocks out p53. The impact of KRASG12D expression on the immune cell landscape in PanIN and PDAC lesions was examined by immunohistochemistry (IHC) and RNA in situ hybridization on mouse pancreas. We used imaging mass cytometry (IMC) of 35 immune markers to better classify and quantify the immune cell subtypes. Our analyses thus far reveal increased Tregs as PanINs progress to PDAC. Furthermore, although CD3+ T cells are recruited to tumors, these immune cells are strictly restricted to the immediate edge of the tumor and predominantly consist of Tregs. For our human analyses, FFPE pancreas sections from treatment naïve patients who had undergone surgical resection without neoadjuvant chemotherapy were evaluated. Each section contained regions of normal tissue, chronic pancreatitis, PanIN and PDAC. These were evaluated using IHC, IMC, and spatial transcriptomics to allow us to spatially evaluate the immune populations associated with lesions and PDAC. The relative density and localization of myeloid and lymphoid cell types in both PanIN and PDAC regions revealed an initial influx of CD8+ and CD4+ T cells to PanINs and a progressively immunosuppressive microenvironment in subsequent stages. While PanINs and PDAC both recruited immune cells, the phenotypes of the immune infiltrates were distinct and revealed unique immune pathways that could contribute to immunosuppression as PanINs develop into PDACs. Our proteomic and transcriptomic data from mouse and human pancreas show that mutant KRAS driven premalignant lesions recruit an evolving immune response that readily becomes immunosuppressive as progression to PDAC occurs.
Citation Format: Melissa R. Lyman, Jacob T. Mitchell, Luciane T. Kagohara, Benjamin Barrett, Amanda Huff, Sarah Shin, Gabriella Longway, Anuj Gupta, Lalitya Andaloori, Todd D. Armstrong, Daniel Haldar, Robert Anders, Elizabeth Thompson, Nilo Azad, Won Jin Ho, Elizabeth Jaffee, Elana J. Fertig, Neeha Zaidi. Evolution of immune cell composition and functionality as pancreatic intraepithelial neoplasia progresses to pancreatic ductal adenocarcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 2873.
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7
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Brahmer JR, Drake CG, Wollner I, Powderly JD, Picus J, Sharfman WH, Stankevich E, Pons A, Salay TM, McMiller TL, Gilson MM, Wang C, Selby M, Taube JM, Anders R, Chen L, Korman AJ, Pardoll DM, Lowy I, Topalian SL. Phase I Study of Single-Agent Anti-Programmed Death-1 (MDX-1106) in Refractory Solid Tumors: Safety, Clinical Activity, Pharmacodynamics, and Immunologic Correlates. J Clin Oncol 2023; 41:715-723. [PMID: 36706735 DOI: 10.1200/jco.22.02270] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
PURPOSE Programmed death-1 (PD-1), an inhibitory receptor expressed on activated T cells, may suppress antitumor immunity. This phase I study sought to determine the safety and tolerability of anti-PD-1 blockade in patients with treatment-refractory solid tumors and to preliminarily assess antitumor activity, pharmacodynamics, and immunologic correlates. PATIENTS AND METHODS Thirty-nine patients with advanced metastatic melanoma, colorectal cancer (CRC), castrate-resistant prostate cancer, non-small-cell lung cancer (NSCLC), or renal cell carcinoma (RCC) received a single intravenous infusion of anti-PD-1 (MDX-1106) in dose-escalating six-patient cohorts at 0.3, 1, 3, or 10 mg/kg, followed by a 15-patient expansion cohort at 10 mg/kg. Patients with evidence of clinical benefit at 3 months were eligible for repeated therapy. RESULTS Anti-PD-1 was well tolerated: one serious adverse event, inflammatory colitis, was observed in a patient with melanoma who received five doses at 1 mg/kg. One durable complete response (CRC) and two partial responses (PRs; melanoma, RCC) were seen. Two additional patients (melanoma, NSCLC) had significant lesional tumor regressions not meeting PR criteria. The serum half-life of anti-PD-1 was 12 to 20 days. However, pharmacodynamics indicated a sustained mean occupancy of > 70% of PD-1 molecules on circulating T cells ≥ 2 months following infusion, regardless of dose. In nine patients examined, tumor cell surface B7-H1 expression appeared to correlate with the likelihood of response to treatment. CONCLUSION Blocking the PD-1 immune checkpoint with intermittent antibody dosing is well tolerated and associated with evidence of antitumor activity. Exploration of alternative dosing regimens and combinatorial therapies with vaccines, targeted therapies, and/or other checkpoint inhibitors is warranted.
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Affiliation(s)
- Julie R Brahmer
- From the Johns Hopkins University School of Medicine and the Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Henry Ford Health Systems, Detroit, MI; Carolina BioOncology Institute, Huntersville, NC; Washington University School of Medicine Siteman Cancer Center, St Louis, MO; and Medarex, Bloomsbury, NJ, and Milpitas, CA
| | - Charles G Drake
- From the Johns Hopkins University School of Medicine and the Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Henry Ford Health Systems, Detroit, MI; Carolina BioOncology Institute, Huntersville, NC; Washington University School of Medicine Siteman Cancer Center, St Louis, MO; and Medarex, Bloomsbury, NJ, and Milpitas, CA
| | - Ira Wollner
- From the Johns Hopkins University School of Medicine and the Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Henry Ford Health Systems, Detroit, MI; Carolina BioOncology Institute, Huntersville, NC; Washington University School of Medicine Siteman Cancer Center, St Louis, MO; and Medarex, Bloomsbury, NJ, and Milpitas, CA
| | - John D Powderly
- From the Johns Hopkins University School of Medicine and the Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Henry Ford Health Systems, Detroit, MI; Carolina BioOncology Institute, Huntersville, NC; Washington University School of Medicine Siteman Cancer Center, St Louis, MO; and Medarex, Bloomsbury, NJ, and Milpitas, CA
| | - Joel Picus
- From the Johns Hopkins University School of Medicine and the Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Henry Ford Health Systems, Detroit, MI; Carolina BioOncology Institute, Huntersville, NC; Washington University School of Medicine Siteman Cancer Center, St Louis, MO; and Medarex, Bloomsbury, NJ, and Milpitas, CA
| | - William H Sharfman
- From the Johns Hopkins University School of Medicine and the Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Henry Ford Health Systems, Detroit, MI; Carolina BioOncology Institute, Huntersville, NC; Washington University School of Medicine Siteman Cancer Center, St Louis, MO; and Medarex, Bloomsbury, NJ, and Milpitas, CA
| | - Elizabeth Stankevich
- From the Johns Hopkins University School of Medicine and the Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Henry Ford Health Systems, Detroit, MI; Carolina BioOncology Institute, Huntersville, NC; Washington University School of Medicine Siteman Cancer Center, St Louis, MO; and Medarex, Bloomsbury, NJ, and Milpitas, CA
| | - Alice Pons
- From the Johns Hopkins University School of Medicine and the Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Henry Ford Health Systems, Detroit, MI; Carolina BioOncology Institute, Huntersville, NC; Washington University School of Medicine Siteman Cancer Center, St Louis, MO; and Medarex, Bloomsbury, NJ, and Milpitas, CA
| | - Theresa M Salay
- From the Johns Hopkins University School of Medicine and the Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Henry Ford Health Systems, Detroit, MI; Carolina BioOncology Institute, Huntersville, NC; Washington University School of Medicine Siteman Cancer Center, St Louis, MO; and Medarex, Bloomsbury, NJ, and Milpitas, CA
| | - Tracee L McMiller
- From the Johns Hopkins University School of Medicine and the Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Henry Ford Health Systems, Detroit, MI; Carolina BioOncology Institute, Huntersville, NC; Washington University School of Medicine Siteman Cancer Center, St Louis, MO; and Medarex, Bloomsbury, NJ, and Milpitas, CA
| | - Marta M Gilson
- From the Johns Hopkins University School of Medicine and the Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Henry Ford Health Systems, Detroit, MI; Carolina BioOncology Institute, Huntersville, NC; Washington University School of Medicine Siteman Cancer Center, St Louis, MO; and Medarex, Bloomsbury, NJ, and Milpitas, CA
| | - Changyu Wang
- From the Johns Hopkins University School of Medicine and the Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Henry Ford Health Systems, Detroit, MI; Carolina BioOncology Institute, Huntersville, NC; Washington University School of Medicine Siteman Cancer Center, St Louis, MO; and Medarex, Bloomsbury, NJ, and Milpitas, CA
| | - Mark Selby
- From the Johns Hopkins University School of Medicine and the Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Henry Ford Health Systems, Detroit, MI; Carolina BioOncology Institute, Huntersville, NC; Washington University School of Medicine Siteman Cancer Center, St Louis, MO; and Medarex, Bloomsbury, NJ, and Milpitas, CA
| | - Janis M Taube
- From the Johns Hopkins University School of Medicine and the Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Henry Ford Health Systems, Detroit, MI; Carolina BioOncology Institute, Huntersville, NC; Washington University School of Medicine Siteman Cancer Center, St Louis, MO; and Medarex, Bloomsbury, NJ, and Milpitas, CA
| | - Robert Anders
- From the Johns Hopkins University School of Medicine and the Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Henry Ford Health Systems, Detroit, MI; Carolina BioOncology Institute, Huntersville, NC; Washington University School of Medicine Siteman Cancer Center, St Louis, MO; and Medarex, Bloomsbury, NJ, and Milpitas, CA
| | - Lieping Chen
- From the Johns Hopkins University School of Medicine and the Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Henry Ford Health Systems, Detroit, MI; Carolina BioOncology Institute, Huntersville, NC; Washington University School of Medicine Siteman Cancer Center, St Louis, MO; and Medarex, Bloomsbury, NJ, and Milpitas, CA
| | - Alan J Korman
- From the Johns Hopkins University School of Medicine and the Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Henry Ford Health Systems, Detroit, MI; Carolina BioOncology Institute, Huntersville, NC; Washington University School of Medicine Siteman Cancer Center, St Louis, MO; and Medarex, Bloomsbury, NJ, and Milpitas, CA
| | - Drew M Pardoll
- From the Johns Hopkins University School of Medicine and the Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Henry Ford Health Systems, Detroit, MI; Carolina BioOncology Institute, Huntersville, NC; Washington University School of Medicine Siteman Cancer Center, St Louis, MO; and Medarex, Bloomsbury, NJ, and Milpitas, CA
| | - Israel Lowy
- From the Johns Hopkins University School of Medicine and the Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Henry Ford Health Systems, Detroit, MI; Carolina BioOncology Institute, Huntersville, NC; Washington University School of Medicine Siteman Cancer Center, St Louis, MO; and Medarex, Bloomsbury, NJ, and Milpitas, CA
| | - Suzanne L Topalian
- From the Johns Hopkins University School of Medicine and the Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Henry Ford Health Systems, Detroit, MI; Carolina BioOncology Institute, Huntersville, NC; Washington University School of Medicine Siteman Cancer Center, St Louis, MO; and Medarex, Bloomsbury, NJ, and Milpitas, CA
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8
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Koury MJ, Agarwal R, Chertow GM, Eckardt K, Fishbane S, Ganz T, Haase VH, Hanudel MR, Parfrey PS, Pergola PE, Roy‐Chaudhury P, Tumlin JA, Anders R, Farag YMK, Luo W, Minga T, Solinsky C, Vargo DL, Winkelmayer WC. Erythropoietic effects of vadadustat in patients with anemia associated with chronic kidney disease. Am J Hematol 2022; 97:1178-1188. [PMID: 35751858 PMCID: PMC9543410 DOI: 10.1002/ajh.26644] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 06/20/2022] [Indexed: 11/09/2022]
Abstract
Patients with chronic kidney disease (CKD) develop anemia largely because of inappropriately low erythropoietin (EPO) production and insufficient iron available to erythroid precursors. In four phase 3, randomized, open-label, clinical trials in dialysis-dependent and non-dialysis-dependent patients with CKD and anemia, the hypoxia-inducible factor prolyl hydroxylase inhibitor, vadadustat, was noninferior to the erythropoiesis-stimulating agent, darbepoetin alfa, in increasing and maintaining target hemoglobin concentrations. In these trials, vadadustat increased the concentrations of serum EPO, the numbers of circulating erythrocytes, and the numbers of circulating reticulocytes. Achieved hemoglobin concentrations were similar in patients treated with either vadadustat or darbepoetin alfa, but compared with patients receiving darbepoetin alfa, those receiving vadadustat had erythrocytes with increased mean corpuscular volume and mean corpuscular hemoglobin, while the red cell distribution width was decreased. Increased serum transferrin concentrations, as measured by total iron-binding capacity, combined with stable serum iron concentrations, resulted in decreased transferrin saturation in patients randomized to vadadustat compared with patients randomized to darbepoetin alfa. The decreases in transferrin saturation were associated with relatively greater declines in serum hepcidin and ferritin in patients receiving vadadustat compared with those receiving darbepoetin alfa. These results for serum transferrin saturation, hepcidin, ferritin, and erythrocyte indices were consistent with improved iron availability in the patients receiving vadadustat. Thus, overall, vadadustat had beneficial effects on three aspects of erythropoiesis in patients with anemia associated with CKD: increased endogenous EPO production, improved iron availability to erythroid cells, and increased reticulocytes in the circulation.
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Affiliation(s)
- Mark J. Koury
- Division of Hematology/Oncology, Department of MedicineVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Rajiv Agarwal
- Department of Medicine, Division of NephrologyIndiana University School of MedicineIndianapolisIndianaUSA
| | | | - Kai‐Uwe Eckardt
- Department of Nephrology and Medical Intensive CareCharité – Universitätsmedizin BerlinBerlinGermany
| | - Steven Fishbane
- Division of Nephrology, Department of MedicineHofstra Northwell School of MedicineGreat NeckNew YorkUSA
| | - Tomas Ganz
- Department of Medicine and Pathology, David Geffen School of MedicineUniversity of CaliforniaLos AngelesCaliforniaUSA
| | - Volker H. Haase
- Department of MedicineVanderbilt University Medical CenterNashvilleTennesseeUSA
- Department of Medical Cell BiologyUppsala UniversityUppsalaSweden
| | - Mark R. Hanudel
- Department of Pediatrics, Division of Pediatric Nephrology, David Geffen School of MedicineUniversity of CaliforniaLos AngelesCaliforniaUSA
| | - Patrick S. Parfrey
- Department of MedicineMemorial UniversitySt John'sNewfoundland and LabradorCanada
| | | | | | | | | | | | - Wenli Luo
- Akebia Therapeutics, Inc.CambridgeMassachusettsUSA
| | - Todd Minga
- Akebia Therapeutics, Inc.CambridgeMassachusettsUSA
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9
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Deshpande A, Loth M, Sidiropoulos D, Zhu Q, Stein-O'Brien G, Rao NI, Uytingco C, Williams S, Santa-Maria C, Gilkes DM, Zhang L, Jaffee E, Anders R, Danilova L, Kagohara LT, Fertig EJ. Abstract 2130: Uncovering the spatial landscape of tumor-immune interactions using latent spaces from spatial transcriptomics. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-2130] [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
Recent advances in spatial transcriptomics (ST) enable us to measure gene expression from cancer tissues while retaining their spatial context. We present a novel bioinformatics pipeline to infer molecular changes from tumor and immune cell interactions in the tumor microenvironment (TME) from ST data. Latent space methods enable inference of biological patterns from ST without the need for spot deconvolution into cell-based spatial features. While linear latent space methods yield interpretable biological patterns, interactions between tumor and immune cells can be nonlinear. To enable comprehensive inference of the pathways in the TME, we developed novel algorithms to characterize biological patterns from ST data using linear latent space methods and further nonlinear effects from their interactions. For any given set of genes, the patternSpotter tool visualizes the spatial variation in the relative contribution of individual patterns to the aggregate expression at each location in the tumor sample. Application of this tool to latent features identified using CoGAPS non-negative matrix factorization on a Visium ST (10x Genomics) data from a lymph node with pancreatic cancer metastasis confirms its known immune cell architecture. Furthermore, we develop a patternMarker algorithm to identify sets of coexpressed genes associated with the patterns, which help us to pinpoint the underlying biological processes and cell types. Further analyzing a breast cancer sample with invasive carcinoma and multiple precursor lesions demonstrates that this approach can uncover tumor and immune regions without prior reliance on pathology annotations from H&E imaging. In this case, an ensemble-based factorization of multiple dimensions enhances our resolution of intra-tumor heterogeneity and identifies distinct hormone receptor pathways in different precursor lesions with the patternMarker algorithm. Additional latent features are associated with immune cells, revealing further heterogeneity in immune infiltration between the invasive carcinoma and distinct precursor lesions. Still, the molecular interactions resulting from this infiltration induce a further non-linear alteration to transcription not captured through the inferred latent spaces. To resolve this, we develop a further interactionMarker statistic to identify regions of inter-pattern interaction and the associated genes. We apply this approach to detect additional intra-tumor heterogeneity in immune signaling from infiltration suggestive of differences in immune attack of invasive lesions. Altogether, our pipeline for latent space analysis of ST can identify the location and context-specific molecular interactions within the TME, broadly applicable to a better understanding of the key drivers of tumorigenesis and resistance to immune attack in cancer.
Citation Format: Atul Deshpande, Melanie Loth, Dimitrios Sidiropoulos, QingFeng Zhu, Genevieve Stein-O'Brien, NIkhil Rao, Cedric Uytingco, Stephen Williams, Cesar Santa-Maria, Daniele M. Gilkes, Lei Zhang, Elizabeth Jaffee, Robert Anders, Ludmila Danilova, Luciane T. Kagohara, Elana J. Fertig. Uncovering the spatial landscape of tumor-immune interactions using latent spaces from spatial transcriptomics [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2130.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Lei Zhang
- 1Johns Hopkins University, Baltimore, MD
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10
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Kagohara LT, Zhang S, Yuan L, Zhu Q, Anders R, Shu D, Popel AS, Jaffee EM, Yarchoan M, Fertig EJ. Abstract 3820: Spatial transcriptomics of advanced hepatocellular carcinomas distinguishes intercellular interactions in responders and non-responders to cabozantinib and nivolumab neoadjuvant therapy. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-3820] [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
The recent development of genome-wide spatial transcriptomics (ST) approaches enable near single-cell gene expression profiling to infer cellular composition and intercellular interactions that drive cancer development and responses to therapy. This study applied ST on 10 surgical biospecimens from a clinical trial with neoadjuvant therapy with cabozantinib (multi-kinase inhibitor) and nivolumab (anti-PD-1 monoclonal antibody) with advanced hepatocellular carcinoma (HCC). Within our cohort, 6 of the samples were obtained from non-responders and 4 with demonstrated pathological response were previously associated with immune infiltration using spatial proteomics technologies. Our analysis with ST was performed to determine the specific pathways that drive immune infiltration in responders and to map intercellular interactions relevant for response and resistance to the combined therapy.Analysis of these data uncovered three main differences between responders and non-responders. First, to better understand the tumor mechanisms of response and resistance, we performed differential expression and pathway analysis only in the subset of tumor clusters from responders versus non-responders. In responders, we observed enrichment for pathways associated with immune response (TNF-alpha, IFN-gamma, T cell differentiation), while in non-responders the deregulated pathways are associated with cell growth, transcriptional activity and hypoxia (Myc, E2F, oxidative phosphorylation). Second, the intercellular interaction analyses indicate that CD8-HLA interactions are more abundant in responders, while interactions activating VEGFR, the main target of cabozantinib, are enriched in non-responders. The interaction profiles are evidence that in responders the tumor cells express tumor specific antigens that are recognized by the cytotoxic cells which activity is enhanced by nivolumab. In non-responders, the activation of the VEGF pathway is an indication that the tumor cells have developed mechanism of resistance to cabozantinib. Third, responding tumors have higher densities of immune and stromal cells, and the immune cells are enriched with aggregates composed of both B and T cells. The regions surrounded by these immune aggregates are transcriptionally distinct from regions enriched for stromal cells, suggesting that tumor gene expression profile drives immune infiltration.Overall, the ST analysis of neoadjuvant HCC treated samples detects tumor induced immune cell immune infiltration in responders compared to non-responders with enrichment of cytotoxic interactions to eliminate the tumor cells. It also identifies intercellular interactions suggestive of resistance to anti-VEGF blockade.
Citation Format: Luciane T. Kagohara, Shuming Zhang, Long Yuan, Qingfeng Zhu, Robert Anders, Daniel Shu, Aleksander S. Popel, Elizabeth M. Jaffee, Mark Yarchoan, Elana J. Fertig. Spatial transcriptomics of advanced hepatocellular carcinomas distinguishes intercellular interactions in responders and non-responders to cabozantinib and nivolumab neoadjuvant therapy [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 3820.
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Affiliation(s)
| | | | - Long Yuan
- 1Johns Hopkins School of Medicine, Baltimore, MD
| | - Qingfeng Zhu
- 1Johns Hopkins School of Medicine, Baltimore, MD
| | | | - Daniel Shu
- 1Johns Hopkins School of Medicine, Baltimore, MD
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11
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Shu DH, Danilova L, Yuan L, Zhu Q, Wang H, Kagohara L, Anders R, Jaffee E, Fertig E, Yarchoan M. Abstract 1323: 12-chemokine gene signature identifies major pathologic response in patients with hepatocellular carcinoma treated with neoadjuvant nivolumab and cabozantinib. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-1323] [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: Tertiary lymphoid structures (TLS) are ectopic lymphoid organs that develop at sites of chronic inflammation. In many solid tumors they have been linked with improved survival, but their prognostic value in hepatocellular carcinoma (HCC) remains uncertain. In immunotherapy-naïve patients with HCC, peritumoral and intratumoral TLS have been associated with improved overall survival, but TLS and increased expression of an associated 12-chemokine gene signature in tumor-adjacent liver parenchyma have also been linked to worse outcomes. In patients with HCC receiving immunotherapy, the prognostic value of TLS and the 12-chemokine signature is not known.
Methods: We collected formalin-fixed, paraffin-embedded tumors of 12 patients with locally advanced HCC treated with neoadjuvant nivolumab and cabozantinib followed by surgical resection. We used immunohistochemistry and imaging mass cytometry to determine TLS density and immunophenotype. We obtained bulk RNA sequencing from 9 patients (4 responders and 5 non-responders) and used hierarchical clustering to define subgroups of patients according to expression of a previously validated 12-chemokine gene signature. The prognostic value of the chemokine signature for predicting disease free survival (DFS) was calculated using the Kaplan-Meier method and analyzed by log-rank test. Additional analysis of the spatial heterogeneity of the 12-chemokine signature was performed using spatial transcriptomics.
Results: Increased TLS density was associated with a major pathologic response to treatment (p = 0.006). Hierarchical clustering of expression of the 12-chemokine gene signature identified increased expression in 4 responders and 1 non-responder and decreased expression in 4 non-responders. The association between chemokine expression and pathologic response to treatment was statistically significant by Fisher’s exact test (p = 0.008). Patients with increased expression of the 12-chemokine signature showed a trend toward improved DFS (HR = 0.23, 95% CI 0.03 to 3.05). Spatial transcriptomics showed heterogeneous chemokine expression across the resection specimen which was highest in immune clusters.
Conclusions: Using immunohistochemistry, bulk RNA sequencing, and spatial transcriptomics, we show that TLS and a TLS-associated 12-chemokine gene signature are associated with a favorable response to treatment in patients receiving neoadjuvant nivolumab and cabozantinib for HCC. We found a trend toward improved DFS in patients with increased expression of the 12-chemokine signature, a finding which should be evaluated in a larger cohort. Further research is necessary to determine the functional role of TLS in anti-tumor immunity.
Citation Format: Daniel H. Shu, Ludmila Danilova, Long Yuan, Qingfeng Zhu, Hao Wang, Luciane Kagohara, Robert Anders, Elizabeth Jaffee, Elana Fertig, Mark Yarchoan. 12-chemokine gene signature identifies major pathologic response in patients with hepatocellular carcinoma treated with neoadjuvant nivolumab and cabozantinib [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1323.
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Affiliation(s)
- Daniel H. Shu
- 1Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
| | - Ludmila Danilova
- 1Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
| | - Long Yuan
- 2Johns Hopkins University School of Medicine, Baltimore, MD
| | - Qingfeng Zhu
- 2Johns Hopkins University School of Medicine, Baltimore, MD
| | - Hao Wang
- 1Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
| | - Luciane Kagohara
- 1Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
| | - Robert Anders
- 2Johns Hopkins University School of Medicine, Baltimore, MD
| | - Elizabeth Jaffee
- 1Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
| | - Elana Fertig
- 1Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
| | - Mark Yarchoan
- 1Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
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12
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Xie F, Ding D, Lin C, Cunningham D, Wright M, Javed AA, Azad N, Lee V, Donehower R, De Jesus-Acosta A, Le DT, Pishvaian M, Shin EJ, Lennon AM, Khashab M, Singh V, Klein AP, Roberts NJ, Hacker-Prietz A, McPhaul T, Burkhart RA, Burns WR, Narang A, Zaheer A, Fishman EK, Thompson ED, Anders R, Yu J, He J, Wolfgang CL, Zheng L, Liu D, Wu K, Laheru DA. RAD51B Harbors Germline Mutations Associated With Pancreatic Ductal Adenocarcinoma. JCO Precis Oncol 2022; 6:e2100404. [PMID: 35737913 PMCID: PMC9848593 DOI: 10.1200/po.21.00404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 02/14/2022] [Accepted: 04/21/2022] [Indexed: 01/21/2023] Open
Abstract
PURPOSE Genetic alterations in many components of the homologous recombination, DNA damage response, and repair (HR-DDR) pathway are involved in the hereditary cancer syndromes, including familial pancreatic cancer. HR-DDR genes beyond BRCA1, BRCA2, ATM, and PALB2 may also mutate and confer the HR-DDR deficiency in pancreatic ductal adenocarcinoma (PDAC). METHODS We conducted a study to examine the genetic alterations using a companion diagnostic 15-gene HR-DDR panel in PDACs. HR-DDR gene mutations were identified and characterized by whole-exome sequencing and whole-genome sequencing. Different HR-DDR gene mutations are associated with variable homologous recombination deficiency (HRD) scores. RESULTS Eight of 50 PDACs with at least one HR-DDR gene mutation were identified. One tumor with BRCA2 mutations is associated with a high HRD score. However, another tumor with a CHEK2 mutation is associated with a zero HRD score. Notably, four of eight PDACs in this study harbor a RAD51B gene mutation. All four RAD51B gene mutations were germline mutations. However, currently, RAD51B is not the gene panel for germline tests. CONCLUSION The finding in this study thus supports including RAD51B in the germline test of HR-DDR pathway genes.
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Affiliation(s)
- Fanfan Xie
- BGI-Shenzhen, Shenzhen, China
- Guangdong Provincial Key Laboratory of Human Disease Genomics, Shenzhen Key Laboratory of Genomics, Shenzhen, China
| | - Ding Ding
- The Pancreatic Cancer “Precision Medicine” Program, The Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Cong Lin
- BGI-Shenzhen, Shenzhen, China
- Guangdong Provincial Key Laboratory of Human Disease Genomics, Shenzhen Key Laboratory of Genomics, Shenzhen, China
| | - Dea Cunningham
- The Pancreatic Cancer “Precision Medicine” Program, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Michael Wright
- The Pancreatic Cancer “Precision Medicine” Program, The Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Ammar A. Javed
- The Pancreatic Cancer “Precision Medicine” Program, The Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Nilo Azad
- The Pancreatic Cancer “Precision Medicine” Program, The Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Valerie Lee
- The Pancreatic Cancer “Precision Medicine” Program, The Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Ross Donehower
- The Pancreatic Cancer “Precision Medicine” Program, The Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Ana De Jesus-Acosta
- The Pancreatic Cancer “Precision Medicine” Program, The Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Dung T. Le
- The Pancreatic Cancer “Precision Medicine” Program, The Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Michael Pishvaian
- The Pancreatic Cancer “Precision Medicine” Program, The Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Eun Ji Shin
- The Pancreatic Cancer “Precision Medicine” Program, The Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Gastroenterology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Anne Marie Lennon
- The Pancreatic Cancer “Precision Medicine” Program, The Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Gastroenterology, The Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Mouen Khashab
- The Pancreatic Cancer “Precision Medicine” Program, The Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Gastroenterology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Vikesh Singh
- The Pancreatic Cancer “Precision Medicine” Program, The Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Gastroenterology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Alison P. Klein
- Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD
- The Sol Goldman Pancreatic Cancer Research Center, Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Nicholas J. Roberts
- Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD
- The Sol Goldman Pancreatic Cancer Research Center, Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Amy Hacker-Prietz
- The Pancreatic Cancer “Precision Medicine” Program, The Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Radiation Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Thomas McPhaul
- The Pancreatic Cancer “Precision Medicine” Program, The Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Richard A. Burkhart
- The Pancreatic Cancer “Precision Medicine” Program, The Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - William R. Burns
- The Pancreatic Cancer “Precision Medicine” Program, The Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Amol Narang
- The Pancreatic Cancer “Precision Medicine” Program, The Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Radiation Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Atif Zaheer
- The Pancreatic Cancer “Precision Medicine” Program, The Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Elliot K. Fishman
- The Pancreatic Cancer “Precision Medicine” Program, The Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Elizabeth D. Thompson
- The Pancreatic Cancer “Precision Medicine” Program, The Johns Hopkins University School of Medicine, Baltimore, MD
- The Sol Goldman Pancreatic Cancer Research Center, Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Robert Anders
- The Pancreatic Cancer “Precision Medicine” Program, The Johns Hopkins University School of Medicine, Baltimore, MD
- The Sol Goldman Pancreatic Cancer Research Center, Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jun Yu
- The Pancreatic Cancer “Precision Medicine” Program, The Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jin He
- The Pancreatic Cancer “Precision Medicine” Program, The Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Christopher L. Wolfgang
- The Pancreatic Cancer “Precision Medicine” Program, The Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Lei Zheng
- The Pancreatic Cancer “Precision Medicine” Program, The Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Dongbing Liu
- BGI-Shenzhen, Shenzhen, China
- Guangdong Provincial Key Laboratory of Human Disease Genomics, Shenzhen Key Laboratory of Genomics, Shenzhen, China
| | - Kui Wu
- BGI-Shenzhen, Shenzhen, China
- Guangdong Provincial Key Laboratory of Human Disease Genomics, Shenzhen Key Laboratory of Genomics, Shenzhen, China
| | - Daniel A. Laheru
- The Pancreatic Cancer “Precision Medicine” Program, The Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD
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13
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Yamada T, Murata D, Kleiner DE, Anders R, Rosenberg AZ, Kaplan J, Hamilton JP, Aghajan M, Levi M, Wang NY, Dawson TM, Yanagawa T, Powers AF, Iijima M, Sesaki H. Prevention and regression of megamitochondria and steatosis by blocking mitochondrial fusion in the liver. iScience 2022; 25:103996. [PMID: 35310936 PMCID: PMC8927900 DOI: 10.1016/j.isci.2022.103996] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/06/2022] [Accepted: 02/24/2022] [Indexed: 02/07/2023] Open
Abstract
Non-alcoholic steatohepatitis (NASH) is a most common chronic liver disease that is manifested by steatosis, inflammation, fibrosis, and tissue damage. Hepatocytes produce giant mitochondria termed megamitochondria in patients with NASH. It has been shown that gene knockout of OPA1, a mitochondrial dynamin-related GTPase that mediates mitochondrial fusion, prevents megamitochondria formation and liver damage in a NASH mouse model induced by a methionine-choline-deficient (MCD) diet. However, it is unknown whether blocking mitochondrial fusion mitigates NASH pathologies. Here, we acutely depleted OPA1 using antisense oligonucleotides in the NASH mouse model before or after megamitochondria formation. When OPA1 ASOs were applied at the disease onset, they effectively prevented megamitochondria formation and liver pathologies in the MCD model. Notably, even when applied after mice robustly developed NASH pathologies, OPA1 targeting effectively regressed megamitochondria and the disease phenotypes. Thus, our data show the efficacy of mitochondrial dynamics as a unique therapy for megamitochondria-associated liver disease. A NASH mouse model induced by the MCD diet produces megamitochondria in hepatocytes Megamitochondria decrease mitophagy Blocking mitochondrial fusion by targeting OPA1 mitigates NASH pathologies Targeting OPA1 improves the SDH activity in the MCD model
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14
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Zhang S, Zhu Q, Gross N, Charmsaz S, Deshpande A, Xavier S, Mohan A, Leatherman J, Mo G, Durham J, Popovic A, Wilt B, Lin D, Quong D, Anders R, Fertig E, Jaffee EM, Yarchoan M, Ho WJ. Abstract 1682: Imaging mass cytometry reveals key spatial features among immune cells in hepatocellular carcinomas treated with neoadjuvant cabozantinib and nivolumab. Cancer Res 2021. [DOI: 10.1158/1538-7445.am2021-1682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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
Hepatocellular carcinoma (HCC) is the most common form of primary liver cancer and carries a poor prognosis. Most HCC is unresectable at presentation, and until recently, the use of perioperative systemic therapy has been hampered by a lack of any effective therapies. We recently conducted a single-arm trial of neoadjuvant cabozantinib followed by nivolumab for borderline resectable or locally advanced HCC (NCT03299946), through which secondary resectability was obtained in a subset of patients. Of 15 patients enrolled, 12/15 patients achieved margin-negative resection, and 5/12 resected patients experienced a major or complete pathologic response. Here we characterize changes in the tumor microenvironment (TME) induced by neoadjuvant therapy. We constructed a tissue microarray containing 37 core liver biopsies (15 from responders, 22 from nonresponders), stained with a 27-marker panel, and used ilastik and CellProfiler to segment the resulting images, producing a single-cell dataset comprising 59,453 cells. We then used FlowSOM to perform unbiased clustering of cells, which we annotated into 17 cell types. Next, we performed spatial analysis using Voronoi diagrams and top neighbors mapping. We generated a minimum spanning tree using shortest Euclidean distances to model the simplest spatial relationships among all cell types and ranked their importance using random forest models. Grossly, responder cores were characterized by the presence of tertiary lymphoid aggregates, as well as a higher percent abundance of several immune cell types, including CD4 T (p < 0.05) and CD8 T cells (p < 0.005). In responders, Voronoi diagrams revealed denser packing of most immune cell types, particularly B cells (p < 0.005), and top neighbors analysis indicated higher numbers of lymphoid-lymphoid, myeloid-myeloid, and lymphoid-myeloid neighbors. This suggests that response is characterized by immune infiltration of the TME. Exploring this further, a minimum spanning tree showed that in nonresponders, CD8 T cells were flanked by CD163+ macrophages, whereas in responders, HCC cells were closely linked to lymphoid cells. Importance plots from random forest models for B, CD4 T, and CD8 T cells revealed that top predictors of responder status were higher minimum distance from CD163+ Arg1+ macrophages and lower minimum distance from CD163+ Ki67+ macrophages, which express higher levels of PD-L1. This suggests that proximity of B and T cells to macrophages that exert immunosuppression via Arg1 is a critical feature of resistance to cabozantinib plus nivolumab, whereas proximity to proliferative macrophages that express higher levels of PD-L1 is a key feature of response. In conclusion, cabozantinib and nivolumab can effectively promote antitumor immunity by altering both the abundance and spatial organization of macrophages, B cells, and T cells in the HCC TME.
Citation Format: Shu Zhang, Qingfeng Zhu, Nicole Gross, Soren Charmsaz, Atul Deshpande, Stephanie Xavier, Aditya Mohan, James Leatherman, Guanglan Mo, Jennifer Durham, Aleksandra Popovic, Brad Wilt, Dongxia Lin, Derek Quong, Robert Anders, Elana Fertig, Elizabeth M. Jaffee, Mark Yarchoan, Won J. Ho. Imaging mass cytometry reveals key spatial features among immune cells in hepatocellular carcinomas treated with neoadjuvant cabozantinib and nivolumab [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 1682.
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Affiliation(s)
- Shu Zhang
- 1Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
| | - Qingfeng Zhu
- 2Johns Hopkins University School of Medicine, Baltimore, MD
| | - Nicole Gross
- 1Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
| | - Soren Charmsaz
- 1Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
| | - Atul Deshpande
- 3McKusick-Nathans Institute of Genetic Medicine at Johns Hopkins, Baltimore, MD
| | - Stephanie Xavier
- 1Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
| | - Aditya Mohan
- 1Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
| | - James Leatherman
- 1Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
| | - Guanglan Mo
- 1Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
| | - Jennifer Durham
- 1Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
| | - Aleksandra Popovic
- 1Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
| | - Brad Wilt
- 1Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
| | - Dongxia Lin
- 4Fluidigm Corporation, South San Francisco, CA
| | - Derek Quong
- 4Fluidigm Corporation, South San Francisco, CA
| | - Robert Anders
- 2Johns Hopkins University School of Medicine, Baltimore, MD
| | - Elana Fertig
- 3McKusick-Nathans Institute of Genetic Medicine at Johns Hopkins, Baltimore, MD
| | | | - Mark Yarchoan
- 1Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
| | - Won J. Ho
- 1Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
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15
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Cheung LS, Chen L, Oke TF, Schaffer TB, Boudadi K, Ngo JT, Gross JM, Kemberling H, Diaz LA, Lipson E, Sidhom JWI, Taube J, Anders R, Pardoll DM, Le DT, Meyer CF, Llosa N. Anti-PD-1 elicits regression of undifferentiated pleomorphic sarcomas with UV-mutation signatures. J Immunother Cancer 2021; 9:e002345. [PMID: 34103354 PMCID: PMC8190056 DOI: 10.1136/jitc-2021-002345] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2021] [Indexed: 01/07/2023] Open
Abstract
Undifferentiated pleomorphic sarcoma (UPS), an aggressive soft-tissue sarcoma of adults, has been characterized by low tumor mutational burden (TMB) and high copy number alterations. Clinical trials of programmed death-1 (PD-1) blockade in UPS have reported widely varying efficacy. We describe two patients with recurrent scalp UPS that experienced clinical benefit from PD-1 blockade. These tumors had high TMB with a UV-induced mutational pattern. Analysis of additional head and neck UPS cases identified five out of seven tumors with high TMB and an ultraviolet (UV) mutational signature. Head and neck UPS tumors also had increased programmed death-ligand 1 (PD-L1) expression and CD8+ T cell infiltration as compared with UPS tumors arising from other sites. In summary, we found that UPS tumors of the head and neck, but not elsewhere, have a PD-L1+, T-cell-inflamed tumor microenvironment and high TMB, suggesting that these tumors represent a distinct genetic subgroup of UPS for which immune checkpoint inhibitor therapy might be effective.
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Affiliation(s)
- Laurene S Cheung
- Johns Hopkins Bloomberg~Kimmel Institute for Cancer Immunotherapy, Baltimore, Maryland, USA
- Department of Oncology, Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
| | - Lingling Chen
- Johns Hopkins Bloomberg~Kimmel Institute for Cancer Immunotherapy, Baltimore, Maryland, USA
- Department of Oncology, Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
| | - Teniola F Oke
- Johns Hopkins Bloomberg~Kimmel Institute for Cancer Immunotherapy, Baltimore, Maryland, USA
- Department of Oncology, Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
| | | | - Karim Boudadi
- Department of Oncology, Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
| | - Jillian T Ngo
- Johns Hopkins Bloomberg~Kimmel Institute for Cancer Immunotherapy, Baltimore, Maryland, USA
| | - John McMahon Gross
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Holly Kemberling
- Department of Oncology, Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
| | - Luis A Diaz
- Division of Solid Tumor Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Evan Lipson
- Johns Hopkins Bloomberg~Kimmel Institute for Cancer Immunotherapy, Baltimore, Maryland, USA
- Department of Oncology, Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
| | - John-WIlliam Sidhom
- Johns Hopkins Bloomberg~Kimmel Institute for Cancer Immunotherapy, Baltimore, Maryland, USA
- Department of Oncology, Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
| | - Janis Taube
- Johns Hopkins Bloomberg~Kimmel Institute for Cancer Immunotherapy, Baltimore, Maryland, USA
- Department of Oncology, Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Robert Anders
- Johns Hopkins Bloomberg~Kimmel Institute for Cancer Immunotherapy, Baltimore, Maryland, USA
- Department of Oncology, Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Drew M Pardoll
- Johns Hopkins Bloomberg~Kimmel Institute for Cancer Immunotherapy, Baltimore, Maryland, USA
- Department of Oncology, Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
| | - Dung T Le
- Johns Hopkins Bloomberg~Kimmel Institute for Cancer Immunotherapy, Baltimore, Maryland, USA
- Department of Oncology, Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
| | - Christian F Meyer
- Department of Oncology, Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
| | - Nicolas Llosa
- Johns Hopkins Bloomberg~Kimmel Institute for Cancer Immunotherapy, Baltimore, Maryland, USA
- Department of Oncology, Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
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16
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Ligon JA, Choi W, Cojocaru G, Fu W, Hsiue EHC, Oke TF, Siegel N, Fong MH, Ladle B, Pratilas CA, Morris CD, Levin A, Rhee DS, Meyer CF, Tam AJ, Blosser R, Thompson ED, Suru A, McConkey D, Housseau F, Anders R, Pardoll DM, Llosa N. Pathways of immune exclusion in metastatic osteosarcoma are associated with inferior patient outcomes. J Immunother Cancer 2021; 9:jitc-2020-001772. [PMID: 34021032 PMCID: PMC8144029 DOI: 10.1136/jitc-2020-001772] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [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] [Accepted: 02/10/2021] [Indexed: 12/02/2022] Open
Abstract
Background Current therapy for osteosarcoma pulmonary metastases (PMs) is ineffective. The mechanisms that prevent successful immunotherapy in osteosarcoma are incompletely understood. We investigated the tumor microenvironment of metastatic osteosarcoma with the goal of harnessing the immune system as a therapeutic strategy. Methods 66 osteosarcoma tissue specimens were analyzed by immunohistochemistry (IHC) and immune markers were digitally quantified. Tumor-infiltrating lymphocytes (TILs) from 25 specimens were profiled by functional cytometry. Comparative transcriptomic studies of distinct tumor-normal lung ‘PM interface’ and ‘PM interior’ regions from 16 PMs were performed. Clinical follow-up (median 24 months) was available from resection. Results IHC revealed a statistically significantly higher concentration of TILs expressing immune checkpoint and immunoregulatory molecules in PMs compared with primary bone tumors (including programmed cell death 1 (PD-1), programmed death ligand 1 (PD-L1), lymphocyte-activation gene 3 (LAG-3), T-cell immunoglobulin and mucin domain-containing protein 3 (TIM-3), and indoleamine 2,3-dioxygenase (IDO1). Remarkably, these lymphocytes are excluded at the PM interface compared with PM interior. TILs from PMs exhibited significantly higher amounts of PD-1 and LAG-3 and functional cytokines including interferon-γ (IFNγ) by flow cytometry. Gene expression profiling further confirmed the presence of CD8 and CD4 lymphocytes concentrated at the PM interface, along with upregulation of immunoregulatory molecules and IFNγ-driven genes in the same region. We further discovered a strong alternatively activated macrophage signature throughout the entire PMs along with a polymorphonuclear myeloid-derived suppressor cell signature focused at the PM interface. Expression of PD-L1, LAG-3, and colony-stimulating factor 1 receptor (CSF1R) at the PM interface was associated with significantly worse progression-free survival (PFS), while gene sets indicative of productive T cell immune responses (CD8 T cells, T cell survival, and major histocompatibility complex class 1 expression) were associated with significantly improved PFS. Conclusions Osteosarcoma PMs exhibit immune exclusion characterized by the accumulation of TILs at the PM interface. These TILs produce effector cytokines, suggesting their capability of activation and recognition of tumor antigens. Our findings suggest cooperative immunosuppressive mechanisms in osteosarcoma PMs including immune checkpoint molecule expression and the presence of immunosuppressive myeloid cells. We identify cellular and molecular signatures that are associated with patient outcomes, which could be exploited for successful immunotherapy.
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Affiliation(s)
- John A Ligon
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Pediatric Oncology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Woonyoung Choi
- Greenberg Bladder Cancer Institute and Brady Urological Institute, Johns Hopkins University, Baltimore, Maryland, USA
| | - Gady Cojocaru
- Greenberg Bladder Cancer Institute and Brady Urological Institute, Johns Hopkins University, Baltimore, Maryland, USA
| | - Wei Fu
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Emily Han-Chung Hsiue
- Cellular and Molecular Medicine Program, Johns Hopkins University, Baltimore, Maryland, USA
| | - Teniola F Oke
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Nicholas Siegel
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Megan H Fong
- Greenberg Bladder Cancer Institute and Brady Urological Institute, Johns Hopkins University, Baltimore, Maryland, USA
| | - Brian Ladle
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Christine A Pratilas
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Carol D Morris
- Division of Orthopaedic Oncology, Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, Maryland, USA
| | - Adam Levin
- Division of Orthopaedic Oncology, Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, Maryland, USA
| | - Daniel S Rhee
- Surgery, Johns Hopkins University, Baltimore, Maryland, USA
| | - Christian F Meyer
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Ada J Tam
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Richard Blosser
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Aditya Suru
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - David McConkey
- Greenberg Bladder Cancer Institute and Brady Urological Institute, Johns Hopkins University, Baltimore, Maryland, USA
| | - Franck Housseau
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Robert Anders
- Pathology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Drew M Pardoll
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Nicolas Llosa
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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17
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Benson AB, D'Angelica MI, Abbott DE, Anaya DA, Anders R, Are C, Bachini M, Borad M, Brown D, Burgoyne A, Chahal P, Chang DT, Cloyd J, Covey AM, Glazer ES, Goyal L, Hawkins WG, Iyer R, Jacob R, Kelley RK, Kim R, Levine M, Palta M, Park JO, Raman S, Reddy S, Sahai V, Schefter T, Singh G, Stein S, Vauthey JN, Venook AP, Yopp A, McMillian NR, Hochstetler C, Darlow SD. Hepatobiliary Cancers, Version 2.2021, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2021; 19:541-565. [PMID: 34030131 DOI: 10.6004/jnccn.2021.0022] [Citation(s) in RCA: 388] [Impact Index Per Article: 129.3] [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: 12/19/2022]
Abstract
The NCCN Guidelines for Hepatobiliary Cancers focus on the screening, diagnosis, staging, treatment, and management of hepatocellular carcinoma (HCC), gallbladder cancer, and cancer of the bile ducts (intrahepatic and extrahepatic cholangiocarcinoma). Due to the multiple modalities that can be used to treat the disease and the complications that can arise from comorbid liver dysfunction, a multidisciplinary evaluation is essential for determining an optimal treatment strategy. A multidisciplinary team should include hepatologists, diagnostic radiologists, interventional radiologists, surgeons, medical oncologists, and pathologists with hepatobiliary cancer expertise. In addition to surgery, transplant, and intra-arterial therapies, there have been great advances in the systemic treatment of HCC. Until recently, sorafenib was the only systemic therapy option for patients with advanced HCC. In 2020, the combination of atezolizumab and bevacizumab became the first regimen to show superior survival to sorafenib, gaining it FDA approval as a new frontline standard regimen for unresectable or metastatic HCC. This article discusses the NCCN Guidelines recommendations for HCC.
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Affiliation(s)
- Al B Benson
- 1Robert H. Lurie Comprehensive Cancer Center of Northwestern University
| | | | | | | | - Robert Anders
- 5The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
| | | | | | | | | | | | - Prabhleen Chahal
- 11Case Comprehensive Cancer Center, University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
| | | | - Jordan Cloyd
- 13The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | | | - Evan S Glazer
- 14St. Jude Children's Research HospitalThe University of Tennessee Health Science Center
| | | | - William G Hawkins
- 16Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
| | | | | | - R Kate Kelley
- 19UCSF Helen Diller Family Comprehensive Cancer Center
| | - Robin Kim
- 20Huntsman Cancer Institute at the University of Utah
| | - Matthew Levine
- 21Abramson Cancer Center at the University of Pennsylvania
| | | | - James O Park
- 23Fred Hutchinson Cancer Research CenterSeattle Cancer Care Alliance
| | | | | | | | | | | | | | | | - Alan P Venook
- 19UCSF Helen Diller Family Comprehensive Cancer Center
| | - Adam Yopp
- 31UT Southwestern Simmons Comprehensive Cancer Center; and
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18
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Ogholikhan S, Schwarz KB, Anders R. Unique Pattern of Intrahepatic T-cell Clonality in Biliary Atresia Livers Versus Intestinal Controls: A Pilot Study. JPGN Rep 2021; 2:e053. [PMID: 37207070 PMCID: PMC10191516 DOI: 10.1097/pg9.0000000000000053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 01/18/2021] [Indexed: 05/21/2023]
Abstract
Biliary atresia (BA) is a rare infantile cholangiopathy of unclear etiology proposed by some to be due to virus-induced autoreactive T-cell-mediated inflammation. The hallmark of T cell activity is clonal expansion of T lymphocytes expressing similar T-cell receptor (TCR) variable regions of the β-chain. Objective To test our hypothesis that BA liver tissues would show clonal expansion of 1 or several TCRs. Methods The complementarity-determining region 3 region of the β-chain of the TCR was characterized using next-generation sequencing of 7 BA liver samples (age 51 ± 14 days) and 9 intestinal control samples (age 38 ± 16 days). Following sequencing, clonality scores, various VDJ recombinations, total and productive templates, and complementarity-determining region 3 length were measured using the immunoSEQ Analyzer. Results Next-generation sequencing revealed 1 common TCR rearrangement in 3 BA samples not found in controls. There was a highly diverse TCR population among BA liver and the control samples. The clonality scores ranged from 0.0004 to 0.0062 using a Shannon's entropy score, with numbers close to 0 being highly diverse and numbers close to 1 being highly clonal. The most common TCR VDJ recombinations comprised 1.47-12.9% of the total population of TCR for the BA tissues and 1.05-10.3% for the control samples. Conclusions Our results show a highly diverse TCR repertoire among all of our samples. However, predominant TCR clonality was not found in any sample. Further studies are required for any possible antigenic triggers responsible for the unique T-cell rearrangements observed in the BA samples.
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Affiliation(s)
- Sina Ogholikhan
- From the Division of Pediatric Gastroenterology, Nutrition and Hepatology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Kathleen B. Schwarz
- From the Division of Pediatric Gastroenterology, Nutrition and Hepatology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Robert Anders
- the Division of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD
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19
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Ding D, Javed AA, Cunningham D, Teinor J, Wright M, Javed ZN, Wilt C, Parish L, Hodgin M, Ryan A, Judkins C, McIntyre K, Klein R, Azad N, Lee V, Donehower R, De Jesus-Acosta A, Murphy A, Le DT, Shin EJ, Lennon AM, Khashab M, Singh V, Klein AP, Roberts NJ, Hacker-Prietz A, Manos L, Walsh C, Groshek L, Brown C, Yuan C, Blair AB, Groot V, Gemenetzis G, Yu J, Weiss MJ, Burkhart RA, Burns WR, He J, Cameron JL, Narang A, Zaheer A, Fishman EK, Thompson ED, Anders R, Hruban RH, Jaffee E, Wolfgang CL, Zheng L, Laheru DA. Challenges of the current precision medicine approach for pancreatic cancer: A single institution experience between 2013 and 2017. Cancer Lett 2021; 497:221-228. [PMID: 33127389 PMCID: PMC8375587 DOI: 10.1016/j.canlet.2020.10.039] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 10/15/2020] [Accepted: 10/23/2020] [Indexed: 12/11/2022]
Abstract
Recent research on genomic profiling of pancreatic ductal adenocarcinoma (PDAC) has identified many potentially actionable alterations. However, the feasibility of using genomic profiling to guide routine clinical decision making for PDAC patients remains unclear. We retrospectively reviewed PDAC patients between October 2013 and December 2017, who underwent treatment at the Johns Hopkins Hospital and had clinical tumor next-generation sequencing (NGS) through commercial resources. Ninety-two patients with 93 tumors tested were included. Forty-eight (52%) patients had potentially curative surgeries. The median time from the tissue available to the NGS testing ordered was 229 days (interquartile range 62-415). A total of three (3%) patients had matched targeted therapies based on genomic profiling results. Genomic profiling guided personalized treatment for PDAC patients is feasible, but the percentage of patients who receive targeted therapy is low. The main challenges are ordering NGS testing early in the clinical course of the disease and the limited evidence of using a targeted approach in these patients. A real-time department level genomic testing ordering system in combination with an evidence-based flagging system for potentially actionable alterations could help address these shortcomings.
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Affiliation(s)
- Ding Ding
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Surgery the Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA; Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Ammar A Javed
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Surgery the Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Dea Cunningham
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jonathan Teinor
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Surgery the Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Michael Wright
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Surgery the Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Zunaira N Javed
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Surgery the Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Cara Wilt
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Lindsay Parish
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mary Hodgin
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Amy Ryan
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Carol Judkins
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Keith McIntyre
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Rachel Klein
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Nilo Azad
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Valerie Lee
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Ross Donehower
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Ana De Jesus-Acosta
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Adrian Murphy
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Dung T Le
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Eun Ji Shin
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Gastroenterology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Anne Marie Lennon
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA; Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA; Department of Gastroenterology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Mouen Khashab
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Gastroenterology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Vikesh Singh
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Gastroenterology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Alison P Klein
- Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA; The Sol Goldman Pancreatic Cancer Research Center, Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Nicholas J Roberts
- Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA; The Sol Goldman Pancreatic Cancer Research Center, Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Amy Hacker-Prietz
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Radiation Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Lindsey Manos
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Surgery the Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Christi Walsh
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Surgery the Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Lara Groshek
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Surgery the Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Caitlin Brown
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Surgery the Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Chunhui Yuan
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Surgery the Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Alex B Blair
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Surgery the Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Vincent Groot
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Surgery the Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Georgios Gemenetzis
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Surgery the Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Jun Yu
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Surgery the Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Matthew J Weiss
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Surgery the Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Richard A Burkhart
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Surgery the Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - William R Burns
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Surgery the Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Jin He
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Surgery the Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - John L Cameron
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Surgery the Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Amol Narang
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Radiation Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Atif Zaheer
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Elliot K Fishman
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Elizabeth D Thompson
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; The Sol Goldman Pancreatic Cancer Research Center, Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Robert Anders
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; The Sol Goldman Pancreatic Cancer Research Center, Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Ralph H Hruban
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; The Sol Goldman Pancreatic Cancer Research Center, Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Elizabeth Jaffee
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Christopher L Wolfgang
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Surgery the Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
| | - Lei Zheng
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
| | - Daniel A Laheru
- The Pancreatic Cancer "Precision Medicine" Program, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
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20
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Ho WJ, Sharma G, Zhu Q, Stein-O'Brien G, Durham J, Anders R, Popovic A, Mo G, Kamel I, Weiss M, Jaffee E, Fertig EJ, Yarchoan M. Integrated immunological analysis of a successful conversion of locally advanced hepatocellular carcinoma to resectability with neoadjuvant therapy. J Immunother Cancer 2020; 8:jitc-2020-000932. [PMID: 33219090 PMCID: PMC7682468 DOI: 10.1136/jitc-2020-000932] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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] [Accepted: 08/26/2020] [Indexed: 12/17/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer death worldwide with a minority of patients being diagnosed early enough for curative-intent interventions. We report the first use of preoperative cabozantinib plus nivolumab to successfully downstage what presented as unresectable HCC as part of an ongoing phase 1b study. Preoperative treatment with cabozantinib and nivolumab led to >99% reduction in alpha-fetoprotein, −37.3% radiographic reduction by RECIST 1.1 and a near complete pathologic response (80% to 100% necrosis). An integrated immunological analysis was performed on the post-treatment surgical tumor sample and matched pre-treatment and post-treatment peripheral blood samples with high-dimensional imaging and cytometry techniques. Bayesian non-negative matrix factorization (CoGAPS, Coordinated Gene Activity in Pattern Sets) and self-organizing map (FlowSOM) algorithms were used to distinguish changes in functional markers across cellular neighborhoods in the single cell data sets. Brisk immunological infiltration into the tumor microenvironment was observed in non-random, organized cellular neighborhoods. Systemically, combination therapy led to marked promotion of effector cytotoxic T cells and effector memory helper T cells. Natural killer cells also increased with therapy. The patient remains without disease recurrence and with a normal alpha-fetoprotein approximately 2 years from presentation. Our study provides proof-of-concept that borderline resectable or locally advanced HCC warrants consideration of downstaging with effective neoadjuvant systemic therapy for subsequent curative resection.
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Affiliation(s)
- Won Jin Ho
- Department of Oncology, Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
| | - Gaurav Sharma
- Division of Biostatistics and Bioinformatics, Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
| | - Qingfeng Zhu
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Genevieve Stein-O'Brien
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jennifer Durham
- Department of Oncology, Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
| | - Robert Anders
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Aleksandra Popovic
- Department of Oncology, Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
| | - Guanglan Mo
- Department of Oncology, Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
| | - Ihab Kamel
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Matthew Weiss
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Elizabeth Jaffee
- Department of Oncology, Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
| | - Elana J Fertig
- Division of Biostatistics and Bioinformatics, Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA.,McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Mark Yarchoan
- Department of Oncology, Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
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21
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Abstract
Abstract
Background
Acute cellular rejection remains a major cause of morbidity after heart transplantation with up to 30% of patients experiencing at least one rejection episode during the first year. Unfortunately, the mechanism underling rejection remains poorly understood and the gold standard for diagnosing rejection remains frequent cardiac biopsy for rejection surveillance – a process that is both invasive and costly.
Purpose
PD-L1 is a co-inhibitory transmembrane protein that interacts with PD-1 on T cells to inhibit T cell activation. Endothelial PD-L1 expression in the heart has been shown in mouse models to play a key role in attenuating immune-mediated cardiac disease like myocarditis. Recent data that anti-PD-1 and anti-PD-L1 therapy can lead to myocarditis further supports a role for PD-1/PD-L1 signaling in cardiovascular homeostasis. We hypothesize that PD-L1 expression correlates with rejection severity.
Methods
Endomyocardial biopsy from a cohort of 19 heart transplant patients were analyzed for PD-L1 expression using immunohistochemistry and image analysis with HALO software. Each patient had biopsies corresponding to 0R, 1R, and 2R grades of rejection (n=57) and thus each patient served as their own internal control. Detailed clinical data was also collected on these patients from the electronic medical record.
Results
Average PD-L1 levels associated with 0R (n=19), 1R (n=21), and 2R (n=17) rejection were 1.54, 9.15, and 18.90 respectively (P<0.001). In patients who were treated for 2R rejection with increased immunosuppression (n=9), PD-L1 levels decreased from an average of 21.72 before treatment to an average of 5.64 after treatment (P<0.05). A multiple regression was run to see if PD-L1 level was associated with right heart pressures, EKG intervals, echo data, or common lab values. Accounting for age, race, and sex, it was found that PD-L1 was significantly associated with PA pressure (P<0.01, beta = 0.45), PCW pressure (P<0.01, beta = 0.42), and BNP (P<0.01, beta = 0.55).
Conclusions
Upregulation of PD-L1 in the heart is strongly associated with severity of cellular rejection after heart transplantation. Successful treatment of rejection with immunosuppression decreases PD-L1 levels. These data suggest that PD-L1 is a potential biomarker for heart transplant rejection. Further correlation of PD-L1 levels with signs of right heart strain (increased PA and PCW pressure) and systolic dysfunction (BNP) supports a clinical picture of PD-L1 as a useful biomarker for detecting both cellular rejection and reversal of rejection after treatment.
Cohort identification and results
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Institutes of Health grants R56 HL141466 and R01 HL141466
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Affiliation(s)
- A Choudhary
- Vanderbilt University Medical Center, Department of Medicine, Nashville, United States of America
| | - W Meijers
- Vanderbilt University Medical Center, Department of Medicine, Nashville, United States of America
| | - S Besharati
- Johns Hopkins University School of Medicine, Department of Pathology, Baltimore, United States of America
| | - Q Zhu
- Johns Hopkins University School of Medicine, Department of Pathology, Baltimore, United States of America
| | - J Lindenfeld
- Vanderbilt University Medical Center, Department of Medicine, Nashville, United States of America
| | - M Brinkley
- Vanderbilt University Medical Center, Department of Medicine, Nashville, United States of America
| | - R Anders
- Johns Hopkins University School of Medicine, Department of Pathology, Baltimore, United States of America
| | - J Moslehi
- Vanderbilt University Medical Center, Department of Medicine, Nashville, United States of America
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22
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Benson AB, D'Angelica MI, Abbott DE, Abrams TA, Alberts SR, Anaya DA, Anders R, Are C, Brown D, Chang DT, Cloyd J, Covey AM, Hawkins W, Iyer R, Jacob R, Karachristos A, Kelley RK, Kim R, Palta M, Park JO, Sahai V, Schefter T, Sicklick JK, Singh G, Sohal D, Stein S, Tian GG, Vauthey JN, Venook AP, Hammond LJ, Darlow SD. Guidelines Insights: Hepatobiliary Cancers, Version 2.2019. J Natl Compr Canc Netw 2020; 17:302-310. [PMID: 30959462 DOI: 10.6004/jnccn.2019.0019] [Citation(s) in RCA: 165] [Impact Index Per Article: 41.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The NCCN Guidelines for Hepatobiliary Cancers provide treatment recommendations for cancers of the liver, gallbladder, and bile ducts. The NCCN Hepatobiliary Cancers Panel meets at least annually to review comments from reviewers within their institutions, examine relevant new data from publications and abstracts, and reevaluate and update their recommendations. These NCCN Guidelines Insights summarize the panel's discussion and updated recommendations regarding systemic therapy for first-line and subsequent-line treatment of patients with hepatocellular carcinoma.
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Affiliation(s)
- Al B Benson
- 1Robert H. Lurie Comprehensive Cancer Center of Northwestern University
| | | | | | | | | | | | - Robert Anders
- 7The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
| | | | | | | | - Jordan Cloyd
- 11The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | | | - William Hawkins
- 12Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
| | | | - Rojymon Jacob
- 14University of Alabama at Birmingham Comprehensive Cancer Center
| | | | - R Kate Kelley
- 16UCSF Helen Diller Family Comprehensive Cancer Center
| | - Robin Kim
- 17Huntsman Cancer Institute at the University of Utah
| | | | - James O Park
- 19University of Washington/Seattle Cancer Care Alliance
| | | | | | | | | | - Davendra Sohal
- 24Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
| | | | - G Gary Tian
- 26St. Jude Children's Research Hospital/The University of Tennessee Health Science Center
| | | | - Alan P Venook
- 16UCSF Helen Diller Family Comprehensive Cancer Center
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23
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Jackson D, Anders R, Padula WV, Daly J, Davidson PM. Vulnerability of nurse and physicians with COVID-19: Monitoring and surveillance needed. J Clin Nurs 2020; 29:3584-3587. [PMID: 32428345 PMCID: PMC7276813 DOI: 10.1111/jocn.15347] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Debra Jackson
- School of Nursing, University of Technology Sydney, Sydney, NSW, Australia
| | | | - William V Padula
- Leonard D. Schaeffer Center for Health Policy & Economics & School of Pharmacy University of Southern California, Los Angeles, CA, USA
| | - John Daly
- Western Sydney University and University of Technology Sydney, Sydney, NSW, Australia
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24
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Affiliation(s)
- John Daly
- Emeritus Professor Western Sydney University and University of Technology Sydney, Baltimore, USA
| | - Debra Jackson
- Professor of Nursing, University of Technology Sydney, Baltimore, USA
| | - Robert Anders
- Emeritus Professor University of Texas El Paso, Baltimore, USA
| | - Patricia M Davidson
- Dean and Professor, School of Nursing, Johns Hopkins University, Baltimore, USA
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25
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Torbenson M, Yasir S, Anders R, Guy CD, Lee HE, Venkatesh SK, Wu TT, Chen ZE. Regenerative hepatic pseudotumor: a new pseudotumor of the liver. Hum Pathol 2020; 99:43-52. [PMID: 32222461 DOI: 10.1016/j.humpath.2020.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Received: 02/06/2020] [Revised: 03/18/2020] [Accepted: 03/20/2020] [Indexed: 10/24/2022]
Abstract
Cases of new pseudotumors of the liver were collected from multiple medical centers. Four resection and 4 biopsy specimens were collected, including 4 women and 4 men at an average age of 48 ± 15 years (range: 28-73 years). The lesions were visible on imaging but were either ill-defined or had indeterminate features for characterization. They ranged in size from 2 to 9 cm and were multiple in five cases. The resection specimens showed lesions that had vague borders but were visible in juxtaposition to the normal liver on gross examination. Histologically, the lesions also had ill-defined borders and were composed of benign reactive liver parenchyma. Central vein thrombi were seen in 5 cases, and portal vein thrombi, in 2 cases. These vascular changes were associated reactive parenchymal changes including sinusoidal dilation, patchy bile ductular proliferation, and portal vein abnormalities. All lesions lacked the histological findings of hepatic adenomas, focal nodular hyperplasia, or other known tumors and pseudotumors of the liver. In summary, this study provides a detailed description of a new pseudotumor of the liver: a reactive, hyperplastic mass-like lesion that forms in association with localized vascular thrombi, for which we propose the term regenerative hepatic pseudotumor. This lesion can closely mimic other benign or malignant hepatic tumors on imaging and histology.
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Affiliation(s)
- Michael Torbenson
- Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, USA, 55905.
| | - Saba Yasir
- Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, USA, 55905
| | - Robert Anders
- Department of Pathology, Johns Hopkins University School of Medicine, USA, 21287
| | - Cynthia D Guy
- Department of Pathology, Duke University Health System, USA, 27710
| | - Hee Eun Lee
- Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, USA, 55905
| | | | - Tsung-Teh Wu
- Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, USA, 55905
| | - Zongming Eric Chen
- Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, USA, 55905
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Torres ETR, Kagohara LT, Davis E, Rafie C, Christmas B, Zhu Q, Wang C, Lim D, Anders R, Fertig E, Chung V, Lorusso P, Brufsky A, Jaffee EM, Stearns V, Connolly R. Abstract P5-04-06: Reprogramming the suppressive tumor microenvironment of breast cancer. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p5-04-06] [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: Immune checkpoint inhibitors (ICIs) provide benefit for immunogenic cancers that naturally attract T cell infiltration, but have limited benefit for patients with tumors that lack natural T cells in the tumor microenvironment (TME) including many breast cancers. Suboptimal and inconsistent immune responsiveness in many cancers is likely the result of a lack of tumor antigen expression and/or recognition together with multiple suppressive signals within the TME that provide a formidable barrier to T cell infiltration. Emerging data suggest that these factors can be overcome by combining epigenetic modulation that reprograms myeloid-derived suppressor cells (MDSCs) and upregulate T cell-attracting signals within the TME, with ICIs. Our paralleled preclinical and clinical trial investigates the mechanisms and efficacy of the epigenetic modulator, entinostat (ENT) to reprogram the immune suppressive cells within the TME.
Methods: We conducted a multicenter phase 1 clinical trial (NCT02453620) of entinostat combined with nivolumab +/- ipilimumab in patients with advanced cancers including hormone-receptor positive or triple-negative breast cancer (TNBC). Mandatory tumor samples are being obtained pre-treatment, post-treatment with 2 weeks of entinostat, and 8 weeks post combination therapy with ICIs. We used immunohistochemical (IHC) for CD8 and FoxP3 to determine a ratio representative of immune infiltration in response to therapy. Preclinical studies utilize mouse models of breast cancer (NeuN and 4T1) and mirror the treatment scheme used in the clinical trial. We employed multiparameter flow cytometry, single cell RNA sequencing, bulk RNA sequencing of tumor specimens and patient samples to specifically interrogate the role of ENT in modulating STAT3 as a master regulator of downstream inflammatory pathways.
Results: With regard to the clinical trial, out of 35 patients enrolled, 11 were diagnosed with breast cancer. We observed 4 partial responses, 2 responses in patients with breast cancer, with an ORR of 12%. We have almost completed accrual of our expansion cohort of 15 patients with advanced HER2 negative breast cancer. The primary outcomes of the clinical trial will be reported elsewhere, here we are focusing on important correlative findings which suggest a combination of ENT with ICIs alters CD8/FoxP3 ratios in certain patients. Bulk-RNA sequencing or patient samples is underway. Preliminary data from animal models obtained using scRNA-seq has begun to elucidate altered MDSC signaling pathways, and to identify gene expression changes in immune, stromal, and tumor cells following treatment with ENT. These data are also expected to identify new targets for ICI sensitization.
Conclusions: Preliminary results with IHC staining suggests increased immune infiltration with combination therapy. Sequencing analysis will likely provide deeper insight into mechanisms driving response. The mechanisms of response to ICIs in patients with breast cancer have yet to be elucidated. These studies will provide the necessary scientific evidence to uncover mechanisms behind the transformation of the immunosuppressive TME and provide new targets that could improve clinical response to ICIs to maximize patient survival. The core biological themes explored will likely have a broad impact in the field of breast cancer and affect the paradigm of therapies available to patients in the clinic. These findings will help determine how treatment with ICIs will be successful to obtain durable responses for breast cancer patients.
Citation Format: Evanthia T Roussos Torres, Luciane Tsukamoto Kagohara, Emily Davis, Christine Rafie, Brian Christmas, Qingfeng Zhu, Chenguang Wang, David Lim, Robert Anders, Elana Fertig, Vincent Chung, Patricia Lorusso, Adam Brufsky, Elizabeth M Jaffee, Vered Stearns, Roisin Connolly. Reprogramming the suppressive tumor microenvironment of breast cancer [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P5-04-06.
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Affiliation(s)
| | | | | | | | | | | | | | - David Lim
- 1Johns Hopkins University, Baltimore, MD
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Hsu C, Gratton E, Anders R, Rosenberg A, Levi M, Ranjit S. Image Correlation Microscopy Approach to Study Collagen Accumulation for Distinguishing Recurrence in Liver Cancer Patients. Biophys J 2020. [DOI: 10.1016/j.bpj.2019.11.1746] [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: 10/25/2022] Open
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De Jesus-Acosta A, Sugar EA, O'Dwyer PJ, Ramanathan RK, Von Hoff DD, Rasheed Z, Zheng L, Begum A, Anders R, Maitra A, McAllister F, Rajeshkumar NV, Yabuuchi S, de Wilde RF, Batukbhai B, Sahin I, Laheru DA. Phase 2 study of vismodegib, a hedgehog inhibitor, combined with gemcitabine and nab-paclitaxel in patients with untreated metastatic pancreatic adenocarcinoma. Br J Cancer 2020; 122:498-505. [PMID: 31857726 PMCID: PMC7029016 DOI: 10.1038/s41416-019-0683-3] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 11/12/2019] [Accepted: 11/28/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The Hedgehog (Hh) signalling pathway is overexpressed in pancreatic ductal adenocarcinoma (PDA). Preclinical studies have shown that Hh inhibitors reduce pancreatic cancer stem cells (pCSC), stroma and Hh signalling. METHODS Patients with previously untreated metastatic PDA were treated with gemcitabine and nab-paclitaxel. Vismodegib was added starting on the second cycle. The primary endpoint was progression-free survival (PFS) as compared with historical controls. Tumour biopsies to assess pCSC, stroma and Hh signalling were obtained before treatment and after cycle 1 (gemcitabine and nab-paclitaxel) or after cycle 2 (gemcitabine and nab-paclitaxel plus vismodegib). RESULTS Seventy-one patients were enrolled. Median PFS and overall survival (OS) were 5.42 months (95% confidence interval [CI]: 4.37-6.97) and 9.79 months (95% CI: 7.85-10.97), respectively. Of the 67 patients evaluable for response, 27 (40%) had a response: 26 (38.8%) partial responses and 1 complete response. In the tumour samples, there were no significant changes in ALDH + pCSC following treatment. CONCLUSIONS Adding vismodegib to chemotherapy did not improve efficacy as compared with historical rates observed with chemotherapy alone in patients with newly diagnosed metastatic pancreatic cancer. This study does not support the further evaluation of Hh inhibitors in this patient population. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01088815.
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Affiliation(s)
- Ana De Jesus-Acosta
- Department of Medical Oncology, Kimmel Comprehensive Cancer Center at Johns Hopkins Hospital, Baltimore, MD, USA.
| | - Elizabeth A Sugar
- Department of Biostatistics, the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Peter J O'Dwyer
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Ramesh K Ramanathan
- Honor Health Research Institute & Translational Genomics Research Institute, Scottsdale, AZ, USA
| | - Daniel D Von Hoff
- Honor Health Research Institute & Translational Genomics Research Institute, Scottsdale, AZ, USA
| | - Zeshaan Rasheed
- Department of Medical Oncology, Kimmel Comprehensive Cancer Center at Johns Hopkins Hospital, Baltimore, MD, USA
| | - Lei Zheng
- Department of Medical Oncology, Kimmel Comprehensive Cancer Center at Johns Hopkins Hospital, Baltimore, MD, USA
| | - Asma Begum
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Robert Anders
- Departments of Pathology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Anirban Maitra
- Departments of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Florencia McAllister
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - N V Rajeshkumar
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Roeland F de Wilde
- Departments of Pathology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Bhavina Batukbhai
- Department of Medical Oncology, Kimmel Comprehensive Cancer Center at Johns Hopkins Hospital, Baltimore, MD, USA
| | - Ismet Sahin
- Department of Engineering, Texas Southern University, Houston, TX, USA
| | - Daniel A Laheru
- Department of Medical Oncology, Kimmel Comprehensive Cancer Center at Johns Hopkins Hospital, Baltimore, MD, USA
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Päts AB, Surov A, Roth C, Anders R, Gräfe D, Sorge I, Hirsch FW. [Differential diagnosis of cystic abdominal masses in children]. Radiologe 2019; 60:154-161. [PMID: 31828384 DOI: 10.1007/s00117-019-00627-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cystic abdominal masses are a common main or incidental finding in daily radiological practice; however, differentiation is not always trivial. OBJECTIVES In children, cystic abdominal masses represent a special feature compared to adults, since the spectrum of congenital lesions must be taken into consideration. The article gives a structured overview of the most common entities. MATERIALS AND METHODS The standard methods in abdominal imaging in pediatric radiology are ultrasound and MRI. Based on a literature review, the most important differential diagnoses with their characteristics in ultrasound and MRI were compiled. RESULTS AND DISCUSSION With anatomical classification, presence or absence of solid components as well as the contrast agent behavior in the MRI, the cystic masses can be well differentiated and classified into three groups: congenital and acquired cysts as well as neoplasms.
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Affiliation(s)
- A B Päts
- Abteilung für pädiatrische Radiologie, Department für Bildgebung und Strahlenmedizin, Universitätsklinikum Leipzig, Liebigstraße 20a, 04103, Leipzig, Deutschland.
| | - A Surov
- Department für Bildgebung und Strahlenmedizin, Klinik für diagnostische und interventionelle Radiologie, Universitätsklinikum Leipzig, Leipzig, Deutschland
| | - C Roth
- Abteilung für pädiatrische Radiologie, Department für Bildgebung und Strahlenmedizin, Universitätsklinikum Leipzig, Liebigstraße 20a, 04103, Leipzig, Deutschland
| | - R Anders
- Abteilung für pädiatrische Radiologie, Department für Bildgebung und Strahlenmedizin, Universitätsklinikum Leipzig, Liebigstraße 20a, 04103, Leipzig, Deutschland
| | - D Gräfe
- Abteilung für pädiatrische Radiologie, Department für Bildgebung und Strahlenmedizin, Universitätsklinikum Leipzig, Liebigstraße 20a, 04103, Leipzig, Deutschland
| | - I Sorge
- Abteilung für pädiatrische Radiologie, Department für Bildgebung und Strahlenmedizin, Universitätsklinikum Leipzig, Liebigstraße 20a, 04103, Leipzig, Deutschland
| | - F W Hirsch
- Abteilung für pädiatrische Radiologie, Department für Bildgebung und Strahlenmedizin, Universitätsklinikum Leipzig, Liebigstraße 20a, 04103, Leipzig, Deutschland
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Tsuge S, Saberi B, Cheng Y, Wang Z, Kim A, Luu H, Abraham JM, Ybanez MD, Hamilton JP, Selaru FM, Villacorta-Martin C, Schlesinger F, Philosophe B, Cameron AM, Zhu Q, Anders R, Gurakar A, Meltzer SJ. Detection of Novel Fusion Transcript VTI1A-CFAP46 in Hepatocellular Carcinoma. Gastrointest Tumors 2019; 6:11-27. [PMID: 31602373 DOI: 10.1159/000496795] [Citation(s) in RCA: 2] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 12/23/2018] [Indexed: 11/19/2022] Open
Abstract
Background Hepatocellular carcinoma (HCC) is now the second-highest cause of cancer death worldwide. Recent studies have discovered a wide range of somatic mutations in HCC. These mutations involve various vital signaling pathways such as: Wnt/β-Catenin, p53, telome-rase reverse transcriptase (TERT), chromatin remodeling, RAS/MAPK signaling, and oxidative stress. However, fusion transcripts have not been broadly explored in HCC. Methods To identify novel fusion transcripts in HCC, in the first phase of our study, we performed targeted RNA sequencing (in HCC and paired non-HCC tissues) on 6 patients with a diagnosis of HCC undergoing liver transplantation. Results As a result of these studies, we discovered the novel fusion transcript, VTI1A-CFAP46. In the second phase of our study, we measured the expression of wild-type VTI1A in 21 HCC specimens, which showed that 10 of 21 exhibited upregulation of wild-type VTI1A in their tumors. VTI1A (Vesicle Transport via Interaction with t-SNARE homolog 1A) is a member of the Soluble N-ethylmaleimide-Sensitive Factor (NSF) attachment protein receptor (SNARE) gene family, which is essential for membrane trafficking and function in endocytosis, autophagy, and Golgi transport. Notably, it is known that autophagy is involved in HCC. Conclusions The link between novel fusion transcript VTI1A-CFAP46 and autophagy as a potential therapeutic target in HCC patients deserves further investigation. Moreover, this study shows that fusion transcripts are worthy of additional exploration in HCC.
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Affiliation(s)
- Shunichi Tsuge
- Division of Gastroenterology and Hepatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Behnam Saberi
- Division of Gastroenterology and Hepatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Yulan Cheng
- Division of Gastroenterology and Hepatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Zhixiong Wang
- Division of Gastroenterology and Hepatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Gastrointestinal Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Amy Kim
- Division of Gastroenterology and Hepatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Harry Luu
- Division of Gastroenterology and Hepatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - John M Abraham
- Division of Gastroenterology and Hepatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Maria D Ybanez
- Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - James P Hamilton
- Division of Gastroenterology and Hepatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Florin M Selaru
- Division of Gastroenterology and Hepatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | | | - Benjamin Philosophe
- Department of Transplant Surgery, The Johns Hopkins University, Baltimore, Maryland, USA
| | - Andrew M Cameron
- Department of Transplant Surgery, The Johns Hopkins University, Baltimore, Maryland, USA
| | - Qingfeng Zhu
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Robert Anders
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Ahmet Gurakar
- Division of Gastroenterology and Hepatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Stephen J Meltzer
- Division of Gastroenterology and Hepatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
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Wang X, Moh S, Hubbard A, Muñoz-Rodríguez JL, Khojasteh M, Martin J, Zhu Q, Anders R, Diaz L, Pestic-Dragovich L, Tang L, Zhang W. Abstract 4030: Case classification with tumor antigen presenting and TGF-β signaling biomarkers to predict anti-PD-1 outcome in GI tract tumors using automated quantitative fluorescence multiplex IHC. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-4030] [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: Anti-PD-1/L1 immune checkpoint blockade results in tumor stabilization or shrinkage in only 15-40% of patients. Predictive biomarkers are crucial in identifying responsive patients while excluding others from the toxicities of immunotherapies. Major histocompatibility complex class I (MHC-I) downregulation is one of the most frequent mechanisms of tumor escape from the host’s immune system, but little attention has been devoted to MHC-I expression in studies of the PD-1/L1 blockade. Recently, Tauriello and Mariathasan revealed stromal transforming growth factor (TGF)-β signaling in CD8+ T lymphocytes exclusion as a key determinant of resistance to PD-1/L1 blockade in colorectal and urothelial carcinomas. We present here a multiplex panel IHC of MHC-I, β2-microglobulin (B2M), CD14, TGF-β receptor 2 (TGFBR2), and pan-cytokeratin (panCK) in tumor micro-environment, and their predictive values to anti-PD-1 treatment.
Methods: With the multiplex panel, 51 pre-pembrolizumab treatment patient specimens were stained, including pancreatic, colorectal and cholangiocarcinoma (33 non-responders: 17 PD, 13 SD, 3 NE; 18 responders: 14 PR, 4 CR). Pathologists annotated tumor areas on whole slide scans. HALO High-Plex FL module was used for image analysis. Epithelial tumor (panCK+) and stroma (panCK-) were masked with HALO’s random forest classifier. Spatial location, count, intensity, and percent abundance of each marker were identified. 43 features were designed based on the rationale of hypothesized biological significance. MATLAB was used for feature selection, ranking, and prediction of responses to anti-PD1 treatment.
Results: There was a trend of higher MHCI expression on tumor cells in the responders than non-responders to pembrolizumab treatment. Heterogeneous MHCI expression of tumor cells, and fraction of TGFBR2+ CD14+ cells in stroma were the top features ranked by Relieff k-nearest neighbor (k=30) for the prediction of the response to pembrolizumab treatment. Using Quadratic Discriminant Analysis (QDA) with five-fold cross-validation, the prediction accuracy was 76.5%. Independent validation was not performed due to small sample size.
Conclusions: Deep immune characterization of tumor microenvironments using high dimensional feature spaces derived from multiplex IHC staining may provide insightful directions on finding and validating predictive markers for various immunotherapy regiments (ex. PD-1/L1 blockade; dual TGF-β and PD-1/L1 blockade; combination of PD-1/L1 blockade with other treatments that enhance MHC-I molecules on tumor cells).
Acknowledgement: We thank Nick Cummins, Jorge Lozano, and John Hurley for their technical assistance.
Citation Format: Xiangxue Wang, Shizen Moh, Antony Hubbard, José L. Muñoz-Rodríguez, Mehrnoush Khojasteh, Jim Martin, Qingfeng Zhu, Robert Anders, Luis Diaz, Lidija Pestic-Dragovich, Lei Tang, Wenjun Zhang. Case classification with tumor antigen presenting and TGF-β signaling biomarkers to predict anti-PD-1 outcome in GI tract tumors using automated quantitative fluorescence multiplex IHC [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 4030.
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Affiliation(s)
| | | | | | | | | | - Jim Martin
- 2Roche Tissue Diagnostics, Santa Clara, CA
| | - Qingfeng Zhu
- 3John Hopkins University Hospital, Baltimore, MD
| | | | - Luis Diaz
- 4John Hopkins University Hospital, Baltimore, CA
| | | | - Lei Tang
- 1Roche Tissue Diagnostics, Tucson, AZ
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Ho WJ, Danilova L, Zhu Q, Vithayathil T, Jesus-Acosta AD, Azad N, Laheru D, Fertig E, Anders R, Jaffee E, Yarchoan M. Abstract 3993: Programmed cell death ligand-1 (PD-L1) and CD8 expression profiling identifies an immunologic subtype of pancreatic ductal adenocarcinomas with favorable survival. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-3993] [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
Unselected cases of pancreatic adenocarcinoma (PDAC) have not shown clinical benefit from single agent immune checkpoint therapy, but a subset of PDAC are known to upregulate pathways involved in acquired immune suppression. Further delineation of immunologic subtypes of PDAC is key to smarter trial designs and progress toward improved immunotherapy strategies. To accomplish this, we first employed clinical survival and RNA expression data from 155 patients in The Cancer Genome Atlas (TCGA) to investigate the relationship between immune modulating checkpoints and immune subset marker, CD8A, and their impact on survival in PDAC patients. Among the markers explored, overexpression of PD-L1 (HR=2.55, p=0.001) and IDO1 (HR=2.24, p<0.01) were individually associated with poor survival. PD-L1 expression was not significantly associated with stage or tumor mutational burden of the PDACs. While CD8A expression alone was not correlated with survival, stratifying the analysis based on PD-L1 and CD8 expression identified a subtype characterized by low PD-L1 and high CD8A with favorable survival (p=0.004). Similarly, the combination of low IDO1 and high CD8A expression was associated with favorable survival (p=0.038). We further extended these observations using an independent PDAC cohort of 33 patients from our institution via immunohistochemistry, again observing that low PD-L1 / high CD8 subtype associates with positive prognosis (p=0.021). Although PDAC is regarded as a poorly immunogenic cancer type, these findings infer that baseline T cell infiltration into PDAC is a feature of long term survival and highlights the importance of developing future immunotherapeutic strategies based on data-supported biomarkers to refine patient selection.
Citation Format: Won Jin Ho, Ludmila Danilova, Qingfeng Zhu, Teena Vithayathil, Ana De Jesus-Acosta, Nilo Azad, Daniel Laheru, Elana Fertig, Robert Anders, Elizabeth Jaffee, Mark Yarchoan. Programmed cell death ligand-1 (PD-L1) and CD8 expression profiling identifies an immunologic subtype of pancreatic ductal adenocarcinomas with favorable survival [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 3993.
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Affiliation(s)
| | | | | | | | | | - Nilo Azad
- Johns Hopkins University, Baltimore, MD
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Danilova L, Ho WJ, Zhu Q, Vithayathil T, De Jesus-Acosta A, Azad NS, Laheru DA, Fertig EJ, Anders R, Jaffee EM, Yarchoan M. Programmed Cell Death Ligand-1 (PD-L1) and CD8 Expression Profiling Identify an Immunologic Subtype of Pancreatic Ductal Adenocarcinomas with Favorable Survival. Cancer Immunol Res 2019; 7:886-895. [PMID: 31043417 DOI: 10.1158/2326-6066.cir-18-0822] [Citation(s) in RCA: 161] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 02/04/2019] [Accepted: 04/23/2019] [Indexed: 12/11/2022]
Abstract
Immune-checkpoint therapy has failed to demonstrate meaningful clinical benefit in unselected cases of pancreatic adenocarcinoma (PDAC), but a subset of PDACs are known to upregulate pathways involved in acquired immune suppression. Further delineation of immunologic subtypes of PDAC is necessary to improve clinical trial designs and identify patients who might benefit from immune-checkpoint therapy. We used clinical survival and RNA expression data from The Cancer Genome Atlas (TCGA) to investigate the relationship between immune-modulating pathways and immune subset markers and their impact on survival in PDAC patients. Of the adaptive immune-resistance pathways, expression of PD-L1 and IDO1 was individually associated with poor survival. Although CD8 expression alone was not correlated with survival, the combination of PD-L1- and high CD8 expression identified a subtype with favorable survival. We further extended these observations using an independent PDAC cohort from our institution via IHC, again observing that the PD-L1-/CD8high subtype was associated with positive prognosis. Although PDAC is regarded as a poorly immunogenic cancer type, these findings infer that T-cell infiltration in the absence of adaptive immune-resistance pathways is a feature of long-term survival in PDAC and imply the importance of developing future immunotherapeutic strategies based on data-supported biomarkers to refine patient selection.
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Affiliation(s)
- Ludmila Danilova
- Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Won Jin Ho
- Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Qingfeng Zhu
- Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Teena Vithayathil
- Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ana De Jesus-Acosta
- Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Nilofer S Azad
- Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Daniel A Laheru
- Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Elana J Fertig
- Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Robert Anders
- Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Elizabeth M Jaffee
- Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, Maryland.
| | - Mark Yarchoan
- Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University School of Medicine, Baltimore, Maryland.
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Fu Y, Nwoke F, Vairavamurthy J, Dreher M, Anders R, Kraitchman D, Weiss C. 03:45 PM Abstract No. 28 Histological sequelae of selective bariatric arterial embolization with radiopaque microspheres in swine. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.066] [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: 10/27/2022] Open
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Abiola G, Pasciak A, Filtes J, Anders R, Weiss C. Abstract No. 461 With rapidly growing use of catheter-directed therapies, preservation of whole-organ gross vascular anatomy using perfusion fixation is an important research tool in interventional radiology. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.542] [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: 11/30/2022] Open
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Berry S, Giraldo N, Nguyen P, Green B, Xu H, Ogurtsova A, Soni A, Succaria F, Wang D, Roberts C, Stein J, Engle E, Pardoll D, Anders R, Cottrell T, Taube JM, Tran B, Voskoboynik M, Kuo J, Bang YL, Chung HC, Ahn MJ, Kim SW, Perera A, Freeman D, Achour I, Faggioni R, Xiao F, Ferte C, Lemech C, Meric-Bernstam F, Werner T, Hodi S, Messersmith W, Lewis N, Talluto C, Dostalek M, Tao A, McWhirter S, Trujillo D, Luke J, Xu C, BoMarelli, Qi J, Qin G, Yu H, Jenkins M, Lo KM, Halle JP, Lan Y, Taylor M, Vogelzang N, Cohn A, Stepan D, Shumaker R, Dutcus C, Guo M, Schmidt E, Rasco D, Brose M, Vogelzang N, Di Simone C, Jain S, Richards D, Encarnacion C, Rasco D, Shumaker R, Dutcus C, Stepan D, Guo M, Schmidt E, Taylor M, Vogelzang N, Encarnacion C, Cohn A, Di Simone C, Rasco D, Richards D, Taylor M, Dutcus C, Stepan D, Shumaker R, Guo M, Schmidt E, Mier J, An J, Yang YY, Lee WH, Yang J, Kim JK, Kim HG, Paek SH, Lee JW, Woo J, Kim JB, Kwon H, Lim W, Paik NS, Kim YK, Moon BI, Janku F, Tan D, Martin-Liberal J, Takahashi S, Geva R, Gucalp A, Chen X, Subramanian K, Mataraza J, Wheler J, Bedard P. Correction to: 33rd Annual Meeting & Pre-Conference Programs of the Society for Immunotherapy of Cancer (SITC 2018). J Immunother Cancer 2019; 7:46. [PMID: 30760319 PMCID: PMC6373015 DOI: 10.1186/s40425-019-0519-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Sneha Berry
- Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Nicolas Giraldo
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Peter Nguyen
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Benjamin Green
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Haiying Xu
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Abha Soni
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Farah Succaria
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Daphne Wang
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Charles Roberts
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Julie Stein
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Elizabeth Engle
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Drew Pardoll
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Robert Anders
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Tricia Cottrell
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Janis M Taube
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ben Tran
- Peter MacCallum Cancer Center, Melbourne, Australia
| | | | - James Kuo
- Scientia Clinical Research, Sydney, Australia
| | - Yung-Lue Bang
- Seoul National University Hospital, Seoul, Korea, Republic of
| | - Hyun-Cheo Chung
- Yonsei Cancer Center, Yonsei University, Seoul, Korea, Republic of
| | - Myung-Ju Ahn
- Samsung Medical Center, Seoul, Korea, Republic of
| | - Sang-We Kim
- Asan Medical Center, Songpa-Gu, Korea, Republic of
| | | | | | | | | | | | | | | | | | | | | | | | - Nancy Lewis
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - Craig Talluto
- Novartis Institutes for BioMedical Resea, Cambridge, MA, USA
| | - Mirek Dostalek
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - Aiyang Tao
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | | | | | - Jason Luke
- The University of Chicago Medicine, Chicago, IL, USA
| | - Chunxiao Xu
- EMD Serono Research and Development, Belmont, MA, USA
| | - BoMarelli
- EMD Serono Research and Development, Belmont, MA, USA
| | - Jin Qi
- EMD Serono Research and Development, Belmont, MA, USA
| | - Guozhong Qin
- EMD Serono Research and Development, Belmont, MA, USA
| | - Huakui Yu
- EMD Serono Research and Development, Belmont, MA, USA
| | - Molly Jenkins
- EMD Serono Research and Development, Belmont, MA, USA
| | - Kin-Ming Lo
- EMD Serono Research and Development, Belmont, MA, USA
| | | | - Yan Lan
- EMD Serono Research and Development, Belmont, MA, USA.
| | - Matthew Taylor
- Oregon Health and Science University, Portland, OR, USA.
| | | | - Allen Cohn
- McKesson Specialty Health, Las Vegas, NV, USA
| | | | | | | | | | | | - Drew Rasco
- South Texas Accelerated Research Therape, San Antonio, TX, USA
| | - Marcia Brose
- Abramson Cancer Center of the University, Philadelphia, PA, USA.
| | | | | | - Sharad Jain
- McKesson Specialty Health, Las Vegas, NV, USA
| | | | | | - Drew Rasco
- South Texas Accelerated Research Therape, San Antonio, TX, USA
| | | | | | | | | | | | | | | | | | - Allen Cohn
- McKesson Specialty Health, Las Vegas, NV, USA
| | | | - Drew Rasco
- South Texas Accelerated Research Therape, San Antonio, TX, USA
| | | | | | | | | | | | | | | | - James Mier
- Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Jeongshin An
- Ewha Womans University, Seoul, Korea, Republic of.
| | | | - Won-Hee Lee
- MD healthcare company, Seoul, Korea, Republic of
| | - Jinho Yang
- MD healthcare company, Seoul, Korea, Republic of
| | - Jong-Kyu Kim
- Ewha Womans University, Seoul, Korea, Republic of
| | - Hyun Goo Kim
- Ewha Womans University, Seoul, Korea, Republic of
| | - Se Hyun Paek
- Ewha Womans University, Seoul, Korea, Republic of
| | - Jun Woo Lee
- Ewha Womans University, Seoul, Korea, Republic of
| | - Joohyun Woo
- Ewha Womans University, Seoul, Korea, Republic of
| | - Jong Bin Kim
- Ewha Womans University, Seoul, Korea, Republic of
| | - Hyungju Kwon
- Ewha Womans University, Seoul, Korea, Republic of
| | - Woosung Lim
- Ewha Womans University, Seoul, Korea, Republic of
| | - Nam Sun Paik
- Ewha Womans University, Seoul, Korea, Republic of
| | | | | | - Filip Janku
- MD Anderson Cancer Center, Houston, TX, USA.
| | - David Tan
- National University Cancer Institute, Singapore, Singapore
| | | | | | - Ravit Geva
- Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Ayca Gucalp
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Xueying Chen
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | | | | | - Jennifer Wheler
- Novartis Institutes for BioMedical Resea, Cambridge, MA, USA
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Penchev VR, Chang YT, Begum A, Ewachiw T, Gocke C, Li J, McMillan RH, Wang Q, Anders R, Marchionni L, Maitra A, Uren A, Rasheed Z, Matsui W. Ezrin Promotes Stem Cell Properties in Pancreatic Ductal Adenocarcinoma. Mol Cancer Res 2019; 17:929-936. [PMID: 30655325 DOI: 10.1158/1541-7786.mcr-18-0367] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 10/09/2018] [Accepted: 01/08/2019] [Indexed: 01/25/2023]
Abstract
Self-renewal maintains the long-term clonogenic growth that is required for cancer relapse and progression, but the cellular processes regulating this property are not fully understood. In many diseases, self-renewal is enhanced in cancer stem cells (CSC), and in pancreatic ductal adenocarcinoma (PDAC), CSCs are characterized by the surface expression of CD44. In addition to cell adhesion, CD44 impacts cell shape and morphology by modulating the actin cytoskeleton via Ezrin, a member of the Ezrin/Radixin/Moesin (ERM) family of linker proteins. We examined the expression of Ezrin in PDAC cells and found higher levels of both total and activated Ezrin in CSCs compared with bulk tumor cells. We also found that the knockdown of Ezrin in PDAC cells decreased clonogenic growth, self-renewal, cell migration, and CSC frequency in vitro as well as tumor initiation in vivo. These effects were associated with cytoskeletal changes that are similar to those occurring during the differentiation of normal stem cells, and the inhibition of actin remodeling reversed the impact of Ezrin loss. Finally, targeting Ezrin using a small-molecule inhibitor limited the self-renewal of clinically derived low-passage PDAC xenografts. Our findings demonstrate that Ezrin modulates CSCs properties and may represent a novel target for the treatment of PDAC. IMPLICATIONS: Our findings demonstrate that Ezrin modulates CSCs' properties and may represent a novel target for the treatment of PDAC.
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Affiliation(s)
- Vesselin R Penchev
- Department of Oncology, Sydney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Yu-Tai Chang
- Department of Oncology, Sydney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Asma Begum
- Department of Oncology, Sydney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Theodore Ewachiw
- Department of Oncology, Sydney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Christian Gocke
- Department of Oncology, Sydney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Joey Li
- Department of Oncology, Sydney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ross H McMillan
- Department of Oncology, Sydney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Qiuju Wang
- Department of Oncology, Sydney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Robert Anders
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Luigi Marchionni
- Department of Oncology, Sydney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Anirban Maitra
- Department of Pathology, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Aykut Uren
- Department of Oncology, Lombardy Comprehensive Cancer Center, Georgetown University Medical Center, Washington, D.C
| | - Zeshaan Rasheed
- Department of Oncology, Sydney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - William Matsui
- Department of Oncology, Sydney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland.
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Chaudhari P, Tian L, Kim A, Zhu Q, Anders R, Schwarz KB, Sharkis S, Ye Z, Jang YY. Transient c-Src Suppression During Endodermal Commitment of Human Induced Pluripotent Stem Cells Results in Abnormal Profibrotic Cholangiocyte-Like Cells. Stem Cells 2018; 37:306-317. [PMID: 30471152 DOI: 10.1002/stem.2950] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 10/05/2018] [Accepted: 10/25/2018] [Indexed: 12/18/2022]
Abstract
Directed differentiation of human induced pluripotent stem cells (iPSCs) toward hepatobiliary lineages has been increasingly used as models of human liver development/diseases. As protein kinases are important components of signaling pathways regulating cell fate changes, we sought to define the key molecular mediators regulating human liver development using inhibitors targeting tyrosine kinases during hepatic differentiation of human iPSCs. A library of tyrosine kinase inhibitors was used for initial screening during the multistage differentiation of human iPSCs to hepatic lineage. Among the 80 kinase inhibitors tested, only Src inhibitors suppressed endoderm formation while none had significant effect on later stages of hepatic differentiation. Transient inhibition of c-Src during endodermal induction of human iPSCs reduced endodermal commitment and expression of endodermal markers, including SOX17 and FOXA2, in a dose-dependent manner. Interestingly, the transiently treated cells later developed into profibrogenic cholangiocyte-like cells expressing both cholangiocyte markers, such as CK7 and CK19, and fibrosis markers, including Collagen1 and smooth muscle actin. Further analysis of these cells revealed colocalized expression of collagen and yes-associated protein (YAP; a marker associated with bile duct proliferation/fibrosis) and an increased production of interleukin-6 and tumor necrosis factor-α. Moreover, treatment with verteporfin, a YAP inhibitor, significantly reduced expression of fibrosis markers. In summary, these results suggest that c-Src has a critical role in cell fate determination during endodermal commitment of human iPSCs, and its alteration in early liver development in human may lead to increased production of abnormal YAP expressing profibrogenic proinflammatory cholangiocytes, similar to those seen in livers of patients with biliary fibrosis. Stem Cells 2019;37:306-317.
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Affiliation(s)
- Pooja Chaudhari
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Cellular and Molecular Medicine Graduate Program, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Lipeng Tian
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Amy Kim
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Qingfeng Zhu
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Robert Anders
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Kathleen B Schwarz
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Saul Sharkis
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Cellular and Molecular Medicine Graduate Program, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Zhaohui Ye
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Yoon-Young Jang
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Cellular and Molecular Medicine Graduate Program, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Institute for Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Zhang W, Khojasteh M, Hubbard A, Martin J, Wang X, Kamthamraju S, Munoz-Rodriguez J, Jiang D, Cai Z, Li J, Anders R, Diaz L, Pestic-Dragovich L, Tang L. Characterization of PD-L1, CD8, CD3, CD68 and PanCK in tumor microenvironment of Gl tract tumors with respect to patients’ mismatch repair status and anti-PD-1 treatment outcome using 5Plex IHC and whole slide image analysis. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy269.115] [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: 11/13/2022] Open
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40
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Mannan R, Anders R, Oshima K. Nodular Regenerative Hyperplasia (NRH): A Clinicopathologic and Immunohistochemical Study. Am J Clin Pathol 2018. [DOI: 10.1093/ajcp/aqy090.081] [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: 11/14/2022] Open
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41
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Khalil NH, Anders R, Flo Forner A, Gutberlet M, Ender J. Radiological incidence of unilateral pulmonary edema after minimally invasive cardiac surgery. J Cardiothorac Vasc Anesth 2018. [DOI: 10.1053/j.jvca.2018.08.111] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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42
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Vairavamurthy J, Anders R, Kraitchman D, Arepally A, Weiss C. 3:36 PM Abstract No. 105 Target vessel size for bariatric embolization: a comparative histologic evaluation of swine and human fundi. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.120] [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: 10/17/2022] Open
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43
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Bove KE, Sheridan R, Fei L, Anders R, Chung CT, Cummings OW, Finegold MJ, Finn L, Ranganathan S, Kim G, Lovell M, Magid MS, Melin-Aldana H, Russo P, Shehata B, Wang L, White F, Chen Z, Spino C, Magee JC. Hepatic Hilar Lymph Node Reactivity at Kasai Portoenterostomy for Biliary Atresia: Correlations With Age, Outcome, and Histology of Proximal Biliary Remnant. Pediatr Dev Pathol 2018; 21:29-40. [PMID: 28474973 PMCID: PMC7986481 DOI: 10.1177/1093526617707851] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 12/18/2022]
Abstract
We hypothesized that if infection is the proximate cause of congenital biliary atresia, an appropriate response to antigen would occur in lymph nodes contiguous with the biliary remnant. We compared the number of follicular germinal centers (GC) in 79 surgically excised hilar lymph nodes (LN) and 27 incidentally discovered cystic duct LNs in 84 subjects at the time of hepatic portoenterostomy (HPE) for biliary atresia (BA) to autopsy controls from the pancreaticobiliary region of non-septic infants >3 months old at death. All 27 control LN lacked GC, a sign in infants of a primary response to antigenic stimulation. GC were found in 53% of 106 LN in 56 of 84 subjects. Visible surgically excised LN contiguous with the most proximal biliary remnants had 1 or more well-formed reactive GC in only 26/51 subjects. Presence of GC and number of GC/LN was unrelated to age at onset of jaundice or to active fibroplasia in the biliary remnant but was related to older age at HPE. Absent GC in visible and incidentally removed cystic duct LNs predicted survival with the native liver at 2 and 3 years after HPE, P = .03, but significance was lost at longer intervals. The uncommon inflammatory lesions occasionally found in remnants could be secondary either to bile-induced injury or secondary infection established as obstruction evolves. The absence of consistent evidence of antigenic stimulation in LN contiguous with the biliary remnant supports existence of at least 1 major alternative to infection in the etiology of biliary atresia.
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Affiliation(s)
- KE Bove
- Division of Pathology and Laboratory Medicine and Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - R Sheridan
- Division of Pathology and Laboratory Medicine and Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - L Fei
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - R Anders
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - CT Chung
- Division of Pathology, The Hospital for Sick Children, Toronto, Canada
| | - OW Cummings
- Department of Pathology, Indiana University School of Medicine, Indianapolis, Indiana
| | - MJ Finegold
- Department of Pathology, Texas Children’s Hospital, Houston, Texas
| | - L Finn
- Department of Pathology, Seattle Children’s Hospital, Seattle, Washington
| | - S Ranganathan
- Department of Pathology, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania
| | - G Kim
- Department of Anatomic Pathology, University of California, San Francisco, San Francisco, California
| | - M Lovell
- Department of Pathology, Children’s Hospital Colorado, Aurora, Colorado
| | - MS Magid
- Department of Pathology, Kravis Children’s Hospital, Mount Sinai Medical Center, New York, New York
| | - H Melin-Aldana
- Department of Pathology, Ann & Robert H. Lurie Children’s Hospital, Chicago, Illinois
| | - P Russo
- Department of Pathology and Laboratory Medicine, the Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - B Shehata
- Department of Pathology, Children’s Healthcare of Atlanta, Atlanta, Georgia
| | - L Wang
- Department of Pathology, Children’s Hospital Los Angeles, Los Angeles, California
| | - F White
- Department of Pathology and Immunology, Washington University School of Medicine, St Louis, Missouri
| | - Z Chen
- Quest Diagnostics, Health Informatics, Madison New Jersey
| | - C Spino
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan
| | - JC Magee
- Department of Surgery, University of Michigan, Ann Arbor, Michigan
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Anders R, Hinault T, Lemaire P. Heuristics versus direct calculation, and age-related differences in multiplication: an evidence accumulation account of plausibility decisions in arithmetic. Journal of Cognitive Psychology 2017. [DOI: 10.1080/20445911.2017.1397676] [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: 10/18/2022]
Affiliation(s)
- R. Anders
- Aix Marseille Univ, CNRS, LPC, Marseille, France
| | - T. Hinault
- Aix Marseille Univ, CNRS, LPC, Marseille, France
| | - P. Lemaire
- Aix Marseille Univ, CNRS, LPC, Marseille, France
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Rimm DL, Han G, Taube JM, Yi ES, Bridge JA, Flieder DB, Homer R, West WW, Wu H, Roden AC, Fujimoto J, Yu H, Anders R, Kowalewski A, Rivard C, Rehman J, Batenchuk C, Burns V, Hirsch FR, Wistuba II. A Prospective, Multi-institutional, Pathologist-Based Assessment of 4 Immunohistochemistry Assays for PD-L1 Expression in Non-Small Cell Lung Cancer. JAMA Oncol 2017; 3:1051-1058. [PMID: 28278348 DOI: 10.1001/jamaoncol.2017.0013] [Citation(s) in RCA: 589] [Impact Index Per Article: 84.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Importance Four assays registered with the US Food and Drug Administration (FDA) detect programmed cell death ligand 1 (PD-L1) to enrich for patient response to anti-programmed cell death 1 and anti-PD-L1 therapies. The tests use 4 separate PD-L1 antibodies on 2 separate staining platforms and have their own scoring systems, which raises questions about their similarity and the potential interchangeability of the tests. Objective To compare the performance of 4 PD-L1 platforms, including 2 FDA-cleared assays, 1 test for investigational use only, and 1 laboratory-developed test. Design, Setting, and Participants Four serial histologic sections from 90 archival non-small cell lung cancers from January 1, 2008, to December 31, 2010, were distributed to 3 sites that performed the following immunohistochemical assays: 28-8 antibody on the Dako Link 48 platform, 22c3 antibody on the Dako Link 48 platform, SP142 antibody on the Ventana Benchmark platform, and E1L3N antibody on the Leica Bond platform. The slides were scanned and scored by 13 pathologists who estimated the percentage of malignant and immune cells expressing PD-L1. Statistical analyses were performed from December 1, 2015, to August 30, 2016, to compare antibodies and pathologists' scoring of tumor and immune cells. Main Outcomes and Measures Percentages of malignant and immune cells expressing PD-L1. Results Among the 90 samples, the SP142 assay was an outlier, with a significantly lower mean score of PD-L1 expression in both tumor and immune cells (tumor cells: 22c3, 2.96; 28-8, 3.26; SP142, 1.99; E1L3N, 3.20; overall mean, 2.85; and immune cells: 22c3, 2.15; 28-8, 2.28; SP142, 1.62; E1L3N, 2.28; overall mean, 2.08). Pairwise comparisons showed that the scores from the 28-8 and E1L3N tests were not significantly different but that the 22c3 test showed a slight (mean difference, 0.24-0.30) but statistically significant reduction in labeling of PD-L1 expression in tumor cells. Evaluation of intraclass correlation coefficients (ICCs) between antibodies to quantify interassay variability for PD-L1 expression in tumor cells showed high concordance between antibodies for tumor cell scoring (0.813; 95% CI, 0.815-0.839) and lower levels of concordance for immune cell scoring (0.277; 95% CI, 0.222-0.334). When examining variability between pathologists for any single assay, the concordance between pathologists' scoring for PD-L1 expression in tumor cells ranged from ICCs of 0.832 (95% CI, 0.820-0.844) to 0.882 (95% CI, 0.873-0.891) for each assay, while the ICCs from immune cells for each assay ranged from 0.172 (95% CI, 0.156-0.189) to 0.229 (95% CI, 0.211-0.248). Conclusions and Relevance The assay using the SP142 antibody is an outlier that detected significantly less PD-L1 expression in tumor cells and immune cells. The assay for antibody 22c3 showed slight yet statistically significantly lower staining than either 28-8 or E1L3N, but this significance was detected only when using the mean of 13 pathologists' scores. The pathologists showed excellent concordance when scoring tumor cells stained with any antibody but poor concordance for scoring immune cells stained with any antibody. Thus, for tumor cell assessment of PD-L1, 3 of the 4 tests are concordant and reproducible as read by pathologists.
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Affiliation(s)
- David L Rimm
- Department of Pathology, Yale University School of Medicine, New Haven, Connecticut
| | - Gang Han
- Department of Epidemiology and Biostatistics, Texas A&M University School of Public Health, College Station
| | - Janis M Taube
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Eunhee S Yi
- Department of Anatomic Pathology, Mayo Clinic, Rochester, Minnesota
| | - Julia A Bridge
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha
| | - Douglas B Flieder
- Department of Pathology, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Robert Homer
- Department of Pathology, Yale University School of Medicine, New Haven, Connecticut
| | - William W West
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha
| | - Hong Wu
- Department of Pathology, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Anja C Roden
- Department of Anatomic Pathology, Mayo Clinic, Rochester, Minnesota
| | - Junya Fujimoto
- Department of Translational Molecular Pathology, The University of Texas M.D. Anderson Cancer Center, Houston
| | - Hui Yu
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora
| | - Robert Anders
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ashley Kowalewski
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora
| | - Christopher Rivard
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora
| | - Jamaal Rehman
- Department of Pathology, NorthShore University Health System, Evanston, Illinois
| | - Cory Batenchuk
- Department of Immuno-Oncology, Bristol-Myers Squibb, Plainsboro, New Jersey
| | - Virginia Burns
- Department of Immuno-Oncology, Bristol-Myers Squibb, Plainsboro, New Jersey
| | - Fred R Hirsch
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora
| | - Ignacio I Wistuba
- Department of Translational Molecular Pathology, The University of Texas M.D. Anderson Cancer Center, Houston
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Surcel A, Schiffhauer ES, Thomas D, Zhu Q, Anders R, Robinson D. Abstract 901: The mechanobiome of pancreatic cancer: a viable, targetable drug space. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-901] [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
Pancreatic ductal adenocarcinoma (PDAC) is a devastating disease with an annual mortality rate of 37,000 in the US alone. Its 5-year survival rate of ~6% remains relatively unchanged over the past 4 decades. Because PDAC has elevated rates of de novo and acquired resistance to traditional chemotherapies, we are exploring new drug spaces that target metastatic hepatic disease, the primary mortality factor for patients. Specifically, we have identified the cluster of proteins that sense and respond to mechanical stimuli - collectively known as the mechanobiome. This cytoskeletal machinery is responsible in large part for endowing metastatic cells with the ability to navigate through different tissue types. Based on their mechanoresponsiveness profile, we have predicted and identified via western blot and immunohistochemistry proteins in the mechanobiome that are upregulated in patient-derived pancreatic tissues. These proteins include non-muscle myosin IIA and IIC, alpha-actin-4, and filamin B. We are performing knockdown and overexpression studies of these isoforms on 2D and 3D behaviors - cell mechanics, migration, invasion, and tissue sphere formation and are poised to begin mouse studies on the metastatic sufficiency in altering the expression of these proteins. In addition, we are testing 4-HAP, a small molecule mechanics modulator that we previously identified that targets myosin IIC, thus affecting PDAC mechanics in PDAC murine models. Limited studies reveal that 4-HAP reduces metastasis. These data suggest that direct targeting of the mechanobiome may eventually expand treatment strategies for pancreatic cancer.
Citation Format: Alexandra Surcel, Eric S. Schiffhauer, Dustin Thomas, Qingfeng Zhu, Robert Anders, Douglas Robinson. The mechanobiome of pancreatic cancer: a viable, targetable drug space [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 901. doi:10.1158/1538-7445.AM2017-901
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Affiliation(s)
| | | | - Dustin Thomas
- Johns Hopkins Univ. School of Medicine, Baltimore, MD
| | - Qingfeng Zhu
- Johns Hopkins Univ. School of Medicine, Baltimore, MD
| | - Robert Anders
- Johns Hopkins Univ. School of Medicine, Baltimore, MD
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Surcel A, Schiffhauer E, Thomas D, Zhu Q, Anders R, Robinson D. Dictyostelium Mechanics Accurately Identifies New Targetable Drug Space for Pancreatic Cancer Delineated by Myosin IIS, Filamins, and Alpha-Actinins, Collectively Comprimising the Mechanobiome. Biophys J 2017. [DOI: 10.1016/j.bpj.2016.11.1829] [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: 10/20/2022] Open
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Hodi FS, Kluger H, Sznol M, Carvajal R, Lawrence D, Atkins M, Powderly J, Sharfman W, Puzanov I, Smith D, Leming P, Lipson E, Taube J, Anders R, Horak C, Jiang J, McDermott D, Sosman J, Brahmer J, Pardoll D, Topalian S. Abstract CT001: Durable, long-term survival in previously treated patients with advanced melanoma (MEL) who received nivolumab (NIVO) monotherapy in a phase I trial. Clin Trials 2016. [DOI: 10.1158/1538-7445.am2016-ct001] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Anders R, Grohmann M, Lindner TH, Bergmann C, Halbritter J. [Hemolytic kidney failure and transient ischemic attack in a 32-year-old female]. Internist (Berl) 2016; 57:1022-1028. [PMID: 27357251 DOI: 10.1007/s00108-016-0092-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We report on the case of a 32-year-old female patient who initially presented with oliguric acute renal failure, hemolytic anemia with moderate thrombocytopenia and subsequently developed a transient ischemic attack in the cerebellum. The kidney biopsy revealed clinically suspected atypical hemolytic-uremic syndrome (aHUS), which was confirmed by intraglomerular thrombotic microangiopathy (TMA). Treatment with plasmapheresis and sustained administration of the C5 inhibitor eculizumab resulted in hematological remission but without improvement of kidney function. Further etiological investigations led to reduced plasma levels of inhibitory complement factor I on the basis of a heterozygous CFI mutation. In patients with aHUS molecular genetic investigations are indicated in order to determine the underlying cause, to regulate the therapeutic regimen and to allow prognostic statements with respect to a potential kidney transplantation.
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Affiliation(s)
- R Anders
- Department für Innere Medizin, Neurologie und Dermatologie, Klinik für Endokrinologie/Nephrologie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland
| | - M Grohmann
- Bioscientia, Zentrum für Humangenetik, Ingelheim, Deutschland
| | - T H Lindner
- Department für Innere Medizin, Neurologie und Dermatologie, Klinik für Endokrinologie/Nephrologie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland
| | - C Bergmann
- Bioscientia, Zentrum für Humangenetik, Ingelheim, Deutschland
| | - J Halbritter
- Department für Innere Medizin, Neurologie und Dermatologie, Klinik für Endokrinologie/Nephrologie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland.
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Llosa NJ, Housseau F, Wick E, Lizzy H, Cruise M, Anders R, Sears C, Pardoll DM, Fan H, Siegel N, Blosser L, Tam A, Wang H. Abstract A141: The vigorous immune microenvironment of microsatellite instable colon cancer isbalanced by multiple counter-inhibitory checkpoints. Cancer Immunol Res 2016. [DOI: 10.1158/2326-6074.cricimteatiaacr15-a141] [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
We examined the immune microenvironment of primary colorectal cancer (CRC) using immunohistochemistry, laser capture microdissection/qRT-PCR, flow cytometry and functional analysis of tumor infiltrating lymphocytes. A subset of CRC displayed high infiltration with activated CD8+ CTL as well as activated Th1 cells characterized by IFN-gamma production and the Th1 transcription factor Tbet. Parallel analysis of tumor genotypes revealed that virtually all of the tumors with this active Th1/CTL microenvironment had defects in mismatch repair, as evidenced by microsatellite instability (MSI). Counterbalancing this active Th1/CTL microenvironment, MSI tumors selectively demonstrated highly up-regulated expression of multiple immune checkpoints, including five - PD-1, PD-L1, CTLA-4, LAG-3 and IDO - currently being targeted clinically with inhibitors. These findings link tumor genotype with the immune microenvironment, and explain why MSI tumors are not naturally eliminated despite a hostile Th1/CTL microenvironment. They further suggest that blockade of specific checkpoints may be selectively efficacious in the MSI subset of CRC. Our findings are the first to demonstrate a link between a genetically defined subtype of cancer and its corresponding expression of immune checkpoints in the tumor microenvironment. The mismatch repair defective subset of CRC selectively up-regulates at least 5 checkpoint molecules that are targets of inhibitors currently being clinically tested. Furthermore, our results were clinically validated in a phase 2 study at Hopkins which showed mismatch-repair status as a predictor of clinical benefit to immune checkpoint blockade with pembrolizumab.
Citation Format: Nicolas J. Llosa, Franck Housseau, Elizabeth Wick, Hechenbleikner Lizzy, Michael Cruise, Robert Anders, Cynthia Sears, Drew M. Pardoll, Hongni Fan, Nicholas Siegel, Lee Blosser, Ada Tam, Hao Wang. The vigorous immune microenvironment of microsatellite instable colon cancer isbalanced by multiple counter-inhibitory checkpoints. [abstract]. In: Proceedings of the CRI-CIMT-EATI-AACR Inaugural International Cancer Immunotherapy Conference: Translating Science into Survival; September 16-19, 2015; New York, NY. Philadelphia (PA): AACR; Cancer Immunol Res 2016;4(1 Suppl):Abstract nr A141.
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Affiliation(s)
| | - Franck Housseau
- 1Johns Hopkins University School of Medicine, Baltimore, MD,
| | - Elizabeth Wick
- 1Johns Hopkins University School of Medicine, Baltimore, MD,
| | | | | | - Robert Anders
- 1Johns Hopkins University School of Medicine, Baltimore, MD,
| | - Cynthia Sears
- 1Johns Hopkins University School of Medicine, Baltimore, MD,
| | - Drew M. Pardoll
- 1Johns Hopkins University School of Medicine, Baltimore, MD,
| | - Hongni Fan
- 1Johns Hopkins University School of Medicine, Baltimore, MD,
| | - Nicholas Siegel
- 1Johns Hopkins University School of Medicine, Baltimore, MD,
| | - Lee Blosser
- 1Johns Hopkins University School of Medicine, Baltimore, MD,
| | - Ada Tam
- 1Johns Hopkins University School of Medicine, Baltimore, MD,
| | - Hao Wang
- 1Johns Hopkins University School of Medicine, Baltimore, MD,
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