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Ngoma T, Adewole I, Ainsworth V, Chin D, Chin J, Elzawawy A, Joseph A, Mallum A, Ndlovu N, Ngoma M, Oladipo A, Swanson W, Ngwa W. Cancer control collaborations between China and African countries. Lancet Oncol 2024; 25:e164-e172. [PMID: 38547900 DOI: 10.1016/s1470-2045(23)00634-4] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/21/2023] [Accepted: 12/05/2023] [Indexed: 04/02/2024]
Abstract
Over the past decade, China has emerged as Africa's largest trade partner and source of foreign direct investment, with public health ranked as a top priority in China-Africa collaborations. During the same period, cancer has emerged as a leading cause of death in Africa, with more than 700 000 deaths per year and projections of more than 1 million deaths per year by 2030. In this Review, we explore the effects of increasing China-Africa collaborations on cancer control in Africa. We review the published literature on health-care assistance, research, education and training, and infrastructure and present the results of an institutional review board-approved survey of African oncology health-care professionals and institutional leaders that assessed their perception of the effects of China-Africa collaborations. From peer-reviewed articles and grey literature, we found that the number of China-Africa collaborations have grown substantially over the past decade in different areas, especially in patient care and infrastructure. Research publications have also surged in quantity in the past decade compared with previous years. However, the survey results suggest research collaborations remain infrequent and that medical professionals in African cancer centres rarely participate in direct research collaborations with Chinese institutions. The Review also highlights the challenges and benefits of increasing China-Africa collaborations. Challenges include insufficient monitoring and evaluation of the projects in Africa and poor coordination and alignment of the various initiatives. The benefits of these collaborations for Africa include improved health outcomes, strengthened health systems, and socioeconomic development. Benefits are also apparent for China, such as securing energy and resource supplies, expanded trade and investment opportunities, and improved diplomatic relations. Overall, China-Africa collaborations are increasing and having a substantial effect in both China and the African continent. Recommendations to minimise the challenges and maximise the benefits for more positive consequences on cancer control in Africa are discussed.
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Affiliation(s)
- Twalib Ngoma
- Department of Clinical Oncology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
| | - Isaac Adewole
- College of Medicine, University of Ibadan, Ibadan, Nigeria
| | | | - David Chin
- United Health Services, Johnson City, NY, USA
| | - Jennifer Chin
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Ahmed Elzawawy
- Suez Canal University, Ismailia, Egypt; Alsoliman Clinical and Radiation Oncology Center, Port Said, Egypt
| | - Adedayo Joseph
- Nigeria Sovereign Investment Authority-Lagos University Teaching Hospital Cancer Center, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Abba Mallum
- University of KwaZulu Natal, Durban South Africa and Inkosi Albert Luthuli Central Hospital, Durban, South Africa
| | - Ntokozo Ndlovu
- Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Mamsau Ngoma
- Academic Unit, Ocean Road Cancer Institute, Dar es Salaam, Tanzania
| | - Aishat Oladipo
- Department of Clinical Oncology, Weill Cornell Medicine, New York, NY, USA
| | - William Swanson
- Department of Clinical Oncology, Weill Cornell Medicine, New York, NY, USA
| | - Wilfred Ngwa
- The University of Massachusetts Lowell, Lowell, MA, USA; Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA; Rutgers Global Health Institute, Rutgers University, New Brunswick, NJ, USA; Department of Information and Sciences, Information and Communications Technology University, Yaoundé, Cameroon
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Adegboyega B, Joseph A, Alabi A, Omomila J, Ngema LM, Ainsworth V, Chin J, Evbuomwan MO, Ngwa W. Patient reported outcomes following whole brain radiotherapy in patients with brain metastases in NSIA-LUTH Cancer Center. BMC Cancer 2023; 23:1233. [PMID: 38098061 PMCID: PMC10722749 DOI: 10.1186/s12885-023-11675-8] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/24/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Brain metastases (BM) are a common complication in advanced cancer patients, and extremely challenging to treat. Consequently, whole brain radiotherapy (WBRT) remains the standard palliative intervention for patients with BM. The present study set to evaluate the clinical benefits of WBRT by assessing the quality of life (QoL) in WBRT-treated patients with BM, in Nigeria. METHODS This was a prospective, longitudinal, hospital-based single-centre study. Consecutive sampling methodology was used to recruit 52 patients with BM undergoing WBRT. Patients were followed up on days 7, 30, 90 and 180 after WBRT. The EORTC QLQ-C15-PAL and EORTC QLQ-BN20 were employed to report patients' responses. The likert scale responses were linearly converted into 0 - 100 scores, and the descriptive analysis was conducted using IBM SPSS Statistics 29.0, at 95% confidence interval, using the two-tailed t-test for continuous variables or the chi-square test for categorical values. The overall survival was calculated with the Kaplan Maier method and the difference tested with Log-rank method, considering the interval from the baseline until death or end of the study. RESULTS The study cohort was predominantly females (82.7%), and accordingly, 65.4% of the respondents had a breast primary tumor. A goodness-of-fit test yielded non-significant Chi square Pearson (p = 0.325) and Deviance (p = 1.000) residuals, indicating the best fit. The median overall survival was 180 days (~ 6 months). A total of 20 patients (38%) that survived up to 180 days reported alleviated symptoms and better functioning. A significant improvement in physical functioning (p < 0.001) and emotional functioning (p = 0.031) was reported at 180 days post WBRT, compared to baseline. CONCLUSIONS WBRT is an effective palliative intervention in patients with BM, resulting in improved QoL. More than 50% of patients that survived ~ 3 months reported alleviation of pain, and 38% of patients that survived for ~ 6 months reported a significantly improved functioning. This demonstrated the clinical benefits of WBRT in palliative care and will add to the body of data on the use of WBRT, from Africa.
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Affiliation(s)
- Bolanle Adegboyega
- NSIA-LUTH Cancer Center, Lagos University Teaching Hospital, Lagos, Nigeria.
| | - Adedayo Joseph
- NSIA-LUTH Cancer Center, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Adewumi Alabi
- NSIA-LUTH Cancer Center, Lagos University Teaching Hospital, Lagos, Nigeria
| | - John Omomila
- NSIA-LUTH Cancer Center, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Lindokuhle M Ngema
- Johns Hopkins Medicine, Sydney Kimmel Comprehensive Cancer Centre, Baltimore, MD, 21218, USA.
| | - Victoria Ainsworth
- Johns Hopkins Medicine, Sydney Kimmel Comprehensive Cancer Centre, Baltimore, MD, 21218, USA
- Department of Physics, University of Massachusetts Lowell, Lowell, MA, 01854, USA
| | - Jennifer Chin
- Johns Hopkins Medicine, Sydney Kimmel Comprehensive Cancer Centre, Baltimore, MD, 21218, USA
| | - Moses O Evbuomwan
- University of Iowa Hospitals and Clinics US, Iowa City, IA, 52242, USA
| | - Wilfred Ngwa
- Johns Hopkins Medicine, Sydney Kimmel Comprehensive Cancer Centre, Baltimore, MD, 21218, USA
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Adegboyega BC, Joseph AO, Alabi OA, Omomila J, Ngema L, Ainsworth V, Chin J, Ngwa W. Patient Reported Outcomes Following Palliative Whole Brain Radiation Therapy in Patients with Brain Metastasis. Int J Radiat Oncol Biol Phys 2023; 117:e217-e218. [PMID: 37784892 DOI: 10.1016/j.ijrobp.2023.06.1115] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Brain metastases (BM) are a common occurrence in patients with advanced cancers, and extremely challenging to treat, resulting in short survival periods. Consequently, whole brain radiation therapy (WBRT) remains the standard palliative intervention for patients with BM. The present study set to evaluate the efficacy of WBRT by assessing the quality of life (QoL) and survival outcomes in WBRT-treated patients with BM. It was hypothesized that the WBRT would enhance the QoL through alleviation of symptoms and functionality, and prolong patient survival. MATERIALS/METHODS This was a prospective, longitudinal, hospital-based single-center study. Consecutive sampling methodology was used to recruit 52 patients with BM undergoing WBRT. Patients were followed up on days 7, 30, 90 and 180 after WBRT. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 15-Palliative care (EORTC QLQ-C15-PAL) was employed to report patient responses in a Likert scale. A descriptive analysis and multi-trait scaling correlation was computed using IBM SPSS Statistics 29.0, 95% confidence interval. The overall survival analysis (Kaplan-Meier) was also performed. RESULTS The study cohort was predominantly females (82.7%), and accordingly, 65.4% of the respondents had a breast primary tumor. A Shapiro-Wilk test of normality revealed that the data was not normally distributed (sig. < 0.05), however, statistic values (W) closer to 1 suggested a good fit. A goodness-of-fit test ascertained the assumption, yielding non-significant Chi square Pearson (p = 0.325) and Deviance (p = 1.000) residuals. There was a significant correlation (p < 0.001) between physical functioning and emotional functioning. Median overall survival was 180 days (∼6 months). A total of 20 patients (38%) that survived up to 180 days reported alleviated symptoms and better functioning. A significant improvement in physical functioning (p < 0.001) and emotional functioning (p = 0.031) was reported at 180 days post WBRT, compared to baseline. Similarly, a significant improvement in visual disorders (p = 0.002), motor dysfunction (p = 0.031), and communication deficit (p = 0.001) was also reported. A significant alleviation of pain was reported at day 90 (p = 0.042) by 53% of the patients that survived. CONCLUSION WBRT is an effective palliative intervention in patients with BM, resulting in improved QoL and prolonged survival. More than 50% of patients that survived 3 months reported a significant alleviation of pain, and 38% of patients that survived for 6 months reported a significantly improved functioning. This demonstrated the effectiveness of WBRT in palliative care and will add to the body of data on the efficacy of radiotherapy.
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Affiliation(s)
| | - A O Joseph
- NSIA-LUTH Cancer Centre, Lagos, Nigeria, Lagos, Nigeria
| | - O A Alabi
- University of Lagos Teaching Hospital, Lagos, Nigeria
| | - J Omomila
- University of Lagos Teaching Hospital, Lagos, Nigeria
| | - L Ngema
- Johns Hopkins Medicine, Baltimore, MD; University of the Witwatersrand, Johannesburg, South Africa
| | | | - J Chin
- Johns Hopkins Medicine, Baltimore, MD
| | - W Ngwa
- Johns Hopkins University Hospital, Baltimore, MD
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Ainsworth V, Moreau M, Guthier R, Zegeye Y, Kozono D, Swanson W, Jandel M, Oh P, Quon H, Hobbs RF, Yasmin-Karim S, Sajo E, Ngwa W. Smart Radiotherapy Biomaterials for Image-Guided In Situ Cancer Vaccination. Nanomaterials (Basel) 2023; 13:1844. [PMID: 37368273 PMCID: PMC10303169 DOI: 10.3390/nano13121844] [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] [Received: 05/10/2023] [Revised: 05/24/2023] [Accepted: 05/26/2023] [Indexed: 06/28/2023]
Abstract
Recent studies have highlighted the potential of smart radiotherapy biomaterials (SRBs) for combining radiotherapy and immunotherapy. These SRBs include smart fiducial markers and smart nanoparticles made with high atomic number materials that can provide requisite image contrast during radiotherapy, increase tumor immunogenicity, and provide sustained local delivery of immunotherapy. Here, we review the state-of-the-art in this area of research, the challenges and opportunities, with a focus on in situ vaccination to expand the role of radiotherapy in the treatment of both local and metastatic disease. A roadmap for clinical translation is outlined with a focus on specific cancers where such an approach is readily translatable or will have the highest impact. The potential of FLASH radiotherapy to synergize with SRBs is discussed including prospects for using SRBs in place of currently used inert radiotherapy biomaterials such as fiducial markers, or spacers. While the bulk of this review focuses on the last decade, in some cases, relevant foundational work extends as far back as the last two and half decades.
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Affiliation(s)
- Victoria Ainsworth
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, MD 21201, USA; (M.M.); (H.Q.); (R.F.H.)
- Department of Physics, Medical Physics, University of Massachusetts Lowell, Lowell, MA 01854, USA (M.J.); (E.S.)
| | - Michele Moreau
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, MD 21201, USA; (M.M.); (H.Q.); (R.F.H.)
- Department of Physics, Medical Physics, University of Massachusetts Lowell, Lowell, MA 01854, USA (M.J.); (E.S.)
| | - Romy Guthier
- Department of Physics, Medical Physics, University of Massachusetts Lowell, Lowell, MA 01854, USA (M.J.); (E.S.)
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA; (Y.Z.); (D.K.); (S.Y.-K.)
| | - Ysaac Zegeye
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA; (Y.Z.); (D.K.); (S.Y.-K.)
- Department of Cell and Molecular Biology, Northeastern University, Boston, MA 02115, USA
| | - David Kozono
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA; (Y.Z.); (D.K.); (S.Y.-K.)
| | - William Swanson
- Department of Radiation Oncology, Weill Cornell Medicine, New York, NY 10065, USA;
| | - Marian Jandel
- Department of Physics, Medical Physics, University of Massachusetts Lowell, Lowell, MA 01854, USA (M.J.); (E.S.)
| | - Philmo Oh
- NanoCan Therapeutics Corporation, Princeton, NJ 08540, USA;
| | - Harry Quon
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, MD 21201, USA; (M.M.); (H.Q.); (R.F.H.)
| | - Robert F. Hobbs
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, MD 21201, USA; (M.M.); (H.Q.); (R.F.H.)
| | - Sayeda Yasmin-Karim
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA; (Y.Z.); (D.K.); (S.Y.-K.)
- Department of Radiation Oncology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Erno Sajo
- Department of Physics, Medical Physics, University of Massachusetts Lowell, Lowell, MA 01854, USA (M.J.); (E.S.)
| | - Wilfred Ngwa
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, MD 21201, USA; (M.M.); (H.Q.); (R.F.H.)
- Department of Physics, Medical Physics, University of Massachusetts Lowell, Lowell, MA 01854, USA (M.J.); (E.S.)
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Ngwa W, Addai BW, Adewole I, Ainsworth V, Alaro J, Alatise OI, Ali Z, Anderson BO, Anorlu R, Avery S, Barango P, Bih N, Booth CM, Brawley OW, Dangou JM, Denny L, Dent J, Elmore SNC, Elzawawy A, Gashumba D, Geel J, Graef K, Gupta S, Gueye SM, Hammad N, Hessissen L, Ilbawi AM, Kambugu J, Kozlakidis Z, Manga S, Maree L, Mohammed SI, Msadabwe S, Mutebi M, Nakaganda A, Ndlovu N, Ndoh K, Ndumbalo J, Ngoma M, Ngoma T, Ntizimira C, Rebbeck TR, Renner L, Romanoff A, Rubagumya F, Sayed S, Sud S, Simonds H, Sullivan R, Swanson W, Vanderpuye V, Wiafe B, Kerr D. Cancer in sub-Saharan Africa: a Lancet Oncology Commission. Lancet Oncol 2022; 23:e251-e312. [PMID: 35550267 PMCID: PMC9393090 DOI: 10.1016/s1470-2045(21)00720-8] [Citation(s) in RCA: 81] [Impact Index Per Article: 40.5] [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: 09/21/2021] [Revised: 12/02/2021] [Accepted: 12/06/2021] [Indexed: 01/13/2023]
Abstract
In sub-Saharan Africa (SSA), urgent action is needed to curb a growing crisis in cancer incidence and mortality. Without rapid interventions, data estimates show a major increase in cancer mortality from 520 348 in 2020 to about 1 million deaths per year by 2030. Here, we detail the state of cancer in SSA, recommend key actions on the basis of analysis, and highlight case studies and successful models that can be emulated, adapted, or improved across the region to reduce the growing cancer crises. Recommended actions begin with the need to develop or update national cancer control plans in each country. Plans must include childhood cancer plans, managing comorbidities such as HIV and malnutrition, a reliable and predictable supply of medication, and the provision of psychosocial, supportive, and palliative care. Plans should also engage traditional, complementary, and alternative medical practices employed by more than 80% of SSA populations and pathways to reduce missed diagnoses and late referrals. More substantial investment is needed in developing cancer registries and cancer diagnostics for core cancer tests. We show that investments in, and increased adoption of, some approaches used during the COVID-19 pandemic, such as hypofractionated radiotherapy and telehealth, can substantially increase access to cancer care in Africa, accelerate cancer prevention and control efforts, increase survival, and save billions of US dollars over the next decade. The involvement of African First Ladies in cancer prevention efforts represents one practical approach that should be amplified across SSA. Moreover, investments in workforce training are crucial to prevent millions of avoidable deaths by 2030. We present a framework that can be used to strategically plan cancer research enhancement in SSA, with investments in research that can produce a return on investment and help drive policy and effective collaborations. Expansion of universal health coverage to incorporate cancer into essential benefits packages is also vital. Implementation of the recommended actions in this Commission will be crucial for reducing the growing cancer crises in SSA and achieving political commitments to the UN Sustainable Development Goals to reduce premature mortality from non-communicable diseases by a third by 2030.
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Affiliation(s)
- Wilfred Ngwa
- Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA; Sidney Kimmel Comprehensive Cancer Center, School of Medicine, Johns Hopkins University, Baltimore, MD, USA; Department of Information and Sciences, ICT University, Yaoundé, Cameroon.
| | - Beatrice W Addai
- Breast Care International, Peace and Love Hospital, Kumasi, Ghana
| | - Isaac Adewole
- College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Victoria Ainsworth
- Department of Physics and Applied Physics, University of Massachusetts Lowell, Lowell, MA, USA
| | - James Alaro
- National Cancer Institute, National Institute of Health, Bethesda, MD, USA
| | | | - Zipporah Ali
- Kenya Hospices and Palliative Care Association, Nairobi, Kenya
| | - Benjamin O Anderson
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Department of Non-communicable Diseases, WHO, Geneva, Switzerland
| | - Rose Anorlu
- Department of Obstetrics and Gynaecology, College of Medicine, University of Lagos, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Stephen Avery
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Prebo Barango
- WHO, Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Noella Bih
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Christopher M Booth
- Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen's University, Kingston, ON, Canada
| | - Otis W Brawley
- Sidney Kimmel Comprehensive Cancer Center, School of Medicine, Johns Hopkins University, Baltimore, MD, USA; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | | | - Lynette Denny
- Department of Obstetrics and Gynaecology, University of Cape Town, Cape Town, South Africa; South African Medical Research Council, Gynaecological Cancer Research Centre, Tygerberg, South Africa
| | | | - Shekinah N C Elmore
- Department of Radiation Oncology, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Ahmed Elzawawy
- Department of Clinical Oncology, Suez Canal University, Ismailia, Egypt
| | | | - Jennifer Geel
- Division of Paediatric Haematology and Oncology, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Katy Graef
- BIO Ventures for Global Health, Seattle, WA, USA
| | - Sumit Gupta
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | | | - Nazik Hammad
- Department of Oncology, Queen's University, Kingston, ON, Canada
| | - Laila Hessissen
- Pediatric Oncology Department, Pediatric Teaching Hospital, Rabat, Morocco
| | - Andre M Ilbawi
- Department of Non-communicable Diseases, WHO, Geneva, Switzerland
| | - Joyce Kambugu
- Department of Pediatrics, Uganda Cancer Institute, Kampala, Uganda
| | - Zisis Kozlakidis
- Laboratory Services and Biobank Group, International Agency for Research on Cancer, WHO, Lyon, France
| | - Simon Manga
- Cameroon Baptist Convention Health Services, Bamenda, Cameroon
| | - Lize Maree
- Department of Nursing Education, University of the Witwatersrand, Johannesburg, South Africa
| | - Sulma I Mohammed
- Department of Comparative Pathobiology, Center for Cancer Research, Purdue University, West Lafayette, IN, USA
| | - Susan Msadabwe
- Department of Radiation Therapy, Cancer Diseases Hospital, Lusaka, Zambia
| | - Miriam Mutebi
- Department of Surgery, Aga Khan University Hospital, Nairobi, Kenya
| | | | - Ntokozo Ndlovu
- Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Kingsley Ndoh
- Department of Global Health, University of Washington, Seattle, WA, USA
| | | | - Mamsau Ngoma
- Ocean Road Cancer Institute, Dar es Salaam, Tanzania
| | - Twalib Ngoma
- Department of Clinical Oncology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Timothy R Rebbeck
- Dana-Farber Cancer Institute, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Lorna Renner
- Department of Paediatrics, University of Ghana School of Medicine and Dentistry, Accra, Ghana
| | - Anya Romanoff
- Department of Health System Design and Global Health, Icahn School of Medicine, The Mount Sinai Hospital, New York, NY, USA
| | - Fidel Rubagumya
- Department of Oncology, Rwanda Military Hospital, Kigali, Rwanda; University of Global Health Equity, Kigali, Rwanda
| | - Shahin Sayed
- Department of Pathology, Aga Khan University Hospital, Nairobi, Kenya
| | - Shivani Sud
- Department of Radiation Oncology, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Hannah Simonds
- Division of Radiation Oncology, Tygerberg Hospital and University of Stellenbosch, Stellenbosch, South Africa
| | | | - William Swanson
- Department of Physics and Applied Physics, Dana-Farber Cancer Institute, University of Massachusetts Lowell, Lowell, MA, USA
| | - Verna Vanderpuye
- National Centre for Radiotherapy, Oncology, and Nuclear Medicine, Korle Bu Teaching Hospital, Accra, Ghana
| | | | - David Kerr
- Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford, UK
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Yasmin-Karim S, Wood J, Wirtz J, Moreau M, Bih N, Swanson W, Muflam A, Ainsworth V, Ziberi B, Ngwa W. Optimizing In Situ Vaccination During Radiotherapy. Front Oncol 2021; 11:711078. [PMID: 34765538 PMCID: PMC8577814 DOI: 10.3389/fonc.2021.711078] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 09/27/2021] [Indexed: 11/13/2022] Open
Abstract
Effective in situ cancer vaccines require both a means of tumor cell death and a source of adjuvant to activate local dendritic cells. Studies have shown that the use of radiotherapy (RT) to induce tumor cell death and anti-CD40 to activate dendritic cells can result in in situ vaccination in animal models. Here, investigations are carried out on potential strategies to enhance such in situ vaccination. Strategies investigated include the use of smart immunogenic biomaterials (IBM) loaded with anti-CD40 in different tumor types including immunologically cold tumors like pancreatic and prostate tumors. The use of downstream checkpoint inhibitors to further boost such in situ vaccination is also examined. Results indicate that the use of IBM to deliver the anti-CD40 significantly enhances the effectiveness of in situ vaccination with anti-CD40 compared with direct injection in pancreatic and prostate cancers (p < 0.001 and p < 0.0001, respectively). This finding is consistent with significant increase in infiltration of antigen-presenting cells in the treated tumor, and significant increase in the infiltration of CD8+ cytotoxic T lymphocyte into distant untreated tumors. Moreover, in situ vaccination with IBM is consistently observed across different tumor types. Meanwhile, the addition of downstream immune checkpoint inhibitors further enhances overall survival when using the IBM approach. Overall, the findings highlight potential avenues for enhancing in situ vaccination when combining radiotherapy with anti-CD40.
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Affiliation(s)
- Sayeda Yasmin-Karim
- Department of Radiation Oncology, Dana Farber Cancer Institute, Boston, MA, United States.,Department of Radiation Oncology, Brigham and Women's Hospital, Boston, MA, United States.,Department of Radiation Oncology, Harvard Medical School, Boston, MA, United States
| | - Jana Wood
- Department of Radiation Oncology, Dana Farber Cancer Institute, Boston, MA, United States.,Department of Radiation Oncology, Brigham and Women's Hospital, Boston, MA, United States.,Department of Radiation Oncology, Harvard Medical School, Boston, MA, United States.,Department of Immunology and Microbiology, University of Veternary Medicine and Pharmacy in Kosice, Kosice, Slovakia
| | - Johanna Wirtz
- Department of Radiation Oncology, Dana Farber Cancer Institute, Boston, MA, United States.,Department of Radiation Oncology, Brigham and Women's Hospital, Boston, MA, United States.,Department of Radiation Oncology, Harvard Medical School, Boston, MA, United States.,Medical Faculty, University of Ulm, Ulm, Germany
| | - Michele Moreau
- Department of Radiation Oncology, Dana Farber Cancer Institute, Boston, MA, United States.,Department of Radiation Oncology, Brigham and Women's Hospital, Boston, MA, United States.,Department of Radiation Oncology, Harvard Medical School, Boston, MA, United States.,Department of Physics and Applied Physics, University of Massachusetts Lowell, Lowell, MA, United States.,Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, MD, United States
| | - Noella Bih
- Department of Radiation Oncology, Dana Farber Cancer Institute, Boston, MA, United States.,Department of Radiation Oncology, Brigham and Women's Hospital, Boston, MA, United States.,Department of Radiation Oncology, Harvard Medical School, Boston, MA, United States
| | - William Swanson
- Department of Radiation Oncology, Dana Farber Cancer Institute, Boston, MA, United States.,Department of Radiation Oncology, Brigham and Women's Hospital, Boston, MA, United States.,Department of Radiation Oncology, Harvard Medical School, Boston, MA, United States.,Department of Physics and Applied Physics, University of Massachusetts Lowell, Lowell, MA, United States
| | - Ashley Muflam
- Department of Library and Information Science, Rutgers University New Brunswick, New Brunswick, NJ, United States
| | - Victoria Ainsworth
- Department of Radiation Oncology, Dana Farber Cancer Institute, Boston, MA, United States.,Department of Radiation Oncology, Brigham and Women's Hospital, Boston, MA, United States.,Department of Radiation Oncology, Harvard Medical School, Boston, MA, United States.,Department of Physics and Applied Physics, University of Massachusetts Lowell, Lowell, MA, United States
| | - Bashkim Ziberi
- Department of Radiation Oncology, Dana Farber Cancer Institute, Boston, MA, United States.,Department of Radiation Oncology, Brigham and Women's Hospital, Boston, MA, United States.,Department of Radiation Oncology, Harvard Medical School, Boston, MA, United States.,Department of Physics, University of Tetova, Tetova, North Macedonia
| | - Wilfred Ngwa
- Department of Radiation Oncology, Dana Farber Cancer Institute, Boston, MA, United States.,Department of Radiation Oncology, Brigham and Women's Hospital, Boston, MA, United States.,Department of Radiation Oncology, Harvard Medical School, Boston, MA, United States.,Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, MD, United States
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Yasmin-Karim S, Ziberi B, Mueller R, Bih N, Moreau M, Ainsworth V, Chuong M, Kozono D, Ngwa W. Abscopal Effect of Partial Versus Whole Tumor Irradiation With Anti-CD40 in Pancreas and Lung Tumor Mouse Models. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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