9351
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Cantwell MM, Murray LJ, Catney D, Donnelly D, Autier P, Boniol M, Fox C, Middleton RJ, Dolan OM, Gavin AT. Second primary cancers in patients with skin cancer: a population-based study in Northern Ireland. Br J Cancer 2009; 100:174-7. [PMID: 19127269 PMCID: PMC2634689 DOI: 10.1038/sj.bjc.6604842] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2008] [Revised: 11/21/2008] [Accepted: 11/28/2008] [Indexed: 11/23/2022] Open
Abstract
Among all 14,500 incident cases of basal cell carcinoma (BCC), 6405 squamous cell carcinomas (SCC) and 1839 melanomas reported to the Northern Ireland Cancer Registry between 1993 and 2002, compared with the general population, risk of new primaries after BCC or SCC was increased by 9 and 57%, respectively. The subsequent risk of cancer, overall, was more than double after melanoma.
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Affiliation(s)
- M M Cantwell
- Cancer Epidemiology and Prevention Research Group, Centre for Clinical and Population Sciences, Queen's University Belfast, Belfast, Northern Ireland.
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9352
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Smalley KSM, Xiao M, Villanueva J, Nguyen TK, Flaherty KT, Letrero R, Belle PV, Elder DE, Wang Y, Nathanson KL, Herlyn M. CRAF inhibition induces apoptosis in melanoma cells with non-V600E BRAF mutations. Oncogene 2009; 28:85-94. [PMID: 18794803 PMCID: PMC2898184 DOI: 10.1038/onc.2008.362] [Citation(s) in RCA: 166] [Impact Index Per Article: 11.1] [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: 05/13/2008] [Revised: 08/06/2008] [Accepted: 08/18/2008] [Indexed: 12/19/2022]
Abstract
Here, we identify a panel of melanoma lines with non-V600E mutations in BRAF. These G469E- and D594G-mutated melanomas were found to exhibit constitutive levels of phospho-extracellular signal-regulated kinase (pERK) and low levels of phospho-mitogen-activated protein kinase/ERK kinase (pMEK) and were resistant to MEK inhibition. Upon treatment with the CRAF inhibitor sorafenib, these lines underwent apoptosis and associated with mitochondrial depolarization and relocalization of apoptosis-inducing factor, whereas the BRAF-V600E-mutated melanomas did not. Studies have shown low-activity mutants of BRAF (G469E/D594G) instead signal through CRAF. Unlike BRAF, CRAF directly regulates apoptosis through mitochondrial localization where it binds to Bcl-2 and phosphorylates BAD. The CRAF inhibitor sorafenib was found to induce a time-dependent reduction in both BAD phosphorylation and Bcl-2 expression in the D594G/G469E lines only. Knockdown of CRAF using a lentiviral shRNA suppressed both Bcl-2 expression and induced apoptosis in the D594G melanoma line but not in a V600E-mutated line. Finally, we showed in a series of xenograft studies that sorafenib was more potent at reducing the growth of tumors with the D594G mutation than those with the V600E mutation. In summary, we have identified a group of melanomas with low-activity BRAF mutations that are reliant upon CRAF-mediated survival activity.
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Affiliation(s)
| | - Min Xiao
- The Wistar Institute, 3601 Spruce Street, Philadelphia, PA
| | | | | | - Keith T. Flaherty
- Division of Hematology-Oncology, University of Pennsylvania School of Medicine, Philadelphia, PA
- The Abramson Cancer Center, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Richard Letrero
- Division of Medical Genetics, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Patricia Van Belle
- Pathology and Laboratory Medicine University of Pennsylvania School of Medicine, Philadelphia, PA
| | - David E. Elder
- Pathology and Laboratory Medicine University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Yan Wang
- Department of Otorhinolaryngology, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Katherine L. Nathanson
- Division of Medical Genetics, University of Pennsylvania School of Medicine, Philadelphia, PA
- The Abramson Cancer Center, University of Pennsylvania School of Medicine, Philadelphia, PA
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9353
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French AD, Fiori JL, Camilli TC, Leotlela PD, O'Connell MP, Frank BP, Subaran S, Indig FE, Taub DD, Weeraratna AT. PKC and PKA phosphorylation affect the subcellular localization of claudin-1 in melanoma cells. Int J Med Sci 2009; 6:93-101. [PMID: 19305641 PMCID: PMC2658888 DOI: 10.7150/ijms.6.93] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2009] [Accepted: 03/12/2009] [Indexed: 12/13/2022] Open
Abstract
Cytoplasmic expression of claudin-1 in metastatic melanoma cells correlates to increased migration, and increased secretion of MMP-2 in a PKC dependent manner, whereas claudin-1 nuclear expression is found in benign nevi. Melanoma cells were transfected with a vector expressing CLDN-1 fused to a nuclear localization signal (NLS). Despite significant nuclear localization of claudin-1, there was still transport of claudin-1 to the cytoplasm. Phorbol ester treatment of cells transfected with NLS-claudin-1 resulted in an exclusion of claudin-1 from the nucleus, despite the NLS. To ascertain whether PKC or PKA were involved in this translocation, we mutated the putative phosphorylation sites within the protein. We found that mutating the PKC phosphorylation sites to mimic a non-phosphorylated state did not cause a shift of claudin-1 to the nucleus of the cells, but mutating the PKA sites did. Mutations of either site to mimic constitutive phosphorylation resulted in cytoplasmic claudin-1 expression. Stable claudin-1 transfectants containing non-phosphorylatable PKA sites exhibited decreased motility. These data imply that subcellular localization of claudin-1 can be controlled by phosphorylation, dicating effects on metastatic capacity.
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Affiliation(s)
- Amanda D French
- Laboratory of Immunology, National Institute on Aging, Baltimore, MD 21124, USA
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9354
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Valachis A, Mauri D, Karampoiki V, Polyzos NP, Cortinovis I, Koukourakis G, Zacharias G, Xilomenos A, Tsappi M, Casazza G. Time-trend of melanoma screening practice by primary care physicians: a meta-regression analysis. Ups J Med Sci 2009; 114:32-40. [PMID: 19242870 PMCID: PMC2852745 DOI: 10.1080/03009730802579620] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To assess whether the proportion of primary care physicians implementing full body skin examination (FBSE) to screen for melanoma changed over time. METHODS Meta-regression analyses of available data. DATA SOURCES MEDLINE, ISI, Cochrane Central Register of Controlled Trials. RESULTS Fifteen studies surveying 10,336 physicians were included in the analyses. Overall, 15%-82% of them reported to perform FBSE to screen for melanoma. The proportion of physicians using FBSE screening tended to decrease by 1.72% per year (P =0.086). Corresponding annual changes in European, North American, and Australian settings were -0.68% (P =0.494), -2.02% (P =0.044), and +2.59% (P =0.010), respectively. Changes were not influenced by national guide-lines. CONCLUSIONS Considering the increasing incidence of melanoma and other skin malignancies, as well as their relative potential consequences, the FBSE implementation time-trend we retrieved should be considered a worrisome phenomenon.
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Affiliation(s)
- Antonis Valachis
- PACMeR (Panhellenic Association for Continual Medical Research), Athens, Greece.
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9355
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Grant WB. A critical review of Vitamin D and Cancer: A report of the IARC Working Group. Dermatoendocrinol 2009; 1:25-33. [PMID: 20046585 PMCID: PMC2715207 DOI: 10.4161/derm.1.1.7729] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2008] [Accepted: 12/29/2008] [Indexed: 12/22/2022]
Abstract
The International Agency for Research on Cancer (IARC) released a report, Vitamin D and Cancer, on November 25, 2008. The report focused on the current state of knowledge and level of evidence of a causal association between vitamin D status and cancer risk. Although presenting and evaluating evidence for the beneficial role of UVB and vitamin D in reducing the risk of cancer, it discounted or omitted important evidence in support of the efficacy of vitamin D. The report largely dismissed or ignored ecological studies on the grounds that confounding factors might have affected the findings. The report accepted a preventive role of vitamin D in colorectal cancer but not for breast cancer.The only randomized controlled trial (RCT) on cancer incidence that used a sufficiently high dose of vitamin D (1,100 IU/day) and calcium (1,400-1,500 mg/day) found a 77% reduction in the risk of all-cancer incidence in postmenopausal women who received both, of which approximately 35% reduction in risk was attributed to vitamin D alone. Unfairly, the report dismissed these findings on the basis of a flawed critique.The report called for RCTs of vitamin D supplementation to settle the issue. Although RCTs theoretically would be beneficial, development of sound and effective public health policies does not necessarily depend on them, and the field of vitamin D, calcium and chronic disease has reached the point where RCTs may not be ethical.The IARC report should therefore not form the basis for public health policy decisions.
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Affiliation(s)
- William B Grant
- Sunlight, Nutrition and Health Research Center (SUNARC); San Francisco, California USA
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9356
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Jacobs JFM, Aarntzen EHJG, Sibelt LAG, Blokx WA, Boullart ACI, Gerritsen MJ, Hoogerbrugge PM, Figdor CG, Adema GJ, Punt CJA, de Vries IJM. Vaccine-specific local T cell reactivity in immunotherapy-associated vitiligo in melanoma patients. Cancer Immunol Immunother 2009; 58:145-51. [PMID: 18392619 PMCID: PMC11029900 DOI: 10.1007/s00262-008-0506-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [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: 01/26/2008] [Accepted: 03/19/2008] [Indexed: 02/07/2023]
Abstract
The occurrence of vitiligo in patients with melanoma is especially reported for patients undergoing immunotherapy. While vitiligo in these patients is thought to be related to an immune response directed against melanoma cells, solid evidence is lacking. Here we report local cytotoxic T cell reactivity in three melanoma patients who developed vitiligo, after experimental immunotherapy using dendritic cell vaccinations. Tetramer analysis showed that vaccine-induced T cells recognizing gp100 and tyrosinase are present at the vitiligo lesions. These T cells secrete IFN-gamma and IL-2 upon peptide specific stimulation as well as upon recognition of the autologous tumor. We show that functional CD8(+) T cells specific for melanoma differentiation antigens used in a melanoma immunotherapy trial, do not only invade the tumor, but also the vitiligo lesions. This directly links vitiligo to the immuno-therapeutic intervention and supports the hypothesis that vitiligo is a marker of immunity against melanoma cells.
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Affiliation(s)
- Joannes F. M. Jacobs
- Department of Pediatric Hemato-oncology, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands
| | - Erik H. J. G. Aarntzen
- Department of Medical Oncology, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands
| | - Lenny A. G. Sibelt
- Department of Dermatology, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands
| | - Willeke A. Blokx
- Department of Pathology, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands
| | - Anna C. I. Boullart
- Department of Medical Oncology, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands
| | - Marie-Jeanne Gerritsen
- Department of Dermatology, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands
| | - Peter M. Hoogerbrugge
- Department of Pediatric Hemato-oncology, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands
| | - Carl G. Figdor
- Department of Tumor Immunology, Nijmegen Centre for Molecular Life Sciences, Nijmegen, The Netherlands
| | - Gosse J. Adema
- Department of Tumor Immunology, Nijmegen Centre for Molecular Life Sciences, Nijmegen, The Netherlands
| | - Cornelis J. A. Punt
- Department of Medical Oncology, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands
| | - I. Jolanda M. de Vries
- Department of Pediatric Hemato-oncology, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands
- Department of Tumor Immunology, Nijmegen Centre for Molecular Life Sciences, Nijmegen, The Netherlands
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9357
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Jandus C, Bioley G, Speiser DE, Romero P. Selective accumulation of differentiated FOXP3(+) CD4 (+) T cells in metastatic tumor lesions from melanoma patients compared to peripheral blood. Cancer Immunol Immunother 2008; 57:1795-805. [PMID: 18414854 PMCID: PMC11030612 DOI: 10.1007/s00262-008-0507-4] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [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: 01/14/2008] [Accepted: 03/22/2008] [Indexed: 01/04/2023]
Abstract
Precise identification of regulatory T cells is crucial in the understanding of their role in human cancers. Here, we analyzed the frequency and phenotype of regulatory T cells (Tregs), in both healthy donors and melanoma patients, based on the expression of the transcription factor FOXP3, which, to date, is the most reliable marker for Tregs, at least in mice. We observed that FOXP3 expression is not confined to human CD25(+/high) CD4(+) T cells, and that these cells are not homogenously FOXP3(+). The circulating relative levels of FOXP3(+) CD4(+) T cells may fluctuate close to 2-fold over a short period of observation and are significantly higher in women than in men. Further, we showed that FOXP3(+) CD4(+) T cells are over-represented in peripheral blood of melanoma patients, as compared to healthy donors, and that they are even more enriched in tumor-infiltrated lymph nodes and at tumor sites, but not in normal lymph nodes. Interestingly, in melanoma patients, a significantly higher proportion of functional, antigen-experienced FOXP3(+) CD4(+) T was observed at tumor sites, compared to peripheral blood. Together, our data suggest that local accumulation and differentiation of Tregs is, at least in part, tumor-driven, and illustrate a reliable combination of markers for their monitoring in various clinical settings.
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Affiliation(s)
- Camilla Jandus
- Division of Clinical Onco-Immunology, Ludwig Institute for Cancer Research, Lausanne Branch, University Hospital (CHUV), Hôpital Orthopédique Niv. 5, aile est, Av. Pierre Decker 4, 1005 Lausanne, Switzerland
- National Center for Competence in Research, Molecular Oncology, Epalinges, Switzerland
| | - Gilles Bioley
- Division of Clinical Onco-Immunology, Ludwig Institute for Cancer Research, Lausanne Branch, University Hospital (CHUV), Hôpital Orthopédique Niv. 5, aile est, Av. Pierre Decker 4, 1005 Lausanne, Switzerland
- Present Address: Laboratory of Cancer Vaccinotherapy, INSERM U601, CLCC René Gauducheau, Saint-Herblain, France
| | - Daniel E. Speiser
- Division of Clinical Onco-Immunology, Ludwig Institute for Cancer Research, Lausanne Branch, University Hospital (CHUV), Hôpital Orthopédique Niv. 5, aile est, Av. Pierre Decker 4, 1005 Lausanne, Switzerland
- National Center for Competence in Research, Molecular Oncology, Epalinges, Switzerland
| | - Pedro Romero
- Division of Clinical Onco-Immunology, Ludwig Institute for Cancer Research, Lausanne Branch, University Hospital (CHUV), Hôpital Orthopédique Niv. 5, aile est, Av. Pierre Decker 4, 1005 Lausanne, Switzerland
- National Center for Competence in Research, Molecular Oncology, Epalinges, Switzerland
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9358
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Bowling BD, Doudican N, Manga P, Orlow SJ. Inhibition of mitochondrial protein translation sensitizes melanoma cells to arsenic trioxide cytotoxicity via a reactive oxygen species dependent mechanism. Cancer Chemother Pharmacol 2008; 63:37-43. [PMID: 18297286 PMCID: PMC2749296 DOI: 10.1007/s00280-008-0705-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [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: 12/17/2007] [Accepted: 02/08/2008] [Indexed: 10/22/2022]
Abstract
PURPOSE Current standard chemotherapeutic regimens for malignant melanoma are unsatisfactory. Although in vitro studies of arsenic trioxide (ATO) have demonstrated promise against melanoma, recent phase II clinical trials have failed to show any significant clinical benefit when used as a single agent. To enhance the efficacy of ATO in the treatment of melanoma, we sought to identify compounds that potentiate the cytotoxic effects of ATO in melanoma cells. Through a screen of 2,000 marketed drugs and naturally occurring compounds, a variety of antibiotic inhibitors of mitochondrial protein translation were identified. METHODS The mechanism of action for the most effective agent identified, thiostrepton, was examined in a panel of melanoma cells. Effects of combinatorial ATO and thiostrepton treatment on cytotoxicity, apoptosis, mitochondrial protein content, and reactive oxygen species (ROS) were assessed. RESULTS Thiostrepton (1 microM) sensitized three out of five melanoma cell lines to ATO-mediated growth inhibition. Treatment with thiostrepton resulted in reduced levels of the mitochondrial-encoded protein cytochrome oxidase I (COX1). Exposure to thiostrepton in combination with ATO resulted in increased levels of cleaved poly (ADP-ribose) polymerase and cellular ROS. The growth inhibitory and pro-apototic effects of addition of the ATO/thiostrepton combination were reversed by the free radical scavenger N-acetyl-L-cysteine. CONCLUSIONS Our data suggest that thiostrepton enhances the cytotoxic effects of ATO through a ROS-dependent mechanism. Co-administration of oxidative stress-inducing drugs such as thiostrepton in order to enhance the efficacy of ATO in the treatment of melanoma warrants further investigation.
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Affiliation(s)
- Benjamin D. Bowling
- NYU School of Medicine, Department of Dermatology, New York City, New York
- Yale University School of Medicine, New Haven, Connecticut
| | - Nicole Doudican
- NYU School of Medicine, Department of Dermatology, New York City, New York
| | - Prashiela Manga
- NYU School of Medicine, Department of Dermatology, New York City, New York
| | - Seth J. Orlow
- NYU School of Medicine, Department of Dermatology, New York City, New York
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9359
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Harstad L, Hess KR, Groves MD. Prognostic factors and outcomes in patients with leptomeningeal melanomatosis. Neuro Oncol 2008; 10:1010-8. [PMID: 18708343 PMCID: PMC2718998 DOI: 10.1215/15228517-2008-062] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.9] [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: 08/14/2007] [Accepted: 07/29/2008] [Indexed: 11/19/2022] Open
Abstract
The purpose of this study was to describe a cohort of patients with leptomeningeal melanomatosis (LM) and to determine prognostic factors for outcomes in these patients. The primary hypothesis was that more extensive burden of CNS metastasis at the time of diagnosis of LM (as evidenced by imaging of the CNS parenchyma and meninges and cerebrospinal fluid [CSF] cytology status [positive versus negative]) correlates with poorer outcomes. The records of all patients with LM treated at M. D. Anderson Cancer Center between 1944 and 2002 were reviewed. Information on clinical course and outcomes was gathered. Univariate and multivariate analyses were performed on 110 patients using Cox proportional hazards regression analysis to examine the effects of possible predictive factors on survival. The overall median survival from LM diagnosis was 10 weeks, with a 95% confidence interval (CI) of 8-14 weeks. Eighty-six (78.2%) patients had cutaneous primary lesions, and 23 (20.9%) had melanoma of unknown primary site. The primary hypothesis was not proven. Neither the presence of parenchymal CNS metastases, nor greater imaging evidence of LM, nor positive CSF cytology at diagnosis correlated with survival outcomes. Univariate analyses revealed possible predictors of longer survival, including the presence of supratentorial or spinal LM on imaging at diagnosis versus its absence and any treatment of LM, whereas elevated serum lactate dehydrogenase at the time of LM diagnosis predicted shorter survival. Multivariate analysis revealed that a history of a primary melanoma lesion originating on the trunk predicted shorter survival after LM diagnosis (hazard ratio [HR] = 2.0, 95% CI = 1.0-3.8, p = 0.035), and treatment with intrathecal chemotherapy predicted longer survival (HR = 0.5, 95% CI = 0.4-0.8, p = 0.0036). The positive result with respect to treatment is unreliable due to the inability to remove treatment selection bias from the analysis. This retrospective analysis confirmed the dismal prognosis associated with LM. The amount of CNS tumor burden at the time of diagnosis of LM did not inversely correlate with survival outcomes, contrary to our hypothesis.
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Affiliation(s)
- Laura Harstad
- Departments of Neuro-Oncology (L.H., M.D.G.) and Biostatistics (K.R.H.)., The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Kenneth R. Hess
- Departments of Neuro-Oncology (L.H., M.D.G.) and Biostatistics (K.R.H.)., The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Morris D. Groves
- Departments of Neuro-Oncology (L.H., M.D.G.) and Biostatistics (K.R.H.)., The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
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9360
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Abstract
CD133 (Prominin-1) is considered the most important cancer stem cell (CSC)-associated marker identified so far, with increased expression in the CSC fraction of a large variety of human malignancies, including melanoma. Here we investigated the effects of CD133 downregulation in vitro and in vivo in human metastatic melanoma. The average number of CD133 molecules on the cell surface of FEMX-I melanoma cells was decreased by 8.7-fold and 1.8-fold using two different short hairpin RNAs. Downregulation of CD133, confirmed by immunocytochemistry, Western blotting, microarray analysis, and reverse transcription-polymerase chain reaction, resulted in slower cell growth, reduced cell motility, and decreased capacity to form spheroids under stem cell-like growth conditions. Clonal analysis revealed that the reduction in growth rate was proportional to the extent of CD133 downregulation. Monoclonal antibodies directed against two different epitopes of the CD133 protein induced a specific, dose-dependent cytotoxic effect in FEMX-I cells. The downregulation of CD133 severely reduced the capacity of the cells to metastasize, particularly to the spinal cord. In the CD133 downregulated cells, microarray analysis revealed expression changes for only 143 annotated genes (76 up- and 67 downregulated). Ten of the 76 upregulated genes coded for Wnt inhibitors, suggesting an interaction between CD133 and the canonical Wnt pathway. We conclude that CD133, in addition to its role as a CSC marker, is an important therapeutic target for metastatic melanoma and, potentially, for other CD133-expressing cancer types.
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Affiliation(s)
- Germana Rappa
- Mitchell Cancer Institute, University of South Alabama, Mobile, Alabama 36688, USA
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9361
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Mazorra Z, Mesa C, Fernández A, Fernández LE. Immunization with a GM3 ganglioside nanoparticulated vaccine confers an effector CD8(+) T cells-mediated protection against melanoma B16 challenge. Cancer Immunol Immunother 2008; 57:1771-80. [PMID: 18351335 PMCID: PMC11029898 DOI: 10.1007/s00262-008-0503-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [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: 11/15/2007] [Accepted: 03/03/2008] [Indexed: 01/11/2023]
Abstract
Preventive immunotherapy is an attractive strategy for patients at a high risk of having cancer. The success of prophylactic cancer vaccines would depend on the selection of target antigens that are essential for tumour growth and progression. The overexpression of GM3 ganglioside in murine and human melanomas and its important role in tumour progression makes this self antigen a potential target for preventive immunotherapy of this neoplasm. We have previously shown that preventive administration of a GM3-based vaccine to C57BL/6 mice elicited the rejection of the GM3 positive-B16 melanoma cells in most of the animals. Despite the crucial role of cellular immune response in tumour protection, the involvement of T cells in anti-tumour immunity of ganglioside vaccines is not described. Here, we examined the mechanisms by which this immunogen confers tumour protection. We have found that induction of anti-GM3 IgG antibodies correlated with tumour protection. Surprisingly, CD8(+) T cells, but not NK1.1(+) cells, are required in the effector phase of the antitumour immune response. The depletion of CD4(+) T cells during immunization phase did not affect the anti-tumour activity. In addition, T cells from surviving-immunized animals secreted IFNgamma when were co-cultured with IFNalpha-treated B16 melanoma cells or DCs pulsed with melanoma extract. Paradoxically, in spite of the glycolipidic nature of this antigen, these findings demonstrate the direct involvement of the cellular immune response in the anti-tumour protection induced by a ganglioside-based vaccine.
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Affiliation(s)
- Zaima Mazorra
- Department of Vaccines, Center of Molecular Immunology, Havana, Cuba.
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9362
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Stoitzner P, Green LK, Jung JY, Price KM, Atarea H, Kivell B, Ronchese F. Inefficient presentation of tumor-derived antigen by tumor-infiltrating dendritic cells. Cancer Immunol Immunother 2008; 57:1665-73. [PMID: 18311487 PMCID: PMC11029823 DOI: 10.1007/s00262-008-0487-4] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.9] [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: 11/07/2007] [Accepted: 02/12/2008] [Indexed: 11/30/2022]
Abstract
BACKGROUND Transplantable B16 melanoma is widely used as a tumor model to investigate tumor immunity. We wished to characterize the leukocyte populations infiltrating B16 melanoma tumors, and the functional properties of tumor-infiltrating dendritic cells (TIDC). MATERIALS AND METHODS We used the B16 melanoma cell line expressing ovalbumin protein (OVA) to investigate the phenotype and T cell stimulatory capacity of TIDC. RESULTS The majority of leukocytes in B16 melanoma were macrophages, which colocalized with TIDCs, B and T cells to the peripheral area of the tumor. Both myeloid and plasmacytoid DC populations were present within tumors. Most of these DCs appeared immature, but about a third expressed a mature phenotype. TIDCs did not present tumor-derived antigen, as they were unable to induce the proliferation of tumor-specific CD4+ and CD8+ T cells in vitro unless in the presence of specific peptides. Some presentation of tumor-derived antigen could be demonstrated in the tumor-draining lymph node using in vivo proliferation assays. However, while proliferation of CD8+ T cells was reproducibly demonstrated, no proliferation of CD4+ T cells was observed. CONCLUSION In summary, our data suggest that DCs in tumors have limited antigen-presenting function. Inefficient antigen presentation extends to the tumor-draining lymph node, and may affect the generation of antitumor immune responses.
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9363
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Abstract
Skin cancer is the most common form of cancer types. It is generally divided into two categories: melanoma (∼ 5%) and nonmelanoma (∼ 95%), which can be further categorized into basal cell carcinoma, squamous cell carcinoma, and some rare skin cancer types. Biopsy is still the gold standard for skin cancer evaluation in the clinic. Various anatomical imaging techniques have been used to evaluate different types of skin cancer lesions, including laser scanning confocal microscopy, optical coherence tomography, high-frequency ultrasound, terahertz pulsed imaging, magnetic resonance imaging, and some other recently developed techniques such as photoacoustic microscopy. However, anatomical imaging alone may not be sufficient in guiding skin cancer diagnosis and therapy. Over the last decade, various molecular imaging techniques (in particular single photon emission computed tomography and positron emission tomography) have been investigated for skin cancer imaging. The pathways or molecular targets that have been studied include glucose metabolism, integrin αvβ3, melanocortin-1 receptor, high molecular weight melanoma-associated antigen, and several other molecular markers. Preclinical molecular imaging is thriving all over the world, while clinical molecular imaging has not lived up to the expectations because of slow bench-to-bedside translation. It is likely that this situation will change in the near future and molecular imaging will truly play an important role in personalized medicine of melanoma patients.
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Affiliation(s)
- Hao Hong
- Departments of Radiology and Medical Physics, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, Wisconsin, USA
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9364
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Tsuji K, Hamada T, Uenaka A, Wada H, Sato E, Isobe M, Asagoe K, Yamasaki O, Shiku H, Ritter G, Murphy R, Hoffman EW, Old LJ, Nakayama E, Iwatsuki K. Induction of immune response against NY-ESO-1 by CHP-NY-ESO-1 vaccination and immune regulation in a melanoma patient. Cancer Immunol Immunother 2008; 57:1429-37. [PMID: 18311489 PMCID: PMC11030644 DOI: 10.1007/s00262-008-0478-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [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: 07/17/2007] [Accepted: 02/04/2008] [Indexed: 10/22/2022]
Abstract
BACKGROUND NY-ESO-1 is a cancer/testis antigen highly immunogenic in cancer patients. Cholesterol-bearing hydrophobized pullulan (CHP) is a nanoparticle-forming antigen-delivery vehicle and CHP complexed with NY-ESO-1 protein (CHP-NY-ESO-1) efficiently activates CD4 and CD8 T cells in vitro. AIM In this study we report on a 50-year-old male melanoma patient with multiple skin and organ metastases (T4N3M1c) who was vaccinated with CHP-NY-ESO-1 at biweekly intervals and who had an unusual disease course. We characterized in this patient humoral and cellular immune responses, immune regulatory cells, and cytokine profiles in the peripheral blood and at local tumor sites. RESULTS Ten days after the second CHP-NY-ESO-1 vaccination (day 25), blisters appeared on the skin at the metastatic lesions associated with inflammatory changes. A skin biopsy showed the presence of many NY-ESO-1-expressing apoptotic melanoma cells as determined by a terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling (TUNEL) test. However, the tumors continued to grow, and the patient died of pulmonary failure due to multiple metastases on day 48. Serum antibody responses were detected after the second CHP-NY-ESO-1 vaccination and antibody titer increased with subsequent vaccinations. Th1 dependent IgG1 was the predominant immunoglobulin subtype. Both, NY-ESO-1-specific CD4 and CD8 T cell responses were detected in PBMC by IFN-gamma secretion assays. After CHP-NY-ESO-1 vaccination a slight decrease in CD4(+)CD25(+)Foxp3(+) Tregs was observed in PBMC but significantly increased numbers of CD4(+)CD25(+)Foxp3(+) Tregs and CD68(+) immunoregulatory macrophages were detected at the local tumor sites. CD4(+)CD25(+)Foxp3(+) Tregs were also increased in the blister fluid. Cytokines in the serum suggested a polarization towards a Th1 pattern in the PBMC and those in the blister fluid suggested a Th2-type response at the tumor site. CONCLUSIONS Our observations indicate induction of specific humoral and cellular immune responses against NY-ESO-1 after CHP-NY-ESO-1 vaccination in a melanoma patient. The concomitant appearance of regulatory T cells and of immune regulatory macrophages and cytokines at the local tumor sites in this patient may explain immune escape.
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Affiliation(s)
- Kazuhide Tsuji
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
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9365
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Buckwalter MR, Srivastava PK. "It is the antigen(s), stupid" and other lessons from over a decade of vaccitherapy of human cancer. Semin Immunol 2008; 20:296-300. [PMID: 18715801 PMCID: PMC6731373 DOI: 10.1016/j.smim.2008.07.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2008] [Accepted: 07/01/2008] [Indexed: 02/08/2023]
Abstract
The lessons are: (a) human cancers certainly respond to immunological manipulations. Efforts at human cancer immunotherapy are therefore worthwhile. (b) Prophylaxis is very different from therapy of pre-existing disease, and hence much enthusiasm should not be derived from successful prophylaxis studies. Even in case of infectious agents against which robust prophylaxis is routinely achieved, therapy is nearly impossible once the disease has established. (c) Studies with appropriate cancer models of mice and rats are useful. The notion that it is easy to cure cancers in mice is generally advanced the most confidently by those who have never cured a mouse of cancer by immunotherapy. (d) With a nod to James Carville, it is the antigen(s), stupid! We still do not know the identity of protective tumor antigens. If any lesson can be drawn at all, it may well be that cancer immunotherapy must move away from the one-shoe-fits-all therapeutic models of chemotherapy and must move to individualized approaches. (e) All targets are equal, but some are more equal than others. The key is specificity for cancer. That does not necessarily mean specificity for cancer cells. (f) Vaccitherapy must be attempted preferably in the minimal residual disease setting, even though this is certain to be time-taking and expensive. In the setting of bulky disease, vaccitherapy must be combined with blockade of inhibitory signals, or depletion of down-regulatory T cells. Inhibition of effector level suppression of immune response is a key. Vaccitherapy alone or immuno-modulation alone is unlikely to succeed in therapy of bulky metastatic disease.
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Affiliation(s)
- Matthew R Buckwalter
- Center for Immunotherapy of Cancers & Infectious Diseases, Department of Immunology, University of Connecticut School of Medicine, MC1601, Farmington, CT 06030-1601, United States
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9366
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Chang TMS. Nanobiotechnological modification of hemoglobin and enzymes from this laboratory. Biochim Biophys Acta 2008; 1784:1435-40. [PMID: 18565337 PMCID: PMC3514548 DOI: 10.1016/j.bbapap.2008.05.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2007] [Revised: 05/13/2008] [Accepted: 05/16/2008] [Indexed: 10/22/2022]
Abstract
Polyhemoglobin is formed by the nanobiotechnological assembling of hemoglobin molecules into soluble nanodimension complex. A further step involves the nanobiotechnological assembly of hemoglobin, catalase and superoxide dismutase into a soluble nanodimension complex. This acts both as oxygen carrier and antioxidant to prevent the oxidative effects of hemoglobin. A further step is the preparation of nanodimension artificial red blood cells that contain hemoglobin and all the enzymes present in red blood cells. Other approaches include a polyhemoglobin-fibrinogen that acts as an oxygen carrier with platelet-like activity, and a polyhemoglobin-tyrosinase to retard the growth of a fatal skin cancer, melanoma.
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Affiliation(s)
- Thomas Ming Swi Chang
- Artificial Cells & Organs Research Centre of the Departments of Physiology, Medicine & Biomedical Engineering, Faculty of Medicine, McGill University, 3655, Drummond Street, Montreal, Quebec, Canada H3G 1Y6.
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9367
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Peterson SL, Lee LA, Ozer K, Fitzpatrick JE. Tattoo pigment interpreted as lymph node metastasis in a case of subungual melanoma. Hand (N Y) 2008; 3:282-5. [PMID: 18780111 PMCID: PMC2525887 DOI: 10.1007/s11552-008-9107-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [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: 03/02/2008] [Accepted: 04/11/2008] [Indexed: 12/19/2022]
Abstract
We present a patient with subungual melanoma of the thumb who, during radioisotope-guided selective sentinel lymphadenectomy, was found to have black, hard lymph nodes at multiple axillary node levels. This finding was interpreted intraoperatively as clinical evidence of metastasis and a formal axillary dissection was carried out. Pathological examination of excised nodes failed to demonstrate metastasis but instead showed collections of tattoo pigment.
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Affiliation(s)
- Steven L Peterson
- Hand Surgery Section, Departments of Orthopedics and Surgery, Denver Health Medical Center and University of Colorado Health Sciences Center, Denver, CO, USA.
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9368
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Abstract
Melanocortin-1 receptor (MC1-R) and melanin are two attractive melanoma-specific targets for peptide-targeted radionuclide therapy for melanoma. Radiolabeled peptides targeting MC1-R/melanin can selectively and specifically target cytotoxic radiation generated from therapeutic radionuclides to melanoma cells for cell killing, while sparing the normal tissues and organs. This review highlights the recent advances of peptide-targeted radionuclide therapy of melanoma targeting MC1-R and melanin. The promising therapeutic efficacies of 188Re-(Arg(11))CCMSH (188Re-[Cys(3,4,10), D-Phe(7),Arg(11)]-alpha-MSH(3-13)), 177Lu- and 212Pb-labeled DOTA-Re(Arg(11))CCMSH (1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid-[ReO-(Cys(3,4,10), D-Phe(7), Arg(11))]-alpha-MSH(3-13)) and 188Re-HYNIC-4B4 (188Re-hydrazinonicotinamide-Tyr-Glu-Arg-Lys-Phe-Trp-His-Gly-Arg-His) in preclinical melanoma-bearing models demonstrate an optimistic outlook for peptide-targeted radionuclide therapy for melanoma. Peptide-targeted radionuclide therapy for melanoma will likely contribute in an adjuvant setting, once the primary tumor has been surgically removed, to treat metastatic deposits and for treatment of end-stage disease. The lack of effective treatments for metastatic melanoma and end-stage disease underscores the necessity to develop and implement new treatment strategies, such as peptide-targeted radionuclide therapy.
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Affiliation(s)
- Yubin Miao
- College of Pharmacy, University of New Mexico, Albuquerque, NM 87131, USA
- Cancer Research and Treatment Center, University of New Mexico, Albuquerque, NM 87131, USA
- Department of Dermatology, University of New Mexico, Albuquerque, NM 87131, USA
| | - Thomas P. Quinn
- Department of Biochemistry, University of Missouri, Columbia, MO 65211, USA
- Department of Radiology, University of Missouri, Columbia, MO 65211, USA
- Harry S. Truman Memorial Veteran Hospital, Columbia, MO 65201, USA
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9369
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Roux S, Bernat C, Al-Sakere B, Ghiringhelli F, Opolon P, Carpentier AF, Zitvogel L, Mir LM, Robert C. Tumor destruction using electrochemotherapy followed by CpG oligodeoxynucleotide injection induces distant tumor responses. Cancer Immunol Immunother 2008; 57:1291-300. [PMID: 18259749 PMCID: PMC11031045 DOI: 10.1007/s00262-008-0462-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [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: 11/22/2007] [Accepted: 01/21/2008] [Indexed: 12/22/2022]
Abstract
PURPOSE Electrochemotherapy (ECT) is an effective local therapy of human cutaneous cancers but has no effect on distant untreated tumors. We addressed whether tumor-associated antigens released after ECT could induce an efficient systemic immunity when associated with an appropriate immunoadjuvant. METHODS AND RESULTS We first studied the nature of the cellular recruitment and the expression of various toll-like receptors (TLRs) in tumors treated by ECT. We found that ECT induced a massive recruitment of CD11c and CD11b positive cells in the tumors and a strong increase of TLR9 expression. We then tested antitumor effects of the combination: ECT followed by TLR-9 ligands, CpG oligodeoxynucleotides (CpG ODN), in three murine tumor models. We found that this combination triggered both potent local synergistic antitumor effects, on the ipsi-lateral ECT-treated tumor, and more interestingly, a systemic antitumor response on the contra-lateral untreated tumor, in the three models. The systemic protection was T-cell dependent as it was not observed in nude littermates. The combination induced tumor-specific T cell effectors in the tumor-draining lymph nodes and in the spleen which secreted significantly more gamma-interferon upon activation than with ECT or CpG ODN alone. CONCLUSIONS Our data show that ECT and CpG ODN synergize and induce a significant increase of the local effect and a systemic T-dependent antitumor response. Such combination constitutes a potential innovative vaccination strategy using in situ tumor-associated antigens that could eventually be translated into the clinic.
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9370
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Schirrmacher V, Beckhove P, Fournier P, Umansky V. Second International Conference on Cancer Vaccines/Adjuvants/Delivery for the Next Decade (CVADD): Heidelberg, Germany, 10-12 October 2007. Cancer Immunol Immunother 2008; 57:1421-7. [PMID: 18270701 PMCID: PMC11030601 DOI: 10.1007/s00262-008-0470-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2007] [Accepted: 01/29/2008] [Indexed: 11/27/2022]
Affiliation(s)
- V Schirrmacher
- Division of Cellular Immunology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
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9371
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Wang W, Edington HD, Jukic DM, Rao UNM, Land SR, Kirkwood JM. Impact of IFNalpha2b upon pSTAT3 and the MEK/ERK MAPK pathway in melanoma. Cancer Immunol Immunother 2008; 57:1315-21. [PMID: 18386001 PMCID: PMC11030104 DOI: 10.1007/s00262-008-0466-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [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: 09/13/2007] [Accepted: 01/28/2008] [Indexed: 12/12/2022]
Abstract
PURPOSE High-dose IFNalpha2b (HDI) was established as the first effective adjuvant therapy for patients with high-risk resected melanoma more than a decade ago, but its fundamental molecular mechanism of action remains unclear. STAT3 and the mitogen activated protein kinases (MAPKs), especially ERK (extracellular signal-regulating kinase) and MEK (MAPK/ERK kinase), play roles in melanoma progression and host immunity. We have therefore evaluated STAT3 and MEK/ERK MAP kinases in patients with regional lymph node metastasis (stage IIIB) of melanoma in the context of a prospective neoadjuvant trial of HDI (UPCI 00-008). PATIENTS AND METHODS In the context of this trial, HDI was administered daily for 20 doses following diagnostic biopsy, and prior to definitive surgery. Immunohistochemistry for pSTAT3, phospho-MEK1/2, phospho-ERK1/2, and EGFR was performed on paired fixed (nine patients) biopsies. RESULTS HDI was found to down-regulate pSTAT3 (P = 0.008) and phospho-MEK1/2 (P = 0.008) levels significantly in tumor cells. Phospho-ERK1/2 was down-regulated by HDI in tumor cells (P = 0.015), but not in lymphoid cells. HDI down-regulated EGFR (P = 0.013), but pSTAT3 activation appeared not to be associated with EGFR expression and the MEK/ERK MAPK pathway. CONCLUSION We conclude that HDI regulates MAPK signaling differentially in melanoma tumor cells and host lymphoid cells in vivo. STAT3 activation is independent of the EGFR/MEK/ERK signaling pathway.
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Affiliation(s)
- Wenjun Wang
- Department of Medicine, Division of Hematology/Oncology, University of Pittsburgh, Hillman Cancer Center, Research Pavilion, Suite 1.32, 5117 Centre Avenue, Pittsburgh, PA 15213-2584 USA
- Melanoma and Skin Cancer Program, University of Pittsburgh Cancer Institute, Hillman Cancer Center, Research Pavilion, Suite 1.32, 5117 Centre Avenue, Pittsburgh, PA 15213-2584 USA
| | | | - Drazen M. Jukic
- Department of Dermatology, University of Pittsburgh Medical Center, Pittsburgh, PA USA
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA USA
| | - Uma N. M. Rao
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA USA
| | - Stephanie R. Land
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA USA
| | - John M. Kirkwood
- Department of Medicine, Division of Hematology/Oncology, University of Pittsburgh, Hillman Cancer Center, Research Pavilion, Suite 1.32, 5117 Centre Avenue, Pittsburgh, PA 15213-2584 USA
- Melanoma and Skin Cancer Program, University of Pittsburgh Cancer Institute, Hillman Cancer Center, Research Pavilion, Suite 1.32, 5117 Centre Avenue, Pittsburgh, PA 15213-2584 USA
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9372
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Dennis LK, Vanbeek MJ, Beane Freeman LE, Smith BJ, Dawson DV, Coughlin JA. Sunburns and risk of cutaneous melanoma: does age matter? A comprehensive meta-analysis. Ann Epidemiol 2008; 18:614-27. [PMID: 18652979 PMCID: PMC2873840 DOI: 10.1016/j.annepidem.2008.04.006] [Citation(s) in RCA: 222] [Impact Index Per Article: 13.9] [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: 10/26/2007] [Revised: 04/07/2008] [Accepted: 04/29/2008] [Indexed: 11/20/2022]
Abstract
PURPOSE Sunburns are an important risk factor for melanoma and those occurring in childhood are often cited as posing the greatest risk. We conducted a meta-analysis to quantify the magnitude of association for melanoma and sunburns during childhood, adolescence, adulthood and over a lifetime. METHODS After reviewing over 1300 article titles and evaluating 270 articles in detail, we pooled odds ratios from 51 independent study populations for "ever" sunburned and risk of cutaneous melanoma. Among these, 26 studies reported results from dose-response analyses. Dose-response analyses were examined using both fixed-effects models and Bayesian random-effects models. RESULTS An increased risk of melanoma was seen with increasing number of sunburns for all time-periods (childhood, adolescence, adulthood, and lifetime). In an attempt to understand how risk between life-periods compares, we also report these same linear models on a scale of five sunburns per decade for each life-period. The magnitude of risk for five sunburns per decade is highest for adult and lifetime sunburns. CONCLUSIONS Overall, these results show an increased risk of melanoma with increasing number of sunburns during all life-periods, not just childhood. Prevention efforts should focus on reducing sunburns during all life-periods.
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Affiliation(s)
- Leslie K Dennis
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242, USA.
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9373
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Hersey P, Halliday GM, Farrelly ML, DeSilva C, Lett M, Menzies SW. Phase I/II study of treatment with matured dendritic cells with or without low dose IL-2 in patients with disseminated melanoma. Cancer Immunol Immunother 2008; 57:1039-51. [PMID: 18157724 PMCID: PMC11030839 DOI: 10.1007/s00262-007-0435-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [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: 10/17/2007] [Accepted: 12/02/2007] [Indexed: 02/06/2023]
Abstract
BACKGROUND In the present study, we have examined whether treatment of patients with metastatic melanoma with matured dendritic cell (DC) vaccines with or without low dose IL-2 may improve treatment outcomes. METHODS Sixteen patients received DC vaccines (DCs) sensitized with autologous melanoma lysates and 18 patients received DCs sensitized with peptides from gp100, MART-1, tyrosinase, MAGE-3.A2, MAGE-A10 and NA17. IL-2 was given subcutaneously (sc) at 1 MU/m2 on the second day after each injection for 5-14 days in half of each group. DCs were given by intranodal injection. RESULTS There were 2 partial responses (PR) and 3 with stable disease (SD) in the nine patients receiving DCs + peptides + IL-2, and 1 PR and 1 SD in nine patients treated with DCs + peptides without IL-2. There were only two patients with SD in the group receiving DCs + autologous lysates and no IL-2. Median overall survival for all patients was very good at 18.5 months but this was most probably due to selection of a favourable group of patients for the study. There was no significant difference in survival between the groups by log rank analysis. Treatment was not associated with significant side effects. The quality and yield of the DCs in the preparations were generally good. CONCLUSIONS We conclude that mature DC preparations may be superior to immature DC preparations for presentation of melanoma peptides and that IL-2 may increase clinical responses to the DCs plus peptides. However, in our view the low response rates do not justify the cost and complexity of this treatment approach.
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Affiliation(s)
- P Hersey
- Oncology and Immunology Unit, Room 443, David Maddison Clinical Sciences Building, Cnr. King & Watt Streets, Newcastle, NSW 2300, Australia.
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9374
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Molhoek KR, Griesemann H, Shu J, Gershenwald JE, Brautigan DL, Slingluff CL. Human melanoma cytolysis by combined inhibition of mammalian target of rapamycin and vascular endothelial growth factor/vascular endothelial growth factor receptor-2. Cancer Res 2008; 68:4392-7. [PMID: 18519701 PMCID: PMC2727753 DOI: 10.1158/0008-5472.can-07-5844] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [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: 11/16/2022]
Abstract
Vascular endothelial growth factor (VEGF) plays a vital role in tumor angiogenesis. VEGF is produced by human melanomas, and the VEGF receptor 2 (VEGFR-2) is expressed by most advanced stage melanomas, suggesting the possibility of an autocrine loop. Here, we show that bevacizumab, an anti-VEGF antibody, inhibits proliferation of VEGFR-2(+) melanoma cell lines by an average of 41%; however, it failed to inhibit proliferation of VEGFR-2(neg) melanoma cell lines. The growth inhibitory effect of bevacizumab was eliminated by VEGFR-2 knockdown with small interfering RNA, showing that VEGF autocrine growth in melanoma is mediated through VEGFR-2. However, bevacizumab inhibition of autocrine signals did not completely inhibit cell proliferation nor cause cell death. Cell survival is mediated partially through mammalian target of rapamycin (mTOR), which is inhibited by rapamycin. Combination of bevacizumab with rapamycin caused loss of half of the VEGFR-2(+) melanoma cells, but no reduction in the number of VEGFR-2(neg) melanoma cells. The results show (a) an autocrine growth loop active in VEGFR-2(+) melanoma, (b) a nonangiogenic mechanism for inhibition of melanoma by blocking autocrine VEGFR-2 activation, and (c) a possible therapeutic role for combination of inhibitors of mTOR plus VEGF in selected melanomas.
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Affiliation(s)
- Kerrington R. Molhoek
- Department of Surgery, Division of Surgical Oncology, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Heinrich Griesemann
- Department of Immunology, Institute for Cell Biology, Eberhard Karls University Tuebingen, Germany
| | - Jianfen Shu
- Department of Public Health Sciences, Division of Biostatistics and Epidemiology, University of Virginia, Charlottesville, VA, USA
| | - Jeffrey E. Gershenwald
- Departments of Surgical Oncology and Cancer Biology, University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - David L. Brautigan
- Center for Cell Signaling, University of Virginia Health System, Charlottesville, VA, USA
| | - Craig L. Slingluff
- Department of Surgery, Division of Surgical Oncology, University of Virginia School of Medicine, Charlottesville, VA, USA
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9375
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Ugurel S, Schrama D, Keller G, Schadendorf D, Bröcker EB, Houben R, Zapatka M, Fink W, Kaufman HL, Becker JC. Impact of the CCR5 gene polymorphism on the survival of metastatic melanoma patients receiving immunotherapy. Cancer Immunol Immunother 2008; 57:685-91. [PMID: 17909797 PMCID: PMC11030845 DOI: 10.1007/s00262-007-0407-z] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [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: 07/25/2007] [Accepted: 09/14/2007] [Indexed: 10/22/2022]
Abstract
PURPOSE Chemokines influence both tumor progression and anti-tumor immune response. A 32-bp-deletion polymorphism in the chemokine receptor 5 gene (CCR5Delta32) has been shown to result in a non-functional protein. This study was aimed at evaluating the potential impact of this gene polymorphism on disease progression and treatment outcome in patients with melanoma. PATIENTS AND METHODS CCR5 genotyping was performed by PCR on DNA extracted from serum samples of 782 cutaneous melanoma patients with known disease history and long-term clinical follow-up. Genotypes were correlated with patient survival and types of treatment. RESULTS Of 782 melanoma patients, 90 (11.5%) were heterozygous and 12 (1.5%) were homozygous for CCR5Delta32. Analyzing the complete cohort, the disease-specific survival from date of primary diagnosis was not influenced by CCR5 status. Similarly, no significant impact could be detected on the treatment outcome of stage III patients. In 139 stage IV patients receiving immunotherapy, CCR5Delta32 was associated with a decreased survival compared to patients not carrying the deletion (median 12.5 vs. 20.3 months, P = 0.029). Multivariate analysis revealed the CCR5 genotype as an independent factor impacting disease-specific survival in this patient population (P = 0.002), followed by gender (P = 0.019) and pathological classification of the primary (pT; P = 0.022). CONCLUSION The presence of the CCR5Delta32 polymorphism in patients with stage IV melanoma results in a decreased survival following immunotherapy and may help to select patients less likely to benefit from this type of treatment.
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Affiliation(s)
- Selma Ugurel
- Department of Dermatology, Julius-Maximilians University, Würzburg, Germany
| | - David Schrama
- Department of Dermatology, Julius-Maximilians University, Würzburg, Germany
| | - Gunhild Keller
- Department of Dermatology, Julius-Maximilians University, Würzburg, Germany
| | - Dirk Schadendorf
- Skin Cancer Unit, German Cancer Research Center Heidelberg/Department of Dermatology, University Hospital Mannheim, Mannheim, Germany
| | | | - Roland Houben
- Department of Dermatology, Julius-Maximilians University, Würzburg, Germany
| | - Marc Zapatka
- Department of Theoretical Bioinformatics, German Cancer Research Center, Heidelberg, Germany
| | - Wolfram Fink
- Skin Cancer Unit, German Cancer Research Center Heidelberg/Department of Dermatology, University Hospital Mannheim, Mannheim, Germany
| | - Howard L. Kaufman
- Division of Surgical Oncology, College of Physicians and Surgeons, Columbia University Medical Center, New York, USA
| | - Jürgen C. Becker
- Department of Dermatology, Julius-Maximilians University, Würzburg, Germany
- Department of Dermatology, University of Würzburg, Josef-Schneider-Str. 2, 97080 Würzburg, Germany
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9376
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Larrieu P, Renaud V, Godet Y, Jotereau F, Fonteneau JF. A HLA-Cw*0701 restricted Melan-A/MART1 epitope presented by melanoma tumor cells to CD8+ tumor infiltrating lymphocytes. Cancer Immunol Immunother 2008; 57:745-52. [PMID: 18097665 PMCID: PMC11030711 DOI: 10.1007/s00262-007-0436-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [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: 08/24/2007] [Accepted: 12/03/2007] [Indexed: 01/12/2023]
Abstract
Melan-A/MART1 is a melanocytic differentiation antigen recognized on melanoma tumor cells by CD8+ and CD4+ T cells. In this study, we describe a new epitope of this protein recognized in the context of HLA-Cw*0701 molecules by a CD8+ tumor infiltrating lymphocyte (TIL) clone. This CD8+ TIL clone specifically recognized and killed a fraction of melanoma cells lines expressing Melan-A/MART1 and HLA-Cw*0701. We further show that the Melan-A/MART1(51-61) peptide is the optimal peptide recognized by this clone. Together, these data significantly enlarge the fraction of melanoma patients susceptible to benefit from a Melan-A/MART1 vaccine approach.
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Affiliation(s)
- Pierre Larrieu
- INSERM U601, Institut de biologie, 9 quai moncousu, 44093 Nantes Cedex, France
| | - Virginie Renaud
- INSERM U601, Institut de biologie, 9 quai moncousu, 44093 Nantes Cedex, France
| | - Yann Godet
- INSERM U601, Institut de biologie, 9 quai moncousu, 44093 Nantes Cedex, France
| | - Francine Jotereau
- INSERM U601, Institut de biologie, 9 quai moncousu, 44093 Nantes Cedex, France
- Université de Nantes, 44322 Nantes, France
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9377
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Abstract
Melanoma is responsible for an estimated 62,000 new American cancer diagnoses and is projected to cause nearly 8000 deaths in 2008 alone. Although the histogenesis of the tumor is not well understood, it is thought to originate from a rare melanocyte stem cell that resides in the skin. The transcription factor PAX3 has a well-established role in the development of melanocytes during embryogenesis, and has recently been characterized as a molecular switch in the mature melanocyte. Based on this function, PAX3 promotes a melanocytic phenotype but blocks terminal differentiation. This mechanism may also contribute to the uncontrolled cell growth and loss of terminal differentiation in melanomas. Here, we find PAX3 expression in 8/8 melanoma cell lines. We also find that PAX3 is commonly expressed in primary melanoma samples (21/58) but significantly less frequently in benign pigmented lesions (9/75). Further analysis of our melanoma set revealed that PAX3 expression is strongly correlated with younger patients with low or no evidence of sun damage. Our data suggest that PAX3-expressing melanomas may be less environmentally dependent and more genetically linked.
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Affiliation(s)
| | | | | | | | | | | | - Deborah Lang
- Contact for page proofs, correspondence, and requests of reprints: Deborah Lang, Ph.D, University of Chicago, Department of Medicine, Section of Dermatology, 5841 South Maryland Avenue, MC5067, L536, Chicago, IL 60637, , phone number: (773) 702 6005, fax number: (773) 702-8398
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9378
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Khan ANH, Gregorie CJ, Tomasi TB. Histone deacetylase inhibitors induce TAP, LMP, Tapasin genes and MHC class I antigen presentation by melanoma cells. Cancer Immunol Immunother 2008; 57:647-54. [PMID: 18046553 PMCID: PMC3146348 DOI: 10.1007/s00262-007-0402-4] [Citation(s) in RCA: 154] [Impact Index Per Article: 9.6] [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: 03/09/2007] [Accepted: 08/29/2007] [Indexed: 12/14/2022]
Abstract
Histone deacetylase inhibitors (HDACi), including trichostatin A (TSA) and valproic acid, can alter the acetylation of histones in chromatin and enhance gene transcription. Previously we demonstrated that HDACi-treated tumor cells are capable of presenting antigen via the MHC class II pathway. In this study, we show that treatment with HDACi enhances the expression of molecules (TAP1, TAP2, LMP2, LMP7, Tapasin and MHC class I) involved in antigen processing and presentation via the MHC class I pathway in melanoma cells. HDACi treatment of B16F10 cells also enhanced cell surface expression of class I and costimulatory molecules CD40 and CD86. Enhanced transcription of these genes is associated with a significant increase in direct presentation of whole protein antigen and MHC class I-restricted peptides by TSA-treated B16F10 cells. Our data indicate that epigenetic modification can convert a tumor cell to an antigen presenting cell capable of activating IFN-gamma secreting T cells via the class I pathway. These findings suggest that the abnormalities, observed in some tumors in the expression of MHC class I antigen processing and presentation molecules, may result from epigenetic repression.
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Affiliation(s)
- A. Nazmul H. Khan
- Laboratory of Molecular Medicine, Department of Immunology, Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY 14263 USA
| | - Christopher J. Gregorie
- Laboratory of Molecular Medicine, Department of Immunology, Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY 14263 USA
| | - Thomas B. Tomasi
- Laboratory of Molecular Medicine, Department of Immunology, Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY 14263 USA
- Department of Medicine, School of Medicine and Biomedical Sciences, State University of New York, Buffalo, NY 14214 USA
- Department of Microbiology and Immunology, School of Medicine and Biomedical Sciences, State University of New York, Buffalo, NY 14214 USA
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9379
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Schwenkert M, Birkholz K, Schwemmlein M, Kellner C, Peipp M, Nettelbeck DM, Schuler-Thurner B, Schaft N, Dörrie J, Ferrone S, Kämpgen E, Fey GH. A single chain immunotoxin, targeting the melanoma-associated chondroitin sulfate proteoglycan, is a potent inducer of apoptosis in cultured human melanoma cells. Melanoma Res 2008; 18:73-84. [PMID: 18337643 PMCID: PMC2741307 DOI: 10.1097/cmr.0b013e3282f7c8f9] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [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: 01/12/2023]
Abstract
A recombinant immunotoxin was constructed by fusing a single chain fragment variable antibody fragment, specific for the melanoma-associated chondroitin sulfate proteoglycan (MCSP), to a truncated variant of Pseudomonas exotoxin A (ETA'), carrying a C-terminal KDEL-peptide for improved retrograde intracellular transport. The resulting immunotoxin MCSP-ETA' was periplasmatically expressed in Escherichia coli and purified under native conditions by affinity chromatography resulting in a yield of approximately 30 mug/l bacterial culture. This immunotoxin induced antigen-specific apoptosis in the cultured human melanoma-derived cell lines A2058 and A375M, and treatment with a single dose of the agent eliminated up to 80% of these cells within 72 h. The dose needed for half-maximum killing (EC50) was approximately 1 nmol/l for both cell lines. MCSP-ETA' also displayed cytotoxic activity against cultured primary melanoma cells from patients with advanced disease (pathologic stages IIIC and IV), with net cell death reaching up to 70% within 96 h after treatment with a single dose of 14 nmol/l. MCSP-ETA' induced cell death synergistically with cyclosporin A, both in established human melanoma cell lines and cultured primary melanoma cells. The distinctive antigen-restricted induction of apoptosis and the synergy with cyclosporin A justify further evaluation of this novel agent with regard to its potential application for the treatment of malignant melanoma.
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Affiliation(s)
- Michael Schwenkert
- Chair of Genetics, University of Erlangen-Nuremberg, Erwin-Rommel-Str. 3, 91058 Erlangen, Germany
| | - Katrin Birkholz
- Department of Dermatology, University Hospital Erlangen, Erlangen, Germany
| | - Michael Schwemmlein
- Chair of Genetics, University of Erlangen-Nuremberg, Erwin-Rommel-Str. 3, 91058 Erlangen, Germany
| | - Christian Kellner
- Chair of Genetics, University of Erlangen-Nuremberg, Erwin-Rommel-Str. 3, 91058 Erlangen, Germany
| | - Matthias Peipp
- Section of Stem Cell Transplantation and Immunotherapy, University Medical Center, University of Schleswig-Holstein, Kiel, Germany
| | - Dirk M. Nettelbeck
- Helmholtz University Group Oncolytic Adenoviruses, German Cancer Research Center, Heidelberg, Germany
| | | | - Niels Schaft
- Department of Dermatology, University Hospital Erlangen, Erlangen, Germany
| | - Jan Dörrie
- Department of Dermatology, University Hospital Erlangen, Erlangen, Germany
| | - Soldano Ferrone
- Department of Immunology, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Eckhart Kämpgen
- Department of Dermatology, University Hospital Erlangen, Erlangen, Germany
| | - Georg H. Fey
- Chair of Genetics, University of Erlangen-Nuremberg, Erwin-Rommel-Str. 3, 91058 Erlangen, Germany
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9380
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Grabowski J, Saltzstein SL, Sadler GR, Tahir Z, Blair S. A comparison of merkel cell carcinoma and melanoma: results from the california cancer registry. Clin Med Oncol 2008; 2:327-33. [PMID: 21892294 PMCID: PMC3161663 DOI: 10.4137/cmo.s423] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Melanoma and Merkel cell carcinoma (MCC) are both aggressive skin malignancies associated with immunosuppression and possible UV exposure. Both tumors get similar surgical treatment; however, MCC is a relatively rare tumor in which less is known about prognosis and clinical behavior. METHODS The California Cancer Registry (CCR), a population-based registry, was reviewed from the years 1988-2003. Merkel cell carcinoma and melanoma were compared with relation to gender, age, ethnicity, disease stage, site, and survival. RESULTS A total of 113,187 cases of melanoma and 1,878 cases of MCC were identified in the CCR. Though both cancers are more common in men than in women, MCC had a higher incidence in men than melanoma (63% vs 57% p < 0.005). MCC occurs in the more elderly, with 73.6% of cases occurring in people over 70 years. In contrast, 69% of melanoma cases occurred in people younger than 70 years (p < 0.005). MCC shows a predilection for the head and neck compared to melanoma (47% vs 25.8%) Additionally, melanoma occurs more frequently on the trunk than MCC (30% vs 8.7%). Finally, the 10-year cumulative survival is lower for MCC than for melanoma (17.7% vs 61.3%, p < 0.005). CONCLUSION Many clinicians assume MCC and melanoma behave similarly. However, MCC occurs in an older population, more frequently on the head and neck, in a higher percentage of men. Additionally, MCC has a higher rate of regional metastasis and thus may have more of a benefit from regional staging procedures. Overall, MCC has a worse prognosis.
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Affiliation(s)
- Julia Grabowski
- Department of Family and Preventive Medicine, University of California at San Diego School of Medicine, La Jolla, CA
| | - Sidney L Saltzstein
- Department of Family and Preventive Medicine, University of California at San Diego School of Medicine, La Jolla, CA
- Department of Pathology, University of California at San Diego School of Medicine, La Jolla, CA
- Department of Surgery, University of California at San Diego School of Medicine, La Jolla, CA
- Rebecca and John Moores UCSD Cancer Center, University of California at San Diego School of Medicine, La Jolla, CA
| | - Georgia Robins Sadler
- Department of Surgery, University of California at San Diego School of Medicine, La Jolla, CA
- Rebecca and John Moores UCSD Cancer Center, University of California at San Diego School of Medicine, La Jolla, CA
| | - Zunera Tahir
- Rebecca and John Moores UCSD Cancer Center, University of California at San Diego School of Medicine, La Jolla, CA
| | - Sarah Blair
- Department of Surgery, University of California at San Diego School of Medicine, La Jolla, CA
- Rebecca and John Moores UCSD Cancer Center, University of California at San Diego School of Medicine, La Jolla, CA
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9381
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Voelter V, Pica A, Laurent J, Rimoldi D, Bouzourene H, Sajadi A, Matter M, Romero P, Rufer N, Speiser DE. An unusual case of metastatic melanoma sensitive to chemotherapy and immunotherapy, with late immune escape in the brain. Cancer Immun 2008; 8:6. [PMID: 18366150 PMCID: PMC2935783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- Verena Voelter
- Multidisciplinary Oncology Center, University of Lausanne Hospitals (CHUV), Lausanne, Switzerland.
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9382
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Tsung AJ, Kargiotis O, Chetty C, Lakka SS, Gujrati M, Spomar DG, Dinh DH, Rao JS. Downregulation of matrix metalloproteinase-2 (MMP-2) utilizing adenovirus-mediated transfer of small interfering RNA (siRNA) in a novel spinal metastatic melanoma model. Int J Oncol 2008; 32:557-564. [PMID: 18292932 PMCID: PMC2267753] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
Matrix metalloproteinases (MMPs) comprise a class of secreted zinc-dependent endopeptidases implicated in the metastatic potential of tumor cells due to their ability to degrade the extracellular matrix (ECM) and basement membrane. Matrix metalloproteinase-2 (MMP-2) has been detected in high levels and correlates with invasiveness in human melanoma. We have studied the effect of adenovirus-mediated transfer of small interfering RNA (siRNA) against MMP-2 in the human melanoma cell line A2058. The delivery of these double-stranded RNA molecules represents an efficient technology in silencing disease-causing genes with known sequences at the post-transcriptional level. siRNA against MMP-2 mRNA (Ad-MMP-2) was found to decrease MMP-2 protein expression and activity in melanoma cells as demonstrated by western blotting and gelatin zymography. Furthermore, infection of cells with Ad-MMP-2 inhibited cellular migration and invasion as indicated by spheroid and matrigel assays. We also observed dose-dependent suppression of vascular network formation in an angiogenesis assay. Finally, we developed a nude mouse spinal metastatic model to investigate the local effects of tumor metastasis. Intravenous tail vein injection with Ad-MMP-2 on days 5, 9 and 11 after tumor implantation resulted in complete retention of neurological function as compared to control and scrambled vector (Ad-SV)-treated groups that showed complete paraplegia by day 14+/-2 days. Hematoxylin and eosin staining revealed decreased tumor size in the Ad-MMP-2-treated animals. This novel experimental model revealed that adenoviral-mediated transfer of RNA interference against MMP-2 results in the retention of neurological function and significantly inhibited tumor growth.
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Affiliation(s)
- Andrew J Tsung
- Department of Neurosurgery, University of Illinois College of Medicine, Peoria, IL 61605, USA
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9383
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Labarrière N, Gervois N, Bonnin A, Bouquié R, Jotereau F, Lang F. PBMC are as good a source of tumor-reactive T lymphocytes as TIL after selection by Melan-A/A2 multimer immunomagnetic sorting. Cancer Immunol Immunother 2008; 57:185-95. [PMID: 17646986 PMCID: PMC11030717 DOI: 10.1007/s00262-007-0361-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [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: 04/24/2007] [Accepted: 06/20/2007] [Indexed: 12/21/2022]
Abstract
Choosing a reliable source of tumor-specific T lymphocytes and an efficient method to isolate these cells still remains a critical issue in adoptive cellular therapy (ACT). In this study, we assessed the capacity of MHC/peptide based immunomagnetic sorting followed by polyclonal T cell expansion to derive pure polyclonal and tumor-reactive Melan-A specific T cell populations from melanoma patient's PBMC and TIL. We first demonstrated that this approach was extremely efficient and reproducible. We then used this procedure to compare PBMC and TIL-derived cells from three melanoma patients in terms of avidity for Melan-A A27L analog, Melan-A(26-35)and Melan-A(27-35), tumor reactivity (lysis and cytokine production) and repertoire. Regardless of their origin, i.e., fresh PBMC, peptide stimulated PBMC or TIL, all sorted populations (from the three patients) were cytotoxic against HLA-A2+ melanoma cell lines expressing Melan-A. Although some variability in peptide avidity, lytic activity and cytokine production was observed between populations of different origins in a given patient, it differed from one patient to another and thus no correlation could be drawn between T cell source and reactivity. Analysis of Vbeta usage within the sorted populations showed the recurrence of Vbeta3 and Vbeta14 subfamilies in the three patients but differences in the rest of the Melan-A repertoire. In addition, in two patients, we observed major repertoire differences between populations sorted from the three sources. We especially documented that in vitro peptide stimulation of PBMC, used to facilitate the sort by enriching in specific T lymphocytes, could significantly alter their repertoire and reactivity towards tumor cells. We conclude that PBMC which are easily obtained from all melanoma patients, can be as good a source as TIL to derive high amounts of tumor-reactive Melan-A specific T cells, with this selection/amplification procedure. However, the conditions of peptide stimulation should be improved to prevent a possible loss of reactive clonotypes.
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Affiliation(s)
| | - Nadine Gervois
- INSERM U601, 44093 Nantes, France
- Faculté des Sciences, Université de Nantes, 44322 Nantes, France
| | | | | | - Francine Jotereau
- INSERM U601, 44093 Nantes, France
- Faculté des Sciences, Université de Nantes, 44322 Nantes, France
| | - François Lang
- INSERM U601, 44093 Nantes, France
- UFR des Sciences Pharmaceutiques, Université de Nantes, 44322 Nantes, France
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9384
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Saenger YM, Wolchok JD. The heterogeneity of the kinetics of response to ipilimumab in metastatic melanoma: patient cases. Cancer Immun 2008; 8:1. [PMID: 18198818 PMCID: PMC2935787] [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] [Subscribe] [Scholar Register] [Received: 10/12/2007] [Accepted: 01/07/2008] [Indexed: 05/25/2023]
Abstract
Cytotoxic T lymphocyte antigen-4 (CTLA-4) is a negative regulator of T-cell mediated immune responses and is the target of new anti-tumor immunotherapy strategies. Ipilimumab is a fully human, antagonistic monoclonal antibody directed against CTLA-4. Results from preclinical and early clinical trials support current phase II/III testing of ipilimumab as first- and second-line therapy for metastatic melanoma. Ipilimumab promotes durable objective responses and/or stable disease in patients with metastatic melanoma. Adverse events are medically manageable, largely immune-related, and presumably linked to the drug's mechanism of action. As more patients are treated with ipilimumab, it is becoming clear that the kinetics of responses are heterogeneous and significantly different from those of chemotherapy and other immunotherapy. Though objective response or stable disease is observed within 'conventional' time frames, responses have been observed weeks to months after therapy initiation. Response or stable disease may be preceded by apparent early disease progression, or may occur simultaneously with different progressing lesions within the same patient (a 'mixed' response). It is likely that the unique kinetics of response is a result of the time required to enhance and maintain an anti-tumor immune response to ipilimumab therapy. Consequently, patients may benefit from continued ipilimumab treatment through clinically known relevant disease progression or non-response during the full induction dosing schedule (12 weeks), without additional therapies. Understanding the kinetics of response to ipilimumab will help clinicians to manage patients who may benefit from treatment. In this article, several cases that illustrate the kinetics of response to ipilimumab are discussed.
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Affiliation(s)
- Yvonne M Saenger
- Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA
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9385
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Ferrari Júnior NM, Muller H, Ribeiro M, Maia M, Sanches Júnior JA. Cutaneous melanoma: descriptive epidemiological study. SAO PAULO MED J 2008; 126:41-7. [PMID: 18425286 PMCID: PMC11020511 DOI: 10.1590/s1516-31802008000100008] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2007] [Revised: 01/09/2008] [Accepted: 01/16/2008] [Indexed: 11/21/2022] Open
Abstract
CONTEXT AND OBJECTIVE Cutaneous melanoma represents around 3% of all skin tumors. About 20% of such patients will have advanced disease and will die before reaching five years of survival. The aim of this paper was to describe the clinical and histopathological variables and their correlations. DESIGN AND SETTING Retrospective, descriptive, epidemiological study at the Melanoma Unit, Dermatological Clinic, Irmandade da Santa Casa de Misericórdia, São Paulo. METHODS Records from 364 cases between May 1993 and January 2006 were analyzed. The frequencies of all study variables and their 95% confidence intervals were determined. The chi-squared test was used to evaluate associations among the variables, adopting a significant level of 0.05. RESULTS Females predominated, with 1.4 women for each man. The patients mean age was 58.9 years. Nonwhite patients represented 13.7% of the sample. The prevalent anatomical sites for cutaneous melanoma were the trunk and feet, for both men and women. Acral lentiginous melanoma represented 22.3% of the cohort. In situ primary lesions were observed in few cases and a high percentage of thick cutaneous melanoma was detected. Ulceration was found in 13.4% of the thin tumors (< 1.0 mm). Thicker and ulcerated lesions predominated in male patients (p = 0.011 and p < 0.001 respectively) and in elderly patients (p = 0.021 and p = 0.015). CONCLUSIONS The cohort mostly presented thick and ulcerated tumors, denoting late diagnosis and bad prognosis. Also, the sample was characterized by considerable prevalence of female patients, nonwhite patients, limb lesions and acral lentiginous melanoma.
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9386
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Doubrovsky A, Scolyer RA, Murali R, McKenzie PR, Watson GF, Lee CS, McLeod DJ, McCarthy WH, Uren RF, Stretch JR, Saw RP, Thompson JF. Diagnostic accuracy of fine needle biopsy for metastatic melanoma and its implications for patient management. Ann Surg Oncol 2008; 15:323-32. [PMID: 17990041 PMCID: PMC2190340 DOI: 10.1245/s10434-006-9341-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2006] [Accepted: 11/15/2006] [Indexed: 11/26/2022]
Abstract
BACKGROUND The use of fine needle biopsy (FNB) for the diagnosis of metastatic melanoma can lead to the early removal and treatment of metastases, reduce the frequency of unnecessary surgery, and facilitate the staging of patients enrolled in clinical trials of adjuvant therapies. In this study, the accuracy of FNB for the diagnosis of metastatic melanoma was investigated. METHODS A retrospective cohort study was performed with 2204 consecutive FNBs performed on 1416 patients known or suspected to have metastatic melanoma. Almost three-quarters (1582) of these FNBs were verified by either histopathologic diagnosis following surgical resection or clinical follow-up. RESULTS FNB for metastatic melanoma was found to have an overall sensitivity of 92.1% and a specificity of 99.2%, with 69 false-negative and 5 false-positive findings identified. The sensitivity of the procedure was found to be influenced by six factors. The use of immunostains, reporting of the specimen by a cytopathologist who had reported >500 cases, lesions located in the skin and subcutis, and patients with ulcerated primary melanomas were factors associated with a significant improvement in the sensitivity of the test. However, FNBs performed in masses located in lymph nodes of the axilla and FNBs that required more than one needle pass to obtain a sample were far more likely to result in false-negative results. CONCLUSIONS FNB is a rapid, accurate, and clinically useful technique for the assessment of disease status in patients with suspected metastatic melanoma.
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Affiliation(s)
- Anna Doubrovsky
- Sydney Melanoma Unit, Sydney Cancer Centre, Royal Prince Alfred Hospital, Camperdown, NSW 2050 Australia
| | - Richard A. Scolyer
- Sydney Melanoma Unit, Sydney Cancer Centre, Royal Prince Alfred Hospital, Camperdown, NSW 2050 Australia
- Department of Anatomical Pathology, Royal Prince Alfred Hospital, Camperdown, NSW Australia
- Discipline of Pathology, Faculty of Medicine, The University of Sydney, Sydney, NSW Australia
- Melanoma and Skin Cancer Research Institute, Royal Prince Alfred Hospital, New South Wales, Camperdown, Australia
| | - Rajmohan Murali
- Sydney Melanoma Unit, Sydney Cancer Centre, Royal Prince Alfred Hospital, Camperdown, NSW 2050 Australia
- Department of Anatomical Pathology, Royal Prince Alfred Hospital, Camperdown, NSW Australia
- Discipline of Pathology, Faculty of Medicine, The University of Sydney, Sydney, NSW Australia
- Melanoma and Skin Cancer Research Institute, Royal Prince Alfred Hospital, New South Wales, Camperdown, Australia
| | - Paul R. McKenzie
- Department of Anatomical Pathology, Royal Prince Alfred Hospital, Camperdown, NSW Australia
| | - Geoffrey F. Watson
- Department of Anatomical Pathology, Royal Prince Alfred Hospital, Camperdown, NSW Australia
| | - C. Soon Lee
- Department of Anatomical Pathology, Royal Prince Alfred Hospital, Camperdown, NSW Australia
- Discipline of Pathology, Faculty of Medicine, The University of Sydney, Sydney, NSW Australia
| | - Duncan J. McLeod
- Department of Anatomical Pathology, Royal Prince Alfred Hospital, Camperdown, NSW Australia
| | - William H. McCarthy
- Sydney Melanoma Unit, Sydney Cancer Centre, Royal Prince Alfred Hospital, Camperdown, NSW 2050 Australia
- Discipline of Surgery, Faculty of Medicine, The University of Sydney, Sydney, NSW Australia
- Melanoma and Skin Cancer Research Institute, Royal Prince Alfred Hospital, New South Wales, Camperdown, Australia
| | - Roger F. Uren
- Nuclear Medicine and Diagnostic Ultrasound and Discipline of Medicine, The University of Sydney, Sydney, NSW Australia
| | - Jonathan R. Stretch
- Sydney Melanoma Unit, Sydney Cancer Centre, Royal Prince Alfred Hospital, Camperdown, NSW 2050 Australia
- Discipline of Surgery, Faculty of Medicine, The University of Sydney, Sydney, NSW Australia
- Melanoma and Skin Cancer Research Institute, Royal Prince Alfred Hospital, New South Wales, Camperdown, Australia
| | - Robyn P. Saw
- Sydney Melanoma Unit, Sydney Cancer Centre, Royal Prince Alfred Hospital, Camperdown, NSW 2050 Australia
- Discipline of Surgery, Faculty of Medicine, The University of Sydney, Sydney, NSW Australia
- Melanoma and Skin Cancer Research Institute, Royal Prince Alfred Hospital, New South Wales, Camperdown, Australia
| | - John F. Thompson
- Sydney Melanoma Unit, Sydney Cancer Centre, Royal Prince Alfred Hospital, Camperdown, NSW 2050 Australia
- Discipline of Surgery, Faculty of Medicine, The University of Sydney, Sydney, NSW Australia
- Melanoma and Skin Cancer Research Institute, Royal Prince Alfred Hospital, New South Wales, Camperdown, Australia
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9387
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Abstract
Certain cancers may be auxotrophic for a particular amino acid, and amino acid deprivation is one method to treat these tumors. Arginine deprivation is a novel approach to target tumors which lack argininosuccinate synthetase (ASS) expression. ASS is a key enzyme which converts citrulline to arginine. Tumors which usually do not express ASS include melanoma, hepatocellular carcinoma, some mesotheliomas and some renal cell cancers. Arginine can be degraded by several enzymes including arginine deiminase (ADI). Although ADI is a microbial enzyme from mycoplasma, it has high affinity to arginine and catalyzes arginine to citrulline and ammonia. Citrulline can be recycled back to arginine in normal cells which express ASS, whereas ASS(-) tumor cells cannot. A pegylated form of ADI (ADI-PEG20) has been formulated and has shown in vitro and in vivo activity against melanoma and hepatocellular carcinoma. ADI-PEG20 induces apoptosis in melanoma cell lines. However, arginine deprivation can also induce ASS expression in certain melanoma cell lines which can lead to in vitro drug resistance. Phase I and II clinical trials with ADI-PEG20 have been conducted in patients with melanoma and hepatocellular carcinoma, and antitumor activity has been demonstrated in both cancers. This article reviews our laboratory and clinical experience as well as that from others with ADI-PEG20 as an antineoplastic agent. Future direction in utilizing this agent is also discussed.
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Affiliation(s)
- L Feun
- Hematology/Oncology, University of Miami School of Medicine, 1201 N.W. 16th Street, Miami, FL. 33136, USA.
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9388
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Xi Y, Riker A, Shevde-Samant L, Samant R, Morris C, Gavin E, Fodstad O, Ju J. Global comparative gene expression analysis of melanoma patient samples, derived cell lines and corresponding tumor xenografts. Cancer Genomics Proteomics 2008; 5:1-35. [PMID: 18359977 PMCID: PMC3226839] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
Various in vitro and in vivo experimental models have been used for the discovery of genes and pathways involved in melanoma and other types of cancer. However, in many cases, the results from various tumor models failed to be validated successfully in clinical studies. Limited information is available on how closely these models reflect the in vivo physiological conditions. In this study, a comprehensive genomics approach was used to systematically compare the expression patterns of snap frozen samples obtained from patients with primary melanoma, lymph node metastasis, and distant metastases, and compare these patterns to those of their corresponding cell lines and tumor xenografts in nude mice. The GE Healthcare 20k human genome array was used and the expression data was normalized and analyzed using GeneSpring 7.2 software. Based on the expression analysis, the correlation rate between the snap frozen primary patient samples vs. derived cell lines was 66%, with 1687 differentially expressed genes. The correlation rate between the snap frozen primary patient samples and the tumor xenografts was 75%, with 1,374 differentially expressed genes, and the correlation rate comparing tumor xenografts to derived cell lines ranged between 58% and 84%. These results demonstrated significant gene expression differences between tumor materials with different in vitro and in vivo growth microenvironments. Such studies can help us to distinguish between genes up- or down-regulated as a result of the microenvironment and those stably expressed independently of the tumor milieu. With the extensive use of cell lines and xenografts in cancer research, the information obtained using our approach may help to better interpret results generated from different tumor models by understanding common differences, as well as similarities at the gene expression level, information that may have important practical and biological implications.
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Affiliation(s)
- Yaguang Xi
- Mitchell Cancer Institute, Mobile, AL 36688, USA
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9389
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Abstract
Background: Systemic sclerosis is a multi-systemic autoimmune disorder. Cardiac involvement by the disease, although not included in the diagnostic criteria, may be seen either clinically, histologically or may be revealed by various investigative modalities. Purpose: To see the profile of cardiac involvement in patients of systemic sclerosis. Materials and Methods: Forty-seven patients of systemic sclerosis were included in the study. After taking a complete history and doing a detailed physical examination, the patients were submitted to electrocardiogram ECG (all leads), echocardiography and x-ray chest. Furst's organ indices scoring system for cardiac involvement was followed. Findings: Forty-seven patients of systemic sclerosis were included in the study. Five females gave a history of palpitations. A loud pulmonic heart sound was heard in 1. Arrhythmias were observed in 5 patients. Significantly, echocardiography revealed valvular involvement in 5 patients. Left ventricular hypertrophy was seen in 2 patients. Conclusions: In our patients, cardiac involvement was rare. In contrast to other studies, valvular involvement was a prominent feature. Limitations: Complete evaluation for arrhythmias with 24-h Holter monitor was not used
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Affiliation(s)
- Qazi Masood Ahmad
- Department of Dermatology, STD and Leprosy and Department of Internal Medicine, Government Medical College, Srinagar Kashmir (Jammu and Kashmir), India
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9390
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Wang Q, Zhang J, Guo Z. Efficient glycoengineering of GM3 on melanoma cell and monoclonal antibody-mediated selective killing of the glycoengineered cancer cell. Bioorg Med Chem 2007; 15:7561-7. [PMID: 17892942 PMCID: PMC2092447 DOI: 10.1016/j.bmc.2007.09.005] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [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: 07/29/2007] [Revised: 09/05/2007] [Accepted: 09/07/2007] [Indexed: 11/22/2022]
Abstract
To verify the principal of a new immunotherapeutic strategy for cancer, a monoclonal antibody 2H3 against N-phenylacetyl GM3, an unnatural form of the tumor-associated antigen GM3, was prepared and employed to demonstrate that murine melanoma cell B16F0 could be effectively glycoengineered by N-phenylacetyl-d-mannosamine to express N-phenylacetyl GM3 and that 2H3 was highly cytotoxic to the glycoengineered B16F0 cell in the presence of complements. It was further demonstrated that B16F0 cell could be glycoengineered 4-5 times more effectively than 3T3 A31 cell, a normal murine embryo fibroblast cell, and that the antibody and complement mediated cytotoxicity was at least 200 times more potent to the glycoengineered B16F0 cell than to the N-phenylacetyl-d-mannosamine-treated 3T3 A31 cell. These results show the promise for developing useful melanoma immunotherapies based on vaccination against N-phenylacetyl GM3 followed by treatment with N-phenylacetyl-d-mannosamine.
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MESH Headings
- Animals
- Antibodies, Monoclonal/pharmacology
- Antigens, Tumor-Associated, Carbohydrate/chemistry
- Antigens, Tumor-Associated, Carbohydrate/immunology
- Antigens, Tumor-Associated, Carbohydrate/metabolism
- Antineoplastic Agents/chemistry
- Antineoplastic Agents/metabolism
- Carbohydrate Sequence
- Cell Line, Tumor
- Drug Screening Assays, Antitumor
- Female
- G(M3) Ganglioside/chemistry
- G(M3) Ganglioside/immunology
- G(M3) Ganglioside/metabolism
- Immunotherapy/methods
- Melanoma, Experimental/immunology
- Melanoma, Experimental/therapy
- Mice
- Mice, Inbred C57BL
- Models, Biological
- Molecular Sequence Data
- Tumor Cells, Cultured
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Affiliation(s)
- Qianli Wang
- Department of Chemistry, Wayne State University, 5101 Cass Avenue, Detroit, MI 48202, USA
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9391
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Mathieu MG, Knights AJ, Pawelec G, Riley CL, Wernet D, Lemonnier FA, Straten PT, Mueller L, Rees RC, McArdle SEB. HAGE, a cancer/testis antigen with potential for melanoma immunotherapy: identification of several MHC class I/II HAGE-derived immunogenic peptides. Cancer Immunol Immunother 2007; 56:1885-95. [PMID: 17487488 PMCID: PMC11030838 DOI: 10.1007/s00262-007-0331-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [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: 02/26/2007] [Accepted: 04/13/2007] [Indexed: 11/30/2022]
Abstract
There remains a need to identify novel epitopes of potential tumour target antigens for use in immunotherapy of cancer. Here, several melanoma tissues and cell lines but not normal tissues were found to overexpress the cancer-testis antigen HAGE at the mRNA and protein level. We identified a HAGE-derived 15-mer peptide containing a shorter predicted MHC class I-binding sequence within a class II-binding sequence. However, only the longer peptide was found to be both endogenously processed and immunogenic for T cells in transgenic mice in vivo, as well as for human T cells in vitro. A different class I-binding peptide, not contained within a longer class II sequence, was subsequently found to be both immunogenic and endogenously processed in transgenic mice, as was a second class II epitope. These novel HAGE-derived epitopes may contribute to the range of immunotherapeutic targets for use in cancer vaccination programs.
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Affiliation(s)
- Morgan G. Mathieu
- School of Biomedical and Natural Science, Nottingham Trent University, Clifton Lane, Nottingham, NG11 8NS UK
| | - Ashley J. Knights
- Section for Transplantation Immunology and Immunohaematology, ZMF, University Hospital Tübingen, Waldhörnlestrasse 22, Tübingen, Germany
- Division of Oncology, University Hospital Zürich, Zurich, Switzerland
| | - Graham Pawelec
- Section for Transplantation Immunology and Immunohaematology, ZMF, University Hospital Tübingen, Waldhörnlestrasse 22, Tübingen, Germany
| | - Catherine L. Riley
- School of Biomedical and Natural Science, Nottingham Trent University, Clifton Lane, Nottingham, NG11 8NS UK
| | - Dorothee Wernet
- Department of Transfusion Medicine, Eberhard Karls University, Tübingen, Germany
| | - François A. Lemonnier
- AIDS-Retrovirus Department, Antiviral Cellular Immunity Unit, Pasteur Institute, Paris, France
| | - Per Thor Straten
- Center for Cancer Immunotherapy (CCIT), Department of Hematology, Herlev University Hospital, Copenhagen, Denmark
| | - Ludmila Mueller
- Section for Transplantation Immunology and Immunohaematology, ZMF, University Hospital Tübingen, Waldhörnlestrasse 22, Tübingen, Germany
| | - Robert C. Rees
- School of Biomedical and Natural Science, Nottingham Trent University, Clifton Lane, Nottingham, NG11 8NS UK
| | - Stephanie E. B. McArdle
- School of Biomedical and Natural Science, Nottingham Trent University, Clifton Lane, Nottingham, NG11 8NS UK
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9392
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Khammari A, Nguyen JM, Pandolfino MC, Quereux G, Brocard A, Bercegeay S, Cassidanius A, Lemarre P, Volteau C, Labarrière N, Jotereau F, Dréno B. Long-term follow-up of patients treated by adoptive transfer of melanoma tumor-infiltrating lymphocytes as adjuvant therapy for stage III melanoma. Cancer Immunol Immunother 2007; 56:1853-60. [PMID: 17549472 PMCID: PMC11030710 DOI: 10.1007/s00262-007-0340-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [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: 11/09/2006] [Accepted: 05/03/2007] [Indexed: 12/29/2022]
Abstract
The first analysis of our clinical trial on interest of using tumor-infiltrating lymphocytes (TIL) as adjuvant therapy for stage III (regional lymph nodes) melanoma was published in 2002 [5]. The aim of this paper is to update clinical results of 7 years of follow-up after the last treated patient. In the trial conducted between December 1993 and January 1999, patients without any detectable metastases after lymph node excision were randomly assigned to receive either TIL plus interleukin-2 (IL-2) for 2 months, or IL-2 only. The duration of the relapse-free interval was the primary objective. Eighty-eight patients were enrolled in the study. Currently, the last analysis performed in June 2006, after a median follow-up of 114.8 months, did not show change of non-significant extension of the relapse-free interval or overall survival. However, this second analysis strengthens our first hypothesis about the relationship between number of invaded lymph nodes and TIL treatment effectiveness. In the group with only one invaded lymph node, the estimated relapse rate was significantly lower (P (adjusted) = 0.0219) and the overall survival was increased (P (adjusted) = 0.0125) in the TIL+IL-2 arm compared with the IL-2 only arm. No differences between the two arms, either with regard to the duration of disease-free survival (P (adjusted) = 0.38) or overall survival (P (adjusted) = 0.43), were noted in the group with more than one invaded lymph node, whatever the number of invaded lymph nodes. Treatment was compatible with normal daily activity. This study, with a very long follow up (median of almost 10 years), postulates for the first time relationship between TIL efficiency in stage III melanoma (AJCC) and number of invaded lymph nodes, indicating that tumor burden might be a crucial factor in the production of an effective in vitro expansion of T cells specific for autologous tumor antigen, a finding which could be of value in future vaccine development for the treatment of melanoma.
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Affiliation(s)
- Amir Khammari
- Skin Cancer Unit, CHU Hôtel Dieu, Nantes, Place Alexis Ricordeau, 44093 Nantes Cedex 01, France
| | - Jean-Michel Nguyen
- PIMESP, CHU Nantes, Hôpital St. Jacques, 85, rue St. Jacques, 44093 Nantes, France
| | | | - Gaëlle Quereux
- Skin Cancer Unit, CHU Hôtel Dieu, Nantes, Place Alexis Ricordeau, 44093 Nantes Cedex 01, France
| | - Anabelle Brocard
- Skin Cancer Unit, CHU Hôtel Dieu, Nantes, Place Alexis Ricordeau, 44093 Nantes Cedex 01, France
| | - Sylvain Bercegeay
- Cellular and Genetic Therapy Unit, CHU Nantes, 9 Quai Moncousu, 44093 Nantes, France
| | - Alain Cassidanius
- Cellular and Genetic Therapy Unit, CHU Nantes, 9 Quai Moncousu, 44093 Nantes, France
| | - Philippe Lemarre
- Cellular and Genetic Therapy Unit, CHU Nantes, 9 Quai Moncousu, 44093 Nantes, France
| | - Christelle Volteau
- PIMESP, CHU Nantes, Hôpital St. Jacques, 85, rue St. Jacques, 44093 Nantes, France
| | | | | | - Brigitte Dréno
- Skin Cancer Unit, CHU Hôtel Dieu, Nantes, Place Alexis Ricordeau, 44093 Nantes Cedex 01, France
- Cellular and Genetic Therapy Unit, CHU Nantes, 9 Quai Moncousu, 44093 Nantes, France
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9393
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Larrieu P, Ouisse LH, Guilloux Y, Jotereau F, Fonteneau JF. A HLA-DQ5 restricted Melan-A/MART-1 epitope presented by melanoma tumor cells to CD4+ T lymphocytes. Cancer Immunol Immunother 2007; 56:1565-75. [PMID: 17318652 PMCID: PMC11031014 DOI: 10.1007/s00262-007-0300-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [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: 10/05/2006] [Accepted: 02/08/2007] [Indexed: 10/23/2022]
Abstract
Melan-A/MART1 is a melanocytic differentiation antigen expressed by tumor cells of the majority of melanoma patients and, as such, is considered as a good target for melanoma immunotherapy. Nonetheless, the number of class I and II restricted Melan-A epitopes identified so far remains limited. Here we describe a new Melan-A/MART-1 epitope recognized in the context of HLA-DQa1*0101 and HLA-DQb1*0501, -DQb1*0502 or -DQb1*0504 molecules by a CD4+ T cell clone. This clone was obtained by in vitro stimulation of PBMC from a healthy donor by the Melan-A51-73 peptide previously reported to contain a HLA-DR4 epitope. The Melan-A51-73 peptide, therefore contains both HLA-DR4 and HLA-DQ5 restricted epitope. We further show that Melan-A51-63 is the minimal peptide optimally recognized by the HLA-DQ5 restricted CD4+ clone. Importantly, this clone specifically recognizes and kills tumor cell lines expressing Melan-A and either HLA-DQb1*0501, -DQb1*0504 or -DQb1*0502 molecules. Moreover, we could detect CD4+ T cells secreting IFN-gamma in response to Melan-A51-63 and Melan-A51-73 peptides among tumor infiltrating and blood lymphocytes from HLA-DQ5+ patients. This suggests that spontaneous CD4+ T cell responses against this HLA-DQ5 epitope occur in vivo. Together these data significantly increase the fraction of melanoma patients susceptible to benefit from a Melan-A class II restricted vaccine approach.
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Affiliation(s)
- Pierre Larrieu
- INSERM U601, Institut de biologie, 9 quai moncousu, 44093 Nantes cedex, France
| | - Laure-Hélène Ouisse
- INSERM U601, Institut de biologie, 9 quai moncousu, 44093 Nantes cedex, France
| | - Yannick Guilloux
- INSERM U601, Institut de biologie, 9 quai moncousu, 44093 Nantes cedex, France
- Université de Nantes, 44322 Nantes, France
| | - Francine Jotereau
- INSERM U601, Institut de biologie, 9 quai moncousu, 44093 Nantes cedex, France
- Université de Nantes, 44322 Nantes, France
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9394
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Dörrie J, Birkholz K, Schaft N. Strategies for immune intervention; from bench to bedside: Symposium 2006 of the Collaborative Research Center "Strategies of cellular immune intervention" July 17th-18th, Erlangen, Germany. Cancer Immunol Immunother 2007; 56:1677-85. [PMID: 17393161 PMCID: PMC11030158 DOI: 10.1007/s00262-007-0311-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2007] [Accepted: 03/03/2007] [Indexed: 10/23/2022]
Affiliation(s)
- Jan Dörrie
- Department Dermatology, University Hospital Erlangen, Hartmannstrasse 14, 91052 Erlangen, Germany
| | - Katrin Birkholz
- Department Dermatology, University Hospital Erlangen, Hartmannstrasse 14, 91052 Erlangen, Germany
| | - Niels Schaft
- Department Dermatology, University Hospital Erlangen, Hartmannstrasse 14, 91052 Erlangen, Germany
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9395
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Søndergaard H, Frederiksen KS, Thygesen P, Galsgaard ED, Skak K, Kristjansen PEG, Odum N, Kragh M. Interleukin 21 therapy increases the density of tumor infiltrating CD8+ T cells and inhibits the growth of syngeneic tumors. Cancer Immunol Immunother 2007; 56:1417-28. [PMID: 17285290 PMCID: PMC11030032 DOI: 10.1007/s00262-007-0285-4] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [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: 10/13/2006] [Accepted: 12/24/2006] [Indexed: 01/04/2023]
Abstract
Interleukin (IL)-21 is a recently discovered cytokine in early clinical development, which has shown anti-tumor activity in various animal models. In the present study, we examine the anti-tumor activity of IL-21 protein therapy in two syngeneic tumor models and its effect on the density of tumor infiltrating T cells. We treated mice bearing established subcutaneous B16 melanomas or RenCa renal cell carcinomas with intraperitoneal (i.p.) or subcutaneous (s.c.) IL-21 protein therapy and subsequently scored the densities of tumor infiltrating CD4(+) and CD8(+) T cells by immunohistochemistry. Whereas both routes of IL-21 administration significantly inhibited growth of small, established RenCa and B16 tumors, only s.c. therapy significantly inhibited the growth of large, established tumors. We found a greater bioavailability and significant drainage of IL-21 to regional lymph nodes following s.c. administration, which could account for the apparent increase in anti-tumor activity. Specific depletion of CD8(+) T cells with monoclonal antibodies completely abrogated the anti-tumor activity, whereas NK1.1(+) cell depletion did not affect tumor growth. In accordance, both routes of IL-21 administration significantly increased the density of tumor infiltrating CD8(+) T cells in both B16 and RenCa tumors; and in the RenCa model s.c. administration of IL-21 led to a significantly higher density of tumor infiltrating CD8(+) T cells compared to i.p. administration. The densities of CD4(+) T cells were unchanged following IL-21 treatments. Taken together, these data demonstrate that IL-21 protein has anti-tumor activity in established syngeneic tumors, and we show that IL-21 therapy markedly increases the density of tumor infiltrating CD8(+) T cells.
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Affiliation(s)
- Henrik Søndergaard
- Department of Cancer Pharmacology, Biopharmaceuticals Research Unit, Novo Nordisk A/S, Novo Nordisk Park F6.2.30, DK, Måløv, Denmark.
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9396
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Ladányi A, Kiss J, Somlai B, Gilde K, Fejos Z, Mohos A, Gaudi I, Tímár J. Density of DC-LAMP(+) mature dendritic cells in combination with activated T lymphocytes infiltrating primary cutaneous melanoma is a strong independent prognostic factor. Cancer Immunol Immunother 2007; 56:1459-69. [PMID: 17279413 PMCID: PMC11030123 DOI: 10.1007/s00262-007-0286-3] [Citation(s) in RCA: 191] [Impact Index Per Article: 11.2] [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: 10/26/2006] [Accepted: 12/22/2006] [Indexed: 12/31/2022]
Abstract
As the most potent antigen presenting cells, dendritic cells (DCs) play key roles in the immune response against tumors. Their density in the tumor tissue has been associated with prognosis in patients with various cancers. However, few studies have been aimed at the presence and maturation state of DCs in cutaneous melanoma, with regard to their potential clinical correlates. In this study, the density of DCs expressing CD1a and the maturation marker DC-LAMP was determined by immunohistochemistry in primary tumor samples from 82 patients with cutaneous malignant melanoma. Intratumoral and peritumoral cell densities were analyzed in relation to tumor thickness and the subsequent development of metastases, as well as to patients' survival. CD1a(+) DCs were found both infiltrating melanoma cell nests and in the surrounding stroma, while DC-LAMP(+) mature DCs were generally confined to the peritumoral areas, associated with lymphocytic infiltrates. DC density values significantly correlated with the number of activated (CD25(+) or OX40(+)) T lymphocytes (p < 0.001). The degree of infiltration by CD1a(+) and DC-LAMP(+) DCs showed strong inverse correlation with the thickness of melanomas (p < 0.001). High peritumoral density of mature DCs was associated with significantly longer survival (p = 0.0195), while density of CD1a(+) cells had a prognostic impact of borderline significance (p = 0.0610). Moreover, combination of high peritumoral CD1a(+) or DC-LAMP(+) cell density with high number of CD25(+) or OX40(+) lymphocytes identified patient subgroups with more favorable survival compared to other subgroups. A multivariate survival analysis involving DC and activated T-cell densities alone and in combinations, as well as traditional prognostic factors, identified high DC-LAMP(+) cell/high OX40(+) cell density and Breslow index as independent predictors of good prognosis. These results suggest that the presence of CD1a(+) DCs primarily depends on the thickness of melanomas, without direct relationship with the patients' survival. On the other hand, the density of mature DCs, especially in association with that of activated T cells, proved of prognostic importance, suggesting that these parameters could be considered as signs of a functional immune response associated with better outcome of the disease.
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Affiliation(s)
- Andrea Ladányi
- Department of Tumor Progression, National Institute of Oncology, 7-9 Ráth György u., Budapest, H-1122, Hungary.
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9397
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Himoudi N, Nabarro S, Yan M, Gilmour K, Thrasher AJ, Anderson J. Development of anti-PAX3 immune responses; a target for cancer immunotherapy. Cancer Immunol Immunother 2007; 56:1381-95. [PMID: 17318653 PMCID: PMC11030167 DOI: 10.1007/s00262-007-0294-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [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: 08/11/2006] [Accepted: 01/21/2007] [Indexed: 10/23/2022]
Abstract
PAX3 is overexpressed in several human cancers and is absent from normal adult human tissues. It is known to have an oncogenic function in human malignancy, and is therefore a promising target for cancer immunotherapy. We screened the murine and human PAX3 amino acid sequences for peptides that bind common MHC class I types, and identified murine GVFINGRPL and human KLTEARVQV sequences. Mice immunised with either a selected PAX3 peptide, or with a PAX3 expressing DNA vector, developed specific anti-PAX3 immune responses that inhibited tumour growth. The intensity of the immune response was significantly enhanced by pulsing of the peptide onto dendritic cells. Anti-PAX3 T cell lines were established from splenocytes of immunised mice. Intravenous administration of anti-PAX3 T cells caused regression of established tumours indicating a promising clinical application for anti-PAX3 immunotherapy. The human peptide stimulated growth of similar T cell lines from peripheral blood of three out of three normal human blood donors. These showed specific cytotoxicity against a range of human PAX3+ and HLA-A2+ cancer cell lines. Moreover, an anti-PAX3 response was detected as a component of the anti-tumour immune response in a patient treated with lysate pulsed dendritic cell vaccination. The ability to generate strong and specific anti PAX3 immune responses from the T cell repertoire in both mice and humans, provides evidence for PAX3 as a promising target for immunotherapy of cancer.
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Affiliation(s)
- Nourredine Himoudi
- Unit of Molecular Haematology and Cancer Biology, Institute of Child Health, London, WC1N 1EH UK
| | - Steven Nabarro
- Unit of Molecular Haematology and Cancer Biology, Institute of Child Health, London, WC1N 1EH UK
| | - Mengyong Yan
- Unit of Molecular Haematology and Cancer Biology, Institute of Child Health, London, WC1N 1EH UK
| | - Kimberly Gilmour
- Unit of Molecular Immunology, Institute of Child Health, London, WC1N 1EH UK
| | - Adrian J. Thrasher
- Unit of Molecular Immunology, Institute of Child Health, London, WC1N 1EH UK
| | - John Anderson
- Unit of Molecular Haematology and Cancer Biology, Institute of Child Health, London, WC1N 1EH UK
- Department of Paediatric Oncology, Great Ormond Street Hospital, London, WC1N 3JH UK
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9398
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Aptsiauri N, Cabrera T, Pawelec G, Gouttefangeas C, Derhovanessian E, Garrido F, Garcia-Lora A. International conference: progress in vaccination against cancer-2006 (PIVAC 6), Granada, Spain. Cancer Immunol Immunother 2007; 56:1311-22. [PMID: 17375297 PMCID: PMC11031018 DOI: 10.1007/s00262-007-0308-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2007] [Accepted: 02/25/2007] [Indexed: 11/30/2022]
Affiliation(s)
- Natalia Aptsiauri
- Servicio de Análisis Clínicos, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Teresa Cabrera
- Servicio de Análisis Clínicos, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Departamento de Bioquimica, Biologia Molecular 3 e Inmunología, Facultad de Medicina, Universidad de Granada, Granada, Spain
| | - Graham Pawelec
- Center for Medical Research, University of Tübingen Clinical School, Tübingen, Germany
| | | | | | - Federico Garrido
- Servicio de Análisis Clínicos, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Departamento de Bioquimica, Biologia Molecular 3 e Inmunología, Facultad de Medicina, Universidad de Granada, Granada, Spain
- Dept. Analisis Clinicos, Hospital Universitario Virgen de las Nieves, Avda. Fuerzas Armadas n=BA2 , Granada, 18014 Spain
| | - Angel Garcia-Lora
- Servicio de Análisis Clínicos, Hospital Universitario Virgen de las Nieves, Granada, Spain
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9399
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Wondrak GT. NQO1-activated phenothiazinium redox cyclers for the targeted bioreductive induction of cancer cell apoptosis. Free Radic Biol Med 2007; 43:178-90. [PMID: 17603928 PMCID: PMC2705808 DOI: 10.1016/j.freeradbiomed.2007.03.035] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2007] [Revised: 03/21/2007] [Accepted: 03/30/2007] [Indexed: 11/24/2022]
Abstract
Altered redox signaling and regulation in cancer cells represent a chemical vulnerability that can be targeted by selective chemotherapeutic intervention. Here, we demonstrate that 3,7-diaminophenothiazinium-based redox cyclers (PRC) induce selective cancer cell apoptosis by NAD(P)H:quinone oxidoreductase (NQO1)-dependent bioreductive generation of cellular oxidative stress. Using PRC lead compounds including toluidine blue against human metastatic G361 melanoma cells, apoptosis occurred with phosphatidylserine externalization, loss of mitochondrial transmembrane potential, cytochrome c release, caspase-3 activation, and massive ROS production. Consistent with reductive activation and subsequent redox cycling as the mechanism of PRC cytotoxicity, coincubation with catalase achieved cell protection, whereas reductive antioxidants enhanced PRC cytotoxicity. Unexpectedly, human A375 melanoma cells were resistant to PRC-induced apoptosis, and PRC-sensitive G361 cells were protected by preincubation with the NQO1 inhibitor dicoumarol. Indeed, NQO1 specific enzymatic activity was 9-fold higher in G361 than in A375 cells. The critical role of NQO1 in PRC bioactivation and cytotoxicity was confirmed, when NQO1-transfected breast cancer cells (MCF7-DT15) stably overexpressing active NQO1 displayed strongly enhanced PRC sensitivity as compared to vector control-transfected cells with baseline NQO1 activity. Based on the known overexpression of NQO1 in various tumors these findings suggest the feasibility of developing PRC lead compounds into tumor-selective bioreductive chemotherapeutics.
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Affiliation(s)
- Georg T Wondrak
- Department of Pharmacology and Toxicology, College of Pharmacy, Arizona Cancer Center, University of Arizona, 1515 North Campbell Avenue, Tucson, AZ 85724, USA.
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9400
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Velazquez EF, Jungbluth AA, Yancovitz M, Gnjatic S, Adams S, O'Neill D, Zavilevich K, Albukh T, Christos P, Mazumdar M, Pavlick A, Polsky D, Shapiro R, Berman R, Spira J, Busam K, Osman I, Bhardwaj N. Expression of the cancer/testis antigen NY-ESO-1 in primary and metastatic malignant melanoma (MM)--correlation with prognostic factors. Cancer Immun 2007; 7:11. [PMID: 17625806 PMCID: PMC2935749] [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] [Subscribe] [Scholar Register] [Received: 03/13/2007] [Accepted: 04/23/2007] [Indexed: 05/16/2023]
Abstract
Cancer/testis (CT) antigens are potential targets for cancer immunotherapy, with NY-ESO-1 being among the most immunogenic. In several clinical trials in malignant melanoma (MM) patients, NY-ESO-1 protein/peptides showed clear evidence of inducing specific immunity. However, little is known about NY-ESO-1 expression in primary and metastatic MM and its relationship to disease progression. We analyzed NY-ESO-1 expression immunohistochemically in a series of primary and metastatic MMs and its relation to prognostic parameters and survival. We studied 61 primary and 63 metastatic MM specimens (from 61 and 56 patients, respectively). The prevalence of NY-ESO-1 expression was significantly higher in metastatic versus primary tumors [18/56 (32%) versus 8/61 (13%), P = 0.015]. There was a significant association between initial stage at presentation and NY-ESO-1 expression [stage I (3.45%), stage II (9.52%) and stage III (45.45%), P = 0.0014]. Primary MMs expressing NY-ESO-1 were significantly thicker than NY-ESO-1 negative cases (median thickness 4.7 mm versus 1.53 mm respectively, P = 0.03). No significant difference was seen in overall survival. In conclusion, NY-ESO-1 is more frequently expressed in metastatic than in primary MM and its expression is associated with thicker primary lesions and a higher frequency of metastatic disease, indicative of a worse prognosis. Our study suggests that patients with metastatic MM who express NY-ESO-1 may benefit from NY-ESO-1-based immunotherapy.
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Affiliation(s)
- Elsa F. Velazquez
- Ronald O. Perelman Department of Dermatology,
New York University School of MedicineNew
York, NYUSA
- Department of Pathology, New York University
School of MedicineNew York, NYUSA
- Department of Pathology, Brigham and
Women's Hospital, Harvard Medical SchoolBoston,
MAUSA
| | | | - Molly Yancovitz
- Ronald O. Perelman Department of Dermatology,
New York University School of MedicineNew
York, NYUSA
| | | | - Sylvia Adams
- Department of Medicine, New York University
School of MedicineNew York, NYUSA
| | - David O'Neill
- Department of Medicine, New York University
School of MedicineNew York, NYUSA
| | - Kira Zavilevich
- Department of Medicine, New York University
School of MedicineNew York, NYUSA
| | - Tatyana Albukh
- Department of Medicine, New York University
School of MedicineNew York, NYUSA
| | - Paul Christos
- Department of Public Health, Weill Medical
College of Cornell UniversityNew York,
NYUSA
| | - Madhu Mazumdar
- Department of Public Health, Weill Medical
College of Cornell UniversityNew York,
NYUSA
| | - Anna Pavlick
- Ronald O. Perelman Department of Dermatology,
New York University School of MedicineNew
York, NYUSA
- Department of Surgery, New York University
School of MedicineNew York, NYUSA
| | - David Polsky
- Ronald O. Perelman Department of Dermatology,
New York University School of MedicineNew
York, NYUSA
| | - Richard Shapiro
- Department of Surgery, New York University
School of MedicineNew York, NYUSA
| | - Russell Berman
- Department of Surgery, New York University
School of MedicineNew York, NYUSA
| | - Joanna Spira
- Ronald O. Perelman Department of Dermatology,
New York University School of MedicineNew
York, NYUSA
| | - Klaus Busam
- Department of Pathology, Memorial Sloan-Kettering
Cancer CenterNew York, NYUSA
| | - Iman Osman
- Ronald O. Perelman Department of Dermatology,
New York University School of MedicineNew
York, NYUSA
- Department of Medicine, New York University
School of MedicineNew York, NYUSA
| | - Nina Bhardwaj
- Ronald O. Perelman Department of Dermatology,
New York University School of MedicineNew
York, NYUSA
- Department of Pathology, New York University
School of MedicineNew York, NYUSA
- Department of Medicine, New York University
School of MedicineNew York, NYUSA
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