Is there a correlation in breast carcinomas between tumor size and number of tumor vessels detected by gadolinium-enhanced magnetic resonance mammography?

Coexpression of IL7 and CCL21 Increases Efficacy of CAR-T Cells in Solid Tumors without Requiring Preconditioned Lymphodepletion

PURPOSE

T-cell recruitment, survival, and proliferation are the important limitations to chimeric antigen receptor (CAR) T cells therapy in the treatment of solid tumors. In this study, we engineered CAR-T cells to coexpress cytokines IL7 and CCL21 (7 × 21 CAR-T), a cytokine combination in order to improve proliferation and chemotaxis of CAR-T cells.

EXPERIMENTAL DESIGN

CLDN18.2-specific second-generation CAR-T cells coexpressing cytokines were prepared using retroviral vector transduction. The proliferation and migration of genetically engineered CAR-T cells were evaluated in vitro. The antitumor activities of genetically engineered CAR-T cells were evaluated against multiple solid tumors in C57BL/6 mice in vivo.

RESULTS

In vitro, the proliferation and chemotaxis of 7 × 21 CAR-T cells are significantly improved when compared with those of the conventional CAR-T cells. In vivo, 7 × 21 CAR-T cells revealed superior therapeutic effects to either conventional CAR-T cells or 7 × 19 CAR-T cells which coexpress IL7 and CCL19 as previously reported in three different solid tumors without cyclophosphamide precondition. Interestingly, 7 × 21 CAR-T cells could also suppress the tumor growth with heterogeneous antigen expression and even induce tumor complete remission. Mechanistically, IL7 and CCL21 significantly improved survival and infiltration of CAR-T cells and dendritic cells in tumor. In addition, CCL21 also inhibited the tumor angiogenesis as proved by IHC.

CONCLUSIONS

Coexpression of IL7 and CCL21 could boost CAR-T cells' antitumor activity, and 7 × 21 CAR-T cells may be served as a promising therapy strategy for solid tumors.

Bilateral analysis of the cross-sectional area of the internal mammary arteries and veins in patients with and without breast cancer on breast magnetic resonance imaging

OBJECTIVE

To analyse bilateral differences in the cross-sectional area of the internal mammary artery (IMA) and vein (IMV) in breast cancer patients compared to healthy controls.

MATERIALS AND METHODS

On 135 breast MRIs the cross-sectional areas of the IMA and IMV were measured on the left and right side in the second and third intercostal space (ICS) by two independent readers. Differences were analysed using a linear mixed model.

RESULTS

In the healthy control group (n = 91) no significant differences between the cross-sectional areas of the IMA and IMV were observed. Both readers reported a mean adjusted difference of 0.12 mm2 (p = 0.298) and 0.21 mm2 (p = 0.058) for the IMA in the second ICS. In the malignancy group (n = 44) the cross-sectional area was significantly larger on the malignancy side compared to the contralateral side. The largest difference in the IMA was measured in the second ICS with a mean adjusted difference for reader 1 of 1.37 mm2 (p < 0.001) and for reader 2 of 0.81 mm2 (p = 0.003).

CONCLUSIONS

The vascular cross-sectional area of internal mammary vessels was significantly different on the side with breast cancer compared to the contralateral side. This difference was not observed in healthy controls.

MAIN MESSAGES

• MRI has become an important imaging modality in the diagnostic workup of breast cancer. • In healthy persons no significant difference in the size of the left and right IMA is observed. • A significant enlargement of the IMA on the malignant side occurs in most patients.

The adjacent vessel on dynamic contrast-enhanced breast MRI

OBJECTIVE

The purpose of this study was to investigate whether an adjacent vessel leading to an enhancing lesion seen on subtraction images can help differentiate malignant from benign breast lesions and therefore increase the specificity of breast MRI.

MATERIALS AND METHODS

The study included 132 histologically verified lesions (71 malignant lesions, 10 pure carcinoma in situ, and 51 benign lesions) enhancing on dynamic breast MRI before biopsy. The lesions were evaluated by three radiologists in a double-blinded manner. The presence of an adjacent vessel was supposed if at least two observers voted positively.

RESULTS

Sixty-one (85.9%) of 71 malignant lesions, six (60%) of 10 carcinomas in situ, and 10 (19.6%) of 51 benign lesions were associated with an adjacent vessel, which differed significantly (p < 0.001) between benign and malignant lesions (the latter with and without including pure carcinoma in situ), leading to a positive predictive value of 85.9% (87% including pure carcinomas in situ), a negative predictive value of 80.4% (74.5% including pure carcinomas in situ), an accuracy of 83.2% (81.6% including pure carcinomas in situ), a sensitivity of 85.9% (82.7% including carcinomas in situ), and a specificity of 80.4% for this sign concerning malignancy.

CONCLUSION

The presence of an adjacent vessel seen on subtraction images promises to be a good marker for malignancy and can therefore help increase the specificity of breast MRI.