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Kokkotou E, Grapsa D, Papadopoulou A, Gaitanakis S, Bakakos P, Poulakou G, Moutsatsou P, Syrigos K. Soluble PD-L1 and Serum Vascular Endothelial Growth Factor-B May Independently Predict Prognosis in Patients with Advanced Non-Small Cell Lung Cancer Treated with Pembrolizumab. Cancers (Basel) 2025; 17:421. [PMID: 39941790 PMCID: PMC11816055 DOI: 10.3390/cancers17030421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2024] [Revised: 01/10/2025] [Accepted: 01/24/2025] [Indexed: 02/16/2025] Open
Abstract
Background: Previous preclinical data have shown that the dynamic cross-talk between abnormal tumor vasculature and immune cell factors in the tumor microenvironment may exert a critical role in the progression and treatment resistance of non-small cell lung cancer (NSCLC). In the clinical setting, a variety of blood-based angiogenesis- and immune-related factors are being increasingly investigated as potential biomarkers of prognosis or treatment response in immunotherapy-treated NSCLC. We herein aimed to evaluate the clinical relevance of the peripheral blood levels of vascular endothelial growth factor-A and -B (VEGF-A and VEGF-B, respectively), soluble programmed cell death-1 (sPD-1), and programmed cell death-ligand 1 (sPD-L1) in patients with advanced NSCLC treated with immune checkpoint inhibitors (ICIs). Methods: Consecutive patients with advanced-stage, non-oncogene-addicted NSCLC, eligible to receive ICIs at the Oncology Unit of Sotiria Athens General Hospital, were prospectively recruited. A group of sex- and age-matched healthy controls was also enrolled for the evaluation of the potential diagnostic significance of the examined biomarkers. Serum levels of all biomarkers were measured using ELISA, both before and after treatment, and were correlated with standard clinicopathological features of patients, treatment response, progression-free survival (PFS), and overall survival (OS). Results: A total of 55 patients and 16 healthy controls were included in the final analysis. The mean age of patients and controls was 66.5 years (SD = 8.0 years) and 65.4 years (SD = 9.1 years), respectively. The majority of patients (65.5%) received pembrolizumab in combination with chemotherapy, while the remaining patients received pembrolizumab monotherapy. ROC curve analysis showed that VEGFB and sPD-1 were the only markers with a significant diagnostic value. Higher pre-treatment values of sPD-L1 (HR = 1.68; p = 0.040) and sPD-1 (HR = 10.96; p = 0.037) as well as higher post-treatment values of VEGF-B (HR = 2.99; p = 0.049) were all significantly associated with a reduced OS in univariate Cox regression analysis. The adverse prognostic significance of higher pre-treatment values of sPD-L1 (HR = 2.10; p = 0.014) and higher post-treatment values of VEGFB (HR = 3.37; p = 0.032) was further confirmed in multivariate analysis. Conclusions: Our study results suggest that serum levels of sPD-L1 and VEGF-B may independently predict prognosis in ICI-treated advanced-stage NSCLC.
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Affiliation(s)
- Eleni Kokkotou
- Oncology Unit, 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (D.G.); (S.G.); (G.P.); (K.S.)
| | - Dimitra Grapsa
- Oncology Unit, 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (D.G.); (S.G.); (G.P.); (K.S.)
| | - Anna Papadopoulou
- Laboratory of Clinical Biochemistry, “Attikon” University General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.P.); (P.M.)
| | - Stylianos Gaitanakis
- Oncology Unit, 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (D.G.); (S.G.); (G.P.); (K.S.)
| | - Petros Bakakos
- 1st Respiratory Medicine Department, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Garyfallia Poulakou
- Oncology Unit, 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (D.G.); (S.G.); (G.P.); (K.S.)
| | - Paraskevi Moutsatsou
- Laboratory of Clinical Biochemistry, “Attikon” University General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.P.); (P.M.)
| | - Konstantinos Syrigos
- Oncology Unit, 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (D.G.); (S.G.); (G.P.); (K.S.)
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Chen L, Chao Y, Li W, Wu Z, Wang Q. Soluble immune checkpoint molecules in cancer risk, outcomes prediction, and therapeutic applications. Biomark Res 2024; 12:95. [PMID: 39218939 PMCID: PMC11368031 DOI: 10.1186/s40364-024-00647-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Accepted: 08/24/2024] [Indexed: 09/04/2024] Open
Abstract
Immunotherapy has emerged as a pivotal modality in cancer treatment, with immune checkpoint inhibitors effectively combating malignancies by impeding crucial pathways within the immune system and stimulating patients' immune responses. Soluble forms of immune checkpoints exhibit a remarkable diversity and can be readily tracked in circulation, holding immense potential as biomarkers for cancer treatment. An increasing number of studies focused on soluble immune checkpoints in cancer have emerged thanks to technological advancements. In this systematic review, we comprehensively summarized the recent studies on soluble immune checkpoints in human cancer risk prediction, outcome prediction, therapeutic applications, and potential molecular mechanisms, which demonstrated the promising future of soluble immune checkpoints in clinical applications. The clinical relevance of soluble immune checkpoints has been recognized in multiple cancers, yet the therapeutic applications and mechanisms remain obscure. Interpreting the impacts and mechanisms of soluble immune checkpoints could shed a light on the novel strategies of cancer screening, treatments, and outcome prediction.
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Affiliation(s)
- Lin Chen
- Department of Surgical Oncology, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Zhejiang, 310009, Zhejiang, PR China
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yuqing Chao
- Department of Surgical Oncology, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Zhejiang, 310009, Zhejiang, PR China
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Wenjing Li
- Department of Surgical Oncology, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Zhejiang, 310009, Zhejiang, PR China
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Zhixia Wu
- Department of Service and Purchase, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Qinchuan Wang
- Department of Surgical Oncology, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Zhejiang, 310009, Zhejiang, PR China.
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
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Zvirble M, Survila Z, Bosas P, Dobrovolskiene N, Mlynska A, Zaleskis G, Jursenaite J, Characiejus D, Pasukoniene V. Prognostic significance of soluble PD-L1 in prostate cancer. Front Immunol 2024; 15:1401097. [PMID: 39055716 PMCID: PMC11269106 DOI: 10.3389/fimmu.2024.1401097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 06/19/2024] [Indexed: 07/27/2024] Open
Abstract
Purpose The aim of this study was to assess the role of sPD-L1 and sPD-1 as potential biomarkers in prostate cancer (PCa). The association of the values of these soluble proteins were correlated to the clinical data: stage of disease, Gleason score, biochemical recurrence etc. For a comprehensive study, the relationship between sPD-L1 and sPD-1 and circulating immune cells was further investigated. Methods A total of 88 patients with pT2 and pT3 PCa diagnosis and 41 heathy men were enrolled. Soluble sPD-L1 and sPD-1 levels were measured in plasma by ELISA method. Immunophenotyping was performed by flow cytometry analysis. Results Our study's findings demonstrate that PCa patients had higher levels of circulating sPD-L1 and sPD-1 comparing to healthy controls (p < 0.001). We found a statistically significant (p < 0.05) relationship between improved progression free survival and lower initial sPD-L1 values. Furthermore, patients with a lower sPD-1/sPD-L1 ratio were associated with a higher probability of disease progression (p < 0.05). Additionally, a significant (p < 0.05) association was discovered between higher Gleason scores and elevated preoperative sPD-L1 levels and between sPD-1 and advanced stage of disease (p < 0.05). A strong correlation (p < 0.05), between immunosuppressive CD4+CD25+FoxP3+ regulatory T cells and baseline sPD-L1 was observed in patients with unfavorable postoperative course of the disease, supporting the idea that these elements influence each other in cancer progression. In addition to the postoperative drop in circulating PD-L1, the inverse relationship (p < 0.05), between the percentage of M-MDSC and sPD-L1 in patients with BCR suggests that M-MDSC is not a source of sPD-L1 in PCa patients. Conclusion Our findings suggest the potential of sPD-L1 as a promising prognostic marker in prostate cancer.
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Affiliation(s)
- Margarita Zvirble
- Laboratory of Immunology, National Cancer Institute, Vilnius, Lithuania
- Institute of Biosciences, Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - Zilvinas Survila
- Institute of Biosciences, Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - Paulius Bosas
- Department of Oncourology, National Cancer Institute, Vilnius, Lithuania
- Department of Immunology and Bioelectrochemistry, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania
| | | | - Agata Mlynska
- Laboratory of Immunology, National Cancer Institute, Vilnius, Lithuania
- Department of Chemistry and Bioengineering, Vilnius Gediminas Technical University, Vilnius, Lithuania
| | - Gintaras Zaleskis
- Department of Immunology and Bioelectrochemistry, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania
| | - Jurgita Jursenaite
- Department of Immunology and Bioelectrochemistry, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania
| | - Dainius Characiejus
- Department of Immunology and Bioelectrochemistry, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania
- Department of Pathology and Forensic Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Vita Pasukoniene
- Laboratory of Immunology, National Cancer Institute, Vilnius, Lithuania
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Pitts SC, Schlom J, Donahue RN. Soluble immune checkpoints: implications for cancer prognosis and response to immune checkpoint therapy and conventional therapies. J Exp Clin Cancer Res 2024; 43:155. [PMID: 38822401 PMCID: PMC11141022 DOI: 10.1186/s13046-024-03074-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 05/19/2024] [Indexed: 06/03/2024] Open
Abstract
Longitudinal sampling of tumor tissue from patients with solid cancers, aside from melanoma and a few other cases, is often unfeasible, and thus may not capture the plasticity of interactions between the tumor and immune system under selective pressure of a given therapy. Peripheral blood analyses provide salient information about the human peripheral immunome while offering technical and practical advantages over traditional tumor biopsies, and should be utilized where possible alongside interrogation of the tumor. Some common blood-based biomarkers used to study the immune response include immune cell subsets, circulating tumor DNA, and protein analytes such as cytokines. With the recent explosion of immune checkpoint inhibitors (ICI) as a modality of treatment in multiple cancer types, soluble immune checkpoints have become a relevant area of investigation for peripheral immune-based biomarkers. However, the exact functions of soluble immune checkpoints and their roles in cancer for the most part remain unclear. This review discusses current literature on the production, function, and expression of nine soluble immune checkpoints - sPD-L1, sPD-1, sCTLA4, sCD80, sTIM3, sLAG3, sB7-H3, sBTLA, and sHVEM - in patients with solid tumors, and explores their role as biomarkers of response to ICI as well as to conventional therapies (chemotherapy, radiotherapy, targeted therapy, and surgery) in cancer patients.
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Affiliation(s)
- Stephanie C Pitts
- Center for Immuno-Oncology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Jeffrey Schlom
- Center for Immuno-Oncology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
| | - Renee N Donahue
- Center for Immuno-Oncology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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Ueda K, Uemura K, Ito N, Sakai Y, Ohnishi S, Suekane H, Kurose H, Hiroshige T, Chikui K, Nishihara K, Nakiri M, Suekane S, Ogasawara S, Yano H, Igawa T. Soluble Immune Checkpoint Molecules as Predictors of Efficacy in Immuno-Oncology Combination Therapy in Advanced Renal Cell Carcinoma. Curr Oncol 2024; 31:1701-1712. [PMID: 38668032 PMCID: PMC11049572 DOI: 10.3390/curroncol31040129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 03/18/2024] [Accepted: 03/21/2024] [Indexed: 04/28/2024] Open
Abstract
Immuno-oncology (IO) combination therapy is the first-line treatment for advanced renal cell carcinoma (RCC). However, biomarkers for predicting the response to IO combination therapy are lacking. Here, we investigated the association between the expression of soluble immune checkpoint molecules and the therapeutic efficacy of IO combination therapy in advanced RCC. The expression of soluble programmed cell death-1 (sPD-1), soluble programmed cell death ligand-1 (sPD-L1), soluble PD-L2 (sPD-L2), and lymphocyte activation gene-3 (sLAG-3) was assessed in plasma samples from 42 patients with advanced RCC who received first-line IO combination therapy. All IMDC risk classifications were represented among the patients, including 14.3, 57.1, and 28.6% with favorable, intermediate, and poor risk, respectively. Univariate analysis revealed that prior nephrectomy, sPD-L2 levels, and sLAG-3 levels were significant factors affecting progression-free survival (PFS), whereas multivariate analyses suggested that sPD-L2 and sLAG-3 levels were independent prognostic factors for PFS. In a univariate analysis of the overall survival, prior nephrectomy and sPD-L2 levels were significant factors; no significant differences were observed in the multivariate analysis. No significant correlation was observed between the sPD-L2 and sLAG-3 levels and PD-L2 and LAG-3 expression via immunohistochemistry. In conclusion, sPD-L2 and sLAG-3 expression may serve as a potential biomarker for predicting IO combination therapy efficacy.
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Affiliation(s)
- Kosuke Ueda
- Department of Urology, Kurume University School of Medicine, Kurume 830-0011, Japan; (K.U.); (N.I.); (Y.S.); (S.O.); (H.S.); (H.K.); (T.H.); (K.C.); (K.N.); (M.N.); (S.S.); (T.I.)
| | - Keiichiro Uemura
- Department of Urology, Kurume University School of Medicine, Kurume 830-0011, Japan; (K.U.); (N.I.); (Y.S.); (S.O.); (H.S.); (H.K.); (T.H.); (K.C.); (K.N.); (M.N.); (S.S.); (T.I.)
| | - Naoki Ito
- Department of Urology, Kurume University School of Medicine, Kurume 830-0011, Japan; (K.U.); (N.I.); (Y.S.); (S.O.); (H.S.); (H.K.); (T.H.); (K.C.); (K.N.); (M.N.); (S.S.); (T.I.)
| | - Yuya Sakai
- Department of Urology, Kurume University School of Medicine, Kurume 830-0011, Japan; (K.U.); (N.I.); (Y.S.); (S.O.); (H.S.); (H.K.); (T.H.); (K.C.); (K.N.); (M.N.); (S.S.); (T.I.)
| | - Satoshi Ohnishi
- Department of Urology, Kurume University School of Medicine, Kurume 830-0011, Japan; (K.U.); (N.I.); (Y.S.); (S.O.); (H.S.); (H.K.); (T.H.); (K.C.); (K.N.); (M.N.); (S.S.); (T.I.)
| | - Hiroki Suekane
- Department of Urology, Kurume University School of Medicine, Kurume 830-0011, Japan; (K.U.); (N.I.); (Y.S.); (S.O.); (H.S.); (H.K.); (T.H.); (K.C.); (K.N.); (M.N.); (S.S.); (T.I.)
| | - Hirofumi Kurose
- Department of Urology, Kurume University School of Medicine, Kurume 830-0011, Japan; (K.U.); (N.I.); (Y.S.); (S.O.); (H.S.); (H.K.); (T.H.); (K.C.); (K.N.); (M.N.); (S.S.); (T.I.)
| | - Tasuku Hiroshige
- Department of Urology, Kurume University School of Medicine, Kurume 830-0011, Japan; (K.U.); (N.I.); (Y.S.); (S.O.); (H.S.); (H.K.); (T.H.); (K.C.); (K.N.); (M.N.); (S.S.); (T.I.)
| | - Katsuaki Chikui
- Department of Urology, Kurume University School of Medicine, Kurume 830-0011, Japan; (K.U.); (N.I.); (Y.S.); (S.O.); (H.S.); (H.K.); (T.H.); (K.C.); (K.N.); (M.N.); (S.S.); (T.I.)
| | - Kiyoaki Nishihara
- Department of Urology, Kurume University School of Medicine, Kurume 830-0011, Japan; (K.U.); (N.I.); (Y.S.); (S.O.); (H.S.); (H.K.); (T.H.); (K.C.); (K.N.); (M.N.); (S.S.); (T.I.)
| | - Makoto Nakiri
- Department of Urology, Kurume University School of Medicine, Kurume 830-0011, Japan; (K.U.); (N.I.); (Y.S.); (S.O.); (H.S.); (H.K.); (T.H.); (K.C.); (K.N.); (M.N.); (S.S.); (T.I.)
| | - Shigetaka Suekane
- Department of Urology, Kurume University School of Medicine, Kurume 830-0011, Japan; (K.U.); (N.I.); (Y.S.); (S.O.); (H.S.); (H.K.); (T.H.); (K.C.); (K.N.); (M.N.); (S.S.); (T.I.)
| | - Sachiko Ogasawara
- Department of Pathology, Kurume University School of Medicine, Kurume 830-0011, Japan; (S.O.); (H.Y.)
| | - Hirohisa Yano
- Department of Pathology, Kurume University School of Medicine, Kurume 830-0011, Japan; (S.O.); (H.Y.)
| | - Tsukasa Igawa
- Department of Urology, Kurume University School of Medicine, Kurume 830-0011, Japan; (K.U.); (N.I.); (Y.S.); (S.O.); (H.S.); (H.K.); (T.H.); (K.C.); (K.N.); (M.N.); (S.S.); (T.I.)
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Riondino S, Rosenfeld R, Formica V, Morelli C, Parisi G, Torino F, Mariotti S, Roselli M. Effectiveness of Immunotherapy in Non-Small Cell Lung Cancer Patients with a Diagnosis of COPD: Is This a Hidden Prognosticator for Survival and a Risk Factor for Immune-Related Adverse Events? Cancers (Basel) 2024; 16:1251. [PMID: 38610929 PMCID: PMC11011072 DOI: 10.3390/cancers16071251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/18/2024] [Accepted: 03/21/2024] [Indexed: 04/14/2024] Open
Abstract
The interplay between the immune system and chronic obstructive pulmonary disease (COPD) and non-small cell lung cancer (NSCLC) is complex and multifaceted. In COPD, chronic inflammation and oxidative stress can lead to immune dysfunction that can exacerbate lung damage, further worsening the respiratory symptoms. In NSCLC, immune cells can recognise and attack the cancer cells, which, however, can evade or suppress the immune response by various mechanisms, such as expressing immune checkpoint proteins or secreting immunosuppressive cytokines, thus creating an immunosuppressive tumour microenvironment that promotes cancer progression and metastasis. The interaction between COPD and NSCLC further complicates the immune response. In patients with both diseases, COPD can impair the immune response against cancer cells by reducing or suppressing the activity of immune cells, or altering their cytokine profile. Moreover, anti-cancer treatments can also affect the immune system and worsen COPD symptoms by causing lung inflammation and fibrosis. Immunotherapy itself can also cause immune-related adverse events that could worsen the respiratory symptoms in patients with COPD-compromised lungs. In the present review, we tried to understand the interplay between the two pathologies and how the efficacy of immunotherapy in NSCLC patients with COPD is affected in these patients.
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