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Garcia-Torralba E, Pérez Ramos M, Ivars Rubio A, Navarro Manzano E, Blaya Boluda N, Lloret Gil M, Aller A, de la Morena Barrio P, García Garre E, Martínez Díaz F, García Molina F, Chaves Benito A, García-Martínez E, Ayala de la Peña F. Deconstructing neutrophil to lymphocyte ratio (NLR) in early breast cancer: lack of prognostic utility and biological correlates across tumor subtypes. Breast Cancer Res Treat 2024; 205:475-485. [PMID: 38453782 PMCID: PMC11101577 DOI: 10.1007/s10549-024-07286-x] [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: 10/30/2023] [Accepted: 02/07/2024] [Indexed: 03/09/2024]
Abstract
PURPOSE The prognostic utility and biological correlates of neutrophil to lymphocyte ratio (NLR), a potential biomarker of the balance between immune response and the inflammatory status, are still uncertain in breast cancer (BC). METHODS We analysed a cohort of 959 women with early breast cancer, mostly treated with neoadjuvant or adjuvant chemotherapy. Clinical and pathological data, survival, NLR (continuous and categorical) and stromal tumor infiltrating lymphocytes (sTIL) were evaluated. RESULTS NLR was only weakly associated with Ki67, while no association was found for grade, histology, immunohistochemical subtype or stage. Lymphocyte infiltration of the tumor did not correlate with NLR (Rho: 0.05, p = 0.30). These results were similar in the whole group and across the different BC subtypes, with no differences in triple negative BC. Relapse free interval (RFI), breast cancer specific survival (BCSS) and overall survival (OS) changed according to pre-treatment NLR neither in the univariate nor in the multivariate Cox models (RFI: HR 0.948, p = 0.61; BCSS: HR 0.920, p = 0.57; OS: HR 0.96, p = 0.59). CONCLUSION These results question the utility of NLR as a prognostic biomarker in early breast cancer and suggest the lack of correlation of NLR with tumor microenvironment immune response.
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Affiliation(s)
- Esmeralda Garcia-Torralba
- Department of Medical Oncology, Hospital Universitario Morales Meseguer, Murcia, 30008, Spain
- Department of Medicine, Medical School, University of Murcia, Murcia, 30001, Spain
- Instituto Murciano de Investigación Biosanitaria, IMIB, Murcia, 30120, Spain
| | - Miguel Pérez Ramos
- Department of Pathology, Hospital Universitario Morales Meseguer, Murcia, 30008, Spain
| | - Alejandra Ivars Rubio
- Department of Medical Oncology, Hospital Universitario Morales Meseguer, Murcia, 30008, Spain
- Department of Medicine, Medical School, University of Murcia, Murcia, 30001, Spain
- Instituto Murciano de Investigación Biosanitaria, IMIB, Murcia, 30120, Spain
| | - Esther Navarro Manzano
- Department of Medical Oncology, Hospital Universitario Morales Meseguer, Murcia, 30008, Spain
- Instituto Murciano de Investigación Biosanitaria, IMIB, Murcia, 30120, Spain
- Centro Regional de Hemodonación, Murcia, 30003, Spain
| | - Noel Blaya Boluda
- Department of Medical Oncology, Hospital Universitario Morales Meseguer, Murcia, 30008, Spain
- Department of Medicine, Medical School, University of Murcia, Murcia, 30001, Spain
- Instituto Murciano de Investigación Biosanitaria, IMIB, Murcia, 30120, Spain
| | - Miguel Lloret Gil
- Department of Medicine, Medical School, University of Murcia, Murcia, 30001, Spain
| | - Alberto Aller
- Department of Medicine, Medical School, University of Murcia, Murcia, 30001, Spain
| | - Pilar de la Morena Barrio
- Department of Medical Oncology, Hospital Universitario Morales Meseguer, Murcia, 30008, Spain
- Instituto Murciano de Investigación Biosanitaria, IMIB, Murcia, 30120, Spain
| | - Elisa García Garre
- Department of Medical Oncology, Hospital Universitario Morales Meseguer, Murcia, 30008, Spain
- Instituto Murciano de Investigación Biosanitaria, IMIB, Murcia, 30120, Spain
| | - Francisco Martínez Díaz
- Instituto Murciano de Investigación Biosanitaria, IMIB, Murcia, 30120, Spain
- Department of Pathology, Hospital Universitario Reina Sofía, Murcia, 30003, Spain
- Department of Pathology, Medical School, University of Murcia, Murcia, 30001, Spain
| | - Francisco García Molina
- Department of Pathology, Hospital Universitario Reina Sofía, Murcia, 30003, Spain
- Department of Pathology, Medical School, University of Murcia, Murcia, 30001, Spain
| | - Asunción Chaves Benito
- Department of Pathology, Hospital Universitario Morales Meseguer, Murcia, 30008, Spain
- Department of Pathology, Medical School, University of Murcia, Murcia, 30001, Spain
| | - Elena García-Martínez
- Department of Medical Oncology, Hospital Universitario Morales Meseguer, Murcia, 30008, Spain
- Instituto Murciano de Investigación Biosanitaria, IMIB, Murcia, 30120, Spain
- Medical School, Universidad Católica San Antonio, Murcia, 30107, Spain
| | - Francisco Ayala de la Peña
- Department of Medical Oncology, School of Medicine, Hospital Universitario Morales Meseguer, University of Murcia, Avda. Marqués de los Vélez, s/n, Murcia, 30008, Spain.
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2
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Dowling GP, Daly GR, Hegarty A, Hembrecht S, Bracken A, Toomey S, Hennessy BT, Hill ADK. Predictive value of pretreatment circulating inflammatory response markers in the neoadjuvant treatment of breast cancer: meta-analysis. Br J Surg 2024; 111:znae132. [PMID: 38801441 PMCID: PMC11129713 DOI: 10.1093/bjs/znae132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 02/21/2024] [Accepted: 05/05/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Systemic inflammatory response markers have been found to have a prognostic role in several cancers, but their value in predicting the response to neoadjuvant chemotherapy in breast cancer is uncertain. A systematic review and meta-analysis of the literature was carried out to investigate this. METHODS A systematic search of electronic databases was conducted to identify studies that explored the predictive value of circulating systemic inflammatory response markers in patients with breast cancer before commencing neoadjuvant therapy. A meta-analysis was undertaken for each inflammatory marker where three or more studies reported pCR rates in relation to the inflammatory marker. Outcome data are reported as ORs and 95% confidence intervals. RESULTS A total of 49 studies were included, of which 42 were suitable for meta-analysis. A lower pretreatment neutrophil-to-lymphocyte ratio was associated with an increased pCR rate (pooled OR 1.66 (95% c.i. 1.32 to 2.09); P < 0.001). A lower white cell count (OR 1.96 (95% c.i. 1.29 to 2.97); P = 0.002) and a lower monocyte count (OR 3.20 (95% c.i. 1.71 to 5.97); P < 0.001) were also associated with a pCR. A higher lymphocyte count was associated with an increased pCR rate (OR 0.44 (95% c.i. 0.30 to 0.64); P < 0.001). CONCLUSION The present study found the pretreatment neutrophil-to-lymphocyte ratio, white cell count, lymphocyte count, and monocyte count of value in the prediction of a pCR in the neoadjuvant treatment of breast cancer. Further research is required to determine their value in specific breast cancer subtypes and to establish optimal cut-off values, before their adoption in clinical practice.
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Affiliation(s)
- Gavin P Dowling
- Department of Surgery, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
- Medical Oncology Lab, Department of Molecular Medicine, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
- Department of Surgery, Beaumont Hospital, Dublin, Ireland
| | - Gordon R Daly
- Department of Surgery, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
- Department of Surgery, Beaumont Hospital, Dublin, Ireland
| | - Aisling Hegarty
- Department of Surgery, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
- Department of Surgery, Beaumont Hospital, Dublin, Ireland
| | - Sandra Hembrecht
- Department of Surgery, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
- Department of Surgery, Beaumont Hospital, Dublin, Ireland
| | - Aisling Bracken
- Department of Surgery, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
| | - Sinead Toomey
- Medical Oncology Lab, Department of Molecular Medicine, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
| | - Bryan T Hennessy
- Medical Oncology Lab, Department of Molecular Medicine, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
| | - Arnold D K Hill
- Department of Surgery, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland
- Department of Surgery, Beaumont Hospital, Dublin, Ireland
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3
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Nakamoto S, Shien T, Iwamoto T, Kubo S, Yamamoto M, Yamashita T, Kuwahara C, Ikeda M. Absolute lymphocyte count and neutrophil-to-lymphocyte ratio as predictors of CDK 4/6 inhibitor efficacy in advanced breast cancer. Sci Rep 2024; 14:9869. [PMID: 38684839 PMCID: PMC11059159 DOI: 10.1038/s41598-024-60101-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 04/18/2024] [Indexed: 05/02/2024] Open
Abstract
Cyclin-dependent kinase 4 and 6 inhibitors (CDK4/6i) are the standard agents for treating patients with estrogen receptor-positive and human epidermal growth factor receptor 2-negative advanced breast cancer (ER + HER2 - ABC). However, markers predicting the outcomes of CDK4/6i treatment have yet to be identified. This study was a single-center retrospective cohort study. We retrospectively evaluated 101 patients with ER + HER2 - ABC receiving CDK4/6i in combination with endocrine therapy at Fukuyama City Hospital between November 2017 and July 2021. We investigated the clinical outcomes and the safety of CDK4/6i treatment, and the absolute lymphocyte count (ALC) and neutrophil-to-lymphocyte ratio (NLR) as predictive markers for CDK4/6i. We defined the cut-off values as 1000/μL for ALC and 3 for NLR, and divided into "low" and "high" groups, respectively. We evaluated 43 and 58 patients who received abemaciclib and palbociclib, respectively. Patients with high ALC and low NLR had significantly longer overall survival than those with low ALC and high NLR (high vs. low; ALC: HR 0.29; 95% CI 0.12-0.70; NLR: HR 2.94; 95% CI 1.21-7.13). There was no significant difference in efficacy between abemaciclib and palbociclib and both had good safety profiles. We demonstrated that ALC and NLR might predict the outcomes of CDK4/6i treatment in patients with ER + HER2 - ABC.
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Affiliation(s)
- Shogo Nakamoto
- Department of Breast and Thyroid Surgery, Fukuyama City Hospital, 5-23-1 Zao, Fukuyama, 721-8511, Japan.
- Department of Breast and Endocrine Surgery, Okayama University Hospital, 2-5-1, Shikata-Cho, Kita-Ku, Okayama, 700-8558, Japan.
| | - Tadahiko Shien
- Department of Breast and Endocrine Surgery, Okayama University Hospital, 2-5-1, Shikata-Cho, Kita-Ku, Okayama, 700-8558, Japan
| | - Takayuki Iwamoto
- Department of Breast and Endocrine Surgery, Okayama University Hospital, 2-5-1, Shikata-Cho, Kita-Ku, Okayama, 700-8558, Japan
| | - Shinichiro Kubo
- Department of Breast and Thyroid Surgery, Fukuyama City Hospital, 5-23-1 Zao, Fukuyama, 721-8511, Japan
| | - Mari Yamamoto
- Department of Breast and Thyroid Surgery, Fukuyama City Hospital, 5-23-1 Zao, Fukuyama, 721-8511, Japan
| | - Tetsumasa Yamashita
- Department of Breast and Thyroid Surgery, Fukuyama City Hospital, 5-23-1 Zao, Fukuyama, 721-8511, Japan
| | - Chihiro Kuwahara
- Department of Breast and Thyroid Surgery, Fukuyama City Hospital, 5-23-1 Zao, Fukuyama, 721-8511, Japan
| | - Masahiko Ikeda
- Department of Breast and Thyroid Surgery, Fukuyama City Hospital, 5-23-1 Zao, Fukuyama, 721-8511, Japan
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Correa WA, das Neves SC, Oliveira RJ, Kassuya CA, Navarro SD, Faustino Martins AC, Saroja B, Mitsuyasu B, Ostaciana Maia Freitas da Silveira I, Vitor N, Coelho HRS, Vilela MLB, do Nascimento VA, de Lima DP, Beatriz A, da Silva Gomes R. Chemotherapeutic Mechanism of Action of the Synthetic Resorcinolic Methyl 3,5-dimethoxy-2-octanoylbenzoate. Chem Res Toxicol 2024; 37:259-273. [PMID: 38183658 DOI: 10.1021/acs.chemrestox.3c00269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2024]
Abstract
Resorcinolic lipids are described as potential examples of selective chemotherapeutic adjuvants that can enhance the effects of cyclophosphamide (CYC) while promoting cell death without causing DNA damage. Therefore, the current study attempted to describe how the resorcinolic lipid methyl 3,5-dimethoxy-2-octanoylbenzoate (AMS35BB) interacted with DNA (DNA docking) and how this compound affected genetic toxicology models and other biological characteristics when combined with CYC. We observed that AMS35BB, used alone (7.5 and 10 mg/kg), increases the frequency of genomic damage (comet assay) but not chromosomal damage (micronuclei assay), lowers phagocytosis, and promotes cell death in Swiss male mice. When used in association with CYC, AMS35BB can reduce the risk of genomic damage by up to 33.8% as well as chromosomal damage, splenic phagocytosis, cell death, and lymphocyte frequency. Molecular docking showed that AMS35BB had a higher affinity than the active metabolite of CYC for binding to the DNA double helix major groove. As a result, AMS35BB has the potential to be both an adjuvant when used in association with CYC and a therapeutic candidate for the development of a selective chemotherapeutic drug.
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Affiliation(s)
- Willian Ayala Correa
- Institute of Chemistry, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul 79070-900, Brazil
| | - Silvia Cordeiro das Neves
- Stem Cell, Cell Therapy and Toxicological Genetics Research Centre (CeTroGen), Medical School, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul 79080-190, Brazil
- Graduate Program in Health and Development in the Midwest Region, Medical School, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul 79070-900, Brazil
| | - Rodrigo Juliano Oliveira
- Stem Cell, Cell Therapy and Toxicological Genetics Research Centre (CeTroGen), Medical School, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul 79080-190, Brazil
- Graduate Program in Health and Development in the Midwest Region, Medical School, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul 79070-900, Brazil
| | - Cândida A Kassuya
- School of Health Sciences, Federal University of Grande Dourados, Dourados, Mato Grosso do Sul 79804-970, Brazil
| | - Stephanie D Navarro
- Institute of Chemistry, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul 79070-900, Brazil
- Stem Cell, Cell Therapy and Toxicological Genetics Research Centre (CeTroGen), Medical School, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul 79080-190, Brazil
| | | | - Baby Saroja
- Department of Pharmaceutical Sciences, North Dakota State University, Fargo, North Dakota 58102, United States
| | - Barbara Mitsuyasu
- Department of Pharmaceutical Sciences, North Dakota State University, Fargo, North Dakota 58102, United States
- Department of Chemical and Biological Sciences, Institute of Biosciences, São Paulo State University (UNESP), Botucatu, São Paulo 18618-689, Brazil
| | | | - Neimar Vitor
- Institute of Chemistry, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul 79070-900, Brazil
| | - Henrique Rodrigues Scherer Coelho
- Stem Cell, Cell Therapy and Toxicological Genetics Research Centre (CeTroGen), Medical School, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul 79080-190, Brazil
| | - Marcelo L B Vilela
- Institute of Chemistry, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul 79070-900, Brazil
| | - Valter A do Nascimento
- Graduate Program in Health and Development in the Midwest Region, Medical School, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul 79070-900, Brazil
| | - Dênis P de Lima
- Institute of Chemistry, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul 79070-900, Brazil
| | - Adilson Beatriz
- Institute of Chemistry, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul 79070-900, Brazil
| | - Roberto da Silva Gomes
- Department of Pharmaceutical Sciences, North Dakota State University, Fargo, North Dakota 58102, United States
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5
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Zhao X, Yang Y, Pan Z, Lv W, Rao X, Wang X, Yu X. Plateletcrit is predictive of clinical outcome and prognosis for early-stage breast cancer: A retrospective cohort study based on propensity score matching. Cancer Med 2024; 13:e6944. [PMID: 38348939 PMCID: PMC10832319 DOI: 10.1002/cam4.6944] [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: 10/08/2023] [Revised: 12/12/2023] [Accepted: 01/06/2024] [Indexed: 02/15/2024] Open
Abstract
PURPOSE Breast cancer (BC) is diagnosed as the most common cancer in women in 2022 according to the American Cancer Society. It is essential to detect early and treat early. Several studies have shown that some blood parameters have important predictive value for BC. In this study, we aim to explore whether some immune-associated blood parameters are relevant to disease-free survival (DFS) in early-stage BC. METHODS A single-center, regression cohort study of 1490 patients with early-stage BC in Shanghai Cancer Center was conducted from January 2008 to December 2016. The patients were matched according to the ratio of 1:1 based on Propensity Score Matching (PSM). All patients who experienced disease progression were matched successfully. Thus, 58 pairs of subjects were obtained. Matched blood parameters were evaluated by paired samples t-test or Wilcoxon signed-rank test. Factors with statistical difference were further evaluated by stratified COX regression model. RESULTS Univariate analysis showed differences in platelet-related parameters (PLT, PCT, and PLR) and NLR between the two matched groups. However, stratified COX regression analysis, which ruled out the confounding effects of multiple factors, found that only PCT had prognostic value in early BC patients at baseline and study endpoint. Meanwhile, platelet-related parameters (PLT, MPV) and NLR were different in the progressive group by self before and after comparison. However, the multiple-factor analysis showed that only the NLR had prognostic value. ROC curve analysis indicated that the best sensitivity (65.45%) and specificity (78.18%) were obtained when the baseline PCT was 0.225. The optimal sensitivity (70.91%) and specificity (65.45%) were obtained when the PCT of disease progression was 0.215. The Kaplan-Meier curve was used to calculate the DFS rate based on the critical values of the two groups. CONCLUSIONS Some blood parameters have value to predict DFS in early-stage BC patients, especially platelet-associated parameters.
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Affiliation(s)
- Xu Zhao
- Department of Radiation OncologyFudan University Shanghai Cancer CenterShanghaiChina
- Department of Oncology, Shanghai Medical CollegeFudan UniversityShanghaiChina
- Shanghai Clinical Research Center for Radiation OncologyShanghaiChina
- Shanghai Key Laboratory of Radiation OncologyShanghaiChina
| | - Yilan Yang
- Department of Radiation OncologyFudan University Shanghai Cancer CenterShanghaiChina
- Department of Oncology, Shanghai Medical CollegeFudan UniversityShanghaiChina
- Shanghai Clinical Research Center for Radiation OncologyShanghaiChina
- Shanghai Key Laboratory of Radiation OncologyShanghaiChina
| | - Zhe Pan
- Department of Radiation OncologyFudan University Shanghai Cancer CenterShanghaiChina
- Department of Oncology, Shanghai Medical CollegeFudan UniversityShanghaiChina
- Shanghai Clinical Research Center for Radiation OncologyShanghaiChina
- Shanghai Key Laboratory of Radiation OncologyShanghaiChina
| | - Weiluo Lv
- Department of Radiation OncologyFudan University Shanghai Cancer CenterShanghaiChina
- Department of Oncology, Shanghai Medical CollegeFudan UniversityShanghaiChina
- Shanghai Clinical Research Center for Radiation OncologyShanghaiChina
- Shanghai Key Laboratory of Radiation OncologyShanghaiChina
| | - Xinxin Rao
- Department of Radiation OncologyFudan University Shanghai Cancer CenterShanghaiChina
- Department of Oncology, Shanghai Medical CollegeFudan UniversityShanghaiChina
- Shanghai Clinical Research Center for Radiation OncologyShanghaiChina
- Shanghai Key Laboratory of Radiation OncologyShanghaiChina
| | - Xuanyi Wang
- Department of Radiation OncologyFudan University Shanghai Cancer CenterShanghaiChina
- Department of Oncology, Shanghai Medical CollegeFudan UniversityShanghaiChina
- Shanghai Clinical Research Center for Radiation OncologyShanghaiChina
- Shanghai Key Laboratory of Radiation OncologyShanghaiChina
| | - Xiaoli Yu
- Department of Radiation OncologyFudan University Shanghai Cancer CenterShanghaiChina
- Department of Oncology, Shanghai Medical CollegeFudan UniversityShanghaiChina
- Shanghai Clinical Research Center for Radiation OncologyShanghaiChina
- Shanghai Key Laboratory of Radiation OncologyShanghaiChina
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6
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Hacker BC, Lin EJ, Herman DC, Questell AM, Martello SE, Hedges RJ, Walker AJ, Rafat M. Irradiated Mammary Spheroids Elucidate Mechanisms of Macrophage-Mediated Breast Cancer Recurrence. Cell Mol Bioeng 2023; 16:393-403. [PMID: 37810999 PMCID: PMC10550896 DOI: 10.1007/s12195-023-00775-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 07/20/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction While most patients with triple negative breast cancer receive radiation therapy to improve outcomes, a significant subset of patients continue to experience recurrence. Macrophage infiltration into radiation-damaged sites has been shown to promote breast cancer recurrence in pre-clinical models. However, the mechanisms that drive recurrence are unknown. Here, we developed a novel spheroid model to evaluate macrophage-mediated tumor cell recruitment. Methods We characterized infiltrating macrophage phenotypes into irradiated mouse mammary tissue via flow cytometry. We then engineered a spheroid model of radiation damage with primary fibroblasts, macrophages, and 4T1 mouse mammary carcinoma cells using in vivo macrophage infiltration results to inform our model. We analyzed 4T1 infiltration into spheroids when co-cultured with biologically relevant ratios of pro-healing M2:pro-inflammatory M1 macrophages. Finally, we quantified interleukin 6 (IL-6) secretion associated with conditions favorable to tumor cell infiltration, and we directly evaluated the impact of IL-6 on tumor cell invasiveness in vitro and in vivo. Results In our in vivo model, we observed a significant increase in M2 macrophages in mouse mammary glands 10 days post-irradiation. We determined that tumor cell motility toward irradiated spheroids was enhanced in the presence of a 2:1 ratio of M2:M1 macrophages. We also measured a significant increase in IL-6 secretion after irradiation both in vivo and in our model. This secretion increased tumor cell invasiveness, and tumor cell invasion and recruitment were mitigated by neutralizing IL-6. Conclusions Our work suggests that interactions between infiltrating macrophages and damaged stromal cells facilitate breast cancer recurrence through IL-6 signaling. Supplementary Information The online version contains supplementary material available at 10.1007/s12195-023-00775-x.
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Affiliation(s)
- Benjamin C. Hacker
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, TN USA
| | - Erica J. Lin
- Department of Biological Sciences, Vanderbilt University, Nashville, TN USA
| | - Dana C. Herman
- Department of Biochemistry, Vanderbilt University, Nashville, TN USA
| | - Alyssa M. Questell
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN USA
| | - Shannon E. Martello
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, TN USA
| | - Rebecca J. Hedges
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, TN USA
| | - Anesha J. Walker
- Department of Biology, Tennessee State University, Nashville, TN USA
| | - Marjan Rafat
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, TN USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN USA
- Department of Radiation Oncology, Vanderbilt University Medical Center, Nashville, TN USA
- Vanderbilt University, Engineering and Science Building, Rm. 426, Nashville, TN 37212 USA
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7
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García-Torralba E, Navarro Manzano E, Luengo-Gil G, De la Morena Barrio P, Chaves Benito A, Pérez-Ramos M, Álvarez-Abril B, Ivars Rubio A, García-Garre E, Ayala de la Peña F, García-Martínez E. A new prognostic model including immune biomarkers, genomic proliferation tumor markers ( AURKA and MYBL2) and clinical-pathological features optimizes prognosis in neoadjuvant breast cancer patients. Front Oncol 2023; 13:1182725. [PMID: 37313470 PMCID: PMC10258327 DOI: 10.3389/fonc.2023.1182725] [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: 03/09/2023] [Accepted: 05/17/2023] [Indexed: 06/15/2023] Open
Abstract
Background Up to 30% of breast cancer (BC) patients treated with neoadjuvant chemotherapy (NCT) will relapse. Our objective was to analyze the predictive capacity of several markers associated with immune response and cell proliferation combined with clinical parameters. Methods This was a single-center, retrospective cohort study of BC patients treated with NCT (2001-2010), in whom pretreatment biomarkers were analyzed: neutrophil-to-lymphocyte ratio (NLR) in peripheral blood, CD3+ tumor-infiltrating lymphocytes (TILs), and gene expression of AURKA, MYBL2 and MKI67 using qRT-PCR. Results A total of 121 patients were included. Median followup was 12 years. In a univariate analysis, NLR, TILs, AURKA, and MYBL2 showed prognostic value for overall survival. In multivariate analyses, including hormone receptor, HER2 status, and response to NCT, NLR (HR 1.23, 95% CI 1.01-1.75), TILs (HR 0.84, 95% CI 0.73-0.93), AURKA (HR 1.05, 95% CI 1.00-1.11) and MYBL2 (HR 1.19, 95% CI 1.05-1.35) remained as independent predictor variables. Conclusion Consecutive addition of these biomarkers to a regression model progressively increased its discriminatory capacity for survival. Should independent cohort studies validate these findings, management of early BC patients may well be changed.
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Affiliation(s)
- Esmeralda García-Torralba
- Department of Haematology and Medical Oncology, University Hospital Morales Meseguer, Murcia, Spain
- Department of Medicine, Medical School, University of Murcia, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain
| | - Esther Navarro Manzano
- Department of Medicine, Medical School, University of Murcia, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain
| | - Gines Luengo-Gil
- Department of Haematology and Medical Oncology, University Hospital Morales Meseguer, Murcia, Spain
- Department of Medicine, Medical School, University of Murcia, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain
| | - Pilar De la Morena Barrio
- Department of Haematology and Medical Oncology, University Hospital Morales Meseguer, Murcia, Spain
- Department of Medicine, Medical School, University of Murcia, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain
| | | | - Miguel Pérez-Ramos
- Department of Pathology, University Hospital Morales Meseguer, Murcia, Spain
| | - Beatriz Álvarez-Abril
- Department of Haematology and Medical Oncology, University Hospital Morales Meseguer, Murcia, Spain
- Department of Medicine, Medical School, University of Murcia, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain
| | - Alejandra Ivars Rubio
- Department of Haematology and Medical Oncology, University Hospital Morales Meseguer, Murcia, Spain
- Department of Medicine, Medical School, University of Murcia, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain
| | - Elisa García-Garre
- Department of Haematology and Medical Oncology, University Hospital Morales Meseguer, Murcia, Spain
- Department of Medicine, Medical School, University of Murcia, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain
| | - Francisco Ayala de la Peña
- Department of Haematology and Medical Oncology, University Hospital Morales Meseguer, Murcia, Spain
- Department of Medicine, Medical School, University of Murcia, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain
| | - Elena García-Martínez
- Department of Haematology and Medical Oncology, University Hospital Morales Meseguer, Murcia, Spain
- Department of Medicine, Medical School, University of Murcia, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain
- Medical School, Catholic University of Murcia, Murcia, Spain
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8
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Ransohoff JD, Ritter V, Purington N, Andrade K, Han S, Liu M, Liang SY, John EM, Gomez SL, Telli ML, Schapira L, Itakura H, Sledge GW, Bhatt AS, Kurian AW. Antimicrobial exposure is associated with decreased survival in triple-negative breast cancer. Nat Commun 2023; 14:2053. [PMID: 37045824 PMCID: PMC10097670 DOI: 10.1038/s41467-023-37636-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 03/24/2023] [Indexed: 04/14/2023] Open
Abstract
Antimicrobial exposure during curative-intent treatment of triple-negative breast cancer (TNBC) may lead to gut microbiome dysbiosis, decreased circulating and tumor-infiltrating lymphocytes, and inferior outcomes. Here, we investigate the association of antimicrobial exposure and peripheral lymphocyte count during TNBC treatment with survival, using integrated electronic medical record and California Cancer Registry data in the Oncoshare database. Of 772 women with stage I-III TNBC treated with and without standard cytotoxic chemotherapy - prior to the immune checkpoint inhibitor era - most (654, 85%) used antimicrobials. Applying multivariate analyses, we show that each additional total or unique monthly antimicrobial prescription is associated with inferior overall and breast cancer-specific survival. This antimicrobial-mortality association is independent of changes in neutrophil count, is unrelated to disease severity, and is sustained through year three following diagnosis, suggesting antimicrobial exposure negatively impacts TNBC survival. These results may inform mechanistic studies and antimicrobial prescribing decisions in TNBC and other hormone receptor-independent cancers.
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Grants
- R01 AI143757 NIAID NIH HHS
- HHSN261201800032I NCI NIH HHS
- HHSN261201800015I NCI NIH HHS
- NU58DP006344 NCCDPHP CDC HHS
- P30 CA124435 NCI NIH HHS
- T32 HG000044 NHGRI NIH HHS
- HHSN261201800009I NCI NIH HHS
- This work was supported by Breast Cancer Research Foundation, the Susan and Richard Levy Gift Fund, the Suzanne Pride Bryan Fund for Breast Cancer Research, the Jan Weimer Junior Faculty Chair in Breast Oncology, the Regents of the University of California’s California Breast Cancer Research Program (16OB-0149 and 19IB-0124), the BRCA Foundation, the G. Willard Miller Foundation, and the Biostatistics Shared Resource of the NIH-funded Stanford Cancer Institute (P30CA124435). The collection of cancer incidence data used in this study was supported by the California Department of Public Health pursuant to California Health and Safety Code Section 103885; the Centers for Disease Control and Prevention’s National Program of Cancer Registries, under Cooperative Agreement No. 5NU58DP006344; and the National Cancer Institute’s SEER Program under Contract No. HHSN261201800032I awarded to the University of California, San Francisco, Contract No. HHSN261201800015I awarded to the University of Southern California, and Contract No. HHSN261201800009I awarded to the Public Health Institute, Cancer Registry of Greater California. K.A. was supported by NIH 5T32HG000044. This work was further supported by a Stand Up 2 Cancer grant, a V Foundation Fellowship, and Damon Runyon Clinical Investigator Award and NIH R01AI14375702 (to A.S.B.).
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Affiliation(s)
- Julia D Ransohoff
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Victor Ritter
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Natasha Purington
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Karen Andrade
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Summer Han
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Mina Liu
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Su-Ying Liang
- Palo Alto Medical Foundation Research Institute, Sutter Health, Palo Alto, CA, USA
| | - Esther M John
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
| | - Scarlett L Gomez
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Melinda L Telli
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Lidia Schapira
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Haruka Itakura
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - George W Sledge
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Ami S Bhatt
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA.
| | - Allison W Kurian
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA.
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA.
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9
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Akış S, Öztürk UK, Keleş E, Alınca CM, Api M, Kabaca C. The percentage of peripheral eosinophils as a sensitive marker for differentiating FIGO grade in endometrial adenocarcinomas. J Turk Ger Gynecol Assoc 2022; 23:99-105. [PMID: 35263838 PMCID: PMC9161002 DOI: 10.4274/jtgga.galenos.2022.2021-9-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: Studies on eosinophils have mostly been directed to parasitic infections and allergic diseases, but the role of eosinophils in oncology has been largely ignored. Eosinophils are an important modulator of the immune response and components of the inflammatory process against the tumor. This study was performed to investigate the pre-operative peripheral blood eosinophil percentages in patients with a histopathologically diagnosed pure endometrioid type endometrial carcinoma. Material and Methods: Patients’ data were analyzed in two groups as present/absent according to whether there are tumor metastases in the adnexes, lymph nodes, cervical stroma, and whether there was lymphovascular space invasion. FIGO grade was taken as the basis of the tumor grade: Low-grade equated to grade 1 or 2, and high-grade equated to grade 3. The requirement for lymph node dissection was based on the Mayo criteria. Results: The data of a total of 268 patients were included. The mean percentage of eosinophils in high-grade patients (n=29) was 2.75±0.35, and was significantly higher than the mean percentage of eosinophils of found in low-grade patients (n=239), which was 1.79±0.09 (p=0.013). Receiver operator curve analysis showed that a cut-off eosinophil percentage of 1.95% resulted in a sensitivity of 62% and specificity of 67% (p=0.004). Conclusion: Eosinophil percentages, which are a simple, easily accessible, and inexpensive can be an important pre-operative predictive tool. Eosinophil percentages can be used in determining the need for surgical staging in endometrial cancer.
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10
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The relationship between pan-immune-inflammation value and survival outcomes in patients with metastatic renal cell carcinoma treated with nivolumab in the second line and beyond: a Turkish oncology group kidney cancer consortium (TKCC) study. J Cancer Res Clin Oncol 2022; 148:3537-3546. [PMID: 35616728 DOI: 10.1007/s00432-022-04055-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 05/03/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Pan-immune-inflammation value (PIV) is an easily accessible immune marker based on peripheral blood to estimate prognosis in patients with cancer. This study evaluates the prognostic value of PIV in patients with metastatic renal cell carcinoma (mRCC) treated with nivolumab. METHODS In this retrospective cohort study, patients with mRCC treated with nivolumab in the second line and beyond were selected from the Turkish Oncology Group Kidney Cancer Consortium (TKCC) database. PIV was calculated using the following formula: neutrophil (103/mm3) x monocyte (103/mm3) x platelet (103/mm3)/lymphocyte (103/mm3). RESULTS A total of 152 patients with mRCC were included in this study. According to cut-off value for PIV, 77 (50.7%) and 75 (49.3%) patients fell into PIV-low ([Formula: see text] 372) and PIV-high (> 372) groups, respectively. In multivariate analysis, PIV-high (HR: 1.64, 95% CI 1.04-2.58, p = 0.033 for overall survival (OS); HR: 1.55, 95% CI 1.02-2.38, p = 0.042 for progression-free survival (PFS)) was independent risk factor for OS and PFS after adjusting for confounding variables, such as performance score, the International mRCC Database Consortium (IMDC) risk score, and liver metastasis. CONCLUSION This study established that pre-treatment PIV might be a prognostic biomarker in patients with mRCC treated with nivolumab in the second line and beyond.
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11
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Feng J, Yi J, Zouxu X, Li J, Xiong Z, Huang X, Zhong W, Huang W, Ye F, Wang X. Peripheral blood lymphocytes subtypes as new predictors for neoadjuvant therapy efficacy in breast cancer. Cancer Med 2022; 11:2923-2933. [PMID: 35411609 PMCID: PMC9359876 DOI: 10.1002/cam4.4666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 01/24/2022] [Accepted: 02/02/2022] [Indexed: 12/02/2022] Open
Abstract
Background Host immunity plays an important role in tumor development and treatment. Tumor‐infiltrating lymphocytes (TILs) have been proven to predict the efficacy of neoadjuvant therapy (NAT) in breast cancer (BC) patients, but their application is limited due to various reasons. This study aims to explore the relationship between peripheral blood lymphocytes (PBLs) subsets distribution and the efficacy of NAT. Methods Between December 2017 and March 2021, a total of 116 BC patients appropriate for NAT in Sun Yat‐Sen University cancer center were enrolled, pre‐NAC baseline blood samples were taken for further flow cytometry analysis to quantitatively evaluate the PBLs subsets distribution, and corresponding clinical information including pathological complete response (pCR) rate of NAT response were recorded. Results Baseline CD3+ T cells(OR 1.11, 1.03–1.21, p = 0.011), CD8+ T cells (OR 1.09, 1.02–1.18, p = 0.015), and NK cells (OR 0.91, 0.83–0.98, p = 0.028) in PBLs subgroup distribution were independent predictors of pCR in BC patients receiving NAT, in which CD8+ T cells had the highest predictive ability (AUC = 0.76). Compared with some previous prediction indicators, its prediction ability has been improved to some extent. Conclusion Peripheral baseline CD3+ T cells, CD8+ T cells, and NK cells were independent predictors of pCR in BC patients receiving NAT, in which CD8+ T cells had the highest predictive ability. Therefore, it can provide newly non‐invasive, relatively accurate and easily accessible predictors for corresponding patients, and help clinicians better understand tumor immunity.
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Affiliation(s)
- Jikun Feng
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China
| | - Jiarong Yi
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China
| | - Xiazi Zouxu
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China
| | - Jianxia Li
- Department of Medical Oncology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangzhou, China
| | - Zhenchong Xiong
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China
| | - Xinjian Huang
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China
| | - Wenjing Zhong
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China
| | - Weiling Huang
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China
| | - Feng Ye
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China
| | - Xi Wang
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China
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12
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Quader S, Kataoka K, Cabral H. Nanomedicine for brain cancer. Adv Drug Deliv Rev 2022; 182:114115. [PMID: 35077821 DOI: 10.1016/j.addr.2022.114115] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 12/18/2021] [Accepted: 01/12/2022] [Indexed: 02/06/2023]
Abstract
CNS tumors remain among the deadliest forms of cancer, resisting conventional and new treatment approaches, with mortality rates staying practically unchanged over the past 30 years. One of the primary hurdles for treating these cancers is delivering drugs to the brain tumor site in therapeutic concentration, evading the blood-brain (tumor) barrier (BBB/BBTB). Supramolecular nanomedicines (NMs) are increasingly demonstrating noteworthy prospects for addressing these challenges utilizing their unique characteristics, such as improving the bioavailability of the payloadsviacontrolled pharmacokinetics and pharmacodynamics, BBB/BBTB crossing functions, superior distribution in the brain tumor site, and tumor-specific drug activation profiles. Here, we review NM-based brain tumor targeting approaches to demonstrate their applicability and translation potential from different perspectives. To this end, we provide a general overview of brain tumor and their treatments, the incidence of the BBB and BBTB, and their role on NM targeting, as well as the potential of NMs for promoting superior therapeutic effects. Additionally, we discuss critical issues of NMs and their clinical trials, aiming to bolster the potential clinical applications of NMs in treating these life-threatening diseases.
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Affiliation(s)
- Sabina Quader
- Innovation Center of NanoMedicine, Kawasaki Institute of Industrial Promotion, 3-25-14 Tonomachi, Kawasaki-ku, Kawasaki 212-0821, Japan
| | - Kazunori Kataoka
- Innovation Center of NanoMedicine, Kawasaki Institute of Industrial Promotion, 3-25-14 Tonomachi, Kawasaki-ku, Kawasaki 212-0821, Japan.
| | - Horacio Cabral
- Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan.
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13
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Da Col G, Del Ben F, Bulfoni M, Turetta M, Gerratana L, Bertozzi S, Beltrami AP, Cesselli D. Image Analysis of Circulating Tumor Cells and Leukocytes Predicts Survival and Metastatic Pattern in Breast Cancer Patients. Front Oncol 2022; 12:725318. [PMID: 35223462 PMCID: PMC8866934 DOI: 10.3389/fonc.2022.725318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 01/14/2022] [Indexed: 11/17/2022] Open
Abstract
Background The purpose of the present work was to test whether quantitative image analysis of circulating cells can provide useful clinical information targeting bone metastasis (BM) and overall survival (OS >30 months) in metastatic breast cancer (MBC). Methods Starting from cell images of epithelial circulating tumor cells (eCTC) and leukocytes (CD45pos) obtained with DEPArray, we identified the most significant features and applied single-variable and multi-variable methods, screening all combinations of four machine-learning approaches (Naïve Bayes, Logistic regression, Decision Trees, Random Forest). Results Best predictive features were circularity (OS) and diameter (BM), in both eCTC and CD45pos. Median difference in OS was 15 vs. 43 (months), p = 0.03 for eCTC and 19 vs. 36, p = 0.16 for CD45pos. Prediction for BM showed low accuracy (64%, 53%) but strong positive predictive value PPV (79%, 91%) for eCTC and CD45, respectively. Best machine learning model was Naïve Bayes, showing 46 vs 11 (months), p <0.0001 for eCTC; 12.5 vs. 45, p = 0.0004 for CD45pos and 11 vs. 45, p = 0.0003 for eCTC + CD45pos. BM prediction reached 91% accuracy with eCTC, 84% with CD45pos and 91% with combined model. Conclusions Quantitative image analysis and machine learning models were effective methods to predict survival and metastatic pattern, with both eCTC and CD45pos containing significant and complementary information.
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Affiliation(s)
- Giacomo Da Col
- Scuola Internazionale Superiore di Studi Avanzati, Trieste, Italy
| | - Fabio Del Ben
- Department of Medicine, University of Udine, Udine, Italy
| | - Michela Bulfoni
- Institute of Pathology, University Hospital of Udine (ASUFC), Udine, Italy
| | - Matteo Turetta
- Immunopathology and Cancer Biomarkers, Department of Translational Research, Centro di Riferimento Oncologico di Aviano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Lorenzo Gerratana
- Department of Medicine, University of Udine, Udine, Italy.,Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Serena Bertozzi
- Department of Surgery, AOU "S. Maria della Misericordia", Udine, Italy
| | | | - Daniela Cesselli
- Department of Medicine, University of Udine, Udine, Italy.,Institute of Pathology, University Hospital of Udine (ASUFC), Udine, Italy
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14
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Huang H, Li L, Luo W, Yang Y, Ni Y, Song T, Zhu Y, Yang Y, Zhang L. Lymphocyte percentage as a valuable predictor of prognosis in lung cancer. J Cell Mol Med 2022; 26:1918-1931. [PMID: 35122390 PMCID: PMC8980931 DOI: 10.1111/jcmm.17214] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 10/19/2020] [Accepted: 01/13/2022] [Indexed: 02/05/2023] Open
Abstract
Lymphocytes and neutrophils are involved in the immune response against cancer. This study aimed to investigate the relationship between lymphocyte percentage/neutrophil percentage and the clinical characteristics of lung cancer patients, and to explore whether they could act as valuable predictors to ameliorate lung cancer prognosis. A total of 1312 patients were eligible to be recruited. Lymphocyte percentage and neutrophil percentage were classified based on their reference ranges. Survival curves were determined using Kaplan–Meier method, and univariate and multivariate cox regression analyses were performed to identify the significant predictors. Decision curve analysis was used to evaluate the clinical benefit. The results of both training and validation cohorts indicated that lymphocyte percentage exhibited high correlation with clinical characteristics and metastasis of lung cancer patients. Both lymphocyte percentage and neutrophil percentage were closely associated with survival status (all p < 0.0001). Low lymphocyte percentage could act as an indicator of poor prognosis; it offered a higher clinical benefit when combined with the clinical characteristic model. Our findings suggested that pretreatment lymphocyte percentage served as a reliable predictor of lung cancer prognosis, and it was also an accurate response indicator in lung adenocarcinoma and advanced lung cancer. Measurement of lymphocyte percentage improved the clinical utility of patient characteristics in predicting mortality of lung cancer patients.
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Affiliation(s)
- Hong Huang
- Institute of Clinical Pathology, Key Laboratory of Transplantation Engineering and Immunology, Ministry of Health, West China Hospital, Sichuan University, Chengdu, China
| | - Lei Li
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Wenxin Luo
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Yongfeng Yang
- Precision Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yinyun Ni
- Precision Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Tingting Song
- Precision Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yihan Zhu
- Institute of Clinical Pathology, Key Laboratory of Transplantation Engineering and Immunology, Ministry of Health, West China Hospital, Sichuan University, Chengdu, China
| | - Ying Yang
- Precision Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Li Zhang
- Institute of Clinical Pathology, Key Laboratory of Transplantation Engineering and Immunology, Ministry of Health, West China Hospital, Sichuan University, Chengdu, China.,Precision Medicine Center, West China Hospital, Sichuan University, Chengdu, China
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15
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Damjanovska S, Davitkov P, Gopal S, Kostadinova L, Kowal C, Lange A, Moreland A, Shive CL, Wilson B, Bej T, Al-Kindi S, Falck-Ytter Y, Zidar DA, Anthony DD. High Red Cell Distribution Width and Low Absolute Lymphocyte Count Associate With Subsequent Mortality in HCV Infection. Pathog Immun 2022; 6:90-104. [PMID: 34988340 PMCID: PMC8714176 DOI: 10.20411/pai.v6i2.467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 09/07/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Hepatitis-C virus (HCV) chronic infection can lead to cirrhosis, hepatocellular carcinoma (HCC), end-stage liver disease, cardiovascular disease (CVD), and mortality. Transient Elastography (TE) is used to non-invasively assess fibrosis. Whether immune monitoring provides additive prognostic value is not established. Increased red-cell distribution width (RDW) and decreased absolute lymphocyte count (ALC) predict mortality in those without liver disease. Whether these relationships remain during HCV infection is unknown. Materials and Methods: A retrospective cohort of 1,715 single-site VA Liver Clinic patients receiving Transient Elastography (TE) 2014-2019 to evaluate HCV-associated liver damage were evaluated for RDW and ALC in relation to traditional parameters of cardiovascular risk, liver health, development of HCC, and mortality. Results: The cohort was 97% male, 55% African American, 26% with diabetes mellitus, 67% with hypertension, and 66% with tobacco use. After TE, 3% were subsequently diagnosed with HCC, and 12% (n=208) died. Most deaths (n=189) were due to non-liver causes. The TE score associated with prevalent CVD, positively correlated with atherosclerotic cardiovascular disease (ASCVD) 10-Year Risk Score, age, RDW, and negatively correlated with ALC. Patients with anisocytosis (RDW above 14%) or lymphopenia (ALC level under 1.2×109/L) had greater subsequent all-cause mortality, even after adjusting for age, TE score, and comorbidities. TE score, and to a modest degree RDW, were associated with subsequent liver-associated mortality, while TE score, RDW, and ALC were each independently associated with non-liver cause of death. Conclusion: Widely available mortality calculators generally require multiple pieces of clinical information. RDW and ALC, parameters collected on a single laboratory test that is commonly performed, prior to HCV therapy may be pragmatic markers of long-term risk of mortality.
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Affiliation(s)
- Sofi Damjanovska
- Department of Medicine, Cleveland VA Medical Center, Case Western Reserve University.,Department of Medicine, University Hospitals Cleveland Medical Center
| | - Perica Davitkov
- Division of Gastroenterology, Cleveland VA Medical Center, Case Western Reserve University
| | - Surya Gopal
- Department of Medicine, Cleveland VA Medical Center, Case Western Reserve University
| | - Lenche Kostadinova
- Department of Medicine, Cleveland VA Medical Center, Case Western Reserve University.,Department of Medicine, University Hospitals Cleveland Medical Center
| | - Corrine Kowal
- Department of Medicine, Cleveland VA Medical Center, Case Western Reserve University
| | - Alyssa Lange
- Department of Medicine, Cleveland VA Medical Center, Case Western Reserve University
| | - Anita Moreland
- Division of Gastroenterology, Cleveland VA Medical Center, Case Western Reserve University
| | - Carey L Shive
- Department of Medicine, Cleveland VA Medical Center, Case Western Reserve University.,Department of Pathology, Case Western Reserve University, Cleveland, OH
| | - Brigid Wilson
- Research and Education Foundation for Cleveland VA, Cleveland, OH
| | - Taissa Bej
- Research and Education Foundation for Cleveland VA, Cleveland, OH
| | - Sadeer Al-Kindi
- University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center
| | - Yngve Falck-Ytter
- Division of Gastroenterology, Cleveland VA Medical Center, Case Western Reserve University
| | - David A Zidar
- Department of Medicine, Cleveland VA Medical Center, Case Western Reserve University
| | - Donald D Anthony
- Department of Medicine, Cleveland VA Medical Center, Case Western Reserve University.,Department of Pathology, Case Western Reserve University, Cleveland, OH.,Department of Medicine, MetroHealth Medical Center, Cleveland, OH
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16
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Yekedüz E, Dogan İ, Kaya DM, Özgür İ, Utkan G, Vatansever S, Demirci S, Akbulut H, Ürün Y. Systemic Immune-Inflammation Index as a Prognostic Marker of Late Recurrence in Operable Gastric Cancer: a Dual-Center Study. J Gastrointest Cancer 2021; 53:870-879. [PMID: 34845631 DOI: 10.1007/s12029-021-00769-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2021] [Indexed: 01/03/2023]
Abstract
AIM To evaluate the prognostic role of the systemic immune-inflammation index (SII) in patients with operable gastric cancer. METHODS We assessed 354 patients with operable gastric cancer from tertiary centers in Turkey. SII was calculated by following formula: [neutrophil (cells × 109/L) × platelet (cells × 109/L)]/lymphocyte (cells × 109/L). The best cut-off value for SII was determined by using "receiver operating characteristics (ROC)" analysis. We used log-rank and Cox-regression analysis for survival analyses. RESULTS One hundred twenty patients were in the late recurrence group (recurrences have developed 36 months after the surgery). SII was not a prognostic factor in the early recurrence group. However, relapse-free survival (RFS) was longer in SII-low patients than SII-high patients in the late recurrence group. In multivariable analysis, SII was the only independent prognostic factor for RFS in the late recurrence group (hazard ratio (HR): 5.42, 95% CI: 1.18-24.82, p = 0.03). CONCLUSION SII was an independent prognostic factor for RFS in GC patients with late recurrence. Late recurrence risk was higher in SII-high patients than SII-low patients. Inflammation contributes to tumor progression, invasion, and metastasis. Prolonged exposure to chronic inflammation could explain the results of this study.
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Affiliation(s)
- Emre Yekedüz
- Department of Medical Oncology, Faculty of Medicine, Ankara University, Ankara, Turkey.
- Ankara University Cancer Research Institute, Ankara, Turkey.
- Ankara Üniversitesi Tıp Fakültesi, Tıbbi Onkoloji Bilim Dalı Cebeci Hastanesi, 06590, Cebeci, Ankara, Turkey.
| | - İzzet Dogan
- Department of Medical Oncology, Istanbul University Institute of Oncology, Istanbul, Turkey
| | | | - İlker Özgür
- Department of General Surgery, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
| | - Güngör Utkan
- Department of Medical Oncology, Faculty of Medicine, Ankara University, Ankara, Turkey
- Ankara University Cancer Research Institute, Ankara, Turkey
| | - Sezai Vatansever
- Department of Medical Oncology, Istanbul University Institute of Oncology, Istanbul, Turkey
| | - Salim Demirci
- Ankara University Cancer Research Institute, Ankara, Turkey
- Department of Surgical Oncology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Hakan Akbulut
- Department of Medical Oncology, Faculty of Medicine, Ankara University, Ankara, Turkey
- Ankara University Cancer Research Institute, Ankara, Turkey
| | - Yüksel Ürün
- Department of Medical Oncology, Faculty of Medicine, Ankara University, Ankara, Turkey
- Ankara University Cancer Research Institute, Ankara, Turkey
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Nakamoto S, Ikeda M, Kubo S, Yamamoto M, Yamashita T, Kuwahara C. The Systemic Immune Markers at Diagnosis Can Predict the Survival Benefit in Advanced Breast Cancer. CANCER DIAGNOSIS & PROGNOSIS 2021; 1:471-478. [PMID: 35403159 PMCID: PMC8962865 DOI: 10.21873/cdp.10063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 10/07/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND/AIM It has been difficult to establish prognostic markers for overall survival (OS) in patients with advanced breast cancer (ABC). Although systemic immune markers were reported as prognostic markers in several cancers, their utility in ABC remains unclear. PATIENTS AND METHODS We retrospectively analyzed 331 ABC patients, who received treatment at Fukuyama City Hospital between April 2009 and December 2020. RESULTS Patients with high absolute lymphocyte count (ALC), low neutrophil-to-lymphocyte ratio (NLR), and high lymphocyte-to-monocyte ratio (LMR) had significantly longer OS (p=0.025, p=0.010, and p<0.001, respectively). High ALC and high LMR were independently associated with longer OS (p=0.020 and p=0.015, respectively). High ALC was also independently associated with longer time to treatment failure (p=0.014). CONCLUSION These systemic immune markers at diagnosis can predict not only a better OS but also a better TTF after first-line treatment.
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Affiliation(s)
- Shogo Nakamoto
- Division of Breast and Thyroid Gland Surgery, Fukuyama City Hospital, Hiroshima, Japan
| | - Masahiko Ikeda
- Division of Breast and Thyroid Gland Surgery, Fukuyama City Hospital, Hiroshima, Japan
| | - Shinichiro Kubo
- Division of Breast and Thyroid Gland Surgery, Fukuyama City Hospital, Hiroshima, Japan
| | - Mari Yamamoto
- Division of Breast and Thyroid Gland Surgery, Fukuyama City Hospital, Hiroshima, Japan
| | - Tetsumasa Yamashita
- Division of Breast and Thyroid Gland Surgery, Fukuyama City Hospital, Hiroshima, Japan
| | - Chihiro Kuwahara
- Division of Breast and Thyroid Gland Surgery, Fukuyama City Hospital, Hiroshima, Japan
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Al Jarroudi O, El Bairi K, Abda N, Zaimi A, Jaouani L, Chibani H, Afqir S. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios as predictors of outcomes in inflammatory breast cancer. Biomark Med 2021; 15:1289-1298. [PMID: 34486882 DOI: 10.2217/bmm-2020-0717] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background: Inflammatory breast cancer (IBC) is uncommon, aggressive and associated with poor survival outcomes. The lack of prognostic biomarkers and therapeutic targets specific to IBC is an added challenge for clinical practice and research. Inflammatory biomarkers such as neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios (NLR and PLR) demonstrated independent prognostic impact for survival in breast cancer. In our study, these biomarkers were investigated in a cohort of patients with nonmetastatic IBC. Methods: A retrospective cohort of 102 IBC patients with nonmetastatic disease was conducted at the Mohammed VI University Hospital (Oujda, Morocco) between January 2010 and December 2014. NLR and PLR were obtained from blood cell count at baseline before neoadjuvant chemotherapy (NACT) from patients' medical records. The receiver operating characteristic was used to find the optimal cut-off. Correlation between these blood-based biomarkers and response to NACT was analyzed by Chi-squared and Fisher's exact test. Their prognostic value for predicting disease-free survival (DFS) and overall survival (OS) was performed based on Cox regression models. Results: Totally, 102 patients with IBC were included in the analysis. Pathologic complete response (pCR) after NACT, defined by the absence of an invasive tumor in the breast tissues and nodes after surgery (ypT0 ypN0), was observed in eight patients (7.8%). NACT response was found to be associated with menopausal status (p = 0.039) and nodal status (p < 0.001). Patients with a low NLR had a higher pCR rate as compared with the high-NLR group (p = 0.043). However, the pCR rate was not significantly associated with age (p = 0.122), tumor side (p = 0.403), BMI (p = 0.615), histological grade (p = 0.059), hormone receptors status (p = 0.206), HER2 (p = 0.491) and PLR (p = 0.096). Pre-treatment blood-based NLR of 2.28 was used as the cut-off value to discriminate between high and low NLR according to the receiver operating characteristic curves. Similarly, a value of 178 was used as the cut off for PLR. Patients with low-NLR had a significantly better 5-year DFS (p < 0.001) and OS (p < 0.001) than the high-NLR group. Moreover, low-PLR was significantly associated with higher DFS (p = 0.001) and OS (p = 0.003). The NLR showed a significant prognostic impact for DFS (HR: 2.57; 95% CI: 1.43-4.61; p = 0.01) and for OS (HR: 2.92; 95% CI: 1.70-5.02; p < 0.001). Similarly, a meaningful association between PLR and 5-year DFS (HR: 1.95; 95% CI: 1.10-3.46; p = 0.021) and OS (HR: 1.82; 95% CI: 1.06-3.14; p = 0.03) was noticed. Conclusions: High NLR and PLR were found associated with reduced DFS and OS in nonmetastatic IBC. Further studies are awaited to confirm these findings.
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Affiliation(s)
- Ouissam Al Jarroudi
- Department of Medical Oncology, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
| | - Khalid El Bairi
- Department of Medical Oncology, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
| | - Naima Abda
- Laboratory of Epidemiology & Public Health, Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
- Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
| | - Adil Zaimi
- Department of Medical Oncology, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
| | - Laila Jaouani
- Department of Medical Oncology, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
| | - Hind Chibani
- Department of Medical Oncology, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
| | - Said Afqir
- Department of Medical Oncology, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine and Pharmacy, Mohammed 1st University, Oujda, Morocco
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Zhao L, Sun J, Wang K, Tai S, Hua R, Yu Y, Fan Y, Huang J. Development of a New Recurrence-Free Survival Prediction Nomogram for Patients with Primary Non-Muscle-Invasive Bladder Cancer Based on Preoperative Controlling Nutritional Status Score. Cancer Manag Res 2021; 13:6473-6487. [PMID: 34429654 PMCID: PMC8379392 DOI: 10.2147/cmar.s323844] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 07/27/2021] [Indexed: 12/18/2022] Open
Abstract
Background Bladder cancer is the second most prevalent neoplasm in the urogenital system in terms of morbidity and mortality, and there is an urgent need for a more accurate assessment of individual prognosis in patients with primary non-muscle-invasive bladder cancer (NMIBC). The Controlling Nutritional Status (CONUT) score is an emerging biomarker score which has been confirmed to have prognostic value in various malignant tumors. The study attempted to systematically identify the prognostic role of preoperative CONUT score on posttreatment recurrence-free survival (RFS) in patients with NMIBC, and determine the predictive value and feasibility of the new prognostic prediction model. Methods A total of 94 patients with NMIBC were analyzed retrospectively between January 2011 and December 2015. Statistical analysis was conducted using the nonparametric method. The Kaplan-–Meier method was used to assess recurrence-free survival (RFS), and Log rank tests was used to analyze the equivalences of survival curves. We used univariate and multivariate Cox proportional hazards regression model to identify important predictors of RFS. Discrimination of nomogram was measured by the concordance index. Predictive accuracy of the model was evaluated using the internal validation. Results In univariate analysis, age, history of smoking, pathological T stage, tumor grade, tumor size, and CONUT score were significantly correlated with RFS. Multivariate analysis indicated that CONUT score (HR =3.855, 95% CI 1.242–11.970, p=0.020) was an independent predictor of RFS in patients with NMIBC. Based on significant parameters in multivariate analysis and reliable recurrence predictors determined in predictive models and relevant guidelines, a new age-, history of smoking-, pathologic factors- and the CONUT score-based scoring model was developed to predict recurrence of NMBIC. In addition, we internally validated the nomogram using the consistency index and calibration plots, which demonstrated that the model has high prediction accuracy (c-index= 0.851). Conclusion The development of a new nomogram based on CONUT score could increase the accuracy of recurrence prediction and improve individualized treatment plans for patients with NMIBC.
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Affiliation(s)
- Liwei Zhao
- Department of Urology, School of Medicine, Hangzhou Normal University, Hangzhou, 311121, Zhejiang Province, People's Republic of China.,Department of Urology, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, 311202, Zhejiang Province, People's Republic of China
| | - Ji Sun
- Department of Urology, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, 311202, Zhejiang Province, People's Republic of China
| | - Kai Wang
- Department of Urology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang Province, People's Republic of China
| | - Shengcheng Tai
- Department of Urology, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, 311202, Zhejiang Province, People's Republic of China
| | - Runmiao Hua
- Department of Urology, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, 311202, Zhejiang Province, People's Republic of China
| | - Yufu Yu
- Department of Urology, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, 311202, Zhejiang Province, People's Republic of China
| | - Yi Fan
- Department of Urology, School of Medicine, Hangzhou Normal University, Hangzhou, 311121, Zhejiang Province, People's Republic of China.,Department of Urology, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, 311202, Zhejiang Province, People's Republic of China
| | - Jiaguo Huang
- Department of Urology, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, 311202, Zhejiang Province, People's Republic of China
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Poncin A, Onesti CE, Josse C, Boulet D, Thiry J, Bours V, Jerusalem G. Immunity and Breast Cancer: Focus on Eosinophils. Biomedicines 2021; 9:biomedicines9091087. [PMID: 34572273 PMCID: PMC8470317 DOI: 10.3390/biomedicines9091087] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/11/2021] [Accepted: 08/24/2021] [Indexed: 01/21/2023] Open
Abstract
The role of eosinophils, a cell type involved in the immune response to parasitic infections and allergies, has been investigated in different cancer types, in both tumor tissue and at the circulating level. Most studies showed a role mainly in conjunction with immunotherapy in melanomas and lung tumors, while few data are available in breast cancer. In this review, we summarize literature data on breast cancer, showing a prognostic role of circulating eosinophil counts as well as of the presence of tumor tissue infiltration by eosinophils. In particular, some studies showed an association between a higher circulating eosinophil count and a good prognosis, as well as an association with response to neoadjuvant chemotherapy in hormone receptor-negative/HER2-positive and in triple negative breast cancer. Several mechanistic studies have also been conducted in in vivo models, but the exact mechanism by which eosinophils act in the presence of breast cancer is still unknown. Further studies on this subject are desirable, in order to understand their role at the cellular level, identify related biomarkers and/or possibly search for new therapeutic targets.
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Affiliation(s)
- Aurélie Poncin
- Department of Medical Oncology, University Hospital of Liege, CHU Sart Tilman, 4000 Liege, Belgium; (A.P.); (G.J.)
| | - Concetta Elisa Onesti
- Clinical and Oncological Research Department, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
- Correspondence:
| | - Claire Josse
- Laboratory of Human Genetics, GIGA Research Center, University of Liège, 4000 Liege, Belgium; (C.J.); (D.B.); (J.T.); (V.B.)
| | - Delphine Boulet
- Laboratory of Human Genetics, GIGA Research Center, University of Liège, 4000 Liege, Belgium; (C.J.); (D.B.); (J.T.); (V.B.)
| | - Jérôme Thiry
- Laboratory of Human Genetics, GIGA Research Center, University of Liège, 4000 Liege, Belgium; (C.J.); (D.B.); (J.T.); (V.B.)
| | - Vincent Bours
- Laboratory of Human Genetics, GIGA Research Center, University of Liège, 4000 Liege, Belgium; (C.J.); (D.B.); (J.T.); (V.B.)
| | - Guy Jerusalem
- Department of Medical Oncology, University Hospital of Liege, CHU Sart Tilman, 4000 Liege, Belgium; (A.P.); (G.J.)
- Department of Medical Oncology, University of Liege, 4000 Liege, Belgium
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21
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Park SJ, Lee J, Kim H, Shin K, Lee M, Park JM, Choi MG, Park CH, Song KY, Lee HH, Kim IH. Association between absolute lymphocyte count and overall mortality in patients with surgically resected gastric cancer. Korean J Intern Med 2021; 36:679-688. [PMID: 33601866 PMCID: PMC8137401 DOI: 10.3904/kjim.2019.358] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 04/13/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND/AIMS Lymphocytes are an important component of the cell-mediated immune system. As lymphopenia is reportedly associated with poor prognoses in patients with various cancers, we investigated this notion in patients who underwent curative gastrectomy. METHODS We retrospectively analyzed the association between absolute lymphocyte count (ALC) and prognosis in patients with stage I-III gastric cancer who underwent curative surgical resection. Ever lymphopenic patients were defined as those with ALCs < 1,000/μL at any time post-diagnosis except within 30 days post-surgery. Adjusted multivariable regression models were used to evaluate the associations between lymphopenia and overall mortality, gastric cancer-specific mortality, and disease-free survival. RESULTS We investigated 1,222 patients diagnosed between January 2011 and December 2015. Fifty-six patients (4.6%) were lymphopenic at diagnosis and nearly one-quarter (24.8%) were ever lymphopenic with a mean minimum ALC of 640/μL. Older age (odds ratio [OR], 1.02) and higher stage (stage III vs. I; OR, 3.01) were positively associated with ever lymphopenia. On multivariable analysis, ever lymphopenia predicted higher overall mortality (hazard ratio [HR], 1.83; p = 0.008), higher gastric cancer-specific mortality (HR, 1.58; p = 0.048), and shorter disease-free survival (HR, 1.83; p = 0.006). The 5-year gastric cancer-specific mortality rates for ever- and never lymphopenic patients were 10.9% and 3.7%, respectively; their 5-year cumulative recurrence rates were 15.1% and 4.6%, respectively. CONCLUSION This study demonstrate that ever lymphopenia is independent prognostic factor for overall mortality and recurrence in patients with potentially curable gastric cancer; hence, ALCs may be a biomarker for predicting the prognoses of patients with stage I-III gastric cancer who had curative gastrectomy.
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Affiliation(s)
- Se Jun Park
- Divisions of Medical Oncology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Jinsoo Lee
- Divisions of Medical Oncology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Hyunho Kim
- Divisions of Medical Oncology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Kabsoo Shin
- Divisions of Medical Oncology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - MyungAh Lee
- Divisions of Medical Oncology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Jae Myung Park
- Gastroenterology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Myung-Gyu Choi
- Gastroenterology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Cho Hyun Park
- Department of Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Kyo Young Song
- Department of Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Han Hong Lee
- Department of Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - In-Ho Kim
- Divisions of Medical Oncology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
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Systemic immunity markers associated with lymphocytes predict the survival benefit from paclitaxel plus bevacizumab in HER2 negative advanced breast cancer. Sci Rep 2021; 11:6328. [PMID: 33737682 PMCID: PMC7973794 DOI: 10.1038/s41598-021-85948-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 03/02/2021] [Indexed: 01/04/2023] Open
Abstract
Although paclitaxel plus bevacizumab (PB) therapy is an effective chemotherapeutic regimen for HER2-negative advanced breast cancer (ABC), predictive markers for its effectiveness remain undefined. We investigated the usefulness of systemic immunity markers associated with lymphocytes as predictive markers for PB therapy in patients with HER2-negative ABC. We retrospectively reviewed data from 114 patients with HER2-negative ABC who underwent PB therapy from November 2011 to December 2019. We calculated the absolute lymphocyte count (ALC), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) as representative systemic immunity markers. The time to treatment failure (TTF) and overall survival (OS) of the patients with high ALC, low NLR, and high LMR were significantly longer compared with those of the patients with low ALC, high NLR, and low LMR. A multivariable analysis revealed that high ALC, low NLR, and low PLR were independent predictors for TTF and high ALC, low NLR, and high LMR were independent predictors for OS. Systemic immunity markers were significantly associated with longer TTF and OS in patients who underwent PB therapy and may represent predictive markers for PB therapy in patients with HER2-negative ABC.
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Batalha S, Ferreira S, Brito C. The Peripheral Immune Landscape of Breast Cancer: Clinical Findings and In Vitro Models for Biomarker Discovery. Cancers (Basel) 2021; 13:1305. [PMID: 33804027 PMCID: PMC8001103 DOI: 10.3390/cancers13061305] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/09/2021] [Accepted: 03/12/2021] [Indexed: 02/07/2023] Open
Abstract
Breast cancer is the deadliest female malignancy worldwide and, while much is known about phenotype and function of infiltrating immune cells, the same attention has not been paid to the peripheral immune compartment of breast cancer patients. To obtain faster, cheaper, and more precise monitoring of patients' status, it is crucial to define and analyze circulating immune profiles. This review compiles and summarizes the disperse knowledge on the peripheral immune profile of breast cancer patients, how it departs from healthy individuals and how it changes with disease progression. We propose this data to be used as a starting point for validation of clinically relevant biomarkers of disease progression and therapy response, which warrants more thorough investigation in patient cohorts of specific breast cancer subtypes. Relevant clinical findings may also be explored experimentally using advanced 3D cellular models of human cancer-immune system interactions, which are under intensive development. We review the latest findings and discuss the strengths and limitations of such models, as well as the future perspectives. Together, the scientific advancement of peripheral biomarker discovery and cancer-immune crosstalk in breast cancer will be instrumental to uncover molecular mechanisms and putative biomarkers and drug targets in an all-human setting.
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Affiliation(s)
- Sofia Batalha
- Instituto de Biologia Experimental e Tecnológica (iBET), Apartado 12, 2781-901 Oeiras, Portugal;
- Instituto de Tecnologia Química e Biológica António Xavier, University Nova de Lisboa, Avenida da República, 2780-157 Oeiras, Portugal
| | - Sofia Ferreira
- Instituto Português de Oncologia de Lisboa Francisco Gentil, Rua Prof Lima Basto, 1099-023 Lisboa, Portugal;
| | - Catarina Brito
- Instituto de Biologia Experimental e Tecnológica (iBET), Apartado 12, 2781-901 Oeiras, Portugal;
- Instituto de Tecnologia Química e Biológica António Xavier, University Nova de Lisboa, Avenida da República, 2780-157 Oeiras, Portugal
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Zhou J, Ma Y, Liu Y, Xiang Y, Tao C, Yu H, Huang J. A Correlation Analysis between the Nutritional Status and Prognosis of COVID-19 Patients. J Nutr Health Aging 2021; 25:84-93. [PMID: 33367467 PMCID: PMC7417110 DOI: 10.1007/s12603-020-1457-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 06/16/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE The present study investigated the correlation between the nutritional status and prognosis of COVID-19 patients, and analyzed the epidemiological characteristics of COVID-19 patients with different nutritional status. METHODS 429 patients who were diagnosed positive for COVID-19 in Hubei Provincial Hospital of Traditional Chinese Medicine from December 2019 to March 2020 were selected and divided into different groups based on Controlling Nutritional Status (CONUT) score (0-4: the low CONUT score group; 5-12: the high CONUT score group). Multivariate logistic regression analysis was applied to investigate the effects of CONUT score on prognosis. RESULTS The total score of admission status of patients with higher CONUT score was higher than that of those with lower CONUT score (χ2 = 7.152, P = 0.007). The number of adverse outcomes of female was higher than that of male (χ2 = 10.253, P = 0.001). The number of adverse outcomes was higher for patients with smoking history (P = 0.004) or hypertension (χ2 = 11.240, P = 0.001) than those without. Also, the number of adverse outcomes was higher for older patients than younger ones (χ2 = 15.681, P < 0.001). Patients with adverse outcomes had lower urine red blood cell count than patients without adverse outcomes (χ2 = 5.029, P = 0.025). However, BMI, drinking history and diabetes did not show correlation with the prognosis of COVID-19 (P > 0.05).Among patients ≥ 61 years old, the risk of adverse outcomes in the high CONUT score group was 6.191 times that of the low CONUT score group (OR = 6.191, 95% CI: 1.431-26.785).Among the non-diabetic patients, the risk of adverse outcomes in the high CONUT group was 11.678 times that of the low CONUT group (OR = 11.678, 95% CI: 2.754-49.41).For the patients who had a total score of admission status < 6, the risk of adverse outcomes in the high CONUT score group was 8.216 times that of the low CONUT score group (OR = 8.216, 95% CI: 2.439-27.682). CONCLUSION COVID-19 patients with good nutritional status showed a small chance to have adverse outcomes. Gender, age, hypertension, the number of urine red blood cell count and CONUT score affected the adverse outcomes of patients.
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Affiliation(s)
- J Zhou
- Yi Ma, Department of Emergency, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China,
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25
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Lee OH, Min SY. Decrease of peripheral blood lymphocyte count predicts response to neoadjuvant chemotherapy in breast cancer patients. KOREAN JOURNAL OF CLINICAL ONCOLOGY 2020; 16:79-88. [PMID: 36945713 PMCID: PMC9942727 DOI: 10.14216/kjco.20013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 11/12/2020] [Accepted: 12/02/2020] [Indexed: 11/07/2022]
Abstract
Purpose Pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) holds promise as a significant prognostic factor to predict NAC response in breast cancer patients. The absolute peripheral blood lymphocyte (PBL) count has been suggested as an independent predictor of response to NAC. The current study evaluated the relationship between pCR and the change of PBL count in patients treated with NAC. Methods A total of 61 patients with histologically confirmed breast cancer treated with NAC followed by mastectomy between January 2010 and December 2019 were analyzed retrospectively. Correlational analyses confirmed a statistically significant relationship between PBL count and pCR. Following conformational correlational analyses, patients were divided into two groups according to cutoff values using the receiver operating characteristics curve and a logistic regression was conducted to determine the optimal conditions for achieving pCR. Results A total of 14 patients (22.9%) achieved pCR. Most PBL counts decreased after NAC relevant to pCR. Logistic regression analysis revealed that a small decrease of PBL was associated with pCR (P=0.028). The cutoff value of PBL decrease was 755×106/L, which was used to divide patients into high and low reduction groups. The pCR rate was 11.43% and 38.46% for the high and low reduction group, respectively (area under the curve, 0.707; 95% confidence interval, 0.556-0.858; P=0.020). The high reduction group was found to have more difficulty achieving pCR. Conclusion The decrease of PBL is significantly associated with pCR. Our data support that the decrease of PBL after NAC may be useful factors in predicting the response to NAC in breast cancer patients.
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Affiliation(s)
- Ok Hee Lee
- Department of Surgery, Kyung Hee University College of Medicine, Seoul, Korea
| | - Sun-Young Min
- Department of Surgery, Kyung Hee University College of Medicine, Seoul, Korea
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Liu XR, Yu JJ, Song GH, Di LJ, Jiang HF, Yan Y, Liang X, Zhang RY, Ran R, Wang J, Bai H, Jia SD, Li HP. Peripheral cytotoxic T lymphocyte predicts first-line progression free survival in HER2-positive advanced breast cancer. Breast 2020; 55:7-15. [PMID: 33296767 PMCID: PMC7723789 DOI: 10.1016/j.breast.2020.11.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 12/26/2022] Open
Abstract
Background The role of peripheral blood lymphocyte (pBL) in breast cancer has long been studied. However, the predictive role of pBL in advanced breast cancer (ABC) is poorly understood. Methods A total of 303 patients with ABC were consecutively recruited at our center between January 2015 and September 2019. At baseline, pBL subtypes were detected in all patients with 229 blood samples available for circulating tumor DNA (ctDNA) detection. pBL was analyzed through flow cytometry. ctDNA-based gene mutations were detected using next generation sequencing. The cutoff value of pCTL was estimated by X-tile software. Progression free survival (PFS) was estimated by Kaplan-Meier curve and Cox hazard proportion regression model, with difference detection by log-rank test. Results Median follow-up time of the study was 21.0 months. The median age of diagnosis was 52.0 years. Among the pBL subtypes, only pCTL level was found predictive for PFS in the HER2+ patients whom received anti-HER2 therapy (13.1 vs. 5.6 months, P = 0.001). However, the predictive role of pCTL was not found in HR-positive (P = 0.716) and TNBC (P = 0.202). pCTL high associated with suppressive immune indictors including lower CD4/CD8 ratio (P = 0.004) and high level of Treg cell (P = 0.004). High occurrence of FGFR1 amplification which has been reported as immune suppressor was also found in HER2+ patients with pCTL high (22.2% vs. 4.3%, P = 0.048). Conclusions Higher pCTLs level associated with shorter PFS and FGFR1 mutation in HER2+ ABC patients. High pCTL level predicts shorter first-line PFS in HER2+ patients receiving anti-HER2 based regimens. The predictive role of pCTL level found in HER2+ patients was not applicable in HR+ and TNBC patients. High level of pCTL was associated with immunosuppressive status and FGFR1 mutations in HER2+ breast cancer patients.
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Affiliation(s)
- Xiao-Ran Liu
- Department of Breast Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Fu-Cheng Road No.52, Hai-Dian District, Beijing, 100142, China
| | - Jian-Jun Yu
- Huidu Shanghai Medical Sciences, Wang-Yuan Road No.1698, Feng-Xian District, Shanghai, 201499, China
| | - Guo-Hong Song
- Department of Breast Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Fu-Cheng Road No.52, Hai-Dian District, Beijing, 100142, China
| | - Li-Jun Di
- Department of Breast Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Fu-Cheng Road No.52, Hai-Dian District, Beijing, 100142, China
| | - Han-Fang Jiang
- Department of Breast Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Fu-Cheng Road No.52, Hai-Dian District, Beijing, 100142, China
| | - Ying Yan
- Department of Breast Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Fu-Cheng Road No.52, Hai-Dian District, Beijing, 100142, China
| | - Xu Liang
- Department of Breast Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Fu-Cheng Road No.52, Hai-Dian District, Beijing, 100142, China
| | - Ru-Yan Zhang
- Department of Breast Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Fu-Cheng Road No.52, Hai-Dian District, Beijing, 100142, China
| | - Ran Ran
- Department of Breast Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Fu-Cheng Road No.52, Hai-Dian District, Beijing, 100142, China
| | - Jing Wang
- Department of Breast Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Fu-Cheng Road No.52, Hai-Dian District, Beijing, 100142, China
| | - Han Bai
- Department of Breast Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Fu-Cheng Road No.52, Hai-Dian District, Beijing, 100142, China
| | - Shi-Dong Jia
- Huidu Shanghai Medical Sciences, Wang-Yuan Road No.1698, Feng-Xian District, Shanghai, 201499, China
| | - Hui-Ping Li
- Department of Breast Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Fu-Cheng Road No.52, Hai-Dian District, Beijing, 100142, China.
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27
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Gutkin PM, Kozak MM, von Eyben R, Horst KC. Lymphopenia and clinical outcomes in patients with residual nodal disease after neoadjuvant chemotherapy for breast cancer. Cancer Causes Control 2020; 31:1021-1026. [PMID: 32888164 DOI: 10.1007/s10552-020-01337-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 08/06/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Patients with residual nodal disease after neoadjuvant chemotherapy for breast cancer have a poor prognosis. We wanted to evaluate whether lymphopenia after treatment for breast cancer impacted clinical outcomes. MATERIALS AND METHODS We assessed 99 patients with node-positive disease after neoadjuvant chemotherapy. Absolute lymphocyte count was recorded 1 year after radiation. Dates of local, regional, and distant failure were recorded. Time to event outcomes were evaluated using Kaplan-Meier analysis. Multivariable analysis determined factors predictive for overall survival. RESULTS Median follow-up was 44 months (range 3-150). Median age was 48 years (range 23-79). Twenty-six patients (26%) had lymphopenia 1 year after RT. Patients with lymphopenia had a greater incidence of regional (p = 0.03) and distant failure (p = 0.009) compared to those with normal lymphocyte counts and had a 6.05 greater risk of death (p = 0.0002). CONCLUSIONS In patients with residual nodal disease after neoadjuvant chemotherapy, lymphopenia after breast cancer treatment was associated with overall survival. The relationship between lymphopenia and breast cancer outcomes warrants further investigation.
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Affiliation(s)
- Paulina M Gutkin
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA, USA
| | - Margaret M Kozak
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA, USA
| | - Rie von Eyben
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA, USA
| | - Kathleen C Horst
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA, USA. .,Department of Radiation Oncology, Stanford Comprehensive Cancer Center, 875 Blake Wilbur Drive, Stanford, CA, 94305-5847, USA.
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28
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Onesti CE, Josse C, Boulet D, Thiry J, Beaumecker B, Bours V, Jerusalem G. Blood eosinophilic relative count is prognostic for breast cancer and associated with the presence of tumor at diagnosis and at time of relapse. Oncoimmunology 2020; 9:1761176. [PMID: 32923121 PMCID: PMC7458605 DOI: 10.1080/2162402x.2020.1761176] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background Cancer outcome is associated with circulating immune cells, including eosinophils. Here we analyze the relative eosinophil count (REC) in different breast cancer subtypes. Methods Stage I–III breast cancer patients were included in the study and classified as REC-high vs low (cutoff 1.5%) or relative lymphocyte count (RLC)-high vs low (cutoff 17.5%). The co-primary endpoints were the breast cancer-specific survival (BCSS) or the time to treatment failure (TTF) in the REC groups. Results Overall 930 patients were included in the study. We observed a benefit for REC-high vs REC-low in TTF (HR 0.610, 95% CI 0.458–0.812), and in BCSS (HR 0.632, 95% CI 0.433–0.923). Similarly, we observed a better TTF (HR 0.421, 95% CI 0.262–0.677) and BCSS (HR 0.350, 95% CI 0.200–0.614) in RLC-high vs low. A lower relapse rate was observed in the REC-high vs REC-low group (17.1% vs 24.7%, p = 0.005), not confirmed in the multivariate analysis. A lower median REC at baseline and at relapse was observed compared to REC after surgery and during cancer-free follow-up (p < .0001). Conclusions REC could be a new promising, affordable and accessible predictive and prognostic biomarker in all breast cancer subtypes.
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Affiliation(s)
- Concetta Elisa Onesti
- Medical Oncology Department, Centre Hospitalier Universitaire Sart-Tilman, Liège, Belgium.,Laboratory of Human Genetics, GIGA Institute, Liège, Belgium
| | - Claire Josse
- Medical Oncology Department, Centre Hospitalier Universitaire Sart-Tilman, Liège, Belgium.,Laboratory of Human Genetics, GIGA Institute, Liège, Belgium
| | - Delphine Boulet
- Laboratory of Human Genetics, GIGA Institute, Liège, Belgium
| | - Jérôme Thiry
- Laboratory of Human Genetics, GIGA Institute, Liège, Belgium
| | | | - Vincent Bours
- Laboratory of Human Genetics, GIGA Institute, Liège, Belgium.,Department of Human Genetics, Centre Hospitalier Universitaire Sart-Tilman, Liège, Belgium
| | - Guy Jerusalem
- Medical Oncology Department, Centre Hospitalier Universitaire Sart-Tilman, Liège, Belgium.,Faculty of Medicine, Liège University, Liège, Belgium
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29
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Li W, Li M, Wang T, Ma G, Deng Y, Pu D, Liu Z, Wu Q, Liu X, Zhou Q. Controlling Nutritional Status (CONUT) score is a prognostic factor in patients with resected breast cancer. Sci Rep 2020; 10:6633. [PMID: 32313183 PMCID: PMC7171067 DOI: 10.1038/s41598-020-63610-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 03/27/2020] [Indexed: 02/05/2023] Open
Abstract
The present study aimed to determine the correlation between controlling nutritional status (CONUT) and prognosis in resected breast cancer patients. Totally, 861 breast cancer patients with surgical resection in West China Hospital of Sichuan University between 2007 and 2010 were included. The relationship between CONUT and various clinicopathological factors as well as prognosis was evaluated. The results showed that the optimal cutoff value for CONUT to predict the 5-year survival was 3 and CONUT had a higher area under the ROC curve (AUC) for 5-year disease free survival (DFS) and overall survival (OS) prediction compared with the neutrophil lymphocyte ratio (NLR) and prognostic nutritional index (PNI). High CONUT was significantly correlated with older age, lymph node involvement, advanced T-stage, and surgery type. In the multivariate analysis, CONUT-high patients had worse DFS and OS, when compared with CONUT-low patients. In conclusion, preoperative CONUT is a useful marker for predicting long term outcomes in breast cancer patients after curative resection.
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Affiliation(s)
- Wen Li
- Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P.R. China
| | - Min Li
- Department of Cancer, The People's Hospital of Yuechi, Guang'an, Sichuan, 638300, P.R. China
| | - Ting Wang
- Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P.R. China
| | - Guangzhi Ma
- Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P.R. China
| | - Yunfu Deng
- Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P.R. China
| | - Dan Pu
- Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P.R. China
| | - Zhenkun Liu
- Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P.R. China
| | - Qiang Wu
- Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P.R. China
| | - Xuejuan Liu
- Department of Breast Surgery, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, P.R. China
| | - Qinghua Zhou
- Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P.R. China.
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30
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Sun GY, Wang SL, Song YW, Jin J, Wang WH, Liu YP, Ren H, Fang H, Tang Y, Zhao XR, Song YC, Yu ZH, Liu XF, Li YX. Radiation-Induced Lymphopenia Predicts Poorer Prognosis in Patients With Breast Cancer: A Post Hoc Analysis of a Randomized Controlled Trial of Postmastectomy Hypofractionated Radiation Therapy. Int J Radiat Oncol Biol Phys 2020; 108:277-285. [PMID: 32147519 DOI: 10.1016/j.ijrobp.2020.02.633] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 02/17/2020] [Accepted: 02/22/2020] [Indexed: 01/05/2023]
Abstract
PURPOSE The aim of this study was to determine whether radiation-induced lymphopenia affects the survival of patients with breast cancer. METHODS AND MATERIALS Post hoc analysis was conducted on data from 598 patients with breast cancer from a randomized controlled trial comparing postmastectomy hypofractionated radiation therapy (HFRT; 43.5 Gy in 15 fractions over 3 weeks) with conventional fractionated radiation therapy (CFRT; 50 Gy in 25 fractions over 5 weeks). Mean peripheral lymphocyte count (PLC) at different time points in the 2 groups was compared by the t test. Disease-free survival and overall survival were analyzed by the Kaplan-Meier method and compared between groups by the log-rank test. RESULTS Baseline PLC (pre-PLC) was comparable between HFRT and CFRT patients (1.60 ± 0.57 × 109/L vs 1.56 ± 0.52 × 109/L; P = .33). In both groups, the PLC declined steadily during the course of radiation therapy but started to recover at 1 month after radiation therapy. Incidence of lymphopenia was significantly lower in HFRT patients (45.4% vs 55.7%; P = .01). Nadir-PLC was significantly higher in HFRT patients (1.08 ± 0.37 × 109/L vs 0.97 ± 0.31× 109/L; P < .001), as was the nadir-PLC/pre-PLC ratio (0.72 ± 0.28 vs 0.67 ± 0.28; P = .02). Median follow-up was 57.6 months (interquartile range, 38.5-81.4). The 5-year disease-free survival was significantly lower in patients with a nadir-PLC/pre-PLC ratio <0.8 than in those with a ratio ≥0.8 (71.8% vs 82.6%; P = .01); however, overall survival was comparable between the groups (85.8% vs 90.6%; P = .24). CONCLUSIONS The risk of radiation-induced lymphopenia in patients with breast cancer is lower with HFRT than with CFRT. A low nadir-PLC/pre-PLC ratio may predict poor prognosis.
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Affiliation(s)
- Guang-Yi Sun
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shu-Lian Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Yong-Wen Song
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Jin
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wei-Hu Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yue-Ping Liu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hua Ren
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hui Fang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yu Tang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xu-Ran Zhao
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yu-Chun Song
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zi-Hao Yu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xin-Fan Liu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ye-Xiong Li
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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31
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Liu J, Ma F, Sun B, Cong Y, Xuan L, Wang Q, Wu S. Predictive Value of Lymphocyte-Related Blood Parameters at the Time Point of Lymphocyte Nadir During Radiotherapy in Breast Cancer. Onco Targets Ther 2020; 13:151-161. [PMID: 32021263 PMCID: PMC6955599 DOI: 10.2147/ott.s233244] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 11/23/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose Various reports found a relationship between lymphocyte-related blood parameters (LRBP), including absolute lymphocyte counts (ALC), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) and prognosis of breast cancer. Most of the studies focused on LRBP pre-treatment. Seldom have studies focused on LRBP during radiotherapy. We intended to perform a retrospective cohort study on the prognostic value of LRBP at the time point of lowest ALC during radiotherapy for breast cancer. Patients and methods A total of 158 female patients were included in radiotherapy group because of the strict limitation standards of complete routine blood test results at pre-treatment and pre-operation, and at least once a week during radiotherapy. Besides 221 patients, including the 158 patients of radiotherapy group, were adopted in pre-treatment group and pre-operation group. Results ALC and PLR at the time point of lowest ALC during radiotherapy are prognostic predictors of breast cancer, and lower ALC and higher PLR are independent significant predictors of poor DFS. Besides, lower ALC, higher NLR and higher PLR at both pre-treatment and pre-operation were found to be independent variables for predicting poor DFS. Conclusion LRBP at pre-treatment, pre-operation, and during radiotherapy may serve as predictors of outcomes of breast cancer.
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Affiliation(s)
- Jiannan Liu
- Academy of Military Medical Sciences, Beijing 100039, People's Republic of China.,Department of Radiation Oncology, The Fifth Medical Center of Chinese PLA General Hospital (Former 307th Hospital of the PLA), Beijing 100071, People's Republic of China
| | - Feiyan Ma
- Baoding No.1 Central Hospital Affiliated with Chengde Medical College, Baoding City, Hebei Province 071000, People's Republic of China
| | - Bing Sun
- Department of Radiation Oncology, The Fifth Medical Center of Chinese PLA General Hospital (Former 307th Hospital of the PLA), Beijing 100071, People's Republic of China
| | - Yang Cong
- Department of Radiation Oncology, The Fifth Medical Center of Chinese PLA General Hospital (Former 307th Hospital of the PLA), Beijing 100071, People's Republic of China
| | - Liang Xuan
- Department of Radiation Oncology, The Fifth Medical Center of Chinese PLA General Hospital (Former 307th Hospital of the PLA), Beijing 100071, People's Republic of China
| | - Qian Wang
- Department of Radiation Oncology, The Fifth Medical Center of Chinese PLA General Hospital (Former 307th Hospital of the PLA), Beijing 100071, People's Republic of China
| | - Shikai Wu
- Department of Radiation Oncology, The Fifth Medical Center of Chinese PLA General Hospital (Former 307th Hospital of the PLA), Beijing 100071, People's Republic of China
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32
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Neutrophil-lymphocyte ratio in metastatic breast cancer is not an independent predictor of survival, but depends on other variables. Sci Rep 2019; 9:16979. [PMID: 31740715 PMCID: PMC6861311 DOI: 10.1038/s41598-019-53606-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 10/30/2019] [Indexed: 12/11/2022] Open
Abstract
The prognostic impact of neutrophil-lymphocyte ratio (NLR) in metastatic breast cancer (MBC) has been previously evaluated in early and metastatic mixed breast cancer cohorts or without considering other relevant prognostic factors. Our aim was to determine whether NLR prognostic and predictive value in MBC was dependent on other clinical variables. We studied a consecutive retrospective cohort of patients with MBC from a single centre, with any type of first line systemic treatment. The association of NLR at diagnosis of metastasis with progression free survival (PFS) and overall survival (OS) was evaluated using Cox univariate and multivariate proportional hazard models. In the full cohort, that included 263 MBC patients, a higher than the median (>2.32) NLR was significantly associated with OS in the univariate analysis (HR 1.36, 95% CI 1.00–1.83), but the association was non-significant (HR 1.12, 95% CI 0.80–1.56) when other clinical covariates (performance status, stage at diagnosis, CNS involvement, visceral disease and visceral crisis) were included in the multivariate analysis. No significant association was observed for PFS. In conclusion, MBC patients with higher baseline NLR had worse overall survival, but the prognostic impact of NLR is likely derived from its association with other relevant clinical prognostic factors.
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33
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Onesti CE, Josse C, Poncin A, Frères P, Poulet C, Bours V, Jerusalem G. Predictive and prognostic role of peripheral blood eosinophil count in triple-negative and hormone receptor-negative/HER2-positive breast cancer patients undergoing neoadjuvant treatment. Oncotarget 2018; 9:33719-33733. [PMID: 30263098 PMCID: PMC6154746 DOI: 10.18632/oncotarget.26120] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 09/04/2018] [Indexed: 12/30/2022] Open
Abstract
In current clinical practices, up to 27% of all breast cancer patients receive neoadjuvant chemotherapy. High pathological complete response rate is frequently associated with tumor-infiltrating lymphocytes. Additionally, circulating immune cells are also often linked to chemotherapy response. We performed a retrospective analysis on a cohort of 112 breast cancer patients (79 triple-negative, 33 hormone receptor-negative/HER2-positive) treated with standard neoadjuvant chemotherapy. Eosinophil and lymphocyte counts were collected from whole blood at baseline and during follow-ups and their associations with pathological complete response, relapse, disease-free and breast cancer-specific survival were analyzed. We observed a higher pathological complete response rate in patients who presented at baseline a relative eosinophil count ≥ 1.5% (55.6%) than in those with a relative eosinophil count < 1.5% (36.2%)(p = 0.04). An improvement in breast cancer-specific survival in patients with high relative eosinophil count (p = 0.05; HR = 0.336; 95% CI = 0.107-1.058) or with high relative lymphocyte count (threshold = 17.5%, p = 0.01; HR = 0.217; 95% CI = 0.060-0.783) were also observed. Upon combining the two parameters into the eosinophil x lymphocyte product with a threshold at 35.8, associations with pathological complete response (p = 0.002), relapse (p = 0.028), disease-free survival (p = 0.012) and breast cancer-specific survival (p = 0.001) were also recorded. In conclusion, the relative eosinophil count and eosinophil x lymphocyte product could be promising, affordable and accessible new biomarkers that are predictive for neoadjuvant chemotherapy response and prognostic for longer survival in triple-negative and hormone receptors-negative/HER2-positive breast cancers. Confirmation of these results in a larger patient population is needed.
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Affiliation(s)
- Concetta Elisa Onesti
- Laboratory of Human Genetics, GIGA Research Institute, University of Liège, Liège, Belgium.,Department of Medical Oncology, University Hospital (CHU Liège), Liège, Belgium.,Laboratory of Medical Oncology, GIGA Research Institute, University of Liège, Liège, Belgium
| | - Claire Josse
- Laboratory of Human Genetics, GIGA Research Institute, University of Liège, Liège, Belgium.,Department of Medical Oncology, University Hospital (CHU Liège), Liège, Belgium.,Laboratory of Medical Oncology, GIGA Research Institute, University of Liège, Liège, Belgium
| | - Aurélie Poncin
- Laboratory of Human Genetics, GIGA Research Institute, University of Liège, Liège, Belgium.,Department of Medical Oncology, University Hospital (CHU Liège), Liège, Belgium.,Laboratory of Medical Oncology, GIGA Research Institute, University of Liège, Liège, Belgium
| | - Pierre Frères
- Laboratory of Human Genetics, GIGA Research Institute, University of Liège, Liège, Belgium.,Department of Medical Oncology, University Hospital (CHU Liège), Liège, Belgium.,Laboratory of Medical Oncology, GIGA Research Institute, University of Liège, Liège, Belgium
| | - Christophe Poulet
- Laboratory of Human Genetics, GIGA Research Institute, University of Liège, Liège, Belgium
| | - Vincent Bours
- Laboratory of Human Genetics, GIGA Research Institute, University of Liège, Liège, Belgium.,Department of Human Genetics, University Hospital (CHU Liège), Liège, Belgium
| | - Guy Jerusalem
- Department of Medical Oncology, University Hospital (CHU Liège), Liège, Belgium.,Laboratory of Medical Oncology, GIGA Research Institute, University of Liège, Liège, Belgium
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34
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Rafat M, Aguilera TA, Vilalta M, Bronsart LL, Soto LA, von Eyben R, Golla MA, Ahrari Y, Melemenidis S, Afghahi A, Jenkins MJ, Kurian AW, Horst KC, Giaccia AJ, Graves EE. Macrophages Promote Circulating Tumor Cell-Mediated Local Recurrence following Radiotherapy in Immunosuppressed Patients. Cancer Res 2018; 78:4241-4252. [PMID: 29880480 PMCID: PMC6072588 DOI: 10.1158/0008-5472.can-17-3623] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 04/09/2018] [Accepted: 05/25/2018] [Indexed: 01/07/2023]
Abstract
Although radiotherapy (RT) decreases the incidence of locoregional recurrence in breast cancer, patients with triple-negative breast cancer (TNBC) have increased risk of local recurrence following breast-conserving therapy. The relationship between RT and local recurrence is unknown. Here, we tested the hypothesis that recurrence in some instances is due to the attraction of circulating tumor cells to irradiated tissues. To evaluate the effect of absolute lymphocyte count on local recurrence after RT in patients with TNBC, we analyzed radiation effects on tumor and immune cell recruitment to tissues in an orthotopic breast cancer model. Recurrent patients exhibited a prolonged low absolute lymphocyte count when compared with nonrecurrent patients following RT. Recruitment of tumor cells to irradiated normal tissues was enhanced in the absence of CD8+ T cells. Macrophages (CD11b+F480+) preceded tumor cell infiltration and were recruited to tissues following RT. Tumor cell recruitment was mitigated by inhibiting macrophage infiltration using maraviroc, an FDA-approved CCR5 receptor antagonist. Our work poses the intriguing possibility that excessive macrophage infiltration in the absence of lymphocytes promotes local recurrence after RT. This combination thus defines a high-risk group of patients with TNBC.Significance: This study establishes the importance of macrophages in driving tumor cell recruitment to sites of local radiation therapy and suggests that this mechanism contributes to local recurrence in women with TNBC that are also immunosuppressed.Graphical Abstract: http://cancerres.aacrjournals.org/content/canres/78/15/4241/F1.large.jpg Cancer Res; 78(15); 4241-52. ©2018 AACR.
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Affiliation(s)
- Marjan Rafat
- Department of Radiation Oncology, Stanford University, Stanford, California
| | - Todd A Aguilera
- Department of Radiation Oncology, Harold C. Simmons Comprehensive Cancer Center, U.T. Southwestern Medical Center, Dallas, Texas
| | - Marta Vilalta
- Department of Radiation Oncology, Stanford University, Stanford, California
| | - Laura L Bronsart
- Department of Radiation Oncology, Stanford University, Stanford, California
| | - Luis A Soto
- Department of Radiation Oncology, Stanford University, Stanford, California
| | - Rie von Eyben
- Department of Radiation Oncology, Stanford University, Stanford, California
| | - Meghana A Golla
- Department of Radiation Oncology, Stanford University, Stanford, California
| | - Yasaman Ahrari
- Department of Radiation Oncology, Stanford University, Stanford, California
| | | | - Anosheh Afghahi
- Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Melissa J Jenkins
- Department of Radiation Oncology, Stanford University, Stanford, California
| | - Allison W Kurian
- Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Kathleen C Horst
- Department of Radiation Oncology, Stanford University, Stanford, California
| | - Amato J Giaccia
- Department of Radiation Oncology, Stanford University, Stanford, California
| | - Edward E Graves
- Department of Radiation Oncology, Stanford University, Stanford, California.
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35
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Afghahi A, Purington N, Han SS, Desai M, Pierson E, Mathur MB, Seto T, Thompson CA, Rigdon J, Telli ML, Badve SS, Curtis CN, West RB, Horst K, Gomez SL, Ford JM, Sledge GW, Kurian AW. Higher Absolute Lymphocyte Counts Predict Lower Mortality from Early-Stage Triple-Negative Breast Cancer. Clin Cancer Res 2018; 24:2851-2858. [PMID: 29581131 PMCID: PMC6366842 DOI: 10.1158/1078-0432.ccr-17-1323] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 10/23/2017] [Accepted: 03/20/2018] [Indexed: 01/07/2023]
Abstract
Purpose: Tumor-infiltrating lymphocytes (TIL) in pretreatment biopsies are associated with improved survival in triple-negative breast cancer (TNBC). We investigated whether higher peripheral lymphocyte counts are associated with lower breast cancer-specific mortality (BCM) and overall mortality (OM) in TNBC.Experimental Design: Data on treatments and diagnostic tests from electronic medical records of two health care systems were linked with demographic, clinical, pathologic, and mortality data from the California Cancer Registry. Multivariable regression models adjusted for age, race/ethnicity, socioeconomic status, cancer stage, grade, neoadjuvant/adjuvant chemotherapy use, radiotherapy use, and germline BRCA1/2 mutations were used to evaluate associations between absolute lymphocyte count (ALC), BCM, and OM. For a subgroup with TIL data available, we explored the relationship between TILs and peripheral lymphocyte counts.Results: A total of 1,463 stage I-III TNBC patients were diagnosed from 2000 to 2014; 1,113 (76%) received neoadjuvant/adjuvant chemotherapy within 1 year of diagnosis. Of 759 patients with available ALC data, 481 (63.4%) were ever lymphopenic (minimum ALC <1.0 K/μL). On multivariable analysis, higher minimum ALC, but not absolute neutrophil count, predicted lower OM [HR = 0.23; 95% confidence interval (CI), 0.16-0.35] and BCM (HR = 0.19; CI, 0.11-0.34). Five-year probability of BCM was 15% for patients who were ever lymphopenic versus 4% for those who were not. An exploratory analysis (n = 70) showed a significant association between TILs and higher peripheral lymphocyte counts during neoadjuvant chemotherapy.Conclusions: Higher peripheral lymphocyte counts predicted lower mortality from early-stage, potentially curable TNBC, suggesting that immune function may enhance the effectiveness of early TNBC treatment. Clin Cancer Res; 24(12); 2851-8. ©2018 AACR.
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Affiliation(s)
- Anosheh Afghahi
- Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado.
| | - Natasha Purington
- Quantitative Science Unit, Stanford University School of Medicine, Stanford, California
| | - Summer S Han
- Quantitative Science Unit, Stanford University School of Medicine, Stanford, California
| | - Manisha Desai
- Quantitative Science Unit, Stanford University School of Medicine, Stanford, California
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California
| | - Emma Pierson
- Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Maya B Mathur
- Quantitative Science Unit, Stanford University School of Medicine, Stanford, California
- Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts
| | - Tina Seto
- Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Caroline A Thompson
- Palo Alto Medical Foundation Research Institute, Palo Alto, California
- Graduate School of Public Health, San Diego State University, San Diego, California
| | - Joseph Rigdon
- Quantitative Science Unit, Stanford University School of Medicine, Stanford, California
| | - Melinda L Telli
- Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Sunil S Badve
- Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana
| | - Christina N Curtis
- Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Robert B West
- Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Kathleen Horst
- Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Scarlett L Gomez
- Department of Medicine, Stanford University School of Medicine, Stanford, California
- Cancer Prevention Institute of California, Fremont, California
| | - James M Ford
- Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - George W Sledge
- Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Allison W Kurian
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California.
- Department of Medicine, Stanford University School of Medicine, Stanford, California
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Noh OK, Oh SY, Kim YB, Suh KW. Prognostic Significance of Lymphocyte Counts in Colon Cancer Patients Treated with FOLFOX Chemotherapy. World J Surg 2018; 41:2898-2905. [PMID: 28707088 DOI: 10.1007/s00268-017-4104-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE There is increasing interest in immune function in combination with chemotherapy for cancer treatment. However, the effects of chemotherapy on the human immune system remain to be determined. The aim of this study was to investigate the prognostic impact of lymphocyte and neutrophil counts in colon cancer patients who were treated with curative surgery and adjuvant chemotherapy. METHODS Two hundred thirty-one patients with colon cancers who underwent curative surgery and FOLFOX adjuvant chemotherapy between November 2005 and December 2011 were included. Oncologic outcomes were analyzed with neutrophil count, lymphocyte count, and neutrophil-to-lymphocyte ratio (NLR) before and after chemotherapy. RESULTS The 5-year DFS rate was lower in colon cancer patients with low lymphocyte count during chemotherapy (61.9 vs. 76.7%, P = 0.026). Cox multivariate analysis demonstrated that low lymphocyte count during chemotherapy was independently associated with poor disease-free survival (HR 1.829; 95% CI 1.096-3.050; P = 0.021) in colon cancer patients who underwent FOLFOX adjuvant chemotherapy. CONCLUSION Lymphocyte count during chemotherapy is a strong predictor of worse disease-free survival in colon cancer patients who have undergone FOLFOX adjuvant chemotherapy.
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Affiliation(s)
- O Kyu Noh
- Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Korea.,Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Korea
| | - Seung Yeop Oh
- Department of Surgery, Ajou University School of Medicine, San 5, Woncheon-dong, Yeongtong-gu, Suwon, 443-721, Korea.
| | - Young Bae Kim
- Department of Pathology, Ajou University School of Medicine, Suwon, Korea
| | - Kwang Wook Suh
- Department of Surgery, Ajou University School of Medicine, San 5, Woncheon-dong, Yeongtong-gu, Suwon, 443-721, Korea
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Shiota T, Miyasato Y, Ohnishi K, Yamamoto-Ibusuki M, Yamamoto Y, Iwase H, Takeya M, Komohara Y. The Clinical Significance of CD169-Positive Lymph Node Macrophage in Patients with Breast Cancer. PLoS One 2016; 11:e0166680. [PMID: 27861544 PMCID: PMC5115774 DOI: 10.1371/journal.pone.0166680] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 11/02/2016] [Indexed: 11/18/2022] Open
Abstract
The immune status of patients can impact on the clinical course of cancer. Lymph node (LN) macrophages play critical roles in anti-cancer immunity via the activation of cytotoxic T-lymphocytes (CTLs). In this study, the prognostic significance of CD169+ LN macrophages was examined in patients with breast cancer. For this purpose the number of CD169+ cells and their ratio relative to total macrophages (CD68+) in regional LNs (RLNs), as well as the number of CD8+ CTLs in tumor tissues, were investigated using immunohistochemistry of paraffin-embedded tissue samples from 146 patients with breast cancer. The association of these data with clinicopathological factors was then analyzed. The number of cells positive for the pan-macrophage marker CD68 remained relatively uniform, while the number of CD169+ cells varied across all cases. Moreover, a high density of CD169+ cells correlated with early clinical stage and no LN metastasis, while a higher CD169+ to CD68+ ratio was significantly associated with small tumor size and a low Ki-67+ rate. There was also a significant correlation between the number of CD8+ CTLs and that of CD169+ macrophages in high grade breast cancer cases with a Ki-67 index greater than 40%. However, neither the density nor the ratio of CD169+ cells, nor the density of CD8+ CTLs, were associated with relapse-free survival, distant relapse-free survival, or breast cancer-specific survival. These findings suggest that CD169+ macrophages in RLNs might be a useful marker for assessing clinical stage, including LN states, in patients with breast cancer.
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Affiliation(s)
- Takuya Shiota
- Department of Cell Pathology Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yuko Miyasato
- Department of Cell Pathology Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Koji Ohnishi
- Department of Cell Pathology Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Mutsuko Yamamoto-Ibusuki
- Department of Molecular-Targeting Therapy for Breast Cancer, Kumamoto University Hospital, Kumamoto, Japan
| | - Yutaka Yamamoto
- Department of Breast and Endocrine Surgery, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan
| | - Hirotaka Iwase
- Department of Breast and Endocrine Surgery, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan
| | - Motohiro Takeya
- Department of Cell Pathology Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yoshihiro Komohara
- Department of Cell Pathology Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
- * E-mail:
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Predictive value of pretreatment lymphocyte count in stage II colorectal cancer and in high-risk patients treated with adjuvant chemotherapy. Oncotarget 2016; 7:1014-28. [PMID: 26510910 PMCID: PMC4808048 DOI: 10.18632/oncotarget.5835] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 10/07/2015] [Indexed: 12/20/2022] Open
Abstract
UNLABELLED Pretreatment lymphocyte count (LC) has been associated with prognosis and chemotherapy response in several cancers. The predictive value of LC for stage II colorectal cancer (CRC) and for high-risk patients treated with adjuvant chemotherapy (AC) has not been determined. A retrospective review of prospectively collected data from 1332 consecutive stage II CRC patients who underwent curative tumor resection was conducted. A pretreatment LC value <1.3 Giga/L(28.1%, 373/1332) was defined as low LC. A total of 738 patients (55.4%) were considered high-risk, 459 (62.2%) of whom received AC. Patients with low LCs had significantly worse 5-year OS (74.6% vs. 90.2%, p < 0.001) and DFS (61.3% vs. 84.6%, p < 0.001). High-risk patients with low LCs had the poorest DFS (p < 0.001). Multivariate analysis indicated that low LC value or combined with high-risk status were both independent prognostic factors(p <0.001). High-risk, AC-treated patients with high LCs had significantly longer DFS than untreated patients (HR, 0.594; 95% CI, 0.364-0.970; p = 0.035). There was no difference or trend for DFS or OS in patients with low LCs, regardless of the use of AC (DFS, p = 0.692; OS, p = 0.522). Low LC was also independently associated with poorer DFS in high-risk, AC-treated patients (HR, 1.885; 95% CI, 1.112-3.196; p = 0.019). CONCLUSIONS Pretreatment LC is an independent prognostic factor for survival in stage II CRC. Furthermore, pretreatment LC reliably predicts chemotherapeutic efficacy in high-risk patients with stage II CRC.
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Tudoran O, Virtic O, Balacescu L, Lisencu C, Fetica B, Gherman C, Balacescu O, Berindan-Neagoe I. Baseline blood immunological profiling differentiates between Her2-breast cancer molecular subtypes: implications for immunomediated mechanisms of treatment response. Onco Targets Ther 2015; 8:3415-23. [PMID: 26604799 PMCID: PMC4655955 DOI: 10.2147/ott.s91720] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Purpose Breast cancer patients’ response to treatment is highly dependent on the primary tumor molecular features, with triple-negative breast tumors having the worst prognosis of all subtypes. According to the molecular features, tumors stimulate the microenvironment to induce distinct immune responses, baseline immune activation being associated with higher likelihood of pathologic response. In this study, we investigated the deconvolution of the immunological status of triple-negative tumors in comparison with luminal tumors and the association with patients’ clinicopathological characteristics. Patients and methods Gene expression of 84 inflammatory molecules and their receptors were analyzed in 40 peripheral blood samples from patients with Her2− primary breast cancer tumors. We studied the association of triple-negative phenotype with age, clinical stage, tumor size, lymph nodes, and menopausal status. Results We observed that more patients with estrogen (ER)/progesterone (PR)-negative tumors had grade III, while more patients with ER/PR-positive tumors had grade II tumors. Gene expression analysis revealed a panel of 14 genes to have differential expression between the two groups: several interleukins: IL13, IL16, IL17C and IL17F, IL1A, IL3; interleukin receptors: IL10RB, IL5RA; chemokines: CXCL13 and CCL26; and cytokines: CSF2, IFNA2, OSM, TNSF13. Conclusion The expression levels of these genes have been previously shown to be associated with reduced immunological status; indeed, the triple-negative breast cancer patients presented with lower counts of lymphocytes and eosinophils than the ER/PR-positive ones. These results contribute to a better understanding of the possible role of antitumor immune responses in mediating the clinical outcome.
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Affiliation(s)
- Oana Tudoran
- Department of Functional Genomics and Experimental Pathology, The Oncology Institute "Prof Dr Ion Chiricuţă", Cluj-Napoca, Romania ; Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Oana Virtic
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Loredana Balacescu
- Department of Functional Genomics and Experimental Pathology, The Oncology Institute "Prof Dr Ion Chiricuţă", Cluj-Napoca, Romania ; Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | | | - Bogdan Fetica
- Department of Pathology, The Oncology Institute "Prof Dr Ion Chiricuţă", Cluj-Napoca, Romania
| | - Claudia Gherman
- Department of Functional Genomics and Experimental Pathology, The Oncology Institute "Prof Dr Ion Chiricuţă", Cluj-Napoca, Romania
| | - Ovidiu Balacescu
- Department of Functional Genomics and Experimental Pathology, The Oncology Institute "Prof Dr Ion Chiricuţă", Cluj-Napoca, Romania
| | - Ioana Berindan-Neagoe
- Department of Functional Genomics and Experimental Pathology, The Oncology Institute "Prof Dr Ion Chiricuţă", Cluj-Napoca, Romania ; Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania ; Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Gündüz S, Göksu SS, Arslan D, Tatli AM, Uysal M, Gündüz UR, Sevinç MM, Coşkun HS, Bozcuk H, Mutlu H, Savas B. Factors affecting disease-free survival in patients with human epidermal growth factor receptor 2-positive breast cancer who receive adjuvant trastuzumab. Mol Clin Oncol 2015; 3:1109-1112. [PMID: 26623060 DOI: 10.3892/mco.2015.610] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 03/31/2015] [Indexed: 01/03/2023] Open
Abstract
Breast cancer is the most frequently diagnosed cancer in women worldwide and the second cause of cancer-related mortality. A total of 20-30% of patients with early-stage breast cancer develop recurrence within the first 5 years following diagnosis. Trastuzumab significantly improves overall survival and disease-free survival (DFS) in women with human epidermal growth factor receptor 2 (HER2)-positive early and locally advanced breast cancer. This study aimed to determine the factors that affect DFS following adjuvant transtuzumab therapy. A total of 62 patients treated with trastuzumab for early and locally advanced breast cancer were included in our study. Data, including pathology, treatment and treatment outcome, rate of recurrence and laboratory tests, were retrospectively collected. There was no significant association between DFS and age, menopausal status, disease stage and hormone receptor status. The median follow-up was 48.4 months. The median DFS of patients treated with adjuvant trastuzumab was 64.1 months. In addition, the median DFS was 44.3 vs. 66.8 months in patients with platelet-lymphocyte ratio (PLR) ≤200 vs. >200, respectively (log-rank test; P=0.001), and 70 vs. 45 months in patients with eosinophil count ≤70 vs. >70×103/mm3 (log-rank test; P=0.001). Our data revealed the prognostic relevance of a decrease in the peripheral blood eosinophil count and PLR value following trastuzumab therapy in breast cancer. PLR and eosinophil count measurements are cost-effective, readily available worldwide, non-invasive and safe. Combined with other markers, such as patient age, tumor stage and tumor histology, may be effectively used for patients with breast cancer.
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Affiliation(s)
- Seyda Gündüz
- Department of Medical Oncology, Akdeniz University Faculty of Medicine, Antalya 67070, Turkey
| | - Sema Sezgin Göksu
- Department of Medical Oncology, Akdeniz University Faculty of Medicine, Antalya 67070, Turkey
| | - Deniz Arslan
- Department of Medical Oncology, Akdeniz University Faculty of Medicine, Antalya 67070, Turkey
| | - Ali Murat Tatli
- Department of Medical Oncology, Akdeniz University Faculty of Medicine, Antalya 67070, Turkey
| | - Mükremin Uysal
- Department of Medical Oncology, Akdeniz University Faculty of Medicine, Antalya 67070, Turkey
| | - Umut Riza Gündüz
- Department of Surgery, Antalya Research and Training Hospital, Antalya 07070, Turkey
| | - Mert Mahsuni Sevinç
- Department of Surgery, Istanbul Research and Training Hospital, Istanbul 34000, Turkey
| | - Hasan Senol Coşkun
- Department of Medical Oncology, Akdeniz University Faculty of Medicine, Antalya 67070, Turkey
| | - Hakan Bozcuk
- Department of Medical Oncology, Akdeniz University Faculty of Medicine, Antalya 67070, Turkey
| | - Hasan Mutlu
- Department of Medical Oncology, Akdeniz University Faculty of Medicine, Antalya 67070, Turkey
| | - Burhan Savas
- Department of Medical Oncology, Akdeniz University Faculty of Medicine, Antalya 67070, Turkey
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Bar M, Othus M, Park HM, Sandhu V, Chen X, Wood BL, Estey E. Elevated lymphocyte count at time of acute myeloid leukemia diagnosis is associated with shorter remission. Leuk Lymphoma 2015; 56:3109-15. [PMID: 25726954 DOI: 10.3109/10428194.2015.1020060] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In solid tumors, decreased absolute lymphocyte count (ALC) at diagnosis was found to be associated with poorer outcome, but there is only limited data on the impact of ALC in acute myeloid leukemia (AML). In this study we evaluated the prognostic value of ALC on outcome in 259 adult patients with AML who responded to induction therapy. Higher than normal ALC at diagnosis was associated with shorter remission (HR 4.06; p < 0.001), and decreased relapse free and overall survival (HR 3.47; p < 0.001 and HR 3.85; p < 0.001 respectively). Flow cytometry showed low frequency of natural killer (NK) cells and high frequency of CD4+ T cells (which includes the subset of T regulatory cells) in the high ALC group. Low frequency of NK cells and potentially high frequency of inhibitory T regulatory cells may result in weaker immune responses against residual leukemia and may explain the poorer outcome of the high ALC group.
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Affiliation(s)
- Merav Bar
- a Division of Clinical Research, Fred Hutchinson Cancer Research Center , Seattle , WA , USA.,b Department of Medicine , University of Washington , Seattle , WA , USA
| | - Megan Othus
- c Public Heath Division, Fred Hutchinson Cancer Research Center , Seattle , WA , USA
| | - Hanahlyn M Park
- a Division of Clinical Research, Fred Hutchinson Cancer Research Center , Seattle , WA , USA
| | - Vicky Sandhu
- a Division of Clinical Research, Fred Hutchinson Cancer Research Center , Seattle , WA , USA
| | - Xueyan Chen
- d Department of Laboratory Medicine , University of Washington , Seattle , WA , USA
| | - Brent L Wood
- a Division of Clinical Research, Fred Hutchinson Cancer Research Center , Seattle , WA , USA.,d Department of Laboratory Medicine , University of Washington , Seattle , WA , USA
| | - Elihu Estey
- a Division of Clinical Research, Fred Hutchinson Cancer Research Center , Seattle , WA , USA.,b Department of Medicine , University of Washington , Seattle , WA , USA
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Péguillet I, Milder M, Louis D, Vincent-Salomon A, Dorval T, Piperno-Neumann S, Scholl SM, Lantz O. High numbers of differentiated effector CD4 T cells are found in patients with cancer and correlate with clinical response after neoadjuvant therapy of breast cancer. Cancer Res 2014; 74:2204-16. [PMID: 24535711 DOI: 10.1158/0008-5472.can-13-2269] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
CD4(+) T cells influence tumor immunity in complex ways that are not fully understood. In this study, we characterized a population of human differentiated effector CD4(+) T cells that is defined by low levels of the interleukin (IL)-2 and IL-7 receptors (CD25(-)CD127(-)). We found that this cell population expands in patients with various types of cancer, including breast cancer, to represent 2% to 20% of total CD4(+) blood T lymphocytes as compared with only 0.2% to 2% in healthy individuals. Notably, these CD25(-)CD127(-)CD4 T cells expressed effector markers such as CD244 and CD11b with low levels of CD27, contrasting with the memory phenotype dominating this population in healthy individuals. These cells did not cycle in patients, nor did they secrete IL-10 or IL-17, but instead displayed cytotoxic features. Moreover, they encompassed oligoclonal expansions paralleling an expansion of effector CD8(+) T cells that included tumor antigen-specific T cells. During neoadjuvant chemotherapy in patients with breast cancer, we found that the increase in CD25(-)CD127(-) CD4(+) T cells correlated with tumor regression. This observation suggested that CD4(+) T cells included tumor antigen-specific cells, which may be generated by or participate in tumor regressions during chemotherapy. In summary, our results lend support to the hypothesis that CD4(+) T cells are involved in human antitumor responses.
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Affiliation(s)
- Isabelle Péguillet
- Authors' Affiliations: Clinical immunology Laboratory; Center of Clinical Investigations CICBT507 IGR/Curie; Departments of Pathology, and Medical Oncology; and Inserm U932, Institut Curie, Paris, France
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Hoskin PJ, Rojas AM, Peiris SN, Mullassery V, Chong IY. Pre-treatment haemoglobin and peripheral blood lymphocyte count as independent predictors of outcome in carcinoma of cervix. Clin Oncol (R Coll Radiol) 2014; 26:179-84. [PMID: 24439272 DOI: 10.1016/j.clon.2013.11.023] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 10/14/2013] [Accepted: 10/17/2013] [Indexed: 10/25/2022]
Abstract
AIMS To evaluate pre-treatment haemoglobin and peripheral blood lymphocyte (PBL) counts as predictors of treatment outcome in cervix carcinoma treated with radical chemoradiation. MATERIALS AND METHODS Pre-treatment PBL counts and haemoglobin concentrations were retrieved from full blood count examinations from 111 patients who received concurrent chemoradiotherapy. Overall survival and relapse-free survival were obtained using the Kaplan-Meier method by ranking the data by median haemoglobin and PBL, singly and then in association. Their independence and significance as predictors of outcome were analysed using the Cox proportional hazard model. RESULTS Survival rates were significantly higher in patients whose haemoglobin level or PBL counts were at or above the corresponding median value. At 5 years, rates of overall survival were 77% versus 41% (P = 0.0003) and 75% versus 42% (P = 0.002), when dichotomised around median haemoglobin and PBL, respectively. In multivariate and univariate analyses, both PBL and haemoglobin were independent and significant predictors for risk of death and relapse. Their predictive power was dramatically enhanced when the data were stratified into four groups by associating patients with haemoglobin ≥ median or < median with those whose PBL was ≥ or < median. CONCLUSION Baseline PBL and haemoglobin seem to be strong, independent predictors of treatment outcome in carcinoma of the cervix, particularly if patient response is ranked using the predictors simultaneously. The hypothesis needs to be tested and, if confirmed, the markers should be used in combination to identify those at greater risk of failure who may benefit from additional therapy, with further validation in prospective trials offering treatment modification.
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Affiliation(s)
- P J Hoskin
- Cancer Centre, Mount Vernon Hospital, Northwood, Middlesex, UK
| | - A M Rojas
- Cancer Centre, Mount Vernon Hospital, Northwood, Middlesex, UK.
| | - S N Peiris
- Cancer Centre, Mount Vernon Hospital, Northwood, Middlesex, UK
| | - V Mullassery
- Cancer Centre, Mount Vernon Hospital, Northwood, Middlesex, UK
| | - I Y Chong
- Cancer Centre, Mount Vernon Hospital, Northwood, Middlesex, UK
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