Baseline effector cells predict response and NKT cells predict pulmonary toxicity in advanced breast cancer patients treated with everolimus and exemestane

Effect of Cyclin-Dependent Kinase 4/6 Inhibitors on Circulating Cells in Patients with Metastatic Breast Cancer

The combination of cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) with endocrine therapy (ET) is the standard-of-care for estrogen receptor (ER)-positive, HER2-negative (ER+/HER2- advanced/metastatic breast cancer (mBC). However, the impact of CDK4/6i on circulating immune cells and circulating tumor cells (CTCs) in patients receiving CDK4/6i and ET (CDK4/6i+ET) remains poorly understood. This was a prospective cohort study including 44 patients with ER+/HER2- mBC treated with CDK4/6i+ET in either first or second line. Peripheral blood samples were collected before (baseline) and 3 months (t2) after therapy. Immune cell's subsets were quantified by flow cytometry, and microfluidic-captured CTCs were counted and classified according to the expression of cytokeratin and/or vimentin. Patients were categorized according to response as responders (progression-free survival [PFS] ≥ 6.0 months; 79.1%) and non-responders (PFS < 6.0 months; 20.9%). CDK4/6i+ET resulted in significant changes in the hematological parameters, including decreased hemoglobin levels and increased mean corpuscular volume, as well as reductions in neutrophil, eosinophil, and basophil counts. Specific immune cell subsets, such as early-stage myeloid-derived suppressor cells, central memory CD4+ T cells, and Vδ2+ T cells expressing NKG2D, decreased 3 months after CDK4/6i+ET. Additionally, correlations between the presence of CTCs and immune cell populations were observed, highlighting the interplay between immune dysfunction and tumor dissemination. This study provides insights into the immunomodulatory effects of CDK4/6i+ET, underscoring the importance of considering immune dynamics in the management of ER+/HER2- mBC.

Plasma Extracellular Vesicle Long RNA in Diagnosis and Prediction in Small Cell Lung Cancer

(1) Introduction: The aim of this study was to identify the plasma extracellular vesicle (EV)-specific transcriptional profile in small-cell lung cancer (SCLC) and to explore the application value of plasma EV long RNA (exLR) in SCLC treatment prediction and diagnosis. (2) Methods: Plasma samples were collected from 57 SCLC treatment-naive patients, 104 non-small-cell lung cancer (NSCLC) patients and 59 healthy participants. The SCLC patients were divided into chemo-sensitive and chemo-refractory groups based on the therapeutic effects. The exLR profiles of the plasma samples were analyzed by high-throughput sequencing. Bioinformatics approaches were used to investigate the differentially expressed exLRs and their biofunctions. Finally, a t-signature was constructed using logistic regression for SCLC treatment prediction and diagnosis. (3) Results: We obtained 220 plasma exLRs profiles in all the participants. Totals of 5787 and 1207 differentially expressed exLRs were identified between SCLC/healthy controls, between the chemo-sensitive/chemo-refractory groups, respectively. Furthermore, we constructed a t-signature that comprised ten exLRs, including EPCAM, CCNE2, CDC6, KRT8, LAMB1, CALB2, STMN1, UCHL1, HOXB7 and CDCA7, for SCLC treatment prediction and diagnosis. The exLR t-score effectively distinguished the chemo-sensitive from the chemo-refractory group (p = 9.268 × 10^-9) with an area under the receiver operating characteristic curve (AUC) of 0.9091 (95% CI: 0.837 to 0.9811) and distinguished SCLC from healthy controls (AUC: 0.9643; 95% CI: 0.9256-1) and NSCLC (AUC: 0.721; 95% CI: 0.6384-0.8036). (4) Conclusions: This study firstly characterized the plasma exLR profiles of SCLC patients and verified the feasibility and value of identifying biomarkers based on exLR profiles in SCLC diagnosis and treatment prediction.

High-dose Everolimus May Induce Pro-inflammatory/Fibrotic Transcriptomic Changes in Bronchial Epithelial Cells from Cystic Fibrosis Patients

Background:

Solid-organ transplantation is an available therapeutic option for Cystic Fibrosis (CF) patients without lung transplantation. However, the use of immunosuppressive agents may cause severe adverse events. In particular, patients treated with mTOR-inhibitors (mTOR-I) may aggravate pulmonary complications. It has been recently described that these drugs may induce Epithelial to Mesenchymal Transition (EMT) of the airway cells.

Objective:

The purpose of this study was to evaluate the effects of mTOR-I on primary bronchial epithelial cells carrying F508del.

Materials and Methods:

Human bronchial epithelial cells homozygous for F508del were treated with 5 and 100 nM EVE for 24 hours, and their RNA was extracted and hybridized to the Human HT-12 v3 Expression BeadChip (Illumina). The microarray results were validated by Real-Time PCR. The transepithelial resistance was measured by a Millicell-ERS ohmmeter.

Results:

High dosage EVE induced a significant up-regulation of 48 genes and a down-regulation of 14 genes. After pathway analysis by GSEA, we found that most of them were implicated in the inflammatory and pro-fibrotic pathways. Real-time PCR confirmed that 100 nM EVE was able to upregulate some identified genes (IL-1alpha, IL-8, Pim-1) as well as pro-fibrotic elements (alpha-SMA, connective tissue growth factor, and metalloproteinase-12). In addition, a high dosage of EVE was also able to reduce transepithelial resistance. In contrast, a lower level of EVE did not produce similar effects.

Conclusion:

Although performed in vitro, our study suggested that in solid organ transplant recipients with CF without a lung transplant, mTOR-I should be used at a low dosage to reduce its contribution to pulmonary inflammation and fibrosis.